plueme/wizJson huggingface dataset:
The Global Diet Quality Score (GDQS) is a comprehensive metric that covers both the risks of nutritional deficiency and the risk of diet-related noncommunicable diseases (NCD). Validation tests were previously performed using secondary data from various countries. However, the study of the application of the GDQS to the Thai population is still necessary. Because Thai food usually consists of a variety of components, the GDQS may reflect the risks of nutrient inadequacy and the risks of NCD differently from the previous studies. Objective: This study aimed to characterize the GDQS’s performance by estimating the associations between the GDQS and diverse outcomes reflective of undernutrition and diet-related NCD risks. Methods: A cross-sectional study was conducted in Thai adults aged 40-60 years. GDQS was calculated from dietary data collected using a 24-hr dietary recall (24HR), a semi-quantitative food frequency questionnaire (FFQ), and the GDQS-Assessment System (GDQS-AS). Additional metrics were also calculated, including the Minimum Dietary Diversity for Women (MDD-W) and the Alternative Healthy Eating Index-2010 (AHEI-2010). Nutritional status was determined through anthropometric, body composition, blood pressure, and biochemical marker assessments. Spearman rank correlations and multivariable adjusted regression models were performed to evaluate the associations between GDQS and diverse outcomes reflective of undernutrition and diet-related NCD risks. Wolfe test and Wald test were used to compare the strength and trend of the correlations of the GDQS and outcomes between different dietary data collection methods and different metrics. Results: The prevalence of overweight to obesity (Body mass index ≥25 kg/m2) was 47.5%. Anemia was reported in 8.9% of men and 23.8% of women, hypertension in 54.1% of men and 39.4% of women, and metabolic syndrome in 42.5% of men and 35.9% of women. Mean urinary sodium excretion was 3,397 mg/day (147.7 mmol/day). The GDQS calculated by GDQS-AS and FFQ were relatively similar, while the GDQS-24HR was lower. Multivariable adjusted regression analysis found that GDQS-AS performed better in reflecting nutrient intakes, nutrient adequacy, and nutritional outcomes than GDQS computed from 24HR and FFQ. GDQS, MDD-W, and AHEI-2010 similarly performed in indicating nutrient adequacy and risks of NCD. Nevertheless, GDQS computed from FFQ better reflected nutrient adequacy. Conclusion: Overall, GDQS-AS had a relatively stronger performance in capturing both nutrient intakes and nutritional outcomes compared with GDQS computed from other methods, whereas GDQS scored from FFQ was outperformed
in capturing nutrient adequacy. Findings from this study only reflected a cross-sectional correlation between GDQS and nutrient adequacy and NCD risks. Thus, further study to longitudinally explore the correlations between GDQS and NCD risks is required.
This study is a developmented research with the objectives as analysis purposes. synthesis and development electronic Personal Health Record (PHRs) systems that are desirable to the health system
of Thai people by connecting the database of the COVID-19 Vaccine Information Management Program. Health Region 9 was selected as the target area. and establishing a framework for the development of a prototype central platform and an information network for the exchange of PHR systems between people and healthcare unit. Development system for connecting and retrieving data for display on smart phone. And central cloud development for interoperability between the different databases. Including designing user interface on the Mohpromt application. The results showed that The electronic personal health record should be Hybrid or Interconnected that can display the healthcare treatment and able to record health data by themselves. Developing program on Mohpromt platform which supports collaboration from multiple departments. Standards data and level of information to be displayed on the application in 3 levels: 1.) General information is the basic that shown immediately after registering Mohpromt application. 2.) Health information for individual That must go through a verification process and verify their identity before accessing and 3.) Treatment information for Healthcare Provider to view history treatment from others and must be obtained permission from the data’s owner before accessing. Personal health data is connected and retrieved between the COVID-19Vaccine management program and various hospital information systems via API to display on the Mohpromt application with more than 1,000 healthcare units. covering both the target group in region 9 and others. Established data governance regarding to the collection and use of personal data in limited According to the Personal Data Protection Act. Application evaluation divided into two aspects: satisfaction on technical quality and application content. Evaluation results from 100 users in region 9 in terms of technical quality and application content. Application development results in terms of technical quality and application content overall, it was a high level (x = 4.14) and users were satisfied with the PHR on the application overall, it was at a very good level (x = 4.89). The overall rating for the application, from 1 to 5 points, users gave an average score of 4.22 and satisfaction with the PHR menu on the application very favorably. 95 percent of users want to use PHR menu and will recommend the others. and suggested that other health behavior data should be recorded manually.
This research aimed to study dental nurses’ satisfaction and effectiveness of moisture control innovation (for tongue and cheek retractor, and saliva contamination (SS-suction)), toward dental sealant service without dental assistants compared to standard service; moisture control with cotton roll and dental assistant. This study was randomized controlled trial implemented among 15 dental nurses who attended a workshop on using SS-suction, recording satisfaction data toward using and safety, recording students’ data and revised dental sealing technic. Dental nurses received SS-suctions and then provided sealant service to 482 children aged 6–8 years old at sub-district health-promoting hospitals. Children were simply randomly allocated into either experimental or control groups. The children in the experiment group were 244, and in the control group, 238. Data collection on dental nurses’ characteristics, satisfaction with SS-suction for each sealed tooth during service. At 15-18 months, sealed teeth were assessed for retention and caries. Quality control for data collection was the validity and reliability of the satisfaction questionnaire and calibration on sealant retention examination. The results showed the median satisfaction level for SS-suction use was 9 out of 10, and the percentage of children with pain during insertion or removal was 17–18. The pain was from a feeling of pressure and disappeared when the suction was in place. Retention and caries were not significantly different between the experiment and control groups. Full retention on the occlusal surface were 32.5% and 31.4% and on the buccal surface were 16.8 and 18.3 in the experiment and control groups, respectively. Caries on the occlusal surface were 26.6% and 27.6% and those on buccal surface were 35.4 and 36.2 in the experiment and control groups. In conclusion, dental nurses were satisfied with SS-Suction both in function and safety. The effectiveness at 15–18 months of SS-Suction was compatible with standard procedure.
Objectives: To report the safety and immunogenicity profile of a protein subunit vaccine (CovovaxTM) given as a third (booster) dose to individuals primed with different primary vaccine regimens. Methods: A third dose was administered to individuals with an interval range of 3-10 months after the second dose. The four groups were classified according to their primary vaccine regimens, including two-dose BBIBP-CorV, AZD1222, BNT162b2, and CoronaVac/AZD1222. Immunogenicity analysis was performed to determine binding antibodies, neutralizing activity, and the T-cell responses. Results: Overall, 210 individuals were enrolled and boosted with the CovovaxTM vaccine. The reactogenicity was mild to moderate. Most participants elicited a high level of binding and neutralizing antibody against Wild-type and Omicron variants after the booster dose. In participants who were anti nucleocapsid immunoglobulin G-negative from all groups, a booster dose could elicit neutralizing activity to Wild-type and Omicron variants by more than 95% and 70% inhibition at 28 days, respectively. The CovovaxTM vaccine could elicit a cell-mediated immune response. Conclusion: The protein subunit vaccine (CovovaxTM) can be proposed as a booster dose after two different priming dose regimens. It has strong immunogenicity and good safety profile
Patients in critical care are at risk of clinical deteriorations such as congestive heart failure, when the heart muscle could not pump the blood as good as it should be, and sudden cardiac arrest, which is caused by the disruption of the heart’s pumping function These clinical deteriorations often appear without any warning. They can cause patients losing consciousness, having clinical complications, or death. A timely treatment is necessary after such complications. The early detection of clinical deteriorations can both improve patient outcomes and reduce the utilization of healthcare resources. Many early warning scores (EWSs) are designed to identify patients at risk of deterioration. The Modified Early Warning Scores (MEWS), for example, utilizes patient data including blood pressure, heart rate, respiration rate, body temperature and patient’s responses in order to identify patients according to their severity. Clinical staff can use the MEWS score as a guide to monitor the patients and give help immediately if needed. This research focuses on the development of machine learning algorithms for the identification of deteriorating patients in intensive care wards with physiological parameters acquired from the hospital information system and the central patient monitoring system. In contrast to other studies in which the algorithms were developed only on public datasets, our study utilizes both public datasets and local clinical dataset from Songklanagarind’s Hospital with an aim to make our algorithms work in local narratives. In the first part, we proposed a data-driven framework for predicting the risk of mortality that combines high-accuracy recurrent neural networks with interpretable explanations. Our model processes time-series of vital signs and laboratory observations to predict the probability of a patient’s mortality in the intensive care unit (ICU). We investigated our approach on three public critical care databases: Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III), MIMIC-IV, and eICU. Our models achieved an area under the receiver operating characteristic curve (AUC) of 0.87–0.91. Our approach was not only able to provide the predicted mortality risk but also to recognize and explain the historical contributions of the associated factors to the prediction. The explanations provided by our model were consistent with the literature. Patients may benefit from early intervention if their clinical observations in the ICU are continuously monitored in real time. In the second part, we used the recurrent neural network (RNN) model to predict the risk of occurrence of clinical conditions. Our results varied with an area under the receiver operating characteristic curve (AUROC) of 0.55-0.73 depending on the clinical condition. Our model can provide interpretive data to explain the influence of model prediction parameters and increase confidence in the model. The clinical staff was informed before the clinical conditions and could determine the treatment plan to achieve a better outcome for the patient.
Digital chest x-ray images are the most widely used medical diagnostic tool Nowsaday. They helps in the diagnosis of diseases such as pulmonary tuberculosis and lung cancer. There are millions of chest radiographs produced by hospitals each year. But only less than 10% of the images were interpreted by radiologists. The rest of the images are often interpreted by general practitioners. But interpreting results by general practitioners is likely to be wrong. Several studies have shown that general practitioners may have chances to misinterpret the results including misdiagnose or missed diagnose up to 20-50% of the images with lung cancer lesions. In addition, the interpretation of results by a single radiologists still has a 5-9 percent chance of error. Artificial intelligence (AI) may be an option to assist in the screening of chest radiographs with lesions or abnormalities that must be reinterpreted by a radiologist. In this study, a database of chest radiographs from the tuberculosis and lung cancer database was created. For the development of AI systems using U-Net and SegNet neural networks, it was found that the SegNet model network yielded satisfactory screening results. Sematic segmentation using the SegNet model and using pre-tutorial VGG19, which added a dropout with a probability value of 0.4. After designing and teaching the network with various patterns until the level of accuracy is satisfactory. The AI was tested with testing images. For the test with 17 images, Small1I lesions was best identified by the AI with an average IoU accuracy of 90.23%, followed by cancer lesions with an average IoU of 89.45%. The lowest correctly classified lesion was cavity with an accuracy of only 5.71%. The AI was further tested with a set of 26 images with cancer lesions. The AI did not detect 4 malignant lesions. When tested with 10 images without lesions the AI incorrectly identified a couple of lesions in 2 images. From the results, this artificial intelligence should be implemented in the form of a Triage to screen images before consulting a radiologist. This can reduce the workload of radiologists and general physicians and thus may be of economic value in terms of radiologist and general practitioner wages and time.
Objective: To investigate the reactogenicity and immunogenicity of the fourth dose mRNA vaccines after different three-dose regimens, followed by a comparison between the 30 μg BNT162b2 and 50 μg mRNA-1273 groups. Methods: The prospective cohort study was performed between June and October 2022. The self-recorded reactogenicity after 7 subsequent days following a fourth booster dose was evaluated. The binding antibodies and neutralizing activity to the Omicron BA.4/5 variants were determined. Results: Overall, 292 healthy adults were enrolled and received either the BNT162b2 or mRNA-1273. The reactogenicity was mild to moderate and well-tolerated within a few days. Sixty-five individuals were excluded. A total of 227 eligible individuals received the fourth booster dose of BNT162b2 (n=109) and mRNA-1273 (n=118). Most participants, regardless of different previous three dose regimens, significantly elicited a high level of binding antibody and neutralizing activity against the Omicron BA.4/5 at 28 days after a fourth dose. The neutralizing activity against the Omicron BA.4/5 between the BNT162b2 (82.8%) and mRNA-1273 (84.2%) groups was comparable with a median ratio of 1.02. Conclusion: The findings indicated that the BNT162b2 and mRNA-1273 can be used as a fourth booster dose for individuals who were previously immunized with any mix-and-match three-dose COVID-19 vaccine.
Objective: To compare the reactogenicity and immunogenicity between the two-dose mRNA COVID-19 vaccine regimen and one or two doses of inactivated vaccine followed by an mRNA vaccine regimen in healthy children between 5-11 years of age. Methods: A prospective cohort study was performed at King Chulalongkorn Memorial Hospital in Thailand between March to June 2022. Healthy children between 5-11 years of age were enrolled and received the two-dose mRNA COVID-19 vaccine (BNT162b2) regimen or the inactivated (CoronaVac) vaccine followed by the BNT162b2 vaccine regimen. In addition, healthy children who received two doses of BBIBP-CorV between 1-3 months prior were enrolled to receive a heterologous BNT162b2 as a third dose (booster). Reactogenicity was assessed by a self-reported online questionnaire. Immunogenicity analysis was performed to determine binding antibodies to wild-type SARS-CoV-2. Neutralizing antibodies to Omicron variants (BA.2 and BA.5) were tested using the focus reduction neutralization test. Results: Overall, 166 eligible children were enrolled. Local and systemic adverse events which occurred within 7 days after vaccination were mild to moderate and well-tolerated. At one-month, post-two or post-three doses, children vaccinated with two-dose BNT162b2 (GMT 2872 BAU/mL), CoronaVac/BNT162b2 (GMT 3021 BAU/mL), and two-dose BBIBP-CorV followed by BNT162b2 (GMT 3269 BAU/mL) elicited similar levels of anti-receptor-binding domain (RBD) IgG (ns). However, the two-dose BNT162b2 and two-dose BBIBP-CorV followed by BNT162b2 groups elicited higher neutralizing activities against Omicron BA.2 and BA.5 variant than the CoronaVac/BNT162b2 group. Conclusion: The heterologous, CoronaVac vaccine followed by the BNT162b2 vaccine, regimen elicited lower neutralizing activities against the emerging Omicron BA.2 and BA.5 variant than the two-dose mRNA regimen. A third dose (booster) mRNA vaccine should be prioritized for this group.
Currently, lung cancer treatment has been developing in several approaches such as; conservative chemotherapy, immunotherapy, or novel targeted therapies which increase the overall response rate, survival rate with good quality of life for the patients. This study aims to explore the whole genome sequencing profile and omics profile in non-targetable advanced non-small cell lung cancer both in tissue and in liquid biopsy. The results of this research project will lead to developing of screening, diagnosis, personalized therapy, and monitor of treatment in this group of patients. We will explore the data according to Thai population which might be different from the other ethnicity and this will lead to developing the new drug for Thai lung cancer patients. This research project composed of 7 sub-research projects which we completed the first-year aim. The first, second, third, fifth, and seventh sub-research projects will continue the research for the consecutive years. Furthermore, the first, second, and the seventh subresearch projects are in the process of preparing for Next Generation Sequencing (NGS) for the second-year proposal aim. In the first year, we could prepare the good quality of DNA and RNA as our purpose in order to proceed in NGS. Regarding the third, fourth, and fifth subresearch projects we found the initial result in potential biomarkers for predicting of treatment response. We also explored the clinical characteristics of 17 locally advanced and advanced non-small cell lung cancer (NSCLC) patients. Majority of patient were male, former/current smokers, adenocarcinoma with the high prevalence of PD-L1 expression (TPS = 1-49%: 23.5 % and TPS ≥ 50%: 35.8 %). In conclusion, the study of molecular alterations in Thai lung cancer patients is very important for drug development in order to drive the innovative lung cancer treatment. However, the other important issue and concern is exploring the whole genome sequencing profile and omics profile in non-targetable advanced non-small cell lung cancer. Our research team hope the results of this research project will lead to developing of screening, diagnosis, personalized therapy, and monitor of treatment in this group of patients.
There are many health information systems in Thailand and various project indicators. Many of them are redundant and unable to integrate both the reporting system and the medical expense reimbursement. has not yet been fully utilized This study is an analytical study. To study and find a suitable management model and approach for the whole ecosystem that affects the drive of the digital health system. It was carried out in three parts: 1) digital health system review; The study found a digital health governance model requires collaborative governance. have a strong leadership, has authority and constantly in position There is a central agency that drives the development of digital health systems. and to focus on the standardization of the health data system There are good examples of Australia, England, Finland, and India. 2) Developed prototype tools of personal health information system; Personal health data from multiple database sources is integrated and automatically linked directly from the hospital to the central, can display health information through mobile applications and link between hospitals to use in medical treatment and 3) synthesize recommendations; to reform data management from Silo Base to Authority Base for sustainable. Therefore, there are proposals in 5 mission and it is necessary to have an agency directly responsible for the digital health system. There is a proposal for an action plan to establish National Digital Health Authority.
The sequential embedded mixed-method research consisted of two phases. In phase 1, the qualitative phase was aimed to explore the experience, barriers and supports of the pharmacists in the primary care cluster. Focus group discussion was conducted with 24 pharmacists from 6 provinces of the health region 6. Findings of content analysis comprised three main themes: barriers and supports from the policy; colleagues; and the pharmacist. The barrier was the health information access and incomplete data flows from the primary care cluster to the hospital and vice versa. Effective patient care needed inter-professional teamwork in receiving updated medication knowledge from the part-time pharmacist in the primary care unit. Communication skills helped the pharmacist provide effective resolutions to drug-related problems (DRPs). In phase 2, the prospective, quasi-experimental study aimed to examine DRPs, blood pressure control, and physician acceptance to pharmacists’ roles, as well as, to examine relationships of patient’s or pharmacist’s factors with the effective resolutions to DRPs. Data collection form of DRPs was adopted from Cipolle et al’s classification. Quantitative data collection was performed on 1,471 hypertensive patients who were attended consecutively 3 visits by the pharmacists participated in the phase 1. Of all 379 DRPs identified, the highest problem was 164 of non-adherence (43.3%). After the primary pharmacy care, the DRPs were significantly decreased by 33.2% and 32.4% (c2(2)=46.78, p < 0.001) at visit 1 and 2, respectively. Blood pressure was unchanged. Physician acceptance rates to pharmacists’ roles were 77.8%, 70.3% and 68.4% consecutively. The factor related to the effective resolving non-adherence was the physician acceptance (rs = 0.18, p = 0.020), consistent to phase 1’s findings. This sequential embedded mixed-method research provided linkages of all findings which clearly illustrated the overview duty of primary care pharmacy.