Scopus 2026
Permanent URI for this collectionhttps://repository.li.mahidol.ac.th/handle/123456789/113786
Browse
Recent Submissions
Item Metadata only Beyond One-Size-Fits-All: Precision Mechanical Ventilation in ARDS(2026-03-01) Azzam S.; Khattab K.; Al Sharie S.; Al-Husinat L.; Silva P.L.; Battaglini D.; Schultz M.J.; Rocco P.R.M.; Azzam S.; Mahidol UniversityAcute respiratory distress syndrome (ARDS) has traditionally been managed with population-based, protocolized mechanical ventilation strategies designed to limit ventilator-induced lung injury. While these approaches have improved outcomes, they fail to account for the pronounced biological, mechanical, radiological, and temporal heterogeneity that characterizes ARDS. Accumulating evidence shows that patients differ markedly in functional lung size, recruitability, chest wall mechanics, inflammatory burden, and tolerance to ventilatory stress, making uniform ventilatory targets physiologically imprecise and, at times, harmful. This narrative review examines the evolution from conventional lung-protective ventilation toward a precision-based paradigm that aligns ventilatory support with individual patient physiology. We conceptualize ARDS not as a static syndrome but as a dynamic spectrum, viewing the injured lung as a heterogeneous mechanical system susceptible to regionally amplified stress and strain. Within this framework, we discuss key principles underlying precision ventilation, including functional lung size (the “baby lung”), driving pressure, mechanical power, patient–ventilator interaction, spontaneous breathing-associated injury, and the time-dependent evolution of lung mechanics. We synthesize current evidence supporting mechanical, biological, and radiological subphenotyping as complementary strategies to individualize ventilatory management, while critically appraising their current limitations. This review also evaluates bedside tools that may operationalize precision ventilation in clinical practice, including esophageal pressure monitoring, lung ultrasound, and electrical impedance tomography, and examines the role of artificial intelligence as a clinician-directed decision-support aid rather than a prescriptive substitute for physiological reasoning. Implications for clinical trial design, ethical considerations, and future directions toward predictive and adaptive ventilation strategies are also addressed. Precision mechanical ventilation represents a shift from rigid thresholds toward proportional, physiology-guided intervention across the disease trajectory. By integrating evolving lung mechanics, ventilatory load, and patient effort over time, this approach provides a coherent framework for safer and more effective mechanical ventilation in ARDS while preserving the core principles of lung protection.Item Metadata only Quality Evaluation and Shelf-Life Prediction of a Mixed Mango and Passion Fruit Smoothie Under Dimethyl Dicarbonate Treatment and Packaging Interventions(2026-03-01) Jafari S.; Rungroj N.; Fikry M.; Umar M.; Shiekh K.A.; Kijpatanasilp I.; Chheng S.; Mishra D.K.; Assatarakul K.; Jafari S.; Mahidol UniversityThis study investigated shelf-life prediction of a cold-stored mixed mango–passion fruit smoothie (60:40) using kinetic modeling to compare the effects of dimethyl dicarbonate (DMDC, 250 ppm), pasteurization (90 °C for 100 s), and packaging type (glass vs. polyethylene terephthalate (PET)) during six weeks at 4 °C. Physicochemical parameters, functional properties (total phenolic content, total flavonoid content, and antioxidant activity by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and Ferric Reducing Antioxidant Power assay (FRAP), and microbial stability were monitored weekly. Zero- and first-order kinetic models were applied to describe quality changes, with the first-order model showing superior fit (average R2 = 0.936). pH remained relatively stable (p > 0.05), while total soluble solids (TSS) gradually declined in all treatments from approximately 16–17 °Brix to 13–14 °Brix by week 6. PET packaging resulted in a significantly higher total color difference (ΔE) than glass by the end of storage (p ≤ 0.05), particularly in DMDC-treated samples. Pasteurization reduced initial polyphenol oxidase (PPO) activity by 44–56% compared with untreated and DMDC-treated samples (p ≤ 0.05), whereas PET generally exhibited higher residual PPO activity than glass. DMDC treatment better preserved antioxidant capacity, phenolics, and flavonoids, with significantly higher DPPH and FRAP values than controls at week 6 (p ≤ 0.05). Microbiologically, DMDC effectively suppressed total viable counts (<5 log CFU/mL) and yeast and mold (<3 log CFU/mL), outperforming pasteurization. Shelf-life was estimated at 27–29 days for pasteurization and 41–42 days for DMDC (250 ppm), particularly when combined with glass packaging. Overall, the DMDC–glass combination demonstrated strong potential as a non-thermal preservation approach for fruit beverages.Item Metadata only Age-dependent changes in the transverse carpal ligament and median nerve: a cadaveric histological and biomechanical study(2026-02-24) Niyomchan A.; Siriphorn A.; Kathinted K.; Pamornpol B.; Niyomchan A.; Mahidol UniversityBackground: Age-related alterations in the transverse carpal ligament (TCL) and the median nerve are thought to increase susceptibility to carpal tunnel syndrome in older individuals. This study aimed to investigate the mechanical properties of the TCL and histological changes in both the TCL and the median nerve in cadavers across a wide age range. Methods: Fifty formalin-embalmed cadavers (40-93 years old) were studied, yielding 100 TCL specimens. A digital palpation device (MyotonPRO) was used in situ to measure TCL dynamic stiffness, elasticity (logarithmic decrement), mechanical stress relaxation time, and creep at proximal, middle, and distal regions. After testing, each TCL and corresponding median nerve were excised. Masson, s trichrome staining and scanning electron microscopy were performed to assess collagen fiber organization, fibroblast density, and nerve structure. Pearson, s correlation was used to determine associations between TCL properties and age. Results: An age-dependent increase in TCL stiffness was observed, alongside decreased elasticity, relaxation time, and creep. Histological analyses revealed reduced fibroblast density, disorganized collagen fibers with large clefts between bundles, and increased fine collagen meshwork in interfascicular matrix in older specimens. Furthermore, thinning of connective tissue layers surrounding the median nerve and diminished myelin sheaths were noted with advancing age. Conclusion: This cadaveric study reveals that the TCL stiffens and becomes structurally disorganized with advancing age, paralleled by degenerative changes in the median nerve. Such age-related alterations may predispose elderly individuals to a higher risk of carpal tunnel syndrome, underscoring the need for targeted preventive and therapeutic strategies.Item Metadata only Evaluation of an Electronic Nose Coupled with In Vitro Fecal Fermentation as a Screening Tool for Fecal Odor in Cats(2026-03-01) Jenjirawatn K.; Kovitvadhi A.; Chotchutima S.; Chundang P.; Areerat S.; Homyog K.; Akrimajirachoote N.; Jenjirawatn K.; Mahidol UniversityIn vitro fecal inoculation coupled with gas chromatography–mass spectrometry (GC-MS) has been used for evaluating fecal deodorants. However, high cost and complex data interpretation limit its routine application. An electronic nose (eNose) offers a rapid, cost-effective alternative. This study aimed to evaluate the eNose as a screening tool for fecal odor compared with solid-phase microextraction gas chromatography–mass spectrometry (SPME GC-MS) and to examine the in vitro effects of fecal deodorant supplements on fecal odor profiles. Feces from ten healthy cats were serially diluted (1:1 to 1:8) and analyzed using both instruments. Four dietary supplements—Yucca schidigera extract (YSE), Quillaja saponaria extract (QSE), fructooligosaccharides (FOS), and oat beta-glucans (OBG)—were tested at concentrations of 0.0, 0.2, 0.4, and 0.8 g/100 mL. The eNose showed comparable performance to GC-MS in discriminating among sample dilutions. In vitro fermentation showed that FOS and OBG significantly increased volatile fatty acid (VFA)-related sensor responses while signals linked to ammonia and sulfur compounds were reduced. QSE had minimal effect, whereas YSE produced moderate changes. The total sensor response intensities did not differ between treatments. These findings indicate that prebiotic supplements exert stronger effects than saponin-based supplements and highlight the potential of eNoses with in vitro fermentation for rapid screening of fecal deodorants.Item Metadata only Bat guano fertilizer as a source of Betacoronavirus: First molecular evidence linking Rhinolophus coelophyllus to viral reservoirs in Thailand(2026-03-01) Suwannasing R.; Kimprasit T.; Suwannasing R.; Mahidol UniversityCommercial bat guano fertilizers distributed in Thailand were screened for the presence of coronavirus genomes to assess potential public health risks. A total of 41 samples were analyzed for Alphacoronavirus (AlphaCoV) and Betacoronavirus (BetaCoV) using partial Spike (S) gene sequences. Two samples (4.88%) tested positive for AlphaCoV, showing 97.08–99.27% sequence similarity, while one sample (2.44%) was positive for BetaCoV with 98.91% similarity. Due to the greater relevance of BetaCoVs to human health, the BetaCoV-positive sample underwent host identification via partial cytochrome oxidase I (COI) gene analysis and next-generation sequencing. The results revealed Rhinolophus coelophyllus as the likely natural reservoir. This study provides the first evidence of bat-derived BetaCoV genome in a commercial fertilizer in Thailand and highlights the importance of monitoring wildlife-derived products for emerging zoonotic viruses.Item Metadata only Defining the Contribution of Genetic Variants in MRGPRX4 With Pruritus in Paediatric Cholestasis: Evidence From Case–Control Study(2026-04-01) Rodrigo M.; Chien D.C.C.; Kawamoto R.; Limjunyawong N.; Rajborirug S.; Dong X.; Karnsakul W.; Rodrigo M.; Mahidol UniversityBackground and Aims: Cholestatic pruritus is a debilitating symptom in paediatric liver disease with a complex and poorly understood pathogenesis. Recent evidence implicates the Mas-related G protein-coupled receptor X4 (MRGPRX4)—a bile acid receptor expressed in human dorsal root ganglia—as a potential mediator of itch signalling. Although MRGPRX4 harbours multiple single nucleotide variants (SNVs), their role in modulating cholestatic pruritus remains unexplored. Methods: We conducted a case–control study at a single paediatric tertiary care center, enrolling patients with Alagille syndrome, Progressive Familial Intrahepatic Cholestasis (PFIC), biliary atresia, and Primary Sclerosing Cholangitis (PSC). Cases were defined as individuals with a history of pruritus; controls had no reported pruritus. Clinical data included peak total and fractionated bile acid levels. Targeted sequencing of the MRGPRX4 coding region was performed to evaluate associations between SNVs and pruritus status. Results: Among 36 participants (17 cases, 19 controls), all harboured at least one coding-region SNV in MRGPRX4. Eleven unique SNVs were identified, with recurrent variants at positions p.Phe8Leu, p.Asn25Lys, p.Val47Val, p.Tyr54Cys, p.Ala182Val, and p.Tyr215Tyr. While no single SNV was significantly associated with pruritus overall, the co-occurring Phe8Leu, Asn25Lys, and Tyr215Tyr variants are less frequent in patients with pruritus, and a rare Lys11Glu variant was exclusively found in patients without pruritus. Conclusions: The functional significance of MRGPRX4 variants remains unknown. However, some of the variants, including Phe8Leu, Asn25Lys, and Lys11Glu, may alter receptor activity, potentially modulating susceptibility to cholestatic pruritus. Further studies with larger cohorts are warranted to elucidate the mechanistic and clinical relevance of these variants in cholestatic pruritus.Item Metadata only Structural analysis of the plant glycoside hydrolase family 116 glucosylceramidase AtGCD3 by cryogenic electron microscopy(2026-03-01) Choknud S.; Arthanareeswaran K.; Rungsarityotin W.; Beagbandee C.; Sanram S.; Kamonsutthipaijit N.; Mo-Mai P.; Lai R.Y.; Suginta W.; Wangkanont K.; Ounjai P.; Ketudat Cairns J.R.; Choknud S.; Mahidol UniversityGlucosylceramide (GlcCer) is a common glycosphingolipid that accumulates in cells in response to Gaucher disease, diabetes, and skin disorders in humans and is also found in plants. In animals, GlcCer is catabolized by glucosylcerebrosidase 1 and 2 (GBA1 and GBA2). GBA1 is a lysosomal enzyme in glycoside hydrolase (GH) family GH30, while GBA2 is a membrane-associated cytoplasmic protein in family GH116. Currently, there are no experimental structures of eukaryotic GH116 homologues. Although the bacterial TxGH116 β-glucosidase structure was determined by X-ray crystallography, TxGH116 does not hydrolyze glucosylceramides, unlike the animal and plant enzymes. Therefore, we have investigated the structure of plant GH116 (AtGCD3) by cryogenic electron microscopy (Cryo-EM) single-particle analysis. The recombinant AtGCD3 protein was produced in Escherichia coli and purified by immobilized-metal affinity chromatography followed by size-exclusion chromatography. The Cryo-EM structure revealed a unique hexameric arrangement, composed of a dimer of trimers. Hydrophobic interactions and hydrogen bonds stabilize each trimer at the trimer interface. The two trimers stack face-to-face with a slight twist, with salt bridges and hydrogen bonding at their interface. Two α-helices not found in previously described GH116 structures cover the active site, forming two hydrophobic channels that may be involved in glucosylceramide binding. Molecular dynamics simulations showed that glucosylceramide can bind stably in the active site with its lipid tails in these channels. This first eukaryotic structure of a GH116 enzyme generates a template for improved modeling of human GBA2, with implications for treating human diseases, such as Gaucher disease and hereditary spastic paraplegia.Item Metadata only Metabolomics Analysis Provides Insights into the Antibacterial Activity of Curcumin-Based Photodynamic Treatment Against Staphylococcus aureus(2026-03-01) Dai W.; Xu F.; Chen M.; Hu J.; Sriboonvorakul N.; Lin S.; Dai W.; Mahidol UniversityStaphylococcus aureus is a major foodborne pathogen that poses persistent challenges to food safety. Antimicrobial photodynamic treatment (PDT) has emerged as a promising non-thermal antimicrobial strategy capable of effectively inactivating S. aureus, though accumulating evidence suggests that the bacteria may initiate adaptive responses to the PDT or even develop tolerance. However, the metabolic mechanisms underlying bacterial responses to PDT exposure, particularly under sub-lethal conditions, remain poorly understood. Thus, in the current study, untargeted metabolomics based on liquid chromatography–tandem mass spectrometry (LC–MS/MS) and gas chromatography–mass spectrometry (GC–MS) were employed to characterize intracellular metabolic alterations in S. aureus following curcumin-mediated PDT (40 µM curcumin, 425 nm blue light at intensity of 0.198 J cm−2). The obtained results revealed a clear separation between the control and PDT-treated groups, indicating sub-lethal PDT induced pronounced metabolic perturbations while preserving partial cellular viability. A total of 97 significantly differential metabolites were identified, encompassing a range of key metabolites associated with amino acid biosynthesis, lipid metabolism, and nucleotide metabolism, indicating the PDT-induced metabolic alterations in pathways could be associated with stress adaptation, membrane integrity, and energy metabolism. Collectively, these findings demonstrate that PDT, even at sub-lethal doses, induces extensive metabolic dysregulation in S. aureus, which potentially represent critical bactericidal vulnerability points target by PDT, yet may paradoxically participate in adaptive metabolic responses that support bacterial survival under PDT exposure. Further investigations are therefore warranted to elucidate the relationships among PDT-induced metabolic perturbations, bacterial inactivation, and long-term phenotypic adaptation. Overall, this work may provide mechanistic insight into PDT-induced antimicrobial action and support further optimization of PDT as an effective non-thermal intervention for food safety and preservation.Item Metadata only Dual Targeting of FAP-Directed Nanoparticles and FRα-Specific CAR-T Cells Induces Additive Anti-Tumor Effects in Triple-Negative Breast Cancer(2026-01-01) Thongkleang T.; Thongchot S.; Rodponthukwaji K.; Luangwattananun P.; Tadpetch K.; Yenchitsomanus P.T.; Thuwajit P.; Punnakitikashem P.; Thuwajit C.; Thongkleang T.; Mahidol UniversityTriple-negative breast cancer (TNBC) is an aggressive malignancy with limited treatment options. It lacks hormone receptors and human epidermal growth factor receptor 2. The immunosuppressive tumor microenvironment (TME), particularly cancer-associated fibroblasts (CAFs), significantly hinders chimeric antigen receptor (CAR)-T cell therapy success. Novel strategies to overcome TME-mediated immunosuppression are urgently needed. We evaluated whether targeting CAFs with fibroblast activation protein alpha (FAP)-coated, 8-O-methylfusarubin-loaded nanoparticles called anti-FAP@OMF-NPs could enhance the anti-tumor efficacy of folate receptor alpha (FRα)-specific CAR-T cells against TNBC in a 3D cancer cells-CAFs co-culture heterospheriod (HS) model. FRα and FAP expression in TNBC cells and primary breast CAFs were assessed using immunofluorescence and flow cytometry. Anti-FRα-CAR-T cells were generated via lentiviral transduction and characterised for activation markers. Cytotoxic activity of CAR-T cells, anti-FAP@OMF-NPs, and their combination was evaluated in 3D-HS comprising FRα-high TNBC cells and FAP-high CAFs. A fluorescent transfection assay measured cell viability. Cytokine bead arrays quantified IFN-γ, granzyme A, and granzyme B levels to assess anti-tumor immune activation. PC-B-130CAFs and PC-B-132CAFs demonstrated high FAP expression compared with PC-B-004CAFs and normal human dermal fibroblast cells (HDFa). Anti-FRα-CAR-T cells selectively targeted FRα-positive TNBC cells whilst showing minimal cytotoxicity towards normal MCF-10A cells. Anti-FAP@OMF-NPs induced potent cytotoxic effects specifically in FAP-expressing CAFs. Combined treatment significantly enhanced the destruction of MDA-MB-231/130CAF and MDA-MB-231/132CAF HSs compared with monotherapies. This combination increased secretion of IFN-γ, granzyme A, and granzyme B from anti-FRα-CAR-T cells. Targeting CAFs using anti-FAP@OMF-NPs enhances the cytotoxic efficacy of FRα-specific CAR-T cells in TNBC. This combinatorial approach offers a promising strategy to overcome TME-mediated immunosuppression. These findings support further development of dual-targeting approaches to improve therapeutic outcomes in TNBC.Item Metadata only The Predictors of Liver Fluke Infection-Preventive Behaviors, Khon Kaen Province: A Structural Equation Model(2026-03-01) Rattaporn W.; Sillabutra J.; Kitidamrongsuk P.; Kamsa-ard S.; Satitvipawee P.; Rattaporn W.; Mahidol UniversityBackground: Liver fluke infection is a public health problem and the main cause of cholangiocarcinoma in northeastern Thailand, especially in Khon Kaen Province. This study aimed to determine the prevalence and predictors of liver fluke infection-preventive behaviors, using the Health Belief Model (HBM) and Structural Equation Modeling (SEM) among adults living in Khon Kaen Province. Methods: This analytical cross-sectional study utilized secondary data. A stratified cluster multi-stage sampling technique, proportional to size, was used to select a provincially representative sample of the Khon Kaen adult population. The participants responded via interview. HBM scale, demographic and environmental factors, knowledge, health behaviors, and information on preventive behaviors (avoidance of consuming various types of uncooked freshwater fish and five personal hygiene practices) were measured. The hypothesized causal path models were examined using SEM analysis. Results: Among the 980 adult participants, the prevalence of non-consumption of raw freshwater fish and the practice of good hygiene during the past month was 2.9% (95% CI: 2.0, 4.1). The final structural model demonstrated a good fit. The predictors explained 25.7% of the variance in preventive behaviors. The model indicated that the total effect of perceived susceptibility had the strongest correlation with liver fluke infection-preventive behaviors (β = 0.34, p < 0.001), followed by perceived severity (β = 0.31, p < 0.001), having a family member who did not consume raw fish (β = 0.27, p < 0.001), education (β = 0.14, p < 0.001), self-efficacy (β = 0.13, p < 0.001), perceived benefit (β = 0.13, p < 0.001), knowledge (β = 0.10, p < 0.001), non-smoking (β = 0.09, p < 0.05), age (β = -0.08, p < 0.05), cue to action (β = 0.06, p < 0.05), and perceived barriers (β = -0.05, p < 0.05). Conclusion: Our study showed that significant predictors of preventive behaviors included the HBM constructs, age, education, knowledge, non-smoking, and living with family members who do not consume raw fish. Public health campaigns should focus on strengthening HBM constructs and knowledge with particular attention to older adults, smokers, less-educated individuals, and households in which family members consume raw fish.Item Metadata only In Vitro Bioaccessibility of Selenium in Popular Thai Seafood Across Cooking Methods(2026-03-01) Rueangsri N.; Limpaninchart C.; Thanopajai N.; Judprasong K.; Sridonpai P.; Laitip N.; Ornthai N.; Feldmann J.; Singhato A.; Rueangsri N.; Mahidol UniversitySelenium (Se) is a vital element for human health and seafood represents one of its major dietary sources. Nevertheless, information regarding the bioaccessibility of Se from seafood commonly consumed in Thailand remains scarce. To address this limitation, the present study evaluated in vitro Se bioaccessibility using the equilibrium dialyzability approach. Ten seafood species frequently selected by Thai consumers were investigated to determine total Se concentrations following different culinary treatments, namely fresh, boiling, frying, and grilling. For thermally processed samples, gastrointestinal digestion was simulated in vitro through enzymatic digestion prior to bioaccessibility assessment using the equilibrium dialyzability method. Inductively coupled plasma triple quadrupole mass spectrometry (ICP-QQQ-MS) was used to precisely quantify the total and dialyzable Se fractions. The effects of seafood species and cooking methods were evaluated statistically using two-way analysis of variance and the Tukey’s honestly significant difference (HSD) test for post hoc comparisons. The findings showed that, across the majority of cooking techniques, Indo-Pacific horseshoe crab eggs consistently showed considerably greater Se contents than other seafood (p < 0.05). Moreover, Se bioaccessibility in Indo-Pacific horseshoe crab eggs (81.1–88.3%) was markedly greater than that observed in other seafood items, including musk crab, blue crab, oysters, and wedge shell, regardless of cooking method (p < 0.05). No statistically significant differences in Se bioaccessibility were observed among boiling, frying, and grilling (p > 0.05), indicating that thermal processing did not adversely affect Se availability. Overall, the seafood species examined in this study, irrespective of preparation method, contained substantial Se levels with high bioaccessibility, underscoring their nutritional value and supporting dietary recommendations that promote balanced consumption of marine foods.Item Metadata only Factors influencing methamphetamine use among Lahu hill tribe youth in Chiang Rai, Thailand: A case‒control study(2026-03-01) Thinpanyawong P.; Apidechkul T.; Peltzer K.; Wongnuch P.; Thinpanyawong P.; Mahidol UniversityBackground Methamphetamine (MA) use presents a significant public health issue that strongly affects human health and social security. Marginalized populations, including youth from the Lahu tribe, which represents the second-largest hill tribe living in the remote border areas of northern Thailand, are among the most vulnerable to MA use. This study aimed to determine the factors associated with MA use among Lahu youths aged 15–24 years who lived in Chiang Rai Province, Thailand. Methods A case‒control study was conducted to determine the factors associated with MA use among Lahu youths aged 15–24 years. The Lahu youths who used MA were considered cases of MA use, and those who never used MA were considered controls. The participants were randomly recruited from Mae Suai, Mae Chan, Mae Fah Luang, and Muang Districts, Chiang Rai Province, Thailand, the areas of Thailand most commonly populated by the Lahu people. A validated questionnaire was used to collect data, and multiple logistic regression was used to detect association factors with a statistical significance set at α = 0.05. Results A total of 136 cases and 272 controls were included in the study. The majority of the participants were male (79.4%), 77.9% held a Thai national identification card, and 24.0% had completed primary school. After controlling for age, those females were 5.29-fold (95% CI = 2.02–13.89) more likely to use MA than males. Those with easy-to-access MA had a 2.28-fold (95% CI = 1.14–4.54) higher likelihood of MA use than those who had difficulty accessing. Those who had no schooling had a 4.29-fold (95% CI = 1.17–15.73) higher likelihood of MA use than those who had vocational and university education. Those who were unemployed had a 3.92-fold (95% CI = 1.14–13.37) higher likelihood of MA than those who were students. Those who smoked or had ever smoked had a 29.08-fold (95% CI = 11.57–73.12) greater likelihood of MA use than those who never smoked. Those who drank alcohol had a 2.53-fold (95% CI = 1.05–6.11) higher likelihood of MA use than those who did not. Those who had high knowledge scores of MA prevention and control would be more likely to use MA than those who had lower scores (AOR = 1.29; 95% CI = 1.11–1.50). Conclusions An effective intervention and policy that focuses on females with low levels of education, unemployed, and having a history of substance use should be urgently developed and implemented to reduce MA use among Lahu youths.Item Metadata only Physical Health and Cognitive Outcomes in Elderly School Members: Insights from a Cross-Sectional Study(2026-03-05) Pakulanon S.; Petviset H.; Yingyongsaksri S.; Pakulanon S.; Mahidol UniversityObjective: This descriptive cross-sectional study aimed to investigate the characteristics of physical fitness, physical activity, depression, and cognitive function among members of elderly schools. Material and Methods: 216 participants provided information on their health status, including age, sex, and educational level. Thai Geriatric Depression Scale-15 was employed to assess depression. The Montreal Cognitive Assessment Thai (MoCA-T) version was used to assess cognitive impairment. Height and body mass were measured using standard anthropometric techniques, and body mass index (BMI) was calculated. The Senior Fitness Test was utilized to assess physical fitness. Results: Most participants demonstrated normal BMI, had low levels of formal education, and exhibited high rates of hypertension, while smoking and alcohol use were uncommon. Despite reporting high levels of physical activity and performing within the normal range on fitness tests, 83.3% showed delayed times on the 8-foot Up-and-Go test. MoCA-T results indicated that most participants had mild to moderate cognitive impairment (44.4% and 42.6%, respectively), and 91.7% reported no depressive symptoms. Conclusion: This study highlights a paradox between high physical activity and a high prevalence of cognitive impairment, suggesting that education and chronic health conditions may play a role in cognitive outcomes. However, the use of a convenience sample, descriptive design, and lack of inferential analysis limit generalizability and causal interpretation. Future research should use representative samples, longitudinal designs, and multi-site to clarify causal pathways and enhance the generalizability of findings to diverse older adult populations.Item Metadata only Enhanced Recovery After Surgery Versus Conventional Care in Simultaneous Colorectal Resection and Hepatectomy for Synchronous Colorectal Liver Metastases(2026-01-01) Lohsiriwat V.; Kaenla E.; Ovartchaiyapong P.; Lohsiriwat V.; Mahidol UniversityBackground: Evidence regarding the feasibility and outcomes of enhanced recovery after surgery (ERAS) programs in patients undergoing simultaneous colorectal resection and hepatectomy remains limited. This study aimed to evaluate the impact of ERAS implementation on perioperative and oncologic outcomes in patients undergoing simultaneous colorectal resection and hepatectomy for synchronous colorectal liver metastases. Methods: A single-center retrospective cohort study was conducted involving 100 consecutive patients who underwent elective simultaneous colorectal resection and hepatectomy before (n = 50) and after (n = 50) ERAS implementation. Outcomes included postoperative complications, length of stay, hospital cost, disease-free survival, and overall survival. Results: The mean age was 63 years, and 55% were male. Rectal cancer was the primary tumor in 38 patients, and 18 patients required major hepatectomy. Baseline characteristics and operative details were comparable between the ERAS and conventional care groups. ERAS implementation significantly reduced postoperative complications (22% vs. 42% and p = 0.032) and time to tolerate a solid diet (3 vs. 5 days and p = 0.001). Median postoperative length of stay was shorter in the ERAS group (6 days [IQR 5–9] vs. 8 days [IQR 6–16] and p = 0.005). Average hospital cost was slightly lower with ERAS (4815 USD vs. 5298 USD and p = 0.446). Five-year overall and disease-free survival rates were similar between groups (86.7% vs. 88.9%; p = 0.583 and 44.4% vs. 48.9%; p = 0.724, respectively). Conclusions: ERAS implementation in simultaneous colorectal resection and hepatectomy resulted in shorter hospitalization, faster bowel recovery, and a modest reduction in cost, while maintaining comparable long-term oncologic outcomes.Item Metadata only A HYBRID ANALYTICAL TECHNIQUE FOR TIME-FRACTIONAL MODELING OF COMPUTER VIRUS PROPAGATION(2026-04-01) Dunnimit P.; Sawangtong W.; Sawangtong P.; Dunnimit P.; Mahidol UniversityThe study of epidemic dynamics of computer viruses is an evolving discipline focused on studying the propagation of computer viruses across networks. This work aims to develop a series of epidemic models for computer viruses utilizing the Katugampola fractional derivative. This study aims to resolve the time-fractional computer virus propagation model using a hybrid approach that integrates the residual power series method with the generalized Laplace transform. In addition, an example demonstrates the fractional order α and the parameter ρ influence the dynamic behavior of the computer virus propagation model.Item Metadata only Smartphone-Based Ecological Momentary Assessment of Pain in Older Adults Undergoing Auricular Point Acupressure for Chronic Low Back Pain: Secondary Analysis of a Randomized Controlled Trial(2026-01-01) Lukkahatai N.; Benjasirisan C.; Huang X.; Wu H.; Kawi J.; Zhang J.; Campbell C.M.; Johnson C.M.; Christo P.J.; Thrul J.; Lukkahatai N.; Mahidol UniversityBackground: Chronic low back pain (cLBP) is a prevalent and disabling condition in older adults. Auricular point acupressure (APA), a nonpharmacologic intervention, has shown promise in managing cLBP. However, its impact on daily symptom fluctuations remains unclear. Ecological momentary assessment (EMA), which collects real-time data, offers a method to capture these fluctuations. Objective: This secondary analysis evaluated the effects of APA on EMA-reported pain intensity and pain interference among older adults with cLBP and examined associations among APA practice patterns, recall-based assessments, and EMA engagement. Methods: Data were drawn from a published 3-arm randomized controlled trial of 272 adults aged ≥60 years with cLBP, randomized to targeted auricular point acupressure (T-APA), nontargeted auricular point acupressure (NT-APA), or education control. For this analysis, only participants who completed at least one EMA entry during the 4-week intervention were included. A total of 61 participants were excluded due to missing EMA data, resulting in a final analytic sample of 211 (T-APA: 72; NT-APA: 74; and control: 65). EMA-reported pain intensity and interference were collected using a smartphone app 3 times daily over 29 days. Linear mixed-effects models assessed the effects of group assignment and APA practice behaviors on EMA outcomes, adjusting for demographics, smoking, opioid use, and baseline recall-based pain. Spearman correlations assessed associations between EMA and 7-day recall measures. Results: The overall compliance rate was 44.8%, with an attrition rate of 54%. There were no significant differences in compliance or attrition across treatment groups. Older participants showed significantly lower compliance, though attrition was not associated with age. Pain intensity reported via EMA was significantly lower than recall-based pain, while EMA-reported pain interference was higher. EMA and 7-day recall pain outcomes were strongly correlated (Spearman =0.53–0.95; P<.001). Both T-APA and NT-APA, analyzed as separate randomized groups, significantly reduced EMA-reported pain and interference compared to the control. T-APA reduced worst pain (β=–0.98, SE 0.33; P<.001), average pain (β=–0.93, SE 0.30; P<.001), and current pain (β=–1.01, SE 0.36; P=.006). NT-APA also reduced worst (β=–0.74, SE 0.12; P<.001), average (β=–1.02, SE 0.30; P=.001), and current pain (β=–1.26, SE 0.37; P=.001). For interference, T-APA significantly reduced interference with enjoyment of life (β=–1.72, SE 0.37; P<.001) and daily activity (β=–1.41, SE 0.34; P=.001), with similar reductions seen in NT-APA. Conclusions: APA significantly reduced daily pain and interference among older adults with cLBP. EMA provided valuable insights into treatment response and symptom variability. Future research should enhance EMA adherence and explore sustained APA use for self-management.Item Metadata only Collaborative Robotic Framework for Emergency Situations Management in Areas of Flood and Landslide Disasters(2026-01-01) Magid E.; Tsoy T.; Matsuno F.; Suthakorn J.; Svinin M.; Magid E.; Mahidol UniversityThe Southeast Asia region is vulnerable to extreme precipitation, leading to hydrological disasters that endanger lives and infrastructure. Rapid response measures necessitate search and rescue operations, where rescue robotics can replace human rescuers and provide supplementary capabilities. Effective rescue efforts require information on victim whereabouts and area mapping, necessitating the development of AI-based information systems. This paper outlines an international framework for using heterogeneous robotic teams and developing information collection systems for hazardous site rescue management. The approach leverages expertise in urban search and rescue robotics from Japan, Thailand, and Russia, countries frequently affected by high precipitation and climate change. The joint research aims to create a new framework and control strategies for cooperative behavior among international robotic teams, focusing on interaction protocols, mapping agreements, data fusion, and other collaborative features. The robotic teams comprise various unmanned ground vehicles, aerial vehicles, underwater vehicles, and surface vehicles. These teams provide local data through sensing and mapping activities from water surfaces, underwater, air, and terrain to create a comprehensive disaster site map. The collaborative framework relies on path planning, disaster area coverage algorithms, control strategies, and multi-robot joint SLAM technologies for heterogeneous teams. Robot Operating System (ROS) and Gazebo simulator are used for modeling and validating the algorithms.Item Metadata only The Deep Motor Branch of the Ulnar Nerve and Its Role in Hand Spasticity: A Narrative Review for Surgical Applications(2026-01-01) Baimai S.; Abrol T.; Kaensa C.; Baimai S.; Mahidol UniversityThe deep motor branch of the ulnar nerve (DMBUN) plays a critical role in intrinsic hand function and deformities related to spasticity. Traditionally described as a single motor trunk, recent anatomical studies demonstrate multiple branching patterns and gender-based differences that challenge classical descriptions. These findings have important implications for selective surgical procedures, particularly hyperselective neurectomy (HSN), which has emerged as a promising treatment for hand spasticity. Evidence from cadaveric mapping, case series, and clinical outcome reports suggests that HSN targeting the DMBUN can achieve durable tone reduction and functional improvement with minimal complications. Conversely, the DMBUN is also at risk of iatrogenic injury during carpal tunnel release, underscoring the importance of respecting anatomical landmarks. Although current outcomes are encouraging, the literature is limited by the use of small cohorts and the absence of randomized controlled trials. Future studies should prioritize patient-specific anatomical mapping and long-term prospective data. Integrating anatomical precision with selective surgical strategies offers the best opportunity to improve outcomes for patients with hand spasticity.Item Metadata only ESC-YOLOv8: An enhanced deep learning framework for semantic understanding of single-line diagram imagery(2026-03-01) Bhanbhro H.; Hooi Y.K.; Kusakunniran W.; Zakaria M.B.N.; Hashmi S.A.M.; Amur Z.H.; Memon V.; Bhanbhro H.; Mahidol UniversityAccurate interpretation of single-line diagrams (SLDs) is crucial for analyzing electrical systems, as they encapsulate vital information about operational safety and efficiency in a simplified format. Traditional SLD processing methods rely on manual inspection and basic image analysis, which are computationally intensive, error-prone, and require extensive preprocessing. Although deep learning has been applied to symbol classification, existing models often fail to capture fine-grained symbol details, leading to misclassification. To address these limitations, this study proposes a hybrid deep learning-based symbol classification method. A newly created dataset was benchmarked using state-of-the-art deep learning models, and an optimal model was systematically designed, developed, and tested. The proposed approach integrates a Hybrid Residual Attention Module (HRAM) to enhance the model’s ability to identify fine-grained symbol details and a Proximity-aware Loss Function to improve performance in cluttered regions by motivation of this work stems penalizing misclassifications based on the spatial proximity of neighboring symbols. These modifications result in an optimized method for semantic processing in symbol classification tasks. The proposed model achieves 93.5% mean average precision (mAP) a 3.8% improvement over the top-performing baseline, alongside a 19.6% reduction in model parameters. These advancements contribute to more efficient and accurate semantic processing of SLDs, paving the way for improved analysis of electrical system diagrams.Item Metadata only Effectiveness of Health Literacy Enhancement Integrated with Telehealth in People Newly Diagnosed with Hypertension in Suburban Thailand: A Quasi-Experimental Study(2026-04-01) Addjanagitti P.; Partiprajak S.; Neelapaichit N.; Addjanagitti P.; Mahidol UniversityPeople newly diagnosed with hypertension often have insufficient health literacy and suboptimal self-care behaviors, particularly in diet, physical activity, and medication adherence. Thus, health literacy enhancement is essential. This quasi-experimental study examined the effectiveness of a telehealth-integrated health literacy enhancement among people newly diagnosed with hypertension. Fifty participants diagnosed with hypertension within the past year were consecutively recruited from subdistrict health-promoting hospitals in two districts. They were assigned at the cluster level to the experimental or control group (25 per group). The experimental group received usual care plus a six-week telehealth-integrated health literacy enhancement program. The control group received only usual care. Data were collected at baseline and post-intervention using the Personal Health Questionnaire, the Health Literacy Questionnaire, and the Self-Care of Hypertension Inventory. Data were analyzed using descriptive statistics, paired t-tests, and independent t-tests. After the intervention, the experimental group demonstrated signif icant improvements in health literacy and self-care behaviors, as well as a substantial reduction in systolic blood pressure compared with baseline and the control group. In contrast, no significant differences in diastolic blood pressure were observed. The findings demonstrate the effectiveness of the Health Literacy Enhancement Integrated with Telehealth program in improving health literacy, self-care behaviors, and blood pressure control among people newly diagnosed with hypertension. Nurses can incorporate this program into routine care to improve outcomes, reduce long-term complications, and support continuity of care. However, future studies should include long-term follow-up, a randomized controlled trial, and multisite research before it can be widely used.