bluuebunny/crossref_metadata_2025_split huggingface dataset:
การทำนายขนาดยาทาโครลิมัสที่ใช้ในช่วงระหว่างการผ่าตัดปลูกถ่ายไตในประชากรไทย
Authors:   , ฤกษ์ฉวี อริศรา 
Published: April 2023

ความสำคัญและที่มาของการวิจัย: ยาทาโครลิมัส (Tacrolimus; TAC) จัดเป็นยากดภูมิที่เป็นรากฐานสําคัญที่ใช้ในผู้ป่วยเข้ารับการผ่าตัดปลูกถ่ายไต การบรรลุเป้าหมายสู่ระดับยาที่กำหนดโดยเร็วที่สุดถือเป็นสิ่งจำเป็น โดยเฉพาะอย่างยิ่งระดับยาในช่วงระยะแรกหลังการผ่าตัดปลูกถ่ายไต การมีระดับยาต่ำหรือสูงเกินไปอาจนําไปสู่ภาวะแทรกซ้อนอันไม่พึงประสงค์ จุดมุ่งหมายของการศึกษานี้เพื่อพัฒนาสมการสำหรับหาขนาดยาทาโครลิมัสที่บรรลุเป้าหมายในช่วงวันที่ 3-5 หลังการผ่าตัดปลูกถ่ายไต

ระเบียบวิธีวิจัย: การศึกษาย้อนหลังจัดทำขึ้นที่โรงพยาบาลจุฬาลงกรณ์ เก็บข้อมูลผู้ป่วยไตวายเรื้อรังทุกรายที่เข้ารับการผ่าตัดปลูกถ่ายไตในโรงพยาบาลจุฬาลงกรณ์ปีพ.ศ. 2558-2563 แบ่งประชากรออกเป็น 2 กลุ่ม ได้แก่ กลุ่มที่ใช้พัฒนาสมการคือผู้ป่วยที่รับการปลูกถ่ายไตในปีพ.ศ. 2558-2561 และกลุ่มที่ใช้ตรวจสอบประสิทธิภาพของสมการคือผู้ป่วยที่รับการปลูกถ่ายไตในปีพ.ศ. 2562-2563 ผู้ป่วยทั้งหมดในการศึกษาใช้ยาทาโครลิมัสเป็นยากดภูมิคุ้มกันพื้นฐาน ผู้ป่วยที่เข้าเกณฑ์การศึกษาจะถูกนำไปคำนวณเพื่อหาสมการพยากรณ์ขนาดยา โดยจะถูกสร้างขึ้นตามฟังก์ชันเอ็กซ์โพเนนเชียลจากความสัมพันธ์ระหว่างขนาดยาทาโครลิมัสเป้าหมาย(มก./กก.) และระดับยาทาโครลิมัสที่ 12 ชั่วโมงหลังรับประทานยาครั้งแรก(TAC C12) โดยเลือกตัวแปรอิสระที่น่าจะมีความสัมพันธ์และส่งผลต่อขนาดยาทาโครลิมัสเพื่อนำมาใช้สร้างสมการ ได้แก่ TAC C12, ฮีโมโกลบิน, เซรั่มอัลบูมิน และค่าพื้นที่ผิวของร่างกาย (BSA) ตัวแปรแต่ละตัวจะถูกนำมาคำนวณและสร้างสมการโดยวิธี stepwise regression เพื่อเลือกสมการที่ดีและเหมาะสมที่สุด และแบบจําลองสมการที่พัฒนาขึ้นจะได้รับการทดสอบประสิทธิภาพการทำนายขนาดยาด้วยกลุ่มประชากรที่ใช้ตรวจสอบ โดยแสดงเป็นค่า R-squared (R2) และค่าเฉลี่ยข้อผิดพลาดสัมบูรณ์ (Mean Absolute Error; MAE)

ผลการศึกษา: ผู้ป่วยเข้ารับการผ่าตัดปลูกถ่ายไตที่เข้าเกณฑ์การศึกษาทั้งหมด 206 คน อยู่ในกลุ่มพัฒนาสมการ 140 คน ลักษณะพื้นฐานของกลุ่มพัฒนาสมการ มีผู้รับไตบริจาคจากผู้เสียชีวิต 99 คน (70.7%) ค่าเฉลี่ยอายุ 44.2 (±11.8) ปี เพศชาย 57.1%, พื้นที่ผิวกาย 1.6 (±0.2) เมตร2, ฮีโมโกลบิน 11.2 (±1.7) มก./ดล., เซรั่มอัลบูมิน 3.7 (±0.5) มก./ล. ปริมาณเฉลี่ยของยาทาโครลิมัสที่ใช้ในวันที่ 3-5 หลังการปลูกถ่ายไตของกลุ่มพัฒนาคือ 5.8 (±1.9) มก./วัน ซึ่งใกล้เคียงกับในกลุ่มตรวจสอบคือ 5.8 (±2.1) มก./วัน เราพบลักษณะความสัมพันธ์ที่ไม่เป็นเส้นตรงระหว่างปริมาณเฉลี่ยของยาทาโครลิมัสที่ใช้ในวันที่ 3-5 หลังการปลูกถ่ายไตและ TAC C12 โดยสามารถนำมาคํานวณหาขนาดยาทาโครลิมัสที่ใช้ในวันที่ 3-5 หลังการปลูกถ่ายเพื่อบรรลุระดับการรักษาที่ระดับยาเฉลี่ย 8.5 นก./มล. ได้เป็นสมการดังต่อไปนี้ log (adjusted TAC dose at day3-5) = -1.32543 - 0.534122 * log(TAC C12) ค่า R-squared จากกลุ่มพัฒนาสมการคือ 0.3044 ค่าเฉลี่ยข้อผิดพลาดสัมบูรณ์(MAE)ของขนาดยาทาโครลิมัส คือ 0.03 มก./กก. สรุป: สมการพยากรณ์ขนาดยาทาโครลิมัสที่ใช้ในช่วงการผ่าตัดปลูกถ่ายไตที่พัฒนาจากปัจจัยทางคลินิก สามารถเป็นแนวทางให้อายุรแพทย์โรคไตเพื่อช่วยในการปรับขนาดยาทาโครลิมัสสำหรับผู้ป่วยแต่ละราย ขนาดยาที่เหมาะสมจะช่วยเพิ่มประสิทธิภาพการรักษาโดยลดทั้งความเป็นพิษจากยาทาโครลิมัสและลดอัตราการปฏิเสธไตได้
The effect of bank competition on bank stability in Thailand
Authors:   , Yamploy Kamolwan 
Published: April 2023

This research studies the impact of competition on bank stabilities, which are capital adequacy, non-performing loans ratio, interest income risk, and non-interest income risk. Lerner index is used to proxy degree of non-structural bank competition. We use data on 11 Thai commercial banks from the year 2010 to 2018 and employ Panel Least Square regression. Our results show that banks with higher market power tend to have lower risk lending behaviors. As a result, this allows them to have lower level of capital and higher level of risk in non-interest income activities. On the other hand, higher concentration ratio 5, measuring degree of structural competition, could lead to higher risk lending behavior. In addition, bank size has positive impact on stabilities by increasing capital level and decreasing credit risk, interest income risk and non-interest income risk. while high loan-to-asset ratio tend to lower credit risk and non-interest income risk.
A comparative study of b-class culture and kawaii culture: a case study of Pengsoo and Kumamon
Authors:   , Wantong Cai 
Published: April 2023

B-class culture is a unique type of South Korean culture, growing in popularity among the young Korean generation. Kawaii culture is the culture of cuteness in Japan, which has become an essential part of modern Japanese culture. In 2020, B-class representative- Pengsoo was accused of copying the Kawaii mascot- Kumamon. Most people compare them in terms of their appearance and PR strategies instead of their cultures. This thesis compares B-class culture and Kawaii culture based on the stratification, production, and consumption function theories. Through document information and sentiment analysis, B-class culture and Kawaii culture share similar generational stratification between the young and old generations. Also, both have an important impact on society's development, promoting cultural production and consumption. Besides, in the COVID-19 era, they play an essential role in increasing public awareness of the pandemic and helping people reduce stress. However, B-class marketing and Kawaii marketing have different mediums, contents and target consumers. B-class culture is aggressive while Kawaii culture is soft, making it easier to evoke the public's emotions and accept its combination with politics.
Parasite: a reflection on social and economic disparities in South Korea
Authors:   , Nichasuk Wilasinee 
Published: April 2023

The purpose of this research is to analyze a reflection of social problems in “Parasite” film. The study is a qualitative research that uses semiology theory to analyze the social problems in the film through elements such as visual sign, scene, dialogue etc.

The results of these analyses show that “Parasite” film reflects the social problems in South Korea through a visual sign, scene, dialogue such as disparity social class problems. These problems that occur in South Korea are partly due to a result of the rapid change in South Korea society and adoption of the capitalist system to develop South Korea’s economic system, which has widened the gap between classes.
Drivers for reverse logistics packaging in circular economy for Thailand beverage industry from the manufacturer perspective
Authors:   , Sajjasophon Patiparn 
Published: April 2023

In Thailand, Municipal Solid Waste (MSW) problems exist, and 15% are due to post-consumption beverage packaging that is left behind after the point of consumption. This study aimed to analyze driving forces in reverse logistics of post consumption packaging for Thailand beverage industry and examine impact of sustainability. 39 variables related to drivers, key success factors including sustainability also modeled. Questionnaire has been designed based on 11-point rating scale and Item-Objective Congruence performed by experts from the academic and business. Sampling conducted through 210 respondents from alcoholic and non-alcoholic manufacturers. Collected data analyzed by using structural equation modeling for hypotheses testing. Results show that both internal and external drivers have the positive impact to key success factors but internal has a stronger impact, while the success factors are positively impact to economics, environmental and social performance respectively. Lastly, this research contributed to Thailand beverage industry for understanding significance of drivers and key success factors in order to improve sustainably.
Graph and number theoretic properties of certain maps over finite field
Authors:   , Doemlim Pratchayaporn 
Published: April 2023

In this thesis, we study the graph over a finite field $\mathbb{F}_q$, where $q$ is a prime power, obtained by iterations of the map $g(x)=x^p$, where $p$ is a prime number. Some properties of the graphs such as a characterization of their vertices and the number of cycles with specific length are showed. Moreover, some statistical estimates about the tail and cycle lengths of the related graphs are established.
The differential dendritic cell properties in response to candida albicans and non-albican candida β-glucan
Authors:   , Dinh Truc 
Published: April 2023

Increased mortality and antifungal drug resistance of non-albicans Candidiasis patients have become an alarming in health problems nowadays, whereas profound knowledge of their pathogenesis mechanisms is still limited. The immune responses of innate and adaptive immunity play a crucial role in protecting from Candida infections. Dendritic cells (DCs) are the most notable because of their roles in bridging an innate immunity and specific adaptive immunity to eliminate fungal invasion. It is little known about DC functions in non-albicans Candida (NACs) infections. Besides, there is less study on evaluating the DC properties upon the interaction between DCs and NACs-derived ß-glucans. Therefore, this work compared DC properties in response to ß-glucans isolated from currently common NACs. As a result, DC maturation and cytokine production altered at various degrees in Candida species-dependent manner. This observation possibly resulted from the structural and morphological differences of ß-glucans of distinct Candida species. Notably, C. krusei ß-glucan could increase the most robust DC activation of enhanced maturation, pro-inflammatory and anti-inflammatory cytokine secretion, whereas ß-glucan of C. tropicalis and C. albicans had similar lower levels of those effects. Moreover, ß-glucan of the former species could influence DCs in both dectin-1-dependent and -independent, distinguished from two latter species. Interestingly, ß-glucan of C. krusei enhanced IL-10 production of DCs, which might expand the high IL-10-producing FoxP3- regulatory T (Treg) cells in vivo C. krusei infection. However, this hypothesis needs further proof. We propose that increased immunomodulation due to C. krusei ß-glucan might prevent the host's protective immune activities and promote immune evasion of C. krusei. In summary, we have shown that altering DC functions of NACs-derived ß-glucans might play a role in NACs infections' pathogenesis.

Key words: Glucan, dendritic cells, non-albicans Candida species (NACs)
Synergistic activities of antibiotic combinations against carbapenem-resistant Klebsiella pneumoniae and mechanisms of carbapenem resistance in Klebsiella pneumoniae clinical isolates.
Authors:   , Muhummudaree Netchanok 
Published: April 2023

Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been increasing reported worldwide. The aims of this study were to investigate the mechanisms of carbapenem resistance in K. pneumoniae Thai isolates and study the synergistic activities of antibiotic combinations against CRKP isolates. Two-hundred and forty CRKP clinical isolates were obtained from patients at King Chulalongkorn Memorial Hospital between September 2016 and April 2020. The antibiotic susceptibility testing was determined by agar dilution to imipenem, meropenem, amikacin, fosfomycin, ciprofloxacin and by broth microdilution to colistin. The prevalence rates of resistance to imipenem, meropenem, ciprofloxacin, fosfomycin, amikacin, and colistin were 90.42%, 91.67%, 95.84%, 41.25%, 20%, and 12.08%, respectively. The majority of CRKP isolates (62.92%) were multidrug-resistant (MDR). Of the 240 CRKP isolates, 236 (98.33%) harbored at least one carbapenemase gene. The blaNDM-like plus blaOXA-48-like were the most common carbapenemase genes (43.75%), followed by blaNDM-like (27.50%), blaOXA-48-like (25.42%), blaIMP-like (0.83%), and blaOXA-48-like plus blaIMP-like (0.83%). Neither blaKPC-like nor blaVIM-like were detected. All isolates harboring carbapenemase genes were positive for carbapenemase activity by modified carbapenem inactivation method (mCIM). The overexpression of efflux pump was detected in 13.33% of CRKP isolates by using carbonyl cyanide m-cholorophenyl hydrazone (CCCP) inhibitor. The loss of OmpK35 and/or OmpK36 was found in 98.33% of CRKP isolates by SDS-PAGE. The combination of carbapenemase production and loss of OmpK was the most common mechanism of carbapenem resistance (83.33%). High level of carbapenem MIC (≥64 mg/L) was found in isolates harboring blaNDM-like plus blaOXA-48-like together with loss of both OmpK35 and OmpK36, and overexpression of efflux pump.

Antibiotic combinations including colistin plus imipenem, colistin plus meropenem, fosfomycin plus amikacin, and fosfomycin plus imipenem were screened for the synergistic activity by checkerboard assay in 31 representative isolates. The most effective combination was fosfomycin plus imipenem which showed synergism in 22.58%, followed by 14.81% in fosfomycin plus amikacin combination. Three CRKP isolates that had additive effect in colistin-based combination showed synergistic effect in fosfomycin plus imipenem combination. Time-kill assay was used to confirm the synergism against 7 CRKP isolates. The results from time-kill assay were consistent with the checkerboard assay. The bactericidal activity was found in 6 isolates (85.71%). In conclusion, this study showed that the carbapenemase production and loss of OmpK were the major mechanisms of carbapenem resistance in CRKP Thai isolates. The combination of fosfomycin plus imipenem may be one of the alternative antibiotic combination for treatment of CRKP infections.
The influence of Polycyclic aromatic hydrocarbons in FcgRIIb -/- lupus mice
Authors:   , Udompornpitak Kanyarat 
Published: April 2023

The activation of aryl hydrocarbon receptor (Ahr) through polycyclic aromatic hydrocarbons (PAHs), the major components of particulate matter at 2.5 micron (PM2.5) in the polluted air, might aggravate inflammation and lupus activity. Hence, 1,4-chrysenequinone (1,4-CQ), a substance in the PAHs group, was tested in a lupus model from FcgRIIb deficiency (FcgRIIb-/-) using macrophages and mice.

Although the activation by 1,4-CQ alone was unable to induce inflammation, the pre-conditioning by lipopolysaccharide (LPS), a representative inflammatory-activator, before 1,4-CQ (LPS/1,4-CQ) induced more predominant inflammation in macrophages when compared with LPS or 1,4-CQ activation alone as determined by supernatant cytokines (TNF-α, IL-6 and IL-10). Additionally, the activation in FcgRIIb-/- macrophages induce the more prominent inflammation than the wild-type (WT) cells, as determined by supernatant cytokines (TNF-α, IL-6 and IL-10), expression of inflammatory-genes (NF-κB, aryl hydrocarbon receptor, iNOS, IL-1β) and cell-surface CD-86, possibly due to the lack of inhibitory-FcgRIIb. Moreover, 8-wk-administration of 1,4-CQ started in 8-week-old FcgRIIb-/- mice, a genetic-prone lupus model, enhanced lupus severity as indicated by anti-dsDNA, serum creatinine, proteinuria, endotoxemia, and gut-leakage (FITC-dextran).

In conclusion, the Ahr activation by PAHs worsened lupus severity in FcgRIIb-/- mice possibly through the increased inflammatory responses due to the loss of the inhibitory-FcgRIIb. These data suggest that patients with lupus are possibly more vulnerable to the air pollution than the healthy persons.
Evaluation of patient doses from 177lu-PSMA in metastases prostate cancer treatment at King Chulalongkorn Memorial hospital
Authors:   , Chatachot Kotchakorn 
Published: April 2023

177Lu-PSMA I&T has increasingly used for targeted radionuclide therapy of metastatic castration-resistant prostate cancer (mCRPC). Dosimetric calculation, therefore, is critical to achieve the optimal therapeutic activity while sparing side effects to the normal tissues. The purpose of this study was to determine the radiation dosimetry for metastases prostate cancer patients treated by 177Lu-PSMA I&T at King Chulalongkorn Memorial Hospital (KCMH). Whole-body planar images were acquired in eight patients (12 treatment cycles) at immediately, 4 and 24 h after 177Lu-PSMA I&T injection (range 4.36 to 8.58 GBq). Region of interests (ROIs) were manually contoured on the whole-body, liver, spleen, urinary bladder, lacrimal glands, and salivary glands (parotid and submandibular glands) in order to determine the time-integrated activity (TIA) in source organs and fitted the time-activity curves with the mono-exponential function. The S-values were extracted from the OLINDA/EXM version 2.0 calculated by the NURBS computational phantoms. These S-values were used to calculate the absorbed dose coefficient in target organs according to the Medical Internal Radiation Dose (MIRD) scheme. The absorbed doses to the red bone marrow were estimated using the planar two-compartment method described by Svensson et al by separating the high-uptake and low-uptake compartment. The spherical model was used to calculate the absorbed doses in the lacrimal glands.

The results showed that mean absorbed dose coefficients to the kidneys, bone marrow, liver, urinary bladder, spleen, lacrimal glands, parotid and submandibular glands were 0.81±0.24, 0.02±0.01, 0.13±0.10, 0.27±0.25, 0.16±0.07, 3.62±1.78, 0.21±0.14, 0.09±0.07 Gy/GBq, respectively. The dose constraints for the kidneys of 23 Gy, and 2 Gy for the bone marrow were not reached in any patients. The dosimetry results in this study suggest that 177Lu-PSMA I&T treatment with higher activities and more cycles is possible without the risk of damaging the organ-at-risk in prostate cancer patients.
Surface and build-up region dose measurement in head and neck region using radio - photoluminescent glass dosimeter
Authors:   , Choki Sonam 
Published: April 2023

The use of commercially available radio-photoluminescent glass dosimeter (RPLGD) for radiation measurement has increased in recent years. It has been shown to have superior dosimetric characteristics as compared to other dosimeters. The purpose of this research is to evaluate the suitability of the GD-302M glass dosimeter for surface and build-up region dose measurement in head and neck region. The glass dosimeter was analyzed for its dosimetric properties in photon beam. Then, the study was performed for surface and build-up region dose comparison between EBT3 film and RPLGD in solid water phantom at 0, 2, 3, 5, 10 and 15mm depths of 6 MV beams. In addition, 3D-CRT and VMAT plans for nasopharyngeal carcinoma were transferred to a Rando phantom for verification of build-up region dose at 5 and 10mm depths. The results found that uniformity obtained in this study was within 1.1%. The dose-response was linear with R2 of 0.999. Dose rate, reproducibility, angular and energy dependence were found to be within 3.0%. Moreover, fading effect was less than 3% over 4 weeks. The dose in homogeneous solid water phantom showed good agreement between RPLGD and EBT3 film in build-up region. However, RPLGD showed over response of signal at the surface due to the thickness of its holder. The verification in Rando phantom illustrated that build-up region doses were higher in TPS calculation compared to RPLGD measurements both in 3DCRT and VMAT. The average dose differences between measurements and calculations were -0.18±1.21% and 2.40±1.49% at 5 mm and 10 mm depth for 3D-CRT, and 4.74±1.12% and 3.44±4.41% at 5 mm and 10 mm depth for VMAT, respectively. In conclusion, RPLGD is less suitable for surface dose measurement but has good potential to be used as an in-vivo dosimeter in build-up dose measurements.
Protein-bound Uremic Toxins Lowering Effect of Sevelamer in Pre-dialysis Chronic Kidney Disease Patients with Hyperphosphatemia: A Randomized Controlled Trial
Authors:   , Takkavatakarn Kullaya 
Published: April 2023

Background: P-cresyl sulfate and indoxyl sulfate are strongly associated with cardiovascular events, and all-cause mortality in chronic kidney disease (CKD). This study was conducted to compare the effects between sevelamer and calcium carbonate on protein-bound uremic toxins in pre-dialysis CKD patients with hyperphosphatemia.

Methods: After 2 weeks of the run-in period, 40 pre-dialysis CKD patients with persistent hyperphosphatemia were randomly assigned to receive either daily 2,400 mg of sevelamer or 1,500 mg of calcium carbonate for 24 weeks. Serum p-cresyl sulfate, indoxyl sulfate, fibroblast growth factor 23 (FGF23), lipid profiles, and high sensitivity C-reactive protein (hs-CRP) were evaluated. The primary endpoint was to evaluate the effect of sevelamer on p-cresyl sulfate level.

Results: After 24 weeks, a significant decrease of serum p-cresyl sulfate was observed in sevelamer compared with calcium carbonate therapy (mean difference -5.61 mg/L; 95% CI -11.01 to -0.27 mg/L; p=0.04). Sevelamer had obvious effects in lowering FGF23 (p= 0.007) and LDL-cholesterol levels (p<0.001) but did not affect serum indoxyl sulfate and hs-CRP levels.

Conclusions: Sevelamer could effectively reduce serum p-cresyl sulfate, FGF23 levels, and improve lipid profiles in pre-dialysis CKD patients with hyperphosphatemia. Our data suggest the additional benefits of sevelamer over calcium-based phosphate binder in cardiovascular protection.
The effect of the program promoting infection prevention behaviors in family caregivers of pre-school age children with acute lymphoblastic leukemia: the application of self-care deficit nursing theory
Authors:   , Lamtrakul Su-ari 
Published: April 2023

This quasi-experimental, pretest-posttest design aimed to compare infection prevention behaviors (medication administration, infection control, and infection surveillance) between the family caregivers of preschool-age children with acute lymphoblastic leukemia (ALL) in the experimental group and the control group. This nursing program is based on the Self-Care Deficit theory, to enable dependent care agencies regarding infection prevention behaviors of family caregivers. The dependent care agency consisted of the ability to acquired knowledge, ability to make a decision, and ability to perform infection prevention behaviors. The sample was 45 family caregivers of preschool age children with ALL, 23 were an experimental group and 22 were a control group. The family caregivers have been evaluated for infection prevention behaviors on the first day and 12th day of study using the Infection Prevention Behaviors Questionnaires (IPBQ).

The finding revealed that the mean difference scores of infection prevention behaviors in the experimental group had significantly higher than those in the control group (p < 0.05).This result indicated the effectiveness of the Self-Care Deficit theory application’s nursing intervention in enhancing infection prevention behaviors in family caregivers of preschool age with ALL.