WorldWideScience

Sample records for resistance management synergy

  1. Combining pest control and resistance management: synergy of engineered insects with Bt crops.

    Science.gov (United States)

    Alphey, Nina; Bonsall, Michael B; Alphey, Luke

    2009-04-01

    Transgenic crops producing insecticidal toxins are widely used to control insect pests. Their benefits would be lost if resistance to the toxins became widespread in pest populations. The most widely used resistance management method is the high-dose/refuge strategy. This requires toxin-free host plants as refuges near insecticidal crops, and toxin doses intended to be sufficiently high to kill insects heterozygous for a resistant allele, thereby rendering resistance functionally recessive. We have previously shown by mathematical modeling that mass-release of harmless susceptible (toxin-sensitive) insects engineered with repressible female-specific lethality using release of insects carrying a dominant lethal ([RIDL] Oxitec Limited, United Kingdom) technology could substantially delay or reverse the spread of resistance and reduce refuge sizes. Here, we explore this proposal in depth, studying a wide range of scenarios, considering impacts on population dynamics as well as evolution of allele frequencies, comparing with releases of natural fertile susceptible insects, and examining the effect of seasonality. We investigate the outcome for pest control for which the plant-incorporated toxins are not necessarily at a high dose (i.e., they might not kill all homozygous susceptible and all heterozygous insects). We demonstrate that a RIDL-based approach could form an effective component of a resistance management strategy in a wide range of genetic and ecological circumstances. Because there are significant threshold effects for several variables, we expect that a margin of error would be advisable in setting release ratios and refuge sizes, especially as the frequency and properties of resistant alleles may be difficult to measure accurately in the field.

  2. Synergy between verapamil and other multidrug -resistance ...

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    Synergy between verapamil and other multidrug-resistance modulators in model membranes. 737. J. Biosci. 32(4), June 2007. 1. Introduction. A major problem in the treatment of cancer is that of multidrug resistance, which remains imperfectly understood, though in some instances it certainly involves altered membrane ...

  3. Managing Risk and Synergies R&D-Collaborations

    DEFF Research Database (Denmark)

    Mahnke, Volker; Overby, Mikkel Lucas

    2004-01-01

    Many companies in the cross section of telecommunication and mobile technology engage in R&D collaborations to manage uncertainty, create synergies and learn. While the challenges of managing individual collaborations are well documented, little is known on how to systematically manage several R......&D collaborations simultaneously. We use modern portfolio theory as an analogy to show how companies active in mobile telecommunication manage risks and create synergies by simultaneously engaging in several inter-firm collaborations.Keywords: Portfolio theory, risk, synergy, R&D collaboration, mobile commerce...

  4. Synergy between verapamil and other multidrug -resistance ...

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    17 18–21. Klohs W D, Steinkampf R W, Havlick M J and Jackson R C. 1986 Resistance to anthrapyrazoles and anthracyclines in multi-resistant P388 murine leukemia cells: reversal by calcium blockers and calmodulin antagonists; Cancer Res. 46. 4352–4356. Loewe S 1928 Die quantitativen Probleme der Pharmakologie;.

  5. Solar + Storage Synergies for Managing Commercial-Customer Demand Charges

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, Pieter J. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Govindarajan, Anand [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bird, Lori A. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, Naim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-10-24

    We study the synergies between behind-the-meter solar and storage in reducing commercial-customer demand charges. This follows two previous studies that examined demand charge savings for stand-alone solar in both the residential and commercial sectors. In this study we show that solar and storage show consistent synergies for demand charge management, that the magnitude of reductions are highly customer-specific, and that the magnitude of savings is influenced by the design of the electricity tariff.

  6. Simple test of synergy between ampicillin and vancomycin for resistant strains of Enterococcus faecium.

    Science.gov (United States)

    Green, M; Barbadora, K; Wadowsky, R M

    1994-11-01

    The combination of ampicillin and vancomycin kills some but not all strains of ampicillin- and vancomycin-resistant Enterococcus faecium. We compared a simple test for synergy utilizing a commercially available microdilution susceptibility system with time-kill studies and determined acceptable breakpoints for this test for 20 strains of ampicillin- and vancomycin-resistant E. faecium. The combination of ampicillin and vancomycin was tested for synergy by time-kill, broth macrodilution, and broth microdilution procedures. Repeat testing of isolates by macro- and microdilution synergy methods yielded MICs that were within one twofold dilution of each other for both intra- and intertest comparisons. Synergy was always detected by time-kill studies when the MIC of ampicillin in the combination synergy screen was 16 micrograms/ml in the combination microdilution synergy screen. The determination of the synergy by the broth microdilution procedure appears to be simple, convenient, and accurate.

  7. Managing Resistance.

    Science.gov (United States)

    Maag, John W.

    2000-01-01

    This article presents some considerations and ideas for managing students' resistance. They are organized around four topics: the impact of context on behavior, the importance of being comprehensive and nonrestrictive in behavior, the adaptive function of resistant behavior, and the benefit of joining children in their frame of reference.…

  8. Simple test of synergy between ampicillin and vancomycin for resistant strains of Enterococcus faecium.

    OpenAIRE

    Green, M; Barbadora, K; Wadowsky, R M

    1994-01-01

    The combination of ampicillin and vancomycin kills some but not all strains of ampicillin- and vancomycin-resistant Enterococcus faecium. We compared a simple test for synergy utilizing a commercially available microdilution susceptibility system with time-kill studies and determined acceptable breakpoints for this test for 20 strains of ampicillin- and vancomycin-resistant E. faecium. The combination of ampicillin and vancomycin was tested for synergy by time-kill, broth macrodilution, and b...

  9. High chlorpyrifos resistance in Culex pipiens mosquitoes: strong synergy between resistance genes.

    Science.gov (United States)

    Alout, H; Labbé, P; Berthomieu, A; Makoundou, P; Fort, P; Pasteur, N; Weill, M

    2016-02-01

    We investigated the genetic determinism of high chlorpyrifos resistance (HCR), a phenotype first described in 1999 in Culex pipiens mosquitoes surviving chlorpyrifos doses ⩾1 mg l(-1) and more recently found in field samples from Tunisia, Israel or Indian Ocean islands. Through chlorpyrifos selection, we selected several HCR strains that displayed over 10 000-fold resistance. All strains were homozygous for resistant alleles at two main loci: the ace-1 gene, with the resistant ace-1(R) allele expressing the insensitive G119S acetylcholinesterase, and a resistant allele of an unknown gene (named T) linked to the sex and ace-2 genes. We constructed a strain carrying only the T-resistant allele and studied its resistance characteristics. By crossing this strain with strains harboring different alleles at the ace-1 locus, we showed that the resistant ace-1(R) and the T alleles act in strong synergy, as they elicited a resistance 100 times higher than expected from a simple multiplicative effect. This effect was specific to chlorpyrifos and parathion and was not affected by synergists. We also examined how HCR was expressed in strains carrying other ace-1-resistant alleles, such as ace-1(V) or the duplicated ace-1(D) allele, currently spreading worldwide. We identified two major parameters that influenced the level of resistance: the number and the nature of the ace-1-resistant alleles and the number of T alleles. Our data fit a model that predicts that the T allele acts by decreasing chlorpyrifos concentration in the compartment targeted in insects.

  10. Resistance to penicillin-streptomycin synergy among clinical isolates of viridans streptococci.

    Science.gov (United States)

    Farber, B F; Eliopoulos, G M; Ward, J I; Ruoff, K; Moellering, R C

    1983-01-01

    Viridans streptococci are thought to be highly susceptible to penicillin and streptomycin. We recently encountered a unique group of 15 isolates from South Africa epidemiologically related to the isolation of penicillin-resistant pneumococci. These organisms were highly resistant to penicillin (PCN) (minimal inhibitory concentration, 1 to 32 micrograms/ml) and streptomycin (SM) (minimal inhibitory concentration, greater than or equal to 2,000 micrograms/ml). Two additional organisms with high-level streptomycin resistance were identified when 168 clinical isolates from Boston were screened. Time-kill studies with four organisms resistant to high levels of SM demonstrated lack of synergy between PCN and SM but marked synergy between PCN and gentamicin. Adenylylating, acetylating, and phosphorylating activity could not be detected in three organisms studied, and novobiocin failed to cure the SM resistance. Protein synthesis by ribosomes isolated from these organisms was dramatically reduced in the presence of gentamicin but was relatively resistant to inhibition by SM. PMID:6559052

  11. Business analysis of opportunities stakeholders management in achieving positive synergy

    Directory of Open Access Journals (Sweden)

    R. V. Nuzhdin

    2016-01-01

    Full Text Available One of the main purposes of processing organizations development is business-activity realization ensuring value-added increase in terms of constantly changing vector and the level of external environment factors influence. In such conditions stakeholder management should be oriented (directed to the use of methodology realizing the advantages of divergent (variative and process- and cost approaches providing creative character of development strategy. The most expedient thing here is the use of a wide range of business-analysis methodical tools as a subprocess of stakeholder management revealing the opportunities of the specific situation (development of unforeseen circumstances to ensure the alternativeness of the same strategy purpose achievement and to manage the development of integration organization forms as flexible module organization systems (FMOS. In the framework of business-analysis procedures the parameters of interrelations with the key (main stakeholders are considered as strategic ones in realizing stakeholder management processes. The structure of FMOS developed on the principle of technological business-cycle and formed under the influence of additive effect of positive synergy allows implementation of the new format of business relationship with strategic stakeholders. This format differs from the traditional one in the intraspecific exchange not associated with an increase in transaction costs. The quantity reduction of the specific transaction costs and the unification of several businesses potentials for strategic purpose achievement corresponding to their business interests leads to the positive synergetic effect that according to the process-cost approach in stakeholder management results in added value increase as well.

  12. Collaborative Performance Research on Multi-level Hospital Management Based on Synergy Entropy-HoQ

    OpenAIRE

    Chen, Lei; Liang, Xuedong; Li, Tao

    2015-01-01

    Because of the general lack of multi-level hospital management collaboration performance effectiveness research, this paper proposes a multi-level hospital management Synergy Entropy-House of Quality (HoQ) Measurement Model by innovatively combining the House of Quality (HoQ) measure model with a Synergy Entropy computing principle. Triangular fuzzy functions are used to determine the importance degree parameter of each hospital management element which combined with the results from the Syne...

  13. In Vitro Synergy of Telavancin and Rifampin Against Enterococcus faecium Resistant to Both Linezolid and Vancomycin.

    Science.gov (United States)

    Pankey, George A; Ashcraft, Deborah S

    2013-01-01

    An emerging pathogen is Enterococcus faecium resistant to both linezolid and vancomycin (LRVRE). Antimicrobial combinations may be required for therapy and need to be evaluated. The combination of daptomycin and rifampin has demonstrated good in vitro activity against gram-positive bacteria, including E faecium. Telavancin, a newer lipoglycopeptide, has shown in vitro activity against E faecium. We evaluated the combination of telavancin and rifampin and compared the results to the combination of daptomycin and rifampin used previously on the same isolates. Twenty-four genetically unique (by pulsed-field gel electrophoresis), clinical LRVRE isolates were collected in the United States from 2001-2004. Etest minimal inhibitory concentrations (MICs) (μg/mL) were 0.064-8 for telavancin, 1-4 for daptomycin, and 0.012 to >32 for rifampin. In vitro synergy testing was performed in triplicate by an Etest MIC:MIC ratio method, and summation fractional inhibitory concentration (ΣFIC) was calculated: synergy ≤0.5; indifference >0.5-4; and antagonism >4. The Etest method showed synergy (ΣFICs of 0.1-0.5) with telavancin + rifampin in 20/24 (83%) isolates and indifference (ΣFICs of 0.6-0.8) in 4/24 (17%) isolates. Similarly, the daptomycin + rifampin combination showed synergy (ΣFICs of 0.1-0.5) in 21/24 (88%) isolates and indifference (ΣFICs of 0.6-1.0) in 3/24 (12%) isolates by the Etest method. No antagonism was found. In vitro synergy with both combinations (rifampin + telavancin or daptomycin) was 83% and 88%, respectively, by Etest against these LRVRE isolates. Although both daptomycin and telavancin in combination with rifampin showed a high incidence of synergistic activity, further in vitro synergy testing with this combination should be performed against additional E faecium isolates. In vitro synergy may or may not translate into in vivo effectiveness.

  14. Determination of in vitro synergy for dual antimicrobial therapy against resistant Neisseria gonorrhoeae using Etest and agar dilution.

    Science.gov (United States)

    Wind, Carolien M; de Vries, Henry J C; van Dam, Alje P

    2015-03-01

    In response to antimicrobial resistance of Neisseria gonorrhoeae to last-resort extended-spectrum cephalosporins, combination therapy of azithromycin+ceftriaxone is now recommended. Dual therapy can be effective to treat monoresistant strains as well as multidrug-resistant strains, preferably employing the effect of in vitro synergy. As reports on in vitro synergy of azithromycin+ceftriaxone in N. gonorrhoeae are conflicting, in this study an evaluation of this combination was performed using a cross-wise Etest method and agar dilution. Synergy was defined as a fractional inhibitory concentration index (FICI) of ≤0.5. To identify other dual treatment options for gonorrhoea, in vitro synergy was evaluated for 65 dual antimicrobial combinations using Etest. Azithromycin, cefixime, ceftriaxone, colistin, ertapenem, fosfomycin, gentamicin, minocycline, moxifloxacin, rifampicin, spectinomycin and tigecycline were screened for synergy in all possible combinations. No synergy or antagonism was found for any of the 65 combinations. The geometric mean FICI ranged from 0.82 to 2.00. The mean FICI of azithromycin+ceftriaxone was 1.18 (Etest) and 0.55 (agar dilution). The difference between both methods did not result in a difference in interpretation of synergy. Ceftriaxone-resistant strain F89 was tested in all combinations and no synergy was found for any of them. Most importantly, the ceftriaxone minimum inhibitory concentration of F89 was not decreased below the breakpoint with any concentration of azithromycin. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  15. Synergy of four macrolide antibiotics with chloroquine against chloroquine-resistant Plasmodium falciparum in vitro.

    Science.gov (United States)

    Gershon, P; Howells, R E

    1986-01-01

    The antimalarial activity of four macrolide antibiotics was investigated against the multidrug resistant K1 strain of Plasmodium falciparum in vitro. ID50 (50% inhibitory concentration) values for erythromycin, spiramycin, tylosin tartrate and oleandomycin phosphate in 48-hour assays were 1.6 X 10(-4)M, 2.5 X 10(-5)M, 1.2 X 10(-5)M and 9 X 10(-6)M respectively, and in 96 hour assays were 10(-5)M, 2.6 X 10(-6)M, 2.6 X 10(-6) and 3 X 10(-6)M, respectively. Comparable values were obtained in assays in which drug effect was quantified from either parasite counts or 14C isoleucine incorporation. Each of the four macrolides displayed synergy with chloroquine at the IC90 (90% inhibitory concentration) level, but at the IC50 level synergy was either less pronounced or absent. For each combination this difference in the degree of synergy was significant at the 95% level of confidence. In replicate assays in which 3H hypoxanthine was the marker of drug effect, synergy between chloroquine and either erythromycin or spiramycin could not be detected.

  16. Disease-management partnership functioning, synergy and effectiveness in delivering chronic-illness care.

    Science.gov (United States)

    Cramm, Jane Murray; Nieboer, Anna Petra

    2012-06-01

    This study explored associations among disease-management partnership functioning, synergy and effectiveness in the delivery of chronic-illness care. This study had a cross-sectional design. The study sample consists of 218 professionals (out of 393) participating in 22 disease-management partnerships in various regions of the Netherlands. We assessed the relationships among partnership functioning, synergy and effectiveness in the delivery of chronic-illness care. Partnership functioning was assessed through leadership, resources, administration and efficiency. Synergy was considered the proximal outcome of partnership functioning, which, in turn, influenced the effectiveness of disease-management partnerships [measured with the Assessment of Chronic Illness Care (ACIC) survey instrument]. Overall ACIC scores ranged from 3 to 10, indicating basic/intermediate to optimal/comprehensive delivery of chronic-illness care. The results of the regression analysis demonstrate that partnership effectiveness was positively associated with leadership (β = 0.25; P≤ 0.01), and resources (β = 0.31; P≤ 0.001). No significant relationship was found between administration, efficiency and partnership effectiveness. Partnership synergy acted as a mediator for partnership functioning and was statistically significantly associated with partnership effectiveness (β = 0.25; P≤ 0.001). Disease-management partnerships seemed better able to deliver higher levels of chronic-illness care when synergy is created between partners. Synergy was more likely to emerge with boundary-spanning leaders who understood and appreciated partners' different perspectives, could bridge their diverse cultures and were comfortable sharing ideas, resources and power. In addition, the acknowledgement of and ability to use members' resources are valuable in engaging partners' involvement and achieving synergy in disease-management partnerships.

  17. CONCEPTUAL PRINCIPLES OF LOGISTICS SYSTEMS MANAGEMENT CONSIDERING SYNERGIES AND SYNERGETICS

    OpenAIRE

    V. Skitsko

    2015-01-01

    The paper researched the current state of the problem of logistics systems. The concept of synergies and synergistic effect in logistics, factors of synergistic effect in logistics systems at various levels are described. The problem of self-organization of logistics systems, in particular are researched, a situation in which the degree of ordering of the logistics system takes boundary values zero or one are describes. Outlined directions for future research.

  18. CONCEPTUAL PRINCIPLES OF LOGISTICS SYSTEMS MANAGEMENT CONSIDERING SYNERGIES AND SYNERGETICS

    Directory of Open Access Journals (Sweden)

    V. Skitsko

    2015-04-01

    Full Text Available The paper researched the current state of the problem of logistics systems. The concept of synergies and synergistic effect in logistics, factors of synergistic effect in logistics systems at various levels are described. The problem of self-organization of logistics systems, in particular are researched, a situation in which the degree of ordering of the logistics system takes boundary values zero or one are describes. Outlined directions for future research.

  19. Synergy of drug combinations in treating multidrug-resistant Pseudomonas aeruginosa.

    Science.gov (United States)

    Rizvi, Meher; Ahmad, Junaid; Khan, Fatima; Shukla, Indu; Malik, Abida; Sami, Hiba

    2015-01-01

    With the emergence of metallo-betalactamases (MBL) in Pseudomonas aeruginosa (P. aeruginosa), the value of carbapenem, the drug of last resort, is being severely compromised. Curtailing the use of carbapenems becomes paramount if resistance is to be reined in. To study the role of synergy between combinations of drugs as an alternative treatment choice for P. aeruginosa. Synergy was studied between combinations of levofloxacin with piperacillin-tazobactam and levofloxacin with cefoperazone-sulbactam by time-kill and chequerboard techniques. P. aeruginosa were tested for antibiotic susceptibility by the disc diffusion assay (260 isolates) and E-test (60 isolates). Synergy testing by chequerboard and time-kill assays was performed with combinations of piperacillin-tazobactam with levofloxacin (11 isolates) and cefoperazone-sulbactam with levofloxacin (10 isolates). Nearly all isolates were susceptible to piperacillin-tazobactam (96.1 per cent), followed by piperacillin (78.5 per cent). Seventy-one isolates (27.3 per cent) were found to be multidrug resistant and 19.6 per cent were ESBL producers. MIC50 of amikacin was 32μg/ml and MIC90 was 64μg/ml. MIC50 and MIC90 of cefoperazone-sulbactam was 32μg/ml and 64μg/ml, and for levofloxacin it was 10μg/ml and 240μg/ml, respectively. Piperacillin-tazobactam had MIC50 and MIC90 of 5μg/ml and 10μg/ml, respectively. Synergy was noted in 72.7 per cent isolates for levofloxacin and piperacillin-tazobactam combination, the remaining 27.3 per cent isolates showed addition by both chequerboard and time-kill assay. For levofloxacin and cefoperazone-sulbactam, only 30 per cent isolates had synergy, 40 per cent showed addition, 20 per cent indifference, and 10 per cent were antagonistic by the chequerboard method. The combination of levofloxacin and piperacillin-tazobactam is a good choice for treatment of such strains.

  20. Synergy of β-Lactams with Vancomycin against Methicillin-Resistant Staphylococcus aureus: Correlation of Disk Diffusion and Checkerboard Methods.

    Science.gov (United States)

    Sy, Cheng Len; Huang, Tsi-Shu; Chen, Chii Shiang; Chen, Yao-Shen; Tsai, Hung-Chin; Wann, Shue-Renn; Wu, Kuan-Sheng; Chen, Jui-Kuang; Lee, Susan Shin-Jung; Liu, Yung-Ching

    2016-03-01

    Modified disk diffusion (MDD) and checkerboard tests were employed to assess the synergy of combinations of vancomycin and β-lactam antibiotics for 59 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and Mu50 (ATCC 700699). Bacterial inocula equivalent to 0.5 and 2.0 McFarland standard were inoculated on agar plates containing 0, 0.5, 1, and 2 μg/ml of vancomycin. Oxacillin-, cefazolin-, and cefoxitin-impregnated disks were applied to the surface, and the zones of inhibition were measured at 24 h. The CLSI-recommended checkerboard method was used as a reference to detect synergy. The MICs for vancomycin were determined using the Etest method, broth microdilution, and the Vitek 2 automated system. Synergy was observed with the checkerboard method in 51% to 60% of the isolates when vancomycin was combined with any β-lactam. The fractional inhibitory concentration indices were significantly lower in MRSA isolates with higher vancomycin MIC combinations (P synergy in MRSA isolates with bacterial inocula equivalent to McFarland standard 0.5 were 33.0% and 62.5% for oxacillin, 45.1% and 52.4% for cefazolin, and 43.1% and 52.4% for cefoxitin when combined with 0.5 and 2 μg/ml of vancomycin, respectively. Based on our study, the simple MDD method is not recommended as a replacement for the checkerboard method to detect synergy. However, it may serve as an initial screening method for the detection of potential synergy when it is not feasible to perform other labor-intensive synergy tests. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  1. Synergy against extensively drug-resistant Acinetobacter baumannii in vitro by two old antibiotics: colistin and chloramphenicol.

    Science.gov (United States)

    Wei, Wen-Juan; Yang, Hai-Fei

    2017-03-01

    Combination antimicrobial therapy is an important option in the fight against Gram-negative 'superbugs'. This study systematically investigated the synergistic effect of colistin (CST) and chloramphenicol (CHL) in combination against extensively drug-resistant Acinetobacter baumannii (XDR-AB). The microtitre plate chequerboard assay was used to test synergy against 50 XDR-AB clinical strains. Then, three XDR-AB clinical isolates and the type strain A. baumannii ATCC 19606 were chosen for further synergy studies using time-kill assay, mutant prevention concentration (MPC) assay and real-time population analysis profile (PAP) assay. In the chequerboard assays, synergistic or additive effects [defined as a fractional inhibitory concentration index (FICI) of ≤0.5 and 0.5 synergy testing, the results of time-kill assays indicated that CST monotherapy produced rapid bacterial killing followed by rapid re-growth, with the emergence of CST resistance; CHL monotherapy was largely ineffective. The combination CST/CHL, however, showed a synergistic effect and enhanced bacterial killing in the four tested strains. It also significantly delayed re-growth and suppressed the emergence of CST resistance. In the MPC assay, a decrease in MPCs for CST was observed in the two CST-susceptible strains. PAP assay showed that both CST-resistant strains were heteroresistant. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  2. The synergy and mode of action of quercetin plus amoxicillin against amoxicillin-resistant Staphylococcus epidermidis.

    Science.gov (United States)

    Siriwong, Supatcharee; Teethaisong, Yothin; Thumanu, Kanjana; Dunkhunthod, Benjawan; Eumkeb, Griangsak

    2016-08-04

    Staphylococcus epidermidis is one of the most multiple resistances to antibiotics in the recent years. Therefore, practically-prescribed antibiotics in the treatment of these strains are not effective. Plant-derived antibacterial is one of the most interesting sources of new therapeutics. The present study was to investigate antibacterial, synergy and modes of action of quercetin and amoxicillin against amoxicillin-resistant Staphylococcus epidermidis (ARSE). The MICs, checkerboard assay, viability curves, cytoplasmic membrane (CM) permeability, enzyme assay, transmission electron microscopy, confocal microscopy and FT-IR microspectroscopy measurement was performed. The MICs of amoxicillin, penicillin, quercetin and kaempferol against all ARSE strains were 16, 200, 256-384 and >1024 μg/mL respectively. Synergistic effects were exhibited on amoxicillin plus quercetin and penicillin plus kaempferol against these strains at FIC index 0.50 and amoxicillin was confirmed by the viable count. This combination increased CM permeability, caused marked morphological, peptidoglycan and cytoplasmic membrane damage, increased protein amide I and II, but decreased fatty acid in bacterial cells. The quercetin had an inhibitory activity against β-lactamase. So, these findings are the first report that quercetin has the synergistic effect with amoxicillin against ARSE via four modes of actions, inhibit peptidoglycan synthesis and β-lactamases activity, increase CM permeability and protein amide I and II but decrease fatty acid in bacterial cells. Of course, this flavonol has the dominant potential to develop a brand-new collateral phytochemical agent plus amoxicillin to treat ARSE. Future work should focus on the bioavailability, efficacy and toxicity in animal and human studies, as well as, the synergistic effect on blood and tissue should be evaluated and achieved.

  3. Combining the FtsZ-Targeting Prodrug TXA709 and the Cephalosporin Cefdinir Confers Synergy and Reduces the Frequency of Resistance in Methicillin-Resistant Staphylococcus aureus.

    Science.gov (United States)

    Kaul, Malvika; Mark, Lilly; Parhi, Ajit K; LaVoie, Edmond J; Pilch, Daniel S

    2016-07-01

    Combination therapy of bacterial infections with synergistic drug partners offers distinct advantages over monotherapy. Among these advantages are (i) a reduction of the drug dose required for efficacy, (ii) a reduced potential for drug-induced toxicity, and (iii) a reduced potential for the emergence of resistance. Here, we describe the synergistic actions of the third-generation oral cephalosporin cefdinir and TXA709, a new, FtsZ-targeting prodrug that we have developed with improved pharmacokinetics and enhanced in vivo efficacy against methicillin-resistant Staphylococcus aureus (MRSA) relative to earlier agents. We show that the active product of TXA709 (TXA707) acts synergistically with cefdinir in vitro against clinical isolates of MRSA, vancomycin-intermediate S. aureus (VISA), vancomycin-resistant S. aureus (VRSA), and linezolid-resistant S. aureus (LRSA). In addition, relative to TXA707 alone, the combination of TXA707 and cefdinir significantly reduces or eliminates the detectable emergence of resistance. We also demonstrate synergy in vivo with oral administration of the prodrug TXA709 and cefdinir in mouse models of both systemic and tissue (thigh) infections with MRSA. This synergy reduces the dose of TXA709 required for efficacy 3-fold. Viewed as a whole, our results highlight the potential of TXA709 and cefdinir as a promising combination for the treatment of drug-resistant staphylococcal infections. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  4. Service-Oriented Architectures and Project Optimization for a Special Cost Management Problem Creating Synergies for Informed Change between Qualitative and Quantitative Strategic Management Processes

    Science.gov (United States)

    2010-05-01

    Strategic Management Processes 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f...Optimization for a Special Cost Management Problem Creating Synergies for Informed Change between Qualitative and Quantitative Strategic Management Processes

  5. Supply Chain Management and Business Sustainability Synergy: A Theoretical and Integrated Perspective

    Directory of Open Access Journals (Sweden)

    Zabihollah Rezaee

    2018-01-01

    Full Text Available Global business organizations face the challenges of adapting proper sustainability strategies and practices to effectively respond to social, ethical, environmental, and governance issues while improving financial performance in creating value for their shareholders. Business sustainability enables the integration of financial economic sustainability performance and non-financial environmental, social, ethical, and governance sustainability performance dimensions into the corporate culture, supply chain management and business models in creating shared value for all stakeholders. Business literature has provided mixed evidence of the tension, and possible link, between financial and non-financial sustainability performance dimensions and sustainability theories have yet to sufficiently address this tension. This paper attempts to fill this void by shedding light on the link between various dimensions of sustainability performance, their integrated effect on creating shared value for all stakeholders and their implications for supply chain sustainability. This paper examines the synergy between business sustainability and supply chain management by presenting a framework consisting of sustainability theories, sustainability performance dimensions, sustainability shared value concept, and sustainability best practices. Companies can use the suggested framework in integrating both financial and non-financial sustainability initiatives into their supply chain sustainability from production design, purchasing and inbound logistics, and manufacturing process to distribution and outbound logistics.

  6. Identifying synergies between water resource protection and farm business objectives: the role of soil management

    Science.gov (United States)

    Stoate, Chris

    2017-04-01

    We use a 3,000 ha BACI experiment on clay soils in central England as a focus for exploring synergies between Water Framework Directive targets for water quality (sediment, nutrients and pesticides) and crop production objectives of farm businesses. Based on base of catchment annual sediment loads, we estimate annual soil loss from farmland to be in the order of 0.3 - 0.6 tonnes per hectare. This has impacts on aquatic ecology, reservoir storage capacity and downstream flood risk through sedimentation of drainage channels. Soil loss is relatively low in a European context but reflects poorly functioning soils with high runoff risk, and poor crop performance due to compaction, low organic matter, waterlogging, and competition from the grass weed, blackgrass (Alopecuris alopoides). We use a range of mechanisms to increase farmers' awareness, understanding and motivation for improving soil management to meet multiple public and private benefits of soil function and present results for soil organic matter testing, earthworm surveying, and horizontal and vertical soil compaction mapping.

  7. [Gestalt synergy.].

    Science.gov (United States)

    Carpentier, L

    1980-01-01

    The author describes a new psychotherapeutic approach called Gestalt Synergy. After presenting it's originality among others Body/Mind approaches, the author retraces the history of it's development through the personal history of the founder of Gestalt Synergy : Ilana Rubenfeld. Then follows an introduction of the Alexander Technique and the Feldenkrais Method which, with Gestalt, inspired Gestalt Synergy. The concepts and techniques of Gestalt Synergy are discussed and, the sequence of one session is illustrated. The author concludes on some personal changes noted from her use of this approach.

  8. In vitro antimicrobial synergy studies of carbapenem-resistant Acinetobacter baumannii isolated from intensive care units of a tertiary care hospital in Egypt.

    Science.gov (United States)

    Nageeb, Wedad; Metwally, Lobna; Kamel, Mahmoud; Zakaria, Sahar

    2015-01-01

    The increasing prevalence of multidrug-resistant and pan drug-resistant Acinetobacter baumannii as a cause of nosocomial infections has led to the need for the reassessment of novel combinations of antibiotics as our only current viable option for handling such infections until a new therapeutic option becomes available. Two of the most commonly used methods for testing antimicrobial synergy are the Time-kill assay method and the E-test method, and these were the methods used in this study. Antibiotic combinations tested in this study were azithromycin and polymyxin, tobramycin and polymyxin, polymyxin and rifampicin, and tobramycin and rifampicin. The azithromycin and polymyxin combination showed synergy, while the rifampicin and polymyxin combination showed antagonism. The synergy was achieved at lower MIC values than using each of the single agents alone against the same isolates. Synergy testing results varied according to the method used, and it is difficult to establish which method is more accurate. The use of these lower MIC values as a guide to determine effective therapeutic doses used in combination therapy can help to decrease the emergence of resistance and can also minimize the side effects associated with using a single agent at a higher dose. Further research is still required to predict in vivo efficacy of such combinations. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  9. Antimicrobial activity and synergy of antibiotics with two biphenyl compounds, protosappanins A and B from Sappan Lignum against methicillin-resistant Staphylococcus aureus strains.

    Science.gov (United States)

    Zuo, Guo-Ying; Han, Zong-Qi; Han, Jun; Hao, Xiao-Yan; Tang, Hua-Shu; Wang, Gen-Chun

    2015-10-01

    This study aims to investigate antimicrobial ingredients from Sappan Lignum and to evaluate their synergy on methicillin-resistant Staphylococcus aureus strains with antibiotics. Bioactivity-guided phytochemical procedures were used to screen the active compounds. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were assayed by broth microdilution. The synergy was evaluated through checkerboard microdilution and loss of viability assays. Protosappanins A (PsA) and B (PsB) were identified from Sappan Lignum extracts. They showed active against both S. aureus and MRSA with MIC or MIC50 at 64 (PsA) and 128 (PsB) mg/L alone. When they were used in combination with antibiotics, they showed best synergy with amikacin and gentamicin with MIC50 (mg/L) of amikacin reduced more significantly from 32 to four (with PsA) and eight (with PsB), and the fractional inhibitory concentration index (FICI) ranged between 0.078 and 0.500 (FICI50  = 0.375). Moreover, the resistance of MRSA towards amikacin and gentamicin could be reversed by the Clinical and Laboratory Standards Institute criteria. The combined bactericidal mode could as well be synergy. PsA and PsB showed very low cytotoxicity in comparison with their promising activity against MRSA. Protosappanins A and B showed both alone activities and resistance reversal effects of amikacin and gentamicin against MRSA, which warrant further investigations for potential combinatory therapy of MRSA infection. © 2015 Royal Pharmaceutical Society.

  10. MIGRATION AND CONSERVATION: FRAMEWORKS, GAPS, AND SYNERGIES IN SCIENCE, LAW, AND MANAGEMENT.

    Science.gov (United States)

    Meretsky, Vicky J; Atwell, Jonathan W; Hyman, Jeffrey B

    2011-01-01

    Migratory animals provide unique spectacles of cultural, ecological, and economic importance. However, the process of migration is a source of risk for migratory species as human actions increasingly destroy and fragment habitat, create obstacles to migration, and increase mortality along the migration corridor. As a result, many migratory species are declining in numbers. In the United States, the Endangered Species Act provides some protection against extinction for such species, but no protection until numbers are severely reduced, and no guarantee of recovery to population levels associated with cultural, ecological, or economic significance. Although groups of species receive some protection from statutes such as the Migratory Bird Treaty Act and Marine Mammal Protection Act, there is no coordinated system for conservation of migratory species. In addition, information needed to protect migratory species is often lacking, limiting options for land and wildlife managers who seek to support these species. In this Article, we outline the existing scientific, legal, and management information and approaches to migratory species. Our objective is to assess present capacity to protect the species and the phenomenon of migration, and we argue that al three disciplines are necessary for effective conservation. We find significant capacity to support conservation in all three disciplines, but no organization around conservation of migration within any discipline or among the three disciplines. Areas of synergy exist among the disciplines but not as a result of any attempt for coordination. As a result, significant gaps in information and capacity exist that must be addressed if effective conservation of migratory species is to be undertaken. We suggest that all three disciplines cooperate to identify the most pressing research needs, so that these can become targets for relevant funding sources. We identify areas of current risk to migratory species that represent gaps

  11. Three Dimensional Checkerboard Synergy Analysis of Colistin, Meropenem, Tigecycline against Multidrug-Resistant Clinical Klebsiella pneumonia Isolates.

    Science.gov (United States)

    Stein, Claudia; Makarewicz, Oliwia; Bohnert, Jürgen A; Pfeifer, Yvonne; Kesselmeier, Miriam; Hagel, Stefan; Pletz, Mathias W

    2015-01-01

    The spread of carbapenem-non-susceptible Klebsiella pneumoniae strains bearing different resistance determinants is a rising problem worldwide. Especially infections with KPC (Klebsiella pneumoniae carbapenemase) - producers are associated with high mortality rates due to limited treatment options. Recent clinical studies of KPC-blood stream infections revealed that colistin-based combination therapy with a carbapenem and/or tigecycline was associated with significantly decreased mortality rates when compared to colistin monotherapy. However, it remains unclear if these observations can be transferred to K. pneumoniae harboring other mechanisms of carbapenem resistance. A three-dimensional synergy analysis was performed to evaluate the benefits of a triple combination with meropenem, tigecycline and colistin against 20 K. pneumoniae isolates harboring different β-lactamases. To examine the mechanism behind the clinically observed synergistic effect, efflux properties and outer membrane porin (Omp) genes (ompK35 and ompK36) were also analyzed. Synergism was found for colistin-based double combinations for strains exhibiting high minimal inhibition concentrations against all of the three antibiotics. Adding a third antibiotic did not result in further increased synergistic effect in these strains. Antagonism did not occur. These results support the idea that colistin-based double combinations might be sufficient and the most effective combination partner for colistin should be chosen according to its MIC.

  12. Three Dimensional Checkerboard Synergy Analysis of Colistin, Meropenem, Tigecycline against Multidrug-Resistant Clinical Klebsiella pneumonia Isolates.

    Directory of Open Access Journals (Sweden)

    Claudia Stein

    Full Text Available The spread of carbapenem-non-susceptible Klebsiella pneumoniae strains bearing different resistance determinants is a rising problem worldwide. Especially infections with KPC (Klebsiella pneumoniae carbapenemase - producers are associated with high mortality rates due to limited treatment options. Recent clinical studies of KPC-blood stream infections revealed that colistin-based combination therapy with a carbapenem and/or tigecycline was associated with significantly decreased mortality rates when compared to colistin monotherapy. However, it remains unclear if these observations can be transferred to K. pneumoniae harboring other mechanisms of carbapenem resistance. A three-dimensional synergy analysis was performed to evaluate the benefits of a triple combination with meropenem, tigecycline and colistin against 20 K. pneumoniae isolates harboring different β-lactamases. To examine the mechanism behind the clinically observed synergistic effect, efflux properties and outer membrane porin (Omp genes (ompK35 and ompK36 were also analyzed. Synergism was found for colistin-based double combinations for strains exhibiting high minimal inhibition concentrations against all of the three antibiotics. Adding a third antibiotic did not result in further increased synergistic effect in these strains. Antagonism did not occur. These results support the idea that colistin-based double combinations might be sufficient and the most effective combination partner for colistin should be chosen according to its MIC.

  13. Synergy of plasma resistivity and electron viscosity in mediating double tearing modes in cylindrical plasmas

    International Nuclear Information System (INIS)

    He Zhixiong; He, H D; Long, Y X; Mou, Z Z; Dong, J Q; Gao Zhe

    2010-01-01

    The linear behaviors of the double tearing mode (DTM) mediated by parallel electron viscosity and plasma resistivity in cylindrical plasmas with reversed magnetic shear and thus two resonant rational flux surfaces are numerically investigated in this paper. It is shown that DTMs mediated by electron viscosity alone behave similarly to the DTMs mediated by resistivity alone. DTMs mediated by electron viscosity are found to be enhanced by plasma resistivity, which is in such a range that the growth rate of the modes induced by the latter alone is comparable with that of the modes mediated by the former alone, and vice versa. Otherwise the growth rate of the modes is equal to the higher of the modes mediated by resistivity or electron viscosity alone when both resistivity and electron viscosity are taken into account. The enhancement is found to be closely related to the profiles of the stream function.

  14. The synergy between mass-media and public management: a positive perspective for the Departments of Communication and Public Relations

    Directory of Open Access Journals (Sweden)

    Prodan (Mocanu Ana-Maria

    2012-12-01

    Full Text Available The aim of this article is to emphasize the major role the departments of communication and public relations detains in the synergy process between mass-media and public institutions, starting from a series of short-circuits which have occurred in Romanian public sector and led to the misunderstanding of messages, due to an unprofessional communication. Synergy, on its basic meaning, represents a simultaneous action oriented in the same direction, which involves several agents who have the same purposes (DEI, 1999. In the present context, I define synergy as intensifying two activities with a determinant role in the proper functioning of public management which contributes, to a large extent, on informing and educating the general public. The premises I start with are that crisis situations occur because of a faulty communication department and these could be avoided if there would be a permanent and efficient relationship between mass-media and public institutions. In other words, an efficiently organized department of communication could enhance company’s activity starting from the partnership between media and public institutions. Through collaboration, both units could present advantages to be felt at the organizational, social, economic and cultural levels.

  15. Environmental, Disaster and Crisis Management Strategies: Interdisciplinarity and Synergy in Postgraduate Studies

    Science.gov (United States)

    Lekkas, Efthymis; Andreadakis, Emmanouil; Nomikou, Paraskevi; Antoniou, Varvara; Kapourani, Eleni; Papaspyropoulos, Konstantinos

    2017-04-01

    , admitted students come, in a large percentage, from services and authorities involved in environmental, disaster and crisis management issues (for example fire service, police, armed forces, ministries, local administration etc) apart from graduate students continuing their studies. An added value of the program has been observed the development of a critical mass of personnel of these organizations and young scientists with increased connectivity, extending from simple acquaintance to cooperation and trust and synergy development of the services themselves. This is a promising condition for a more effective risk and emergency management in a context of ethical and responsible practices. The curriculum comprises live or online lectures, asynchronous education with exercises and essay writing, seminars on tools such as related GIS and SPSS applications, and applied field exercises on both scientific and emergency management subjects. The program completed the second year of function, and was upgraded after internal and external evaluation, to adjust to new fields, ideas and challenges and include students' suggestions. More than one hundred students have graduated so far, and another 350 are currently attending. The program, which originally available in Greek, is going to be available in English starting September 2017, and is open for applications, and presented at: http://www.edcm.edu.gr

  16. Insecticide Resistance Management

    Science.gov (United States)

    2013-01-01

    thuringiensis var. membranes israeknsis A2 Bacillus sphaencus Inhibitocs of chitin biosynthesis type 0 15 Benzaylureas Diflubenzuron, triflnmuron...resources/ pdf /fsp/ir_manual/ir_cdc_bioassay_en.pdf 22 STEP 5: INTERPRETING RESULTS The time required for all susceptible mosquitoes to die in the...purchase by contacting: Dr Zairi Jaal, Tel: 604-6574776; zairi@usm.my http://www.who.int/whopes/resistance/en/WHO_CDS_CPE_PV C_2001.2. pdf 27

  17. Efficacy of ampicillin against methicillin-resistant Staphylococcus aureus restored through synergy with branched poly(ethylenimine).

    Science.gov (United States)

    Foxley, Melissa A; Friedline, Anthony W; Jensen, Jessica M; Nimmo, Susan L; Scull, Erin M; King, Jarrod B; Strange, Stoffel; Xiao, Min T; Smith, Benjamin E; Thomas Iii, Kieth J; Glatzhofer, Daniel T; Cichewicz, Robert H; Rice, Charles V

    2016-12-01

    β-Lactam antibiotics kill Staphylococcus aureus bacteria by inhibiting the function of cell wall penicillin-binding proteins (PBPs) 1 and 3. However, β-lactams are ineffective against PBP2a, used by methicillin-resistant S. aureus (MRSA) to perform essential cell wall crosslinking functions. PBP2a requires teichoic acid to properly locate and orient the enzyme, and thus MRSA is susceptible to antibiotics that prevent teichoic acid synthesis in the bacterial cytoplasm. As an alternative, we have used branched poly(ethylenimine), BPEI, to target teichoic acid in the bacterial cell wall. The result is restoration of MRSA susceptibility to the β-lactam antibiotic ampicillin with a MIC of 1 μg ml -1 , superior to that of vancomycin (MIC=3.7 μg ml -1 ). A checkerboard assay shows synergy of BPEI and ampicillin. NMR data show that BPEI alters the teichoic acid chemical environment. Laser scanning confocal microscopy images show BPEI residing on the bacterial cell wall, where teichoic acids and PBPs are located.

  18. Bactericidal Activity and Synergy Studies of Peptide AP-CECT7121 Against Multi-resistant Bacteria Isolated from Human and Animal Soft Tissue Infections.

    Science.gov (United States)

    Delpech, Gastón; Bistoletti, Mariana; Ceci, Mónica; Lissarrague, Sabina; Bruni, Sergio Sánchez; Sparo, Mónica

    2017-09-01

    AP-CECT7121 is an antimicrobial peptide, produced by Enterococcus faecalis CECT7121, with bactericidal activity against Gram-positive bacteria. The aim of this study was to evaluate the bactericidal activity of AP-CECT7121, alone and with gentamicin, against multi-resistant bacteria isolated from human and animals with soft tissue infections. During the period 2014-2015, bacterial strains producing human and animal soft tissue infections were studied. Samples from patients attended at a general hospital and cattle from four dairies in the Province of Buenos Aires (Argentina) were included. Twenty-two methicillin-resistant Staphylococcus aureus (11, human blood samples; 11, cow milk) and five vancomycin-resistant Ent. faecium strains isolated from four mastitic dairy cows were tested. AP-CECT7121 (12 mg/L) potency was assessed by time-kill curves alone or with sub-inhibitory concentrations of gentamicin. All staphylococcal strains were susceptible to gentamicin; enterococci did not show high-level gentamicin resistance. Colony counts were carried out at 0, 2, 4, 8, and 24 h of incubation. AP-CECT7121 showed bactericidal activity against all the enterococcal strains. In addition, AP-CECT7121 had a bactericidal effect on most staphylococci (16/22). Early AP-CECT7121/gentamicin synergy (4-8 h) for all staphylococci was detected. At 24 h, synergy (19/22) and indifference (3/22) were observed. Synergy with gentamicin was detected for staphylococci. AP-CECT7121 constitutes an attractive candidate for its use as a natural therapeutic tool for the treatment of infections produced by multi-resistant Staph. aureus and vancomycin-resistant Ent. faecium isolated from humans and animals.

  19. Synergy of aminoglycoside antibiotics by 3-Benzylchroman derivatives from the Chinese drug Caesalpinia sappan against clinical methicillin-resistant Staphylococcus aureus (MRSA).

    Science.gov (United States)

    Zuo, G Y; Han, Z Q; Hao, X Y; Han, J; Li, Z S; Wang, G C

    2014-06-15

    The in vitro antimicrobial activities of three 3-Benzylchroman derivatives, i.e. Brazilin (1), Brazilein (2) and Sappanone B (3) from Caesalpinia sappan L. (Leguminosae) were assayed, which mainly dealt with synergistic evaluation of aminoglycoside and other type of antibiotics against methicillin-resistant Staphylococcus aureus (MRSA) by the three compounds through the Chequerboard and Time-kill curve methods. The results showed that Compounds 1-3 alone exhibited moderate to weak activity against methicillin-susceptible S. aureus (MSSA) and other standard strains by MICs/MBCs ranged from 32/64 to >1024/>1024 μg/ml, with the order of activity as 1>2>3. Chequerboard method showed significant anti-MRSA synergy of 1/Aminoglycosides (Gentamicin, Amikacin, Etimicin and Streptomycin) combinations with (FICIs)50 at 0.375-0.5. The combined (MICs)50 values (μg/ml) reduced from 32-128/16-64 to 4-8/4-16, respectively. The percent of reduction by MICs ranged from 50% to 87.5%, with a maximum of 93.8% (1/16 of the alone MIC). Combinations of 2 and 3 with Aminoglycosides and the other antibiotics showed less potency of synergy. The dynamic Time-killing experiment further demonstrated that the combinations of 1/aminoglycoside were synergistically bactericidal against MRSA. The anti-MRSA synergy results of the bacteriostatic (Chequerboard method) and bactericidal (time-kill method) efficiencies of 1/Aminoglycoside combinations was in good consistency, which made the resistance reversed by CLSI guidelines. We concluded that the 3-Benzylchroman derivative Brazilin (1) showed in vitro synergy of bactericidal activities against MRSA when combined with Aminoglycosides, which might be beneficial for combinatory therapy of MRSA infection. Copyright © 2014. Published by Elsevier GmbH.

  20. In vitro synergy of baicalein and gentamicin against vancomycin-resistant Enterococcus.

    Science.gov (United States)

    Chang, Ping Chin; Li, Hua Yu; Tang, Hung Jen; Liu, Jien Wei; Wang, Jhi Joung; Chuang, Yin Ching

    2007-02-01

    Little is known about the possible synergism of baicalein, a bioactive flavone of Scutellariae radix (a Chinese herb), when used in conjunction with other antimicrobial agents against vancomycin-resistant Enterococcus (VRE). This in vitro study examined the possible synergism of the combination of baicalein and gentamicin against VRE. Minimal inhibitory concentrations (MICs) of baicalein as well as gentamicin were determined against 39 clinical isolates of VRE by the agar dilution method. Synergistic activities were determined using the checkerboard method based on the fractional inhibitory concentration indices and also the time-kill method. Further time-kill studies were conducted with these two agents against one randomly chosen clinical isolate, VRE-096. Minimal concentrations inhibiting 50% (MIC(50)) and 90% (MIC(90)) of isolates for baicalein and gentamicin were all >256 microg/mL. Synergism between baicalein and gentamicin was demonstrated against four clinical isolates of VRE (VRE-70, VRE-940, VRE-096 and VRE-721). When approximately 5 x 10(5) colony-forming units/mL of VRE-096 was incubated with both baicalein at a concentration of 32 microg/mL (1/8 x MIC) and gentamicin at a concentration of 128 microg/mL (1/2 x MIC), there was an inhibitory effect against VRE that persisted for 48 h. At 48 h, the combination of baicalein and gentamicin at these respective concentrations resulted in a reduction of growth by approximately 2 orders of magnitude compared to that for the starting inoculum and by 3 orders of magnitude compared to that for baicalein alone, the more active single agent. This study demonstrated that baicalein and gentamicin can act synergistically in inhibiting VRE in vitro.

  1. Antimicrobial activity of essential oils and carvacrol, and synergy of carvacrol and erythromycin, against clinical, erythromycin-resistant Group A Streptococci.

    Directory of Open Access Journals (Sweden)

    Gloria eMagi

    2015-03-01

    Full Text Available In the present study, we have evaluated the in vitro antibacterial activity of essential oils from Origanum vulgare, Thymus vulgaris, Lavandula angustifolia, Mentha piperita, and Melaleuca alternifolia against 32 erythromycin-resistant [MIC ≥1 µg/mL; inducible, constitutive, and efflux-mediated resistance phenotype; erm(TR, erm(B, and mef(A genes] and cell-invasive Group A streptococci (GAS isolated from children with pharyngotonsillitis in Italy. Over the past decades erythromycin resistance in GAS has emerged in several countries; strains combining erythromycin resistance and cell invasiveness may escape β-lactams because of intracellular location and macrolides because of resistance, resulting in difficulty of eradication and recurrent pharyngitis. Thyme and origanum essential oils demonstrated the highest antimicrobial activity with MICs ranging from 256 to 512 µg/mL. The phenolic monoterpene carvacrol [2-Methyl-5-(1-methylethyl phenol] is a major component of the essential oils of Origanum and Thymus plants. MICs of carvacrol ranged from 64 to 256 µg/mL. In the live/dead assay several dead cells were detected as early as 1 h after incubation with carvacrol at the MIC. In single-step resistance selection studies no resistant mutants were obtained. A synergistic action of carvacrol and erythromycin was detected by the checkerboard assay and calculation of the FIC Index. A 2- to 2048-fold reduction of the erythromycin MIC was documented in checkerboard assays. Synergy (FIC Index ≤0.5 was found in 21/32 strains and was highly significant (p <0.01 in strains where resistance is expressed only in presence of erythromycin. Synergy was confirmed in 17/23 strains using 24-h time-kill curves in presence of carvacrol and erythromycin. Our findings demonstrated that carvacrol acts either alone or in combination with erythromycin against erythromycin-resistant GAS and could potentially serve as a novel therapeutic tool.

  2. Progressive Abduction Loading Therapy with Horizontal-Plane Viscous Resistance Targeting Weakness and Flexion Synergy to Treat Upper Limb Function in Chronic Hemiparetic Stroke: A Randomized Clinical Trial.

    Science.gov (United States)

    Ellis, Michael D; Carmona, Carolina; Drogos, Justin; Dewald, Julius P A

    2018-01-01

    Progressive abduction loading therapy has emerged as a promising exercise therapy in stroke rehabilitation to systematically target the loss of independent joint control (flexion synergy) in individuals with chronic moderate/severe upper-extremity impairment. Preclinical investigations have identified abduction loading during reaching exercise as a key therapeutic factor to improve reaching function. An augmentative approach may be to additionally target weakness by incorporating resistance training to increase constitutive joint torques of reaching with the goal of improving reaching function by "overpowering" flexion synergy. The objective was, therefore, to determine the therapeutic effects of horizontal-plane viscous resistance in combination with progressive abduction loading therapy. 32 individuals with chronic hemiparetic stroke were randomly allocated to two groups. The two groups had equivalent baseline characteristics on all demographic and outcome metrics including age (59 ± 11 years), time poststroke (10.1 ± 7.6 years), and motor impairment (Fugl-Meyer, 26.7 ± 6.5 out of 66). Both groups received therapy three times/week for 8 weeks while the experimental group included additional horizontal-plane viscous resistance. Quantitative standardized progression of the intervention was achieved using a robotic device. The primary outcomes of reaching distance and velocity under maximum abduction loading and secondary outcomes of isometric strength and a clinical battery were measured at pre-, post-, and 3 months following therapy. There was no difference between groups on any outcome measure. However, for combined groups, there was a significant increase in reaching distance (13.2%, effect size; d  = 0.56) and velocity (13.6%, effect size; d  = 0.27) at posttesting that persisted for 3 months and also a significant increase in abduction, elbow extension, and external rotation strength at posttesting that did not persist 3

  3. Antibacterial and Synergy of Berberines with Antibacterial Agents against Clinical Multi-Drug Resistant Isolates of Methicillin-Resistant Staphylococcus aureus (MRSA

    Directory of Open Access Journals (Sweden)

    Zhong-Qi Bian

    2012-08-01

    Full Text Available Antibacterial activity of berberine (Ber and 8-acetonyl-dihydroberberine (A-Ber alone and combined uses with antibacterial agents ampicillin (AMP, azithromycin (AZM, cefazolin (CFZ and levofloxacin (LEV was studied on 10 clinical isolates of SCCmec III type methicillin-resistant Staphylococcus aureus (MRSA. Susceptibility to each agent alone was tested using a broth microdilution method and the chequerboard and time-kill tests for the combined evaluations, respectively. The alone MICs/MBCs (mg/mL ranges were 32–128/64–256 (Ber and 32-128/128-512 (A-Ber. Significant synergies were observed for the Ber (A-Ber/AZM and Ber (A-Ber/LEV combinations against 90% of the tested MRSA strains, with fractional inhibitory concentration indices (FICIs values ranged  from 0.188 to 0.500. An additivity result was also observed for the Ber/AZM combination by time-kill curves. These results demonstrated for the first time that Ber and A-Ber enhanced the in vitro inhibitory efficacy of AZM and LEV to a same extent, which had potential for further investigation in combinatory therapeutic applications of patients infected with MRSA.

  4. Resistance to the macrolide antibiotic tylosin is conferred by single methylations at 23S rRNA nucleotides G748 and A2058 acting in synergy

    Science.gov (United States)

    Liu, Mingfu; Douthwaite, Stephen

    2002-01-01

    The macrolide antibiotic tylosin has been used extensively in veterinary medicine and exerts potent antimicrobial activity against Gram-positive bacteria. Tylosin-synthesizing strains of the Gram-positive bacterium Streptomyces fradiae protect themselves from their own product by differential expression of four resistance determinants, tlrA, tlrB, tlrC, and tlrD. The tlrB and tlrD genes encode methyltransferases that add single methyl groups at 23S rRNA nucleotides G748 and A2058, respectively. Here we show that methylation by neither TlrB nor TlrD is sufficient on its own to give tylosin resistance, and resistance is conferred by the G748 and A2058 methylations acting together in synergy. This synergistic mechanism of resistance is specific for the macrolides tylosin and mycinamycin that possess sugars extending from the 5- and 14-positions of the macrolactone ring and is not observed for macrolides, such as carbomycin, spiramycin, and erythromycin, that have different constellations of sugars. The manner in which the G748 and A2058 methylations coincide with the glycosylation patterns of tylosin and mycinamycin reflects unambiguously how these macrolides fit into their binding site within the bacterial 50S ribosomal subunit. PMID:12417742

  5. Soil health: an emergent set of soil properties that result from synergy among agricultural management practices

    Science.gov (United States)

    The responses of a selected soil microbial property to a single agricultural management practice are often inconsistent among field studies, possibly reflecting the site-specific nature of field studies. An equally compelling explanation is that in complex systems where outcomes are the result of n...

  6. Is there a place for β-lactams in the treatment of multidrug-resistant/extensively drug-resistant tuberculosis? Synergy between meropenem and amoxicillin/clavulanate.

    Science.gov (United States)

    Gonzalo, Ximena; Drobniewski, Francis

    2013-02-01

    To: (i) assess if amoxicillin/clavulanate is a useful option for the management of multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB); (ii) assess if meropenem/clavulanate is active against Mycobacterium tuberculosis at concentrations achievable in vivo; and (iii) determine whether there was inhibition of meropenem/clavulanate activity in the presence of amoxicillin. Twenty-eight M. tuberculosis strains (7 susceptible, 2 monoresistant, 16 MDR and 3 XDR) were included in the study and tested against different concentrations of meropenem, meropenem/clavulanate, amoxicillin/meropenem, amoxicillin/clavulanate and amoxicillin/meropenem/clavulanate using the Bactec 960 MGIT(®) system. All 28 strains were resistant to meropenem at the highest concentration tested (5 mg/L). Although 24 strains were susceptible to amoxicillin/clavulanate, 7 strains were susceptible only to 7.2/2.5 mg/L amoxicillin/clavulanate, 10 strains were susceptible to 3.6/2.5 mg/L amoxicillin/clavulanate, 6 strains were susceptible to 1.8/2.5 mg/L amoxicillin/clavulanate and 1 strain was susceptible to 0.9/2.5 mg/L amoxicillin/clavulanate. Therefore, 4/28 strains (14.29%) were resistant to the highest concentration of amoxicillin tested (7.2 mg/L); all of them were MDR. All of the 11 strains resistant to amoxicillin or susceptible only to 7.2 mg/L amoxicillin increased their susceptibility to amoxicillin/clavulanate after the addition of meropenem. The addition of clavulanate to meropenem reduced the MIC of meropenem by an average of over 1.8 dilutions. The combination of amoxicillin/clavulanate plus meropenem is active against MDR/XDR-TB in vitro, and this triple therapy could be a useful therapy for MDR/XDR-TB and possibly help to reduce the development of further resistance. The drug susceptibility technique used here is routinely used, with modification, in mycobacteriology laboratories.

  7. Synergies across the natural resources management fields in Southern Africa: Disaster Risk Reduction and One Health

    Directory of Open Access Journals (Sweden)

    Clara Bocchino

    2013-02-01

    Full Text Available For various reasons, Southern Africa may be considered the playground as well as the thinking tank for many theories and practices in the natural resources management field. History has contributed to reshape conservation practices through colonial times, and recent wars have led to the relocation of people from their homelands and the appropriation by people of previously protected areas due to socio-economic pressures. Contemporary practices stemming from sustainable development have not yielded the expected results in resolving critical socio-economic stresses that impact on environmental health. Furthermore, human health has deteriorated in remote rural areas due to the failures of governance systems and the perpetration of non-participatory models for natural resources management, especially conservation. This paper seeks to explore how two relatively new approaches, Disaster Risk Reduction and One Health, can together tap into the theoretical and practical gaps left by previous paradigms in order to instill a sustainable development approach that can benefit both people and natural resources in remote and poor rural areas.

  8. Synergy of fuzzy AHP and Six Sigma for capacity waste management in Indian automotive industry

    Directory of Open Access Journals (Sweden)

    Rajeev Rathi

    2015-07-01

    Full Text Available Capacity waste management is highly essential because under utilization of capacity is often referred to as a major reason for lower productivity among industries around the world. For better estimation of capacity and its utilization and then for its improved management; newer techniques are being devised in industrial sector. The current case of capacity waste problem has been taken up as a Six Sigma project, where we try to analyze critical factors responsible for the capacity waste. Decisions on critical factor selection in analysis phase of Six Sigma are always very crucial. The paper discusses an approach for selection of capacity waste factors at an automotive industry using fuzzy logic based AHP method. The fuzzy AHP is a well recognized tool to undertake the fuzziness of the data involved in choosing the preferences of the different decision variables engaged in the process of capacity waste factors selection. In this context, we have explored six crucial parameters for selection of capacity waste factors. Final ranking is calculated through priority vector thus obtained and it is seen that conveyor malfunction is found to be the key factor for capacity waste among all alternatives at the selected site.

  9. Synergy in efficacy of fungal entomopathogens and permethrin against West African insecticide-resistant Anopheles gambiae mosquitoes

    NARCIS (Netherlands)

    Farenhorst, Marit; Knols, Bart G. J.; Thomas, Matthew B.; Howard, Annabel F. V.; Takken, Willem; Rowland, Mark; N'Guessan, Raphael

    2010-01-01

    Increasing incidences of insecticide resistance in malaria vectors are threatening the sustainable use of contemporary chemical vector control measures. Fungal entomopathogens provide a possible additional tool for the control of insecticide-resistant malaria mosquitoes. This study investigated the

  10. Synergy in Efficacy of Fungal Entomopathogens and Permethrin against West African Insecticide-Resistant Anopheles gambiae Mosquitoes

    NARCIS (Netherlands)

    Farenhorst, M.; Knols, B.G.J.; Thomas, M.B.; Howard, A.F.V.; Takken, W.; Rowland, M.; N'Guessan, R.

    2010-01-01

    Background: Increasing incidences of insecticide resistance in malaria vectors are threatening the sustainable use of contemporary chemical vector control measures. Fungal entomopathogens provide a possible additional tool for the control of insecticide-resistant malaria mosquitoes. This study

  11. Synergy in efficacy of fungal entomopathogens and permethrin against West African insecticide-resistant Anopheles gambiae mosquitoes

    NARCIS (Netherlands)

    Farenhorst, M.; Knols, B.G.J.; Thomas, M.B.; Howard, A.F.V.; Takken, W.; Rowland, M.; N'Guessan, R.

    2010-01-01

    Background Increasing incidences of insecticide resistance in malaria vectors are threatening the sustainable use of contemporary chemical vector control measures. Fungal entomopathogens provide a possible additional tool for the control of insecticide-resistant malaria mosquitoes. This study

  12. From silos to synergy.

    Science.gov (United States)

    Treadwell, Janet; Levermann, Laurie; Soffar, Gail; Giardino, Angelo

    2007-08-01

    Texas Children's Health Plan (TCHP) redesigned its approach to care management in an effort to provide support for member-centric care and the medical home. The changes in process and structure focused on connecting information and programs to promote care for members in a collaborative manner and taking advantage of the synergy between staff, programming, and the physician practices serving health plan membership. The results brought about an improvement in job satisfaction, positive change in the medical-loss ratio, and new innovations to support preventive and chronic care service delivery needs of the TCHP membership.

  13. Fractional maximal effect method for in vitro synergy between amoxicillin and ceftriaxone and between vancomycin and ceftriaxone against Enterococcus faecalis and penicillin-resistant Streptococcus pneumoniae.

    Science.gov (United States)

    Desbiolles, N; Piroth, L; Lequeu, C; Neuwirth, C; Portier, H; Chavanet, P

    2001-12-01

    In the present study we assessed the use of a new in vitro testing method and graphical representation of the results to investigate the potential effectiveness of combinations of amoxicillin (AMZ) plus ceftriaxone (CRO) and of CRO plus vancomycin (VAN) against strains of Streptococcus pneumoniae highly resistant to penicillin and cephalosporins (PRP strains). We used the fractional maximal effect (FME) method of time-kill curves to calculate adequate concentrations of the drugs to be tested rather than relying on arbitrary choices. The concentrations obtained, each of which corresponded to a fraction of the maximal effect, were tested alone and in combination with the bacterial strains in a broth medium. Synergy was defined as a ratio of observed effect/theoretical effect, called FME, of greater than 1, additivity was defined as an FME equal to 1, and antagonism was defined as an observed effect lower than the best effect of one of the antibiotics used alone. The area between antagonism and additivity is the indifference zone. The well-known synergy between amoxicillin and gentamicin against a reference strain of Enterococcus faecalis was confirmed, with a best FME equal to 1.07. Two strains of PRP, strains PRP-1 and PRP-2, were studied. The MICs for PRP-1 and PRP-2 were as follows: penicillin, 4 and 16 microg/ml, respectively; AMZ, 2 and 8 microg/ml, respectively, CRO, 1 and 4 microg/ml, respectively; and VAN, 0.5 and 0.25 microg/ml, respectively. For PRP-1 the best FME for the combination AMZ-CRO was 1.22 with drug concentrations of 1.68 mg/liter for AMZ and 0.17 mg/liter for CRO; the best FME for the combination VAN-CRO was 1.75 with VAN at 0.57 mg/liter and CRO at 0.17 mg/liter. For PRP-2 the best FME obtained for the combination AMZ-CRO was 1.05 with drug concentrations of 11.28 mg/liter for AMZ and 0.64 mg/liter for CRO; the best FME obtained for the combination VAN-CRO was 1.35 with VAN at 0.25 mg/liter and CRO at 1.49 mg/liter. These results demonstrated

  14. Determination of in vitro synergy for dual antimicrobial therapy against resistant Neisseria gonorrhoeae using Etest and agar dilution

    NARCIS (Netherlands)

    Wind, Carolien M.; de Vries, Henry J. C.; van Dam, Alje P.

    2015-01-01

    In response to antimicrobial resistance of Neisseria gonorrhoeae to last-resort extended-spectrum cephalosporins, combination therapy of azithromycin + ceftriaxone is now recommended. Dual therapy can be effective to treat monoresistant strains as well as multidrug-resistant strains, preferably

  15. Clinical Management of HIV Drug Resistance

    Science.gov (United States)

    Cortez, Karoll J.; Maldarelli, Frank

    2011-01-01

    Combination antiretroviral therapy for HIV-1 infection has resulted in profound reductions in viremia and is associated with marked improvements in morbidity and mortality. Therapy is not curative, however, and prolonged therapy is complicated by drug toxicity and the emergence of drug resistance. Management of clinical drug resistance requires in depth evaluation, and includes extensive history, physical examination and laboratory studies. Appropriate use of resistance testing provides valuable information useful in constructing regimens for treatment-experienced individuals with viremia during therapy. This review outlines the emergence of drug resistance in vivo, and describes clinical evaluation and therapeutic options of the individual with rebound viremia during therapy. PMID:21994737

  16. Management of treatment resistant schizophrenia

    African Journals Online (AJOL)

    Adele

    symptoms, cognitive deficits, excitement or aggression, co- morbidity such as depressive and anxiety symptoms, .... another domain of treatment resistance, cognitive deficits, risperidone and olanzapine may be more .... support, teaching the recognition of early warning signs and addressing issues of medication adherence ...

  17. Synergy in efficacy of fungal entomopathogens and permethrin against West African insecticide-resistant Anopheles gambiae mosquitoes.

    Science.gov (United States)

    Farenhorst, Marit; Knols, Bart G J; Thomas, Matthew B; Howard, Annabel F V; Takken, Willem; Rowland, Mark; N'Guessan, Raphael

    2010-08-11

    Increasing incidences of insecticide resistance in malaria vectors are threatening the sustainable use of contemporary chemical vector control measures. Fungal entomopathogens provide a possible additional tool for the control of insecticide-resistant malaria mosquitoes. This study investigated the compatibility of the pyrethroid insecticide permethrin and two mosquito-pathogenic fungi, Beauveria bassiana and Metarhizium anisopliae, against a laboratory colony and field population of West African insecticide-resistant Anopheles gambiae s.s. mosquitoes. A range of fungus-insecticide combinations was used to test effects of timing and sequence of exposure. Both the laboratory-reared and field-collected mosquitoes were highly resistant to permethrin but susceptible to B. bassiana and M. anisopliae infection, inducing 100% mortality within nine days. Combinations of insecticide and fungus showed synergistic effects on mosquito survival. Fungal infection increased permethrin-induced mortality rates in wild An. gambiae s.s. mosquitoes and reciprocally, exposure to permethrin increased subsequent fungal-induced mortality rates in both colonies. Simultaneous co-exposure induced the highest mortality; up to 70.3+/-2% for a combined Beauveria and permethrin exposure within a time range of one gonotrophic cycle (4 days). Combining fungi and permethrin induced a higher impact on mosquito survival than the use of these control agents alone. The observed synergism in efficacy shows the potential for integrated fungus-insecticide control measures to dramatically reduce malaria transmission and enable control at more moderate levels of coverage even in areas where insecticide resistance has rendered pyrethroids essentially ineffective.

  18. Synergy in efficacy of fungal entomopathogens and permethrin against West African insecticide-resistant Anopheles gambiae mosquitoes.

    Directory of Open Access Journals (Sweden)

    Marit Farenhorst

    Full Text Available BACKGROUND: Increasing incidences of insecticide resistance in malaria vectors are threatening the sustainable use of contemporary chemical vector control measures. Fungal entomopathogens provide a possible additional tool for the control of insecticide-resistant malaria mosquitoes. This study investigated the compatibility of the pyrethroid insecticide permethrin and two mosquito-pathogenic fungi, Beauveria bassiana and Metarhizium anisopliae, against a laboratory colony and field population of West African insecticide-resistant Anopheles gambiae s.s. mosquitoes. METHODOLOGY/FINDINGS: A range of fungus-insecticide combinations was used to test effects of timing and sequence of exposure. Both the laboratory-reared and field-collected mosquitoes were highly resistant to permethrin but susceptible to B. bassiana and M. anisopliae infection, inducing 100% mortality within nine days. Combinations of insecticide and fungus showed synergistic effects on mosquito survival. Fungal infection increased permethrin-induced mortality rates in wild An. gambiae s.s. mosquitoes and reciprocally, exposure to permethrin increased subsequent fungal-induced mortality rates in both colonies. Simultaneous co-exposure induced the highest mortality; up to 70.3+/-2% for a combined Beauveria and permethrin exposure within a time range of one gonotrophic cycle (4 days. CONCLUSIONS/SIGNIFICANCE: Combining fungi and permethrin induced a higher impact on mosquito survival than the use of these control agents alone. The observed synergism in efficacy shows the potential for integrated fungus-insecticide control measures to dramatically reduce malaria transmission and enable control at more moderate levels of coverage even in areas where insecticide resistance has rendered pyrethroids essentially ineffective.

  19. Potential Synergy Activity of the Novel Ceragenin, CSA-13, against Carbapenem-Resistant Acinetobacter baumannii Strains Isolated from Bacteremia Patients

    Directory of Open Access Journals (Sweden)

    Cagla Bozkurt-Guzel

    2014-01-01

    Full Text Available Carbapenem-resistant Acinetobacter baumannii is an important cause of nosocomial infections, particularly in patients in the intensive care units. As chronic infections are difficult to treat, attempts have been made to discover new antimicrobials. Ceragenins, designed to mimic the activities of antimicrobial peptides, are a new class of antimicrobial agents. In this study, the in vitro activities of CSA-13 either alone or in combination with colistin (sulphate, tobramycin, and ciprofloxacin were investigated using 60 carbapenem-resistant A. baumannii strains isolated from bacteremia patients blood specimens. MICs and MBCs were determined by microbroth dilution technique. Combinations were assessed by using checkerboard technique. The MIC50 values (mg/L of CSA-13, colistin, tobramycin, and ciprofloxacin were 2, 1, 1.25, and 80, respectively. The MIC90 (mg/L of CSA-13 and colistin were 8 and 4. The MBCs were equal to or twice greater than those of the MICs. Synergistic interactions were mostly seen with CSA-13-colistin (55%, whereas the least synergistic interactions were observed in the CSA-13-tobramycin (35% combination. No antagonism was observed. CSA-13 appears to be a good candidate for further investigations in the treatment of A. baumannii infections. However, future studies should be performed to correlate the safety, efficacy, and pharmacokinetic parameters of this molecule.

  20. Theoretical Aspects of Innovatization of the Management of Regional Social Systems on the Basis of the Phenomena Complex «Syntellect – Synergy – Synarchy»

    Directory of Open Access Journals (Sweden)

    Vartsaba Vjera I.

    2015-09-01

    Full Text Available The article is aimed at the theoretical substantiation of the role and practicability of the both search and elaboration of innovative concepts, technologies and tools for regional management based on the contemporary management requirements of the managerial harmonization of goals, interests, relationships and interaction of participants in the regional markets under the respective acts on the part of public policy and regional management. A model for transforming resources of the regional social system into the economically and socially significant results of its development has been proposed. A graphical-analytic model for managing the status of dysergy-synergy of a socio-economic system by means of the organizational integration of its subsystems has been created, the coefficients for determining the degree of harmonization when controlling the system have been suggested. A base management algorithm for the 3С-Technology of harmonizing objectives and interests of the subsystems of a socio-economic system has been developed. Proceeding from the fact that the basis of the underlying algorithm for the managerial 3С-Technology is in its turn based on the algorithm for implementation of the management tool Strategic Planning (SP, which is supplemented by the mandatory use with the aim of the progressive transformation of the material resources of the system with an intensive and managed participation of the intellectual resources of the latter, becomes quite practical to explore and evaluate the relationship between the results obtained from the use of this technology

  1. CONSIDERATIONS CONCERNING THE MANAGEMENT OF RESISTANCE IN ORGANIZATIONS

    OpenAIRE

    Marius-Dan DALOTĂ

    2011-01-01

    The difficulty of organisational change is often exacerbated by the mismanagement of resistance derived from a simple set of assumptions that misunderstand resistance’s essential nature. It is suggested that management may greatly gain from techniques that carefully manage resistance to change by looking for ways of utilising it rather than overcoming it. Today, suggestions and prescriptions for managing resistance have left little room for utility in resistance. Traditionally, resistance has...

  2. Messages on "Resistance to change" in German change management approaches

    OpenAIRE

    Fassauer, Gabriele

    2015-01-01

    "Resistance to change" is one of the most important topics of change management in organizations. The paper investigates the analytical framing of „resistance“ and the „resistant employee“ in established German literature on change management. The analysis reveals three main messages referring the characteristics of resistance and the resistant change recipient. These are 1) that resistance is a „natural“, nearly inevitable phenomenon in organizational change processes, 2) that every behavior...

  3. Synergy in supramolecular chemistry

    CERN Document Server

    Nabeshima, Tatsuya

    2014-01-01

    Synergy and Cooperativity in Multi-metal Supramolecular Systems, T. NabeshimaHierarchically Assembled Titanium Helicates, Markus AlbrechtSupramolecular Hosts and Catalysts Formed by Self-assembly of Multinuclear Zinc Complexes in Aqueous Solution, Shin AokiSupramolecular Assemblies Based on Interionic Interactions, H. MaedaSupramolecular Synergy in the Formation and Function of Guanosine Quadruplexes, Jeffery T. DavisOn-Surface Chirality in Porous Self-Assembled Monolayers at Liquid-Solid Interface, Kazukuni Tahar

  4. CHANGE RESISTANCE IN THE PROCESS OF CHANGE MANAGEMENT

    OpenAIRE

    Polat TUNÇER

    2013-01-01

    Purpose of this article the resistance to change of the employees in the process of organizational change, in terms of change management is to handle. Made of the literature on the subject, the concepts of change management and resistance to change are examined and focused on the causes to resist and prevention methods its. In addition, in order to manage change successfully, the prevention or elimination of resistance to organizational change, it is necessary matters were discussed. Operati...

  5. Managing Resistance: An Essential Consulting Skill for Learning Disabilities Teachers.

    Science.gov (United States)

    Friend, Marilyn; Bauwens, Jeanne

    1988-01-01

    The article explores characteristics of resistance by general educators to special education consultation programs. It offers teachers of learning disabled students strategies for managing specific types of resistance as well as a general plan for minimizing resistance as well as suggestions for evaluating the impact of resistance management…

  6. Recognition and Management of Resistant Hypertension.

    Science.gov (United States)

    Braam, Branko; Taler, Sandra J; Rahman, Mahboob; Fillaus, Jennifer A; Greco, Barbara A; Forman, John P; Reisin, Efrain; Cohen, Debbie L; Saklayen, Mohammad G; Hedayati, S Susan

    2017-03-07

    Despite improvements in hypertension awareness and treatment, 30%-60% of hypertensive patients do not achieve BP targets and subsequently remain at risk for target organ damage. This therapeutic gap is particularly important to nephrologists, who frequently encounter treatment-resistant hypertension in patients with CKD. Data are limited on how best to treat patients with CKD and resistant hypertension, because patients with CKD have historically been excluded from hypertension treatment trials. First, we propose a consistent definition of resistant hypertension as BP levels confirmed by both in-office and out-of-office measurements that exceed appropriate targets while the patient is receiving treatment with at least three antihypertensive medications, including a diuretic, at dosages optimized to provide maximum benefit in the absence of intolerable side effects. Second, we recommend that each patient undergo a standardized, stepwise evaluation to assess adherence to dietary and lifestyle modifications and antihypertensive medications to identify and reduce barriers and discontinue use of substances that may exacerbate hypertension. Patients in whom there is high clinical suspicion should be evaluated for potential secondary causes of hypertension. Evidence-based management of resistant hypertension is discussed with special considerations of the differences in approach to patients with and without CKD, including the specific roles of diuretics and mineralocorticoid receptor antagonists and the current place of emerging therapies, such as renal denervation and baroreceptor stimulation. We endorse use of such a systematic approach to improve recognition and care for this vulnerable patient group that is at high risk for future kidney and cardiovascular events. Copyright © 2017 by the American Society of Nephrology.

  7. Diagnosing resistance to change in the change management process

    OpenAIRE

    Kuzhda, Tetiana

    2016-01-01

    This article explains the change management process and resistance to organizational change through examining causes of resistance to change, diagnosing them, and finding the ways to deal with resistance to change. In business environment, the one thing any company can be assured of is change. If an organization experiences change it may also need to implement new business strategies, which can create resistance among employees. Managers need to know in which phase they have to expect unusual...

  8. An Analysis of Synergies of IT-Applications and Knowledge Management Strategies with Regard to Organizational Change

    National Research Council Canada - National Science Library

    Richter, Joachim

    2003-01-01

    ... a central research issue. Along with these research issues a new awareness with regard to organization-internal existing knowledge and the necessity to exploit and manage this knowledge to the benefits of the organization...

  9. An Analysis of Synergies of IT-Applications and Knowledge Management Strategies with Regard to Organizational Change

    National Research Council Canada - National Science Library

    Richter, Joachim

    2003-01-01

    ... has been arising as well. In an era of forth-coming new advanced information technologies on a nearly day-to-day basis and the increasing awareness and willingness to incorporate knowledge management strategies...

  10. IT Portfolio Selection and IT Synergy

    Science.gov (United States)

    Cho, Woo Je

    2010-01-01

    This dissertation consists of three chapters. The primary objectives of this dissertation are: (1) to provide a methodological framework of IT (Information Technology) portfolio management, and (2) to identify the effect of IT synergy on IT portfolio selection of a firm. The first chapter presents a methodological framework for IT project…

  11. Synergy between Ursolic and Oleanolic Acids from Vitellaria paradoxa Leaf Extract and β-Lactams against Methicillin-Resistant Staphylococcus aureus: In Vitro and In Vivo Activity and Underlying Mechanisms.

    Science.gov (United States)

    Catteau, Lucy; Reichmann, Nathalie T; Olson, Joshua; Pinho, Mariana G; Nizet, Victor; Van Bambeke, Françoise; Quetin-Leclercq, Joëlle

    2017-12-16

    Combining antibiotics with resistance reversing agents is a key strategy to overcome bacterial resistance. Upon screening antimicrobial activities of plants used in traditional medicine, we found that a leaf dichloromethane extract from the shea butter tree ( Vitellaria paradoxa ) had antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA) with further evidence of synergy when combined with β-lactams. Using HPLC-MS, we identified ursolic (UA) and oleanolic acids (OA) in leaves and twigs of this species, and quantified them by HPLC-UV as the major constituents in leaf extracts (21% and 6% respectively). Both pure triterpenic acids showed antimicrobial activity against reference and clinical strains of MRSA, with MICs ranging from 8-16 mg/L for UA to 32-128 mg/L for OA. They were highly synergistic with β-lactams (ampicillin and oxacillin) at subMIC concentrations. Reversion of MRSA phenotype was attributed to their capacity to delocalize PBP2 from the septal division site, as observed by fluorescence microscopy, and to disturb thereby peptidoglycan synthesis. Moreover, both compounds also inhibited β-lactamases activity of living bacteria (as assessed by inhibition of nitrocefin hydrolysis), but not in bacterial lysates, suggesting an indirect mechanism for this inhibition. In a murine model of subcutaneous MRSA infection, local administration of UA was synergistic with nafcillin to reduce lesion size and inflammatory cytokine (IL-1β) production. Thus, these data highlight the potential interest of triterpenic acids as resistance reversing agents in combination with β-lactams against MRSA.

  12. Managing Resistance: Remembering How to Fly a Kite.

    Science.gov (United States)

    Maag, John W.

    1997-01-01

    Describes a technique for managing resistance in which adults alter their responses to fit a child's perspective. Offers a cognitive perspective of reality and ways in which to create rapport through mirroring, postural congruence, and crossover mirroring. Provides techniques for managing resistance, such as acknowledging pessimistic beliefs and…

  13. Future Combat Systems (FCS) Creates Cannon and Mortar Synergy

    National Research Council Canada - National Science Library

    Beard, Kirby; James, Jeff; Tolbert, Vincent J

    2008-01-01

    .... The NLOS-C is one of the eight MGVs. Program Manager FCS (Brigade Combat Team (PM FCS(BCT)) is leveraging previous and current research and development efforts to create synergy between cannons and mortars, without duplication of effort...

  14. Preventing and managing antiretroviral drug resistance.

    Science.gov (United States)

    Kuritzkes, Daniel R

    2004-05-01

    Development of resistance to antiretroviral drugs (ARVs) is a major impediment to optimum treatment of HIV-1 infection. Although resistance testing can help to select subsequent regimens when virologic failure occurs, cross-resistance, which affects all classes of ARVs, may make it more difficult to achieve optimum control of HIV. We have known for some time that our first choice of antiretroviral therapy offers the best chance to control HIV replication and that initial therapy should be selected with an eye on future options. Potency is the first line of defense against the development of resistance. Other factors that affect resistance development include: tolerability, potential for optimum adherence, and genetic and pharmacologic barriers to development of resistance. If resistance emerges, only a single drug may be affected initially, and a rapid change in ARVs may preserve the efficacy of other components. One cautionary note is that we can no longer assume that a patient's HIV is fully susceptible to all ARVs even in the initial regimen. Transmission of drug-resistant HIV means that the genetic composition may be that of an "experienced" virus with reduced susceptibility to ARVs. Resistance testing at the time of transmission is most likely to reveal this resistance, but over time the dominant genetic pattern may revert to wild-type, and be missed by resistance testing. Because "archived" resistant HIV may emerge quickly once treatment is initiated, we need to keep this in mind when selecting initial therapy.

  15. Obesity and Insulin Resistance: Management in Diabetes

    OpenAIRE

    Suhel Ashraff; Muhammad A. Siddiqui; Thomas E. Carline

    2013-01-01

    Obesity today, is a major public health problem across the world. The rapid increase in the incidence of obesity and associated co-morbidities presents a major challenge to health care globally. Insulin resistance is commonly associated with obesity and other life style diseases. However, much uncertainty remains about the mechanism regarding the association between insulin resistance and human disease mainly because of the difficulties of defining insulin resistance in clinical terms and of ...

  16. Resistant hypertension and sleep apnea: pathophysiologic insights and strategic management.

    Science.gov (United States)

    Williams, Stephen K; Ravenell, Joseph; Jean-Louis, Girardin; Zizi, Ferdinand; Underberg, James A; McFarlane, Samy I; Ogedegbe, Gbenga

    2011-02-01

    Resistant hypertension is common among adults with hypertension affecting up to 30% of patients. The treatment of resistant hypertension is important because suboptimal blood pressure control is the leading preventable cause of death worldwide. A frequent comorbid condition in patients with resistant hypertension is obstructive sleep apnea. The pathophysiology of sleep apnea-associated hypertension is characterized by sustained adrenergic activation and volume retention often posing treatment challenges in patients with resistant hypertension. This review will address some of the epidemiologic data associating apnea with the pathogenesis of resistant hypertension. Diagnosis and management of apnea and its associated hypertension will also be considered.

  17. Muscle Synergy-Driven Robust Motion Control.

    Science.gov (United States)

    Min, Kyuengbo; Iwamoto, Masami; Kakei, Shinji; Kimpara, Hideyuki

    2018-04-01

    Humans are able to robustly maintain desired motion and posture under dynamically changing circumstances, including novel conditions. To accomplish this, the brain needs to optimize the synergistic control between muscles against external dynamic factors. However, previous related studies have usually simplified the control of multiple muscles using two opposing muscles, which are minimum actuators to simulate linear feedback control. As a result, they have been unable to analyze how muscle synergy contributes to motion control robustness in a biological system. To address this issue, we considered a new muscle synergy concept used to optimize the synergy between muscle units against external dynamic conditions, including novel conditions. We propose that two main muscle control policies synergistically control muscle units to maintain the desired motion against external dynamic conditions. Our assumption is based on biological evidence regarding the control of multiple muscles via the corticospinal tract. One of the policies is the group control policy (GCP), which is used to control muscle group units classified based on functional similarities in joint control. This policy is used to effectively resist external dynamic circumstances, such as disturbances. The individual control policy (ICP) assists the GCP in precisely controlling motion by controlling individual muscle units. To validate this hypothesis, we simulated the reinforcement of the synergistic actions of the two control policies during the reinforcement learning of feedback motion control. Using this learning paradigm, the two control policies were synergistically combined to result in robust feedback control under novel transient and sustained disturbances that did not involve learning. Further, by comparing our data to experimental data generated by human subjects under the same conditions as those of the simulation, we showed that the proposed synergy concept may be used to analyze muscle synergy

  18. Resistance gene management: concepts and practice

    Science.gov (United States)

    Christopher C. Mundt

    2012-01-01

    There is now a very long history of genetics/breeding for disease resistance in annual crops. These efforts have resulted in conceptual advances and frustrations, as well as practical successes and failures. This talk will review this history and its relevance to the genetics of resistance in forest species. All plant breeders and pathologists are familiar with boom-...

  19. Patterns of Resistance in Managing Assessment Change

    Science.gov (United States)

    Deneen, Christopher; Boud, David

    2014-01-01

    Achieving change in assessment practices in higher education is difficult. One of the reasons for this is resistance among those responsible for teaching and assessing. This paper seeks to explore this resistance through an analysis of staff dialogue during a major attempt to change the assessment practices at one institution. An institution-wide…

  20. Management of treatment resistant schizophrenia | Jones | African ...

    African Journals Online (AJOL)

    This article selectively reviews the literature treatment resistance in schizophrenia, and emphasises the importance of an holistic approach to individual patients. Keywords: schizophrenia, treatment resistance, antipsychotics, augmentation, psychosocial treatments. South African Psychiatry Review Vol. 9(1) 2006: 17-23 ...

  1. Synergies between energy supply networks

    DEFF Research Database (Denmark)

    Wu, Jianzhnog; Yan, Jinyue; Desideri, Umberto

    2017-01-01

    Energy system integration uses a whole-system approach to optimize the synergies between energy supply networks to facilitate and coordinate the grid integration of distributed energy resources while enabling the synergies and conflicts between the local distribution networks and the national lev...... and integration of local renewables including solar energy wind geothermal waste heat and biomass is presented.......Energy system integration uses a whole-system approach to optimize the synergies between energy supply networks to facilitate and coordinate the grid integration of distributed energy resources while enabling the synergies and conflicts between the local distribution networks and the national level...... objectives to be understood and optimally coordinated. The latest research on the network coupling technologies analysis of synergies between energy supply networks and optimal use of synergies in network operation is discussed. A diagram on the possible interactions between different energy networks...

  2. Synergy management at knowledge locations

    NARCIS (Netherlands)

    van Winden, Willem; Carvalho, Luis; Miao, Julie Tian; Benneworth, Paul; Phelps, Nicholas A.

    The world has changed profoundly since the publication of the influential book Technopoles of the World. As policy-makers and practitioners attempt to harness science, technology and innovation to create dynamic and vibrant cities many wonder how relevant Manuel Castells and Peter Hall's messages

  3. Synergy between Ursolic and Oleanolic Acids from Vitellaria paradoxa Leaf Extract and β-Lactams against Methicillin-Resistant Staphylococcus aureus: In Vitro and In Vivo Activity and Underlying Mechanisms

    Directory of Open Access Journals (Sweden)

    Lucy Catteau

    2017-12-01

    Full Text Available Combining antibiotics with resistance reversing agents is a key strategy to overcome bacterial resistance. Upon screening antimicrobial activities of plants used in traditional medicine, we found that a leaf dichloromethane extract from the shea butter tree (Vitellaria paradoxa had antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA with further evidence of synergy when combined with β-lactams. Using HPLC-MS, we identified ursolic (UA and oleanolic acids (OA in leaves and twigs of this species, and quantified them by HPLC-UV as the major constituents in leaf extracts (21% and 6% respectively. Both pure triterpenic acids showed antimicrobial activity against reference and clinical strains of MRSA, with MICs ranging from 8–16 mg/L for UA to 32–128 mg/L for OA. They were highly synergistic with β-lactams (ampicillin and oxacillin at subMIC concentrations. Reversion of MRSA phenotype was attributed to their capacity to delocalize PBP2 from the septal division site, as observed by fluorescence microscopy, and to disturb thereby peptidoglycan synthesis. Moreover, both compounds also inhibited β-lactamases activity of living bacteria (as assessed by inhibition of nitrocefin hydrolysis, but not in bacterial lysates, suggesting an indirect mechanism for this inhibition. In a murine model of subcutaneous MRSA infection, local administration of UA was synergistic with nafcillin to reduce lesion size and inflammatory cytokine (IL-1β production. Thus, these data highlight the potential interest of triterpenic acids as resistance reversing agents in combination with β-lactams against MRSA.

  4. Uptake of resistant varieties and integrated management packages ...

    African Journals Online (AJOL)

    ACSS

    control measures to the BRR disease. All local varieties previously grown in the area were susceptible to the disease. Therefore, there was urgent need to avail. BRR resistant varieties and other management practices to the affected farming communities. Farmers in the area identified, resistant bean varieties, improved soil ...

  5. Does CircuLite Synergy assist device as partial ventricular support have a place in modern management of advanced heart failure?

    Science.gov (United States)

    Mohite, Prashant N; Sabashnikov, Anton; Simon, Andre Ruediger; Weymann, Alexander; Patil, Nikhil Prakash; Unsoeld, Bernhard; Bireta, Christian; Popov, Aron Frederik

    2015-01-01

    The discrepancy between the number of patients on the waiting list and available donor hearts has led to the successful development of left ventricular assist devices (LVAD) as a bridge to transplantation. The conventional LVADs are designed to provide full hemodynamic support for the end-stage failing heart. However, full-support LVAD implantation requires major surgery, sternotomy and cardiopulmonary bypass in majority of cases. The Synergy Micro-pump is the smallest implantable LVAD and provides partial flow support up to 3 l/min. It was shown that early intervention with this device can provide substantial benefits to patients with severe heart failure not yet sick enough for a full-support LVAD. Due the small dimensions it can be implanted without cardiopulmonary bypass or a sternotomy. The purpose of this article is to review the clinical use of the Synergy Micro-pump as partial hemodynamic support.

  6. Managing resistance and negotiating co-design

    DEFF Research Database (Denmark)

    Yndigegn, Signe Louise

    work. The aim was to design services for senior citizens with the focus on social interaction – and with technology as a way to support the interaction among communities of elderlies. The dissertation is a retrospective reflection of the author’s experience with taking part and being heavily involved...... as participant in this project. This is done through a series of selected “moments” from the project and beyond, which in various ways are significant for what is happening in the project – and how the project is enacted. The dissertation contains of two research aims. The first is concerned with resistance...... as part of co-design and citizen involvement with the aim to reflect upon something that is rarely described or discussed within co-design and participatory design. The question is here how resistance is performed in practice, especially in the meetings between citizens and the project, and how resistance...

  7. Herbicide-Resistant Crops: Utilities and Limitations for Herbicide-Resistant Weed Management

    OpenAIRE

    Green, Jerry M.; Owen, Micheal D. K.

    2010-01-01

    Since 1996, genetically modified herbicide-resistant (HR) crops, particularly glyphosate-resistant (GR) crops, have transformed the tactics that corn, soybean, and cotton growers use to manage weeds. The use of GR crops continues to grow, but weeds are adapting to the common practice of using only glyphosate to control weeds. Growers using only a single mode of action to manage weeds need to change to a more diverse array of herbicidal, mechanical, and cultural practices to maintain the effec...

  8. Hand Grasping Synergies As Biometrics

    Directory of Open Access Journals (Sweden)

    Ramana Vinjamuri

    2017-05-01

    Full Text Available Recently, the need for more secure identity verification systems has driven researchers to explore other sources of biometrics. This includes iris patterns, palm print, hand geometry, facial recognition, and movement patterns (hand motion, gait, and eye movements. Identity verification systems may benefit from the complexity of human movement that integrates multiple levels of control (neural, muscular, and kinematic. Using principal component analysis, we extracted spatiotemporal hand synergies (movement synergies from an object grasping dataset to explore their use as a potential biometric. These movement synergies are in the form of joint angular velocity profiles of 10 joints. We explored the effect of joint type, digit, number of objects, and grasp type. In its best configuration, movement synergies achieved an equal error rate of 8.19%. While movement synergies can be integrated into an identity verification system with motion capture ability, we also explored a camera-ready version of hand synergies—postural synergies. In this proof of concept system, postural synergies performed well, but only when specific postures were chosen. Based on these results, hand synergies show promise as a potential biometric that can be combined with other hand-based biometrics for improved security.

  9. Managing resistance with multiple pesticide tactics: theory, evidence, and recommendations.

    Science.gov (United States)

    Tabashnik, B E

    1989-10-01

    Sequences, mixtures, rotations, and mosaics are potential strategies for using more than one pesticide to manage pest populations and for slowing the evolution of pesticide resistance. Results from theoretical models suggest that, under certain conditions, mixtures might be especially effective for resistance management. The assumptions of such models, however, are probably not widely applicable. Potential disadvantages associated with mixtures that are usually not considered in modeling studies include disruption of biological control, promotion of resistance in secondary pests, and intense selection for cross-resistance. Results from limited experimental work suggest that pesticide combinations do not consistently suppress resistance development. More thorough evaluation of tactics that seek to optimize benefits of more than one insecticide will require rigorous experiments with the particular pest and pesticide combinations. Because of the difficulty in generalizing results across systems and the potential negative effects of multiple insecticide use, emphasis on minimizing insecticide use is recommended.

  10. Framing the issues of resistance management in soybean

    Science.gov (United States)

    The soybean insect-pest complex consists of both long-established and new invasive pests. Management of these pests has been achieved by various means, but often relies heavily on the application of insecticides and the development of insect-resistant soybean varieties. Pest management practitione...

  11. Evaluation of stem borer resistance management strategies for Bt ...

    African Journals Online (AJOL)

    GREGORY

    2011-06-01

    Jun 1, 2011 ... However, for successful management of a refugia strategy, strict stewardship is required from appropriate government or community institutions. Key words: Refugia, cost-benefit analysis, Bt-maize, insect pest resistance management. INTRODUCTION. Maize is the leading staple food in the world with two-.

  12. Management of treatment resistant schizophrenia | Jones | African ...

    African Journals Online (AJOL)

    Whilst gains have been made in recent years in the pharmacological treatment of schizophrenia, a number of patients still have residual symptoms and disabilities, or simply do not show response to antipsychotic medications. For such 'treatment resistant' patients, there is little by way of randomised controlled data to ...

  13. The antimicrobial resistance crisis: management through gene monitoring

    Science.gov (United States)

    2016-01-01

    Antimicrobial resistance (AMR) is an acknowledged crisis for humanity. Its genetic origins and dire potential outcomes are increasingly well understood. However, diagnostic techniques for monitoring the crisis are currently largely limited to enumerating the increasing incidence of resistant pathogens. Being the end-stage of the evolutionary process that produces antimicrobial resistant pathogens, these measurements, while diagnostic, are not prognostic, and so are not optimal in managing this crisis. A better test is required. Here, using insights from an understanding of evolutionary processes ruling the changing abundance of genes under selective pressure, we suggest a predictive framework for the AMR crisis. We then discuss the likely progression of resistance for both existing and prospective antimicrobial therapies. Finally, we suggest that by the environmental monitoring of resistance gene frequency, resistance may be detected and tracked presumptively, and how this tool may be used to guide decision-making in the local and global use of antimicrobials. PMID:27831476

  14. Resistance to medical educational change: management and communication.

    Science.gov (United States)

    Tsai, Tsuen-Chiuan

    2007-01-01

    Medical education in Taiwan is currently undergoing active renovation. Reform and changes always bring resistance from the levels of individuals, institution and even the society. As an educational leader, to be able to manage resistance is a key to successful reform. This review article provides management strategies and communication skills to solve the resistance problem. The best solution to the problem is "to prevent" resistance from happening through identifying those who may be reluctant to change, and the reasons behind the potential resistance. Some of the reasons for resistance are threatening of self-interest and a loss of face, excess uncertainty, conservatism, fear of personal-worth declination in the organization, and different assessment or perception. The management and communication strategies are suggested to adjust to fit reform process, i.e., recognizing the needs for change, planning process, implementation, and institutionalization innovation. Finally, it is only with respect, empathy, sincerity and support that the resistance to changes can be resolved and difficulties can be overcome.

  15. Herbicide-resistant weed management: focus on glyphosate.

    Science.gov (United States)

    Beckie, Hugh J

    2011-09-01

    This review focuses on proactive and reactive management of glyphosate-resistant (GR) weeds. Glyphosate resistance in weeds has evolved under recurrent glyphosate usage, with little or no diversity in weed management practices. The main herbicide strategy for proactively or reactively managing GR weeds is to supplement glyphosate with herbicides of alternative modes of action and with soil-residual activity. These herbicides can be applied in sequences or mixtures. Proactive or reactive GR weed management can be aided by crop cultivars with alternative single or stacked herbicide-resistance traits, which will become increasingly available to growers in the future. Many growers with GR weeds continue to use glyphosate because of its economical broad-spectrum weed control. Government farm policies, pesticide regulatory policies and industry actions should encourage growers to adopt a more proactive approach to GR weed management by providing the best information and training on management practices, information on the benefits of proactive management and voluntary incentives, as appropriate. Results from recent surveys in the United States indicate that such a change in grower attitudes may be occurring because of enhanced awareness of the benefits of proactive management and the relative cost of the reactive management of GR weeds. Copyright © 2011 Society of Chemical Industry.

  16. Dialogue as interpersonal synergy

    DEFF Research Database (Denmark)

    Fusaroli, Riccardo; Raczaszek-Leonardi, Joanna; Tylén, Kristian

    2014-01-01

    What is the proper unit of analysis in the psycholinguistics of dialogue? While classical approaches are largely based on models of individual linguistic processing, recent advances stress the social coordinative nature of dialogue. In the influential interactive alignment model, dialogue is thus...... dialogue based on the notion of interpersonal synergy. Crucial to this synergetic model is the emphasis on dialogue as an emergent, self-organizing, interpersonal system capable of functional coordination. A consequence of this model is that linguistic processes cannot be reduced to the workings...... of individual cognitive systems but must be approached also at the interpersonal level. From such a perspective follows a number of new predictions: beyond simple synchrony, dialogue affords complementary dynamics, constrained by contextual sensitivity and functional specificity. We substantiate our arguments...

  17. Geneva international synergies

    CERN Multimedia

    2010-01-01

    Geneva has a long history of hosting international organizations, which is part of the reason why CERN is here, and it makes the canton an ideal place to forge links between such organizations. Over recent weeks, CERN has signed agreements with the ITU, WIPO and the WMO. At first sight, there may not seem to be much common ground between CERN and, say, the World Meteorological Organization, but scratch the surface, and you’ll soon find a common thread. All of these organizations have a vocation to stimulate technological innovation, and together we’re stronger.   Let’s start with ITU, the International Telecommunications Union. There, the synergies are evident. When ITU organized the World Summit on the Information Society in 2003, CERN provided a significant side event examining the Role of Science in the Information Society. The current agreement builds on that, allowing our two organizations to work together on important societal issues such as the extension of b...

  18. Anticancer Synergy Between Polyphenols

    Directory of Open Access Journals (Sweden)

    Urszula Lewandowska

    2014-01-01

    Full Text Available Chemoprevention has recently gained a new dimension due to the possibility of studying the mechanisms of action of chemopreventive agents at the molecular level. Many compounds have been proved to inhibit early stages of carcinogenesis in experimental models. These compounds include both recognized drugs (such as tamoxifen and nonsteroidal anti-inflammatory drugs and natural constituents of edible and therapeutic plants, particularly polyphenols. Phenolics are characterized by high structural diversity and, consequently, a very broad spectrum of biological activities. They are increasingly looked upon as a valuable alternative or a support for synthetic drugs, as evidenced by a growing number of clinical trials regarding the use of phenolic compounds and polyphenol-rich extracts in chemoprevention and therapy. In the present work, we discuss the effectiveness of natural polyphenols as cancer preventive and therapeutic agents resulting from their synergy with synthetic or semisynthetic anticancer drugs as well as with other phenolic compounds of plant origin.

  19. A Weed Resistance Management Game: A Teaching Tool.

    Science.gov (United States)

    Frisvold, George B

    2018-04-15

    This article provides instructions and materials to moderate an interactive resistance management game. The game is designed to generate discussion about the challenges and possibilities of coordinating resistance management activities among groups of farmers. The game has been successfully applied in classroom settings, extension workshops, and at professional weed science meetings. Research has found farmers often perceive the success of their own resistance management may be thwarted if their neighbors are not adequately managing resistance as well. This can lead to negative "tragedy of the commons" outcomes. In past applications of the game exercise, participants have often responded in ways consistent with similar studies in experimental and behavioral economics. This includes dividing benefits evenly (even though this is not a requirement of the game) or treating one-time transactions as potentially repeated exchanges. Player behavior may also be greatly influenced by their attitudes toward monetary risks. The game allows participants to explore ways to overcome the tragedy of the commons and illustrates the roles of information sharing and economic incentives in finding solutions. It also allows participants to experiment with bottom-up voluntary approaches toward resistance management as an alternative to top-down regulatory approaches. This article is protected by copyright. All rights reserved.

  20. Management of multidrug resistant bacterial endemic.

    Science.gov (United States)

    Zahar, J-R; Lesprit, P

    2014-09-01

    The fight against multi-drug resistant Gram-negative bacilli (MDRGNB), especially extended-spectrum β-lactamase producing Enterobacteriaceae, is about to be lost in our country. The emergence of new resistance mechanisms to carbapenems in these Enterobacteriaceae exposes patients to a risk of treatment failure without any other therapeutic options. This dramatic situation is paradoxical because we are well aware of the 2 major factors responsible for this situation: 1) MDRO cross-transmission, associated with a low compliance to standard precautions, especially hand hygiene, and 2) overexposure of patients to antibiotics. The implementation of a "search and isolate" policy, which was justified to control the spread of some MDRO that remained rare in the country, was not associated with a better adherence to standard precautions. The antibiotic policy and the measures implemented to control antibiotic consumptions have rarely been enforced and have shown inconsistent results. Notably, no significant decrease of antibiotic consumption has been observed. There is no excuse for these poor results, because some authors evaluating the effectiveness of programs for the control of MDRO have reported their positive effects on antimicrobial resistance without any detrimental effects. It is now urgent to deal with the 2 major factors by establishing an educational and persuasive program with quantified and opposable objectives. Firstly, we have to improve the observance of hand hygiene above 70%. Secondly, we have to define and reach a target for the reduction of antibiotic consumption both in community and in hospital settings. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Synergy between molybdenum and nitrogen on the pitting corrosion and passive film resistance of austenitic stainless steels as a pH-dependent effect

    Energy Technology Data Exchange (ETDEWEB)

    Loable, Carole, E-mail: carole.loable@lepmi.grenoble-inp.fr [Univ. Grenoble Alpes, LEPMI, F-38000 Grenoble (France); CNRS, LEPMI, F-38000 Grenoble (France); Dep. Eng. Quimica, Instituto Superior Técnico-Universidade de Lisboa, Av. Rovisco Pais, 1049 001 Lisbon (Portugal); Viçosa, Isadora N., E-mail: inogueira@poli.ufrj.br [Univ. Grenoble Alpes, LEPMI, F-38000 Grenoble (France); CNRS, LEPMI, F-38000 Grenoble (France); Mesquita, Thiago J., E-mail: Thiago.mesquita@total.com [CRU Ugitech, Avenue Paul Girod, 73403 Ugine Cedex (France); Mantel, Marc, E-mail: Marc.Mantel@ugitech.com [CRU Ugitech, Avenue Paul Girod, 73403 Ugine Cedex (France); Université Grenoble Alpes, SIMAP, F-38000 Grenoble (France); CNRS, SIMAP, F-38000 Grenoble (France); Nogueira, Ricardo P., E-mail: rnogueira@pi.ac.ae [Univ. Grenoble Alpes, LEPMI, F-38000 Grenoble (France); CNRS, LEPMI, F-38000 Grenoble (France); Department of Chemical Engineering, The Petroleum Institute, P.O. Box 2533, Abu Dhabi (United Arab Emirates); Berthomé, Gregory, E-mail: gregory.berthome@simap.grenoble-inp.fr [Université Grenoble Alpes, SIMAP, F-38000 Grenoble (France); CNRS, SIMAP, F-38000 Grenoble (France); Chauveau, Eric, E-mail: eric.chauveau@ugitech.fr [Department of Chemical Engineering, The Petroleum Institute, P.O. Box 2533, Abu Dhabi (United Arab Emirates); Roche, Virginie, E-mail: virginie.roche@lepmi.grenoble-inp.fr [Univ. Grenoble Alpes, LEPMI, F-38000 Grenoble (France); CNRS, LEPMI, F-38000 Grenoble (France)

    2017-01-15

    This paper brings up some insights upon the pH dependence of the synergistic effect of Mo and N on the localized corrosion resistance of austenitic stainless steels. The objective of this work is to study the synergetic effect of Mo and N additions on corrosion and passive film properties of austenitic grades. A comparison between Mo containing (3 wt% Mo); Mo and N containing (3 wt% Mo and 0.1% N) and free Mo or free Mo and N grades of highly controlled laboratory heats was done considering their localized corrosion resistance and oxide film formation in different aggressive conditions, from neutral to alkaline pH. The passive layer was characterized by EIS and XPS analyses. The combined effect of Mo and N on the pitting potential was confirmed to be synergistic, and not just the addition of their individual effects. Moreover, this effect was found to be pH-dependent, being very positive in acid to neutral conditions whereas it was almost inexistent in high pH. - Highlights: • Laboratory austenitic stainless steels with Mo and/or N were tested. • Mo and N acted synergistically to improve pitting resistance. • Synergistic effect is pH-dependent. • N clearly enhanced the repassivation of austenitic SS in presence of Mo.

  2. Emerging fluconazole resistance: Implications for the management of cryptococcal meningitis.

    Science.gov (United States)

    Mpoza, Edward; Rhein, Joshua; Abassi, Mahsa

    2018-03-01

    We present the case of an HIV-seropositive individual with cryptococcal meningitis who was found to have a fluconazole resistant strain of Cryptococcus neoformans . The individual required multiple rounds of amphotericin and fluconazole 800-1200 mg after several episodes of clinical relapse. Cerebrospinal fluid sterilization was achieved and maintained with high doses of fluconazole. This case demonstrates the emerging dilemma of increasing rates of fluconazole resistance in Cryptococcus and the clinical difficulties in meningitis management.

  3. Emerging fluconazole resistance: Implications for the management of cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Edward Mpoza

    2018-03-01

    Full Text Available We present the case of an HIV-seropositive individual with cryptococcal meningitis who was found to have a fluconazole resistant strain of Cryptococcus neoformans. The individual required multiple rounds of amphotericin and fluconazole 800–1200 mg after several episodes of clinical relapse. Cerebrospinal fluid sterilization was achieved and maintained with high doses of fluconazole. This case demonstrates the emerging dilemma of increasing rates of fluconazole resistance in Cryptococcus and the clinical difficulties in meningitis management.

  4. Amphiphilic Cargo-Loaded Nanocarrier Enhances Antibiotic Uptake and Perturbs Efflux: Effective Synergy for Mitigation of Methicillin-Resistant Staphylococcus aureus.

    Science.gov (United States)

    Thiyagarajan, Durairaj; Das, Gopal; Ramesh, Aiyagari

    2017-07-20

    A pyridinium-amphiphile-loaded poly(lactic-co-glycolic acid) (PLGA) nanocarrier (C1-PNC) was developed as an adjuvant in order to break the resistance and restore the susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) cells to therapeutic antibiotics. Notably, against a clinical MRSA strain, C1-PNC was found to render 8- and 6-fold decreases in the minimum biofilm eradication concentration (MBEC 90 ) of gentamicin and ciprofloxacin, respectively. Mechanistic studies on MRSA planktonic cells revealed that in the case of gentamicin, C1-PNC promotes enhanced cellular uptake of the antibiotic, whereas the propensity of C1-PNC to inhibit efflux pump activity could be leveraged to enhance cellular accumulation of ciprofloxacin, leading to effective killing of MRSA cells. Interestingly, the combinatorial dosing regimen of C1-PNC and the antibiotics was nontoxic to cultured HEK293 cells. This nontoxic amphiphile-loaded nanomaterial holds considerable promise as an adjuvant for antibiotic-mediated alleviation of MRSA biofilms. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Herbicide-resistant crops: utilities and limitations for herbicide-resistant weed management.

    Science.gov (United States)

    Green, Jerry M; Owen, Micheal D K

    2011-06-08

    Since 1996, genetically modified herbicide-resistant (HR) crops, particularly glyphosate-resistant (GR) crops, have transformed the tactics that corn, soybean, and cotton growers use to manage weeds. The use of GR crops continues to grow, but weeds are adapting to the common practice of using only glyphosate to control weeds. Growers using only a single mode of action to manage weeds need to change to a more diverse array of herbicidal, mechanical, and cultural practices to maintain the effectiveness of glyphosate. Unfortunately, the introduction of GR crops and the high initial efficacy of glyphosate often lead to a decline in the use of other herbicide options and less investment by industry to discover new herbicide active ingredients. With some exceptions, most growers can still manage their weed problems with currently available selective and HR crop-enabled herbicides. However, current crop management systems are in jeopardy given the pace at which weed populations are evolving glyphosate resistance. New HR crop technologies will expand the utility of currently available herbicides and enable new interim solutions for growers to manage HR weeds, but will not replace the long-term need to diversify weed management tactics and discover herbicides with new modes of action. This paper reviews the strengths and weaknesses of anticipated weed management options and the best management practices that growers need to implement in HR crops to maximize the long-term benefits of current technologies and reduce weed shifts to difficult-to-control and HR weeds.

  6. Resistant starches for the management of metabolic diseases.

    Science.gov (United States)

    Bindels, Laure B; Walter, Jens; Ramer-Tait, Amanda E

    2015-11-01

    Recent clinical trials and animal studies indicate that resistant starches may be beneficial therapeutic tools for the management of metabolic diseases. The purpose of this review is to summarize these findings and discuss the established and proposed mechanisms by which resistant starches exert their benefits. We also examine open questions regarding how resistant starches improve metabolism and propose future research directions for the field. Data from both humans and animal models clearly support a role for resistant starches in improving a variety of metabolic features; however, discrepancies do exist regarding specific effects. Concomitant improvements in both insulin levels and body fat depots are often reported in rodents fed resistant starches, whereas resistant starch feeding in humans improves insulin sensitivity without having a major impact on fat mass. These differences could be explained by the coexistence of several mechanisms (both gut microbiota-dependent and gut microbiota-independent) underpinning the metabolic benefits of resistant starches. Together, the studies presented in this review offer new insights into the potential pathways by which resistant starches enhance metabolic health, including modulation of the gut microbiota, gut peptides, circulating inflammatory mediators, innate immune cells, and the bile acid cycle.

  7. Change Management Employees’ Resistance Towards Organizational Change

    OpenAIRE

    Liviu Tudor

    2014-01-01

    The paper presents the results of a study carried out using data from the AnticrisisManager platform, in order to identify the Romanian economy areas that offer the biggest opportunities for change. The model used in this study allows ranking the economic sectors on a scale from 1 (low variation/risk) to 10 (high variation/risk), each industry / sub-industry being correlated with a risk factor. Taking into consideration the high rate of failure for change projects, approx. 70% according to th...

  8. Towards a durable management of genetic resistances to Leptosphaeria maculans

    Directory of Open Access Journals (Sweden)

    Pinochet Xavier

    2003-05-01

    Full Text Available Blackeg is the major disease of winter oilseed rape in France. For an efficient control of the disease several tools could be combined, but mainly plant breeding has been used to increase winter oilseed rape resistance to blackleg. A useful step was reached in the nineties, using a specific resistance gene (Rlm1. After being widely used this resistance was broken down by an increase of the virulent sub-populations of the fungus. Such a situation worried the different actors and raised the question of the promotion of a durable management of genetic resistances to Leptosphaeria. After a synthetic presentation of the state of the art in the fields of genetics of resistance, of Leptosphaeria populations and on agronomic practices able to control the pathogen, the promotion of a durable management of resistances is discussed. This target needs to precise the strategy, to improve methodologies to characterise genotypes, to promote proper agronomic practices, to follow Leptosphaeria population behaviour and to motivate economic actors.

  9. Synergy between Competitive Intelligence (CI), Knowledge Management (KM) and Technological Foresight (TF) as a strategic model of prospecting--the use of biotechnology in the development of drugs against breast cancer.

    Science.gov (United States)

    Canongia, Claudia

    2007-01-01

    The aim of this paper is to demonstrate the synergy between Competitive Intelligence, Knowledge Management and Technological Foresight, and to emphasize the proposal of a strategic model of data prospecting as a mechanism to support decision-making in regard to three approaches for sustainable development and innovation: technological, social and economic. The use of biotechnology in the development of drugs against breast cancer is the case study. The article shows the results of data and text mining in specialized medical and patent databases, identifying the most frequently cited drugs, as well as the authors of research, and the inventors of new technology at the beginning of the 21st century. In addition, the study includes reference to Brazilian competence in breast cancer area, the international trends in drugs for treatment of this cancer, leading international institutions and Brazilian competencies. A framework is presented, which could serve as a guide and support for the decision-making process.

  10. Insecticide Resistance and Management Strategies in Urban Ecosystems

    Directory of Open Access Journals (Sweden)

    Fang Zhu

    2016-01-01

    Full Text Available The increased urbanization of a growing global population makes imperative the development of sustainable integrated pest management (IPM strategies for urban pest control. This emphasizes pests that are closely associated with the health and wellbeing of humans and domesticated animals. Concurrently there are regulatory requirements enforced to minimize inadvertent exposures to insecticides in the urban environment. Development of insecticide resistance management (IRM strategies in urban ecosystems involves understanding the status and mechanisms of insecticide resistance and reducing insecticide selection pressure by combining multiple chemical and non-chemical approaches. In this review, we will focus on the commonly used insecticides and molecular and physiological mechanisms underlying insecticide resistance in six major urban insect pests: house fly, German cockroach, mosquitoes, red flour beetle, bed bugs and head louse. We will also discuss several strategies that may prove promising for future urban IPM programs.

  11. Gene pyramiding as a Bt resistance management strategy: How ...

    African Journals Online (AJOL)

    Reports on the emergence of insect resistance to Bacillus thuringiensis delta endotoxins have raised doubts on the sustainability of Bt-toxin based pest management technologies. Corporate industry has responded to this challenge with innovations that include gene pyramiding among others. Pyramiding entails stacking ...

  12. Uptake of resistant varieties and integrated management packages ...

    African Journals Online (AJOL)

    ACSS

    Data were collected on BRR disease, resistant varieties and control management package adopted and factors including the adoption choice. Additional data were collected on the changes in bean yields, consumption, marketable surplus and household income as well as farmers' participation in the different promotional.

  13. Development of a resistance management strategy for ixodid ticks ...

    African Journals Online (AJOL)

    The strategy developed for managing resistance in ticks with the acaricidal products on the market was based on mode of action of the active ingredients. The strategy requires the rotaional use of the acaricidal products in ways that reduces the selection pressure of active ingredients of same chemistry on the target-site in ...

  14. HIV Drug-Resistant Patient Information Management, Analysis, and Interpretation.

    Science.gov (United States)

    Singh, Yashik; Mars, Maurice

    2012-06-07

    The science of information systems, management, and interpretation plays an important part in the continuity of care of patients. This is becoming more evident in the treatment of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS), the leading cause of death in sub-Saharan Africa. The high replication rates, selective pressure, and initial infection by resistant strains of HIV infer that drug resistance will inevitably become an important health care concern. This paper describes proposed research with the aim of developing a physician-administered, artificial intelligence-based decision support system tool to facilitate the management of patients on antiretroviral therapy. This tool will consist of (1) an artificial intelligence computer program that will determine HIV drug resistance information from genomic analysis; (2) a machine-learning algorithm that can predict future CD4 count information given a genomic sequence; and (3) the integration of these tools into an electronic medical record for storage and management. The aim of the project is to create an electronic tool that assists clinicians in managing and interpreting patient information in order to determine the optimal therapy for drug-resistant HIV patients.

  15. Management of treatment-resistant depression.

    Science.gov (United States)

    Keitner, Gabor I; Mansfield, Abigail K

    2012-03-01

    Given the limitations of evidence for treatment options that are consistently effective for TRD and the possibility that TRD is in fact a form of depression that has a low probability of resolving, how can clinicians help patients with TRD? Perhaps the most important conceptual shift that needs to take place before treatment can be helpful is to accept TRD as a chronic illness, an illness similar to many others, one that can be effectively managed but that is not, at our present level of knowledge, likely to be cured. An undue focus on remission or even a 50% diminution of symptoms sets unrealistic goals for both patients and therapists and may lead to overtreatment and demoralization. The focus should be less on eliminating depressive symptoms and more on making sense of and learning to function better in spite of them. It is important to acknowledge the difficult nature of the depressive illness, to remove blame from the patient and clinician for not achieving remission, to set realistic expectations, and to help promote better psychosocial functioning even in the face of persisting symptoms. The critical element when implementing such an approach is a judicious balance between maintaining hope for improvement without setting unrealistic expectations. It is important to reemphasize that following a disease management model with acceptance of the reality of a chronic illness is not nihilistic and does not mean the abandonment of hope for improvement. The first step in treating a patient with TRD is to perform a comprehensive assessment of the patient’s past and current treatment history to ensure that evidence-based treatment trials have in fact been undertaken, and if not, such treatment trials should be implemented. If the patient continues to have significant residual symptoms, it is important to determine the impact is of these symptoms on the patient’s quality of life and ability to function. It is also important to evaluate the factors that may be

  16. Novel AChE inhibitors for sustainable insecticide resistance management.

    Directory of Open Access Journals (Sweden)

    Haoues Alout

    Full Text Available Resistance to insecticides has become a critical issue in pest management and it is particularly chronic in the control of human disease vectors. The gravity of this situation is being exacerbated since there has not been a new insecticide class produced for over twenty years. Reasoned strategies have been developed to limit resistance spread but have proven difficult to implement in the field. Here we propose a new conceptual strategy based on inhibitors that preferentially target mosquitoes already resistant to a currently used insecticide. Application of such inhibitors in rotation with the insecticide against which resistance has been selected initially is expected to restore vector control efficacy and reduce the odds of neo-resistance. We validated this strategy by screening for inhibitors of the G119S mutated acetylcholinesterase-1 (AChE1, which mediates insensitivity to the widely used organophosphates (OP and carbamates (CX insecticides. PyrimidineTrione Furan-substituted (PTF compounds came out as best hits, acting biochemically as reversible and competitive inhibitors of mosquito AChE1 and preferentially inhibiting the mutated form, insensitive to OP and CX. PTF application in bioassays preferentially killed OP-resistant Culex pipiens and Anopheles gambiae larvae as a consequence of AChE1 inhibition. Modeling the evolution of frequencies of wild type and OP-insensitive AChE1 alleles in PTF-treated populations using the selectivity parameters estimated from bioassays predicts a rapid rise in the wild type allele frequency. This study identifies the first compound class that preferentially targets OP-resistant mosquitoes, thus restoring OP-susceptibility, which validates a new prospect of sustainable insecticide resistance management.

  17. Managing the risk of glyphosate resistance in Australian glyphosate- resistant cotton production systems.

    Science.gov (United States)

    Werth, Jeff A; Preston, Christopher; Taylor, Ian N; Charles, Graham W; Roberts, Grant N; Baker, Jeanine

    2008-04-01

    Glyphosate-resistant cotton varieties are an important tool for weed control in Australian cotton production systems. To increase the sustainability of this technology and to minimise the likelihood of resistance evolving through its use, weed scientists, together with herbicide regulators, industry representatives and the technology owners, have developed a framework that guides the use of the technology. Central to this framework is a crop management plan (CMP) and grower accreditation course. A simulation model that takes into account the characteristics of the weed species, initial gene frequencies and any associated fitness penalties was developed to ensure that the CMP was sufficiently robust to minimise resistance risks. The simulations showed that, when a combination of weed control options was employed in addition to glyphosate, resistance did not evolve over the 30 year period of the simulation. These simulations underline the importance of maintaining an integrated system for weed management to prevent the evolution of glyphosate resistance, prolonging the use of glyphosate-resistant cotton. Copyright (c) 2007 Society of Chemical Industry.

  18. Physics and chemistry synergies, the roots of recycling and treatment of wastes, basis of sustainable development; Les synergies physico-chimiques, racines de la gestion des dechets

    Energy Technology Data Exchange (ETDEWEB)

    Pichat, Ph. [Cour de Cassation, Expert National, 75 - Paris (France); Nogrette, J.F. [Sotrenor, 62 - Courrieres (France)

    2005-09-01

    The processes of treatment and recycling of toxic wastes together with the stabilization/solidification technologies of ultimate wastes remind us that the synergies between physics and chemistry are the roots of the management of toxic and hazardous wastes. (authors)

  19. Postural Synergies and Their Development

    Directory of Open Access Journals (Sweden)

    Mark L. Latash

    2005-01-01

    Full Text Available The recent developments of a particular approach to analyzing motor synergies based on the principle of motor abundance has allowed a quantitative assessment of multieffector coordination in motor tasks involving anticipatory adjustments to self-triggered postural perturbations and in voluntary posturalsway. This approach, the uncontrolled manifold (UCM hypothesis, is based on an assumption that the central nervous system organizes covariation of elemental variables to stabilize important performance variables in a task-specific manner. In particular, this approach has been used to demonstrate and to assess the emergence of synergies and their modification with motor practice in typical persons and persons with Down syndrome. The framework of the UCM hypothesis allows the formulation of testable hypotheses with respect to developing postural synergies in typically and atypically developing persons.

  20. Cry1F resistance among lepidopteran pests: a model for improved resistance management?

    Science.gov (United States)

    Vélez, Ana M; Vellichirammal, Neetha Nanoth; Jurat-Fuentes, Juan Luis; Siegfried, Blair D

    2016-06-01

    The Cry1Fa protein from the bacterium Bacillus thuringiensis (Bt) is known for its potential to control lepidopteran pests, especially through transgenic expression in maize and cotton. The maize event TC1507 expressing the cry1Fa toxin gene became commercially available in the United States in 2003 for the management of key lepidopteran pests including the European corn borer, Ostrinia nubilalis, and the fall armyworm, Spodoptera frugiperda. A high-dose/refuge strategy has been widely adopted to delay evolution of resistance to event TC1507 and other transgenic Bt crops. Efficacy of this strategy depends on the crops expressing a high dose of the Bt toxin to targeted pests and adjacent refuges of non-Bt host plants serving as a source of abundant susceptible insects. While this strategy has proved effective in delaying O. nubilalis resistance, field-evolved resistance to event TC1507 has been reported in S. frugiperda populations in Puerto Rico, Brazil, and the southeastern United States. This paper examines available information on resistance to Cry1Fa in O. nubilalis and S. frugiperda and discusses how this information identifies opportunities to refine resistance management recommendations for Bt maize. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Empirical Evaluation of Voluntarily Activatable Muscle Synergies

    Directory of Open Access Journals (Sweden)

    Shunta Togo

    2017-09-01

    Full Text Available The muscle synergy hypothesis assumes that individual muscle synergies are independent of each other and voluntarily controllable. However, this assumption has not been empirically tested. This study tested if human subjects can voluntarily activate individual muscle synergies extracted by non-negative matrix factorization (NMF, the standard mathematical method for synergy extraction. We defined the activation of a single muscle synergy as the generation of a muscle activity pattern vector parallel to the single muscle synergy vector. Subjects performed an isometric force production task with their right hand, and the 13 muscle activity patterns associated with their elbow and shoulder movements were measured. We extracted muscle synergies during the task using electromyogram (EMG data and the NMF method with varied numbers of muscle synergies. The number (N of muscle synergies was determined by using the variability accounted for (VAF, NVAF and the coefficient of determination (CD, NCD. An additional muscle synergy model with NAD was also considered. We defined a conventional muscle synergy as the muscle synergy extracted by the NVAF, NCD, and NAD. We also defined an extended muscle synergy as the muscle synergy extracted by the NEX> NAD. To examine whether the individual muscle synergy was voluntarily activatable or not, we calculated the index of independent activation, which reflects similarities between a selected single muscle synergy and the current muscle activation pattern of the subject. Subjects were visually feed-backed the index of independent activation, then instructed to generate muscle activity patterns similar to the conventional and extended muscle synergies. As a result, an average of 90.8% of the muscle synergy extracted by the NVAF was independently activated. However, the proportion of activatable muscle synergies extracted by NCD and NAD was lower. These results partly support the assumption of the muscle synergy

  2. Synergy disclosures in mergers and acquisitions

    NARCIS (Netherlands)

    M.D.R.P. Dutordoir (Marie); P.G.J. Roosenboom (Peter); M. Teixeira de Vasconcelos (Manuel)

    2013-01-01

    textabstractWe examine bidding firms’ motives for disclosing a synergy forecast when announcing a merger or acquisition. Our sample consists of 1,990 M&A deals, of which 345 announce synergy estimates. Our results suggest that synergy disclosures serve to obtain a more favorable market reception for

  3. Lethal synergy involving bicyclomycin: an approach for reviving old antibiotics.

    Science.gov (United States)

    Malik, Muhammad; Li, Liping; Zhao, Xilin; Kerns, Robert J; Berger, James M; Drlica, Karl

    2014-12-01

    One way to address the growing problem of antimicrobial resistance is to revive old compounds that may have intrinsic lethal activity that is obscured by protective factors. Bicyclomycin is an old inhibitor of the Rho transcription terminator that by itself shows little rapid lethal activity. However, bicyclomycin participates in bacteriostatic synergy, which raises the possibility that conditions for lethal synergy may exist, perhaps through a suppression of protective factors. Bicyclomycin was combined with bacteriostatic inhibitors of gene expression, and bactericidal activity was measured with several cultured Gram-negative pathogens. When used alone, bicyclomycin failed to rapidly kill growing cultures of Escherichia coli; however, the additional presence of bacteriostatic concentrations of tetracycline, chloramphenicol or rifampicin led to rapid killing. Four other pathogen species, Acinetobacter baumannii, Klebsiella pneumoniae, Salmonella enterica serotype Typhimurium and Shigella dysenteriae, also exhibited enhanced killing when bicyclomycin was combined with tetracycline or rifampicin. This lethal synergy was achieved at low concentrations (slightly above the MIC) for all agents tested in combinations. Follow-up work with E. coli indicated that lethal synergy arose from a blockage of transcription elongation. Moreover, lethal synergy was reduced when bicyclomycin was added 60 min before tetracycline, suggesting that bicyclomycin induces a protective factor. The action of bicyclomycin illustrates the potential present in a largely abandoned antibacterial agent; it exhibits lethal synergy when coadministered with known, bacteriostatic inhibitors of gene expression. The identification of protective factors, which are currently uncharacterized, may reveal new ways to promote the lethal action of some old antibiotics. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved

  4. Entrepreneurial Creativity through Motivational Synergy.

    Science.gov (United States)

    Amabile, Teresa M.

    1997-01-01

    Defines and describes entrepreneurial creativity, which is the generation and implementation of novel, appropriate ideas to establish a new venture. Discusses the need for motivational synergy, which results when strong levels of personal interest and involvement are combined with the promise of rewards that confirm competence. (Author/CR)

  5. RhoB mediates antitumor synergy of combined ixabepilone and sunitinib in human ovarian serous cancer.

    Science.gov (United States)

    Vishnu, Prakash; Colon-Otero, Gerardo; Kennedy, Gregory T; Marlow, Laura A; Kennedy, William P; Wu, Kevin J; Santoso, Joseph T; Copland, John A

    2012-03-01

    The aim was to evaluate antitumor activity of the combination of ixabepilone and sunitinib in pre-clinical models of chemotherapy naïve and refractory epithelial ovarian tumors, and to investigate the mechanism of synergy of such drug combination. HOVTAX2 cell line was derived from a metastatic serous papillary epithelial ovarian tumor (EOC) and a paclitaxel-resistant derivative was established. Dose response curves for ixabepilone and sunitinib were generated and synergy was determined using combination indexes. The molecular mechanism of antitumor synergy was examined using shRNA silencing. The combination of ixabepilone and sunitinib demonstrated robust antitumor synergy in naïve and paclitaxel-resistant HOVTAX2 cell lines due to increased apoptosis. The GTPase, RhoB, was synergistically upregulated in cells treated with ixabepilone and sunitinib. Using shRNA, RhoB was demonstrated to mediate antitumor synergy. These results were validated in two other EOC cell lines. Ixabepilone plus sunitinib demonstrated antitumor synergy via RhoB in naïve and paclitaxel-resistant cells resulting in apoptosis. This study demonstrates a novel mechanism of action leading to antitumor synergy and provides 'proof-of-principle' for combining molecular targeted agents with cytotoxic chemotherapy to improve antitumor efficacy. RhoB could be envisioned as an early biomarker of response to therapy in a planned Phase II clinical trial to assess the efficacy of ixabepilone combined with a receptor tyrosine kinase inhibitor such as sunitinib. To the best of our knowledge, this is the first demonstration of antitumor synergy between these two classes of drugs in EOC and the pivotal role of RhoB in this synergy. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Blended Refuge and Insect Resistance Management for Insecticidal Corn

    Science.gov (United States)

    Crespo, Andre L B; Pan, Zaiqi; Crain, Philip R; Thompson, Stephen D; Pilcher, Clinton D; Sethi, Amit

    2018-01-01

    Abstract In this review, we evaluate the intentional mixing or blending of insecticidal seed with refuge seed for managing resistance by insects to insecticidal corn (Zea mays). We first describe the pest biology and farming practices that will contribute to weighing trade-offs between using block refuges and blended refuges. Case studies are presented to demonstrate how the trade-offs will differ in different systems. We compare biological aspects of several abstract models to guide the reader through the history of modeling, which has played a key role in the promotion or denigration of blending in various scientific debates about insect resistance management for insecticidal crops. We conclude that the use of blended refuge should be considered on a case-by-case basis after evaluation of insect biology, environment, and farmer behavior. For Diabrotica virgifera virgifera, Ostrinia nubilalis, and Helicoverpa zea in the United States, blended refuge provides similar, if not longer, delays in the evolution of resistance compared to separate block refuges. PMID:29220481

  7. Blended Refuge and Insect Resistance Management for Insecticidal Corn.

    Science.gov (United States)

    Onstad, David W; Crespo, Andre L B; Pan, Zaiqi; Crain, Philip R; Thompson, Stephen D; Pilcher, Clinton D; Sethi, Amit

    2018-02-08

    In this review, we evaluate the intentional mixing or blending of insecticidal seed with refuge seed for managing resistance by insects to insecticidal corn (Zea mays). We first describe the pest biology and farming practices that will contribute to weighing trade-offs between using block refuges and blended refuges. Case studies are presented to demonstrate how the trade-offs will differ in different systems. We compare biological aspects of several abstract models to guide the reader through the history of modeling, which has played a key role in the promotion or denigration of blending in various scientific debates about insect resistance management for insecticidal crops. We conclude that the use of blended refuge should be considered on a case-by-case basis after evaluation of insect biology, environment, and farmer behavior. For Diabrotica virgifera virgifera, Ostrinia nubilalis, and Helicoverpa zea in the United States, blended refuge provides similar, if not longer, delays in the evolution of resistance compared to separate block refuges. © The Author(s) 2017. Published by Oxford University Press on behalf of Entomological Society of America.

  8. By Product Synergy Analysis

    Science.gov (United States)

    2011-03-24

    14 Figure 3. PDCA Cycle...management point of view these activities are considered as the Deming Cycle, Deming Wheel or PDCA Cycle – Plan, Do, Check and Act (Figure 3). These...four phases represent an easy way to implement continuous improvement activities. Figure 3. PDCA Cycle (Heizer and Render, 2006

  9. An approach to diagnosis and management of resistant hypertension

    Directory of Open Access Journals (Sweden)

    Hitesh C Patel

    2015-01-01

    Full Text Available Hypertension is a key determinant of cardiovascular disease morbidity and mortality, directly accounting for approximately 10% of deaths in India. There is a causal association between the magnitude of blood pressure (BP elevation and adverse cardiovascular event rate, which provides the rationale for implementing BP reduction in routine clinical practice. However, an estimated 30-50% of the hypertensive population remain uncontrolled with a BP >140/90 mmHg, of whom a subgroup fulfill the diagnostic criteria for resistant hypertension. This cohort lies at the extreme end of the cardiovascular risk spectrum, and hence stands to benefit most from specialist input to optimize BP control. This review summarizes a management approach in patients with resistant hypertension, focusing on accurate diagnosis and evidence-based treatments.

  10. Sustainability of insect resistance management strategies for transgenic Bt corn.

    Science.gov (United States)

    Glaser, John A; Matten, Sharlene R

    2003-12-01

    Increasing interest in the responsible management of technology in the industrial and agricultural sectors of the economy has been met thorough the development of broadly applicable tools to assess the "sustainability" of new technologies. An arena ripe for application of such analysis is the deployment of transgenic crops. The new transgenic pesticidal or plant-incorporated protectant (PIP) crops have seen widespread application in the United States based on the features of higher yield, lower applications of insecticides, and control of mycotoxin content. However, open rejection of these new crops in Europe and in other countries has been a surprising message and has limited their worldwide acceptance. The US Environmental Protection Agency's (USEPA) Office of Pesticide Programs (OPP) has worked on the development and analysis of insect resistance management (IRM) strategies and has mandated specific IRM requirements for Bacillus thuringiensis (Bt) crops since 1995 under the Food, Fungicide, Insecticide, and Rodenticide Act. Improvement of data quality and sustainability of IRM strategies have been targeted in an ongoing partnership between the USEPA Office of Research and Development and the Office of Pesticide Programs that will further enhance the agency's ability to develop sustainable insect resistance management strategies for transgenic field corn (Bt corn) producing B. thuringiensis (Bt) insecticidal proteins.

  11. Hemiplegic limb synergies in stroke patients.

    Science.gov (United States)

    Welmer, Anna-Karin; Holmqvist, Lotta Widén; Sommerfeld, Disa K

    2006-02-01

    To describe the extent to which the voluntary movements of hemiparetic stroke patients are restricted to the hemiplegic limb synergies (which are marked by the inability to master individual joint movements) described by Brunnström. The study also aimed to describe the extent to which the synergies are related to functioning. In a prospective observational study design, 64 consecutive hemiparetic stroke patients were assessed with Brunnström's hemiplegic limb synergies, the modified Ashworth scale for spasticity, the Rivermead mobility index, and the Barthel ADL index. Three months after stroke, 8 of the 64 patients were moving completely or partly within the synergies. All patients whose movements were restricted to the synergies also exhibited spasticity. Hemiparetic patients whose movements were restricted to the synergies had significantly worse functioning scores than hemiparetic patients whose movements were not restricted to the synergies although severe disabilities were seen in both groups. Three months after stroke, the voluntary movements of only 13% of hemiparetic stroke patients were restricted to the synergies. The synergies were associated with spasticity and activity limitations. The use of the synergies might only be suitable for a small fraction of hemiparetic patients-namely, those displaying spasticity.

  12. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment

    Science.gov (United States)

    Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resist...

  13. Western flower thrips resistance to insecticides: detection, mechanisms, and management strategies

    Science.gov (United States)

    Insecticide resistance continues to be one of the most important issues facing agricultural production. The challenges in insecticide resistance and its management are exemplified by the situation with the western flower thrips Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae). This ...

  14. Synergy between the Multiple Supply Chain and Green Supply Chain Management (GSCM) approaches: an initial analysis aimed at fostering supply chain sustainability

    OpenAIRE

    Ana Lima de Carvalho; Livia Rodrigues Ignácio; Kleber Francisco Esposto; Aldo Roberto Ometto

    2016-01-01

    The concept of Green Supply Chain Management (GSCM) was created in the 90s to reduce the environmental impacts of productive systems. This approach seeks to improve the environmental performance of all the participants in a supply chain, from the extraction of raw materials to the use and final disposal of the product, through relationships of collaboration or conformity between the parties. The multiple supply chains approach established by Gattorna (2009) brought to light different supply c...

  15. Coupled Hydro-Mechanical Simulations of CO2 Storage Supported by Pressure Management Demonstrate Synergy Benefits from Simultaneous Formation Fluid Extraction

    Directory of Open Access Journals (Sweden)

    Kempka Thomas

    2015-04-01

    Full Text Available We assessed the synergetic benefits of simultaneous formation fluid extraction during CO2 injection for reservoir pressure management by coupled hydro-mechanical simulations at the prospective Vedsted storage site located in northern Denmark. Effectiveness of reservoir pressure management was investigated by simulation of CO2 storage without any fluid extraction as well as with 66% and 100% equivalent volume formation fluid extraction from four wells positioned for geothermal heat recovery. Simulation results demonstrate that a total pressure reduction of up to about 1.1 MPa can be achieved at the injection well. Furthermore, the areal pressure perturbation in the storage reservoir can be significantly decreased compared to the simulation scenario without any formation fluid extraction. Following a stress regime analysis, two stress regimes were considered in the coupled hydro-mechanical simulations indicating that the maximum ground surface uplift is about 0.24 m in the absence of any reservoir pressure management. However, a ground uplift mitigation of up to 37.3% (from 0.24 m to 0.15 m can be achieved at the injection well by 100% equivalent volume formation fluid extraction. Well-based adaptation of fluid extraction rates can support achieving zero displacements at the proposed formation fluid extraction wells located close to urban infrastructure. Since shear and tensile failure do not occur under both stress regimes for all investigated scenarios, it is concluded that a safe operation of CO2 injection with simultaneous formation fluid extraction for geothermal heat recovery can be implemented at the Vedsted site.

  16. Infrastructures for healthcare: From synergy to reverse synergy.

    Science.gov (United States)

    Langhoff, Tue Odd; Amstrup, Mikkel Hvid; Mørck, Peter; Bjørn, Pernille

    2018-03-01

    The Danish General Practitioners Database has over more than a decade developed into a large-scale successful information infrastructure supporting medical research in Denmark. Danish general practitioners produce the data, by coding all patient consultations according to a certain set of classifications, on the entire Danish population. However, in the Autumn of 2014, the system was temporarily shut down due to a lawsuit filed by two general practitioners. In this article, we ask why and identify a political struggle concerning authority, control, and autonomy related to a transformation of the fundamental ontology of the information infrastructure. We explore how the transformed ontology created cracks in the inertia of the information infrastructure damaging the long-term sustainability. We propose the concept of reverse synergy as the awareness of negative impacts occurring when uncritically adding new actors or purposes to a system without due consideration to the nature of the infrastructure. We argue that while long-term information infrastructures are dynamic by nature and constantly impacted by actors joining or leaving the project, each activity of adding new actors must take reverse synergy into account, if not to risk breaking down the fragile nature of otherwise successful information infrastructures supporting research on healthcare.

  17. Cultural synergy in information institutions

    CERN Document Server

    Smiraglia, Richard P

    2014-01-01

    Cultural forces govern a synergistic relationship among information institutions that shapes their roles collectively and individually. Cultural synergy is the combination of perception- and behavior-shaping knowledge within, between, and among groups. Our hyperlinked era makes information-sharing among institutions critically important for scholarship as well as for the advancement of humankind. Information institutions are those that have, or share in, the mission to preserve, conserve, and disseminate information objects and their informative content. A central idea is the notion of social

  18. Synergy for a Strong Future FY 2008

    International Nuclear Information System (INIS)

    Devore, L.; Chrzanowski, P.

    2008-01-01

    Lawrence Livermore National Security, LLC is committed to delivering the best combination of scientific research, technology development, business management, and safe, secure operations in support of Lawrence Livermore National Laboratory's critical national security mission. LLNS was formed specifically to manage LLNL for the Department of Energy's National Nuclear Security Administration. LLNS consists of a team of five organizations renowned for their expertise and accomplishments throughout the U.S. nuclear weapons complex and beyond - Bechtel National, University of California, Babcock and Wilcox, Washington Division of URS Corporation, and Battelle. Bechtel is the nation's largest engineering and construction firm and a leader in project management. The University of California is the world's largest public research institution. Babcock and Wilcox and the Washington Division of URS Corporation are top nuclear facilities contractors and between them manage four of DOE's five safest sites. Battelle is a global leader in science and technology development and commercialization. The LLNS Board of Governors provides oversight for the management of the Laboratory and holds the Director and LLNS President responsible for the Laboratory's performance. The Board has seven standing committees that assist in assessing Laboratory performance and monitoring risks and internal controls. Through the Board of Governors, the Laboratory can reach back to LLNS partner organizations to help ensure that it fulfills its national security mission with excellence in scientific research, technology development, business management, and safe, secure operations. LLNS assumed management of LLNL on October 1, 2007. This report highlights LLNS accomplishments in FY2008, its first year as the Laboratory's managing contractor. It is clear that LLNS and the Laboratory have exploited numerous synergies inherent in their relationship - for example, science and engineering, mission and

  19. Synergy for a Strong Future FY 2008

    Energy Technology Data Exchange (ETDEWEB)

    Devore, L; Chrzanowski, P

    2008-11-06

    Lawrence Livermore National Security, LLC is committed to delivering the best combination of scientific research, technology development, business management, and safe, secure operations in support of Lawrence Livermore National Laboratory's critical national security mission. LLNS was formed specifically to manage LLNL for the Department of Energy's National Nuclear Security Administration. LLNS consists of a team of five organizations renowned for their expertise and accomplishments throughout the U.S. nuclear weapons complex and beyond - Bechtel National, University of California, Babcock & Wilcox, Washington Division of URS Corporation, and Battelle. Bechtel is the nation's largest engineering and construction firm and a leader in project management. The University of California is the world's largest public research institution. Babcock & Wilcox and the Washington Division of URS Corporation are top nuclear facilities contractors and between them manage four of DOE's five safest sites. Battelle is a global leader in science and technology development and commercialization. The LLNS Board of Governors provides oversight for the management of the Laboratory and holds the Director and LLNS President responsible for the Laboratory's performance. The Board has seven standing committees that assist in assessing Laboratory performance and monitoring risks and internal controls. Through the Board of Governors, the Laboratory can reach back to LLNS partner organizations to help ensure that it fulfills its national security mission with excellence in scientific research, technology development, business management, and safe, secure operations. LLNS assumed management of LLNL on October 1, 2007. This report highlights LLNS accomplishments in FY2008, its first year as the Laboratory's managing contractor. It is clear that LLNS and the Laboratory have exploited numerous synergies inherent in their relationship - for example, science and

  20. Insecticide resistance management strategies against the western flower thrips, Frankliniella occidentalis.

    Science.gov (United States)

    Bielza, Pablo

    2008-11-01

    Western flower thrips (WFT), Frankliniella occidentalis (Pergande), is an economically important pest of a wide range of crops grown throughout the world. Insecticide resistance has been documented in many populations of WFT. Biological and behavioural characteristics and pest management practices that promote insecticide resistance are discussed. In addition, an overview is provided of the development of insecticide resistance in F. occidentalis populations and the resistance mechanisms involved. Owing to widespread resistance to most conventional insecticides, a new approach to insecticide resistance management (IRM) of F. occidentalis is needed. The IRM strategy proposed consists of two parts. Firstly, a general strategy to minimise the use of insecticides in order to reduce selection pressure. Secondly, a strategy designed to avoid selection of resistance mechanisms, considering cross-resistance patterns and resistance mechanisms. Copyright (c) 2008 Society of Chemical Industry.

  1. Synergy in RF Current Drive

    International Nuclear Information System (INIS)

    Dumont, R.J.; Giruzzi, G.

    2005-01-01

    Auxiliary methods for efficient non-inductive current drive in tokamaks generally involve the interaction of externally driven waves with superthermal electrons. Among the possible schemes, Lower Hybrid (LH) and Electron Cyclotron (EC) current drive have been so far the most successful. An interesting aspect of their combined use is the fact that since they involve possibly overlapping domains in velocity and configuration spaces, a synergy between them is expected for appropriate parameters. The signature of this effect, significant improvement of the EC current drive efficiency, results from a favorable interplay of the quasilinear diffusions induced by both waves. Recently, improvements of the EC current drive efficiency in the range of 2-4 have been measured in fully non-inductive discharges in the Tore Supra tokamak, providing the first clear evidence of this effect in steady-state conditions. We present here the experimental aspects of these discharges. The associated kinetic modeling and current state of understanding of the LH-EC synergy phenomenon are also discussed. (authors)

  2. Synergy in RF Current Drive

    International Nuclear Information System (INIS)

    Dumont, R.J.; Giruzzi, G.

    2005-01-01

    Auxiliary methods for efficient non-inductive current drive in tokamaks generally involve the interaction of externally driven waves with superthermal electrons. Among the possible schemes, Lower Hybrid (LH) and Electron Cyclotron (EC) current drive have been so far the most successful. An interesting aspect of their combined use is the fact that since they involve possibly overlapping domains in velocity and configuration spaces, a synergy between them is expected for appropriate parameters. The signature of this effect, significant improvement of the EC current drive efficiency, results from a favorable interplay of the quasilinear diffusions induced by both waves. Recently, improvements of the EC current drive efficiency in the range of 2-4 have been measured in fully non-inductive discharges in the Tore Supra tokamak, providing the first clear evidence of this effect in steady-state conditions. We present here the experimental aspects of these discharges. The associated kinetic modeling and current state of understanding of the LH-EC synergy phenomenon are also discussed

  3. Veterans Health Administration Office of Nursing Services exploration of positive patient care synergies fueled by consumer demand: care coordination, advanced clinic access, and patient self-management.

    Science.gov (United States)

    Wertenberger, Sydney; Yerardi, Ruth; Drake, Audrey C; Parlier, Renee

    2006-01-01

    The consumers who utilize the Veterans Health Administration healthcare system are older, and most are learning to live with chronic diseases. Their desires and needs have driven changes within the Veterans Health Administration. Through patient satisfaction initiatives and other feedback sources, consumers have made it clear that they do not want to wait for their care, they want a say in what care is provided to them, and they want to remain as independent as possible. Two interdisciplinary processes/models of healthcare are being implemented on the national level to address these issues: advanced clinic access and care coordination. These programs have a synergistic relationship and are integrated with patient self-management initiatives. Positive outcomes of these programs also meet the needs of our staff. As these new processes and programs are implemented nationwide, skills of both patients and nursing staff who provide their care need to be enhanced to meet the challenges of providing nursing care now and into the 21st century. Veterans Health Administration Office of Nursing Services Strategic Planning Work Group is defining and implementing processes/programs to ensure nurses have the knowledge, information, and skills to meet these patient care demands at all levels within the organization.

  4. Analysis of the Factors Affecting Resistance to Changes in Management Accounting Systems

    OpenAIRE

    Rodrigo Angonese; Carlos Eduardo Facin Lavarda

    2014-01-01

    Despite changes in the environment and management accounting practices, studies indicate that management accounting systems do not change or change at a much slower rate than expected. The stability of the management accounting systems used by companies may relate to resistance to changing these systems. This study analyzes the factors that contribute to resistance to implementing an integrated management system from the perspective of institutional theory, grounded in the old institutional e...

  5. Systematic synergy modeling: understanding drug synergy from a systems biology perspective.

    Science.gov (United States)

    Chen, Di; Liu, Xi; Yang, Yiping; Yang, Hongjun; Lu, Peng

    2015-09-16

    Owing to drug synergy effects, drug combinations have become a new trend in combating complex diseases like cancer, HIV and cardiovascular diseases. However, conventional synergy quantification methods often depend on experimental dose-response data which are quite resource-demanding. In addition, these methods are unable to interpret the explicit synergy mechanism. In this review, we give representative examples of how systems biology modeling offers strategies toward better understanding of drug synergy, including the protein-protein interaction (PPI) network-based methods, pathway dynamic simulations, synergy network motif recognitions, integrative drug feature calculations, and "omic"-supported analyses. Although partially successful in drug synergy exploration and interpretation, more efforts should be put on a holistic understanding of drug-disease interactions, considering integrative pharmacology and toxicology factors. With a comprehensive and deep insight into the mechanism of drug synergy, systems biology opens a novel avenue for rational design of effective drug combinations.

  6. Systematic review and meta-analysis of in vitro synergy of polymyxins and carbapenems.

    Science.gov (United States)

    Zusman, Oren; Avni, Tomer; Leibovici, Leonard; Adler, Amos; Friberg, Lena; Stergiopoulou, Theodouli; Carmeli, Yehuda; Paul, Mical

    2013-10-01

    Our objective was to examine the evidence of in vitro synergy of polymyxin-carbapenem combination therapy against Gram-negative bacteria (GNB). A systematic review and meta-analysis were performed. All studies examining in vitro interactions of antibiotic combinations consisting of any carbapenem with colistin or polymyxin B against any GNB were used. A broad search was conducted with no language, date, or publication status restrictions. Synergy rates, defined as a fractional inhibitory concentration index of ≤0.5 or a >2-log reduction in CFU, were pooled separately for time-kill, checkerboard, and Etest methods in a mixed-effect meta-analysis of rates. We examined whether the synergy rate depended on the testing method, type of antibiotic, bacteria, and resistance to carbapenems. Pooled rates with 95% confidence intervals (CI) are shown. Thirty-nine published studies and 15 conference proceeding were included, reporting on 246 different tests on 1,054 bacterial isolates. In time-kill studies, combination therapy showed synergy rates of 77% (95% CI, 64 to 87%) for Acinetobacter baumannii, 44% (95% CI, 30 to 59%) for Klebsiella pneumoniae, and 50% (95% CI, 30 to 69%) for Pseudomonas aeruginosa, with low antagonism rates for all. Doripenem showed high synergy rates for all three bacteria. For A. baumannii, meropenem was more synergistic than imipenem, whereas for P. aeruginosa the opposite was true. Checkerboard and Etest studies generally reported lower synergy rates than time-kill studies. The use of combination therapy led to less resistance development in vitro. The combination of a carbapenem with a polymyxin against GNB, especially A. baumannii, is supported in vitro by high synergy rates, with low antagonism and less resistance development. These findings should be examined in clinical studies.

  7. Systematic Review and Meta-Analysis of In Vitro Synergy of Polymyxins and Carbapenems

    Science.gov (United States)

    Avni, Tomer; Leibovici, Leonard; Adler, Amos; Friberg, Lena; Stergiopoulou, Theodouli; Carmeli, Yehuda; Paul, Mical

    2013-01-01

    Our objective was to examine the evidence of in vitro synergy of polymyxin-carbapenem combination therapy against Gram-negative bacteria (GNB). A systematic review and meta-analysis were performed. All studies examining in vitro interactions of antibiotic combinations consisting of any carbapenem with colistin or polymyxin B against any GNB were used. A broad search was conducted with no language, date, or publication status restrictions. Synergy rates, defined as a fractional inhibitory concentration index of ≤0.5 or a >2-log reduction in CFU, were pooled separately for time-kill, checkerboard, and Etest methods in a mixed-effect meta-analysis of rates. We examined whether the synergy rate depended on the testing method, type of antibiotic, bacteria, and resistance to carbapenems. Pooled rates with 95% confidence intervals (CI) are shown. Thirty-nine published studies and 15 conference proceeding were included, reporting on 246 different tests on 1,054 bacterial isolates. In time-kill studies, combination therapy showed synergy rates of 77% (95% CI, 64 to 87%) for Acinetobacter baumannii, 44% (95% CI, 30 to 59%) for Klebsiella pneumoniae, and 50% (95% CI, 30 to 69%) for Pseudomonas aeruginosa, with low antagonism rates for all. Doripenem showed high synergy rates for all three bacteria. For A. baumannii, meropenem was more synergistic than imipenem, whereas for P. aeruginosa the opposite was true. Checkerboard and Etest studies generally reported lower synergy rates than time-kill studies. The use of combination therapy led to less resistance development in vitro. The combination of a carbapenem with a polymyxin against GNB, especially A. baumannii, is supported in vitro by high synergy rates, with low antagonism and less resistance development. These findings should be examined in clinical studies. PMID:23917322

  8. Differences between kinematic synergies and muscle synergies during two-digit grasping

    Directory of Open Access Journals (Sweden)

    Michele eTagliabue

    2015-03-01

    Full Text Available The large number of mechanical degrees of freedom of the hand is not fully exploited during actual movements such as grasping. Usually, angular movements in various joints tend to be coupled, and EMG activities in different hand muscles tend to be correlated. The occurrence of covariation in the former was termed kinematic synergies, in the latter muscle synergies. This study addresses two questions: (i Whether kinematic and muscle synergies can simultaneously accommodate for kinematic and kinetic constraints. (ii If so, whether there is an interrelation between kinematic and muscle synergies. We used a reach-grasp-and-pull paradigm and recorded the hand kinematics as well as 8 surface EMGs. Subjects had to either perform a precision grip or side grip and had to modify their grip force in order to displace an object against a low or high load. The analysis was subdivided into three epochs: reach, grasp-and-pull, and static hold. Principal component analysis (PCA, temporal or static was performed separately for all three epochs, in the kinematic and in the EMG domain. PCA revealed that (i Kinematic- and muscle-synergies can simultaneously accommodate kinematic (grip type and kinetic task constraints (load condition. (ii Upcoming grip and load conditions of the grasp are represented in kinematic- and muscle-synergies already during reach. Phase plane plots of the principal muscle-synergy against the principal kinematic synergy revealed (iii that the muscle-synergy is linked (correlated, and in phase advance to the kinematic synergy during reach and during grasp-and-pull. Furthermore (iv, pair-wise correlations of EMGs during hold suggest that muscle-synergies are (in part implemented by coactivation of muscles through common input. Together, these results suggest that kinematic synergies have (at least in part their origin not just in muscular activation, but in synergiestic muscle activation. In short: kinematic synergies may result from muscle

  9. The antimicrobial resistance crisis: causes, consequences and management.

    Directory of Open Access Journals (Sweden)

    Carolyn Anne Michael

    2014-09-01

    Full Text Available The Antimicrobial Resistance (AMR crisis is the increasing global incidence of infectious diseases affecting the human population, which are untreatable with any known antimicrobial agent. This crisis will have a devastating cost on human society as both debilitating and lethal diseases increase in frequency and scope. Three major factors determine this crisis: 1/ The increasing frequency of AMR phenotypes amongst microbes is an evolutionary response to the widespread use of antimicrobials. 2/ The large and globally connected human population allows pathogens in any environment access to all of humanity. 3/ The extensive and often unnecessary use of antimicrobials by humanity provides the strong selective pressure that is driving the evolutionary response in the microbial world. Of these factors, the size of the human population is least amenable to rapid change. In contrast the remaining two factors may be affected, so offering a means of managing the crisis: The rate at which AMR, as well as virulence factors evolve in microbial world may be slowed by reducing the applied selective pressure. This may be accomplished by radically reducing the global use of current and prospective antimicrobials. Current management measures to legislate the use of antimicrobials and to educate the healthcare world in the issues, while useful, have not comprehensively addressed the problem of achieving an overall reduction in the human use of antimicrobials. We propose that in addition to current measures and increased research into new antimicrobials and diagnostics, a comprehensive education programme will be required to change the public paradigm of antimicrobial usage from that of a first line treatment to that of a last resort when all other therapeutic options have failed.

  10. The antimicrobial resistance crisis: causes, consequences, and management.

    Science.gov (United States)

    Michael, Carolyn Anne; Dominey-Howes, Dale; Labbate, Maurizio

    2014-01-01

    The antimicrobial resistance (AMR) crisis is the increasing global incidence of infectious diseases affecting the human population, which are untreatable with any known antimicrobial agent. This crisis will have a devastating cost on human society as both debilitating and lethal diseases increase in frequency and scope. Three major factors determine this crisis: (1) the increasing frequency of AMR phenotypes among microbes is an evolutionary response to the widespread use of antimicrobials; (2) the large and globally connected human population allows pathogens in any environment access to all of humanity; and (3) the extensive and often unnecessary use of antimicrobials by humanity provides the strong selective pressure that is driving the evolutionary response in the microbial world. Of these factors, the size of the human population is least amenable to rapid change. In contrast, the remaining two factors may be affected, so offering a means of managing the crisis: the rate at which AMR, as well as virulence factors evolve in microbial world may be slowed by reducing the applied selective pressure. This may be accomplished by radically reducing the global use of current and prospective antimicrobials. Current management measures to legislate the use of antimicrobials and to educate the healthcare world in the issues, while useful, have not comprehensively addressed the problem of achieving an overall reduction in the human use of antimicrobials. We propose that in addition to current measures and increased research into new antimicrobials and diagnostics, a comprehensive education program will be required to change the public paradigm of antimicrobial usage from that of a first line treatment to that of a last resort when all other therapeutic options have failed.

  11. Cultural Synergy and Organizational Change

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig; Vogt, Joachim

    2013-01-01

    This paper explores informal codes and rhythms of social behavior at work and their relation to organizational change and wellbeing. After a merger within a public service organization we organized 8 focus groups of 2-3 clerical or academic employees within a head office and a division office (N...... = 21). Word counts of ‘I’ and ‘we’ revealed that people sharing pre-merger organizational background (homogeneous groups) used ‘we’ more often than heterogeneous groups. Head office employees were concerned with workload and social code, whereas division office employees mainly discussed meetings......, commitment, and office space. Organizational background rather than office cultures guided these differences. We found that in a merged organization cultural synergies are possible to create if practical and social values for employees are offered. Thus, interesting new ways to transform problems...

  12. Studies and Application of the Platform for Synergies among Tobacco Enterprises in Tobacco Leaf Threshing and Redrying

    Science.gov (United States)

    Xu, Xiao-Shuang; Wang, Hong-Lv

    2018-03-01

    Departing from the formulas of cigarette products, synergized business framework is established on the basis of cross-enterprise synergies for tobacco leaf threshing and redrying through the introduction of batch management, remote quality data sharing and consistent processes, among others. Functions of the business framework are achieved and a platform for synergies is erected by applying IOT, cross-enterprise system integration and big data processing technologies, resulting in a new pattern for intensive interaction and synergies between China Tobacco Zhejiang (CTZ) and tobacco redrying plants for more delicate management of the redrying process, more interactive information flows and more stable tobacco strip quality.

  13. Managing Tensions And Forging Creative Synergies Between ...

    African Journals Online (AJOL)

    The article explores the apparent similarities in conceptions of space utilization, security and sustainability, deriving from the nature of dwelling and settlement design, how these articulated the existing modes of production of space, society and the economy – and therefore could be reproduced sustainably. The article also ...

  14. A values-based approach to exploring synergies between livestock farming and landscape conservation in Galicia (Spain)

    NARCIS (Netherlands)

    Swagemakers, Paul; Garcia, Maria Dolores Dominguez; Torres, Amanda Onofa; Oostindie, Henk; Groot, Jeroen C.J.

    2017-01-01

    The path to sustainable development involves creating coherence and synergies in the complex relationships between economic and ecological systems. In sustaining their farm businesses farmers' differing values influence their decisions about agroecosystem management, leading them to adopt diverging

  15. Management options for reducing the release of antibiotics and antibiotic resistance genes to the environment

    DEFF Research Database (Denmark)

    Pruden, Amy; Larsson, D.G. Joakim; Amézquita, Alejandro

    2013-01-01

    Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic resistance...... of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little...... associated with antibiotic resistance strongly indicate the need for action....

  16. Synergy cycles in the Norwegian innovation system: The relation between synergy and cycle values

    OpenAIRE

    Inga Ivanova; Oivind Strand; Loet Leydesdorff

    2014-01-01

    The knowledge base of an economy measured in terms of Triple Helix relations can be analyzed in terms of mutual information among geographical, sectorial, and size distributions of firms as dimensions of the probabilistic entropy. The resulting synergy values of a TH system provide static snapshots. In this study, we add the time dimension and analyze the synergy dynamics using the Norwegian innovation system as an example. The synergy among the three dimensions can be mapped as a set of part...

  17. Management of insecticide resistance in Oriental fruit moth (Grapholita molesta; Lepidoptera: Tortricidae) populations from Ontario.

    Science.gov (United States)

    Kanga, Lambert H B; Pree, David J; van Lier, Jennifer L; Walker, Gerald M

    2003-08-01

    The development of resistance in the Oriental fruit moth, Grapholita molesta (Busck) to organophosphorus (OP) insecticides (azinphos-methyl and phosmet) is a serious threat to the tender fruit industry in Ontario (50% crop losses in 1994). Resistance to carbamate insecticides and increased survival of field-collected moths at diagnostic concentrations of pyrethroids were widespread. As a result, four different treatment regimes were tested to manage resistance in G molesta, and the changes in resistance frequencies under each treatment regime were monitored from 1996 to 1999. The data indicated that the levels of resistance were significantly influenced by the various treatment regimes. The seasonal pattern of resistance was similar for all treatment regimes, in that resistance peaked in mid-season and declined in the late season. Levels of resistance in G molesta to OPs decreased from 55% to 14% and that to pyrethroids declined from 30% to 10% from 1996 to 1999 under a treatment regime consisting of endosulfan-organophosphate-pyrethroid rotation. Similarly, under a treatment regime implemented in commercial orchards (organophosphate-pyrethroid rotation), resistance to OP insecticides declined from 50% to 12% and resistance to pyrethroids evolved to around 16%. The overall data indicated that resistance was unstable; a strategy based on rotation of insecticides by class for each generation of G molesta was successful in managing resistance to both OP and pyrethroid insecticides. The rotational strategy has been widely adopted by growers and is applied to ca 85% of the acreage.

  18. Time-kill assay and Etest evaluation for synergy with polymyxin B and fluconazole against Candida glabrata.

    Science.gov (United States)

    Pankey, George; Ashcraft, Deborah; Kahn, Heather; Ismail, Abdulrahim

    2014-10-01

    Fluconazole-resistant Candida glabrata is an emerging pathogen that causes fungemia. Polymyxin B, a last-resort antibiotic used to treat multidrug-resistant Gram-negative bacterial infections, has been found to possess in vitro fungicidal activity and showed synergy with fluconazole against a single strain of C. glabrata. Since both agents may be used simultaneously in intensive care unit (ICU) patients, this study was performed to test for possible synergy of this combination against 35 C. glabrata blood isolates, using 2 methods: a time-kill assay and an experimental MIC-MIC Etest method. Thirty-five genetically unique C. glabrata bloodstream isolates were collected from 2009 to 2011, identified using an API 20C system, and genotyped by repetitive sequence-based PCR (rep-PCR). MICs were determined by Etest and broth microdilution methods. Synergy testing was performed using a modified bacterial Etest synergy method and time-kill assay, with final results read at 24 h. The Etest method showed synergy against 19/35 (54%) isolates; the time-kill assay showed synergy against 21/35 (60%) isolates. Isolates not showing drug synergy had an indifferent status. Concordance between methods was 60%. In vitro synergy of polymyxin B and fluconazole against the majority of C. glabrata isolates was demonstrated by both methods. The bacterial Etest synergy method adapted well when used with C. glabrata. Etest was easier to perform than time-kill assay and may be found to be an acceptable alternative to time-kill assay with antifungals. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  19. Multi drug resistant tuberculosis: a challenge in the management of ...

    African Journals Online (AJOL)

    kemrilib

    Multi drug resistant tuberculosis (MDR-TB) will not usually respond to short course chemotherapy. Unless the individual infected with this bug is treated appropriately, they can continue spreading resistant strains in the community and further fuel the tuberculosis epidemic. Diagnosis requires drug sensitivity testing and the ...

  20. Managing Resistance to Instructional Modifications in Mainstreamed Environments.

    Science.gov (United States)

    Margolis, Howard; McGettigan, James

    1988-01-01

    Classroom teachers serving handicapped students in the mainstream often need to make instructional modifications. This article discusses reasons for teacher resistance to instructional modifications and provides strategies that consultative staff can use to prevent or reduce resistance. Expectancy theory is used to provide a framework for…

  1. Herbicide-resistant weeds: Management strategies and upcoming technologies

    Science.gov (United States)

    Herbicides have contributed to substantial increase in crop yields over the past seven decades. Over reliance on herbicides for weed control has led to rapid evolution of herbicide-resistant (HR) weeds. Increased awareness of herbicide resistance and adoption of diversified weed control tactics by f...

  2. Environmental Innovation and Employment: Drivers and Synergies

    Directory of Open Access Journals (Sweden)

    Ángela Triguero

    2017-11-01

    Full Text Available Numerous empirical studies focus on the drivers of environmental innovation or their potential employment effects. Nevertheless, we have scarce knowledge about whether factors that influence eco-innovation and employment generation are related. The main purpose is to analyze the synergies between eco-innovation and employment using a sample of more than 6000 innovative Spanish manufacturing and service firms. Using different econometric procedures, the main findings show that size, R&D and export influence eco-innovation and employment in the same direction, while age, belonging to a group, public subsidies and internal and external knowledge sources exert a different effect. Thus, older firms create less employment but have a high probability of being environmental innovators compared with younger firms. Furthermore, the size of the company moderates the positive role of eco-innovation on employment growth, while young firms not belonging to a group (eco-entrepreneurs contribute more to employment growth than old firms belonging to a parent firm. Implications for scholars, managers and policy makers in terms of sustainable and economic growth are made.

  3. Sensory Synergy as Environmental Input Integration

    Directory of Open Access Journals (Sweden)

    Fady eAlnajjar

    2015-01-01

    Full Text Available The development of a method to feed proper environmental inputs back to the central nervous system (CNS remains one of the challenges in achieving natural movement when part of the body is replaced with an artificial device. Muscle synergies are widely accepted as a biologically plausible interpretation of the neural dynamics between the CNS and the muscular system. Yet the sensorineural dynamics of environmental feedback to the CNS has not been investigated in detail. In this study, we address this issue by exploring the concept of sensory synergy. In contrast to muscle synergy, we hypothesize that sensory synergy plays an essential role in integrating the overall environmental inputs to provide low-dimensional information to the CNS. We assume that sensor synergy and muscle synergy communicate using these low-dimensional signals. To examine our hypothesis, we conducted posture control experiments involving lateral disturbance with 9 healthy participants. Proprioceptive information represented by the changes on muscle lengths were estimated by using the musculoskeletal model analysis software SIMM. Changes on muscles lengths were then used to compute sensory synergies. The experimental results indicate that the environmental inputs were translated into the two dimensional signals and used to move the upper limb to the desired position immediately after the lateral disturbance. Participants who showed high skill in posture control were found to be likely to have a strong correlation between sensory and muscle signaling as well as high coordination between the utilized sensory synergies. These results suggest the importance of integrating environmental inputs into suitable low-dimensional signals before providing them to the CNS. This mechanism should be essential when designing the prosthesis’ sensory system to make the controller simpler

  4. Coevolution: A synergy in biology and ecology

    Directory of Open Access Journals (Sweden)

    WenJun Zhang

    2015-06-01

    Full Text Available Synergy refers to that in an open and complex system consisting of a large number of subsystems, far from equilibrium, its subsystems interact in a nonlinear way to produce synergistic effects and thus make the system generate a self-organization structure in space/time with certain functions. Biologists and ecologists, tend to use coevolution/coadaptation to represent the terminology "synergy". Coevolution and research methodology were briefly discussed in present paper.

  5. Sensory synergy as environmental input integration.

    Science.gov (United States)

    Alnajjar, Fady; Itkonen, Matti; Berenz, Vincent; Tournier, Maxime; Nagai, Chikara; Shimoda, Shingo

    2014-01-01

    The development of a method to feed proper environmental inputs back to the central nervous system (CNS) remains one of the challenges in achieving natural movement when part of the body is replaced with an artificial device. Muscle synergies are widely accepted as a biologically plausible interpretation of the neural dynamics between the CNS and the muscular system. Yet the sensorineural dynamics of environmental feedback to the CNS has not been investigated in detail. In this study, we address this issue by exploring the concept of sensory synergy. In contrast to muscle synergy, we hypothesize that sensory synergy plays an essential role in integrating the overall environmental inputs to provide low-dimensional information to the CNS. We assume that sensor synergy and muscle synergy communicate using these low-dimensional signals. To examine our hypothesis, we conducted posture control experiments involving lateral disturbance with nine healthy participants. Proprioceptive information represented by the changes on muscle lengths were estimated by using the musculoskeletal model analysis software SIMM. Changes on muscles lengths were then used to compute sensory synergies. The experimental results indicate that the environmental inputs were translated into the two dimensional signals and used to move the upper limb to the desired position immediately after the lateral disturbance. Participants who showed high skill in posture control were found to be likely to have a strong correlation between sensory and muscle signaling as well as high coordination between the utilized sensory synergies. These results suggest the importance of integrating environmental inputs into suitable low-dimensional signals before providing them to the CNS. This mechanism should be essential when designing the prosthesis' sensory system to make the controller simpler.

  6. Insights from agriculture for the management of insecticide resistance in disease vectors.

    Science.gov (United States)

    Sternberg, Eleanore D; Thomas, Matthew B

    2018-04-01

    Key to contemporary management of diseases such as malaria, dengue, and filariasis is control of the insect vectors responsible for transmission. Insecticide-based interventions have contributed to declines in disease burdens in many areas, but this progress could be threatened by the emergence of insecticide resistance in vector populations. Insecticide resistance is likewise a major concern in agriculture, where insect pests can cause substantial yield losses. Here, we explore overlaps between understanding and managing insecticide resistance in agriculture and in public health. We have used the Global Plan for Insecticide Resistance Management in malaria vectors, developed under the auspices of the World Health Organization Global Malaria Program, as a framework for this exploration because it serves as one of the few cohesive documents for managing a global insecticide resistance crisis. Generally, this comparison highlights some fundamental differences between insect control in agriculture and in public health. Moreover, we emphasize that the success of insecticide resistance management strategies is strongly dependent on the biological specifics of each system. We suggest that the biological, operational, and regulatory differences between agriculture and public health limit the wholesale transfer of knowledge and practices from one system to the other. Nonetheless, there are some valuable insights from agriculture that could assist in advancing the existing Global Plan for Insecticide Resistance Management framework.

  7. Southern African Treatment Resistance Network (SATuRN) RegaDB HIV drug resistance and clinical management database: supporting patient management, surveillance and research in southern Africa.

    Science.gov (United States)

    Manasa, Justen; Lessells, Richard; Rossouw, Theresa; Naidu, Kevindra; Van Vuuren, Cloete; Goedhals, Dominique; van Zyl, Gert; Bester, Armand; Skingsley, Andrew; Stott, Katharine; Danaviah, Siva; Chetty, Terusha; Singh, Lavanya; Moodley, Pravi; Iwuji, Collins; McGrath, Nuala; Seebregts, Christopher J; de Oliveira, Tulio

    2014-01-01

    Substantial amounts of data have been generated from patient management and academic exercises designed to better understand the human immunodeficiency virus (HIV) epidemic and design interventions to control it. A number of specialized databases have been designed to manage huge data sets from HIV cohort, vaccine, host genomic and drug resistance studies. Besides databases from cohort studies, most of the online databases contain limited curated data and are thus sequence repositories. HIV drug resistance has been shown to have a great potential to derail the progress made thus far through antiretroviral therapy. Thus, a lot of resources have been invested in generating drug resistance data for patient management and surveillance purposes. Unfortunately, most of the data currently available relate to subtype B even though >60% of the epidemic is caused by HIV-1 subtype C. A consortium of clinicians, scientists, public health experts and policy markers working in southern Africa came together and formed a network, the Southern African Treatment and Resistance Network (SATuRN), with the aim of increasing curated HIV-1 subtype C and tuberculosis drug resistance data. This article describes the HIV-1 data curation process using the SATuRN Rega database. The data curation is a manual and time-consuming process done by clinical, laboratory and data curation specialists. Access to the highly curated data sets is through applications that are reviewed by the SATuRN executive committee. Examples of research outputs from the analysis of the curated data include trends in the level of transmitted drug resistance in South Africa, analysis of the levels of acquired resistance among patients failing therapy and factors associated with the absence of genotypic evidence of drug resistance among patients failing therapy. All these studies have been important for informing first- and second-line therapy. This database is a free password-protected open source database available on

  8. Notification: Evaluation of Office of Pesticide Programs’ Genetically Engineered Corn Insect Resistance Management

    Science.gov (United States)

    Project #OPE-FY15-0055, July 09, 2015. The EPA OIG plans to begin preliminary research on the EPA's ability to manage and prevent increased insect resistance to genetically engineered Bacillus thuringiensis (Bt) corn.

  9. Notification: Evaluation of EPA's Management of Resistance Issues Related to Herbicide Tolerant Genetically Engineered Crops

    Science.gov (United States)

    Project #OPE-FY16-0023, March 25, 2016. The EPA OIG plans to begin preliminary research to assess the EPA's management and oversight of resistance issues related to herbicide tolerant genetically engineered crops.

  10. Harnessing Resistance: Using the Theory of Constraints To Assist Change Management.

    Science.gov (United States)

    Mabin, Victoria J.; Forgeson, Steve; Green, Lawrence

    2001-01-01

    Applies the Theory of Constraints, which views resistance to change as a necessary, positive force, to a case study of a bank merger. For each resistance factor, the theory provides tools for using it and managing change successfully. (Contains 46 references.) (SK)

  11. Challenges of drug resistance in the management of pancreatic cancer.

    LENUS (Irish Health Repository)

    Sheikh, Rizwan

    2012-02-01

    The current treatment of choice for metastatic pancreatic cancer involves single-agent gemcitabine or a combination of gemcitabine with capecitabine or erlotinib (a tyrosine kinase inhibitor). Only 25–30% of patients respond to this treatment and patients who do respond initially ultimately exhibit disease progression. Median survival for pancreatic cancer patients has reached a plateau due to inherent and acquired resistance to these agents. Key molecular factors implicated in this resistance include: deficiencies in drug uptake, alteration of drug targets, activation of DNA repair pathways, resistance to apoptosis and the contribution of the tumor microenvironment. Moreover, for newer agents including tyrosine kinase inhibitors, overexpression of signaling proteins, mutations in kinase domains, activation of alternative pathways, mutations of genes downstream of the target and\\/or amplification of the target represent key challenges for treatment efficacy. Here we will review the contribution of known mechanisms and markers of resistance to key pancreatic cancer drug treatments.

  12. Treatment-resistant panic disorder: clinical significance, concept and management.

    Science.gov (United States)

    Chen, Mu-Hong; Tsai, Shih-Jen

    2016-10-03

    Panic disorder is commonly prevalent in the population, but the treatment response for panic disorder in clinical practice is much less effective than that in our imagination. Increasing evidence suggested existence of a chronic or remitting-relapsing clinical course in panic disorder. In this systematic review, we re-examine the definition of treatment-resistant panic disorder, and present the potential risk factors related to the treatment resistance, including the characteristics of panic disorder, other psychiatric and physical comorbidities, and psychosocial stresses. Furthermore, we summarize the potential pathophysiologies, such as genetic susceptibility, altered brain functioning, brain-derived neurotrophic factor, and long-term inflammation, to explain the treatment resistance. Finally, we conclude the current therapeutic strategies for treating treatment-resistant panic disorder from pharmacological and non-pharmacological views. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Carbapenem-resistant Enterobacteriaceae: biology, epidemiology, and management.

    Science.gov (United States)

    Temkin, Elizabeth; Adler, Amos; Lerner, Anat; Carmeli, Yehuda

    2014-09-01

    Introduced in the 1980s, carbapenem antibiotics have served as the last line of defense against multidrug-resistant Gram-negative organisms. Over the last decade, carbapenem-resistant Enterobacteriaceae (CRE) have emerged as a significant public health threat. This review summarizes the molecular genetics, natural history, and epidemiology of CRE and discusses approaches to prevention and treatment. © 2014 New York Academy of Sciences.

  14. Recent advances in the management of resistant hypertension

    OpenAIRE

    Manolis, Athanasios J.; Kallistratos, Manolis S.; Doumas, Michalis; Pagoni, Stamatina; Poulimenos, Leonidas

    2015-01-01

    And suddenly, following the preliminary results of renal denervation and carotid baroreceptor stimulation, a big interest in resistant hypertension rose, and all interventionists, many of them with no previous experience with hypertension, fell in love with hypertension and especially resistant hypertension. In the European Society of Hypertension/International Society of Hypertension (ESH/ISH) 2014 Joint Hypertension meeting in Athens, there were no more than four to five sessions related to...

  15. The Power to Resist: Irrigation Management Transfer in Indonesia

    NARCIS (Netherlands)

    Suhardiman, D.

    2013-01-01

    In the last two decades, international donors have promoted Irrigation Management Transfer (IMT) as an international remedy to management problems in government irrigation systems in many developing countries. This article analyses the political processes that shape IMT policy formulation and

  16. SynergyFinder: a web application for analyzing drug combination dose-response matrix data.

    Science.gov (United States)

    Ianevski, Aleksandr; He, Liye; Aittokallio, Tero; Tang, Jing

    2017-08-01

    Rational design of drug combinations has become a promising strategy to tackle the drug sensitivity and resistance problem in cancer treatment. To systematically evaluate the pre-clinical significance of pairwise drug combinations, functional screening assays that probe combination effects in a dose-response matrix assay are commonly used. To facilitate the analysis of such drug combination experiments, we implemented a web application that uses key functions of R-package SynergyFinder, and provides not only the flexibility of using multiple synergy scoring models, but also a user-friendly interface for visualizing the drug combination landscapes in an interactive manner. The SynergyFinder web application is freely accessible at https://synergyfinder.fimm.fi ; The R-package and its source-code are freely available at http://bioconductor.org/packages/release/bioc/html/synergyfinder.html . jing.tang@helsinki.fi.

  17. Greenhouses and their humanizing synergies

    Science.gov (United States)

    Haeuplik-Meusburger, Sandra; Paterson, Carrie; Schubert, Daniel; Zabel, Paul

    2014-03-01

    Greenhouses in space will require advanced technical systems of automatic watering, soil-less cultivation, artificial lighting, and computerized observation of plants. Functions discussed for plants in space habitats include physical/health requirements and human psychology, social cohesion, as well as the complex sensorial benefits of plants for humans. The authors consider the role of plants in long-term space missions historically since 1971 (Salyut 1) and propose a set of priorities to be considered within the design requirements for greenhouses and constructed environments given a range of benefits associated with plant-human relationships. They cite recent research into the use of greenhouses in extreme environments to reveal the relative importance of greenhouses for people living in isolated locations. Additionally, they put forward hypotheses about where greenhouses might factor into several strata of human health. In a recent design-in-use study of astronauts' experiences in space habitats discussed in Architecture for Astronauts (Springer Press 2011) it was found that besides the basic advantages for life support there are clearly additional "side benefits" for habitability and physical wellbeing, and thus long-term mission success. The authors have composed several key theses regarding the need to promote plant-human relationships in space, including areas where synergy and symbiosis occur. They cite new comprehensive research into the early US Space Program to reveal where programmatic requirements could be added to space architecture to increase the less quantifiable benefits to astronauts of art, recreation, and poetic engagement with their existential condition of estrangement from the planet. Specifically in terms of the technological requirements, the authors propose the integration of a new greenhouse subsystem component into space greenhouses—the Mobile Plant Cultivation Subsystem—a portable, personal greenhouse that can be integrated

  18. Synergy between repellents and non-pyrethroid insecticides strongly extends the efficacy of treated nets against Anopheles gambiae

    Directory of Open Access Journals (Sweden)

    N'Guessan Raphaël

    2007-03-01

    Full Text Available Abstract Background To manage the kdr pyrethroid-resistance in Anopheline malaria vectors, new compounds or new strategies are urgently needed. Recently, mixing repellents (DEET and a non-pyrethroid insecticide (propoxur was shown to be as effective as deltamethrin, a standard pyrethroid, under laboratory conditions, because of a strong synergy between the two compounds. In the present study, the interactions between two repellents (DEET and KBR 3023 and a non-pyrethroid insecticide (pyrimiphos methyl or PM on netting were investigated. The residual efficacy and the inhibition of blood feeding conferred by these mixtures were assessed against Anopheles gambiae mosquitoes. Methods DEET and KBR 3023 were mixed with pyrimiphos methyl (PM, a organophosphate (OP insecticide. The performance of mono- and bi-impregnated nets against adult mosquitoes was assessed using a miniaturized, experimental hut system (laboratory tunnel tests that allows expression of behavioural responses to insecticide, particularly the mortality and blood feeding effects. Results Both mixtures (PM+DEET and PM+KBR3023 induced 95% mortality for more than two months compared with less than one week for each compound used alone, then reflecting a strong synergy between the repellents and PM. A similar trend was observed with the blood feeding rates, which were significantly lower for the mixtures than for each component alone. Conclusion Synergistic interactions between organophosphates and repellents may be of great interest for vector control as they may contribute to increase the residual life of impregnated materials and improve the control of pyrethroid-resistance mosquitoes. These results prompt the need to evaluate the efficacy of repellent/non-pyrethroid insecticide mixtures against field populations of An. gambiae showing high level of resistance to Ops and pyrethroids.

  19. Analysis of the Factors Affecting Resistance to Changes in Management Accounting Systems

    Directory of Open Access Journals (Sweden)

    Rodrigo Angonese

    2014-12-01

    Full Text Available Despite changes in the environment and management accounting practices, studies indicate that management accounting systems do not change or change at a much slower rate than expected. The stability of the management accounting systems used by companies may relate to resistance to changing these systems. This study analyzes the factors that contribute to resistance to implementing an integrated management system from the perspective of institutional theory, grounded in the old institutional economics. Methodologically, this study provides a qualitative assessment of the problem and a descriptive analysis of the resistance factors through a case-study approach. The data were collected using semi-structured interviews and analyzed through content analysis. Two companies were selected for this study due to their differing characteristics. The following seven factors were analyzed for resistance to implementing integrated management systems: institutional power, ontological insecurity, trust, inertia, lack of knowledge, acceptance of routines and decoupling. However, there was no evidence to characterize hierarchical power. The research findings indicate that changing management accounting systems, through the implementation of an integrated management system, faces internal resistance in these organizations. Each factor varies in intensity but is permanently present in these companies, such as ontological insecurity, trust, inertia, lack of knowledge, acceptance of routines and decoupling. These factors are awakened when the change process begins and, if they gather enough force, can stop the change.

  20. No Solutions: Resisting Certainty in Water Supply Management

    Science.gov (United States)

    Cockerill, K.; Armstrong, M.; Richter, J.; Okie, J. G.

    2017-12-01

    Although most scholars and water managers implicitly understand that managing water resources is an ongoing need, both popular and academic literature routinely use the words `solution' and `solve' in discussing water management concerns. The word `solution' reflects a quest for certainty, stability, permanence. A focus on `solving' creates a simplistic expectation that some person or institution is responsible for implementing a solution and that once `solved' the issue no longer requires attention. The reality, however, is water management is a wicked problem, meaning it is amorphous, involves multiple definitions, is embedded in complex systems, and hence is intractable. By definition, wicked problems defy solution. Our interdisciplinary project integrates research from across a broad spectrum of biological, physical, and social sciences. We find that framing a problem in terms of `solving' affects how people think, feel, behave toward the problem. Further, our work suggests that the prevalence of solution- based language has simultaneously generated expectations that science / scientists can predict and control biophysical systems and that science is not to be trusted because it has failed to deliver on previous promises to permanently `solve' events like floods or droughts. Hydrologic systems, are, of course highly uncertain. Hence, reiterating a simplistic insistence on `solving' water management concerns may result in decreased public attention to or support for more complex policy discussions that could provide long-term management strategies. Using the language of `solutions' with expectations of certainty sets hydrologic researchers and water managers up to fail. Managing water is a social responsibility and it will require consistent attention in the future, just as it has throughout human history. Scientists have a key role to play in explaining how various hydrologic systems function, but they should not be expected to `solve' pressing water management

  1. Six Strategies for Breaking Out of Another HRD Box--Management's Resistance to Change Itself

    Science.gov (United States)

    Bowen, Robert; Mok, Paul

    1976-01-01

    Many human resources development (HRD) people play out self-fulfilling roles of incongruency with top management, but when management resistance to change is real, the six strategies offered in the article can be used by HRD specialists to help themselves and their companies. (Author/AJ)

  2. Synergy effects of herb extracts: pharmacokinetics and pharmacodynamic basis.

    Science.gov (United States)

    Yang, Yong; Zhang, Zaiqi; Li, Shuping; Ye, Xiaoli; Li, Xuegang; He, Kai

    2014-01-01

    Herbal medicine, especially traditional Chinese medicine and Ayurvedic medicine have played and still play an important role in fighting against various diseases. Emerging clinical studies regarding traditional Chinese medicine have provided convincing evidence for the first time to gain credibility and reputation outside China. Although synergistic therapeutic actions of herbal ingredients have been frequently reported, few reports have offered clear underlying mechanisms. This might be the main reason for the conflicting views with respect to the therapeutic efficacy of medicinal herbs. Therefore, this paper reviews the herb synergisms reported in the recent literature and discusses thoroughly the mechanisms underlying synergistic actions of herbal ingredients. The authors conducted an electronic literature search to detect articles published mainly in the last five years. Articles were included if they pertained to synergy research of ethnomedicines or the active compounds derived from them, included verification of synergy effects using modern analytical tools and molecular-biological methods. Results have revealed that the multi-component nature of medicinal herbs makes them particularly suitable for treating complex diseases and offers great potential for exhibiting synergistic actions. The mechanisms underlying synergistic therapeutic actions of herb medicines are (1): different agents may regulate either the same or different target in various pathways, and therefore cooperate in an agonistic, synergistic way; (2): regulate the enzymes and transporters that are involved in hepatic and intestinal metabolism to improve oral drug bioavailability; (3): overcome the drug resistance mechanisms of microbial and cancer cells; and (4): eliminate the adverse effects and enhance pharmacological potency of agents by "processing" or by drug-drug interaction. The exploration of synergistic mechanisms of herbal ingredients will not only help researchers to discover new

  3. Current concepts in the management of resistant hypertension: a ...

    African Journals Online (AJOL)

    Background: Resistant hypertension is defined as uncontrolled hypertension above the target goal despite treatment with 3 or more antihypertensive agents, one of which is a diuretic, at optimum and best tolerated doses. The target blood pressure is defined as < 140/90 mmHg in most people and < 130/80 mmHg in those ...

  4. Extensively drug-resistant tuberculosis: epidemiology and management challenges

    NARCIS (Netherlands)

    Dheda, Keertan; Warren, Robin M.; Zumla, Alimuddin; Grobusch, Martin P.

    2010-01-01

    Widespread global use of rifampin for 2 decades preceded the emergence of clinically significant multidrug-resistant tuberculosis (MDR-TB) in the early 1990s. The prevalence of MDR-TB has gradually increased such that it accounts for approximately 5% of the global case burden of disease

  5. Evaluation of stem borer resistance management strategies for Bt ...

    African Journals Online (AJOL)

    Stem borers are the major insect pests of maize in Kenya. The use of Bacillus thuringiensis (Bt) technology is an effective way of controlling lepidopteran pests. However, the likelihood of development of resistance to the Bt toxins by the target stem borer species is a concern. Forages, sorghum and maize varieties were ...

  6. Evaluation of stem borer resistance management strategies for Bt ...

    African Journals Online (AJOL)

    GREGORY

    2011-06-01

    Jun 1, 2011 ... Stem borers are the major insect pests of maize in Kenya. The use of Bacillus thuringiensis (Bt) technology is an effective way of controlling lepidopteran pests. However, the likelihood of development of resistance to the Bt toxins by the target stem borer species is a concern. Forages, sorghum and maize ...

  7. 5 Development of a resistance management.cdr

    African Journals Online (AJOL)

    user

    Koney E. M. B. and Nipah G. (2000). Amblyomma variegatum resistance to acaricides in the Accra plains of Ghana. Ghana J. Sci. 40:39-49. Morrow A. N., Arnott J. L., Heron I. D., Koney E. M. B. and Walker A. R. (1993). The effect of tick control on the prevalence of dermatophilosis on indigenous cattle in Ghana. Revue Elev.

  8. Skid resistance determination for pavement management and wet-weather road safety

    Directory of Open Access Journals (Sweden)

    T.F. Fwa

    2017-09-01

    Full Text Available Road accidents during wet weather have been a topic of major concern of road engineers in regions of wet-tropical climate and in other parts of the world during the wet season of the year. Road safety studies indicate that approximately 20% of all road accidents occurred during wet weather, and that the skid resistance of wet pavements have a major influence on the occurrences of wet-weather accidents. Monitoring of wet pavement skid resistance has been an integral part of a typical pavement management system. However, because of the lack of prediction capability of pavement skid resistance under various rainfall intensities, the minimum skid resistance threshold for safe wet-weather driving has been specified by highway agencies based on either engineering judgement or past experience. It is shown in this paper that the single-point minimum skid resistance threshold is inadequate to offer a complete description of the skid resistance performance of the pavement sections in question for effective management of a road network. It is unable to assess the risk involved in an actual wet-weather condition where the pavement surface water-film thickness and vehicle speed are different from standard test conditions. This limitation of the current system of specifying a minimum skid resistance threshold can be overcome by adopting a theoretically sound approach to represent pavement skid resistance under different conditions of water-film thickness and vehicle speed. This paper describes the theoretical basis of the approach and the development of a mechanistically derived three-dimensional finite-element skid resistance simulation model to predict skid resistance. The application of the proposed approach and the skid resistance prediction procedure in pavement management system and wet-weather driving safety assessment is presented.

  9. Team Synergies in Sport: Theory and Measures

    Science.gov (United States)

    Araújo, Duarte; Davids, Keith

    2016-01-01

    Individual players act as a coherent unit during team sports performance, forming a team synergy. A synergy is a collective property of a task-specific organization of individuals, such that the degrees of freedom of each individual in the system are coupled, enabling the degrees of freedom of different individuals to co-regulate each other. Here, we present an explanation for the emergence of such collective behaviors, indicating how these can be assessed and understood through the measurement of key system properties that exist, considering the contribution of each individual and beyond These include: to (i) dimensional compression, a process resulting in independent degree of freedom being coupled so that the synergy has fewer degrees of freedom than the set of components from which it arises; (ii) reciprocal compensation, if one element do not produce its function, other elements should display changes in their contributions so that task goals are still attained; (iii) interpersonal linkages, the specific contribution of each element to a group task; and (iv), degeneracy, structurally different components performing a similar, but not necessarily identical, function with respect to context. A primary goal of our analysis is to highlight the principles and tools required to understand coherent and dynamic team behaviors, as well as the performance conditions that make such team synergies possible, through perceptual attunement to shared affordances in individual performers. A key conclusion is that teams can be trained to perceive how to use and share specific affordances, explaining how individual’s behaviors self-organize into a group synergy. Ecological dynamics explanations of team behaviors can transit beyond mere ratification of sport performance, providing a comprehensive conceptual framework to guide the implementation of diagnostic measures by sport scientists, sport psychologists and performance analysts. Complex adaptive systems, synergies, group

  10. Robustness of muscle synergies during visuomotor adaptation

    Directory of Open Access Journals (Sweden)

    Reinhard eGentner

    2013-09-01

    Full Text Available During visuomotor adaptation a novel mapping between visual targets and motor commands is gradually acquired. How muscle activation patterns are affected by this process is an open question. We tested whether the structure of muscle synergies is preserved during adaptation to a visuomotor rotation. Eight subjects applied targeted isometric forces on a handle instrumented with a force transducer while electromyographic (EMG activity was recorded from 13 shoulder and elbow muscles. The recorded forces were mapped into horizontal displacements of a virtual sphere with simulated mass, elasticity, and damping. The task consisted of moving the sphere to a target at one of eight equally spaced directions. Subjects performed three baseline blocks of 32 trials, followed by six blocks with a 45° CW rotation applied to the planar force, and finally three wash-out blocks without the perturbation. The sphere position at 100 ms after movement onset revealed significant directional error at the beginning of the rotation, a gradual learning in subsequent blocks, and aftereffects at the beginning of the wash-out. The change in initial force direction was closely related to the change in directional tuning of the initial EMG activity of most muscles. Throughout the experiment muscle synergies extracted using a non-negative matrix factorization algorithm from the muscle patterns recorded during the baseline blocks could reconstruct the muscle patterns of all other blocks with an accuracy significantly higher than chance indicating structural robustness. In addition, the synergies extracted from individual blocks remained similar to the baseline synergies throughout the experiment. Thus synergy structure is robust during visuomotor adaptation suggesting that changes in muscle patterns are obtained by rotating the directional tuning of the synergy recruitment.

  11. Muscle synergy space: learning model to create an optimal muscle synergy.

    Science.gov (United States)

    Alnajjar, Fady; Wojtara, Tytus; Kimura, Hidenori; Shimoda, Shingo

    2013-01-01

    Muscle redundancy allows the central nervous system (CNS) to choose a suitable combination of muscles from a number of options. This flexibility in muscle combinations allows for efficient behaviors to be generated in daily life. The computational mechanism of choosing muscle combinations, however, remains a long-standing challenge. One effective method of choosing muscle combinations is to create a set containing the muscle combinations of only efficient behaviors, and then to choose combinations from that set. The notion of muscle synergy, which was introduced to divide muscle activations into a lower-dimensional synergy space and time-dependent variables, is a suitable tool relevant to the discussion of this issue. The synergy space defines the suitable combinations of muscles, and time-dependent variables vary in lower-dimensional space to control behaviors. In this study, we investigated the mechanism the CNS may use to define the appropriate region and size of the synergy space when performing skilled behavior. Two indices were introduced in this study, one is the synergy stability index (SSI) that indicates the region of the synergy space, the other is the synergy coordination index (SCI) that indicates the size of the synergy space. The results on automatic posture response experiments show that SSI and SCI are positively correlated with the balance skill of the participants, and they are tunable by behavior training. These results suggest that the CNS has the ability to create optimal sets of efficient behaviors by optimizing the size of the synergy space at the appropriate region through interacting with the environment.

  12. Hypertension management and microvascular insulin resistance in diabetes.

    Science.gov (United States)

    Ko, Seung-Hyun; Cao, Wenhong; Liu, Zhenqi

    2010-08-01

    Type 2 diabetes is in essence a vascular disease and is frequently associated with hypertension, macrovascular events, and microvascular complications. Microvascular dysfunction, including impaired recruitment and capillary rarefaction, has been implicated in the pathogenesis of diabetic complications. Microvascular insulin resistance and renin-angiotensin system upregulation are present in diabetes, and each contributes to the development of hypertension and microvascular dysfunction. In the insulin-sensitive state, insulin increases microvascular perfusion by increasing endothelial nitric oxide production, but this effect is abolished by insulin resistance. Angiotensin II, acting via the type 1 receptors, induces inflammation and oxidative stress, leading to impaired insulin signaling, reduced nitric oxide availability, and vasoconstriction. Conversely, it acts on the type 2 receptors to cause vasodilatation. Because substrate and hormonal exchanges occur in the microvasculature, antihypertensive agents targeted to improve microvascular insulin sensitivity and function may have beneficial effects beyond their capacity to lower blood pressure in patients with diabetes.

  13. RESISTANCE TO CHANGE AND ERP IMPLEMENTATION SUCCESS: THE MODERATING ROLE OF CHANGE MANAGEMENT INITIATIVES

    Directory of Open Access Journals (Sweden)

    Zafar U. Ahmed

    2006-01-01

    Full Text Available Enterprise Resource Planning (ERP is a useful tool that builds strong capabilities, improves performance, supports better decision making, and provides competitive advantage for businesses. ERP aims to help the management by setting better business practices and equipping them with the right information to take timely decision. In any new technology implementation, one of the issues that need to be addressed is the resistance to change. Many implementations have failed due to strong resistance from the end users. Thus, the main purpose of this paper is to test the impact of resistance to change on ERP's implementation success and how change management initiatives acts in the capacity of a moderating role. Using data collected from 69 manufacturing organizations through a mail survey, it was found that resistance to change is negatively related to achievement of predetermined goals (b = –0.930, p < 0.01 and usersatisfaction (b = –0.952, p < 0.01. Further, change management initiatives did not moderate the relationship between resistance and predetermined goals but it moderated the relationship between resistance and user satisfaction. In addition, change management initiatives have a direct positive impact on user satisfaction. This research concludes that the human factor is very important in ERP's implementation.

  14. Surgical management of cavernous malformations coursing with drug resistant epilepsy

    OpenAIRE

    Mario Arturo Alonso-Vanegas; Jose Miguel eCisneros-Franco; Taisuke eOtsuki

    2012-01-01

    Cerebral cavernous malformations (CM) are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CM pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, completed ...

  15. Picture this: Managed change and resistance in business network settings

    DEFF Research Database (Denmark)

    Kragh, Hanne; Andersen, Poul Houman

    2009-01-01

    This paper discusses change management in networks. The literature on business networks tends to downplay the role of managerial initiative in network change. The change management literature addresses such initiative, but with its single-firm perspective it overlooks the interdependence of network...... actors. In exploring the void between these two streams of literature, we deploy the concept of network pictures to discuss managed change in network settings. We analyze a change project from the furniture industry and address the consequences of attempting to manage change activities in a network...... context characterized by limited managerial authority over these activities. Our analysis suggests that change efforts unfold as a negotiated process during which the change project is re-negotiated to fit the multiple actor constituencies. The degree of overlap in the co-existing network pictures...

  16. The Power to Resist: Irrigation Management Transfer in Indonesia

    Directory of Open Access Journals (Sweden)

    Diana Suhardiman

    2013-02-01

    Full Text Available In the last two decades, international donors have promoted Irrigation Management Transfer (IMT as an international remedy to management problems in government irrigation systems in many developing countries. This article analyses the political processes that shape IMT policy formulation and implementation in Indonesia. It links IMT with the issue of bureaucratic reform and argues that its potential to address current problems in government irrigation systems cannot be achieved if the irrigation agency is not convinced about the need for management transfer. IMT’s significance cannot be measured only through IMT outcomes and impacts, without linking these with how the irrigation agency perceives the idea of management transfer in the first place, how this perception (redefines the agency’s position in IMT, and how it shapes the agency’s action and strategy in the policy formulation and implementation. I illustrate how the irrigation agency contested the idea of management transfer by referring to IMT policy adoption in 1987 and its renewal in 1999. The article concludes that for management transfer to be meaningful it is pertinent that the issue of bureaucratic reform is incorporated into current policy discussions.

  17. Ecosystem service trade-offs and synergies misunderstood without landscape history

    Directory of Open Access Journals (Sweden)

    Stephanie A. Tomscha

    2016-03-01

    Full Text Available Dramatic changes in ecosystem services have motivated recent work characterizing their interactions, including identifying trade-offs and synergies. Although time is arguably implicit in these ideas of trade-offs and synergies (e.g., temporal dynamics or changes in ecosystem services, such interactions are routinely inferred based on the spatial relationships among ecosystem services alone (e.g., spatial concordance of ecosystem services indicates synergies, whereas incongruence signifies trade-offs. The limitations of this approach have not been fully explored. We quantified ecosystem service interactions using correlations among contemporary ecosystem services and compared these results to those derived by incorporating change in ecosystem services from an earlier decade. To document change over ~60 years in an urbanizing floodplain, we used aerial photography to map multiple floodplain-associated ecosystem services. Our results demonstrate how incorporating landscape baselines can influence measured synergies and trade-offs. Spatial correlations among contemporary ecosystem services missed several interactions that were detected when using prior baseline ecosystem services. Ignoring the history of ecosystem services and their change over time may result in missed opportunities to foster their synergies and lead to unnecessary trade-offs. Efforts to incorporate ecosystem services into land management should include long-term monitoring and baseline reconstructions of ecosystem services.

  18. Resensitizing Resistant Bacteria to Antibiotics

    Science.gov (United States)

    2011-04-01

    Next, we added the phage displaying #39 or a randomized version of #39 to growing staphylococci and showed that #39, but not the randomized...synergy with oxacillin against methicillin-resistant staphylococci as well as synergy with vancomycin against vancomycin-resistant staphylococci . We...below in Task 3).   2 Task 3. Test top binding display phage against whole staphylococci . (months 7-9) Despite being covalently attached to a

  19. Cortex integrity relevance in muscle synergies in severe chronic stroke

    Directory of Open Access Journals (Sweden)

    Eliana eGarcía-Cossio

    2014-09-01

    Full Text Available Background: Recent experimental evidence has indicated that the motor system coordinates muscle activations through a linear combination of muscle synergies that are specified at the spinal or brainstem networks level. After stroke upper limb impairment is characterized by abnormal patterns of muscle activations or synergies. Objective: This study aimed at characterizing the muscle synergies in severely affected chronic stroke patients. Furthermore, the influence of integrity of the sensorimotor cortex on synergy modularity and its relation with motor impairment was evaluated. Methods: Surface electromyography from 33 severely impaired chronic stroke patients was recorded during six bilateral movements. Muscle synergies were extracted and synergy patterns were correlated with motor impairment scales. Results: Muscle synergies extracted revealed different physiological patterns dependent on the preservation of the sensorimotor cortex. Patients without intact sensorimotor cortex showed a high preservation of muscle synergies. On the contrary, patients with intact sensorimotor cortex showed poorer muscle synergies preservation and an increase in new generated synergies. Furthermore, the preservation of muscle synergies correlated positively with hand functionality in patients with intact sensorimotor cortex and subcortical lesions only.Conclusions: Our results indicate that severely paralyzed chronic stroke patient with intact sensorimotor cortex might sculpt new synergy patterns as a response to maladaptive compensatory strategies.

  20. Potential shortfall of pyramided transgenic cotton for insect resistance management

    OpenAIRE

    Brévault, Thierry; Heuberger, Shannon; Zhang, Min; Ellers-Kirk, Christa; Ni, Xinzhi; Masson, Luke; Li, Xianchiun; Tabashnik, Bruce E.; Carrière, Yves

    2013-01-01

    To delay evolution of pest resistance to transgenic crops producing insecticidal proteins from Bacillus thuringiensis (Bt), the “pyramid” strategy uses plants that produce two or more toxins that kill the same pest. In the United States, this strategy has been adopted widely, with two-toxin Bt cotton replacing one-toxin Bt cotton. Although two-toxin plants are likely to be more durable than one-toxin plants, the extent of this advantage depends on several conditions. One key assumption favori...

  1. Space and Terrestrial Photovoltaics: Synergy and Diversity

    Science.gov (United States)

    Bailey, Sheila; Raffaelle, Ryne; Emery, Keith

    2002-01-01

    A historical view of the research and development in photovoltaics from the perspective of both the terrestrial and the space communities is presented from the early days through the '70s and '80s and the '90s and beyond. The synergy of both communities in the beginning and once again in the present and hopefully future are highlighted, with examples of the important features in each program. The space community which was impressed by the light-weight and reliability of photovoltaics drove much of the early development. Even up to today, nearly every satellites and other scientific space probe that has been launched has included some solar power. However, since the cost of these power systems were only a small fraction of the satellite and launch cost, the use of much of this technology for the terrestrial marketplace was not feasible. It was clear that the focus of the terrestrial community would be best served by reducing costs. This would include addressing a variety of manufacturing issues and raising the rate of production. Success in these programs and a resulting globalization of effort resulted in major strides in the reduction of PV module costs and increased production. Although, the space community derived benefit from some of these advancements, its focus was on pushing the envelope with regard to cell efficiency. The gap between theoretical efficiencies and experimental efficiencies for silicon, gallium arsenide and indium phosphide became almost non-existent. Recent work by both communities have focused on the development thin film cells of amorphous silicon, CuInSe2 and CdTe. These cells hold the promise of lower costs for the terrestrial community as well as possible flexible substrates, better radiation resistance, and higher specific power for the space community. It is predicted that future trends in both communities will be directed toward advances through the application of nanotechnology. A picture is emerging in which the space and

  2. Elicitors and soil management to induce resistance against fungal plant diseases

    OpenAIRE

    Tamm, L.; Thürig, B.; Fließbach, A.; Goltlieb, A. E.; Karavani, S.; Cohen, Y.

    2011-01-01

    Air-borne foliar diseases as well as soil-borne diseases can cause substantial losses in agricultural production systems. One of the strategies to overcome production losses caused by plant diseases is the targeted use of disease defence mechanisms that are inherent to plants. In this paper, the potential to enhance the plant’s health status either by inducing resistance through optimized soil management techniques or by foliar application of inducers of resistance is explored on the basis of...

  3. Anthelmintic resistance: Management of parasite refugia for Haemonchus contortus through the replacement of resistant with susceptible populations.

    Science.gov (United States)

    Muchiut, Sebastián Manuel; Fernández, Alicia Silvina; Steffan, Pedro Eduardo; Riva, Eliana; Fiel, César Alberto

    2018-04-30

    Sheep production in tropical and temperate regions is hampered by the presence of Haemonchus contortus, the blood-sucking nematode that is the major cause of economic losses in small ruminant enterprises. The most limiting factor in the control of this parasitic disease is the steady progress of anthelmintic resistance worldwide. The search for control strategies that minimise the use of anthelmintics is therefore central to various efforts worldwide. One strategy is the introduction of susceptible parasites in refugia when these refugia are at low levels. This strategy could lead to a renewed possibility anthelmintics being effective. At farm level, this management practice could recover the use of anthelmintics in flocks with high levels of resistance. This review explores the possibility of replacing resistant H. contortus populations with susceptible ones through refugia management and. highlights the experiences of on-farm research attempts carried out in different geographical areas, reaching various degrees of success. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Synergies between nonproliferation regimes: A pragmatic approach

    International Nuclear Information System (INIS)

    Findlay, Trevor; Meier, Oliver

    2001-01-01

    Full text: With the recent progress in establishing international nonproliferation regimes, the question of synergies between different verification and monitoring regimes is becoming more acute. Three multilateral and universal nonproliferation organisations covering safeguards on civil nuclear materials, nuclear testing, and chemical weapons are up and running. A regime on biological weapons is under negotiation. Several regional organisations concerned with monitoring nonproliferation commitments in the nuclear field are in place; others are being established. Past discussions on synergies between these regimes have suffered from being too far-reaching. These discussions often have not reflected adequately the political difficulties of cooperation between regimes with different membership, scope and institutional set-up. This paper takes a pragmatic look at exploiting synergies and identifies some potential and real overlaps in the work between different verification regimes. It argues for a bottom-up approach and identifies building blocks for collaboration between verification regimes. By realising such, more limited potential for cooperation, the ground could be prepared for exploiting other synergies between these regimes. (author)

  5. The effect of aging on respiratory synergy.

    Science.gov (United States)

    Kweon, Migyoung; Son, Sung Min; Kwon, Yong Hyun

    2015-04-01

    [Purpose] The purpose of this study was to investigate the effect of aging on respiratory synergy, through the comparison of an elderly group and a young group, to help further understanding of postural control in the elderly. [Subjects and Methods] Ten community-dwelling elderly subjects and ten young subjects performed standing under two different respiratory conditions: quiet breathing and apnea. Center of foot pressure displacement and joint angular movements of the head, trunk, pelvis, hips, knees and ankles were measured. [Results] The results of this study showed that the elderly group had a respiratory synergy different from that of the young group. The elderly group in quiet stance used significantly more hip and pelvis movements when compensating for respiratory disturbance than standing with apnea, while the young group used significantly more whole body segments. There were no differences in angular displacements in the quiet stance between the elderly and the young groups. [Conclusion] The elderly group demonstrated a respiratory synergy pattern different from that of the young group. The findings indicate that aging changes the respiratory synergy pattern and this change is not due to decreased functioning of the ankle joint alone.

  6. Synergy between phenothiazines and oxacillin against clinical ...

    African Journals Online (AJOL)

    Methods: Minimum inhibitory concentrations (MIC) of the compounds were determined by agar dilution method, and synergy between phenothiazines and oxacillin was investigated using Checkerboard (microbroth dilution) technique. Results: We found that all S. aureus strains, regardless of their susceptibility to oxacillin, ...

  7. Synergy between indigenous knowledge systems, modern health ...

    African Journals Online (AJOL)

    ... the people of this country should harness a synergy between indigenous health care systems, scientific research and modern health care methods. This article attempts to address the historical evolution of health care methods in South Africa, its effect on the community as well as challenges facing the health professions.

  8. SYNERGY ENTERPRISES AND STANDARDIZATION OF WORKING PRACTICE

    Directory of Open Access Journals (Sweden)

    Mikhail N. Konotopov

    2014-01-01

    Full Text Available This article examines the main causes of low productivity in domestic enterprises, as well as the issues of production processes standardization and the coordination of work in relation to the possible organizational interventions aimed at improving the synergy of workforce joint activities.

  9. Human synergy in the rotten banana

    DEFF Research Database (Denmark)

    Svensson, Christian Franklin

    Counter-activity and synergy canbe viewed as a renaissance when recapturing the human potentials in civil society. The paper discusses employees' navigations and their imaginings of the future both relating to social enterprises and civil society and relating to the municipality as a rural area....

  10. Soil management effect on soil penetration resistance in the vineyard

    Directory of Open Access Journals (Sweden)

    Pietro Catania

    2013-09-01

    Full Text Available In environments characterized by steep slopes or arranged in terraces, among the shallow tillage systems, rototilling is extensively used. However, the effect of the repeated use of rototilling has a considerable influence on soil characteristics; it appears finely powdered, soft and without structure. In order to limit these inconveniences, an innovative self-propelled machine equipped with working tools as a spade, to be used in steep slopes or arranged in terraces areas, was designed by the Mechanics Section of the SAF (Scienze Agrarie e Forestali Department of the University of Palermo in cooperation with Agrotec company, Padua, Italy. The aim of this study is to compare the effects of three machines for shallow tillage: a chisel plough (CP, a rototilling (RT and a spading machine (SM on penetration resistance in semi-arid environments of the Mediterranean basin. No tillage was also included. Penetration resistance (PR was surveyed for all the treatments to a depth of 300 mm with an electronic dynamometer. The treatments consisted in the execution of a shallow tillage to a depth of 150 mm. SP treatment allowed us to obtain PR lower values throughout the tillage profile than RT, CP and NT. It follows that the type of machine used influences soil PR, and then the soil water storage capacity, key factor for the agricultural productions in semi-arid environments as in Sicily.

  11. Surgical management of cavernous malformations coursing with drug resistant epilepsy

    Directory of Open Access Journals (Sweden)

    Mario Arturo Alonso-Vanegas

    2012-01-01

    Full Text Available Cerebral cavernous malformations (CM are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CM pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, completed with SPECT, PET, functional MRI and/or invasive monitoring as needed. Radiosurgery shows variable rates of seizure freedom and a high incidence of complications, thus microsurgical resection remains the optimal treatment for CM coursing with drug-resistant epilepsy.Two thirds of patients reach Engel I class at three-year follow-up, regardless of lobar location. Those with secondarily generalized seizures, a higher seizure frequency, and generalized abnormalities on preoperative or postoperative EEG, show poorer outcomes, while factors such as gender, duration of epilepsy, lesion size, age, bleeding at the time of surgery, do not correlate consistently with seizure outcome. Electrocorticography and a meticulous removal of all cortical hemosiderin –beyond pure lesionectomy– reduce the risk of symptomatic recurrences.

  12. Mechanisms and management of diuretic resistance in congestive heart failure.

    Science.gov (United States)

    De Bruyne, L K M

    2003-05-01

    Diuretic drugs are used almost universally in patients with congestive heart failure, most frequently the potent loop diuretics. Despite their unproven effect on survival, their indisputable efficacy in relieving congestive symptoms makes them first line therapy for most patients. In the treatment of more advanced stages of heart failure diuretics may fail to control salt and water retention despite the use of appropriate doses. Diuretic resistance may be caused by decreased renal function and reduced and delayed peak concentrations of loop diuretics in the tubular fluid, but it can also be observed in the absence of these pharmacokinetic abnormalities. When the effect of a short acting diuretic has worn off, postdiuretic salt retention will occur during the rest of the day. Chronic treatment with a loop diuretic results in compensatory hypertrophy of epithelial cells downstream from the thick ascending limb and consequently its diuretic effect will be blunted. Strategies to overcome diuretic resistance include restriction of sodium intake, changes in dose, changes in timing, and combination diuretic therapy.

  13. Antiviral resistance in herpes simplex virus and varicella-zoster virus infections: diagnosis and management.

    Science.gov (United States)

    Piret, Jocelyne; Boivin, Guy

    2016-12-01

    Aciclovir (ACV) is the first-line drug for the management of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections. Long-term administration of ACV for the treatment of severe infections in immunocompromised patients can lead to the development of drug resistance. Furthermore, the emergence of isolates resistant to ACV is increasingly recognized in immunocompetent individuals with herpetic keratitis. This review describes the mechanisms involved in drug resistance for HSV and VZV, the laboratory diagnosis and management of patients with infections refractory to ACV therapy. Genotypic testing is more frequently performed for the diagnosis of infections caused by drug-resistant HSV or VZV isolates. Molecular biology-based systems for the generation of recombinant viruses have been developed to link unknown mutations with their drug phenotypes. Fast and sensitive methods based on next-generation sequencing will improve the detection of heterogeneous viral populations of drug-resistant viruses and their temporal changes during antiviral therapy, which could allow better patient management. Novel promising compounds acting on targets that differ from the viral DNA polymerase are under clinical development. Antiviral drug resistance monitoring for HSV and VZV is required for a rational use of antiviral therapy in high-risk populations.

  14. Antimicrobial resistance in Helicobacter pylori: current situation and management strategy in Vietnam.

    Science.gov (United States)

    Phan, Trung Nam; Tran, Van Huy; Tran, Thi Nhu Hoa; Le, Van An; Santona, Antonella; Rubino, Salvatore; Paglietti, Bianca

    2015-07-04

    Increasing antimicrobial resistance to key antibiotics in Helicobacter pylori has become a main cause of treatment failures in many countries, including Vietnam. For this reason it is advisable to perform antimicrobial sensitivity tests to provide more focused regimens for H. pylori eradication. However, this approach is generally unavailable for H. pylori in Vietnam and the selection of treatment regimens is mainly based on the trend of antibiotic use in the population, resistance development in the region, and history of H. pylori eradication of patients. The aim of this review is to examine the current situation of antimicrobial resistance in Vietnam and suggest management strategies for treatment selection.

  15. Implications of Antibiotic Resistance in the Management of Helicobacter pylori Infection: Canadian Helicobacter Study Group

    Directory of Open Access Journals (Sweden)

    RH Hunt

    2000-01-01

    Full Text Available Eradication of Helicobacter pylori from the gastric and duodenal mucosa is an important clinical goal in the treatment of infected patients with peptic ulcer disease and other H pylori-associated conditions. Although several oral drug combination regimens are associated with eradication rates of approximately 85% in controlled trials, the success rate in patients infected with a resistant strain of H pylori is closer to 75%. Resistance to metronidazole and clarithromycin, which are common components of combination treatment regimens, is of greatest concern. Reported rates of H pylori resistance to various antibiotics vary considerably. In Canada, the data documenting H pylori susceptibility are limited but suggest that resistance to these antibiotics varies geographically and within specific treatment groups. Although susceptibility testing is not a prerequisite for initial treatment of individual patients infected with H pylori, formal efforts to identify and monitor both the causes and prevalence of antibiotic resistance across Canada are a much needed step in the ongoing management of this important infection. Recommended treatment regimens may be useful, even for treating apparently resistant H pylori strains. However, it is important to understand the mechanisms of the development of resistant strains to manage patients with treatment failure better.

  16. Team synergies in sport: Theory and measures

    Directory of Open Access Journals (Sweden)

    Duarte Araújo

    2016-09-01

    Full Text Available Individual players act as a coherent unit during team sports performance, forming a team synergy. A synergy is a collective property of a task-specific organization of individuals, such that the degrees of freedom of each individual in the system are coupled, enabling the degrees of freedom of different individuals to co-regulate each other. Here, we present an explanation for the emergence of such collective behaviors, indicating how these can be assessed and understood through the measurement of key system properties that exist, considering the contribution of each individual and beyond These include: to (i dimensional compression, a process resulting in independent degree of freedom being coupled so that the synergy has fewer degrees of freedom than the set of components from which it arises; (ii reciprocal compensation, if one element do not produce its function, other elements should display changes in their contributions so that task goals are still attained; (iii interpersonal linkages, the specific contribution of each element to a group task; and (iv, degeneracy, structurally different components performing a similar, but not necessarily identical, function with respect to context. A primary goal of our analysis is to highlight the principles and tools required to understand coherent and dynamic team behaviors, as well as the performance conditions that make such team synergies possible, through perceptual attunement to shared affordances in individual performers. A key conclusion is that teams can be trained to perceive how to use and share specific affordances, explaining how individual’s behaviours self-organize into a group synergy.Ecological dynamics explanations of team behaviors can transit beyond mere ratification of sport performance, providing a comprehensive conceptual framework to guide the implementation of diagnostic measures by sport scientists, sport psychologists and performance analysts.

  17. The management of insulin resistance in polycystic ovary syndrome.

    Science.gov (United States)

    Teede, Helena J; Hutchison, Samantha K; Zoungas, Sophia

    2007-09-01

    Polycystic ovary syndrome (PCOS) has reproductive and metabolic implications. Insulin resistance (IR), secondary to genetic and lifestyle factors, is integral in the pathogenesis, metabolic, clinical features and the long-term sequelae in the majority of people with PCOS. Therapeutic strategies targeting IR in PCOS ameliorate clinical features and might reduce long-term sequelae including diabetes. The mainstay for improving IR is lifestyle change; however, feasibility and sustainability remain concerns. In PCOS, metformin reduces IR, improves ovarian function, regulates cycles, lowers androgens, improves clinical hyperandrogenism and potentially improves fertility. Metformin is also likely to delay diabetes onset and has a role in PCOS in those at high risk of diabetes; however, further research is needed to clarify specific target subgroups and clinical indications.

  18. Management of patients with resistant hypertension: current treatment options

    Directory of Open Access Journals (Sweden)

    Kumar N

    2013-10-01

    Full Text Available Nilay Kumar,1 David A Calhoun,2 Tanja Dudenbostel21Department of Medicine, 2Division of Cardiovascular Disease, Hypertension and Vascular Biology Program, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: Resistant hypertension (RHTN is an increasingly common clinical problem that is often heterogeneous in etiology, risk factors, and comorbidities. It is defined as uncontrolled blood pressure on optimal doses of three antihypertensive agents, ideally one being a diuretic. The definition also includes controlled hypertension with use of four or more antihypertensive agents. Recent observational studies have advanced the characterization of patients with RHTN. Patients with RHTN have higher rates of cardiovascular events and mortality compared with patients with more easily controlled hypertension. Secondary causes of hypertension, including obstructive sleep apnea, primary aldosteronism, renovascular disease, are common in patients with RHTN and often coexist in the same patient. In addition, RHTN is often complicated by metabolic abnormalities. Patients with RHTN require a thorough evaluation to confirm the diagnosis and optimize treatment, which typically includes a combination of lifestyle adjustments, and pharmacologic and interventional treatment. Combination therapy including a diuretic, a long-acting calcium channel blocker, an angiotensin-converting enzyme inhibitor, a beta blocker, and a mineralocorticoid receptor antagonist where warranted is the classic regimen for patients with treatment-resistant hypertension. Mineralocorticoid receptor antagonists like spironolactone or eplerenone have been shown to be efficacious in patients with RHTN, heart failure, chronic kidney disease, and primary aldosteronism. Novel interventional therapies, including baroreflex activation and renal denervation, have shown that both of these methods may be used to lower blood pressure safely, thereby providing exciting and promising new

  19. Management of Upper Airway Resistance Syndrome: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Ranjan Mathur

    2015-01-01

    Full Text Available Background : This disorder, also known by terms such as obstructive sleep apnea (OSA, upper airway sleep disorder and snoring. Snoring has also been identified as a possible risk factor for hyper tension, ischemic heart disease and stroke. The role of dentistry in sleep disorders is becoming more significant, especially in co- managing patients with simple snoring and mild to moderate OSA. The practicing dental professional has the opportunity to assist patients at a variety of levels, starting with the recognition of a sleep -related disorder, referring patients to a physician for evaluation and assisting in the management of sleep disorders. The first and simplest option would be behaviour modification, followed by insertion of oral devices suited to the patient, especially in those with mild to moderate OSA. Continuous positive airway pressure (CPAP and surgic al options are chosen for patients with moderate to severe OSA.

  20. Positive and normative modeling for Palmer amaranth control and herbicide resistance management.

    Science.gov (United States)

    Frisvold, George B; Bagavathiannan, Muthukumar V; Norsworthy, Jason K

    2017-06-01

    Dynamic optimization models are normative; they solve for what growers 'ought to do' to maximize some objective, such as long-run profits. While valuable for research, such models are difficult to solve computationally, limiting their applicability to grower resistance management education. While discussing properties of normative models in general, this study presents results of a specific positive model of herbicide resistance management, applied to Palmer amaranth control on a representative cotton farm. This positive model compares a proactive resistance management strategy to a reactive strategy with lower short-run costs, but greater risk of herbicide resistance developing. The proactive strategy can pay for itself within 1-4 years, with a yield advantage of 4% or less if the yield advantage begins within 1-2 years of adoption. Whether the proactive strategy is preferable is sensitive to resistance onset and yield losses, but less sensitive to cotton prices or baseline yields. Industry rebates to encourage residual herbicide use (to delay resistance to post-emergence treatments) may be too small to alter grower behavior or they may be paid to growers who would have used residuals anyway. Rebates change grower behavior over a relatively narrow range of model parameters. The size of rebates needed to induce a grower to adopt the proactive strategy declines significantly if growers extend their planning horizon from 1 year to 3-4 years. Whether proactive resistance management is more profitable than a reactive strategy is more sensitive to biological parameters than economic ones. Simulation results suggest growers with longer time horizons (perhaps younger ones) would be more responsive to rebate programs. More empirical work is needed to determine how much rebates increase residual use above what would occur without them. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  1. Dietary antioxidant synergy in chemical and biological systems.

    Science.gov (United States)

    Wang, Sunan; Zhu, Fan

    2017-07-24

    Antioxidant (AOX) synergies have been much reported in chemical ("test-tube" based assays focusing on pure chemicals), biological (tissue culture, animal and clinical models), and food systems during the past decade. Tentative synergies differ from each other due to the composition of AOX and the quantification methods. Regeneration mechanism responsible for synergy in chemical systems has been discussed. Solvent effects could contribute to the artifacts of synergy observed in the chemical models. Synergy in chemical models may hardly be relevant to biological systems that have been much less studied. Apparent discrepancies exist in understanding the molecular mechanisms in both chemical and biological systems. This review discusses diverse variables associated with AOX synergy and molecular scenarios for explanation. Future research to better utilize the synergy is suggested.

  2. Monitoring and managing antibiotic resistance in refugee children.

    Science.gov (United States)

    Maltezou, Helena C; Elhadad, Dana; Glikman, Daniel

    2017-11-01

    The past decade the Middle East and Southeastern Europe have witnessed an enormous movement of refugees due to the Syrian war and conflicts in Asia and Africa. Although carriage of and infections with multi-drug resistant (MDR) pathogens in refugees have been reported, pediatric data are scarce. Areas covered: MDR bacterial carriage and infections, and MDR-tuberculosis (TB) in refugee children from 2010. Expert commentary: High MDR carriage rates in refugee children are attributed to high pre-civil war MDR rates, war-damaged infrastructure and healthcare systems, and poor hygiene conditions. Currently there are no international guidelines about MDR screening in refugee children. Given the medical importance of MDRs, challenging therapeutics and risk of importation in non/low-endemic countries, we recommend routine screening and contact isolation upon hospitalization of refugees. TB, including MDR-TB, is highly-endemic in many Asian and African countries, however, current data in refugee children are lacking. TB Screening in refugees is widely implemented but there is no consensus on methods and target populations. Coordinated TB detection and treatment, use of rapid molecular tests and drug-susceptibility testing, better access to healthcare, cross border TB care collaboration, and protection from deportation while on treatment should be integrated parts of TB control and prevention.

  3. Using mass-release of engineered insects to manage insecticide resistance

    International Nuclear Information System (INIS)

    Alphey, Nina; Coleman, Paul G.; Donnelly, Christl A.

    2006-01-01

    Transgenic crops expressing insecticidal toxins derived from Bacillus thuringiensis (Bt) are widely used to control insect pests. The benefits of such crops would be lost if resistance to the toxins spread to a significant proportion of the pest population. The main resistance management method, mandatory in the US, is the high-dose/refuge strategy, requiring nearby refuges of toxin-free crops, and the use of toxin doses sufficiently high to kill not only wild type insects but also insects heterozygous for a resistance allele, thereby rendering the resistance functionally recessive. We propose that mass-release of harmless toxin-sensitive insects could substantially delay or even reverse the spread of resistance. Mass-release of such insects is an integral part of RIDL, a genetics-based method of pest control related to the Sterile Insect Technique. We used a population genetic mathematical model to analyze the effects of releasing male insects homozygous for a female-specific dominant lethal genetic construct, and concluded that this RIDL strategy could form an effective component of a resistance management scheme for insecticidal plants and other toxins. (author)

  4. Using mass-release of engineered insects to manage insecticide resistance

    Energy Technology Data Exchange (ETDEWEB)

    Alphey, Nina [University of Oxford (United Kingdom). Dept. of Zoology; Alphey, Luke [Oxitec Limited, Oxford (United Kingdom); Coleman, Paul G. [London School of Hygiene and Tropical Medicine (United Kingdom). Dept. of Infectious and Tropical Diseases; Donnelly, Christl A. [Imperial College Faculty of Medicine, London (United Kingdom). Dept. of Infectious Disease Epidemiology

    2006-07-01

    Transgenic crops expressing insecticidal toxins derived from Bacillus thuringiensis (Bt) are widely used to control insect pests. The benefits of such crops would be lost if resistance to the toxins spread to a significant proportion of the pest population. The main resistance management method, mandatory in the US, is the high-dose/refuge strategy, requiring nearby refuges of toxin-free crops, and the use of toxin doses sufficiently high to kill not only wild type insects but also insects heterozygous for a resistance allele, thereby rendering the resistance functionally recessive. We propose that mass-release of harmless toxin-sensitive insects could substantially delay or even reverse the spread of resistance. Mass-release of such insects is an integral part of RIDL, a genetics-based method of pest control related to the Sterile Insect Technique. We used a population genetic mathematical model to analyze the effects of releasing male insects homozygous for a female-specific dominant lethal genetic construct, and concluded that this RIDL strategy could form an effective component of a resistance management scheme for insecticidal plants and other toxins. (author)

  5. Beta-Lactams combinations with Vancomycin provide synergy against VSSA, hVISA, and VISA.

    Science.gov (United States)

    Tran, Kieu-Nhi; Rybak, Michael J

    2018-03-19

    Background: Increasing utilization of vancomycin due to the high prevalence of methicillin-resistant S. aureus (MRSA) infections has lead to the emergence of vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA). In vitro data suggest the potential for potent synergy between several beta-lactams and vancomycin. The objective of this study is to evaluate the synergy between beta-lactams and vancomycin against MRSA that is vancomycin susceptible, vancomycin susceptible Staphylococcus aureus (VSSA), hVISA, and VISA. Methods: Fifty randomly selected clinical MRSA strains with varying susceptibility to vancomycin were evaluated for vancomycin alone and vancomycin in combination with varying concentrations of cefazolin (CFZ), cefepime (FEP), ceftaroline (CPT), and nafcillin (NAF) minimum inhibitory concentration (MIC). The potential for synergy was assessed by 24h time-kills. Results: Beta-lactams reduced vancomycin MIC values against all strains (4-16 fold reduction). In time-kill studies against MRSA, CFZ, FEP, CPT, and NAF all demonstrated a similar extent of killing at 24h, and all showed synergistic activity with vancomycin against VSSA, hVISA, and VISA. Each of these combinations was also superior to any single agent against isolates of all three phenotypes, and each was bactericidal (P synergy of vancomycin against these Staphylococcus strains. Copyright © 2018 American Society for Microbiology.

  6. Overcoming resistance against managed care - insights from a bargaining model.

    Science.gov (United States)

    Ehlert, Andree; Wein, Thomas; Zweifel, Peter

    2017-12-01

    Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed. In a "three-player/three-cake" game the coalitions {SHI, MCO}, {MCO, RI}, and {SHI, RI} can form. Players' possibility to switch between coalitions creates new outside options, causing the conventional bilateral Nash bargaining solution to be replaced by the so-called von Neumann-Morgenstern triple. These triples are compared to the status quo (where the RI has no threat potential) and related to institutional conditions characterizing Germany, the Netherlands, and Switzerland.

  7. Complex Interactions between Fungal Avirulence Genes and Their Corresponding Plant Resistance Genes and Consequences for Disease Resistance Management

    Directory of Open Access Journals (Sweden)

    Yohann Petit-Houdenot

    2017-06-01

    Full Text Available During infection, pathogens secrete an arsenal of molecules, collectively called effectors, key elements of pathogenesis which modulate innate immunity of the plant and facilitate infection. Some of these effectors can be recognized directly or indirectly by resistance (R proteins from the plant and are then called avirulence (AVR proteins. This recognition usually triggers defense responses including the hypersensitive response and results in resistance of the plant. R—AVR gene interactions are frequently exploited in the field to control diseases. Recently, the availability of fungal genomes has accelerated the identification of AVR genes in plant pathogenic fungi, including in fungi infecting agronomically important crops. While single AVR genes recognized by their corresponding R gene were identified, more and more complex interactions between AVR and R genes are reported (e.g., AVR genes recognized by several R genes, R genes recognizing several AVR genes in distinct organisms, one AVR gene suppressing recognition of another AVR gene by its corresponding R gene, two cooperating R genes both necessary to recognize an AVR gene. These complex interactions were particularly reported in pathosystems showing a long co-evolution with their host plant but could also result from the way agronomic crops were obtained and improved (e.g., through interspecific hybridization or introgression of resistance genes from wild related species into cultivated crops. In this review, we describe some complex R—AVR interactions between plants and fungi that were recently reported and discuss their implications for AVR gene evolution and R gene management.

  8. Managing the Risk of European Corn Borer Resistance to Transgenic Corn: An Assessment of Refuge Recommendations

    OpenAIRE

    Terrance M. Hurley; Silvia Secchi; Bruce A. Babcock

    1999-01-01

    The use of Genetically Modified Organisms (GMOs) in agriculture has been on the rise since 1995. Scientists have been working to develop a high-dose refuge management plan that can effectively delay European corn borer resistance to pesticidal GMO corn. This paper develops a stochastic agricultural production model to assess and provide insight into the reasons why refuge recommendations remain controversial.

  9. Resilience and resistance of sagebrush ecosystems: Implications for state and transition models and management treatments

    Science.gov (United States)

    Jeanne C. Chambers; Richard F. Miller; David I. Board; David A. Pyke; Bruce A. Roundy; James B. Grace; Eugene W. Schupp; Robin J. Tausch

    2014-01-01

    In sagebrush ecosystems invasion of annual exotics and expansion of pinon (Pinus monophylla Torr. and Frem.) and juniper (Juniperus occidentalis Hook., J. osteosperma [Torr.] Little) are altering fire regimes and resulting in large-scale ecosystem transformations. Management treatments aim to increase resilience to disturbance and enhance resistance to invasive species...

  10. FARMER DEMAND FOR CORN ROOTWORM BT CORN: DO INSECT RESISTANCE MANAGEMENT GUIDELINES MATTER?

    OpenAIRE

    Langrock, Ines; Hurley, Terrance M.; Ostlie, Kenneth

    2003-01-01

    Farmer adoption of Bt corn and compliance with insect resistance management (IRM) regulations will influence the success of these regulations. The purpose of this paper is to use farmer survey data to estimate the demand for new corn rootworm Bt corn and the cost of complying with proposed IRM regulations.

  11. Using epidemiological principles to explain fungicide resistance management tactics: why do mixtures outperform alternations?

    Science.gov (United States)

    Elderfield, James A; Lopez Ruiz, Fran; van den Bosch, Frank; Cunniffe, Nik J

    2018-01-29

    Whether fungicide resistance management is optimised by spraying chemicals with different modes of action as a mixture (i.e. simultaneously) or in alternation (i.e. sequentially) has been studied by experimenters and modellers for decades. However results have been inconclusive. We use previously-parameterised and validated mathematical models of wheat septoria leaf blotch and grapevine powdery mildew to test which tactic provides better resistance management, using the total yield before resistance causes disease control to become economically-ineffective ("lifetime yield") to measure effectiveness. We focus on tactics involving the combination of a low-risk and a high-risk fungicide, and the case in which resistance to the high-risk chemical is complete (i.e. in which there is no partial resistance). Lifetime yield is then optimised by spraying as much low-risk fungicide as is permitted, combined with slightly more high-risk fungicide than needed for acceptable initial disease control, applying these fungicides as a mixture. That mixture rather than alternation gives better performance is invariant to model parameterisation and structure, as well as the pathosystem in question. However if comparison focuses on other metrics, e.g. lifetime yield at full label dose, either mixture or alternation can be optimal. Our work shows how epidemiological principles can explain the evolution of fungicide resistance, and also highlights a theoretical framework to address the question of whether mixture or alternation provides better resistance management. It also demonstrates that precisely how spray tactics are compared must be given careful consideration.

  12. Insecticide resistance in disease vectors from Mayotte: an opportunity for integrated vector management.

    Science.gov (United States)

    Pocquet, Nicolas; Darriet, Frédéric; Zumbo, Betty; Milesi, Pascal; Thiria, Julien; Bernard, Vincent; Toty, Céline; Labbé, Pierrick; Chandre, Fabrice

    2014-07-01

    Mayotte, a small island in the Indian Ocean, has been affected for many years by vector-borne diseases. Malaria, Bancroftian filariasis, dengue, chikungunya and Rift Valley fever have circulated or still circulate on the island. They are all transmitted by Culicidae mosquitoes. To limit the impact of these diseases on human health, vector control has been implemented for more than 60 years on Mayotte. In this study, we assessed the resistance levels of four major vector species (Anopheles gambiae, Culex pipiens quinquefasciatus, Aedes aegypti and Aedes albopictus) to two types of insecticides: i) the locally currently-used insecticides (organophosphates, pyrethroids) and ii) alternative molecules that are promising for vector control and come from different insecticide families (bacterial toxins or insect growth regulators). When some resistance was found to one of these insecticides, we characterized the mechanisms involved. Larval and adult bioassays were used to evaluate the level of resistance. When resistance was found, we tested for the presence of metabolic resistance through detoxifying enzyme activity assays, or for target-site mutations through molecular identification of known resistance alleles. Resistance to currently-used insecticides varied greatly between the four vector species. While no resistance to any insecticides was found in the two Aedes species, bioassays confirmed multiple resistance in Cx. p. quinquefasciatus (temephos: ~ 20 fold and deltamethrin: only 10% mortality after 24 hours). In An. gambiae, resistance was scarce: only a moderate resistance to temephos was found (~5 fold). This resistance appears to be due only to carboxyl-esterase overexpression and not to target modification. Finally, and comfortingly, none of the four species showed resistance to any of the new insecticides. The low resistance observed in Mayotte's main disease vectors is particularly interesting, because it leaves a range of tools useable by vector control

  13. Active sensor synergy for arctic cloud microphysics

    Directory of Open Access Journals (Sweden)

    Sato Kaori

    2018-01-01

    Full Text Available In this study, we focus on the retrieval of liquid and ice-phase cloud microphysics from spaceborne and ground-based lidar-cloud radar synergy. As an application of the cloud retrieval algorithm developed for the EarthCARE satellite mission (JAXA-ESA [1], the derived statistics of cloud microphysical properties in high latitudes and their relation to the Arctic climate are investigated.

  14. Scientific Synergy between LSST and Euclid

    Science.gov (United States)

    Rhodes, Jason; Nichol, Robert C.; Aubourg, Éric; Bean, Rachel; Boutigny, Dominique; Bremer, Malcolm N.; Capak, Peter; Cardone, Vincenzo; Carry, Benoît; Conselice, Christopher J.; Connolly, Andrew J.; Cuillandre, Jean-Charles; Hatch, N. A.; Helou, George; Hemmati, Shoubaneh; Hildebrandt, Hendrik; Hložek, Renée; Jones, Lynne; Kahn, Steven; Kiessling, Alina; Kitching, Thomas; Lupton, Robert; Mandelbaum, Rachel; Markovic, Katarina; Marshall, Phil; Massey, Richard; Maughan, Ben J.; Melchior, Peter; Mellier, Yannick; Newman, Jeffrey A.; Robertson, Brant; Sauvage, Marc; Schrabback, Tim; Smith, Graham P.; Strauss, Michael A.; Taylor, Andy; Von Der Linden, Anja

    2017-12-01

    Euclid and the Large Synoptic Survey Telescope (LSST) are poised to dramatically change the astronomy landscape early in the next decade. The combination of high-cadence, deep, wide-field optical photometry from LSST with high-resolution, wide-field optical photometry, and near-infrared photometry and spectroscopy from Euclid will be powerful for addressing a wide range of astrophysical questions. We explore Euclid/LSST synergy, ignoring the political issues associated with data access to focus on the scientific, technical, and financial benefits of coordination. We focus primarily on dark energy cosmology, but also discuss galaxy evolution, transient objects, solar system science, and galaxy cluster studies. We concentrate on synergies that require coordination in cadence or survey overlap, or would benefit from pixel-level co-processing that is beyond the scope of what is currently planned, rather than scientific programs that could be accomplished only at the catalog level without coordination in data processing or survey strategies. We provide two quantitative examples of scientific synergies: the decrease in photo-z errors (benefiting many science cases) when high-resolution Euclid data are used for LSST photo-z determination, and the resulting increase in weak-lensing signal-to-noise ratio from smaller photo-z errors. We briefly discuss other areas of coordination, including high-performance computing resources and calibration data. Finally, we address concerns about the loss of independence and potential cross-checks between the two missions and the potential consequences of not collaborating.

  15. Predicting synergy in atomic layer etching

    Energy Technology Data Exchange (ETDEWEB)

    Kanarik, Keren J. [Lam Research Corp., Fremont, CA (United States); Tan, Samantha [Lam Research Corp., Fremont, CA (United States); Yang, Wenbing [Lam Research Corp., Fremont, CA (United States); Kim, Taeseung [Lam Research Corp., Fremont, CA (United States); Lill, Thorsten [Lam Research Corp., Fremont, CA (United States); Kabansky, Alexander [Lam Research Corp., Fremont, CA (United States); Hudson, Eric A. [Lam Research Corp., Fremont, CA (United States); Ohba, Tomihito [Lam Research Corp., Fremont, CA (United States); Nojiri, Kazuo [Lam Research Corp., Fremont, CA (United States); Yu, Jengyi [Lam Research Corp., Fremont, CA (United States); Wise, Rich [Lam Research Corp., Fremont, CA (United States); Berry, Ivan L. [Lam Research Corp., Fremont, CA (United States); Pan, Yang [Lam Research Corp., Fremont, CA (United States); Marks, Jeffrey [Lam Research Corp., Fremont, CA (United States); Gottscho, Richard A. [Lam Research Corp., Fremont, CA (United States)

    2017-03-27

    Atomic layer etching (ALE) is a multistep process used today in manufacturing for removing ultrathin layers of material. In this article, the authors report on ALE of Si, Ge, C, W, GaN, and SiO2 using a directional (anisotropic) plasma-enhanced approach. The authors analyze these systems by defining an “ALE synergy” parameter which quantifies the degree to which a process approaches the ideal ALE regime. This parameter is inspired by the ion-neutral synergy concept introduced in the 1979 paper by Coburn and Winters. ALE synergy is related to the energetics of underlying surface interactions and is understood in terms of energy criteria for the energy barriers involved in the reactions. Synergistic behavior is observed for all of the systems studied, with each exhibiting behavior unique to the reactant–material combination. By systematically studying atomic layer etching of a group of materials, the authors show that ALE synergy scales with the surface binding energy of the bulk material. This insight explains why some materials are more or less amenable to the directional ALE approach. Furthermore, they conclude that ALE is both simpler to understand than conventional plasma etch processing and is applicable to metals, semiconductors, and dielectrics.

  16. Synergy within a Scientific Research Centre

    Directory of Open Access Journals (Sweden)

    Paul Marinescu

    2014-05-01

    Full Text Available The analysis of the social-economic systems prove us that the whole is distinct from the sum of the parts. The concurrence of the components forming a system produces cumulated effects whose value exceeds the sum of effects of the components considered individually. Interactions at the level of parts help us understand the causes that sometimes generate spectacular outcomes of the system composing them. As a matter of fact, organizations exist because they mean more than the sum of the parts. Synergy facilitates precisely this pulling together of the members of an organization around a joint vision. From this perspective, we can connect organizational dynamics to the components of organizational culture. In this article, we aim at making a summary analysis of how synergy has intensifying effects by cooperation among the departments of CSOL-UB, but also between the latter and other entities: TEAM WORK,AERS, CARO, CAEN, SPHERAA SCHOOL, etc.Synergy analysis at the level of CSOL-UB leads us to the conclusion that cooperation among its departments generates benefits to the partners as well.

  17. Options for the management of antiviral resistance during hepatitis B therapy: reflections on battles over a decade.

    Science.gov (United States)

    Yim, Hyung Joon; Hwang, Seong Gyu

    2013-09-01

    Although much advancement has been achieved in the treatment of chronic hepatitis B, antiviral resistance is still a challenging issue. Previous generation antiviral agents have already developed resistance in a number of patients, and it is still being used especially in resource limited countries. Once antiviral resistance occurs, it predisposes to subsequent resistance, resulting in multidrug resistance. Therefore, prevention of initial antiviral resistance is the most important strategy, and appropriate choice and modification of therapy would be the cornerstone in avoiding treatment failures. Until now, management of antiviral resistance has been evolving from sequential therapy to combination therapy. In the era of tenofovir, the paradigm shifts again, and we have to decide when to switch and when to combine on the basis of newly emerging clinical data. We expect future eradication of chronic hepatitis B virus infection by proper prevention and optimal management of antiviral resistance.

  18. Neural synergies for controlling reach and grasp movement in macaques.

    Science.gov (United States)

    Hao, Yaoyao; Zhang, Shaomin; Zhang, Qiaosheng; Li, Guanglin; Chen, Weidong; Zheng, Xiaoxiang

    2017-08-15

    It has been suggested that the brain adopts a simplified strategy to coordinate a large number of degrees of freedom in motor control. Synergies have been proposed as a strategy to produce movements by recruitment of a small number of fixed modular patterns. However, there is no direct support for a synergistic organization of the brain itself. In this study, we recorded neural activities from the dorsal premotor cortex (PMd) of monkeys trained to reach and grasp differently shaped objects (grasping task) or the same object in different positions (reaching task). Non-negative matrix factorization (NNMF) was applied to the neural data to extract neural synergies, whose functional roles were verified in several ways. We found that motor cortex used similar neural synergies for grasping different objects; combining only a few of the synergies accounted for most of the variance in the original data. When used for single-trial task decoding, the synergy coefficients performed as well and robustly as the original data in both tasks. The synergy amplitudes for each unit were significantly correlated with the corresponding neuron's firing rate. In addition, we also observed synergies shared between tasks and task-specific synergies, as shown before for muscle synergies. Altogether, we demonstrated that neural synergies are effective in describing neural population activity during reach to grasp movements and provide a new tool for interpreting neural data for movement control. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  19. [Do different interpretative methods used for evaluation of checkerboard synergy test affect the results?].

    Science.gov (United States)

    Ozseven, Ayşe Gül; Sesli Çetin, Emel; Ozseven, Levent

    2012-07-01

    In recent years, owing to the presence of multi-drug resistant nosocomial bacteria, combination therapies are more frequently applied. Thus there is more need to investigate the in vitro activity of drug combinations against multi-drug resistant bacteria. Checkerboard synergy testing is among the most widely used standard technique to determine the activity of antibiotic combinations. It is based on microdilution susceptibility testing of antibiotic combinations. Although this test has a standardised procedure, there are many different methods for interpreting the results. In many previous studies carried out with multi-drug resistant bacteria, different rates of synergy have been reported with various antibiotic combinations using checkerboard technique. These differences might be attributed to the different features of the strains. However, different synergy rates detected by checkerboard method have also been reported in other studies using the same drug combinations and same types of bacteria. It was thought that these differences in synergy rates might be due to the different methods of interpretation of synergy test results. In recent years, multi-drug resistant Acinetobacter baumannii has been the most commonly encountered nosocomial pathogen especially in intensive-care units. For this reason, multidrug resistant A.baumannii has been the subject of a considerable amount of research about antimicrobial combinations. In the present study, the in vitro activities of frequently preferred combinations in A.baumannii infections like imipenem plus ampicillin/sulbactam, and meropenem plus ampicillin/sulbactam were tested by checkerboard synergy method against 34 multi-drug resistant A.baumannii isolates. Minimum inhibitory concentration (MIC) values for imipenem, meropenem and ampicillin/sulbactam were determined by the broth microdilution method. Subsequently the activity of two different combinations were tested in the dilution range of 4 x MIC and 0.03 x MIC in

  20. Organizational risk management of resistance to care episodes in health facilities.

    Science.gov (United States)

    Kable, Ashley; Guest, Maya; McLeod, Mary

    2012-09-01

    This article reports a study of organizational risk management approaches to resistance to care episodes in specific clinical areas: prevention measures, provision of subsequent support and follow-up by management and resultant organizational change. Resistance to care describes a patient's unwillingness to be assisted by healthcare staff and is manifested in defensive behaviours ranging from minor non-compliance/dissent to aggression. It has previously been studied in aged care settings and focused on patient behaviours and appropriate responses. This was a cross-sectional survey of a representative sample of nurses (n = 5044) who were members of the New South Wales Nurses' Association in Australia, in 2008-2009. Of 1132 participants, 80% reported being involved in resistance to care episodes during the previous month and this was higher in some settings. Episodes were not routinely reported internally, and often did not lead to organizational change. Nurses reported that talking with other staff was the most effective action in dealing with the consequences of these episodes. Half of the respondents considered that they were provided with sufficient support and follow-up after a resistance to care episode. Prevention measures and follow-up strategies adopted by employers varied across clinical settings. Resistance to care is not confined to aged care settings, and risk management of resistance to care can increase safety in the workplace. Preventive strategies such as increased staff, training and security should be focused on high risk clinical areas; and appropriate support, follow-up and organizational change instituted in response to these episodes. © 2011 Blackwell Publishing Ltd.

  1. The Impact of Volunteer Corn on Crop Yields and Insect Resistance Management Strategies

    Directory of Open Access Journals (Sweden)

    Paul T. Marquardt

    2013-06-01

    Full Text Available Volunteer corn (VC has reemerged as a problematic weed in corn/soybean rotational cropping systems. This reemergence and increasing prevalence of volunteer corn has been correlated to an increased adoption of herbicide-resistant (HR corn hybrids and the adoption of conservation tillage. Since the introduction of HR crops, control options, weed/crop competition, and other concerns (i.e., insect resistance management of Bt traits have increased the amount of attention that volunteer corn is receiving. The objective of this review is to discuss what is known about VC prior to and after the introduction of HR crops, and to discuss new information about this important weed.

  2. Synergy among rat T cells in the proliferative response to alloantigen

    International Nuclear Information System (INIS)

    Wright, P.W.; Loop, S.M.; Bernstein, I.D.

    1979-01-01

    A synergistic interaction in the proliferative response to alloantigen is described for mixtures of rat thymus and lymph node cells. The optimal conditions for synergy are quantitatively defined. Regression analysis of the slope of the dose-response curve has been utilized to estimate the degree of interaction in thymus--lymph node cell mixtures. The slope of the response of cell mixtures was noted to be significantly greater than the slope for the response of lympth node cells alone. Irradiation was shown to have a differential effect on the response of thymus and lymph node cells in mixtures. Irradiated thymus cells retained the capacity for synergy in mixtures, whereas irradiated lymph node cells did not. Additional studies have demonstrated that both de novo protein synthesis and specific antigen recognition by both responding cell populations in mixtures was required for maximal synergy. These studies demonstrate that synergy cannot be explained as an artifact of altered cell density in vitro. They establish that thymus cells and lymph node cells represent distinct subsets which manifest qualitatively different functions in the proliferative response to alloantigen. Thymus cells can respond directly to alloantigen by proliferation but also have the capacity to amplify the proliferative response of lymph node cells, a capacity which is resistant to X irradiation but requires recognition of alloantigen and de novo protein synthesis. Lymph node cells may similarly respond by proliferation to alloantigen but lack the amplifier activity of thymus cells. Synergy for rat lymphoidcells, like mouse lymphoid cells, has been shown to involve an interaction of thymus-derived lymphocytes

  3. Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

    Science.gov (United States)

    Sjölund-Karlsson, Maria; Gordon, Melita A.; Parry, Christopher M.

    2015-01-01

    SUMMARY Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica, initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015. PMID:26180063

  4. Evaluation and modeling of synergy to pheromone and plant kairomone in American palm weevil.

    Science.gov (United States)

    Saïd, Imen; Kaabi, Belhassen; Rochat, Didier

    2011-04-04

    Many behavioral responses to odors are synergistic, particularly in insects. In beetles, synergy often involves a pheromone and a plant odor, and pest management relies on them for the use of combined lures. To investigate olfactory synergy mechanisms, we need to distinguish synergistic effects from additive ones, when all components of the mixture are active. As versatile tools and procedures were not available, we developed a bioassay, and a mathematical model to evaluate synergy between aggregation pheromone (P) and host plant odors (kairomone: K) in the American palm weevil, a pest insect showing enhanced responses to P+K mixtures. Responses to synthetic P and natural K were obtained using a 4-arm olfactometer coupled to a controlled volatile delivery system. We showed that: (1) Response thresholds were ca. 10 and 100 pg/s respectively for P and K. (2) Both stimuli induced similar maximum response. (3) Increasing the dose decreased the response for P to the point of repellence and maintained a maximum response for K. (4) P and K were synergistic over a 100-fold range of doses with experimental responses to P+K mixtures greater than the ones predicted assuming additive effects. Responses close to maximum were associated with the mixture amounts below the response threshold for both P and K. These results confirm the role of olfactory synergy in optimizing active host-plant localization by phytophagous insects. Our evaluation procedure can be generalized to test synergistic or inhibitory integrated responses of various odor mixtures for various insects.

  5. Unprecedented Silver Resistance in Clinically Isolated Enterobacteriaceae: Major Implications for Burn and Wound Management.

    Science.gov (United States)

    Finley, Phillip J; Norton, Rhy; Austin, Cindy; Mitchell, Amber; Zank, Sara; Durham, Paul

    2015-08-01

    Increased utilization of inorganic silver as an adjunctive to many medical devices has raised concerns of emergent silver resistance in clinical bacteria. Although the molecular basis for silver resistance has been previously characterized, to date, significant phenotypic expression of these genes in clinical settings is yet to be observed. Here, we identified the first strains of clinical bacteria expressing silver resistance at a level that could significantly impact wound care and the use of silver-based dressings. Screening of 859 clinical isolates confirmed 31 harbored at least 1 silver resistance gene. Despite the presence of these genes, MIC testing revealed most of the bacteria displayed little or no increase in resistance to ionic silver (200 to 300 μM Ag(+)). However, 2 isolates (Klebsiella pneumonia and Enterobacter cloacae) were capable of robust growth at exceedingly high silver concentrations, with MIC values reaching 5,500 μM Ag(+). DNA sequencing of these two strains revealed the presence of genes homologous to known genetic determinants of heavy metal resistance. Darkening of the bacteria's pigment was observed after exposure to high silver concentrations. Scanning electron microscopy images showed the presence of silver nanoparticles embedded in the extracellular polymeric substance of both isolates. This finding suggested that the isolates may neutralize ionic silver via reduction to elemental silver. Antimicrobial testing revealed both organisms to be completely resistant to many commercially available silver-impregnated burn and wound dressings. Taken together, these findings provide the first evidence of clinical bacteria capable of expressing silver resistance at levels that could significantly impact wound management. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  6. Unprecedented Silver Resistance in Clinically Isolated Enterobacteriaceae: Major Implications for Burn and Wound Management

    Science.gov (United States)

    Norton, Rhy; Austin, Cindy; Mitchell, Amber; Zank, Sara; Durham, Paul

    2015-01-01

    Increased utilization of inorganic silver as an adjunctive to many medical devices has raised concerns of emergent silver resistance in clinical bacteria. Although the molecular basis for silver resistance has been previously characterized, to date, significant phenotypic expression of these genes in clinical settings is yet to be observed. Here, we identified the first strains of clinical bacteria expressing silver resistance at a level that could significantly impact wound care and the use of silver-based dressings. Screening of 859 clinical isolates confirmed 31 harbored at least 1 silver resistance gene. Despite the presence of these genes, MIC testing revealed most of the bacteria displayed little or no increase in resistance to ionic silver (200 to 300 μM Ag+). However, 2 isolates (Klebsiella pneumonia and Enterobacter cloacae) were capable of robust growth at exceedingly high silver concentrations, with MIC values reaching 5,500 μM Ag+. DNA sequencing of these two strains revealed the presence of genes homologous to known genetic determinants of heavy metal resistance. Darkening of the bacteria's pigment was observed after exposure to high silver concentrations. Scanning electron microscopy images showed the presence of silver nanoparticles embedded in the extracellular polymeric substance of both isolates. This finding suggested that the isolates may neutralize ionic silver via reduction to elemental silver. Antimicrobial testing revealed both organisms to be completely resistant to many commercially available silver-impregnated burn and wound dressings. Taken together, these findings provide the first evidence of clinical bacteria capable of expressing silver resistance at levels that could significantly impact wound management. PMID:26014954

  7. Resistance-resistant antibiotics.

    Science.gov (United States)

    Oldfield, Eric; Feng, Xinxin

    2014-12-01

    New antibiotics are needed because drug resistance is increasing while the introduction of new antibiotics is decreasing. We discuss here six possible approaches to develop 'resistance-resistant' antibiotics. First, multitarget inhibitors in which a single compound inhibits more than one target may be easier to develop than conventional combination therapies with two new drugs. Second, inhibiting multiple targets in the same metabolic pathway is expected to be an effective strategy owing to synergy. Third, discovering multiple-target inhibitors should be possible by using sequential virtual screening. Fourth, repurposing existing drugs can lead to combinations of multitarget therapeutics. Fifth, targets need not be proteins. Sixth, inhibiting virulence factor formation and boosting innate immunity may also lead to decreased susceptibility to resistance. Although it is not possible to eliminate resistance, the approaches reviewed here offer several possibilities for reducing the effects of mutations and, in some cases, suggest that sensitivity to existing antibiotics may be restored in otherwise drug-resistant organisms. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Use of an individual-based simulation model to explore and evaluate potential insecticide resistance management strategies.

    Science.gov (United States)

    Slater, Russell; Stratonovitch, Pierre; Elias, Jan; Semenov, Mikhail A; Denholm, Ian

    2017-07-01

    Tools with the potential to predict risks of insecticide resistance and aid the evaluation and design of resistance management tactics are of value to all sectors of the pest management community. Here we describe use of a versatile individual-based model of resistance evolution to simulate how strategies employing single and multiple insecticides influence resistance development in the pollen beetle, Meligethes aeneus. Under repeated exposure to a single insecticide, resistance evolved faster to a pyrethroid (lambda-cyhalothrin) than to a pyridine azomethane (pymetrozine), due to difference in initial efficacy. A mixture of these compounds delayed resistance compared to use of single products. The effectiveness of rotations depended on the sequence in which compounds were applied in response to pest density thresholds. Effectiveness of a mixture strategy declined with reductions in grower compliance. At least 50% compliance was needed to cause some delay in resistance development. No single strategy meets all requirements for managing resistance. It is important to evaluate factors that prevail under particular pest management scenarios. The model used here provides operators with a valuable means for evaluating and extending sound resistance management advice, as well as understanding needs and opportunities offered by new control techniques. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  9. Can Measured Synergy Excitations Accurately Construct Unmeasured Muscle Excitations?

    Science.gov (United States)

    Bianco, Nicholas A; Patten, Carolynn; Fregly, Benjamin J

    2018-01-01

    Accurate prediction of muscle and joint contact forces during human movement could improve treatment planning for disorders such as osteoarthritis, stroke, Parkinson's disease, and cerebral palsy. Recent studies suggest that muscle synergies, a low-dimensional representation of a large set of muscle electromyographic (EMG) signals (henceforth called "muscle excitations"), may reduce the redundancy of muscle excitation solutions predicted by optimization methods. This study explores the feasibility of using muscle synergy information extracted from eight muscle EMG signals (henceforth called "included" muscle excitations) to accurately construct muscle excitations from up to 16 additional EMG signals (henceforth called "excluded" muscle excitations). Using treadmill walking data collected at multiple speeds from two subjects (one healthy, one poststroke), we performed muscle synergy analysis on all possible subsets of eight included muscle excitations and evaluated how well the calculated time-varying synergy excitations could construct the remaining excluded muscle excitations (henceforth called "synergy extrapolation"). We found that some, but not all, eight-muscle subsets yielded synergy excitations that achieved >90% extrapolation variance accounted for (VAF). Using the top 10% of subsets, we developed muscle selection heuristics to identify included muscle combinations whose synergy excitations achieved high extrapolation accuracy. For 3, 4, and 5 synergies, these heuristics yielded extrapolation VAF values approximately 5% lower than corresponding reconstruction VAF values for each associated eight-muscle subset. These results suggest that synergy excitations obtained from experimentally measured muscle excitations can accurately construct unmeasured muscle excitations, which could help limit muscle excitations predicted by muscle force optimizations.

  10. Next-Generation Human Immunodeficiency Virus Sequencing for Patient Management and Drug Resistance Surveillance.

    Science.gov (United States)

    Noguera-Julian, Marc; Edgil, Dianna; Harrigan, P Richard; Sandstrom, Paul; Godfrey, Catherine; Paredes, Roger

    2017-12-01

    High-quality, simplified, and low-cost human immunodeficiency virus (HIV) drug resistance tests that are able to provide timely actionable HIV resistance data at individual, population, and programmatic levels are needed to confront the emerging drug-resistant HIV epidemic. Next-generation sequencing technologies embedded in automated cloud-computing analysis environments are ideally suited for such endeavor. Whereas NGS can reduce costs over Sanger sequencing, automated analysis pipelines make NGS accessible to molecular laboratories regardless of the available bioinformatic skills. They can also produce highly structured, high-quality data that could be examined by healthcare officials and program managers on a real-time basis to allow timely public health action. Here we discuss the opportunities and challenges of such an approach. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  11. Moving beyond resistance to restraint minimization: a case study of change management in aged care.

    Science.gov (United States)

    Johnson, Susan; Ostaszkiewicz, Joan; O'Connell, Beverly

    2009-01-01

    This case study describes a quality initiative to minimize restraint in an Australian residential aged care facility. The process of improving practice is examined with reference to the literature on implementation of research into practice and change management. The differences between planned and emergent approaches to change management are discussed. The concepts of resistance and attractors are explored in relation to our experiences of managing the change process in this initiative. The importance of the interpersonal interactions that were involved in facilitating the change process is highlighted. Recommendations are offered for dealing with change management processes in clinical environments, particularly the need to move beyond an individual mind-set to a systems-based approach for quality initiatives in residential aged care.

  12. Understanding successful resistance management: the European corn borer and Bt corn in the United States.

    Science.gov (United States)

    Siegfried, Blair D; Hellmich, Richard L

    2012-01-01

    The European corn borer, Ostrinia nubilalis Hübner (Lepidoptera: Crambidae) has been a major pest of corn and other crops in North America since its accidental introduction nearly a hundred years ago. Wide adoption of transgenic corn hybrids that express toxins from Bacillus thuringiensis, referred to as Bt corn, has suppressed corn borer populations and reduced the pest status of this insect in parts of the Corn Belt. Continued suppression of this pest, however, will depend on managing potential resistance to Bt corn, currently through the high-dose refuge (HDR) strategy. In this review, we describe what has been learned with regard to O. nubilalis resistance to Bt toxins either through laboratory selection experiments or isolation of resistance from field populations. We also describe the essential components of the HDR strategy as they relate to O. nubilalis biology and ecology. Additionally, recent developments in insect resistance management (IRM) specific to O. nubilalis that may affect the continued sustainability of this technology are considered.

  13. RESISTANCE TO CHANGE AND ERP IMPLEMENTATION SUCCESS: THE MODERATING ROLE OF CHANGE MANAGEMENT INITIATIVES

    OpenAIRE

    Zafar U. Ahmed; Imad Zbib; Sawaridass Arokiasamy; T. Ramayah; Lo May Chiun

    2006-01-01

    Enterprise Resource Planning (ERP) is a useful tool that builds strong capabilities, improves performance, supports better decision making, and provides competitive advantage for businesses. ERP aims to help the management by setting better business practices and equipping them with the right information to take timely decision. In any new technology implementation, one of the issues that need to be addressed is the resistance to change. Many implementations have failed due to strong resistan...

  14. Biomimetic microstructures for photonic and fluidic synergies

    Science.gov (United States)

    Vasileiou, Maria; Mpatzaka, Theodora; Alexandropoulos, Dimitris; Vainos, Nikolaos A.

    2017-08-01

    Nature-inspired micro- and nano-structures offer a unique platform for the development of novel synergetic systems combining photonic and microfluidic functionalities. In this context, we examine the paradigm of butterfly Vanessa cardui and develop artificial diffractive microstructures inspired by its natural designs. Softlithographic and nanoimprint protocols are developed to replicate surfaces of natural specimens. Further to their optical behavior, interphases tailored by such microstructures exhibit enhanced hydrophobic properties, as compared to their planar counterparts made of the same materials. Such synergies exploited by new design approaches pave the way to prospective optofluidic, lab-on-chip and sensing applications.

  15. A Novel Role for Raloxifene Nanomicelles in Management of Castrate Resistant Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Sebastien Taurin

    2014-01-01

    Full Text Available Of patients with castrate resistant prostate cancer (CRPC, less than 25–33% survive more than five years. Recent studies have implicated estrogen, acting either alone or synergistically with androgens in the development of castrate resistant prostate cancer. Several in vitro and in vivo studies, as well as a limited number of clinical trials, have highlighted the potential of selective estrogen receptor modulators, such as raloxifene (Ral for the treatment of castrate resistant prostate cancer. However, the poor oral bioavailability and metabolism of selective estrogen receptor modulators limit their efficiency in clinical application. To overcome these limitations, we have used styrene co-maleic acid (SMA micelle to encapsulate raloxifene. Compared to free drug, SMA-Ral micelles had 132 and 140% higher cytotoxicity against PC3 and DU 145 prostate cell lines, respectively. SMA-Ral effectively inhibits cell cycle progression, increases apoptosis, and alters the integrity of tumor spheroid models. In addition, the micellar system induced changes in expression and localization of estrogen receptors, epidermal growth factor receptor (EGFR, and downstream effectors associated with cell proliferation and survival. Finally, SMA-Ral treatment decreased migration and invasion of castrate resistant prostate cancer cell lines. In conclusion, SMA-Ral micelles can potentially benefit new strategies for clinical management of castrate resistant prostate cancer.

  16. Synergy between Security and Safeguards in Uranium Concentrate Export Control

    International Nuclear Information System (INIS)

    Soumana, T.

    2010-01-01

    This paper is a proposal to the government of Niger and all national institutions involved in the ISSAS and INSSERV Missions held in Niger to optimally coordinate they activities in nuclear field. It is essential to notice that Niger has significant nuclear activities, mainly in uranium prospecting, mining, milling, and export. In Niger, there are also many radioactive sources in non nuclear use. The safeguards agreement of Niger, infcirc/664, is in force since 16 February 2005 and its relating additional protocol since 2 May 2007. For the safeguards implementation in Niger, Government has requested to the IAEA an ISSAS Mission which was completed in February 2008. A main recommendation of this mission is to consider an overall plan for security measures and in this regards, an INSSERV Mission was completed in December 2008. Nuclear safeguards conclusions focus on correctness and completeness of declarations provided by operators. Nuclear security activities (prevention, detection and response) are useful contributions to confirm safeguards conclusions specially, a good detection strategy at national level can help to confirm the absence of undeclared activities in a country like Niger. Many governmental institutions are involved in nuclear activities and there are lacks of communication between them. Creating a synergy between safeguards and security can federate the mechanisms of control at national level and have impact in many aspects specially in (i) awareness of decision makers (ii) optimal use of the equipments (iii) organizing training activities and human resource management and (iv) designing national strategic plans. The institution which hosted the two IAEA consultative missions (Directorate of Peaceful Use of Nuclear Techniques-DUPTN for the ISSAS Mission and Civil Defence for INSSERV Mission) in consultation with other national institutions had to create a framework for this synergy. This framework must be submitted to the IAEA for observation and

  17. Synergy between verapamil and other multidrug-resistance ...

    Indian Academy of Sciences (India)

    4. Faculté de Pharmacie, 27, Boulevard Jean Moulin, 13385 Marseille, France; CNRS Délégation Régionale Languedoc-Roussillon, 34293 Montpellier, France; Faculté de Médecine Xavier -Bichat, 75870 Paris, France; Institut de Biologie ...

  18. Alberta industrial synergy CO2 programs initiative

    International Nuclear Information System (INIS)

    Yildirim, E.

    1998-01-01

    The various industrial sectors within Alberta produce about 350,000 tonnes of CO 2 per day. This presentation was concerned with how this large volume and high concentration of CO 2 can be used in industrial and agricultural applications, because every tonne of CO 2 used for such purposes is a tonne that does not end up in the atmosphere. There is a good potential for an industrial synergy between the producers and users of CO 2 . The Alberta Industrial Synergy CO 2 Programs Initiative was established to ultimately achieve a balance between the producers of CO 2 and the users of CO 2 by creating ways to use the massive quantities of CO 2 produced by Alberta's hydrocarbon-based economy. The Alberta CO 2 Research Steering Committee was created to initiate and support CO 2 programs such as: (1) CO 2 use in enhanced oil recovery, (2) creation of a CO 2 production inventory, (3) survey of CO 2 users and potential users, (4) investigation of process issues such as power generation, oil sands and cement manufacturing, and (5) biofixation by plants, (6) other disposal options (e.g. in depleted oil and gas reservoirs, in aquifers, in tailings ponds, in coal beds). The single most important challenge was identified as 'rationalizing the formation of the necessary infrastructure'. Failing to do that will greatly impede efforts directed towards CO 2 utilization

  19. Resilience and resistance of sagebrush ecosystems: implications for state and transition models and management treatments

    Science.gov (United States)

    Chambers, Jeanne C.; Miller, Richard F.; Board, David I.; Pyke, David A.; Roundy, Bruce A.; Grace, James B.; Schupp, Eugene W.; Tausch, Robin J.

    2014-01-01

    In sagebrush ecosystems invasion of annual exotics and expansion of piñon (Pinus monophylla Torr. and Frem.) and juniper (Juniperus occidentalis Hook., J. osteosperma [Torr.] Little) are altering fire regimes and resulting in large-scale ecosystem transformations. Management treatments aim to increase resilience to disturbance and enhance resistance to invasive species by reducing woody fuels and increasing native perennial herbaceous species. We used Sagebrush Steppe Treatment Evaluation Project data to test predictions on effects of fire vs. mechanical treatments on resilience and resistance for three site types exhibiting cheatgrass (Bromus tectorum L.) invasion and/or piñon and juniper expansion: 1) warm and dry Wyoming big sagebrush (WY shrub); 2) warm and moist Wyoming big sagebrush (WY PJ); and 3) cool and moist mountain big sagebrush (Mtn PJ). Warm and dry (mesic/aridic) WY shrub sites had lower resilience to fire (less shrub recruitment and native perennial herbaceous response) than cooler and moister (frigid/xeric) WY PJ and Mtn PJ sites. Warm (mesic) WY Shrub and WY PJ sites had lower resistance to annual exotics than cool (frigid to cool frigid) Mtn PJ sites. In WY shrub, fire and sagebrush mowing had similar effects on shrub cover and, thus, on perennial native herbaceous and exotic cover. In WY PJ and Mtn PJ, effects were greater for fire than cut-and-leave treatments and with high tree cover in general because most woody vegetation was removed increasing resources for other functional groups. In WY shrub, about 20% pretreatment perennial native herb cover was necessary to prevent increases in exotics after treatment. Cooler and moister WY PJ and especially Mtn PJ were more resistant to annual exotics, but perennial native herb cover was still required for site recovery. We use our results to develop state and transition models that illustrate how resilience and resistance influence vegetation dynamics and management options.

  20. Integrated Adaptive Scenarios for Ariculture: Synergies and Tradeoffs.

    Science.gov (United States)

    Malek, K.; Rajagopalan, K.; Adam, J. C.; Brady, M.; Stockle, C.; Liu, M.; Kruger, C. E.

    2017-12-01

    A wide variety of factors can drive adaptation of the agricultural production sector in response to climate change. Warming and increased growing season length can lead to adoption of newer plant varieties as well as increases in double cropping systems. Changes in expectations of drought frequency or economic factors could lead to adoption of new technology (such as irrigation technology or water trading systems) or crop choices with a view of reducing farm-level risk, and these choices can result in unintended system wide effects. These are all examples of producer adaptation decisions made with a long-term (multiple decades) view. In addition, producers respond to short-term (current year) shocks - such as drought events - through management strategies that include deficit irrigation, fallowing, nutrient management, and engaging in water trading. The effects of these short- and long-term decisions are not independent, and can drive or be driven by the other. For example, investment in new irrigation systems (long-term) can be driven by expectations of short-term crop productivity losses in drought years. Similarly, the capacity to manage for short-term shocks will depend on crop type and variety as well as adopted irrigation technologies. Our overarching objective is to understand the synergies and tradeoffs that exist when combining three potential long-term adaptation strategies and two short-term adaptation strategies, with a view of understanding the synergies and tradeoffs. We apply the integrated crop-hydrology modeling framework VIC-CropSyst, along with the water management module Yakima RiverWare to address these questions over our test area, the Yakima River basin. We consider adoption of a) more efficient irrigation technologies, slower growing crop varieties, and increased prevalence of double cropping systems as long-term adaptation strategies; and b) fallowing and deficit irrigation as short-term responses to droughts. We evaluate the individual and

  1. Tapping Geography's Potential for Synergy with Creative Instructional Approaches

    Science.gov (United States)

    Conway-Gomez, Kristen; Williams, Nikki; Atkinson-Palombo, Carol; Ahlqvist, Ola; Kim, Eje; Morgan, Miranda

    2011-01-01

    We define synergy, explain its importance within the context of rapidly changing academia, and provide examples of how geographic educators have used creative instructional approaches to create synergies. Both the content of geography and some of the instructional approaches used by geographic educators support the discipline's ability to deliver…

  2. Does Synergy Exist in Nursing? A Concept Analysis.

    Science.gov (United States)

    Witges, Kim A; Scanlan, Judith M

    2015-01-01

    The aim is to analyze the concept of synergy, particularly as the concept applies to teamwork, and determine if the concept has utility in improving the work environment for nurses. Tackling nursing shortages that result from a poor work environment is a priority for many nurse leaders. Producing synergy among teams may be an effective strategy in enhancing the work environment. However, the understanding of synergy and the ability to produce synergy among teams has been seldom highlighted or discussed within nursing literature. Walker and Avant's approach was used to guide this concept analysis of synergy. Literature searches involved databases (PsycInfo, Medline, Cumulative Index for Nursing and Allied Health Literature [CINAHL], and Scopus), Internet search engines (Google), and hand searches. The analysis suggests that synergy is an outcome of the successful collaboration of the following three attributes: group cohesion, the pursuit of a common goal, and the achievement of a positive gain, considerably more than what was thought possible by the group. The foundation for this accomplishment requires an underlying feeling of special importance, the acknowledgment of each member's role, and open communication and dialogue among members. Nursing leaders would benefit from a broader understanding of synergy, and the mindful application and utility of synergy as an outcome of effective teamwork among nurses. © 2014 Wiley Periodicals, Inc.

  3. In vitro synergy of polymyxins with other antibiotics for Acinetobacter baumannii: a systematic review and meta-analysis.

    Science.gov (United States)

    Ni, Wentao; Shao, Xiaodi; Di, Xiuzhen; Cui, Junchang; Wang, Rui; Liu, Youning

    2015-01-01

    In order to provide preliminary guidance for rational antibiotic combination therapy in the clinic, a systematic review and meta-analysis was performed to evaluate the in vitro synergistic activity of polymyxins combined with other antibiotics against Acinetobacter baumannii. An extensive literature search was undertaken without restriction according to region, publication type or language. All available in vitro synergy tests on antibiotic combinations consisting of polymyxins were included. The primary outcome assessed was the in vitro activity of combination therapy on bacterial kill or inhibition. In total, 70 published studies and 31 conference proceedings reporting testing of polymyxins in combination with 11 classes consisting of 28 antibiotic types against 1484 A. baumannii strains were included in the analysis. In time-kill studies, high in vitro synergy and bactericidal activity were found for polymyxins combined with several antibiotic classes such as carbapenems and glycopeptides. Carbapenems or rifampicin combination could efficiently suppress the development of colistin resistance and displayed a >50% synergy rate against colistin-resistant strains. Synergy rates of chequerboard microdilution and Etest methods in most antibiotic combinations were generally lower than those of time-kill assays. The benefits of these antibiotic combinations should be further demonstrated by well-designed clinical studies. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  4. Lack of evidence to support policy development for management of contacts of multidrug-resistant tuberculosis patients: two systematic reviews

    NARCIS (Netherlands)

    van der Werf, M. J.; Langendam, M. W.; Sandgren, A.; Manissero, D.

    2012-01-01

    BACKGROUND: Existing international guidelines provide different recommendations for the management of contacts of multidrug-resistant tuberculosis (MDR-TB) patients. OBJECTIVE: To conduct two systematic reviews with the aim of identifying chemoprophylactic approaches that are effective in contacts

  5. Antibiotic Resistance: New Challenge in the Management of Bacterial Eye Infections.

    Science.gov (United States)

    Talukder, A K; Sultana, Z; Jahan, I; Khanam, M; Rahman, M; Rahman, M F; Rahman, M B

    2017-01-01

    Ophthalmologists are still facing difficulties in managing bacterial eye infections. The study was designed for the isolation and identification of bacteria from infected eyes and observation of the sensitivity and resistant pattern. This cross sectional study was performed among 160 patients of suspected bacterial eye infection at Dr. K. Zaman BNSB Eye Hospital, Mymensingh and Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh from March, 2010 to June, 2014. After collection of the samples from suspected infected eyes, it was nourished into nutrient broth in shaking incubator for three hours and then cultured into nutrient agar media followed by Mannitol salt agar, MacConkey's agar and blood agar. Bacteria were categorized by colony characteristics and Gram staining. Antibiogram was performed by disc diffusion method on Mueller Hinton agar media. McFarland Equivalence Turbidity Standard was maintained. The efficacy of the drug was evaluated by measuring the diameter of the zone of inhibition surrounding the disc. Ten percent Staphylococcus species isolates was resistant to Gatifloxacin, Gentamicin, Tobramycin and Cloxacillin, 26.0% to Ciprofloxacin, 40.0% to Azythromycin and Moxifloxacin, 58.0% to Cefixime and 64.0% to Cephalexin. Methicillin resistant Staphylococcus aureus was 62.8%. About 24.0% Streptococcus species isolates was resistant to Gatifloxacin, 33.3% to Azythromycin, Ciprofloxacin, Gentamycin, Moxifloxacin and Tobramycin, 52.4% to Cefixime and 71.4% to Cephalexin. About 9.0% of Pseudomonas species was resistant to Gatifloxacin and Tobramycin, 14.7% to Ciprofloxacin, 26.5% to Cefixime, 29.4% to Gentamicin and Moxifloxacin, 44.1% to Azythromycin and 82.3% to Cephalexin and Cloxacillin. Rational use of antibiotics and proper attentions of concerned authorities are necessary to overcome the emergent ocular situation leaded by antibiotic resistant.

  6. In vitro testing of daptomycin plus rifampin againstmethicillin-resistant Staphylococcus aureus resistant to rifampin

    International Nuclear Information System (INIS)

    Khaswneh, Faisal A.; Ashcraft, Deborah S.; Pankey, George A.

    2008-01-01

    Objective was to test for synergy between daptomycin (DAP) and rifampin(RIF) against RIF-resistant methicillin-resistant Staphylococcus aureus(MRSA) isolates. Synergy testing using time-kill assay (TKA) was performed on6 clinically and genetically unique RIF-resistant MRSA isolates. The isolateswere identified out of 489 (1.2%) samples collected during April 2003 toAugust 2006, from patients at the Ochsner Medical Center in New Orleans,Louisiana, United States of America. Synergy testing of DAP plus RIF by TKAshowed that 5 isolates were different, but one isolate was antagonistic. Ourin-vitro study failed to demonstrate synergy between DAP plus RIF, againstour RIF-resistant MRSA isolates. Clinical failure of this combination shouldprompt the clinician to consider antagonism as one of the potential causes.(author)

  7. Trade-Off and Synergy among Ecosystem Services in the Guanzhong-Tianshui Economic Region of China.

    Science.gov (United States)

    Qin, Keyu; Li, Jing; Yang, Xiaonan

    2015-11-03

    Natural ecosystems provide society with important goods and services. With rapidly increasing populations and excessive utilization of natural resources, humans have been enhancing the production of some services at the expense of others. Although the need for certain trade-offs between conservation and development is urgent, having only a small number of efficient methods to assess such trade-offs has impeded progress. This study focuses on the evaluation of ecosystem services under different land use schemes. It reveals the spatial and temporal distributions of and changes in ecosystem services. Based on a correlation rate model and distribution mapping, the trade-offs and synergies of these ecosystem services can be found. Here, we also describe a new simple approach to quantify the relationships of every trade-off and synergy. The results show that all ecosystem services possess trade-offs and synergies in the study area. The trend of improving carbon sequestration and water interception indicate that these key ecosystem services have the strongest synergy. And the decrease in regional agricultural production and other services, except water yield, may be considered as trade-offs. The synergy between water yield and agricultural production was the most significant, while the trade-off between water interception and carbon sequestration was the most apparent, according to our interaction quantification model. The results of this study have implications for planning and monitoring the future management of natural capital and ecosystem services, and can be integrated into land use decision-making.

  8. Trade-Off and Synergy among Ecosystem Services in the Guanzhong-Tianshui Economic Region of China

    Science.gov (United States)

    Qin, Keyu; Li, Jing; Yang, Xiaonan

    2015-01-01

    Natural ecosystems provide society with important goods and services. With rapidly increasing populations and excessive utilization of natural resources, humans have been enhancing the production of some services at the expense of others. Although the need for certain trade-offs between conservation and development is urgent, having only a small number of efficient methods to assess such trade-offs has impeded progress. This study focuses on the evaluation of ecosystem services under different land use schemes. It reveals the spatial and temporal distributions of and changes in ecosystem services. Based on a correlation rate model and distribution mapping, the trade-offs and synergies of these ecosystem services can be found. Here, we also describe a new simple approach to quantify the relationships of every trade-off and synergy. The results show that all ecosystem services possess trade-offs and synergies in the study area. The trend of improving carbon sequestration and water interception indicate that these key ecosystem services have the strongest synergy. And the decrease in regional agricultural production and other services, except water yield, may be considered as trade-offs. The synergy between water yield and agricultural production was the most significant, while the trade-off between water interception and carbon sequestration was the most apparent, according to our interaction quantification model. The results of this study have implications for planning and monitoring the future management of natural capital and ecosystem services, and can be integrated into land use decision-making. PMID:26540068

  9. Evaluation of alternative tactics for management of insecticide-resistant horn flies (Diptera: Muscidae).

    Science.gov (United States)

    Steelman, C D; McNew, R W; Simpson, R B; Rorie, R W; Phillips, J M; Rosenkrans, C F

    2003-06-01

    A 3-yr study was conducted to determine the efficacy of tactics that could be used to manage populations of insecticide-resistant horn flies, Hematobia irritans irritans (L.). Insecticide spray, spot-on or pour-on formulations and two IGRs in bolus formulation, 1.3- and 3.2-ha pasture rotations on different rotation schedules, 0-50% Brahman breeding, selected fly-resistant cows, and a mechanical trap were evaluated singly and in combination. Concentration-mortality tests indicated that horn flies collected from cows used in the current study were significantly less susceptible to diazinon, coumaphos, and methoxychlor than horn flies from cows at the same locations previously used to determine baseline susceptibility. During the 3-yr study at the Southeast Research and Extension Center (SEREC), the IGR-bolus significantly reduced (P management treatments. All tactics and tactic-combinations used at SWREC on cattle having no Brahman breeding failed to significantly reduce insecticide-resistant horn fly numbers. However, the combination of Brahman breeding with the IGR-Bolus and mechanical trap significantly reduced horn fly numbers and resulted in significant increases in calf weaning weight. In addition, mean horn fly numbers decreased significantly as the percentage Brahman breeding increased with 50% Brahman breeding reducing horn fly numbers by 140 flies per cow. No significant difference was found between the mean fly numbers on the fly-resistant purebred group and the cows that had no Brahman breeding but received the IGR-Bolus or used the mechanical trap. The use of synergized zeta-cypermethrin pour-on treatment successfully complimented the use of IGR-bolus and mechanical traps in reducing insecticide-resistant horn fly numbers. Neither 1.3- nor 3.2-ha size paddocks and stocking rates used in the rotation graze regimens at SEREC and SWREC, respectively, significantly reduced horn fly numbers when compared with continuously grazed paddocks. Data indicated the

  10. The Relationship between Participative Management and Resistance to Change from the Perspective of Administrators at Educational Hospitals in Yazd, 2013

    Directory of Open Access Journals (Sweden)

    Elham Tayefi

    2016-10-01

    r = -0.325, and control and supervision (P = 0.01, r = -0.292 indicated an inverse significant correlation with resistance to change. Conclusion: According to the results of this study applying participative management could be an appropriate and beneficial strategy to reduce staff resistance to change.

  11. Improving management of resistant hypertension: Rationale and protocol for a cluster randomized trial addressing physician managers in primary care.

    Science.gov (United States)

    Weltermann, Birgitta; Viehmann, Anja; Kersting, Christine

    2016-03-01

    Resistant hypertension (RH) is defined as uncontrolled blood pressure (BP) despite ≥3 antihypertensive agents. It is estimated to account for 12-28% of all hypertensive patients. Despite a higher risk of cardiovascular events, hypertension therapy in these patients is often insufficient. In a previous study we successfully tested an evidence-based, physician manager-centered hypertension management. For this cluster randomized trial (CRT), a random sample of 102 German primary care practices will be randomized into two study arms (1:1). Physician managers and practice assistants of the intervention arm will participate in three-session medical education on hypertension management to implement 1) standardized diagnostic and therapeutic procedures for RH patients, 2) structured recall of patients with uncontrolled BP, and 3) teaching and supervision of RH patients on BP self-measurements. Practice tools are provided to facilitate implementation, e.g., how to distinguish true from pseudo RH and guideline-based medication selection. Physicians will specify guideline-algorithms for their practice to manage RH. A secured web-based peer-group exchange with hypertension specialists is offered to both professional groups. Physicians of both study arms will consecutively recruit patients with RH. BP will be measured by ambulatory BP monitoring at baseline and after 12 months. The primary endpoint is defined as treatment success with either normalized BP (24h<130/80 mmHg) and/or a reduction by ≥20 mmHg systolic and/or ≥10 mmHg diastolic. Secondary analyses will focus on changes in physicians' knowledge and practice routines. This CRT will determine the effectiveness of a physician manager-centered intervention on treatment success in high-risk patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Management of steroid resistant nephrotic syndrome in children with cyclosporine - a tertiary care centre experience

    International Nuclear Information System (INIS)

    Shah, S.S.H.; Akhtar, N.; Sunbleen, F.

    2015-01-01

    Objective: To observe the response and adverse effects of cyclosporine in combination with oral steroids for management of idiopathic steroid resistant nephrotic syndrome in pediatric patients. Methodology: It was an observational study conducted at Children Hospital, Lahore, Pakistan from March 2014 to June 2015. Forty normotensive patients of idiopathic steroid resistant nephrotic syndrome between one and twelve years of age with normal renal function were included in the study. Patients were prescribed cyclosporine with prednisolone and were followed to see the response and adverse effects of drugs. Results: Out of 40 patients, 20(50%) were males and 20(50%) females. Mesangioproliferative glomerulonephritis was found in 27(67.5%) patients followed by Focal segmental glomerulosclerosis in 9(22.5%) patients. Complete response was observed in 32(80%) children while partial response in 8(20%) patients at the end of six months. The most common adverse effects were cushingoid features seen in 26(65%) and cyclosporine related hypertrichosis in 34(85%). Conclusion: Management of idiopathic steroid resistant nephrotic syndrome in children with a combination of cyclosporine and prednisolone provided good results as response to treatment was seen in 80% patients. (author)

  13. Host Resistance and Chemical Control for Management of Sclerotinia Stem Rot of Soybean in Ohio.

    Science.gov (United States)

    Huzar-Novakowiski, Jaqueline; Paul, Pierce A; Dorrance, Anne E

    2017-08-01

    Recent outbreaks of Sclerotinia stem rot (SSR) of soybean in Ohio, along with new fungicides and cultivars with resistance to this disease, have led to a renewed interest in studies to update disease management guidelines. The effect of host resistance (in moderately resistant [MR] and moderately susceptible [MS] cultivars) and chemical control on SSR and yield was evaluated in 12 environments from 2014 to 2016. The chemical treatments evaluated were an untreated check, four fungicides (boscalid, picoxystrobin, pyraclostrobin, and thiophanate-methyl), and one herbicide (lactofen) applied at soybean growth stage R1 (early flowering) alone or at R1 followed by a second application at R2 (full flowering). SSR developed in 6 of 12 environments, with mean disease incidence in the untreated check of 2.5 to 41%. The three environments with high levels of SSR (disease incidence in the untreated check >20%) were used for further statistical analysis. There were significant effects (P soybean cultivar and chemical treatment on SSR levels. Significantly lower levels of SSR were observed in MR cultivars. Both boscalid and lactofen reduced SSR but did not increase yield. Pyraclostrobin increased SSR compared with the untreated check in the three environments with high levels of disease. In the six fields where SSR did not develop, chemical treatment did not increase yield, nor was the yield from the MR cultivar significantly different from the MS cultivar. For Ohio, MR cultivars alone were effective for management of SSR in soybean fields where this disease has historically occurred.

  14. Muscle synergy analysis in children with cerebral palsy

    Science.gov (United States)

    Tang, Lu; Li, Fei; Cao, Shuai; Zhang, Xu; Wu, De; Chen, Xiang

    2015-08-01

    Objective. To explore the mechanism of lower extremity dysfunction of cerebral palsy (CP) children through muscle synergy analysis. Approach. Twelve CP children were involved in this study, ten adults (AD) and eight typically developed (TD) children were recruited as a control group. Surface electromyographic (sEMG) signals were collected bilaterally from eight lower limb muscles of the subjects during forward walking at a comfortable speed. A nonnegative matrix factorization algorithm was used to extract muscle synergies. In view of muscle synergy differences in number, structure and symmetry, a model named synergy comprehensive assessment (SCA) was proposed to quantify the abnormality of muscle synergies. Main results. There existed larger variations between the muscle synergies of the CP group and the AD group in contrast with the TD group. Fewer mature synergies were recruited in the CP group, and many abnormal synergies specific to the CP group appeared. Specifically, CP children were found to recruit muscle synergies with a larger difference in structure and symmetry between two legs of one subject and different subjects. The proposed SCA scale demonstrated its great potential to quantitatively assess the lower-limb motor dysfunction of CP children. SCA scores of the CP group (57.00 ± 16.78) were found to be significantly less (p < 0.01) than that of the control group (AD group: 95.74 ± 2.04; TD group: 84.19 ± 11.76). Significance. The innovative quantitative results of this study can help us to better understand muscle synergy abnormality in CP children, which is related to their motor dysfunction and even the physiological change in their nervous system.

  15. Managing head lice in an era of increasing resistance to insecticides.

    Science.gov (United States)

    Downs, Anthony M R

    2004-01-01

    Head lice are present in all age groups, however, the peak age for infestation is 7-8 years and the incidence varies throughout the year with higher incidence during the winter. Different insecticides have been used over the past 60 years to manage this condition. There is now strong evidence of insecticide resistance established in many countries to such an extent that some of these chemicals have become obsolete. Resistance to some pediculicides can vary from country to country and region to region within a country. The lack of a local monitoring system of resistance patterns means that parents and pupils are hampered in making an informed decision regarding how to treat head lice. One should no longer assume that treatment failure is due to poor treatment compliance or re-infestation. Clear treatment guidelines drawn up by healthcare professionals with an interest in head lice and taking into account regional/national resistance patterns should be implemented. These guidelines should combine chemical and non-chemical approaches to treatment and be coordinated and regularly reviewed by local public health departments. Drug companies should be made to provide up-to-date efficacy of their products.

  16. Impact Of Merger And Acquisition On Debt Management Ratio: A Case Study In Malaysian Banking Sectors

    OpenAIRE

    Mohammad Talha; Abdullah Sallehhuddin

    2011-01-01

    This study based on efficiency theory of shareholders wealth maximization of acquisition principle attempted to investigate the debt management ratio of ten Malaysian anchor banks after undergoing mega merger and acquisition program which was completed in the year of 2000. As efficiency theory consists of three elements that are financial synergy, operation synergy and managerial synergy, the study will primarily focus its analysis on financial synergy (debt management). Using accounting tech...

  17. Nutritional management of insulin resistance in nonalcoholic fatty liver disease (NAFLD).

    Science.gov (United States)

    Conlon, Beth A; Beasley, Jeannette M; Aebersold, Karin; Jhangiani, Sunil S; Wylie-Rosett, Judith

    2013-10-11

    Nonalcoholic fatty liver disease (NAFLD) is an emerging global health concern. It is the most common form of chronic liver disease in Western countries, affecting both adults and children. NAFLD encompasses a broad spectrum of fatty liver disease, ranging from simple steatosis (NAFL) to nonalcoholic steatohepatitis (NASH), and is strongly associated with obesity, insulin resistance, and dyslipidemia. First-line therapy for NAFLD includes weight loss achieved through diet and physical activity. However, there is a lack of evidenced-based dietary recommendations. The American Diabetes Association's (ADA) recommendations that aim to reduce the risk of diabetes and cardiovascular disease may also be applicable to the NAFLD population. The objectives of this review are to: (1) provide an overview of NAFLD in the context of insulin resistance, and (2) provide a rationale for applying relevant aspects of the ADA recommendations to the nutritional management of NAFLD.

  18. Evaluating synergy between marbofloxacin and gentamicin in Pseudomonas aeruginosa strains isolated from dogs with otitis externa.

    Science.gov (United States)

    Jerzsele, Ákos; Pásztiné-Gere, Erzsébet

    2015-03-01

    The aim of this study was to determine antimicrobial susceptibility of Pseudomonas aeruginosa strains to marbofloxacin and gentamicin, and investigate the possible synergistic, additive, indifferent or antagonistic effects between the two agents. P. aeruginosa strains can develop resistance quickly against certain antibiotics if used alone, thus the need emerges to find synergistic combinations. A total of 68 P. aeruginosa strains isolated from dogs were examined. In order to describe interactions between marbofloxacin and gentamicin the checkerboard microdilution method was utilized. The MICs (minimum inhibitory concentrations) for marbofloxacin and gentamicin were in the range 0.25-64 mg/L and 0.25-32 mg/L, respectively. The combination of marbofloxacin and gentamicin was more effective with a MIC range of 0.031-8 mg/L and a MIC90 of 1 mg/L, compared to 16 mg/L for marbofloxacin alone and 8 mg/L for gentamicin alone. The FIC (fractional inhibitory concentration) indices ranged from 0.0945 (pronounced synergy) to 1.0625 (indifference). Synergy between marbofloxacin and gentamicin was found in 33 isolates. The mean FIC index is 0.546, which represents a partial synergistic/additive effect close to the full synergy threshold. In vitro results indicate that marbofloxacin and gentamicin as partially synergistic agents may prove clinically useful in combination therapy against P. aeruginosa infections. Although marbofloxacin is not used in the human practice, the interactions between fluoroquinolones and aminoglycosides may have importance outside the veterinary field.

  19. Implementation synergies that exploit situational knowledge strategically

    DEFF Research Database (Denmark)

    Quitzau, Maj-Britt; Petersen, Jens-Phillip

    This paper illustrates how strategic and situated forms of knowledge may increase capacity to implement energy strategies in local urban development projects. Through analysis of front runner implementation projects, we show that the involved planners utilize situational learning processes...... strategically to develop more viable implementation trajectories. These findings resonate well with relational and network orienteered research in contemporary planning theory. In the selected case studies, we can see that planners deliberately seek to extend traditional planning approaches, like e.......g. regulation, with broader context‐specific learning processes. In doing so, we argue that – what we call – an implementation synergy is established by interlacing different forms of situational knowledge with strategic knowledge about how to reach a desired energy target. In conclusion, the paper identifies...

  20. Pedagogical Synergy: Linking Assessment, Curriculum, and Instruction

    Directory of Open Access Journals (Sweden)

    Caro Rolheiser

    2010-05-01

    Full Text Available This paper describes the evolution of attempts to build coherence and capacity in an Ontario school district, focusing on the development of literacy strategies in all of the district’s elementary and secondary schools. In reviewing case studies in four elementary schools, the authors have identified three key elements (instruction, curriculum, and assessment as the key dimensions which have the greatest influence on student achievement. The authors of this paper present a new construct, pedagogical synergy, in which those three elements are combined. Improvements can occur at both the district and school levels when there are horizontal and reciprocal strategies for building capacity and increasing coherence. It is the mutual support between district and schools that provides the power in this new concept.

  1. In-host adaptation and acquired triazole resistance in Aspergillus fumigatus: a dilemma for clinical management.

    Science.gov (United States)

    Verweij, Paul E; Zhang, Jianhua; Debets, Alfons J M; Meis, Jacques F; van de Veerdonk, Frank L; Schoustra, Sijmen E; Zwaan, Bas J; Melchers, Willem J G

    2016-11-01

    Aspergillus fumigatus causes a range of diseases in human beings, some of which are characterised by fungal persistence. A fumigatus can persist by adapting to the human lung environment through physiological and genomic changes. The physiological changes are based on the large biochemical versatility of the fungus, and the genomic changes are based on the capacity of the fungus to generate genetic diversity by spontaneous mutations or recombination and subsequent selection of the genotypes that are most adapted to the new environment. In this Review, we explore the adaptation strategies of A fumigatus in relation to azole resistance selection and the clinical implications thereof for management of diseases caused by Aspergillus spp. We hypothesise that the current diagnostic tools and treatment strategies do not take into account the biology of the fungus and might result in an increased likelihood of fungal persistence in patients. Stress factors, such as triazole exposure, cause mutations that render resistance. The process of reproduction-ie, sexual, parasexual, or asexual-is probably crucial for the adaptive potential of Aspergillus spp. As any change in the environment can provoke adaptation, switching between triazoles in patients with chronic pulmonary aspergillosis might result in a high-level pan-triazole-resistant phenotype through the accumulation of resistance mutations. Alternatively, when triazole therapy is stopped, an azole-free environment is created that could prompt selection for compensatory mutations that overcome any fitness costs that are expected to accompany resistance development. As a consequence, starting, switching, and stopping azole therapy has the risk of selecting for highly resistant strains with wildtype fitness. A similar adaptation is expected to occur in response to other stress factors, such as endogenous antimicrobial peptides; over time the fungus will become increasingly adapted to the lung environment, thereby limiting

  2. Facilitating Inter-Domain Synergies in Ambient Assisted Living Environments.

    Science.gov (United States)

    Schwartze, Jonas; Schrom, Harald; Wolf, Klaus-Hendrik; Marschollek, Michael

    2016-01-01

    Current Ambient Assisted Living (AAL) environments lack integration of sensors and actuators of other sub-domains. Creating technical and organizational integration is addressed by the BASIS project (Build Automation by a Scalable and Intelligent System), which aims to build a cross-domain home bus system. The main objective of this paper is to present an overview of design, architecture and state of realization of BASIS by describing the requirements development process, underlying hardware design and software architecture. We built a distributed system of one independent building manager with several redundantly meshed segment controllers, each controlling a bus segment with any number of bus nodes. The software system layer is divided into logical partitions representing each sub-domain. Structured data storage is possible with a special FHIR based home centered data warehouse. The system has been implemented in six apartments running under daily living conditions. BASIS integrates a broad range of sub-domains, which poses challenges to all project partners in terms of a common terminology, and project management methods, but enables development of inter-domain synergies like using the same sensor and actuator hardware for a broad range of services and use cases.

  3. Ginger phytochemicals exhibit synergy to inhibit prostate cancer cell proliferation

    Science.gov (United States)

    Brahmbhatt, Meera; Gundala, Sushma R.; Asif, Ghazia; Shamsi, Shahab A; Aneja, Ritu

    2014-01-01

    Dietary phytochemicals offer non-toxic therapeutic management as well as chemopreventive intervention for slow-growing prostate cancers. However, the limited success of several single-agent clinical trials suggest a paradigm shift that the health benefits of fruits and vegetables are not ascribable due to individual phytochemicals rather may be ascribed to but to synergistic interactions among them. We recently reported growth-inhibiting and apoptosis-inducing properties of ginger extract (GE) in in vitro and in vivo prostate cancer models. Nevertheless, the nature of interactions among the constituent ginger biophenolics, viz. 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogoal, remains elusive. Here we show antiproliferative efficacy of the most-active GE biophenolics as single-agents and in binary combinations, and investigate the nature of their interactions using the Chou-Talalay combination-index (CI) method. Our data demonstrate that binary combinations of ginger phytochemicals synergistically inhibit proliferation of PC-3 cells with CI values ranging from 0.03-0.88. To appreciate synergy among phytochemicals present in GE, the natural abundance of ginger biophenolics was quantitated using LC-UV/MS. Interestingly, combining GE with its constituents (in particular, 6-gingerol) resulted in significant augmentation of GE’s antiproliferative activity. These data generate compelling grounds for further preclinical evaluation of GE alone and in combination with individual ginger biophenols for prostate cancer management. PMID:23441614

  4. Direct costs of managing adverse drug reactions during rifampicin-resistant tuberculosis treatment in South Africa.

    Science.gov (United States)

    Schnippel, K; Firnhaber, C; Berhanu, R; Page-Shipp, L; Sinanovic, E

    2018-04-01

    To estimate the provider costs of managing adverse drug reactions (ADRs) to standard long-course treatment for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) according to South African guidelines. We parameterised a published Markov health state model for MDR/RR-TB with guidelines-based, bottom-up public-sector provider costing of ADR management. Frequency of ADR occurrence was extracted from the literature. Costs were estimated over 10 years, discounted 3% annually and tested using probabilistic sensitivity analysis. On average, guidelines-based costing of moderate ADRs weighted by the frequency of occurrence was US$135.76 (standard deviation [SD] US$17.18) and the cost of serious ADRs was US$521.29 (SD US$55.99). We estimated that the incremental costs of ADR management were US$380.17 annually per patient initiating MDR/RR-TB treatment. The incremental costs of ADR management for the public health sector in South Africa was US$4.76 million, 8.3% of the estimated cohort costs of MDR/RR-TB treatment ($57.55 million) for the 2015 cohort of 12 527 patients. Management of multiple ADRs and serious ADRs, which are common during the first 6 months of standard, long-course MDR/RR-TB treatment, substantially increases provider treatment costs. These results need to be taken into account when comparing regimen costs, and highlight the urgent need to identify drug regimens with improved safety profiles.

  5. Synergy as a rationale for phage therapy using phage cocktails.

    Science.gov (United States)

    Schmerer, Matthew; Molineux, Ian J; Bull, James J

    2014-01-01

    Where phages are used to treat bacterial contaminations and infections, multiple phages are typically applied at once as a cocktail. When two or more phages in the cocktail attack the same bacterium, the combination may produce better killing than any single phage (synergy) or the combination may be worse than the best single phage (interference). Synergy is of obvious utility, especially if it can be predicted a priori, but it remains poorly documented with few examples known. This study addresses synergy in which one phage improves adsorption by a second phage. It first presents evidence of synergy from an experimental system of two phages and a mucoid E. coli host. The synergy likely stems from a tailspike enzyme produced by one of the phages. We then offer mathematical models and simulations to understand the dynamics of synergy and the enhanced magnitude of bacterial control possible. The models and observations complement each other and suggest that synergy may be of widespread utility and may be predictable from easily observed phenotypes.

  6. How valid are claims for synergy in published clinical studies?

    Science.gov (United States)

    Ocana, A; Amir, E; Yeung, C; Seruga, B; Tannock, I F

    2012-08-01

    Clinical trials evaluating drug combinations are often stimulated by claims of synergistic interactions in preclinical models. Overuse or misuse of the term synergy could lead to poorly designed clinical studies. We searched PubMed using the terms 'synergy' or 'synergistic' and 'cancer' to select articles published between 2006 and 2010. Eligible studies were those that referred to synergy in preclinical studies to justify a drug combination evaluated in a clinical trial. Eighty-six clinical articles met eligibility criteria and 132 preclinical articles were cited in them. Most of the clinical studies were phase I (43%) or phase II trials (56%). Appropriate methods to evaluate synergy in preclinical studies included isobologram analysis in 18 studies (13.6%) and median effect in 10 studies (7.6%). Only 26 studies using animal models (39%) attempted to evaluate therapeutic index. There was no association between the result of the clinical trial and the use of an appropriate method to evaluate synergy (P=0.25, chi-squared test). Synergy is cited frequently in phase I and phase II studies to justify the evaluation of a specific drug combination. Inappropriate methods for evaluation of synergy and poor assessment of therapeutic index have been used in most preclinical articles.

  7. Preliminary Favorable Outcome for Medically and Surgically Managed Extensively Drug-Resistant Tuberculosis, France, 2009-2014.

    Science.gov (United States)

    Henry, Benoît; Revest, Matthieu; Dournon, Nathalie; Epelboin, Loïc; Mellon, Guillaume; Bellaud, Guillaume; Mordant, Pierre; Le Dû, Damien; Véziris, Nicolas; Bernard, Christine; Morel, Sébastien; Jauréguiberry, Stéphane; Michelet, Christian; Bricaire, Françcois; Tattevin, Pierre; Caumes, Éric

    2016-03-01

    We report 20 cases of extensively drug-resistant tuberculosis managed in France. Treatment was individualized and included bedaquiline and linezolid for most patients and surgery in 8 patients. At last follow-up (22 months), 19 patients had achieved conversion from positive to negative on culture testing. These promising results of comprehensive management obtained in a small series deserve confirmation.

  8. Preliminary Favorable Outcome for Medically and Surgically Managed Extensively Drug-Resistant Tuberculosis, France, 2009–2014

    Science.gov (United States)

    Henry, Benoît; Revest, Matthieu; Dournon, Nathalie; Epelboin, Loïc; Mellon, Guillaume; Bellaud, Guillaume; Mordant, Pierre; Le Dû, Damien; Véziris, Nicolas; Bernard, Christine; Morel, Sébastien; Jauréguiberry, Stéphane; Michelet, Christian; Bricaire, François; Caumes, Éric

    2016-01-01

    We report 20 cases of extensively drug-resistant tuberculosis managed in France. Treatment was individualized and included bedaquiline and linezolid for most patients and surgery in 8 patients. At last follow-up (22 months), 19 patients had achieved conversion from positive to negative on culture testing. These promising results of comprehensive management obtained in a small series deserve confirmation. PMID:26891089

  9. Management of Severe Insulin Resistance in Patients with Type 1 Diabetes.

    Science.gov (United States)

    Schechter, Rebecca; Reutrakul, Sirimon

    2015-10-01

    Managing severe insulin resistance (IR) in patients with type 1 diabetes (T1DM) can be challenging for both clinicians and patients. As average weight for patients with T1DM has increased in recent decades, IR in this population has become more widespread. Currently, almost 50 % of patients with T1DM are overweight or obese. While intensive insulin therapy is associated with reduction in complications, aggressive treatment can lead to weight gain. With increasing weight, insulin can become less effective to control glycemia, resulting in higher insulin doses and hence more weight gain. Novel strategies to break this vicious cycle are needed. This review will investigate current research on insulin formulations, lifestyle modification, adjunct therapies, and surgery that may help better manage patients with T1DM and IR.

  10. Role of resveratrol in the management of insulin resistance and related conditions: Mechanism of action.

    Science.gov (United States)

    Abbasi Oshaghi, Ebrahim; Goodarzi, Mohammad Taghi; Higgins, Victoria; Adeli, Khosrow

    2017-06-01

    Resveratrol (RES), a well-known antioxidant, is present in numerous plant species and, as a result, is easily obtained through dietary intake of plant-based foods and beverages. Several studies suggest that RES has anti-carcinogenic, anti-microbial, and anti-viral effects. It may also have beneficial metabolic properties that result in mitigation of insulin resistance (IR) and related metabolic abnormalities, including dyslipidemia, hyperglycemia, and hyperinsulinemia through regulation of gene expression or the activity of rate-limiting enzymes. A large body of evidence supports the beneficial effects of RES in the management and treatment of IR, type 2 diabetes, and related complications through a multitude of mechanisms. This review article focuses on the mechanisms of action of RES, the mechanisms leading to improved insulin sensitivity, and its clinical role in the management and treatment of type 2 diabetes.

  11. Fundamentals and Catalytic Innovation: The Statistical and Data Management Center of the Antibacterial Resistance Leadership Group.

    Science.gov (United States)

    Huvane, Jacqueline; Komarow, Lauren; Hill, Carol; Tran, Thuy Tien T; Pereira, Carol; Rosenkranz, Susan L; Finnemeyer, Matt; Earley, Michelle; Jiang, Hongyu Jeanne; Wang, Rui; Lok, Judith; Evans, Scott R

    2017-03-15

    The Statistical and Data Management Center (SDMC) provides the Antibacterial Resistance Leadership Group (ARLG) with statistical and data management expertise to advance the ARLG research agenda. The SDMC is active at all stages of a study, including design; data collection and monitoring; data analyses and archival; and publication of study results. The SDMC enhances the scientific integrity of ARLG studies through the development and implementation of innovative and practical statistical methodologies and by educating research colleagues regarding the application of clinical trial fundamentals. This article summarizes the challenges and roles, as well as the innovative contributions in the design, monitoring, and analyses of clinical trials and diagnostic studies, of the ARLG SDMC. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  12. Fiscal 1997 achievement report. Research and development of synergy ceramics; 1997 nendo synergy ceramics no kenkyu kaihatsu seika hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    Research and development is conducted on two subjects, that is, 1) hyper organized structure control technology and 2) structural element control technology. In addition, joint research and development is conducted on the creation of new materials by hyper organized structure controlling, hyper organized structure controlling for ceramics by a structurization reaction process, designing of precursors to ceramics, and the hyper organized structure control for ceramics by nanostructure process control. The joint research and development endeavors further deal with re-entrusted projects which involve researches on sintered structure control by powdery particulate structure control; dynamic process of synergy ceramics; oxynitride liquids, glasses, and glass-ceramics; and multifunctional ceramic laminates for engineering applications. Under subject 1), researches are made on the development of precursors into ceramics by utilizing chemical reactions of organic metal compounds, and analyses are conducted into the effects, exerted by the molecular structures of precursors and the conditions of a reaction for their development into ceramics, on the microstructures and various properties of the ceramics to be composed. Under subject 2), high strength, great hardness, and high resistance to wear are realized by allowing the precipitation of nano-particulates in crystals of a fine and very compact sintered body of alumina. (NEDO)

  13. Evaluation and management of the patient with difficult-to-control or resistant hypertension.

    Science.gov (United States)

    Viera, Anthony J; Hinderliter, Alan L

    2009-05-15

    High blood pressure is often difficult to control. Resistant hypertension is blood pressure above goal despite adherence to a combination of at least three antihypertensive medications of different classes, optimally dosed and usually including a diuretic. The approach to blood pressure that is apparently difficult to control begins with an assessment of the patient's adherence to the management plan, including lifestyle modifications and medications. White-coat hypertension may need to be ruled out. Suboptimal therapy is the most common reason for failure to reach the blood pressure goal. Once-daily fixed-dose combination pills may improve control through the synergism of antihypertensive agents from different classes and improved adherence. Truly drug-resistant hypertension is commonly caused by chronic kidney disease, obstructive sleep apnea, or hyperaldosteronism, all of which can lead to fluid retention. Higher doses of diuretics (or a change to a loop diuretic) are usually needed. Other strategies include adding an alpha blocker, alpha-beta blocker, clonidine, or an aldosterone antagonist (e.g., spironolactone). Particularly in patients with diabetes or renal disease, combining a long-acting nondihydropyridine with a dihydropyridine calcium channel . blocker can also be considered. Obesity, heavy alcohol intake, high levels of dietary sodium, and interfering substances (especially nonsteroidal anti-inflammatory drugs) contribute to hypertension that is resistant or difficult to control.

  14. Resistance Management for Asian Citrus Psyllid, Diaphorina citri Kuwayama, in Florida

    Directory of Open Access Journals (Sweden)

    Xue Dong Chen

    2017-09-01

    Full Text Available The Asian citrus psyllid, Diaphorina citri Kuwayma, is one of the most important pests in citrus production. The objective of this study was to evaluate D. citri resistance management with three insecticide rotations and compare them with no rotation and an untreated check. The different insecticides (modes of action tested were: dimethoate, imidacloprid, diflubenzuron, abamectin 3% + thiamethoxam 13.9%, and fenpropathrin. Eggs, nymph, and adult psyllids were counted weekly. Five insecticide applications were made in 2016. Insecticide susceptibility was determined by direct comparison with a laboratory susceptible population and field populations before and after all treatments were applied. Rankings of eggs, nymphs, and adults counted in treated plots were significantly lower than in the untreated control plots after each application. Initially, the resistance ratio (RR50 for each rotation model, as compared with laboratory susceptible strain and the field population before application, was less than 5.76 and 4.31, respectively. However, after five applications with dimethoate, the RR50 using the laboratory and pre-treatment field populations was 42.34 and 34.74, respectively. Our results indicate that effectively rotating modes of action can delay and/or prevent development of insecticide resistance in populations of D. citri.

  15. MATHEMATICAL EVALUATION OF SYNERGY, FLEXIBILITY, SERVICE AND MOBILITY IN EDUCATIONAL SYSTEMS

    Directory of Open Access Journals (Sweden)

    A. S. Mikhalev

    2011-01-01

    Full Text Available The paper shows how applying an analogy method it is possible to describe complicated hierarchic educational systems while using such robotics notions as «synergy», «flexibility», «service» and «mobility» which are well developed and filled with mathematical content. It has been shown that the indicated notions positively supplement terminology and main principles of organizational designing, system analysis and an idea of staff management while using mathematical knowledge-activity personnel models in order to form and manage innovation projects. 

  16. Molecular detection of rifampin and isoniazid resistance to guide chronic TB patient management in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Pinsi Gabriele

    2009-08-01

    Full Text Available Abstract Background Drug-resistant tuberculosis (DR-TB is considered a real threat to the achievement of TB control. Testing of mycobacterial culture and testing of drug susceptibility (DST capacity are limited in resource-poor countries, therefore inadequate treatment may occur, favouring resistance development. We evaluated the molecular assay GenoType® MTBDRplus (Hain Lifescience, Germany in order to detect DR-TB directly in clinical specimens as a means of providing a more accurate management of chronic TB patients in Burkina Faso, a country with a high TB-HIV co-infection prevalence. Methods Samples were collected in Burkina Faso where culture and DST are not currently available, and where chronic cases are therefore classified and treated based on clinical evaluation and sputum-smear microscopy results. One hundred and eight chronic TB patients (sputum smear-positive, after completing a re-treatment regimen for pulmonary TB under directly observed therapy were enrolled in the study from December 2006 to October 2008. Two early morning sputum samples were collected from each patient, immediately frozen, and shipped to Italy in dry ice. Samples were decontaminated, processed for smear microscopy and DNA extraction. Culture was attempted on MGIT960 (Becton Dickinson, Cockeysville, USA and decontaminated specimens were analyzed for the presence of mutations conferring resistance to rifampin and isoniazid by the molecular assay GenoType® MTBDRplus. Results We obtained a valid molecular test result in 60/61 smear-positive and 47/47 smear-negative patients. Among 108 chronic TB cases we identified patients who (i harboured rifampin- and isoniazid-susceptible strains (n 24, (ii were negative for MTB complex DNA (n 24, and (iii had non-tuberculous mycobacteria infections (n 13. The most represented mutation conferring rifampin-resistance was the D516V substitution in the hotspot region of the rpoB gene (43.8% of cases. Other mutations recognized

  17. Managing resistance in cognitive behavioural therapy: the application of motivational interviewing in mixed anxiety and depression.

    Science.gov (United States)

    Westra, Henny A

    2004-01-01

    While cognitive behavioural therapy is highly effective in the treatment of anxiety and depression, a substantive number of individuals either refuse treatment, fail to respond to treatment or respond only partially. Arguably, ambivalence about change or about engaging in treatment tasks may in part be related to incomplete recovery rates in cognitive behavioural therapy. Motivational interviewing is a client-centred, directive treatment originally developed in the addictions domain whose goal is to enhance motivation for change by understanding and resolving ambivalence. This method has consistently received support for enhancing outcomes in the addictions domain, particularly when used as an adjunct to further treatment. As yet, motivational methods have not been generalized to the treatment of prevalent mental health problems, such as anxiety and depression. The present paper presents the application of a treatment targeting motivation (motivational interviewing adapted for anxiety and depression) to the management of resistance in cognitive behavioural therapy for 3 clients with mixed anxiety and depression. Motivational interviewing is conceived as an adjunct to highly effective traditional cognitive behavioural therapy methods, which is indicated for use with clients resistant to and significantly ambivalent about change-based techniques for managing anxiety or alleviating depression.

  18. Performance and cross-crop resistance of Cry1F-maize selected Spodoptera frugiperda on transgenic Bt cotton: implications for resistance management.

    Science.gov (United States)

    Yang, Fei; Kerns, David L; Brown, Sebe; Kurtz, Ryan; Dennehy, Tim; Braxton, Bo; Head, Graham; Huang, Fangneng

    2016-06-15

    Transgenic crops producing Bacillus thuringiensis (Bt) proteins have become a primary tool in pest management. Due to the intensive use of Bt crops, resistance of the fall armyworm, Spodoptera frugiperda, to Cry1F maize has occurred in Puerto Rico, Brazil, and some areas of the southeastern U.S. The sustainability of Bt crops faces a great challenge because the Cry1F-maize resistant S. frugiperda may also infest other Bt crops in multiple cropping ecosystems. Here we examined the survival and plant injury of a S. frugiperda population selected with Cry1F maize on three single-gene and five pyramided Bt cotton products. Larvae of Cry1F-susceptible (SS), -heterozygous (RS), and -resistant (RR) genotypes of S. frugiperda were all susceptible to the pyramided cotton containing Cry1Ac/Cry2Ab, Cry1Ac/Cry1F/Vip3A, Cry1Ab/Cry2Ae, or Cry1Ab/Cry2Ae/Vip3A, and the single-gene Cry2Ae cotton. Pyramided cotton containing Cry1Ac/Cry1F was effective against SS and RS, but not for RR. These findings show that the Cry1F-maize selected S. frugiperda can cause cross-crop resistance to other Bt crops expressing similar insecticidal proteins. Resistance management and pest management programs that utilize diversify mortality factors must be implemented to ensure the sustainability of Bt crops. This is especially important in areas where resistance to single-gene Bt crops is already widespread.

  19. A Synergy Cropland of China by Fusing Multiple Existing Maps and Statistics.

    Science.gov (United States)

    Lu, Miao; Wu, Wenbin; You, Liangzhi; Chen, Di; Zhang, Li; Yang, Peng; Tang, Huajun

    2017-07-12

    Accurate information on cropland extent is critical for scientific research and resource management. Several cropland products from remotely sensed datasets are available. Nevertheless, significant inconsistency exists among these products and the cropland areas estimated from these products differ considerably from statistics. In this study, we propose a hierarchical optimization synergy approach (HOSA) to develop a hybrid cropland map of China, circa 2010, by fusing five existing cropland products, i.e., GlobeLand30, Climate Change Initiative Land Cover (CCI-LC), GlobCover 2009, MODIS Collection 5 (MODIS C5), and MODIS Cropland, and sub-national statistics of cropland area. HOSA simplifies the widely used method of score assignment into two steps, including determination of optimal agreement level and identification of the best product combination. The accuracy assessment indicates that the synergy map has higher accuracy of spatial locations and better consistency with statistics than the five existing datasets individually. This suggests that the synergy approach can improve the accuracy of cropland mapping and enhance consistency with statistics.

  20. Mapping synergies and trade-offs between energy and the Sustainable Development Goals

    Science.gov (United States)

    Fuso Nerini, Francesco; Tomei, Julia; To, Long Seng; Bisaga, Iwona; Parikh, Priti; Black, Mairi; Borrion, Aiduan; Spataru, Catalina; Castán Broto, Vanesa; Anandarajah, Gabrial; Milligan, Ben; Mulugetta, Yacob

    2018-01-01

    The 2030 Agenda for Sustainable Development—including 17 interconnected Sustainable Development Goals (SDGs) and 169 targets—is a global plan of action for people, planet and prosperity. SDG7 calls for action to ensure access to affordable, reliable, sustainable and modern energy for all. Here we characterize synergies and trade-offs between efforts to achieve SDG7 and delivery of the 2030 Agenda as a whole. We identify 113 targets requiring actions to change energy systems, and published evidence of relationships between 143 targets (143 synergies, 65 trade-offs) and efforts to achieve SDG7. Synergies and trade-offs exist in three key domains, where decisions about SDG7 affect humanity's ability to: realize aspirations of greater welfare and well-being; build physical and social infrastructures for sustainable development; and achieve sustainable management of the natural environment. There is an urgent need to better organize, connect and extend this evidence, to help all actors work together to achieve sustainable development.

  1. Generational Differences in Work-Family Conflict and Synergy

    Directory of Open Access Journals (Sweden)

    Nicholas J. Beutell

    2013-06-01

    Full Text Available This paper examines differences in work-family conflict and synergy among the four generational groups represented in the contemporary workforce: Generation Y Generation X, Baby Boomers, and Matures using data from the 2008 National Study of the Changing Workforce (n = 3,502. Significant generational differences were found for work-family conflict (work interfering with family and family interfering with work but not for work-family synergy. Mental health and job pressure were the best predictors of work interfering with family conflict for each generational group. Work-family synergy presented a more complex picture. Work-family conflict and synergy were significantly related to job, marital, and life satisfaction. Implications and directions for future research are discussed.

  2. Target Choice and Unique Synergies in Global Mobile Telephony

    DEFF Research Database (Denmark)

    Claussen, Jörg; Köhler, Rebecca; Kretschmer, Tobias

    2018-01-01

    The success of acquisitions rests on detecting and realizing unique synergies between buyer and target through their dyadic relationships. We study the role of unique dyad-specific synergies in the selection of takeover targets in the global mobile telecommunications industry. Firms use their for......The success of acquisitions rests on detecting and realizing unique synergies between buyer and target through their dyadic relationships. We study the role of unique dyad-specific synergies in the selection of takeover targets in the global mobile telecommunications industry. Firms use...... their foresight to select specific targets: First, they lower integration costs by selecting geographically close targets. This effect is stronger when buyer and target are in the same country, but only if the market is not so concentrated that it provokes regulatory interventions. Second, they select targets...

  3. Generational Differences in Work-Family Conflict and Synergy

    Science.gov (United States)

    Beutell, Nicholas J.

    2013-01-01

    This paper examines differences in work-family conflict and synergy among the four generational groups represented in the contemporary workforce: Generation Y Generation X, Baby Boomers, and Matures using data from the 2008 National Study of the Changing Workforce (n = 3,502). Significant generational differences were found for work-family conflict (work interfering with family and family interfering with work) but not for work-family synergy. Mental health and job pressure were the best predictors of work interfering with family conflict for each generational group. Work-family synergy presented a more complex picture. Work-family conflict and synergy were significantly related to job, marital, and life satisfaction. Implications and directions for future research are discussed. PMID:23783221

  4. Food synergies for improving bioavailability of micronutrients from plant foods.

    Science.gov (United States)

    Nair, K Madhavan; Augustine, Little Flower

    2018-01-01

    Plant foods are endowed with micronutrients but an understanding of bioavailability is essential in countries primarily dependent on plant based foods. Bioavailability depends majorly on food synergies. This review examines the nature of certain food synergies and methods to screen and establish it as a strategy to control micronutrient deficiency in the populations. Strong evidence on the synergistic effect of inclusion of vitamin C rich fruits and non-vegetarian foods in enhancing the bioavailability of iron has been demonstrated. Fat is found to be synergistic for vitamin A absorption. Red wine and protein have been explored for zinc absorption and effect of fat has been studied for vitamin D. Methods for screening of bioavailability, and biomarkers to demonstrate the synergistic effects of foods are required. Translation of food synergy as a strategy requires adaptation to the context and popularization of intelligent food synergies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Ethnic diversity and knowledge synergies: Rethinking the interrelations

    DEFF Research Database (Denmark)

    Lauring, Jakob

    2005-01-01

    The link between cultural diversity, innovation, creativity and knowledge synergies has often been equated directly with competitive advantages. However, this positive link is only supported to a limited degree by in-depth empirical research and is subsequently based on an intuitive seductive...... desire to see ethnical diversity as productive. Theoretical reviews and empirical research have indicated that the link between diversity and knowledge synergy cannot be taken for granted. This article argues that some theoretical rethinking of managerial strategies toward cultural diversity...... and innovation might be appropriate. Based on my empirical research, barriers preventing a positive link between diversity and knowledge synergies can come in different forms and my empirical findings illustrate situations where both containing and constraining patterns have to be overcome for synergy to thrive....

  6. What is the best management strategy for patients with severe insulin resistance?

    Science.gov (United States)

    Semple, Robert K; Williams, Rachel M; Dunger, David B

    2010-09-01

    Management of severe insulin resistance (IR) is a major clinical challenge in many patients with obesity or lipodystrophy, and also in rarer patients with proven or suspected genetic defects in the insulin receptor or downstream signalling. The latter group can present at any time between birth and early adult life, with a variable clinical course broadly correlated with the severity of IR. Primary insulin signalling defects are usually associated with poor weight gain rather than obesity. Initially, extreme hyperinsulinaemia produces ovarian enlargement and hyperandrogenism in women, and often fasting or postprandial hypoglycaemia. However, any hypoglycaemia gradually evolves into insulin-resistant hyperglycaemia when beta cell function declines. Optimal management of these complex disorders depends on early diagnosis and appropriate targeting of both high and low glucose levels. In newborns, continuous nasogastric feeding may reduce harmful glycaemic fluctuations, and in older patients, acarbose may mitigate postprandial hypoglycaemia. Insulin sensitization, initially with metformin but later with trials of additional agents such as thiazolidinediones, is the mainstay of early therapy, but insulin replacement, eventually with very high doses, is required once diabetes has supervened. Preliminary data suggest that rhIGF-1 can improve survival in infants with the most severe insulin receptor defects and also improve beta cell function in older patients with milder receptoropathies. The utility of newer therapies such as glucagon-like peptide-1 agonists and dipeptidyl peptidase-IV inhibitors remains untested in this condition. Thus, management of these patients remains largely empirical, and there is a pressing need to collate data centrally to optimize treatment algorithms.

  7. Association between Slip Severity and Muscle Synergies of Slipping

    Directory of Open Access Journals (Sweden)

    Mohammad Moein Nazifi

    2017-11-01

    Full Text Available Falls impose significant negative impacts to the US population and economy. A significant number of falls may be prevented via appropriate slip-responses since a strong relation exists between slips and falls. More importantly, as severe slips are more prone to result in a fall, identifying severe slippers along with the responsible factors for their adverse motor control and severe slipping should be the highest priority in fall prevention process. Previous studies have suggested that muscle synergies may be building blocks of the central nervous system in controlling motor tasks. Muscle synergies observed during slipping (‘post-slip-initiation synergies’ or ‘just briefly,’ ‘slipping muscle synergies’, may represent the fundamental blocks of the neural control during slipping. Hence, studying the differences in slipping muscle synergies of mild and severe slippers can potentially reveal the differences in their neural control and subsequently, indicate the responsible factors for the adverse post-slip response in severe slippers. Even though the slipping muscle synergies have been investigated before, it still remains unclear on how the slip severity is associated with the slipping muscle synergies. More importantly, muscle synergies can be interpreted not only as neural blocks but also as physical sub-tasks of the main motor task. Hence, studying the differences of slipping synergies of mild and severe slippers would reveal the discrepancies in sub-tasks of their post-slip response. These discrepancies help pinpoint the malfunctioning sub-function associated with inadequate motor response seen in severe slippers. Twenty healthy subjects were recruited and underwent an unexpected slip (to extract their slipping synergies. Subjects were classified into mild and severe slippers based on their Peak Heel Speed. An independent t-test revealed several significant inter-group differences for muscle synergies of mild and severe slippers

  8. Evaluation and modeling of synergy to pheromone and plant kairomone in American palm weevil

    Directory of Open Access Journals (Sweden)

    Rochat Didier

    2011-04-01

    Full Text Available Abstract Background Many behavioral responses to odors are synergistic, particularly in insects. In beetles, synergy often involves a pheromone and a plant odor, and pest management relies on them for the use of combined lures. To investigate olfactory synergy mechanisms, we need to distinguish synergistic effects from additive ones, when all components of the mixture are active. Results As versatile tools and procedures were not available, we developed a bioassay, and a mathematical model to evaluate synergy between aggregation pheromone (P and host plant odors (kairomone: K in the American palm weevil, a pest insect showing enhanced responses to P+K mixtures. Responses to synthetic P and natural K were obtained using a 4-arm olfactometer coupled to a controlled volatile delivery system. We showed that: (1 Response thresholds were ca. 10 and 100 pg/s respectively for P and K. (2 Both stimuli induced similar maximum response. (3 Increasing the dose decreased the response for P to the point of repellence and maintained a maximum response for K. (4 P and K were synergistic over a 100-fold range of doses with experimental responses to P+K mixtures greater than the ones predicted assuming additive effects. Responses close to maximum were associated with the mixture amounts below the response threshold for both P and K. Conclusion These results confirm the role of olfactory synergy in optimizing active host-plant localization by phytophagous insects. Our evaluation procedure can be generalized to test synergistic or inhibitory integrated responses of various odor mixtures for various insects.

  9. European Synergies for Soil-Related Training Provisions

    Science.gov (United States)

    Arnoult, Matthieu; Reynders, Suzanne; Dittmann, Marie; Lukac, Martin

    2017-04-01

    The University of Reading (UK) has created an original massive online open course (MOOC) the concepts and practices of Climate Smart Agriculture (CSA), a new approach to agriculture based on three principles: mitigation of climate change, adaptation to climate change, stable or increased productivity, and sustainable food security. Through 2 case studies (dairy farming and wine production) this MOOC is an opportunity to highlight the importance of soil conditions for farmers (e.g., organic matter content, erosion, leaching), an issue which had been overlooked but is now seen as an essential part of integrated farm management or techniques such as no-till farming. Furthermore, this 3-week course launching in January 2017 will be translated in several European languages in order to foster international interest in CSA from students across Europe, but also to create collaborative synergies with research partners. To that effect, collaborative work is under way between the University of Reading, INRA, and Agreenium to develop a soil-oriented MOOC, around the 4‰ Initiative to be launched by France in 2017/18. This session will present the existing MOOC material developed at Reading in the context of British and French farming, the current issues facing farmers with respect to soil, and how these will be addressed in the forthcoming MOOC to be developed in partnership with INRA and Agreenium. The use of online training provision to elicit interest in climate change in general and soil topics in particular will also be outlined.

  10. Energy mitigation, adaptation and biodiversity: Synergies and antagonisms

    International Nuclear Information System (INIS)

    Berry, P M; Paterson, J S

    2009-01-01

    In this paper we review the current impacts of different energy producers (and energy conservation) on biodiversity and investigate the potential for achieving positive biodiversity effects along with mitigation and adaptation objectives. Very few energy producers achieve all three aims - although it may be possible with careful choice of location and management. In some instances, energy conservation can provide mitigation, adaptation and biodiversity benefits. There is still a gap in knowledge regarding the effects of newer energy technologies on biodiversity. There is an additional concern that many supposedly 'green' renewable energy projects may actually harm biodiversity to such a degree that their overall human benefits are negated. The increasing understanding that ecosystem services are vital for human well-being though means that attempting positive mitigation, adaptation and biodiversity conservation in the energy sector should be an imperative goal for international policy. Whilst research into synergies between mitigation and adaptation is established, there has been very little that has examined the impacts on biodiversity as well. Further work is required to identify and provide evidence of the best ways of optimising mitigation, adaptation and biodiversity in the energy sector.

  11. Radiation technology: synergy with conventional and emerging food preservation techniques

    International Nuclear Information System (INIS)

    Sharma, A.K.

    2006-01-01

    Conservative estimates put post-harvest losses in India between 10-40%. This hidden burden to economy translates to several thousand crore of rupees annually. Of course one reason for these large losses is our hot and humid climate. But mainly it is lack of proper infrastructure and management that is responsible. Inadequate storage, transport and very low processing or value addition to raw produce diminish return to the primary producer. With increasing population, diminishing agricultural land and expensive inputs, we can hardly afford to waste what we produce. It is estimated that by the year 2020 we may need 340 million tones of food grains to feed our ever-increasing population. It is difficult to expect the desired quantum of increase in productivity through conventional or biotechnological means, especially when arable land is shrinking and being progressively degraded. Increased agricultural productivity needs to be complemented with appropriate post-harvest processing technologies, particularly to reduce wastage, improve quality and add value. The article deals with the synergy of radiation technology with conventional and emerging food preservation techniques

  12. Do muscle synergies reduce the dimensionality of behaviour?

    Directory of Open Access Journals (Sweden)

    Naveen eKuppuswamy

    2014-06-01

    Full Text Available The muscle synergy hypothesis is an archetype of the notion of Dimensionality Reduction (DR occurring in the central nervous system due to modular organisation. Towards validating this hypothesis, it is however important to understand if muscle synergies can reduce the state-space dimensionality while suitably achieving task control. In this paper we present a scheme for investigating this reduction, utilising the temporal muscle synergy formulation. Our approach is based on the observation that constraining the control input to a weighted combination of temporal muscle synergies instead constrains the dynamic behaviour of a system in trajectory-specific manner. We compute this constrained reformulation of system dynamics and then use the method of system balancing for quantifying the DR; we term this approach as Trajectory Specific Dimensionality Analysis (TSDA. We then use this method to investigate the consequence of minimisation of this dimensionality for a given task. These methods are tested in simulation on a linear (tethered mass and a nonlinear (compliant kinematic chain system; dimensionality of various reaching trajectories is compared when using idealised temporal synergies. We show that as a consequence of this Minimum Dimensional Control (MDC model, smooth straight-line Cartesian trajectories with bell-shaped velocity profiles are obtained as the solution to reaching tasks in both of the test systems. We also investigate the effect on dimensionality due to adding via-points to a trajectory. The results indicate that a synergy basis and trajectory-specific DR of motor behaviours results from usage of muscle synergy control. The implications of these results for the synergy hypothesis, optimal motor control, developmental skill acquisition and robotics are then discussed.

  13. Do muscle synergies reduce the dimensionality of behavior?

    Science.gov (United States)

    Kuppuswamy, Naveen; Harris, Christopher M.

    2014-01-01

    The muscle synergy hypothesis is an archetype of the notion of Dimensionality Reduction (DR) occurring in the central nervous system due to modular organization. Toward validating this hypothesis, it is important to understand if muscle synergies can reduce the state-space dimensionality while maintaining task control. In this paper we present a scheme for investigating this reduction utilizing the temporal muscle synergy formulation. Our approach is based on the observation that constraining the control input to a weighted combination of temporal muscle synergies also constrains the dynamic behavior of a system in a trajectory-specific manner. We compute this constrained reformulation of system dynamics and then use the method of system balancing for quantifying the DR; we term this approach as Trajectory Specific Dimensionality Analysis (TSDA). We then investigate the consequence of minimization of the dimensionality for a given task. These methods are tested in simulations on a linear (tethered mass) and a non-linear (compliant kinematic chain) system. Dimensionality of various reaching trajectories is compared when using idealized temporal synergies. We show that as a consequence of this Minimum Dimensional Control (MDC) model, smooth straight-line Cartesian trajectories with bell-shaped velocity profiles emerged as the optima for the reaching task. We also investigated the effect on dimensionality due to adding via-points to a trajectory. The results indicate that a trajectory and synergy basis specific DR of behavior results from muscle synergy control. The implications of these results for the synergy hypothesis, optimal motor control, motor development, and robotics are discussed. PMID:25002844

  14. The efficacy of Elekta Synergy image-guided radiotherapy

    International Nuclear Information System (INIS)

    Takamatsu, Shigeyuki; Takanaka, Tsuyoshi; Kumano, Tomoyasu

    2008-01-01

    We evaluated the efficacy of Elekta Synergy image-guided radiotherapy (IGRT) system equipped with cone beam CT (CBCT) for high accuracy radiation therapy. In cases set up with body marking who had large set up error could be adjusted by this system within 1 mm error. IGRT with CBCT correction provided precise set up. Elekta Synergy IGRT system is useful for high accuracy set up and will facilitate novel precise radiotherapy techniques. (author)

  15. Muscle Synergy Analysis in Transtibial Amputee during Ramp Ascending Activity

    OpenAIRE

    Mehryar, P; Shourijeh, MS; Maqbool, HF; Torabi, M; Dehghani-Sanij, AA

    2016-01-01

    In developed countries, the highest number of amputees are elderly with transtibial amputation. Walking on inclined surfaces is difficult for amputees due to loss of muscle volume and strength thereby transtibial amputees (TA) rely on the intact limb to maintain stability. The aim of this study was to use the concatenated non-negative matrix factorization (CNMF) technique to calculate muscle synergy components and compare the difference in muscle synergies and their associated activation prof...

  16. Adaptation and mitigation: synergies and trade-offs

    CSIR Research Space (South Africa)

    Thambiran, Tirusha

    2017-10-01

    Full Text Available be different (Locatelli, 2011). Infrastructure and planning in cities encompass issues of energy, transport, building, industries and water where the interactions across sectors have the potential for many synergies and trade-offs. Spatial configurations... in the infrastructure planning sector Sector Measure Synergies Trade-offs Mitigation Adaptation Mitigation Adaptation Energy Energy- efficient stoves Reduced emissions due to more efficient burning, improved carbon sequestration due to avoided deforestation...

  17. Preventing Ototoxic Synergy of Prior Noise Trauma During Aminoglycoside Therapy

    Science.gov (United States)

    2015-12-01

    Johns Hopkins University. 212 p (2007). 9. Liao S, et al. Noise Exposure in the Neonatal Intensive Care Unit : A Prospective Study. American Academy...AD_________________ Award Number: W81XWH-14-1-0006 TITLE: Preventing Ototoxic Synergy Of Prior Noise Trauma During Aminoglycoside Therapy ...Dec 2014 - 30 Nov 2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Preventing Ototoxic Synergy Of Prior Noise Trauma During Aminoglycoside Therapy

  18. Similarity of different lifting techniques in trunk muscular synergies.

    Science.gov (United States)

    Mirakhorlo, Mojtaba; Azghani, Mahmood Reza

    2015-01-01

    Lifting is known to be a major reason for musculoskeletal injuries. In this way, lifting has a crucial effect on human musculoskeletal system and intensity of this impact depends slightly on the selection of techniques. Underlying mechanisms by which trunk muscles are executed during performing lifting are central to biomechanical study of lifting techniques. In the current study, the trunk muscular control mechanisms of lifting are investigated using the synergetic control analysis. Non-negative matrix factorization has been used to extract trunk muscles synergies from their activities - which are computed by a previously validated musculoskeletal model - during different lifting techniques aimed to investigate motor control strategies. Three lifting techniques are considered; stoop, squat and semi-squat. Three synergies account for variety among muscle activation of trunk muscles with related VAF (Variability Account For) of over 95%. Trunk muscle synergy weightings and related time-varying coefficients are calculated for each kind of lifting techniques considering three synergies. Paired correlation coefficients between muscle synergies are all greater than 0.91 (P < 0.05) suggesting that trunk muscle synergies are similar for examined techniques in spite of their kinematic diversity. This similarity can be a result of their common ultimate goal. The acquired results also elucidate the mechanisms of muscle activation patterns that can be exploited in future studies and ergonomic interventions.

  19. Muscle synergy extraction during arm reaching movements at different speeds.

    Science.gov (United States)

    Sabzevari, Vahid Reza; Jafari, Amir Homayoun; Boostani, Reza

    2017-01-01

    Muscle synergy is the activation of a group of muscles that contribute to a particular movement. The goal of the present study is to examine the hypothesis that human reaching movements at different speeds share similar muscle synergies and to investigate the kinesiology basis and innervation of muscles. Electromyographic activity from six muscles of the upper limb and shoulder girdle were recorded during three movements at different speeds, i.e. slow, moderate and fast. The effect of window length on the RMS signal of the EMG was analyzed and then EMG envelope signals were decomposed using non-negative matrix factorization. For each of the ten subjects, three synergies were extracted which accounted for at least 99% of the VAF. For each movement, the muscle synergies and muscle activation coefficients of all participants were clustered in to three partitions. Investigation showed a high similarity and dependency of cluster members due to the cosine similarity and mutual information in muscle synergy clustering. For further verification, the EMG envelope signals for all subjects were reconstructed. The results indicated a lower reconstruction error using the center of the muscle synergy clusters in comparison with the average of the activation coefficients, which confirms the current research's hypothesis.

  20. What is synergy? The Saariselkä agreement revisited.

    Science.gov (United States)

    Tang, Jing; Wennerberg, Krister; Aittokallio, Tero

    2015-01-01

    Many biological or chemical agents when combined interact with each other and produce a synergistic response that cannot be predicted based on the single agent responses alone. However, depending on the postulated null hypothesis of non-interaction, one may end up in different interpretations of synergy. Two popular reference models for null hypothesis include the Bliss independence model and the Loewe additivity model, each of which is formulated from different perspectives. During the last century, there has been an intensive debate on the suitability of these synergy models, both of which are theoretically justified and also in practice supported by different schools of scientists. More than 20 years ago, there was a community effort to make a consensus on the terminology one should use when claiming synergy. The agreement was formulated at a conference held in Saariselkä, Finland in 1992, stating that one should use the terms Bliss synergy or Loewe synergy to avoid ambiguity in the underlying models. We review the theoretical relationships between these models and argue that one should combine the advantages of both models to provide a more consistent definition of synergy and antagonism.

  1. Global mental health and neuroscience: potential synergies.

    Science.gov (United States)

    Stein, Dan J; He, Yanling; Phillips, Anthony; Sahakian, Barbara J; Williams, John; Patel, Vikram

    2015-02-01

    Global mental health has emerged as an important specialty. It has drawn attention to the burden of mental illness and to the relative gap in mental health research and services around the world. Global mental health has raised the question of whether this gap is a developmental issue, a health issue, a human rights issue, or a combination of these issues-and it has raised awareness of the need to develop new approaches for building capacity, mobilising resources, and closing the research and treatment gap. Translational neuroscience has also advanced. It comprises an important conceptual approach to understanding the neurocircuitry and molecular basis of mental disorders, to rethinking how best to undertake research on the aetiology, assessment, and treatment of these disorders, with the ultimate aim to develop entirely new approaches to prevention and intervention. Some apparent contrasts exist between these fields; global mental health emphasises knowledge translation, moving away from the bedside to a focus on health systems, whereas translational neuroscience emphasises molecular neuroscience, focusing on transitions between the bench and bedside. Meanwhile, important opportunities exist for synergy between the two paradigms, to ensure that present opportunities in mental health research and services are maximised. Here, we review the approaches of global mental health and clinical neuroscience to diagnosis, pathogenesis, and intervention, and make recommendations for facilitating an integration of these two perspectives. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Evolving concepts in the management of drug resistant ovarian cancer: dose dense chemotherapy and the reversal of clinical platinum resistance.

    Science.gov (United States)

    Pinato, David J; Graham, Janet; Gabra, Hani; Sharma, Rohini

    2013-04-01

    Despite the initially high response rate to standard front-line debulking surgery followed by platinum-based chemotherapy, the relapse rate in ovarian cancer is high and many patients will recur within 6 months of completing platinum based treatment. These patients may still require further chemotherapy despite being considered "platinum resistant". In this setting, response rates to conventionally scheduled second line platinum and non-platinum agents is low, ranging between 5% and 15%. There is an emerging body of evidence that in this scenario, chemotherapeutic activity can be enhanced using unconventionally scheduled "dose-dense" platinum and non-platinum based regimens with improved response rates of up to 65%. Randomised studies to evaluate the impact of this approach on survival in recurrent, platinum resistant disease are urgently required to confirm the promising phase II findings if there is to be a change in the standard of care of patients with platinum resistant disease. In this review we discuss the evolving strategies to overcome resistance in patients with platinum resistant ovarian cancer with a particular focus on alterations in dose schedule as a means of reversing platinum resistance. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. A prospective study of tuberculosis drug susceptibility in sabah, malaysia, and an algorithm for management of isoniazid resistance.

    Science.gov (United States)

    Rashid Ali, Muhammad Redzwan S; Parameswaran, Uma; William, Timothy; Bird, Elspeth; Wilkes, Christopher S; Lee, Wai Khew; Yeo, Tsin Wen; Anstey, Nicholas M; Ralph, Anna P

    2015-01-01

    Introduction. The burden of tuberculosis is high in eastern Malaysia, and rates of Mycobacterium tuberculosis drug resistance are poorly defined. Our objectives were to determine M. tuberculosis susceptibility and document management after receipt of susceptibility results. Methods. Prospective study of adult outpatients with smear-positive pulmonary tuberculosis (PTB) in Sabah, Malaysia. Additionally, hospital clinicians accessed the reference laboratory for clinical purposes during the study. Results. 176 outpatients were enrolled; 173 provided sputum samples. Mycobacterial culture yielded M. tuberculosis in 159 (91.9%) and nontuberculous Mycobacterium (NTM) in three (1.7%). Among outpatients there were no instances of multidrug resistant M. tuberculosis (MDR-TB). Seven people (4.5%) had isoniazid resistance (INH-R); all were switched to an appropriate second-line regimen for varying durations (4.5-9 months). Median delay to commencement of the second-line regimen was 13 weeks. Among 15 inpatients with suspected TB, 2 had multidrug resistant TB (one extensively drug resistant), 2 had INH-R, and 4 had NTM. Conclusions. Current community rates of MDR-TB in Sabah are low. However, INH-resistance poses challenges, and NTM is an important differential diagnosis in this setting, where smear microscopy is the usual diagnostic modality. To address INH-R management issues in our setting, we propose an algorithm for the treatment of isoniazid-resistant PTB.

  4. A Prospective Study of Tuberculosis Drug Susceptibility in Sabah, Malaysia, and an Algorithm for Management of Isoniazid Resistance

    Directory of Open Access Journals (Sweden)

    Muhammad Redzwan S. Rashid Ali

    2015-01-01

    Full Text Available Introduction. The burden of tuberculosis is high in eastern Malaysia, and rates of Mycobacterium tuberculosis drug resistance are poorly defined. Our objectives were to determine M. tuberculosis susceptibility and document management after receipt of susceptibility results. Methods. Prospective study of adult outpatients with smear-positive pulmonary tuberculosis (PTB in Sabah, Malaysia. Additionally, hospital clinicians accessed the reference laboratory for clinical purposes during the study. Results. 176 outpatients were enrolled; 173 provided sputum samples. Mycobacterial culture yielded M. tuberculosis in 159 (91.9% and nontuberculous Mycobacterium (NTM in three (1.7%. Among outpatients there were no instances of multidrug resistant M. tuberculosis (MDR-TB. Seven people (4.5% had isoniazid resistance (INH-R; all were switched to an appropriate second-line regimen for varying durations (4.5–9 months. Median delay to commencement of the second-line regimen was 13 weeks. Among 15 inpatients with suspected TB, 2 had multidrug resistant TB (one extensively drug resistant, 2 had INH-R, and 4 had NTM. Conclusions. Current community rates of MDR-TB in Sabah are low. However, INH-resistance poses challenges, and NTM is an important differential diagnosis in this setting, where smear microscopy is the usual diagnostic modality. To address INH-R management issues in our setting, we propose an algorithm for the treatment of isoniazid-resistant PTB.

  5. A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital

    DEFF Research Database (Denmark)

    Andersen, Stig Ejdrup; Knudsen, Inge Jenny Dahl

    2013-01-01

    BACKGROUND: Bacteria-producing extended spectrum β-lactamase (ESBL) enzymes are resistant to commonly used antimicrobials. In 2008, routine monitoring revealed a clonal hospital outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-KP). METHODS: At a 510-bed Danish university hospital......, a multidisciplinary change project inspired by Kotter's Eight Steps of Change was designed. In addition to revision of antimicrobial guidelines and restriction of selected antimicrobials, the complex, managed, multi-faceted intervention comprised training and education, enhanced isolation precautions, and a series...... of actions to improve the infection control measures and standardise procedures across the hospital. A prospective interrupted time series design was used to analyse data collected at hospital level from January 2008 through December 2011. RESULTS: Though overall antimicrobial consumption remained unaffected...

  6. Insulin resistance and management of the menopause: a clinical hypothesis in practice.

    Science.gov (United States)

    Whitcroft, Sovra; Herriot, Anne

    2011-03-01

    Insulin resistance (IR) is associated with a number of metabolic abnormalities including glucose intolerance, dyslipidemia and central obesity (the metabolic syndrome), which predispose to cardiovascular disease, diabetes mellitus and some cancers. The incidence of many of these conditions increases after the menopause, a time when IR also increases. Medical intervention to help alleviate menopausal symptoms, frequently vasomotor in origin, usually involves hormone replacement therapy (HRT), but some women may only experience partial symptom relief. We have hypothesized that this may be due to concurrent IR. Our approach is therefore to manage menopausal symptoms in conjunction with the treatment of any concurrent IR, achieved through a combination of hormone replacement, dietary intervention and, if necessary, an insulin sensitizer. We suggest that this approach may not only improve symptom relief but may also reduce the risk of developing more serious health complaints in the future.

  7. Antibody-Based Agents in the Management of Antibiotic-Resistant Staphylococcus aureus Diseases

    Science.gov (United States)

    Speziale, Pietro; Rindi, Simonetta

    2018-01-01

    Staphylococcus aureus is a human pathogen that can cause a wide spectrum of diseases, including sepsis, pneumonia, arthritis, and endocarditis. Ineffective treatment of a number of staphylococcal infections with antibiotics is due to the development and spread of antibiotic-resistant strains following decades of antibiotic usage. This has generated renewed interest within the scientific community in alternative therapeutic agents, such as anti-S. aureus antibodies. Although the role of antibodies in the management of S. aureus diseases is controversial, the success of this pathogen in neutralizing humoral immunity clearly indicates that antibodies offer the host extensive protection. In this review, we report an update on efforts to develop antibody-based agents, particularly monoclonal antibodies, and their therapeutic potential in the passive immunization approach to the treatment and prevention of S. aureus infections. PMID:29533985

  8. An empirical evaluation of competency requirements for first-line managers to deal with resistance to change.

    OpenAIRE

    2007-01-01

    The point of departure of this study is that first-line managers play a pivotal role in the facilitation of change initiatives in organisations world-wide. Resistance to change is one of the primary reasons why change interventions fail or why success is not achieved in the change process. More specific, the inability of first-line managers to deal with resistance to change has been cited as a primary cause for change projects to fail. There is no evidence that any research has been conducted...

  9. Gene expression profiling of the synergy of 5-aza-2′-deoxycytidine and paclitaxel against renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Han Tiandong

    2012-09-01

    Full Text Available Abstract Background Renal cell carcinoma (RCC is one of the most common kidney cancers and is highly resistant to chemotherapy. We previously demonstrated that 5-aza-2′-deoxycytidine (DAC could significantly increase the susceptibility of renal cell carcinoma (RCC cells to paclitaxel (PTX treatment in vitro, and showed the synergy of DAC and PTX against RCC. The purpose of this study is to investigated the gene transcriptional alteration and investigate possible molecular mechanism and pathways implicated in the synergy of DAC and PTX against RCC. Methods cDNA microarray was performed and coupled with real-time PCR to identify critical genes in the synergistic mechanism of both agents against RCC cells. Various patterns of gene expression were observed by cluster analysis. IPA software was used to analyze possible biological pathways and to explore the inter-relationships between interesting network genes. Results We found that lymphoid enhancer-binding factor 1 (LEF1, transforming growth factor β-induced (TGFBI, C-X-C motif ligand 5 (CXCL5 and myelocytomatosis viral related oncogene (c-myc may play a pivotal role in the synergy of DAC and PTX. The PI3K/Akt pathway and other pathways associated with cyclins, DNA replication and cell cycle/mitotic regulation were also associated with the synergy of DAC and PTX against RCC. Conclusion The activation of PI3K/Akt-LEF1/β-catenin pathway could be suppressed synergistically by two agents and that PI3K/Akt-LEF1/β-catenin pathway is participated in the synergy of two agents.

  10. The influence of information sharing, supplier trust and supplier synergy on supplier performance: The case of small and medium enterprises

    Directory of Open Access Journals (Sweden)

    David Pooe

    2015-10-01

    Full Text Available Background: The assessment of supplier performance is an important activity for small to medium enterprises (SMEs as they adopt and implement plans and policies aimed at enhancing their performance in order to achieve sustainable competitive advantages. Objectives: The purpose of this study was to examine the influence of information sharing, supplier trust and supplier synergy on supplier performance in SMEs. Method: A quantitative research design was adopted in which a survey questionnaire was administered to a sample of 309 owners and managers of SMEs based in southern Gauteng, South Africa. A confirmatory factor analysis was undertaken to assess the properties of the measurement scale. Hypotheses were tested using the path modelling technique. Results: Information sharing exerted a moderate positive and significant influence on supplier trust and a weak but sigificant influence on supplier synergy. Supplier synergy had a strong positive and significant influence on supplier performance. However, the influence of supplier trust on supplier performance was weak and insignificant. Conclusion: The study provides a useful framework for analysing the interplay between information sharing, supplier trust, supplier synergy and supplier performance in SMEs.

  11. Dissection of protein interactomics highlights microRNA synergy.

    Science.gov (United States)

    Zhu, Wenliang; Zhao, Yilei; Xu, Yingqi; Sun, Yong; Wang, Zhe; Yuan, Wei; Du, Zhimin

    2013-01-01

    Despite a large amount of microRNAs (miRNAs) have been validated to play crucial roles in human biology and disease, there is little systematic insight into the nature and scale of the potential synergistic interactions executed by miRNAs themselves. Here we established an integrated parameter synergy score to determine miRNA synergy, by combining the two mechanisms for miRNA-miRNA interactions, miRNA-mediated gene co-regulation and functional association between target gene products, into one single parameter. Receiver operating characteristic (ROC) analysis indicated that synergy score accurately identified the gene ontology-defined miRNA synergy (AUC = 0.9415, psynergy, implying poor expectancy of widespread synergy. However, targeting more key genes made two miRNAs more likely to act synergistically. Compared to other miRNAs, miR-21 was a highly exceptional case due to frequent appearance in the top synergistic miRNA pairs. This result highlighted its essential role in coordinating or strengthening physiological and pathological functions of other miRNAs. The synergistic effect of miR-21 and miR-1 were functionally validated for their significant influences on myocardial apoptosis, cardiac hypertrophy and fibrosis. The novel approach established in this study enables easy and effective identification of condition-restricted potent miRNA synergy simply by concentrating the available protein interactomics and miRNA-target interaction data into a single parameter synergy score. Our results may be important for understanding synergistic gene regulation by miRNAs and may have significant implications for miRNA combination therapy of cardiovascular disease.

  12. Managing anthelmintic resistance-Variability in the dose of drug reaching the target worms influences selection for resistance?

    Science.gov (United States)

    Leathwick, Dave M; Luo, Dongwen

    2017-08-30

    The concentration profile of anthelmintic reaching the target worms in the host can vary between animals even when administered doses are tailored to individual liveweight at the manufacturer's recommended rate. Factors contributing to variation in drug concentration include weather, breed of animal, formulation and the route by which drugs are administered. The implications of this variability for the development of anthelmintic resistance was investigated using Monte-Carlo simulation. A model framework was established where 100 animals each received a single drug treatment. The 'dose' of drug allocated to each animal (i.e. the concentration-time profile of drug reaching the target worms) was sampled at random from a distribution of doses with mean m and standard deviation s. For each animal the dose of drug was used in conjunction with pre-determined dose-response relationships, representing single and poly-genetic inheritance, to calculate efficacy against susceptible and resistant genotypes. These data were then used to calculate the overall change in resistance gene frequency for the worm population as a result of the treatment. Values for m and s were varied to reflect differences in both mean dose and the variability in dose, and for each combination of these 100,000 simulations were run. The resistance gene frequency in the population after treatment increased as m decreased and as s increased. This occurred for both single and poly-gene models and for different levels of dominance (survival under treatment) of the heterozygote genotype(s). The results indicate that factors which result in lower and/or more variable concentrations of active reaching the target worms are more likely to select for resistance. The potential of different routes of anthelmintic administration to play a role in the development of anthelmintic resistance is discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Management and control of multidrug-resistant tuberculosis (MDR-TB): Addressing policy needs for India.

    Science.gov (United States)

    Atre, Sachin R; Murray, Megan B

    2016-05-06

    Multidrug-resistant tuberculosis (MDR-TB) challenges TB control efforts because of delays in diagnosis plus its long-term treatment which has toxic effects. Of TB high-incidence countries, India carries the highest burden of MDR-TB cases. We describe policy issues in India concerning MDR-TB diagnosis and management in a careful review of the literature including a systematic review of studies on the prevalence of MDR-TB. Of 995 articles published during 2001-2016 and retrieved from the PubMed, only 20 provided data on the population prevalence of MDR-TB. We further reviewed and describe diagnostic criteria and treatment algorithms in use and endorsed by the Revised National TB Control Program of India. We discuss problems encountered in treating MDR-TB patients with standardized regimens. Finally, we provide realistic suggestions for policymakers and program planners to improve the management and control of MDR-TB in India.Journal of Public Health Policy advance online publication, 6 May 2016; doi:10.1057/jphp.2016.14.

  14. ReTrust: attack-resistant and lightweight trust management for medical sensor networks.

    Science.gov (United States)

    He, Daojing; Chen, Chun; Chan, Sammy; Bu, Jiajun; Vasilakos, Athanasios V

    2012-07-01

    Wireless medical sensor networks (MSNs) enable ubiquitous health monitoring of users during their everyday lives, at health sites, without restricting their freedom. Establishing trust among distributed network entities has been recognized as a powerful tool to improve the security and performance of distributed networks such as mobile ad hoc networks and sensor networks. However, most existing trust systems are not well suited for MSNs due to the unique operational and security requirements of MSNs. Moreover, similar to most security schemes, trust management methods themselves can be vulnerable to attacks. Unfortunately, this issue is often ignored in existing trust systems. In this paper, we identify the security and performance challenges facing a sensor network for wireless medical monitoring and suggest it should follow a two-tier architecture. Based on such an architecture, we develop an attack-resistant and lightweight trust management scheme named ReTrust. This paper also reports the experimental results of the Collection Tree Protocol using our proposed system in a network of TelosB motes, which show that ReTrust not only can efficiently detect malicious/faulty behaviors, but can also significantly improve the network performance in practice.

  15. Pneumonia due to methicillin-resistant Staphylococcus aureus: clinical features, diagnosis and management.

    Science.gov (United States)

    Tacconelli, Evelina; De Angelis, Giulia

    2009-05-01

    The review highlights the clinical findings and the management of community-acquired, health-care associated and nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). Although previously considered as a purely nosocomial event, community-acquired MRSA pneumonia is underestimated and is spreading worldwide. A retrospective study showed that almost half of patients with nonnosocomial MRSA pneumonia admitted to a large teaching hospital did not present established criteria for healthcare-associated infections. Recent data show that MRSA ventilator-associated pneumonia is associated with significantly higher mortality than ventilator-associated pneumonia caused by methicillin-susceptible Staphylococcus aureus. Therefore, prompt and appropriate therapy is essential. The optimal therapy for MRSA pneumonia has not been fully elucidated. Although vancomycin has been considered the gold standard for the treatment of MRSA infections, clinical failures have also been reported in the presence of in-vitro susceptibility. Linezolid may provide improved outcomes compared with vancomycin in patients with MRSA pneumonia, but validation in a prospective trial is currently lacking. Recently licensed tigecycline and dalbavancin, a drug in phase III trial, look promising. Animal models showed that immunization against a cytolytic toxin secreted by most Staphylococcus aureus strains protects against lethal pneumonia. Rapid recognition of possible staphylococcal infection in patients with severe pneumonia is essential. The treatment of MRSA pneumonia must be prompt and effective in order to allow a fast microbiological clearance and to successfully manage the infection.

  16. Frankliniella fusca resistance to neonicotinoid insecticides: an emerging challenge for cotton pest management in the eastern United States.

    Science.gov (United States)

    Huseth, Anders S; Chappell, Thomas M; Langdon, Kevin; Morsello, Shannon C; Martin, Scott; Greene, Jeremy K; Herbert, Ames; Jacobson, Alana L; Reay-Jones, Francis Pf; Reed, Timothy; Reisig, Dominic D; Roberts, Phillip M; Smith, Ron; Kennedy, George G

    2016-10-01

    Over the past two decades, neonicotinoid seed treatments have become the primary method to manage tobacco thrips, Frankliniella fusca Hinds, on seedling cotton. Because this insect is highly polyphagous and the window of insecticide exposure is short, neonicotinoid resistance was expected to pose a minimal risk. However, reports of higher than expected F. fusca seedling damage in seed-treated cotton fields throughout the Mid-South and Southeast US production regions suggested neonicotinoid resistance had developed. To document this change, F. fusca populations from 86 different locations in the eastern United States were assayed in 2014 and 2015 for imidacloprid and thiamethoxam resistance to determine the extent of the issue in the region. Approximately 57 and 65% of the F. fusca populations surveyed had reduced imidacloprid and thiamethoxam sensitivity respectively. Survivorship in diagnostic bioassays was significantly different at both the state and regional scales. Multiple-dose bioassays conducted on 37 of the populations documented up to 55- and 39-fold resistance ratios for imidacloprid and thiamethoxam respectively. Estimates of neonicotinoid resistance indicate an emerging issue for management of F. fusca in the eastern United States. Significant variation in survivorship within states and regions indicated that finer-scale surveys were needed to determine factors (genetic, insecticide use) driving resistance evolution. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  17. Managing for soil health can suppress pests

    Directory of Open Access Journals (Sweden)

    Amanda Hodson

    2016-08-01

    Full Text Available A “healthy” soil can be thought of as one that functions well, both agronomically and ecologically, and one in which soil biodiversity and crop management work in synergy to suppress pests and diseases. UC researchers have pioneered many ways of managing soil biology for pest management, including strategies such as soil solarization, steam treatment and anaerobic soil disinfestation, as well as improvements on traditional methods, such as reducing tillage, amending soil with organic materials, and cover cropping. As managing for soil health becomes more of an explicit focus due to restrictions on the use of soil fumigants, integrated soil health tests will be needed that are validated for use in California. Other research needs include breeding crops for disease resistance and pest suppressive microbial communities as well as knowledge of how beneficial organisms influence plant health.

  18. SUCCESSION PROCESS IN A FAMILY BUSINESS: KNOWLEDGE MANAGEMENT OVERCOMING RESISTANCE TO ORGANIZATIONAL CHANGES

    Directory of Open Access Journals (Sweden)

    Patricia de Sá Freire

    2010-12-01

    Full Text Available This study examined the perception of a family business’ employees over changes brought about by the company’s succession procsess through the identification of existing problems and the probabilities of overcoming them. The company was classified as a family business organization as per Bernhoeft´s (1991 definition, and the perspectives proposed by Motta (2001 were used as a basis for change analysis. The succession challenges were studied through the knowledge management viewpoint. The methodological approach is characterized as a qualitative descriptive study done through interviews and document analysis. Quantitative data was used, with the application of questionnaires in order to obtain primary data. Data analysis is mainly characterized by its qualitative and descriptive content. After data analysis, the following issues were detected: (1 lack of or inneficient internal communication, (2 the decision making process was either slow or not committed to the desired results and (3 there was either dual leadership or no leadership. It was concluded that in order to achieve the objectives of the changes, it would require a new look into the intraorganizational integration to eliminate features of the family business such as lack of dialogue and unilateral decisions. It is finally suggested the use of strategies for sharing information and knowledge that will pave the way for understanding the entire succession process, overcoming uncertainties and individual resistance. Thus, the inclusion of Knowledge Management in the family business succession process will result in more aware leaders, managers and employees in terms of change of power during the mentioned process.

  19. A neuroanatomical framework for upper limb synergies after stroke

    Directory of Open Access Journals (Sweden)

    Angus JC McMorland

    2015-02-01

    Full Text Available Muscle synergies describe common patterns of co- or reciprocal activation that occur during movement. After stroke, these synergies change, often in stereotypical ways. The mechanism underlying this change reflects damage to key motor pathways as a result of the stroke lesion, and the subsequent reorganization along the neuroaxis, which may be further detrimental or restorative to motor function. The time course of abnormal synergy formation seems to lag spontaneous recovery that occurs in the initial weeks after stroke. In healthy individuals, motor cortical activity, descending via the corticospinal tract (CST is the predominant driver of voluntary behaviour. When the CST is damaged after stroke, other descending pathways may be up-regulated to compensate. The contribution of these pathways may emerge as new synergies which take shape at the chronic stage after stroke, as a result of plasticity along the neuroaxis. The location of the stroke lesion, and properties of the secondary descending pathways and their regulation are then critical for shaping the synergies in the remaining motor behaviour. A consideration of the integrity of remaining descending motor pathways may aid in the design of new rehabilitation therapies.

  20. Explosive spreading on complex networks: The role of synergy.

    Science.gov (United States)

    Liu, Quan-Hui; Wang, Wei; Tang, Ming; Zhou, Tao; Lai, Ying-Cheng

    2017-04-01

    In spite of the vast literature on spreading dynamics on complex networks, the role of local synergy, i.e., the interaction of elements that when combined produce a total effect greater than the sum of the individual elements, has been studied but only for irreversible spreading dynamics. Reversible spreading dynamics are ubiquitous but their interplay with synergy has remained unknown. To fill this knowledge gap, we articulate a model to incorporate local synergistic effect into the classical susceptible-infected-susceptible process, in which the probability for a susceptible node to become infected through an infected neighbor is enhanced when the neighborhood of the latter contains a number of infected nodes. We derive master equations incorporating the synergistic effect, with predictions that agree well with the numerical results. A striking finding is that when a parameter characterizing the strength of the synergy reinforcement effect is above a critical value, the steady-state density of the infected nodes versus the basic transmission rate exhibits an explosively increasing behavior and a hysteresis loop emerges. In fact, increasing the synergy strength can promote the spreading and reduce the invasion and persistence thresholds of the hysteresis loop. A physical understanding of the synergy promoting explosive spreading and the associated hysteresis behavior can be obtained through a mean-field analysis.

  1. Explosive spreading on complex networks: The role of synergy

    Science.gov (United States)

    Liu, Quan-Hui; Wang, Wei; Tang, Ming; Zhou, Tao; Lai, Ying-Cheng

    2017-04-01

    In spite of the vast literature on spreading dynamics on complex networks, the role of local synergy, i.e., the interaction of elements that when combined produce a total effect greater than the sum of the individual elements, has been studied but only for irreversible spreading dynamics. Reversible spreading dynamics are ubiquitous but their interplay with synergy has remained unknown. To fill this knowledge gap, we articulate a model to incorporate local synergistic effect into the classical susceptible-infected-susceptible process, in which the probability for a susceptible node to become infected through an infected neighbor is enhanced when the neighborhood of the latter contains a number of infected nodes. We derive master equations incorporating the synergistic effect, with predictions that agree well with the numerical results. A striking finding is that when a parameter characterizing the strength of the synergy reinforcement effect is above a critical value, the steady-state density of the infected nodes versus the basic transmission rate exhibits an explosively increasing behavior and a hysteresis loop emerges. In fact, increasing the synergy strength can promote the spreading and reduce the invasion and persistence thresholds of the hysteresis loop. A physical understanding of the synergy promoting explosive spreading and the associated hysteresis behavior can be obtained through a mean-field analysis.

  2. A Method for Locomotion Mode Identification Using Muscle Synergies.

    Science.gov (United States)

    Afzal, Taimoor; Iqbal, Kamran; White, Gannon; Wright, Andrew B

    2017-06-01

    Active lower limb transfemoral prostheses have enabled amputees to perform different locomotion modes such as walking, stair ascent, stair descent, ramp ascent and ramp descent. To achieve seamless mode transitions, these devices either rely on neural information from the amputee's residual limbs or sensors attached to the prosthesis to identify the intended locomotion modes or both. We present an approach for classification of locomotion modes based on the framework of muscle synergies underlying electromyography signals. Neural information at the critical instances (e.g., heel contact and toe-off) was decoded for this purpose. Non-negative matrix factorization was used to extract the muscles synergies from the muscle feature matrix. The estimation of the neural command was done using non-negative least squares. The muscle synergy approach was compared with linear discriminant analysis (LDA), support vector machine (SVM), and neural network (NN) and was tested on seven able-bodied subjects. There was no significant difference ( p > 0.05 ) in transitional and steady state classification errors during stance phase. The muscle synergy approach performed significantly better ( ) than NN and LDA during swing phase while results were similar to SVM. These results suggest that the muscle synergy approach can be used to discriminate between locomotion modes involving transitions.

  3. Review of a major epidemic of methicillin-resistant Staphylococcus aureus: The costs of screening and consequences of outbreak management

    NARCIS (Netherlands)

    A. van der Zee (Anneke); W. Hendriks; L.D. Roorda (Lieuwe); J.M. Ossewaarde (Jacobus); J. Buitenwerf (Johannes)

    2013-01-01

    textabstractBackground: A major outbreak of methicillin-resistant Staphylococcus aureus (MRSA) occurred in locations C and Z of our hospital and lasted for several years. It affected 1,230 patients and 153 personnel. Methods: Outbreak management was installed according to the Dutch "search and

  4. Kdr mutations in Triatoma infestans from the Gran Chaco are distributed in two differentiated foci: Implications for pyrethroid resistance management.

    Science.gov (United States)

    Sierra, Ivana; Capriotti, Natalia; Fronza, Georgina; Mougabure-Cueto, Gastón; Ons, Sheila

    2016-06-01

    Point mutations in the voltage-gated sodium channel, the primary target of pyrethroid insecticides, have been associated with the resistance in Triatoma infestans, an important vector of Chagas' disease. Hence, the sustainability of vector control programs requires the implementation of resistance management strategies. We determined the sensitivity of the molecular assays previously designed for early resistance detection to be used in pooled samples from a wide area of the endemic region, and validated them for their routine use in control campaigns for the monitoring of insecticide resistance in T. infestans. Consequently, we used these methods to examine the distribution of resistance-associated mutations in the sodium channel gene in populations of T. infestans from the Argentinean and Bolivian Gran Chaco. The PASA and REA assays tested proved sensitive enough to detect kdr SNPs in pooled samples, indicating these assays are suitable for routine screening in insecticide resistance surveillance. Two geographically differentiated foci were detected in T. infestans populations from the Argentinean and Bolivian Gran Chaco, with populations on the Bolivian-Argentinean border carrying L1014F mutation, and those from the Argentinean Chaco carrying L925I mutation. In all highly resistant populations analyzed, one of both kdr mutations was present, and toxicological assays determined that all pyrethroid resistant populations analyzed herein were sensitive to fenitrothion. The principal cause of pyrethroid resistance in T. infestans from the Gran Chaco ecoregion is kdr mutations in the sodium channel. Different levels of resistance occur in different populations carrying identical mutation, suggesting the existence of contributory mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Synergy and antagonism between iron chelators and antifungal drugs in Cryptococcus.

    Science.gov (United States)

    Lai, Yu-Wen; Campbell, Leona T; Wilkins, Marc R; Pang, Chi Nam Ignatius; Chen, Sharon; Carter, Dee A

    2016-10-01

    Fungal infections remain very difficult to treat, and developing new antifungal drugs is difficult and expensive. Recent approaches therefore seek to augment existing antifungals with synergistic agents that can lower the therapeutic dose, increase efficacy and prevent resistance from developing. Iron limitation can inhibit microbial growth, and iron chelators have been employed to treat fungal infections. In this study, chequerboard testing was used to explore combinations of iron chelators with antifungal agents against pathogenic Cryptococcus spp. with the aim of determining how disruption to iron homeostasis affects antifungal susceptibility. The iron chelators ethylenediaminetetraacetic acid (EDTA), deferoxamine (DFO), deferiprone (DFP), deferasirox (DSX), ciclopirox olamine and lactoferrin (LF) were paired with the antifungal agents amphotericin B (AmB), fluconazole, itraconazole, voriconazole and caspofungin. All chelators except for DFO increased the efficacy of AmB, and significant synergy was seen between AmB and LF for all Cryptococcus strains. Addition of exogenous iron rescued cells from the antifungal effect of LF alone but could not prevent inhibition by AmB + LF, indicating that synergy was not due primarily to iron chelation but to other properties of LF that were potentiated in the presence of AmB. Significant synergy was not seen consistently for other antifungal-chelator combinations, and EDTA, DSX and DFP antagonised the activity of azole drugs in strains of Cryptococcus neoformans var. grubii. This study highlights the range of interactions that can be induced by chelators and indicates that most antifungal drugs are not enhanced by iron limitation in Cryptococcus. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  6. Captures of MFO-resistant Cydia pomonella adults as affected by lure, crop management system and flight.

    Science.gov (United States)

    Bosch, D; Rodríguez, M A; Avilla, J

    2016-02-01

    The main resistance mechanism of codling moth (Cydia pomonella) in the tree fruit area of Lleida (NE Spain) is multifunction oxidases (MFO). We studied the frequency of MFO-resistant adults captured by different lures, with and without pear ester, and flights in orchards under different crop management systems. The factor year affected codling moth MFO-resistance level, particularly in the untreated orchards, highlighting the great influence of codling moth migration on the spread of resistance in field populations. Chemical treatments and adult flight were also very important but mating disruption technique showed no influence. The second adult flight showed the highest frequency, followed by the first flight and the third flight. In untreated orchards, there were no significant differences in the frequency of MFO-resistant individuals attracted by Combo and BioLure. Red septa lures baited with pear ester (DA) captured sufficient insects only in the first generation of 2010, obtaining a significantly lower proportion of MFO-resistant adults than Combo and BioLure. In the chemically treated orchards, in 2009 BioLure caught a significantly lower proportion of MFO-resistant adults than Combo during the first and third flight, and also than DA during the first flight. No significant differences were found between the lures or flights in 2010. These results cannot support the idea of a higher attractiveness of the pear ester for MFO-resistant adults in the field but do suggest a high influence of the response to the attractant depending on the management of the orchard, particularly with regard to the use of chemical insecticides.

  7. Resource synergy in stream periphyton communities

    Energy Technology Data Exchange (ETDEWEB)

    Hill, Walter [University of Illinois, Urbana-Champaign; Fanta, S.E. [University of Illinois; Roberts, Brian J [ORNL; Francoeur, Steven N. [Eastern Michigan University, Ypsilanti, MI

    2011-03-01

    1. Light and nutrients play pivotal roles in determining the growth of autotrophs, yet the potential for synergistic interactions between the two resources in algal communities is poorly understood, especially in stream ecosystems. In this study, light and phosphorus were manipulated in large experimental streams to examine resource colimitation and synergy in stream periphyton. 2. Whole-stream metabolism was simultaneously limited by light and phosphorus. Increasing the supply of either light or phosphorus resulted in significant increases in primary production and the transformation of the streams from heterotrophy to autotrophy. 3. Resource-driven changes in periphyton community structure occurred in concert with changes in production. Algal assemblages in highly shaded streams were composed primarily of small diatoms such as Achnanthidium minutissima, whereas larger diatoms such as Melosira varians predominated at higher irradiances. Phosphorus enrichment had relatively little effect on assemblage structure, but it did substantially diminish the abundance of Meridion circulare, a diatom whose mucilaginous colonies were conspicuously abundant in phosphorus-poor, high-light streams. Bacterial biomass declined relative to algal biomass with increases in primary productivity, regardless of whether the increases were caused by light or phosphorus. 4. Synergistic effects on primary production appeared to occur because the availability of one resource facilitated the utilization of the other. Light increased the abundance of large diatoms, which are known to convert high concentrations of nutrients into primary production more effectively than smaller taxa. Phosphorus enrichment led to the replacement of Meridion circulare by non-mucilaginous taxa in phosphorus-enriched streams, and we hypothesize that this change enabled more efficient use of light in photosynthesis. Higher ratios of chlorophyll a : biomass in phosphorus-enriched streams may have also led to more

  8. Solar + Storage Synergies for Managing Commercial-Customer Demand Charges

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, P. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Govindarajan, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Barbose, G. L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, N. R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mills, A. D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-10-18

    Demand charges, which are based on a customer’s maximum demand in kilowatts (kW), are a common element of electricity rate structures for commercial customers. Customer-sited solar photovoltaic (PV) systems can potentially reduce demand charges, but the level of savings is difficult to predict, given variations in demand charge designs, customer loads, and PV generation profiles. Lawrence Berkeley National Laboratory (Berkeley Lab) and the National Renewable Energy Laboratory (NREL) are collaborating on a series of studies to understand how solar PV can impact demand charges. Prior studies in the series examined demand charge reductions from solar on a stand-alone basis for residential and commercial customers. Those earlier analyses found that solar, alone, has limited ability to reduce demand charges depending on the specific design of the demand charge and on the shape of the customer’s load profile. This latest analysis estimates demand charge savings from solar in commercial buildings when co-deployed with behind-the-meter storage, highlighting the complementary roles of the two technologies. The analysis is based on simulated loads, solar generation, and storage dispatch across a wide variety of building types, locations, system configurations, and demand charge designs.

  9. Manejo de Conyza bonariensis resistente ao herbicida glyphosate Management of Glyphosate-resistant Conyza bonariensis

    Directory of Open Access Journals (Sweden)

    J.M. Paula

    2011-03-01

    Full Text Available C. bonariensis (Conyza bonariensis é uma planta daninha da família Asteraceae, amplamente distribuída no Brasil, com presença marcante nos Estados do Rio Grande do Sul e do Paraná. Biótipos de C. bonariensis resistentes ao glyphosate foram identificados nos Estados do Rio Grande do Sul, Paraná e São Paulo. O objetivo deste trabalho foi avaliar o efeito de diferentes manejos de inverno e na pré-semeadura da soja sobre a população de plantas de C. bonariensis resistente ao herbicida glyphosate. Os resultados evidenciaram que a população de C. bonariensis é maior em áreas mantidas sem cultivo (pousio do que naquelas áreas cultivadas com trigo ou aveia-preta durante o inverno. Observou-se que o trigo e a aveia-preta exercem efeito supressor sobre a população de C. bonariensis, proporcionando maior facilidade de controle com herbicida na pré-semeadura da cultura usada em sucessão. O controle de C. bonariensis resistente ao herbicida glyphosate foi satisfatório quando se utilizaram herbicidas pós-emergentes na cultura do trigo e glyphosate + 2,4-D ou glyphosate + diuron + paraquat na pré-semeadura da soja.Horseweed (Conyza bonariensis, which belongs to the Asteraceae family, is a weed species widely spread in Brazil. Horseweed biotypes resistant to glyphosate, the main herbicide used in Roundup Ready soybean fields, were identified in the states of Rio Grande do Sul and Parana. The aim of this study was to evaluate the effect of different winter and pre-sowing management techniques on soybean plant population of C. bonariensis resistant to glyphosate. The results showed that the population of C. bonariensis is larger in areas maintained fallow than in areas planted with wheat or oats during the winter. Wheat and oats were found to exert a suppressive effect on the population of C. bonariensis, providing greater ease of control with herbicide before seeding in the culture used in succession. The control of glyphosate-resistant C

  10. Nuclear and Renewable Energy Synergies Workshop: Report of Proceedings

    International Nuclear Information System (INIS)

    Ruth, M.; Antkowiak, M.; Gossett, S.

    2011-01-01

    Two of the major challenges the U.S. energy sector faces are greenhouse gas emissions and oil that is both imported and potentially reaching a peak (the point at which maximum extraction is reached). Interest in development of both renewable and nuclear energy has been strong because both have potential for overcoming these challenges. Research in both energy sources is ongoing, but relatively little research has focused on the potential benefits of combining nuclear and renewable energy. In September 2011, the Joint Institute for Strategic Energy Analysis (JISEA) convened the Nuclear and Renewable Energy Synergies Workshop at the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) to identify potential synergies and strategic leveraging opportunities between nuclear energy and renewable energy. Industry, government, and academic thought leaders gathered to identify potential broad categories of synergies and brainstorm topic areas for additional analysis and research and development (R and D). This report records the proceedings and outcomes of the workshop.

  11. Handwriting: three-dimensional kinetic synergies in circle drawing movements.

    Science.gov (United States)

    Hooke, Alexander W; Karol, Sohit; Park, Jaebum; Kim, Yoon Hyuk; Shim, Jae Kun

    2012-07-01

    The purpose of this study was to investigate central nervous system (CNS) strategies for controlling multifinger forces during a circle-drawing task. Subjects drew 30 concentric, discontinuous clockwise and counter clockwise circles, at self and experimenter-set paces. The three-dimensional trajectory of the pen's center of mass and the three-dimensional forces and moments of force at each contact between the hand and the pen were recorded. Uncontrolled Manifold Analysis was used to quantify the synergies between pen-hand contact forces in radial, tangential and vertical directions. Results showed that synergies in the radial and tangential components were significantly stronger than in the vertical component. Synergies in the clockwise direction were significantly stronger than the counterclockwise direction in the radial and vertical components. Pace was found to be insignificant under any condition.

  12. Enhancing synergies in a collaborative environment

    CERN Document Server

    Maeso-González, Elvira; Escudero-Santana, Alejandro

    2015-01-01

    This volume contains a selection of the best papers presented at the 8th International Conference on Industrial Engineering and Industrial Management, Engineering International Conference on Industrial Engineering and Operations Management, and International IIE Conference 2014,  hosted by ADINGOR, ABEPRO and the IIE, whose mission is to promote links between researchers and practitioners from different branches, to enhance an interdisciplinary perspective of industrial engineering and management.  The conference topics covered: operations research, modelling and simulation, computer and information systems, operations research, scheduling and sequencing, logistics, production and information systems, supply chain and logistics, transportation, lean management, production planning and control, production system design, reliability and maintenance, quality management, sustainability and eco-efficiency, marketing and consumer behavior, business administration and strategic management, economic and financial m...

  13. Integrated Palmer Amaranth Management in Glufosinate-Resistant Cotton: II. Primary, Secondary and Conservation Tillage

    Directory of Open Access Journals (Sweden)

    Michael G. Patterson

    2013-01-01

    Full Text Available A three year field experiment was conducted to evaluate the role of soil inversion, cover crops and spring tillage methods for Palmer amaranth between-row (BR and within-row (WR management in glufosinate-resistant cotton. Main plots were two soil inversion treatments: fall inversion tillage (IT and non-inversion tillage (NIT. Subplots were three cover treatments: crimson clover, cereal rye or none (i.e., winter fallow; and the sub subplots were four secondary spring tillage methods: disking followed by (fb cultivator (DCU, disking fb chisel plow (DCH, disking fb disking (DD and no tillage (NT. Averaged over years and soil inversion, the crimson clover produced maximum cover biomass (4390 kg ha−1 fb cereal rye (3698 kg ha−1 and winter fallow (777 kg ha−1. Two weeks after planting (WAP and before the postemergence (POST application, Palmer amaranth WR and BR density were two- and four-times less, respectively, in IT than NIT. Further, Palmer amaranth WR and BR density were reduced two-fold following crimson clover and cereal rye than following winter fallow at 2 WAP. Without IT, early season Palmer amaranth densities were 40% less following DCU, DCH and DD, when compared with IT. Following IT, no spring tillage method improved Palmer amaranth control. The timely application of glufosinate + S-metolachlor POST tank mixture greatly improved Palmer amaranth control in both IT and NIT systems. The highest cotton yields were obtained with DD following cereal rye (2251 kg ha−1, DD following crimson clover (2213 kg ha−1 and DD following winter fallow (2153 kg ha−1. On average, IT cotton yields (2133 kg ha−1 were 21% higher than NIT (1766 kg ha−1. Therefore, from an integrated weed management standpoint, an occasional fall IT could greatly reduce Palmer amaranth emergence on farms highly infested with glyphosate-resistant Palmer amaranth. In addition, a cereal rye or crimson clover cover crop can effectively reduce early season Palmer

  14. Synergy Maps: exploring compound combinations using network-based visualization.

    Science.gov (United States)

    Lewis, Richard; Guha, Rajarshi; Korcsmaros, Tamás; Bender, Andreas

    2015-01-01

    The phenomenon of super-additivity of biological response to compounds applied jointly, termed synergy, has the potential to provide many therapeutic benefits. Therefore, high throughput screening of compound combinations has recently received a great deal of attention. Large compound libraries and the feasibility of all-pairs screening can easily generate large, information-rich datasets. Previously, these datasets have been visualized using either a heat-map or a network approach-however these visualizations only partially represent the information encoded in the dataset. A new visualization technique for pairwise combination screening data, termed "Synergy Maps", is presented. In a Synergy Map, information about the synergistic interactions of compounds is integrated with information about their properties (chemical structure, physicochemical properties, bioactivity profiles) to produce a single visualization. As a result the relationships between compound and combination properties may be investigated simultaneously, and thus may afford insight into the synergy observed in the screen. An interactive web app implementation, available at http://richlewis42.github.io/synergy-maps, has been developed for public use, which may find use in navigating and filtering larger scale combination datasets. This tool is applied to a recent all-pairs dataset of anti-malarials, tested against Plasmodium falciparum, and a preliminary analysis is given as an example, illustrating the disproportionate synergism of histone deacetylase inhibitors previously described in literature, as well as suggesting new hypotheses for future investigation. Synergy Maps improve the state of the art in compound combination visualization, by simultaneously representing individual compound properties and their interactions. The web-based tool allows straightforward exploration of combination data, and easier identification of correlations between compound properties and interactions.

  15. ON THE NOTION OF SYNERGY OF MONOCLONAL ANTIBODIES AS DRUGS

    Directory of Open Access Journals (Sweden)

    Michael Sela

    2013-08-01

    Full Text Available History of developing synergy between monoclonal antibodies, anti-tumor activity of monoclonal antibodies against tyrosine-kinases receptors EGFR/ErbB-1 and HER2/ErbB-2 as well as growth factor VEGF in various combinations are considered in the article. There were proposed hypotheses about potential molecular mechanisms underlay synergy between monoclonal antibodies (for homo- and hetero combinations of antibodies appropriately specific for antigenic determinants on the same or different receptors. Future trends in researches necessary to deeper understanding causes of this phenomenon and perspectives for practical application of monoclonal antibodies acted synergistically as immunotherapeutic drugs for human tumors treatment are reviewed.

  16. Synergies between renewable energy and fresh water production. Scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Geurts, F.; Noothout, P.; Schaap, A. [Ecofys Netherlands, Utrecht (Netherlands)

    2011-02-15

    The IEA Implementing Agreement for Renewable Energy Technology Deployment (IEA-RETD) investigated the opportunities for coupling renewable energy systems with fresh water supply systems. The four main conclusions of the scoping study, carried out by Ecofys, are: (1) Fresh water production based on desalination technologies provide most options for synergies with renewable energy production; (2) Linking desalination to renewable sources is currently not economically viable; (3) There is a large potential for small scale (decentralised) desalination plants; (4) Current commercially-sized desalination technologies are in need of a constant operation point. Reverse osmosis and thermal membrane technologies might give future synergies as deferrable load.

  17. Synergy in spreading processes: from exploitative to explorative foraging strategies.

    Science.gov (United States)

    Pérez-Reche, Francisco J; Ludlam, Jonathan J; Taraskin, Sergei N; Gilligan, Christopher A

    2011-05-27

    An epidemiological model which incorporates synergistic effects that allow the infectivity and/or susceptibility of hosts to be dependent on the number of infected neighbors is proposed. Constructive synergy induces an exploitative behavior which results in a rapid invasion that infects a large number of hosts. Interfering synergy leads to a slower and sparser explorative foraging strategy that traverses larger distances by infecting fewer hosts. The model can be mapped to a dynamical bond percolation with spatial correlations that affect the mechanism of spread but do not influence the critical behavior of epidemics. © 2011 American Physical Society

  18. Development of Partial Ontogenic Resistance to Powdery Mildew in Hop Cones and Its Management Implications

    Science.gov (United States)

    Twomey, Megan C.; Wolfenbarger, Sierra N.; Woods, Joanna L.; Gent, David H.

    2015-01-01

    Knowledge of processes leading to crop damage is central to devising rational approaches to disease management. Multiple experiments established that infection of hop cones by Podosphaera macularis was most severe if inoculation occurred within 15 to 21 days after bloom. This period of infection was associated with the most pronounced reductions in alpha acids, cone color, and accelerated maturation of cones. Susceptibility of cones to powdery mildew decreased progressively after the transition from bloom to cone development, although complete immunity to the disease failed to develop. Maturation of cone tissues was associated with multiple significant affects on the pathogen manifested as reduced germination of conidia, diminished frequency of penetration of bracts, lengthening of the latent period, and decreased sporulation. Cones challenged with P. macularis in juvenile developmental stages also led to greater frequency of colonization by a complex of saprophytic, secondary fungi. Since no developmental stage of cones was immune to powdery mildew, the incidence of powdery mildew continued to increase over time and exceeded 86% by late summer. In field experiments with a moderately susceptible cultivar, the incidence of cones with powdery mildew was statistically similar when fungicide applications were made season-long or targeted only to the juvenile stages of cone development. These studies establish that partial ontogenic resistance develops in hop cones and may influence multiple phases of the infection process and pathogen reproduction. The results further reinforce the concept that the efficacy of a fungicide program may depend largely on timing of a small number of sprays during a relatively brief period of cone development. However in practice, targeting fungicide and other management tactics to periods of enhanced juvenile susceptibility may be complicated by a high degree of asynchrony in cone development and other factors that are situation

  19. Considerations of the Principles of Resistance Training in Exercise Studies for the Management of Knee Osteoarthritis: A Systematic Review.

    Science.gov (United States)

    Minshull, Claire; Gleeson, Nigel

    2017-09-01

    To evaluate the methodologic quality of resistance training interventions for the management of knee osteoarthritis. A search of the literature for studies published up to August 10, 2015, was performed on MEDLINE (OVID platform), PubMed, Embase, and Physiotherapy Evidence Database databases. Search terms associated with osteoarthritis, knee, and muscle resistance exercise were used. Studies were included in the review if they were published in the English language and met the following criteria: (1) muscle resistance training was the primary intervention; (2) randomized controlled trial design; (3) treatment arms included at least a muscle conditioning intervention and a nonexercise group; and (4) participants had osteoarthritis of the knee. Studies using preoperative (joint replacement) interventions with only postoperative outcomes were excluded. The search yielded 1574 results. The inclusion criteria were met by 34 studies. Two reviewers independently screened the articles for eligibility. Critical appraisal of the methodology was assessed according to the principles of resistance training and separately for the reporting of adherence using a specially designed scoring system. A rating for each article was assigned. There were 34 studies that described a strength training focus of the intervention; however, the principles of resistance training were inconsistently applied and inadequately reported across all. Methods for adherence monitoring were incorporated into the design of 28 of the studies, but only 13 reported sufficient detail to estimate average dose of exercise. These findings affect the interpretation of the efficacy of muscle resistance exercise in the management of knee osteoarthritis. Clinicians and health care professionals cannot be confident whether nonsignificant findings are because of the lack of efficacy of muscle resistance interventions, or occur through limitations in treatment prescription and patient adherence. Future research that

  20. Human Management of a Wild Plant Modulates the Evolutionary Dynamics of a Gene Determining Recessive Resistance to Virus Infection.

    Directory of Open Access Journals (Sweden)

    Nils Poulicard

    2016-08-01

    Full Text Available This work analyses the genetic variation and evolutionary patterns of recessive resistance loci involved in matching-allele (MA host-pathogen interactions, focusing on the pvr2 resistance gene to potyviruses of the wild pepper Capsicum annuum glabriusculum (chiltepin. Chiltepin grows in a variety of wild habitats in Mexico, and its cultivation in home gardens started about 25 years ago. Potyvirus infection of Capsicum plants requires the physical interaction of the viral VPg with the pvr2 product, the translation initiation factor eIF4E1. Mutations impairing this interaction result in resistance, according to the MA model. The diversity of pvr2/eIF4E1 in wild and cultivated chiltepin populations from six biogeographical provinces in Mexico was analysed in 109 full-length coding sequences from 97 plants. Eleven alleles were found, and their interaction with potyvirus VPg in yeast-two-hybrid assays, plus infection assays of plants, identified six resistance alleles. Mapping resistance mutations on a pvr2/eIF4E1 model structure showed that most were around the cap-binding pocket and strongly altered its surface electrostatic potential, suggesting resistance-associated costs due to functional constraints. The pvr2/eIF4E1 phylogeny established that susceptibility was ancestral and resistance was derived. The spatial structure of pvr2/eIF4E1 diversity differed from that of neutral markers, but no evidence of selection for resistance was found in wild populations. In contrast, the resistance alleles were much more frequent, and positive selection stronger, in cultivated chiltepin populations, where diversification of pvr2/eIF4E1 was higher. This analysis of the genetic variation of a recessive resistance gene involved in MA host-pathogen interactions in populations of a wild plant show that evolutionary patterns differ according to the plant habitat, wild or cultivated. It also demonstrates that human management of the plant population has profound

  1. Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences.

    Science.gov (United States)

    de Vries, Gerard; Tsolova, Svetla; Anderson, Laura F; Gebhard, Agnes C; Heldal, Einar; Hollo, Vahur; Cejudo, Laura Sánchez-Cambronero; Schmid, Daniela; Schreuder, Bert; Varleva, Tonka; van der Werf, Marieke J

    2017-04-19

    In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months' evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients' emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of rapid molecular diagnostic tests; development of context-specific treatment

  2. Synergies of multiple remote sensing data sources for REDD+ monitoring

    NARCIS (Netherlands)

    Sy, de V.; Herold, M.; Achard, F.; Asner, G.P.; Held, A.; Kellndorfer, J.; Verbesselt, J.

    2012-01-01

    Remote sensing technologies can provide objective, practical and cost-effective solutions for developing and maintaining REDD+ monitoring systems. This paper reviews the potential and status of available remote sensing data sources with a focus on different forest information products and synergies

  3. Academic Entrepreneurship and Traditional Academic Duties: Synergy or Rivalry?

    Science.gov (United States)

    De Silva, Muthu

    2016-01-01

    This study investigates the influence of academic entrepreneurship on traditional academic duties carried out in a resource-constrained environment, particularly focusing on whether there is synergy or rivalry between these two activities. Using qualitative evidence, we discover that there are funding, resource, knowledge and skill and networking…

  4. Possible causes of dry pea synergy to corn

    Science.gov (United States)

    Dry pea improves corn yield and tolerance to weed interference compared with soybean, spring wheat, or canola as preceding crops. To understand this synergy between dry pea and corn, we examined growth and nutrient concentration of corn following dry pea or soybean in sequence. Each corn plot was ...

  5. Cortex integrity relevance in muscle synergies in severe chronic stroke

    NARCIS (Netherlands)

    Garcia Cossio, E.; Brötz, D.; Birbaumer, N.; Ramos-Murguialday, A.

    2014-01-01

    Background: Recent experimental evidence has indicated that the motor system coordinates muscle activations through a linear combination of muscle synergies that are specified at the spinal or brainstem networks level. After stroke upper limb impairment is characterized by abnormal patterns of

  6. Determination of in vitro synergy between linezolid and other antimicrobial agents against Mycobacterium tuberculosis isolates.

    Science.gov (United States)

    Zou, Lin; Liu, Min; Wang, Yufeng; Lu, Jie; Pang, Yu

    2015-12-01

    In this study, our objective was to explore the potential in vitro synergy between linezolid (LZD) and six other anti-TB drugs in Mycobacterium tuberculosis strains, especially multidrug-resistant tuberculosis (MDR-TB) strains. Among the different combinations, the LZD-clarithromycin (CLA) combination showed the best synergism, which was observed in 85% (34/40) of 40 isolates. In addition, one (2.5%) and twenty-one (52.5%) of 40 isolates showed synergism for the LZD-levofloxcin (LEV) and LZD-moxifloxacin (MOX) combinations, respectively, and the difference in the proportion of synergy between these two combinations was significantly different (P synergy against non-MDR group seemed higher than that against MDR group in each combination, while the significant difference was only observed in the LZD-EMB combination (P = 0.046). In conclusion, our findings demonstrate that LZD shows the synergistic activity against both non-MDR and MDR M. tuberculosis strains when in combination with CLA, EMB, MOX, amikacin and clofazimine, indicating that LZD may be considered as a promising component involving the regimen for the treatment of MDR-TB. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Potential synergies between existing multilateral environmental agreements in the implementation of land use, land-use change and forestry activities

    International Nuclear Information System (INIS)

    Cowie, Annette; Schneider, Uwe A.; Montanarella, Luca

    2007-01-01

    There is potential for synergy between the global environmental conventions on climate change, biodiversity and desertification: changes in land management and land use undertaken to reduce net greenhouse gas emissions can simultaneously deliver positive outcomes for conservation of biodiversity, and mitigation of desertification and land degradation. However, while there can be complementarities between the three environmental goals, there are often tradeoffs. Thus, the challenge lies in developing land use policies that promote optimal environmental outcomes, and in implementing these locally to promote sustainable development. The paper considers synergies and tradeoffs in implementing land use measures to address the objectives of the three global environmental conventions, both from an environmental and economic perspective. The intention is to provide environmental scientists and policy makers with a broad overview of these considerations, and the benefits of addressing the conventions simultaneously

  8. European and Russian physician awareness of best management approaches for infections due to antibiotic-resistant Gram-negative bacteria.

    Science.gov (United States)

    Irani, Paurus; Salimi, Tehseen; Epstein, Robert; Leone-Perkins, Megan; Aubert, Ronald; Khalid, Mona; Epstein, Emma; Teagarden, J Russell

    2017-08-01

    The rapid spread of infections due to antibiotic-resistant, Gram-negative bacteria in Europe and surrounding regions requires a heightened level of awareness among physicians within their practice settings. We surveyed 800 physicians who treat these infections across France, Germany, Spain, Italy, and Russia to assess their awareness of best management approaches. We found that more than two-thirds do not consider themselves highly aware of best management practices. The respondents are facing these resistant infections as evidenced by the antibiotics they report using and their stated interest in newer agents. Respondents indicated that precious time is lost waiting for culture results, but also said they will need more information about accuracy, use, and costs for adopting rapid molecular testing. The survey further identified the need for treatment guidelines and clinical decision support tools that can be applied at the bedside.

  9. A methodology for resistance to change management in information systems projects

    OpenAIRE

    Vrhovec, Simon

    2015-01-01

    The rate of failed information systems development projects remains high despite increasing investments into information systems and their major importance for contemporary organizations. Resistance to change is one of the critical reasons for such high failure rates. Organizations faced resistance to change long before the emergence of first computers as it is a natural reaction to change. With the emergence of computers and introduction of information technology to organizations, resistance...

  10. Unprecedented Silver Resistance in Clinically Isolated Enterobacteriaceae: Major Implications for Burn and Wound Management

    OpenAIRE

    Finley, Phillip J.; Norton, Rhy; Austin, Cindy; Mitchell, Amber; Zank, Sara; Durham, Paul

    2015-01-01

    Increased utilization of inorganic silver as an adjunctive to many medical devices has raised concerns of emergent silver resistance in clinical bacteria. Although the molecular basis for silver resistance has been previously characterized, to date, significant phenotypic expression of these genes in clinical settings is yet to be observed. Here, we identified the first strains of clinical bacteria expressing silver resistance at a level that could significantly impact wound care and the use ...

  11. A novel computational framework for deducing muscle synergies from experimental joint moments

    Directory of Open Access Journals (Sweden)

    Anantharaman eGopalakrishnan

    2014-12-01

    Full Text Available Prior experimental studies have hypothesized the existence of a ‘muscle synergy’ based control scheme for producing limb movements and locomotion in vertebrates. Such synergies have been suggested to consist of fixed muscle grouping schemes with the co-activation of all muscles in a synergy resulting in limb movement. Quantitative representations of these groupings (termed muscle weightings and their control signals (termed synergy controls have traditionally been derived by the factorization of experimentally measured EMG. This study presents a novel approach for deducing these weightings and controls from inverse dynamic joint moments that are computed from an alternative set of experimental measurements – movement kinematics and kinetics. This technique was applied to joint moments for healthy human walking at 0.7 and 1.7 m/s, and two sets of ‘simulated’ synergies were computed based on two different criteria (1 synergies were required to minimize errors between experimental and simulated joint moments in a musculoskeletal model (pure-synergy solution (2 along with minimizing joint moment errors, synergies also minimized muscle activation levels (optimal-synergy solution. On comparing the two solutions, it was observed that the introduction of optimality requirements (optimal-synergy to a control strategy solely aimed at reproducing the joint moments (pure-synergy did not necessitate major changes in the muscle grouping within synergies or the temporal profiles of synergy control signals. Synergies from both the simulated solutions exhibited many similarities to EMG derived synergies from a previously published study, thus implying that the analysis of the two different types of experimental data reveals similar, underlying synergy structures.

  12. RESISTANCE TO ORGANIZATIONAL CHANGE: ANALYSIS OF THE PROCESS OF IMPLEMENTATION OF THE INTEGRATED MANAGEMENT SYSTEM IN SENAI-BA

    Directory of Open Access Journals (Sweden)

    Danielle Soares Paiva

    2013-09-01

    Full Text Available More and more, organizations are challenged to anticipate an uncertain future in order to survive in the market, so it is natural that the processes of organizational change part of their routine and it will be perceived resistance from those who takes part the organization. So, this article aims to analyze, though the view internal public, in which perspectives are the main resistances to the organization change in a non-profit organization, upon the implementation of Integrated Management Systems. The present work was realized in Serviço Nacional de Aprendizagem Industrial – Departamento Regional da Bahia (SENAI/BA, over the period of 2006 upon 2009. For this, was realized a bibliography search of organization change and resistance for it. The research was essentially qualitative, with methodologists procedures that had included documentary analysis, the application of the technique of focus groups, interviews and participated observation. From the obtained results, concludes that the main resistance for the organization change, when the implementation of Integrated Management Systems, are concentrated in the politic, human and cultural perspectives.

  13. Using resilience and resistance concepts to manage persistent threats to sagebrush ecosystems and greater sage-grouse

    Science.gov (United States)

    Chambers, Jeanne C.; Maestas, Jeremy D.; Pyke, David A.; Boyd, Chad S.; Pellant, Mike; Wuenschel, Amarina

    2017-01-01

    Conservation of imperiled species often demands addressing a complex suite of threats that undermine species viability. Regulatory approaches, such as the US Endangered Species Act (1973), tend to focus on anthropogenic threats through adoption of policies and regulatory mechanisms. However, persistent ecosystem-based threats, such as invasive species and altered disturbance regimes, remain critical issues for most at-risk species considered to be conservation-reliant. We describe an approach for addressing persistent ecosystem threats to at-risk species based on ecological resilience and resistance concepts that is currently being used to conserve greater sage-grouse (Centrocercus urophasianus)and sagebrush ecosystems. The approach links biophysical indicators of ecosystem resilience and resistance with species-specific population and habitat requisites in a risk-based framework to identify priority areas for management and guide allocation of resources to manage persistent ecosystem-based threats. US federal land management and natural resource agencies have adopted this framework as a foundation for prioritizing sage-grouse conservation resources and determining effective restoration and management strategies. Because threats and strategies to address them cross-cut program areas, an integrated approach that includes wildland fire operations, postfire rehabilitation, fuels management, and habitat restoration is being used. We believe this approach is applicable to species conservation in other largely intact ecosystems with persistent, ecosystem-based threats.

  14. Acceptability and perceived side effects of insecticide indoor residual spraying under different resistance management strategies

    Directory of Open Access Journals (Sweden)

    Rodríguez Américo David

    2006-01-01

    Full Text Available OBJECTIVE: To assess household acceptability and perceived side effects of residual indoor pyrethroid (PYR, carbamate and organophosphate insecticides sprayed by annual rotation (ROT, spatial mosaic (MOS, and a single insecticide (DDT or PYR in communities of the coastal plain of Chiapas, Mexico. MATERIAL AND METHODS: A questionnaire to assess the acceptability and perceived side effects of indoor insecticides was administered to one member of 30% of the families in eight villages of Chiapas. The association of different insecticide treatments with their responses was evaluated (Chi-square. The intensity of side effects indicated under different treatments was compared in an ordered logistic model, using a severity index as the response variable. RESULTS: Insecticide spraying as a probable cause of symptoms was identified by 2.1% of interviewees. A significantly high percentage of persons with blurred vision, dizziness, sneezing, coughing, numbness, watery eyes, and itching lived in villages under MOS and ROT and a high severity index was significantly associated with ROT treatment. Reduction of mosquito bites and cockroaches were the perceived main benefits, and most villagers that perceived no benefits lived in DDT treated villages. Most of the interviewees welcomed spraying (83.7%, but the smell and having to remove furniture from houses were the main arguments against it. CONCLUSIONS: Acceptability correlated with insecticide spray coverage, although the most frequent suggestion for improvement was to increase the understanding of the objectives of spraying in the communities. The frequency of side effects was low, but higher in localities where a combination of insecticides was applied. This is a limitation for the use of this type of resistance management strategy in public health.

  15. Synergies Between ' and Cavity Formation in HT-9 Following High Dose Neutron Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Field, Kevin G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Parish, Chad M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Saleh, Tarik A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Eftink, Benjamin P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-06-01

    Candidate cladding materials for advanced nuclear power reactors including fast reactor designs require materials capable of withstanding high dose neutron irradiation at elevated temperatures. One candidate material, HT-9, through various research programs have demonstrated the ability to withstand significant swelling and other radiation-induced degradation mechanisms in the high dose regime (>50 displacements per atom, dpa) at elevated temperatures (>300 C). Here, high efficiency multi-dimensional scanning transmission electron microscopy (STEM) acquisition with the aid of a three-dimensional (3D) reconstruction and modeling technique is used to probe the microstructural features that contribute to the exceptional swelling resistance of HT-9. In particular, the synergies between ' and fine-scale and moderate-scale cavity formation is investigated.

  16. A New Maraging Stainless Steel with Excellent Strength–Toughness–Corrosion Synergy

    Directory of Open Access Journals (Sweden)

    Jialong Tian

    2017-11-01

    Full Text Available A new maraging stainless steel with superior strength–toughness–corrosion synergy has been developed based on an innovative concept of alloy design. The high strength–toughness combination is achieved by forming dispersive nano-sized intermetallic compounds in the soft lath martensitic matrix with a slight amount of residual austenite. The good corrosion resistance is guaranteed by exactly controlling the Co content based on understanding the synergistic effect between Co and Cr. The fine structure characteristics of two dominant strengthening precipitations including Ni3Ti and Mo-rich phases were finely characterized associated with transmission electron microscope (TEM and atom probe tomography (APT analyses. The relationship among microstructure, strength and toughness is discussed. The precipitation mechanism of different precipitates in the new maraging stainless steel is revealed based on the APT analysis.

  17. Adaptive synergy between catechol and lysine promotes wet adhesion by surface salt displacement

    Science.gov (United States)

    Maier, Greg P.; Rapp, Michael V.; Waite, J. Herbert; Israelachvili, Jacob N.; Butler, Alison

    2015-08-01

    In physiological fluids and seawater, adhesion of synthetic polymers to solid surfaces is severely limited by high salt, pH, and hydration, yet these conditions have not deterred the evolution of effective adhesion by mussels. Mussel foot proteins provide insights about adhesive adaptations: Notably, the abundance and proximity of catecholic Dopa (3,4-dihydroxyphenylalanine) and lysine residues hint at a synergistic interplay in adhesion. Certain siderophores—bacterial iron chelators—consist of paired catechol and lysine functionalities, thereby providing a convenient experimental platform to explore molecular synergies in bioadhesion. These siderophores and synthetic analogs exhibit robust adhesion energies (Ead ≥-15 millijoules per square meter) to mica in saline pH 3.5 to 7.5 and resist oxidation. The adjacent catechol-lysine placement provides a “one-two punch,” whereby lysine evicts hydrated cations from the mineral surface, allowing catechol binding to underlying oxides.

  18. A New Maraging Stainless Steel with Excellent Strength-Toughness-Corrosion Synergy.

    Science.gov (United States)

    Tian, Jialong; Wang, Wei; Babar Shahzad, M; Yan, Wei; Shan, Yiyin; Jiang, Zhouhua; Yang, Ke

    2017-11-10

    A new maraging stainless steel with superior strength-toughness-corrosion synergy has been developed based on an innovative concept of alloy design. The high strength-toughness combination is achieved by forming dispersive nano-sized intermetallic compounds in the soft lath martensitic matrix with a slight amount of residual austenite. The good corrosion resistance is guaranteed by exactly controlling the Co content based on understanding the synergistic effect between Co and Cr. The fine structure characteristics of two dominant strengthening precipitations including Ni₃Ti and Mo-rich phases were finely characterized associated with transmission electron microscope (TEM) and atom probe tomography (APT) analyses. The relationship among microstructure, strength and toughness is discussed. The precipitation mechanism of different precipitates in the new maraging stainless steel is revealed based on the APT analysis.

  19. Insulin signaling pathways in a patient with insulin resistance of difficult management - a case report

    OpenAIRE

    Taboada, Giselle F; de Freitas, Marta S; da S Corr?a, Fernanda H; Junior, Carlos RMA; de B Gomes, Mar?lia

    2009-01-01

    Insulin signalling pathways were investigated in a 33 year-old woman with immunologic insulin resistance. Her past medical history was remarkable for intermittent use of insulin and allergic reactions to several drugs, and measure of plasma anti-insulin antibodies level corroborated the clinical suspicion of immune mediated insulin resistance (8074 nU/ml - RIA - Ref value:

  20. Epidemiology of antifungal resistance in human pathogenic yeasts: current viewpoint and practical recommendations for management.

    Science.gov (United States)

    Farmakiotis, Dimitrios; Kontoyiannis, Dimitrios P

    2017-09-01

    In this review, we describe the epidemiology and clinical significance of resistance in Candida spp. and other non-Cryptococcus yeasts. The rise in echinocandin resistance, azole resistance and cross-resistance to two or more antifungal classes [multidrug resistance (MDR)] has been a worrisome trend, mainly in US large tertiary and oncology centres, particularly as it relates to Candida glabrata. Candida kefyr is also a concern as it can be resistant to echinocandins and polyenes, especially in patients with haematological malignancies. Lately, Candida auris has drawn a lot of attention: this uncommon Candida spp. is the first globally emerging fungal pathogen that exhibits MDR and strong potential for nosocomial transmission. Its almost simultaneous spread in four continents could be indicative of increasing selection pressures from the use of antifungal agents. Echinocandin non-susceptibility is also common among non-Candida, non-Cryptococcus yeasts. As Candida resistance patterns reflect, in part, institutional practices of antifungal administration, the benefits of antifungal stewardship protocols are increasingly recognised and endorsed in recent guidelines. Development of rapid diagnostic methods for detecting or ruling out the presence of candidaemia and antifungal resistance, as well as discovery of novel antifungals, are key priorities in medical mycology research. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  1. Spectral properties of multiple myoelectric signals: New insights into the neural origin of muscle synergies.

    Science.gov (United States)

    Frère, Julien

    2017-07-04

    It is still unclear if muscle synergies reflect neural strategies or mirror the underlying mechanical constraints. Therefore, this study aimed to verify the consistency of muscle groupings between the synergies based on the linear envelope (LE) of muscle activities and those incorporating the time-frequency (TF) features of the electromyographic (EMG) signals. Twelve healthy participants performed six 20-m walking trials at a comfort and fast self-selected speed, while the activity of eleven lower limb muscles was recorded by means of surface EMG. Wavelet-transformed EMG was used to obtain the TF pattern and muscle synergies were extracted by non-negative matrix factorization. When five muscle synergies were extracted, both methods defined similar muscle groupings whatever the walking speed. When accounting the reconstruction level of the initial dataset, a new TF synergy emerged. This new synergy dissociated the activity of the rectus femoris from those of the vastii muscles (synergy #1) and from the one of the tensor fascia latae (synergy #5). Overall, extracting TF muscle synergies supports the neural origin of muscle synergies and provides an opportunity to distinguish between prescriptive and descriptive muscle synergies. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  2. Accelerator magnet R/D in the perspective of a LHeC and HE-LHC, synergy or competition?

    International Nuclear Information System (INIS)

    Bottura, L.; Auchmann, B.; Bajko, M.; Ballarino, A.; Borgnolutti, F.; Ferracin, P.; Fessia, P.; Karppinen, M.; Kirby, G.; Oberli, L.; Perez, J.C.; Rossi, L.; Rijk, G. de; Russenschuck, S.; Smekens, D.; Todesco, E.; Tommasini, D.

    2012-01-01

    Beyond HL-LHC, CERN has a number of physics options that offer potential and challenges. This contribution dwells on the long-term projects HE-LHC and LHeC to put the magnet research and development at CERN (resistive and superconducting, slow and fast) in a long-term perspective. In particular synergies and parallel road-maps will be highlighted. We will show how the on-going development (2012-2015) on low-field, high-field, and low-loss magnets can be used towards longer term objectives. (authors)

  3. Accelerator Magnet R&D in the Perspective of a LHeC and HE-LHC - Synergy or Competion?

    CERN Document Server

    Bottura, L; Bajko, M; Ballarino, A; Borgnolutti, F; Ferracin, P; Fessia, P; Karppinen, M; Kirby, G; Oberli, L; Perez, J C; Rossi, L; De Rijk, G; Russenschuck, S; Smekens, D; Todesco, E; Tommasini, D

    2012-01-01

    Beyond HL-LHC, CERN has a number of physics options that offer potential and challenges. This contribution dwells on the long-term projects HE-LHC and LHeC to put the magnet R&D at CERN (resistive and superconducting, slow and fast) in a long-term perspective. In particular synergies and parallel roadmaps will be highlighted. We will show how the on-going development (2012-2015) on low-field, high-field, and low-loss magnets can be used towards longer term objectives.

  4. Exo-exo synergy between Cel6A and Cel7A from Hypocrea jecorina

    DEFF Research Database (Denmark)

    Badino, Silke Flindt; Christensen, Stefan Jarl; Kari, Jeppe

    2017-01-01

    Synergy between cellulolytic enzymes is essential in both natural and industrial breakdown of biomass. In addition to synergy between endo- and exo-lytic enzymes, a lesser known but equally conspicuous synergy occurs among exo-acting, processive cellobiohydrolases (CBHs) such as Cel7A and Cel6A...... from Hypocrea jecorina. We studied this system using microcrystalline cellulose as substrate and found a degree of synergy between 1.3 and 2.2 depending on the experimental conditions. Synergy between enzyme variants without the carbohydrate binding module (CBM) and its linker was strongly reduced...... compared to the wild types. One plausible interpretation of this is that exo-exo synergy depends on the targeting role of the CBM. Many earlier works have proposed that exo-exo synergy was caused by an auxiliary endo-lytic activity of Cel6A. However, biochemical data from different assays suggested...

  5. Optimizing the resource usage in Cloud based environments: the Synergy approach

    Science.gov (United States)

    Zangrando, L.; Llorens, V.; Sgaravatto, M.; Verlato, M.

    2017-10-01

    Managing resource allocation in a cloud based data centre serving multiple virtual organizations is a challenging issue. In fact, while batch systems are able to allocate resources to different user groups according to specific shares imposed by the data centre administrator, without a static partitioning of such resources, this is not so straightforward in the most common cloud frameworks, e.g. OpenStack. In the current OpenStack implementation, it is only possible to grant fixed quotas to the different user groups and these resources cannot be exceeded by one group even if there are unused resources allocated to other groups. Moreover in the existing OpenStack implementation, when there aren’t resources available, new requests are simply rejected: it is then up to the client to later re-issue the request. The recently started EU-funded INDIGO-DataCloud project is addressing this issue through “Synergy”, a new advanced scheduling service targeted for OpenStack. Synergy adopts a fair-share model for resource provisioning which guarantees that resources are distributed among users following the fair-share policies defined by the administrator, taken also into account the past usage of such resources. We present the architecture of Synergy, the status of its implementation, some preliminary results and the foreseen evolution of the service.

  6. Value Engineering Synergies with Lean Six Sigma

    Science.gov (United States)

    2010-09-01

    would inflate in some future year. The net present worth of each of the alternatives should be calculated but only after management agrees on two...tered and recommend corrective action for the next study • Publicize accomplishments • Initiate recommendations for potential future VE studies on ideas...or for use in conjunction with SIPOC include a Pert Chart, which captures workflow and output, and value stream mapping ( VSM ). A value stream map

  7. Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial

    Science.gov (United States)

    Wollesen, Bettina; Mattes, Klaus; Schulz, Sören; Bischoff, Laura L.; Seydell, L.; Bell, Jeffrey W.; von Duvillard, Serge P.

    2017-01-01

    Background: Dual-task (DT) training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions. Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group) in gait performance compared to a single task (ST) strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years) participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task) were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h-1). Specific gait variables, cognitive performance, and fear of falling were compared between all groups. >Results: Training improved gait performance for step length (p changes in cognitive performance. Both interventions reduced fear of falling (p management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals. Trial registration: German register of clinical trials DRKS00012382. PMID:29326581

  8. High levels of insecticide resistance in introduced horn fly (Diptera: Muscidae) populations and implications for management.

    Science.gov (United States)

    Oyarzún, M P; Li, A Y; Figueroa, C C

    2011-02-01

    The horn fly, Haematobia irritans (L.) (Diptera: Muscidae), was introduced to Chile in the beginning of the 1990s. Since its introduction, farmers have controlled this pest almost exclusively with insecticides. To understand the consequences of different control strategies on the development of insecticide resistance and their persistence, a field survey was conducted at eight farms in the south of Chile to characterize insecticide resistance in field populations and resistance mechanisms. Horn fly samples were assayed to determine levels of resistance to pyrethroids and diazinon, genotyped for kdr and HialphaE7 mutations, and tested for general esterase activity. All field populations, including ones that were not treated with insecticides for the past 5 yr, showed high levels of cypermethrin resistance and high frequencies of the kdr mutation. None of the fly populations demonstrated resistance to diazinon and the HialphaE7 mutation was not detected in any of the fly samples. Esterase activities in all populations were comparable to those found in the susceptible reference strain. The findings of high frequencies of homozygous resistant and heterozygous individuals both in insecticide treated horn fly populations and in the untreated fly populations suggests complex interactions among field populations of the horn fly in Chile.

  9. Durable resistance: a key to sustainable management of pathogens and pests.

    Science.gov (United States)

    Mundt, Christopher C

    2014-10-01

    This review briefly addresses what has been learned about resistance durability in recent years, as well as the questions that still remain. Molecular analyses of major gene interactions have potential to contribute to both breeding for resistance and improved understanding of virulence impacts on pathogen fitness. Though the molecular basis of quantitative resistance is less clear, substantial evidence has accumulated for the relative simplicity of inheritance. There is increasing evidence for specific interactions with quantitative resistance, though implications of this for durability are still unknown. Mechanisms by which resistance gene pyramids contribute to durability remain elusive, though ideas have been generated for identifying gene combinations that may be more durable. Though cultivar mixtures and related approaches have been used successfully, identifying the diseases and conditions that are most conducive to the use of diversity has been surprisingly difficult, and the selective influence of diversity on pathogen populations is complex. The importance of considering resistance durability in a landscape context has received increasing emphasis and is an important future area of research. Experimental systems are being developed to test resistance gene deployment strategies that previously could be addressed only with logic and observation. The value of molecular markers for identifying and pyramiding major genes is quite clear, but the successful use of quantitative trait loci (QTL) for marker-assisted selection of quantitative resistance will depend greatly on the degree to which the identified QTL are expressed in different genetic backgrounds. Transgenic approaches will likely provide opportunities for control of some recalcitrant pathogens, though issues of durability for transgenes are likely to be no different than other genes for resistance. The need for high quality phenotypic analysis and screening methodologies is a priority, and field

  10. The flexion synergy, mother of all synergies and father of new models of gait

    Directory of Open Access Journals (Sweden)

    Jacques eDuysens

    2013-03-01

    Full Text Available Recently there has been a growing interest in the modular organization of leg movements, in particular those related to locomotion. One of the basic modules involves the flexion of the leg during swing and it was shown that this module is already present in neonates (Dominici, et al. 2011. In this paper, we question how these finding build upon the original work by Sherrington, who proposed that the flexor reflex is the basic building block of the flexion during swing phase. Similarly, the relation between the flexor reflex and the withdrawal reflex modules of Schouenborg et al. (1994 will be discussed. It will be argued that there is large overlap between these notions on modules and the older concepts of reflexes. In addition, it will be shown that there is a great flexibility in the expression of some of these modules during gait, thereby allowing for a phase-dependent modulation of the appropriate responses. In particular, the end of the stance phase is a period when the flexor synergy is facilitated. It is proposed that this is linked to the activation of circuitry that is responsible for the generation of locomotor patterns (CPG, central pattern generator. More specifically, it is suggested that the responses in that period relate to the activation of a flexor burst generator. The latter structure forms the core of a new asymmetric model of the CPG. This activation is controlled by afferent input (facilitation by a broad range of afferents, suppression by load afferent input. Meanwhile, many of these physiologic features have found their way in the control of very flexible walking bipedal robots.

  11. Perioperative management of neurosurgical patients with methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Akins, Paul T; Belko, John; Banerjee, Amit; Guppy, Kern; Herbert, David; Slipchenko, Tamara; DeLemos, Christi; Hawk, Mark

    2010-02-01

    The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has posed a challenge in the treatment of neurosurgical patients. The authors investigated the impact of MRSA colonization and infection in the neurosurgical population at a community-based, tertiary care referral center. Hospitalized patients under the care of the Kaiser Permanente inpatient neurosurgery service were prospectively entered into a database. In Phase I of the study, 492 consecutive patients were followed. Per hospital policy, the 260 patients from this group who were admitted to the intensive care unit (ICU) underwent screening for MRSA based on nasal swab cultures and a review of their medical history for prior MRSA infections. These patients were designated as either MRSA positive (17 patients, 6.5% of screened patients) or MRSA negative (243 patients). The 232 patients admitted to non-ICU nursing units did not undergo MRSA screening and were designated as unscreened. In Phase II of the study, the authors reviewed 1005 neurosurgical admissions and completed a detailed chart review in 62 MRSA-positive patients (6.2%). Eleven patients received nonoperative treatment. Five patients presented with community-acquired neurosurgical infections, and the causative organism was MRSA in 3 cases. Forty-six patients underwent 55 procedures, and the authors reviewed their perioperative management. In Phase I of the study, the authors found that for the MRSA-positive, MRSA-negative, and unscreened groups, the rates of postoperative neurosurgical wound infections caused by all pathogens were 23.5, 4.1, and 1.3%, respectively. For MRSA wound infections, the rates were 23.5, 0.8, and 0%, respectively. In Phase II, patients with MRSA were noted to have the following clinical features: male sex in 63%, a malignancy in 39.1%, diabetes in 34.8%, prior MRSA infection in 21.7%, immunosuppressed state in 17.4%, and a traumatic injury in 15.2%. The rate of postoperative neurosurgical wound infection in

  12. Managing anthelmintic resistance in small ruminant livestock of resource-poor farmers in South Africa : review article

    Directory of Open Access Journals (Sweden)

    A.F. Vatta

    2006-06-01

    Full Text Available Gastrointestinal parasitism is one of the most important disease complexes of sheep and goats impacting on the resource-poor livestock farmer. Of the responsible nematodes, Haemonchus contortus, a blood-sucking worm of the abomasum, poses possibly the greatest threat. Over the past several decades, the worm has been controlled through the use of anthelmintics, but the emergence of anthelmintic resistance has threatened this chemotherapeutic approach. In Africa, the overall prevalence of anthelmintic resistance has not been extensively investigated, particularly within the resource-poor farming sector, but resistance has been reported from at least 14 countries with most of the reports emanating from Kenya and South Africa and the majority concerning H. contortus. While levels of resistance under commercial sheep farming systems in South Africa is considered to be amongst the worst in the world, resistance has also been reported from the resource-poor farming sector. Increases in productivity and reproduction of livestock and the development of markets for sale of animals are seen by international funding bodies as a way out of poverty for communities that keep livestock. This must lead to the greater need for parasite control. At such times, the risk of levels of anthelmintic resistance escalating is much greater and there is therefore a need to look at alternatives to their use. Proposed strategies include the appropriate, but judicious use of anthelmintics by application of the FAMACHA(c system and the use of alternatives to anthelmintics such as strategic nutrient supplementation. It is also very clear that there is a strong demand for knowledge about animal diseases, including helminthosis, and their effective management in the resource-poor livestock farming communities. This is an important challenge to meet.

  13. Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe

    DEFF Research Database (Denmark)

    Bothamley, Graham H.; Lange, Christoph; Albrecht, Dirk

    2017-01-01

    AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. METHODS: TBNET is a pan......-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. RESULTS: 68/105 responses gave valid information and were from countries within the WHO...... widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. CONCLUSION...

  14. Exploiting the synergy between carboplatin and ABT-737 in the treatment of ovarian carcinomas.

    KAUST Repository

    Jain, Harsh Vardhan

    2014-01-06

    Platinum drug-resistance in ovarian cancers mediated by anti-apoptotic proteins such as Bcl-xL is a major factor contributing to the chemotherapeutic resistance of recurrent disease. Consequently, concurrent inhibition of Bcl-xL in combination with chemotherapy may improve treatment outcomes for patients. Here, we develop a mathematical model to investigate the potential of combination therapy with ABT-737, a small molecule inhibitor of Bcl-xL, and carboplatin, a platinum-based drug, on a simulated tumor xenograft. The model is calibrated against in vivo experimental data, wherein xenografts established in mice were treated with ABT-737 and/or carboplatin on a fixed periodic schedule. The validated model is used to predict the minimum drug load that will achieve a predetermined level of tumor growth inhibition, thereby maximizing the synergy between the two drugs. Our simulations suggest that the infusion-duration of each carboplatin dose is a critical parameter, with an 8-hour infusion of carboplatin given weekly combined with a daily bolus dose of ABT-737 predicted to minimize residual disease. The potential of combination therapy to prevent or delay the onset of carboplatin-resistance is also investigated. When resistance is acquired as a result of aberrant DNA-damage repair in cells treated with carboplatin, drug delivery schedules that induce tumor remission with even low doses of combination therapy can be identified. Intrinsic resistance due to pre-existing cohorts of resistant cells precludes tumor regression, but dosing strategies that extend disease-free survival periods can still be identified. These results highlight the potential of our model to accelerate the development of novel therapeutics such as BH3 mimetics.

  15. Report: EPA Needs Better Data, Plans and Tools to Manage Insect Resistance to Genetically Engineered Corn

    Science.gov (United States)

    Report #16-P-0194, June 1, 2016. Bt crops have reduced insecticide applications by 123 million pounds. The EPA can preserve this significant public benefit through enhanced monitoring and preparation to address insect resistance in Bt corn.

  16. Gestores do SUS: apoio e resistências à Homeopatia Support for and resistance to Homeopathy among managers of the Unified National Health System

    Directory of Open Access Journals (Sweden)

    Sandra Abrahão Chaim Salles

    2009-01-01

    Full Text Available Este artigo apresenta parte dos resultados de pesquisa que investigou características do movimento de aproximação e afastamento entre homeopatas e médicos da Biomedicina, segundo o ponto de vista dos profissionais não homeopatas. Foram entrevistados 48 profissionais de saúde (docentes, gestores e médicos que trabalham na rede publica. Toma-se para análise apenas os resultados das entrevistas com gestores. Foram usadas como referências as concepções de: campo social e científico de Bourdieu; racionalidades médicas de Madel Luz; arranjos tecnológicos do trabalho em saúde de Mendes-Gonçalves e de identidade profissional de médico de Donnangelo e de Schraiber. Os resultados indicam que o apoio de gestores à presença da Homeopatia no SUS relaciona-se à percepção da demanda social, à defesa do direito de escolha dos usuários e à constatação de tratar-se de uma prática médica que resgata a dimensão humanista da medicina, contribuindo assim para a satisfação do usuário. As dificuldades e resistências apontadas pelos gestores ressaltam que a falta de informações sobre os procedimentos homeopáticos limita as possibilidades de utilização da Homeopatia porque gera insegurança sobre esta medicina.This article presents partial findings from a study on trends towards greater or lesser proximity between homeopathic and allopathic physicians, from the perspective of the latter. Forty-eight health professionals were interviewed (faculty, managers, and physicians working in the public health system. This specific article focused only on the interviews with health system managers. The following concepts were used as references: social and scientific field (Bourdieu; medical rationalities (Madel Luz; technological arrangements in health work (Mendes-Gonçalves; and physician's professional identity (Donnangelo & Schraiber. According to the findings, support by managers for the presence of Homeopathy in the Unified National

  17. Stride time synergy in relation to walking during dual task

    DEFF Research Database (Denmark)

    Læssøe, Uffe; Madeleine, Pascal

    2012-01-01

    with a positive slope going through the mean of the strides, and bad variance with respect to a similar line with a negative slope. The general variance coefficient (CV%) was also computed. The effect of introducing a concurrent cognitive task (dual task: counting backwards in sequences of 7) was evaluated...... point of view elemental and performance variables may represent good and bad components of variability [2]. In this study we propose that the gait pattern can be seen as an on-going movement synergy in which each stride is corrected by the next stride (elemental variables) to ensure a steady gait...... (performance variable). AIM: The aim of this study was to evaluate stride time synergy and to identify good and bad stride variability in relation to walking during dual task. METHODS: Thirteen healthy young participants walked along a 2x5 meter figure-of-eight track at a self-selected comfortable speed...

  18. Stride time synergy in relation to walking during dual task

    DEFF Research Database (Denmark)

    Læssøe, Uffe; Madeleine, Pascal

    2012-01-01

    point of view elemental and performance variables may represent good and bad components of variability [2]. In this study we propose that the gait pattern can be seen as an on-going movement synergy in which each stride is corrected by the next stride (elemental variables) to ensure a steady gait...... (performance variable). AIM: The aim of this study was to evaluate stride time synergy and to identify good and bad stride variability in relation to walking during dual task. METHODS: Thirteen healthy young participants walked along a 2x5 meter figure-of-eight track at a self-selected comfortable speed....... RESULTS: The variance coefficient (CV%) increased significantly from 1.59 to 1.90 (psynergy approach, the good/bad variance ratio during single task was: 2.53 (CI95%: 2.07-3.00). When shifting to dual task the good/bad ratio was 2.28 (CI95...

  19. Intravenous salbutamol and aminophylline in asthma: a search for synergy.

    Science.gov (United States)

    Handslip, P D; Dart, A M; Davies, B H

    1981-10-01

    The bronchodilation produced by increasing intravenous doses of aminophylline, salbutamol, and a combination of aminophylline and salbutamol given in random order was determined in 10 stable asthmatics on three consecutive days. On a fourth day, response to placebo injections was determined. Forced expiratory volume in one second (FEV1) was measured at two-minute intervals after each dose until FEV1 returned to a new baseline. At no dosage level was there synergy between the two agents in terms of either mean percentage increase in FEV1 or the integrated response. The failure to demonstrate synergy has implications both with respect to the clinical use and the underlying mechanism of action of these drugs.

  20. Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management

    Directory of Open Access Journals (Sweden)

    O’Driscoll T

    2015-07-01

    Full Text Available Tristan O’Driscoll,1 Christopher W Crank2 1Department of Pharmacy Practice, Chicago College of Pharmacy, Downers Grove, IL, USA; 2Pharmacy Services, Rush-Copley Medical Center, Aurora, IL, USA Abstract: Since its discovery in England and France in 1986, vancomycin-resistant Enterococcus has increasingly become a major nosocomial pathogen worldwide. Enterococci are prolific colonizers, with tremendous genome plasticity and a propensity for persistence in hospital environments, allowing for increased transmission and the dissemination of resistance elements. Infections typically present in immunosuppressed patients who have received multiple courses of antibiotics in the past. Virulence is variable, and typical clinical manifestations include bacteremia, endocarditis, intra-abdominal and pelvic infections, urinary tract infections, skin and skin structure infections, and, rarely, central nervous system infections. As enterococci are common colonizers, careful consideration is needed before initiating targeted therapy, and source control is first priority. Current treatment options including linezolid, daptomycin, quinupristin/dalfopristin, and tigecycline have shown favorable activity against various vancomycin-resistant Enterococcus infections, but there is a lack of randomized controlled trials assessing their efficacy. Clearer distinctions in preferred therapies can be made based on adverse effects, drug interactions, and pharmacokinetic profiles. Although combination therapies and newer agents such as tedizolid, telavancin, dalbavancin, and oritavancin hold promise for the future treatment of vancomycin-resistant Enterococcus infections, further studies are needed to assess their possible clinical impact, especially in the treatment of serious infections. Keywords: Gram-positive, Enterococcus faecalis, Enterococcus faecium, VRE, antibiotic resistance, multidrug resistance

  1. Citizen Science & Open Science: Synergies & Future Areas of Work

    OpenAIRE

    DITOs Consortium

    2018-01-01

    Citizen Science (CS) and Open Science (OS) are among the most discussed topics in current research and innovation policy, and are becoming increasingly related. This policy brief was developed with contributions from a mixed group of experts from both fields. It aims at informing decision makers who have adopted Citizen Science or Open Science on the synergies between these approaches and the benefits of considering them together. By showcasing initiatives implemented in Europe, this document...

  2. Analgesic synergy between opioid and α2 -adrenoceptors.

    Science.gov (United States)

    Chabot-Doré, A-J; Schuster, D J; Stone, L S; Wilcox, G L

    2015-01-01

    Opioid and α2 -adrenoceptor agonists are potent analgesic drugs and their analgesic effects can synergize when co-administered. These supra-additive interactions are potentially beneficial clinically; by increasing efficacy and/or reducing the total drug required to produce sufficient pain relief, undesired side effects can be minimized. However, combination therapies of opioids and α2 -adrenoceptor agonists remain underutilized clinically, in spite of a large body of preclinical evidence describing their synergistic interaction. One possible obstacle to the translation of preclinical findings to clinical applications is a lack of understanding of the mechanisms underlying the synergistic interactions between these two drug classes. In this review, we provide a detailed overview of the interactions between different opioid and α2 -adrenoceptor agonist combinations in preclinical studies. These studies have identified the spinal cord as an important site of action of synergistic interactions, provided insights into which receptors mediate these interactions and explored downstream signalling events enabling synergy. It is now well documented that the activation of both μ and δ opioid receptors can produce synergy with α2 -adrenoceptor agonists and that α2 -adrenoceptor agonists can mediate synergy through either the α2A or the α2C adrenoceptor subtypes. Current hypotheses surrounding the cellular mechanisms mediating opioid-adrenoceptor synergy, including PKC signalling and receptor oligomerization, and the evidence supporting them are presented. Finally, the implications of these findings for clinical applications and drug discovery are discussed. This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2. © 2014 The British Pharmacological Society.

  3. Collective Intelligence for Evaluating Synergy in Collaborative Innovation

    OpenAIRE

    Altay , Ayca; Kayakutlu , Gulgun

    2012-01-01

    International audience; Collaborative innovation is an unavoidable need for the small and medium enterprises (SME) both in terms of economic scale and technological knowledge. Risks and the innovation power are analyzed for the wealth of collaboration. This paper aims to present the synergy index as a multiplier of the innovation power of research partners to construct a successful collaboration. The proposed index can be used with different number of companies in collaboration cluster and th...

  4. Food synergy: an operational concept for understanding nutrition1234

    OpenAIRE

    Jacobs, David R; Gross, Myron D; Tapsell, Linda C

    2009-01-01

    Research and practice in nutrition relate to food and its constituents, often as supplements. In food, however, the biological constituents are coordinated. We propose that “thinking food first”' results in more effective nutrition research and policy. The concept of food synergy provides the necessary theoretical underpinning. The evidence for health benefit appears stronger when put together in a synergistic dietary pattern than for individual foods or food constituents. A review of dietary...

  5. USING THE SYNERGY OF ALLIANCES AND PARTNERSHIP FOR SUSTAINABLE GROWTH

    OpenAIRE

    Elena DOVAL; Oriana DOVAL

    2010-01-01

    The purpose of this research is to demonstrate by searching the literature that the synergy of different types of alliances and partnership brings much more opportunities for the sustainable growth of the companies. After a briefing about definitions, types and purpose of alliances and partnership the paper reminds the process of alliances and partnership formation and emphasises the main advantages and limits of alliances and partnership Finally, a new type of company is defined, i.e. ‘the s...

  6. Cooperation Formats of China and Europe: Synergies and Divergences

    Directory of Open Access Journals (Sweden)

    Šteinbuka Inna

    2017-06-01

    Full Text Available This contribution articulates the synergies and divergences of the various formats of cooperation between China and the European countries. The EU and China have a strong interest in each other’s flagship initiatives, namely the Investment Plan for Europe, and the One Belt, One Road Initiative (Silk Road Economic Belt and 21st-Century Maritime Silk Road. The authors argue that there are certain synergies between these initiatives. Furthermore, the new initiative EU-China Connectivity Platform is aimed to explore these synergies. The authors explore the recent developments in the EU-China investments, trade cooperation and the challenges of the ever-growing CEEC-China partnership in different formats, including the new platform of 16+1. The authors examine these implications in relation to the need to expand and adapt the content and approach of the EU-China Bilateral Investment agreement. The article concludes that the CEEC-China relation does not go against the EU; moreover, neither the CEE countries nor China have any motivation to try to weaken the EU.

  7. Muscle synergy analysis in transtibial amputee during ramp ascending activity.

    Science.gov (United States)

    Mehryar, P; Shourijeh, M S; Maqbool, H F; Torabi, M; Dehghani-Sanij, A A

    2016-08-01

    In developed countries, the highest number of amputees are elderly with transtibial amputation. Walking on inclined surfaces is difficult for amputees due to loss of muscle volume and strength thereby transtibial amputees (TA) rely on the intact limb to maintain stability. The aim of this study was to use the concatenated non-negative matrix factorization (CNMF) technique to calculate muscle synergy components and compare the difference in muscle synergies and their associated activation profiles in the healthy and amputee groups during ramp ascending (RA) activity. Healthy subjects' dominant leg and amputee's intact leg (IL) were considered for recording surface electromyography (sEMG). The muscle synergies comparison showed a reasonable correlation between the healthy and amputee groups. This suggests the central nervous system (CNS) activates the same group of muscles synergistically. However, the activation coefficient profile (C) results indicated statistically significant difference (p amputee groups. The difference exhibited in activation profiles of amputee's IL could be due to the instability of the prosthetic leg during the GC which resulted in alteration of the IL muscles activations. This information will be useful in rehabilitation and in the future development of prosthetic devices by using the IL muscles information to control the prostheses.

  8. Nuclear and Renewable Energy Synergies Workshop: Report of Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, M.; Antkowiak, M.; Gossett, S.

    2011-12-01

    Two of the major challenges the U.S. energy sector faces are greenhouse gas emissions and oil that is both imported and potentially reaching a peak (the point at which maximum extraction is reached). Interest in development of both renewable and nuclear energy has been strong because both have potential for overcoming these challenges. Research in both energy sources is ongoing, but relatively little research has focused on the potential benefits of combining nuclear and renewable energy. In September 2011, the Joint Institute for Strategic Energy Analysis (JISEA) convened the Nuclear and Renewable Energy Synergies Workshop at the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) to identify potential synergies and strategic leveraging opportunities between nuclear energy and renewable energy. Industry, government, and academic thought leaders gathered to identify potential broad categories of synergies and brainstorm topic areas for additional analysis and research and development (R&D). This report records the proceedings and outcomes of the workshop.

  9. Characterization of Cardiac Patients Based on the Synergy Model

    Directory of Open Access Journals (Sweden)

    Tavangar

    2014-10-01

    Full Text Available Background Cardiac patients need comprehensive support due to the adverse effects of this disease on different aspects of their lives. Synergy intervention is a model that focuses on patients' requirements. Objectives This study aimed to determine the eightfold characteristic of cardiac patients based on the synergy model that represent their clinical requirements. Materials and Methods In this descriptive cross-sectional study, 40 cardiac patients hospitalized at the cardiac care unit (CCU of Yazd Afshar Hospital were randomly selected. The data were collected by using a two-part check-list including demographic characteristics and also by studying eight characteristics of patients through interviewing and reviewing their records. The results were analyzed using descriptive statistics such as frequency (percentage and analytical statistics such as Spearman and Mann-Whitney test with the SPSS software, version 18. Results The results showed that among patients' internal characteristics, reversibility (70.6%, vulnerability (68.6%, and predictability (80.4% at level 1 (the minimum score had the highest frequency and stability (49% and complexity (54.9% were at level 3 (average score. Among external characteristics participation in decision-making (80.4% at level 1 had the highest frequency while care (62.7% and recourses (98% were at level 3. Conclusions Ignoring any of the eightfold characteristics based on the synergy model interferes with comprehensive support of cardiac patients. Therefore, it is necessary for professional health practitioners, especially nurses, to consider patients' eightfold characteristics in order to provide quality care.

  10. Normal aging reduces motor synergies in manual pointing.

    Science.gov (United States)

    Verrel, Julius; Lövdén, Martin; Lindenberger, Ulman

    2012-01-01

    Depending upon its organization, movement variability may reflect poor or flexible control of a motor task. We studied adult age-related differences in the structure of postural variability in manual pointing using the uncontrolled manifold (UCM) method. Participants from 2 age groups (younger: 20-30 years; older: 70-80 years; 12 subjects per group) completed a total of 120 pointing trials to 2 different targets presented according to 3 schedules: blocked, alternating, and random. The age groups were similar with respect to basic kinematic variables, end point precision, as well as the accuracy of the biomechanical forward model of the arm. Following the uncontrolled manifold approach, goal-equivalent and nongoal-equivalent components of postural variability (goal-equivalent variability [GEV] and nongoal-equivalent variability [NGEV]) were determined for 5 time points of the movements (start, 10%, 50%, 90%, and end) and used to define a synergy index reflecting the flexibility/stability aspect of motor synergies. Toward the end of the movement, younger adults showed higher synergy indexes than older adults. Effects of target schedule were not reliable. We conclude that normal aging alters the organization of common multidegree-of-freedom movements, with older adults making less flexible use of motor abundance than younger adults. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Complexity and Health Coaching: Synergies in Nursing

    Directory of Open Access Journals (Sweden)

    Gail J. Mitchell

    2013-01-01

    Full Text Available Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons’ lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living.

  12. Complexity and Health Coaching: Synergies in Nursing

    Science.gov (United States)

    Mitchell, Gail J.; Wong, Winnie; Rush, Danica

    2013-01-01

    Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons' lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living. PMID:24102025

  13. Novel Methods to Enhance Precision and Reliability in Muscle Synergy Identification during Walking

    Science.gov (United States)

    Kim, Yushin; Bulea, Thomas C.; Damiano, Diane L.

    2016-01-01

    Muscle synergies are hypothesized to reflect modular control of muscle groups via descending commands sent through multiple neural pathways. Recently, the number of synergies has been reported as a functionally relevant indicator of motor control complexity in individuals with neurological movement disorders. Yet the number of synergies extracted during a given activity, e.g., gait, varies within and across studies, even for unimpaired individuals. With no standardized methods for precise determination, this variability remains unexplained making comparisons across studies and cohorts difficult. Here, we utilize k-means clustering and intra-class and between-level correlation coefficients to precisely discriminate reliable from unreliable synergies. Electromyography (EMG) was recorded bilaterally from eight leg muscles during treadmill walking at self-selected speed. Muscle synergies were extracted from 20 consecutive gait cycles using non-negative matrix factorization. We demonstrate that the number of synergies is highly dependent on the threshold when using the variance accounted for by reconstructed EMG. Beyond use of threshold, our method utilized a quantitative metric to reliably identify four or five synergies underpinning walking in unimpaired adults and revealed synergies having poor reproducibility that should not be considered as true synergies. We show that robust and unreliable synergies emerge similarly, emphasizing the need for careful analysis in those with pathology. PMID:27695403

  14. Alterations in upper limb muscle synergy structure in chronic stroke survivors

    Science.gov (United States)

    Rymer, William Z.; Perreault, Eric J.; Yoo, Seng Bum; Beer, Randall F.

    2013-01-01

    Previous studies in neurologically intact subjects have shown that motor coordination can be described by task-dependent combinations of a few muscle synergies, defined here as a fixed pattern of activation across a set of muscles. Arm function in severely impaired stroke survivors is characterized by stereotypical postural and movement patterns involving the shoulder and elbow. Accordingly, we hypothesized that muscle synergy composition is altered in severely impaired stroke survivors. Using an isometric force matching protocol, we examined the spatial activation patterns of elbow and shoulder muscles in the affected arm of 10 stroke survivors (Fugl-Meyer synergies were identified using non-negative matrix factorization. In both groups, muscle activation patterns could be reconstructed by combinations of a few muscle synergies (typically 4). We did not find abnormal coupling of shoulder and elbow muscles within individual muscle synergies. In stroke survivors, as in controls, two of the synergies were comprised of isolated activation of the elbow flexors and extensors. However, muscle synergies involving proximal muscles exhibited consistent alterations following stroke. Unlike controls, the anterior deltoid was coactivated with medial and posterior deltoids within the shoulder abductor/extensor synergy and the shoulder adductor/flexor synergy in stroke was dominated by activation of pectoralis major, with limited anterior deltoid activation. Recruitment of the altered shoulder muscle synergies was strongly associated with abnormal task performance. Overall, our results suggest that an impaired control of the individual deltoid heads may contribute to poststroke deficits in arm function. PMID:23155178

  15. Novel methods to enhance precision and reliability in muscle synergy identification during walking

    Directory of Open Access Journals (Sweden)

    Yushin Kim

    2016-09-01

    Full Text Available Muscle synergies are hypothesized to reflect modular control of muscle groups via descending commands sent through multiple neural pathways. Recently, the number of synergies has been reported as a functionally relevant indicator of motor control complexity in individuals with neurological movement disorders. Yet the number of synergies extracted during a given activity, e.g. gait, varies within and across studies, even for unimpaired individuals. With no standardized methods for precise determination, this variability remains unexplained making comparisons across studies and cohorts difficult. Here, we utilize k-means clustering and intra-class and between-level correlation coefficients to precisely discriminate reliable from unreliable synergies. EMG was recorded bilaterally from eight leg muscles during treadmill walking at self-selected speed. Muscle synergies were extracted from 20 consecutive gait cycles using non-negative matrix factorization. We demonstrate that the number of synergies is highly dependent on the threshold when using the variance accounted for by reconstructed EMG. In contrast, our method utilized a quantitative metric to reliably identify four or five synergies underpinning walking in unimpaired adults and revealed synergies having poor reproducibility that should not be considered as true synergies. We show that robust and unreliable synergies emerge similarly, emphasizing the need for careful analysis in those with pathology.

  16. Novel Methods to Enhance Precision and Reliability in Muscle Synergy Identification during Walking.

    Science.gov (United States)

    Kim, Yushin; Bulea, Thomas C; Damiano, Diane L

    2016-01-01

    Muscle synergies are hypothesized to reflect modular control of muscle groups via descending commands sent through multiple neural pathways. Recently, the number of synergies has been reported as a functionally relevant indicator of motor control complexity in individuals with neurological movement disorders. Yet the number of synergies extracted during a given activity, e.g., gait, varies within and across studies, even for unimpaired individuals. With no standardized methods for precise determination, this variability remains unexplained making comparisons across studies and cohorts difficult. Here, we utilize k -means clustering and intra-class and between-level correlation coefficients to precisely discriminate reliable from unreliable synergies. Electromyography (EMG) was recorded bilaterally from eight leg muscles during treadmill walking at self-selected speed. Muscle synergies were extracted from 20 consecutive gait cycles using non-negative matrix factorization. We demonstrate that the number of synergies is highly dependent on the threshold when using the variance accounted for by reconstructed EMG. Beyond use of threshold, our method utilized a quantitative metric to reliably identify four or five synergies underpinning walking in unimpaired adults and revealed synergies having poor reproducibility that should not be considered as true synergies. We show that robust and unreliable synergies emerge similarly, emphasizing the need for careful analysis in those with pathology.

  17. Prediction of functional outcomes in stroke patients: the role of motor patterns according to limb synergies.

    Science.gov (United States)

    Gialanella, Bernardo; Santoro, Raffaele

    2015-10-01

    To address the relationships among motor patterns evaluated according to the limb synergies and functional outcomes in stroke patients and clarify which motor pattern was the most important predictor of functional outcomes. The study was conducted on 208 patients with primary diagnosis of stroke admitted for in-hospital rehabilitation. At entry, the Fugl-Meyer Scale was administered to assess motor function according to limb synergies. Pearson's correlation was used to assess the relationship between variables, and backward stepwise regression analysis was used to identify the outcome determinants. Final functional independence measure (FIM) scores and length of in-hospital stay were the outcome measures. At the end of rehabilitation, motor-FIM scores of patients with extensor and flexor synergies, mixing synergies, and no dependence from the synergies were higher than those of no movements and flexor synergy. Multivariate regression analysis showed that extensor synergy of upper limb was an independent predictor of final motor-FIM, personal care and mobility, extensor synergy of lower limb of locomotion, while mixing synergies of upper limb was an independent predictor of length of in-hospital stay. In stroke rehabilitation, the patients' motor patterns according to the synergies strongly relate with functional outcomes and are important outcome predictors.

  18. Quantitative evaluation of muscle synergy models: a single-trial task decoding approach

    Directory of Open Access Journals (Sweden)

    Ioannis eDelis

    2013-02-01

    Full Text Available Muscle synergies, i.e. invariant coordinated activations of groups of muscles, have been proposed as building blocks that the central nervous system uses to construct the patterns of muscle activity utilized for executing movements. Several efficient dimensionality reduction algorithms that extract putative synergies from electromyographic (EMG signals have been developed. Typically, the quality of synergy decompositions is assessed by computing the variance accounted for (VAF. Yet, little is known about the extent to which the combination of those synergies encodes task-discriminating variations of muscle activity in individual trials. To address this question, here we conceive and develop a novel computational framework to evaluate muscle synergy decompositions in task space. Unlike previous methods considering the total variance of muscle patterns (VAF based metrics, our approach focuses on variance discriminating execution of different tasks. The procedure is based on single-trial task decoding from muscle synergy activation features. The task decoding based metric evaluates quantitatively the mapping between synergy recruitment and task identification and automatically determines the minimal number of synergies that captures all the task-discriminating variability in the synergy activations. In this paper, we first validate the method on plausibly simulated EMG datasets. We then show that it can be applied to different types of muscle synergy decomposition and illustrate its applicability to real data by using it for the analysis of EMG recordings during an arm pointing task. We find that time-varying and synchronous synergies with similar number of parameters are equally efficient in task decoding, suggesting that in this experimental paradigm they are equally valid representations of muscle synergies. Overall, these findings stress the effectiveness of the decoding metric in systematically assessing muscle synergy decompositions in task

  19. Consequences of biomechanically constrained tasks in the design and interpretation of synergy analyses.

    Science.gov (United States)

    Steele, Katherine M; Tresch, Matthew C; Perreault, Eric J

    2015-04-01

    Matrix factorization algorithms are commonly used to analyze muscle activity and provide insight into neuromuscular control. These algorithms identify low-dimensional subspaces, commonly referred to as synergies, which can describe variation in muscle activity during a task. Synergies are often interpreted as reflecting underlying neural control; however, it is unclear how these analyses are influenced by biomechanical and task constraints, which can also lead to low-dimensional patterns of muscle activation. The aim of this study was to evaluate whether commonly used algorithms and experimental methods can accurately identify synergy-based control strategies. This was accomplished by evaluating synergies from five common matrix factorization algorithms using muscle activations calculated from 1) a biomechanically constrained task using a musculoskeletal model and 2) without task constraints using random synergy activations. Algorithm performance was assessed by calculating the similarity between estimated synergies and those imposed during the simulations; similarities ranged from 0 (random chance) to 1 (perfect similarity). Although some of the algorithms could accurately estimate specified synergies without biomechanical or task constraints (similarity >0.7), with these constraints the similarity of estimated synergies decreased significantly (0.3-0.4). The ability of these algorithms to accurately identify synergies was negatively impacted by correlation of synergy activations, which are increased when substantial biomechanical or task constraints are present. Increased variability in synergy activations, which can be captured using robust experimental paradigms that include natural variability in motor activation patterns, improved identification accuracy but did not completely overcome effects of biomechanical and task constraints. These results demonstrate that a biomechanically constrained task can reduce the accuracy of estimated synergies and highlight

  20. Quantitative evaluation of muscle synergy models: a single-trial task decoding approach.

    Science.gov (United States)

    Delis, Ioannis; Berret, Bastien; Pozzo, Thierry; Panzeri, Stefano

    2013-01-01

    Muscle synergies, i.e., invariant coordinated activations of groups of muscles, have been proposed as building blocks that the central nervous system (CNS) uses to construct the patterns of muscle activity utilized for executing movements. Several efficient dimensionality reduction algorithms that extract putative synergies from electromyographic (EMG) signals have been developed. Typically, the quality of synergy decompositions is assessed by computing the Variance Accounted For (VAF). Yet, little is known about the extent to which the combination of those synergies encodes task-discriminating variations of muscle activity in individual trials. To address this question, here we conceive and develop a novel computational framework to evaluate muscle synergy decompositions in task space. Unlike previous methods considering the total variance of muscle patterns (VAF based metrics), our approach focuses on variance discriminating execution of different tasks. The procedure is based on single-trial task decoding from muscle synergy activation features. The task decoding based metric evaluates quantitatively the mapping between synergy recruitment and task identification and automatically determines the minimal number of synergies that captures all the task-discriminating variability in the synergy activations. In this paper, we first validate the method on plausibly simulated EMG datasets. We then show that it can be applied to different types of muscle synergy decomposition and illustrate its applicability to real data by using it for the analysis of EMG recordings during an arm pointing task. We find that time-varying and synchronous synergies with similar number of parameters are equally efficient in task decoding, suggesting that in this experimental paradigm they are equally valid representations of muscle synergies. Overall, these findings stress the effectiveness of the decoding metric in systematically assessing muscle synergy decompositions in task space.

  1. The Effects of Difunctional Urone Catalysis on Selected Non-Halogenated Flame Retardant Synergies of Dicyandiamide Cured Epoxy Resins

    Science.gov (United States)

    Phillips, Nathan M.

    thermal performance of each non-halogenated flame retardant synergy. The effects of the urone catalysis were shown to be highly dependent on the mechanism of decomposition for each flame-retardant synergy. It was also determined that the flame resistance and RTI were dependent on the ability of each flame retardant to synergize with decomposing nitrogen moieties that were contained in the selected urone catalyst.

  2. Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management.

    Science.gov (United States)

    González-Saldivar, Gloria; Rodríguez-Gutiérrez, René; Ocampo-Candiani, Jorge; González-González, José Gerardo; Gómez-Flores, Minerva

    2017-03-01

    Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, ~382 million individuals live with diabetes, and 40-50% of the global population is labeled at "high risk" (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted. In both diabetes and obesity, genetic, epigenetic, and environmental factors overlap and are inclusive rather than exclusive. De facto, 70-80% of the patients with obesity and virtually every patient with type 2 diabetes have insulin resistance. Insulin resistance is a well-known pathophysiologic factor in the development of type 2 diabetes, characteristically appearing years before its diagnosis. The gold standard for insulin resistance diagnosis (the euglycemic insulin clamp) is a complex, invasive, costly, and hence unfeasible test to implement in clinical practice. Likewise, laboratory measures and derived indexes [e.g., homeostasis model assessment of insulin resistance (HOMA-IR-)] are indirect, imprecise, and not highly accurate and reproducible tests. However, skin manifestations of insulin resistance (e.g., acrochordons, acanthosis nigricans, androgenetic alopecia, acne, hirsutism) offer a reliable, straightforward, and real-time way to detect insulin resistance. The objective of this review is to aid clinicians in recognizing skin manifestations of insulin resistance. Diagnosing these skin manifestations accurately may cascade positively in the patient's health by triggering an adequate metabolic evaluation, a timely treatment or referral with the ultimate objective of decreasing diabetes and obesity burden, and improving the

  3. Antimicrobial Resistance: Its Surveillance, Impact, and Alternative Management Strategies in Dairy Animals

    Science.gov (United States)

    Sharma, Chetan; Rokana, Namita; Chandra, Mudit; Singh, Brij Pal; Gulhane, Rohini Devidas; Gill, Jatinder Paul Singh; Ray, Pallab; Puniya, Anil Kumar; Panwar, Harsh

    2018-01-01

    Antimicrobial resistance (AMR), one among the most common priority areas identified by both national and international agencies, is mushrooming as a silent pandemic. The advancement in public health care through introduction of antibiotics against infectious agents is now being threatened by global development of multidrug-resistant strains. These strains are product of both continuous evolution and un-checked antimicrobial usage (AMU). Though antibiotic application in livestock has largely contributed toward health and productivity, it has also played significant role in evolution of resistant strains. Although, a significant emphasis has been given to AMR in humans, trends in animals, on other hand, are not much emphasized. Dairy farming involves surplus use of antibiotics as prophylactic and growth promoting agents. This non-therapeutic application of antibiotics, their dosage, and withdrawal period needs to be re-evaluated and rationally defined. A dairy animal also poses a serious risk of transmission of resistant strains to humans and environment. Outlining the scope of the problem is necessary for formulating and monitoring an active response to AMR. Effective and commendably connected surveillance programs at multidisciplinary level can contribute to better understand and minimize the emergence of resistance. Besides, it requires a renewed emphasis on investments into research for finding alternate, safe, cost effective, and innovative strategies, parallel to discovery of new antibiotics. Nevertheless, numerous direct or indirect novel approaches based on host–microbial interaction and molecular mechanisms of pathogens are also being developed and corroborated by researchers to combat the threat of resistance. This review places a concerted effort to club the current outline of AMU and AMR in dairy animals; ongoing global surveillance and monitoring programs; its impact at animal human interface; and strategies for combating resistance with an extensive

  4. Antimicrobial Resistance: Its Surveillance, Impact, and Alternative Management Strategies in Dairy Animals

    Directory of Open Access Journals (Sweden)

    Chetan Sharma

    2018-01-01

    Full Text Available Antimicrobial resistance (AMR, one among the most common priority areas identified by both national and international agencies, is mushrooming as a silent pandemic. The advancement in public health care through introduction of antibiotics against infectious agents is now being threatened by global development of multidrug-resistant strains. These strains are product of both continuous evolution and un-checked antimicrobial usage (AMU. Though antibiotic application in livestock has largely contributed toward health and productivity, it has also played significant role in evolution of resistant strains. Although, a significant emphasis has been given to AMR in humans, trends in animals, on other hand, are not much emphasized. Dairy farming involves surplus use of antibiotics as prophylactic and growth promoting agents. This non-therapeutic application of antibiotics, their dosage, and withdrawal period needs to be re-evaluated and rationally defined. A dairy animal also poses a serious risk of transmission of resistant strains to humans and environment. Outlining the scope of the problem is necessary for formulating and monitoring an active response to AMR. Effective and commendably connected surveillance programs at multidisciplinary level can contribute to better understand and minimize the emergence of resistance. Besides, it requires a renewed emphasis on investments into research for finding alternate, safe, cost effective, and innovative strategies, parallel to discovery of new antibiotics. Nevertheless, numerous direct or indirect novel approaches based on host–microbial interaction and molecular mechanisms of pathogens are also being developed and corroborated by researchers to combat the threat of resistance. This review places a concerted effort to club the current outline of AMU and AMR in dairy animals; ongoing global surveillance and monitoring programs; its impact at animal human interface; and strategies for combating resistance

  5. Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries

    DEFF Research Database (Denmark)

    Ballif, M; Nhandu, V; Wood, R

    2014-01-01

    SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons. OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries. DESIGN......: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB...... patients seen at 40 of the participating ART programs. RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43...

  6. Management of multidrug-resistant tuberculosis in human immunodeficiency virus patients

    Science.gov (United States)

    Jamil, K. F.

    2018-03-01

    Tuberculosis (TB) is a chronic infectious disease mainly caused by Mycobacterium tuberculosis(MTB). 10.4 million new TB cases will appear in 2015 worldwide. There were an estimated 1.4 million TB deaths in 2015, and an additional 0.4 million deaths resulting from TB disease among people living with human immunodeficiency virus (HIV). Multidrug- resistant and extensively drug-resistant tuberculosis (MDR and XDR-TB) are major public health concerns worldwide. 480.000 new cases of MDR-TB will appear in 2015 and an additional 100,000 people with rifampicin-resistant TB (RR-TB) who were also newly eligible for MDR-TB treatment. Their association with HIV infection has contributed to the slowing down of TB incidence decline over the last two decades, therefore representing one important barrier to reach TB elimination. Patients infected with MDR-TB require more expensive treatment regimens than drug-susceptible TB, with poor treatment.Patients with multidrug- resistant tuberculosis do not receive rifampin; drug interactions risk is markedly reduced. However, overlapping toxicities may limit options for co-treatment of HIV and multidrug- resistant tuberculosis.

  7. Stop fighting alone, let synergy rule!

    CERN Multimedia

    Computer Security Team

    2013-01-01

    Could it be true, as it seems to me, that CERN still has manpower to spare? I thought that now, during LS1, resources were scarce and everybody was very busy. But apparently not. We are getting more requests than ever to open firewalls for stand-alone web servers running local databases and custom web applications.   What we are talking about here are “newly” created software applications with similar functions to existing alternatives. We often encounter computing hardware and network equipment managed in multiple ways by multiple people, and commercial software or cloud services that closely resemble CERN’s existing computing services are bought or rented – for instance, SurveyMonkey vs. SharePoint or tinyurl.com vs. cern.ch/go. Why does CERN run two document stores, CDS and EDMS, that provide similar functions and workflows? Wouldn’t one be sufficient? And four (or more!) JIRA ticketing systems? Why are there so many local Git instances, do...

  8. Pesticide Resistance in Stored-Product Insects and Alternative Biorational Management: A Brief Review

    Directory of Open Access Journals (Sweden)

    Farid Talukder

    2009-01-01

    Full Text Available Conventional pesticides are being used as the major tools for stored grain and food protection. Many conventional pesticides have created problems including pesticide resistance, toxic residues in the treated products, handling hazards, health hazards to operatives and pest resurgence. Among these, the incidence of pesticide resistance is a growing problem in stored product protection. Problems associated with synthetic pesticides, especially pesticide resistance, have created a worldwide interest in the development of alternative biorational strategies. Plant-derived materials, biological control agents, insect growth regulators, solar disinfestation systems, use of inert dusts and diatomaceous earth, etc., are potential viable alternatives. Most of these alternatives have low toxicity or are not toxic to humans, making them environmentally acceptable and enabling them to be incorporated in stored product protection.

  9. Emergence of motor synergy in vertical reaching task via tacit learning.

    Science.gov (United States)

    Hayashibe, Mitsuhiro; Shimoda, Shingo

    2013-01-01

    The dynamics of multijoint limbs often causes complex dynamic interaction torques which are the inertial effect of other joints motion. It is known that Cerebellum takes important role in a motor learning by developing the internal model. In this paper, we propose a novel computational control paradigm in vertical reaching task which involves the management of interaction torques and gravitational effect. The obtained results demonstrate that the proposed method is valid for acquiring motor synergy in the system with actuation redundancy and resulted in the energy efficient solutions. It is highlighted that the tacit learning in vertical reaching task can bring computational adaptability and optimality with model-free and cost-function-free approach differently from previous studies.

  10. Skid resistance determination for pavement management and wet-weather road safety

    OpenAIRE

    T.F. Fwa

    2017-01-01

    Road accidents during wet weather have been a topic of major concern of road engineers in regions of wet-tropical climate and in other parts of the world during the wet season of the year. Road safety studies indicate that approximately 20% of all road accidents occurred during wet weather, and that the skid resistance of wet pavements have a major influence on the occurrences of wet-weather accidents. Monitoring of wet pavement skid resistance has been an integral part of a typical pavement ...

  11. Antibiotic resistance and therapeutic management of sepsis in a Malaysian public Hospital

    Directory of Open Access Journals (Sweden)

    Forouzan Bayat Nejad

    2009-12-01

    Full Text Available This study aims to document the microbial profile and pattern of use of antibiotics in the government hospital of Penang state, Malaysia. An audit was conducted in 2007 in the general medical ward of Hospital Pulau Pinang, Malaysia. The mortality rate was 54.22% with severesepsis or septicaemia. Mithicillin resistant staphylococcus aureus caused 37% of deaths, while 33% of deaths involved Klebsiella Spp. Commonly prescribed antibiotics included; cloxacillin 500mg (qid 20%, tazocin 2gm (bid1.1%, and vancomycin 1gm (od 27%. We report the useof high doses of antibiotics in the six months prior to anotable rise in resistant infections.

  12. Synergy between the Host Immune System and Bacteriophage Is Essential for Successful Phage Therapy against an Acute Respiratory Pathogen.

    Science.gov (United States)

    Roach, Dwayne R; Leung, Chung Yin; Henry, Marine; Morello, Eric; Singh, Devika; Di Santo, James P; Weitz, Joshua S; Debarbieux, Laurent

    2017-07-12

    The rise of multi-drug-resistant (MDR) bacteria has spurred renewed interest in the use of bacteriophages in therapy. However, mechanisms contributing to phage-mediated bacterial clearance in an animal host remain unclear. We investigated the effects of host immunity on the efficacy of phage therapy for acute pneumonia caused by MDR Pseudomonas aeruginosa in a mouse model. Comparing efficacies of phage-curative and prophylactic treatments in healthy immunocompetent, MyD88-deficient, lymphocyte-deficient, and neutrophil-depleted murine hosts revealed that neutrophil-phage synergy is essential for the resolution of pneumonia. Population modeling of in vivo results further showed that neutrophils are required to control both phage-sensitive and emergent phage-resistant variants to clear infection. This "immunophage synergy" contrasts with the paradigm that phage therapy success is largely due to bacterial permissiveness to phage killing. Lastly, therapeutic phages were not cleared by pulmonary immune effector cells and were immunologically well tolerated by lung tissues. Copyright © 2017. Published by Elsevier Inc.

  13. Combination Cancer Therapy Can Confer Benefit via Patient-to-Patient Variability without Drug Additivity or Synergy.

    Science.gov (United States)

    Palmer, Adam C; Sorger, Peter K

    2017-12-14

    Combination cancer therapies aim to improve the probability and magnitude of therapeutic responses and reduce the likelihood of acquired resistance in an individual patient. However, drugs are tested in clinical trials on genetically diverse patient populations. We show here that patient-to-patient variability and independent drug action are sufficient to explain the superiority of many FDA-approved drug combinations in the absence of drug synergy or additivity. This is also true for combinations tested in patient-derived tumor xenografts. In a combination exhibiting independent drug action, each patient benefits solely from the drug to which his or her tumor is most sensitive, with no added benefit from other drugs. Even when drug combinations exhibit additivity or synergy in pre-clinical models, patient-to-patient variability and low cross-resistance make independent action the dominant mechanism in clinical populations. This insight represents a different way to interpret trial data and a different way to design combination therapies. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects

    Science.gov (United States)

    Russo, Ethan B

    2011-01-01

    Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin, cannabigerol and cannabichromene, exert additional effects of therapeutic interest. Innovative conventional plant breeding has yielded cannabis chemotypes expressing high titres of each component for future study. This review will explore another echelon of phytotherapeutic agents, the cannabis terpenoids: limonene, myrcene, α-pinene, linalool, β-caryophyllene, caryophyllene oxide, nerolidol and phytol. Terpenoids share a precursor with phytocannabinoids, and are all flavour and fragrance components common to human diets that have been designated Generally Recognized as Safe by the US Food and Drug Administration and other regulatory agencies. Terpenoids are quite potent, and affect animal and even human behaviour when inhaled from ambient air at serum levels in the single digits ng·mL−1. They display unique therapeutic effects that may contribute meaningfully to the entourage effects of cannabis-based medicinal extracts. Particular focus will be placed on phytocannabinoid-terpenoid interactions that could produce synergy with respect to treatment of pain, inflammation, depression, anxiety, addiction, epilepsy, cancer, fungal and bacterial infections (including methicillin-resistant Staphylococcus aureus). Scientific evidence is presented for non-cannabinoid plant components as putative antidotes to intoxicating effects of THC that could increase its therapeutic index. Methods for investigating entourage effects in future experiments will be proposed. Phytocannabinoid-terpenoid synergy, if proven, increases the likelihood that an extensive pipeline of new therapeutic products is possible from this venerable plant. LINKED ARTICLES

  15. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects.

    Science.gov (United States)

    Russo, Ethan B

    2011-08-01

    Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin, cannabigerol and cannabichromene, exert additional effects of therapeutic interest. Innovative conventional plant breeding has yielded cannabis chemotypes expressing high titres of each component for future study. This review will explore another echelon of phytotherapeutic agents, the cannabis terpenoids: limonene, myrcene, α-pinene, linalool, β-caryophyllene, caryophyllene oxide, nerolidol and phytol. Terpenoids share a precursor with phytocannabinoids, and are all flavour and fragrance components common to human diets that have been designated Generally Recognized as Safe by the US Food and Drug Administration and other regulatory agencies. Terpenoids are quite potent, and affect animal and even human behaviour when inhaled from ambient air at serum levels in the single digits ng·mL(-1) . They display unique therapeutic effects that may contribute meaningfully to the entourage effects of cannabis-based medicinal extracts. Particular focus will be placed on phytocannabinoid-terpenoid interactions that could produce synergy with respect to treatment of pain, inflammation, depression, anxiety, addiction, epilepsy, cancer, fungal and bacterial infections (including methicillin-resistant Staphylococcus aureus). Scientific evidence is presented for non-cannabinoid plant components as putative antidotes to intoxicating effects of THC that could increase its therapeutic index. Methods for investigating entourage effects in future experiments will be proposed. Phytocannabinoid-terpenoid synergy, if proven, increases the likelihood that an extensive pipeline of new therapeutic products is possible from this venerable plant. http

  16. Resistance evolution to the first generation of genetically modified Diabrotica-active Bt-maize events by western corn rootworm: management and monitoring considerations.

    Science.gov (United States)

    Devos, Yann; Meihls, Lisa N; Kiss, József; Hibbard, Bruce E

    2013-04-01

    Western corn rootworm (Diabrotica virgifera virgifera; WCR) is a major coleopteran maize pest in North America and the EU, and has traditionally been managed through crop rotation and broad-spectrum soil insecticides. Genetically modified Bt-maize offers an additional management tool for WCR and has been valuable in reducing insecticide use and increasing farm income. A concern is that the widespread, repeated, and exclusive deployment of the same Bt-maize transformation event will result in the rapid evolution of resistance in WCR. This publication explores the potential of WCR to evolve resistance to plant-produced Bt-toxins from the first generation of Diabrotica-active Bt-maize events (MON 863 and MON 88017, DAS-59122-7 and MIR604), and whether currently implemented risk management strategies to delay and monitor resistance evolution are appropriate. In twelve of the twelve artificial selection experiments reported, resistant WCR populations were yielded rapidly. Field-selected resistance of WCR to Cry3Bb1 is documented in some US maize growing areas, where an increasing number of cases of unexpected damage of WCR larvae to Bt-maize MON 88017 has been reported. Currently implemented insect resistance management measures for Bt-crops usually rely on the high dose/refuge (HDR) strategy. Evidence (including laboratory, greenhouse and field data) indicates that several conditions contributing to the success of the HDR strategy may not be met for the first generation of Bt-maize events and WCR: (1) the Bt-toxins are expressed heterogeneously at a low-to-moderate dose in roots; (2) resistance alleles may be present at a higher frequency than initially assumed; (3) WCR may mate in a non-random manner; (4) resistance traits could have non-recessive inheritance; and (5) fitness costs may not necessarily be associated with resistance evolution. However, caution must be exercised when extrapolating laboratory and greenhouse results to field conditions. Model predictions

  17. Potential management of resistant microbial infections with a novel non-antibiotic

    DEFF Research Database (Denmark)

    Dutta, Noton Kumar; Annadurai, Subramanian; Mazumdar, Kaushiki

    2007-01-01

    Diclofenac sodium (Dc), an anti-inflammatory agent, has remarkable inhibitory action both against drug-sensitive and drug-resistant clinical isolates of various Gram-positive and Gram-negative bacteria. The aim of this study was to determine the ability of Dc to protect mice from a virulent...

  18. Managing Instructor Cyberanxiety: The Role of Self-Efficacy in Decreasing Resistance to Change.

    Science.gov (United States)

    George, Gerard; Camarata, M. R.

    1996-01-01

    Discussion of educational technology innovations focuses on some of the behavioral challenges facing the drive toward multimedia instruction and suggests a method by which instructor resistance to technological change can be lessened or eliminated based on the concept of self-efficacy. A typology of instructors is explained. (Author/LRW)

  19. Exercising Synergy of Safeguards Safety and Security at Facility Level of the GA Siwabessy Multi-Purpose Reactor, Indonesia

    International Nuclear Information System (INIS)

    Susilowati, E.

    2015-01-01

    Safeguards, safety and security (3Ss) constitute as essential elements for successful development of nuclear technology in the life time of nuclear installation. All 3Ss need to be coordinated due workers, the public and the environment require protection from plant malfunction, human error, malicious acts and proliferation of nuclear materials and technologies. Then the importance of the 3Ss was deemed valuable, particularly to a country having willingness to expand to nuclear power reactor such as Indonesia that in the near future plans to build small experimental power reactor. This paper is aimed to discuss synergy among safeguards, safety and security which will have opportunity been exercising at the GA Siwabessy Reactor (RSG-GAS), Indonesia. Synergy among safeguards, safety and security offers much opportunity for cost savings and enhance efficiency. Discussion is carried out by first investigating common values and conflicts exist among 3S. Up to now each of them was accomplished separately by different division and using different equipment due lack of coordination among them. The objective of this exercise is to develop more efficient and effective 3Ss infrastructures and also to support skill and knowledge of human resources. Benefitting from synergy between safeguards and security such as management of nuclear material and non proliferation; safeguards and safety such as management of nuclear material and waste management; safety and security such as prevent radiological release and also tension among them if any are discussed. It is expected that outcome of this exercise will able to develop a role model of infrastructures to the up-coming small experimental power reactor in Indonesia. (author)

  20. Simulating Serial-Target Antibacterial Drug Synergies Using Flux Balance Analysis

    DEFF Research Database (Denmark)

    Krueger, Andrew S.; Munck, Christian; Dantas, Gautam

    2016-01-01

    Flux balance analysis (FBA) is an increasingly useful approach for modeling the behavior of metabolic systems. However, standard FBA modeling of genetic knockouts cannot predict drug combination synergies observed between serial metabolic targets, even though such synergies give rise to some...... the possibility for more accurate genome-scale predictions of drug synergies, which can be used to suggest treatments for infections and other diseases....

  1. The number and choice of muscles impact the results of muscle synergy analyses

    Directory of Open Access Journals (Sweden)

    Katherine Muterspaugh Steele

    2013-08-01

    Full Text Available One theory for how humans control movement is that muscles are activated in weighted groups or synergies. Studies have shown that electromyography (EMG from a variety of tasks can be described by a low-dimensional space thought to reflect synergies. These studies use algorithms, such as nonnegative matrix factorization, to identify synergies from EMG. Due to experimental constraints, EMG can rarely be taken from all muscles involved in a task. However, it is unclear if the choice of muscles included in the analysis impacts estimated synergies. The aim of our study was to evaluate the impact of the number and choice of muscles on synergy analyses. We used a musculoskeletal model to calculate muscle activations required to perform an isometric upper-extremity task. Synergies calculated from the activations from the musculoskeletal model were similar to a prior experimental study. To evaluate the impact of the number of muscles included in the analysis, we randomly selected subsets of between 5 and 29 muscles and compared the similarity of the synergies calculated from each subset to a master set of synergies calculated from all muscles. We determined that the structure of synergies is dependent upon the number and choice of muscles included in the analysis. When five muscles were included in the analysis, the similarity of the synergies to the master set was only 0.57 ± 0.54; however, the similarity improved to over 0.8 with more than ten muscles. We identified two methods, selecting dominant muscles from the master set or selecting muscles with the largest maximum isometric force, which significantly improved similarity to the master set and can help guide future experimental design. Analyses that included a small subset of muscles also over-estimated the variance accounted for (VAF by the synergies compared to an analysis with all muscles. Thus, researchers should use caution using VAF to evaluate synergies when EMG is measured from a small

  2. Connecting public administration and change management literature : The effects of policy alienation on resistance to change

    NARCIS (Netherlands)

    L.G. Tummers (Lars)

    2013-01-01

    textabstractAbstract The main goal of this article is to contribute to change management literature in the public sector. A recent literature review argues that there is a gap in the literature on change management specifically using the public administration perspective. We therefore analyze

  3. Beyond Resistance: Exploring Health Managers' Propensity for Participatory Evaluation in a Developing Country

    Science.gov (United States)

    Smits, Pernelle A.; Champagne, Francois; Farand, Lambert

    2012-01-01

    The evaluation of interventions is becoming increasing common and now often seeks to involve managers in the process. Such practical participatory evaluation (PPE) aims to increase the use of evaluation results through the participation of stakeholders. This study focuses on the propensity of health managers for PPE, as measured through the…

  4. Activity of levofloxacin alone and in combination with a DnaK inhibitor against gram-negative rods, including levofloxacin-resistant strains.

    Science.gov (United States)

    Credito, Kim; Lin, Gengrong; Koeth, Laura; Sturgess, Michael A; Appelbaum, Peter C

    2009-02-01

    Synergy time-kill testing of levofloxacin alone and in combination with CHP-105, a representative DnaK inhibitor, against 50 gram-negative rods demonstrated that 34 of the 50 strains tested showed significant synergy between levofloxacin and CHP-105 after 12 h and 24 h. Fourteen of these 34 organisms were quinolone resistant (levofloxacin MICs of > or =4 microg/ml).

  5. Using electrical resistivity tomography to assess the effectiveness of managed aquifer recharge in a salinized coastal aquifer.

    Science.gov (United States)

    García-Menéndez, Olga; Ballesteros, Bruno J; Renau-Pruñonosa, Arianna; Morell, Ignacio; Mochales, Tania; Ibarra, Pedro I; Rubio, Félix M

    2018-01-27

    Over 40 years, the detrital aquifer of the Plana de Castellón (Spanish Mediterranean coast) has been subjected to seawater intrusion because of long dry periods combined with intensive groundwater exploitation. Against this backdrop, a managed artificial recharge (MAR) scheme was implemented to improve the groundwater quality. The large difference between the electrical conductivity (EC) of the ambient groundwater (brackish water due to marine intrusion) and the recharge water (freshwater) meant that there was a strong contrast between the resistivities of the brackish water saturated zone and the freshwater saturated zone. Electrical resistivity tomography (ERT) can be used for surveying similar settings to evaluate the effectiveness of artificial recharge schemes. By integrating geophysical data with lithological information, EC logs from boreholes, and hydrochemical data, we can interpret electrical resistivity (ER) with groundwater EC values and so identify freshwater saturated zones. Using this approach, ERT images provided a high-resolution spatial characterization and an accurate picture of the shape and extent of the recharge plume of the MAR site. After 5 months of injection, a freshwater plume with an EC of 400-600 μS/cm had formed that extended 400 m in the W-E direction, 250 m in the N-S direction, and to a depth of 40 m below piezometric level. This study also provides correlations between ER values with different lithologies and groundwater EC values that can be used to support other studies.

  6. Evaluation of Bt Corn with Pyramided Genes on Efficacy and Insect Resistance Management for the Asian Corn Borer in China.

    Directory of Open Access Journals (Sweden)

    Fan Jiang

    Full Text Available A Bt corn hybrid (AcIe with two Bt genes (cry1Ie and cry1Ac was derived by breeding stack from line expressing Cry1Ie and a line expressing Cry1Ac. Efficacy of this pyramided Bt corn hybrid against the Asian corn borer (ACB, Ostrinia furnacalis, was evaluated. We conducted laboratory bioassays using susceptible and resistant ACB strains fed on artificial diet or fresh plant tissues. We also conducted field trials with artificial infestations of ACB neonates at the V6 and silk stages. The toxin-diet bioassay data indicated that mixtures of Cry1Ac and Cry1Ie proteins had synergistic insecticidal efficacy. The plant tissue bioassay data indicated that Bt corn hybrids expressing either a single toxin (Cry1Ac or Cry1Ie or two toxins had high efficacy against susceptible ACB. Damage ratings in the field trials indicated that the Bt corn hybrids could effectively protect against 1st and the 2nd generation ACB in China. The hybrid line with two Bt genes showed a higher efficacy against ACB larvae resistant to Cry1Ac or CryIe than the hybrid containing one Bt gene, and the two gene hybrid would have increased potential for managing or delaying the evolution of ACB resistance to Bt corn plants.

  7. Evaluation of Bt Corn with Pyramided Genes on Efficacy and Insect Resistance Management for the Asian Corn Borer in China.

    Science.gov (United States)

    Jiang, Fan; Zhang, Tiantao; Bai, Shuxiong; Wang, Zhenying; He, Kanglai

    2016-01-01

    A Bt corn hybrid (AcIe) with two Bt genes (cry1Ie and cry1Ac) was derived by breeding stack from line expressing Cry1Ie and a line expressing Cry1Ac. Efficacy of this pyramided Bt corn hybrid against the Asian corn borer (ACB), Ostrinia furnacalis, was evaluated. We conducted laboratory bioassays using susceptible and resistant ACB strains fed on artificial diet or fresh plant tissues. We also conducted field trials with artificial infestations of ACB neonates at the V6 and silk stages. The toxin-diet bioassay data indicated that mixtures of Cry1Ac and Cry1Ie proteins had synergistic insecticidal efficacy. The plant tissue bioassay data indicated that Bt corn hybrids expressing either a single toxin (Cry1Ac or Cry1Ie) or two toxins had high efficacy against susceptible ACB. Damage ratings in the field trials indicated that the Bt corn hybrids could effectively protect against 1st and the 2nd generation ACB in China. The hybrid line with two Bt genes showed a higher efficacy against ACB larvae resistant to Cry1Ac or CryIe than the hybrid containing one Bt gene, and the two gene hybrid would have increased potential for managing or delaying the evolution of ACB resistance to Bt corn plants.

  8. A Methodology to Measure Synergy Among Energy-Efficiency Programs at the Program Participant Level

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, B.E.

    2003-11-14

    This paper presents a methodology designed to measure synergy among energy-efficiency programs at the program participant level (e.g., households, firms). Three different definitions of synergy are provided: strong, moderate, and weak. Data to measure synergy can be collected through simple survey questions. Straightforward mathematical techniques can be used to estimate the three types of synergy and explore relative synergistic impacts of different subsets of programs. Empirical research is needed to test the concepts and methods and to establish quantitative expectations about synergistic relationships among programs. The market for new energy-efficient motors is the context used to illustrate all the concepts and methods in this paper.

  9. Muscle Synergies Control during Hand-Reaching Tasks in Multiple Directions Post-stroke

    Directory of Open Access Journals (Sweden)

    Sharon Israely

    2018-02-01

    Full Text Available Purpose: A muscle synergies model was suggested to represent a simplifying motor control mechanism by the brainstem and spinal cord. The aim of the study was to investigate the feasibility of such control mechanisms in the rehabilitation of post-stroke individuals during the execution of hand-reaching movements in multiple directions, compared to non-stroke individuals.Methods: Twelve non-stroke and 13 post-stroke individuals participated in the study. Muscle synergies were extracted from EMG data that was recorded during hand reaching tasks, using the NMF algorithm. The optimal number of synergies was evaluated in both groups using the Variance Accounted For (VAF and the Mean Squared Error (MSE. A cross validation procedure was carried out to define a representative set of synergies. The similarity index and the K-means algorithm were applied to validate the existence of such a set of synergies, but also to compare the modulation properties of synergies for different movement directions between groups. The similarity index and hierarchical cluster analysis were also applied to compare between group synergies.Results: Four synergies were chosen to optimally capture the variances in the EMG data, with mean VAF of 0.917 ± 0.034 and 0.883 ± 0.046 of the data variances, with respective MSE of 0.007 and 0.016, in the control and study groups, respectively. The representative set of synergies was set to be extracted from movement to the center of the reaching space. Two synergies had different muscle activation balance between groups. Seven and 17 clusters partitioned the muscle synergies of the control and study groups. The control group exhibited a gradual change in the activation in the amplitude in the time domain (modulation of synergies, as reflected by the similarity index, whereas the study group exhibited consistently significant differences between all movement directions and the representative set of synergies. The study findings support

  10. Responding to the multidrug-resistant tuberculosis crisis: mainstreaming programmatic management to the Philippine National Tuberculosis Programme.

    Science.gov (United States)

    Quelapio, M I D; Mira, N R C; Orillaza-Chi, R B; Belen, V; Muñez, N; Belchez, R; Egos, G E; Evangelista, M; Vianzon, R; Tupasi, T E

    2010-06-01

    The Philippines ranks eighth among 27 priority countries for multidrug-resistant TB (MDR-TB). To describe a model of public-private partnership in MDR-TB management. An exploratory study of integrating MDR-TB management initiated in private-public mix DOTS into the National TB Programme (NTP). Recognising that MDR-TB was a threat to DOTS, the Tropical Disease Foundation initiated MDR-TB management in 1999. An official mandate for the integration of MDR-TB services into the NTP was issued by the Department of Health in 2008. With an increased government budget augmented by support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, 1294 MDR-TB patients were placed on treatment from 1999 to 2008. The treatment success rate improved from 64% in 1999 to 75% in 2005. There are now five MDR-TB treatment centres with 181 treatment sites in Metro Manila, and three culture centres. People trained include 12 master trainers, 31 trainers, 25 treatment centre and 381 treatment site staff. Mainstreaming into the NTP of this unique model of MDR-TB management through a dynamic public-private collaboration can be considered best practice in implementation science of an evidence-based intervention leading to change in health care policy and practice.

  11. Effect of human placental extract in the management of biofilm mediated drug resistance - A focus on wound management.

    Science.gov (United States)

    Goswami, Sutapa; Sarkar, Ratul; Saha, Pritam; Maity, Amit; Sarkar, Tridib; Das, Debmalya; Chakraborty, Piyali Datta; Bandyopadhyay, Subhasri; Ghosh, Chandan Kumar; Karmakar, Sanmoy; Sen, Tuhinadri

    2017-10-01

    Management of infectious wounds, particularly chronic wounds and burn injuries, is a matter of global concern. Worldwide estimates reveal that, billions of dollars are being spent annually for the management of such chronic ailments. Evidently, bacterial biofilms pose a greater problem in the effective management of infection in chronic wounds, since most of the currently available antibiotics are unable to act on the microorganisms residing inside the protected environment of the biofilms. Accordingly, in the present study, we have attempted to evaluate the anti-biofilm properties of human placental extract (PLX) and also other virulence factors that are mediated via the quorum sensing (QS) signalling system. PLX is well known for its anti inflammatory action and it has been shown earlier some anti microbial and enzymatic activity also. PLX was found to produce significant inhibition of biofilm formation and also decreased the levels of pyoverdin and pyocyanin. The microscopic analysis (both light microscopy and atomic force microscopy) of biofilms was also used for substantiating the findings from spectrophotometric (crystal violet estimation) and fluorescence analysis (resazurin uptake). PLX pre-treatment decreased the hydrophobicity of gram-positive and gram negative cells, indicating the effect of placental extract on adherence property of planktonic cell, serving as an indicator for its antibiofilm effect on microorganisms. The reduced extracellular DNA (eDNA) content in biofilm matrix following treatment with PLX also indicates the effectiveness of placenta extract on bacterial adherence, which in turn serves as evidence substantiating the antibiofilm effects of the PLX. Furthermore, PLX was also found to be significantly effective in the in vitro wound biofilm model. Thus the present study, the first of its kind with PLX, establishes the therapeutic benefit of the same particularly in infected wounds, opening up newer avenue for further exploration

  12. Management of resistant supraventricular tachycardia in the immediate postpartum period: A case report

    Directory of Open Access Journals (Sweden)

    Gangadharaiah Narasimhaiah

    2013-01-01

    Full Text Available Supraventricular tachycardia (SVT during pregnancy or immediate postpartum is the commonest arrhythmia during pregnancy. Usually, the clinical symptoms are mild or go unrecognized. Rarely as in our case, can patient present with severe symptoms of agitation and restlessness which can mimic puerperal psychosis. A 12 lead electrocardiogram (ECG and an echocardiogram usually are sufficient to diagnose SVT. Amiodarone, even though is not the drug recommended to be used during pregnancy, in resistant types of SVT it is an useful drug.

  13. Management of the Patient with Aggressive and Resistant Papillary Thyroid Carcinoma

    OpenAIRE

    Miftari, Rame; Top?iu, Valdete; Nura, Adem; Haxhibeqiri, Valdete

    2016-01-01

    Purpose: Papillary carcinoma is the most frequent type of thyroid cancer and was considered the most benign of all thyroid carcinomas, with a low risk of distant metastases. However, there are some variants of papillary thyroid carcinoma that have affinity to spread in many organs, such as: lymph nodes, lungs and bones. Aim: The aim of this study was presentation of a case with papillary carcinoma of the thyroid gland, very persistent and resistant in treatment with I 131. Material and result...

  14. Surgical Management of Cavernous Malformations Presenting with Drug-Resistant Epilepsy

    OpenAIRE

    Alonso-Vanegas, Mario Arturo; Cisneros-Franco, José M.; Otsuki, Taisuke

    2012-01-01

    Cerebral cavernous malformations (CMs) are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CMs pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, complete...

  15. Wet weather highway accident analysis and skid resistance data management system (volume II : user's manual).

    Science.gov (United States)

    1992-06-01

    The objectives and scope of this research are to establish an effective methodology for wet weather accident analysis and to develop a database management system to facilitate information processing and storage for the accident analysis process, skid...

  16. Wet weather highway accident analysis and skid resistance data management system (volume I).

    Science.gov (United States)

    1992-06-01

    The objectives and scope of this research are to establish an effective methodology for wet weather accident analysis and to develop a database management system to facilitate information processing and storage for the accident analysis process, skid...

  17. Nuclear Security and Nuclear Safeguards; Differences, Commonalities and Synergies

    International Nuclear Information System (INIS)

    Jorant, C.

    2015-01-01

    Reference to the three S's in the nuclear world is recurring and much has been said about the need to build on synergies to reinforce safeguards, safety and security. In practice, the 3S's communities are seldom interconnected even though some interaction can be observed between safety and security and security and safeguards. Ensuring a better understanding between those three sectors about their scope, requirements, implementation methods and tools would stimulate cooperation. The second Nuclear Security Summit and particularly the industry related event stressed the synergies between safety and security. The first IAEAs Security Conference organized in July 2013 did not address specifically nuclear safeguards and security relations. Last Security Summit took place in The Hague in March 2014 and this type of issue was not really raised either. The safeguards Symposium provides a timely opportunity to tackle possible enhanced cooperation between safeguards and security communities and assess the prospect for addressing such issue at the next and allegedly last security summit in 2016. This presentation will analyze the differences and commonalities between those two sectors, in particular with regards to the objectives and actors, the organization and technicalities, or to the conceptual approaches (DBT and APA/SLC, attractiveness/accessibility). It will then assess the possible synergies or cooperation between both communities. It will discuss the merits of a global and comprehensive involvement of the different actors, (State, industry and international bodies including the NGOs) and of exchanges on good practices to contribute to a common understanding and references while allowing for an adaptable and national approach. Indeed the need to reassure the stakeholders, including the general public, that security, as well as safeguards are addressed in a consistent manner worldwide is of utmost importance for building future nuclear energy programmes on a

  18. A sigmoidal transcriptional response: cooperativity, synergy and dosage effects.

    Science.gov (United States)

    Veitia, Reiner A

    2003-02-01

    A sigmoidal transcriptional response (STR) is thought to act as a molecular switch to control gene expression. This nonlinear behaviour arises as a result of the cooperative recognition of a promoter/enhancer by transcription factors (TFs) and/or their synergy to attract the basal transcriptional machinery (BTM). Although this cooperation between TFs is additive in terms of energy, it leads to an exponential increase in affinity between the BTM and the pre-initiation complexes. This exponential increase in the strength of interactions is the principle that governs synergistic systems. Here, I propose a minimalist quasi-equilibrium model to explore qualitatively the STR taking into account cooperative recognition of the promoter/enhancer and synergy. Although the focus is on the effect of activators, a similar treatment can be applied to inhibitors. One of the main insights obtained from the model is that generation of a sigmoidal threshold is possible even in the absence of cooperative DNA binding provided the TFs synergistically interact with the BTM. On the contrary, when there is cooperative binding, the impact of synergy diminishes. It will also be shown that a sigmoidal response to a morphogenetic gradient can be used to generate a nested gradient of another morphogen. Previously, I had proposed that halving the amounts of TFs involved in sigmoidal transcriptional switches could account for the abnormal dominant phenotypes associated with some of these genes. This phenomenon, called haploinsufficiency (HI), has been recognised as the basis of many human diseases. Although a formal proof linking HI and a sigmoidal response is lacking, it is tempting to explore the model from the perspective of dosage effects.

  19. Building synergies between climate change mitigation and energy poverty alleviation

    International Nuclear Information System (INIS)

    Ürge-Vorsatz, Diana; Tirado Herrero, Sergio

    2012-01-01

    Even though energy poverty alleviation and climate change mitigation are inextricably linked policy goals, they have remained as relatively disconnected fields of research inquiry and policy development. Acknowledging this gap, this paper explores the mainstream academic and policy literatures to provide a taxonomy of interactions and identify synergies and trade-offs between them. The most important trade-off identified is the potential increase in energy poverty levels as a result of strong climate change action if the internalisation of the external costs of carbon emissions is not offset by efficiency gains. The most significant synergy was found in deep energy efficiency in buildings. The paper argues that neither of the two problems – deep reductions in GHG emissions by mid-century, and energy poverty eradication – is likely to be solved fully on their own merit, while joining the two policy goals may provide a very solid case for deep efficiency improvements. Thus, the paper calls for a strong integration of these two policy goals (plus other key related benefits like energy security or employment), in order to provide sufficient policy motivation to mobilise a wide-scale implementation of deep energy efficiency standards. - Highlights: ► A taxonomy of interactions between climate change and energy poverty is offered. ► Energy poverty levels may increase as a result of strong climate change action. ► However, strong synergies are offered by deep improvements of energy efficiency. ► Access to modern energy carriers is a key requirement in developing countries. ► Sufficiently solving both problems requires the integration of policy goals.

  20. Mosquitocidal carbamates with low toxicity to agricultural pests: an advantageous property for insecticide resistance management.

    Science.gov (United States)

    Swale, Daniel R; Carlier, Paul R; Hartsel, Joshua A; Ma, Ming; Bloomquist, Jeffrey R

    2015-08-01

    Insecticide resistance in the malaria mosquito Anopheles gambiae is well documented, and widespread agricultural use of pyrethroids may exacerbate development of resistance when pyrethroids are used in vector control. We have developed carbamate anticholinesterases that possess a high degree of An. gambiae:human selectivity for enzyme inhibition. The purpose of this study was to assess the spectrum of activity of these carbamates against other mosquitoes and agricultural pests. Experimental carbamates were potent inhibitors of mosquito acetylcholinesterases, with IC50 values in the nanomolar range. Similar potencies were observed for Musca domestica and Drosophila melanogaster enzymes. Although meta-substituted carbamates were potent inhibitors, two ortho-substituted carbamates displayed poor enzyme inhibition (IC50 ≥ 10(-6)  M) in honey bee (Apis mellifera), Asian citrus psyllid (Diaphorina citri) and lepidopteran agricultural pests (Plutella xylostella and Ostrinia nubilalis). Enzyme inhibition results were confirmed by toxicity studies in caterpillars, where the new carbamates were 2-3-fold less toxic than propoxur and up to tenfold less active than bendiocarb, indicating little utility of these compounds for crop protection. The experimental carbamates were broadly active against mosquito species but not agricultural pests, which should mitigate selection for mosquito insecticide resistance by reducing agricultural uses of these compounds. © 2014 Society of Chemical Industry. © 2014 Society of Chemical Industry.

  1. Nuclear energy and its synergies with renewable energies

    International Nuclear Information System (INIS)

    Carre, F.; Mermilliod, N.; Devezeaux De Lavergne, J.G.; Durand, S.

    2011-01-01

    France has the ambition to become a world leader in both nuclear industry and in renewable energies. 3 types of synergies between nuclear power and renewable energies are highlighted. First, nuclear power can be used as a low-carbon energy to produce the equipment required to renewable energy production for instance photovoltaic cells. Secondly, to benefit from the complementary features of both energies: continuous/intermittency of the production, centralized/local production. The future development of smart grids will help to do that. Thirdly, to use nuclear energy to produce massively hydrogen from water and synthetic fuels from biomass. (A.C.)

  2. INPRO-SYNERGIES - a new international INPRO/IAEA project

    International Nuclear Information System (INIS)

    Andreeva-Andrievskaya, L.N.; Kuznetsov, V.V.; Busurin, Yu.N.; Ponomarev, A.V.; )

    2012-01-01

    The new INPRO project entitled Synergistic Nuclear Energy Regional Group Interactions Evaluated for Sustainability (INPRO- SYNERGIES) is described. The project aims to improve the analytical software and databases to model more specifically the particular forms of synergistic architectures involving collaboration among supplier countries and user countries to support an efficient transition towards sustainable energy systems. The project's objectives, methods and contents of the work are analyzed. The synergistic collaborative scenarios for fuel cycle infrastructure development are evaluated. The course of the project and expected outputs are also described [ru

  3. The synergy of creativity and critical thinking in engineering design

    DEFF Research Database (Denmark)

    Spuzic, Sead; Narayanan, Ramadas; Adriansen, Hanne Kirstine

    2016-01-01

    Analysis of the impact of interaction and experience on quality components such as “usability”, “producibility”, “reliability”, “sustainability” and “aesthetics” is presented using the case of engineering design, a discipline that traditionally has an image of being a strictly calculated, rigid...... framework. It has been widely recognised that engineering design encompasses two ways of thinkingdcreative and critical. A central argument that the synergy of creativity and criticality is significantly enhanced by connecting true interdisciplinary augmentation with the fine arts is discussed along...

  4. Policy Synergies in Health-Promoting Education in Bhutan

    DEFF Research Database (Denmark)

    Schmidt, Johannes Dragsbæk; Christensen, Line Kikkenborg

    2017-01-01

    This contribution analyzes how the intentions for social development activities within the area of health promotion through education are in conflict with outcomes. The paper asks; what are the discrepancies between policies intention at central level and the implementation on ‘the ground......’? It will furthermore explore whether there are relevant synergies in the policy flow from center to local levels in terms of delivering efficient health through educational policies. The focus lies on the formulation, planning and implementation level of health in education....

  5. Strategies for Fostering Synergy between Neuroscience Programs and Chemistry Departments

    Science.gov (United States)

    Ulness, Darin J.; Mach, Julie R.

    2011-01-01

    The successful model of the Neuroscience Program at Concordia College is used as a source of illustrative examples in a presentation of strategies to foster synergy between neuroscience programs and chemistry departments. Chemistry is an increasing voice in the dialog of modern neuroscience. To be well-prepared to engage in this dialog, students must have strong chemistry training and be comfortable applying it to situations in neuroscience. The strategies presented here are designed to stimulate thought and discussion in the undergraduate neuroscience education community. Hopefully this will lead to greater interaction between chemistry and neuroscience at the undergraduate level in other institutions. PMID:23626488

  6. Antibiotic management of methicillin-resistant Staphylococcus aureus--associated acute pulmonary exacerbations in cystic fibrosis.

    Science.gov (United States)

    Fusco, Nicholas M; Toussaint, Kimberly A; Prescott, William Allan

    2015-04-01

    To review the treatment of methicillin-resistant Staphylococcus aureus (MRSA)-associated acute pulmonary exacerbations (APEs) in cystic fibrosis (CF). A search of PubMed, MEDLINE, Cochrane Library and Clinicaltrials.gov databases through November 2014 was conducted using the search terms Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, pulmonary exacerbations, and cystic fibrosis. All English-language research articles, case reports, and case series were evaluated. A total of 185 articles were identified related to MRSA and CF; 30 articles that studied treatments of MRSA APE in CF were included. The persistent presence of MRSA in the respiratory tract of patients with CF has been associated with higher morbidity and an increased risk of death. Limited clinical data exist supporting the efficacy of any specific antimicrobial currently available for the treatment of APE secondary to MRSA. Data extrapolated from other populations suggest that vancomycin and linezolid are appropriate first-line treatment options for the treatment of APE secondary to MRSA. Second-line options include doxycycline or minocycline and trimethoprim/sulfamethoxazole, each of which may be useful in patients coinfected with other respiratory pathogens, for which they may provide overlapping coverage. Ceftaroline and ceftobiprole are newer antibiotics that appear to have a potential role in the treatment of APE in CF, but the latter is not currently available to the US market. Although potentially useful, clindamycin is limited by high rates of resistance, telavancin is limited by its toxicity profile, and tigecycline is limited by a lack of demonstrated efficacy for infections that are similar to that seen in the CF population. Studies investigating the clinical utility of the above-cited antibiotics for APE in CF secondary to MRSA are desperately needed to broaden the treatment armamentarium for this medical condition. © The Author(s) 2015.

  7. Dilemma of managing asymptomatic children referred with 'culture-confirmed' drug-resistant tuberculosis.

    Science.gov (United States)

    Loveday, Marian; Sunkari, Babu; Marais, Ben J; Master, Iqbal; Brust, James C M

    2016-07-01

    The diagnosis of drug-resistant tuberculosis (DR-TB) in children is challenging and treatment is associated with many adverse effects. We aimed to assess if careful observation, without initiation of second-line treatment, is safe in asymptomatic children referred with 'culture-confirmed' DR-TB. KwaZulu-Natal, South Africa-an area with high burdens of HIV, TB and DR-TB. We performed an outcome review of children with 'culture-confirmed' DR-TB who were not initiated on second-line TB treatment, as they were asymptomatic with normal chest radiographs on examination at our specialist referral hospital. Children were followed up every other month for the first year, with a final outcome assessment at the end of the study. In total, 43 asymptomatic children with normal chest radiographs were reviewed. The median length of follow-up until final evaluation was 549 days (IQR 259-722 days); most (34; 83%) children were HIV uninfected. Resistance patterns included 9 (21%) monoresistant and 34 (79%) multidrug-resistant (MDR) strains. Fifteen children (35%) had been treated with first-line TB treatment, prior to presentation at our referral hospital. At the final evaluation, 34 (80%) children were well, 7 (16%) were lost to follow-up, 1 (2%) received MDR-TB treatment and 1 (2%) died of unknown causes. The child who received MDR-TB treatment developed new symptoms at the 12-month review and responded well to second-line treatment. Bacteriological evaluation should not be performed in the absence of any clinical indication. If drug-resistant Mycobacterium tuberculosis is detected in an asymptomatic child with a normal chest radiograph, close observation may be an appropriate strategy, especially in settings where potential laboratory error and poor record keeping are constant challenges. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Resistance and the management of complicated skin and skin structure infections: the role of ceftobiprole

    Directory of Open Access Journals (Sweden)

    April Barbour

    2010-09-01

    Full Text Available April Barbour1, Hartmut Derendorf21GlaxoSmithKline, King of Prussia, PA, USA; 2Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USAAbstract: Antimicrobial resistant bacteria are an increasing concern due to the resulting increase in morbidity, mortality, and health-care costs associated with the administration of inadequate or delayed antimicrobial therapy. The implications of inadequate antimicrobial therapy in complicated skin and skin structure infections (cSSSIs have gained more attention recently, most likely due to the recent emergence of community-acquired methicillin resistant Staphylococcus aureus (MRSA and the already high prevalence of MRSA in the nosocomial setting. Due to the continuous threat of resistance arising and the limitations of currently available agents for the treatment of cSSSIs, it is necessary to develop new antimicrobials for this indication. Ceftobiprole medocaril, the prodrug of ceftobiprole, is a parental investigational cephalosporin for the treatment of cSSSIs displaying a wide-spectrum of activity against both Gram-positive and Gram-negative species, including MRSA. Ceftobiprole displays noncomplex linear pharmacokinetics, is eliminated primarily by glomerular filtration, and distributes to extracellular fluid. Additionally, it has been shown that the extent of distribution to the site of action with regard to cSSSIs, ie, the extracellular space fluid of subcutaneous adipose tissue and skeletal muscle, is expected to be efficacious, as free concentrations meet efficacy targets for most pathogens. Similar to other beta-lactams, it displays an excellent safety and tolerability profile with the primary adverse events being dysgeusia in healthy volunteers, resulting from the conversion of the prodrug to the active, and nausea in patients. Ceftobiprole has demonstrated noninferiority in two large-scale pivotal studies comparing it to vancomycin, clinical cure rates 93.3% vs

  9. Cotton pest management practices and the selection of pyrethroid resistance in Anopheles gambiae population in Northern Benin

    Directory of Open Access Journals (Sweden)

    Yadouleton Anges

    2011-04-01

    An. gambiae from BP areas gave a high level of susceptibility to permethrin with an average mortality of 94%. Molecular analysis identified An. gambiae s.s, and An. arabiensis with a high predominance of An. gambiae s.s (90%. The two molecular forms, M and S, were also determined with a high frequency of the S form (96%. The Kdr gene seemed the main target- site resistance mechanism detected in CCP, TICP, and BP areas at the rates ranging from 32 to 78%. The frequency of ace-1R gene was very low ( The presence of inhibiting factors in soil samples under insecticide treatments were found and affected negatively in delaying the development of An. gambiae larval populations. Conclusions This research shows that Kdr has spread widely in An. gambiae, mainly in CCP and TICP areas where pyrethroids are extensively used. To reduce the negative impact of pesticides use in cotton crop protection, the application of BP-like programs, which do not appear to select for vector resistance would be useful. These results could serve as scientific evidence of the spread of resistance due to a massive agricultural use of insecticides and contribute to the management of pesticides usage on cotton crops hence reducing the selection pressure of insecticides on An. gambiae populations.

  10. Synergy between low and high energy radical femtochemistry

    International Nuclear Information System (INIS)

    Gauduel, Y A

    2011-01-01

    The deleterious effects of ionizing radiation on integrated biological targets being dependent on the spatio-temporal distribution of short-lived radical processes, a thorough knowledge of these early events requires a real-time probing in the range 10 -15 - 10 -10 s. This manuscript review is focused on the synergy that exists between low (1-10 eV) and high (MeV) energy radiation femtochemistry (LERF, HERF respectively). The synergy remains crucial for the investigation of primary radical processes that take place within the prethermal regime of low energy secondary electrons. The quantum character of very-short lived electron in a prehydrated configuration provides a unique sub-nanometric probe to spatially explore some early radiation-induced biomolecular damage. This approach would foreshadow the development of innovative applications for spatio-temporal radiation biology such as, i) a highly-selective pro-drug activation using well-defined quantum states of short-lived radicals, ii) the real-time nanodosimetry in biologically relevant environments, and iii) the ultrashort irradiation of living cells.

  11. Research on a Novel Hydraulic/Electric Synergy Bus

    Directory of Open Access Journals (Sweden)

    Kegang Zhao

    2017-12-01

    Full Text Available In recent years, increasing concerns regarding environmental pollution and requirements for lower fossil fuel consumption have increased interest in alternative hybrid powertrains. As a result, this paper presents a novel hydraulic/electric synergy powertrain with multiple working modes. The three energy sources (i.e., engine, battery, and hydraulic accumulator in this configuration are regulated by a dual planetary gear set to achieve optimal performances. This paper selects the component sizes of a hybrid electric vehicle (HEV, a hydraulic hybrid vehicle (HHV, and a hydraulic/electric synergy vehicle (HESV, based on the dynamic performance of a target vehicle (TV. In addition, this paper develops the forward simulation models of the four aforementioned vehicles in the MATLAB/Simulink/Driveline platform, in which the fuel economy simulations are carried out in relation to the Chinese urban bus cycle. The simulation results show that the fuel consumption of the three hybrid vehicles is similar, but much better than, that of the TV. Finally, based on the operating cost calculations over a five-year working period, the lowest cost ranges of the three hybrid vehicles are determined, which provides a method for choosing the optimal hybrid scheme.

  12. Flexible cortical control of task-specific muscle synergies.

    Science.gov (United States)

    Nazarpour, Kianoush; Barnard, Amy; Jackson, Andrew

    2012-09-05

    Correlation structure in the activity of muscles across movements is often interpreted as evidence for low-level, hardwired constraints on upper-limb function. However, muscle synergies may also emerge from optimal strategies to achieve high-level task goals within a redundant control space. To distinguish these contrasting interpretations, we examined the structure of muscle variability during operation of a myoelectric interface in which task constraints were dissociated from natural limb biomechanics. We found that, with practice, human subjects learned to shape patterns of covariation between arbitrary pairs of hand and forearm muscles appropriately for elliptical targets whose orientation varied on a trial-by-trial basis. Thus, despite arriving at the same average location in the effector space, performance was improved by buffering variability into those dimensions that least impacted task success. Task modulation of beta-frequency intermuscular coherence indicated that differential recruitment of divergent corticospinal pathways contributed to positive correlations among muscles. However, this feedforward mechanism could not account for negative correlations observed in the presence of visual feedback. A second experiment revealed the development of fast, target-dependent visual responses consistent with "minimum intervention" control correcting predominantly task-relevant errors. Together, these mechanisms contribute to the dynamic emergence of task-specific muscle synergies appropriate for a wide range of abstract task goals.

  13. Omalizumab is efficacious for management of recalcitrant, antihistamine-resistant chronic urticaria.

    Science.gov (United States)

    Lang, D M

    2015-06-01

    Chronic urticaria continues to be a challenging condition for both patients and physicians. Despite improved understanding of chronic urticaria, many patients continue to experience ongoing symptoms and impaired quality of life. Omalizumab is a recombinant humanized monoclonal antibody that binds to the domain at which IgE binds to the high-affinity IgE receptor on mast cells and basophils. The efficacy of omalizumab for antihistamine-resistant chronic urticaria has been demonstrated in several randomized controlled trials as well as observational studies. Omalizumab is generally well tolerated, and is associated with less potential for harm compared with other therapeutic alternatives (e.g., calcineurin inhibitors) for recalcitrant chronic urticaria. Omalizumab has become the best-studied agent for treatment of antihistamine-resistant chronic urticaria, and the agent for which the data in support of its efficacy is most methodologically sound. Omalizumab is an effective therapeutic option for patients with recalcitrant chronic urticaria. Copyright 2015 Prous Science, S.A.U. or its licensors. All rights reserved.

  14. Surgical Management of Cavernous Malformations Presenting with Drug-Resistant Epilepsy

    Science.gov (United States)

    Alonso-Vanegas, Mario Arturo; Cisneros-Franco, José M.; Otsuki, Taisuke

    2011-01-01

    Cerebral cavernous malformations (CMs) are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CMs pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, completed with SPECT, PET, functional MRI, and/or invasive monitoring as needed. Radiosurgery shows variable rates of seizure freedom and a high incidence of complications, thus microsurgical resection remains the optimal treatment for CMs presenting with drug-resistant epilepsy. Two thirds of patients reach Engel I class at 3-year follow-up, regardless of lobar location. Those with secondarily generalized seizures, a higher seizure frequency, and generalized abnormalities on preoperative or postoperative EEG, show poorer outcomes, while factors such as gender, duration of epilepsy, lesion size, age, bleeding at the time of surgery, do not correlate consistently with seizure outcome. Electrocorticography and a meticulous removal of all cortical hemosiderin – beyond pure lesionectomy – reduce the risk of symptomatic recurrences. PMID:22319505

  15. Ixabepilone: a new treatment option for the management of taxane-resistant metastatic breast cancer

    International Nuclear Information System (INIS)

    Cobham, Marta Vallee; Donovan, Diana

    2009-01-01

    Ixabepilone (Ixempra ® ; Bristol-Myers Squibb) is a novel microtubule stabilizing agent recently approved for the treatment of metastatic breast cancer (MBC). This article focuses on considerations for ixabepilone administration and adverse event (AE) management, drawing from the biomedical literature indexed in PubMed, published abstracts from the American Society of Clinical Oncology annual meetings, and the manufacturer’s prescribing information for ixabepilone. Administered as monotherapy or in combination with capecitabine in clinical studies, ixabepilone demonstrated positive clinical response rates, prolonged progression-free survival, and a favorable safety profile in patients with MBC. Treatment-related AEs were predictable and manageable with dose modification, treatment interruption, and active management. As ixabepilone undergoes development in earlier lines of breast cancer therapy and in other solid tumors, oncology nurses will encounter more and more patients receiving ixabepilone therapy. If nurses are acquainted with the unique management strategies associated with ixabepilone treatment, as detailed herein, patients are more likely to receive the full benefit of therapy

  16. Management of obesity, insulin resistance and type 2 diabetes in children: consensus and controversy

    Directory of Open Access Journals (Sweden)

    Amy Fleischman

    2009-11-01

    Full Text Available Amy Fleischman, Erinn T RhodesDivision of Endocrinology, Children’s Hospital Boston, Boston, MA, United StatesAbstract: Childhood obesity has become a national and international epidemic. The prevalence and incidence of type 2 diabetes in youth have been increasing, and type 2 diabetes is one of the most challenging complications of obesity in childhood. Comprehensive lifestyle interventions that include attention to dietary change, increased physical activity and behavior change appear to be required for the successful treatment of pediatric obesity. In particular, aspects of behavioral interventions that have been identified as contributing to effectiveness have included intensity, parent/family participation, addressing healthy dietary change, promoting physical activity, and involving behavioral management principles such as goal setting. A multidisciplinary team approach is required for successful management of type 2 diabetes in youth as well. As with many therapies in pediatrics, clinical trials and support for treatments of obesity and type 2 diabetes in youth lag behind adult data. Pediatric recommendations may be extrapolated from adult data and are often based on consensus guidelines. Type 2 diabetes in children is most commonly managed with lifestyle modification and medications, metformin and/or insulin, the only medications currently approved for use in children. However, many opportunities exist for ongoing research to clarify optimal management for obesity and type 2 diabetes in youth.Keywords: children, obesity, type 2 diabetes, metformin, insulin, bariatric surgery

  17. The Management of Resistance to Change and Polarity in Educational Organisations.

    Science.gov (United States)

    Theron, A. M. C.; Westhuizen, Philip C. van der

    Research has shown that organizations differ on the basis of their willingness to change and the strategies they use to manage change. For this paper, data were gathered through a review of the literature and through nonstandard interviews with persons in two identified organizations who handle grievance procedures. The analysis identifies the…

  18. Conversion of natural forest to managed forest plantations decreases tree resistance to prolonged droughts

    Science.gov (United States)

    Jean-Christophe Domec; John S. King; Eric Ward; A. Christopher Oishi; Sari Palmroth; Andrew Radecki; Dave M. Bell; Guofang Miao; Michael Gavazzi; Daniel M. Johnson; Steve G. McNulty; Ge Sun; Asko. Noormets

    2015-01-01

    Throughout the southern US, past forest management practices have replaced large areas of native forests with loblolly pine plantations and have resulted in changes in forest response to extreme weather conditions. However, uncertainty remains about the response of planted versus natural species to drought across the geographical range of these forests. Taking...

  19. Management of obesity, insulin resistance and type 2 diabetes in children: consensus and controversy.

    Science.gov (United States)

    Fleischman, Amy; Rhodes, Erinn T

    2009-11-27

    Childhood obesity has become a national and international epidemic. The prevalence and incidence of type 2 diabetes in youth have been increasing, and type 2 diabetes is one of the most challenging complications of obesity in childhood. Comprehensive lifestyle interventions that include attention to dietary change, increased physical activity and behavior change appear to be required for the successful treatment of pediatric obesity. In particular, aspects of behavioral interventions that have been identified as contributing to effectiveness have included intensity, parent/family participation, addressing healthy dietary change, promoting physical activity, and involving behavioral management principles such as goal setting. A multidisciplinary team approach is required for successful management of type 2 diabetes in youth as well. As with many therapies in pediatrics, clinical trials and support for treatments of obesity and type 2 diabetes in youth lag behind adult data. Pediatric recommendations may be extrapolated from adult data and are often based on consensus guidelines. Type 2 diabetes in children is most commonly managed with lifestyle modification and medications, metformin and/or insulin, the only medications currently approved for use in children. However, many opportunities exist for ongoing research to clarify optimal management for obesity and type 2 diabetes in youth.

  20. Intra-Personal and Inter-Personal Kinetic Synergies During Jumping

    Directory of Open Access Journals (Sweden)

    Slomka Kajetan

    2015-12-01

    Full Text Available We explored synergies between two legs and two subjects during preparation for a long jump into a target. Synergies were expected during one-person jumping. No such synergies were expected between two persons jumping in parallel without additional contact, while synergies were expected to emerge with haptic contact and become stronger with strong mechanical contact. Subjects performed jumps either alone (each foot standing on a separate force platform or in dyads (parallel to each other, each person standing on a separate force platform without any contact, with haptic contact, and with strong coupling. Strong negative correlations between pairs of force variables (strong synergies were seen in the vertical force in one-person jumps and weaker synergies in two-person jumps with the strong contact. For other force variables, only weak synergies were present in one-person jumps and no negative correlations between pairs of force variable for two-person jumps. Pairs of moment variables from the two force platforms at steady state showed positive correlations, which were strong in one-person jumps and weaker, but still significant, in two-person jumps with the haptic and strong contact. Anticipatory synergy adjustments prior to action initiation were observed in oneperson trials only. We interpret the different results for the force and moment variables at steady state as reflections of postural sway.

  1. Synergy among School and District Leaders in the Application of Quality Standards in Kuwaiti Public Schools

    Science.gov (United States)

    Aldaihani, Sultan Ghaleb

    2017-01-01

    This study sought to identify existing levels of synergy, or cooperation and compatibility, among school and district leaders and the impact of synergy on standards of quality in Kuwaiti schools. The researcher employed a qualitative methodology based on interviews with principals and administrators representing the six educational districts in…

  2. Hybrid fiber reinforced self-compacting concrete: fiber synergy at low ...

    African Journals Online (AJOL)

    Flexural toughness tests were performed and results were extensively analysed to identify synergy, if any, associated with various fiber combinations. Based on various analysis schemes, the paper identifies fiber combinations that demonstrate maximum synergy in terms of flexural toughness. Journal of Civil Engineering ...

  3. A model-based approach to predict muscle synergies using optimization: application to feedback control

    Directory of Open Access Journals (Sweden)

    Reza eSharif Razavian

    2015-10-01

    Full Text Available This paper presents a new model-based method to define muscle synergies. Unlike the conventional factorization approach, which extracts synergies from electromyographic data, the proposed method employs a biomechanical model and formally defines the synergies as the solution of an optimal control problem. As a result, the number of required synergies is directly related to the dimensions of the operational space. The estimated synergies are posture-dependent, which correlate well with the results of standard factorization methods. Two examples are used to showcase this method: a two-dimensional forearm model, and a three-dimensional driver arm model. It has been shown here that the synergies need to be task-specific (i.e. they are defined for the specific operational spaces: the elbow angle and the steering wheel angle in the two systems. This functional definition of synergies results in a low-dimensional control space, in which every force in the operational space is accurately created by a unique combination of synergies. As such, there is no need for extra criteria (e.g., minimizing effort in the process of motion control. This approach is motivated by the need for fast and bio-plausible feedback control of musculoskeletal systems, and can have important implications in engineering, motor control, and biomechanics.

  4. A model-based approach to predict muscle synergies using optimization: application to feedback control.

    Science.gov (United States)

    Sharif Razavian, Reza; Mehrabi, Naser; McPhee, John

    2015-01-01

    This paper presents a new model-based method to define muscle synergies. Unlike the conventional factorization approach, which extracts synergies from electromyographic data, the proposed method employs a biomechanical model and formally defines the synergies as the solution of an optimal control problem. As a result, the number of required synergies is directly related to the dimensions of the operational space. The estimated synergies are posture-dependent, which correlate well with the results of standard factorization methods. Two examples are used to showcase this method: a two-dimensional forearm model, and a three-dimensional driver arm model. It has been shown here that the synergies need to be task-specific (i.e., they are defined for the specific operational spaces: the elbow angle and the steering wheel angle in the two systems). This functional definition of synergies results in a low-dimensional control space, in which every force in the operational space is accurately created by a unique combination of synergies. As such, there is no need for extra criteria (e.g., minimizing effort) in the process of motion control. This approach is motivated by the need for fast and bio-plausible feedback control of musculoskeletal systems, and can have important implications in engineering, motor control, and biomechanics.

  5. Mechanisms of the negative synergy effect between electron cyclotron current drive and lower hybrid current drive in tokamak

    International Nuclear Information System (INIS)

    Chen Shaoyong; Hong Binbin; Tang Changjian; Yang Wen; Zhang Xinjun

    2013-01-01

    The synergy current drive by combining electron cyclotron wave (ECW) with lower hybrid wave (LHW) can be used to either increase the noninductive current drive efficiency or shape the plasma current profile. In this paper, the synergy current drive by ECW and LHW is studied with numerical simulation. The nonlinear relationship between the wave powers and the synergy current of ECW and LHW is revealed. When the LHW power is small, the synergy current reduces as the ECW power increases, and the synergy current is even reduced to lower than zero, which is referred as negative synergy in the this context. Research shows that the mechanism of the negative synergy is the peaking effect of LHW power profile and the trapped electrons effect. The present research is helpful for understanding the physics of synergy between electron cyclotron current drive and lower hybrid current drive, it can also instruct the design of experiments. (authors)

  6. Synergy among thymol, eugenol, berberine, cinnamaldehyde and streptomycin against planktonic and biofilm-associated food-borne pathogens.

    Science.gov (United States)

    Liu, Q; Niu, H; Zhang, W; Mu, H; Sun, C; Duan, J

    2015-05-01

    Essential oils have been found to exert antibacterial, antifungal, spasmolytic, and antiplasmodial activity and therapeutic effect in cancer treatment. In this study, the antibacterial activities of four main essential oils' components (thymol (Thy), eugenol (Eug), berberine (Ber), and cinnamaldehyde (Cin)) were evaluated against two food-borne pathogens, Listeria monocytogenes and Salmonella Typhimurium, either alone or in combination with streptomycin. Checkerboard assay demonstrated that Thy and Cin elicited a synergistic effect with streptomycin against L. monocytogenes, while a synergy existed between Cin or Eug and streptomycin against Salm. Typhimurium. Further experiments showed that this synergy was sufficient to eradicate biofilms formed by these two bacteria. Thus, our data highlighted that the combinations of specific components from essential oils and streptomycin were useful for the treatment of food-borne pathogens, which might help prevent the spread of antibiotic resistance through improving antibiotic effectiveness. This study has shown the synergistic effect of four components of essential oil (thymol, eugenol, berberine and cinnamaldehyde) combined with streptomycin on planktonic and biofilm-associated food-borne pathogens Listeria monocytogenes and Salmonella Typhimurium. These findings indicate that combination of specific components of essential oils with streptomycin may provide alternative methods to overcome the problem of food-borne bacteria both in suspension and in biofilm. © 2015 The Society for Applied Microbiology.

  7. Investigating IT Faculty Resistance to Learning Management System Adoption Using Latent Variables in an Acceptance Technology Model.

    Science.gov (United States)

    Bousbahi, Fatiha; Alrazgan, Muna Saleh

    2015-01-01

    To enhance instruction in higher education, many universities in the Middle East have chosen to introduce learning management systems (LMS) to their institutions. However, this new educational technology is not being used at its full potential and faces resistance from faculty members. To investigate this phenomenon, we conducted an empirical research study to uncover factors influencing faculty members' acceptance of LMS. Thus, in the Fall semester of 2014, Information Technology faculty members were surveyed to better understand their perceptions of the incorporation of LMS into their courses. The results showed that personal factors such as motivation, load anxiety, and organizational support play important roles in the perception of the usefulness of LMS among IT faculty members. These findings suggest adding these constructs in order to extend the Technology acceptance model (TAM) for LMS acceptance, which can help stakeholders of the university to implement the use of this system. This may assist in planning and evaluating the use of e-learning.

  8. Resistance to Change—A New Perspective: A Textbook for Managers Who Plan to Implement a Change” by Daniela Bradutanu

    Directory of Open Access Journals (Sweden)

    James W. Barnes

    2015-12-01

    Full Text Available hange is inevitable—it’s in our experience wherever we turn. One area, however, where most people do not want to experience change is in the work place. Whether the change is beneficial or not, those who are subjected to a change in the workplace will almost without fail resist a change to their status quo. Managers have normally come to accept this and just plough ahead, coercing their subordinates into accepting the change. With the advent of Dr Daniela Bradutanu’s new book “Resistance to Change”, there is another way—a way of cooperation between managers and employees.

  9. A step ahead of PPARγ full agonists to PPARγ partial agonists: therapeutic perspectives in the management of diabetic insulin resistance.

    Science.gov (United States)

    Chigurupati, Sridevi; Dhanaraj, Sokkalingam A; Balakumar, Pitchai

    2015-05-15

    Described since long as a member of the nuclear receptor superfamily, peroxisome proliferator-activated receptors (PPARs) regulate the gene expression of proteins involved in glucose and lipid metabolism. PPARs indeed regulate several physiologic processes, including lipid homeostasis, adipogenesis, inflammation, and wound healing. PPARs bind natural or synthetic PPAR ligands can function as cellular sensors to regulate the gene transcription. Dyslipidemia, and type 2 diabetes mellitus (T2DM) with insulin resistance are treated using agonists of PPARα and PPARγ, respectively. The PPARγ is a key regulator of insulin sensitization and glucose metabolism, and therefore is considered as an imperative pharmacological target to combat diabetic metabolic disease and insulin resistance. Of note, currently available PPARγ full agonists like rosiglitazone display serious adverse effects such as fluid retention/oedema, weight gain, and increased incidence of cardiovascular events. On the other hand, PPARγ partial agonists are being suggested to devoid or having less incidence of these undesirable events, and are under developmental stages. Current research is on the way for the development of novel PPARγ partial agonists with enhanced therapeutic efficacy and reduced adverse effects. This review sheds lights on the current status of development of PPARγ partial agonists, for the management of T2DM, having comparatively less or no adverse effects to that of PPARγ full agonists. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. SnO2-based memristors and the potential synergies of integrating memristors with MEMS

    Science.gov (United States)

    Zubia, David; Almeida, Sergio; Talukdar, Arka; Mireles, Jose; MacDonald, Eric

    2012-06-01

    Memristors, usually in the form metal/metal-oxide/metal, have attracted much attention due to their potential application for non-volatile memory. Their simple structure and ease of fabrication make them good candidates for dense memory with projections of 22 terabytes per wafer. Excellent switching times of ~10 ns, memory endurance of >109 cycles, and extrapolated retention times of >10 yrs have been reported. Interestingly, memristors use the migration of ions to change their resistance in response to charge flow, and can therefore measure and remember the amount of current that has flowed. This is similar to many MEMS devices in which the motion of mass is an operating principle of the device. Memristors are also similar to MEMS in the sense that they can both be resistant to radiation effects. Memristors are radiation tolerant since information is stored as a structural change and not as electronic charge. Functionally, a MEMS device's sensitivity to radiation is concomitant to the role that the dielectric layers play in the function of the device. This is due to radiation-induced trapped charge in the dielectrics which can alter device performance and in extreme cases cause failure. Although different material systems have been investigated for memristors, SnO2 has received little attention even though it demonstrates excellent electronic properties and a high resistance to displacement damage from radiation due to a large Frenkel defect energy (7 eV) compared its bandgap (3.6 eV). This talk discusses recent research on SnO2-based memristors and the potential synergies of integrating memristors with MEMS.

  11. Metallo beta lactamase mediated resistance in Carbapenem resistant gram-negative bacilli: A cause for concern

    Directory of Open Access Journals (Sweden)

    Malini Jagannatha Rao, Shruti A Harle, Padmavathy M, Umapathy BL, Navaneeth BV

    2014-04-01

    Full Text Available Introduction: The emergence of acquired metallo-β-lactamases (MBL in Gram-negative bacilli is becoming a therapeutic challenge, as these enzymes usually possess a broad hydrolysis profile that includes carbapenems, extended-spectrum β-lactams. Aim: To detect Extended spectrum β-lactamases and metallo-β-lactamase in carbapenem resistant Gram negative clinical isolates from various clinical specimens and to evaluate their antibiotic susceptibility patterns. Material and Methods: A total of 100 non duplicates imipenem resistant isolates were tested for the presence of extended spectrum β-lactamases by phenotypic confirmatory test, metallo-β-lactamases by Double disk synergy test with various distances from edge to edge (10mm,15mm,20mm, between the IPM and EDTA and combined disc test. Result: Of the 100 IMP resistant isolates screened 30 (30% were MBL positive by phenotypic methods, i.e., double disk synergy test and combined disc test. Co-existence of Extended spectrum β-lactamases and MBL were detected in 3 (30%. All the 30 MBL positive isolates had shown synergy at (100% at 10 mm distance, 27 (90% isolates had shown synergy at 15 mm distance and 13 (43.4% isolates were shown synergy at 20 mm distance. All the 30 MBLs producers were multidrug resistant and 27 (90% were sensitive to colistin (CL. All MBL positive Pseudomonas aeruginosa were sensitive to polymyxin B (100µg. Conclusion: Microbiologists are now facing a challenge of drug resistance due to MBL production. Although CLSI guidelines do not quote about the ESBL detection in Pseudomonas aeruginosa MBLs and ESBL have to be detected in them. The use of combination tests would increase the sensitivity to detect the presence of MBL among the clinical isolates of Gram-negative bacilli. The spread of MBL producing Gram negative organism can be prevented if they are detected in all isolates and routinely adopted in all laboratories.

  12. Negotiating peace across identities : are identity conflicts especially intractable and resistant to conflict management?

    OpenAIRE

    Humberset, Arne

    2005-01-01

    This Master s Thesis develops the concept of identity conflict on the basis of needs- and identity-based approaches to conflict resolution. These various theoretical perspectives share the assumption that identity conflicts make up a particularly intractable type of conflict that is not amendable to conventional methods of conflict management. The concept of identity conflict incorporates several key assumptions from the needs- and identity-based approaches to conflict resolution. First it as...

  13. Change, resistance and coping: a study of first tier managers in further education

    OpenAIRE

    Page, Damien

    2011-01-01

    This thesis presents findings from a study of first tier managers (FTMs) in Further Education colleges, a role that has been largely neglected by the extant literature. The study investigated the role in four general FE colleges and adopted a case study approach, employing semi-structured interviews as the main research method. The findings suggest that the FTM role is extremely diverse and heterogeneous, elastic and poorly understood. Yet FTMs themselves enjoyed a high degree of autonomy in ...

  14. Mechanisms of glyphosate resistance and response to alternative herbicide-based management in populations of the three Conyza species introduced in Southern Spain.

    Science.gov (United States)

    Amaro-Blanco, Ignacio; Fernández-Moreno, Pablo Tomás; Osuna-Ruiz, María Dolores; Bastida, Fernando; De Prado, Rafael

    2018-02-25

    In perennial crops, the most common method of weed control is to spray herbicides, and glyphosate has long been the first choice of farmers. Three species of the genus Conyza are among the most problematic weeds for farmers, exhibiting resistance to glyphosate. The objectives of this work were to evaluate resistance levels and mechanisms, and to test chemical control alternatives in putative resistant (R) populations of Conyza bonariensis, Conyza canadensis and Conyza sumatrensis. Plants of the three R-populations of Conyza spp. survived high doses of glyphosate compared to plants of susceptible (S) populations. The rate of movement of 14 C glyphosate out of treated leaves in plants of S-populations was higher than in plants of R-populations. Only in plants of the R-population of C. sumatrensis contained the known target-site 5-enolpyruvylshikimate-3-phosphate synthase mutation Pro-106-Thr. Field responses to the different alternative herbicide treatments tested indicated injury and high effectiveness in most cases. The results indicate that non-target-site resistant (NTSR) mechanisms explain resistance in C. bonariensis and C. canadensis, whereas both NTSR and target-site resistant (TSR) mechanisms contribute to resistance in C. sumatrensis. The results obtained in the field trials suggest that the resistance problem can be solved through Integrated Weed Management. This article is protected by copyright. All rights reserved.

  15. The role of water management on the oxygen transport resistance in polymer electrolyte fuel cell with ultra-low precious metal loading

    Science.gov (United States)

    Srouji, A. K.; Zheng, L. J.; Dross, R.; Aaron, D.; Mench, M. M.

    2017-10-01

    Limiting current measurements are used to evaluate oxygen transport resistance in the catalyst layer of a polymer electrolyte fuel cell (PEFC). The pressure independent oxygen transport resistance in the electrode is quantified for two cell architectures and two cathode Pt loadings (0.4 and 0.07 mgPt.cm-2). The compounded effect of the flow field and Pt loading is used to shed light on the nature of the observed transport resistance, especially its response to fundamentally different flow fields, which is shown to directly or indirectly scale with Pt loading in the open literature. By varying gas pressure and using low oxygen concentrations, the total oxygen transport resistance is divided into intermolecular gas diffusion (a pressure-dependent component) and a pressure independent component, which can be attributed to Knudsen diffusion or dissolution film resistance. The pressure-independent oxygen transport resistance in the catalyst layer varies between 13.3 and 34.4 s/m. It is shown that the pressure independent oxygen transport resistance increases with reduced Pt loading, but that effect is greatly exacerbated by using conventional channel/lands. The results indicate that open metallic element architecture improves the oxygen transport resistance in ultra-low Pt loading electrodes, likely due to enhanced water management at the catalyst layer.

  16. Resistance training program for fatigue management in the workplace: exercise protocol in a cluster randomized controlled trial.

    Science.gov (United States)

    Santos, Hélio Gustavo; Chiavegato, Luciana Dias; Valentim, Daniela Pereira; da Silva, Patricia Rodrigues; Padula, Rosimeire Simprini

    2016-12-22

    Fatigue is a multifactorial condition that leads to disease and loss in production, and it affects a large number of workers worldwide. This study aims to demonstrate a resistance exercise protocol that individuals will perform during the work schedule, and to evaluate the effectiveness of this exercises program for fatigue control. This is a cluster randomized controlled trial with two arms and is assessor blinded. A total of 352 workers of both sexes, aged 18-65 years, from a medium-sized dairy plant were enrolled in this study. Participants will be recruited from 13 production sectors according to the eligibility criteria and will be randomized by clusters to either the Progressive Resistance Exercise (PRE) intervention group or the Compensatory Workplace Exercise (CWE) comparative group. A resistance exercise program will be implemented for both groups. The groups will receive instructions on self-management, breaks, adjustments to workstations, and the benefits of physical exercise. The PRE group will perform resistance exercises with gradual loads in an exercise room, and the CWE group will perform exercise at their workstations using elastic bands. The exercise sessions will be held 3 times a week for 20 min. The primary outcome measures will be symptoms of physical and mental fatigue, and muscular fatigue based on a one-repetition maximum (1RM). The secondary outcome measures will be level of physical activity, musculoskeletal symptoms, physical condition, perceived exposure, and productivity. The workers will be assessed at baseline and after a 4-month program. A linear mixed model will be applied on an intention-to-treat basis. This intervention is expected to reduce symptoms of fatigue in the workers. The exercise program is indicating in the workplace, although there are few studies describing the effects of exercise on the control of fatigue in the workplace. Emphasis will be placed on adherence to the program, which may result in significant and

  17. Resistance training program for fatigue management in the workplace: exercise protocol in a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hélio Gustavo Santos

    2016-12-01

    Full Text Available Abstract Background Fatigue is a multifactorial condition that leads to disease and loss in production, and it affects a large number of workers worldwide. This study aims to demonstrate a resistance exercise protocol that individuals will perform during the work schedule, and to evaluate the effectiveness of this exercises program for fatigue control. Methods/Design This is a cluster randomized controlled trial with two arms and is assessor blinded. A total of 352 workers of both sexes, aged 18–65 years, from a medium-sized dairy plant were enrolled in this study. Participants will be recruited from 13 production sectors according to the eligibility criteria and will be randomized by clusters to either the Progressive Resistance Exercise (PRE intervention group or the Compensatory Workplace Exercise (CWE comparative group. A resistance exercise program will be implemented for both groups. The groups will receive instructions on self-management, breaks, adjustments to workstations, and the benefits of physical exercise. The PRE group will perform resistance exercises with gradual loads in an exercise room, and the CWE group will perform exercise at their workstations using elastic bands. The exercise sessions will be held 3 times a week for 20 min. The primary outcome measures will be symptoms of physical and mental fatigue, and muscular fatigue based on a one-repetition maximum (1RM. The secondary outcome measures will be level of physical activity, musculoskeletal symptoms, physical condition, perceived exposure, and productivity. The workers will be assessed at baseline and after a 4-month program. A linear mixed model will be applied on an intention-to-treat basis. Discussion This intervention is expected to reduce symptoms of fatigue in the workers. The exercise program is indicating in the workplace, although there are few studies describing the effects of exercise on the control of fatigue in the workplace. Emphasis will be placed on

  18. Challenges in the sequencing of therapies for the management of metastatic castration-resistant prostate cancer.

    Science.gov (United States)

    Parente, Phillip; Parnis, Francis; Gurney, Howard

    2014-09-01

    Prior to 2010, docetaxel was the standard option for chemotherapy in men with metastatic castration-resistant prostate cancer (mCRPC). Today, the picture is vastly different: several additional therapies have each demonstrated a survival benefit such that we now have chemotherapy (cabazitaxel), androgen suppressive agents (abiraterone acetate and enzalutamide), a cellular vaccine (sipuleucel-T) and radium-233 (for symptomatic bone metastases). With several other agents in the pipeline for late-stage disease, the future looks promising for mCRPC. As the available data are not able to inform as to the optimum sequencing of therapy, this remains a challenge. This paper draws on insights from published and ongoing clinical studies to provide a practical patient-focused approach to maximize the benefits of the current therapeutic armamentarium. Preliminary sequencing suggestions are made based on clinical trial criteria. But until more data become available, clinical gestalt, experience, cost and individual patient preferences will continue to drive choices. © 2014 Wiley Publishing Asia Pty Ltd.

  19. Beyond synergy: The revolutionary elements in horizontal technology

    International Nuclear Information System (INIS)

    Hatala, R.

    1994-01-01

    The petroleum industry is undergoing a fundamental restructuring that is changing the shape and texture of the business. Four principles are guiding this restructuring: proactivity, simplicity/focus, flexibility and synergy. These four elements are contained within horizontal technology applications in Canada and are impacting the upstream operating companies and the service and supply sectors. The evolving socio-economic and political environments of these changes within the petroleum industry are examined. The specific resource base potential, financial, regulatory and market forces that support the application of horizontal technology are addressed and their forecast impacts on industry relationships, production and economic trends over the next 5 years are discussed. The blurred distinctions between operating and service sectors will continue such that service entities will participate directly in oil and gas opportunities in consort with operating companies or countries. 4 refs., 3 figs

  20. Synergy potential for oil and geothermal energy exploitation

    DEFF Research Database (Denmark)

    Ziabakhsh-Ganji, Zaman; Nick, Hamidreza M.; Donselaar, Marinus E.

    2018-01-01

    and feasibility analyses of the synergy potential of thermally-enhanced oil recovery and geothermal energy production are performed. A series of simulations are carried out to examine the effects of reservoir properties on energy consumption and oil recovery for different injection rates and injection temperature......A new solution for harvesting energy simultaneously from two different sources of energy by combining geothermal energy production and thermal enhanced heavy oil recovery is introduced. Numerical simulations are employed to evaluate the feasibility of generating energy from geothermal resources......, both for thermally enhanced oil recovery from a heavy oil reservoir and for direct heating purposes. A single phase non-isothermal fluid flow modeling for geothermal doublet system and a two-phase non-isothermal fluid flow modelling for water flooding in an oil reservoir are utilised. Sensitivity...