Mahidol University

Employing advanced technology in manufacturing will improve productivity and resource efficiency as well as reduce long term operating cost. Storage drive manufacturers focus on the advanced technology adoption as a way to reduce their operating cost. Despite many benefits of Industry 4.0, integration and implementation are not easily achievable. This research aims to identify the barriers of Industry 4.0 implementation in storage drive industry in the context of hard disk drive (HDD) and solid‐state drive (SSD) manufacturing and to suggest guidelines to overcome the barriers. Starting from extensive literature review, followed by expert justification, 15 barriers for the implementation of Industry 4.0 in storage drive manufacturing industry were identified. The fuzzy AHP approach was used to prioritise the barriers. The study found that for both HDD and SSD industries, ‘economic’ criteria is the priority followed by ‘technology’ and ‘organisation’ criteria. The result suggests that decision makers should find avenues to overcome these three barriers before implementing Industry 4.0 in the storage drive manufacturing industry. Getting sufficient financial fund for capital investment, being technological‐oriented organisation and getting strong management support for new technology are the main guideline for the industry. The research methodology in this study could be applied in other manufacturing industries to identify barriers and plan for strategic actions before the intelligent manufacturing implementation.

Accurate diagnosis of glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is crucial for relapse malaria treatment using 8‐aminoquinolines (primaquine and tafenoquine), which can trigger haemolytic anaemia in G6PD‐deficient individuals. This is particularly important in regions where the prevalence of G6PD deficiency exceeds 3%–5%, including Southeast Asia and Thailand. While quantitative phenotypic tests can identify women with intermediate activity who may be at risk, they cannot unambiguously identify heterozygous females who require appropriate counselling. This study aimed to develop a genetic test for G6PD deficiency using high‐resolution melting curve analysis, which enables zygosity identification of 15 G6PD alleles. In 557 samples collected from four locations in Thailand, the prevalence of G6PD deficiency based on indirect enzyme assay was 6.10%, with 8.08% exhibiting intermediate deficiency. The developed high‐resolution melting assays demonstrated excellent performance, achieving 100% sensitivity and specificity in detecting G6PD alleles compared with Sanger sequencing. Genotypic variations were observed across four geographic locations, with the combination of c.1311C>T and c.1365‐13T>C being the most common genotype. Compound mutations, notably G6PD Viangchan (c.871G>A, c.1311C>T and c.1365‐13T>C), accounted for 15.26% of detected mutations. The high‐resolution melting assays also identified the double mutation G6PD Chinese‐4 + Canton and G6PD Radlowo, a variant found for the first time in Thailand. Biochemical and structural characterisation revealed that these variants significantly reduced catalytic activity by destabilising protein structure, particularly in the case of the Radlowo mutation. The refinement of these high‐resolution melting assays presents a highly accurate and high‐throughput platform that can improve patient care by enabling precise diagnosis, supporting genetic counselling and guiding public health efforts to manage G6PD deficiency—especially crucial in malaria‐endemic regions where 8‐aminoquinoline therapies pose a risk to deficient individuals.

Background Entertainment platforms have become more popular among children since the COVID-19 outbreak. The entertainment designed for education; “edutainment” could be a promising learning tool on oral health education (OHE). This study aimed to evaluate the effectiveness of edutainment use for OHE in school-age children. Methods A total of 210 students (age range 9.2–10.8 years) were included. The three-arm parallel randomized controlled trial was conducted in three schools, receiving the same contents of OHE with different learning methods; classroom learning (CL), edutainment in video-based learning with and without repetition at a three-month follow-up (EVBL and EVBL-R). The knowledge, behavior, behavioral intention score, and oral health (OH) status; visble plaue (VPI) and gingival index (GI) were evaluated at baseline, immediate post-intervention, 3, and 6 months. Differences within and between groups for knowledge scores and OH status were analyzed by repeated measures and one-way ANOVA, respectively, and for both behavior and behavioral intention scores, Friedman’s two-way analysis of variance and Kruskal-Wallis test were analyzed, respectively, at a significant level of 0.05. Results The knowledge score was significantly higher in CL for two out of three content domains (p = 0.01, p < 0.001) yet immediately improved within all groups (p < 0.001) with the range of 26.58–53.35% vs. 4.12–29.77% of both EVBLs. No significant difference was found in the behavior and behavioral intention scores among groups. EVBL and EVBL-R had significantly improved behavior scores throughout their follow-ups (p = 0.017, p = 0.006) with the range of 1.19–28.13% vs. 1.90-15.16% of CL and had a significant improvement for VPI (p < 0.001) or 32.5-57.08% vs. 36.45–38.79% of CL. There was no significant difference in GI, but it significantly improved only within the EVBL-R group after the repetition. Conclusion EVBL was comparable to the CL in encouraging positive behaviors, while the CL was preferable for providing core knowledge. EVBL was more applicable to how-to content, and the repetition at least every three months might be able to promote a better OH status. Trial registration The trial was registered in the Thai Clinical Trials Registry under the number TCTR20240816001 on 16/08/2024 (retrospective registration).

Purpose : The Anterior Cruciate Ligament Return to Sports after Injury scale (ACL-RSI) has been translated and culturally adapted into the Thai version. This study aimed to evaluate the reliability and validity of the Thai ACL-RSI for athletes recovering from ACL reconstruction. Methods : This study was a cross-sectional study. Forward-backward translation, cultural adaptation, and validation of the Thai ACL-RSI were performed and tested in 40 athletes (8 females, 32 males; mean age 30.2 ± 7.32 years; mean body weight 70.7 ± 13.36 kg; mean height 170.1 ± 6.53 cm; mean body mass index 24.5 ± 3.74 kg/m ² ; mean time from surgery to evaluation 8.43 ± 1.83 months). Participants completed the translated Thai ACL-RSI and the validated Thai Tampa Scale of Kinesiophobia (TSK). The Thai ACL-RSI underwent content validity, internal consistency, reliability, and construct validity assessment. Results : The Thai ACL-RSI demonstrated commendable content validity (item-objective congruence index [IOC] 0.91), internal consistency (Cronbach’s alpha coefficient 0.84), and test-retest reliability (intraclass correlation coefficient [ICC] 0.75). There was a significant negative correlation with TSK ( r = −0.67, p < 0.001). Conclusion : The Thai ACL-RSI is validated, reliable, and consistent with the Thai TSK. This instrument can potentially measure psychological factors influencing preparedness for sports participation after ACL reconstruction. The evaluation of return-to-sport readiness should involve a multidisciplinary approach, including surgeons, physiotherapists, and psychologists, to ensure a comprehensive assessment of physical, functional, and psychological factors.

Purpose The purpose of this study was to explore the barriers and facilitators to taking medication in newly diagnosed patients with type 2 diabetes (T2DM) at each stage of change from the perspective of the Transtheoretical model. Methods This qualitative descriptive study used purposive sampling to select 32 newly diagnosed patients with T2DM, with 8 representing each of the 4 stages of change (precontemplation, contemplation, preparation, and action). Participants were recruited at a community health service center in Sichuan Province, China. Semistructured interviews were conducted, and data were transcribed and analyzed using qualitative content analysis. Results This study identified barriers and facilitators related to the patient, medication, health care service, and sociocultural dimensions. At the precontemplation and contemplation stages, various barriers across different domains predominated (e.g., incomplete comprehension of the disease; gaps in medication knowledge regarding importance, benefits, and indications; limited access to care; preferred traditional and alternative medication approaches). At the preparation and action stages, although patient, medication, health care service, and sociocultural facilitators were more reported (e.g., awareness of medication benefits, health system financial support, peer medication experiences), medication-related barriers persisted (e.g., medication knowledge gaps regarding side effects, adverse reactions, administration procedures, and missed dose management). Conclusions The primary barriers to taking medication in newly diagnosed patients with T2DM are medication-related factors, with barriers and facilitators dynamically evolving across the stages of change. Future research should focus on developing and evaluating stage-matched interventions to promote medication-taking behavior and patient well-being.

Objectives We aimed to understand the (1) perspectives of patients with atrial fibrilation (AF) regarding their experience and implementation of The SAMe-TT 2 R 2 score-guided approach in anticoagulant-nave Thai patients with atrial fibrillation (TREATS-AF) educational intervention for warfarin therapy control, including views on cultural transferability to the Thai context, and (2) healthcare professionals’ (HCPs) experience of implementing the intervention. Design Qualitative research study. Setting Three university hospitals and four tertiary care hospitals in Thailand. Participants 13 newly diagnosed patients with AF and 13 HCPs delivering the TREATS-AF intervention, an intensive structured educational programme. Methods Semistructured interviews. Patient participants were interviewed at two time points: 4 weeks and 6 months after intervention delivery. HCPs were interviewed when they had at least 6 months experience of intervention delivery. A thematic analysis of content was informed by the framework analytical approach. Results 13 patients and 13 HCPs were interviewed; most were female (73.3% of patients and all HCPs). Mean age was 70 (68–76) and 40 (38–42.5) years for patients and HCPs, respectively. There were four categories related to the experience of the TREATS-AF intervention: (1) key experiences of the educational sessions, (2) core perceptions of the educational materials provided, (3) suggestions for improving the educational materials and session, and (4) behavioural change and self-management influenced by the TREATS-AF intervention. Conclusions The TREATS-AF intervention assisted interviewees who were newly diagnosed with AF in preparing themselves with the necessary knowledge and skills to manage their condition. They stated that it increased their confidence in self-management. For implementation, regionalised Thai-related food and beverages, patients' literacy and family support should be considered, and infrastructure support for widespread use in healthcare settings would be required. Trial registeration number TCTR20180711003.

Background The objective of this study was to compare the risk of estimated glomerular filtration rate (eGFR) decline between atrial fibrillation (AF) patients with direct oral anticoagulants (DOACs) and warfarin. Methods We studied patients with nonvalvular AF from a prospective multicenter national AF registry in Thailand. Patients with missing eGFR data or eGFR less than 30 mL/min/1.73 m² were excluded. Follow‐up data including eGFR were collected every 6 months until 3 years. eGFR decline was assessed by eGFR slope. We compared eGFR slope between patients who received DOACs and warfarin at baseline. In the warfarin group, we assessed the impact of good anticoagulation control by time in the therapeutic range (TTR). Results A total of 1708 patients were studied (mean age 68.1 years; 42.6% female). Patients with DOACs had a significantly slower rate of eGFR decline compared to warfarin. The eGFR slope was 2.32 mL/min/1.73 m² per year in the warfarin group (95% CI: 3.09 to 1.55), and 1.31 mL/min/1.73 m² per year in the DOAC group (95% CI: 1.97 to 0.64). The effect of OAC type on the eGFR slope remained significant even after the adjustment of baseline variables including baseline eGFR. There was no difference in GFR decline as reflected by eGFR slope when comparing warfarin patients with TTR <65% and ≥65%. Conclusion In this prospective cohort of Asian patients with AF, DOACs were associated with a slower rate of eGFR decline when compared with warfarin. In the latter group, this was irrespective of the quality of anticoagulation control.

Many new active pharmaceutical ingredients (APIs) demonstrate high hydrophobicity and low water‐solubility issues. In this regard, polymeric nanoparticles (NPs) have been extensively used as drug delivery carriers for the encapsulation of such APIs. One commonly used polymer is polyethylene glycol (PEG), owing to its biocompatibility, high water solubility, and capacity to prolong the drug residence time. However, concerns have arisen regarding PEG's immunogenicity and limited biodegradability. In addition, inherent limitations, including limited chemical handles can restrict PEG's effectiveness in physiological conditions. For this reason, in the present study, we combine the advantages offered by PEG with the use of an enzymatic synthetic route to produce novel PEGylated polyesters. Furthermore, it has been proven that incorporation of hydrophobic diols into the PEGylated backbone influences NPs formation, stability, and drug encapsulation, despite high chemical similarity. As a preliminary result, samples containing PEG and 1,6‐hexanediol in a 50 : 50 ratio (PEGA‐Hex 50 %) and PEG and 2‐hydroxyethyl disulfide in a 50 : 50 ratio (PEGA‐SS 50 %) have proved to be the most promising candidates in this small library analysed. Both samples exhibited sufficient NPs stability, biocompatibility, and superior encapsulation efficiency compared to the other variants.

Pharmaceutical pollution, particularly contamination of aquatic environments, poses a significant global environmental challenge. This study introduces a novel photocatalytic approach for tetracycline removal using zinc-doped strontium magnesium aluminum ferrite (ZnxSr0.7−xMg0.3Al0.1Fe1.9O4, (x = 0, 0.3)) nanoparticles. We successfully engineered photocatalysts with enhanced structural and photocatalytic properties using a sophisticated sol–gel synthesis method. The zinc-doped material demonstrated remarkable improvements compared to its undoped counterpart. The key structural modifications included a reduced crystallite size (from 35.55 nm to 27.55 nm), significantly increased surface area (from 6.63 m²/g to 32.14 m²/g), and a narrowed bandgap (from 2.7 eV to 2.4 eV). These modifications directly translated into superior photocatalytic performance, with the tetracycline degradation efficiency increasing from 73.67 to 98.43%. Mechanistic investigations revealed the presence of hydroxyl radicals as the primary degradation mechanism, with first-order kinetics governing the reaction. The catalyst demonstrated exceptional stability, maintaining 93.45% degradation efficiency after five consecutive cycles. The quantum efficiency was improved by 34%, highlighting the potential of strategic metal doping for enhancing photocatalytic materials. This study provides a promising strategy for pharmaceutical pollution remediation and offers insights into advanced material design for environmental applications. Zinc-doped spinel ferrite represents a significant advancement in the development of efficient recyclable photocatalysts for water treatment. Graphical abstract

Objective The CONVERGE (Cardiovascular Outcomes and Value in the Real‐World with GLP‐1RAs) study characterized demographics, clinical characteristics, and medication use in treatment‐intensified (add‐on to metformin) adults with type 2 diabetes (T2D) in Thailand. Methods A retrospective cross‐sectional study of data from medical records (Jul 26, 2013, to Dec 31, 2017) was descriptively summarized for overall population and subgroups defined by glucose‐lowering agent (GLA) classes. Results Data from 1,000 adults were collected in reverse chronological order. At baseline, the mean (SD) age was 60 (12) years, HbA1c was 8.0%, and the median (IQR) T2D duration was 1.0 (0.2–2.4) years. Patients taking SGLT2‐is (sodium glucose cotransporter‐2 inhibitors) had a longer T2D duration (1.8 years, 0.8–3.2), GLP‐1RAs (glucagon‐like peptide‐1 receptor agonists) had a higher body mass index of 32.0 (8.84) kg/m², and insulin subgroup had a higher HbA1c 8.5% (7.5–10.1). The utilization of GLP‐1 RAs/SGLT‐2is was low (1.5% and 6%, respectively). Among the subgroups, most patients in the GLP‐1RA (80.0%) and insulin subgroup (81.3%) receiving 3/≥4 GLAs. The most frequently prescribed GLAs post‐metformin were sulfonylureas (45.2%) and dipeptidyl peptidase‐4 inhibitors (39.4%). Overall, 90% received ≥1 cardiovascular (CV) medication; lipid‐lowering agents (78%) were the most prescribed. Conclusions These results indicate low utilization of GLAs with CV benefits, attributed to a lack of CV benefit data during the study period and partial reimbursement implementation. Future studies must identify barriers to adoption and estimate the usage of these GLAs with CV benefits as more evidence becomes available on positive CV outcomes to improve patient care in Thailand.

Objectives This cross-sectional study aimed to investigate the oral health-related quality of life (OHRQoL), its associated factors, and the prevalence of possible sarcopenia in Thai well-maintained patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD). Materials and Methods Data were collected from 63 participants undergoing PD at Banphaeo-Charoenkrung Hemodialysis Center. Dry mouth was evaluated through unstimulated salivary flow rate measurement and self-reported xerostomia questionnaires. OHRQoL was assessed using the Thai version of Oral Health Impact Profile (OHIP-14). Statistical Analysis Statistical analyses were conducted using IBM SPSS Statistics version 21.0. Descriptive statistics summarized participant characteristics, and normality was tested with the Kolmogorov–Smirnov test. Continuous variables were expressed as medians and interquartile ranges, while categorical variables were presented as frequencies and percentages. The Mann–Whitney U test and Fisher's exact test were used to assess differences between OHRQoL groups. Partial Spearman's rank correlation examined variable relationships, and logistic regression identified factors linked to a higher negative impact on OHRQoL, adjusting for age, sex, body mass index, chair stand test, and salivary flow rate. A p-value of < 0.05 was considered significant. Results The median age was 59 years (range 27–79), with a possible sarcopenia prevalence of 52.4%. OHIP-14 scores ranged from 0 to 32, with medians of 4 and 13 in a lower (n = 31) and higher (n = 32) negative impact on OHRQoL, respectively. Those with a higher negative impact on OHRQoL exhibited a significantly higher proportion of self-reported xerostomia (p = 0.01), lower salivary flow rate (p = 0.01), and longer 5-time chair stand test (p = 0.04) compared to individuals with the lower negative impact on OHRQoL. Correlation between the time of the chair stand test and the handgrip strength adjusting for age (r = –0.439, p < 0.001) and sex (r = –0.351, p = 0.006) was revealed. Multivariate logistic regression showed a significant association between salivary flow rate and a higher negative impact on OHRQoL (odds ratio 0.018; 95% confidence interval: 0.001, 0.545; p = 0.02). Conclusion This finding suggests that reduced salivary flow affected OHRQoL in well-maintained ESRD patients with PD, highlighting the importance of managing dry mouth to alleviate their OHRQoL.