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Using data from Vietnamese-origin older immigrants/refugees in the Houston, Texas area, we assessed their overall health, chronic conditions, disability, depressive symptoms, and cognitive impairment, and examined the association between their chronic conditions and disability by comorbidity clusters. The mean age of the sample was 76 years old. The majority were married in fair/poor health with several chronic conditions and disabilities and lived with families in low-income households. Hypertension and arthritis were the most common health conditions, but cognitive impairment had the most significant impact on their disability. They experienced similar health conditions to other older Americans but had higher rates of depressive symptoms and cognitive impairment possibly due to cultural factors that may have delayed mental health treatment. Culturally and linguistically tailored services created by policymakers, healthcare professionals, and local social service agencies are recommended for the well-being of immigrants/refugees who migrated to the U.S. for a better life.

From a critical refugee studies orientation, our article redefines care within the context of myriad forms of state violence impacting Southeast Asian post-war refugee communities. Research reveals how harm is compounded at every step of Southeast Asian refugee journeys: war, forced displacement, resettlement, family separation, inherited health conditions, and generational trauma. How do we reckon with refugee trauma without conceding to it as an unchangeable fact of our lives? What knowledge might we gain by attending to the everyday work of survival in refugee communities? To answer these questions, the authors conceptualize care through (a) abolitionist organizing, (b) queer kinship and affective labor, (c) historiographic caretaking, and (d) refugee reunion.

OBJECTIVE: To develop a predictive model for thiamine responsive disorders (TRDs) among infants and young children hospitalized with signs or symptoms suggestive of thiamine deficiency disorders (TDDs) based on response to therapeutic thiamine in a high-risk setting. STUDY DESIGN: Children aged 21 days to

IntroductionMany Asian immigrants, including Filipino Americans (FilAms), experience psychological distress (PD) due to the challenges in adjusting to their new country and culture. This descriptive comparative study aimed to compare FilAms and Filipinos concerning their levels of PD, sources of stress, and use of health-promotion strategies.MethodsData from 89 FilAms and 95 Filipinos living in urban cities, obtained from the I-HELP-FILIPINOS database, measuring cardiometabolic risks, mental health, and environmental stressors in 2017, including PD, were examined.ResultsThe mean age of all participants (N = 184) was 44.2 ± 22.8 years old. Both groups rated their health as good to excellent, although Filipinos were significantly more likely to be distressed (p < .001). Filipinos were also more likely to ascribe stress to employment (48.3% vs. 68.2%, p =.006) and finances (28.1% vs. 52.6%, p

BackgroundSoutheast Asian countries have been trying to increase HIV testing coverage of women since awareness of HIV status is essential to eliminate mother-to-child transmission of HIV. This study determined factors related to lifetime HIV testing uptake among women aged 15-49 years in four Southeast Asian countries: Myanmar, Cambodia, the Philippines and Timor-Leste.MethodsThis study used cross-sectional data from the 2015-16 Myanmar Demographic and Health Survey (DHS), the 2014 Cambodia DHS, the 2017 Philippines National DHS and the 2016 Timor-Leste DHS. We conducted multivariable logistic regression analyses to identify factors associated with lifetime HIV testing among women aged 15-49 years who completed the surveys in each country and ran a fixed effects logistic regression model using pooled data.ResultsThe proportions of lifetime HIV testing uptake among women aged 15-49 years were 42.1% in Cambodia, 19.5% in Myanmar, 4.6% in the Philippines, and 3.7% in Timor-Leste. Marital status, age, education, and wealth were significantly associated with lifetime HIV testing uptake among women in all four countries. Other factors (e.g., comprehensive knowledge of HIV, rural/urban residence, positive attitudes towards negotiation for safer sex) were also significant determinants of HIV testing uptake among women in some of these countries.ConclusionsA multi-sectoral collaboration of related sectors and organizations is necessary to increase access to HIV testing and HIV knowledge of women to overcome the barriers to HIV testing. It is critical to make HIV testing services available and accessible to women, especially in rural areas.

BackgroundColorectal cancer is a leading cause of morbidity and mortality across U.S. racial/ethnic groups. Existing studies often focus on a particular race/ethnicity or single domain within the care continuum. Granular exploration of disparities among different racial/ethnic groups across the entire colon cancer care continuum is needed. We aimed to characterize differences in colon cancer outcomes by race/ethnicity across each stage of the care continuum.MethodsWe used the 2010-2017 National Cancer Database to examine differences in outcomes by race/ethnicity across six domains: clinical stage at presentation; timing of surgery; access to minimally invasive surgery; post-operative outcomes; utilization of chemotherapy; and cumulative incidence of death. Analysis was via multivariable logistic or median regression, with select demographics, hospital factors, and treatment details as covariates.Results326,003 patients (49.6% female, 24.0% non-White, including 12.7% Black, 6.1% Hispanic/Spanish, 1.3% East Asian, 0.9% Southeast Asian, 0.4% South Asian, 0.3% AIAE, and 0.2% NHOPI) met inclusion criteria. Relative to non-Hispanic White patients: Southeast Asian (OR 1.39, p

Modified maxillomandibular advancement (MMMA) has been proposed as an alternative to the classic maxillomandibular advancement (MMA) in East and Southeast Asian populations in which bimaxillary protrusion is a prevalent trait. The key difference between MMMA and MMA is the inclusion of anterior segmental osteotomies to reduce the protrusion of the perioral region. The aim of this scoping review was to identify the variations in MMMA and treatment outcomes. A search was conducted in the PubMed, Embase, and Cochrane electronic databases for articles published up to January 2023. Ten articles were included in this review. Three variations of MMMA have been reported in the literature. Treatment outcomes have mostly been favourable for all of these variations. Mandibular advancement of >10 mm and a greater than 50% reduction in the apnoea–hypopnoea index (AHI) have been well reported. Improvements in other outcome measures, such as enlargement of the airway dimension on computed tomography and the Epworth Sleepiness Scale score, have also been shown. Despite additional surgical procedures, complications have been uncommon and mostly minor in nature. It is necessary to be cognizant of MMMA and its variations when providing sleep surgery for East and Southeast Asian patients, tailoring this to the patient's profile and needs. [ABSTRACT FROM AUTHOR]

Telomerase reverse transcriptase (TERT) and β-catenin (CTNNB1) mutations may occur following the hepatocellular carcinoma (HCC) pathway signal. We conducted a Hierarchical cluster analysis study on 408 patients diagnosed with HCC by pathological surgery, identifying TERT promoter and CTNNB1 exon 3 mutations by sequencing. The overall preclinical characteristics, cumulative cut-point values, and the factors associated with these somatic mutations were analyzed in uni/multidimensional scaling model. HBV(+) HCV(-) HCC male patients who were older than 62.74 years old and have TERT promoter mutation as well as AFP > 489.78 ng/ml got a higher risk of HCC grade more than two from 27 % to 200 % with p < 0.05 (RR are from 1.27 [1.09-1.47] to 3.06 [2.04-4.61]). This mutation was a good indicator of grade 2 risk (HR = 0.37 [2.72-0.16], β = -1.00, p = 0.019). TERT promoter and CTNNB1 exon 3 mutations independently influenced tumor size and tumor site status in grade 3 and HBV(-) HCV (-) male HCC patients, where the hazard rates, respectively, were 0.28 [0.09-0.89], 0.023 [0.0023-0.23] and 0.06 [0.012-0.32] (β < 0 and p < 0.01). These two mutations inversely impacted each other the tumor sites status, especially in male HCC patients with grade 2 without B, C hepatitis virus (RR CTNNB1 exon 3 mutate - TERT promoter wildtype  = 1.12 [1.04-1.20], p < 0.05). Consequently, the mutations in TERT promoter and CTNNB1 exon 3 may synchronize with other factors or independently impact the hepatocarcinogenesis and are important indicators for HCC prognostic in male patients with very high AFP levels or with moderately as well as poorly differentiated in tumor. Our results serve as the basis for further studies to understand the impact of different factors on the outcome of HCC, especially in monitoring and assessing the cancer risk of patients infect HBV and carry mutations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Constipation poses a significant health concern affecting individuals of varying ages and geographic locations worldwide. While the impacts of numerous probiotics on constipation are well-characterized, there has been limited assessment of the potential prebiotic effects of resistant starches. We therefore conducted a randomized, double-blind and placebo-controlled, clinical trial of resistant starch type 3 (RS-3) in Thai adults with self-reported chronic constipation. The effects of these mixed natural starch fibers on beneficial gut bacteria, bowel movements and stool consistency were evaluated after 6- and 12-week periods. Regardless of subject age, consumption of RS-3 compared to placebo resulted in significant improvements in gut health by dramatically increasing levels of beneficial bacteria (Bifidobacterium, Prevotella, Akkermansia and Megamonas) in the gut and relieving constipation. RS-3 consumption was associated with a significantly increased frequency of bowel movements, with subjects reporting these as healthy stools. Our findings provide important insights into the therapeutic advantages of RS-3 for constipation, and propose RS-3 as a feasible alternative strategy for management of constipation., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics approval and consent to participate This study was conducted in accordance with the International Guidelines for Human Research Protection, including the Declaration of Helsinki, The Belmont Report, CIOMS Guidelines and the International Conference on Harmonization in Good Clinical Practice (ICH-GCP). The study protocol was approved by Mahidol University’s Central Institutional Review Board (Protocol No. MU-CIRB 2022/300.0711 and COA No. MU-CIRB 2023/004.0901). This study is registered in the NIH’s Protocol Registration and Results System (PRS) on their website (ClinicalTrials.gov ID: NCT06274242). All subjects provided written informed consent in compliance with the MU-CIRB informed consent guidelines., (© 2024. The Author(s).)

Background: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of non-Hodgkin lymphoma associated with hemophagocytic lymphohistiocytosis (HLH)/HLH-like systemic illnesses and germline HAVCR2 mutations. Although previous studies suggested successful treatment of SPTCL with immunosuppressive therapy (IST) without chemotherapy, IST data in pediatric SPTCL remain scarce. To explore characteristics and therapeutic outcomes, comparing IST-based and chemotherapy-based regimens in pediatric SPTCL, in this retrospective cohort study, patients with SPTCL diagnosed at age ≤20 years during 2007-2023 were enrolled from 6 hematology/oncology centers in Thailand. HAVCR2 exon 2 sequencing was performed using DNA extracted from peripheral blood or bone marrow. Presence of HLH/HLH-like systemic illnesses, treatment outcomes, and adverse events (AEs) were reviewed and analyzed., Results: Of 22 patients with SPTCL (median age at diagnosis, 11.5 years [range, 6.0-19.0]; 63.6% males), 86.4% harbored germline HAVCR2 mutation, either homozygous (77.3%) or heterozygous (9.1%) p.Y82C variant, while 68.2% developed HLH/HLH-like systemic illnesses. Overall, 36.4% received IST as first-line treatment. Durable complete remission (CR) was achieved in 71.4% and 50.0% after first-line chemotherapy and IST, respectively (P=0.45); however, chemotherapy tended to increase any AEs compared to IST (57.1% vs. 12.5%; P=0.07). The most common AEs were hypertension (27.3%), febrile neutropenia (18.2%), and fungal infection (13.6%). Among the relapsed cases, 71.4% could reach CR after subsequent-line therapy. Fatality (4.5%) only occurred in the chemotherapy group., Conclusions: Pediatric SPTCL in Thailand frequently involves germline HAVCR2 mutations and/or HLH/HLH-like systemic illnesses. With comparable response and modest therapy-related toxicity, IST-based regimens may alternatively be considered as first-line treatment for pediatric SPTCL., Competing Interests: Declarations Ethical approval and consent to participate The study protocol was ethically approved by the Institutional Review Boards of all the study sites, including the central study site at the Faculty of Medicine, Chulalongkorn University (IRB no. 0607/65). Written informed consent forms were obtained from each patient and/or their parents/guardians prior to participation in the study, in accordance with the Declaration of Helsinki. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests., (© 2024. The Author(s).)

Background: Under Thailand's universal health coverage every citizen has access to primary care including free hypertension treatment. This study describes temporal trends in hypertension prevalence, awareness, treatment, and control in Thailand., Methods: Data were analyzed from four survey cycles of Thailand's National Health Examination Survey (NHES), between 2004 and 2019-2020. The NHES is a nationally-representative cross-sectional survey conducted every five years using a multistage probability sample. Hypertension was defined as systolic blood pressure > = 140 or diastolic blood pressure > = 90 mmHg or currently taking antihypertensive medicines; blood pressure control was defined as < 140/90 mmHg for patients without diabetes and < 130/80 mmHg for those with diabetes., Results: In 2019-2020, age-standardized hypertension prevalence in Thailand was 25.7% (24.6% females, 26.8% males). Among people with hypertension, 51.5% were aware of their diagnosis, 47.9% were treated, and 22.7% had controlled blood pressure. Age-standardized hypertension prevalence remained relatively unchanged in Thai adults from 2004 to 2019-2020, however trends varied by age group. Hypertension control increased from 8.8% in 2004 to a peak of 30% in 2014 but dropped to 22.7% by 2019-2020. Hypertension awareness increased from 30.7 to 55.8% between 2004 and 2014, but decreased to 51.5% by 2019-2020., Conclusion: Hypertension prevalence in Thailand has remained high over the past 15 years. Despite universal health coverage, hypertension awareness has not improved and blood pressure control has decreased in the past five years. An urgent and concerted public health response is needed to improve diagnosis and control of hypertension to prevent avoidable cardiovascular disease., Competing Interests: Declarations Ethical approval Ethical approval for this study was obtained from the Human Research Ethics Committee, Faculty of Medicine Ramathibodi Hospital, Mahidol University (COA. MURA2022/389). Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Gut microbiota is considered a key player modulating the response to immune checkpoint inhibitors (ICI) in cancer. The effects of dietary pattern on this interaction is not well-studied. A prospective multicenter cohort of 95 patients with advanced non-small cell lung cancer (NSCLC) undergoing ICI therapy were enrolled. Stool shotgun metagenomic sequencing was performed. Three-day dietary patterns before ICI were assessed. Patients were categorized as hyperprogressive disease (HPD) if they exhibited a time to treatment failure of less than 2 months. All others were categorized as non-hyperprogressive disease (non-HPD). The correlation between dietary patterns, gut microbiome, and response to ICI therapy was analyzed. In the multivariate analysis, a high abundance of Firmicutes unclassified and the Ruminococcaceae family correlated with a significantly diminished progression-free survival (PFS) with an HR of 2.40 [P = 0.006] and 4.30 [P = 0.005], respectively. More specifically, within the subset of NSCLC patients treated solely with ICI therapy, a high abundance of Intestinimonas and the Enterobacteriaceae family were associated with substantially reduced PFS with an HR of 2.61 [P = 0.02] and HR 3.34 [P = 0.005], respectively. In our comprehensive dietary pattern analysis, the HPD group showed increased consumption of cholesterol, sodium, and fats beyond recommended levels compared to the non-HPD group. This group also displayed a tendency towards higher food pattern scores characterized by a high intake of fat and dairy products. Our study revealed a distinct association between the gut microbiome composition and treatment outcomes. The overall composition of diet might be related to ICI therapeutic outcomes., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethical approval All patients provided written informed consent. This study was approved by the Institutional Review Board of the Faculty of Medicine at Chulalongkorn University (IRB No. 385/63) and Mahidol University (IRB No. 374/2564)., (© 2024. The Author(s).)

Objectives: This study developed and investigated the possibility of using the walking and turning test (WTT) to indicate fall risk in community-dwelling older adults., Design: Retrospective diagnostic study., Setting: The study was carried out in a community setting., Participants: The study focused on community-dwelling older Thai adults., Primary and Secondary Outcome Measures: The participants were assessed based on demographics, fear of falls using a 'yes/no' question and the Short Falls Efficacy Scale International, as well as fall data in the previous 6 months. The participants then performed the WTT, timed up and go test, five times sit-to-stand test and handgrip strength test (HG) in random order., Results: There were a total of 86 participants with an average age of 69.95±6.10 years (range from 60 to 88 years), most of whom were female (67.44%). 40 participants (46.51%) reported that they had fallen at least once in the previous 6 months. A comparison of various physical ability tests revealed significant differences between faller and non-faller participants (p<0.001). The outcomes of the WTT showed significant correlations with fall variables, balance and muscle strength (0.394 to 0.853, p<0.001). Based on sensitivity, specificity and area under the curve, the cut-off score of 6.40 s showed the highest level of ability to indicate falls among community-dwelling older adults, with a sensitivity of 92.50% and a specificity of 78.26%., Conclusions: The study suggests the clinical usefulness of the WTT in determining falls in older individuals. WTT is a physical ability measurement that indicates balance ability and muscle strength. The test is practical, requires little space and equipment and can be used in large populations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study investigated the associations between CAV1 variants and metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and cardiometabolic risk factors, as well as the influence of CAV1 variants on CAV1 mRNA expression. We genotyped 743 T2DM patients for CAV1 variants. Multiple logistic regression was conducted to adjust for sex, age, and body mass index (BMI), and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The expression of mRNA was measured by reverse transcription polymerase chain reaction. The rs926198 variant, but not the rs3807989 variant, was associated with T2DM. Crude ORs were 1.87 (95% CI: 1.32-2.69, p = 0.0005) and adjusted ORs were 1.81 (95% CI: 1.12-2.96, p = 0.016), respectively. Additionally, patients with Mets and T2DM who had the rs926198 variant exhibited a significant 44.3% reduction in CAV1 mRNA expression (P < 0.05). Clinical samples revealed that the rs926198 variant is strongly linked to T2DM, with significantly reduced CAV1 mRNA. Our findings suggest a crucial role for the rs926198 variant in T2DM, indicating its potential for prevention, diagnosis, and intervention purposes., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Mental health disparities exist for sexual minority populations globally. Microaggressions and microaffirmations related to sexual orientation may negatively or positively impact well-being. Culturally validated tools are needed to assess these constructs among LGBQ+ (lesbian, gay, bisexual, queer/questioning) individuals in Thailand's high-context culture. This study aimed to develop and validate the Thai Sexual Orientation Microaggressions Scale (T-SOMG) and the Thai Sexual Orientation Microaffirmations Scale (T-SOMF) to quantify experiences among LGBQ+ Thais. A mixed-methods approach was utilized. Initial scale items were derived from a literature review, expert consultation, and interviews with LGBQ+ Thais. Exploratory factor analysis ( n  = 164) refined the item pools. Confirmatory factor analysis ( n  = 200) confirmed the factor structures. Reliability and validity were examined. The final 18-item T-SOMG contained two subscales-Interpersonal and Environmental Microaggressions. The 13-item T-SOMF contained Interpersonal and Environmental Microaffirmations subscales. All scales demonstrated good model fit, reliability, convergent validity, and discriminant validity. The T-SOMG and T-SOMF are culturally valid tools for assessing microaggressions and microaffirmations among LGBQ+ Thais. These localized scales can enable research on factors impacting LGBQ+ well-being. Further validation in diverse samples is warranted.

Background: Seeing portrayals of tobacco and alcohol in music videos (MVs) may reduce perceived risks, increase susceptibility, and lead to the initiation of tobacco and alcohol use among adolescents and young adults. Previous studies have predominantly concentrated on assessing tobacco and alcohol contents in English-language MVs within Western countries. However, many other countries have not only been influenced by the English music market but have also produced music in their native languages, and this content remains underexamined., Objective: This study aims to investigate the prevalence of tobacco- and alcohol-related content in top Vietnamese MVs on YouTube from 2013 to 2021, to describe how tobacco and alcohol are portrayed in these MVs, and to examine associations between these portrayals and MV characteristics., Methods: A total of 410 Vietnamese MVs, including the top 40 or 50 most viewed released each year between 2013 and 2021, were analyzed. General information, such as the song name, its release date and ranking, age restriction, musical genre, and type of MV, was collected. We examined tobacco and alcohol content in the MVs, with specific details such as tobacco types, their brands, as well as the number, age, sex, and roles of individuals smoking or drinking., Results: Among the 410 MVs, 36 (8.8%) contained tobacco-related content and 136 (33.2%) featured alcohol-related content. Additionally, 28 (6.8%) out of 410 MVs included both tobacco and alcohol content. The prevalence of videos with tobacco and alcohol content fluctuated over the years. In MVs with tobacco-related content, a higher proportion of hip-hop or rap songs contained tobacco-related content (n=6, 30%) compared to other music genres. In MVs with tobacco-related content, cigarettes were the most frequently shown product (n=28, 77.8%), and smoking scenes were often depicted at parties (n=13, 36.1%) and during dancing and singing scenes (n=12, 33.3%). Among the 31 MVs portraying actual tobacco use, tobacco use was typically depicted with 1 person, often a young adult male, while 38.7% (n=12) showed singer(s) smoking. For MVs with alcohol-related content, there was a high proportion showing alcohol images at parties, bars, or pubs (n=96, 70.6%). Among 87 MVs containing drinking scenes, 60.9% (n=53) involved groups of young adults of both sexes, and 64% (n=56) depicted singers drinking. Additionally, only 2 (5.6%) MVs included health warnings about tobacco harm, and 2 MVs (1.5%) included warnings about drinking restricted to individuals 18 years and above., Conclusions: The notable prevalence of tobacco and alcohol content in leading Vietnamese YouTube MVs raises concerns, especially as most of this content is portrayed without any warnings. The study underscores a regulatory gap in addressing such content on the internet, emphasizing the urgent need for stricter regulations and age restrictions on platforms such as YouTube., (©Thi Phuong Thao Tran, Thu Trang Vu, Yachao Li, Lucy Popova. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 08.11.2024.)

Purpose: This study aims to examine attitudes toward LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning, and more) physicians among Thai psychiatric patients and to identify associated factors across three regions of Thailand., Patients and Methods: A cross-sectional survey was conducted from June to August 2023 in Central, Northern, and Southern Thailand. The Attitudes Toward LGBTQ+ Physician Questionnaire and a patient-doctor relationship questionnaire were utilized. Data analysis involved descriptive statistics and linear regression., Results: The study included 543 participants with a median age of 37 years (IQR 26-52), predominantly female (68.9%) and Buddhist (78.1%). The median score for perceived attitudes toward LGBTQ+ physicians was 86 (IQR 73.0-95.5), with significant regional variations. Most participants perceived LGBTQ+ physicians as normal (85.5%) and integral to society (94.5%). A significant portion disagreed with the idea that being an LGBTQ+ physician was sinful (85.3%) or immoral (84.0%). However, 20.3% expressed discomfort with the possibility of LGBTQ+ physicians conducting private physical examinations. Lower perceived attitudes were associated with older age and being Muslim. Conversely, higher education, female gender, having LGBTQ+ connections, and a reported gender non-conformity showed a correlation with more positive attitudes., Conclusion: Thai psychiatric patients generally hold positive attitudes toward LGBTQ+ physicians, though demographic factors influence these attitudes. There needs to be a particular focus on improving attitudes regarding conducting private physical examinations to maximize patient comfort and trust., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Pitanupong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Patients with diabetes are susceptible to acute kidney injury (AKI) as compared to counterparts without diabetes. However, data on the long-term clinical outcome of AKI specifically in people with diabetes are still scarce. We sought to study risk factors for and adverse cardio-renal outcomes of AKI in multi-ethnic Southeast Asian people with type 2 diabetes. 1684 participants with type 2 diabetes from a regional hospital were followed an average of 4.2 (SD 2.0) years. Risks for end stage kidney disease (ESKD), major adverse cardiovascular events (MACE) and all-cause death after AKI were assessed by survival analyses. 219 participants experienced at least one AKI episode. Age, cardiovascular disease history, minor ethnicity, diuretics usage, HbA1c, baseline eGFR and albuminuria independently predicted risk for AKI with good discrimination. Compared to those without AKI, participants with any AKI episode had a significantly high risk for ESKD, MACE and all-cause death after adjustment for multiple risk factors including baseline eGFR and albuminuria. Even AKI defined by a mild serum creatinine elevation (0.3 mg/dL) was independently associated with a significantly high risk for premature death. Therefore, individuals with diabetes and any episode of AKI deserve intensive surveillance for cardio-renal dysfunction., (© 2024. The Author(s).)

The purpose of this study was to examine mental health problems and sleep quality among undergraduate students in the post-COVID-19 era, as well as related factors. This cross-sectional study involved 627 undergraduate students from Chiang Mai University in northern Thailand between October and December 2022. Data were collected using a self-administered online questionnaire that included the General Health Questionnaire-12 (GHQ-12), the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Pittsburgh Sleep Quality Index (PSQI). The study found that 57.9% of participants experienced mental health problems (95% CI: 54.0-61.8), 32.2% experienced depression (95% CI: 28.5-35.9), and 68.1% reported poor sleep quality (95% CI: 64.4-71.8). Multiple logistic regression analysis revealed that medical conditions, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score were all associated with mental health problems and poor sleep quality (p < 0.05). Depression was associated with the field of study, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score (p < 0.05). The findings highlight a significant occurrence of poor sleep and mental health issues, including depression, among undergraduate students in the post-COVID-19 era, underscoring the need for ongoing mental health monitoring and interventions to mitigate negative outcomes., (© 2024. The Author(s).)

This study aims to evaluate impaired insulin tolerance among Vietnamese diabetes with or without dyslipidemia. Diabetes mellitus (DM) remains the serious global health and social burden that has increased over the past few decades. It progresses silently to vascular injury and disability of injured vascular-perfused tissues/organs. Insulin intolerance and dyslipidemia exacerbate and accelerate the implications of DM. Thus, early detection and more evidence of early insulin intolerance and dyslipidemia is needed for proactive management. This cross-sectional descriptive study recruited 100 healthy control (HC) and 297 DM patients in Military Hospital 103 from 2021 to 2023. Patients with DM were subgrouped into lipid metabolism disorder (LMD, n = 98) and non-LMD (NLMD, n = 99). The biochemists' serum levels were measured automatically and the accuracy of the test result was strictly controlled. Insulin tolerance indices (HOMA2-IR, HOMA2-%S and HOMA2-%B) were compared between HC, DM with or without dyslipidemia as well as correlated with lipid ingredients (total Cholesterol, triglyceride, LDL-C and HDL-C). Among DM patients, HOMA2-IR was significantly high and HOMA2-%S and HOMA2-%B were significantly low. HOMA2-IR was higher and HOMA2-%S and HOMA2-%B were lower in DM with LMD than in DM without LMD. In addition, HOMA2-IR was positively correlated with serum cholesterol, triglyceride and LDL-C concentration, and negatively correlated to HDL-C concentration. In contrast, HOMA2-%S and HOMA2-%B was negatively correlated with serum cholesterol, triglyceride and LDL-C, and positively correlated with HDL-C. Impaired insulin intolerance occurred in early stage of DM, and more serious among DM with LMD, compared to DM with NLMD., Competing Interests: The authors declare no potential conflicts of interest., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Influenza is a common contagious respiratory virus that primarily causes respiratory tract infections. Neurological complications associated with influenza have also been reported, mainly in pediatric populations, and may be fatal., Methods: A descriptive study evaluated pediatric patients who were diagnosed with severe influenza-associated neurological complications at the Tropical Pediatrics Center-Vietnam National Children's Hospital from October 2022 to February 2024., Results: In this study involving 20 patients, 80% of children were under 5 years old; 70% of patients had a history of good health. All patients had not received an influenza vaccination within 12 months. The median time from onset to neurological symptoms was 1 day. The most common neurological complication was encephalitis (16/20 patients) with symptoms included altered consciousness and seizures. Most patients had elevated levels of ALT (60%), AST (90%), LDH (94%), and ferritin (69%) in serum. The imaging of brain damage on MRI and CT scans varied in patterns and locations. There was no difference in the timing of methylprednisolone treatment within and after 48 h. The mortality rate was 20%, with 45% of patients experiencing severe sequelae., Conclusions: IANCs are severe with damage to both white matter and central gray matter and can occur in healthy children, emphasizing the importance of vaccination to reduce the risk., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Background: Respiratory syncytial virus (RSV) is an important cause of acute lower respiratory infections worldwide, including Thailand. This study aimed to assess clinical and economic burdens of RSV infections across different age groups in Thailand., Method: A retrospective cohort study was conducted using data from a tertiary care hospital from 2014 to 2021. Patients who tested at least one positive RSV were included and stratified into five age groups (< 2, 2-5, 5-18, 18-65, and > 65 years). Healthcare resource utilization, direct medical costs, and clinical outcomes were analyzed with descriptive statistics. Generalized linear models with gamma distributions and log link were used to model cost outcomes. Costs were reported in 2021 US dollars (USD), with 1 USD = 31.98 Thai Baht., Results: A total of 2122 RSV-positive patients were identified, half of which (1097) were hospitalized. The median (interquartile range [IQR]) total hospitalization costs ranged from USD780 (IQR: USD488-USD1185) in those < 2 years to USD2231 (IQR: USD1250-USD4989) in those aged 65+ years. Case fatality rates among hospitalized patients also varied from 2.5% to 28.4% depending on age. Increased age, presence of comorbidities, and need for critical care were associated with higher hospitalization costs., Conclusion: Among RSV-positive patients, younger children experienced the greatest burden, but poorer outcomes were observed in older adults. Higher costs were associated with older age, comorbidities and critical care needs. Understanding RSV economic burdens is crucial for assessing the cost-effectiveness and public health value of vaccination programs that prioritize at-risk groups to mitigate the public health impact., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Introduction: The micro-autologous fat transplantation (MAFT)-gun technique is applied to accurately deliver small fat parcels to multiple fat layers across different sites. Our study presents the surgical and clinical outcomes of using the MAFT-gun technique for full-face contouring., Methods: From January 2021 to June 2023, 31 healthy participants undergoing full-face volumization using the MAFT-gun technique at our hospital were included in this study. Data on fat volume grafted at different facial sites, complications, and satisfaction rates (%) were collected and analyzed., Results: The average fat volumes grafted over the left and right cheeks were 10.3 ± 0.31 ml and 10.2 ± 0.30 ml, respectively. The forehead and temples required lower fat volumes of 9.8 ± 0.23 ml and 4.5 ± 0.21 ml, respectively. Small fat volumes were required for the nasolabial fold, the tear trough, and the infraorbital areas, with 2.2 ± 0.11 ml, 1.9 ± 0.10 ml, and 1.4 ± 0.11 ml, respectively. The fat volumes for the nasolabial fold and the tear trough were significantly different between young and old people. No complications, including infection, necrosis, or vascular injury, were noted. At the end of the follow-up, 26 patients (83.9%) expressed their satisfaction after the procedure., Conclusion: The MAFT-gun technique is safe and effective for full-face autologous fat grafting. Commercial closed-system processors could be an effective alternative to centrifugation for fat processing. The procedure significantly improved facial hollowness and resulted in a more attractive and satisfied appearance to people even after 12 months postoperatively., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Human activities related to land use and land cover (LULC) conversion have been the primary factor driving changes to mangrove distribution over recent decades. In order to quantify the anthropogenic influences associated with LULC changes on mangroves in the Vietnamese Southern Coast (VSC), we investigated the variations and trends in mangrove distribution between 1988 and 2023. We used a time-series of Landsat spectral indices from Google Earth Engine and applied hot spot analysis and machine learning algorithms to analyse mangrove variations and LULC classification, respectively. Our findings revealed that over the past 36 years, approximately half of the mangrove area has been lost due to LULC conversions. The most significant losses in mangrove cover occurred during the 1998-2011 period, with a decline of 46.79% in total area (an average of 3.6% per annum). The rate of mangrove deforestation more than halved to 17.49% (1.5% per annum) in the period between from 2011 to 2023. We attribute the reduction in mangrove loss to conservation efforts and natural regeneration processes. The emerging hot spot analysis indicated that the most significant restoration of new mangrove areas occurred between 1988 and 1998, totalling 1795 ha (1.4%), while the highest rate of mangrove deforestation was observed between 1998 and 2011, amounting to 2249 ha (2.0%). The primary causes of these variations in mangrove distribution were the conversion of mangrove areas to shrimp farming (38.91%), followed by other agricultural land use (5.82%) and the expansion of impervious surfaces (3.34%). In contrast, a result of enhanced conservation efforts and natural regeneration was associated with a 17.91% of mangrove area gain in the 2011-2023 period. Despite the regeneration potential of mangroves, our study highlighted the ongoing need to manage and protect mangrove forests to facilitate their expansion in the VSC. The analytical approach adopted in this study is applicable to other coastal areas when assessing changes in mangroves and land use practices., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: The main purpose of this study was to investigate the dimensions of cerebral arteries in the Thai population using digital subtraction angiography (DSA), with a focus on the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA). The research aimed to explore anatomical variations in diameters and lengths of these arteries across different sexes and age groups, which are crucial for cerebrovascular interventions., Methods: This retrospective study measured the diameters and lengths of the ACA, MCA, and PCA in 177 Thai patients with an average age of 47.6 years (range: 11-82 years) with normal cerebral angiograms. Digital subtraction angiography (DSA) was used for the measurements., Results: The study found significant sex-based differences in the mean diameters of the left ACA (males: 2.12 ± 0.28 mm, females: 1.92 ± 0.20 mm; p < 0.01), right MCA (males: 2.50 ± 0.25 mm, females: 2.31 ± 0.17 mm; p < 0.01), and left MCA (males: 2.44 ± 0.19 mm, females: 2.30 ± 0.17 mm; p < 0.01) with males exhibiting larger diameters. The right ACA length was significantly longer in males (15.46 ± 1.74 mm) compared to females (13.98 ± 1.92 mm; p < 0.01). While no significant age-related differences were observed in diameters, a significant increase in length with age was noted for the left ACA in the ≥ 60 years group (13.61 ± 1.64 mm) compared to the < 60 years group (12.63 ± 1.36 mm; p < 0.01). Among others, significant correlations were found between the diameters of the left ACA and right MCA (r = 0.699; p < 0.01), and a strong correlation between left ACA length and left PCA diameter (r = 0.975; p < 0.01)., Conclusion: The findings provide invaluable data for tailoring neurosurgical approaches and designing angiographic equipment for the Thai population, emphasizing the importance of considering anatomical variations in clinical practice. These results highlight the necessity for personalized medical care based on anatomical differences to improve cerebrovascular intervention outcomes., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Eating behaviors, which are shaped during childhood, are one of the important factors influencing children's growth. This study aimed to investigate the variations in eating behaviors among Vietnamese preschool children aged 3 to 6 years using the Children Eating Behavior Questionnaire (CEBQ) and their association with anthropometric Z -scores. A cross-sectional study was conducted on 10 172 children from 36 to 72 months old, recruited from three different socioeconomic regions of Hanoi. Differentiation of eating behaviors between two sexes was observed across all age groups, but most obvious at 36 to 48 months of age. The subscales of emotional overeating (EOE), enjoyment of food (EF), and desire to drink (DD) were higher in 60- to 72-month age groups and vice versa for slowness in eating (SE) and emotional undereating (EUE) subscales. Analyses using the general linear model showed that CEBQ subscales were associated with anthropometric Z -scores in both girls and boys., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Older adults are at greater risk of mental health issues. This study examined the factors influencing mental well-being among 2230 Malaysian older adults, using data from the 2018 to 2019 Malaysia Ageing and Retirement Survey. The World Health Organization-Five Well-Being Index (WHO-5) was used to assess mental well-being, and linear regression analysis identified the significant factors. Women had lower mental well-being scores than men ( P = .012, β = -0.016). Chinese ( P = .024, β = -0.020), Indian ( P < .001, β = -0.043), and other ethnicities ( P < .001, β = -0.031) reported lower scores than Malays. The factors associated with better well-being were secondary ( P = .001, β = 0.032) and tertiary education ( P < .001, β = 0.063), and good ( P < .001, β = 0.081) and moderate ( P < .001, β = 0.038) health status. Diseases-limiting activities were associated with poor well-being ( P < .001, β = -0.030). Support from family ( P < .001, β = 0.062) and friends ( P < .001, β = 0.032), social activity participation ( P < .001, β = 0.026), and functional ability ( P < .001, β = 0.043) were significant positive factors. There is a need for targeted interventions to enhance mental health among Malaysian older adults., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep problems in preschoolers., Methods: The cross-cultural adaptation of JSQ-P into Thai version of JSQ-P (TH-JSQ-P) was performed including forward translation, reconciliation, backward translation, and final approval by the original creator. Children aged 2-6 years from community and clinical settings were enrolled. The TH-JSQ-P was completed by parents of preschool children twice within 10-14 days to assess its reliability and validity. Six validity tests including face validity, content validity, structural validity, construct validity, criterion validity and predictive validity were assessed. Demographic data, Epworth sleepiness scale (ESS), medical and behavior problems, and socioeconomic status were collected for analysis., Results: A total of 2613 participants completed the TH-JSQ-P, with 1207 completing it twice to assess test-retest reliability. The TH-JSQ-P had good internal consistency reliability and test-retest ability with Cronbach's alpha value of 0.898 and intraclass correlation coefficient of 0.814. The content validity was acceptable. The ESS had correlation with sleep problems in almost all subscales except for sleep habit., Conclusions: The TH-JSQ-P is a valid and reliable instrument for evaluating sleep problems in preschool children in Thailand. It has the potential to be extensively utilized to screen for sleep problems, thereby enabling healthcare professionals to identify them early and implement prompt management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Examining the rising prevalence of subjective cognitive decline as an early indicator of dementia in adults, this study investigates its complex interaction with loneliness and quality of life in individuals with preclinical dementia. Using a convergent parallel mixed-method approach, we employed Structural Equation Modeling on a cohort of 149 older adults. Qualitative insights were derived from focused group discussions and in-depth semi-structured interviews with a cohort of 23 older adults. Loneliness emerges as a pivotal contributor, exerting a discernible partial indirect effect on quality of life through subjective cognitive decline (indirect effect = -0.145, p = .006). Noteworthy differentials surfaced, with the impact of subjective cognitive decline on quality of life heightened in those with chronic diseases (△ χ 2 = 6.139, p = .013). Loneliness, wielding a palpable impact, intricately interlaces with quality of life, the nexus of which is intricately mediated by subjective cognitive decline., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Data on reference values for lean mass (LM) and fat mass (FM) in the Southeast Asian populations are currently lacking. Therefore, we aimed to estimate the normative values and generate anthropometric prediction models for LM and FM in the Thai population. Methods: Consecutive community-dwelling individuals aged 20-90 years were recruited from Srinagarind Hospital, Khon Kaen, Thailand, between 2010 and 2015. LM and FM were measured using dual energy X-ray absorptiometry. Age and sex stratified percentile of LM and FM were presented. Anthropometric prediction models for LM and FM were developed by using linear regression to generate competing models. Results: A total of 832 individuals (334 males and 498 females) were included in the study. The mean ± SD age, LM, and FM were 50.0 ± 16.2 years, 38.9 ± 8.0 kg, and 15.5 ± 7.7 kg, respectively. LM decreased with age from 49.4 kg in 20-29 years group to 42.3 kg in ≥70 years group in male and 34.6 kg in 30-39 years group to 30.8 kg in ≥70 years group in females. FM has an inverse U-shaped association with age, which peaked at 11.9 kg in 60-69 years group in males and 20.7 kg in 50-59 years group in females. Among the various anthropometric models, the models incorporating age, sex, weight, and height were considered the best fit for predicting both LM and FM. Conclusion: In the Thai population, peak LM was reached during early adulthood and decline with age, whereas FM showed an inverse U-shaped association with age. The prediction models incorporating age, sex, weight, and height were proposed as practical tools for assessing LM and FM in clinical practice.

Our goal is to create a population pharmacokinetic (PK) model and identify the best loading dose (LD) of intravenous valproic acid for hospitalized Thai patients. Data from patients who received intravenous valproic acid and underwent measurement of serum valproic acid concentrations during hospitalization were collected retrospectively. A nonlinear mixed-effects modeling approach was conducted to estimate the PK parameters of valproic acid. Covariates affecting the PK parameters of valproic acid were examined and ranked based on their impact on the model's performance. Monte Carlo simulations of 1000 patients were conducted to estimate the optimal LD of valproic acid. A total of 120 hospitalized patients (51.7% male) with 167 valproic acid concentrations were included in the study. A linear one-compartment model with constant residual error was the best base model. An age-covariate model was the best predictor of valproic acid clearance (CL). The typical values of CL and volume of distribution for valproic acid were 0.77 L/h and 14.56 L, respectively. The LD of 1000-1200 mg intravenous was identified as the pragmatic option as an empirical regimen for hospitalized Thai patients. The recommended time to initiate maintenance dose (MD) is 4-8 h following the LD. The population PK model and optimal LD of valproic acid in hospitalized Thai patients has been established, and it may be advisable to initiate the MD at a later time for the elderly., (© 2024, The American College of Clinical Pharmacology.)

Background: This study aims to investigate the prevalence of possible sarcopenia and its associated factors among middle-aged Vietnamese women. Methods: A cross-sectional study was conducted on 205 women aged 40-55 years who were admitted to the Can Tho Obstetrics and Gynecology Hospital between February and December 2023. The presence of possible sarcopenia was determined according to the AWGS 2019 criteria. Associated factors were dietary intake (total energy, protein, lipid, and carbohydrate intake), the severity of menopausal symptoms by using the Kupperman index, and body composition by using the bioelectrical impedance analysis device, Inbody S10. Logistic regressions were built to analyze the association between possible sarcopenia and its associated factors. Results: The prevalence of possible sarcopenia was 29.8%, with a mean age of 47.2. Possible sarcopenia was detected in 23% of the participants based on the criterion of low handgrip strength, whereas 83.6% of the participants when considered low performance in the chair stand test. Adjusted logistic regression analysis showed that living in a rural area (adjusted odds ratio [AOR]: 2.16, 95% confidence interval [95% CI]: 1.22-4.72), energy intake <25 kcal/body weight, (AOR: 1.94, 95% CI: 1.75-5.06), protein intake <0.91 g/body weight (AOR: 2.42, 95% CI: 1.51-5.76), skipping breakfast (AOR: 2.03, 95% CI: 0.91-4.54), mild menopausal symptoms (AOR: 2.68, 95% CI: 1.61-5.36), and obesity (AOR: 1.59, 95% CI: 1.29-3.67) were significantly associated with higher risk of possible sarcopenia. Conversely, higher muscle mass and higher upper limb mass were associated with a decreased risk of possible sarcopenia (total muscle mass AOR: 0.20, 95% CI: 0.07-0.59). Conclusions: These findings would provide a basis for enhancing management and prevention strategies to reduce the risk of sarcopenia in Vietnam. In particular, attention to nutrient intake and the management of menopausal symptoms may reduce the risk of sarcopenia.

Background: The dialect spoken by children influences diagnostic decision-making regarding the identification and severity of speech sound disorder (SSD)., Aims: The primary objective was to review papers that examined the influence of dialect on the identification of SSD in Vietnamese-speaking children., Methods & Procedures: Five studies of mono- and multilingual Vietnamese-speaking children living in Vietnam and Australia were reviewed to examine the influence of dialect on the assessment and analysis children's speech. The main Vietnamese dialects (Standard, Northern, Central, Southern) differ in the production of consonants, vowels and tones., Main Contribution: Most speech assessments define correct production using the standard dialect of a language. Insights from recent studies of Vietnamese provide recommendations for also considering dialect in diagnostic decision-making. First, we recommend adding column(s) to the assessment score sheet that includes the dialectal variants spoken by adults in the child's family or community. Second, we calculate the accuracy of production twice, based on the standard form and dialectal form. Third, we report the percentage of consonants correct-standard (PCC-S) and percentage of consonants correct-dialect (PCC-D)., Conclusions & Implications: Diagnostic decision-making is influenced by dialectal variation in children's speech, so speech and language therapists need to compare standard and dialectal productions when undertaking assessments, analysis and diagnostic decision-making., What This Paper Adds: What is already known on the subject Most speech assessments use the standard form of a dialect as the correct production. The standard dialect is used for diagnosis of SSD and identification of intervention targets. What this paper adds to the existing knowledge This paper examines five research studies of Vietnamese to identify ways to consider dialect in speech and language therapy assessment and analysis. Vietnamese provides a complex environment for this examination since there are numerous Vietnamese dialects and they differ according to consonants, vowels and tones. What are the potential or actual clinical implications of this work? Speech and language therapists are encouraged to add column(s) to their assessment score sheet that includes the dialectal variants spoken by adults and to report the PCC-S and PCC-D., (© 2023 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Purpose: To develop and validate MNREAD acuity charts in the Thai language (MNREAD-TH)., Methods: In total, 180 Thai sentences were generated using words specific to the primary 1-3 students. Each sentence contained 60 characters divided into three lines with even left and right margins and was evaluated by instructors in the education program in Thai. The selected 118 sentences were tested in 20 adults and 20 children by measuring reading time and recording the errors. Sentences with extremely high or low mean reading speeds were excluded. The remaining sentences were selected for contributing to the MNREAD-TH charts. For validation, the charts were tested in another 20 normal-sighted adult groups., Results: In total, 118 sentences were tested on 20 adults (range: 23-58 years) and 20 primary school students (age: 8-9 years). The mean (SD) reading speeds in adult and children's groups were 134.09 (12.45) and 71.33 (10.77) words/min (wpm), respectively. After removing the sentences that deviated by ±1 SD from the mean reading speed, repeatedly had difficulty words, and had low subjective scoring, 60 matched sentences between the groups were selected to develop three versions of the MNREAD-TH chart. The intraclass correlation coefficients between charts were 0.85 for reading acuity, 0.94 for maximum reading speed, and 0.79 for critical print size., Conclusion: The MNREAD-TH charts can be reliably used for evaluating reading performance in Thai people for both children and adults with either normal sight or low vision. These charts are standardized and helpful in clinical trials involving reading., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Background: Thai older adults are valuable resources in their society. The Thai health service system is challenged when it comes to ensuring that older Thai adults can continue to live healthy and independent lives in society. It is of great value to support independence and improve older people's active ageing. Promoting lifestyle changes by applying the Plan-Do-Study-Act cycle (PDSA cycle), at group meetings in a municipality context, is a way of focusing on active ageing. This study aims to describe older adults´ experiences of lifestyle change six months after finishing group meetings applying the PDSA cycle., Methods: A qualitative approach with individual interviews and a qualitative content analysis were used with 12 Thai older adults who participated in the meetings applying the PDSA cycle., Results: Six months after finishing applying the PDSA cycle, some older adults kept their individual goals and were influenced by their family surroundings. They also formulated additional goals. Three categories and six sub-categories emerged: Keeping individual goals, influenced by the surroundings, and formulation of additional goals were the overall categories., Conclusions: These Thai older adults showed that they had the ability to make lifestyle changes with the support of the PDSA cycle, but not all maintained their planned activities after six months. The question is how healthcare professionals and the surroundings, may further support and motivate these people to maintain these changes based on their own preferences in a sustainable way., (© 2024. The Author(s).)

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals' mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13-4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01-2.24], AOR = 1.48, 95% CI [1.09-2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population., (© 2024. The Author(s).)

Obesity and overweight are major health concerns, with a 19.7% prevalence among Malaysian adults, as reported in the 2019 National Health and Morbidity Survey. This study assessed the effectiveness of an educational intervention on weight control intention using the Health Belief Model (HBM). A quasi-experimental design was employed, involving 140 participants equally divided into an intervention group (IG) and a control group (CG). Post-intervention, the IG showed significant improvement in perceived self-efficacy in dieting (mean score 3.96 ± 0.85) compared to the CG (3.76 ± 0.86, p = 0.003). Perceived self-efficacy in exercise also increased in the IG (4.12 ± 0.52) compared to the CG (3.51 ± 0.94, p < 0.001). While behavioral intention scores improved in the IG (4.00 ± 0.59), the difference was not significant (p = 0.300). This study highlights that educational interventions using HBM can effectively improve self-efficacy and influence weight control behaviors., (© 2024. The Author(s).)

Background: Osteoporosis has been recognized as a significant health issue in Thailand. Pharmacological interventions are important way to prevent fracture. However, one of the main challenges in selecting a medication is high cost, particularly for brand-name drugs. Data on generic bisphosphonate use in Thai are still lacking. Therefore, our study aimed to assess the efficacy and safety of generic risedronate in postmenopausal Thai women with osteoporosis., Methods: This prospective study was conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from December 2022 to January 2024. Serum C-terminal cross-linking telopeptide of type I collagen (CTX) and procollagen type I N-propeptide (P1NP) were measured at baseline. All participants subsequently received 35 milligrams of oral risedronate once weekly for 52 weeks. Serum CTX and P1NP were remeasured at different time points. BMD was reevaluated at 52 weeks after risedronate treatment initiation., Results: A total of 80 participants were included. The mean age was 65.2 ± 6.6 years. The mean body mass index (BMI) was 23.45 ± 3.49 kg/m 2 . The median (IQR) serum CTX level at 12 weeks was significantly lower than that at baseline (0.28 (0.16-0.46) ng/mL versus 0.44 (0.26-0.64) ng/mL, respectively; p value < 0.01). The suppression of serum CTX was confirmed at 52 weeks after treatment initiation. Compared with those at baseline, the serum P1NP levels were significantly lower at 24 weeks after treatment initiation (30.33 (19.19-39.58) ng/mL versus 41.90 (30.33-68.67) ng/mL, respectively; p value < 0.01). In terms of the BMD assessment at 52 weeks, significant improvements were observed in both areal BMD (g/cm 2 ) and T scores at all measured sites compared with baseline. The lumbar spine, femoral neck, and total hip BMD increased from baseline by 4.76%, 3.84% and 4.54%, respectively., Conclusion: Postmenopausal women with osteoporosis who were treated with generic risedronate demonstrated significant suppression of the bone remodelling process at 3, 6, and 12 months after treatment initiation. Additionally, significant improvements in the lumbar spine, femoral neck, and total hip BMD were observed at 12 months of therapy. These findings suggest that generic risedronate could be considered a reasonable and interesting option for treating postmenopausal women with osteoporosis in Thailand., (© 2024. The Author(s).)

Background: Maple syrup urine disease (MSUD) is a rare autosomal recessive metabolic disorder caused by variants in any of the following genes: BCKDHA, BCKDHB, and DBT gene. Previous reports have highlighted a variety of common causing genes and variants among different ethnic groups affected by MSUD. This study is the first to describe the molecular characteristics, potential common variants, clinical phenotypes, and treatment outcomes of 20 Thai MSUD patients before the implementation of expanded newborn screening in Thailand., Results: A cross-sectional, multicenter study was conducted, including twenty Thai MSUD patients from 1997 to 2023. Most of the patients presented with classic neonatal onset (95%). The mortality rate was 20%, while global developmental delay was observed in 40% of the patients. Variants in the BCKDHB gene were detected in 85% (17/20) of the patients, while the BCKDHA gene accounted for 15% (3/20). The study identified the 11-kb deletion involving 5'UTR, exon 1, and intron 1 in the BCKDHB gene, from a position of g.80102385 to g.80113453 (NC&#95;000006.12), accounting for 50% of all variants (20/40 alleles) in Thai MSUD patients. All patients with the 11-kb deletion in BCKDHB presented with the classic type. The gap-PCR for this common deletion was established in the study., Conclusion: This study is the first to describe the clinical and molecular spectrum of Thai MSUD patients before the implementation of expanded NBS. The 11-kb deletion involving exon 1 in the BCKDHB emerges as the most common variant among Thai individuals with MSUD. Furthermore, the gap-PCR test for detecting the 11-kb exon 1 deletion status holds the potential for integration into stepwise molecular analysis following positive expanded newborn screening., (© 2024. The Author(s).)

The association between host country language proficiency and disease prevention among migrants is underexplored. The objective of this study is to assess the extent to which self-reported command of the Thai language is associated with adherence to COVID-19 protective behaviors (CPB) among Myanmar migrant workers in Thailand. We distributed a self-administered structured questionnaire in Burmese language to 1,050 Myanmar migrant workers in Southern Thailand from September 2022 to January 2023. The questionnaire included background characteristics, self-reported Thai language proficiency based on the Common European Framework Reference (CEFR), and self-reported CPB adherence at residence and workplace. We analyzed data using descriptive statistics and multivariate linear regression analysis. Although slightly less than half of the participants reported CEFR A1 level or higher in Thai speaking and listening skills, less than 10 percent did so for reading and writing skills. Workplace COVID-19 preventive adherence scores were initially found to be significantly associated with A1 level or higher speaking and listening skills. However, after adjusting for confounders, these associations were not statistically significant (Speaking skill's Adjusted Beta = 0.713, 95% CI = -0.011, 1.437; Listening skill's Adjusted Beta = -0.367, 95% CI = -1.087, 0.353). No significant associations were found between any language skill domain and residence COVID-19 preventive adherence scores for both unadjusted and adjusted analysis. The study findings may have implications for relevant stakeholders in migrant services, migrant health, and infectious disease control. However, information biases, language barriers, and lack of generalizability should be considered as caveats in the interpretation of the study findings., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2024 Htet et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Artificial Intelligence (AI) has made a profound impact on the medical sector, particularly in radiology. The integration of AI knowledge into medical education is essential to equip future healthcare professionals with the skills needed to effectively leverage these advancements in their practices. Despite its significance, many medical schools have yet to incorporate AI into their curricula. This study aims to assess the attitudes of medical students in Thailand toward AI and its application in radiology, with the objective of better planning for its inclusion., Methods: Between February and June 2022, we conducted a survey in two Thai medical schools: Chiang Mai University in Northern Thailand and Prince of Songkla University in Southern Thailand. We employed 5-point Likert scale questions (ranging from strongly agree to strongly disagree) to evaluate students' opinions on three main aspects: (1) their understanding of AI, (2) the inclusion of AI in their medical education, and (3) the potential impact of AI on medicine and radiology., Results: Our findings revealed that merely 31% of medical students perceived to have a basic understanding of AI. Nevertheless, nearly all students (93.6%) recognized the value of AI training for their careers and strongly advocated for its inclusion in the medical school curriculum. Furthermore, those students who had a better understanding of AI were more likely to believe that AI would revolutionize the field of radiology (p = 0.02), making it more captivating and impactful (p = 0.04)., Conclusion: Our study highlights a noticeable gap in the understanding of AI among medical students in Thailand and its practical applications in healthcare. However, the overwhelming consensus among these students is their readiness to embrace the incorporation of AI training into their medical education. This enthusiasm holds the promise of enhancing AI adoption, ultimately leading to an improvement in the standard of healthcare services in Thailand, aligning with the country's healthcare vision., (© 2024. The Author(s).)

This study investigated Vietnamese people's behavior and future intention to purchase medicines and functional foods online and their associated factors. From March to May 2023, a Google Form questionnaire was distributed via social networks and online platforms. Convenience and snowballing sampling methods were employed to recruit 1,305 Vietnamese people. In the past year, 50.3% of participants purchased at least one kind of medicine and/or functional foods online (medicines: 27.6%, functional foods: 45.1%). Among 656 buyers, nearly a third bought these products more than three times and only 5.9% felt dissatisfied with their previous experiences. This purchasing behavior was more prevalent among females, those married, having higher education levels, usually shopping online, having longer time of Internet use per day, and seeking health information on the Internet (p < 0.001). In addition, 77.5% of participants intended to purchase these products online in the future and 61.2% would introduce this kind of online purchase to other people. The purchase intention was significantly associated with the participants' previous experiences, area, contracting chronic diseases, and using the Internet for self-medication, while factors associated with the introducing intention included their education level, occupation, and previous experiences in online purchases (p < 0.001)., (© 2024. The Author(s).)

Introduction: Hepatitis B is a significant public health concern and a leading cause of liver cancer across the world. In Australia, hepatitis B is largely endemic in migrant communities, particularly amongst the Chinese and Vietnamese communities. Negative attitudes towards hepatitis B can be a major barrier to hepatitis B testing and linkage to care. This mixed-methods research explores the attitudes and beliefs, including stigma, about hepatitis B among students of Vietnamese and Chinese background in Australia. Students were chosen as participants as there is little research examining hepatitis B among university students in Australia and they provide a point of entry to communities with high prevalence of hepatitis B, that otherwise may be hard to access., Methods: Online surveys were distributed in Chinese, Vietnamese, and English via social media and completed by 112 students of Chinese and 95 students of Vietnamese backgrounds. In-depth interviews were also conducted with 13 Vietnamese and 10 Chinese participants to further explore the survey results., Results: Survey findings suggest that students have varied attitudes towards people living with hepatitis B. Around half of the participants reported they would behave negatively towards other people with hepatitis B and that they would expect to experience stigma or discrimination if they had hepatitis B. While over 70% in both samples reported that people who have hepatitis B should not be isolated by family and friends, 47.6% of the Chinese sample and 28.3% of the Vietnamese sample reported they would avoid close contact with someone with hepatitis B. The qualitative data expands on the quantitative data. Four key themes were identified: (1) Caution not discrimination (2) Hepatitis B as a sign of immoral behaviour (3) Discriminatory behaviour based on perceived effects of hepatitis B and (4) Shifting attitudes., Conclusion: This research provides insights that could inform culturally sensitive health promotion programs to address negative attitudes towards hepatitis B among the broader Chinese and Vietnamese communities living in Australia., (© 2024. The Author(s).)

Background: Cardiovascular disease (CVD) remains one of the major causes of death around the world in which ST elevation MI (STEMI) is in the lead. Although the mortality rate from STEMI seems to decline, this result might not be demonstrated in young adults who basically have different baseline characteristics and outcomes compared with older patients., Methods: Data of the STEMI patients aged 18 years or older who underwent PCI during May 2018 to August 2019 from Thai PCI Registry, a prospective, multi-center, nationwide study, was included and aimed to investigate the predisposing factors and short-term outcomes of patients aged < 40 years compared with age 41-60, and > 61 years., Results: Data of 5,479 STEMI patients were collected. The patients' mean age was 62.6 (SD = 12.6) years, and 73.6% were males. There were 204, 2,154, and 3,121 patients in the youngest, middle, and oldest groups. The young patients were mainly male gender (89.2% vs. 82.4% and 66.6%; p < 0.001), were current smokers (70.6%, 57.7%, 34.1%; p < 0.001), had BMI ≥ 25 kg/m2 more frequently (60.8%, 44.1%, 26.1%; p < 0.001), and had greater family history of premature CAD (6.9%, 7.2%, 2.9%; p < 0.001). The diseased vessel in the young STEMI patients was more often single vessel disease with the highest percentage of proximal LAD stenosis involvement. Interestingly, there were trends of higher events of procedural failure (2.9%, 2.1%, 3.3%; p = 0.028) and procedural complications (8.8%, 5.8%, 9.4%; p < 0.001) in both youngest and oldest groups compared to the middle-aged group. In-hospital death was found in 3.4% in the youngest group compared to 3.3% in the middle-aged patients and 9.2% in the older patients (p < 0.001)., Conclusions: Despite experiencing higher rates of procedural failure and complications during treatment compared to middle-aged and older patients, young STEMI individuals demonstrate a significantly lower risk of death during hospitalization and within one year of the event. Younger patients might have a more robust physiological reserve or benefit from more aggressive post-procedure management. However, the higher prevalence of modifiable risk factors like smoking and obesity in younger individuals underscores the need for preventative measures. Encouraging smoking cessation and weight control in this demographic is crucial not only to prevent STEMI but also to potentially improve their long-term survival prospects., (© 2024. The Author(s).)

Background: Post-COVID- 19 syndrome (PCS) significantly impacts the quality of life of survivors. There is, however, a lack of a standardized approach to PCS diagnosis and management. Our bidirectional cohort study aimed to estimate PCS incidence, identify risk factors and biomarkers, and classify clinical phenotypes for enhanced management to improve patient outcomes., Methods: A bidirectional prospective cohort study was conducted at five medical sites in Hatyai district in Songkhla Province, Thailand. Participants were randomly selected from among the survivors of COVID-19 aged≥18 years between May 15, 2022, and January 31, 2023. The selected participants underwent a scheduled outpatient visit for symptom and health assessments 12 to 16 weeks after the acute onset of infection, during which PCS was diagnosed and blood samples were collected for hematological, inflammatory, and serological tests. PCS was defined according to the World Health Organization criteria. Univariate and multiple logistic regression analyses were used to identify biomarkers associated with PCS. Moreover, three clustering methods (agglomerative hierarchical, divisive hierarchical, and K-means clustering) were applied, and internal validation metrics were used to determine clustering and similarities in phenotypes., Findings: A total of 300 survivors were enrolled in the study, 47% of whom developed PCS according to the World Health Organization (WHO) definition. In the sampled cohort, 66.3% were females, and 79.4% of them developed PCS (as compared to 54.7% of males, p-value <0.001). Comorbidities were present in 19% (57/300) of all patients, with 11% (18/159) in the group without PCS and 27.7% (39/141) in the group with PCS. The incidence of PCS varied depending on the criteria used and reached 13% when a quality of life indicator was added to the WHO definition. Common PCS symptoms were hair loss (22%) and fatigue (21%), while mental health symptoms were less frequent (insomnia 3%, depression 3%, anxiety 2%). According to our univariate analysis, we found significantly lower hematocrit and IgG levels and greater ALP levels in PCS patients than in patients who did not develop PCS (p-value < 0.05). According to our multivariable analysis, adjusted ALP levels remained a significant predictor of PCS (OR 1.02, p-value= 0.005). Clustering analysis revealed four groups characterized by severe clinical symptoms and mental health concerns (Cluster 1, 4%), moderate physical symptoms with predominant mental health issues (Cluster 2, 9%), moderate mental health issues with predominant physical symptoms (Cluster 3, 14%), and mild to no PCS (Cluster 4, 77%). The quality of life and ALP levels varied across the clusters., Interpretation: This study challenges the prevailing diagnostic criteria for PCS, emphasizing the need for a holistic approach that considers quality of life. The identification of ALP as a biomarker associated with PCS suggests that its monitoring could be used for early detection of the onset of PCS. Cluster analysis revealed four distinct clinical phenotypes characterized by different clinical symptoms and mental health concerns that 'exhibited varying impacts on quality of life. This finding suggested that accounting for the reduced quality of life in the definition of PCS could enhance its diagnosis and management and that moving toward personalized interventions could both improve patient outcomes and help reduce medicalization and optimally target the available resources., Funding: The research publication received funding support from Medical Council of Thailand (Police General Dr. Jongjate Aojanepong Foundation), Hatyai Hospital Charity and Wellcome Trust., (© 2024. The Author(s).)

Choriocarcinoma is characterized as the most aggressive malignant alternation of gestational trophoblastic neoplasm; however, this illness is a curable malignancy. Although a rarity, this disease affects a female patient's life and causes a fatal condition. Choriocarcinoma is a life-threatening disease since it is initially insidious and can rapidly lead to masive hemorrhage, even death. Choriocarcinoma should be suspected in childbearing-age women with the high-risk scores according to FIGO. The study aims to report a severe case of widespread metastatic choriocarcinoma to optimize the treatment with multiagent chemotherapy and a multidisciplinary cooperation at our center. A G1P0 20-year-old woman was referred to the hospital for suspicion of metastatic choriocarcinoma after self-stopping chemotherapy because of the COVID-19 pandemic. During hospitalization, the tumor metastasized and presented profuse intraabdominal hemorrhage. The patient underwent immediate surgical intervention to control bleeding, and a definitive diagnosis was accurately established by the histopathological examination. After surgery, the EMA/CO regimen was administered as the first line of treatment, despite the patient being in a coma and requiring a ventilator machine. After 6 cycles of the EMA/CO regimen, her serum β-hCG level decreased to 8 mUI/mL, however, her β-hCG concentration was not down to a negative value. Thus, the patient received paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE regimen) for complete remission following 2 cycles. The delays in choriocarcinoma treatment are prognostic factors for worse outcomes, whereas chemotherapy may be considered a suitable treatment even in a patient's coma, thus improving a prognosis substantially.

Background: Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component., Materials and Methods: This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure., Results: T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings., Conclusion: T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity., (© 2024. The Author(s).)

Background: Oxygenation index (OI) is associated with severity of newborn pulmonary hypertension (PH) in congenital diaphragmatic hernia (CDH). Higher OI may indicate worst degree(s) of PH., Objectives: This study reports OI dynamic(s) over the first 72 h of life and its correlation with (1) perioperative morbidity and (2) CDH mortality., Methods: Medical records of inborn CDH babies during 2002-2022 were examined. OI on Days (s) 1-3 and perioperative OI trends were recorded. Operation (primary vs patch repair) and survival rates (%) were studied., Results: Fifty-five CDH newborns (54.5% male: 45.5% female)-mean birth GA 37.5 ± 2.7 wks. had a mean birth weight 2813 ± 684 g with prenatal diagnosis in 32.7% cases. 52/55 (94.5%) were intubated at birth and HFOV deployed in 29 (55.8%). Those requiring HFOV had higher OI on DOL1 (24.8 ± 17 vs 10.3 ± 11.5; p < 0.05), DOL 2 (26.3 ± 22.9 vs 6.7 ± 12.1; p < 0.05) and DOL 3 (21.9 ± 33.8 vs 5.5 ± 9.3; p = 0.04). Operation was undertaken in 36/55 (65.5%). Preoperative mortality group had significant higher OI on DOL 2 (42.1 ± 21.0 vs 14.9 ± 9.3; p = 0.04). CDH defects were-Type A N = 27 (75%), Type B N = 7 (19.4%) and Type C N = 2 (5.6%). Overall mortality was 40% (22/55). Statistically significant OI trends were recorded in non-survival vs. survival groups on DOL 1 (31.6 ± 16.8. vs 10.5 ± 9.0; p < 0.05, DOL 2 (38.1 ± 21.9 vs 6.3 ± 7.1; p < 0.05), and DOL 3 (38.8 ± 39.4; p = 0.012)., Conclusions: OI dynamics are highly predictive for accurate monitoring of CDH cardiorespiratory physiology and crucially may guide ventilatory management as well as timing of surgery., (© 2024. The Author(s).)

Background: Plaque biofilm is a major etiologic factor of periodontitis, and its effective removal prevents or ameliorates the disease. However, toothbrushing alone does not sufficiently clean the interdental area, and additional interdental cleaning is required to completely remove the plaque from this locale. This cross-sectional study aimed to assess the association of interdental cleaning on the prevalence of periodontitis in a large urban Thai adult cohort., Methods: Interdental cleaning data were retrieved from a dental survey of 1,743 employees of the Electricity Generating Authority of Thailand (EGAT) in 2019. The Centers for Disease Control and Prevention/American Association of Periodontology (CDC/AAP) periodontal case definitions were applied. The participants were subdivided into two groups as those with or without periodontitis depending on their oral health status assessed by calibrated professional examiners. The proportion of subjects who performed interdental cleaning was assessed through a self-reported questionnaire by frequency (daily/ ≥ 1 per week/ none) and profile (correct/ incorrect) of interdental cleaning. Then, the association between interdental cleaning and periodontitis was calculated using logistic regression analysis controlling for the common risk factors of periodontitis such as age, sex, education, smoking, and diabetes., Results: Participants who performed interdental cleaning on a daily basis and ≥ 1 per week were 27.5% (95% CI: 25.4, 29.6) and 29.1% (95% CI: 27.0, 31.3), respectively while the remainder did not practice. Of those who used interdental cleaning, about one-half focused on sites with food impaction. There was a significant 44% lower prevalence of periodontitis (adjusted odds ratio of 0.56 (95%CI: 0.40, 0.79) in the cohort with a frequent and correct group., Conclusions: Our data indicate an inverse association between interdental cleaning and periodontitis, particularly in those who routinely adhered to it. Regular interdental cleaning is likely to have a salutary effect on oral health., Trial Registration: The study was registered retrospectively in Thai Clinical Trials Registry, Registration number: TCTR20240817005, on 17 Aug 2024 ( https://www.thaiclinicaltrials.org )., (© 2024. The Author(s).)