Mahidol University's Institutional Repository
คลังสารสนเทศสถาบันของมหาวิทยาลัยมหิดล
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Recent Submissions
Cost-effectiveness of treatment strategies for non-displaced osteoporotic femoral neck fractures in older adults in Ontario, Canada
(2026-05-01) Ruangsomboon P.; Huang Y.Q.; Ruangsomboon O.; Tam D.; Zywiel M.; Ravi B.; Naimark D.M.J.; Ruangsomboon P.; Mahidol University
Aims: This economic evaluation study assessed the cost-effectiveness of six treatment strategies for non-displaced osteoporotic femoral neck fractures (NDFNFs) in older adults using a Markov cohort model from the Ontario, Canada, public payer perspective. Methods: A probabilistic Markov chain Monte Carlo decision analysis model was developed to compare six strategies: 1) cemented femoral fixation total hip arthroplasty (THA; hybrid, cemented femoral component/uncemented cup - 'cemented THA'); 2) cementless THA; 3) cemented hip hemiarthroplasty (HHA); 4) cementless HHA; 5) internal fixation (IF); and 6) conservative treatment. The base case cohort consisted of Canadian patients presenting with a NDFNF aged 65 years, modelled with a lifetime horizon. Outcomes included quality-adjusted life-months (QALMs), lifetime costs (discounted at 1.5% annually), net monetary benefits (NMBs), and incremental cost-effectiveness ratios (ICERs). All costs are presented in Canadian dollars (CAD, $). The cost-effectiveness threshold (λ) was $4,166.67 per QALM. The primary outcome measure was expected NMBs, and the preferred strategy was the one with the highest expected NMBs over the lifetime horizon. Results: The estimated mean costs were $6,054 (IF), $11,995 (cemented THA), $11,011 (cemented HHA), $11,854 (cementless HHA), $15,405 (cementless THA), and $7,617 (conservative treatment). Cemented THA yielded the highest QALMs (192.7). Cemented THA had the highest NMB ($790,784). Cementless THA, cementless HHA, and conservative treatment were absolutely dominated while cemented HHA was extendedly dominated. After excluding dominated strategies, the ICER for cemented THA compared with IF was $127.5 per QALM, indicating that cemented THA is cost-effective relative to IF. At a λ of $4,166.67 per QALM, cemented THA was the most cost-effective strategy in 48.7% of simulations, followed by cemented HHA (31.2%) and IF (17.9%). Conclusion: Cemented femoral fixation THA is the most preferred strategy (highest expected NMB at λ) for NDFNFs in 65-year-old patients. When evaluated against a λ of $4,166.67 per QALM, cemented THA outperforms cementless THA, HHA, IF, and conservative treatment.
Obstetric Service Utilization in Public Health Facilities during COVID-19 Pandemic among Cross-border Migrants in Thailand, 2019–2022
(2025-04-01) Cetthakrikul N.; Ngamvirojcharoen B.; Manaboriboon N.; Wongsuwanphon S.; Suphanchaimat R.; Cetthakrikul N.; Mahidol University
The COVID-19 pandemic caused changes in obstetric care for the general population in Thailand. This study aimed to determine changes in obstetric admissions among migrants and assess potential factors influencing obstetric inpatient visits during the COVID-19 pandemic. An ecological time-series cross-sectional study was conducted using nationwide data between 2019 and 2022. Descriptive statistics were used to investigate outcome variables, including incidence number for obstetric inpatient care among insured migrants and uninsured migrants, and admission rate for obstetric inpatients among insured migrants. Independent variables included the cumulative incidence number of COVID-19 cases in a particular quarter, the number of hospital beds, geographical regions and time periods. This study then used random-effects negative binomial regression to explore the relationships between the outcome and independent variables. The incidence of all outcome variables during the COVID-19 pandemic (2020–2022) was higher than in 2019. The incidence of COVID-19 cases did not show a strong effect towards the change in obstetric admissions. For every 1,000-bed increase in hospital capacity, the admission rate decreased by approximately 8% (IRR 0.92, 95% CI 0.89–0.95) when adjusted for yearly periods, and by 9% (IRR 0.91, 95% CI 0.89–0.94) when adjusted for 6-monthly interval periods. Compared to Greater Bangkok, other regions exhibited lower numbers of hospital admissions for both insured and uninsured migrants. Conversely, the admission rate among insured migrants was higher in these regions. Continuous monitoring of the utilization of obstetric services by migrants offers benefits for proper policy design to ensure universal healthcare access for all.
Study the Physicochemical Property of Basil Mucilage Powder and Applying for Development of Weight Control Beverage
(2023-05-01) Sangsuriyawong A.; Phongsrikun S.; Sinchaipanit P.; Peasura N.; Sirivarasai J.; Sangsuriyawong A.; Mahidol University
The objective of this study was to analyze the physicochemical properties of basil mucilage for the development of weight control beverage. The extraction yield of the basil seed mucilage powder was about 15% by weight. Basil mucilage powder ( 100 g) contained 1. 65 g protein, 0. 82 g fat, 5. 22 g ash, 86. 5 g carbohydrates, and 5.8% moisture content. In addition, basil mucilage powder contained about 78% by weight of dietary fiber that was composed of about 21% soluble fiber and 57% insoluble fiber. Basil mucilage powder showed very high swelling property (40%), water holding value about 140 g/g, particle size range between 100-120 mesh, and 0. 25 of water activity. The result of microbiological analysis showed that total plate count was 6.6 x 103 CFU/g, Escherichia coli was less than 3 MPN/g, and Salmonella was not detected in 25 g of sample. The development of an orange flavor and sugar free beverage powder was further studied by using the extracted basil mucilage powder. A beverage formulation with the highest sensory acceptance score (n = 6, 5-points hedonic scale) contained 6 g basil mucilage powder, 1.5 g sorbitol, 0.045 g sucralose, 0.6 g citric acid, 0. 06 g salt, 0. 15 g orange flavor, and 0. 03 g of orange food coloring per 1 sachet or 1 serving size. A basil mucilage beverage product will be further studied the influence satiation in human studies.
The Grammar of Science: Chance and Magnitude
(2024-01-01) Kaewkungwal J.; Kaewkungwal J.; Mahidol University
Enhanced adenoviral reactivity in Guillain-Barré syndrome after SARS-CoV-2 infection and vaccination
(2026-05-01) Bellanti R.; Iserte A.C.; Johnson C.B.; Goodfellow J.; Johnson M.; Dejnirattisai W.; Keddie S.; Campo J.J.; Screaton G.; Goldblatt D.; Lunn M.P.; Davies A.J.; Rinaldi S.; Bellanti R.; Mahidol University
Case reports and series suggested an association between SARS-CoV-2 and Guillain-Barré syndrome (GBS). However, the GBS epidemic which was predicted from early risk estimates did not materialize in overall case numbers, and no plausible mechanism for any link has been established. An increased risk of GBS following adenoviral vector-based COVID-19 vaccination has been more consistently demonstrated, but a pathophysiological explanation for this association has also not yet emerged. Here, we sought to identify whether patients with GBS following COVID-19 infection or vaccination had any distinct clinical or serological features differentiating them from one another or non-pandemic GBS, and to explore the potential mechanisms of any associations. Between March 2020 and October 2021, sera from patients with GBS (n = 64) and controls (n = 70) were collected. Clinical features were retrieved from medical records. GBS cases were evaluated for diagnostic certainty by Brighton criteria and classified as non-COVID-19 associated (GBS-NC, n = 20), GBS after COVID-19 infection (GBS-AC, n = 10), or GBS after COVID-19 vaccination (GBS-AV, n = 34). The humoral responses to SARS-CoV-2 proteins and putative peripheral nerve antigens, and the cytokine profile of each group were established and compared. Antibodies cloned from the acute-phase plasmablasts of an individual with GBS-AC were also assessed for reactivity against SARS-CoV-2 and peripheral nerve antigens. Sera from GBS patients and from individuals who received COVID-19 vaccinations (n = 36: 16 ChAdOx1, 10 Ad26.COV2.S/Janssen and 10 tozinameran/Pfizer–BioNTech) without developing GBS were tested for IgG reactivity against SARS-CoV-2 and adenoviral proteins. There were no clinical differences between the GBS groups. Patients with GBS-AC had a greater IgG reactivity to the S1 component of the SARS-CoV-2 spike protein compared to non-GBS COVID-19 controls. A minority of antibodies from cloned plasmablasts targeted SARS-CoV-2 proteins but there was no reactivity or cross reactivity with peripheral nerve antigens or tissue. There were no other serological or immunological differences between the GBS groups. However, when compared to uncomplicated vaccine recipients, GBS patients in toto, and each group individually, demonstrated significantly greater antibody reaction to a range of human adenoviral proteins. Compared to controls exposed to the same immunological stimulus, antibody reactivities to viral antigens are enhanced in patients with GBS. However, we found no mechanistic link between S1 and peripheral nerve reactivity or pathology. Serological responses to adenoviral proteins may be directly involved in the pathogenesis of Guillain-Barré syndrome, potentially contributing to cases with currently unexplained aetiology.