- ItemGeneration of protoplasts provides a powerful experimental research tool for biological and pathogenicity studies of Pythium insidiosum(2023-11-01) Sae-Chew P.; Mahidol UniversityIntroduction: Pythiosis is a high-mortality infectious condition in humans and animals. The etiologic agent is Pythium insidiosum. Patients present with an ocular, vascular, cutaneous/subcutaneous, or gastrointestinal infection. Antifungal medication often fails to fight against P. insidiosum. The effective treatment is limited to radical surgery, resulting in organ loss. Fatal outcomes are observed in advanced cases. Pythiosis needs to be studied to discover novel methods for disease control. Genome data of P. insidiosum is publicly available. However, information on P. insidiosum biology and pathogenicity is still limited due to the lack of a cost-effective animal model and molecular tools. Materials and methods: We aimed to develop a high-efficiency protocol for generating P. insidiosum protoplast, and used it to set up an animal model, in vitro drug susceptibility assay, and DNA transformation for this pathogen. Results: P. insidiosum protoplast was successfully generated to establish a feasible pythiosis model in embryonic chicken eggs and an efficient in vitro drug susceptibility assay. DNA transformation is a critical method for gene manipulation necessary for functional genetic studies in pathogens. Attempts to establish a DNA transformation method for P. insidiosum using protoplast were partly successful. Significant work needs to be done for genetically engineering a more robust selection marker to generate stable transformants at increased efficiency. Conclusion: This study is the first to report an efficient P. insidiosum protoplast production for clinical and research applications. Such advances are crucial to speeding up the pathogen's biology and pathogenicity exploration.
- ItemEffects of mobility dose on discharge disposition in critically ill stroke patients(2023-01-01) Mazwi N.; Mahidol UniversityBackground: Mobilization in the intensive care unit (ICU) has the potential to improve patient outcomes following acute stroke. The optimal duration and intensity of mobilization for patients with hemorrhagic or ischemic stroke in the ICU remain unclear. Objective: To assess the effect of mobilization dose in the ICU on adverse discharge disposition in patients after stroke. Design: This is an international, prospective, observational cohort study of critically ill stroke patients (November 2017–September 2019). Duration and intensity of mobilization was quantified daily by the mobilization quantification score (MQS). Setting: Patients requiring ICU-level care were enrolled within 48 hours of admission at four separate academic medical centers (two in Europe, two in the United States). Participants: Participants included individuals (>18 years old) admitted to an ICU within 48 hours of ischemic or hemorrhagic stroke onset who were functionally independent at baseline. Interventions: Not applicable. Main Outcome Measure: The primary outcome was adverse discharge disposition. Results: Of the patients screened, 163 were eligible for inclusion in the study. One patient was subsequently excluded due to insufficient data collection (n = 162). The dose of mobilization varied greatly between centers and patients, which could not be explained by patients' comorbidities or disease severity. High dose of mobilization (mean MQS > 7.3) was associated with a lower likelihood of adverse discharge (adjusted odds ratio, [aOR]: 0.14; 95% confidence interval [CI]: 0.06–0.31; p <.01). Conclusion: The increased use of mobilization acutely in the ICU setting may improve patient outcomes.
- ItemHuman gnathostomiasis: A review on the biology of the parasite with special reference on the current therapeutic management(2023-12-01) Nogrado K.; Mahidol UniversityGnathostoma is a parasitic nematode that can infect a wide range of animal species, but human populations have become accidental hosts because of their habit of eating raw or undercooked meat from a wide variety of intermediate hosts. While gnathostomiasis is considered an endemic disease, cases of human gnathostomiasis have been increasing over time, most notably in nonendemic areas. There are several complexities to this parasitic disease, and this review provides an update on human gnathostomiasis, including the life cycle, diagnosis, treatment, and treatment strategies used to combat drug resistance. Even now, a definitive diagnosis of gnathostomiasis is still challenging because it is difficult to isolate larvae for parasitological confirmation. Another reason is the varying clinical symptoms recorded in reported cases. Clinical cases can be confirmed by immunodiagnosis. For Gnathosotoma spinigerum, the detection of IgG against a specific antigenic band with a molecular weight of 24 kDa from G. spinigerum advanced third-stage larvae (aL3), while for other species of Gnathostoma including G. binucleatum, the 33-kDa antigen protein is being used. This review also discusses cases of recurrence of gnathostomiasis and resistance mechanisms to two effective chemotherapeutics (albendazole and ivermectin) used against gnathostomiasis. This is significant, especially when planning strategies to combat anthelmintic resistance. Lastly, while no new chemotherapeutics against gnathostomiasis have been made available, we describe the management of recurrent gnathostomiasis using albendazole and ivermectin combinations or extensions of drug treatment plans.
- ItemEngagement in Online Learning Among Thai and German students: The role of Classmates, Instructors, and Technology across Country Contexts(2023-09-01) Grothaus C.; Mahidol UniversitySince the outbreak of COVID-19, an increasing number of educators around the world have been challenged to support student engagement in online environments. However, there is a lack of research in online learning that considers the role of the country context. This study explores student engagement in online learning, comparing the experiences of 9 German and 11 Thai students with help of in-depth interviews. Findings reveal differences in affective, behavioral, and cognitive engagement across groups. Only German students referred to a lack of affective engagement due to ineffective communication with peers and lecturers, tools used, and privacy concerns. The learning environment influenced affective and cognitive engagement differently. German students felt exhausted because of increased self-study time and lack of guidance. Thai students spent more time studying via videoconferences due to institutional policies. They highlighted a lack of focus due to distraction by digital technologies as well as family members, which they associated with Thai cultural norms to spend time with family. Behavioral engagement, particularly verbal participation during videoconferences, was negatively affected among Thai students. They worried about the effect voicing behavior could have on classmates’ feelings, which they attributed to cultural values of being considerate and the need for social harmony. These and other findings are discussed considering the possible role of national, local, and cybercultures as well as institutional contexts.
- ItemPhysicochemical and in vitro investigation of trace element-incorporated hydroxyapatite and starPCL@chitosan composite scaffold for bone tissue engineering(2023-12-01) Tithito T.; Mahidol UniversityOrganic-inorganic composite scaffolds are of interest for bone tissue engineering and post injury-bone regeneration. In the present study, aimed to investigate the suitability of the trace element-incorporated hydroxyapatite (THA) integrated bioactive gel (BioGel) (star-shaped polycaprolactone (starPCL)/Chitosan (Chit)) (THAiBioGel) composite scaffold which was fabricated using melt/solution blending method as a bone scaffold. The results revealed that the as-prepared THAiBioGel demonstrated that THA was successfully incorporated into BioGel and yield a desirable porous structure with mechanical strength of 10.35 ± 0.27 MPa, 13.62 ± 0.32 MPa and 18.30 ± 0.54 MPa for weight ratio of THA:BioGel 5:5, 7:3 and 9:1, respectively. Furthermore, the in vitro biological assay confirmed that the present material was not only good for osteoblast-like UMR-106 cell attachment on its surface, but also significantly promoted bone formation as demonstrated by an increase in alkaline phosphatase (ALP) activity. Our data, therefore, strongly suggested that THAiBioGel could be used as scaffold for bone tissue engineering.
- ItemCurcuminoid extraction from rhizomes of Curcuma longa via aqueous two phases system(2023-01-01) Kasemwattanarot P.; Mahidol UniversityThe extraction of curcuminoids [curcumin (C21H20O6, CUR), demethoxycurcumin (C20H18O5, DMC), and bisdemethoxycurcumin (C19H16O4, BDMC)] from Curcuma longa rhizomes was investigated using an aqueous two-phase system (ATPS) with ethanol/salt. The optimized conditions for the extraction process were determined by a central composite design to be an ethanol concentration of 13.6%, an ammonium sulfate concentration of 33.2%, and a temperature of 66.8 °C. Under these conditions, the highest yield of 97.9% was achieved, accompanied by a notable antioxidant activity of 84.38%. The experimental data exhibited good agreement with a second-order kinetic model, as confirmed by the evaluation of the coefficient of determination (R 2), normalized standard deviation, and average relative error.
- ItemInclusive Education for Students with Visual Impairments in Lao People’s Democratic Republic: a Qualitative Study(2023-09-02) Lee Y.; Mahidol UniversityPurpose: This study aimed to explore the perspectives of teachers, students and parents on practices used in inclusive education (IE) settings for students with visual impairments. Their perspectives were then used to create a proposed suitable inclusive education model for these students in the Lao People’s Democratic Republic (Lao PDR). Method: A qualitative study was designed. The 20 participants included teachers, parents and students with visual impairments. Data was collected through focus groups, in-depth interviews, and non-participatory observations. Results: It was found that inclusive education has been prioritised in Lao PDR. However, special schools or centres are still needed to teach students Braille and enable them to complete grades 1 and 2 before entering inclusive primary schools in the neighbourhood. Conclusion: An inclusive education policy exists, but guidelines for implementation are missing, and coordination and cooperation among stakeholders is poor. The inclusive education model proposed by the study consists of clear policy.
- ItemImplementation and evaluation of recovery-oriented practice interventions for people with mental illness in Asia: An integrative review(2023-11-01) Khanthavudh C.; Mahidol UniversityBackground: Recovery is a process involving empowering individuals to take control of their lives and develop meaningful and purposeful life, regardless of whether their mental health symptoms persist. Recovery-oriented practice has been widely implemented, particularly in Anglophone countries, during the past two decades. Mental health recovery in Asia is also moving towards recovery-oriented practice. Little is known about how recovery-oriented interventions originating in the West have been implemented and evaluated in Asian contexts. Objective: This review aimed to identify 1) types of recovery-oriented practice interventions that have been implemented in Asia, 2) how they have been culturally adapted, 3) barriers and facilitators to implementation, and 4) how the interventions have been evaluated. Design: This is an integrative review. Methods: This integrative review followed Whittemore and Knafl's five-stage framework. Six electronic databases (e.g., PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library) were systematically searched from their inception to January 2022 to identify eligible studies published in English language. The key search terms included “mental illness”, “recovery-oriented intervention”, and “Asia”. Studies reporting on implementation and evaluation of recovery-focused interventions in Asian settings were eligible. Quality assessment and narrative synthesis were subsequently undertaken. Results: Thirty-eight studies were included. Seven main types of recovery-oriented intervention were identified: (1) peer programmes; (2) illness management and recovery; (3) individual placement and support; (4) strength model case management; (5) clubhouse model; (6) wellness recovery action plan and (7) psychiatric advance directive, alongside several novel recovery programmes. Studies reported cultural adaptations for language, content, cultural norms, religious beliefs, family, and local context. Barriers to implementation included a poor understanding of recovery concepts and inadequate organisational resources. A range of clinical and personal recovery outcome measures were reported. Conclusions: Recovery-oriented interventions are increasing in Asia, with nearly half of reviewed studies featuring cultural adaptations. However, research is geographically skewed, and more rigorously conducted studies are needed across a wider range of Asian countries. Registration: This review was registered with the PROSPERO International prospective register of systematic reviews (CRD42022310049). Tweetable abstract: Recovery-oriented practice interventions for people with mental illness are on the rise in Asia @chonmananNN.
- ItemEffect of Crocodile Oil (Crocodylus siamensis) on Brain Mitochondrial Protein Expression and Cognition in Male Rats(2023-06-01) Srisuksai K.; Mahidol UniversityCrocodile oil (CO) is rich in polyunsaturated (PUFAs) fatty acids. Diets rich in PUFAs can maintain mitochondrial function, which is important in signal transduction and survival of neuronal cells. We investigated the effects of CO on brain mitochondrial protein expression and cognitive function in male rats. Twenty-one rats were randomly divided into three groups: (1) control, (2) treated with CO (3 mL/kg), and (3) treated with palm oil (PO; 3 mL/kg). Animals received oral gavage once-daily for seven weeks. The parameters that were measured were food intake, energy intake, body weight, serum lipid profiles, cognitive behavior, brain mitochondrial architecture, brain mitochondrial expression, and hippocampal structure. In CO and PO groups, food intake decreased significantly compared with that in the control group (p<0.05), but energy intake, body weight, and lipid profiles were not affected. Spatial learning in the PO group decreased significantly compared with that in control and CO groups (p<0.05). Crocodile oil significantly decreased the percentage of abnormal mitochondria (p<0.05) and the expression of apoptotic marker (p<0.05) compared with those in the PO treatment but also increased energy production marker (p<0.05) compared with those in the control and PO treatment. Moreover, percentage of intact hippocampal cells was not different between CO and control groups, but neuronal cells were lost in the PO group (p<0.05). This study suggest that CO could enhance the brain energy production and maintain cognitive function. CO can be an alternative dietary oil for treating brain energy disorder in the future.
- ItemAssessing Tongue Strength and Swallowing Function Following Hyoid Bone Resection Surgery(2023-01-01) Sanguanchom M.; Mahidol UniversityPurpose: The tongue and hyoid bone are responsible for the oral phase of swallowing. The purpose of this study was to assess tongue strength and endurance, and to evaluate swallowing functions in patients who underwent hyoid bone resection surgery. Material and Methods: This was an experimental, non-randomized trial. It included participants who underwent hyoid bone resection surgery, divided into 2 groups; post-Sistrunk procedure and post-total laryngectomy. Swallowing problem history was recorded, and tongue strength and endurance were measured using the Iowa Oral Performance Instrument (IOPI). Post-Sistrunk procedure participants also underwent flexible endoscopic evaluation of swallowing (FEES) to assess objective swallowing function. Descriptive and bivariate statistics were used to analyze the association between the tongue strength and endurance, and the type of surgeries. Results: The study involved 26 participants, including 16 males and 10 females, with a mean age of 58.4 ± 12.8 years. A total of 10 subjects underwent the Sistrunk procedure and 16 underwent total laryngectomy surgery. The average tongue strength of all participants was 40.8 ± 11.7 kPa and the average tongue endurance was 30.6 ± 13.2 s. The difference in average tongue strength between the post-Sistrunk procedure group and post-total laryngectomy group was not significantly different (37.5 ± 11.6 kPa vs. 44.1 ± 11.3kPa, P =.153). However, there was a statistically significant difference in average tongue strength between male and female participants (46.3 ± 10.0 kPa vs. 32.0 ± 8.5 kPa, P =.001). FEES did not reveal any evidence of objective swallowing abnormalities in the post-Sistrunk group. Conclusion: The resection of the hyoid bone, whether partial or total, did not significantly affect tongue strength and swallowing functions.