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Fulltext Neuropsychological profile at three months post injury in patients with traumatic brain injury

Ali R, Wahab S, Abdul Rahman AH

Sains Malaysiana, 2013;42(3):403-408.

This study looked into the rate and pattern of neuropsychological impairment in patients with traumatic brain injury patients at three months post injury. Forty patients attending the neurosurgery outpatient clinic were included in the study. Benton visual retention test (BVRT), rey auditory verbal learning test (RAVLT), digit span test, trail making test (TMT) and mini mental state examination (MMSE) were used for assessment. Forty five percent (n=18) sustained moderate to severe head injury. Twenty five percent (n=10) have abnormal MMSE result. Forty two and a half percent (n=17) have abnormal BVRT result. Seventy five percent (n=30) have abnormal RAVLT result while 35% (n=14) have abnormal digit span test result. Seventy seven and a half percent (n=31) have at least one neurological deficit. There was significant association between severity of head injury (GCS score) and neuropsychological deficit. This study highlights the point that in post head injury patients, there are high occurrences of cognitive dysfunction. MMSE and GCS play a significant and important role in assessing cognitive dysfunction. Severity of head injury as determined by GCS scores also influence the outcome in patients with head injury
Fulltext Semantic visual simultaneous localization and mapping (SLAM) using deep learning for dynamic scenes

Zhang XY, Abd Rahman AH, Qamar F

PeerJ Comput Sci, 2023;9:e1628.
PMID: 37869467 DOI: 10.7717/peerj-cs.1628

Simultaneous localization and mapping (SLAM) is a fundamental problem in robotics and computer vision. It involves the task of a robot or an autonomous system navigating an unknown environment, simultaneously creating a map of the surroundings, and accurately estimating its position within that map. While significant progress has been made in SLAM over the years, challenges still need to be addressed. One prominent issue is robustness and accuracy in dynamic environments, which can cause uncertainties and errors in the estimation process. Traditional methods using temporal information to differentiate static and dynamic objects have limitations in accuracy and applicability. Nowadays, many research trends have leaned towards utilizing deep learning-based methods which leverage the capabilities to handle dynamic objects, semantic segmentation, and motion estimation, aiming to improve accuracy and adaptability in complex scenes. This article proposed an approach to enhance monocular visual odometry's robustness and precision in dynamic environments. An enhanced algorithm using the semantic segmentation algorithm DeeplabV3+ is used to identify dynamic objects in the image and then apply the motion consistency check to remove feature points belonging to dynamic objects. The remaining static feature points are then used for feature matching and pose estimation based on ORB-SLAM2 using the Technical University of Munich (TUM) dataset. Experimental results show that our method outperforms traditional visual odometry methods in accuracy and robustness, especially in dynamic environments. By eliminating the influence of moving objects, our method improves the accuracy and robustness of visual odometry in dynamic environments. Compared to the traditional ORB-SLAM2, the results show that the system significantly reduces the absolute trajectory error and the relative pose error in dynamic scenes. Our approach has significantly improved the accuracy and robustness of the SLAM system's pose estimation.
Polymorphism of the serotonin transporter gene (5-HTTLPR) in major depressive disorder patients in Malaysia

Mohamed Saini S, Muhamad Radzi A, Abdul Rahman AH

Asia Pac Psychiatry, 2012 Jun;4(2):126-30.
PMID: 26767356 DOI: 10.1111/j.1758-5872.2012.00190.x

The serotonin transporter promoter (5-HTTLPR) is a potential susceptibility locus in the pathogenesis of major depressive disorder. However, data from Malaysia is lacking. The present study aimed to determine the association between the homozygous short variant of the serotonin transporter promoter gene (5-HTTLPR) with major depressive disorder.
Fulltext Psychosis post corona radiata and lentiform nucleus infarction

Abdullah KH, Saini SM, Sharip S, Rahman AH

BMJ Case Rep, 2015 Apr 02;2015.
PMID: 25837653 DOI: 10.1136/bcr-2014-208954

Complications of stroke can include neuropsychiatric symptoms. However, post-stroke psychosis is rare. We report a case where an acute presentation of psychosis, depression and fluctuating cognitive impairment in a middle-aged man turned out to be related to a silent brain infarction. The patient had a background of poorly controlled type 2 diabetes mellitus with glycated haemoglobin level of 9.0-11.0%, hypertension and ischaemic heart disease. His CT brain results showed multifocal infarct with hypodensities at bilateral lentiform nucleus and bilateral corona radiata. His strong genetic predisposition of psychosis and a history of brief psychotic disorder with complete remission 3 years prior to the current presentation might possibly contribute to his post-stroke atypical neuropsychiatric presentation, and posed diagnostic challenges. He showed marked improvement with risperidone 6 mg nocte, chlorpromazine 50 mg nocte and fluvoxamine of 200 mg nocte. The need of comprehensive treatments to modify his stroke risk factors was addressed.
Fulltext Artificial intelligence maturity model: a systematic literature review

Sadiq RB, Safie N, Abd Rahman AH, Goudarzi S

PeerJ Comput Sci, 2021;7:e661.
PMID: 34541308 DOI: 10.7717/peerj-cs.661

Organizations in various industries have widely developed the artificial intelligence (AI) maturity model as a systematic approach. This study aims to review state-of-the-art studies related to AI maturity models systematically. It allows a deeper understanding of the methodological issues relevant to maturity models, especially in terms of the objectives, methods employed to develop and validate the models, and the scope and characteristics of maturity model development. Our analysis reveals that most works concentrate on developing maturity models with or without their empirical validation. It shows that the most significant proportion of models were designed for specific domains and purposes. Maturity model development typically uses a bottom-up design approach, and most of the models have a descriptive characteristic. Besides that, maturity grid and continuous representation with five levels are currently trending in maturity model development. Six out of 13 studies (46%) on AI maturity pertain to assess the technology aspect, even in specific domains. It confirms that organizations still require an improvement in their AI capability and in strengthening AI maturity. This review provides an essential contribution to the evolution of organizations using AI to explain the concepts, approaches, and elements of maturity models.
Fulltext Real-Time Robotic Presentation Skill Scoring Using Multi-Model Analysis and Fuzzy Delphi-Analytic Hierarchy Process

Alshammari RFN, Abd Rahman AH, Arshad H, Albahri OS

Sensors (Basel), 2023 Dec 05;23(24).
PMID: 38139465 DOI: 10.3390/s23249619

Existing methods for scoring student presentations predominantly rely on computer-based implementations and do not incorporate a robotic multi-classification model. This limitation can result in potential misclassification issues as these approaches lack active feature learning capabilities due to fixed camera positions. Moreover, these scoring methods often solely focus on facial expressions and neglect other crucial factors, such as eye contact, hand gestures and body movements, thereby leading to potential biases or inaccuracies in scoring. To address these limitations, this study introduces Robotics-based Presentation Skill Scoring (RPSS), which employs a multi-model analysis. RPSS captures and analyses four key presentation parameters in real time, namely facial expressions, eye contact, hand gestures and body movements, and applies the fuzzy Delphi method for criteria selection and the analytic hierarchy process for weighting, thereby enabling decision makers or managers to assign varying weights to each criterion based on its relative importance. RPSS identifies five academic facial expressions and evaluates eye contact to achieve a comprehensive assessment and enhance its scoring accuracy. Specific sub-models are employed for each presentation parameter, namely EfficientNet for facial emotions, DeepEC for eye contact and an integrated Kalman and heuristic approach for hand and body movements. The scores are determined based on predefined rules. RPSS is implemented on a robot, and the results highlight its practical applicability. Each sub-model is rigorously evaluated offline and compared against benchmarks for selection. Real-world evaluations are also conducted by incorporating a novel active learning approach to improve performance by leveraging the robot's mobility. In a comparative evaluation with human tutors, RPSS achieves a remarkable average agreement of 99%, showcasing its effectiveness in assessing students' presentation skills.
Malignant catatonia secondary to viral meningoencephalitis in a young man with bipolar disorder

Saini SM, Eu CL, Wan Yahya WN, Abdul Rahman AH

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:55-8.
PMID: 23857838 DOI: 10.1111/appy.12045
Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia

Ibrahim NM, Shohaimi S, Chong HT, Rahman AH, Razali R, Esther E, et al.

Dement Geriatr Cogn Disord, 2009;27(3):247-53.
PMID: 19246909 DOI: 10.1159/000203888

BACKGROUND/AIMS: In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics).
METHODS: Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell 'dunia' backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves.
RESULTS: Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders.
CONCLUSION: All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied.
Study site: Community, neurology and dementia outpatient clinics, Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC)
Serotonin transporter gene polymorphism and its association with bipolar disorder across different ethnic groups in Malaysia

Mohamed Saini S, Nik Jaafar NR, Sidi H, Midin M, Mohd Radzi A, Abdul Rahman AH

Compr Psychiatry, 2014 Jan;55 Suppl 1:S76-81.
PMID: 23410635 DOI: 10.1016/j.comppsych.2012.12.005

The risk variants have been shown to vary substantially across populations and a genetic study in a heterogeneous population might shed a new light in the disease mechanism. This preliminary study aims to determine the frequency of the serotonin transporter gene polymorphism (5-HTTLPR) in the three main ethnic groups in Malaysia and its association with bipolar disorder.
Fulltext The Hyperactivity of Efferent Auditory System in Patients with Schizophrenia: A Transient Evoked Otoacoustic Emissions Study

Abdul Wahab NA, Wahab S, Abdul Rahman AH, Sidek D, Zakaria MN

Psychiatry Investig, 2016 Jan;13(1):82-8.
PMID: 26766950 DOI: 10.4306/pi.2016.13.1.82

Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia.
Evaluation of auditory hallucinations in patients with schizophrenia: A validation study of the Malay version of Psychotic Symptom Rating Scales (PSYRATS)

Wahab S, Zakaria MN, Sidek D, Abdul Rahman AH, Shah SA, Abdul Wahab NA

Psychiatry Res, 2015 Aug 30;228(3):462-7.
PMID: 26142835 DOI: 10.1016/j.psychres.2015.06.014

The Psychotic Symptom Rating Scales (PSYRATS) is the most widely used validated scale to measure the specific symptoms of auditory hallucination and delusion. The aim of this study was to validate and to examine the psychometric properties of the auditory hallucination component of the Malay PSYRATS (MyPSYRATS). The research was done in the Universiti Kebangsaan Malaysia Medical Center (UKMMC) among 51 schizophrenia inpatients and outpatients who had experienced or reported verbal auditory hallucination. The psychometric properties of MyPSYRATS (auditory hallucination) were studied and a comparison was made between the psychometric properties obtained and the Positive and Negative Syndrome Scale (PANSS). The internal consistency of MyPSYRATS was good as revealed by Cronbach's alpha value. Factor analysis replicated three components (emotional, cognitive, and physical) similar to the factorial structure of the original auditory hallucination scale. However, two items were regrouped under the emotional component. Spearman's rank-order correlation showed a significant positive relationship between the total score of auditory hallucinations and PANSS auditory hallucinations item (P3). In conclusion, the auditory hallucination domain of MyPSYRATS is a reliable and valid assessment tool for further clinical applications.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Fulltext Malay Version of the mHealth App Usability Questionnaire (M-MAUQ): Translation, Adaptation, and Validation Study

Mustafa N, Safii NS, Jaffar A, Sani NS, Mohamad MI, Abd Rahman AH, et al.

JMIR Mhealth Uhealth, 2021 02 04;9(2):e24457.
PMID: 33538704 DOI: 10.2196/24457

BACKGROUND: Mobile health (mHealth) apps play an important role in delivering education, providing advice on treatment, and monitoring patients' health. Good usability of mHealth apps is essential to achieve the objectives of mHealth apps efficiently. To date, there are questionnaires available to assess the general system usability but not explicitly tailored to precisely assess the usability of mHealth apps. Hence, the mHealth App Usability Questionnaire (MAUQ) was developed with 4 versions according to the type of app (interactive or standalone) and according to the target user (patient or provider). Standalone MAUQ for patients comprises 3 subscales, which are ease of use, interface and satisfaction, and usefulness.
OBJECTIVE: This study aimed to translate and validate the English version of MAUQ (standalone for patients) into a Malay version of MAUQ (M-MAUQ) for mHealth app research and usage in future in Malaysia.
METHODS: Forward and backward translation and harmonization of M-MAUQ were conducted by Malay native speakers who also spoke English as their second language. The process began with a forward translation by 2 independent translators followed by harmonization to produce an initial translated version of M-MAUQ. Next, the forward translation was continued by another 2 translators who had never seen the original MAUQ. Lastly, harmonization was conducted among the committee members to resolve any ambiguity and inconsistency in the words and sentences of the items derived with the prefinal adapted questionnaire. Subsequently, content and face validations were performed with 10 experts and 10 target users, respectively. Modified kappa statistic was used to determine the interrater agreement among the raters. The reliability of the M-MAUQ was assessed by 51 healthy young adult mobile phone users. Participants needed to install the MyFitnessPal app and use it for 2 days for familiarization before completing the designated task and answer the M-MAUQ. The MyFitnessPal app was selected because it is one among the most popular installed mHealth apps globally available for iPhone and Android users and represents a standalone mHealth app.
RESULTS: The content validity index for the relevancy and clarity of M-MAUQ were determined to be 0.983 and 0.944, respectively, which indicated good relevancy and clarity. The face validity index for understandability was 0.961, which indicated that users understood the M-MAUQ. The kappa statistic for every item in M-MAUQ indicated excellent agreement between the raters (κ ranging from 0.76 to 1.09). The Cronbach α for 18 items was .946, which also indicated good reliability in assessing the usability of the mHealth app.
CONCLUSIONS: The M-MAUQ fulfilled the validation criteria as it revealed good reliability and validity similar to the original version. M-MAUQ can be used to assess the usability of mHealth apps in Malay in the future.
Validation of the Schizophrenia Quality of Life Scale Revision 4 among chronic schizophrenia patients in Malaysia

Taha NA, Ibrahim MI, Rahman AF, Shafie AA, Rahman AH

Value Health Reg Issues, 2012 May;1(1):82-86.
PMID: 29702832 DOI: 10.1016/j.vhri.2012.03.006

OBJECTIVES: To explore the validity and reliability of a disease-specific health-related quality-of-life questionnaire-the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4)-in patients with schizophrenia in Malaysia.
METHODS: A total of 222 outpatients with schizophrenia receiving treatment at the Universiti Kebangsaan Malaysia Medical Centre completed the SQLS-R4 in either the Malay or the English language. A generic self-report health-related quality-of-life measure-the EuroQoL group EuroQol five-dimensional questionnaire-and a measure of symptom severity-the Clinical Global Impression-Schizophrenia scale-were also administered to assess validity.
RESULTS: Good internal consistency reliability was found for both the psychosocial and vitality domains (Cronbach's α = 0.95 and 0.85, respectively). Most items were also significantly correlated with their own scale score (rs ranging from 0.29 to 0.74). There was a moderate correlation between the SQLS-R4 "vitality" domain and the EuroQol five-dimensional questionnaire "usual activities" domain (rs = 0.44) and a large correlation between the SQLS-R4 "psychosocial" domain and the EuroQol five-dimensional questionnaire "anxiety/depression" domain (rs = 0.44-0.57). Most of the symptom dimensions of the Clinical Global Impression-Schizophrenia scale were also moderately correlated with the SQLS-R4 subscale scores.
CONCLUSIONS: The SQLS-R4 is a valid and reliable health-related quality-of-life instrument for use in minimally ill patients with schizophrenia in Malaysia, but some of the items may be redundant and irrelevant. Validation of SQLS-R4 in different types of patients and various levels of illness severity is required to further verify its application.
Study site: Psychiatry clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Listening to Sentences in Noise: Revealing Binaural Hearing Challenges in Patients with Schizophrenia

Abdul Wahab NA, Zakaria MN, Abdul Rahman AH, Sidek D, Wahab S

Psychiatry Investig, 2017 Nov;14(6):786-794.
PMID: 29209382 DOI: 10.4306/pi.2017.14.6.786

Objective: The present, case-control, study investigates binaural hearing performance in schizophrenia patients towards sentences presented in quiet and noise.
Methods: Participants were twenty-one healthy controls and sixteen schizophrenia patients with normal peripheral auditory functions. The binaural hearing was examined in four listening conditions by using the Malay version of hearing in noise test. The syntactically and semantically correct sentences were presented via headphones to the randomly selected subjects. In each condition, the adaptively obtained reception thresholds for speech (RTS) were used to determine RTS noise composite and spatial release from masking.
Results: Schizophrenia patients demonstrated significantly higher mean RTS value relative to healthy controls (p=0.018). The large effect size found in three listening conditions, i.e., in quiet (d=1.07), noise right (d=0.88) and noise composite (d=0.90) indicates statistically significant difference between the groups. However, noise front and noise left conditions show medium (d=0.61) and small (d=0.50) effect size respectively. No statistical difference between groups was noted in regards to spatial release from masking on right (p=0.305) and left (p=0.970) ear.
Conclusion: The present findings suggest an abnormal unilateral auditory processing in central auditory pathway in schizophrenia patients. Future studies to explore the role of binaural and spatial auditory processing were recommended.
Waist circumference and not body mass index as the outcome of a group weight intervention for patients with severe mental illness

Nik Jaafar NR, Midin M, Mahadevan R, Sinniah A, Rahman AH, Ming W, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S60-4.
PMID: 24139853 DOI: 10.1016/j.comppsych.2013.09.002

OBJECTIVE: Most weight interventions among patients with severe mental illness (SMI) used body mass index (BMI) as outcome measure but excluded waist circumference (WC) although the latter is a stronger predictor of obesity complications. This study aimed to assess a weight-management program consisting of education, exercise and behavioural techniques for patients with SMI using weight parameters including WC as the outcome measures.
METHODS: A group intervention was carried out as part of psychiatric outpatient community service. It used structured modules on diet, exercise and related topics comprising of education and exercises sessions with a total of 12-week duration. The participants were outpatients with SMI recruited through referrals to the program by the treating doctor. The participants' body weight, BMI and WC were measured at the baseline, fortnightly and at the end of the program.
RESULTS: A total of 27 patients participated in the program which was carried out in 6 cycles. The pre- and post-intervention comparisons analysis of the weight parameters found a significant reduction in the WC (mean=3.878 cm+5.165, p=0.001) while no significant changes were recorded in body weight and BMI.
CONCLUSION: Small but significant loss in WC and possibly weight maintenance were achieved using this non-pharmacological intervention. Modest loss in WC may have an impact on reducing the risk of obesity-related health risks.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Association between cognitive reserve with cognitive impairment, social and occupational functioning, and quality of life in schizophrenia: A preliminary study in the Malaysian population

Sharip S, Zairani MI, Ing LP, Baharom NN, Asarapoo NS, Rahman NA, et al.

Asian J Psychiatr, 2020 Oct;53:102230.
PMID: 32585635 DOI: 10.1016/j.ajp.2020.102230

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