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. 2025 Jan 2;15:95. doi: 10.1038/s41598-024-83862-x

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 5 — Conceptual diagram of factors explaining day-to-day changes in therapeutic intensity. The percentage values represent the differential explanation of ordinal variation in next-day changes in TIL^(Basic) as measured by Somers’ D_xy. The bolded percentage values represent the 95% confidence interval of Somers’ D_xy from days 2–6 of ICU stay, whilst the percentage values below them represent the 95% confidence interval of Somers’ D_xy from day 1 of ICU stay (Fig. 3c). The 95% confidence intervals were derived using bias-corrected bootstrapping (1000 resamples) to represent the variation across 20 repeated five-fold cross-validation partitions. The leading static and dynamic pathophysiological factors were determined by qualitative categorisation of the variables with the highest contribution to next-day changes in TIL^(Basic) based on ΔTimeSHAP values (Fig. 4). Abbreviations: TIL = therapy intensity Level, TIL^(Basic) = condensed, five-category TIL scale as defined in Table 1.