Scopus 2021
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Publication Metadata only Improved immunization access through health systems strengthening project for townships in myanmar: A mixed method study(2021-01-01) Win Yee Mon; Nithat Sirichotiatana; Sukhontha Kongsin; Sukhum Jiamtom; Chardsumon Prutipinyo; Siriraj Hospital; Mahidol UniversityMany areas of Myanmar have limited access to immunization due to a range of management, logistics and security barriers. The objectives of this study were to describe the situation of immunization services and the health systems strengthening (HSS) project, and to analyze the effect of the health systems strengthening project on access to immunization services. Mixed-method study design was used. Secondary data for all health systems strengthening and immunization services from 2011 to 2015 were collected. The qualitative data were collected by key informant interviews with 28 key stakeholders from the HSS project and the expanded program on immunization (EPI) project, and six study townships and twelve Rural Health Centers, along with twelve focus group discussions with 121 mothers of children under two years of age. The results showed that DPT3/Pentavalent 3 immunization coverage increased from 79.4 in 2011 to 87.8 in 2015. The integrated service packages were conducted in remote areas. The appointed midwife to PHS 2 ratio went from 6.57 in 2011 to 2.06 in 2015. The government budget mainly supported salaries, and the HSS project supported integrated immunization service packages and supervision. In addition, the basic health staff (BHS) received leadership and management training. In conclusion, the findings of this study provided substantial insight into health systems strengthening factors such as service delivery, healthcare workforce, information, medical products and technology, financing and leadership, improving access to immunization services which have an effect on the national intervention programs and policies, and implementation of interventions.Publication Metadata only Women and other risk factors for chronic kidney disease of unknown etiology in Thailand: National Health Examination V Survey(2021-12-01) Wichai Aekplakorn; Suwat Chariyalertsak; Pattapong Kessomboon; Sawitri Assanangkornchai; Surasak Taneepanichskul; Nareemarn Neelapaichit; Anchalee Chittamma; Chagriya Kitiyakara; Ramathibodi Hospital; Chulalongkorn University; Faculty of Medicine, Khon Kaen University; Faculty of Medicine, Prince of Songkia University; Chiang Mai UniversityThere are limited data on chronic kidney disease of unknown etiology (CKDu) from Southeast Asia. Initially described in working age men, a common approach to detect CKDu that includes all adults has recently been proposed. We determined the prevalence, and risk factors for CKDu using data from a cross-sectional, nationally representative survey of the adult population of Thailand. We used a proxy for CKDu as age < 70 with impaired kidney function (eGFR < 60) in the absence of diabetes and hypertension (CKDu1) and heavy proteinuria (CKDu2). Prevalence estimates were probability-weighted for the Thai population. The associations between risk factors and CKDu or elderly subjects with eGFR < 60 without traditional causes were assessed by multivariable logistic regression. Of 17,329 subjects, the prevalence were: eGFR < 60, 5.3%; CKDu1 0.78%; CKDu2, 0.75%. CKDu differed by 4.3-folds between regions. Women, farmers/laborers, older age, gout, painkillers, rural area, and stones were independent risk factors for CKDu. Women, age, rural, gout, painkillers were significant risk factors for both CKDu and elderly subjects. These data collected using standardized methodology showed that the prevalence of CKDu in Thailand was low overall, although some regions had higher risk. Unlike other countries, Thai women had a two-fold higher risk of CKDu.Publication Metadata only Comparison of single-and mixed-sized gold nanoparticles on lateral flow assay for albumin detection(2021-07-01) Sasima Chotithammakul; Michael B. Cortie; Dakrong Pissuwan; University of Technology Sydney; Mahidol UniversityThe sensitivity and reproducibility of the lateral flow assay can be influenced by multiple factors, such as the size of gold nanoparticles (GNPs) employed. Here, we evaluated the analytical performance of single-sized and mixed-sized GNPs using a simple lateral flow assay (LFA) platform. This platform was used as a model assay to diagnose albumin levels and demonstrate the analytical performance of single-sized and mixed-sized GNPs in LFA tests. Two sizes of GNPs@anti-bovine serum albumin (BSA) conjugate proteins were mixed at different ratios. The unique optical properties of the GNPs induced a distinguishing color-shedding effect on the single-and mixed-sized GNPs@anti-BSA conjugates interacting with the target analyte BSA spotted on the test line. The use of mixed-sized GNPs@anti-BSA conjugates enhanced signal relative to the 20 nm GNPs, and provided superior stability compared with solely employing the large GNPs (50 nm). The proposed platform in this study could provide an efficient BSA detection mechanism that can be utilized as a model biomarker for confronting chronic kidney disease.Publication Metadata only Single-Strand Conformation Polymorphism Fingerprint Method for Dictyostelids(2021-08-27) Phongthana Pasookhush; Asmatullah Usmani; Kowit Suwannahong; Prasit Palittapongarnpim; Kamolchanok Rukseree; Kanchiyaphat Ariyachaokun; Sureemas Buates; Suradej Siripattanapipong; Pravech Ajawatanawong; Siriraj Hospital; Ubon Ratchathani University; Mahidol University; Burapha University; Thailand National Science and Technology Development Agency; Kandahar UniversityDictyostelid social amoebae are a highly diverse group of eukaryotic soil microbes that are valuable resources for biological research. Genetic diversity study of these organisms solely relies on molecular phylogenetics of the SSU rDNA gene, which is not ideal for large-scale genetic diversity study. Here, we designed a set of PCR–single-strand conformation polymorphism (SSCP) primers and optimized the SSCP fingerprint method for the screening of dictyostelids. The optimized SSCP condition required gel purification of the SSCP amplicons followed by electrophoresis using a 9% polyacrylamide gel under 4°C. We also tested the optimized SSCP procedure with 73 Thai isolates of dictyostelid that had the SSU rDNA gene sequences published. The SSCP fingerprint patterns were related to the genus-level taxonomy of dictyostelids, but the fingerprint dendrogram did not reflect the deep phylogeny. This method is rapid, cost-effective, and suitable for large-scale sample screening as compared with the phylogenetic analysis of the SSU rDNA gene sequences.Publication Metadata only A One Health approach to assessing occupational exposure to antimicrobial resistance in Thailand: The FarmResist project(2021-01-01) Duangdao Sudatip; Kittipong Chasiri; Anamika Kritiyakan; Wantanee Phanprasit; Chuanphot Thinphovong; Surapee Tiengrim; Visanu Thamlikitkul; Rim Abdallah; Sophie Alexandra Baron; Jean Marc Rolain; Serge Morand; Markus Hilty; Anne Oppliger; Siriraj Hospital; Faculty of Tropical Medicine, Mahidol University; Université de Montpellier; Aix Marseille Université; Kasetsart University; University of Bern; Mahidol University; Université de Lausanne (UNIL)This Southeast Asia-Europe research project will use a One Health approach to identify the major parameters responsible for the presence of animal-associated antimicrobial resistant bacteria in animal production facilities in Thailand and the risk of their transmission from animals to humans. We will focus on traditional, small, extensive pig and poultry farms where information on antibiotic use is scarce and animals live in close contact with humans. This cross-sectional study will be based on the epidemiological analysis of the antimicrobial resistance (AMR) present in fecal samples from animals and humans. Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) and Enterobacteriaceae resistant to colistin will be actively searched in the feces of farm animals (pigs and poultry), small wild rodents and farmers. Phenotypic (selective plating) and genotypic (multilocus seuquence typing and sequencing) methods will be used for the detection of AMR, the identification of antibiotic resistance genes (ARGs) and the characterization of strains carrying resistance genes. Questionnaires will be administered to investigate the effects of antibiotic use, farm characteristics and biosecurity measures on the occurrence of AMR in animals. Subsequently, the fecal carriage of AMR and ARGs in farmers will be compared to a control population with no occupational contacts with animals, thus enabling an estimation of the risk of transmission of AMR/ARGs from animals to farmers.Publication Metadata only Counting mosquitoes in the wild: An internet of things approach(2021-09-09) Dinarte Vasconcelos; Myat Su Yin; Fabian Wetjen; Alexander Herbst; Tim Ziemer; Anna Förster; Thomas Barkowsky; Nuno Nunes; Peter Haddawy; Mahidol University; Universität Bremen; Instituto SuperiorCounting mosquitoes in the wild is a crucial capability for monitoring, prediction, and control of vector-borne diseases. Current approaches are mainly manual, where specially designed mosquito traps or ovitraps are placed in areas of interest and recovered the next day. The counting itself is performed in an entomological laboratory, where individual mosquitoes are classified into species and counted. This process is costly, slow and inefficient. At the same time, mosquito counting is most relevant in tropical and sub-tropical countries, where mosquitoes spread deadly diseases like malaria, yellow fever and dengue fever. Many countries in these regions have relatively weak public health systems and so cannot support large-scale vector counting efforts. In this paper, we present a system architecture and a prototype to count mosquitoes in the wild with an Internet of Things approach. A sensor board is developed to gather audio data, and models are developed to detect, classify, and count mosquito species. Here, we present our prototype and an extensive background study of classifying mosquitoes based on sound recordings and some preliminary results and discussion.Publication Metadata only Distortion-free, high-isotropic-resolution diffusion MRI with gSlider BUDA-EPI and multicoil dynamic B0 shimming(2021-08-01) Congyu Liao; Berkin Bilgic; Qiyuan Tian; Jason P. Stockmann; Xiaozhi Cao; Qiuyun Fan; Siddharth Srinivasan Iyer; Fuyixue Wang; Chanon Ngamsombat; Wei Ching Lo; Mary Kate Manhard; Susie Y. Huang; Lawrence L. Wald; Kawin Setsompop; Siriraj Hospital; Siemens USA; Massachusetts General Hospital; Massachusetts Institute of Technology; Harvard Medical SchoolPurpose: We combine SNR-efficient acquisition and model-based reconstruction strategies with newly available hardware instrumentation to achieve distortion-free in vivo diffusion MRI of the brain at submillimeter-isotropic resolution with high fidelity and sensitivity on a clinical 3T scanner. Methods: We propose blip-up/down acquisition (BUDA) for multishot EPI using interleaved blip-up/blip-down phase encoding and incorporate B0 forward-modeling into structured low-rank reconstruction to enable distortion-free and navigator-free diffusion MRI. We further combine BUDA-EPI with an SNR-efficient simultaneous multislab acquisition (generalized slice-dithered enhanced resolution [“gSlider”]), to achieve high-isotropic-resolution diffusion MRI. To validate gSlider BUDA-EPI, whole-brain diffusion data at 860-μm and 780-μm data sets were acquired. Finally, to improve the conditioning and minimize noise penalty in BUDA reconstruction at very high resolutions where B0 inhomogeneity can have a detrimental effect, the level of B0 inhomogeneity was reduced by incorporating slab-by-slab dynamic shimming with a 32-channel AC/DC coil into the acquisition. Whole-brain 600-μm diffusion data were then acquired with this combined approach of gSlider BUDA-EPI with dynamic shimming. Results: The results of 860-μm and 780-μm datasets show high geometry fidelity with gSlider BUDA-EPI. With dynamic shimming, the BUDA reconstruction’s noise penalty was further alleviated. This enables whole-brain 600-μm isotropic resolution diffusion imaging with high image quality. Conclusions: The gSlider BUDA-EPI method enables high-quality, distortion-free diffusion imaging across the whole brain at submillimeter resolution, where the use of multicoil dynamic B0 shimming further improves reconstruction performance, which can be particularly useful at very high resolutions.Publication Metadata only Response to “Pharmacometric Approach to Evaluate Drug Dosing Adherence”(2021-07-01) Junjie Ding; Richard M. Hoglund; Joel Tarning; Faculty of Tropical Medicine, Mahidol University; Nuffield Department of Medicine; WorldWide Antimalarial Resistance NetworkPublication Metadata only Development of the sympathetic trunks in human embryos(2021-07-01) Nutmethee Kruepunga; Jill P.J.M. Hikspoors; Cindy J.M. Hülsman; Greet M.C. Mommen; S. Eleonore Köhler; Wouter H. Lamers; Universiteit Maastricht; Mahidol University; Amsterdam UMC - University of AmsterdamAlthough the development of the sympathetic trunks was first described >100 years ago, the topographic aspect of their development has received relatively little attention. We visualised the sympathetic trunks in human embryos of 4.5–10 weeks post-fertilisation, using Amira 3D-reconstruction and Cinema 4D-remodelling software. Scattered, intensely staining neural crest-derived ganglionic cells that soon formed longitudinal columns were first seen laterally to the dorsal aorta in the cervical and upper thoracic regions of Carnegie stage (CS)14 embryos. Nerve fibres extending from the communicating branches with the spinal cord reached the trunks at CS15-16 and became incorporated randomly between ganglionic cells. After CS18, ganglionic cells became organised as irregular agglomerates (ganglia) on a craniocaudally continuous cord of nerve fibres, with dorsally more ganglionic cells and ventrally more fibres. Accordingly, the trunks assumed a “pearls-on-a-string” appearance, but size and distribution of the pearls were markedly heterogeneous. The change in position of the sympathetic trunks from lateral (para-aortic) to dorsolateral (prevertebral or paravertebral) is a criterion to distinguish the “primary” and “secondary” sympathetic trunks. We investigated the position of the trunks at vertebral levels T2, T7, L1 and S1. During CS14, the trunks occupied a para-aortic position, which changed into a prevertebral position in the cervical and upper thoracic regions during CS15, and in the lower thoracic and lumbar regions during CS18 and CS20, respectively. The thoracic sympathetic trunks continued to move further dorsally and attained a paravertebral position at CS23. The sacral trunks retained their para-aortic and prevertebral position, and converged into a single column in front of the coccyx. Based on our present and earlier morphometric measurements and literature data, we argue that differential growth accounts for the regional differences in position of the sympathetic trunks.Publication Metadata only Microbiological Profile and Antimicrobial Resistance in Burn Unit of Ramathibodi Hospital(2021-12-01) Suparerk Laohapitakworn; Chonlada Krutsri; Suppachok Kirdlarp; Phurit Bovornchutichai; Napatsorn Wongwiriya; Napat Rojsirikulchai; Kidakorn Kiranantawat; Chalermpong Chatdokmaiprai; Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityBackground: Infection of burn patients remains a major challenge due to an immunocompromised state and prolonged hospitalization. Knowing bacteriology and antibiotic susceptibility would therefore facilitate tailored management of infection in the Burn Unit. Objective: To investigate microbiological profile and antimicrobial resistance in the Burn Unit, Ramathibodi Hospital. Materials and Methods: A retrospective review of patients admitted to the Burn Unit was conducted during a two-year period (June 2019 to May 2021). Demographic data of infected and non-infected patients were collected including percentage of total body surface area (%TBSA), number of operations, length of hospital stay, and mortality. Bacterial isolates were cultured from burn wounds and blood. Antibiotic resistant profile of all common pathogens was analyzed. Results: A total of 49 burn patients were included. There were 33 patients (67.3%) in the infected group and 16 patients (32.7%) in the non-infected group. Infected patients had larger burn sizes (25.5 vs. 4.0 %TBSA, p=0.001) and required more operations (4 vs. 0.5, p=0.008) and longer hospitalization (36 vs. 11.5 days, p<0.001). Nevertheless, mortality of both groups was not significantly different (9.1% vs. 0%, p=0.213). Of all 212 bacterial isolates, the common organisms from the wounds were Pseudomonas aeruginosa (25.0%), Klebsiella pneumoniae (20.8%), and Enterococcus faecalis (16.5%). The common pathogens from 16 isolates of hemocultures were coagulase-negative staphylococcus (12.5%), Klebsiella pneumoniae (12.5%), and Proteus mirabilis (12.5%). Acinetobacter baumannii and Pseudomonas aeruginosa were two majority of multiple-drug resistant organisms (MDROs). These two strains were resistant to most antibiotics. However, colistin was still effective against the MDROs. Conclusion: The present study reviewed the prevalence of bacterial infection obtained from burn wounds and hemocultures to determine the bacteriological profile and antibiotic resistant patterns. This knowledge help improve decision making for appropriate antibiotic prescription in the Burn Unit.Publication Metadata only Learning to think for the development of environmental ethics model for mangrove children(2021-01-01) Jitikan Jinarak; Tassanee Ounvichit; Mahidol UniversityInculcation of ethics heavily influenced by materialism may fail to arrest environmental problems. Leveraging on the thinking potential of children in their real life context, this action research was carried out with 15 children from Ko Klang mangrove community in Krabi province with the purposes to analyze their thinking patterns and innovate an alternative model for environmental ethics development. The verbalized data on their invisible thinking were collected by interviewing them as well as their teachers and parents and participant observation. The data were analyzed and coded against a schedule of 29 thinking modes and compared with the results of the test conducted to identify any trends of change in their egocentric, homocentric and ecocentric ethics. The results of the study indicated that there was a positive influence of the diversity and thoroughness of the thinking patterns for the development of ecocentric ethics, which was characterized by three main aspects of thinking about environmental situations, thinking about solving environmental problems, and thinking with environmental goals in mind. The Learn to Think for the Development of Environmental Ethics Model was innovated, comprising four steps of building confidence in self, reflecting on the value and attitudes towards the mangrove environment, planning environmental actions in the mangrove community, and reflecting on a new environmental ethical self. Recommended for further study were the sustainability of the children’s environmental ethics and the capacity development of learning managers with regard to uses of questions to stimulate thinking for environmental ethics development.Publication Metadata only Value of age and alarm features for predicting upper gastrointestinal malignancy in patients with dyspepsia: An endoscopic database review of 4664 patients in Thailand(2021-10-27) Uayporn Kaosombatwattana; Phunchai Charatcharoenwitthaya; Nonthalee Pausawasdi; Monthira Maneerattanaporn; Julajak Limsrivilai; Somchai Leelakusolvong; Udom Kachintorn; Siriraj HospitalObjective Age and alarm features are commonly used as indicators for endoscopy in dyspeptic patients; however, the age cut-off and the predictive value of these parameters for identifying upper gastrointestinal (UGI) malignancies are uncertain. Design Cross-sectional study. Setting Data were extracted from the Gastrointestinal Endoscopy Centre of Siriraj Hospital, Thailand, during 2005-2011. Participants Consecutive patients underwent a first-time upper endoscopy for dyspepsia. Patients with previous surgery, suspected UGI malignancy by imaging, or indefinite biopsy results on prior examination were excluded. Main outcome measures Alarm features included dysphagia, unintentional weight loss, GI bleeding/anaemia, and persistent vomiting. The diagnostic performance of each alarm feature and different age cut-off values were evaluated. Results A total of 4664 patients (mean age: 52.0±14.4 years, 66% female) were included. Alarm symptoms were presented in 21.6%. The prevalence of active Helicobacter pylori infection was 26.3%. Fifty-eight (1.2%) patients had UGI malignancy. The prevalence of malignancy significantly increased with increasing age (0.6% in patients aged <50 years, and 1.8% in patients aged >60 years (p<0.001)). Cancer was found in two patients aged <50 years who did not have alarm features. Patients with alarm features had a higher prevalence of malignancy (OR 22.3, 95% CI 10.5 to 47.4; p<0.001) than those without. The pooled sensitivity, specificity, positive predictive value and negative predictive value of alarm features for UGI malignancy were 87.0%, 79.1%, 4.7% and 99.8%, respectively. Among all age groups, persistent vomiting had a positive likelihood ratio (PLR) >10, while dysphagia and GI bleeding/anaemia had a PLR >10 in patients <50 years old. Conclusion Despite the overall limited value of age and alarm features, persistent vomiting, dysphagia, and GI bleeding/anaemia are strong predictors for malignancy in patients aged <50 years. Without these symptoms, cancer prevalence is negligible; thus, they are worthy guidance for endoscopic evaluation in this age group.Publication Metadata only Effect of hot wind on insects in longan (Dimocarpus longan Lour.) orchard during off-season production in the Chao Phraya Delta(2021-06-01) A. Pichakum; C. Kaewmanee; S. Detpitthayanan; W. Chintakovid; Mahidol UniversityOff-season longan is an important commercial frui crop grown in the alluvial plains of Chao Phraya Delta, Thailand. Hot winds during the off-season production period has been reported to significantly reduce shoot growth and cause flower buds to dry out and fall off. In addition, the effect of these hot winds on the bio-ecological environmental is still unknown. This study monitored the all year round (May 2018-April 2019) change in insect populations surrounding longan orchards. Five different insect trap sheets, four coloured (white, yellow, green and blue) and a transparant trap were located on the four compass directions (north, south, east and west) in Ban Phaeo District, Samut Sakhon Province. Apical shoots were induced in May (May pot) to initiated early flower buds to avoid the hot winds and compared with the flower buds initiated in June (June plot) that were exposed to the hot winds. The trap sheets were replaced and evaluated for insect population every month. The results showed, regardless of growth pattern differences between the two plots, insect populations in both plots clearly increased at the same time during June to November, when the annual hot winds blew at Ban Phaeo. Interestingly, during this period, insect populations increased in conjunction with situations of high-water vapour pressure deficit which is related to high temperature and low relative humidity. The insect category focused on, was those pests related to longan productivity, natural enemies, and water quality indicators. Trap location from the four compass directions showed the same trend. Major insect pests and enemies were found on yellow colour trap sheets. These results will benefit selective integrated pest management programs for controlling insect populations in longan orchards.Publication Metadata only Vitamin d and rheumatic diseases: A review of clinical evidence(2021-10-01) Nipith Charoenngam; Siriraj Hospital; Boston University School of Medicine; Harvard Medical SchoolVitamin D plays an important role in maintaining a healthy mineralized skeleton. It is also considered an immunomodulatory agent that regulates innate and adaptive immune sys-tems. The aim of this narrative review is to provide general concepts of vitamin D for the skeletal and immune health, and to summarize the mechanistic, epidemiological, and clinical evidence on the relationship between vitamin D and rheumatic diseases. Multiple observational studies have demonstrated the association between a low level of serum 25-hydroxyvitamin D [25(OH)D] and the presence and severity of several rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies, and osteoarthritis (OA). Nevertheless, the specific benefits of vitamin D supplements for the treatment and prevention of rheumatic diseases are less accepted as the results from randomized clinical trials are inconsistent, although some conceiv-able benefits of vitamin D for the improvement of disease activity of RA, SLE, and OA have been demonstrated in meta-analyses. It is also possible that some individuals might benefit from vitamin D differently than others, as inter-individual difference in responsiveness to vitamin D supplementa-tion has been observed in genomic studies. Although the optimal level of serum 25(OH)D is still debatable, it is advisable it is advisable that patients with rheumatic diseases should maintain a serum 25(OH)D level of at least 30 ng/mL (75 nmol/L) to prevent osteomalacia, secondary osteoporosis, and fracture, and possibly 40–60 ng/mL (100–150 nmol/L) to achieve maximal benefit from vitamin D for immune health and overall health.Publication Metadata only Ozone nanobubble modulates the innate defense system of Nile tilapia (Oreochromis niloticus) against Streptococcus agalactiae(2021-05-01) Nguyen Vu Linh; Le Thanh Dien; Wattana Panphut; Anat Thapinta; Saengchan Senapin; Sophie St-Hilaire; Channarong Rodkhum; Ha Thanh Dong; Suan Sunandha Rajabhat University; Chulalongkorn University; City University of Hong Kong; Mahidol University; Thailand National Center for Genetic Engineering and Biotechnology; Tien Giang UniversityOzone nanobubble (NB–O3) is a promising technology for improving dissolved oxygen and reducing bacterial concentration in aquaculture systems. Here, we investigated the effects of NB-O3 on the innate immunity of fish by monitoring the expression levels of nonspecific immune-related genes (IL-1β, IL-2β, TNF-α), heat-shock protein genes (HSP70, HSP90-α), and a bacteriolytic enzyme, C-type lysozyme, gene (LYZ) post-treatment with this technology. Following exposure to NB-O3, the different tissues of Nile tilapia (Oreochromis niloticus) were collected over time for quantitative real-time PCR (qPCR) analysis. The expression of all the genes evaluated in the gills, the head kidney, and the spleen of the NB-O3 treated group was significantly up-regulated compared to that in the untreated control group. The expression levels were the highest (approx. 2 to 4-fold) at 15 min and 3 h post-exposure and then decreased from 6 to 24 h. These findings suggested that NB-O3 could switch on the innate immunity genes of Nile tilapia. Thus, we hypothesized that the NB-O3-immune-activated fish would respond more effectively to subsequent bacterial infections, thereby improving survivability compared to that of untreated fish. To test this hypothesis, 3 h post NB-O3 exposed fish and unexposed fish were challenged with a lethal dose of Streptococcus agalactiae. Interestingly, the survival rate of the NB-O3 group was significantly higher than that of the non-treated controls, with a relative percent survival (RPS) of 60–70%. Together, these findings indicate, for the first time, that NB-O3 may trigger the nonspecific defense system of the fish, thereby improving fish survivability during subsequent bacterial infections. This research identified another potential benefit of NB-O3 in aquaculture for preventing infectious bacterial diseases.Publication Metadata only Effects of gamified interactive e-books on students’ flipped learning performance, motivation, and meta-cognition tendency in a mathematics course(2021-12-01) Jiahua Zhao; Gwo Jen Hwang; Shao Chen Chang; Qi fan Yang; Artorn Nokkaew; National Taiwan University of Science and Technology; Naresuan University; Fujian Normal University; Yuan Ze University; Mahidol UniversityIt is widely recognized that flipped learning has great potential for enhancing students’ conceptual understanding through the reversed arrangement of before-class learning activities and in-class settings. However, this approach also raises the challenge of students having to obtain the learning content by themselves, especially for abstract concepts such as fractions, where students frequently encounter problems in mathematics education. In this study, we proposed a gamified interactive e-book approach to supporting a flipped mathematics classroom. To evaluate the effectiveness of the proposed approach, a quasi-experimental study was implemented in an elementary school mathematics course. There were three groups: the students who adopted the gamified interactive e-book in the mathematical flipped classroom (the GIEBFL group), the students who learned with conventional flipped learning (the CFL group), and those who learned with traditional instruction (the TI group). The results from a paper-and-pencil test indicated that the GIEBFL students significantly outperformed the CFL and TI students. In addition, the questionnaire of students’ learning motivation showed that the GIEBFL students had better motivation than the CFL and TI students. Also, the GIEBFL students achieved significantly higher meta-cognition tendency than the TI students.Publication Metadata only Silk fibroin/polyurethane patch implantation in hyperglycemic rat model(2021-10-01) Pitipat Kitpipatkun; Kripitch Sutummaporn; Konosuke Kato; Tomoaki Murakami; Kyoko Kobayashi; Yasumoto Nakazawa; Ryou Tanaka; Mahidol University; Tokyo University of Agriculture and Technology; Rajamangala University of Agriculture and TechnologyPurpose: To understand the complication and histopathological characteristics between the Silk Fibroin/Polyurethanes (SF/PU) and the host response, and to unveil the compatibility of the patch in diabetes individuals. Methods: Rats were divided into DM and control (CT) groups, and the DM group was induced with streptozotocin. All groups underwent the SF/PU patch implantation in the abdominal aorta, and the implanted patches were evaluated at one, two, three, and four weeks after implantation. Results: DM group had more fibrosis formation and a delayed endothelialization compared to the CT group. There was no evidence of chronic inflammation in both DM and CT groups. Conclusions: Fibrosis in hyperglycemic individuals could promote the formation of new vascular structures in the implanted patch such as endothelial and vascular smooth muscle cells. In summary, the SF/PU patch was no serious complications when implanted under hyperglycemia, and the patch was suitable to implant in diabetes mellitus.Publication Metadata only Estimating occupational exposure to vocs, svocs, particles and participant survey reported symptoms in central thailand rice farmers using multiple sampling techniques(2021-09-01) Saowanee Norkaew; Wantanee Phanprasit; Mark Gregory Robson; Susan Woskie; Brian T. Buckley; University of Massachusetts Lowell; School of Environmental and Biological Sciences; Mahidol University; Thammasat University; Rutgers Environmental and Occupational Health Sciences InstituteThailand is known for its agricultural productivity and rice exportation. Most farms use small machines and manual labor, creating potential exposure to multiple health hazards. A cross-sectional study was conducted to measure pollutants liberated during preparation, pesticide applica-tion, and harvesting. Thirty rice farmers, mostly males from 41 to 50 years old, participated. The participant survey data showed that 53.3% of the respondents spent >2 h per crop on preparation, <1 h on pesticide application, and about 1–2 h harvesting; 86.7% of the respondents maintained and stored mechanical applicators at home, suggesting possible after-work exposures. Gloves, fabric masks, boots, and hats were worn during all activities, and >90% wore long sleeved shirts and pants. VOCs and SVOCs were collected using charcoal tubes and solid phase micro sample extraction (SPME). An analysis of the charcoal and SPME samplers found that 30 compounds were detected overall and that 10 were in both the charcoal tubes and SPME samplers. The chemicals most often detected were 1, 1, 1 Trichloro ethane and xylene. Additionally, farmers experienced the highest exposure to particulates during harvesting. These results demonstrated that farmers experience multiple exposures while farming and that risk communication with education or training programs may mitigate exposure.Publication Metadata only The association of nitrous oxide on length of stay in the postanesthesia care unit: a retrospective observational study(2021-11-01) Salameh Sameh Obeidat; Karuna Wongtangman; Michael Blank; Luca J. Wachtendorf; Maximilian Hammer; Maximilian S. Schaefer; Peter Santer; Matthias Eikermann; Eswar Sundar; Siriraj Hospital; Heinrich-Heine-Universität Düsseldorf; Universitätsklinikum Essen; Harvard Medical School; Albert Einstein College of Medicine of Yeshiva UniversityPurpose: To assess whether intraoperative use of nitrous oxide (N2O) as an adjunct to general anesthesia is associated with a shorter length of stay in the postanesthesia care unit (PACU). Methods: We analyzed data from adult patients who underwent non-cardiothoracic surgery under general anesthesia between May 2008 and December 2018. We assessed the association between intraoperative low- and high-dose N2O and PACU length of stay. Results: A total of 148,284 patients were included in the primary analysis. After adjusting for a priori defined confounders, a high dose of N2O significantly decreased PACU length of stay, with a calculated difference of −9.1 min (95% confidence interval [CI], −10.5 to −7.7; P < 0.001). Patients who received high-dose N2O had a lower incidence of both short- and prolonged-duration of intraoperative hypotension (adjusted odds ratio [aOR], 0.85; 95% CI, 0.83 to 0.88; P < 0.001 and aOR, 0.76; 95% CI, 0.73 to 0.80; P < 0.001, respectively) and received a lower total intraoperative vasopressor dose (−0.04 mg of norepinephrine equivalents; 95% CI, −0.06 to −0.01; P = 0.01). The effect of high-dose N2O on PACU length of stay was modified by surgical complexity (adjusted absolute difference: −26.1 min; 95% CI, −29.2 to −23.1; P < 0.001; P for interaction < 0.001), and most pronounced in patients who underwent complex surgery and received intraoperative antiemetic therapy (adjusted absolute difference: −38.9 min; 95% CI, −43.1 to −34.6; P < 0.001; P for interaction < 0.001). Conclusions: Nitrous oxide was dose-dependently associated with a decreased PACU length of stay. The effect was clinically relevant (> 30 min difference) in patients who underwent complex surgical procedures and received intraoperative antiemetic therapy.Publication Metadata only Longevity, tumor, and physical vitality in rats consuming ginsenoside Rg1(2021-01-01) Chao Chieh Hsieh; Chiung Yun Chang; Tania Xu Yar Lee; Jinfu Wu; Suchada Saovieng; Yu Wen Hsieh; Maijian Zhu; Chih Yang Huang; Chia Hua Kuo; Tzu Chi University of Science and Technology; University of Taipei; Asia University; China Medical University Hospital; Buddhist Tzu-Chi General Hospital Taiwan; Mahidol University; China Medical University; South China Normal UniversityBackground: Effects of the major ginsenoside Rg1 on mammalian longevity and physical vitality are rarely reported. Purpose: To examine longevity, tumor, and spontaneous locomotor activity in rats consuming Rg1. Methods: A total of 138 Wistar rats were randomized into 2 groups: control (N = 69) and Rg1 (N = 69). Rg1 (0.1 mg/kg per day) were orally supplemented from 6 months of age until natural death. Spontaneous mobility was measured by video-tracking together with body composition (dual energy x-ray absorptiometry) and inflammation markers at 5, 14, 21, and 28 months of age. Results: No significant differences in longevity (control: 706 days; Rg1: 651 days, p = 0.77) and tumor incidence (control: 19%; Rg1: 12%, p = 0.24) were observed between the two groups. Movement distance in the control group declined significantly by ∼60% at 21 months of age, together with decreased TNF-α (p = 0.01) and increased IL-10 (p = 0.02). However, the movement distance in the Rg1 group was maintained ∼50% above the control groups (p = 0.01) at 21 months of age with greater magnitudes of TNF-α decreases and IL-10 increases. Glucose, insulin, and body composition (bone, muscle and fat percentages) were similar for both groups during the entire observation period. Conclusion: The results of the study suggest a delay age-dependent decline in physical vitality during late life by lifelong Rg1 consumption. This improvement is associated with inflammatory modulation. Significant effects of Rg1 on longevity and tumorigenesis were not observed.