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Abstract: Background: Taiwan has separated drug prescribing and drug dispensing services since 1997. Because of this, patients with chronic illness as well as those with diseases that have a relatively stable status may have their prescriptions refilled in nearby clinic pharmacies without having to go to hospitals. Methods: Shuang-Ho Hospital in Taipei, Taiwan, implemented a drive-through pharmacy service as a more convenient refilling system to provide patients in need with a more effective way to refill their prescriptions. To assess the efficacy of this new refilling system, changes in patient drug prescription behavior were compared 6 months before and 6 months after the system was deployed. Results: We found an increase in the overall refilling prescription rate, with an increased use of online reservations (7.9% vs. 4.9%, p < 0.001), an increased proportion of medications picked up (93.0% vs. 88.1%, p < 0.001) after the implementation period, and an elevation in the percentage of patients using drive-through pharmacy services (45.4% vs. 28.9%, p < 0.001; second vs. first quarter, respectively) during the 6 months after the implementation period. Generally, the prescription refilling rate for all population categories at Shuang-Ho Hospital increased significantly after the drive-through service was provided (51.1% vs. 50.2%, p < 0.01). The middle-aged population group (40–65 years of age) was found to utilize the drive-through prescription service more than other age groups. Conclusion: The drive-through pharmacy provides patients with convenient access to pick up refilling prescriptions in a shorter time than ordinary pharmacy service. During a short-term follow-up, an overall increase in the prescription refilling rate was noted after the drive-through service was put into place. Our survey revealed that an upward of 90% of the patients were satisfied with the drive-through service. Future promotion of the service may help patients effectively utilize drive-through pharmacy prescription refilling and enhance disease control. [Copyright &y& Elsevier]

Abstract: In addition to the probability density function (pdf) derived with maximum entropy principle (MEP), several kinds of mixture probability functions have already been applied to estimate wind energy potential in scientific literature, such as the bimodal Weibull function (WW) and truncated Normal Weibull function (NW). In this paper, two other mixture functions are proposed for the first time to wind energy field, i.e. the mixture Gamma–Weibull function (GW) and mixture truncated normal function (NN). These five functions will be reviewed and compared together with conventional Weibull function. Wind speed data measured from 2006 to 2008 at three wind farms experiencing different climatic environments in Taiwan are selected as sample data to test their performance. Judgment criteria include four kinds of statistical errors, i.e. the max error in Kolmogorov–Smirnov test, root mean square error, Chi-square error and relative error of wind potential energy. The results show that all the mixture functions and the maximum entropy function describe wind characterizations better than the conventional Weibull function if wind regime presents two humps on it, irrespective of wind speed and power density. For wind speed distributions, the proposed GW pdf describes best according to the Kolmogorov–Smirnov test followed by the NW and WW pdfs, while the NN pdf performs worst. As for wind power density, the MEP and GW pdfs perform best followed by the WW and NW pdfs. The GW pdf could be a useful alternative to the conventional Weibull function in estimating wind energy potential. [Copyright &y& Elsevier]

Abstract: In this study, the electric energy from a photovoltaic module was calculated theoretically at different azimuths and tilt angles in Taiwan. The gain of the module mounted on a single-axis tracking panel relative to a traditional fixed panel was analyzed. To simulate different operation environments, both types of radiation will be considered in addition to observed radiation, i.e. the extraterrestrial radiation and the global radiation predicted by an empirical model. The results show that the optimal tilt angle obtained from the observed data is flatter than those from other two radiation types and becomes flatter while the panel deviates from due south. The yearly gains obtained from the extraterrestrial, predicted and observed radiations are 51.4%, 28.5% and 18.7%, respectively, if a single-axis tracked panel is installed with the yearly optimal tilt angle; the similar gains are 45.3%, 25.9% and 17.5%, respectively, while the panel is adjusted to its monthly optimal angle each month. The amount of yearly energy in due west (or east) is less than its maximum in due south by about 11%, 10% and 5% for the extraterrestrial, predicted and observed radiation respectively. The yearly conversion efficiency of a fixed module is 10.2%, 9.2% and 8.3% for the extraterrestrial, predicted and observed radiation, respectively. [Copyright &y& Elsevier]

Abstract: A theoretical study on the performance of an east–west oriented single-axis tracked panel was originally proposed in this paper. Mathematic expressions applicable for calculating the angle that the tracked panel should rotate by to follow the Sun are derived. The incident angle of sunlight upon the panel as well as the instantaneous increments of solar energy captured by the panel relative to a fixed horizontal surface are then demonstrated graphically. To simulate different operation environments, three kinds of radiation sources will be considered, i.e. the extraterrestrial radiation, global radiation predicted by empirical models under clear sky situation and global radiation observed in Taiwan. Simulation results show that the yearly gains correlate positively with the radiation level, i.e. 21.2%, 13.5% and 7.4% for the extraterrestrial, predicted and observed radiations, respectively, which are far less than those obtained from a north–south oriented single-axis tracked panel. The irradiation increases with the maximum rotation angle of the panel, the benefit of increasing the rotation in overcast environment is not as good as in clear sky, for annual energy collection 45° is recommended. The irradiation received decreases with latitude, but it has a greater gain in higher latitude zone. [Copyright &y& Elsevier]

Abstract: In this paper, the performance of a south facing single-axis tracked panel was analyzed according to global radiation predicted by empirical model. Mathematic expressions appropriate for single-axis tracking system were derived to calculate the radiation on it. Instantaneous increments of solar energy collected by the tracked panel relative to fixed panel are illustrated. The validity of the empirical model to Taiwan area will also be examined with the actual irradiation data observed in Taipei. The results are summarized as follows: the gains made by the tracked panel relative to a fixed panel are between 20.0% and 33.9% for four specified days of year, between 20.9% and 33.2% for the four seasons and 27.6% over the entire year. For latitudes below 65°, the yearly optimal tilt angle of a fixed panel is close to 0.8 times latitude, the irradiation ratio of the tracked panel to the fixed panel is about 1.3, which are smaller than the corresponding values calculated from extraterrestrial radiation, suggesting us that the installation angle should be adjusted toward a flatter angle and that the gain of the tracked panel will reduce while it works in cloudy climate or in air pollution environment. Although the captured radiation increases with the maximal rotation angle of panel, but the benefit on the global radiation case is still not so good as that on extraterrestrial radiation case. The irradiation data observed is much less than the data predicted by the empirical model, however the trend of fitting curve to the observed data is somewhat in agreement with that to the predicted one; the yearly gain is 14.3% when a tracked panel is employed throughout the year. [Copyright &y& Elsevier]

Abstract: In this paper, the global irradiation observed in Taiwan from 1990 to 1999 was used to estimate the optimal tilt angle for solar collectors. The observed data are resolved into diffusion and beam components, and transformed into instantaneous time frames using mathematical models. The energy gain on installing a single-axis tracked panel as compared to a traditional fixed panel is originally analyzed theoretically. In addition to the observation data, both types of radiation will be taken into account for comparison, i.e. both extraterrestrial radiation and global radiation predicted using empirical models. The results show that the yearly optimal angles for six selected stations are about 0.95 and 0.88 times their latitudes for extraterrestrial and predicted radiation, respectively. All of the observed irradiations are less than the predicted values for all times and stations, consequently resulting in a flatter tilt angle, with a few exceptions in summer. Since Taipei has the lowest clearness index, its yearly optimal angle calculated from observed data shows the greatest discrepancy when compared to its latitude. By employing a tracked panel, the yearly gains calculated from the observed data lie between 14.3% and 25.3%, which is significantly less than those from the extraterrestrial and predicted radiations. [Copyright &y& Elsevier]

This population-based retrospective cohort study investigated the prevalence of myopia among patients with Type 1 and Type 2 diabetes mellitus (DM) and evaluate risk factors for myopia in these groups. Records from 2000 to 2012 with at least one year of follow-up from the Taiwan National Health Insurance Research Database were included. This study included 35,538 patients with DM and 71,076 patients without DM. Patients with DM had a significantly higher adjusted hazard ratio for myopia in all age groups and both sexes compared with patients without DM. The subgroup analysis results revealed that the rates of myopia and astigmatism were significantly higher among patients with DM compared with patients without DM aged < 60 years. However, the rates of high myopia or myopia progression to high myopia did not differ significantly between the two groups. These findings indicate that DM is a critical risk factor for myopia and astigmatism among patients aged < 60 years. Therefore, active surveillance and earlier treatment of myopia are critical for patients with DM.

It has rarely been studied whether the presence and severity of diabetic retinopathy (DR) could influence the renal disease progression among all chronic kidney disease (CKD) diabetic patients. This study investigates the characteristics of diabetic patients, with different stages of chronic kidney disease (CKD), according to the occurrence of diabetic retinopathy and determines the influence of retinopathy in the deterioration of renal function. We conduct a multicenter, longitudinal cohort study based on the Epidemiology and Risk Factors Surveillance of the CKD project (2008⁻2013) and the National Health Insurance Research Database (NHIRD) (2001⁻2013). A total of 4050 diabetic patients with CKD, 20⁻85 years of age, from 14 hospitals and the community are included in this study. As compared to CKD patients without DR, CKD patients with DR have a lower baseline estimated glomerular filtration rate (eGFR) (39.17 ± 30.36 mL/min per 1.73 m² vs. 54.38 ± 33.67 mL/min per 1.73 m² ); poorer glycemic control (higher glycated hemoglobin (HbA1c) 7.85 ± 4.97 vs. 7.29 ± 4.02, p < 0.01); higher proteinuria (urine protein-to-creatinine ratio (UPCR )1.94 ± 2.96 g/dL vs. 0.91 ± 2.11 g/dL, p < 0.01); more anemia (Hb 11.22 ± 2.43 g/dL vs. 12.39 ± 3.85 g/dL, p < 0.01), and more hypoalbuminemia (3.88 ± 0.95 g/dL vs. 4.16 ± 1.74 g/dL, p < 0.01). Later stage (stage 3b⁻5) CKD patients with DR had significantly higher CKD progression compared with patients without DR (OR (odds ratio) 1.66 (1.36⁻2.02)). Patients with proliferative DR had significantly higher CKD progression events compared to patients with non-proliferative DR (OR 2.18 (1.71⁻2.78)). The presence and severity of DR is a risk factor for CKD progression among our Taiwanese CKD patients with diabetes. Prevention and early detection of DR are important and DR should be routinely screened as early as possible among diabetic CKD patients.

It remains unclear how different uses of angiotensin-converting inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) influence the progression of chronic kidney disease (CKD). This study explored CKD progression in a multicentre, longitudinal cohort study that included 2639 patients with CKD stage 1-5 and hypertension. Patients treated with ACEI or ARB for ≥90 days during a 6-mo period comprised the study group, or no treatment, comprised the control group. The study group was subdivided on the basis of treatment: ACEI monotherapy or ARB monotherapy. Progression of renal deterioration was defined by an average eGFR decline of more than 5 mL/min/1.73 m 2 /yr or the commencement of dialysis. With at least 1-year follow up, a progression of renal deterioration was demonstrated in 29.70% of the control group and 25.09% of the study group. Patients in the study group had significantly reduced progression of CKD with adjusted odds ratio 0.79 (95% confidence interval: 0.63-0.99). However, when ACEI monotherapy and ARB monotherapy were analyzed separately, none of their associations with CKD progression was statistically significant. In conclusion, ACEI or ARB monotherapy may retard the deterioration of renal function among patients with CKD and hypertension.