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  1. Wahaj Z, Alam MM, Al-Amin AQ
    Environ Sci Pollut Res Int, 2022 Mar;29(11):16739-16748.
    PMID: 34989992 DOI: 10.1007/s11356-021-18402-5
    Pandemics leave their mark quickly. This is true for all pandemics, including COVID-19. Its multifarious presence has wreaked havoc on people's physical, economic, and social life since late 2019. Despite the need for social science to save lives, it is also critical to ensure future generations are protected. COVID-19 appeared as the world grappled with the epidemic of climate change. This study suggests policymakers and practitioners address climate change and COVID-19 together. This article offers a narrative review of both pandemics' impacts. Scopus and Web of Science were sought databases. The findings are reported analytically using important works of contemporary social theorists. The analysis focuses on three interconnected themes: technology advancements have harmed vulnerable people; pandemics have macro- and micro-dimensions; and structural disparities. To conclude, we believe that collaborative effort is the key to combating COVID-19 and climate change, while understanding the lessons learnt from the industrialised world. Finally, policymakers can decrease the impact of global catastrophes by addressing many socioeconomic concerns concurrently.
  2. Rahman MA, Ahmad R, Ismail I
    Environ Sci Pollut Res Int, 2023 Feb;30(6):15689-15707.
    PMID: 36173521 DOI: 10.1007/s11356-022-23189-0
    This study measures the impact of the implementation of the Regional Greenhouse Gas Initiative (RGGI) on firms' green innovation initiatives. We used 20 years of panel data from the Fortune 500 list of the US largest companies. Based on DID, a benchmark regression, the RGGI has a significant adverse effect on the green innovation of Fortune 500 companies, and we verified these findings with multiple robustness tests. As we investigate how energy-intensive industries were affected by RGGI, we found that it slowed down green innovation, but it was not statistically significant. This study provides a novel perspective on how the RGGI influences green innovation in firms and how different types of sectors respond to the policy. The findings indicate that the "weak" Porter Hypothesis has not been confirmed in the present carbon trading market (particularly the RGGI) for Fortune 500 firms in the USA. In terms of policy, we believe that a well-covered and differentiated legislation that fosters green innovation while being realistic about the policy's goal and the firm's environmental attitude, like emissions reduction through green innovation, is essential.
  3. Aktar MA, Alam MM, Harun M
    PMID: 35028847 DOI: 10.1007/s11356-021-18257-w
    Reduced electricity demand through the implementation of an energy efficiency policy is a central pillar of the Malaysian government's energy strategy. Energy efficiency first emerged as part of Malaysia's energy policy agenda in 1979 but only came into force during the 2000s. Initially, it was seen from global fears about the shortage of fossil fuels, then as a way of combating climate change. This paper offers a comprehensive review of Malaysia's energy policies with a focus on adopting policies to improve energy efficiency. Starting with Malaysia's preliminary policy in response to the OPEC-driven global oil crisis in 1973, the paper discusses how policymakers are considering energy efficiency from Malaysia's sustainable development perspective and what relevant government efforts have been made to improve it. The review evaluates the progress that has been made over the past 25 years to address energy efficiency in the economy and highlights the achievements and remaining difficulties. Findings show that the level of energy efficiency while having shown improvement during 1990-2015 was lower than expected. In terms of electricity intensity of GDP, Malaysia has a relatively large position among the ASEAN countries and the world's largest electricity consumers. Researchers, scientists, and practitioners will benefit from the extensive review material of this study, which will help them better understand energy efficiency and the sustainability strategy implemented in Malaysia to date.
  4. Jion MMMF, Jannat JN, Mia MY, Ali MA, Islam MS, Ibrahim SM, et al.
    Sci Total Environ, 2023 Mar 13;876:162851.
    PMID: 36921864 DOI: 10.1016/j.scitotenv.2023.162851
    Nitrogen dioxide (NO2) and sulfur dioxide (SO2) are two major atmospheric pollutants that significantly threaten human health, the environment, and ecosystems worldwide. Despite this, only some studies have investigated the spatiotemporal hotspots of NO2 and SO2, their trends, production, and sources in Asia. Our study presents a literature review covering the production, trends, and sources of NO2 and SO2 across Asian countries (e.g., Bangladesh, China, India, Iran, Japan, Pakistan, Malaysia, Kuwait, and Nepal). Based on the findings of the review, NO2 and SO2 pollution are increasing due to industrial activity, fossil fuel burning, biomass burning, heavy traffic movement, electricity generation, and power plants. There is significant concern about health risks associated with NO2 and SO2 emissions in Bangladesh, China, India, Malaysia, and Iran, as they pay less attention to managing and controlling pollution. Even though the lack of quality datasets and adequate research in most Asian countries further complicates the management and control of NO2 and SO2 pollution. This study has NO2 and SO2 pollution scenarios, including hotspots, trends, sources, and their influences on Asian countries. This study highlights the existing research gaps and recommends new research on identifying integrated sources, their variations, spatiotemporal trends, emission characteristics, and pollution level. Finally, the present study suggests a framework for controlling and monitoring these two pollutants' emissions.
  5. Zubair M, Anwar F, Ashraf M, Uddin MK
    Int J Mol Sci, 2012;13(4):4608-4622.
    PMID: 22605998 DOI: 10.3390/ijms13044608
    The present study reports the composition and variation of fatty acids, sterols, tocopherols and γ-oryzanol among selected varieties namely Basmati Super, Basmati 515, Basmati 198, Basmati 385, Basmati 2000, Basmati 370, Basmati Pak, KSK-139, KS-282 and Irri-6 of Pakistani rice (Oryza sativa L). Oil content extracted with n-hexane from different varieties of brown rice seed (unpolished rice) ranged from 1.92% to 2.72%. Total fatty acid contents among rice varieties tested varied between 18240 and 25840 mg/kg brown rice seed. The rice tested mainly contained oleic (6841-10952 mg/kg) linoleic (5453-7874 mg/kg) and palmitic acid (3613-5489 mg/kg). The amounts of total phytosterols (GC and GC-MS analysis), with main contribution from β-sitosterol (445-656 mg/kg), campesterol (116-242 mg/kg), Δ(5)-avenasterol (89-178 mg/kg) and stigmasterol (75-180 mg/kg) were established to be 739.4 to 1330.4 mg/kg rice seed. The content of α-, γ- and δ-tocopherols as analyzed by HPLC varied from 39.0-76.1, 21.6-28.1 and 6.5-16.5 mg/kg rice seed, respectively. The amounts of different γ-oryzanol components (HPLC data), identified as cycloartenyl ferulate, 24-methylene cycloartanyl ferulate, campesteryl ferulate and β-sitosteryl ferulate, were in the range of 65.5-103.6, 140.2-183.1, 29.8-45.5 and 8.6-10.4 mg/kg rice seed, respectively. Overall, the concentration of these bioactives was higher in the Basmati rice cultivars showing their functional food superiority. In conclusion, the tested varieties of Pakistani rice, especially the Basmati cultivars, can provide best ingredients for functional foods.
  6. Masud MAA, Shin WS, Septian A, Samaraweera H, Khan IJ, Mohamed MM, et al.
    Sci Total Environ, 2024 May 20;926:171944.
    PMID: 38527542 DOI: 10.1016/j.scitotenv.2024.171944
    Fluoroquinolone (FQ) antibiotics have become a subject of growing concern due to their increasing presence in the environment, particularly in the soil and groundwater. This review provides a comprehensive examination of the attributes, prevalence, ecotoxicity, and remediation approaches associated with FQs in environmental matrices. The paper discusses the physicochemical properties that influence the fate and transport of FQs in soil and groundwater, exploring the factors contributing to their prevalence in these environments. Furthermore, the ecotoxicological implications of FQ contamination in soil and aquatic ecosystems are reviewed, shedding light on the potential risks to environmental and human health. The latter part of the review is dedicated to an extensive analysis of remediation approaches, encompassing both in-situ and ex-situ methods employed to mitigate FQ contamination. The critical evaluation of these remediation strategies provides insights into their efficacy, limitations, and environmental implications. In this investigation, a correlation between FQ antibiotics and climate change is established, underlining its significance in addressing the Sustainable Development Goals (SDGs). The study further identifies and delineates multiple research gaps, proposing them as key areas for future investigational directions. Overall, this review aims to consolidate current knowledge on FQs in soil and groundwater, offering a valuable resource for researchers, policymakers, and practitioners engaged in environmental management and public health.
  7. Hossen MJ, Ramanathan TT, Al Mamun A
    Int J Telemed Appl, 2024;2024:8188904.
    PMID: 38660584 DOI: 10.1155/2024/8188904
    The respiratory disease of coronavirus disease 2019 (COVID-19) has wreaked havoc on the economy of every nation by infecting and killing millions of people. This deadly disease has taken a toll on the life of the entire human race, and an exact cure for it is still not developed. Thus, the control and cure of this disease mainly depend on restricting its transmission rate through early detection. The detection of coronavirus infection facilitates the isolation and exclusive care of infected patients. This research paper proposes a novel data mining system that combines the ensemble feature selection method and machine learning classifier for the effective identification of COVID-19 infection. Different feature selection approaches including chi-square test, recursive feature elimination (RFE), genetic algorithm (GA), particle swarm optimization (PSO), and random forest are evaluated for their effectiveness in enhancing the classification accuracy of the machine learning classifiers. The classifiers that are considered in this research work are decision tree, naïve Bayes, K-nearest neighbor (KNN), multilayer perceptron (MLP), and support vector machine (SVM). Two COVID-19 datasets were used for testing from which the best features supporting the dataset were extracted by the proposed system. The performance of the machine learning classifiers based on the ensemble feature selection methods is analyzed.
  8. Yan LY, Peng TL, Goni MD
    Vet Parasitol Reg Stud Reports, 2024 Jan;47:100952.
    PMID: 38199695 DOI: 10.1016/j.vprsr.2023.100952
    The close relationship between dogs and humans has led to concerns regarding the transmission of zoonotic pathogens through ectoparasites such as ticks. This study aimed to investigate the occurrence of ticks and the intensity on stray dogs with specific risk factors (size, sex, neutering status, body part). Additionally, identifying the predilection sites of ticks on stray dogs was crucial for developing an effective tick control program in Malaysia. A cross-sectional study was conducted among 64 stray dogs from Kelantan and Selangor States. These dogs were subjected to integumentary examinations, collecting 431 ticks comprising Rhipicephalus sanguineus s.l. "tropical lineage" and Haemaphysalis bispinosa from 53 infested dogs. The overall occurrence of tick infestation was 82.81% (53/64), with an average intensity of 8.13 ticks (range: 1-17) per stray dog. All the potential risk factors considered in this study showed no statistically significant result (P value >0.05). The head, ear, and neck were the most preferred attachment sites for ticks. These findings underscore the importance of implementing tick control programs for stray dogs, which serve as reservoirs of ticks and tick-borne pathogens for owned dogs and humans.
  9. Arafath MA, Kwong HC, Adam F
    Acta Crystallogr E Crystallogr Commun, 2019 May 01;75(Pt 5):571-575.
    PMID: 31110788 DOI: 10.1107/S2056989019004444
    In the title compound, C10H13N3OS, the azomethine C=N double bond has an E configuration. The phenyl ring and methyl-hydrazine carbo-thio-amide moiety [maximum deviation = 0.008 (2) Å] are twisted slightly with a dihedral angle of 14.88 (10)°. In the crystal, mol-ecules are linked into sheets parallel to the ab plane via N-H⋯S hydrogen bonds and C-H⋯π inter-actions.
  10. Arafath MA, Kwong HC, Adam F
    Acta Crystallogr E Crystallogr Commun, 2019 Jul 01;75(Pt 7):1065-1068.
    PMID: 31392026 DOI: 10.1107/S2056989019008946
    The asymmetric unit of the title compound, C15H21N3OS, comprises of two crystallographically independent mol-ecules (A and B). Each mol-ecule consists of a cyclo-hexane ring and a 2-hy-droxy-3-methyl-benzyl-idene ring bridged by a hydrazinecarbo-thio-amine unit. Both mol-ecules exhibit an E configuration with respect to the azomethine C=N bond. There is an intra-molecular O-H⋯N hydrogen bond in each mol-ecule forming an S(6) ring motif. The cyclo-hexane ring in each mol-ecule has a chair conformation. The benzene ring is inclined to the mean plane of the cyclo-hexane ring by 47.75 (9)° in mol-ecule A and 66.99 (9)° in mol-ecule B. The mean plane of the cyclo-hexane ring is inclined to the mean plane of the thio-urea moiety [N-C(=S)-N] by 55.69 (9) and 58.50 (8)° in mol-ecules A and B, respectively. In the crystal, the A and B mol-ecules are linked by N-H⋯S hydrogen bonds, forming 'dimers'. The A mol-ecules are further linked by a C-H⋯π inter-action, hence linking the A-B units to form ribbons propagating along the b-axis direction. The conformation of a number of related cyclo-hexa-nehydrazinecarbo-thio-amides are compared to that of the title compound.
  11. Daghash H, Abdullah KL, Ismail MD
    Qual Manag Health Care, 2022 02 16;31(3):114-121.
    PMID: 35180731 DOI: 10.1097/QMH.0000000000000336
    BACKGROUND AND OBJECTIVES: A care pathway is a structured care plan based on best clinical practice for a particular patient group. It reorganizes a complex process by providing structured, standardized care and supportive multidisciplinary teamwork. Although care pathways are used worldwide, the impact and benefit of a care pathway for coronary care practices have been minimally debated. This preliminary study aimed to examine the effect of a care pathway on the autonomy, teamwork, and burnout levels among coronary care nurses in a tertiary hospital.

    METHODS: A preliminary study was conducted using a pre/posttest one-group quasi-experimental design. A self-administered questionnaire was provided to 37 registered nurses from the cardiac ward of a tertiary hospital. The care pathway was developed on the basis of the current literature, local guidelines, and expert panel advice. The autonomy, teamwork, and burnout levels at the beginning and 4 months after disseminating the care pathway were measured. Implementing the care pathway included educational sessions, training in using the care pathway, and site visits to monitor nursing practices.

    RESULTS: Most of the respondents were female (94.6%; n = 35), the median age of the respondents was 26.5 years (interquartile range [IQR] = 23-31), and the median length of the clinical experience was 4 years (IQR = 2-8). A statistically significant reduction in the mean burnout score was observed (mean of 58.12 vs 52.69, P < .05). A slight improvement in autonomy level was found, although it was not statistically significant. No statistically significant improvement was found in the teamwork levels.

    CONCLUSION: The care pathway was associated with reduced nurse burnout. The results showed a slight improvement in autonomy level among coronary care nurses after implementing the care pathway. From a practical viewpoint, the current study can help policy makers and managers reduce burnout. This study highlights the importance of using care pathways as a tool to reorganize the care process and improve the working environment. Managers must support nursing decisions and provide continuous education to enhance nurses' autonomy, which may increase understanding of respective roles, leading to higher levels of teamwork. However, with a small sample size, caution must be applied, as the findings might not be generalizable.

  12. Rahman M, Islam MJ, Haque SE, Saw YM, Haque MN, Duc NH, et al.
    Public Health Nutr, 2017 Feb;20(2):305-314.
    PMID: 27608854 DOI: 10.1017/S136898001600224X
    OBJECTIVE: To explore the association between high-risk fertility behaviours and the likelihood of chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women of reproductive age.

    DESIGN: The 2011 Bangladesh Demographic and Health Survey, conducted from 8 July to 27 December 2011.

    SETTING: Selected urban and rural areas of Bangladesh.

    SUBJECTS: A total of 2197 ever-married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of high-risk fertility behaviours. We considered three parameters, maternal age at the time of delivery, birth order and birth interval, to define the high-risk fertility behaviours. Chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women were the outcome variables.

    RESULTS: A substantial percentage of women were exposed to have a high-risk fertility pattern (41·8 %); 33·0 % were at single high-risk and 8·8 % were at multiple high-risk. After adjusting for relevant covariates, high-risk fertility behaviours were associated with increased likelihood of chronic undernutrition (adjusted relative risk; 95 % CI: 1·22; 1·03, 1·44), anaemia (1·12; 1·00, 1·25) and the coexistence of anaemia and undernutrition (1·52; 1·17, 1·98). Furthermore, multiple high-risk fertility behaviours appeared to have more profound consequences on the outcome measured.

    CONCLUSIONS: Maternal high-risk fertility behaviours are shockingly frequent practices among women in Bangladesh. High-risk fertility behaviours are important predictors of the increased likelihood of women's chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition.

  13. Zara J, Nordin SM, Isha ASN
    Front Public Health, 2023;11:1225995.
    PMID: 37614453 DOI: 10.3389/fpubh.2023.1225995
    Health, safety, and environment (HSE) are critical aspects of any industry, particularly in high-risk environments, such as the oil and gas industry. Continuous accident reports indicate the requirement for the effective implementation of safety rules, regulations, and practices. This systematic literature review examines the relationship between safety communication and safety commitment in high-risk workplaces, specifically focusing on the oil and gas industry. The review comprises 1,439 articles from 2004 to 2023, retrieved from the Scopus and Web of Science databases following the PRISMA comprehensive guidelines. This study considers safety communication, communication climate, and communication satisfaction to evaluate their influence on safety commitment under occupational health and safety. This study identifies safety commitment issues and their underlying factors, discussing measures for preventing and reducing accidents and incidents and highlighting preventive measures for future research. It also signifies the variables influencing accident and incident rates. The research underscores the importance of communication dimensions and the need for workers to possess adequate skills, knowledge, and attitudes regarding occupational safety and health procedures. Moreover, the study contributes to the industrial and academic domains by improving organizational safety commitment, promoting a safety culture, and developing effective communication strategies. Furthermore, practitioners may benefit from this comprehensive overview in developing, evaluating, and enhancing occupational safety.
  14. Jing X, Sarker MMR, Gifari MAJ, Maruf MRA, Alam S, Khan F, et al.
    Cell Mol Biol (Noisy-le-grand), 2022 Sep 30;68(9):1-13.
    PMID: 36905282 DOI: 10.14715/cmb/2022.68.9.1
    Piper betle L. leaves are very popular and traditionally used to chew with betel nut in many Asian countries. In this study, P. betle leaves juice (PBJ) was subjected to evaluation for its antihyperlipidemic activity in the high-fat-diet-induced hyperlipidemic rats model. Swiss albino rats were allowed to high-fat- diet for one month, followed by concurrent administration of PBJ for another month. The rats were then sacrificed and collected blood, tissues and organs. Pharmacokinetic, toxicological studies and molecular docking studies were performed using SwissADME, admetSAR and schrodinger suit-2017. Our investigation showed a promising effect of PBJ on body weight, lipid profile, oxidative and antioxidative enzymes, and the principle enzyme responsible for the synthesis of cholesterol. PBJ at 0.5 - 3.0 mL/rat significantly reduced body weight of hyperlipidemic rats compared to control. PBJ at the doses of 1.0, 1.5, 2.0, and 3.0 mL/rat significantly (p<0.05, p<0.01, p<0.001) improved the levels of TC, LDL-c, TG, HDL-c and VLDL-c. Similarly, PBJ doses starting from 1.0 mL/rat to 3.0 mL/rat reduced the oxidative biomarkers AST, ALT, ALP, and creatinine. The level of HMG-CoA was significantly reduced by PBJ doses 1.5, 2, and 3 ml/rat. A number of compounds have been found to have good pharmacokinetic profile and safety and 4-coumaroylquinic acid exerted the best docking score among them. Thus our findings clearly demonstrated the potential lipid-lowering activities of PBJ both in vivo and in silico studies. PBJ can be a good candidate for the development of antihyperlipidemic medication or as an alternative medicine.
  15. Islam MA, Kundu S, Hassan R
    Curr Gene Ther, 2020;19(6):376-385.
    PMID: 32141417 DOI: 10.2174/1566523220666200306092556
    Multiple Sclerosis (MS) is the most common autoimmune demyelinating disease of the Central Nervous System (CNS). It is a multifactorial disease which develops in an immune-mediated way under the influences of both genetic and environmental factors. Demyelination is observed in the brain and spinal cord leading to neuro-axonal damage in patients with MS. Due to the infiltration of different immune cells such as T-cells, B-cells, monocytes and macrophages, focal lesions are observed in MS. Currently available medications treating MS are mainly based on two strategies; i) to ease specific symptoms or ii) to reduce disease progression. However, these medications tend to induce different adverse effects with limited therapeutic efficacy due to the protective function of the blood-brain barrier. Therefore, researchers have been working for the last four decades to discover better solutions by introducing gene therapy approaches in treating MS generally by following three strategies, i) prevention of specific symptoms, ii) halt or reverse disease progression and iii) heal CNS damage by promoting remyelination and axonal repair. In last two decades, there have been some remarkable successes of gene therapy approaches on the experimental mice model of MS - experimental autoimmune encephalomyelitis (EAE) which suggests that it is not far that the gene therapy approaches would start in human subjects ensuring the highest levels of safety and efficacy. In this review, we summarised the gene therapy approaches attempted in different animal models towards treating MS.
  16. Sukindar NA, Md Yasir ASH, Azhar MD, Md Azhar MA, Abd Halim NFH, Sulaiman MH, et al.
    Heliyon, 2024 Feb 29;10(4):e25508.
    PMID: 38384568 DOI: 10.1016/j.heliyon.2024.e25508
    Fused deposition modeling (FDM) is currently used in several fields, such as architecture, manufacturing, and medical applications. FDM was initially developed to produce and create prototypes, but the expense appears excessive for producing final products. Nevertheless, in this day and age, engineers have developed a low-cost 3D printer. One of the major issues with low-cost 3D printers is the low dimensional accuracy and high tolerances of the printed products. Herein, different printing parameters, i.e., layer thickness, printing speed, and raster angle, need to be investigated to enhance the surface roughness of the parts produced using FDM. Thus, the present study focuses on investigating the performance of the surface finish produced by FDM by manipulating different parameters such as layer thickness, printing speed, and raster angle. Taguchi's method, based on the L9 array for experimental design, was employed to elucidate the response variables. The sample model was developed following ISO standards, utilizing polylactic acid (PLA)-aluminum as the filament material. The analysis of variance results indicated that the layer thickness and raster angle significantly affect the surface roughness of the printed parts, with statistical P-values of 0.016 and 0.039, respectively. This enables an easy selection of the optimal printing parameters to achieve the desired surface roughness. The dimensional accuracy of the fabricated part was also evaluated. Thirteen dimensions of the part features were analyzed, and the results showed that the FDM machine exhibited good accuracy for most of the shapes, with a deviation below 5%.
  17. Hossen MA, Reza ASMA, Ahmed AMA, Islam MK, Jahan I, Hossain R, et al.
    Biomed Pharmacother, 2021 Mar;135:111211.
    PMID: 33421733 DOI: 10.1016/j.biopha.2020.111211
    Blumea lacera (Burm.f.) DC. is described as a valuable medicinal plant in various popular systems of medicine. The aim of the experiment reports the in vivo antiulcer activity of methanol extract of Blumea lacera (MEBLL) and in silico studies of bioactive constituents of MEBLL. In this study, fasted Long-Evans rat treated with 80 % ethanol (0.5 mL) to induce gastric ulcer, were pretreated orally with MEBLL at different doses (250 and 500 mg/kg, p.o., b.w) and omeprazole (20 mg/kg, p.o.) and distilled water were used as a reference drug and normal control respectively. In silico activity against gastric H+-K+ATPase enzyme was also studied. The findings demonstrated that the treatment with MEBLL attenuated markedly ulcer and protected the integrity of the gastric mucosa by preventing the mucosal ulceration altered biochemical parameters of gastric juice such total carbohydrate, total protein and pepsin activity. Additionally, the experimental groups significantly (p 
  18. Menke JM, Ahsan MS, Khoo SP
    Biomark Cancer, 2017;9:1179299X17732007.
    PMID: 29085239 DOI: 10.1177/1179299X17732007
    Signal detection and Bayesian inferential tools were applied to salivary biomarkers to improve screening accuracy and efficiency in detecting oral squamous cell carcinoma (OSCC). Potential cancer biomarkers are identified by significant differences in assay concentrations, receiver operating characteristic areas under the curve (AUCs), sensitivity, and specificity. However, the end goal is to report to individual patients their risk of having disease given positive or negative test results. Likelihood ratios (LRs) and Bayes factors (BFs) estimate evidential support and compile biomarker information to optimize screening accuracy. In total, 26 of 77 biomarkers were mentioned as having been tested at least twice in 137 studies and published in 16 summary papers through 2014. Studies represented 10 212 OSCC and 25 645 healthy patients. The measure of biomarker and panel information value was number of biomarkers needed to approximate 100% positive predictive value (PPV). As few as 5 biomarkers could achieve nearly 100% PPV for a disease prevalence of 0.2% when biomarkers were ordered from highest to lowest LR. When sequentially interpreting biomarker tests, high specificity was more important than test sensitivity in achieving rapid convergence toward a high PPV. Biomarkers ranked from highest to lowest LR were more informative and easier to interpret than AUC or Youden index. The proposed method should be applied to more recently published biomarker data to test its screening value.
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