Isodose mapping of terrestrial gamma radiation in Sarawak-Borneo: Insights from surface-weathered soil analysis.

Presentation of baseline data on terrestrial gamma radiation (TGR) levels is crucial for assessing the annual effective dose received by the public due to natural radiation exposure. Cumulative doses from various sources can become significant, warranting a spatial understanding of TGR distribution. Few countries have comprehensively mapped TGR on a national scale, often facing challenges due to remote or inaccessible regions. This study investigated the influence of weathered soil groups on TGR dose rates in Sarawak-Borneo, Malaysia, to facilitate insights for TGR projection and isodose mapping. A total of 1044 TGR dose rate measurements were collected using NaI (Tl) scintillation detector survey meters, with a mean of 100 nGy h-1 and a range of 8-375 nGy h-1. Non-parametric statistical analyses of variance using Welch's ANOVA, Brown-Forsythe, and Kruskal-Wallis validated (P-sig.=.000) notable dissimilarities among six categories of superficial-weathered soil. Graphical analysis using Sinclair's cumulative plot revealed deviations at intervals of 50, 80, 100, 120, 175, and 205 nGy h-1. These deviations indicate distinct lithological influences. Skeletal soil (entisols) and podzolic soils had high mean dose rates (148 and 113 nGy h-1, respectively) due to limited development, thus preserving abundant uranium (U) and thorium (Th). Meanwhile, gleysols and thionic soils exhibited compatible means (90 and 82 nGy h-1, respectively), while alluvial (or transported soils) and organic soils displayed lower dose rate ranges (mean of 76 and 47 nGy h-1, respectively), reflecting rapid hydrolysis weathering processes. Simple linear regression analysis revealed a strong relationship between TGR dose rate and mean value of weathered soil groups (y = 0.851x + 0.141 nGy h-1), signifying the significance and magnitude of weathered soil groups' impact on TGR dose rates. The obtained R-value is 0.704, indicating a strong linear correlation among soil group variables, and a Durbin-Watson statistic of 1.41, suggesting positive autocorrelation among residuals, thus positive relationships. An isodose map was successfully developed using the Kriging technique, aligning with lithological features of the study area. Semivariogram analysis reveals spatial dependence within a range of 1.47°, supporting the Kriging technique's suitability for spatial inference. In conclusion, this study has successfully revealed the relationship between TGR dose rates and superficial-weathered soil in Sarawak-Borneo. While the linear relationship is applicable to the Sundaland-Borneo tectonic block, it has potential to be used as a valuable tool for spatial inference of TGR dose rates in isodose development with similar lithologial characteristics, aiding in radiation exposure assessment and environmental monitoring.

Tabulation of organ dose conversion factors for terrestrial radioactivity monitoring program.

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.

Radiological hazard associated with amang processing industry in Peninsular Malaysia and its environmental impacts.

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.

Validity and reliability of the Patient Activation Measure® (PAM®)-13 Malay version among patients with Metabolic Syndrome in primary care.

INTRODUCTION: The Patient Activation Measure (PAM) is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation levels in self-management. This study aimed to determine the validity and reliability of the PAM-13 Malay version among patients with Metabolic Syndrome (MetS) attending a primary care clinic. METHODS: This work is a cross-sectional validation study among patients with MetS attending a university primary care clinic in Selangor. The PAM-13 Malay version underwent a validation process and field testing. Psychometric properties were examined using principal component analysis (PCA) with varimax rotation, scree plot, Monte Carlo simulation, internal consistency, and test-retest reliability analyses. RESULTS: The content of the PAM-13 Malay version and the original version were conceptually equivalent. The questionnaire was refined after face validation by 10 patients with MetS. The refined version was then field-tested among 130 participants (response rate 89.7%). The Kaiser-Meyer-Olkin test was 0.767, and Bartlett's test of sphericity was ≤0.001, indicating sampling adequacy. Two factors were identified and labeled as (1) Passive and Building Knowledge, and (2) Taking Action and Maintaining Behavior. These labels were chosen as they were conceptually consistent with the items representing the levels of activation in PAM-13. The validated PAM-13 Malay version consisted of 13 items, framed into two domains. The overall Cronbach's α was 0.79, and the intraclass correlation coefficient was 0.45. CONCLUSIONS: The PAM-13 Malay version is valid, reliable, and fairly stable over time. This questionnaire can be used to evaluate the levels of activation among patients with MetS in primary care in Malaysia.

Pleuritic chest pain and fever: An unusual presentation of aortic dissection.

It remains a challenge to diagnose aortic dissection in primary care, as classic clinical features are not always present. This case describes an atypical presentation of aortic dissection, in which the patient walked in with pleuritic central chest pain associated with a fever and elevated C-reactive protein. Classic features of tearing pain, pulse differentials, and a widened mediastinum on chest X-ray were absent. This unusual presentation highlights the need for a heightened level of clinical suspicion for aortic dissection in the absence of classic features. The case is discussed with reference to the literature on the sensitivity and specificity of the classic signs and symptoms of aortic dissection. A combination of the aortic dissection detection risk score (ADD-RS) and D-dimer test is helpful in ruling out this frequently lethal condition.

Adaption, translation and validation of the Diabetes Mellitus in the Offspring Questionnaire (DMOQ): The Malay version.

BACKGROUND: The Diabetes Mellitus in the Offspring Questionnaire (DMOQ) assesses the perceptions of Type 2 diabetes mellitus (T2DM) patients on the risk of their offspring developing T2DM and the possibility of intervention to reduce this risk. It has 34 items framed within seven domains. This study aimed to adapt, translate and validate the DMOQ from English into the Malay language. METHODS: This was a cross-sectional validation study among 159 T2DM patients attending a public primary care clinic in Selangor. The DMOQ English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using Exploratory Factor Analysis, internal consistency and testretest reliability. RESULTS: The DMOQ domains were conceptually equivalent between English and Malay language. A total of 13 items and two domains were removed during the validation process (three items during the content validation, three items due to poor factor loadings, five items as they loaded onto two domains which were not interpretable, one item as it did not fit conceptually into the factor it loaded onto and one openended question as it did not fit into the retained domains). Therefore, the final DMOQ Malay version consisted of 21- items within five domains. The Cronbach alpha was 0.714 and the intraclass-correlation coefficient was 0.868. CONCLUSION: The DMOQ Malay version is a valid and reliable tool which is consistent over time. It can be used to examine the perception of T2DM patients towards the risk of their offspring developing diabetes and possibility of intervention in Malay-speaking patients.

Correction to: Breast cancer subtype discordance: impact on post-recurrence survival and potential treatment options.

It has been highlighted that the original manuscript [1] contains a typesetting error regarding the authorship.

Breast cancer subtype discordance: impact on post-recurrence survival and potential treatment options.

BACKGROUND: Recent studies have shown that breast cancer subtype can change from the primary tumour to the recurrence. Discordance between primary and recurrent breast cancer has implications for further treatment and ultimately prognosis. The aim of the study was to determine the rate of change between primary and recurrence of breast cancer and to assess the impact of these changes on survival and potential treatment options. METHODS: Patient demographics were collected on those who underwent surgery for breast cancer between 2001 and 2014 and had a recurrence with biopsy results and pathology scoring of both the primary and recurrence. RESULTS: One hundred thirty two consecutive patients were included. There were 31 (23.5%) changes in subtype. Discordance occurred most frequently in luminal A breast cancer (n = 20), followed by triple negative (n = 4), luminal B (n = 3) and HER2 (n = 3). Patients who changed from luminal A to triple negative (n = 18) had a significantly worse post-recurrence survival (p < 0.05) with overall survival approaching significance (p = 0.064) compared to concordant luminal A cases (n = 46). Overall receptor discordance rates were: estrogen receptor 20.4% (n = 27), progesterone receptor 37.7% (n = 50) and HER2 3% (n = 4). Loss of estrogen receptor and progesterone receptor was more common than gain (21 vs. 6 (p = 0.04) and 44 vs. 6 (p = 0.01) respectively). Nine patients (6.8%) gained receptor status potentially impacting treatment options. CONCLUSION: Discordance in subtype and receptor status occurs between primary and recurrent breast cancer, ultimately affecting survival and potentially impacting treatment options.

Feasibility of Implementing Chronic Care Model in the Malaysian Public Primary Care Setting.

INTRODUCTION: Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM. METHODOLOGY: A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM. All public PHC with Family Medicine Specialist in Selangor and Kuala Lumpur were invited to participate. A site feasibility questionnaire was distributed to collect site investigator and clinic information as well as delivery of care for diabetes and hypertension. RESULTS: there were a total of 34 public PHC invited to participate with a response rate of 100%. there were 20 urban and 14 suburban clinics. the average number of patients seen per day ranged between 250-1000 patients. the clinic has a good mix of multidisciplinary team members. All clinics had a diabetic registry and 73.5% had a hypertensive registry. 23.5% had a dedicated diabetes and 26.5% had a dedicated hypertension clinic with most clinic implementing integrated care of acute and NCD cases. DISCUSSION: the implementation of the essential components of CCM is feasible in public PHCs, despite various constraints. Although variations in delivery of care exists, majority of the clinics have adequate staff that were willing to be trained and are committed to improving patient care.

Assessment of impact of urbanisation on background radiation exposure and human health risk estimation in Kuala Lumpur, Malaysia.

Kuala Lumpur has been undergoing rapid urbanisation process, mainly in infrastructure development. The opening of new township and residential in former tin mining areas, particularly in the heavy mineral- or tin-bearing alluvial soil in Kuala Lumpur, is a contentious subject in land-use regulation. Construction practices, i.e. reclamation and dredging in these areas are potential to enhance the radioactivity levels of soil and subsequently, increase the existing background gamma radiation levels. This situation is worsened with the utilisation of tin tailings as construction materials apart from unavoidable soil pollutions due to naturally occurring radioactive materials in construction materials, e.g. granitic aggregate, cement and red clay brick. This study was conducted to assess the urbanisation impacts on background gamma radiation in Kuala Lumpur. The study found that the mean value of measured dose rate was 251±6nGyh-1 (156-392nGyh-1) and 4 times higher than the world average value. High radioactivity levels of 238U (95±12Bqkg-1), 232Th (191±23Bqkg-1,) and 40K (727±130Bqkg-1) in soil were identified as the major source of high radiation exposure. Based on statistical ANOVA, t-test, and analyses of cumulative probability distribution, this study has statistically verified the dose enhancements in the background radiation. The effective dose was estimated to be 0.31±0.01mSvy-1 per man. The recommended ICRP reference level (1-20mSvy-1) is applicable to the involved existing exposure situation in this study. The estimated effective dose in this study is lower than the ICRP reference level and too low to cause deterministic radiation effects. Nevertheless based on estimations of lifetime radiation exposure risks, this study found that there was small probability for individual in Kuala Lumpur being diagnosed with cancer and dying of cancer.

Regulatory requirements for nuclear power plant site selection in Malaysia-a review.

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.

Multi-platform metabolomics analyses of a broad collection of fragrant and non-fragrant rice varieties reveals the high complexity of grain quality characteristics.

The quality of rice in terms not only of its nutritional value but also in terms of its aroma and flavour is becoming increasingly important in modern rice breeding where global targets are focused on both yield stability and grain quality. In the present paper we have exploited advanced, multi-platform metabolomics approaches to determine the biochemical differences in 31 rice varieties from a diverse range of genetic backgrounds and origin. All were grown under the specific local conditions for which they have been bred and all aspects of varietal identification and sample purity have been guaranteed by local experts from each country. Metabolomics analyses using 6 platforms have revealed the extent of biochemical differences (and similarities) between the chosen rice genotypes. Comparison of fragrant rice varieties showed a difference in the metabolic profiles of jasmine and basmati varieties. However with no consistent separation of the germplasm class. Storage of grains had a significant effect on the metabolome of both basmati and jasmine rice varieties but changes were different for the two rice types. This shows how metabolic changes may help prove a causal relationship with developing good quality in basmati rice or incurring quality loss in jasmine rice in aged grains. Such metabolomics approaches are leading to hypotheses on the potential links between grain quality attributes, biochemical composition and genotype in the context of breeding for improvement. With this knowledge we shall establish a stronger, evidence-based foundation upon which to build targeted strategies to support breeders in their quest for improved rice varieties.

Predicting terrestrial gamma dose rate based on geological and soil information: case study of Perak state, Malaysia.

An extensive terrestrial gamma radiation dose (TGRD) rate survey has been conducted in Perak State, Peninsular Malaysia. The survey has been carried out taking into account geological and soil information, involving 2930 in situ surveys. Based on geological and soil information collected during TGRD rate measurements, TGRD rates have been predicted in Perak State using a statistical regression analysis which would be helpful to focus surveys in areas that are difficult to access. An equation was formulated according to a linear relationship between TGRD rates, geological contexts and soil types. The comparison of in situ measurements and predicted TGRD dose rates was tabulated and showed good agreement with the linear regression equation. The TGRD rates in the study area ranged from 38 nGy h(-1) to 1039 nGy h(-1) with a mean value of 224 ± 138 nGy h(-1). This value is higher than the world average as reported in UNSCEAR 2000. The TGRD rates contribute an average dose rate of 1.37 mSv per year. An isodose map for the study area was developed using a Kriging method based on predicted and in situ TGRD rate values.

Thermoluminescence dosimetry properties and kinetic parameters of lithium potassium borate glass co-doped with titanium and magnesium oxides.

Lithium potassium borate (LKB) glasses co-doped with TiO2 and MgO were prepared using the melt quenching technique. The glasses were cut into transparent chips and exposed to gamma rays of (60)Co to study their thermoluminescence (TL) properties. The TL glow curve of the Ti-doped material featured a single prominent peak at 230 °C. Additional incorporation of MgO as a co-activator enhanced the TL intensity threefold. LKB:Ti,Mg is a low-Z material (Z(eff)=8.89) with slow signal fading. Its radiation sensitivity is 12 times lower that the sensitivity of TLD-100. The dose response is linear at doses up to 10(3) Gy. The trap parameters, such as the kinetics order, activation energy, and frequency factor, which are related to the glow peak, were determined using TolAnal software.

Isodose mapping of terrestrial gamma radiation dose rate of Selangor state, Kuala Lumpur and Putrajaya, Malaysia.

A terrestrial gamma radiation survey for the state of Selangor, Kuala Lumpur and Putrajaya was conducted to obtain baseline data for environmental radiological health practices. Based on soil type, geological background and information from airborne survey maps, 95 survey points statistically representing the study area were determined. The measured doses varied according to geological background and soil types. They ranged from 17 nGy h(-1) to 500 nGy h(-1). The mean terrestrial gamma dose rate in air above the ground was 182 ± 81 nGy h(-1). This is two times higher than the average dose rate of terrestrial gamma radiation in Malaysia which is 92 nGy h(-1) (UNSCEAR 2000). An isodose map was produced to represent exposure rate from natural sources of terrestrial gamma radiation.

Recognizing Life-threatening Features of Dengue in Children and Health Seeking Behavior in Dengue Emergency Amongst Parents and Carers: A Cross-sectional study in Gombak District, Malaysia.

Dengue is life-threatening and the paediatric population is highly susceptible to complications. Deterioration can occur rapidly and ability to recognise early warning signs is crucial. This study aims to determine the knowledge and awareness of parents and carers and to predict their ability in recognising life-threatening symptoms and signs of dengue in children and to assess their health-seeking behaviour in dengue emergency. Methods This is a crosssectional study involving parents and carers of children ≤ 12 years old in schools and kindergartens in the Gombak district. Demographic details, knowledge on life-threatening symptoms and signs of dengue and health-seeking behaviour were collected using a self-administered questionnaire and knowledge scoring was done. The questionnaire was pilot tested with a Cronbach alpha of 0.82. The results were analysed using SPSS version 20.0. Results Total respondents were 866 with 44.8% men and 55.2% women. The mean age was 40.3 years (SD ± 5.7). Knowledge score of dengue life threatening features among respondents were good (30.0%) to average (56.8%). Respondents were able to recognise fever (98.5%), petechial rash (97.1%) and bleeding (65.2%) but were less able to recognise abdominal pain (22.3%) and passing less urine (28.2%) as life threatening dengue features. However, the ability to recognise fever is a poor predictor in recognising life threatening dengue in children compared to all other symptoms which were good predictors. A respondent that recognise stomach pain or neck stiffness were five times more likely to recognise life-threatening dengue. Respondents preferred to bring their children to the clinic (50.8%) or hospital (37.8%) themselves Instead of calling for ambulance. Worryingly, some would give antipyretics (3.6%) or wait for improvements (7.8%). Conclusion Concerted efforts by the schools, healthcare professionals and health authorities are required to educate parents and carers to identify life-threatening features of dengue and to improve their health seeking-behaviour.

Thermoluminescence responses of photon- and electron-irradiated lithium potassium borate co-doped with Cu+Mg or Ti+Mg.

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.

Improvement of digital mammogram images using histogram equalization, histogram stretching and median filter.

Breast cancer is one of the most important diseases in females worldwide. According to the Malaysian Oncological Society, about 4% of women who are 40 years old and above are involved have breast cancer. Masses and microcalcifications are two important signs of breast cancer diagnosis on mammography. Enhancement techniques, i.e. histogram equalization, histogram stretching and median filters, were used to provide better visualization for radiologists in order to help early detection of breast abnormalities. In this research 60 digital mammogram images which includes 20 normal and 40 confirmed diagnosed cancerous cases were selected and manipulated using the mentioned techniques. The original and manipulated images were scored by three expert radiologists. Results showed that the selected methods have a positive significant effect on image quality.

The thermoluminescence response of doped SiO2 optical fibres subjected to fast neutrons.

This paper describes a preliminary study of the thermoluminescence (TL) response of doped SiO(2) optical fibres subjected to (241)AmBe neutron irradiation. The TL materials, which comprise Al- and Ge-doped silica fibres, were exposed in close contact with the (241)AmBe source to obtain fast neutron interactions through use of measurements obtained with and without a Cd filter (the filter being made to entirely enclose the fibres). The neutron irradiations were performed for exposure times of 1-, 2-, 3-, 5- and 7-days in a neutron tank filled with water. In this study, use was also made of the Monte Carlo N-particle (MCNP) code version 5 (V5) to simulate the neutron irradiations experiment. It was found that the commercially available Ge-doped and Al-doped optical fibres show a linear dose response subjected to fast neutrons from (241)AmBe source up to seven days of irradiations. The simulation performed using MCNP5 also exhibits a similar pattern, albeit differing in sensitivity. The TL response of Ge-doped fibre is markedly greater than that of the Al-doped fibre, the total absorption cross section for Ge in both the fast and thermal neutrons region being some ten times greater than that of Al.