Tripartite prehabilitation of patients with acute myeloid leukaemia and high-risk myelodysplastic syndromes during intensive chemotherapy before allogeneic haematopoietic stem cell transplantation (COHABILIT): protocol for an innovating prospective multicentre study.

OBJECTIVES: Acute myeloid leukaemia (AML) and high-risk myelodysplastic syndromes (MDS) are often treated with intensive chemotherapy followed by allogeneic haematopoietic stem cell transplantation (allo-HSCT). The pretransplant treatment results in a general deterioration of the patient's health and quality of life. Furthermore, allo-HSCT can be responsible for significant toxicity with risks of graft-versus-host disease (GvHD). Developing strategies to prevent physical deconditioning, undernutrition and psychological distress could help maintain a satisfactory general state of health before transplantation and thus limit these deleterious effects. This protocol evaluates the feasibility and adherence to a personalised prehabilitation programme, which can be modulated and assisted by connected objects, provided from the diagnosis to the allo-HSCT. METHODS AND ANALYSIS: This multicentre interventional study will include 50 patients treated for AML or high-risk MDS with intensive chemotherapy and eligible for allo-HSCT. The intervention consists of a coached, supervised or self-directed physical activity programme, organised during the hospitalisation phases and periods at home. At the same time, patients will receive a weekly dietary follow-up. The whole intervention is controlled and modulated through the use of a dedicated application and connected objects allowing adaptation and individualisation. The rate of participation in the prescribed physical activity sessions will assess the feasibility of this study. In addition, the evolution of physical capacities (Short Physical Performance Battery, grip and quadriceps strengths), psychosocial parameters (Functional Assessment of Cancer Therapy - Leukaemia, Functional Assessment of Cancer Therapy - Fatigue, subjective well-being, Hospital Anxiety and Depression Scale, self-efficacy, Coach-Athlete Relationship Questionnaire, interviews) and clinical status (weight, lean body mass, survival rate, number of infections, days of hospitalisation, GvHD) will be evaluated. ETHICS AND DISSEMINATION: The study procedures have been approved by the National Ethics Committee (21.00223.000003). Consent is given in person by each participant. The information collected on the participants contains only a non-identifiable study identifier. The results of this protocol will be published in a scientific paper and communicated to the medical staff of the medical centre. TRIAL REGISTRATION NUMBER: NCT03595787.

Case-control study of behavior data from automated milk feeders in healthy or diseased dairy calves.

Group housing of preweaning dairy calves is increasing in popularity throughout the dairy industry. However, it can be more difficult to individually monitor calves to identify disease in these group systems. Automated milk feeders (AMF) not only provide producers with the opportunity to increase the milk allowance offered to preweaning calves but they can also monitor individual feeding behaviors that could identify calves at increased risk of disease. The objective of this retrospective case-control study was to determine how feeding behaviors change in preweaning calves leading up to and during a disease bout. This study was conducted between fall 2015 and fall 2016 on 2 commercial dairy farms in Ontario, Canada. Producers' treatment records for respiratory or enteric illness were used to identify cases. Control calves were selected from calves not treated for disease and matched on the days on the AMF. Both farms housed calves in dynamic groups of 9 to 11 calves with an AMF and fed milk replacer. Differences in feeding behaviors, including milk consumption, drinking speed, rewarded visits, unrewarded visits, and total visits to the AMF per day, were analyzed by mixed models accounting for repeated measures. Data were analyzed for the 7 d before, the day of, and 7 d after treatment. A total of 28 cases and 28 control calves (n = 56) were analyzed. Calves with disease consumed significantly less milk than their healthy counterparts, beginning 5 d before disease and until 3 d after disease detection. Sick calves had fewer unrewarded visits starting 3 d before until 2 d after illness detection. Sick calves drank significantly more slowly starting 4 d before illness detection until the day after illness detection compared with healthy controls. No differences were found between cases and controls for rewarded visits. Calves on a high plane of milk nutrition significantly alter feeding behaviors before illness detection. Data from AMF on feeding behaviors may help to detect disease earlier in preweaning dairy calves.