Utilizing predictive machine-learning modelling unveils feature-based risk assessment system for hyperinflammatory patterns and infectious outcomes in polytrauma.

Purpose: Earlier research has identified several potentially predictive features including biomarkers associated with trauma, which can be used to assess the risk for harmful outcomes of polytraumatized patients. These features encompass various aspects such as the nature and severity of the injury, accompanying health conditions, immune and inflammatory markers, and blood parameters linked to organ functioning, however their applicability is limited. Numerous indicators relevant to the patients` outcome are routinely gathered in the intensive care unit (ICU) and recorded in electronic medical records, rendering them suitable predictors for risk assessment of polytraumatized patients. Methods: 317 polytraumatized patients were included, and the influence of 29 clinical and biological features on the complication patterns for systemic inflammatory response syndrome (SIRS), pneumonia and sepsis were analyzed with a machine learning workflow including clustering, classification and explainability using SHapley Additive exPlanations (SHAP) values. The predictive ability of the analyzed features within three days after admission to the hospital were compared based on patient-specific outcomes using receiver-operating characteristics. Results: A correlation and clustering analysis revealed that distinct patterns of injury and biomarker patterns were observed for the major complication classes. A k-means clustering suggested four different clusters based on the major complications SIRS, pneumonia and sepsis as well as a patient subgroup that developed no complications. For classification of the outcome groups with no complications, pneumonia and sepsis based on boosting ensemble classification, 90% were correctly classified as low-risk group (no complications). For the high-risk groups associated with development of pneumonia and sepsis, 80% of the patients were correctly identified. The explainability analysis with SHAP values identified the top-ranking features that had the largest impact on the development of adverse outcome patterns. For both investigated risk scenarios (infectious complications and long ICU stay) the most important features are SOFA score, Glasgow Coma Scale, lactate, GGT and hemoglobin blood concentration. Conclusion: The machine learning-based identification of prognostic feature patterns in patients with traumatic injuries may improve tailoring personalized treatment modalities to mitigate the adverse outcomes in high-risk patient clusters.

Discriminating Free Hand Movements Using Support Vector Machine and Recurrent Neural Network Algorithms.

Decoding natural hand movements is of interest for human-computer interaction and may constitute a helpful tool in the diagnosis of motor diseases and rehabilitation monitoring. However, the accurate measurement of complex hand movements and the decoding of dynamic movement data remains challenging. Here, we introduce two algorithms, one based on support vector machine (SVM) classification combined with dynamic time warping, and the other based on a long short-term memory (LSTM) neural network, which were designed to discriminate small differences in defined sequences of hand movements. We recorded hand movement data from 17 younger and 17 older adults using an exoskeletal data glove while they were performing six different movement tasks. Accuracy rates in decoding the different movement types were similarly high for SVM and LSTM in across-subject classification, but, for within-subject classification, SVM outperformed LSTM. The SVM-based approach, therefore, appears particularly promising for the development of movement decoding tools, in particular if the goal is to generalize across age groups, for example for detecting specific motor disorders or tracking their progress over time.