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This study employs a mathematical model to analyze and forecast the severe outbreak of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), focusing on the socio-economic ramifications within the Thai population and among foreign tourists. Specifically, the model examines the impact of the disease on various population groups, including susceptible (S), exposed (E), infected (I), quarantined (Q), and recovered (R) individuals among tourists visiting the country. The stability theory of differential equations is utilized to validate the mathematical model. This involves assessing the stability of both the disease-free equilibrium and the endemic equilibrium using the basic reproduction number. Emphasis is placed on local stability, the positivity of solutions, and the invariant regions of solutions. Additionally, a sensitivity analysis of the model is conducted. The computation of the basic reproduction number (R0) reveals that the disease-free equilibrium is locally asymptotically stable when R0 is less than 1, whereas the endemic equilibrium is locally asymptotically stable when R0 exceeds 1. Notably, both equilibriums are globally asymptotically stable under the same conditions. Through numerical simulations, the study concludes that the outcome of COVID-19 is most sensitive to reductions in transmission rates. Furthermore, the sensitivity of the model to all parameters is thoroughly considered, informing strategies for disease control through various intervention measures. [ABSTRACT FROM AUTHOR]

Background: Most real-world data on CGRP mAbs have been published from high-income countries such as the USA, Western countries, Japan, Korea, and Singapore. However, data from low- and middle-income countries in Southeast Asia is lacking. This is the first real-world study from Thailand to describe the efficacy of CGRP mAbs therapy in migraine patients and to analyze the response trends between episodic migraine and chronic migraine. Methods: We conducted a single-center, real-world retrospective chart review study with an observation period of 6 months after CGRP mAbs initiation. We aim to compare treatment responses to CGRP mAbs between EM and CM patients. Results: A total of 47 Thai patients were enrolled (median [IQR] age 37.2 [28.6–50.4] years; 85.1%F, 44.7% EM; 70.2% galcanezumab). There was no difference in baseline characteristics and migraine disability assessment (MIDAS) between EM and CM. The overall ≥ 30%, ≥ 50%, and ≥ 70% monthly migraine day reduction rates at 6 months were 89.0%, 71.6%, and 58.5% with higher responders in EM. There was a significant decrease in monthly headache days (MHDs) over time (adjusted β = -0.42, p < 0.001) and a significant decrease in MIDAS score over time after the initiation of CGRP mAbs (adjusted β = -1.12, p = 0.003). However, there were no differences between the two diagnoses. There was no significant decrease in the number of abortive medication pills used over time after the initiation of CGRP mAbs. CM had a significantly steeper trend compared to those with EM. Conclusion: The first real-world study in Thailand demonstrated that CGRP mAbs therapy had efficacy for migraine treatment, as evidenced by a reduction in MHDs, decreased disability, and reduced use of abortive medications. Additionally, the response pattern to CGRP mAbs therapy was similar between EM and CM in terms of MHDs reduction and MIDAS score improvement. [ABSTRACT FROM AUTHOR]

Background: Streptococcus mutans is studied for its acidogenic and aciduric characteristics, notably its biofilm formation in the presence of sucrose, toward its role in the caries process. Variations in both genotype and phenotype have been reported among clinical isolates of S. mutans. This study aimed to examine genotypic and phenotypic characteristics of S. mutans obtained from Thai children with varying caries statuses. Methods: We determined the presence of S. mutans and caries status in 395 children aged 3–4 years. From 325 children carrying S. mutans, we selected 90 with different caries statuses—caries-free (CF; n = 30), low severity of caries (LC; n = 30), or high severity of caries (HC; n = 30). Three isolates of S. mutans were taken from each child, thus, a total of 270 isolates were obtained. Multilocus sequence typing (MLST) was used to genotype the isolates and assess their clonal relationships. The properties, including biofilm formation, collagen binding, and acid production and tolerance were also evaluated. Results: Children with carious lesions showed a higher detection rate and number of S. mutans in saliva than those without caries. S. mutans from individuals with HC status showed the lowest biofilm formation ability, while this group had the highest detection rate of collagen-binding isolates. There was no difference in acid production or tolerance by caries status. Genotyping by MLST did not reveal any clone of S. mutans specific to CF status. This result remained even when we included MLST data from the open-access PubMLST database. MLST did identify clones containing only strains from caries-affected hosts, but tests of their phenotypic properties did not reveal any differences between S. mutans from these clones and clones that were from both caries-free and caries-affected children. Conclusions: The clonal relationships of S. mutans indicated by MLST were not associated with the status of dental caries in the host. [ABSTRACT FROM AUTHOR]

Background. Limited knowledge exists about genital psoriasis in Thai individuals. Objectives. This study aimed to assess the clinical features of genital psoriasis and its effects on quality of life and sexual health in Thai patients. Materials and Methods. A cross‐sectional, self‐administered question‐based study was conducted at Siriraj Hospital. Participants were psoriasis patients older than 18 years of age with past or current genital involvement. The study assessed quality of life and sexual health. Results. Among the 50 patients, 33 (66%) were female. The mean (standard deviation) age was 45.4 (±13.4) years. Genital psoriasis was active in 34% of the participants. The mons pubis (48.5%) and labia majora (18.2%) were the most frequently affected sites in females, while in males, the penile shaft (52.9%) and glans (47.1%) were the most common sites. Itch‐related symptoms predominated, affecting 82% of patients. The median dermatology life quality index score was 6.5 for females and 10 for males. A sexual health survey revealed that 54% of participants had low self‐esteem. This issue was more pronounced in males, with 76.5% reporting lower self‐esteem compared to 42.4% of females (P = 0.022). Males were also more inclined to postpone or avoid marriage (47.1% vs. 15.6%, P = 0.038) and more embarrassed about sexual activities (63.6% vs. 14.3%, P = 0.017). In addition, males were more inclined to avoid sexual encounters due to their genital condition. Notably, 42.9% of all patients had never disclosed to a doctor that they had genital psoriasis. Conclusions. Genital psoriasis impacts quality of life and sexual function, with male patients being particularly impacted. Improved awareness of these issues among health professionals might increase patient satisfaction. [ABSTRACT FROM AUTHOR]

The epidemiology of idiopathic inflammatory myopathies (IIMs) varies by country. Investigating the epidemiological profile among Thai IIMs could help to inform public health policy, potentially leading to cost-reducing strategies. We aimed to assess the prevalence and incidence of IIM in the Thai population between 2017 and 2020. A descriptive epidemiological study was conducted on patients 18 or older, using data from the Information and Communication Technology Center, Ministry of Public Health, with a primary diagnosis of dermatopolymyositis, as indicated by the ICD-10 codes M33. The prevalence and incidence of IIMs were analyzed with their 95% confidence intervals (CIs) and then categorized by sex and region. In 2017, the IIM cases numbered 9,074 among 65,204,797 Thais, resulting in a prevalence of 13.9 per 100,000 population (95% CI 13.6–14.2). IIMs were slightly more prevalent among women than men (16.8 vs 10.9 per 100,000). Between 2018 and 2020, the incidence of IIMs slightly declined from 5.09 (95% CI 4.92–5.27) in 2017 and 4.92 (95% CI 4.76–5.10) in 2019 to 4.43 (95% CI 4.27–4.60) per 100,000 person-years in 2020. The peak age group was 50–69 years. Between 2018 and 2020, the majority of cases occurred in southern Thailand, with incidence rates of 7.60, 8.34, and 8.74 per 100,000 person-years. IIMs are uncommon among Thais, with a peak incidence in individuals between 60 and 69, especially in southern Thailand. The incidence of IIMs decreased between 2019 and 2020, most likely due to the COVID-19 pandemic, which reduced reports and investigations. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are more likely to have a higher severity of illness after being infected with coronavirus disease 2019 compared with the general population, particularly in the hyperinflammatory phase. However, immunomodulatory drugs are contraindicated and have been associated with an increased risk of fetal abnormalities. Therefore, we are reporting our experience with the use of HA330 hemoperfusion in combination with standard therapy in severe to critical coronavirus disease 2019 cases among pregnant patients. Case presentation: From January 2020 to December 2021, four pregnant Thai women were treated with hemoperfusion using a cytokine adsorptive technique. The patients' ages ranged from 21 to 36 years old, and their gestational ages at the time of admission ranged from 18 to 38 weeks. Two patients required intubation. Extracorporeal blood purification with an adsorptive cartridge (HA330®, Jafron, China) was applied as an adjunctive strategy to standard therapy approximately one week after the onset of symptoms, and most patients received three sessions of hemoperfusion. The baseline C-reactive protein level was greater than 80 mg/dL. The results showed that hemoperfusion could decrease the C-reactive protein level by approximately 80% and improve oxygenation. The newborns were delivered by Cesarean section without complications. Neither mortality nor serious adverse events related to hemoperfusion occurred. Conclusion: This report may help ensure the use of the hemoperfusion strategy in pregnant patients during a cytokine storm. However, a larger cohort is needed to confirm its safety and efficacy. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of self-reported bruxism, awareness of bruxism's adverse effects, and bruxism management among Thai undergraduate dental students. Methods: An online self-reported questionnaire was designed and tested for validity and reliability and then distributed to dental students at 12 universities in Thailand from September 2020 to January 2021. Results: There were 464 respondents (338 females and 126 males) with an average age of 21.42 ± 2.06 years. The prevalence of self-reported awake and sleep bruxism was 35.78% and 37.28%, respectively, and 19.40% had both awake and sleep bruxism. Awareness scores were higher for dentists than for patients (p< 0.001). Only 12.14% of sleep bruxers still wear an occlusal splint for bruxism management. Conclusion: The prevalence of self-reported awake and sleep bruxism was high among Thai dental students. They are well aware of the adverse effects of bruxism with inappropriate management of the condition. [ABSTRACT FROM AUTHOR]

Learning English has always been valued highly in Thailand at all educational levels. Supporting students' reading comprehension ability is crucial when studying English, particularly for undergraduate degrees. Although Thai students have been learning English for years, they are kept from meeting the curriculum goals and obtaining high grades. The study included 24students from the Faculty of Education at Kamphaeng Phet Rajabhat University, Thailand, and their English reading comprehension ability was investigated. The study examines the effects of employing a GFOS (Grouping, Foreseeing, Obtaining, Summarizing) model based on Collaborative Learning (CL), built for the GFOS teaching process, considering literal, interpretive, critical, and creative comprehension levels. The research findings show that the models' processes and theories are beneficial in encouraging EFL students to improve their reading comprehension. It is an effective way for English educators to improve learners' reading comprehension at the same or different levels. [ABSTRACT FROM AUTHOR]

According to prior research, Asian and Pacific Islander American (APIA) immigrants often refrain from seeking health care unless necessitated by medical conditions. Utilizing data from health screenings conducted in APIA immigrant enclaves in Los Angeles, we hypothesize that poorer obesity status would predict higher rates of regular physician access. Analyses involved objectively measured percent body fat (%BF) and survey responses collected between 2011 and 2019. We assessed the association between obesity status and regular physician access, adjusting for insurance status, demographic, and socioeconomic factors. The study population (n = 4102) primarily consisted low-income, low English proficiency APIAs. Participants with a regular physician were significantly more likely to be obese compared to participants without (adjusted odds ratio [aOR] = 1.28). This association may suggest that care was sought reactively rather than proactively within this community. Interventions with emphasis on cultural competency and language services may encourage preventative care utilization among this understudied community. [ABSTRACT FROM AUTHOR]

Objective: This study examined perceptions and attitudes toward electronic cigarettes (e-cigarettes) among young adults aged 15-20 years in Samut Songkhram Province, Thailand, and their relationship. Materials and Methods: A descriptive cross-sectional study was conducted between July and October 2023. The study included 328 young adults aged 15-20 selected from an educational institution in Samut Songkhram Province using simple random sampling. Data were collected using a self-administered questionnaire and analyzed using descriptive statistics and Pearson's correlation coefficient. Results: The participants had a good level of knowledge about e-cigarettes. They exhibited a positive attitude towards electronic cigarettes regarding health aspects (M=3.05, SD=0.97) and a positive attitude towards the legal dimensions of e-cigarettes (M=3.12, SD=0.80). However, no statistically significant correlation was found between the perception of e-cigarettes and health-related attitudes toward them (r=0.013, p=0.820). On the other hand, there was a statistically significant positive correlation between the perception of e-cigarettes and legally oriented attitudes (r=0.192, p<0.001). Furthermore, a borderline positive correlation emerged between the perception of electronic cigarettes and the general attitudes toward them (r=0.102, p=0.065). Conclusion: Young adults in rural Thailand have a good knowledge of e-cigarettes. However, they exhibit positive attitudes towards the health aspects and legal dimensions of e-cigarettes. Moreover, no significant relationship exists between perceptions and health-related attitudes. These insights emphasize the need for targeted strategies to address misperceptions and raise awareness about the health risks of e-cigarette use among rural youth. [ABSTRACT FROM AUTHOR]

Objective: Individuals with psychiatric disorders are found to struggle with emotion regulation, which is considered a transdiagnostic factor. However, due to a limitation in the assessment of emotion regulation in Thailand, this study aimed to translate the Difficulty in Emotion Regulation Scale (DERS) into Thai (DERS-Thai) and evaluate its psychometric properties. Materials and Methods: The DERS-Thai was initially translated by one of the researchers before being re-reviewed. A pre-testing phase was then conducted to preliminarily evaluate the psychometric properties of the DERS-Thai. Subsequently, the testing phase involved 446 participants who completed an online questionnaire platform containing demographic data, DERS-Thai, the Emotion Regulation Scale (ERQ), and the Depression Anxiety Stress Scale 21 (DASS-21). The factor structure was then evaluated, along with its concurrent and criterion validity, as well as its internal consistency. Results: DERS-Thai demonstrated acceptable content validity (I-CVI = 0.8 to 1.0, S-CVI/Ave = 0.85). In the testing phase with 446 participants (mean age = 29.19, SD = 8.50), predominantly female (81.8%), and mostly residing in central Thailand (81.31%), the original model did not fit well. After modification, fit indices were improved. DERS-Thai showed a negative correlation with ERQ and a moderate to strong correlation with DASS-21. Known-group analysis revealed significant differences in DERS-Thai scores between DASS-21 groups (p-value < 0.001). The scale exhibited excellent internal consistency (α = 0.94, ω = 0.96). Conclusion: The DERS-Thai has demonstrated appropriate psychometric properties for assessing emotion regulation skills in individuals. [ABSTRACT FROM AUTHOR]

This article discusses a case of nest predation involving a Japanese Sparrowhawk and a Siberian Weasel in China. The researchers observed the weasel attacking the sparrowhawk and taking all of the nestlings and the remaining unhatched egg. The study highlights the vulnerability of small raptors to nest predation and its potential impact on their reproductive success. The document is a list of literature cited in a research article on various topics related to raptors, including breeding biology, nesting habits, and behavior, with studies conducted in different regions. The topics explored in the cited literature range from nesting failure to population decline and include aspects such as fearfulness, competitive interactions, migration routes, and parental investment theory. [Extracted from the article]

Purpose: To report a case of Epstein-Barr virus (EBV) keratouveitis-induced malignant glaucoma after repeat penetrating keratoplasty (PK). Methods: Retrospective review of the patient's medical records and review of literature on EBV corneal endotheliitis and/or anterior uveitis. Results: A 78-year-old Thai female patient presented with a markedly edematous corneal graft, dense pigmented keratic precipitates, fibrinous anterior chamber reaction, uniformly flat anterior chamber, and ocular hypertension of 55 mmHg in the left eye on the first day after the third PK. An aqueous tap for polymerase chain reaction analysis was positive for EBV DNA but negative for other herpesviruses. The patient was diagnosed with EBV endotheliitis and anterior uveitis-induced malignant glaucoma; and successfully treated with oral valacyclovir and topical 2% ganciclovir eye drops. Conclusions: EBV endotheliitis and anterior uveitis can induce malignant glaucoma following PK. A high index of suspicion is required when a patient has a history of unexplained multiple graft rejections. [ABSTRACT FROM AUTHOR]

To determine factors affecting successful research and publication among medical students, a cross-sectional survey study was carried out at four Thai medical schools during 2018–2022. Medical students who had previously performed research under research advisors' supervision and their research advisors were included. There were 120 participants, 78 medical students and 42 research advisors. The most common problems reported by the students were student's lack of knowledge of research design (78%) and research topic (53%), while the most common problems reported by the advisors were student's lack of knowledge of research topic (55%) and how to prepare documents for ethics committee approval (48%). The promoting factors for research success commonly reported by the students and advisors were "an advisor helps with protocol writing and reviewing the manuscript", "research teaching in the curriculum", "provision of an example of a written ethics committee protocol", and "arranging a special session so that advisors can talk to students about their research of interest". Among the 78 participating students, 20 (26%) had successfully published their research in journals. These 20 students were more likely than those without publications to be from an institute that had a special research project or conference for medical students (20% vs. 0%,) and to suggest that teaching protocol writing helped in promoting research success (70% vs. 43%). These findings suggest that teaching research, a special research project or conference for medical students, and faculty development of research advising could potentially increase the success rate of students' research publications. [ABSTRACT FROM AUTHOR]

Endometritis is an important factor in cattle fertility. Pathogenicity and the development of numerous reproductive diseases are directly related to bacterial imbalance in the genital tract. A commercial antibiotic can be relatively costly and can disrupt the animal's usual gut microflora; instead of plant medicals. The aim of this study was to develop an effective artificial insemination (AI) gel from traditional Thai herbs that exhibit bacterial inhibition. Twenty-four female Thai native cattle were divided into two groups: endometritis and healthy. Uterine swabs were isolated, identified, and tested for bacterial biofilm formation in vitro. Brucella ovis, Campylobacter fetus, Helicobacter trogontum, and Arcobacter cryaerophilus were found in female genitalia with endometritis based on weak biofilm information. Garcinia mangostana Linn. and Achyranthes aspera Linn. extracts were tested for antibacterial activity using agar dilution assay. A 10 μg/mL concentration of both extracts in combination was effective against the mixed bacterial isolation. The specific AI gel with those extracts was then developed (so-called GA-Gel) in vivo. The combined extracts inhibited the endometritis bacteria that expressed antimicrobial activity in vivo. Their hematological profiles indicated that the total white blood cells, neutrophils, and lymphocytes counts decreased (p=0.05). Compared to healthy cattle, the treated cattle had no significant difference in the levels of aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine. Both in vivo and in vitro indicated that the GA-Gel was effective for the prevention of an increase of bacteria and can be potentially developed to be an efficient AI gel. [ABSTRACT FROM AUTHOR]

Austroasiatic (AA) speakers constitute around 4% of the population of Thailand, while the majority (89.4%) speak Kra-Dai (KD) languages. Previous forensic and population genetic studies in various Thai populations have employed a limited number of short tandem repeats (STRs). This study aims to expand the investigation of the genetic makeup of AA populations in Thailand and their relationship to KD populations using a larger number of autosomal STRs with the VeriFiler™ Plus PCR Amplification Kit. We generated 593 new genotypes from AA-speaking groups and combined them with previously reported data from AA and KD groups. A total of 1,129 genotypes across 23 STR loci were used to construct the largest allelic frequency profile for Thai and Lao populations. However, several loci deviated from Hardy–Weinberg equilibrium, likely due to the reduced genetic diversity in some highland populations, which should be considered in forensic investigations. Beyond forensic applications, our findings reveal genetic differences between AA-speaking groups in Northern and Northeastern Thailand. The AA groups from Northeastern Thailand exhibit greater genetic homogeneity and diversity, likely due to population interactions. In contrast, reduced diversity and increased heterogeneity in AA groups from Northern Thailand are possibly driven by genetic drift and cultural and geographic isolation. In conclusion, we emphasize the usefulness of increasing the number of autosomal STRs in forensic and anthropological genetic studies. Additional Y-STR and X-STR data from various AA-speaking groups in Thailand would further enhance and strengthen forensic STR databases in the region. [ABSTRACT FROM AUTHOR]

Background: Pattern of dental anomalies encountered in cleft patients shows subtle signs of genetic involvement. This study aimed to evaluate the prevalence and pattern of tooth agenesis and supernumerary teeth in Thai cleft population according to the cleft type. Methods: Data collected from patients with cleft lip and palate, who had been treated at Tawanchai Cleft Center, Khon Kaen University, Thailand, available during year 2012–2022, were investigated. Records from 194 patients with non-syndromic clefts met the inclusion criteria. Standard dental records, and at least either orthopantomogram (OPG) or cone beam computed tomography (CBCT), were examined. Statistical analysis was performed using chi-square and binominal test (p ≤ 0.05). Results: Prevalence of tooth agenesis was higher (77.3%) than that of supernumerary teeth (5.7%) and was more common in bilateral cleft lip and palate (BCLP) (88.1%) than in unilateral cleft lip and palate (UCLP) (72.6%) (p = 0.017). The upper lateral incisor was more frequently affected (46.4%), followed by the upper second premolar. The number of missing teeth observed on the left side was significantly higher. Patients with left UCLP (ULCLP) had the highest prevalence of tooth agenesis. A total of 41 tooth agenesis code (TAC) patterns was found. The prevalence of supernumerary teeth was comparable with 6.6% of ULCLP, 5.1% of BCLP, and 4.5% of URCLP. Tooth-number anomalies were observed more often in the BCLP and were most likely to occur on the left side of the maxilla. Both types of anomalies could be featured in a small proportion of cleft patients. Conclusions: More than half of the patients with non-syndromic cleft lip and palate in this study, presented with tooth-number anomalies. Tooth agenesis was approximately 10-time more prevalent than supernumerary teeth. Tooth agenesis was likely to appear on the left-side of the maxilla regardless of the laterality of the cleft. [ABSTRACT FROM AUTHOR]

Ramon syndrome (MIM 266270) is an extremely rare genetic syndrome, characterized by gingival fibromatosis, cherubism-like lesions, epilepsy, intellectual disability, hypertrichosis, short stature, juvenile rheumatoid arthritis, and ocular abnormalities. Hereditary or non-syndromic gingival fibromatosis (HGF) is also rare and considered to represent a heterogeneous group of disorders characterized by benign, slowly progressive, non-inflammatory gingival overgrowth. To date, two genes, ELMO2 and TBC1D2B, have been linked to Ramon syndrome. The objective of this study was to further investigate the genetic variants associated with Ramon syndrome as well as HGF. Clinical, radiographic, histological, and immunohistochemical examinations were performed on affected individuals. Exome sequencing identified rare variants in TBC1D2B in both conditions: a novel homozygous variant (c.1879_1880del, p.Glu627LysfsTer61) in a Thai patient with Ramon syndrome and a rare heterozygous variant (c.2471A>G, p.Tyr824Cys) in a Cambodian family with HGF. A novel variant (c.892C>T, p.Arg298Cys) in KREMEN2 was also identified in the individuals with HGF. With support from mutant protein modeling, our data suggest that TBC1D2B variants contribute to both Ramon syndrome and HGF, although variants in additional genes might also contribute to the pathogenesis of HGF. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were to translate and culturally adapt the Barriers to Physical Activity and Disability Survey (B-PADS) into the Thai context and to assess its inter- and intra-rater reliability. Methods: Participants were experts in the field of spinal cord injury (SCI, n = 3), linguistic experts (n = 7), Thai-English bilingual speakers (n = 40), Thai physiotherapists (n = 8), and people with SCI living in Thailand (n = 43). The translation and cross-cultural adaptation of the B-PADS into the Thai context was conducted using a 6-step process; forward translation, reconciliation of the two translated versions, backward-translation, harmonisation, backward-translation of the revised version, and cognitive debriefing with potential users and target population. The reliability of the translated tool was assessed using Cohen's kappa (K) and McNemar's test. Results: The inter-rater reliability test demonstrated high-range agreement for the majority of statements (27 out of 38; Cohen's K > 0.60) in the Thai-B-PADS final version. The intra-rater reliability test revealed that the majority of the statements (29 out of 38) in the Thai-B-PADS final version obtained substantial (Cohen's K = 0.61–0.80, p < 0.05) to perfect agreement (Cohen's K = 1.0, p < 0.05). McNemar's test displayed no statistically significant differences amongst assessors (p > 0.05) for nearly all statements. Conclusion: The Thai-B-PADS final version was successfully translated and culturally adapted for people with SCI. IMPLICATIONS FOR REHABILITATION: Multi-stakeholders, including academic experts, researchers, translators, clinicians, target users and clients, should be involved in developing health-related questionnaires' translation and cultural adaptation processes. The Thai version of Barriers to Physical Activity and Disability Survey (B-PADS) possessed high levels of inter- and intra-rater reliability to assess barriers related to undertaking physical activities or exercise in people with spinal cord injury. Interactional biases and perceived social status effects may not be avoided when deploying a face-to-face interview of health-related questionnaires in a culture where social hierarchy is present within the language. The translation and adaptation processes used in this study were thorough, systematic and comprehensive, providing a culturally competent exemplar for translating health-related questionnaires between languages of different root origins. [ABSTRACT FROM AUTHOR]

Background: The Charlson Comorbidity Index (CCI) is commonly employed for predicting mortality. Nonetheless, its performance has rarely been evaluated in patients with dementia. This study aimed to examine the predictive capability of the CCI-based model for survival prediction in Thai patients diagnosed with dementia. Methods: An external validation study was conducted using retrospective data from adults with dementia who had visited the outpatient departments at Maharaj Nakorn Chiang Mai Hospital between 2006 and 2012. The data obtained from electronic medical records included age, gender, date of dementia diagnosis and death, types of dementia, and comorbidities at the time of dementia diagnosis. The discriminative ability and calibration of the CCI-based model were estimated using Harrell's C Discrimination Index and visualized with calibration plot. As the initial performance did not meet satisfaction, model updating and recalibration were performed. Results: Of 702 patients, 56.9% were female. The mean age at dementia diagnosis was 75.22 (SD 9.75) year-old. During external validation, Harrell's C-statistic of the CCI-based model was 0.58 (95% CI, 0.54–0.61). The model showed poor external calibration. Model updating was subsequently performed. All updated models demonstrated a modest increase in Harrell's C-statistic. Temporal recalibration did not significantly improve the calibration of any of the updated models. Conclusion: The CCI-based model exhibited fair discriminative ability and poor calibration for predicting survival in Thai patients diagnosed with dementia. Despite attempts at model updating, significant improvements were not achieved. Therefore, it is important to consider the incorporation of other influential prognostic factors. [ABSTRACT FROM AUTHOR]

Background: Withholding or withdrawing life-sustaining treatment in end-of-life patients is a challenging ethical issue faced by physicians. Understanding physicians' experiences and factors influencing their decisions can lead to improvement in end-of-life care. Objectives: To investigate the experiences of Thai physicians when making decisions regarding the withholding or withdrawal of life-sustaining treatments in end-of-life situations. Additionally, the study aims to assess the consensus among physicians regarding the factors that influence these decisions and to explore the influence of families or surrogates on the decision-making process of physicians, utilizing case-based surveys. Methods: A web-based survey was conducted among physicians practicing in Chiang Mai University Hospital (June - October 2022). Results: Among 251 physicians (response rate 38.3%), most of the respondents (60.6%) reported that they experienced withholding or withdrawal treatment in end-of-life patients. Factors that influence their decision-making include patient's preferences (100%), prognosis (93.4%), patients' quality of life (92.8%), treatment burden (89.5%), and families' request (87.5%). For a chronic disease with comatose condition, the majority of the physicians (47%) chose to continue treatments, including cardiopulmonary resuscitation (CPR). In contrast, only 2 physicians (0.8%) would do everything, in cases when families or surrogates insisted on stopping the treatment. This increased to 78.1% if the families insisted on continuing treatment. Conclusion: Withholding and withdrawal of life-sustaining treatments are common in Thailand. The key factors influencing their decision-making process included patient's preferences and medical conditions and families' requests. Effective communication and early engagement in advanced care planning between physicians, patients, and families empower them to align treatment choices with personal values. [ABSTRACT FROM AUTHOR]

Researchers' reflexivity usually focuses on the spatiality and sociality of their ethnographic fieldwork. As a result, the temporal context of their positionality, whereby their various identities interact with one another at different research phases, is often overlooked. This paper adopts an agentic intersectional approach and draws from our separate studies of Thai migrant women in Belgium and Hong Kong to unpack the temporality of the power dynamics between study participants and us (the researchers). Through this reflexive exercise, we identify three salient aspects: first, different identities of the researchers intersect at each phase of the study; second, researchers are dependent on gatekeepers and study participants, notably during the data-gathering phase; and third, the changing researcher–participant dynamics throughout the research process are embedded in broader relations of power that encompass social institutions and migrant/ethnic networks. Hence, researchers' self-discipline and constant awareness of positionality are of utmost importance for achieving well-situated knowledge (re)production. [ABSTRACT FROM AUTHOR]

Studies on ovarian cancer (OC) diagnosis, treatment and survival across disaggregated Asian sub-ethnic groups are sparse. Few studies have also conducted trend analyses of these outcomes within and across Asian groups. Using logistic, Cox, and Joinpoint regression analyses of the 2000–2018 Surveillance, Epidemiology, and End Results (SEER) data, we examined disparities and trends in OC advanced stage diagnosis, receipt of treatments and the 5-year cause-specific survival across seven Asian sub-ethnic groups. There were 6491 OC patients across seven Asian sub-ethnic groups (mean [SD] age, 57.29 [13.90] years). There were 1583(24.39%) Filipino, 1183(18.23%) Chinese, and 761(11.72%) Asian Indian or Pakistani (AIP) patients. The majority (52.49%) were diagnosed with OC with at an advanced stage. AIP were more likely to have advanced stage diagnosis than other subgroups (ORs, 95%CIs: 0.77, 0.62−0.96 [Filipino]; 0.76, 0.60−0.95 [Chinese]; 0.71, 0.54−0.94 [Japanese]; 0.74, 0.56−0.98 [Vietnamese] and 0.66, 0.53−0.83 [Other Asians]). The Filipinos were least likely to receive surgery but most likely to undergo chemotherapy. Japanese patients had the worst 5-year OC cause-specific survival (50.29%, 95%CI: 46.20%−54.74%). Based on the aggregated analyses, there was a significantly decreased trend in advanced-stage diagnosis and an increased trend in receipt of chemotherapy. Trends in OC outcomes for several subethnicities differed from those observed in aggregated analyses. In this cohort study of 6491 patients, OC diagnosis, treatment, survival, and trends differed across Asian American ethnic subgroups. Such differences must be considered in future research and interventions to ensure all Asian American subethnicities equally benefit from the advancements in OC care and control. [ABSTRACT FROM AUTHOR]

Dengue shock syndrome (DSS) substantially worsens the prognosis of children with dengue infection. This study aimed to develop a simple clinical tool to predict the risk of DSS. A cohort of 2221 Thai children with a confirmed dengue infection who were admitted to King Chulalongkorn Memorial Hospital between 1987 and 2007 was conducted. Another data set from a previous publication comprising 2,301 Vietnamese children with dengue infection was employed to create a pooled data set, which was randomly split into training (n = 3182), testing (n = 697) and validating (n = 643) datasets. Logistic regression was compared to alternative machine learning algorithms to derive the most predictive model for DSS. 4522 children, including 899 DSS cases (758 Thai and 143 Vietnamese children) with a mean age of 9.8 ± 3.4 years, were analyzed. Among the 12 candidate clinical parameters, the Bayesian Model Averaging algorithm retained the most predictive subset of five covariates, including body weight, history of vomiting, liver size, hematocrit levels, and platelet counts. At an Area Under the Curve (AUC) value of 0.85 (95% CI: 0.81–0.90) in testing data set, logistic regression outperformed random forest, XGBoost and support vector machine algorithms, with AUC values being 0.82 (0.77–0.88), 0.82 (0.76–0.88), and 0.848 (0.81–0.89), respectively. At its optimal threshold, this model had a sensitivity of 0.71 (0.62–0.80), a specificity of 0.84 (0.81–0.88), and an accuracy of 0.82 (0.78–0.85) on validating data set with consistent performance across subgroup analyses by age and gender. A logistic regression‐based nomogram was developed to facilitate the application of this model. This work introduces a simple and robust clinical model for DSS prediction that is well‐tailored for children in resource‐limited settings. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nitrous oxide, an inhalational anaesthetic, is popular with adolescents worldwide as an accessible recreational drug which induces a euphoric effect. However, chronic abuse leads to serious complications such as myeloneuropathy and bone marrow suppression by inactivation of vitamin B12. A 17-year-old girl presented with nitrous oxide-induced myeloneuropathy. She reported chronic nitrous oxide inhalation for 10 months and was admitted to the emergency department on account of repeated falls for 2 weeks. She also had ascending paraesthesia in both legs and urinary incontinence. Neurological examination demonstrated bilateral lower extremity weakness [motor power: proximal muscles 4/5, plantar flexion and extensor hallucis longus (EHL) 3/5], decreased sensation, proprioception and vibration of the lower extremities. Deep tendon reflexes were absent in the ankles and knees. Laboratory results demonstrated mild anaemia [Hb 11.2 g/dL (12.0–16.0), haematocrit 35.4% (36–50), MCV 89.4 fl (78–102)] with significant hypersegmented neutrophils in a peripheral blood smear. Serum vitamin B12 was 340 pg/mL (197–771), but serum homocysteine was increased at 65.8 µmol/L (5–15). A nerve conduction study was prolonged, and F-waves were absent from the bilateral perineal and tibial nerves, indicating diffuse demyelinating motor polyneuropathy. Magnetic resonance imaging of the whole spine demonstrated faint T2 hypersignal intensity and an inverted V-shape appearance at the posterior column of the upper thoracic cord (around T2–T6), a pathognomonic sign of vitamin B12 deficiency or subacute combined degeneration of the nitrous oxide-induced myeloneuropathy. A 7-day course of 1000 µg cyanocobalamin was given intramuscularly, followed by weekly doses for 4 weeks. Supplements of daily oral vitamin B1, B6 and B12 (65 µg vitamin B12) were administered, along with rehabilitation. At the 6-months outpatient follow-up, there were a few residual neurological abnormalities: weakness of the left EHL (grade 4/5) and an absent deep tendon reflex in the left ankle. This case emphasises the significant health consequences of chronic abuse of nitrous oxide, myeloneuropathy and megaloblastic anaemia, by inactivation of vitamin B12. The myelopathy is noticeably improved by cyanocobalamin. Abbreviations: EHL: extensor hallucis longus; MRI: magnetic resonance imaging; NCS: nerve conduction study [ABSTRACT FROM AUTHOR]

Background: Medication dosing in overweight and obese children often involves complex weight-based calculations, leading to higher dosing errors, particularly with intravenous drugs. Currently, tools to aid in dosage calculations are lacking for these patients, especially in Thai population. Objective : This study aimed to develop a mobile application with the intent of utilizing it as a tool to enhance the efficiency and accuracy of dosing calculations required for obese and overweight Thai children. Methods: The performance of the application was assessed in 3 key aspects using a sample of 30 healthcare professionals. These key aspects included: 1) the accuracy of dosage calculations, assessed through pre- and posttests comparing manual calculations to app-based calculations using a 10-item questionnaire, 2) the time taken for calculations before and after app usage, 3) user satisfaction, which was measured through a questionnaire. Results: The integration of applications into the calculation demonstrated a significant improvement when compared to the manual calculation in both accuracy (6.10 vs 9.33 out of 10, P <.001) and efficiency (10.40 vs 8.53 minutes per 10 questions, P =.008). Also, the application elicited high levels of satisfaction among users, as reflected by an overall mean satisfaction score of 4.57 on a 5-point scale. Conclusion : The integration of this application to assist in dosage calculations for overweight and obese pediatric Thai patients has yielded favorable outcomes concerning accuracy, efficiency, and user satisfaction. Further development should be pursued within a larger cohort, with an emphasis on real-world implementation in clinical settings. [ABSTRACT FROM AUTHOR]

Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin lymphoma (NHL) that accounts for approximately 25–40% of all NHL cases. The objective of this study was to investigate the protein expression, clinical impact, and prognostic role of MYC, BCL2, and Ki-67 in Thai DLBCL patients. A retrospective analysis was conducted on 100 DLBCL patients diagnosed between January 2018 and December 2019. Immunohistochemistry was used to assess the expression of MYC, BCL2, and Ki-67. The study revealed a significant association between extranodal involvement and positive cases of MYC and BCL2. MYC expressions were associated with Ki-67 expression, while BCL2 positivity was associated with the non-germinal center B-cell (non-GCB) subtype. However, there were no significant differences in the three-year overall survival (OS) and three-year progression-free survival (PFS) rates when using cut-off points of ≥ 40% for MYC, ≥ 50% for BCL2, and ≥ 70% for Ki-67. Notably, DLBCL cases with co-expression of MYC and BCL2 exhibited significantly inferior three-year OS compared to other cases (0% vs. 53%; p = 0.020). Multivariate analysis identified age ≥ 60 years and Eastern Cooperative Oncology Group (ECOG) performance status as independent prognostic factors. In conclusion, MYC, BCL2, and Ki-67 expression can serve as prognostic biomarkers; however, their prognostic value may vary based on the specific cut-off values used. Therefore, determining the appropriate threshold for each biomarker based on individual laboratory analyses and clinical outcomes is crucial. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop clinical predictor tools for guiding the use of computed tomography (CT) head scans in non-traumatic Thai patients presented with seizure. A prediction model using a retrospective cross-sectional design was conducted. We recruited adult patients (aged ≥ 18 years) who had been diagnosed with seizures by their physicians and had undergone CT head scans for further investigation. Positive CT head defined as the presence of any new lesion that related to the patient's presented seizure officially reported by radiologist. A total of 9 candidate predictors were preselected. The prediction model was developed using a full multivariable logistic regression with backward stepwise elimination. We evaluated the model's predictive performance in terms of its discriminative ability and calibration via AuROC and calibration plot. The application was then constructed based on final model. A total of 362 patients were included into the analysis which comprising of 71 patients with positive CT head findings and 291 patients with normal results. Six final predictors were identified including: Glasgow coma scale, the presence of focal neurological deficit, history of malignancy, history of CVA, Epilepsy, and the presence of alcohol withdrawal symptom. In terms of discriminative ability, the final model demonstrated excellent performance (AuROC of 0.82 (95% CI: 0.76–0.87)). The calibration plot illustrated a good agreement between observed and predicted risks. This prediction model offers a reliable tool for effectively reduce unnecessary use and instill confidence in supporting physicians in determining the need for CT head scans in non-traumatic patients with seizures. [ABSTRACT FROM AUTHOR]

Background: Blastocystis is a unicellular eukaryote commonly found in the intestinal tract of humans and other animals. The prevalence of Blastocystis has been investigated in both developed and developing countries, yet its occurrence and distribution in rural locations has been less studied. Herein, we aimed to examine the distribution of Blastocystis colonization in Thai adults representing background populations along a rural/peri-urban gradient, as well as associations between colonization and personal characteristics. Methodology: A total of 238 participants were recruited from rural and peri-urban areas situated in three provinces. The presence of Blastocystis in feces was evaluated using PCR and qPCR. Information on gender, age, region (province), rural/peri-urban location, and body mass index (BMI) was collected. Principal findings: The overall rate of Blastocystis carriage was 67.2%. Univariate analysis revealed significant associations between Blastocystis carriage and region (p<0.05), location (p<0.001) and age group (p<0.05). Logistic regression analysis revealed that rural/peri-urban location and BMI were significantly associated with Blastocystis carriage. Nine subtypes (ST1-ST7, ST10 and ST23) were identified with ST3, ST7 and ST1 as the most abundant ones, in this order. The greatest diversity of subtypes, in terms of numbers, was found in the middle aged group (nine subtypes), while the least diversity was found in the young adult and obese (three subtypes each) groups. Conclusions: This study increases the understanding of the epidemiology of Blastocystis colonization and its association with population parameters and characteristics in middle-income countries. Author summary: Blastocystis is an enteric microbial eukaryote of ubiquitous, worldwide occurrence in both humans and animals. Based on the small subunit ribosomal RNA gene, Blastocystis has been divided into genetically distinct subgroups, called subtypes. It has been hypothesized that some of these subtypes might be pathogenic. Despite a century of research efforts, gaps remain on our knowledge of Blastocystis epidemiology. In this study, the authors investigated occurrence of Blastocystis among Thai, gut-healthy adults from three provinces in a rural/peri-urban gradient and examined associations with age, area of residence and body mass index (BMI). In this study, 67% of the participants were Blastocystis positive. Region, location and age group were individually associated with Blastocystis infection. Statistical model testing indicated that location and BMI were also associated with Blastocystis carriage. Nine subtypes were identified with the middle aged group having the greatest diversity (all nine subtypes). The obese and young adult groups had the least subtype diversity (three subtypes). This study sheds lights on the molecular epidemiology of Blastocystis and the relevant risk factors in middle-income countries. [ABSTRACT FROM AUTHOR]

Introduction: This article explores the significance of the Thai Buddhist temple for Thai women's sense of safety in Finland. Despite the growing popularity of Buddhism in the country, research literature and media have largely ignored the religiosity of Thai women, focusing instead on negative stereotypes. The article highlights the importance of Buddhism and the temple in the lives of Thai women who have migrated to European countries and challenges biased portrayals of Thai women in previous research. Methods: Based on ethnographic research at the Thai temples in Finland and life story interviews with twelve Thai women. Results: The article argues that the temple plays a crucial role in promoting a sense of safety among Thai women by providing a sense of home, belonging, and meaning. The temple's material and symbolic characteristics, in addition to its communality and relationality, work together to connect individuals with the temple's religious significance, contributing to the women's sense of security. Discussion: These findings speak for the fact that when facing the challenges of Thai women or other religious and ethical minorities, it is necessary to also look to their religion as a source of mental and spiritual well-being. [ABSTRACT FROM AUTHOR]

The use of antimicrobials in Thailand has been reported as one of the highest in the world in human and animal sectors. Our engagement project aimed to improve our understanding of the issue of antimicrobial use and antimicrobial resistance (AMR) among adult Thai communities, and co-create locally relevant solutions to AMR, especially those focusing on raising awareness to improve related policies in Thailand. We conducted a series of online and in-person 'conversations' according to Wellcome's 'Responsive Dialogues' engagement approach, designed to bring together different voices to understand complex AMR problems and find potential solutions. This approach enabled key AMR stakeholders and policy makers to hear directly from communities and members of the public, and vice versa. Conversations events took place between 25 November 2020 and 8 July 2022, and we engaged 179 AMR key stakeholders and members of the public across Thailand. The issues found were: there were quite a lot of misunderstandings around antimicrobials and AMR; participants felt that communications and engagement around antimicrobial resistance had limited reach and impact; asking for and taking antibiotics for self-limiting ailments is a social norm in Thailand; and there appeared to be a wide availability of cheap antimicrobials. To mitigate the spread of AMR, participants suggested that the messages around AMR should be tailored to the target audience, there should be more initiatives to increase general health literacy, there should be increased availability of AMR related information at the local level and there should be increased local leadership of AMR mitigation efforts. Trial registration Thaiclinicaltrials.org registration: TCTR20210528003 (28/05/2021). [ABSTRACT FROM AUTHOR]

Learning-oriented reading assessment (LORA) has expanded multiple views of assessment for learning reading. Most EFL reading assessment contexts tended not to utilise feedback and self-assessment for the redesign of authentic tasks and tests. This mixed-methods study investigated how LORA enhanced EFL students' reading after the implementation of LORA. Participants consist of sixty-seven tenth Grade Thai students from the urban public school. They were divided into two groups, including 32 students for the LORA group and 35 students for the control group. The reading test was designed to compare post-test scores of both groups and was analyzed using Mann-Whitney U-test. In addition to perceptions on assessment, only those in the LORA group responded to the LORA questionnaire to give their perceptions of the assessment, and the three highestranking and the three lowest-ranking students were selected for the semi-structured interviews to explore five aspects of the design, including task, test, teacher's observation, feedback, and redesign. Findings from the questionnaire were analyzed using descriptive statistics whereas the semi-structured interview was categorized through thematic analysis. Although there was no statistically significant difference between groups, students in the LORA group tended to gain higher scores on reading after participating in the study. They perceived positively on the implementation. Implications indicated connecting reading assessment and feedback for learning with authentic tasks and tests. [ABSTRACT FROM AUTHOR]

There are insufficient data and measuring tools for parental perception of defecation and constipation in Thai children. The primary objective of this study was to develop a tool to measure parental perceptions towards defecation and constipation in children. The secondary objective was to identify parental understanding and misconceptions about these issues. The authors developed a questionnaire in three domains: knowledge, attitude, and practice. Content validity was evaluated using the item-objective congruence index (IOC) by five experts. The reliability of the measure was assessed based on both internal consistency and test-retest reliability. Then, a descriptive cross-sectional survey was conducted on Thai parents at pediatric outpatient clinics and wards in Bhumibol Adulyadej Hospital. The authors developed a first draft questionnaire consisting of 31 items, which were categorized into three domains of knowledge, attitude, and practice. During expert validation, five items were disqualified. To assess the questionnaire's reliability, Cronbach's alpha value was calculated and found to be 0.229 for the original questionnaire. However, after removing irrelevant questions, Cronbach's alpha value increased to 0.511 for an 18-item questionnaire. The adjusted questionnaire demonstrated excellent test-retest reliability (Intraclass correlation coefficient, ICC = 0.91). The survey with 306 parents revealed parental misconceptions about the pathophysiology of stool withholding, stool soiling indicating constipation, toilet training after meals, and monitoring bowel movements. The developed questionnaire helps to assess parental perception regarding defecation and constipation in Thai children. Based on the survey results, the authors suggest that parental education on these issues is still necessary. [Display omitted] [ABSTRACT FROM AUTHOR]

Mastering writing in English is crucial for English as a foreign language (EFL) learners; nevertheless, they encounter numerous difficulties, such as idea development, grammar complexities, vocabulary range, or even the pressure from writing anxiety. Consequently, many educators employ digital writing tools to enhance EFL learners' English writing skills. This study aimed to explore Thai EFL university students' perceptions of two digital writing tools, Paragraph Punch and ProWritingAid, as well as to investigate students' writing performance. Participants consisted of 53 undergraduate EFL students enrolled in English education at a university in Thailand. Three research instruments were utilized: a 30-item questionnaire investigating participants' perceptions of writing problems, a pre- and post-writing test assessing students' writing development, and a semi-structured interview exploring students' views on integrating digital writing tools in writing classes. The questionnaire findings emphasized various challenges students encountered in writing, including difficulties with idea development, grammar, and paragraph organization. The research further indicated a significant enhancement in students' writing abilities after using digital writing tools. Additionally, students perceived that the improvements in their writing proficiency were due to the supportive guidance and real-time feedback provided by these digital writing tools. Nevertheless, there were concerns regarding excessive dependency on digital tools, the need for supplementary teacher feedback, and technological barriers. [ABSTRACT FROM AUTHOR]

Copyright of Ido Movement for Culture. Journal of Martial Arts Anthropology is the property of Idokan Poland Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: CYP2C19 plays a major role in the metabolism of various drugs. The most common genetic variants were the CYP2C19*2 and *3 alleles (rs4244285 and rs4986893, non-functional variants). In previous studies, we found that genetic polymorphisms in CYP2C19 variants influenced the active metabolites of clopidogrel and caused major adverse cardiovascular and cerebrovascular effects. However, the distribution of CYP2C19 varies among ethnic groups and according to adverse drug reactions. This study aimed to investigate the frequency of CYP2C19 genetic polymorphisms in the Thai population and analyze the differences in the frequency of CYP2C19 genetic polymorphisms between Thai and other populations. Methods: This study enrolled 211 unrelated healthy Thai individuals in total. We performed a real-time polymerase chain reaction to genotype CYP2C19*2 (681G > A) and CYP2C19*3 (636G > A). Results: In the Thai population, the CYP2C19*1 allele was the most prevalent at 70.14%, while the CYP2C19*2 and *3 alleles were found at frequencies of 25.36% and 4.50%, respectively. Conversely, the CYP2C19*3 allele was not detected in Caucasian, Hispanic, African, Italian, Macedonian, Tanzanian, or North Indian populations. The phenotypic profile of this gene revealed that the frequency of intermediate metabolizers (IMs) is nearly equal to that of extensive metabolizers (EMs), at 42.65% and 48.82% respectively, with genotypes *1/*2 (36.02%) and *1/*3 (6.63%). Likewise, poor metabolizers (PMs) with genotypes *2/*2 (6.16%), *2/*3 (2.37%), and *3/*3 (< 1%) are more prevalent in our population as well. Conclusion: The distribution of CYP2C19 genotype and phenotype influenced by non-functional alleles has potential as a pharmacogenomics biomarker for precision medicine and is dependent on an ethnic-specific genetic variation database. [ABSTRACT FROM AUTHOR]

Introduction: There are more than 6000 genetic syndromes, therefore the recognition of facial patterns may present a challenge for clinicians. The 22q11.2 deletion syndrome (22q11.2 DS) and Williams syndrome (WS) are two different genetic syndromes but share some common phenotypic traits and subtle facial dysmorphisms. Therefore, any tool that would help clinicians recognize genetic syndromes would likely result in a more accurate diagnosis. Methods: The syndrome identification accuracy was compared between 2 different facial analysis algorithms (DeepGestalt and GestaltMatcher) of the Face2Gene (F2G) tool and a group of 9 clinicians with different levels of expertise before and after using F2G for a cohort of 64 Thai participants' frontal facial photos divided into 3 groups of 22q11.2 DS, WS and unaffected controls. Results: The higher accuracy from the DeepGestalt algorithm than from clinicians was demonstrated, especially when comparing between the two syndromes. The accuracy was highest when clinicians use the tool combined with their own decision-making process. The tool's second algorithm, GestaltMatcher revealed clear separation among these three groups of photos. Discussion: The result of F2G outperforming clinicians was not surprising. However, the highest increase in accuracy was with nondysmorphology clinicians using F2G. Conclusion: Face2Gene would be a useful tool to help clinicians in facial recognition of genetic syndromes, before ordering specific tests to confirm the definite diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present the case for critical realism (CR) as a framework in steering the anticipatory and participatory activities an appropriate analysis of complex problems, aiming toward a transformative change. Design/methodology/approach: Through observation, interview and facilitation for Circular Design Lab and Thai Clean Air Network, this paper unpacks their foresight activities, their key findings and subsequently connects to the Morphogenesis analysis based on an alternative foresight epistemology of CR. Findings: Foresight based on CR philosophy provides a deeper understanding of the complexity and invisibility of air pollution issues in Thailand. Acknowledging the transitive reality beyond this study's perception, the activity design applies the iceberg models to investigate problem framing and illustrate the stratified reality in three domains: the empirical based on emission reports and legislative regulations; the actual based on patterns of farmers practice and industrial development, activated by causal mechanisms; the real based on structural and mental models, driven by cultural and belief systems in Thailand. At the bottom layer of the iceberg, the real lies the generative mechanisms of pre-existing structural and cultures that constrain Thai citizen from acting on social change. Research limitations/implications: CR's emancipatory theory provides an immanent critique towards social improvement by illustrating comprehensive causal explanations of complex problems such as air pollution; while morphogenesis theory elaborates on the unconscious domination of the existing social structures, agencies, and cultures. Thus, the ethical inquiry of CR research is committed to the emancipation of false beliefs and creating conditions for "human prosperity". However, this non-neutral value commitment is debated in the futures studies field. Practical implications: The anticipatory activities on air pollution in Thailand bring to light the reality of power and oppression beyond human perception and illustrate the connection to the belief systems and its consequential action or lack thereof in dealing with the issues. The insight to power relationship provides an unconventional way to empower citizens in creating transformative change. Originality/value: Modern foresight practice has developed under western cultures and societies. Recent efforts are made to investigate the epistemology underlying this field, for the future issues are ever more complex and interrelated across multiple sectors. This requires this study's consideration of the meaning of knowledge and knowing, influencing the research paradigm. This paper proposes CR as a suitable foresight approach to emancipate this study from the widely accepted epistemologies and examine this study's presupposition about social reality by a philosophical explanation based on the elements of ontology, causation, structure and persons. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the efficacy of the aMAP score and compare it with other risk scores for predicting hepatocellular carcinoma (HCC) development in Thai patients with chronic hepatitis B (CHB). We retrospectively analyzed patients with CHB between 1 January 2008 and 31 December 2019. Data on demographics, clinical parameters, cirrhosis status, HCC imaging, and alpha fetoprotein surveillance were collected to calculate the aMAP score (0–100) based on age, sex, albumin–bilirubin level, and platelet count. Of the 1060 patients analyzed, 789 were eligible, of whom 51 developed HCC. The cumulative HCC incidences in the low-, moderate-, and high-risk groups at 3, 5, and 10 years were significantly different (log-rank, p < 0.0001). The area under the receiver operating characteristic curves (AUROCs) of the aMAP scores for predicting HCC at 3, 5, and 10 years were 0.748, 0.777, and 0.784, respectively. Among the risk scores, the CU-HCC score had the highest AUROCs (0.823) for predicting 5-year HCC development. The aMAP score is a valuable tool for predicting HCC risk in Thai patients with CHB and can enhance surveillance strategies. However, its performance is inferior to that of the CU-HCC score, suggesting the need for new predictive tools for HCC surveillance. [ABSTRACT FROM AUTHOR]

Cryotherapy is widely used in health contexts, including first aid, treating acute musculoskeletal injuries and women undergoing chemotherapy. Studies have shown that frozen gloves can help reduce nail toxicity for women undergoing chemotherapy. Nail toxicity is a common issue among people undergoing chemotherapy, causing disfigurement and pain. Although cooling gloves have been shown to reduce nail toxicity, the range of temperatures used remains unclear, often resulting in discomfort. In this innovative study, we used a quasi-experimental, two group pretest-posttest design to evaluate the effectiveness of Chemo-Cooling Gloves developed by the researchers to help prevent nail toxicity. We assessed satisfaction with the gloves among 27 Thai women undergoing chemotherapy who were purposively recruited according to the inclusion criteria from a chemotherapy center of a university-affiliated hospital in a southern region of Thailand. Participants underwent a regimen of cyclophosphamide in combination with doxorubicin and 5-flu- orouracil every 21 days for six cycles. Each participant served as their own control, wearing the cooling glove on the one hand randomly selected, while the other hand remained unprotected and acted as the control. Data were collected using a demographic questionnaire, the Common Terminology Criteria for Adverse Events version 3.0, and the Chemo-Cooling Gloves Satisfaction Questionnaire. Data analysis utilized descriptive statistics and Cochran's Q test. The results revealed that nail toxicity was significantly lower in the protected hand than in the control hand during cycles 2 to 3 and 2 to 4, but no significant difference between the two hands during cycles 2 to 5 and 2 to 6. Overall satisfaction with the Chemo-Cooling Gloves was at the highest level. The use of frozen gloves aligns with evidence-based practice, as supported by our study. Nurses need to be trained in the proper use and application of the gloves and educate patients on the benefits and correct usage to maximize comfort and efficacy. By incorporating the Chemo-Cooling Gloves into routine practice, nurses can help improve patient adherence to chemotherapy regimens and potentially enhance treatment outcomes. [ABSTRACT FROM AUTHOR]

Sofosbuvir/Velpatasvir (SOF/VEL) is a combination drug used for chronic hepatitis C (HCV) infection. However, limited information exists regarding the pharmacokinetics of SOF/VEL and its metabolites in hemodialysis patients. We conducted a prospective investigation of the pharmacokinetic parameters of SOF/VEL after a single dose of SOF/VEL (400/100 mg) on days with and without dialysis in 12 Thai hemodialysis patients with chronic HCV infection, who had been undergoing hemodialysis for a duration of 0.5–20 years. Blood samples were collected before dose (0) and 0.5, 1.0, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, and 12.0 h after dose. Dialysate samples were also collected before dose (0) and 1.0, 2.0, 3.0, and 4.0 h after dose. Plasma and dialysate samples were quantified for SOF and its metabolite, GS‐331007, and VEL concentrations using a fully validated LCMS technique. In addition, a preliminary efficacy study was conducted using the proposed SOF/VEL dose reduction regimen in all patients. No differences in SOF/VEL PK parameters between on‐ and off‐dialysis studies. On the contrary, GS‐331007 exhibited a 30% reduction in the area under the plasma concentration–time curve from time 0 to 24 h (AUC0‐24h) on dialysis days compared with non‐dialysis days (AUC0‐24h ratio 0.68 vs. 1.04, respectively). The dialysis clearance of SOF and GS‐331007 was 9.35 (8.72–15.11) and 8.89 (8.52–14.07) mL/min, respectively. Subsequently, an alternate‐day regimen of SOF/VEL (400/100 mg) was administered for 12 weeks, resulting in an undetectable plasma HCV viral load without side effects. Further clinical studies are warranted to validate the efficacy and safety of our proposed dose reduction regimen. [ABSTRACT FROM AUTHOR]

Global uncertainty is a time when unexpected events occur that have a negative impact on a company. Unforeseen world situations lead to economic disaster. Therefore, decisions must be made quickly, correctly, and appropriately so as not to affect the entire operation of the organization. This is a clear action to reduce negative impacts. A crisis is an event that can destroy a company, its employees, its products, and its services. and the company's financial health, such as the spread of the coronavirus. Serious financial conditions can result from an economic disaster that is not managed. Events that have wide-ranging social impacts are considered crises. The financial reputation of commercial companies may be permanently damaged by this crisis. For this reason, this study aims to examine whether economic factors affect the financial stability of family businesses. Structural equation modeling techniques were used to analyze the data. There are more than 269 family companies listed on the Thai Stock Exchange. (Stock Exchange of Thailand: SET) Research results show the financial impact of Thai family businesses on business factors. The global economy is important in the current economic crisis. As a result, preparing to deal with both negative and positive economic situations may be related to and affect the ability of family businesses to maintain financial stability amid global economic instability. This study examines the financial stability of family businesses by selecting key factors including net profit margin (NPF), return on assets (ROA), and return on equity (ROE) in an unstable economy in Thailand. In the Stock Exchange of Thailand by the study of economic factors and financial stability of family businesses in Thailand. The empirical results using the Panel Regression Model and Robustness Tests exhibit that P>[z] and sectoral indices have a relationship and effect in the short term, and the coefficients in the period of t-1 are significantly positive and negative at the statistical significance at the 0.01, 0.05 and 0.10 level. In the long term have a relationship and effect with Banking, Finance, Economics and Business. [ABSTRACT FROM AUTHOR]

(1) Background: Parents of children with autism spectrum disorders often experience psychological distress, which can affect the quality of childcare they provide. It is crucial to screen for psychiatric symptoms among these parents. The core symptom index (CSI) is a widely recognized tool used to assess general symptoms, including depression, anxiety, and somatic issues. It has proven validity and reliability across diverse Thai populations. Given the cultural similarities between Thai and Chinese populations, the CSI has been successfully implemented within the Chinese population. Nevertheless, it is crucial to research its validity and reliability in the general Chinese population. This study aimed to investigate the psychometric properties of the Chinese version of the CSI among parents of children with autism spectrum disorders using confirmatory factor analysis (CFA). (2) Methods: A total of 794 Chinese parents raising children with autism participated in this study. All completed the CSI, along with the social inhibition subscale of the Interpersonal Problems Inventory and the Couple Satisfaction Index. Factorial validity was assessed using CFA to determine how well the bifactor three-factor model fits the data. Various structural models were compared using model fit indices. Convergent and discriminant validity were examined by exploring correlations with the social inhibition subscale and the Couple Satisfaction Index. Invariance testing of the CSI was conducted across multiple groups based on gender, age, and education using CFA. The reliability of the CSI was evaluated using McDonald's omega coefficients. (3) Results: The bifactor model emerged as the best-fitting model for the data, suggesting that the total score of the CSI adequately represents overall psychiatric symptoms. The CSI exhibited significant correlations with the social inhibition subscale (r = 0.41, p < 0.01) and smaller correlation coefficients with the Couple Satisfaction Index (r = −0.16, p < 0.05), indicating both convergent and discriminant validity. The invariant test results support scalar invariance levels based on gender and age but only partial invariance for education. The Chinese version of the CSI demonstrated high consistency, with McDonald's omega coefficients ranging between 0.86 and 0.95. (4) Conclusions: The bifactor model of the Chinese version of the CSI is validated, making it a suitable tool for measuring depression, anxiety, and somatization symptoms among parent(s) of children with autism spectrum disorders. Further research on other Chinese populations is encouraged. [ABSTRACT FROM AUTHOR]

In 2014, the Expanded Program on Immunization of Thailand changed the timing of the second dose of the measles–mumps–rubella (MMR) vaccine from 4–6 years to 2.5 years, while maintaining the first dose at 9 months of age. This study aimed to examine the dynamics and durability of immune responses induced by the two-dose MMR vaccine in a group of 169 Thai children from 4 to 7 years of age (4.5 years after the second MMR dose). We followed a cohort of healthy children from a clinical trial (ClinicalTrials.gov NCT02408926) where they were administered either the Priorix vaccine (GlaxoSmithKline Biologicals, Rixensart, Belgium) or M-M-RII (Merck & Co., Kenilworth, NJ, USA) at 9 months and 2.5 years of age. Blood samples were collected annually from ages 4 to 7 years. Anti-measles, -mumps, and -rubella IgG levels were evaluated using the enzyme-linked immunosorbent assay (EUROIMMUN, Lubeck, Germany). A total of 169 children completed this study. Over the 4.5 years following the two-dose MMR vaccination, we observed a decline in the seroprotection rates against measles and mumps, but not rubella. Longitudinal monitoring of antibody persistence, among other strategies, will help predict population-level immunity and inform public health interventions to address potential future outbreaks. [ABSTRACT FROM AUTHOR]

Most of the common models to examine depression are one-factor models; however, previous studies provided several-factor structure models on each depressive symptom using the Patient Health Questionnaire-9 (PHQ-9). The Nine-Questions Depression-Rating Scale (9Q) is an alternative assessment tool that was developed for assessing the severity of depressive symptoms in Thai adults. This study aimed to examine the factor structure of this tool based on the factor structure models for the PHQ-9 provided in previous studies using confirmatory factor analysis (CFA). We also examined the association of chronic diseases and depressive symptoms using the Multiple Indicators Multiple Causes model among 1346 participants aged 19 years old or more without psychiatric disorders. The results show that the two-factor CFA model with six items in the cognitive-affective domain and three items in the somatic domain provided the best fit for depressive symptoms in the study population (RMSEA = 0.077, CFI = 0.953, TLI = 0.936). Dyslipidemia was positively associated with both cognitive-affective symptoms (β = 0.120) and somatic depressive symptoms (β = 0.080). Allergies were associated with a higher level of cognitive-affective depressive symptoms (β = 0.087), while migraine (β = 0.114) and peptic ulcer disease (β = 0.062) were associated with a higher level of somatic symptoms. Increased age was associated with a lower level of somatic symptoms (β = −0.088). Our findings suggested that considering depressive symptoms as two dimensions yields a better fit for depressive symptoms. The co-occurrence of chronic diseases associated with depressive symptoms should be monitored. [ABSTRACT FROM AUTHOR]

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder potentially linked to gut dysbiosis. This comparative cross-sectional study profiled the gut microbiota in 24 treatment-naïve Thai children diagnosed with ADHD and 24 healthy ones matched by age and gender (median age: 7 years). Fecal microbial compositions were genetically analyzed using 16s rRNA gene amplicon sequencing. The study findings indicated no statistically significant differences in microbial diversity between groups, although Firmicutes and Actinobacteria appeared dominant in both groups. Moreover, ADHD patients exhibited enrichment in Alloprevotella, CAG-352, Succinivibrio, and Acidaminococcus genera, while healthy controls had higher levels of Megamonas, Enterobacter, Eubacterium hallii, and Negativibacillus genera. Spearman correlation analysis demonstrated a significant positive association between CAG-352 and inattention and hyperactivity/impulsivity scores, whereas the Eubacterium hallii group and Megamonas exhibited negative correlations with these symptomatology domains. Beta-carotene intake was associated with the Eubacterium hallii group and Succinivibrio: likewise, vitamin B2 intake was associated with Alloprevotella. Additional research should aim to elucidate the underlying mechanisms influencing clinical biomarkers that signify alterations in specific gut microbiome profiles linked to ADHD. [ABSTRACT FROM AUTHOR]