European Journal of Integrative Medicine最新文献

{"title":"Ethnobotanical exploration of botanical remedies used by traditional healers and herbalists for voice disorders","authors":"Hala Jarrar ,&nbsp;Mahmoud Alatrash ,&nbsp;Faten Amer","doi":"10.1016/j.eujim.2024.102374","DOIUrl":"10.1016/j.eujim.2024.102374","url":null,"abstract":"<div><h3>Background</h3><p>Traditional herbal medicine is an integral part of global healthcare, with a growing reliance on natural remedies. This study investigates herbal medicine practitioners' perspectives on plants used to treat voice disorders in Palestine.</p></div><div><h3>Methods</h3><p>A quantitative cross-sectional study was conducted in the West Bank of Palestine, involving 100 herbal medicine practitioners who completed a semi-structured questionnaire between March and June 2023. Information on herbs was collected, including their Arabic names, parts used, and preparation methods. Plant samples were preserved and identified at the pharmacognosy lab at An-Najah National University. Quantitative analysis employed fidelity level, use-value, and choice value to assess cultural and ecological aspects.</p></div><div><h3>Results</h3><p>The herbalists recommended 20 herbs. The top five herbs identified were <em>Anthemis cotula, Pimpinella anisum, Zingiber officinale, Clinopodium serpyllifolium</em>, and <em>Mentha spicata</em>, with fidelity levels ranging from 76 % to 96 %. Leaves and fruits were the most commonly utilized plant parts, with the Lamiaceae and Apiaceae families being the most frequent.</p></div><div><h3>Conclusion</h3><p>Folkloric herbal medicine contributes to community healthcare and drug development. This study documents 20 indigenous Palestinian phyto-remedies that enhance vocal health, highlighting rich traditional knowledge. Collaboration between traditional healers and healthcare professionals can offer informed recommendations, while educational programs bridge traditional and contemporary healthcare. This pioneering research provides valuable insights globally, being the first to explore herbalists' indigenous knowledge of voice disorder remedies. While focusing on the West Bank, its implications extend worldwide, guiding future research into herbal remedies for voice disorders.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"69 ","pages":"Article 102374"},"PeriodicalIF":1.9,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and implementation of an evidence-based biofield therapy standardized documentation tool","authors":"Paul Guillory ,&nbsp;Tanecia Blue ,&nbsp;John Casken ,&nbsp;Courtnee Nunokawa","doi":"10.1016/j.eujim.2024.102369","DOIUrl":"10.1016/j.eujim.2024.102369","url":null,"abstract":"<div><h3>Introduction</h3><p>Biofield therapy (BT) is a complementary health practice involving the use of subtle energy to promote healing; however, monitoring the quality of care after implementing a BT program can be particularly challenging. The aim of this project was to strategically design, implement, and evaluate an evidence-based BT documentation tool to capture relevant data elements to display in a quality metric dashboard, while also being satisfactory to the practitioners who use it.</p></div><div><h3>Methods</h3><p>Utilizing the Consolidated Framework for Implementation Research (CFIR) method, key stakeholders at a government healthcare facility were gathered to design and use a structured documentation tool. After the tool's deployment, the stakeholders were routinely assessed over a three-month period to evaluate its effectiveness and identify areas for improvement. At the end of the period a practitioner satisfaction questionnaire was deployed and a quality metric dashboard was launched.</p></div><div><h3>Results</h3><p>Seven of the eleven BT-trained practitioners (64 %) used the template during the evaluation period and 255 sessions were documented. Forty-five percent of the staff responded to the Likert scored satisfaction questionnaire with 100 % indicating the template improved documentation, fit into the workflow, and facilitated interdisciplinary communication. The dashboard presented nine data elements, such as session indication and patient symptom scores, which can be filtered by date and location.</p></div><div><h3>Discussion</h3><p>The satisfaction scores validated findings from the literature relative to structured documentation, quality review, and program evaluation. These outcomes support the expansion of BT into different clinical settings, foster future BT research endeavors, and allow for BT to be included in broader medical data analytic efforts.</p></div><div><h3>Conclusion</h3><p>A structured documentation tool designed with findings from the evidence and input from key stakeholders can be an effective and satisfactory means of capturing quality metrics for evaluating the implementation of BT.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102369"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141058203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposing a novel research method for acupoint selection","authors":"Nick Lowe,&nbsp;Spod Dutton","doi":"10.1016/j.eujim.2024.102372","DOIUrl":"10.1016/j.eujim.2024.102372","url":null,"abstract":"<div><h3>Introduction</h3><p>Acupoint selection in both clinical trials and practice is predominantly informed by traditional theory and experience rather than clinical or mechanistic research. In-clinic acupoint testing methods are used by some practitioners to help determine acupoint selection based on patient feedback, but to date no quantitative data on these approaches has been published. This paper reports preliminary data where an acupoint testing method was utilised to help inform acupoint selection. These results were then used to develop a theoretical framework to validate the acupoint testing approach as a novel research method.</p></div><div><h3>Methods</h3><p>Preliminary data on the acupoint testing method was collected as part of a routine clinic audit from a single private practice in the UK using an electronic health record (EHR) and included; patient clinical demographic data, health complaints categorised according to the International Classification of Primary Care (ICPC-2) codes and patient outcomes using a Patient Global Impression of Change (PGIC) scale. The acupoint testing method used acupressure and/or acupuncture on acupoints to establish whether there was an immediate positive therapeutic effect for a patient for either; i) local areas of pain, ii) restricted/painful range of movements (ROM) and/or iii) acute symptoms related to a patients’ health complaint.</p></div><div><h3>Results</h3><p>A total of 506 acupoint tests were recorded from 398 treatments delivered to 74 patients (63.5% female, 36.5% male, mean age 58 years) presenting with predominantly chronic (77.1%) musculoskeletal (65.7%) issues. Tests were recorded for 61/74 (82.4%) patients and the mean number of tests per patient was 8.3. The majority of test results were positive (78.5%). For most patients at least one positive and negative test was recorded (52.5%). Solely positive tests were recorded for 44.3% of patients and soley negative tests were recorded for 3.3% of patients. The mixture of positive and negative test results suggests acupoint specificity may be clinically relevant.</p></div><div><h3>Conclusion</h3><p>Preliminary data suggests the testing method was versatile and useful for informing acupoint selection in clinical practice. Further research is required to establish its validity and reliability. The acupoint testing approach may represent a valuable new research method to help inform acupoint selection for both clinical trials and practice.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"69 ","pages":"Article 102372"},"PeriodicalIF":2.5,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141144932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of acupuncture therapy for leukopenia after chemotherapy or radiotherapy: A systematic review and meta-analysis","authors":"Yunpeng Deng ,&nbsp;Huanhuan Zhang ,&nbsp;Tengteng Wei ,&nbsp;Guangshuai He ,&nbsp;Zhixin Zhu ,&nbsp;Shuning Zhang ,&nbsp;Meijun Liu ,&nbsp;Jingjing Xue ,&nbsp;Weixing Zhang ,&nbsp;Xuguang Yang","doi":"10.1016/j.eujim.2024.102373","DOIUrl":"10.1016/j.eujim.2024.102373","url":null,"abstract":"<div><h3>Introduction</h3><p>Acupuncture-Moxibustion Therapy (AMT) has been used to treat leukopenia associated with cancer treatment. This systematic review and meta-analysis aimed to assess the clinical efficacy, safety, and degree of evidence of AMT in the treatment of post-chemoradiotherapy leukopenia.</p></div><div><h3>Methods</h3><p>Four English databases (The Cochrane Library, PubMed, EMBASE, Web of Science) and four Chinese databases (Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and WanFang Database) were searched from inception to February 6, 2023 for randomized controlled trials (RCTs) regarding post-chemoradiotherapy leukopenia with AMT. Two authors extracted data and assessed the quality of trials through the Cochrane risk of bias tool 2.0 independently. All meta-analysis was performed using Review Manager 5.4.1 and GRADE was usually used to measure the certainty of evidence.</p></div><div><h3>Results</h3><p>The analysis included 18 RCTs with 1,377 patients. The results showed that in treating post-chemoradiotherapy leukopenia, AMT is more effective compared to Chinese herbal medicine (CHM) (e.g., the effective rate: risk ratio (RR)=1.33, 95 % confidence interval (CI) 1.16 to 1.53, 3 RCTs, 349 cases; the white blood cell count (WBC): standardized mean difference (SMD)=1.03, 95 %CI 0.04 to 2.01, 2 RCTs, 148 cases), experimental synthetic drugs (ESDs) (e.g., the effective rate: RR=1.35, 95 %CI 1.13 to 1.61, 3 RCTs, 184 cases; the WBC: SMD=1.43, 95 %CI 1.21 to 1.65, 3 RCTs, 244 cases). AMT in combination with myeloid growth factors (MGFs) significantly improved the effective rate (RR=1.21, 95 %CI 1.09 to 1.35, 3 RCTs, 187 cases) and WBC (SMD=1.86, 95 %CI 1.56 to 2.17, 2 RCTs, 117 cases) compared to MGFs. However, there are no data to support the benefits of AMT or in combination with drugs in terms of Karnofsky performance status scores. The certainty of the overall evidence is very low due to the small sample sizes and poor quality of the included RCTs.</p></div><div><h3>Conclusions</h3><p>Very low certainty evidence suggests that AMT may be an effective complementary therapy for post-chemoradiotherapy leukopenia. The present evidence does not support a definitive safety profile for AMT. However, the quality of the current studies are low, and these conclusions need to be further validated by conducting more high quality RCTs.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102373"},"PeriodicalIF":2.5,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187638202400043X/pdfft?md5=aff8faba0e1cc7840759810f3f4a627a&pid=1-s2.0-S187638202400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Are we there yet?” – Green shoots of progress in acupuncture implementation in healthcare","authors":"Sandro Graca ,&nbsp;Matthias Huemer ,&nbsp;Beverley de Valois ,&nbsp;Bobbee Vang ,&nbsp;Lara McClure","doi":"10.1016/j.eujim.2024.102371","DOIUrl":"10.1016/j.eujim.2024.102371","url":null,"abstract":"<div><p>Despite a growing body of research and clinical guidelines advocating for acupuncture, its adoption in healthcare systems remains limited. This manuscript explores the considerable gap between evidence-based recommendations for acupuncture and its implementation, while providing practical examples of collaborative and integrative use of acupuncture in healthcare settings in the UK, USA, and Austria. We aim to inspire and provide guidance for those seeking to replicate these successful initiatives and drive the integration of acupuncture in their own healthcare settings.</p><p>Narrative accounts of the experience of three clinician-researchers delivering acupuncture within mainstream healthcare systems in the UK, USA, and Austria respectively were captured. These are presented as standalone exemplars of the integration of acupuncture in real-world settings from the perspective of embedded professionals. Each of the three contributors explores and discusses the challenges faced and opportunities presented in their specific setting, as well as lessons learned in the process which may be more widely transferable. The collective relevance of these three narratives may extend beyond the individual settings, serving as possible blueprints and stimulating further professional discourse and innovation.</p><p>In the UK, thanks to a unique collaborative environment, research has provided a platform for the implementation of long-running, sustainable acupuncture services in the National Health Service. In the USA, the provision of acupuncture in a hospital setting is supported by an emphasis on communication and comprehensive multidisciplinary approach to integrative care, aided by the use of electronic medical records. In Austria, acupuncture is predominantly administered by medical doctors and its integration is attributed to evidence-based discussions with patients and caregivers within the hospital setting. These green shoots of acupuncture provision within healthcare systems in three different countries bridge the translational gap between guidelines and delivery, shedding light on the multi-faceted aspects of acupuncture implementation.</p><p>Concerted efforts focusing on education, dissemination, and fostering bidirectional communication between acupuncture research and clinical practice are essential for moving beyond the principle of “It Seemed Like A Good Idea At The Time” in acupuncture service provision, and consequently supporting the integration and implementation of acupuncture in healthcare systems utilising existing guidelines.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"69 ","pages":"Article 102371"},"PeriodicalIF":2.5,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876382024000416/pdfft?md5=731796cdfa48553d691b26374287d69e&pid=1-s2.0-S1876382024000416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the Social Cognitive Factor Scale (SCFS) to analyze the determinants influencing the utilization of traditional chinese medicine preventive health services among older adults","authors":"Yan Chen ,&nbsp;Yuhuan Sun ,&nbsp;Yang Yi ,&nbsp;Yujie Chang ,&nbsp;Dahui Wang ,&nbsp;Jiaqi Yang ,&nbsp;Ying Sun ,&nbsp;Lan Jiang ,&nbsp;Binyan Zhu ,&nbsp;Guozhong Chen","doi":"10.1016/j.eujim.2024.102368","DOIUrl":"10.1016/j.eujim.2024.102368","url":null,"abstract":"<div><h3>Introduction</h3><p>Traditional Chinese medicine (TCM) boosts immunity, aids self-repair, and supports elderly health. Despite government efforts, older adults underutilize TCM preventive health services. This study aimed to develop a reliable and valid Social Cognitive Factor Scale (SCFS) to understand this from a behavioral psychology perspective.</p></div><div><h3>Methods</h3><p>The SCFS, a self-report questionnaire rooted in Bandura's social cognitive theory, was developed by an expert panel using insights from current literature, focus group qualitative research, and scale testing. Twenty experts in TCM public health research and 840 community-dwelling older adults were included in this study. Scale development involved a literature review to establish the initial item pool, two Delphi expert consultations for item screening and revision, and comprehensive testing for reliability and effectiveness.</p></div><div><h3>Results</h3><p>The SCFS consisted of 22 items classified into six dimensions: perceived environment, social support, belief and knowledge, self-efficacy, outcome expectations, and self-regulation. The overall Cronbach's alpha of the scale was 0.946, and the split-half reliability of the total scale was 0.828, showing good reliability. A total of six factors were extracted, explaining 78.85 % of the total variation. Exploratory factor analysis showed that the scale had good construct validity. Scores on the SCFS were significantly and positively correlated with the utilization rate of TCM preventive health services for older adults (<em>r</em> = 0.537, <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>TCM plays a significant role in actively addressing the challenges of aging. The SCFS provides a reliable and valid tool for understanding the underutilization of TCM preventive health services among older adults. A positive correlation with service utilization rates highlights its potential for guiding interventions.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102368"},"PeriodicalIF":2.5,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876382024000386/pdfft?md5=3b9c7683630203e21b51c0e940604e6b&pid=1-s2.0-S1876382024000386-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141036869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of breathing exercises during first stage of labor: A systematic review and meta-analysis","authors":"Alexandre Delgado ,&nbsp;Geyson Marinho ,&nbsp;Renato S. Melo ,&nbsp;Filipe Pinheiro ,&nbsp;Andrea Lemos","doi":"10.1016/j.eujim.2024.102370","DOIUrl":"10.1016/j.eujim.2024.102370","url":null,"abstract":"<div><h3>Introduction</h3><p>Breathing appears to be an important outcome during labor. Therefore, this systematic review aims to evaluate, using the highest level of evidence, the benefits and potential risks of using breathing exercises during the first stage of labor on maternal and neonatal outcomes.</p></div><div><h3>Methods</h3><p>A search was conducted in the MEDLINE/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, PEDro, EMBASE, CINAHL, Web of Science, Scopus databases and gray literature was also searched, with no restrictions on period or language. The terms \"Breathing Exercises\" and \"Labor\" were used. Randomized and quasi-randomized clinical trials comparing a group using breathing exercises during the first stage of labor with a control group receiving usual care were included. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the certainty of evidence was evaluated using the GRADE system. Quantitative analysis was performed through meta-analyses.</p></div><div><h3>Results</h3><p>Thirteen studies were included. There was a reduction in pain by -1.64 (95 % CI: -2.81 to -0.46, eight studies, I² 99 %; T2 2.82; <em>p</em> &lt; 0.00001), based on very low certainty of evidence, and a reduction in the duration of the second stage of labor by -7.23 min (95 % CI: -11.08 to -3.38, three studies, random-effects: I² 0 %; T2 0.00; <em>p</em> &lt; 0.0002), based on moderate certainty of evidence.</p></div><div><h3>Conclusion</h3><p>There is moderate evidence that the use of breathing exercises during the first stage of labor can reduce the duration of the pushing stage and decrease pain intensity, although with very low certainty of evidence. However, there was no difference in other maternal and neonatal outcomes.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102370"},"PeriodicalIF":2.5,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidance on assessing efficacy and harms in traditional Chinese medicine dietotherapy: Introducing the Dietotherapy Intention, Evaluation, and Harm Tracking (DIET) pathway","authors":"Lixia Yuan ,&nbsp;Jianrong Chen ,&nbsp;XunXun Yuan ,&nbsp;Jieyi Zhou ,&nbsp;Sheng Xu ,&nbsp;Weifeng Zhu ,&nbsp;Xu Zhou","doi":"10.1016/j.eujim.2024.102367","DOIUrl":"10.1016/j.eujim.2024.102367","url":null,"abstract":"<div><h3>Introduction</h3><p>Traditional Chinese medicine (TCM) dietotherapy, based on the principle of “medicine and food homology”, is widely used across diverse healthcare domains. However, the dual attributes of “medicine” and “food” possessed by medicinal and edible herbs make it challenging to assess the efficacy and harms of TCM dietotherapy using currently available methodological systems. This limits the advancement of health services and regulations in this field. This study introduces the Dietotherapy Intention, Evaluation, and Harm Tracking (DIET) pathway, a staged approach for assessing the efficacy and harms of TCM dietotherapy.</p></div><div><h3>Results</h3><p>The DIET pathway was developed through comprehensive analysis and two rounds of Delphi expert consensus. Based on the distinct characteristics and management requirements of TCM dietotherapy, the DIET pathway divides the assessment process into three stages: Stage 1 (Intention) aims to establish intended efficacy goals, Stage 2 (Evaluation) aims to validate efficacy and harms, and Stage 3 (Harm Tracking) aims to assess harms in special scenarios. Elaborate methodological guidelines are provided for each stage.</p></div><div><h3>Conclusion</h3><p>The DIET pathway has created a methodological environment that enables systematic and efficient assessment of the efficacy and harms of TCM dietotherapy regimens, which will facilitate the application and management of TCM dietotherapy.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102367"},"PeriodicalIF":2.5,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemical characterization of Thymus zygis L. (thyme) and Elettaria cardamomum L. (cardamom) essential oils and investigation of their inhibitory potentials against cervicovaginal Escherichia coli isolates","authors":"Gulcan Sahal ,&nbsp;Hanife Guler Donmez ,&nbsp;Mehmet Sinan Beksac","doi":"10.1016/j.eujim.2024.102366","DOIUrl":"10.1016/j.eujim.2024.102366","url":null,"abstract":"<div><h3>Introduction</h3><p>The cervicovaginal microbiota plays a crucial role in women's well-being and reproductive health. This study initially focuses on identifying the chemical components of the essential oils (EOs) from <em>Elettaria cardamomum</em> L. (cardamom) (Ec) and <em>Thymus zygis</em> L. (thyme) (Tz). Subsequently, this study aims to determine the antimicrobial and biofilm inhibitory effects of these EOs against both cervicovaginal mixed cultures and the microbial strains isolated from them.</p></div><div><h3>Methods</h3><p>The compositions of EOs were determined by GC–MS analysis using an Agilent 7890B GC/5977A Series MSD System. Cervicovaginal samples were obtained from two women presenting complaints of a strong odor and vaginal discharge. Samples were collected from the cervix using a sterile cytobrush, ensuring no contact with the urethra, rectum, or external parts of the vagina. The cytological examination was conducted using Papanicolaou staining. Isolated microorganisms were identified through 16S Ribosomal RNA Gene Sequence Analysis and characterized using antibiogram tests. Antimicrobial tests of the EOs were performed by broth microdilution and disc diffusion methods. Biofilm formation was assessed using a crystal violet binding assay.</p></div><div><h3>Results</h3><p>The major components of Ec EO were <em>α</em>-terpinyl acetate (41.95 %) and eucalyptol (28.58 %), whereas Tz EO contained significant amounts of <em>o</em>-cymene (38.76 %), carvacrol (22.66 %), and thymol (20.69 %). <em>Escherichia coli</em> codes OR651248 and OR651249 were isolated from CV 6 and CV 7 mixed cultures, respectively. <em>E. coli</em> OR651248 demonstrated a higher antibiotic resistance level than <em>E. coli</em> OR651249. Biofilm formation by mixed cultures was significantly higher than that by <em>E. coli</em> isolates (<em>P</em> &lt; 0.05). The Ec EO displayed minimal to no effect against both mixed cultures, showing zero inhibition zone, 500 μL/mL minimum inhibitory concentrations (MICs), and 500 μL/mL minimum microbicidal concentrations (MMCs). However, the Tz EO exhibited antimicrobial activity against both mixed cultures and the <em>E. coli</em> isolates, with inhibition zones &gt; 15 mm and MICs/MMCs &lt; 4 μL/mL (<em>P</em> &lt; 0.05). In all microbial cultures, 0.5 MIC of both EOs inhibited biofilm formation by more than 80 %.</p></div><div><h3>Conclusion</h3><p>The Tz EO exhibits promising potential as an antimicrobial and biofilm inhibitory agent for managing cervicovaginal <em>E. coli</em> infections.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102366"},"PeriodicalIF":2.5,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of clinical trials in integrative medicine: The issue of personalization","authors":"Kam Wa Chan ,&nbsp;Jian-ping Liu ,&nbsp;Zhao-xiang Bian","doi":"10.1016/j.eujim.2024.102365","DOIUrl":"10.1016/j.eujim.2024.102365","url":null,"abstract":"<div><h3>Introduction</h3><p>Classic randomized controlled trial design provides information about the effectiveness of a treatment at population level. In clinical practice based on precision medicine, we seek study designs that provide estimates accounting for individual patients’ demographics and context. Integrative medicine has a strong emphasis on personalization, and there is a pressing need for advancements in trial design to support clinical decisions.</p></div><div><h3>Discussion</h3><p>To enhance the generalizability and implementation of research evidence, study designs first need to mimic the real-world from both the clinicians’ and patients’ perspectives, which could be optimized based on stakeholder analysis. Previous stakeholder analyzes showed that the lack of personalization in clinical trial design is a key challenge for the adoption of evidence clinically. Variations of randomized controlled trial design including better-powered and better-designed subgroup analysis, pragmatic design, the N-of-1 cross-over design, and adaptive design have been introduced to personalize clinical trials. Each of these variations has unique advantages, assumptions and limitations. Stratified randomization can be used to divide a disease population into subgroups according to different schools of theory to match with the corresponding treatment, while preserving the generalizability to general readership. Patient-level meta-analysis can improve the power and precision of subgroup analysis. Enrichment design can increase the efficiency of a trial in detecting treatment effect(s) and in mimicking actual clinical use. Practical issues, including bias control and assessment in pragmatic trials, and N-of-1 trials are also discussed with recent trials as examples. We suggest strategies to maximize the validity and translation potential of clinical trials in integrative medicine with pragmatic or personalized design.</p></div><div><h3>Conclusion</h3><p>Variations of randomized controlled trial design improve the precision of estimates at patient level, which should be carefully considered in the trial design of integrative medicine according to the context of the future application of evidence.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"68 ","pages":"Article 102365"},"PeriodicalIF":2.5,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}