When is diabetes distress clinically meaningful?: establishing cut points for the Diabetes Distress Scale.

ObjectiveTo identify the pattern of relationships between the 17-item Diabetes Distress Scale (DDS17) and diabetes variables to establish scale cut points for high distress among patients with type 2 diabetes.Research design and methodsRecruited were 506 study 1 and 392 study 2 adults with type 2 diabetes from community medical groups. Multiple regression equations associated the DDS17, a 17-item scale that yields a mean-item score, with HbA(1c), diabetes self-efficacy, diet, and physical activity. Associations also were undertaken for the two-item DDS (DDS2) screener. Analyses included control variables, linear, and quadratic (curvilinear) DDS terms.ResultsSignificant quadratic effects occurred between the DDS17 and each diabetes variable, with increases in distress associated with poorer outcomes: study 1 HbA(1c) (P < 0.02), self-efficacy (P < 0.001), diet (P < 0.001), physical activity (P < 0.04); study 2 HbA(1c) (P < 0.03), self-efficacy (P < 0.004), diet (P < 0.04), physical activity (P = NS). Substantive curvilinear associations with all four variables in both studies began at unexpectedly low levels of DDS17: the slope increased linearly between scores 1 and 2, was more muted between 2 and 3, and reached a maximum between 3 and 4. This suggested three patient subgroups: little or no distress, <2.0; moderate distress, 2.0-2.9; high distress, ≥3.0. Parallel findings occurred for the DDS2.ConclusionsIn two samples of type 2 diabetic patients we found a consistent pattern of curvilinear relationships between the DDS and HbA(1c), diabetes self-efficacy, diet, and physical activity. The shape of these relationships suggests cut points for three patient groups: little or no, moderate, and high distress

Making automation pay - cost & throughput trade-offs in the manufacture of large composite components

The automation of complex manufacturing operations can provide significant savings over manual processes, and there remains much scope for increasing automation in the production of large scale structural composites. However the relationships between driving variables are complex, and the achievable throughput rate and corresponding cost for a given design are often not apparent. The deposition rate, number of machines required and unit production rates needed are interrelated and consequently the optimum unit cost is difficult to predict. A detailed study of the costs involved for a series of composite wing cover panels with different manufacturing requirements was undertaken. Panels were sized to account for manufacturing requirements and structural load requirements allowing both manual and automated lay-up procedures to influence design. It was discovered that the introduction of automated tape lay-up can significantly reduce material unit cost, and improve material utilisation, however higher production rates are needed to see this benefit

Detection of Coronal Mass Ejections in V471 Tauri with the Hubble Space Telescope

V471 Tauri, an eclipsing system consisting of a hot DA white dwarf (WD) and a dK2 companion in a 12.5-hour orbit, is the prototype of the pre-cataclysmic binaries. The late-type component is magnetically active, due to its being constrained to rotate synchronously with the short orbital period. During a program of UV spectroscopy of V471 Tau, carried out with the Goddard High Resolution Spectrograph (GHRS) onboard the Hubble Space Telescope, we serendipitously detected two episodes in which transient absorptions in the Si III 1206 A resonance line appeared suddenly, on a timescale of <2 min. The observations were taken in a narrow spectral region around Ly-alpha, and were all obtained near the two quadratures of the binary orbit, i.e., at maximum projected separation (~3.3 Rsun) of the WD and K star. We suggest that these transient features arise when coronal mass ejections (CME's) from the K2 dwarf pass across the line of sight to the WD. Estimates of the velocities, densities, and masses of the events in V471 Tau are generally consistent with the properties of solar CME's. Given our detection of 2 events during 6.8 hr of GHRS observing, along with a consideration of the restricted range of latitudes and longitudes on the K star's surface that can give rise to trajectories passing in front of the WD as seen from Earth, we estimate that the active V471 Tau dK star emits some 100-500 CME's per day, as compared to 1-3 per day for the Sun. The K dwarf's mass-loss rate associated with CME's is at least (5-25) x 10^{-14} Msun/yr, but it may well be orders of magnitude higher if most of the silicon is in ionization states other than Si III.Comment: 24 pages AASTeX, 4 figures. Accepted by Astrophysical Journa

Mapping warm molecular hydrogen with Spitzer's Infrared Array Camera (IRAC)

Photometric maps, obtained with Spitzer's Infrared Array Camera (IRAC), can provide a valuable probe of warm molecular hydrogen within the interstellar medium. IRAC maps of the supernova remnant IC443, extracted from the Spitzer archive, are strikingly similar to spectral line maps of the H2 pure rotational transitions that we obtained with the Infrared Spectrograph (IRS) instrument on Spitzer. IRS spectroscopy indicates that IRAC Bands 3 and 4 are indeed dominated by the H2 v=0-0 S(5) and S(7) transitions, respectively. Modeling of the H2 excitation suggests that Bands 1 and 2 are dominated by H2 v=1-0 O(5) and v=0-0 S(9). Large maps of the H2 emission in IC433, obtained with IRAC, show band ratios that are inconsistent with the presence of gas at a single temperature. The relative strengths of IRAC Bands 2, 3, and 4 are consistent with pure H2 emission from shocked material with a power-law distribution of gas temperatures. CO vibrational emissions do not contribute significantly to the observed Band 2 intensity. Assuming that the column density of H2 at temperatures T to T+dT is proportional to T raised to the power -b for temperatures up to 4000 K, we obtained a typical estimate of 4.5 for b. The power-law index, b, shows variations over the range 3 to 6 within the set of different sight-lines probed by the maps, with the majority of sight-lines showing b in the range 4 to 5. The observed power-law index is consistent with the predictions of simple models for paraboloidal bow shocks.Comment: 27 pages, including 11 figures. Accepted for publication in Ap

Observations of the Ca II K line in Hel0830A dark points on August 3, 1985

Spectroheliograms taken in the light of He I 10830 A at the National Solar Observatory Vacuum Telescope on Kitt Peak were used to identify coronal holes and bright points (BPs). Target points were identified, coordinates calculated, and spectra recorded. For each spectrum, the difference in wavelength between the Ca II K minimum and the FeI reference line was calculated. It was noteworthy that the overall effect is a blueshift. It should be noted that if material of chromospheric density moves outward at this velocity, it could supply the mass flux of the solar wind if this chromospheric flow was concentrated in a few dozen sources, each of a diameter of a few arc seconds

Kramers rate theory of ionization and dissociation of bound states

Calculating the microscopic dissociation rate of a bound state, such as a classical diatomic molecule, has been difficult so far. The problem was that standard theories require an energy barrier over which the bound particle (or state) escapes into the preferred low-energy state. This is not the case when the long-range repulsion responsible for the barrier is either absent or screened (as in Cooper pairs, ionized plasma, or biomolecular complexes). We solve this classical problem by accounting for entropic memory at the microscopic level. The theory predicts dissociation rates for arbitrary potentials and is successfully tested on the example of plasma, where it yields an estimate of ionization in the core of Sun in excellent agreement with experiments. In biology, the new theory accounts for crowding in receptor-ligand kinetics and protein aggregation

From Solar and Stellar Flares to Coronal Heating: Theory and Observations of How Magnetic Reconnection Regulates Coronal Conditions

There is currently no explanation of why the corona has the temperature and density it has. We present a model which explains how the dynamics of magnetic reconnection regulates the conditions in the corona. A bifurcation in magnetic reconnection at a critical state enforces an upper bound on the coronal temperature for a given density. We present observational evidence from 107 flares in 37 sun-like stars that stellar coronae are near this critical state. The model may be important to self-organized criticality models of the solar corona.Comment: 13 pages, 2 figures, accepted to Ap. J. Lett., February 200

Efficacy of alternative seating on attention, in-seat behavior, and occupational performance in children with Attention Deficit Hyperactivity Disorder

Currently, there is one systematic review conducted by Gochenour and Poskey7 that synthesize current research evidence regarding alternative seating for students with attention difficulties. A limitation of this review, as noted by the authors, is a lack of a consistent definition of attention difficulty in the studies they included. A systematic review focused on a specific, well-defined diagnosis will better contribute to practice recommendations since these recommendations will be tailored to a clear and comprehensive understanding of the child’s attentional and occupational challenges. The review also included studies of children with autism spectrum disorder (ASD).7 While those with ASD may also have difficulties with attention, in-seat behavior and occupational performance, the underlying mechanism yielding these symptoms may be different than in children with ADHD. Thus, alternative seating may not work in the same way for children with ASD as it would for children with ADHD.7 Thus, a systematic review is needed to examine the evidence from all current studies regarding alternative seating on improving attention, in-seat behavior and occupational performance in students with ADHD to increase evidence-based practice in the field of occupational therapy