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Background Artificial intelligence of things (AIoT) may be a solution for predicting adverse outcomes in emergency department (ED) patients with pneumonia; however, this issue remains unclear. Therefore, we conducted this study to clarify it. Methods We identified 52,626 adult ED patients with pneumonia from three hospitals between 2010 and 2019 for this study. Thirty-three feature variables from electronic medical records were used to construct an artificial intelligence (AI) model to predict sepsis or septic shock, respiratory failure, and mortality. After comparisons of the predictive accuracies among logistic regression, random forest, support-vector machine (SVM), light gradient boosting machine (LightGBM), multilayer perceptron (MLP), and eXtreme Gradient Boosting (XGBoost), we selected the best one to build the model. We further combined the AI model with the Internet of things as AIoT, added an interactive mode, and implemented it in the hospital information system to assist clinicians with decision making in real time. We also compared the AIoT-based model with the confusion-urea-respiratory rate-blood pressure-65 (CURB-65) and pneumonia severity index (PSI) for predicting mortality. Results The best AI algorithms were random forest for sepsis or septic shock (area under the curve [AUC] = 0.781), LightGBM for respiratory failure (AUC = 0.847), and mortality (AUC = 0.835). The AIoT-based model represented better performance than CURB-65 and PSI indicators for predicting mortality (0.835 vs. 0.681 and 0.835 vs. 0.728). Conclusions A real-time interactive AIoT-based model might be a better tool for predicting adverse outcomes in ED patients with pneumonia. Further validation in other populations is warranted.

Objectives This study investigated morning salivary cortisol concentration in relation to total body fat composition among community-dwelling Papua New Guinean adults. Methods In addition to demographic and anthropometric measurements, saliva was collected in a single morning from 478 residents in Eastern Highlands Province and Madang Province. Results After adjusting for age, region, and occupation, the morning salivary cortisol concentration was significantly negatively correlated with body mass index among men (B = −0.01, P

Various functional units FUs have been designed in modern embedded processors to perform different functions when running an application. Traditionally, compilers did not take this characteristic into account to reduce the temperature of a processor during execution. For many applications, the occurrences of different instructions are not the same after they are compiled. As a consequence, the temperature of the processor is very high, arising from the major heating contribution of the special structure of the active functional unit, and thus, the system will suffer severe damage. Consequently, to remedy this hurdle, this paper provides a solution by shifting the loading from heavy-loading FUs to light-loading FUs. Our approach first identifies all the FUs that can exchange the loading among themselves and then presents a thermal model for these exchangeable FUs to estimate the temperature impact on shifting loading. Finally, the loading shifting has been performed by transforming code under the consideration of limited performance loss without hardware cost. The result shows that our approach can reduce the temperature to a small cost of performance degradation and code expansion. Copyright © 2014 John Wiley & Sons, Ltd.

Hepatitis B virus Ag (HBsAg), a major antigen of hepatitis B virus (HBV), is also a vaccine component for prevention of HBV infection. Dendritic cells (DCs) of HBV carriers reportedly exhibit functional impairment. In this study, the aim was to investigate the effect of HBsAg on activation of human monocyte-derived dendritic cells (MD-DCs), and the subsequent signal transduction pathway. Treatment of MD-DCs with HBsAg resulted in enhanced cell surface expression of cluster of differentiation 80, CD83, CD86 and major histocompatibility complex class II, and increased interleukin (IL)-12 p40, IL-12p70, and IL-10 production. Furthermore, HBsAg treatment of MD-DCs with HBsAg resulted in enhanced T cell-stimulatory capacity and increased T cell secretion of interferon and IL-10. The pathway of MD-DCs activation by HBsAg was further investigated in the present study. Inhibition of nuclear factor (NF)-kappa B (κB) by helenalin and p38 mitogen-activated protein kinase (MAPK) by SB203580 prevented production of IL-12 p40, IL-12 p70, and IL-10. HBsAg also augmented MAPK phosphorylation. Thus, cytokine secretion of human MD-DCs by HBsAg is blocked by inhibition of the NF-κB and p38 MAPK pathways. Likewise, decreased inhibition of kappa B alpha concentrations and MAPK phosphorylation are critical for MD-DC maturation by HBsAg. These findings may provide a strategy for improving the prophylactic and therapeutic efficacy of vaccines and tumor therapies that utilize these pathways.

A reliable forecasting model is essential in real-time flood forecasting for reducing natural damage. Efforts to develop a real-time forecasting model over the past two decades have been numerous. This work applies the Grey model to forecast rainfall and runoff owing to the model's relative ability to predict the future using a small amount of historical data. Such a model significantly differs from the stochastic and deterministic models developed previously. Ten historical storm events from two catchment areas in northern Taiwan are selected to calibrate and verify the model. Results in this study demonstrate that the proposed models can reasonably forecast runoff one to four hours ahead, if the Grey error prediction method is further used to update the output of the model.

Maximum rainfall intensity–duration–frequency (IDF) curves are commonly applied to determine the design rainfall in water resource projects. Normally, the IDF relationship is derived from recording rain gauges. As the network of non-recording rain gauges (daily rainfall) in Taiwan has a higher density than recording rain gauges, attempts were made in this study to extend the IDF relationship to non-recording rain gauges. Eighteen recording rain gauges and 99 non-recording rain gauges over the Chi-Nan area in Southern Taiwan provide the data sets. The regional IDF formulae were generated for ungauged areas to estimate rainfall intensity for various return periods and rainfall durations larger than or equal to one hour. For rainfall durations less than one hour, a set of adjustment formulae were applied to modify the regional IDF formulae. The method proposed in this study had reasonable application to non-recording rain gauges, which was concluded from the verification of four additional recording rain gauges. © 1997 John Wiley & Sons, Ltd.

From January 1976 through December 1985, 895 patients with cervical carcinoma were treated with radical hysterectomy and pelvic lymphadenectomy. The surgical specimens of 23 cases were proved to be adenosquamous cell carcinoma, the incidence being 2.6%. Among them, 15 were at stage IB, 7 were at stage IIA and one was at stage IIB. The overall 5-year survival rate was 55.0% and there was no difference between patients at stage IB and IIA. During the same period the 5-year survival rate of squamous cell carcinoma was 87.5% for patients at stage IB and 75.0% for patients at stage IIA. Pelvic lymph node metastasis and parametrial involvement are considered to be poor prognostic factors. When metastasis or invasion happens, the metastatic or invasive lesions can be found in the form of pure squamous carcinoma or adenocarcinoma. Postoperative adjuvant radiotherapy (external irradiation plus brachytherapy) seems to be effective in preventing recurrence. Chemotherapy (PVB regimen) needs more clinical evaluation. In this study, when metastasis or recurrence developed, the response to radiotherapy and/or chemotherapy were poor and 75% of patients died within one year.

This retrospective study collected the surgical tissues and the clinical records of 197 surgically treated patients with microinvasive carcinoma of the cervix, which was defined as a limited microinvasion not more than 3 mm in depth regardless of lymph-vascular involvement. Depth of invasion was 1 mm or less in 13.2% and 1.1 to 3 mm in 86.8%. The mean age was 47.2 years. About half of the patients were asymptomatic but suspected cytologically. Random cervical biopsy alone was inadequate for diagnosis. Cone biopsy demonstrated an accuracy of 94% in diagnosis, but failed to eliminate microinvasive carcinoma in 23.0% of the hysterectomy specimens. In 14 cases, the invasion was more extensive in the uterus than in the cone. A positive correlation has been found between the diagnostic rate of conization and the depth of stromal invasion. Cervical conization, while relatively accurate in assessing the existence of stromal invasion that characterizes microinvasion, failed to diagnose those with deeper stromal invasion, especially beyond 1 mm. The recommended approach in diagnosing microinvasion is careful colposcope-directed cone biopsy and proper examination of the conization specimen in order to exclude the possibility of more advanced disease.