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Recent Submissions
Impact of thiamin supplementation on thiamin pyrophosphate effect and cardiac function in pediatric heart disease patients on diuretics: a randomized controlled trial
(2026-03-23) Sumboonnanonda R.; Vijarnsorn C.; Saengpanit P.; Srisawat C.; Chotipanang K.; Junnu S.; Kunnangja S.; Rukprayoon H.; Phuangphan P.; Suiwongsa B.; Liammongkolkul S.; Laohathai P.; Densupsoontorn N.; Sumboonnanonda R.; Mahidol University
Thiamin is a water-soluble vitamin essential for energy metabolism. Patients on long-term diuretics, particularly those with heart disease, are at risk of thiamin deficiency (TD) due to increased urinary loss, which may impact cardiac function. We evaluated changes in thiamin pyrophosphate effect (TPPE) values after 4 weeks of thiamin supplementation compared to placebo in pediatric heart disease patients receiving diuretics. The secondary objectives included assessing changes in left ventricular ejection fraction (LVEF) and identifying factors associated with TPPE changes. In this triple-blinded, randomized controlled trial, we recruited 45 children (aged 1 month to 15 years) with heart disease with increased pulmonary blood flow or congestive heart failure, all on diuretics for ≥ 1 month. Participants were randomly allocated to receive thiamin 25 mg/day, thiamin 50 mg/day, or placebo for 4 weeks. TD was defined as TPPE values ≥ 15%. At baseline, 9 of 45 participants (20%) had TD. After 4 weeks, no significant differences in changes in TPPE values (p = 0.540) or LVEF (p = 0.441) were observed among the three groups. Multiple linear regression showed that furosemide dosage was independently associated with TPPE changes (β: +0.36, p = 0.015), indicating a dose-dependent association with thiamin status. Thiamin supplementation at 25 mg/day or 50 mg/day did not significantly improve TPPE values or LVEF. However, furosemide dosage correlated with TPPE changes, indicating a need for tailored thiamin supplementation strategies in pediatric heart disease patients on diuretics. For those with TD, doses exceeding 50 mg/day may be necessary.Trial registration NCT03989700 (ClinicalTrials.gov). Date of registration: 18/06/2019.
The Use of Simulation and Gamification in Education: Transforming Learning for the 21st Century
(2026-01-01) Pokhrel T.R.; Acharya N.H.; Kuwar R.; Pokhrel T.R.; Mahidol University
This chapter explores Schell’s Four Game Elements and the MDA framework, highlighting their roles in game design, simulation, and gamification. While MDA focuses on mechanics, dynamics, and aesthetics to shape player experiences, Schell’s model incorporates story, mechanism, technology, and aesthetics for a more holistic approach. The integration of simulation and gamification in education leverages these principles to create engaging, interactive, and skill-based learning environments. Despite challenges like technological barriers and teacher training, advancements in artificial intelligence, virtual reality, and augmented reality promise a more immersive and personalized future for education. These frameworks collectively offer innovative solutions for enhancing motivation, engagement, and learning outcomes. Simulation and gamification are the key to addressing the challenges faced by teachers of the students of the alpha-generation.
Impact of 14 weeks combined exercise on serum cadmium levels, DNA methylation, and epigenetic aging in older women
(2026-01-01) da Silva Rodrigues G.; Yumi Noronha N.; Ribeiro de Lima J.G.; Sae-Lee C.; Chitta P.; da Silva Sobrinho A.C.; Harumi Yonehara Noma I.; Maria Diani L.; Barbosa Júnior F.; Barbosa Nonino C.; Moriguchi Watanabe L.; Roberto Bueno Júnior C.; da Silva Rodrigues G.; Mahidol University
Introduction: Cadmium is a toxic heavy metal linked to impaired cardiorespiratory fitness and altered DNA methylation patterns. This study investigated the effects of 14 weeks of combined exercise training on epigenetic modifications and blood cadmium levels in women with varying aerobic fitness. Methods: Participants underwent three weekly training sessions totaling 180 minutes. Pre- and post-intervention evaluations included anthropometry, blood pressure, physical performance, and heavy metal analysis. DNA methylation was assessed using the Illumina EPIC BeadChip. Results: Based on baseline 6-minute walk test and age, participants were divided into lower (LAF, n = 32) and higher (HAF, n = 17) aerobic fitness groups. Pre-intervention, LAF had significantly higher cadmium levels than HAF (p = 0.003). After the intervention, LAF showed a significant reduction of 0.056 µg/L (63%), while HAF decreased by 0.019 µg/L (28%) (p = 0.046). A total of 513 differentially methylated regions (DMRs) related to cadmium were identified, with enrichment in pathways associated with neurodegeneration-related processes. Intrinsic epigenetic age acceleration (IEAA) also differed significantly between groups at baseline. Conclusion: Combined exercise training significantly reduced cadmium levels in women aged 50–70 years with low aerobic fitness and induced locus-specific epigenetic changes associated with cadmium-related pathways, which may be relevant to pathways implicated in age-related neurological conditions. Clinical Trial: The study was registered in the Brazilian Clinical Trials Registry (ReBEC; identifier RBR-3g38dx).
Multi-transmitter characteristics and functional specialization of oxytocin neuron subpopulations in zebrafish
(2026-05-01) Liu S.T.; Liao B.K.; Shaio M.S.; Chen Y.L.; Huang Y.F.; Chou M.Y.; Liu S.T.; Mahidol University
Teleost oxytocin (OXT) neurons are much fewer in number than those reported in mammals, suggesting that individual neurons may support a broader range of functions. This phenomenon raises the possibility that co-expression of multiple neurotransmitters allows teleost OXT neurons to support various functions. To test this possibility, we systematically examined neurotransmitter characteristics and activity patterns of OXT neuron subtypes in adult zebrafish brain. We found that OXT neurons are distributed across the parvocellular preoptic nucleus (anterior, PPa; posterior, PPp) and the periventricular posterior tuberculum (TPp), segregating by soma size into parvocellular (≤11.62 μm) and magnocellular (>11.62 μm) subtypes. The number of the parvocellular OXT neurons follows an anterior-to-posterior enrichment gradient, whereas magnocellular neurons display an inverse posterior-to-anterior gradient. The OXT neurons co-express glutamatergic, GABAergic and cholinergic neuron markers and show partial co-localization with vasotocin (AVT), while lacking dopaminergic and serotonergic synthesis markers. We also quantified activity-dependent p-S6 expression during mating. p-S6 increased in parvocellular OXT neurons of the PPa and PPp, but not in magnocellular neurons of these regions or in either neuronal type in the TPp. Together, these findings suggest that zebrafish OXT neurons may coordinate behavioral and endocrine functions through multi-transmitter expression and partial AVT co-expression. These results further indicate that anatomically distinct OXT neuron subtypes differ in their functional recruitment, with parvocellular neurons in the PPa and PPp possibly involved in mating-related interactions.
An Exploration of the Younger Thai Generation’s Perceptions of Alcohol Control Policies
(2026-04-01) Marohabutr T.; Thawornwutichat R.; Haisog S.; Marohabutr T.; Mahidol University
This study explores how younger Thai generation perceived alcohol control policies under the Alcoholic Beverage Control Act (2008), Excise Act (2017), and Land Traffic Act (1979), within the context of a developing country like Thailand. Using a qualitative approach, 15 participants aged 18 to 41 from the Bangkok Metropolitan Region (BMR), including both drinkers and non-drinkers, were interviewed through semi-structured, in-depth face-to-face sessions. Content analysis was applied to the verbal data. Findings indicated that the Alcoholic Beverage Control Act was perceived as effective in regulating producers, sales, advertising, and treatment services, though some measures were perceived as ineffective. The Excise Act was perceived as ineffective in changing drinking behaviors and controlling alcohol sales. The Land Traffic Act was viewed as effective in regulating drunk individuals’ behaviors. The study highlights the importance of clear communication and education on alcohol policies to enhance compliance among the younger generation. Future research should extend to other regions in Thailand and other developing countries.