Embodied Knowledge: Writing Researchers’ Bodies Into Qualitative Health Research

After more than a decade of postpositivist health care research and an increase in narrative writing practices, social scientific, qualitative health research remains largely disembodied. The erasure of researchers’ bodies from conventional accounts of research obscures the complexities of knowledge production and yields deceptively tidy accounts of research. Qualitative health research could benefit significantly from embodied writing that explores the discursive relationship between the body and the self and the semantic challenges of writing the body by incorporating bodily details and experiences into research accounts. Researchers can represent their bodies by incorporating autoethnographic narratives, drawing on all of their senses, interrogating the connections between their bodily signifiers and research processes, and experimenting with the semantics of self and body. The author illustrates opportunities for embodiment with excerpts from an ethnography of a geriatric oncology team and explores implications of embodied writing for the practice of qualitative health research

Mapping the column density and dust temperature structure of IRDCs with Herschel

Infrared dark clouds (IRDCs) are cold and dense reservoirs of gas potentially available to form stars. Many of these clouds are likely to be pristine structures representing the initial conditions for star formation. The study presented here aims to construct and analyze accurate column density and dust temperature maps of IRDCs by using the first Herschel data from the Hi-GAL galactic plane survey. These fundamental quantities, are essential for understanding processes such as fragmentation in the early stages of the formation of stars in molecular clouds. We have developed a simple pixel-by-pixel SED fitting method, which accounts for the background emission. By fitting a grey-body function at each position, we recover the spatial variations in both the dust column density and temperature within the IRDCs. This method is applied to a sample of 22 IRDCs exhibiting a range of angular sizes and peak column densities. Our analysis shows that the dust temperature decreases significantly within IRDCs, from background temperatures of 20-30 K to minimum temperatures of 8-15 K within the clouds, showing that dense molecular clouds are not isothermal. Temperature gradients have most likely an important impact on the fragmentation of IRDCs. Local temperature minima are strongly correlated with column density peaks, which in a few cases reach NH2 = 1 x 10^{23} cm^{-2}, identifying these clouds as candidate massive prestellar cores. Applying this technique to the full Hi-GAL data set will provide important constraints on the fragmentation and thermal properties of IRDCs, and help identify hundreds of massive prestellar core candidates.Comment: Accepted for publication in A&A Herschel special issu

The dynamical evolution of molecular clouds near the Galactic Centre – II. Spatial structure and kinematics of simulated clouds

This article has been accepted for publication in Monthly Notices of the Royal Astronomical Society ©: 2019 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society. All rights reserved.The evolution of molecular clouds in galactic centres is thought to differ from that in galactic discs due to a significant influence of the external gravitational potential. We present a set of numerical simulations of molecular clouds orbiting on the 100-pc stream of the Central Molecular Zone (the central ∼500pc of the Galaxy) and characterize their morphological and kinematic evolution in response to the background potential and eccentric orbital motion. We find that the clouds are shaped by strong shear and torques, by tidal and geometric deformation, and by their passage through the orbital pericentre. Within our simulations, these mechanisms control cloud sizes, aspect ratios, position angles, filamentary structure, column densities, velocity dispersions, line-of-sight velocity gradients, spin angular momenta, and kinematic complexity. By comparing these predictions to observations of clouds on the Galactic Centre ‘dust ridge’, we find that our simulations naturally reproduce a broad range of key observed morphological and kinematic features, which can be explained in terms of well-understood physical mechanisms. We argue that the accretion of gas clouds on to the central regions of galaxies, where the rotation curve turns over and the tidal field is fully compressive, is accompanied by transformative dynamical changes to the clouds, leading to collapse and star formation. This can generate an evolutionary progression of cloud collapse with a common starting point, which either marks the time of accretion on to the tidally compressive region or of the most recent pericentre passage. Together, these processes may naturally produce the synchronized starbursts observed in numerous (extra)galactic nuclei

New insights into risk factors for transplant-associated thrombotic microangiopathy in pediatric HSCT

This study aimed to identify a risk profile for development of transplant-associated thrombotic microangiopathy (TA-TMA) in children undergoing hematopoietic stem cell transplantation (HSCT). Between 2013 and 2016, 439 children underwent 474 HSCTs at 2 supraregional United Kingdom centers. At a median of 153 days post-HSCT, TA-TMA occurred among 25 of 441 evaluable cases (5.6%) with no evidence of center variation. Sex, underlying disease, intensity of the conditioning, total body irradiation–based conditioning, the use of calcineurin inhibitors, venoocclusive disease, and viral reactivation did not influence the development of TA-TMA. Donor type: matched sibling donor/matched family donor vs matched unrelated donor vs mismatched unrelated donor/haplo-HSCT, showed a trend toward the development of TA-TMA in 1.8% vs 6.1% vs 8.3%, respectively. Presence of active comorbidity was associated with an increased risk for TA-TMA; 13% vs 3.7% in the absence of comorbidity. The risk of TA-TMA was threefold higher among patients who received >1 transplant. TA-TMA rates were significantly higher among patients with acute graft-versus-host disease (aGVHD) grades III to IV vs aGVHD grade 0 to II. On multivariate analysis, the presence of active comorbidity, >1 transplant, aGVHD grade III to IV were risk factors for TA-TMA (odds ratio [OR]: 5.1, 5.2, and 26.9; respectively), whereas the use of cyclosporine A/tacrolimus-based GVHD prophylaxis was not a risk factor for TA-TMA (OR: 0.3). Active comorbidity, subsequent transplant, and aGVHD grades III to IV were significant risk factors for TA-TMA. TA-TMA might represent a form of a vascular GVHD, and therefore, continuing control of aGVHD is important to prevent worsening of TA-TMA associated with GVHD

Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples’ experiences

Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status varied. Participants experienced distress as their notion of self identity shifted and emotions that reflected the various stages of the grief process were evident in participants’ accounts. The process of self-managing lifestyle took place through experiential learning; the level of engagement with lifestyle change reflected an individual’s unique view of the balance needed to manage ‘realistic change’ whilst leading to a life that was perceived as ‘worth living’. Findings highlight the importance of providing person centred care that aligns with both psychological and physical dimensions of recovery which are inextricably linked

Dense gas in the Galactic central molecular zone is warm and heated by turbulence

The Galactic center is the closest region in which we can study star formation under extreme physical conditions like those in high-redshift galaxies. We measure the temperature of the dense gas in the central molecular zone (CMZ) and examine what drives it. We mapped the inner 300 pc of the CMZ in the temperature-sensitive J = 3-2 para-formaldehyde (p-H$_2$CO) transitions. We used the $3_{2,1} - 2_{2,0} / 3_{0,3} - 2_{0,2}$ line ratio to determine the gas temperature in $n \sim 10^4 - 10^5$cm$^{-3}$ gas. We have produced temperature maps and cubes with 30" and 1 km/s resolution and published all data in FITS form. Dense gas temperatures in the Galactic center range from ~60 K to > 100 K in selected regions. The highest gas temperatures T_G > 100 K are observed around the Sgr B2 cores, in the extended Sgr B2 cloud, the 20 km/s and 50 km/s clouds, and in "The Brick" (G0.253+0.016). We infer an upper limit on the cosmic ray ionization rate ${\zeta}_{CR} < 10^{-14}$ 1/s. The dense molecular gas temperature of the region around our Galactic center is similar to values found in the central regions of other galaxies, in particular starburst systems. The gas temperature is uniformly higher than the dust temperature, confirming that dust is a coolant in the dense gas. Turbulent heating can readily explain the observed temperatures given the observed line widths. Cosmic rays cannot explain the observed variation in gas temperatures, so CMZ dense gas temperatures are not dominated by cosmic ray heating. The gas temperatures previously observed to be high in the inner ~75 pc are confirmed to be high in the entire CMZ

A Sensitive Branched DNA HIV-1 Signal Amplification Viral Load Assay with Single Day Turnaround

Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. The VERSANT® HIV-1 RNA 3.0 Assay (bDNA) (“Versant Assay”) currently used in clinical laboratories was modified to allow shorter target incubation, enabling the viral load assay to be run in a single day. To dramatically reduce the target incubation from 16–18 h to 2.5 h, composition of only the “Lysis Diluent” solution was modified. Nucleic acid probes in the assay were unchanged. Performance of the modified assay (assay in development; not commercially available) was evaluated and compared to the Versant Assay. Dilution series replicates (>950 results) were used to demonstrate that analytical sensitivity, linearity, accuracy, and precision for the shorter modified assay are comparable to the Versant Assay. HIV RNA-positive clinical specimens (n = 135) showed no significant difference in quantification between the modified assay and the Versant Assay. Equivalent relative quantification of samples of eight genotypes was demonstrated for the two assays. Elevated levels of several potentially interfering endogenous substances had no effect on quantification or specificity of the modified assay. The modified assay with drastically improved turnaround time demonstrates the viability of signal-amplifying technology, such as bDNA, as an alternative to the PCR-based assays dominating viral load monitoring in clinical laboratories. Highly sensitive bDNA assays with a single day turnaround may be ideal for laboratories with especially stringent cost, contamination, or reliability requirements

Molecular gas kinematics within the central 250 pc of the Milky Way

This article has been accepted for publication in Monthly Notices of the Royal Astronomical Society. ©2016 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society.Using spectral line observations of HNCO, N2H+, and HNC, we investigate the kinematics of dense gas in the central ∼250 pc of the Galaxy. We present SCOUSE (Semi-automated multi-COmponent Universal Spectral-line fitting Engine), a line-fitting algorithm designed to analyse large volumes of spectral line data efficiently and systematically. Unlike techniques which do not account for complex line profiles, SCOUSE accurately describes the {l, b, vLSR} distribution of Central Molecular Zone (CMZ) gas, which is asymmetric about Sgr A* in both position and velocity. Velocity dispersions range from 2.6 km s−1 < σ < 53.1 km s−1. A median dispersion of 9.8 km s−1, translates to a Mach number, M3D≥28. The gas is distributed throughout several ‘streams’, with projected lengths ∼100–250 pc. We link the streams to individual clouds and sub-regions, including Sgr C, the 20 and 50 km s−1 clouds, the dust ridge, and Sgr B2. Shell-like emission features can be explained by the projection of independent molecular clouds in Sgr C and the newly identified conical profile of Sgr B2 in {l, b, vLSR} space. These features have previously invoked supernova-driven shells and cloud–cloud collisions as explanations. We instead caution against structure identification in velocity-integrated emission maps. Three geometries describing the 3D structure of the CMZ are investigated: (i) two spiral arms; (ii) a closed elliptical orbit; (iii) an open stream. While two spiral arms and an open stream qualitatively reproduce the gas distribution, the most recent parametrization of the closed elliptical orbit does not. Finally, we discuss how proper motion measurements of masers can distinguish between these geometries, and suggest that this effort should be focused on the 20 km s−1 and 50 km s−1 clouds and Sgr C.Peer reviewe