{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:35:47Z","timestamp":1772138147289,"version":"3.50.1"},"reference-count":89,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T00:00:00Z","timestamp":1709337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cardiff University School of Medicine PhD Studentships"},{"name":"EU Horizon 2020 Marie Sk\u0142odowska-Curie postdoctoral fellowship"},{"name":"Welsh Government\u2019s Accelerate"},{"name":"S\u00ear Cymru II programmes"},{"name":"Health and Care Research Wales Clinical Research Time Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sepsis is characterized by a dysfunctional host response to infection culminating in life-threatening organ failure that requires complex patient management and rapid intervention. Timely diagnosis of the underlying cause of sepsis is crucial, and identifying those at risk of complications and death is imperative for triaging treatment and resource allocation. Here, we explored the potential of explainable machine learning models to predict mortality and causative pathogen in sepsis patients. By using a modelling pipeline employing multiple feature selection algorithms, we demonstrate the feasibility of identifying integrative patterns from clinical parameters, plasma biomarkers, and extensive phenotyping of blood immune cells. While no single variable had sufficient predictive power, models that combined five and more features showed a macro area under the curve (AUC) of 0.85 to predict 90-day mortality after sepsis diagnosis, and a macro AUC of 0.86 to discriminate between Gram-positive and Gram-negative bacterial infections. Parameters associated with the cellular immune response contributed the most to models predictive of 90-day mortality, most notably, the proportion of T cells among PBMCs, together with expression of CXCR3 by CD4+ T cells and CD25 by mucosal-associated invariant T (MAIT) cells. Frequencies of V\u03b42+ \u03b3\u03b4 T cells had the most profound impact on the prediction of Gram-negative infections, alongside other T-cell-related variables and total neutrophil count. Overall, our findings highlight the added value of measuring the proportion and activation patterns of conventional and unconventional T cells in the blood of sepsis patients in combination with other immunological, biochemical, and clinical parameters.<\/jats:p>","DOI":"10.1093\/cei\/uxae019","type":"journal-article","created":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T15:32:46Z","timestamp":1709393566000},"page":"293-306","source":"Crossref","is-referenced-by-count":8,"title":["Conventional and unconventional T-cell responses contribute to the prediction of clinical outcome and causative bacterial pathogen in sepsis patients"],"prefix":"10.1093","volume":"216","author":[{"given":"Ross J","family":"Burton","sequence":"first","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"},{"name":"Adult Critical Care, University Hospital of Wales, Cardiff and Vale University Health Board , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lo\u00efc","family":"Raffray","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"},{"name":"Department of Internal Medicine, F\u00e9lix Guyon University Hospital of La R\u00e9union , Saint Denis, R\u00e9union Island , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda M","family":"Moet","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone M","family":"Cuff","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A","family":"White","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E","family":"Baker","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4354-4572","authenticated-orcid":false,"given":"Bernhard","family":"Moser","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"},{"name":"Systems Immunity Research Institute, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4089-8460","authenticated-orcid":false,"given":"Valerie B","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"},{"name":"Systems Immunity Research Institute, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0035-2228","authenticated-orcid":false,"given":"Peter","family":"Ghazal","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"},{"name":"Systems Immunity Research Institute, Cardiff University , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2357-7190","authenticated-orcid":false,"given":"Matt P","family":"Morgan","sequence":"additional","affiliation":[{"name":"Adult Critical Care, University Hospital of Wales, Cardiff and Vale University Health Board , Cardiff , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7501-4090","authenticated-orcid":false,"given":"Andreas","family":"Artemiou","sequence":"additional","affiliation":[{"name":"School of Mathematics, Cardiff University , Cardiff , UK"},{"name":"Department of Information Technologies, University of Limassol , 3025 Limassol, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-5348","authenticated-orcid":false,"given":"Matthias","family":"Eberl","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"},{"name":"Systems Immunity Research Institute, Cardiff University , Cardiff , 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