Mahidol University's Institutional Repository
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Recent Submissions
Cost-Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors and Angiotensin Receptor-Neprilysin Inhibitors in Addition to Standard Treatment of Chronic Heart Failure: A Systematic Review and Meta-Analysis
(2026-01-01) Tongpoonsakdi N.; Tansawet A.; Yingchoncharoen T.; Amornritvanich P.; Noviyani R.; Thavorncharoensap M.; McKay G.J.; Attia J.; Thakkinstian A.; Tongpoonsakdi N.; Mahidol University
Background: Guideline-directed medical therapies (GDMTs) have improved heart failure (HF) outcomes, particularly with the emergence of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and angiotensin receptor-neprilysin inhibitors (ARNI). However, their cost-effectiveness remains uncertain across HF phenotypes, income levels, and analytic perspectives. Objectives: The study aimed to evaluate and compare the incremental net benefit (INB) of SGLT2i and/or ARNI added to traditional GDMTs, stratified by HF phenotype, country income level, and study perspective. Methods: PubMed, Scopus, and the Cost-Effectiveness Analysis Registry were searched through October 2024. Economic evaluations assessing SGLT2i or ARNI added to traditional GDMTs were included. INBs and variances were extracted or calculated; if unavailable, variances were imputed via regression or based on similar studies. Random-effects meta-analyses were performed by treatment-comparator pairs, HF phenotype, income level, and perspective. Risk of bias was assessed using the Bias in Economic Evaluation checklist. Results: Seventy studies were included. Adding SGLT2i to traditional GDMTs was cost-effective in high-income countries (HICs) for HF with reduced ejection fraction (HFrEF) from healthcare perspective (pooled INB = US $13 114.52; 95% CI: 4257.40–21 971.63), whereas evidence was inconclusive for upper-middle (UMICs) or lower-income countries. Quadruple regimen (SGLT2i + ARNI) appeared cost-effective in HICs and UMICs, although evidence was limited. Replacing other renin-angiotensin-aldosterone system blockers with ARNI was only cost-effective for HFrEF from societal perspective in HICs (INB = US $14 843.66; 95% CI: 566.36–29 120.96). Evidence for other HF phenotypes remained inconclusive evidence. Conclusions: Adding SGLT2i and ARNI improves GDMTs cost-effectiveness for the treatment of HFrEF, especially in HICs. More evidence is needed for other HF types and income settings.
Antioxidant Activity and a-Glucosidase Inhibitory Activity of Mesona chinensis Aqueous Extract
(2023-09-01) Suriyaphan O.; Tangsathitkulchai K.; Chewchinda S.; Lomarat P.; Sato V.H.; Suriyaphan O.; Mahidol University
Mesona chinensis is raw material for the production of a black grass jelly in Thailand. Mesona chinensis aqueous extract (MCAE) has been reported as a promising anti-hyperglycemia agent. The better understanding of MCAE on its production and biological activities would facilitate the development of a new functional ingredient and beverage. Thus, the effects of botanical source on bioactive compounds, antioxidant activity and hypoglycemic activity of MCAE were investigated. In this present study, we prepared four MCAEs from M. chinensis plants imported from China (2 sources), Vietnam, and Indonesia. Based on data analysis, botanical source of M. chinensis significantly governed total phenolic content, total flavonoids content, DPPH radical scavenging activity and a-glucosidase inhibition activity of MCAE ( p<0. 05) . The results showed that MCAEs possessed considerable amount of total phenolics (68.63-133.27 mg GAE/g) and trace amount of total flavonoids (3.49-5.83 mg QE/g). MCAEs exhibited potent antioxidant (IC50=17.54-37.98 mg/mL) and efficient inhibitor against alpha-glucosidase (IC50=4.77-26.86 mg/mL). The enzyme kinetics data revealed that MCAE inhibited a-glucosidase activity in a concentration-dependent manner. Moreover, the Lineweaver-Burk plot elucidated that the inhibition type of a-glucosidase activity by MCAE was a noncompetitive manner with the inhibitory constant (Ki) of 2.67 mg/mL.
Coupled thickness optimization of PEM, CL, and GDL in Two-Phase PEMFCs using OpenFOAM-Based 3D CFD and Sensitivity-Guided ANN–GA surrogate modeling
(2026-05-01) Seanglumlert C.; Boekfah A.; Kamma P.; Loksupapaiboon K.; Chaiworapuek W.; Punurai W.; Promtong M.; Suvanjumrat C.; Seanglumlert C.; Mahidol University
Proton exchange membrane fuel cell (PEMFC) performance is governed by tightly coupled electrochemical reactions and multi-phase transport processes occurring within the membrane electrode assembly (MEA). In particular, the thicknesses of the proton exchange membrane (PEM), catalyst layer (CL), and gas diffusion layer (GDL) jointly control protonic resistance, catalyst utilization, oxygen accessibility, and liquid water evacuation. However, most available studies still optimize MEA layers independently, despite the fact that realistic PEMFC operation is dominated by nonlinear coupling between charge transport and two-phase water dynamics. In this work, a high-fidelity three-dimensional two-phase PEMFC model was developed in OpenFOAM using the openFuelCell2 framework to resolve multi-species transport, electrochemical kinetics, conjugate heat transfer, and multiphase water transport across all MEA layers. A systematic multi-parameter dataset was generated by simultaneously varying PEM thickness (25–200 μm), CL thickness (3–20 μm), and GDL thickness (150–350 μm) under fixed operating conditions. To enable efficient exploration of the nonlinear high-dimensional design space, a surrogate-assisted artificial neural network–genetic algorithm (ANN–GA) optimization framework was constructed. The ANN surrogate was trained using CFD-generated polarization data and subsequently coupled with a real-coded GA to maximize power density. The integrated optimization identified an optimal MEA configuration of tPEM = 25 μm, tCL = 14.0037 μm, and tGDL = 167.6356 μm, achieving a maximum predicted power density of 0.3785 W/cm2 at 0.8733 A/cm2. High-fidelity CFD verification yielded 0.3748 W/cm2, corresponding to a deviation below 1.01%, confirming the reliability of the surrogate-driven optimization. Mechanistic analysis reveals that the optimum arises from the combined minimization of protonic ohmic losses (thin PEM), enhancement of electrochemically active reaction volume without severe oxygen diffusion limitation (moderate CL), and reduction of cathode-side mass transport resistance while suppressing excessive liquid water accumulation (thin-to-moderate GDL). The proposed CFD–ANN–GA framework provides a computationally scalable pathway for high-dimensional MEA structural optimization and offers quantitative design guidance for next-generation PEMFC development under two-phase operating conditions.
3-D electromagnetic imaging of highly deformed fluid-rich weak zones and locked section of the North Anatolian fault beneath the Marmara Sea
(2026-01-01) Kaya-Eken T.; Ogawa Y.; Usui Y.; Kasaya T.; Tunçer M.K.; Honkura Y.; Oshiman N.; Matsushima M.; Siripunvaraporn W.; Kaya-Eken T.; Mahidol University
Reliable knowledge of the crustal properties beneath the North Anatolian fault (NAF), seismically silent for more than 250 years beneath the Marmara Sea (MS), is crucial for understanding seismic hazard and mitigating the potential for disaster on an enormous scale. In the present work, the first three-dimensional inverse modeling performed on a magneto-telluric dataset of the MS has unveiled localized weak and locked fault segments along this shear deformation zone. Low-resistivity regions along the northern branch of the NAF beneath the Central and Çınarcık-Imralı basins are likely attributed to the presence of fluids, which may represent a fault zone conductor in a fractured zone and can explain the densely populated microseismicity. These low-resistivity anomalies surrounded by higher resistivity structures imply that the segmented, multi-branched NAF system extends beneath the MS, following the Intra-Pontide suture zone. The resistive anomalies, between the Central and Çınarcık basins, along with those at the western and eastern extremities of the MS, presumably signify regions of stress accumulation, shedding light on the ongoing processes of fault mechanics at play in this critical region.
Predictive factors for hypertensive encephalopathy in hospitalized pediatric patients: a retrospective case-control study
(2026-01-01) Sengsomwong P.; Likasitwattanakul S.; Piyaphanee N.; Chaiyapak T.; Lomjansook K.; Supavekin S.; Pattaragarn A.; Sengsomwong P.; Mahidol University
Background: Hypertensive emergency in children often exhibits neurological symptoms indicative of hypertensive encephalopathy (HE). The risk factors concerning HE development remain unclear, motivating the objective of this study to identify risk factors and formulate an equation for forecasting HE in hospitalized pediatric patients. Methods: This retrospective case-control study focused on pediatric patients aged 1–18 years diagnosed with hypertension from 2011 to 2021. Logistic regression analysis was utilized to identify variables associated with HE. A HE predictive equation was developed based on significant factors, with sensitivity, specificity, and predictive values assessed using receiver operating characteristics curves. Results: Three hundred thirty-two patients with mean age 9.3 years were recruited. 12.3% developed HE. Univariable analysis revealed risk factors for HE, including central nervous system symptoms, peak systolic and diastolic blood pressure z-score (Z-SBP and Z-DBP), corticosteroid and calcineurin inhibitor use, and leukemia/lymphoma. Logistic regression formed the equation predicting HE occurrence as follows: 2.162 (vomiting) + 2.921 (headache/dizziness) + 2.363 (leukemia/lymphoma) + 1.807 (corticosteroid) + 0.783 (peak Z-SBP). The equation demonstrated robust correlation with predicted probability of developing HE and had AUC of 0.95. A cutoff score of 4 showed high sensitivity (97.6%) and negative predictive value (99%), identifying 98% of HE cases. Conclusions: This study pinpointed key risk factors and introduced an accurate predictive equation, underscoring the significance of assessing multiple factors beyond blood pressure levels for HE prediction in hypertensive pediatric patients.