Conectar
by Areeya Madsusan, Saowaluk Krainara, Wantanasak Suksong, Kittithat Sudchoo, Nadeyah Tohmoh, Pattharaporn Jonggrijug, Chomkaeo Maipunklang, Chanitsara Chadaram, Kholeeyoh Samaeng, Piyadhida Kurdthongmee, Uratit Noosab, Arun Nakapong, Yanawut Udomsri, Suttiporn Kanaso, Natee Sakorn, Ng Yee Guan, Sukrit Sangkhano
Gross anatomy dissection is an essential component of medical and health science education, yet it presents notable occupational hazards, particularly from formaldehyde (FA) exposure and microbial contamination. These risks may be intensified in anatomy dissection halls located in tropical monsoon (Am) climates, where elevated humidity and temperature promote both chemical volatility and microbial persistence. This study assessed the combined effects of such climatic conditions on FA concentrations and microbial ecology within a naturally ventilated dissection hall in southern Thailand. FA levels were measured through personal and area air sampling across seven anatomical regions, while microbial contamination on cadaver-contact surfaces was evaluated using culture-based methods and high-throughput sequencing. Functional prediction of microbial communities was performed using PICRUSt2 to assess their metabolic adaptation to environmental stressors. The results revealed that both personal and indoor FA concentrations (mean 1.17 ± 0.39 ppm and 1.09 ± 0.45 ppm, respectively) exceeded several international occupational exposure limits, with the highest levels observed during dissections involving deep or adipose-rich anatomical regions. Microbial analyses identified stress-tolerant and potentially pathogenic genera, including Bdellovibrio, Aequorivita, and Aspergillus spp., along with enriched pathways involved in aromatic compound degradation and environmental resilience. These findings highlight the limitations of natural ventilation in controlling occupational exposures and microbial contamination in Am climate anatomy laboratories. The study supports the implementation of climate-responsive engineering controls and laboratory management strategies that address chemical safety, thermal regulation, and biosafety to promote healthier and more sustainable dissection environments in similar high-risk settings.by Danai Sangthong, Pradit Sangthong, Warin Rangubpit, Prapasiri Pongprayoon, Eukote Suwan, Kannika Wongpanit, Wissanuwat Chimnoi, Pacharathon Simking, Sinsamut Sae Ngow, Serge Morand, Roger W. Stich, Sathaporn Jittapalapong
Phylogenetic and population genetic analyses were conducted on tick specimens collected from cattle in northern, northeastern, central, and southern regions of Thailand. Morphological identification indicated these ticks consisted of three species, Rhipicephalus microplus from all four regions, R. sanguineus from the northern and northeastern regions, and a Haemaphysalis species only collected from the northeastern region. Analysis of cytochrome c oxidase subunit I gene (COI) sequences identified R. microplus clades A and C, while clade B was not detected in this study. The same analysis indicated specimens morphologically identified as Haemaphysalis were H. bispinosa, confirming previous reports of their prevalence in northeastern Thailand. H. bispinosa showed low haplotype and nucleotide diversity, suggesting either a bottleneck or founder effect. Both R. microplus clades displayed high haplotype diversity and low nucleotide diversity, a pattern associated with population expansion. Genetic structural analysis revealed significant genetic differences in R. microplus clade A, especially between mainland (northern, northeastern, and central regions) and peninsular (southern region) populations, which indicated limited gene flow between these areas while suggesting movement of these ticks across the mainland. The sequence analyses described in this report enhance understanding of the natural history of ticks in Thailand and are expected to guide and strengthen tick control strategies across Southeast Asia.by Jitra Limthongkul, Saradee Warit, Panya Sunintaboon, Sukathida Ubol, Tuksin Jearanaiwitayakul
Bacillus Calmette-Guérin cell wall skeleton (BCG-CWS) has been shown to enhance vaccine effectiveness and antitumor immunity. In our previous study, we reported that co-administration of BCG-CWS with the encapsidated dengue antigens, UV-inactivated DENV2 and DENV2 NS1, synergistically induced DENV-specific adaptive immune responses in mice. As dendritic cells (DCs) are key immune players that mediate innate and adaptive immunity, we, here, asked how well the response of DCs to this adjuvant aligns with the immune responses elicited in vivo. The responses of primary monocyte-derived DCs to BCG-CWS-adjuvanted encapsidated dengue immunogens compared with the unadjuvanted vaccine were investigated. DCs stimulated by BCG-CWS and the dengue nanoparticle vaccine exhibited a superior response. This response correlated well with the stronger immune response observed in mice. This was evidenced by the marked elevation in expression levels of DC activation markers, such as CD80, CD83, CD86, and HLA-DR, and various innate immune cytokines. Additionally, this adjuvant markedly elevated the expression levels of miRNAs related to DC function, such as miR-146a, miR-147, miR-223, and miR-155. These immune components could suppress DENV2 multiplication in bystander skin cells. BCG-CWS exerted an adjuvant effect on DC responses by enhancing antigen-processing activity and activating several innate immune cytokines and immune-related miRNAs.by Naphatsamon Uthailak, Sadudee Chotirat, Ammarind Anatjitsupha, Waraporn Thongyod, Phornpimon Tipthara, Jetsumon Sattabongkot, Joel Tarning, Wang Nguitragool, Onrapak Reamtong
Malaria remains a major global health challenge, caused by several Plasmodium species and transmitted via mosquito vectors. Among these, Plasmodium knowlesi is notable for its zoonotic nature, capable of infecting both macaques and humans. The incidence of P. knowlesi infections has been rising, particularly in Southeast Asia, raising public health concerns. However, compared to other Plasmodium species, the biology, pathophysiology, and transmission dynamics of P. knowlesi remain poorly understood. Given the absence of a licensed vaccine and the increasing threat of drug resistance, a deeper understanding of P. knowlesi biology is essential for effective control and management strategies. This study investigates the metabolomic landscape of P. knowlesi across three intraerythrocytic stagesring, trophozoite, and schizont using mass spectrometry-based metabolomics to gain insights into parasite biology. The analysis revealed distinct metabolic profiles, particularly in the ring stage compared to the other two stages. While glycerophospholipid metabolism and sphingolipid de novo biosynthesis emerged as key pathways associated with common metabolites across all stages, phosphatidylserine synthesis was specifically linked to ring-stage-biased metabolites. Notably, CDP-diacylglycerol-inositol 3-phosphatidyltransferase was highlighted as a promising target based on shared and stage-biased metabolites. Collectively, our findings offer a comprehensive metabolomic profile of P. knowlesi blood-stage development, enhancing our understanding of its biology and identifying potential drug targets that could support the development of novel therapeutic strategies against P. knowlesi malaria.The aim of this study was to determine the prevalence of groin rash among Thai military personnel and to identify associated risk factors, clinical features and patient perceptions. We also evaluated care-seeking behaviour and treatment practices.
Cross-sectional, questionnaire-based study.
Conducted among Thai military personnel in a tropical environment.
A total of 500 male military personnel were recruited between August 2022 and September 2023. Of these, 475 participants were included in the analysis, while 25 were excluded due to non-participation in field training. Eligibility was restricted to those actively engaged in field exercises at the time of study.
Not applicable.
Primary outcome was the prevalence of groin rash, defined by self-report aided by standardised clinical images. Secondary outcomes included risk factors, rash morphology, symptom severity, treatment practices and healthcare-seeking behaviour. Associations were analysed using multivariable logistic regression adjusted for age, body mass index (BMI) and other covariates.
Lifetime prevalence of groin rash was 22.3% (106/475), and the point prevalence was 3.8% (18/475). Among those with rash, 39.6% were classified as probable fungal infections. Independent risk factors included reusing underwear (aOR 2.25; 95% CI 1.27 to 3.99; p=0.005) restricted bathing time (aOR 1.73; 95% CI 1.06 to 2.83; p=0.030) and higher BMI (aOR 1.10; 95% CI 1.02 to 1.42; p=0.030). Most affected participants (54.7%) reported minimal impact on daily life, and only 18.9% sought professional care. Self-medication was common, with 50% using topical over-the-counter antifungals alone, while 16% used a combination of oral and topical drugs. Relapse occurred in 36.1% of cases.
Groin rash is relatively common among young Thai military personnel and is associated with modifiable hygiene-related factors. Only a small proportion of affected individuals appear to present for medical evaluation. Educational interventions emphasising regular laundering and adequate bathing during training may assist in reducing its prevalence.
by Pimwarat Srikummoon, Patrinee Traisathit, Wimrak Onchan, Chagkrit Ditsatham, Natthapat Thongsak, Nawapon Nakharutai, Salinee Thumronglaohapun, Titaporn Supasri, Phonpat Hemwan, Imjai Chitapanarux
Luminal A is the most common subtype of breast cancer and has the best prognosis comparing to the others. The association between air pollution and survival of breast cancer have been reported but not specific to this subtype. We examined pollutant distributions over a decade in upper Northern Thailand, the area of high average annual particulate matter levels, and their impact on the mortality and recurrence risks of patients with luminal A breast cancer. Retrospective data of 1,305 luminal A breast cancer patients diagnosed from 2003 to 2018 were enrolled to this study. Cox proportional hazard models were used to identify factors associated with mortality and recurrence risks including all known risk factors and the annually averaged concentrations of pollutants. On multivariable analysis; metastatic stage (adjusted hazard ratio (aHR) =10.50; 95% confidence interval (95%CI): 7.23–15.25), smoking history (aHR = 1.72; 95% CI: 1.14–2.60), and age ≥ 50 years old (aHR = 1.46; 95% CI: 1.13–1.90) were significant factors influencing mortality risk. Factors contributing to recurrence risk included metastatic stage (aHR) 4.96 (95% CI: 2.78–8.83) and exposure to the time-updated local concentration of PM10 > 55 µg/m3 (aHR = 1.68; 95% CI: 1.16–2.45). Exposure to air pollutants is one of the detrimental factors affected to recurrence and mortality in luminal A subtype breast cancer.Effective community-based disease management is essential for public health. In low- and middle-income countries, sustainable strategies for timely diagnosis and treatment are a research priority. This study aims to assess the feasibility of a non-invasive saliva self-sampling method, paired with digitally linked molecular point-of-care diagnostics, for detecting respiratory infections among paediatric patients in the Tshwane District, South Africa.
A field study will be conducted at Steve Biko Academic Hospital to compare saliva collection using the CandyCollect lollipop device and standard mouth swabs. The spiral groove of the lollipop device captures pathogens, which are stored in DNA/RNA preservation media and later analysed using quantitative PCR and commercially available rapid antigen tests. The multiplex respiratory pathogen panel, based on TaqMan real-time PCR technology, targets key paediatric pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, respiratory syncytial virus (RSV) and influenza A/B. Nucleic acids will be extracted using standard viral extraction kits and analysed following manufacturer protocols. Internal controls will be included in each qPCR run, and samples with CT values below defined thresholds will be considered positive. Rapid antigen tests will detect common pathogens such as influenza A/B, RSV and SARS-CoV-2 for comparative analysis. User experience and acceptability will be assessed via child-friendly and caregiver surveys following sample collection. The study will be implemented in two phases: diagnostic performance evaluation and user feedback assessment. The protocol is aligned with the Standard Protocol Items: Recommendations for Interventional Trials 2013 checklist.
Ethical approval has been granted by the University of Pretoria (509/2023) and the Gauteng Department of Health (GP_202406_032). The study is registered in the Pan African Clinical Trial Registry (PACTR202411743094783). Findings will be disseminated through peer-reviewed journals, conferences and stakeholder briefings. The study complies with South Africa’s Protection of Personal Information Act. Data collection is scheduled from November 2024 to February 2025, with project completion expected within 1 year.
Pan African Clinical Trial Registry (PACTR202411743094783).
To estimate the healthcare costs associated with post-stroke dysphagia during acute hospitalisation and to identify factors influencing these costs in a tertiary hospital setting in Vietnam.
A cross-sectional study using clinical and billing data from hospital records.
The study was conducted at the Neurology Center of Bach Mai Hospital, a tertiary care facility in Hanoi, Vietnam, between June 2020 and January 2022.
A total of 951 patients aged ≥18 years with acute ischaemic stroke confirmed by CT or MRI were included. Dysphagia was assessed using the Gugging Swallowing Screen.
Direct healthcare costs during hospitalisation were collected from the hospital billing system and categorised as medications, diagnostic imaging, medical supplies, accommodation, food, procedures and laboratory tests. All costs were converted to USD. Associations between patient characteristics and total healthcare costs were analysed using generalised linear models (Gamma distribution with log link), applying robust standard errors.
The median treatment cost was 10.08 million VND (436.24 USD) in the dysphagia group vs 6.37 million VND (275.78 USD) in the non-dysphagia group. Costs increased with dysphagia severity, reaching 22.64 million VND (979.49 USD) among patients with severe dysphagia. In multivariate analysis, dysphagia was associated with a 21% increase in costs (exp(β) = 1.21; 95% CI 1.10 to 1.33; p14, pneumonia, prolonged hospitalisation and higher educational level.
Post-stroke dysphagia substantially increases acute hospitalisation costs in Vietnam. Early screening, standardised management and preventive care for complications may improve outcomes and reduce costs.
The study was registered on the Research Registry website (https://www.researchregistry.com/) under the unique identification number: researchregistry8203.
To determine the incidence of in-hospital postoperative mortality and validate the Preoperative Score to Predict Postoperative Mortality (POSPOM).
Retrospective case–control study.
A tertiary university hospital in Thailand.
All patients who underwent surgical procedures in 2019 under any anaesthesia technique.
Incidence of in-hospital postoperative mortality and POSPOM score performance (sensitivity, specificity and predictive values).
A total of 39 674 patients underwent surgery in 2019. The in-hospital postoperative mortality rate was 0.76% (95% CI 0.68% to 0.85%). After excluding cases per POSPOM criteria, 270 deceased patients remained. The POSPOM score was validated against these 270 cases and 270 randomly selected survivors, yielding an area under the receiver operating characteristic curve of 0.73 (95% CI 0.69 to 0.77). At a cut-off of 21, the sensitivity was 71.5% (95% CI 65.7% to 76.8%), and the specificity was 61.9% (95% CI 55.8% to 67.7%).
This single-centre study found a low in-hospital postoperative mortality rate. The POSPOM score demonstrated moderate predictive accuracy for postoperative mortality risk and may be useful for preoperative risk stratification.
The management of autism spectrum disorder (ASD) involves a varied and comprehensive range of support services at various stages of an autistic individual’s life. In Thailand, parents/legal guardians of children with ASD often encounter challenges such as difficulty travelling from rural areas to access support services. The aim of the present study is to investigate the effectiveness of a computer-based intervention programme for caregivers of children with ASD called the Thai Early Intervention for Autism—Assistive Technology for Caregivers (TEI4A-ATC), designed and implemented by a multidisciplinary team.
160 children and their caregivers are being recruited. They will be randomised 1:1 into two treatment arms: access to TEI4A-ATC for the intervention group and standard care for the control group. Before enrolment, ASD diagnosis will be conducted using the Thai Diagnostic Autism Scale: children’s ASD scores will be determined using the Thai Autism Treatment Evaluation Checklist for evaluating communication, sociability and sensory/cognitive awareness and the Thai Early Developmental Assessment for Intervention for evaluating motor skills, social interaction, language development and problem-solving. Both assessment tools will be used again after 3 months of treatment. Similarly, the caregivers’ knowledge, attitude and practice (KAP) for ASD care will be assessed using a questionnaire at enrolment and again after treatment. Comparison of the children’s ASD scores and caregivers’ KAP responses between the treatment groups and before and after treatment will be performed based on the intention-to-treat principle.
This study was approved by the Human Research Ethics Committee for Mental Health and Psychiatry, Department of Mental Health, Ministry of Public Health (DMH.IRB.COA 037/2565). Written informed consent will be obtained from the participants prior to enrolment. The study’s findings may be disseminated through scientific publications and conference presentations. The results of the study will be shared with key stakeholders, including caregivers, psychiatrists, policymakers and the general public, via appropriate dissemination channels to aid in creating appropriate practice and policy guidelines.
This study was registered with the Thai Clinical Trials Registry (TCTR20240320010) on 20 March 2024.
Background
Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults.
Objectives
The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas.
Methods
This was a qualitative study using interpretive description for analysis. Young adults (18–24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS.
Results
Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction.
Discussion
Findings have implications for ENDS cessation interventions targeting young adults in rural areas. 
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