Local Magnetic Field Role in Star Formation

We highlight distinct and systematic observational features of magnetic field morphologies in polarized submm dust continuum. We illustrate this with specific examples and show statistical trends from a sample of 50 star-forming regions.Comment: 4 pages, 3 figures; to appear in the EAS Proceedings of the 6th Zermatt ISM Symposium "Conditions and Impact of Star Formation from Lab to Space", September 201

Financial Toxicity in Cancer Patients and Subsequent Risk of Repeat Acute Care Utilization

BACKGROUND: Acute care (AC) visits by cancer patients are costly sources of healthcare resources and can exert a financial burden of oncology care both for individuals with cancer and healthcare systems. We sought to identify whether cancer patients who reported more severe initial financial toxicity (FT) burdens shouldered excess risks for acute care utilization. METHODS: In 225 adult patients who participated in the Economic Strain and Resilience in Cancer (ENRICh) survey study of individuals receiving ambulatory cancer care between March and September 2019, we measured the baseline FT (a multidimensional score of 0-10 indicating the least to most severe global, material, and coping FT burdens). All AC visits, including emergency department (ED) and unplanned hospital admissions, within 1-year follow-up were identified. The association between the severity of FT and the total number of AC visits was tested using Poisson regression models. RESULTS: A total of 18.6% ( CONCLUSION: In this prospective study of acute oncology care utilization outcomes among adult cancer patients, FT was a predictor of a higher burden of acute care visits. Patients with severely depleted material and also practical and social coping resources were at particular risk for repeated visits. Future studies are needed to identify whether early FT screening and intervention efforts may help to mitigate urgent acute care utilization burdens

Magnetic Fields and Massive Star Formation

Massive stars ($M > 8$ \msun) typically form in parsec-scale molecular clumps that collapse and fragment, leading to the birth of a cluster of stellar objects. We investigate the role of magnetic fields in this process through dust polarization at 870 $\mu$m obtained with the Submillimeter Array (SMA). The SMA observations reveal polarization at scales of \lsim 0.1 pc. The polarization pattern in these objects ranges from ordered hour-glass configurations to more chaotic distributions. By comparing the SMA data with the single dish data at parsec scales, we found that magnetic fields at dense core scales are either aligned within $40^\circ$ of or perpendicular to the parsec-scale magnetic fields. This finding indicates that magnetic fields play an important role during the collapse and fragmentation of massive molecular clumps and the formation of dense cores. We further compare magnetic fields in dense cores with the major axis of molecular outflows. Despite a limited number of outflows, we found that the outflow axis appears to be randomly oriented with respect to the magnetic field in the core. This result suggests that at the scale of accretion disks (\lsim 10^3 AU), angular momentum and dynamic interactions possibly due to close binary or multiple systems dominate over magnetic fields. With this unprecedentedly large sample massive clumps, we argue on a statistical basis that magnetic fields play an important role during the formation of dense cores at spatial scale of 0.01 - 0.1 pc in the context of massive star and cluster star formation.Comment: Accepted for publication in Astrophysical Journa

Multi-scale physical properties of NGC 6334 as revealed by local relative orientations between magnetic fields, density gradients, velocity gradients, and gravity

We present ALMA dust polarization and molecular line observations toward 4 clumps (I(N), I, IV, and V) in the massive star-forming region NGC 6334. In conjunction with large-scale dust polarization and molecular line data from JCMT, Planck, and NANTEN2, we make a synergistic analysis of relative orientations between magnetic fields ($\theta_{\mathrm{B}}$), column density gradients ($\theta_{\mathrm{NG}}$), local gravity ($\theta_{\mathrm{LG}}$), and velocity gradients ($\theta_{\mathrm{VG}}$) to investigate the multi-scale (from $\sim$30 pc to 0.003 pc) physical properties in NGC 6334. We find that the relative orientation between $\theta_{\mathrm{B}}$ and $\theta_{\mathrm{NG}}$ changes from statistically more perpendicular to parallel as column density ($N_{\mathrm{H_2}}$) increases, which is a signature of trans-to-sub-Alfv\'{e}nic turbulence at complex/cloud scales as revealed by previous numerical studies. Because $\theta_{\mathrm{NG}}$ and $\theta_{\mathrm{LG}}$ are preferentially aligned within the NGC 6334 cloud, we suggest that the more parallel alignment between $\theta_{\mathrm{B}}$ and $\theta_{\mathrm{NG}}$ at higher $N_{\mathrm{H_2}}$ is because the magnetic field line is dragged by gravity. At even higher $N_{\mathrm{H_2}}$, the angle between $\theta_{\mathrm{B}}$ and $\theta_{\mathrm{NG}}$ or $\theta_{\mathrm{LG}}$ transits back to having no preferred orientation or statistically slightly more perpendicular, suggesting that the magnetic field structure is impacted by star formation activities. A statistically more perpendicular alignment is found between $\theta_{\mathrm{B}}$ and $\theta_{\mathrm{VG}}$ throughout our studied $N_{\mathrm{H_2}}$ range, which indicates a trans-to-sub-Alfv\'{e}nic state at small scales as well. The normalised mass-to-flux ratio derived from the polarization-intensity gradient (KTH) method increases with $N_{\mathrm{H_2}}$.Comment: 35 pages, 18 figures. Accepted by Ap

Pilot Study of a Spanish Language Measure of Financial Toxicity in Underserved Hispanic Cancer Patients With Low English Proficiency

BACKGROUND: Financial toxicity (FT) reflects multi-dimensional personal economic hardships borne by cancer patients. It is unknown whether measures of FT-to date derived largely from English-speakers-adequately capture economic experiences and financial hardships of medically underserved low English proficiency US Hispanic cancer patients. We piloted a Spanish language FT instrument in this population. METHODS: We piloted a Spanish version of the Economic Strain and Resilience in Cancer (ENRICh) FT measure using qualitative cognitive interviews and surveys in un-/under-insured or medically underserved, low English proficiency, Spanish-speaking Hispanics (UN-Spanish, RESULTS: UN-Spanish Hispanic participants reported high acceptability of the instrument (only 0% responded that the instrument was very difficult to answer and 4% that it was very difficult to understand the questions ; 8% responded that it was very difficult to remember resources used and 8% that it was very difficult to remember the burdens experienced ; and 4% responded that it was very uncomfortable to respond ). Internal consistency of the FT measure was high (Cronbach\u27s CONCLUSION: In medically underserved, uninsured Hispanic patients with cancer, comprehensive Spanish-language FT assessment in low English proficiency participants was feasible, acceptable, and internally consistent. Future studies employing tailored FT assessment and intervention should encompass the key privations and hardships in this population

Financial toxicity in cancer patients and subsequent risk of repeat acute care utilization

BackgroundAcute care (AC) visits by cancer patients are costly sources of healthcare resources and can exert a financial burden of oncology care both for individuals with cancer and healthcare systems. We sought to identify whether cancer patients who reported more severe initial financial toxicity (FT) burdens shouldered excess risks for acute care utilization.MethodsIn 225 adult patients who participated in the Economic Strain and Resilience in Cancer (ENRICh) survey study of individuals receiving ambulatory cancer care between March and September 2019, we measured the baseline FT (a multidimensional score of 0–10 indicating the least to most severe global, material, and coping FT burdens). All AC visits, including emergency department (ED) and unplanned hospital admissions, within 1-year follow-up were identified. The association between the severity of FT and the total number of AC visits was tested using Poisson regression models.ResultsA total of 18.6% (n = 42) of patients had any AC visit, comprising 64.3% hospital admissions and 35.7% ED visits. Global FT burden was associated with the risk of repeat AC visits within 1-year follow-up (RR = 1.17, 95% CI 1.07–1.29, P < 0.001 for every unit increase), even after adjusting for sociodemographic and disease covariates. When examining subdimensions of FT, the burden of depleted FT coping resources (coping FT) was strongly associated with the risk of repeat AC visits (RR = 1.27, 95% CI 1.15–1.40, P < 0.001) while material FT burden showed a trend toward association (RR = 1.07, 95% CI 0.99–1.15, P = 0.07).ConclusionIn this prospective study of acute oncology care utilization outcomes among adult cancer patients, FT was a predictor of a higher burden of acute care visits. Patients with severely depleted material and also practical and social coping resources were at particular risk for repeated visits. Future studies are needed to identify whether early FT screening and intervention efforts may help to mitigate urgent acute care utilization burdens