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  1. Ahmad Fadzil MH, Izhar LI, Nugroho H, Nugroho HA
    Med Biol Eng Comput, 2011 Jun;49(6):693-700.
    PMID: 21271293 DOI: 10.1007/s11517-011-0734-2
    Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. In this article, a computerised DR grading system, which digitally analyses retinal fundus image, is used to measure foveal avascular zone. A v-fold cross-validation method is applied to the FINDeRS database to evaluate the performance of the DR system. It is shown that the system achieved sensitivity of >84%, specificity of >97% and accuracy of >95% for all DR stages. At high values of sensitivity (>95%), specificity (>97%) and accuracy (>98%) obtained for No DR and severe NPDR/PDR stages, the computerised DR grading system is suitable for early detection of DR and for effective treatment of severe cases.
  2. Ahmad Fadzil MH, Izhar LI, Nugroho HA
    Comput Biol Med, 2010 Jul;40(7):657-64.
    PMID: 20573343 DOI: 10.1016/j.compbiomed.2010.05.004
    Monitoring FAZ area enlargement enables physicians to monitor progression of the DR. At present, it is difficult to discern the FAZ area and to measure its enlargement in an objective manner using digital fundus images. A semi-automated approach for determination of FAZ using color images has been developed. Here, a binary map of retinal blood vessels is computer generated from the digital fundus image to determine vessel ends and pathologies surrounding FAZ for area analysis. The proposed method is found to achieve accuracies from 66.67% to 98.69% compared to accuracies of 18.13-95.07% obtained by manual segmentation of FAZ regions from digital fundus images.
  3. Ku Abd Rahim KN, Elamvazuthi I, Izhar LI, Capi G
    Sensors (Basel), 2018 Nov 26;18(12).
    PMID: 30486242 DOI: 10.3390/s18124132
    Increasing interest in analyzing human gait using various wearable sensors, which is known as Human Activity Recognition (HAR), can be found in recent research. Sensors such as accelerometers and gyroscopes are widely used in HAR. Recently, high interest has been shown in the use of wearable sensors in numerous applications such as rehabilitation, computer games, animation, filmmaking, and biomechanics. In this paper, classification of human daily activities using Ensemble Methods based on data acquired from smartphone inertial sensors involving about 30 subjects with six different activities is discussed. The six daily activities are walking, walking upstairs, walking downstairs, sitting, standing and lying. It involved three stages of activity recognition; namely, data signal processing (filtering and segmentation), feature extraction and classification. Five types of ensemble classifiers utilized are Bagging, Adaboost, Rotation forest, Ensembles of nested dichotomies (END) and Random subspace. These ensemble classifiers employed Support vector machine (SVM) and Random forest (RF) as the base learners of the ensemble classifiers. The data classification is evaluated with the holdout and 10-fold cross-validation evaluation methods. The performance of each human daily activity was measured in terms of precision, recall, F-measure, and receiver operating characteristic (ROC) curve. In addition, the performance is also measured based on the comparison of overall accuracy rate of classification between different ensemble classifiers and base learners. It was observed that overall, SVM produced better accuracy rate with 99.22% compared to RF with 97.91% based on a random subspace ensemble classifier.
  4. Ahmad Fadzil M, Ngah NF, George TM, Izhar LI, Nugroho H, Adi Nugroho H
    PMID: 21097305 DOI: 10.1109/IEMBS.2010.5628041
    Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. At present, the classification of DR is based on the International Clinical Diabetic Retinopathy Disease Severity. In this paper, FAZ enlargement with DR progression is investigated to enable a new and an effective grading protocol DR severity in an observational clinical study. The performance of a computerised DR monitoring and grading system that digitally analyses colour fundus image to measure the enlargement of FAZ and grade DR is evaluated. The range of FAZ area is optimised to accurately determine DR severity stage and progression stages using a Gaussian Bayes classifier. The system achieves high accuracies of above 96%, sensitivities higher than 88% and specificities higher than 96%, in grading of DR severity. In particular, high sensitivity (100%), specificity (>98%) and accuracy (99%) values are obtained for No DR (normal) and Severe NPDR/PDR stages. The system performance indicates that the DR system is suitable for early detection of DR and for effective treatment of severe cases.
  5. Ahmad Fadzil MH, Izhar LI, Venkatachalam PA, Karunakar TV
    J Med Eng Technol, 2007 Nov-Dec;31(6):435-42.
    PMID: 17994417 DOI: 10.1080/03091900601111201
    Information about retinal vasculature morphology is used in grading the severity and progression of diabetic retinopathy. An image analysis system can help ophthalmologists make accurate and efficient diagnoses. This paper presents the development of an image processing algorithm for detecting and reconstructing retinal vasculature. The detection of the vascular structure is achieved by image enhancement using contrast limited adaptive histogram equalization followed by the extraction of the vessels using bottom-hat morphological transformation. For reconstruction of the complete retinal vasculature, a region growing technique based on first-order Gaussian derivative is developed. The technique incorporates both gradient magnitude change and average intensity as the homogeneity criteria that enable the process to adapt to intensity changes and intensity spread over the vasculature region. The reconstruction technique reduces the required number of seeds to near optimal for the region growing process. It also overcomes poor performance of current seed-based methods, especially with low and inconsistent contrast images as normally seen in vasculature regions of fundus images. Simulations of the algorithm on 20 test images from the DRIVE database show that it outperforms many other published methods and achieved an accuracy range (ability to detect both vessel and non-vessel pixels) of 0.91 - 0.95, a sensitivity range (ability to detect vessel pixels) of 0.91 - 0.95 and a specificity range (ability to detect non-vessel pixels) of 0.88 - 0.94.
  6. Abdul Wahit MA, Ahmad SA, Marhaban MH, Wada C, Izhar LI
    Sensors (Basel), 2020 Jul 27;20(15).
    PMID: 32727150 DOI: 10.3390/s20154174
    Trans-radial prosthesis is a wearable device that intends to help amputees under the elbow to replace the function of the missing anatomical segment that resembles an actual human hand. However, there are some challenging aspects faced mainly on the robot hand structural design itself. Improvements are needed as this is closely related to structure efficiency. This paper proposes a robot hand structure with improved features (four-bar linkage mechanism) to overcome the deficiency of using the cable-driven actuated mechanism that leads to less structure durability and inaccurate motion range. Our proposed robot hand structure also took into account the existing design problems such as bulky structure, unindividual actuated finger, incomplete fingers and a lack of finger joints compared to the actual finger in its design. This paper presents the improvements achieved by applying the proposed design such as the use of a four-bar linkage mechanism instead of using the cable-driven mechanism, the size of an average human hand, five-fingers with completed joints where each finger is moved by motor individually, joint protection using a mechanical stopper, detachable finger structure from the palm frame, a structure that has sufficient durability for everyday use and an easy to fabricate structure using 3D printing technology. The four-bar linkage mechanism is the use of the solid linkage that connects the actuator with the structure to allow the structure to move. The durability was investigated using static analysis simulation. The structural details and simulation results were validated through motion capture analysis and load test. The motion analyses towards the 3D printed robot structure show 70-98% similar motion range capability to the designed structure in the CAD software, and it can withstand up to 1.6 kg load in the simulation and the real test. The improved robot hand structure with optimum durability for prosthetic uses was successfully developed.
  7. Feng YX, Roslan NS, Izhar LI, Abdul Rahman M, Faye I, Ho ETW
    PMID: 34574777 DOI: 10.3390/ijerph18189858
    Studies showed that introversion is the strongest personality trait related to perceived social isolation (loneliness), which can predict various complications beyond objective isolation such as living alone. Lonely individuals are more likely to resort to social media for instantaneous comfort, but it is not a perpetual solution. Largely negative implications including poorer interpersonal relationship and depression were reported due to excessive social media usage. Conversational task is an established intervention to improve verbal communication, cognitive and behavioral adaptation among lonely individuals. Despite that behavioral benefits have been reported, it is unclear if they are accompanied by objective benefits underlying physiological changes. Here, we investigate the physiological signals from 28 healthy individuals during a conversational task. Participants were ranked by trait extraversion, where greater introversion is associated with increased susceptibility to perceived social isolation as compared to participants with greater extraversion as controls. We found that introverts had a greater tendency to be neurotic, and these participants also exhibited significant differences in task-related electrodermal activity (EDA), heart rate (HR) and HR variability (HRV) as compared to controls. Notably, resting state HRV among individuals susceptible to perceived loneliness was below the healthy thresholds established in literature. Conversational task with a stranger significantly increased HRV among individuals susceptible to isolation up to levels as seen in controls. Since HRV is also elevated by physical exercise and administration of oxytocin hormone (one form of therapy for behavioral isolation), conversational therapy among introverts could potentially confer physiological benefits to ameliorate social isolation and loneliness. Our findings also suggest that although the recent pandemic has changed how people are interacting typically, we should maintain a healthy dose of social interaction innovatively.
  8. Roslan NS, Izhar LI, Faye I, Amin HU, Mohamad Saad MN, Sivapalan S, et al.
    PLoS One, 2019;14(7):e0219839.
    PMID: 31344061 DOI: 10.1371/journal.pone.0219839
    The extraversion personality trait has a positive correlation with social interaction. In neuroimaging studies, investigations on extraversion in face-to-face verbal interactions are still scarce. This study presents an electroencephalography (EEG)-based investigation of the extraversion personality trait in relation to eye contact during face-to-face interactions, as this is a vital signal in social interactions. A sample of healthy male participants were selected (consisting of sixteen more extraverted and sixteen less extraverted individuals) and evaluated with the Eysenck's Personality Inventory (EPI) and Big Five Inventory (BFI) tools. EEG alpha oscillations in the occipital region were measured to investigate extraversion personality trait correlates of eye contact during a face-to-face interaction task and an eyes-open condition. The results revealed that the extraversion personality trait has a significant positive correlation with EEG alpha coherence in the occipital region, presumably due to its relationship with eye contact during the interaction task. Furthermore, the decrease in EEG alpha power during the interaction task compared to the eyes-open condition was found to be greater in the less extraverted participants; however, no significant difference was observed between the less and more extraverted participants. Overall, these findings encourage further research towards the understanding of neural mechanism correlates of the extraversion personality trait-particularly in social interaction.
  9. Chai MT, Amin HU, Izhar LI, Saad MNM, Abdul Rahman M, Malik AS, et al.
    Front Neuroinform, 2019;13:66.
    PMID: 31649522 DOI: 10.3389/fninf.2019.00066
    Color is a perceptual stimulus that has a significant impact on improving human emotion and memory. Studies have revealed that colored multimedia learning materials (MLMs) have a positive effect on learner's emotion and learning where it was assessed by subjective/objective measurements. This study aimed to quantitatively assess the influence of colored MLMs on emotion, cognitive processes during learning, and long-term memory (LTM) retention using electroencephalography (EEG). The dataset consisted of 45 healthy participants, and MLMs were designed in colored or achromatic illustrations to elicit emotion and that to assess its impact on LTM retention after 30-min and 1-month delay. The EEG signal analysis was first started to estimate the effective connectivity network (ECN) using the phase slope index and expand it to characterize the ECN pattern using graph theoretical analysis. EEG results showed that colored MLMs had influences on theta and alpha networks, including (1) an increased frontal-parietal connectivity (top-down processing), (2) a larger number of brain hubs, (3) a lower clustering coefficient, and (4) a higher local efficiency, indicating that color influences information processing in the brain, as reflected by ECN, together with a significant improvement in learner's emotion and memory performance. This is evidenced by a more positive emotional valence and higher recall accuracy for groups who learned with colored MLMs than that of achromatic MLMs. In conclusion, this paper demonstrated how the EEG ECN parameters could help quantify the influences of colored MLMs on emotion and cognitive processes during learning.
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