Primary dysmenorrhea (PD) is a gynecological condition characterized by painful menstrual cramps, with pain intensity varying across menstrual cycle phase. Physiotherapy is a non-pharmacological treatment used to manage PD symptoms, but it is unclear whether the menstrual cycle phase has been considered in physiotherapy randomized clinical trials (RCTs) for PD.
Aim
This scoping review aims to investigate whether the menstrual cycle phases are considered in the assessment of pain in clinical trials of physical therapy modalities for women with PD.
Methods
A search was conducted in PubMed, Embase, Scopus, Lilacs, and PEDro. This review included RCTs of physiotherapy modalities for management of pain in women with PD, published until December 2024.
Findings
The review included 42 RCTs with a total of 3694 participants. Most studies were from Iran (21.4 %), Turkey (19 %), China (11.9 %), and Brazil (11.9 %). The most common physiotherapy modalities were exercise (23.8 %), acupressure (21.4 %), acupuncture (11.9 %), transcutaneous electrical nerve stimulation (11.9 %), education/information booklets (11.9 %), and massage (7.1 %). The mean PEDro score for the trials was 5.81 (range: 3–9).
Discussion
The majority of included studies focused on pain assessment during menstruation, which aligns with the critical period of pain for many women with PD. However, the lack of focus on pain in the 48 h leading up to menstruation may lead to an underestimation of pain severity.
Conclusion
This scoping review highlights the importance of considering menstrual cycle phases in pain assessments and PD treatment for more personalized and effective physiotherapy interventions.
{"title":"Has the menstrual cycle been considered in assessment of pain in clinical trials of physical therapy modalities for women with primary dysmenorrhea? A scoping systematic review","authors":"Jéssica Cordeiro Rodrigues , Néville Ferreira Facchini de Oliveira , Daiana Priscila Rodrigues-de-Souza , Mariana Arias Avila , Patricia Driusso , Francisco Alburquerque-Sendín","doi":"10.1016/j.aimed.2026.100615","DOIUrl":"10.1016/j.aimed.2026.100615","url":null,"abstract":"<div><h3>Problem</h3><div>Primary dysmenorrhea (PD) is a gynecological condition characterized by painful menstrual cramps, with pain intensity varying across menstrual cycle phase. Physiotherapy is a non-pharmacological treatment used to manage PD symptoms, but it is unclear whether the menstrual cycle phase has been considered in physiotherapy randomized clinical trials (RCTs) for PD.</div></div><div><h3>Aim</h3><div>This scoping review aims to investigate whether the menstrual cycle phases are considered in the assessment of pain in clinical trials of physical therapy modalities for women with PD.</div></div><div><h3>Methods</h3><div>A search was conducted in PubMed, Embase, Scopus, Lilacs, and PEDro. This review included RCTs of physiotherapy modalities for management of pain in women with PD, published until December 2024.</div></div><div><h3>Findings</h3><div>The review included 42 RCTs with a total of 3694 participants. Most studies were from Iran (21.4 %), Turkey (19 %), China (11.9 %), and Brazil (11.9 %). The most common physiotherapy modalities were exercise (23.8 %), acupressure (21.4 %), acupuncture (11.9 %), transcutaneous electrical nerve stimulation (11.9 %), education/information booklets (11.9 %), and massage (7.1 %). The mean PEDro score for the trials was 5.81 (range: 3–9).</div></div><div><h3>Discussion</h3><div>The majority of included studies focused on pain assessment during menstruation, which aligns with the critical period of pain for many women with PD. However, the lack of focus on pain in the 48 h leading up to menstruation may lead to an underestimation of pain severity.</div></div><div><h3>Conclusion</h3><div>This scoping review highlights the importance of considering menstrual cycle phases in pain assessments and PD treatment for more personalized and effective physiotherapy interventions.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100615"},"PeriodicalIF":1.7,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.aimed.2026.100612
Yanping Huang , Lu Liu , Jingru Song , Dengcheng Hui , Lanfeng Xie , Silan Shen , Yulang Jiang , Dan Wang , Hongyan Cao , Yancheng Dai , Mingmei Zhou , Qin Zhang , Mingyu Sun
<div><h3>Background</h3><div>CHB patients with NAs still suffer from TCM symptoms which affect the quality of life varying severity. The pathogenesis of CHB in TCM is the accumulation of damp-heat, while there are sub-types of damp heat syndrome.</div></div><div><h3>Objective</h3><div>To evaluate the clinical efficacy and safety of Yinchen Wuling powder combined with NAs on CHB patients of damp-heat and damp-predominant syndrome, while investigate the potential mechanisms and novel applications of classical prescriptions through network pharmacology combined with metabolomics.</div></div><div><h3>Design setting participants and intervention</h3><div>It was a randomized, placebo-controlled clinical study at 3 hospitals in Shanghai. A total of 62 participants diagnosed with damp-heat and damp-predominant syndrome of CHB patients with NAs were randomly allocated to receive either Yinchen Wuling powder or placebo; the therapy consisted of 8.4 g dosage, administered twice a day after meals for a duration of 4 weeks. Blood samples were collected for non-targeted metabolomics research of characteristic metabolites of CHB patients and pathways enriched by YCWLP treatment. The metabolic network and target of YCWLP on CHB patients of damp-heat and damp-predominant syndrome was constructed by the integration of network pharmacology and non-targeted metabolomics.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome measures of the TCM syndrome were assessed at baseline and 4 weeks treatment with total scores of TCM Syndrome. Serum HBsAg decrease, serum HBV DNA negative rate and serum HBeAg conversion were investigated as exploratory indicators during the clinical study.</div></div><div><h3>Results</h3><div>The findings demonstrated that Yinchen Wuling powder has an effect on TCM syndrome on damp-heat and damp-predominant syndrome of CHB patients with NAs, the total efficiency rate of TCM syndrome was 61.3 % in YCWLP group (<em>P</em> < 0.05). A reduction of serum HBsAg was found in HBeAg negative CHB patients with NAs by YCWLP (<em>P</em> < 0.05). No significant adverse drug responses were noticed in either group during the study. The TCM syndrome of damp-heat syndrome of CHB patients with NAs may be improved by regulating linoleic acid metabolism, arachidonic acid metabolism, glycolysis/gluconeogenesis, etc. By integrating related metabolic pathways constructed with network pharmacology and metabolomics and gene sets of metabolite enzyme, the active ingredients of YCWLP (such as quercetin, β-sitosterol and capillarisin, et al.) may improve TCM syndrome through these core targets by regulate metabolism.</div></div><div><h3>Conclusions</h3><div>The findings indicated that Yinchen Wuling powder effectively improved the TCM syndrome in treatment of damp-heat and damp-predominant syndrome of CHB patients with NAs in safety. Clinically, it is necessary for damp-heat syndrome of CHB patients to finely distinguish between damp and heat in or
{"title":"The regulatory effects of Yinchen Wuling powder on chronic Hepatitis B patients with NAs by integrating network pharmacology and metabolomics: A randomized -controlled clinical study","authors":"Yanping Huang , Lu Liu , Jingru Song , Dengcheng Hui , Lanfeng Xie , Silan Shen , Yulang Jiang , Dan Wang , Hongyan Cao , Yancheng Dai , Mingmei Zhou , Qin Zhang , Mingyu Sun","doi":"10.1016/j.aimed.2026.100612","DOIUrl":"10.1016/j.aimed.2026.100612","url":null,"abstract":"<div><h3>Background</h3><div>CHB patients with NAs still suffer from TCM symptoms which affect the quality of life varying severity. The pathogenesis of CHB in TCM is the accumulation of damp-heat, while there are sub-types of damp heat syndrome.</div></div><div><h3>Objective</h3><div>To evaluate the clinical efficacy and safety of Yinchen Wuling powder combined with NAs on CHB patients of damp-heat and damp-predominant syndrome, while investigate the potential mechanisms and novel applications of classical prescriptions through network pharmacology combined with metabolomics.</div></div><div><h3>Design setting participants and intervention</h3><div>It was a randomized, placebo-controlled clinical study at 3 hospitals in Shanghai. A total of 62 participants diagnosed with damp-heat and damp-predominant syndrome of CHB patients with NAs were randomly allocated to receive either Yinchen Wuling powder or placebo; the therapy consisted of 8.4 g dosage, administered twice a day after meals for a duration of 4 weeks. Blood samples were collected for non-targeted metabolomics research of characteristic metabolites of CHB patients and pathways enriched by YCWLP treatment. The metabolic network and target of YCWLP on CHB patients of damp-heat and damp-predominant syndrome was constructed by the integration of network pharmacology and non-targeted metabolomics.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome measures of the TCM syndrome were assessed at baseline and 4 weeks treatment with total scores of TCM Syndrome. Serum HBsAg decrease, serum HBV DNA negative rate and serum HBeAg conversion were investigated as exploratory indicators during the clinical study.</div></div><div><h3>Results</h3><div>The findings demonstrated that Yinchen Wuling powder has an effect on TCM syndrome on damp-heat and damp-predominant syndrome of CHB patients with NAs, the total efficiency rate of TCM syndrome was 61.3 % in YCWLP group (<em>P</em> < 0.05). A reduction of serum HBsAg was found in HBeAg negative CHB patients with NAs by YCWLP (<em>P</em> < 0.05). No significant adverse drug responses were noticed in either group during the study. The TCM syndrome of damp-heat syndrome of CHB patients with NAs may be improved by regulating linoleic acid metabolism, arachidonic acid metabolism, glycolysis/gluconeogenesis, etc. By integrating related metabolic pathways constructed with network pharmacology and metabolomics and gene sets of metabolite enzyme, the active ingredients of YCWLP (such as quercetin, β-sitosterol and capillarisin, et al.) may improve TCM syndrome through these core targets by regulate metabolism.</div></div><div><h3>Conclusions</h3><div>The findings indicated that Yinchen Wuling powder effectively improved the TCM syndrome in treatment of damp-heat and damp-predominant syndrome of CHB patients with NAs in safety. Clinically, it is necessary for damp-heat syndrome of CHB patients to finely distinguish between damp and heat in or","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100612"},"PeriodicalIF":1.7,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Complementary and alternative medicine (CAM) plays a significant role in asthma management.
Objectives
This study evaluated the efficacy of an herbal sachet as an adjunct to conventional asthma therapy, focusing on its impact on the Asthma Control Test (ACT) and cough severity (CS) scores in patients with mild to moderate asthma.
Materials and methods
In this randomized, triple-blind, placebo-controlled trial, 102 patients with mild to moderate asthma were assigned to receive either a herbal sachet (5000 mg, Bis in die [BID]) or a placebo for 30 days, alongside standard therapy. The primary outcomes were Cough severity (CS) that was assessed at baseline (T0), at 15 days (T1) and at the 30-day follow-up (T2), with assessments conducted via telephone. The ACT was evaluated at T0 and T2.
Result
There were no significant differences between the two groups regarding baseline characteristics. However, within-group and between-group analyses revealed a significant improvement in ACT scores in the treatment group (herbal sachet [n = 51], p < 0.001). Additionally, a significant interaction effect of time and intervention on CS scores was observed in the treatment group (F = 1574.41, p < 0.001, effect size = 0.94). Within-group analysis showed a significant reduction in CS scores at T0, T1, and T2 (75.58 ± 3.17, 55.02 ± 1.48, and 40.12 ± 2.23, respectively; F = 3375.79, p < 0.001, effect size = 0.96). In contrast, the placebo group exhibited a modest yet significant decrease in CS scores at T0, T1, and T2 (75.81 ± 0.94, 70.32 ± 2.14, and 67.84 ± 3.89, respectively; F = 160.31, p < 0.001, effect size = 0.76).
Conclusion
This trial demonstrated that the standardized herbal sachet, as an adjunct therapy, significantly improved ACT and CS in patients with mild to moderate asthma, with no serious adverse events reported during the study period. These findings may be related to the formulation’s multi-target effects on inflammatory pathways, as suggested by previous preclinical research on its components. However, these mechanisms were not directly measured in our trial, and further biomarker-based studies are required. Potential mechanisms include modulation of biomarkers such as interleukin (IL)-1β, IL-4, IL-5, IL-13, Tumor Necrosis Factor-alpha (TNF-α), prostaglandin E2 (PGE2), Thromboxane A₂ (TXA2), and 12-Hydroxyeicosatetraenoic (12-HETE) acid. These findings support its use as a well-tolerated, quality-controlled complementary treatment for asthma management.
背景：补充和替代医学（CAM）在哮喘治疗中发挥着重要作用。目的本研究评价中药小袋作为常规哮喘辅助治疗的疗效，重点关注其对轻中度哮喘患者哮喘控制测试（ACT）和咳嗽严重程度（CS）评分的影响。在这项随机、三盲、安慰剂对照试验中，102名轻度至中度哮喘患者被分配接受草药小袋（5000 mg, Bis in die [BID]）或安慰剂，为期30天，同时接受标准治疗。主要结局是咳嗽严重程度（CS），分别在基线（T0）、15天（T1）和30天随访（T2）时进行评估，并通过电话进行评估。在T0和T2时评估ACT。结果两组患者的基线特征无显著差异。然而，组内和组间分析显示，治疗组ACT评分有显著改善（草药香囊[n = 51],p <； 0.001）。此外，治疗组时间和干预对CS评分有显著的交互作用（F = 1574.41, p <； 0.001，效应量 = 0.94）。会分析显示显著减少CS分数在T0, T1, T2(75.58 ± 3.17,55.02 ± 1.48,和40.12 ±2.23 ,分别;F = 3375.79, p & lt; 0.001,影响大小 = 0.96)。相比之下,安慰剂组表现出温和而显著降低CS分数在T0, T1, T2(75.81 ± 0.94,70.32 ± 2.14,和67.84 ±3.89 ,分别;F = 160.31, p & lt; 0.001,影响大小 = 0.76)。结论本试验表明，标准化中药香囊作为辅助治疗，可显著改善轻中度哮喘患者的ACT和CS，研究期间无严重不良事件报告。这些发现可能与该配方对炎症途径的多靶点作用有关，正如先前对其成分的临床前研究所表明的那样。然而，这些机制在我们的试验中没有直接测量，需要进一步的基于生物标志物的研究。潜在的机制包括调节生物标志物，如白细胞介素(IL)-1β、IL-4、IL-5、IL-13、肿瘤坏死因子-α (TNF-α)、前列腺素E2 （PGE2）、血栓素A₂（TXA2）和12-羟基二糖四烯酸（12-HETE）。这些发现支持其作为一种耐受性良好、质量可控的哮喘管理补充治疗。
{"title":"Herbal medicine formula for asthma: A triple-blind placebo-controlled randomized clinical trial","authors":"Mohammadreza Zarei , Mehdi Zarei , Abdollatif Moini , Nahid Norouzi , Reza Biranvand , Rezvan Ghafarzadegan","doi":"10.1016/j.aimed.2026.100609","DOIUrl":"10.1016/j.aimed.2026.100609","url":null,"abstract":"<div><h3>Background</h3><div>Complementary and alternative medicine (CAM) plays a significant role in asthma management.</div></div><div><h3>Objectives</h3><div>This study evaluated the efficacy of an herbal sachet as an adjunct to conventional asthma therapy, focusing on its impact on the Asthma Control Test (ACT) and cough severity (CS) scores in patients with mild to moderate asthma.</div></div><div><h3>Materials and methods</h3><div>In this randomized, triple-blind, placebo-controlled trial, 102 patients with mild to moderate asthma were assigned to receive either a herbal sachet (5000 mg, Bis in die [BID]) or a placebo for 30 days, alongside standard therapy. The primary outcomes were Cough severity (CS) that was assessed at baseline (T0), at 15 days (T1) and at the 30-day follow-up (T2), with assessments conducted via telephone. The ACT was evaluated at T0 and T2.</div></div><div><h3>Result</h3><div>There were no significant differences between the two groups regarding baseline characteristics. However, within-group and between-group analyses revealed a significant improvement in ACT scores in the treatment group (herbal sachet [n = 51], p < 0.001). Additionally, a significant interaction effect of time and intervention on CS scores was observed in the treatment group (F = 1574.41, p < 0.001, effect size = 0.94). Within-group analysis showed a significant reduction in CS scores at T0, T1, and T2 (75.58 ± 3.17, 55.02 ± 1.48, and 40.12 ± 2.23, respectively; F = 3375.79, p < 0.001, effect size = 0.96). In contrast, the placebo group exhibited a modest yet significant decrease in CS scores at T0, T1, and T2 (75.81 ± 0.94, 70.32 ± 2.14, and 67.84 ± 3.89, respectively; F = 160.31, p < 0.001, effect size = 0.76).</div></div><div><h3>Conclusion</h3><div>This trial demonstrated that the standardized herbal sachet, as an adjunct therapy, significantly improved ACT and CS in patients with mild to moderate asthma, with no serious adverse events reported during the study period. These findings may be related to the formulation’s multi-target effects on inflammatory pathways, as suggested by previous preclinical research on its components. However, these mechanisms were not directly measured in our trial, and further biomarker-based studies are required. Potential mechanisms include modulation of biomarkers such as interleukin (IL)-1β, IL-4, IL-5, IL-13, Tumor Necrosis Factor-alpha (TNF-α), prostaglandin E2 (PGE2), Thromboxane A₂ (TXA2), and 12-Hydroxyeicosatetraenoic (12-HETE) acid. These findings support its use as a well-tolerated, quality-controlled complementary treatment for asthma management.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100609"},"PeriodicalIF":1.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Traditional medicine, as defined by the World Health Organization, encompasses the knowledge, skills, and practices derived from various cultures used for health maintenance and disease treatment. Angelica archangelica (AA) has been used in traditional medicine for its purported healing properties. This systematic review aims to analyze the use of AA as a supplement in treating diseases in humans and animals and to investigate its potential health benefits.
Methods
The PRISMA 2020 guidelines were followed, and the review was registered in PROSPERO (CRD42023443289). Six databases were searched, and studies that evaluate AA effects on various pathologies in humans or animals were included.
Results
Of the 1092 identified records, 17 studies met the inclusion criteria, with two human studies. Both human studies analyzed symptoms related to overactive bladder and had a double-blind randomized controlled trial design. One found no significant effects of AA on nocturia, however, the second found improvements on daytime voids and quality of life and nearly significant results on nocturia. The remaining animal studies showed that AA had beneficial effects on anxiety, breast cancer growth, gastric ulcers, hepatotoxicity, seizures, fibromyalgia, diabetic neuropathy and asthma, but results varied based on dosage and extract type.
Conclusion
The evidence suggests AA supplementation could provide benefits in managing overactive bladder, anxiety, cancer, gastrointestinal issues, liver health, neurological disorders, and respiratory conditions, however, the plant’s effects are influenced by dosage, extract origin, and treatment duration and more human studies are needed to confirm these benefits and determine optimal usage parameters.
{"title":"Angelica archangelica and its role in traditional medicine: A systematic review of its therapeutic applications","authors":"Jaime López-Seoane , Matteo Ferraro , Margarita Pérez-Ruiz , Marcela González-Gross","doi":"10.1016/j.aimed.2026.100611","DOIUrl":"10.1016/j.aimed.2026.100611","url":null,"abstract":"<div><h3>Background</h3><div>Traditional medicine, as defined by the World Health Organization, encompasses the knowledge, skills, and practices derived from various cultures used for health maintenance and disease treatment. <em>Angelica archangelica</em> (AA) has been used in traditional medicine for its purported healing properties. This systematic review aims to analyze the use of AA as a supplement in treating diseases in humans and animals and to investigate its potential health benefits.</div></div><div><h3>Methods</h3><div>The PRISMA 2020 guidelines were followed, and the review was registered in PROSPERO (CRD42023443289). Six databases were searched, and studies that evaluate AA effects on various pathologies in humans or animals were included.</div></div><div><h3>Results</h3><div>Of the 1092 identified records, 17 studies met the inclusion criteria, with two human studies. Both human studies analyzed symptoms related to overactive bladder and had a double-blind randomized controlled trial design. One found no significant effects of AA on nocturia, however, the second found improvements on daytime voids and quality of life and nearly significant results on nocturia. The remaining animal studies showed that AA had beneficial effects on anxiety, breast cancer growth, gastric ulcers, hepatotoxicity, seizures, fibromyalgia, diabetic neuropathy and asthma, but results varied based on dosage and extract type.</div></div><div><h3>Conclusion</h3><div>The evidence suggests AA supplementation could provide benefits in managing overactive bladder, anxiety, cancer, gastrointestinal issues, liver health, neurological disorders, and respiratory conditions, however, the plant’s effects are influenced by dosage, extract origin, and treatment duration and more human studies are needed to confirm these benefits and determine optimal usage parameters.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100611"},"PeriodicalIF":1.7,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Propolis contains antioxidant compounds with antimicrobial and anti-inflammatory properties that can help control cancer progression and reduce chemotherapy side effects by influencing various biochemical pathways. Chemotherapy for ovarian cancer is associated with side effects such as nausea, vomiting, peripheral neuropathy, and anemia. It is anticipated honeybee propolis will effectively reduce these side effects
Study methods
This clinical trial involved 70 patients with epithelial ovarian cancer from Oct 2021 to Jun 2023 in Ghaem Hospital of Mashhad, Iran. The chemotherapy regimen included carboplatin and paclitaxel at standard dose, accompanied by a placebo control, while two capsules of Provex were administered daily throughout the treatment period. The incidence and severity of gastrointestinal side effects (nausea and vomiting) were evaluated using a Visual Analog Scale (VAS), along with liver function tests and blood factors before starting each course of chemotherapy and tumor marker CA-125 after three and six courses of chemotherapy.
Results
In the intervention group, the severity and frequency of nausea and vomiting significantly decreased compared to the control group (P < 0.001). No significant differences were observed in blood factors. CA-125 levels significantly decreased in both groups, indicating that propolis did not interfere with treatment.
Conclusion
Propolis reduces side effects in patients without interfering with chemotherapy. Therefore, it can be used as a supplement to enhance the quality of life for patients with epithelial ovarian cancer.
{"title":"The effect of propolis on the side effects of adjuvant chemotherapy in patients with epithelial ovarian cancer","authors":"Marjaneh Farazestanian , Nafiseh Saghafi , Elnaz Sadat Hosseini , Malihe Hasanzadeh Mofrad , Maryam Emadzadeh , Mansoureh Sadat Golmohammadi Tavalaei , Elham Dolat","doi":"10.1016/j.aimed.2026.100610","DOIUrl":"10.1016/j.aimed.2026.100610","url":null,"abstract":"<div><h3>Objective</h3><div>Propolis contains antioxidant compounds with antimicrobial and anti-inflammatory properties that can help control cancer progression and reduce chemotherapy side effects by influencing various biochemical pathways. Chemotherapy for ovarian cancer is associated with side effects such as nausea, vomiting, peripheral neuropathy, and anemia. It is anticipated honeybee propolis will effectively reduce these side effects</div></div><div><h3>Study methods</h3><div>This clinical trial involved 70 patients with epithelial ovarian cancer from Oct 2021 to Jun 2023 in Ghaem Hospital of Mashhad, Iran. The chemotherapy regimen included carboplatin and paclitaxel at standard dose, accompanied by a placebo control, while two capsules of Provex were administered daily throughout the treatment period. The incidence and severity of gastrointestinal side effects (nausea and vomiting) were evaluated using a Visual Analog Scale (VAS), along with liver function tests and blood factors before starting each course of chemotherapy and tumor marker CA-125 after three and six courses of chemotherapy.</div></div><div><h3>Results</h3><div>In the intervention group, the severity and frequency of nausea and vomiting significantly decreased compared to the control group (P < 0.001). No significant differences were observed in blood factors. CA-125 levels significantly decreased in both groups, indicating that propolis did not interfere with treatment.</div></div><div><h3>Conclusion</h3><div>Propolis reduces side effects in patients without interfering with chemotherapy. Therefore, it can be used as a supplement to enhance the quality of life for patients with epithelial ovarian cancer.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100610"},"PeriodicalIF":1.7,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.aimed.2025.100607
Alastair C. Gray , Christine D. Luketic , Jess Coleman , Barbara Roberts
Complementary medicine (CM) appears to be thriving in New Zealand. Homeopathy is an important profession within the broader field of CM, yet there is little empirical evidence relating to homeopathy in New Zealand. In response, the aim of this study is to understand practitioner perceptions to the challenges faced in establishing and maintaining a practice, the broader systemic challenges faced by the homeopathic profession, as well as the supplementary forms of work and income undertaken by practitioners alongside their practice of homeopathy. An online survey was administered to homeopaths in New Zealand. The three biggest challenges identified were: ‘difficulty building a client base’ (11.7 %), a ‘lack of business skills and experience’ (10 %) and ‘confidence in building practice’ (8.6 %). The largest age grouping, 51–60-year-olds, found difficulties in ‘managing their confidence’, ‘applying business skills’, ‘experiencing feelings of isolation’ and identified that the ‘public of New Zealand did not understand homeopathy’. Many respondents (69 %) were engaged in homeopathy practice at least 6 h a week, with 25 % engaged in practice more than 20 h per week. Most respondents (64 %) see less than 5 clients per week. Many (66 %) of respondents reported that other work and income were required to supplement the income derived from homeopathy. Despite reporting satisfaction with their work, and readiness to practice homeopathy most homeopaths are in other employment. More than half of homeopaths in New Zealand (almost two thirds) have a second job and/or income supplementation, and this additional work can total on average 25 h per week. Practitioners perceive that they are learning on the job and require supplementary income at the same time. These two forces seem to be possibly incompatible and further examination of homeopaths’ perceptions appear warranted in order to more deeply understand the profession and practice of homeopathy in New Zealand.
{"title":"Tensions, challenges, risks and opportunities in the current and future delivery of homeopathy in New Zealand: A survey of practitioner perceptions","authors":"Alastair C. Gray , Christine D. Luketic , Jess Coleman , Barbara Roberts","doi":"10.1016/j.aimed.2025.100607","DOIUrl":"10.1016/j.aimed.2025.100607","url":null,"abstract":"<div><div>Complementary medicine (CM) appears to be thriving in New Zealand. Homeopathy is an important profession within the broader field of CM, yet there is little empirical evidence relating to homeopathy in New Zealand. In response, the aim of this study is to understand practitioner perceptions to the challenges faced in establishing and maintaining a practice, the broader systemic challenges faced by the homeopathic profession, as well as the supplementary forms of work and income undertaken by practitioners alongside their practice of homeopathy. An online survey was administered to homeopaths in New Zealand. The three biggest challenges identified were: ‘difficulty building a client base’ (11.7 %), a ‘lack of business skills and experience’ (10 %) and ‘confidence in building practice’ (8.6 %). The largest age grouping, 51–60-year-olds, found difficulties in ‘managing their confidence’, ‘applying business skills’, ‘experiencing feelings of isolation’ and identified that the ‘public of New Zealand did not understand homeopathy’. Many respondents (69 %) were engaged in homeopathy practice at least 6 h a week, with 25 % engaged in practice more than 20 h per week. Most respondents (64 %) see less than 5 clients per week. Many (66 %) of respondents reported that other work and income were required to supplement the income derived from homeopathy. Despite reporting satisfaction with their work, and readiness to practice homeopathy most homeopaths are in other employment. More than half of homeopaths in New Zealand (almost two thirds) have a second job and/or income supplementation, and this additional work can total on average 25 h per week. Practitioners perceive that they are learning on the job and require supplementary income at the same time. These two forces seem to be possibly incompatible and further examination of homeopaths’ perceptions appear warranted in order to more deeply understand the profession and practice of homeopathy in New Zealand.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100607"},"PeriodicalIF":1.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.aimed.2025.100605
Andressa Bressan Pedroso , Aline Josiane Waclawovsky , Eduarda Bitencourt dos Santos , Felipe Barreto Schuch , Gabriele Ferreira da Silva da Costa , Diego Chemello , Patrícia Chagas
Background and purpose
non-pharmacological therapies have been used as part of the treatment of insomnia. Laying on of Hands (LH) is an Integrative and Complementary Health Practice that involves the transfer of vital energy through touch and encompasses techniques such as Reiki and Therapeutic Touch (TT). The effects of LH on anxiety, depression, and stress have been studied through systematic reviews; however, to the best of our knowledge, the effect on sleep quality has not been systematically summarized. This study aimed to evaluate the effect of LH on the sleep quality of adults and elderly.
Methods
This is a systematic review of randomized clinical trials, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Clinical trials with adult and elderly population evaluating the effects of LH on sleep quality and related domains were included. The results of individual studies were analyzed qualitatively and the risk of bias was assessed using Rob2 tool.
Results
18,585 articles were found, and 9 were eligible for systematic review. The studies used different LH techniques, and were conducted in diverse populations. The results are mixed, with most studies suggest favorable effects of LH on sleep quality. However, these findings are based on studies with high or moderate risk of bias.
Conclusion
most studies found significant effects of LH on sleep quality; however, the lack of possibility of running a meta-analysis and the high risk of bias of the included studies requires caution when interpreting the findings of this study.
{"title":"Effect of the laying on of hands techniques on sleep quality: A systematic review","authors":"Andressa Bressan Pedroso , Aline Josiane Waclawovsky , Eduarda Bitencourt dos Santos , Felipe Barreto Schuch , Gabriele Ferreira da Silva da Costa , Diego Chemello , Patrícia Chagas","doi":"10.1016/j.aimed.2025.100605","DOIUrl":"10.1016/j.aimed.2025.100605","url":null,"abstract":"<div><h3>Background and purpose</h3><div>non-pharmacological therapies have been used as part of the treatment of insomnia. Laying on of Hands (LH) is an Integrative and Complementary Health Practice that involves the transfer of vital energy through touch and encompasses techniques such as Reiki and Therapeutic Touch (TT). The effects of LH on anxiety, depression, and stress have been studied through systematic reviews; however, to the best of our knowledge, the effect on sleep quality has not been systematically summarized. This study aimed to evaluate the effect of LH on the sleep quality of adults and elderly.</div></div><div><h3>Methods</h3><div>This is a systematic review of randomized clinical trials, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Clinical trials with adult and elderly population evaluating the effects of LH on sleep quality and related domains were included. The results of individual studies were analyzed qualitatively and the risk of bias was assessed using Rob2 tool.</div></div><div><h3>Results</h3><div>18,585 articles were found, and 9 were eligible for systematic review. The studies used different LH techniques, and were conducted in diverse populations. The results are mixed, with most studies suggest favorable effects of LH on sleep quality. However, these findings are based on studies with high or moderate risk of bias.</div></div><div><h3>Conclusion</h3><div>most studies found significant effects of LH on sleep quality; however, the lack of possibility of running a meta-analysis and the high risk of bias of the included studies requires caution when interpreting the findings of this study.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100605"},"PeriodicalIF":1.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iron nanoparticles (FeNPs) synthesized using the homeopathic medicine Thuja occidentalis mother tincture represent a promising candidate in nanomedicine due to their broad therapeutic potential. This study focuses on the characterization and biological evaluation of these nanoparticles synthesized through a green route.
Methods
Iron nanoparticles (FeNPs) were prepared using a green synthesis approach with Thuja occidentalis mother tincture as the reducing and stabilizing agent. The nanoparticles were characterized by Ultraviolet–Visible (UV–Vis) spectroscopy, Dynamic Light Scattering (DLS) analysis, Fourier Transform Infrared (FT–IR) spectroscopy, Scanning Electron Microscopy with Energy Dispersive X–ray (SEM–EDX) analysis, X–ray Diffraction (XRD), and Thermogravimetric Analysis (TGA).
Results
The anticancer activity of Thuja occidentalis-functionalized iron nanoparticles (TIONPs) was evaluated against AGS gastric cancer cells using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, revealing a dose-dependent cytotoxic effect. Antioxidant activity was determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, while anti-inflammatory potential was assessed via the albumin denaturation assay. Both tests demonstrated significant efficacy of the nanoparticles.
Conclusion
The findings indicate that Thuja occidentalis-functionalized iron nanoparticles (TIONPs) effectively target cancer cells, scavenge free radicals, and inhibit protein denaturation. The synthesis of iron nanoparticles (FeNPs) using Thuja occidentalis mother tincture is a sustainable and eco-friendly strategy, providing an avenue for developing safe nanomaterials with diverse biomedical applications.
{"title":"Bioinspired organometallic synthesis of iron nanoparticles using Thuja occidentalis: Anticancer, antioxidant and anti-inflammatory properties","authors":"Chandana Yesudas , Uma Maheshwari , Krishnan Raguvaran , Murni Handayani , Rajeshwari-Srinivasan Kaarmukhilnilavan , Illakkiam Devaraj , Murugesan Mohana Keerthi , Sri Sudewi , Akhtar Rasool","doi":"10.1016/j.aimed.2025.100608","DOIUrl":"10.1016/j.aimed.2025.100608","url":null,"abstract":"<div><h3>Background</h3><div>Iron nanoparticles (FeNPs) synthesized using the homeopathic medicine <em>Thuja occidentalis</em> mother tincture represent a promising candidate in nanomedicine due to their broad therapeutic potential. This study focuses on the characterization and biological evaluation of these nanoparticles synthesized through a green route.</div></div><div><h3>Methods</h3><div>Iron nanoparticles (FeNPs) were prepared using a green synthesis approach with Thuja occidentalis mother tincture as the reducing and stabilizing agent. The nanoparticles were characterized by Ultraviolet–Visible (UV–Vis) spectroscopy, Dynamic Light Scattering (DLS) analysis, Fourier Transform Infrared (FT–IR) spectroscopy, Scanning Electron Microscopy with Energy Dispersive X–ray (SEM–EDX) analysis, X–ray Diffraction (XRD), and Thermogravimetric Analysis (TGA).</div></div><div><h3>Results</h3><div>The anticancer activity of <em>Thuja occidentalis</em>-functionalized iron nanoparticles (TIONPs) was evaluated against AGS gastric cancer cells using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, revealing a dose-dependent cytotoxic effect. Antioxidant activity was determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, while anti-inflammatory potential was assessed via the albumin denaturation assay. Both tests demonstrated significant efficacy of the nanoparticles.</div></div><div><h3>Conclusion</h3><div>The findings indicate that <em>Thuja occidentalis</em>-functionalized iron nanoparticles (TIONPs) effectively target cancer cells, scavenge free radicals, and inhibit protein denaturation. The synthesis of iron nanoparticles (FeNPs) using Thuja occidentalis mother tincture is a sustainable and eco-friendly strategy, providing an avenue for developing safe nanomaterials with diverse biomedical applications.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100608"},"PeriodicalIF":1.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1016/j.aimed.2025.100604
Y. Rosy Ayda , Abinaya Suresh , M. Alkousar Taz , MaheshKumar Kuppysamy
Intervertebral disc bulge (IVDB) is a prevalent spinal condition that significantly affects quality of life, yet current diagnostic methods can be expensive and not always easily accessible. This study explores the potential of pupil flattening as an iridological marker for IVDB. A case-control study was conducted with 60 IVDB patients and 60 healthy controls. High-resolution iris images were analyzed for pupil flattening, revealing a markedly higher prevalence in IVDB patients (88.3 % in the right iris, 81.7 % in the left iris) compared to controls (15 % in the right iris, 10 % in the left iris). ROC analysis demonstrated strong diagnostic accuracy, with AUC values of 0.79 for males (95 % CI: 0.60–0.98) and 0.88 (95 % CI: 0.78–0.99) for females. Sensitivity and specificity were particularly high in females, at 80 % and 97.62 %, respectively. These findings indicate that pupil flattening could serve as a non-invasive, cost-effective diagnostic tool for IVDB, offering a potential complement to existing diagnostic approaches.
{"title":"Pupil flattening as a diagnostic marker for intervertebral disc bulge: An iridology-based approach","authors":"Y. Rosy Ayda , Abinaya Suresh , M. Alkousar Taz , MaheshKumar Kuppysamy","doi":"10.1016/j.aimed.2025.100604","DOIUrl":"10.1016/j.aimed.2025.100604","url":null,"abstract":"<div><div>Intervertebral disc bulge (IVDB) is a prevalent spinal condition that significantly affects quality of life, yet current diagnostic methods can be expensive and not always easily accessible. This study explores the potential of pupil flattening as an iridological marker for IVDB. A case-control study was conducted with 60 IVDB patients and 60 healthy controls. High-resolution iris images were analyzed for pupil flattening, revealing a markedly higher prevalence in IVDB patients (88.3 % in the right iris, 81.7 % in the left iris) compared to controls (15 % in the right iris, 10 % in the left iris). ROC analysis demonstrated strong diagnostic accuracy, with AUC values of 0.79 for males (95 % CI: 0.60–0.98) and 0.88 (95 % CI: 0.78–0.99) for females. Sensitivity and specificity were particularly high in females, at 80 % and 97.62 %, respectively. These findings indicate that pupil flattening could serve as a non-invasive, cost-effective diagnostic tool for IVDB, offering a potential complement to existing diagnostic approaches.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100604"},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1016/j.aimed.2025.100606
Dibyendu Mandal , Soumyadeep Maity , Sudeshna Sardar , Abhijit Rana , Srijana Panda , Soma Pramanick , Subhranil Saha
Background
Needle punctures during hematology practicals can induce discomfort, anxiety, and diminished cooperation. Homeopathic literature indicates Hypericum perforatum for puncture wounds and neuropathic pain. This trial aimed to evaluate the efficacy of Hypericum perforatum 200CH in preventing and treating fingertip puncture site pain and tenderness compared with placebo.
Methods
An exploratory, double-blind, randomized (2:1), placebo-controlled study was conducted with 90 undergraduate students during hematology practical classes. Participants were randomly allocated to the Hypericum perforatum 200CH group (n = 60) or the placebo group (n = 30). Three doses were administered: the night before, thirty minutes earlier, and immediately after the puncture. Standardized fingertip punctures were performed once using sterile lancets and pricking guns, with the instrument calibrated to 0.5 to ensure procedural uniformity. The primary outcome was the time until total relief of pain and tenderness. The secondary outcome measure was the intensity of pain and tenderness, evaluated using a pain visual analog scale (VAS; 0–100 mm), measured until the 4th day.
Results
Kaplan-Meier analysis indicated a significantly shorter median time to achieve complete pain resolution in the Hypericum perforatum 200CH group (10 h versus 14 h; log-rank test, p < 0.001). Tenderness scores exhibited no significant differences between the groups (p = 0.475). The group difference in the pain VAS score was statistically significant, favoring the Hypericum perforatum group compared to placebo (p < 0.001). No adverse events were recorded.
Conclusion
A significantly faster resolution of pain was achieved in the Hypericum perforatum 200CH group compared with placebo; however, no impact on tenderness was noted.
背景：血液学实习中针刺可引起不适、焦虑和减少合作。顺势疗法文献表明贯叶连翘用于穿刺伤口和神经性疼痛。本试验旨在比较贯叶连翘200CH与安慰剂对指尖穿刺部位疼痛和压痛的预防和治疗效果。方法采用探索性、双盲、随机（2:1）、安慰剂对照的方法，对90名血液学实训本科生进行研究。参与者被随机分配到贯叶连体200CH组（n = 60）或安慰剂组（n = 30）。注射三次：前一晚、前三十分钟和穿刺后。标准化指尖穿刺一次，使用无菌枪和穿刺枪，仪器校准至0.5，确保操作均匀。主要观察指标是疼痛和压痛完全缓解的时间。次要结果测量是疼痛和压痛的强度，使用疼痛视觉模拟量表（VAS; 0-100 mm）评估，测量至第4天。结果kaplan - meier分析显示，贯叶连片200CH组实现完全疼痛缓解的中位时间显著缩短（10 h vs 14 h； log-rank检验，p <； 0.001）。压痛评分组间差异无统计学意义（p = 0.475）。疼痛VAS评分组间差异有统计学意义，贯叶连翘组优于安慰剂组（p <； 0.001）。无不良事件记录。结论贯叶连翘200CH组疼痛缓解明显快于安慰剂组；然而，没有注意到对压痛的影响。
{"title":"An exploratory, randomized, placebo-controlled, double-blind trial of Hypericum perforatum 200CH in preventing and treating fingertip puncture site pain and tenderness","authors":"Dibyendu Mandal , Soumyadeep Maity , Sudeshna Sardar , Abhijit Rana , Srijana Panda , Soma Pramanick , Subhranil Saha","doi":"10.1016/j.aimed.2025.100606","DOIUrl":"10.1016/j.aimed.2025.100606","url":null,"abstract":"<div><h3>Background</h3><div>Needle punctures during hematology practicals can induce discomfort, anxiety, and diminished cooperation. Homeopathic literature indicates <em>Hypericum perforatum</em> for puncture wounds and neuropathic pain. This trial aimed to evaluate the efficacy of <em>Hypericum perforatum</em> 200CH in preventing and treating fingertip puncture site pain and tenderness compared with placebo.</div></div><div><h3>Methods</h3><div>An exploratory, double-blind, randomized (2:1), placebo-controlled study was conducted with 90 undergraduate students during hematology practical classes. Participants were randomly allocated to the <em>Hypericum perforatum</em> 200CH group (<em>n = 60</em>) or the placebo group (<em>n</em> = 30). Three doses were administered: the night before, thirty minutes earlier, and immediately after the puncture. Standardized fingertip punctures were performed once using sterile lancets and pricking guns, with the instrument calibrated to 0.5 to ensure procedural uniformity. The primary outcome was the time until total relief of pain and tenderness. The secondary outcome measure was the intensity of pain and tenderness, evaluated using a pain visual analog scale (VAS; 0–100 mm), measured until the 4th day.</div></div><div><h3>Results</h3><div>Kaplan-Meier analysis indicated a significantly shorter median time to achieve complete pain resolution in the <em>Hypericum perforatum</em> 200CH group (10 h versus 14 h; log-rank test, <em>p</em> < 0.001). Tenderness scores exhibited no significant differences between the groups (<em>p</em> = 0.475). The group difference in the pain VAS score was statistically significant, favoring the <em>Hypericum perforatum</em> group compared to placebo (<em>p</em> < 0.001). No adverse events were recorded.</div></div><div><h3>Conclusion</h3><div>A significantly faster resolution of pain was achieved in the <em>Hypericum perforatum</em> 200CH group compared with placebo; however, no impact on tenderness was noted.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"13 1","pages":"Article 100606"},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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