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  1. Abdul Kadir NB, Ismail WNK, Abdullah NA, Helma R, Abdul Jalil SJ, Che Kasim A, et al.
    Int J Environ Res Public Health, 2021 Oct 03;18(19).
    PMID: 34639710 DOI: 10.3390/ijerph181910410
    The aim of this study was to validate the Short Multidimensional Inventory Lifestyle Evaluation-Confinement (SMILE-C) in a Malaysian context. The SMILE-C, which is a respondent-generated instrument, was used to ask participants questions on their lifestyle during the COVID-19 pandemic. The indices of seven sub-scores were then calculated. A total of 121 university staff members completed the Malay version of the SMILE-C as well as instruments for measuring well-being, family life satisfaction, mindfulness and awareness, work engagement, and quality of life. The Cronbach's alpha values and Pearson correlation coefficients were satisfactory in this initial validation of the instrument. The SMILE-C showed positive correlations with all the variables being studied. The results supported the criterion-related validity and psychometric properties of the Malay version of the SMILE-C as an instrument for assessing lifestyle changes during the COVID-19 pandemic.
    Matched MeSH terms: Malaysia
  2. Shohaimi SA, Leow BL, Mohd Yusop FF, Sidik MR, Barker Z, Mohd Saeid FH
    Trop Biomed, 2024 Jun 01;41(2):183-189.
    PMID: 39154271 DOI: 10.47665/tb.41.2.008
    Low pathogenic avian influenza (LPAI) subtype H9N2 is a causative agent that has raised increasing concern about its impact on poultry and potential public health threats. Even though H9N2 is endemic in Peninsular Malaysia, it was first reported in Sabah in August 2022, after an outbreak associated with high mortality in broiler chickens. In the present study, based on the hemagglutinin (HA) gene, we report the genetic variations and phylogenetic analysis of a H9N2 virus isolated from broiler chickens in Sabah. The sequence analysis of the HA gene revealed a 98% similarity to the H9N2 virus recently isolated from China in 2018. The amino acids in the HA cleavage site displayed a characteristic LPAI motif (PARSSR/ GLF). Notably, at position 226, the isolate had amino acid Leucine (L) demonstrating its ability to bind to the receptor of mammals, resulting in the potential risk of transmission to humans. In addition, the H9N2 isolate harboured seven potential N-glycosylation sites. The phylogenetic analysis revealed that the isolate belonged to clade h9.4.2.5 in the Y280 lineage, similar to previously reported in Malaysia. However, we observed that the isolate in this study falls in a different cluster compared with previous Malaysian isolates, suggesting different source of H9N2 introduction into the country. This prompts us to propose continuous and thorough surveillance of poultry across the country and the necessity of implementing farm biosecurity to minimize economic losses and potential threats to public health.
    Matched MeSH terms: Malaysia
  3. Cicero A, Meyer D, Shearer MP, AbuBakar S, Bernard K, Carus WS, et al.
    Emerg Infect Dis, 2019 May;25(5).
    PMID: 31002062 DOI: 10.3201/eid2505.181659
    A strategic multilateral dialogue related to biosecurity risks in Southeast Asia, established in 2014, now includes participants from Singapore, Malaysia, Indonesia, Thailand, Philippines, and the United States. This dialogue is conducted at the nonministerial level, enabling participants to engage without the constraints of operating in their official capacities. Participants reflect on mechanisms to detect, mitigate, and respond to biosecurity risks and highlight biosecurity issues for national leadership. Participants have also identified factors to improve regional and global biosecurity, including improved engagement and collaboration across relevant ministries and agencies, sustainable funding for biosecurity programs, enhanced information sharing for communicable diseases, and increased engagement in international biosecurity forums.
    Matched MeSH terms: Malaysia
  4. Syed-Mohamad SM, Ali SH, Mat-Husin MN
    Health Inf Manag, 2010 Mar;39(1):30-35.
    PMID: 28683624 DOI: 10.1177/183335831003900105
    This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open-source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.
    Matched MeSH terms: Malaysia
  5. Syed-Mohamad SM, Ali SH, Mat-Husin MN
    Health Inf Manag, 2010;39(1):30-5.
    PMID: 20335647
    This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.
    Matched MeSH terms: Malaysia
  6. Lim KC, Then AY, Loh KH
    PeerJ, 2023;11:e15849.
    PMID: 37637173 DOI: 10.7717/peerj.15849
    Small coastal demersal sharks form a major proportion of the sharks landed in Malaysia. However, little is known about their feeding ecology and reproduction. This study sought to elucidate the dietary patterns, role of ontogeny in prey consumption, and reproductive biology of four dominant small demersal shark species in Malaysian waters: the Hasselt's bamboo shark, Chiloscyllium hasseltii; brownbanded bamboo shark, C. punctatum; spadenose shark, Scoliodon laticaudus; and Pacific spadenose shark, S. macrorhynchos. Dietary analyses revealed a high overlap in prey taxa consumed; clear resource partitioning among co-occurring species based on the percentage Prey-specific Index of Relative Importance (%PSIRI), with higher fish %PSIRI for Chiloscyllium hasseltii, higher cephalopod %PSIRI for C. punctatum, and higher crustacean %PSIRI for both Scoliodon species; and an ontogenetic diet shift, seen through changes in prey size. Based on the examination of reproductive organs, the results showed larger sizes at maturity for males compared to females for all four species; no obvious reproductive cycles, based on hepatosomatic and gonadosomatic indices for all species; female bias in the sex ratio of the embryos of Scoliodon species; and increased reproductive output (number of eggs or embryos and size of eggs) with larger female size for C. hasseltii and Scoliodon species. The partitioning of food resources minimizes direct competition for food and supports coexistence within shared coastal habitats. The reproductive strategies of these small coastal sharks appear to be favorable for supporting short-term population productivity; although a reduction in fishing pressure, especially from bottom trawlers, is essential for the long-term sustainable use of these sharks.
    Matched MeSH terms: Malaysia
  7. Laderman C
    Birth, 1988 Jun;15(2):86-7.
    PMID: 3390277
    Matched MeSH terms: Malaysia
  8. Soo OYM, Gastineau R, Verdon G, Winsor L, Justine JL
    Zootaxa, 2023 May 03;5277(3):585-599.
    PMID: 37518300 DOI: 10.11646/zootaxa.5277.3.11
    We present here the first observation of Bipalium admarginatum de Beauchamp, 1933 since its original description 90 years ago. Three specimens were found on Perhentian Kecil Island, off Terengganu State, Malaysia and photographed in the field, and two were collected. This report thus includes the first colour photographs published for this species, from a locality close to the type-locality, Tioman Island (which is ca. 200 km south of the locality in this study, on the east coast of Peninsula Malaysia). We describe the external morphology and colour pattern of the species, which correspond well to the original description, itself based only on two preserved specimens. We performed an in-depth molecular characterisation of the species, including its complete mitochondrial genome, the 18S sequence and elongation 1-alpha (EF1-α) sequence. In addition, EF1-α sequences were also retrieved for 5 additional geoplanid species. No tRNA-Thr could be detected in the mitogenome of B. admarginatum, a lack already reported in several species of geoplanids, but we found a 13 bp sequence that contains the anticodon loop and seems to be conserved among geoplanids and might thus possibly represent a non-canonical undetected tRNA. We discuss the difficulties encountered in trying to reconstruct the cluster of nuclear ribosomal genes, a problem already mentioned for other Triclads. Three phylogenies, based respectively on all mitochondrial proteins, 18S, and EF1-α, were computed; the position of B. admarginatum within the Bipaliinae was confirmed in each tree, as sister-group to various bipaliine species according to the sequences available for each tree. In the mitochondrial proteins tree, which had high support, B. admarginatum was sister to Bipalium kewense and Diversibipalium multilineatum.
    Matched MeSH terms: Malaysia
  9. Loh EYX, Ab Ghani A, Ahmad R
    Adv Exp Med Biol, 2023;1430:181-195.
    PMID: 37526848 DOI: 10.1007/978-3-031-34567-8_10
    The National Pharmaceutical Regulatory Agency (NPRA) is the agency responsible for the registration of pharmaceutical, natural, and health supplement products and notification of cosmetic products that are marketed in Malaysia. The implementation of regulatory oversight of the different types of product was in a progressive manner, with the latest addition to be regulated being the cell and gene therapy products (CGTPs), beginning January 1, 2021. CGTP can be classified as low risk (that does not require registration) or high risk (that needs to be registered). Generally, the regulation of high-risk CGTP is similar to other biological products. This chapter describes the chronology of the CGTP framework, classification of CGTP, how CGTPs fit into the current registration pathways and registration procedure, dossier requirements, and what is the current status and future direction of CGTP in Malaysia.
    Matched MeSH terms: Malaysia
  10. Lee VWM, Khoo TB, Teh CM, Heng HS, Li L, Yusof YLM, et al.
    Dev Med Child Neurol, 2023 Sep;65(9):1256-1263.
    PMID: 36748407 DOI: 10.1111/dmcn.15536
    This case series compared clinical variables and various combinations of immunotherapy received with outcomes of patients with severe acute necrotizing encephalopathy (ANE). We performed a retrospective review of clinical variables, immunotherapy received, and outcomes (based on the modified Rankin Scale) in Malaysia between February 2019 and January 2020. Twenty-seven children (12 male), aged 7 months to 14 years (mean 4 years) at diagnosis were included. Of these, 23 had an ANE severity score of 5 to 9 out of 9 (high risk). Eleven patients received tocilizumab (four in combination with methylprednisolone [MTP], seven with MTP + intravenous immunoglobulin [IVIG]) and 16 did not (two received MTP alone, 14 received MTP + IVIG). Nine died. Among the survivors, six had good outcomes (modified Rankin Score 0-2) at 6 months follow-up. All patients who received tocilizumab in combination with MTP + IVIG survived. Twenty children received first immunotherapy within 48 hours of admission. No significant association was found between the timing of first immunotherapy with outcomes. Those with brainstem dysfunction (p = 0.016) were observed to have poorer outcomes. This study showed a trend towards better survival when those with severe ANE were treated with tocilizumab in combination with MTP + IVIG. However, larger studies will be needed to determine the effect of this regime on the long-term outcomes.
    Matched MeSH terms: Malaysia
  11. Lee KY, Ismail M, Bakit P, Zakaria N, Zakaria N, Jinah N, et al.
    Leadersh Health Serv (Bradf Engl), 2022 Nov 11;ahead-of-print(ahead-of-print):219-35.
    PMID: 36350129 DOI: 10.1108/LHS-06-2022-0071
    PURPOSE: Formal structured leadership training is increasingly incorporated as a regular fixture in developed nations to produce competent leaders to ensure the provision of quality patient care. However, most low- and middle-income countries (LMICs) rely on one-off external training opportunities for selected individuals as they lack the necessary resources to implement long-term training for a wider pool of potential health care leaders. This case study shares the establishment process of the Talent Grooming Programme for technical health care professionals (TGP), a three-year in-house leadership training programme specially targeted at potential health care leaders in Malaysia.

    DESIGN/METHODOLOGY/APPROACH: This case study aims to share a comprehensive overview of the ideation, conceptualisation and implementation of TGP. The authors also outlined its impact from the individual and organisational perspectives, besides highlighting the lessons learned and recommendations for the way forward.

    FINDINGS: TGP set out to deliver experiential learning focusing on formal training, workplace experiences, practical reflection and mentoring by supervisors and other esteemed leaders to fulfil the five competency domains of leadership, organisational governance, communication and relationship, professional values and personal values. The successes and challenges in TGP programme delivery, post-training assessment, outcome evaluation and programme sustainability were outlined.

    PRACTICAL IMPLICATIONS: The authors' experience in setting up TGP provided valuable learning points for other leadership development programme providers. As for any development programme, a continuous evaluation is vital to ensure its relevance and sustainability.

    ORIGINALITY/VALUE: Certain aspects of TGP establishment can be referenced and modified to adapt to country-specific settings for others to develop similar leadership programme, especially those in LMICs.

    Matched MeSH terms: Malaysia
  12. Teh KJ, Tang HY, Lim LS, Pung HS, Gan SY, Lai NS
    Eur Rev Med Pharmacol Sci, 2023 May;27(10):4378-4385.
    PMID: 37259718 DOI: 10.26355/eurrev_202305_32443
    Lyme borreliosis is caused by the Gram-negative spirochetes Borrelia spp., particularly Borrelia burgdorferi sensu lato complex. The disease is transmitted through the bite of the infected black-legged Ixodes tick. Lyme borreliosis extensively occurs in the Northern Hemisphere, mainly in the United States. Lyme borreliosis cases are also detected in Asian countries including Korea, Nepal, China, Taiwan, and Japan. However, there is an inadequate understanding of Lyme borreliosis in the Southeast Asian region. Hence, this review aims to provide a brief update on the prevalence of Lyme borreliosis infection in Southeast Asia based on the latest literature on this issue. Lyme borreliosis has been discovered in human serum in Indonesia, Malaysia, and Singapore. The human serum samples were mainly examined with ELISA test using Borrelia spp. IgG and IgM antigens. Borrelia spp. also has been detected in ticks found on host animals such as Sundamys muelleri and Python in Malaysia, Thailand, and Laos. Polymerase chain reaction (PCR) is used to detect the presence of Borrelia DNAs in the samples. The published studies have demonstrated that Borrelia spp. exists in Southeast Asia and although the incidence is relatively low, it is believed that Lyme disease cases are under-reported.
    Matched MeSH terms: Malaysia
  13. Tiew PY, Dicker AJ, Keir HR, Poh ME, Pang SL, Mac Aogáin M, et al.
    Eur Respir J, 2021 Mar;57(3).
    PMID: 32972986 DOI: 10.1183/13993003.02050-2020
    INTRODUCTION: The chronic obstructive pulmonary disease (COPD) bacteriome associates with disease severity, exacerbations and mortality. While COPD patients are susceptible to fungal sensitisation, the role of the fungal mycobiome remains uncertain.

    METHODS: We report the largest multicentre evaluation of the COPD airway mycobiome to date, including participants from Asia (Singapore and Malaysia) and the UK (Scotland) when stable (n=337) and during exacerbations (n=66) as well as nondiseased (healthy) controls (n=47). Longitudinal mycobiome analysis was performed during and following COPD exacerbations (n=34), and examined in terms of exacerbation frequency, 2-year mortality and occurrence of serum specific IgE (sIgE) against selected fungi.

    RESULTS: A distinct mycobiome profile is observed in COPD compared with controls as evidenced by increased α-diversity (Shannon index; p<0.001). Significant airway mycobiome differences, including greater interfungal interaction (by co-occurrence), characterise very frequent COPD exacerbators (three or more exacerbations per year) (permutational multivariate ANOVA; adjusted p<0.001). Longitudinal analyses during exacerbations and following treatment with antibiotics and corticosteroids did not reveal any significant change in airway mycobiome profile. Unsupervised clustering resulted in two clinically distinct COPD groups: one with increased symptoms (COPD Assessment Test score) and Saccharomyces dominance, and another with very frequent exacerbations and higher mortality characterised by Aspergillus, Curvularia and Penicillium with a concomitant increase in serum sIgE levels against the same fungi. During acute exacerbations of COPD, lower fungal diversity associates with higher 2-year mortality.

    CONCLUSION: The airway mycobiome in COPD is characterised by specific fungal genera associated with exacerbations and increased mortality.

    Matched MeSH terms: Malaysia
  14. Ababneh BF, Ong SC, Alsaloumi L, Hussain R
    Front Public Health, 2023;11:1144466.
    PMID: 37601205 DOI: 10.3389/fpubh.2023.1144466
    INTRODUCTION: Community pharmacists' roles have expanded and undergone a significant transition over the last few years. Consequently, new and different pharmacy services, such as drive-thru pharmacy services, have emerged. Drive-thru pharmacy services began three decades ago and continued even during outbreaks such as the COVID-19 pandemic. Patients' perceptions are essential to the successful implementation and satisfaction with any new service. This study examines the reliability and validity of the assessment tool of public perceptions toward drive-thru community pharmacy services in Malaysia during COVID-19.

    METHODS: A cross-sectional study was conducted. The developed tool consists of 28 items to evaluate believed advantages toward drive-thru community pharmacy services, believed disadvantages toward drive-thru community pharmacy services, differences between drive-thru community pharmacy services and instore drug refill services, perceptions toward drive-thru community pharmacy services and feelings regarding how the introduction of drive-thru pharmacy services may affect the image of community pharmacists. Exploratory factor analysis (EFA) was performed to identify the factors of the developed tool, and confirmatory factor analysis (CFA) evaluated the model fitness.

    RESULTS: The EFA identified five elements and 25 items for the tool, and through CFA results, the observed model of the 25 items structure of the tool was verified as an excellent fit for the data [χ2 (265, N = 565) = 819.586, p < 0.001, IFI = 0.931, CFI = 0.93, RMSEA = 0.064]. The results of the CFA indicated a good model fit between the observed model and the proposed model. The internal reliability of the entire tool and each factor was very satisfactory as Cronbach's Alpha for the whole structured tool was 0.843 and for each factor was as follows, first factor (believed advantages) = 0.909, second factor (believed disadvantages) = 0.921, third factor (differences between drive-thru and instore refill) = 0.647, fourth factor (perceptions) = 0.926, and fifth factor (feelings) = 0.681.

    CONCLUSION: The developed and validated tool would be valuable for assessing the public's perceptions of the drive-thru community pharmacy service during COVID-19 and future pandemics.

    Matched MeSH terms: Malaysia
  15. Hartog J
    Am J Psychiatry, 1980 Jul;137(7):869.
    PMID: 7386683
    Matched MeSH terms: Malaysia
  16. Lim SM, Law BP
    J Hum Nutr Diet, 2023 Oct;36(5):2073-2084.
    PMID: 37475527 DOI: 10.1111/jhn.13213
    BACKGROUND: Children are vulnerable, and they may experience their first serious food allergy reaction at school, where they spend much of their time. The present study aims to determine the level of food allergy knowledge, attitude and management (KAM) among preschool personnel in Klang Valley, Malaysia.

    METHODS: A cross-sectional study was conducted with 292 personnel working in Klang Valley preschools. The participants completed an online questionnaire asking about sociodemographic information and food allergy KAM. Mann-Whitney U and chi-squared tests were used to compare the KAM level between public and private preschool personnel and examine the association of KAM of food allergy with various sociodemographic factors, respectively.

    RESULTS: Some 86.3% of the participants demonstrated a low level of food allergy knowledge, 64.7% showed a negative food allergy attitude and 57.9% indicated fair food allergy management. The total mean score for food allergy knowledge was higher (p 

    Matched MeSH terms: Malaysia
  17. Ruwaimana M, Satyanarayana B, Otero V, M Muslim A, Syafiq A M, Ibrahim S, et al.
    PLoS One, 2018;13(7):e0200288.
    PMID: 30020959 DOI: 10.1371/journal.pone.0200288
    Satellite data and aerial photos have proved to be useful in efficient conservation and management of mangrove ecosystems. However, there have been only very few attempts to demonstrate the ability of drone images, and none so far to observe vegetation (species-level) mapping. The present study compares the utility of drone images (DJI-Phantom-2 with SJ4000 RGB and IR cameras, spatial resolution: 5cm) and satellite images (Pleiades-1B, spatial resolution: 50cm) for mangrove mapping-specifically in terms of image quality, efficiency and classification accuracy, at the Setiu Wetland in Malaysia. Both object- and pixel-based classification approaches were tested (QGIS v.2.12.3 with Orfeo Toolbox). The object-based classification (using a manual rule-set algorithm) of drone imagery with dominant land-cover features (i.e. water, land, Avicennia alba, Nypa fruticans, Rhizophora apiculata and Casuarina equisetifolia) provided the highest accuracy (overall accuracy (OA): 94.0±0.5% and specific producer accuracy (SPA): 97.0±9.3%) as compared to the Pleiades imagery (OA: 72.2±2.7% and SPA: 51.9±22.7%). In addition, the pixel-based classification (using a maximum likelihood algorithm) of drone imagery provided better accuracy (OA: 90.0±1.9% and SPA: 87.2±5.1%) compared to the Pleiades (OA: 82.8±3.5% and SPA: 80.4±14.3%). Nevertheless, the drone provided higher temporal resolution images, even on cloudy days, an exceptional benefit when working in a humid tropical climate. In terms of the user-costs, drone costs are much higher, but this becomes advantageous over satellite data for long-term monitoring of a small area. Due to the large data size of the drone imagery, its processing time was about ten times greater than that of the satellite image, and varied according to the various image processing techniques employed (in pixel-based classification, drone >50 hours, Pleiades <5 hours), constituting the main disadvantage of UAV remote sensing. However, the mangrove mapping based on the drone aerial photos provided unprecedented results for Setiu, and was proven to be a viable alternative to satellite-based monitoring/management of these ecosystems. The improvements of drone technology will help to make drone use even more competitive in the future.
    Matched MeSH terms: Malaysia
  18. Ghani NDH, Abd Rahman MH, Mohamad Fadzil N, Mohammed Z, Mohd Rasdi HF, Shafie NS
    PLoS One, 2023;18(9):e0291062.
    PMID: 37682886 DOI: 10.1371/journal.pone.0291062
    BACKGROUND: Most eye problems among children can be detected and treated at an early age to reduce the prevalence of visual impairment. Understanding the knowledge, attitude, and practice (KAP) among parents about common children's eye problems is fundamental to encourage parents to seek early eye care services for their children. This study aims to develop a Parental Knowledge, Attitude, and Practice in Eye Problem among Children Questionnaire (PEPC-KAPQ) and evaluate its psychometric properties.

    METHODS: This study involved developing a questionnaire and was conducted in Kuala Lumpur, Malaysia from July 2021 until June 2022. The questionnaire was developed based on a literature review and expert consultation. The first phase includes a systematic literature review to generate the items for the questionnaire. A group of five panels was then invited to perform content validity for the questionnaire. Face validity was conducted among ten parents to get feedback for the questionnaire. Construct validity and reliability of the questionnaire were measured by which the questionnaire was administered to a total of 134 parents and 64 parents for reliability test.

    RESULT: The final PEPC-KAPQ consists of four main sections: demographic, knowledge, attitude, and practice with 52 items. The content validity index was 0.85 for all domains of KAP. Modified kappa showed excellent value for most items for all domains. The Kaiser-Meyer-Olkin sampling adequacy showed acceptable scores of 0.84, and Bartlett's Test of Sphericity was significant (x2 = 3172.09, p<0.0001). Kuder-Richardson-2 of the domain knowledge was 0.95. Cronbach's α coefficient of domain attitude and practice were 0.92 and 0.88, respectively and the intraclass correlation of domain attitude and practice were 0.93 and 0.94 respectively. Bland and Altman's plots show that majority of the data fell within the limits of agreement.

    CONCLUSION: The findings of this validation and reliability study show that the developed questionnaire has a satisfactory psychometric property for measuring the KAP of parents regarding eye problems among children.

    Matched MeSH terms: Malaysia
  19. Yap LM, Jamalludin Z, Ng AH, Ung NM
    Phys Eng Sci Med, 2023 Sep;46(3):1331-1340.
    PMID: 37470929 DOI: 10.1007/s13246-023-01303-x
    The survey is to assess the current state of adaptive radiation therapy (ART) for head and neck (H&N) cases among radiotherapy centers in Malaysia and to identify any implementation limitations. An online questionnaire was sent to all radiotherapy centers in Malaysia. The 24-question questionnaire consists of general information about the center, ART practices, and limitations faced in implementing ART. 28 out of 36 radiotherapy centers responded, resulting in an overall response rate of 78%. About 52% of the responding centers rescanned and replanned less than 5% of their H&N patients. The majority (88.9%) of the respondents reported the use Cone Beam Computed Tomography alone or in combination with other modalities to trigger the ART process. The main reasons cited for adopting ART were weight loss, changes in the immobilization fitting, and anatomical variation. The adaptation process typically occurred during week 3 or week 4 of treatment. More than half of the respondents require three days or more from re-simulation to starting a new treatment plan. Both target and organ at risk delineation on new planning CT relied heavily on manual delineation by physicians and physicists, respectively. All centers perform patient-specific quality assurance for their new adaptive plans. Two main limitations in implementing ART are "limited financial resources or equipment" and "limitation on technical knowledge". There is a need for a common consensus to standardize the practice of ART and address these limitations to improve the implementation of ART in Malaysia.
    Matched MeSH terms: Malaysia
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