Mahidol University's Institutional Repository

คลังสารสนเทศสถาบันของมหาวิทยาลัยมหิดล

"Wisdom Repository You Discover"

To collect Mahidol University's academic publications and intellectual properties more than 39 faculties

To present over 50,000 items of information in digital formats

To make it easy to access to all information at anytime, anywhere

 

Recent Submissions

Item
Representation of Women in Atrial Fibrillation Ablation Randomized Controlled Trials: Systematic Review
(2025-01-21) Khaing E.; Aroudaky A.; Dircks D.; Almerstani M.; Alziadin N.; Frankel S.; Hollenberg B.; Limsiri P.; Schleifer W.; Easley A.; Tsai S.; Anderson D.; Windle J.; Khan F.; Haynatzki G.; Peeraphatdit T.; Goyal N.; Dunbar Matos C.L.; Naksuk N.; Khaing E.; Mahidol University
BACKGROUND: Sex inequality in randomized controlled trials (RCTs) related to cardiovascular disease has been observed. This study examined the proportion of women enrolled in atrial fibrillation (AF) ablation RCTs and the potential risks of underrepresentation of women. METHODS AND RESULTS: We systematically searched PubMed and Embase for AF ablation RCTs published from 2015 to 2022. Participant characteristics were compared among trials with higher and lower proportions of women. Of 147 AF ablation RCTs (30,055 participants), only 10 trials had enrolled women ≥50% of the total participants. Additionally, 42 trials (28.57%) excluded pregnant/breastfeeding women; 6 (4.1%) excluded reproductive-age women without reliable birth control. The proportion of women in AF RCTs ranged from 9% to 71% (median 31.5%), whereas the median proportion of men was 67.7%. The rate of women included in the trials was stable from 2015 to 2022 (P=0.49). Study characteristics, including funding source, showed no correlation with the rate of inclusion of women. RCTs with a higher proportion of female participants enrolled older patients with AF, had a higher prevalence of hypertension but less persistent AF, and smaller left atrium size (P<0.05 for all). Biological sex was evaluated as a risk factor or in a subgroup analysis in 28 RCTs; 10.7% of these trials observed the implication of sex on their results. CONCLUSION: Women were underrepresented in contemporary AF ablation RCTs. Additionally, women enrolled in AF RCTs were likely to have more comorbidities but less advanced AF, limiting the applicability of the results to women with AF.
Item
APAGE Position Statements on Green and Sustainability in Gastroenterology, Hepatology, and Gastrointestinal Endoscopy
(2025-01-01) Ang T.; Hang D.; Li J.; Ho J.; Sy-Janairo M.; Raja Ali R.; Makharia G.; Sundaram S.; Chantarojanasiri T.; Kim H.G.; Isayama H.; Pausawasdi N.; Wu K.; Syam A.; Aye T.; Rehman S.; Niriella M.; Jurawan R.; Wang L.; Leung W.; Liou J.M.; Rizan C.; Wu J.; Ooi C.; Ang T.; Mahidol University
Background and Aim: The APAGE Position Statements aimed to provide guidance to healthcare practitioners on clinical practices aligned with climate sustainability. Methods: A taskforce convened by APAGE proposed provisional statements. Twenty-two gastroenterologists from the Asian Pacific region participated in online voting and consensus was assessed through an anonymized and iterative Delphi process. Results: There were five sections that addressed the rationale for climate action, the importance of adopting principles of waste management, clinical practice, gastrointestinal endoscopy, and issues related to advocacy and research. Sixteen statements achieved consensus and included the following: 1. APAGE recommends adopting prompt measures to reduce the carbon footprint of clinical practice due to the importance of climate action and its health cobenefits. 5. APAGE recommends adherence to professional clinical guidelines to optimize clinical care delivery in gastroenterology and hepatology to avoid the environmental impact of unnecessary procedures and tests. 8. APAGE recommends an emphasis on health promotion, disease prevention, and appropriate screening and surveillance, when resources are available, to reduce the environmental impact of managing more advanced diseases that require more intensive resources. 12. APAGE recommends that technological advances in endoscopic imaging and artificial intelligence, when available, be used to improve the precision of endoscopic diagnosis to reduce the risk of missed lesions and need for unnecessary biopsies. 13. APAGE recommends against the routine use of single-use endoscopes. Conclusion: The position statements provide guidance to healthcare practitioners on clinical practices in gastroenterology, hepatology, and endoscopy that promote climate sustainability.
Item
Hyponatremia Correction and Osmotic Demyelination Syndrome Risk: A Systematic Review and Meta-Analysis
(2025-03-01) Suppadungsuk S.; Krisanapan P.; Kazeminia S.; Nikravangolsefid N.; Singh W.; Prokop L.J.; Kashani K.B.; Domecq Garces J.P.; Suppadungsuk S.; Mahidol University
Rationale & Objective: Osmotic demyelination syndrome (ODS) is a rare but severe condition often attributed to the rate of sodium collection. We evaluated the association between the overly rapid sodium correction in adult hospitalized patients with ODS. Study Design: Systematic review and meta-analysis. Setting & Study Populations: Adults hospitalized hyponatremia patients. Selection Criteria for Studies: The studies comparing the incidence of ODS with and without rapid sodium correction inception to January 2024. Data Extraction: Two reviewers independently extracted data and assessed the risk of bias and the certainty of evidence. Analytic Approach: The incidence of ODS following a rapid and nonrapid sodium correction was pooled using the random effects model. Subgroup and meta-regression analyses were performed for the robustness and the source of heterogeneity. Results: Eleven cohort studies were included with 26,710 hospitalized hyponatremia patients. The definition of hyponatremia varied from <116 to <130 mmol/L, and overly rapid sodium correction was defined as >8 to 12 mmol/L within 24 hours. The overall incidence of ODS was 0.23%. The incidence of ODS in rapid and nonrapid sodium correction was 0.73% and 0.10%, respectively. Meta-analysis demonstrated that a rapid rate of sodium correction was associated with a higher incidence of ODS (odds ratio 3.16, 95% CI, 1.54-6.49, I2 = 27%), whereas some patients with hyponatremia developed ODS without rapid sodium level correction. The sensitivity analysis based on the quality of the studies was consistent with the main result. Limitation: Various definition criteria for ODS diagnosis across studies, lack of potential electrolyte and treatment data that may affect the incidence of ODS. Conclusions: The rapid rate of sodium correction had a statistical correlation with a higher incidence of ODS. Among ODS without rapid correction, further studies are recommended to evaluate and comprehend the relationship for better and proper management of hospitalized patients with hyponatremia. Plain Language Summary: Hyponatremia is a common electrolyte disorder that is essential to treat symptoms to prevent further neurologic complications, even from hyponatremia itself or following treatment. This meta-analysis evaluated the association between sodium correction rate and osmotic demyelination syndrome (ODS). The finding demonstrated that rapid correlation >8 mmol/L/24 h had a statistical correlation with a higher risk of ODS. Rapid sodium correction occurred in 21.5% of patients with hyponatremia. The overall incidence of ODS was 0.23% and 0.73% among those with rapid sodium correction. Even without rapid correction, 0.1% of patients with hyponatremia developed ODS. Further studies are needed to comprehend the relationship between hyponatremia and ODS among all individuals, including those without rapid correction, to optimize the management of hyponatremia.
Item
Molecular mechanisms underlying the decolorization of indigo carmine and coomassie blue R-250 by Streptomyces salinarius CS29 laccase
(2025-02-01) Sanachai K.; Nutho B.; Sarnthima R.; Mongkolthanaruk W.; Pluemjai J.; Kittika M.; Khammuang S.; Sanachai K.; Mahidol University
Laccase, a multicopper oxidase enzyme, possesses broad substrate specificity, enabling the oxidation of a diverse array of compounds. Among various microbial sources, Streptomyces species are prominent for producing stable and highly efficient laccases. This study investigated the decolorization potential of crude laccase extracted from Streptomyces salinarius CS29, specifically targeting indigo carmine and Coomassie Blue R-250 (CBBR). Optimal decolorization of both dyes was achieved within a pH range of 3–3.5, with pH 3.5 selected for subsequent experiments. Indigo carmine, at a concentration of 100 μM, demonstrated superior decolorization efficiency, reaching approximately 90% within 100 min. In contrast, decolorization of CBBR was less efficient. At concentrations of 50, 100, and 250 μM, approximately 50% decolorization was observed after 180 min. These findings suggest that laccase from S. salinarius CS29 exhibits greater efficacy in decolorizing indigo carmine compared to CBBR. Additionally, molecular docking and molecular dynamics (MD) simulations were employed to investigate the structural dynamics of the enzyme-dye complexes. MD simulations revealed that both indigo carmine and CBBR bind within the active site of the enzyme, predominantly through van der Waals interactions. Furthermore, key binding residues crucial for these interactions were identified. The findings of this study offer a foundational understanding that could significantly contribute to the development of environmentally sustainable strategies for the detoxification of dye-contaminated wastewater.