Purpose: This systematic review aims to assess and summarize the clinical values of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameter changes as early biomarkers of tumor responses following radiation therapy (RT) in patients with spinal metastases. Materials and Methods: A systematic search was conducted on five electronic databases: PubMed, Scopus, Science Direct, Cochrane, and Embase. Studies were included if they mentioned DCE-MRI parameter changes before and after RT in patients with spinal metastases with a correlation to tumor responses based on clinical and imaging criteria. The Quality Assessment of Diagnostic Accuracy Studies 2 was used to assess study quality. Results: This systematic review included seven studies involving 107 patients. All seven studies evaluated the transfer constant (Ktrans), six studies evaluated the plasma volume fraction (Vp), three studies evaluated the extravascular extracellular space volume fraction, and two studies evaluated the rate constant. There were variations in the type of primary cancer, RT techniques used, post-treatment scan time, and median follow-up time. Despite the variations, however, the collected evidence generally suggested that significant differences could be detected in DCE-MRI parameters between before and after RT, which might reflect treatment success or failures in long-term follow-up. Responders showed higher reduction and lower values of Ktrans and Vp after RT. DCE-MRI parameters showed changes and detectable recurrences significantly earlier (up to 6 months) than conventional MRI with favorable diagnostic values. Conclusion The results of this systematic review suggested that DCE-MRI parameter changes in patients with spinal metastases could be a promising tool for treatment-response assessment following RT. Lower values and higher reduction of Ktrans and Vp after treatment demonstrated good prediction of local control. Compared to conventional MRI, DCE-MRI showed more rapid changes and earlier prediction of treatment failure.

Objective: To prove 5-time sit-to-stand (5-STS) and 30-second sit-to-stand (30sSTS) tests in assessing cardiorespiratory fitness in chronic heart failure (HF) patients with systolic dysfunction. Alternative tests, such as 5-STS and 30sSTS, may be used to assess cardiorespiratory fitness in patients with HF but have not been thoroughly evaluated. Thus, this study aimed to prove 5-STS and 30sSTS tests in assessing cardiorespiratory fitness in chronic HF patients with systolic dysfunction. Methods: A cross-sectional study was done, evaluating chronic HF patients with systolic dysfunction that have received optimal guideline directed medical treatment for at least 3 months. All patients underwent the same intervention on the same day, starting with an initial 5-STS test, followed by a 30sSTS, and a 6-minute walk test (6MWT). Results: A total of 34 patients were enrolled in this study. The median left ventricular ejection fraction was 44% (interquartile range=34%–48%). Mean values of 5-STS, 30sSTS, and 6MWT were 13.90±4.72, 13.29±3.38, and 463.65±87.04, respectively. 5-STS showed moderate correlation with 6MWT (r=-0.436, p=0.01). However, the 30sSTS revealed strong correlation with 6MWT (r=0.629, p<0.001). Conclusion The 30sSTS test had strong correlation with 6MWT. It could be used to illustrate cardiorespiratory fitness in chronic HF patients with systolic dysfunction.

Pedicle screws are commonly used for vertebral instrumentation, and a postoperative computed tomography (CT) scan is used to evaluate their position within the pedicle. Medial pedicle screw breaching occurs in 20%–40% of cases. This study investigated the correlation between radiographically evident medial breaching and the incidence of nerve injury, shedding light on the clinical implications. A literature search was conducted on biomedical databases regarding neurologic deficits associated with medially breached pedicle screws with pre-defined inclusion and exclusion criteria. The methodology of the included studies was analyzed, and a systematic review and meta-analysis were performed to investigate the correlation between medial breach on axial CT and clinical neurologic deficits. Our study included thirteen articles. Medial breaches <2 mm caused no neurologic deficit. Medial breaches of 2–4 mm increased the risk of neurologic deficit by 83%, with a risk ratio of 0.17. Breaches exceeding 4 mm increased the risk by 90%, with a risk ratio of 0.1, and were associated with radiculopathy or muscle weakness in 25%–100% of cases. Medial pedicle screw breaches <2 mm are safe, carrying no risk of neurologic injury. Breaches exceeding ≥2 mm significantly increase this risk. For patients experiencing new neurologic deficit (sensory or motor) after pedicle screw instrumentation, particularly in lumbar vertebrae, a postoperative axial CT scan is recommended to identify breaches exceeding 2 mm as the potential cause of neurologic deficit.

Objective: To prove 5-time sit-to-stand (5-STS) and 30-second sit-to-stand (30sSTS) tests in assessing cardiorespiratory fitness in chronic heart failure (HF) patients with systolic dysfunction. Alternative tests, such as 5-STS and 30sSTS, may be used to assess cardiorespiratory fitness in patients with HF but have not been thoroughly evaluated. Thus, this study aimed to prove 5-STS and 30sSTS tests in assessing cardiorespiratory fitness in chronic HF patients with systolic dysfunction. Methods: A cross-sectional study was done, evaluating chronic HF patients with systolic dysfunction that have received optimal guideline directed medical treatment for at least 3 months. All patients underwent the same intervention on the same day, starting with an initial 5-STS test, followed by a 30sSTS, and a 6-minute walk test (6MWT). Results: A total of 34 patients were enrolled in this study. The median left ventricular ejection fraction was 44% (interquartile range=34%–48%). Mean values of 5-STS, 30sSTS, and 6MWT were 13.90±4.72, 13.29±3.38, and 463.65±87.04, respectively. 5-STS showed moderate correlation with 6MWT (r=-0.436, p=0.01). However, the 30sSTS revealed strong correlation with 6MWT (r=0.629, p<0.001). Conclusion The 30sSTS test had strong correlation with 6MWT. It could be used to illustrate cardiorespiratory fitness in chronic HF patients with systolic dysfunction.

Pedicle screws are commonly used for vertebral instrumentation, and a postoperative computed tomography (CT) scan is used to evaluate their position within the pedicle. Medial pedicle screw breaching occurs in 20%–40% of cases. This study investigated the correlation between radiographically evident medial breaching and the incidence of nerve injury, shedding light on the clinical implications. A literature search was conducted on biomedical databases regarding neurologic deficits associated with medially breached pedicle screws with pre-defined inclusion and exclusion criteria. The methodology of the included studies was analyzed, and a systematic review and meta-analysis were performed to investigate the correlation between medial breach on axial CT and clinical neurologic deficits. Our study included thirteen articles. Medial breaches <2 mm caused no neurologic deficit. Medial breaches of 2–4 mm increased the risk of neurologic deficit by 83%, with a risk ratio of 0.17. Breaches exceeding 4 mm increased the risk by 90%, with a risk ratio of 0.1, and were associated with radiculopathy or muscle weakness in 25%–100% of cases. Medial pedicle screw breaches <2 mm are safe, carrying no risk of neurologic injury. Breaches exceeding ≥2 mm significantly increase this risk. For patients experiencing new neurologic deficit (sensory or motor) after pedicle screw instrumentation, particularly in lumbar vertebrae, a postoperative axial CT scan is recommended to identify breaches exceeding 2 mm as the potential cause of neurologic deficit.

Objective: To prove 5-time sit-to-stand (5-STS) and 30-second sit-to-stand (30sSTS) tests in assessing cardiorespiratory fitness in chronic heart failure (HF) patients with systolic dysfunction. Alternative tests, such as 5-STS and 30sSTS, may be used to assess cardiorespiratory fitness in patients with HF but have not been thoroughly evaluated. Thus, this study aimed to prove 5-STS and 30sSTS tests in assessing cardiorespiratory fitness in chronic HF patients with systolic dysfunction. Methods: A cross-sectional study was done, evaluating chronic HF patients with systolic dysfunction that have received optimal guideline directed medical treatment for at least 3 months. All patients underwent the same intervention on the same day, starting with an initial 5-STS test, followed by a 30sSTS, and a 6-minute walk test (6MWT). Results: A total of 34 patients were enrolled in this study. The median left ventricular ejection fraction was 44% (interquartile range=34%–48%). Mean values of 5-STS, 30sSTS, and 6MWT were 13.90±4.72, 13.29±3.38, and 463.65±87.04, respectively. 5-STS showed moderate correlation with 6MWT (r=-0.436, p=0.01). However, the 30sSTS revealed strong correlation with 6MWT (r=0.629, p<0.001). Conclusion The 30sSTS test had strong correlation with 6MWT. It could be used to illustrate cardiorespiratory fitness in chronic HF patients with systolic dysfunction.

Pedicle screws are commonly used for vertebral instrumentation, and a postoperative computed tomography (CT) scan is used to evaluate their position within the pedicle. Medial pedicle screw breaching occurs in 20%–40% of cases. This study investigated the correlation between radiographically evident medial breaching and the incidence of nerve injury, shedding light on the clinical implications. A literature search was conducted on biomedical databases regarding neurologic deficits associated with medially breached pedicle screws with pre-defined inclusion and exclusion criteria. The methodology of the included studies was analyzed, and a systematic review and meta-analysis were performed to investigate the correlation between medial breach on axial CT and clinical neurologic deficits. Our study included thirteen articles. Medial breaches <2 mm caused no neurologic deficit. Medial breaches of 2–4 mm increased the risk of neurologic deficit by 83%, with a risk ratio of 0.17. Breaches exceeding 4 mm increased the risk by 90%, with a risk ratio of 0.1, and were associated with radiculopathy or muscle weakness in 25%–100% of cases. Medial pedicle screw breaches <2 mm are safe, carrying no risk of neurologic injury. Breaches exceeding ≥2 mm significantly increase this risk. For patients experiencing new neurologic deficit (sensory or motor) after pedicle screw instrumentation, particularly in lumbar vertebrae, a postoperative axial CT scan is recommended to identify breaches exceeding 2 mm as the potential cause of neurologic deficit.

Introduction: Proper nutrition for premature babies is vital for optimal growth. However, a lack of confidence and knowledge among parents causes them to search for online information which may sometimes be misleading or unreliable. The primary objective of this study is to develop a validated website as an educational tool for parents about nutrition for premature babies. Methods: This study was conducted by referring to the Waterfall Software Development Life Cycle (SDLC) model, which consists of five main stages. Stages one to three are related to the development of the website, namely, the requirements stage, design stage and implementation stage. This is then followed by a testing stage where 11 expert panels evaluated the content and face validity of the website. The final stage is the maintenance stage. Results: The website was developed with nine topics. The value of Item Content Validity Index (I-CVI) for every item exceeded the minimum value of I-CVI (0.78), the value of the content validity index by scale, average (S-CVI/Ave) is 0.98, and the content validity index by scale, universal agreement (S-CVI/UA) is 0.83. Both S-CVIs have exceeded the minimum value, which is 0.90 and 0.80 respectively. The value of Krippendorff's Alpha (Kalpha) for the overall section of face validity is 0.53, which does not achieve the minimum acceptable value of Kalpha (0.67). Conclusion: The content validation has high agreement among the expert panels. However, the interphase, layout, and design of the website need to be improvised.

Aims: A study on biosorption ability using encapsulated endophytic fungi has been carried out to investigate its biosorption potential in removing heavy metals. Biosorption has emerged as an alternative bioremediation process to remove and sequester heavy metal ions from polluted water. An endophytic Pestalotiopsis sp. (isolated from Nypa fruticans) was found to be able to resist copper (Cu), chromium (Cr), lead (Pb) and zinc (Zn) up to 1,000 ppm and thus the aim of this study was to investigate the biosorption ability using encapsulated live and dead Pestalotiopsis sp. biomass (at pH 4-6) to remove heavy metals. Additionally, a proteomic study was conducted to investigate down- and up-regulation expression levels of proteins under the treatment of the heavy metals. Methodology and results: Encapsulated live fungal biomass displayed higher efficiency in removing chromium at pH 5 and 6, while both encapsulated live and dead biomass were able to remove lead at pH 4 and 5 and copper at pH 5. Five (5) proteins of interest were identified via MALDI-ToF analysis. Among the proteins identified, multidrug resistance protein (MRP homolog) was up-regulated in the presence of lead. Conclusion, significance and impact of study The data obtained in this study provides an initial understanding of the biosorptive and defensive mechanisms of Pestalotiopsis sp. under heavy metal stress.