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  1. Hadi H, Elkalmi R, Awadh A, Jamshed S, Al-Shami A
    Value Health, 2014 Nov;17(7):A605.
    PMID: 27202095 DOI: 10.1016/j.jval.2014.08.2105
    Objectives: To evaluate the knowledge and perception of medical and pharmacy students toward the usage of sunblock as skin protection against ultraviolet (UV).
    Methods: This cross-sectional study was conducted among the undergraduate final year medical and pharmacy students at the International Islamic University Malaysia (IIUM). Validated questionnaire were used to collect the data. The questionnaires were distributed to 134 students from medicine and 100 pharmacy students. Descriptive and inferential statistics are used whenever appropriate.
    Results: Overall, 161 participants out of a total of 234 completed the questionnaire with 101 medical students (75.4%) and 60 pharmacy students (60.0%). Majority of the respondents were female 64 (63.4%) and 37 (36.6%) were male. The median of knowledge scores of the final year medical students was significantly lower than the final year pharmacy students (p<0.01). There is no significant differnce between the knowledge of the female and male students (Mann Whitney U Test value = 0.27, p<0.01). This study reported that 24 (39.3 %) of pharmacy students were influenced by the media to use sunblock whereas 35 (34.7%) of medical students had the highest influence from friends to use sunblock. However, this study showed there was no significant difference in the perception of pharmacy and medical students p=0.020.
    Conclusion: In conclusion, the knowledge of pharmacy students is significantly higher than the knowledge of medical students had on the usage of sunblock. Both medical and pharmacy students have the same level of perception towards the usage of sunblock.
    Matched MeSH terms: Sunscreening Agents*
  2. Awadh AI, Jamshed S, Elkalmi RM, Hadi H
    J Res Pharm Pract, 2016 Jul-Sep;5(3):193-9.
    PMID: 27512711 DOI: 10.4103/2279-042X.185731
    OBJECTIVE: To evaluate the knowledge, attitude, perception, and practice of medical and pharmacy students toward the usage of sunscreen as protection for the skin against ultraviolet (UV) radiation.
    METHODS: This cross-sectional study was conducted among final year medical and pharmacy undergraduates at the International Islamic University Malaysia. Validated questionnaires were distributed to 134 medical students and 100 pharmacy students. Descriptive and inferential statistics were used where appropriate.
    FINDINGS: One hundred and sixty-one out of 234 participants completed the questionnaires. The participants comprised 101 medical students (75.4%) and sixty pharmacy students (60.0%). The majority of the respondents were females (102; 63.4%), and 59 (36.6%) were males. The median of the knowledge scores of the final year medical students was significantly lower than that of the final year pharmacy students (P < 0.001). The female students showed significantly higher knowledge scores than the male students (P = 0.027). This study reported that 24 (39.3%) pharmacy students were influenced by the media to use sunscreen, whereas 35 (34.7%) medical students were influenced the most by friends to use sunscreen. The final year pharmacy students had a better perception compared to the medical students, with the total perception score of the final year pharmacy students being significantly higher than that of the final year medical students (P = 0.020). Most of the participants were also aware of the harmful effects of UV radiation and had a positive reaction toward the usage of sunscreen to prevent those harmful effects.
    CONCLUSION: The knowledge and perception of final year pharmacy students were significantly higher than the knowledge and perception of final year medical students with regard to the usage of sunscreen.
    KEYWORDS: Attitude; knowledge; perception; practice; sunscreen
    Matched MeSH terms: Sunscreening Agents*
  3. Yong SS, Han WH, Faheem NAA, Puvan N, Tan LL, Wong SM, et al.
    Photodermatol Photoimmunol Photomed, 2022 Nov;38(6):541-547.
    PMID: 35324018 DOI: 10.1111/phpp.12787
    BACKGROUND: Airline pilots face significant ultraviolet radiation exposure resulting in an increased risk of sun damage and skin cancers. We aimed to evaluate sun-protective practices and associated factors among airline pilots.

    METHODS: We disseminated an online questionnaire evaluating the use of sunscreen, sunglasses, hats and protective clothing during daytime hours in the cockpit and during outdoor activities to 346 global commercial airline pilots, and we received 220 completed responses. The Pearson chi-squared test or Fisher's exact test where necessary were used to determine possible factors associated with the use of sun-protective practices. Potential confounders were adjusted for using multivariate analyses.

    RESULTS: The most common sun protective behaviour was the wearing of sunglasses during daytime flights (89.5%), followed by the use of caps during outdoor activities (47.7%). More pilots applied sunscreen during daytime flights (14.1%) compared with walk-arounds (8.2%). Males were less likely to use sunscreen during flights (adjusted odds ratio, aOR = 0.76), use sunscreen for walk-arounds (aOR = 0.175) and wear long sleeves (aOR = 0.013). Pilots who flew less than 30 h a month in high latitude regions were less likely to use a cap or hat outdoors (aOR = 0.419) or use sunscreen during walk-arounds (aOR = 0.241). Younger pilots were also less likely to use caps or hats outdoors (aOR = 0.446).

    CONCLUSION: Male pilots and those who spent less time in high latitudes were less likely to practice sun protection. Targeted educational efforts may be implemented to reduce occupational ultraviolet exposure.

    Matched MeSH terms: Sunscreening Agents/therapeutic use
  4. Goldsberry A, Dinner A, Hanke CW
    J Drugs Dermatol, 2014 Mar;13(3):306-7.
    PMID: 24595576
    Limonia acidissima or Hesperethusa crenulata is a common tree in Southeast Asia. It is indigenous to the Republic of Myanmar (formerly Burma) as well as India, Sri Lanka, Java, and Pakistan. In English, the common names for Limonia acidissima are sandalwood, wood-apple, elephant-apple, monkey fruit, and curd fruit tree. The plant has a number of different names in different languages including bal or bael in Assamese, bael in Bengali, kaitha in Hindi, belingai in Malaysia, and thanaka in Burmese. Unique to the Burmese people, thanaka has been used as a cosmetic product for over 2000 years. Mention of thanaka has been traced back to ancient Burmese lyrics, and relics of equipment used by ancient royalty to grind thanaka can be found in museums.
    Matched MeSH terms: Sunscreening Agents/administration & dosage*; Sunscreening Agents/isolation & purification
  5. Megat Nabil Mohsin S, Hussein MZ, Sarijo SH, Fakurazi S, Arulselvan P, Taufiq-Yap YH
    Int J Nanomedicine, 2018;13:6359-6374.
    PMID: 30349255 DOI: 10.2147/IJN.S171390
    Introduction: The potential of layered double hydroxide (LDH) as a host of multiple ultraviolet-ray absorbers was investigated by simultaneous intercalation of benzophenone 4 (B4) and Eusolex® 232 (EUS) in Zn/Al LDH.

    Methods: The nanocomposites were prepared via coprecipitation method at various molar ratios of B4 and EUS.

    Results: At equal molar ratios, the obtained nanocomposite showed an intercalation selectivity that is preferential to EUS. However, the selectivity ratio of intercalated anions was shown to be capable of being altered by adjusting the molar ratio of intended guests during synthesis. Dual-guest nanocomposite synthesized with B4:EUS molar ratio 3:1 (ZEB [3:1]) showed an intercalation selectivity ratio of B4:EUS =53:47. Properties of ZEB (3:1) were monitored using powder X-ray diffractometer to show a basal spacing of 21.8 Å. Direct-injection mass spectra, Fourier transform infrared spectra, and ultraviolet-visible spectra confirmed the dual intercalation of both anions into the interlayer regions of dual-guest nanocomposite. The cytotoxicity study of dual-guest nanocomposite ZEB (3:1) on human dermal fibroblast cells showed no significant toxicity until 25 μg/mL.

    Conclusion: Overall, the findings demonstrate successful customization of ultraviolet-ray absorbers composition in LDH host.

    Matched MeSH terms: Sunscreening Agents/administration & dosage*; Sunscreening Agents/chemistry
  6. Lanca C, Teo A, Vivagandan A, Htoon HM, Najjar RP, Spiegel DP, et al.
    Transl Vis Sci Technol, 2019 Jul;8(4):7.
    PMID: 31360613 DOI: 10.1167/tvst.8.4.7
    Purpose: Lack of outdoor time is a known risk factor for myopia. Knowledge of the light levels reaching the eye and exposure settings, including sun-protective measures, is essential for outdoor programs and myopia. We evaluated the impact of sun-protective strategies (hat and sunglasses) on maintaining high illuminance levels to prevent myopia.

    Methods: A child-sized mannequin head was developed to measure light illuminance levels with and without sun-protective equipment, across a wide range of environments in Singapore, outdoors (open park, under a tree, street) and indoors (under a fluorescent illumination with window, under white LED-based lighting without window). A comparison was made between indoor and outdoor light levels that are experienced while children are involved in day-to-day activities.

    Results: Outdoor light levels were much higher (11,080-18,176 lux) than indoors (112-156 lux). The higher lux levels protective of myopia (>1000 lux) were measured at the tree shade (5556-7876 lux) and with hat (4112-8156 lux). Sunglasses showed lux levels between 1792 and 6800 lux. Although with sunglasses readings were lower than tree shade and hat, light levels were still 11 to 43 times higher than indoors.

    Conclusions: Recommendations on spending time outdoors for myopia prevention with adequate sun protection should be provided while partaking in outdoor activities, including protection under shaded areas, wearing a hat or sunglasses, sunscreen, and adequate hydration.

    Translational Relevance: Light levels outdoors were higher than indoors and above the threshold illuminance for myopia prevention even with adequate sun-protective measures.

    Matched MeSH terms: Sunscreening Agents
  7. Kwan Z, Yong SS, Robinson S
    PMID: 31508854 DOI: 10.1111/phpp.12510
    BACKGROUND: Analysis of Internet search trends has been performed to evaluate interest in sun protection, artificial tanning, and skin cancers among the public, particularly in Western countries. This observational study aimed to investigate the relative popularity of search terms relating to sun protection, sunburn, skin cancers, and tanning used in Google Trends® in three South-East Asian countries (Malaysia, Singapore, and Indonesia).

    METHODS: The relevant search terms were queried using the Google Trends® in each location and worldwide. The search volume indices were compared between locations and over a time period from January 1, 2004, to January 31, 2019. Correlations between "sunblock" and "sunburn" as well as "sunblock" and search terms relating to skin cancers ("skin cancer," "melanoma," "basal cell carcinoma," and "squamous cell carcinoma") were evaluated.

    RESULTS: The favored search term relating to sun protection in this region was "sunblock" despite the term itself being a misnomer. The relative popularity of searches for "sunblock" also showed an increase over time and was generally higher compared with interest in sunburn, skin cancers, and artificial tanning practices. Positive correlations were noted between "sunblock" and "sunburn" in Malaysia and "sunblock" and "melanoma" in Singapore.

    CONCLUSION: Insights into search trends may assist public health promotion to raise awareness regarding sun protection and skin cancers in the region by targeting commonly used terms for each geographical location.

    Matched MeSH terms: Sunscreening Agents/therapeutic use*
  8. Ibrahim MNM, Iqbal A, Shen CC, Bhawani SA, Adam F
    BMC Chem, 2019 Dec;13(1):17.
    PMID: 31384766 DOI: 10.1186/s13065-019-0537-3
    Titanium dioxide (TiO2) is added in sunscreens due to its ability to absorb ultraviolet (UV) light. However, upon irradiation of UV light, reactive oxygen species particularly hydroxyl radical which can damage human skin will be generated. In this study, lignin/TiO2 composites were employed to quench the hydroxyl radicals generated by the TiO2. The lignin was extracted from oil palm empty fruit bunch (OPEFB) via kraft and soda pulping processes. The kraft lignin composite was labelled as KL/TiO2 whereas the soda lignin composite was labelled as SL/TiO2. The lignins and the composites were characterized by FTIR, UV spectroscopy, 13C NMR, SEM, EDX, and XRD. The relative hydroxyl radical production of composites and TiO2 were compared through photo-oxidation of coumarin to 7-hydroxycoumarin as a test medium. The effect of types and amounts of lignin used were studied. The KL/TiO2 composite showed the least radical production due to higher phenolic hydroxyl content of kraft lignin. The activity of the hydroxyl radicals will be quenched when it abstract hydrogen atoms from the phenolic hydroxyl groups.
    Matched MeSH terms: Sunscreening Agents
  9. Khamsiah, N., Lai, N.S., Nurfarhanim, M., Nor Aimi, A.R., Mohd Syazwan, C. S., Goon, J.A.
    Medicine & Health, 2012;7(2):84-96.
    MyJurnal
    The Malaysian skincare industry is growing rapidly with a vast number of new sunscreens being produced annually. Inadequate skincare regulations and lack of enforcement have resulted in the overrating of sunscreens’ quality. The objectives of this study were to evaluate the efficacy and safety of the local and international sunscreens and to determine the effects of adding concentrated antioxidants into them. Three local and three internationally manufactured sunscreens were tested for the in vitro Ultraviolet A protection factor (UVAPF), Sun Protection Factor (SPF) and photostability. The creams were spread onto roughened polymethylmethacrylate plates where the absorbance was measured using a spectrophotometer before and after two hours of sunlight irradiation. The procedure was repeated combining available concentrated vitamin C and E creams. International sunscreens were found to have more accurate SPF labels (p=0.009) while local sunscreens were found to be more photostable (p=0.003). However, both sunscreens had inadequate UVAPF (p=0.471). Vitamin C enhanced the SPF values (p= 0.04) of both groups of sunscreens while vitamin E enhanced their photostability (p=0.000). Interestingly, combining vitamins C and E rich creams with the sunscreens had no effect on the SPF and UVAPF values as compared to the use of a single vitamin. More importantly, the combination of vitamins decreased the photostability (p=0.002) of sunscreens as compared to the addition of vitamin E alone. In conclusion, photoprotection is best achieved when sunscreens are used together with creams containing either vitamin C or E alone.
    Matched MeSH terms: Sunscreening Agents
  10. Karim AA, Azlan A, Ismail A, Hashim P, Abd Gani SS, Zainudin BH, et al.
    BMC Complement Altern Med, 2014 Oct 07;14:381.
    PMID: 25292439 DOI: 10.1186/1472-6882-14-381
    BACKGROUND: Cocoa pod is an outer part of cocoa fruits being discarded during cocoa bean processing. Authors found out that data on its usage in literature as cosmetic materials was not recorded in vast. In this study, cocoa pod extract was investigated for its potential as a cosmetic ingredient.

    METHODS: Cocoa pod extract (CPE) composition was accomplished using UHPLC. The antioxidant capacity were measured using scavenging assay of 1,2-diphenyl-2-picrylhydrazyl (DPPH), β-carotene bleaching assay (BCB) and ferric reducing antioxidant power (FRAP). Inhibiting effect on skin degradation enzymes was carried out using elastase and collagenase assays. The skin whitening effect of CPE was determined based on mushroom tyrosinase assay and sun screening effect (UV-absorbance at 200-400 nm wavelength).

    RESULTS: LC-MS/MS data showed the presence of carboxylic acid, phenolic acid, fatty acid, flavonoids (flavonol and flavones), stilbenoids and terpenoids in CPE. Results for antioxidant activity exhibited that CPE possessed good antioxidant activity, based on the mechanism of the assays compared with ascorbic acid (AA) and standardized pine bark extract (PBE); DPPH: AA > CPE > PBE; FRAP: PBE > CPE > AA; and BCB: BHT > CPE > PBE. Cocoa pod extract showed better action against elastase and collagenase enzymes in comparison with PBE and AA. Higher inhibition towards tyrosinase enzyme was exhibited by CPE than kojic acid and AA, although lower than PBE. CPE induced proliferation when tested on human fibroblast cell at low concentration. CPE also exhibited a potential as UVB sunscreen despite its low performance as a UVA sunscreen agent.

    CONCLUSIONS: Therefore, the CPE has high potential as a cosmetic ingredient due to its anti-wrinkle, skin whitening, and sunscreen effects.

    Matched MeSH terms: Sunscreening Agents/analysis; Sunscreening Agents/pharmacology; Sunscreening Agents/chemistry
  11. Al-Naggar RA
    Asian Pac J Cancer Prev, 2013;14(8):4577-81.
    PMID: 24083705
    BACKGROUND: The objective of this study was to determine the practice of skin cancer prevention among Malaysian road traffic police officers.

    MATERIALS AND METHODS: This cross-sectional study involved 202 Malaysian Road Police Traffic officers. Inclusion criteria were those officers who work wearing white uniform regulating traffic. The survey took place at the Police Traffic Station, Jln Tun H.S. Lee, Kuala Lumpur, the main Head Quarters of Malaysian's Traffic Department where almost 600 police traffic officers are employed. The police traffic officers are given the task to take care of the traffic from the main office of the police station, then, according to the task, the officers drive to their given location for their duty. Each task is approved by the Chief Traffic Inspector of Kuala Lumpur. Data collected in this study were analyzed using SPSS 13, with the T-test for univariate analysis and multiple linear regression for multivariate analysis.

    RESULTS: A total of 202 road traffic police officers participated. The majority were older than 30 years of age, male, Malay, married, with secondary education, with monthly income more than 2000 Ringgit Malaysia (66.3%, 91.1%, 86.6%, 84.7%, 96%, 66.3%; respectively). Regarding the practice of skin cancer prevention, 84.6% of the study participants were found to wear hats, 68.9% sunglasses and 85.6% clothing that covering most of the body but only 16.9% used a sunscreen when they were outdoors. When analysis of the factors that influenced the practice of skin cancer prevention was performed, univariate analysis revealed that gender, age and monthly income significantly influenced the practice of skin cancer prevention. For multivariate analysis, gender, monthly income and race significantly influenced the practice of using sunscreen among road traffic police officers (p<0.001, p=0.019, p=0.027; respectively).

    CONCLUSIONS: The practice of skin cancer prevention among the traffic police officers showed good practices in terms of wearinga hat, sun glasses and clothing that covers most of the body. However, the study revealed a poor practice of the use of sunscreen. The factors that influence the practice of sunscreen use were found to be gender, income, and race. The study suggests that more awareness campaign among traffic police officers is needed. Providing sunscreen for free for police traffic officers should be considered by the Police authorities.

    Matched MeSH terms: Sunscreening Agents/administration & dosage*
  12. Al-Naggar RA, Al-Naggar TH, Bobryshev YV
    Asian Pac J Cancer Prev, 2011;12(4):995-9.
    PMID: 21790240
    INTRODUCTION: Malignant melanoma in particular is one of the few remaining cancers with an increasing incidence.

    OBJECTIVES: The objective of this study is to explore the perceptions and opinions of young Malaysians towards skin cancer prevention.

    METHODOLOGY: Focus group discussions were conducted among 33 medical science students from Management and Science University (MSU), Shah Alam, Malaysia, using convenience sampling. Students were divided into 4 focus groups consisting of 8, 8, 9 and 8 students respectively. The facilitator wrote down the conversations and data obtained were classified into various categories and analyzed manually.

    RESULTS: The majority of the participants mentioned that overexposure to ultraviolet light is the commonest cause of skin cancer but also that the most benefit we get from sun ight is vitamin D synthesis. The majority mentioned that the best prevention measure for skin cancer is using a sunscreen, followed by limit exposure to the sun.

    CONCLUSION: The present study demonstrated there is a lack of knowledge regarding screening methods and prevention measures of skin cancer. Therefore, there is a need to establish health education unit in all universities to educate all university students regarding various health problems including skin cancer prevention.
    Matched MeSH terms: Sunscreening Agents/administration & dosage*
  13. Liu X, Zhang R, Shi H, Li X, Li Y, Taha A, et al.
    Mol Med Rep, 2018 05;17(5):7227-7237.
    PMID: 29568864 DOI: 10.3892/mmr.2018.8791
    Ultraviolet (UV) radiation induces DNA damage, oxidative stress, and inflammatory processes in skin, resulting in photoaging. Natural botanicals have gained considerable attention due to their beneficial protection against the harmful effects of UV irradiation. The present study aimed to evaluate the ability of curcumin (Cur) to protect human dermal fibroblasts (HDFs) against ultraviolet A (UVA)‑induced photoaging. HDFs were treated with 0‑10 µM Cur for 2 h and subsequently exposed to various intensities of UVA irradiation. The cell viability and apoptotic rate of HDFs were investigated by MTT and flow cytometry assays, respectively. The effect of UVA and Cur on the formation of reactive oxygen species (ROS), malondialdehyde levels, which are an indicator of ROS, and the levels/activity of antioxidative defense proteins, including glutathione, superoxide dismutase and catalase, were evaluated using 2',7'-dichlorofluorescin diacetate and commercial assay kits. Furthermore, western blotting was performed to determine the levels of proteins associated with endoplasmic reticulum (ER) stress, the apoptotic pathway, inflammation and the collagen synthesis pathway. The results demonstrated that Cur reduced the accumulation of ROS and restored the activity of antioxidant defense enzymes, indicating that Cur minimized the damage induced by UVA irradiation in HDFs. Furthermore, western blot analysis demonstrated that Cur may attenuate UVA‑induced ER stress, inflammation and apoptotic signaling by downregulating the protein expression of glucose‑regulated protein 78, C/EBP‑homologous protein, nuclear factor‑κB and cleaved caspase‑3, while upregulating the expression of Bcl‑2. Additionally, it was demonstrated that Cur may regulate collagen metabolism by decreasing the protein expression of matrix metalloproteinase (MMP)‑1 and MMP‑3, and may promote the repair of cells damaged as a result of UVA irradiation through increasing the protein expression of transforming growth factor‑β (TGF‑β) and Smad2/3, and decreasing the expression of the TGF‑β inhibitor, Smad7. In conclusion, the results of the present study indicate the potential benefits of Cur for the protection of HDFs against UVA‑induced photoaging and highlight the potential for the application of Cur in skin photoprotection.
    Matched MeSH terms: Sunscreening Agents/pharmacology*
  14. Low QJ, Teo KZ, Lim TH, Cheo SW, Yap WYE
    Med J Malaysia, 2021 03;76(2):212-217.
    PMID: 33742630
    INTRODUCTION: Excessive ultraviolet light (UV) can cause premature skin aging and potentially skin cancer. Currently there is a lack of awareness among health care professionals and the public on sun protection. The objectives of this study were to determine knowledge on sunscreen and skin cancer among health care professionals, to evaluate the knowledge, attitude, practice and perception of doctors and pharmacists toward the usage of sunscreen as protection against UV radiation.

    MATERIALS AND METHODS: This is a cross-sectional study conducted among doctors and pharmacists in Hospital Sultanah Nora Ismail, Batu Pahat, Johor, Malaysia. Questionnaires were used in this study.

    RESULTS: A total of 384 participants completed the questionnaires. The participants consisted of 323 doctors (84.1%) and 61 pharmacists (15.9%). The age group of the participants ranged between 25 till 55 years old. Ninety doctors (27.9%) and thirty-one pharmacists (51.0%) reported used sunscreen daily (p<0.001). This finding showed that there was a deficit in the practice of sun protection. Pharmacists scored a higher knowledge score of median 12 (IQR=3.0) while the doctors scored 11 (IQR=2.0). This study showed a significant association between ethnicity and skin cancer knowledge (p<0.05).

    CONCLUSION: This study demonstrated a lack of knowledge of sunscreen and skin cancer prevention among health care practitioners. This finding supports better medical education program on this topic.

    Matched MeSH terms: Sunscreening Agents
  15. Santhanam RK, Fakurazi S, Ahmad S, Abas F, Ismail IS, Rukayadi Y, et al.
    Phytother Res, 2018 Aug;32(8):1608-1616.
    PMID: 29672974 DOI: 10.1002/ptr.6092
    The antiphoto aging property of Zanthoxylum rhetsa obtained from Pangkor Island, Malaysia, was evaluated. Solvent fractions of different polarity obtained from the methanolic extract of the bark material were initially tested for anticollagenase and antielastase activities. The ethyl acetate fraction showed bioactivity against the protease enzymes. Hence, it was subjected to further purification via column chromatography, to yield a major constituent, hesperidin. Subsequently, the ethyl acetate fraction and hesperidin were tested for their effects against UVB-induced cytotoxicity and expressions of inflammatory cytokines (IL-6, IL-1β, and TNF-α), NF-κB, and MMPs (MMP1, 3, and 9) in human dermal fibroblasts (HDF). Both fraction and pure compound prevented UVB-induced cytotoxicity in HDF cells, in a dose dependent manner. Moreover, the ethyl acetate fraction inhibited the increase of pro-inflammatory cytokines induced by UVB to a level similar to the control (without UV treatment). Additionally, the fraction significantly inhibited the expressions of NF-κB, MMP 1, MMP 3, and MMP 9 in HDF cells treated with UVB. Similar effects were observed with hesperidin. The results obtained suggested that the ethyl acetate fraction of Z. rhetsa and its bioactive constituent, hesperidin, have the potential to be used as active ingredients in sunscreen and antiphoto aging formulations.
    Matched MeSH terms: Sunscreening Agents
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