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Articles 3661 - 3690 of 7018

Full-Text Articles in Pharmacology, Toxicology and Environmental Health

Pcb Disruption Of Gut And Host Health: Implications Of Prebiotic Nutritional Intervention, Jessie Baldwin Hoffman Jan 2018

Pcb Disruption Of Gut And Host Health: Implications Of Prebiotic Nutritional Intervention, Jessie Baldwin Hoffman

Theses and Dissertations--Pharmacology and Nutritional Sciences

Exposure to environmental pollutants poses numerous risk factors for human health, including increasing incidence of cardiovascular disease and diabetes. Persistent organic pollutants, such as polychlorinated biphenyls (PCBs) have been strongly linked to the development of these chronic inflammatory diseases and the primary route of exposure is through consumption of contaminated food products. Thus, the gastrointestinal tract is susceptible to the greatest levels of these pollutants and is an important facet to study.

The first two hypotheses of this dissertation tested that exposure to PCBs disrupts gut microbiota directly (in vitro) and within a whole body system. PCB exposure …


Role Of Sex Chromosomes In Sexual Dimorphism Of Angii-Induced Abdominal Aortic Aneurysms, Yasir Alsiraj Jan 2018

Role Of Sex Chromosomes In Sexual Dimorphism Of Angii-Induced Abdominal Aortic Aneurysms, Yasir Alsiraj

Theses and Dissertations--Pharmacology and Nutritional Sciences

Abdominal aortic aneurysms (AAAs), a permanent dilation in the abdominal region of the aorta, is a highly sexually dimorphic disease. AAAs prevalence is ranging from 4-10 fold higher in males than females. Defining the mechanistic basis for reduced (in females) or increased (in males) AAA formation and progression may uncover potential therapeutic targets. The majority of studies examining sexual dimorphism focus on the role of sex hormones. However, genes residing on sex chromosomes, in addition to sex hormones, may contribute to sexual dimorphism of AAAs. For example, the X chromosome contains about 5% of the whole genome, but the role …


Under The Influence: An Interdisciplinary Approach To Psychedelics, Jody Roun Jan 2018

Under The Influence: An Interdisciplinary Approach To Psychedelics, Jody Roun

Master of Liberal Studies Theses

The following research will outline the effects of psychedelics from an interdisciplinary approach, which is to say that I will explore the neuroscience behind psychedelic drugs and how it relates to creativity, as a primary focus, while examining the role of additional points included along the way. The goal of this research, is to gain a deeper understanding of psychedelics and truly decipher what it means to be under the influence, as the most important goal of this human existence is to achieve understanding. The aforementioned is a point that great minds like Albert Einstein and Humphry Osmond impressed on …


Regulatory Issues Concerning The Preclinical Testing Of Synthetic Peptides, Vamsi Vardhan Niraghatam Jan 2018

Regulatory Issues Concerning The Preclinical Testing Of Synthetic Peptides, Vamsi Vardhan Niraghatam

Master's Theses and Doctoral Dissertations

Any new drug or biological product undergoes rigorous testing in animals and humans for review by the United States Food and Drug Administration (FDA) before it becomes available for human use. A sponsor files an investigational new drug (IND) application with the FDA with supporting animal data, after which testing is continued with humans. There is sufficient guidance from the FDA on new small molecules and biological products as to which preclinical studies are to be conducted. Synthetic peptides present a unique scenario in which a case-by-case approach is needed for the conduct of preclinical studies. For peptides containing components …


Scalable Feature Selection And Extraction With Applications In Kinase Polypharmacology, Derek Jones Jan 2018

Scalable Feature Selection And Extraction With Applications In Kinase Polypharmacology, Derek Jones

Theses and Dissertations--Computer Science

In order to reduce the time associated with and the costs of drug discovery, machine learning is being used to automate much of the work in this process. However the size and complex nature of molecular data makes the application of machine learning especially challenging. Much work must go into the process of engineering features that are then used to train machine learning models, costing considerable amounts of time and requiring the knowledge of domain experts to be most effective. The purpose of this work is to demonstrate data driven approaches to perform the feature selection and extraction steps in …


Application Of Polymer-Coated Magnetic Nanoparticles For Oil Separation, Seyyedali Mirshahghassemi Jan 2018

Application Of Polymer-Coated Magnetic Nanoparticles For Oil Separation, Seyyedali Mirshahghassemi

Theses and Dissertations

Oil spills and storm water runoffs can have serious impact on the environment with potentially major economic impacts. Given the limitation of current oil clean-up technique, the application of nanotechnology for oil remediation has been widely studied showing a promising avenue of research. This dissertation reports a cheap, facile and cost-effective nanotechnology-based oil clean-up technique that has been optimized for effectiveness and feasibility and reduced adverse environmental impacts. The synthesized polyvinylpyrrolidone (PVP)-coated magnetic nanoparticles (NPs) have been characterized using different techniques and the oil removal efficiency investigated under a wide range of environmentally relevant conditions. Based on the characterization data, …


Investigating The Ecology Of A Rare Species On St. John, Usvi: Reintroducing Solanum Conocarpum In Light Of Climate Change, Cecilia Rogers Jan 2018

Investigating The Ecology Of A Rare Species On St. John, Usvi: Reintroducing Solanum Conocarpum In Light Of Climate Change, Cecilia Rogers

Senior Honors Projects, 2010-2019

Approximately two thirds of St. John is National Park territory. However, the land has been threatened with tourism and development, greatly impacting island biodiversity. One species that may become extinct due to this degradation is Solanum conocarpum. S. conocarpum is a rare shrub, endemic to the dry tropical forests of St. John, USVI. This plant is a species of conservation concern and is one of very few native and endemic plants on this island. Very little is known about the ecology and reproduction of S. conocarpum. Most plants are found on the southern half of the island. Recent observations …


Dna Barcoding For Authentication Of The Endangered Plants In Genus Aquilaria, Worathat Thitikornpong, Chanida Palanuvej, Nijsiri Ruangrungsi Jan 2018

Dna Barcoding For Authentication Of The Endangered Plants In Genus Aquilaria, Worathat Thitikornpong, Chanida Palanuvej, Nijsiri Ruangrungsi

The Thai Journal of Pharmaceutical Sciences

Agarwood is a type of wood that is used in traditional Thai medicines and has been applied in several recipes; in particular, this wood is considered as a costly resinous non-wood product. However, the morphological characteristics of the plant in the ge.


Bioactivities Of Organic Riceberry Broken Rice And Crude Riceberry Rice Oil, Vijitra Luang-In, Manatchanok Yotchaisarn, Issaraporn Somboonwatthanakul, Sirirat Deeseenthum Jan 2018

Bioactivities Of Organic Riceberry Broken Rice And Crude Riceberry Rice Oil, Vijitra Luang-In, Manatchanok Yotchaisarn, Issaraporn Somboonwatthanakul, Sirirat Deeseenthum

The Thai Journal of Pharmaceutical Sciences

Objectives: Riceberry broken rice (RBR) and crude riceberry rice oil (CRO) are inevitable by-products generated from organic rice process in Thailand for several tons per year with low value. The aims of this work were to determine gamma-oryzanol content.


Effects Of Age, Hydration Level, And Cosmetic Treatment On Skin Mechanical Properties Of Thai, Anyarporn Tansirikongkol Jan 2018

Effects Of Age, Hydration Level, And Cosmetic Treatment On Skin Mechanical Properties Of Thai, Anyarporn Tansirikongkol

The Thai Journal of Pharmaceutical Sciences

Purpose: Age and skin hydration influence skin mechanical properties. However, correlation between hydration improved by cosmetic and mechanical properties is uncertain. This study aimed to investigate the relationship between age, intrinsic skin hydrati.


Antiproliferative Effects Of Pereskiopsis Diguetii, Caralluma Speciosa And Euphorbia Ritchiei Hydroalcoholic Extract, Tossawan Jitwasinkul, Purin Charoensuksai Jan 2018

Antiproliferative Effects Of Pereskiopsis Diguetii, Caralluma Speciosa And Euphorbia Ritchiei Hydroalcoholic Extract, Tossawan Jitwasinkul, Purin Charoensuksai

The Thai Journal of Pharmaceutical Sciences

To date, cancers remain to be global health problem. The toxicity and the emergence of chemotherapy resistance of currently prescribed anticancer agents highlight the need for the discovery and the development of novel anticancer drugs. The previous succ.


Development And Validation Of Hptlc And Lc Ms-Ms Method For Estimation Of Terizidone In Pharmaceutical Dosage Form, Ritesh P. Bhole, Sonali Phadke Jan 2018

Development And Validation Of Hptlc And Lc Ms-Ms Method For Estimation Of Terizidone In Pharmaceutical Dosage Form, Ritesh P. Bhole, Sonali Phadke

The Thai Journal of Pharmaceutical Sciences

The estimation of Terizidone in pharmaceutical dosage form by using High Performance Thin Layer Chromatography was done using CAMAG HPTLC system. The separation was achieved using precoated silica gel 60 F254 aluminium plates with mobile phase Toluene: n.


Evaluating The Effect Of Donepezil On Depression And Obsessive–Compulsion Disorder In Mice Models And Proposing The Mechanism Involved, Azadeh Mesripour, Valiollah Hajhashemi, Shahrzad Rezaie Jan 2018

Evaluating The Effect Of Donepezil On Depression And Obsessive–Compulsion Disorder In Mice Models And Proposing The Mechanism Involved, Azadeh Mesripour, Valiollah Hajhashemi, Shahrzad Rezaie

The Thai Journal of Pharmaceutical Sciences

Introduction: Considering that donepezil (DPZ) is commonly prescribed for Alzheimer's disease patients, the aim of the present study was evaluating DPZ antidepressant effect and introducing the possible mechanism. Therefore nicotinic (mecamylamine) and m.


Anti-Hyperglycemic Effect And Subchronic Toxicity Of The Combined Extract From Sattagavata- Mathurameha -Tubpikarn Anti-Diabetic Herbal Formulae, Penchom Peungvicha Jan 2018

Anti-Hyperglycemic Effect And Subchronic Toxicity Of The Combined Extract From Sattagavata- Mathurameha -Tubpikarn Anti-Diabetic Herbal Formulae, Penchom Peungvicha

The Thai Journal of Pharmaceutical Sciences

The three herbal formulae (Sattagavata, Mathurameha, Tubpikarn) were prescribed to diabetic patients for a long times and they included Sattagavata for circulatory system promotion, Mathurameha for diabetics and Tubpikarn for hepatoprotection with less s.


Carbazole Based Multifunctional Dopamine Agonists And Related Molecules As Potential Symptomatic And Disease Modifying Therapeutic Agents For Parkinson’S Disease, Asma S.Mohamed Elmabruk Jan 2018

Carbazole Based Multifunctional Dopamine Agonists And Related Molecules As Potential Symptomatic And Disease Modifying Therapeutic Agents For Parkinson’S Disease, Asma S.Mohamed Elmabruk

Wayne State University Dissertations

Parkinson’s disease (PD) is a progressive neurodegenerative disease that develops from gradual depletion of dopamine (DA) and dopaminergic neurons in the substantia nigra pars compacta (SNc) with the accumulation of intraneuronal proteinaceous matter named as Lewy bodies. The four cardinal symptoms associated with PD are tremor, rigidity, bradykinesia, and postural instability. Although the exact mechanism and etiology of PD are not fully understood, several factors have been implicated in the pathogenesis and progression of PD including protein aggregation, oxidative stress, mitochondrial dysfunction, environmental, and genetic factors.

The current therapy of Parkinson’s disease is categorized into four classes: levodopa, DA agonists, …


Discovery Of Piperlongumine Derivatives As Anti-Leukemic And Anti-Prostate Cancer Agents, Yi Liao Jan 2018

Discovery Of Piperlongumine Derivatives As Anti-Leukemic And Anti-Prostate Cancer Agents, Yi Liao

Wayne State University Dissertations

Piperlongumine (PL) is an electrophilic anti-cancer natural product. Through non-covalent or covalent interactions with cellular targets, PL inactivates multiple oncogenic pathways and suppresses key components of cellular anti-oxidant/anti-electrophile defense systems. These actions result in pleiotropic anticancer effects and are expected to be effective to heterogeneous acute myeloid leukemia (AML) and prostate cancer (PCa). We applied two approaches to enhance the anticancer potency of PL: 1) To design PL-histone deacetylase inhibitor hybrid drugs (PL-HDACis; e.g., 1-58), and 2) To dimerize PL pharmacophore to generate a dimeric PL (DiPL) warhead that is suitable for further conjugation (e.g., 5-17). Both 1-58 and 5-17 …


Sensitivity Of Quagga Mussels (Dreissena Rostriformis Bugensis) To Cyanobacteria At Multiple Life History Stages, Anna Boegehold Jan 2018

Sensitivity Of Quagga Mussels (Dreissena Rostriformis Bugensis) To Cyanobacteria At Multiple Life History Stages, Anna Boegehold

Wayne State University Dissertations

Quagga mussels (Dreissena rostriformis bugensis) originate from brackish waters of the Ponto-Caspian area and are nuisance invasive species in North American and European freshwaters. Their invasion has caused major economic and ecological damages in the Laurentian Great Lakes. Through selective filter feeding, quagga mussels have promoted the growth of cyanobacteria. Harmful cyanobacteria blooms have the potential to produce toxins, which can be toxic to humans and wildlife. Although quagga mussels can increase the prevalence of cyanobacteria blooms, it is unknown how they are physiologically affected by cyanobacteria and understanding these dynamics can be useful in the management of this invasive …


Exposure To Polybrominated Diphenyl Ethers (Pbdes) In American And Canadian Workers: Biomonitoring Data From Two National Surveys, Sabrina Gravel, Jérôme Lavoué, France Labrèche Jan 2018

Exposure To Polybrominated Diphenyl Ethers (Pbdes) In American And Canadian Workers: Biomonitoring Data From Two National Surveys, Sabrina Gravel, Jérôme Lavoué, France Labrèche

Études primaires

Polybrominated diphenyl ethers (PBDEs) are flame retardants commonly found in many household and industrial products. They can be detected in the serum of the general population, and in even higher concentrations in workers of certain industries, due to an additional occupational exposure. The purpose of this analysis is to determine background exposure levels of PBDEs in the general working population, using national surveys where working status was self-reported. Participants aged 20–65 were selected from the 2003–2004 U.S. National Health and Nutrition Examination Survey (n = 1141) and the 2007–2009 Canadian Health Measures Survey (n = 1337). Only four congeners were …


Raman Spectroscopy Detects Biochemical Changes Due To Different Cell Culture Environments In Live Cells In Vitro, Mahmoud Gargotti, Esen Efeoglu, Hugh Byrne, Alan Casey Jan 2018

Raman Spectroscopy Detects Biochemical Changes Due To Different Cell Culture Environments In Live Cells In Vitro, Mahmoud Gargotti, Esen Efeoglu, Hugh Byrne, Alan Casey

Articles

The in vitro cell culture environment can impact on cell biochemistry and cell cycle. The manifestation of such substrate-induced changes in cell cycle in the Raman microspectroscopic profiles of cell cultures is investigated at the level of nucleolus, nucleus and cytoplasm. HeLa immortalised human cervical cells and HaCaT dermal cells were cultured on three different substrates, conventional polystyrene cell culture dishes, CaF2 slides as a commonly used Raman substrate, and glass slides coated with collagen rat tail, as a mimic of the extra-cellular matrix (ECM) environment. A cell cycle study, based on percentage DNA content, as determined using propidium iodide …


Exosomes Released From Multiple Myeloma Cells Influence The Angiogenic Function Of Endothelial Cells By Regulating Microrna-29b, Qinmao Ye Jan 2018

Exosomes Released From Multiple Myeloma Cells Influence The Angiogenic Function Of Endothelial Cells By Regulating Microrna-29b, Qinmao Ye

Browse all Theses and Dissertations

Multiple myeloma is a hematological malignancy characterized by clonal proliferation of plasma cells generally caused by chromosomal abnormalities. It occurs in the bone marrow, which is the microenvironment of multiple myeloma. Exosomes (EXs) are 30-100 nm membrane-derived micro-vesicles containing various of bioactive molecules, such as microRNAs, to mediate the cell-cell interaction. Numerous studies reported that exosomes play a significant role in tumor microenvironment. Angiogenesis has the important implication in tumor exacerbation to supply nutrients to promote the progression of cancer cells through endothelial cells (ECs). Some studies demonstrated that microRNA-29b (miR-29b) can suppress tumor development and inhibit angiogenesis. Therefore, in …


Regulation Of Microvesicle Particle Release In Keratinocytes, Azeezat Afolake Awoyemi Jan 2018

Regulation Of Microvesicle Particle Release In Keratinocytes, Azeezat Afolake Awoyemi

Browse all Theses and Dissertations

Microvesicle particles (MVPs) are produced from cellular membranes and are thought to mediate cell-cell communication, including in response to stressors such as UVB radiation and thermal burn injury. Previous studies have shown that stress-induced MVP release requires the platelet-activating factor (PAF) receptor in human keratinocytes and that pharmacological inhibition of acid sphingomyelinase (ASM) blocked this release. To validate a genetic role for ASM in MVP release, we used CRISPR-Cas9 gene silencing in human keratinocytes and primary fibroblasts derived from ASM-knockout mice. Though MVP release was partially blocked in ASM-deficient mouse fibroblasts, the inability to fully knockdown ASM in HaCaT cells …


Role Of C121a In Mglur2 Homodimeric Expression And Function, Jong M. Shin Jan 2018

Role Of C121a In Mglur2 Homodimeric Expression And Function, Jong M. Shin

Theses and Dissertations

The group II metabotropic glutamate receptors are known for their involvement in various psychiatric disorders. The mGluR2 in particular is linked with etiology of schizophrenia especially in the context of crosstalk with 5-HT2A. Thus, the mGluR2 has attracted attentions for its potential therapeutic applications. Despite numerous physiological evidences on the actions of mGluR2, its mechanism is still unclear to this day. It is partially due to the lack of understanding in characteristics of mGluR2 homodimer which is its functionally active form. Therefore, the characterization of dimeric interaction serves as a foundation to advanced understanding of the role of mGluR2. On …


The Influence Of Physiological And Abiotic Factors On The Sensitivity Of The Sea Lamprey (Petromyzon Marinus) To The Lampricide 3-Trifluoromethyl-4-Nitrophenol (Tfm), Alexandra Muhametsafina Jan 2018

The Influence Of Physiological And Abiotic Factors On The Sensitivity Of The Sea Lamprey (Petromyzon Marinus) To The Lampricide 3-Trifluoromethyl-4-Nitrophenol (Tfm), Alexandra Muhametsafina

Theses and Dissertations (Comprehensive)

Invasive sea lamprey (Petromyzon marinus) in the Great Lakes are controlled using the pesticide (lampricide) 3-trifluoromethyl-4-nitrophenol (TFM), which is applied to nursery streams containing larval lamprey. The toxicity of TFM to lamprey is affected by various environmental and physiological factors, which can lead to residual lamprey that survive TFM treatment. The goal of this study was to investigate how abiotic (season and temperature) factors interacted with physiological parameters (whole body and tissue energy reserves) to influence TFM sensitivity in sea lamprey. Toxicity tests were conducted at different times of the year (spring, early and late summer, fall) and …


Protein Participants Of Cytosolic Internalization Of The Ouabain-Bound Na⁺/K⁺Atpase Receptor In Human B-3 Lens Epithelial Cells, Joshua Lysle Stricker Jan 2018

Protein Participants Of Cytosolic Internalization Of The Ouabain-Bound Na⁺/K⁺Atpase Receptor In Human B-3 Lens Epithelial Cells, Joshua Lysle Stricker

Browse all Theses and Dissertations

The primary function of Na⁺/K⁺ATPase (NKA) discovered by Jens Christian Skou in 1958, through electrogenic exchange of 3 Na⁺ for 2 K⁺ ions (Robert L Post, 1958), is the homeostatic preservation of their electrochemical gradient across the plasma membrane (PM) of almost all species and their derived cell lines. Cardiotonic steroids (CTS), such as cardenolides or bufadienolides, are well established inhibitors of NKA. Fox glove plant extracts containing CTS, including digitalis, were first described by William Withering (1744-91) for their positive inotropic effect in heart failure patients. Later research identified the mechanism of their action through direct inhibition of NKA …


Design, Synthesis And Biological Evaluation Of Inhibitors Against Both Human And Mouse Microsomal Prostaglandin E2 Synthase-1 Enzymes, Kai Ding Jan 2018

Design, Synthesis And Biological Evaluation Of Inhibitors Against Both Human And Mouse Microsomal Prostaglandin E2 Synthase-1 Enzymes, Kai Ding

Theses and Dissertations--Chemistry

As the principal pro-inflammatory prostanoid, prostaglandin E2 (PGE2) serves as mediator of pain and fever in inflammatory reactions. The biosynthesis of PGE2 starts from arachidonic acid (AA). Cyclooxygenase (COX)-1 and/or COX-2 converts AA to prostaglandin H2 (PGH2), and PGE2 synthases transform PGH2 to PGE2. Current mainstream approach for treating inflammation-related symptoms remains the application of traditional non-steroidal anti-inflammatory drugs (tNSAIDs) and selective COX-2 inhibitors (coxibs). As both categories shut down the biosynthesis of all downstream prostanoids, their application renders several deleterious effects including gastrointestinalulceration and cardiovascular risk. Microsomal prostaglandin …


Study Of The Mechanism Of Action For Ru(Ii) Polypyridyl Complexes As Potential Anticancer Agents, Yang Sun Jan 2018

Study Of The Mechanism Of Action For Ru(Ii) Polypyridyl Complexes As Potential Anticancer Agents, Yang Sun

Theses and Dissertations--Chemistry

Application of chemotherapeutic agents in current cancer treatment has been limited by adverse effects as poor selectivity results in systemic toxicity; most chemotherapy approaches also experience inherited or acquired drug resistance which lead to reduced treatment outcome. Research efforts have focused on the discovery of novel chemotherapies that overcome the limitations mentioned above. Ru(II) polypyridyl complexes with anti-cancer properties have been extensively studied as traditional cytotoxic agents and photodynamic therapy agents due to their photophysical and photochemical characteristics.

Most research has focused on the design of Ru(II) polypyridyl complexes that have affinities to nucleic acids as inspired by the classic …


Validated Thin-Layer Chromatography-Densitometric Method For Simultaneous Determination Of Piperine And Plumbagin In “Benjakul” Thai Polyherbal Formulation And Its Antioxidant Activities, Savita Chewchinda, Pattamapan Lomarat, Pongtip Sithisarn Jan 2018

Validated Thin-Layer Chromatography-Densitometric Method For Simultaneous Determination Of Piperine And Plumbagin In “Benjakul” Thai Polyherbal Formulation And Its Antioxidant Activities, Savita Chewchinda, Pattamapan Lomarat, Pongtip Sithisarn

The Thai Journal of Pharmaceutical Sciences

The purpose of this study was to evaluate antioxidant activity and quantitative analysis of piperine and plumbagin content in “Benjukul (BEN)” Thai polyherbal formulation by TLC densitometric method. BEN was recognized in the list of herbal medicinal...


Antihypercholesterol Activity Of Costus Speciosus Water Extract, Hari Susanti, Subagus Wahyuono, Ratna Asmah Susidarti, Ika Puspita Sari Jan 2018

Antihypercholesterol Activity Of Costus Speciosus Water Extract, Hari Susanti, Subagus Wahyuono, Ratna Asmah Susidarti, Ika Puspita Sari

The Thai Journal of Pharmaceutical Sciences

Hypercholesterol is one of cause of cardiovascular disease. Costus speciosus is known empirically as an antihypercholesterol remedy. The study was conducted to determine the effect of water extract of Costus speciosus (CS) on cholesterol blood serum leve.


Characterization Of Lactic Acid Producing Bacillus Coagulans Strains With Their Antibacterial Activity And L-Lactic Acid Production, Vasana Tolieng Jan 2018

Characterization Of Lactic Acid Producing Bacillus Coagulans Strains With Their Antibacterial Activity And L-Lactic Acid Production, Vasana Tolieng

The Thai Journal of Pharmaceutical Sciences

Objectives: Screening of antibacterial activity, identification, and L-lactic acid production of spore forming Bacillus isolates. Materials and methods: Fourteen Bacillus isolates were characterized based on their phenotypic characteristics and 16SrRNA .


Cost-Effectiveness Analysis Of Aripiprazole Compared With Risperidone In Treatment Of Acute Schizophrenia Patients In Thailand, Wiwat Thavornwattanayong Jan 2018

Cost-Effectiveness Analysis Of Aripiprazole Compared With Risperidone In Treatment Of Acute Schizophrenia Patients In Thailand, Wiwat Thavornwattanayong

The Thai Journal of Pharmaceutical Sciences

OBJECTIVES: Schizophrenia is the third leading cause of loss of life years in Thailand. Currently, aripiprazole is the latest drug for the treatment of acute schizophrenia in Thailand but its cost-effectiveness has not been studied. The purpose of this s.