plueme/wizJson huggingface dataset:
Background and Objectives: Familial hypercholesterolemia (FH) is the most common genetic cause of cardiovascular disease. This study was aimed to 1) compare Achilles tendon thickness and characteristics using skin calipers, plain radiograph of lateral heels and ultrasonography in 63 FH patients (diagnosed using the Dutch Lipid Clinic Network [DLCN] score above 3 [possible, probable or definite FH]), 58 non-FH patients with elevated LDL-cholesterol (LDL-C) >130 mg/dL and 55 subjects with LDL-C below 130 mg/dL and determine the cutoff values with the highest diagnostic accuracy for FH diagnosis among Thai patients. 2) compare the coronary calcium score (CAC) and aortic valve calcium (AoVC) score using computed tomography in 62 FH patients and 58 non-FH patients Results: 1) Skinfold calipers demonstrated 61% accuracy for diagnosing FH. An anteroposterior (AP) diameter on plain radiographs ≥7.7 mm showed 75% sensitivity, 82% specificity, and 80% accuracy whereas ultrasonographic thickness ≥6.4 mm showed 46% sensitivity, 93% specificity and 76% accuracy and tendon area ≥78 mm2 showed 47% sensitivity, 93% specificity and 77% accuracy. Tendon border irregularities, diffuse hypoechogenicity and calcification were reported in a higher percentage of patients with FH compared with the other 2 groups. 2) FH participants had a nonsignificantly higher CAC score than that of non-FH participants (56.90 AU (0-2,370.5 AU) vs. 26.65 AU (0-512 AU), P = 0.105) with a higher proportion of patients who had a CAC score >0 AU (50.0% vs. 36.2%, P = 0.476). In addition, the FH group also had a greater proportion of subjects who had an AoVC score >0 AU (16.1% vs. 1.7%, P = 0.006). The CAC score of all participants was strongly correlated with age, total LDL-C burden, Achilles tendon thickness and a Thai CV risk score (R = 0.530, 0.364, 0.293 and 0. 528 respectively, P <0.005). Age, Achilles tendon thickness and statin use were significantly associated with CAC >0 AU (OR 14.30 for age >56 years, P = 0.002, OR 11.91, P = 0.005 and OR 5.91, P = 0.007, respectively) Conclusions: 1) Achilles tendon thickness measured by calipers showed low accuracy for diagnosis of FH. An AP diameter on plain radiographs demonstrated highest sensitivity and accuracy, whereas ultrasonographic thickness and area of Achilles tendon showed high specificity. Tendon irregularities, diffuse hypoechogenicity and calcification might serve as supportive findings. These findings may be helpful for the diagnostic criteria for FH in Thailand. 2) FH patients exhibited nonsignificantly higher CAC score than that of non-FH subjects, but the proportion of patients with AoVC >0 was significantly higher. Age, Achilles tendon thickness and statin use were associated with the CAC score >0 in all patients. These findings may be useful in tailoring treatment based on an individual risk of a particular subject.
COVID-19 is a pandemic disease. Healthcare workers (HCWs) have a high risk of SARS-CoV-2 infection. However, the information of HCWs with COVID-19 in Thailand is still limited. The objective of the study was to evaluate rate and risk factors of COVID-19 among HCWs in Thailand. Methods: The prospective cohort study was conducted at the tertiary care hospitals in Thailand from May 2020 to May 2021. The study participants were HCWs in Thailand who presented with fever and/or acute respiratory tract symptoms. All of them were tested with RT-PCR for SARS-CoV-2 and their clinical data were collected. Results: There were 1,432 HCWs in this study. Among them, 167 patients were front-line HCWs and 1,265 patients were non-front-line HCWs. Of 60 HCWs with COVID-19, 2 patients were the front-line HCWs, and 58 patients were the non-front-line HCWs. Rate of COVID-19 in all HCWs was 4.2% (60/1,432). Rate of COVID-19 in the front-line HCWs was 1.7% (2/167), whereas rate of COVID-19 in non-front-line HCWs was 4.6% (58/1,265) (p=0.04). In addition, non-front-line HCWs, non-medical staffs, history of contact confirmed COVID-19 case at home/family, unvaccinated status, fair compliance to personal protective equipment (PPE) standard, and initial presentation with pneumonia were significantly more common in HCWs with COVID-19 than those without COVID-19. Front-line HCWs, history of contact confirmed COVID-19 case at the clinical care areas, vaccinated status, good compliance to PPE standard, and initial presentation with upper respiratory infection were significantly more common in HCWs without COVID-19 than those with COVID-19. Conclusions: COVID-19 was more frequently found in the non-front-line HCWs than the front-line HCWs. Thai guidelines of infection prevention and control are effective in preventing SARS-CoV-2 transmission. Therefore, these interventions should be encouraged.
The COVID-19 pandemic causes sudden public panic and people take appropriate precautions by wearing masks, physical distancing in public according to new-normal life style. If an antiseptic can exert rapid virucidal effect with prolonged activity on SARS-CoV-2 that accumulate on nasal, buccal and pharyngeal epithelia, it can help prevent the spread of the virus from infected persons to healthy people including medical personnel during resuscitation, treatment or transportation. Numerous existing in vitro data have confirmed that povidone-iodine (PVI) inactivates many common respiratory viruses, including SARS-CoV-2 approximaltely 100 folds in less than one minute of PVI exposure. Povidone-iodine also has good profile for mucosal tolerance in upper aerodigestive tract. Thus, we propose a pilot study to demonstrate its virucidal efficacy of SARS-CoV-2 by the application of topical PVI or diluted solution of PVI to the upper aerodigestive tract in infected patients using the self comparison study design method. The first three serial pilot studies recruited 55 infected patients and illustrated that SARS-CoV-2 could be detected by the RT-PCR in both specimens of nasopharyngeal and throat swabs but the Ct values of throat specimens were usually higher compared to the nasal specimens in the same patient and at the same time of specimen collection. Viable SARS-CoV-2 was detected only from nasopharyngeal specimens with Ct values equal or less than 25 using vero-E6 cells for tissue culture. Viable SARS-CoV-2 cannot be cultured from throat or tongue samples which made oral samples inappropriate for the demonstration of virucidal effect of PVI. The fourth study in 14 patients revealed viable culture was obtained from 12 patients and involved only nasopharyngeal specimens. After 3 minutes of contact time with nasal spray of PVI or 0.4% PVI solution, a median value of 1.1 log reduction of viable viruses (IQR: 0.6-1.7 log reduction) or 90.7% virus reduction (median; IQR: 75.0%-98.0%) were found. After 4 hours of contact, a median value of 0.8 log reduction (IQR: 0.4-1.8 log reduction) or 81.3% virus reduction (IQR: 56.3%-98.4%) were found. The amount of virus reduction after PVI contact and speed of virucidal activity were much less impressive than the results from the in vitro study. In conclusion, we were able to consistently culture viable SARS-CoV-2 in vero-E6 cells only from nasopharyngeal specimens in newly infected patients who had Ct value equal or less than 25 from RT-PCR testing. Viable SARS-CoV-2 can not be cultured from any oropharyngeal samples. Commercial PVI nasal spray or 0.4% PVI solution have minimally, if there is any, virucidal activity in nasal cavities of infected patients after PVI exposure for three minutes and four hours. This level of virucidal activity from the study may not be significant to prevent the spread of COVID-19. The PVI nasal spray and 0.4% PVI solution were very safe, very tolerable without any side effect.
The development of economy and society significantly affect to many factors involving national health system including the demographic and population behavior change, the increasing of senior citizen while workforce age is decreasing significantly, the expanding of industry and urbanization, the Inefficient natural resource management causing environment pollution, and the emerging infectious diseases and non-communicable disease causing the increasing of direct and indirect health cost. Consequently, Health system competency evaluation is necessary in formulating effective health policy for Thailand. However, Thailand still does not have an overall health system competency evaluation, while there are only specific aspects health evaluation report such as health systems financing research, health promotion in different age populations and health impact assessment This research is to evaluate overall health system competency by using international organization health impact assessment concept as well as comparing Thailand's health result to other ASEAN countries and the average value of Organisation for Economic Co-operation and Development (OECD) country in health dimensions consist of health status, health risk factor, service access, healthcare quality and health resource. We are hoping that this research would be useful in health policy making level. Health executive boards at every level can manage their health resource and compare results at provincial, regional, national and international levels.
COVID-19 The epidemic continues to find more infected people, especially in the Eastern Economic Corridor (EEC) area, which is the highest controlled area. There became a public health crisis which doctors, nurses and emergency room are the front line at the risk of being exposed to germs easily. It increased workflows and processes resulting in long working hours. The fatigue and mental stress became stressful. It affects the body and mind both in the short and long term. The purpose of this research was to study the factors affecting the quality of life of emergency room physicians and nurses in public and private hospitals affected by COVID-19 in the EEC area. It is a specific population. The study was conducted from a population of 400 people. The targets were divided into 2 groups: 1) emergency room physicians 2) emergency room nurses. There perform both full-time and temporary contract work in emergency rooms during COVID-19 in public and private hospitals in the EEC area. The analyze data conducting both qualitative and quantitative research. It is a tool to perceive an opinion piece on current situation factors (WRQoL) that affect the quality of work life to measure quality of work life. A total of 472 real data were collected using both descriptive and reference statistics. The study found that the factors affecting the quality of life of doctors and emergency room nurses in public and private hospitals affected by COVID-19 in the EEC area with the highest mean were social relativity factors, including the team that support patients are part of the success. The psychological factors include that I have pride in myself every time and I take care of and keep patients out of danger. The physical factors include work performed with too much risk of harm to health and environmental factors such as receiving compensation for risks during COVID-19 delayed and overwhelmed. The results of the analysis of the importance of factors affecting the quality of life from the hypothesis. It found that there were no significant differences between public and private hospitals in the overall quality of life of physicians and emergency room nurses at the .05 level. There are improving the quality of life passed the assessment criteria were consistent with the empirical data. The probability chi-squared was .170, the relative chi-squared was 1.189, the concordance index was .979, and the mean squared root index of the error estimation was .020. The recommendations were as a result of this research, hospital administrators and agencies that utilize the research can apply factors affecting the quality of life of physicians and nurses to improve quality of life in order to create models and contextual guidelines which on each organization in accordance with the policy and culture. It can also be adapted to other agencies that need to receive critically ill patients and should be studied further developing a model to enhance the quality of life of personnel working in emergency room departments under the COVID-19 outbreak.
Background: Healthcare workers (HCWs) pose a higher risk of infection caused by SARS-CoV-2, leading to more frequent swab and testing with real-time PCR. Serology test to detect SARS-CoV-2 antibodies in the blood is easier and could be useful as part of surveillance. This study aims to determine the prevalence and incidence of infection caused by SARS-CoV-2 by serology testing in frontline HCWs. Methods: This study was prospectively conducted in 360 HCWs (240 frontline and 120 non-frontline HCWs) at Siriraj Hospital between June 2020 and April 2021. Blood samples taken at baseline, 4 weeks, 12 weeks and 48 weeks were tested for qualitative IgG using Pan-IgG [Elecsys Anti-SARS-CoV-2]) and quantitative IgG measured by anti-SARS-CoV-2 RBD IgG enzymes-linked immunoassay (ELISA). The cut-off of negative and positive control were 0.64 and 1.60, respectively. The samples positive by anti-SARS-CoV-2 RBD IgG were tested with micro-neutralizing assay (NT). Results: Among 360 HCWs, 82.2% were female and the median age was 32.5 years. One participant in non-frontline HCWs had positive rapid IgG test from baseline throughout 48 weeks but negative testing by anti-SARS-CoV-2 RBD IgG. With the cut-off determined in the study, two participants in frontline HCWs had positive anti-SARS-CoV-2 RBD IgG from baseline throughout 48 weeks and no participants had seroconversion afterward, given the prevalence of SARS-CoV-2 infection among frontline HCWs of 0.83% (2/240). One participant in non-frontline HCWs had seroconversion at 12 weeks, given the incidence of SARS-CoV-2 infection among non-frontline HCWs of 0.83% (1/120). Approximately 13-17 participants in frontline and 4-7 participants in non-frontline HCWs had borderline level of anti-SARS-CoV-2 RBD IgG. Testing with micro-NT for all samples with positive and borderline anti-SARS-CoV-2 RBD IgG showed negative result with the titers less than 1:10. Further study of the cross-reactivity with other human coronavirus is ongoing. Conclusions: The prevalence and incidence of HCWs was extremely low and no difference of infection was found between the frontline and non-frontline HCWs during the limited spread of transmission and well-control of COVID-19 outbreak. Serology testing with different methods may show the discordant result. Further study of the cross-reactivity with other human coronavirus is ongoing
Background: The COVID-19 pandemic has caused immense health and financial loss globally. Prior to mass vaccination, the only way to limit its spread was with standard health precautions, including mask-wearing, hand washing and social distancing. Compliance with these measures vary between countries, depending on the culture, the public awareness and the policies enacted by the government. A higher rate of mask-wearing is thought to be more effective in limiting the spread of the disease and methods of monitoring mask-wearing would be useful for campaigns to increase mask-wearing. Although the mask-wearing rate has been estimated with questionnaires and episodic counting studies, there are very few reports visually documenting the rate of mask wearing sequentially over time. In this study we developed an artificial intelligence (AI) system to analyze images from public CCTV’s to document the rate of mask wearing in Bangkok, Thailand, and correlate the rate with public health policies and COVID-19 events. Methodology: Public CCTV cameras in the Bangkok Metropolitan Area (BMA) were selected in view of their location and camera viewpoints. Every week, 9 hours of video clips from each of these cameras were downloaded and sent for analysis by an AI that had been trained to detect mask-wearing using pictures with and without masks from public databases. Images were divided for analysis into 2 parts, one part containing the mobile population and the other the non-mobile/vendor population. A number of the images was also visually checked for accuracy. The rate of mask-wearing was analyzed and correlated to public health measures and COVID-19 infections. The images of faces without masks were reviewed to understand factors related to not wearing masks. An in-person questionnaire was also performed on pedestrians in Bangkok to ascertain the factors for mask-wearing, or not, and to try to ascertain the attitudes, understanding and behavior of the general population in Bangkok. The mask-wearing rate seen on CCTV was compared with the mask-wearing rate obtained by a governmental online questionnaire.
The project of wastewater surveillance for SAR-CoV-2 in provinces that have comfirmed COVID-19 cases was conducted by Division of Communicable Diseases, Department of Disease Control. The objectives of this project were to detect SARS-CoV-2 in wastewater and to characterize the relationship between the presences of SARS-CoV-2 genetic materials and the number of infected cases in the particular areas. The result could elucidate the correlation between degree of SARS-CoV-2 genetic materials and the number of COVID-19 patients in the community. Moreover, our result could be useful for disease surveillance and monitoring programs, conducive to setting appropriate measures and policies in controlling this kind of virus effectively in the future. From May to December 2021, a total of 248 of wastewater samples was collected from 11 places, including markets, apartments, universities, and prisons, located in the COVID-19 outbreak areas, Bangkok and Samut Sakhon. The real time RT-PCR technique was used for SARS-CoV-2 detection. The results showed that 118 samples were detected from 10 places, related to the number of infected cases. Moreover, variant of COVID-19 was also analyzed. Based on our results, we suggest that the detection of SARS-CoV-2 in wastewater can be used for COVID-19 monitoring and for integrating with other disease investigation practices in the community. Since individual detection of COVID-19 infection is limited, wastewater analysis could be considered one of the sensitive and cost-effective strategies. Routine implementation of this surveillance tool together with personal hygiene practices and social distancing would significantly improve our preparedness against new or re-occurring viral outbreaks.
The purpose of this mixed-method study was to syntheses policy recommendations nursing workforce development: production, distribution, and retention as COVID-19 pandemic. The quantitative data were collected from 396 samples through the questionnaire of actual and expected workforce retention operation due to COVID-19 pandemic. The qualitative data were collected from 120 subjects through in-depth interview. The findings were as follow: 1) The production of nursing workforce, the Ministry of Public Health, governer, and educational institute network should mutually plan to determin the nursing workforce production needs in longterm period, analyze recent nursing curriculum to find the competency gap due to the pandemic, develop the knowledge and skills of professional nurses according to new normal services, establish clearly procedure to support nursing students when they got infection or high risk to infection. 2) The distribution of nursing workforce, the ministry of public health should systematically review and plan to distribute nursing workforce in all level-ministry, area health, and settings for appropriate manpower rate according to the contex of areas and the complex of nursing services. The nursing administrators should consider the distribution of nursing workforce of their setting. 3) The retention of nursing workforce, the administrators should determin the nursing workforce retention procedures or protocals, encourage and motivation through appoint the worker to be a government officer; promote to a higher position; set up the clearly systems of compensation, welfare benefit and privilege; follow up the health of nursing personel in order to safe them from COVID-19 infection. Moreover, they should have a human development plan for nursing career progression.
This mixed-methods study consists of quantitative research using questionnaires and qualitative research using focus group discussion. The aim of this study was to examine the impact of the COVID-19 on occupational engagement of physical, developmental, learning and psychosocial impairment clients and study of their needs for healthcare services, and adaptation of OT services in public and private hospital. Addition with the impact on practical fieldwork education and guideline for solution. The Occupational Therapists (OTs) (n = 153) were asked to complete the questionnaires while those (n = 45) were invited to once in focus group sessions. Results showed that COVID-19 has caused a negative impact on clients with occupational deprivation owing to uncontrolled situations especially social participation and health management. Three service types provided by the OTs in the pandemic have emerged along with infection control which are onsite, online or telehealth, and hybrid. OTs are developing telethealth services by use information and communication technology or social media through telephone, the LINE application, and VDO calls. Performances evaluation and home-based rehab training activities were provided according to the personal context. Caregiver consultation and education with media resources were innovatively enhanced in various channels. Contributing and barrier factors related to the institute’s policy, supporting infrastructure and readiness to use digital technology-assisted devices was highlighted in both service providers and clients. The impact of COVID-19 on occupational therapy students (OTS) were lack of fieldwork settings and clinical skills due to the decrease in number of clients. To maintain standards of clinical teaching in fieldwork placements, a combination of online case simulation and real client practice was used. The necessary skills for enhancing OTS’s competency in this situation were awareness and practice according to the infection control procedure, resilience skills, good communication, and the creation of innovative skills for telehealth services to be an OTs who response with the needs of client and society in the future.
Data on real-life vaccine effectiveness (VE) against the delta and omicron variant of COVID-19 infection among COVID-19 vaccine regimens are urgently needed to impede the COVID-19 pandemic. We conducted a test-negative case-control study to assess the VE of various vaccine regimens for preventing COVID-19 during the period when the delta variant and omicron was the dominant causative virus in Thailand. All individuals (age ≥18 years) at-risk for COVID-19 who presented for nasopharyngeal real-time polymerase chain reaction (RT-PCR) testing were prospectively enrolled and followed-up for disease development. Vaccine effectiveness was estimated with adjustment for individual demographic and clinical characteristics. Concerning the period of delta variant, there were 1,871 cases of the total of 4,589. The adjusted VE among persons receiving two-dose CoronaVac plus one BNT162b2 booster was highest (98%; 95% confidence interval [CI] 87 to 100), followed by those receiving two-dose CoronaVac plus one ChAdOx1 nCoV-19 booster (86%; 95% CI 74 to 93), two-dose ChAdOx1 nCoV-19 (83%; 95% CI 70 to 90), one CoronaVac dose and one ChAdOx1 nCoV-19 dose (74%; 95% CI 43 to 88) and two-dose CoronaVac (60%; 95% CI 49 to 69). Concerning the period of omicron variant, there were 471 cases of the total of 1,975. The diseases severity markly decreased while the vaccine effectiveness aso markly decreased, compared to the period of delta variant. Our study demonstrated the incremental VE with the increase in number of vaccine doses received. The two-dose CoronaVac plus one BNT162b2 or ChAdOx1 nCoV-19 booster regimens were highly effective in preventing COVID-19 during the rise of delta variant.