Scopus 2024

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    RHINACANTHIN-C: A TARGETED REVIEW ON ITS PHARMACOLOGICAL PROPERTIES AND PROSPECTS FOR DRUG DEVELOPMENT
    (2024-01-01) Suksawat T.; Panichayupakaranant P.; Suksawat T.; Mahidol University
    Rhinacanthin-C, a naphthoquinone ester derived from Rhinacanthus nasutus (L.) Kurz, has garnered attention due to its broad spectrum of pharmacological properties, particularly in areas such as anticancer, anti-inflammatory, antidiabetic, and neuroprotective activities. As the major bioactive compound of R. nasutus, rhinacanthin-C shows potential as a therapeutic agent for chronic diseases including diabetes, cancer, and neurodegenerative disorders. Recent studies have further explored its pharmacokinetics, safety, and toxicity profiles, highlighting its efficacy and possible clinical applications. Despite its potency, one challenge in the development of rhinacanthin-C for therapeutic use is the cost and complexity of its extraction and purification processes. A promising alternative is the use of rhinacanthins-rich extract (RRE), which offer comparable pharmacological benefits with a low-cost of production. This review illustrates the current findings on rhinacanthin-C, discussing its therapeutic potential, methods for standardization, and prospects for pharmaceutical applications.
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    The survey of learning experience of pediatric injection among registered nurses and nursing students using a design thinking approach
    (2024-06-01) Tantacharoenrat C.; Precharattana M.; Tantacharoenrat C.; Mahidol University
    INTRODUCTION: Pediatric injection is an essential skill of nursing. The survey of the learner’s experience during the learning process helps identify problems and leads to improvement. We here applied a three‑phrase design thinking framework. The study aims to investigate (1) the registered nurses’ experience in learning injection technique, (2) the nursing students’ experience in learning injection, and (3) the cause of problems and to propose (4) a learning material that will be used to solve the encountered problems. MATERIALS AND METHODS: A cross‑sectional study was applied. The study employed convenience sampling. Registered nurses from a tertiary hospital in Bangkok, Thailand, and fourth‑year nursing students from a nursing school in Bangkok, Thailand, were selected. The data collecting tools contain a personal information form and the experience of injection learning. The inferential and descriptive statistics was used to analyze the data. RESULTS: The results show that the major issues of injection learning include selecting the correct site for injection and determining the needle length and injection angle and contamination. CONCLUSIONS: Therefore, teaching materials for the anatomy of the injection area and the technique to determine the correct size and depth of injection are needed.
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    The Future of AI-Assisted Patient Education in Critical Care Nephrology
    (2024-01-01) Sheikh M.S.; Thongprayoon C.; Suppadungsuk S.; Miao J.; Qureshi F.; Kashani K.; Cheungpasitporn W.; Sheikh M.S.; Mahidol University
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    Molecular detection and characterization of Histomonas meleagridis in fighting cocks Thailand
    (2024-07-01) Taweethavonsawat P.; Singh M.N.; Kesdangsakonwut S.; Jitsamai W.; Sonia C.; Phupolpan C.; Taweethavonsawat P.; Mahidol University
    Histomoniasis caused by the protozoa Histomonas meleagridis is a disease of gallinaceous birds which is of special importance to the poultry industry. The turkey is highly susceptible, which results in high mortality. However, the disease is less severe in chickens but sometimes leads to mortality, especially in those reared in the free-range system. During the present study, four dead fighting cocks were presented to the Veterinary Diagnostic Laboratory, Livestock Animal Hospital, Faculty of Veterinary Science, Chulalongkorn University for post-mortem examination. Based on history and pathological changes, it was preliminarily diagnosed as histomoniasis. The affected livers and caeca samples were collected from which the genomic DNA was extracted. Using species-specific primers, the 18S rRNA gene was amplified by PCR and sequenced. The sequences thus obtained were analyzed using the BLAST search algorithm demonstrating that they are specific for H. meleagridis. The sequences were aligned and compared with the other related sequences published in the GenBank database. The four Thailand isolates showed 98-100% nucleotide sequence identity. In comparison, it shows 93-100%, 93-99%, and 88-99% nucleotide sequence identity to China, France, and Austria genotypes, respectively. Phylogenetic analysis of 18S rRNA gene fragments with pair-wise deletion of all gaps and insertion showed that three of the 4 Thailand isolates were closely related to China and France isolates and formed a distinct cluster. While the other Thailand isolates formed a separate cluster along with Austria isolates. Therefore, the PCR method sequences and phylogenetic tree analysis based on the 18S rRNA gene carried out during the present study revealed that the PCR method is highly sensitive for the detection of H. meleagridis and there is the genetic diversity of H. meleagridis which indicates the presence of different genotypes of this parasite in Thailand.
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    General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants
    (2024-08-31) Zhou B.; Bennett J.E.; Wickham A.P.; Singleton R.K.; Mishra A.; Carrillo-Larco R.M.; Ikeda N.; Jain L.; Barradas-Pires A.; Heap R.A.; Lhoste V.P.F.; Sheffer K.E.; Phelps N.H.; Rayner A.W.; Gregg E.W.; Woodward M.; Stevens G.A.; Iurilli M.L.C.; Danaei G.; Cesare M.D.; Aguilar-Salinas C.A.; Ahmad N.A.; Bovet P.; Chen Z.; Damasceno A.; Filippi S.L.; Janszky I.; Kengne A.P.; Khang Y.H.; Khunti K.; Laxmaiah A.; Lim L.L.; Lissner L.; Margozzini P.; Mbanya J.C.; McGarvey S.; Shaw J.E.; Söderberg S.; Soto-Mota L.A.; Wang J.; Zaccardi F.; Ezzati M.; Abarca-Gómez L.; AbbasiKangevari M.; Abdrakhmanova S.; Abdul Ghaffar S.A.; Abdul Rahim H.F.; Abdurrahmonova Z.; Abu-Rmeileh N.M.; Acosta-Cazares B.; Adam I.; Adamczyk M.; Aekplakorn W.; Agdeppa I.A.; Aghazadeh-Attari J.; Agyemang C.; Ahmad M.H.; Ahmadi A.; Ahmadi N.; Ahmadi N.; Ahmed S.H.; Ahrens W.; Aitmurzaeva G.; Ajlouni K.; Al-Hazzaa H.M.; Al-Hinai H.; Al-Lawati J.A.; Al-Raddadi R.; Asfoor D.A.; Al Hourani H.M.; Alarouj M.; AlBuhairan F.; AlDhukair S.; Ali M.M.; Alieva A.V.; Alkandari A.; Alkhatib B.M.; Aly E.; Amarapurkar D.N.; Amiano Etxezarreta P.; Amougou N.; Andersen L.B.; Anderssen S.A.; Androutsos O.; Anjana R.M.; Ansari-Moghaddam A.; Anufrieva E.; Aounallah-Skhiri H.; Aris T.; Arku R.E.; Arlappa N.; Aryal K.K.; Assah F.K.; Assembekov B.; Assunção M.C.F.; Auvinen J.; Avdicová M.; Azad K.; Azevedo A.; Azimi-Nezhad M.; Zhou B.; Mahidol University
    Background: Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. Methods: We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31–3·28) lower for women and 1·28 kg/m2 (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. Funding: UK Medical Research Council and UK Research and Innovation (Innovate UK).
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    Predicting factors of survival rates among alpha- and beta-thalassemia patients: a retrospective 10-year data analysis
    (2024-01-01) Iam-arunthai K.; Suwanban T.; Thungthong P.; Chamnanchanunt S.; Fucharoen S.; Iam-arunthai K.; Mahidol University
    Background: Thalassemia is a genetic hemoglobinopathy in which a defective globin chain can cause transfusion-dependent anemia and other complications. As genotype interactions lead to variations in the clinical course among patients with thalassemia, clinical factors may help predict survival in the types of thalassemia complicated by gene interactions. Aim: This study aimed to determine the clinical factors associated with survival in patients with thalassemia. We retrospectively reviewed the medical records of patients with thalassemia older than 15 years between 2002 and 2020 that were available at the Rajavithi Hospital. Data on the clinical parameters, laboratory tests, treatments, and survival status were collected and analyzed. Results: Of the 478 thalassemia patients included, 68.8% were women, and the mean age was 41 ± 17 years. The most common type of thalassemia was β-thalassemia (53.3%). Male sex, low body mass index, the thalassemia type, comorbidities, low hemoglobin level, high ferritin level, and regular blood transfusion were significantly associated with short-term survival. However, only the thalassemia type (β-thalassemia, p = 0.048) and the co-inheritance of the α- and β-thalassemia genotypes (p = 0.03) were independently associated with death. The overall survival rates among patients with α-thalassemia, β-thalassemia, and co-inheritance of the α- and β-thalassemia genotypes were 98.1%, 90.6%, and 75.0%, respectively. The death rate was 6.3%, and the most common cause of death was infection. Conclusion: The thalassemia genotype was a predictive factor of survival, and co-inheritance of the α- and β-thalassemia genotypes results in a shorter-term survival compared with other types, especially transfusion-dependent thalassemia. These results can be applied in clinical settings to predict and possibly extend the life expectancy of patients with thalassemia.
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    Phosphazene-Catalyzed Cascade Esterification/Stereoselective Aza-Michael Addition of Chiral β-Trifluoromethyl-α,β-unsaturated N -Acylated Oxazolidin-2-ones
    (2024-08-05) Racochote S.; Kuhakarn C.; Leowanawat P.; Reutrakul V.; Soorukram D.; Racochote S.; Mahidol University
    Upon treatment of chiral β-trifluoromethyl-α,β-unsaturated N -acylated oxazolidin-2-ones with a range of alcohols using phosphazene base as a catalyst, the unexpected cascade esterification/stereoselective aza-Michael addition was observed. The reactions proceeded with high diastereoselectivities (up to >99:1) to give a series of enantioenriched aza-Michael addition products in good to high yields. The structure and stereochemistry of the representative aza-Michael adduct were confirmed by X-ray crystal structure analysis. The plausible mechanism was proposed on the basis of the experimental results.The synthetic transformations of chiral aza-Michael addition products were also demonstrated highlighting the synthetic application of the present work. 2024. Thieme. All rights reserved.
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    Effectiveness of Nurse-led Heart Failure Transitional Care Services in Improving Clinical Outcomes and Applicability to Low-resource Settings: A Meta-analysis
    (2024-07-01) Koontalay A.; Samai T.; Samutalai C.; Onthuam W.; Fonghiranrat D.; Koontalay A.; Mahidol University
    ABSTRACT: Nurse-led interventions are tailored to the specific needs of heart failure (HF) patients, facilitating the transfer of knowledge in ways that are more feasible and applicable within the context of diverse healthcare settings. These programs emphasize comprehensive discharge planning, patient education on self-care practices, medication management, and early symptom recognition. The meta-analysis included 11 randomized controlled trials, selected from databases including MEDLINE, EBSCO, CINAHL, and the Cochrane Library. Quality assessment of the included studies was conducted independently by two reviewers. The overall pooled effect showed a relative risk (RR) of 0.69 (95% confidence interval [CI]: 0.54-0.89) for all-cause readmission and a RR of 0.80 (95% CI: 0.71-0.91) for combined outcomes of all-cause readmission and mortality in the nurse-led group compared to the control group. These results indicate that nurse-led transitional care interventions contribute substantially to reducing both readmission rates and mortality among HF patients. The review also explored the applicability of these interventions in low-resource settings, emphasizing their potential to be adapted and implemented effectively in lower-middle-income countries. This review highlights the pivotal role of nurse-led transitional care programs in addressing these challenges by providing close support to patients and their families. Leveraging existing resources and fostering interdisciplinary collaboration are essential in optimizing healthcare delivery in low-resource settings.
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    Rare cell-based liquid biopsy for improved measurement of low-grade chronic inflammation
    (2024-01-01) Schreier S.; Budchart P.; Borwornpinyo S.; Lertsithichai P.; Triampo W.; Schreier S.; Mahidol University
    Objectives and design: Low-grade inflammation is a hallmark of chronic diseases. More sensitive tools for chronic low-grade inflammation detection are needed and herein presented as a proof of concept. Heightened sensitivity to inflammation may be achieved by analyzing the compensation mechanisms of hematopoiesis in response to stress. The production of red blood cells and platelets, which are particularly vulnerable to physiological imbalances, are especially important in this context due to their high turnover rates. The compensatory mechanisms involve the production or release of rare immature blood cell types that herein serve as important biomarker targets. Methods: A cell-based liquid biopsy platform, using negative selection, was used to detect circulating rare cells in comprehension, allowing simultaneous analysis of an immature cell panel from one sample. The concentration ranges under physiological conditions for each cell marker were evaluated on a self-reported healthy control cohort and prospectively tested on three individuals undergoing various interventions: one afflicted with early-stage breast cancer, another with atherosclerosis in follow-up, and a third healthy individual with cardiovascular disease risk. Results: The approach effectively identified rare cellular abnormalities in asymptomatic individuals who exhibited no abnormalities in their complete blood counts. This condition was designated as silent inflammation (SI). SI was effective in monitoring response to intervention and predicting inflammation state. Conclusions: The detection of SI proved valuable in aiding inflammation differential diagnosis and for monitoring the response to interventions in all three subjects.
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    The Policy on the Development of Science and Technology in the Thai Armed Forces by Sending Military Personnel to Study Abroad between 1932-1941
    (2024-09-01) Boontanondha T.; Boontanondha T.; Mahidol University
    , ย Abstract Objectives: This research aimed to examine the policies of the Thai military following the Revolution of 1932, with a focus on initiatives to enhance scientific and technological knowledge and skills within the armed forces. The study emphasizes the military's strategy of sending personnel abroad for advanced education during the interwar period, between World War I and World War II. It seeked to illustrate how the Thai military's policies responded to evolving military strategies that increasingly relied on advancements in science and technology. Methods: The research used a historical research methodology to analyse data, emphasizing the importance of utilizing primary sources from the National Archives of Thailand for studying the government policies, rather than focusing on individual cases. The research is presented through an analytical descriptive. Results: After the Revolution of 1932, the government of Khana Ratsadorn (People’s Party) prioritized the development of science and technology within the armed forces resulting from the significant role that technology had played during World War I. As a result, the armed forces quickly focused on improving their scientific and technological knowledge. The army established the Department of Science and the Military Technical Academy. The navy focused on advancing sciences related to meteorology, hydrography, and naval combat forces. The air force, on the other hand, emphasized building its capabilities by commissioning a large number of aircraft, which required highly skilled pilots and mechanics. However, at that time, the armed forces lacked personnel with expertise in science and technology. As a result, they had to send many individuals abroad to study in these specialized fields. Application of this study: This research studies military history after the Revolution of 1932, which can be applied to the topics of scientific history and military history.
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    Cold War Modernism and Women’s Representation in Anti-Communist Seriphap Magazine
    (2024-09-01) Posrithong N.; Posrithong N.; Mahidol University
    Objectives: This research explored the various issues of the American-sponsored Seriphap magazine ( Free World), published between 1953 and 1963, focusing on how it presented women as the agents of modern ideologies and cosmopolitan feminism in the Cold War era. This research aimed to uncover the changes of cosmopolitan feminism and its influence on the representation of women in Thailand that contradicted the perceived image of those women in the competing communist regime. Methods: This research employs historical and documentary research methodologies, analyzing primary sources, secondary sources, and relevant internet sources. Using content and visual analytical methods, the results are presented through a comprehensive descriptive analysis. Results: In 1953, the United States Information Agency (USIA) was founded with its centers located around the world to implement the cultural war strategies during the Cold War. The overseas offices of the USIA carried out a mission to control the encroachment of communism through the production and distribution of pro-American propaganda materials. With its close proximity to Vietnam, Thailand played a crucial role to the American consolidation of power in Southeast Asia during the post-colonial period. As a result, American-sponsored films, magazines, and anti-communist materials were widely distributed in the country. From the study of the selected issues of Seriphap magazine, the researcher observed the captivating employment of women’ s representations with the agenda to promote Free World ideas. 1. The magazine demonstrates the role models of cosmopolitanism through the selected stories of inspiring American and Asian women by showcasing them as selfless heroines, as opposed to the communist villains. 2. The effort of the United States to disseminate its cultural products served as an agenda for the magazine to employ women as their agents of modernity. 3. The magazine adopts the discourse of universal rights to convince local readers that Thai women have better opportunities and freedom than those women in the communist camp. Through these results, women’ s representations were seen to have served various purposes, from being the agents of cosmopolitanism, American modernity, to even the idols of traditions and cultural values. Application of this study: This study provides an opportunity to examine the product of the American culture during the Cold War and the impact on women’ s representations in an Asian context. In addition, the study fills the gap in the Cold War history with its new perspective, which also contributes to the field of Southeast Asian post-colonial women studies.
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    Utilization of Trichoderma viride to Increase Patchouli Alcohol from Crude Extract of Acehnese Patchouli Leaves
    (2024-12-01) Hardjo P.H.; Askitosari T.D.; Wijaya A.N.; Edbert J.; Artadana I.B.M.; Wittayathanarattana T.; Hardjo P.H.; Mahidol University
    Acehnese Patchouli var. Sidikalang can produce patchouli oil, one of the country's sources of foreign exchange, and it is advantageous in many industries. However, patchouli alcohol (PA) content in patchouli oil is still low. The higher PA content determines the better quality of patchouli oil. So, delignification with Trichoderma viride was carried out to increase PA and yield of patchouli oil. The duration of delignification patchouli leaves is one factor affecting the increase in PA and yield. This study aimed to determine the effect of delignification duration on PA content and yield. The research method was completely randomized with 8 treatments (a combination of 2 treatments: with and without delignification, and 4 delignification durations: 0, 3, 6, and 9 days). The inoculum used for delignification was an inoculum ball, and then patchouli leaf samples were extracted using microwave-assisted extraction (MAE). Gas chromatography was carried out for PA analysis. Delignification of patchouli leaves, with a delignification time of 9 days, showed high PA and yield, which were (0.3129 ± 0.1557)% and (1.4543 ± 0.7717)%, respectively. The success of delignification at 9 days was also shown by increased phenolic content. Trichoderma viride is often utilized in delignification process, but the optimal duration of its delignification of Aceh patchouli leaves that can help improve patchouli oil quality is not yet known. This research is hoped to help related industries improve the secondary metabolites of plants, which has many benefits for the community. Implication/benefit for science development/society.
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    The Research Landscape and Emerging Trends in Technical and Vocational Education and Training for Sustainability (1998-2023)
    (2024-01-01) Narong D.K.; Narong D.K.; Mahidol University
    Research on sustainability within technical and vocational education and training has grown in recent years, yet a comprehensive review of the literature remains lacking. This systematic review fills this gap by using bibliometric methods to analyze 170 Scopus-indexed documents, establishing empirical benchmarks and revealing insights into the field's growth and thematic development. The findings suggest that this area is still significantly underexplored and would benefit from enhanced international collaboration. This study highlights key scholars and influential publications that serve as foundational resources to support future research and practical applications. Major areas of scholarly interest include engineering and teacher education, along with the integration of economic and environmental sustainability dimensions. Emerging research fronts suggest a growing intersection between technological advancements and sustainability in this field. Additionally, trends show an increasing diversity in educational disciplines and research methodologies, inspiring new research directions and providing valuable perspectives for those aiming to position their work within the broader dialogue on sustainable education.
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    Puen-Paeng Phordeekhum: The Adaptation of Jacob’s Short Story to the Television Series
    (2024-08-30) Klaewkasikam Y.; Naknuan N.; Klaewkasikam Y.; Mahidol University
    Objectives: This article points to the adaptation of Jacob’ s short story to Puen-Paeng, the television series of Phordeekhum. Methods: This study examines Jacob's Puen-Paeng from 1933 and the Puen-Paeng Phordeekhum television series from 2015 using narratology, along with literature and adaptation studies, as the conceptual framework. Results: The study found that the television series expanded both the plot and character dimensions. It revealed adaptation procedures in the digital era through transtextuality, notably by creating intertext with other texts, both internal and external, and by using paratext to attract attention and enhance viewing. The adaptation of Puen-Paeng Phordeekhum integrates Jacob’ s short story while also incorporating intertextual elements in line with digital television production, where content, form, and media converge. Application of this study: This study provides a framework for the study of the adaptation of literature to television series.
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    Psychological Distress among Breast Cancer Survivor and Their Spousal Caregiver
    (2024-12-19) Sharma A.; Sriyuktasuth A.; Phligbua W.; Vongsirimas N.; Sharma A.; Mahidol University
    BACKGROUND: Cancer journey increases the risk for anxiety and depression not only for the breast cancer survivor but also for the spousal caregiver. The purpose of this study was to determine the relationship between psychological distress among breast cancer survivors and their spousal caregivers. METHODS: This study used a cross-sectional design where the baseline data on anxiety and depression of breast cancer survivors and their spousal caregivers (dyads) collected for Randomized Controlled Trial were analyzed. Hospital Anxiety and Depression Scale was used to collect data from 64 breast dyads during June to July 2022. RESULTS: Among breast cancer survivors 37.6% had moderate to severe anxiety while 15.6% of spouses had moderate anxiety. Among breast cancer survivors 35.9% had mild, 15.6% had moderate and 4.5% had severe depression level. Among spouses 18.8% had mild and 7.8% had moderate depression level. The anxiety and depression of dyads were positively correlated. There has been significant direct effect of anxiety of survivor on depression of survivors. Moreover, there is significant direct effect of spouse' anxiety and survivor's depression on spouse's depression while survivor's anxiety has significant indirect effect on spouse's depression. CONCLUSIONS: There has been significant influence of spouse's anxiety, survivors' anxiety and depression on the depression level of the spouse. Thus, early dyadic stress management interventions are warranted.
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    Reliability, validity, and minimal clinically important differences for the Thai-version of the Aberdeen Varicose Vein Questionnaire (AVVQ-Thai) in patients with chronic venous disease
    (2024-01-01) Siribumrungwong B.; Noorit P.; Reanpang T.; Pornwaragorn C.; Wilasrusmee C.; Wongsuwanich S.; Srikuea K.; Orrapin S.; Benyakorn T.; Garratt A.M.; Rerkaserm K.; Siribumrungwong B.; Mahidol University
    Background: Patient-reported outcome measures (PROMs) are essential for assessing the health of patients with chronic venous disease (CVD). Therefore, we aimed to translate the Aberdeen Varicose Vein Questionnaire into Thai language (AVVQ-Thai) and evaluate its reliability and validity. Minimal clinically important differences (MCID) of the AVVQ-Thai also be estimated. Methods: International standards for PROM translation were followed including the forward-backwards translation of the AVVQ. Patients with Clinical-Etiology-Anatomy-Pathophysiology (CEAP) C2-C6 with truncal reflux were prospectively included. Venous interventions were used to treat reflux and varicosities. Patients' characteristics, venous clinical severity scores (VCSS), EuroQol EQ-5D, and AVVQ-Thai were collected pre- and one-month post-intervention. AVVQ-Thai was also collected one to two weeks after the initial visit by reply-paid postal questionnaire. Results: The study included 119 patients (30% C2, 29% C3, 28% C4, 11% C5, and 2% C6). The AVVQ-Thai had good internal consistency with Cronbach's alpha of 0.783 and moderate reliability with the intraclass correlation coefficient of 0.67 (95%CI: 0.50, 0.79). The AVVQ-Thai was significantly correlated with VCSS and was able to discriminate patients with different levels of health problems as assessed by EQ-5D at both pre-and post-intervention, demonstrating good construct and discriminative validity. The median AVVQ scores improved significantly after intervention from 15.4 (IQR 8.3, 24.2) to 4.2 (IQR 1.3, 8.4) in C2-C3, and 18.9 (IQR 14.1, 25.5) to 7.3 (IQR 4.6, 16.3) in C4-C6. The MCID of the AVVQ was 6.21 on the 0-100 scale, which equates to the level of difference necessary to be clinically meaningful. Conclusions: AVVQ-Thai has satisfactory evidence for internal consistency, reliability, validity, and responsiveness to change and is recommended for application in Thailand.
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    The association between surgical margins and local recurrence in women with ductal carcinoma in situ treated with breast conserving therapy: Observational study
    (2024-01-01) Naowaset P.; Naowaset P.; Mahidol University
    Introduction: The incidence of DCIS (DCIS) constitutes 25 % of the newly identified breast cancers. Approximately 35 % of DCIS cases are detected in asymptomatic women during routine mammography screening. The 20-year breast-cancer-specific mortality rate was 3.3 %. Breast-conserving surgery(BCS), followed by radiotherapy, is the treatment of choice. However, an adequate margin for BCS remains unclear. Therefore, we need to investigate the relationship between the margin distance and cancer recurrence. Methods: A total of 4,355 patients with DCIS were assessed between January 1, 2010, and January 31, 2020. Of these, 4,123 patients who had invasive ductal carcinoma co-existing DCIS and who were treated with mastectomy were excluded. Thus, 232 patients with pure DCIS treated with BCS were included. All distant radial margins were measured. Results: A total of 232 patients with DCIS underwent breast-conserving surgery, 169 patients received whole breast radiotherapy, and 63 did not. Most patients received hormone therapy, and as indicated, the median follow-up was 73 months. Recurrence was observed in seven patients. Among them, four had margins <2 mm, while the others had margins > 2 mm. There were no significant differences in disease-free survival (DFS) among the margin statuses. Conclusion: Margins wider than 2 mm did not demonstrate a reduction in local recurrence for women receiving adjuvant whole-breast radiation therapy, supporting the recommendation of a negative margin threshold for surgical management of DCIS.
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    Corrigendum: Superficial Inferior Epigastric Artery Flap: Vascular Pattern and Territory Across the Midline
    (2024-07-01) Lohasammakul S.; Tonaree W.; Suppasilp C.; Numwong T.; Ratanalekha R.; Han H.H.; Lohasammakul S.; Mahidol University
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    Development of a social learning theory-based pressure injury training program for nursing assistants in Chinese nursing homes
    (2024-01-01) Guo Y.; Yang S.; Boonyamalik P.; Powwattana A.; Zhu W.; Xu L.; Guo Y.; Mahidol University
    Introduction: Pressure injury (PI) is a significant concern in Chinese nursing homes, particularly in China, especially due to the rapidly aging population. Nursing assistants play a vital role in PI prevention and management but often lack adequate training. To address this gap, we developed a training program for nursing assistants based on Social Learning Theory (SLT), aimed at improving their competencies in PI prevention and management. The modified Delphi method was used to gather expert consensus on the program’s structure and content. Methods: A two-round Delphi process was performed involving an expert panel in wound care, community nursing, geriatric nursing, and nursing education. The training program was designed based on SLT, emphasizing observational learning, enactive learning, and behavioral reinforcement. Several experts evaluated the training program’s content, which was informed by systematic reviews and qualitative interviews with stakeholders. Data analysis included expert’s positive coefficient, expert’s authority coefficient (Cr), expert’s coordination coefficient (Kendall’s W), and coefficient of variation (CV) were used to reflect reliability and consensus. Results: Consensus was reached on 79 key indicators for the training program, which included 4 first-level indicators (training objectives, content, methods, and evaluation), 13 second-level indicators, and 62 third-level indicators. The expert authority coefficient was 0.93, and Kendall’s W values of 0.372 (p < 0.001) in the first round and 0.177 (p < 0.001) in the second round indicated strong agreement among experts. The program integrates SLT principles, such as attention, retention, motor reproduction, and motivation, to enhance the training’s effectiveness. Conclusion: The study developed a comprehensive SLT-based PI training program for nursing assistants in Chinese nursing homes using the modified Delphi method. The program addresses the critical need for competency-based training in PI prevention and management. Future research should focus on the implementation and evaluation of this program in real-world settings to determine its effectiveness in improving nursing assistants’ skills and reducing PI incidence among older adult residents.
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    Impact of the Power of Adaptive Weight on Penalized Logistic Regression: Application to Adipocytic Tumors Classification
    (2024-01-01) Sudjai N.; Duangsaphon M.; Chandhanayingyong C.; Sudjai N.; Mahidol University
    Introduction: MRI-based texture features in adipocytic tumors to serve as non-invasive predictive biomarkers that can provide precise outcomes for decision-making. Power of adaptive weight and the initial weight for the adaptive Lasso is one of the important parameters. This study aimed to compare the impact of the initial weight together with the power of adaptive weight for this adaptive Lasso under high-dimensional sparse data with multicollinearity. Methods: All independent variables in the Monte Carlo simulation were generated using the Toeplitz correlation structure. Performance of the initial weight together with the power of adaptive weight on penalized approaches was evaluated using the mean of the predicted mean squared error (MPMSE) for simulation study and the area under the receiver operator characteristic curve (AUC), precision, recall, F1-score, and the classification accuracy of models for real-data applications. Results: The simulation study showed that the smallest MPMSE value was obtained from the square root of the adaptive Lasso together with the initial weight using Lasso. Additionally, the results of this approach on the real-data application achieved high performance to distinguish the intramuscular lipomas from well-differentiated liposarcomas: the values of AUC, accuracy, precision, recall, and F1-score for the model based on penalized logistic regression classifier were 0.935, 0.928, 0.919, 0.921, and 0.925 respectively, and 0.946, 0.935, 0.932, 0.934, and 0.930 respectively for the model based on support vector machine classifier. Both the simulation study and the real-data application presented that the square root of the adaptive Lasso together with the initial weight using Lasso was the best option under high-dimensional sparse data with multicollinearity. Conclusion: Our finding showed that the power of adaptive weight on penalty function and the initial weight can affect certain the classification accuracy of machine-learning model. In practice, if choosing these parameters are appropriate, it produces models that have good performance.