{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:17:34Z","timestamp":1787761054499,"version":"build-2784847793"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["273500"],"award-info":[{"award-number":["273500"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Fatigue is a prevalent and distressing late effect among childhood cancer survivors (CCSs), yet its physiological determinants remain unclear. This study examined the associations between physical fitness (VO\n                      <jats:sub>2<\/jats:sub>\n                      peak and muscular strength), physical function (sit\u2010to\u2010stand [STS] performance), physical activity, and fatigue in adolescent CCSs, and whether these associations differ from those observed in healthy controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional analysis was part of the international multicenter Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study, including CCSs and age\u2010 and sex\u2010matched healthy controls. Fatigue was assessed using the Pediatric Quality of Life Inventory\u2013Multidimensional Fatigue Scale. Physical fitness and function were evaluated by cardiopulmonary exercise testing (VO\n                      <jats:sub>2<\/jats:sub>\n                      peak), isometric muscular strength (knee extension, chest press, and handgrip), and the 1\u2010min STS test. Physical activity was measured by accelerometry. Associations between physical fitness, physical activity, and fatigue were examined using multivariable mixed\u2010effects linear regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 123 CCSs (mean age 13.5\u00a0\u00b1\u00a02.5 years, 6.7\u00a0\u00b1\u00a03.5 years posttreatment) and 99 controls (mean age 13.1\u00a0\u00b1\u00a02.6 years) were included. Total fatigue scores among CCSs and controls were 72.6\u00a0\u00b1\u00a017.1 and 74.8\u00a0\u00b1\u00a015.7, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.324). Higher VO\n                      <jats:sub>2<\/jats:sub>\n                      peak (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.66, 95% confidence interval [CI] 0.14\u20131.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012) and greater muscular strength (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a05.85, 95% CI 0.63\u201311.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.028) were associated with less fatigue in CCSs, whereas activity levels were not associated with fatigue. No significant differences were observed in the association of physical fitness or physical activity measures with fatigue between CCSs and controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher physical fitness, but not physical activity level, was associated with lower fatigue in adolescent CCSs, with similar associations observed in healthy controls. These findings highlight physical fitness as a potential target for fatigue management in adolescent CCSs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70478","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:03:36Z","timestamp":1785384216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Physical Fitness and Fatigue in Adolescent Childhood Cancer Survivors: The PACCS Study"],"prefix":"10.1002","volume":"73","author":[{"given":"Sara Hassing","family":"Johansen","sequence":"first","affiliation":[{"name":"Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Edvardsen","sequence":"additional","affiliation":[{"name":"Department of Physical Performance The Norwegian School of Sport Sciences  Oslo Norway"},{"name":"Department of Sports Medicine The Norwegian School of Sport Sciences  Oslo Norway"},{"name":"Department of Pulmonary Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2567-3004","authenticated-orcid":false,"given":"Truls","family":"Raastad","sequence":"additional","affiliation":[{"name":"Department of Physical Performance The Norwegian School of Sport Sciences  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Ruud","sequence":"additional","affiliation":[{"name":"Department of Adolescent and Pediatric Medicine Oslo University Hospital  Oslo Norway"},{"name":"Institute for Clinical Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-9303","authenticated-orcid":false,"given":"Wei Hai","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Bratteteig","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine The Norwegian School of Sport Sciences  Oslo Norway"},{"name":"Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Grydeland","sequence":"additional","affiliation":[{"name":"Department of Physical Performance The Norwegian School of Sport Sciences  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Peder","family":"Bovim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina Silvia","family":"Rueegg","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital  Oslo Norway"},{"name":"Epidemiology, Biostatistics and Prevention Institute University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne C.","family":"Lie","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(19)30273\u20106"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6296"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(19)30800\u20109"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012681"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/31.2.271"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2023.102044"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2022.103804"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010022\u201001217\u20109"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.12.1583"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2022.02.029"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102023\u2010107849"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwae317"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2015.1079756"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000003758"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2196\/35838"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10428"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23818"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.45.242.534"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038\u2010013\u20100504\u2010z"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1123\/jpah.10.3.437"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.05.005"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640410802334196"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7244.1240"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u20105\u201043"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70425"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30746"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2024.11.004"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000461"},{"key":"e_1_2_11_30_1","volume-title":"Textbook of Work Physiology: Physiological Bases of Exercise","author":"Aastrand P. O.","year":"2003"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12968\u2010020\u201000658\u20104"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2013.195"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/aac2.12027"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573400510666141114223827"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2024.04.006"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1123\/jpah.2023\u20100100"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2018.08.012"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31647"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2013.123"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibab028"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010024\u201001741\u2010w"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27949"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35207"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010023\u201002410\u2010y"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.32110"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001561"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/s22083008"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010020\u201000904\u20109"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.977365"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70478","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/1545-5017.70478","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70478","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:17:44Z","timestamp":1787757464000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/1545-5017.70478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/1545-5017.70478"],"URL":"https:\/\/doi.org\/10.1002\/1545-5017.70478","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"assertion":[{"value":"2026-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70478"}}