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However, it is a good surrogate for gauging the providers awareness of central neurologic symptoms, which is important since we are ultimately interested in the physicians intent in ordering the neuroimaging study.Thirdly, the documented MRI ordering physician department data point may not fully capture the physician behavior around obtaining neuroimaging.Specically, physicians who do not routinely evaluate patients for lung cancer may ask a colleague who is more familiar, or they could be required to order a study as a precondition for making a referral.The effect on our measure would be to overestimate the contribution of internal and family medicine doctors as ordering department for neuroimaging studies in this cohort of NSCLC patients.Lastly, we chose a pragmatic design so while independent radiographic review could have altered the measured rates of brain metastasis, our approach is more consistent with routine clinical care where a single radiologist reviews neuroimaging.Engl. J. Med. This work is subject to copyright.The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication.Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made.The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.Discovering drugs or developing an ingredient for pharmaceuticals is all about integration of scientic disciplines.Usually, developing a new drug is a serious challenge as it involves time for research trials and the whole processes is very expensive, sometimes huge investments are required, for example, more than billion US for one drug.The number of new drugs discovered each year has not kept pace with either the rate of medicine discovery or the money spent in research and development.Curiosity for treating wounds or getting relief from disease by applying local herbs using ageold traditional knowledge and combinatorial chemistry advancement in recent few decades has lled the gap of developing new bioactive chemical ingredients from plants; however, the chances to overcome different hurdles according to FDA guideline and then succeed is very low, as this has to undergo several clinical trials and postmarketing studies.Since ancient times, botanical resources are known to provide many classes of new ingredients for drug discovery.However, in certain cases, drug discovery from plant sources puts extra pressure on natural resources causing unconditional environmental issues for human and animal survival.In the recent past, rened observations, translational research and hypothesisdriven biological approaches accelerated drug discovery programmes which focused on human and animal biology.The sciencedriven translational discovery and phytopharmaceutical development have created a new reality and initiated great changes in strategies, technologies and disciplines, and these new changes have embraced the pharmaceutical and biotech industries.This book contains excellent chapters covering the theme of modern approaches to drug discovery and ethnobotany.I am condent that the research covered herein by all the contributors will provide essential background information on the origin and development of compounds in drug discovery as well as offer a sense of promise of what this eld of research may deliver in the upcoming future.

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