Modern linear accelerators, the predominant teletherapy machine in major radiotherapy centres worldwide, provide multiple electron and photon beam energies. To obtain reasonable treatment times, intense electron beam currents are achievable. In association with this capability, there is considerable demand to validate patient dose using systems of dosimetry offering characteristics that include good spatial resolution, high precision and accuracy. Present interest is in the thermoluminescence response and dosimetric utility of commercially available doped optical fibres. The important parameter for obtaining the highest TL yield during this study is to know the dopant concentration of the SiO2 fibre because during the production of the optical fibres, the dopants tend to diffuse. To achieve this aim, proton-induced X-ray emission (PIXE), which has no depth resolution but can unambiguously identify elements and analyse for trace elements with detection limits approaching microg/g, was used. For Al-doped fibres, the dopant concentration in the range 0.98-2.93 mol% have been estimated, with equivalent range for Ge-doped fibres being 0.53-0.71 mol%. In making central-axis irradiation measurements a solid water phantom was used. For 6-MV photons and electron energies in the range 6, 9 and 12 MeV, a source to surface distance of 100 cm was used, with a dose rate of 400 cGy/min for photons and electrons. The TL measurements show a linear dose-response over the delivered range of absorbed dose from 1 to 4 Gy. Fading was found to be minimal, less than 10% over five days subsequent to irradiation. The minimum detectable dose for 6-MV photons was found to be 4, 30 and 900 microGy for TLD-100 chips, Ge- and Al-doped fibres, respectively. For 6-, 9- and 12-MeV electron energies, the minimum detectable dose were in the range 3-5, 30-50 and 800-1400 microGy for TLD-100 chip, Ge-doped and Al-doped fibres, respectively.
We retrospectively reviewed poisoning admissions to all government health facilities from 1999 to 2001, in an effort to expand our current knowledge on poisoning in Malaysia to a level that better reflects a nationwide burden. There were 21 714 admissions reported with 779 deaths. The case-fatality rate was 35.88/1000 admissions. The majority of admissions (89.7%) and deaths (98.9%) occurred in adults. Some 55.1% of all admissions were female, mostly involving pharmaceutical agents. Male poisoning admissions were more often due to chemical substances. The prevalence of poisoning and death was highest among Indians compared to all other races in Malaysia. Overall, the majority of poisoning admissions were due to pharmaceutical agents, with agents classified as non-opioid analgesics, anti-pyretics and anti-rheumatics the most common. Pesticides accounted for the largest number of fatalities. It was also the commonest substance reported in cases of intentional self-harm. Most cases of poisoning admissions occurred due to accidental exposure (47%), followed by cases of intentional self-harm (20.7%). Overall, this study has managed to contribute substantial additional information regarding the epidemiology of poisoning in Malaysia, highlighting important issues, such as the rampant poisonings involving pesticides and analgesics, as well as the high prevalence of poisoning among Indians in Malaysia.
Long exposure to radiation from fluoroscopy-guided interventions (FGIs) can be detrimental to both patients and radiologists. The effective doses received by the interventional radiology staff after performing 230 FGIs in a year were assessed by using double dosimetry and five various algorithms. The Shapiro-Wilk test revealed normally-distributed data (p < 0.01), while the significant correlation coefficients between the effective doses ranged between 0.88 and 1.00. As for the Bland-Altman analysis, both Niklason and Boetticher algorithms strongly supported the absence of statistical significance between the estimated effective doses. This portrays that the occupational doses received by the interventional radiology staff during FGIs fall within the acceptable limit regardless of the varied algorithms applied. In short, the Niklason and Boetticher algorithms appeared to be the more interchangeable ones for effective evaluation of doses. This is in view of their strong mutual correlations and excellent agreement.
Continuous depletion in tin productions has led to a newly emerging industry that is a tin by-product (amang) processing industry to harness mega tons of tin by-products produced in the past. Amang composed of profitable multi-heavy minerals and rare-earth elements. With poorly established safety and health practices in operating plant, amang poses extremely high radioactivity problem associated with high occupational ionizing radiation exposures to workers and continuously impacting the local environment with radioactive contamination from industrial effluent and solid waste into lithosphere and water bodies. The radioactivity level of 238U and 232Th series in the mineral varies from few hundreds up to ~200,000 and ~400,000 Bq kg-1 respectively and are potential to yield more than ~ 30,000 nGy h-1 of gamma (γ) radiation exposure to plant workers. The study found out that for 8 h of work time, a worker is estimated to receive an average effective dose of 0.1 mSv per day from external γ radiation source with a maximum up to 2 mSv per day for extreme exposure situation. Interferences of different exposure routes for examples inhalation of equivalent equilibrium concentration (ECC) of 222Rn and 220Rn progenies and airborne long-lived α particles from the dusty working environment could pose a higher total effective dose as much as 5 mSv per day and 115 mSv per year. The value is 5 times higher than the annual dose limit for designated radiation worker (20 mSv) in Peninsular Malaysia. The study found that 41% of the total received an effective dose received by a worker is contributed by 222Rn, 32% of airborne particulates and dust, 23% from external γ exposure and 4% from 220Rn. Based on radioecological risk assessment, the study found out that the aquatic environment is the highly exposed group to ionizing radiation from industrial effluent discharge and sand residues. With the impotent establishment of radiation protection in the industry, plus the country newly introduced long-term plan to revive tin mining as well as its accessory amang mineral, it is necessary for the government to harmonize current regulation to improve the worker safety and health as well as sustaining local environment.
Malaysia has initiated a range of pre-project activities in preparation for its planned nuclear power programme. Clearly one of the first steps is the selection of sites that are deemed suitable for the construction and operation of a nuclear power plant. Here we outline the Malaysian regulatory requirements for nuclear power plant site selection, emphasizing details of the selection procedures and site characteristics needed, with a clear focus on radiation safety and radiation protection in respect of the site surroundings. The Malaysia Atomic Energy Licensing Board (AELB) site selection guidelines are in accord with those provided in International Atomic Energy Agency (IAEA) and United Stated Nuclear Regulatory Commission (USNRC) documents. To enhance the suitability criteria during selection, as well as to assist in the final decision making process, possible assessments using the site selection characteristics and information are proposed.
This paper describes the development of a custom-designed underwater scanner to support the experimental works for characterizing irradiated fuel stored in the TRIGA PUSPATI pool by means of radiography technique. Materials used to build the scanner are aluminum 6061, lead and teflon. Three main units that make up the scanner are rig structure, arm block and collimator. Collimator is designed to control radiation exposure by opening and closing the shutter. The experimental works were conducted underwater at 5-m depth hence water tightness is one of the main design criteria. Radiation in terms of gamma energy is captured by radiography film which after development and processing revealed the image of the radiation impact in terms of pixel and gray value. The film size used is 4in x 8in which was slot in the collimator. To validate the scanner, fuel element containing 8.5 wt% and 12 wt% enriched Uranium 235 were used. It was found that the experimental output is consistent with the fuel type and confirmed that the scanner is viable for fuel characterization study.
The capacity limitation of working memory is a widely recognised determinant of human learning. A cognitive load exceeding the capacity hampers learning. Cognitive load can be controlled by tailoring an instructional design to levels of learner prior knowledge. However, such as design does not necessarily motivate to use the available capacity for better learning. The present review examines literatures on the effects of instructional design, motivation, emotional state, and expertise level on cognitive load and cognitive effort, which ultimately affect working memory performance and learning. This examination suggests further studies on the effects of motivation and negative emotional states on the use of working memory. Prospective findings would help better explain and predict individual differences in the use of working memory for cognitive learning and task performance.
An extensive study was conducted to determine the activity concentrations of natural and artificial radionuclides 226Ra, 232Th, 40K, and 137Cs in soil samples of each governate of Jordan. A total of 370 samples have been measured using a high-purity germanium detector. The activity concentration for 226Ra, 232Th, 40K, and 137Cs has mean values of 42 ± 3, 23 ± 3, 309 ± 21, and 3.7 ± 0.9 Bq kg-1, respectively. The highest mean activity concentration for 226Ra was found to be 138 ± 4 Bq kg-1 in the Alkarak governate. In the Ajloun and Jarash governates, the highest mean activity concentration was 35 ± 3 Bq kg-1 for 232Th, and 14.2 ± 1.9 Bq kg-1 for 137Cs, respectively. Geological influence on the activity concentrations was investigated using the one-way analysis of variance (ANOVA) and independent samples. The ANOVA results indicate that there are strong significant differences between the activity concentrations of 232Th, 40K, and 137Cs based on geological formations the radionuclides occur. The main contribution to gamma dose rate was due to 226Ra activity concentration. Radium equivalent and external hazard index are associated with a mean value of 98 Bq kg-1, and 0.266, respectively.
Vaginal drug delivery is regarded as a promising route against women-related health issues such as unwanted pregnancies and sexually transmitted infections. However, only a very few studies have been reported on the use of hydrogel rings with low cytotoxicity for vaginal drug delivery applications. Moreover, the effect of nanoparticles on hydrogel vaginal rings has not been clearly evaluated. To overcome these challenges, we hereby developed nanocomposite hydrogel rings based on polyacrylamide-sodium carboxymethyl cellulose-montmorillonite nanoparticles in the ring-shaped aluminum mold for controlled drug delivery. The hydrogel rings were synthesized by using N,N'-methylene bisacrylamide, N,N,N',N'-tetramethyl ethylene diamine, and ammonium persulfate, as a crosslinker, accelerator, and initiator, respectively. The obtained rings were 5.5 cm in diameters and 0.5 cm in rims. Chemical structures of the nanocomposite rings were confirmed by Fourier transform infrared, and Nuclear Magnetic Resonance spectroscopies. Additionally, the swelling ratio of hydrogels was appeared to be adjusted by the introduction of nanoparticles. In vitro release experiment of methylene blue, as a hydrophilic model drug, revealed that the nanocomposite rings could not only reduce burst effect (almost more than twice), but also achieve prolonged release for 15 days in the vaginal fluid simulant which mimic the vaginal conditions at pH of almost 4.2, and a temperature of 37 °C. Importantly, the resultant hydrogel rings with or without various concentrations of montmorillonite showed low cytotoxicity toward human skin fibroblasts. Furthermore, different antibacterial activities against Escherichia coli were observed for various concentrations of montmorillonite in hydrogels. These results suggest the great potential of montmorillonite-based hydrogel rings for vaginal drug delivery.
The concentrations of radon, thoron and terrestrial gamma radiation were measured to evaluate the outdoor effective dose. The outdoor radon activity concentration ranged from 5.79 to 5110 ± 46.36 Bq m-3, with a mean of 320.03 Bq m-3 which is higher than the EPA level of 14.8 Bq m-3. The range of the thoron activity concentration outdoor was from 0.00 to 4226.7 ± 58.5 Bq m-3, with a mean of 226.1 Bq m-3 which was above the UNSCEAR recommended level of 10 Bq m-3. The terrestrial gamma radiation dose rates range was from 98.31 to 3769.71 nGy h-1 with a mean of 446.27 nGy h-1. The effective dose contribution from radon exposures in the study was estimated to be 3.2 ± 0.5 mSv y-1 is about 84% total annual effective dose received by the population in those areas. The estimated thoron and gamma dose contributions (15%, and 1% respectively) were not significant. The outdoor doses for thoron and gamma were lower than the ICRP (2007) value of 1 mSv. The total annual outdoor effective dose with an occupancy factor of 1825 h (5 h day-1) was estimated to be within the range of 0.30-551.41 ± 0.65 mSv, with a mean of 3.75 mSv which is a little higher than the world average of 2.4 mSv.
Terrestrial radioactivity monitoring of 238U and 232Th series, and 40K in soil is an essential practice for radioactivity and radiation measurement of a place. In conventional practice, only basic data can be in-situ measured using a survey instrument, for example radioactivity concentration in soil and ambient dose equivalent rate. For other physical quantities, for example organ absorbed dose and organ equivalent dose, the measurement is impossible to be performed and can only be computed using Monte Carlo radiation transport simulations. In the past, most of the works only focused on calculating air-kerma-to-effective dose conversion factors. However, the information on organ dose conversion factors is scarcely documented and reported. This study was conducted to calculate organ absorbed and tissue-weighted equivalent dose conversion factors as a result of exposure from terrestrial gamma radiation. Series of organ dose conversion factors is produced based on computations from Monte Carlo MCNP5 simulations using modelled gamma irradiation geometry and established adult MIRD phantom. The study found out that most of the radiation exposed organs absorb energy at comparable rates, except for dense and superficial tissues i.e., skeleton and skin, which indicated slightly higher values. The good agreement between this work and previous studies demonstrated that our gamma irradiation geometry and modelling of gamma radiation sources are adequate. Therefore, the proposed organ dose conversion factors from this study are reasonably acceptable for dose estimation in environmental radioactivity monitoring practices.
Hemangiopericytomas (HPCs) are uncommon tumours. We present the case of a 41-year-old female with multiple resections at different sites over the course of 11 years. The approach considerations, as well as treatment options and prognosis are discussed. A 41-year-old female with two previous resections for intracranial meningeal HPC in 2004 and 2008, as well as adjuvant radiotherapy, presented in 2015 with left intrathoracic and left hip recurrence confirmed by positron emission tomography/computed tomography (PET/CT). She underwent left proximal femur resection/reconstruction and video-assisted thoracoscopic surgery (VATS) resection of the intrathoracic tumour was attempted. She was discharged home on her 4th post-operative day with minimal pain. There were no neurosensory or motor deficits. Any patient who has been diagnosed with HPC in the past who develops new symptoms should be worked up for recurrence, regardless of the length of disease-free interval, as our case study suggested. There has yet to be a standardized follow-up regime due to the rarity of these tumours. HPC remains a rare soft tissue sarcoma with high recurrence rate. Planned VATS evaluation and resection is possible provided complete resection with clear surgical margins can be achieved, as clear surgical margins offer the best chance of survival.
The global pandemic of COVID-19 is caused by SARS-CoV-2 virus. We continue to discover the wide spectrum of complications associated with COVID-19. Some well-known complications include pneumonia, acute respiratory distress syndrome, pneumothorax, disseminated intravascular coagulation (DIC), chronic fatigue, multiorgan dysfunction, and long COVID-19 syndrome. We report a rare case of a 51-year-old man with severe COVID-19 pneumonia who developed haemorrhagic shock secondary to spontaneous haemothorax after 17 days of hospitalisation. Clinicians should be aware of such occurrence, and hence, high clinical suspicion, prompt recognition of signs and symptoms of shock, and adequate resuscitation will improve the outcomes of patients.
Organic food has gained much importance due to consumers' rising environmental and health concerns. Purchase intention of organic food has been explored widely, but the repurchase intention of organic food has gained little attention among researchers. So, it has become important to explore repurchase intention among generation Z; a generation considered more educated and aware of rising environmental concerns. Generation Z is more tech-savvy and brand conscious, so its impact on repurchase intention through consumer satisfaction has been explored. The data in this paper was collected from 400 respondents through a structured questionnaire in Islamabad, Pakistan. We used the PLS-SEM approach for data analysis and results; we found that social media influence and brand purchase impact brand awareness and positively impact brand awareness on consumer satisfaction. Moreover, it is also found that consumer satisfaction positively impacts the repurchase intention of organic food. Our study found that Generation Z has a strong social media influence, so marketers' managers must consider and address the issues when consumers consider social media for their concerns and suggestion.
Post-stroke cognitive impairment (PSCI) is a common decline in cognitive abilities that occurs within 3 months after a stroke. During recovery, stroke survivors often experience varying degrees of cognitive decline, with some patients experiencing permanent cognitive deficits. Thus, it is crucial to prioritise recovery and rehabilitation after a stroke to promote optimal protection of and improvement in cognitive function. Honey derived from stingless bees has been linked to various therapeutic properties, including neuroprotective effects. However, scientific evidence for the mechanisms through which these honey supplements enhance cognitive function remains limited. This narrative review aims to provide an overview of the causes of PSCI, current treatments, the biomarkers influencing cognition in post-stroke patients and the potential of stingless bee honey (SBH) as a neuroprotective agent against the progression of PSCI.
A study was conducted to describe the prevalence and distribution of zoonotic Brucella melitensis in goats in Peninsular Malaysia. Using serosurveillance data of the last decade (2000-2009) involving 119,799 goats and 3555 farms, the seroprevalence of brucellosis among goats was 0.91% (95% CI=0.86-0.96) and among farms was 7.09% (95% CI=6.27-7.98). The odds of brucellosis was significantly (P<0.05) higher in the later part of the decade, in larger herd size and among the states located in the peninsula as compared to eastern Malaysia. The infection was detected throughout Malaysia but at generally low seroprevalences with states like Perlis that border neighbouring countries having higher seroprevalence of brucellosis than other non-border states.
A new photonics biosensor configuration comprising a Double-side Ring Add-drop Filter microring resonator (DR-ADF) made from SiO2-TiO2 material is proposed for the detection of Salmonella bacteria (SB) in blood. The scattering matrix method using inductive calculation is used to determine the output signal's intensities in the blood with and without presence of Salmonella. The change in refractive index due to the reaction of Salmonella bacteria with its applied antibody on the flagellin layer loaded on the sensing and detecting microresonator causes the increase in through and dropper port's intensities of the output signal which leads to the detection of SB in blood. A shift in the output signal wavelength is observed with resolution of 0.01 nm. The change in intensity and shift in wavelength is analyzed with respect to the change in the refractive index which contributes toward achieving an ultra-high sensitivity of 95,500 nm/RIU which is almost two orders higher than that of reported from single ring sensors and the limit of detection is in the order of 1 × 10(-8) RIU. In applications, such a system can be employed for a high sensitive and fast detection of bacteria.
New glasses Li2CO3-K2CO3-H3BO3 (LKB) co-doped with CuO and MgO, or with TiO2 and MgO, were synthesized by the chemical quenching technique. The thermoluminescence (TL) responses of LKB:Cu,Mg and LKB:Ti,Mg irradiated with 6 MV photons or 6 MeV electrons were compared in the dose range 0.5-4.0 Gy. The standard commercial dosimeter LiF:Mg,Ti (TLD-100) was used to calibrate the TL reader and as a reference in comparison of the TL properties of the new materials. The dependence of the responses of the new materials on (60)Co dose is linear in the range of 1-1000 Gy. The TL yields of both of the co-doped glasses and TLD-100 are greater for electron irradiation than for photon irradiation. The TL sensitivity of LKB:Ti,Mg is 1.3 times higher than the sensitivity of LKB:Cu,Mg and 12 times less than the sensitivity of TLD-100. The new TL dosimetric materials have low effective atomic numbers, good linearity of the dose responses, excellent signal reproducibility, and a simple glow curve structure. This combination of properties makes them suitable for radiation dosimetry.
BACKGROUND: Knowledge is believed to be a driving factor for patients' early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation.
METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer.
RESULTS: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help.
CONCLUSION: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients' help seeking behavior other than knowledge.
Acute poisoning is a common medical emergency in Malaysia. Life can be saved if the patient is diagnosed properly and receives the appropriate treatment such as gastrointestinal decontamination techniques and resources to increase poison elimination according to clinical guidelines at a reasonable time. The aims of this study were to determine the availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in accident and emergency departments in Malaysia, and to compare the availability of such facilities among various types of hospitals. A comparative, descriptive cross-sectional study was conducted using a structured questionnaire. Seventy-four (58.3%) out of the targeted 127 hospitals replied and completed the questionnaire. The availabilities of most items related to stabilization resources were far better in general hospitals compared to district hospitals with specialists and district hospitals without specialists. These items were mechanical ventilators (p = 0.011), non-invasive positive pressure ventilators (0.024), pacemakers (p = 0.019), and transcutaneous cardiac pacing (p < 0.001). The availability of decontamination resources varied substantially with hospital type. Nevertheless, these differences did not reach statistical significance in any of the cases, whereas sodium sulphate, sorbitol, and polyethylene glycol were almost never available. The availabilities of most items related to elimination enhancement resources were far better in general hospitals and district hospitals with specialists compared to district hospitals without specialists. These items were haemodialysis (p = 0.046), haemoperfusion (p = 0.002), haemofiltration (p = 0.002), acid diuresis (p = 0.04), peritoneal dialysis (p < 0.001), and exchange transfusion (p < 0.001). Most Malaysian hospitals have certain important immediate interventions such as gastrointestinal decontamination techniques and resources to increase poison elimination. The availabilities of most facilities were far better in the general hospitals. Coordination between the National Poison Centre in Malaysia and hospitals should be established regarding the emergency facilities for effective management of poisoning cases in each hospital in order to direct the poisoned patients to the hospital where the appropriate management resources is available.