Interdependent relationship between depression and Internet gaming disorder in parent-child dyads: The mediating role of family relationship and gaming time

by Qian Li, Yilun Huang, Samuel Yeung-Shan Wong, Winnie W. S. Mak, Xue Yang

Background and objective

A well-established link exists between depression and Internet gaming disorder (IGD) at the individual level, while it remains unexplored within the family system. This study aims to investigate the interdependent relationship between parent and adolescent depression and IGD, and to identify the potential mechanisms.

Methods

A cross-sectional dyadic study was conducted with adolescents and their parents (primary caregiver) in Hong Kong. Adolescents completed anonymous surveys in classrooms, and parents completed online surveys via WhatsApp or phone interviews. The Actor-Partner Interdependence Model (APIM) and Actor-Partner Interdependence Mediation Model (APIMeM) were utilized to test the interdependence and mediators between depression and IGD in parent-child dyads, respectively.

Results

A total of 1,277 parent-child dyads were included. Depressive symptoms in parents (β = 0.072) and adolescents (β = 0.273, both p  Conclusions

Adolescent depressive symptoms were positively associated with their own and parental IGD symptoms, which were mediated by adolescent-reported family relationships and adolescent gaming time. The influence of adolescents’ mental health problems on parents’ problematic behaviors within the family system should not be overlooked.

Effect of intravenous vitamin C administration on chemotherapy-induced adverse events in patients with nasopharyngeal cancer

by Peesit Leelasawatsuk, Pasawat Supanimitjaroenporn, Nattida Rodsom, Theepat Wongkittithaworn, Manupol Tangthongkum

Nasopharyngeal carcinoma is prevalent in Thailand, with a substantial proportion of cases diagnosed at advanced stages. The standard treatment, concurrent chemoradiotherapy, is associated with considerable adverse effects, which may compromise therapeutic efficacy and diminish patients’ quality of life. While vitamin C has shown potential in reducing chemotherapy-induced toxicities in some cancers, its effects in nasopharyngeal carcinoma remain unclear. In this randomized, double-blind, placebo-controlled trial, patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy were assigned to receive either 2 g of intravenous vitamin C or placebo prior to chemotherapy. The incidence of gastrointestinal adverse effects—including nausea, anorexia, mucositis, diarrhea, and dysphagia—did not differ significantly between groups. However, longitudinal analysis demonstrated a significantly attenuated decline in platelet counts in the vitamin C group compared with placebo. Although intravenous vitamin C did not reduce gastrointestinal toxicities, the observed platelet preservation suggests a potential supportive effect that warrants further investigation. Trial registration The study was registered with the Thai Clinical Trial Registry (TCTR20190316003) on March 16, 2019.

Associations of tumor necrosis factor alpha genetic variants with metabolic syndrome and type 2 diabetes mellitus in a Thai population

by Metha Yaikwawong, Khanittha Kamdee, Kasarnchon Mek-yong, Somlak Chuengsamarn

This work aimed to clarify how polymorphisms in the TNF gene relate to metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and a broad spectrum of cardiometabolic characteristics, while also determining their impact on circulating TNF‑α concentrations. A total of 765 participants were genotyped for rs1800629 and rs361525, and serum TNF-α was also measured. To assess these relationships, multivariable logistic regression models—incorporating age, sex, and body mass index (BMI)—were applied to estimate adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs). Both variants were significantly associated with MetS: rs1800629 (crude OR = 2.22, 95% CI: 1.45–3.44, P P P = 0.035; adjusted OR = 2.84, 95% CI: 1.17–7.31, P = 0.025). The rs1800629 variant was also linked to T2DM risk (adjusted OR = 2.61, 95% CI: 1.35–5.24, P = 0.006), whereas rs361525 showed no such association. Carriers of rs1800629 had higher mean TNF-α levels (P 

Improving the composition of donor milk using machine learning and optimisation techniques

by Jacqueline Muts, Danée Knevel, Dick den Hertog, Rachel K. Wong, Timothy C.Y. Chan, Britt J. van Keulen, Johannes B. van Goudoever, Chris H.P. van den Akker

Background and aims

The macronutrient composition of donor human milk (DHM) can vary substantially due to several factors such as maternal age, diet, and lactation duration. However, consistent macronutrient levels in DHM facilitate the administration of the required amounts to preterm infants. The current pooling strategy at most human milk banks combines milk from different batches from a single donor. This study aims to stabilize the macronutrient quality of DHM by pooling milk from different donors by utilizing machine learning prediction and optimisation techniques.

Methods

The current pooling strategy is compared with a new theoretical approach that pools milk batches from up to 5 donors. To predict the crude protein and energy content, we used the following variables: body mass index, the donor’s diet (vegetarian or non-vegetarian), maternal age, full-term or preterm delivery, lactation stage, and volume pumped. These predictions are then used within an optimisation model to create milk pools that minimize the deviations from the target macronutrient levels (1.0 g protein/100 mL and 70 kcal/100 mL).

Results

The prediction model is based on 2236 created single-donor pools from 480 donors. Random forest regression models provided the most accurate predictions of macronutrient content. The new pooling strategy using multiple donors shows reduced deviations from target values compared to the current single-donor approach (average total absolute deviation 0.402 versus 0.664).

Conclusion

This study proves the potential of data-driven methods to improve operational efficiency in human milk banks, and improving the consistency of donor human milk.

Impact of storage conditions on the stability and biological efficacy of <i>trans</i>-arachidin-1 and <i>trans</i>-arachidin-3

by Ploy Khongrungjarat, Chonnikan Tothong, Chanyanut Pankaew, Suchada Phimsen, Nopawit Khamto, Nutthamon Kijchalao, Warissara Wongkham, Piyathida Wongkham, Wipaporn Chuaymaung, Adsadayu Thonnondang, Apinun Limmongkon

Prenylated stilbenoids, particularly trans-arachidin-1 (Ara-1) and trans-arachidin-3 (Ara-3), have gained attention for their notable bioactivities and potential health-promoting properties. This study presents the first comprehensive investigation into the stability and biological efficacy of these compounds in both peanut hairy root culture crude extracts (PCE) and partially purified fractions derived from elicited peanut hairy root cultures. PCE stored at –20 °C and 4 °C maintained higher antioxidant capacity, total phenolic content compared to samples stored at room temperature. In cytotoxicity assays using SW480 colon cancer cells, the extract stored at –20 °C retained bioactivity with only minor changes in IC₅₀ values over three months, demonstrating superior stability under frozen conditions. Over a six-month period, partially purified fractions of Ara-1 and Ara-3 showed a time-dependent decline in compound content. However, Ara-3 maintained strong cytotoxicity against KKU-100 cholangiocarcinoma cells, while Ara-1 exhibited a significant loss in activity. These findings demonstrate that low-temperature storage, particularly at –20 °C, is crucial for preserving the chemical integrity and bioactivity of stilbenoid-rich extracts. The study underscores the importance of optimizing storage conditions to ensure consistent bioactivity, supporting the potential application of these compounds in the development of stable and effective pharmaceutical or nutraceutical products.

Anal HPV shedding assessed by self-sampling and multiplex real-time PCR among men who have sex with men in N’Djamena, Chad: a feasibility and acceptability study

by Donato Koyalta, Zita Aleyo Nodjikouambaye, Jonathan Muwonga Tukisadila, Hachim Djamal Abdoulaye Bargo, Suitombaye Noubaramadji Yamti, Amine Akouya, Ralph-Sydney Mboumba Bouassa, Laurent Belec

Background

High-risk (HR) human papillomavirus (HPV) infection remains a great concern in sub-Saharan Africa in men who have sex with men (MSM). The prevalence of anal shedding of HPV and associated risk factors was estimated for the first time in a cross-sectional observational study covering MSM living in N’Djamena, the capital city of Chad.

Methods

MSM were recruited from the community in 21 sites in neighborhoods of 5 districts randomly selected in N’Djamena by respondent-driven sampling (RDS) method. Anal Collector V-Veil UP2™ device was used for anal canal self-sampling. Manual silica-extracted DNA was subjected for HPV detection and genotyping using BMRT Human Papillomavirus Genotyping Real Time PCR assay (Jiangsu Bioperfectus Technologies Co., Ltd., Taizhou, China). HIV serostatus was assessed using two rapid tests in series.

Results

A total of 70 MSM (mean age: 29.9 years; range, 18–50) were included. The overall acceptability to practice veil-based anal self-sampling was 95.9%. The usability of the veil collector device was high (92.3%), with easy understandable instructions for use and correct placement in the anal canal. Satisfaction questionnaire reported high overall feeling, intimacy respect and lack of shame. The majority of MSM (44/70, 62.8%) showed anal shedding of HPV DNA, with HR-HPV frequently detected (38,70, 54.3%), including HPV-33 (30/70, 42.9%) HPV-68 (16/70, 22.9%), HPV-18 (4/70, 5.7%), HPV-35 (3/70, 4.3%), HPV-58 (2/70, 2.9%), and HPV-45 (1/70, 1.4%). The distribution of genotypes in HR-HPV DNA-positive MSM revealed that HPV-33 (30/70; 42.9%) was the predominant genotype, followed by the HPV-68 (16/70; 22.9%), HPV-18 (4/70; 5.7%), HPV-35 (3/70; 4.3%), HPV-58 (2/70; 2.9%), and HPV-45, HPV-51 and HPV-56 (each type, 1/70;1.4%).Among all HPV detected, only 42 HPV (36.8%) were covered by Gardasil-9^® vaccine, including the HR-HPV-33, −18, −58 and −45, and the low risk-HPV-6 (5.7%) and HPV-11 (1.4%). The majority of detected HPV were non-covered by Gardasil-9^® vaccine (63.1%). Overall HIV prevalence was 5.7%.

Conclusions

Taken together, these observations point the MSM population in N’Djamena as a very particular core group of HIV and HPV transmission. HIV prevalence was higher than that of general adult population, but limited to only one MSM of twenty. The RDS method of recruitment allowed to include MSM likely belonging to the same sexual network of HPV transmission leading to the selection of an atypical and specific profile of anal HPV distribution. The potential efficacy of HPV prophylactic vaccination in this population can be estimated at relatively weak.

A psycho-ecological signal recognition framework for user behavior prediction on digital media platforms

by Lei Xiong, Ke Li, Wendy Siuyi Wong

Background

Digital media usage has become an integral part of daily life, but prolonged or emotionally driven engagement—especially during late-night hours—may lead to concerns about behavioral and mental health. Existing predictive systems fail to account for the nuanced interplay between users’ internal psychological states and their surrounding ecological contexts.

Objective

This study aims to develop a psychologically and ecologically informed behavior prediction model to identify high-risk patterns of digital media usage and support early-stage intervention strategies.

Methods

We propose a Dual-Channel Cross-Attention Network (DCCAN) architecture composed of three layers: signal identification (for psychological and ecological encoding), interaction modeling (via cross-modal attention), and behavior prediction. The model was trained and tested on a dataset of 9,782 users and 51,264 behavior sequences, annotated with labels for immersive usage, late-night activity, and susceptibility to health misinformation.

Results

The DCCAN model achieved superior performance across all three tasks, especially in immersive usage prediction (F1-score: 0.891, AUC: 0.913), outperforming LSTM, GRU, and XGBoost baselines. Ablation studies confirmed the critical role of both psychological and ecological signals, as well as the effectiveness of the cross-attention mechanism.

Conclusions

Incorporating psychological and ecological modalities through attention-based fusion yields interpretable and accurate predictions for digital risk behaviors. This framework shows promise for scalable, real-time behavioral health monitoring and adaptive content moderation on media platforms.

Impacts of polymorphisms in drug-metabolizing enzyme and transporter genes on irinotecan toxicity and efficacy in Thai colorectal cancer patients

by Natthakul Akarapredee, Chalirmporn Atasilp, Chonlaphat Sukasem, Pimonpan Jinda, Rattanaporn Sukprasong, Jiraporn Jensuriyarkun, Soravit Wongjitjanyong, Patompong Satapornpong, Natchaya Vanwong

Introduction

Irinotecan is a chemotherapy agent commonly prescribed for metastatic colorectal cancer but often leads to neutropenia. Variations in genes encoding drug-metabolizing enzymes and transporters may affect the toxicity and effectiveness of irinotecan. This study aimed to examine the impact of these genetic polymorphisms on irinotecan outcomes in Thai colorectal cancer patients.

Methods

The study retrospectively analyzed 41 metastatic colorectal cancer patients treated with irinotecan-based chemotherapy. Genotyping was conducted for 23 single nucleotide polymorphisms in genes including UGT1A1, CYP3A4, CYP3A5, CES1, ABCB1, ABCC2, ABCC5, ABCG1, ABCG2, and SLCO1B1.Toxicity and efficacy were assessed, with statistical significance set at a Bonferroni-corrected P value  Results

In terms of toxicity, UGT1A1*6 was significantly associated with both all-grade and severe neutropenia in the first cycle (p p p ABCC2 -24C > T variant was linked to all-grade neutropenia in the second cycle (p = 0.001). For efficacy, patients with the wild-type UGT1A1*6 had longer progression-free survival (PFS) (p SLCO1B1 521T > C variant was associated with improved PFS (p  Conclusion

UGT1A1*6 and ABCC2 -24C > T variants emerge as potential predictors of irinotecan-induced neutropenia, while UGT1A1*6 and SLCO1B1 521T > C may serve as markers of prolonged PFS in Thai patients. Validation through larger prospective studies is essential to confirm and refine these genetic associations.

CRE-Ter enhances murine bone differentiation, improves muscle cell atrophy, and increases irisin expression

by Sompot Jantarawong, Wipapan Khimmaktong, Pharkphoom Panichayupakaranant, Yutthana Pengjam

Ternary complex of curcuminoid-rich extract (CRE-Ter) is a developed water-soluble Curcuma longa extract containing 14% w/w curcuminoids, hydroxypropyl-β-cyclodextrin, and polyvinylpyrrolidone K30. This study aimed to investigate the biomolecular effects of CRE-Ter on differentiation of bone cells (murine MC3T3-E1 preosteoblasts), muscle cells (murine dexamethasone-treated C2C12 myotubes) atrophy and irisin expression. In MC3T3-E1 preosteoblasts, CRE-Ter treatment increased alkaline phosphatase activity, calcium deposition, and expression of Bmp-2, Runx2, and collagen 1a significantly and dose-dependently. 5, 10, and 20 µg/mL CRE-Ter upregulated β-catenin expression significantly. CRE-Ter improved the atrophy of dexamethasone-treated C2C12 myotubes. CRE-Ter decreased proinflammatory cytokine (TNF-α and IL-6) expression but increased FNDC5 and irisin expression and nitric oxide production in dexamethasone-treated C2C12 myotubes significantly and dose-dependently. Dexamethasone promoted β-catenin and total p38 expression in C2C12 myotubes. CRE-Ter at 2.5–20 µg/mL reversed the increase in β-catenin expression, whereas 2.5 µg/mL reversed total p38 expression. Crosstalk experiments further revealed that conditioned medium from C2C12 myotubes enhanced osteocalcin expression in MC3T3-E1 osteoblasts. Molecular docking simulations using CB-Dock2 showed strong interactions between each curcuminoid molecule and irisin. Therefore, CRE-Ter may stimulate osteoblast differentiation, ameliorate myotube atrophy, and increase irisin expression, indicating its therapeutic potential in osteoporosis, sarcopenia, and osteosarcopenia.

Molecular characterization of <i>Rhipicephalus microplus</i> and <i>Haemaphysalis bispinosa</i> ticks from cattle across Thailand: Regional identification and evidence of different genetic sub-structures between mainland and penins

by Danai Sangthong, Pradit Sangthong, Warin Rangubpit, Prapasiri Pongprayoon, Eukote Suwan, Kannika Wongpanit, Wissanuwat Chimnoi, Pacharathon Simking, Sinsamut Sae Ngow, Serge Morand, Roger W. Stich, Sathaporn Jittapalapong

Phylogenetic and population genetic analyses were conducted on tick specimens collected from cattle in northern, northeastern, central, and southern regions of Thailand. Morphological identification indicated these ticks consisted of three species, Rhipicephalus microplus from all four regions, R. sanguineus from the northern and northeastern regions, and a Haemaphysalis species only collected from the northeastern region. Analysis of cytochrome c oxidase subunit I gene (COI) sequences identified R. microplus clades A and C, while clade B was not detected in this study. The same analysis indicated specimens morphologically identified as Haemaphysalis were H. bispinosa, confirming previous reports of their prevalence in northeastern Thailand. H. bispinosa showed low haplotype and nucleotide diversity, suggesting either a bottleneck or founder effect. Both R. microplus clades displayed high haplotype diversity and low nucleotide diversity, a pattern associated with population expansion. Genetic structural analysis revealed significant genetic differences in R. microplus clade A, especially between mainland (northern, northeastern, and central regions) and peninsular (southern region) populations, which indicated limited gene flow between these areas while suggesting movement of these ticks across the mainland. The sequence analyses described in this report enhance understanding of the natural history of ticks in Thailand and are expected to guide and strengthen tick control strategies across Southeast Asia.

Skeletal muscle index, grip strength, and physical performance as predictors of severe chemotherapy toxicity among older adults with malignancy

by Efthymios Papadopoulos, Dmitry Rozenberg, Andy Kin On Wong, Sharon Hiu Ching Law, Sarah Costa, Angela M. Cheung, Shabbir M. H. Alibhai

Background

Skeletal muscle index (SMI), grip strength, and physical performance have been shown to predict clinically relevant outcomes in geriatric oncology. However, their predictive ability for chemotherapy toxicity is poorly understood. We examined whether SMI, grip strength, or physical performance are independently associated with severe toxicity among older adults receiving chemotherapy.

Methods

Older adults (≥65y) who had received chemotherapy at an academic cancer center between June 2015 and June 2022 were included in the analysis. SMI prior to chemotherapy was determined via computed tomography (CT), using the entire cross-sectional area of the muscle (cm²) at the third lumbar vertebra (L3) divided by the square of patient height in meters. Grip strength and lower extremity physical performance were measured prior to chemotherapy. Multivariable logistic regression was used to examine the independent associations between SMI, low grip strength, and low physical performance with severe (grade≥3) chemotherapy toxicity.

Results

Of the 115 older adults in the study, 71.3% were males. The most common disease site was genitourinary (53.9%) and most participants received chemotherapy with palliative intent (67.8%). A total of 69 (60.0%) participants experienced at least one grade ≥3 toxicity during the study. In multivariable analyses, low grip strength per the Sarcopenia Definitions and Outcomes Consortium (SDOC) definition was significantly associated with grade ≥3 toxicity (adjusted odds ratio (OR): 2.77, 95%CI: 1.03–7.45, p = 0.044). SMI either as a continuous (OR: 1.03, 95%CI: 0.97–1.09, p = 0.40) or categorical variable (OR: 1.17, 95%CI: 0.47–2.89, p = 0.74) was not predictive of grade ≥3 toxicity. Similarly, low physical performance did not have significant associations with grade ≥3 toxicity (OR: 2.06, 95%CI: 0.86–4.95, p = 0.11).

Conclusion

Low grip strength may predict grade ≥3 toxicity among older adults receiving chemotherapy. Integrating grip strength into geriatric assessment may help clinicians identify older adults who might be at greater risk for severe chemotherapy toxicity.

Comparison of patients’ acceptance of cuff-based vs wearable 24-hour ambulatory blood pressure monitoring devices: A multi-method study

by Ariffin Kawaja, Aminath Shiwaza Moosa, Eric Kam Pui Lee, Ian Kwong Yun Phoon, Andrew Teck Wee Ang, Zi Ying Chang, Aileen Chelsea Ai’En Lim, Jonathan Yap, Weiting Huang, Ding Xuan Ng, Melvin Yuansheng Sng, Hao Yuan Loh, Chirk Jenn Ng

Introduction

Recent hypertension guidelines recommend ambulatory blood pressure monitoring (ABPM) for accurate diagnosis and monitoring. However, patients’ experiences with cuff and wearable ABPM devices in primary care remain unclear. This study compared the acceptance of three devices (oscillometry cuff, tonometry wrist, and photoplethysmography chest devices) among patients with hypertension in primary care.

Methods

A multi-method study was conducted. Thirty-five participants with hypertension were recruited from two public primary care clinics in Singapore. All participants used cuff-based and either wrist or chest wearable devices for 24 hours. Structured surveys and in-depth audio-recorded interviews were used to gather feedback on their views, experiences, and challenges using the devices. The interviews were thematically analysed, and the surveys were analysed using descriptive statistics.

Results

All participants used the cuff (n = 35) device, while the wrist and chest devices were used by two-thirds (n = 22) and a third (n = 11) of the participants, respectively.The device usability questionnaire found that most participants were satisfied with the chest device, which did not disrupt their daily activities. Conversely, cuff arm devices interfered with daily activities (48%) and sleep (26%), were cumbersome (32%), and caused embarrassment (26%). The wrist device was uncomfortable (33%) and painful (22%) for some participants.The qualitative data were categorised into five themes: comfort, convenience, perceived accuracy, and impact on routine and sleep. Participants found the chest device more comfortable and convenient than the cuff and wrist devices. The cuff device was perceived as the most accurate due to its inflation-based BP measurement. All devices minimally affected routines and sleep, though participants expressed safety concerns about the cuff device, particularly while driving.

Conclusion

While wearable ABPM devices offer increased comfort, convenience and reduced impact on patient’s daily activities, concerns regarding their accuracy must be addressed before the widespread adoption of these devices in routine clinical practice.