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Background: The aim of this study was to build a clinical decision support system (CDSS) in diabetic retinopathy (DR), based on type 2 diabetes mellitus (DM) patients. Method: We built a CDSS from a sample of 2,323 patients, divided into a training set of 1,212 patients, and a testing set of 1,111 patients. The CDSS is based on a fuzzy random forest, which is a set of fuzzy decision trees. A fuzzy decision tree is a hierarchical data structure that classifies a patient into several classes to some level, depending on the values that the patient presents in the attributes related to the DR risk factors. Each node of the tree is an attribute, and each branch of the node is related to a possible value of the attribute. The leaves of the tree link the patient to a particular class (DR, no DR). Results: A CDSS was built with 200 trees in the forest and three variables at each node. Accuracy of the CDSS was 80.76%, sensitivity was 80.67%, and specificity was 85.96%. Applied variables were current age, gender, DM duration and treatment, arterial hypertension, body mass index, HbA1c, estimated glomerular filtration rate, and microalbuminuria.

Fuzzy measures are used to express background knowledge of the information sources. In fuzzy rule-based models, the rule confidence gives an important information about the final classes and their relevance. This work proposes to use fuzzy measures and integrals to combine rules confidences when making a decision. A Sugeno λ-measure and a distorted probability have been used in this process. A clinical decision support system (CDSS) has been built by applying this approach to a medical dataset. Then we use our system to estimate the risk of developing diabetic retinopathy. We show performance results comparing our system with others in the literature.

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A Fuzzy Decision Tree is a classification method consisting of a set of rules defined on fuzzy variables. The final class assignment is done according to the output of all the rules of the tree. Generally, the maximum operator is used to aggregate the results of the rules. However, some approaches based on more complex aggregation operators have appeared recently. In this work we propose to use Sugeno and Choquet integrals together with a Hierarchically ⊥-Decomposable Fuzzy Measure (HDFM) to aggregate the rules' values. The HDFM exploits the hierarchical structure of the fuzzy decision tree and takes into account the confidence value of the output together with the classification ambiguity of the rules. The HDFM is built using Sugeno-Weber t-conorms.We validate this approach on several classification problems and make a comparison of the performance with the state of art aggregation operators. Finally, a case study with a real dataset of diabetic patients is analyzed to predict the risk of suffering from diabetic retinopathy.

[Co(AMPY)(DAPY)Cl2(H2O)].H2O (1) [Cu(AMPY)(DAPY)Cl2(H2O)].H2O (2) [Zn(AMPY)(DAPY)Cl2(H2O)] (3) were prepared from the ligands; AMPY = 2-amino-4-methylpyrimidine (L1), DAPY = 2,3-diaminopyridine (L2) and CoCl2.6H2O, CuCl2.2H2O and ZnCl2 in water/ethanol solutions and the three products characterized by elemental analysis, ultraviolet-visible spectroscopy (UV–Vis), Fourier-transform infrared spectroscopy (FT-IR), magnetic susceptibility, molar conductivity methods, and TGA analysis. The X-ray powder diffraction of the Co(II), Cu(II), and Zn(II) compounds showed that the geometry of monoclinic and SEM analysis revealed their morphology with a smooth surface. Molecular modeling was performed for all compounds using the density functional method DFT/B3LYP to study the structures and the frontier molecular orbitals (HOMO and LUMO). We have used Gaussian09 software for the calculations. In this study, different complexes were tested against Gram negative and Gram positive bacterial species to give insight into their broad-spectrum effects. The used pathogenic strains were two Gram positive species "Staphylococcus aureus and Micrococcus luteus" and two Gram negative species "Salmonella thyphimurium and Escherichia coli. The antifungal activity was evaluated against a pathogenic reference strain of the yeast Candida albicans. The antimicrobial and antioxidant assay results demonstrate that the tested compounds are effective against Gram positive and negative bacteria. Additionally, the compounds have an antifungal effect against Candida albicans with a maximum inhibitory zone of 2.5cm. The results demonstrated high antioxidant potential for the Zn(II) complex with a DPPH scavenging of 91.5%, however, the Cu(II) complex was low (16.5%). The data of docking with tyrosyl-tRNA synthetase presented that all compounds fit very well in the catalytic pockets of the proteins of the receptor.