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The current state of the art of Quantum Mechanical/molecular mechanical (QM/MM) molecular dynamics approaches in ground and electronically excited states and their applications to biological problems is reviewed. For a complete description of quantum phenomena, the quantum nature of both electrons and nuclei has to be taken into account. Most of the current QM/MM applications are based on adiabatic dynamics in the electronic ground state. However, for dynamics in electronically excited states, the coupling between states, which is mediated via the nuclear motion, can be sizable, and nonadiabatic effects have to be taken into account. Configuration Interaction Singles (CIS) is a popular method in QM/MM applications due to its computational expedience that allows for the treatment of several hundred atoms. Since the 1990s, the Modified Neglect of Differential Overlap (MNDO) method has been further extended to a d orbital basis. This MNDO/d extension allows for the treatment of heavier elements. By using feature selection algorithms348 to identify the most appropriate subset of relevant variables that describe a certain phenomenon, the high-dimensionality of QM/MM data can be reduced and used for further analysis with causal inference algorithms to establish unique cause-effect relationships.