Nakornping Hospital (Thai: โรงพยาบาลนครพิงค์) is a hospital located in Chiang Mai, Thailand. It is the second largest hospital in Chiang Mai with an in-patient capacity of 742 beds as of 2022. It is now serving as the regional hospital of Chiang Mai province. It is a CPIRD Medical Education Center for the School of Medicine, University of Phayao.
OBJECTIVE:This study examined Thai wildland firefighters' cardiopulmonary fitness, comparing previous and updated NFPA criteria. METHODS:Chiang Mai wildland firefighters' health was cross-sectionally examined. Chester Step cardiopulmonary fitness was assessed using the fixed 12-MET threshold and age- and sex-adjusted 50th percentile criterion. McNemar test indicated standard concordance, and multivariable linear regression found MET values. Statistical significance was assigned by p-values < 0.05. RESULTS:Significant differences in fitness classifications between two methods (p < 0.05). Two previously passed participants failed, while 13 previously failed participants passed. Age (B=-0.07; 95% CI: -0.13, -0.01; p=0.016) and resting heart rate (B=-0.11; 95% CI: -0.16, -0.07; p<0.001) strongly correlated with METs. CONCLUSION:The age- and sex-adjusted 50th percentile criteria requirements allow for better cardiovascular fitness and practical work duties. Updates in standards are beneficial for firefighters' safety and health monitoring.
Background: Fiberoptic bronchoscopy training is constrained by high equipment costs and limited patient availability. This pilot feasibility and usability study describes the development and preliminary evaluation of a Simulation-Based VR Bronchoscopy Training system that incorporates game-design elements (an objective-based task, real-time scoring, and feedback) within an ADDIE-driven development framework. A high-fidelity prototype was built for the Meta Quest 3. Methods: Ten experienced anesthesiologists completed a pre-test, a one-week practice period (participants were instructed to complete at least 3–4 sessions/week, approximately 4–6 h total, with standardized technical support), and a post-test. Procedural time and mucosal collisions, System Usability Scale (SUS), perceived realism, and motion sickness were assessed; pre-/post-test differences were analyzed with the Wilcoxon signed-rank test. Results: System usability was rated “Excellent” (mean SUS = 81.80, SD = 7.02). Mean procedural completion time decreased significantly from 41.00 s (median 38.50, IQR 28.25–46.75) to 27.00 s (median 24.50, IQR 15.25–35.00; Z = −2.80, p = 0.005, r = −0.89), with all 10 participants improving. Mucosal collisions decreased from a mean of 3.80 (median 3.5) to 3.30 (median 3.0), a non-significant change (Z = −1.07, p = 0.285, r = −0.62); only 3 of 10 participants showed any change in collision count. Perceived realism was rated highly (21.90/25.00) and motion sickness was minimal (2.80/30.00). Conclusions: This pilot study indicates that the simulation is feasible, usable, and well accepted by experienced anesthesiologists, with a preliminary improvement in simulated procedural fluency. Given the small, experienced, single-group sample and the absence of a control condition, these findings should be interpreted as evidence of feasibility and usability rather than demonstrated training effectiveness; larger, controlled studies including novice learners are needed.
Background Timely creation of arteriovenous (AV) access before hemodialysis initiation is recommended to reduce catheter-related complications and improve clinical outcomes. However, predialysis AV access preparation remains suboptimal in Thailand despite guideline recommendations and expanded hemodialysis services. Evidence comparing perspectives among professional groups involved in the AV access care pathway is limited. This exploratory regional study compared the perspectives of nephrologists, vascular surgeons, and dialysis nurses in Upper Northern Thailand and identified supportive strategies that providers considered relevant to improving timely AV access preparation. Methods We conducted a cross-sectional convergent mixed-methods study using a self-administered survey among nephrologists, vascular surgeons, and dialysis nurses practicing in hospitals and dialysis clinics across Upper Northern Thailand from February to April 2025. Likert-scale responses were summarized and compared across professional groups, and brief open-ended responses were analyzed thematically. Quantitative and qualitative findings were integrated during interpretation. Results A total of 113 providers participated, including 78 nurses, 19 surgeons, and 16 nephrologists. Integration of the quantitative and qualitative findings identified five priority barriers: limited patient understanding, late presentation, procedural waiting times, insurance or reimbursement constraints, and clinical suitability concerns. Although the broad barrier patterns were shared, the emphasis placed on particular barriers varied across professional groups. Four supportive strategies were consistently endorsed: predictable financial coverage and reimbursement mechanisms, a dedicated vascular access coordinator, electronic referral and longitudinal follow-up systems, and proactive, stage-aligned AV access planning guidelines. Qualitative responses provided context by showing that providers associated these shared strategies with different role-related considerations, including patient preparation, referral coordination, procedural feasibility, and timing of care. Conclusions Providers in this regional study identified shared priorities for improving timely predialysis AV access preparation, while differing in the meanings and considerations they associated with those priorities. These context-specific, hypothesis-generating findings may inform locally adapted service improvement and future evaluation of the proposed strategies.
Background:Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and debilitating side effect that significantly reduces cancer patients' quality of life, limits treatment tolerance, and can compromise treatment efficacy. Accurate prediction of CIPN risk is crucial for targeted interventions. Objective:To develop and validate a risk prediction model, Foresight Neuro-Wing, for identifying patients at increased risk of CIPN during chemotherapy with common cytotoxic agents. Methods:A retrospective cohort study was used to analyze the electronic medical records of patients receiving chemotherapy at a single institution. Potential risk factors (demographic characteristics, as well as cancer-related and chemotherapy-related factors) were assessed using logistic regression. Model performance was evaluated using area under the receiver operating characteristic curve and calibration plots. Internal validation involved bootstrapping and cross-validation. A classified score model stratified patients into 4 risk groups. Results:A total of 346 patients met the inclusion criteria. The incidence of CIPN was 33.5% (n = 116). Significant predictors included sex, underlying disease, cancer type, previous and current chemotherapy regimens, and number of chemotherapy cycles. The scoring model achieved a predictive performance of 87.33%, and the classified score model had a predictive performance of 85.93%. Decision curve analysis demonstrated that using the model to guide intervention decisions provided a greater net benefit than treating all or treating none. Conclusions:The Foresight Neuro-Wing model effectively identified patients at increased risk of CIPN. This tool has the potential to inform clinical decision-making, enabling targeted monitoring and preventive strategies, ultimately improving patient outcomes and quality of life.
