Psychosocial Factors in Diabetes and Cardiovascular Risk

Type 2 diabetes is a chronic disease that is increasing in prevalence globally. Cardiovascular disease is a major cause of mortality and morbidity in diabetes, and lifestyle and clinical risk factors do not fully account for the link between the conditions. This article provides an overview of the evidence concerning the role of psychosocial stress factors in diabetes risk, as well as in cardiovascular complications in people with existing diabetes. Several types of psychosocial factors are discussed including depression, other types of emotional distress, exposure to stressful conditions, and personality traits. The potential behavioral and biological pathways linking psychosocial factors to diabetes are presented and implications for patient care are highlighted

Ground simulation and tunnel blockage for a swept, jet-flapped wing tested to very high lift coefficients

Ground effects experiments and large/small tunnel interference studies were carried out on a model with a 20 inch (50.8 cm) 25 degree swept wing. The wing is slatted, has a 60 degree knee-blown flap and can be fitted with unflapped tips. A tail rake of pitch-yaw probes can be fitted to the fuselage. Certain check tests were also made with a very similar straight-wing model

Exploratory studies of the cruise performance of upper surface blown configurations: Experimental program, high-speed pressure tests

Basic pressure data are presented which was obtained from an experimental study of upper-surface blown configurations at cruise. The high-speed (subsonic) experimental work, studying the aerodynamic effects of wing-nacelle geometric variations, was conducted around semi-span model configurations composed of diversified, interchangeable components. Power simulation was provided by high-pressure air ducted through closed forebody nacelles. Nozzle geometry was varied across size, exit aspect ratio, exit position and boattail angle. Both 3-D force and 2-D pressure measurements were obtained at cruise Mach numbers from 0.5 to 0.8 and at nozzle pressure ratios up to about 3.0. The experimental investigation was supported by an analytical synthesis of the system using a vortex lattice representation with first-order power effects. Results are also presented from a compatibility study in which a short-haul transport is designed on the basis of the aerodynamic findings in the experimental study as well as acoustical data obtained in a concurrent program. High-lift test data are used to substantiate the projected performance of the selected transport design

Exploratory studies of the cruise performance of upper surface blown configuration: Experimental program, high-speed force tests

The work to develop a wing-nacelle arrangement to accommodate a wide range of upper surface blown configuration is reported. Pertinent model and installation details are described. Data of the effects of a wide range of nozzle geometric variations are presented. Nozzle aspect ratio, boattail angle, and chordwise position are among the parameters investigated. Straight and swept wing configurations were tested across a range of nozzle pressure ratios, lift coefficients, and Mach numbers

Exploratory studies of the cruise performance of upper surface blown configurations. Experimental program: Test facilities, model design instrumentation, and lowspeed, high-lift tests

The model hardware, test facilities and instrumentation utilized in an experimental study of upper surface blown configurations at cruise is described. The high speed (subsonic) experimental work, studying the aerodynamic effects of wing nacelle geometric variations, was conducted around semispan model configurations composed of diversified, interchangeable components. Power simulation was provided by high pressure air ducted through closed forebody nacelles. Nozzle geometry was varied across size, exit aspect ratio, exit position and boattail angle. Three dimensional force and two dimensional pressure measurements were obtained at cruise Mach numbers from 0.5 to 0.8 and at nozzle pressure ratios up to about 3.0. The experimental investigation was supported by an analytical synthesis of the system using a vortex lattice representation with first order power effects. Results are also presented from a compatibility study in which a short haul transport is designed on the basis of the aerodynamic findings in the experimental study as well as acoustical data obtained in a concurrent program. High lift test data are used to substantiate the projected performance of the selected transport design

Ground simulation and tunnel blockage for a jet-flapped, basic STOL model tested to very high lift coefficients

Ground effects experiments and large/small-tunnel interference studies were carried out on a model with a 20-inch (50.8 cm) span wing. The wing, which includes a highly deflected knee-blown flap can be fitted with unflapped tips and slats. A low-mounted tailplane can be fitted to the aft fuselage. Three-component balance meaurements, made with a fixed ground equipped with a single boundary-layer blowing slot, were compared with datum, moving-ground results. Good comparisons were obtained up to model blowing momentum coefficients of approximately two, after which the particular floor blowing settings used proved insufficient to prevent floor separation in the vicinity of the model. Skin friction measurements, taken routinely along the floor centerline, proved invaluable during the analysis of results, and their use is recommended as input to determination of floor BLC setting. A careful investigation was made of pitching moments, including tail-on, close-to-ground cases, with favorable results. Drag proved the most sensitive to the change from a moving to the boundary-layer controlled ground

Optimism moderates psychophysiological responses to stress in older people with Type 2 diabetes

Optimism is thought to be beneficial for health, and these effects may be mediated through modifications in psychophysiological stress reactivity. Type 2 diabetes (T2D) is associated with reduced cardiovascular responses to stress and heightened cortisol over the day. This study assessed the relationships between optimism, stress responsivity, and daily cortisol output in people with T2D. A total of 140 participants with T2D were exposed to laboratory stress. Heart rate (HR), systolic (SBP), diastolic blood pressure (DBP), and cortisol were measured throughout the session. Cortisol output over the day was also assessed. Optimism and self-reported health were measured using the revised Life Orientation Test and the Short Form Health Survey. Optimism was associated with heightened SBP and DBP stress reactivity (ps  .180). Low optimism was related to poorer self-reported physical and mental health (ps < .01). Optimism could have a protective role in modulating stress-related autonomic and neuroendocrine dysregulation in people with T2D

Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery.

BACKGROUND: Stroke is the major cause of adult disability. Selective serotonin reuptake inhibitors (SSRIs) have been used for many years to manage depression. Recently, small trials have demonstrated that SSRIs might improve recovery after stroke, even in people who are not depressed. Systematic reviews and meta-analyses are the least biased way to bring together data from several trials. Given the promising effect of SSRIs on stroke recovery seen in small trials, a systematic review and meta-analysis is needed. OBJECTIVES: To determine whether SSRIs improve recovery after stroke, and whether treatment with SSRIs was associated with adverse effects. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (August 2011), Cochrane Depression Anxiety and Neurosis Group Trials Register (November 2011), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 8), MEDLINE (from 1948 to August 2011), EMBASE (from 1980 to August 2011), CINAHL (from 1982 to August 2011), AMED (Allied and Complementary Medicine) (from 1985 to August 2011), PsycINFO (from 1967 to August 2011) and PsycBITE (Pyschological Database for Brain Impairment Treatment Efficacy) (March 2012). To identify further published, unpublished and ongoing trials we searched trials registers, pharmaceutical websites, reference lists, contacted experts and performed citation tracking of included studies. SELECTION CRITERIA: We included randomised controlled trials that recruited stroke survivors (ischaemic or haemorrhagic) at any time within the first year. The intervention was any SSRI, given at any dose, for any period. We excluded drugs with mixed pharmacological effects. The comparator was usual care or placebo. In order to be included, trials had to collect data on at least one of our primary (dependence and disability) or secondary (impairments, depression, anxiety, quality of life, fatigue, healthcare cost, death, adverse events and leaving the trial early) outcomes. DATA COLLECTION AND ANALYSIS: We extracted data on demographics, type of stroke, time since stroke, our primary and secondary outcomes, and sources of bias. For trials in English, two review authors independently extracted data. For Chinese papers, one review author extracted data. We used standardised mean differences (SMD) to estimate treatment effects for continuous variables, and risk ratios (RR) for dichotomous effects, with their 95% confidence intervals (CIs). MAIN RESULTS: We identified 56 completed trials of SSRI versus control, of which 52 trials (4059 participants) provided data for meta-analysis. There were statistically significant benefits of SSRI on both of the primary outcomes: RR for reducing dependency at the end of treatment was 0.81 (95% CI 0.68 to 0.97) based on one trial, and for disability score, the SMD was 0.91 (95% CI 0.60 to 1.22) (22 trials involving 1343 participants) with high heterogeneity between trials (I(2) = 87%; P < 0.0001). For neurological deficit, depression and anxiety, there were statistically significant benefits of SSRIs. For neurological deficit score, the SMD was -1.00 (95% CI -1.26 to -0.75) (29 trials involving 2011 participants) with high heterogeneity between trials (I(2) = 86%; P < 0.00001). For dichotomous depression scores, the RR was 0.43 (95% CI 0.24 to 0.77) (eight trials involving 771 participants) with high heterogeneity between trials (I(2) = 77%; P < 0.0001). For continuous depression scores, the SMD was -1.91 (95% CI -2.34 to -1.48) (39 trials involving 2728 participants) with high heterogeneity between trials (I(2) = 95%; P < 0.00001). For anxiety, the SMD was -0.77 (95% CI -1.52 to -0.02) (eight trials involving 413 participants) with high heterogeneity between trials (I(2) = 92%; P < 0.00001). There was no statistically significant benefit of SSRI on cognition, death, motor deficits and leaving the trial early. For cognition, the SMD was 0.32 (95% CI -0.23 to 0.86), (seven trials involving 425 participants) with high heterogeneity between trials (I(2) = 86%; P < 0.00001). The RR for death was 0.76 (95% CI 0.34 to 1.70) (46 trials involving 3344 participants) with no heterogeneity between trials (I(2) = 0%; P = 0.85). For motor deficits, the SMD was -0.33 (95% CI -1.22 to 0.56) (two trials involving 145 participants). The RR for leaving the trial early was 1.02 (95% CI 0.86 to 1.21) in favour of control, with no heterogeneity between trials. There was a non-significant excess of seizures (RR 2.67; 95% CI 0.61 to 11.63) (seven trials involving 444 participants), a non-significant excess of gastrointestinal side effects (RR 1.90; 95% CI 0.94 to 3.85) (14 trials involving 902 participants) and a non-significant excess of bleeding (RR 1.63; 95% CI 0.20 to 13.05) (two trials involving 249 participants) in those allocated SSRIs. Data were not available on quality of life, fatigue or healthcare costs.There was no clear evidence from subgroup analyses that one SSRI was consistently superior to another, or that time since stroke or depression at baseline had a major influence on effect sizes. Sensitivity analyses suggested that effect sizes were smaller when we excluded trials at high or unclear risk of bias.Only eight trials provided data on outcomes after treatment had been completed; the effect sizes were generally in favour of SSRIs but CIs were wide. AUTHORS' CONCLUSIONS: SSRIs appeared to improve dependence, disability, neurological impairment, anxiety and depression after stroke, but there was heterogeneity between trials and methodological limitations in a substantial proportion of the trials. Large, well-designed trials are now needed to determine whether SSRIs should be given routinely to patients with stroke

Asymptotic Flatness in Rainbow Gravity

A construction of conformal infinity in null and spatial directions is constructed for the Rainbow-flat space-time corresponding to doubly special relativity. From this construction a definition of asymptotic DSRness is put forward which is compatible with the correspondence principle of Rainbow gravity. Furthermore a result equating asymptotically flat space-times with asymptotically DSR spacetimes is presented.Comment: 11 page

An evaluation of genotyping by sequencing (GBS) to map the <em>Breviaristatum-e (ari-e)</em> locus in cultivated barley

ABSTRACT: We explored the use of genotyping by sequencing (GBS) on a recombinant inbred line population (GPMx) derived from a cross between the two-rowed barley cultivar ‘Golden Promise’ (ari-e.GP/Vrs1) and the six-rowed cultivar ‘Morex’ (Ari-e/vrs1) to map plant height. We identified three Quantitative Trait Loci (QTL), the first in a region encompassing the spike architecture gene Vrs1 on chromosome 2H, the second in an uncharacterised centromeric region on chromosome 3H, and the third in a region of chromosome 5H coinciding with the previously described dwarfing gene Breviaristatum-e (Ari-e). BACKGROUND: Barley cultivars in North-western Europe largely contain either of two dwarfing genes; Denso on chromosome 3H, a presumed ortholog of the rice green revolution gene OsSd1, or Breviaristatum-e (ari-e) on chromosome 5H. A recessive mutant allele of the latter gene, ari-e.GP, was introduced into cultivation via the cv. ‘Golden Promise’ that was a favourite of the Scottish malt whisky industry for many years and is still used in agriculture today. RESULTS: Using GBS mapping data and phenotypic measurements we show that ari-e.GP maps to a small genetic interval on chromosome 5H and that alternative alleles at a region encompassing Vrs1 on 2H along with a region on chromosome 3H also influence plant height. The location of Ari-e is supported by analysis of near-isogenic lines containing different ari-e alleles. We explored use of the GBS to populate the region with sequence contigs from the recently released physically and genetically integrated barley genome sequence assembly as a step towards Ari-e gene identification. CONCLUSIONS: GBS was an effective and relatively low-cost approach to rapidly construct a genetic map of the GPMx population that was suitable for genetic analysis of row type and height traits, allowing us to precisely position ari-e.GP on chromosome 5H. Mapping resolution was lower than we anticipated. We found the GBS data more complex to analyse than other data types but it did directly provide linked SNP markers for subsequent higher resolution genetic analysis