Scopus 2026
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Item Metadata only Comment on ‘Asian Reference Values for Handgrip Strength, Gait Speed, Five-Times-Sit-to-Stand Test, Muscle Mass and Calf Circumference’ by Grgic et al.(2026-06-01) Lim W.S.; Assantachai P.; Merchant R.; Won C.W.; Woo J.; Chen L.K.; Arai H.; Lim W.S.; Mahidol UniversityItem Metadata only Knowledge, attitude, and prevention practices of cutaneous leishmaniasis in highly-endemic rural areas of Kandahar province, Afghanistan: A large cross-sectional community-based study(2026-06-01) Rahimi B.A.; Resha S.; Khaksar M.; Saeed K.M.I.; Osmani H.; Daqiq A.B.; Rahmani H.; Saleem H.; Taylor W.R.; Rahimi B.A.; Mahidol UniversityBACKGROUND: Cutaneous leishmaniasis (CL) is highly endemic in Kandahar province of Afghanistan, but data on the population's knowledge of CL and measures they adopt to prevent it are unknown. The main objectives of the study were to study the knowledge, attitude, and prevention practices of CL, and their associated factors, in two highly-endemic rural districts, Daman and Arghandab, in Kandahar province. METHODS: This community-based cross-sectional analytical study took place over seven months, from September 2024-March 2025, in adults. Data were analysed by descriptive statistics, the Chi-square test, and multivariate logistic regression. RESULTS: A total of 2,118 adults were recruited with a mean age of 35.8 years; 60.3% were males, 56.1% farmers, 91.5% illiterate, and 91.4% from poor families. Among the study participants, 24.1%, 41.5%, and 17.9% had good CL knowledge, a positive attitude towards CL, and good preventive practices towards CL. Independent factors associated with: (i) poor CL knowledge were being not single (adjusted odds ratio [AOR] 1.2), being a farmer (AOR 1.1) and coming from a poor family (AOR 1.3), (ii) a negative attitude towards CL were being aged >40 years (AOR 1.3) female (AOR 1.5), a resident in Arghandab district (AOR 1.2), and literate (AOR 1.1), and (iii) poor preventive practices against CL were being resident of Daman district (AOR 1.6), single (AOR 1.5), and illiterate (AOR 2.5). CONCLUSIONS: The majority of Daman and Arghandab residents had poor CL knowledge, a negative attitude, and poor prevention practices. Our results underscore the need for the Afghan Ministry of Public Health and international donor agencies, such as WHO and UNICEF, to plan and implement strategies to create/increase awareness of CL and measures to prevent and control it in Kandahar Province and beyond.Item Metadata only Multilevel Determinants of Engagement in Lifelong Learning in Orthodontics From Formal to AI-Supported Approaches: Development of a Conceptual Framework Through a Qualitative Study(2026-01-01) Nakornnoi T.; Wimonchaijit J.; Chintavalakorn R.; Sipiyaruk K.; Nakornnoi T.; Mahidol UniversityBackground: Lifelong learning (LLL) is increasingly important for health care professionals, particularly within the field of orthodontics, driven by emerging technologies, updated treatment techniques, and rising patient expectations. To maintain competence in current practice, orthodontists are expected to engage in continuous professional development throughout their careers. While the value of LLL is widely acknowledged, engagement levels among orthodontic professionals can vary due to a number of factors. Objective: This study aims to investigate how orthodontic professionals perceive and engage with LLL by examining their learning strategies, along with the barriers and enablers. In addition, this study integrates these determinants of professional development to construct a conceptual framework to explain LLL engagement among orthodontic professionals. Methods: A qualitative study using semistructured interviews with a topic guide was conducted among 16 orthodontic professionals who were recruited using purposive sampling to ensure diversity in settings and experience levels. Interviews were audio recorded and transcribed verbatim until data saturation was achieved. Data were analyzed using framework analysis informed by the theory of planned behavior. To ensure analytic rigor and credibility, an iterative coding process was performed independently by 2 researchers, with any discrepancies resolved through consensus among the research team. Results: All participants believed that LLL was important for clinical improvement and personal fulfillment. However, they reported several challenges, including time constraints, financial restrictions, and limited access to learning resources. Social influences, institutional contexts, technological advancements, and patient expectations were considered key determinants in shaping LLL engagement. The results also revealed a pedagogical shift in LLL activities from formal short course training to the use of generative artificial intelligence for self-directed learning. A conceptual framework illustrating key determinants of LLL engagement was developed. Conclusions: LLL engagement was perceived as essential for clinical competence and personal development, which could be influenced by individual, social, institutional, and external factors. The conceptual framework developed in this study demonstrates the key determinants of LLL in orthodontic practice and suggests that multilevel strategies are required to sustain long-term engagement.Item Metadata only Validation and reliability of the prosthesis evaluation questionnaire-Thai version for lower-limb amputees(2026-06-01) Dajpratham P.; Anyapho W.; Muangpaisan W.; Pattaravoratham S.; Amattayakul M.; Dajpratham P.; Mahidol UniversityBACKGROUND: Prosthesis-specific outcome measures are essential for assessing the quality of life among lower-limb amputees. While the prosthesis evaluation questionnaire (PEQ) is internationally recognized and endorsed by the International Society for Prosthetics and Orthotics through the Consensus Outcome Measures for Prosthetic and Amputation Services framework, no culturally adapted Thai version currently exists. OBJECTIVES: To translate, culturally adapt, and evaluate the psychometric properties of the Thai version of the PEQ (PEQ-TH) for use among lower-limb prosthesis users in Thailand. STUDY DESIGN: Cross-sectional validation study. METHODS: Following standard cross-cultural adaptation guidelines, the PEQ was translated into Thai, back-translated, and reviewed by a multidisciplinary expert panel. Eighty-three lower-limb amputees from 5 rehabilitation centers completed the PEQ-TH and short form 36 health survey Thai version at baseline; 71 completed the PEQ-TH again after 14 days. Psychometric evaluation included content and construct validity, internal consistency (Cronbach alpha), test-retest reliability (intraclass correlation coefficients), and floor/ceiling effects. RESULTS: The PEQ-TH demonstrated strong content validity (item-objective congruence = 0.99). Construct validity was supported by moderate correlations between PEQ-TH subscales (e.g., Ambulation, Social Burden) and corresponding short form 36 health survey Thai version domains. Internal consistency was acceptable for most subscales (α > 0.70), though Appearance, Well-Being, and Social Burden were marginally lower. Test-retest reliability ranged from moderate to good (intraclass correlation coefficient = 0.55-0.76). No floor or ceiling effects were observed. CONCLUSIONS: The PEQ-TH is a valid and reliable patient-reported outcome measure aligned with International Society for Prosthetics and Orthotics's Lower Extremity Amputation Data set and Consensus Outcome Measures for Prosthetic and Amputation Services recommendations. It enables culturally relevant assessment of prosthesis-related quality of life in Thai lower-limb amputees and supports patient-centered care and outcome monitoring.Item Metadata only Biosafety and biosecurity for Burkholderia pseudomallei and Burkholderia mallei: evidence, gaps, and sustainable practice in endemic, low-resource settings(2026-06-01) Blacksell S.D.; Le K.K.; Dhawan S.; Wuthiekanun V.; Limmathurotsukul D.; Dunachie S.J.; Norton R.; Meumann E.; Currie B.J.; Day N.P.J.; Dance D.A.B.; Blacksell S.D.; Mahidol UniversityBurkholderia pseudomallei and Burkholderia mallei present significant biosafety challenges due to their high pathogenicity, environmental resilience, intrinsic antimicrobial resistance, and potential use as bioterrorism agents. This review examines key aspects of laboratory management and infection control for these organisms, focusing on inconsistencies in biosafety protocols and risk classifications across regions. We synthesize current evidence on biocontainment requirements, disinfection strategies, and personal protective equipment (PPE), with particular emphasis on sustainable practices for laboratories in low-resource settings. Although laboratory-acquired infections are rare, their potential severity underscores the importance of stringent safety measures. Critical gaps remain in our understanding of infectious dose, the effectiveness.Item Metadata only Hospital Mortality and Predicting Factors in Patients with Sepsis-associated Acute Kidney Injury Requiring Renal Replacement Therapy(2026-01-01) Permpikul C.; Wongtirawit N.; Tongyoo S.; Khemmongkon M.; Naorungroj T.; Permpikul C.; Mahidol UniversityObjective: To investigate the clinical predictors for hospital mortality in patients with sepsis-associated acute kidney injury who required renal replacement therapy. Materials and Methods: A retrospective cohort study enrolling adult patients hospitalized in medical wards at Siriraj Hospital between 2018-2021, who were concurrently diagnosed with sepsis and acute kidney injury. Patients who previously received long-term renal replacement therapy were excluded. We compared clinical characteristics and treatment strategies, then analyzed the predictors of mortality according to hospital mortality. Results: Among 189 patients with acute kidney injury requiring renal replacement therapy, 132 (69.8%) died during hospitalization. A receiver operating characteristic curve analysis for predictors of hospital mortality revealed cutoff values for age > 60 years, SOFA score > 10, APACHE II score > 20, total colloid in 72 hr > 1,500 mL, maximum vasopressor > 0.3 mcg/kg/min, white blood cell count < 12 cells/μL, serum creatinine < 4 mg/dL, and serum albumin < 2.5 g/dL. Multivariate analysis identified age > 60 (OR 2.8, 1.27-6.38), APACHE II score > 20 (OR 2.57, 1.23-5.42), and maximum vasopressor dose > 0.3 μg/kg/min (OR 4.26, 1.94-9.86) as independent mortality predictors, while creatinine > 4 mg/dL was protective (OR 0.36, 0.17-0.75). Conclusion: Patients with sepsis-associated acute kidney injury who underwent renal replacement therapy had high hospital mortality. Age > 60 years, APACHE II score > 20, maximum vasopressor dose > 0.3 mcg/kg/min, and serum creatinine ≤ 4 mg/dL were predictors for hospital mortality.Item Metadata only Eustachian Tube Opening in Children With and Without Cleft Palate and Association With Otitis Media(2026-01-01) Atipas K.; Ungkanont K.; Tanphaichitr A.; Vathanophas V.; Wannarong T.; Atipas K.; Mahidol UniversityObjectives: To characterize morphology and opening pattern of the Eustachian tube (ET) in children with and without cleft palate (CP), and to examine the associations between endoscopic findings and otologic outcomes. Methods: This cross-sectional study included children aged 4–12 years with CP (n = 25) and without CP (n = 25) who underwent transnasal endoscopy for clinical indications. Endoscopic evaluation assessed adenoid, torus tubarius, tubal tonsil, discharge at the opening, ET opening visibility and movement, and the Eustachian Tube Inflammation Scale (ETIS). Findings were compared between groups using the chi-square or Fisher's exact test. Associations between endoscopic findings and middle ear outcomes were analyzed using Spearman's rank correlation. Results: Torus tubarius anomalies were more frequent in children with CP than in non-CP children (52% vs. 20%, p = 0.02), with all anomalies involving the posterior lip of the torus tubarius. Copious discharge at the ET opening was observed more frequently in children without CP (p = 0.04). Adenoid size, dynamic ET opening visibility, and ETIS grades showed significant correlations with both middle ear status and the rate of myringotomy in children with CP, whereas discharge-related findings were more associated with middle ear status in children without CP. Conclusion: Transnasal endoscopy provides important insights into ET opening in children with CP, in whom torus tubarius anomalies are common. Associations between adenoid size, ET lumen visibility, and middle ear disease highlighted the potential role of ET opening assessment for individualized management in this population. Level of Evidence: 3.Item Metadata only Diagnostic Utility of PRAME Immunohistochemistry for Distinguishing Acral Melanoma From Acral Melanocytic Nevi(2026-01-01) Phatcharamaneepakorn K.; Sitthinamsuwan P.; Pattanaprichakul P.; Chairatchaneeboon M.; Yodrabum N.; Phatcharamaneepakorn K.; Mahidol UniversityIntroduction: Preferentially expressed antigen in melanoma (PRAME) immunohistochemistry helps distinguish non-acral melanocytic lesions, but few studies have addressed its value in acral lesions. We aimed to identify an optimal PRAME cut-off score to differentiate acral melanoma (AM) from acral melanocytic nevi (AMN). Methods: Formalin-fixed, paraffin-embedded specimens of AM, AMN, and small biopsy of atypical melanocytic lesions (AMLs) were included. PRAME staining was performed. Expression was categorized into five groups: 0 (0%), 1+ (1%–25%), 2+ (26%–50%), 3+ (51%–75%), and 4+ (> 75%). PRAME nuclear expression was compared between AM and AMN to identify the best cut-off score, which was then assessed in small-sized biopsies of AML specimens. Results: We analyzed 62 AMs, 62 AMNs, and 23 AMLs. A PRAME score of ≥ 3+ optimally differentiated AM from AMN (sensitivity 80.6%, specificity 98.4%, positive predictive value 98%, and negative predictive value 83.6%). PRAME expression score ≥ 3+ was strongly associated with AM, whereas AMN showed expression score < 3+ (p < 0.001). However, one AM was completely negative for PRAME, and one AMN exhibited strong PRAME staining. Conclusions: PRAME immunohistochemistry with a cut-off of ≥ 3+ is useful for differentiating AM from AMN. However, false positivity and negativity of PRAME expression must be considered.Item Metadata only Correction: Comparing the Effectiveness of Artificial Intelligence Technology with 6th Year Dental Students for the Diagnosis of Inflammatory Bone Lesions of the Mandible in Panoramic Radiography (Journal of Imaging Informatics in Medicine, (2026), 10.1007/s10278-026-02001-2)(2026-01-01) Songsiriritthigul S.; Sriphet J.; Suphan J.; Choengprapakorn D.; Wongratwanich P.; Suthisopapan P.; Srimaneekarn N.; Songsiriritthigul S.; Mahidol UniversityDr. Dheeratt Choengprapakorn, who served as the principal supervisor of this study and is responsible for ongoing academic correspondence related to this work, should be designated as corresponding author.Item Metadata only A modified Delphi consensus on tenosynovial giant cell tumour and giant cell tumour of bone : a report from the Birmingham Orthopaedic Oncology Meeting (BOOM)(2026-06-09) Jeys L.M.; Botello E.; Boyle R.; Ebeid W.; Hilton T.; Houdek M.T.; Hosking K.; Kurisunkal V.J.; Laubscher M.; Morris G.V.; Puri A.; Ruggieri P.; Laitinen M.K.; Abdul Bari Y.; Abood A.; Abraham J.A.; Acosta Marin M.; Agarwal M.; Agarwal R.; Aguirre M.; Ajit Singh V.; Akiyama T.; Al Farii H.; Alaqeel M.; Alaseem A.; Aldosari O.; Alexander K.; Alfaro P.; Aljuhani W.; Allison D.C.; Almashahedi M.; Alotaibi A.; Alpan B.; Alshaygy I.S.; Althunayan T.; Andreani L.; Andreou D.; Andriandi A.; Annabelle L.; Aponte-Tinao L.; Ardelt M.; Armas S.; Aston W.; Aycan O.E.; Baad-Hansen T.; Baeza P.; Baird C.; Balach T.; Banse X.; Barriga J.; Barry J.; Basile G.; Bastoni S.; Basuki M.H.; Bauer H.C.; Baydar S.; Bayliss L.; Becker R.; Bedi A.; Benevenia J.; Bengoa F.; Berger C.; Bernthal N.; Binitie O.; Bird J.; Bobseit A.; Bodian C.; Boffano M.; Bonilla Huertas P.; Bramer J.; Broadhead M.; Broekhuis D.; Broida S.E.; Brown D.; Bruschi A.; Budny T.; Buist M.; Burke Z.; Busse T.; Cabrolier J.; Calvo-Haro J.A.; Campanacci D.A.; Cardoso R.; Carey Smith R.; Carrasco M.G.; Casales N.; Castan A.; Ceballos O.; Chan C.M.; Chan L.; Chang L.Z.; Charoenlap C.; Chaustre Florez J.F.; Chin J.; Choong P.; Chrobok A.; Chung Y.G.; Ciechanowicz D.; Clara-Altamirano M.A.; Consuegra Guzman L.A.; Jeys L.M.; Mahidol UniversityAims: The aim of this study was to achieve consensus on important topics related to tenosynovial giant cell tumour (TGCT) and giant cell tumour of bone (GCTB), and to identify areas for future research. Methods: In January 2026, a consensus meeting, The Birmingham Orthopaedic Oncology Meeting (BOOM), held in Cape Town, South Africa, gathered 314 delegates from 59 countries to debate 21 consensus statements on tenosynovial giant cell tumour (TGCT) and giant cell tumour of bone (GCTB) through a modified Delphi process. Results: Of the 21 statements, two achieved unanimous consensus, 18 strong consensus, and one moderate consensus. Unanimous consensus was reached for prioritizing joint-preserving intralesional curettage in GCTB when feasible, and for supporting non-surgical approaches in anatomically challenging cases, particularly sacral lesions. The statement addressing the role of denosumab in GCTB achieved only moderate consensus. The use of adjuvants in GCTB, as well as the management of recurrent and systemic GCTB, including long-term use of denosumab, reached strong consensus. Strong consensus was achieved in the surgical and non-surgical management for both primary and recurrent TGCT. Surveillance strategies for both TGCT and GCTB generated substantial discussion despite strong consensus, reflecting ongoing uncertainty and lack in evidence. Conclusion: This international consensus provides practical guidance for the management of TGCT and GCTB while identifying important gaps in evidence. Joint-preserving surgery remains central to the treatment of GCTB, with selective integration of systemic therapies and individualized surveillance. The consensus framework highlights priorities for future collaborative research in orthopaedic oncology.Item Metadata only Landmark-based morphometrics with fewer landmarks: Some examples for medical entomology(2026-06-01) Dujardin J.P.; Sriwichai P.; Samung Y.; Ruangsittichai J.; Sumruayphol S.; Dujardin S.; Dujardin J.P.; Mahidol UniversityGeometric morphometrics based on two-dimensional landmarks is a powerful tool for distinguishing morphologically similar or cryptic taxa, an important asset in the fight against medically and veterinary important arthropods. While it is commonly assumed that increasing the number of landmarks should improve discriminatory power by capturing more shape information, our findings challenge this assumption. In terms of shape discrimination (thus excluding size variation), we demonstrate that small subsets of landmarks can equal or even outperform full sets of landmarks. Fifteen examples of comparisons between closely related species were considered.These examples are drawn from published data covering six insect families: Culicidae, Glossinidae, Muscidae, Psychodidae, Reduviidae and Tabanidae. To assess the relevance of smaller subsets of landmarks, we compared the accuracy scores of unsupervised classification using full sets of landmarks (10-22 points) with those obtained using smaller subsets. To eliminate the potential influence of chance on reclassification scores, we validated our results by accounting for correct reclassification due to chance alone. The strategy for selecting relevant landmark subsets employed two different approaches. The first relied on each landmark's contribution to the total distance between shapes, thus establishing a hierarchy among them. The second, more comprehensive approach compared the reclassification scores of large random samples of landmarks, from the smallest subsets (3 landmarks) to the full set. From a public health perspective, the value of our approach lies in simplifying the tasks required for entomological surveillance: it could accelerate morphometric identification for large surveillance datasets, improve standardization among users, and reduce noise introduced by problematic landmarks. These gains are particularly relevant for distinguishing medically important but morphologically similar taxa, or when molecular tools are unavailable or too resource-intensive. The statistical procedures have been integrated into the XYOM online software, providing accessible tools for efficient landmark selection and improved morphometric analysis.Item Metadata only The EQ-5D-5L valuation study in Nigeria(2026-08-01) Yusuf A.H.; Ardo B.U.; Thavorncharoensap M.; Roudijk B.; Purba F.D.; Yang Z.; Liao M.; Chaikledkaew U.; Youngkong S.; Thakkinstian A.; Agada-Amade Y.A.; Amole T.G.; Sambo M.N.; Ohiri K.; Yusuf A.H.; Mahidol UniversityPurpose: A country-specific EQ-5D-5L value set ensures that health utility estimates reflect national preferences, enabling contextually appropriate health technology assessment (HTA) to inform efficient resource allocation decisions. This study aimed to develop the first EQ-5D-5L value set for Nigeria. Methods: Adult Nigerians were recruited from 12 states using multi-stage stratified quota sampling based on age, sex, and education. Face-to-face interviews were conducted through Computer-Assisted Personal Interviews using the EQ-PVT protocol. The interview comprises 2 main parts: composite time-trade-off (cTTO) and discrete choice experiment (DCE) tasks. The cTTO data were modelled using random intercept, Tobit, linear (heteroskedasticity-corrected), and Tobit (heteroskedasticity-corrected) models. DCE data were analyzed using Mixed Logit Model (MLM). Hybrid models combining the cTTO and DCE data were also estimated. Results: A total of 1,200 interviews were conducted. The Hybrid Tobit model with intercept, corrected for heteroscedasticity, and excluded flagged responses was considered the preferred model. The utility values of the best (11,111), 2nd best (21,111), worst (55,555), and 2nd worst (54,555) health states are 1, 0.963, − 0.733, and − 0.653, respectively. The most important dimension is Pain/Discomfort followed by Anxiety/Depression, Mobility, Usual Activity, and Self-care, respectively. Conclusion: This study provides the first EQ-5D-5L value set for Nigeria, derived from a representative adult population. This value set provides a strong foundation for HTA, supporting evidence-informed policy decisions and advancing progress towards Universal Health Coverage (UHC) in Nigeria and the wider West African region.Item Metadata only Engaging youth in health and research in rural Cambodia: a qualitative study(2026-01-01) Ean M.; Dysoley L.; Vattanak H.; Soviet U.; Driessen F.v.; Dahal A.; Mishra A.; Tripura R.; Callery J.J.; Dondorp A.M.; Peto T.J.; Cheah P.Y.; Adhikari B.; Ean M.; Mahidol UniversityBackground: The Youth Advisory Group on Health and Research Engagement (YAGHRE) has been a collaborative initiative between school students and Mahidol Oxford Tropical Medicine Research Unit (MORU) staff in Siem Pang, Cambodia since 2021. Members provide input on health and research activities conducted by MORU. Objective: The main objective of this study was to explore key stakeholders’ perspectives on the YAGHRE. Methods: A total of 35 respondents participated in this study, including YAGHRE members (n = 14), teachers (n = 6), healthcare staff (n = 2), school students (n = 6), and family members (n = 7). Data were collected through focus group discussions and individual interviews. Thematic analysis was used to identify cross-cutting patterns in participants’ understandings, experiences, and recommendations related to YAGHRE. Results: YAGHRE members were viewed as a link between MORU and the community for health promotion and engagement with research. Participation in YAGHRE seemed to foster members’ confidence, communication, and digital literacy. Parents and teachers also reported improvements in members’ leadership and youth-led engagement activities. The knowledge and skills acquired were shared with families, peers, and community members, potentially enhancing awareness of health and hygiene. The participatory nature of YAGHRE, where members planned activities with MORU staff seemed to have cultivated a sense of ownership. YAGHRE was perceived as a transformative platform for youth skill-building and health education, strengthening community–research partnerships and local health and research capacity in rural Cambodia. Conclusions: Our engagement model suggests how community-based research and engagement can simultaneously advance scientific goals, build local capacity, and strengthen public trust through participatory approaches.Item Metadata only Dynamic versus fixed pillow height systems and cervical muscle function: a randomized crossover trial(2026-04-01) Kiatkulanusorn S.; Luangpon N.; Klarod K.; Watechagit S.; Kiatkulanusorn K.; Kleawyothatis W.; Sukkho O.; Kiatkulanusorn S.; Mahidol UniversityBACKGROUND: Pillow height and mechanical support influence cervical alignment and neuromuscular load. However, the physiological effects of dynamically adjustable pillow systems remain poorly defined. AIM: To compare the effects of fixed and dynamically adjustable pillow height inserts on cervical muscle oxygenation, neuromuscular modulation, and comfort in healthy young adults. DESIGN: Randomized crossover trial. SETTING: Controlled laboratory setting simulating sleep-related postures. POPULATION: Thirty healthy adults (18-45 years) without cervical or musculoskeletal disorders. METHODS: Participants underwent six pillow conditions: no pillow (NP), non-adjustable polyester pillow (NA), three fixed inserts (memory foam [MF], latex [LT], polyester fiber [PE]), and a dynamically adjustable air-based (DA). Muscle oxygen saturation (SmO2) of the sternocleidomastoid (SCM) and upper trapezius (UT) was assessed using near-infrared spectroscopy. Surface electromyography (EMG) was analyzed via root mean square (RMS) and zero-crossing (ZC) slopes, representing adaptive motor unit recruitment and firing modulation. RESULTS: Repeated-measures ANOVA revealed a significant pillow effect for SmO2 (SCM: η2P=0.24; UT: η2P=0.14, P<0.05). DA and PE inserts showed superior SmO2 across phases, with DA yielding the highest levels and fastest reoxygenation. Both DA and PE conditions exhibited steeper RMS and more negative ZC slopes during activity, indicating more efficient neuromuscular adaptation. Comfort ratings were highest for DA (VAS 75.52±16.94 mm). CONCLUSIONS: DA pillows may enhance cervical oxygenation, adaptive neuromuscular control, and comfort compared with fixed-height systems. CLINICAL REHABILITATION IMPACT: DA pillows may provide individualized ergonomic support to improve cervical alignment and comfort.Item Metadata only Therapeutic advances in Alzheimer’s disease: Current strategies and future possibilities(2026-07-01) Varinthra P.; Ibiayo A.G.; Liu C.H.; Pakaprot N.; Paromi I.N.; Do T.T.N.; Raza M.; Liu I.Y.; Varinthra P.; Mahidol UniversityAlzheimer’s disease (AD) is a progressive neurodegenerative disorder causing memory, cognitive, and behavioral impairments in older adults and poses a major worldwide health challenge. The pathophysiology of AD is highly complex and multifactorial, arising from interrelated processes such as amyloid-β (Aβ) aggregation, tau hyperphosphorylation, synaptic dysfunction, neuroinflammation, mitochondrial impairment, and oxidative stress. In addition, both genetic predisposition and environmental or lifestyle factors play critical roles in disease susceptibility and progression. Despite decades of investigation, therapeutic options with robust disease-modifying potential remain limited. Based on published studies from 2021 to 2025, current treatments primarily focus on symptomatic management with cholinesterase inhibitors, N-methyl-D-aspartate receptor antagonists, and combined therapies, complemented by nonpharmacological interventions to support cognition and quality of life. Recently, advances in disease-modifying strategies, particularly monoclonal antibodies targeting Aβ, tau-directed therapies, and approaches modulating neuroinflammation, have generated cautious optimism for shifting the treatment paradigm. Importantly, emerging evidence suggests that specific herbal extracts with antioxidant, anti-inflammatory, and neuroprotective properties may serve as promising adjuncts to conventional therapy. Effective long-term management of AD may ultimately require multimodal strategies that integrate pharmacological, herbal, and lifestyle interventions with precision medicine approaches guided by biomarkers and neuroimaging. This minireview summarizes current therapeutic strategies, emerging advances, and persistent challenges, while highlighting future directions to enable earlier intervention and more effective modulation of disease progression.Item Metadata only The association between plasma aldosterone level, transtubular potassium gradient, or their ratios and causes of hyperkalemia in the outpatient setting(2026-03-01) Wuthapanich T.; Phakdeekitcharoen P.; Sevamontree C.; Phakdeekitcharoen B.; Wuthapanich T.; Mahidol UniversityBackground: Hyperkalemia is a lethal condition resulting in cardiac dysrhythmias and death. Identifying the causes of hyperkalemia is crucial for treating and preventing future recurrence. Methods: A prospective cohort study was conducted to evaluate the association between plasma aldosterone level, transtubular potassium gradient, and their ratios in distinguishing the causes of hyperkalemia (serum potassium ≥ 5.8 mmol/L) in the outpatient clinic. Results: Forty-two patients and 26 controls completed the study. The causes of hyperkalemia were classified into three major groups: 1) drug-induced (27 cases), 2) diabetes-related (7 cases), and 3) chronic kidney disease (CKD)-related hyperkalemia (7 cases), and one case of renal tubular acidosis. The mean serum potassium level of the hyperkalemia group was significantly higher than the control group (6.13 ± 0.29 vs 4.27 ± 0.44 mmol/L, P < .001). The mean transtubular potassium gradient values were 3.48 ± 1.87 vs 5.27 ± 1.46, P < .001, respectively. The cut-off aldosterone/transtubular potassium gradient ratio of >2.5 ng/dL or transtubular potassium gradient <5 had comparable sensitivity (64.3% vs 76.2%) and specificity (76.9% vs 53.8%) in discriminating between the hyperkalemia group and the control group, suggesting an inadequate collecting tubule response to hyperkalemia. CKD-related hyperkalemia showed a wide range of transtubular potassium gradients. Lastly, our population was likely to develop diabetes-related hyperkalemia, possibly due to aldosterone resistance from tubular defects. Conclusion: The combined utilization of plasma aldosterone level, transtubular potassium gradient, and their ratios provides a maximum advantage in differentiating causes of hyperkalemia. Additional studies with larger sample sizes and different cut-off serum potassium levels for hyperkalemia are required to further characterize these findings.Item Metadata only Prevalence and correlates of physical, emotional, sexual, and technology-facilitated gender-based violence among a national sample of adolescent and adult women living with HIV in Zambia(2026-12-01) Peltzer K.; Pengpid S.; Peltzer K.; Mahidol UniversityBackground: The study’s objective was to assess the prevalence and correlates of physical, emotional, sexual, and technology-facilitated intimate partner violence (IPV) as well as poly-victimization among a national sample of adolescent and adult women living with HIV (WLHIV) in Zambia in 2024. Methods: Data from 1,063 WLHIV between the ages of 15 and 49 who took part in the 2024 Zambia Demographic and Health Survey and responded to the domestic violence and mental health module were examined. Logistic regressions were used to estimate predictors of physical, emotional, sexual, and technology-facilitated IPV as well as poly-victimization. Results: More than one in four women (28.8%) had exposure to physical violence, followed by emotional violence (24.6%), sexual violence (9.4%) and technology-based violence (6.0%). Exposure to any IPV was 40.8% and 20.1% had poly-victimization (2–4 types of IPV). In adjusted logistic regression analysis being widowed, divorced, or separated were associated with physical IPV, emotional IPV, and poly-victimization. Internet use and urban residence were associated with technology-based IPV. Screened depression and/or anxiety disorders and/or on medication for depression or anxiety was associated with emotional IPV, technology-facilitated IPV, and poly-victimization. Suicidal ideation was associated with physical IPV. Being ashamed of HIV was associated with emotional IPV, sexual IPV technology-facilitated IPV, and poly-victimization. HIV disclosure was inversely associated with technology-facilitated violence. Current tobacco use was negatively and current alcohol use was positively associated with physical IPV. A supportive attitude towards wife beating was associated with sexual IPV and poly-victimization. Experiencing controlling behaviour and having a husband or partner who is often drunk were highly associated with physical IPV, emotional IPV, sexual IPV and poly-victimization. Conclusion: More than one in four WLHIV (28.8%) had exposure to physical violence, followed by emotional violence (24.6%), sexual violence (9.4%) and technology-based violence (6.0%). Exposure to any IPV was 40.8% and 20.1% had poly-victimization (2-4 types of IPV). In addition, the survey identified the multifaceted nature of physical, emotional, sexual, and technology-facilitated IPV, highlighting contributing individual-level, relationship-level, and community/societal-level factors. Findings underscore the need for an integrated policy response to IPV among WLHIV in Zambia.Item Metadata only Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries(2026-06-01) Loaeza L.M.; Lara-Castor L.; Sharib J.R.; Cudhea F.; Wang M.; Li P.; Mozaffarian D.; Bas M.; Haidar Ali J.; Abumweis S.; Krishnan A.; Misra P.; Hwalla N.C.; Janakiram C.; Liputo N.I.; Musaiger A.; Pourfarzi F.; Alam I.; DeRidder K.; Termote C.; Memon A.; Turrini A.; Lupotto E.; Piccinelli R.; Sette S.; Anzid K.; Vossenaar M.; Mazumdar P.; Rached I.; Zapata M.E.; Rovirosa A.; Taye Asayehu T.; Aluso L.; Oduor F.; Boedecker J.; Ortiz-Ulloa J.; Meenakshi J.V.; Castro M.; Grosso G.; Waskiewicz A.; Thanopoulou A.; Malekzadeh R.; Calleja N.; Etemad Z.; Ocke M.; Al Nsour M.; Waswa L.M.; Nurk E.; Lee H.J.; Arsenault J.; Lopez-Jaramillo P.; Mehio Sibai A.; Damasceno A.; Arambepola C.; Lunet N.; Severo M.; Lopes C.; Torres D.; Palacios C.; Angeles Agdeppa I.; Desnacido J.; Capanzana M.; Misra A.; Ai Ng S.; Tan-Khouw I.; Gamboa Delgado E.; Caballero M.; Otero J.; Koksal E.; Guessous I.; Lachat C.; De Henauw S.; Sekiyama M.; Chiplonkar S.; Arici M.; Ngoan L.T.; Panagiotakos D.; Ding E.; Li Y.; Trichopoulou A.; Barengo N.; Ekbote V.; Khadilkar A.; Kovalskys I.; Meshram I.; Avula L.; Arlappa N.; Rajkumar H.; Rachakulla H.; Hemalatha R.; Laxmaiah A.; Lacoviello L.; Costanzo S.; Bonaccio M.; Martin-Prevel Y.; Castetbon K.; Hsieh Y.T.; Olivares S.; Hadziomeragic A.; de Moura Souza A.; Loaeza L.M.; Mahidol UniversityBackground: Taxes on sugar-sweetened beverages can improve public health. We aimed to characterise the extent and types of sugar-sweetened beverage taxes implemented worldwide and the national characteristics predicting implementation, such as sugar-sweetened beverage intake amounts, disease rates, or economic development. Methods: This longitudinal analysis aggregated serial global datasets (including the Global Dietary Database, Non-Communicable Diseases Risk Factor Collaboration, Global Burden of Disease study, and World Bank data) from 1990 to 2024 in 183 countries to assess sugar-sweetened beverage tax characteristics and national predictors of policy adoption. Sugar-sweetened beverage taxes for public health purposes were identified and characterised, including amounts, fiscal instruments, structures, and covered beverages. Sugar-sweetened beverage consumption, obesity and diabetes prevalence, gross domestic product (GDP), and sociodemographic index (SDI) were assessed as predictors of tax implementation using Cox proportional hazards models with time-varying covariates. Findings: From 1990 to 2024, 64 countries implemented sugar-sweetened beverage taxes, accelerating over time and covering 3·5 billion people globally. South Asia led in adoption (50% of countries; median tax rate 7·5%), followed by southeast and east Asia (47·8%; 5·0%), the Middle East and North Africa (30·0%; 17·0%), and Latin America and the Caribbean (31·3%; 7·0%). Taxes were ad valorem (ie, based on price; 45%), volume-based (44%), sugar-content-based (5%), or mixed (6%), and 13% of countries earmarked revenue for public health. Multivariable-adjusted predictors of tax implementation included diabetes prevalence (hazard ratio [HR]=1·22 [95% CI 1·05–1·43]), obesity prevalence (1·14 [1·00–1·29]), GDP per capita (HR per $10 000: 1·19 [1·06–1·34]), and SDI (0·70 [0·57–0·86]), but not sugar-sweetened beverage intake (0·77 [0·42–1·39]). Interpretation: Global adoption of sugar-sweetened beverage taxes has rapidly accelerated since 1990; however, there is important heterogeneity by region and tax structure, and the taxes are shaped by a country's economic capacity, social development, and health conditions. Funding: This work was supported by the National Institutes of Health (R01HL115189).Item Metadata only Walking the path: exploring the pathways of emerging viral diseases(2026-09-01) Gavotte L.; Gaucherel C.; Goubier T.; Frutos R.; Gavotte L.; Mahidol UniversityBackground: The COVID-19 pandemic has demonstrated the limitations of our current understanding of the underlying mechanisms driving the emergence of new epidemics. The circulation theory has provided a hypothesis for explaining the mechanism of viral disease emergence in humans. We modelled the circulation theory to test whether the proposed mechanism is plausible. Method: We tested scientific theories of viral disease emergence using an approach implemented in engineering and industry to assess the validity and plausibility of a model. We used an EDEN possibilistic modeling framework based on a qualitative and discrete event formalism. Results: A possibilistic model based on discrete-event systems validated the circulation theory of viral zoonotic diseases emergence. The model explored all potential pathways within a pathosystem and analysed the dynamics of known zoonotic RNA viruses and one DNA virus (Mpox). Five different pathways, all relevant to the circulation theory, can explain all dynamics of viral disease emergence. Conclusion: This works shows that simple biological pathways can easily explain the emergence of zoonotic viruses. It also shows that the circulation model is plausible and meets the requirements to pass the Petri's nets test. This work also shows that the circulation can be broken down into several pathways matching known viral processes.Item Metadata only Effect of higher dose primaquine for the radical cure of Plasmodium vivax malaria in Indonesia: a systematic review and individual patient data meta-analysis(2026-07-01) Fadilah I.; Watson J.A.; Pasaribu A.P.; Sutanto I.; Nelwan E.J.; Lidia K.; Rajasekhar M.; Elyazar I.R.; Taylor W.R.; Thriemer K.; Day N.P.; Poespoprodjo J.R.; Simpson J.A.; Price R.N.; Baird J.K.; Commons R.J.; Fadilah I.; Mahidol UniversityBackground: Plasmodium vivax malaria has diverse transmission and relapse patterns in Indonesia. The optimal dose of primaquine to prevent relapses across the country is unknown. We evaluated the anti-relapse efficacy, gastrointestinal tolerability, and haematological safety (G6PD activity ≥30%) of different primaquine regimens in varied endemic settings in Indonesia. Methods: We systematically searched for studies published between 1 January 2000 and 23 July 2024 prospectively enrolling patients with acute uncomplicated P. vivax malaria where some patients were treated with primaquine. Individual patient data (IPD) from eligible studies were pooled and harmonised. We fitted one-stage IPD multivariable regression models to estimate the causal relationship between the body weight-adjusted primaquine dose with three separate primary outcomes: (i) the time to first P. vivax recurrence (days 7–180), (ii) any gastrointestinal discomfort (days 5–7), and (iii) ≥25% reduction relative to baseline haemoglobin and a reduction to <7 g/dL (days 1–14). Findings: Of ten eligible studies, seven were available for inclusion. Compared with a total dose of 3.5 mg/kg primaquine, patients treated with a total dose of 7 mg/kg had a lower rate of recurrence over 6 months (adjusted hazard ratio 0.53; 95% confidence interval [CI] 0.45–0.63; n = 1797); the relative efficacy was consistent across regions, but the absolute benefit varied. Gastrointestinal discomfort was more frequent with higher doses (adjusted risk ratio 1.32 per 0.25 mg/kg daily dose; 95% CI 1.15–1.51; n = 952). In 822 patients available to be assessed for haematological safety (788 [96%] with G6PD activity ≥70% and 34 [4%] with activity 30% to <70%), only one patient developed clinically relevant haemolysis. Interpretation: Across all transmission settings in Indonesia, a total dose of 7 mg/kg halved the rate of recurrent P. vivax malaria over a 6-month period compared with the low dose of 3.5 mg/kg. However, increased daily doses slightly increased risks of gastrointestinal discomfort and haemolysis. Funding: NDM Tropical Network Fund, Bill and Melinda Gates Foundation.