Journal of Associated Medical Sciences

Impacts of social media use on occupations of youths with hearing disability in a special education school in upper northern Thailand

Siriyanee Limthongchalearn, Suchitporn Lersilp, Supawadee Putthinoi — Thu, 04 Jan 2024 00:00:00 +0700

Background: Social media have been used increasingly in the daily lives of the global population. Youths with hearing disability participate in many activities through social media, as do those in general. However, due to their hearing loss, they may experience different impacts, particularly in the special education context.

Objective: The purpose of this study was to investigate the impacts of social media use on occupations of youths with hearing disability, and the relationship of activity limitation and participation restriction in the special education school context.

Materials and methods: The participants comprised 92 youths with hearing disability, who were studying in a special education school. The research instrument

was a questionnaire in two forms: paper-based and a sign language video clip. It was presented with acceptable content validity (IOC=0.60-1.00), good internal consistency reliability (α=0.88) and moderate stability reliability (ICC=0.70).

Results: Results showed that most of the participants had their own smart phone and used a hearing aid for access to social media. Frequency of social media use was daily for 1-3 hour(s) per day. Overall, most of the participants had no activity limitation or participation restriction in their occupations, but they showed a minimal level of limitation and restriction in education. In terms of social media use, most of the youths presented a positive impact on occupations, particularly in social participation. The overall results indicated the relationship between activity limitation and participation restriction and impacts of social media use on occupations (r= -0.293, p=0.005). When considering each type of occupation, the results indicated the relationships of education, work, and social participation significantly.

Conclusion: The findings of this study revealed the relationship between activity limitation and participation restriction and overall impacts of social media use on occupations. These findings were applied to social media use, particularly in parts of the text and virtual networks, as an optional channel for providing occupational therapy services and accessing meaningful occupations for youths with hearing disability.

The development of a cylindrical phantom for nanoDotTM calibration with multiple beam angles

Wed, 10 Jan 2024 00:00:00 +0700

Background: The nanoDotTM dosimeter, an optically stimulated luminescent dosimeter (OSLD), is compact and precise, ideal for various applications like radiation dosimetry. The nanoDotTM requires calibration before use with the detector alignment perpendicular to the central beam axis. It exhibits angular dependence that may impact the calibration factor, requiring the fabrication of a specific cylindrical phantom for the calibration procedure.

Objective: This study aimed to develop a cylindrical phantom for nanoDotTM calibration to facilitate dose measurements in composite fields with various beam angles and to evaluate the nanoDotTM calibration factors for different plans.

Materials and methods: The cylindrical phantom was constructed using cast nylon material to accommodate the nanoDotTM or a cylindrical ionization chamber (IC). The novel phantom underwent validation for physical characteristics, including dimensions, density, and uniformity. Validation for the calibration factor, using cylindrical phantom (CF cylin) under standard conditions with a 10x10 cm² field size at 10 cm depth was conducted with 6 MV X-rays, comparing it with calibration factor using slab solid water phantoms (CFsolid). The CFcylin for different numbers of beams were determined and validated against a reference IC in various planning conditions. Furthermore, angular correction factors were determined for their application in the single-beam calibration factor.

Results: The cylindrical phantom had dimensions of 20 cm in diameter and 30 cm in length, a density of 1.145 g/cm³ and good uniformity. As a result of single beam, the CF cylin, agreed well with CFsolid, showing a difference of -0.069%. The CFcylin increased with the number of beams, ranging between 1.179 and 1.242. Additionally, the angular correction factor increased as the number of beams increased, peaking at 1.058 with 9 beams. When comparing the results to the IC, it was observed that with an increase in the number of beams to 4 beams, the single-beam calibration factor exhibited a variation of more than 2%. However, when applying the CF cylin specific to the number of beams or correcting for the angular correction factor, the dose differences between nanoDotTM and IC measurements were within 2%.

Conclusion: The developed cylindrical phantom is suitable for nanoDotTM calibration under single beam angle and in composite fields with various beam angles. The new calibration factors for specific numbers of beams allow for accurate dose measurements using nanoDotTM, thus reducing the dose difference from the IC to acceptable levels. Further studies should investigate its application in clinical situations.

Activity Card Sort’s existence and execute in various languages and versions: A scoping review

Mon, 15 Jan 2024 00:00:00 +0700

Background: Activity Card Sort (ACS) measures patient activity participation, especially in older adults. It was developed to evaluate instrumental, social, and leisure activities of low and high demand in various populations. Transferring an ACS tool between diverse settings is challenging due to significant socio-economic, linguistic, and environmental impacts. Hence, to tailor ACS tools to a specific society’s socio-cultural context, comprehension of the accessible validated ACS tools and their psychometric attributes is essential.

Objective: This scoping review was conducted to explore the availability of the ACS tool and to summarize the psychometric properties, such as the reliability and validity, of different languages and versions of ACS available worldwide.

Materials and methods: A search was performed in PubMed, PsycNET, Cochrane, and Embase. Two independent reviewers conducted the screening process and extracted the data. The total sample included 370 articles, of which 26 studies met the inclusion criteria, providing information on psychometric properties. English and non-English versions (Arabic, Dutch, and Spanish) in different populations were included.

Results: Among the 26 studies in this review, most ACS studies used the English version (62.5%). All the reported studies revealed “good” internal consistency, in which the Cronbach’s alpha (α) ranges between 0.61 and 0.91. Test-retest reliability was measured using ICC values ranging from 0.78 to 0.98 for numeric data and Kappa statistics for binary data. Two studies used Kappa statistics to test the reliability, which ranged from 0.48 to 0.85 for all domains, indicating moderate to good reliability. Measures of content validation, face validity, concurrent, convergent, and discriminative validity were also reported.

Conclusion: Good psychometric properties were reported. No study is available on the Indian population using the ACS tool. Hence, developing and validating an ACS tool for the Tamil Nadu population is needed.

Speech services by speech volunteers for children with cleft lip and palate in professional lacking area: Pilot study

Wed, 07 Feb 2024 00:00:00 +0700

Background: Cleft lip and cleft palate are the most common birth defects. Children with cleft lip with or without cleft palate (CP±L) face a vary of challenges, depending on the type and severity of the cleft including speech difficulty, dental problems, feeding difficulty, ear infections and hearing loss. Articulation error is the most common residual defect in children with cleft palate with or without cleft lip.

Objective: To compare the numbers of pre- and post- articulation errors after using the Model of Speech Therapy by Volunteers (STV) for children with CP±L.

Materials and methods: 9 children, aged range 6; 4-14; 2 years old, were included in this study and completely participated in the study. Pre- and post-articulation tests by Myanmar Articulation, Resonation, Nasal Emission and Nasal Turbulence Test were assessed at Mahamuni Monastery, and Thiriyadana Guha Pone Htoon Shan Monastery, Tachileik, Myanmar. STV is composed of a 3-day speech camp (1^st month), 3 times 1-day site visits for complicated cases (2^nd, 6^th, and 10^th months) and 3 times of 1-day follow-up speech camps (4^th, 8^th, and 12^th months), Phonological approaches, traditional strategies, and specific techniques for speech correction in children with CP±L were taught to speech volunteers (SVs) and caregivers. Homework was assigned to SVs and caregivers. SVs provided a session of 45-minute speech correction every week. Caregivers practiced 5 sessions of 30 minutes in speech exercises /weeks at home.

Results: STV revealed significant reductions in the numbers of articulation errors including articulation screening test [median difference: MD=6 (95% confident interval: CI=5.2-9.2)], and Myanmar articulation standard test at both word and sentence levels; [MD=8 (95% CI=6.5-10.8) and MD=5 (95% CI=4.2-8.3), respectively].

Conclusion: STV significantly decreased a number of articulation errors in children with CP±L of Myanmar, a professional lacking area, and could be applied in any area that has a similar situation. The result was a primary study, the further research should enroll more participants for generalization.

Does mild chronic obstructive pulmonary disease need a standard pulmonary rehabilitation program? A case report

Mon, 12 Feb 2024 00:00:00 +0700

Background: Patients with mild chronic obstructive pulmonary disease (COPD) are usually not recommended for a standard pulmonary rehabilitation (PR)program based on the GOLD guideline in mild COPD GOLD A classification. Especially, the scientific evidence on exercise capacity that can be identified for recruitment in PR programs has been less reported. Thus, a preliminary case study to identify the exercise capacity under cardiopulmonary responses by aerobic exercise testing among patients in mild COPD GOLD A classification was the aim of this study.

Objective: To evaluate the cardiopulmonary responses from exercise capacity testing in individual COPD patients with mild COPD GOLD A Classification.

Materials and methods: Four participants with mild COPD GOLD A performed an exercise endurance capacity test at home using Spot Marching Exercise Test (SMT), marching on the spot with high hip and arm raising. The load of SMT was indicated by a controlled stepping rate at 70, 80, 90, 100, and 110 steps/min. Every participant performed Incremental SMT (ISMT) with every 3 min incremental load, and the Constant SMT (CSMT) at the peak load. Both exercise tests were terminated at symptom limit. Resting time between ISMT and CSMT was at least 30 minutes. Cardiopulmonary exercise responses, Borg perceived breathlessness (RPB) and exertion (RPE) were monitored every minute during the exercise test. The duration of exercises was recorded.

Results: Peak exercise capacity using ISMT was low with the end exercise load at 70, 80, 80, and 90 steps/min which is equivalent to moderate to high intensity at 81%, 62%, 65% and 93% of age-predicted maximum heart rate (HRmax). The exercise test was stopped by breathlessness at RPB 7, 8, 6, and 5. Respiratory rates (RR) were 36, 26, 38, and 38 breaths/min. With CSMT, the results showed very short exercise duration 1.78, 4.60, 2.15, and 2.47 mins with RPB 7, 8, 5, and 5 and RR of 33, 27, 34, and 41 breaths/min respectively.

Conclusion: This preliminary report reveals that all four mild COPD GOLD A show low exercise capacity and very poor exercise endurance that should identify the appropriated standard PR program in the future.

Comparative analysis of deep learning techniques for accurate stroke detection

Titipong Kaewlek, Ketmanee Sitinwan, Kunaporn Lueangaroon, Wasita Sansuriyawong — Mon, 12 Feb 2024 00:00:00 +0700

Background: The traditional diagnosis of strokes through computed tomography (CT) heavily relies on radiologists’ expertise for accurate interpretation. However, the increasing demand for this critical task exceeds the available radiologist workforce, necessitating innovative solutions. This research addresses this challenge by introducing deep learning techniques to enhance the initial screening of stroke cases, thereby augmenting radiologists’ diagnostic capabilities.

Objective: This study aims to compare four techniques for classifying stroke lesions in CT images.

Materials and methods: Four distinct models-CNN-2-Model, LeNet, GoogleNet, and VGG-16-were trained using a dataset comprising 1,636 CT images, including 1,111 normal brain images and 525 stroke images. Seventy percent of the images were used to train the most effective deep learning model, and subsequently, these images were utilized to evaluate the performance of each model. The evaluation involved assessing accuracy, precision, sensitivity, specificity, F1 score, false positive rate, and AUC.

Results: The evaluation process included a comprehensive statistical analysis of the models’ prediction results. The findings revealed that VGG-16 emerged as the top-performing deep learning model, achieving an impressive accuracy of 0.969, precision of 0.952, sensitivity of 0.952, specificity of 0.978, F1 score of 0.952, false positive rate of 0.022, and AUC of 0.965.

Conclusion: In conclusion, deep learning techniques, particularly the VGG-16 model, demonstrate significant promise in enhancing the accuracy of stroke lesion classification in CT images. These findings underscore the potential of leveraging advanced technologies to address the growing challenges in stroke diagnosis and pave the way for more efficient and accessible healthcare solutions.

Cognitive intervention using Montessori and DementiAbility for people with mild cognitive impairment

Thu, 22 Feb 2024 00:00:00 +0700

Background: Age-related illnesses are more prevalent with advancing age, with seniors facing more chronic diseases and disabilities. Chronic diseases that mostly older adults deal with are caused by high blood pressure, diabetes, and high cholesterol-also called noncommunicable diseases (NCDs). NCDs can cause severe chronic diseases such as heart disease, kidney failure, and cerebrovascular disease, and these can result in a high risk of Mild Cognitive Impairment (MCI). Together, brain cells shrink around 2,000 million cells when getting older, causing difficulty recalling names or words, decreased attention span, or a decreased ability to handle many tasks simultaneously. Therefore, protecting senior citizens with MCI needs to be seriously consideration.

Objectives: This quasi-experimental research aimed to study the effects of a program to reduce brain deterioration in older people with Mild Cognitive Impairment (MCI).

Materials and methods: The samples consisted of senior males and females requiring service at Songkhla Rajanagarindra Psychiatric Hospital, Songkhla, Thailand. A sample group was selected using an equivalent group design. The researcher utilized inclusion and exclusion criteria to gather 32 older adults and employed a simple random selection into experimental and control groups. For three months, the experimental group engaged in a seven-care-kit program based on Montessori’s philosophy and DementiAbility methods to help protect against brain deterioration. Mann-Whitney U test and Wilcoxon Value were used to analyze the result of the program’s effectiveness, which assessed cognitive ability by MoCA.

Results: The attention span domain showed a significant statistical difference at (p=0.03) after post-tests comparing the experimental and control groups. A comparison of the pre-test and post-test of the experimental group found four domains-total cognitive domain, attention span domain, delayed recall domain, and visuospatial perception domain were significant with a statistical difference of (p=0.001, p=0.002, p=0.003, and p=0.004 respectively). Moreover, two domains- the delayed recall domain and the total cognitive domain in the control group showed a significant statistically increasing difference at (p=0.001 and p=0.005, respectively).

Conclusion: The senior citizens’ active daily activities may help protect against dementia in older adults with MCI. The Home-Based Protection of Brain Deterioration Program demonstrated a satisfactory program that enhanced the attention span, visuospatial domain, and delayed recall of older people with mild cognitive impairment. Hence, the program as a dementia prevention program for older adults with MCI.

Effect of mangiferin isolated from Mangifera indica leaves on in vitro blood coagulation and cell migration activities

Fri, 23 Feb 2024 00:00:00 +0700

Background: Mangiferin, a natural compound has been reported to possess a variety of biological activities such as anticancer, anti-diabetic, antimicrobial, antioxidant, cardioprotective activities, etc. Screening on blood coagulation activity effects of mangiferin might be helpful for further activities investigation.

Objective: This study aimed to isolate mangiferin from mango leaves and evaluate its blood coagulation and anticancer activities against human lung cancer cell lines (A549 cells).

Materials and methods: Mangiferin was extracted from mango leaves and characterized by IR, NMR, and mass spectroscopic techniques. It was determined in vitro activities as follows: blood clotting time, platelet aggregation, activated partial thromboplastin time (aPTT), prothrombin time (PT), clot lysis, fibrinolysis, and cell migration assay.

Results: It was found that mangiferin had a significantly slower effect on inducing blood clots than the control group, with the coagulation value of 13.09±2.97 minutes and decreasing platelet aggregation at an inhibition percentage value of 14.1±1.2. There was significant (p<0.05) prolongation of PT and aPTT activities tested with the mangiferin at the value of 12.4±1.2 and 29.9±3.1 seconds, respectively. However, mangiferin was unable to cause fibrin clot dissolution on fibrinolysis test. Mangiferin also showed anticancer activity against A549 cells by inhibition of cell migration assay.

Conclusion: Mangiferin showed antiplatelet aggregation activity and prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) assay without fibrinolysis activity. In addition, mangiferin showed anticancer activity against A549 cells by inhibiting cell migration.

Sine hunter prey optimization enabled deep residual network for diabetes mellitus detection using tongue image

Jimsha K. Mathew, S. Sathyalakshmi — Tue, 27 Feb 2024 00:00:00 +0700

Background: Many people suffer from Diabetes Mellitus (DM), a disease caused by high blood glucose levels. In real-time, many methods are implemented to diagnose DM to obtain a good accuracy level, but those methods remain costlier.

Objective: To develop a method for DM detection with good accuracy and minimum cost.

Materials and methods: In this research, DM is detected using tongue image based on DL model, named Deep Residual Network (DRN) that is trained by proposed Sine Hunter Prey Optimization (SHPO). Here, an adaptive median filter is used for the pre-processing phase, and image segmentation is done using ResUNet++, which is trained by Exponential Anti Corona Virus Optimization (ExpACVO). Here, ExpACVO integrates Anti Corona Virus Optimization (ACVO) and Exponential Weighted Moving Average (EWMA). Further, image augmentation and appropriate feature extraction stages are carried out, leading to DM detection by DRN. Moreover, SHPO is formed by combining the Sine Cosine Algorithm (SCA) and Hunter Prey Optimization (HPO). The performance of the proposed method is analyzed using the Tongue image dataset and the Diabetic images dataset.

Results: The performance of SHPO_DRN is found using four evaluation metrics: accuracy, sensitivity, specificity, and f-measure. Here, these metrics exhibit superior performance with high-range values of 0.961, 0.970, 0.948, and 0.961.

Conclusion: The proposed method detects the DM at earlier stages with a good accuracy.

CRISPR 2 spacer architecture analysis and virulotyping for epidemiological study of Salmonella enterica subsp. Enterica circulating in northern Thailand (2015 -2017)

Tue, 27 Feb 2024 00:00:00 +0700

Background: Salmonella enterica subsp. enterica, particularly serotype S. 4[5],12:i:-, S. Typhimurium, and S. Enteritidis, represents a significant causative agent of diarrhea, particularly impacting children and immunocompromised individuals on a global scale. Molecular typing of Salmonella spp. has a vital role in understand Salmonella epidemiology.

Objective: The objective of this study is to utilize CRISPR 2 spacer analysis coupled with multiple-locus variable number tandem-repeat (VNTR) analysis and virulotyping to perform molecular typing and potential subtyping of Salmonella spp.

Materials and methods: CRISPR 2 - multiple-locus variable number tandem-repeat (VNTR) analysis, complemented by additional virulotyping, were performed to rapidly characterize those Salmonella isolates including eight unidentified strains. Serotype-specific CRISPR 2 amplicons were subjected to sequencing and the obtained sequences were blasted with corresponding whole-genome sequencing (WGS) data in order to extract CRISPR 2 information, especially the number and sequence of spacers which were then utilized to predict Salmonella serotypes. Moreover, the similar CRISPR 2 spacer architectures to the corresponding WGS offered the prediction of multilocus sequence types (MLST).

Results: S. 4,[5],12:i:-, S. Typhimurium, S. Enteritidis, S. Weltevraden, and S. Derby exhibited distinct clustering, while eight unidentified Salmonella serotypes displayed unique CRISPR 2-MLVA profiles. Through subsequent sequence analysis and comparison with publicly available whole-genome sequencing data, serotype-specific CRISPR 2 amplicon lengths and spacer architectures were unveiled, enabling precise prediction of MLST types. Intriguingly, a linear correlation emerged between CRISPR 2 amplicon length (500-2000 bps) and the number of spacers (6-32) across diverse Salmonella serotypes. Critically, the molecular signatures of CRISPR 2 amplicons accurately predicted the identity of eight unknown Salmonella isolates, aligning with conventional serotyping standards. Furthermore, MLST sequences for prevalent S. 4,[5],12:i:-, S. Typhimurium, and S. Enteritidis were unveiled as ST 34, ST 19, and ST 10, respectively. Subtyping of S. 4,[5],12:i:- using the sopE1 procession (a bacteriophage gene) revealed two major subtypes within ST 34. These subtypes encompassed all six virulent genes, including InvA, bcfC, csgA, agfA, sodC1, and gipA, either with sopE1 (N=8) or without sopE1 (N=10). These findings contribute preliminary insights into the genetic diversity and subtyping of S. 4,[5],12:i:-.

Conclusion: The combination of CRISPR 2 sequence analysis and virulotyping emerged as a potent epidemiological tool, facilitating the identification of Salmonella serotypes and potentially informative subtypes, thereby aiding in the surveillance, and tracking of Salmonella transmission in northern Thailand.

A comparison of the phonation quotient between patients with voice disorders caused by benign vocal fold lesions and normal adults 20-80 years of age

Mon, 04 Mar 2024 00:00:00 +0700

Background: A voice evaluation is an important first step in analyzing voice symptoms and determining appropriate treatment plans. The phonation quotient is a valid aerodynamic parameter in voice evaluations which is an indirect source of information for evaluating the valve function of the vocal folds of patients with voice disorders, especially patients with voice disorders caused by tumors of the vocal folds which is the most common cause in the patients with voice disorders.

Objective: The present study aims to determine and compare the phonation quotient between patients with voice disorders caused by benign vocal fold lesions and normal adults between 20-80 years of age.

Materials and methods: The participants comprised 40 adults with voice disorders caused by benign vocal fold lesions and 40 with normal voices. All participants’ voices were evaluated in the Speech Clinic at Ramathibodi Hospital, Bangkok. The phonation quotient (PQ) was calculated by the ratio of vital capacity (VC) to the maximum phonation time (MPT). VC and MPT were measured using a phonatory aerodynamic system (PAS).

Results: The results of the present study indicated that the mean value of the PQ of adults with normal voices was 122.60 cc/sec (SD=16.36). The mean value of the PQ of adults with voice disorders caused by benign vocal fold lesions was 292.08 cc/ sec (SD=97.14). The mean value of the PQ in the group with voice disorders caused by benign vocal fold lesions was significantly more significant than the mean value of the PQ in the group with normal voice.

Conclusion: The significant difference between the phonation quotient of adults with voice disorders caused by benign vocal fold lesions and adults with normal voice was that the PQ might be an indicator for indirect evaluation of the airflow leakage related to the efficiency of vocal fold movement during phonation. The PQ can be the optional voice measurement for monitoring and analyzing the outcomes of voice therapy.

Analyzing DNA barcoding and identifying toxins caused by neurotoxic mushroom poisoning using liquid chromatography tandem mass spectrometry

Mon, 04 Mar 2024 00:00:00 +0700

Background: Neurotoxic mushroom poisoning often exhibits rapid symptom onset, typically attributed to compounds such as Ibotenic acid, which affect the central nervous system. This study addresses a new case of mushroom-related food poisoning in southern Thailand.

Objective: The objectives are to determine the presence of ibotenic acid in cases of mushroom-related food poisoning utilizing liquid chromatography-tandem mass spectrometry (LC-MS/MS) and to identify toxic Amanita species implicated in these cases.

Materials and methods: Remnant mushroom samples obtained from three clinically reported cases were used. Nucleotide similarity was compared against the rRNA/ ITS databases using NCBI BLAST search. Phylogenetic analyses were conducted using maximum likelihood (ML) and FastTree approaches. LC-MS/MS was employed to separate of Ibotenic acid, determine its molecular weight and perform precursor ion fragmentation.

Results: Analysis of the rRNA/ITS databases revealed a high nucleotide similarity between suspected mushroom samples and Amanita digitosa. Detailed phylogenetic analysis confirmed that mushroom samples from the three poisoning cases clustered with A. digitosa. LC-MS/MS analysis showed the presence of ibotenic acid, with precursor ion (m/z 159) and product ion (m/z 113.1) as the major toxic substances. Clinically, patients poisoned by ibotenic acid-containing mushrooms exhibited a short latent period with symptoms of nausea, vomiting, vertigo, delirium, confusion, and fatigue.

Conclusion: The genus Amanita comprises both edible and inedible species that produce several lethal toxins. The report of ibotenic acid in A. digitosa is a novel finding, valuable for food safety monitoring and healthcare decision-maker. This is especially notable due to the accuracy and rapidity of the analytical process.

Balance abilities in high dynamic-sport athletes with different maximal voluntary contraction

Pornpimol Konkeaw, Sainatee Pratanaphon — Wed, 13 Mar 2024 00:00:00 +0700

Background: Previous studies have shown that muscle force control during submaximal isometric contractions is associated with the ability of dynamic balance to a greater extent than static balance in healthy adults. However, the effect of maximal voluntary contraction (MVC) on balance abilities of athletes with high dynamicsport, which are most popular in Thailand, needs to be addressed.

Objective: To determine static and balance abilities of high dynamic-sport athletes at different levels of MVC.

Materials and methods: Three groups of high dynamic-sport athletes at different levels of maximal voluntary contraction (MVC), were voluntarily recruited using a sports matrix classification. Outcome measures comprised the Balance Error Scoring System (BESS) and the Star Excursion Balance Test (SEBT). Correlations between BESS and SEBT and confounding variables comprised of performance time of the Mcgill core endurance tests (Core), single-leg sit-to-stand (STS) test, and flexibility were investigated using Pearson’s correlation. After controlling for Core and STS, a factorial analysis of covariance (ANCOVA) was used to determine group differences in SEBT and BESS variables.

Results: Athletes with high- and low- MVC had significantly different reaching distances in all SEBT directions (all, p<0.05). Significant differences between the high- and the moderate- MVC groups were observed in anterior and lateral directions (p<0.05). A significant difference between the moderate- and the low MVC groups was found in the medial direction (p<0.05). After controlling for Core and STS, the observed group differences disappeared, except in the posterolateral reaching distance between the high- and the low-MVC groups (p<0.05). A significant difference between the high- and the low-MVC groups was only observed in the total foam BESS scores with tandem stance (p<0.05) and then disappeared after adjusting for Core and STS (all, p>0.05).

Conclusion: The observed differences in all SEBT directions among groups and the difference in the total BESS scores between the high- and the low- MVC, which were observed only in challenged conditions i.e., tandem-foam stance, suggested that dynamic, but not static balance performance of athletes with high dynamicsport appears to be associated with the magnitude of MVC. Core and STS, but not flexibility, are considered significant contributions to their balance performance.

Preliminary study of distal forearm bone mineral density in residents of Doi Lo District: Observation and comparison with Mae Chaem, and Omkoi Districts, Chiang Mai Province, Thailand

Tue, 19 Mar 2024 00:00:00 +0700

Background: We previously reported distal forearm bone mineral density (BMD) information for individuals residing in Mae Chaem and Omkoi districts, Chiang Mai Province, Thailand.

Objective: This study was aimed to observe distal forearm BMD in residents of Doi Lo District and compare this data with individuals residing in Mae Chaem District and Omkoi District in Chiang Mai Province, Thailand.

Materials and methods: Two hundred fifty-one subjects (215 women, 36 men), aged 24 to 69 years, currently reside in Doi Lo District. BMD was measured on the non-dominant distal forearm using peripheral dual-energy X-ray absorptiometry (pDEXA). Subsequently, data from Doi Lo District were compared with data from Mae Chaem District and Omkoi District obtained from earlier studies.

Results: Distal forearm BMD decreased, and the prevalence of osteoporosis increased in both females and males across age groups. This trend was consistent with data from Mae Chaem District and Omkoi District.

Conclusion: This study demonstrated the prevalence of distal forearm BMD and osteoporosis among females and males in Doi Lo District. The findings from Doi Lo District were consistent with those from Mae Chaem District and Omkoi District in Chiang Mai Province, Thailand. These results provide valuable insights into bone health among residents of Chiang Mai Province, Thailand.

A comparative study of pre-processing methods to improve glioma segmentation performance in brain MRI using deep learning

Kasatapad Naknaem, Titipong Kaewlek — Tue, 19 Mar 2024 00:00:00 +0700

Background: Glioma is the most common brain tumor in adult patients and requires accurate treatment. The delineation of tumor boundaries must be accurate and precise, which is crucial for treatment planning. Currently, delineating boundaries for tumors is a tedious, time-consuming task and may be prone to human error among oncologists. Therefore, artificial intelligence plays a vital role in reducing these problems.

Objective: This study aims to find a relationship between improving image enhancement and evaluating the performance of deep learning models for segmenting glioma image data on brain MRI images.

Materials and methods: The BraTs2023 dataset was used in this study. The image dataset was converted from three dimensions to two dimensions and then subjected to pre-processing via four image enhancement techniques, including contrast-limited adaptive histogram equalization (CLAHE), gamma correction (GC), non-local mean filter (NLMF), and median and Wiener filter (MWF). Subsequently, it was evaluated for structural similarity index (SSIM) and mean squared error. The deep learning segmentation model was created using the U-Net architecture and assessed for dice similarity coefficient (DSC), accuracy, precision, recall, F1-score, and Jaccard index for tumor segmentation.

Results: The performance of enhanced image results for CLAHE, GC, NLMF, and MWF techniques shows SSIM values of 0.912, 0.905, 0.999, and 0.911, respectively. The dice similarity coefficient (DSC) for segmentation without image enhancement was 0.817. The DSC of segmentation for CLAHE, GC, NLMF, and MWF techniques were 0.818, 0.812, 0.820, and 0.797, respectively.

Conclusion: The enhanced image technique could affect the performance of tumor segmentation. by the enhanced image for use in a trained model may increase or decrease performance depending on the chosen image enhancement technique and the parameters determined by each method.

Evaluation of the offset couch parameter between kilovoltage on-board imaging and cone-beam computed tomography in patients with prostate cancer

Thu, 21 Mar 2024 00:00:00 +0700

Background: External Beam Radiation Therapy (EBRT) is a curative therapy technique for prostate cancer. Since the prostate is unstable and surrounded by the bladder and rectum, precision of the target location is critical. Image Guided Radiation Therapy (IGRT) can improve treatment precision. The bladder and rectum may alter volume during IGRT, shifting the prostate’s position and resulting in missed target volume doses and extra organs at risk (OARs) doses.

Objective: To assess setup error and residual error during patient positioning, as well as the current IGRT protocol efficiency, in prostate cancer patients while recommending a planning target volume (PTV) margin.

Materials and methods: The offset couch parameter of on-board imaging (OBI) and cone-beam computed tomography (CBCT) was computed to determine the error distribution, magnitude, and error difference between treatment phases. The systematic and random errors were calculated using the van Herk equation to determine the planning target volume (PTV) margin.

Results: The setup error was -0.86 to 0.25 mm, and the residual error was -0.15 to 0.32 mm. The couch displacement percentage for OBI was 29.44% to 58.89%, and for CBCT was 8.10% to 34.12%. The systematic error was 1.65 to 3.21. The random error was 1.78 to 3.29. The setup error was greatest in the longitudinal (Lng) direction, residual error was greatest in the vertical (Vrt) direction, and systematic and random error were greatest in the Vrt and lateral (Lat) direction, respectively. The PTV margin was greatest in the Vrt direction, while the Lng direction was the narrowest margin for every treatment phase.

Conclusion: The highest setup error occurs in the Lng direction for all treatment phases. For the 46 Gy and 60 Gy phases, the highest residual error is in the Vrt direction. However, in the 78 Gy phase, the error is relatively close to 0.01mm in every direction. The current IGRT protocol is effective in detecting setup and residual errors. The 78 Gy phase has the greatest PTV margin, whereas the 46 Gy phase shows the narrowest margins in all directions.

AI-based diagnosis of chronic obstructive pulmonary disease from low-dose CT images

Wed, 10 Apr 2024 00:00:00 +0700

Background: Chronic obstructive pulmonary disease (COPD) is a group of diseases characterized by airflow blockage. It is one of the leading causes of global mortality and is primarily attributed to smoking. COPD patients are usually diagnosed by spirometry test. Although regarded as the gold standard for COPD diagnosis, the spirometry test carries contraindications, thus prompting the development of low-dose computed tomography (low-dose CT) scan as an alternative for COPD screening. However, a practical limitation of diagnosing COPD from CT images is its reliance on the expertise of a skilled radiologist.

Objective: To address this limitation, we aimed to develop a deep-learning model for the automated classification of COPD and non-COPD from low-dose CT images.

Materials and methods: We examined the potential of a convolutional neural network for identifying COPD. Our dataset consisted of 10,000 low-dose CT images obtained from a lung cancer screening program, involving both ex-smokers and current smokers deemed at high risk of lung cancer. Spirometry data served as the ground truth for defining COPD. We used 90% of the datasets for training and 10% for testing.

Results: Our developed model achieved notable performance metrics: an area under the receiver operating characteristic curve (AUC) of 0.97, an accuracy of 0.89, a precision of 0.85, a recall of 0.96, and an F1-score of 0.90.

Conclusion: Our study demonstrates the potential of deep learning models to augment clinical assessments and improve the diagnosis of COPD, thereby enhancing diagnostic accuracy and efficiency. The findings suggest the feasibility of integrating this technology into routine lung cancer screening programs for COPD detection.

Community rehabilitation by the trained village health volunteers on activities of daily living and quality of life in stroke survivors

Wed, 24 Apr 2024 00:00:00 +0700

Background: The number of people with disabilities resulting from strokes is increasing in Thailand. The major sequela of the disease was weakness in one side of the body that causes difficulty in activities of daily living (ADL) and poor quality of life (QOL) for stroke survivors. Community-based rehabilitation could be one of the strategies that enhances functional performance and improves QOL in these individuals. There were many disabled people in Mae Ka subdistrict, San Pa Tong District, Chiang Mai Province, where health care providers and local people were enthusiastic to take care of each other’s health in the community.

Objective: The present study aimed to investigate rehabilitation outcomes in ADL and QOL of stroke participants who received rehabilitation services from trained village health volunteers (VHVs).

Materials and methods: This study was a quasi-experimental research design. Subjects were recruited using purposive sampling, including 10 stroke survivors. Instruments used were 1) ADL Assessment for Occupational Therapy Clients; and 2) World Health Organization Quality of Life Assessment, Short Form-Thai version. The statistics used were descriptive, as well as the Wilcoxon Signed Ranks Test.

Results: Results demonstrated that scores of basic activities of daily living (BADL) in the participants increased significantly (p<0.05) except for sexual expression. The score in the instrumental activities of daily living (IADL) was also significantly higher at post-rehabilitation than pre-intervention (p<0.05), as was the total ADL score. Stroke patients had significantly higher QOL scores after intervention than the pretest (p<0.05).

Conclusion: These indicated that the community rehabilitation center at Mae Ka Subdistrict Administrative Organization, San Pa Tong District, Chiang Mai Province, run by the trained VHVs could promote ability in daily activities and improve QOL in stroke participants who come for their services.

Development and implementation of the external quality assessment program for erythrocyte sedimentation rate in hematology laboratories in Thailand

Fri, 26 Apr 2024 00:00:00 +0700

Background: The erythrocyte sedimentation rate (ESR) remains the most widely used screening test for monitoring the course of infections, inflammatory diseases, and some types of cancer. Proficiency Testing (PT) programs are unavailable in Thailand for ESR.

Objective: This study aimed to develop and initiate the PT program to improve testing quality through evaluation and analysis of the laboratory test results for ESR.

Materials and methods: The PT program for ESR was established at the AMS CMU EQA Unit by the ISO/IEC17043:2010 requirements. The unit produced and sent the ESR control materials to participants for laboratory analysis; the test results were returned to the unit. The PT program was carried out in two cycles per year, with two samples in each cycle. The performance of each laboratory was assessed using robust Z score and performance score.

Results: ESR control materials presented with satisfactory homogeneity and stability according to ISO 13528: 2015. One hundred and four laboratories were enrolled in the PT program. Of these laboratories, 96 (92.3%) returned their data: 40 (42.7%) used the modified Westergren method, 29 (29.2%), 14 (15.7%), and 13 (12.4%) used Microsed, Mixrate, and other methods, respectively. Satisfactory and questionable performance was obtained in 82/96 (85.4.%) and 8/96 (8.3%), respectively. Unsatisfactory performance was noted at 6/96 (6.3%). The level of excellent performance was achieved by 82 (approx. 85%) of these laboratories. Two main types of errors found from analyzing the received data were (i) specimen processing and (ii) incorrect identification of the analytical method.

Conclusion: Our results indicate that the advantage of participation in the PT program for ESR is that the laboratories can monitor and investigate the source of laboratory errors. Therefore, the PT program for ESR testing should become an integral part of the quality assurance system in the laboratory.