Long COVIDACUCM-LCNCT07285707
Acupuncture and Chinese Herbal Medicine for Long COVID
A study testing Acupuncture in people with Long COVID, run by Southern California University of Health Sciences at 1 site in United States.
Trial summary
List of the Hypothesis: Primary hypothesis: A flexible acupuncture and Chinese herbal medicine protocol will be feasible, acceptable, and useful for the treatment of long COVID. Secondary hypothesis: Long COVID patients receiving acupuncture treatment or acupuncture treatment and Chinese herbal supplements over an… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Long COVID
- What is being tested?
- Acupuncture
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteUnited States
- Study dates
- 10 Sep 2025to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18 years of age or older
- We will include adults of any age in our study. Adults of all ages can experience long COVID symptoms, although it is more common in older adults
- Confirmed and documented COVID-19 illness (confirmed by healthcare provider or test; acceptable documentation includes but is not limited to a doctor's note or a photo of test result)
- COVID-19 illness is a necessary precursor to the development of long COVID
- Experiencing at least one of the following common long COVID symptoms for at least 4 weeks after confirmed COVID-19 illness:
- Fatigue or post-exertional malaise,
Show all 17Show fewer
- Dyspnea, cough,
- Brain fog, sleep disturbance, depression, anxiety,
- Arthralgia, myalgia, or
- Constipation, diarrhea, stomach pain
- Over 200 different long COVID symptoms have been identified. The proposed study is a small pragmatic pilot study which only plans to enroll 10 participants. It is necessary to limit inclusion to some of the most common symptoms to ensure that the findings are broadly relevant across the long COVID patient population.
- The symptoms were not present prior to the confirmed COVID-19 illness
- o If the symptoms were present prior to the confirmed COVID-19 illness, then they are most likely attributable to a cause other than long COVID
- Willingness to comply with the treatment schedule
- o It is important that all those who qualify for the study are willing to comply with the protocol that is being adopted. If the patient is not willing to attend acupuncture treatment sessions or comply with the supplement schedule, then they may not be enrolled in the study.
- Ability to read and understand English o Informed consent will be in the English language. Inability to read and understand English will interfere with provision of informed consent. Moreover, compliance is a potential issue with herbal supplementation. Recruiting patients who are able to read and understand English instructions for supplement intake will help to improve compliance with the protocol.
- Ability to provide informed consent o It is important that participants are aware that they are required to provide written informed consent before they are allowed to participate. Some individuals who are eligible might be unwilling to sign the informed consent form.
Who cannot join
- • Under 18 years of age
- Pulmonary fibrosis or on continuous oxygen treatment
- Certain preexisting conditions:
- Diagnosed with Alzheimer's or demonstrating onset of dementia
- Uncontrolled hypertension, diabetes, or autoimmune conditions
- Other comorbid conditions that might imitate long COVID symptoms
Show all 11Show fewer
- Undergoing cancer treatments
- Use of acupuncture or Chinese medicine in the past three months
- Involved in health-related litigation or legal claims
- Missing either baseline visit and deemed unlikely to comply with the study protocol
- Pregnant or breastfeeding or trying to get pregnant
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
SCUHS
Whittier, California, 90604
About this study
Official title: Acupuncture for Long COVID - A Pragmatic Pilot Study
List of the Hypothesis:
Primary hypothesis: A flexible acupuncture and Chinese herbal medicine protocol will be feasible, acceptable, and useful for the treatment of long COVID.
Read more
Secondary hypothesis: Long COVID patients receiving acupuncture treatment or acupuncture treatment and Chinese herbal supplements over an 8-week period will see improvements in their symptoms, function, and quality of life measurements.
Specific Aims of This Research (Purpose of the study):
To study the feasibility, acceptability and utility of an acupuncture and Chinese herbal supplement treatment protocol for patients with long COVID and preliminarily assess the effects of treatment.
Currently Available Research on This Subject:
Studies indicate that acupuncture can effectively treat symptoms that are similar to those often seen in long COVID patients. Additionally, recent studies and clinical evidence suggest that there is substantial potential for acupuncture in the treatment of long COVID. Acupuncture may be beneficial because it can address many symptoms simultaneously with a single intervention, whereas symptom clusters can be difficult to manage with pharmaceuticals due to the need for multiple pharmaceutical agents.
Summary of the research protocol/methodology:
Five patients will receive acupuncture treatment, and five patients will receive acupuncture and Chinese herbal medicine. Each participant will receive 16 acupuncture treatments over the course of eight weeks (i.e., twice per week). Each treatment session will last for 30 minutes. Follow-up will occur at 12 weeks (i.e., four weeks after the final treatment session).
Significance of this research to the health and welfare of general public:
There is currently not a single, specific treatment for long COVID. If acupuncture treatment alone and/or acupuncture and Chinese herbal medicine combined are feasible, acceptable, and efficacious in the improvement of long COVID symptoms, it will offer patients additional treatment options, which may help some patients to avoid pharmaceutical treatment side effects or polypharmacy challenges.
- Conditions
- Long COVID
- Being tested
- Acupuncture
- Keywords
- long covid, acupuncture for long COVID, Chinese medicine for long COVID, Chinese herbal medicine for long COVID, acupuncture, Chinese herbal medicine
- Medical subject headings
- Post-Acute COVID-19 Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AcupunctureProcedure or surgery
The investigators have developed a list of core acupoints, which will be used by all clinicians for each specific TCM diagnosis pattern identified in each patient. Similarly, a list of common herbal formulas, that we will keep in stock based on the specific diagnosis patterns, has been developed. Clinicians will have the option of using additional acupoints as necessary and will be asked to record and explain any variations from the core protocol.
- Residual Heat: LI-11, KI-6;Bai He Gu Jin Tang
- Residual Phlegm: ST-40, Sp-9;Ban Xia Bai Zhu Tian Ma Tang,Er Chen Tang
- Deficiency of Spleen: SP-3, ST-36;Gui Pi Tang,Xiang Sha Liu Jun Zi Tang
- Lung Qi Deficiency with Dampness: LU-9, LU-7;Zhi Sou San,Er Chen Tang
- Blood Stagnation: SP-10, SP-6;Xue Fu Zhu Yu Tang,Tao Hong Si Wu Tang
- Deficiency of Lung: LU-9, LU-7; Bu Fei Tang
- Liver Qi Stagnation: LV-3, PC-6;Xiao Yao San, Chai Hu Shu Gan Tang
- Yin Deficiency: KI-6, SP-6;Liu Wei Di Huang Wan
- Deficiency of Kidney: KI-3, KI-6;
| Study group | Role | What they receive |
|---|---|---|
| Pragmatic experimental arm | Experimental | Single-arm study looking at feasibility and acceptability of acupuncture treatment for 5 patients and acupuncture and Chinese herbal medicine for 5 patients Receives: Procedure: Acupuncture |
What is being measured
The primary outcome is the main question the study is designed to answer.
Feasibility of Implementing a Combined Acupuncture and Chinese Herbal Medicine Intervention for long COVID
Feasibility will be measured through a feasibility assessment questionnaire which will evaluate recruitment, retention, and adherence metrics across the 12-week intervention and the final follow-up. Feasibility indicators will be summarized as proportions and descriptive statistics to evaluate the practicality of the study procedures and protocol implementation.
Measured: From enrollment to the final follow-up at 12 weeks
Secondary outcomes (13)
Patient-Reported Acceptability of the Study Procedures and Treatments
Acceptability will be evaluated using a participant satisfaction questionnaire administered at the end of the 12-week intervention. The survey includes Likert-scale items (1 = very dissatisfied to 5 = very satisfied) assessing participants' comfort with study procedures, satisfaction with the acupuncture and herbal treatment, and willingness to recommend participation to others. Mean scores will be calculated; higher scores indicate greater acceptability and satisfaction with the study protocol and treatment experience
Measured: Week 12 (final follow-up).
Clinician-Reported Acceptability of the Study Protocol
Clinician acceptability will be measured through a self-administered survey at the end of the 12-week intervention. The survey uses a 5-point Likert scale (1 = very dissatisfied to 5 = very satisfied) to assess satisfaction with the clinical feasibility, workflow, and perceived patient benefit of the combined acupuncture and herbal medicine protocol. Scores will be averaged, and higher scores indicate greater clinician-reported acceptability.
Measured: Week 12 (final follow-up).
Change in Health-Related Quality of Life Measured by PROMIS-29 v2.1
Quality of life will be assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS-29 v2.1) at baseline, mid-intervention, and post-intervention. The PROMIS-29 measures physical function, anxiety, depression, fatigue, sleep disturbance, pain interference, and social participation. Each domain produces a standardized T-score (mean = 50, SD = 10). Higher scores represent better functioning for positive domains and greater symptom burden for negative domains. Changes from baseline to Week 12 will reflect improvements or declines in overall quality of life.
Measured: Baseline, Week 4, Week 8, and Week 12.
Change in Symptom Burden Measured by the Symptom Burden Questionnaire for Long COVID (SBQ™-LC)
Symptom burden will be assessed using the Symptom Burden Questionnaire for Long COVID (SBQ™-LC). At baseline, participants complete all domains; at Weeks 8 and 12, they complete up to four domains corresponding to their most bothersome baseline symptoms, as well as the mandatory Mental Health and Well-Being domain. Each item is rated from 0 (no symptom) to 10 (worst possible symptom). Higher scores indicate greater symptom severity. Domain and total scores will be compared across time points to evaluate changes in symptom burden.
Measured: Baseline, Week 8, and Week 12.
Change in Whole Health Person Index (WHPI)
Overall well-being will be measured using the Whole Health Person Index (WHPI), a 0-100 scale that assesses physical, emotional, and social wellness. Higher scores indicate better overall health and life balance. The change in WHPI from baseline to Week 12 will be used to evaluate perceived improvements in general well-being associated with the intervention.
Measured: Baseline, Week 8, and Week 12.
Change in Laboratory Biomarkers - Complete blood count
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Test includes complete blood count (CBC) with differential. Changes in this marker will indicate biological trends in inflammation.
Measured: Baseline and Week 8.
Incidence and Severity of Adverse Events Associated with Acupuncture and Herbal Medicine
Safety will be monitored throughout the 12-week study by documenting adverse events (AEs) and serious adverse events (SAEs) related to acupuncture or herbal supplementation. Each event will be recorded in Qualtrics using the Adverse Event Form and graded as mild, moderate, or severe per Institutional Review Board (IRB) and Common Terminology Criteria for Adverse Events (CTCAE v5.0) guidelines. Frequency and type of AEs will be summarized descriptively as counts and percentages.
Measured: Throughout the 12-week study period
Change in Laboratory Biomarkers - Comprehensive metabolic panel
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Test includes complete comprehensive metabolic panel (CMP). Changes in this marker will indicate biological trends in inflammation and metabolic function.
Measured: Baseline and Week 8.
Change in Laboratory Biomarkers - C-reactive protein
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Test includes C-reactive protein (CRP). Changes in this marker will indicate biological trends in inflammation.
Measured: Baseline and Week 8.
Change in Laboratory Biomarkers - Erythrocyte sedimentation rate
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Test includes erythrocyte sedimentation rate (ESR). Changes in this marker will indicate biological trends in inflammation.
Measured: Baseline and Week 8.
Change in Laboratory Biomarkers - Tumor necrosis factor-alpha
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Test includes tumor necrosis factor-alpha. Changes in this marker will indicate biological trends in inflammation and metabolic function.
Measured: Baseline and Week 8.
Change in Laboratory Biomarkers - thyroid panel
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Test includes thyroid panel. Changes in this marker will indicate biological trends in metabolic function.
Measured: Baseline and Week 8.
Change in Laboratory Biomarkers - Vitamin D levels.
Laboratory values will be compared from baseline to Week 8 to assess physiological effects of the intervention. Tests include vitamin D levels. Changes in these markers will indicate biological trends in inflammation and metabolic function.
Measured: Baseline and Week 8.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Dec 2025
- Study start10 Sep 2025
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Long COVIDStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 10 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Southern California University of Health Sciences
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07285707
- Sponsor's protocol ID
- VINJ011
- Other IDs
- VINJ011
- Acronym
- ACUCM-LC
- Status last verified
- Dec 2025
- First submitted
- 1 Nov 2025
- Last updated
- 16 Dec 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Acupuncture for Long COVID - A Pragmatic Pilot Study
- ClinicalTrials.gov ID
- NCT07285707
- Acronym / sponsor ID
- ACUCM-LC / VINJ011
- Conditions
- Long COVID
- Keywords
- long covid, acupuncture for long COVID, Chinese medicine for long COVID, Chinese herbal medicine for long COVID, acupuncture, Chinese herbal medicine
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 10 participants (estimated)
- Lead sponsor
- Southern California University of Health SciencesUniversity, hospital or other
- Study start
- 10 Sep 2025 (actual)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 16 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
List of the Hypothesis:
Primary hypothesis: A flexible acupuncture and Chinese herbal medicine protocol will be feasible, acceptable, and useful for the treatment of long COVID.
Secondary hypothesis: Long COVID patients receiving acupuncture treatment or acupuncture treatment and Chinese herbal supplements over an 8-week period will see improvements in their symptoms, function, and quality of life measurements.
Specific Aims of This Research (Purpose of the study):
To study the feasibility, acceptability and utility of an acupuncture and Chinese herbal supplement treatment protocol for patients with long COVID and preliminarily assess the effects of treatment.
Currently Available Research on This Subject:
Studies indicate that acupuncture can effectively treat symptoms that are similar to those often seen in long COVID patients. Additionally, recent studies and clinical evidence suggest that there is substantial potential for acupuncture in the treatment of long COVID. Acupuncture may be beneficial because it can address many symptoms simultaneously with a single intervention, whereas symptom clusters can be difficult to manage with pharmaceuticals due to the need for multiple pharmaceutical agents.
Summary of the research protocol/methodology:
Five patients will receive acupuncture treatment, and five patients will receive acupuncture and Chinese herbal medicine. Each participant will receive 16 acupuncture treatments over the course of eight weeks (i.e., twice per week). Each treatment session will last for 30 minutes. Follow-up will occur at 12 weeks (i.e., four weeks after the final treatment session).
Significance of this research to the health and welfare of general public:
There is currently not a single, specific treatment for long COVID. If acupuncture treatment alone and/or acupuncture and Chinese herbal medicine combined are feasible, acceptable, and efficacious in the improvement of long COVID symptoms, it will offer patients additional treatment options, which may help some patients to avoid pharmaceutical treatment side effects or polypharmacy challenges.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Pragmatic experimental arm | Experimental | Procedure: AcupunctureSingle-arm study looking at feasibility and acceptability of acupuncture treatment for 5 patients and acupuncture and Chinese herbal medicine for 5 patients |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (17 listed)
- 18 years of age or older
- Over 200 different long COVID symptoms have been identified. The proposed study is a small pragmatic pilot study which only plans to enroll 10 participants. It is necessary to limit inclusion to some of the most common symptoms to ensure that the findings are broadly relevant across the long COVID patient population.
- o If the symptoms were present prior to the confirmed COVID-19 illness, then they are most likely attributable to a cause other than long COVID
- o It is important that all those who qualify for the study are willing to comply with the protocol that is being adopted. If the patient is not willing to attend acupuncture treatment sessions or comply with the supplement schedule, then they may not be enrolled in the study.
Key exclusion criteria (11 listed)
- • Under 18 years of age
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AcupunctureThe investigators have developed a list of core acupoints, which will be used by all clinicians for each specific TCM diagnosis pattern identified in each patient. Similarly, a list of common herbal formulas, that we will keep in stock based on the specific diagnosis patterns, has been developed. Clinicians will have the option of using additional acupoints as necessary and will be asked to record and explain any variations from the core protocol. 1. Residual Heat: LI-11, KI-6;Bai He Gu Jin Tang 2. Residual Phlegm: ST-40, Sp-9;Ban Xia Bai Zhu Tian Ma Tang,Er Chen Tang 3. Deficiency of Spleen: SP-3, ST-36;Gui Pi Tang,Xiang Sha Liu Jun Zi Tang 4. Lung Qi Deficiency with Dampness: LU-9, LU-7;Zhi Sou San,Er Chen Tang 5. Blood Stagnation: SP-10, SP-6;Xue Fu Zhu Yu Tang,Tao Hong Si Wu Tang 6. Deficiency of Lung: LU-9, LU-7; Bu Fei Tang 7. Liver Qi Stagnation: LV-3, PC-6;Xiao Yao San, Chai Hu Shu Gan Tang 8. Yin Deficiency: KI-6, SP-6;Liu Wei Di Huang Wan 9. Deficiency of Kidney: KI-3, KI-6; | Procedure or surgery | Pragmatic experimental arm |
Primary outcome
Feasibility of Implementing a Combined Acupuncture and Chinese Herbal Medicine Intervention for long COVID
Time frame: From enrollment to the final follow-up at 12 weeks
Feasibility will be measured through a feasibility assessment questionnaire which will evaluate recruitment, retention, and adherence metrics across the 12-week intervention and the final follow-up. Feasibility indicators will be summarized as proportions and descriptive statistics to evaluate the practicality of the study procedures and protocol implementation.
13 secondary outcomes
Patient-Reported Acceptability of the Study Procedures and Treatments
Time frame: Week 12 (final follow-up).
Clinician-Reported Acceptability of the Study Protocol
Time frame: Week 12 (final follow-up).
Change in Health-Related Quality of Life Measured by PROMIS-29 v2.1
Time frame: Baseline, Week 4, Week 8, and Week 12.
Change in Symptom Burden Measured by the Symptom Burden Questionnaire for Long COVID (SBQ™-LC)
Time frame: Baseline, Week 8, and Week 12.
Change in Whole Health Person Index (WHPI)
Time frame: Baseline, Week 8, and Week 12.
Change in Laboratory Biomarkers - Complete blood count
Time frame: Baseline and Week 8.
Incidence and Severity of Adverse Events Associated with Acupuncture and Herbal Medicine
Time frame: Throughout the 12-week study period
Change in Laboratory Biomarkers - Comprehensive metabolic panel
Time frame: Baseline and Week 8.
Change in Laboratory Biomarkers - C-reactive protein
Time frame: Baseline and Week 8.
Change in Laboratory Biomarkers - Erythrocyte sedimentation rate
Time frame: Baseline and Week 8.
Change in Laboratory Biomarkers - Tumor necrosis factor-alpha
Time frame: Baseline and Week 8.
Change in Laboratory Biomarkers - thyroid panel
Time frame: Baseline and Week 8.
Change in Laboratory Biomarkers - Vitamin D levels.
Time frame: Baseline and Week 8.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Dec 2025.
- Individual participant dataSharing planned: No
Related trials for Long COVID
Not yet recruitingPhase 1
Phase I Open-Label Safety Trial of Pembrolizumab for Neurological Post- Acute Sequelae of SARS-CoV-2 (PD1-PASC I)
Post-Acute COVID-19 Syndrome
Recruiting
Whole-body Cryotherapy in Those With Chronic Fatigue: A Feasibility Study
ME/CFS, Fibromyalgia (FM)
Not yet recruitingPhase 3
The Study of Brave-LC LDN Treatment Trial
Post-acute COVID-19 Syndrome
Active, not recruitingObservational study
Epigenetic Changes in Long COVID Patients
Long COVID-19 Syndrome, Long COVID Symptoms
Enrolling by invitationPhase 2
Immunotherapy for Neurological Post-Acute Sequelae of SARS-CoV-2
Systemic Inflammation, Neuroinflammation
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Acupuncture in people with Long COVID, run by Southern California University of Health Sciences at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 17 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 16 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact S. Prasad Vinjamury, MD (Ayurveda) DACM, MPH (562-947-8755 ext. ext:736, prasad@scuhs.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Feasibility of Implementing a Combined Acupuncture and Chinese Herbal Medicine Intervention for long COVID (time frame: From enrollment to the final follow-up at 12 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Dec 2025.