Recent evidence has suggested that in Japan, professionals and managers have a higher risk of poor health than other workers , and this effect may be stronger among women than men. Low organizational justice, which is known to be a potential risk factor for poor health among employees, may explain the gender-specific association.We examined the associations between perceived organizational justice and psychological distress and stress-related behaviors (smoking and heavy drinking) in 2,216 female and 7,557 male employees aged 18 to 69 years from the Japanese Study of Health, Occupation, and Psychosocial Factors Related Equity. We measured both procedural and interactional justice, and compared managers and professionals with other employees.After adjusting for demographic characteristics and occupational stress, low levels of perceived procedural and interactional justice were found to be associated with a high prevalence of psychological distress for both women and men, regardless of occupational status. Among female managers and professionals, perceived interactional justice  was significantly associated with smoking, whereas no such association was observed among other workers. When interactional justice was perceived to be low, the prevalence of smoking was 6.5 percentage points higher among managers and professionals than among others. Neither procedural nor interactional justice was associated with risk of heavy drinking.Female managers and professionals in a workplace with unsupportive supervisors may be more likely to engage in unhealthy coping behaviors to manage their stress. Creating supportive workplaces may be beneficial in increasing workers’ health, especially for female managers and professionals. Mental illness and psychological distress are key topics in industrial health. Research suggests that psychological distress attributable to job strain and effort-reward imbalances increases the worker’s risk of cardiovascular disease and psychological disorders ,2. In JaAmong the workplace environmental factors, organizational justice has been actively studied as a determinant of health and of health inequality among workers, and we consider that to be an important factor explaining the potential gender gap in workplace psychosocial conditions . OrganizRecent studies also suggest differing strengths of association between organizational justice and health according to socioeconomic status, with evidence of increased health risks among those who are worse off in public sector workplaces with poor procedural justice ,11. HoweTo our knowledge, few studies have examined the gender-specific associations between organizational justice and psychosocial distress or relevant health behaviors, specifically focusing on their occupational statuses. In this study, we therefore investigated the relationships between organizational justice and risk of psychological distress and two stress-related behaviors–namely, smoking and heavy drinking–using data collected in multiple Japanese private companies. Given the recently-discovered evidence of poorer health among female managers and professionals than among other workers, the associations between organizational injustice and the stress-related outcomes might be stronger among women than men, as well as among managers and professionals compared to other workers ,6.In the present study, we used data collected in the first survey waves of the Study of Health, Occupation, and Psychosocial Factors Related Equity (J-HOPE), an occupational cohort study on social class and health conducted from 2010 to 2014 in Japan. This study was approved by the Ethics review Board of the University of Tokyo Faculty of Medicine., Kitasato University School of Medicine/Hospital, and University of Occupational and Environmental Health. The response rate was 77%. Data were mainly collected at health checkup opportunities; it is legally mandated that employers provide such opportunities for all employees. According to the survey on the health of workers in 2012, about 80% of workers were undergoing medical check-up . A totalnone of the time) to 4 , and the total score for each participant was derived by summing the item scores with equal weight. We categorized participants as either exhibiting psychosocial distress (scores ≧5) or not (scores <5), based on Sakurai et al.’s suggested cut-off [never) to 3 (currently) and from 1 (no) to 3 , respectively. For the purpose of our study, we regarded those who reported smoking currently as smokers, and those who reported drinking alcohol almost every day as heavy drinkers.Psychological distress was evaluated using the Japanese version of the Kessler 6 (K6) scale . The K6  cut-off . Smokingstrongly disagree) to 5 (strongly agree). In this study, we calculated the sum of each participant’s responses to each subscale and categorized participants by tertiles, in the same way as previous studies [Organizational justice was measured using the Japanese version of the Organizational Justice Questionnaire (OJQ), which is a translation of the original English version . The rel studies ,21.In the J-HOPE, occupational position was evaluated based on which set of duties were most similar to those carried out by the respondent, including managers, professionals, technicians, clerks, service and sales workers, craft and related trade workers, machine operators and assemblers, laborers, and others. We dichotomized occupational status into managers and professionals vs. others based on skill specialization and skill level.We also entered educational attainment and household income into the analysis as covariates. We categorized educational attainment as 1) junior high school, 2) senior high school, or (3) college or higher. We categorized household income as (1) ≦ JPY 2.99 million, (2) JPY 3–4.99 million, (3) JPY 5–7.99 million, (4) JPY 8–9.99 million, (5) JPY 10–14.99 million, or (6) ≧ JPY 15 million. Other covariates included age and working hours per week. Working hours were classified as (1) ≦ 30 hr, (2) 31–40 hr, (3) 41–50 hr, (4) 51–60 hr, or (5) ≧ 61 hr. To assess other indicators of job stress, we used the 10-item Japanese version of the Effort-Reward Imbalance Questionnaire (ERIQ) and the 22-item Japanese version of the Job Content Questionnaire (JCQ) [ junior h senior hAfter computing descriptive statistics for participants’ general characteristics, we calculated the prevalence ratios (PRs) of psychological distress (≧5), smoking, and heavy drinking, along with their 95% confidence intervals (CIs), between levels of perceived organizational justice, for workers of different occupational status . The hypFor comparison, we also conducted the same analyses for males. Statistical analyses were conducted using STATA 11.1 for Windows.The J-HOPE participants included in the present analyses consisted of 420 female managers and professionals, and 1,796 other female workers. Among these, 58.57% of managers and professionals and 52.39% of other workers exhibited psychological distress. The proportion of smokers in each group was 9.52% and 11.41%, respectively, and the proportion of heavy drinkers was 13.57% and 12.14%, respectively .Among men, 2,641 managers and professionals, and 4,916 other workers responded. Of these, 46.80% of managers and professionals and 52.81% of other workers exhibited psychological distress. The proportion of smokers in each group was 30.59% and 37.53%, respectively, and the proportion of heavy drinkers was 39.11% and 32.45%, respectively .Among women, the prevalence of psychological distress among those reporting lower perceived levels of organizational justice was significantly higher among both managers and professionals and other workers. Compared to high procedural justice, the raw PR was 1.55 (95% CI: 1.25–1.91) among managers and professionals, and 1.43 (95% CI: 1.18–1.73) among other workers . The corp = 0.04 for intermediate and 0.06 for low interactional justice). Procedural justice and interactional justice were not related to differences in alcohol intake among participants in any occupation  the prevalence of psychological distress was higher among working women and men with low perceived levels of organizational justice, regardless of their occupational positions; and (2) among women low levels of perceived interactional justice were associated with twice the prevalence of smoking, compared with high levels of perceived interactional justice, among managers and professionals, while this association was weaker among other workers. These associations remained statistically significant even adjusting for variables relating to workplace psychosocial status, including job control/demands and effort-reward imbalance. In both women and men, poor perceived procedural justice was associated with psychological distress .Our finding of an association between poor organizational justice and health is concordant with the findings of earlier studies in other countries ,11,25. RThis may in part be attributable to the male-dominant structure of the labor market in Japan, which results in a very small proportion of women in managerial positions in the private sector (10% or less) . Being aAlthough our findings may be explained by the effects of excessive work-related psychosocial stress, in our analysis the associations between organizational justice and psychological distress and smoking were independent of other work-related psychosocial characteristics (as measured by the JCQ and ERIQ) . Thus, oThis study has several limitations. First, we used a self-reported measure of perceived organizational justice. An individual’s perceptions of their workplace could be influenced by personality and how they tend to appraise stress, factors that were not accounted for in this study. Second, all variables were measured by self-report, potentially producing a common method bias. Moreover, some measurements might not be valid enough to capture the problematic health behavior. For example, we did not find a difference in alcohol consumption by occupational class and organizational justice. This might be because frequency of drinking might not be sensitive enough to capture problematic alcohol consumption. Further research should evaluate workplace organizational justice, alcohol consumption, and other variables using more objective and accurate measures. Third, the participants in this study were employed at only 12 companies in Japan. Moreover, there are disparities in social security/welfare services and working conditions between full- and part-time workers. Hence, generalization of the findings of this study could be limited to full-time workers working for companies evaluated in this study. Nonetheless, the 12 companies covered various industries, including manufacturing, transportation, service industries, and others. Fourth, there may be additional unmeasured potential confounders in the relationships investigated, including work-family conflict, marital status, and family composition . Fifth, In conclusion, our findings provide evidence that organizational justice is important to build workplaces that support good mental health for all female workers in Japan, and that good support and understanding from one’s supervisor may be more important for female managers and professionals. As the Japanese government has stressed, organizational justice may be a key factor in achieving gender equity in the workforce ,35,36. A


The study collected particulate matter (PM)-related documents in Korea and classified main keywords related to particulate matter, health, and social problems using text and opinion mining. The study attempted to present a prediction model for important causes related to particulate matter by using social big-data analysis. Topics related to particulate matter were collected from online  from 1 January 2015, to 31 May 2016, and 226,977 text documents were included in the analysis. The present study applied machine-learning analysis technique to forecast the risk of particulate matter. Emotions related to particulate matter were found to be 65.4% negative, 7.7% neutral, and 27.0% positive. Intelligent services that can detect early and prevent unknown crisis situations of particulate matter may be possible if risk factors of particulate matter are predicted through the linkage of the machine-learning prediction model. The Wormosphere , interesmosphere . It is amosphere .10 and PM2.5 to the Act in 1993 and 2011, respectively. The number of deaths due to the air pollution in South Korea is estimated to have been 11,944  in 2008 (http://apps.who). Generally, air pollution level is represented by daily or annual mass concentration (µg/m3) of particulate matter or ultrafine particles in the air. The WHO recommends daily and annual averages of ultrafine particles (PM10) equal to or less than 50 µg/m3 and 20 µg/m3, respectively. Because South Korea has higher particulate-matter concentration than other countries, damage from particulate-matter exposure is quite high [10 pollution concentration in South Korea was 51–61 µg/m3 during 2001–2006, but, due to the implementation of an air-quality management plan in the Seoul metropolitan area (2005–2014), it has been decreasing since 2007. The improvement in air quality has, however, stagnated recently [10 concentration in Seoul in 2011 was 2.1 times higher than Tokyo, 1.6 times higher than Paris, and 1.4 times higher than London [South Korea set the standard for Total Suspended Particles (TSP) in the “Framework Act on Environmental Policy” in 1991 before adding PMn London .2.5 constituents with mortality and have implications for policy making on sources of PM2.5 and on the relevance of PM2.5 health studies from other areas to this region [10 concentration and weather conditions in the Kathmandu area, Nepal, and found that seasons greatly affect PM10 concentration and air quality [Health concerns are increasing because air pollutants can be transported in from northeastern China along with yellow sand. The analysis of the effects of yellow sand on deaths in Seoul from 1995 to 1998 showed that death risks increased by 1.7% during the yellow sand period. Among the population aged 65 years or older, however, death risks increased by 2.2% . The anas region . Cobourns region . Brian e quality . Further quality .10 concentration in the Volos area, Greece, through a neural network and a regression model, and proved that air pollution is deeply related to meteorological elements [x, CO, SO2, PM10, and PM2.5 provided on the US EPA website and daily average data of RPMA (Respiratory Particulate Matter Average) from 3 July 2000, to 20 August 2001, provided on the website of the Tata Energy Research Institute, and analyzed it, finding that a neural network model is appropriate if it has a large-scale training data set [10 data along with temperature data such as wind speed, humidity, and temperature from 1 January 2003, to 12 December 2004, and developed an RNN  model [2.5, and developed a Deep Recurrent Neural Network (DRNN) model with a reinforced pre-training method using an autoencoder in the process of learning [10 concentration in Belgium and found that the changes in daily average PM10 concentration in Belgian urban areas is mainly influenced by weather conditions such as previous PM10 concentration, wind speed, temperature, the amount of clouds, and wind direction, but less influenced by anthropogenic factors such as mechanical friction of fossil fuels, smelting, and combustion [In addition, as the interest in artificial intelligence increases, various research studies predicting particulate matter using machine learning have been conducted at home and abroad. Papanastasiou et al. collected air pollution and meteorological data to predict PMelements . Chaloulelements . Barai edata set . Ghazi ak) model . Ong et learning . Hooybermbustion . Koo et mbustion . Lee et mbustion .2.5 forecasting using comparative analysis of prediction performance for the additive version of Holt-Winters method, autoregressive integrated moving average (ARIMA) model and neural network autoregressive model (NNAM) in Taiwan [Regarding the research related to East Asian region, Mahajan, Chen, and Tsai examined PMn Taiwan . Luo, Yan Taiwan . Mei, Lin Taiwan . Similarn Taiwan .Recently, the Social Network Service (SNS) has been emerging as a communication tool for emergency and crisis response as its influence increases. The SNS is a space where concerns over anxiety about various social phenomena occurring in everyday life can be heard and their forms understood. The results of social media issue analysis conducted by the Ministry of Security and Public Administration showed that the public responded sensitively in that anxious Tweets increased when a particulate-matter watch was issued and rapidly changed to relieved Tweets of relief when the watch was lifted. In addition, various methods for coping with the discomfort and dissatisfaction with particulate matter were shown when the concentration of yellow sand was the highest in mid-March 2014 . As suchThe present study collected PM-related documents mentioned in all online channels from which documents can be collected in South Korea and classified main keywords related to particulate matter using text and opinion mining and attempted to present a prediction model for important causes related to particulate matter.The present study used social big data collected through the Internet such as online news sites, blogs, cafés, social network services, and bulletin boards. The present analysis defined social big data as text-based web documents (buzz) collectible through a total of 166 online channels including 146 online news sites, four blogs , two cafés , one SNS (Twitter), and 13 bulletin boards . Topics related to particulate matter were collected every hour regardless of the day of the week, weekends, and holidays from the applicable channels from 1 January 2015, to 31 May 2016, and 226,977 text documents that mentioned causes and diseases related to particulate matter out of a total of 587,099 collected documents were included in the analysis. A crawler was used to collect social big data for the present study, and text-mining techniques were used to classify topics. Particulate matter topics used to collect all relevant documents were “particulate matter, ultrafine particles, yellow sand, smog, atmospheric pollution, and air pollution,” and documents were collected after removing documents using stop words such as “smog wrinkles, contaminated children, smog films, and smog work,” which were unrelated to particulate matter, during the collection period. The main purpose of social big-data analysis is to examine complex social and environmental issued based on the various opinion of large amount of online data. By conducting social big-data analysis, we can predict more accurately to find risk factors or protective factors of particulate matter.Text documents collected in relation to particulate matter were encoded as standardized data through the text-mining process as follows.Emotions related to particulate matter, which were dependent variables of the present study, were defined according to classifications through text-mining in which positive emotions  were defined as positive, and negative emotions  were defined as negative. Emotional dictionary includes positive feelings  and negative feeling  in the online document. The emotional dictionary was developed by SK Telecom Korea’s leading communication company. In addition, if positive and negative attitudes were equal, they were defined as neutral.10, powder, tobacco, grilling, influenced China, PM2.5, air pollution, ozone, smog, pollutant, carcinogen, fossil fuel, bacteria, exhaust gas, and chemical substance.”Causes related to particulate matter were defined with 17 keywords classified in the subject analysis, which include “dust, yellow sand, PMDiseases related to particulate matter were defined with seven keywords, “common cold, lung disease, cardiac disorder, cerebrovascular disease, hypertension, depression, death disease,” which were classified through text-mining.The present study applied machine-learning analysis technique to forecast the risk of particulate matter. Representative machine-learning algorithms used in the present study were random forest, decision-tree analysis, and multilayer neural network. In addition, to determine the relationships among the independent variables that influence the risk of particulate matter, association analysis was carried out. An a priori principle algorithm was used for the association analysis. Social big data and data mining is based on the causal relationship between the emotional effects of PM. The research finding could provide the risk factors and protective factor on the PM issue. The ROC (Receiver Operating Characteristic) curve and AUC (Area under the Curve) were used for the evaluation of machine-learning models. IBM SPSS 24.0  was used for the decision-tree analysis, and R 3.4.2  was used for the random forest, multilayer neural network analysis, association analysis, and model evaluation.2.5 (9.7%), air pollution (9.1%), dust (7.5%), and pollutants (6.3%). Diseases related to particulate matter were in the following order: common colds (45.9%), lung disease (18.6%), cardiac disorder (10.4%), cerebrovascular disease (8.0%), death disease (7.4%), depression (5.0%), and hypertension (4.7%), from the highest to the lowest.Status of online documents related to particulate matter is shown in 2.5, and pollutants.The results of the analysis of main factors influencing the emotions related to particulate matter  using a random forest model are presented in The decision-tree model for the prediction of the risk factor of particulate matter is shown in 10, powder, tobacco, grilling, influenced China, PM2.5, air pollution, ozone, smog, pollutant, carcinogen, fossil fuel, bacteria, exhaust gas, and chemical substance) and seven diseases  as the input layer, and five hidden layers and risk (Negative) as one output layer is shown in 10 (0.79%), common cold (0.56%), cerebrovascular disease (0.52%), grilling (0.49%), air pollution (0.48%), depression (0.35%), powder (0.31%), hypertension (0.23%), PM2.5 (0.14%), and dust (0.08%), from the highest to the lowest.A multilayer neural network model using 17 causes related to particulate matter  forecast by the Korea Meteorological Administration  forecast by the Korea Meteorological Administration.Fifth, in association analysis between the cause of particulate matter and disease factors, the probability of mentioning lung disease increased by about 11.6 times when “pollutant, carcinogen, and common cold” factors are mentioned, and the common cold is found to be interconnected with yellow sand, dust, pollutants, lung disease, carcinogens, cardiac disorders, and bacteria. Lastly, the risk prediction of the disease-prediction neural network model on the cause of particulate matter showed a similar trend to the particulate-matter (PMThe policy implications and conclusions of the findings of the present study are as follows. The implication of the finding is to predict the risk of PM and predict the degree of PM by using the prediction model. The research can provide more accurate weather information related to PM concentration and prevention system can be established.First, when causes and diseases related to particulate matter are mentioned in online documents, the negative emotions toward particulate matter increase. Accordingly, management as well as promotion measures need to be prepared through accurate diagnosis of the causes of particulate matter for correct public understanding. To that end, the establishment of countermeasures based on the identification of causes through the analysis of various big data of particulate matter and an integrated management system that includes the influence of neighboring countries and the interaction of climate changes appears to be needed.Second, the prevalence rate of diseases due to particulate matter is serious. Particulate matter has been reported to increase the risk of respiratory-related diseases such as asthma exacerbation and chronic obstructive pulmonary disease, and cardiovascular diseases such as irregular heartbeats, vascular dysfunction, and arrhythmia . It alsoThird, as the existing particulate-matter prediction models use the data measured by organizations such as the Korea Meteorological Administration, the neural network model was also found to be superior for prediction models using social big data. Since the input variable used as the learning data of the neural network of the present study, however, used words about causes and diseases mentioned in relation to particulate matter, and positive and negative emotional words in relation to particulate matter as output variables, it can be less accurate than the existing measurements of causes, diseases, and emotional state by the existing operational definitions. Accordingly, the development of an analysis technique that can perform subject analysis of causes, diseases, and emotions at the sentence level appears to be necessary.Fourth, high-quality learning data with accurate classification are needed to increase the accuracy of the machine-learning model for particulate matter developed in the present study, and to that end, the development of ontology for a terminology system for particulate matter and a dictionary of emotional words is needed.Fifth, continuous data updates used in the machine-learning model are necessary. In the case of machine-learning models developed through the learning of training data, the actual classification and predicted classification are different when test data are applied. Accordingly, the prediction accuracy of machine-learning models can be improved if training data are learned again after producing high-quality training data by selecting cases for which classification of actual data and predicted data are the same to increase the prediction accuracy rate of the model.Sixth, the development of glossaries of colloquial or slang words for the causes of particulate matter and diseases and a system that allows collecting such words is necessary since many general consumers do not use professional terminology of the causes of particulate matter and diseases. Lastly, intelligent services that can detect early and prevent unknown crisis of particulate matter may be possible if risk factors of particulate matter are predicted through the linkage of the machine-learning prediction model for particulate matter developed in the present study with weather big data and disease big data.


A lumbar herniated intervertebral disc (LHIVD) is a common problem that usually causes low back pain and radiating pain. The effectiveness of Bosinji, one of the herbal medicines used for low back pain and radiating pain in patient with LHIVD, has been reported in several studies; however, little clinical evidence is available owing to the methodological limitations in previous studies. Hence, the present study aims to establish the clinical evidence regarding the efficacy and safety of Bosinji in improving pain, function, and quality of life in LHIVD patients.This is a multicenter, open-label, randomized, controlled, and equivalence trial with 2 parallel arms. A total of 74 patients who have low back pain and radiating pain due to LHIVD will be recruited and randomly allocated to the experimental group and control group. The patients in the experimental group and control group will take 2.5 g of Bosinji granule (1.523 g of Bosinji extract) or Loxonin tablet (60 mg of loxoprofen) 3 times a day for 6 weeks. Additionally, both groups will receive the same acupuncture treatment once a week for 6 weeks as a concurrent treatment. Changes in the 100-mm visual analogue scale (VAS) for low back pain after 6 weeks from baseline will be assessed as the primary outcome. Furthermore, the 100-mm VAS for radiating pain, Oswestry disability index (ODI), Roland–Morris disability questionnaire (RMDQ), EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), global perceived effect (GPE), and deficiency syndrome of kidney index (DSKI) will be used to evaluate secondary outcomes. Outcomes will be assessed at baseline and at 3, 6, and 10 weeks after screening. For the safety evaluation, laboratory examinations including complete blood count, liver function test, renal function test, blood coagulation test, inflammation test, and urine analysis will be conducted before and after taking the medications.The results of this trial will be used to establish clinical evidence regarding the use of Bosinji with acupuncture treatment in the treatment of patients with LHIVD.NCT03386149  and KCT0002848 . Catalpol, an iridoid glucoside found in Rehmannia glutinosa, also has an anti-nociceptive effect associated with modulation of neuroinflammation in the spinal cord in rats. Other components of Bosinji such as Corni officinalis,Alisma orientale,Poria cocos,Paeonia suffruticosa, and Cinnamomum cassia, show anti-inflammatory effects.Each component of Bosinji has shown several pharmacological effects in experimental studies; these effects may explain the mechanism of its effect on LHIVD. Aconitum carmichaelii, Bosinji has an anti-nociceptive effect that involves the activation of kappa-opioid receptors, thereby reducing paresthesia, as well as vasodilating effect via increase in nitric oxide production. Nakanishi et al have reported that Bosinji suppresses the expression of tumor necrosis factor-α, which is a critical molecular mediator in the pathogenesis of radiating pain.Experimental research has shown Bosinji to be possessing properties similar to those of its individual components. Similar to ,19 One randomized controlled trial (RCT) reported that the effectiveness of Bosinji was similar to that of nonsteroidal anti-inflammatory drugs (NSAIDs) for low back pain and paresthesia in the lower extremities; however, this trial carried many unclear risks of bias and methodological limitations, and hence, a definite conclusion could not be arrived at.Based on the mechanisms revealed in experimental studies, Bosinji have also been shown to be clinically effective in the treatment of LHIVD in observational studies. is required. Therefore, we will evaluate the equivalence of Bosinji to NSAIDs in concurrent with acupuncture using a rigorously designed, full-scale RCT protocol that includes assessments on pain, function, quality of life (QoL), and safety.For the clinical application of Bosinji in treating low back pain with radiating pain caused by LHIVD, reliable evidence from pragmatic RCT reflecting the actual clinical situation in Korean medical clinics where herbal medicine treatment is conducted with acupuncture treatment concurrently22.1This study is a multicenter, open-label, randomized, controlled, and equivalence trial with 2 parallel arms (1:1 ratio). The trial will be conducted at the Kyung Hee University Hospital at Gangdong (KHUHGD), Kyung Hee University Medical Center (KHUMC), Dongguk University Bundang Oriental Hospital (DUBOH), and Daegu Korean Medicine Hospital of Daegu Haany University (DKMHDHU). The efficacy and safety of Bosinji in patients with low back pain with radiculopathy due to LHIVD will be evaluated by comparison with loxoprofen, one of the NSAIDs. and with the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA).This protocol has been approved by the Institutional Review Boards (IRBs) of the institutions . The trial has also been registered at clinicaltrials.gov, which is a website of the United States National Institutes of Health (registration number: NCT03386149), as well as in the Clinical Research Information Service of the Republic of Korea (registration number: KCT0002848). All research procedures comply with Korean Good Clinical Practice (KGCP) and the Declaration of Helsinki. The methodology was established in accordance with the Standard Protocol Items: Recommendation for Interventional Trials (SPIRIT)2.2,25; low back pain score between 40 and 80 points on the 100-mm pain visual analogue scale (VAS); and voluntary participation and provision of a signed informed consent form after a detailed explanation of the clinical trial has been provided.The inclusion criteria for this study are as follows: age over 19 years; radiating pain consistent with abnormalities in the lumbar spine that are more severe than bulging, as shown on computerized tomography (CT) or magnetic resonance imaging (MRI)Participants who have the following characteristics will be excluded:1.congenital abnormalities or surgical history in the lumbar region;2.red flag signs that may indicate cauda equina syndrome, such as bladder and bowel dysfunction or saddle anesthesia;3.tumor, fracture, or infection in the lumbar region;4.injection in the lumbar region within 1 week of the screening;5.psychiatric disorder currently being treated, such as depression or schizophrenia;6.liver function abnormality ;7.renal function abnormality (serum creatinine >2.0 mg/dL);8.other diseases that could affect or interfere with therapeutic outcomes, including severe gastrointestinal disease, cardiovascular disease, hypertension, diabetes, renal disease, liver disease, or thyroid disorder;9.contraindications for NSAIDs, including concurrent disease, hypersensitivity reaction, or other medication;10.conditions for which acupuncture is contraindicated, for example, skin disease or hemostatic disorder ;11.pregnancy, breastfeeding or having pregnancy plans;12.other condition for which herbal medicine treatment is contraindicated; and13.participation in other clinical trials within 1 month of the screening.2.3A total of 74 participants with LHIVD will be recruited at four institutions, each of which will recruit an appointed number of patients . All participants who can read and write in Korean will be informed that they may voluntarily participate and that they can withdraw their consent at any stage. They will also be given essential information regarding the study protocol, including purpose, selection of participants, interventions by random allocation, schedule, expected benefits and risks, alternative treatment options, and confidentiality. Those who agree and sign the informed consent form will be screened through the assessment of demographics, medical history, present illness, vital sign, pregnancy test, and laboratory test. If they meet the eligibility criteria, the participants will be randomly allocated to the experimental group or control group. After random allocation, the assigned group will undergo a 6-week treatment, and assessment of outcome measure will be performed at 3, 6, and 10 weeks later according to schedule  will be orally administered 3 times a day at 30 minutes after every meal for 6 weeks. Bonsinji extract comprises a mixture of extract from the following 10 crude drugs in fixed proportions  will be orally administered 3 times a day at 30 minutes after each meal for 6 weeks. Three weeks of medication will be provided at week 0 and week 3, and the remaining medication will be withdrawn to confirm the medication compliance.2.5,27 by a committee of Korean medical doctors (KMDs) experienced in LHIVD and acupuncture. Acupuncture treatment will be performed by KMDs who have completed or have been taking a specialist acupuncture and moxibustion course for at least 3 years. To maintain homogeneity of treatment among the participating centers, all practitioners will undertake a training course together in advance.As a concurrent treatment, an identical acupuncture treatment will be conducted once a week for all participants regardless of group during the medication period. Acupuncture treatment will be performed on 20 predefined acupoints using 40 mm x 0.25 mm acupuncture needles according to STRICTA , Roland-Morris disability questionnaire (RMDQ), EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), global perceived effect (GPE), and deficiency syndrome of kidney index (DSKI). Additionally, all adverse events will be recorded at each visit.2.6.12.6.1.1 Participants will be asked to record their pain intensity within the past week on a 100-mm linear scale . Changes from baseline after 6 weeks of treatment will be compared between the groups as the primary outcome.The intensity of low back pain will be evaluated using the 100-mm VAS at pre-trial screening and at weeks 0 (baseline), 3, 6 (primary endpoint), and 10 (follow-up sessions).2.6.22.6.2.1The intensity of radiating pain in the lower extremities will also be assessed using a 100-mm VAS at pre-trial screening and at weeks 0, 3, 6, and 10. Participants will be asked to record their pain intensity within the past week on a 100-mm linear scale .2.6.2.2Inability to function in daily life due to low back pain will be assessed using the ODI at weeks 0, 3, 6, and 10. The ODI questionnaire consists of 10 sections: pain, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, and traveling. Each question is scored from 0 to 5, and the total score is calculated as a percentage disability.2.6.2.3Physical disability due to low back pain will be assessed using the RMDQ at weeks 0, 3, 6, and 10. The RMDQ contains 24 sentences describing the discomfort that may occur with low back pain. Participants will need to check the sentences that would best describe their life on that day, and the score is based on the total number of sentences checked (from 0 to 24).2.6.2.4The QoL and general health status will be assessed using the EQ-5D-5L at weeks 0, 3, 6, and 10. The EQ-5D-5L consists of the EQ-5D descriptive system and EQ-VAS. The EQ-5D descriptive system assesses the following five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is rated from 1 to 5 . The EQ-VAS scale can be used to assess a patient's current health status. It is a 20-cm scale numbered from 0 to 100 .2.6.2.5The subjective change of symptom will be assessed using the GPE at weeks 3, 6, and 10. The participants will score their perceived change after treatment using a 7-point scale .2.6.2.6The deficiency syndrome of kidney (DSK), a concept of the Korean medical diagnosis system, will be assessed using DSKI at weeks 0 and 6. The DSKI shows the severity of the DSK by scoring the 12 DSK-related symptoms from 0 to 2 points .2.7To confirm the safety of the medications, the following laboratory tests will be carried out at the pre-screening point and at week 6 when the medication treatment is completed; complete blood count , liver function test , renal function test , fasting plasma glucose, prothrombin time, activated partial thromboplastin time, erythrocyte sedimentation rate, C-reactive protein, and urine analysis . Additionally, AST, ALT, BUN, and creatinine will be examined at week 3. For women of childbearing potential, a urine human chorionic gonadotropin test will be performed using a stick-type pregnancy tester, and they will be educated about the need for medically acceptable contraception during the study period.At each visit, the researchers will measure the vital signs, such as blood pressure, pulse rate, and body temperature and collect information about the occurrence of adverse event (AE) and changes in the drug being taken. Information about expected AEs, as well as a contact number, will be given to the participants along with the informed consent form before the pre-trial screening. If AEs do occur, the principal investigator will evaluate the severity of the incident, as well as its relation to the interventions, and provide proper examination and treatment in accordance with the compensation rules. The progress of all AEs will be recorded in the case report form (CRF) and handled in accordance with the standard operation protocol (SOP) of the IRB and the regulation of KGCP.2.8 = 10), and the equivalence margin for the primary outcome was set at 18. With a 0.05 significance level, 80% power, and 1:1 ratio, we calculated the adequate sample size using the following formula: The sample size was calculated based on a previous similar study  and medication compliance rate (95%) on the calculated value. The 74 participants will be recruited separately at the four research sites; each site will recruit the following numbers of participants: KHUHGD: 20, KHUMC: 18, DUBOH: 18, and DKMHDHU: 18.2.9A total of 74 participants will be randomly allocated to the experimental group or control group according to a block randomization procedure with a 1:1 ratio after stratifying them by institutions. The randomization sequence will be generated by an independent statistician using the package “blockrand” 1.3 of R . For allocation concealment, sealed, opaque envelopes containing random code will be sent to each institution. The clinical research coordinator will open the envelope and allocate participants to their groups after screening.2.10The medications used in this study are in the form of tablets and granules and can easily be distinguished visually. Therefore, because it is impossible to achieve patient blinding, this research was designed as an open-label study. However, for objective analysis, evaluators and statisticians do not provide information on group assignments.2.11t test and Chi-square test will be used to compare the differences in general characteristics between groups. As a primary outcome, changes in the 100-mm VAS for low back pain from baseline to the end of the end of the medication treatment will be compared between groups using an independent t test. Equivalence will be evaluated based on the equivalence margin of 18 mm and 95% confidence interval (CI). To compare the outcomes of each session with the baseline values, an analysis of covariance will be used. Trends over time and time-by-treatment interactions will be analyzed using a repeated measures analysis of variance. All statistical analyses will be performed using PASW statistics 18 for Windows, and the statistical significance level will be set at .05.The data will be corrected using the “last observation carried forward” method and then analyzed using the “intention-to-treat” principle. The independent 2.12All research data will be collected and double-checked by two independent researchers based on source documents including the CRF. All sensitive information obtained from the trial will be confidentially preserved, and personally identifiable information will be discarded after a certain period, in accordance with the SOP. All researchers will be given training in protecting the privacy of participants.2.13To maintain the quality of the trial, the study procedure and documents will be periodically monitored by the Korean Medicine Clinical Trial Center.3Ucha-Shinki-hwan, which is described in a medical book called “Je-Saeng-Bang” written in the 13th century. Due to the characteristic of this herbal formulation composed of 10 kinds of herbs, Ucha-Shinki-hwan has been reported to have beneficial effects on various diseases including chemotherapy-induced neuropathy,–37 diabetic neuropathy, and overactive bladder.,40 In addition, its effect on low back pain with radiating pain was reported in an RCT; however, there were many unclear risks of bias in random sequence generation, allocation concealment, outcome assessment blinding, and incomplete outcome data. In addition, since the outcome measurement was only limited to pain, it is not enough to confirm the definite evidence due to the low quality of the report.Bosinji is a granule-shaped herbal medicine derived from Ucha-Shinki-hwan was originally designed to treat a group of complex symptoms called DSK, not a single specific symptom, it is necessary to verify the relation between the therapeutic effect and traditional diagnostic system.To confirm the efficacy of Bosinji compared with NSAIDs for low back pain and radiculopathy caused by LHIVD, this RCT was designed in a methodologically rigorous, full-scale setting. The indicators for pain, function, QoL, and safety will be comprehensively evaluated, and DSKI will be assessed to reflect the diagnostic conception of traditional Korean medicine. Because  The clinical benefit of NSAIDs for LHIVD remains controversial; however, they are most commonly used for conservative treatment of LHIVD because inflammatory signaling plays an important role in the production of nerve pain.,2 Therefore, NSAIDs have been used as a control intervention in studies attempting to identify a new therapeutic agent for LHIVD. Although patient blinding is not possible due to the differences in the shape of medications, bias can be minimized through blinding of assessors and statisticians.Loxoprofen, used as an active control intervention in this study, is one of the NSAIDs in the propionic acid group. Therefore, evaluating the effects of herbal medicine along with acupuncture may help determine the practical usefulness.As a concurrent treatment, acupuncture will be practiced to reflect the actual clinical situation in Korea. While about 90% of patients who visit Korean medical institutions due to low back pain choose acupuncture as a primary treatment, about 30% of patients opt for herbal medicine treatment.The results of this study will suggest clinical evidence comparing Bosinji with NSAIDs by providing data about the changes in various measurements from the rigorously conducted trial. These findings will help clinicians to utilize Bosinji with acupuncture as a therapeutic option for patients with LHIVD.Conceptualization: Byung-Kwan Seo.Funding acquisition: Byung-Kwan Seo.Methodology: Eun-Jung Kim, Dongwoo Nam, Hyun-Jong Lee, Jae-Soo Kim, Yeon-Cheol Park, Yong-Hyeon Baek, Sang-Soo Nam, Byung-Kwan Seo.Project administration: Bonhyuk Goo, Sung-Jin Kim, Eun-Jung Kim, Dongwoo Nam, Hyun-Jong Lee, Jae-Soo Kim, Byung-Kwan Seo.Supervision: Byung-Kwan Seo.Writing – original draft: Bonhyuk Goo, Sung-Jin Kim.Writing – review & editing: Eun-Jung Kim, Dongwoo Nam, Hyun-Jong Lee, Jae-Soo Kim, Yeon-Cheol Park, Yong-Hyeon Baek, Sang-Soo Nam, Byung-Kwan Seo.


Composite particles associated with graphene oxide (GO) and inorganic materials provide the synergistic properties of an appropriate electrical conductivity of GO with the good dielectric characteristics of inorganic materials, making them attractive candidates for electrorheological (ER) materials. This review paper focuses on the fabrication mechanisms of GO/inorganic composites and their ER response when suspended in a non-conducting medium, including steady shear flow curves, dynamic yield stress, On-Off tests, and dynamic oscillation analysis. Furthermore, the morphologies of these composites, dielectric properties, and sedimentation of the ER fluids are covered. Based on these excellent properties, graphene-based materials have potential applications in sensors, catalysts, adsorbents, capacitors, and electromagnetic interference (EMI) shielding devices, etc. [Graphene, a 2-D carbon sheet comprised of spes, etc. ,4,5,6. Oes, etc. ,8. GO ises, etc. ,10. Theres, etc. ,12,13,14Smart materials are designed materials with one or more stimuli-response properties and form the basis for many industrial applications. The properties of such materials can vary significantly due to input stimuli, including temperature, light, electric field, magnetic field, mechanical, and chemicals ,16,17,18The response of ER fluids under electrical field stimulation has been attributed to the polarization behavior of the suspended particles compared to the dispersion medium caused by an external electric field. This polarization may come from a variety of charge transport mechanisms, including electrons, dipoles, atoms, or interfacial polarization. The connected polarized particles attract each other when they are paired in the direction parallel to the electric field, and repel each other in the vertical electrical field direction, thereby causing them to form a chain structure in the parallel electrical field direction. Therefore, under an electrical field, to make particles move with the flow, the hydrodynamic force must act on the electrostatic force between the particles to deform or even destroy the fibrous structure, leading to an increase in shear stress and shear viscosity. Based on the electrostatic polarization mechanism, many models have been proposed to evaluate the magnitude of the electrostatic force caused by an electric field. In idealized electrostatic polarization theory, it is envisaged that ER fluids are composed of suspended, hard, monodisperse spherical particles suspended in a Newtonian liquid, and both phases are assumed to be uncharged and non-conducting. In this model, the mismatch of permittivity between the dispersed phase and continuous phase is considered to be the cause of the electrostatic forces. The electrostatic interactions among particles can be expressed as ic field ,29,30,31For decades, numerous particles have been introduced as ER materials, such as polyaniline (PANI), polypyrrole (PPy), polydiphenylamine (PDPA), polyindole (PIn), clay, and oxide mineral ,37,38,392 hybridized orbitals between layers, in which electrons can move freely, so that graphene has a very strong electrical conductivity. GO is an oxidized state of graphene, resulting in destruction of the conjugated structure to be reduced conductivity. On the other hand, electron transport between the layers can also occur in GO because graphene usually is not oxidized completely and is generally not peeled off into a single-layer structure. In addition, the oxygen-containing groups on the surface of the GO give it greater polarizability.Layered graphene has delocalized π bonds formed by spThe polar functional groups on the surface of the GO, as well as the inorganic components, allow GO/inorganic materials to be polarized by an external electric field, and the insertion of inorganic components makes the polarizability of GO/inorganic composites higher than GO, which gives the composites a chance to have higher ER characteristics. Therefore, the transport of electrons between the GO layers, the polarization of polarizable functional groups, and the polarization of inorganic components contribute to the ER effect of the GO/inorganic composites.2O3, TiO2, SiO2, and Fe3O4, have attracted considerable attention because they can combine the appropriate conductivity of GO with the good dielectric properties of inorganic materials. Because the dielectric characteristics are strongly associated with the ER effects, the insertion of high dielectric constant inorganic substances can improve the achievable interfacial polarization of GO/inorganic properties, resulting in improved ER characteristics. This article reviews the fabrication mechanisms of various GO/inorganic composite particles and their ER properties. Their dielectric properties are also related to corresponding ER performance.In particular, composites of GO and inorganic materials, such as AlBecause GO sheets possess many oxygen functional groups, including epoxy, hydroxyl, and carboxyl groups, GO generally exhibits a strong negatively charged property. Therefore, synthetic strategies utilizing electrostatic interactions are used widely as a facile method for the synthesis of GO-based composites. To synthesize composites with negatively charged GO through an electrostatic interaction, the other component needs to be positively charged. A few different methods can be used to realize the electrostatic interactions between GO and inorganic particles.In an aqueous solution environment, for a mineral oxide, water can be adsorbed chemically onto the oxide by hydrogen bonding, or it can be dissociated.  The diss2) by treating TiO2 nanoparticles with a 1M HCl solution and GO/TiO2 composites were prepared by electrostatic interactions between negatively charged GO and positively charged TiO2. As shown in the scanning electron microscopy (SEM) image  prepared by Zhang et al. [2O3 particles, and the GO sheet then covered the Al2O3 particle through electrostatic attraction, which was confirmed by transmission electron microscopy (TEM)  image a, nanosig et al.  also emppy (TEM) b.3O4/GO composite using an ultrasonic-assisted electrostatic reaction synthetic route and adopted it as an electro-magneto dual stimuli-responsive material. 3O4 nanoparticles were prepared using the modified Hummers’ method and a chemical co-precipitation method, respectively. Subsequently, Fe3O4 nanoparticles were added to the aqueous suspension of GO, and the pH of the suspension of GO was adjusted to 4 to impart a positive charge to the Fe3O4, and the Fe3O4/GO composite was then synthesized by an electrostatic reaction assisted by sonication. The Fe3O4/GO composite combines the paramagnetic properties of Fe3O4 nanoparticles with the polarization properties of GO. Therefore, their suspension exhibited excellent electro-magneto dual stimuli-responsive behaviors.Zhang et al.  synthesi2 by dispersing it in an ethanol solution of 3-aminopropyl-triethoxy-silane (APTES) using a silanization reaction between the surface hydroxyl groups of TiO2 and ethoxy groups of APTES [2 microspheres were then prepared by coating GO on the positively charged amine-terminated TiO2 using an electrostatic interaction. The diameter of GO-wrapped TiO2 microspheres was 800–1000 nm and the thickness of GO was approximately 5–10 nm , in which the thickness of GO layers was less than 10 nm, whereas the densities of GO/nSiO2, GO/p1SiO2, GO/p2SiO2, and GO/epSiO2 were determined to be 2.67, 2.52, 2.28, and 2.03 g/cm3, respectively. Among them, the GO/epSiO2-based ER suspension showed the highest yield stress, largest polarizability, and shortest relaxation time of interfacial polarization. The improved ER performance was attributed to the reduced particle density and altered dielectric properties.Yoon et al.  fabricat2 spheres with a diameter of 200 nm and SiO2 rods with aspect ratios of 1.8, 3.1, 5.0, 8.0, and 20. These were then modified with amine groups and coated with GO to form GO-coated silica with different aspect ratios. 3O4/SiO2/GO) [3O4, Fe3O4/SiO2, and Fe3O4/SiO2/GO. The diameter of the Fe3O4, Fe3O4/SiO2, and Fe3O4/SiO2/GO nanoparticles were 12, 24, and 28 nm, respectively, showing that the thickness of the GO layer is approximately 2.0 nm.Lee et al.  synthesiSiO2/GO)  were als3·H2O) and fabricated a Si-GO composite using the in-situ hydrolysis of TEOS on the GO sheet. Because the in-situ growth method utilizes a covalent bond between silica (Si-O-C) and GO (C=O), the composite prepared by this method generally has better stability. SEM and TEM images of the Si-GO  under a DC electrical field. The ER fluid in the absence of an electrical field indicates that the particles are freely suspended in silicone oil, at which point, the ER suspension exhibits general fluid-like characteristics. On the other hand, in the presence of an electrical field, the particles will be polarized and arranged in a chain-like structure along the electric field direction in an extremely short time, resulting from electrostatic interactions between polarizable particles. At this time, the ER suspension exhibits solid-like properties, usually expressed as instantaneously enhanced shear stress, shear viscosity, and dynamic moduli [ER fluids are typically composed of polarizable solid particles dispersed in an insulating carrier liquid. The state of the ER fluids is tunable between fluid-like and solid-like within milliseconds by the application or removal of an external electrical field. c moduli . In the The characteristics of ER suspensions under an electrical field are controlled mainly by the competition of electrostatic interactions caused by an electrical field and the hydrodynamic interactions from fluid flow. Therefore, the dielectric characteristics are considered to be strongly associated with the ER performance.According to this equation, the permittivity τ=τ0+1 and t2, combined with the exponents, α and β, control the reduced and rising regions of the shear stress, respectively. The dashed lines and solid lines in In many ER systems, however, the Bingham fluid model is not sufficient to fit the flow behaviors of ER suspensions. As shown in 3O4/GO-based ER suspension follows the conduction model [The dynamic yield stress is defined as the minimum stress that can break up the chain-like structures continuously, while being recombined continuously by electrostatic interactions. That is, when the shear stress is higher than the yield stress, the particles begin to move with the flow field. The dynamic yield stress is usually estimated by extrapolating the shear stresses near a zero shear rate according to the log-log scaled flow curves. The correlation between the yield stress and electrical field strength is expressed ason model ,75. Figuon model . In some−1). Under an applied electrical field, the shear viscosity increases instantaneously, and when the electric field is off, the shear viscosity decreases rapidly to an original (0–20 s) zero-field level. This means that the ER fluid is sensitive to the stimuli of the electrical field. Under the stimuli of an electric field, the particles can align rapidly to form chain-like structures, and in the absence of an electrical field, they can return to their freely dispersed state in time. The sensitivity and tunable properties of ER fluids is the main reason for their attention in the industrial applications of smart devices. To examine the response sensitivity of the ER suspensions to electrical field stimuli, the flow properties of the ER suspensions were tested while the electrical field was alternately turned on and turned off. In dynamic mechanical analysis, an oscillatory  deformation (stress or strain) is applied to the ER fluids and the complex modulus can be measured. Phase change in the ER fluid can be also evaluated through the change in storage modulus (3O4/GO-based ER fluid (15 wt.%), the LVE region ranges from 0.001% to 0.02%. Therefore, to avoid damage to the structures by high strain, angular frequency sweep tests  of composites not only has an important influence on the sedimentation of ER fluids because their sedimentation problem is an important factor limiting its ER performance, making it difficult to use widely in industry, but also because it affects the ER properties. GO-coated silica spheres  with difcone oil ,86. Furtcone oil ,88 repor−12 S/cm) may lead to unsatisfactory ER performance.According to the slope of the yield stress vs. the electric field strength, most of them are close to 1.5, which conforms to the conduction model. In addition, some follow the polarization model with a slope of 2.0, or the polarization model converts to a conductive model at high electric field strengths. A few materials exhibit a low slope of 1.0 or 1.5 at low electric field strengths and change to 1.0 at high electric field strengths. Moreover, the common feature of these materials is the lower electrical conductivity of particles (The storage modulus (G’) and loss modulus (G″) are also important data for measuring the viscoelasticity of ER fluids. In the absence of an electric field, G′ shows a lower or slightly higher value than G″, indicating that the ER fluids are in a liquid-like or weak solid-like state. Under an electric field strength of 3 kV/mm, however, G′ is an order of magnitude higher than G″, meaning that elasticity predominates and the ER fluids exhibit stronger solid-like properties.In addition, the insertion of inorganic components into the composite materials of GO to combine the dielectric properties of the inorganic component with the appropriate conductivity of GO can result in stronger ER characteristics compared to GO/polymer composites. GO/inorganic composite materials usually have higher thermal stability, abrasion resistance, and corrosion resistance. Although many studies on the ER properties have been performed under DC electric fields, the behavior of ER fluids under AC electric fields has also been reported. The frequency (2, but the amount of related information is insufficient. On the other hand, the leakage current density is closely related to the electrical conductivity of the particles (−6 to 10−13 can be applied at an electric field strength of at least 2.0 kV/mm. When an electric field is applied, the particles are arranged in chain-like structures between the electrodes, which may cause an excessive leakage current density, resulting in a safety problem. When the shear rate increases, the chain structures are deformed or destroyed, and the leakage current density is correspondingly reduced. As the electric field strength continues to increase, however, more and stronger chain structures are formed, resulting in a higher leakage current density. Moreover, a stable chain structure may result in a high leakage current density at higher shear rates, thereby increasing the risk of security problems. To reduce this risk, it is important to adjust the electrical conductivity of the particles. In this paper, particles with electrical conductivity of 10−6 S/cm or lower were shown to act as safe ER materials. In addition, the leakage current density may increase sharply with increasing operating temperature [On the other hand, a high leakage current density (strength , and tenperature , which lFurthermore, there are many factors affecting the characteristics of ER fluids, such as the shape, size, conductivity of the particles, and the particle concentration of the ER fluid. In industrial applications, ER fluids with a high yield stress are usually required. On the other hand, excellent sedimentation stability and low leakage current density are important conditions for ER fluid to maintain long-term effects under high electric field strengths. In addition, with the advent of the intelligent era, the controlled rheological properties of ER fluids make it possible to create more applications in smart devices. In this case, the sensitivity of an ER fluid to electric field stimulation and the ability to recover when the electric field is removed are particularly important.This paper reviewed various GO/inorganic composites adopted in ER fluids, focusing on the fabrication mechanisms and ER properties, including the dielectric properties and sedimentation stabilities. The synthesis mechanism of the GO/inorganic composites is divided into two main categories. One is to separately synthesize GO sheets and inorganic particles, and then use electrostatic or chemical grafting to fabricate the composite material. The other is to synthesize inorganic materials directly on GO sheets, in which case, it is generally subjected to in-situ hydrolysis of the inorganic particle precursor. The numerous oxygen functional groups on the surface of GO provide important convenience for synthesis.The dielectric characteristics of GO/inorganic ER materials are strongly related to the ER effect, in which materials possessing a high permittivity difference between zero and infinite frequency and a rapid polarization rate can contribute to stronger ER effects. The morphology of ER particles is also an important factor on the ER effect. GO/inorganic composite particles with a higher aspect ratio contributed to a larger electric field-induced dipole moment, resulting in better polarization. The higher the aspect ratio of the rods, the more inclined they are to obtain higher polarizability and shorter relaxation time of interfacial polarization. In addition, particles with a low density and better dielectric properties including GO composites could contribute a high mobility, such that they have a low response time, thereby contributing to better ER properties.The sedimentation stability of GO/inorganic composite-based ER fluids is also due mainly to the properties of GO. First, the oxygen-containing functional groups on the surface of GO allow them to be well dispersed in water as well as in common organic solvents, and electrostatic repulsion between these functional groups prevent aggregation, which reduces the rate of sedimentation. Second, GO can reduce the overall density of the composites and reduce the density difference with the carrier liquid, thereby reducing settling. In addition, the attached GO acts as a “parachute” to slow down the sedimentation of composites owing to its sheet morphology and high specific surface area.As can be determined from a comprehensive summary of currently known GO/inorganic composite ER materials we covered in this review, some materials can not only hold yield stresses of up to several thousand Pa, but also exhibit reasonable sedimentation stability. Moreover, the relatively good thermal stability, wear resistance, and corrosion resistance of GO/inorganic composites add to the market for its application in the industry. In addition, compared to GO/polymer composites, GO/inorganic composites have powerful advantages that can be designed, including the shape, size, and density, which assists in the design of suitable materials for a range of applications. Overall, GO/inorganic composites will benefit from more in-depth research.


There are contradictory results or lack of validity studies concerning the namingfunction and brain laterality. Although anomia is a frequent symptom of memoryimpairment, and the most relevant symptom of aphasia, few studies have beenconducted to evaluate its validity for detecting patients with left-hemispheredamage (LD), as per the MeSH definition.To validate a paper-and-pencil confrontation naming test (CNT) according toside of brain injury; to select a valid and reliable abbreviated CNT whereinthe effect of demographic variables is minimized; and to use the selectedCNT to develop a computer-aided confrontation-naming evaluation (CACNE).Control data were obtained from 213 healthy participants (HP) aged 15 to 89years. A subsample of 106 HP was demographically matched to 39 patients withLD and 40 patients with right-hemisphere damage (RD). Anomia definition andCNT cues were considered for the CACNE.Test-retest and inter-rater reliability, internal consistency, and validityfor detecting LD were demonstrated. A significant age effect was observed inHP. The CACNE was developed to detect anomia in interaction withenvironmental interventions.The inconsistencies observed in the CNT studies were probably due to thepresence of anomia in almost 50% of the RD patients. According to the MeSH, anomia is defined as “A language dysfunction characterized by theinability to name people and objects that are correctly perceived. The individual isable to describe the object in question, but cannot provide the name. This condition isassociated with lesions of the dominant hemisphere…”.,-Although anomia is considered a common early sign in primary progressive aphasia(PPA)-Likely based on the above assumptions, and in spite of the definition of anomia, fewstudies have been conducted to evaluate the validity of this measure for detectinglesions in the left hemisphere. In any case, contradictory findings have been reportedwhen confrontation naming tests (CNT), in particular, have been employed (seereports).Regarding the influence of demographic variables on these tests, results are alsocontradictory and highly dependent on participant recruitment.,Most of the validity studies based on CNT have been carried out in patients withAlzheimer’s disease (AD) and, within this framework, clinical studies indicate that ADdisproportionately affects women in terms of both disease prevalence and rate of symptomprogression.-,,,Naming tests can be considered language indicators of semantic memory: in visual CNT, theinterviewee is usually assessed through pictures, in which he/she must recognize theirfunction or meaning, involving visual knowledge, and retrieve their names, involvingverbal knowledge.,,-Considering brain laterality and naming, some new perspectives have emerged (focusedmainly on specific brain areas or pathologies), and there is now a substantial body ofwork about this issue.,Semantic memory has been linked to the anterior temporal lobes (ATLs) in bothhemispheres, in patients with temporal lobe epilepsy (TLE).A previous fMRI meta-analysis showed that visual semantic concept tasks exhibit strongbilateral activation across the ATLs in healthy participants.These views are relevant for the present study because the current CNT deals with bothlinguistic and non-linguistic stimuli, as well as with the concept of semanticcognition. The present study involves a CNT which was initially based on that of Oldfield andWingfield,Given the lack of validity studies and presence of contradictory results with the namingfunction regarding brain laterality, the main objective of the present study was tovalidate a CNT according to the side of brain injury.Since the present study is part of a bigger research project developing brief, efficientand/or easy-to-apply neuropsychological techniques, the complementary objectives of thepresent study were: To abbreviate the initial CNT from 60 to 30 items by developing two parallel forms fromthe test and selecting one of them.To verify the internal consistency and reliability of the abbreviated scales and how theywere influenced by demographic variablesTo verify the validity of the abbreviated scales to discriminate patients with lefthemisphere damage and, if possible, select a valid and reliable abbreviated scalewherein the effect of demographic variables is minimized. To use the selected abbreviated scale to develop a computer-aided confrontation-namingevaluation (CACNE).-We used the CNT from the battery of Neuropsychological Tests Abbreviated andAdapted to Spanish Speakers (NTAASS).,Since in a previous study , a gendereffect was observed which was significant from the age of 60 years for any levelof education,,Since the overlapping effects of stimulus characteristics  are ultimately related to accuracy (i.e. itemdifficulty), we first used face validity to avoid, e.g. the selection of itemsfavoring males, and then the effect of each item on the scales was verifiedcase-by-case, according to the demographic variables for this particular sampleand context. We also added items of lower frequency, such as geometric figures,with the intention of achieving a wide range of difficulty. Regarding the age atacquisition, it is worth noting that picture naming is a current approach toestablish this word property, which relates to familiarity, frequency of use,etc. , who werecommunity-dwellers, without any known neurological or psychiatric disease. Therecruitment method is further described elsewhere.Clinical data were obtained from 79 consecutive preoperative inpatients withfocal and unilateral cerebral lesions. The sample was recruited from theNeurological and Neurosurgery Service of the Cordoba Hospital, a public hospitalfor adults. Lesions were confirmed by CT scan and/or MRI techniques, as well asby complementary diagnostic studies. None of the patients suffered from anyother (previous or simultaneous) associated neurological disease. We excluded patients who were unable to understand the test instructions or whohad visual agnosia, hemianopia, hemineglect, or sensory or motor difficultieswhich might affect visual perception. We also excluded patients who answeredless than 50% of the first ten pictures of the initial scale correctly,The initial sample consisted of 83 patients, from which one patient was excludedfor probable visual agnosia, another for having hemianopia with hemineglect, athird one because of difficulty understanding the test instructions andanswering less than 50% of the first ten pictures of the initial scalecorrectly; finally, another patient was excluded for producing severelydistorted descriptions on more than nine pictures of the initial scale. We excluded patients with visual agnosia or with visual-perception difficulties,because we sought to assess genuine word retrieval failures or anomicstates.,,,,As we needed interviewees to recognize CNT pictures, when the presence ofconceptual blurring was suspected ); and type of lesion ); no significantdifferences were found when specific lobe lesions were also compared (resultsavailable on request). Regarding clinical intervening variables, no significant differences wereobserved between patients with left and right-hemisphere damage  for disease duration =0.00, p=0.97); risk factors for cognitive impairment =0.30, p=0.58); site of lesion: LD=9, RD=13, posterior : LD=19, RD=19, antero-posterior: LD=5, RD=5, and subcortical: LD=6,RD=3  signed theinformed consent form. The pertinent institutional review board approved theproject and the study, which was carried out in accordance with the ethicalstandards established in the Declaration of Helsinki.We developed the parallel forms from the initial CNT and verified the internalconsistency of these abbreviated scales, along with the effect of demographicvariables in a sample of 213 HP see  aged 15 From this total sample, a sub group of 37 participants was re-evaluated fortest-retest and inter-rater reliability. In this subsample of 17 to 84-year-olds(45.41±20.66), 62% (N=23) of the participants were females and 38% (14) males;40% (15) had first level education, 38% (14) second level and 22% (8) thirdlevel. In this study, all the participants, either HP or patients, received the original60 items  at the time of testing in any step of the research.With the data provided by the participants, we then developed the abbreviatedscales by analyzing and modeling two parallel forms and selecting one of them.Subsequently, the CACNE was developed using the selected scale.We developed the two parallel forms of the initial scale  andform 2 (F2)) by verifying that they were comparable in terms of difficulty andrelationship with demographic variables. The parallel forms were selected byconsidering the items of the initial scale which contributed most to attenuateboth demographic differences in general, and the effect of gender and itsinteractions in particular.For test-retest reliability, at least 30 days of inter-test interval wasestablished, with a maximum of 120 days. For inter-rater reliability, twotrained interviewers acting independently evaluated the spontaneous (uncued)performance of the same interviewee. Specifically, the second rater interpretedthe first rater’s written records of the administration protocol, in whichmultiple variables were registered.A subsample of HP was matched with LD and RD, according to demographic variablessee . With th--In developing the CACNE, we took into account the definition of anomiat-test for dependent samples.The correlation between the two parallel forms, and of these forms with theinitial CNT, was analyzed by the Pearson correlation coefficient (r). Theinternal consistency for either F1 or F2 was analyzed by Cronbach’s alphacoefficient, while the difference between the two forms was explored by -Student’s A gender × age × education ANOVA was carried out to determine the effect ofdemographic variables on the spontaneous performance of CNT, which was thenumber of correct responses  on any of the three scales. Agewas recoded into five levels see ; educatit-test for dependent samples.Test-retest and inter-rater reliability indices were analyzed by the intra-classcorrelation coefficient (ICC). Differences between test and retest anddifferences between both raters were analyzed by Student’s2 for education and gender.When HP were compared with LD and RD for demographics, data were analyzed byANOVA for years of age or by ChiReceiver Operating Characteristic (ROC) curve analysis was performed to determinethe sensitivity and specificity of the scales for differentiating non-LD and LD.The cut-off point that produced a more uniform frequency distribution betweensensitivity and specificity was considered the most satisfactory. When this wasnot possible, or when one of the frequencies was <70% (see below),sensitivity was prioritized. In order to select optimal cut-off points based onseveral criteria, ROC curve analysis was done with the “Statistica” computerprogram, using neural networks and a linear model.2, using the selected cut-off points. The validity of the scales for discriminating among LD, RD and HP was verified bycross-tabulation and ChiIn general, indices ≥70%  wereconsidered acceptable.The r between F1 and F2 was 0.81 and between either of these forms and the initialCNT was 0.95 (N=213). The Cronbach’s alpha coefficient with 29 items in each scale(excluding items with zero variance) was 0.77 for F1 and 0.79 for F2. The differencebetween F1 and F2 was not significant . The three-way ANOVA for demographic variables indicated a significant main effect forage in both forms =2.96, p=0.02 see ; F2: F: F1:t=1.64, df: 36, p<0.12, Test: 24.76±3.27, Retest: 25.27±3.62; F2: t=1.83, df: 36,p<0.08, Test: 24.62±3.21, Retest: 25.22±3.79. Indices for inter-raterreliability: F1: t=0.80, df: 36, p<0.43, Rater 1: 24.76±3.27, Rater 2:24.51±3.31; F2: t = 0.46, df: 36, p<0.65, Rater 1: 24.62±3.21, Rater 2:24.49±3.09. The optimal cut-off points for the scales are shown in In the matched samples, descriptive data of the total scores for the initial scale,as well as for F1 and F2 were 45.20±8.61; 22.72±4.55; and 22.48±4.37, respectively.The difference between F1 and F2 was not significant .With the exception of maybe internal consistency, F1 was selected for the CACNE inview of fulfilling most of the criteria required for this purpose.nsvigliecca@gmail.com.CACNE introduction, instructions, correct words, and translation (from Spanish toEnglish) are shown in In the present study, we validated three CNT versions, according to side of braininjury. Specifically, we abbreviated the initial CNT from 60 to 30 items, bydeveloping two parallel forms from this test and then selecting one of them. Weverified the reliability and validity of the selected CNT and how it was influencedby demographic variables. By evaluating score on spontaneous performance, wedemonstrated test-retest and inter-rater reliability, internal consistency, as wellas its validity for detecting patients with lesions of the dominant hemisphere. Onlya significant effect of age in the present sample of HP was observed in the selectedCNT. Results were similar for the parallel form. Also, using the selected CNT, wedeveloped the CACNE, in which both spontaneous performance and cued performance weredesigned to detect anomia in interaction with environmental interventions. -,,The present results also showed that the inconsistencies observed in CNT studiesregarding either the involvement of the dominant hemisphere, or the detection ofanomia in certain disorders,Considering aging and bilateral damage, semantic dementia, which has been studied toreveal the individual roles of left versus right ATL in semantic function, can beasymmetric in early cases; however, the disease is inherently bilateral and it isthus hard to infer a unilateral model for this function.Taking into account both the probable influence of the type of inputs and the twoATLs on the representation of semantic knowledge,,Accordingly, Mesulam et al.Considering the objectives of the present study, in which only unilateral lesionswere assessed, and comparing present findings with previous research by thislaboratory,Overall, the three CNT versions in the present study are quantitative measures whichare highly sensitive to procedural changes (see paper).Limitations of the study: The current proposal requires that the objectives examinedhere be verified for the researchers’ particular approach and sample. For example,it is likely that increasing performance in older women with first level ofeducation produces an increase in performance in younger women with higher levels ofeducation. [Note: descriptive data for non-significant results of the presentinitial scale were very similar to the previously used version,


Most methods used for date fruit inspection, harvesting, grading, and classification are manual, which makes them ineffective in terms of both time and economy. Research on automated date fruit harvesting is limited as there is no public dataset for date fruits to aid in this. In this work, we present a comprehensive dataset for date fruits that can be used by the research community for multiple tasks including automated harvesting, visual yield estimation, and classification tasks. The dataset contains images of date fruit bunches of different date varieties, captured at different pre-maturity and maturity stages. These images cover multiple sets of variations such as multi-scale images, variable illumination, and different bagging states. We also marked date bunches for selected palms and measured the weights of the bunches, captured their images on a graph paper, and recorded 360° video of the palms. This dataset can help in advancing research and automating date palm agricultural applications, including robotic harvesting, fruit detection and classification, maturity analysis, and weight/yield estimation. The dataset is freely and publicly available for the research community in the IEEE DataPort repository [1] ( The two most important applications are automatic harvesting and visual yield estimation. Since date applications require different types of data with different characteristics, we built two separate datasets for the benefits of researchers in different date applications. The first dataset (dataset-1) contains images of date fruit bunches for different date varieties, showing various pre-maturity and maturity stages. These images cover a large degree of variabilities in order to address the challenges in the date orchard environment, such as multi-scale images, variable illumination, different angles, and diverse bagging states. Dataset-1 can be used in many applications such as automatic harvesting tasks, fruit detection, fruit recognition, maturity analysis, etc.The second dataset (dataset-2) contains images, videos, and weight measurements to help in many applications such as yield estimation. In this dataset, we marked date bunches for selected palms, recorded 360° video for each palm, and measured their data . We also captured images of each bunch from different angles before harvesting and on a graph paper after harvesting. Due to the enormous work needed and the huge amount of data, this dataset built for only one date variety. However, the proposed method for yield estimation (as a major application of dataset-2) based on one date variety can be generalized for other varieties because visual weight features, e.g. bunch area, perimeter, compactness, volume, etc., are almost invariable in different date varieties.1.1Dataset-1 consists of 8079 images of more than 350 date bunches captured from 29 date palms. The date bunches belong to five date varieties: Naboot Saif, Khalas, Barhi, Meneifi, and Sullaj. The images of date bunches were captured using two color cameras, their models and settings are described in the next section, in six imaging sessions (recording times). The imaging sessions covered all date maturity stages: immature, Khalal, Rutab, and Tamar. Date fruits can be harvested and marketed at three stages of their development—Khalal, Rutab, and Tamar, as shown in In order to build a comprehensive dataset that can address various machine vision applications and challenges for date fruits in an orchard environment, the dataset was provided with multiple sets of variations: multi-scale images, variable illumination, different date varieties, multiple maturity stages, and different bagging states, as shown in The dataset includes multi-scale images of date bunches, as shown in 1.2This dataset consists of 152 Barhi date bunches belonging to 13 palms. All bunches were weighted after harvesting, and their images were captured in front of a white graph paper, as shown in The selected 13 date palms had different heights and ages (1.7–4.85 m and 10–25 years) to maintain the variation in bunch area, perimeter, and date size as much as possible. The dataset also has variations in bunch compactness and the angle of view . IncludiThe uniform background in the graph paper is used to achieve better image segmentation, where we can get a high contrast between the background and the bunch. The graph paper has six reference objects, which are uniquely identifiable by shape (square), color (black), and position (corners). The graph paper with the reference objects can be used to estimate geometric information of the bunch, i.e., area, dimensions, and perimeter.In addition to the whole bunch data, other information was collected: images and weights of the bunch components . The primary purpose of this information is to estimate the bunch weight based on its components, i.e., by using dates' dimensions and weights and estimating the number of dates in the bunch. In the current dataset, images of 256 individual dates of Sullaj, Barhi, and Meneifi dates were recorded. 2The datasets were recorded in an orchard in Al-Ammaria, located 25 km Northwest of Riyadh, Saudi Arabia. The orchard contained more than 800 date palms of different varieties and ages.Tokyo, Japan, with variable focal length and in automatic mode. The resolutions of the cameras were 5184 × 3456 and 4272 × 2848, respectively. The orientation of the camera and the distance between the camera and the fruits depend on the height of the palm. Because the selected date palms were with different heights (1.7–6 m), these parameters were variable. For short palms, the orientation was approximately 0° and the distance approximately 3 m, but for tall palms, the orientation was from 45° to 90° and the distance was from three to 6 m.The images of dataset-1 were taken during one season in six imaging sessions over the period of June–September 2016. The usual period between imaging sessions was 20 days, but because the Rutab stage has a short development time, we made the period during the Rutab stage 10 days . The images in dataset-1 were taken under different natural daylight conditions: in the morning (9:00–11:00) or afternoon (3:00–5:00). These images were captured using two RGB  cameras: Canon, EOS-600D (camera-1) and EOS-1100D (camera-2), In dataset-2, the images and videos were acquired in the morning (5:00–7:00 am) during the harvesting period of Barhi dates , 16–26 August. At the beginning of this period (16 August), each date bunch was marked as shown in Immediately after harvesting, the date bunches in dataset-2 were placed in front of the white graph paper, as in The images of individual dates were acquired under laboratory conditions at 18 °C. For each image, 16 dates in one maturity stage were placed above a white reference paper numbered from the top left side, as illustrated in 2.1In this dataset, we arranged the data , with a coding scheme to simplify referring, linking, and facilitating future extensions of the dataset.The coding scheme consists of four parts separated by dots, as shown in 2.2In dataset-1, In dataset-2, the information of the date palms and their bunches are included in an excel file. This file consists of several tables. Each table provides information about one palm tree, which includes palm variety, code, height, trunk circumference, number of bunches, weight of bunches, harvesting date, and the state of the recording. In the current dataset, images of 256 individual dates of Sullaj, Barhi, and Meneifi dates were captured, as shown in