Colliding winds in WR21 and WR31 -- I. The X-ray view

WR21 and WR31 are two WR+O binaries with short periods, quite similar to the case of V444 Cyg. The XMM-Newton observatory has monitored these two objects and clearly revealed phase-locked variations as expected from colliding winds. The changes are maximum in the soft band (0.5--2.keV, variations by a factor 3--4) where they are intrinsically linked to absorption effects. The increase in absorption due to the dense WR wind is confirmed by the spectral analysis. The flux maximum is however not detected exactly at conjunction with the O star in front but slightly afterwards, suggesting Coriolis deflection of the collision zone as in V444 Cyg. In the hard band (2.--10. keV), the variations (by a factor of 1.5--2.0) are much more limited. Because of the lower orbital inclinations, eclipses as observed for V444 Cyg are not detected in these systems.Comment: accepted for publication by MNRA

Colliding winds in WR21 and WR31 – I. The X-ray view

peer reviewedABSTRACT WR21 and WR31 are two WR + O binaries with short periods, quite similar to the case of V444 Cyg. The XMM-Newton observatory has monitored these two objects and clearly revealed phase-locked variations as expected from colliding winds. The changes are maximum in the soft band (0.5–2.0 keV, variations by a factor 3–4) where they are intrinsically linked to absorption effects. The increase in absorption due to the dense WR wind is confirmed by the spectral analysis. The flux maximum is however not detected exactly at conjunction with the O star in front but slightly afterwards, suggesting Coriolis deflection of the collision zone as in V444 Cyg. In the hard band (2–10 keV), the variations (by a factor of 1.5–2.0) are much more limited. Because of the lower orbital inclinations, eclipses as observed for V444 Cyg are not detected in these systems

Exercise recommendations for people with bone metastases: Expert consensus for healthcare providers and clinical exercise professionals

Purpose: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. Methods: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. Results: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment–related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. Conclusion: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases

Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals

PURPOSE:Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion.METHODS:The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement.RESULTS:Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment–related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential.CONCLUSION:Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases

Immune Modulation by Androgen Deprivation and Radiation Therapy: Implications for Prostate Cancer Immunotherapy

Prostate cancer patients often receive androgen deprivation therapy (ADT) in combination with radiation therapy (RT). Recent evidence suggests that both ADT and RT have immune modulatory properties. First, ADT can cause infiltration of lymphocytes into the prostate, although it remains unclear whether the influx of lymphocytes is beneficial, particularly with the advent of new classes of androgen blockers. Second, in rare cases, radiation can elicit immune responses that mediate regression of metastatic lesions lying outside the field of radiation, a phenomenon known as the abscopal response. In light of these findings, there is emerging interest in exploiting any potential synergy between ADT, RT, and immunotherapy. Here, we provide a comprehensive review of the rationale behind combining immunotherapy with ADT and RT for the treatment of prostate cancer, including an examination of the current clinical trials that employ this combination. The reported outcomes of several trials demonstrate the promise of this combination strategy; however, further scrutiny is needed to elucidate how these standard therapies interact with immune modulators. Inaddition,wediscusstheimportanceofsynchronizingimmunemodulationrelativetoADTandRT, and provide insight into elements that may impact the ability to achieve maximum synergy between these treatments

A case of intraplacental gestational choriocarcinoma; characterised by the methylation pattern of the early placenta and an absence of driver mutations

Background: Gestational choriocarcinoma is a rare malignancy believed to arise from the trophoblast cells of the placenta. Despite the frequently aggressive clinical nature, choriocarcinoma has been routinely curable with cytotoxic chemotherapy for over 50 years. To date little is known regarding the route to oncogenesis in this malignancy. Methods: In a case of intraplacental choriocarcinoma, we have performed detailed genetic studies including microsatellite analysis, whole genome sequencing (WGS) and methylation analysis of the tumour and surrounding mature placenta. Results: The results of the WGS sequencing indicated a very low level of mutation and the absence of any driver mutations or oncogene activity in the tumour. The methylation analysis identified a distinctly different profile in the tumour from that of the mature placenta. Comparison with a panel of reference methylation profiles from different stages of placental development indicated that the tumour segregated with the first trimester samples. Conclusions: These findings suggest that gestational choriocarcinoma is likely to arise as a result of aberrations of methylation during development, rather than from DNA mutations. The results support the hypothesis that gestational choriocarcinoma arises from a normally transient early trophoblast cell. At this point in development this cell naturally has a phenotype of rapid division, tissue invasion and sensitivity to DNA damaging chemotherapy that is very similar to that of the mature choriocarcinoma cell.Medicine, Faculty ofNon UBCMedical Genetics, Department ofReviewedFacult

The Chandra Delta Ori Large Project: Occultation Measurements of the Shocked Gas in the Nearest Eclipsing O-Star Binary

Delta Ori is the nearest massive, single-lined eclipsing binary (O9.5 II+OB, P=5^{d}.7324). High resolution X-ray spectrometry offers a unique opportunity to geometrically measure the dynamics of the shocked gas around the primary star. We summarize our recent campaign of phase-constrained high-resolution X-ray spectra obtained with the CHANDRA/HETGS plus high-precision photometry with MOST. These observations provide local measurement of the distribution of the embedded, X-ray emitting shocks in the wind of an O star via radial velocity variations and occultation effects, along with standard f/i ratio diagnostics, and enable us to look for correlations with the broad-band photometric variability. We discuss how these observations can help determine the primary star's clumping-corrected mass loss rate, and resolve critical uncertainties in our understanding of the connection between stellar and mass loss parameters