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Recent Submissions
Loneliness and isolation: Are they associated with the wish for an earlier end of life?
(2025-01-01) Hajek A.; Zwar L.; Gyasi R.M.; Yon D.K.; Pengpid S.; Peltzer K.; König H.H.; Hajek A.; Mahidol University
Aim: To examine the association of loneliness and social isolation with the desired age at death among middle-aged and older adults in Germany. Methods: Data were taken from the German Aging Survey (wave 8: nationally representative sample of community-dwelling individuals aged ≥43 years; n = 3826). The mean age equaled 69.3 years (SD 11.3 years, 43–99 years). Loneliness and social isolation were both quantified using psychometrically sound and widely used tools. Several sociodemographic, lifestyle-related and health-related covariates were included in linear regression analysis (with robust standard errors). Results: The mean desired age at death was 90.1 years (SD 8.0 years). Regressions showed that there was a robust association of loneliness (β = −1.47, P < 0.001) and social isolation (β = −1.49, P < 0.001) with lower desired age at death among the total sample, even after adjusting for a wide array of covariates. In the fully-adjusted model, such associations were also present among both men and women (with significant sex differences for the association between loneliness and the outcome; i.e., more pronounced association between loneliness and the desired age at death among men). Conclusions: Loneliness (among men in particular) and social isolation were both associated with a lower desired age at death. This stresses the importance of tackling loneliness and social isolation in later life. It is of note that this is the very first study examining the association of loneliness and social isolation with the desired age at death. Thus, it can serve as a basis for future studies. Geriatr Gerontol Int 2025; ••: ••–••.
Genomic decoding of drug-resistant tuberculosis transmission in Thailand over three decades
(2025-12-01) Thawong N.; Srilohasin P.; Phelan J.E.; Phornsiricharoenphant W.; Tongsima S.; Suriyaphol P.; Prammananan T.; Faksri K.; Sawaengdee W.; Wang L.; Hinthong W.; Hibberd M.L.; Campino S.; Wattanapokayakit S.; Mahasirimongkol S.; Chaiprasert A.; Clark T.G.; Thawong N.; Mahidol University
Thailand has a high burden of tuberculosis, with control efforts hindered by drug-resistant Mycobacterium tuberculosis (Mtb). The increasing use of whole-genome sequencing (WGS) of Mtb offers valuable insights for clinical management and public health surveillance. WGS can be used to profile drug resistance, identify circulating sub-lineages, and trace transmission pathways or outbreaks. We analysed WGS data from 2,005 Mtb isolates collected across Thailand from 1994–2020, including 816 retrieved and 1,189 newly sequenced samples, with most isolates being multidrug-resistant (MDR-TB). Most isolates are lineage two strains (78·3%), primarily the Beijing sub-lineage (L2.2.1). Drug resistance profiling revealed substantial isoniazid and rifampicin resistance, and 67·3% classified as MDR-TB. Phenotypic and genotypic drug susceptibility testing showed high concordance (91·1%). Clustering analysis identified 206 transmission clades (maximum size 288), predominantly with MDR-TB, especially in Central and Northeastern regions. One cluster (n = 22) contains the ddn Gly81Ser mutation, linked to delamanid resistance, with some members pre-dating drug roll-out. In the largest cluster (n = 288), containing isolates spanning two decades, we applied transmission reconstruction methods to estimate a mutation rate of 1·1 × 10–7 substitutions per site per year. Overall, this study demonstrates the value of WGS in uncovering TB transmission and drug resistance, offering key data to inform better control strategies in Thailand and elsewhere.
Significance of Genotype-Specific High-Risk Human Papillomavirus Testing in Cervical Cancer Screening: A Hospital-Based Study
(2025-08-01) Boonkate S.; Karnchanabanyong W.; Ruengkhachorn I.; Kuljarusnont S.; Jareemit N.; Horthongkham N.; Pattama A.; Athipanyasilp S.; Hanamornroongruang S.; Boonkate S.; Mahidol University
This study explored histopathological outcomes among women who tested positive for high-risk human papillomavirus (hrHPV), examined the significance of extended HPV genotyping, and identified predictors of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). This retrospective review assessed medical records of women who screened positive for hrHPV between January 1, 2020, and December 31, 2023. Genotyping results, diagnostic procedures, and histopathological findings were collected. Data were analyzed using SPSS, with p < 0.05 considered statistically significant. Among 1981 women, the median age was 40 years (IQR 32.0‒49.0), and the median parity was 1 (IQR 0‒2). Overall, 1223 women (61.7%) had prior screening, 1215 women (61.3%) had previous cytology, and 107 women (5.4%) had prior hrHPV testing. Single-genotype infection occurred in 1408 women (74.7%), with HPV52, HPV16, and HPV58 identified in 23.7%, 15.6%, and 15.4% of cases, respectively. CIN2+ was detected in 152 women (7.7%), including 130 with CIN2/CIN3/AIS and 22 with cancer. Detection of HPV16 significantly increased the risk of CIN2+ (odds ratio [OR] 4.534, 95% CI: 3.197‒6.430), as did multiparity (OR 1.497, 95% CI: 1.070‒2.094). The immediate risk of CIN2+ for HPV31, HPV39, HPV56, HPV66, and HPV68 was below 4%. Among hrHPV-positive women, 7.7% had CIN2+. Extended hrHPV genotyping may refine risk stratification by highlighting HPV16 and multiparity as significant predictors of CIN2+ lesions.
Dual-matrix immobilization of cellulolytic consortium KKU-MC1 for Enhancing biohydrogen production from Napier grass and oil palm frond
(2025-10-01) Wongfaed N.; Anukhroa P.; Sittijunda S.; Imai T.; Reungsang A.; Wongfaed N.; Mahidol University
Agricultural residues offer sustainable feedstock for biohydrogen production, but conventional processes face challenges including enzyme inhibition, poor cell retention, and limited catalyst reusability. This study compared separate hydrolysis and fermentation (SHF) versus simultaneous saccharification and fermentation (SSF) while developing a dual-matrix entrapment (ENT) system combining sodium-alginate with activated carbon. Using Napier grass (NG) and oil palm frond (10-50 g-volatile solid (VS)/L) without pretreatment, SHF outperformed SSF by 1.5–4.8 times across all conditions. Maximum hydrogen yield (HY) (119.9 ± 10.5 mL-H2/g-VS) was achieved with the dual-matrix ENT system using NG at 10 g-VS/L. Scanning electron microscopy revealed hierarchical porous structures that enhanced enzyme diffusion and protected microbial cells. The dual-matrix ENT system maintained significantly higher cell concentrations and enzyme activity (r = 0.949 correlation with HY) through four reuse cycles, retaining 83.8 % of initial performance compared to 55.6 % for encapsulation (ENC) and 33.3 % for free cells. This approach creates ideal microenvironments for cellulolytic consortia while avoiding sugar inhibition, offering a practical solution for sustainable bioenergy production without energy-intensive pretreatment.
Low Back Pain Prevalence in Indonesian Older Adults: Systematic Review and Meta-Analysis
(2025-01-01) Susanto H.; Dang L.T.; Winitchayothin S.; Hidayat J.; Pradana A.A.; Susanto H.; Mahidol University
Objectives: Low back pain (LBP) in Indonesia has emerged as a significant health issue among older adults. Consequently, this systematic review and meta-analysis were conducted to evaluate the prevalence of LBP among older adults in Indonesia. Data Sources: Five electronic databases (Cumulated Index in Nursing and Allied Health Literature [CINAHL], PubMed, EMBASE, OVID Medline, and GARUDA database) were systematically searched without restrictions on language or publication year for relevant articles from their inception through October 2024. Review/Analysis Methods: This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The qualitative synthesis was done regarding the pain severity, study settings, age groups, sex, and occupation of the older adults. All analyses were conducted using Comprehensive Meta-Analysis software, and results are presented as percentages with 95% confidence intervals (CIs). Results: A total of 12 studies were included. These studies covered 8 of 34 provinces in Indonesia, and the overall pooled prevalence of LBP in older adults was estimated to be 32.2% (95% CI: 17.6%-51.5%). The trim-and-fill analysis showed that the adjusted pooled prevalence of LBP was 14.32% (95% CI: 6.2%-29.6%) after four studies were trimmed. Subgroup analyses were conducted across five variables: pain severity, study settings, age group, sex, and occupation among older adults. Conclusions: This study is the first meta-analysis to report the pooled prevalence of LBP in older adults residing in Indonesia. The rising incidence of LBP among older adults necessitates greater attention from both government authorities and healthcare professionals.