Scopus 2025
Permanent URI for this collectionhttps://repository.li.mahidol.ac.th/handle/123456789/102712
Browse
Recent Submissions
Item Metadata only How active is ‘active’? Overcoming Misconceptions and Optimizing Pedagogical Practices of Active Learning in EFL Classrooms(2025-05-01) Lu B.D.; Watanapokakul S.; Lu B.D.; Mahidol UniversityActive Learning (AL) has emerged as a promising pedagogical alternative to traditional passive learning across various educational fields, including English as a Foreign Language (EFL) instruction. Despite its increasing adoption, discrepancies and misconceptions persist in its implementation within EFL contexts. This review article first delineates the core principles of AL as recognised in contemporary educational literature. It then addresses prevalent misunderstandings that hinder effective practice. In response, the paper proposes an updated, comprehensive framework tailored to EFL classrooms, with practical recommendations for instructional design, activity integration, and the strategic use of educational technologies, including generative artificial intelligence (GenAI). Finally, it outlines key criteria for evaluating the effectiveness of AL, focusing on student achievement, attitudes, and engagement.Item Metadata only Safety and Efficacy of High-Dosage Infliximab in Recalcitrant Retinal Vasculitis(2025-01-01) Li Y.; Thongborisuth T.; Lee R.; Stolberg N.; Sweiss N.; Lobo-Chan A.M.; Bhat P.; Li Y.; Mahidol UniversityPurpose: We evaluated the long-term safety and efficacy of high-dosage infliximab and biosimilars (IFX+) in recalcitrant, non-infectious inflammatory retinal vasculitis (RV) after antimetabolite and adalimumab failure. Methods: This retrospective study included patients from the University of Illinois at Chicago Uveitis Service (2014–2024) who transitioned to IFX+ after prior treatment failure. Patients were categorized into low-dosage (LD, ≤5 mg/kg/Q4W, n = 14), medium-dosage (MD, 5.5–9.5 mg/kg/Q4W, n = 8), and high-dosage (HD, ≥10 mg/kg/Q4W, n = 9) groups. Efficacy was defined as ≥ 1 zone fluorescein angiographic (FA) improvement, prednisone reduction to < 10 mg/day with no flares, or both, at 6, 12, and 24 months, and last follow-up. Secondary outcomes included visual acuity (VA) and central macular thickness changes. Results: At 12 months, efficacy was achieved by 57.1%, 87.5%, and 88.9% of LD, MD, and HD IFX+ patients, increasing to 83.3%, 75.0%, and 100% by last visits. FA improvement rate was 60.0% (LD), 50.0% (MD), and 87.5% (HD) at 12 months, increasing to 71.4%, 60.0%, and 100% at last visits. VA significantly improved in HD by 12 months (p = 0.03) and MD by 24 months (p = 0.02). LD and MD groups required dosage increases to sustain inflammation control. By 24 months, no significant dosage differences between groups existed. No adverse events were reported in the HD group. Conclusion: In this retrospective study, medium- and high-dosage IFX+ achieved better inflammation control and visual outcomes versus low-dosage IFX+, with no additional safety concerns, in treating recalcitrant non-infectious inflammatory RV. Early initiation at greater dosages may optimize IFX response, reduce treatment duration, and improve health-related quality of life.Item Metadata only Mitapivat in adults with non-transfusion-dependent α-thalassaemia or β-thalassaemia (ENERGIZE): a phase 3, international, randomised, double-blind, placebo-controlled trial(2025-01-01) Taher A.T.; Al-Samkari H.; Aydinok Y.; Besser M.; Boscoe A.N.; Dahlin J.L.; De Luna G.; Estepp J.H.; Gheuens S.; Gilroy K.S.; Glenthøj A.; Sim Goh A.; Iyer V.; Kattamis A.; Loggetto S.R.; Morris S.; Musallam K.M.; Osman K.; Ricchi P.; Salido-Fiérrez E.; Sheth S.; Tai F.; Tevich H.; Uhlig K.; Urbstonaitis R.; Viprakasit V.; Cappellini M.D.; Kuo K.H.M.; Taher A.T.; Mahidol UniversityBackground: Non-transfusion-dependent (NTD) thalassaemia is characterised by ineffective erythropoiesis and haemolytic anaemia, leading to long-term complications, poor quality of life, and early mortality. No oral disease-modifying therapies are approved for β-thalassaemia and no agents are approved for α-thalassaemia. The objective of this study was to evaluate the efficacy and safety of mitapivat, an oral activator of pyruvate kinase, in adults with NTD α-thalassaemia or NTD β-thalassaemia. Methods: ENERGIZE is a phase 3, double-blind, randomised, placebo-controlled trial followed by an open-label extension conducted at 70 hospitals in 18 countries globally. Participants had to be aged 18 years or older with NTD α-thalassaemia or NTD β-thalassaemia and haemoglobin concentrations of 10 g/dL or lower. Participants were randomly assigned 2:1 to mitapivat or placebo (100 mg orally twice a day for 24 weeks) via a central interactive response technology system using block randomisation, stratified by baseline haemoglobin concentration and thalassaemia genotype. Everyone was masked to the patients' treatment assignment until the study was unblinded for the analysis of the primary endpoint. The primary endpoint was haemoglobin response (≥1·0 g/dL increase from baseline in mean haemoglobin concentration from week 12 through week 24), analysed in all patients who were randomly assigned. Safety was analysed in all patients who received at least one dose of study treatment. This study is registered with ClinicalTrials.gov, number NCT04770753, and is active but not recruiting. Findings: Between Nov 8, 2021, and March 31, 2023, 235 patients were screened, of whom 194 were enrolled (123 [63%] were female and 71 [37%] were male). 130 patients were randomly assigned to mitapivat and 64 patients to placebo and formed the full analysis set. One patient in each group was randomly assigned but not given treatment and was therefore excluded from the safety analysis set (mitapivat 129 patients and placebo 63 patients). Seven patients in the mitapivat group and one patient in the placebo group discontinued treatment before the end of the 24-week double-blind period. 55 (42%) of 130 patients in the mitapivat group had a haemoglobin response versus one (2%) of 64 in the placebo group (least-squares mean difference 41% [95% CI 32–50], two-sided p<0·0001). Adverse events were reported in 107 (83%) of 129 patients who received mitapivat and 50 (79%) of 63 patients who received placebo. The most commonly reported adverse events with mitapivat were headache (29 [22%] of 129 patients in the mitapivat group vs six [10%] of 63 in the placebo group), initial insomnia (18 [14%] vs three [5%]), nausea (15 [12%] vs five [8%]), and upper respiratory tract infection (14 [11%] vs four [6%]). No deaths were reported. Interpretation: Mitapivat could be a new oral treatment for adults with NTD α-thalassaemia or NTD β-thalassaemia by increasing haemoglobin concentration and improving fatigue. Funding: Agios Pharmaceuticals.Item Metadata only Multipoint Observations and Modeling of the 2021 November 4 Forbush Decrease Using Solar Orbiter, CSES-01, and Ground-based Neutron Monitor Data(2025-06-20) Benella S.; Laurenza M.; Martucci M.; Ruffolo D.; Hu Q.; Nicolaou G.; Owen C.J.; Stumpo M.; Plainaki C.; Palma F.; Piersanti M.; Sorbara M.; Sotgiu A.; Sparvoli R.; Benella S.; Mahidol UniversityDuring their propagation in the heliosphere, interplanetary coronal mass ejections (ICMEs) interact with galactic cosmic ray (GCR) particles, modifying their spectrum and driving anisotropies. We analyze the first large Forbush decrease (FD) of Solar Cycle 25 on 2021 November 3-5 by using multipoint in situ observations and neutron monitors to study the association between FD characteristics and ICME. We use the Grad-Shafranov reconstruction to infer the magnetic field configuration of the ICME. We model the neutron monitor response through primary spectrum and anisotropy. The primary spectrum is parameterized with the force-field approximation and the anisotropy is modeled through a spherical harmonic expansion. We optimize the model parameters during the FD by using ground-based observations provided by the worldwide neutron-monitor network. The model’s results are compared with space-based measurements of the differential proton flux measured by the HEPD-01 detector on board the CSES-01 satellite and of the integral counts of both the High-Energy Particle Detector (HEPD-01) and the High Energy Telescope on board the Solar Orbiter. Anisotropy develops during the ICME passage, within the magnetic flux rope (MFR) and is found to be bidirectional. The force-field parameterization of the primary GCR fluxes based on ground-based measurements is found to be in very good agreement with spacecraft observations in the sub-GeV range. The GCR anisotropy obtained by fitting the model to ground-based observations is consistent with interplanetary magnetic field observations. The results suggest that the local magnetic field has a substantial axial component that is aligned to the MFR axis, and determines the GCR anisotropy at the typical neutron monitor energies.Item Metadata only Epidemiology and excess mortality of antimicrobial resistance in bacteraemias among cancer patients: A cohort study using routinely collected health data from regional hospital trusts in Oxford and Oslo, 2008-2018(2025-06-13) Danielsen A.S.; Lim C.; Yoon C.H.; Gran J.M.; Kacelnik O.; Eyre D.W.; Bjørnholt J.V.; Danielsen A.S.; Mahidol UniversityObjectives We investigated the epidemiology and impact on mortality of antimicrobial resistance (AMR) in cancer patients with bacteraemia at Oxford University Hospitals (OxUH), UK, and Oslo University Hospital (OsUH), Norway, during 2008-2018. Design Historical cohort study. Setting Regional hospital trusts with multiple sites in OxUH and OsUH. Methods Patients with cancer and blood cultures positive for one of six pathogen groups during a hospital stay within 3 years following their first cancer diagnosis were followed for 30 days after their first bacteraemia episode. We determined the number of cases and the proportion of infections with an AMR phenotype. Excess mortality and the population-attributable fraction (PAF) due to AMR were estimated by contrasting observed mortality at the end of follow-up with an estimated counterfactual scenario where AMR was absent from all bacteraemias, using inverse probability weighting. Main outcome measure 30-day all-cause mortality following the first bacteraemia episode. Main exposure measure A resistant phenotype of the causative pathogen. Results The study included 1929 patients at OxUH and 1640 patients at OsUH. The highest resistance proportions were found for vancomycin resistance in enterococci (85/314, 27.1%) and carbapenem-resistance in Pseudomonas aeruginosa (63/260, 24.2%) at OxUH, and third-generation cephalosporin resistance in Escherichia coli (62/743, 8.3%) and Klebsiella pneumoniae (14/223, 6.3%) at OsUH. Observed mortality for all infections was 26.4% at OxUH, with an estimated counterfactual mortality without AMR of 24.7%, yielding an excess mortality of 1.7% (95% CI: 0.8 to 2.5%). The PAF was 6.3% (95% CI: 2.9 to 9.6%), meaning an estimated 32 of 509 deaths could be attributed to AMR. Limited events at OsUH precluded a similar estimate. Conclusions Despite estimating modest excess mortality, the mortality attributable to resistance in these two high-income, low-prevalence settings highlights the potential for escalation if global resistance trends continue to worsen.Item Metadata only Prevalence of dry eye disease and its association with sleep quality and depression: A hospital-based survey in Thai population(2025-06-18) Jongkhajornpong P.; Lekhanont K.; Anothaisintawee T.; Rattanasiri S.; McKay G.; Attia J.; Thakkinstian A.; Jongkhajornpong P.; Mahidol UniversityObjectives To estimate the prevalence of dry eye disease (DED) and explore its association with depression and poor sleep quality. Design A cross-sectional study. Setting The study was conducted at the ophthalmology outpatient clinic of a tertiary university hospital in Thailand, from September 2022 to April 2023. Participants A total of 1321 patients aged 18 years or older, without any history of orbital disease, active superficial or intraocular infection/inflammation, eyelid pathology, or prior intraocular or eyelid surgery within the past 6 months, were enrolled in the study. Interventions All patients underwent dry eye examination, including the Ocular Surface Disease Index questionnaire, tear break-up time and ocular surface staining. Physical activity was measured using the Global Physical Activity Questionnaire, which was expressed as total Metabolic Equivalent of Task-minutes per week. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), Composite Scale of Morningness (CSM) and STOP-Bang. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9). Primary and secondary outcome measures Prevalence of DED and association pathways involving depression, sleep quality and DED. Results The mean age of the participants was 58.3±14.0 years, with a female predominance of 73.7%. Of the 1321 patients, 668 were diagnosed with DED, resulting in a hospital-based prevalence of 50.6% (95% CI: 47.8%, 53.3%). After adjusting for age, sex and underlying disease, PSQI, PHQ-9, STOP-Bang and CSM scores remained significantly associated with DED with adjusted ORs of 2.48 (95% CI: 1.96, 3.14; p<0.001), 1.65 (95% CI: 1.05, 2.61; p=0.031), 1.81 (95% CI: 1.05, 3.14; p=0.033) and 1.32 (95% CI: 1.04, 1.68; p=0.023), respectively. The effects of depression on DED were mediated indirectly via poor sleep quality (OR=1.32; 95% CI: 1.18, 1.49; p<0.001) and directly via other mechanisms (OR=1.66; 95% CI: 1.06, 2.58; p=0.021). Conclusions DED is notably common among Thai patients. Depression and poor sleep quality are significantly associated with DED. Poor sleep quality may mediate the relationship between depression and DED.Item Metadata only Dynamics and key directions of sustainable development of regional agriculture in the context of ensuring national and food security of the Russian Federation(2025-01-01) Ryazantsev S.V.; Vartanova M.L.; Ryazantsev S.V.; Mahidol UniversityThe article identifies the problems and features of agricultural production in Russia’s regions. The main arguments proving the relevance of target qualitative indicators in the methodology of regional management of the agricultural sector (improved efficiency of agricultural sector and increased output of agricultural and food products to the level that ensures regional food security) were chosen according to the initial and projected situation in food supply. This allowed the authors to apply statistical forecasting methods and make a matrix of key directions in the development of agricultural production according to the national security requirements, to identify significant differences between Russia’s regions and to present an optimal ratio of productivity and profitability, production and consumption of agricultural products for each territory. Thus, the article provides general theoretical ideas adapted to the current trends of social-economic and scientific-technical development to assess the role of agriculture and agro-industrial complex in Russian regions with different climatic conditions, and the authors formulate scientifically sound recommendations on the scope and directions for expanding agricultural specialization even in regions with unfavorable climatic conditions.Item Metadata only Epidemiological changes in the incidence of human leptospirosis in Thailand: Findings from the National Disease Surveillance System from 2013 to 2022(2025-09-01) Sawangpol C.; Aimyong N.; Phosri A.; Sawangpol C.; Mahidol UniversityObjectives: To describe the epidemiological changes in leptospirosis incidence from 2013 to 2022, and to further quantify factors associated with leptospirosis mortality in Thailand. Methods: We analyzed the epidemiological trends of leptospirosis incidence using data from the National Disease Surveillance System from January 2013 to December 2022 and estimated potential factors associated with leptospirosis mortality using a multiple logistic regression model. Results: A total of 25,006 cases were reported during the study period, with an average incidence rate of 3.8 cases per 100,000 population. The incidence rate gradually decreased from 2013 to 2021, followed by a sharp increase in 2022. The case fatality rate increased steadily from 2013 to 2015 and then began to decline after 2015. A higher incidence rate was observed in men than in women, in individuals aged ≥15 years than in children <15 years, in residents of rural areas than urban areas, in people living in the southwestern region than in those living in other regions, and in individuals engaged in agriculture. We also observed that age groups, regions of residence, healthcare facilities and services, and duration from symptom onset to treatment initiation were significantly associated with a mortality risk from leptospirosis. Conclusion: A decreasing trend in leptospirosis incidence was observed from 2013 to 2021, followed by a recent increase in 2022, indicating that it is crucial to enhance the current surveillance system for implementing targeted interventions and to develop appropriate guidelines for reducing leptospirosis incidence and mortality by controlling the associated prognostic factors.Item Metadata only Determinants of Caregiver's Knowledge of Infant’s Early Nutrition in Indonesia(2025-05-01) Supriatin; Dioso R.; Hassan H.C.; Maretalinia; Supriatin M.K.; Supriatin; Mahidol UniversityIntroduction: The knowledge of early nutrition for infants is fundamental for mothers and caregivers. This study aimed to investigate the determinants of caregiver’s knowledge of Infant Early Nutrition in Indonesia. Materials and methods: This study used secondary data from the World Bank, Indonesia High-Frequency Monitoring of COVID-19 Impacts in 2023. The total sample of this study was 4,098 caregivers for children under five years old. Results: According to the colostrum, the factors associated are the kid's age, caregivers are not the main family members/ others, and did not know about stunted children. The knowledge about exclusive breastfeeding duration revealed that kids' age was correlated, for age one, not knowing stunting is also significant, caregivers age 55 years or older, caregivers’ education level with tertiary, and grandmothers as caregiver. Conclusion: There is a need for collaboration among stakeholders to increase the knowledge of caregivers about infant early nutrition.Item Metadata only Corrigendum to “A prospective study of plasma and bronchoalveolar lavage fluid CMV DNA load quantification for the diagnosis and outcome of CMV pneumonitis in immunocompromised hosts” [J. Clin. Virol. 155 (2022) 105243] (Journal of Clinical Virology (2022) 155, (S1386653222001755), (10.1016/j.jcv.2022.105243))(2025-01-01) Saksirisampant G.; Kawamatawong T.; Promsombat K.; Sukkasem W.; Liamsombut S.; Pasomsub E.; Bruminhent J.; Saksirisampant G.; Mahidol UniversityThe authors would like to inform that the correct Approval number for the article is COA. MURA2019/1031. This correction does not affect the study's results or conclusions. The authors would like to apologise for any inconvenience caused.Item Metadata only Vaccination strategies, public health impact and cost-effectiveness of dengue vaccine TAK-003: A modeling case study in Thailand(2025-06-01) Shen J.; Kharitonova E.; Tytula A.; Zawieja J.; Aballea S.; Biswal S.; Sharma M.; Rungmaitree S.; Sruamsiri R.; Wallace D.; Hanley R.; Shen J.; Mahidol UniversityBackground Dengue is an increasing global problem associated with negative health and economic impacts. Vaccination is an important measure to reduce the significant public health and economic burden caused by dengue. Our study assesses the public health impact and cost-effectiveness of a new dengue vaccine, TAK-003, using Thailand as a case study. Methods and findings We developed a dynamic transmission model with both host and vector populations, 4 serotype-specific infections, seasonality, and other key elements of dengue natural history. We estimated efficacy of TAK-003 from the DEN-301 trial. We first used the model to determine the optimal cohort age for different vaccination strategies with TAK-003, based on Thai dengue epidemiology. Secondly, we assessed the public health impact of a pragmatic strategy integrating TAK-003 into an existing national immunization program in Thailand. Cost-effectiveness was evaluated from a societal perspective using disability-adjusted life-years (DALYs) over a 20-year horizon. TAK-003 is estimated to prevent 41%−57% of symptomatic cases and 47%−70% of hospitalizations, with the greatest impact observed when routinely vaccinating children aged 6 years with 10 additional catch-up cohorts. This strategy resulted in 104,415 fewer DALYs and savings of US$1,786 million. If introduced into the national immunization program at 11 years of age (alongside the existing human papillomavirus vaccine), TAK-003 is estimated to prevent 44% of symptomatic cases and 53% of hospitalizations. This strategy prevented 87,715 DALYs and saved US$1,346 million. Sensitivity analyses demonstrated that the results were robust. The main limitations were inherent to the assumptions and simplifications made in the model, which are unavoidable when approximating the impact of vaccination in the real world. Conclusions TAK-003 can considerably reduce dengue burden and lead to cost savings in Thailand. These benefits can be maximized by identifying optimal age cohorts for vaccination and adding catch-up programs. Our model can be used to assess the vaccination impact in other dengue-endemic countries.Item Metadata only Poor sleep quality is a predictor of severe hypoglycemia during comprehensive diabetes care in type 1 diabetes(2025-08-01) Dejkhamron P.; Tharavanij T.; Likitmaskul S.; Rawdaree P.; Santiprabhob J.; Deerochanawong C.; Nitiyanant W.; Reutrakul S.; Dejkhamron P.; Mahidol UniversityPurpose: Sleep disturbances is common in type 1 diabetes (T1D) and can be associated with poor glycemic control, and possibly hypoglycemia. This study aims to investigate whether poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), was associated with glycemic control or severe hypoglycemia in T1D individuals. Methods: This one-year prospective cohort study included 221 (148 F/63 M) T1D participants (aged ≥ 13 years), receiving intensive insulin therapy. A1C levels were obtained at baseline and during the 12-month follow-up. Incidences of diabetic ketoacidosis (DKA) and severe hypoglycemia were collected. Results: The mean age of participants was 21.4 ± 8.9 years, with a baseline A1C of 9.27 ± 2.61%. Poor sleep quality was reported in 33.0% of participants. A1C levels improved over the one-year follow-up, but there was no significant difference in A1C reduction between those with good vs. poor sleep quality (-0.42 ± 1.73 vs. -0.42 ± 1.67, P = 0.835), nor in DKA incidence (P = 0.466). However, participants with poor sleep quality experienced more SH episodes (6.53 (2.45–17.41) vs. 0 per 100-person year, P = 0.01). After adjusting for age, body mass index, and glucose monitoring, each one-point increase in PSQI score was associated with a higher severe hypoglycemia risk (OR 1.31, 95%CI 1.13–1.52). Poor sleep quality predicted an increased risk of severe hypoglycemia (OR 24.54, 95%CI 1.31-459.29). Conclusion: Poor sleep quality is common in T1D individuals and is a risk factor for incident SH. These findings highlight the importance of incorporating sleep assessment into routine T1D diabetes care and the need of targeted interventions to improve sleep quality in T1D individuals. These findings support the importance of addressing sleep quality in T1D management, particularly in relation to hypoglycemia risk.Item Metadata only Thiamin deficiency in children with chronic kidney disease on peritoneal dialysis and its association with dialysis duration and transport peritoneal membrane status(2025-01-01) Suwanboriboon W.; Chaiyapuk T.; Tinnabut I.; Sanpawitayakul G.; Srisawat C.; Junnu S.; Liammongkolkul S.; Chotipanang K.; Rukprayoon H.; Laohathai P.; Densupsoontorn N.; Suwanboriboon W.; Mahidol UniversityBackground: Patients with chronic kidney disease (CKD) stage 5D receiving peritoneal dialysis (PD) are at risk for thiamin deficiency (TD). This study compared the proportion of TD in pediatric CKD patients undergoing PD with that in healthy controls and evaluated the associations of various factors with TD in CKD patients. Methods: Thirty-two patients with CKD stage 5D and 34 healthy children were recruited. The participants reported their consumption of foods containing antithiamin factors and completed a 3-day food record to assess their intake of thiamin, energy, and macronutrients. The medical records of the CKD group were reviewed. Thiamin status was assessed via an erythrocyte transketolase activity assay, where the thiamin pyrophosphate effect was determined. Results: Thirteen percent of participants in the CKD group had TD, whereas 29% of the healthy controls did (p = 0.093). The CKD group had significantly greater total thiamin intake per 1,000 kcal of energy due to thiamin supplementation (2.14 [1.83, 2.99] vs. 0.87 [0.59, 1.14] mg/1,000 kcal; p < 0.001), despite inadequate dietary thiamin intake. A longer PD duration (in months) and a high-transport peritoneal membrane status were significantly associated with poorer thiamin status (β = + 0.59, p < 0.001, and β = + 0.38, p = 0.013, respectively). In contrast, greater total thiamin intake was correlated with improved thiamin status (β = -0.35, p = 0.022). Conclusions: Thiamin deficiency was observed in 13% of pediatric CKD patients on PD and 29% of healthy controls. In CKD patients, TD was associated with longer PD duration (in months), high-transport peritoneal membrane status, and low total thiamin intake.Item Metadata only Characterization of the Complete Mitochondrial Genome of the Red Alga Ahnfeltiopsis flabelliformis (Rhodophyta, Gigartinales, Phyllophoraceae) and Its Phylogenetic Analysis(2025-06-01) Patil M.P.; Kim J.O.; Kim Y.R.; Nirmal N.; Kim G.D.; Kim K.; Patil M.P.; Mahidol UniversityRed algae are recognized for their health-promoting bioactive substances and dietary fibers, making them important as functional food. In order to identify species and determine phylogenetic relationships, mitochondrial genes serve as important markers. Thus, this study sequenced the complete mitochondrial genome of Ahnfeltiopsis flabelliformis, compared with Phyllophoraceae species, and performs phylogenetic analysis to reveal its evolutionary position. The genome is 25,992 bp long, has 71.3% of biased AT content, and comprises 24 protein-coding genes (PCGs), 22 tRNA, and three rRNA genes. The overall base composition of its mitochondrial genome was 37.4% for A, 33.9% for T, 14.7% for G, 14.0% for C and 28.7% for GC. The gene content, annotation, and genetic makeup are identical to those of Phyllophoraceae species. Phylogenetic study based on the complete mitochondrial genome and shared mitochondrial genes revealed that the six Phyllophoraceae species form a well-supported clade. Within this clade, A. flabelliformis groups with Gymnogongrus griffithsiae, and together they form a distinct subclade including four species of the Mastocarpus. The results indicate that A. flabelliformis shares a closer evolutionary relationship with G. griffithsiae than with Mastocarpus species. Future research on Ahnfeltiopsis is necessary to comprehend the evolutionary history and phylogenetic relationships among species in this genus.Item Metadata only Prediction model for etiology of fever of unknown origin in children(2025-07-01) Rienvichit P.; Lerkvaleekul B.; Apiwattanakul N.; Pakakasama S.; Rattanasiri S.; Vilaiyuk S.; Rienvichit P.; Mahidol UniversityDiagnosing fever of unknown origin (FUO) in children remains challenging, particularly in differentiating between infections, autoimmune diseases, and malignancies. We aimed to develop and validate a prediction model for determining the etiology of pediatric FUO. We retrospectively reviewed medical records of children aged 1–18 years with FUO lasting ≥ 7 days from 2007 to 2023. Clinical and laboratory data were collected. The study was conducted in two phases: (1) model development (development cohort) and (2) internal validation (validation cohort). Multinomial logistic regression and predictive margin analyses were used to construct the model, with performance assessed by the area under the Receiver Operating Characteristic curve (AUC). In the development cohort (n = 240, median age: 6.4 years, IQR 3.4–11.6), FUO was attributed to infections (32.5%), autoimmune diseases (34.2%), and malignancies (33.3%). Using infections as a reference, arthritis (OR = 32.8, 95%CI 6.5–166.4) and fever > 30 days (OR = 10.3, 95%CI 2.9–35.4) were predictors of autoimmune diseases; while splenomegaly (OR = 5.2, 95%CI 1.8–15.6), lymphadenopathy (OR = 4.2, 95%CI 1.6–11.2), severe anemia (OR = 9.2, 95%CI 2.3–36.9), thrombocytopenia (OR = 10.0, 95%CI 3.3–30.1), and fever > 30 days (OR = 19.4, 95%CI 5.1–73.8) were predictors of malignancies. Coughing was inversely associated with both autoimmune (OR = 0.1, 95%CI 0.1–0.4) and malignancies (OR = 0.1, 95%CI 0.04–0.4). A computerized prediction model was constructed using these parameters. The validation cohort (n = 78) demonstrated good discrimination for infection (AUC = 0.82), autoimmune (AUC = 0.88), and malignancies (AUC = 0.83). Conclusions: A prediction model has been developed and validated to assist pediatricians in differentiating the causes of FUO. It demonstrates good performance and supports data-driven decision-making in pediatric FUO.Item Metadata only A DNA Biometric Implementation Model to Promote Thailand’s Criminal Justice System(2025-04-01) Worasuwannarak W.; Poonyarith S.; Kanyajit S.; Rujipak V.; Waiyawuth W.; Worasuwannarak W.; Mahidol UniversityDNA biometrics has proven to be a valuable tool in criminal justice systems world-wide, providing accurate identification and helping solve crimes effectively. However, Thailand faces several challenges in implementing DNA biometrics in its criminal justice system. This study aimed to explore the use of DNA as reliable biometric data in Thailand’s judicial and authentication processes, develop operational procedures for practical use, identify problems and obstacles, and propose a suitable model for implementation. The study employed documentary research and in-depth interviews with sixteen experts in the criminal justice system. The findings revealed that the absence of a central authority for collecting DNA biometric data results in disparate management of DNA databases and a lack of coordination between agencies. Personnel and budget issues, insufficient professional standards for forensic science officers, and the absence of a central agency responsible for forensic science work management also hinder Thailand’s forensic science operations. Issues related to crime scene protection, such as the lack of operational guidelines for collecting evidence and insufficient first-response units, were also identified. Furthermore, Thai judges often lack sufficient knowledge to assess the reliability of forensic evidence. Another major obstacle is the absence of a law to establish a central agency that administers the National DNA Database. The study proposes the establishment of a central agency to oversee the collection and management of DNA biometric data, the development of clear operational guidelines, and the provision of training for personnel involved in the criminal justice system to effectively implement DNA biometrics in Thailand.Item Metadata only Utility of Computed Tomography for Identifying Vocal Fold Motion Impairment Etiology(2025-01-01) Hirunpat B.; Hirunpat S.; Sanghan N.; Hirunpat P.; Tanomkiat W.; Hirunpat B.; Mahidol UniversityObjectives: Although the role of computed tomography (CT) in vocal fold paralysis is well established, its utility in vocal fold motion impairment (VFMI) remains controversial. We aimed to examine the utility of CT in the etiological assessment of patients with unexplained VFMI and to identify the underlying pathological causes. Methods: We retrospectively reviewed the records of consecutive adults with VFMI who underwent neck CT between June 2010 and March 2023. CT findings were correlated with management and final diagnoses. Results: CT helped identify the cause of VFMI in 119 of 177 patients (diagnostic yield: 67.23%). The accuracy, sensitivity, and specificity of CT in detecting the underlying causes of VFMI were 96.05%, 99.17%, and 89.47%, respectively. The leading cause of VFMI was malignancy, followed by idiopathic disease. Conclusion: CT is highly recommended in patients with unexplained VFMI because of its high accuracy and high diagnostic yield.Item Metadata only A Case Report of Lithium-Induced Tardive Dyskinesia(2025-07-01) Boonrod C.; Pattanaseri K.; Lortrakul J.; Boonrod C.; Mahidol UniversityOur case involves an elderly patient with bipolar disorder with a history of long-term low-dose lithium monotherapy (600 mg/day) who subsequently developed tardive dyskinesia as an adverse drug reaction. Generally, tardive dyskinesia is an iatrogenic movement disorder resulting from the long-term use of dopamine-blocking agents. However, lithium, a mood stabilizer with a mechanism of action that is not completely understood, has also been identified in some studies for its potential impact on dopamine synthesis and transmission. While common adverse effects of lithium include nausea, vomiting, and fine tremors, it rarely causes movement disorders. Limited reports exist regarding tardive dyskinesia associated with lithium usage. Following normal laboratory investigations, lithium was discontinued and diazepam was prescribed instead. Subsequent follow-up visits showed an improvement in symptoms.Item Metadata only Coronary anatomic, functional, and prognostic correlates of ischemic electrocardiographic changes during stress echocardiography(2025-01-01) Kobal S.; Ciampi Q.; Arbucci R.; Zagatina A.; Kalinina E.; Padang R.; Kane G.C.; Villarraga H.R.; Arruda-Olson A.M.; Vazquez J.P.; Boshchenko A.; Ryabova T.; Celutkiene J.; Saad A.; Bursi F.; Djordjevic-Dikic A.; Lisi M.; Merli E.; Manganelli F.; Borguezan-Daros C.; Rodriguez-Zanella H.; D'Alfonso M.G.; Mori F.; Gaibazzi N.; Kasprzak J.D.; Safarova A.; Timofeeva T.; Mosto H.; Wierzbowska-Drabik K.; Ratanasit N.C.; Costantino M.F.; Colonna P.; Preradović T.K.; Ostojic M.; Cortigiani L.; Varga A.; Nikolic A.; Cocchia R.; Palinkas A.; Rigo F.; Benfari G.; Valente F.X.; Soulis D.; Wang Y.; Yin L.; Lowenstein J.; Lowenstein Haber D.M.; Marconi S.; Tripepi G.; Villari B.; Pepi M.; Carerj S.; Pellikka P.A.; Picano E.; Kobal S.; Mahidol UniversityItem Metadata only Asia-Pacific consensus on the use of artificial intelligence in colorectal cancer screening and surveillance(2025-01-01) Koh F.H.; Li J.W.; Wong S.H.; Lee J.; John S.; Chong V.H.; Wu K.c.; Lui R.; Ng S.S.M.; Lam T.Y.T.; Lau L.H.S.; Makharia G.K.; Abdullah M.; Maulahela H.; Kobayashi N.; Sekiguchi M.; Byeon J.S.; Kim H.s.; Lee Y.Y.; Chiu H.M.; Wu I.C.; Leelakusolvong S.; Sharma P.; Lieberman D.; Sung J.J.Y.; Koh F.H.; Mahidol UniversityBackground and Aims: Artificial intelligence (AI)-assisted colonoscopy has been widely investigated for colorectal adenoma and cancer detection and characterization. However, clinical guidance on its use in colorectal cancer (CRC) screening and surveillance is lacking. In this study, we developed consensus guiding when and how to use AI-assisted colonoscopy in the daily practice of screening and surveillance of colorectal neoplasia. Methods: Experts from 12 Asian-Pacific countries and regions together with 4 international experts developed a set of consensus statements based on existing clinical evidence using the modified Delphi process. Results: Based on existing evidence, computer-assisted detection should be evaluated for use if available and deemed cost-effective as an adjunct to conventional colonoscopy for CRC screening. Computer-assisted diagnosis may be used for characterization of polyps but is not yet considered sufficient to determine if a polyp is neoplastic and needs to be removed. Computer-assisted quality assurance is generally welcome to improve the quality of colonoscopy. Early engagement of patients and nurses and training of endoscopists to use AI-assisted colonoscopy are crucial for the successful implementation. Conclusions: More validation studies on AI-assisted colonoscopy need to be done while AI technologies continue to improve.