Bumrungrad International Hospital

Background:Mucosal histological activity is increasingly valued as a treatment endpoint in inflammatory bowel diseases (IBD). In the Asia Pacific region, the utility and acceptability of IBD histology as a treatment endpoint are uncertain due to the heterogeneity of IBD prevalence, resourcing and level of knowledge among practitioners. There is an opportunity to engage clinicians to harmonise histology reporting and collaborate with pathologists in this field.Objectives:We aimed to develop consensus statements through anonymous voting on histological features, processing, reporting and relevance to treatment outcomes in IBD, including ulcerative colitis (UC) and Crohn’s disease (CD).Design:The consensus document was developed through a comprehensive literature review, followed by a deliberation process among experts in the field.Methods:Representatives of the Asia Pacific Association of Gastroenterology, in collaboration with pathologists, voted anonymously in accordance with modified Delphi methodology on statements relevant to IBD and histology. Domains of interest were histological features of UC and CD, relevance to clinical management and the potential utility of artificial intelligence (AI) in grading histological disease severity. Level of evidence and recommendation grade were included in accordance with the National Health and Medical Research Council, Australia guidelines of Australia.Results:Consensus was reached on 37 out of 38 statements concerning definitions, pathology processing and reporting, scoring system and relevance to clinical outcomes. Knowledge gaps were identified with uncertainty over the role of AI.Conclusion:These consensus statements provide recommendations, with specific relevance to the Asia Pacific region, on the role of histology in IBD to harmonise its use. The statements will promote understanding and applicability in research and in the routine management of IBD.

Lumbar spondylolysis can be asymptomatic but is a common cause of low back pain in adolescent athletes. We report a rare case of focal increased FDG uptake at the left pars interarticularis of L5 vertebra, along with an associated transverse fracture line on 18F-FDG PET/CT, in a 15-year-old boy with newly diagnosed osteosarcoma. This led to the incidental diagnosis of L5 spondylolysis. Attention to CT findings and history-taking is prerequisite to avoid misinterpretation of the FDG PET/CT in this clinical setting.

As demand for higher energy density, faster charging, and longer lifespan increases, so too does the need for sophisticated analysis of battery performance. This study focuses on the development of a lithium-ion battery analyzer for data-driven battery performance analysis. The system comprises a hardware platform and a cloud-connected software infrastructure. The hardware utilizes an STM32 microcontroller integrated with an LTC6803 for precise battery parameter measurements, including voltage, current, and temperature. The charging circuit is an LTC-4162, allowing for controlled charging profiles. A Raspberry Pi, running Raspbian OS, acts as the central processing unit, collecting data from the microcontroller and displaying it on a user-friendly human machine interface developed using Node-RED. Crucially, the system leverages cloud connectivity for data storage, analysis, and remote monitoring. The system transmits measured data to a cloud platform, which offers scalable storage and facilitates the development of sophisticated data analysis algorithms. This cloud integration allows for real-time battery performance monitoring and visualization through a dedicated application. Additionally, the system incorporates a local data backup mechanism, ensuring data accessibility even during internet disruptions. The developed system provides a comprehensive platform for data-driven insights into battery health, enabling informed decisions regarding battery operation and maintenance.

Background: The relationship between consuming Thai desserts—predominantly composed of carbohydrates—and gut microbiome profiles remains unclear. This study aimed to evaluate the effects of consuming various Thai desserts with different GI values on the gut microbiomes of healthy volunteers. Methods: This open-label, parallel randomized clinical trial involved 30 healthy individuals aged 18 to 45 years. Participants were randomly assigned to one of three groups: Phetchaburi’s Custard Cake (192 g, low-GI group, n = 10), Saraburi’s Curry Puff (98 g, medium-GI group, n = 10), and Lampang’s Crispy Rice Cracker (68 g, high-GI group, n = 10), each consumed alongside their standard breakfast. Fecal samples were collected at baseline and 24 h post-intervention for metagenomic analysis of gut microbiome profiles using 16S rRNA gene sequencing. Results: After 24 h, distinct trends in the relative abundance of various gut microbiota were observed among the dessert groups. In the high-GI dessert group, the abundance of Collinsella and Bifidobacterium decreased compared to the low- and medium-GI groups, while Roseburia and Ruminococcus showed slight increases. Correlation analysis revealed a significant negative relationship between sugar intake and Lactobacillus abundance in the medium- and high-GI groups, but not in the low-GI group. Additionally, a moderately negative association was observed between Akkermansia abundance and sugar intake in the high-GI group. These bacteria are implicated in energy metabolism and insulin regulation. LEfSe analysis identified Porphyromonadaceae and Porphyromonas as core microbiota in the low-GI group, whereas Klebsiella was enriched in the high-GI group, with no predominant bacteria identified in the medium-GI group. Conclusions: The findings suggest that Thai desserts with varying GI levels can influence specific gut bacteria, though these effects may be temporary.

This research studies four sensor positions for measuring vehicle speed through ground vibrations induced by transverse rumble strips. The study also introduces an automatic signal collection and processing method that utilizes amplitude thresholds in the time domain to differentiate between random background noise and the actual rumbling caused by vehicles crossing the rumble strips by looking for periodicity. The collected signal undergoes a 4-band band-pass filter and zero-padding before applying a Fast Fourier Transform (FFT). The frequency with the highest magnitude among the four spectra is used to calculate the vehicle's speed. Additionally, the research proposes using the calculated speed and the time-domain length of the signal to measure the vehicle’s wheelbase. Experimental results show a correlation with analytical findings.

Abstract Disclosure: R. Jerawatana: None. B. Weinstein: None. C.N. Phattanasri: None. S. Saetung: None. P. Tachanivate: None. A. Hathaidechadusadee: None. C. Deeampai: None. J. Sakmanarit: None. N. Saibuathong: None. S. Korpaisarn: None. N. Numsriskulrat: None. T. Sahakitrungruang: None. S. Reutrakul: Speaker; Self; Eli Lilly & Company. Background: Diabetes distress is associated with worse glycemic control and self-management in person with type 1 diabetes (T1D). Kindness to oneself may have positive effects on diabetes distress and glycemic control but the data were limited. This study explored the effects of a culturally adapted, brief version of the mindful self-compassion program (MSC), remotely delivered, in adolescents and young adults with T1D in Thailand. Methods: Thirty-four participants, age 18-30 years, who owned a smartphone or tablet, were randomized to receive MSC (n=17) or to a wait-list control group (n=17). Patients with significant co-morbidities and uncontrolled diabetes were excluded. MSC consisted of bi-weekly 2-hour virtual group meetings with the psychologist and study staff for 12 weeks. The content and activities were based on three domains i.e. self-compassion, mindfulness, and self-motivation. Each session emphasized skill practice within small groups of 5-6 participants. After 12-week, the control group was offered the MSC program. Measures of diabetes distress (primary outcome), A1C, diabetes self-efficacy, self-compassion, depressive symptoms, stress, and self-reported sleep quality (secondary outcomes) were collected at baseline, 12- and 24-week. Results: Mean (SD) age was 23.6 (3.6) years, and 22 (64.7%) were female. At 12-week, there was no significant difference in diabetes distress between the two groups, mean difference (MD) 0.38, 95%CI (-4.48, 5.23), p=0.876. However, the intervention group had a significant reduction in A1C compared to control group, MD -0.51%, 95% CI (-0.97, -0.04), p=0.035. Other secondary outcomes did not differ between groups. At 24-week, compared to 12-week, the intervention group maintained A1C reduction (7.33 (1.00) vs 7.49 (0.95)%, MD 0.16 95%CI (-0.04, 0.36), p=0.118 , while the wait-list control group had a reduction in A1C, (8.34 (1.96) vs. 7.76 (1.46)%, MD -0.58%, 95%CI (-0.95, -0.20), p=0.005. Diabetes distress and other secondary outcomes did not differ between 12- and 24-week in both groups. Satisfaction was high (5.8/7). There was no adverse event. Conclusion: This culturally adapted, brief version of the MSC program in adolescents and young adults with T1D did not reduce diabetes distress but resulted in improved glycemic control. It is possible that the improvement in A1C was mediated by other mechanisms than diabetes distress. The results of this study highlight the importance of empowering approaches for improved outcomes in this population. Presentation: 6/1/2024