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Objectives: To investigate the role of normal weight central obesity (NWCO) in the prognosis of sudden sensorineural hearing loss (SSNHL). Methods: We retrospectively investigated 807 cases of SSNHL from January of 2008 to August of 2019 from the Department of Otorhinolaryngology at Kaohsiung Medical University Hospital in southern Taiwan. We analyzed the association between overweight and obesity, NWCO, and the prognosis of SSNHL. The demographic and clinical characteristics, audiometry results, and outcomes were also reviewed. Results: The nonobese (body mass index [BMI] < 24 kg/m2) and overweight and obese groups (BMI ≥ 24 kg/m2) comprised 343 (42.50%) and 464 (57.50%) patients, respectively. The favorable prognosis rates in the nonobese and the overweight and obese groups were 45.48% and 45.91%, respectively, without a significant difference (P =.9048). Multivariate logistic regression revealed that BMI (adjusted odds ratio [aOR] = 1.00, 95% CI = 0.948-1.062, P =.9165) was not significantly associated with SSNHL recovery. The normal weight noncentral obesity (NWNCO) and NWCO groups comprised 266 (77.55%) and 77 (22.45%) patients, respectively, and had favorable prognosis rates of 48.50% and 35.06%, respectively. The difference between the groups was significant (P =.0371). Multivariate logistic regression analysis revealed that NWCO (aOR = 2.51, 95% CI = 1.292-5.019, P =.0075) was significantly associated with SSNHL recovery. Conclusions: NWCO may significantly affect the prognosis of SSNHL. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the etiology and ossicular pathology of traumatic ossicular injury in Taiwan and examine the hearing outcomes and predictive factors between the titanium prosthesis and autologous incus groups. Methods: We retrospectively analyzed patients with traumatic ossicular injury from 2011 to 2020 in Taiwan. Patients were divided into the titanium or autologous group according to the surgical materials used. The audiometric outcomes and predictive factors of ossiculoplasty were analyzed between groups. Results: Twenty patients with ossicular chain discontinuity were enrolled (8 in the titanium group and 12 in the autologous group). The postoperative hearing threshold (26.6 ± 8.9 dB) and air-bone gap (10.3 ± 5.6 dB) improved significantly compared with the preoperative hearing threshold (50.7 ± 13.3 dB) and air-bone gap (29.9 ± 11.0 dB). The improvements in the hearing threshold and air-bone gap were not significantly different between the titanium and autologous groups. Our patients presented an improvement in hearing restoration with 65% closure of the air-bone gap in 0 to 10 dB range and 30% in 11 to 20 dB range, without sensorineural hearing loss during surgery. Univariate regression analysis revealed that vertigo, benign paroxysmal positional vertigo, and temporal bone fracture may serve as negative factors influencing the air-bone gap gain. Conclusions: Ossiculoplasty with both titanium prosthesis and autologous materials demonstrated favorable hearing recovery in traumatic ossicular injury. Vertigo, benign paroxysmal positional vertigo, and temporal bone fracture may serve as negative predictive factors of the hearing benefit after surgery. [ABSTRACT FROM AUTHOR]

In order to improve the precipitation forecast of the next-generation Global Prediction System with the Finite-Volume Cubed-Sphere Dynamical Core in Taiwan's Central Weather Bureau, this study modified the convective processes in the New Simplified Arakawa-Schubert scheme based on the methodology of scale-aware parameterization developed in Kwon and Hong (2017) and investigated its impacts on a front event, which propagated across Taiwan and produced heavy rainfall in late May of 2020. Results show that the modified scale-aware parameterization has significantly improved the intensity and the spatial distribution of frontal precipitation forecasts due to the proper definition of convective updraft fraction. However, the synoptic-scale features perform a larger warm bias with the modified scale-aware parameterization. Therefore, further modification of the scale-aware capability of convective cloud water detrainment is proposed to reduce the heating from microphysical processes and result in a better overall performance for the medium-range weather forecasts. [ABSTRACT FROM AUTHOR]

Tropical Cyclone Atsani occurred in late October 2020 and moved westward offshore south of Taiwan. During its offshore passage, the cyclone deflects northward as it closes to the southern end of Taiwan. A global model MPAS at a multi-resolution of 60-15-3-km is applied to explore the track responses of Atsani and identify the topographic effects of the Central Mountain Range (CMR) on the cyclone circulation and the associated track deflection. With a 3-km resolution targeted at the Taiwan area, the cyclone track deflection can be reasonably simulated, with more sensitivity to physics schemes and dynamic vortex initialization and less sensitivity to initial environmental perturbations. When the Taiwan terrain is removed, the cyclone indeed deflects more northward earlier, in particular for simulations with a stronger cyclone that tends to generate stronger east-west wind asymmetry in the absence of the terrain. Idealized simulations with a regional model WRF at 3-km resolution are also utilized to contrast the track deflection of different departing cyclones, similar to the real case. It was found that northward deflection will be induced near south of the CMR-like terrain for both stronger and weaker westbound cyclones departing at different latitudes south of the terrain. We have explained why a further northward track at earlier stages is induced in the absence of the terrain effects in regard to model initial states. In both real and idealized cases, the track deflection of the cyclone moving around the terrain is dominated by the wavenumber-one horizontal potential vorticity (PV) advection that is somewhat offset by both vertical PV advection and differential diabatic heating. [ABSTRACT FROM AUTHOR]

Background: Sudden sensorineural hearing loss (SSNHL) is a disease with an unknown etiology; damage to the auditory nerve from inflammation due to viral infection or vascular incidents has been implicated. According to several studies, cytokines, including interleukins, are associated with SSNHL in terms of serum expression and genetic polymorphisms. Interleukin-1 (IL-1) plays a key role in inflammation and may be associated with SSNHL. This study analyzed the association of single nucleotide polymorphisms (SNPs) of IL-1 receptor (IL-1R) genes with SSNHL in Taiwan. Methods: We conducted a case–control study involving 401 patients with SSNHL and 730 healthy controls. Four SNPs (IL-1R type 1 gene [IL1R1] [rs3917225 and rs2234650] and IL-1R type 2 gene [IL1R2] [rs4141134 and rs2071008]) were selected. The genotypes were determined using the TaqMan assay. The Hardy–Weinberg equilibrium (HWE) was tested for each SNP, and genetic effects were evaluated. Results: The TT genotype of rs2234650 had an adjusted odds ratio (OR) of 2.988 (95% confidence interval [95% CI] 1.27–6.82) (P = 0.012) compared with the CC genotype in patients with SSNHL. The SNP rs2234650 was associated with SSNHL in the recessive model (TT vs. CC + CT, P = 0.0206, OR = 2.681). The CT genotype of rs4141134 had an adjusted OR of 3.860 (95% CI 2.01–7.44; P < 0.0001) compared with the TT genotype, in patients with SSNHL. The SNP rs4141134 was associated with SSNHL under the dominant model (CC + CT vs. TT, P < 0.0001, OR = 4.087). Conclusion: These findings suggest that IL1R1 and IL1R2 gene polymorphisms may contribute to an increased risk of SSNHL in Taiwan. [ABSTRACT FROM AUTHOR]

The Central Weather Bureau in Taiwan successfully implemented a version of WRF coined as TWRF (Typhoon WRF) as the operational typhoon prediction system. The TWRF has two nested domains with 15/3 km resolution covering large areas over the western North Pacific, which has led to significant improvements of typhoon predictions over the previous version with coarser resolutions. Built upon this success, the WRF Four-Dimensional Data Assimilation (FDDA) system has been implemented in TWRF. This study investigates the impact of assimilating dual-Doppler radar retrieval winds from eight sets of dual-Doppler radars using FDDA on the prediction of Typhoon Nesat (2017) that passed over Taiwan. The wind field retrieved with dual-Doppler radars has a vertical extent from 1 to 10 km and the horizontal resolution is 1 km. After quality control and data thinning, the radar retrieval winds are assimilated using FDDA for two update cycles in addition to the existing hybrid 3DEnVar for all other observations in TWRF. Furthermore, we assimilate the additional radar data that become available during the 4-hour waiting period for the completion of the global model prediction to be used as the lateral boundary condition for TWRF. For Typhoon Nesat, the wind structure and rainfall forecasts are improved with the assimilation of radar-retrieval winds. The overall improvements demonstrated by this case study suggest potentially high impacts for improving the prediction of typhoon-related rainfall with assimilation of dual-Doppler radar data. [ABSTRACT FROM AUTHOR]

Background: Impaired cochlear blood perfusion and microvascular damage can cause sudden sensorineural hearing loss (SSHL), which is a potential risk factor for dementia. This study explored the association between SSHL and dementia.Methods: This retrospective cohort study used a random sample of 1000,000 individuals from Taiwan's National Health Insurance Research Database. We identified 3725 patients newly diagnosed with SSHL between January 1, 2000, and December 31, 2009, and propensity score matching according to age, sex, index year, comorbidities, and medications was used to select the comparison group of 11,175 patients without SSHL. Participants were stratified by age (<65 and ≧65 years) and sex for the subgroup analyses. The outcome of interest was all cause dementia (ICD-9-CM codes 290.0, 290.4, 294.1, 331.0). Both groups were followed up until December 31, 2010, for diagnoses of dementia. Cox regression models were used to estimate the hazard ratio (HR) of dementia.Results: During the average 5-year follow-up period, the incidence rate of dementia in the SSHL cohort was 6.5 per 1000 person-years compared with 5.09 per 10,000 person-years in the comparison group. After adjustment for potential confounders, patients with SSHL were 1.39 times more likely to develop dementia than those without SSHL (95% confidence interval = 1.13-1.71). When stratified by patients' age and sex, the incidence of dementia was 1.34- and 1.64-fold higher in patients with SSHL aged ≥65 years (P = .013) and in women (P = .001), respectively, compared with the comparison group. Women with SSHL who were < 65 years old had the highest risk (2.14, 95% CI = 1.17-4.11, P = .022). In addition, a log-rank test revealed that patients with SSHL had significantly higher cumulative incidence of dementia than those without SSHL (P = .002).Conclusions: Patients with SSHL, especially women aged < 65 years, were associated with higher risk of dementia than those without SSHL. Thus, clinicians managing patients with SSHL should be aware of the increased risk of dementia. [ABSTRACT FROM AUTHOR]

The impact of global positioning system (GPS) radio occultation (RO) soundings on the prediction of severe mei-yu frontal rainfall near Taiwan in June 2012 was investigated in this study using a developed local bending angle (LBA) operator. Two operators for local refractivity (REF) and nonlocal refractivity [excess phase (EPH)] were also used for comparisons. The devised LBA simplifies the calculation of the Abel transform in inverting model local refractivity without a loss of accuracy. These operators have been implemented into the three-dimensional variational data assimilation system of the Weather Research and Forecasting (WRF) Model to assimilate GPS RO soundings available from the Formosa Satellite Mission 3/Constellation Observing Systems for Meteorology, Ionosphere and Climate ( FORMOSAT-3/COSMIC). The RO data are found to be beneficial to the WRF forecast of local severe rainfall in Taiwan. Characteristics of assimilation performance and innovation for the three operators are discussed. Both of the local operators performing assimilation at observation levels appear to produce mostly larger positive moisture increments than do the current nonlocal operators performing assimilation on the mean height of each model vertical level. As the information of the initial increments has propagated farther south with the frontal flow, the simulation for LBA shows better prediction of rainfall peaks in Taiwan on the second day than both REF and EPH, with a maximum improvement of about 25%. The positive impact of the RO data results partially from several RO observations near Mongolia and north China. This study provides an intercomparison among the three RO operators, and shows the feasibility of regional assimilation with LBA. [ABSTRACT FROM AUTHOR]

In this study, an ensemble typhoon quantitative precipitation forecast (ETQPF) model was developed to provide typhoon rainfall forecasts for Taiwan. The ETQPF rainfall forecast is obtained by averaging the pick-out cases, which are screened using certain criterion based on given typhoon tracks from an ensemble prediction system (EPS). Therefore, the ETQPF model resembles a climatology model. However, the ETQPF model uses the quantitative precipitation forecasts (QPFs) from an EPS instead of historical rainfall observations. Two typhoon cases, Fanapi (2010) and Megi (2010), are used to evaluate the ETQPF model performance. The results show that the rainfall forecast from the ETQPF model, which is qualitatively compared and quantitatively verified, provides reasonable typhoon rainfall forecasts and is valuable for real-time operational applications. By applying the forecast track to the ETQPF model, better track forecasts lead to better ETQPF rainfall forecasts. Moreover, the ETQPF model provides the 'scenario' of the typhoon QPFs according to the uncertainty of the forecast tracks. Such a scenario analysis can provide valuable information for risk assessment and decision making in disaster prevention and reduction. Deficiencies of the ETQPF model are also presented, including that the average over the pick-out case usually offsets the extremes and reduces the maximum ETQPF rainfall, the underprediction is especially noticeable for weak phase-locked rainfall systems, and the ETQPF rainfall error is related to the model bias. Therefore, reducing model bias is an important issue in further improving the ETQPF model performance. [ABSTRACT FROM AUTHOR]

Highlights: [•] Ensemble forecast of typhoon tracks has a comparable skill to operational centers. [•] Ensemble forecast has better performance for rainfall than a deterministic forecast. [•] Ensemble prediction provides useful probabilistic information. [•] Runoff forecast over mountainous watershed is sensitive to rainfall forecast. [Copyright &y& Elsevier]

A mesoscale mountain such as the Central Mountain Range (CMR) of Taiwan can considerably affect the motion and the structure of an approaching tropical cyclone in very complicated ways. Many studies have presented and explained the mechanism for the change of moving speed, track deflection, or track discontinuity. In the past, the tracks of Typhoon Mary (1965), Tropical Cyclone Polly (1993), and Typhoon Haitang (2005) have a looping motion prior to making landfall on Taiwan. When the looping occurs, the timing and the intensity of the typhoon to affect Taiwan can be very different from the one moving with smooth track. It is very important to have a correct forecast for disaster mitigation operations. However, the mechanism causing such looping has not been fully understood. In this study, the case of Typhoon Haitang is examined. The radar reflectivity diagrams are used to illustrate looping in its track. By applying piecewise potential vorticity inversion analysis and numerical model simulations, it is shown that the looping motion of Typhoon Haitang near Taiwan resulted from the CMR terrain effect. When Typhoon Haitang approaches Taiwan and its circulation encounters the CMR, the terrain induces a cyclonic vortex in the lee side of the mountain over southeast of Taiwan. This terrain-induced vortex interacts with Typhoon Haitang in a way similar to the binary vortex interaction. The two vortex centers rotate around their system center, which causes looping of Typhoon Haitang. [ABSTRACT FROM AUTHOR]

Abstract: Stock price variation predictions are at the core of many research issues, and neural networks (NNs) are widely applied and were proven to be more efficient than time series forecasting for stock price forecasting. However, this type of research always determines the parameter settings of the NNs rationally through a trial-and-error methodology. This paper integrates design of experiment (DOE), Taguchi method, and back-propagation NN (BPNN) to construct a robust engine to further optimize the prediction accuracy under a robust DOE-based predictor. Adopting data from Taiwan Stock Exchange (TWSE), the technical analytical indexes and β value of the listed stocks of TWSE were computed. The research results indicated that the proposed approach can effectively improve the forecasting rate of stock price variations. [Copyright &y& Elsevier]

Taiwan's economic growth has improved the quality of life and raised the standard of the tourism industry in Taiwan. This paper selects the hotel industry, in order to assess how international tourist hotels operate their business by applying data envelopment analysis (DEA) to measure their operational efficiency and effectiveness. By using the DEA model to assess the results of the relative efficiency and effectiveness of hotels to improve their operations, the paper also aims to rank the hotels by applying the VlseKriterijumska Optimizacija I Kompromisno Resenje method combined with entropy weight among the criteria. [ABSTRACT FROM AUTHOR]

This research utilizes relational network data envelopment analysis to construct a model to analyze the efficiency and effectiveness of international tourist hotels (ITHs) in Taiwan. The different production processes within the hotel are evaluated, as well as the relationships between efficiency, effectiveness, and overall performance. Finally, based on the results, we recommend ways of enhancing the overall performance of the hotel industry in Taiwan. [Copyright &y& Elsevier]

This research explores customer''s expectations of service quality in hot spring hotels in Taiwan. Based on the five dimensions of PZB service quality, a specialist questionnaire is utilized to establish a complete service quality evaluation framework for hot spring hotels. In this research, analysis network process (ANP) is applied to find the relative weights among the criteria and to emphasize the interdependent relationships, thus increasing the accuracy of our results. Finally, the service quality evaluation framework and evaluation results can be used as a guide for hot spring hotel proprietors to review, improve, and enhance service planning and service qualities in the future. [Copyright &y& Elsevier]

Abstract: Although the same culture and language pertains in Taiwan and the Chinese mainland, perceptions of service quality vary. Here notions of air service quality is examined in terms of passengers’ backgrounds, and especially of those from cross-strait areas based on the perception data of Taiwan travelers and Mainland China travelers. Significant differences are found between cross-strait airlines and Taiwan and Mainland China travelers regarding service attributes. [Copyright &y& Elsevier]

Typhoon WRF (TWRF) based on the Advanced Research Weather Research and Forecasting Model (ARW WRF) was operational at the Central Weather Bureau (CWB) for tropical cyclone (TC) predictions since 2010 (named TWRF V1). CWB has committed to improve this regional model, aiming to increase the model predictability toward typhoons over East Asia. In 2016, an upgraded version designed to replace TWRF V1 became operational (named TWRF V2). Compared with V1, which has triple-nested meshes with coarser resolution (45/15/5 km), V2 increased the model resolution to 15/3 km. Since V1 and V2 were maintained in parallel from 2016 to 2018, this study utilized the real-time forecasts to investigate the impact of model resolution on TC prediction. Statistical measures pointed out the superiority of the high-resolution model on TC prediction. The forecast performance was also found competitive with that of two leading global models. The case study further pointed out, with the higher resolution, the model not only advanced the prediction on the TC track and inner core structure but also improved the representativeness of the complex terrain. Overall, the high-resolution model can better handle the so-called terrain phase-lock effect and, therefore, improve the TC quantitative precipitation forecast over the complex Taiwanese terrain. [ABSTRACT FROM AUTHOR]

A high-resolution air pollution numerical model system (APOPS) is applied to simulate the sea/land breeze and its impacts on the ozone distribution in northern Taiwan. The system can successfully simulate local flow patterns such as sea/land breezes and mountain-valley wind. The predicted surface ozone concentrations also agree with observed surface ozone values (). The sea/land breezes in northern Taiwan play a significant role in the distribution of ozone and transport of ozone from the urban to the coastal and mountain areas. The sea breeze is a weak system, extending vertically to a height of less than 1 km with the wind speed less than 4 ms-1. The land breeze can transport the photochemically produced ozone and its precursors over the sea. The accumulated ozone on the sea can return to the land in the daytime with the sea breeze. This kind of transport tends to contribute significantly to high-ozone episodes in clean coastal and mountain regions. [Copyright &y& Elsevier]

Summary: Short duration rainfall intensity in Taiwan has increased in recent years, which results in street runoff exceeding the design capacity of storm sewer systems and causing inundation in urban areas. If potential inundation areas could be forecasted in advance and warnings message disseminated in time, additional reaction time for local disaster mitigation units and residents should be able to reduce inundation damage. In general, meteorological–hydrological ensemble forecast systems require moderately long lead times. The time-consuming modeling process is usually less amenable to the needs of real-time flood warnings. Therefore, the main goal of this study is to establish an inundation evaluation system suitable for all metropolitan areas in Taiwan in conjunction with the quantitative precipitation forecast technology developed by the Taiwan Typhoon and Flood Research Institute, which can be used for inundation forecast 24h before the arrival of typhoons. In this study, information for the design capacity of storm sewer throughout Taiwan was collected. Two methods are proposed to evaluate the inundations: (a) evaluation based on the criterion of sewer capacity (CSC), and (b) evaluation based on the percentage of ensemble members (PEM). In addition, the probability of inundation is classified into four levels (high, medium, low, and no inundation). To verify the accuracy of the proposed system, Typhoon Megi and Typhoon Nanmadol were used as test cases. Four verification indices were adopted to evaluate the probability of inundation for metropolitan areas during typhoons. The inundation evaluation results basically match the observed data on flooding, which demonstrate that this flood evaluation system has an effective grasp on the probability of inundation for storm sewer systems. [Copyright &y& Elsevier]

Background: Few studies have investigated the relationship between chronic obstructive pulmonary disease (COPD) and chronic rhinosinusitis without nasal polyps (CRSsNP) outcomes. The aim of this study was to investigate the association between COPD and the risk of CRSsNP in a large national sample., Methods: Patients 15 years or older with a new primary diagnosis of COPD (International Classification of Diseases, Ninth edition [ICD-9], 491, 492, 494, and 496) between 2000 and 2007 were identified from the National Health Insurance Research Database of Taiwan. The patients were compared with sex-, age-, residence-, and insurance premium-matched controls, and both groups were followed up until the end of 2008 for instances of CRSsNP, defined as ICD-9 codes CRS (473, 473.0, 473.1, 473.2, 473.3, 473.8, and 473.9), excluding NP (471, 471.0, 471.1, 471.8, and 471.9). Competing risk-adjusted Cox regression analyses were applied after adjusting for sex, age, residence, insurance premium, steroid use (topical or systemic), hyperlipidemia, diabetes, hypertension, coronary artery disease, hospital admission days, and mortality., Results: We included 34,029 cases and 34,029 matched controls in this study. Among the 68,058 subjects, 569 developed CRSsNP during a mean (standard deviation [SD]) follow-up period of 5.0 years (SD 2.2 years). COPD was an independent predictor of CRSsNP in the fully adjusted model (hazard ratio = 3.24; 95% CI = 2.65-3.96; p < 0.01)., Conclusion: COPD was associated with an increased risk of CRSsNP in this study population, independent of a number of potential confounding factors.

Objective: To systematically investigate the role of matrix metalloproteinase-2 (MMP2) tagging single nucleotide polymorphisms (SNPs) and promoter functional polymorphism in the development of nasal polyps in a Chinese population in Taiwan., Design: We conducted a case-control study in 136 cases of chronic rhinosinusitis with bilateral nasal polyps and 136 controls. Seventeen SNPs were selected, including 16 tagging SNPs and 1 promoter functional SNP. The genotypes were determined by TaqMan technology. Hardy-Weinberg equilibrium was tested for each SNP, and genetic effects were evaluated according to 3 modes of inheritance. Subset analysis based on the recurrence of nasal polyps was also performed., Setting: Medical university center hospital., Results: All 17 SNPs were in Hardy-Weinberg equilibrium. When comparing the patients with recurrent nasal polyps and controls, none of the SNPs reached the significant level of P < .05 except rs857403. The AT genotype of rs857403 had an adjusted odds ratio of 2.07 (95% confidence interval, 1.09-3.95) (P = .03). However, the result became nonsignificant after including an additional 691 controls. Therefore, we considered that the initial significance was a false-positive finding. Neither haplotype analysis nor subset analysis yielded any significant result., Conclusion: The MMP2 gene does not play a crucial role in conferring risk for nasal polyps in a Taiwanese population.

Objectives: To analyze mastoid findings, such as facial nerve dehiscence (FND), labyrinthine fistula, and dural exposure; to review its incidence at cholesteatoma surgery; to analyze its association with semicircular canal fistula; and to elucidate its relationship with dural exposure., Design: One hundred fifty-two patients (65 males and 87 females; 155 ears) were enrolled in a retrospective study of tympanoplasty with or without mastoidectomy., Setting: Medical university center hospital., Results: The incidence of FND after exenteration of disease was 29.7% (46/155 ears) for total surgical procedures, 29.7% (43/145 ears) for initial procedures, and 30% (3/10 ears) for revision procedures. The prevalence of FND in the tympanic segment only was 87%, with 8.7% in the vertical segment only and 4.3% in both segments. Three patients (2.0%) developed facial palsy postoperatively, with 8 lateral semicircular canal fistulas (5.2% of total ears operated on), half of these with concomitant FND. The incidence of dural exposure of the mastoid tegmen in the entire surgical group was 16.8% (26 ears), 38.5% with concomitant FND., Conclusions: The overall incidence of FND in our sample was high at 29.7%, with rates of lateral semicircular canal fistula and dural exposure of 5.2% and 16.8%, respectively. The relationship between FND incidence and presence of lateral semicircular canal fistula was positive in our study. The surgeon should bear in mind that the location of FND with cholesteatoma coincides with the most common area of iatrogenic facial nerve injury during otologic surgery.