Transforming Non-Digital, Clinical Workflows to Detect and Track Vision-Threatening Diabetic Retinopathy via a Digital Platform Integrating Artificial Intelligence: Implementation Research.

Introduction: Screening diabetic retinopathy (DR) for timely management can reduce global blindness. Many existing DR screening programs worldwide are non-digital, standalone, and deployed with grading retinal photographs by trained personnel. To integrate the screening programs, with or without artificial intelligence (AI), into hospital information systems to improve their effectiveness, the non-digital workflow must be transformed into digital.

Country-specific key lifestyle factors and health outcomes for resource allocation in the general population: a network analysis across 29 countries.

Background: We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements.

Methods: From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks.

Biochar Amendment Alleviates the Risk of High-Salinity Saltwater Intrusion for the Growth and Yield of Rice L.).

Introduction: Saltwater intrusion poses a serious risk to global food security. As a soil amendment, biochar mitigates the negative effects of saltwater intrusion in rice, yet the beneficial effects on agricultural productivity with different exposure times and salt concentrations have not been fully examined.

Methods: A pot experiment was conducted to investigate the effects of 30% (w/w) rice husk biochar on the growth, ion accumulation, and yield of the Phitsanulok 2 rice cultivar under salt stress due to saltwater intrusion.

An eco-physiological model of forest photosynthesis and transpiration under combined nitrogen and water limitation.

Although the separate effects of water and nitrogen (N) limitations on forest growth are well known, the question of how to predict their combined effects remains a challenge for modeling of climate change impacts on forests. Here, we address this challenge by developing a new eco-physiological model that accounts for plasticity in stomatal conductance and leaf N concentration. Based on optimality principle, our model determines stomatal conductance and leaf N concentration by balancing carbon uptake maximization, hydraulic risk and cost of maintaining photosynthetic capacity.

The missing links of value congruence: evidence from the Thai healthcare workforce.

Purpose: This study aims to investigate possible factors, such as trust in management and shared vision, that influence value congruence and its mediating effect on work engagement. It also explores how resilience, functioning as a moderator, could change the nature of the links between value congruence and its determinants.

Design/methodology/approach: Data were collected through an online survey from 301 healthcare employees in Thailand.

Uncovering genetic determinants of antioxidant properties in Thai landrace rice through genome-wide association analysis.

Pigmented rice (Oryza sativa L.) is recognized as a source of natural antioxidant compounds, such as flavonoids, oryzanol, tocopherol, and anthocyanin. Because of their nutritional benefits, anthocyanin-enriched or pigmented rice varieties are feasible alternatives for promoting human health.

Neutralization of omicron subvariants and antigenic cartography following multiple COVID 19 vaccinations and repeated omicron non JN.1 or JN.1 infections.

The ongoing emergence of SARS-CoV-2 variants, combined with antigen exposures from different waves and vaccinations, poses challenges in updating COVID-19 vaccine antigens. We collected 206 sera from individuals with vaccination-only, hybrid immunity, and single or repeated omicron post-vaccination infections (PVIs), including non-JN.1 and JN.

Using the appropriate modulus of elasticity of periodontal ligament matters in stress analysis of human first premolar tooth and periodontium structures.

Although the modulus of elasticity of the human periodontal ligament (E) values used in dentistry widely ranged from 0.01 to 175 MPa, the exact E value has not been determined. This study aimed to verify whether and how E values affect the stress distribution over the tooth and periodontium structures, and to determine the appropriate E range.

The effects of mandibular setback surgery on the upper airway and sleep quality in skeletal Class III patients and comparison with control subjects: a pilot study.

The aim of this study was to determine the effects of mandibular setback surgery exceeding 5 mm on upper airway and sleep quality in skeletal Class III patients, with comparisons to Class I controls. Sixteen individuals per group were selected based on their ANB angle and surgical need. 2D and 3D airway analyses were conducted.

Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis.

Background:  Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.

Methods:  This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital.

Leisure activity and subjective well-being of older adults in Australia and Thailand: The impact of affiliation, restoration and meaning.

Objectives: To explore leisure activity types among older adults in Australia and Thailand and how psychological mechanisms of restoration, affiliation and meaning in leisure activities impact subjective well-being (SWB).

Methods: A survey was administered to 125 older adults aged 60 and above (65 from Australia and 60 from Thailand). The survey collected demographic information, self-rated health and SWB.

Prediction of cccDNA dynamics in hepatitis B patients by a combination of serum surrogate markers.

Quantification of intrahepatic covalently closed circular DNA (cccDNA) is a key for evaluating an elimination of hepatitis B virus (HBV) in infected patients. However, quantifying cccDNA requires invasive methods such as a liver biopsy, which makes it impractical to access the dynamics of cccDNA in patients. Although HBV RNA and HBV core-related antigens (HBcrAg) have been proposed as surrogate markers for evaluating cccDNA activity, they do not necessarily estimate the amount of cccDNA.

Biomarkers.

Background: Biomarkers for Alzheimer's disease (AD) in blood samples has the potential to facilitate early diagnosis and improve the accuracy of AD diagnosis. Plasma phosphorylated tau (p-tau) is a key biomarker for AD; however, its utility for estimating the prevalence of AD and screening for cognitive impairment is still limited.

Method: The study recruited 71 participants over the age of 40.

Biomarkers.

Background: Alzheimer's disease(AD) raises global concern with its impact on daily living. Anti-amyloid monoclonal antibodies (mAb) serving as specific treatments used in mild cognitive impairment(MCI) and mild dementia due to AD. Severe cerebral small vessel disease(SVD) lesions such as microbleeds and white matter hyperintensities are listed as exclusions according to the recommendation for mAb treatment.

Biomarkers.

Background: The validation of blood-based biomarkers presents a promising role in Alzheimer's disease (AD) diagnosis owing to their accessibility and diminished invasiveness. However, despite awareness of confounding factors like kidney function, inaccuracies persist in AD diagnosis using plasma p-tau. Notably, diverse conditions that modify blood-brain barrier (BBB) permeability have been linked to high plasma p-tau levels, irrespective of AD pathophysiology.

Biomarkers.

Background: Aging is an established confounding factor influencing the plasma levels of neurofilament light chain (NfL). While age-specific cutoff values for NfL in healthy Caucasian populations have been documented, the potential variations in ethnically and socioeconomically underrepresented populations remain underexplored. This study aims to evaluate the acceptability of proposed NfL cutoff values in the healthy Thai population.

Biomarkers.

Background: Tauopathy is recognized not only as a pathological substrate but also exhibits a robust correlation with the clinical manifestations of dementia, leading to diverse neuropsychiatric manifestation. However, human brain functions as networks rather than modules. The conventional query of 'Where is the lesion (regionally)?' may inadequately capture the entirety of dementia manifestations.

Biomarkers.

Background: Alzheimer's disease (AD) is referred as one of the most common causes of dementia and frailty. To address this impending public health crisis, there is a critical need to identify simple and reliable biomarkers for early AD diagnosis. Recent research has highlighted the potential utility of salivary lactoferrin (Lf) as a promising biomarker for AD diagnosis.

Public Health.

Background: Dementia poses an escalating socioeconomic challenge, yet evidence suggests potential prevention through proactive correction of risk factors and multidomain interventions. In cost-conscious Thailand, targeting prevalent risk factors may offer the most feasible strategy for disease prevention, ultimately alleviating healthcare burdens.

Method: Non-demented participants were consecutively selected from the INDIE cohort, a longitudinal study on cognitive aging at Chulalongkorn University in Bangkok, Thailand.

Biomarkers.

Background: The roles of reactive astrogliosis in response to the accumulation of amyloid-β (Aβ) and early tau phosphorylation in Alzheimer's disease (AD) have been more elucidated. Plasma glial fibrillary acidic protein (GFAP) has taken the spotlight, following phosphorylated tau (p-tau), in evaluating patients with AD. In this study, we aimed to assess the performance of plasma GFAP compared to other biomarkers.

Biomarkers.

Background: The blood-brain barrier (BBB) is considered the crucial part of neuroprotection from various neurological insults including infection, inflammation, and neurodegeneration including Alzheimer's disease (AD). The cerebral small vessel disease (CSVD) pathologies especially cerebral microbleeds (CMBs) and gadolinium enhancement might reflect the disruption of BBB. The correlation between BBB permeability measured by cerebrospinal fluid (CSF)/plasma albumin quotient (Qalb) and CSVD biomarkers is poorly understood.

Biomarkers.

Background: Tau-PET and plasma phosphorylated tau (p-tau) have emerged as pivotal biomarkers for Alzheimer's disease. Despite the practical advantages of using plasma p-tau, there is limited understanding regarding its relationship with the topographic distribution of tau-PET, particularly within the Southeast Asian population. This study aims to elucidate the correlation between plasma p-tau levels and the spatial patterns observed in tau-PET among Thai patients diagnosed with amnestic mild cognitive impairment (MCI) or mild dementia due to probable Alzheimer's disease (AD).

Biomarkers.

Background: Plasma tau phosphorylated at Thr217 (p-tau217) has demonstrated excellent performance in identifying individuals with Alzheimer's disease (AD) in both research and memory clinic settings. Nonetheless, implementing plasma p-tau217 into clinical practice remains a challenge requiring careful clinical judgement and conservative interpretation near the cutpoint. The present study proposes a strategy that utilizes Bayes theorem in considering the clinical context, individualized (ie.

Biomarkers.

Background: Dementia is a critical concern in the aging population, and understanding biomarkers associated with cognitive trajectories can provide valuable insights to improve diagnosis and intervention strategies.

Method: We conducted our study at a geriatric check-up clinic at King Chulalongkorn Memorial Hospital, focusing on a healthy cohort of older adults aged 60 or older without dementia. This study included patients with available plasma p-tau181 levels (Quanterix, Simoa) concurrent with cognitive evaluations no more than one year before the blood test, as well as at least one cognitive test administered after the blood test.