Search results for: adverse drug effects
11702 Identifying and Optimizing the Critical Excipients in Moisture Activated Dry Granulation Process for Two Anti TB Drugs of Different Aqueous Solubilities
Authors: K. Srujana, Vinay U. Rao, M. Sudhakar
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Isoniazide (INH) a freely water soluble and pyrazinamide (Z) a practically water insoluble first line anti tubercular (TB) drugs were identified as candidates for optimizing the Moisture Activated Dry Granulation (MADG) process. The work focuses on identifying the effect of binder type and concentration as well as the effect of magnesium stearate level on critical quality attributes of Disintegration time (DT) and in vitro dissolution test when the tablets are processed by the MADG process. Also, the level of the drug concentration, binder concentration and fluid addition during the agglomeration stage of the MADG process was evaluated and optimized. For INH, it was identified that for tablets with HPMC as binder at both 2% w/w and 5% w/w level and Magnesium stearate upto 1%w/w as lubrication the DT is within 1 minute and the dissolution rate is the fastest (> 80% in 15 minutes) as compared to when PVP or pregelatinized starch is used as binder. Regarding the process, fast disintegrating and rapidly dissolving tablets are obtained when the level of drug, binder and fluid uptake in agglomeration stage is 25% w/w 0% w/w binder and 0.033%. w/w. At the other 2 levels of these three ingredients, the DT is significantly impacted and dissolution is also slower. For pyrazinamide,it was identified that for the tablets with 2% w/w level of each of PVP as binder and Cross Caramellose Sodium disintegrant the DT is within 2 minutes and the dissolution rate is the fastest(>80 in 15 minutes)as compared to when HPMC or pregelatinized starch is used as binder. This may be attributed to the fact that PVP may be acting as a solubilizer for the practically insoluble Pyrazinamide. Regarding the process,fast dispersing and rapidly disintegrating tablets are obtained when the level of drug, binder and fluid uptake in agglomeration stage is 10% w/w,25% w/w binder and 1% w/w.At the other 2 levels of these three ingredients, the DT is significantly impacted and dissolution is comparatively slower and less complete.Keywords: agglomeration stage, isoniazide, MADG, moisture distribution stage, pyrazinamide
Procedia PDF Downloads 24011701 Biosurfactant-Mediated Nanoparticle Synthesis by Bacillus subtilis
Authors: Satya Eswari Jujjavarapu, Swasti Dhagat, Lata Upadhyay, Reecha Sahu
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Silver nanoparticles have a broad range of antimicrobial and antifungal properties ranging from soaps, pastes to sterilization and drug delivery systems. These can be synthesized by physical, chemical and biological methods; biological methods being the most popular owing to their non-toxic nature and reduced energy requirements. Microbial surfactants, produced on the microbial cell surface or excreted extracellularly are an alternative to synthetic surfactants for the production of silver nanoparticles. Hence, they are also called as green molecules. Microbial lipopeptide surfactants (biosurfactant) exhibit anti-tumor and anti-microbial properties and can be used as drug delivery agents. In this study, biosurfactant was synthesized by using a strain of acillus subtilis. The biosurfactant thus produced was analysed by emulsification assay, oil spilling test, and haemolytic test. Biosurfactant-mediated silver nanoparticles were synthesised by microwave irradiation of the culture supernatant and further characterized by UV–vis spectroscopy for a range of 400-600 nm. The UV–vis spectra showed a surface plasmon resonance vibration band at 410 nm corresponding to the peak of silver nanoparticles.Keywords: biosurfactant, Bacillus subtilis, silver nano particle, lipopeptide
Procedia PDF Downloads 24011700 Copula-Based Estimation of Direct and Indirect Effects in Path Analysis Models
Authors: Alam Ali, Ashok Kumar Pathak
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Path analysis is a statistical technique used to evaluate the direct and indirect effects of variables in path models. One or more structural regression equations are used to estimate a series of parameters in path models to find the better fit of data. However, sometimes the assumptions of classical regression models, such as ordinary least squares (OLS), are violated by the nature of the data, resulting in insignificant direct and indirect effects of exogenous variables. This article aims to explore the effectiveness of a copula-based regression approach as an alternative to classical regression, specifically when variables are linked through an elliptical copula.Keywords: path analysis, copula-based regression models, direct and indirect effects, k-fold cross validation technique
Procedia PDF Downloads 4311699 Ionic Liquids-Polymer Nanoparticle Systems as Breakthrough Tools to Improve the Leprosy Treatment
Authors: A. Julio, R. Caparica, S. Costa Lima, S. Reis, J. G. Costa, P. Fonte, T. Santos De Almeida
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The Mycobacterium leprae causes a chronic and infectious disease called leprosy, which the most common symptoms are peripheral neuropathy and deformation of several parts of the body. The pharmacological treatment of leprosy is a combined therapy with three different drugs, rifampicin, clofazimine, and dapsone. However, clofazimine and dapsone have poor solubility in water and also low bioavailability. Thus, it is crucial to develop strategies to overcome such drawbacks. The use of ionic liquids (ILs) may be a strategy to overcome the low solubility since they have been used as solubility promoters. ILs are salts, liquid below 100 ºC or even at room temperature, that may be placed in water, oils or hydroalcoholic solutions. Another approach may be the encapsulation of drugs into polymeric nanoparticles, which improves their bioavailability. In this study, two different classes of ILs were used, the imidazole- and the choline-based ionic liquids, as solubility enhancers of the poorly soluble antileprotic drugs. Thus, after the solubility studies, it was developed IL-PLGA nanoparticles hybrid systems to deliver such drugs. First of all, the solubility studies of clofazimine and dapsone were performed in water and in water: IL mixtures, at ILs concentrations where cell viability is maintained, at room temperature for 72 hours. For both drugs, it was observed an improvement on the drug solubility and [Cho][Phe] showed to be the best solubility enhancer, especially for clofazimine, where it was observed a 10-fold improvement. Later, it was produced nanoparticles, with a polymeric matrix of poly(lactic-co-glycolic acid) (PLGA) 75:25, by a modified solvent-evaporation W/O/W double emulsion technique in the presence of [Cho][Phe]. Thus, the inner phase was an aqueous solution of 0.2 % (v/v) of the above IL with each drug to its maximum solubility determined on the previous study. After the production, the nanosystem hybrid was physicochemically characterized. The produced nanoparticles had a diameter of around 580 nm and 640 nm, for clofazimine and dapsone, respectively. Regarding the polydispersity index, it was in agreement of the recommended value of this parameter for drug delivery systems (around 0.3). The association efficiency (AE) of the developed hybrid nanosystems demonstrated promising AE values for both drugs, given their low solubility (64.0 ± 4.0 % for clofazimine and 58.6 ± 10.0 % for dapsone), that prospects the capacity of these delivery systems to enhance the bioavailability and loading of clofazimine and dapsone. Overall, the study achievement may signify an upgrading of the patient’s quality of life, since it may mean a change in the therapeutic scheme, not requiring doses of drug so high to obtain a therapeutic effect. The authors would like to thank Fundação para a Ciência e a Tecnologia, Portugal (FCT/MCTES (PIDDAC), UID/DTP/04567/2016-CBIOS/PRUID/BI2/2018).Keywords: ionic liquids, ionic liquids-PLGA nanoparticles hybrid systems, leprosy treatment, solubility
Procedia PDF Downloads 15211698 Strategies of Drug Discovery in Insects
Authors: Alaaeddeen M. Seufi
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Many have been published on therapeutic derivatives from living organisms including insects. In addition to traditional maggot therapy, more than 900 therapeutic products were isolated from insects. Most people look at insects as enemies and others believe that insects are friends. Many beneficial insects rather than Honey Bees, Silk Worms and Shellac insect could insure human-insect friendship. In addition, insects could be MicroFactories, Biosensors or Bioreactors. InsectFarm is an amazing example of the applied research that transfers insects from laboratory to market by Prof Mircea Ciuhrii and co-workers. They worked for 18 years to derive therapeutics from insects. Their research resulted in production of more than 30 commercial medications derived from insects (e.g. Imunomax, Noblesse, etc.). Two general approaches were followed to discover drugs from living organisms. Some laboratories preferred biochemical approach to purify components of the innate immune system of insects and insect metabolites as well. Then the purified components could be tested for many therapeutic trials. Other researchers preferred molecular approach based on proteomic studies. Components of the innate immune system of insects were then tested for their medical activities. Our Laboratory team preferred to induce insect immune system (using oral, topical and injection routes of administration), then a transcriptomic study was done to discover the induced genes and to identify specific biomarkers that can help in drug discovery. Biomarkers play an important role in medicine and in drug discovery and development as well. Optimum biomarker development and application will require a team approach because of the multifaceted nature of biomarker selection, validation, and application. This team uses several techniques such as pharmacoepidemiology, pharmacogenomics, and functional proteomics; bioanalytical development and validation; modeling and simulation to improve and refine drug development. Our Achievements included the discovery of four components of the innate immune system of Spodoptera littoralis and Musca domestica. These components were designated as SpliDef (defesin), SpliLec (lectin), SpliCec (cecropin) and MdAtt (attacin). SpliDef, SpliLec and MdAtt were confirmed as antimicrobial peptides, while SpliCec was additionally confirmed as anticancer peptide. Our current research is going on to achieve something in antioxidants and anticoagulants from insects. Our perspective is to achieve something in the mass production of prototypes of our products and to reach it to the commercial level. These achievements are the integrated contributions of everybody in our team staff.Keywords: AMPs, insect, innate immunitty, therappeutics
Procedia PDF Downloads 37111697 Synthetic Coumarin Derivatives and Their Anticancer Properties
Authors: Kabange Kasumbwe, Viresh Mohanlall, Bharti Odhav, Venu Narayanaswamy
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Coumarins are naturally occurring plant metabolites known for their pharmacological properties such as anticoagulant, antimicrobial, anticancer, antioxidant, anti-inflammatory and antiviral properties. The pharmacological and biochemical properties and curative applications of coumarins depend on the substitution around the coumarin core structure. In the present study, seven halogenated coumarins CMRN1-CMRN7 were synthesized and evaluated for their anticancer activity. The cytotoxicity potential of the test compounds was evaluated against UACC62 (Melanoma), MCF-7 (Breast cancer) and PBM (Peripheral Blood Mononuclear) cell lines using MTT assay keeping doxorubicin as standard drug. The apoptotic potential of the coumarin compounds was evaluated against UACC62 (Melanoma) cell by assessing their morphological changes, membrane change, mitochondria membrane potential; pro-apoptotic changes were investigated using the AnnexinV-PI staining, JC-1, caspase-3 enzyme kits respectively on flow cytometer. The synthetic coumarin has strongly suppressed the cell proliferation of UACC-62 (Melanoma) and MCF-7 (Breast) Cancer cells, the higher toxicity of these compounds against UACC-62 (Melanoma) and MCF-7 (Breast) were CMRN3, CMRN4, CMRN5, CMRN6. However, compounds CMRN1, CMRN2, and CMRN7 had no significant inhibitory effect. Furthermore the active compounds CMRN3, CMRN4, CMRN5, CMRN6 exerted antiproliferative effects through apoptosis induction against UACC-62 (Melanoma), suggesting their potential could be considered as attractive lead molecules in the future for the development of potential anticancer agents since one of the important criteria in the development of therapeutic drugs for cancer treatment is to have high selectivity and less or no side-effects on normal cells and these compounds had no inhibitory effect against the PBMC cells.Keywords: coumarin, MTT, apoptosis, cytotoxicity
Procedia PDF Downloads 23911696 The Effects on Abomasal Emtying Rate of Erythromycin and Bethanechol in Healthy, Premature and Diarrheic Calves
Authors: Sebnem Canikli Engin, Mutlu Sevinc, Hasan Guzelbektes
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In this study, we aim to define the effects of erythromycin and bethanechol which are prokinetic agents, on the value of abomasal discharge in healthy, diarrhea and premature calves. In the work, 5 healty calves, 12 diarrheaic calves and 12 premature calves, amounting to a total of 29 calves. In healty calves work; the same 5 calves were used for controlled, erythromycin and bethanechol studies (there was a 48-hour waiting period between each work). In diarrheic calves work; 12 diarrheic calves were used during the study (4 of them for control group, 4 of them bethanechol group and last 4 calves erythromycin group). In premature calves works; 12 premature calves were used during the study (4 of them for control group, 4 of them bethanechol group and last 4 calves erythromycin group). 10 mg/kg IM dose of erythromycin were applied to each erythromycin group, 0,07 mg/kg IM dose of bethanechol were applied on bethanechol group. No drugs were applied to the control group and substitution milk was given to all calves. 50 mg/kg acetominophen and 25 gram/L glucose have been added into the substitution milk to evaluate the speed of gastrointestinal motility with the test results of absorptions of acetominophen and glucose. The blood samples have been taken before substitution milk application and 30, 60, 90, 120, 180, 240 and 300 minutes after substitution milk application. Respiratory rates and number of heartbeats were also recorded during the test time. No changes were observed in the number of heartbeats, respiratory rates and general conditions for all groups after drug application. It is observed that, the feces of some calves became slightly watery and viscous and premature calves generaly defecated after 180 minutes. When Cmax, Tmax and AUC values of acetaminophen and glucose are compared with control group’s after applying erythromycin on the calves in the premature group, we obtain higher Cmax (P<0,05), shorter Tmax and greather AUC (P>0,05) values. In conclusion, according to clinical and laboratory findings, it may be stated that the application of 10 mg/kg doze of erythromycin IM has provided faster abomazal emptying in premature calves.Keywords: abomazal emptying, bethanechol, calf, erythromycin
Procedia PDF Downloads 33811695 Identification of Potent and Selective SIRT7 Anti-Cancer Inhibitor via Structure-Based Virtual Screening and Molecular Dynamics Simulation
Authors: Md. Fazlul Karim, Ashik Sharfaraz, Aysha Ferdoushi
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Background: Computational medicinal chemistry approaches are used for designing and identifying new drug-like molecules, predicting properties and pharmacological activities, and optimizing lead compounds in drug development. SIRT7, a nicotinamide adenine dinucleotide (NAD+)-dependent deacylase which regulates aging, is an emerging target for cancer therapy with mounting evidence that SIRT7 downregulation plays important roles in reversing cancer phenotypes and suppressing tumor growth. Activation or altered expression of SIRT7 is associated with the progression and invasion of various cancers, including liver, breast, gastric, prostate, and non-small cell lung cancer. Objectives: The goal of this work was to identify potent and selective bioactive candidate inhibitors of SIRT7 by in silico screening of small molecule compounds obtained from Nigella sativa (N. sativa). Methods: SIRT7 structure was retrieved from The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB), and its active site was identified using CASTp and metaPocket. Molecular docking simulation was performed with PyRx 0.8 virtual screening software. Drug-likeness properties were tested using SwissADME and pkCSM. In silico toxicity was evaluated by Osiris Property Explorer. Bioactivity was predicted by Molinspiration software. Antitumor activity was screened for Prediction of Activity Spectra for Substances (PASS) using Way2Drug web server. Molecular dynamics (MD) simulation was carried out by Desmond v3.6 package. Results: A total of 159 bioactive compounds from the N. Sativa were screened against the SIRT7 enzyme. Five bioactive compounds: chrysin (CID:5281607), pinocembrin (CID:68071), nigellidine (CID:136828302), nigellicine (CID:11402337), and epicatechin (CID:72276) were identified as potent SIRT7 anti-cancer candidates after docking score evaluation and applying Lipinski's Rule of Five. Finally, MD simulation identified Chrysin as the top SIRT7 anti-cancer candidate molecule. Conclusion: Chrysin, which shows a potential inhibitory effect against SIRT7, can act as a possible anti-cancer drug candidate. This inhibitor warrants further evaluation to check its pharmacokinetics and pharmacodynamics properties both in vitro and in vivo.Keywords: SIRT7, antitumor, molecular docking, molecular dynamics simulation
Procedia PDF Downloads 8011694 Estimation of Stress Intensity Factors from near Crack Tip Field
Authors: Zhuang He, Andrei Kotousov
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All current experimental methods for determination of stress intensity factors are based on the assumption that the state of stress near the crack tip is plane stress. Therefore, these methods rely on strain and displacement measurements made outside the near crack tip region affected by the three-dimensional effects or by process zone. In this paper, we develop and validate an experimental procedure for the evaluation of stress intensity factors from the measurements of the out-of-plane displacements in the surface area controlled by 3D effects. The evaluation of stress intensity factors is possible when the process zone is sufficiently small, and the displacement field generated by the 3D effects is fully encapsulated by K-dominance region.Keywords: digital image correlation, stress intensity factors, three-dimensional effects, transverse displacement
Procedia PDF Downloads 61611693 Influence of Vibration Amplitude on Reaction Time and Drowsiness Level
Authors: Mohd A. Azizan, Mohd Z. Zali
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It is well established that exposure to vibration has an adverse effect on human health, comfort, and performance. However, there is little quantitative knowledge on performance combined with drowsiness level during vibration exposure. This paper reports a study investigating the influence of vibration amplitude on seated occupant reaction time and drowsiness level. Eighteen male volunteers were recruited for this experiment. Before commencing the experiment, total transmitted acceleration measured at interfaces between the seat pan and seatback to human body was adjusted to become 0.2 ms-2 r.m.s and 0.4 ms-2 r.m.s for each volunteer. Seated volunteers were exposed to Gaussian random vibration with frequency band 1-15 Hz at two level of amplitude (low vibration amplitude and medium vibration amplitude) for 20-minutes in separate days. For the purpose of drowsiness measurement, volunteers were asked to complete 10-minutes PVT test before and after vibration exposure and rate their subjective drowsiness by giving score using Karolinska Sleepiness Scale (KSS) before vibration, every 5-minutes interval and following 20-minutes of vibration exposure. Strong evidence of drowsiness was found as there was a significant increase in reaction time and number of lapse following exposure to vibration in both conditions. However, the effect is more apparent in medium vibration amplitude. A steady increase of drowsiness level can also be observed in KSS in all volunteers. However, no significant differences were found in KSS between low vibration amplitude and medium vibration amplitude. It is concluded that exposure to vibration has an adverse effect on human alertness level and more pronounced at higher vibration amplitude. Taken together, these findings suggest a role of vibration in promoting drowsiness, especially at higher vibration amplitude.Keywords: drowsiness, human vibration, karolinska sleepiness scale, psychomotor vigilance test
Procedia PDF Downloads 28411692 An Occupational Health Risk Assessment for Exposure to Benzene, Toluene, Ethylbenzene and Xylenes: A Case Study of Informal Traders in a Metro Centre (Taxi Rank) in South Africa
Authors: Makhosazana Dubazana
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Many South Africans commuters use minibus taxis daily and are connected to the informal transport network through metro centres informally known as Taxi Ranks. Taxi ranks form part of an economic nexus for many informal traders, connecting them to commuters, their prime clientele. They work along designated areas along the periphery of the taxi rank and in between taxi lanes. Informal traders are therefore at risk of adverse health effects associated with the inhalation of exhaust fumes from minibus taxis. Of the exhaust emissions, benzene, toluene, ethylbenzene and xylenes (BTEX) have high toxicity. Purpose: The purpose of this study was to conduct a Human Health Risk Assessment for informal traders, looking at their exposure to BTEX compounds. Methods: The study was conducted in a subsection of a taxi rank which is representative of the entire taxi rank. This subsection has a daily average of 400 minibus taxi moving through it and an average of 60 informal traders working in it. In the health risk assessment, a questionnaire was conducted to understand the occupational behaviour of the informal traders. This was used to deduce the exposure scenarios and sampling locations. Three sampling campaigns were run for an average of 10 hours each covering the average working hours of traders. A gas chronographer was used for collecting continues ambient air samples at 15 min intervals. Results: Over the three sampling days, the average concentrations were, 8.46ppb, 0.63 ppb, 1.27ppb and 1.0ppb for benzene, toluene, ethylbenzene, and xylene respectively. The average cancer risk is 9.46E-03. In several cases, they were incidences of unacceptable risk for the cumulative exposure of all four BTEX compounds. Conclusion: This study adds to the body of knowledge on the Human Health Risk effects of urban BTEX pollution, furthermore focusing on the impact of urban BTEX on high risk personal such as informal traders, in Southern Africa.Keywords: human health risk assessment, informal traders, occupational risk, urban BTEX
Procedia PDF Downloads 23311691 Inventory Management to Minimize Storage Costs and Improve Delivery Time in a Pharmaceutical Industry
Authors: Israel Becerril Rosales, Manuel González De La Rosa, Gerardo Villa Sánchez
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In this work, the effects that produce not having a good inventory management is analyzed, in addition of the way that how it affects the storage costs. The research began conducting the historical analysis about stored products, its storage capacity, and distribution. The results were not optimal, since in all its raw materials (RM) have overstocking, the warehouse capacity is only used by 61%, does not have a specific place for each of its RM, causing that the delivery times increases and makes difficult a cyclical inventory. These shortcomings allowed to view and select as design alternatives the inventory ABC, so that depending on the consumption of each RM would be redistributed by using economic amount requested. Also, the Delphi method to ensure the practical applicability of the proposed tool was used, taking in account comments and suggestions of the involved experts, as well as the compliance of NOM-059-SSA1-2015 good manufacturing practices of drug. With the actions implemented, the utilization rate drops of 61% to 32% capacity, it shows that the warehouse was not designed properly due to there is not an industrial engineering area.Keywords: lead time, improve delivery, storage costs, inventory management
Procedia PDF Downloads 23411690 Bioprotective Role of Soil Borne Bacillus Strains against Selected Fungal Pathogens of Agriculture Relevance
Authors: Asad Ali, Asif Jamal
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The agriculture productivity losses due to microbial pathogens have been a serious issue in Pakistan and rest of the world. Present work was designed to isolate soil borne microorganisms having the antagonistic ability against notorious phytopathogens. From the initial collection of 23 bacterial isolates, two potent strains of Bacillus were screened on the basis of their comparative efficacy against devastating fungal pathogens. The strains AK-1 and AK-5 showed excellent inhibitory indexes against the majority of tested fungal strains. It was noted that both strains of Bacillus showed significant biocontrolling activity against Aspergillus flavus, Fusarium moniliforme, Colletotricum falcatum, Botrytis cinerea, Aspergillus niger, Fusarium oxysporum, Phythopthora capsici and Rhizopus oryzae. The strain AK-1 was efficient to suppress Aspergillus species and Rhizopus oryzae while AK-5 expressed significant antagonistic activity against Fusarium, Botrytis and Colletotricum species. On the basis of in vitro assay, it can be postulated that the Bacillus strains AK-1 and AK-5 can be used as bio-protective agent against various plant diseases. In addition, their applications as natural pesticides could be very helpful to prevent the adverse effects of chemical pesticides.Keywords: bacillus species, biocontrol agent, biopesticides, phytopathogens
Procedia PDF Downloads 24211689 A Study on the Synthesis and Antioxidant Activity of Hybrid Pyrazoline Integrated with Pyrazole and Thiazole Nuclei
Authors: Desta Gebretekle Shiferaw, Balakrishna Kalluraya
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Pyrazole is an aromatic five-membered heterocycle with two nitrogen and three carbon atoms in its ring structure. According to the literature, pyrazoline, pyrazole, and thiazole-containing moieties are found in various drug structures and are responsible for nearly all pharmacological effects. The pyrazoline linked to pyrazole moiety carbothioamides was synthesized via the reaction of pyrazole-bearing chalcones (3-(5-chloro-3-methyl-¹-phenyl-1H-pyrazol-4-yl)-¹-(substituted aryl) prop-2-ene-¹-one derivatives) with a nucleophile thiosemicarbohyrazide by heating in ethanol using fused sodium acetate as a catalyst. Then the carbothioamide derivatives were converted into the pyrazoline hybrid to pyrazole and thiazole derivatives by condensing with substituted phenacyl bromide in alcohol in a basic medium. Next, the chemical structure of the newly synthesized molecules was confirmed by IR, 1H-NMR, and mass spectral data. Further, they were screened for their in vitro antioxidant activity. Compared to butylated hydroxy anisole (BHA)., the antioxidant data showed that the synthesized compounds had good to moderate activity.Keywords: pyrazoline-pyrazole carbothioamide derivatives, pyrazoline-pyrazole-thiazole derivatives, spectral studies, antioxidant activity
Procedia PDF Downloads 7411688 Effect of Urban Informal Settlements and Outdoor Advertisement on the Quality of Built Environment and Urban Upgrading in Nigeria
Authors: Amao Funmilayo Lanrewaju, T. Ogunlade
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The paper examines the causes and characteristics of informal settlements and outdoor advertisement in the evaluation of quality of environment. The paper identifies the problems that have aided informal settlements to: Urbanization, poverty, growth of informal sector, non-affordability of land and housing shortage. The paper asserts that the informal settlements have serious adverse effects on the people’s health, their built environment and quality of life. The secondary data was obtained from books, journals and seminar papers. The paper argues that, although the urban upgrading possesses great potential for improving quality of built environment in informal settlements, there is a need to repackage the upgrading exercise so that majority can benefit from it. It is necessary to incorporate community participation into the urban upgrading in order to assist the very poor that cannot take care of their housing consumption needs. Therefore, government is encouraged to see informal settlements as a solution to new city planning rather than problem to the urban areas. This paper suggests the implementation of policies and planning, physical infrastructural development, social economic improvement, environment and health improvement. Government, private and communities interventions on informal settlements are required in order to prevent further decay for sustainable development.Keywords: quality of environment, informal settlements, urban upgrading, outdoor advertisement
Procedia PDF Downloads 48711687 Title: Real World Evidence a Tool to Overcome the Lack of a Comparative Arm in Drug Evaluation in the Context of Rare Diseases
Authors: Mohamed Wahba
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Objective: To build a comparative arm for product (X) in specific gene mutated advanced gastrointestinal cancer using real world evidence to fulfill HTA requirements in drug evaluation. Methods: Data for product (X) were collected from phase II clinical trial while real world data for (Y) and (Z) were collected from US database. Real-world (RW) cohorts were matched to clinical trial base line characteristics using weighting by odds method. Outcomes included progression-free survival (PFS) and overall survival (OS) rates. Study location and participants: Internationally (product X, n=80) and from USA (Product Y and Z, n=73) Results: Two comparisons were made: trial cohort 1 (X) versus real-world cohort 1 (Z), trial cohort 2 (X) versus real-world cohort 2 (Y). For first line, the median OS was 9.7 months (95% CI 8.6- 11.5) and the median PFS was 5.2 months (95% CI 4.7- not reached) for real-world cohort 1. For second line, the median OS was 10.6 months (95% CI 4.7- 27.3) for real-world cohort 2 and the median PFS was 5.0 months (95% CI 2.1- 29.3). For OS analysis, results were statistically significant but not for PFS analysis. Conclusion: This study provided the clinical comparative outcomes needed for HTA evaluation.Keywords: real world evidence, pharmacoeconomics, HTA agencies, oncology
Procedia PDF Downloads 9011686 Safety Evaluation of Intramuscular Administration of Zuprevo® Compared to Draxxin® in the Treatment of Swine Respiratory Disease at Weaning Age
Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis
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The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin
Procedia PDF Downloads 39711685 Factors Contributing to Adverse Maternal and Fetal Outcome in Patients with Eclampsia
Authors: T. Pradhan, P. Rijal, M. C. Regmi
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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors
Procedia PDF Downloads 17011684 The Impact of Corporate Governance Regulation in the Nigerian Banking Sector
Authors: Simisola I. Akintoye, Sunday K. Iyaniwura
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Recent global corporate failures have called for increase in the need to regulate corporate governance across the world. In Nigeria, the impact of corporate governance regulation in the banking sector has reached epidemic levels contributing to the country’s economic depression. This study critically evaluates Nigeria’s corporate governance regime and explores how weak regulation has impacted on the banking sector. By adopting a socio legal methodology, the study analyses both theoretical and empirical works from a socio-scientific point of view to examine the role of Nigeria’s legal, cultural and social arrangements in corporate governance regulation. The study reveals that Nigeria’s institutional arrangement has contributed to its weak system of corporate governance regulation with adverse effects on the banking sector. The research mainly impacts on current global corporate governance literature in sub-Saharan Africa by contributing to knowledge of the peculiarities of corporate governance regulation in different institutional jurisdictions. The particular focus on emerging economies such as Nigeria expands on the need for countries to develop a bespoke system of corporate governance regulation that takes into consideration the peculiarities of individual countries devoid of external influence.Keywords: banks, corporate governance, emerging economies, Nigeria
Procedia PDF Downloads 32511683 Application of Liquid Chromatographic Method for the in vitro Determination of Gastric and Intestinal Stability of Pure Andrographolide in the Extract of Andrographis paniculata
Authors: Vijay R. Patil, Sathiyanarayanan Lohidasan, K. R. Mahadik
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Gastrointestinal stability of andrographolide was evaluated in vitro in simulated gastric (SGF) and intestinal (SIF) fluids using a validated HPLC-PDA method. The method was validated using a 5μm ThermoHypersil GOLD C18column (250 mm × 4.0 mm) and mobile phase consisting of water: acetonitrile; 70: 30 (v/v) delivered isocratically at a flow rate of 1 mL/min with UV detection at 228 nm. Andrographolide in pure form and extract Andrographis paniculata was incubated at 37°C in an incubator shaker in USP simulated gastric and intestinal fluids with and without enzymes. Systematic protocol as per FDA Guidance System was followed for stability study and samples were assayed at 0, 15, 30 and 60 min intervals for gastric and at 0, 15, 30, 60 min, 1, 2 and 3 h for intestinal stability study. Also, the stability study was performed up to 24 h to see the degradation pattern in SGF and SIF (with enzyme and without enzyme). The developed method was found to be accurate, precise and robust. Andrographolide was found to be stable in SGF (pH ∼ 1.2) for 1h and SIF (pH 6.8) up to 3 h. The relative difference (RD) of amount of drug added and found at all time points was found to be < 3%. The present study suggests that drug loss in the gastrointestinal tract takes place may be by membrane permeation rather than a degradation process.Keywords: andrographolide, Andrographis paniculata, in vitro, stability, gastric, Intestinal HPLC-PDA
Procedia PDF Downloads 24311682 Formulation Design and Optimization of Orodispersible Tablets of Diphenhydramine Hydrochloride Having Adequate Mechanical Strength
Authors: Jiwan P. Lavande, A. V. Chandewar
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In the present study, orodispersible tablets of diphenhydramine hydrochloride were prepared using croscarmellose sodium, crospovidone and camphor, menthol (as subliming agents) in different ratios and ODTs prepared with superdisintegrants were compared with ODTs prepared with camphor and menthol (subliming agents) for the following evaluation of in vitro disintegration time, dispersion time, wetting time, hardness and water absorption ratio. Results revealed that the tablets of all formulations have acceptable physical parameters. The drug and excipients compatibility study was evaluated using FTIR technique and has not detected any incompatibility. The in vitro release of drug from DC6 formulation was quick when compared to other formulations. Stability study was carried out as per ICH guidelines for three months and results revealed that upon storage disintegration time of tablets had not shown any significant difference. Microscopic study of different formulations of sublimed tablets showed formation of pores for the tablets prepared by sublimation method. Thus, conclusion can be made that the stable orodispersible tablets of diphenhydramine hydrochloride can be developed for the rapid release of diphenhydramine hydrochloride.Keywords: orodispersible tablet, subliming agent, super disintegrants, diphenhydramine hydrochloride
Procedia PDF Downloads 23611681 New Strategy for Breeding of Artemisia annua L. for a Sustainable Production of the Antimalarial Drug Artemisinin
Authors: Nadali Babaeian Jelodar, Chan Lai Keng, Arvind Bhatt, Laleh Bordbar, Leow E Shuen, Kamaruzaman Mohamed
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Recently artemisinin (the endoperoxide sesquiterpene lactone) has received considerable attention because of its antimalarial activity. It is isolated from the aerial part of the Artemisia annua L. Artemisinin is very difficult to synthesise also its production by mean of cell, tissue or organ cultures is very low. Presently, only its extraction from A. annua L. plants remains the only source of the drug. The reported yield of artemisinin from leaves of A. annua L. is very low and unstable, with yields typically less than 1% of leaf dry weight. To increase the percentage of artemisinin, researchers have been engaged in developing new varieties. A review concerning the breeding of A. annua L. is presented. The aim of this review is to bring together most of the available scientific research papers about the breeding conducted on the genus A. annua L., which is currently scattered across various publications. Through this review the authors hope to attract the attention of breeders throughout the world to focus on the unexplored potential of A. annua L. species. Also the future scope of this plant has been emphasized with a view of the importance of breeding of A. annua L. for increasing of artemisinin content. By releasing of new cultivar of A. annua L. and cultivation of this plant offers the opportunity to optimize yield and achieve a uniform, high quality product.Keywords: Artemisia annua L., breeding, artemisinin, cultivation, medicinal plant
Procedia PDF Downloads 26511680 Bioprotective Role of Soil Borne Bacillus Strain against Selected Fungal Pathogens of Agriculture Relevance
Authors: Asif Jamal, Asad Ali, Muhammad Ishtiaq Ali
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The agriculture productivity losses due to microbial pathogens have been a serious issue in Pakistan and rest of the world. Present work was designed to isolate soil borne microorganisms having the antagonistic ability against notorious phytopathogens. From the initial collection of 23 bacterial isolates, two potent strains of Bacillus were screened on the basis of their comparative efficacy against devastating fungal pathogens. The strains AK-1 and AK-5 showed excellent inhibitory indexes against the majority of tested fungal strains. It was noted that both strains of Bacillus showed significant biocontrolling activity against Aspergillus flavus, Fusarium moniliforme, Colletotricum falcatum, Botrytis cinerea, Aspergillus niger, Fusarium oxysporum, Phythopthora capsici and Rhizopus oryzae. The strain AK-1 was efficient to suppress Aspergillus species and Rhizopus oryzae while AK-5 expressed significant antagonistic activity against Fusarium, Botrytis, and Colletotricum species. On the basis of in vitro assay, it can be postulated that the Bacillus strains AK-1 and AK-5 can be used as a bio-protective agent against various plant diseases. In addition, their applications as natural pesticides could be very helpful to prevent the adverse effects of chemical pesticides.Keywords: biological control, Bacillus spp, fungal pathogens, agriculture
Procedia PDF Downloads 27311679 Phytochemical Screening and Assessment of Hepatoprotective Activity of Geigeria alata Leaves Ethanolic Extract on Wistar Rats
Authors: Girgis Younan, Ikram Eltayeb
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Geigeria alata belongs to the family Asteraceae, is an effective plant traditionally used in Sudan as a therapy for hepatic disease and as an antiepileptic, antispasmodic and to treat cough and intestinal complaints.The liver is responsible for many critical functions within the body and any liver disease or injury will result in the loss of those functions leading to significant damage in the body. Liver diseases cause increase in liver enzymes (AST, ALP ALT) and total bilirubin and a decrease in total blood protein level. The objective of this study is to investigate the hepato-protective activity of Geigeria alata leaves ethanolic extract. The plant leaves were extracted using 96% ethanol using Soxhlet apparatus. The hepatoprotective effect was determined using 25 wistar rats, the rats was divided to 5 groups, each group contain 5 rats: [Normal control group] receiving purified water, liver damage was induced in wistar rats by administering a 1:1 (v/v) mixture of CCl4 (1.25 ml/kg) and olive oil once at day four of the experiment [negative control group]. Two doses of extract [400mg/kg and 200mg/kg] was applied daily for 7 days, and standard drug Silymarin (200 mg/kg) were administered daily for 7 days to CCl4-treated rats. The degree of hepato-protective activity was evaluated by determining the hepatic marker enzymes AST, ALP, ALT, total Bilirubin and total proteins (TP). Results have shown that, the extract of G.alata leaves reduced the level of liver enzymes ALT, AST, ALP, total bilirubin and increased the level of total proteins. Since the levels of liver enzymes; bilirubin and total protein are considered as markers of liver function, the extract has proven to reduce the detrimental effects of liver toxicity induced using CCl4. The hepato-protective effect of extract on liver was found to be dose dependent, where the 400mg/kg dose of the extract exhibited higher activity than 200mg/kg dose. In addition, the effect of the higher dose (400mg/kg) of the extract was found to be higher than Silymarin standard drug. The result concludes that, G.alata leaves extract was found to exhibit profound hepato-protective activity, which justifies the traditional use of the plant for the treatment of hepatic diseases.Keywords: alata, extract, geigeria, hepatoprotective
Procedia PDF Downloads 23511678 In Vitro Assessment of True Digestibility and Rumen Parameters of Forage-Based Sheep Diet, Supplemented with Dietary Fossil Shell Flour
Authors: Olusegun O. Ikusika, Conference T. Mpendulo
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The abundance of fossil shell flour (FSF) globally has increased interest in its use as a natural feed additive in livestock diets. Therefore, identifying its optimum inclusion levels in livestock production is essential for animal productivity. This study investigated the effects of various fossil shell flour (FSF) inclusion levels on in vitro digestibility, relative feed values, and rumen parameters of Dohne-Merino wethers. Twenty-four fistulated wethers with an average body weight of 20 ± 1•5 kg in a complete randomized design of four treatments having six wethers per treatment were used. They were fed a basal diet without fossil shell flour (control, 0%) or with the addition of 2% FSF (T2), 4% FSF(T3), and 6% FSF (T4) of diet DM for 35 days, excluding 14 days adaptation period. The results showed that increasing FSF levels had no effect on ruminal T0C or pH, but Ammonia-N increased (P<0.01) with increasing FSF. The total molar concentrations of volatile fatty acids (VFA) decreased (P<0.05) with increasing levels of FSF. Acetic: propionic ratio decreased except at the 4 % inclusion level. IVTDDM, IVTDNDF and IVTDADF decreased up till 4% FSF inclusion but tended to increase (P = 0.06) at 6% inclusion. Relative feed values of the diets tended to increase (P=0.07) by adding fossil shell flour. In conclusion, adding FSF to the diets of Dohne-Merino wether up to 6% FSF inclusion rates did not improve IVTDDM (In vitro true digestibility dry matter), IVTDNDF (In vitro true digestibility neutral detergent fiber), and IVTDADF (In vitro true digestibility acid detergent fiber). However, a small increment of rumen nitrogen with no adverse effects on the rumen parameters was observed. The relative feed value (RFV) moved the feed from good to premium when supplemented. Therefore, FSF supplementation could improve feed value and maintain a normal range of rumen parameters for the effective functionality of the rumen.Keywords: fossil shell flour, rumen parameters, in vitro digestibility, feed quality, dohne-merino sheep
Procedia PDF Downloads 10711677 Biochemical Changes in the Liver of Mice after Exposure to Different Doses of Diclofenac Sodium
Authors: Deepak Mohan, Sushma Sharma
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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a group of widely used drugs for the treatment of rheumatoid diseases and to relieve pain and inflammation due to their analgesic anti-pyretic and anti-inflammatory properties. The therapeutic and many of the toxic effects of NSAIDs result from reversible inhibition of enzymes in the cyclooxygenase (COX) group. In the present investigation the effect of the drug on the concentration of lipids, and on the activity of the enzymes i.e. acid and alkaline phosphatase, GOT, GPT and lipid peroxidase were studied. There was a significant enhancement in the activities of both acid and alkaline phosphatase after 21 days of treatment. Proportionate increase in the MDA contents was observed after different days of diclofenac treatment. Cellular damage in the liver resulted in decrease in the activity of both GOT (Glutamate oxaloacetate transaminase) and GPT (Glutamate pyruvate transaminase) in both low and high dose groups. Significant decrease in the liver contents was also observed in both dose groups.Keywords: anti-inflammatory, cyclooxygenase, glutamate oxaloacetate transaminase, malondialdehyde
Procedia PDF Downloads 30211676 Genistein Suppresses Doxorubicin Associated Genotoxicity in Human Lymphocytes
Authors: Tanveer Beg, Yasir H. Siddique, Gulshan Ara, Asfar S. Azmi, Mohammad Afzal
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Doxorubicin is a well-known DNA intercalating chemotherapy drug that is widely used for treatment of different cancers. Its clinical utility is limited due to the observed genotoxic side effects on healthy cells suggesting that newer combination and genoprotective regimens are urgently needed for the management of doxorubicin chemotherapy. Some dietary phytochemicals are well known for their protective mechanism of action and genistein from soy is recognized as an anti-oxidant with similar properties. Therefore, the present study investigates the effect of genistein against the genotoxic doses of doxorubicin by assessing chromosomal aberrations, sister chromatid exchanges, cell cycle kinetics, cell viability, apoptosis, and DNA damage markers in cultured human lymphocytes. Our results reveal that genistein treatment significantly suppresses genotoxic damage induced by doxorubicin. It is concluded that genistein has the potential to reduce the genotoxicity induced by anti-cancer drugs, thereby reducing the chances of developing secondary tumors during the therapy.Keywords: apoptosis, DNA damage markers, doxorubicin, genistein, genotoxicity, human lymphocyte culture
Procedia PDF Downloads 36011675 The Effects of Three Leadership Styles on Individual Performance
Authors: Leilei Liang
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Leadership is commonly classified as formal leadership and informal leadership, which ignores and neglects the effects of 3rd type leadership. The emergence of 3rd type of leadership is closely related to special relations. To figure out the mechanism and effects of 3rd type leadership as well as the impacts of formal leadership and informal leadership on employee performance, this study collects data from 350 participants through a survey and proposes three hypotheses respectively from the perspective of expectation theory. The analytical results provide strong evidence for two of the three hypotheses, which demonstrate the positive correlation between formal leadership and individual performance and the negative relationship between 3rd type leadership and individual performance. This study contributes to leadership literature by putting forward the concept of the 3rd type of leadership. In addition, the effects of formal leadership, informal leadership, and 3rd type leadership on individual performance are discussed respectively in this study.Keywords: formal leadership, informal leadership, 3rd leadership, individual performance, expectation theory
Procedia PDF Downloads 24311674 Streamline Marketing Strategies for Survival of Librarianship in Developing Countries in the 21st Century: A Study Related to Sri Lanka
Authors: Wilfred Jeyatheese Jeyaraj
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Considering the current digital age, Library Marketing, in its entirety, has evolved to elucidate the importance of falling back to the roots of searching for tangible and intangible resources, traversing through pages and references to acquire the required knowledge needs with proper guidance. With the turn of the century, the present generation has deeply entrenched their virtual presence, browsing via search engines for all their information needs. Not fully realizing the adverse effects of the materials available digitally, the authenticity of such resources cannot be verified. So a user might be led to believe false misdirected data. This paper tends to elucidate the prominent strategies to market Sri Lankan libraries in a proper manner so as to captivate a large user base making them aware that all resources and materials that they access without guidance outside the libraries are also available within the libraries with added guidance towards accessing the right data. The main contemplation here is to focus on getting more users to visit libraries in person to copiously apprehend the importance of browsing for materials with the proper direction. The current library marketing strategies in Sri Lankan libraries need to be streamlined to align with the best interest of acquiring the present generations to visit libraries in person to reap its benefits.Keywords: accessibility, librarianship, marketing, Sri Lanka
Procedia PDF Downloads 28411673 Alternative General Formula to Estimate and Test Influences of Early Diagnosis on Cancer Survival
Authors: Li Yin, Xiaoqin Wang
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Background and purpose: Cancer diagnosis is part of a complex stochastic process, in which patients' personal and social characteristics influence the choice of diagnosing methods, diagnosing methods, in turn, influence the initial assessment of cancer stage, the initial assessment, in turn, influences the choice of treating methods, and treating methods in turn influence cancer outcomes such as cancer survival. To evaluate diagnosing methods, one needs to estimate and test the causal effect of a regime of cancer diagnosis and treatments. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to estimate and test these causal effects via point effects. The purpose of the work is to estimate and test causal effects under various regimes of cancer diagnosis and treatments via point effects. Challenges and solutions: The cancer stage has influences from earlier diagnosis as well as on subsequent treatments. As a consequence, it is highly difficult to estimate and test the causal effects via standard parameters, that is, the conditional survival given all stationary covariates, diagnosing methods, cancer stage and prognosis factors, treating methods. Instead of standard parameters, we use the point effects of cancer diagnosis and treatments to estimate and test causal effects under various regimes of cancer diagnosis and treatments. We are able to use familiar methods in the framework of single-point causal inference to accomplish the task. Achievements: we have applied this method to stomach cancer survival from a clinical study in Sweden. We have studied causal effects under various regimes, including the optimal regime of diagnosis and treatments and the effect moderation of the causal effect by age and gender.Keywords: cancer diagnosis, causal effect, point effect, G-formula, sequential causal effect
Procedia PDF Downloads 196