Comparison of Evapotranspiration Methods Under Limited Data

A limited number of parameters or a single meteorological parameter was used in this study to estimate evapotranspiration. The main objectives of this study are as follows. (1) The Penman-Monteith method was used to estimate ET. The empirical formula published by the Food and Agriculture Organization (FAO) was applied via substitution to compare situations that were missing certain meteorological parameters. (2) Radiation-based methods and temperature-based methods were compared with the Penman-Monteith method to estimate ET and discuss their applicability in the study area. With Tainan Weather Station of Taiwan as the study area, this study selected the Penman-Monteith method as well as six other radiation-based estimation formulas: Makkink, Turc, Jensen-Haise, Priestley-Taylor, Doorenbos-Pruit, and Abtew methods. The other four temperature-based estimation formulas, namely, Thornthwaite, Blaney-Criddle, Hamon, and Linacre methods, were used to estimate ET and compare the differences and the results were compared with the Penman-Monteith method. The results showed that there was little effect on estimating ET using the Penman-Monteith method when the wind speed data was missing or insufficient. The Turc method was the best among the six radiation-based estimation formulas, while the Linacre method was the best temperature-based estimation formula. Generally speaking, radiation-based estimation formulas were more accurate than temperature-based estimation formulas

The Discharge-Storage Relationship and the Long-Term Storage Changes of Southern Taiwan

In this study, the water balance concept is used to understand the relationship between discharge and storage in a basin. Three low flow analysis models developed by Brutsaert, Vogel and Kroll, and Kirchner are used to select recession curves that are parameterized using lower envelope, linear regression, and binning methods to characterize basin hydrological behavior. Furthermore, the lowest annual groundwater storage, which is analyzed according to trend, slope, and a change point test, is used to assess the long-term storage properties of southern Taiwan and is also quantified. The water balance concept is used to assess the impact of discharge on groundwater storage that is affected by the different low flow analysis models. This can lead to a more clear understanding of the relationship between groundwater storage and discharge. After statistical tests of trend, it was determined that Chaozhou Station, which has a significant decreasing trend of the lowest groundwater storage, should implement precautionary measures such as an underground reservoir, an artificial recharge, and a collection gallery in the Donggang River Basin

Spatiotemporal Analysis of Groundwater Recharge Trends and Variability in Northern Taiwan

In this study, the base flow estimation method was used to assess long‐term changes of groundwater recharge in Northern Taiwan. The Mann‐Kendall test was used to examine the characteristics of the trends. This was followed by trend slope calculation and change‐point analysis. The annual groundwater recharge was found to exhibit a significant upward trend for the Fushan and Hengxi stations (Tamsui river basin). On the other hand, the Ximen Bridge station (Lanyang river basin) recorded a significant downward trend. Calculations showed that the rate of change for the Fengshan and Touqian river basins was small (less than 10%). However, that for the following stations was greater than 30%: Fushan, Hengxi, Ximen Bridge, and Niudou (also in the Lanyang river basin). The results of the change‐point analysis further indicated a significant change‐point for the annual recharge at Fushan, Hengxi, and Ximen Bridge stations in 1999, 1983, and 2001, respectively. The findings can be used for regional hydrological studies and as reference for water resource planning

Different Renal Function Equations and Dosing of Direct Oral Anticoagulants in Atrial Fibrillation

BACKGROUND: Randomized trials of direct oral anticoagulants (DOACs) adopted the Cockcroft-Gault (CG) formula to calculate estimated glomerular filtration rate (eGFR) to determine the dosages of DOACs. OBJECTIVES: The authors aimed to investigate the agreements/disagreements of eGFRs calculated using different equations (CG, Modified Diet in Renal Disease [MDRD], and Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] formulas), and their impacts on the dosages of DOACs and clinical outcomes. METHODS: Medical data from a multicenter health care provider in Taiwan including 39,239 patients with atrial fibrillation were used. Among these patients, there were 11,185 and 2,323 patients treated with DOACs and warfarin, respectively. RESULTS: At the cutoff values of eGFR of 50 mL/min, the agreements were 78% between MDRD and CG and 81% between CKD-EPI and CG. The disagreements among the different equations were largely due to overestimations, especially for patients aged >75 years and with a body weight of <50 kg (58.8% for MDRD and 50.9% for CKD-EPI). Among patients receiving DOACs whose dosages were defined as “on label” based on MDRD or CKD-EPI, only those whose dosages were “truly on label” based on CG were associated with a lower risk of major bleeding (adjusted HR: 0.34; 95% CI: 0.26-0.45) compared to warfarin. CONCLUSIONS: The adoptions of MDRD or CKD-EPI rather than CG would result in inappropriate dosing of DOACs (mainly overdosing), which would attenuate the advantages of DOACs compared to warfarin. The CG equation should be used as the gold standard to calculate eGFRs and guide the DOAC dosages

Association between use of non–vitamin k oral anticoagulants with and without concurrent medications and risk of major bleeding in nonvalvular atrial fibrillation

Importance:  Non–vitamin K oral anticoagulants (NOACs) are commonly prescribed with other medications that share metabolic pathways that may increase major bleeding risk. Objective:  To assess the association between use of NOACs with and without concurrent medications and risk of major bleeding in patients with nonvalvular atrial fibrillation. Design, Setting, and Participants:  Retrospective cohort study using data from the Taiwan National Health Insurance database and including 91 330 patients with nonvalvular atrial fibrillation who received at least 1 NOAC prescription of dabigatran, rivaroxaban, or apixaban from January 1, 2012, through December 31, 2016, with final follow-up on December 31, 2016. Exposures:  NOAC with or without concurrent use of atorvastatin; digoxin; verapamil; diltiazem; amiodarone; fluconazole; ketoconazole, itraconazole, voriconazole, or posaconazole; cyclosporine; erythromycin or clarithromycin; dronedarone; rifampin; or phenytoin. Main Outcomes and Measures:  Major bleeding, defined as hospitalization or emergency department visit with a primary diagnosis of intracranial hemorrhage or gastrointestinal, urogenital, or other bleeding. Adjusted incidence rate differences between person-quarters (exposure time for each person during each quarter of the calendar year) of NOAC with or without concurrent medications were estimated using Poisson regression and inverse probability of treatment weighting using the propensity score. Results:  Among 91 330 patients with nonvalvular atrial fibrillation (mean age, 74.7 years [SD, 10.8]; men, 55.8%; NOAC exposure: dabigatran, 45 347 patients; rivaroxaban, 54 006 patients; and apixaban, 12 886 patients), 4770 major bleeding events occurred during 447 037 person-quarters with NOAC prescriptions. The most common medications co-prescribed with NOACs over all person-quarters were atorvastatin (27.6%), diltiazem (22.7%), digoxin (22.5%), and amiodarone (21.1%). Concurrent use of amiodarone, fluconazole, rifampin, and phenytoin with NOACs had a significant increase in adjusted incidence rates per 1000 person-years of major bleeding than NOACs alone: 38.09 for NOAC use alone vs 52.04 for amiodarone (difference, 13.94 [99% CI, 9.76-18.13]); 102.77 for NOAC use alone vs 241.92 for fluconazole (difference, 138.46 [99% CI, 80.96-195.97]); 65.66 for NOAC use alone vs 103.14 for rifampin (difference, 36.90 [99% CI, 1.59-72.22); and 56.07 for NOAC use alone vs 108.52 for phenytoin (difference, 52.31 [99% CI, 32.18-72.44]; P &lt; .01 for all comparisons). Compared with NOAC use alone, the adjusted incidence rate for major bleeding was significantly lower for concurrent use of atorvastatin, digoxin, and erythromycin or clarithromycin and was not significantly different for concurrent use of verapamil; diltiazem; cyclosporine; ketoconazole, itraconazole, voriconazole, or posaconazole; and dronedarone. Conclusions and Relevance:  Among patients taking NOACs for nonvalvular atrial fibrillation, concurrent use of amiodarone, fluconazole, rifampin, and phenytoin compared with the use of NOACs alone, was associated with increased risk of major bleeding. Physicians prescribing NOAC medications should consider the potential risks associated with concomitant use of other drugs

Investigation of Novel Noncontacting Measurement Method by the Design of Loop-Type Probe and Reconstruction of Radiation Modeling

Because the ICs’ application frequency and speed become higher and trends of system packaging and device under test request higher reliability, a novel technology combining noncontacting measurement method and reconstructing radiation model was proposed to solve signal deliveries in system packages or PCBs. In this study, a novel noncontacting method for the ICs’ measurements was investigated by the design of loop-type near-field probe and reconstructed the radiation model to substitute the traditional measurement methods, such as using probes and SMA connectors. A near-field probe was used to receive the coupling signal. The assessing circuit modeling could be completed by some synthesized theorems. According to the study’s results, frequency responses of reconstruction model developed by theorems, radiation measurements, and simulated by EM methods were highly curve fitting

Development of Interstitial Lung Disease Among Patients With Atrial Fibrillation Receiving Oral Anticoagulants in Taiwan.

ImportanceThere are emerging concerns from case reports and pharmacovigilance analyses of a possible risk of interstitial lung disease (ILD) associated with the use of factor Xa (FXa) inhibitors.ObjectiveTo evaluate the risk of incident ILD associated with the use of oral anticoagulants (OACs) in patients with nonvalvular atrial fibrillation (NVAF).Design, setting, and participantsThis nationwide retrospective cohort study used data from the Taiwan National Health Insurance Research Database. Patients with NVAF without preexisting lung disease who received OACs from June 1, 2012, to December 31, 2017, were included. Propensity score stabilized weighting (PSSW) was used to balance covariates across the medication groups (FXa inhibitors, dabigatran, and warfarin, with warfarin as the reference). Patients were followed up from the drug index date until the onset of ILD, death, or end of the study (December 31, 2019), whichever occurred first. Data were analyzed from September 11, 2021, to August 3, 2022.ExposuresPatients with NVAF were treated with FXa inhibitors, dabigatran, or warfarin.Main outcomes and measuresNew-onset idiopathic ILD.ResultsAmong the 106 044 patients (mean [SD] age, 73.4 [11.9] years; 59 995 men [56.6%]) included in the study, 64 555 (60.9%) received FXa inhibitors (apixban [n = 15 386], edoxaban [n = 12 413], and rivaroxaban [n = 36 756]), 22 501 (21.2%) received dabigatran, and 18 988 (17.9%) received warfarin at baseline. The FXa inhibitors were associated with a higher risk of incident ILD (0.29 vs 0.17 per 100 patient-years; hazard ratio, 1.54 [95% CI, 1.22-1.94]; P Conclusions and relevanceResults of this study suggest that FXa inhibitors were associated with lung injury among patients with NVAF who were treated with OACs. Physicians should be vigilant in monitoring for any potential adverse lung outcomes associated with the use of these drugs

Direct Oral Anticoagulants in Atrial Fibrillation Patients With Concomitant Hyperthyroidism

Objective Patients with hyperthyroidism were excluded from randomized clinical trials of direct oral anticoagulants(DOACs) for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Methods We performed a nationwide retrospective cohort study using data from the Taiwan National Health Insurance Research Database. We enrolled 3,213 and 1,181 NVAF patients with hyperthyroidism taking DOACs and warfarin, respectively, from June 1, 2012 to December 31, 2017. We also enrolled 53,591 and 16,564 NVAF patients without hyperthyroidism taking DOACs and warfarin, respectively. We used propensity score-based stabilized weights (PSSWs) to balance covariates across the study groups. We also used 1:4 matching on both taking DOACs, with (n=3,213) and without hyperthyroidism (n=12,852); and both taking warfarin, with (n=1,181) and without hyperthyroidism (n=4,724). Results After PSSW, DOAC had a comparable risk of ischemic stroke/systemic embolism (IS/SE) and a lower risk of major bleeding (hazard ratio (HR):0.65; [95% confidential interval (CI):0.44-0.96]; P=0.0295) than warfarin among patients with hyperthyroidism. There were comparable risks of IS/SE and major bleeding between those patients with and without hyperthyroidism. However, patients taking warfarin with hyperthyroidism had a lower risk of IS/SE than those without hyperthyroidism (HR:0.61; [95%CI:0.43-0.86]; P=0.0050). Conclusion Among NVAF Asian patients with concomitant hyperthyroidism, DOACs may be an effective and safer alternative to warfarin. Thromboprophylaxis with DOACs may be considered for such patients, and it is important to validate this finding in further prospective study.Supplemental materials (figures and tables) for the article of "Direct Oral Anticoagulants in Atrial Fibrillation Patients with Concomitant Hyperthyroidism" Funding provided by: Chang Gung Memorial HospitalCrossref Funder Registry ID: http://dx.doi.org/10.13039/100012553Award Number: CMRPG3G1371-3Funding provided by: Chang Gung Memorial HospitalCrossref Funder Registry ID: http://dx.doi.org/10.13039/100012553Award Number: CMRPG3F0991-3Funding provided by: Chang Gung Memorial HospitalCrossref Funder Registry ID: http://dx.doi.org/10.13039/100012553Award Number: CMRPD1K0031Funding provided by: Chang Gung Memorial HospitalCrossref Funder Registry ID: http://dx.doi.org/10.13039/100012553Award Number: CMRPG3K0021We performed a nationwide retrospective cohort study using data from the Taiwan National Health Insurance Research Database. We enrolled 3,213 and 1,181 NVAF patients with hyperthyroidism taking DOACs and warfarin, respectively, from June 1, 2012 to December 31, 2017

The risk of incident atrial fibrillation in patients with type 2 diabetes treated with sodium glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and dipeptidyl peptidase-4 inhibitors: a nationwide cohort study.

BackgroundAlthough a few meta-analyses were conducted to compare the risk of incident atrial fibrillation (AF) between sodium-glucose cotransporter-2 inhibitor (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and other anti-hyperglycemic agents using indirect or direct comparison, the above analyses showed conflicting results with each other. We aimed to evaluate the risk of new-onset AF associated with the use of SGLT2i, GLP-1RA, and dipeptidyl peptidase-4 inhibitor (DPP4i) among a large longitudinal cohort of diabetic patients.MethodsIn this nationwide retrospective cohort study based on the Taiwan National Health Insurance Research Database, a total of 344,893, 44,370, and 393,100 consecutive patients with type 2 diabetes without preexisting AF receiving GLP-1RA, SGLT2i, and DPP4i, respectively, were enrolled from May 1, 2016, to December 31, 2019. We used 1:1 propensity score matching (PSM) to balance covariates across paired study groups. Patients were followed from the drug index date until the occurrence of AF, death, discontinuation of the index drug, or the end of the study period (December 31, 2020), whichever occurred first.ResultsAfter PSM, there were 245,442, 43,682, and 39,190 paired cohorts of SGLT2i-DPP4i, SGLT2i-GLP-1RA, and GLP-1RA-DPP4i, respectively. SGLT2i treatment was associated with lower risk of new-onset AF in participants with type 2 diabetes compared with either DPP4i [hazard ratio (HR):0.90; 95% confidential interval (CI) 0.84-0.96; P = 0.0028] or GLP-1RA [HR 0.74; 95% CI 0.63-0.88; P = 0.0007] treatment after PSM. There was no difference in the risk of incident AF between GLP-1RA and DPP4i users [HR 1.01; 95% CI 0.86-1.19; P = 0.8980]. The above findings persisted among several important subgroups. Dapagliflozin was specifically associated with a lower risk of new-onset AF compared with DPP4i (P interaction = 0.02).ConclusionsCompared with DPP4i, SGLT2i but not GLP-1RA was associated with a lower risk of incident AF in patients with type 2 diabetes