Displaying publications 21 - 40 of 134 in total

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  1. Voon NS, Lau FN, Zakaria R, Md Rani SA, Ismail F, Manan HA, et al.
    Cancer Radiother, 2021 Feb;25(1):62-71.
    PMID: 33414057 DOI: 10.1016/j.canrad.2020.07.008
    PURPOSE: Nasopharyngeal carcinoma (NPC) radiotherapy (RT) irradiates parts of the brain which may cause cerebral tissue changes. This study aimed to systematically review the brain microstructure changes using MRI-based measures, diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI) and voxel-based morphometry (VBM) and the impact of dose and latency following RT.

    METHODS: PubMed and Scopus databases were searched based on PRISMA guideline to determine studies focusing on changes following NPC RT.

    RESULTS: Eleven studies fulfilled the inclusion criteria. Microstructural changes occur most consistently in the temporal region. The changes were correlated with latency in seven studies; fractional anisotropy (FA) and gray matter (GM) volume remained low even after a longer period following RT and areas beyond irradiation site with reduced FA and GM measures. For dosage, only one study showed correlation, thus requiring further investigations.

    CONCLUSION: DTI, DKI and VBM may be used as a surveillance tool in detecting brain microstructural changes of NPC patients which correlates to latency and brain areas following RT.

  2. Lee YJ, Zakaria R, Manaf ZA, Mohamed Z, Lee YY
    Chin Med J (Engl), 2013;126(11):2049-53.
    PMID: 23769556
    There is increasing evidence that CT pulmonary arteriography and venography allow a better diagnostic yield for deep vein thrombosis (DVT) in suspected acute pulmonary embolism (PE). The aim was to investigate the value for using such an approach in a multiracial Asian population.
  3. Zakaria R, Ahmi A, Ahmad AH, Othman Z
    Chronobiol Int, 2021 01;38(1):27-37.
    PMID: 33164592 DOI: 10.1080/07420528.2020.1838534
    This study presents a bibliometric analysis of the publications on melatonin research from the Scopus database during the period 2015-2019. Based on the keywords used, which are related to melatonin in the article title, the study retrieved 4411 documents for further analysis using various tools. We used Microsoft Excel to conduct the frequency analysis, VOSviewer for data visualization, and Harzing's Publish or Perish for citation metrics and analysis. This study reports the results using standard bibliometric indicators such as the growth of publications, authorship patterns, collaboration, and prolific authors, country contribution, most active institutions, preferred journals, and top-cited articles. Based on our findings, there is a continuous growth of publications on melatonin research for 5 years since 2015. China was the largest contributor to melatonin research, followed by the United States. The Journal of Pineal Research published the most number of publications related to melatonin research. Our findings suggest that the role of melatonin in plant and food sciences, as well as in cancer, may in later years take over the clusters that earlier dominated melatonin research.
  4. Lee SK, Sirajudeen KN, Sundaram A, Zakaria R, Singh HJ
    Clin Exp Pharmacol Physiol, 2011 Dec;38(12):854-9.
    PMID: 21973174 DOI: 10.1111/j.1440-1681.2011.05624.x
    1. The hypotensive effect of cross-fostering in spontaneously hypertensive rats (SHR) is thought to involve adjustments in renal function. However, its association with renal anti-oxidant/oxidant balance during cross-fostering is not known. 2. The present study examined the effect of cross-fostering and in-fostering of 1-day-old offspring between SHR and Wistar-Kyoto (WKY) dams on renal anti-oxidant/oxidant status and systolic blood pressure (SBP). Renal anti-oxidant/oxidant status and SBP were determined in the offspring from 4-16 weeks of age. 3. Cross-fostered SHR had significantly lower SBP than in-fostered SHR at 6, 8 and 12 weeks, but not at 16 weeks (127 ± 1 vs 144 ± 2, 138 ± 1 vs 160 ± 1, 174 ± 2 vs 184 ± 2 and 199 ± 2 vs 194 ± 3 mmHg at 6, 8, 12 and 16 weeks, respectively). No differences in SBP were evident between cross-fostered and in-fostered WKY rats. There were no significant differences in levels of thiobarbituric acid-reactive substances (TBARS), protein carbonyl and total anti-oxidant status (TAS) or superoxide dismutase, catalase, glutathione peroxidase (GPx), glutathione S-transferase and glutathione reductase activity between cross-fostered and in-fostered SHR or WKY offspring. However, compared with WKY rats, catalase activity was higher at 6 and 16 weeks, TAS was higher at 16 weeks and GPx activity and TBARS were lower at 16 weeks in SHR. 4. It appears that cross-fostering of SHR offspring to WKY dams during the early postnatal period causes a transient delay in the rise in blood pressure in SHR and that this does not involve the renal anti-oxidant/oxidant system.
  5. Ab Wahab SZ, Nik Hussain NH, Zakaria R, Abdul Kadir A, Mohamed N, Tohit NM, et al.
    Complement Ther Med, 2018 Dec;41:154-160.
    PMID: 30477832 DOI: 10.1016/j.ctim.2018.08.015
    OBJECTIVE: To investigate the long-term effects of Tualang Honey versus Honey Cocktail (mixture of honey, bee bread, and royal jelly) on cardiovascular markers and anthropometric measurements of postmenopausal women.

    METHODS: We conducted a randomised, double blinded, two-armed parallel study comparing 20 g/day of Tualang Honey versus 20 g/day Honey Cocktail among postmenopausal women aged 45-65 years. The cardiovascular parameters and anthropometrics measurements were assessed at baseline, 6 months, and 12 months of the intervention.

    RESULTS: 100 subjects were successfully randomised into the groups. There was a significant decrease in the diastolic blood pressure from 77.92 mmHg at baseline to 73.45 mmHg at 12 months (F-statistic = 2.55, p-value = 0.047) in the Tualang Honey group compared to Honey Cocktail. There was also a significant decrease in the fasting blood sugar from 6.11 mmol/L at baseline to 5.71 mmol/L at 12 months (F-statistic = 4.03, p-value = 0.021) in the Tualang Honey group compared to the Honey Cocktail group. The body mass index remained unchanged at 27 kg/m2 (F-statistic = 1.60, p-value = 0.010) throughout 12 months of the intervention in the Honey Cocktail group.

    CONCLUSION: Subjects who received Honey Cocktail showed remarkable effects on body mass index. However, Tualang Honey supplementation showed superior effect in lowering diastolic blood pressure and fasting blood sugar compared to Honey Cocktail. Further studies are required to ascertain the underlying mechanism(s) of Tualang Honey and Honey Cocktail on each observed parameter.

  6. Tang LW, Alias Y, Zakaria R, Woi PM
    Crit Rev Anal Chem, 2023;53(4):869-886.
    PMID: 34672838 DOI: 10.1080/10408347.2021.1989657
    A detailed overview toward the advancement of amino acid-based electrochemical sensors on the detection of heavy metals is presented. Discussion is focused on the unique properties of various amino acids (AAs) and its composites which allow them being employed in a diverse range of sensing platforms. Formation of metal-ligand complexes in between metal ions and different AAs has been discussed. The essential insights on the interaction between amino acid-based sensors and target heavy metal ions (HMIs) are provided, along with the discussion on their pros and cons. Voltammetry analysis of metal ions based on various interfaces of electrochemical sensors has been highlighted, together with the incorporation of AAs with organic, inorganic and bio-materials. In all these cases, the amino acid modified electrodes have demonstrated large active surface area with abundant adsorption sites for HMIs. The developed sensors are promising for environmental applications, as evidenced by the high selectivity, high sensitivity, high catalytic activity, and low detection limits. The materials involved, fabrication techniques and its sensing mechanism were comprehensively discussed, and the future outlooks of electrochemical sensing platforms are emphasized in this review.
  7. Ping KS, Poobathy RR, Zakaria R, Subramaniam S
    Cryo Letters, 2018 5 8;38(4):290-298.
    PMID: 29734430
      BACKGROUND: Conservation of commercially important ornamental plants is important to maintain its unique beauty to cater the market demands.

    OBJECTIVE: The main objective is to develop an efficient cryopreservation technique for Aranda Broga Blue orchid PLBs using droplet-vitrification method.

    MATERIALS AND METHODS: Several critical factors in cryopreservation were accessed such as preculture concentrations and durations, choice of vitrification solutions, two-step or three-step vitrification, growth recovery medium and PVS2 exposure duration.

    RESULTS: The best growth regeneration percentage (5%) was obtained when 3-4mm PLBs were precultured in 0.2M sucrose for 3 days, followed by osmoprotection for 20 minutes, dehydration in PVS2 for 20 minutes at 0 degree C, LN storage, thawed and unloading for 20 minutes, and growth regeneration in VW10 medium. PLBs were found to be very sensitive to osmotic stress imposed by high molecular weight cryoprotectant such as sucrose and glycerol. Osmotic potential of growth recovery medium is one of the main factors that affect growth recovery in cryopreserved PLBs.

    CONCLUSION: Current report showed possibilities in cryopreserving Aranda Broga Blue PLBs using droplet-vitrification technique. However, further improvement of growth recovery can be done by focussing on approaches that facilitate sufficient water removal from PLBs without causing severe osmotic injuries to the plant cells.

  8. Vit P, van der Meulen J, Diaz M, Pedro SRM, Esperança I, Zakaria R, et al.
    Curr Res Food Sci, 2023;6:100386.
    PMID: 36846470 DOI: 10.1016/j.crfs.2022.11.005
    The biodiversity of Ecuadorian stingless bees is almost 200 species. Traditional pot-honey harvest in Ecuador is mostly done from nests of the three genera selected here Geotrigona Moure, 1943, Melipona Illiger, 1806, and Scaptotrigona Moure, 1942. The 20 pot-honey samples collected from cerumen pots and three ethnic honeys "abeja de tierra", "bermejo", and "cushillomishki" were analyzed for qualitative and quantitative targeted 1H-NMR honey profiling, and for the Honey Authenticity Test by Interphase Emulsion (HATIE). Extensive data of targeted organic compounds (41 parameters) were identified, quantified, and described. The three honey types were compared by ANOVA. Amino acids, ethanol, hydroxymethylfurfural, aliphatic organic acids, sugars, and markers of botanical origin. The number of phases observed with the HATIE were one in Scaptotrigona and three in Geotrigona and Melipona honeys. Acetic acid (19.60 ± 1.45 g/kg) and lactic acid (24.30 ± 1.65 g/kg) were particularly high in Geotrigona honey (in contrast to 1.3 g/kg acetic acid and 1.6 g/kg lactic acid in Melipona and Scaptotrigona), and with the lowest fructose + glucose (18.39 ± 1.68) g/100g honey compared to Melipona (52.87 ± 1.75) and Scaptotrigona (52.17 ± 0.60). Three local honeys were tested using PCA (Principal Component Analysis), two were assigned with a correct declared bee origin, but "bermejo" was not a Melipona and grouped with the Scaptotrigona cluster. However after HCA (Hierarchical Cluster Analysis) the three honeys were positioned in the Melipona-Scaptotrigona cluster. This research supports targeted 1H-NMR-based profiling of pot-honey metabolomics approach for multi-parameter visualization of organic compounds, as well as descriptive and pertained multivariate statistics (HCA and PCA) to discriminate the stingless bee genus in a set of Geotrigona, Melipona and Scaptotrigona honey types. The NMR characterization of Ecuadorian honey produced by stingless bees emphasizes the need for regulatory norms. A final note on stingless bee markers in pot-honey metabolites which should be screened for those that may extract phylogenetic signals from nutritional traits of honey. Scaptotrigona vitorum honey revealed biosurfactant activity in the HATIE, originating a fingerprint Honey Biosurfactant Test (HBT) for the genus in this set of pot-honeys.
  9. Law ZK, Tan HJ, Chin SP, Wong CY, Wan Yahya WNN, Muda AS, et al.
    Cytotherapy, 2021 Sep;23(9):833-840.
    PMID: 33992536 DOI: 10.1016/j.jcyt.2021.03.005
    BACKGROUND AIMS: Mesenchymal stromal cells (MSCs) are characterized by paracrine and immunomodulatory functions capable of changing the microenvironment of damaged brain tissue toward a more regenerative and less inflammatory milieu. The authors conducted a phase 2, single-center, assessor-blinded randomized controlled trial to investigate the safety and efficacy of intravenous autologous bone marrow-derived MSCs (BMMSCs) in patients with subacute middle cerebral artery (MCA) infarct.

    METHODS: Patients aged 30-75 years who had severe ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score of 10-35) involving the MCA territory were recruited within 2 months of stroke onset. Using permuted block randomization, patients were assigned to receive 2 million BMMSCs per kilogram of body weight (treatment group) or standard medical care (control group). The primary outcomes were the NIHSS, modified Rankin Scale (mRS), Barthel Index (BI) and total infarct volume on brain magnetic resonance imaging (MRI) at 12 months. All outcome assessments were performed by blinded assessors. Per protocol, analyses were performed for between-group comparisons.

    RESULTS: Seventeen patients were recruited. Nine were assigned to the treatment group, and eight were controls. All patients were severely disabled following their MCA infarct (median mRS = 4.0 [4.0-5.0], BI = 5.0 [5.0-25.0], NIHSS = 16.0 [11.5-21.0]). The baseline infarct volume on the MRI was larger in the treatment group (median, 71.7 [30.5-101.7] mL versus 26.7 [12.9-75.3] mL, P = 0.10). There were no between-group differences in median NIHSS score (7.0 versus 6.0, P = 0.96), mRS (2.0 versus 3.0, P = 0.38) or BI (95.0 versus 67.5, P = 0.33) at 12 months. At 12 months, there was significant improvement in absolute change in median infarct volume, but not in total infarct volume, from baseline in the treatment group (P = 0.027). No treatment-related adverse effects occurred in the BMMSC group.

    CONCLUSIONS: Intravenous infusion of BMMSCs in patients with subacute MCA infarct was safe and well tolerated. Although there was no neurological recovery or functional outcome improvement at 12 months, there was improvement in absolute change in median infarct volume in the treatment group. Larger, well-designed studies are warranted to confirm this and the efficacy of BMMSCs in ischemic stroke.

  10. Munjir N, Othman Z, Zakaria R, Shafin N, Hussain NA, Desa AM, et al.
    EXCLI J, 2015;14:801-8.
    PMID: 26600750 DOI: 10.17179/excli2015-280
    This study aims to develop two alternate forms for Malay version of Auditory Verbal Learning Test (MAVLT) and to determine their equivalency and practice effect. Ninety healthy volunteers were subjected to the following neuropsychological tests at baseline, and at one month interval according to their assigned group; group 1 (MAVLT - MAVLT), group 2 (MAVLT - Alternate Form 1 - Alternate Form 1), and group 3 (MAVLT - Alternate Form 2 - Alternate Form 2). There were no significant difference in the mean score of all the trials at baseline among the three groups, and most of the mean score of trials between MAVLT and Alternate Form 1, and between MAVLT and Alternate Form 2. There was significant improvement in the mean score of each trial when the same form was used repeatedly at the interval of one month. However, there was no significant improvement in the mean score of each trial when the Alternate Form 2 was used during repeated neuropsychological testing. The MAVLT is a reliable instrument for repeated neuropsychological testing as long as alternate forms are used. The Alternate Form 2 showed better equivalency to MAVLT and less practice effects.
  11. Zakaria WNA, Yoon SY, Wijaya A, Ahmad AH, Zakaria R, Othman Z
    Eur J Hum Genet, 2023 Oct;31(10):1181-1184.
    PMID: 37142766 DOI: 10.1038/s41431-023-01371-3
    This article seeks to highlight the most recent trends and themes in genetic counseling that are of broad interest. A total of 3505 documents were published between 1952 and 2021, with a trend toward increase in paper/year. The most common documents are original articles (2515, 71.8%), followed by review articles (341, 9.7%). Journal of Genetic Counseling publishes the highest number of genetic counseling articles (587, 16.7%), followed by Clinical Genetics (103, 2.9%) and the South American Journal of Medical Genetics (95, 2.7%). Co-occurrence analysis revealed five research themes: genetic testing, cancer, genetic counselor, prenatal diagnosis, and psychiatry. The genetic counselor theme contained most of the recent keywords, including "covid-19," "underrepresented population," "service delivery models," "workforce," "disparities," "service delivery," "professional development," "cultural competence," "access," "diversity," "telemedicine," and "health literacy." Genetic counseling researchers may use these keywords to find topics pertinent to their future research and practice.
  12. Azman KF, Safdar A, Zakaria R
    Exp Gerontol, 2021 07 15;150:111372.
    PMID: 33905879 DOI: 10.1016/j.exger.2021.111372
    Aging is associated with a variety of morphological and functional changes in the liver. Oxidative stress and inflammation are now widely accepted as the main mechanisms involved in the aging process that may subsequently cause severe injury to mitochondrial DNA which leads to apoptosis. As aging may increase the risks for various liver diseases and plays as an adverse prognostic factor increasing the mortality rate, knowledge regarding the mechanisms of age-related liver susceptibility and the possible therapeutic interventions is imperative. Due to cost and time constraints, a mimetic aging model is generally preferred to naturally aged animals to study the underlying mechanisms of aging liver. The use of D-galactose in aging research is dated back to 1962 and has since been used widely. This review aims to comprehensively summarize the effects of D-galactose-induced aging on the liver and the underlying mechanisms involved. Its potential therapeutic interventions are also discussed. It is hoped that this invaluable information may facilitate researchers in choosing the appropriate aging model and provide a valuable platform for testing potential therapeutic strategies for the prevention and treatment of age-related liver diseases.
  13. Haron MN, D'Souza UJ, Jaafar H, Zakaria R, Singh HJ
    Fertil. Steril., 2010 Jan;93(1):322-4.
    PMID: 19709655 DOI: 10.1016/j.fertnstert.2009.07.995
    Daily intraperitoneal injection of 5-30 microg/kg body weight of leptin for 42 days to adult rats decreases sperm count and increases the fraction of abnormal sperm.
  14. Zakaria R, Ahmad AH, Othman Z
    Folia Biol. (Praha), 2016;62(5):181-187.
    PMID: 27978412
    Pineal melatonin biosynthesis is regulated by the circadian clock located in the suprachiasmatic nucleus of the hypothalamus. Melatonin has been found to modulate the learning and memory process in human as well as in animals. Endogenous melatonin modulates the process of newly acquired information into long-term memory, while melatonin treatment has been found to reduce memory deficits in elderly people and in various animal models. However, the mechanisms mediating the enhancing effect of melatonin on memory remain elusive. This review intends to explore the possible mechanisms by looking at previous data on the effects of melatonin treatment on memory performance in rodents.
  15. Zamri NA, Ghani N, Ismail CAN, Zakaria R, Shafin N
    Front Aging Neurosci, 2022;14:1092596.
    PMID: 36733498 DOI: 10.3389/fnagi.2022.1092596
    Since ancient times, honey has been employed in many aspects of everyday life, the most popular of which is as a natural sweetener. Honey is used not only as a nutritional product but also in health as a supplement and in various applications, especially related to brain booster health. Brain health is the capacity to carry out all mental functions necessary for cognition, such as learning and judging, utilizing language, and recalling. This review presents the current trend of research on honey, particularly the interest in underlying mechanisms related to brain booster health. A total of 34 original articles addressing brain health from the consumption of honey were analyzed. We identified four main brain health benefits, which are memory booster, neuroprotective effect, anti-stress, and anti-nociceptive potentials with the proposed underlying mechanism. A lot of attention has been paid to the role that honey plays in brain health research, with the goal of examining the link between honey and brain health as well as the mechanism underlying it, the findings from this review may be potentially beneficial to develop new therapeutic roles for honey to help determine the best and most promising to benefit and boost overall brain health.
  16. Othman Z, Abdul Halim AS, Azman KF, Ahmad AH, Zakaria R, Sirajudeen KNS, et al.
    Front Aging Neurosci, 2022;14:876159.
    PMID: 35572132 DOI: 10.3389/fnagi.2022.876159
    OBJECTIVES: This study aimed to profile the cognitive aging research landscape from 1956 to 2021.

    METHODS: A total of 3,779 documents were retrieved from the Scopus database for the bibliometric analysis and network visualization. By comparing each keyword's overall connection strength (centrality), frequency (density), and average year of publication (novelty) to the calculated median values acquired from the overlay view of the VOSviewer map, the enhanced strategic diagrams (ESDs) were constructed.

    RESULTS: The findings showed an increasing trend in the number of publications. The United States leads the contributing countries in cognitive aging research. The scientific productivity pattern obeyed Lotka's law. The most productive researcher was Deary, I. J., with the highest number of publications. The collaborative index showed an increasing trend from 1980 onwards. Frontiers in Aging Neuroscience is the most prestigious journal in the field of cognitive aging research. In Bradford core journals zone 1, the top 10 core journals of cognitive aging research provided more than half of the total articles (697, or 55.36 percent).

    CONCLUSIONS: For the next decades, the trending topics in cognitive aging research include neuropsychological assessment, functional connectivity, human immunodeficiency virus (HIV), decision-making, gender, compensation, default mode network, learning and memory, brain-derived neurotrophic factor (BDNF), obesity, D-galactose, epigenetics, frailty, mortality, mini-mental state examination (MMSE), anxiety, and gait speed.

  17. Ab Aziz S, Mohd Nasir MH, Jusoh AR, Azman KF, Ismail CAN, Ahmad AH, et al.
    Heliyon, 2024 Feb 29;10(4):e26106.
    PMID: 38390049 DOI: 10.1016/j.heliyon.2024.e26106
    Olfactory marker protein (OMP) is extensively studied in mature olfactory receptor neurons (ORNs) for understanding olfaction physiology. However, no bibliometric analysis on this topic exists. We conducted a bibliometric analysis of OMP research articles, wherein the publication count was assessed by year, country, journal, and author, collaboration by country, and productivity of the authors. Additionally, key terms and research themes were identified. Using the search phrase "olfactory marker protein" in Scopus, we retrieved 691 original research articles by 2487 authors since 1974. Publications showed an increasing trend, with the United States leading in quantity and collaboration. Our thematic map highlights "Olfactory bulb, regeneration, olfactory" as the primary research domain, while "olfaction, olfactory sensory neuron, glomerulus" and "olfactory receptor neurons, apoptosis, olfactory dysfunction" emerge as essential future research topics. These bibliometric findings offer insights into the global OMP research landscape, guiding researchers in potential collaborations and intriguing future research fields.
  18. Qaid E, Zakaria R, Sulaiman SF, Yusof NM, Shafin N, Othman Z, et al.
    Hum Exp Toxicol, 2017 Dec;36(12):1315-1325.
    PMID: 28111974 DOI: 10.1177/0960327116689714
    Impairment of memory is one of the most frequently reported symptoms during sudden hypoxia exposure in human. Cortical atrophy has been linked to the impaired memory function and is suggested to occur with chronic high-altitude exposure. However, the precise molecular mechanism(s) of hypoxia-induced memory impairment remains an enigma. In this work, we review hypoxia-induced learning and memory deficit in human and rat studies. Based on data from rat studies using different protocols of continuous hypoxia, we try to elicit potential mechanisms of hypobaric hypoxia-induced memory deficit.
  19. Srinivasan V, Mohamed M, Zakaria R, Ahmad AH
    Infect Disord Drug Targets, 2012 Oct;12(5):371-9.
    PMID: 23082960
    Malaria, one of the most deadly diseases of our time affects more than 200 million people across the globe and is responsible for about one million deaths annually. Until recently Plasmodium falciparum has been the main cause for malarial infection in human beings but now Plasmodium knowlesi from Malaysia remains as one of the most virulent parasite spreading fast not only in Malaysia but in different parts of the world. Hence there is urgent need for the global fight to control malaria. Global malaria eradication program by use of insecticide spraying has resulted in good response in the past. Treatment of malaria infected patients with anti-malarial drugs has helped to eliminate malarial infections successfully but with increased resistance displayed by malarial parasites to these drugs there is resurgence of malaria caused both by drug resistance as well as by infection caused by new malarial species like Plasmodium knowlesi. With recent advances on molecular studies on malarial parasites it is now clear that the pineal hormone melatonin acts as a cue for growth and development of Plasmodium falciparum. Same may be true for Plasmodium knowlesi also. Hence treatment modalities that can effectively block the action of melatonin on Plasmodium species during night time by way of using either bright light therapy or use of melatonin receptor blocking can be considered as useful approaches for eliminating malarial infection in man.
  20. Sajid MR, Muhammad N, Zakaria R, Shahbaz A, Bukhari SAC, Kadry S, et al.
    Interdiscip Sci, 2021 Jun;13(2):201-211.
    PMID: 33675528 DOI: 10.1007/s12539-021-00423-w
    BACKGROUND: In the broader healthcare domain, the prediction bears more value than an explanation considering the cost of delays in its services. There are various risk prediction models for cardiovascular diseases (CVDs) in the literature for early risk assessment. However, the substantial increase in CVDs-related mortality is challenging global health systems, especially in developing countries. This situation allows researchers to improve CVDs prediction models using new features and risk computing methods. This study aims to assess nonclinical features that can be easily available in any healthcare systems, in predicting CVDs using advanced and flexible machine learning (ML) algorithms.

    METHODS: A gender-matched case-control study was conducted in the largest public sector cardiac hospital of Pakistan, and the data of 460 subjects were collected. The dataset comprised of eight nonclinical features. Four supervised ML algorithms were used to train and test the models to predict the CVDs status by considering traditional logistic regression (LR) as the baseline model. The models were validated through the train-test split (70:30) and tenfold cross-validation approaches.

    RESULTS: Random forest (RF), a nonlinear ML algorithm, performed better than other ML algorithms and LR. The area under the curve (AUC) of RF was 0.851 and 0.853 in the train-test split and tenfold cross-validation approach, respectively. The nonclinical features yielded an admissible accuracy (minimum 71%) through the LR and ML models, exhibiting its predictive capability in risk estimation.

    CONCLUSION: The satisfactory performance of nonclinical features reveals that these features and flexible computational methodologies can reinforce the existing risk prediction models for better healthcare services.

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