bluuebunny/crossref_metadata_2025 huggingface dataset:
Women political participation in Myanmar’s house of representatives
Authors:   , Swe Thu
Published: September 2023

The thesis mainly discusses about main obstacles and challenges for women to participate in political activities in Myanmar including economic factor, social factor, political factor, and the ways how women are empowered to participate in political activities in Myanmar by using both primary and secondary data. The primary concept for this study is based on women empowerment processes which are included four different pathways in which women are changed –material (economy), perceptual (knowledge and skill), cognitive (self-confident and self-esteemed) and relational (bargaining power). Moreover, the thesis analyses actor’s roles in these four pathways. The thesis found out external factors namely economy, relgion, culture and tradition, verbal gender-discrimination and gender-violence as well as lack of gender-concept in policy and poltiical factor are obstacles and challenges for women. On the other hand, internal factors namely education, knowledge and skills and self-confident are not challenges for women to participate in poltiical activities. In order to empower women, there are four main actors in Myanmar: state (Ministry of Social Welfare, Union Election Commission), political parties, CSO/NGO/INGO and media for four pathways. It is observed that for four pathways, state and political parties takes cooperation and leading roles for economic (material pathway), knowledge and skills (cognitive pathway) and self-confident (perceptual pathway) of women empowerment with CSO/NGO/INGO sector. But state cannot do its cooperation and leading role very well like political parties. The thesis found out CSO/NGO/INGO can do a lot for women empowerment. Without support of CSO/NGO/INGO, state and political parties cannot do anything for material, cognitive and perceptual pathways. And for bargaining power (relational pathway), CSO/NGO/INGO does not have power to do. State and Political parties have power but in reality, state and political parties cannot do anything for bargaining power for women. For media sector, the thesis found out it can just support for improving knowledge for women.
Application of the principle of complementarity by the international criminal court, 2002 - 2018
Authors:   , Jayangakula Kitti
Published: September 2023

The International Criminal Court (ICC) was established for ensuring the effectiveness of bringing the perpetrators of international crimes to justice. In addition, the ICC plays its role in order to promote the rule of law in the international community. To archive these ultimate goals, the Rome Statute of the International Criminal Court outlines its role as a court of the last resort by emphasising states themselves are primarily responsible for the prosecution of international crimes. The main duty of the Court is to complement the proceedings at the national level of the state concerned (the principle of complementarity). The ICC will step in to intervene to investigate and prosecute the crime of genocide, crimes against humanity, war crimes, and the crime of aggression, only when the justice cannot be achieved at the national level due to the unwillingness or the inability of the state concerned. The principle of complementarity is outlined article 17 of the Rome Statute as the criteria for admissibility of a case. The complementarity determination will be done at two main stages of the ICC proceedings: the preliminary examination stage and the admissibility stage. At the preliminary proceedings, the Court will determine the principle of complementarity, for the authorization of an investigation into a situation. Then, at the admissibility stage, the complementarity test will be assessed, for rendering the admissibility determination of a case. In this regard, the Court will determine national proceedings of the state concerned, the same-case test (person and conduct), the willingness, and the ability of the state concerned. If all of these criteria for admissibility are satisfied, the Court will render the case inadmissible. This dissertation aims at examining the complementarity provision under the Rome Statute, analysing the dynamic application of the principle by the Court during 2002-2018, and scrutinising the problems and challenges faced by the Court. The result of the analysis demonstrates the dynamism of the application of the principle of complementarity. However, the inconsistency of the dynamic application, in turn, challenges the effectiveness of the ICC complementarity system as well as the credibility and legitimacy of the entire ICC system. The study, therefore, aims at providing appropriate measures to ensure more effective and more coherent of the application of the principle of complementarity by the ICC.
B-cell activating factor as an immunological marker of disease outcome and treatment response in patients with chronic hepatitis B virus infection
Authors:   , Khlaiphuengsin Apichaya
Published: September 2023

B-cell activating factor (BAFF), an important cytokine for B lymphocyte activation that implicated in the pathogenesis and disease progression chronic hepatitis B (CHB) patients. This study aimed at evaluating clinical correlation and prognostic role of plasma BAFF, BAFF receptor and related polymorphisms in patients with CHB undergoing pegylated interferon (peg-IFN) treatment and HBV-related hepatocellular carcinoma (HCC). This study shown that BAFF levels were elevated during treatment but decreased to pre-treatment levels after peg-IFN cessation in HBeAg-positive CHB patients. Patients with HCC had significantly higher BAFF levels compared with the non-HCC group and healthy controls. Moreover, the frequency of rs9514828 CT+TT genotypes were higher distributed in patients with chronic HBV infection compared with healthy controls. In summary, low baseline BAFF was associated with treatment response to peg-IFN and high baseline BAFF levels showed clinical correlation in terms of disease severity and overall survival in HBV-related HCC patients. These data suggest that BAFF may play an essential role in predicting a treatment response and promoting tumor development and progression.
Investigation of Parameters for Metallic Artifact Reduction using 3-D SPACE in MR Lumbar Spine at 1.5 Tesla: A Phantom Study
Authors:   , Lowong Thanatchaya
Published: September 2023

Metallic artifact reduction in magnetic resonance imaging (MRI) has increasingly interested especially metal implant postoperative in lumbar spine. Recently, the new pulse sequence based on true isotropic 3D voxel with high resolution namely Sampling Perfection with Application Optimized Contrasts using Different Flip Angle Evolutions (SPACE) was introduced. This study aimed to determine the appropriate 3D T2-SPACE parameters for reducing the metallic artifact in MR lumbar spine 1.5 Tesla. Cylindrical phantom filled with 3.3 g/L, NiCl2-6H2O and 2.4 g/L NaCl solution, and two commonly used metal implants (stainless steel and titanium) for lumbar spine were acquired using turbo spin echo (TSE) and SPACE pulse sequences in T2-weighted image contrast. A receiver bandwidth of 296, 501, 723 Hz/pixel and flip angle at 100°,150°, 180° were adjusted in order to determine the 3D T2-SPACE appropriate parameters. The volume of metal artifact was quantitatively assessed by applying a histogram distribution for obtaining the normal background signal intensity (mean value±3SD) of the solution. Such normal background range was applied to the metal artifact image dataset to determine the thresholding level. All signal values outside this normal range were calculated as susceptibility artifacts from the metal implants. The quantitative image quality was evaluated in terms of signal-to-noise ratio (SNR). The appropriate protocol was selected according to ranking score (1-10 points) by sorting the volume of metallic artifact, SNR and specific absorption rate (SAR).

By acquiring the phantom with the 3D T2 SPACE (protocol 1-9) and 2D T2 TSE (protocol 10) at 1.5 T, the results showed that the average metallic artifact volume of protocol 1-10 were 162.64±1.88, 158.30±1.79, 157.82±2.36, 126.43±1.22, 124.87±0.29, 122.93±1.57, 117.55±1.03, 114.82±1.55, 112.40±0.43 and 184.89±1.19 cm3 for the stainless-steel and for titanium, the average metallic artifact volume of protocol 1-10 were 33.80±1.03, 32.56±0.48, 33.79±0.90, 13.39±0.67, 13.77±0.73, 12.74±0.48, 10.89±0.77, 11.42±0.64, 10.67±0.71 and 38.86±0.97 cm3. The metal artifacts were highest reduced at protocol 9 by 39.21% for stainless steel and 72.55% for titanium.

In conclusions, using the 3D SPACE pulse sequence, the artifact volume can be effectively reduced by increasing the receiver bandwidth. The appropriate parameters for metallic artifact reduction with highest-ranking scores were protocol 4 and 5 with bandwidth 501 Hz/pixel, flip angle 100° and 150° in both of stainless steel and titanium respectively.
Antilithogenic Efficacy Of An Innovative Beverage Hydrozitla: In Vitro And In Vivo Studies
Authors:   , Lordumrongkiat Nalinthip
Published: September 2023

Urinary stone disease is a common urologic disease worldwide, and it is highly recurrent.  Calcium oxalate (CaOx) stone is the most common type of urinary stones. The main causes of urinary stone formation include inadequate water intake, low urinary citrate excretion and increased oxidative stress. At the present day, potassium citrate is a drug of choice for preventing stone formation and recurrence. We developed a new regimen for preventing urinary stone formation, called HydroZitLa. It was in a form of concentrate in pouch. For consumption, water was added up to 500 mL and shake well before drink. Therefore, drinking of HydroZitLa ensured that patients gained more water intake.  The active antilithogenic ingredients of HydroZitLa were citrate (16 mEq/pouch) and natural antioxidants from Thai medicinal plants. In vitro study found that HydroZitLa significantly inhibited CaOx crystal aggregation. HydroZitLa had antioxidative function to reduce oxidative stress in HK-2 cells treated with CaOx and H2O2. In vivo experiment was performed to investigate the stone inhibitory effect of HydroZitLa in nephrolithic rats was induced by ethylene glycol (EG). Twenty male Wistar rats were randomly divided into four groups; control (n=2), EG (n=6), EG+HydroZitLa (n=6) and EG+Uralyt-U (n=6). The results showed that CaOx crystal deposits in the kidneys of EG+HydroZitLa and EG+Uralyt-U groups were significantly lower than the EG group. Inflammation and oxidative stress in the kidney tissues of EG group were evidently higher than the EG+HydroZitLa and EG+Uralyt-U groups. Urinary citrate excretion in the EG+HydroZitLa and EG+Uralyt-U groups were increased compared to the EG group. In conclusion, the present study demonstrated that HydroZitLa and Uralyt-U drug exhibited the ability to inhibit CaOx crystal deposition and reduce oxidative stress in the kidneys of EG-induced nephrolithic rats. This innovative HydroZitLa product could be an effective therapeutic regimen for the treatment of urinary stone disease. The pre-clinical antilithogenic efficacy of HydroZitLa was comparable to the potassium citrate drug, Uralyt-U. Clinical efficacy of HydroZitLa will be further tested in the clinical trials.
Phosphoproteomic analysis of Fc gamma receptor Iib deficient macrophages in enhancing the severity of endotoxin tolerance
Authors:   , Ondee Thunnicha
Published: September 2023

Sepsis is a severe response to systemic infection and one of the leading causes of
death in patients world-wide. Bacterial endotoxin (lipopolysaccharide; LPS), is a potent inducer of inflammation that has been associated with the pathophysiology of sepsis. The repeated LPS exposure can induce a suppressive effect as refer to endotoxin tolerance. Fc gamma receptor IIb (CD32b), the only inhibitory receptor among FcGR family, associates with systemic lupus erythematosus (FcGRIIb defunctioning polymorphisms) which are commonly found in Asian populations. Because of an inhibitory nature of the signaling, endotoxin tolerance in lupus with FcGRIIb deficient (FcGRIIb-/-) is interesting and might be translated into the infection in lupus patients. Therefore, we aim to explore the endotoxin tolerance in FcGRIIb-/- mice and the underlying mechanisms. Indeed, several characteristics of endotoxin tolerance using two sequential LPS stimulations in FcGRIIb-/- bone marrow-derived macrophage (BMM) including cytokine production, phagocytosis and killing activity were lower than the wild-type (WT) cell. For in vivo, cecal ligation and puncture (CLP) induce sepsis after LPS preconditioning was more severe in FcGRIIb -/- mice, as measured by mortality rate, bacteria count in blood, serum cytokines, creatinine (kidney injury) and alanine transaminase (liver damage). Then the phosphoproteomic analysis, using a dimethyl labeling method, in endotoxin tolerance of FcGRIIb-/- macrophage revealed the prominently decreased protein kinase C-β type II (PKCBII) in comparison with WT cell. In addition, the validation analysis including western blot analysis of macrophage in vitro and the immunoblot of spleen from FcGRIIb-/- mice with sequential LPS administration demonstrated the lower PKCBII in LPS tolerance FcGRIIb-/- groups. The impact of FcGRIIb and endotoxin tolerance association with sepsis might lead to the new strategies for the prevention and/or treatment of bacterial infections in patients with lupus in the future
Host and viral factors influencing disease progression and treatment response in chronic HBV infection
Authors:   , Limothai Umaporn
Published: September 2023

Hepatitis B virus (HBV) infection represents a major risk factor of developing chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). The clinical outcome of HBV infection depends on complex of host and virus interactions. In this study, we found that serum HBV RNA levels has emerged as a potential viral marker for active HBV infection and may be used to evaluate response to antiviral therapy and disease progression. Serum HBV RNA levels varied among different phases of chronic HBV infection (CHB).  There was a correlation between serum HBV RNA levels and amount of intrahepatic covalently closed circular DNA (cccDNA), suggesting that serum HBV RNA quantification represents a useful non-invasive marker for disease monitoring in patients with CHB. In addition, the measurement of serum HBV RNA prior to pegylated interferon (PEG-IFN)-based therapy could identify patients with high probability of sustained response (SR, HBV DNA <2,000 IU/mL). Moreover, early HBV RNA kinetics identified subgroup of patients who had a minimal chance of achieving favorable outcome, which could allow response guided therapy. Host genetic factors can also affect the outcome of HBV infection. We investigated the influence of single nucleotide polymorphisms (SNPs) in vitamin D-related genes including 25-Hydroxyvitamin D-1 alpha-hydroxylase (CYP27B1), vitamin D binding protein (DBP) and vitamin D receptor (VDR) and genetic variation in signal transducer and activator of transcription 4 (STAT4) on HBV infection outcomes. The results of this study showed that variations of both rs4646536 in the CYP27B1 gene and rs7574865 in the STAT4 gene might contribute to increased susceptibility to HBV-related HCC in the Thai population but did not correlate with HBV susceptibility and HBV natural clearance. In addition, both SNPs were predictive factors of response to PEG-IFN therapy in Thai patients with CHB. Thus, the determination of these SNPs could maximize cost-effectiveness of PEG-IFN in patients with CHB.
The difference patterns of electrophysiological properties and effects of kynurenic acid in trigeminal ganglion neurons isolated from rats migraine models
Authors:   , Haji-a-sa Naeemah
Published: September 2023

Migraine headache generates in trigeminal nociceptive system which is activated by cortical spreading depression (CSD) phenomenon. There are also some neurotransmitter changes relating to pathogenesis of migraine, one of representative examples is serotonin (5-HT) depletion that may predispose to migraine development. Trigeminal ganglion (TG) is a structure containing cell body of neurons that undertakes a role as first order neuron in trigeminal nociceptive system. Moreover, the alteration of glutamate may contribute to hyperactivity of its specific receptors, for instance N-methyl-D-aspartate (NMDA) receptor. Endogenous biomolecule, such as kynurenic acid (KYNA) which is derived form of 5-HT can inhibit NMDA receptor. Basically, KYNA plays a role as NMDA antagonist, and at the same time, it is one of metabolites of tryptophan pathways as well as 5-HT. This study aimed to explore the electrophysiological properties change of TG neuron isolated from rat migraine models (CSD and 5-HT depletion), and the effects of KYNA on them. The results revealed that resting membrane potential (RMP) of TG neurons had significant depolarization shift in CSD and combined model of CSD and 5-HT depletion, while this alteration was not observed in 5-HT depletion only. In conclusion, CSD is a cortical model of migraine that affects to TG neuron. Thus, CSD has a potential to alter RMP of TG neurons that may results to increase of neuronal excitability in trigeminal nociceptive system.
Anticancer activity of plumbagin on stem-like characteristics, tumor angiogenesis and metastatic potential in endocrine resistant breast cancer
Authors:   , Sakunrangsit Nithidol
Published: September 2023

Plumbagin (PLB), a naphthoquinone compound and vitamin K3 derivative, was shown its potent cytotoxicity and anti-invasion in anti-hormonal resistant cells through the inhibition of Snail-induced epithelial mesenchymal transition (EMT). Overexpression of Snail leads to decrease E-cadherin and increase of beta-catenin, resulting in the activation of Wnt pathway that increases cancer stem-like characteristics in these resistant cells. This study was aimed to investigate the inhibitory effects of PLB on cancer stem-like cells (CSLCs), angiogenesis and Wnt signaling-mediated cell proliferation and invasion. In addition, our study also focused on the anticancer activity of PLB in anti-hormonal resistant breast cancer in vivo. Both anti-hormonal resistant LCC2 and LCC9 cells increased beta-catenin and dysregulated Wnt signaling. Thus, these two cell lines were able to form mammospheres with elevated stem cell markers. This property is the characteristic of CSLCs. Our study showed that PLB significantly diminished the colony and mammosphere formation in a concentration-dependent manner. PLB also dramatically reduced angiogenic factors, stem cell markers and p-Akt expression. Our findings demonstrated the anti-proliferative and anti-invasive properties of PLB were partly mediated by Wnt signaling. Importantly, the inhibitory effects of PLB in cell lines were consistent with the result in xenograft mice. PLB at the doses of 2 mg/kg/day and 4 mg/kg/day significantly inhibited tumor growth without any adverse effects on body weight and blood coagulation. Moreover, PLB treatment not only repressed tumor angiogenesis, but also inhibited lung metastasis. Overall, these findings supported the role of PLB as an anti-cancer agent for anti-hormonal resistant breast cancer.
Does Early Initiation of Renal Replacement Therapy Have an Impact on 28-day mortality in Critically Ill Patients with Acute Kidney Injury with Positive Furosemide Stress Test?: a Multicenter Randomized Controlled Trial
Authors:   , Lumlertgul Nuttha
Published: September 2023

Background: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. Methods: FST was performed using intravenous furosemide (1 mg/kg in furosemide-naive patients or 1.5 mg/kg in previous furosemide users). FST-nonresponsive patients (urine output less than 200 mL in 2 h) were then randomized to early (initiation within 6 h) or standard (initiation by urgent indication) RRT. The primary outcome is 28-day difference in mortality rates between early and standard RRT. Results: FST was completed in 162 patients. Only 6/44 (13.6%) FST-responsive patients ultimately received RRT. Among 118 FST-nonresponsive patients, 98.3% in the early RRT arm and 75% in the standard RRT arm received RRT. We observed no differences in 28-day mortality (62.1 versus 58.3%, p = 0.68), 7-day fluid balance, or RRT dependence at day 28. Conclusion: The furosemide stress test appears to be feasible and effective in identifying patients for randomization to different RRT initiation times. There was no difference between 28-day mortality rates between furosemide-nonresponsive patients who were randomized to early or standard RRT initiation.
Struggling to live a new normal life among Chinese women after losing the only child
Authors:   , Wang Haiyan
Published: September 2023

Losing the only child was a destructive disaster that had destroyed Chinese women’s life and health in all dimensions. However, there is no suitable theory or knowledge to guide nursing practice to these women. This study, thus, employed Glaserian grounded theory to discover substantive theory on the living process of Chinese women after losing the only child.

Purposive sampling, snowball sampling, and theoretical sampling were used to recruited participants. Thirteen Chinese women who have lost the only child aged 50 to 68 years old recruited. Data were collected through in-depth interview, observation, and field notes. Data were analyzed by the constant comparative method concurrently with data collection. A qualitative data analysis program, namely ATLAS.ti, was used to facilitate data analysis.

Struggling to live a new normal life was emerged as the basic social process of Chinese women after losing the only child. It consists of three phases, living in agony (losing the life anchor and sinking in grief and fear), coming to term (accepting loss and self-controlling), being alive in a new way (treasuring the deceased only child, resetting life goals and reconstructing a new life). In order to live a new normal life, which participants defined it in their way; participants put much effort and developed various strategies to move forward. Receiving support motivates and facilitates these Chinese women to deal with the loss. However, whenever encountering adverse triggering situations would bring them back to the first phase. Then participants repeated the process. Therefore, Chinese women are moving back and forth among these three phases.

This substantive theory provides new knowledge and insights of the living process of Chinese women after losing the only child. It can be applied as a guideline to develop nursing interventions to assist Chinese women in dealing with the loss of the only child in the future.
Comparison of the implant deviation between implants placed using static and dynamic computer assisted surgery methods
Authors:   , Kaewsiri Dechawat
Published: September 2023

Objectives: The aim of this study was to compare the accuracy of implant placement in terms of deviations related to the virtual plan between static and dynamic computer assisted implant surgery (CAIS) systems in single tooth space.

Materials & Methods: 60 single implants were randomly placed using two difference CAIS systems by one surgeon. Preoperative CBCT transferred to implant planning software were used to plan the virtual implant position. Implants were placed using either stereolithographic guide template for static CAIS group (n = 30) or implant navigation system for dynamic CAIS group (n = 30). Postoperative CBCT were taken to acquire the implant position and were imported to implant planning software in order to perform the implant deviation analysis. Primary outcomes were the deviations at implant platform, implant apex, and angular deviation.

Results: The mean deviations at implant platform and implant apex in static CAIS group were 0.97 ± 0.44 mm and 1.28 ± 0.46 mm respectively, while in dynamic CAIS group were 1.05 ± 0.44 mm and 1.29 ± 0.50 mm respectively. The angular deviation in static and dynamic CAIS group were 2.84 ± 1.71 degrees and 3.06 ± 1.37 degrees respectively. No significant differences between both groups was found.

Conclusions: Dynamic CAIS system provides the accuracy of implant placement in single tooth space similar to static CAIS system.
Association Between Chronic Periodontitis And Hypertension Among Thai Adults
Authors:   , Rassamee Ploysiri
Published: September 2023

Previous studies suggest that periodontitis may be associated with an increasing risk of hypertension. However, data from large epidemiological studies are limited. The aim of this cross-sectional study was to examine the association between periodontitis and hypertension using data from a cohort study in a Thai population. The study population comprised of 1,378 employees of the Electricity Generating Authority of Thailand (EGAT), aged 53 to 73 years old, were categorized into no/mild, moderate, or severe periodontitis groups. Hypertension was determined as having systolic blood pressure 140 mmHg or more or diastolic blood pressure 90 mmHg or more, or taking antihypertensive medication. The results of multivariate analysis, after adjusting confounders including age, gender, education level, diabetes mellitus, smoking status, alcohol consumption, frequency of exercise, obesity, hypertriglyceridemia, and hypercholesterolemia, there was a significant association between severe periodontitis and hypertension with an odds ratio of 1.55 (95% CI: 1.03-2.33; P = 0.035). In conclusion, severe periodontitis was associated with an increasing risk of hypertension in this group of Thai adults. However, further longitudinal epidemiological studies are needed.
Development of a determinant scale of pharmacist’s care for herbal and dietary supplement users
Authors:   , Wahab Mohd
Published: September 2023

Objective: There is a lack of instrument that is valid and reliable to measure the determinant of pharmacist’s care (PCare) for herbal and dietary supplement (HDS) users. The present study aimed to develop scales to measure the determinant of PCare for HDS users and to quantify the practices. The study utilized qualitative and quantitative approaches.

Methods: Three scales were developed: Direct TPB scale based on a modified Theory of Planned Behaviour (m-TPB) framework, Indirect TPB scale based on the m-TPB and beliefs elicited from community pharmacists (CPs), and PCare-HDS scale based on findings from the qualitative study. This study involved three phases: (1) qualitative study to explore CPs’ salient practices of PCare for HDS users, and the beliefs associated with the practices; (2) generation of item pools; and (3) psychometric evaluation of the scales.

Results: The qualitative study identified eight domains of PCare for HDS users, divided into two dimensions of direct and non-direct customer/patient care activities, and identified relevant beliefs underlying the practices. Item generation procedures produced pools of items for the scales. These items were examined and refined by a group of pharmacy experts in a content validity study. A face validity study established the clarity and comprehensibility of the items. For the third phase, a cross-sectional survey was carried out among CPs in Bangkok. The sample was divided into two datasets: sample 1, to explore the factor structures and to refine the scales; and sample 2, to cross-validate the factor structures. Additionally, Rasch analysis and criterion validity tests were performed on the entire sample of CPs. Exploratory factor analysis (EFA) supported the factor structures of the Direct TPB and PCare-HDS scales, and identified an additional factor for the Indirect TPB scale. Both the EFA and a preliminary confirmatory factor analysis (CFA) guided the refinement of the scales. Data from the second dataset for all three scales fitted well with the models using CFA. Discriminant and convergent validity were shown for the scales. Rasch analysis showed no substantial misfit and the category functioning followed monotonic increases in mean and step measures for all domains of the scales. All constructs of the scales had good to excellent internal consistency reliability. The scales had criterion validity to some extent.

Conclusion: The scales were shown to have validity and reliability and can be of interest to researchers aiming to understand PCare for HDS users. Further study can validate the scales in different sample of CPs such as in the Northern and Southern regions of Thailand.
Physicochemical, biopharmaceutical and anti-hepatocellular carcinoma properties of curcumin diethyl disuccinate
Authors:   , Muangnoi Chawanphat
Published: September 2023

Curcumin ( Cur) has been reported for an anticancer activity by inducing apoptosis. However, the poor oral bioavailability of Cur due to chemical instability limits itself for further development as a chemotherapeutic agent. Previously, a succinate ester prodrug of Cur named as curcumin diethyl disuccinate (CurDD) has been designed and synthesized to enhance chemical stability of Cur. In this study, physicochemical and biopharmaceutical properties as well as in vitro and in vivo anti-hepatocellular carcinoma activities of CurDD were investigated and compared with those of Cur. CurDD could improve the stability of Cur in buffer pH 7.4 and simulated gastrointestinal fluids. The bioavailable fractions ( BF) of CurDD had the significantly higher amount of transported Cur and exerted higher cytotoxicity against HepG2 cells comparing to those of Cur (p<0.05). The BF of CurDD induced apoptosis by increasing and suppressing Bax and Bcl-2 expression, respectively, resulting in the activation of caspase-3 and -9 activities in the higher extent in comparison with Cur. CurDD also exhibited the better anti-hepatocellular carcinoma activity in HepG2-induced tumor mice after oral administration in comparison with Cur (p<0.05) . CurDD inhibited the angiogenesis by decreasing COX-2 expression and suppressing VEGF production. These results suggest that CurDD could improve the oral bioavailability as well as the anti-hepatocellular carcinoma activity of Cur. Therefore, CurDD, as a prodrug of Cur, has a potential to be further developed for the treatment of liver cancer.
Association of genetic and non-genetic factors with clinical responses of donepezil and Galantamine in Thai patients with dementia
Authors:   , Yaowaluk Thitipon
Published: September 2023

Donepezil and galantamine are commonly prescribed for the treatment of dementia. However, the response rate of acetylcholinesterase inhibitors is only 15-35 %. Inter-individual variability in donepezil and galantamine response has been associated with genetic factor in some population.  Moreover, non-genetic factors such as age, gender, education level, comorbidities and drug-drug interactions can influence pharmacokinetic profiles and drug responses. Therefore, this study aims to investigate the association of genetic variations that involved therapeutic effects of donepezil and galantamine including pathogenic gene; APOE, drug metabolizing genes; CYP2D6, CYP3A5, UGT1A1, transporter gene; ABCB1 and non-genetic factors with therapeutic outcomes as measured as Thai Mental State Examination (TMSE) scores and steady-state plasma concentrations (Cpss) of donepezil and galantamine in Thai patients with firstly diagnosed dementia. Both univariate and multiple linear regression analysis indicated that only CYP2D6*10 allele was associated with higher Cpss (p-value = 0.029 and B = 0.478, p-value = 0.032, respectively) and a better clinical outcomes of donepezil i.e. ΔTMSE (p-value = 0.023 and B = 4.107, p-value = 0.002), especially in patients with Alzheimer’s disease (AD). Concomitant use of memantine was found to be associated with increased Cpss of donepezil. Whereas, co-medication with antidepressant drugs attenuated clinical responses of donepezil in patients with AD. Age was found to be negative associated with donepezil response in vascular dementia patients. For galantamine, the multivariate regression model revealed that patients with mixed dementia who carried a more detrimental allelic variants in combined CYP2D6, CYP3A5, and UGT1A1 were associated with higher galantamine’s adjusted Cpss (B = 34.559, p-value = 0.045). Both multiple linear and logistic regression analysis consistently revealed that CYP2D6*10 carriers was significantly associated with higher ΔTMSE (B = 5.227, p-value = 0.001). UGT1A1 mutant alleles and non-genetic factors including concomitant use of statin drugs and higher education level may attenuate the therapeutic outcome of galantamine. The present findings highlight the possibility of using genetic testing to guide personalized dementia therapy with donepezil and galantamine in the forthcoming precision medicine era.
Effect of citric acid on color stability and surface roughness of translucent monolithic zirconia with different staining techniques
Authors:   , Rinthong Panisa
Published: September 2023

Background and rationale: Translucent monolithic zirconia is developed to solve the problem of esthetic in the conventional generation of zirconia with high opacity. When these materials are used for anterior restoration in the oral cavity, they can contact with foods and beverages that are acidic, which may affect the color stability and surface roughness of the material at different levels.

Objective: The objective of this study was to determine the effects of citric acid on color stability and surface roughness of translucent monolithic zirconia with different staining techniques.

Materials and Methods: A total of 80 disc specimens of VITA YZ® XT (14 mm in diameter and 1.5 mm in thickness) were designed with computer-aided design and computer-aided manufacturing (CAD-CAM) software then cut with a low-speed saw and sintered, according to the manufacturer's instruction. All sintered specimens were divided into 4 groups, including no treatment (NT), polishing (PO), stained then glazed (S-G) and mixing of stain and glaze (S+G). For the PO specimens, they were polished by diamond coated grinding bur and VITA SUPRINITY® polishing set. The S-G and S+G groups were subjected to glaze coated by VITA AKZENT Plus® STAIN and GLAZE. All specimens were separated into 2 subgroups (n=10). The first subgroup was immersed in artificial saliva at 37 °C for 14 days to simulate the exposure of saliva in the oral cavity for 2 years in vivo. It was also used as a control group. The other subgroup was immersed in 2% citric acid solution for 8 h to simulate 2-year exposure of citric acid in the oral cavity. The measurement of color change (∆E) and surface roughness (Ra) before and after the immersion was conducted with a spectrophotometer and a contact type profilometer respectively.

Results: For the color change, the results showed that S+G and S-G groups had significantly higher mean values of ∆E than NT and PO groups in both solutions. When considering these 2 staining techniques, ∆E value in citric acid solution was significantly higher than artificial saliva. However, no significant difference of ∆E was observed between S+G and S-G groups. For the surface roughness, there was no statistically significant difference between surface roughness (Ra) and surface roughness change (∆Ra) among 4 surface finish groups in both solutions.

Conclusions: It can be concluded that citric acid had an unfavorable effect on the color stability of both staining techniques on translucent monolithic zirconia but did not exceed the perceptible threshold. However, citric acid did not affect the surface roughness in all surface finish groups.
Comparison Of The Efficacy Of Chemical Cleaning Methods In Removing Candida Albicans From Polymethyl Methacrylate
Authors:   , Thanamee Thanaporn
Published: September 2023

The proper denture hygiene is important to reduce the risk of denture stomatitis. Mechanical cleaning is not sufficient to remove the dental plaque from acrylic denture base, accordingly chemical cleaning is needed. The purpose of this study was to compare the efficacy of chemical cleaning methods in removing Candida albicans  from polymethyl methacrylate (PMMA) by comparing the remaining viable cells after cleaning. The total of 120 specimens were prepared. Candida albicans was cultured in broth to log phase. All specimens were randomly placed in 24-well tissue culture plate with 1 ml of Candida albicans cultured for biofilm formation at 37 degree Celsius for 24 hours. After that, all specimens were randomly immersed in 20 experimental groups of cleaning methods including distilled water as the negative controls for 1 hour and 12, 0.1% acetic acid for 1 hour and 12 hours, 0.2% acetic acid for 1 hour and 12 hours, 3 mg/ml oligomer chitosan for 1 hour and 12 hours, 6 mg/ml oligomer chitosan for 1 hour and 12 hours, 3 mg/ml 30 kDa chitosan for 1 hour and 12 hours, 6 mg/ml 30 kDa chitosan for 1 hour and 12 hours, Polident® for 5 minutes, 1 hour and 12 hours and 0.2% chlorhexidine for 15 minutes, 1 hour and 12 hours. The viable cells of Candida albicans after cleaning were determined by MTT assay as optical density and calculated into the percentage for statistically analysis. The results showed that the cleaning method which had the highest efficacy to remove Candida albicans from PMMA was using 3 mg/ml oligomer chitosan with 12-hours immersion time compared with other experimental groups except all of chitosan groups with 12-hours immersion, the percentage of viable cells after this cleaning method was 6.22±4.30% (p < 0.05) by using One-Way ANOVA for statistically analysis. The results of this study concluded that 3 mg/ml oligomer chitosan can used as antifungal denture cleanser to reduce Candida albicans.
Health policies and programs facilitating access to high-cost anticancer drugs
Authors:   , Patikorn Chanthawat
Published: September 2023

Access to anticancer drugs is limited mainly due to their high cost. To support policymakers in Thailand to develop policies and programs to facilitate better access to high-cost anticancer drugs, global and local evidence are needed. A systematic review of literature was conducted using PubMed, Embase and Web of Science between October 8-11, 2018 to identify peer-reviewed articles published in English from 2000 to 2018. Studies were included if they described health policies or programs facilitating access to high-cost anticancer drugs. Using thematic synthesis, policies and programs were summarized by themes and by income classification of countries. In addition, a qualitative in-depth interview was conducted with key informants in Thailand to study access to high-cost anticancer drugs across three health benefit schemes. The search identified 2112 studies, of which 113 studies in 178 countries were included in this review. Four themes of policies and programs were identified: Reimbursement and pricing policies, Alternative funding models for high-cost drugs, Procurement, Flexibility of patent law and Assistance programs. Access to high-cost anticancer drugs mainly depends on individual country’s pricing and reimbursement policies as the costs of these drugs are beyond patients’ affordability. Low- and middle-income countries mainly facilitate patient access through pharmaceutical industry-initiated patient assistance programs. In high-income countries utilized various strategies to overcome uncertainties and relatively poor cost-effectiveness of these drugs, for example, Managed Entry Agreements (MEAs) and dedicated fund for anticancer drugs. Interviews were conducted between July 2018 and November 2018 with 9 informants in Thailand. Six key themes emerged from the analysis synthesized by patient access to high-cost anticancer drugs under different programs and drug formularies. For example, E2 access program under National List of Essential Medicines (NLEM), Oncology Prior Authorization (OCPA), and Patient Access Programs (PAPs). Patients under the three health benefit schemes can access to high-cost anticancer drugs listed in NLEM especially E2 access program. Prescription of non-NLEM drugs requires out-of-pocket payments from patients. Civil servant medical benefit schemes patients have better access to high-cost drugs compared to the other two schemes, through the OCPA. However, OCPA has limited number of reimbursed drugs as well as strict prior authorization process. PAPs also play major role in supporting self-paying patients, but they have to be simpler in order to reduce burdens to the healthcare professionals. The use of MEAs is found to be introduced to Thailand which is the further step to deal with sustainability of PAPs, which have limited budget. MEAs are written contractual agreements between payers and pharmaceutical companies to ensure transparency and could share the risk of uncertainties among these parties
Needs Analysis And Development Of Professional Development Program For Thai Community Pharmacists
Authors:   , Puengrung Surangkana
Published: September 2023

Background: Primary care services, as recommended by the National Health Security Office (NHSO), are crucial for Thai community pharmacists. Training needs for the services and a professional development or training program however remained unexplored. Objectives: To analyze community pharmacists' training needs and develop professional development programs to meet their needs. Methods: A mixed-methods study with two phases was conducted during 2018-2019. Phase 1 was involved in the needs assessment using semi-structured interview with 10 key informants who were community pharmacists and stakeholders based on three levels (i.e. tasks, person, and organization) and needs confirmation with a self-administered questionnaire surveyed in community pharmacists.The questionnaire was specially designed, checked for content validity and posted to randomly selected pharmacists using a systematic sampling technique. Some professional development programs were then constructed according to the gaps analysis of important tasks and performance levels. Phase 2 was the pharmacists' perceptions and verification of the programs using a focus group of nine key participants who were pharmacy preceptors and practicing pharmacists. Results: Pharmacists' training needs for primary care services were qualitatively analyzed with 14 themes. The themes, together with core competencies and NHSO's specified duties, were used to draft the questionnaire containing seven domains with 44 tasks, i.e., management (8 tasks), basic services (4), follow-up plan (5), advanced services (11), health promotion for community services (5), health promotion for service users (5), and behavioral modifications (6). The response rate of the survey was 28% (365/1,289). Three development programs, i.e. depression screening, home visit, and family planning, were proposed based on the top three widest gaps between the important tasks and performance levels. For the focus group, they sll agreed on the three model programs and preferred a one-day training session. Conclusion: Training needs for primary care services were successfully analyzed and three professional development programs were proposed and accepted. Further studies are required to adjust and assess the priority training programs for community pharmacists.
The Effects of Communicative Framework Instruction Using Computer-Assisted Pronunciation Training (CAPT) on English Pronunciation Ability of Chinese Undergraduate Students
Authors:   , Chang Ching-yueh
Published: September 2023

The study aimed 1) to examine the effects of the communicative framework instruction using CAPT on the English pronunciation ability of Chinese undergraduate students; 2) to investigate the opinions of students towards the communicative framework instruction using CAPT. The participants consisted of 17 Chinese undergraduate students in at Siam University at during the first semester of the 2018 academic year in 2018. The instruments used to collect data were a pronunciation pre-test and a post-test, a student opinion questionnaire, and semi-structured interview questions. The analyzed statistics computed from the data included the mean scores, standard deviation, and Wilcoxon signed ranks test; the qualitative data obtained from the interview were analyzed using content analysis The findings revealed that 1) there was a significant difference in students’ mean scores at a significance level of 0.05 on the English pronunciation ability before and after the students’ participation in the communicative framework instruction using CAPT; 2) students had provided positive feedbacks on learning how to pronounce and improve the pronunciation skills, self-confidence, engaging learning environments, more opportunities to learn inside and outside the classroom, cooperative learning, and learner autonomy. However, students had problems regarding the recording quality, as well as the materials and time allocation. time
การพัฒนารูปแบบการจัดการค่ายโดยใช้ระบบสนับสนุนการตัดสินใจแบบกลุ่มด้วยเทคนิคการคิดนอกกรอบและ PMI เพื่อส่งเสริมความสามารถในการแก้ปัญหาเชิงสร้างสรรค์สำหรับผู้เรียนในระดับอุดมศึกษา
Authors:   , พูลสวัสดิ์ ขจรพงษ์
Published: September 2023

การวิจัยครั้งนี้มีวัตถุประสงค์ ดังนี้ 1) เพื่อศึกษาสภาพปัญหาและประเมินความต้องการจำเป็น ในการจัดการกิจกรรมค่ายของนิสิตนักศึกษาระดับอุดมศึกษา 2) เพื่อพัฒนารูปแบบการจัดการค่ายโดยใช้ระบบสนับสนุนการตัดสินใจแบบกลุ่มด้วยเทคนิคการคิดนอกกรอบและ PMI เพื่อส่งเสริมความสามารถในการแก้ปัญหาเชิงสร้างสรรค์สำหรับผู้เรียนในระดับอุดมศึกษา ตัวอย่างในการวิจัยได้จากการสุ่มตัวอย่างแบบหลายขั้นตอน คือ นิสิต นักศึกษา ระดับอุดมศึกษา ผู้ที่เคยมีประสบการณ์เข้าร่วมค่าย จำนวน 480 คน  นิสิต นักศึกษา ระดับอุดมศึกษา ผู้ที่เคยมีประสบการณ์จัดค่าย จำนวน 54 คน เครื่องมือที่ใช้ ประกอบด้วย แบบสัมภาษณ์ แบบสอบถาม และรูปแบบการจัดการค่ายฯ วิเคราะห์ข้อมูลโดยใช้ แจกแจงความถี่ ร้อยละ ค่าเฉลี่ย และวิเคราะห์ความต้องการจำเป็น

ผลการวิจัยมีดังนี้

1. นิสิต นักศึกษา ระดับอุดมศึกษามีความต้องการจำเป็นในระบบสื่อสารกันในทีมเพื่อการประชุมตัดสินใจเพื่อแก้ไขปัญหาและวางแผนล่วงหน้า ในลำดับความต้องการมากที่สุด รองลงมาคือ ระบบช่วยดำเนินการจัดค่ายเป็นขั้นตอน ระบบเตือนความจำ บันทึกรายงาน แจกจ่ายงาน และตามงาน และ ระบบวางแผนและแสดงผลแบบ Timeline

2. รูปแบบการจัดการค่ายฯ มี 5 องค์ประกอบ ได้แก่ 1) กลยุทธ์การจัดการค่าย 2) คุณลักษณะผู้จัดค่าย 3) บทบาทอาจารย์ที่ปรึกษาค่าย 4) ระบบเว็บสนับสนุนการตัดสินใจแบบกลุ่ม และ 5) ประเมินผล ขั้นตอนรูปแบบการจัดการค่าย 6 ขั้นตอน ได้แก่ 1) เตรียมความพร้อม 2) ศึกษากระบวนการ 3) วางแผนจัดค่าย 4) เตรียมค่าย 5) ดำเนินการจัดค่าย และ 6) สรุปและประเมินผลการจัดค่าย

3. ผลการทดลองใช้รูปแบบพบว่า นิสิตกลุ่มทดลองมีคะแนนเฉลี่ยความสามารถในการแก้ปัญหาเชิงสร้างสรรค์สูงกว่าคะแนนเฉลี่ยก่อนใช้อย่างมีนัยสำคัญทางสถิติที่ระดับ .05

4. ผลการประเมินและรับรองรูปแบบการจัดการค่ายฯ โดยผู้ทรงคุณวุฒิ มีค่าเฉลี่ยเท่ากับ 4.83 อยู่ในระดับเหมาะสมมากที่สุด