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EDITOR'S SIGNALRotating editor's selection

Stepped-Wedge Cluster Randomized Trial

A Smartphone Antimicrobial Prescribing App Did Not Outperform Paper Guidelines Across Six Lao Hospitals

Across a stepped-wedge cluster randomized trial in six Lao hospitals, a smartphone version of national antimicrobial prescribing guidelines plus one stewardship training session did not significantly improve adherence over paper versions after adjustment for time, clustering, and confounders. Inpatient adherence was 25.6% versus 17.0% before adjustment, but the adjusted odds ratio was 1.26 (95% CI 0.8–1.9; p=0.276); outpatient results were also null. The finding argues for sustained, multifaceted stewardship rather than guideline access alone.

Sue J. Lee · Mavuto Mukaka · Nicholas P. J. Day · Paul N. NewtonMahidol University · Mahidol Oxford Tropical Medicine Research Unit (MORU)

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IMPACT92/100

EDITORIAL DEEP DIVES

In-depth research analyses

Source-verified editorial analyses, ordered by latest publication date

1,027 analyses

public-health70IMPACT SIGNAL

Application of underutilized straw mushroom (Volvariella volvacea) powder in cereal bars: Nutritional composition, amino acid profiling, and multivariate analysis

An underutilized straw mushroom ( Volvariella volvacea ) is an agricultural resource with potential as a functional food ingredient due to its nutritional value and bioactive compounds. This study aimed to evaluate the effects of incorporating straw mushroom powder into cereal bars on sensory attributes, nutritional composition, antioxidant activity, and amino acid profiles. Cereal bars containing 0%, 5%, 10%, and 15% straw mushroom powder were prepared and evaluated for sensory acceptability, proximate composition, physicochemical properties, antioxidant activity, and amino acid composition. Multivariate analysis was performed to assess relationships among quality attributes and formulations. The cereal bar containing 10% straw mushroom powder achieved the highest sensory acceptance, particularly for appearance and texture. Compared with the control, this formulation exhibited higher protein (30.31% vs. 26.60%) and dietary fiber contents (19.66% vs. 12.54%), enhanced antioxidant activity, and lower moisture content and water activity. Amino acid analysis revealed increased levels of lysine, aspartic acid, glutamic acid, and arginine. These results indicate that straw mushroom powder improves the nutritional quality, antioxidant properties, and physicochemical characteristics of cereal bars while maintaining consumer acceptability. In conclusion, the incorporation of 10% straw mushroom powder provided the most favorable balance between sensory acceptance and nutritional enhancement, supporting its potential use as a sustainable functional ingredient for nutrient-dense cereal bar products. Future studies should assess shelf-life stability and microbial quality to confirm the long-term efficacy of the treatment.

Thai researchers

multidisciplinary70IMPACT SIGNAL

LC-MS/MS-Based Phytochemical Profiling and Biological Activities of Eurycoma longifolia Jack Extracts with Cosmeceutical Potential

This study investigates the optimization of extraction conditions, phytochemical contents, biological activities, and cosmeceutical potential of Eurycoma longifolia Jack extracts obtained from wild and cultivated plant roots, stems, and leaves. HPLC analysis revealed that eurycomanone was predominantly accumulated in the root extracts. Among the extraction solvents, 70% ethanol exhibited the most effective extraction of bioactive compounds. Leaf extracts showed the highest total flavonoid content (255.71–269.67 mg quercetin/g sample) and total phenolic content (20.34–20.80 mg gallic acid/g sample). Furthermore, 70% ethanol leaf extracts demonstrated strong antioxidant activity with DPPH IC50 values of 6.37 ± 0.74 and 7.95 ± 0.86 µg/mL for wild and cultivated samples, respectively, and potent tyrosinase inhibitory activity with IC50 values of 50.71 ± 3.92 and 55.80 ± 4.75 µg/mL. The extracts also exhibited selective antibacterial activity against Gram-positive bacteria. Moreover, the in silico molecular docking of biflorin against the 2QVD protein exhibited the highest binding affinity (−7.4 kcal/moL). Anti-inflammatory activity was evidenced by nitric oxide inhibition in LPS-stimulated RAW 264.7 macrophages without significant cytotoxicity. Overall, 70% ethanol extracts, particularly from leaves and roots, exhibited promising biological activities and may serve as potential natural ingredients for future cosmeceutical applications. However, further studies are required to confirm their efficacy and safety before practical applications can be considered.

Thai researchers

multidisciplinary70IMPACT SIGNAL

Efficacy and Safety of Syzygium cumini and Related Myrtaceae Interventions for Dysglycemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Syzygium cumini and other Myrtaceae plants are widely used as traditional remedies for dysglycemia, yet clinical evidence remains fragmented and heterogeneous. This study aimed to evaluate the efficacy and safety of S. cumini and related Myrtaceae interventions in individuals with dysglycemia. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420261332539). PubMed, Scopus, Embase, MEDLINE, and Web of Science were searched from inception to 3 September 2025. Eligible trials enrolled participants with type 2 diabetes mellitus (T2DM) or prediabetes and evaluated Myrtaceae interventions versus controls. Random-effects meta-analyses were performed to estimate mean differences (MDs) with 95% confidence intervals (CIs). Results: Thirteen trials comprising 802 participants were included. Myrtaceae interventions were associated with a statistically significant but modest reduction in fasting plasma glucose (MD −14.40 mg/dL, 95% CI −23.12 to −5.67; I2 = 98.57%). However, effects on postprandial glucose (MD −12.99 mg/dL, 95% CI −27.74 to 1.76; I2 = 97.93%) and HbA1c (MD −0.46%, 95% CI −0.98 to 0.06; I2 = 99.20%) were not statistically significant. Overall effects on lipid outcomes and laboratory safety markers were also not significant. Subgroup analyses suggested possible variation by participant type, plant part, formulation composition, comparator type, and treatment duration, but these findings were exploratory and accompanied by substantial heterogeneity. Conclusions: Myrtaceae interventions may provide a modest short-term reduction in fasting glycemia among adults with T2DM or prediabetes. However, the clinical significance and generalizability of this…

Thai researchers

public-health70IMPACT SIGNAL

Mapping Psychosocial Interventions for Mental Health and Well-Being Among Pregnant Women Living with HIV: A Scoping Review

Background: Pregnant women living with HIV are at increased risk of depression, anxiety, stigma, gender-based violence, and poor engagement in prevention of mother-to-child transmission services. Psychosocial interventions are increasingly used to complement routine maternal and HIV care, yet evidence remains fragmented across intervention types, settings, and outcomes. Objective: This scoping review aimed to map psychosocial interventions designed to improve mental health and well-being among pregnant women living with HIV. Methods: This scoping review followed the Arksey and O’Malley framework, refined by Levac et al, and was reported according to the PRISMA-ScR guideline. PubMed, Scopus, and CINAHL were searched for English-language experimental and quasi-experimental studies published from January 2010 to March 2025. Eligible studies focused on non-pharmacological psychosocial interventions for pregnant or perinatal women living with HIV. Data were extracted using a standardized form and synthesized narratively. Results: Fourteen studies met the inclusion criteria. Interventions included problem-solving therapy, cognitive-behavioral approaches, peer-mentor and structured support groups, empowerment-based interventions for gender-based violence, community-based counseling, and integrated maternal mental health–parenting programs. Many interventions used task-shifting, peer or lay providers, culturally adapted content, and delivery through clinics, home visits, groups, telephone support, or hybrid formats. Reported benefits included reduced depressive symptoms, improved coping, self-efficacy, disclosure, social support, ART retention, viral suppression, and selected infant growth outcomes. However, findings varied across studies, and some benefits declined over…

Thai researchers

clinical-medicine70IMPACT SIGNAL

Early detection of postoperative pulmonary complications after cardiothoracic surgery by chest ultrasound versus ordinary chest radiography

Background The prompt identification of postoperative pulmonary complications is crucial for minimizing patient morbidity and mortality. Chest ultrasound (US) is a valuable alternative to traditional chest radiography (CXR) due to its bedside accessibility, greater sensitivity, and enhanced diagnostic accuracy. Objective This study aimed to compare the effectiveness of chest US and CXR in the early diagnosis of postoperative pulmonary complications, including pneumothorax, pleural effusion, and lung consolidation. Lung US was administered by a trained pulmonologist. Study design This prospective cross-sectional observational study was conducted from 2024 to 2025 and included 30 patients scheduled for elective cardiothoracic surgery. Results The results of our study showed a significant increase in diagnostic findings using US compared with radiography at both 48 and 72 h postoperatively. Conclusion Compared with CXR, bedside ultrasonography proved to be a more accessible and informative tool for detecting key postoperative findings that are beneficial to surgical teams.

Thai researchers

public-health70IMPACT SIGNAL

Effects of anthocyanin-rich blackcurrant extract on cardiovascular and metabolic responses during rest and treadmill running: a case study in an elite national level female Southeast Asian endurance athlete

Introduction Anthocyanin-rich blackcurrant extract altered exercise-induced metabolic responses (e.g., enhanced fat oxidation) in case studies with Caucasian non-heat acclimatized male endurance athletes. We examined 2–3 weeks before marathon competition the effects of 7-day intake of the extract (i.e., 420 mg of anthocyanins per day) during supine rest and 1 h of moderate-intensity running in an elite national level female Southeast Asian endurance athlete (age: 48 years, BMI: 19.3 kg·m −2 , body fat: 21.8%, V ˙ O 2 max : 44.4 mL·kg −1 ·min −1 , 28 marathons since 2017) living and training outdoors in Thailand. Methods Non-invasive beat-to-beat hemodynamic monitoring (PhysioFlow®) and breath-by-breath gas technology (Cortex Metalyzer 3B) techniques were used during supine rest and a 1-hour indoor (∼24.5 °C, relative humidity: ∼42%) treadmill run at 50% V ˙ O 2 max (7.5 km·h −1 ) with blood lactate (XPER L1) taken 3 min on completion. Study was single-blind and placebo-controlled with final intake of the extract 2 h before starting the treadmill run. Results During rest, the blackcurrant extract condition was associated with higher heart rate (+6 bpm), cardiac output (+10%), carbohydrate oxidation (+31%), and respiratory exchange ratio (+0.02 units), with lower systemic vascular resistance (−18%) compared with placebo. Stroke volume, oxygen uptake, and fat oxidation values appeared similar between conditions. During the 1-h treadmill run at 50% V ˙ O 2 max , the blackcurrant extract condition was associated with higher stroke volume (+9%), cardiac output (+10%), oxygen uptake (+6%), carbohydrate oxidation (+43%), and respiratory exchange ratio (+0.03 units), with lower systemic vascular resistance (−24%) and fat oxidation (−7%) compared with placebo. Heart rate and…

Thai researchers

environmental-engineering70IMPACT SIGNAL

Upcycling of Low-Density Polyethylene and Multilayer Plastic Waste into Sand-Plastic Paving Blocks: Material Characterization and Mechanical Properties

This study investigates the upcycling of low-density polyethylene (LDPE) plastic bags and multilayer plastic (MLP) wastes into sand-plastic paving blocks and evaluates the influence of plastic type and plastic-sand ratio on their physicochemical and mechanical properties Fourier Transform Infrared Spectroscopy (FTIR) and Thermogravimetric Analysis (DSC/TG/DTG) showed that LDPE behaves as a single-polymer system with higher crystallinity, distinct melting behaviour, and greater thermal stability, whereas MLP exhibits multiple polymer phases and inorganic residues that reduce melt compatibility. Paving blocks were produced at plastic-sand ratios ranging from 100:0 to 40:60 and characterized for density, porosity, water absorption, and compressive strength. LDPE composites achieved the best performance at a 60:40 ratio, reaching a compressive strength of 25.7 MPa with water absorption below 0.4%. MLP-based blocks showed higher porosity and lower compressive strength, with a maximum value of 18.4 MPa, attributed to immiscible polymer layers and metallic impurities. Nevertheless, all samples exhibited excellent water resistance, with water absorption below 1%, outperforming conventional cement-based paving materials. These findings demonstrate that both mono-material and complex plastic wastes can be effectively upcycled into durable paving products, providing a sustainable waste valorization route that links physicochemical characteristics to engineering performance for the minimization and utilization of difficult-to-recycle plastic waste.

Thai researchers

BIBLIOGRAPHIC RESEARCH WATCHLIST

Bibliographic research records

Thailand-affiliated bibliographic records. These are not full analyses; they are ordered by Impact Signal and should be verified against the original source.

2,955records

2,955 records

85IMPACT SIGNAL

Multidisciplinary30 Sep 2026

Effectiveness of an Integrated Activity-Based and Tele-Monitoring Intervention on Mental Health Literacy and Resilience among Urban Older Adults in Thailand: A Quasi-Experimental Study

Journal of Health Research

Thailand-affiliated authors: Khunatpakorn Makkabphalanon · Pramote Thangkratok · Jutamast Wongjan · Natchaya Palacheewa
Institutions: Praboromarajchanok Institute Ministry of Public Health · Boromarajonani College of Nursing, Nakhon Ratchasima · Srisavarindhira Thai Red Cross Institute of Nursing

85IMPACT SIGNAL

Multidisciplinary30 Sep 2026

Valorization of polyphenol-rich extracts from Oroxylum indicum (L.) kurz outer stem bark as sustainable textile colourants: Comparison concerns selected GOTS 7.0 colour fastness criteria on effects of six mordants and pre-, meta- and post-mordanting techniques on dyeing properties

Frontiers in Engineering Innovation Research

Thailand-affiliated authors: Siripan Metanawin · Apichart Sonthisombat · Mahamasuhaimi Masae · Sumonman Niamlang · Jantana Sutdaen · Pannarai Rug-ngarn · Orathai Tangsirinaruenart · Tanapak Metanawin · Sarunya Puakpong
Institutions: Rajamangala University of Technology · Rajamangala University of Technology Srivijaya · King Mongkut's University of Technology North Bangkok · Kasetsart University

85IMPACT SIGNAL

Multidisciplinary30 Sep 2026

Role of Legislation in Occupational Disease Prevention: A Case of Chronic Silicosis with Progressive Massive Fibrosis

THE BANGKOK MEDICAL JOURNAL

Thailand-affiliated authors: Thammarath Thiamsuk · Supakorn Chansaengpetch · Tirathat Virojskulchai · Ekanut Jamsai · Sitthiphon Bunman · Narongpon Dumavibhat
Institutions: Siriraj Hospital · Mahidol University · Chulalongkorn University · Thammasat University

85IMPACT SIGNAL

Environmental Engineering30 Sep 2026

Macroevolutionary dynamics and predictors of tropical rain forest plant diversity

Science Advances

Thailand-affiliated authors: Pasakorn Bunchalee · Tanawat Chaowasku · Anissara Damthongdee · Charan Leeratiwong
Institutions: Mahasarakham University · Chiang Mai University · Prince of Songkla University

85IMPACT SIGNAL

Multidisciplinary30 Sep 2026