Background Recently, the explainability of the prediction results of machine learning models has attracted attention. Most high-performance prediction models are black boxes that cannot be explained. Artificial neural networks are also considered black box models. Although they can explain image classification results to some extent, they still struggle to explain the classification and regression results for tabular data. In this study, we explain the individual prediction results derived from a neural network-based prediction model. Methods The output of a neural network is fundamentally determined by multiplying the input values by the network weights. In other words, the output is a weighted sum of the input values. The weights control how much each input value contributes to the output. The degree of influence of an input value xi on the output can be evaluated as (xi · weight value wi)/weighted sum. From this insight, we can calculate the contribution of each input value to the output as it flows through the neural network. Results With the proposed method, the neural network is no longer a black box. The proposed method effectively explains the predictions made by the neural network and is independent of the depth of the hidden layers and the number of nodes in each hidden layer. This provides a clear rationale for this interpretation. It can be applied to both regression and classification models. The proposed method is implemented as a Python library, making it easy to use.
Abstract Funding Acknowledgements Type of funding sources: None. Background The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. Purpose We aimed to investigate the relationship between hypertension burden and the development of incident AF. Methods and Results: Using the Korean National Health Insurance Service database, we identified 3,726,172 subjects who underwent four consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22,012 patients (0.59% of the total study population, 1.168 per 1,000 person-years). Using the BP values at each health checkup, we determined the burden of hypertension (systolic blood pressure [SBP] ≥130 mmHg or diastolic blood pressure [DBP] ≥80 mmHg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n = 742,806), 19% (n = 704,623), 19% (n = 713,258), 21% (n = 766,204), and 21% (n = 799,281). Compared to normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semi-quantitative analyses with further stratification of stage 1 (SBP 130-139 mmHg or DBP 80-89 mmHg) and stage 2 (SBP ≥140 mmHg or DBP ≥90 mmHg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. Conclusions Both a sustained exposure and the degree of increased blood pressure were associated with an increased risk of incident AF. Tailored blood pressure management should be emphasized to reduce the risk of AF. Abstract Figure.
AbstractThe title compound is synthesized by solid state reaction of U, Se, CsCl or Cs2Se3, and P or As (1273 K for 4 h, 1223 K for 96 h, 1073 K for 96 h, 5 wt.% yield).
Ernesto Schulz Lang, Gelson Manzoni de Oliveira, Ramão Marceli Fernandes Jr.
et al.
AbstractThe direct reaction between PhTeCl3 and CsCl in methanol affords {Cs[PhTeCl4]·CH3OH}. Cs[PhTeBr4] was prepared by refluxing [2‐Br‐C5NH5][PhTeBr4] and CsCl in ethanol in the presence of an excess of HBr. In {Cs[PhTeCl4]·CH3OH} the [PhTeCl4]— units form dimers by secondary Te···Cl bonds with methanol molecules bridging adjacent Cs+ cations. In both compounds, the alkali metal cation interacts secondarily with the chlorine and bromine Te‐ligands, achieving singular coordination polyhedrons and holding the lattices in supramolecular tridimensional assemblies. The new complexes, {Cs[PhTeCl4]·CH3OH} and Cs[PhTeBr4], crystallize in the space groups P21/c and P21/n, respectively. Only one such structure has been reported before.
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Escalating healthcare costs in Singapore have produced a significant movement of patients into ambulatory care, and the consequent dearth of clinical teaching materials. This deficiency has likewise prompted the creation of ambulatory teaching clinics and the use of standardised patients and simulators. In the last few decades, educators have utilised digital technology, for instance, digitally recorded heart and breath sounds, and digitised video vignettes, in medical education. We describe several pedagogical initiatives that we have undertaken at our university school of medicine. Key words: Clinical material, Digital image, Multimedia
Introduction: Singaporeans are superstitious, and medical staff are no exception to the rule. We conducted a survey to determine the prevalence of superstitious beliefs and practices amongst doctors, nurses and medical students in Singapore. Methods: Internet and face-to-face surveys of 68 respondents, all of whom completed the survey after being threatened with curses and hexes. Results: Sixty-eight doctors, nurses and medical students responded to our survey. Only 11 admitted to being superstitious, yet 31 believed in the ill-fortune associated with eating bao or meat dumplings, 6 in the nefarious powers of black (5) or red (1) outfits on call, and 14 believed that bathing (6 insisting on the powers of the seven-flower bath) prior to the onset of a call portended good fortune, in terms of busy-ness of a call. Twenty-four believed in “black clouds”, i.e. people who attracted bad luck whilst on call, and 32 refused to mouth the words “having a good call” until the day after the event. We discovered 2 hitherto undescribed and undiscovered superstitions, namely the benefits of eating bread and the need to avoid beef, for the good and ill fortune associated with their ingestion. Discussion: Superstitious practices are alive and well in modern-day Singapore, the practice not necessarily being restricted to the poorly-educated or foolish. Key words: Call, Doctor, Duty, Superstition