An improved Random Forest based on Feature Selection and Feature weighting for case retrieval in CBR system Application to medical data

: The medical diagnostic process works very similarly to the Case Based Reasoning (CBR) cycle scheme. CBR is a problem solving approach based on the reuse of past experiences called cases. To improve the performance of the retrieval phase, a Random Forest (RF) model is proposed, in this respect we used this algorithm in three different ways (three different algorithms): Classic Random Forest (CRF) algorithm, Random Forest with Feature Selection (RF_FS) algorithm where we selected the most important attributes and deleted the less important ones and Weighted Random Forest (WRF) algorithm where we weighted the most important attributes by giving them more weight. We did this by multiplying the entropy with the weight corresponding to each attribute.We tested our three algorithms CRF, RF_FS and WRF with CBR on data from 11 medical databases and compared the results they produced. We found that WRF and RF_FS give better results than CRF. The experiemental results show the performance and robustess of the proposed approach.

Cyclic Vomiting Syndrome in Pediatric Patients: A Review of Therapeutics

Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder that can present quite a challenge to clinicians caring for children with this complex disease. Different therapeutic interventions are recommended for prophylaxis and acute abortive therapy for a CVS attack. The aim of this review is to summarize therapeutic treatment recommendations from the 2008 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHN) Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome and discuss studies contemporary to this expert recommendation. After an extensive search of medical databases, 8 studies that evaluated therapeutic treatments for CVS were identified. Amitriptyline and cyproheptadine remain the standard of care for prophylaxis. Nutritional supplements such as carnitine and coenzyme Q10 have shown efficacy in decreasing episodes and severity in small studies with high tolerability among patients. The combination of ondansetron and sumatriptan are recommended for abortion of an acute vomiting episode, but other agents such as aprepitant and sedative agents can be considered when vomiting is refractory to initial treatments.

From Pre- and Probiotics to Post-Biotics: A Narrative Review

Background and aims: gut microbiota (GM) is a complex ecosystem containing bacteria, viruses, fungi, and yeasts. It has several functions in the human body ranging from immunomodulation to metabolic. GM derangement is called dysbiosis and is involved in several host diseases. Pre-, probiotics, and symbiotics (PRE-PRO-SYMB) have been extensively developed and studied for GM re-modulation. Herein, we review the literature data regarding the new concept of postbiotics, starting from PRE-PRO-SYMB. Methods: we conducted a search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials, and case series using the following keywords and acronyms and their associations: gut microbiota, prebiotics, probiotics, symbiotic, and postbiotics. Results: postbiotics account for PRO components and metabolic products able to beneficially affect host health and GM. The deeper the knowledge about them, the greater their possible uses: the prevention and treatment of atopic, respiratory tract, and inflammatory bowel diseases. Conclusions: better knowledge about postbiotics can be useful for the prevention and treatment of several human body diseases, alone or as an add-on to PRE-PRO-SYMB.

Otorhinolaryngological Manifestations in COVID-19: Review of Recent Evidence

Objectives: In this review we provide an updated concise review about the most common Otorhinolaryngological symptoms in COVID-19 patients. Methods: A searched strategy designed on published literature in different large medical databases and journals using various keywords to get the recent described manifestations. Results: 25 included studies that focused on ENT symptoms and involved the confirmed cases only. 6276 patients were accounted for the results which showed that the most prevalent ENT manifestation were cough in 3498 (56%) patients, headache in 2013 (32%) patients, sore throat in 1966 (31%) patients, anosmia in 1340 (21%) patients, loss of taste in 914 (15%) patients, and rhinorrhea in 196 (3%) patients. Conclusion: Cough was the commonest symptoms which should raise the suspicion to do COVID-19 swab especially if associated with smell and taste disorder.

Dorsal Preservation Rhinoplasty: A Literature Review

Acceptance of the preservation principle in rhinoplasty surgery has increased dramatically, and surgeons worldwide are now performing preservation rhinoplasty, leading to an expanding list of indications and techniques. Rhinoplasty surgeons are increasingly opting for rhinoplasty preservation because of its conservative approach and more predictable outcome. This review aims to evaluate the efficacy of dorsal preservation rhinoplasty, as well as the techniques, indications, surgical protocols, complications, and any practical challenges associated with this type of rhinoplasty. A number of medical databases, including Medline-PubMed, Embase, and Scopus, were searched. These searches were supplemented with a manual search using the keyword “preservation rhinoplasty” (PR) during the 1970 to May 2020 time span. The search strategy was limited to case reports, randomized clinical trials, and prospective studies of preservation dorsal rhinoplasty in journals published in English. A total of 150 articles that incorporated preservation dorsal rhinoplasty as a newer surgical technique were reviewed: 136 from PubMed, 17 experimental studies from Embase, 17 clinical studies from Scopus, and 8 studies identified by data extraction. Preservation rhinoplasty represents a paradigm shift in rhinoplasty philosophy. While techniques continue to improve, the philosophy remains the same: preserving and reshaping the existing nasal structures. Although not all patients benefit from and are satisfied with PR and some may only benefit from partial PR, preserving the anatomy allows for a more intuitive operation and natural results. For a more exhaustive review, readers are encouraged to turn their attention to dorsal preservation as a versatile and adaptable technique. Dorsal preservation avoids long-term issues with the middle vault and keystone area, and the patient benefits from total preservation, as the underlying structure can be reshaped without disruption.

Effects of Kinesio-Taping in Lateral Epicondylitis: A Narrative Review

Aim: The objective of this narrative review was to assess the effects of Kinesio-Taping in Lateral Epicondylitis. Methods: A comprehensive search of already published relevant articles only from medical databases like Google Scholar, PubMed and ScienceDirect was carried out for obtaining the same from the year 2014-2019. Background: Lateral epicondylitis is a familiar musculoskeletal disorder that primarily affects the extensors of the wrist. Kinesio-taping (KT) is a newer generation taping technique that aid's the body’s healing process whilst supporting and giving stability to the muscles and joints without hindering the range of motion of the body. Conclusion: The current review recognises the need for Kinesio-Taping in individuals with Lateral Epicondylitis as it has shown to enhance the functionality of the wrists and reduce pain. Limitations: More in-depth studies are to be conducted to find out the mechanism behind Kinesio-Taping.

Connecting the Dots Between Mental and Menstrual Health: An Exploratory Review

Context: Mental and menstrual health, two emerging aspects of health critical to the female population, are bidirectionally linked. But there is limited empirical evidence that establishes the association between these entities. This essay aims to draw the attention of researchers to this healthcare niche. Evidence Acquisition: An exploratory review was carried out on literatures sourced from medical databases (e.g. PubMed, Google Scholar, Scopus, Science Direct, and Web of Science), and gray sources-popular and reputable institutional and journalistic websites that publishes mental or menstrual health research. The key words used for the search are “menstruation, menstrual hygiene, menstrual disorders, premenstrual syndrome, period poverty, menarche, menopause, mental health, mental disorder, mental illness, depression, anxiety, phobia, mania, mood, and affect”. The initial search generated 368 results. But after the duplicates were removed, the exclusion criteria (publication before 2000, and in languages other than English) was applied, and manual review of abstract (for relevance) was done, 21 publications from the databases and 5 from gray sources were included in this review. Results: Associations were found between menstrual cycle irregularities and disorders; and mental disorders such as premenstrual syndrome, premenstrual dysphoric disorder, major depressive disorder, major anxiety disorder, psychotic disorder, bipolar disorder, borderline personality disorder, sleep disorder, substance use/abuse, and suicidal ideation and attempts. Few positive associations between mental and menstrual health were recorded, and several research and treatment gaps were identified. Conclusions: Research into the links between mental and menstrual health should not remain a fringe area of scientific curiosity, as it shows tremendous promise in improving healthcare offered to women/girls globally.

A new case-deletion strategy for case-base maintenance based on K-means Clustering Algorithm applied to medical data

Case-Based Reasoning (CBR) system maintenance is an important issue for current medical systems research. Large-scale CBR systems are becoming more omnipresent, with immense case libraries consisting of millions of cases. Case-Base Maintenance (CBM) is the implementation of the following policies allowing to revise the organization and/or the content (information content, representation field of application, or the implementation) of the Case Base (CB) to improve future thinking. Diverse case-base deletion and addition policies have been proposed which claim to preserve case-base competence. This paper presents a novel clustering-based deletion policy for CBM that exploits the K-means clustering algorithm. Thus, CBM becomes a central subject whose objective is to guarantee the quality of the CB and improve the performance of CBM. The proposed approach exploited clustering, which groups similar cases using the K-means algorithm. We rely on the characterization made of the different cases in the CB, and we find this characterization by a method based on a criterion of competence and performance. From this categorization, case deletion becomes obvious. This quality depends on the competence and performance of the CB. Test results show that the proposed deletion strategy improved the efficiency of the CB while preserving competence.Furthermore, its performance was 13% more reliable. The effectiveness of the proposed approach examined on the medical databases and its performance has been compared with the existing approaches on deletion policy. Experimental results are very encouraging.

Circulating Brain-Derived Neurotrophic Factor as a potential biomarker in stroke: a Systematic review and Meta-analysis

Background Stroke, an acute cerebrovascular event, is a leading cause of disability, placing a significant psycho-socioeconomic burden worldwide. Neuroplasticity is adaptation and reorganization following neuronal damage. Brain-derived neurotrophic factor (BDNF) is a neurotrophin coordinating neuroplasticity after various neurological disorders such as stroke. Methods We conducted a systematic search in the main electronic medical databases through January 2021 and identified studies that measured blood levels of BDNF in patients with stroke. The primary aim was to compare BDNF levels between patients with stroke and healthy controls (HC). The secondary aims included investigation of (1) longitudinal changes in the BDNF levels post-stroke, (2) effects of physical training, (3) repeated transcranial magnetic stimulation (rTMS), and presence of depression on BDNF levels in patients with stroke. Results Among 6243 reviewed records from PubMed, Web of Science, and Scopus, 62 studies were eligible for inclusion. Subjects with stroke, n = 1856, showed lower BDNF levels compared to HC, n=1191 (SMD [95%CI] = -1.04 [-1.49 to -0.58]). No significant difference was detected in the level of BDNF through time points past stroke. BDNF levels were lower in the patients with depression compared to non-depressed subjects (SMD [95%CI] = -0.60 [-1.10 to -0.10]). Physical training had an immediate positive effect on the BDNF levels and not statistically significant effect in the long term; SMD [95%CI] = 0.49 [0.09 to 0.88]) and SMD [95%CI] = 0.02 [-0.43 to 0.47]). Lastly, rTMS showed no effect on the level of BDNF with 0.00 SMD. Conclusions This study confirms that stroke significantly affects the level of BDNF in various domains such as cognition, affect, and motor function. We believe that BDNF could be regarded as a valuable diagnostic biomarker for acute stroke and a potential prognostic biomarker for depression and cognitive deficits.

Socioeconomic status and use of analgesic drugs before and after primary hip arthroplasty: a population-based cohort study of 103,209 patients during 1996–2018

Background and purpose — Total hip arthroplasty (THA) is an effective and common procedure. However, persistent pain and analgesic requirement up to 2 years after THA surgery are common. We examined the trends in the utilization of analgesics before and after THA, overall, and in relation to socioeconomic status (SES) in a populationbased cohort. Patients and methods — We used the Danish Hip Arthroplasty Register to identify 103,209 patients who underwent THA between 1996 and 2018. Data on prescriptions and SES markers was obtained from Danish medical databases. Prevalence rates of redeemed prescriptions for analgesics with 95% confidence intervals were calculated for 4 quarters before and 4 quarters after THA for the entire THA population, and by 3 SES markers (education, cohabiting status, and wealth). Results — Overall, the prevalence of analgesic use prior to surgery was 42% at 9–12 months and 59% at 0–3 months before the THA. The prevalence of analgesics reached its highest at 64% 0–3 months after THA but declined to 27% at 9–12 months after THA. Low education, living alone, and having low wealth (low SES) were associated with higher prevalence of analgesics use both before and after THA. Interpretation — 59% of patients used analgesics 0–3 months before surgery, which could indicate that THA might not be considered the last option for treatment and that surgery criteria might depend more on factors such as patient preferences or hip function. Moreover, health professionals should prioritize the use of a detailed plan when phasing out analgesics after THA to counteract unnecessary use, especially when treating patients with low SES.