Medicine and Health Sciences Commons^™

Tau Pet Positivity In Individuals With And Without Cognitive Impairment Varies With Age, Amyloid-Β Status, Apoe Genotype And Sex, Rik Ossenkoppele, Tammy L S Benzinger, Et Al.

2020-Current year OA Pubs

Tau positron emission tomography (PET) imaging allows in vivo detection of tau proteinopathy in Alzheimer's disease, which is associated with neurodegeneration and cognitive decline. Understanding how demographic, clinical and genetic factors relate to tau PET positivity will facilitate its use for clinical practice and research. Here we conducted an analysis of 42 cohorts worldwide (N = 12,048), including 7,394 cognitively unimpaired (CU) participants, 2,177 participants with mild cognitive impairment (MCI) and 2,477 participants with dementia. We found that from age 60 years to 80 years, tau PET positivity in a temporal composite region increased from 1.1% to 4.4% among CU …

Human Thalamocortical Structural Connectivity Develops In Line With A Hierarchical Axis Of Cortical Plasticity, Valerie J Sydnor, Deanna M Barch, Et Al.

2020-Current year OA Pubs

Human cortical development follows a hierarchical, sensorimotor-to-association sequence. The brain's capacity to enact this sequence indicates that it relies on unknown mechanisms to regulate regional differences in the timing of cortical maturation. Given evidence from animal systems that thalamic axons mechanistically regulate periods of cortical plasticity, here we evaluate in humans whether the development of structural connections between the thalamus and cortex aligns with cortical maturational heterochronicity. By deriving a new tractography atlas of human thalamic connections and applying it to diffusion data from three youth samples (8-23 years; total n = 2,676), we demonstrate that thalamocortical connectivity matures in …

Shared And Disease-Specific Pathways In Frontotemporal Dementia And Alzheimer's And Parkinson's Diseases, Muhammad Ali, Yike Chen, Ying Xu, Katherine Gong, Menghan Liu, Jigyasha Timsina, Daniel Western, Chengran Yang, Gyujin Heo, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

Neurodegenerative diseases (NDs), such as Alzheimer's disease (AD), Parkinson's disease (PD) and frontotemporal dementia (FTD), exhibit distinct yet overlapping pathological mechanisms. Leveraging large-scale plasma proteomics data from the Global Neurodegeneration Proteomics Consortium, we analyzed 10,527 plasma samples (1,936 AD, 525 PD, 163 FTD, 1,638 dementia and 6,265 controls) to identify disease-specific and shared proteins across NDs. We identified 5,187 proteins significantly associated with AD, 3,748 with PD and 2,380 with FTD that revealed both common and divergent proteomic signatures, which were confirmed by multiple analytical approaches and orthogonal validation. PD and FTD showed the highest overlap (r

Do Risk Factors For Hcc Impact The Association Of Ct/Mri Lirads Major Features With Hcc? An Individual Participant Data Meta-Analysis, Robert G Adamo, Daniel R Ludwig, Tyler J Fraum, Et Al.

2020-Current year OA Pubs

No abstract provided.

The Microrna Mir-30a Blocks Adipose Tissue Fibrosis Accumulation In Obesity, Pradip K Saha, Robert Sharp, Aaron R. Cox, Rabie Habib, Michael J. Bolt, Jessica B. Felix, Claudia E. Ramirez Bustamante, Xin Li, Sung Yun Jung, Kang Ho Kim, Kai Sun, Huaizhu Wu, Samuel Klein, Sean M. Hartig

2020-Current year OA Pubs

White adipose tissue (WAT) fibrosis occurring in obesity contributes to the inflammatory and metabolic comorbidities of insulin resistance and type 2 diabetes, yet the mechanisms involved remain poorly understood. Here, we report a role for the broadly conserved miRNA miR-30a as a regulator of WAT fibrosis and systemic glucose metabolism. Mice modified to express miR-30a at elevated levels in adipose tissues maintain insulin sensitivity coupled with reduced fatty liver disease when fed a high-fat diet. These effects were attributable to cell-autonomous functions of miR-30a that potently increase expression of adipocyte-specific genes. Proteomic screening revealed miR-30a limits profibrotic programs in subcutaneous …

Formation Control Between Leader And Migratory Follower Tissues Allows Coordinated Growth, Toru Kawanishi, Takamichi Sushida, Tony Y-C Tsai, Hiroyuki Takeda, Sean G Megason

2020-Current year OA Pubs

Coordinated growth of multiple tissues is fundamental to shaping our body, but the underlying mechanisms remain underexplored. In zebrafish embryos, midline tissues composed of the notochord, floorplate, and hypochord elongate synchronously with their lengths aligned. We show that floorplate and hypochord cells collectively migrate posteriorly along the nascent notochord extracellular matrix as it extends posteriorly, maintaining the tripartite configuration. Fibroblast growth factor-mediated migration in a spatially graded manner causes cell stretching, which triggers Yap-dependent proliferation and controls floorplate and hypochord growth. Supported by mathematical modeling, we further suggest that their growth is fine-tuned by mechanical tethering to the notochord via …

Association Between Nt-Probnp Changes And Clinical Outcomes In Paediatric Patients With Heart Failure: Insights From Panorama-Hf And Paradigm-Hf, Robert Shaddy, Charles Canter, Et Al.

2020-Current year OA Pubs

AIMS: The PANORAMA-HF trial demonstrated significant N-terminal pro-B-type natriuretic peptide (NT-proBNP) reductions in paediatric patients with left ventricular systolic dysfunction with sacubitril/valsartan or enalapril treatment over 52 weeks. This post hoc analysis aims to correlate changes in NT-proBNP levels with clinical outcomes in PANORAMA-HF patients receiving either sacubitril/valsartan or enalapril. Additionally, NT-proBNP reductions in the paediatric population were compared with a subset of adult heart failure with reduced ejection fraction (HFrEF) patients from the PARADIGM-HF trial.

METHODS AND RESULTS: This post hoc analysis utilized data from Part 2 of the PANORAMA-HF trial. Associations between baseline NT-proBNP levels, changes post-baseline and …

Collaborative Healthcare: Advancing Interprofessional Practice & Education, Volume 15, Number 2, Spring/Summer 2025

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this Issue:

• From the Editors
• Bridging the Gaps : Reflecting on a Summer of Immigrant and Refugee Health in Philadelphia
• Meet an IPE/CP Faculty Champion
• Meet an IPE/CP Alumna Champion
• Spotlight on Interprofessional Clinical Team
• Interprofessional Training on Inclusivity for Sexual and Gender Minority Populations

Is “Pre-Sepsis” The New Sepsis? A Narrative Review, Rémy Gerard, Antoine Dewitte, Fridolin Gross, Thomas Pradeu, Maël Lemoine, Julien Goret, Maria Mamani-Matsuda

Presidential Fellows Articles and Research

Sepsis is a life-threatening condition caused by a dysregulated immune response to infection, leading to organ dysfunction and high mortality. Despite advances in treatment, sepsis remains difficult to manage. Historically, the concept of sepsis evolved from ancient observations of infection-related decay to the germ theory of the 19th century. The latest Sepsis-3 definition describes sepsis as life-threatening organ dysfunction due to a dysregulated host response. However, this clinical characterization may be too late for effective intervention. The concept of endotypes and the ontological data applied to sepsis highlight the substantial heterogeneity in pathophysiological pathways leading to this endpoint. We propose …

Effectiveness And Safety Of Abobotulinumtoxina In Pediatric Lower Limb Spasticity: A Phase Iv, Prospective, Observational, Multicenter Study, Mark E. Gormley, Edward Dabrowski, Mauricio R. Delgado, Ann Tilton, Asare Christian, Sarah Helen Evans, Anne-Sophie Grandoulier, Jumaah Goldberg

School of Medicine Faculty Publications

Aim: To assess the longitudinal attainment of patient-centered, function-related Goal Attainment Scaling Total (GAS T)-score after repeated abobotulinumtoxinA (AboBoNT-A) injections over a period of up to 30 months and up to 10 cycles. Method: In this prospective observational study, the investigators' clinical practices recruited patients aged 2 to 17 years with pediatric lower limb spasticity (PLLS). GAS T-scores were assessed for each injection, and goals could be redefined at each visit; scores of 50 reflected goal achievement. Adverse events were recorded. Results: Of 210 patients in the effectiveness population, 171 had cerebral palsy and 163 were previously treated with a …

Providing An Evidence-Based Miscarriage Care Education Program For Nurses Caring For Women Experiencing An Early Pregnancy Loss, Kailee Draz

DNP Projects

Objective
Women often seek emergency care during an early pregnancy loss. Unfortunately, research shows that women are overwhelmingly dissatisfied with their miscarriage care due to lack of support and guidance, provider knowledge, communication and follow-up care. Mishandled miscarriage situations can cause women to suffer physical and psychological consequences. The purpose of this project was to discover if providing emergency room nursing staff with pregnancy loss bereavement education allows for enhanced support, knowledge, and confidence when caring for women experiencing pregnancy loss. The aim of the project is to measure if perceptions of ER registered nurses support, resources, knowledge, and confidence …

“Medication Is Only 10% Of Recovery”: A Mixed-Method Analysis Of Facilitators And Barriers To The Equitable Implementation Of Medications For Opioid Use Disorder Treatment, Alexandra Hernandez-Vallant

Psychology ETDs

Medications for opioid use disorder (MOUD), the gold standard treatment for OUD, are underutilized. Yet, research on MOUD clinical encounters is limited. Attention to social determinants of health (SDOH) can help improve engagement and retention in MOUD treatment. This dissertation project describes development of a clinical vignette-based survey using a two phase exploratory sequential design to examine the extent to which SDOH influence clinical decision-making among MOUD providers. Study 1 included interviews with 23 providers to learn their perspectives on facilitators/barriers to MOUD treatment and the clinical and social determinants most influential to their clinical decision-making. Study 2 involved development …

Tackling Data Quality Challenges In Remote Sensing: Solutions For Reliable Urban Heat Island Analysis, Wei Xia, Aqil Tariq, Hesham El-Askary, Rana Waqar Aslam, Elgar Barboza, Dmitry E. Kucher, Youssef M. Youssef, Habib Kraiem

Mathematics, Physics, and Computer Science Faculty Articles and Research

Urban heat islands (UHIs) pose critical challenges to public health, energy demand, and environmental sustainability, particularly in rapidly expanding urban regions. This study examines the complex relationship between building configurations and integrated green spaces, as well as their combined impact on thermal regulation. It focuses on addressing data quality issues commonly encountered in remote sensing applications. Using high-resolution multispectral and thermal imagery, we developed an integrated modeling approach that captures the collective influence of built form and green infrastructure on urban microclimates. A key finding is the significant linear inverse relationship between green space coverage and land surface temperature, underscoring …

The Effectiveness Of Remote Patient Monitoring In Reducing The Risk Of Rehospitalizations In Covid-19 Patients: A Meta-Analysis, Dela Riadi, Indang Trihandini, Dewi Nirmala Sari, Fikri Wijaya

Kesmas

An integrated analysis of various Remote Patient Monitoring (RPM) studies is needed to evaluate the reduction rate of the risk of rehospitalization in COVID-19 patients. This meta-analysis aimed to provide an overview of the effectiveness of RPM. A literature search through online databases (PubMed, Science Direct, Scopus, ProQuest, and Embase) was conducted from 2019 to 2022. After using the Cochrane Collaboration's risk of bias tool, five studies on COVID-19 were selected. Based on the data collected from 2,685 participants (intervention = 1,060, control = 1,625), the use of RPM was found to reduce rehospitalization by 0.56 times compared to not …

Direct Medical Costs Of Diabetes Mellitus Treatment For Patients With Cardiovascular And Renal Complications, Rizki Fadila, Ayu Tyas Purnamasari, A.A. Istri Citra Dewiyani

Kesmas

Type 2 Diabetes Mellitus (T2DM) represents a growing global health challenge with significant clinical and economic implications, notably in Indonesia. The burden is intensified by renal and cardiovascular complications, especially among National Health Insurance beneficiaries. This retrospective study evaluated the direct medical costs of hospitalized T2DM patients with such complications at a type B hospital from 2019 to 2022. Costs were analyzed from both healthcare provider and payer perspectives, covering medical services, medical support services, pharmaceuticals, and other support services. Of the 192 patients reviewed, most were male (57.8%), aged 45–64 years (72.4%), with hospital stays of 1–5 days (90,1%) …

Cross-Cultural Adaptation And Validation Of Ranas-Based Instrument For Measuring Latrine Use Behavior In Indonesia, Vera Yulyani, Fatwa Sari Tetra Dewi, Iswanto Iswanto

Kesmas

Using toilets is a simple way to prevent diarrhea, yet no validated tool exists to measure this habit. This study aimed to develop and validate instruments for measuring latrine use consistency. This questionnaire was adapted from the risk, attitude, norm, ability, and self-regulation (RANAS) framework developed in India and modified for Indonesia. It was evaluated by three experts using the content validity index (CVI). The face validity index (FVI) was pilot-tested on 40 community respondents. Variables measured included behavior, habits, intentions to use toilets, knowledge, attitudes, norms, abilities, and self-regulation. Question items with relevance and clarity scores of item CVI …

Contribution Of National Health Insurance Patient Revenue To Financial Performance Of Private-Profit Hospitals From 2017 To 2022, Fadlul Imansyah, Amal Chalik Sjaaf, Mardiati Nadjib, Rina Hartini

Kesmas

This study investigated the relationship between National Health Insurance (NHI) patient revenue and profit-private hospital financial performance in Indonesia. As the NHI provider, Badan Penyelenggara Jaminan Sosial (BPJS) Healthcare Security’s influence on hospital revenues has raised concerns about its impact on financial sustainability. This study used financial performance indicators to develop a financial performance index—Return on Assets (ROA), Return on Equity (ROE), Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) Margin, Current Ratio, and Net Profit Margin (NPM)—to assess the financial impact of BPJS Healthcare Security revenue. A partial model approach of multiple linear regression was employed using secondary data …

Supporting And Hindering Factors Associated With Covid-19 Health Protocol Adherence Among Online Motorcycle Taxi Riders In Samarinda City, Indonesia, Dina Lusiana Setyowati, Tanti Asrianti, Ismail Kamba, Rina Tri Agustini

Kesmas

The COVID-19 pandemic has underscored the importance of preventive health protocols, especially for high-contact occupations, such as online motorcycle taxi riders. However, adherence among these riders is inconsistent, particularly in economically constrained regions, such as Samarinda, a buffer zone for Indonesia's new capital. This study examined the influence of supporting and hindering factors on COVID-19 protocol compliance. A cross-sectional design was employed with 87 riders selected through quota sampling. Data were collected using structured questionnaires and analyzed using Spearman's rank correlation to assess the relationships between influencing factors and compliance levels. Economic barriers, especially high personal protective equipment (PPE) costs …

Sustaining Digital Health Interventions For Long-Term Cardiovascular Disease Prevention In The Energy Industry, Yul Isnadi, L. Meily Kurniawidjaja, Doni Hikmat Ramdhan

Kesmas

Cardiovascular disease (CVD) is a major health concern for energy industry workers due to occupational risks. Digital health interventions (DHIs) offer innovative strategies for CVD prevention in this high-risk group. This study aimed to explore the effectiveness and sustainability of DHI by incorporating behavior change theories, behavior change techniques, and principles of persuasive system design. A literature review was performed using PubMed, Scopus, Web of Science, and CINAHL databases to collect relevant information on interventions for CVD prevention among energy sector workers. The results indicated that while DHI could improve physical activity, dietary habits, and medication adherence in the short …

Health Economics Perspective On Indonesian Telemedicine Platform Practices: A Qualitative Study, Yossico Ria Wibowo, Rina Djunita Pasaribu

Kesmas

Telemedicine in Indonesia has experienced significant growth since its introduction in 2014. The financing system is regulated independently by each platform, leading to disparities in teleconsultation fees and medical incentives. This qualitative study, which involved a literature review and interviews with 33 participants, offered a health economics perspective on the implementation of telemedicine. The recommended teleconsultation fee ranges from USD 0.05 to USD 2.54, with medical incentives set at USD 1,59-3.18 for general practitioners and USD 4.77-6.36 for specialists, using telephone or video calls as the preferred means of teleconsultation. Although most patients and Indonesian Medical Association administrators generally agreed …

Noncommunicable Diseases (Hypertension Or Diabetes Mellitus) Among Private University Lecturers And Related Factors, Ummi Kalsum, Melati Puti Andini, Hendra Dhermawan Sitanggang, Helmi Suryani Nasution

Kesmas

Excessive workload, lack of rest, poor diet, stress, and insufficient physical activity are some contributing factors to a high risk of noncommunicable diseases (NCDs) for lecturers. This study aimed to develop a predictive model for the risk of NCDs among lecturers at a private university in Jambi City, Indonesia. A cross-sectional design was used, and the sample included 93 lecturers who met the inclusion criteria. The independent variables were workload, rest pattern, diet, physical activity, stress, smoking, and family history. The dependent variable was NCDs (hypertension or diabetes mellitus), measured through interviews based on a doctor's diagnosis. Data analysis was …

Factors Of Anxiety Symptoms Due To Large-Scale Social Restriction Policy During The Covid-19 Pandemic In Indonesia, Indri Hapsari Susilowati, Sudibyo Alimoeso, Susiana Nugraha, Bonardo Prayogo Hasiholan, Magda Sabrina Theofany Simanjuntak, Nur Rachmat Satria

Kesmas

The Indonesian Government took some preventive measures to slow the spread of the COVID-19 virus, including social restrictions and encouraging individuals to stay at home and avoid needless gatherings. This study aimed to identify factors related to anxiety symptoms during large-scale social restrictions. This study employed a cross-sectional design using the snowball technique in an online survey. A total of 788 respondents comprised the target population to detect the smallest effect size (Cohen's dz = .2), with the level of power of 0.8 using G*Power 3.1, specifically targeting adults aged over 18 years. Out of 1,194 people who took part …

Determinants Influencing The Readiness Of Non-Medical Hospital Personnel To Perform Basic Life Support, Elin Hidayat, Suaib Suaib, I Made Rio Dwijayanto, Nur Aviva Pemasi, Ilne Ai Purana Adel

Jurnal Keperawatan Indonesia

All healthcare personnel, including both medical and non-medical staff within hospitals, are expected to possess the capability to administer Basic Life Support (BLS) in order to provide immediate assistance during emergencies. However, many non-medical hospital staff remain unprepared to perform BLS due to a lack of knowledge, willingness, and confidence. This study aims to identify the factors affecting the preparedness of non-medical hospital staff in carrying out BLS at Undata Hospital, a healthcare facility in Central Sulawesi. This research employed quantitative design with a cross-sectional approach. The sample comprised 103 non-medical respondents selected through total sampling. Data were collected through …

Implementation Of A Discharge Process For Pediatric Patients Hospitalized With Asthma Exacerbations To Improve Post-Discharge Follow-Up, Emiko N. Dudley

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to improve pediatric pulmonary outpatient follow-up after hospital discharge for pediatric patients hospitalized with asthma exacerbations through the implementation of a standardized discharge process designed to improve communication, education, and care coordination.

Background

The project was completed in acute care and intermediate care units within a women's and children’s hospital in San Antonio, Texas.

Methodology

Following the IHI Improvement Model, serial PDSA cycles were completed over a 10-week period. An interprofessional team developed a standardized process map and interventions, including a discharge checklist, communication board, patient/family education, medications in hand at discharge, community asthma …

Angioedema: Is Icu Admission Warranted? A Single Institution Assessment, Madeleine Brill-Edwards, W. Chase Hamilton, Erika J. Yoo, Jennifer Costello, George J. Koenig, Murray J. Cohen, Joshua A. Marks

Department of Surgery Faculty Papers

INTRODUCTION: Angioedema has potential for rapid airway decompensation requiring intervention. Patients are often admitted to an ICU for "airway watch." There is a lack of evidence to support which patients require this.

AIM: We aimed to characterize admission patterns and outcomes of angioedema patients at our institution to assess resource utilization and necessity of ICU use. We hypothesized that patients not requiring intubation upon presentation are safe to manage outside the ICU.

MATERIALS AND METHODS: Retrospective chart review of patients admitted to our urban academic quaternary referral institution with angioedema ICD-10 codes between 2017 and 2020. Charts reviewed for demographics, …

Shifting From Crisis To Prevention: Community-Generated Materials From The Core Sipp Listening Sessions (Version 1), Camille Velarde, Mahtab Soleimani, Yvonnie Baik, Theresa Cruz

Reports & Documents

The Core State Injury Prevention Program (CORE SIPP) in New Mexico sought to understand how communities can prevent injury and violence before crisis occurs. In 2025, the University of New Mexico Prevention Research Center, in partnership with the New Mexico Department of Health, listened to service providers, advocates, and community leaders working with youth and families across the state. Participants described overlapping challenges, including poverty, unsafe housing, limited mental health care, transportation gaps, and a lack of safe spaces for young people, and emphasized that real prevention must start early and address families’ basic needs. From these sessions, community members …

Global, Regional, And National Time Trends In Falls And Their Predictions: An Age-Period-Cohort Analysis Of The Global Burden Of Disease Study 2021, Huan Jiang, Ning Sun, Huiqi Yang, Ye Li, Lihong Jiang, Huicui Zhao, Yi Zeng, Chengyang Sun, Chun Xu, Yongqiang Lai, Jia Meng

Health & Biomedical Sciences Faculty Publications

Background: Falls are a global public health issue with a heavy disease and socioeconomic burden, with an increasing number of risky people. The aim of this study is to explore the global disease burden of falls and to provide a scientific basis for the prevention and management of falls.

Methods: This study used data from the Global Burden of Disease Study 2021 (GBD 2021) to analyse global, regional, and national temporal trends in falls. An age-period-cohort (APC) model was applied to analyse data from 1990 to 2021, with global predictions made through 2046.

Findings: Although the falls mortality of all …

A Retrospective Data Analysis Of Factors Contributing To Surgical Patients Not Achieving Normothermia, Joseph P. O'Rourke Jr, Megan Casselberry

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postoperative hypothermia, defined as a core temperature below 36°C, is a prevalent and underrecognized complication in surgical settings, contributing to increased patient morbidity, prolonged recovery, and higher healthcare costs. This program evaluation project aimed to identify and address factors contributing to intraoperative and postoperative hypothermia by retrospectively analyzing patient records from a local hospital’s EPIC electronic health record system. Guided by the Iowa Model of Evidence-Based Practice and the W.K. Kellogg Foundation Program Evaluation Model, the project systematically reviewed perioperative temperature management protocols and warming interventions across diverse surgical specialties. Data extraction and analysis focused on patient demographics, procedural variables, …

High-Gamma And Beta Bursts In The Left Supramarginal Gyrus Can Differentiate Verbal Memory States And Performance, Shennan Aibel Weiss, Nicolás Sawczuk, Daniel Y. Rubinstein, Michael R Sperling, Katrina Wendel-Mitoraj, Päivi Österman, René Dumay-Roscher, Charles B. Mikell, Sima Mofakham, Kelly Coulehan, Petar M. Djuric, Diego Fernandez Slezak, Juan Esteban Kamienkowski

Department of Neurology Faculty Papers

INTRODUCTION: The left supramarginal gyrus (LSMG) contributes to attentional allocation for memory encoding and may also reflect memory state and performance. Given the roles of high-gamma and beta bursts in cognition and memory, this proof-of-concept study investigated whether these signals within the LSMG could classify memory state and performance.

METHODS: Using secondary data from 103 epilepsy patients undergoing presurgical iEEG evaluation, we analyzed 141 delayed verbal free recall experiments. Intracranial EEG (iEEG) data, recorded solely from LSMG electrode contacts, were processed to create two-dimensional (2D) tensors of convolved high-gamma (HG), and beta (15-40 Hz) burst activity. Convolutional neural networks (CNNs) …

Cholinesterase Enzyme Association With Quality Of Life Among Farmers In Khong Chai District, Kalasin Province, Thailand, Supasin Deeraksa, Mayuree Suuwunnakhot, Khanittha Madngammuang

Jurnal Keperawatan Indonesia

The agricultural sector in Thailand faces challenges that impact farmers' health and quality of life. This study examines the quality of life, cholinesterase enzyme levels, and factors associated with quality of life among farmers in Khong Chai District, Kalasin Province, Thailand. This cross-sectional analytical study was conducted using systematic random sampling. The respondents had a mean age of 54.97 ± 10.50 years (range 25–75 years) and comprised 75.56% females (n = 204), 24.44% males(n = 66). Data collection included demographic information, blood samples to assess cholinesterase enzyme safety levels, and responses to the World Health Organization Quality of Life Brief-Thai …