Category Archives: Integrative Medicine

Interested in integrative medicine? Read the following excerpt from the Mayo Clinic Guide to Integrative Medicine.

People who take an active role in their health care experience better health and improved healing. Its a commonsense concept thats been gaining scientific support for several years now.

As studies continue to reveal the important role the mind plays in healing and in fighting disease, a transformation is taking place in hospitals and clinics across the country. Doctors, in partnership with their patients, are turning to practices once considered alternative as they attempt to treat the whole person mind and spirit, as well as body. This type of approach is known today as integrative medicine.

Integrative medicine describes an evolution taking place in many health care institutions. This evolution is due in part to a shift in the medical industry as health care professionals focus on wellness as well as on treating disease. This shift offers a new opportunity for integrative therapies.

Integrative medicine is the practice of using conventional medicine alongside evidence-based complementary treatments. The idea behind integrative medicine is not to replace conventional medicine, but to find ways to complement existing treatments.

For example, taking a prescribed medication may not be enough to bring your blood pressure level into a healthy range, but adding meditation to your daily wellness routine may give you the boost you need and prevent you from needing to take a second medication.

Integrative medicine isnt just about fixing things when theyre broken; its about keeping things from breaking in the first place. And in many cases, it means bringing new therapies and approaches to the table, such as meditation, mindfulness and tai chi. Sometimes, integrative approaches help lead people into a complete lifestyle of wellness.

What are some of the most promising practices in integrative medicine? Heres a list of 10 treatments that you might consider for your own health and wellness:

A number of surveys focused on the use of integrative medicine by adults in the United States suggest that more than a third of Americans are already using these practices as part of their health care.

These surveys demonstrate that although the United States has the most advanced medical technology in the world, Americans are turning to integrative treatments and there are several reasons for this trend. Here are three of the top reasons why more and more people are exploring integrative medicine.

One reason integrative medicine is popular is that people in general are taking a greater, more active role in their own health care. People are more aware of health issues and are more open to trying different treatment approaches.

Internet access is also helping to fuel this trend by playing a significant role in improving patient education. Two decades ago, consumers had little access to research or reliable medical information. Today, clinical trials and pharmaceutical developments are more widely available for public knowledge.

For example, people who have arthritis can find a good deal of information about it online. They may find research showing that glucosamine, for example, helps with joint pain and doesnt appear to have a lot of risks associated with it. With this information in hand, they feel empowered to ask their doctors if glucosamine might work with their current treatment plans.

A second reason for the wider acceptance of integrative treatments is the influence of the baby boomer generation. This generation is open to a variety of treatments as it explores ways to age well. In addition, baby boomers are often dealing with several medical issues, from weight control to joint pain, high blood pressure and elevated cholesterol. Not everyone wants to start with medication; many prefer to try complementary methods first.

A third reason for the growth, interest and use of integrative therapies is the degree of chronic stress in the American lifestyle. Workplace stress, long commutes, relationship issues and financial worries are just some of the concerns that make up a long list of stressors.

Although medications can effectively treat short-term stress, they can become just as damaging and even as life-threatening as stress itself is when taken long term. Integrative medicine, on the other hand, offers several effective, evidence-based approaches to dealing with stress that dont involve medication. Many otherwise healthy people are learning to manage the stress in their lives successfully by using complementary methods such as yoga, meditation, massage and guided imagery.

Considering that many healthy people are engaging in integrative practices, it isnt surprising to find out that theyre turning to these treatments in times of illness, as well. Here are just a few ways integrative medicine is used to help people cope with medical conditions:

Conventional Western medicine doesnt have cures for everything. Many people who have arthritis, back pain, neck pain, fibromyalgia and anxiety look to integrative treatments to help them manage these often-chronic conditions without the need for medications that may have serious side effects or that may be addictive.

As interest in integrative medicine continues to grow, so does the research in this field. Researchers are studying these approaches in an effort to separate evidence-based, effective therapies from those that dont show effectiveness or may be risky. In the process, this research is helping to identify many genuinely beneficial treatments. In essence, both consumer interest and scientific research have led to further review of these therapies within modern medicine.

As evidence showing the safety and efficacy of many of these therapies grows, physicians are starting to integrate aspects of complementary medicine into conventional medical care. Ultimately, this is what has led to the current term integrative medicine.

If youre interested in improving your health, many integrative medicine practices can help. Not only can they speed your recovery from illness or surgery, but they can also help you cope with a chronic condition. In addition, complementary practices such as meditation and yoga can work to keep you healthy and may actually prevent many diseases.

Relevant reading

Mayo Clinic Guide to Integrative Medicine

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A holistic approach to integrative medicine - Mayo Clinic Press

Welcome to Fullscripts integrative medicine education series. Discover how integrative medicine improves patient outcomes and why its being adopted by forward-thinking practitioners across North America.

One of the key tenets of integrative medicine is that good medicine is based on good science, which is inquiry-driven and open to new paradigms. (22) Integrative medicine is good medicine and so much more.

In this article, youll learn what integrative medicine is, the benefits of it, and more.

Integrative medicine can be described and defined in different ways. But for the most comprehensive description, it helps to refer to the Father of Integrative Medicine, Dr. Andrew Weil.

The Andrew Weil Center for Integrative Medicine describes integrative medicine as healing-oriented medicine that considers the whole person within the context of a collaborative therapeutic relationship between practitioner and patient. It is informed by scientific evidence, uses all appropriate integrative therapies, and is guided by the defining principles outlined in the graphic below.

In addition to treating the physical body, integrative medicine treats patients via emotional, environmental, mental, and spiritual means by integrating mind and body with a holistic approach. (5)

Other keywords often used to define integrative medicine include empowering, evidence-based, individualized, interprofessional, and patient-centered. (17) According to a 2009 paper on the topic of integrative medicine and patient-centered care, the authors explain that patient-centered care is a core component of integrative medicine and has a movement all its own, which is rooted in customized treatments and decision-making based on the patients beliefs and preferences. (8)

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Many people wonder how integrative medicine relates to conventional or Western medicine. Integrative medicine is an approach to health and wellness that combines:

Many licensed healthcare practitioners provide integrative care to their patients. Examples of practitioners and doctors who may practice integrative care include:

Individuals of all ages and those with varying health conditions may benefit from integrative medicine. Integrative medicine can help promote overall health and well-being and aid in chronic disease management and prevention. (11)

Dietary supplements are the most commonly used integrative modality; however, other popular approaches include therapeutic breathing techniques, diet therapy, and yoga. (10) Integrative medicine further incorporates a variety of integrative therapies including acupuncture, Ayurveda, chiropractic, homeopathic, naturopathic, and traditional Chinese medicine alongside conventional medicine. (20)

Examples of complementary therapies include:

How does integrative medicine differ from alternative, complementary, and conventional medicine?

When a provider or medical facility utilizes both complementary and conventional medical care, it is considered integrative medicine. (12)

There are significant events that have taken place over the past 50 years that have helped form integrative medicine as we know it is today. Here is a timeline illustrating some of those key events. (1)(9)(13)(17)(19)

Today its estimated that more than one third of Americans use some form of complementary or integrative health approach. (10) Within cancer care that percentage skyrockets, with some estimates as high as 95% and most surveys at around 50%. (7) Among people with chronic illness, surveys indicate that 70 to 90% use an integrative approach. (3)

Based on a 2020 systematic review, the number one reason people use integrative medicine worldwide is because of the expected benefits, and the second reason is that they are dissatisfied with conventional medicine. (21)

Obviously, for something to be sustainably popular, the user needs to get some benefit. Based on a 2018 review, the scientifically validated benefits of integrative medicine are many and varied, including:

Integrative medicine also excels when it comes to addressing gastrointestinal disorders, (6) musculoskeletal conditions, (4) cardiovascular disease, (25) and stroke. (15)

Perhaps the most well-known randomized controlled clinical trials showing that an integrative approach using diet and lifestyle could reverse cardiovascular disease was conducted by Dean Ornish et al in 1998. (14) Acupuncture, another key integrative treatment modality, has been backed by a significant amount of scientific research. According to a 2019 review, clinical evidence suggests that acupuncture may help treat 96 different health problems including cancer-related symptoms, a variety of different types of pain, and mental health issues such as anxiety and depression. (2)

As with all types of medicine, there are some risks to consider when receiving integrative medicine therapies. Its important to note that some therapies may have side effects or cause adverse effects or injuries, and not all natural therapies are inherently safe. (24) When considering or seeking integrative health care, its important to:

My hope for the future is that integrative medicine will be taught to all health professionals and payment incentives will be revised to support its practice, said Victoria Maizes, MD, the Executive Director of the Andrew Weil Center for Integrative Medicine.

integrative medicine is here to stay and nations who ignore its precious resources would do so at their own economic and health costs, concluded the authors of a 2021 paper on the future of medicine. The authors conclude that integrative medicine must be integrated into medical research, education, and policy. (18) While its true that integrative medicine is here to stay, some would argue that its always been here and we just needed to rediscover it.

In the coming years, there will likely continue to be an increase in usage and an increase in the number of integrative medicine programs offered throughout North America. This is good news for both integrative medicine practitioners and their patients.

If you are interested in exploring integrative medicine, consider consulting with an integrative healthcare practitioner.

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References

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Integrative Medicine: What Is It, Types & Benefits | Fullscript

Andrew Weil, M.D., is the worlds leading proponent of alternative medicine, right? Wrong.

Although this is how the popular media often portrays him, Dr. Andrew Weil is actually the worlds leading proponent of integrative medicine, a philosophy that is considerably different from a blanket endorsement of alternative medicine. To fully understand Dr. Weils advice presented in his website, bestselling books and lectures, and reflected in the daily practice of thousands of physicians worldwide (thanks to the in-depth training acquired at the Andrew Weil Center For Integrative Medicine at the University Of Arizona in Tucson) its important to grasp what integrative medicine is, and is not.

The first step is mastering some basic terms. Using synthetic drugs and surgery to treat health conditions was known just a few decades ago as, simply, medicine. Today, this system is increasingly being termed conventional medicine. This is the kind of medicine most Americans still encounter in hospitals and clinics. Often both expensive and invasive, it is also very good at some things; for example, handling emergency conditions such as massive injury or a life-threatening stroke. Dr. Weil is unstinting in his appreciation for conventional medicines strengths. If I were hit by a bus, he says, Id want to be taken immediately to a high-tech emergency room. Some conventional medicine is scientifically validated, some is not.

Any therapy that is typically excluded by conventional medicine, and that patients use instead of conventional medicine, is known as alternative medicine. Its a catch-all term that includes hundreds of old and new practices ranging from acupuncture to homeopathy to iridology. Generally alternative therapies are closer to nature, cheaper and less invasive than conventional therapies, although there are exceptions. Some alternative therapies are scientifically validated, some are not. An alternative medicine practice that is used in conjunction with a conventional one is known as a complementary medicine. Example: using ginger syrup to prevent nausea during chemotherapy. Together, complementary and alternative medicines are often referred to by the acronym CAM.

Enter integrative medicine. As defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.

In other words, integrative medicine cherry picks the very best, scientifically validated therapies from both conventional and CAM systems. In his New York Times review of Dr. Weils latest book, Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being, Abraham Verghese, M.D., summed up this orientation well, stating that Dr. Weil, doesnt seem wedded to a particular dogma, Western or Eastern, only to the get-the-patient-better philosophy.

So this is a basic definition of integrative medicine. What follows is the complete one, which serves to guide both Dr. Weils work and that of integrative medicine physicians and teachers around the world:

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

The principles of integrative medicine:

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What is Integrative Medicine? - Andrew Weil, M.D. - DrWeil.com

"Supporting people on their journey to realizing wholeness

At the UF Health Integrative Medicine Program we treat the whole person mind, body and spirit. We are dedicated to helping you achieve optimal health and well-being in all aspects of life.

Integrative medicine brings together practices once thought of as alternative medicine. Combining those with the latest research and medical technology, fosters the connection between the mind, body and spirit that is often missing in conventional medicine. Integrative medicine bridges the gap between conventional medicine and complementary therapies.

Integrative medicine is an approach to care that puts the patient at the center. It addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a persons health.

The defining principles of integrative medicine are:

At the UF Health Integrative Medicine Program, we are redefining personalized care by addressing all aspects of a patients well-being. Establishing a partnership between patient and practitioner is essential. It helps provide a treatment plan that achieves optimal health.

Integrative medicine is not a replacement for a primary care doctor. Instead, think of an integrative medicine doctor as someone who works with all your health care providers. This helps offer a more comprehensive care plan that utilizes treatments that combine conventional medicine with other therapies. These therapies may include, but are not limited to:

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Integrative Medicine - UF Health

Integrative medicine (IM) is an approach that combines conventional medicine with complementary treatments. The aim of IM is to treat the whole person, not just a health problem.

Because IM is holistic, it can target the behavioral, social, and environmental aspects of a persons life as well as help treat the underlying health issue.

Many people are requesting more complementary therapies as part of their treatment plans, especially in certain health areas, such as cancer. That said, it is important to note that people should not replace their prescribed clinical treatments with complementary approaches alone, as this could lead to worse health outcomes.

Instead, people should discuss their current therapies with a doctor who can advise on the best course of treatment.

Read on to learn more about IM, including the risks, the benefits, and some of the conditions it may be useful for.

IM is a whole-person treatment plan that aims to treat the body, mind, and spirit. It specifically includes and coordinates the use of complementary therapies alongside conventional medicine.

Usually, a complementary therapy practitioner will suggest a combination of treatments to improve a persons well-being. For example, they may suggest that a person practices yoga to reduce stress but also recommend that they get in touch with an acupuncturist.

Practitioners tend to group complementary therapies into three key areas: nutritional, psychological, and physical.

Nutritional complementary therapies include products such as herbs, vitamin and mineral supplements, and probiotics. Supplements come in many forms, such as capsules, liquids, and powders. A person may also receive a specific diet plan.

A person should always speak with a doctor before taking any supplements in addition to their prescribed treatment. Doing so can cause certain interactions. For example, vitamin K can reduce the effectiveness of warfarin, which is a blood-thinning medication.

Psychological forms of complementary therapy aim to settle the mind and reduce stress. These therapies include:

There is a lot of overlap between mind and body practices. For example, although yoga and tai chi are physical practices, they also promote psychological well-being.

Learn more about types of meditation here.

Physical approaches to complementary health may include some form of muscle manipulation, such as massage. People may also receive treatment from a chiropractor, who can manipulate the spine to reduce pain or alleviate other health problems.

Alternatively, acupuncture is a physical treatment during which a practitioner inserts fine needles through the skin to stimulate specific pressure points.

Physical therapies that a person can try on their own or as part of a class include yoga and tai chi.

The use of integrative care is growing, especially in specialist cancer centers, where more people are requesting complementary approaches in addition to clinical treatments, such as chemotherapy.

In fact, one 2017 systemic review found that 45 National Cancer Institute treatment centers had increased the number of complementary treatments they offered on their websites over the course of 7 years, from 2009 to 2016. The most popular therapies included acupuncture, meditation, and yoga.

When a healthcare professional introduces complementary therapies as part of a persons treatment plan, the goal is usually to alleviate some side effects of conventional medicine.

For example, the authors of a 2018 meta-analysis note that acupuncture seems particularly effective at reducing fatigue in people with breast cancer who receive anticancer treatment.

However, an additional 2019 systematic review of studies that investigated the relationship between complementary therapies and cancer states that more robust study designs are necessary to fully understand the effectiveness of complementary therapies in an oncology environment.

Another area that may benefit from complementary therapy is fertility. One 2018 review suggests that females who practice Hatha yoga alongside other mind and body therapies may feel less stressed and anxious during in vitro fertilization treatment. Their psychosocial health may also improve.

Introducing IM may have some benefits. For example, a 2018 review notes that, overall, IM helps people deal with difficult illnesses and reduces their distress.

Furthermore, in some instances, IM may actually improve health outcomes. For example, a 2018 study based in South Korea found that when people received IM after experiencing a stroke, they had stronger survival rates at 3 and 12 months than those who received conventional medicine alone.

Although integrative care was more expensive, it prevented future hospital admissions, which can help hospitals save money in the long run.

People should be aware of the risks associated with some complementary approaches when including them in their treatment regimen.

The Food and Drug Administration (FDA) approves all conventional medications before manufacturers can sell them, but manufacturers of supplements do not need FDA approval to put their products on the market.

Additionally, some supplements can interact with some medications. This can increase the risk of complications if a person is also taking another medication.

It is also important that people do not view supplements and other herbal remedies as a cure or a replacement for conventional medication. If a manufacturer promotes its supplement as a cure, the product is likely unsafe.

Study design is also an important point that people should think about when researching the health benefits of some complementary therapies. Complementary health studies do not usually have robust study designs that other researchers can replicate, which means that the findings and conclusions could be inaccurate.

That said, the National Center for Complementary and Integrative Health is funding more studies to further investigate the health benefits of complementary therapies and how healthcare professionals can use them in addition to conventional medicine.

IM and alternative medicine are two terms that describe treatment that sits outside of conventional medical care.

If a person uses a nonconventional treatment option in a coordinated manner alongside conventional medicine, the practice is IM.

If a person uses a nonconventional treatment option instead of conventional medicine, the practice is alternative medicine.

Integrative medicine (IM) includes both complementary and conventional treatment approaches and specifically coordinates the use of the two as part of a holistic treatment plan.

Some benefits of IM include reducing distress and helping people process living with a difficult illness. Some healthcare professionals are expanding the use of IM, especially in the treatment of cancer.

Although researchers are taking a proactive attitude toward investigating the possible benefits of IM, studies that support complementary approaches often have design flaws, which means that their conclusions could be inaccurate.

More here:
What is integrative medicine (IM)? - Medical News Today

First, we strongly believe in the value of preventative care, a concept grounded in traditional Chinese medicine. Brian Carter's Pulse of Oriental Medicine states the traditional Chinese doctor's job was to keep the village from getting sick and they in return would make sure his needs were met. Once they became sick, they were unable to take care of the doctor, therefore, it only made sense for him to keep them well. Our role is to keep you well before any signs of disease surface. By keeping mind, body and spirit in balance, maintaining appropriate nutrient levels and exercising a positive lifestyle, one is proactively taking care of themselves.

Second, we believe in natural healing. The body has an innate ability to heal itself, we simply assist you on your journey towards wellness. While western medication is effective at treating many illnesses, it can also act as a double-edged sword; the chemicals in pills and other drugs can have many potentially harmful side effects. Our doctors take a comprehensive look at your medical concerns and prescribe the healthiest solution that is individualized for your needs.

Third, the Center for Primary Care and Integrative Medicine seeks to reduce the increasingly prevalent abuse of narcotics. The United States consumes 60% of the world's narcotics and 99% of global Norco, and these are increasingly prescribed unnecessarily. This has adverse effects on the patient's body. More than 96,000 Americans and 4500 Texans died of drug overdoses in 2020 per CDC data. We should reduce their use as much as possible without compromising pain control. Today, more and more people are turning to natural methods of healing. The Center for Primary Care and Integrative Medicine incorporates the best of conventional and alternative medicine to provide the highest quality of care possible.

While preventing chronic disease has been our main focus of practice, we emphasize the importance of helping patients who already suffer from a variety of chronic diseases actively recover. In addition to regular cardiopulmonary rehab, we offer Taichi, massage, and acupuncture to help patients from a variety of chronic conditions, e.g., chronic Congestive Heart Failure, COPD, Parkinsons disease, etc., improve functional status. Studies have shown that acupuncture and Taichi can favorably affect heart rate variability and thus decrease post-myocardial infarct mortality. Acupuncture as adjunctive therapy can be used to alleviate chronic stable angina (JAMA intern Med. 2019;179 (10):1388-1397). Taichi-based cardiac rehabilitation was associated with an increase in peak oxygen consumption, a marker of functional capacity, in patients with recent MI. Acupuncture has been shown to reduce interleukin-17 (IL-17, inflammation marker) in asthmatic patients and increase 6 minute walking distance and quality of life in COPD patients. Recent studies, published in CHEST 2018; 153 (5): 116-1124, has shown that Tai Chi is equivalent to pulmonary rehab in improving functional status in COPD patients. Tai chi training has been shown to reduce balance impairments in patients with mild -to-moderate Parkinsons disease, with additional benefits of improved functional capacity and reduced falls (N Engl J Med 2012;366:511-9). Preliminary study has shown that Scalp acupuncture effectively slows down disease progress in Parkinsons disease patients and improve quality of life.

Last, but not least, we strive to reduce the cost of medicine for both individuals and the nation. Health care costs have been rising for several years and remains a focus of worldwide discussion. National health expenditures have doubled over the past decade from $1.3 trillion in 2000 to $2.6 trillion in 2010. It exceeded $ 4 trillion in 2020 according to Center for Medicare & Medicaid services (CMS). Total health care expenditures grew at an annual rate of 4.4 percent in 2008, outpacing inflation and the growth in national income. Indeed, we are a nation providing the best "sick" care. If we looked at replacing "sick" care with preventative medicine, we would be a healthier and wealthier nation. Spending on new medical technology and prescription drugs has been cited as a leading contributor to the increase in overall health. The Center for Primary Care and Integrative Medicine focuses on prevention and treatment of chronic diseases such as hypertension, diabetes, obesity, and chronic pain. Integrative medicine has been known to be highly effective in the treatment of such illnesses. In addition,the Center also gives consults to patients who want to learn taichi and yoga to improve well being.

Center for primary care and Integrative Medicine has also been actively collaborating with world renowned institutes to explore mechanisms underlying the effects of acupuncture, Ethnopharmacology, and the application of traditional Chinese Medicine in health regimen.

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Houston Integrative Medicine

Journal of Integrative Medicine (JIM) is a peer-reviewed journal sponsored by Shanghai Association of Integrative Medicine and Shanghai Changhai Hospital, China. It is a continuation of the Journal of Chinese Integrative Medicine (JCIM), which was established in 2003 and published in Chinese language (The phonetic romanization of the Chinese title used by MEDLINE/PubMed is Zhong Xi Yi Jie He Xue Bao). Since 2013, JIM has been published in English language.

JIM is an interdisciplinary journal focusing on academic research and clinical studies in the field of integrative medicine. It aims to be a leading journal for studies in integrative medicine, and to promote communication and integration among traditional medicinal systems, complementary and alternative medicine (CAM), and conventional western medicine. The editorial board is committed to publishing high-quality papers on integrative medicine and creating an open forum in which the international scholarly community can exchange views, share research and clinical experience, discuss integrative medicine education, and confer about issues and problems in our various disciplines and in integrative medicine as a whole. The journal's international scope ensures that research and progress from all regions of the world are widely covered.

Topics covered include all aspects of integrative medicine, such as acupuncture and moxibustion, traditional Chinese medicine, Ayurvedic medicine, herbal medicine, homeopathy, nutrition, chiropractic, mind-body medicine, Taichi, Qigong, meditation, and any other modalities of CAM, as well as their integration with the conventional medicine.

Article types include, but are not limited to, randomized controlled and pragmatic trials, translational and patient-centered effectiveness outcome studies, case series and reports, clinical trial protocols, preclinical and basic science studies, systematic reviews and meta-analyses, papers on methodology and medical history or education, conference proceedings, editorials, commentaries, short reports, book reviews, and letters to the editor.

Headed by experienced and internationally recognized Editors-in-Chief and supported by a strong, internationally diverse team of editors, JIM benefits various groups, including clinical researchers, practitioners, academics and administrators worldwide in the field of medical healthcare. With its global reach, JIM looks to establish itself as an outstanding English language journal in its area of focus.

Benefits to Authors JIM is published both in print and online. The print issues are published bimonthly. However, the journal publishes articles in their full-citable form as soon as the final author corrections have been approved. Therefore, online publication is ahead of the printed journal at the website http://www.jcimjournal.com/jim/. JIM is indexed in MEDLINE/PubMed, ScienceDirect, Embase, Chemical Abstracts, CAB Abstracts, EBSCO, Western Pacific Region Index Medicus (WPRIM), Chinese Science Citation Database (CSCD) and China National Knowledge Infrastructure (CNKI). This ensures that articles published in JIM have the maximum exposure and visibility to the international scholarly community. JIM does not levy any submission fee or page charges to any author. We also provide many other author benefits, such as free PDFs, special discounts on Elsevier publications and much more. Please click here for more information on our author services.

Please see our Guide for Authors (https://www.elsevier.com/journals/journal-of-integrative-medicine/2095-4964/guide-for-authors) for information on article submission. If you require any further information or help, please visit our support pages: https://service.elsevier.com.

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