plueme/wizJson huggingface dataset:
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Operational system for excellence in medical bioinformatics for lower southern Thailand in health region 12 
abstract:Operational system for excellence in medical bioinformatics for lower southern Thailand in health region 12 is a fundamental implementation of genomic medicine in South of Thailand co-operated by the Faculty of Medicine, Prince of Songkhla University and Health Systems Research Institute, Ministry of Public Health. To integrate genomic medicine into the healthcare system in the Heath Region 12, infrastructures including clinical data management, biological sample processing and storage and certified molecular laboratory were considered to be organized in Translational Medicine Research Center (TMRC), Songklanagarind Hospital. Not only infrastructure standardization, but the project has also consent volunteers for clinical data and biological sample retrieval under the approval of the Human Ethical Committee, Faculty of Medicine, Prince of Songkla University. To achieve goal of the study, we included 175 participants covering 3 major genetic associated diseases (hereditary cancer, rare diseases and infectious diseases). Moreover, clinical data and specimens were collected under standard operation procedure of Genomic Thailand Consortium and consecutively shipped to Department of Medical Science, Ministry of Public Health. For the leftover specimens, whole exome sequencing was performed to intensively discover pathogenic variants related to respective participants and their families. Ultimately, annotated exome sequences were comprehensively integrated to establish aggregated exome database which provides useful clinical implication of each variant and regional specific minor allele frequency as a public database. In conclusion, our project has laid infrastructures for genomic medicine and linked them to the clinical environment in the South of Thailand.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Implementation for tuberculosis preventive therapy among latent tuberculosis infection in HIV-infected individuals using   novel regimen of Isoniazid/Rifapentine daily (4 weeks) compared to Isoniazid/Rifapentine weekly (12 weeks) (1st Year) 
abstract:Tuberculosis remains the leading killer of people living with HIV (PLHIV) and HIV greatly increases the risk of reactivation tuberculosis (100 fold). Although tuberculosis prophylaxis therapy (TPT) could prevent TB reactivation in 60-90% but current regimen (INH 9 months:9H) is limited by poor implementation and low completion rate due to long duration, fear of INH resistance and dormant TB could not be killed by INH. We evaluated the safety and efficacy of a novel shorter TPT in Thailand, a high TB/HIV burden country. Methods: PLHIV on ART > 2 weeks and free of active TB are randomized to Arm A: 1 HP (isoniazid 300 mg plus rifapentine 450-600 mg once daily for 4 weeks) or Arm B: 3HP (isoniazid 700-900 mg plus rifapentine 750-900 mg once weekly for 12 weeks) from 14 hospitals in Thailand. The participants will be followed up for 3 years. The primary end point was the first diagnosis of TB or death from TB or unknown cause. This study is ongoing, plan to enroll 2500 PLHIV. However, it is affected by COVID 19 pandemic and also impurified of rifapentine. By the way, the impurified of the study drug has been approved from the US FDA that it has a few impurification so it causes a few effects to the develop cancer. This analysis is focused on 1st year with 644 PLHIV enrolled. Results: A total of 644 patients (86% male) were enrolled, 322 each were assigned to Arm A or Arm B. Median age was 30 (IQR 25-39) years, median baseline CD4 cells counts were 300 (201-415) cells/mm3, and 24% of them had baseline CD4< 200 cells/mm3. All received FDC of tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/efavirenz (EFV) for a median 1.3 months. The median duration of follow-up was 1 year at the study entry. There were no active TB or death reported. Adverse event occurred 6.1% (Arm A = 6.5% and Arm B = 5.6%) as following hepatitis (elevated ALT) (Arm A=3.1% and Arm B 4%). Majority of hepatitis were asymptomatic cases, it was found during schedule blood testing. Rash occurred 0.8% (Arm A=1.2% and Arm B 0.3%). 1 case (Arm A) had numbness of feet. Serious side effect occurred among 10 cases (Arm A=0.9% and Arm B 2.1%. Totally 2 cases developed hypersensitivity reaction (rash and hepatitis), both of them were in Arm B. The percentage of treatment completion was 93.2% and 91.6% in Arm A and Arm B, respectively. At 48 weeks after starting TB drugs, 96% and 95.7% of Arm A and Arm B had HIV RNA <50 copies/ml, respectively. Conclusion: In the treatment of latent tuberculosis infection, both Arm A and Arm B resulted in better adherence, low percentage of discontinued treatments and highly efficacy to prevent active TB. No active TB or death were reported during 1 year.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: The preparedness and responses of the health services system to the COVID-19 crisis in Thailand: Hospital operation and economic and social impacts within the boundary of the health services system 
abstract:The research project on the preparedness and responses of the health services system to the COVID-19 crisis in Thailand: Hospital operation and economic and social impacts within the boundary of the health services system consisted of 6 main parts using mixed research methods, pursuing the following key objectives: (1) To study overall research areas and topics for health services system to prepare and respond to the COVID-19 situation focusing on hospital systems, and economic and social impacts within the boundary of the system by reviewing key literature and expert panel suggestions, and by piloting data collection based on the framework. (2) To study key characteristics of hospital wards and innovation in hospital services for COVID-19, and to synthesize recommendations for hospital accreditation processes by making case studies on selected hospitals, and sharing discussions in focus groups. (3) To study challenges, problems, obstacles, preparedness, adaptation and new normal in key service offerings by hospitals in response to the COVID-19 situations, and synthesize new normal that may persist after the crisis by surveying hospitals and surveyors of the hospital accreditation programs in Thailand, organizing online focus groups and case study of the Bangkok area. (4) To estimate cost and opportunity costs of a hospital in responding to the COVID-19 situation involving all kinds of activities in a hospital by working with a case-study hospital. (5) To study and monitor operations of universal health coverage schemes in Thailand in responding to the COVID-1 9 situations, including reimbursement in the fiscal year B.E.2563 by reviewing documents and analysis of the reimbursement databases of the universal coverage scheme (UCS) and (6) To study governmental mechanisms in responding to the COVID-19 situation in Thailand, including key features in different phases of the situation, policies and measures to prevent and control the pandemic situation, related factors, and consequences by examining overall situations and making case studies of selected key events.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Extended shedding of viable SARS-CoV2 from COVID-19 patients 
abstract:Persistence of viral RNA in respiratory samples of COVID-19 patients and asymptomatically infected individuals is a common and important problem in the outbreak control. The main question is whether the persistence of viral RNA reflects viable virus shedding. And, if there is viable virus shedding, there is an interesting scientific question of how the virus survives in the presence of immune response, which should be developed soon after the infection. Possible explanations include a failure of developing immune response or an immune escape by viral mutations. To answer these questions, this project performed viral isolation in sequential respiratory samples and antibody detection in serum samples of 30 cases with mild-symptom or asymptomatic, who showed viral RNA positive by RT-PCR after 1 week from the diagnosis. Samples in the first week showed a large variation in the viral load levels which significantly declined in most samples from the second week forward together with positive for specific antibody in serum samples. For viral isolation, there were 6 positive samples with high viral load; 4 samples and 2 samples from the first and second week samples, respectively. The two culture positive samples from the second week, one of them had low level of neutralizing antibody in serum at the same time point and these neutralizing antibody level increased in the third and fourth week samples together with a drastic decline in viral load and negative viral culture. The other sample showed high viral load and positive viral culture together with negative neutralizing antibody in the samples from the second and third week. These data indicate that most patients and infected individuals with persistent positive RT-PCR have low level of viral load and this does not indicated shedding of viable virus. However, failure in mounting the immune response in some individuals may result in persistent shedding of viable virus. High viral load and negative neutralizing antibody may be used as markers to identify such individuals.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Development of Good Health Promotion Model that Integrated with Buddhist Ways for the Prevention and Control of Non-communicable Diseases 
abstract:The objectives of this research were to develop a model, and to study the effectiveness of a good health promotion integrated with Buddhist ways model for prevention and control of non-communicable diseases. It was designed as two group pretest-posttest design. The samples were 99 patients with uncontrolled diabetes and or hypertension, divided into two groups: 50-person group; the study group who were managed by the model, and 49-person group: the control group managed by routine care. Data were collected using mixed method, both quantitative and qualitative approach. The research tools were: 1) the good health promotion program integrated with Buddhist ways was named in Thai as 3 Sor, 3 Orr, 1 Nor from which comprised: pray, meditation, Buddhist dialogue, nutrition, exercise, emotion, biological clockwise daily activities with Buddhist integration. 2) health assessment form 3) self-report manual 4) the knowledge test 5) the happiness test 6) the satisfaction questionnaire 7) group discussion and in-depth interview guidelines. The KR 20 of the data collecting tools no. 4 was 0.8. The Cronbach's alpha coefficients of the data collecting tools no. 5, 6 were 0.85, 0.84 respectively. The quantitative data were analyzed using descriptive statistics, paired t-test and independent t-test. The qualitative data were analyzed using content analysis. The results of the model development found 3 components: 1) the good health promotion program integrated with Buddhist ways 2) self-reporting towards the program and 3) monitoring, supporting, and empowering by the health team. The findings on the effectiveness of the model found that 1) After try-out the model, the study group had lower average in health status namely weight, waist circumference, BMI, blood pressure and blood sugar levels were significantly decreased. 2) Before try-out the model, the study group had average in health status not different with those of the control group while after try-out the model, the average of health status in study group were significantly lower than those of the control group. 3) After try-out the model, the study group had significantly higher average in the knowledge scores and higher average in happiness score towards the activities of the program. And they were satisfied with the activities of the program at a high level.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Mechanism of proteins involved in signal transduction and pathogenesis of dengue virus infection 
abstract:Antibody-dependent enhancement (ADE) has been considered as one of the mechanism that leads to the development of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). During secondary dengue infection monocytes can be infected by the ADE phenomenon. This study aimed to investigate the proteins involved in ADE of DENV infection in the primary human monocytes isolated from volunteers. The phosphoproteins were used to perform and analyze for protein expression using mass spectrometry (GeLC-MS/MS). The differential phosphoproteins revealed 517 altered proteins compared between isotype- and DENV-specific antibody-treated monocytes. The altered proteins revealed 253 upregulated proteins and 264 downregulated proteins. Approximately 70-80% of altered proteins was classified into binding and catalytic activity proteins, while 20-30% was proteins with molecular function regulator, molecular transducer activity, structural molecule activity, transcription regulator activity or translation regulator activity and transporter activity. Protein disulfide isomerase (PDI), which is an enzyme that had a high-ranking fold change and that catalyzes the formation, breakage, and rearrangement of disulfide bonds within a protein molecule, was selected for further study. PDI was found to be important for dengue virus infectivity during the ADE model. The effect of PDI inhibition was also shown to be involved in the early stage of life cycle by time-of-drug-addition assay. These results suggest that PDI is important for protein translation and virion assembly of dengue virus during infection in human monocytes, and it may play a significant role as a chaperone to stabilize dengue protein synthesis. Moreover, other proteins were further performed by interaction network analysis and found that most structural proteins were interacted together. Alpha-actinin was observed to be altered and may be associated to play important role in viral replication and viral infection in monocytes.
location: nan, 'Thailand 
year: 2020 source: HSRI 
title: A synthesis of factors affecting an access to opioid analgesics for palliative care of end-stage patients in Thailand 
abstract:In Thailand, nowadays, there is an increasing number of terminally ill patients who need palliative care. Opioids are deemed to be an essential treatment for severe pain that can help to reduce suffering and increase the quality of life significantly. Even though opioids have been already included in the National List of Essential Medicines in Thailand, access to this kind of treatment remains a problem. This study aims to explore the factors that influence the access to opioids for palliative care in Thailand. The methodology used in this study includes literature and document review, in-depth interview, as well as focus group discussion which obtained data from personnel in the national institutes related to opioids regulation and palliative care. Key informants consisted of patients’ representatives, doctors, nurses, and pharmacists. Data collection was performed in nine secondary- and four tertiary-hospitals. Thereafter, record files were transcribed verbatim in accordance with key informants’ consent and analyzed as content analysis. This study found that obstacle factors to access opioids for palliative care are divided into four issues including (1) opioids regulations are inconsistent with practices when opioids are suddenly out of stock or nearly expired; however, hospitals cannot borrow or swap these drugs from each other. (2) Inadequate drug management system leads to insufficient amount of drugs stored in hospitals as recommended by the WHO. (3) Doctors, nurses, and pharmacists acquire scarce knowledge of and have negative perspectives toward opioids that cause them afraid to prescribe opioids. Besides that, patients and relatives and laypeople are lack knowledge and understanding of opioids which results in unacceptance. (4) Governance and palliative care system are not robust together with vague policy, deficient budget for operation, unreadiness of services, lack of monitoring and evaluation. This study recommended (1) revising regulations for consistency with opioids administration and management. (2) developing a management system for medical supplies in areas. (3) improving the education system and training for professions as well as counselling or advising patients and their relatives and within the community. (4) Promoting governance for accessing opioids.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Integration of genome sequencing in the diagnostic process for Thai infants with infantile cholestatic jaundice 
abstract:Integration of genome sequencing in the diagnostic process for Thai infants with infantile cholestatic jaundice co-operated by Faculty of Medicine, Prince of Songkhla University and Health Systems Research Institute, Ministry of Public Health. To discover new genetic susceptibility of infantile cholestasis, next generation sequencing was implemented to operate in our study together with clinical finding and investigation. Focusing on biliary atresia, a half of cases had successful bile drainage from the hepatoportoenterostomy. According to similarity of clinical finding, the poor prognosis with naïve liver may be miss diagnosis from other cholestatic jaundice disease. Genetic biomarker became an important application to help discrimination of isolated biliary atresia and the others, improve post-operative outcome and delay queuing for liver transplantation. In our study, 64 individuals with cholestatic jaundice were included together with consent for blood sampling and genomic investigation under standard operation procedure of Genomic Thailand Consortium. All of retrieved samples and metadata information were processed at Translational Medicine Research Center (TMRC), Faculty of Medicine, Prince of Songkla University and delivered to Department of Medical Science, Ministry of Public Health. For the leftover specimens, whole exome sequencing was undergone to intensively discover pathogenic variants related to the cholestatic syndromes. Annotated exome sequences were comprehensively reviewed and discovered 45 possible deleterious variants. Moreover, genetic association was performed for SNPs located in ADD3 and EFEMP1 genes (rs2501577, rs17095355, rs6761893 and rs727878). The statistical appraisal of susceptibility shown significant association of first three SNPs with the disease together with additive biological interaction between both genes. In summary, we purpose that our study will be a beginning of implementation of high-throughput sequencing and genetic biomarker in pediatric surgical diseases.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Pharmacokinetics and Pharmacodynamics of Ivermectin in Pediatric Dengue Patients (PKIDEN) 
abstract:Dengue disease is an important problem in global public health. Annually, 390 people are infected with dengue virus. The majority of infections results in asymptomatic cases. For symptomatic cases, patients will develop either mild dengue fever (DF) or severe dengue hemorrhagic fever (DHF). DF is a self-limiting disease meaning the patients will recover within 4-7 days without any significant intervention. However, DHF patients will eventually develop plasma leakage which may progress into potentially fatal hypovolemic shock known as dengue shock syndrome (DSS) without prompt and adequate fluid management. Dengue disease is caused by dengue virus which belongs to the genus Flavivirus. There are four serotypes of the virus including dengue virus 1, 2, 3 and 4. The virus is transmitted by Aedes mosquitoes. There is no antiviral drug against dengue virus and the only available vaccine has limited efficacy and elevates the risk of hospitalization from dengue disease in seronegative vaccines. We previously conducted a phase 2/3 trial by repurposing ivermectin to treat adult dengue patients. We found that ivermectin was safe, and the drug could significantly speed dengue virus non-structural protein NS1 clearance. In addition, the drug showed a potential efficacy in reducing the severity of the disease. In this study, we primarily evaluated the safety and pharmacology of ivermectin in pediatric dengue patients (age younger than 15 years and weighing more than 15 kilograms). Since ivermectin ingestibility, absorption, metabolism and excretion in pediatric patients were expected to be dissimilar from adult patients, this study was essential for determining the appropriate dose of ivermectin before conducting a trial for evaluating clinical efficacy. Two doses of ivermectin were studied: 400 μg/kg per day for three days and 600 μg/kg per day for three days. The patients in each dosage group were also stratified by weights into two groups including those weighing over 30 kg and those weighing between 15 to 30 kg. Our analyses showed that both doses of ivermectin were safe for treating pediatric dengue patients. However, no dose dependent relationship in efficacy against viral load or NS1 levels were found between the two administered doses. Advanced pharmacological analysis is required to confirm this finding. If the finding is confirmed, the more appropriate dose for phase 3 clinical trials in pediatric patients will be 400 μg/kg per day for three days.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Development of molecular diagnostic assays for personalized lung cancer treatment in Thai patients 
abstract:Cancers are still the major cause of death in Thai population. Personalized treatment that targets specific genes or proteins is efficacious in cancer patients. Various molecular analyses of patients' tumors are used to determine whether they contain somatic mutations that could be used as reliable predictive biomarkers for tailoring therapy. Patients with primary lung adenocarcinomarcinoma harboring activating EGFR gene mutations respond well to targeted treatment by EGFR Tyrosine Kinase Inhibitors (EGFR-TKIs). Approximately 50 percent of Thai lung Adenocarcinomarcinoma patients have these mutated variants of EGFR gene in their tumors. Some patients who do not have EGFR mutation harbor mutations of other genes, such as ALK fusions and BRAF mutations that may benefit from treatment with other targeted therapy. However clinical samples yield nucleic acids in limited quantity and often of low quality. Sensitive molecular assays are therefore crucial to detect these somatic mutations. We engage in the development of new polymerase chain reaction (PCR)-based assays for determination of predictive molecular biomarkers for targeted medications. We have developed assays that efficiently detect clinically important mutant alleles, including mutations in EGFR, BRAF and ALK genes, presented in ultrashort nucleic acid sequences. These simple, highly sensitive and cost-effective mutation detection assays will be useful tools to enhance precision medicine in oncology.