Displaying publications 1 - 20 of 75 in total

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  1. The founding of the medical school in Singapore in 1905
    Lee YK
    Ann Acad Med Singap, 2005 Jul;34(6):4C-13C.
    PMID: 16010374
    This article traces briefly the origins of medical education in the early years of the Straits Settlements (Singapore, Penang and Malacca), which culminated in the founding of Medical School in Singapore in 1905. The first attempt was made in the early 19th century, when boys were recruited from local schools as Medical Apprentices to be trained as "assistant doctors". They were to assist the British doctors and doctors from India in running the medical services. This scheme was not successful. There are 3 landmark years in the evolution of medical education in the Straits Settlements, namely 1852, 1867 and 1904. In 1852, the Governor, to relieve the shortage of staff in the Medical Department, instructed the Principal Civil Medical Officer to organise a proper course of training for Medical Apprentices and to establish a local Medical Service. This scheme was also unsuccessful and the Straits Settlements continued to rely on doctors recruited from India. In 1867, the Straits Settlements were transferred from the India Office to the Colonial Office and became a Crown Colony. The Indian Government requested that all its doctors be sent back. This would have led to the collapse of the Straits Settlements Medical Service. As a stop-gap measure, the Governor offered the Indian doctors appointment in the new Straits Settlements Medical Service, and at the same time arranged with the Madras Government for boys from the Straits Settlements to be trained in its Medical Colleges. The first 2 boys were sent in 1869. In 1889, the Principal Civil Medical Officer proposed to the Governor that a Medical School should be founded in Singapore, but not enough candidates passed the preliminary entrance examination. The plan was shelved and boys continued to be sent to Madras for training. In 1902, the Committee on English Education proposed that a Medical School should be started in Singapore, but senior British doctors opposed this. On 8 September 1904, Mr Tan Jiak Kim and other local community leaders petitioned the Governor to start a Medical School, raised enough funds to establish the School and the Straits and Federated Malay States Government Medical School (predecessor of the King Edward VII College of Medicine, and the Faculties of Medicine, University of Singapore and University of Malaya) was founded on 3 July 1905.
  2. Lipoma: an unusual case with a brief review of the literature
    Lee YK
    Med J Malaysia, 1975 Mar;30(3):231-3.
    PMID: 1160685
  3. Medical education in the Straits: 1786-1871
    Lee YK
    J Malays Branch R Asiat Soc, 1973;46(1):101-22.
    PMID: 11632305
  4. The first anaesthetic in the straits settlements (Singapore, Penang and Malacca)--1847
    Lee YK
    Br J Anaesth, 1972 Apr;44(4):408-11.
    PMID: 4555711
  5. The management of solitary thyroid nodules under local anaesthesia
    Cunningham IG, Lee YK
    Aust N Z J Surg, 1975 Aug;45(3):285-9.
    PMID: 1058690
    A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.
  6. The state of shared decision making in Malaysia
    Lee YK, Ng CJ
    Z Evid Fortbild Qual Gesundhwes, 2017 Jun;123-124:66-68.
    PMID: 28527637 DOI: 10.1016/j.zefq.2017.05.019
    Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships. Current research on SDM comprises baseline surveys of decisional role preferences, development and implementation of locally developed patient decision aids, and conducting of SDM training workshops. Most of this research is carried out by public research universities. In summary, the current state of SDM in Malaysia is still at its infancy. However, there are increasing recognition and efforts from the academic institutions and Ministry of Health to conduct research in SDM, develop patient decision support tools and initiate national discussion on patient involvement in decision making.
  7. Fulltext How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals' views
    Lee PY, Lee YK, Ng CJ
    BMC Public Health, 2012;12:313.
    PMID: 22545648 DOI: 10.1186/1471-2458-12-313
    BACKGROUND: The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system.
    METHODS: In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach.
    RESULTS: Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose monitoring equipment. Finally, the healthcare professionals proposed the establishment of multidisciplinary teams as a strategy to increase the rate of insulin initiation. Having team members from different ethnic backgrounds would help to overcome language and cultural differences when communicating with patients.
    CONCLUSION: The challenges faced by a dual-sector health system in delivering insulin initiation may be addressed by greater collaborations between the private and public sectors and governmental and non-government organisations, and among different healthcare professionals.
    Study site: Healthcare professionals from three states (Wilayah Federal Territory, Negeri Sembilan and Selangor) and from both urban and semi-rural locations (including Klinik Kesihatan), Malaysia
  8. Fulltext A qualitative study on healthcare professionals' perceived barriers to insulin initiation in a multi-ethnic population
    Lee YK, Lee PY, Ng CJ
    BMC Fam Pract, 2012;13:28.
    PMID: 22469132 DOI: 10.1186/1471-2296-13-28
    BACKGROUND: Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals' views on barriers to starting insulin therapy in people with type 2 diabetes.
    METHODS: Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach.
    RESULTS: Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients' barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals' barriers include negative attitudes towards insulin therapy and the 'legacy effect' of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges.
    CONCLUSIONS: Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds.
    Study site: healthcare professionals who provided diabetes care in the three healthcare settings in Malaysia: the government health clinics (Klinik Kesihatan); government university-based primary care clinic and hospital; and private general practice (GP) clinics and hospitals
  9. A study into salivary-based measurement of human stress subjected to Ellestad stress test protocol
    Lee YK, Za'aba A, Madzhi NK, Ahmad A
    Annu Int Conf IEEE Eng Med Biol Soc, 2009;2009:765-8.
    PMID: 19964239 DOI: 10.1109/IEMBS.2009.5333674
    Previous works on the effects of salivary alpha amylase in respond to various stressors report encouraging findings on it being a good indicator of stress. Ellestad protocol is a clinical procedure to screen for coronary artery disease by introducing exercise induced physical stress. If a salivary based biomarker profile in accordance to a stress test protocol could be established, the critical stress state which disable rational decision making could be ascertained in a standardized procedure. This technique would serve to aid human resource management in times of critical events such as rescue, firefighting or even military, that would potentially prevent unnecessary sacrifice of human lives. In this pilot study with five healthy volunteers performing the Ellestad protocol treadmill, a measurement profile with physiologic and salivary based biomarker is obtained. It is found that the alpha amylase levels or the changes in it as workload changes from resting-walking-running at ease-exhaustive running, is relatively more significant in reflecting the stress state than heart rate and blood pressure. Moreover, it is strongly associated with mood state with correlation coefficient of 0.8 and significance of 0.01.
  10. Assessment of computerized analysis algorithms for one dimension physiologic data with multiple databases
    Lee YK, Bister M, Salleh YM, Blanchfield P
    Annu Int Conf IEEE Eng Med Biol Soc, 2008;2008:5004-7.
    PMID: 19163841 DOI: 10.1109/IEMBS.2008.4650338
    Software technology enables computerized analysis to offer second opinion in various screening and diagnostic tasks to assist the clinicians. Yet, the performance of these computerized methods for medical images is questioned by experts in CAD research, owing to the use of different databases and criteria for evaluating the computer results for comparison. This paper intends to substantiate this statement by illustrating the effects of such issues with the use of 1D physiologic data and multiple databases. For this purpose, the detection of desaturation events in Sp02 and spike events in EEG are used. This is the first time that comparison between different algorithms on a common basis is carried out on an individual effort. The appraisal for all the algorithms is made on the same databases and criteria. It is surprising to find that issues for 2/3D images concur with those found in 1D data here. In evaluating the accuracy of a new algorithm, a single independent database gives results fast. This paper reveals weaknesses of such an approach. It is hoped that the supportive evidence shown here is enough for researchers to innovate a better platform for credibility in reporting performance comparison of computerized analysis algorithms.
  11. Effect of amplitude criteria on operating characteristic of detection for OSAH events with oxygen saturation
    Lee YK, Bister M, Salleh YM, Blanchfield P
    Annu Int Conf IEEE Eng Med Biol Soc, 2007;2007:4645-8.
    PMID: 18003041
    Effect of amplitude criteria on the operating characteristics of algorithms for detecting OSAH events based on the analysis of oxygen saturation alone is investigated. The objective is to establish that there exists an oxygen desaturation level that leverages these algorithms to be more sensitive or more specific, irrespective of the differences in detection mechanism and database, a first ever attempt. Linear classification of algorithms from previous studies discovered that a drop in oxygen saturation of 3% or less makes the detection algorithms more sensitive while a drop of 4% or more makes it more specific. Results from two algorithms developed here also supported this. This finding explains the contradiction cited in the performance of algorithms from the different authors, which casts doubts on their detection ability. It could lead to the establishment of standard oxygen desaturation levels for screening and diagnosis of moderate/severe OSA, thus providing a more credible comparison basis for automated detection algorithms or even clinical tests.
  12. Automated detection of obstructive apnea and hypopnea events from oxygen saturation signal
    Lee YK, Bister M, Blanchfield P, Salleh YM
    Conf Proc IEEE Eng Med Biol Soc, 2007 2 3;2006:321-4.
    PMID: 17271675
    Our objective is to automate the detection of apnea and hypopnea events in obstructive sleep apnea hypopnea (OSAH) syndrome based on analysis of arterial oxygen saturation signal alone. This is the first attempt where wavelet is used to detect OSAH events. Detection of OSAH events through wavelet depends on the fluctuations in the magnitude of the transformed coefficients, thus circumventing the problem of variability in the criteria on the magnitude and duration of the signal. Our work evaluates the performance of the wavelet transform to detect OSAH events against three conventional amplitude and duration algorithms. High performance in the detection of OSAH events can be achieved through the wavelet algorithm (score 96.55%, sensitivity 95.74% and specificity 97.02%) if the threshold on wavelet coefficients is individually tuned for each study. However, this is impossible in clinical practice. It is interesting to observe that the conventional methods based on amplitude and duration are able to attain a performance as close as this. The Nervus algorithm obtains the best result (score 96.66%, sensitivity 95.26% and specificity 97.46%) compared to the amplitude duration algorithm, the drop duration algorithm and the wavelet algorithm with global threshold, in descending order of performance.
  13. Fulltext Non-communicable diseases in the Asia-Pacific region: Prevalence, risk factors and community-based prevention
    Low WY, Lee YK, Samy AL
    Int J Occup Med Environ Health, 2015;28(1):20-6.
    PMID: 26159943 DOI: 10.2478/s13382-014-0326-0
    Non-communicable diseases (NCDs) lead to substantial mortality and morbidity worldwide. The most common NCDs are cardiovascular diseases (CVD), diabetes, cancer and chronic respiratory diseases. With the rapid increase in NCD-related deaths in Asia Pacific countries, NCDs are now the major cause of deaths and disease burden in the region. NCDs hamper achievement of the Millennium Development Goals (MDG). People in the low socio-economic group are most affected by NCDs as they have poor access to policies, legislations, regulations and healthcare services meant to combat NCDs. This results in loss of productivity by a decreasing labor force with implications at the macroeconomic level. The 3 major NCDs in the Asia Pacific region are CVDs, cancer and diabetes due to the increasing loss of disability adjusted life years (DALYs). The 4 major behavioral risk factors for NCDs are: tobacco use, alcohol consumption, inadequate physical activity and unhealthy diet. The underlying risk factors are urbanization, globalization, sedentary lifestyle, obesity and hypertension. Strategies to combat NCDs in the Asia Pacific region are as follows: population-based dietary salt reduction, health education, psychological interventions, i.e., cognitive behavioral therapy and motivational-interviewing, taxation and bans on tobacco-related advertisements, implementing smoke-free zones and surveillance by the World Health Organization. Control measures must focus on prevention and strengthening inter-sectorial collaboration.
  14. Fulltext A qualitative study on parents' reasons and recommendations for childhood vaccination refusal in Malaysia
    Rumetta J, Abdul-Hadi H, Lee YK
    J Infect Public Health, 2020 Feb;13(2):199-203.
    PMID: 31431420 DOI: 10.1016/j.jiph.2019.07.027
    BACKGROUND: Vaccine-related diseases are increasing in developing countries. This study aimed to explore parents' reasons for refusal of childhood vaccinations in Malaysia and their recommendations on addressing their concerns.

    METHODS: A qualitative study design involving individual both face-to-face and online in-depth interview was used. The topic guide was developed from the Health Belief Model theoretical framework. Seven face-to-face and seven online interviews were conducted with parents in the Klang Valley (an urban area) who had refused childhood vaccination. All interviews were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyze the data. Data was collected until data saturation was reached.

    RESULTS: Findings were summarized into two main categories: Personal Health Beliefs and Vaccine Related Concerns. Six personal health beliefs were identified: lack of confidence in modern medicine and health care personnel, pharmaceutical conspiracy to sell medicines, preference to a natural approach to health, personal instincts, religious beliefs and having a partner with similar beliefs. Four main vaccine-related concerns were identified: negative effects and content concerns, doubts of necessity and lack of information and knowledge regarding vaccines. Parents recommended that more empathy from healthcare professionals and evidence on safety and content purity would help them reconsider vaccination.

    CONCLUSION: Parents had multiple reasons for refusing childhood vaccinations but felt that communication and empathy from healthcare professionals was lacking. Besides individual consultations with parents, addressing these concerns at multiple levels in the health care system and society may help to increase the uptake of childhood vaccinations in the future.

  15. Selective magnetic mercury(ii) ion capturing ligand-doped silica gel for water analysis
    Khor SW, Lee YK, Tay KS
    Analyst, 2019 Mar 21;144(6):1968-1974.
    PMID: 30694266 DOI: 10.1039/c8an02362j
    Preparation of selective magnetic adsorbents for dispersive micro-solid phase extraction often involves multi-step reactions which are time consuming. This study demonstrates a simplified method for the synthesis of a magnetic adsorbent, which is selective towards the adsorption of mercury(ii) ions (Hg2+). In this method, the incorporation of a metal capturing ligand (3-oxo-1,3-diphenylpropyl-2-(naphthalen-2-ylamino) ethylcarbamodithioate) and the coating of magnetic particles with silica gel was performed in a single step. This adsorbent was then used in solid-phase microextraction for the preconcentration of Hg2+ in water. In this study, a mercury analyzer was used to quantify the Hg2+. Under optimized conditions, the developed analytical method achieved a low detection limit (4.0 ng L-1), satisfactory enrichment factor (96.4) and wide linearity range (50.0-5000 ng L-1) with a good coefficient of determination (0.9985) and good repeatability (<7%). The preconcentration factor of this method was 100. This proposed method was also successfully utilized for the determination of Hg2+ in drinking water, tap water and surface water with good recovery (>91%) and high intra-day and inter-day precision.
  16. Addressing unmet needs of patients with chronic diseases: Impact of the VISIT website during consultations
    Lee YK, Ng CJ, Low WY
    J Eval Clin Pract, 2017 Dec;23(6):1281-1288.
    PMID: 28585242 DOI: 10.1111/jep.12777
    RATIONALE, AIMS, AND OBJECTIVES: Patient concerns are often neglected in consultations, especially for chronic diseases where patients and providers fall into the routine of chronic disease management in consultations. One strategy to elicit patient concerns has been to ask patients to complete agenda lists before the consultation. This study aimed to explore the impact of a preconsultation agenda website in addressing patients' unmet needs during chronic disease consultations.
    METHODS: Patients entered their concerns into a website (Values In Shared Interactions Tool (VISIT)). Doctors accessed this information via the electronic medical records before consultations. Individual in-depth interviews were then conducted with patients and doctors on the website's impact on consultations. Interviews were transcribed verbatim and analysed thematically.
    RESULTS: The average age (years) was 65.7 for patients (n = 8) and 35.7 for doctors (n = 7). Patients in the study entered between 1 to 6 items in the website. From postconsultation interviews, we found that the website impacted the consultation in 5 ways: (1) It facilitated patients to communicate their full agenda to doctors; (2) it helped address unmet patient needs as it gave them opportunity to raise other issues besides their chronic condition; (3) it facilitated rapport between doctor and patient; (4) it facilitated doctors to organize their consultation around the concerns the patient had listed; and (5) it disrupted the doctor's usual consultation style if the list of concerns was lengthy.
    CONCLUSIONS: Integrating patient concerns into electronic health records helped to facilitate patient-centred consultations. Doctors found this information useful but felt uneasy if the agenda list was too long or too complex. Areas for future studies include training doctors to manage complex agendas and formal evaluation of the VISIT tool.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  17. Fulltext Exploring patient values in medical decision making: a qualitative study
    Lee YK, Low WY, Ng CJ
    PLoS One, 2013;8(11):e80051.
    PMID: 24282518 DOI: 10.1371/journal.pone.0080051
    BACKGROUND: Patient decisions are influenced by their personal values. However, there is a lack of clarity and attention on the concept of patient values in the clinical context despite clear emphasis on patient values in evidence-based medicine and shared decision making. The aim of the study was to explore the concept of patient values in the context of making decisions about insulin initiation among people with type 2 diabetes.

    METHODS AND FINDINGS: We conducted individual in-depth interviews with people with type 2 diabetes who were making decisions about insulin treatment. Participants were selected purposively to achieve maximum variation. A semi-structured topic guide was used to guide the interviews which were audio-recorded and analysed using a thematic approach. We interviewed 21 participants between January 2011 and March 2012. The age range of participants was 28-67 years old. Our sample comprised 9 women and 12 men. Three main themes, 'treatment-specific values', 'life goals and philosophies', and 'personal and social background', emerged from the analysis. The patients reported a variety of insulin-specific values, which were negative and/or positive beliefs about insulin. They framed insulin according to their priorities and philosophies in life. Patients' decisions were influenced by sociocultural (e.g. religious background) and personal backgrounds (e.g. family situations).

    CONCLUSIONS: This study highlighted the need for expanding the current concept of patient values in medical decision making. Clinicians should address more than just values related to treatment options. Patient values should include patients' priorities, life philosophy and their background. Current decision support tools, such as patient decision aids, should consider these new dimensions when clarifying patient values.

  18. Factors influencing decision-making role preferences: A qualitative study of Malaysian patients with type 2 diabetes during insulin initiation
    Lee YK, Low WY, Lee PY, Ng CJ
    Int J Nurs Pract, 2015 May;21 Suppl 2:125-31.
    PMID: 24804909 DOI: 10.1111/ijn.12355
    Patient decision-making role preference (DMRP) is a patient's preferred degree of control when making medical decisions. This descriptive qualitative study aimed to explore Malaysian patients' views on their DMRP. Between January 2011 and March 2012, 22 individual face-to-face in-depth interviews were conducted with patients with type 2 diabetes who were deciding about insulin initiation. The interviews were audio-recorded and analysed using a thematic approach. The age range of participants was 28-67 years old with 11 men. Ten patients preferred to make the decision themselves, six patients indicated that the clinician should make the decision and only one patient expressed a preference for a collaborative role. The following factors influenced DMRP: trust in clinicians, responsibility for diabetes care, level of knowledge and awareness, involvement of family and personal characteristics. In conclusion, the concept of shared decision-making is still alien, and a more participative communication style might help to facilitate patients' expression of DMRP.
    Study site: Public university hospital-based primary care clinic, Public health-care clinics (Klinik Kesihatan), Private specialist clinic, Malaysia
  19. Fulltext How do health care professionals assess patients when initiating insulin therapy? A qualitative study
    Lee PY, Lee YK, Khoo EM, Ng CJ
    Prim Care Diabetes, 2014 Apr;8(1):49-55.
    PMID: 24315732 DOI: 10.1016/j.pcd.2013.11.003
    Aims: To explore how health care professionals (HCPs) assess patients when initiating insulintherapy in type 2 diabetes.
    Methods: Focus group discussions and in-depth interviews were conducted with 41 healthcare professionals in Malaysia in 2010–2011. A semi-structured topic guide was used for theinterview. The interviews were transcribed verbatim and analysed using the Nvivo9 softwarebased on a thematic approach.
    Results: HCPs were less likely to initiate insulin therapy in patients who were older, withirregular dietary patterns and poor financial status. They also assessed patients’ knowl-edge, views and misconceptions of insulin. However, there was a variation in how doctors assessed patients’ comorbidities before starting insulin therapy. Medical officers were more likely to initiate insulin therapy in patients with comorbidities and complications, whereas family medicine specialists were more cautious. In addition, most HCPs considered patients’ psychosocial status, including self-care ability, social support and quality of life.
    Conclusions: HCPs’ assessment of patients’ need to start insulin therapy depends on their perception rather than objective evaluation of patients’ background, knowledge, perception and abilities. The background and the type of practice of HCPs influence their assessment.
  20. Optimization of MFCC parameters using Particle Swarm Optimization for diagnosis of infant hypothyroidism using Multi- Layer Perceptron
    Zabidi A, Lee YK, Mansor W, Yassin IM, Sahak R
    Annu Int Conf IEEE Eng Med Biol Soc, 2010;2010:1417-20.
    PMID: 21096346 DOI: 10.1109/IEMBS.2010.5626712
    This paper presents a new application of the Particle Swarm Optimization (PSO) algorithm to optimize Mel Frequency Cepstrum Coefficients (MFCC) parameters, in order to extract an optimal feature set for diagnosis of hypothyroidism in infants using Multi-Layer Perceptrons (MLP) neural network. MFCC features is influenced by the number of filter banks (f(b)) and the number of coefficients (n(c)) used. These parameters are critical in representation of the features as they affect the resolution and dimensionality of the features. In this paper, the PSO algorithm was used to optimize the values of f(b) and n(c). The MFCC features based on the PSO optimization were extracted from healthy and unhealthy infant cry signals and used to train MLP in the classification of hypothyroid infant cries. The results indicate that the PSO algorithm could determine the optimum combination of f(b) and n(c) that produce the best classification accuracy of the MLP.
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