Mahidol University's Institutional Repository
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Recent Submissions
The Benefits of an Intracardiac Conduit in the Fontan Operation for Complex Systemic Venous Anomalies in Patients with Single Ventricle Physiology
(2026-01-01) Tocharonechok T.; Vijarnsorn C.; Chanthong P.; Chungsomprasong P.; Kanjanauthai S.; Tocharonechok T.; Mahidol University
Background: Systemic venous anomalies pose challenges to cavopulmonary connections in univentricular patients. At our unit, the intracardiac conduit (ICC) Fontan has been introduced for cases involving apicocaval juxtaposition (ACJ). This addresses issues of a long-curved extracardiac conduit (ECC) to the contralateral pulmonary artery (PA) and potential compression of the ECC to the ipsilateral PA. Methods: We present four patients at various stages who underwent an ICC Fontan operation. This includes primary Glenn connections with the setup for the cath lab Fontan. Results: The ICC placement was done in four levocardic patients. The first patient had an interrupted inferior vena cava (IVC) who previously underwent the Kawashima operation on the left side with pulmonary arteriovenous malformation. The ipsilateral drainage hepatic veins (HVs) were connected to the right PA using an ICC. The second and third patients with left ACJ and preexisting bilateral Glenns underwent IVC to the right PA connection using an ICC. The fourth patient had bilateral superior vena cava, left ACJ, ipsilateral HV drainage, and presented at 10 years of age having had no prior operations. He underwent construction of a bilateral bidirectionalGlenn, right HV to conduit baffling, and IVC to the main PA connection using an ICC with two fenestrations (to allow a gradual ventricular preload change; discharge saturation of 80%). This set him up for interventional closure of the larger fenestration later for physiologic Fontan completion. All the patients recovered with unobstructed conduits and were anticoagulated without thromboembolic/bleeding events. Conclusions: The ICC Fontan operation provides a safe and effective cavopulmonary connection in selected patients with complex systemic venous anomalies.
The Frame of Survival for Sepsis: A Practical Systems Framework for Time-Sensitive Critical Illness in Low-Resource Settings
(2026-01-01) Hidalgo J.L.; Akech S.O.; Acharya S.P.; Coopersmith C.M.; Jacob S.T.; Johnston C.; Kissoon N.; Machado F.R.; Maves R.C.; Molyneux E.; Morrow B.M.; Myatra S.N.; Pérez Cornejo M.S.; Perez-Fernandez J.; Permpikul C.; Piyavechviratana K.; Rhodes A.; Kortz T.B.; Kumar V.K.; Ulisubisya M.M.; Nadkarni V.; Hidalgo J.L.; Mahidol University
Objectives: – Sepsis is a time-sensitive cause of preventable death worldwide, with disproportionate mortality in low-resource settings (LRS). Many recommendations in international sepsis guidance presume resources unavailable in many facilities and communities. We sought to develop a practical framework that helps health systems embed feasible sepsis actions within broader emergency and essential critical care systems, while highlighting where evidence is limited and where local learning systems are needed. Data Sources: – A targeted scoping review of peer-reviewed and grey literature on sepsis epidemiology, emergency care systems, essential emergency and critical care, implementation strategies, and quality improvement (QI) in LRS; and key guideline and policy documents relevant to sepsis and emergency care. Study Selection: – We prioritized publications and guidance relevant to LRS, including observational studies, pragmatic implementation reports, consensus statements, and policies addressing emergency care organization, workforce, supply chains, diagnostics, and QI. Data Extraction: – Task force members abstracted actionable strategies, implementation barriers/enablers, and feasibility considerations across the care continuum (community, transport/prehospital, facility-based acute care, and referral). We also identified domains where guideline certainty is low or indirect for LRS. Data Synthesis: – A Society of Critical Care Medicine-convened multidisciplinary task force iteratively developed the “Sepsis Frame of Survival” using a structured process that included 1) scoping evidence review, 2) a Delphi-style prioritization of candidate framework elements by importance and feasibility, and 3) a structured consensus meeting (“Utstein-style” conference format) to finalize the model and its priority actions. We produced a concise implementation roadmap and a feasible measurement set aligned with resource constraints. Conclusions: – The Sepsis Frame of Survival is a pragmatic model to organize sepsis improvement as part of emergency and essential critical care strengthening. It emphasizes high-impact actions that can be implemented with limited resources (triage and early recognition, timely antimicrobials, oxygen and basic supportive care, cautious fluid resuscitation with reassessment, source control and referral, diagnostics/microbiology where feasible, and QI). The framework explicitly distinguishes near-term, feasible changes from longer-term system investments and highlights the need for locally generated evidence to guide quality indicators and resuscitation strategies in LRS.
FEW-VIEW X-RAY CT SEGMENTATION OF THIN TUBULAR STRUCTURES
(2025-01-01) Fitriyah H.; Muneesawang P.; Lee I.; Fitriyah H.; Mahidol University
X-ray CT scanning is both time-consuming and radiation-intensive due to the large number of projections needed to produce high-quality images. Reducing the number of projections can accelerate acquisition and reduce radiation exposure, but often leads to degraded image quality, making the segmentation of fine-grained structures particularly challenging. To address this few-view imaging challenge, this study proposed a modified 3D U-Net model for segmenting thin tubular structures, with scalability that ensures high accuracy even with reduced input quality. The proposed model integrates residual blocks, squeeze-and-excitation (SE) blocks, and dilated convolutions to enlarge the receptive field and emphasise important channels, without significantly increasing the number of learnable parameters. Training was performed on few-view CT reconstructions generated from images with a dense projection. Experiments conducted in plant root and lung vessel datasets demonstrate that certain enhancements improved segmentation accuracy under severe sparsity.
Tailoring Re-loaded core–shell Ni structures embedded in mesoporous silica for the selective transformation of levulinic acid into γ-valerolactone
(2026-01-01) Maneewong Y.; Lakhani P.; Ratchahat S.; Sakdaronnarong C.; Limphirat W.; Assabumrungrat S.; Choojun K.; Sooknoi T.; Tomishige K.; Srifa A.; Maneewong Y.; Mahidol University
Heterogeneous core–shell catalysts have attracted significant interest because they integrate multiple catalytic functions within a single, precisely engineered architecture. In this work, we report the rational synthesis and catalytic evaluation of a Re-loaded Ni core–shell catalyst embedded in mesoporous silica for the efficient hydrogenation of levulinic acid (LA) to γ-valerolactone (GVL). The core–shell configuration enables effective confinement of Ni nanoparticles within the porous silica matrix and stabilizes spatially separated Ni and ReOX species with complementary catalytic functions. Comprehensive physicochemical characterization confirmed the successful formation of the core–shell structure, its high structural stability, and the presence of confined metallic Ni sites responsible for H2 activation and oxophilic ReOX-derived acid sites for oxygenate activation. Under optimized conditions, the Ni12Re1.63-CS catalyst achieved complete LA conversion with a GVL yield exceeding 94% within 2 h, outperforming non-core-shell catalysts. The catalyst also displayed high intrinsic activity, with a turnover frequency of up to ∼36 h−1, and retained an excellent GVL selectivity of approximately 80% during recycling, despite a gradual decrease in LA conversion. These findings demonstrate that spatial separation of hydrogenation and oxophilic adsorption sites within a core–shell architecture is critical for enhancing activity and selectivity in biomass-derived platform molecule upgrading.
Recent insights into morphology evolutions during 3D printing processes of advanced materials
(2026-01-01) Ree B.J.; Sinta J.; Pyo R.; Waennil P.; Singkammo S.; Rugmai S.; Ree B.J.; Mahidol University
Three-dimensional (3D) printing technologies have attracted significant interest from both academia and industry because of their extraordinary power and merits in manufacturing products over traditional manufacturing techniques. They are particularly well suited for the fabrication of complex 3D structures. Over the past two decades, substantial research and development efforts have led to remarkable advances in these technologies. Nevertheless, significant challenges remain, particularly in establishing comprehensive and reliable databases that capture the evolution of morphological structures during the printing process. Such structures include hierarchical features across multiple length scales and orientations, dimensional accuracy, and surface quality. These data are essential for optimizing processing conditions, understanding structure–property relationships, improving property performances, and expanding the global additive manufacturing market. Real-time approaches for monitoring morphological evolution during 3D printing have been demonstrated; however, their implementation remains at an early and relatively limited stage. In-situ scattering techniques enable probing of hierarchical structures from atomic to micrometer length scales, while real-time microscopy methods provide complementary information on porosity, geometry, and material dynamics during fabrication. To date, however, these studies have focused on a narrow range of materials and have largely relied on basic or qualitative analyses. This highlights the need for broader adoption of such techniques and for more rigorous, quantitative data analysis to establish robust correlations among processing parameters, structural evolution, and resulting material properties. This article reviews real-time morphology analysis techniques that have been implemented or are under development for 3D printing technologies, along with the analytical outputs they generate. It also discusses perspectives on future advances in in-situ monitoring of morphological evolution across all areas of additive manufacturing.