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Recent Submissions
Implementation of a Web-Based Application (Wellhealth) for Osteoporosis Medication Management in Older Adults: Prospective Feasibility Study
(2026-01-01) Mahaisavariya C.; Supamontri K.; Limtrakun N.; Fuangfoo A.; Sakunma P.; Mahaisavariya C.; Mahidol University
Background: Osteoporosis is a major global health challenge, but treatment uptake and long-term adherence remain low, raising the risk of future fractures. Barriers to effective care include low patient awareness, financial constraints, and challenges with ongoing monitoring and follow-up. Although mobile health and telemedicine tools can support chronic disease management, many osteoporosis apps lack clinical validation and structured medication management features. Objective: This study aimed to evaluate the feasibility of implementing a newly developed web-based application, Wellhealth, to support osteoporosis treatment management. A secondary objective was to explore potential associations between patient demographic characteristics and the frequency of in-app medication logging over a 1-year period. Methods: We conducted a feasibility study at the Golden Jubilee Medical Center, Mahidol University, between January 2023 and March 2025. Participants were recruited using convenience sampling during routine outpatient osteoporosis clinic visits. Eligible patients with a primary osteoporosis diagnosis used the Wellhealth web-based system, including the Assisted Liaison Service feature, over a 1-year period. Weekly in-app reports of medication use, satisfaction, and related outcomes were analyzed. Feasibility outcomes were summarized using descriptive statistics. Potential associations between participant characteristics and consistent in-app medication logging were explored using univariable and multivariable logistic regression analyses. Differences between in-app medication logging rates and medication possession ratio values were summarized using medians and IQRs. Results: We enrolled 32 participants with a mean age of 71 (range 58-91) years. The average in-app medication logging rate was 62.38% (SD 27.4%) for antiosteoporosis medications and 64.67% (SD 34.5%) for calcium supplementation. Vitamin D logging data were available for 27 participants, with an average logging rate of 68.23% (SD 31.6%). Overall satisfaction with the application was high, with 49% (15/32) of participants reporting high satisfaction, 42% (14/32) good, and 9% (3/32) average. User interaction increased markedly between the first and third quarters of 2023 before stabilizing through the second quarter of 2024. In multivariable analysis, consistent calcium logging was the only factor independently associated with higher antiosteoporosis logging rates (P=.02). Although younger age was associated with higher logging in univariable analysis (P=.01), this was no longer significant after multivariable adjustment (P=.12). Conclusions: Use of the Wellhealth system was feasible in this small cohort, with consistent medication logging, high user acceptability, and sustained digital engagement. Only consistent calcium logging was independently associated with higher antiosteoporosis medication tracking rates. Larger studies are needed to assess the app’s clinical effectiveness and impact on long-term outcomes.
Impact of kidney transplantation on sex hormone level and sexual function in end stage renal disease men
(2026-01-01) Sirisopana K.; Piyawannarat S.; Ketsuwan C.; Arpornsujaritkun N.; Kantachuvesiri S.; Kijvikai K.; Kongcharoensombat W.; Phengsalae Y.; Matang W.; Sangkum P.; Sirisopana K.; Mahidol University
Objective – This study aimed to prospectively evaluate changes in erectile function and sex hormone levels, including free and bioavailable testosterone, in male end-stage renal disease (ESRD) patients before and at various time points after kidney transplantation (KT). Methods – Male ESRD patients aged 18–70 years who underwent living KT were enrolled between September 2019 and April 2021. Participants completed the International Index of Erectile Function (IIEF-5) and Aging Male Symptoms (AMS) questionnaires one day before KT and at one, six, and 12 months post-transplant. Sex hormones, including testosterone, sex hormone-binding globulin (SHBG), albumin, FSH, and LH, were measured at the same intervals. Free and bioavailable testosterone levels were calculated using a verified calculator. Results – Twenty-eight male patients were enrolled, with a mean age of 43.5 years. The IIEF-5 scores significantly improved at six months after KT (p = 0.006) and were maintained over one year. Patients with a dialysis duration of one to three years showed significant improvement in IIEF-5 scores (p = 0.019), whereas those on dialysis for more than three years did not demonstrate significant changes. AMS scores significantly decreased (improved) starting from the first month post-KT (p < 0.001). Regarding hormones, bioavailable testosterone increased significantly six and 12 months after KT, while free testosterone revealed non-significant increases. LH levels decreased at one month post-KT (p < 0.001) and remained reduced throughout the study. Conclusion – Successful KT significantly enhanced erectile function, particularly in patients with a dialysis duration of less than three years, with significant improvements observed after six months. The increase in bioavailable testosterone and the reduction in LH levels, alongside improved AMS scores, may reflect the restoration of testicular functioning following transplantation. Clinical Trial Registration – https://www.thaiclinicaltrials.org/show/TCTR20181123003, identifier: TCTR20181123003.
Climate Change Interacts with Plastic Stressors and Amplifies Food Insecurity
(2026-01-01) Kamble M.T.; Medhe S.V.; Chavan B.R.; Kettawan A.; Jeamsripong S.; Pirarat N.; Kamble M.T.; Mahidol University
Climate change and plastic pollution are escalating global stressors that interact in complex ways to undermine food security. Climate-driven shifts in temperature, precipitation, sea-level rise, and extreme weather events reduce agricultural yields, destabilize fisheries and aquaculture, and weaken the resilience of food systems. Simultaneously, the proliferation of plastics, from macroplastics to micro- and nanoplastics, contaminates soils, freshwater, and marine environments, impairing nutrient utilization, reducing food safety, and transporting hazardous chemicals through food chains. When combined, these stressors exert synergistic effects that amplify physiological stress in crops, livestock, and aquatic organisms, while accelerating plastic fragmentation and dispersal. The resulting impacts compromise all four pillars of food security: availability, access, utilization, and stability. Vulnerable communities face the greatest risks due to limited adaptive capacity and high dependence on natural resources. This chapter synthesizes pathways through which climate change and plastic stressors interact, highlights case studies from key food systems, and discusses implications for human health and the Sustainable Development Goals (SDGs). It proposes integrated mitigation and adaptation strategies spanning agriculture, aquaculture, waste management, and policy frameworks to strengthen resilience and safeguard global food systems.
Optimization of ultrasound-assisted extraction of bioactive compounds from Theobroma cacao bean shell using response surface methodology
(2026-12-01) Krongrawa W.; Ponphaiboon J.; Samran C.; Limmatvapirat S.; Limmatvapirat C.; Krongrawa W.; Mahidol University
Cocoa bean shell, a major by-product of cocoa processing, is an underutilized source of phenolic bioactive compounds. However, efficient recovery of these compounds and the influence of upstream processing conditions remain insufficiently explored, particularly in relation to sustainable food applications. This study developed an integrated strategy combining roasting process evaluation with statistical optimization of ultrasound-assisted extraction (UAE) to enhance bioactive compound recovery. The physicochemical properties of cocoa butter obtained under different roasting conditions were evaluated to identify suitable processing parameters. Although low-temperature roasting preserved lipid quality, high-temperature roasting provided higher butter yield and improved processing efficiency and was therefore selected. Key extraction variables were screened using a Plackett–Burman design and optimized using a Box–Behnken design with response surface methodology to maximize extraction yield, antioxidant activity, total phenolic and flavonoid contents, and anti-inflammatory activity. Optimal conditions (50.96% v/v ethanol, 5 min, 47.87°C) yielded 33.34 ± 2.81% extract with strong antioxidant capacity. Enhanced extraction efficiency was attributed to acoustic cavitation, which promotes cell disruption and phenolic release. Safety assessment confirmed compliance with international standards, highlighting the potential of cocoa bean shell extract as a sustainable functional ingredient for food and nutraceutical applications and supporting its valorization within a circular bioeconomy framework.
Computed Tomography Detection of Accessory Foramen in the Jugular Foramen: Implications for Skull Base Surgery
(2026-06-01) Triantafyllou G.; Paschopoulos I.; Papadopoulos-Manolarakis P.; Suwannakhan A.; Tsakotos G.; Samolis A.; Piagkou M.; Triantafyllou G.; Mahidol University
Accurate anatomic knowledge of the jugular foramen (JF) is essential in skull base surgery, where morphologic variations—particularly ossified dural septations—can significantly impact surgical planning and outcomes. A recently described variant, the accessory foramen (AF) located on the inferior surface of the JF, may represent such ossified septations. This study aimed to assess the radiologic presence of AF using high-resolution computed tomography (CT). A retrospective analysis was conducted on 168 high-resolution head CT scans (336 sides). Scans were reconstructed in three dimensions (3D) and analyzed using multiplanar reconstructions (MPR). AF was identified unilaterally in 6 patients (3.6% 6/168 patients; 1.8% of sides). All cases were visualized via 3D reconstruction (3DR), while MPR delineated the variation in only 2 cases. Accessory foramen appeared more frequently on the left side (P=0.099), with no significant association with sex (P=0.936) or age (P=0.893). The mean diameter of the AF was 2.41±0.49 mm. This study confirms the presence of a rare AF likely resulting from ossified dural septations, detectable in vivo via 3D CT reconstruction. Recognition of this variant holds important neurosurgical implications, enabling enhanced preoperative assessment and reducing the risk of lower cranial nerve injury during skull base procedures.