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Abstract Secondary neurologic decline (ND) after traumatic brain injury (TBI) is independently associated with outcome, but robust predictors of ND are lacking. In this retrospective analysis of consecutive isolated TBI admissions to the R. Adams Cowley Shock Trauma Center between November 2015 and June 2018, we aimed to develop a triage decision support tool to quantify risk for early ND. Three machine learning models based on clinical, physiologic, or combined characteristics from the first hour of hospital resuscitation were created. Among 905 TBI cases, 165 (18%) experienced one or more ND events (130 clinical, 51 neurosurgical, and 54 radiographic) within 48 h of presentation. In the prediction of ND, the clinical plus physiologic data model performed similarly to the physiologic only model, with concordance indices of 0.85 (0.824–0.877) and 0.84 (0.812–0.868), respectively. Both outperformed the clinical only model, which had a concordance index of 0.72 (0.688–0.759). This preliminary work suggests that a data-driven approach utilizing physiologic and basic clinical data from the first hour of resuscitation after TBI has the potential to serve as a decision support tool for clinicians seeking to identify patients at high or low risk for ND.

Band clustering has been widely used for hyperspectral band selection (BS). However, selecting an appropriate band to represent a band cluster is a key issue. Density peak clustering (DPC) provides an effective means for this purpose, referred to as DPC-based BS (DPC-BS). It uses two indicators, cluster density and cluster distance, to rank all bands for BS. This paper reinterprets cluster density and cluster distance as band local density (BLD) and band distance (BD) and also introduces a new concept called band prominence value (BPV) as a third indicator. Combining BLD and BD with BPV derives new band prioritization criteria for BS, which can extend the currently used DPC-BS to a new DPC-BS method referred to as band density prominence clustering (BDPC). By taking advantage of the three key indicators of BDPC, i.e., cut-off band distance bc, k nearest neighboring-band local density, and BPV, two versions of BDPC can be derived called bc-BDPC and k-BDPC, both of which are quite different from existing DPC-based BS methods in three aspects. One is that the parameter bc of bc-BDPC and the parameter k of k-BDPC can be automatically determined by the number of clusters and virtual dimensionality (VD), respectively. Another is that instead of using Euclidean distance, a spectral discrimination measure is used to calculate BD as well as inter-band correlation. The most important and significant aspect is a novel idea that combines BPV with BLD and BD to derive new band prioritization criteria for BS. Extensive experiments demonstrate that BDPC generally performs better than DPC-BS as well as many current state-of-the art BS methods.