Displaying publications 1 - 20 of 807 in total

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  1. A A, R N, K P, Bing CH, R R
    Mar Pollut Bull, 2018 Aug;133:655-663.
    PMID: 30041362 DOI: 10.1016/j.marpolbul.2018.06.033
    The concentrations of nine trace metals (Cr, Mn, Co, Ni, Cu, Zn, Rb, Cd, and Pb) were measured in different tissues of two pelagic and five demersal fish species collected from the Miri coast, Sarawak. The sequence of accumulation of trace metals in different tissues were: liver > gill > gonad > muscle. Zn (301.00 μg g-1) and Cd (0.10 μg g-1) was the maximum and minimum accumulated elements. According to the Hazard Index calculation, none of the elements will pose any adverse health effects to humans for both ingestion rates (normal and habitual fish consumers) proposed by USEPA, except for Pb and Cd in certain fish species. On the basis of the results, the level of elements in the edible muscle tissues of all the analyzed fish species from the Miri coast are below the maximum permissible limits of Malaysian and International seafood guideline values and safe for consumers.
    Matched MeSH terms: Risk Assessment/methods*
  2. Ab Rahman A, Ahmad Z, Naing L, Sulaiman SA, Hamid AM, Daud WN
    PMID: 18613559
    The objective of this case-control study was to determine the association between herbal medicine use during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia. Cases were mothers who gave birth from June 2002 to June 2005 with a history of perinatal mortality, while controls were those without a history of perinatal infant mortality. A total of 316 mothers (106 cases and 210 controls) were interviewed. The use of unidentified herbs prepared by traditional midwives and other types of herbal medicines during the first trimester of pregnancy were positively associated with perinatal mortality (OR = 5.24, 95% CI = 1.13; 24.23 and OR = 8.90, 95%, CI = 1.35; 58.53, respectively). The use of unidentified "Orang Asli" herbs and coconut oil during the third trimester of pregnancy were negatively associated with perinatal mortality in Tumpat (OR = 0.10, 95% CI = 0.02; 0.59 and OR = 0.48, 95% CI = 0.25; 0.92, respectively). These findings suggest the use of unidentified "Orang Asli" herbs and coconut oil in late pregnancy are protective against perinatal mortality, while the use of unidentified herbs prepared by traditional midwives and other types of herbal medicines in early pregnancy has an increased risk of perinatal infant mortality. Pharmacological studies to confirm and identify the compounds in these herbs and their effects on the fetus should be conducted in the future.
    Matched MeSH terms: Risk Assessment
  3. Ab Razak NH, Praveena SM, Aris AZ, Hashim Z
    Public Health, 2016 Feb;131:103-11.
    PMID: 26715317 DOI: 10.1016/j.puhe.2015.11.006
    Information about the quality of drinking water, together with analysis of knowledge, attitude and practice (KAP) analysis and health risk assessment (HRA) remain limited. The aims of this study were: (1) to ascertain the level of KAP regarding heavy metal contamination of drinking water in Pasir Mas; (2) to determine the concentration of heavy metals (Al, Cr, Cu, Fe, Ni, Pb, Zn and Cd) in drinking water in Pasir Mas; and (3) to estimate the health risks (non-carcinogenic and carcinogenic) caused by heavy metal exposure through drinking water using hazard quotient and lifetime cancer risk.
    Matched MeSH terms: Risk Assessment
  4. Ab Razak NH, Praveena SM, Aris AZ, Hashim Z
    J Epidemiol Glob Health, 2015 Dec;5(4):297-310.
    PMID: 25944153 DOI: 10.1016/j.jegh.2015.04.003
    Malaysia has abundant sources of drinking water from river and groundwater. However, rapid developments have deteriorated quality of drinking water sources in Malaysia. Heavy metal studies in terms of drinking water, applications of health risk assessment and bio-monitoring in Malaysia were reviewed from 2003 to 2013. Studies on heavy metal in drinking water showed the levels are under the permissible limits as suggested by World Health Organization and Malaysian Ministry of Health. Future studies on the applications of health risk assessment are crucial in order to understand the risk of heavy metal exposure through drinking water to Malaysian population. Among the biomarkers that have been reviewed, toenail is the most useful tool to evaluate body burden of heavy metal. Toenails are easy to collect, store, transport and analysed. This review will give a clear guidance for future studies of Malaysian drinking water. In this way, it will help risk managers to minimize the exposure at optimum level as well as the government to formulate policies in safe guarding the population.
    Matched MeSH terms: Risk Assessment
  5. Abd Rahman MN, Abdul Rani MR, Rohani JM
    J Hum Ergol (Tokyo), 2011 Dec;40(1-2):19-36.
    PMID: 25665205 DOI: 10.11183/jhe.40.19
    This paper describes the development of the Workplace Ergonomic Risk Assessment (WERA) for investigating the physical risk factor associated with work-related musculoskeletal disorders (WMSDs). The initial development of WERA tool involved the following procedures: (1) first stage, development of WERA prototype from literature review, (2) second stage, evaluation of the psychometric properties including (a) validity trials and (b) reliability and usability trials. In the validity trials, the relationship of the individual WERA body part scores to the development of pain or discomfort is statistically significant for the wrist, shoulder and back regions. It shows that the WERA assessment provided a good indication of work-related musculoskeletal disorders which might be reported as pain, ache or discomfort in the relevant body regions. In the reliability trials, the results of inter-observer reliability shows that moderate agreement among the observers while from the feedback questionnaire survey about the usability of WERA tool, all participants including expert and management teams agreed that the prototype of WERA tool was easy and quick to use, applicable to workplace assessment for the wide range of job/task and valuable at work. It was confirmed that there was no need of training required to do WERA assessment. Therefore, the WERA assessment has been designed for easy and quick use, and for those who are trained to use it do not need previous skills in observation techniques although this would be an advantage. As WERA is a pen and paper technique that can be used without any special equipment, WERA assessment can be done in any space of workplaces without disruption to the task that have been observed.
    Matched MeSH terms: Risk Assessment/statistics & numerical data*
  6. Abdelhaq M, Alsaqour R, Abdelhaq S
    PLoS One, 2015;10(5):e0120715.
    PMID: 25946001 DOI: 10.1371/journal.pone.0120715
    A mobile ad hoc network (MANET) is a set of mobile, decentralized, and self-organizing nodes that are used in special cases, such as in the military. MANET properties render the environment of this network vulnerable to different types of attacks, including black hole, wormhole and flooding-based attacks. Flooding-based attacks are one of the most dangerous attacks that aim to consume all network resources and thus paralyze the functionality of the whole network. Therefore, the objective of this paper is to investigate the capability of a danger theory-based artificial immune algorithm called the mobile dendritic cell algorithm (MDCA) to detect flooding-based attacks in MANETs. The MDCA applies the dendritic cell algorithm (DCA) to secure the MANET with additional improvements. The MDCA is tested and validated using Qualnet v7.1 simulation tool. This work also introduces a new simulation module for a flooding attack called the resource consumption attack (RCA) using Qualnet v7.1. The results highlight the high efficiency of the MDCA in detecting RCAs in MANETs.
    Matched MeSH terms: Risk Assessment
  7. Abdollahi A, Talib MA
    Psychiatry Res, 2015 Aug 30;228(3):591-7.
    PMID: 26117250 DOI: 10.1016/j.psychres.2015.05.046
    Suicide is a substantial public health problem, and it remains a serious cause of death in the world. Therefore, this study was designed to examine the relationships between brooding, reflection, emotional intelligence (assessed by performance-based test), and suicidal ideation; the mediation role of emotional intelligence on the relationships between brooding and reflection with suicidal ideation; and the moderating role of suicidal history on the relationships between brooding, reflection, and emotional intelligence with suicidal ideation among Iranian depressed adolescents. The study consisted of a cross-sectional sample of 202 depressed adolescent inpatients from five public hospitals in Tehran, Iran completed measures of depression, rumination, emotional intelligence, and suicide attempt history as indices of suicidal ideation. Structural Equation Modelling estimated that depressed adolescent inpatients with high levels of brooding and reflective rumination, and low levels of emotional intelligence were more likely to report suicidal ideation. Moreover, emotional intelligence partially mediated the relationships between brooding and reflective rumination with suicidal ideation. Suicidal history moderated the relationships between brooding, reflection, and emotional intelligence with suicidal ideation. These findings reinforce the importance of emotional intelligence as an influencing factor against the deleterious effects of rumination styles and suicidal ideation. The results indicate that brooding and reflection have detrimental effects on suicidal ideation in depressed inpatients.
    Matched MeSH terms: Risk Assessment
  8. Abdul Aziz AF, Mohd Nordin NA, Ali MF, Abd Aziz NA, Sulong S, Aljunid SM
    BMC Health Serv Res, 2017 Jan 13;17(1):35.
    PMID: 28086871 DOI: 10.1186/s12913-016-1963-8
    BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking.

    METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. Care algorithms were designed around existing work schedules at public health centres.

    RESULTS: Indication for patients eligible for monitoring by primary care at public health centres were identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Essential information required during transfer of care from tertiary care to primary care providers was identified. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Shared care approaches with Specialist Stroke care team were outlined. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems.

    CONCLUSION: Coordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services.

    TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016).
    Matched MeSH terms: Risk Assessment
  9. Abdul Rahman HI, Shah SA, Alias H, Ibrahim HM
    Asian Pac J Cancer Prev, 2008 Oct-Dec;9(4):649-52.
    PMID: 19256754
    BACKGROUND: In Malaysia, acute leukemia is the most common cancer among children below the age of 15. A case-control study was here conducted for cases from the Klang Valley, Malaysia, who received treatment at the National University of Malaysia Hospital (HUKM) and Kuala Lumpur General Hospital (GHKL). The main objective was to determine any association with environmental factors.

    METHODS: Case subjects were children aged below 15 years and diagnosed with acute leukemia in HUKM and GHKL between January 1, 2001 and May 30, 2007. Control subjects were children aged below 15 years who were diagnosed with any non-cancerous acute illnesses in these hospitals. A total of 128 case subjects and 128 control subjects were enrolled in this study. The information was collected using a structured questionnaire and a global positioning system (GPS) device. All factors were analyzed using unmatched logistic regression.

    RESULTS: The analysis showed that the occurrence of acute leukemia among children was strongly determined by the following factors: family income (odds ratio (OR) 0.19, 95% confidence interval (CI): 0.09-0.42), father with higher social contact (OR 7.61, 95% CI: 3.78-15.4), number of elder siblings (OR 0.36, 95% CI: 0.18-0.77), father who smokes (OR 2.78, 95% CI: 1.49-5.16), and the distance of the house from a power line (OR 2.30, 95% CI: 1.18-4.49).

    CONCLUSIONS: Some socioeconomic, demographic, and environmental factors are strong predictors of the occurrence of acute leukemia among children in Klang Valley, Malaysia. In terms of environmental factors, it is recommended that future housing areas should be developed at least 200 m away from power lines.
    Matched MeSH terms: Risk Assessment
  10. Abdullah AH, Todo M, Nakashima Y
    Med Eng Phys, 2017 06;44:8-15.
    PMID: 28373012 DOI: 10.1016/j.medengphy.2017.03.006
    Femoral bone fracture is one of the main causes for the failure of hip arthroplasties (HA). Being subjected to abrupt and high impact forces in daily activities may lead to complex loading configuration such as bending and sideway falls. The objective of this study is to predict the risk of femoral bone fractures in total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA). A computed tomography (CT) based on finite element analysis was conducted to demonstrate damage formation in a three dimensional model of HAs. The inhomogeneous model of femoral bone was constructed from a 79 year old female patient with hip osteoarthritis complication. Two different femoral components were modeled with titanium alloy and cobalt chromium and inserted into the femoral bones to present THA and RHA models respectively. The analysis included six configurations, which exhibited various loading and boundary conditions, including axial compression, torsion, lateral bending, stance and two types of falling configurations. The applied hip loadings were normalized to body weight (BW) and accumulated from 1 BW to 3 BW. Predictions of damage formation in the femoral models were discussed as the resulting tensile failure as well as the compressive yielding and failure elements. The results indicate that loading directions can forecast the pattern and location of fractures at varying magnitudes of loading. Lateral bending configuration experienced the highest damage formation in both THA and RHA models. Femoral neck and trochanteric regions were in a common location in the RHA model in most configurations, while the predicted fracture locations in THA differed as per the Vancouver classification.
    Matched MeSH terms: Risk Assessment
  11. Abdullah B, Chew SC, Aziz ME, Shukri NM, Husain S, Joshua SW, et al.
    Sci Rep, 2020 03 12;10(1):4600.
    PMID: 32165705 DOI: 10.1038/s41598-020-61610-1
    Keros and Gera classifications are widely used to assess the risk of skull base injury during endoscopic sinus surgery. Although, both classifications are useful preoperatively to stratify risk of patients going for surgery, it is not practical to measure the respective lengths during surgery. In this study, we aimed to propose a new radiological classification (Thailand-Malaysia-Singapore (TMS)) to assess the anatomical risk of anterior skull base injury using the orbital floor (OF) as a reference. A total of 150 computed tomography images of paranasal sinuses (300 sides) were reviewed. The TMS classification was categorized into 3 types by measuring OF to cribriform plate and OF to ethmoid roof. Most patients were classified as TMS type 1, Keros type 2 and Gera class II, followed by patients classified as TMS type 3, Keros type 1 and Gera class 1. TMS has significant correlation with Keros classification (p risk assessment of skull base injury among patients undergoing ESS. It serves as an additional assessment besides the Keros and Gera classifications.
    Matched MeSH terms: Risk Assessment
  12. Abdullah JM, Kumaraswamy N, Awang N, Ghazali MM, Abdullah MR
    Asian J Surg, 2005 Jul;28(3):163-7.
    PMID: 16024307
    To use data from a prospective, longitudinal study to determine whether psychomotor functions improve spontaneously during the first year following paediatric traumatic brain injury without modern rehabilitation facilities in a rural area of Malaysia.
    Matched MeSH terms: Risk Assessment
  13. Abdullah R, Alhusainy W, Woutersen J, Rietjens IM, Punt A
    Food Chem Toxicol, 2016 Jun;92:104-16.
    PMID: 27016491 DOI: 10.1016/j.fct.2016.03.017
    Aristolochic acids are naturally occurring nephrotoxins. This study aims to investigate whether physiologically based kinetic (PBK) model-based reverse dosimetry could convert in vitro concentration-response curves of aristolochic acid I (AAI) to in vivo dose response-curves for nephrotoxicity in rat, mouse and human. To achieve this extrapolation, PBK models were developed for AAI in these different species. Subsequently, concentration-response curves obtained from in vitro cytotoxicity models were translated to in vivo dose-response curves using PBK model-based reverse dosimetry. From the predicted in vivo dose-response curves, points of departure (PODs) for risk assessment could be derived. The PBK models elucidated species differences in the kinetics of AAI with the overall catalytic efficiency for metabolic conversion of AAI to aristolochic acid Ia (AAIa) being 2-fold higher for rat and 64-fold higher for mouse than human. Results show that the predicted PODs generally fall within the range of PODs derived from the available in vivo studies. This study provides proof of principle for a new method to predict a POD for in vivo nephrotoxicity by integrating in vitro toxicity testing with in silico PBK model-based reverse dosimetry.
    Matched MeSH terms: Risk Assessment
  14. Abdullah R, Diaz LN, Wesseling S, Rietjens IM
    PMID: 27892830 DOI: 10.1080/19440049.2016.1266098
    After the incidences of induction of aristolochic acid nephropathy after consumption of herbal weight loss preparations that accidentally contained aristolochic acids (AAs), several countries defined national restrictions on the presence of AAs in food, including plant food supplements (PFS) and herbal products. This study investigates whether the risks associated with exposure to AAs via PFS and herbal products are at present indeed negligible. Data reported in literature on AA levels in PFS and other herbal products and also obtained from a new series of PFS in the present study were used to calculate the estimated daily intakes (EDIs) and corresponding margins of exposure (MOEs). Available literature data revealed that 206 out of 573 samples were found to contain aristolochic acid I (AAI) and/or aristolochic acid II (AAII). The results obtained from recently collected PFS revealed that both AAI and AAII were detected in three out of 18 analysed PFS at levels up to 594.8 and 235.3 µg g(-1), respectively, being in line with the levels reported in literature. The EDIs resulting from intake of these PFS resulted in MOEs that were generally below 10,000, corroborating the priority for risk management. Although these results refer to PFS collected by targeted sampling strategies, the data reveal that AA-containing PFS are still freely available. When considering that the use of these samples may be limited to shorter periods of time, the EDIs might be lower, but MOE values would still be lower than 10,000 for more than 50% of the AA-containing PFS and herbal products. In conclusion, the presence of AAs in PFS and herbal products even several years after instalment of the legal restrictions still raises concern, especially for people who frequently use the respective PFS and herbal products.
    Matched MeSH terms: Risk Assessment
  15. Abubakar A, Zangina AS, Maigari AI, Badamasi MM, Ishak MY, Abdullahi AS, et al.
    Environ Sci Pollut Res Int, 2022 Aug;29(40):61065-61079.
    PMID: 35435558 DOI: 10.1007/s11356-022-19974-6
    Improper treatment during recycling of e-waste materials by means of open burning is on the rise which has led to an increase in air pollution. This study looked at heavy metal concentrations, concentrations in relation to threshold values, and assessments of risk for noncarcinogenic and cancer risk threat. The Microwave Plasma-Atomic Emission Spectrometry (MP-AES 4210) series instrument of Agilent Technology, United States of America (USA), was used in analyzing heavy metal (Cd, Cu, and Pb) concentrations. The result of the analysis of the Kuka Bulukiya treatment point revealed that Pb has the highest mean concentration of 0.0693 ppm, Cu 0.0525 parts per million (PPM), and Cd 0.0042 ppm. The mean concentration at PRP Gidan Ruwa for Cd was found to be 0.0059 ppm, Cu 0.0363 ppm, and Pb 0.049 ppm. The result of the adult and children population calculated shows that the hazard quotient (HQ) and hazard index (HI) values are not up to 1 in all the pathways (inhalation, ingestion, and dermal) at both treatment points (1.2 ˟ 10-4 and 9.8 ˟ 10-5) and (6.4 ˟ 10-4 and 5.9 ˟ 10-4), respectively. The cancer risk for Kuka Bulukiya 6 ˟ 10-10 and PRP G/Ruwa 5 ˟ 10-10 for adults and 7 ˟ 10-10 and 4 ˟ 10-10 for children were both lower than the threshold set for cancer risk by the United States Environmental Protection Agency (USEPA). This meant that both adults and children were not at risk of cancer and noncarcinogenic threat based on the assessment in this study. The study concluded that informal e-waste burning has substantially helped in the relatively high levels of air pollution identified in the treatment points and in turn posed environmental and public health concerns to people around the area. This study recommends that samples of the vegetable products at the PRP G/Ruwa treatment point should be investigated immediately and adequate restrictions and regulations should be enacted and enforced in order to safeguard the environment and the populace. There is need for caution from the authorities to avert the possible implications (e-waste extractors and the public) of being affected with noncarcinogenic or carcinogenic ailments over time.
    Matched MeSH terms: Risk Assessment
  16. Abul Aziz A
    Prehosp Disaster Med, 2003 Apr-Jun;18(2):115-9.
    PMID: 15074492
    In the peace-loving, moderate and progressive country of Muslim-dominated Malaysia, violence generally is alien to the culture. Terrorism initially took shape during the post-independence, communist era by jungle recalcitrant actions. In recent years, this has been superceded by a more internationally related trend of violence. Only very few incidents were based locally, while the majority were linked to international groups or organizations abroad, including the Kumpulan Mujahidin Malaysia (KMM), Jemaah Islamiyah (JI), and the Abu Sayyaf Group (ASG). Kidnapping with ransom seemed to have been the most commone modus operandi, while killing and robbery accounted for very few of these incidents. The number of victims in each event so far has been small, and smaller for those physically harmed or killed. This pattern of terrorist attacks suggests that the current level of provision of emergency medical services is sufficient to handle such incidents. Recent advances in local emergency medicine also have witnessed the establishment of various teaching and training modules, a pivotal role played by university hospitals and supported by the Ministry of Health. However, the spate of ongoing events of mass destruction such as the conflict in Israel/Palestine, wars in Afghanistan and Iraq, the World Trade Center and Pentagon tragedies of 11 September 2001, and the Bali bombing in Indonesia, remain as great concerns to Malaysians. Both the government and the people of Malaysia abhor such unjustified uses of terror, and take every measure to curtail them. The National Security Council policies of Arahan No. 18 and Arahan No. 20 detail specific roles and responsibilities of various agencies in managing terrorism and disasters respectively, while the use of the stern Internal Security Act that allows indefinite detention without trial, evidently has been an efficient intelligence and security apparatus. With more recent developments of terrorist events regionally and globally, Malaysia continues to face an ongoing threat from such activities. Various measures have been and will be actively undertaken both by government and non-governmental agencies in facing these challenges.
    Matched MeSH terms: Risk Assessment
  17. Adams-Guppy J, Guppy A
    Ergonomics, 2003 Jun 20;46(8):763-79.
    PMID: 12745978 DOI: 10.1080/0014013021000056980
    As part of an organizational review of safety, interviews and questionnaire surveys were performed on over 700 commercial goods drivers and their managers within a series of related companies operating across 17 countries. The results examine the reported incidence of fatigue-related problems in drivers and their associations with near miss and accident experience as well as work and organizational factors. Experience of fatigue problems while driving was linked to time of day and rotation of shifts, though most associations were small. There were significant associations found between fatigue experiences and driver and management systems of break taking and route scheduling. The quantitative combined with qualitative information suggested that, where feasible, more flexible approaches to managing the scheduling and sequencing of deliveries assisted drivers in managing their own fatigue problems through appropriate break-taking. The results are interpreted within the overarching principles of risk assessment and risk control.
    Matched MeSH terms: Risk Assessment/statistics & numerical data
  18. Adeel M, Zain M, Fahad S, Rizwan M, Ameen A, Yi H, et al.
    Environ Sci Pollut Res Int, 2018 Dec;25(36):36712-36723.
    PMID: 30377972 DOI: 10.1007/s11356-018-3588-4
    Since the inception of global industrialization, the growth of steroid estrogens becomes a matter of emerging serious concern for the rapid population. Steroidal estrogens are potent endocrine-upsetting chemicals that are excreted naturally by vertebrates (e.g., humans and fish) and can enter natural waters through the discharge of treated and raw sewage. Steroidal estrogens in plants may enter the food web and become a serious threat to human health. We evaluated the uptake and accumulation of ethinylestradiol (EE2) and 17β-estradiol (17β-E2) in lettuce plants (Lactuca sativa) grown under controlled environmental condition over 21 days growth period. An effective analytical method based on ultrasonic liquid extraction (ULE) for solid samples and solid phase extraction (SPE) for liquid samples with gas chromatography-mass spectrometry (GC/MS) has been developed to determine the steroid estrogens in lettuce plants. The extent of uptake and accumulation was observed in a dose-dependent manner and roots were major organs for estrogen deposition. Unlike the 17β-E2, EE2 was less accumulated and translocated from root to leaves. For 17β-E2, the distribution in lettuce was primarily to roots after the second week (13%), whereas in leaves it was (10%) over the entire study period. The distribution of EE2 at 2000 μg L-1 in roots and leaves was very low (3.07% and 0.54%) during the first week and then was highest (12% in roots and 8% in leaves) in last week. Bioaccumulation factor values of 17β-E2 and EE2 in roots were 0.33 and 0.29 at 50 μg L-1 concentration as maximum values were found at 50 μg L-1 rather than 500 and 2000 in all observed plant tissues. Similar trend was noticed in roots than leaves for bioconcentration factor as the highest bioconcentration values were observed at 50 μg L-1 concentration instead of 500 and 2000 μg L-1 spiked concentration. These findings mainly indicate the potential for uptake and bioaccumulation of estrogens in lettuce plants. Overall, the estrogen contents in lettuce were compared to the FAO/WHO recommended toxic level and were found to be higher than the toxic level which is of serious concern to the public health. This analytical procedure may aid in future studies on risks associated with uptake of endocrine-disrupting chemicals in lettuce plants.
    Matched MeSH terms: Risk Assessment
  19. Adham M, Anam K, Reksodiputro L
    Med J Malaysia, 2022 01;77(1):53-59.
    PMID: 35086995
    INTRODUCTION: Treatment of head and neck cancer patients amidst the COVID-19 pandemic is challenging, whereas prolonged treatment initiation in head and neck squamous cell carcinoma may increase mortality and likelihood of recurrence. Special attention is needed to ensure safe and appropriate care of these patients. This article aims to review and discuss existing research on treatment prioritization and risk stratification of head and neck cancer patients during the pandemic.

    MATERIALS AND METHODS: The authors conducted literature search in three databases (PubMed, Cochrane, and Clinical Key) on July 15th, 2020. The keywords were ("Head and Neck Mucosal Malignancy" OR "Head and Neck Cancer") AND ("Management" OR "Head and Neck Surgery") AND ("COVID-19" OR "Pandemic"). The inclusion criteria were cancer in adult patients, published from 2020 in English, and with available access to full text. The exclusion criteria were comments, letters, and case reports. The articles were critically appraised using the Centre of Evidence-based Medicine (CEBM), University of Oxford and Duke University. The literature search strategy is illustrated using Preferred Reporting Items for Systematic review and meta-analysis (PRISMA) flow diagram.

    RESULTS: A total of 150 articles were identified; 21 articles were gathered from Clinical Key, 33 from Cochrane, and 96 from Pubmed. After screening abstracts and reviewing the full text, the authors determined five articles met the inclusion criteria. There are several key points of head and neck cancer management in the COVID-19 pandemic. Head and neck cancer management is considered a high-risk procedure; the clinician should use proper personal protective equipment. Before operative treatment, all patients should undergo a PCR test 14 days before surgery. In diagnosing head and neck cancer, laryngoscopy should be considered carefully; and cytology should be preferred instead. Medically Necessary, Time-sensitive (MeNTS) score is recommended for risk stratification and surgery prioritization; it has three domains: procedure, disease, and patient. However, it is not specified to head and neck cancer; therefore, it should be combined with other references. Stanford University Head and Neck Surgery Division Department of Otolaryngology made surgery prioritization into three groups, urgent (should be operated immediately), can be postponed for 30 days, and can be postponed for 30- 90 days. Some urgent cases and should be operated on immediately include cancers involving the airways, decreased renal function, and metastases. For chemoradiation decision to delay or continue should refer to the goal of treatment, current oncologic status, and tolerance to radiation. In terms of patient's follow up, telephone consultation should be maximized.

    CONCLUSION: MeNTS scoring combined with Guideline from Department of Otolaryngology at Stanford University prioritizing criteria can be helpful in decision making of stratifying Risk and prioritizing surgery in head and neck cancer management.

    Matched MeSH terms: Risk Assessment
  20. Afifi M
    Singapore Med J, 2006 Jun;47(6):551; author reply 552-3.
    PMID: 16752028
    Comment on: Norsaʼadah B, Rusli BN, Imran AK, Naing L, Winn T. Risk factors of breast cancer in women in Kelantan, Malaysia. Singapore Med J 2005;
    46:698-705
    Matched MeSH terms: Risk Assessment/methods
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