Predicting De-Handing Point in Bananas Using Crown Morphology and Interpretable Machine Learning

Repeat transurethral resection (ReTUR) is essential for reducing residual and recurrent non-muscle-invasive bladder cancer (NMIBC). Pathological upstaging after ReTUR significantly influences prognosis. This study aimed to develop an interpretable machine learning model using CT radiomics to predict the risk of pathological upstaging following ReTUR in NMIBC patients. We retrospectively analyzed 104 NMIBC patients who underwent ReTUR at the Second Affiliated Hospital of Nanchang University from March 2019 to July 2022. Data were split 7:3 into training and internal validation sets. An external validation set included 40 patients from two other hospitals. Radiomic features were extracted from preoperative CT scans. Least Absolute Shrinkage and Selection Operator (LASSO) and multivariate logistic regression were used to identify predictors of pathological upstaging. Four machine learning models, including Extreme Gradient Boosting (XGBoost), Gradient Boosting Decision Tree (GBDT), Random Forest (RF), and Linear Discriminant Analysis (LDA), were constructed and evaluated using AUC, accuracy, precision, F1 score, calibration curves, and decision curve analysis (DCA). The best model was interpreted via SHapley Additive exPlanations (SHAP) to identify key predictive features. umor grade (OR = 7.02, 95% CI: 1.17-42.21), tumor size (OR = 5.83, 95% CI: 1.21-28.15), and tumor number (OR = 6.83, 95% CI: 1.18-39.52) were independent risk factors. From 4,738 radiomic features, nine were selected. The XGBoost model outperformed others, with an AUC of 0.804 (95% CI: 0.756-0.862), accuracy of 77.4%, precision of 82.7%, and F1 score of 0.701 in internal validation. External validation confirmed its robustness. SHAP analysis highlighted Wavelet_LLH_firstorder_Maximum.1, Gradient_ngtdm_Complexity, and tumor grade as top predictors. The model showed good calibration and clinical utility on DCA. An interpretable CT radiomics-based machine learning model integrating clinical and imaging features was developed to accurately predict pathological upstaging risk after ReTUR in NMIBC patients. This tool may support clinical decision-making for individualized treatment after multicenter validation.

Background Currently, endoscopic submucosal dissection (ESD) has become the preferred treatment for superficial oesophageal squamous cell carcinoma (SESCC). However, due to the residual background mucosa, some patients are still at risk of postoperative recurrence. This study aimed to develop and validate an explainable machine learning model to predict recurrence risk in SESCC patients undergoing ESD. Methods We enrolled SESCC patients treated with ESD between 1 January 2016 and 31 December 2023. Patients from 2016 to 2021 were allocated to the training set, further split into a 7:3 ratio for model training and internal validation. Patients from 2022 to 2023 constituted the temporal validation set. Seven machine learning algorithms – logistic regression, extreme gradient boosting, light gradient boosting machine, random forest (RF), gradient boosting decision tree, Gaussian Naïve Bayes and Multilayer Perceptron – were employed to construct risk models. Shapley Additive exPlanations (SHAP) method was applied to interpret the optimal model’s feature importance. Results Eight predictors were identified for model construction: platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, low-density lipoprotein level, biological age, mid-oesophageal location, multiple tumour lesions, poor differentiation and infiltration depth (muscularis mucosa or superficial submucosa). Among the seven models, the RF algorithm demonstrated superior performance, achieving an area under the receiver operating characteristic curve of 0.892 in internal validation and 0.761 in temporal validation. An online prediction platform (https://zzhapp.shinyapps.io/shiny/) was developed for clinical application. Conclusion This study successfully developed and validated an explainable RF-based machine learning model to accurately predict recurrence risk in SESCC patients after ESD.

Colorectal Cancer (CRC) is a highly prevalent malignancy globally, and early prediction is crucial for improving prognosis. This study used a multidimensional CRC dataset (n=1000) provided by the Kaggle platform, which contains 14 clinical and lifestyle characteristics. First, data imbalance was mitigated through Random Oversampling (ROM) and standardization. Subsequently, a comprehensive evaluation was performed on seven baseline machine learning models, including Gradient Boosting Decision Tree (GBDT), eXtreme Gradient Boosting (XGBoost) and so on. Based on performance metrics such as accuracy and F1 score, GBDT and XGBoost were subsequently selected as the optimal base learners. Finally, the predictive probability features generated by the base learners are fed into the meta-learners such as Random Forest (RF), K Nearest Neighbor (KNN) and Multi-Layer Perceptron (MLP) for secondary modeling. The interpretability of the model is achieved through the Shapley Additive exPlanations (SHAP) value, which quantifies the marginal contribution of each feature to the prediction. Experiments show that the RF integration architecture based on GBDT and XGBoost baseline models has the best performance (accuracy of 0.9527 and AUC of 0.9923). SHAP analysis showed that Activity_Level and BMI were core predictors with limited contribution from gender, confirming the prioritization of exercise and weight management in CRC prevention. The framework demonstrated excellent robustness and maintained its predictive advantage even when inefficient base models e.g., Logistic Regression (LR) were introduced. This study provides an interpretable machine learning paradigm for CRC risk stratification with potential for clinical translation.

BackgroundThis study aims to develop a advanced machine learning model to predict the fall risk among community-dwelling elders. This study could present actionable advices for early prevention of fall risk.MethodsBetween October and December 2022, 977 older adults from the Hannan District of Wuhan were recruited. Data was collected using structured questionnaires. The sample was randomly split into training (732 participants) and testing (245 participants) sets at a 3:1 ratio. The primary outcome was the occurrence of fall. Five machine learning models—Random Forest (RF), Gradient Boosted Decision Tree (GBDT), Light Gradient Boosting Machine (LGBM), Extreme Gradient Boosting (XGBoost), and Categorical Features Gradient Boosting (CatBoost)—were evaluated against a Logistic Regression (LR) model. Model performance was assessed using AUC, accuracy, precision, sensitivity, specificity, and F1 score.ResultsAmong the 977 older adults, 195 experienced falls (20.0%). ROC curve analysis showed AUC values of LR, RF, LGBM, GBDT, XGBoost, and CatBoost were, respectively, 0.8390, 0.8632, 0.8614, 0.8544, 0.8705, and 0.8719. CatBoost had the highest AUC, indicating the best predictive performance. SHapley Additive exPlanations (SHAP) analysis identified key features influencing the CatBoost model: history of falls, comorbidities, polypharmacy, sleep disorders, ADL, TUG results, frailty status, and use of assistive devices.ConclusionThe fall risk prediction model for community-dwelling older adults, developed with CatBoost, showed excellent performance and can aid in early clinical assessment and fall prevention.

Accurate prediction of in-hospital mortality for patients with severe community-acquired pneumonia (SCAP) complicated by respiratory failure admitted to the intensive care unit (ICU) remains a critical challenge. This study aimed to develop and validate a machine learning (ML) model to predict this risk and compare its performance with conventional scoring systems. In this retrospective study, data from 164 patients with SCAP and respiratory failure admitted to the ICU between January 2017 and January 2024 were analyzed. Patients were randomly divided into a training set (n = 114) and a validation (test) set (n = 50). Forty-five clinical features collected at admission were used as candidate predictors. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed for feature selection. Six ML models, including Gradient Boosting Decision Tree (GBDT), Random Forest (RF), eXtreme Gradient Boosting (XGBoost), Decision Tree(DT),Support Vector Machine (SVM), and Logistic Regression(LR), were constructed and evaluated.Use SHAP analysis to assess the contribution of each feature in a machine learning model. Construct a nomogram using the top six most influential features. The GBDT model demonstrated the best predictive performance, achieving an area under the receiver operating characteristic curve (AUC) of 0.83 (95% CI: 0.757-0.927) in the internal validation set, significantly outperforming the Acute Physiology and Chronic Health Evaluation II (APACHE-II, AUC = 0.70). Calibration curves demonstrated good agreement between predicted and observed mortality risks, particularly across the mid-probability range. Decision curve analysis indicated that the model provided a higher net benefit than "treat-all" and "treat-none" strategies across a broad range of threshold probabilities. SHapley Additive exPlanations (SHAP) analysis identified lactate, D-dimer, temperature, albumin, Prothrombin Time and Fraction of Inspired Oxygen as the six most influential predictors of in-hospital mortality. Based on these key predictors, we further developed a simplified nomogram to facilitate bedside risk estimation. The GBDT ML model, developed from routinely available clinical data, provides a highly accurate and clinically interpretable tool for predicting in-hospital mortality in SCAP patients with respiratory failure. It outperforms traditional severity scores and holds promise for assisting clinicians in risk stratification and early intervention.

PurposeTo analyze the risk factors for preterm birth in patients with early-onset preeclampsia (EOPE) based on multi-algorithm machine learning and to construct a predictive model to explore the predictive value of the model.MethodsA retrospective analysis was conducted on 442 EOPE patients from a single tertiary center, divided into preterm birth (<37 weeks, n=358) and term-born (≥37 weeks, n=84) groups. Univariate analysis, random forest importance assessment, lasso regression combined with multivariate regression analysis were used for feature evaluation. Eight machine learning models were trained (70% data) and validated (30% data). A Stacking ensemble model was constructed, and SHapley Additive exPlanations (SHAP) was used for feature interpretation.ResultsThe area under the receiver operating characteristic curve (AUROC) for predicting preterm birth in EOPE patients using Logistic Regression, Gaussian Naive Bayes, Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine, Support Vector Machine (SVM), Gradient Boosting Decision Tree (GBDT), Multi-Layer Perceptron, and Elastic Net were 0.763, 0.712, 0.821, 0.832, 0.821, 0.842, 0.784, and 0.763, respectively. The Stacking model (XGBoost+GBDT+SVM) achieved superior performance (AUROC=0.865). Three independent risk factors were identified: fetal growth restriction (aOR=3.50, p = 0.047), serum cystatin C (aOR=11.27, p = 0.018), and C-reactive protein (aOR=1.37, p < 0.001). SHAP analysis revealed GBDT as the top contributor to Stacking predictions, with microalbunminuria (GBDT, XGBoost) and age (SVM) being the most influential features.ConclusionMachine learning models can serve as reliable assessment tools for predicting the risk of preterm birth in patients with EOPE. The ensemble prediction model demonstrates the best predictive performance, helping obstetricians identify high-risk patients and perform early intervention to improve perinatal outcomes.

Chronic pain around the temporomandibular joint (TMJ) and masticatory muscles is a primary symptom of temporomandibular disorders (TMD). However, the clinical significance of magnetic resonance imaging (MRI) features in predicting TMD-related pain remains unclear. This study aimed to develop and interpret machine learning (ML) models based on MRI characteristics for predicting pain severity in patients with TMD. The present retrospective study included 584 patients with TMD between January 2022 and December 2024, yielding a total of 755 TMJ MRI data sets. Pain severity was classified using the visual analogue scale (VAS). Demographic variables (age, sex) and MRI features-including lesion side, disc position, disc morphology, disc signal, disc perforation, bilaminar zone tear, joint space, joint effusion, condylar movement, bony changes and morphology/signal of the lateral pterygoid muscle-were collected. Eleven ML models based on demographic and MRI features were developed: logistic regression (LR), support vector machine (SVM), random forest (RF), extreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM), adaptive boosting (AdaBoost), gradient boosting classifier (GBC), bagging classifier (BC), extremely randomised trees (ETC), decision tree classifier (DTC) and multilayer perceptron (MLP). Model performance was evaluated using multiple metrics, including the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity and F1 score. Precision-recall (PR) curves and calibration curves were plotted to assess discrimination and model calibration. Decision curve analysis (DCA) was conducted to evaluate the clinical net benefit across a range of threshold probabilities. Model interpretability was enhanced using Shapley Additive Explanations (SHAP), which quantified the contribution of each feature to individual predictions. Feature selection was conducted based on mean SHAP values, and separate LightGBM models were constructed using the Top 3, 5, and 9 most important features, as well as the full-feature set, for performance comparison. The data set was randomly divided into a training set (n = 604) and a test set (n = 151). Among the 11 ML models, the LightGBM model demonstrated the best predictive performance, with an AUC of 0.899, and was therefore identified as the optimal model. SHAP analysis identified age, disc position and condylar movement as the top three contributing features. Feature selection analysis indicated that selecting the top nine SHAP-ranked variables led to the highest diagnostic performance, with an AUC of 0.829. This study developed an interpretable, high-performing MRI-based ML model incorporating SHAP analysis to integrate imaging and clinical features for objective pain assessment, which may help identify high-risk TMD patients and guide personalised treatment strategies.

The frequent occurrence and spread of wildfires pose a serious threat to the ecological environment and urban development. Therefore, assessing regional wildfire susceptibility is crucial for the early prevention of wildfires and formulation of disaster management decisions. However, current research on wildfire susceptibility primarily focuses on improving the accuracy of models, while lacking in-depth study of the causes and mechanisms of wildfires, as well as the impact and losses they cause to the ecological environment and urban development. This situation not only increases the uncertainty of model predictions but also greatly reduces the specificity and practical significance of the models. We propose a comprehensive evaluation framework to analyze the spatial distribution of wildfire susceptibility and the effects of influencing factors, while assessing the risks of wildfire damage to the local ecological environment and urban development. In this study, we used wildfire information from the period 2013–2022 and data from 17 susceptibility factors in the city of Guilin as the basis, and utilized eight machine learning algorithms, namely logistic regression (LR), artificial neural network (ANN), K-nearest neighbor (KNN), support vector regression (SVR), random forest (RF), gradient boosting decision tree (GBDT), light gradient boosting machine (LGBM), and eXtreme gradient boosting (XGBoost), to assess wildfire susceptibility. By evaluating multiple indicators, we obtained the optimal model and used the Shapley Additive Explanations (SHAP) method to explain the effects of the factors and the decision-making mechanism of the model. In addition, we collected and calculated corresponding indicators, with the Remote Sensing Ecological Index (RSEI) representing ecological vulnerability and the Night-Time Lights Index (NTLI) representing urban development vulnerability. The coupling results of the two represent the comprehensive vulnerability of the ecology and city. Finally, by integrating wildfire susceptibility and vulnerability information, we assessed the risk of wildfire disasters in Guilin to reveal the overall distribution characteristics of wildfire disaster risk in Guilin. The results show that the AUC values of the eight models range from 0.809 to 0.927, with accuracy values ranging from 0.735 to 0.863 and RMSE values ranging from 0.327 to 0.423. Taking into account all the performance indicators, the XGBoost model provides the best results, with AUC, accuracy, and RMSE values of 0.927, 0.863, and 0.327, respectively. This indicates that the XGBoost model has the best predictive performance. The high-susceptibility areas are located in the central, northeast, south, and southwest regions of the study area. The factors of temperature, soil type, land use, distance to roads, and slope have the most significant impact on wildfire susceptibility. Based on the results of the ecological vulnerability and urban development vulnerability assessments, potential wildfire risk areas can be identified and assessed comprehensively and reasonably. The research results of this article not only can improve the specificity and practical significance of wildfire prediction models but also provide important reference for the prevention and response of wildfires.

Lung cancer remains the leading cause of cancer-related incidence and mortality worldwide. Its tendency for postoperative distant metastasis significantly compromises long-term prognosis and survival. Accurately predicting the metastatic potential in a timely manner is crucial for formulating optimal treatment strategies. This study aimed to comprehensively compare the predictive performance of nine machine learning (ML) models and to enhance interpretability through SHAP (Shapley Additive Explanations), with the goal of developing a practical and transparent risk stratification tool for postoperative lung cancer management. Clinical data from 3,120 patients with stage I-III lung cancer who underwent radical surgery were retrospectively collected and randomly divided into training and testing cohorts. A total of 52 clinical, pathological, imaging, and laboratory variables were analyzed. Nine ML models-including eXtreme Gradient Boosting (XGBoost), Random Forest (RF), Light Gradient Boosting Machine (LightGBM), Adaptive Boosting (AdaBoost), Decision Tree (DT), Gradient Boosting Decision Tree (GBDT), Gaussian Naive Bayes (GNB), Complement Naive Bayes (CNB), and Multilayer Perceptron classifier (MLP)-were developed and evaluated. Model performance was assessed using accuracy, precision, recall, F1 score, ROC-AUC, PR-AUC, calibration, and decision curve analysis (DCA). All models were evaluated using nested cross-validation (outer stratified 70/30 splits repeated 10 times; inner fivefold tuning), with decision thresholds prespecified in the inner loop and applied unchanged to held-out tests. Given the approximately 4:1 class imbalance, cost-sensitive learning was primarily adopted, and PR-AUC was reported in addition to ROC-AUC. Among the nine models, GBDT demonstrated the highest predictive performance, achieving an AUC of 0.810 (95% CI: 0.748-0.872), accuracy of 0.766, sensitivity of 0.698, and specificity of 0.786 in the test set. SHAP analysis revealed that adjuvant chemotherapy, adjuvant radiotherapy, pathological N stage, age, body mass index (BMI), and preoperative neutrophil count (Pre-ANC) were the most influential predictors of distant metastasis. The combination of model performance and interpretability supported the model's potential for integration into clinical workflows to assist in real-time decision-making. In this work, we carried out a systematic comparison of nine machine learning algorithms in a large postoperative cohort under a coherent and interpretable framework. By jointly considering discrimination, calibration, clinical benefit (via decision curve analysis), and SHAP-based explanations, we constructed a practical prognostic tool to guide personalized treatment strategies and follow-up care. This methodology offers a data-driven basis for precision management. Ultimately, our findings provide an internally validated reference framework that warrants external and multicenter validation prior to clinical deployment.

Mastitis in dairy cows is a significant challenge faced by the global dairy industry, significantly affecting the quality and output of milk from dairy enterprises and causing them to suffer severe economic losses. With the increasing public concern over food safety and the rational use of antibiotics, how to identify cows at risk of disease early has become a key issue that needs to be urgently addressed. Especially subclinical mastitis, due to the lack of obvious external symptoms, makes detection more difficult, so early warning of it is particularly important. In this study, a time series prediction method, combined with machine learning techniques, was used to predict the risk of mastitis in dairy cows. The study data were obtained from the production records of 4000 dairy cows in a large farm in Hexi region of Gansu. By constructing time-series features, production indicators such as milk yield, fat rate and protein rate of each cow in two consecutive months, April and May, were utilized to predict its health status in June. To fully exploit the value of the time series features, we designed a multidimensional feature set that included raw indicator values, monthly change rates, and statistical features. After data preprocessing and sample balancing, data from 2821 cows were selected for model training. Finally, the applicability of each model was assessed by comparing and analyzing the prediction performance of six models, namely eXtreme Gradient Boosting(XGBoost), Gradient Boosting Decision Tree (GBDT), Support Vector Machine (SVM), K Nearest Neighbors (KNN), Logistic Regression, and Long Short-Term Memory Network (LSTM). The XGBoost model demonstrated optimal performance, achieving an area under the ROC curve (AUC) of 0.75 with an accuracy rate of 71.36%. Feature importance analysis revealed three key temporal indicators significantly influencing prediction outcomes: May milk yield (22.29%), standard deviation of fat percentage (20.27%), and fat percentage change rate (19.87%). SHapley Additive exPlanations (SHAP) value analysis further validated the predictive value of these temporal features, providing dairy farm managers with clearly defined monitoring priorities. The XGBoost model demonstrates strong potential as an accurate predictive tool for subclinical mastitis in dairy cows. This study presents an effective early-warning approach through time-series modeling that offers significant practical value for mastitis prevention in dairy farm management.

How urban air quality affects land values: Exploring non-linear and threshold mechanism using explainable artificial intelligence

The prediction of torque capacity in circular Concrete-Filled Double-Skin Tubular (CFDST) members under pure torsion is considered vital for structural design and analysis. In this study, torque capacity is predicted using machine learning (ML) algorithms, such as Categorical Boosting (CatBoost), Extreme Gradient Boosting (XGBoost), Gradient Boosting Machine (GBM), Random Forest (RF), and Decision Tree (DT), which are employed. The interpretation of the results is conducted using Shapley Additive Explanations (SHAPs). The performance of these ML models is evaluated against two traditional analytical formulas that have been proposed and are available in the literature. Through comprehensive analysis, it is shown that superior predictive capabilities are possessed by the CatBoost and XGBoost models, characterized by high R2 values and minimal mean errors. Additionally, insights into the influence of input features are provided by SHAP interpretation, with an emphasis on key parameters such as concrete compressive strength and steel tube dimensions. The gap between empirical models and ML techniques is bridged by this study, offering engineers a more accurate and efficient tool for CFDST structural design. Significant implications for optimizing CFDST column designs and advancing structural engineering practices are presented by these findings. Directions for future research include the further refinement of ML models and the integration of probabilistic analyses for enhanced structural resilience. Overall, the transformative potential of ML and SHAP interpretation in advancing the field of structural engineering is showcased by this study.

Radiomics and machine learning have been extensively utilized in the realm of urinary stones, particularly in forecasting stone treatment outcomes. The objective of this study was to integrate clinical variables and radiomic features to develop a machine learning model for predicting the stone-free rate (SFR) following percutaneous nephrolithotomy (PCNL).A total of 212 eligible patients who underwent PCNL surgery at the Second Affiliated Hospital of Nanchang University were included in a retrospective analysis. Preoperative clinical variables and non-contrast-enhanced CT images of all patients were collected, and radiomic features were extracted after delineating the stone ROI. Univariate analysis was conducted to identify clinical variables strongly correlated with the stone-free rate after PCNL, and the least absolute shrinkage and selection operator algorithm (lasso regression) was utilized to screen radiomic features. Four supervised machine learning algorithms, including Logistic Regression, Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Gradient Boosting Decision Tree (GBDT), were employed. The clinical variables with strong correlation and screened radiomic features were integrated into the four machine learning algorithms to construct a prediction model, and the receiver operating curve was plotted. The area under the receiver operating curve (AUC), the accuracy rate, the specificity, etc., were used to evaluate the predictive performance of the four models.After analyzing postoperative statistics, the stone-free rate following the procedure was found to be 70.3% (n = 149). Among the various clinical variables examined, factors, such as stone number, stone diameter, stone CT value, stone location, and history of stone surgery, were identified as statistically significant in relation to the stone-free rate after PCNL. A total of 121 radiomic features were extracted, and through lasso regression, 7 features most closely associated with the stone-free rate post-PCNL were identified. The predictive accuracy of different models (Logistic Regression, RF, XGBoost, and GBDT) for determining the stone-free rate after PCNL was evaluated, yielding accuracies of 78.1%, 76.6%, 75.0%, and 73.4%, respectively. The corresponding area under the curve AUC (95%CI) were 0.85 (0.83-0.89), 0.81 (0.76-0.85), 0.82 (0.78-0.85), and 0.77 (0.73-0.81), positioning these models among the top performers in logistic regression prediction. In terms of predictive importance scores, the key factors identified by the logistic regression model were number of stone, zone percentage, stone diameter, and surface area. Similarly, the RF model highlighted number of stone, stone CT value, stone diameter, and surface area as the top predictors.Among the four machine learning models, the logistic regression model demonstrated the highest accuracy and discrimination ability in predicting the stone-free rate following PCNL. In comparison to XGBoost and GBDT, RF also exhibited superior accuracy and a certain level of discrimination ability. However, based on the performance of all four models, logistic regression is more likely to aid in clinical decision-making by assisting clinicians in diagnosing PCNL in patients. This enables us to effectively predict the presence of residual stones post-surgery and ultimately select patients who are suitable candidates for PCNL.

To construct machine learning prediction model for sepsis-associated encephalopathy (SAE), and analyze the application value of the model on early identification of SAE risk in elderly septic patients. Patients aged over 60 years with a primary diagnosis of sepsis admitted to intensive care unit (ICU) from 2008 to 2023 were selected from Medical Information Mart for Intensive Care-IV 2.2 (MIMIC-IV 2.2). Demographic variables, disease severity scores, comorbidities, interventions, laboratory indicators, and hospitalization details were collected. Key factors associated with SAE were identified using univariate Logistic regression analysis. The data were randomly divided into training and validation sets in a 7 : 3 ratio. Multivariable Logistic regression analysis was conducted in the training set and visualized using a nomogram model for prediction of SAE. The discrimination of the model was evaluated in the validation set using the receiver operator characteristic curve (ROC curve), and its calibration was assessed using calibration curve. Furthermore, multiple machine learning algorithms, including multi-layer perceptron (MLP), support vector machine (SVM), naive bayes (NB), gradient boosting machine (GBM), random forest (RF), and extreme gradient boosting (XGB), were constructed in the training set. Their predictive performance was subsequently evaluated on the validation set. Taking the XGB model as an example, the interpretability of the model through the SHapley Additive exPlanations (SHAP) algorithm was enhanced to identify the key predictive factors and their contributions. A total of 2 204 septic patients were finally enrolled, of whom 840 developed SAE (38.1%). A total of 21 variables associated with SAE were screened through univariate Logistic regression analysis. Multivariable Logistic regression analysis showed that endotracheal intubation [odds ratio (OR) = 0.40, 95% confidence interval (95%CI) was 0.19-0.88, P < 0.001], oxygen therapy (OR = 0.76, 95%CI was 0.53-0.95, P = 0.023), tracheotomy (OR = 0.20, 95%CI was 0.07-0.53, P < 0.001), continuous renal replacement therapy (CRRT; OR = 0.32, 95%CI was 0.15-0.70, P < 0.001), cerebrovascular disease (OR = 0.31, 95%CI was 0.16-0.60, P < 0.001), rheumatic disease (OR = 0.44, 95%CI was 0.19-0.99, P < 0.001), male (OR = 0.68, 95%CI was 0.54-0.86, P = 0.001), and maximum anion gap (AG; OR = 0.95, 95%CI was 0.93-0.97, P < 0.001) were associated with an decreased probability of SAE, and age (OR = 1.05, 95%CI was 1.03-1.06, P < 0.001), acute physiology score III (APSIII; OR = 1.02, 95%CI was 1.01-1.02, P < 0.001), Oxford acute severity of illness score (OASIS; OR = 1.04, 95%CI was 1.03-1.06, P < 0.001), and length of hospital stay (OR = 1.01, 95%CI was 1.01-1.02, P < 0.001) were associated with an increased probability of SAE. A nomogram model was constructed based on these variables. In the validation set, ROC curve analysis showed that the model achieved an area under the ROC curve (AUC) of 0.723, and the calibration curve showed good consistency between the predicted probability of the model and the observed probability. Among the machine learning algorithms, including MLP, SVM, NB, GBM, RF, and XGB, the SVM model and RF model demonstrated relatively good predictive performance, with AUC of 0.748 and 0.739, respectively, and the sensitivity was both exceeding 85%. The predictive performance of the XGB model was explained through SHAP analysis, and the results indicated that APSIII score (SHAP value was 0.871), age (SHAP value was 0.521), and OASIS score (SHAP value was 0.443) were important factors affecting the predictive performance of the model. The machine learning-based SAE prediction model exhibits good predictive capability and holds significant application value for the early identification of SAE risk in elderly septic patients.

Machine learning-driven prediction of tensile strength in 3D-printed PLA parts