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Prevalence of Gastrointestinal Parasites in Wild Asian Elephants (Elephas maximus) at a National Park in Eastern Thailand
(2026-02-01) Kaewchot S.; Thongyuan S.; Sripiboon S.; Chaiyarat R.; Yingyong P.; Bunsermyos W.; Jarudecha T.; Sanyathitiseree P.; Kaewchot S.; Mahidol University
Protected national parks continue to face increased pressure from the expansion of human–wildlife interface zones, where habitat encroachment promotes human–wildlife contact and zoonotic disease transmission. Gastrointestinal parasites (GIPs) are a significant health issue in wild Asian elephants (Elephas maximus), affecting their fitness, survival, and potential for cross-species transmission. This study aimed to investigate the prevalence of GIPs among wild elephants at Khao Sip Ha Chan National Park in eastern Thailand. Direct smear, formalin-ethyl acetate sedimentation, flotation, and McMaster egg per gram (EPG) counting were used to examine 135 fecal samples from three populations. The findings showed that nematodes (Strongyle-type and Strongyloides spp.) and trematodes (Paramphistomum spp. and Fascioloides jacksoni) were identified. All samples were positive for at least one parasite species, and 84.4% were affected by mixed infections. The prevalence of Strongyle-type and Strongyloides spp. varied significantly among the studied populations, but Paramphistomum spp. had a moderate prevalence, and Fascioloides jacksoni had a low prevalence. The high parasite burden could be explained by environmental factors, host density, and movement patterns influencing parasite transmission, and these factors should be further investigated. These findings provide crucial baseline data and underscore the need for integrated parasite surveillance, alongside long-term conservation and future research.
Genomic Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Isolated from Patients Admitted to Intensive Care Units in Network Hospitals in Southern Thailand
(2026-02-01) Chukamnerd A.; Surachat K.; Pomwised R.; Palittapongarnpim P.; Singkhamanan K.; Chusri S.; Chukamnerd A.; Mahidol University
Background/Objectives: Carbapenem-resistant Acinetobacter baumannii (CRAB) is classified as an urgent-threat pathogen because of its resistance to nearly all available antibiotics, resulting in high morbidity and mortality rates. However, data on the molecular epidemiology of CRAB isolates in southern Thailand are limited. This study aimed to investigate the genomic epidemiology of CRAB isolates within a hospital network in lower southern Thailand. Methods: Whole-genome sequencing data of CRAB clinical isolates (n = 224) were obtained from a previous study. Additional isolates (n = 70) were included, for which genomic DNA was extracted and sequenced. In total, 294 isolates were collected from patients across seven hospitals in southern Thailand between 2019 and 2020. Their genomes were analyzed using several bioinformatic tools. Results: A high proportion of isolates were obtained from sputum samples of patients with CRAB infection or colonization. Sequence type (ST) 2 was the most frequent ST and was classified in the quadrant with high resistance and virulence. The Sankey diagram showed that ST2 was the dominant and most versatile CRAB lineage circulating across major hospitals, commonly associated with pneumonia, and that diverse resistance genes and plasmid combinations were dominated by blaOXA-23. The core single-nucleotide polymorphism (SNP)-based phylogenetic tree revealed clades A1 (ST215), A2 (multiple STs), and B (ST2). Bloodstream, skin, and soft tissue infections were predominantly observed in clade B. Conclusions: Our analysis revealed widespread circulation of a high-risk ST2 CRAB lineage with enhanced resistance and virulence across hospital networks in the studied region, highlighting the importance of genomics-informed surveillance for controlling CRAB dissemination.
Global Burden of Trichostrongylus Infections in Humans: A Systematic Review and Meta-Analysis
(2026-02-01) Jongthawin J.; Wangdi K.; Mahittikorn A.; Masangkay F.R.; Kotepui M.; Jongthawin J.; Mahidol University
Trichostrongylus species are zoonotic gastrointestinal nematodes that occasionally infect humans, particularly in rural areas with close contact to livestock. However, the global prevalence of human trichostrongylosis remains uncertain. This systematic review and meta-analysis aimed to synthesize available prevalence data and describe regional and methodological differences in reported infections. Studies published between 2000 and 2025 reporting the prevalence of Trichostrongylus infections in humans (primarily T. colubriformis, T. axei, and T. orientalis) were searched in six databases (EMBASE, Ovid, PubMed, Scopus, Nursing & Allied Health Premium, and Web of Science) and Google Scholar. Pooled prevalence was estimated using a random-effects model. Subgroup analyses were conducted to assess prevalence by continent, country, population group, and diagnostic method. Thirty-seven studies from 14 countries, comprising 111,408 participants, were included. Most studies were conducted in Asia (23, 62.2%), particularly in Iran (12, 32.4%), and in Africa (12, 32.4%), mainly in Nigeria (5, 13.5%). The global pooled prevalence of Trichostrongylus infection was 1.2%. Prevalence was highest in Africa (1.7%), followed by South America (1.2%), Asia (1.0%), and Europe (0.8%). Subgroup analyses revealed substantial heterogeneity in prevalence across study populations, age groups, and detection methods (p < 0.05). Available evidence suggests that human Trichostrongylus infection remains a localized but persistent zoonotic concern in specific endemic regions, rather than a globally uniform problem. Diagnostic variability, limited regional coverage, and high heterogeneity highlight the need for standardized molecular diagnostics and broader surveillance to accurately define the global epidemiology of trichostrongylosis.
Implementing log file-based patient-specific QA for VMAT plans: A comparative study of MobiusFX and measurement-based approaches
(2026-03-01) Sawapabmongkon T.; Changkaew P.; Puttanawarut C.; Tangboonduangjit P.; Khachonkham S.; Sawapabmongkon T.; Mahidol University
BACKGROUND: The current interest in utilizing log file-based patient-specific quality assurance (PSQA) is growing as an alternative to measurement-based approaches for volumetric modulated arc therapy (VMAT) plans. However, implementing log file-based PSQA requires further experience and understanding since there are no guidelines. PURPOSE: This study aimed to evaluate the feasibility of implementing commercial log file-based PSQA (MobiusFX) for pretreatment verification of VMAT plans by comparing its outcomes with measurement-based methods. METHODS: The study was conducted by selecting 40 VMAT plans and these plans were performed for pretreatment verification for both MobiusFX and measurement-based methods, including portal dosimetry, ArcCHECK, and Octavius4D with gamma analysis at criteria 3%/3 mm, 3%/2 mm, and 2%/2 mm. The agreement of gamma passing rate between MobiusFX and measurement-based methods was assessed through scatter plots and percentage agreement score. Additionally, the root mean square (RMS) errors obtained from MobiusFX were investigated in each machine parameter, and examined the correlation between the gamma passing rate and plan complexity metric (MU/Gy) by Spearman's rank correlation coefficient. The statistical control process concept from TG 218 was also applied to establish the action limit (AL) and tolerance limit (TL) for MobiusFX. RESULTS: The scatter plots of MobiusFX illustrated a trend similar to the measurement-based methods, with high percentage agreement scores observed at 3%/3 mm and 3%/2 mm criteria. RMS errors were zero for all parameters except multileaf collimator (MLC), and the maximum RMS was 0.06 mm. No correlation was found between the gamma passing rate and the complexity metric in this study. The most appropriate TL and AL for the gamma passing rate with MobiusFX were determined to be 95.38% and 94.75%, respectively, at the 3%/2 mm criterion. CONCLUSION: MobiusFX showed interchangeable gamma passing rates with measurement-based methods at the 3%/3 mm and 3%/2 mm criteria, supporting its use as an alternative for VMAT pretreatment verification. Machine- and system-specific factors should be considered for reliable clinical implementation.
Validation of simplified scoring systems for assessing cutaneous disease activity in dermatomyositis
(2026-02-01) Pongtarakulpanit N.; Bishnoi A.; Chandra T.; Dzanko S.; Gkiaouraki E.; Keret S.; Lomanto Silva R.; Sriram S.; Saygin D.; Liarski V.M.; Ascherman D.P.; Moghadam-Kia S.; Oddis C.V.; Aggarwal R.; Pongtarakulpanit N.; Mahidol University
OBJECTIVES: The Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) is a standard clinician-scored outcome measure for dermatomyositis (DM), but requires expertise and training. We aimed to validate simplified versions of the CDASI activity score. METHODS: Adult DM patients were prospectively enrolled with two clinic visits ≥2 months apart. Two rheumatologists independently assessed patients using the CDASI activity score (range 0-100) and the cutaneous visual analogue scale of the Myositis Disease Activity Assessment Tool (MDAAT cutaneous VAS). Additionally, patients completed the Skindex questionnaire. Four simplifications (sCDASI) were derived: (1) sCDASI-1 (range 0-66), simplified erythema to absent/present (0-1); (2) sCDASI-2 (range 0-36), simplified erythema and exclusion of scale scoring; (3) sCDASI-3 (range 0-20), simplified erythema, exclusion of scale and ulcer scoring; (4) sCDASI-4, (range 0-50), simplification of all parameters to absent/present. RESULTS: Twenty-seven DM patients (81.5% female, 96.3% White, median age 50.0) were included. Median CDASI activity was 4.5 (IQR 1.0-12.0). All sCDASI scores correlated strongly with the full CDASI (Spearman ρ=0.97-0.98), MDAAT cutaneous VAS (Spearman ρ=0.94), and Skindex (Spearman ρ=0.82-0.83), indicating good convergent validity. Inter-rater reliability for all simplifications was high, as indicated by strong correlations between assessors. The changes from baseline in simplified CDASI scores correlated strongly with the changes in full CDASI scores and MDAAT cutaneous VAS, demonstrating good responsiveness. CONCLUSIONS: Simplified CDASI scorings demonstrated preliminary evidence of favourable validity, reliability, and responsiveness in the longitudinal evaluation of rashes in DM patients.