Mahidol University's Institutional Repository
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Recent Submissions
Association of 24- Hour Computed Tomography Infarct Density on Functional Outcomes in Stroke: Secondary Analysis From the AcT Trial
(2026-01-01) Pensato U.; Zhang J.; Barakhanov K.; Tanaka K.; Bala F.; Kaveeta C.; Almekhlafi M.; Dowlatshahi D.; Field T.S.; Tkach A.; Swartz R.; Hunter G.; Shankar J.J.S.; Ademola A.; Shamy M.; Hu S.X.; Gubitz G.; Demchuk A.M.; Menon B.K.; Ganesh A.; Singh N.; Pensato U.; Mahidol University
BACKGROUND: The final infarct volume has been historically considered the most critical radiological outcome in ischemic stroke. Yet, discrepancies between final infarct volume and functional outcomes occur frequently. We aim to evaluate whether 24- hour computed tomography (CT) infarct density modifies the relationship between 24- hour CT infarct volume and functional outcomes and is associated with outcomes in acute ischemic stroke. METHODS: Data are from the AcT (Alteplase Versus Tenecteplase in AIS [Acute Ischemic Stroke] Within 4.5 Hours) trial. Patients with detected 24- hour CT infarct and no parenchymal hematoma were included. To capture within- lesion heterogeneity, “24hour CT standardized infarct density” was calculated as mean Hounsfield Unit/SD for every patient. Primary outcome was the 90- day ordinal modified Rankin Scale score. We assessed effect modification using interaction terms and performed adjusted regression analyses. RESULTS: Of 1577 patients, 839 (53.2%) were included (median age 75 years [interquartile range, 64–84], 414 [9.3%] female). Median infarct volume was 7. 5 mL (interquartile range, 1.6–28.0), and median standardized infarct density was 4.8 standardized-Hounsfield Units (interquartile range, 4.0–5.8). Standardized infarct density significantly modified the effect of infarct volume on modified Rankin Scale score (P- interaction=0.001) and mortality (P- interaction=0.014). Higher standardized infarct density (ie, less severe infarct degree) was associated with better 90- day modified Rankin Scale score (adjusted common odds ratio [acOR], 0.87 [95% CI, 0.80–0.96] per 1- standardized- Hounsfield Unit increase), whereas infarct volume was not (acOR, 0.96 [95% CI, 0.90–1.01] per 5- mL increase). CONCLUSIONS: CT infarct density modifies the effect of infarct volume on outcomes and is independently associated with better outcomes. These findings suggest that 24- hour CT infarct volume and density may provide complementary information on the infarct burden.
The 2026 FIFA World Cup: Communicable disease risks and advice for visitors to Canada, the United States, and Mexico
(2026-01-01) Rodriguez-Morales A.J.; Rodríguez-Sabogal I.A.; Porras-Pedroza B.E.; Faccini-Martínez Á.A.; Grisales-Nieto D.; Escarrá F.; Quispe-Torrez P.P.; Membrillo F.J.; Orduna T.; Lloveras S.; Chaves T.S.S.; Cabada M.M.; Perret C.; Echavarría R.; Ribeiro A.F.; Tanabe M.; Bazzino F.; Ramirez M.; Diaz B.; Morejón K.M.L.; Daly K.; Rosas R.; Lopez M.B.; Miranda C.; Fernandez M.L.; Özsürekçi Y.; Matsee W.; Carrero Y.; Biscayart C.; Cimerman S.; Avila-Aguero M.L.; Debbag R.; Brea J.; Risquez A.; Acosta-España J.D.; Ulloa-Gutierrez R.; Espinal C.; Torres-Martinez C.N.; González-Sanz M.; Abbara A.; Weatherhead J.; Masana M.; Rodriguez-Morales A.J.; Mahidol University
Neoadjuvant and adjuvant (neoadj-adj) enfortumab vedotin (EV) plus pembrolizumab (pembro) in participants with cisplatin-ineligible muscle-invasive bladder cancer (MIBC): An analysis of clinically relevant subgroups in KEYNOTE-905.
(2026-06-01) Adra N.; Vulsteke C.; Loriot Y.; Rodriguez-Vida A.; Zhang Z.; Ku J.H.; Olah J.; Kolodziej A.; Sabadash M.; Von Amsberg G.; Alimohamed N.S.; O'Donnell P.H.; Lychkovsky O.; Kulkarni G.S.; Lichfield J.; Meng C.; Huang D.; Ramamurthy C.; Homet Moreno B.; Danchaivijitr P.; Adra N.; Mahidol University
4613Background: Results from the phase 3 KEYNOTE-905/EV-303 study (NCT03924895) showed that neoadj-adj EV + pembro and radical cystectomy with pelvic lymph node dissection (RC + PLND) led to superior event-free survival (EFS; HR 0.40; 95% CI 0.28-0.57), overall survival (OS; HR 0.50; 95% CI 0.33-0.74), and pathological complete response (pCR) rate (57.1% vs 8.6%) vs RC + PLND alone in participants (pts) with MIBC who were ineligible for or declined cisplatin. We report efficacy in subgroups of clinical interest, including advanced age, ECOG PS, cisplatin eligibility status, and baseline clinical tumor stage. Methods: Adults with stage T2-T4aN0M0 or T1-T4aN1M0 MIBC by central review who were cisplatin-ineligible or declined cisplatin were randomly assigned 1:1 to neoadj-adj EV + pembro and RC + PLND vs RC + PLND alone (control). EFS by BICR, OS, and pCR (pT0N0) rate by central review were analyzed in subgroups by age (≥65 to <75 vs ≥75 yr), ECOG PS (0-1 vs 2), cisplatin-ineligibility status (ineligible vs declined), and clinical stage (T2N0 vs T3-T4aN0 vs T1-4aN1). The analyses were exploratory; no formal statistical testing was performed. Results: 170 pts were assigned to EV + pembro and 174 to control. Median follow-up at data cutoff (Jun 6, 2025) was 25.6 mo (range 11.8-53.7). 30 pts in the EV + pembro arm and 32 in the control arm had stage T2N0 MIBC; 133 and 132 pts had stage T3-T4aN0; 7 and 10 had stage T1-4aN1. In pts with T2N0 MIBC, median EFS was not reached (NR) with EV + pembro vs NR with control (HR 0.26; 95% CI 0.08-0.80), and pCR rate was 60.0% vs 18.8%. In pts with T3-T4aN0 MIBC, median EFS was NR with EV + pembro vs 17.2 mo with control (HR 0.43; 95% CI 0.29-0.63); median OS was NR vs 41.7 mo (HR 0.54; 95% CI 0.35-0.82); pCR rate was 57.1% vs 6.8%. In pts with T1-4aN1 MIBC, median EFS was 36.7 vs 7.2 mo (HR 0.35; 95% CI 0.09-1.40); pCR rate was 42.9% vs 0%. OS for T2N0 and T1-4aN1 will be assessed after additional follow-up (currently <10 events). Outcomes by age, ECOG PS, and cisplatin eligibility are shown in the Table. Conclusions: An efficacy benefit was observed with neoadj-adj EV + pembro added to RC + PLND vs RC + PLND alone across clinically relevant subgroups, consistent with the ITT population. Results further support EV + pembro as a potential new standard treatment for pts with cisplatin-ineligible MIBC. Clinical trial information: NCT03924895. [Table Presented.]
Beyond Passive Substituents: Tosyl-Directed Self-Templation Enables Selective Pillar[4 + 1]arene Formation and Topology Switching
(2026-06-17) Ruengsuk A.; Khamphaijun K.; Laoviwat P.; Kamonsutthipaijit N.; Tuntirungrotechai J.; Shigeta Y.; Hengphasatporn K.; Harding D.J.; Bunchuay T.; Ruengsuk A.; Mahidol University
Substituents in supramolecular chemistry are usually treated as passive handles that tune solubility or reactivity rather than as active determinants of assembly pathways. Here we show that tosyl groups promote directional noncovalent recognition and thereby control both cocyclization selectivity and postassembly topology in pillararenes. Under otherwise identical conditions, brominated analogues give statistical mixtures in which the pillar[4 + 1]arene product appears at only 1–19% distribution, whereas tosyl-substituted monomers undergo pseudorotaxane-like preassembly that enables highly selective self-templated pillar[4 + 1]arene formation without added external templates. A crystallographic survey of 12 single-crystal structures (N = 12), together with VT NMR, SAXS, molecular dynamics (MD) simulations, and fragment molecular orbital (FMO) analysis, establishes a valency–topology relationship in which increasing tosyl valency drives a progression from discrete monomers to interpenetrated dimers and higher-order aggregates. This substituent-dependent behavior extends across a broader alkoxy series, indicating that the effect is not limited to a single monomer pair. Upon benzoquinone oxidation, the tosyl-containing copillar[4 + 1]arene undergoes temperature-dependent switching between interpenetrated and self-included states, accompanied by changes in aggregation, a charge-transfer spectral shift, and reversible thermochromism quantifiable by ultraviolet–visible (UV–vis) spectroscopy and smartphone colorimetry. These findings establish substituent identity as an active design parameter for constructing reconfigurable and functionally responsive macrocyclic systems.
Combined Effects of Halloysite Nanotubes, Nucleating Agent, and Thermal Annealing on the Printability and Mechanical Performances of 3D-Printable Polypropylene Random Copolymer-Based Composites
(2026-06-23) Thavornyutikarn B.; Inthana K.; Kosorn W.; Hongsaprapart P.; Janvikul W.; Sirisinha K.; Thavornyutikarn B.; Mahidol University
This study developed three-dimensional (3D)-printable polypropylene random copolymer (PPR)-based composites incorporating halloysite nanotubes (HNTs) and a nucleating agent (NA) for extrusion-based additive manufacturing. The combined effects of HNT loading (0–5 wt %), NA incorporation (0.1 wt %), and postprinting thermal annealing on their thermal behavior, crystallization, printability, and mechanical performance were systematically investigated. Thermogravimetric analysis (TGA) demonstrated enhanced thermal stability with HNT addition due to the barrier effect of the aluminosilicate structure. Differential scanning calorimetry (DSC) revealed that HNTs had limited influence on crystallization behavior, whereas NA significantly increased the crystallization and onset temperatures, indicating accelerated crystallization kinetics without altering the dominant α-phase crystal structure, as confirmed by X-ray diffraction (XRD). HNT incorporation improved filament dimensional stability during extrusion, yielding uniform, near-circular cross sections compared to neat PPR, and enhanced build plate adhesion and dimensional stability during printing without external adhesives. Mechanically, HNT addition increased stiffness but reduced impact strength. Postprinting thermal annealing increased melting enthalpy and refined crystalline morphology, resulting in partial recovery of impact strength in HNT-filled samples, although the values remained below that of neat PPR. The combined use of HNT incorporation, nucleation control, and thermal annealing provided an effective strategy to enhance the 3D-printability and mechanical performance of PPR-based composites.