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Displaying publications 21 - 40 of 180 in total

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A systematic review of statistical methods used to test for reliability of medical instruments measuring continuous variables

Zaki R, Bulgiba A, Nordin N, Azina Ismail N

Iran J Basic Med Sci, 2013 Jun;16(6):803-7.
PMID: 23997908

Reliability measures precision or the extent to which test results can be replicated. This is the first ever systematic review to identify statistical methods used to measure reliability of equipment measuring continuous variables. This studyalso aims to highlight the inappropriate statistical method used in the reliability analysis and its implication in the medical practice.
Fulltext Receptor for advanced glycation end products and its involvement in inflammatory diseases

Chuah YK, Basir R, Talib H, Tie TH, Nordin N

Int J Inflam, 2013;2013:403460.
PMID: 24102034 DOI: 10.1155/2013/403460

The receptor for advanced glycation end products (RAGE) is a transmembrane receptor of the immunoglobulin superfamily, capable of binding a broad repertoire of ligands. RAGE-ligands interaction induces a series of signal transduction cascades and lead to the activation of transcription factor NF-κB as well as increased expression of cytokines, chemokines, and adhesion molecules. These effects endow RAGE with the role in the signal transduction from pathogen substrates to cell activation during the onset and perpetuation of inflammation. RAGE signaling and downstream pathways have been implicated in a wide spectrum of inflammatory-related pathologic conditions such as arteriosclerosis, Alzheimer's disease, arthritis, acute respiratory failure, and sepsis. Despite the significant progress in other RAGE studies, the functional importance of the receptor in clinical situations and inflammatory diseases still remains to be fully realized. In this review, we will summarize current understandings and lines of evidence on the molecular mechanisms through which RAGE signaling contributes to the pathogenesis of the aforementioned inflammation-associated conditions.
Lentivirus vector driven by polybiquitin C promoter without woodchuck posttranscriptional regulatory element and central polypurine tract generates low level and short-lived reporter gene expression

Ngai SC, Rosli R, Nordin N, Veerakumarasivam A, Abdullah S

Gene, 2012 May 1;498(2):231-6.
PMID: 22366305 DOI: 10.1016/j.gene.2012.01.071

Lentivirus (LV) encoding woodchuck posttranscriptional regulatory element (WPRE) and central polypurine tract (cPPT) driven by CMV promoter have been proven to act synergistically to increase both transduction efficiency and gene expression. However, the inclusion of WPRE and cPPT in a lentiviral construct may pose safety risks when administered to human. A simple lentiviral construct driven by an alternative promoter with proven extended duration of gene expression without the two regulatory elements would be free from the risks. In a non-viral gene delivery context, gene expression driven by human polybiquitin C (UbC) promoter resulted in higher and more persistent expression in mouse as compared to cytomegalovirus (CMV) promoter. In this study, we measured the efficiency and persistency of green fluorescent protein (GFP) reporter gene expression in cells transduced with LV driven by UbC (LV/UbC/GFP) devoid of the WPRE and cPPT in comparison to the established LV construct encoding WPRE and cPPT, driven by CMV promoter (LV/CMV/GFP). However, we found that LV/UbC/GFP was inferior to LV/CMV/GFP in many aspects: (i) the titer of virus produced; (ii) the levels of reporter gene expression when MOI value was standardized; and (iii) the transduction efficiency in different cell types. The duration of reporter gene expression in selected cell lines was also determined. While the GFP expression in cells transduced with LV/CMV/GFP persisted throughout the experimental period of 14 days, expression in cells transduced with LV/UbC/GFP declined by day 2 post-transduction. In summary, the LV driven by the UbC promoter without the WPRE and cPPT does not exhibit enhanced or durable transgene expression.
Fulltext Induced pluripotent stem cells: history, properties and potential applications

Nordin N, Lai MI, Veerakumarasivam A, Ramasamy R, Abdullah S, Wendy-Yeo WY, et al.

Med J Malaysia, 2011 Mar;66(1):4-9.
PMID: 23765134 MyJurnal

The development of induced pluripotent stem cells (iPSCs) has been met with much enthusiasm and hailed as a breakthrough discovery by the scientific and research communities amidst the divisive and ongoing debates surrounding human embryonic stem cells (hESC) research. The discovery reveals the fact that embryonic pluripotency can be generated from adult somatic cells by the induction of appropriate transcriptional factor genes essential for maintaining the pluripotency. They provide an alternative source for pluripotent stem cells, thus representing a powerful new research tool besides their potential application in the field of regenerative medicine. In this review, the historical background of iPSCs generation will be discussed together with their properties and characteristics as well as their potential therapeutic applications.
Fulltext Conjugated Oligo-Aromatic Compounds Bearing a 3,4,5-Trimethoxy Moiety: Investigation of Their Antioxidant Activity Correlated with a DFT Study

Kareem HS, Nordin N, Heidelberg T, Abdul-Aziz A, Ariffin A

Molecules, 2016 Feb 17;21(2).
PMID: 26901175 DOI: 10.3390/molecules21020224

A series of heterocyclic compounds bearing the well-known free radical scavenging 3,4,5-trimethoxybenzyloxy group, was synthesized. The key compound 4-(3,4,5-trimethoxybenzyl-oxy)benzohydrazide was converted into thiosemicarbazide derivatives, which were subsequently cyclized with NaOH to provide 1,2,4-triazole derivatives. Alternative treatment of the acid hydrazide with carbon disulfide in the presence of KOH led to the corresponding 1,3,4-oxadiazole and various alkylated derivatives. The newly synthesized compounds were purified and the structures of the products were elucidated and confirmed on the basis of their analytical and spectral data. Their antioxidant activities were evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH(•)) and Ferric Reducing Antioxidant Power (FRAP) assays. The thiosemicarbazide derivatives were highly active in both antioxidant assays with the lowest IC50 value for DPPH radical scavenging. Theoretical calculations based on density functional theory (DFT) were performed to understand the relative importance of NH, SH and CH hydrogens on the radical scavenging activities of these compounds.
Fulltext In Vivo Anti-Tumor Effects of Citral on 4T1 Breast Cancer Cells via Induction of Apoptosis and Downregulation of Aldehyde Dehydrogenase Activity

Nigjeh SE, Yeap SK, Nordin N, Rahman H, Rosli R

Molecules, 2019 Sep 05;24(18).
PMID: 31492037 DOI: 10.3390/molecules24183241

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among females globally. The tumorigenic activities of cancer cells such as aldehyde dehydrogenase (ALDH) activity and differentiation have contributed to relapse and eventual mortality in breast cancer. Thus, current drug discovery research is focused on targeting breast cancer cells with ALDH activity and their capacity to form secondary tumors. Citral (3,7-dimethyl-2,6-octadienal), from lemon grass (Cymbopogoncitrates), has been previously reported to have a cytotoxic effect on breast cancer cells. Hence, this study was conducted to evaluate the in vivo effect of citral in targeting ALDH activity of breast cancer cells. BALB/c mice were challenged with 4T1 breast cancer cells followed by daily oral feeding of 50 mg/kg citral or distilled water for two weeks. The population of ALDH+ tumor cells and their capacity to form secondary tumors in both untreated and citral treated 4T1 challenged mice were assessed by Aldefluor assay and tumor growth upon cell reimplantation in normal mice, respectively. Citral treatment reduced the size and number of cells with ALDH+ activity of the tumors in 4T1-challenged BALB/c mice. Moreover, citral-treated mice were also observed with smaller tumor size and delayed tumorigenicity after reimplantation of the primary tumor cells into normal mice. These findings support the antitumor effect of citral in targeting ALDH+ cells and tumor recurrence in breast cancer cells.
Generation of induced pluripotent stem cells by a polycistronic lentiviral vector in feeder- and serum- free defined culture

Al Abbar A, Nordin N, Ghazalli N, Abdullah S

Tissue Cell, 2018 Dec;55:13-24.
PMID: 30503056 DOI: 10.1016/j.tice.2018.09.004

Induced pluripotent stem cells (iPSCs) have great potentials for regenerative medicine. However, serious concerns such as the use of the viral-mediated reprogramming strategies and exposure of iPSCs to animal products from feeder cells and serum-containing medium have restricted the application of iPSCs in the clinics. Therefore, the generation of iPSCs with minimal viral integrations and in non-animal sourced and serum-free medium is necessary. In this report, a polycistronic lentiviral vector carrying Yamanaka's factors was used to reprogram mouse fibroblasts into iPSCs in feeder- and xeno-free culture environment. The generated iPSCs exhibited morphology and self-renewal properties of embryonic stem cells (ESCs), expression of specific pluripotent markers, and potentials to differentiate into the three-major distinct specialized germ layers in vitro. The iPSCs were also shown to have the potential to differentiate into neural precursor and neurons in culture, with greater than 95% expression of nestin, Pax6 and βIII-tubulin. This body of work describes an alternative method of generating iPSCs by using polycistronic lentiviral vector that may minimize the risks associated with viral vector-mediated reprogramming and animal derived products in the culture media.
Fulltext A Web-Based Intervention for Social Media Addiction Disorder Management in Higher Education: Quantitative Survey Study

Dogan H, Norman H, Alrobai A, Jiang N, Nordin N, Adnan A

J Med Internet Res, 2019 10 02;21(10):e14834.
PMID: 31579018 DOI: 10.2196/14834

BACKGROUND: Social media addiction disorder has recently become a major concern and has been reported to have negative impacts on postgraduate studies, particularly addiction to Facebook. Although previous studies have investigated the effects of Facebook addiction disorder in learning settings, there still has been a lack of studies investigating the relationship between online intervention features for Facebook addiction focusing on postgraduate studies.
OBJECTIVE: In an attempt to understand this relationship, this study aimed to carry out an investigation on online intervention features for effective management of Facebook addiction in higher education.
METHODS: This study was conducted quantitatively using surveys and partial least square-structural equational modeling. The study involved 200 postgraduates in a Facebook support group for postgraduates. The Bergen Facebook Addiction test was used to assess postgraduates' Facebook addiction level, whereas online intervention features were used to assess postgraduates' perceptions of online intervention features for Facebook addiction, which are as follows: (1) self-monitoring features, (2) manual control features, (3) notification features, (4) automatic control features, and (5) reward features.
RESULTS: The study discovered six Facebook addiction factors (relapse, conflict, salience, tolerance, withdrawal, and mood modification) and five intervention features (notification, auto-control, reward, manual control, and self-monitoring) that could be used in the management of Facebook addiction in postgraduate education. The study also revealed that relapse is the most important factor and mood modification is the least important factor. Furthermore, findings indicated that notification was the most important intervention feature, whereas self-monitoring was the least important feature.
CONCLUSIONS: The study's findings (addiction factors and intervention features) could assist future developers and educators in the development of online intervention tools for Facebook addiction management in postgraduate education.
Fulltext A simple, portable, electrochemical biosensor to screen shellfish for Vibrio parahaemolyticus

Nordin N, Yusof NA, Abdullah J, Radu S, Hushiarian R

AMB Express, 2017 Dec;7(1):41.
PMID: 28205102 DOI: 10.1186/s13568-017-0339-8

An earlier electrochemical mechanism of DNA detection was adapted and specified for the detection of Vibrio parahaemolyticus in real samples. The reader, based on a screen printed carbon electrode, was modified with polylactide-stabilized gold nanoparticles and methylene blue was employed as the redox indicator. Detection was assessed using a microprocessor to measure current response under controlled potential. The fabricated sensor was able to specifically distinguish complementary, non-complementary and mismatched oligonucleotides. DNA was measured in the range of 2.0 × 10(-8)-2.0 × 10(-13) M with a detection limit of 2.16 pM. The relative standard deviation for 6 replications of differential pulse voltammetry (DPV) measurement of 0.2 µM complementary DNA was 4.33%. Additionally, cross-reactivity studies against various other food-borne pathogens showed a reliably sensitive detection of the target pathogen. Successful identification of Vibrio parahaemolyticus (spiked and unspiked) in fresh cockles, combined with its simplicity and portability demonstrate the potential of the device as a practical screening tool.
Fulltext Application of occupational health surveillance program among responder’s during chemical incident at Pasir Gudang, Johor

Salvaraji L., Haidar R.T., Mohd Aris N., Ayob Q. A., Nordin N., Abdul Latif N., et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):29-29.
MyJurnal

Introduction: Responder’s action during mass environmental chemical incident involves collaboration of multiple agency. They clean the exposure site, control public safety and safe lives. The health of the responder is also as valuable as the public and always been neglected. Hence, this study is to highlights the method used and challenges during the incidents. Methods: A modified Occupational Health Surveillance Programme designed by Baker and Matte (Thirteen Steps in designing and implementing an Occupational Health Surveillance Programme) was imple-mented. These method full fill the criteria of impossible further reduce exposure to known hazards and uncertain health effect of the offending chemicals. Two core workplace namely the source of chemical contamination locale and victims’ evacuation centre were identified. The exposed responder is identified and categorised according to their expected exposure. Offending chemicals identified were known hazardous to health. An electronic survey form was developed and the surveillance were conducted during the event and post-exposures of one, third and sixth months. Laboratory tests were performed as a grab sample randomly and strategically to represent responder exposure. Results: During the event, 1338 responders were surveyed and twenty percent had symptoms of cough, headache, sore throat, nausea and skin irritation. After one-month post-exposure, three percent of responder noted to have continue symptoms. Laboratory tests were performed randomly due to the sheer numbers of responders in action. Only sixty-one samples were collected and sixteen percent had positive metabolites for urine cyanide. Re-sponders with abnormal laboratory result (FBC/LFT/RP/Urine) were interviewed and a repeat sample were performed. Conclusion: The health surveillance of the responder in mass environmental chemical incident is a great challenge when the exposure level is unsure and involve more than one chemicals. Likewise, reliability and validity adopting statistical test for health surveillance instruments is unattainable due to urgency. However, a proper method of occu-pational surveillance need to be devised and implemented to ensure the protection of worker’s health is guaranteed.
Fulltext A comparative study of machine learning techniques for suicide attempts predictive model

Nordin N, Zainol Z, Mohd Noor MH, Lai Fong C

Health Informatics J, 2021 3 23;27(1):1460458221989395.
PMID: 33745355 DOI: 10.1177/1460458221989395

Current suicide risk assessments for predicting suicide attempts are time consuming, of low predictive value and have inadequate reliability. This paper aims to develop a predictive model for suicide attempts among patients with depression using machine learning algorithms as well as presents a comparative study on single predictive models with ensemble predictive models for differentiating depressed patients with suicide attempts from non-suicide attempters. We applied and trained eight different machine learning algorithms using a dataset that consists of 75 patients diagnosed with a depressive disorder. A recursive feature elimination was used to reduce the features via three-fold cross validation. An ensemble predictive models outperformed the single predictive models. Voting and bagging revealed the highest accuracy of 92% compared to other machine learning algorithms. Our findings indicate that history of suicide attempt, religion, race, suicide ideation and severity of clinical depression are useful factors for prediction of suicide attempts.
Mesenchymal stem cells: From stem cells to sarcomas

Lye KL, Nordin N, Vidyadaran S, Thilakavathy K

Cell Biol Int, 2016 Jun;40(6):610-8.
PMID: 26992453 DOI: 10.1002/cbin.10603

Mesenchymal stem cells (MSCs) have garnered vast interests in clinical settings, especially in regenerative medicine due to their unique properties-they are reliably isolated and expanded from various tissue sources; they are able to differentiate into mesodermal tissues such as bones, cartilages, adipose tissues, and muscles; and they have unique immunosuppressive properties. However, there are some concerns pertaining to the role of MSCs in the human body. On one hand, they are crucial component in the regeneration and repair of the human body. On the contrary, they are shown to transform into sarcomas. Although the exact mechanisms are still unknown, many new leads have pointed to the belief that MSCs do play a role in sarcomagenesis. This review focuses on the current updates and findings of the role of MSCs in their transformation process into sarcomas.
Sensitive detection of multiple pathogens using a single DNA probe

Nordin N, Yusof NA, Abdullah J, Radu S, Hushiarian R

Biosens Bioelectron, 2016 Dec 15;86:398-405.
PMID: 27414245 DOI: 10.1016/j.bios.2016.06.077

A simple but promising electrochemical DNA nanosensor was designed, constructed and applied to differentiate a few food-borne pathogens. The DNA probe was initially designed to have a complementary region in Vibrio parahaemolyticus (VP) genome and to make different hybridization patterns with other selected pathogens. The sensor was based on a screen printed carbon electrode (SPCE) modified with polylactide-stabilized gold nanoparticles (PLA-AuNPs) and methylene blue (MB) was employed as the redox indicator binding better to single-stranded DNA. The immobilization and hybridization events were assessed using differential pulse voltammetry (DPV). The fabricated biosensor was able to specifically distinguish complementary, non-complementary and mismatched oligonucleotides. DNA was measured in the range of 2.0×10(-9)-2.0×10(-13)M with a detection limit of 5.3×10(-12)M. The relative standard deviation for 6 replications of DPV measurement of 0.2µM complementary DNA was 4.88%. The fabricated DNA biosensor was considered stable and portable as indicated by a recovery of more than 80% after a storage period of 6 months at 4-45°C. Cross-reactivity studies against various food-borne pathogens showed a reliably sensitive detection of VP.
Fulltext Development of an Electrochemical DNA Biosensor to Detect a Foodborne Pathogen

Nordin N, Yusof NA, Radu S, Hushiarian R

J Vis Exp, 2018 06 03.
PMID: 29912194 DOI: 10.3791/56585

Vibrio parahaemolyticus (V. parahaemolyticus) is a common foodborne pathogen that contributes to a large proportion of public health problems globally, significantly affecting the rate of human mortality and morbidity. Conventional methods for the detection of V. parahaemolyticus such as culture-based methods, immunological assays, and molecular-based methods require complicated sample handling and are time-consuming, tedious, and costly. Recently, biosensors have proven to be a promising and comprehensive detection method with the advantages of fast detection, cost-effectiveness, and practicality. This research focuses on developing a rapid method of detecting V. parahaemolyticus with high selectivity and sensitivity using the principles of DNA hybridization. In the work, characterization of synthesized polylactic acid-stabilized gold nanoparticles (PLA-AuNPs) was achieved using X-ray Diffraction (XRD), Ultraviolet-visible Spectroscopy (UV-Vis), Transmission Electron Microscopy (TEM), Field-emission Scanning Electron Microscopy (FESEM), and Cyclic Voltammetry (CV). We also carried out further testing of stability, sensitivity, and reproducibility of the PLA-AuNPs. We found that the PLA-AuNPs formed a sound structure of stabilized nanoparticles in aqueous solution. We also observed that the sensitivity improved as a result of the smaller charge transfer resistance (Rct) value and an increase of active surface area (0.41 cm2). The development of our DNA biosensor was based on modification of a screen-printed carbon electrode (SPCE) with PLA-AuNPs and using methylene blue (MB) as the redox indicator. We assessed the immobilization and hybridization events by differential pulse voltammetry (DPV). We found that complementary, non-complementary, and mismatched oligonucleotides were specifically distinguished by the fabricated biosensor. It also showed reliably sensitive detection in cross-reactivity studies against various food-borne pathogens and in the identification of V. parahaemolyticus in fresh cockles.
Comparative efficacy of stem cells and secretome in articular cartilage regeneration: a systematic review and meta-analysis

Muhammad SA, Nordin N, Mehat MZ, Fakurazi S

Cell Tissue Res, 2019 Feb;375(2):329-344.
PMID: 30084022 DOI: 10.1007/s00441-018-2884-0

Articular cartilage defect remains the most challenging joint disease due to limited intrinsic healing capacity of the cartilage that most often progresses to osteoarthritis. In recent years, stem cell therapy has evolved as therapeutic strategies for articular cartilage regeneration. However, a number of studies have shown that therapeutic efficacy of stem cell transplantation is attributed to multiple secreted factors that modulate the surrounding milieu to evoke reparative processes. This systematic review and meta-analysis aim to evaluate and compare the therapeutic efficacy of stem cell and secretome in articular cartilage regeneration in animal models. We systematically searched the PubMed, CINAHL, Cochrane Library, Ovid Medline and Scopus databases until August 2017 using search terms related to stem cells, cartilage regeneration and animals. A random effect meta-analysis of the included studies was performed to assess the treatment effects on new cartilage formation on an absolute score of 0-100% scale. Subgroup analyses were also performed by sorting studies independently based on similar characteristics. The pooled analysis of 59 studies that utilized stem cells significantly improved new cartilage formation by 25.99% as compared with control. Similarly, the secretome also significantly increased cartilage regeneration by 26.08% in comparison to the control. Subgroup analyses revealed no significant difference in the effect of stem cells in new cartilage formation. However, there was a significant decline in the effect of stem cells in articular cartilage regeneration during long-term follow-up, suggesting that the duration of follow-up is a predictor of new cartilage formation. Secretome has shown a similar effect to stem cells in new cartilage formation. The risk of bias assessment showed poor reporting for most studies thereby limiting the actual risk of bias assessment. The present study suggests that both stem cells and secretome interventions improve cartilage regeneration in animal trials. Graphical abstract ᅟ.
Suicidal behaviour prediction models using machine learning techniques: A systematic review

Nordin N, Zainol Z, Mohd Noor MH, Chan LF

Artif Intell Med, 2022 10;132:102395.
PMID: 36207078 DOI: 10.1016/j.artmed.2022.102395

BACKGROUND: Early detection and prediction of suicidal behaviour are key factors in suicide control. In conjunction with recent advances in the field of artificial intelligence, there is increasing research into how machine learning can assist in the detection, prediction and treatment of suicidal behaviour. Therefore, this study aims to provide a comprehensive review of the literature exploring machine learning techniques in the study of suicidal behaviour prediction.
METHODS: A search of four databases was conducted: Web of Science, PubMed, Dimensions, and Scopus for research papers dated between January 2016 and September 2021. The search keywords are 'data mining', 'machine learning' in combination with 'suicidal behaviour', 'suicide', 'suicide attempt', 'suicidal ideation', 'suicide plan' and 'self-harm'. The studies that used machine learning techniques were synthesized according to the countries of the articles, sample description, sample size, classification tasks, number of features used to develop the models, types of machine learning techniques, and evaluation of performance metrics.
RESULTS: Thirty-five empirical articles met the criteria to be included in the current review. We provide a general overview of machine learning techniques, examine the feature categories, describe methodological challenges, and suggest areas for improvement and research directions. Ensemble prediction models have been shown to be more accurate and useful than single prediction models.
CONCLUSIONS: Machine learning has great potential for improving estimates of future suicidal behaviour and monitoring changes in risk over time. Further research can address important challenges and potential opportunities that may contribute to significant advances in suicide prediction.
Fulltext Chemo-Sensitization of CD133+ Cancer Stem Cell Enhances the Effect of Mesenchymal Stem Cell Expressing TRAIL in Non-Small Cell Lung Cancer Cell Lines

Fakiruddin KS, Lim MN, Nordin N, Rosli R, Abdullah S

Biology (Basel), 2021 Oct 26;10(11).
PMID: 34827096 DOI: 10.3390/biology10111103

Pre-clinical studies have demonstrated the efficacy of mesenchymal stem cells (MSCs) expressing tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) or MSC-TRAIL against several tumors. However, due to the existence of cancer stem cells (CSCs), some tumors, including non-small cell lung cancer (NSCLC), exhibit TRAIL resistance. This study was designed to evaluate the capacity of using first-line chemotherapies including cisplatin, 5-fluorouracil (5-FU) and vinorelbine to act as a chemo-sensitizer on CD133+ (prominin-1 positive) CSCs derived from NSCLC cell lines (A549, H460 and H2170) for the purpose of MSC-TRAIL-induced inhibition. We showed that MSC-TRAIL was resistant to all three chemotherapies compared to the NSCLC cell lines, suggesting that the chemotherapies had little effect on MSC-TRAIL viability. Pre-treatment using either cisplatin or 5-FU, but not with vinorelbine, was able to increase the efficacy of MSC-TRAIL to kill the TRAIL-resistant A549-derived CSCs. The study also demonstrated that both 5-FU and vinorelbine were an effective chemo-sensitizer, used to increase the anti-tumor effect of MSC-TRAIL against H460- and H2170-derived CSCs. Furthermore, pre-treatment using cisplatin was noted to enhance the effect of MSC-TRAIL in H460-derived CSCs; however, this effect was not detected in the H2170-derived CSCs. These findings suggest that a pre-treatment using certain chemotherapies in NSCLC could enhance the anti-tumor effect of MSC-TRAIL to target the CSCs, and therefore the combination of chemotherapies and MSC-TRAIL may serve as a novel approach for the treatment of NSCLC.
Survival Time and Prognostic Factors for Breast Cancer among Women in North-East Peninsular Malaysia

Nordin N, Yaacob NM, Abdullah NH, Mohd Hairon S

Asian Pac J Cancer Prev, 2018 Feb 26;19(2):497-502.
PMID: 29480991

Background: Breast cancer is the most common malignant disease and the leading cause of cancer death among
women globally. This study aimed to determine the median survival time and prognostic factors for breast cancer
patients in a North-East State of Malaysia. Methods: This retrospective cohort study was conducted from January till
April 2017 using secondary data obtained from the state’s cancer registry. All 549 cases of breast cancer diagnosed
from 1st January 2007 until 31st December 2011 were selected and retrospectively followed-up until 31st December
2016. Sociodemographic and clinical information was collected to determine prognostic factors. Results: The average
(SD) age at diagnosis was 50.4 (11.2) years, the majority of patients having Malay ethnicity (85.8%) and a histology of
ductal carcinoma (81.5%). Median survival times for those presenting at stages III and IV were 50.8 (95% CI: 25.34,
76.19) and 6.9 (95% CI: 3.21, 10.61) months, respectively. Ethnicity (Adj. HR for Malay vs non-Malay ethnicity=2.52;
95% CI: 1.54, 4.13; p<0.001), stage at presentation (Adj. HR for Stage III vs Stage I=2.31; 95% CI: 1.57, 3.39; p<0.001
and Adj. HR for Stage IV vs Stage I=6.20; 95% CI: 4.45, 8.65; p<0.001), and history of surgical treatment (Adj. HR
for patients with no surgical intervention=1.95; 95% CI: 1.52, 2.52; p<0.001) were observed to be the statistically
significant prognostic factors associated with death caused by breast cancer. Conclusion: The median survival time
among breast cancer patients in North-East State of Malaysia was short as compared to other studies. Primary and
secondary prevention aimed at early diagnosis and surgical management of breast cancer, particularly among the Malay
ethnic group, could improve treatment outcome.
An explainable predictive model for suicide attempt risk using an ensemble learning and Shapley Additive Explanations (SHAP) approach

Nordin N, Zainol Z, Mohd Noor MH, Chan LF

Asian J Psychiatr, 2023 Jan;79:103316.
PMID: 36395702 DOI: 10.1016/j.ajp.2022.103316

Machine learning approaches have been used to develop suicide attempt predictive models recently and have been shown to have a good performance. However, those proposed models have difficulty interpreting and understanding why an individual has suicidal attempts. To overcome this issue, the identification of features such as risk factors in predicting suicide attempts is important for clinicians to make decisions. Therefore, the aim of this study is to propose an explainable predictive model to predict and analyse the importance of features for suicide attempts. This model can also provide explanations to improve the clinical understanding of suicide attempts. Two complex ensemble learning models, namely Random Forest and Gradient Boosting with an explanatory model (SHapley Additive exPlanations (SHAP)) have been constructed. The models are used for predictive interpretation and understanding of the importance of the features. The experiment shows that both models with SHAP are able to interpret and understand the nature of an individual's predictions with suicide attempts. However, compared with Random Forest, the results show that Gradient Boosting with SHAP achieves higher accuracy and the analyses found that history of suicide attempts, suicidal ideation, and ethnicity as the main predictors for suicide attempts.
A Patient with Third-Space Fluid Loss

Tay TY, Nordin N, Badaruddin IA, Othman H

Clin Chem, 2023 Feb 01;69(2):125-128.
PMID: 36724481 DOI: 10.1093/clinchem/hvac205

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