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Abstract Objectives Migraine is a prevalent neurological disorder severely impacting children and adolescents, yet only one pharmacological treatment is approved for ages 6−12 years. Remote electrical neuromodulation (REN) is a nonpharmacological, prescribed, wearable device cleared by the Food and Drug Administration for acute and/or preventive treatment of migraine with or without aura in patients 12 years and older. This study evaluates REN's safety and efficacy in ages 6−11 years. Methods Prospective acute treatment of migraine data were collected through the REN device (Nerivio) smartphone application. Endpoints were device safety (primary); consistent treatment efficacy (headache pain, functional disability, associated migraine symptoms), and REN‐medication combinations 2 h post‐treatment. Results Children (n = 293), median age 11 years (interquartile range = 9−11), 73.7% girls, conducted 5493 REN treatments. No adverse events were reported. Efficacy in at least 50% of REN treatments was calculated from all patients who voluntarily reported pain levels, symptoms, and/or disability at treatment onset and at 2 h post‐treatment, with 72.2% (13/18) of patients reporting pain relief, 36.0% (9/25) pain freedom, 83.3% (15/18) functional disability relief, and 38.9% (7/18) functional disability freedom. Migraine‐associated symptoms disappeared in at least 50% of REN treatments in 70.0% (7/10) of patients for nausea/vomiting, 50.0% (4/8) phonophobia, and 22.2% (2/9) photophobia; 63.6% (7/11) reported freedom from at least one associated symptom. REN was used as a standalone treatment, with over‐the‐counter medications, and with prescribed headache medications in 45.4%, 34.4%, and 20.9% of treatments, respectively. Interpretation REN may serve as a safe and efficacious acute treatment of migraine for children. Providers and families seeking a safe, effective, pill‐ and needle‐free treatment option for children suffering from migraine may consider REN.

Abstract This paper is a write-up of the ideas that were presented, developed and discussed at the fourth International Workshop on QCD Challenges from pp to AA, which took place in February 2023 in Padua, Italy. The goal of the workshop was to focus on some of the open questions in the field of high-energy heavy-ion physics and to stimulate the formulation of concrete suggestions for making progresses on both the experimental and theoretical sides. The paper gives a brief introduction to each topic and then summarizes the primary results.

We explored the potential of plasma-based In-Situ Resource Utilization (ISRU) for Mars through the conversion of Martian atmosphere (∼96% CO2, 2% N2, and 2% Ar) into life-sustaining chemicals. As the Martian surface pressure is about 1% of the Earth’s surface pressure, it is an ideal environment for plasma-based gas conversion using microwave reactors. At 1000 W and 10 Ln/min (normal liters per minute), we produced ∼76 g/h of O2 and ∼3 g/h of NOx using a 2.45 GHz waveguided reactor at 25 mbar, which is ∼3.5 times Mars ambient pressure. The energy cost required to produce O2 was ∼0.013 kWh/g, which is very promising compared to recently concluded MOXIE experiments on the Mars surface. This marks a crucial step towards realizing the extension of human exploration.

Abstract Background Prediabetes (PD) is defined as impaired fasting glucose and/or impaired glucose tolerance (IGT) and may be associated with high risk of cardiovascular injury. It is recommended that PD patients be screened for signs of arterial stiffness and cardiovascular injury to reinforce therapeutic strategies. Objectives To identify pulse wave velocity values discriminative for arterial stiffness and cardiovascular injury in PD patients. Methods A cross-sectional study was conducted with PD (N=43) and normoglycemic (N=37) patients who underwent clinical evaluation, arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor, laboratory blood analysis, investigation of morphological and functional cardiac variables by transthoracic echocardiogram, and assessment of carotid intima-media-thickness (CIMT) by carotid ultrasonography. A statistical analysis was performed using SPSS software and values of p

During our spectroscopic survey of central stars of faint planetary nebulae (PNe), we found that the nucleus of Abell 57 exhibits strong nebular emission lines. Using synthetic narrowband images, we show that the emission arises from an unresolved compact emission knot (CEK) coinciding with the hot (90,000 K) central star. Thus Abell 57 belongs to the rare class of “EGB 6-type” PNe, characterized by dense emission cores. Photometric data show that the nucleus exhibits a near-infrared excess, due to a dusty companion body with the luminosity of an M0 dwarf but a temperature of ∼1800 K. Emission-line analysis reveals that the CEK is remarkably dense (electron density ∼ 1.6 × 10 ^7 cm ^−3 ), and has a radius of only ∼4.5 au. The CEK suffers considerably more reddening than the central star, which itself is more reddened than the surrounding PN. These puzzles may suggest an interaction between the knot and central star; however, Hubble Space Telescope imaging of EGB 6 itself shows that its CEK lies more than ∼125 au from the PN nucleus. We discuss a scenario in which a portion of the asymptotic giant branch wind that created the PN was captured into a dust cloud around a distant stellar companion; this cloud has survived to the present epoch, and has an atmosphere photoionized by radiation from the hot central star. However, in this picture EGB 6-type nuclei should be relatively common, yet they are actually extremely rare; thus they may arise from a different transitory phenomenon. We suggest future observations of Abell 57 that may help unravel its mysteries.

Objectives: Cell therapy using multipotential stromal cells (MSCs) is being used in a variety of clinical settings to induce tissue regeneration. Promising results have also been achieved in the therapy of osteoarthritis. MSCs have been demonstrated to be safe (Borakati et al., 2018). They can be used in a one step procedure as minimally manipulated mesenchymal stem cells or after in vitro expansion. The in vitro step allows for the selection of a more homogeneous cell population, meeting the standard criteria for MSC identification (Lv et al., 2014). In vitro expansion of MSCs is cost intensive, time consuming and furthermore associated with gradual accumulation of senescent cells (Wagner et al., 2008), telomere erosion (Baxter et al., 2004), and changing phenotypes (Jones et al., 2010; Halfon et al., 2011). These disadvantages could be surpassed by the use of “minimally manipulated mesenchymal stem cells” from bone marrow or adipose tissue (Di Matteo et al., 2019) such as the adipogenic stromal-vascular fraction (SVF).The study investigates whether infiltration of the Hoffa fat pad with autologous SVF is an effective and safe treatment option for patients with gonarthrosis. Furthermore, the number and vitality of the injected cells as well as the clinical efficacy will be evaluated. Materials and methods: We conduct a prospective study. Patients with osteoarthritis of the knee receive infiltration of SVF into the Hoffa fat pad. The number and vitality of the cells are measured with a cell counter. The clinical outcome is checked using VAS, KOOS and SF12 questionnaires with a follow-up period of 1 year. Results: A total of 33 patients and 36 knees were included in this Study. An average of 45 million cells were injected with a standard deviation of 2,5 million Cells. After 6 months a significant improvement of the VAS and the respective subscales of the KOOS could be observed compared to the baseline. After one year of follow-up, a significant improvement in all KOOS subscales compared to baseline was still observed. A significant correlation between reduced knee pain on the VAS and the number of injected cells could be observed as well. Thus, patients injected with a higher number of cells seem to have a better outcome. The average viability of the cells was 64,4% with a standard deviation of 15,9%. A correlation between higher cell viability and better outcome on the QOL subscale of the KOOS was observed. There were no major complications or side effects. Discussion: These initial results indicate that treatment with SVF is a safe therapeutic option that has the potential to relieve joint pain and significantly improved function. The cell number and vitality of the injected cells appear to be important factors influencing the success of the therapy.

Automated manufacturing systems (AMSs) consist of computer-controlled interconnected manufacturing components (MCs) that are used to transport and process different product types. Each product type requires a certain sequence of processing steps in different MCs. Hereby, multiple product types can share processing steps on the same MC and the paths of different products types can overlap. In this paper we consider the modeling of AMSs in the scope of supervisory control for discrete event systems (DES). On the one hand, a suitable AMS model must allow the representation of sequential and concurrent processing steps in MCs. On the other hand, such model must be able to track different product types traveling through the AMS so as to process the products correctly. While previous work is commonly concerned with the first requirement, this paper identifies that the existing literature lacks a general treatment of the second requirement. Accordingly, we first introduce order-preserving (OP) languages that preserve the order of different product types in MCs and we propose a suitable finite state automaton model for OP languages. Then, we show that the composition of OP languages again leads to an OP language. That is, modeling MCs by OP languages, an OP model of a complete AMS that is suitable for supervisory control is obtained. In addition, it is possible to use both OP models and non-OP models for general AMSs, where MCs have different properties. We demonstrate the applicability of the proposed modeling technique by a flexible manufacturing system example.

The subject of this paper is the computation of paths for mobile robots that navigate from a start position to a goal position in environments with static obstacles. Specifically, we focus on paths that are represented by straight lines. Such paths can for example directly be followed by omni-directional robots or can be used as an initial solution for path smoothing. In this context, the most common performance metrics are the path length, the obstacle clearance and the computation time. In this paper, we develop a new path planning algorithm that addresses all the stated performance metrics. Our method first determines all possible connections between the start position and goal position along the edges of the generalized Voronoi diagram (GVD) of a given obstacle map. The shortest connections are then refined using a balanced method for creating shortcuts along existing waypoints and introducing new waypoints in order to cut corners. As an important feature, our method reduces the number of required waypoints by iteratively adding new waypoints and then removing unnecessary waypoints along solution paths. Moreover, our method takes into account multiple start-goal connections, since the shortest start-goal connection along the edges of the GVD might not lead to the shortest solution path. A comprehensive computational evaluation for a large number of maps with different properties shows that the proposed method outperforms sampling-based algorithms such as Probabilistic Roadmaps (PRM) and exact methods such as Visibility Graphs (VG) by computing close-to-optimal solution paths with a specified minimum obstacle clearance in less time.

We present the results of new time-series photometric observations of 29 pre–white dwarf stars of PG 1159 spectral type, carried out in the years 2014–2022. For the majority of stars, a median noise level in Fourier amplitude spectra of 0.5–1.0 mmag was achieved. This allowed the detection of pulsations in the central star of planetary nebula A72 (Abell 72), consistent with g modes excited in GW Vir stars, and variability in RX J0122.9–7521 that could be due to pulsations, binarity, or rotation. For the remaining stars from the sample that were not observed to vary, we placed upper limits for variability. After combination with literature data, our results place the fraction of pulsating PG 1159 stars within the GW Vir instability strip at 36%. An updated list of all known PG 1159 stars is provided, containing astrometric measurements from the recent Gaia DR3 data, as well as information on physical parameters, variability, and nitrogen content. Those data are used to calculate luminosities for all PG 1159 stars to place the whole sample on the theoretical Hertzsprung–Russell diagram for the first time in that way. The pulsating stars are discussed as a group, and arguments are given that the traditional separation of GW Vir pulsators in “DOV” and “PNNV” stars is misleading and should not be used.

Natural rubber with 50 mol % epoxidation (ENR-50) was filled with carbon nanotubes (CNTs) and conductive carbon black (CCB) hybrid fillers with various CCB loadings of 2.5, 5.0, 7.0, 10.0 and 15.0 phr, and the compounds were mixed with ferric ion (Fe3+) as a crosslinking agent. The ENRs filled exclusively with CNTs, and CNT–CCB hybrid fillers exhibited typical curing curves at different CCB loadings, i.e., increasing torque with time and thus crosslinked networks. Furthermore, the incorporation of CNT–CCB hybrid fillers and increasing CCB loadings caused an enhancement of tensile properties (modulus and tensile strength) and crosslink densities, which are indicated by the increasing torque difference and the crosslink densities. The crosslink densities are determined by swelling and temperature scanning stress relaxation (TSSR). Increasing CCB loadings also caused a significant improvement in bound rubber content, filler–rubber interactions, thermal resistance, glass transition temperature (Tg) and electrical conductivity. A combination of 7 phr CNT and CCB with loading higher than 2.5 phr gave superior properties to ENR vulcanizates. Furthermore, the secondary CCB filler contributes to the improvement of CNT dispersion in the ENR matrix by networking the CNT capsules and forming CNT–CCB–CNT pathways and thus strong CNT–CCB networks, indicating the improvement in the tensile properties, bound rubber content and dynamic properties of the ENR composites. Moreover, higher electrical conductivity with a comparatively low percolation threshold of the hybrid composites was found as compared to the ENR filled with CNTs without CCB composite. The superior mechanical and other properties are due to the finer dispersion and even distribution of CNT–CCB hybrid fillers in the ENR matrix.

The major controlling factors that determine the various mechanical properties of an elastomer system are type of chemical crosslinking and crosslink density of the polymer network. In this study, a catalytic amount of acrylonitrile butadiene copolymer (NBR) was used as a co-accelerator for the curing of polybutadiene (BR) elastomer. After the addition of this copolymer along with other conventional sulphur ingredients in polybutadiene compounds, a clear and distinct effect on the curing and other physical characteristics was noticed. The crosslinking density of BR was increased, as evidenced by rheometric properties, solid-state NMR and swelling studies. The vulcanization kinetics study revealed a substantial lowering of the activation energy of the sulphur crosslinking process when acrylonitrile butadiene copolymer was used in the formulation. The compounds were also prepared in the presence of carbon black and silica, and it was found that in the carbon black filled system the catalytic effect of the NBR was eminent. The effect was not only reflected in the mechanical performance but also the low-temperature crystallization behavior of BR systems was altered.

The preparation of intelligent structures for multiple smart applications such as soft-robotics, artificial limbs, etc., is a rapidly evolving research topic. In the present work, the preparation of a functional fabric, and its integration into a soft elastomeric matrix to develop an adaptive fiber-elastomer composite structure, is presented. Functional fabric, with the implementation of the shape memory effect, was combined with liquid polybutadiene rubber by means of a low-temperature vulcanization process. A detailed investigation on the crosslinking behavior of liquid polybutadiene rubber was performed to develop a rubber formulation that is capable of crosslinking liquid rubber at 75 °C, a temperature that is much lower than the phase transformation temperature of SMA wires (90–110 °C). By utilizing the unique low-temperature crosslinking protocol for liquid polybutadiene rubber, soft intelligent structures containing functional fabric were developed. The adaptive structures were successfully activated by Joule heating. The deformation behavior of the smart structures was experimentally demonstrated by reaching a 120 mm bending distance at an activation voltage of 8 V without an additional load, whereas 90 mm, 70 mm, 65 mm, 57 mm bending distances were achieved with attached weights of 5 g, 10 g, 20 g, 30 g, respectively.

Background/Aims: Recruitment and retention of research participants are challenging and critical components of successful clinical trials and natural history studies. Infants with spinal muscular atrophy (SMA) have been a particularly challenging population to study due to their fragile and complex medical issues, poor prognosis and, until 2016, a lack of effective therapies. Recruitment of healthy infants into clinical trials and natural history studies is also challenging and sometimes assumed to not be feasible. Methods: In 2011, our group initiated a two-year, longitudinal natural history study of infants with SMA and healthy infant controls to provide data to assist in the analysis and interpretation of planned clinical trials in infants with SMA. The recruitment goal was to enroll 27 infants less than 6 months of age with SMA and 27 age-matched healthy infants within the two-year enrollment period. A detailed recruitment and retention plan was developed for this purpose. In addition, a survey was administered to participant families to understand the determinants of participation in the study. Results: All healthy infants were recruited within the study's first year and 26 SMA infants were recruited within the two-year recruitment period. Thirty-eight participant families responded to the recruitment determinants survey. Nearly half of respondents (18/38, 48%) reported that they first heard of the study from their physician or neurologist. The most common reason to decide to enroll their infant (22/38, 58%) and to remain in the study (28/38, 74%) was their understanding of the importance of the study. Thematic recruitment tools such as a study brochure, video on social media, and presentations at advocacy meetings were reported to positively influence the decision to enroll. Conclusions: A proactive, thematic and inclusive recruitment and retention plan that effectively communicates the rationale of a clinical study and partners with patients, advocacy groups and the local communities can effectively recruit participants in vulnerable populations. Recommendations for the proactive integration of recruitment and retention plans into clinical trial protocol development are provided. Keywords: Social media, Altruism, Spinal muscle atrophy, Healthy controls, Network

From an environmental and economic viewpoint, it is a win–win strategy to use materials obtained from renewable resources for the production of high-performance elastomer composites. Lignin, being a renewable biomass, was employed as a functional filler material to obtain an elastomer composite with a higher degree of mechanical performance. In the presence of a suitable coupling agent, an elevated temperature was preferred for the reactive mixing of lignin with polybutadiene rubber (BR). It is quite fascinating that the mechanical performance of this composite was comparable with carbon black-filled composites. The extraordinary reinforcing behavior of lignin in the BR matrix was understood by an available model of rubber reinforcement. In rubber composite preparation, the interfacial interaction between polybutadiene rubber and lignin in the presence of a coupling agent enabled the efficient dispersion of lignin into the rubber matrix, which is responsible for the excellent mechanical properties of the rubber composites. The rubber composites thus obtained may lead to the development of a sustainable and cost-effective end product with reliable performance. This novel approach could be implemented in other type of elastomeric materials, enabling a genuine pathway toward a sustainable globe.

Kooperatif otomatik seyir kontrolü (CACC), araçtan araca haberleşme yöntemiyle veri iletilmesini ve uzaklık ölçümlerine göre yoğun trafikte güvenilir araç takibinin yapılmasını sağlar. Kullanılan CACC dizaynları dizi kararlılığının temel özelliklerini sorunsuz bir şekilde yerine getirirken doğrusal araç modelleri için sınırlıdır. Bu makalede ise, doğrusal olmayan araç modeli kullanıldığında ve lider araca uygulanan giriş sinyali doyuma uğramadığında dizi kararlılığının korunabildiği gösterilmiştir.

The friction and wear behavior of coated rubber components is strongly dependent on the substrate properties. This work deals with the impact of the crosslink density, i.e., the hardness of the rubber substrate on the tribological performance of uncoated and coated rubber. The hardness of nitrile butadiene rubber (NBR) is varied altering the sulfur content. Both the uncoated and coated rubber samples are characterized in terms of surface and mechanical properties. Tribological tests comprise the examination of the macroscopic contact area and the temperature in the contact zone. It was found that the functional layer enhances the wear resistance significantly. Apparently, the wear and friction behavior of the coated rubber correlates with the hardness and the bulk properties of the substrate material.

Dielectric elastomers (DEs) represent a class of electroactive polymers that deform due to electrostatic attraction between oppositely charged electrodes under a varying electric field. Over the last couple of decades, DEs have garnered considerable attention due to their much-coveted actuation properties. As far as the precise measurement systems are concerned, however, there is no standard instrument or interface to quantify various related parameters, e.g., actuation stress, strain, voltage and creeping etc. In this communication, we present an in-depth study of dielectric actuation behavior of dielectric rubbers by the state-of-the-art “Dresden Smart Rubber Analyzer” (DSRA), designed and developed in-house. The instrument allowed us to elucidate various factors that could influence the output efficiency of the DEs. Herein, several non-conventional DEs such as hydrogenated nitrile rubber, nitrile rubber with different acrylonitrile contents, were employed as an electro-active matrix. The effect of viscoelastic creeping on the prestrain, molecular architecture of the matrices, e.g., nitrile content of nitrile-butadiene rubber (NBR) etc., are also discussed in detail.

The article focuses on comparing the friction, abrasion, and crack growth behavior of two different kinds of silica-filled tire tread compounds loaded with (a) in-situ generated alkoxide silica and (b) commercial precipitated silica-filled compounds. The rubber matrix consists of solution styrene butadiene rubber polymers (SSBR). The in-situ generated particles are entirely different in filler morphology, i.e., in terms of size and physical structure, when compared to the precipitated silica. However, both types of the silicas were identified as amorphous in nature. Influence of filler morphology and surface modification of silica on the end performances of the rubbers like dynamic friction, abrasion index, and fatigue crack propagation were investigated. Compared to precipitated silica composites, in-situ derived silica composites offer better abrasion behavior and improved crack propagation with and without admixture of silane coupling agents. Silane modification, particle morphology, and crosslink density were identified as further vital parameters influencing the investigated rubber properties.

Specific physical and reactive compatibilization strategies are applied to enhance the interfacial adhesion and mechanical properties of heterogeneous polymer blends. Another pertinent challenge is the need of energy-intensive blending methods to blend high-tech polymers such as the blending of a pre-made hard polyurethane (-urea) with rubbers. We developed and investigated a reactive blending method to prepare the outstanding blends based on polyurethane-urea and rubbers at a low blending temperature and without any interfacial compatibilizing agent. In this study, the polyurethane-urea (PUU) was synthesized via the methylene diphenyl diisocyanate end-capped prepolymer and m-phenylene diamine based precursor route during blending at 100 °C with polar (carboxylated nitrile rubber (XNBR) and chloroprene rubber (CR)) and non-polar (natural rubber (NR), styrene butadiene rubber (sSBR), and ethylene propylene butadiene rubber (EPDM)) rubbers. We found that the in situ PUU reinforces the tensile response at low strain region and the dynamic-mechanical response up to 150 °C in the case of all used rubbers. Scanning electron microscopy reveals a stronger rubber/PUU interface, which promotes an effective stress transfer between the blend phases. Furthermore, energy filtered transmission electron microscopy (EFTEM) based elemental carbon map identifies an interphase region along the interface between the nitrile rubber and in situ PUU phases of this exemplary blend type.

In this work, we report about the mechanical relaxation characteristics of an intrinsically self-healable imidazole modified commercial rubber. This kind of self-healing rubber was prepared by melt mixing of 1-butyl imidazole with bromo-butyl rubber (bromine modified isoprene-isobutylene copolymer, BIIR). By this melt mixing process, the reactive allylic bromine of bromo-butyl rubber was converted into imidazole bromide salt. The resulting development of an ionic character to the polymer backbone leads to an ionic association of the groups which ultimately results to the formation of a network structure of the rubber chains. The modified BIIR thus behaves like a robust crosslinked rubber and shows unusual self-healing properties. The non-covalent reversible network has been studied in detail with respect to stress relaxation experiments, scanning electron microscopic and X-ray scattering.

O receio em nosso meio, em se retardar, erroneamente, a revascularização do miocárdio (RM) em pacientes idosos determinou a realização deste estudo. Um total de 361 pacientes foram, consecutivamente, submetidos a RM entre 1992 e 1995, no InCór, dos quais 30,7% eram mulheres, 69,3% homens; 36,7% encontravam-se em classe funcional III/IV. Foi realizada análise univariada com 19 fatores perioperatórios e, a seguir, multivariada (regressão logística) com as variáveis que mostraram associação significativa (p < 0,005). Os fatores prognósticos da morbidade operatória foram: diabete melito, ICC, angina instável. Os pós-operatórios foram: acidente vascular cerebral, insuficiência renal, infecção e suporte respiratório prolongado. Concluímos que a revascularização do miocárdio pode ser realizada em pacientes com idade avançada, acompanhada de excelentes resultados (baixa mortalidade operatória) especialmente pacientes em classe funcional de ICC não muito avançada, propiciando melhora significativa da qualidade de vida.The trend in Brazil of erroneously delaying myocardial revascularization in the elderly determined this study. Three hundred consecutive elderly patients (mean age: 73,92, standard deviation: 3.32). Between October 1992 and July 1995, 361 consecutive patients underwent isolated coronary artery bypass grafting, of whom 111 (30,7%) were females and 250 (69,35) males. There were 128 (35,5%) diabetic patients and 128 (36,7%) were in NYHA III/IV. Univariate analysis per-operatory of 19 factors followed by multivariate logistic regression analysis of the significant variables (p 0.005) were done. Major complication ocurred in 178 (49.3%) and were independent predictors of operative morbidity: Diabetes mellitus, NYHA funcional classification, urgent cases and DP2. There were 33 (9,1%) in hospital deaths, and diabetes mellitus, NYHA functional classification, unstable pre-operative angina and cerebral vascular acidents, renal failure, infection and insufficiency respiratory failure were independent predictors of operative mortality. We concluded that coronary artery bypass grafting is possible in elderly patients with a favorable outcome, especially when done in patients with normal to moderately depressed left ventricular function.