Scopus 2025
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Item Metadata only Energy calibration of LHAASO-KM2A using the cosmic ray Moon shadow(2025-01-01) Cao Z.; Aharonian F.; Bai Y.X.; Bao Y.W.; Bastieri D.; Bi X.J.; Bi Y.J.; Bian W.; Bukevich A.V.; Cai C.M.; Cao W.Y.; Cao Z.; Chang J.; Chang J.F.; Chen A.M.; Chen E.S.; Chen G.H.; Chen H.X.; Chen L.; Chen L.; Chen M.J.; Chen M.L.; Chen Q.H.; Chen S.; Chen S.H.; Chen S.Z.; Chen T.L.; Chen X.B.; Chen X.J.; Chen Y.; Cheng N.; Cheng Y.D.; Chu M.C.; Cui M.Y.; Cui S.W.; Cui X.H.; Cui Y.D.; Dai B.Z.; Dai H.L.; Dai Z.G.; Danzengluobu; Diao Y.X.; Dong X.Q.; Duan K.K.; Fan J.H.; Fan Y.Z.; Fang J.; Fang J.H.; Fang K.; Feng C.F.; Feng H.; Feng L.; Feng S.H.; Feng X.T.; Feng Y.; Feng Y.L.; Gabici S.; Gao B.; Gao C.D.; Gao Q.; Gao W.; Gao W.K.; Ge M.M.; Ge T.T.; Geng L.S.; Giacinti G.; Gong G.H.; Gou Q.B.; Gu M.H.; Guo F.L.; Guo J.; Guo X.L.; Guo Y.Q.; Guo Y.Y.; Han Y.A.; Hannuksela O.A.; Hasan M.; He H.H.; He H.N.; He J.Y.; He X.Y.; He Y.; Hernández-Cadena S.; Hou B.W.; Hou C.; Hou X.; Hu H.B.; Hu S.C.; Huang C.; Huang D.H.; Huang J.J.; Huang T.Q.; Huang W.J.; Huang X.T.; Huang X.Y.; Huang Y.; Huang Y.Y.; Ji X.L.; Jia H.Y.; Jia K.; Cao Z.; Mahidol UniversityWe present a precise measurement of the westward rigidity-dependent shift of the Moon’s shadow using three and a half years of cosmic ray data collected by the kilometer square array (KM2A) of the Large High Altitude Air Shower Observatory (LHAASO) experiment. These measurements enable us to calibrate the detector energy response in the range of 20 to 260 TeV, with results showing excellent agreement with the energy response derived from Monte Carlo (MC) simulations of the KM2A detector. We also measure a best-fit parameter ϵ ¼ 0.015 ± 0.08, corresponding to a 95% CI of ½−14%; +17%] for the energy scale estimation. This result establishes the exceptional accuracy of the KM2A-MC in simulating the detector’s response within this energy range.Item Metadata only Ankle Bracelet Laser as a Novel Portable Device to Improve Walking in Patients With Parkinsonism: Randomized Crossover Controlled Trial(2025-01-01) Ruthiraphong P.; Srisilpa K.; Ratanasutiranont C.; Mres; Ruthiraphong P.; Mahidol UniversityBackground: Freezing of gait (FOG) is a common and debilitating symptom of parkinsonism. Although visual cues have proven efficacy in alleviating FOG, most current visual cues are fixed in place, restricting their use to controlled environments such as clinics or homes. Mobile open-loop cueing devices have been developed to address this limitation; however, they typically require manual activation to deliver the visual cues, which can be particularly challenging for patients with attention or cognitive impairments, leading to equivocal results in improving gait performance. Objective: The aim of the study is to assess the efficacy of an ankle bracelet laser, a new mobile visual cue designed for practical use, in improving gait performance in patients with parkinsonism and FOG. Methods: A randomized controlled 2-period crossover trial was conducted from June 15, 2020, to October 1, 2020, at Ramathibodi Hospital. In total, 10 patients with parkinsonism and FOG were enrolled in 2 conditions: walking with laser-off first and walking with laser-on first. Gait speed, the timed up and go test, stride length, and the locomotor rehabilitation index were assessed twice in each trial with a 10-minute washout period. Results: The results showed favorable improvement in all parameters. Gait speed and stride length improved by 0.07 m/s (95% CI 0.04-0.09 m/s; P<.001) and 0.17 m (95% CI 0.11-0.23 m; P<.001), respectively, with laser-on. The timed up and go test duration was reduced by 7.69 seconds (95% CI 2.82-12.55 seconds; P=.002). The locomotor rehabilitation index improved by 4.46% (95% CI 2.56%-6.36%; P<.001). When using the device, there were no adverse effects, such as dizziness or blurred vision. Conclusions: The ankle bracelet laser cue produced immediate improvements in gait speed, stride length, and balance in patients with parkinsonism and FOG, suggesting that the device can acutely enhance gait performance. Further research is needed to determine whether these benefits are sustained and applicable to daily life activities.Item Metadata only Trends in the global, regional, and national burden of oral conditions from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021(2025-03-15) Bernabe E.; Marcenes W.; Abdulkader R.S.; Abreu L.G.; Afzal S.; Alhalaiqa F.N.; Al-Maweri S.; Alsharif U.; Anyasodor A.E.; Arora A.; Asgary S.; Ashraf T.; Balasubramanian M.; Banakar M.; Barrow A.; Bashiri A.; Belay S.A.; Belgaumi U.I.; Berhie A.Y.; Bhardwaj P.; Bhaskar S.; Bijani A.; Bouaoud S.; Cao Y.; Chaurasia A.; Chen M.X.; Chu D.T.; Cruz-Martins N.; Dadras O.; Dai X.; Diaz D.; Du M.; Ekholuenetale M.; Ekundayo T.C.; Tantawi M.E.; Elhadi M.; Fagbamigbe A.F.; Farshidfar N.; Fatehizadeh A.; Fischer F.; Folayan M.O.; Gaewkhiew P.; Gajdács M.; Golechha M.; Gupta B.; Gupta S.; Hagins H.; Halboub E.S.; Hamidi S.; Hariyani N.; Hay S.I.; Heidari M.; Herrera-Serna B.Y.; Heyi D.Z.; Hostiuc S.; Humphrey K.M.; Ibitoye S.E.; Ilic M.D.; Isola G.; Kandaswamy E.; Kantar R.S.; Kaur N.; Kemmer L.; Khader Y.S.; Khateri S.; Kisa A.; Krishan K.; Kruger E.; Lalloo R.; An L.; Lim S.S.; Mestrovic T.; Mokdad A.H.; Moreira R.S.; Morrison S.D.; Murray C.J.L.; Natto Z.S.; Nayak B.P.; Nguyen T.; Nguyen V.T.; Omotayo A.O.; Padron-Monedero A.; Patel J.; Patil S.; Pawar S.; Petcu I.R.; Qattea I.; Rahman M.; Ratan Z.A.; Riad A.; Manjula S.; Chandan S.N.; Sabour S.; Sharif-Askari F.S.; Sahebkar A.; Sakshaug J.W.; Samy A.M.; Sarode S.C.; Sawhney M.; Schwendicke F.; Bernabe E.; Mahidol UniversityBackground: The WHO Global Oral Health Action Plan has set an overarching global target of achieving a 10% reduction in the prevalence of oral conditions by 2030. Robust and up-to-date information on the global burden of oral conditions is paramount to monitor progress towards this target. The aim of this systematic data analysis was to produce global, WHO region, and country-level estimates of the prevalence of, and disability-adjusted life-years (DALYs) attributed to, untreated caries, severe periodontitis, edentulism, other oral disorders, lip and oral cavity cancer, and orofacial clefts from 1990 to 2021. Methods: This report is based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Input data were extracted from epidemiological surveys, population-based registries, and vital statistics. Data were modelled with DisMod-MR 2.1, a Bayesian meta-regression modelling tool, to ensure consistency between prevalence, incidence, remission, and mortality estimates for oral conditions. DALYs were estimated as the aggregation of the years of life lost (YLLs) due to premature mortality and years lived with disability (YLDs). YLDs were calculated by multiplying prevalence estimates, the severity of the oral condition's sequelae (disability weight) and duration of the sequelae. Although all oral conditions lead to YLDs, only lip and oral cavity cancer and orofacial clefts lead to YLLs as well. 95% uncertainty intervals (UIs) were generated for every metric with the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: The combined global age-standardised prevalence of the main oral conditions (untreated caries, severe periodontitis, edentulism, and other oral disorders) was 45 900 (95% UI 42 300 to 49 800) per 100 000 population in 2021, with 3·69 billion (3·40 to 4·00) people affected globally. Untreated dental caries of permanent teeth and severe periodontitis were the most common oral conditions, with a global age-standardised prevalence of 27 500 (24 000 to 32 000) per 100 000 population and 12 500 (10 500 to 14 500) per 100 000 population, respectively. Edentulism, severe periodontitis, and lip and oral cavity cancer caused the highest burden as demonstrated by their counts of DALYs and age-standardised DALY rates. Existing trends for 1990–2021 reveal relatively small changes (upward or downward) in prevalence and burden. Increasing counts of prevalent cases and DALYs were noted for all oral conditions but untreated caries of deciduous teeth (no percentage change in prevalence or DALYs) and orofacial clefts (–68·3% [–79·3 to –46·5] decrease in DALYs). There were decreases in both age-standardised prevalence and DALY rate for untreated caries of permanent teeth and edentulism, no change in both for untreated caries of deciduous teeth and severe periodontitis, an increase in the prevalence but no change in the DALY rate for lip and oral cavity cancer, and no change in the prevalence but a decrease in the DALY rate for orofacial clefts. By WHO region, the African and Eastern Mediterranean regions showed the largest increases in prevalent cases and DALYs for most oral conditions, while the European region showed the smallest increases or no change. The European region was the only region with decreasing age-standardised prevalence of untreated caries in both deciduous (–9·88%; –12·6 to –6·71) and permanent teeth (–5·94% (–8·38 to –3·62). The prevalence and DALY rate of severe periodontitis decreased in the African region, while the prevalence and DALY rate of edentulism decreased in the African region, South-East Asia region, and Western Pacific region. Furthermore, DALY rates of lip and oral cavity cancer decreased in the European region and the region of the Americas, while DALY rates of orofacial clefts decreased in all regions. Interpretation: The minor changes in the burden of oral conditions over the past 30 years demonstrate that past and current efforts to control oral conditions have not been successful and that different approaches are needed. Many countries now face the double challenge of controlling the occurrence of new cases of oral conditions and addressing the huge unmet need for oral health care. Funding: Bill & Melinda Gates Foundation.Item Metadata only Barriers to Healthcare Access for Myanmar Migrants in Thailand and Japan during COVID-19(2025-09-01) Kaewwilai L.; Khin E.T.; Han S.M.; Moriguchie N.; Namboonsri N.; Igarashi N.H.; Sugawara J.; Amnatsatsue K.; Kaewboonchoo O.; Kaewwilai L.; Mahidol UniversityThe COVID-19 pandemic has profoundly impacted global health systems, affecting migrants who face multiple barriers to healthcare access. This study explores and compares the healthcare access experiences of Myanmar migrants in Thailand and Japan during the COVID-19 pandemic. A qualitative study was conducted with semi-structured interviews with 20 Myanmar migrants (10 each in Thailand and Japan) and focus group discussions with healthcare professionals in both countries. Data was analyzed thematically using the Health Care Access Barriers (HCAB) model to identify financial, structural, and cognitive barriers. The study revealed multifaceted barriers across financial, structural, cognitive, and cultural dimensions. Financial barriers were particularly pronounced, with migrants in Thailand experiencing significant income loss when seeking medical care. Structural challenges included limited-service accessibility, complicated administrative processes, and geographical constraints. Cognitive barriers manifested through language difficulties, limited health literacy, and fear of discrimination. In Thailand, while the government provided free COVID-19 services to all migrants, challenges persisted in communication and service delivery. Japan presented similar complexities, with migrants facing additional difficulties in system navigation and cultural integration. Enhancing migrant health equity requires systemic interventions that go beyond individual-level health education. Strengthening community outreach, translation services, and migrant-inclusive policies are crucial. Future efforts should foster collaborative partnerships among healthcare facilities, local governments, NGOs, employers, and the Myanmar government or its embassies in Thailand and Japan, ensuring shared responsibility for the health and well-being of migrant populations.Item Metadata only Knowledge, Attitude, and Practice Regarding COVID-19 among Healthcare Workers in a Tertiary Teaching Hospital(2025-09-01) Supramanian R.K.; Cheng L.Y.; Hoe V.C.W.; Sundram B.M.; Anuar A.; Singh S.; Othman N.F.; Kuan W.C.; Kaewboonchoo O.; Lim N.H.H.; Tsong T.B.; Hashim N.H.N.; Kumar S.S.; Supramanian R.K.; Mahidol UniversityHealthcare workers are the frontline battling the COVID-19 pandemic and are at a high risk of infection. This paper assesses knowledge, attitude, and practice towards COVID-19 among healthcare workers in Universiti Malaya Medical Centre (UMMC). This cross-sectional study was conducted among healthcare workers in UMMC, Kuala Lumpur. Data collection period was from 1st March to 30th April 2021. A validated 19-item was used to measure knowledge, attitude and practice (KAP) scores. Univariate and multivariate analyses were conducted to identify factors associated with KAP scores, with significance set at p<0.05. A total of 162 respondents participated, including nurses (37.7%), allied health professional (24.7%), clinical specialist (6.8%), medical assistant (6.2%), medical doctors (4.9%), pharmacist (1.2%) and others (18.5%). Majority of HCWs (98.8%, n=160) had good knowledge, poor attitude (93.2%, n=151) and good COVID-19 preventive measure practices (97.5%, n=158). Multivariate logistic regression demonstrated that gender (adjusted Odds Ratio, OR 4.41; 95% Confidence Intervals, 95%CI: 1.25, 15.62) and profession (aOR 2.49; 95%CI: 0.68, 9.12) were found to be the significant factors associated with good attitude towards COVID-19 prevention measures. While healthcare workers demonstrated good overall knowledge and practice, their attitude towards COVID-19 prevention was poor. Behavioural interventions are recommended to improve attitude and strengthen safety culture in healthcare settings.Item Metadata only Outcomes in Critically Ill Patients Aged 90 Years and Older: A Scoping Review(2025-01-01) Kitisin N.; Pattamin N.; Thongpibul N.; Raykateeraroj N.; Kitisin N.; Mahidol UniversityThe growing population of nonagenarians has led to increased intensive care unit (ICU) admissions among elderly patients. However, evidence on their outcomes and optimal management strategies remains limited and fragmented. This scoping review aimed to explore mortality outcomes, factors associated with mortality, and treatment intensity in nonagenarians, comparing them to younger patients. A systematic search of MEDLINE and Embase from 1946 to September 2024 identified studies reporting ICU, in-hospital, and long-term mortality in nonagenarians. Twenty-nine studies involving 21,420 nonagenarians and 244,323 younger patients were included. ICU mortality among nonagenarians ranged from 1.42% to 66.7%, with an overall rate of 17.05% (2,738/16,062). In-hospital mortality ranged from 5.6% to 47%, with an overall rate of 26.54% (5,563/20,962). Long-term (one-year) mortality varied from 19% to 77%, with an overall rate of 53.45% (7,020/13,134). Key predictors of mortality included comorbidities, high severity scores (APACHE II, SAPS II), and less aggressive treatment. Despite these factors, nonagenarians had comparable mortality rates to younger patients when adjusted for illness severity. Nonagenarians in ICUs display variable but acceptable mortality rates, suggesting that age alone should not determine care intensity. Their heightened vulnerability after discharge calls for more effective and personalized post-ICU and post-hospital discharge care plans to better address their ongoing risks.Item Metadata only Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia(2025-01-01) Boonsawat N.; Suraarunsumrit P.; Pitiyarn S.; Pengsorn N.; Srinonprasert V.; Mandee S.; Wongviriyawong T.; Boonsawat N.; Mahidol UniversityObjective: To evaluate the reliability and validity of the Thai version of the PAINAD (PAINAD-Th) scale for assessing pain in people with dementia (PwD). Materials and methods: A cross-cultural translation of the PAINAD scale involving forward and back-translation to and from Thai was conducted, and then the content validity index (CVI) of semantic equivalence was evaluated. The PAINAD-Th was tested on 120 videos of PwD. Each participant was recorded in two videos: one during an activity and the other at rest. Subsequently, two trained nurses independently observed the videos and rated the PAINAD-Th to assess inter-rater reliability. The rating process was repeated in one week to investigate the test-retest reliability. The concurrent validity was assessed against the Visual Analogue Scale rated by the expert committee. Results: The CVI of PAINAD-Th was 1.00 for forward translation and 0.93 for back translation. The PAINAD-Th showed strong correlations with the reference standard (rs=0.854–0.943, p-value < 0.001). The inter-rater agreement for the total scores was 0.937 and 0.955, and the test-retest reliabilities were 0.914 to 0.964 for the activity stage and 0.880 for the resting stage, respectively. The concurrent validity index did not vary significantly across different stages of dementia; the findings remained consistent in the delirium subgroup analysis. Conclusions: The PAINAD-Th is a valuable tool for evaluating pain in PwD, not only in severe dementia but also in moderately severe stage, regardless of concurrent delirium. It also demonstrated good-to-excellent concurrent validity, inter-rater reliability, and test-retest reliability.Item Metadata only Obstetric Service Utilization in Public Health Facilities during COVID-19 Pandemic among Cross-border Migrants in Thailand, 2019–2022(2025-04-01) Cetthakrikul N.; Ngamvirojcharoen B.; Manaboriboon N.; Wongsuwanphon S.; Suphanchaimat R.; Cetthakrikul N.; Mahidol UniversityThe COVID-19 pandemic caused changes in obstetric care for the general population in Thailand. This study aimed to determine changes in obstetric admissions among migrants and assess potential factors influencing obstetric inpatient visits during the COVID-19 pandemic. An ecological time-series cross-sectional study was conducted using nationwide data between 2019 and 2022. Descriptive statistics were used to investigate outcome variables, including incidence number for obstetric inpatient care among insured migrants and uninsured migrants, and admission rate for obstetric inpatients among insured migrants. Independent variables included the cumulative incidence number of COVID-19 cases in a particular quarter, the number of hospital beds, geographical regions and time periods. This study then used random-effects negative binomial regression to explore the relationships between the outcome and independent variables. The incidence of all outcome variables during the COVID-19 pandemic (2020–2022) was higher than in 2019. The incidence of COVID-19 cases did not show a strong effect towards the change in obstetric admissions. For every 1,000-bed increase in hospital capacity, the admission rate decreased by approximately 8% (IRR 0.92, 95% CI 0.89–0.95) when adjusted for yearly periods, and by 9% (IRR 0.91, 95% CI 0.89–0.94) when adjusted for 6-monthly interval periods. Compared to Greater Bangkok, other regions exhibited lower numbers of hospital admissions for both insured and uninsured migrants. Conversely, the admission rate among insured migrants was higher in these regions. Continuous monitoring of the utilization of obstetric services by migrants offers benefits for proper policy design to ensure universal healthcare access for all.Item Metadata only A Study on the Embryo Transfer of 2-Cell Stage Embryos in Mlac:WR(2025-05-01) Buaban T.; Wongwigkan J.; Cherdyhu S.; Likitsuntonwong W.; Talang N.P.N.; Saliwan S.; Buaban T.; Mahidol UniversityBackground and Objectives: The National Laboratory Animal Center, Mahidol University, aims to preserve the strains of Wistar rats (Mlac:WR) in the embryo bank. The benefits of embryo banking are genetic resources. To prevent the loss of laboratory animal strains due to genetic changes, failure of the reproductive system, failure of the animal husbandry system, infections in the laboratory animal colony, natural disasters, cessation of laboratory animal breeding, and reduction of laboratory animal breeding costs. Additionally, preserving laboratory animal strains in the embryo bank is beneficial in preventing a shortage of laboratory animals in Thailand and reducing the importation of expensive laboratory animals. Therefore, in this study, we attempt to study the superovulation protocol for the in vivo embryo production of 2-cell stage embryos in Mlac:WR rats to determine the percentage of 2-cell stage embryos (% 2-cell stage embryos). The 2-cell stage embryos were frozen using the vitrification method. After that, the vitrified 2-cell stage embryos were thawed to determine the percentage of survival rate (% survival), and then the surviving 2-cell stage embryos were used for embryo transfer to determine the percentage of newborns (% newborn). Methodology: Mlac:WR rats were maintained in the animal room with strict hygienic conventional controlled temperature at 22±3ºC, 30-70% humidity, and 12 hours light conditions (lights on from 6:00 AM to 6:00 PM). Rats were supplied with a 5-7 ppm choline reverse osmosis water and standard diet (ad libitum). All animal procedures were conducted at the Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC) International. This study was approved by the National Laboratory Animal Center-Animal Care and Use Committee (NLAC-ACUC, protocol no. RA2023-33). Eight female rats with 9-week-olds were induced to superovulate through an intraperitoneal (IP) injection of 175 IU/kg BW pregnant mare serum gonadotropin (PMSG) at 9:00-10:00 AM, followed by 300 IU/kg BW IP of human chorionic gonadotropin (hCG) 50 hours later (11:00-12:00 AM). These females were then mated with 12-week-old Mlac:WR male rats overnight. 46-47 hours after the hCG injection, female rats were euthanized by carbon dioxide. The oviducts were collected, and embryos were flushed out from the oviducts with M2 medium under a stereomicroscope. The 2-cell stage embryos with normal morphology were counted and washed in 50 µl of M2 medium 3 times. After that, 2-cell stage embryos were cultured in 150 µl of M16 medium covered with mineral oil in a CO2 incubator (37ºC, 5% CO2, 95% humidity). For the vitrification, the 2-cell stage embryos were pretreated with EFS20 solution (20% v/v ethylene glycol, 15% w/v Ficoll® PM 70, 0.25 M sucrose) for 2 minutes and then frozen by the vitrification method using an EFS40 solution (40% v/v ethylene glycol, 30% w/v Ficoll® PM 70, 0.5 M sucrose) in a 0.25 ml straw tube. After being stored in a liquid nitrogen tank for 7 days, the vitrified 2-cell stage embryos were thawed using 0.75 M and 0.25 M sucrose (thawing solution), respectively. The surviving 2-cell embryos were counted and cultured in M16 medium, waiting for embryo transfer. The Mlac:WR female rats with 8-week-olds were tested for the proestrus by vaginal smear technique after that set mating overnight with the 12-week-old vasectomized Mlac:WR male rats. Female rats with vaginal plugs or mated with vasectomized males were used as recipients. The surviving 2-cell stage embryos were used for transfer to the oviducts of recipients. The recipients were natural-born on days 19-20 after embryo transfer. Main Results: The in vivo embryo production of 2-cell stage embryos in Mlac:WR female rats at 9-week-old by the superovulation technique. The results show that the total number of embryos harvested from the superovulation was 202 embryos, divided into 139 of 2-cell stage embryos (17.4±6.4), 18 of 4-cell stage embryos (2.3±0.9), and 45 of abnormal embryos (5.6±3.5). The percentage of 2-cell stage embryos was 68.8 (139/202). The 139 of 2-cell stage embryos were divided into 3 groups (47, 47, and 45 embryos) and frozen by vitrification for 3 tubes. After thawing the first tube, 45 of the 2-cell stage embryos were discovered under a stereomicroscope; after that, 13 of the 2-cell stage embryos were dead. The 32 of the 2-cell stage embryos were alive after thawing. The percentage of survival 2-cell stage embryos was 68.1 (32/47). The surviving 2-cell stage embryos were used for embryo transfer to 2 recipients (16 of 2-cell stage embryos per recipient). 19-20 days later, the number of newborns was 1 and 3 in recipients, respectively, with the percentage of newborns being 12.5 (4/32), 1 female, and 3 males. Conclusions: The 2-cell stage embryos of Mlac:WR rats can be used to establish the embryo bank. Because of that, the percentage of 2-cell stage embryos obtained from in vivo embryo production and the percentage of survival 2-cell stage embryos after vitrification are relatively high, although the percentage of newborns after embryo transfer was low. However, this study was the first successful embryo transfer in Mlac:WR rats at the National Laboratory Animal Center. The knowledge and skills gained from this study will be used to improve the embryo transfer protocol. To successfully establish a rat embryo bank and promote the National Laboratory Animal Center as a source of learning on laboratory animal embryo bank techniques in Thailand.Item Metadata only A Study on the Production of 2-Cell Stage Embryos in C57BL/6Mlac Mice with Adult Age(2025-09-01) Buaban T.; Saliwan S.; Buaban T.; Mahidol UniversityBackground and Objectives: The embryo bank unit was established in the National Laboratory Animal Center, Mahidol University, Thailand. The primary role of the embryo bank unit is to preserve various mouse strains. The assisted reproductive technologies for the embryo bank unit included superovulation, in vitro fertilization, in vivo embryo production, vitrification and thawing, in vitro culture, embryo transfer, and cesarean section. In the embryo bank unit, female mice aged 8-10 weeks were used for in vivo embryo production of 2-cell stage embryos, while older mice were terminated from the colony. To optimize animal use, we focus on producing 2-cell stage embryos from adult C57BL/6Mlac female mice through in vitro embryo production, followed by vitrification, thawing, in vitro culture, and embryo transfer. This study aims to determine the percentage of superovulation (% superovulation), the percentage of in vitro fertilization (% in vitro fertilization), the percentage of surviving 2-cell stage embryos after vitrification and thawing (% survival), the percentage of development to blastocysts after in vitro culture (% development), and the percentage of newborn after the embryo transfer (% newborn). Methodology: C57BL/6Mlac mice were bred in the embryo bank unit. Mice were maintained under routine husbandry procedures in the animal room with strict hygienic conventional, controlled temperature at 22±3ºC, 30-70% humidity, regulated light conditions, a standard mouse diet, and 5-7 ppm choline reverse osmosis water. Mice were kept in plastic cages and stainless-steel lids. The sterile bedding used consisted of corn cobs and dried water hyacinth. Eleven 17-week-old C57BL/6Mlac female mice were used for oocyte production following the routine superovulation protocol. C57BL/6Mlac female mice were induced to superovulation through an intraperitoneal (IP) injection of 10 IU pregnant mare serum gonadotropin (PMSG) at 2:00-3:00 PM, followed by an IP injection of 10 IU human chorionic gonadotropin (hCG) 48 hours later. Nineteen to twenty-one hours after the hCG injection, female mice were euthanized by cervical dislocation. Oviducts were removed and placed in M2 medium. Cumulus oocyte complexes (COCs) were released from the ampulla under a stereomicroscope. COCs of one female mouse were kept in EmbryoMax® Human Tubal Fluid (HTF) medium covered with mineral oil in a CO2 incubator (37ºC, 5%CO2, 95%humidity). Two 12-week-old C57BL/6Mlac male mice were used for fresh sperm collection. A 5 µl of sperm solution was transferred into a COCs drop by micropipette. The sperm and COCs were incubated in a CO2 incubator overnight. The next morning, the 2-cell stage embryos with normal morphology were counted to determine the % in vitro fertilization. The 2-cell stage embryos were collected and pretreated with a Holding medium (Bovine serum albumin, M2 medium) for 3 minutes and frozen by the vitrification method using a 35EG solution (35% v/v ethylene glycol, Bovine serum albumin, Polyvinylpyrrolidone, Trehalose dehydrate, M2 medium) in a 0.25 ml straw tube at room temperature. The 0.25 ml straw tube was placed over liquid nitrogen for 3 minutes, plunged into liquid nitrogen directly, and stored in a liquid nitrogen tank for 6 months. These straw tubes were taken out of the liquid nitrogen tank, warmed at room temperature for 20 seconds, and then warmed at 37ºC water for 20 seconds. The 2-cell stage embryos were found under a stereomicroscope and thawed using a 0.3 M Trehalose, a 0.15 M Trehalose, a 0.075 M Trehalose, and a Holding medium. The surviving 2-cell stage embryos were counted to determine the % survival and then divided into two groups for quality testing through in vitro culture and embryo transfer. Main Results: Nine 17-week-old C57BL/6Mlac female mice responded to the 10 IU PMSG/hCG superovulation, with the % superovulation was 81.8 (9/11 females). After superovulation and overnight in vitro fertilization, the number of 2-cell stage embryos was 130, the number of oocytes was 38, and the number of abnormal oocytes was 137. The % in vitro fertilization was 42.6 (130/305). The 2-cell stage embryos were kept in a liquid nitrogen tank for 6 months. After thawing, 110 of 2-cell stage embryos were observed under a stereomicroscope, 23 embryos were dead. A total of 87 2-cell stage embryos remained alive after thawing, the % survival was 66.9 (87/130). In Group 1, 29 out of 47 embryos developed into blastocysts, the % development was 61.7 (29/47). In Group 2, 40 embryos were used for embryo transfer into 4 recipients. On the day of birth, the number of newborns was 2, 2, and 2 in the 1st, 2nd, and 4th recipients, respectively, the 3rd recipient gave birth but consumed all the newborns. The % newborn was 15.0 (6/40) after embryo transfer. At 4 weeks old, 2 male and 4 female immature C57BL/6Mlac mice were counted at weaning. Conclusions: Adult C57BL/6Mlac female mice can be used to produce the 2-cell stage embryos by in vitro embryo production consisting of the 10 IU PMSG/hCG superovulation and the in vitro fertilization. The 2-cell stage embryos are resistant to vitrification and suitable for use in the embryo bank unit. Although the % in vitro fertilization and the % newborn were low, there are sufficient numbers of newborns to establish a new colony. Additionally, it promotes the use of laboratory animals for maximum benefit at the National Laboratory Animal Center.Item Metadata only Can ChatGPT perform as well as pharmacists in identifying potentially inappropriate medications (PIMs) in elderly cancer patients?(2025-06-01) Khanthavit R.; Putthipokin K.; Khudamkreng S.; Wetchaphan B.; Kongsuphon N.; Thokanit N.S.; Chansriwong P.; Khanthavit R.; Mahidol Universitye23121Background: Polypharmacy remains a significant issue among older adults, primarily due to its association with an increased risk of potentially inappropriate medications (PIMs). Using PIMs in this population is associated with adverse drug events, heightened healthcare costs, and poorer clinical outcomes. ChatGPT, a sophisticated language model developed by OpenAI based on the Generative Pre-trained Transformer (GPT) architecture, has demonstrated potential utility in a variety of healthcare applications. Despite these advancements, the comparative effectiveness of ChatGPT in identifying PIMs and its efficiency relative to clinical pharmacists remains under-explored. This study sought to evaluate the capability of ChatGPT to detect PIMs in elderly cancer patients and to compare its time efficiency with that of pharmacists in the drug reconciliation process. Methods: A cross-sectional study was conducted involving elderly cancer patients receiving treatment at the outpatient cancer clinic of Ramathibodi Hospital. PIMs were identified and categorized based on the American Geriatrics Society (AGS) 2023 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Comprehensive demographic and clinical data, including diagnoses and prescribed medications, were input into ChatGPT version 4.0 using standardized prompts. The results generated by ChatGPT were subsequently compared with independent evaluations performed by two clinical pharmacists. The time required for medication reconciliation by ChatGPT and the pharmacists was measured and analyzed. All statistical analyses were conducted using Stata version 18. Results: The study included a cohort of 200 patients, with a median of 6.08 medications per patient (range: 0-22). Polypharmacy was identified in 55.0% of participants, with these patients exhibiting a significantly higher prevalence of PIMs compared to those prescribed fewer than 5 medications (P < 0.001). Pharmacists identified PIMs in 29.5% of cases, with the most frequently identified PIMs being benzodiazepines, metoclopramide, and proton pump inhibitors. The agreement between ChatGPT and the pharmacists was limited, with a Pearson correlation coefficient of r = +0.43. In terms of time efficiency, pharmacists required an average of 3.04 minutes to complete the drug reconciliation process, while ChatGPT completed the same task in 2.09 minutes, significant difference (P < 0.001). Conclusions: ChatGPT shows potential as an artificial intelligence tool for enhancing medication reconciliation processes in healthcare settings. While it offers a time-efficient solution for identifying PIMs, the level of agreement with clinical pharmacists remains moderate. Further refinement and validation of this technology are necessary to ensure its reliability and safety before broader clinical implementation.Item Metadata only The Grammar of Science: How “Robust” Are Your Study Results?(2025-04-01) Kaewkungwal J.; Kaewkungwal J.; Mahidol UniversityItem Metadata only The Grammar of Science: Do Clusters Really Matter?(2025-07-01) Kaewkungwal J.; Kaewkungwal J.; Mahidol UniversityItem Metadata only The Grammar of Science: The Challenge of Competing Outcomes(2025-10-01) Kaewkungwal J.; Kaewkungwal J.; Mahidol UniversityItem Metadata only The Grammar of Science: Bar, Pie, Line, and Lie(2025-04-01) Kaewkungwal J.; Kaewkungwal J.; Mahidol UniversityItem Metadata only Welcome Address from General Chair(2025-01-01) Suthakorn J.; Suthakorn J.; Mahidol UniversityItem Metadata only Ground Reaction Force Analysis of Robot-Assisted Walking Using Inertial Sensors(2025-01-01) Moonjaita C.; Sivaraman D.; Sai-Aroon K.; Luangon P.; Pillai B.M.; Suthakorn J.; Moonjaita C.; Mahidol UniversityThe growing elderly population faces increasing mobility challenges, particularly knee joint problems during walking, which limit independence and increase the risk of falls. Traditional force plate measurements for ground reaction force (GRF) analysis are constrained to laboratory environments, limiting the assessment of assistive technologies in natural settings. This study developed a mathematical framework to estimate the GRF during robot-assisted walking using inertial sensors, with the BART LAB AI-Elderly Supporting Robot designed specifically for elderly mobility assistance. Ten healthy participants performed walking trials under controlled and robot-assisted conditions to validate the proposed measurement framework. Inertial measurement unit sensors captured motion data, and mathematical models estimated the GRF by incorporating gravitational, dynamic, and robotic assistance components. Robotic assistance achieved a 28.9 ± 8.6% peak GRF reduction, with 90% of the participants showing clinically meaningful improvements (>20%). Individual reductions ranged from 12.4-39.8%, equivalent to a substantial joint load reduction. The framework successfully quantifies the effectiveness of robotic assistance without force plate constraints, providing a foundation for the objective evaluation of elderly mobility support systems before clinical implementation.Item Metadata only Adaptive Learning-Based Haptic Motion Copying for Stroke Rehabilitation Using Gaussian Process Regression(2025-01-01) Sai-Aroon K.; Siripala N.; Pillai B.M.; Chumnanvej S.; Vinjamuri R.; Suthakorn J.; Sai-Aroon K.; Mahidol UniversityUpper-limb rehabilitation for stroke patients often depends on subjective assessments and intensive therapist supervision, which limits scalability and consistency. This study developed a motion-copying system integrated with a Gaussian Process Regression (GPR)-based trajectory correction framework to replicate healthy subjects' movements and improve rehabilitation accuracy. A haptic device was used to collect precise position and velocity data during three predefined trajectory patterns: Square, Sine, and Sawtooth waves. The GPR-based correction achieved mean error reductions of 91.02 ± 3.05% for the Square wave, 82.12 ± 6.24% for the Sine wave, and 69.62 ± 24.30% for the Sawtooth wave. These findings confirm the system's technical capability to deliver accurate, real-time trajectory correction for consistent and predictable motions, while identifying areas for improvement in handling irregular movements. The proposed framework provides an objective and adaptive technical tool that holds promise for reducing physiotherapist workload and potentially enhancing patient outcomes in future clinical applications.Item Metadata only Pre-procedural Planning Algorithm for Mammogram-guided Wire-Localization of Breast Microcalcifications Lesions(2025-01-01) Suppuang C.; Wiratkapun C.; Suthakorn J.; Suppuang C.; Mahidol UniversityWire localization under conventional mammography presents challenges in translating two-dimensional imaging into precise spatial targeting due to compression variability between craniocaudal (CC) and mediolateral oblique (MLO) views. This work presents a computer-assisted planning algorithm combining domain-adapted UNet segmentation with clinician-decision mimicking algorithmic reasoning for optimal wire placement recommendations. The system employs a UNet segmentation model for microcalcifications adapted to institutional data and mammographic image segmentation pipeline for breast feature segmentation using gradient-based methods. The algorithm calculates minimum lesion-to-surface distances in CC and MLO views, recommending optimal compression approaches based on shortest access paths, with simplified 3D visualization through geometric decompression and view correlation. The novelty of this approach lies in providing an automated, pre-procedural planning solution that replicates radiologists' spatial reasoning. Retrospective evaluation on 30 cases demonstrates 83.3% agreement with expert clinical decisions, 86.7% successful completion rate, and 94 seconds mean processing time on general-purpose workstation. The system provides clinically acceptable decision support while preserving physician autonomy in mammographic wire localization procedures.Item Metadata only A Practical Workflow for Implementing FEM-Based Brain Shift Prediction in Preoperative Neurosurgical Planning(2025-01-01) Somboonwong T.; Ono K.; Chumnanvej S.; Suthakorn J.; Ongwattanakul S.; Somboonwong T.; Mahidol UniversityAccurate image guidance in neurosurgery is often compromised by brain shift, tissue deformation that occurs after craniotomy. While advanced intraoperative imaging can compensate for this, it remains cost-prohibitive and unavailable in many hospitals, particularly in resource-limited settings. To address this gap, we propose a practical workflow for predicting brain shift preoperatively using the finite element method (FEM) and only standard MRI and/or CT scans. The workflow includes data preparation, meshing, material assignment, simulation setup, and integration strategies for clinical adoption. It is designed to be accessible and scalable, running on standard hardware and producing results within a timeframe suitable for preoperative planning. Feasibility was demonstrated through phantom-based validation, with accuracy remaining within clinically acceptable limits. Future work will focus on automating the workflow, accelerating computation, and connecting the system with hospital ICT infrastructure to support wider clinical adoption.