Study protocol:rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

BACKGROUND: During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. METHODS/DESIGN: The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n = 120) and a matched control group in western Denmark (n = 120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO(2max) one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child’s schoolteachers and classmates, and the child’s parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. DISCUSSION: RESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness. TRIAL REGISTRATION: Clinical Trials.gov: file. NCT01772849 and NCT0177286

Community-based football in men with prostate cancer:1-year follow-up on a pragmatic, multicentre randomised controlled trial

BACKGROUND:Physical exercise has been shown to be effective in relation to fatigue, aerobic fitness, and lower body strength in men with prostate cancer. However, research into the clinically relevant effects of interventions conducted in heterogeneous patient populations and in real-life clinical practice settings is warranted. METHODS AND FINDINGS:We conducted a pragmatic, multicentre, parallel randomised controlled trial in 5 Danish urological departments. Recruitment began in May 2015, the first participant was randomised in June 2015, and the last participant was included in February 2017. In total, 214 men with prostate cancer were randomly assigned to either 6 months of free-of-charge football training twice weekly at a local club (football group [FG]) (n = 109) or usual care (usual care group [UG]) (n = 105), including brief information on physical activity recommendations at randomisation. Participants were on average 68.4 (SD 6.2) years old, 157 (73%) were retired, 87 (41%) were on castration-based treatment, 19 (9%) had received chemotherapy, and 41 (19%) had skeletal metastases at baseline. In this 1-year follow-up study, we evaluated the effects of community-based football training on the following outcomes: primary outcome, quality of life; secondary outcomes: continuation of football after 6 months, hip and lumbar spine bone mineral density (BMD), mental health score, fat and lean body mass, and safety outcomes, i.e., fractures, falls, and hospital admissions. Intention to treat (ITT) and per protocol (PP) analyses were conducted. No statistically significant between-group difference was observed in change in prostate-cancer-specific quality of life (ITT: 1.9 points [95% CI -1.9 to 5.8], p = 0.325; PP: 3.6 points [95% CI -0.9 to 8.2], p = 0.119). A statistically significant between-group difference was observed in change in total hip BMD, in favour of FG (0.007 g/cm2 [95% CI 0.004 to 0.013], p = 0.037). No differences were observed in change in lumbar spine BMD or lean body mass. Among patients allocated to football, 59% chose to continue playing football after the end of the 6-month intervention period. At 1-year follow-up in the PP population, FG participants had more improvement on the Mental Component Summary (2.9 [95% CI 0.0 to 5.7], p = 0.048 points higher) than UG participants, as well as a greater loss of fat mass (-0.9 kg [95% CI -1.7 to -0.1], p = 0.029). There were no differences between groups in relation to fractures or falls. Hospital admissions were more frequent in UG compared to FG (33 versus 20; the odds ratio based on PP analysis was 0.34 for FG compared to UG). There were 3 deaths in FG and 4 in UG. Main limitations of the study were the physically active control group and assessment of physical activity by means of self-report. CONCLUSIONS:In this trial, participants allocated to football appeared to have improved hip BMD and fewer hospital admissions. Men who played football more than once a week for 1 year lost fat mass and reported improved mental health. Community-based football proved to be acceptable, even when club membership was not subsidised. TRIAL REGISTRATION:ClinicalTrials.gov NCT02430792

AT2019wxt: An ultra-stripped supernova candidate discovered in electromagnetic follow-up of a gravitational wave trigger

We present optical, radio and X-ray observations of a rapidly-evolving transient AT2019wxt (PS19hgw), discovered during the search for an electromagnetic (EM) counterpart to the gravitational-wave (GW) trigger S191213g (LIGO Scientific Collaboration & Virgo Collaboration 2019a). Although S191213g was not confirmed as a significant GW event in the off-line analysis of LIGO-Virgo data, AT2019wxt remained an interesting transient due its peculiar nature. The optical/NIR light curve of AT2019wxt displayed a double-peaked structure evolving rapidly in a manner analogous to currently know ultra-stripped supernovae (USSNe) candidates. This double-peaked structure suggests presence of an extended envelope around the progenitor, best modelled with two-components: i) early-time shock-cooling emission and ii) late-time radioactive $^{56}$Ni decay. We constrain the ejecta mass of AT2019wxt at $M_{ej} \approx{0.20 M_{\odot}}$ which indicates a significantly stripped progenitor that was possibly in a binary system. We also followed-up AT2019wxt with long-term Chandra and Jansky Very Large Array observations spanning $\sim$260 days. We detected no definitive counterparts at the location of AT2019wxt in these long-term X-ray and radio observational campaigns. We establish the X-ray upper limit at $9.93\times10^{-17}$ erg cm$^{-2}$ s$^{-1}$ and detect an excess radio emission from the region of AT2019wxt. However, there is little evidence for SN1993J- or GW170817-like variability of the radio flux over the course of our observations. A substantial host galaxy contribution to the measured radio flux is likely. The discovery and early-time peak capture of AT2019wxt in optical/NIR observation during EMGW follow-up observations highlights the need of dedicated early, multi-band photometric observations to identify USSNe.Comment: 20 pages, 14 figures, Submitted to Ap