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  1. Sow AY, Ismail A, Zulkifli SZ, Amal MN, Hambali KA
    Sci Rep, 2019 04 23;9(1):6391.
    PMID: 31015502 DOI: 10.1038/s41598-019-42753-2
    This work investigates the metals concentration in the tissues of Asian swamp eel, Monopterus albus. Five selected tissues, including liver, gill, bone, skin, and muscle were examined for the concentration of Zn, Cu, Cd, Pb, and Ni. The concentrations of Cd and Pb were found high in the muscle tissues of the eels. Additionally, high amounts of Zn and Cu metals were observed in the liver, whereas the Cd, Pb, and Ni metals were highly detected in gill. The accumulation of Zn, Cu, Cd, Pb, and Ni in both skin and bone of the eel seems to vary between seasons. Low levels of Zn, Cu, and Ni were identified in the muscle tissues of the eels. This study revealed that the concentration of Cd and Pb in the muscle tissues of Asian swamp eels exceeded the permissible limits by the US EPA, suggesting the consumption of the muscle may be hazardous and can severely affect one's health.
    Matched MeSH terms: Risk Assessment*
  2. Wong JJ, Phan HP, Phumeetham S, Ong JSM, Chor YK, Qian S, et al.
    Crit Care Med, 2017 Jul 26.
    PMID: 28749854 DOI: 10.1097/CCM.0000000000002623
    OBJECTIVES: The Pediatric Acute Lung Injury Consensus Conference developed a pediatric specific definition for acute respiratory distress syndrome (PARDS). In this definition, severity of lung disease is stratified into mild, moderate, and severe groups. We aim to describe the epidemiology of patients with PARDS across Asia and evaluate whether the Pediatric Acute Lung Injury Consensus Conference risk stratification accurately predicts outcome in PARDS.

    DESIGN: A multicenter, retrospective, descriptive cohort study.

    SETTING: Ten multidisciplinary PICUs in Asia.

    PATIENTS: All mechanically ventilated children meeting the Pediatric Acute Lung Injury Consensus Conference criteria for PARDS between 2009 and 2015.

    INTERVENTIONS: None.

    MEASUREMENTS AND MAIN RESULTS: Data on epidemiology, ventilation, adjunct therapies, and clinical outcomes were collected. Patients were followed for 100 days post diagnosis of PARDS. A total of 373 patients were included. There were 89 (23.9%), 149 (39.9%), and 135 (36.2%) patients with mild, moderate, and severe PARDS, respectively. The most common risk factor for PARDS was pneumonia/lower respiratory tract infection (309 [82.8%]). Higher category of severity of PARDS was associated with lower ventilator-free days (22 [17-25], 16 [0-23], 6 [0-19]; p < 0.001 for mild, moderate, and severe, respectively) and PICU free days (19 [11-24], 15 [0-22], 5 [0-20]; p < 0.001 for mild, moderate, and severe, respectively). Overall PICU mortality for PARDS was 113 of 373 (30.3%), and 100-day mortality was 126 of 317 (39.7%). After adjusting for site, presence of comorbidities and severity of illness in the multivariate Cox proportional hazard regression model, patients with moderate (hazard ratio, 1.88 [95% CI, 1.03-3.45]; p = 0.039) and severe PARDS (hazard ratio, 3.18 [95% CI, 1.68, 6.02]; p < 0.001) had higher risk of mortality compared with those with mild PARDS.

    CONCLUSIONS: Mortality from PARDS is high in Asia. The Pediatric Acute Lung Injury Consensus Conference definition of PARDS is a useful tool for risk stratification.

    Matched MeSH terms: Risk Factors; Risk Assessment
  3. Pal C, Mani S, Pal AK, Ramuni K, Hassan HC
    Enferm Clin, 2020 06;30 Suppl 5:6-11.
    PMID: 32713585 DOI: 10.1016/j.enfcli.2019.11.015
    OBJECTIVE: Management of osteoporotic fractures becomes challenging because of its multiple associated factors as well as poor bone quality. Therefore, assessments of the risk factors of osteoporotic fractures among low impact trauma client is a matter of great concern which can be addressed properly to reduce their occurrence in future.

    METHOD: Thirty patients with single or multiple fractures were selected purposively for descriptive survey study between January 2018 to December 2018. Their ages varied from 41 to 80 years. There were 26 female and four males. 24 patients have single fracture and six had multiple fractures following low impact trauma. The demographic parameters were studied by structured interview schedule, and the research variable, the risk factors were studied by interview, biophysical assessment and records of BMD value through DEXA and serum level of vitamin D. Socio-demographic variables like age, sex, body weight, Body mass index (BMI), etc. were selected and their relationship were assessed to find out the risk factors of fragility fractures in society by research variables like risk factors of osteoporotic fractures. For statistical analysis of determination of association between such factors and fragility fractures, non-parametric Fisher exact test and Odds ratio was used.

    RESULTS: In our study, osteoporotic fractures occurred majority (86.66%) among female maximally among 60-69 years age group. Whereas in relatively younger age (40-60 years), abnormal BMI (low or high) is responsible for fragility fracture as 46.6% of such fractures occurred in this group as 20% fracture are associated with underweight and 40.66% with overweight BMI. Tobacco smoking increases the risk of fragility fractures twice (as relative risk ratio 2) and rheumatoid arthritis increases the six-fold (as relative risk ratio 6). All 100% had history of fall. Level of serum vitamin D, low DEXA scan value (less than -2.5) and fall on ground resulting in low impact injuries shows strong association between those and fragility fractures. On the other hand, all the risk factors remain same for the recent and old fractures.

    CONCLUSION: Several risk factors need to be addressed properly apart from medical managements to reduce the risk of occurrence of osteoporotic fractures.

    Matched MeSH terms: Risk Factors; Risk Assessment
  4. Sadeghi H, Mohandes SR, Hosseini MR, Banihashemi S, Mahdiyar A, Abdullah A
    PMID: 33202768 DOI: 10.3390/ijerph17228395
    Occupational Health and Safety (OHS)-related injuries are vexing problems for construction projects in developing countries, mostly due to poor managerial-, governmental-, and technical safety-related issues. Though some studies have been conducted on OHS-associated issues in developing countries, research on this topic remains scarce. A review of the literature shows that presenting a predictive assessment framework through machine learning techniques can add much to the field. As for Malaysia, despite the ongoing growth of the construction sector, there has not been any study focused on OHS assessment of workers involved in construction activities. To fill these gaps, an Ensemble Predictive Safety Risk Assessment Model (EPSRAM) is developed in this paper as an effective tool to assess the OHS risks related to workers on construction sites. The developed EPSRAM is based on the integration of neural networks with fuzzy inference systems. To show the effectiveness of the EPSRAM developed, it is applied to several Malaysian construction case projects. This paper contributes to the field in several ways, through: (1) identifying major potential safety risks, (2) determining crucial factors that affect the safety assessment for construction workers, (3) predicting the magnitude of identified safety risks accurately, and (4) predicting the evaluation strategies applicable to the identified risks. It is demonstrated how EPSRAM can provide safety professionals and inspectors concerned with well-being of workers with valuable information, leading to improving the working environment of construction crew members.
    Matched MeSH terms: Risk Assessment*
  5. Teh CL, Chuah SL, Lee HK, Wan SA, Leong TS, Tan FHS, et al.
    Med J Malaysia, 2020 03;75(2):191-193.
    PMID: 32281610
    Osteoporosis is commonly underdiagnosed and undertreated. We performed a clinical audit to assess the risk factors and clinical care for osteoporosis among older persons who attended medical clinic during a 4-week period in August 2013. There was a total of 128 patients with a mean age of 73.1±5.8 years, and 20.3%. had a history of fall. Fracture Risk Assessment Tool (FRAX) scores assessment showed 14.2% and 68.8% had a 10-year risk of major osteoporotic and hip fractures respectively. Only 6.3% underwent Dual-energy X-ray absorptiometry (DXA) and 73.4% did not receive any preventive treatment for osteoporosis. Older persons attending medical clinic at high risk of osteoporosis fractures did not receive appropriate screening and treatment. There is a need to improve the suboptimal care for bone health among older persons.
    Matched MeSH terms: Risk Factors; Risk Assessment
  6. Yap CK, Wong KW, Al-Shami SA, Nulit R, Cheng WH, Aris AZ, et al.
    PMID: 33383875 DOI: 10.3390/ijerph18010195
    This study aimed to analyse ten trace metal concentrations in the edible part of the freshwater clam Corbicula javanica and to provide a critical assessment of the potential risks to human health through consumption of this clam as food based on well-established indices and food safety guidelines. The clams were captured from a pristine original site and transplanted to other sites with different environmental qualities. The trace metal levels in the edible total soft tissue (TST) of the clam were below those of the food safety guidelines referred to except for Pb, which exceeded the permissible limit set by the European Commission (2006) and the US Food and Drug Administration/ Center for Food Safety and Applied Nutrition); Interstate Shellfish Sanitation Conference. (USFDA/CFSAN; ISSC) (2007). The estimated daily intake (EDI) values of the clam were found to be lower than the oral reference dose and the calculated target hazard quotient (THQ) and total THQ were found to be less than 1. Therefore, in conclusion, the human health risk for consumption of TST of C. javanica at both average and high-level were insignificant regardless of the environment it was exposed to.
    Matched MeSH terms: Risk Assessment*
  7. Ayob KA, Merican AM, Sulaiman SH, Hariz Ramli AR
    Jt Dis Relat Surg, 2021;32(1):239-244.
    PMID: 33463444 DOI: 10.5606/ehc.2021.77862
    Injuries to the pelvic vasculature during total hip arthroplasties are rare but have serious consequence. They demand urgent and early identification so that appropriate treatment can be instituted. If the bleeding is severe, cardiovascular compromise occurs intraoperatively and this will alert the surgeon of this possibility during acetabular screw placement. Alternatively, a delay in diagnosis can occur because the bleeding and the injured vessel are in the pelvic cavity and not visualized during the surgery. In this article, we report two cases from our center occurring within a six-month interval that sustained a vascular injury during acetabular drilling for screw placement for cementless cup fixation. Each case had a different vessel injury and different lessons can be learned from these rare injuries. The first case had an injury of the inferior gluteal artery following a breach of the sciatic notch. The vessel was treated with percutaneous embolization. The second case demonstrated a venous injury, following a medial protrusio technique for congenital hip dysplasia and a short anterosuperior screw, transecting the external iliac vein. This was subsequently repaired using an endovascular technique. We conclude the reasons for these vessel injuries after analyzing advanced imaging, discuss measures to avoid vessel injury and detail the minimally invasive method for their treatment.
    Matched MeSH terms: Risk Adjustment/methods
  8. Rajbanshi S, Norhayati MN, Nik Hazlina NH
    PMID: 34071394 DOI: 10.3390/ijerph18115801
    Maternal and neonatal morbidity and mortality tend to decrease if referral advice during pregnancy is utilized appropriately. This study explores the reasons for nonadherence to referral advice among high-risk pregnant women. A qualitative study was conducted in Morang District, Nepal. A phenomenological inquiry was used. Fourteen participants were interviewed in-depth. High-risk women who did not comply with the referral to have a hospital birth were the study participants. Participants were chosen purposively until data saturation was achieved. The data were generated using thematic analysis. Preference of homebirth, women's diminished autonomy and financial dependence, conditional factors, and sociocultural factors were the four major themes that hindered hospital births. Women used antenatal check-ups to reaffirm normalcy in their current pregnancies to practice homebirth. For newly-wed young women, information barriers such as not knowing where to seek healthcare existed. The poorest segments and marginalized women did not adhere to referral hospital birth advice even when present with high-risk factors in pregnancy. Multiple factors, including socioeconomic and sociocultural factors, affect women's decision to give birth in the referral hospital. Targeted interventions for underprivileged communities and policies to increase facility-based birth rates are recommended.
    Matched MeSH terms: Pregnancy, High-Risk*
  9. Rahmah MA, Shahraniza B
    MyJurnal
    Introduction : Social problems among adolescents are on the increasing trend. Their involvement in different kinds of high risk behaviours could lead them into juvenile delinquency. Early adolescence is the stage where they are easily influenced. However, this is the period where they should be captured for health prevention enhancement.
    Objectives : A cross-sectional study was carried out to identify factors associated with risk taking behaviours involving form one adolescents in selected secondary schools in Johor Bharu.
    Methods : Using self administered questionnaires, a total of 280 respondents were recruited via multi-stage sampling.
    Results : The prevalence of risk taking behaviour among respondents was 66.8%. Going to video games and karaoke centres was the most popular risk taking behaviour (46.8%) to be followed by truancy (30.7%). Among all the factors studied, being male (AOR=4.5, 95% CI 2.39-8.4), Malay (AOR=7.5, 95% CI 3.30-17.19), and having negative perception towards teachers (AOR 0.3, 95% CI 0.16-0.65) were risk factors for such behaviour among respondents. However, coming from an intact family (AOR=0.1), 95% CI 0.02-0.47) was found to be protective against risk taking behaviour.
    Conclusion : Intact family structure and having positive perception towards teachers were found to be protective against risk taking behaviours among adolescents.
    Matched MeSH terms: Risk Factors; Risk-Taking
  10. Nur Hidayah Rani, Emilia Zainal Abidin, Noor Afifah Ya'acob, Karmegam Karuppiah, Irniza Rasdi
    MyJurnal
    Pineapple plantation workers are exposed to strenuous physical activities. This study aims to determine the prevalence
    of musculoskeletal symptoms (MSS), analyse the body postural risks related to work tasks and identify relevant MSS risk factors
    among pineapple plantation workers. This was a cross-sectional study performed at a pineapple plantation in Johor in 2016. MSS,
    information on socio-demographic background and occupational history were collected via structured questionnaires. Identification
    and risk assessment of ergonomic hazard and postural risk analysis were performed for a subset of workers. Data were entered into
    statistical software and analyse according to relevant objectives. A total of 108 workers participated in this study. The prevalence
    of MSS was 87.0% and was highest for the lower back (64.8%). In terms of ergonomic hazards, Harvesting were categorised as a
    task with the highest risk. Harvesting was also the task with the highest postural risk. From the multivariate analysis, lower back
    pain is mainly contributed by a working tenure of 10 to 25 years (Odds Ratio, OR: 3.90; 95% Confidence Interval, CI 1.05-14.4) and
    more than 25 years (OR: 7.45 (95% CI 1.26 to 44.0). Workers who worked more than 7-hour daily have a higher risk for reporting
    lower back pain. Pineapple plantation workers are exposed to excessive bending, twisting and carrying of heavy loads that may be
    linked to MSS. Effective preventive strategies are required to address MSS in this population in order to minimize risk for subsequent
    musculoskeletal disorders.
    Matched MeSH terms: Risk Factors; Risk Assessment
  11. Bukar Ali, Bularafa, Abdul Rashid, Abdullah
    MyJurnal
    Unemployment and poverty are seriously issue of concern globally, especially in developing countries like Nigeria. Unemployment and poverty among university graduates in Nigeria, the trends on rising every year, major corporations are cutting down jobs and graduates who were interested to work can’t seem to find a job. However, entrepreneurship and business formation have been recognised around the World as a remedy for unemployment and pivotal for economies to grow. Therefore, promotion of entrepreneurial activity becomes the most top priority on the government agenda. Despite the unique role played by entrepreneurship to the economy as a whole and to the person that established business, in Nigeria, the rate of university graduates in entrepreneurship is far below expected. This led to many research efforts on factors that are having an effect on student’s entrepreneurial intentions. This review paper proposed the intention to be an entrepreneur can be explained by Ajzen, (1991) theory of planned behaviour, institutional, and core self-evaluation theories. Psychological (self-efficacy, risk-taking propensity, locus of control, innovativeness, need for achievement) and institutional (university environment, government support programmes) factors will have an effect on attitudes, subjective norms, perceived behavioural control. Consequently, the study predicted the entrepreneurial intentions of the Nigerian university students.
    Matched MeSH terms: Risk; Risk-Taking
  12. Mohd Nordin NA, Ajit Singh DK, Lim K
    Sains Malaysiana, 2014;43:423-428.
    Identification of associated risk factors is important to enable successful implementation of low back pain prevention strategies. To date, there is limited research data on back pain among young adults in Malaysia despite an increasing incidence of this disabling condition worldwide. A cross-sectional survey was conducted to determine the incidence of low back pain (LBP) and associated factors among health science undergraduates. A self-administered questionnaire was distributed to full time students of a main public university. One hundred and forty undergraduates; mean age 21.4±1.3 years, 70% female, 60% in year 3 of study, participated in the survey. The results showed that 31% spent between 6 and 8 h and another 31% spent more than 9 h sitting in a day. Twelve percent of the undergraduates rated their fitness level as ‘poor’. The incidence of LBP was 40.3% among the undergraduates. LBP incidence was associated with age (X2=12.1, p=0.007), years of study (X2=8.7, p=0.03), self-rated physical fitness (X2=7.0, p=0.02) and hours spent sitting (X2 =8.7, p=0.03). Gender, body mass index and hours spent in sports and physical activity were not associated with LBP. The findings from this study demonstrate that physical fitness and sitting duration is associated with low back pain among health science undergraduates. Health science undergraduates should improve their physical fitness, practice frequent breaks and stretching during sitting. This will help to minimize LBP related to decreased fitness levels and prolonged sitting.
    Matched MeSH terms: Risk Factors*
  13. Nurliyana Juhan, Yong Zulina Zubairi, Zarina Mohd Khalid, Ahmad Syadi Mahmood Zuhdi
    MATEMATIKA, 2018;34(101):15-23.
    MyJurnal
    Cardiovascular disease (CVD) includes coronary heart disease, cerebrovascular disease (stroke), peripheral artery disease, and atherosclerosis of the aorta. All females face the threat of CVD. But becoming aware of symptoms and signs is a great challenge since most adults at increased risk of cardiovascular disease (CVD) have no symptoms or obvious signs especially in females. The symptoms may be identified by the assessment of their risk factors. The Bayesian approach is a specific way in dealing with this kind of problem by formalizing a priori beliefs and of combining them with the available observations. This study aimed to identify associated risk factors in CVD among female patients presenting with ST Elevation Myocardial Infarction (STEMI) using Bayesian logistic regression and obtain a feasible model to describe the data. A total of 874 STEMI female patients in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Bayesian Markov Chain Monte Carlo (MCMC) simulation approach was applied in the univariate and multivariate analysis. Model performance was assessed through the model calibration and discrimination. The final multivariate model of STEMI female patients consisted of six significant variables namely smoking, dyslipidaemia, myocardial infarction (MI), renal disease, Killip class and age group. Females aged 65 years and above have higher incidence of CVD and mortality is high among female patients with Killip class IV. Also, renal disease was a strong predictor of CVD mortality. Besides, performance measures for the model was considered good. Bayesian logistic regression model provided a better understanding on the associated risk factors of CVD for female patients which may help tailor prevention or treatment plans more effectively.
    Matched MeSH terms: Risk Factors*
  14. Taheri E, Mollabahrami F, Farokhzad M, Ghasemi F, Assari MJ
    Int J Environ Health Res, 2020 Apr;30(2):198-211.
    PMID: 30879332 DOI: 10.1080/09603123.2019.1588232
    In the laboratories staffs, there is potential for adverse health effects in exposure to chemicals. Therefore, risk assessment is one of the main issues to prevent these effects. The purpose of this study was to assess the health risk of laboratory staffs and compare the two methods, including 'Chemical Health Risk Assessment' (CHRA) and 'Regional Screening Levels' (RSLs), that developed by the Department of Occupational Safety and Health of Malaysia and the Environmental Protection Agency respectively. Using these two methods, the places with the highest risk were identified. Comparisons showed that RSLs is a precise method without personal judgment. The CHRA is a simple method for wider chemicals that categorize risk. But CHRA includes fewer parameters compared to RSLs, as well as personal judgment. The results of the present study showed that two methods did not compatible. According to the characteristics of these two methods, it is recommended to use them as a compliment each other to obtain accurate results.
    Matched MeSH terms: Risk Assessment/methods*
  15. Arokiasamy JT
    JUMMEC, 1996;1:33-36.
    A group of 265 urban private sector workers in Kuala Lumpur and adjacent Petaling Jaya responded to a self-administered questionnaires. Their knowledge of cardio-pulmonary resuscitation, risk factors for and preventive measures against cardiovascular diasease a n d w h e n these should be started are relatively weak, though knowledge on symptoms of heart a attack are satisfactory. Relatively more males than females are current smokers and consumers of alcohol. Males tended to start smoking and drinking in their teen years while females tended to do so later in their non-teen years.
    Matched MeSH terms: Risk; Risk Factors
  16. Firus Khan AY, Ramli AS, Abdul Razak S, Mohd Kasim NA, Chua YA, Ul-Saufie AZ, et al.
    Int J Environ Res Public Health, 2022 Sep 19;19(18).
    PMID: 36142062 DOI: 10.3390/ijerph191811789
    Cardiovascular disease (CVD) has been a burden to many developing countries for decades, including Malaysia. Although various steps have been taken to prevent and manage CVD, it remains the leading cause of morbidity and mortality. The rising prevalence of CVD risk factors such as hypertension, hypercholesterolaemia, diabetes, overweight and obesity is the main driving force behind the CVD epidemic. Therefore, a nationwide health study coined as the Malaysian Health and Wellbeing Assessment (MyHEBAT) was designed. It aimed to investigate the prevalence of CVD and the associated risk factors in the community across Malaysia. The MyHEBAT study recruited participants (18-75 years old) through community health screening programmes from 11 states in Malaysia. The MyHEBAT study was further divided into two sub-studies, namely, the Cardiovascular Risk Epidemiological Study (MyHEBAT-CRES) and the MyHEBAT Familial Hypercholesterolaemia Study (MyHEBAT-FH). These studies assessed the prevalence of CVD risk factors and the prevalence of FH in the community, respectively. The data garnered from the MyHEBAT study will provide information for healthcare providers to devise better prevention and clinical practice guidelines for managing CVD in Malaysia.
    Matched MeSH terms: Risk Factors; Risk Assessment
  17. Shahab A, Hui Z, Rad S, Xiao H, Siddique J, Huang LL, et al.
    Environ Geochem Health, 2023 Mar;45(3):585-606.
    PMID: 35347514 DOI: 10.1007/s10653-022-01255-3
    In order to expound on the present situation and potential risk of road dust heavy metals in major cities, a total of 114 literatures mainly over the past two decades, involving more than 5000 sampling sites in 61 cities of 21 countries, were screened through the collection and analysis of research papers. The concentration, sources, distribution, health risk, sample collection, and analytical methods of heavy metal research on road dust in cities around the world are summarized. The results show that Cd, Zn, and Cu in many urban road dusts in the world are higher than the grade II of the Chinese maximum allowable concentration of potentially toxic elements in the soil. Geo-accumulation index values show that Pb > Cd > Zn > Cu had the highest contamination levels. Hazard index assessment indicates Pb and Cr had the highest potential health risk, especially for children in which ingestion was found as the main exposure pathway. Moreover, through comparative analysis, it is found that some pollutants are higher in developed and industrialized cities and transport (53%) followed by industrial emissions (35%) provide the major contributions to the sources of heavy metals.
    Matched MeSH terms: Risk Assessment/methods
  18. Song Z, Zhang W, Jiang Q, Deng L, Du L, Mou W, et al.
    Int J Surg, 2023 Dec 01;109(12):3848-3860.
    PMID: 37988414 DOI: 10.1097/JS9.0000000000000862
    BACKGROUND: The early detection of high-grade prostate cancer (HGPCa) is of great importance. However, the current detection strategies result in a high rate of negative biopsies and high medical costs. In this study, the authors aimed to establish an Asian Prostate Cancer Artificial intelligence (APCA) score with no extra cost other than routine health check-ups to predict the risk of HGPCa.

    PATIENTS AND METHODS: A total of 7476 patients with routine health check-up data who underwent prostate biopsies from January 2008 to December 2021 in eight referral centres in Asia were screened. After data pre-processing and cleaning, 5037 patients and 117 features were analyzed. Seven AI-based algorithms were tested for feature selection and seven AI-based algorithms were tested for classification, with the best combination applied for model construction. The APAC score was established in the CH cohort and validated in a multi-centre cohort and in each validation cohort to evaluate its generalizability in different Asian regions. The performance of the models was evaluated using area under the receiver operating characteristic curve (ROC), calibration plot, and decision curve analyses.

    RESULTS: Eighteen features were involved in the APCA score predicting HGPCa, with some of these markers not previously used in prostate cancer diagnosis. The area under the curve (AUC) was 0.76 (95% CI:0.74-0.78) in the multi-centre validation cohort and the increment of AUC (APCA vs. PSA) was 0.16 (95% CI:0.13-0.20). The calibration plots yielded a high degree of coherence and the decision curve analysis yielded a higher net clinical benefit. Applying the APCA score could reduce unnecessary biopsies by 20.2% and 38.4%, at the risk of missing 5.0% and 10.0% of HGPCa cases in the multi-centre validation cohort, respectively.

    CONCLUSIONS: The APCA score based on routine health check-ups could reduce unnecessary prostate biopsies without additional examinations in Asian populations. Further prospective population-based studies are warranted to confirm these results.

    Matched MeSH terms: Risk Assessment/methods
  19. Inayat-Hussain SH, Fukumura M, Muiz Aziz A, Jin CM, Jin LW, Garcia-Milian R, et al.
    Environ Int, 2018 08;117:348-358.
    PMID: 29793188 DOI: 10.1016/j.envint.2018.05.010
    BACKGROUND: Recent trends have witnessed the global growth of unconventional oil and gas (UOG) production. Epidemiologic studies have suggested associations between proximity to UOG operations with increased adverse birth outcomes and cancer, though specific potential etiologic agents have not yet been identified. To perform effective risk assessment of chemicals used in UOG production, the first step of hazard identification followed by prioritization specifically for reproductive toxicity, carcinogenicity and mutagenicity is crucial in an evidence-based risk assessment approach. To date, there is no single hazard classification list based on the United Nations Globally Harmonized System (GHS), with countries applying the GHS standards to generate their own chemical hazard classification lists. A current challenge for chemical prioritization, particularly for a multi-national industry, is inconsistent hazard classification which may result in misjudgment of the potential public health risks. We present a novel approach for hazard identification followed by prioritization of reproductive toxicants found in UOG operations using publicly available regulatory databases.

    METHODS: GHS classification for reproductive toxicity of 157 UOG-related chemicals identified as potential reproductive or developmental toxicants in a previous publication was assessed using eleven governmental regulatory agency databases. If there was discordance in classifications across agencies, the most stringent classification was assigned. Chemicals in the category of known or presumed human reproductive toxicants were further evaluated for carcinogenicity and germ cell mutagenicity based on government classifications. A scoring system was utilized to assign numerical values for reproductive health, cancer and germ cell mutation hazard endpoints. Using a Cytoscape analysis, both qualitative and quantitative results were presented visually to readily identify high priority UOG chemicals with evidence of multiple adverse effects.

    RESULTS: We observed substantial inconsistencies in classification among the 11 databases. By adopting the most stringent classification within and across countries, 43 chemicals were classified as known or presumed human reproductive toxicants (GHS Category 1), while 31 chemicals were classified as suspected human reproductive toxicants (GHS Category 2). The 43 reproductive toxicants were further subjected to analysis for carcinogenic and mutagenic properties. Calculated hazard scores and Cytoscape visualization yielded several high priority chemicals including potassium dichromate, cadmium, benzene and ethylene oxide.

    CONCLUSIONS: Our findings reveal diverging GHS classification outcomes for UOG chemicals across regulatory agencies. Adoption of the most stringent classification with application of hazard scores provides a useful approach to prioritize reproductive toxicants in UOG and other industries for exposure assessments and selection of safer alternatives.

    Matched MeSH terms: Risk Assessment/methods*
  20. Dench E, Bond-Smith D, Darcey E, Lee G, Aung YK, Chan A, et al.
    BMJ Open, 2019 Dec 31;9(12):e031041.
    PMID: 31892647 DOI: 10.1136/bmjopen-2019-031041
    INTRODUCTION: For women of the same age and body mass index, increased mammographic density is one of the strongest predictors of breast cancer risk. There are multiple methods of measuring mammographic density and other features in a mammogram that could potentially be used in a screening setting to identify and target women at high risk of developing breast cancer. However, it is unclear which measurement method provides the strongest predictor of breast cancer risk.

    METHODS AND ANALYSIS: The measurement challenge has been established as an international resource to offer a common set of anonymised mammogram images for measurement and analysis. To date, full field digital mammogram images and core data from 1650 cases and 1929 controls from five countries have been collated. The measurement challenge is an ongoing collaboration and we are continuing to expand the resource to include additional image sets across different populations (from contributors) and to compare additional measurement methods (by challengers). The intended use of the measurement challenge resource is for refinement and validation of new and existing mammographic measurement methods. The measurement challenge resource provides a standardised dataset of mammographic images and core data that enables investigators to directly compare methods of measuring mammographic density or other mammographic features in case/control sets of both raw and processed images, for the purposes of the comparing their predictions of breast cancer risk.

    ETHICS AND DISSEMINATION: Challengers and contributors are required to enter a Research Collaboration Agreement with the University of Melbourne prior to participation in the measurement challenge. The Challenge database of collated data and images are stored in a secure data repository at the University of Melbourne. Ethics approval for the measurement challenge is held at University of Melbourne (HREC ID 0931343.3).

    Matched MeSH terms: Risk Assessment/methods
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