Oral Administration of East Asian Herbal Medicine for Inflammatory Skin Lesions in Plaque Psoriasis: A Systematic Review,Meta-Analysis,and Exploration of Core Herbal Materials

Psoriasis is an inflammatory autoimmune skin disease with various clinical manifestations. The aim of this review was to systematically evaluate the efficacy and safety of oral administration of East Asian herbal medicine (EAHM) for inflammatory skin lesions in psoriasis and to explore core herbal materials for drug discovery. A comprehensive search was conducted in 10 electronic databases for randomized controlled trials from their inception until 29 July 2021. Statistical analysis was performed in R version 4.1.2 and R studio. When heterogeneity in studies was detected, the cause was identified through sensitivity analysis, meta-regression, and subgroup analysis. Methodological quality was independently assessed using the revised tool for risk of bias in randomized trials. A total of 56 trials with 4966 psoriasis patients met the selection criteria. Meta-analysis favored EAHM monotherapy on Psoriasis Area Severity Index (PASI) 70 (RR: 1.2845; 95% CI: 1.906 to 1.3858, p < 0.0001), PASI 60 (RR: 1.1923; 95% CI: 1.1134 to 1.2769, p < 0.0001), continuous PASI score (MD: −2.3386, 95% CI: −3.3068 to −1.3704, p < 0.0001), IL-17, IL-23, TNF-α, and Dermatology Life Quality Index. Patients treated with EAHM monotherapy had significantly reduced adverse events incidence rate. In addition, based on additional examination of the herb data included in this meta-analysis, 16 core materials were identified. They are utilized in close proximity to one another, and all have anti-inflammatory properties. The findings in this study support that oral EAHM monotherapy may be beneficial for inflammatory skin lesions in psoriasis. Meanwhile, the identified core materials are expected to be utilized as useful drug candidate hypotheses through follow-up studies on individual pharmacological activities and synergistic effects.     

Performance Improvement Effect of Asphalt Binder Using Pyrolysis Carbon Black

The generation of waste tires is rapidly increasing. Waste tire pyrolysis is an alternative to waste tire recycling. The main substances extracted in the waste tire pyrolysis method include oil, carbon black, and iron. In this study, carbon black from the pyrolysis of waste tires was used to modify and improve the permanent deformation properties of the asphalt binder, and 0%, 5%, 10%, 15%, and 20% of pyrolysis carbon black by weight were mixed in raw asphalt, which is called AP-3 and AP-5. Laboratory tests, such as the softening point test, flash point test, rotational viscometer test, dynamic shear rheometer test, and bending beam rheometer test, were carried out. The use of pyrolysis carbon black increased the softening point and rotational viscosity at 135 °C. When using 15% PCB for AP-3 and 10% PCB for AP-5, the performance improvement effect of the resistance to permanent deformation was significant. The use of pyrolysis carbon black decreased fatigue at room temperature and improved the resistance of low-temperature cracking up to −12 °C but gave poor results at −18 °C.     

Fabrication of Large-Area Mullite–Cordierite Composite Substrates for Semiconductor Probe Cards and Enhancement of Their Reliability

This work aims to fabricate a large-area ceramic substrate for the application of probe cards. Mullite (M) and cordierite (C), which both have a low thermal expansion coefficient, excellent resistance to thermal shock, and high durability, were selected as starting powders. The mullite–cordierite composites were produced through different composition ratios of starting powders (M:C = 100:0, M:C = 90:10, M:C = 70:30, M:C = 50:50, M:C = 30:70, and M:C = 0:100). The effects of composition ratio and sintering temperature on the density, porosity, thermal expansion coefficient, and flexural strength of the mullite–cordierite composite pellets were investigated. The results showed that the mullite–cordierite composite pellet containing 70 wt% mullite and 30 wt% cordierite sintered at 1350 °C performed exceptionally well. Based on these findings, a large-area mullite–cordierite composite substrate with a diameter of 320 mm for use in semiconductor probe cards was successfully fabricated. Additionally, the changes in sheet resistance and flexural strength were measured to determine the effect of the environmental tests on the large-area substrate such as damp heat and thermal shock. The results indicated that the mullite–cordierite composite substrate was extremely reliable and durable.     

Al2O3-Coated Si-Alloy Prepared by Atomic Layer Deposition as Anodes for Lithium-Ion Batteries

Silicon-based anodes can increase the energy density of Li-ion batteries (LIBs) owing to their large weights and volumetric capacities. However, repeated charging and discharging can rapidly deteriorate the electrochemical properties because of a large volume change in the electrode. In this study, a commercial Fe-Si powder was coated with Al₂O₃ layers of different thicknesses via atomic layer deposition (ALD) to prevent the volume expansion of Si and suppress the formation of crack-induced solid electrolyte interfaces. The Al₂O₃ content was controlled by adjusting the trimethyl aluminum exposure time, and higher Al₂O₃ contents significantly improved the electrochemical properties. In 300 cycles, the capacity retention rate of a pouch full-cell containing the fabricated anodes increased from 69.8% to 72.3% and 79.1% depending on the Al₂O₃ content. The powder characterization and coin and pouch cell cycle evaluation results confirmed the formation of an Al₂O₃ layer on the powder surface. Furthermore, the expansion rate observed during the charging/discharging of the pouch cell indicated that the deposited layer suppressed the powder expansion and improved the cell stability. Thus, the performance of an LIB containing Si-alloy anodes can be improved by coating an ALD-synthesized protective Al₂O₃ layer.     

Initial Abdominal CT and Laboratory Findings Prior to Diagnosis of Crohn’s Disease in Children

PurposeTo identify initial abdominal computed tomography (CT) and laboratory findings prior to a diagnosis of Crohn’s disease (CD) in children.Materials and MethodsIn this retrospective study, patients (≤18 year-old) who were diagnosed with CD from 2004 to 2019 and had abdominal CT just prior to being diagnosed with CD were included in the CD group. Patients (≤18 years old) who were diagnosed with infectious enterocolitis from 2018 to 2019 and had undergone CT prior to being diagnosed with enterocolitis were included as a control group. We assessed the diagnostic performances of initial CT and laboratory findings for the diagnosis of CD using logistic regression and the area under the curve (AUC).ResultsIn total, 107 patients (50 CD patients, 57 control patients) were included, without an age difference between groups (median 13 years old vs. 11 years old, p=0.119). On univariate logistic regression analysis, multisegmental bowel involvement, mesenteric vessel engorgement, higher portal vein/aorta diameter ratio, longer liver longitudinal diameter, lower hemoglobin (≤12.5 g/dL), lower albumin (≤4 g/dL), and higher platelet (>320×10³/µL) levels were significant factors for CD. On multivariate analysis, multisegmental bowel involvement [odds ratio (OR) 111.6, 95% confidence interval (CI) 4.778–2605.925] and lower albumin levels (OR 0.9, 95% CI 0.891–0.993) were significant factors. When these two features were combined, the AUC value was 0.985 with a sensitivity of 96% and specificity of 100% for differentiating CD.ConclusionMultisegmental bowel involvement on CT and decreased albumin levels can help differentiate CD from infectious enterocolitis in children prior to a definite diagnosis of CD.     

Machine Learning Model for Classifying the Results of Fetal Cardiotocography Conducted in High-Risk Pregnancies

PurposeFetal well-being is usually assessed via fetal heart rate (FHR) monitoring during the antepartum period. However, the interpretation of FHR is a complex and subjective process with low reliability. This study developed a machine learning model that can classify fetal cardiotocography results as normal or abnormal.Materials and MethodsIn total, 17492 fetal cardiotocography results were obtained from Ajou University Hospital and 100 fetal cardiotocography results from Czech Technical University and University Hospital in Brno. Board-certified physicians then reviewed the fetal cardiotocography results and labeled 1456 of them as gold-standard; these results were used to train and validate the model. The remaining results were used to validate the clinical effectiveness of the model with the actual outcome.ResultsIn a test dataset, our model achieved an area under the receiver operating characteristic curve (AUROC) of 0.89 and area under the precision-recall curve (AUPRC) of 0.73 in an internal validation dataset. An average AUROC of 0.73 and average AUPRC of 0.40 were achieved in the external validation dataset. Fetus abnormality score, as calculated from the continuous fetal cardiotocography results, was significantly associated with actual clinical outcomes [intrauterine growth restriction: odds ratio, 3.626 (p=0.031); Apgar score 1 min: odds ratio, 9.523 (p<0.001), Apgar score 5 min: odds ratio, 11.49 (p=0.001), and fetal distress: odds ratio, 23.09 (p<0.001)].ConclusionThe machine learning model developed in this study showed precision in classifying FHR signals. This suggests that the model can be applied to medical devices as a screening tool for monitoring fetal status.     

Short-Term Outcomes of the First in Vivo Gene Therapy for RPE65-Mediated Retinitis Pigmentosa

Here, we report early treatment outcomes of gene therapy for early onset retinitis pigmentosa (RP) (Leber congenital amaurosis) associated with biallelic RPE65 mutation in a 30-year-old female patient. Initially, her visual acuity (VA) was 20/200, and her visual field (VF) was severely constricted to the center in the left eye. Her electroretinography showed nearly extinct signals. Full-field stimulus threshold test (FST) revealed diminished dark-adapted light sensitivity. Voretigene neparvovec-rzyl (VN) is the first in vivo viral gene therapy agent to be approved. At 3 months after subretinal injection of VN in the left eye, VA, VF, and FST showed sustained improvement. She did not exhibit any signs of adverse effects from the treatment. Gene therapy for RP proved to be an effective and safe treatment in an advanced case of RPE65-associatied early onset RP.     

Effects of Asthma Medication Type on Asthma Exacerbation in a Real-World Setting

PurposeCurrently, there are multiple options for the pharmacological treatment of asthma. This study aimed to compare the effects of different asthma medications on exacerbation in a real-world setting.Materials and MethodsWe retrospectively reviewed electronic medical records of asthma patients who visited the hospital from November 1, 2016 to October 31, 2019. The number of asthma exacerbations requiring administration of systemic steroids was the primary outcome. A time-varying Cox regression analysis was used to reflect the real-world setting: variable usage times, discontinuation, and switching of medication.ResultsAmong 937 patients with asthma, 228 (24.3%) experienced asthma exacerbation during the study period. Asthma exacerbation was observed in patients using short-acting β₂-agonists (SABA) alone (50.4% vs. 28.6%, p<0.001) as well as in patients not using inhaled corticosteroids (ICS) (58.8% vs. 40.3%, p<0.001), long-acting β₂-agonists (LABA) (54.8% vs. 36.1%, p<0.001), and leukotriene receptor antagonists (71.5% vs. 50.8%, p<0.001). A time-varying Cox regression analysis of asthma exacerbations according to the duration of asthma medication showed that SABA alone increased the risk of asthma exacerbation [hazard ratio (HR), 1.834; 95% confidence interval (CI), 1.299–2.588; p=0.001], whereas ICS-LABA decreased the risk (HR, 0.733; 95% CI, 0.538–0.997; p=0.048). However, in the subgroup analysis according to medication type, specific ingredients showed no significant differences.ConclusionIn the real world, asthma medications affect asthma exacerbation variably according to the medication type.     

Friction Properties of Solid Lubricants with Different Multiwalled Carbon Nanotube Contents

Bushes are circular bearings that surround a shaft and help it rotate smoothly. In heavy equipment, bushes are coated with solid lubricants to reduce friction. Although the coating layer of the lubricant has a stable coefficient of friction (CoF), it is important that this should last for a long time. In this study, multiwalled carbon nanotubes (MWCNTs), which have a low CoF, were added to the lubricant to improve its performance. When 2.3 wt% MWCNTs were added to the polymer resin, the dynamic CoF (under a 29 N external load) decreased by 78% in relation to that of the resin without MWCNTs. As the MWCNT content increased, the roughness of the coating decreased, which reduced the CoF. Moreover, MWCNT addition increased the overall tensile strength owing to an increase in the bonding force between the resins. Under a high load of 20 tonnes (t), the MWCNT-based solid lubricant had a CoF of 0.05, lower than commercial MoS₂-based solid lubricants; this was maintained for more than 10,000 cycles in a bush and shaft test. With the MWCNT-based solid lubricant, a lubricating polymer film formed, even on worn bush surfaces. The CoF of the solid lubricant was reduced and the number of cycles with a constant CoF increased when MWCNTs were added owing to the formation of the lubricating polymer film.