An Analysis of Factors Related to Care Engagement along the Cancer Survivorship Care Continuum for Cancer Survivors in Florida.

PURPOSE: This study identifies factors associated with care engagement along the cancer survivorship care continuum for Floridians. METHODS: We identified patients from the OneFlorida Data Trust with a cancer diagnosis at any age and encounters from 2012-2020. Multivariable logistic regression models produced odds ratios (OR) predicting 1) any outpatient non-acute care visit, 2) cancer-related visit with any provider, 3) cancer-related visit with a cancer provider, and 4) survivorship visit with a cancer provider. Encounter-based independent variables were insurance, Social Deprivation Index quartile, and Rural Urban Continuum Area (adjusted for age, sex, race, ethnicity, and treatment). RESULTS: 662,489 survivors were included in the sample. Those with Medicaid and dual eligible status (Medicare and Medicaid) were more likely to have an outpatient visit (Medicaid OR 2.02, 95%CI 1.93-2.12; dual eligible 3.06, 2.91-3.22) or a cancer-related visit with a cancer provider (Medicaid 1.82, 1.77-1.86; dual eligible 1.32, 1.28-1.35), and less likely to have a survivorship visit (Medicaid 0.27, 0.26-0.28; dual eligible 0.20, 0.19-0.21). Uninsured survivors were less likely to have all visit types, while those with Medicare were more likely. Those from the most socially deprived areas were more likely to have an outpatient visit (1.09, 1.03-1.14) and less likely to have a cancer-related visit with any provider (0.90, 0.88-0.92) or a cancer provider (0.93, 0.91-0.95). Survivors from non-metropolitan areas were more likely to have an outpatient visit (1.38, 1.22-1.56), cancer-related visit (1.22, 1.16-1.28), cancer-related visit with a cancer provider (1.45, 1.39-1.52), and a survivorship visit (1.34, 1.22-1.48). CONCLUSIONS: Survivors who have public insurance are more likely to have outpatient visits, and those with Medicaid or dual eligible status are less likely to have survivorship visits. Uninsured status is consistently associated with lack of engagement across the care continuum. Those from areas with higher social deprivation are more likely to have outpatient visits, but less likely to have a cancer-related visit with or without a cancer provider. Survivors from non-metropolitan areas are more likely to engage in all visit types along the care continuum.

Probing insulators under pressure.

Applying pressure on a material can reveal many physical properties and is a very efficient tool to understand its physics. Resistivity measurements have been the ideal probe to study metals under pressure. However, in the case of insulators, resistivity, or conductivity, it is often not the appropriate quantity characterizing the material. In this work, we present a newly developed in situ pressure tuning system that can be used over a wide temperature range (2 K-300 K) and allows changing the pressure at any temperature. We also present AC calorimetry and capacitance/loss measurements under pressure and demonstrate how this combination can be used to characterize a material that is too insulating for standard resistivity techniques.

Fermi-Surface Instability in the Heavy-Fermion Superconductor UTe_{2}.

Transport measurements are presented up to fields of 29 T in the recently discovered heavy-fermion superconductor UTe_{2} with magnetic field H applied along the easy magnetization a axis of the body-centered orthorhombic structure. The thermoelectric power varies linearly with temperature above the superconducting transition, T_{SC}=1.5 K, indicating that superconductivity develops in a Fermi liquid regime. As a function of field the thermoelectric power shows successive anomalies which appear at critical values of the magnetic polarization. Remarkably, the lowest magnetic field instability for H∥a occurs for the same critical value of the magnetization (0.4 µ_{B}) than the first order metamagnetic transition at 35 T for field applied along the b axis. It can be clearly identified as a Lifshitz transition. The estimated number of charge carriers at low temperature reveals a metallic ground state distinct from LDA calculations indicating that strong electronic correlations are a major issue.

Pressure-induced valence crossover in superconducting CeCu2Si2.

Measurement of the Ce valence in the heavy fermion CeCu(2)Si(2) is reported for the first time under pressure and at low temperature (T=14 K) in proximity of the superconducting region. CeCu(2)Si(2) is considered as a strong candidate for a new type of pairing mechanism related to critical valence fluctuations which could set in at high pressure in the vicinity of the second superconducting dome. A quantitative estimate of the valence in this pressure region was achieved from the measurements of the Ce L(3) edge in the high-resolution partial-fluorescence yield mode and subsequent analysis of the spectra within the Anderson impurity model. While a clear increase of the Ce valence is found, the weak electron transfer and the continuous valence change under pressure suggests a crossover regime with the hypothetical valence line terminating at a critical end point T(cr) close to zero.

Superconducting and normal phases of FeSe single crystals at high pressure.

We report on the synthesis of superconducting single crystals of FeSe and their characterization by x-ray diffraction, magnetization and resistivity. We have performed ac susceptibility measurements under high pressure in a hydrostatic liquid argon medium up to 14 GPa and we find that T(C) increases up to 33-36 K in all samples, but with slightly different pressure dependences on different samples. Above 12 GPa no traces of superconductivity are found in any sample. We have also performed a room temperature high pressure x-ray diffraction study up to 12 GPa on a powder sample, and we find that, between 8.5 and 12 GPa, the tetragonal PbO structure undergoes a structural transition to a hexagonal structure. This transition results in a volume decrease of about 16% and is accompanied by the appearance of an intermediate, probably orthorhombic, phase.

Hidden magnetic frustration by quantum relaxation in anisotropic Nd langasite.

The static and dynamic magnetic properties of the Nd(3)Ga(5)SiO(14) compound, which appears as the first materialization of a rare-earth kagome-type lattice, were reexamined, owing to contradictory results in the previous studies. Neutron scattering, magnetization, and specific heat measurements were performed and analyzed, in particular, by fully taking account of the crystal electric field effects on the Nd(3+) ions. One of the novel findings is that the peculiar temperature independent spin dynamics observed below 10 K expresses single-ion quantum processes. This would short-circuit the frustration induced cooperative dynamics, which would emerge only at very low temperature.

Simple adaptation of the Bridgman high pressure technique for use with liquid media.

We present a simple novel technique to adapt a standard Bridgman cell for the use of a liquid pressure transmitting medium. The technique has been implemented in a compact cell, able to fit in a commercial Quantum Design PPMS system, and would also be easily adaptable to extreme conditions of very low temperatures or high magnetic fields. Several media have been tested and a mix of fluorinert FC84:FC87 has been shown to produce a considerable improvement over the pressure conditions in the standard steatite solid medium, while allowing a relatively easy setup procedure. For optimized hydrostatic conditions, the success rate is about 80% and the maximum pressure achieved so far is 7.1 GPa. Results are shown for the heavy fermion system YbAl(3) and for NaV(6)O(15), an insulator showing charge order.

Superconducting PrOs4Sb12: a thermal conductivity study.

The superconducting state of the heavy fermion PrOs4Sb12 is studied by heat transport measurements on a highly homogeneous single crystal exhibiting only one transition peak in the specific heat. The field and temperature dependence of the thermal conductivity confirm multiband superconductivity and point to fully open gaps on the whole Fermi surface.

Spontaneous thoracic duct cyst.

Spontaneous and asymptomatic supraclavicular thoracic duct cysts (lymphoceles ) are rare. Only five cases have been reported so far. They are more common after surgery or trauma and have been reported in the abdomen, mediastinum, pelvis and neck. They must be differentiated from other neck cysts as failure to recognise their attachment may result in the disastrous consequence of chylothorax. A high index of suspicion is necessary, and diagnosis usually can be established by fine-needle aspiration and suitable imaging. This case is reported along with a review of the literature and management options, including that of inadvertent damage to the thoracic duct.

Coexistence of superconductivity and ferromagnetism in URhGe.

The discovery of superconductivity at high pressure (albeit over a restricted range) in the ferromagnetic material UGe2 raised the possibility that bulk superconductivity might be found in other ferromagnets. The exact symmetry of the paired state and the dominant mechanism responsible for the pairing, however, remain unidentified. Meanwhile, the conjecture that superconductivity could occur more generally in ferromagnets has been fuelled by the recent observation of a low-temperature transition that suggests an onset of superconductivity in high-quality crystals of the itinerant-ferromagnet ZrZn2 (ref. 2), although the thermodynamic signature of this transition could not be detected. Here we show that the ferromagnet URhGe is superconducting at ambient pressure. In this case, we find the thermodynamic signature of the transition-its form is consistent with a superconducting pairing of a spin-triplet type, although further testing with cleaner samples is needed to confirm this. The combination of superconductivity and ferromagnetism may thus be more common and consequently more important than hitherto realized.

Superconductivity on the border of itinerant-electron ferromagnetism in UGe2

The absence of simple examples of superconductivity adjoining itinerant-electron ferromagnetism in the phase diagram has for many years cast doubt on the validity of conventional models of magnetically mediated superconductivity. On closer examination, however, very few systems have been studied in the extreme conditions of purity, proximity to the ferromagnetic state and very low temperatures required to test the theory definitively. Here we report the observation of superconductivity on the border of ferromagnetism in a pure system, UGe2, which is known to be qualitatively similar to the classic d-electron ferromagnets. The superconductivity that we observe below 1 K, in a limited pressure range on the border of ferromagnetism, seems to arise from the same electrons that produce band magnetism. In this case, superconductivity is most naturally understood in terms of magnetic as opposed to lattice interactions, and by a spin-triplet rather than the spin-singlet pairing normally associated with nearly antiferromagnetic metals.

Communication of social support in computer-mediated groups for people with disabilities.

This study documented the types and extent of social support messages exchanged by persons with disabilities who participated in a computer-based support group. A modified version of Cutrona & Suhr's (1992) social support category system was used to code 1,472 support messages. The largest percentage of these messages offered emotional and informational support, whereas network support and tangible assistance were least frequently offered. It appeared that many of the support messages directly redressed limitations and challenges associated with disability-related mobility, socialization, and self-care. Results are discussed in terms of the generalizability of existing category systems for coding support to this mediated context, the relative importance of different types of support in the communication of support group members, and the unique features of social support in mediated environments. The implications of this study for social support researchers, persons with disabilities, and human services professionals are also discussed.

Evolution of dnaQ, the gene encoding the editing 3' to 5' exonuclease subunit of DNA polymerase III holoenzyme in Gram-negative bacteria.

The nucleotide sequences of the dnaQ genes from Salmonella typhimurium and Buchnera aphidicola, encoding the epsilon-subunit of the DNA polymerase III holoenzyme, have been determined. The Salmonella typhimurium dnaQ protein consists of 243 amino acid residues with a calculated molecular weight of 27224. The Buchnera aphidicola dnaQ protein contains 233 amino acid residues with a calculated molecular weight of 27170. A multiple sequence alignment of the amino acid sequences of the dnaQ proteins and those of DNA polymerase IIIs from Gram-positive bacteria produced six homologous segments. These homologous segments contain highly conserved amino acid sequence motifs involved in catalytically important metal ion bindings (ligands 1, 2 and 3). However, metal ligand 4 is found to be altered in the 3'-5' exonuclease domain of the family C DNA polymerases and dnaQ proteins in Gram-negative bacteria. From these results, we propose that the last common ancestor of the dnaQ gene of Gram-negative bacteria and the DNA polymerase III gene (pol C gene) of Gram-positive bacteria was a single gene containing both 3'-5' exonuclease and DNA polymerase domains and then the dnaQ gene separated from the polymerase gene in Gram-negative bacteria.

Project 2000 student wastage: a case study.

High wastage rates associated with the nursing profession were a contributory factor driving recent reforms in the form of Project 2000 (P2000). Such changes beg the question: to what extent has this new educational initiative affected current wastage patterns among nursing students? This paper examines whether or not this new initiative is having an effect on student wastage at a first-wave college of nursing, midwifery and health visiting which implemented P2000 in 1989. Thus far, 10 cohorts of students have been admitted on to the course, seven full-time and three part-time. It is hoped other institutions involved in nurse education and training may gain some beneficial insights from the lessons learnt and measures taken to stem wastage at the college described in this case study.