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What is Sjögren’s syndrome and how can TCM help?

15 Feb 2024

By: Lee Hui Min

Blog, Acupuncture, Article, Autoimmune Disease, Fertility, Physician Lee 李医师, TCM Herbs

What is Sjögren's syndrome? Sjögren’s syndrome is a chronic autoimmune disorder characterized by inflammation that primarily affects the glands responsible for producing tears and saliva. This inflammation leads to the hallmark symptoms of the condition, which include dry eyes and dry mouth. However, Sjögren’s syndrome can also affect other parts of the body, leading to a variety of symptoms beyond dryness, such as joint pain, fatigue, and organ involvement.The exact cause of Sjögren’s syndrome is not fully understood, but it is believed to involve a combination of genetic, environmental, and hormonal factors. The immune system mistakenly attacks the body’s own moisture-producing glands, leading to their dysfunction and the resulting dryness. How is Sjögren’s syndrome diagnosed and treated? Diagnosis of Sjögren’s syndrome involves a combination of medical history, physical examination, and various tests, including blood tests, eye tests, and salivary gland tests. While there is no cure for Sjögren’s syndrome, treatment focuses on managing symptoms and preventing complications. This may involve the use of artificial tears and saliva substitutes to alleviate dryness, as well as medications to reduce inflammation and manage other symptoms. It’s important to note that diagnosis of Sjögren’s syndrome can be challenging due to its varied symptoms and overlap with other autoimmune conditions. A comprehensive evaluation by healthcare professionals familiar with the condition is essential for an accurate diagnosis. Treatment for Sjögren’s syndrome focuses on managing symptoms, preventing complications, and improving quality of life. Since Sjögren’s syndrome is a chronic autoimmune disorder, there is currently no cure, but various treatment options are available to alleviate symptoms. Treatment plans are often individualized based on the specific symptoms and needs of each patient. Some common approaches to managing Sjögren’s syndrome includes the use of Artificial Tears and Eye Lubricants, Saliva Substitutes and Prescription Medications It’s essential for individuals with Sjögren’s syndrome to work closely with healthcare providers, including rheumatologists, ophthalmologists, dentists, and other specialists, to develop a comprehensive treatment plan tailored to their needs. Additionally, lifestyle modifications such as staying hydrated, avoiding irritants, and protecting the eyes from dry environments can help manage symptoms and improve quality of life. How can TCM help with the management of Sjögren’s syndrome? Traditional Chinese Medicine (TCM) offers a unique perspective on health and illness, including autoimmune conditions like Sjögren’s syndrome. In TCM theory, Sjögren’s syndrome would likely be viewed as a manifestation of underlying imbalances in the body’s Qi (vital energy), Yin and Yang energies, and organ systems. Here’s a brief overview of how TCM might approach Sjögren’s syndrome:Imbalance of Yin and Yang: TCM considers health to be a state of balance between Yin and Yang energies. Sjögren’s syndrome, with its symptoms of dryness, might be seen as an excess of Yang energy leading to the depletion of Yin fluids in the body. Treatment would focus on nourishing Yin to restore balance.Deficiency of Body Fluids: Dryness is a key characteristic of Sjögren’s syndrome, indicating a deficiency of body fluids. TCM views body fluids as essential for maintaining health and lubricating the body’s tissues. Treatment would aim to tonify the body’s Yin and fluids through herbal medicine, acupuncture, and dietary modifications.Kidney and Liver Imbalances: In TCM, the Kidney and Liver organ systems are often implicated in conditions involving dryness and autoimmune disorders. Kidney Yin deficiency and Liver Qi stagnation are common patterns seen in Sjögren’s syndrome. Treatment would involve nourishing Kidney Yin and regulating Liver Qi circulation to address these imbalances.Heat and Inflammation: TCM recognizes the presence of heat and inflammation in autoimmune conditions. Sjögren’s syndrome may be associated with internal heat patterns, which can exacerbate dryness and inflammation. Herbal formulas and acupuncture points aimed at clearing heat and dampness may be used to alleviate symptoms.Acupuncture and Herbal Medicine: Acupuncture and herbal medicine are integral components of TCM treatment. Acupuncture can help regulate the flow of Qi and nourish Yin, while specific herbal formulas may be prescribed to address underlying imbalances and alleviate symptoms associated with Sjögren’s syndrome.Dietary Recommendations: TCM emphasizes the importance of diet in maintaining health and treating illness. Foods that nourish Yin and fluids, such as soups, stews, and hydrating fruits and vegetables, may be recommended. Avoiding spicy, heating foods and excessive caffeine intake, which can exacerbate dryness and inflammation, may also be advised.It’s important to note that TCM treatment is highly individualized, and practitioners would assess each patient’s unique pattern of disharmony before prescribing specific treatments. Additionally, TCM is often used as complementary therapy alongside conventional medical treatments for conditions like Sjögren’s syndrome. Patients interested in exploring TCM should consult with a qualified TCM practitioner for a personalized assessment and treatment plan.
What is an Auto Immune Thyroid Disease (AITD) and how can TCM help?

15 Feb 2024

By: Lee Hui Min

Blog, Acupuncture, Article, Autoimmune Disease, Fertility, Physician Lee 李医师, TCM Herbs

What is an Auto Immune Thyroid Disease (AITD)? Autoimmune thyroid disease, also known as autoimmune thyroiditis or autoimmune thyroid disorder, refers to a group of conditions in which the immune system mistakenly attacks the thyroid gland, leading to inflammation and potentially affecting its function. The two main types of autoimmune thyroid disease are:Hashimoto’s thyroiditis: This is the most common form of autoimmune thyroid disease. In Hashimoto’s thyroiditis, the immune system produces antibodies that attack the thyroid gland, leading to chronic inflammation and eventual destruction of thyroid tissue. As a result, the thyroid gland becomes unable to produce enough thyroid hormones, leading to hypothyroidism (underactive thyroid).Graves’ disease: In Graves’ disease, the immune system produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormones. This leads to hyperthyroidism (overactive thyroid) and can cause symptoms such as weight loss, rapid heartbeat, tremors, and anxiety.Autoimmune thyroid disease can have various symptoms depending on whether it causes hypothyroidism or hyperthyroidism. Treatment typically involves managing the symptoms and may include medications to regulate thyroid hormone levels, such as thyroid hormone replacement therapy for hypothyroidism or medications to reduce thyroid hormone production for hyperthyroidism. In some cases, surgery or radioactive iodine therapy may be recommended to treat severe cases of hyperthyroidism. AITD and Fertility Autoimmune thyroid disease, particularly when it leads to thyroid dysfunction such as hypothyroidism or hyperthyroidism, can potentially affect fertility in both men and women. In women, hypothyroidism or hyperthyroidism can disrupt ovulation and menstrual cycles, leading to irregular or absent periods (amenorrhea) and thus affecting fertility. Thyroid hormones play a crucial role in regulating the menstrual cycle, and low levels or high levels of thyroid hormones can interfere with normal ovulation. In men, hypothyroidism and hyperthyroidism can affect sperm production and quality, leading to reduced fertility. Autoimmune thyroid disease itself, regardless of thyroid hormone levels, has been associated with an increased risk of fertility issues. Autoimmune disorders can cause inflammation and immune system dysfunction, which may affect reproductive organs and processes. How is AITD managed? Autoimmune thyroid disease, such as Hashimoto’s thyroiditis and Graves’ disease, is typically managed through a combination of western medication, lifestyle modifications, and, in some cases, surgical interventions or radioactive iodine therapy. Treatment aims to alleviate symptoms, regulate thyroid hormone levels, and minimize autoimmune-related inflammation. The specific approach to treatment depends on the type and severity of the autoimmune thyroid disease. A balanced diet rich in nutrients, including iodine and selenium, is important for thyroid health. Some individuals with autoimmune thyroid disease may benefit from dietary modifications, such as avoiding excessive iodine intake or following a gluten-free diet if they have coexisting autoimmune conditions like celiac disease. Regular exercise and stress management techniques can help support overall health and may positively impact thyroid function. Individuals with autoimmune thyroid disease require regular monitoring of thyroid hormone levels and thyroid antibodies to assess treatment response and adjust medication dosages as needed. Follow-up appointments with healthcare providers, including endocrinologists, are essential for ongoing management and optimization of treatment strategies. What is TCM perspective on AITD? Traditional Chinese Medicine (TCM) offers a unique perspective on autoimmune thyroid disease, viewing it as a manifestation of imbalances within the body’s energy systems rather than solely as a malfunction of the thyroid gland itself. In TCM theory, autoimmune thyroid disease is often associated with patterns of disharmony involving multiple organ systems and energetic imbalances. Here are some key aspects of the TCM perspective on autoimmune thyroid disease:Energetic Imbalances: TCM views autoimmune thyroid disease as a result of disruptions in the flow of Qi (vital energy) and Blood, as well as imbalances between Yin and Yang energies within the body. These imbalances can affect the proper functioning of the thyroid gland and contribute to the development of autoimmune conditions.Organ Systems Involved: According to TCM, the health of the thyroid gland is closely connected to the functioning of other organ systems, including the Spleen, Kidney, Liver, and Heart. Imbalances in these organ systems can contribute to the development or exacerbation of autoimmune thyroid disease.Patterns of Disharmony: TCM practitioners diagnose autoimmune thyroid disease based on patterns of disharmony, which may include:Spleen Qi Deficiency: Weakness or dysfunction of the Spleen, which may lead to poor digestion, fatigue, and accumulation of Dampness in the body.Kidney Yin Deficiency: Insufficiency of Kidney Yin, which may manifest as heat symptoms, night sweats, and dryness in the body.Liver Qi Stagnation: Impaired flow of Liver Qi, which can result in emotional imbalances, stress, and stagnant energy in the body.Heart and Kidney Yang Deficiency: Weakness or depletion of Heart and Kidney Yang energies, leading to cold intolerance, fatigue, and fluid retention. How can TCM help manage AITD? The management of autoimmune thyroid disease through TCM aims to rebalance the body’s energies and address the underlying patterns of disharmony. Treatment modalities may include:Acupuncture: Acupuncture points are selected to stimulate Qi flow and promote balance within the body’s energy systems.Herbal Medicine: Chinese herbal formulas are prescribed to tonify deficient energies, clear heat, resolve stagnation, and harmonize Yin and Yang.Dietary Therapy: Recommendations for dietary modifications may be provided to support digestion, nourish Yin, and avoid foods that exacerbate Dampness or heat.Lifestyle Recommendations: TCM often emphasizes lifestyle factors such as stress management, adequate rest, and regular exercise to support overall health and balance.Individualized Treatment: TCM treatment is highly individualized, with practitioners tailoring therapy to address each patient’s unique pattern of disharmony and constitution. Conclusion It’s important to note that while TCM can offer complementary approaches to managing autoimmune thyroid disease, it should not replace conventional medical care. Individuals with autoimmune thyroid disease should work with qualified healthcare providers, including TCM practitioners and conventional medical doctors, to develop comprehensive treatment plans that address their specific needs.
Unexplained Infertility and TCM

15 Feb 2024

By: Lee Hui Min

Blog, Acupuncture, Article, Fertility, Physician Lee 李医师, TCM Herbs

What is unexplained infertility? Unexplained infertility is a diagnosis given to couples who have been trying to conceive for at least 12 months without success and where no specific cause for their infertility can be identified after a thorough medical evaluation. In other words, it is a situation where a couple is unable to conceive despite having regular unprotected sex and no medical problems have been identified that could explain why they are not able to conceive. Unexplained infertility is a relatively common diagnosis, accounting for approximately 10-30% of all infertility cases. It is more common in women over the age of 35 and in couples who have been trying to conceive for longer than 12 months. The exact cause of unexplained infertility is not fully understood, and it is considered a diagnosis of exclusion, meaning that no identifiable cause of infertility has been found after a thorough evaluation. Despite the absence of a clear explanation for why a couple is unable to conceive, several factors may contribute to unexplained infertility, including:Abnormalities in sperm function or qualityOvulatory dysfunction, including irregular or absent ovulationFallopian tube dysfunction or blockagesEndometriosis or other reproductive disordersHormonal imbalances that affect fertilityImmune system issues that may impact fertilityLifestyle factors such as smoking, alcohol consumption, or obesityIt is believed that a combination of these factors may play a role in unexplained infertility, but further research is needed to better understand the condition. What are the treatment options for unexplained infertility? Unexplained infertility can be a frustrating diagnosis, but there are several treatment options that may help couples conceive. Treatment for unexplained infertility will depend on various factors such as the couple’s age, duration of infertility, and any additional medical conditions that may be present. Here are some of the treatment options: Fertility drugs: These medications are used to stimulate ovulation in women and increase the chances of conception. They work by regulating hormones that are involved in the menstrual cycle and can help to increase the number of eggs that are released each month. Intrauterine insemination (IUI): This involves placing washed sperm directly into the uterus during the woman’s ovulation cycle, increasing the chances of fertilization. In vitro fertilization (IVF): This is a process where the woman’s eggs are fertilized with sperm outside the body and the resulting embryos are then transferred to the woman’s uterus. Intracytoplasmic sperm injection (ICSI): This is a procedure that involves injecting a single sperm into an egg to facilitate fertilization, which is often used in conjunction with IVF. Surgery: In some cases, surgery may be necessary to correct anatomical issues such as blocked fallopian tubes or endometriosis. Lifestyle changes: Some lifestyle changes such as maintaining a healthy weight, quitting smoking, reducing alcohol and caffeine intake, and managing stress may also help to increase fertility. How does TCM view unexplained infertility? Traditional Chinese Medicine (TCM) has been used for centuries to promote fertility and improve reproductive health. TCM may be a helpful option for couples with unexplained infertility, as it can help address underlying imbalances in the body that may be contributing to infertility. Traditional Chinese Medicine (TCM) views unexplained infertility through the lens of imbalance within the body’s systems, particularly the reproductive system and related meridians (energy pathways). In TCM, infertility is often seen as a manifestation of underlying disharmonies rather than a specific diagnosis. Here are some key perspectives from TCM on unexplained infertility:Qi and Blood Stagnation: TCM believes that the smooth flow of Qi (vital energy) and Blood throughout the body is essential for optimal health, including fertility. Qi and Blood stagnation, which can be caused by factors like stress, emotional disturbances, or lifestyle habits, may obstruct the flow of energy and nutrients to the reproductive organs, leading to infertility.Kidney Deficiency: In TCM, the Kidneys play a vital role in reproduction and are often considered the foundation of reproductive health. Kidney Deficiency, whether in terms of Yin, Yang, or Jing (essence), can contribute to infertility by affecting hormone balance, ovulation, and overall reproductive function.Liver Qi Stagnation: The Liver is responsible for the smooth flow of Qi throughout the body. When Liver Qi becomes stagnant due to factors like stress, emotional issues, or poor diet, it can lead to disruptions in the menstrual cycle, ovulation, and overall reproductive function.Spleen and Stomach Imbalances: The Spleen and Stomach in TCM are responsible for the transformation and transportation of nutrients and fluids in the body. Imbalances in these organs, such as Spleen Qi Deficiency or Dampness, can affect the body’s ability to nourish the reproductive organs and support a healthy menstrual cycle.Blood Deficiency or Stasis: In TCM, Blood is considered a vital substance that nourishes the body, including the reproductive organs. Blood Deficiency or Stasis, which can result from factors like poor diet, excessive menstrual bleeding, or emotional stress, may impair the quality of the endometrial lining or disrupt the menstrual cycle, leading to infertility.Emotional Factors: TCM recognizes the influence of emotions on overall health, including fertility. Emotional imbalances such as stress, anxiety, or unresolved emotions can affect the flow of Qi and Blood in the body, contributing to infertility. What can TCM do for unexplained infertility? TCM management of unexplained infertility typically involve a combination of acupuncture, herbal medicine, dietary therapy, lifestyle modifications, and stress reduction techniques to address the underlying imbalances and promote overall health and well-being. By restoring balance within the body, TCM aims to support natural fertility and improve the chances of conception. However, it’s important to consult with a qualified TCM practitioner for personalized diagnosis and treatment recommendations.Numerous research studies indicate that Traditional Chinese Medicine (TCM) can be a promising option for treating unexplained infertility, whether used on its own or in conjunction with Western medical approaches like IVF. However, further investigation is necessary to gain a deeper understanding of this matter.Acupuncture, in particular, has been found to be effective in treating infertility by regulating the menstrual cycle, improving blood flow to the reproductive organs, and reducing stress and anxiety. Several studies have suggested that acupuncture may increase the success rates of IVF and IUI in women with unexplained infertility. A meta-analysis published in 2018 found that acupuncture improved pregnancy rates and live birth rates in women with unexplained infertility who underwent in vitro fertilization (IVF) compared to control groups who did not receive acupuncture.Herbal medicine may also be prescribed by a TCM practitioner to address underlying imbalances that may be contributing to infertility. These herbal formulas are tailored to the individual’s specific pattern of symptoms and may include herbs that help to regulate the menstrual cycle, improve ovarian function, and support the health of the reproductive organs. Another meta-analysis published in 2017 found that herbal medicine was associated with a significant increase in pregnancy rates and live birth rates in couples with unexplained infertility compared to control groups who received either no treatment or placebo.Dietary therapy and lifestyle modifications, such as stress reduction techniques and exercise, may also be recommended by a TCM practitioner to support fertility.The best course of action for unexplained infertility will depend on several factors, including the age and overall health of the couple, as well as their personal preferences and financial resources. Couples with unexplained infertility should consult with a healthcare provider to determine the best course of treatment for their individual needs. References Qian, Y., Xia, X., & Cui, Y. (2018). Acupuncture for uterine fibroids. Cochrane Database of Systematic Reviews, (8). https://doi.org/10.1002/14651858.CD007221.pub4Ried, K., Stuart, K., & Travaglia, J. (2017). Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: A systematic review. Complementary Therapies in Medicine, 34, 137-142. https://doi.org/10.1016/j.ctim.2017.07.008
The Integrative Approach of Traditional Chinese Medicine (TCM) and Reproductive Technology (i.e. IUI and IVF)

22 Jan 2024

By: Kang Ting Tan

Article, Acupuncture, Blog, Fertility, IVF, Physician KT 陈医师

Infertility, characterized by the inability to conceive after a year of active attempts, affects both men and women alike. Assisted Reproductive Technology (ART), such as Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF), becomes a viable option when conventional methods fall short. However, the challenges of these fertility treatments, marked by stress and expenses, create high expectations for success. IUI is a fertility treatment involving placing sperm inside a woman’s uterus through a catheter by a gynaecologist to facilitate fertilisation. The goal is to improve the chances of fertilization by increasing the number of sperms (by giving them a “shortcut”) that reach the fallopian tubes during ovulation and thus increase the chances of pregnancy. IVF refers to the fertilisation of an egg outside the body. During IVF, mature eggs are retrieved from ovaries and combined with sperm in the laboratory to achieve fertilisation. Then, the fertilised egg(s)/embryo(s) are transferred to a uterus.  Both are commonly used to improve the chances of pregnancy. Contrary to common belief, TCM, particularly acupuncture, proves to be a synergistic partner with modern medicine, enhancing the body’s condition and augmenting the success rates of IUI and IVF. Let’s understand conception first “Seed  and Soil” Analogy (种子论) Conception is like gardening and there are 3 basic requirements for fertilization to take place. Fertile, nutritious Soil  肥沃的土地–having a healthy developed uterus and endometrium lining and no “weeds” like cysts, endometriosis or fibroids that can affect implantation and growth  Seeds of life 种(zhong3)子 ( *种子必先育卵*) – Healthy egg and the sperm are crucial components for successful fertilization Time is key 对的时间点– Sperm and egg need to meet at the correct time and location, i.e. during ovulation (usually day 12-16 of the period cycle)  Age and its Impact on Fertility: For decades, the average marriage age has been in the 20s. However, getting married in the 30s may just be the new normal. Getting married later in life is a modern trend and hence affects reproductive and fertility status.  The optimal age for childbearing is between 20 and 35. The proportion of women aged 35 years and above who are intentionally delaying pregnancies has been rising in the past few years. Delayed pregnancies lead to an increased chance of infertility. Ovarian Reserve and Ageing: TCM acknowledges the natural reduction in ovarian reserve with age, emphasizing the correlation between age and declining fertility. Women are born with a fixed number of oocytes (eggs) inside their ovaries. 1 Age No of Eggs Puberty 300,000-500,000 20-30 100,000-300,000 30-40 10,000-50,000 40-50 1,000-10,000 50 (Menopause) 1000+ Ageing naturally reduces a woman’s ovarian reserve. The quantity and quality of a woman’s ovarian reserve declines with age. At the start of puberty, there can be 300,000- 500,000 eggs and it reduces to about 25,000 at around the age of 37. Male Infertility and Its Causes: On the other hand, male infertility is responsible for up to 30% of infertility. It can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm.  Sperm quality: low sperm count, poor sperm mobility, abnormally shaped sperm or no sperm present.  Varicoceles (enlarged veins in the scrotum) can negatively impacts testicular sperm production Obstruction of the vas deferens or epididymis (the tubes that carry sperm). Blockages can be a result of infection such as traumatic injury or gonorrhoea. Enhancing sperm count and quality involves adopting positive lifestyle changes. Consider the following measures: Stop smoking  Tobacco smoke contains more than 4000 kinds of chemicals, including nicotine, tar, carbon monoxide, polycyclic aromatic hydrocarbons and heavy metals. Smoking is associated with dysfunction of spermatogenesis and impaired spermatozoa function2, leading to reduced semen quality including semen volume, sperm mobility, sperm density and normal morphology.  Stop habitual heavy alcohol consumption  Alcohol can affect sperm mobility and alter sperm count, shape and mobility. In men, heavy drinking can lower testosterone, follicle stimulating hormone, and luteinizing hormone levels  and increase estrogen levels3. These hormone changes can reduce sperm production and development.  Have a  healthy diet rich in fruits, vegetables and whole grains.   Do not be a picky eater. You may be lacking zinc, Vitamin B, C or E. Zinc deficiency impedes spermatogenesis and causes sperm abnormalities4. Zinc cannot be stored in the body and hence regular dietary intake is essential. Vitamin C And E are essential antioxidants that protect the cells from damage from oxidative stress and free radicals.  Avoid excessive heat The normal physiological temperature of the human testis ranges between 32 and 35 °C. It is cooler than the core body temperature of 36.9°C. This is essential for optimal sperm production, maturity and function5. Hence, it is important to avoid potential heat exposure to the testicles such as prolonged hot baths, laptop, high-temperature work area and prolonged sitting. Avoid wearing tight pants too as it can affect the blood circulation to the testes.  Reasons for Choosing IUI and IVF: We recognize the various reasons (listed below), including cervical mucus conditions, ovulation disorders, and unexplained infertility, leading couples to opt for ART. Unexplained infertility Hostile cervical mucus condition Ovulation disorder Fallopian tube blockage or damage Impaired sperm production or function (poor sperm motility, count or quality) Ejaculation dysfunction Acupuncture’s Role in Enhancing IUI and IVF Success: Accepted Treatment for IUI and IVF: Acupuncture’s compatibility with Western medicine makes it a widely accepted form of treatment for ART. Optimizing the Body with Acupuncture: TCM’s acupuncture sessions, especially when initiated three months before IUI/IVF treatments, are highlighted for their role in conditioning the body for optimal success. This is especially so for those who have low ovarian reserve or poor egg quality.  Improving Sperm Quality: Acupuncture’s positive impact on reducing structural defects in sperm and enhancing quality, mobility, and concentration of sperm with normal morphology is emphasized6,7. As couples navigate the intricate journey of fertility treatments, the harmonious integration of Traditional Chinese Medicine, notably acupuncture, with modern reproductive technology emerges as a holistic and powerful strategy. This comprehensive approach not only enhances physical well-being but also addresses the emotional toll, providing a personalized path to fertility success. Embracing TCM alongside conventional treatments presents a well-rounded and supportive framework for individuals seeking to maximize their chances of conception. References: https://www.healthline.com/health/womens-health/how-many-eggs-does-a-woman-have#eggs-at-puberty https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814952/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761906/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/ https://www.clevelandclinic.org/reproductiveresearchcenter/docs/publications/93_Durairajanayagam_et_al_Heat_Stress.pdf https://www.webmd.com/infertility-and-reproduction/news/20050803/acupuncture-may-improve-sperm-quality https://www.sciencedirect.com/science/article/pii/S2305050015000226