Background/Objectives: Calcaneal spurs are pathological bone formations at entheseal attachment sites with clinical implications but limited forensic anthropological applications. While entheseal changes have been proposed as age estimation markers in forensic contexts, empirical validation remains insufficient, particularly for Southeast Asian populations. This study evaluated calcaneal spur utility for forensic age estimation in Thai skeletal remains while establishing population-specific osteological reference data for forensic individuation. Materials and Methods: The 3516 dry calcanei from 1758 Northeastern Thai skeletons (1031 males, 727 females; age 22–106 years) were examined. Spurs were classified by anatomical location as dorsal (D-type), plantar (P-type), or combined plantar–dorsal (P–D type). The morphometric measurements were performed bilaterally. Age-associated patterns were analyzed across four age cohorts (≤40, 41–50, 51–60, ≥61 years), and Random Forest machine learning classification tested forensic age estimation capacity using 10-fold cross-validation. Results: Overall prevalence reached 67.63% with distinctive P–D type predominance. While age-stratified prevalence increased from 24.56% (≤40 years) to 74.77% (≥61 years), Random Forest modeling explicitly demonstrated overall classification accuracy of 62.5%. Compared between sexes, the maximum length of calcaneal spurs was significantly longer in males. Dimensional analyses revealed weak age correlations and substantial inter-individual morphological variation precluded reliable age prediction. Interestingly, the unique P–D type distribution pattern (77.5% among spur-bearing individuals) may serve as an auxiliary marker for Thai population affinity assessment in forensic contexts. Conclusions: This study established the first comprehensive Thai-specific osteological reference for calcaneal spurs, revealing distinctive plantar–dorsal type predominance valuable for forensic population affinity assessment and provided population-specific baseline data for forensic individuation.

Early recognition of DPN gives physicians the opportunity to deliver appropriate treatment and counseling to minimize subsequent complications. This study aimed to evaluate the diagnostic performance of tibial nerve cross-sectional area (CSA) in detecting DPN using a Modified Toronto Clinical Neuropathy Score (mTCNS) ≥ 3 as the diagnostic reference in Thai diabetic patients. A total of 67 diabetic patients (120 limbs) were enrolled from Srinagarind Hospital between 2022 and 2023. A total of 120 limbs belonging to 67 patients were categorized into two groups: non-DPN group (mTCNS < 3) (n = 42) and DPN group (mTCNS ≥ 3) (n = 78). Tibial nerve CSA was measured 3 cm proximal to the medial malleolus using ultrasound. Clinical parameters and metabolic profiles were recorded. Receiver operating characteristic analysis, correlation analyses, and multivariable logistic regression were performed to evaluate diagnostic utility and associations between CSA and clinical parameters. The tibial nerve CSA was significantly higher in the DPN group (13.49 mm2, 95% CI: 12.84-14.13) compared to the non-DPN group (11.98 mm2, 95% CI: 10.95-13.02) (p = 0.015). A CSA threshold of 13 mm2 yielded a sensitivity of 58.5% and specificity of 74.2%. CSA positively correlated with mTCNS (r = 0.49, p < 0.001) and sensation score (r = 0.37, p = 0.002) in DPN patients. Logistic regression identified CSA and estimated glomerular filtration rate as independent predictors of DPN status. Tibial nerve CSA may serve as a useful structural marker to support the identification of DPN. When used alongside established clinical assessments, CSA measurement could contribute to earlier detection and improved risk stratification in diabetic populations.

Facial soft tissue thickness (FSTT) includes the layers from the bone to the skin surface and is influenced by various factors. Ultrasound (US) serves as one modality for FSTT measurement. This study aimed to explore fundamental data regarding FSTT and examined the association of FSTT and sex, age, body mass index (BMI), and facial side. B-mode US was used to measure FSTT at 11 midline and 32 bilateral landmarks in 100 unembalmed cadavers within 120h postmortem. The association of FSTT with sex, age, BMI, and facial side, were analyzed by descriptive and analytical statistics, with statistical significance set at a p-value of less than 0.05. The parotid-masseteric region was the thickest with the most variation, while the nose was the thinnest. BMI played a significant role, with significant differences in FSTT across all landmarks between underweight and normal BMI groups. Females generally exhibited thicker FSTT, particularly significant difference in the mid-infraorbital, endocanthion, gonion, and mid-mandibular border areas. However, males had greater thickness in nasal and perioral regions, especially significant at the prosthion and supracanine landmarks. Aging had a minimal impact on FSTT in individuals over 50, with only the mid-philtrum and labrale inferius showing age-related significant differences. Facial asymmetry was observed, with significant variations in the lateral perioral and buccal regions between the left and right sides. Sex, age, BMI, and facial side each influence FSTT, though their effects vary in magnitude across different facial regions. This data enhances foundational facial anatomy, guides aesthetic procedures in underweight and normal-weight individuals, and supports forensic facial reconstruction.

BackgroundLow-dose computed tomography (LDCT) screening reduces lung cancer mortality among high-risk smokers, but data from Southeast Asia remain limited. This study evaluated the detection yield and risk factors of lung cancer among adults undergoing LDCT health screening in Thailand.MethodsWe retrospectively reviewed 4,478 adults aged 18–85 years who underwent LDCT between January 2019 and December 2023 at a tertiary private hospital in Bangkok. Scans were performed using a Philips IQon Spectral CT (256-slice, 120 kV, 30 mA, 1 mm slice thickness, radiation dose <1.5 mSv) and interpreted according to Lung Imaging Reporting and Data System (Lung-RADS) version 1.1. Lung-RADS 3–4X were confirmed histopathologically. Multivariable logistic regression identified predictors of lung cancer.ResultsAmong all participants, 1,980 (44.2%) were female and 84.0% were never-smokers, with a mean age of 56.9 years [standard deviation (SD) 12.5]. LDCT positivity was 55.8%, and 53 cancers (1.2%) were detected. Most were stage 0–IB (69.8%), with adenocarcinoma as the predominant histology (85%) and solid morphology (77.4%). Incidental findings occurred in 65.2%, most commonly coronary artery calcification (CAC) (39.8%). Independent predictors included age ≥55 years [adjusted odds ratio (OR) 4.82, 95% confidence interval (CI): 1.68–13.86], smoking history (P<0.001), CAC (adjusted OR 23.63, 95% CI: 2.09–266.98), and extrapulmonary malignancy (adjusted OR 173.54, 95% CI: 42.73–704.77).ConclusionsLDCT health screening in an unselected Thai population detected a meaningful burden of early-stage lung cancer. The findings support age-based screening beginning at 55 years, highlighting the potential role of chronic inflammation and environmental injury, such as PM2.5 exposure and prior tuberculosis.

The precise anatomy of the anterior spinal artery is clinically important for surgical and endovascular procedures. Therefore, this study aims to investigate variations in the anterior spinal artery, including its origin, morphometry and formation patterns, in the Thai population. Twenty-six adult cadaveric brains (52 sides) were examined. In each brain, the site of origin, external diameter and formation patterns of the anterior spinal artery were recorded. The distances between the site of origin and both the vertebrobasilar junction and the posterior inferior cerebellar artery were measured on the left and right sides. The anterior spinal artery most commonly originated from a posteromedial (62.5%), followed by a medial origin (37.5%). A classification of anterior spinal artery morphology in Thai population was proposed, comprising three main types (I to III) and subtypes (Ia to Ic, IIa to IIc). Type III (independent bilateral anterior spinal artery) was most frequent (34.5%), followed by Type Ia (23.6%) and Type IIa (15.4%). The left vertebral artery showed a significantly larger diameter (p < 0.05). Several arterial diameters demonstrated strong positive correlations, all statistically significant (p < 0.05). The present study delineates the origin and formation patterns of the anterior spinal artery in the Thai population, demonstrating type III as the predominant configuration. These findings provide a robust foundation for subsequent investigations. Comprehensive knowledge of anterior spinal artery anatomical variation is critical for reducing the risk of vascular complications during surgical interventions.

Objective: This cross-sectional study aimed to develop and validate the Short-Video Applications Addiction Questionnaire (S-VAAQ) and evaluate its reliability and validity among Thai individuals aged 13 years and older. Materials and Methods: The S-VAAQ is a 9-item screening tool adapted from the three core domains of gaming disorder outlined in ICD-11: impaired control over usage, increased priority given to gaming, and continued use despite negative consequences. Items were modified to better reflect short-form video consumption behaviors. Data were collected through an online questionnaire distributed via short-form video platforms and Line, targeting Thai participants aged 13 and above who regularly watched short-form videos and were proficient in Thai. Statistical analyses included content validity index (CVI) assessments by five experts, Cronbach’s alpha for internal consistency, and exploratory factor analysis (EFA). Results: A total of 1,932 participants aged 13 years and older were included. The median daily duration of short-form video viewing was three hours. All items demonstrated CVI scores exceeding 0.78. The scale exhibited good internal consistency, with a Cronbach’s alpha of 0.884. KMO Measure of Sampling Adequacy of 0.898 and EFA revealed factor loadings ranging from 0.594 to 0.904 supporting the scale’s construct validity. Conclusions: In conclusion, the S-VAAQ demonstrated good reliability and validity. This instrument can serve as a useful tool for screening short-form video addiction in the Thai population and support further research and intervention strategies.

The impact of diet on gut microbial metabolism is essential for advancing microbiome-based health interventions. This study introduces a novel systems biology pipeline that integrates genome-scale metabolic models (GSMMs) with Thai dietary intake data to simulate gut microbiome metabolism and assess prebiotic responses. Utilizing metagenomic data from healthy Thai adults and an average Thai diet derived from national surveys, community-scale metabolic models (CSMMs) were developed and simulated under both typical dietary and prebiotic-supplemented condition. Flux variability analysis was employed to assess metabolic capacities, short-chain fatty acids (SCFAs) production in relation to microbial taxonomy. The results promisingly revealed inter-individual variability in SCFA profiles, with Bacteroides and Phocaeicola notably linked to isobutyrate production and Bifidobacterium emerged as a key responder to prebiotic supplementation. This integrative framework offers biological insights into diet-gut microbiome interactions and provides a foundation for the development of precision nutrition strategies tailored to the Thai population.

To externally validate the Surgery in Cervical Cancer, Observational, Retrospective (SUCCOR) Risk score for predicting recurrence in early-stage cervical cancer treated with radical hysterectomy in a Thai population. A retrospective cohort of patients with the International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage IB1 cervical cancer who underwent radical hysterectomy at our institution between 2003 and 2019 was analyzed. The SUCCOR Risk score was calculated using original model specifications. Progression-free survival (PFS) and overall survival were estimated by Kaplan-Meier analysis and compared across risk groups. Model performance was evaluated in terms of discrimination, calibration, and overall accuracy. Of 1,309 eligible cases, 954 met the inclusion criteria. After a median follow-up of 79 months, 83 relapses (8.7%) and 66 deaths (6.9%) were observed. Five-year PFS was 95.3% in the low-risk, 88.0% in the medium-risk, and 88.0% in the high-risk groups (log-rank p=0.002). Medium-risk patients had a significantly higher relapse risk than low-risk patients (HR=2.62; 95% CI=1.51-4.53). The SUCCOR Risk score demonstrated moderate discrimination for 5-year relapse (area under the receiver operating characteristic curve=0.65; Harrell's c-statistic=0.68). Calibration analyses showed good average agreement but an attenuated calibration slope of 0.72, reflecting overdispersion of risk predictions. Overall model performance was useful, with a 5-year Brier score of 0.068 and an integrated Brier score (IBS) of 0.080, outperforming the null model (IBS=0.084). The SUCCOR Risk score maintained moderate discriminative ability and acceptable calibration in this Thai cohort, with modest improvement over baseline prediction. These findings support its generalizability across diverse clinical settings, though recalibration may enhance accuracy for local application.

Intrinsic Factors Influencing Simvastatin and Simvastatin Acid Pharmacokinetics: Age‐Related Studies in Thai Adults and Cross‐Population Comparisons

Age estimation is a crucial component in the identification of individuals. The London Atlas is a radiographic method for dental age estimation, and it is non-invasive, easy to apply, and widely utilized. Previous studies confirmed the high accuracy of the London Atlas in Northern and Central Thai groups. However, this study aimed to evaluate its accuracy in a southern Thai population since genetic and environmental differences occur among populations. A total of 360 digital panoramic radiographs from Thai children aged between 7 and 15 years (180 males and 180 females) were analyzed. The sample was divided into nine age groups. Each group included 40 radiographs. Dental age was estimated by comparing the radiographs with the London Atlas. Differences between chronological and dental ages were assessed using the Wilcoxon signed rank test. Intra- and inter-observer reliability scores were 0.839 and 0.816, respectively. The mean dental age estimated using the London Atlas (11.57 years) slightly exceeded the actual mean chronological age (11.52 years). However, the difference was not statistically significant in either sex (P &gt; 0.05). The London Atlas method showed a minor overestimation of 0.01 years in males and 0.09 years in females. In conclusion, the London Atlas method demonstrated a high level of accuracy and is appropriate for dental age estimation in the southern Thai population.

BackgroundChronic kidney disease (CKD) is a frequent non-communicable complication in people living with HIV (PLHIV), influenced by antiretroviral therapy (ART), comorbidities, and healthcare setting. The Data Collection on Adverse Events of Anti-HIV Drugs (DAD) CKD risk score is widely applied internationally, while the Thai CKD risk score, developed for the general Thai population, has not been validated in HIV cohorts. This study compared the predictive accuracy of the DAD models and the Thai CKD risk score in Thai people living with HIV receiving ART.MethodsA retrospective cohort analysis was conducted using electronic medical records of adults (≥18years) living with HIV at Warinchamrap Hospital between January 2020 and May 2024. Patients with pre-existing CKD or incomplete data were excluded. CKD was defined per Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Model calibration was assessed with the Hosmer-Lemeshow test, and discrimination with the C-statistic.ResultsAmong 901 PLHIV receiving ART, 104 (11.5%) developed incident CKD during a median follow-up of approximately 4years. Patients who developed CKD were more likely to be male and have a lower baseline estimated glomerular filtration rate, and higher prevalence of proteinuria and comorbidities. All evaluated models stratified CKD risk; however, the full and short DAD scores showed moderate discrimination (C-statistics ≈0.76) with evidence of risk underestimation and suboptimal calibration. The Thai CKD risk score demonstrated higher discrimination (C-statistic 0.93), sensitivity (88.5%), and better calibration in this cohort.ConclusionsIn this Thai HIV cohort, all evaluated risk models provided CKD risk stratification, but the Thai CKD risk score showed more reliable discrimination and calibration than the DAD models. These findings highlight the importance of population-specific validation when applying CKD risk prediction tools in HIV care.

Background: Radiological wrist parameters are used to evaluate the treatment of distal radius fractures. Accurately restoring the distal radius is essential for good functional outcomes, but the reference values used for the Thai population are based on Western databases. This study aims to determine the reference values for normal wrist parameters in the Thai population. Methods: Two orthopaedic hand surgeons analysed 200 posteroanterior (PA) and lateral wrist radiographs, measuring radial height, radial inclination, ulnar variance and volar tilt using the central reference point (CRP) as a reference, with comparisons between sex and wrist side. Interobserver reliability was assessed using the intraclass correlation coefficient (ICC). Results: The mean values of wrist parameters were as follows: radial height, 10.7 ± 1.3 mm; radial inclination, 22.8° ± 2.4°; ulnar variance, -0.2 ± 1.2 mm and volar tilt, 13.5° ± 3.0°. All parameters had significant sex-based differences, with higher radial height in males and higher radial inclination, ulnar variance and volar tilt in females. No significant differences were found between the wrist sides. The interobserver reliability was excellent for radial inclination (ICC = 0.92) and ulnar variance (ICC = 0.93) and good for radial height (ICC = 0.90) and volar tilt (ICC = 0.79). Conclusions: Reference values were established for normal wrist parameters in the Thai population, with notable sex-based differences. The values are comparable to Western references except for volar tilt, which is higher in Thais. These findings can be applied in the treatment of distal radius fractures, the design of implants and the development of research or artificial intelligence databases. Level of Evidence: Level IV (Diagnostic).

Background/Objective: Accurate biological profile estimation from skeletal remains is fundamental to forensic identification. While the humerus demonstrates considerable sexual dimorphism, population-specific validation data for Thai populations remain limited. This study aimed to develop and independently validate population-specific equations for sex and stature estimation from humeral measurements in Northeastern Thai populations. Methods: This cross-sectional study examined 300 adult humeri (150 male, 150 female) from the Khon Kaen University skeletal collection. Four osteometric measurements (maximum length, midshaft circumference, epicondylar breadth, superior–inferior head diameter) and weight were recorded. The sample was randomly divided into development (n = 200) and validation (n = 100) datasets. Logistic regression for sex estimation and linear regression for stature estimation were developed using stepwise selection. Results: Sex classification achieved 93.5% accuracy in development and 93.0% in independent validation. The optimal model incorporated midshaft circumference, superior–inferior head diameter, and weight, with an area under the curve of 0.977 (95% CI: 0.953–1.000), sensitivity 90.0%, specificity 96.0%, and Cohen’s kappa 0.86. Stature estimation demonstrated a correlation coefficient of 0.81 with a mean absolute error of 4.36 cm (2.74% of the mean stature). Independent validation confirmed minimal performance deterioration for both models. Conclusions: These independently validated, population-specific equations provide accurate and reliable methods for biological profile estimation in Northeastern Thai forensic contexts. The rigorous validation framework supports confident operational application and provides a methodological model for developing regional forensic standards.

Background: The rising consumption of Western-style fast food—high in carbohydrates, sugar, and fat—together with a fast-paced lifestyle, occupational stress, and physical inactivity, represents a major risk factor for fatty liver disease, which can progress to hepatitis, cirrhosis, or hepatocellular carcinoma. Evidence linking fatty liver and cholelithiasis is growing globally, yet data from Thailand and Southeast Asia remain scarce, despite both conditions being increasingly prevalent. Cholelithiasis, a common gastrointestinal disorder affecting 5–10% of the Thai population, particularly females and older adults, may also be associated with fatty liver disease. Objectives: This study investigated the correlation between cholelithiasis and fatty liver disease using ultrasonographic data from patients at Vajira Hospital, aiming to address this regional knowledge gap and inform preventive strategies. Materials and methods: A retrospective analysis was performed on 311 patients aged ≥50 years who underwent upper abdominal ultrasonography at Vajira Hospital between 2023 and 2024. Collected data included gender, age, gallstone size, and diagnostic findings. Patients were classified into two groups: 132 with cholelithiasis and 179 without. Statistical analyses included descriptive statistics (mean, SD, frequency, percentage) and inferential tests (t-test, chi-square test, and logistic regression). Results: Of the 311 patients, 162 (52.1%) had fatty liver, with a mean age of 62±8.46 years; 62.3% were female and 37.7% were male. Among these, 73 patients (45.1%) had concurrent cholelithiasis (66% female, 34% male), with a mean gallstone size of 1.09±0.53 cm. The remaining 89 patients (54.9%) had fatty liver disease without cholelithiasis (60% female, 40% male). A significant inverse association was observed between age and fatty liver disease (p=0.003), indicating that younger patients within this ≥50-year cohort were more likely to be affected. Conclusion: Cholelithiasis was not significantly associated with fatty liver disease. However, fatty liver showed a novel inverse correlation with age, with higher prevalence among younger adults within the ≥50-year cohort. This finding, which contrasts with previous reports of increasing prevalence with age, may reflect methodological factors and lifestyle influences in Thailand’s urban population. These results emphasize the need for early screening and targeted public health interventions for working-age adults, while acknowledging limitations related to study design, absence of key confounders, and restricted age range.

Disparities in the performance of various kidney function equations in predicting aminoglycoside clearance (CL) have been identified. However, data specific to the Thai population remains limited. This study aimed to evaluate the performance of kidney function equations in estimating aminoglycoside CL in Thai patients. Data were retrospectively collected from hospitalized Thai patients who received amikacin or gentamicin over a 10-year period. Population pharmacokinetic (PK) analysis was performed using a nonlinear mixed-effects modeling approach. The association between aminoglycoside CL and kidney function, estimated by various equations, was ranked based on the magnitude of change in the Akaike Information Criterion (AIC) relative to the base model. A total of 138 adult Thai patients treated with either gentamicin (66%) or amikacin (34%) were enrolled. The non-body surface area (BSA)-indexed estimated glomerular filtration rate (eGFR) equations showed a stronger association with aminoglycoside CL compared to the 1.73 m2 BSA-indexed equations. The non-BSA-indexed 2021 Chronic Kidney Disease Epidemiology Collaboration eGFR (2021 CKD-EPI eGFRcr) equation demonstrated the highest association with aminoglycoside CL. The estimated volume of distribution (V) and CL from the final model were 21.91L and 2.62L/h, respectively. Among the Thai population, the non-BSA-indexed 2021 CKD-EPI eGFRcr equation of the non-race demonstrated the highest performance in estimating aminoglycoside CL. Further studies are warranted to confirm these findings with other renally eliminated drugs.

Temporomandibular disorders (TMD) are prevalent orofacial pain conditions; however, the interrelationships among clinical, psychological, and behavioral factors remain insufficiently explored, particularly within the Thai population. This single-center retrospective study aimed to examine the associations among clinical characteristics, pain, bruxism, and psychological factors in patients with TMD. The medical records of 222 adult patients diagnosed with TMD at the Orofacial Pain Clinic between January and December 2024 were reviewed. The primary outcomes were the associations of pain severity and symptom duration with psychological factors, and the secondary outcomes were the relationships of sleep and awake bruxism with psychological factors and related variables. Statistical analyses included nonparametric tests, chi-square tests, and logistic regression. Among the 222 patients (75.7% female; mean age 35.83 ± 17.08 years), 56.8% presented with chronic symptoms, 36.0% reported sleep bruxism, and 37.8% reported awake bruxism. Higher pain severity was significantly associated with depression (p = 0.004), anxiety (p = 0.001), and stress (p = 0.045). Chronic symptoms (>3 months) were associated with depression, anxiety, and stress (p < 0.001). Awake bruxism demonstrated significant associations with all three psychological factors (p < 0.001), whereas sleep bruxism did not show such associations. In multivariable analyses, patients with acute symptoms (≤3 months) had lower odds of sleep bruxism compared with those with chronic symptoms (odds ratio (OR) = 0.37, p = 0.003), and higher stress levels were associated with awake bruxism (OR = 1.15, p < 0.001). The findings highlight the burden of psychological factors among TMD patients, particularly those with higher pain intensity, chronic symptoms, and awake bruxism. Awake bruxism may serve as a clinical indicator of psychological factors, underscoring the importance of psychological screening and biopsychosocially oriented management. Nonetheless, the results should be interpreted with caution given the retrospective design and the single-center setting.

Melatonin, a hormone secreted by the pineal gland, regulates circadian rhythm and has been investigated for therapeutic use in conditions linked to altered melatonin levels. However, pharmacokinetic data in the Thai population are limited, and interindividual variability may be influenced by CYP1A2 activity. This study evaluated the pharmacokinetics of melatonin and the effect of CYP1A2 induction in 25 healthy Thai male volunteers. The study was conducted in two phases: a baseline phase to characterize melatonin pharmacokinetics under normal conditions, and a postinduction CYP1A2 induction with 120 mg/day omeprazole for 7 days. An in vivo CYP1A2 activity was assessed using the saliva paraxanthine/caffeine (PX/CA) ratio. In both phases, a single oral dose of 20 mg melatonin was administered, and blood samples were collected at 0, 0.25, 0.5, 1.0, 1.25, 1.5, 2, 3, 4, 5 and 6 hrs post-dose. Plasma melatonin concentrations were quantified using an HPLC-fluorescence technique. Results from the baseline phase showed rapid absorption with a mean maximum concentration (Cmax) of 53.42 ± 49.52 ng/mL, a total area under the curve (AUC0-inf) of 63.10 ± 53.15 ng·h/mL, an apparent clearance (Cl/F) of 8.08 ± 5.23 L/hr·kg, and an elimination half-life (T1/2) of 0.80 ± 0.14 hr. Following omeprazole treatment, the saliva PX/CA ratio increased by approximately 1.77-fold, indicating enhanced in vivo CYP1A2 activity. Concomitantly, both the Cmax and AUC0-inf of melatonin decreased by approximately twofold, to 26.33 ± 34.83 ng/mL and 30.29 ± 28.10 ng·h/mL. In conclusion, CYP1A2 activity appears to play a significant role in modulating bioavailability of melatonin.

BackgroundThalassemia is a common hereditary hemoglobin disorder in Vietnam. Elucidating the epidemiological and genetic patterns in children is essential for developing screening and prevention strategies.MethodsA retrospective analysis of 1,240 children under 10 years of age with Thalassemia treated at the National Institute of Hematology and Blood Transfusion in Vietnam, between 2014 and 2023.ResultsThe median age at treatment initiation was 1 year (range 0–9 years), with 94.5% of patients aged 0–5 years. Children born after 2020 were diagnosed and treated earlier than those born before 2020 (0 year (range 0–2 years) vs 1 year (range 0–9 years); p < 0.0001), concurrent with the implementation of the national prenatal screening program. β-thalassemia and β-thalassemia/HbE accounted for nearly 90% of cases, with subtype distribution varying by ethnicity and region. β-thalassemia/HbE predominated in the Northwest and North Central regions, particularly among the Thai and Muong populations. In contrast, β-thalassemia was more prevalent in the Northeast, notably among the Tay and Nung populations. Eight α-globin and thirteen β-globin mutated types were detected. The common β-globin variants (CD17, CD41/42, CD71/72, −28, and IVSI-1) and HbE (CD26) mirror patterns reported in neighboring Laos and Guangxi Province, China. For α-globin genotypes, --SEA (49.83%), Hb CS (31.53%), and −α3.7 (8.47%) were most frequent.ConclusionGeography, ethnicity, and genetic background strongly shape Thalassemia epidemiology in Northern Vietnam. Targeted genetic counseling, early carrier screening, and region-focused community programs are urgently needed to reduce disease burden in high-risk populations.

Accurate age classification using mandibular third molar radiographs is crucial for legal and forensic applications. This study evaluated different methods for classifying age as under or over 18 years in a Thai population. We compared three approaches: (i) a traditional human-based method using a modified Demirjian classification adapted for mandibular third molars, (ii) an end-to-end deep learning model in which a convolutional neural network (CNN) directly predicts age group, and (iii) a human-defined feature extraction approach, where a CNN estimates tooth developmental stages that are subsequently used for age classification. The dataset included 3,407 images of individuals aged 14-23 years. The results indicated that the traditional human-based method achieved high specificity (0.99) and a strong Bayes' post-test probability (0.99), but it exhibited low sensitivity (0.45). In comparison, the end-to-end deep learning models showed higher sensitivity (0.65 to 0.74) than the traditional method, along with a specificity of 0.91 to 0.95 and Bayes' post-test probability of 0.93 to 0.95. The human-defined feature extraction approach, which used developmental stages for age determination, achieved an accuracy of 0.88 to 0.92 in developmental stage classification. For age classification, the models demonstrated higher specificity (0.95 to 0.97) and Bayes' post-test probability (0.95 to 0.97) than the end-to-end deep learning method, along with sensitivity ranging from 0.51 to 0.56. Our results indicate that although traditional methods excel in specificity, the human-defined feature extraction approach provides a balanced solution with high specificity and interpretability, suggesting its potential value in clinical practice for age estimation.

Migration is a microevolutionary process that shapes cultural, societal, and genetic diversity in human populations. While previous genetic studies have examined the effects of migrations in several key areas of the world, there is a paucity of such studies in the upper Greater Mekong Subregion (GMS). The upper GMS, encompassing northern Thailand, Laos, Myanmar, and southern China, has been a major corridor for human migration and interaction between East and Southeast Asian populations for thousands of years. We generated new genome-wide data for Tai-Kadai (TK)-speaking ethnic groups, namely Lue and Yong, from northern Thailand and integrated them with data from the upper GMS and across Asia. Our results highlight the genetic diversity among ethnic groups in the GMS, particularly the genetic continuity of TK migration from southern China to northern Thailand. The TK speakers in Thailand predominantly exhibit multiple ancestries from East Asia and Southeast Asia, with regional differentiations. The TK groups in northern Thailand primarily derive their genetic contributions from Dai-related communities, while northeastern Thai populations show a higher proportion of Lao-related ancestry. Those in central and southern Thailand display additional ancestries from other groups, such as Austroasiatic and South Asian populations. The genetic history of TK-speaking Lue populations illustrates the role of TK migration, founder effects, and historical resettlements in shaping genetic diversity. Overall, analyses of genome-wide data reveal that the genetic background of TK speakers in Thailand is predominantly of East Asian origin, with additional contribution from Southeast Asian populations. This pattern supports the idea of sustained migration from southern China into Thailand, particularly concentrated in the northern part. Our findings reinforce the historical continuity of TK movements across the upper GMS and provide new insights into the genetic and cultural transformations that have shaped present-day Thai populations.