Effect of cannabis use on blood levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF): A systematic review and meta-analysis.

BACKGROUND: The impact of cannabis uses on blood levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) remains uncertain, with conflicting findings reported in the literature. BDNF and NGF both are essential proteins for neuron's growth, and their dysregulation is seen in various mental disorders. This study aims to evaluate the relationship between cannabis usage and BDNF and NGF levels due to their potential implications for mental health. METHODS: A comprehensive search of electronic databases was performed using appropriate MeSH terms and keywords. Inclusion criteria comprised human studies investigating the relationship between cannabis use and BDNF and NGF levels. RESULTS: A total of 11 studies met the inclusion criteria and were included. The pooled analysis revealed a nonsignificant association between cannabis use and dysregulated blood levels of BDNF (random-effects model, standardized mean differences [SMD] = .26, 95% CI -.34 to .76, p = .40). The results of our subgroup analysis based on BDNF source showed a nonsignificant between-group difference. For NGF levels, four studies were included, the pooled analysis revealed a nonsignificant association between cannabis use and dysregulated blood levels of NGF (random-effects model, SMD = -.60, 95% CI -1.43 to -.23, p = .16). In both analyses, high heterogeneity was observed among the included studies which is a notable limitation to current meta-analysis. CONCLUSION: This systematic review highlights the need for further research to elucidate the relationship between cannabis use and these neurotrophic factors. A better understanding of these associations can contribute to our knowledge of the neurobiological effects of cannabis and inform potential implications for mental health, cognitive function, and neurodegenerative disorders.

The effect of psychedelics on the level of brain-derived neurotrophic factor: A systematic review and meta-analysis.

BACKGROUND: Recent interest in the potential therapeutic effects of psychedelics has led to investigations into their influence on molecular signaling pathways within the brain. AIMS: Integrated review and analysis of different studies in this field. METHODS: A systematic search was conducted across international databases including Embase, Scopus, Web of Science, and PubMed from inception to 9 July 2023. Eligibility criteria encompassed published and peer-reviewed studies evaluating changes in brain-derived neurotrophic factor (BDNF) levels after psychedelic consumption. OUTCOMES: A total of nine studies were included in our study. The meta-analysis demonstrated significantly higher BDNF levels in psychedelic consumers compared to healthy controls, with a pooled standardized mean difference of 0.26 (95% CI: 0.10-0.42, I2 = 38.51%, p < 0.001). Leave-one-out analysis indicated robustness in results upon removal of individual psychedelics. No significant publication bias was observed. The results highlight the potential influence of psychedelics on neuroplasticity by altering BDNF levels. CONCLUSIONS: More precisely, the documented rise in BDNF levels indicates a neurobiological mechanism by which psychedelics could enhance synaptic plasticity and foster the growth of neurons. Given the limited data available on this topic, the conclusions remain uncertain. Consequently, we highly recommend additional research with more extensive sample sizes to yield more reliable evidence in this field.

Effect of alcohol on Brain-Derived Neurotrophic Factor (BDNF) blood levels: a systematic review and meta-analysis.

Brain-Derived Neurotrophic Factor (BDNF) is a vital protein involved in neuronal development, survival, and plasticity. Alcohol consumption has been implicated in various neurocognitive deficits and neurodegenerative disorders. However, the impact of alcohol on BDNF blood levels remains unclear. This systematic review and meta-analysis aimed to investigate the effect of alcohol consumption on BDNF blood levels. A comprehensive search of electronic databases was conducted to identify relevant studies. Eligible studies were selected based on predefined inclusion criteria. Data extraction was performed, and methodological quality was assessed using appropriate tools. A meta-analysis was conducted to estimate the overall effect size of alcohol consumption on BDNF levels. A total of 25 studies met the inclusion criteria and were included in the final analysis. Alcohol use and BDNF blood levels were significantly correlated, according to the meta-analysis (p = 0.008). Overall, it was discovered that drinking alcohol significantly decreased BDNF levels (SMD: - 0.39; 95% CI: - 0.68 to - 0.10; I2: 93%). There was a non-significant trend suggesting that alcohol withdrawal might increase BDNF levels, with an SMD of 0.26 (95% CI: - 0.09 to 0.62; I2: 86%; p = 0.14). Subgroup analysis based on the source of BDNF demonstrated significant differences between the subgroups (p = 0.0008). No significant publication bias was observed. This study showed that alcohol consumption is associated with a significant decrease in BDNF blood levels. The findings suggest a negative impact of alcohol on BDNF levels regardless of alcohol dosage. Further studies are needed to strengthen the evidence and elucidate the underlying mechanisms.

Efficacy and safety of sodium-glucose cotransporter-2 inhibitors for heart failure with mildly reduced or preserved ejection fraction: a systematic review and meta-analysis of randomized controlled trials.

Aims: We sought to conduct a meta-analysis to evaluate the efficacy and safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with heart failure (HF) with preserved ejection fraction (HFpEF) and HF with mildly reduced ejection fraction (HFmrEF). Methods: We searched the Cochrane Library, MEDLINE (via PubMed), Embase, and ClinicalTrials.gov till March 2023 to retrieve all randomized controlled trials of SGLT2i in patients with HFpEF or HFmrEF. Risk ratios (RRs) and standardized mean differences (SMDs) with their 95% confidence intervals (95% CIs) were pooled using a random-effects model. Results: We included data from 14 RCTs. SGLT2i reduced the risk of the primary composite endpoint of first HF hospitalization or cardiovascular death (RR 0.81, 95% CI: 0.76, 0.87; I2 = 0%); these results were consistent across the cohorts of HFmrEF and HFpEF patients. There was no significant decrease in the risk of cardiovascular death (RR 0.96, 95% CI: 0.82, 1.13; I2 = 36%) and all-cause mortality (RR 0.97, 95% CI: 0.89, 1.05; I2 = 0%). There was a significant improvement in the quality of life in the SGLT2i group (SMD 0.13, 95% CI: 0.06, 0.20; I2 = 51%). Conclusion: The use of SGLT2i is associated with a lower risk of the primary composite outcome and a higher quality of life among HFpEF/HFmrEF patients. However, further research involving more extended follow-up periods is required to draw a comprehensive conclusion. Systematic Review Registration: PROSPERO (CRD42022364223).

Frailty among patients undergoing breast reconstruction surgery: A systematic review and meta-analysis.

BACKGROUND: We conducted a systematic review and meta-analysis to evaluate the predictive value of frailty for predicting postsurgical complications in patients undergoing breast reconstruction surgery. METHODS: MEDLINE (PubMed), Scopus, Web of Science, and Embase were searched for relevant studies up to September 13, 2022. A systematic review and meta-analysis of studies were performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement criteria. RESULTS: Nine studies were included in this research. The rates of overall complications (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.17-1.97, I2 = 76%; p = 0.002), wound complications (OR 1.87, 95% CI 1.56-2.26, I2 = 16%; p < 0.0001), readmissions (OR 1.94, 95% CI 1.61-2.34, I2 = 15%; p < 0.0001), and reoperations (OR 1.41, 95% CI 1.12-1.77, I2 = 39%; p = 0.003) were significantly greater in frail patients than in nonfrail undergoing breast reconstruction surgery. Furthermore, compared with nonfrail patients, this difference remained significantly higher among prefrail individuals (overall complications: OR 1.27, 95% CI 1.13-1.41, I2 = 67%; p < 0.001, wound complications: OR 1.48, 95% CI 1.33-1.66, I2 = 24%; p < 0.0001, readmission: OR 1.47, 95% CI 1.34-1.61, I2 = 0%; p < 0.0001, reoperation: OR 1.32, 95% CI 1.23-1.42, I2 = 0%; p < 0.0001). We found that frail patients undergoing immediate autologous reconstruction surgery are the most vulnerable to experiencing overall postoperative complications. CONCLUSION: Frailty is a strong predictor of postsurgical complications after breast reconstruction surgery in frail and prefrail patients. The most frailty index utilized was the modified five-item frailty index (mFI-5). More research is needed on this topic to assess the utility of frailty in practice, especially in countries other than the United States.

The effects of Gymnema Sylvestre supplementation on lipid profile, glycemic control, blood pressure, and anthropometric indices in adults: A systematic review and meta-analysis.

There is a growing interest in the considerable health benefits of Gymnema Sylvestre (GS) supplementation, as some studies have reported that it may improve cardiometabolic risk factors. However, the widespread impact of GS supplementation on the parameters mentioned above is not fully resolved. Consequently, this study aimed to examine the effects of GS supplementation on lipid profile, glycemic control, blood pressure, and anthropometric indices in adults. Eligible randomized controlled trials (RCT), published up to November 2021, were identified through PubMed, Scopus, and ISI Web of Science databases. Six studies were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence intervals (CI). All studies were conducted in adults that used a GC supplement (>1 week) and assessed our selected cardiovascular risk factors. Outcomes revealed that GS supplementation significantly decreased triglyceride (p < .001), total cholesterol (p < .001), low-density lipoprotein (p < .001), fasting blood sugar (p < .001), and diastolic blood pressure (p = .003). Some limitations, including notable heterogeneity, low quality of studies, and lack of diversity among research participants, should be considered when interpreting our results. Our outcomes suggest that GS supplementation may improve cardiovascular risk factors. Future large-high-quality RCTs with longer duration and various populations are needed to firmly establish the clinical efficacy of the plant.

Self-Supervised Learning for Electroencephalography.

Decades of research have shown machine learning superiority in discovering highly nonlinear patterns embedded in electroencephalography (EEG) records compared with conventional statistical techniques. However, even the most advanced machine learning techniques require relatively large, labeled EEG repositories. EEG data collection and labeling are costly. Moreover, combining available datasets to achieve a large data volume is usually infeasible due to inconsistent experimental paradigms across trials. Self-supervised learning (SSL) solves these challenges because it enables learning from EEG records across trials with variable experimental paradigms, even when the trials explore different phenomena. It aggregates multiple EEG repositories to increase accuracy, reduce bias, and mitigate overfitting in machine learning training. In addition, SSL could be employed in situations where there is limited labeled training data, and manual labeling is costly. This article: 1) provides a brief introduction to SSL; 2) describes some SSL techniques employed in recent studies, including EEG; 3) proposes current and potential SSL techniques for future investigations in EEG studies; 4) discusses the cons and pros of different SSL techniques; and 5) proposes holistic implementation tips and potential future directions for EEG SSL practices.

Mental health status of students during coronavirus pandemic outbreak: A cross-sectional study.

Introduction: University students have been extensively affected with psychological problems due to outbreak of COVID-19 pandemic given their special position and status. In this study, we intend to examine the prevalence of depression, anxiety and stress among a group of students. Methods: This cross-sectional study was performed in medical Sciences universities of Mazandaran Province. 352 students were recruited by simple available sampling method. Data collection tools were Standard Mental Health Questionnaire (DASS-21) and demographic information questionnaire. Data analysis was done using SPSS software through descriptive and analytical statistics. Results: The mean age of students was 22.44 ± 3.4 and 54.3% of them were females. 33.6, 28.4, and 27.3% of students had moderate to extremely severe levels of symptoms of depression, anxiety, and stress, respectively. There was a significant relationship between total mental health score with physical activity (p < 0.04) and with smoking (p < 0.02). There was also a significant relationship between smoking and depression (p < 0.01). Conclusion: Considering the fact that anxiety, stress and depression are common among medical sciences students of Mazandaran Province, necessary measures must be taken to improve their mental health status.

COVID-19 Infection Among Women in Iran Exposed vs Unexposed to Children Who Received Attenuated Poliovirus Used in Oral Polio Vaccine.

Importance: Live attenuated vaccines may provide short-term protection against infectious diseases through stimulation of the innate immune system. Objective: To evaluate whether passive exposure to live attenuated poliovirus is associated with diminished symptomatic infection with SARS-CoV-2. Design, Setting, and Participants: In a longitudinal cohort study involving 87 923 people conducted between March 20 and December 20, 2020, the incidence of COVID-19 was compared between 2 groups of aged-matched women with and without exposure to live attenuated poliovirus in the oral polio vaccine (OPV). Participants were people receiving health care services from the Petroleum Industry Health Organization and residing in 2 cities in Iran (ie, Ahwaz and Shiraz). Participants were women aged 18 to 48 years whose children were aged 18 months or younger and a group of age-matched women from the same residence who had had no potential exposure to OPV. Exposures: Indirect exposure to live attenuated poliovirus in OPV. Main Outcomes and Measures: Symptomatic COVID-19, diagnosed by reverse transcription-polymerase chain reaction. Results: After applying the inclusion and exclusion criteria, 419 mothers (mean [SD] age, 35.5 [4.9] years) indirectly exposed to the OPV and 3771 age-matched women (mean [SD] age, 35.7 [5.3] years) who had no exposure to OPV were available for analysis. COVID-19 was diagnosed in 1319 of the 87 923 individuals in the study population (151 per 10 000 population) during the study period. None of the mothers whose children received OPV developed COVID-19 after a median follow-up of 141 days (IQR, 92-188 days; range, 1-270 days); 28 women (0.74%; 95% CI, 0.47%-1.02%) in the unexposed group were diagnosed with COVID-19 during the 9 months of the study. Point-by-point comparison of the survival curves of the exposed and unexposed groups found that indirect exposure to OPV was significantly associated with decreased COVID-19 acquisition; probability of remaining without infection was 1.000 (95% CI, 1.000-1.000) in the exposed group vs 0.993 (95% CI, 0.990-0.995) in the unexposed group after 9 months (P < .001). Conclusions and Relevance: In this cohort study, indirect exposure to live attenuated poliovirus was associated with decreased symptomatic infection with COVID-19. Further study of the potential protective effect of OPV should be conducted, especially in nations where OPV is already in use for polio prevention and specific COVID-19 vaccines are delayed, less affordable, or fail to meet demand.

The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study.

OBJECTIVE: Handover without a structured format is prone to the omission of information and could be a potential risk to patient safety. We sought to determine the effect of a structured checklist on the quality of intraoperative change of shift handover between scrubs and circulars. METHODS: We conducted a control intervention study on operating room wards of two teaching hospitals from 20 Feb to 21 Nov 2020. This research was conducted in three stages as follows: assessing the current situation (as a group before the intervention), performing the intervention and evaluating the effect of using a checklist on handover quality after the intervention in two groups: with and without checklist. We examined the quality of handover between scrub and circular personnel in terms of handover duration and quality, omission of information and improvement in OR staff satisfaction. RESULTS: A total of 120 handovers were observed and evaluated. After intervention in the group using the checklist, the percentage of information omission in surgical report was decreased from 19.5 to 12.1% between scrubs (P < 0.00) and from 16.8 to 14.1% between circulars (P < 0.03). Also, in the role of scrub, the mean overall score of handover process quality was significantly higher after the intervention (x̄ = 7 ± 1.5) than before it (x̄ = 6.5 ± 0.9) (p < 0.02). In the role of circulating, despite the positive effect of overall score checklist, no significant difference was observed (p < 0.08). The use of checklist significantly increased the handover duration between scrubs (p < 0.03) and circulars (p < 0.00). The overall mean percentage of handover satisfaction increased from 67.5% before the intervention to 85.5% after the intervention (p < 0.00). CONCLUSION: The implementation of a new structured handover checklist had a positive impact on improving the quality of communication between the surgical team, reducing the information omission rate and increasing the satisfaction.

Development and Psychometric Evaluation of the Gerontological Nursing Competence Questionnaire in Iranian Hospitals.

BACKGROUND: This study evaluated the Gerontological Nursing Competence Questionnaire-Farsi version (GNCQ-F) in Iranian hospitals. METHOD: This exploratory sequential study used a mixed-methods design. The questionnaire items were developed based on a qualitative descriptive exploratory study and a review of the literature. The psychometric properties of the initial questionnaire including face validity, content validity, construct validity, internal consistency, and stability were evaluated. RESULTS: Exploratory factor analysis resulted in the extraction of 42 items in five factors including care competence and patient/older adult and family empowerment, ethical and compassionate care competence, patient safety competence, continuous professional development and self-care competence, and collaborative and team care competence. Cronbach's alpha coefficient confirmed the internal consistency of each subscale and the entire tool (0.942). The stability reliability was 0.973 and was determined by calculating the intra-cluster correlation coefficient. CONCLUSION: Nurses can use this self-evaluation instrument to assess their gerontological nursing competence. [J Contin Educ Nurs. 2021;52(7):335-343.].

The risk of surgery-related pressure ulcer in diabetics: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Postoperative pressure ulcers are known as the most important quality indicators of intraoperative care that create critical and costly complications during hospital care. Accordingly, this study was performed to determine the risk factor for diabetes in postoperative pressure ulcers. MATERIALS AND METHODS: The present study is a systematic review of PubMed, Scopus and the Web of Science databases with using standardized keywords of the performed English language articles between Jan 2010 to Jan 2020. The articles were searched independently by two related researchers to avoid possible biases. Then, all collected articles were reviewed, and articles with inclusion criteria were evaluated using a data collection table. It should be noted that the data were analyzed using STATA software version 11.1. RESULTS: Overall, the results showed that 19724 patients were identified from 15 studies conducted in Asia (six), the America (four), Europe (four), and Australia (one) from 1989 to 2019. The results showed that patients with diabetes were more likely to experience surgery-related pressure ulcers than patients without diabetes (The odds ratio of 1.52; the 95% confidence interval: 1.25-1.85). CONCLUSION: In general, patients with diabetes increased the risk of surgery-related pressure ulcers about 1.5 times more than others. Accordingly, the reduction of surgery-induced pressure ulcers should be more extensively considered in patients with diabetes.

Gene expression of angiogenesis and apoptotic factors in female BALB/c mice with breast cancer after eight weeks of aerobic training.

OBJECTIVES: Breast cancer is the most common cancer in women, caused by a disorder in the angiogenesis and apoptosis process. Exercise can affect the process of angiogenesis and apoptosis in the tumor tissue. Thus, the aim of the present study was to investigate the changes in angiogenesis and apoptotic factors in mice with breast cancer after 8 weeks of exercise training. MATERIALS AND METHODS: Sixteen females BALB/c mice (age: 3-5 weeks and weight: 17.1 ± 0.1 g) with breast cancer were randomly divided into two groups of aerobic training and control. The aerobic training included 8 weeks and 5 sessions per week of running with an intensity of 14-20 m.min-1. HIF-1α, VEGF, miR-21 and cytochrome C, Apaf-1, caspase-9, and caspase-3 gene expressions were examined by real-time PCR. Repeated measures ANOVA, Bonferroni's post hoc test, and independent samples t-test were used to analyze the data (P<0.05). RESULTS: The results showed that aerobic training reduced the growth of tumor volume and significantly reduced miR-21 gene expression. Aerobic training also significantly increased the gene expression of HIF-1α, cytochrome C, Apaf-1, caspase-9, and caspase-3, while changes in VEGF gene expression were not statistically significant. CONCLUSION: It appears that aerobic exercise training reduces tumor size and ameliorates breast cancer by reducing miR-21 gene expression, suppressing the apoptosis process, and reducing angiogenesis.

The Relationship Between the Level of Copper, Lead, Mercury and Autism Disorders: A Meta-Analysis.

BACKGROUND AND OBJECTIVES: There is a likelihood of a possible relationship between the concentrations of copper, lead, and mercury and autism. The present review was carried out to determine the relationship between the concentrations of these elements and autism by meta-analysis. METHODS: In this study, searching Scopus, PubMed, and Science Direct databases, 18 articles conducted in different countries from 1982 to 2019 were collected. Studies' heterogeneity was investigated using the I2 index. The data were analyzed using R and STATA software. RESULTS: In these 18 studies, 1797 patients (981 cases and 816 controls) aged 2 to 16 years were examined. Concentration of the samples (blood, hair, and nails) for both case and control groups was evaluated. There was no significant relationship between copper concentration and autism (SMD (95% CI): 0.02 (-1.16,1.20); I2=97.7%; P=0.972); there was a significant relationship between mercury concentration and autism (SMD (95% CI): 1.96 (0.56,3.35); I2=98.6%; P=0.006); there was also a significant relationship between lead concentration and autism (SMD (95% CI): 2.81 (1.64,3.98); I2=97.8%; P=0.000). CONCLUSION: There is, nevertheless, a significant relationship between mercury concentration and autism. Thus, the concentration of mercury can be listed as a pathogenic cause (disease-causing) for autism.

Comparison of child abuse history in patients with and without functional abdominal pain: a case-control study.

BACKGROUND: Gastrointestinal (GI) disorders are ranked first amongst medical diseases as a trigger of requests for mental health counselling. Child abuse has been regarded as one of the main causes of the development of functional abdominal pain (FAP) in children. This study aimed, therefore, to compare the prevalence of child abuse experience among two groups of patients with and without FAP. METHODS: A case-control study of children in Arak, Iran, in which experience of child abuse was compared in children with (n = 100) and without functional abdominal pain (n = 100). Three categories of child abuse - emotional abuse, physical abuse, and neglect - were assessed using the Child Abuse Questionnaire. The data were analyzed using Stata software. RESULTS: After adjusting for potential confounders, there were group differences in emotional abuse (96% vs. 81%, aOR = 5.13, 95% CI: 1.3-20.3, p = 0.017), neglect (28% vs. 8%, aOR = 4.27, 95% CI: 1.8-11.8, p = 0.001) and total child abuse score (98% vs. 84%, aOR = 8.2, 95% CI: 1.5-43.8, p = 0.014) but not in physical abuse (57% vs. 46%, aOR = 1.47, 95% CI: 0.81-2.60, p = 0.728). CONCLUSIONS: As the prevalence of child abuse is higher in patients with FAP, child abuse appears to be related to the occurrence of FAP in children. However, the results of this study cannot be generalized to Iranian society generally and further longitudinal studies are recommended.

Correlation of Cardiac and Liver Iron Level with T2*MRI and Vitamin D3 Serum Level in Patients with Thalassemia Major.

INTRODUCTION: Thalassemia is a hypochromic microcytic anemia, which is characterized by congenital disorders. In thalassemia patients, bone diseases are one of the causes of mortality. Our goal was to investigate the association between vitamin D deficiency and increased iron uptake by cardiac myocytes and hepatocytes. MATERIALS AND METHODS: Forty patients with thalassemia major were studied in Amir Kabir Hospital, Arak, Iran. The information obtained through clinical examination. Serum ferritin level was determined by ELISA and T2*MRI performed for measuring iron content in the heart and the liver. RESULTS: The average age of the patients was 23.8 ± 10.7 years. The mean T2*MRI values were 23.7 ± 7. The vitamin D3 level in 33 patients (82.5% cases) was less than 20 ng/dl, 2 patients (5%) in the range of 20-30 ng/dl, and the others had above 30 ng/dl. Correlation between vitamin D and age was 0.611. Correlation coefficient between heart and liver T2*MRI with ferritin level in patients was 0.437 and 0.335, respectively. CONCLUSION: Due to significant associations, the periodic measurement of vitamin D, as well as PTH, is recommended for patients with thalassemia major.

The relationship between body mass index and preeclampsia: A systematic review and meta-analysis.

BACKGROUND: One of the causes of maternal and fetal mortality and morbidity is pregnancy-induced hypertension, the most common form of which is preeclampsia that causes many complications for mother and fetus. OBJECTIVE: The aim of this systematic review and meta-analysis was to determine the relationship between body mass index (BMI) and preeclampsia in Iran. MATERIALS AND METHODS: Using valid keywords in the SID database, PubMed, Scopus, data obtained from all the articles, which were reviewed in Iran between 2000 and 2016, were combined using the meta-analysis method (random-effects model) and analyzed using STATA version 11.1. RESULTS: A total number of 5,946 samples were enrolled in 16 studies with the mean BMI values of 25.13, 27.42, and 26.33 kg /m 2 in the healthy, mild, and severe preeclamptic groups, respectively. CONCLUSION: The results of this study revealed that there is a significant relationship between BMI and the risk of preeclampsia, so it can be said that BMI may be one of the ways to diagnose preeclampsia.

Predicting Improved Daily Use of the More Affected Arm Poststroke Following Constraint-Induced Movement Therapy.

BACKGROUND: Constraint-induced movement therapy (CI therapy) produces, on average, large and clinically meaningful improvements in the daily use of a more affected upper extremity in individuals with hemiparesis. However, individual responses vary widely. OBJECTIVE: The study objective was to investigate the extent to which individual characteristics before treatment predict improved use of the more affected arm following CI therapy. DESIGN: This study was a retrospective analysis of 47 people who had chronic (> 6 months) mild to moderate upper extremity hemiparesis and were consecutively enrolled in 2 CI therapy randomized controlled trials. METHODS: An enhanced probabilistic neural network model predicted whether individuals showed a low, medium, or high response to CI therapy, as measured with the Motor Activity Log, on the basis of the following baseline assessments: Wolf Motor Function Test, Semmes-Weinstein Monofilament Test of touch threshold, Motor Activity Log, and Montreal Cognitive Assessment. Then, a neural dynamic classification algorithm was applied to improve prognostic accuracy using the most accurate combination obtained in the previous step. RESULTS: Motor ability and tactile sense predicted improvement in arm use for daily activities following intensive upper extremity rehabilitation with an accuracy of nearly 100%. Complex patterns of interaction among these predictors were observed. LIMITATIONS: The fact that this study was a retrospective analysis with a moderate sample size was a limitation. CONCLUSIONS: Advanced machine learning/classification algorithms produce more accurate personalized predictions of rehabilitation outcomes than commonly used general linear models.