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Recent Submissions
Appeals of Deceit from the Tobacco Companies: Rejecting Tobacco Industry Influence in Thailand
(2026-01-01) Hamann S.L.; Wongsuriyanan C.; Kungskulniti N.; Ruangkanchanasetr S.; Kasemsup V.; Jongkhajornpong P.; Hamann S.L.; Mahidol University
INTRODUCTION: The tobacco industry goes to great lengths to identify its target audience and provide incentives for tobacco use. It often does so through disinformation, purposely deceiving its customers. There is evidence that the behaviors of social movements can replace shallow appeals with genuine social motivations. While stories of communication, recognition, and mutual support can arise as anecdotal examples, the enduring strengths of a social commitment are also worth examining. METHOD: This review examines the people, events, and accomplishments of tobacco control efforts in Thailand that are vital to continuous vigilance and advocacy for social advancement, with a deep respect for how the goals of health reflect a culture of care. The focus is on exposing the long battle between the tobacco industry and tobacco control and prevention advocates, with specific examples from Thailand. RESULTS: Thai culture takes a moderate, life-enhancing position anchored in fundamental conceptions of moral/ethical action in politics, religion, and economics. This position has enabled a sustained culture of care, not a cultural affectation mimicking the latest transitory political or economic trends. Thailand has persisted in visibly renewing its commitment to tobacco control campaigns and efforts, which have led to a deepened public understanding that stands firm with the goals of tobacco control. CONCLUSION: Thais have been enlisted in a great battle for health through the authenticity of their culture and have made strides in countering the predatory influences and exploitative interests of the tobacco industry. Viewing the dimensions of this battle encourages further social commitments for progress against tobacco harms.
Nature Medicine Commission on dialysis policy in low- and middle-income countries
(2026-01-01) Teerawattananon Y.; Chavarina K.K.; Phannajit J.; Sutawong J.; Yongphiphatwong N.; Chawla N.; Botwright S.; Chuanchaiyakul T.; Anothaisintawee T.; Arogundade F.; Ashuntantang G.; Thammatacharee J.; Sola L.; Chuengsaman P.; Chunharas S.; Wibulpolprasert S.; Tang S.C.W.; Kanjanabuch T.; Luyckx V.; Ophascharoensuk V.; Isaranuwatchai W.; Jha V.; Praditpornsilpa K.; Tungsanga K.; Teerawattananon Y.; Limsawart W.; Thitjuea S.; Boonkaew S.; Khamkom S.; Tatiyanupanwong S.; Ngam-prukwanit R.; Supapol P.; Kiatkrissada N.; Thamcharoen N.; Gandhi N.; Chareonrungruengchai K.; Khositrangsikun K.; Piyawong J.; Aryani H.; Butani D.H.; Pandejpong D.; Sriprach S.; Pichaiwong W.; Dokkaew T.; Sirilak S.; Sitthitham N.; Aiyasanon N.; Kiattisunthorn K.; Tabongkaraksa C.; Dabak S.V.; Boonma C.; Teerawattananon Y.; Mahidol University
The global demand for kidney replacement therapy (KRT) continues to increase, yet access remains limited in many low- and middle-income countries. Thailand has been recognized for integrating a sustainable KRT delivery model into its Universal Health Coverage scheme through a peritoneal dialysis–first (‘PD-First’) policy adopted in 2008. In 2022, the policy was revised to allow individuals to choose between hemodialysis or peritoneal dialysis as their first-line treatment. The intention was to improve patient choice and avoid high out-of-pocket costs, but the policy produced unintended consequences for the health system and patients. A Commission was convened to first assess the impact of the policy change and provide policy recommendations to the Thai government and, second, provide lessons for countries working to expand equitable access to KRT within national universal health coverage frameworks. Drawing on empirical data, the Commission—composed of Thai and international multidisciplinary experts—employed a structured deliberative process to inform policy interventions. The process and findings underscore the importance of participatory policymaking, underpinned by evidence and a systematic process, and monitoring and evaluation in managing complex policy transitions.
Breast composition and dose deposition to fat and fibroglandular tissues are associated with breast side effects after radiation therapy
(2026-02-01) Jaikuna T.; Wilson F.; Anandadas C.; Azria D.; Chang-Claude J.; De Santis M.C.; Gutiérrez-Enríquez S.; van Herk M.; Hoskin P.; Kotzki L.; Lambrecht M.; Lingard Z.; Seibold P.; Seoane A.; Sperk E.; Symonds R.P.; Talbot C.J.; Rancati T.; Rattay T.; Reyes V.; Rosenstein B.S.; de Ruysscher D.; Vega A.; Veldeman L.; Webb A.; West C.M.L.; Vasquez Osorio E.; Aznar M.C.; Jaikuna T.; Mahidol University
Objective: Breast comprises different tissues with potentially different dose responses to radiation therapy (RT). This study investigates the correlation between RT dose, breast composition, and side effects from breast RT. Material/methods: Data from 922 early-stage breast cancer patients who underwent breast-conserving surgery and RT from the REQUITE study were included. Breast pain, oedema, atrophy, and induration were assessed immediately post-RT, one-year, and two-years post-RT. Maximum severity scores for each toxicity were used for analysis. Breast tissue was divided into “fat” and “fibroglandular” substructures from computed tomography (CT) using a Gaussian Mixture Model. The correlation between breast characteristics, toxicity, dosimetric parameters, and patient and clinical variables was investigated using ordinal regression. The model's fit was evaluated using the Akaike Information Criterion in SPSS v.29. Results: Breast volume and breast density were associated with increased risk of breast oedema, atrophy, and induration in multivariable analysis (p<0.05). Higher mean dose and dose uniformity were observed for fibroglandular compared to fatty tissue at all severity levels, while there was no significant difference in the maximum dose to either substructure. Higher dose deposit to fat was associated with breast pain and oedema, while breast atrophy and induration were associated with dose to fibroglandular tissue. All best-performing toxicity models included dosimetric parameters derived from breast composition. Conclusion: Breast characterisation offers new insight into the link between dose and toxicity. Breast density and dose parameters from different substructures were associated with different breast toxicity. These findings further support the importance of dose homogeneity of breast RT planning.
mRNA vaccines targeting Leptospira immunoglobulin-like proteins confer partial protection in a hamster model of leptospirosis
(2026-02-15) Techawiwattanaboon T.; Leekitcharoenphon R.; Alameh M.G.; Boonkea S.; Sangkanjanavanich N.; Nakornpakdee Y.; Ajimathorn Y.; Prompetchara E.; Ketloy C.; Buranapraditkun S.; Palaga T.; Kanthawong S.; Heyes J.; Weissman D.; Ruxrungtham K.; Patarakul K.; Techawiwattanaboon T.; Mahidol University
Leptospirosis is a neglected tropical disease with significant global health and economic impacts, particularly in resource-limited regions. This study reports the development of the first mRNA-based vaccines for leptospirosis, targeting the C-terminal region of LigA (LigAc) and the N-terminal region of LigB (LigBn) of Leptospira interrogans serovar Pomona. Transfection of lipid nanoparticle (LNP)-encapsulated mRNA constructs into HEK293T cells confirmed antigen expression and secretion, with proteins exhibiting higher-than-expected molecular weights due to glycosylation. In Jcl:ICR mice, LigAc- and LigBn-mRNA-LNPs elicited rapid and robust antibody responses, with significantly higher IgG titers than recombinant proteins formulated with AddaVax adjuvant. Immune sera from Lig-mRNA-LNP-vaccinated mice promoted complement-mediated killing of pathogenic leptospires in vitro. Moreover, the mRNA-LNP vaccines generated antigen-stimulated IFN-γ–ELISpot responses consistent with Th1-associated cellular activation, similar to recombinant proteins. Protective efficacy was then evaluated in golden Syrian hamsters immunized either intramuscularly or intradermally. Lig-mRNA-LNPs conferred partial protection, with a maximum survival rate of 25 % in LigBn-mRNA-LNPs vaccinated hamsters. The protective rates of Lig-mRNA-LNPs were equivalent to those of recombinant Lig protein formulations. The surviving hamsters showed reduced renal leptospiral colonization and histopathological changes, comparable to those observed in the uniformly surviving killed-leptospires group. These findings establish proof-of-concept for an mRNA vaccine platform against leptospirosis and highlight its potential application pending further optimization.
Hidden Diversity of Cave Millipedes From Mainland Southeast Asia Revealed by Species Delimitation and Phylogenetic Analysis, With a Description of a New Genus (Spirostreptida: Cambalopsidae)
(2026-01-01) Seesamut T.; Likhitrakarn N.; Jirapatrasilp P.; Jeratthitikul E.; Sutcharit C.; Seesamut T.; Mahidol University
Southeast Asia’s karst landscapes host a remarkable yet understudied diversity of cave-dwelling fauna, where morphological conservatism often masks true species boundaries. Using an integrative taxonomic framework, we investigated the systematics of the millipede family Cambalopsidae Cook, 1895 inhabiting caves across Thailand, Laos, Myanmar, and Cambodia, combining morphological evidence with mitochondrial cytochrome c oxidase subunit I (COI) sequences. Analyses of 213 specimens revealed the polyphyletic relationships of the two largest genera, Glyphiulus Gervais, 1847 and Plusioglyphiulus Silvestri, 1923, necessitating major taxonomic revision. Consequently, we erect Somsakiulus Seesamut & Likhitrakarn, gen. nov. to accommodate a distinct clade formerly classified within Plusioglyphiulus, and resurrect Cambalomorpha Pocock, 1895 stat. resurr. from synonymy within Glyphiulus. Species delimitation analyses using four single-locus methods (ASAP, GMYC, bPTP, and mPTP) consistently uncovered extensive cryptic diversity, with molecular data identifying substantially more putative species (molecular operational taxonomic units [MOTUs]) than morphology, most notably within the Trachyjulus unciger species complex (46–54 MOTUs vs. 25 morphospecies). This work underscores the limitations of relying on traditional gonopod-based taxonomy alone, elevates the diagnostic importance of peripheral characters, such as the male first legs, and collum and mid-body carinotaxy, and provides a robust systematic framework essential for future evolutionary studies and conservation planning within these vulnerable cave ecosystems.