Scopus 2025
Permanent URI for this collectionhttps://repository.li.mahidol.ac.th/handle/20.500.14594/102712
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Item Metadata only A data-driven model to estimate breathing-induced intra-trunk blood shifts during exercise(2025-06-01) Corigliano G.; Uva B.; Kayser B.; Aliverti A.; Stucky F.; Corigliano G.; Mahidol UniversityThe pressure swings generated by the respiratory muscles induce blood shifts (Vbs) between the trunk and the extremities. Vbs varies with swing amplitude and breathing pattern and can reach sizable volumes. Although Vbs was successfully explored using double-body plethysmography, the extent of intra-trunk blood shifting (between abdomen and thorax, VbsIT) remains to be quantified. We here present an electrical model of the cardiovascular system that allows to derive quantitative estimates of breath-by-breath VbsIT. We first validated the model with experimental data collected from healthy participants performing exercise with various breathing patterns, including spontaneous (CTRL), abdominal (AB), and rib cage breathing (RC), and with external expiratory flow limitation (EFLe). We then fed the model with other experimental data to derive VbsIT in a proof-of-concept fashion. Breath-by-breath fluctuations in Vbs derived from the model matched experimental data. Computations of VbsIT were in line with expectations, showing small fluctuations with spontaneous breathing and substantial increases during AB, RC, and EFLe. Intrabreath VbsIT showed a close relationship with intra-breath transdiaphragmatic pressure during inspiration in all conditions and during expiration in AB and RC, reflecting the net effect of hydraulic pressure fluctuations on blood displacement between the two compartments. This model may benefit further work investigating (patho)physiological mechanisms of various conditions affecting cardiorespiratory function, both at rest and during exercise.Item Metadata only Prevalence of genetic alterations in basal cell carcinoma patients resistant to Hedgehog pathway inhibitors: a systematic review(2025-01-01) Untaaveesup S.; Srichana P.; Techataweewan G.; Pongphaew C.; Dendumrongsup W.; Ponvilawan B.; Nampipat N.; Limwongse C.; Untaaveesup S.; Mahidol UniversityIntroduction: Basal cell carcinoma (BCC) is a prevalent form of skin cancer that can be localized or metastatic. Current evidence supports the use of Hedgehog (Hh) pathway inhibitors for locally advanced or metastatic BCC with resistance due to genetic alterations in the Hh pathway. This systematic review evaluated the prevalence of genetic alterations in Hh pathway genes in BCC. Materials and methods: We conducted a comprehensive search across four databases: PubMed, EMBASE, SCOPUS and the Cochrane Library. We included articles reporting genetic alterations in patients with locally advanced or metastatic BCC resistant to Hh pathway inhibitors. Results: We included three prospective cohort studies encompassing 27 samples, all of which were resistant to vismodegib treatment. The most prevalent genetic mutations in the Hh pathway were in PTCH1, SMO and TP53, with a pooled prevalence of 44.44%. Conclusions: This systematic review highlights the prevalence of genetic alterations in the Hh pathway in BCC and offers insights into the mechanisms involved in treatment resistance. Understanding the high resistance rates of these genes may facilitate the development of more effective targeted therapies for BCC.Item Metadata only Advancing Circular Economy for Climate Change Mitigation and Sustainable Development in the Nordic Region(2025-01-01) Ridwan M.; Akther A.; Dhar B.K.; Roshid M.M.; Mahjabin T.; Bala S.; Hossain H.; Ridwan M.; Mahidol UniversityThis study examines how circular economy (CE) strategies contribute to climate change mitigation and sustainable development in the Nordic region. Analyzing resource productivity, environmental taxation, and corporate recycling practices from 1995 to 2021, it examines the impact of economic growth, trade openness, urbanization, and regulatory incentives on CE adoption. Using the STIRPAT model and quantile regression, findings highlight that resource productivity and environmental taxation are key drivers of circularity, while trade and urbanization present both opportunities and challenges. A bidirectional relationship between environmental taxation and recycling rates underscores the dynamic role of green fiscal policies. The study also contributes to institutional theory by demonstrating how fiscal mechanisms—such as environmental taxes—not only shape but also are shaped by recycling outcomes, reflecting adaptive and co-evolving institutional arrangements. The study offers insights for businesses and policymakers, emphasizing the need for integrated governance and sustainable trade to support CE transitions. Implications extend beyond the Nordic context, offering a robust empirical foundation for CE integration in other high-income and industrializing economies aiming to build low-carbon, resource-efficient systems.Item Metadata only Knowledge and Prevalence of Urinary Incontinence Among Third-Trimester Pregnant Women(2025-01-01) Khamkayan C.; Saraluck A.; Komon W.; Khamkayan C.; Mahidol UniversityIntroduction and Hypothesis: To evaluate the knowledge regarding urinary incontinence (UI) among third-trimester pregnant women, identify associated factors, and determine the prevalence of UI. Material and Methods: A cross-sectional study was performed on pregnant women in their third trimester, aged 20 years and older, at a tertiary care hospital from October 2023 to July 2024. The Prolapse and Incontinence Knowledge Questionnaire—Urinary Incontinence subscale (PIKQ-UI) was utilized as the principal instrument for evaluating knowledge. Participants achieving a score of 80% or higher on the PIKQ-UI questionnaire were considered proficient in UI knowledge. The associations between patient characteristics variables and proficient level of UI knowledge were investigated to identify associated factors. International Consultation on Incontinence Questionnaire—Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) was used to determine the prevalence of UI. Results: A total of 692 participants completed the questionnaire, with a mean age of 29.49 ± 5.92 years, and 13.58% (94/692) of third-trimester pregnant women exhibited proficiency in UI knowledge. The mean UI knowledge, as indicated by the PIKQ-UI score, was 6.27 ± 2.66. Multivariate analysis of variables correlated with proficiency in UI knowledge indicated that employment as a health system worker was only one factor exhibiting a statistically significant correlation with proficiency in UI knowledge (OR 7.38, 95%CI 3.47–15.67, p value 0.03). The prevalence of UI was 66.33%, with mixed UI being the most common type. Conclusion: Despite the high prevalence of UI, third-trimester pregnant women were still perceived as having incomplete knowledge of the condition. Educating on UI may enhance understanding of the condition, improve healthcare accessibility, and improve the quality of life for affected women.Item Metadata only INTERDEPENDENT CAUSES OF THE TOM YUM KUNG CRISIS: A PATICCASAMUPPĀDA PERSPECTIVE(2025-01-12) Bukkavesa K.; Frutos-Bencze D.; Makcharoen P.; Bukkavesa K.; Mahidol UniversityThis study explores the application of the Buddhist principle of Paticcasamuppāda (Dependent Origination) in analyzing the 1997 Asian Financial Crisis, commonly known as the “Tom Yum Kung” crisis. This crisis, marked by financial liberalization, speculative investments, and inadequate risk management, demonstrated the systemic vulnerabilities within Thailand’s economic structure. Through the lens of Paticcasamuppāda, this crisis can be understood as a chain reaction where economic decisions and external pressures accumulated into a major collapse. Key factors include ignorance (Avijjā) of financial risks, misguided policy actions (Saṅkhāra), and the persistence of a fragile financial system (Bhava). The primary objective of this study is to demonstrate how each of the twelve links of Paticcasamuppāda can be systematically mapped onto the stages of the Thai economic collapse, thereby offering a novel interpretive framework that reveals the interdependent causes of the crisis. By adopting this Buddhist perspective, the study highlights the importance of mindful economic planning and sustainable governance. In addition, the study advocates for integrating awareness of interdependence and impermanence into economic strategies, fostering resilience in a globalized financial environment.Item Metadata only Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand(2025-07-01) Charoenwisedsil R.; Soravipukuntorn T.; Panyatanakun K.; Pisutsan P.; Looareesuwan P.; Asawapaithulsert P.; Imad H.A.; Schneitler S.; Piyaphanee W.; Matsee W.; Charoenwisedsil R.; Mahidol UniversityBackground: Rabies exposure remains a significant public health concern in South and Southeast Asia. Despite the disease being vaccine-preventable, international travelers remain at risk of rabies infection due to the limited access to vaccines and immunoglobulin. This retrospective review aims to analyze post-exposure rabies consultations at the Thai Travel Clinic providing insights into epidemiology, risk factors, and post-exposure management for international travelers. Methods: A retrospective study included international travelers of all ages who visited the Thai Travel Clinic at the Hospital for Tropical Diseases in Bangkok, Thailand for potential rabid animal post-exposure management between January 1, 2019, and March 31, 2024. Results: Among 306 international travelers, 91.5 % were healthy with no underlying medical conditions. Approximately 30.9 % traveled in Southeast Asia for less than one month, 46.6 % for one to six months, and 20.8 % for over six months. The majority of bites were from dogs (46.3 %), followed by monkeys (23.9 %) and cat (23.5 %). Common exposure locations included streets (40.1 %), followed by islands or beaches (20.5 %). The median time from arrival in Thailand to animal exposure was 30 days, with 14.7 % bitten within the first week. World Health Organization (WHO) category III rabies wounds accounted for 59.8 % (176/294) of cases. Only 47.5 % (144/303) received the first dose of the rabies vaccine on the day of exposure, and 57.9 % (70/121) experienced delays in receiving rabies immunoglobulin. Additionally, two travelers (2/149; 1.3 %) refused rabies immunoglobulin despite it being clinically indicated. Only 35.3 % (108/306) had pre-travel consultations, and 9.5 % (29/306) of all travelers completed rabies pre-exposure vaccination. Conclusions: Over half of the international travelers delayed initiating rabies vaccine or immunoglobulin after potential rabid animal exposure. As rabies is a fatal yet preventable disease, this review underscores the urgent need to raise awareness about the importance of prompt post-exposure management. Strengthening traveler education and advocating for pre-exposure immunization are critical strategies to mitigate risks and improve outcomes.Item Metadata only EPHX1 and ERCC2 polymorphisms are associated with cisplatin-induced nephrotoxicity and prognosis in Thai cancer patients(2025-06-01) Ahmed S.; Eu-Ahsunthornwattana J.; Thamrongjirapat T.; Taweewongsounton A.; Rittavee Y.; Thokanit N.S.; Ngodngamthaweesuk M.; Hiranyatheb P.; Reungwetwattana T.; Ngamphaiboon N.; Jinawath N.; Ahmed S.; Mahidol UniversityCisplatin is a widely used chemotherapeutic drug for various cancers. One of the common adverse effects of cisplatin is nephrotoxicity including acute kidney injury (AKI) and acute kidney disease (AKD). Single Nucleotide Polymorphisms (SNPs) can be used to identify cancer patients who are susceptible to developing cisplatin-induced nephrotoxicity (CIN). In this study, we validated the association between 6 SNPs in the drug metabolizing enzyme genes, SLC22A2 (rs316019) & EPHX1 (rs1051740), and the DNA repair genes, ERCC1 (rs11615 & rs3212986) & ERCC2 (rs13181 & rs1799793), and CIN in the 169 Thai patients with head and neck, lung, or esophageal cancer. Effect of these SNPs on cumulative incidence of AKD, progression-free survival (PFS), and overall survival (OS) was also assessed. EPHX1 rs1051740 TC genotype was significantly associated with AKD in co-dominant [OR 2.894, 95% CI 1.091–7.680; P=0.033] and over-dominant [OR 2.793, 95% CI 1.333–5.851; P=0.006] models, and with an increased cumulative incidence of AKD (P=0.021). Additionally, ERCC2 rs13181 and rs1799793 were significantly associated with OS (P=0.002 and 0.004). Our results reveal an association between EPHX1 rs1051740 and AKD, and confirms the previously reported associations between ERCC2 SNPs and OS. These findings may help in predicting CIN in Thai cancer patients.Item Metadata only Prevalence and Risk Factors of Recurrent Falls in Older People Post-Hip Fracture Surgery After Discharge: A Cross-Sectional Study(2025-07-01) Phonlakid P.; Roopsawang I.; Aree-Ue S.; Phonlakid P.; Mahidol UniversityRecurrent falls and fall-related injuries are common in older adults after a hip fracture. This cross-sectional study aimed to investigate the prevalence and risk factors associated with recurrent falls in older people following hip fracture surgery after their discharge from the hospital. With purposive sampling, the participants were 180 older adults who underwent hip fracture surgery six months prior and visited orthopedic outpatient services at three tertiary care hospitals in Bangkok from July 2023 to May 2024. Data collection utilized standard assessments, including the Personal Health Information Questionnaire, the 6-Item Cognitive Impairment Test, the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement, the Falls Efficacy Scale International, the Activities-specific Balance Confidence Scale, and the St Thomas’s Risk Assessment Tool in Falling Elderly Inpatients. Data analysis was performed using descriptive statistics and multiple logistic regression, with a significant level set at 0.05. The results indicated that the prevalence of recurrent falls among older people who underwent hip fracture surgery was 27.8% within the first six months after being discharged from the hospital. Participants identified as high risk for falls had a risk of recurrent falls that was 4.74 times greater than those classified as low risk. Additionally, participants taking medications related to falls had a 2.71 times higher risk of experiencing recurrent falls compared to those who were not on such medications. Findings from this study suggest that health professionals, particularly gerontological nurse practitioners, should emphasize the importance of assessing fall risks and the potential side effects of medications that could lead to falls before discharging patients from the hospital.Item Metadata only Functional cure with new antiviral therapy for hepatitis B virus: a systematic review and meta-analysis(2025-01-01) Chen J.; Ji D.; Jia J.; Zhuang H.; Zhang X.; Wang F.S.; Zhang W.; Dou X.; Tanwandee T.; Sarin S.K.; Maiwall R.; Kumar M.; Goh G.B.B.; Ghazinyan H.; Chutaputti A.; Chen P.J.; You H.; Yu M.L.; George J.; Omata M.; Wang G.Q.; Lau G.; APASL Viral Elimination Taskforce; Chen J.; Mahidol UniversityBackground: Achieving a “functional” cure for chronic hepatitis B (HBV) is primary goal for novel antiviral treatments. We sought to evaluate efficacy and safety of these novel treatments and identified emerging barriers to achieving a functional cure. Approach: We systematically reviewed clinical trials from 2018 to 2023, identifying 244 trials from clinicaltrials.gov records on HBV. The primary outcome was functional cure rate at the end of follow-up (EOF). Secondary outcomes included changes in HBsAg levels, HBsAg loss rates, HBV DNA rebound, and adverse events. Meta-analysis was performed. Results: Our meta-analysis of 19 studies involving 1789 non-cirrhotic HBV patients found a minimal functional cure rate (0.0%, 95%CI 0.0–0.4%) and low HBsAg loss rates (0.9% at the end of treatment [EOT] and 0.1% at EOF). HBsAg levels declined at EOT (−0.41 log10 IU/mL, 95%CI −0.45 to −0.37, p < 0.001) but this reduction was not sustained to EOF. Virological relapse occurred in 20.5% of cases off-treatment. Although novel treatments were well-tolerated, they had higher adverse event rates (OR = 1.77, 95%CI 1.26–2.48). Challenges to achieving a functional cure include complex trial designs and unknown confounding factors. Conclusion: Novel antiviral treatments showed limited effectiveness in achieving HBsAg loss and reduction, highlighting the need to address identified barriers in future research.Item Metadata only A CRITICAL ANALYSIS OF DEBUSSY’S FEUX D’ARTIFICE IN THE ASPECTS OF HARMONY, INTERVALLIC RELATIONSHIPS, AND MOTIVIC DEVELOPMENT(2025-01-01) Sookjaeng A.; Sookjaeng A.; Mahidol UniversityBackground and Objectives: Among works for piano by Debussy, Préludes remains one of the most significant compositions in the piano literature. Préludes consists of two books, each containing twelve pieces. The first book was published in 1910, and the second in 1913. Although the two volumes were published in different years, they should be regarded as a unified work, as the collection reflects the assimilation of non-traditional materials, such as pentatonic scales, modality, parallelism, and whole-tone scales. However, the second volume demonstrates greater advancement in terms of piano performance techniques and interpretation. Notably, the titles of the pieces in Préludes differ from those in other works by Debussy, where he typically placed the title at the end of each piece in brackets. The titles themselves are significant, as they provide subtle hints to the characteristics and images of each prelude. Additionally, placing the title at the end of each piece allows performers more freedom in interpretation, as they are not influenced by the composer's suggestions beforehand. This article aims to study and analyze the last piece of the second book, Feux d’artifice (literally meaning “fireworks”). Despite its importance, there are hardly any detailed scholarly analyses of the piece, and those that exist rarely explore it in terms of harmony, intervallic relationships, and motivic development in each section of the piece. Moreover, research on this topic that the author has reviewed is not recent. For these reasons, a comprehensive theoretical analysis is needed to enhance our understanding of Debussy’s compositional style. Methods: The research design of this qualitative research is documentary analysis, focusing on Debussy’s compositional techniques employs in the piece in order to understand how important musical elements are treated throughout the entire piece. By carefully exploring the work, the analysis will clearly reveal Debussy’s craftsmanship and his approach to conveying ideas through music. Results: The study shows that Feux d’artifice exemplifies Debussy's meticulous compositional skill in multiple aspects. As the title suggests, the piece aims to evoke the vivid colors of fireworks in the night sky through innovative piano techniques, lush harmonies, and motivic transformations. Debussy treats the primary motif economically, beginning with a two-note motif that is transformed throughout the piece. Each time it reappears, the motif is presented in a way that makes it stand out from the texture, yet still recalls its original form. The relationship of intervals is significant in Feux d’artifice, appearing in both the melody and accompaniment. The initial motif, starting on the note C in measure 27, is quickly transposed a half-step higher to C in measure 30, and then returns to C in the following measure. This intervallic relationship can be described enharmonically as a minor second (m2). The same relationship is also prominent in measure 65, where the key signature changes from F major to F major. Additionally, this intervallic relationship appears in harmony through swift chord changes, such as the C 9-D9 progression in measure 30. Furthermore, a tritone is also a crucial element in the piece, as it is a part of the whole-tone scale, which plays an important role in the aspect of harmony. The tritone relationship is evident in several places, reaching its peak in the chord progression C major-F major-E major-B major and E minor-A major-G major-C major in measures 61 and 63. The use of harmony in Feux d’artifice is distinctive. Debussy skillfully manipulates with different scales and chords, frequently changing or combine them to create an unstable feeling that reflects the piece’s ambiguous tonality. From the outset, two whole-tone collections (WT0 and WT1) are used to introduce a sense of tonal instability. This technique becomes more pronounced later, particularly in measure 67, where both hands play different chords, and in the ending in measures 90-98, where the melody in C major is placed over a bass note on D . The use of quickly transposed reaches its zenith as parallel harmony in the chord progression E 7 9-E7 9-F7 9-F 7 9 during the climax in measures 85-86. Throughout the piece, the key signatures mostly indicate the relationship between distantly related keys. Although they suggest the key to each section, the harmony is permeated with unresolved dissonance, particularly in dominant ninth chords that never resolve to a tonic. Broadly speaking, Feux d’artifice exhibits an overall instability of tonality, achieved through techniques such as combining different scales, superimposing chords, rapidly shifting harmonies, using distantly related keys, and leaving dissonance unresolved. Ultimately, the piece subtly implies tonal stability, ending with a resolution on D . Conclusions: From an overall perspective, Feux d’artifice flows almost seamlessly, using similar material at the ends of sections to bridge them into the following ones. The piece captivates the listener from the outset, gradually introducing musical materials and building tension until it dissolves in the coda. Above all, the harmonic techniques employed in the work contribute significantly to evoking the vibrant colors of fireworks on the Champ de Mars during France's National Day celebrations.Item Metadata only PERFORMANCE PRACTICE AND INTERPRETATION ON PHRA ABHAI MANI FOR PIANO SOLO COMPOSED BY DEN EUPRASERT(2025-05-07) Lertpibulchai K.; Lertpibulchai K.; Mahidol UniversityBackground and Objectives: This research article focuses on the performance practice and interpretation of Phra Abhai Mani for Piano Solo composed by Associate Professor Dr. Den Euprasert, inspired by the Thai literary masterpiece “Phra Abhai Mani” by Sunthorn Phu. This composition uniquely blends Western musical techniques with Thai cultural narratives, using the expressive capabilities of the piano to depict characters, mythical creatures, and scenes from the epic tale. Comprising ten movements, each piece captures emotional depth and character portrayals through diverse tempi, tonalities, and pianistic techniques. The study aims to enhance performance practice, bridge cultural narratives with classical music, and promote Thai cultural identity on the international stage. The following objectives drive the research: 1) To investigate the historical and cultural background of “Phra Abhai Mani” and its influence on the composition. 2) To develop performance techniques and interpretation methods that align with the emotional and narrative aspects of the music. 3) To promote and preserve Thai cultural heritage through public performances of the composition. 4) To enhance the researcher’s piano performance skills through dedicated practice and interpretative exploration. 5) To provide a performance and study guide for future musicians interested in contemporary Thai piano compositions. Methods: This research was inspired by the opportunity to perform internationally, supported by a research grant from the College of Music, Mahidol University. The methodology involved the following steps: 1) Historical and Literary Analysis 2) Literature Review and Comparative Analysis 3) Interpretative Exploration and Performance Practice 4) Public Performance and Cultural Promotion 5) Data Analysis and Conclusion Results: The study revealed several key findings: 1) Cultural and Musical Integration: The composition successfully bridges Thai cultural narratives with Western classical music, using Western harmonic structures and tonalities to express Thai emotions and characterizations. The composer skillfully integrates Thai storytelling with Western pianistic techniques, creating a unique and culturally expressive musical work. 2) Effective Performance Techniques: The study identified specific performance techniques to enhance the narrative and emotional expression of each movement, including staccato articulation for energetic and playful characters, legato phrasing and rubato for lyrical and emotional passages, dynamic contrasts and tempo fluctuations to convey narrative tension and emotional conflict, and polyrhythms to depict mystical or dramatic scenes. These techniques effectively communicated the cultural narratives and emotional depth of each movement, enhancing audience engagement and emotional connection. 3) Audience Reception: Public performances received positive feedback, with audiences expressing an emotional connection to the music. The combination of Thai narrative elements and Western musical expression provided a unique cultural experience, increasing appreciation for Thai classical music on an international stage. Conclusions: This research article explores the performance practice and interpretation of Phra Abhai Mani, a composition by Den Euprasert, which is inspired by the Thai literary work Phra Abhai Mani by Sunthorn Phu. The piece consists of ten movements, blending Western music composition techniques with Thai cultural narratives to create a unique artistic expression. The researcher studied the historical background of the literary work and conducted musical analysis to gain a deeper understanding of the emotional and stylistic characteristics of each movement. This led to the selection of appropriate performance techniques, which not only enhanced the pianist’s technical and interpretative skills but also improved the overall musical expression of the piece. Additionally, the study and public performances aimed to preserve and promote Thai culture through classical music. Following the performances, the findings confirmed that the analysis and interpretative approaches could be effectively applied in practice, allowing for a clearer and more expressive performance. The use of suitable performance techniques significantly enhanced the conveyance of emotions and storytelling within the composition, leading to a stronger connection between the music and the audience. Furthermore, audience feedback indicated that listeners were able to perceive and understand the emotions of the piece more clearly due to the interpretative choices and expressive techniques employed. This highlights the importance of interpretation in music performance and its role in effectively communicating musical narratives and emotions. This study serves as a valuable reference for musicians interested in developing interpretative approaches to contemporary Thai compositions within the context of Western classical music. It contributes to the artistic growth of performers and supports the preservation and international recognition of Thai classical music. The findings of this research pave the way for future creative developments and the continued integration of Thai musical identity into the global classical music landscape.Item Metadata only The effect of strengthening nurse practitioners' competency in occupational health services for agricultural workers exposed to pesticides in primary care units, Thailand: a before-and-after study(2025-01-01) Pumsopa N.; Jirapongsuwan A.; Kalampakorn S.; Siri S.; Pumsopa N.; Mahidol UniversityPURPOSE: This study aimed to evaluate the effect of the Strengthening Nurse Practitioners' Competency in Occupational Health Service (SNPCOHS) program. It was hypothesized that nurse practitioners (NPs) participating in the program would demonstrate increased competency in providing occupational health services to agricultural workers exposed to pesticides in primary care units (PCUs) compared to their baseline competency and to a comparison group. METHODS: A quasi-experimental study was conducted between August and December 2023. The 4-week intervention included 5 hours of an e-learning program, 3 hours of online discussion, and 2 hours dedicated to completing an assignment. The program was evaluated at 3 time points: pre-intervention, post-intervention (week 4), and follow-up (week 8). Sixty NPs volunteered to participate, with 30 in the experimental group and 30 in the comparison group. Data on demographics, professional attributes, knowledge, skills, and perceived self-efficacy were collected using self-administered questionnaires via Google Forms. Data analysis involved descriptive statistics, independent t-tests, and repeated measures analysis of variance. RESULTS: The experimental group demonstrated significantly higher mean scores in professional attributes, knowledge, skills, and perceived self-efficacy in providing occupational health services to agricultural workers exposed to pesticides compared to the comparison group at both week 4 and week 8 post-intervention. CONCLUSION: The SNPCOHS program is well-suited for self-directed learning for nurses in PCUs, supporting effective occupational health service delivery. It should be disseminated and supported as an e-learning resource for NPs in PCUs (Thai Clinical Trials Registry: TCTR20250115004).Item Metadata only A new public management model for open data collaboration in sustainable digital insurance ecosystems(2025-01-01) Sukma N.; Yamnill S.; Sukma N.; Mahidol UniversityDigital transformation is rapidly reshaping insurance markets, creating unprecedented regulatory challenges that require balancing innovation with market protection. This study develops a theoretical model integrating new public management (NPM) principles, technology acceptance factors, and collaborative governance to explain the emergence of sustainable digital insurance ecosystems powered by open data. Using structural equation modeling with data from 368 professionals (121 regulatory stakeholders, 178 industry professionals, and 69 technology enablers), we investigated how NPM principles and technology adoption factors influence behavioral intention, use behavior, and principled participation in open data initiatives. The results revealed dual pathways to sustainable outcomes: technological adoption (β = 0.27) and collaborative governance through open data sharing, with principled engagement demonstrating stronger influence (β = 0.45). Performance expectancy emerged as the strongest predictor of behavioral intention, while accountability and market-driven services significantly enhanced stakeholder engagement in open data platforms. Multigroup analysis showed differential effects across stakeholder categories, with regulatory stakeholders less influenced by efficiency considerations but more likely to translate technology use into collaborative engagement. This study contributes to public administration theory by demonstrating complementarities between NPM and collaborative governance in open data contexts, extends technology adoption frameworks to regulatory technology contexts, and provides evidence-based guidance for developing balanced digital regulatory approaches. The stronger influence of principled engagement on sustainable outcomes suggests that collaborative governance mechanisms are particularly critical for sustainability, challenging technocentric perspectives that prioritize digital tools over relational dimensions of regulatory governance in open data initiatives. By illuminating the complex interplay between managerial principles, technological factors, and collaborative mechanisms in open data ecosystems, this research offers a comprehensive framework to navigate the digital transformation in insurance regulation.Item Metadata only DEVELOPMENT OF PĀḶI BASED ON EPIGRAPHICAL EVIDENCE FROM THE BAGAN ERA(2025-01-02) Lwin P.M.; Lwin P.M.; Mahidol UniversityPāḷi is regarded as the sacred language of Theravāda Buddhism and holds great significance for Theravādins, serving as the principal language for preserving and transmitting the teachings of the Buddha. The Bagan kingdom (11th to 13th century) in present-day Myanmar is widely recognized as a golden age of Buddhist culture, evidenced by the enduring presence of ancient temples, murals, and an extensive corpus of stone inscriptions. This article aims to investigate the profound impact of the Pāḷi language on the intellectual, religious, and social life of Bagan society. The study draws upon a wide range of both primary and secondary sources, including donative inscriptions, Burmese chronicles, epigraphic evidence, and the works of modern scholars. It employs historical and textual analysis to reveal the development of both Pāḷi and Theravāda Buddhism in ancient Bagan after the 11th century. The findings demonstrate that Pāḷi was not only used for religious purposes but also functioned as an indicator of prestige, particularly among the royal elite and learned monks. This study highlights how Pāḷi played the crucial role in shaping Bagan society and in promoting the wider spread of Buddhism. By focusing on the Bagan kingdom, this research contributes to the broader discussion on the relationship between language, religion, and culture in pre-modern Southeast Asia.Item Metadata only Comparing two cannabis tax-base systems: Lessons learned from legal cannabis products sold in Ontario, Canada(2025-06-04) Sornpaisarn B.; Nipun R.F.; Ali F.; Crépault J.F.; Imtiaz S.; Russell C.; Rehm J.; Sornpaisarn B.; Mahidol UniversityAim: To examine the price and tax structures of cannabis products sold in Ontario in order to formulate a policy recommendation regarding the best cannabis tax base to use from a public health standpoint. Design: Economic analysis to compare price and tax structures of various cannabis products by applying two tax bases (grams [g] of flower versus milligrams [mg] of tetrahydrocannabinol [THC]). Setting: Ontario, Canada Data Sources: Data of cannabis products legally sold in Ontario according to the Ontario Cannabis Store’s (OCS) buy and sell prices and product characteristics, including the product’s type, quantity per package, and quantity of THC and cannabidiol (CBD). The OCS provided data on 2,601 units of cannabis products in March 2022. Measures: Measures include the harmonized sales tax, the seller’s mark-up, the producer’s price, the flat-rate tax, ad valorem tax, effective excise tax, provincial adjustment tax, and excise tax per milligram of THC. The percentage of each tax compared to the retail price was also calculated. Findings: Cannabis prices were correlated to the products’ THC levels rather than their flower weights. The current taxation system based on grams of flower produced lower tax rates for the higher THC potency products. This situation would be improved if the tax base were changed from grams of flower to milligrams of THC. Conclusions: The Ontario government may consider changing the cannabis excise tax base from grams of flower to milligrams of THC to make the strong THC products less affordable. Moreover, indexing the flat-rate tax to inflation is important to prevent the tax’s flat rate from becoming lower over time.Item Metadata only Association between prehospital oxygen saturation and outcomes in hypotensive traumatic brain injury patients in Asia (Pan-Asian Trauma Outcomes Study (PATOS))(2025-12-01) Thirawattanasoot N.; Chantanakomes J.; Pansiritanachot W.; Rangabpai W.; Surabenjawong U.; Chaisirin W.; Riyapan S.; Shin S.D.; Song K.J.; Chiang W.C.; Jamaluddin S.F.; Kajino K.; Thirawattanasoot N.; Mahidol UniversityBackground: It has been shown that blood pressure (BP) and peripheral oxygen saturation (SpO2) influence the outcomes in Traumatic Brain Injury (TBI) patients. This study aims to determine the association between prehospital SpO2 and in-hospital mortality in hypotensive TBI patients. Methods: Prehospital trauma patients who were 18 years old or above with a diagnosis of TBI using ICD 10 codes (S06.0-S06.9) and had prehospital hypotension (systolic blood pressure (SBP) < 100 mmHg for patients aged 50–69 and < 110 mmHg for patients aged 15–49 or over 70 years) recorded from November 2015 to December 2022 in participating PATOS facilities were analyzed. SpO2 was measured by Emergency Medical Services (EMS) and divided into three levels: normoxia (≥ 94%), moderate hypoxia (80–93%), and severe hypoxia (< 80%). The outcomes were survival and disability at hospital discharge. Multivariable logistic regression analysis with interaction analysis was performed to calculate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: Out of 1,210 patients, 777 (64.2%) had normoxia, 319 (26.4%) had moderate hypoxia and 114 (9.4%) had severe hypoxia. Of these, survival to discharge was 92.5%, 74.9%, and 52.6% in the normoxia, moderate hypoxia, and severe hypoxia group, respectively (p < 0.0001). Favorable neurological outcomes in normoxia, moderate hypoxia, and severe hypoxia were 74.1%, 48.9 and 36%, respectively. AORs (95% CI) for survival and favorable neurological outcome compared with severe hypoxia were 3.34 (1.77–6.32)/1.83 (1.04–3.25) in the normoxia group and 2.15 (1.23–3.74)/2.23 (1.31–3.78) in the moderate hypoxia group respectively. Conclusion: An initial prehospital saturation of ≥ 94% was significantly associated with better hospital outcomes in hypotensive TBI patients.Item Metadata only Comparing Efficacy and Complications Between Stylet-Driven Leads and Lumenless Leads in Left Bundle Branch Area Pacing(2025-01-01) Sripusanapan A.; Wareesawetsuwan N.; Deepan N.; Yinadsawaphan T.; Qin D.; Rattanawong P.; Ng C.Y.; Sripusanapan A.; Mahidol UniversityBackground: Left bundle branch area pacing (LBBAP) is an emerging technique in conduction system pacing (CSP) that may offer improved outcomes over traditional methods. Typically, lumenless leads are used; however, stylet-driven leads have recently been considered. This study conducts a systematic review and meta-analysis evaluating the efficacy and complications of stylet-driven leads versus lumenless leads. Method: Databases including PubMed, Embase, and Scopus were searched from inception to June 2024 for relevant studies. We included published prospective or retrospective randomized controlled trials and cohort studies using stylet-driven leads or lumenless leads for LBBAP. Data were combined using a random-effects, generic inverse variance method of DerSimonian and Laird. Results: Sixty-eight studies involving 8996 patients from 2016 to 2023 were included. From eight head-to-head studies, the stylet-driven leads group had a comparable success rate (OR = 1.46, 95% CI: 0.89, 2.39) but showed shorter procedural time (weighted mean difference [WMD] = −16.82 min, 95% CI: −24.42, −9.21). Stylet-driven leads had a higher pacing threshold at implantation (WMD = 0.09 V, 95% CI: 0.00, 0.17) and lower lead impedance (WMD = −86.13 ohms, 95% CI: −129.46, −42.80). QRS duration and R wave amplitude were comparable initially, but at follow-up (1–12 months), stylet-driven leads had a lower R wave amplitude (WMD = −1.92 mV, 95% CI: −3.33, −0.51). Complication rates were higher with stylet-driven leads (OR = 1.80, 95% CI: 1.34, 2.41), particularly lead dislodgement (OR = 3.26, 95% CI: 1.75, 6.07) and helix damage (OR = 11.46, 95% CI: 3.58, 36.63). Conclusion: In this meta-analysis of 8996 patients, stylet-driven leads for LBBAP showed a comparable success rate to lumenless leads but was associated with a higher complication risk.Item Metadata only Reducing Pain and Fatigue Through Self-Care Ability Support Program among People with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization: A Pretest-Posttest with Repeated-Measures Design(2025-07-01) Kaewjaladvilai O.; Chaiviboontham S.; Sumdaengrit B.; Kaewjaladvilai O.; Mahidol UniversityTranscatheter arterial chemoembolization is an effective treatment for intermediate-stage liver cancer. Despite its effectiveness, this treatment often brings about common complications, such as pain and cancer-related fatigue, requiring self-management at home. In Thailand, where liver cancer prevalence is high, structured support is essential to enhance self-care and improve patients’ ability to manage symptoms. Guided by Orem’s Self-Care Theory, this one-group, pretest-posttest intervention program aimed to assess the potential of a self-care ability support program for reducing pain and cancer-related fatigue among people with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization. Thirty participants being treated at a university hospital in central Thailand were selected through purposive sampling when receiving treatment from October 2022 to January 2023. Data were collected utilizing the Personal Information Questionnaire, the Self-Care Agency Questionnaire, the Pain Numeric Rating Scale, and the Thai version of the Revised Piper Fatigue Scale. Data analysis involved descriptive statistics, repeated measures ANOVA, and paired t-tests. The results indicated that following participation in the program, there was a notable increase in the average self-care ability score among the participants. Moreover, there was a significant decrease in back pain and abdominal pain scores post-transcatheter arterial chemoembolization from moderate levels on day 1 to mild or no pain by day 21. Additionally, cancer-related fatigue peaked at a moderate level on day 7 before significantly decreasing to a low level by day 21. The findings suggested that the self-care ability support program has the potential benefit of enhancing self-care ability to reduce pain and fatigue among patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization. Nurses can integrate this program into their practice. However, further randomized control trials with multi-site studies are recommended to confirm its effectiveness before being integrated into practice.Item Metadata only Comparative efficacy and safety of targeted narrowband ultraviolet B, 308-nm excimer laser, and 308-nm excimer lamp in vitiligo: a retrospective study(2025-01-01) Tantivithiwate T.; Chaiyabutr C.; Wongpraparut C.; Yothachai P.; Nuntawisuttiwong N.; Silpa-archa N.; Tantivithiwate T.; Mahidol UniversityBackground: Data directly comparing targeted narrowband ultraviolet B (NB-UVB), 308-nm excimer laser, and 308-nm excimer lamp for vitiligo are limited. Objectives: We compared the efficacy and safety of these three modalities in vitiligo. Methods: In this retrospective study, we reviewed the medical records of vitiligo patients at the Photodermatology Clinic, Siriraj Hospital. Patients received either targeted NB-UVB (group A), a 308-nm excimer laser (group B), or a 308-nm excimer lamp (group C), administered two to three times per week for at least 3 months. Photographs taken before and after therapy were evaluated. The primary outcome was repigmentation, graded on a five-tier scale: poor (0–25%), fair (26–50%), good (51–75%), very good (76–90%), and excellent (91–100%). The secondary outcome was treatment-related adverse events. Results: No statistically significant differences in efficacy were observed among the three groups, indicated by a very good to excellent response in 42.4% (group A), 17.6% (group B), and 29.4% (group C). Although group A showed higher response rates at 3 and 6 months, differences were not significant. Adverse effects were significantly more frequent in group C. Conclusions: All three devices demonstrated comparable efficacy and promoted rapid repigmentation. However, the excimer lamp had the highest rate of adverse effects.Item Metadata only Modelling Supply Chain Measurement in Omni-Channel Supply Chain(2025-09-01) Liangrokapart J.; Prakongwittaya S.; Liangrokapart J.; Mahidol UniversityRetail business has transformed into omni-channel retail, a modern approach utilizing multiple channels several years ago. The performance measurement used in the past which mainly focused on financial measures may not be applicable to omni-channel retail. This research aims to model a supply chain performance measurement framework for the omni-channel supply chain and to draw a relationship among performance measures and their association with the goals of resource efficiency, customer service level, and flexibility. Total Interpretive Structural Model (TISM), a qualitative modelling technique, is applied in the study for building links between measures. The experts were asked to complete the TISM questionnaires for interpretive logic-knowledge. Then, a hierarchical model with interpretive logic for the overall supply chain performance measurement framework was developed. An omni-channel supply chain was used as a case study, and the result showed that the relationships among measures including “demand forecast accuracy,” “planning accuracy,” “urgent order response speed,” “service reliability,” “cost,” and “information readiness” can lead to “efficiency,” “time for decision-making,” “market change response speed,” and “revenues.” The key contribution of this research is a structured performance measurement framework for omni-channel supply chain using TISM to identify and interpret the relationships among key performance indicators, particularly for the goals of efficiency, customer service, and responsiveness. Detailed strategies for improving supply chain performance have been provided. Lastly, theoretical and managerial implications are discussed, and recommendations for future research are presented.