Quality of life and symptom intensity over time in people with cancer receiving palliative care : results from the international European Palliative Care Cancer Symptom study

Background People with advanced cancer experience multiple symptoms during their illness trajectory, which can fluctuate in intensity. Aim To describe the course of self-reported quality of life, emotional functioning, physical functioning and symptom intensity over time in cancer patients receiving palliative care. Design Longitudinal study with monthly assessments, using the EORTC QLQ-C15-PAL. Data were analysed (1) prospectively, from baseline to >= 8-month follow-up; and (2) retrospectively, by taking death as index date and comparing results from three cross-sectional subsamples at different stages of illness (time to death >= 6, 5-3 and 2-0 months). Linear mixed models were calculated. Setting/participants A total of 1739 patients (mean age 66, 50% male) from 30 palliative care centers in 12 countries were included. Results In prospective analyses, quality of life, functioning and symptoms-except nausea/vomiting-remained generally stable over time. In retrospective analyses, patients 2-0 months before death reported significantly lower quality of life and physical functioning scores than those 5-3 months before death, who in turn scored lower than those >= 6 months before death, suggesting progressive decline. Emotional functioning remained initially unchanged, but decreased in the last months. Pain, fatigue and appetite loss showed a stable increase in intensity towards death. Dyspnea, insomnia and constipation increased from 5-3 to 2-0 months before death. Nausea/vomiting only increased when comparing those >= 6 months before death with those 2-0 months before death. Conclusion While the prospective approach showed predominantly stable patterns for quality of life, functioning and symptom severity throughout study duration, retrospective analyses indicated that deterioration was already apparent before the terminal phase and accelerated close to death. Our findings support the importance of early symptom identification and treatment in this population, and highlight the need for further studies to explore what characterizes those with either lower or higher symptom burden at different time points towards death

Correlated Photon Emission from a Single II-VI Quantum Dot

We report correlation and cross-correlation measurements of photons emitted under continuous wave excitation by a single II-VI quantum dot (QD) grown by molecular-beam epitaxy. A standard technique of microphotoluminescence combined with an ultrafast photon correlation set-up allowed us to see an antibunching effect on photons emitted by excitons recombining in a single CdTe/ZnTe QD, as well as cross-correlation within the biexciton ($X_{2}$)-exciton ($X$) radiative cascade from the same dot. Fast microchannel plate photomultipliers and a time-correlated single photon module gave us an overall temporal resolution of 140 ps better than the typical exciton lifetime in II-VI QDs of about 250ps.Comment: 4 pages, 3 figures, to appear in Appl. Phys. Let

Excitonic giant Zeeman effect in GaN:Mn^3+

We describe a direct observation of the excitonic giant Zeeman splitting in (Ga,Mn)N, a wide-gap III-V diluted magnetic semiconductor. Reflectivity and absorption spectra measured at low temperatures display the A and B excitons, with a shift under magnetic field due to s,p-d exchange interactions. Using an excitonic model, we determine the difference of exchange integrals between Mn^3+ and free carriers in GaN, N_0(alpha-beta)=-1.2 +/- 0.2 eV. Assuming a reasonable value of alpha, this implies a positive sign of beta which corresponds to a rarely observed ferromagnetic interaction between the magnetic ions and the holes.Comment: 4 pages, 4 figure

Ferromagnetic (Ga,Mn)N epilayers versus antiferromagnetic GaMn3_3N clusters

Mn-doped wurtzite GaN epilayers have been grown by nitrogen plasma-assisted molecular beam epitaxy. Correlated SIMS, structural and magnetic measurements show that the incorporation of Mn strongly depends on the conditions of the growth. Hysteresis loops which persist at high temperature do not appear to be correlated to the presence of Mn. Samples with up to 2% Mn are purely substitutional Ga$_{1-x}$Mn$_x$N epilayers, and exhibit paramagnetic properties. At higher Mn contents, precipitates are formed which are identified as GaMn$_3$N clusters by x-ray diffraction and absorption: this induces a decrease of the paramagnetic magnetisation. Samples co-doped with enough Mg exhibit a new feature: a ferromagnetic component is observed up to $T_c\sim175$ K, which cannot be related to superparamagnetism of unresolved magnetic precipitates.Comment: Revised versio

Remote optical addressing of single nano-objects

We present a scheme for remotely addressing single nano-objects by means of near-field optical microscopy that makes only use of one of the most fundamental properties of electromagnetic radiation: its polarization. A medium containing optically active nano-objects is covered with a thin metallic film presenting sub-wavelength holes. When the optical tip is positioned some distance away from a hole, surface plasmons in the metal coating are generated which, by turning the polarization plane of the excitation light, transfer the excitation towards a chosen hole and induce emission from the underlying nano-objects. The method, easily applicable to other systems, is demonstrated for single quantum dots (QDs) at low temperature. It may become a valuable tool for future optical applications in the nanoworld

Magneto-optical spectroscopy of (Ga,Mn)N epilayers

We report on the magneto-optical spectroscopy and cathodoluminescence of a set of wurtzite (Ga,Mn)N epilayers with a low Mn content, grown by molecular beam epitaxy. The sharpness of the absorption lines associated to the Mn$^{3+}$ internal transitions allows a precise study of its Zeeman effect in both Faraday and Voigt configurations. We obtain a good agreement if we assume a dynamical Jahn-Teller effect in the 3d$^{4}$ configuration of Mn, and we determine the parameters of the effective Hamiltonians describing the $^{5}T\_{2}$ and $^{5}E$ levels, and those of the spin Hamiltonian in the ground spin multiplet, from which the magnetization of the isolated ion can be calculated. On layers grown on transparent substrates, transmission close to the band gap, and the associated magnetic circular dichroism, reveal the presence of the giant Zeeman effect resulting from exchange interactions between the Mn$^{3+}$ ions and the carriers. The spin-hole interaction is found to be ferromagnetic

Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review

QuestionWhat are the effects of strength training alone, exercise therapy alone, and exercise with additional passive manual mobilisation on pain and function in people with knee osteoarthritis compared to control? What are the effects of these interventions relative to each other?DesignA meta-analysis of randomised controlled trials.ParticipantsAdults with osteoarthritis of the knee.Intervention typesStrength training alone, exercise therapy alone (combination of strength training with active range of motion exercises and aerobic activity), or exercise with additional passive manual mobilisation, versus any non-exercise control. Comparisons between the three interventions were also sought.Outcome measuresThe primary outcome measures were pain and physical function.Results12 trials compared one of the interventions against control. The effect size on pain was 0.38 (95% CI 0.23 to 0.54) for strength training, 0.34 (95% CI 0.19 to 0.49) for exercise, and 0.69 (95% CI 0.42 to 0.96) for exercise plus manual mobilisation. Each intervention also improved physical function significantly. No randomised comparisons of the three interventions were identified. However, meta-regression indicated that exercise plus manual mobilisations improved pain significantly more than exercise alone (p = 0.03). The remaining comparisons between the three interventions for pain and physical function were not significant.ConclusionExercise therapy plus manual mobilisation showed a moderate effect size on pain compared to the small effect sizes for strength training or exercise therapy alone. To achieve better pain relief in patients with knee osteoarthritis physiotherapists or manual therapists might consider adding manual mobilisation to optimise supervised active exercise programs