Corporal diagnostic work and diagnostic spaces: Clinicians' use of space and bodies during diagnosis

© 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.An emerging body of literature in sociology has demonstrated that diagnosis is a useful focal point for understanding the social dimensions of health and illness. This article contributes to this work by drawing attention to the relationship between diagnostic spaces and the way in which clinicians use their own bodies during the diagnostic process. As a case study, we draw upon fieldwork conducted with a multidisciplinary clinical team providing deep brain stimulation (DBS) to treat children with a movement disorder called dystonia. Interviews were conducted with team members and diagnostic examinations were observed. We illustrate that clinicians use communicative body work and verbal communication to transform a material terrain into diagnostic space, and we illustrate how this diagnostic space configures forms of embodied 'sensing-and-acting' within. We argue that a 'diagnosis' can be conceptualised as emerging from an interaction in which space, the clinician-body, and the patient-body (or body-part) mutually configure one another. By conceptualising diagnosis in this way, this article draws attention to the corporal bases of diagnostic power and counters Cartesian-like accounts of clinical work in which the patient-body is objectified by a disembodied medical discourse.The Wellcome Trust (Wellcome Trust Biomedical Strategic Award 086034

Vanishing Fe 3d orbital moments in single-crystalline magnetite

We show detailed magnetic absorption spectroscopy results of an in situ cleaved high quality single crystal of magnetite. In addition the experimental setup was carefully optimized to reduce drift, self absorption, and offset phenomena as far as possible. In strong contradiction to recently published data, our observed orbital moments are nearly vanishing and the spin moments are quite close to the integer values proposed by theory. This very important issue supports the half metallic full spin polarized picture of magnetite.Comment: 7 pages, 4 figure

Spectral and polarimetric characterization of the Gas Pixel Detector filled with dimethyl ether

The Gas Pixel Detector belongs to the very limited class of gas detectors optimized for the measurement of X-ray polarization in the emission of astrophysical sources. The choice of the mixture in which X-ray photons are absorbed and photoelectrons propagate, deeply affects both the energy range of the instrument and its performance in terms of gain, track dimension and ultimately, polarimetric sensitivity. Here we present the characterization of the Gas Pixel Detector with a 1 cm thick cell filled with dimethyl ether (DME) at 0.79 atm, selected among other mixtures for the very low diffusion coefficient. Almost completely polarized and monochromatic photons were produced at the calibration facility built at INAF/IASF-Rome exploiting Bragg diffraction at nearly 45 degrees. For the first time ever, we measured the modulation factor and the spectral capabilities of the instrument at energies as low as 2.0 keV, but also at 2.6 keV, 3.7 keV, 4.0 keV, 5.2 keV and 7.8 keV. These measurements cover almost completely the energy range of the instrument and allows to compare the sensitivity achieved with that of the standard mixture, composed of helium and DME.Comment: 20 pages, 11 figures, 5 tables. Accepted for publication by NIM

Detailed Calculation of Test-Mass Charging in the LISA Mission

The electrostatic charging of the LISA test masses due to exposure of the spacecraft to energetic particles in the space environment has implications in the design and operation of the gravitational inertial sensors and can affect the quality of the science data. Robust predictions of charging rates and associated stochastic fluctuations are therefore required for the exposure scenarios expected throughout the mission. We report on detailed charging simulations with the Geant4 toolkit, using comprehensive geometry and physics models, for Galactic cosmic-ray protons and helium nuclei. These predict positive charging rates of 50 +e/s (elementary charges per second) for solar minimum conditions, decreasing by half at solar maximum, and current fluctuations of up to 30 +e/s/Hz^{1/2}. Charging from sporadic solar events involving energetic protons was also investigated. Using an event-size distribution model, we conclude that their impact on the LISA science data is manageable. Several physical processes hitherto unexplored as potential charging mechanisms have also been assessed. Significantly, the kinetic emission of very low-energy secondary electrons due to bombardment of the inertial sensors by primary cosmic rays and their secondaries can produce charging currents comparable with the Monte Carlo rates.Comment: 31 pages, 18 figures, 4 tables. to be published in Astroparticle Physics. Changed due to error found in normalisation of the simulation result

Hot dense capsule implosion cores produced by z-pinch dynamic hohlraum radiation

Hot dense capsule implosions driven by z-pinch x-rays have been measured for the first time. A ~220 eV dynamic hohlraum imploded 1.7-2.1 mm diameter gas-filled CH capsules which absorbed up to ~20 kJ of x-rays. Argon tracer atom spectra were used to measure the Te~ 1keV electron temperature and the ne ~ 1-4 x10^23 cm-3 electron density. Spectra from multiple directions provide core symmetry estimates. Computer simulations agree well with the peak compression values of Te, ne, and symmetry, indicating reasonable understanding of the hohlraum and implosion physics.Comment: submitted to Phys. Rev. Let

Low energy polarization sensitivity of the Gas Pixel Detector

An X-ray photoelectric polarimeter based on the Gas Pixel Detector has been proposed to be included in many upcoming space missions to fill the gap of about 30 years from the first (and to date only) positive measurement of polarized X-ray emission from an astrophysical source. The estimated sensitivity of the current prototype peaks at an energy of about 3 keV, but the lack of readily available polarized sources in this energy range has prevented the measurement of detector polarimetric performances. In this paper we present the measurement of the Gas Pixel Detector polarimetric sensitivity at energies of a few keV and the new, light, compact and transportable polarized source that was devised and built to this aim. Polarized photons are produced, from unpolarized radiation generated with an X-ray tube, by means of Bragg diffraction at nearly 45 degrees. The employment of mosaic graphite and flat aluminum crystals allow the production of nearly completely polarized photons at 2.6, 3.7 and 5.2 keV from the diffraction of unpolarized continuum or line emission. The measured modulation factor of the Gas Pixel Detector at these energies is in good agreement with the estimates derived from a Monte Carlo software, which was up to now employed for driving the development of the instrument and for estimating its low energy sensitivity. In this paper we present the excellent polarimetric performance of the Gas Pixel Detector at energies where the peak sensitivity is expected. These measurements not only support our previous claims of high sensitivity but confirm the feasibility of astrophysical X-ray photoelectric polarimetry.Comment: 15 pages, 12 figures. Accepted for publication in NIM

Canine NAPEPLD-associated models of human myelin disorders

Canine leukoencephalomyelopathy (LEMP) is a juvenile-onset neurodegenerative disorder of the CNS white matter currently described in Rottweiler and Leonberger dogs. Genome-wide association study (GWAS) allowed us to map LEMP in a Leonberger cohort to dog chromosome 18. Subsequent whole genome re-sequencing of a Leonberger case enabled the identification of a single private homozygous non-synonymous missense variant located in the highly conserved metallo-beta-lactamase domain of the N-acyl phosphatidylethanolamine phospholipase D (NAPEPLD) gene, encoding an enzyme of the endocannabinoid system. We then sequenced this gene in LEMP-affected Rottweilers and identified a different frameshift variant, which is predicted to replace the C-terminal metallo-beta-lactamase domain of the wild type protein. Haplotype analysis of SNP array genotypes revealed that the frameshift variant was present in diverse haplotypes in Rottweilers, and also in Great Danes, indicating an old origin of this second NAPEPLD variant. The identification of different NAPEPLD variants in dog breeds affected by leukoencephalopathies with heterogeneous pathological features, implicates the NAPEPLD enzyme as important in myelin homeostasis, and suggests a novel candidate gene for myelination disorders in people

Epidemiology of Aortic Aneurysm Repair in the United States from 1993 to 2003

The epidemiology of abdominal aortic aneurysm (AAA) disease has been well described over the preceding 50 years. This disease primarily affects elderly males with smoking, hypertension, and a positive family history contributing to an increased risk of aneurysm formation. The aging population as well as increased screening in high-risk populations has led some to suggest that the incidence of AAAs is increasing. The National Inpatient Sample (1993 2003), a national representative database, was used in this study to determine trends in mortality following AAA repair in the United States. In addition, the impact of the introduction of less invasive endovascular AAA repair was assessed. Overall rates of treated unruptured and ruptured AAAs remained stable (unruptured 12 to 15 100,000; ruptured 1 to 3 100,000). In 2003, 42.7 of unruptured and 8.8 of ruptured AAAs were repaired through an endovascular approach. Inhospital mortality following unruptured AAA repair continues to decline for open repair (5.3 to 4.7 , P 0.007). Mortality after elective endovascular AAA repair also has statistically decreased (2.1 to 1.0 , P 0.024) and remains lower than open repair. Mortality rates for ruptured AAAs following repair remain high (open: 46.5 to 40.7 , P 0.01; endovascular: 40.0 to 35.3 , P 0.823). These data suggest that the numbers of patients undergoing elective AAA repair have remained relatively stable despite the introduction of less invasive technology. A shift in the treatment paradigm is occurring with a higher percentage of patients subjected to elective endovascular AAA repair compared to open repair. This shift, at least in the short term, appears justified as the mortality in patients undergoing elective endovascular AAA repair is significantly reduced compared to patients undergoing open AAA repair.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73855/1/annals.1383.030.pd

Comment on "X-ray resonant scattering studies of orbital and charge ordering in Pr1-xCaxMnO3"

In a recent published paper [Phys. Rev. B 64, 195133 (2001)], Zimmermann et al. present a systematic x-ray scattering study of charge and orbital ordering phenomena in the Pr1-xCaxMnO3 series with x= 0.25, 0.4 and 0.5. They propose that for Ca concentrations x=0.4 and 0.5, the appearance of (0, k+1/2, 0) reflections are originated by the orbital ordering of the eg electrons in the a-b plane while the (0, 2k+1, 0) reflections are due to the charge ordering among the Mn3+ and Mn4+ ions. Moreover, for small Ca concentrations (x<0.3), the orbital ordering is only considered and it occurs at (0, k, 0) reflections. A rigorous analysis of all these resonance reflections will show the inadequacy of the charge-orbital model proposed to explain the experimental results. In addition, this charge-orbital model is highly inconsistent with the electronic balance. On the contrary, these reflections can be easily understood as arising from the anisotropy of charge distribution induced by the presence of local distortions, i.e. due to a structural phase transition.Comment: 10 pages, 2 figures.To be published Phys. Rev.