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PurposeThe aim of this study was to test the effect of intrapersonal and interpersonal emotional competence on cancer patients’ supportive care needs, as mediated by anxiety and depression symptoms.MethodsCross-sectional design: 137 cancer patients (42% breast or ovarian cancer, 58% gastrointestinal cancer) in 4 French hospitals completed the Profile of Emotional Competence (PEC), the Hospital Anxiety and Depression Scale (HADS), and the Supportive Care Needs Survey Short Form (SCNS-SF). Bootstrap methods with PROCESS Macro were used to test multiple mediation models.ResultsEmotional competence presented a direct or indirect beneficial effect on the satisfaction of supportive care needs, anxiety and depression symptoms. As expected, anxiety and depression symptoms had also strong positive correlations with unmet needs. All multiple mediation models were significant, except for physical needs: intrapersonal and interpersonal emotional competence impacted anxiety and depression symptoms, which in turn impacted psychological, sexual, care/support, and information needs.ConclusionsThese innovative results show the important effect of patients’ emotional competence on their supportive care need satisfaction, as mediated by anxiety and depression. Consequently, patients with high emotional competence may require less psychosocial input from medical clinicians. Thus, emotional competence may be integrated into health models and psychosocial interventions to improve patient adjustment. Further investigation is, however, needed to know which are the most beneficial specific emotional competences and at what point of the cancer pathway.

IntroductionInternational medical oncology societies recommended early integration of palliative care to alleviate symptoms, improve quality of life and significantly reduce aggressiveness of care near the end of life, defined as the use of chemotherapy, high rate of hospitalisation/visits to emergency or intensive care unit in the last month of life or death in acute care unit. However, the most appropriate schedule for patient referral is still to be determined. Scores and criteria are debated, with uncontrolled symptoms (pain, dyspnoea, distress, etc) being one of the main indicators. These symptoms are also the leading causes for patients with cancer to seek care in emergency units. Several studies in North America suggested that referral to palliative care from emergency units is feasible and efficient.The aim of this study is to determine if systematic early referral to palliative care in a context of emergency reduces aggressiveness of care near the end of life compared with referral on medical team request.Methods and analysisThis multicentric randomised study plans to enrol patients with a PALLIA-10 score >3 attending unscheduled on-site visits in French comprehensive cancer centres, and allocate them to randomisation (1:1) to receive palliative care systematically (experimental group) or on medical oncology team request (standard group). The primary objective is to compare the proportion of patients meeting at least one criterion of clinical care aggressiveness near the end of life, in each group. Secondary objectives include a description of clinical care aggressiveness components, palliative care requirement (psychologist, social worker, nutritional counselling, etc), patient-reported outcomes (FACT-G7, Hospital Anxiety and Depression Scale, Edmonton Symptoms Assessment System), the place of death and overall survival. Health economics and human and social sciences substudies will be presented.The study needs to include 192 patients (96 patients per arm) to reach a 20% decrease in care aggressiveness in the last month of life from 65% to 45%, with a statistical power of 80%, and a 2-sided type I error rate of 5%, using systematic referral. Considering a 20% rate of dropout or patients still alive at the time of analysis, 240 patients will need to be allocated to randomisation.Ethics and disseminationThis clinical study received approval from the Ethics committee CPP Est III on 25 October 2023, and complies with the MR001 Commission Nationale de l’Informatique et des Libertés (#1994173, 27 September 2016). The first consent was signed on 12 September 2024.Results will be presented and published in international academic journals.Protocol identifierV.2.1 dated 10 July 2024.Trial registration number NCT06150027.

Since the emergence of graphene, we have seen several proposals for the realization of Landau lasers tunable over the terahertz frequency range. The hope was that the non-equidistance of the Landau levels from Dirac fermions would suppress the harmful non-radiative Auger recombination. Unfortunately, even with this non-equidistance, an unfavourable non-radiative process persists in Landau-quantized graphene, and so far no cyclotron emission from Dirac fermions has been reported. One way to eliminate this last non-radiative process is to sufficiently modify the dispersion of the Landau levels by opening a small gap in the linear band structure. HgTe quantum wells close to the topological phase transition are a proven example of such gapped graphene-like materials. In this work we experimentally demonstrate Landau emission from Dirac fermions in such HgTe quantum wells, where the emission is tunable by both the magnetic field and the carrier concentration. Consequently, these results represent an advance in the realization of terahertz Landau lasers tunable by a magnetic field and gate voltage.Two-dimensional massive and massless Dirac fermions in HgTe/CdHgTe quantum wells yield terahertz Landau emission. The emission frequency is continuously tunable with magnetic field or carrier concentration, over the range from 0.5 to 3 THz.

Binary interactions have been proposed to explain a variety of circumstellar structures seen around evolved stars, including asymptotic giant branch (AGB) stars and planetary nebulae. Studies resolving the circumstellar envelopes of AGB stars have revealed spirals, disks and bipolar outflows, with shaping attributed to interactions with a companion. Here we use a combined chemical and dynamical analysis to reveal a highly eccentric and long-period orbit for W Aquilae, a binary system containing an AGB star and a main-sequence companion. Our results are based on anisotropic SiN emission, the detections of irregular NS and SiC emission towards the S-type star, and density structures observed in the CO emission. These features are all interpreted as having formed during periastron interactions. Our astrochemistry-based method can yield stringent constraints on the orbital parameters of long-period binaries containing AGB stars, and will be applicable to other systems. When stars like our Sun die, they expel their outer layers in a dramatic stellar wind. This study of an unusual chemical signature in one particular stellar wind reveals that the signature is due to the presence of a binary system whose components had a close approach around 200 years ago.

We compare detailed observations of multiple H2O maser transitions around the red supergiant star VY CMa with models to constrain the physical conditions in the complex outflows. The temperature profile is consistent with a variable mass loss rate but the masers are mostly concentrated in dense clumps. High-excitation lines trace localised outflows near the star.

Outstanding problems concerning mass-loss from evolved stars include initial wind acceleration and what determines the clumping scale. Reconstructing physical conditions from maser data has been highly uncertain due to the exponential amplification. ALMA and e-MERLIN now provide image cubes for five H2O maser transitions around VY CMa, at spatial resolutions comparable to the size of individual clouds or better, covering excitation states from 204 to 2360 K. We use the model of Gray et al. 2016, to constrain variations of number density and temperature on scales of a few au, an order of magnitude finer than is possible with thermal lines, comparable to individual cloud sizes or locally almost homogeneous regions. We compare results with the models of Decin et al. 2006 and Matsuura et al. 2014 for the circumstellar envelope of VY CMa; in later work this will be extended to other maser sources.

Two-dimensional Dirac fermions in HgTe quantum wells close to the topological phase transition can generate significant cyclotron emission that is magnetic field tunable in the Terahertz (THz) frequency range. Due to their relativistic-like dynamics, their cyclotron mass is strongly dependent on their electron concentration in the quantum well, providing a second tunability lever and paving the way for a gate-tunable, permanent-magnet Landau laser. In this work, we demonstrate the proof-of-concept of such a back-gate tunable THz cyclotron emitter at fixed magnetic field. The emission frequency detected at 1.5 Tesla is centered on 2.2 THz and can already be electrically tuned over 250 GHz. With an optimized gate and a realistic permanent magnet of 1.0 Tesla, we estimate that the cyclotron emission could be continuously and rapidly tunable by the gate bias between 1 and 3 THz, that is to say on the less covered part of the THz gap.

We have undertaken a comprehensive search for the first excited state of OH emission (J=5/2, 2Π3/2) in Planetary and Proto- Planetary Nebulae. With the Effelsberg telescope, we confirm the detection of Vy 2–2 and we present one new detection in the pPN K3−35. This detection has been confirmed by subsequent observations made at 6035 MHz with the MERLIN interferometer. This is the first detection of 6 GHz OH maser emission from a post-AGB star.

Since the emergence of graphene, we have seen several proposals for the realization of Landau lasers tunable over the terahertz frequency range. The hope was that the non-equidistance of the Landau levels from Dirac fermions would suppress the harmful non-radiative Auger recombination. Unfortunately, even with this non-equidistance an unfavorable non-radiative process persists in Landau-quantized graphene, and so far no cyclotron emission from Dirac fermions has been reported. One way to eliminate this last non-radiative process is to sufficiently modify the dispersion of the Landau levels by opening a small gap in the linear band structure. A proven example of such gapped graphene-like materials are HgTe quantum wells close to the topological phase transition. In this work, we experimentally demonstrate Landau emission from Dirac fermions in such HgTe quantum wells, where the emission is tunable by both the magnetic field and the carrier concentration. Consequently, these results represent an advance in the realization of terahertz Landau lasers tunable by magnetic field and gate-voltage.

Binary interactions have been proposed to explain a variety of circumstellar structures seen around evolved stars, including asymptotic giant branch (AGB) stars and planetary nebulae. Studies resolving the circumstellar envelopes of AGB stars have revealed spirals, discs and bipolar outflows, with shaping attributed to interactions with a companion. For the first time, we have used a combined chemical and dynamical analysis to reveal a highly eccentric and long-period orbit for W Aquilae, a binary system containing an AGB star and a main sequence companion. Our results are based on anisotropic SiN emission, the first detections of NS and SiC towards an S-type star, and density structures observed in the CO emission. These features are all interpreted as having formed during periastron interactions. Our astrochemistry-based method can yield stringent constraints on the orbital parameters of long-period binaries containing AGB stars, and will be applicable to other systems.