Mahidol University's Institutional Repository
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Recent Submissions
Assessment of antibody responses to Anopheles SG6-P1 and Aedes N-term 34 kDa salivary peptides: a randomised human-challenge trial of controlled exposures to vector bites
(2026-03-02) Chaumeau V.; Kearney E.A.; Wasisakun P.; Sawasdichai S.; Aung A.A.; Agius P.A.; Min T.H.; da Silva Gonçalves D.; O'Flaherty K.; Rouers A.; Aryalamloed S.; Htoo G.N.; Sue M.P.; Tha N.M.; Chanida N.; Gornsawun G.; Chotirat S.; Simpson J.A.; Rénia L.; Nosten F.; Fowkes F.J.I.; Chaumeau V.; Mahidol University
BACKGROUND: Human antibodies against mosquito salivary proteins are proposed as proxy biomarkers of exposure to vector bites. This trial sought to characterise the boosting and decay dynamics of antibodies against Anopheles SG6-P1 and Aedes N-term 34kDa salivary peptides in a human challenge model of controlled exposure to the main Southeast Asian malaria and global dengue vectors. METHODS: In this single-centre, open-label, randomised, exploratory factorial trial, healthy volunteers aged 18-60 years with no history of recent travel to rural areas were recruited in Mae Sot, Thailand (ClincalTrials.gov: NCT04478370). Participants were randomly assigned to receive either 35 or 305 bites of mosquitos of laboratory-adapted colonies of Anopheles dirus, Anopheles maculatus, Anopheles minimus, Aedes aegypti and Aedes albopictus using a block randomisation schedule. Samples were collected weekly before, during and after the challenges for 16 weeks. The primary endpoint was total IgG antibodies against Anopheles SG6-P1 peptides measured using high-throughput ELISA and analysed with generalised estimating equations. Outcome assessors were masked to the intervention groups. RESULTS: Between January 21, 2021, and May 10, 2022, 248 volunteers were screened, of whom 210 were randomly assigned to receive either 35 or 305 bites of Ae. aegypti (n = 20 and n = 19, respectively), Ae. albopictus (n = 20, n = 21), An. dirus (n = 21, n = 21), An. maculatus (n = 23, n = 24), or An. minimus (n = 22, n = 19), comprising the intention-to-treat population. In participants exposed to 305 An. minimus bites, total anti-gSG6-P1 IgG levels increased 1.14-fold (95% confidence interval [CI] 1.03-1.26) and 1.18-fold (95% CI 1.05-1.33) during the exposure and post-exposure periods respectively (relative to baseline), with minimal or no boosting observed in other groups. The estimated half-life of anti-gSG6-P1 antibodies was 421 (95% CI 155-688) days. Seven participants were withdrawn due to an adverse event. CONCLUSIONS: Anti-gSG6-P1 antibodies were boosted in response to exposure to 305 bites of An. minimus, but the magnitude of boosting was small and antibodies decayed slowly. Future research is warranted to identify and validate serological markers of vector biting exposures. TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov: NCT04478370.
“Thaifying” Kodály: Developing an Applied Prototype Pedagogical Method for 7th-Grade Students in Thailand
(2025-01-01) Jumneanpan W.; Pidokrajt N.; Jumneanpan W.; Mahidol University
This study focused on creating an applied prototype of a Kodály-based pedagogical method for 7th-grade students in the Thai education system and on evaluating its implementation in a school in Central Thailand. The research objectives were: 1) to develop Kodály-based lessons to improve students’ musicianship skills; 2) to analyse the learning process of students taught with this approach; 3) to gather students’ views on the method; and 4) to obtain feedback from music educators, academics, and experts on its applicability. The sample comprised 18 students and 15 respondents from the music education community. The findings showed clear improvement in musicianship skills, and students reported increased confidence and engagement, suggesting that Kodály-based instruction can help make complex concepts more accessible. Feedback from the specialist group affirmed the method’s suitability for strengthening foundational skills and its adaptability within Thai educational settings. The applied prototype incorporates culturally grounded components, including a Thai song composed for this research, the use of Thai solfège, and the Thai quarter rest (yood). The study demonstrates how Kodály’s pedagogical principles may be reinterpreted through context-specific modifications and provides a model for culturally responsive music education.
Emergence of novel zoonotic and multidrug-resistant Streptococcus suis lineages
(2026-01-01) Brizuela J.; Murray G.G.R.; Boueroy P.; Balmer A.J.; Wongsurawat T.; Jenjaroenpun P.; Chopjitt P.; Hatrongjit R.; Weinert L.A.; Kerdsin A.; Schultsz C.; Brizuela J.; Mahidol University
Objectives Streptococcus suis is an emerging zoonotic porcine pathogen and a leading cause of adult bacterial meningitis in Southeast Asia, associated with raw pork consumption. Most zoonotic S. suis infections globally are caused by strains from lineage CC1 carrying a serotype 2 capsule. However, in Thailand, ∼40% of the reported zoonotic infections are caused by 2 endemic lineages, CC104 and CC233, which also have a serotype 2 capsule. In this study, we aimed to identify the drivers of the emergence and recent evolution of these two lineages. Methods We sequenced the whole genomes of 141 Thai S. suis zoonotic and porcine strains isolated over a 15-year period and combined them with a curated global dataset of 2761 published S. suis genomes. Using comparative genomics, Bayesian evolutionary models, and multivariate analysis, we investigated the emergence of zoonotic potential and multidrug resistance in CC104 and CC233. Results We estimated recent emergence dates for both CC104 (1990; 95% posterior: 1987–1992) and CC233 (2002; 95% posterior: 2000–2004). Both lineages acquired a serotype capsule 2 from CC1 through a capsule locus switching event, prior to their emergence. Both lineages have also experienced multiple antimicrobial resistance acquisition events, with some strains carrying 12 determinants encoding resistance against 8 classes of antibiotics. Most importantly, CC104 and CC233 lineages are the first zoonotic lineages to have acquired increased resistance to penicillin and ceftriaxone, which form the standard therapy to treat S. suis infections in humans. Conclusions Horizontal transfer of multiple genomic regions can cause rapid emergence of novel multidrug-resistant zoonotic S. suis lineages. As S. suis is mainly controlled and treated through the use of antibiotics in both pigs and humans, these findings highlight the urgent need for improved and enhanced surveillance, infection control, and treatments.
Accelerated bone loss increases osteoporosis and fracture risk in moderate to severe chronic kidney disease
(2026-01-01) Unwanatham N.; Disthabanchong S.; Ponthongmak W.; Prechaporn W.; Assanatham M.; Nimitphong H.; Sritara C.; Thakkinstian A.; Unwanatham N.; Mahidol University
Chronic kidney disease–mineral and bone disorder (CKD-MBD) contributes to bone loss and fractures. Evidence on longitudinal changes in bone mineral density (BMD) in CKD remains limited. This retrospective cohort study evaluated the longitudinal decline in BMD across levels of kidney function and examined the associations between kidney function and the risk of osteoporosis and fractures. Patients with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 who underwent dual-energy X-ray absorptiometry between 2010 and 2023 were included. Associations between kidney function, longitudinal BMD changes, and a composite outcome of new-onset osteoporosis or incident fracture were analyzed. A total of 2,909 patients had BMD measurements at the total hip (TH) and femoral neck (FN), and 2,596 at the lumbar spine (LS). At baseline, over 90% had an eGFR of 30–59 mL/min/1.73 m2. Lower eGFR was associated with reduced TH BMD and, to a lesser extent, FN BMD, while LS BMD showed no consistent decline. An eGFR <45 mL/min/1.73 m2 was an independent risk factor for lower TH and FN BMD. Among 1,301 patients with serial measurements (median follow-up 4.5 years), declines in TH and FN BMD and T-scores were observed, with greater loss in the eGFR <45 mL/min/1.73 m2 group. Lower BMD at all sites and eGFR <45 mL/min/1.73 m2 were independent risk factors of the composite outcome. In conclusion, declining kidney function is associated with accelerated bone loss and increased risk of osteoporosis and fractures, underscoring the importance of BMD monitoring in patients with moderate to severe CKD.
Intravitreal GD2-Specific Chimeric Antigen Receptor T-Cell Therapy for Refractory Retinoblastoma
(2026-01-01) Subhadhirasakul S.; Sujjitjoon J.; Yenchitsomanus P.t.; Jarutatsanangkoon K.; Loon N.W.; Sanpakit K.; Buaboonnam J.; Takpradit C.; Yuti P.; Sawasdee N.; Luangwattananun P.; Sangkitporn S.; Limmahachai A.; Atchaneeyasakul L.o.; Subhadhirasakul S.; Mahidol University
Effective treatments for advanced, treatment-resistant retinoblastoma (RB) remain limited. GD2-specific chimeric antigen receptor (CAR) T cells show potent antitumor activity with minimal toxicity but have not previously been evaluated in RB. Under compassionate use, a patient with refractory RB received two intravitreal GD2-CAR T-cell injections. Localized ocular inflammation developed around the tumor within 1 week, subsided, and recurred after the second injection. Elevated intraocular pressure required enucleation at 6 weeks. Histopathology demonstrated dense peritumoral lymphocytic infiltration without anterior segment involvement. Intravitreal GD2-CAR T-cell therapy was feasible, well tolerated, and induced localized immune activation and tumor regression, supporting further investigation.