Bone-mimicking scaffold based on silk fibroin incorporated with hydroxyapatite and titanium oxide as enhanced osteo-conductive material for bone tissue formation: fabrication, characterization, properties, andin vitrotesting.

Bone-mimicking scaffolds based on silk fibroin (SF) mixed with hydroxyapatite nanoparticles (HA NPs) and titanium oxide (TiO2) nanoparticles were created as materials for bone formation. Six scaffold groups were fabricated: S1 (SF), S2 (Silk + (HA: TiO2; 100: 0)), S3 (Silk, (HA: TiO2; 70: 30)), S4 (Silk + (HA NPs: TiO2; 50: 50)), S5 (Silk + (HA: TiO2; 30: 70)), and S6 (Silk + (HA NPs: TiO2; 0:100)). Scaffolds were characterized for molecular formation, structure, and morphology by Fourier transform infrared spectroscopy, element analysis, and X-ray diffraction. They were tested for physical swelling and compressive modulus. Scaffolds were cultured with MC3T3 and testedin vitroto evaluate their biological performance. The results showed that scaffolds with HA and TiO2demonstrated molecular interaction via amide I and phosphate groups. These scaffolds had smaller pore sizes than those without HA and TiO2. They showed more swelling and higher compressive modulus than the scaffolds without HA and TiO2. They exhibited better biological performance: cell adhesion, viability, proliferation, alkaline phosphatase activity, and calcium content than the scaffolds without HA and TiO2. Their porous walls acted as templates for cell aggregation and supported synthesis of calcium secreted from cells. S3 were the most suitable scaffolds. With their enhanced osteo-conductive function, they are promising for bone augmentation for oral and maxillofacial surgery.

Experience of online physiology laboratory teaching for undergraduate students during the COVID-19 pandemic in Thailand.

The COVID-19 pandemic has disrupted traditional face-to-face human physiology teaching for students at the Faculty of Medicine, Thammasat University, Thailand since February 2020. An online curriculum for both lectures and laboratory sessions was developed to continue the education. This work compared the effectiveness of online physiology labs to the traditional onsite counterparts for 120 dental and pharmacy sophomore students during the 2020 academic year. The method used was a Microsoft Teams synchronous online laboratory experience consisting of eight topics. Faculty lab facilitators created protocols, video scripts, online assignments, and instruction notes. Group lab instructors prepared and delivered the content for recording and led the student discussion. Data recording and live discussion were synchronized and executed. The response rates for the control (2019) and study (2020) groups were 36.89 and 60.83%, respectively. The control group reported higher satisfaction about general laboratory experience, compared to the online study group. The online group rated the laboratory online experience with equal satisfaction to that of an onsite lab experience. The onsite control group reported 55.26% satisfaction with the equipment instrument, while only 32.88% online group voiced their approval of this measure. It was understandable because the excitement in physiology work relies heavily on the experience of the work (P < 0.027). With the same difficulty index for both academic year examination papers, the nonsignificant difference in academic performance of the control and study groups (59.50 ± 13.50 and 62.40 ± 11.43, respectively) showed the effectiveness of our online synchronous physiology lab teaching. In conclusion, the online physiology learning experience was appreciated when a good design was achieved.NEW & NOTEWORTHY The COVID-19 pandemic has forced physiology educators to use online teaching. At the time of this work, there was no research investigating the effectiveness of online and face-to-face physiology lab teaching in undergraduate students. A synchronized online lab teaching of a virtual lab classroom on the Microsoft Teams platform was successfully implemented. Our data showed that online physiology lab teaching could make the students understand physiology concepts and have the same effectiveness as the onsite lab experience.

Using Facebook for Ongoing Learning Promotes Higher National Licensing Examination Success.

OBJECTIVE: This study proposes Facebook usage as a motivational vehicle for studying block subjects in Problem-Based Learning Curriculum. Facebook page engagement should allow self-motivated medical students the opportunity to review subject materials. Frequent use and practice resulted in better National Licensing Examination step 1 (NLE1) scores amongst frequent users of posted material. METHODS: The scenarios and exercises were posted on a Facebook page every 2 months after completion of the relevant block. Participants were classified into four groups by frequency of Facebook page usage. Participants completed exit surveys after the NLE1 results were posted. The mean opinion scores of each group were compared using one-way ANOVA. The correlation coefficient of the percentage of the NLE1 success and frequency of page participation was calculated. RESULT: Most students spent excess of 3 months preparing for the NLE1. The most popular study aid was the MCQ bank. Frequent Facebook page users often preferred self-study and group work compared to "never" users (p < 0.05). Strong positive correlation (r = 0.956) was shown between the frequency of Facebook page usage and the success rate of the NLE1. CONCLUSION: Facebook study cases allowed self-motivated medical students to periodically review subject materials. Frequent users' regular practice resulted in better passing rates of the NLE1 exam.

Possibility of using superoxide dismutase and glutathione peroxidase as endometriosis biomarkers.

OBJECTIVE: To study the possibility of using superoxide dismutase (SOD) and glutathione peroxidase (GPx) as combined preoperative biomarkers for endometriosis. PARTICIPANTS AND METHODS: Female patients aged between 18 and 45 years old who came to the Gynecology outpatient clinic, Thammasat University Hospital, during September 2013-2016 with the complaint of gynecologic symptoms suspected of endometriosis, and who were positively diagnosed with endometriosis, were included in this study. All patients underwent conservative laparoscopic ovarian cystectomy with histopathological report. The control group consisted of healthy females of reproductive age who came to the outpatient clinic. The plasma SOD and GPx were measured from blood samples with commercial kits. A receiver operating characteristic curve was generated for plasma activity of SOD, GPx, and combined tests. The cutoff values were selected at the most appropriate sensitivity and specificity. RESULT: All 36 cases were included in this study. Mean ages of patients in the patient and control groups were 33.1 and 28.6 years old, respectively. SOD and GPx activities of disease and control group were 6.15 and 8.11, 463.9 and 472.34 nmole/min/mL unit, respectively. The sensitivity and 1-specificity of the combined test were calculated at 0.78, with sensitivity, specificity, accuracy, positive predictive value, and negative predictive value being 68.75, 80.77, 76.50, 69.23, and 80.33, respectively. CONCLUSION: A combination testing of SOD and GPx can possibly be used as preoperative biomarker for endometriosis.

Perception of social networking benefits in the support of a PBL module according to students' performance levels.

BACKGROUND: The use ofsocial networking to all levels of medical teaching as a communication tool between instructors and students has drawn much interest and increased usage. As Facebook is one of the most popular social networking sites among students, a Facebook page has been used in the Genitourinary System problem-based learning (PBL) course at the Faculty of Medicine, Thammasat University in the year 2014. OBJECTIVE: The objective of this work is to study the perception ofusing a Facebook page to support PBL in an integrated pre- clinical year course. MATERIAL AND METHOD: The Genitourinary System course committee introduced Facebook page to the 2"d year medical students who enrolled and instructors involved in the course. At the beginning ofthe course, the objectives ofFacebook page setting were informed as follows: 1) public relations, 2) channelfor questions and responses to address curiosities between students and instructors, 3) learning stimulation and 4) supporting good relationship between course coordinators and students. The participants consisted of 177 students who voluntarily allowed their opinion to be used in analysis and dissemination after completing a questionnaire about using the Facebook page in PBL at the end. A Likert scale was used to determine satisfaction scores for nine questions. Finally, the mean satisfaction was compared for each question and for students with different academic performances (great, good, fine, weak). RESULTS: The students liked the page (averaged satisfaction score 4.64) and wanted it to continue to be used in coursework (4.63), especiallyfor students at mid-level when compared to students with great performances (p<0.05). It was beneficial in allowing questions to be directed to instructors, both in lecture learning (4.54) and SDL (4.35), and lessened the time it took to understand content in SDL (4.03). However, although it did notcreate stress (2.10), students had not madefull use of it, as much as they could (3.25), as they were not able study all posts in detail (3.68). Therefore, if the Facebook pages were developed for students to study in more detail, it would enhance its benefits as SDL stimulus (4.09). CONCLUSION: Using social networking, particularly Facebook pages, achieved all the four the stated objectives. Since this was the first time social networking was applied, some of faculty members had concern that their personal information would be disseminated to the public. Moreover there was still minimal knowledge of sharing among students. The Facebook "closed group" with a good protective system may be an interesting option to enhance effectiveness in integrated PBL-styled courses.

Impact of hemostasis methods, electrocoagulation versus suture, in laparoscopic endometriotic cystectomy on the ovarian reserve: a randomized controlled trial.

OBJECTIVE: To evaluate the impact on ovarian reserve between two different methods ofhemostasis after laparoscopic ovarian endometrioma excision. MATERIAL AND METHOD: A randomized controlled study was conducted from January to December 2013 in Thammasat University Hospital, Thailand. Reproductive women, age 18-45years who underwent laparoscopic ovarian cystectomy were randomized in electrocoagulation and suture groups. Clinical baseline data and ovarian reserve outcome (anti-Mullerian hormone (AMH)) were evaluated. RESULTS: Fifty participants were recruited and randomized in two groups. Electrocoagulation and suture groups consisted of 25 participants. Baseline characteristics between 2 groups (age, weight, BMI, height, cyst diameter, duration and estimated blood loss) were not statistically different. There were no significant difference of AMIH between electrocoagulation and suture group atpre-operative (2.90±2.26 vs. 2.52±2.37 ng/ml), 1 week (1.78±1.51 vs. 1.99±1.71 ng/ml), 1 month (1.76±1.50 vs. 2.09±1.62 ng/ml), 3 months (2.09±1.66 vs. 1.96±1.68 ng/ml) and 6 months (2.11±1.84 vs 1.72±1.68 ng/ml), respectively. However mean AMH ofboth groups significantly decreased since the first week of operation. Effect oflaparoscopic ovarian surgery had significantly declined and sustained AMH level until 6 months. CONCLUSION: Laparoscopic cystectomy of ovarian endometrioma has negative impact to ovarian reserve. Either electroco- agulation or suture method had no different effects.

Antimullerian hormone changes after laparoscopic ovarian cystectomy for endometrioma compared with the nonovarian conditions.

Laparoscopic ovarian cystectomy is recommended for surgical procedure of endometrioma. The negative impact on ovarian reserve following removal had been documented. Little evidence had been reported for nonovarian originated effects. Objective. To evaluate the impact of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve, measured by serum antimullerian hormone (AMH), compared to nonovarian pelvic surgery. Materials and Methods. A prospective study was conducted. Women who underwent laparoscopic ovarian cystectomy (LOC) and laparoscopic nonovarian pelvic surgery (NOS) were recruited and followed up through 6 months. Clinical baseline data and AMH were evaluated. Results. 39 and 38 participants were enrolled in LOC and NOS groups, respectively. Baseline characteristics (age, weight, BMI, and height) and preoperative AMH level between 2 groups were not statistically different. After surgery, AMH of both groups decreased since the first week, at 1 month and at 3 months. However, as compared to the LOC group at 6 months after operation, the mean AMH of the NOS group had regained its value with a highly significant difference. Conclusion. This study demonstrated the negative impact of nonovarian or indirect effects of laparoscopic surgery to ovarian reserve. The possible mechanisms are necessary for more investigations.