Backgrand and Objective: Aquatic exercise may be an effective strategy for promoting healthy aging among older women with obesity because it reduces joint loading while improving physical and functional capacity. In this prospective observational study, we examined longitudinal changes in fall-related physical function, executive function, and circulating myokine levels among older women with obesity according to their participation in a 16-week combined aquatic exercise program. Materials and Methods: Thirty older women with obesity were included in this prospective observational study and classified into an aquatic exercise group (n = 15) or a comparison group (n = 15) according to their participation in an existing community-based aquatic exercise program. Group membership was not assigned by the researchers. Participants in the aquatic exercise group attended the 16-week program, whereas those in the comparison group maintained their usual daily activities. Fall-related physical function, executive function, and circulating levels of the myokines irisin and interleukin-6 (IL-6) were assessed at baseline and at Weeks 8 and 16. Descriptive statistics were used to summarize participant characteristics, and two-way repeated-measures analyses of variance were performed to examine group differences, changes over time, and group & times; time interactions. When significant group & times; time interactions were observed, planned contrast analyses were conducted to examine changes across measurement time points. Statistical significance was set at p < 0.05. Results: Compared with the comparison group, the aquatic exercise group exhibited greater longitudinal improvements in several measures of fall-related physical function, including body composition, muscular function, and balance. However, no significant group & times; time interactions were observed for gait speed or endurance. Executive function demonstrated a significant group & times; time interaction (p < 0.001). Among the assessed myokines, irisin demonstrated a significant group & times; time interaction (p = 0.002), whereas IL-6 did not (p = 0.372), although IL-6 levels tended to decrease in the aquatic exercise group. Conclusions: Participation in the 16-week combined aquatic exercise program was associated with favorable longitudinal changes in several measures of fall-related physical function, executive function, and circulating irisin levels among older women with obesity. No significant group & times; time interactions were observed for gait performance or IL-6 levels. These findings suggest that participation in a community-based combined aquatic exercise program may be associated with favorable changes in selected indicators of healthy aging among older women with obesity.
Background and Objectives: SPES was a 2016-2017 regional biomonitoring program. We conducted a secondary cross-sectional analysis of associations between current serum trace-element distributions and heterogeneous, self-reported physician-diagnosed tumor history, rather than registry-confirmed or incident cancer. Materials and Methods: Among 4137 questionnaire responders, 86 reported a tumor history. Mixed-effects logistic models for 20 channels were adjusted for age, sex, smoking, and geographic cluster and pooled across 30 completed datasets. Benjamini-Hochberg FDR control was applied across 20 primary comparisons. Results: Higher Cr-52 was associated with lower prevalence odds of reported history (odds ratio per one-standard-deviation increase in log concentration, 0.751; 95% confidence interval, 0.601-0.937; p = 0.011; q = 0.226), but no channel met q < 0.05. Cr-52 was below the limit of quantification in 45/86 (52.3%) participants with reported history and 1646/4048 (40.7%) without. The inverse direction persisted in non-independent complementary analyses; none met the applicable FDR threshold. Conclusions: No channel met the FDR criterion. The Cr-52 pattern was nominal and exploratory. These prevalence associations with a heterogeneous, unvalidated self-reported outcome do not establish temporality, causality, chromium speciation, or a protective effect.
Background and Objectives: Total hip (TH) and femoral neck (FN) T-scores from the same dual-energy X-ray absorptiometry (DXA) examination often diverge. We evaluated whether the signed TH-FN difference is associated with prevalent proximal femur fracture and whether it has individual-level discriminative value, explicitly separating statistical association from discrimination. Materials and Methods: In a single-center retrospective case-control study (complete case N = 3752; 448 fractures), multivariable logistic regression adjusting for the TH T-score and 12 covariates estimated the association of the signed difference, interaction with severity, and standalone and incremental discrimination (AUC, cross-validated Delta AUC). Additional analyses examined standardized and BMD-scale exposures, a low-energy-restricted cohort, a subtype case-case comparison, and adjustment for the ISCD lowest-site T-score including the lumbar spine. Results: The signed difference was associated with fracture (adjusted OR 1.65, 95% CI 1.39-1.97; interaction OR 1.06, 0.75-1.50), persisting with inpatient-restricted controls (OR 1.74), standardized and BMD-scale exposures, and low-energy restriction (OR 1.68). Standalone discrimination was weak (AUC 0.547) and out-of-sample incremental value negligible (Delta AUC +0.005, 95% CI -0.009 to +0.014). Adjusting for the ISCD lowest-site T-score abolished the full-cohort association (OR 1.04, 0.88-1.23)-the adjusted signal is femoral neck information already captured by the lowest-site rule-while a residual association persisted within the TH <= -2.5 subgroup (OR 1.34, 1.02-1.76). Fracture proportions are within-sample case-control fractions, not population incidence. Conclusions: The signed TH-FN discordance is a robust, routinely derivable correlate of prevalent proximal femur fracture whose standalone discrimination is nonetheless limited-a concrete demonstration that statistical significance need not confer predictive utility. It is best positioned as a supplementary, hypothesis-generating marker; any clinical role requires prospective validation against FRAX and the ISCD lowest-site rule.
Background and Objectives: Radiotherapy (RT) is a standard component of palliative treatment for brain metastases. The aim of this retrospective analysis of consecutive patients treated between 2017 and 2023 is to analyze overall survival after brain radiotherapy depending on the type of radiotherapy delivered and to monitor the shift from whole-brain radiotherapy (WBRT) to stereotactic radiotherapy (SRS/FSRT) in real-world practice before the era of routinely used modern brain-penetrant targeted therapy. Materials and Methods: A total of 734 patients treated with radiotherapy for brain metastases were analyzed. Clinical data were collected via an electronic hospital information system and radiotherapy details were obtained using the Eclipse (TM) treatment planning system. The survival analysis divides patients according to cancer types and according to the RT technique used. Results: A total of 734 patients (median age 65.2 years; 50.5% women) were analyzed, with 104 undergoing more than one course of radiotherapy. Lung cancer (42.3%) and breast cancer (17.2%) were the most common primary diagnoses. Median overall survival (OS) after radiotherapy for the entire cohort was 2.8 months (2.6-3.2 months). Survival varied by radiotherapy technique: 2 months for WBRT-based approaches, 5.7 months for stereotactic radiotherapy (SRS/FSRT), and 7 months for combined WBRT and stereotactic treatment. Breast cancer patients had the longest median OS (3.6 months), with substantially improved outcomes in those treated with stereotactic or combined approaches (12.8 and 11.9 months, respectively). A decline in treated patients was observed during the COVID-19 pandemic (notably in 2021) and a consistent increase in the use of stereotactic techniques between 2017 and 2023 was noted. Conclusions: A wide range of radiotherapy techniques are used in the treatment of brain metastases with the primary concern being the prognosis and diagnosis of a patient. A clearly identifiable trend is a shift away from WBRT toward an increased use of targeted stereotactic irradiation techniques for brain lesions. Overall survival varies significantly across primary sites with most favorable outcomes in breast cancer patients irradiated with SRS/FSRT.
Background and Objectives: Anti-hepatitis B core antibody (anti-HBc) is generally regarded as a lifelong serological marker of previous hepatitis B virus (HBV) infection. However, anti-HBc seroclearance has been increasingly reported in patients receiving anti-CD20 therapy, while its incidence, longitudinal serological dynamics, and clinical significance remain insufficiently characterized. In this study, we aimed to evaluate the incidence, timing, and predictors of anti-HBc seroclearance and investigate longitudinal changes in HBV serology in HBsAg-negative/anti-HBc-positive patients undergoing anti-CD20 therapy. Materials and Methods: This retrospective single-center cohort study included 230 HBsAg-negative/anti-HBc-positive adults who received anti-CD20 therapy between 2011 and 2025. Anti-HBc seroclearance was evaluated using Kaplan-Meier analysis and Cox proportional hazards regression. Longitudinal changes in anti-HBc and anti-HBs titers were assessed using linear mixed-effects models. Results: Confirmed anti-HBc seroclearance occurred in 38 of 230 patients (16.5%). Younger age (adjusted hazard ratio (aHR) 0.96, 95% confidence interval (CI) 0.93-0.98; p = 0.001), fewer anti-CD20 treatment cycles (aHR 0.90, 95% CI 0.83-0.99; p = 0.025), and mycophenolate mofetil therapy (aHR 2.52, 95% CI 1.14-5.56; p = 0.022) were independently associated with anti-HBc seroclearance. Anti-HBc titers progressively declined during follow-up, with a significantly steeper decline among patients receiving mycophenolate mofetil. HBV reactivation occurred in five of 230 patients (2.2%), including two who had developed anti-HBc seroclearance. HBsAg seroreversion occurred in all five patients. Conclusions: Anti-HBc seroclearance is a relatively frequent serological finding in HBsAg-negative/anti-HBc-positive patients receiving anti-CD20 therapy and is accompanied by progressive declines in anti-HBc titers. Despite seroclearance, HBV reactivation may still occur, indicating that anti-HBc loss should not be considered evidence of elimination of HBV-related immunological risk. These findings improve our understanding of HBV serological dynamics during anti-CD20 therapy and support maintaining current antiviral prophylaxis and virological monitoring strategies regardless of anti-HBc seroclearance.
