WorldWideScience

Sample records for sustained nevirapine exposure

  1. High exposure to nevirapine in plasma is associated with an improved virological response in HIV-1-infected individuals

    NARCIS (Netherlands)

    Veldkamp, A. I.; Weverling, G. J.; Lange, J. M.; Montaner, J. S.; Reiss, P.; Cooper, D. A.; Vella, S.; Hall, D.; Beijnen, J. H.; Hoetelmans, R. M.

    2001-01-01

    OBJECTIVE: To explore relationships between exposure to nevirapine and the virological response in HIV-1-infected individuals participating in the INCAS trial. METHODS: The elimination rate constant of plasma HIV-1 RNA (k) was calculated during the first 2 weeks of treatment with nevirapine,

  2. First-line antiretroviral therapy after single-dose nevirapine exposure in South Africa: a cost-effectiveness analysis of the OCTANE trial.

    Science.gov (United States)

    Ciaranello, Andrea L; Lockman, Shahin; Freedberg, Kenneth A; Hughes, Michael; Chu, Jennifer; Currier, Judith; Wood, Robin; Holmes, Charles B; Pillay, Sandy; Conradie, Francesca; McIntyre, James; Losina, Elena; Walensky, Rochelle P

    2011-02-20

    The OCTANE trial reports superior outcomes of lopinavir/ritonavir vs. nevirapine-based antiretroviral therapy (ART) among women previously exposed to single-dose nevirapine to prevent mother-to-child HIV transmission. However, lopinavir/ritonavir is 12 times costlier than nevirapine. We used a computer model, with OCTANE and local data, to simulate HIV-infected, single-dose nevirapine-exposed women in South Africa. Outcomes of three alternative ART sequences were projected: no ART (for comparison), first-line nevirapine, and first-line lopinavir/ritonavir. OCTANE data included mean age (31 years) and CD4 cell count (135/μl); median time since single-dose nevirapine (17 months); and 24-week viral suppression efficacy for first-line ART (nevirapine: 85%, lopinavir/ritonavir: 97%). Outcomes included life expectancy, per-person costs (2008 US$), and incremental cost-effectiveness ratios. With no ART, projected life expectancy was 1.6 years and per-person cost was $2980. First-line nevirapine increased life expectancy (15.2 years) and cost ($13 990; cost-effectiveness ratio: $810/year of life saved versus no ART). First-line lopinavir/ritonavir further increased life expectancy to 16.3 years and cost to $15 630 (cost-effectiveness ratio: $1520/year of life saved versus first-line nevirapine). First-line lopinavir/ritonavir cost-effectiveness was sensitive to prevalence of nevirapine-resistant virus at ART initiation, time from single-dose nevirapine exposure to ART initiation (6-12, 12-24, or >24 months), second-line ART efficacies, and outcomes after 24 weeks on ART. First-line lopinavir/ritonavir-based ART is very cost-effective in single-dose nevirapine-exposed, South African women similar to OCTANE participants. Lopinavir/ritonavir should be initiated in women with known nevirapine resistance or single-dose nevirapine exposure less than 12 months prior, or in whom such information is unknown.

  3. Evaluation of polycaprolactone matrices for sustained vaginal delivery of nevirapine in the prevention of heterosexual HIV transmission.

    Science.gov (United States)

    Dang, Nhung; Sivakumaran, Haran; Harrich, David; Shaw, P Nicholas; Coombes, Allan G A

    2014-07-01

    Nevirapine (NVP) was loaded in polycaprolactone (PCL) matrices to produce vaginal inserts with the aim of preventing HIV transmission. NVP dispersions in PCL were prepared, at 10% (w/w) theoretical loading, measured with respect to the PCL content of the matrices, in the form of (1) NVP only, (2) a physical mixture of NVP with polyethylene glycol (PEG) 6000 or (c) a solid dispersion (SD) with PEG produced by co-dissolution in ethanol. Characterisation of SD by differential scanning calorimetry and attenuated total reflectance-Fourier transform infrared spectroscopy suggested transformation of the crystalline structure of NVP to an amorphous form which consequently increased the dissolution rate of drug. A low-loading efficiency of 13% was obtained for NVP-loaded matrices and less than 20% for matrices prepared using physical mixtures of drug and PEG. The loading efficiency was improved significantly to around 40% when a 1:4 NVP-PEG SD was used for matrix production. After 30 days, 40% of the drug content was released from NVP-loaded matrices, 55% from matrices containing 1:4 NVP-PEG physical mixtures and 60% from matrices loaded with 1:4 NVP-PEG SDs. The in vitro anti-viral activity of released NVP was assessed using a luciferase reporter gene assay following the infection of HeLa cells with pseudo-typed HIV-1. NVP released from PCL matrices in simulated vaginal fluid retained over 75% anti-HIV activity compared with the non-formulated NVP control. In conclusion, 1:4 NVP-PEG SDs when loaded in PCL matrices increase drug loading efficiency and improve release behaviour. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

  4. Prevention of TB using rifampicin plus isoniazid reduces nevirapine concentrations in HIV-exposed infants.

    Science.gov (United States)

    McIlleron, Helen; Denti, Paolo; Cohn, Silvia; Mashabela, Fildah; Hoffmann, Jennifer D; Shembe, Saba; Msandiwa, Regina; Wiesner, Lubbe; Velaphi, Sithembiso; Lala, Sanjay G; Chaisson, Richard E; Martinson, Neil; Dooley, Kelly E

    2017-07-01

    Newborns of HIV-infected mothers are given daily doses of nevirapine to prevent HIV-1 acquisition. Infants born to mothers with TB should also receive TB preventive therapy. TB preventive regimens include isoniazid for 6 months or rifampicin plus isoniazid for 3 months (RH preventive therapy). The effect of concomitant RH preventive therapy on nevirapine concentrations in infants is unknown. Tshepiso was a prospective case-control cohort study of pregnant HIV-infected women with and without TB whose newborn infants received standard doses of nevirapine for HIV prophylaxis. Infants born to mothers with TB also received RH preventive therapy. Infant plasma nevirapine concentrations were measured at 1 and 6 weeks. The effects of RH preventive therapy on nevirapine disposition were investigated in a population pharmacokinetic model. Of 164 infants undergoing pharmacokinetic sampling, 46 received RH preventive therapy. After adjusting for weight using allometric scaling, the model estimated a 33% reduction in nevirapine trough concentrations with RH preventive therapy compared with TB-unexposed infants not receiving concomitant rifampicin and a 30% decline in trough concentrations in a typical infant between day 7 and 35 post-partum. Rifampicin-based TB preventative treatment reduces nevirapine concentrations significantly in HIV-exposed infants. Although the nevirapine exposures required to prevent HIV acquisition in breastfeeding infants are undefined, given the potential risks associated with underdosing nevirapine in this setting, it is prudent to avoid rifampicin-based preventive therapy in HIV-exposed children receiving prophylactic nevirapine.

  5. [Hepatotoxicity in healthy infants exposed to nevirapine during pregnancy].

    Science.gov (United States)

    Iveli, Pablo; Noguera-Julian, Antoni; Soler-Palacín, Pere; Martín-Nalda, Andrea; Rovira-Girabal, Núria; Fortuny-Guasch, Clàudia; Figueras-Nadal, Concepció

    2016-01-01

    The use of nevirapine in HIV-infected pregnant women is discouraged due to its potential to cause hepatotoxicity. There is limited information available on the toxicity in non-HIV infected newborn exposed to this drug during pregnancy. The aim of the study is to determine the extent of hepatotoxicity in the newborn exposed to nevirapine and HIV during pregnancy. A cross-sectional, observational, multicenter study was conducted on a cohort of healthy infants born to HIV-infected mothers, in whom the first determination of alanine aminotransferase (ALT), before 6weeks of age, was collected. Patients were allocated to 2groups according to exposure to nevirapine during pregnancy. Hepatotoxicity was rated according to the AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS). This study included 160newborns from 159pregnancies (88exposed to nevirapine-based regimens and 71 exposed to protease inhibitors-based therapies). No cases of hepatotoxicity were observed according to the DAIDS Table for Grading. Two cases of ALT above normal values (2.8%; 95%CI: 0.3-9.8%) were observed in patients not exposed to nevirapine, and one case (1.1%; 95%CI: 0.0-6.1%) in the group exposed to nevirapine (P=.585). The lack of differences between groups suggests that highly active antiretroviral treatment regimens including nevirapine administered during pregnancy do not involve a higher risk of liver disease compared to other treatment combinations. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Renal histoarchitectural changes in nevirapine therapy: possible ...

    African Journals Online (AJOL)

    Renal histoarchitectural changes in nevirapine therapy: possible role of kolaviron ... Department of Anatomy, School of Medicine, University of Namibia, Windhoek, ... However, co-administration of nevirapine and vitamin C did not improve.

  7. ORIGINAL ARTICLES Nevirapine toxicity- implications for ...

    African Journals Online (AJOL)

    of mother-to-child HIV transmission (MTCT) in resource-poor settings. Early in nevirapine development, ... of serious liver toxicity in patients with preserved CD4 cell counts commencing nevirapine. This article will review ... efavirenz and 2.1% for nevirapine, and liver failure rates of 0.4 and 0.3 cases per 100 person-years, ...

  8. Compatibility studies of nevirapine in physical mixtures with excipients for oral HAART

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, G.G.G. de; Ferraz, H.G. [Department of Pharmacy, Faculty of Pharmaceutical Health, University of Sao Paulo, Sao Paulo 05508-900 (Brazil); Severino, P. [Department of Biotechnological Processes, School of Chemical Engineering, University of Campinas, Campinas 13083-970 (Brazil); Department of Pharmaceutical Technology, Faculty of Health Sciences, Fernando Pessoa University, Porto 4200-150 (Portugal); Souto, E.B., E-mail: eliana@ufp.edu.pt [Department of Pharmaceutical Technology, Faculty of Health Sciences, Fernando Pessoa University, Porto 4200-150 (Portugal); Institute for Biotechnology and Bioengineering, Centre for Genomics and Biotechnology, University of Tras-os-Montes e Alto Douro (IBB-CGB/UTAD), 5001-801 Vila Real (Portugal)

    2013-03-01

    Nevirapine is a hydrophobic non-nucleoside reverse transcriptase inhibitor, used in first line regimens of highly active antiretroviral therapy (HAART). The drug has more than one crystalline form, which may have implications for its behaviour during production and also for its in vivo performance. This study was aimed at exploring the suitability of thermoanalytical methods for the solid-state characterization of commercial crystalline forms of nevirapine. The drug powder was characterized by ultraviolet spectrophotometry, stereoscopy, scanning electron microscopy, wide-angle X-ray diffraction, measurements of density, flowability, solubility and intrinsic dissolution rate (IDR), differential scanning calorimetry, thermogravimetric analysis, and photostability measurements. The results showed that nevirapine has high stability and is not susceptible to degradation under light exposure. The drug showed compatibility with the excipients tested (lactose, microcrystalline cellulose, polyvinylpyrrolidone and polyvinyl acetate copolymer (PVP/PVA), and hydroxypropylmethylcellulose (HPMC)). Nevirapine has low solubility, an acid medium being the most appropriate medium for assessing the release of the drug from dosage forms. However, the data obtained from IDR testing indicate that dissolution is the critical factor for the bioavailability of this drug. - Graphical abstract: Bulk nevirapine powder analysed by scanning electron microscopy and the drug solubility profile in various buffer solutions. The pH values of the media in which the tests were conducted are also presented. Highlights: Black-Right-Pointing-Pointer Nevirapine shows more than one crystalline form, that influence its in vivo and in vitro behaviour. Black-Right-Pointing-Pointer DSC and TGA were used for solid-state characterization of crystalline forms of nevirapine. Black-Right-Pointing-Pointer Nevirapine is compatible with lactose, microcrystalline cellulose, PVP/PVA copolymers and HPMC. Black

  9. Renal histoarchitectural changes in nevirapine therapy: possible ...

    African Journals Online (AJOL)

    This study investigates the attenuating effect of kolaviron in nevirapine- therapy on the histological structure of the kidneys of adult male Sprague-Dawley rats. ... were significantly reduced in kolaviron and vitamin C treated animals, whereas in the nevirapine group these parameters were significantly elevated (P<0.05).

  10. Nevirapine

    Science.gov (United States)

    ... HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other life-style changes may decrease the risk of transmitting (spreading) ...

  11. Nevirapine Resistance by Timing of HIV Type 1 Infection in Infants Treated with Single-Dose Nevirapine

    Science.gov (United States)

    Micek, Mark A.; Blanco, Ana Judith; Beck, Ingrid A.; Dross, Sandra; Matunha, Laurinda; Montoya, Pablo; Seidel, Kristy; Gantt, Soren; Matediane, Eduardo; Jamisse, Lilia; Gloyd, Stephen; Frenkel, Lisa M.

    2011-01-01

    Background In women, single-dose nevirapine for prophylaxis against mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) selects for nevirapine-resistant HIV-1, which subsequently decays rapidly. We hypothesized that the selection, acquisition, and decay of nevirapine-resistant HIV-1 differs in infants, varying by the timing of HIV-1 infection. Methods We conducted a prospective, observational study of 740 Mozambican infants receiving single-dose nevirapine prophylaxis and determined the timing of infection and concentrations of nevirapine-resistant HIV-1 over time. Results Infants with established in utero infection had a high rate (87.0%) of selection of nevirapine-resistant HIV-1 mutants, which rapidly decayed to undetectable levels. The few without nevirapine resistance received zidovudine with single-dose nevirapine and/or their mothers took alternative antiretroviral drugs. Infants with acute in utero infection had a lower rate of nevirapine-resistant HIV-1 (33.3%; P =.006, compared with established in utero infection), but mutants persisted over time. Infants with peripartum infection also had a lower rate of nevirapine-resistant HIV-1 (38.1%; P =.001, compared with established in utero infection) but often acquired 100% mutant virus that persisted over time (P =.017, compared with established in utero infection). Conclusions The detection and persistence of nevirapine-resistant HIV-1 in infants after single-dose nevirapine therapy vary by the timing of infection and the antiretroviral regimen. In infants with persistent high-level nevirapine-resistant HIV-1, nevirapine-based antiretroviral therapy is unlikely to ever be efficacious because of concentrations in long-lived viral reservoirs. However, the absence or decay of nevirapine-resistant HIV-1 in many infants suggests that nevirapine antiretroviral therapy may be effective if testing can identify these individuals. PMID:20384494

  12. Maternal deaths following nevirapine- based antiretroviral therapy

    African Journals Online (AJOL)

    2012-11-02

    Nov 2, 2012 ... Stevens-Johnson Syndrome (SJS). Although relatively uncommon, the occurrence of ART-related toxicity deaths was twice as high during 2010 than in previous years. This increase coincided with the release of the 2010 SA PMTCT guidelines4 that promoted nevirapine (NVP)-based ART for pregnant ...

  13. Environmentally Sustainable Occupational Exposure to Nanoparticles

    African Journals Online (AJOL)

    The entire sample of respondents was 40; however, 15 cases could not be used because these respondents did not complete the questionnaire survey. The remaining 25 were used for the pilot study. The survey included questions on type of work and vehicle; exposure; symptoms such as frequency and severity of wheeze ...

  14. A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS Trial. Italy, The Netherlands, Canada and Australia Study.

    Science.gov (United States)

    Montaner, J S; Reiss, P; Cooper, D; Vella, S; Harris, M; Conway, B; Wainberg, M A; Smith, D; Robinson, P; Hall, D; Myers, M; Lange, J M

    1998-03-25

    Current guidelines recommend that individuals infected with the human immunodeficiency virus type 1 (HIV-1) be treated using combinations of antiretroviral agents to achieve sustained suppression of viral replication as measured by the plasma HIV-1 RNA assay, in the hopes of achieving prolonged remission of the disease. However, until recently, many drug combinations have not led to sustained suppression of HIV-1 RNA. To compare the virologic effects of various combinations of nevirapine, didanosine, and zidovudine. Double-blind, controlled, randomized trial. University-affiliated ambulatory research clinics in Italy, the Netherlands, Canada and Australia (INCAS). Antiretroviral therapy-naive adults free of the acquired immunodeficiency syndrome with CD4 cell counts between 0.20 and 0.60x10(9)/L (200-600/microL). Patients received zidovudine plus nevirapine (plus didanosine placebo), zidovudine plus didanosine (plus nevirapine placebo), or zidovudine plus didanosine plus nevirapine. Plasma HIV-1 RNA. Of the 153 enrolled patients, 151 were evaluable. At week 8, plasma HIV-1 RNA levels had decreased by log 2.18, 1.55, and 0.90 in the triple drug therapy, zidovudine plus didanosine, and zidovudine plus nevirapine groups, respectively (P<.05). The proportions of patients with plasma HIV-1 RNA levels below 20 copies per milliliter at week 52 were 51%, 12%, and 0% in the triple drug therapy, zidovudine plus didanosine, and zidovudine plus nevirapine groups, respectively (P<.001). Viral amplification was attempted in 59 patients at 6 months. Viral isolation was unsuccessful in 19 (79%) of 24, 10 (53%) of 19, and 5 (31%) of 16 patients in the triple drug therapy, zidovudine plus didanosine, and zidovudine plus nevirapine groups, respectively. Among patients from whom virus could be amplified, resistance to nevirapine was found in all 11 patients receiving zidovudine plus nevirapine and in all 5 patients receiving triple drug therapy. Rates of disease progression or death

  15. Incidence and determinants of nevirapine and efavirenz-related skin rashes in West Africans: nevirapine's epitaph?

    Directory of Open Access Journals (Sweden)

    Fred Stephen Sarfo

    Full Text Available Non-nucleoside reverse transcriptase inhibitor (NNRTI associated rash is common and frequently leads to discontinuation of NNRTIs. This study assessed the risk of developing rashes and discontinuing NNRTIs and associated factors in a large clinic in central Ghana. In this retrospective cohort study, clinical data were obtained in patients starting efavirenz or nevirapine between 2004-2010. Factors associated with rashes were explored using a multivariate Cox proportional hazards regression model. Of 3,999 patients who started NNRTI-based ART, 281 (7.0% experienced at least one episode of NNRTI-related rash with an incidence of 2.63 events/100 person-years, occurring in 10.2% and 5.6% of patients taking nevirapine and efavirenz respectively. Most rashes (94% were grade 1 or 2 and were reported a median of 2 months following initiation of ART. In multivariate analysis developing a rash was associated with nevirapine use (aHR 1.67, 95% CI 1.28-2.10, female gender (aHR of 1.39, 95% CI 1.01-1.92 and lower baseline CD4 counts (aHR 0.88, 95% CI 0.82-0.95 per 50 cells/mm³ increment. Patients with nevirapine-associated rash were 11 times more likely to discontinue treatment as patients with efavirenz-associated rash. In contrast to findings in other studies, NNRTI-associated rashes in Ghanaians appear more common in patients with lower baseline CD4 counts. Given the increased frequency of rashes with nevirapine and subsequent discontinuations in many patients, along with other treatment-limiting toxicities, this provides further impetus for the replacement of nevirapine by efavirenz as the first-line NNRTI treatment of choice in Africa.

  16. The efficacy, pharmacokinetics, safety and cardiovascular risks of switching nevirapine to rilpivirine in HIV-1 patients: the RPV switch study

    NARCIS (Netherlands)

    Rokx, C.; Blonk, M.; Verbon, A.; Burger, D.M.; Rijnders, B.J.

    2014-01-01

    INTRODUCTION: Nevirapine (NVP) induces cytochrome P450 3A4 by which rilpivirine (RPV) is metabolized. Switching NVP to RPV could result in decreased RPV exposure with subsequent virological failure and dyslipidemia because NVP is regarded as the least dyslipidemic, non-nucleoside, reverse

  17. Therapeutic drug monitoring of nevirapine in resource-limited settings.

    NARCIS (Netherlands)

    L'homme, R.F.A.; Muro, E.P.; Droste, J.A.H.; Wolters, L.R.; Kolmer, NW van Ewijk-Benek; Schimana, W.; Burger, D.M.

    2008-01-01

    BACKGROUND: We developed a simple and inexpensive thin-layer chromatography (TLC) assay for semiquantitative detection of saliva concentrations of nevirapine in resource-limited settings. The method was validated in an African target population. METHODS: Paired plasma and saliva nevirapine

  18. Efficacy and durability of nevirapine in antiretroviral drug naive patients

    NARCIS (Netherlands)

    Lange, Joep M. A.

    2003-01-01

    Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that was first reported in the scientific literature in 1990. Varying doses of nevirapine (NVP) and a number of regimens containing this NNRTI have been studied in antiretroviral (ARV) naive patients. Four key studies have

  19. Nevirapine plasma concentrations are still detectable after more than 2 weeks in the majority of women receiving single-dose nevirapine: implications for intervention studies.

    Science.gov (United States)

    Muro, Eva; Droste, Jacqueline A H; Hofstede, Hadewych Ter; Bosch, Marjolein; Dolmans, Wil; Burger, David M

    2005-08-01

    Single-dose nevirapine is a highly cost-effective strategy to reduce perinatal HIV-1 transmission. Its major disadvantage is the selection of nevirapine resistance in 20% to 30% of women, probably attributable to the long elimination half-life of nevirapine. To develop intervention strategies, it is important to know the interpatient variability in nevirapine half-life in women receiving a single dose of nevirapine. HIV-negative, healthy, nonpregnant Dutch women were eligible for this study. After administration of a single 200-mg dose of nevirapine to the subjects, blood was sampled for measurement of nevirapine twice a week for a total of 21 days. Nevirapine plasma levels were determined by a validated high-performance liquid chromatography method with a lower limit of quantification of 0.15 mg/L. The primary end point was the first sample with an undetectable nevirapine concentration. Forty-four subjects participated. The median age, height, and body weight (interquartile range) were 26 (21-33) years, 1.72 (1.68-1.75) m, and 64 (59-75) kg, respectively. The median elimination half-life of nevirapine was 56.7 hours, with a range of 25.6 to 164 hours. The time to the first undetectable nevirapine plasma concentration was 10 days in 4 subjects, 14 days in 12 subjects, 17 days in 12 subjects, and 21 days in 9 subjects. In the remaining 7 subjects, nevirapine was still detectable on day 21, the last day of sampling. Time to an undetectable nevirapine plasma concentration was influenced by oral contraceptive use but not by age, height, body weight, body surface area, alcohol use, or smoking. Most women who received a single 200-mg nevirapine dose still had detectable plasma concentrations of nevirapine after more than 2 weeks. This information is valuable for designing intervention studies to prevent the development of nevirapine resistance.

  20. Genotypic and phenotypic nevirapine resistance correlates with virological failure during salvage therapy including abacavir and nevirapine

    DEFF Research Database (Denmark)

    Jørgensen, L B; Katzenstein, T L; Gerstoft, J

    2000-01-01

    OBJECTIVE: To study the development of resistance during 8 weeks of salvage therapy with abacavir and nevirapine in combination with other reverse transcriptase inhibitors (RTIs) and protease inhibitors (PIs). METHODS: Samples obtained at baseline and after 8 weeks of therapy from 16 heavily...... pretreated patients were analysed for genotypic and phenotypic resistance. Genotypic resistance was analysed in cell-associated DNA and plasma HIV-RNA using direct sequencing. Phenotypic resistance was analysed in a PBMC-based assay and in a recombinant virus assay. Plasma viral load was measured at baseline...... and after 2, 4 and 8 weeks of therapy. RESULTS: The majority of patients was genotypically and phenotypically resistant to lamivudine, abacavir, zidovudine and PIs, whereas 50% of the patients showed resistance to nevirapine at baseline in at least one of the methods used. After 8 weeks of salvage therapy...

  1. Toxicogenomics of nevirapine-associated cutaneous and hepatic adverse events among populations of African, Asian, and European descent

    NARCIS (Netherlands)

    Yuan, Jing; Guo, Sheng; Hall, David; Cammett, Anna M.; Jayadev, Supriya; Distel, Manuel; Storfer, Stephen; Huang, Zimei; Mootsikapun, Piroon; Ruxrungtham, Kiat; Podzamczer, Daniel; Haas, David W.; Benetucci, Jorge; Ortega, Gerardo; Cahn, Pedro; Cesar, Carina; Cassetti, Isabel; Bissio, Emiliano; Lupo, Sergio; Chuah, John; Workman, Cassy; Rees, Vanessa; Cooper, David A.; Hickey, Rebecca; Anderson, Jonathan; Moore, Richard; Hoy, Jennifer; Downs, Cath; Finlayson, Robert; Bodsworth, Neil; Eu, Beng; Lau, Helen; Montaner, Julio; Harris, Marianne; Walmsley, Sharon; d'Aquila, Adrianna; Conway, Brian; Tossonian, Harout; Morlat, Philippe; Louis, Isabelle; Yazdanpanah, Yazdan; Ajana, Faiza; Bollens, Diane; Girard, Pierre-Marie; May, Thierry; Pialoux, Gilles; Slama, Laurence; Lyavanc, Thomas; Piketty, Christophe; Pluot, Christel; Cotte, Laurent; Miailhes, Patrick; Reliquet, Veronique; Raffi, François; Phung, Bao; Yeni, Patrick; Simon, Anne; Bonmarchand, Manuela; Ponscarme, Diane; Rozenbaum, Willy; Alvarez, Muriel; Marchou, Bruno; Plettenberg, Andreas; Stoehr, Albrecht; Rockstroh, Jürgen; Schwarze-Zander, Carolynne; Brockmeyer, Norbert H.; Klinker, Hartwig; Heinz, Werner; Hoffmann, Christian; Bergmann, Frank; Schuermann, Dirk; Lutz, Thomas; Gute, Peter; Arastéh, Keikawus; Hartikainen, Jukka; Rittweger, Michael; Kern, Peter; Härter, Georg; Reuter, Stefan; Jensen, Björn; Esser, Stefan; Jablonka, Robert; Morbach, Karin; Jaegel-Guedes, Eva; Reiss, Peter; van den Berk, Guido; Branger, Judith; Brinkman, Kees; Puig, Jordi; Negredo, Eugènia; Viciana, Pompeyo; Lopez-Cortes, Luis; de Los Santos, Ignacio; Sanz, Jesús; Mallolas, Josep; Laguno, Montserrat; Ribera, Esteban; Villar del Saz, Sara; Vergas, Jorge; Téllez, M. Jesús; López, Juan Carlos; Sanchez-Conde, Matilde; Domingo, Pere; Casado, José L.; Pumares, María; Lin, Hsi-Hsun; Liu, Yung-Ching; Wang, Yung-Hsing; Tsai, Hung-Chin; Wang, Jen-Hsien; Wong, Wing Wai; Hu, Bor-Shen; Hsieh, Szu-Min; Sheng, Wang-Huei; Lin, Yu-Hui; Lu, Po-Liang; Chen, Tun-Chieh; Avihingsanon, Anchalee; Anekthananon, Thanomsak; Ratanasuwan, Winai; Tawana, Cheryl; Limb, Simon; Vilar, Francisco Javier; Clowes, Yvonne; Barrett, Sarah; Taylor, Stephen; Allan, Sris; Barnes, Justine; Fisher, Martin; Perry, Nicky; Pozniak, Anton L.; Boffito, Marta; Sadiq, Tariq; Adebiyi, Ade; Davis, Charles; Redfield, Robert R.; Kozal, Michael J.; Andrews, Laurie; Miller, Mark; Johnston, Barbara; Savage, Karen; Saag, Michael; Grossman, Howard A.; Cohen, Daniel E.; Overton, Edgar Turner; Snell, Mariea B.; Burman, William; Britt, Dale; Martorell, Claudia; Rivera, Jacqueline; Eron, Joseph J.; Menezes, Prema

    2011-01-01

    Nevirapine is widely prescribed for HIV-1 infection. We characterized relationships between nevirapine-associated cutaneous and hepatic adverse events and genetic variants among HIV-infected adults. We retrospectively identified cases and controls. Cases experienced symptomatic nevirapine-associated

  2. Nevirapine concentrations in HIV-infected children treated with divided fixed-dose combination antiretroviral tablets in Malawi and Zambia.

    NARCIS (Netherlands)

    Ellis, J.C.; L'homme, R.F.A.; Ewings, F.M.; Mulenga, V.; Bell, F.; Chileshe, R.; Molyneux, E.; Abernethy, J.; Oosterhout, J.J. van; Chintu, C.; Walker, A.S.; Gibb, D.M.; Burger, D.M.

    2007-01-01

    OBJECTIVE: To investigate nevirapine concentrations in African HIV-infected children receiving divided Triomune tablets (stavudine+lamivudine+nevirapine). DESIGN: Cross-sectional study. METHODS: Steady-state plasma nevirapine concentrations were determined in Malawian and Zambian children aged 8

  3. Oral lesions associated with Nevirapine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A report of 10 cases

    OpenAIRE

    BV Ramana Reddy; P Chandra Shekar; K Lalith Prakash Chandra; R S Aravind

    2013-01-01

    Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are closely related severe, acute mucocutaneous reactions usually caused by drugs. They are acute life-threatening conditions and cause widespread necrosis of the epithelium. There is persistence of a high risk of SJS or TEN in relation to human immunodeficiency virus (HIV) infection associated with exposure to nevirapine (NVP). In this article, we present nine cases of SJS and one case of TEN in HIV-seropositive individuals ...

  4. Pharmacological and clinical evidence of nevirapine immediate- and extended-release formulations

    Directory of Open Access Journals (Sweden)

    Ena J

    2012-11-01

    Full Text Available Javier Ena, Concepción Amador, Conxa Benito, Francisco PasquauHIV Unit, Hospital Marina Baixa, Villajoyosa, SpainAbstract: We reviewed the current information available on nevirapine immediate- and extended-release formulations and its role in single-dose and combination antiretroviral therapy. Nevirapine was approved in 1996 and was the first non-nucleoside reverse-transcriptase inhibitor available for the treatment of HIV-1 infection. Nevirapine has demonstrated good efficacy and a well-characterized safety profile. A major drawback is the low genetic barrier, allowing the emergence of resistance in the presence of single mutations in the reverse-transcriptase gene. This shortcoming is particularly relevant when nevirapine is administered in a single dose to prevent mother-to-child transmission of HIV-1 infection, compromising the efficacy of future non-nucleoside reverse transcriptase–inhibitor regimens. Studies published recently have probed the noninferiority of nevirapine compared to ritonavir-boosted atazanavir with both tenofovir disoproxil fumarate and emtricitabine in antiretroviral treatment–naïve patients. In 2011, a new formulation of nevirapine (nevirapine extended release that allowed once-daily dosing was approved by the Food and Drug Administration and by the European Medicines Agency. VERxVe, a study comparing nevirapine extended release with nevirapine immediate release in antiretroviral treatment–naïve patients, and TRANxITION, a study carried out in antiretroviral treatment–experienced patients who switched therapy from nevirapine immediate release to nevirapine extended release, provided data on the noninferiority of the new formulation of nevirapine compared with nevirapine immediate release in terms of efficacy and safety. Nevirapine extended release will further increase the durability and persistence of nevirapine-containing antiretroviral therapy, allowing once-daily dosing regimens.Keywords: nevirapine

  5. Disposition of amodiaquine and desethylamodiaquine in HIV-infected Nigerian subjects on nevirapine-containing antiretroviral therapy.

    Science.gov (United States)

    Scarsi, Kimberly K; Fehintola, Fatai A; Ma, Qing; Aweeka, Francesca T; Darin, Kristin M; Morse, Gene D; Akinola, Ibrahim Temitope; Adedeji, Waheed A; Lindegardh, Niklas; Tarning, Joel; Ojengbede, Oladosu; Adewole, Isaac F; Taiwo, Babafemi; Murphy, Robert L; Akinyinka, Olusegun O; Parikh, Sunil

    2014-05-01

    Artesunate plus amodiaquine is used for malaria treatment in regions with overlapping HIV endemicity. Co-administration of artesunate/amodiaquine with antiretroviral therapy (ART) may result in drug-drug interactions, but minimal data exist. This study evaluated the impact of nevirapine-based ART, containing a backbone of zidovudine and lamivudine, on the disposition of amodiaquine and its active metabolite, desethylamodiaquine (DEAQ). This was an open-label, parallel-group pharmacokinetic comparison between HIV-infected, adult subjects receiving steady-state nevirapine-based ART (n = 10) and ART-naive subjects (control group, n = 11). All subjects received a loose formulation of artesunate/amodiaquine (200/600 mg) daily for 3 days, with serial pharmacokinetic sampling over 96 h following the final dose of artesunate/amodiaquine. Amodiaquine and DEAQ were quantified using a validated HPLC method with UV detection. Pharmacokinetic parameters were determined using standard non-compartmental methods. Exposures to both amodiaquine and DEAQ were significantly lower in the nevirapine-based ART group compared with the control group (amodiaquine AUC₀₋₂₄ 145 versus 204 ng·h/mL, P = 0.02; DEAQ AUC₀₋₉₆ 14,571 versus 21,648 ng·h/mL, P ART group 116 versus control group 102, P = 0.67). Subjects on nevirapine-based ART had lower exposure to both amodiaquine and DEAQ (28.9% and 32.7%, respectively). Consequently, this may negatively impact the effectiveness of artesunate/amodiaquine in HIV-infected individuals on this ART combination.

  6. Steady-state nevirapine plasma concentrations are influenced by pregnancy.

    NARCIS (Netherlands)

    Nellen, J.F.; Damming, M.; Godfried, M.H.; Boer, K.; Ende, M.E. van der; Burger, D.M.; Wolf, F. de; Wit, F.W.; Prins, J.M.

    2008-01-01

    OBJECTIVES: Optimal plasma concentrations of antiretroviral drugs are required during pregnancy to treat maternal HIV infection and prevent mother-to-child transmission. We investigated the effect of pregnancy on nevirapine (NVP) plasma concentrations. METHODS: We included all HIV-1-infected women

  7. Sustained Adenosine Exposure Causes Lung Endothelial Barrier Dysfunction via Nucleoside Transporter–Mediated Signaling

    Science.gov (United States)

    Newton, Julie; Hsiao, Vivian; Shamirian, Paul; Blackburn, Michael R.; Pedroza, Mesias

    2012-01-01

    Previous studies by our group as well as others have shown that acute adenosine exposure enhances lung vascular endothelial barrier integrity and protects against increased permeability lung edema. In contrast, there is growing evidence that sustained adenosine exposure has detrimental effects on the lungs, including lung edema. It is well established that adenosine modulates lung inflammation. However, little is known concerning the effect of sustained adenosine exposure on lung endothelial cells (ECs), which are critical to the maintenance of the alveolar–capillary barrier. We show that exogenous adenosine plus adenosine deaminase inhibitor caused sustained elevation of adenosine in lung ECs. This sustained adenosine exposure decreased EC barrier function, elevated cellular reactive oxygen species levels, and activated p38, JNK, and RhoA. Inhibition of equilibrative nucleoside transporters (ENTs) prevented sustained adenosine-induced p38 and JNK activation and EC barrier dysfunction. Inhibition of p38, JNK, or RhoA also partially attenuated sustained adenosine-induced EC barrier dysfunction. These data indicate that sustained adenosine exposure causes lung EC barrier dysfunction via ENT-dependent intracellular adenosine uptake and subsequent activation of p38, JNK, and RhoA. The antioxidant N-acetylcysteine and the NADPH inhibitor partially blunted sustained adenosine-induced JNK activation but were ineffective in attenuation of p38 activation or barrier dysfunction. p38 was activated exclusively in mitochondria, whereas JNK was activated in mitochondria and cytoplasm by sustained adenosine exposure. Our data further suggest that sustained adenosine exposure may cause mitochondrial oxidative stress, leading to activation of p38, JNK, and RhoA in mitochondria and resulting in EC barrier dysfunction. PMID:22744860

  8. Oral lesions associated with nevirapine-related Stevens Johnson syndrome: A report of four cases.

    Science.gov (United States)

    Balasundaram, S; Ranganathan, K; Umadevi, K; Gunaseelan, R; Kumaraswamy, N; Solomon, Sunithi; Devaleenol, Bella; Ambrose, Pradeep

    2011-01-01

    Nevirapine is a non-nucleoside reverse transcriptase inhibitor, widely used in combination with other antiretroviral agents for treatment of HIV infection. Steven Johnson syndrome (SJS) is the major toxicity of nevirapine. We describe here four cases of SJS in HIV seropositive patients following nevirapine therapy. In all four cases cutaneous hypersensitivity reaction was seen with extreme oral lesions, three patients presented clinically with elevated liver enzymes and hepatitis, and two patients had ocular involvement.

  9. Spectroscopic and molecular docking studies on the interaction of antiviral drug nevirapine with calf thymus DNA.

    Science.gov (United States)

    Moghadam, Neda Hosseinpour; Salehzadeh, Sadegh; Shahabadi, Nahid

    2017-09-02

    The interaction of calf thymus DNA with nevirapine at physiological pH was studied by using absorption, circular dichroism, viscosity, differential pulse voltammetry, fluorescence techniques, salt effect studies and computational methods. The drug binds to ct-DNA in a groove binding mode, as shown by slight variation in the viscosity of ct-DNA. Furthermore, competitive fluorimetric studies with Hoechst 33258 indicate that nevirapine binds to DNA via groove binding. Moreover, the structure of nevirapine was optimized by DFT calculations and was used for the molecular docking calculations. The molecular docking results suggested that nevirapine prefers to bind on the minor groove of ct-DNA.

  10. Investigating the continuous synthesis of a nicotinonitrile precursor to nevirapine

    Directory of Open Access Journals (Sweden)

    Ashley R. Longstreet

    2013-11-01

    Full Text Available 2-Chloro-3-amino-4-picoline (CAPIC is a strategic building block for the preparation of nevirapine, a widely-prescribed non-nucleosidic reverse transcriptase inhibitor for the treatment of HIV-infected patients. A continuous synthesis to the bromo derivative of a CAPIC intermediate, 2-bromo-4-methylnicotinonitrile, that terminates in a dead-end crystallization is described. The route uses inexpensive, acyclic commodity-based raw materials and has the potential to enable lower cost production of nevirapine as well as other value added structures that contain complex pyridines. The route terminates in a batch crystallization yielding high purity CAPIC. This outcome is expected to facilitate regulatory implementation of the overall process.

  11. Oral lesions associated with Nevirapine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A report of 10 cases.

    Science.gov (United States)

    Reddy, Ramana Bv; Shekar, P Chandra; Chandra, K Lalith Prakash; Aravind, Rs

    2013-09-01

    Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are closely related severe, acute mucocutaneous reactions usually caused by drugs. They are acute life-threatening conditions and cause widespread necrosis of the epithelium. There is persistence of a high risk of SJS or TEN in relation to human immunodeficiency virus (HIV) infection associated with exposure to nevirapine (NVP). In this article, we present nine cases of SJS and one case of TEN in HIV-seropositive individuals who developed cutaneous, oral, ocular and genital lesions while being treated with NVP.

  12. Harmonizing exposure metrics and methods for sustainability assessments of food contact materials

    DEFF Research Database (Denmark)

    Ernstoff, Alexi; Jolliet, Olivier; Niero, Monia

    2016-01-01

    We aim to develop harmonized and operational methods for quantifying exposure to chemicals in food packaging specifically for sustainability assessments. Thousands of chemicals are approved for food packaging and numerous contaminates occur, e.g. through recycling. Chemical migration into food......, like LCA, finally facilitates including exposure to chemicals as a sustainable packaging design issue. Results were demonstrated in context of the pilot-scale Product Environmental Footprint regulatory method in the European Union. Increasing recycled content, decreasing greenhouse gas emissions...... by selecting plastics over glass, and adding chemicals with a design function were identified as risk management issues. We conclude developing an exposure framework, suitable for sustainability assessments commonly used for food packaging, is feasible to help guide packaging design to consider both...

  13. Pharmacokinetics of nevirapine: once-daily versus twice-daily dosing in the 2NN study

    NARCIS (Netherlands)

    Kappelhoff, Bregt S.; Huitema, Alwin D. R.; van Leth, Frank; Robinson, Patrick A.; MacGregor, Thomas R.; Lange, Joep M. A.; Beijnen, Jos H.

    2005-01-01

    OBJECTIVE: As part of the large international, randomized 2NN trial, the pharmacokinetics of nevirapine in once-daily 400 mg and twice-daily 200 mg dosing regimens were investigated. METHOD: Treatment-naive HIV-1-infected patients were randomized to receive nevirapine 400 mg once daily or 200 mg

  14. HLA-Cw*04 allele associated with nevirapine-induced rash in HIV-infected Thai patients

    Directory of Open Access Journals (Sweden)

    Tunthanathip Preecha

    2009-10-01

    Full Text Available Abstract Background A high incidence of rash has been reported in HIV-1 patients who received the anti-retroviral drug nevirapine. In addition, several studies have suggested that polymorphisms of human leukocyte antigen (HLA genes may play important roles in nevirapine-induced rash. The aim of the present study was to evaluate the effects of different HLA-C alleles on rash associated with nevirapine in patients who started highly active anti-retroviral therapy (HAART containing nevirapine in Thailand. Results A case-control study was carried out involving HIV-1 patients under treatment at Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand between March 2007 and March 2008. The study included all HIV/AIDS patients being treated with nevirapine-containing regimens. The study population comprised 287 HIV/AIDS patients of whom 248 were nevirapine-tolerant and 39 developed rash after nevirapine treatment. From the nevirapine-tolerant patients, 60 were selected as the control group on the basis of age, sex, and therapy history matched for nevirapine-induced rash cases. We observed significantly more HLA-Cw*04 alleles in nevirapine-induced rash cases than in nevirapine-tolerant group, with frequencies of 20.51% and 7.50%, respectively (P = 0.009. There were no significant differences between the rash and tolerant groups for other HLA-C alleles except for HLA-Cw*03 (P = 0.015. Conclusion This study suggests that HLA-Cw*04 is associated with rash in nevirapine treated Thais. Future screening of patients' HLA may reduce the number of nevirapine-induced rash cases, and patients with alleles associated with nevirapine-induced rash should be started on anti-retroviral therapy without nevirapine.

  15. Steady state bioequivalence of generic and innovator formulations of stavudine, lamivudine, and nevirapine in HIV-infected Ugandan adults.

    Directory of Open Access Journals (Sweden)

    Jayne Byakika-Tusiime

    Full Text Available Generic antiretroviral therapy is the mainstay of HIV treatment in resource-limited settings, yet there is little evidence confirming the bioequivalence of generic and brand name formulations. We compared the steady-state pharmacokinetics of lamivudine, stavudine and nevirapine in HIV-infected subjects who were receiving a generic formulation (Triomune or the corresponding brand formulations (Epivir, Zerit, and Viramune.An open-label, randomized, crossover study was carried out in 18 HIV-infected Ugandan subjects stabilized on Triomune-40. Subjects received lamivudine (150 mg, stavudine (40 mg, and nevirapine (200 mg in either the generic or brand formulation twice a day for 30 days, before switching to the other formulation. At the end of each treatment period, blood samples were collected over 12 h for pharmacokinetic analysis. The main outcome measures were the mean AUC(0-12h and C(max. Bioequivalence was defined as a geometric mean ratio between the generic and brand name within the 90% confidence interval of 0.8-1.25. The geometric mean ratios and the 90% confidence intervals were: stavudine C(max, 1.3 (0.99-1.71 and AUC(0-12h, 1.1 (0.87-1.38; lamivudine C(max, 0.8 (0.63-0.98 and AUC(0-12h, 0.8 (0.65-0.99; and nevirapine C(max, 1.1 (0.95-1.23 and AUC(0-12h, 1.1 (0.95-1.31. The generic formulation was not statistically bioequivalent to the brand formulations during steady state, although exposures were comparable. A mixed random effects model identified about 50% intersubject variability in the pharmacokinetic parameters.These findings provide support for the use of Triomune in resource-limited settings, although identification of the sources of intersubject variability in these populations is critical.

  16. Voluntary counselling and testing (VCT) uptake, nevirapine use and infant feeding options at the University of Nigeria Teaching Hospital.

    Science.gov (United States)

    Onah, H E; Ibeziako, N; Nkwo, P O; Obi, S N; Nwankwo, T O

    2008-04-01

    This study assessed voluntary counselling and testing (VCT) uptake, nevirapine use and infant feeding options among the pregnant women seen in a tertiary care centre in Enugu, South-east Nigeria, with the aim of identifying gaps (if any) in the prevention of mother-to-child transmission (PMTCT) implementation in the hospital. It was a prospective study of all antenatal clinic attendees and those who delivered at the University of Nigeria Teaching Hospital, Enugu, within a 7-month period (1 March to 30 September 2005). During the 7-month period, 635 pregnant women accessed the PMTCT services in the hospital. With respect to VCT, 25 (3.9%) of the antenatal clinic attendees had only group counselling, while 610 (96.1%) others had both group and individual pre-test counselling. A total of 87 (13.7%) of the 635 women tested were HIV positive. Some 426 (67.1%) women had post-test counselling carried out. Twenty (23.0%) of the 87 HIV-positive women had their infection diagnosed prior to the current pregnancy, while 67 (77.0%) had the disease diagnosed during the index pregnancy. Eight (9.2%) of them had previously had anti-retroviral therapy with nevirapine. Twelve (13.8%) of the women were on antiretroviral therapy in the index pregnancy - two on highly active antiretroviral therapy (HAART) and 10 on nevirapine. A total of 41 (47.1%) of the 87 HIV-positive women had delivered as at 30 September 2005. Ten of them had antiretrovirals administered to them during the antenatal period. The remaining 31 had antiretrovirals administered to them on arrival at the labour ward for delivery. Of the 41 women who delivered, 39 had intra-partum nevirapine, while the 2 women on HAART took their usual daily dosage. Regarding mode of delivery, one-third of the women had a caesarean section and two-thirds had vaginal delivery. Ten (24.4%) of the 41 women had episiotomy, while seven of the remaining 31 women who did not receive episiotomy sustained varying degrees of perineal tear. There

  17. Maternal deaths following nevirapine-based antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    E Bera

    2012-11-01

    Full Text Available We report 2 cases illustrating that it is too simplistic to link nevirapine (NVP toxicity exclusively to individuals with immune preservation. Not enough is known about the mechanism of hepatotoxicity or cutaneous eruption to predict these events. This type of hypersensitivity reaction occurs rarely among HIV-exposed infants taking NVP prophylaxis or antiretroviral therapy (ART-experienced adults with complete plasma viral load suppression. Conversely, HIV-uninfected adults and ART-naive pregnant women appear to be disproportionately affected by the adverse effects of NVP.

  18. Good performance of an immunoassay based method for nevirapine measurements in human breast milk.

    Science.gov (United States)

    Salado-Rasmussen, Kirsten; Theilgaard, Zahra Persson; Chiduo, Mercy; Pedersen, Court; Gerstoft, Jan; Katzenstein, Terese Lea

    2011-07-01

    Understanding the distribution of antiretro-virals in breastfeeding HIV-positive mothers is essential, both for prevention of mother-to-child HIV transmission and for research on the development of drug resistance. The ARK nevirapine (NVP)-test is an immunoassay method for nevirapine measurements, developed and validated for plasma use. In this study, the ARK NVP-test was evaluated for measurement of nevirapine concentrations in breast milk. High performance liquid chromatography (HPLC) is the method currently used to determine nevirapine in breast milk. This method, however, requires complicated extraction techniques. The ARK method employs an immunoassay technology and requires a small sample volume (40 μL) and no pre-treatment of the samples. Commercial enzyme and antibody were used and calibration standards and quality controls were prepared from pooled breast milk from HIV-uninfected women. Clinical samples from HIV-infected women receiving a single-dose of nevirapine were analyzed. Precision and accuracy were evaluated with two concentrations of quality control materials analyzed in three replicates on four different days and was milk 1 week post-partum was 0.29 μg/mL (range 0.11-0.90 μg/mL) in women treated with a single-dose of nevirapine. The ease of use and small sample volume makes the ARK assay an attractive alternative to HPLC analyses for determinations of nevirapine concentrations in breast milk.

  19. Sustainable exposure prevention through innovative detection and remediation technologies from the NIEHS Superfund Research Program.

    Science.gov (United States)

    Henry, Heather F; Suk, William A

    2017-03-01

    Innovative devices and tools for exposure assessment and remediation play an integral role in preventing exposure to hazardous substances. New solutions for detecting and remediating organic, inorganic, and mixtures of contaminants can improve public health as a means of primary prevention. Using a public health prevention model, detection and remediation technologies contribute to primary prevention as tools to identify areas of high risk (e.g. contamination hotspots), to recognize hazards (bioassay tests), and to prevent exposure through contaminant cleanups. Primary prevention success is ultimately governed by the widespread acceptance of the prevention tool. And, in like fashion, detection and remediation technologies must convey technical and sustainability advantages to be adopted for use. Hence, sustainability - economic, environmental, and societal - drives innovation in detection and remediation technology. The National Institute of Health (NIH) National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) is mandated to advance innovative detection, remediation, and toxicity screening technology development through grants to universities and small businesses. SRP recognizes the importance of fast, accurate, robust, and advanced detection technologies that allow for portable real-time, on-site characterization, monitoring, and assessment of contaminant concentration and/or toxicity. Advances in non-targeted screening, biological-based assays, passive sampling devices (PSDs), sophisticated modeling approaches, and precision-based analytical tools are making it easier to quickly identify hazardous "hotspots" and, therefore, prevent exposures. Innovation in sustainable remediation uses a variety of approaches: in situ remediation; harnessing the natural catalytic properties of biological processes (such as bioremediation and phytotechnologies); and application of novel materials science (such as nanotechnology, advanced

  20. Exposure to chemicals in food packaging as a sustainability trade-off in LCA

    DEFF Research Database (Denmark)

    Ernstoff, Alexi; Muncke, Jane; Trier, Xenia

    2016-01-01

    packaging in a life cycle impact assessment (LCIA) framework. To put exposure during use in a life cycle context we perform a screening-level LCA of several life cycle stages of high impact polystyrene packaging (HIPS), with a functional unit of containing and delivering one kilogram of yogurt......Hazardous chemicals in packaging, including ‘eco-friendly’ and recycled food packaging, can migrate into food and expose humans. LCA has been fundamental to indicate more ‘eco-friendly’ packages, but currently LCA does not consider exposure to chemical migrants and methods have not yet been...... developed. In this study we question if exposure to chemicals in food packaging should be considered as a sustainable design consideration, i.e. if this human health risk is relevant in a life cycle context. To answer this question, we focus on developing methods to quantify exposure to chemicals in food...

  1. Risk factors for treatment-limiting toxicities in patients starting nevirapine-containing antiretroviral therapy

    NARCIS (Netherlands)

    Kesselring, Anouk M.; Wit, Ferdinand W.; Sabin, Caroline A.; Lundgren, Jens D.; Gill, M. John; Gatell, Jose M.; Rauch, Andri; Montaner, Julio S.; de Wolf, Frank; Reiss, Peter; Mocroft, Amanda; Bronsveld, W.; Hillebrand-Haverkort, M. E.; Prins, J. M.; Bos, J. C.; Eeftinck Schattenkerk, J. K. M.; Geerlings, S. E.; Godfried, M. H.; Lange, J. M. A.; van Leth, F. C.; Lowe, S. H.; van der Meer, J. T. M.; Nellen, F. J. B.; Pogány, K.; van der Poll, T.; Ruys, T. A.; Sankatsing, Raaj R.; Steingrover, R.; vanTwillert, G.; van der Valk, M.; van Vonderen, M. G. A.; Vrouenraets, S. M. E.; van Vugt, M.; van Eeden, A.; ten Veen, J. H.; van Dam, P. S.; Roos, J. C.; Brinkman, K.; Frissen, P. H. J.; Weigel, H. M.; Mulder, J. W.; van Gorp, E. C. M.; Meenhorst, P. L.; Mairuhu, A. T. A.; Veenstra, J.; Danner, S. A.; van Agtmael, M. A.; Claessen, F. A. P.; Perenboom, R. M.; Rijkeboer, A.; van Vonderen, M.; Richter, C.; van der Berg, J.; van Leusen, R.; Vriesendorp, R.; Jeurissen, F. J. F.; Kauffman, R. H.; Koger, E. L. W.; HAGA, A. N.; Bravenboer, B.; ten Napel, C. H. H.; Kootstra, G. J.; Sprenger, H. G.; Miesen, W. M. A. J.; Doedens, R.; Scholvinck, E. H.; ten Kate, R. W.; van Houte, D. P. F.; Polee, M.; Kroon, F. P.; van den Broek, A. N.; van Dissel, J. T.; Schippers, E. F.; Schreij, G.; van de Geest, S.; Verbon, A.; Koopmans, P. P.; Keuter, M.; Post, F.; van der Ven, A. J. A. M.; van der Ende, M. E.; Gyssens, I. C.; van der Feltz, M.; den Hollander, J. G.; de Marie, S.; Nouwen, J. L.; Rijnders, B. J. A.; de Vries, T. E. M. S.; Juttmann, J. R.; van de Heul, C.; van Kasteren, M. E. E.; Schneider, M. M. E.; Bonten, M. J. M.; Borleffs, J. C. C.; Ellerbroek, P. M.; Hoepelman, I. M.; Jaspers, C. A. J. J.; Schouten, I.; Schurink, C. A. M.; Blok, W. L.; Tanis, A. A.; Groeneveld, P. H. P.; Alexander, Chris; Barrios, Rolando; Braitstein, Paula; Brumme, Zabrina; Chan, Keith; Cote, Helen; Gataric, Nada; Geller, Josie; Guillemi, Silvia; Richard Harrigan, P.; Harris, Marrianne; Hogg, Robert; Joy, Ruth; Levy, Adrian; Montaner, Julio; Montessori, Val; Palepu, Anita; Phillips, Elizabeth; Phillips, Peter; Press, Natasha; Tyndall, Mark; Wood, Evan; Yip, Benita; Losso, M.; Elias, C.; Vetter, N.; Zangerle, R.; Karpov, I.; Vassilenko, A.; Mitsura, V. M.; Suetnov, O.; de Wit, S.; Delforge, M.; Clumeck, N.; Colebunders, R.; Vandekerckhove, L.; Hadziosmanovic, V.; Kostov, K.; Begovac, J.; Machala, L.; Rozsypal, H.; Sedlacek, D.; Nielsen, J.; Kronborg, G.; Benfield, T.; Larsen, M.; Gerstoft, J.; Katzenstein, T.; Hansen, A.-B. E.; Pedersen, C.; Oestergaard, L.; Zilmer, K.; Ristola, M.; Katlama, C.; Girard, J.-P.; Livrozet, J. M.; Vanhems, P.; Pradier, C.; Dabis, F.; Neau, D.; Rockstroh, J.; Schmidt, R.; van Lunzen, J.; Degen, O.; Stellbrink, H. J.; Staszewski, S.; Bogner, J.; Fätkenheuer, G.; Kosmidis, J.; Gargalianos, P.; Xylomenos, G.; Perdios, J.; Panos, G.; Filandras, A.; Karabatsaki, E.; Sambatakou, H.; Banhegyi, D.; Mulcahy, F.; Yust, I.; Turner, D.; Burke, M.; Pollack, S.; Hassoun, G.; Maayan, S.; Chiesi, A.; Esposito, R.; Mazeu, I.; Mussini, C.; Arici, C.; Pristera, R.; Mazzotta, F.; Gabbuti, A.; Vullo, V.; Lichtner, M.; Chirianni, A.; Montesarchio, E.; Gargiulo, M.; Antonucci, G.; Iacomi, F.; Narciso, P.; Vlassi, C.; Zaccarelli, M.; Lazzarin, A.; Finazzi, R.; Galli, M.; Ridolfo, A.; d'Arminio Monforte, A.; Rozentale, B.; Aldins, P.; Chaplinskas, S.; Hemmer, R.; Staub, T.; Bruun, J.; Maeland, A.; Ormaasen, V.; Knysz, B.; Horban, A.; Bakowska, E.; Prokopowicz, D.; Flisiak, R.; Boron-Kaczmarska, A.; Pynka, M.; Beniowski, M.; Mularska, E.; Trocha, H.; Jablonowska, E.; Malolepsza, E.; Wojcik, K.; Antunes, F.; Valadas, E.; Mansinho, K.; Maltez, F.; Duiculescu, D.; Babes, Victor; Rakhmanova, A.; Vinogradova, A.; Buzunova, S.; Jevtovic, D.; Mokrás, M.; Staneková, D.; Tomazic, J.; González-Lahoz, J.; Soriano, V.; Martin-Carbonero, L.; Labarga, P.; Moreno, S.; Clotet, B.; Jou, A.; Paredes, R.; Tural, C.; Puig, J.; Bravo, I.; Gatell, J. M.; Miró, J. M.; Domingo, P.; Gutierrez, M.; Mateo, G.; Sambeat, M. A.; Karlsson, A.; Persson, P. O.; Flamholc, L.; Ledergerber, B.; Weber, R.; Francioli, P.; Cavassini, M.; Hirschel, B.; Boffi, E.; Furrer, H.; Battegay, M.; Elzi, L.; Kravchenko, E.; Chentsova, N.; Kutsyna, G.; Servitskiy, S.; Antoniak, S.; Krasnov, M.; Barton, S.; Johnson, A. M.; Mercey, D.; Phillips, A.; Johnson, M. A.; Murphy, M.; Weber, J.; Scullard, G.; Fisher, M.; Leen, C.; Gatell, J.; Gazzard, B.; D'Arminio Montforte, A.; Lundgren, J.; Kirk, O.; Mocroft, A.; Friis-Møller, N.; Cozzi-Lepri, A.; Bannister, W.; Ellefson, M.; Borch, A.; Podlekareva, D.; Kjaer, J.; Peters, L.; Reekie, J.; Kowalska, J.; Perez, Iñaki; Gatell, Jose; Gill, John; Read, Ron; Krentz, Hartmut; Beckthold, Brenda; Bernasconi, E.; Böni, J.; Bucher, H. C.; Bürgisser, Ph; Calmy, A.; Cattacin, S.; Dubs, R.; Egger, M.; Erb, P.; Fischer, M.; Flepp, M.; Fontana, A.; Fux, C.; Gorgievski, M.; Günthard, H.; Hirsch, H.; Hösli, I.; Kahlert, Ch; Kaiser, L.; Karrer, U.; Kind, C.; Klimkait, Th; Martinetti, G.; Martinez, B.; Müller, N.; Nadal, D.; Opravil, M.; Paccaud, F.; Pantaleo, G.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schultze, D.; Schüpbach, J.; Speck, R.; Taffé, P.; Tarr, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Yerly, S.; Phillips, Andrew N.; Gilson, Richard; Easterbrook, Philippa; Fisher, Martin; Gazzard, Brian; Johnson, Margaret; Walsh, John; Leen, Clifford; Orkin, Chloe; Anderson, Jane; Pillay, Deenan; Delpech, Valerie; Schwenk, Achim; Dunn, David; Gompels, Mark; Hill, Teresa; Porter, Kholoud; Babiker, Abdel; Sabin, Caroline; Bansi, Loveleen; Phillips, Andrews; Sheehan, Stephen; Waters, Anele; Crates, Dorian; Mohamed-Saad, Siti; Perry, Nick; Pullin, Anthony; Churchill, Duncan; Harris, Wendy; Bulbeck, Steve; Mandalia, Sundhiya; Clarke, Jemima; Dodds, Julie; Rider, Andy; Williams, Ian; Youle, Mike; Lampe, Fiona; Smith, Colette; Gumley, Helen; Chaloner, Clinton; Puradiredja, Dewi Ismajani; Weber, Jonathan; Cashin, Shane; Kemble, Christian; Mackie, Nicky; Winston, Alan; Thomas, Rachel; Jones, Kevin; Gann, Selina; Wilson, Alan; Ainsworth, Jonathan

    2009-01-01

    BACKGROUND: This collaboration of seven observational clinical cohorts investigated risk factors for treatment-limiting toxicities in both antiretroviral-naive and experienced patients starting nevirapine-based combination antiretroviral therapy (NVPc). METHODS: Patients starting NVPc after 1

  2. Good performance of an immunoassay based method for nevirapine measurements in human breast milk

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Persson Theilgaard, Zahra; Chiduo, Mercy

    2011-01-01

    , developed and validated for plasma use. In this study, the ARK NVP-test was evaluated for measurement of nevirapine concentrations in breast milk. High performance liquid chromatography (HPLC) is the method currently used to determine nevirapine in breast milk. This method, however, requires complicated......Understanding the distribution of antiretro-virals in breastfeeding HIV-positive mothers is essential, both for prevention of mother-to-child HIV transmission and for research on the development of drug resistance. The ARK nevirapine (NVP)-test is an immunoassay method for nevirapine measurements...... extraction techniques. The ARK method employs an immunoassay technology and requires a small sample volume (40 µL) and no pre-treatment of the samples....

  3. 2'-Deoxythymidine Adducts from the Anti-HIV Drug Nevirapine

    Directory of Open Access Journals (Sweden)

    M. Matilde Marques

    2013-04-01

    Full Text Available Nevirapine (NVP is a non-nucleoside reverse transcriptase inhibitor (NNRTI used against HIV-1. Currently, NVP is the most widely used anti-HIV drug in developing countries, both in combination therapy and to prevent mother-to-child transmission of HIV. Despite its efficacy against HIV, NVP produces a variety of toxic responses, including hepatotoxicity and skin rash. It is also associated with increased incidences of hepatoneoplasias in rodents. In addition, epidemiological data suggest that NNRTI use is a risk factor for non-AIDS-defining cancers in HIV-positive patients. Current evidence supports the involvement of metabolic activation to reactive electrophiles in NVP toxicity. NVP metabolism includes oxidation to 12-hydroxy-NVP; subsequent Phase II sulfonation produces an electrophilic metabolite, 12-sulfoxy-NVP, capable of reacting with DNA to yield covalent adducts. Since 2’-deoxythymidine (dT adducts from several alkylating agents are regarded as having significant mutagenic/carcinogenic potential, we investigated the formation of NVP-dT adducts under biomimetic conditions. Toward this goal, we initially prepared and characterized synthetic NVP-dT adduct standards using a palladium-mediated Buchwald-Hartwig coupling strategy. The synthetic standards enabled the identification, by LC-ESI-MS, of 12-(2'-deoxythymidin-N3-yl-nevirapine (N3-NVP-dT in the enzymatic hydrolysate of salmon testis DNA reacted with 12-mesyloxy-NVP, a synthetic surrogate for 12-sulfoxy-NVP. N3-NVP-dT, a potentially cytotoxic and mutagenic DNA lesion, was also the only dT-specific adduct detected upon reaction of dT with 12-mesyloxy-NVP. Our data suggest that N3-NVP-dT may be formed in vivo and play a role in the hepatotoxicity and/or putative hepatocarcinogenicity of NVP.

  4. The impact of a Wastewater Treatment Works in Southern Gauteng, South Africa on efavirenz and nevirapine discharges into the aquatic environment

    Directory of Open Access Journals (Sweden)

    C. Schoeman

    2017-06-01

    Although an order of magnitude lower nevirapine concentrations displayed the opposite behaviour and gradually increased through the various stages of purification in the WWTP. Minor fluctuations occurred but the concentrations of nevirapine were higher at the effluent (between 92 and 473 ng/L than those entering the WWTP. No nevirapine was detected in the PST sludge. The increase in nevirapine concentrations are likely to be the result of the de-conjugation of the hydroxylated metabolites of nevirapine in the WWTP, its resistance to degradation and the lack of binding of the nevirapine to the PST sludge.

  5. Pooled individual data analysis of 5 randomized trials of infant nevirapine prophylaxis to prevent breast-milk HIV-1 transmission.

    Science.gov (United States)

    Hudgens, Michael G; Taha, Taha E; Omer, Saad B; Jamieson, Denise J; Lee, Hana; Mofenson, Lynne M; Chasela, Charles; Kourtis, Athena P; Kumwenda, Newton; Ruff, Andrea; Bedri, Abubaker; Jackson, J Brooks; Musoke, Philippa; Bollinger, Robert C; Gupte, Nikhil; Thigpen, Michael C; Taylor, Allan; van der Horst, Charles

    2013-01-01

    In resource-limited settings, mothers infected with human immunodeficiency virus type 1 (HIV-1) face a difficult choice: breastfeed their infants but risk transmitting HIV-1 or not breastfeed their infants and risk the infants dying of other infectious diseases or malnutrition. Recent results from observational studies and randomized clinical trials indicate daily administration of nevirapine to the infant can prevent breast-milk HIV-1 transmission. Data from 5396 mother-infant pairs who participated in 5 randomized trials where the infant was HIV-1 negative at birth were pooled to estimate the efficacy of infant nevirapine prophylaxis to prevent breast-milk HIV-1 transmission. Four daily regimens were compared: nevirapine for 6 weeks, 14 weeks, or 28 weeks, or nevirapine plus zidovudine for 14 weeks. The estimated 28-week risk of HIV-1 transmission was 5.8% (95% confidence interval [CI], 4.3%-7.9%) for the 6-week nevirapine regimen, 3.7% (95% CI, 2.5%-5.4%) for the 14-week nevirapine regimen, 4.8% (95% CI, 3.5%-6.7%) for the 14-week nevirapine plus zidovudine regimen, and 1.8% (95% CI, 1.0%-3.1%) for the 28-week nevirapine regimen (log-rank test for trend, P < .001). Cox regression models with nevirapine as a time-varying covariate, stratified by trial site and adjusted for maternal CD4 cell count and infant birth weight, indicated that nevirapine reduces the rate of HIV-1 infection by 71% (95% CI, 58%-80%; P < .001) and reduces the rate of HIV infection or death by 58% (95% CI, 45%-69%; P < .001). Extended prophylaxis with nevirapine or with nevirapine and zidovudine significantly reduces postnatal HIV-1 infection. Longer duration of prophylaxis results in a greater reduction in the risk of infection.

  6. Pregnancy rates in HIV-positive women using contraceptives and efavirenz-based or nevirapine-based antiretroviral therapy in Kenya: a retrospective cohort study.

    Science.gov (United States)

    Patel, Rena C; Onono, Maricianah; Gandhi, Monica; Blat, Cinthia; Hagey, Jill; Shade, Starley B; Vittinghoff, Eric; Bukusi, Elizabeth A; Newmann, Sara J; Cohen, Craig R

    2015-11-01

    Concerns have been raised about efavirenz reducing the effectiveness of contraceptive implants. We aimed to establish whether pregnancy rates differ between HIV-positive women who use various contraceptive methods and either efavirenz-based or nevirapine-based antiretroviral therapy (ART) regimens. We did this retrospective cohort study of HIV-positive women aged 15-45 years enrolled in 19 HIV care facilities supported by Family AIDS Care and Education Services in western Kenya between Jan 1, 2011, and Dec 31, 2013. Our primary outcome was incident pregnancy diagnosed clinically. The primary exposure was a combination of contraceptive method and efavirenz-based or nevirapine-based ART regimen. We used Poisson models, adjusting for repeated measures, and demographic, behavioural, and clinical factors, to compare pregnancy rates among women receiving different contraceptive and ART combinations. 24,560 women contributed 37,635 years of follow-up with 3337 incident pregnancies. In women using implants, adjusted pregnancy incidence was 1.1 per 100 person-years (95% CI 0.72-1.5) for nevirapine-based ART users and 3.3 per 100 person-years (1.8-4.8) for efavirenz-based ART users (adjusted incidence rate ratio [IRR] 3.0, 95% CI 1.3-4.6). In women using depot medroxyprogesterone acetate, adjusted pregnancy incidence was 4.5 per 100 person-years (95% CI 3.7-5.2) for nevirapine-based ART users and 5.4 per 100 person-years (4.0-6.8) for efavirenz-based ART users (adjusted IRR 1.2, 95% CI 0.91-1.5). Women using other contraceptive methods, except for intrauterine devices and permanent methods, had 3.1-4.1 higher rates of pregnancy than did those using implants, with 1.6-2.8 higher rates in women using efavirenz-based ART. Although HIV-positive women using implants and efavirenz-based ART had a three-times higher risk of contraceptive failure than did those using nevirapine-based ART, these women still had lower contraceptive failure rates than did those receiving all other

  7. Nevirapine-Based Antiretroviral Therapy Impacts Artesunate and Dihydroartemisinin Disposition in HIV-Infected Nigerian Adults

    Directory of Open Access Journals (Sweden)

    Fatai A. Fehintola

    2012-01-01

    Full Text Available Background. Nevirapine- (NVP- based antiretroviral therapy (ART and artesunate-amodiaquine are frequently coprescribed in areas of HIV and malaria endemicity. We explored the impact of this practice on artesunate and dihydroartemisinin pharmacokinetics. Methods. We conducted a parallel-group pharmacokinetic comparison between HIV-infected patients receiving NVP-based ART (n=10 and ART-naive controls (n=11. Artesunate-amodiaquine 200/600 mg was given daily for three days. Measurement of drug concentrations occurred between 0 and 96 hours after the final dose. Pharmacokinetic parameters were determined using noncompartmental analysis. Results. Comparing the NVP group to controls, clearance of artesunate was reduced 50% (1950 versus 2995 L/h; P=0.03, resulting in a 45% increase in the AUC0-96 (105 versus 69 ug∗hr/L; P=0.02. The half-life of dihydroartemisinin was shorter in the NVP group (1.6 versuss 3.2 h; P=0.004, but other dihydroartemisinin pharmacokinetic parameters were unchanged. A lower conversion of artesunate to dihydroartemisinin was observed in the NVP group (dihydroartemisinin: artesunate AUC0-96=5.6 versuss 8.5 in NVP and control groups, respectively, P=0.008. Conclusion. Although NVP-containing ART impacted some pharmacokinetic parameters of artesunate and dihydroartemisinin, overall exposure was similar or better in the NVP group.

  8. Reproductive system behavior following exposure of sustained delivery of npy antagonist in ovariectomized (ovx) rats.

    Science.gov (United States)

    Cason, Zelma; Wilson, Gerri; Golanov, Olga; Tucci, Michelle; McGuire, Robert; Benghuzzi, Hamed

    2012-01-01

    Several investigations have documented that sustained delivery of estrogen can modulate or sustain normal female reproductive functions. However, the literature is lacking scientific evidence regarding the mechanism of estrogen and neuropeptide Y antagonist (NPY) effect on the hypothalamic-pituitary-gonadal axis. The objective of this study was to explore the role of sustained delivery of estrogen and its effects on reproductive unction compared to an antagonist such as NPY. A total of twenty adult female rats (OVX, n=15; intact control, n=5) were divided into five groups (intact control, OVX, sham, OVX + estrogen, and OVX + NPY). Animals in two groups were surgically implanted with a TCP delivery device loaded with estrogen or NPY. Vaginal smears and body weights (BW) were evaluated at baseline and at two weeks post implantation. At the end of two weeks, all animals were euthanized and vital and reproductive organs were retrieved for histopathological evaluation. The results revealed differences in BW between intact control and OVX animals. Furthermore, there was statistical difference (P<0.05) in BW between OVX and OVX + NPY animals. Vaginal smear evaluation revealed that estrogen exposure induced estrus cyclic activities as compared to OVX and sham animals. The animals exposed to sustained delivery of NPY triggered moderate cyclic activities compared to intact control animals. There were no significant differences (P<0.5) in vital organ wet weights among and between animals in all groups. Overall this study proved the capability of TCP to release estrogen and NPY at sustained levels, which resulted inpathophysiological changes in female reproductive organs.

  9. Effect of diurnal variation, CYP2B6 genotype and age on the pharmacokinetics of nevirapine in African children

    NARCIS (Netherlands)

    Bienczak, A.; Cook, A.; Wiesner, L.; Mulenga, V.; Kityo, C.; Kekitiinwa, A.; Walker, A.S.; Owen, A.; Gibb, D.M.; Burger, D.M.; McIlleron, H.; Denti, P.

    2017-01-01

    OBJECTIVES: To characterize the effects of CYP2B6 polymorphisms, diurnal variation and demographic factors on nevirapine pharmacokinetics in African children. METHODS: Non-linear mixed-effects modelling conducted in NONMEM 7.3 described nevirapine plasma concentration-time data from 414 children

  10. Pharmacokinetics of nevirapine in HIV-infected children under 3 years on rifampicin-based antituberculosis treatment.

    NARCIS (Netherlands)

    Oudijk, J.M.; McIlleron, H.; Mulenga, V.; Chintu, C.; Merry, C.; Walker, A.S.; Cook, A.; Gibb, D.M.; Burger, D.M.

    2012-01-01

    OBJECTIVE:: There is an urgent need to optimize cotreatment for children with tuberculosis and HIV infection. We described nevirapine pharmacokinetics in Zambian children aged less than 3 years, cotreated with nevirapine, lamivudine and stavudine in fixed-dose combination (using WHO weight bands)

  11. Sub-therapeutic nevirapine concentration during antiretroviral treatment initiation among children living with HIV: Implications for therapeutic drug monitoring.

    Directory of Open Access Journals (Sweden)

    Bindu Parachalil Gopalan

    Full Text Available Nevirapine, a component of antiretroviral therapy (ART in resource-limited settings, known for auto-induction of metabolism, is initiated at half therapeutic dose until day 14 ('lead-in period', and subsequently escalated to full dose. However, studies have shown that this dosing strategy based on adult studies may not be appropriate in children, given that younger children have higher drug clearance rates. In this prospective cohort study, we studied trough plasma nevirapine levels by high performance liquid chromatography (HPLC at days 7, 14 (lead-in period and 28 (full dose period after ART initiation amongst HIV-1 infected children initiating nevirapine-based ART in southern India. Among the 20 children (50% male, median age 9 years included in the study, sub-therapeutic trough plasma nevirapine concentration (<4μg/ml was seen in 65% (13/20 of children during the lead-in period within two weeks of ART initiation and among 10% of children at 4 weeks during full-dose nevirapine. Adherence was documented as ≥95% in all children by both caregiver self-report and pill count. Median nevirapine concentrations achieved at week 1 was 4.8 μg/ml, significantly lower than 8 μg/ml, the concentration achieved at week 4 (p = 0.034. Virological failure at one year of ART was observed in six children, and was not associated with median nevirapine concentration achieved during week 1, 2 or 4. We conclude that the dose escalation strategy currently practiced among young children living with HIV-1 resulted in significant subtherapeutic nevirapine concentration (≤4μg/ml during the lead-in period. We call for a closer look at pediatric-focused dosing strategies for nevirapine initiation in young children. Further studies to establish age-appropriate threshold nevirapine concentration are warranted in young children to corroborate the role of therapeutic drug monitoring in predicting virological outcome.

  12. HIV infection, viral load, low birth weight, and nevirapine are independent influences on growth velocity in HIV-exposed South African infants.

    Science.gov (United States)

    Ramokolo, Vundli; Lombard, Carl; Fadnes, Lars T; Doherty, Tanya; Jackson, Debra J; Goga, Ameena E; Chhagan, Meera; Van den Broeck, Jan

    2014-01-01

    Data from a prospective multisite cohort study were used to examine the effect of HIV exposure, untreated HIV infection, and single-dose nevirapine on infant growth velocity. The 2009 WHO growth velocity standards constitute a new tool for this type of investigation and are in need of functional validation. In period 1 (3-24 wk), 65 HIV-infected, 502 HIV-exposed uninfected (HEU), and 216 HIV-unexposed infants were included. In period 2 (25-36 wk), 31 infants moved from the HEU group to the HIV-infected group. We compared weight velocity Z-scores (WVZ) and length velocity Z-scores (LVZ) by HIV group and assessed their independent influences. In period 1, mean WVZ (95% CI) was significantly (P infected [-0.87 (-1.77, 0.04)] than HEU [0.81 (0.67, 0.94)] and unexposed [0.55 (0.33, 0.78)] infants. LVZ showed similar associations. In both periods, sick infants and those exposed to higher maternal viral loads had lower WVZ. Higher mean LVZ was associated with low birth weight. Infants that had received nevirapine had higher LVZ. In conclusion, HIV infection and not exposure was associated with low WVZ and LVZ in period 1. Eliminating infant HIV infection is a critical component in averting HIV-related poor growth patterns in infants in the first 6 mo of life.

  13. Children’s exposure to sustainability practices during the transition from preschool into school and their learning and socioemotional development

    Science.gov (United States)

    Benner, Aprile D.; Thornton, Anna; Crosnoe, Robert

    2017-01-01

    Evidence that the learning gains of preschool fade as children transition into elementary school has led to increased efforts to sustain preschool advantages during this key transitional period. This study explores whether the observed benefits of sustainability practices for a range of child outcomes are explained and/or moderated by family and school mechanisms selecting children into experiencing these practices. Analyses of the Early Childhood Longitudinal Study-Birth Cohort revealed that both family and school factors predicted children’s exposure to several PK-3 sustainability practices. PK-3 sustainability practices were associated with reading (but not math) gains and better interpersonal skills (but not fewer externalizing behaviors) following the transition into kindergarten. These links were not conditioned by the selection mechanisms. The findings highlight who is more likely to seek out (at the family level) or offer (at the school level) sustainability practices and how relevant they are to fighting preschool fadeout. PMID:28794610

  14. Sustained exposure to catecholamines affects cAMP/PKA compartmentalised signalling in adult rat ventricular myocytes.

    Science.gov (United States)

    Fields, Laura A; Koschinski, Andreas; Zaccolo, Manuela

    2016-07-01

    In the heart compartmentalisation of cAMP/protein kinase A (PKA) signalling is necessary to achieve a specific functional outcome in response to different hormonal stimuli. Chronic exposure to catecholamines is known to be detrimental to the heart and disrupted compartmentalisation of cAMP signalling has been associated to heart disease. However, in most cases it remains unclear whether altered local cAMP signalling is an adaptive response, a consequence of the disease or whether it contributes to the pathogenetic process. We have previously demonstrated that isoforms of PKA expressed in cardiac myocytes, PKA-I and PKA-II, localise to different subcellular compartments and are selectively activated by spatially confined pools of cAMP, resulting in phosphorylation of distinct downstream targets. Here we investigate cAMP signalling in an in vitro model of hypertrophy in primary adult rat ventricular myocytes. By using a real time imaging approach and targeted reporters we find that that sustained exposure to catecholamines can directly affect cAMP/PKA compartmentalisation. This appears to involve a complex mechanism including both changes in the subcellular localisation of individual phosphodiesterase (PDE) isoforms as well as the relocalisation of PKA isoforms. As a result, the preferential coupling of PKA subsets with different PDEs is altered resulting in a significant difference in the level of cAMP the kinase is exposed to, with potential impact on phosphorylation of downstream targets. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. A retrospective cohort analysis comparing pregnancy rates among HIV-positive women using contraceptives and efavirenz- or nevirapine-based antiretroviral therapy in Kenya

    Science.gov (United States)

    PATEL, Rena C.; ONONO, Maricianah; GANDHI, Monica; BLAT, Cinthia; HAGEY, Jill; SHADE, Starley B.; VITTINGHOFF, Eric; BUKUSI, Elizabeth A.; NEWMANN, Sara J.; COHEN, Craig R.

    2015-01-01

    SUMMARY Background Given recent concerns of efavirenz reducing the efficacy of contraceptive implants, we sought to determine if pregnancy rates differ among HIV-positive women using various contraceptive methods and efavirenz- or nevirapine-based antiretroviral therapy (ART) regimens. Methods We conducted a retrospective cohort analysis of HIV-positive women aged 15–45 years enrolled in HIV care facilities in western Kenya from January 2011 to December 2013. Pregnancy was diagnosed clinically and the primary exposure was a combination of contraceptive method and ART regimen. We used Poisson models, adjusting for repeated measures, as well as demographic, behavioral and clinical factors, to compare pregnancy rates among women on different contraceptive/ART combinations. Findings 24,560 women contributed 37,635 years of follow-up with 3,337 incident pregnancies. Among women using implants, adjusted pregnancy incidence for nevirapine- and efavirenz-based ART users were 1·1 (95% CI 0·72–1·5) and 3·3 (95% CI 1·8–4·8) per 100 women-years (w-y), respectively (adjusted incidence rate ratio (aIRR) 3·0, 95% CI 1·3–4·6). Among women using depomedroxyprogesterone acetate (DMPA), adjusted pregnancy incidence for nevirapine- and efavirenz-based ART users were 4·5 (95% CI 3·7–5·2) and 5·4 (95% CI 4·0–6·8) per 100 w-y, respectively (aIRR 1·2, 95% CI 0·91–1·5). Women using other contraceptive methods, except for intrauterine devices and permanent methods, experienced 3·1–4·1 higher rates of pregnancy than women using implants, with 1·6–2·8 higher rates specifically among women using efavirenz-based ART. Interpretation While HIV-positive women using implants on efavirenz-based ART faced three times higher risk of contraceptive failure than those on nevirapine-based ART, these women still experienced lower contraceptive failure rates than women on all other contraceptive methods, except for intrauterine devices and permanent methods

  16. Exposure to intermittent hypoxia and sustained hypercapnia reduces therapeutic CPAP in participants with obstructive sleep apnea.

    Science.gov (United States)

    El-Chami, Mohamad; Sudan, Sukhesh; Lin, Ho-Sheng; Mateika, Jason H

    2017-07-06

    To determine if exposure to mild intermittent hypoxia leads to a reduction in the therapeutic continuous positive airway pressure required to eliminate breathing events. Ten male participants were treated with twelve 2-minute episodes of hypoxia (PETO2 ≈ 50 mmHg) separated by 2-minute intervals of normoxia in the presence of PETCO2 that was sustained 3 mmHg above baseline. During recovery from the last episode the positive airway pressure was reduced in a step-wise fashion until flow limitation was evident. The participants also completed a sham protocol under normocapnic conditions, which mimicked the timeframe of the intermittent hypoxia protocol. After exposure to intermittent hypoxia the therapeutic pressure was significantly reduced (i.e. 5 cmH2O) without evidence of flow limitation (103.4 ± 6.3 % of baseline, P = 0.5) or increases in upper airway resistance (95.6 ± 15.0 % of baseline, P = 0.6). In contrast, a similar decrease in pressure was accompanied by flow limitation (77.0 ± 1.8 % of baseline, P = 0.001) and an increase in upper airway resistance (167.2 ± 17.5 % of baseline, P = 0.01) after the sham protocol. Consistent with the initiation of long-term facilitation of upper airway muscle activity exposure to intermittent hypoxia reduced the therapeutic pressure required to eliminate apneic events which could improve treatment compliance. This possibility coupled with the potential beneficial effects of intermittent hypoxia on co-morbidities linked to sleep apnea suggests that mild intermittent hypoxia may have a multipronged therapeutic effect on sleep apnea. Copyright © 2017, Journal of Applied Physiology.

  17. Development of drug resistance in patients receiving combinations of zidovudine, didanosine and nevirapine

    NARCIS (Netherlands)

    Conway, B.; Wainberg, M. A.; Hall, D.; Harris, M.; Reiss, P.; Cooper, D.; Vella, S.; Curry, R.; Robinson, P.; Lange, J. M.; Montaner, J. S.

    2001-01-01

    OBJECTIVE: To evaluate the development of phenotypic and genotypic resistance to zidovudine, didanosine and nevirapine as a function of the virologic response to therapy in a group of drug-naive individuals receiving various combinations of these agents. DESIGN: All patients were enrolled in a

  18. The chlorination behaviour and environmental fate of the antiretroviral drug nevirapine in South African surface water.

    Science.gov (United States)

    Wood, Timothy Paul; Basson, Adriaan Erasmus; Duvenage, Cornelia; Rohwer, Egmont Richard

    2016-11-01

    The wastewater treatment process, besides discharging pharmaceuticals into the environment, has been found to result in the formation of a variety of undescribed compounds. Here we investigate the laboratory scale chlorination of the commonly used anti-HIV drug Nevirapine, characterise its disinfection transformation products (DTPs), and using liquid chromatography with high resolution mass spectrometry, screen environmental surface water for these DTPs. Chlorination of Nevirapine was scaled up, fractioned by preparative chromatography and the fractions were tested in vitro for toxicity and anti-HIV activity. Nevirapine was found to be resistant to degradation at relevant chlorination levels, which may partially explain its ubiquitous presence in South African surface water. During simulated chlorination, a variety of DTPs with varying properties were formed, some of which were detected in the environment, close to wastewater treatment plants. Interestingly, some of these compounds, although not as toxic as Nevirapine, retained antiviral activity. Further purification and synthesis is required to fully characterise these novel molecules. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Determinants of virological outcome and adverse events in African children treated with paediatric nevirapine fixed-dose-combination tablets

    NARCIS (Netherlands)

    Bienczak, A.; Denti, P.; Cook, A.; Wiesner, L.; Mulenga, V.; Kityo, C.; Kekitiinwa, A.; Gibb, D.M.; Burger, D.M.; Walker, A.S.; McIlleron, H.

    2017-01-01

    BACKGROUND: Nevirapine is the only nonnucleoside reverse transcriptase inhibitor currently available as a paediatric fixed-dose-combination tablet and is widely used in African children. Nonetheless, the number of investigations into pharmacokinetic determinants of virological suppression in African

  20. Nevirapine-Resistant HIV-1 DNA in Breast Milk After Single-Dose Nevirapine With or Without Zidovudine for Prevention of Mother-to-Child Transmission.

    Science.gov (United States)

    Gantt, Soren; Payant, Rachel; Carlsson, Jacquelyn; Micek, Mark A; Blanco, Ana Judith; Beck, Ingrid A; Matunha, Laurinda; Montoya, Pablo; Matediana, Eduardo; Gloyd, Stephen; Frenkel, Lisa M

    2012-09-01

    Among 30 human immunodeficiency virus type 1 (HIV-1)-infected women who received single-dose nevirapine (NVP), 17 (57%) had NVP-resistant HIV-1 detected in breast milk. NVP resistance in breast milk persisted for at least 8 months postpartum and was apparently transmitted to at least 1 infant. NVP resistance was detected less often in women who also received zidovudine. © The Author 2012. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. A New Validated RP- HPLC Method for the Determination of Nevirapine in Human Plasma

    Directory of Open Access Journals (Sweden)

    C. H. Venkata Kumar

    2010-01-01

    Full Text Available A rapid, selective and sensitive high performance liquid chromatographic method for the estimation of nevirapine in human plasma has been developed. Chromatography was carried out on a Hypersil BDS C18 column using a mixture of ammonium acetate buffer (pH 4.0 ± 0.05 and acetonitrile (85:15 v/v as the mobile phase. The eluents were monitored for the drug by UV detection at 254 nm. Oxcarbazepine was used as an internal standard for this study. The retention times for nevirapine and oxcarbazepine were found to be 7.2 and 14.7 min respectively. The method was found to be linear in the concentration range of 50 ng/mL to 5003.7 ng/mL. The method was validated as per FDA guidelines and was found to be suitable for bioequivalence and pharmacokinetic studies.

  2. Outcome of protease inhibitor substitution with nevirapine in HIV-1 infected children

    Directory of Open Access Journals (Sweden)

    Gomez M Luisa

    2008-10-01

    Full Text Available Abstract Background Protease inhibitors (PIs have been associated with metabolic complications. There is a trend to switch to simpler therapy to improve these disturbances. We report a case-series describing the effects in metabolic abnormalities in seven HIV-infected children, previously treated with protease inhibitor (PI after switching to nevirapine. Methods Seven children with stable PI-containing regimen and a long lasting HIV-1 RNA Results Seven HIV-infected children were enrolled. Median age: 130 months (99,177. Median baseline CD4%: 32%. All had HIV-1 RNA Conclusion PI substitution with nevirapine improved lipid profile in our patients, although this strategy did not show significant changes in body fat or lipodystrophy.

  3. FORMULATION AND IN-VITRO EVALUATION OF GASTRORETENTIVE DRUG DELIVERY SYSTEM FOR NEVIRAPINE

    OpenAIRE

    Mahajan Ashwini; Dr. Sarode S. M.; Prof. Sathe B.S; Dr. Vadnere G.P.

    2015-01-01

    Floating matrix tablets of nvirapine were developed to prolong gastric residence time and increase its bioavailability. In the present investigation it was thought worthwhile to develop a gastric floating drug delivery system of nevirapine to improve the efficacy of dosage form. Inevirapine a potent antiviral drug with low toxicity used in treatment of HIV. It has maximum absorption in stomach and upper part of small intestine. Due to low gastric retention time, the bioavailability of drug...

  4. Hepatic adverse events during highly active antiretroviral therapy containing nevirapine: a case report

    Directory of Open Access Journals (Sweden)

    Yamazhan Tansu

    2002-09-01

    Full Text Available Abstract Background Hepatotoxicity is one of the most serious complications of highly active antiretroviral therapy (HAART. The aim of this report is to analyse an HIV infected patient on HAART including nevirapine and taking antidepressive agents, with acute toxic hepatitis. Case presentation A 39 year old patient diagnosed as HIV positive one month ago administered to the clinical ward of the Department of Infectious Diseases and Clinical Microbiology in Ege University Medical School with high fever, malaise, nausea, diarrheae and elevated liver enzymes (ALT 1558 U/L, AST 4288 U/L. He has been using HAART including zidovudine+lamivudine (2 × 1/day and nevirapine (2 × 200 mg/day, following dose escalation for 22 days, sertralin and diazepam for 12 days and lithium for 10 days. The patient was hospitalized. Antiretroviral and antidepressant treatments were stopped. The day after admission, his fever dropped and his symptoms improved. Clinical improvement continued on the following days. The patient was discharged upon his request on the 14th day of hospitalization. The liver function tests returned to normal levels in two weeks following discharge. Conclusion Close monitoring of liver enzymes during the first 12 weeks of nevirapine therapy is critical to prevent life threatening events.

  5. A validated new method for nevirapine quantitation in human plasma via high-performance liquid chromatography.

    Science.gov (United States)

    Silverthorn, Courtney F; Parsons, Teresa L

    2006-01-01

    A fully validated and clinically relevant assay was developed for the assessment of nevirapine concentrations in neonate blood plasma samples. Solid-phase extraction with an acid-base wash series was used to prepare subject samples for analysis. Samples were separated by high performance liquid chromatography and detected at 280 nm on a C8 reverse-phase column in an isocratic mobile phase. The retention times of nevirapine and its internal standard were 5.0 and 6.9 min, respectively. The method was validated by assessment of accuracy and precision (statistical values 0.996) and the average recovery was 93% (n = 18). The lower limit of quantification (relative standard deviation <20%) was determined to be 25 ng/mL for 50 microL of plasma, allowing detection of as little as 1.25 ng of nevirapine in a sample. This value represents an increase in sensitivity of up to 30-fold over previously published methods. Copyright 2005 John Wiley & Sons, Ltd.

  6. Sustained action of developmental ethanol exposure on the cortisol response to stress in zebrafish larvae and adults.

    Science.gov (United States)

    Baiamonte, Matteo; Brennan, Caroline H; Vinson, Gavin P

    2015-01-01

    Ethanol exposure during pregnancy is one of the leading causes of preventable birth defects, leading to a range of symptoms collectively known as fetal alcohol spectrum disorder. More moderate levels of prenatal ethanol exposure lead to a range of behavioural deficits including aggression, poor social interaction, poor cognitive performance and increased likelihood of addiction in later life. Current theories suggest that adaptation in the hypothalamo-pituitary-adrenal (HPA) axis and neuroendocrine systems contributes to mood alterations underlying behavioural deficits and vulnerability to addiction. In using zebrafish (Danio rerio), the aim is to determine whether developmental ethanol exposure provokes changes in the hypothalamo-pituitary-interrenal (HPI) axis (the teleost equivalent of the HPA), as it does in mammalian models, therefore opening the possibilities of using zebrafish to elucidate the mechanisms involved, and to test novel therapeutics to alleviate deleterious symptoms. The results showed that developmental exposure to ambient ethanol, 20mM-50mM 1-9 days post fertilisation, had immediate effects on the HPI, markedly reducing the cortisol response to air exposure stress, as measured by whole body cortisol content. This effect was sustained in adults 6 months later. Morphology, growth and locomotor activity of the animals were unaffected, suggesting a specific action of ethanol on the HPI. In this respect the data are consistent with mammalian results, although they contrast with the higher corticosteroid stress response reported in rats after developmental ethanol exposure. The mechanisms that underlie the specific sensitivity of the HPI to ethanol require elucidation.

  7. Assessing shoreline exposure and oyster habitat suitability maximizes potential success for sustainable shoreline protection using restored oyster reefs

    Directory of Open Access Journals (Sweden)

    Megan K. La Peyre

    2015-10-01

    Full Text Available Oyster reefs provide valuable ecosystem services that contribute to coastal resilience. Unfortunately, many reefs have been degraded or removed completely, and there are increased efforts to restore oysters in many coastal areas. In particular, much attention has recently been given to the restoration of shellfish reefs along eroding shorelines to reduce erosion. Such fringing reef approaches, however, often lack empirical data to identify locations where reefs are most effective in reducing marsh erosion, or fully take into account habitat suitability. Using monitoring data from 5 separate fringing reef projects across coastal Louisiana, we quantify shoreline exposure (fetch + wind direction + wind speed and reef impacts on shoreline retreat. Our results indicate that fringing oyster reefs have a higher impact on shoreline retreat at higher exposure shorelines. At higher exposures, fringing reefs reduced marsh edge erosion an average of 1.0 m y−1. Using these data, we identify ranges of shoreline exposure values where oyster reefs are most effective at reducing marsh edge erosion and apply this knowledge to a case study within one Louisiana estuary. In Breton Sound estuary, we calculate shoreline exposure at 500 random points and then overlay a habitat suitability index for oysters. This method and the resulting visualization show areas most likely to support sustainable oyster populations as well as significantly reduce shoreline erosion. Our results demonstrate how site selection criteria, which include shoreline exposure and habitat suitability, are critical to ensuring greater positive impacts and longevity of oyster reef restoration projects.

  8. Assessing shoreline exposure and oyster habitat suitability maximizes potential success for sustainable shoreline protection using restored oyster reefs

    Science.gov (United States)

    LaPeyre, Megan K.; Serra, Kayla; Joyner, T. Andrew; Humphries, Austin T.

    2015-01-01

    Oyster reefs provide valuable ecosystem services that contribute to coastal resilience. Unfortunately, many reefs have been degraded or removed completely, and there are increased efforts to restore oysters in many coastal areas. In particular, much attention has recently been given to the restoration of shellfish reefs along eroding shorelines to reduce erosion. Such fringing reef approaches, however, often lack empirical data to identify locations where reefs are most effective in reducing marsh erosion, or fully take into account habitat suitability. Using monitoring data from 5 separate fringing reef projects across coastal Louisiana, we quantify shoreline exposure (fetch + wind direction + wind speed) and reef impacts on shoreline retreat. Our results indicate that fringing oyster reefs have a higher impact on shoreline retreat at higher exposure shorelines. At higher exposures, fringing reefs reduced marsh edge erosion an average of 1.0 m y−1. Using these data, we identify ranges of shoreline exposure values where oyster reefs are most effective at reducing marsh edge erosion and apply this knowledge to a case study within one Louisiana estuary. In Breton Sound estuary, we calculate shoreline exposure at 500 random points and then overlay a habitat suitability index for oysters. This method and the resulting visualization show areas most likely to support sustainable oyster populations as well as significantly reduce shoreline erosion. Our results demonstrate how site selection criteria, which include shoreline exposure and habitat suitability, are critical to ensuring greater positive impacts and longevity of oyster reef restoration projects.

  9. Damage of rat liver tissue caused by repeated and sustained +Gz exposure and the mechanism thereof

    Directory of Open Access Journals (Sweden)

    Wen-bing LI

    2014-03-01

    Full Text Available Objective  To explore the mechanisms of positive acceleration (+Gz on the damage of rat liver tissue and the effect of +Gz on the expression of JNK/c-Jun in liver cells. Methods  Twenty four male Wistar rats were randomly divided into 4 groups (n=6: control, +2Gz, +6Gz and +10Gz group. With prone position, the rats in control group were fixed to the turning arm of centrifuge with head towards the axis for 5 minutes. The fixation method in +2Gz, +6Gz and +10Gz group was the same as in the control group. The increase rate of acceleration was 1G/s with a peak-time of 3 minutes, and each +Gz exposure repeated 5 times with an interval of 30 minutes. HE staining was used to observe the morphological changes of liver tissue, fluorescence real-time quantitative PCR to detect the expression of hepatic c-Jun mRNA, and Western blotting to detect the hepatic protein expression of p-c-Jun, c-Jun, p-JNK and JNK. Plasma aspartate aminotransferase (AST and alanine aminotransferase (ALT were determined. Results  The levels of serum ALT and AST increased significantly in +6Gz and, especially, the +10Gz group than in control group and +2Gz group (P<0.05. The same situation also existed in the increase of c-Jun mRNA expression (P<0.05. Hepatic c-jun and p-c-Jun (c-Jun activated form protein expression increased with the increase of G value. Compared with control group, no change was found in JNK protein expression in the other three groups, but the expression of p-JNK (activated form of JNK increased in +6Gz and +10Gz groups (P<0.05. HE staining showed the disorganized liver cells with irregular shapes, the unclear cell gap and the vacuolar changes in +6Gz and +10Gz groups. Conclusions  Repeated and sustained +Gz may cause enhanced expression of c-Jun/ p-c-Jun and p-JNK in hepatic cells. JNK/c-Jun signaling pathway may play an important role in the process of hepatic stress injury. DOI: 10.11855/j.issn.0577-7402.2014.03.15

  10. How Exposure to ”Role Model” Projects Can Lead to Decisions for More Sustainable Infrastructure

    Directory of Open Access Journals (Sweden)

    Nora Harris

    2016-01-01

    Full Text Available A role model, whether an individual or a project, can inspire similar performance in others. This research examines such a phenomenon during the design process for more sustainable physical infrastructure. In this empirical study, engineering professionals (n = 54 were randomly assigned either a modified version of the Envision rating system for sustainable infrastructure, which was changed to include details from an exemplary role model project, or the current version of Envision, with no role model. Professionals given the role model version of Envision achieved on average 34% more points (SD = 27 than the control group (p = 0.001. A positive role model project appears to lead engineering professionals to higher goals for sustainability performance in their design decisions. This finding, and the corresponding line of interdisciplinary research, can be used in decision-structuring interventions, which are a relatively low-cost approach to support greater sustainability in physical infrastructure development.

  11. Electrochemical studies of nevirapine, an anti-HIV drug, and its assay in tablets and biological samples

    Directory of Open Access Journals (Sweden)

    JALDAPPAGARI SEETHARAMAPPA

    2012-06-01

    Full Text Available The electrochemical oxidation of nevirapine, an anti-HIV drug, at a glassy carbon electrode has been studied by voltammetric techniques. Nevirapine showed one well defined irreversible oxidation peak with a potential of 0.749 V in phosphate buffer at pH 10. The effects of different electrolytes, pH and scan rate on the electrochemical behaviour of nevira¬pine were examined to determine the optimum reaction conditions. The oxidation peak current was found to vary linearly with the concentration of nevirapine in the range of 5.0 – 350 µM. The limit of detection and limit of quantification values were calculated and found to be 1.026 µM and 3.420 µM, respectively. The low relative standard deviation values of inter-day and intra-day assays highlighted the good reproducibility of the proposed m¬ethod for assay of nevirapine. Further, a sensitive and accurate differential pulse voltammetric method was developed for the determination of nevirapine concentrations in pharma¬ceutical formulations.

  12. Epicutaneous immunotherapy (EPIT blocks the allergic esophago-gastro-enteropathy induced by sustained oral exposure to peanuts in sensitized mice.

    Directory of Open Access Journals (Sweden)

    Lucie Mondoulet

    Full Text Available BACKGROUND: Food allergy may affect the gastrointestinal tract and eosinophilia is often associated with allergic gastrointestinal disorders. Allergy to peanuts is a life-threatening condition and effective and safe treatments still need to be developed. The present study aimed to evaluate the effects of sustained oral exposure to peanuts on the esophageal and jejunal mucosa in sensitized mice. We also evaluated the effects of desensitization with epicutaneous immunotherapy (EPIT on these processes. METHODS: Mice were sensitized by gavages with whole peanut protein extract (PPE given with cholera toxin. Sensitized mice were subsequently exposed to peanuts via a specific regimen and were then analysed for eosinophilia in the esophagus and gut. We also assessed mRNA expression in the esophagus, antibody levels, and peripheral T-cell response. The effects of EPIT were tested when intercalated with sensitization and sustained oral peanut exposure. RESULTS: Sustained oral exposure to peanuts in sensitized mice led to severe esophageal eosinophilia and intestinal villus sub-atrophia, i.e. significantly increased influx of eosinophils into the esophageal mucosa (136 eosinophils/mm(2 and reduced villus/crypt ratios (1.6±0.15. In the sera, specific IgE levels significantly increased as did secretion of Th2 cytokines by peanut-reactivated splenocytes. EPIT of sensitized mice significantly reduced Th2 immunological response (IgE response and splenocyte secretion of Th2 cytokines as well as esophageal eosinophilia (50 eosinophils/mm(2, p<0.05, mRNA expression of Th2 cytokines in tissue--eotaxin (p<0.05, IL-5 (p<0.05, and IL-13 (p<0.05--GATA-3 (p<0.05, and intestinal villus sub-atrophia (2.3±0.15. EPIT also increased specific IgG2a (p<0.05 and mRNA expression of Foxp3 (p<0.05 in the esophageal mucosa. CONCLUSIONS: Gastro-intestinal lesions induced by sustained oral exposure in sensitized mice are efficaciously treated by allergen specific EPIT.

  13. Sustained Reprogramming of the Estrogen Response After Chronic Exposure to Endocrine Disruptors

    OpenAIRE

    Andrea R Patterson; Mo, Xiaokui; Shapiro, Ali; Wernke, Karen E.; Archer, Trevor K.; Burd, Craig J.

    2015-01-01

    The pervasive nature of estrogenic industrial and dietary compounds is a growing health concern linked to cancer, obesity, and neurological disorders. Prior analyses of endocrine disruptor action have focused primarily on the short-term consequences of exposure. However, these studies are unlikely to reflect the consequences of constant exposures common to industrialized countries. Here we examined the global effects of long-term endocrine disruption on gene transcription and estrogen signali...

  14. When Legitimacy Shapes Environmentally Responsible Behaviors: Considering Exposure to University Sustainability Initiatives

    Science.gov (United States)

    Watson, Lesley; Hegtvedt, Karen A.; Johnson, Cathryn; Parris, Christie L.; Subramanyam, Shruthi

    2017-01-01

    This study examines how perceptions of the legitimacy of university sustainability efforts--support by the administration (authorization) or from students' peers (endorsement)--as well as the physical context in which students live, matter in shaping students' environmentally responsible behaviors (ERBs). Using survey data collected from…

  15. Sustained action of developmental ethanol exposure on the cortisol response to stress in zebrafish larvae and adults.

    Directory of Open Access Journals (Sweden)

    Matteo Baiamonte

    Full Text Available Ethanol exposure during pregnancy is one of the leading causes of preventable birth defects, leading to a range of symptoms collectively known as fetal alcohol spectrum disorder. More moderate levels of prenatal ethanol exposure lead to a range of behavioural deficits including aggression, poor social interaction, poor cognitive performance and increased likelihood of addiction in later life. Current theories suggest that adaptation in the hypothalamo-pituitary-adrenal (HPA axis and neuroendocrine systems contributes to mood alterations underlying behavioural deficits and vulnerability to addiction. In using zebrafish (Danio rerio, the aim is to determine whether developmental ethanol exposure provokes changes in the hypothalamo-pituitary-interrenal (HPI axis (the teleost equivalent of the HPA, as it does in mammalian models, therefore opening the possibilities of using zebrafish to elucidate the mechanisms involved, and to test novel therapeutics to alleviate deleterious symptoms.The results showed that developmental exposure to ambient ethanol, 20mM-50mM 1-9 days post fertilisation, had immediate effects on the HPI, markedly reducing the cortisol response to air exposure stress, as measured by whole body cortisol content. This effect was sustained in adults 6 months later. Morphology, growth and locomotor activity of the animals were unaffected, suggesting a specific action of ethanol on the HPI. In this respect the data are consistent with mammalian results, although they contrast with the higher corticosteroid stress response reported in rats after developmental ethanol exposure. The mechanisms that underlie the specific sensitivity of the HPI to ethanol require elucidation.

  16. Induced peroxidase and cytoprotective enzyme expressions support adaptation of HUVECs to sustain subsequent H2O2 exposure.

    Science.gov (United States)

    Patel, Hemang; Chen, Juan; Kavdia, Mahendra

    2016-01-01

    H2O2 mediates autocrine and paracrine signaling in the vasculature and can propagate endothelial dysfunction. However, it is not clear how endothelial cells withstand H2O2 exposure and promote H2O2-induced vascular remodeling. To understand the innate ability of endothelial cells for sustaining excess H2O2 exposure, we investigated the genotypic and functional regulation of redox systems in primary HUVECs following an H2O2 treatment. Primary HUVECs were exposed to transient H2O2 exposure and consistent H2O2 exposure. Following H2O2 treatments for 24, 48 and 72 h, we measured O2(-) production, mitochondrial membrane polarization (MMP), and gene expressions of pro-oxidative enzymes, peroxidase enzymes, and cytoprotective intermediates. Our results showed that the 24 h H2O2 exposure significantly increased O2(-) levels, hyperpolarized MMP, and downregulated CAT, GPX1, TXNRD1, NFE2L2, ASK1, and ATF2 gene expression in HUVECs. At 72 h, HUVECs in both treatment conditions were shown to adapt to reduce O2(-) levels and normalize MMP. An upregulation of GPX1, TXNRD1, and HMOX1 gene expression and a recovery of NFE2L2 and PRDX1 gene expression to control levels were observed in both consistent and transient treatments at 48 and 72 h. The response of endothelial cells to excess levels of H2O2 involves a complex interaction amongst O2(-) levels, mitochondrial membrane polarization and anti- and pro-oxidant gene regulation. As a part of this response, HUVECs induce cytoprotective mechanisms including the expression of peroxidase and antioxidant enzymes along with the downregulation of pro-apoptotic genes. This adaptation assists HUVECs to withstand subsequent exposures to H2O2. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Good performance of an immunoassay based method for nevirapine measurements in human breast milk

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Theilgaard, Zahra Persson; Chiduo, Mercy

    2011-01-01

    , requires complicated extraction techniques. The ARK method employs an immunoassay technology and requires a small sample volume (40 μL) and no pre-treatment of the samples. Methods: Commercial enzyme and antibody were used and calibration standards and quality controls were prepared from pooled breast milk...... from HIV-uninfected women. Clinical samples from HIV-infected women receiving a single-dose of nevirapine were analyzed. Results: Precision and accuracy were evaluated with two concentrations of quality control materials analyzed in three replicates on four different days and was...

  18. An analysis of blood and body fluid exposures sustained by house officers, medical students, and nursing personnel on acute-care general medical wards: a prospective study.

    Science.gov (United States)

    Stotka, J L; Wong, E S; Williams, D S; Stuart, C G; Markowitz, S M

    1991-10-01

    To prospectively examine the epidemiology of blood and body fluid exposures sustained by medicine housestaff, medical school students, registered nurses (RNs), licensed practical nurses (LPNs), and nurses' aides (NAs) on general medicine wards and to define problem areas that may be amenable to change. Daily data collection during 9 months using a self-reporting questionnaire. General medical wards in 2 tertiary referral hospitals. Medicine housestaff/students and nursing personnel. Physicians reported 644 exposures, of which 98 (15.2%), 296 (46.0%), and 250 (38.8%) were sustained by medicine residents, interns, and students, respectively. Blood contact occurred with 591 (91.8%) exposures. For physicians, 575 (89.3%) exposures occurred during venipuncture, intravenous catheter manipulation, and arterial punctures. Interns and students most commonly incurred exposures during venipunctures and intravenous manipulations; residents commonly were exposed during emergent intravenous catheter placements. Five-hundred-twenty-two (81%) exposures occurred between 7 A.M. and 7 P.M. During 524 (81.4%) exposures, physicians were not using barrier devices. Nurses reported 235 exposures, of which 140 (59.6%), 23 (9.8%), and 72 (30.6%) were sustained by RNs, LPNs, and NAs, respectively. RN exposures commonly occurred during intravenous manipulations and glucometer fingersticks. LPNs and NAs incurred a higher percentage of exposures during nonprocedural patient care. Blood contact and wound drainage accounted for 167 (71.1%) and 31 (13.2%) exposures, respectively. Exposures to blood and body fluids frequently are incurred by healthcare workers on general medical wards. Efforts to reduce these exposures should be directed not only at improving procedural skills of healthcare workers for venipunctures, intravenous catheter insertions, and glucometer fingersticks, but also in increasing barrier use during procedural and nonprocedural tasks.

  19. Sustainability of Public Health Interventions to Reduce the Risk of Dioxin Exposure at Severe Dioxin Hot Spots in Vietnam.

    Science.gov (United States)

    Tuyet-Hanh, Tran Thi; Vu-Anh, Le; Dunne, Michael; Toms, Leisa-Maree; Tenkate, Thomas; Harden, Fiona

    2015-08-01

    Severe dioxin contamination at Bien Hoa and Da Nang airbases, Vietnam is of international concern. Public Health risk reduction programs were implemented in Bien Hoa in 2007-2009 and in Da Nang in 2009-2011. In 2009 and 2011 we reported the encouraging results of these interventions in improving the knowledge, attitude and practices (KAP) of local residents in reducing the dioxin exposure risk through foods. In 2013 we revisited these dioxin hot spots, aimed to evaluate whether the results of the intervention were maintained and to identify factors affecting the sustainability of the programs. To assess this, 16 in-depth interviews, six focus group discussions, and pre and post intervention KAP surveys were undertaken. 800 respondents from six intervention wards and 200 respondents from Buu Long Ward (the control site) were randomly selected to participate in the surveys. The results showed that as of 2013, the programs were rated as "moderately sustained" with a score of 3.3 out of 5.0 (cut off points 2.5 to Bien Hoa, and "well sustained" with a score of 3.8 out of 5.0 (cut off points 3.5 to <4.5) for Da Nang. Most formal intervention program activities had ceased and dioxin risk communication activities were no longer integrated into local routine health education programs. However, the main outcomes were maintained and were better than that in the control ward. Migration, lack of official guidance from City People's Committees and local authorities as well as the politically sensitive nature of dioxin issues were the main challenges for the sustainability of the programs.

  20. Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study.

    Science.gov (United States)

    Monera-Penduka, Tsitsi G; Maponga, Charles C; Wolfe, Alan R; Wiesner, Lubbe; Morse, Gene D; Nhachi, Charles F B

    2017-01-01

    Moringa oleifera Lam., an herb commonly consumed by HIV-infected people on antiretroviral therapy, inhibits cytochrome P450 3A4, 1A2 and 2D6 activity in vitro; and may alter the pharmacokinetics (PK) of antiretroviral drugs metabolized via the same pathways. However, in vitro drug interaction activity may not translate to a clinically significant effect. Therefore, the effect of moringa leaf powder on the PK of nevirapine in HIV-infected people was investigated. Adult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling following a 21-day herbal medicine washout. Blood sampling was repeated after 14 days of nevirapine and moringa (1.85 g leaf powder/day) co-administration. Nevirapine plasma concentrations were determined by liquid chromatography-tandem mass spectrometry. To assess the effect of moringa on nevirapine PK, the change in nevirapine area under the plasma concentration-time curve (AUC) was determined. The mean difference in pre- and post-moringa nevirapine, maximum concentration (Cmax) and concentration at 12 h (C12h) were also calculated. The PK parameters were compared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs). Pharmacokinetics analyses were performed on the results from 11 participants for whom complete data were obtained. The post/pre GMRs and associated 90% CIs for nevirapine were 1.07 (1.00-1.14) for the AUC; 1.06 (0.98-1.16) for Cmax and 1.03 (0.92-1.16) for C12h. Co-administration of Moringa oleifera Lam. leaf powder at the traditional dose did not significantly alter the steady-state PK of nevirapine. Trial registration number NCT01410058 (ClinicalTrials.gov).

  1. Effectiveness of a Treatment Switch to Nevirapine plus Tenofovir and Emtricitabine (or Lamivudine) in Adults with HIV-1 Suppressed Viremia

    DEFF Research Database (Denmark)

    Llibre, Josep M; Bravo, Isabel; Ornelas, Arelly

    2015-01-01

    BACKGROUND: Switching subjects with persistently undetectable HIV-1 viremia under antiretroviral treatment (ART) to once-daily tenofovir/emtricitabine (or lamivudine) + nevirapine is a cost-effective and well-tolerated strategy. However, the effectiveness of this approach has not been established...

  2. Comparison of genotypic resistance profiles and virological response between patients starting nevirapine and efavirenz in EuroSIDA

    DEFF Research Database (Denmark)

    Bannister, Wendy P; Ruiz, Lidia; Cozzi-Lepri, Alessandro

    2008-01-01

    OBJECTIVE: To compare virological outcome and genotypic resistance profiles in HIV-1-infected patients starting non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing regimens. METHODS: NNRTI-naive patients were included who started treatment with nevirapine (NVP) or efavirenz (EFV) wi...

  3. Brief report : enzyme inducers reduce elimination half-life after a single dose of nevirapine in healthy women

    NARCIS (Netherlands)

    L'homme, R.F.A.; Dijkema, T.; Ven, A.J.A.M. van der; Burger, D.M.

    2006-01-01

    OBJECTIVE: Single-dose nevirapine (SD-NVP) to prevent mother-to-child transmission (MTCT) of HIV is associated with development of NVP resistance, probably because of its long half-life in combination with a low genetic barrier to resistance. The objective of this study was to find enzyme inducers

  4. The antiretroviral efficacy of highly active antiretroviral therapy and plasma nevirapine concentrations in HIV-TB co-infected Indian patients receiving rifampicin based antituberculosis treatment

    Directory of Open Access Journals (Sweden)

    Sinha Sanjeev

    2011-11-01

    Full Text Available Abstract Background Rifampicin reduces the plasma concentrations of nevirapine in human immunodeficiency virus (HIV and tuberculosis (TB co-infected patients, who are administered these drugs concomitantly. We conducted a prospective interventional study to assess the efficacy of nevirapine-containing highly active antiretroviral treatment (HAART when co-administered with rifampicin-containing antituberculosis treatment (ATT and also measured plasma nevirapine concentrations in patients receiving such a nevirapine-containing HAART regimen. Methods 63 cases included antiretroviral treatment naïve HIV-TB co-infected patients with CD4 counts less than 200 cells/mm3 started on rifampicin-containing ATT followed by nevirapine-containing HAART. In control group we included 51 HIV patients without tuberculosis and on nevirapine-containing HAART. They were assessed for clinical and immunological response at the end of 24 and 48 weeks. Plasma nevirapine concentrations were measured at days 14, 28, 42 and 180 of starting HAART. Results 97 out of 114 (85.1% patients were alive at the end of 48 weeks. The CD4 cell count showed a mean increase of 108 vs.113 cells/mm3 (p=0.83 at 24 weeks of HAART in cases and controls respectively. Overall, 58.73% patients in cases had viral loads of less than 400 copies/ml at the end of 48 weeks. The mean (± SD Nevirapine concentrations of cases and control at 14, 28, 42 and 180 days were 2.19 ± 1.49 vs. 3.27 ± 4.95 (p = 0.10, 2.78 ± 1.60 vs. 3.67 ± 3.59 (p = 0.08, 3.06 ± 3.32 vs. 4.04 ± 2.55 (p = 0.10 respectively and 3.04 μg/ml (in cases. Conclusions Good immunological and clinical response can be obtained in HIV-TB co-infected patients receiving rifampicin and nevirapine concomitantly despite somewhat lower nevirapine trough concentrations. This suggests that rifampicin-containing ATT may be co administered in resource limited setting with nevirapine-containing HAART regimen without substantial reduction in

  5. When Legitimacy Shapes Environmentally Responsible Behaviors: Considering Exposure to University Sustainability Initiatives

    Directory of Open Access Journals (Sweden)

    Lesley Watson

    2017-01-01

    Full Text Available This study examines how perceptions of the legitimacy of university sustainability efforts—support by the administration (authorization or from students’ peers (endorsement—as well as the physical context in which students live, matter in shaping students’ environmentally responsible behaviors (ERBs. Using survey data collected from fourth-year students at a university in the Southeastern US, we employ Seeming Unrelated Regression to analyze the impact of perceived legitimacy and context on recycling and conservation behaviors, controlling for demographic characteristics, pro-environmental attitudes, and environmental identity. Our findings indicate that students’ perceptions of what university administrators support affect the likelihood of students to enact recycling and conservation behaviors, and peer support influences conservation behaviors. This research contributes to the literature on legitimacy by examining how legitimacy processes work in natural, rather than experimental, settings.

  6. Nevirapine resistance and breast-milk HIV transmission: effects of single and extended-dose nevirapine prophylaxis in subtype C HIV-infected infants.

    Directory of Open Access Journals (Sweden)

    Anitha Moorthy

    Full Text Available Daily nevirapine (NVP prophylaxis to HIV-exposed infants significantly reduces breast-milk HIV transmission. We assessed NVP-resistance in Indian infants enrolled in the "six-week extended-dose nevirapine" (SWEN trial who received single-dose NVP (SD-NVP or SWEN for prevention of breast-milk HIV transmission but who also acquired subtype C HIV infection during the first year of life.Standard population sequencing and cloning for viral subpopulations present at > or =5% frequency were used to determine HIV genotypes from 94% of the 79 infected Indian infants studied. Timing of infection was defined based on when an infant's blood sample first tested positive for HIV DNA. SWEN-exposed infants diagnosed with HIV by six weeks of age had a significantly higher prevalence of NVP-resistance than those who received SD-NVP, by both standard population sequencing (92% of 12 vs. 38% of 29; p = 0.002 and low frequency clonal analysis (92% of 12 vs. 59% of 29; p = 0.06. Likelihood of infection with NVP-resistant HIV through breast-milk among infants infected after age six weeks was substantial, but prevalence of NVP-resistance did not differ among SWEN or SD-NVP exposed infants by standard population sequencing (15% of 13 vs. 15% of 20; p = 1.00 and clonal analysis (31% of 13 vs. 40% of 20; p = 0.72. Types of NVP-resistance mutations and patterns of persistence at one year of age were similar between the two groups. NVP-resistance mutations did differ by timing of HIV infection; the Y181C variant was predominant among infants diagnosed in the first six weeks of life, compared to Y188C/H during late breast-milk transmission.Use of SWEN to prevent breast-milk HIV transmission carries a high likelihood of resistance if infection occurs in the first six weeks of life. Moreover, there was a continued risk of transmission of NVP-resistant HIV through breastfeeding during the first year of life, but did not differ between SD-NVP and SWEN groups. As with SD-NVP, the

  7. Protective effect of SP600125 against liver cell injury in rats under repeated and sustained high +Gz exposure

    Directory of Open Access Journals (Sweden)

    Wen-bing LI

    2015-01-01

    Full Text Available Objective To explore the effect of JNK inhibitor SP600125 on expression of JNK/c-jun in liver cells of rats under repeated and sustained high +Gz exposure and its mechanism of the effect. Methods Eighteen inbred adult male Wistar rats were randomly divided into control group, +10Gz group and SP600125 group (n=6. The rats in +10Gz group and SP600125 group were fixed to the rotating arm of a centrifuge with head towards the axis. The increase rate of acceleration was 1G/s with a peak-time of 3 minutes, and the +Gz exposure was repeated 5 times with an interval of 30 minutes. SP600125 was given to rats of SP600125 group 30 minutes before the first centrifugation by intraperitoneal injection. All of the animals were sacrificed 30 minutes after centrifugation. Blood samples were collected from inferior vena cava to determine the plasma level of aspartate aminotransferase (AST and alanine aminotransferase (ALT. The expression of c-jun mRNA was determined by quantitative real-time RT-PCR (qRTPCR. The expressions of p-JNK, JNK, p-c-jun and c-jun protein were determined by Western blotting. The morphological change in the liver tissue was observed after HE staining. Results The plasma level of ALT and AST, expression level of c-jun mRNA and p-JNK, p-c-jun, c-jun protein in the liver tissue of SP600125 group were significantly higher than those of control group (P0.05. HE staining revealed disorganized hepatic cords, irregular liver cells, vacuolar changes, and marked edema of hepatocytes, and collapsed hepatic sinusoids in +10Gz group, but these changes were alleviated obviously in SP600125 group. Conclusion SP600125 could alleviate the liver cell injury in rats under repeated and sustained high +Gz exposure. DOI: 10.11855/j.issn.2577-7402.2014.11.02

  8. Transmission of nevirapine-resistant HIV type 1 via breast milk to infants after single-dose nevirapine in Beira, Mozambique.

    Science.gov (United States)

    Micek, Mark A; Dross, Sandra; Blanco, Ana Judith; Beck, Ingrid A; Matunha, Laurinda; Seidel, Kristy; Montoya, Pablo; Matediana, Eduardo; Gantt, Soren; Gloyd, Stephen; Frenkel, Lisa

    2014-08-15

    Acquisition of nevirapine (NVP)-resistant human immunodeficiency virus type 1 (HIV-1) by breast-feeding infants after receipt of single-dose NVP to prevent mother-to-child transmission is not well defined. A prospective observational study of 307 infants evaluated the rate of breast milk transmission of NVP-resistant HIV and the concentrations of mutants over time. NVP resistance was detected in 9 of 24 infants (37.5%; 95% confidence interval, 18.8%-59.4%) infected via breast milk. Eight had a pure mutant HIV population at the time infection was first detected, and majority mutant populations persisted in all 6 infants with follow-up specimens. Infection of breast-feeding infants with NVP-resistant HIV resulted in mutants persisting as the dominant virus, which may indefinitely compromise treatment with NVP-based antiretroviral regimens. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Risk factors for treatment-limiting toxicities in patients starting nevirapine-containing antiretroviral therapy

    DEFF Research Database (Denmark)

    Kesselring, Anouk M; Wit, Ferdinand W; Sabin, Caroline A

    2009-01-01

    BACKGROUND: This collaboration of seven observational clinical cohorts investigated risk factors for treatment-limiting toxicities in both antiretroviral-naive and experienced patients starting nevirapine-based combination antiretroviral therapy (NVPc). METHODS: Patients starting NVPc after 1...... January 1998 were included. CD4 cell count at starting NVPc was classified as high (>400/microl/>250/microl for men/women, respectively) or low. Cox models were used to investigate risk factors for discontinuations due to hypersensitivity reactions (HSR, n = 6547) and discontinuation of NVPc due...... to treatment-limiting toxicities and/or patient/physician choice (TOXPC, n = 10,186). Patients were classified according to prior antiretroviral treatment experience and CD4 cell count/viral load at start NVPc. Models were stratified by cohort and adjusted for age, sex, nadir CD4 cell count, calendar year...

  10. Nevirapine Use to Reduce Mother-To-Child Transmission of HIV in Canada

    Directory of Open Access Journals (Sweden)

    Committee for Canadian Paediatric AIDS Research Group

    2001-01-01

    Full Text Available Nevirapine (NVP is a non-nucleoside reverse transcriptase inhibitor (NNRTI that is used to treat adults and children with human immunodeficiency virus (HIV infection. The drug was licensed in Canada in September 1998 and has been widely used in combination antiretroviral therapy regimens, usually along with two nucleoside reverse transcriptase inhibitors. NVP is, generally, well tolerated; however, up to 20% of patients may develop rash, with a severe rash occurring in 6% of patients and Stevens-Johnson syndrome reported in 0.5% of patients. A large number of NNRTI mutations have been documented, and a single mutation, K103N, confers a degree of broad NNRTI resistance. Distinctions occur in resistance patterns to different NNRTIs (1.

  11. Synergistic activity of tenofovir and nevirapine combinations released from polycaprolactone matrices for potential enhanced prevention of HIV infection through the vaginal route.

    Science.gov (United States)

    Dang, Nhung T T; Sivakumaran, Haran; Harrich, David; Shaw, Paul N; Davis-Poynter, Nicholas; Coombes, Allan G A

    2014-10-01

    Polycaprolactone (PCL) matrices were simultaneously loaded with the antiviral agents, tenofovir (TFV) and nevirapine (NVP), in combination to provide synergistic activity in the prevention of HIV transmission through the vaginal route. TFV and NVP were incorporated in PCL matrices at theoretical loadings of 10%TFV-10% NVP, 5%TFV-5%NVP and 5%TFV-10%NVP, measured with respect to the PCL content of the matrices. Actual TFV loadings ranged from 2.1% to 4.2% equating to loading efficiencies of about 41-42%. The actual loadings of NVP were around half those of TFV (1.2-1.9%), resulting in loading efficiencies ranging from 17.2% to 23.5%. Approximately 80% of the initial content of TFV was released from the PCL matrices into simulated vaginal fluid (SVF) over a period of 30 days, which was almost double the cumulative release of NVP (40-45%). The release kinetics of both antivirals over 30 days were found to be described most satisfactorily by the Higuchi model. In vitro assay of release media containing combinations of TFV and NVP released from PCL matrices confirmed a potential synergistic/additive effect of the released antivirals on HIV-1 infection of HeLa cells. These findings indicate that PCL matrices loaded with combinations of TFV and NVP provide an effective strategy for the sustained vaginal delivery of antivirals with synergistic/additive activity. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. The orally active glutamate carboxypeptidase II inhibitor E2072 exhibits sustained nerve exposure and attenuates peripheral neuropathy.

    Science.gov (United States)

    Wozniak, Krystyna M; Wu, Ying; Vornov, James J; Lapidus, Rena; Rais, Rana; Rojas, Camilo; Tsukamoto, Takashi; Slusher, Barbara S

    2012-12-01

    Peripheral neuropathy from nerve trauma is a significant problem in the human population and often constitutes a dose-limiting toxicity in patients receiving chemotherapy. (3-2-Mercaptoethyl)biphenyl-2,3-dicarboxylic acid (E2072) is a potent (K(i) = 10 nM), selective, and orally available inhibitor of glutamate carboxypeptidase II (GCPII). Here, we report that E2072 attenuates hyperalgesia and nerve conduction velocity deficits in preclinical rodent models of neuropathic pain and oxaliplatin-induced neuropathy. In the chronic constrictive injury model, orally administered E2072 reversed pre-existing thermal hyperalgesia in rats in a dose-dependent fashion with a minimally effective dose of 0.1 mg/kg/day. It is noteworthy that multiple days of dosing of E2072 were required before analgesia was realized even though GCPII inhibitory exposures were achieved on the first day of dosing. In addition, analgesia was found to persist for up to 7 days after cessation of dosing, consistent with E2072's pharmacokinetic profile and sustained exposure. Furthermore, in a chronic oxaliplatin-induced neuropathy model (6 mg/kg i.p. oxaliplatin twice weekly for 4 weeks), female BALB/c mice receiving daily oral E2072 at 1.0 and 0.1 mg/kg displayed no deficits in either caudal or digital velocity compared with significant deficits observed in mice treated with oxaliplatin alone (12 ± 3 and 9 ± 2%, respectively). Similar findings were seen with oxaliplatin-induced digital and caudal amplitude deficits. It is noteworthy that E2072 showed no interference with the antineoplastic efficacy of oxaliplatin in mice bearing leukemia (L1210), even at doses 100 times its neuroprotective/analgesic dose, indicating a selective effect on neuropathy. These data support the therapeutic utility of GCPII inhibitors in neuropathy and neuropathic pain.

  13. Estimated Reduction in Cancer Risk due to PAH Exposures If Source Control Measures during the 2008 Beijing Olympics Were Sustained

    Science.gov (United States)

    Jia, Yuling; Stone, Dave; Wang, Wentao; Schrlau, Jill; Tao, Shu; Massey Simonich, Staci L.

    2011-01-01

    Background The 2008 Beijing Olympic Games provided a unique case study to investigate the effect of source control measures on the reduction in air pollution, and associated inhalation cancer risk, in a Chinese megacity. Objectives We measured 17 carcinogenic polycyclic aromatic hydrocarbons (PAHs) and estimated the lifetime excess inhalation cancer risk during different periods of the Beijing Olympic Games, to assess the effectiveness of source control measures in reducing PAH-induced inhalation cancer risks. Methods PAH concentrations were measured in samples of particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) collected during the Beijing Olympic Games, and the associated inhalation cancer risks were estimated using a point-estimate approach based on relative potency factors. Results We estimated the number of lifetime excess cancer cases due to exposure to the 17 carcinogenic PAHs [12 priority pollutant PAHs and five high-molecular-weight (302 Da) PAHs (MW 302 PAHs)] to range from 6.5 to 518 per million people for the source control period concentrations and from 12.2 to 964 per million people for the nonsource control period concentrations. This would correspond to a 46% reduction in estimated inhalation cancer risk due to source control measures, if these measures were sustained over time. Benzo[b]fluoranthene, dibenz[a,h]anthracene, benzo[a]pyrene, and dibenzo[a,l]pyrene were the most carcinogenic PAH species evaluated. Total excess inhalation cancer risk would be underestimated by 23% if we did not include the five MW 302 PAHs in the risk calculation. Conclusions Source control measures, such as those imposed during the 2008 Beijing Olympics, can significantly reduce the inhalation cancer risk associated with PAH exposure in Chinese megacities similar to Beijing. MW 302 PAHs are a significant contributor to the estimated overall inhalation cancer risk. PMID:21632310

  14. Oral Ezatiostat HCl (TLK199) and Myelodysplastic syndrome: a case report of sustained hematologic response following an abbreviated exposure.

    Science.gov (United States)

    Quddus, Fahd; Clima, Jessica; Seedham, Helen; Sajjad, Ghulam; Galili, Naomi; Raza, Azra

    2010-04-23

    Treatment options for patients with lower risk non-del(5q) myelodysplastic syndromes (MDS) who fail erythroid stimulating agents are restricted to one of the hypomethylating drugs with an expected response rate of approximately 50%. Ezatiostat HCl, an agent with the potential for producing multi-lineage responses in this population is currently in clinical investigation phase. This case report describes a 77 year old male who received less than two cycles of therapy with ezatiostat HCl which had to be aborted due to intolerable side effects, but which produced a sustained normalization of all three blood counts. This trilineage response has now lasted for more than a year. Interestingly, the patient began with a del(5q) abnormality and responded briefly to lenalidomide. Upon relapse of the anemia, a bone marrow showed the disappearance of the del(5q) but the appearance of a new clonal abnormality t(2;3). Given that the patient had a complete cytogenetic response to a truncated exposure to lenalidomide followed by a trilineage response to an even briefer course of ezatiostat HCl suggests a potential role for ezatiostat HCl in del(5q) patients who relapse following lenalidomide.

  15. Sustained exposure to abscisic acid enhances the colonization potential of the mutualist fungus Piriformospora indica on Arabidopsis thaliana roots.

    Science.gov (United States)

    Peskan-Berghöfer, Tatjana; Vilches-Barro, Amaya; Müller, Teresa M; Glawischnig, Erich; Reichelt, Michael; Gershenzon, Jonathan; Rausch, Thomas

    2015-11-01

    Root colonization by the beneficial fungus Piriformospora indica is controlled by plant innate immunity, but factors that channel this interaction into a mutualistic relationship are not known. We have explored the impact of abscisic acid (ABA) and osmotic stress on the P. indica interaction with Arabidopsis thaliana. The activation of plant innate immunity in roots was determined by measuring the concentration of the phytoalexin camalexin and expression of transcription factors regulating the biosynthesis of tryptophan-related defence metabolites. Furthermore, the impact of the fungus on the content of ABA, salicylic acid, jasmonic acid (JA) and JA-related metabolites was examined. We demonstrated that treatment with exogenous ABA or the ABA analogue pyrabactin increased fungal colonization efficiency without impairment of plant fitness. Concomitantly, ABA-deficient mutants of A. thaliana (aba1-6 and aba2-1) were less colonized, while plants exposed to moderate stress were more colonized than corresponding controls. Sustained exposure to ABA attenuated expression of transcription factors MYB51, MYB122 and WRKY33 in roots upon P. indica challenge or chitin treatment, and prevented an increase in camalexin content. The results indicate that ABA can strengthen the interaction with P. indica as a consequence of its impact on plant innate immunity. Consequently, ABA will be relevant for the establishment and outcome of the symbiosis under stress conditions. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

  16. Deficits in Sustained Attention and Changes in Dopaminergic Protein Levels following Exposure to Proton Radiation Are Related to Basal Dopaminergic Function.

    Directory of Open Access Journals (Sweden)

    Catherine M Davis

    Full Text Available The current report assessed the effects of low-level proton irradiation in inbred adult male Fischer 344 and Lewis rats performing an analog of the human Psychomotor Vigilance Test (PVT, commonly utilized as an object risk assessment tool to quantify fatigue and sustained attention in laboratory, clinical, and operational settings. These strains were used to determine if genetic differences in dopaminergic function would impact radiation-induced deficits in sustained attention. Exposure to head-only proton irradiation (25 or 100 cGy disrupted rPVT performance in a strain-specific manner, with 25 cGy-exposed Fischer 344 rats displaying the most severe deficits in sustained attention (i.e., decreased accuracy and increased premature responding; Lewis rats did not display behavioral deficits following radiation. Fischer 344 rats displayed greater tyrosine hydroxylase and dopamine transporter levels in the frontal cortex compared to the Lewis rats, even though radiation exposure increased both of these proteins in the Lewis rats only. Tyrosine hydroxylase was decreased in the parietal cortex of both rat strains following radiation exposure, regardless of proton dose. Strain-specific cytokine changes were also found in the frontal cortex, with the Lewis rats displaying increased levels of putative neurotrophic cytokines (e.g., CNTF. These data support the hypothesis that basal dopaminergic function impacts the severity of radiation-induced deficits in sustained attention.

  17. Switch from efavirenz to nevirapine, with full dose after one week: efficacy, safety and pharmacokinetics

    Directory of Open Access Journals (Sweden)

    A Curran

    2012-11-01

    Full Text Available Purpose of the study: In a prior study in patients switching from efavirenz (EFV due to neurologic side effects, we compared nevirapine (NVP full dose (200 mg twice-daily from the beginning to the standard dosage (200 mg once-daily for two weeks and then increase to 200 mg twice-daily [1]. Adequate concentrations were seen with the experimental arm but with a trend towards higher toxicity, with 25% of patients having to stop NVP due to rash or hepatitis. Our hypothesis is that NVP 200 mg daily for 1 week and then increasing it to 200 mg twice-daily will achieve adequate plasmatic concentrations with better tolerability. Methods: Patients taking an EFV-based regimen were offered to switch to NVP without changing the backbone. Patients received NVP 200 mg once-daily for 1 week and 200 mg twice-daily thereafter. EFV and NVP plasma trough levels were determined at days 0, 3, 7, 14, 30 and 90. Blood tests were performed at each visit and AE recorded. Chi-squared and Fisher exact test were used for qualitative variables and Mann-Whitney U and Wilcoxon signed rank tests for quantitative variables. Summary of results: 22 patients were included, 73% male, median age 48 years, median CD4 569 cell/mm3, all with CV <25 copies/mL and 41% had HCV co-infection. Reasons for switch were CNS symptoms in 50%, dyslipidemia in 46% and pregnancy desire in 4%. Backbone was TDF+FTC in 73% and ABC+3TC in 27%. Median NVP trough concentrations were 2.2, 2.7, 4.3, 4.5 and 5.5 µg/mL at 3, 7, 14, 30 and 90 days, respectively. 35% of patients had NVP plasma trough levels >3 µg/mL at day 7 and 88% at day 14. EFV concentrations were subtherapeutic (<1 µg/mL at day 7 and undetectable in all but one patient at day 14. There was a significant increase in GGT (+22 mg/dL, p=.013 and significant decreases in total cholesterol (−16 mg/dL, p=.035 and triglycerides (−50 mg/dL, p=.005 after 3 months. In the first month, two patients had to stop NVP due to rash and one due to rash

  18. Chronic administration of nevirapine during pregnancy: impact of pregnancy on pharmacokinetics.

    Science.gov (United States)

    Capparelli, E V; Aweeka, F; Hitti, J; Stek, A; Hu, C; Burchett, S K; Best, B; Smith, E; Read, J S; Watts, H; Nachman, S; Thorpe, E M; Spector, S A; Jimenez, E; Shearer, W T; Foca, M; Mirochnick, M

    2008-04-01

    To determine the impact of pregnancy on the pharmacokinetics (PK) of nevirapine (NVP) during chronic dosing in HIV-infected women and appropriate NVP dosing in this population. Twenty-six pregnant women participating in two open-label Pediatric AIDS Clinical Trials Group studies (P1022 and P1026S) were evaluated. Each patient received 200 mg NVP every 12 h and had PK evaluations during the second or third trimester; these evaluations were repeated postpartum. Paired maternal and cord blood NVP concentrations were collected at delivery in nine patients. Ante- and postpartum comparisons were made using paired t-tests and using a 'bioequivalence' approach to determine confidence interval (CI). The average NVP Area Under the Curve (AUC) was 56 +/- 13 mcg(*)h/mL antepartum and 61 +/- 15 mcg(*)h/mL postpartum. The typical parameters +/- standard error were apparent clearance (CL/F)=3.51 +/- 0.18 L/h and apparent volume of distribution (Vd/F)=121 +/- 19.8 L. There were no significant differences between antepartum and postpartum AUC or pre-dose concentrations. The AUC ratio was 0.90 with a 90% CI of the mean equal to 0.80-1.02. The median (+/- standard deviation) cord blood to maternal NVP concentration ratio was 0.91 +/- 0.90. Pregnancy does not alter NVP PK and the standard dose (200 mg every 12 h) is appropriate during pregnancy.

  19. The effect of malnutrition on the pharmacokinetics and virologic outcomes of lopinavir, efavirenz and nevirapine in food insecure HIV-infected children in Tororo, Uganda.

    Science.gov (United States)

    Bartelink, Imke H; Savic, Rada M; Dorsey, Grant; Ruel, Theodore; Gingrich, David; Scherpbier, Henriette J; Capparelli, Edmund; Jullien, Vincent; Young, Sera L; Achan, Jane; Plenty, Albert; Charlebois, Edwin; Kamya, Moses; Havlir, Diane; Aweeka, Francesca

    2015-03-01

    Malnutrition may impact the pharmacokinetics (PKs) of antiretroviral medications and virologic responses in HIV-infected children. The authors therefore evaluated the PK of nevirapine (NVP), efavirenz (EFV) and lopinavir (LPV) in associations with nutritional status in a cohort of HIV-infected Ugandan children. Sparse dried blood spot samples from Ugandan children were used to estimate plasma concentrations. Historical PK data from children from 3 resource-rich countries (RRC) were utilized to develop the PK models. Concentrations in 330 dried blood spot from 163 Ugandan children aged 0.7-7 years were analyzed in reference to plasma PK data (1189 samples) from 204 children from RRC aged 0.5-12 years. Among Ugandan children, 48% was malnourished (underweight, thin or stunted). Compared to RRC, Ugandan children exhibited reduced bioavailability of EFV and LPV; 11% (P=0.045) and 18% (P=0.008), respectively. In contrast, NVP bioavailability was 46% higher in Ugandan children (PChildren receiving LPV, EFV or NVP had comparable risk of virologic failure. Among children on NVP, low height and weight for age Z scores were associated with reduced risk of virologic failure (P=0.034, P=0.068, respectively). Ugandan children demonstrated lower EFV and LPV and higher NVP exposure compared to children in RRC, perhaps reflecting the consequence of malnutrition on bioavailability. In children receiving NVP, the relation between exposure, malnutrition and outcome turned out to be marginally significant. Further investigations are warranted using more intensive PK measurements and adequate adherence assessments, to further assess causes of virologic failure in Ugandan children.

  20. Children's Exposure to Sustainability Practices during the Transition from Preschool into School and Their Learning and Socioemotional Development

    Science.gov (United States)

    Benner, Aprile D.; Thornton, Anna; Crosnoe, Robert

    2017-01-01

    Evidence that the learning gains of preschool fade as children transition into elementary school has led to increased efforts to sustain preschool advantages during this key transitional period. This study explores whether the observed benefits of sustainability practices for a range of child outcomes are explained and/or moderated by family and…

  1. Switching to Efavirenz Versus Remaining on Ritonavir-boosted Lopinavir in Human Immunodeficiency Virus-infected Children Exposed to Nevirapine: Long-term Outcomes of a Randomized Trial.

    Science.gov (United States)

    Murnane, Pamela M; Strehlau, Renate; Shiau, Stephanie; Patel, Faeezah; Mbete, Ndileke; Hunt, Gillian; Abrams, Elaine J; Coovadia, Ashraf; Kuhn, Louise

    2017-08-01

    We previously demonstrated the noninferiority of switching to efavirenz (EFV) versus remaining on ritonavir-boosted lopinavir (LPV/r) for virologic control in children infected with human immunodeficiency virus (HIV) and exposed to nevirapine (NVP) for prevention of mother-to-child transmission. Here we assess outcomes up to 4 years post-randomization. From 2010-2013, 298 NVP-exposed HIV-infected children ≥3 years of age were randomized to switch to EFV or remain on LPV/r in Johannesburg, South Africa (Clinicaltrials.gov NCT01146873). After trial completion, participants were invited to enroll into observational follow-up. We compared HIV RNA levels, CD4 counts and percentages, lipids, and growth across groups through four years post-randomization. HIV RNA levels 51-1000 copies/mL were less frequently observed in the EFV group than the LPV/r group (odds ratio [OR] 0.67, 95% confidence interval [CI]: 0.51-0.88, P = .004), as was HIV RNA >1000 copies/mL (OR 0.52 95% CI: 0.28-0.98, P = .04). The probability of confirmed HIV RNA >1000 copies/mL by 48 months was 0.07 and 0.12 in the EFV and LPV/r groups, respectively (P = .21). Children randomized to EFV had a reduced risk of elevated total cholesterol (OR 0.45 95% CI: 0.27-0.75, P = .002) and a reduced risk of abnormal triglycerides (OR 0.42, 95% CI 0.29-0.62, P switching virologically suppressed NVP-exposed HIV-infected children ≥3 years of age from LPV/r to EFV are sustained long-term. This approach has several advantages, including improved palatability, reduced metabolic toxicity, simplified cotreatment for tuberculosis, and preservation of second line options. NCT01146873.

  2. Sustained Interleukin-1β Exposure Modulates Multiple Steps in Glucocorticoid Receptor Signaling, Promoting Split-Resistance to the Transactivation of Prominent Anti-Inflammatory Genes by Glucocorticoids

    Directory of Open Access Journals (Sweden)

    Pedro Escoll

    2015-01-01

    Full Text Available Clinical treatment with glucocorticoids (GC can be complicated by cytokine-induced glucocorticoid low-responsiveness (GC-resistance, GCR, a condition associated with a homogeneous reduction in the expression of GC-receptor- (GR- driven anti-inflammatory genes. However, GR level and phosphorylation changes modify the expression of individual GR-responsive genes differently. As sustained IL-1β exposure is key in the pathogenesis of several major diseases with prevalent GCR, we examined GR signaling and the mRNA expression of six GR-driven genes in cells cultured in IL-1β and afterwards challenged with GC. After a GC challenge, sustained IL-1β exposure reduced the cytoplasmic GR level, GRSer203 and GRSer211 phosphorylation, and GR nuclear translocation and led to selective GCR in the expression of the studied genes. Compared to GC alone, in a broad range of GC doses plus sustained IL-1β, FKBP51 mRNA expression was reduced by 1/3, TTP by 2/3, and IRF8 was completely knocked down. In contrast, high GC doses did not change the expression of GILZ and DUSP1, while IGFBP1 was increased by 5-fold. These effects were cytokine-selective, IL-1β dose- and IL-1R1-dependent. The integrated gain and loss of gene functions in the “split GCR” model may provide target cells with a survival advantage by conferring resistance to apoptosis, chemotherapy, and GC.

  3. Risk of discontinuation of nevirapine due to toxicities in antiretroviral-naive and -experienced HIV-infected patients with high and low CD4+ T-cell counts

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Staszewski, Schlomo; Weber, Rainer

    2007-01-01

    It is unknown whether the increased risk of toxicities in antiretroviral-naive HIV-infected patients initiating nevirapine-based (NVPc) combination antiretroviral therapy (cART) with high CD4+ T-cell counts is also observed when NVPc is initiated in cARTexperienced patients.......It is unknown whether the increased risk of toxicities in antiretroviral-naive HIV-infected patients initiating nevirapine-based (NVPc) combination antiretroviral therapy (cART) with high CD4+ T-cell counts is also observed when NVPc is initiated in cARTexperienced patients....

  4. Nevirapine Loaded Core Shell Gold Nanoparticles by Double Emulsion Solvent Evaporation: In vitro and In vivo Evaluation.

    Science.gov (United States)

    Dalvi, Bhagyashree R; Siddiqui, Ejaz A; Syed, Asad S; Velhal, Shilpa M; Ahmad, Absar; Bandivdekar, Atmaram B; Devarajan, Padma V

    2016-01-01

    HIV/AIDS is a macrophage resident infection localized in the reticuloendothelial system and remote locations of brain and bone marrow. We present core shell nanoparticles of gold(AuNPs) and nevirapine(NVP) for targeted delivery to the multiple HIV reservoirs. The aim of the study was to design core shell NVP loaded AuNPs with high drug loading and to evaluate biodistribution of the nanoparticles in possible HIV reservoirs in vivo. A specific objective was to assess the possible synergy of AuNPs with NVP on anti-HIV activity in vitro. Core shell nanoparticles were prepared by double emulsion solvent evaporation method and characterized. Glyceryl monostearate-nevirapine-gold nanoparticles(GMS-NVP-AuNPs) revealed high entrapment efficiency (>70%), high loading (~40%), particle size anti-HIV activity. The superior anti-HIV activity in vitro coupled with extensive localization of the nanoparticles in multiple HIV reservoirs suggests great promise of the core shell GMS-NVP-AuNPs for improved therapy of HIV.

  5. Sustained impairment of respiratory function and swim performance following acute oil exposure in a coastal marine fish.

    Science.gov (United States)

    Johansen, J L; Esbaugh, A J

    2017-06-01

    Acute exposure to crude oil polycyclic aromatic hydrocarbons (PAH) can severely impair cardiorespiratory function and swim performance of larval fish; however, the effects of acute oil exposure on later life stages and the capacity for subsequent recovery is less clear. Red drum (Sciaenops ocellatus) is an economically important apex predator native to the Gulf of Mexico, which was directly exposed to the 2010 Deep Water Horizon (DWH) oil spill. Here we examine impact and recovery of young adult red drum from exposure to concentrations of 0, 4.1, and 12.1μgL(-1) ΣPAH50 naturally weathered oil-water accommodated fractions (geometric mean), which are well within the range of concentrations measured during the DWH incident. We focused on aerobic scope (ASc), burst- and critical swimming speeds (Uburst and Ucrit), cost of transport (COT), as well as the capacity to repay oxygen debt following exhaustive exercise (EPOC), which are critical parameters for success of all life stages of fishes. A 24h acute exposure to 4.1μgL(-1) ΣPAH caused a significant 9.7 and 12.6% reduction of Uburst and Ucrit respectively, but no change in ASc, COT or EPOC, highlighting a decoupled effect on the respiratory and swimming systems. A higher exposure concentration, 12.1μgL(-1) ΣPAH, caused an 8.6 and 8.4% impairment of Uburst and Ucrit, as well as an 18.4% reduction in ASc. These impairments persisted six weeks post-exposure, suggesting that recorded impacts are entrenched. Large predatory fishes are critically dependent on the cardiorespiratory and swimming systems for ecological fitness, and long-term impairment of performance due to acute oil exposure suggests that even acute exposure events may have long lasting impacts on the ecological fitness of affected populations. Copyright © 2017. Published by Elsevier B.V.

  6. Intermittent hypobaric hypoxia exposure does not cause sustained alterations in autonomic control of blood pressure in young athletes.

    NARCIS (Netherlands)

    Fu, Q.; Townsend, N.E.; Shiller, S.M.; Martini, E.R.; Okazaki, K.; Shibata, S.; Truijens, M.J.; Rodriquez, F.A.; Gore, C.J.; Stray-Gundersen, J.; Levine, B.D.

    2007-01-01

    Intermittent hypoxia (IH), which refers to the discontinuous use of hypoxia to reproduce some key features of altitude acclimatization, is commonly used in athletes to improve their performance. However, variations of IH are also used as a model for sleep apnea, causing sustained sympathoexcitation

  7. A comparison of the long-term durability of nevirapine, efavirenz and lopinavir in routine clinical practice in Europe: a EuroSIDA study

    DEFF Research Database (Denmark)

    Reekie, J; Reiss, P; Ledergerber, B

    2011-01-01

    The durability of combination antiretroviral therapy (cART) regimens can be measured as time to discontinuation because of toxicity or treatment failure, development of clinical disease or serious long-term adverse events. The aim of this analysis was to compare the durability of nevirapine, efav...

  8. Incidence and risk factors of skin rashes and hepatotoxicity in HIV-infected patients receiving nevirapine-containing combination antiretroviral therapy in Taiwan

    Directory of Open Access Journals (Sweden)

    Yu-Tzu Tseng

    2014-12-01

    Conclusions: Abnormal liver function at baseline was significantly associated with skin rashes, while a higher CD4 count and the concurrent use of trimethoprim/sulfamethoxazole were associated with hepatotoxicity after the initiation of nevirapine-containing cART in HIV-infected Taiwanese patients.

  9. Pharmacokinetics and 48-week efficacy of nevirapine: 400 mg versus 600 mg per day in HIV-tuberculosis coinfection receiving rifampicin.

    NARCIS (Netherlands)

    Avihingsanon, A.; Manosuthi, W.; Kantipong, P.; Chuchotaworn, C.; Moolphate, S.; Sakornjun, W.; Gorowara, M.; Yamada, N.; Yanai, H.; Mitarai, S.; Ishikawa, N.; Cooper, D.A.; Phanuphak, P.; Burger, D.; Ruxrungtham, K.

    2008-01-01

    BACKGROUND: We aim here to determine the appropriate dose of nevirapine (NVP) in Thai HIV-tuberculosis (TB)-coinfected patients receiving rifampicin. METHODS: Thirty-two HIV-infected adults with CD4+ T-cell counts <200 cells/mm3 and active TB, receiving rifampicin for 2-6 weeks were randomized to

  10. Strategies for nevirapine initiation in HIV-infected children taking pediatric fixed-dose combination "baby pills" in Zambia: a randomized controlled trial.

    NARCIS (Netherlands)

    Mulenga, V.; Cook, A.; Walker, A.S.; Kabamba, D.; Chijoka, C.; Ferrier, A.; Kalengo, C.; Kityo, C.; Kankasa, C.; Burger, D.M.; Thomason, M.; Chintu, C.; Gibb, D.M.

    2010-01-01

    BACKGROUND: Fixed-dose combination scored dispersible stavudine, lamivudine, and nevirapine minitablets (Triomune Baby and Junior; Cipla Ltd) are simpler and cheaper than liquid formulations and have correct dose ratios for human immunodeficiency virus-infected children. However, they cannot be used

  11. Development of Nevirapine Resistance in Children Exposed to the Prevention of Mother-to-Child HIV-1 Transmission Programme in Maputo, Mozambique

    Science.gov (United States)

    Antunes, Francisco; Zindoga, Pereira; Gomes, Perpétua; Augusto, Orvalho; Mahumane, Isabel; Veloso, Luís; Valadas, Emília; Camacho, Ricardo

    2015-01-01

    Background Single-dose nevirapine (sd-NVP) has been the main option for prevention of mother-to-child transmission (PMTCT) of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM) in the context of PMTCT. Objectives To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique. Methods One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012) at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq). Sequencing was performed with ABI 3100 (Applied Biosystems). Logistic regression modelling was undertaken to identify the factors associated with NVP RAM. Results Seventy-nine children had their samples genotyped. Their median age was 7.0 (3–12) months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs) for PMTCT. ARV RAM were detected in 43 (54.4%) of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16) and Y181C (n = 15). NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93–186.34) and with mother’s CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02–9.32). In the multivariable analysis the mother’s exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33–253.66). Conclusions We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers’ exposure to PMTCT significantly increased the risk of NVP RAM. PMID:26161559

  12. Development of Nevirapine Resistance in Children Exposed to the Prevention of Mother-to-Child HIV-1 Transmission Programme in Maputo, Mozambique.

    Directory of Open Access Journals (Sweden)

    Francisco Antunes

    Full Text Available Single-dose nevirapine (sd-NVP has been the main option for prevention of mother-to-child transmission (PMTCT of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM in the context of PMTCT.To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique.One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012 at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq. Sequencing was performed with ABI 3100 (Applied Biosystems. Logistic regression modelling was undertaken to identify the factors associated with NVP RAM.Seventy-nine children had their samples genotyped. Their median age was 7.0 (3-12 months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs for PMTCT. ARV RAM were detected in 43 (54.4% of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16 and Y181C (n = 15. NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93-186.34 and with mother's CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02-9.32. In the multivariable analysis the mother's exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33-253.66.We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers' exposure to PMTCT significantly increased the risk of NVP RAM.

  13. Safety and efficacy of once-daily nevirapine dosing: a multicohort study.

    Science.gov (United States)

    Calmy, Alexandra; Vallier, Nathalie; Nguyen, Alain; Lange, Joep Ma; Battegay, Manuel; de Wolf, Frank; Reiss, Peter; Lima, Viviane D; Hirschel, Bernard; Hogg, Robert S; Yip, Benita; Montaner, Julio S G; Wit, Ferdinand W

    2009-01-01

    Nevirapine (NVP) is often prescribed once daily in clinical practice in combination with a once daily nucleoside backbone. We investigated the relationship of NVP dosing with safety and efficacy. Patients from the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort study, Canadian HAART Observational Medical Evaluation and Research (HOMER) cohort and Swiss HIV Cohort Study (SHCS) using NVP-based combination therapy either once daily or twice daily were included. Risk factors for discontinuing NVP because of hypersensitivity reactions (HSRs) were investigated using multivariate logistic regression. Risk factors for virological failure 96 weeks after NVP initiation were identified using logistic regression and Cox models. Of 5,636 patients (774 once daily and 4,862 twice daily), 268 (4.8%) discontinued NVP because of HSR between 2 and 18 weeks. Logistic regression showed that, compared with patients with detectable HIV type-1 (HIV-1) RNA starting twice-daily NVP, there was a significantly higher risk of discontinuation of once-daily NVP because of HSR in patients with detectable HIV-1 RNA at the start of NVP (odds ratio [OR] 1.52; P=0.04), whereas the risk was actually significantly lower in patients starting once-daily NVP with undetectable HIV-1 RNA (OR 0.44; P=0.04). Cox models showed that risk of virological failure was not different for twice- versus once-daily NVP in treatment-naive patients (twice-daily versus once-daily hazard ratio [HR] 1.01; P=0.95), treatment-experienced patients experiencing treatment failure (twice-daily versus once-daily HR 1.22; P=0.30) or patients with undetectable HIV-1 RNA simplifying treatment with NVP (twice-daily versus once-daily HR 1.29; P=0.30). Initiation of a once-daily NVP-based regimen in patients with suppressed viraemia carries a low risk of treatment-limiting HSR. Once- or twice-daily NVP-based regimens appear to have similar antiretroviral efficacy.

  14. Sex differences in apolipoprotein A1 and nevirapine-induced toxicity

    Directory of Open Access Journals (Sweden)

    Aline Marinho

    2014-11-01

    Full Text Available Nevirapine (NVP is associated with severe liver and skin toxicity through sulfotransferase (SULT bioactivation of the phase I metabolite 12-hydroxy-NVP [1–3]. The female sex, a well-known risk factor for NVP-induced toxicity, is associated with higher SULT expression (4 and lower plasma levels of 12-hydroxy-NVP [3]. Interestingly, apolipoprotein A1 (ApoA1 increases SULT2B1 activity and ApoA1 synthesis is increased by NVP [5, 6]. Herein, we explore the effect of ApoA1 levels on NVP metabolism and liver function. The study protocol was firstly approved by the hospitals’ Ethics Committees. All included individuals were HIV-infected patients treated with NVP for at least one month. The plasma concentrations of NVP and its phase I metabolites were quantified by HPLC [7]. ApoA1 levels were assessed by an immunoturbidimetric assay. Forty-nine HIV-infected patients on NVP were included (53% men, 59% Caucasian. NVP plasma levels were correlated with HDL-cholesterol (Spearman r=0.2631; p=0.0441 and ApoA1 (Spearman r=0.3907; p=0.0115. Women had higher ApoA1 levels than men (Student's t Test; p=0.0051. In both sexes, 12-hydroxy-NVP levels were negatively correlated with ApoA1 (male: Spearman r=−0.3810; p=0.0499 female: Spearman r=−0.5944; p=0.0415. In men, ApoA1 was positively correlated with aspartate aminotransferase (AST, Spearman r=0.5507; p=0.0413, while in women ApoA1 was associated (Spearman r=0.6408; p=0.0056 with alanine aminotransferase (ALT. These results show sex differences in NVP-induced ApoA1 synthesis. The higher ApoA1 levels in women might stabilize SULT2B1 [6]. This would explain the lower levels of 12-hydroxy-NVP [3] and the higher hepatotoxicity found in women, due to increased sulfonation of this metabolite. These data support a role for ApoA1 in the sex dimorphic mechanism leading to NVP-induced toxicity.

  15. Bioactivation of nevirapine to a reactive quinone methide: implications for liver injury.

    Science.gov (United States)

    Sharma, Amy M; Li, Yan; Novalen, Maria; Hayes, M Anthony; Uetrecht, Jack

    2012-08-20

    Nevirapine (NVP) treatment is associated with a significant incidence of liver injury. We developed an anti-NVP antiserum to determine the presence and pattern of covalent binding of NVP to mouse, rat, and human hepatic tissues. Covalent binding to hepatic microsomes from male C57BL/6 mice and male Brown Norway rats was detected on Western blots; the major protein had a mass of ~55 kDa. Incubation of NVP with rat CYP3A1 and 2C11 or human CYP3A4 also led to covalent binding. Treatment of female Brown Norway rats or C57BL/6 mice with NVP led to extensive covalent binding to a wide range of proteins. Co-treatment with 1-aminobenzotriazole dramatically changed the pattern of binding. The covalent binding of 12-hydroxy-NVP, the pathway that leads to a skin rash, was much less than that of NVP, both in vitro and in vivo. An analogue of NVP in which the methyl hydrogens were replaced by deuterium also produced less covalent binding than NVP. These data provide strong evidence that covalent binding of NVP in the liver is due to a quinone methide formed by oxidation of the methyl group. Attempts were made to develop an animal model of NVP-induced liver injury in mice. There was a small increase in ALT in some NVP-treated male C57BL/6 mice at 3 weeks that resolved despite continued treatment. Male Cbl-b(-/-) mice dosed with NVP had an increase in ALT of >200 U/L, which also resolved despite continued treatment. Liver histology in these animals showed focal areas of complete necrosis, while most of the liver appeared normal. This is a different pattern from the histology of NVP-induced liver injury in humans. This is the first study to report hepatic covalent binding of NVP and also liver injury in mice. It is likely that the quinone methide metabolite is responsible for NVP-induced liver injury.

  16. Sustained expression of CYPs and DNA adduct accumulation with continuous exposure to PCB126 and PCB153 through a new delivery method: Polymeric implants

    Directory of Open Access Journals (Sweden)

    Farrukh Aqil

    2014-01-01

    Full Text Available A new delivery method via polymeric implants was used for continuous exposure to PCBs. Female Sprague-Dawley rats received subcutaneous polymeric implants containing PCB126 (0.15% load, PCB153 (5% load, or both, for up to 45 d and release kinetics and tissue distribution were measured. PCB153 tissue levels on day 15 were readily detected in lung, liver, mammary and serum, with highest levels in the mammary tissue. PCB126 was detected only in liver and mammary tissues. However, a completely different pharmacokinetics was observed on co-exposure of PCB153 and PCB126, with a 1.8-fold higher levels of PCB153 in the liver whereas a 1.7-fold lower levels in the mammary tissue. PCB126 and PCB153 caused an increase in expression of key PCB-inducible enzymes, CYP 1A1/2 and 2B1/2, respectively. Serum and liver activities of the antioxidant enzymes, PON1 and PON3, and AhR transcription were also significantly increased by PCB126. 32P-postlabeling for polar and lipophilic DNA-adducts showed significant quantitative differences: PCB126 increased 8-oxodG, an oxidative DNA lesion, in liver and lung tissues. Adduct levels in the liver remained upregulated up to 45 d, while some lung DNA adducts declined. This is the first demonstration that continuous low-dose exposure to PCBs via implants can produce sustained tissue levels leading to the accumulation of DNA-adducts in target tissue and induction of indicator enzymes. Collectively, these data demonstrate that this exposure model is a promising tool for long-term exposure studies.

  17. Associations between ABCB1, CYP2A6, CYP2B6, CYP2D6, and CYP3A5 alleles in relation to efavirenz and nevirapine pharmacokinetics in HIV-infected individuals.

    NARCIS (Netherlands)

    Heil, S.G.; Ende, M.E. van der; Schenk, P.W.; Heiden, I. van der; Lindemans, J.; Burger, D.M.; Schaik, R.H. van

    2012-01-01

    BACKGROUND: Human immunodeficiency virus (HIV)-infected individuals show large interindividual variation in response to antiretroviral therapy. Efavirenz (EFV) and nevirapine (NVP) are nonnucleoside reverse transcriptase inhibitors, which are prescribed in combination with other antiretroviral

  18. Lipid-based nutrient supplements do not affect efavirenz but lower plasma nevirapine concentrations in Ethiopian adult HIV patients

    DEFF Research Database (Denmark)

    Abdissa, A; Olsen, Mette Frahm; Yilma, D

    2015-01-01

    OBJECTIVES: Lipid-based nutrient supplements (LNSs) are increasingly used in HIV programmes in resource-limited settings. However, the possible effects of LNSs on the plasma concentrations of antiretroviral drugs have not been assessed. Here, we aimed to assess the effects of LNSs on plasma...... efavirenz and nevirapine trough concentrations in Ethiopian adult HIV-infected patients. METHODS: The effects of LNSs were studied in adults initiating antiretroviral therapy (ART) in a randomized trial. Patients with body mass index (BMI) > 17 kg/m(2) (n = 282) received daily supplementation of an LNS.......9; -0.9 μg/mL; P = 0.01), respectively, compared with the group not receiving supplements. There were no differences between groups with respect to efavirenz plasma concentrations. The CYP2B6 516 G>T polymorphism was associated with a 5 μg/mL higher plasma efavirenz concentration compared with the wild...

  19. Shared peptide binding of HLA Class I and II alleles associate with cutaneous nevirapine hypersensitivity and identify novel risk alleles

    DEFF Research Database (Denmark)

    Pavlos, Rebecca; McKinnon, Elizabeth J.; Ostrov, David A.

    2017-01-01

    Genes of the human leukocyte antigen (HLA) system encode cell-surface proteins involved in regulation of immune responses, and the way drugs interact with the HLA peptide binding groove is important in the immunopathogenesis of T-cell mediated drug hypersensitivity syndromes. Nevirapine (NVP......), is an HIV-1 antiretroviral with treatment-limiting hypersensitivity reactions (HSRs) associated with multiple class I and II HLA alleles. Here we utilize a novel analytical approach to explore these multi-allelic associations by systematically examining HLA molecules for similarities in peptide binding...... specificities and binding pocket structure. We demonstrate that primary predisposition to cutaneous NVP HSR, seen across ancestral groups, can be attributed to a cluster of HLA-C alleles sharing a common binding groove F pocket with HLA-C*04:01. An independent association with a group of class II alleles which...

  20. Possible promotion of neuronal differentiation in fetal rat brain neural progenitor cells after sustained exposure to static magnetism.

    Science.gov (United States)

    Nakamichi, Noritaka; Ishioka, Yukichi; Hirai, Takao; Ozawa, Shusuke; Tachibana, Masaki; Nakamura, Nobuhiro; Takarada, Takeshi; Yoneda, Yukio

    2009-08-15

    We have previously shown significant potentiation of Ca(2+) influx mediated by N-methyl-D-aspartate receptors, along with decreased microtubules-associated protein-2 (MAP2) expression, in hippocampal neurons cultured under static magnetism without cell death. In this study, we investigated the effects of static magnetism on the functionality of neural progenitor cells endowed to proliferate for self-replication and differentiate into neuronal, astroglial, and oligodendroglial lineages. Neural progenitor cells were isolated from embryonic rat neocortex and hippocampus, followed by culture under static magnetism at 100 mT and subsequent determination of the number of cells immunoreactive for a marker protein of particular progeny lineages. Static magnetism not only significantly decreased proliferation of neural progenitor cells without affecting cell viability, but also promoted differentiation into cells immunoreactive for MAP2 with a concomitant decrease in that for an astroglial marker, irrespective of the presence of differentiation inducers. In neural progenitors cultured under static magnetism, a significant increase was seen in mRNA expression of several activator-type proneural genes, such as Mash1, Math1, and Math3, together with decreased mRNA expression of the repressor type Hes5. These results suggest that sustained static magnetism could suppress proliferation for self-renewal and facilitate differentiation into neurons through promoted expression of activator-type proneural genes by progenitor cells in fetal rat brain.

  1. A randomized trial comparing initial HAART regimens of nelfinavir/nevirapine and ritonavir/saquinavir in combination with two nucleoside reverse transcriptase inhibitors

    DEFF Research Database (Denmark)

    Kirk, Ole; Lundgren, Jens D; Pedersen, Court

    2003-01-01

    BACKGROUND: A triple-class HAART regimen may be associated with a better virological effect than conventional regimens, but may also lead to toxicity and more profound resistance. METHODS: Randomized, controlled, open-label trial of 233 protease inhibitor- and non-nucleoside reverse transcriptase...... inhibitor-naive HIV-infected patients allocated to a regimen of nelfinavir and nevirapine (1250/200 mg twice daily; n = 118) or ritonavir and saquinavir (400/400 mg twice daily; n = 115), both in combination with two nucleoside reverse transcriptase inhibitors. The primary end-point was HIV RNA ....037. CONCLUSION: A regimen of nelfinavir/nevirapine had a favourable virological effect and tolerability over a 48-week period compared with ritonavir/saquinavir, when administered in combination with two nucleoside reverse transcriptase inhibitors. However, more extensive follow-up is required to determine...

  2. Nevirapine, Sodium Concentration and HIV-1 RNA in Breast Milk and Plasma among HIV-Infected Women Receiving Short-Course Antiretroviral Prophylaxis

    Science.gov (United States)

    Salado-Rasmussen, Kirsten; Theilgaard, Zahra P.; Chiduo, Mercy G.; Bygbjerg, Ib C.; Gerstoft, Jan; Lüneborg-Nielsen, Margrethe; Lemnge, Martha; Katzenstein, Terese L.

    2015-01-01

    Introduction Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis. Objective To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma and breast milk after intrapartum single-dose nevirapine combined with either 1-week tail of Combivir (zidovudine/lamivudine) or single-dose Truvada (tenofovir/emtricitabine). Methods Maternal plasma and bilateral breast milk samples were collected between April 2008 and April 2011 at 1, 4 and 6 weeks postpartum from HIV-infected Tanzanian women. Moreover, plasma samples were collected at delivery from mother and infant. Results HIV-1 RNA was quantified in 1,212 breast milk samples from 273 women. At delivery, 96% of the women and 99% of the infants had detectable nevirapine in plasma with a median (interquartile range, IQR) of 1.5 μg/mL (0.75–2.20 μg/mL) and 1.04 μg/mL (0.39–1.71 μg/mL), respectively (P Subclinical mastitis was detected in 67% of the women at some time during 6 weeks, and in 38% of the breast milk samples. Breast milk samples with subclinical mastitis had significantly higher HIV-1 RNA at 1, 4 and 6 weeks (all P < 0.05). Conclusion After short-course antiretroviral prophylaxis, nevirapine was detectable in most infant cord blood samples and the concentration in maternal plasma and breast milk was high through week 1 accompanied by suppressed HIV-1 RNA in plasma and breast milk. PMID:25812161

  3. Long-term efficacy and safety of protease inhibitor switching to nevirapine in HIV-infected patients with undetectable virus load.

    Science.gov (United States)

    Gil, Paloma; de Górgolas, Miguel; Estrada, Vicente; Arranz, Alberto; Rivas, Pablo; Yera, Carmen; García, Rosa; Granizo, Juan J; Fernández-Guerrero, Manuel

    2004-10-01

    Simplified highly active antiretroviral therapy (HAART) regimens are becoming widely used, particularly as a result of the side effects of and difficult compliance with protease inhibitor (PI) therapy. However, the long-term efficacy of HAART has not been properly assessed. We performed a prospective study of 110 patients infected with human immunodeficiency virus type 1 (HIV-1) with undetectable virus load who discontinued PI therapy and initiated therapy with nevirapine without changing nucleoside analogues. Reasons for switching were treatment simplification (45%), lipodystrophy (24%), renal problems (23%), and dyslipidemia (8%). HIV-1 load, CD4 cell count, and fasting biochemistry profiles were performed at the time of switching (baseline) and every 3-4 months thereafter. The aim of the study was to evaluate the long-term efficacy and safety of this combination. Sixty-eight patients (61.8%) had a duration of follow-up of 3 years. The mean increase in the CD4 cell count after 3 years was 90 cells/microL (13.8% from baseline). Virus loads remained undetectable in all patients but 9 (8.2%). Triglyceride levels dramatically improved at 12 months (a 75% decrease; P<.02) and remained statistically significant over time (P<.04). The same occurred with serum cholesterol levels: there was an initial reduction of 25% (P<.02) and at the end of the follow-up period (P<.015). However, at the long-term evaluation, complete normalization of mean serum cholesterol and triglyceride levels could not be achieved. Sixteen patients (14.5%) had to stop therapy as a result of nevirapine-associated side effects. The switching of a PI to nevirapine is a safe and well-tolerated option for maintaining long-term virological suppression and immunological control. Three years after starting nevirapine therapy, rates of hypercholesterolemia and hypertriglyceridemia improved, although normal cholesterol and triglyceride values were not achieved.

  4. QbD-oriented development and validation of a bioanalytical method for nevirapine with enhanced liquid-liquid extraction and chromatographic separation.

    Science.gov (United States)

    Beg, Sarwar; Chaudhary, Vandna; Sharma, Gajanand; Garg, Babita; Panda, Sagar Suman; Singh, Bhupinder

    2016-06-01

    The present studies describe the systematic quality by design (QbD)-oriented development and validation of a simple, rapid, sensitive and cost-effective reversed-phase HPLC bioanalytical method for nevirapine in rat plasma. Chromatographic separation was carried out on a C18 column using isocratic 68:9:23% v/v elution of methanol, acetonitrile and water (pH 3, adjusted by orthophosphoric acid) at a flow rate of 1.0 mL/min using UV detection at 230 nm. A Box-Behnken design was applied for chromatographic method optimization taking mobile phase ratio, pH and flow rate as the critical method parameters (CMPs) from screening studies. Peak area, retention time, theoretical plates and peak tailing were measured as the critical analytical attributes (CAAs). Further, the bioanalytical liquid-liquid extraction process was optimized using an optimal design by selecting extraction time, centrifugation speed and temperature as the CMPs for percentage recovery of nevirapine as the CAA. The search for an optimum chromatographic solution was conducted through numerical desirability function. Validation studies performed as per the US Food and Drug Administration requirements revealed results within the acceptance limit. In a nutshell, the studies successfully demonstrate the utility of analytical QbD approach for the rational development of a bioanalytical method with enhanced chromatographic separation and recovery of nevirapine in rat plasma. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Missed opportunities for participation in prevention of mother to child transmission programmes: Simplicity of nevirapine does not necessarily lead to optimal uptake, a qualitative study

    Directory of Open Access Journals (Sweden)

    Chopra Mickey

    2007-11-01

    Full Text Available Abstract Background The objective of this study was to examine missed opportunities for participation in a prevention of mother-to-child transmission (PMTCT programme in three sites in South Africa. A rapid anthropological assessment was used to collect in-depth data from 58 HIV-positive women who were enrolled in a larger cohort study to assess mother-to-child HIV transmission. Semi-structured interviews were conducted with the women in order to gain an understanding of their experiences of antenatal care and to identify missed opportunities for participation in PMTCT. Results 15 women actually missed their nevirapine not because of stigma and ignorance but because of health systems failures. Six were not tested for HIV during antenatal care. Two were tested but did not receive their results. Seven were tested and received their results, but did not receive nevirapine. Health Systems failure for these programme leakages ranged from non-availability of counselors, supplies such as HIV test kits, consent forms, health staff giving the women incorrect instructions about when to take the tablet and health staff not supplying the women with the tablet to take. Conclusion HIV testing enables access to PMTCT interventions and should therefore be strengthened. The single dose nevirapine regimen is simple to implement but the all or nothing nature of the regimen may result in many missed opportunities. A short course dual or triple drug regimen could increase the effectiveness of PMTCT programmes.

  6. Inhibition of cytochrome P450 3A enzyme by Millettia aboensis: its effect on the pharmacokinetic properties of efavirenz and nevirapine

    Directory of Open Access Journals (Sweden)

    Sunday O. Nduka

    Full Text Available ABSTRACT The chronic and comorbid nature of HIV infection necessitate the use of multiple drugs including herbs to relieve symptoms with a possible increase in herb–drug interaction cases. This study was designed to evaluate the effect of Millettia aboensis (Hook. f. Baker, Fabaceae, on cytochrome P450 3A isoenzyme and the influence of this effect on the bioavailability of two antiretroviral agents. In vitro effect of ethanol extract of M. aboensis on intestinal and liver microsomes extracted from female rats was assessed using erythromycin-N-demethylation assay method while in vivo effects were determined by estimating simvastatin plasma concentrations in rats. The effect of the extract on pharmacokinetic parameters of orally administered efavirenz (25 mg/kg and nevirapine (20 mg/kg was determined in rats divided into groups (n = 5. Plasma drug concentrations were assayed using HPLC and pharmacokinetic parameters determined through a non-compartmental analysis as implemented in WinNonlin pharmacokinetic program. The extract inhibited both intestinal and liver microsomal cytochrome P450 3A isoenzyme activities in vitro and enhanced simvastatin absorption in vivo with possible inhibition of metabolizing enzymes as indicated by significant (p 0.05 changes in the pharmacokinetic parameters of efavirenz and nevirapine. HPLC fingerprinting indicated the presence of quercetin and kaempferol in the extract. These findings revealed M. aboensis as an inhibitor of cytochrome P450 3A enzyme but, with no significant effect on the bioavailability of orally administered nevirapine and efavirenz.

  7. N348I in the connection domain of HIV-1 reverse transcriptase confers zidovudine and nevirapine resistance.

    Directory of Open Access Journals (Sweden)

    Soo-Huey Yap

    2007-12-01

    Full Text Available The catalytically active 66-kDa subunit of the human immunodeficiency virus type 1 (HIV-1 reverse transcriptase (RT consists of DNA polymerase, connection, and ribonuclease H (RNase H domains. Almost all known RT inhibitor resistance mutations identified to date map to the polymerase domain of the enzyme. However, the connection and RNase H domains are not routinely analysed in clinical samples and none of the genotyping assays available for patient management sequence the entire RT coding region. The British Columbia Centre for Excellence in HIV/AIDS (the Centre genotypes clinical isolates up to codon 400 in RT, and our retrospective statistical analyses of the Centre's database have identified an N348I mutation in the RT connection domain in treatment-experienced individuals. The objective of this multidisciplinary study was to establish the in vivo relevance of this mutation and its role in drug resistance.The prevalence of N348I in clinical isolates, the time taken for it to emerge under selective drug pressure, and its association with changes in viral load, specific drug treatment, and known drug resistance mutations was analysed from genotypes, viral loads, and treatment histories from the Centre's database. N348I increased in prevalence from below 1% in 368 treatment-naïve individuals to 12.1% in 1,009 treatment-experienced patients (p = 7.7 x 10(-12. N348I appeared early in therapy and was highly associated with thymidine analogue mutations (TAMs M41L and T215Y/F (p < 0.001, the lamivudine resistance mutations M184V/I (p < 0.001, and non-nucleoside RTI (NNRTI resistance mutations K103N and Y181C/I (p < 0.001. The association with TAMs and NNRTI resistance mutations was consistent with the selection of N348I in patients treated with regimens that included both zidovudine and nevirapine (odds ratio 2.62, 95% confidence interval 1.43-4.81. The appearance of N348I was associated with a significant increase in viral load (p < 0.001, which

  8. Morphological and metabolic components of lipodystrophy in various nevirapine-based highly active antiretroviral therapy (HAART) regimens: a cross-sectional, observational study.

    Science.gov (United States)

    Guaraldi, Giovanni; Zona, Stefano; Orlando, Gabriella; Carli, Federica; Stentarelli, Chiara; Luzi, Kety; Garlassi, Elisa; Menozzi, Marianna; Bagni, Pietro; Adorni, Fulvio

    2011-11-01

    Morphological abnormalities (lipoatrophy and central fat accumulation) and metabolic changes (dyslipidaemia and glucose regulation impairment) have emerged as components of lipodystrophy and as major tolerability issues with long-term use of highly active antiretroviral therapy (HAART) in HIV-positive patients. Protease inhibitors (PIs) are recognized as having the greatest impact in terms of metabolic complications, followed by nucleoside reverse transcriptase inhibitors, while the non-nucleoside reverse transcriptase inhibitors (NNRTIs) have the least impact. In particular, regimens based on the NNRTI nevirapine have been shown to achieve significant metabolic benefits and may help to improve dyslipidaemia. Improvements in body shape changes associated with lipodystrophy have also been reported when nevirapine replaced a PI in long-term triple therapy. The objective of this cross-sectional observational ('real-world') study was to investigate the effect of three HAART regimens plus stable nevirapine therapy on morphological and metabolic components of lipodystrophy in HIV-infected patients. Consecutive patients (aged >18 years) with serologically documented HIV infection, who had received HAART for at least 2 years and who had been diagnosed with lipodystrophy, were followed up as outpatients at the metabolic clinic of the University of Modena and Reggio Emilia, Modena, Italy. Patients received stable nevirapine therapy plus fixed-dose combinations of tenofovir disoproxil fumarate plus emtricitabine (Truvada(®); TVD), zidovudine plus lamivudine (3TC) [Combivir(®); CBV], or abacavir plus lamivudine (Kivexa(®); KVX). Multivariate regression analyses were performed to analyse predictors of four components of lipodystrophy: lipoatrophy using leg fat mass measured by dual-emission x-ray absorptiometry (DXA), fat accumulation using waist circumference, dyslipidaemia using apolipoprotein (Apo)B/ApoA1 ratio, and glucose intolerance using the Homeostasis Model

  9. Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis.

    Directory of Open Access Journals (Sweden)

    Kirsten Salado-Rasmussen

    Full Text Available Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis.To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma and breast milk after intrapartum single-dose nevirapine combined with either 1-week tail of Combivir (zidovudine/lamivudine or single-dose Truvada (tenofovir/emtricitabine.Maternal plasma and bilateral breast milk samples were collected between April 2008 and April 2011 at 1, 4 and 6 weeks postpartum from HIV-infected Tanzanian women. Moreover, plasma samples were collected at delivery from mother and infant.HIV-1 RNA was quantified in 1,212 breast milk samples from 273 women. At delivery, 96% of the women and 99% of the infants had detectable nevirapine in plasma with a median (interquartile range, IQR of 1.5 μg/mL (0.75-2.20 μg/mL and 1.04 μg/mL (0.39-1.71 μg/mL, respectively (P < 0.001. At 1 week postpartum, 93% and 98% of the women had detectable nevirapine in plasma and breast milk, with a median (IQR of 0.13 μg/mL (0.13-0.39 μg/mL and 0.22 μg/mL (0.13-0.34 μg/mL, respectively. Maternal plasma and breast milk HIV-1 RNA correlated at all visits (R = 0.48, R = 0.7, R = 0.59; all P = 0.01. Subclinical mastitis was detected in 67% of the women at some time during 6 weeks, and in 38% of the breast milk samples. Breast milk samples with subclinical mastitis had significantly higher HIV-1 RNA at 1, 4 and 6 weeks (all P < 0.05.After short-course antiretroviral prophylaxis, nevirapine was detectable in most infant cord blood samples and the concentration in maternal plasma and breast milk was high through week 1 accompanied by suppressed HIV-1 RNA in plasma and breast milk.

  10. The snakehead Channa asiatica accumulates alanine during aerial exposure, but is incapable of sustaining locomotory activities on land through partial amino acid catabolism.

    Science.gov (United States)

    Chew, Shit F; Wong, Mei Y; Tam, Wai L; Ip, Yuen K

    2003-02-01

    The freshwater snakehead Channa asiatica is an obligatory air-breather that resides in slow-flowing streams and in crevices near riverbanks in Southern China. In its natural habitat, it may encounter bouts of aerial exposure during the dry seasons. In the laboratory, the ammonia excretion rate of C. asiatica exposed to terrestrial conditions in a 12 h:12 h dark:light regime was one quarter that of the submerged control. Consequently, the ammonia contents in the muscle, liver and plasma increased significantly, and C. asiatica was able to tolerate quite high levels of ammonia in its tissues. Urea was not the major product of ammonia detoxification in C. asiatica, which apparently did not possess a functioning ornithine urea cycle. Rather, alanine increased fourfold to 12.6 micromol g(-1) in the muscle after 48 h of aerial exposure. This is the highest level known in adult teleosts exposed to air or an ammonia-loading situation. The accumulated alanine could account for 70% of the deficit in ammonia excretion during this period, indicating that partial amino acid catabolism had occurred. This would allow the utilization of certain amino acids as energy sources and, at the same time, maintain the new steady state levels of ammonia in various tissues, preventing them from rising further. There was a reduction in the aminating activity of glutamate dehydrogenase from the muscle and liver of specimens exposed to terrestrial conditions. Such a phenomenon has not been reported before and could, presumably, facilitate the entry of alpha-ketoglutarate into the Krebs cycle instead of its amination to glutamate, as has been suggested elsewhere. However, in contrast to mudskippers, C. asiatica was apparently unable to reduce the rates of proteolysis and amino acid catabolism, because the reduction in nitrogenous excretion during 48 h of aerial exposure was completely balanced by nitrogenous accumulation in the body. Alanine accumulation also occurred in specimens exposed to

  11. Changes in IL-2 and IL-10 during Chronic Administration of Isoniazid, Nevirapine, and Paracetamol in Rats.

    Science.gov (United States)

    Bekker, Zanelle; Walubo, Andrew; Du Plessis, Jan B

    2016-01-01

    The aim of this study was to illustrate the initial subclinical drug-induced liver injury and the associated adaptive immune response by monitoring for the changes in plasma IL-2, IL-10, and some cytochrome P450 activity during chronic administration of nevirapine (NVP), isoniazid (INH), and paracetamol (PAR) in rats without clinical hepatotoxicity. Male Sprague-Dawley (SD) rats were divided into four groups (saline (S), NVP, INH, and PAR) of 25 animals each. The drugs were administered daily for 42 days at therapeutic doses (NVP 200 mg/kg, PAR 500 mg/kg, and INH 20 mg/kg) to the respective groups by oral gavage and five rats per group were sacrificed weekly. All the three drugs induced a subclinical liver injury in the first 2-3 weeks followed by healing, indicating adaption. The liver injury was pathologically similar and was associated with immune stimulation and increased cytochrome P450 activity. NVP- and PAR-induced liver injury lasted up to 14 days while that for INH lasted for 28 days. NVP-induced liver injury was associated with increased IL-2, CD4 count, and CYP3A2 activity, followed by increased IL-10 during the healing phase. In conclusion, the initial drug-induced subclinical liver injury, its spontaneous healing, and the associated adaptive immune response have been demonstrated.

  12. Outcome of Different Nevirapine Administration Strategies in Preventin g Mother-to-Child Transmission (PMTCT Programs in Tanzania and Uganda

    Directory of Open Access Journals (Sweden)

    Karcher Heiko

    2006-04-01

    Full Text Available Abstract Objective Prevention-of-mother-to-child transmission (PMTCT interventions based on single-dose nevirapine (NVP are widely implemented in Africa, but strategies differ regarding how and when to administer the drug to women and infants. The aim of this study was to analyze the outcome of different strategies with regard to NVP intake in pregnant women and their infants in Tanzania and Uganda. Methods In an observational study carried out between March 2002 and December 2004, we compared a directly observed NVP administration strategy in Tanzania (supervised NVP intake for women and infants at a health unit and a semi-observed administration strategy (self-administered NVP for women at home and supervised intake for infants at a health unit in Uganda. Results The proportions of HIV-positive women accepting receipt of NVP from the health units were similar in the 2 countries (42.4% in Tanzania vs 45.6% in Uganda; P = .06. NVP intake in infants was significantly higher in Tanzania than in Uganda (43.7% vs 24.1%; P Conclusion In our settings, the directly observed administration strategy resulted in a higher NVP intake in infants. The semi-observed strategy, which implies that, after home delivery, the infant has to be presented to a health unit for NVP administration, was less successful.

  13. Sensitive Enzyme Immunoassay for Measuring Plasma and Intracellular Nevirapine Levels in Human Immunodeficiency Virus-Infected Patients

    Science.gov (United States)

    Azoulay, Stéphane; Nevers, Marie-Claire; Créminon, Christophe; Heripret, Laurence; Durant, Jacques; Dellamonica, Pierre; Grassi, Jacques; Guedj, Roger; Duval, Danièle

    2004-01-01

    We have developed an enzyme immunoassay to measure nevirapine (NVP) in plasma and peripheral blood mononuclear cells. Anti-NVP polyclonal antibodies were raised in rabbits by using a synthetic NVP derivative coupled to keyhole limpet hemocyanin as the immunogen, and the enzyme tracer was prepared by chemically coupling the NVP derivative with acetylcholinesterase. These reagents were used to develop a sensitive competitive enzyme immunoassay performed in microtitration plates with a 100-pg ml−1 limit of detection and thus ∼100 times more sensitive than previously published techniques. The plasma assay was performed directly without extraction (in this case, a 500-pg ml−1 limit of detection was observed) on a minimum of 30 μl of plasma. This assay shows good precision and efficiency, since recovery from human plasma and cell extracts spiked with NVP ranged between 87 and 104%, with coefficients of variation of <10%. A pharmacokinetic analysis of plasma NVP was performed for seven patients infected with human immunodeficiency virus (HIV), and it gave results similar to published findings. Intracellular concentrations of NVP were measured in cultured human T-lymphoblastoid cells and peripheral blood mononuclear cells from HIV-infected patients. The results indicated a very low intracellular/extracellular concentration ratio (0.134), thus demonstrating the absence of intracellular drug accumulation. This is the first intracellular assay of a nonnucleoside reverse-transcriptase inhibitor, and this method could be useful in monitoring plasma and intracellular NVP levels in HIV-infected patients. PMID:14693526

  14. The influence of nevirapine and efavirenz-based anti-retroviral therapy on the pharmacokinetics of lumefantrine and anti-malarial dose recommendation in HIV-malaria co-treatment.

    Science.gov (United States)

    Maganda, Betty A; Ngaimisi, Eliford; Kamuhabwa, Appolinary A R; Aklillu, Eleni; Minzi, Omary M S

    2015-04-25

    HIV-malaria co-infected patients in most parts of sub-Saharan Africa are treated with both artemether-lumefantrine (AL) and efavirenz (EFV) or nevirapine (NVP)-based antiretroviral therapy (ART). EFV, NVP, artemether and lumefantrine are substrates, inhibitors or inducers of CYP3A4 and CYP2B6, creating a potential for drug-drug interactions. The effect of EFV and/or NVP on lumefantrine pharmacokinetic profile among HIV-malaria co-infected patients on ART and treated with AL was investigated. Optimal lumefantrine dosage regimen for patients on EFV-based ART was determined by population pharmacokinetics and simulation. This was a non-randomized, open label, parallel, prospective cohort study in which 128, 66 and 75 HIV-malaria co-infected patients on NVP-based ART (NVP-arm), EFV-based ART (EFV-arm) and ART naïve (control-am) were enrolled, respectively. Patients were treated with AL and contributed sparse venous plasma samples. Pharmacokinetic analysis of lumefantrine was done using non-linear mixed effect modelling. Of the evaluated models, a two-compartment pharmacokinetic model with first order absorption and lag-time described well lumefantrine plasma concentrations time profile. Patients in the EFV-arm but not in the NVP-arm had significantly lower lumefantrine bioavailability compared to that in the control-arm. Equally, 32% of patients in the EFV-arm had day-7 lumefantrine plasma concentrations below 280 ng/ml compared to only 4% in the control-arm and 3% in the NVP-arm. Upon post hoc simulation of lumefantrine exposure, patients in the EFV-arm had lower exposure (median (IQR)) compared to that in the control-arm; AUC0-inf; was 303,130 (211,080-431,962) versus 784,830 (547,405-1,116,250); day-7 lumefantrine plasma concentrations was: 335.5 (215.8-519.5) versus 858.7 (562.3-1,333.8), respectively. The predictive model through simulation of lumefantrine exposure at different dosage regimen scenarios for patients on EFV-based ART, suggest that AL taken twice

  15. Sustained Domestic Vector Exposure Is Associated With Increased Chagas Cardiomyopathy Risk but Decreased Parasitemia and Congenital Transmission Risk Among Young Women in Bolivia.

    Science.gov (United States)

    Kaplinski, Michelle; Jois, Malasa; Galdos-Cardenas, Gerson; Rendell, Victoria R; Shah, Vishal; Do, Rose Q; Marcus, Rachel; Pena, Melissa S Burroughs; Abastoflor, Maria del Carmen; LaFuente, Carlos; Bozo, Ricardo; Valencia, Edward; Verastegui, Manuela; Colanzi, Rony; Gilman, Robert H; Bern, Caryn

    2015-09-15

    We studied women and their infants to evaluate risk factors for congenital transmission and cardiomyopathy in Trypanosoma cruzi-infected women. Women provided data and blood for serology and quantitative polymerase chain reaction (PCR). Infants of infected women had blood tested at 0 and 1 month by microscopy, PCR and immunoblot, and serology at 6 and 9 months. Women underwent electrocardiography (ECG). Of 1696 women, 456 (26.9%) were infected; 31 (6.8%) transmitted T. cruzi to their infants. Women who transmitted had higher parasite loads than those who did not (median, 62.0 [interquartile range {IQR}, 25.8-204.8] vs 0.05 [IQR, 0-29.6]; P < .0001). Transmission was higher in twin than in singleton births (27.3% vs 6.4%; P = .04). Women who had not lived in infested houses transmitted more frequently (9.7% vs 4.6%; P = .04), were more likely to have positive results by PCR (65.5% vs 33.9%; P < .001), and had higher parasite loads than those who had lived in infested houses (median, 25.8 [IQR, 0-64.1] vs 0 [IQR, 0-12.3]; P < .001). Of 302 infected women, 28 (9.3%) had ECG abnormalities consistent with Chagas cardiomyopathy; risk was higher for older women (odds ratio [OR], 1.06 [95% confidence interval {CI}, 1.01-1.12] per year) and those with vector exposure (OR, 3.7 [95% CI, 1.4-10.2]). We observed a strong dose-response relationship between ECG abnormalities and reported years of living in an infested house. We hypothesize that repeated vector-borne infection sustains antigen exposure and the consequent inflammatory response at a higher chronic level, increasing cardiac morbidity, but possibly enabling exposed women to control parasitemia in the face of pregnancy-induced Th2 polarization. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Inactivation of uptake hydrogenase leads to enhanced and sustained hydrogen production with high nitrogenase activity under high light exposure in the cyanobacterium Anabaena siamensis TISTR 8012

    Directory of Open Access Journals (Sweden)

    Khetkorn Wanthanee

    2012-10-01

    Full Text Available Abstract Background Biohydrogen from cyanobacteria has attracted public interest due to its potential as a renewable energy carrier produced from solar energy and water. Anabaena siamensis TISTR 8012, a novel strain isolated from rice paddy field in Thailand, has been identified as a promising cyanobacterial strain for use as a high-yield hydrogen producer attributed to the activities of two enzymes, nitrogenase and bidirectional hydrogenase. One main obstacle for high hydrogen production by A. siamensis is a light-driven hydrogen consumption catalyzed by the uptake hydrogenase. To overcome this and in order to enhance the potential for nitrogenase based hydrogen production, we engineered a hydrogen uptake deficient strain by interrupting hupS encoding the small subunit of the uptake hydrogenase. Results An engineered strain lacking a functional uptake hydrogenase (∆hupS produced about 4-folds more hydrogen than the wild type strain. Moreover, the ∆hupS strain showed long term, sustained hydrogen production under light exposure with 2–3 folds higher nitrogenase activity compared to the wild type. In addition, HupS inactivation had no major effects on cell growth and heterocyst differentiation. Gene expression analysis using RT-PCR indicates that electrons and ATP molecules required for hydrogen production in the ∆hupS strain may be obtained from the electron transport chain associated with the photosynthetic oxidation of water in the vegetative cells. The ∆hupS strain was found to compete well with the wild type up to 50 h in a mixed culture, thereafter the wild type started to grow on the relative expense of the ∆hupS strain. Conclusions Inactivation of hupS is an effective strategy for improving biohydrogen production, in rates and specifically in total yield, in nitrogen-fixing cultures of the cyanobacterium Anabaena siamensis TISTR 8012.

  17. Pharmacogenetics of toxicity, plasma trough concentration and treatment outcome with nevirapine-containing regimen in anti-retroviral-naïve HIV-infected adults: an exploratory study of the TRIANON ANRS 081 trial.

    Science.gov (United States)

    Gozalo, Claire; Gérard, Laurence; Loiseau, Pascale; Morand-Joubert, Laurence; Peytavin, Gilles; Molina, Jean-Michel; Dellamonica, Pierre; Becquemont, Laurent; Aboulker, Jean-Pierre; Launay, Odile; Verstuyft, Céline

    2011-12-01

    The aim of this exploratory study was to investigate in a homogeneous population of anti-retroviral naïve HIV-1-infected adults, the relationships between genetic polymorphisms involved in nevirapine metabolism [CYP2B6 516G>T, 785A>G and 1459C>T; CYP3A5 6986A>G (CYP3A5*3)], transport (ABCB1 2677G>T/A and 3435C>T), and antigen recognition (HLA-DRB1*0101), and the hepatic and/or cutaneous toxicity occurring within the first 8 or 72 weeks of treatment, plasma trough concentrations (C(trough) ) at week 8 and immuno-virological response to nevirapine at week 24. Associations between genetic polymorphisms and toxicity, C(trough) and response to nevirapine were performed in a population of 72 HIV-1 positive and nevirapine-treated patients followed during 72 weeks, as part of the previous study called: ANRS081 'Trianon' trial. Among the 18 patients who developed toxicity events during the 72 weeks of the study, 12 patients exhibited early toxicity before week 8. No significant association could be evidenced between any of the analysed single nucleotide polymorphisms (SNPs) and nevirapine early or global toxicity, pharmacokinetics and immuno-virological responses even though a possible association between CYP2B6 516G>T and 1459C>T and the trough level of nevirapine was suggested. © 2011 The Authors. Basic & Clinical Pharmacology & Toxicology © 2011 Nordic Pharmacological Society.

  18. Cost effectiveness of single-dose nevirapine regimen for mothers and babies to decrease vertical HIV-1 transmission in sub-Saharan Africa.

    Science.gov (United States)

    Marseille, E; Kahn, J G; Mmiro, F; Guay, L; Musoke, P; Fowler, M G; Jackson, J B

    1999-09-04

    Identification of economical interventions to decrease HIV-1 transmission to children is an urgent public-health priority in sub-Saharan Africa. We assessed the cost effectiveness of the HIVNET 012 nevirapine regimen. We assessed cost effectiveness in a hypothetical cohort of 20,000 pregnant women in sub-Saharan Africa. Our main outcome measures were programme cost, paediatric HIV-1 cases averted, cost per case averted, and cost per disability-adjusted life-year (DALY). We compared HIVNET 012 with other short-course antiretroviral regimens. We also compared two implementation strategies: counselling and HIV-1 testing before treatment (targeted treatment), or nevirapine for all pregnant women (universal treatment, no counselling and testing). We did univariate and multivariate sensitivity analyses. For universal treatment with 30% HIV-1 seroprevalence, the HIVNET 012 regimen would avert 603 cases of HIV-1 in babies, cost US$83,333, and generate 15,862 DALYs. The associated cost-effectiveness ratios were $138 per case averted or $5.25 per DALY. At 15% seroprevalence, the universal treatment option would cost $83,333 and avert 302 cases at $276 per case averted or $10.51 per DALY. For targeted treatment at 30% seroprevalence, HIVNET 012 would cost $141,922 and avert 476 cases at $298 per case averted or $11.29 per DALY. With seroprevalence higher than 3.0% for universal and 4.5% for targeted treatment, the HIVNET 012 regimen was likely to be as cost effective as other public-health interventions. The cost effectiveness of HIVNET 012 was robust under a wide range of parameters in the sensitivity analysis. The HIVNET 012 regimen can be highly cost-effective in high seroprevalence settings. In lower seroprevalence areas, when multidose regimens are not cost effective, nevirapine therapy could have a major public-health impact at a reasonable cost.

  19. Factors affecting high-density lipoprotein cholesterol in HIV-infected patients on nevirapine-based antiretroviral therapy

    Science.gov (United States)

    Padmapriyadarsini, C.; Ramesh, K.; Sekar, L.; Ramachandran, Geetha; Reddy, Devaraj; Narendran, G.; Sekar, S.; Chandrasekar, C.; Anbarasu, D.; Wanke, Christine; Swaminathan, Soumya

    2017-01-01

    Background & objectives: Cardiovascular disease (CVD) risk with low high-density lipoprotein cholesterol (HDL-C) and high triglycerides is common in the general population in India. As nevirapine (NVP)-based antiretroviral therapy (ART) tends to increase HDL-C, gene polymorphisms associated with HDL-C metabolism in HIV-infected adults on stable NVP-based ART were studied. Methods: A cross-sectional study was conducted between January 2013 and July 2014 among adults receiving NVP-based ART for 12-15 months. Blood lipids were estimated and gene polymorphisms in apolipoprotein C3 (APOC3), cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genes were analyzed by real-time polymerase chain reaction. Framingham's 10-yr CVD risk score was estimated. Logistic regression was done to show factors related to low HDL-C levels. Results: Of the 300 patients included (mean age: 38.6±8.7 yr; mean CD4 count 449±210 cell/μl), total cholesterol (TC) >200 mg/dl was observed in 116 (39%) patients. Thirty nine per cent males and 47 per cent females had HDL-C levels below normal while 32 per cent males and 37 per cent females had TC/HDL ratio of 4.5 and 4.0, respectively. Body mass index [adjusted odds ratio (aOR)=1.70, 95% confidence interval (CI) 1.01-2.84, P=0.04] and viral load (aOR=3.39, 95% CI: 1.52-7.52, P=0.003) were negatively associated with serum HDL-C levels. The 10-yr risk score of developing CVD was 11-20 per cent in 3 per cent patients. Allelic variants of APOC3 showed a trend towards low HDL-C. Interpretation & conclusions: High-risk lipid profiles for atherosclerosis and cardiovascular disease were common among HIV-infected individuals, even after 12 months of NVP-based ART. Targeted interventions to address these factors should be recommended in the national ART programmes. PMID:28948955

  20. Nevirapine and efavirenz elicit different changes in lipid profiles in antiretroviral-therapy-naive patients infected with HIV-1.

    Directory of Open Access Journals (Sweden)

    Frank van Leth

    2004-10-01

    Full Text Available BACKGROUND: Patients infected with HIV-1 initiating antiretroviral therapy (ART containing a non-nucleoside reverse transcriptase inhibitor (NNRTI show presumably fewer atherogenic lipid changes than those initiating most ARTs containing a protease inhibitor. We analysed whether lipid changes differed between the two most commonly used NNRTIs, nevirapine (NVP and efavirenz (EFV. METHODS AND FINDINGS: Prospective analysis of lipids and lipoproteins was performed in patients enrolled in the NVP and EFV treatment groups of the 2NN study who remained on allocated treatment during 48 wk of follow-up. Patients were allocated to NVP (n = 417, or EFV (n = 289 in combination with stavudine and lamivudine. The primary endpoint was percentage change over 48 wk in high-density lipoprotein cholesterol (HDL-c, total cholesterol (TC, TC:HDL-c ratio, non-HDL-c, low-density lipoprotein cholesterol, and triglycerides. The increase of HDL-c was significantly larger for patients receiving NVP (42.5% than for patients receiving EFV (33.7%; p = 0.036, while the increase in TC was lower (26.9% and 31.1%, respectively; p = 0.073, resulting in a decrease of the TC:HDL-c ratio for patients receiving NVP (-4.1% and an increase for patients receiving EFV (+5.9%; p < 0.001. The increase of non-HDL-c was smaller for patients receiving NVP (24.7% than for patients receiving EFV (33.6%; p = 0.007, as were the increases of triglycerides (20.1% and 49.0%, respectively; p < 0.001 and low-density lipoprotein cholesterol (35.0% and 40.0%, respectively; p = 0.378. These differences remained, or even increased, after adjusting for changes in HIV-1 RNA and CD4+ cell levels, indicating an effect of the drugs on lipids over and above that which may be explained by suppression of HIV-1 infection. The increases in HDL-c were of the same order of magnitude as those seen with the use of the investigational HDL-c-increasing drugs. CONCLUSION: NVP-containing ART shows larger increases in HDL

  1. Case Report: Stevens-Johnson syndrome following a single double dosing of nevirapine-containing regimen once in an HIV-infected woman on long-term antiretroviral therapy. [version 1; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Betty Kakande

    2015-06-01

    Full Text Available A 31-year old HIV-infected African woman on nevirapine, tenofovir and lamivudine for more than 4 years presented with an 8-day history of symptoms and signs of Stevens-Johnson syndrome. She was on no other medication. Her viral load was undetectable and she had maintained a CD4 count of between 356 and 387cells/mm3 in the preceding 2½ years. She missed her antiretrovirals 10 days before the onset of her symptoms and subsequently doubled her daily dose the following day. She had been on no other medication in the preceding 8 weeks. Her ARVs were stopped and she fully re-epithelialized with the exception of the lips, over the following 10 days. She was started on a daily single tablet of Odimune® (a fixed drug combination antiretroviral containing tenofovir, emtricitabine and efavirenz.   Nevirapine is the most common offender in cases of antiretroviral-associated SJS in published literature. Lamivudine is very rarely implicated while there are no similar reports with tenofovir.  We concluded that nevirapine was by far the most likely offender in this case. Nevirapine toxicity is associated with high CD4 counts, undetectable viral load and high drug plasma level. We postulate that the sudden increase of the plasma levels of nevirapine in a patient with a high CD4 count and undetectable viral load created a perfect storm for the development of SJS in our patient, who had been on the NVP-containing regimen for many years. Clinicians should be aware that severe adverse drug reactions are dynamic and can occur even when the drug has been in use for a long time.

  2. Increased virological failure in naive HIV-1-infected patients taking lamivudine compared with emtricitabine in combination with tenofovir and efavirenz or nevirapine in the Dutch nationwide ATHENA cohort.

    Science.gov (United States)

    Rokx, Casper; Fibriani, Azzania; van de Vijver, David A M C; Verbon, Annelies; Schutten, Martin; Gras, Luuk; Rijnders, Bart J A

    2015-01-01

    Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART. This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression. The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available. © The Author 2014

  3. Sustained Silent Reading Experiences among Korean Teachers of English as a Foreign Language: The Effect of a Single Exposure to Interesting, Comprehensible Reading.

    Science.gov (United States)

    Cho, Kyung-Sook; Krashen, Stephen

    2001-01-01

    Describes how a single positive experience in self-selected reading of children's books resulted in a profound change in attitudes toward recreational reading among Korean teachers in English as a foreign language. Concludes that after the experience, nearly all teachers reported they were interested in using sustained silent reading in their…

  4. Sustainable Food & Sustainable Economics

    OpenAIRE

    Alvarez, Mavis Dora

    2012-01-01

    Cuba today is immersed in a very intense process of perfecting its agricultural production structures with the goal of making them more efficient and sustainable in their economic administration and in their social and environmental management. Agricultural cooperatives in Cuba have the responsibility of producing on 73% of the country's farmland. Their contributions are decisive to developing agricultural production and to ensuring more and better food for the population, in addition to redu...

  5. Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Theilgaard, Zahra Persson; Chiduo, Mercy G.

    2015-01-01

    Introduction Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis. Objective To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma....../mL), respectively. Maternal plasma and breast milk HIV-1 RNA correlated at all visits (R = 0.48, R = 0.7, R = 0.59; all P = 0.01). Subclinical mastitis was detected in 67% of the women at some time during 6 weeks, and in 38% of the breast milk samples. Breast milk samples with subclinical mastitis had significantly...

  6. A randomized trial comparing initial HAART regimens of nelfinavir/nevirapine and ritonavir/saquinavir in combination with two nucleoside reverse transcriptase inhibitors

    DEFF Research Database (Denmark)

    Kirk, Ole; Lundgren, Jens D; Pedersen, Court

    2003-01-01

    copies/ml after 48 weeks (missing value = failure). Patients remained under follow-up also in case of switch from the randomized therapy. RESULTS: At baseline, the median CD4 cell counts were 126 (range: 0-942) (nelfinavir/nevirapine) and 150 (0-642) (ritonavir/saquinavir) cells/mm3, and HIV RNA...... measurements 5.0 copies/ml (1.3-6.4) in both groups. A total of 102 (86%) and 101 (88%) were antiretroviral-naive. 44% discontinued randomized therapy; P = 0.13. Of these, 80 and 73% switched therapy due to adverse events; P = 0.99. At week 48, 69 and 56%, respectively, had a HIV RNA

  7. Nevirapine- versus lopinavir/ritonavir-based initial therapy for HIV-1 infection among women in Africa: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Shahin Lockman

    Full Text Available Nevirapine (NVP is widely used in antiretroviral treatment (ART of HIV-1 globally. The primary objective of the AA5208/OCTANE trial was to compare the efficacy of NVP-based versus lopinavir/ritonavir (LPV/r-based initial ART.In seven African countries (Botswana, Kenya, Malawi, South Africa, Uganda, Zambia, and Zimbabwe, 500 antiretroviral-naïve HIV-infected women with CD4<200 cells/mm(3 were enrolled into a two-arm randomized trial to initiate open-label ART with tenofovir (TDF/emtricitabine (FTC once/day plus either NVP (n = 249 or LPV/r (n = 251 twice/day, and followed for ≥48 weeks. The primary endpoint was time from randomization to death or confirmed virologic failure ([VF] (plasma HIV RNA<1 log(10 below baseline 12 weeks after treatment initiation, or ≥400 copies/ml at or after 24 weeks, with comparison between treatments based on hazard ratios (HRs in intention-to-treat analysis. Equivalence of randomized treatments was defined as finding the 95% CI for HR for virological failure or death in the range 0.5 to 2.0. Baseline characteristics were (median: age = 34 years, CD4 = 121 cells/mm(3, HIV RNA = 5.2 log(10copies/ml. Median follow-up = 118 weeks; 29 (6% women were lost to follow-up. 42 women (37 VFs, five deaths; 17% in the NVP and 50 (43 VFs, seven deaths; 20% in the LPV/r arm reached the primary endpoint (HR 0.85, 95% CI 0.56-1.29. During initial assigned treatment, 14% and 16% of women receiving NVP and LPV/r experienced grade 3/4 signs/symptoms and 26% and 22% experienced grade 3/4 laboratory abnormalities. However, 35 (14% women discontinued NVP because of adverse events, most in the first 8 weeks, versus none for LPV/r (p<0.001. VF, death, or permanent treatment discontinuation occurred in 80 (32% of NVP and 54 (22% of LPV/r arms (HR = 1.7, 95% CI 1.2-2.4, with the difference primarily due to more treatment discontinuation in the NVP arm. 13 (45% of 29 women tested in the NVP versus six (15% of 40

  8. The Promise of Exposure Science

    Science.gov (United States)

    Exposure science is the bedrock for protection of public health. It fundamentally informs decisions that relate to smart and sustainable design, prevention and mitigation of adverse exposures, and ultimately health protection.

  9. Effect of system variables involved in packed column SFC of nevirapine as model analyte using response surface methodology: application to retention thermodynamics, solute transfer kinetic study and binary diffusion coefficient determination.

    Science.gov (United States)

    Kaul, Neerej; Agrawal, Himani; Paradkar, A R; Mahadik, K R

    2005-08-31

    A multifactor optimization technique is successfully applied to study the effect of simultaneously varying the system variables on feasibility of nevirapine analysis by packed column supercritical fluid chromatography (PC-SFC). The optimal conditions were determined with the aid of the response surface methodology using 3(3) factorial designs. The method is based on methanol-modified carbon dioxide as the mobile phase at flow rate of 3.0 ml/min with elution through a JASCO Finepak SIL-5, [C18 (5-micron, 25 cm x 4.6 mm, i.d.)] column using photodiode array detection. The method has been successfully used to analyze commercial solid dosage form to assess the chromatographic performance of SFC system. The present work briefs the thermodynamic applications of PC-SFC with an emphasis on the results of nevirapine. The foremost of such applications is the determination of solute diffusion coefficient in supercritical mobile phase by Taylor-Aris peak broadening technique.

  10. Sustainable agriculture

    National Research Council Canada - National Science Library

    Lichtfouse, Eric

    2009-01-01

    ... : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : 9 Part I CLIMATE CHANGE Soils and Sustainable Agriculture: A Review : : : : : : : : : : : : : : : : : : : : : : : : : : Rattan Lal 15 Soils and Food Sufficiency...

  11. Sustainable Marketing

    NARCIS (Netherlands)

    Dam, van Y.K.

    2017-01-01

    In this article, three different conceptions of sustainable marketing are discussed and compared. These different conceptions are referred to as social, green, and critical sustainable marketing. Social sustainable marketing follows the logic of demand-driven marketing management and places the

  12. Sustainable Disruptions

    DEFF Research Database (Denmark)

    Friis, Silje Alberthe Kamille; Kjær, Lykke Bloch

    2016-01-01

    Since 2012 the Sustainable Disruptions (SD) project at the Laboratory for Sustainability at Design School Kolding (DK) has developed and tested a set of design thinking tools, specifically targeting the barriers to economically, socially, and environmentally sustainable business development....... The tools have been applied in practice in collaboration with 11 small and medium sized companies (SMEs). The study investigates these approaches to further understand how design thinking can contribute to sustainable transition in a business context. The study and the findings are relevant to organizations...... invested in the issue of sustainable business development, in particular the leaders and employees of SMEs, but also to design education seeking new ways to consciously handle and teach the complexity inherent in sustainable transformation. Findings indicate that the SD design thinking approach contributes...

  13. Computational sustainability

    CERN Document Server

    Kersting, Kristian; Morik, Katharina

    2016-01-01

    The book at hand gives an overview of the state of the art research in Computational Sustainability as well as case studies of different application scenarios. This covers topics such as renewable energy supply, energy storage and e-mobility, efficiency in data centers and networks, sustainable food and water supply, sustainable health, industrial production and quality, etc. The book describes computational methods and possible application scenarios.

  14. Sustainable transformation

    DEFF Research Database (Denmark)

    Andersen, Nicolai Bo

    This paper is about sustainable transformation with a particular focus on listed buildings. It is based on the notion that sustainability is not just a question of energy conditions, but also about the building being robust. Robust architecture means that the building can be maintained and rebuilt...... theoretical lenses. It is proposed that three parameters concerning the ꞌtransformabilityꞌ of the building can contribute to a more nuanced understanding of sustainable transformation: technical aspects, programmatic requirements and narrative value. It is proposed that the concept of ꞌsustainable...

  15. A randomized two-way crossover bioequivalence study in healthy adult volunteers of paediatric zidovudine/lamivudine/nevirapine fast-disintegrating fixed-dose combination tablet.

    Science.gov (United States)

    Joshi, Anjali; Gbadero, Daniel; Esseku, Fredrick; Adesanya, Olufikayo J; Adeyeye, Moji C

    2017-04-01

    The bioequivalence study was conducted to compare the developed paediatric fixed-dose combination (FDC) zidovudine/lamivudine/nevirapine (60/30/50 mg) tablet - the test formulation - with the combined mixture of single-entity innovator products (reference product). A single-dose open-label randomized two-way crossover study was conducted in healthy adult African volunteers after an informed consent was obtained. The 24 volunteers, divided into two groups, were administered the products after an overnight fast on two treatment days with 14 days of washout period. Blood samples were collected for 96 h and analysed using a validated RP-HPLC-UV assay method. Pharmacokinetic (PK) parameters (non-compartmental model) were assessed with WinNonlin® software. Analysis of variance (ANOVA) and FDA bioequivalence statistical criterion of 90% CI or 80% to 125% range (set at P 0.05). The 90% CIs for all the drugs were within the 80% to 125% range. The developed FDC tablet is bioequivalent to the reference product. © 2016 Royal Pharmaceutical Society.

  16. Reuse of single-dose nevirapine in subsequent pregnancies for the prevention of mother-to-child HIV transmission in Lusaka, Zambia: A cohort study

    Science.gov (United States)

    Walter, Jan; Kuhn, Louise; Kankasa, Chipepo; Semrau, Katherine; Sinkala, Moses; Thea, Donald M; Aldrovandi, Grace M

    2008-01-01

    Background Single-dose nevirapine (SDNVP) for the prevention of mother-to-child HIV transmission (PMTCT) results in the selection of resistance mutants among HIV-infected mothers. The effects of these mutations on the efficacy of SDNVP use in a subsequent pregnancy are not well understood. Methods We compared risks of perinatal HIV transmission between multiparous women who had previously received a dose of SDNVP (exposed) and those that had not (unexposed) and who were given SDNVP for the index pregnancy within a PMTCT clinical study. We also compared transmission risks among exposed and unexposed women who had two consecutive pregnancies within the trial. Logistic regression modeling was used to adjust for possible confounders. Results Transmission risks did not differ between 59 SDNVP-exposed and 782 unexposed women in unadjusted analysis or after adjustment for viral load and disease stage (adjusted odds ratio 0.6, 95% confidence interval [CI] 0.2 to 2.0). Among 43 women who had two consecutive pregnancies during the study, transmission risks were 7% (95% CI 1% to 19%) at both the first (unexposed) and second (exposed) delivery. The results were unchanged, if infant death was included as an outcome. Conclusion These data suggest that the efficacy of SDNVP may not be diminished when reused in subsequent pregnancies. PMID:19116004

  17. Reuse of single-dose nevirapine in subsequent pregnancies for the prevention of mother-to-child HIV transmission in Lusaka, Zambia: A cohort study

    Directory of Open Access Journals (Sweden)

    Sinkala Moses

    2008-12-01

    Full Text Available Abstract Background Single-dose nevirapine (SDNVP for the prevention of mother-to-child HIV transmission (PMTCT results in the selection of resistance mutants among HIV-infected mothers. The effects of these mutations on the efficacy of SDNVP use in a subsequent pregnancy are not well understood. Methods We compared risks of perinatal HIV transmission between multiparous women who had previously received a dose of SDNVP (exposed and those that had not (unexposed and who were given SDNVP for the index pregnancy within a PMTCT clinical study. We also compared transmission risks among exposed and unexposed women who had two consecutive pregnancies within the trial. Logistic regression modeling was used to adjust for possible confounders. Results Transmission risks did not differ between 59 SDNVP-exposed and 782 unexposed women in unadjusted analysis or after adjustment for viral load and disease stage (adjusted odds ratio 0.6, 95% confidence interval [CI] 0.2 to 2.0. Among 43 women who had two consecutive pregnancies during the study, transmission risks were 7% (95% CI 1% to 19% at both the first (unexposed and second (exposed delivery. The results were unchanged, if infant death was included as an outcome. Conclusion These data suggest that the efficacy of SDNVP may not be diminished when reused in subsequent pregnancies.

  18. Durability of Stavudine, Lamivudine and Nevirapine among Advanced HIV-1 Infected Patients with/without Prior Co-administration of Rifampicin: A 144-week Prospective Study

    Directory of Open Access Journals (Sweden)

    Prasithisirikul Wisit

    2008-10-01

    Full Text Available Abstract Background To date, data on the durability of a regimen of stavudine, lamivudine and nevirapine are very limited, particularly from the resource-limited settings. Methods A prospective cohort study was conducted among 140 antiretroviral-naïve patients who were enrolled to initiate d4T, 3TC and NVP between November 2004 and March 2005. The objectives were to determine immunological and virological responses after 144 weeks of antiretroviral therapy. Seventy patients with tuberculosis also received rifampicin during the early period of antiviral treatment (TB group. Results Of all, median (IQR baseline CD4 cell count was 31 (14–79 cells/mm3; median (IQR baseline HIV-1 RNA was 433,500 (169,000–750,000 copies/mL. The average body weight was 55 kilograms. By intention-to-treat analysis at 144 weeks, the overall percentage of patients who achieved plasma HIV-1 RNA P = 0.731. Eight (5.8% patients discontinued d4T due to neuropathy and/or symptomatic lactic acidosis. Conclusion The overall durability and efficacy of antiviral response of d4T, 3TC and NVP are satisfied and they are not different between HIV-1 infected patients with and without co-administration of rifampicin due to tuberculosis. However, stavudine-related adverse effects are concerns. Trial registration ClinicalTrials.gov Identifier NCT00703898

  19. Sustainable Transportation

    DEFF Research Database (Denmark)

    Hall, Ralph P.; Gudmundsson, Henrik; Marsden, Greg

    2014-01-01

    that relate to the construction and maintenance of transportation infrastructure and the operation or use of the different transportation modes. The concept of sustainable transportation emerged in response to these concerns as part of the broader notion of sustainable development. Given the transportation...

  20. Sustaining dairy

    NARCIS (Netherlands)

    Villarreal Herrera, Georgina

    2017-01-01

    Dairy in Europe has undergone many changes in the last few years—the abolition of milk production quotas being a fundamental one. This study explores these changes in relation to the sustained social and environmental viability of the sector and how dairy processors' sustainability

  1. Sustainable Universities

    DEFF Research Database (Denmark)

    Grindsted, Thomas Skou

    2011-01-01

    . Declarations tend to have impact on three trends. Firstly, there is emerging international consensus on the university’s role and function in relation to sustainable development; secondly, the emergence of national legislation, and thirdly, an emerging international competition to be leader in sustainable...... campus performance....

  2. Sustainable Transition

    DEFF Research Database (Denmark)

    Hansen, Ole Erik; Søndergård, Bent

    2014-01-01

    of agendas/vision, technologies, actors and institutions in the emergent design of an urban mobility system based on an electric car sharing system. Why. Designing for sustainability is a fundamental challenge for future design practices; designers have to obtain an ability to contribute to sustainable...

  3. Sustainable Learning

    Science.gov (United States)

    Cadwell, Louise; Dillon, Robert

    2011-01-01

    Green schools have moved into a new era that focuses on building a culture of sustainability in every aspect of learning in schools. In the early stages of sustainability education, the focus was on recycling and turning off the lights. Now, students and adults together are moving into the areas of advocacy and action that are based on a deep…

  4. Cost-effectiveness of pre-exposure prophylaxis targeted to high-risk serodiscordant couples as a bridge to sustained ART use in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Roger Ying

    2015-07-01

    Full Text Available Introduction: Despite scale-up of antiretroviral therapy (ART for treating HIV-positive persons, HIV incidence remains elevated among those at high risk such as persons in serodiscordant partnerships. Antiretrovirals taken by HIV-negative persons as pre-exposure prophylaxis (PrEP has the potential to avert infections in individuals in serodiscordant partnerships. Evaluating the cost-effectiveness of implementing time-limited PrEP as a short-term bridge during the first six months of ART for the HIV-positive partner to prevent HIV transmission compared to increasing ART coverage is crucial to informing policy-makers considering PrEP implementation. Methods: To estimate the real world delivery costs of PrEP, we conducted micro-costing and time and motion analyses in an open-label prospective study of PrEP and ART delivery targeted to high-risk serodiscordant couples in Uganda (the Partners Demonstration Project. The cost (in USD, in 2012 of PrEP and ART for serodiscordant couples was assessed, with and without research components, in the study setting. Using Ministry of Health costs, the cost of PrEP and ART provision within a government programme was estimated, as was the cost of providing PrEP in addition to ART. We parameterized an HIV transmission model to estimate the health and economic impacts of 1 PrEP and ART targeted to high-risk serodiscordant couples in the context of current ART use and 2 increasing ART coverage to 55% of HIV-positive persons with CD4 ≤500 cells/µL without PrEP. The incremental cost-effectiveness ratios (ICERs per HIV infection and disability-adjusted life year (DALY averted were calculated over 10 years. Results: The annual cost of PrEP and ART delivery for serodiscordant couples was $1058 per couple in the study setting and $453 in the government setting. The portion of the programme cost due to PrEP was $408 and $92 per couple per year in the study and government settings, respectively. Over 10 years, a

  5. Differences in Lipid Measurements by Antiretroviral Regimen Exposure in Cohorts from Asia and Australia

    Directory of Open Access Journals (Sweden)

    Amit C. Achhra

    2012-01-01

    Full Text Available We explored the mean differences in routinely measured lipids (total cholesterol, triglycerides, and high-density lipoprotein cholesterol according to exposure to different combination antiretroviral regimens in Asian (n=2051 and Australian (predominantly Caucasian, n=794 cohorts. The regimen was defined as at least 3 antiretroviral drugs with at least 2 nucleoside-reverse transcriptases (NRTIs and either of at least one protease inhibitor (PI or non-nucleoside-reverse transcriptases (NNRTIs. We categorised cART regimens as: NRTIs as tenofovir based or not; NNRTIs as nevirapine or efavirenz (but not both; and PI as atazanavir based or not. We found that the impact of various antiretroviral regimens on lipids in Asian and Australian cohorts was only different by cohort for total cholesterol (P for interaction between regimen and cohort: 0.05. The differences in total cholesterol were however small and unlikely to be of clinical significance. Overall, tenofovir with nevirapine or atazanavir was associated with the most favorable lipids, while the PI regimens without tenofovir and atazanavir were associated with least favorable lipids. We conclude that the impact of various ART regimens on lipids is largely similar in Asian and Australian cohorts and that the newer drugs such as tenofovir and atazanavir are likely to provide similar benefit in terms of lipid profiles in both populations.

  6. Sustainable consumption

    DEFF Research Database (Denmark)

    Prothero, Andrea; Dobscha, Susan; Freund, Jim

    2011-01-01

    This essay explores sustainable consumption and considers possible roles for marketing and consumer researchers and public policy makers in addressing the many sustainability challenges that pervade our planet. Future research approaches to this interdisciplinary topic need to be comprehensive...... and systematic and will benefit from a variety of different perspectives. There are a number of opportunities for future research, and three areas are explored in detail. First, the essay considers the inconsistency between the attitudes and behaviors of consumers with respect to sustainability; next, the agenda...... is broadened to explore the role of individual citizens in society; and finally, a macro institutional approach to fostering sustainability is explored. Each of these areas is examined in detail and possible research avenues and public policy initiatives are considered within each of these separate...

  7. Stabilizing Sustainability

    DEFF Research Database (Denmark)

    Reitan Andersen, Kirsti

    The publication of the Brundtland Report in 1987 put the topic of sustainable development on the political and corporate agenda. Defining sustainable development as “a development that meets the needs of the future without compromising the ability of future generations to meet their own needs......” (WCED, 1987, p. 43), the Report also put a positive spin on the issue of sustainability by upholding capitalist beliefs in the possibility of infinite growth in a world of finite resources. While growth has delivered benefits, however, it has done so unequally and unsustainably. This thesis focuses...... on the textile and fashion industry, one of the world’s most polluting industries and an industry to some degree notorious for leading the ‘race to the bottom’ in global labour standards. Despite being faced with increasing demands to practise sustainability, most textile and fashion companies continue to fail...

  8. Sustainability reporting

    NARCIS (Netherlands)

    Kolk, A.

    2005-01-01

    This article gives an overview of developments in sustainability (also sometimes labelled corporate social responsibility) reporting. The article will first briefly indicate how accountability on social and environmental issues started, already in the 1970s when social reports were published.

  9. Sustainable Cities

    DEFF Research Database (Denmark)

    Georg, Susse; Garza de Linde, Gabriela Lucía

    Judging from the number of communities and cities striving or claiming to be sustainable and how often eco-development is invoked as the means for urban regeneration, it appears that sustainable and eco-development have become “the leading paradigm within urban development” (Whitehead 2003......), urban design competitions are understudied mechanisms for bringing about field level changes. Drawing on actor network theory, this paper examines how urban design competitions may bring about changes within the professional field through the use of intermediaries such as a sustainable planning....../assessment tool. The context for our study is urban regeneration in one Danish city, which had been suffering from industrial decline and which is currently investing in establishing a “sustainable city”. Based on this case study we explore how the insights and inspiration evoked in working with the tool...

  10. Sustainable responsibilities?

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    2015-01-01

    This working paper analyzes the conceptions of corporate responsibility for sustainable development in EU policies on CSR. The notion of corporate responsibility has until recently been limited to economical and legal responsibilities. Based on this narrow conception of corporate responsibility.......e. a combination of destruction and construction, this chapter will deconstruct conceptions of responsibility for sustainable development in these EU documents on CSR. A deconstructive conceptual analysis involves destructing dominant interpretations of a text and allowing for constructions of alternative...... such as sustainability actually means, but on what the concept says and does not say. A deconstructive analysis of EU policies on CSR, then, pinpoints that such policies are sites of conceptual struggles. This kind of analysis is suitable for studying conceptions of corporate responsibility for sustainable development...

  11. Agriculture: Sustainability

    Science.gov (United States)

    Sustainability creates and maintains the conditions under which humans and nature can exist in productive harmony, that permit fulfilling the food, feed, and fiber needs of our country and the social, economic and other requirements.

  12. Sustainable finance

    OpenAIRE

    Boersma-de Jong, Margreet F.

    2012-01-01

    Presentation for Springschool of Strategy, University of Groningen, 10 October 2012. The role of CSR is to stimulate ethical behaviour, and as a result, mutual trust in society. Advantage of CSR for the company and the evolution of CSR. From CSR to Sustainable Finance: how does CSR influence Sustainable Business Administration & Management Accounting, Financial Leadership and what is the importance of CSR in the financial sector

  13. SUSTAINABLE TRANSPORTATION

    Directory of Open Access Journals (Sweden)

    Linda STEG

    2007-01-01

    Full Text Available This paper discusses possible contributions of psychologists to sustainable transportation. It is argued that in order to reach sustainable transportation, among others, behaviour changes of individual car users are needed. As transport policies will be more effective if they target important antecedents of travel behaviour, first, factors influencing such behaviour are discussed. It is argued that car use is very attractive and sometimes even necessary for many different reasons. This implies that a combination of policies is called for, each targeting different factors that support car use and hinder the use of more sustainable modes of transport. Next, the paper elaborates on policy strategies that may be employed to achieve sustainable transportation by changing car use. Increasing the attractiveness of sustainable transport modes by means of pull measures seems not sufficient to reduce the level of car use. Besides, car use should be made less attractive by means of push measures to force drivers to reconsider their travel behaviour. The acceptability of such policies may be increased by clearly communicating the aim of these policies, and the expected positive consequences (e.g., less congestion, improved environmental quality. Moreover, possible negative effects for individual freedom may be compensated by implementing additional policies aimed at facilitating the use of sustainable transport modes.

  14. Sustainable markets for sustainable energy

    Energy Technology Data Exchange (ETDEWEB)

    Millan, J.; Smyser, C.

    1997-12-01

    The author discusses how the Inter-American Development Bank (IDB) is involved in sustainable energy development. It presently has 50 loans and grants for non conventional renewable energy projects and ten grants for efficiency programs for $600 and $17 million respectively, representing 100 MW of power. The IDB is concerned with how to create a sustainable market for sustainable energy projects. The IDB is trying to work with government, private sector, NGOs, trading allies, credit sources, and regulators to find proper roles for such projects. He discusses how the IDB is working to expand its vision and objectives in renewable energy projects in Central and South America.

  15. Greenroads : a sustainability performance metric for roadway design and construction.

    Science.gov (United States)

    2009-11-01

    Greenroads is a performance metric for quantifying sustainable practices associated with roadway design and construction. Sustainability is defined as having seven key components: ecology, equity, economy, extent, expectations, experience and exposur...

  16. Efficacy of Six-Week Extended-Dose Nevirapine Varies by Infant Birth Weight with Greatest Relative Efficacy in Low Birth Weight Infants.

    Directory of Open Access Journals (Sweden)

    Nikhil Gupte

    Full Text Available Latest World Health Organization guidelines recommend weight-based nevirapine prophylaxis for all HIV-exposed infants in resource-limited settings, yet low birth weight (LBW infants (2000 g and ≤ 2500 g, and normal birth weight (NBW > 2500 g. Outcomes were HIV-1 infection, HIV-1 infection or death by 12 months, and severe adverse events (SAEs. The Kaplan-Meier method was used to estimate probability of efficacy outcomes in birth weight groups, and differential effects of SWEN by birth weight group were examined using Cox proportional hazards models adjusting for independent risk factors for HIV maternal-to-child transmission and significant covariates. Among 50 VLBW, 249 MLBW, and 433 NBW infants, 50% were randomized to SWEN; median gestational age was 36, 38 and 38 weeks, respectively; and there was no difference in breastfeeding duration (p = 0.99. Compared to SD: SWEN-treated VLBW had lower estimates of HIV-1 infection (13% vs. 38%, p = 0.004 and HIV-1 infection or death (13% vs. 41%, p = 0.002; SWEN-treated MLBW had lower estimated HIV-1 infection (13% vs. 17%, p = 0.042; and efficacy endpoints were similar by treatment arm in NBW. In multivariate analysis, SWEN was associated with reduced risk of HIV-1 infection or death by 83% (p = 0.03 in VLBW versus 45% (p = 0.05 in MLBW. SAE frequency was similar by treatment arm in VLBW (68% vs. 76%, p = 0.53 and MLBW (37% vs. 36%, p = 0.93. SWEN may safely increase HIV-free survival among HIV-exposed LBW infants with greatest protective advantage among infants ≤ 2000 g.

  17. Role of Rilpivirine and Etravirine in Efavirenz and Nevirapine-Based Regimens Failure in a Resource-Limited Country: A Cross- Sectional Study.

    Directory of Open Access Journals (Sweden)

    Phairote Teeranaipong

    Full Text Available Etravirine(ETR can be used for patients who have failed NNRTI-based regimen. In Thailand, ETR is approximately 45 times more expensive than rilpivirine(RPV. However, there are no data of RPV use in NNRTI failure. Therefore, we assessed the susceptibility and mutation patterns of first line NNRTI failure and the possibility of using RPV compared to ETV in patients who have failed efavirenz(EFV- and nevirapine(NVP-based regimens.Clinical samples with confirmed virological failure from EFV- or NVP-based regimens were retrospectively analyzed. Resistance-associated mutations (RAMs were interpreted by IAS-USA Drug Resistance Mutations. Susceptibility of ETR and RPV were interpreted by DUET, Monogram scoring system, and Stanford University HIV Drug Resistance Database.1,279 and 528 patients failed EFV- and NVP-based regimens, respectively. Y181C was the most common NVP-associated RAM (54.3% vs. 14.7%, p<0.01. K103N was the most common EFV-associated RAM (56.5% vs. 19.1%, P<0.01. The results from all three scoring systems were concordant. 165(11.1% and 161(10.9% patients who failed NVP-based regimen were susceptible to ETR and RPV, respectively (p = 0.85. 195 (32.2% and 191 (31.6% patients who failed EFV-based regimen, were susceptible to ETR and RPV, respectively (p = 0.79. The susceptibility of ETV and RPV in EFV failure was significantly higher than NVP failure (p<0.01.The mutation patterns for ETR and RPV were similar but 32% and 11% of patients who failed EFV and NVP -based regimen, respectivly were susceptible to RPV. This finding suggests that RPV can be used as the alternative antiretroviral agent in patients who have failed EFV-based regimen.

  18. Outcomes for efavirenz versus nevirapine-containing regimens for treatment of HIV-1 infection: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Prinitha Pillay

    Full Text Available There is conflicting evidence and practice regarding the use of the non-nucleoside reverse transcriptase inhibitors (NNRTI efavirenz (EFV and nevirapine (NVP in first-line antiretroviral therapy (ART.We systematically reviewed virological outcomes in HIV-1 infected, treatment-naive patients on regimens containing EFV versus NVP from randomised trials and observational cohort studies. Data sources include PubMed, Embase, the Cochrane Central Register of Controlled Trials and conference proceedings of the International AIDS Society, Conference on Retroviruses and Opportunistic Infections, between 1996 to May 2013. Relative risks (RR and 95% confidence intervals were synthesized using random-effects meta-analysis. Heterogeneity was assessed using the I(2 statistic, and subgroup analyses performed to assess the potential influence of study design, duration of follow up, location, and tuberculosis treatment. Sensitivity analyses explored the potential influence of different dosages of NVP and different viral load thresholds.Of 5011 citations retrieved, 38 reports of studies comprising 114 391 patients were included for review. EFV was significantly less likely than NVP to lead to virologic failure in both trials (RR 0.85 [0.73-0.99] I(2 = 0% and observational studies (RR 0.65 [0.59-0.71] I(2 = 54%. EFV was more likely to achieve virologic success than NVP, though marginally significant, in both randomised controlled trials (RR 1.04 [1.00-1.08] I(2 = 0% and observational studies (RR 1.06 [1.00-1.12] I(2 = 68%.EFV-based first line ART is significantly less likely to lead to virologic failure compared to NVP-based ART. This finding supports the use of EFV as the preferred NNRTI in first-line treatment regimen for HIV treatment, particularly in resource limited settings.

  19. Risk of nevirapine-associated Stevens-Johnson syndrome among HIV-infected pregnant women: the Medunsa National Pharmacovigilance Centre, 2007 - 2012.

    Science.gov (United States)

    Dube, N; Adewusi, E; Summers, R

    2013-05-01

    Stevens-Johnson syndrome (SJS) is an acute life-threatening condition often elicited by drugs. The government's indecisiveness in deciding to stop the use of nevirapine (NVP) in HIV-infected pregnant women owing to the increase of SJS among this population group in South Africa prompted this investigation. To investigate if pregnancy is a risk factor for SJS among HIV-infected women taking NVP-containing regimens and registered within the Medunsa National Pharmacovigilance Centre database. A matched case-control study with 5:1 matching was conducted. Women with SJS (cases) taking NVP-containing regimens were matched with women without SJS (controls) taking NVP-containing regimens. Controls were randomly selected and matched to cases by hospital, age, treatment duration and CD4 count. Conditional logistic regression was used to determine if pregnancy was a risk factor for SJS. Six SJS cases were identified and 30 controls selected. The median age of both cases and controls was 29 years and the average CD4 counts were 237 and 234 cells/microl respectively. Subjects were on NVP treatment for 18 - 31 days before the onset of SJS. Controls did not develop SJS after treatment of between 1 and 365 days. Pregnancy increased the chances of developing SJS 14-fold (OR 14.28, p = 0.006, 95% CI 1.54 - 131.82). NVP-containing ARV regimens taken during pregnancy increase the risk of developing SJS. Healthcare workers are advised to offer informed consent to patients and recommend effective contraception methods if NVP treatment is considered. In the light of our findings, further studies of the association between NVP, pregnancy and SJS are necessary before general conclusions can be reached.

  20. A Pharmacogenetics Study in Mozambican Patients Treated with Nevirapine: Full Resequencing of TRAF3IP2 Gene Shows a Novel Association with SJS/TEN Susceptibility

    Directory of Open Access Journals (Sweden)

    Cinzia Ciccacci

    2015-03-01

    Full Text Available Steven–Johnson Syndrome (SJS and Toxic Epidermal Necrolysis (TEN are severe adverse drug reactions, characterized by extensive epidermal detachment and erosions of mucous membrane. SJS/TEN is one of the most serious adverse reactions to Nevirapine (NVP treatment, commonly used in developing countries as first-line treatment of human immunodeficiency virus infection. In the last years TRAF3IP2 gene variants had been described as associated with susceptibility to several diseases such as psoriasis and psoriatic arthritis. We hypothesized that this gene, involved in immune response and in NF-κB activation, could also be implicated in the SJS/TEN susceptibility. We performed a full resequencing of TRAF3IP2 gene in a population of patients treated with NVP. Twenty-seven patients with NVP-induced SJS/TEN and 78 controls, all from Mozambique, were enrolled. We identified eight exonic and three intronic already described variants. The case/control association analysis highlighted an association between the rs76228616 SNP in exon 2 and the SJS/TEN susceptibility. In particular, the variant allele (C resulted significantly associated with a higher risk to develop SJS/TEN (p = 0.012 and OR = 3.65 (95% CI 1.33–10.01. A multivariate analysis by logistic regression confirmed its significant contribution (p = 0.027, OR = 4.39 (95% CI 1.19–16.23. In conclusion, our study suggests that a variant in TRAF3IP2 gene could be involved in susceptibility to SJS/TEN.

  1. A pharmacogenetics study in Mozambican patients treated with nevirapine: full resequencing of TRAF3IP2 gene shows a novel association with SJS/TEN susceptibility.

    Science.gov (United States)

    Ciccacci, Cinzia; Rufini, Sara; Mancinelli, Sandro; Buonomo, Ersilia; Giardina, Emiliano; Scarcella, Paola; Marazzi, Maria C; Novelli, Giuseppe; Palombi, Leonardo; Borgiani, Paola

    2015-03-12

    Steven-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe adverse drug reactions, characterized by extensive epidermal detachment and erosions of mucous membrane. SJS/TEN is one of the most serious adverse reactions to Nevirapine (NVP) treatment, commonly used in developing countries as first-line treatment of human immunodeficiency virus infection. In the last years TRAF3IP2 gene variants had been described as associated with susceptibility to several diseases such as psoriasis and psoriatic arthritis. We hypothesized that this gene, involved in immune response and in NF-κB activation, could also be implicated in the SJS/TEN susceptibility. We performed a full resequencing of TRAF3IP2 gene in a population of patients treated with NVP. Twenty-seven patients with NVP-induced SJS/TEN and 78 controls, all from Mozambique, were enrolled. We identified eight exonic and three intronic already described variants. The case/control association analysis highlighted an association between the rs76228616 SNP in exon 2 and the SJS/TEN susceptibility. In particular, the variant allele (C) resulted significantly associated with a higher risk to develop SJS/TEN (p = 0.012 and OR = 3.65 (95% CI 1.33-10.01)). A multivariate analysis by logistic regression confirmed its significant contribution (p = 0.027, OR = 4.39 (95% CI 1.19-16.23)). In conclusion, our study suggests that a variant in TRAF3IP2 gene could be involved in susceptibility to SJS/TEN.

  2. Roundtabling Sustainability

    DEFF Research Database (Denmark)

    Ponte, Stefano

    2014-01-01

    The willingness of public authority to delegate social and environmental regulation to the private sector has varied from sector to sector, but has often led to the establishment of ‘voluntary’ standards and certifications on sustainability. Many of these have taken the form of ‘stewardship...... councils’ and ‘sustainability roundtables’ and have been designed around a set of institutional features seeking to establish legitimacy, fend off possible criticism, and ‘sell’ certifications to potential users. The concept of ‘roundtabling’ emphasizes the fitting a variety of commodity......-specific sustainability situations into a form that not only ‘hears more voices’ (as in ‘multi-stakeholder’), but also portrays to give them equal standing at the table of negotiations (roundtable), thus raising higher expectations on accountability, transparency and inclusiveness. In this article, I examine to what...

  3. Sustainability Evaluation.

    Science.gov (United States)

    Stichnothe, Heinz

    2017-03-17

    The long-term substitution of fossil resources can only be achieved through a bio-based economy, with biorefineries and bio-based products playing a major role. However, it is important to assess the implications of the transition to a bio-based economy. Life cycle-based sustainability assessment is probably the most suitable approach to quantify impacts and to identify trade-offs at multiple levels. The extended utilisation of biomass can cause land use change and affect food security of the most vulnerable people throughout the world. Although this is mainly a political issue and governments should be responsible, the responsibility is shifted to companies producing biofuels and other bio-based products. Organic wastes and lignocellulosic biomass are considered to be the preferred feedstock for the production of bio-based products. However, it is unlikely that a bio-based economy can rely only on organic wastes and lignocellulosic biomass.It is crucial to identify potential problems related to socio-economic and environmental issues. Currently there are many approaches to the sustainability of bio-based products, both quantitative and qualitative. However, results of different calculation methods are not necessarily comparable and can cause confusion among decision-makers, stakeholders and the public.Hence, a harmonised, globally agreed approach would be the best solution to secure sustainable biomass/biofuels/bio-based chemicals production and trade, and to avoid indirect effects (e.g. indirect land use change). However, there is still a long way to go.Generally, the selection of suitable indicators that serve the purpose of sustainability assessment is very context-specific. Therefore, it is recommended to use a flexible and modular approach that can be adapted to various purposes. A conceptual model for the selection of sustainability indicators is provided that facilitates identifying suitable sustainability indicators based on relevance and significance in a

  4. Sustainable Soesterkwartier

    NARCIS (Netherlands)

    Abrahams, H.; Goosen, H.; Jong, de F.; Sickmann, J.; Prins, D.

    2010-01-01

    The municipality of Amersfoort wants to construct an endurable and sustainable eco-town in the Soesterkwartier neighbourhood, by taking future climate change into account. The impact of climate change at the location of the proposed eco-town was studied by a literature review.

  5. Sustainable agriculture

    International Development Research Centre (IDRC) Digital Library (Canada)

    New farming techniques, better food security. Since 1970, IDRC-supported research has introduced sustainable agricultural practices to farmers and communities across the devel- oping world. The result: higher productivity, less poverty, greater food security, and a healthier environment. Opportunities grow on trees in ...

  6. Sustainable Development

    African Journals Online (AJOL)

    Tsegai Berhane Ghebretekle

    Abstract. This article examines the concept of sustainable development after the Post-. 2015 Paris Climate Change Agreement with particular emphasis on Ethiopia. Various African countries are vulnerable to climate change, as is evidenced by recent droughts. Ethiopia is selected as a case study in light of its pace in.

  7. Sustainable machining

    CERN Document Server

    2017-01-01

    This book provides an overview on current sustainable machining. Its chapters cover the concept in economic, social and environmental dimensions. It provides the reader with proper ways to handle several pollutants produced during the machining process. The book is useful on both undergraduate and postgraduate levels and it is of interest to all those working with manufacturing and machining technology.

  8. Architecture Sustainability

    NARCIS (Netherlands)

    Avgeriou, Paris; Stal, Michael; Hilliard, Rich

    2013-01-01

    Software architecture is the foundation of software system development, encompassing a system's architects' and stakeholders' strategic decisions. A special issue of IEEE Software is intended to raise awareness of architecture sustainability issues and increase interest and work in the area. The

  9. Sustainability reporting

    NARCIS (Netherlands)

    Kolk, A.

    2005-01-01

    This article gives an overview of developments in sustainability (also sometimes labelled corporate social responsibility) reporting. It The article will first briefly indicate how accountability on social and environmental issues started, already in the 1970s when social reports were published.

  10. Exergy sustainability.

    Energy Technology Data Exchange (ETDEWEB)

    Robinett, Rush D. III (.; ); Wilson, David Gerald; Reed, Alfred W.

    2006-05-01

    Exergy is the elixir of life. Exergy is that portion of energy available to do work. Elixir is defined as a substance held capable of prolonging life indefinitely, which implies sustainability of life. In terms of mathematics and engineering, exergy sustainability is defined as the continuous compensation of irreversible entropy production in an open system with an impedance and capacity-matched persistent exergy source. Irreversible and nonequilibrium thermodynamic concepts are combined with self-organizing systems theories as well as nonlinear control and stability analyses to explain this definition. In particular, this paper provides a missing link in the analysis of self-organizing systems: a tie between irreversible thermodynamics and Hamiltonian systems. As a result of this work, the concept of ''on the edge of chaos'' is formulated as a set of necessary and sufficient conditions for stability and performance of sustainable systems. This interplay between exergy rate and irreversible entropy production rate can be described as Yin and Yang control: the dialectic synthesis of opposing power flows. In addition, exergy is shown to be a fundamental driver and necessary input for sustainable systems, since exergy input in the form of power is a single point of failure for self-organizing, adaptable systems.

  11. Sustainable processing

    DEFF Research Database (Denmark)

    Kristensen, Niels Heine

    2004-01-01

    Kristensen_NH and_Beck A: Sustainable processing. In Otto Schmid, Alexander Beck and Ursula Kretzschmar (Editors) (2004): Underlying Principles in Organic and "Low-Input Food" Processing - Literature Survey. Research Institute of Organic Agriculture FiBL, CH-5070 Frick, Switzerland. ISBN 3-906081-58-3...

  12. Sustainable finance

    NARCIS (Netherlands)

    dr. Margreet F. Boersma-de Jong

    2012-01-01

    Presentation for Springschool of Strategy, University of Groningen, 10 October 2012. The role of CSR is to stimulate ethical behaviour, and as a result, mutual trust in society. Advantage of CSR for the company and the evolution of CSR. From CSR to Sustainable Finance: how does CSR influence

  13. Vorinostat with sustained exposure and high solubility in poly(ethylene glycol)-b-poly(DL-lactic acid) micelle nanocarriers: characterization and effects on pharmacokinetics in rat serum and urine.

    Science.gov (United States)

    Mohamed, Elham A; Zhao, Yunqi; Meshali, Mahasen M; Remsberg, Connie M; Borg, Thanaa M; Foda, Abdel Monem M; Takemoto, Jody K; Sayre, Casey L; Martinez, Stephanie E; Davies, Neal M; Forrest, M Laird

    2012-10-01

    The histone deacetylase inhibitor suberoylanilide hydroxamic acid, known as vorinostat, is a promising anticancer drug with a unique mode of action; however, it is plagued by low water solubility, low permeability, and suboptimal pharmacokinetics. In this study, poly(ethylene glycol)-b-poly(DL-lactic acid) (PEG-b-PLA) micelles of vorinostat were developed. Vorinostat's pharmacokinetics in rats was investigated after intravenous (i.v.) (10 mg/kg) and oral (p.o.) (50 mg/kg) micellar administrations and compared with a conventional polyethylene glycol 400 solution and methylcellulose suspension. The micelles increased the aqueous solubility of vorinostat from 0.2 to 8.15 ± 0.60 and 10.24 ± 0.92 mg/mL at drug to nanocarrier ratios of 1:10 and 1:15, respectively. Micelles had nanoscopic mean diameters of 75.67 ± 7.57 and 87.33 ± 8.62 nm for 1:10 and 1:15 micelles, respectively, with drug loading capacities of 9.93 ± 0.21% and 6.91 ± 1.19%, and encapsulation efficiencies of 42.74 ± 1.67% and 73.29 ± 4.78%, respectively. The micelles provided sustained exposure and improved pharmacokinetics characterized by a significant increase in serum half-life, area under curve, and mean residence time. The micelles reduced vorinostat clearance particularly after i.v. dosing. Thus, PEG-b-PLA micelles significantly improved the p.o. and i.v. pharmacokinetics and bioavailability of vorinostat, which warrants further investigation. Copyright © 2012 Wiley Periodicals, Inc.

  14. SUSTAINABLE CORPORATE AND SUSTAINABLE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    DORU CÎRNU

    2017-06-01

    Full Text Available In recent decades, the image of the international business environment has changed significantly. Studies conducted by UNCTAD shows that corporate phenomenon developments in the world economy is growing. Without claiming to present an exhaustive topic so vast we tried to capture some "facets" of sustainable development from the perspective of multinational corporations, given the expansion of these economic entities and strengthening their power in the global economy. We present more negative aspects of the actions of multinational corporations in terms of sustainable development, it is very important to know both sides of the coin, which will not only help transnational giants including release. Based on issues such as corporate social responsibility, environmental pollution and workers' rights, we sought to counter official statements. The conclusion is that these economic entities are real forces that can not be ignored in today's world and the obvious problem of sustainable development can not be addressed independently of the phenomenon, context we also identified some possible solutions to conflict of corporations and essence of the concept of sustainable development.

  15. Virological failure of staggered and simultaneous treatment interruption in HIV patients who began Efavirenz-based regimens after allergic reactions to nevirapine

    Directory of Open Access Journals (Sweden)

    Siripassorn Krittaecho

    2013-01-01

    Full Text Available Abstract Objective The objective of this work was to study the virological outcomes associated with two different types of treatment interruption strategies in patients with allergic reactions to nevirapine (NVP. We compared the virological outcomes of (1 HIV-1-infected patients who discontinued an initial NVP-based regimen because of cutaneous allergic reactions to NVP; different types of interruption strategies were used, and second-line regimen was based on efavirenz (EFV; and (2 HIV-1-infected patients who began an EFV-based regimen as a first-line therapy (controls. Methods This retrospective cohort included patients who began an EFV-based regimen, between January 2002 and December 2008, as either an initial regimen or as a subsequent regimen after resolving a cutaneous allergic reaction against an initial NVP-based regimen. The study ended in March 2010. The primary outcome was virological failure, which was defined as either (a two consecutive plasma HIV-1 RNA levels >400 copies/mL or (b a plasma HIV-1 RNA level >1,000 copies/mL plus any genotypic resistance mutation. Results A total of 559 patients were stratified into three groups: (a Simultaneous Interruption, in which the subjects simultaneously discontinued all the drugs in an NVP-based regimen following an allergic reaction (n=161; (b Staggered Interruption, in which the subjects discontinued NVP treatment while continuing nucleoside reverse transcriptase inhibitor (NRTI backbone therapy for a median of 7 days (n=82; and (c Control, in which the subjects were naïve to antiretroviral therapy (n=316. The overall median follow-up time was 43 months. Incidence of virological failure in Simultaneous Interruption was 12.9 cases per 1,000 person-years, which trended toward being higher than the incidences in Staggered Interruption (5.4 and Control (6.6. However, differences were not statistically significant. Conclusions Among the patients who had an acute allergic reaction to first

  16. Sustainable Consumption

    DEFF Research Database (Denmark)

    Røpke, Inge

    2015-01-01

    in wider social, economic and technological frameworks is emphasised. In particular, the chapter is inspired by practice theory and transition theory. First, various trends in consumption are outlined to highlight some of the challenges for sustainability transitions. Then, it is discussed how consumption...... patterns are shaped over time and what should be considered in sustainability strategies. While discussions on consumption often take their point of departure in the perspective of the individual and then zoom to the wider context, the present approach is the opposite. The outline starts with the basic...... biophysical, distributional and economic conditions for high consumption in rich countries and then zooms in on the coevolution of provision systems and consumption, and how consumption is shaped by practices and projects in everyday life. Furthermore, the paper discusses whether and how transition...

  17. Sustainable Buildings

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Elle, Morten

    The scientific community agrees that: all countries must drastically and rapidly reduce their CO2 emissions and that energy efficient houses play a decisive role in this. The general attitude at the workshop on Sustainable Buildings was that we face large and serious climate change problems that ...... that need urgent action. The built environment is an obvious area to put effort into because of the large and cost-effective energy saving potential and potential for Renewable Energy-based supply systems for buildings.......The scientific community agrees that: all countries must drastically and rapidly reduce their CO2 emissions and that energy efficient houses play a decisive role in this. The general attitude at the workshop on Sustainable Buildings was that we face large and serious climate change problems...

  18. SUSTAINABLE CHEMISTRY FOR SUSTAINABLE INDUSTRY

    Directory of Open Access Journals (Sweden)

    G. Rizzuto

    2015-01-01

    Full Text Available Foundry Alfe Chem is an industrial reality working in the field of lubrication and chemical auxiliaries for industrial processes, which falls within the framework of the emerging and increasingly important «green chemistry». The goal of the company is to develop products that are more environmentally friendly by using raw materials from renewable sources; specifically, Foundry Alfe Chem has a program of self-sustainability that contemplates, for the foreseeable future, the direct production of renewable raw materials. The company has developed a new dedicated product line, Olitema, whose purpose is to offer highly technological solutions with complete environmental sustainability. In this context, Foundry Alfe CHEM has created a new product which represents a breakthrough in the class of HFC hydraulic fluids: Ecosafe Plus is a biodegradable fire-resistant hydraulic fluid with high engineering and technological performances, high environmental sustainability and the best security guarantees in workplaces. Its formulation is glycols-free, and it allows for easier disposal of the exhausted fluid, compared to a traditional water/ glycol-based HFC hydraulic fluid. For what concern the technological properties, Ecosafe Plus has been tested by accredited laboratories with tribological trials (4 Ball wear test ASTM D 4172, Ball on disc test ASTM 6425, Brugger test DIN 51347, Vickers test ASTM D 2882, with elastomer compatibility test (ASTM D 471 and biodegradability test (OECD 310 F.

  19. Sustainable Procurement

    DEFF Research Database (Denmark)

    Telles, Pedro; Ølykke, Grith Skovgaard

    2017-01-01

    and within it how sustainable requirements have increased the level of compliance required, particularly regulatory compliance. Compliance was already present in previous EU public procurement frameworks, but its extent on Directive 2014/24/EU leads the authors to consider the current legal framework...... as subject to substantial regulatory compliance obligations external to the process of procurement. In short, procurement has been transformed in a way to enforce regulatory obligations that are not intrinsic to the process of buying. This leads to the conclusion that questions such as the cost and trade...

  20. Sustainable consumption and marketing

    NARCIS (Netherlands)

    Dam, van Y.K.

    2016-01-01

    Sustainable development in global food markets is hindered by the discrepancy between positive consumer attitudes towards sustainable development or sustainability and the lack of corresponding sustainable consumption by a majority of consumers. Apparently for many (light user) consumers the

  1. Discontinuation of nevirapine because of hypersensitivity reactions in patients with prior treatment experience, compared with treatment-naive patients: the ATHENA cohort study.

    Science.gov (United States)

    Wit, Ferdinand W N M; Kesselring, Anouk M; Gras, Luuk; Richter, Clemens; van der Ende, Marchina E; Brinkman, Kees; Lange, Joep M A; de Wolf, Frank; Reiss, Peter

    2008-03-15

    Recommendations that nevirapine (NVP) should be avoided in female individuals with CD4 cell counts >250 cells/microL and in male individuals with CD4 cell counts >400 cells/microL are based on findings in treatment-naive patients. It is unclear whether these guidelines also apply to treatment-experienced patients switching to NVP-based combination therapy. Patients in the ATHENA cohort study who had used NVP-based combination therapy were included. We identified patients who discontinued NVP-based combination therapy because of hypersensitivity reactions (HSRs; rash and/or hepatotoxicity) within 18 weeks after starting such therapy. We grouped patients according to their CD4 cell count at the start of NVP-based combination therapy (current CD4 cell count) as having a high CD4 cell count (for female patients, >250 cells/microL; for male patients, >400 cells/microL) or a low CD4 cell count. Treatment-experienced patients were further subdivided according to the last available CD4 cell count before first receipt of antiretroviral therapy (ART; pre-ART CD4 cell count) using the same criteria. Risk factors for HSR were assessed using multivariate logistic regression. Of 3752 patients receiving NVP-based combination therapy, 231 patients (6.2%) discontinued NVP therapy because of HSRs. Independent risk factors included female sex and Asian ethnicity. Having an undetectable viral load (VL) at the start of NVP therapy was associated with reduced risk of developing an HSR (adjusted odds ratio [OR], 0.52; 95% confidence interval [CI], 0.38-0.71). Pretreated patients with low pre-ART and high current CD4 cell counts and a detectable VL when switching to NVP-based combination therapy had a significantly higher risk of developing an HSR, compared with treatment-naive patients who started NVP therapy with low CD4 cell counts (adjusted OR, 1.87; 95% CI, 1.11-3.12); pretreated patients with low pre-ART CD4 cell counts who switched to NVP therapy with a high current CD4 cell count

  2. Virtual Sustainability

    Directory of Open Access Journals (Sweden)

    William Sims Bainbridge

    2010-09-01

    Full Text Available In four ways, massively multiplayer online role-playing games may serve as tools for advancing sustainability goals, and as laboratories for developing alternatives to current social arrangements that have implications for the natural environment. First, by moving conspicuous consumption and other usually costly status competitions into virtual environments, these virtual worlds might reduce the need for physical resources. Second, they provide training that could prepare individuals to be teleworkers, and develop or demonstrate methods for using information technology to replace much transportation technology, notably in commuting. Third, virtual worlds and online games build international cooperation, even blending national cultures, thereby inching us toward not only the world consciousness needed for international agreements about the environment, but also toward non-spatial government that cuts across archaic nationalisms. Finally, realizing the potential social benefits of this new technology may urge us to reconsider a number of traditional societal institutions.

  3. Sustainability; Sustentabilidade

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-10-15

    This chapter analyses the production chain of ethanol, considering the impacts on the quality of the air, water supplies, soil occupation and biodiversity, and the efforts for the soil preservation. It is pointed out the activities of the production cycle and use of bio ethanol due to great uncertainties as far the environmental impacts is concerning and that will deserve more attention in future evaluations. At same time, the chapter highlights another activities where the present acknowledge is sufficient to assure the control and/or prediction of consequences of the desired intervention on the environment media to accommodate the sugar and ethanol production expansion. The consideration is not conservative but to promote the sustainable development.

  4. Sustainability Science Needs Sustainable Data!

    Science.gov (United States)

    Downs, R. R.; Chen, R. S.

    2013-12-01

    Sustainability science (SS) is an 'emerging field of research dealing with the interactions between natural and social systems, and with how those interactions affect the challenge of sustainability: meeting the needs of present and future generations while substantially reducing poverty and conserving the planet's life support systems' (Kates, 2011; Clark, 2007). Bettencourt & Kaur (2011) identified more than 20,000 scientific papers published on SS topics since the 1980s with more than 35,000 distinct authors. They estimated that the field is currently growing exponentially, with the number of authors doubling approximately every 8 years. These scholars are undoubtedly using and generating a vast quantity and variety of data and information for both SS research and applications. Unfortunately we know little about what data the SS community is actually using, and whether or not the data that SS scholars generate are being preserved for future use. Moreover, since much SS research is conducted by cross-disciplinary, multi-institutional teams, often scattered around the world, there could well be increased risks of data loss, reduced data quality, inadequate documentation, and poor long-term access and usability. Capabilities and processes therefore need to be established today to support continual, reliable, and efficient preservation of and access to SS data in the future, especially so that they can be reused in conjunction with future data and for new studies not conceived in the original data collection activities. Today's long-term data stewardship challenges include establishing sustainable data governance to facilitate continuing management, selecting data to ensure that limited resources are focused on high priority SS data holdings, securing sufficient rights to allow unforeseen uses, and preparing data to enable use by future communities whose specific research and information needs are not yet known. Adopting sustainable models for archival

  5. Exposure Forecaster

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Exposure Forecaster Database (ExpoCastDB) is EPA's database for aggregating chemical exposure information and can be used to help with chemical exposure...

  6. John Deakin: Double Exposures

    Directory of Open Access Journals (Sweden)

    Paul Rousseau

    2015-11-01

    Full Text Available In this series of short films made by Jonathan Law, the art historian James Boaden, and the curator of The John Deakin Archive, Paul Rousseau, discuss the double-exposure images made by the photographer John Deakin (1912-1972 in the 1950s and 1960s. The films ask you, firstly, to look closely at the images being discussed. Each one begins with a sustained and intense shot of a single image before opening up to a wide-ranging discussion about Deakin, double exposures, and photography.

  7. Sustainable Scientists

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan

    2008-12-31

    Scientists are front and center in quantifying and solving environmental problems. Yet, as a spate of recent news articles in scientific journals point out, much can be done to enhance sustainability within the scientific enterprise itself, particularly by trimming the energy use associated with research facilities and the equipment therein (i,ii,iii, iv). Sponsors of research unwittingly spend on the order of $10 billion each year on energy in the U.S. alone, and the underlying inefficiencies drain funds from the research enterprise while causing 80 MT CO2-equivalent greenhouse-gas emissions (see Box). These are significant sums considering the opportunity costs in terms of the amount of additional research that could be funded and emissions that could be reduced if the underlying energy was used more efficiently. By following commercially proven best practices in facility design and operation, scientists--and the sponsors of science--can cost-effectively halve these costs, while doing their part to put society on alow-carbon diet.

  8. Sustainable agriculture - selected papers

    OpenAIRE

    Krasowicz, Stanisław; Wrzaszcz, Wioletta; Zegar, Jozef St.

    2007-01-01

    The concept of research on socially sustainable agriculture. Features of sustainable agriculture. Sustainability of private farms in the light of selected criteria. Subsistence agricultural holdings and the sustainable development of agriculture. Sustainable farms in the light of the FADN data. Description of organic holdings in Poland.

  9. Sustainable NREL - Site Sustainability Plan FY 2015

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2015-01-01

    NREL's Site Sustainability Plan FY 2015 reports on sustainability plans for the lab for the year 2015 based on Executive Order Goals and provides the status on planned actions cited in the FY 2014 report.

  10. Sustainability in Transport Planning

    DEFF Research Database (Denmark)

    Gudmundsson, Henrik; Greve, Carsten

    Contribution to session J: Joint University Sustainability Initiatives. This session will provide an inspiring overview of interdisciplinary research and teaching activities on sustainability bridging DTU, KU, and CBS, and introduce the joint collaboration Copenhagen Sustainability Initiative (COSI...

  11. Sustainability : Politics and governance

    NARCIS (Netherlands)

    Heinrichs, Harald; Biermann, Frank

    2016-01-01

    he article gives an overview of global sustainability policy and politics. It is shown how international policy making on sustainable development has progressed from environmental policy toward recent approaches of Earth system governance. Key challenges of international sustainability politics are

  12. Textiles and clothing sustainability sustainable technologies

    CERN Document Server

    2017-01-01

    This is the first book to deal with the innovative technologies in the field of textiles and clothing sustainability. It details a number of sustainable and innovative technologies and highlights their implications in the clothing sector. There are currently various measures to achieve sustainability in the textiles and the clothing industry, including innovations in the manufacturing stage, which is the crux of this book.

  13. A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS Trial. Italy, The Netherlands, Canada and Australia Study

    NARCIS (Netherlands)

    Montaner, J. S.; Reiss, P.; Cooper, D.; Vella, S.; Harris, M.; Conway, B.; Wainberg, M. A.; Smith, D.; Robinson, P.; Hall, D.; Myers, M.; Lange, J. M.

    1998-01-01

    CONTEXT: Current guidelines recommend that individuals infected with the human immunodeficiency virus type 1 (HIV-1) be treated using combinations of antiretroviral agents to achieve sustained suppression of viral replication as measured by the plasma HIV-1 RNA assay, in the hopes of achieving

  14. Assessing sustainable remediation frameworks using sustainability principles.

    Science.gov (United States)

    Ridsdale, D Reanne; Noble, Bram F

    2016-12-15

    The remediation industry has grown exponentially in recent decades. International organizations of practitioners and remediation experts have developed several frameworks for integrating sustainability into remediation projects; however, there has been limited attention to how sustainability is approached and operationalized in sustainable remediation frameworks and practices - or whether sustainability plays any meaningful role at all in sustainable remediation. This paper examines how sustainability is represented in remediation frameworks and the guidance provided for practical application. Seven broad sustainability principles and review criteria are proposed and applied to a sample of six international remediation frameworks. Not all review criteria were equally satisfied and none of the frameworks fully met all criteria; however, the best performing frameworks were those identified as sustainability remediation frameworks. Intra-generational equity was addressed by all frameworks. Integrating social, economic and biophysical components beyond triple-bottom-line indicators was explicitly addressed only by the sustainable remediation frameworks. No frameworks provided principle- or rule-based guidance for dealing with trade-offs in sustainability decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Performance of HIV Prevention of Mother-To-Child Transmission Programs in Sub-Saharan Africa: Longitudinal Assessment of 64 Nevirapine-Based Programs Implemented in 25 Countries, 2000-2011.

    Directory of Open Access Journals (Sweden)

    Joël Ladner

    Full Text Available To evaluate the performance and to identify predictive factors of performance in prevention of mother-to-child HIV transmission programs (PMTCT in sub-Saharan African countries.From 2000 to 2011, PMTCT programs included in the Viramune Donation Programme (VDP were prospectively followed. Each institution included in the VDP provided data on program implementation, type of management institution, number of PMTCT sites, key programs outputs (HIV counseling and testing, NVP regimens received by mothers and newborns. Nevirapine Coverage Ratio (NCR, defined as the number of women who should have received nevirapine (observed HIV prevalence x number of women in antenatal care, was used to measure performance. Included programs were followed every six months through progress reports.A total of 64 programs in 25 sub-Saharan African countries were included. The mean program follow-up was 48.0 months (SD = 24.5; 20,084,490 women attended in antenatal clinics were included. The overall mean NCR was 0.52 (SD = 0.25, with an increase from 0.37 to 0.57 between the first and last progress reports (p<.0001; NCR increased by 3.26% per year-program. Between the first and the last report, the number of women counseled and tested increased from 64.3% to 86.0% (p<.0001, the number of women post-counseled from 87.5% to 91.3% (p = 0.08. After mixed linear regression analysis, type of responsible institution, number of women attended in ANC, and program initiation in 2005-2006 were significant predictive factors associated with the NCR. The effect of the time period increased from earlier to later periods.A longitudinal assessment of large PMTCT programs shows that scaling-up of programs was increased in sub-Saharan African countries. The PMTCT coverage increased throughout the study period, especially after 2006. Performance may be better for programs with a small or medium number of women attended in ANC. Identification of factors that predict PMTCT program

  16. Organizing for Sustainability

    Science.gov (United States)

    Brown, William M.; Hamburger, Michael W.

    2012-01-01

    A successful campus sustainability effort catalyzes broad engagement of the campus community and integration of sustainability principles into the academic and operational components of campus life. Although many universities have embraced sustainability as a new core value, others have been more sluggish in adopting sustainability principles to…

  17. Technology and sustainability

    NARCIS (Netherlands)

    Kroeze, C.; Boersema, J.J.; Tellegen, E.; Cremers, A.

    2011-01-01

    In ten essays, this book addresses a broad range of issues related to the interplay of sustainability and technology. How do population growth and technology relate to sustainable development? Can globalization be reconciled with sustainable development? Is sustainability a subjective or an

  18. Action Research for Sustainability

    DEFF Research Database (Denmark)

    Egmose, Jonas

    by analysing processes of social learning. The book addresses the need to move towards sustainability at societal level as a democratic challenge questioning the way we live on planet earth. By conceptualising sustain-ability as an immanent and emergent ability of ecological and social life, continuously...... to renew itself without eroding its own foundation of existence, it argues that since sustainability cannot be invented but only supported (or eroded) by science, we need to reframe science in the role of sustaining sustain-ability. Through analyses of a three year action research programme, aiming...

  19. Sustainable Investment. Literature Overview

    Energy Technology Data Exchange (ETDEWEB)

    Weda, J.; Kerste, M.; Rosenboom, N.

    2010-08-15

    Corporate Social Responsibility (CSR), or sustainability at the company level, entails incorporating ecological (environmental stakeholders) and social aspects (stakeholders other than shareholders and environmental stakeholders) when doing business. Socially Responsible Investment (SRI) concerns sustainability at the investment, fund or portfolio level and involves screening the sustainability of companies before investing in them. This report highlights leading literature and empirical findings on 'sustainable investment', amongst others addressing the economic rationale for CSR and SRI. This report is part of a set of SEO-reports on finance and sustainability. The other reports deal with: Financing the Transition to Sustainable Energy; Carbon Trading; Innovations in financing environmental and social sustainability.

  20. Efavirenz or nevirapine in three-drug combination therapy with two nucleoside or nucleotide-reverse transcriptase inhibitors for initial treatment of HIV infection in antiretroviral-naïve individuals.

    Science.gov (United States)

    Mbuagbaw, Lawrence; Mursleen, Sara; Irlam, James H; Spaulding, Alicen B; Rutherford, George W; Siegfried, Nandi

    2016-12-10

    The advent of highly active antiretroviral therapy (ART) has reduced the morbidity and mortality due to HIV infection. The World Health Organization (WHO) ART guidelines focus on three classes of antiretroviral drugs, namely nucleoside or nucleotide reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors. Two of the most common medications given as first-line treatment are the NNRTIs, efavirenz (EFV) and nevirapine (NVP). It is unclear which NNRTI is more efficacious for initial therapy. This systematic review was first published in 2010. To determine which non-nucleoside reverse transcriptase inhibitor, either EFV or NVP, is more effective in suppressing viral load when given in combination with two nucleoside reverse transcriptase inhibitors as part of initial antiretroviral therapy for HIV infection in adults and children. We attempted to identify all relevant studies, regardless of language or publication status, in electronic databases and conference proceedings up to 12 August 2016. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov to 12 August 2016. We searched LILACS (Latin American and Caribbean Health Sciences Literature) and the Web of Science from 1996 to 12 August 2016. We checked the National Library of Medicine (NLM) Gateway from 1996 to 2009, as it was no longer available after 2009. We included all randomized controlled trials (RCTs) that compared EFV to NVP in people with HIV without prior exposure to ART, irrespective of the dosage or NRTI's given in combination.The primary outcome of interest was virological success. Other primary outcomes included mortality, clinical progression to AIDS, severe adverse events, and discontinuation of therapy for any reason. Secondary outcomes were change in CD4 count, treatment failure

  1. Action Research for Sustainability

    DEFF Research Database (Denmark)

    Egmose, Jonas

    How can action research further new research orientations towards sustainability? This book, empirically situated in the field of upstream public engagement, involving local residents, researchers and practitioners in bottom-up processes deliberating on urban sustainability, answers this question...... by analysing processes of social learning. The book addresses the need to move towards sustainability at societal level as a democratic challenge questioning the way we live on planet earth. By conceptualising sustain-ability as an immanent and emergent ability of ecological and social life, continuously...... to renew itself without eroding its own foundation of existence, it argues that since sustainability cannot be invented but only supported (or eroded) by science, we need to reframe science in the role of sustaining sustain-ability. Through analyses of a three year action research programme, aiming...

  2. Sustaining Rural Communities through Sustainable Agriculture.

    Science.gov (United States)

    Ikerd, John

    A 5-year collaborative project between Missouri, Michigan State, and Nebraska Universities to provide new opportunities for rural community self-development through sustainable agriculture had mixed results. This happened because community members did not understand the principles of sustainability, and because the extension education system was…

  3. Photic effects on sustained performance

    Science.gov (United States)

    French, J.; Whitmore, J.; Hannon, P. J.; Brainard, G.; Schiflett, S.

    1992-01-01

    Research is described which evaluates manipulating environmental light intensity as a means to attenuate fatigue. A counter balanced, within-subjects design was used to compare nine male subjects exposed to dim (100 lux) and bright (3000 lux) light conditions. Oral temperature values were greater for the bright light group over the dim light condition. Melatonin levels were suppressed by bright light treatment. Also, the frequency of eye blink rate was less for subjects during bright over dim light exposure. Light exposure was without effect on subjective fatigue. However, irrespective of light condition, significant effects on confusion, fatigue, and vigor mood dimensions were found as a result of 30 hour sleep deprivation. The findings suggest that bright lights may be used to help sustain nocturnal activity otherwise susceptible to fatigue. Such findings may have implications for the lighting arrangements on space flights during the subjective night for astronauts.

  4. Sustainable Marketing : The Importance of Being a Sustainable Business

    OpenAIRE

    Reutlinger, Janina

    2012-01-01

    This thesis deals with sustainable marketing, as well as the necessity for more sustainability. The purpose of this thesis was to determine the importance of sustainable marketing for companies. The theoretical part is divided into sustainability and sustainable marketing. Sustainability covers current issues and sustainable development, which form a background for a better understanding of sustainable marketing. Sustainable marketing includes a definition of the concept, as well as susta...

  5. Action Research for Sustainability

    DEFF Research Database (Denmark)

    Egmose, Jonas

    Analysing processes of social learning this work addresses how action research can further new research orientations towards sustainability. Empirically situated in the field of upstream public engagement, involving local residents, researchers and practitioners in bottom-up processes deliberating...... on urban sustainability the need to move towards sustainability at societal level is conceptualised as a democratic challenge questioning the way we live on planet earth. By understanding sustainability as an immanent and emergent ability of ecological and social life, continuously to renew itself without...... eroding its own foundation of existence, it argues that since sustainability cannot be invented but only supported (or eroded) by science, we need to reframe science in the role of sustaining sustain-ability. Through analyses of a three year action research programme, aiming to provide local citizens...

  6. Handbook of sustainable engineering

    CERN Document Server

    Lee, Kun-Mo

    2013-01-01

    "The efficient utilization of energy, sustainable use of natural resources, and large-scale adoption of sustainable technologies is the key to a sustainable future. The Handbook of Sustainable Engineering provides tools that will help us achieve these goals". Nobel Prize Winner Dr. R.K. Pauchauri, Chairman, UN Intergovernmental Panel on Climate Change As global society confronts the challenges of diminishing resources, ecological degradation, and climate change, engineers play a crucial role designing and building technologies and products that fulfil our needs for utility and sustainability. The Handbook of Sustainable Engineering equips readers with the context and the best practices derived from both academic research and practical examples of successful implementations of sustainable technical solutions. The handbook’s content revolves around the two themes, new ways of thinking and new business models, including sustainable production, products, service systems and consumption while addressing key asse...

  7. FORUM: Is Ecotourism Sustainable?

    Science.gov (United States)

    Wall

    1997-07-01

    / It is legitimate to ask whether and in what form tourism might contribute to sustainable development. This is not the same as sustainable tourism which, as a single-sector approach to development, may overlook important linkages with other sectors. If tourism is to contribute to sustainable development, then it must be economically viable, ecologically sensitive and culturally appropriate. Ecotourism is often advocated as being a sustainable form of tourism but imprecision in terminology clouds basic issues and there are strong economic, ecological, and cultural reasons for believing that, even in its purest forms, ecotourism is likely to present substantial challenges to destination areas, particularly if it competes for scarce resources and displaces existing uses and users. Sustainable tourism and ecotourism are not synonyms, many forms of ecotourism may not be sustainable, and if ecotourism is to contribute to sustainable development, then careful planning and management will be required.KEY WORDS: Ecotourism; Sustainable development; Development; Tourism

  8. Livestock biodiversity and sustainability

    NARCIS (Netherlands)

    Hoffmann, I.

    2011-01-01

    Sustainable development equally includes environmental protection including biodiversity, economic growth and social equity, both within and between generations. The paper first reviews different aspects related to the sustainable use of livestock biodiversity and property regimes that influence

  9. Sustainable Public Bids

    Directory of Open Access Journals (Sweden)

    Gil César Costa de Paula

    2016-06-01

    Full Text Available In this article we will discuss the issue of sustainability in public procurement, given that the government in Brazil is constituted as a great promoter of economic development and needs to adapt its acquisitions worldwide sustainability agenda.

  10. Indicators for environmental sustainability

    DEFF Research Database (Denmark)

    Dong, Yan; Hauschild, Michael Zwicky

    2017-01-01

    . In this study, we reviewed indicators applied in life cycle assessment (LCA), planetary boundary framework (PB), and Sustainable Development Goals (SDGs) developed under United Nation. The aim is to 1) identify their applications and relevant decision context; 2) Review their indicators and categorize them......Decision making on sustainable consumption and production requires scientifically based information on sustainability. Different environmental sustainability targets exist for specific decision problems. To observe how well these targets are met, relevant environmental indicators are needed...

  11. Sustainable Learning Organizations

    Science.gov (United States)

    Velazquez, Luis E.; Esquer, Javier; Munguia, Nora E.; Moure-Eraso, Rafael

    2011-01-01

    Purpose: The purpose of this paper is to debate how companies may better become a sustainable learning organization by offering the most used and insightful concepts of sustainability. Design/methodology/approach: Through literature review, learning organization and sustainability perspectives are explored and compared. Findings: Learning…

  12. Measuring Educational Sustainability

    Science.gov (United States)

    Selvanathan, Rani G.

    2013-01-01

    There are many definitions that are attributable to the meaning of sustainability. Sustainability can be viewed as long-lasting, effective result of a project, venture, action, or investment without consuming additional future resources. Because of the wide nature of its applicability, a universal measure of sustainability is hard to come by. This…

  13. ORNL Annual Sustainability Report

    Energy Technology Data Exchange (ETDEWEB)

    Lapsa, Melissa Voss [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nichols, Teresa A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-02-01

    As described in this report, we have made substantial progress across the 25 roadmaps of the Sustainable Campus Initiative. The report also outlines our plans to continue integrating sustainable practices into the planning, execution, and evaluation of all ORNL activities. We appreciate your interest in our journey to sustainability, and we welcome your comments, questions, and suggestions.

  14. Toward sustainable logistics

    NARCIS (Netherlands)

    Soysal, Mehmet; Bloemhof-Ruwaard, Jacqueline M.

    2017-01-01

    The fast evolution of sustainability leads to the development of a new fast-growing concept called sustainable logistics management. This research addresses recent business trends and challenges in logistics and their implications for sustainable logistics management. Additionally, we discuss policy

  15. LCA and Sustainability

    DEFF Research Database (Denmark)

    Moltesen, Andreas; Bjørn, Anders

    2017-01-01

    LCA is often presented as a sustainability assessment tool. This chapter analyses the relationship between LCA and sustainability. This is done by first outlining the history of the sustainability concept, which gained momentum with the Brundtland Commission’s report ‘Our Common Future report ’ i...

  16. Lean maturity, lean sustainability

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Matthiesen, Rikke; Nielsen, Jacob

    2007-01-01

    Although lean is rapidly growing in popularity, its implementation is far from problem free and companies may experience difficulties sustaining long term success. In this paper, it is suggested that sustainable lean requires attention to both performance improvement and capability development...... that support lean capability development and consequently, lean sustainability....

  17. Food sustainability: diverging interpretations

    NARCIS (Netherlands)

    Aiking, H.; de Boer, J.

    2004-01-01

    The concept of sustainability in general and food sustainability, in particular, entails many aspects and many interpretations. During a conference on food sustainability a broad, multidisciplinary picture was painted and many key issues were dealt with, from ecology, economy and society. In

  18. Transferring Education for Sustainability

    Science.gov (United States)

    Gafoor, Kunnathodi Abdul; Umer Farooque, T. K.

    2013-01-01

    Sustainability stands for sustaining the past, meeting needs of the present without compromising the ability to meet future needs. It should meet the individual and social needs, present and future needs local and global needs. A sustainable education that meets this requirements surely be a transferable education; an education that transfers from…

  19. Sustainability: An Overview.

    Science.gov (United States)

    Wormsley, W. E.

    1990-01-01

    This article introduces a group of six papers on sustainability of programs for visually handicapped persons in developing countries. Sustainability is discussed from an anthropological perspective, noting the importance of a social soundness analysis and a social impact assessment, enemies of sustainability, and the need for broad local input in…

  20. Sustainability in logistics practice

    NARCIS (Netherlands)

    Hans-Heinrich Glöckner; Reinder Pieters; Stef Weijers

    2009-01-01

    This conceptual paper wants to emphasis the use of the concept of sustainability within logistics and especially transportation. While working on a new tool to help companies develop sustainable European networks, we discovered that we want to use a specific concept of sustainability: People, planet

  1. Liquid sulfur mustard exposure.

    Science.gov (United States)

    Newmark, Jonathan; Langer, Janice M; Capacio, Benedict; Barr, John; McIntosh, Roger G

    2007-02-01

    A 35-year-old active duty service member sustained a 6.5% body surface area burn as a result of exposure to the chemical warfare agent sulfur mustard, which is the most severe mustard exposure of a U.S. military member since World War II that is known to us. New techniques were used to demonstrate the detectable persistence of mustard metabolites in the patient's blood for at least 41 days after exposure, validating these techniques for the first time for a human mustard patient; they were also used for the first time with human mustard blister fluid. The techniques extend eightfold the period of time that mustard exposure can be definitively diagnosed, compared with previous techniques. Although this patient's lesions were never life-threatening, he required 2 weeks of intensive burn care. He has been left with ongoing posttraumatic stress disorder and has had an incomplete dermatological recovery. In a major terrorist attack involving many patients exposed to sulfur mustard, care resources would be depleted quickly.

  2. LCA and Sustainability

    DEFF Research Database (Denmark)

    Moltesen, Andreas; Bjørn, Anders

    2017-01-01

    LCA is often presented as a sustainability assessment tool. This chapter analyses the relationship between LCA and sustainability. This is done by first outlining the history of the sustainability concept, which gained momentum with the Brundtland Commission’s report ‘Our Common Future report...... is then demonstrated, and the strategy of LCA to achieving environmental protection, namely to guide the reduction of environmental impacts per delivery of a function, is explained. The attempt to broaden the scope of LCA, beyond environmental protection, by so-called life cycle sustainability assessment (LCSA......) is outlined. Finally, the limitations of LCA in guiding a sustainable development are discussed....

  3. From sustainable buildings to sustainable business

    OpenAIRE

    Mia Andelin

    2012-01-01

    The United Nations Environment Program (UNEP) Sustainable Buildings & Climate Initiative reports that buildings are responsible for more than 40 percent of global energy use and over one third of global greenhouse gas (GHG) emissions. The construction and real estate sector has the potential to play a significant role in the response to climate change. During the latest years the increase in attention to sustainability and green building by planners, developers, and investors has been remarka...

  4. Action Research for Sustainability

    DEFF Research Database (Denmark)

    Egmose, Jonas

    to renew itself without eroding its own foundation of existence, it argues that since sustainability cannot be invented but only supported (or eroded) by science, we need to reframe science in the role of sustaining sustain-ability. Through analyses of a three year action research programme, aiming...... to provide local citizens with a greater say in the future of urban sustainability research, this book shows how action research can make important methodological contributions to processes of social learning between citizens and scientists by enabling free spaces in peoples everyday life and within academia......How can action research further new research orientations towards sustainability? This book, empirically situated in the field of upstream public engagement, involving local residents, researchers and practitioners in bottom-up processes deliberating on urban sustainability, answers this question...

  5. Action Research for Sustainability

    DEFF Research Database (Denmark)

    Egmose, Jonas

    to provide local citizens with a greater say in the future of urban sustainability research, this book shows how action research can make important methodological contributions to processes of social learning between citizens and scientists by enabling free spaces in peoples everyday life and within academia...... to renew itself without eroding its own foundation of existence, it argues that since sustainability cannot be invented but only supported (or eroded) by science, we need to reframe science in the role of sustaining sustain-ability. Through analyses of a three year action research programme, aiming......How can action research further new research orientations towards sustainability? This book, empirically situated in the field of upstream public engagement, involving local residents, researchers and practitioners in bottom-up processes deliberating on urban sustainability, answers this question...

  6. Sustainability in Business

    DEFF Research Database (Denmark)

    Tollin, Karin; Vej, Jesper

    2012-01-01

    How do companies integrate sustainability into their strategy and practices, and what factors explain their approach? In this paper a typology of sustainability strategies is presented as well as a conceptual framework relating sustainability at the company level to the functional level...... of marketing. The central contribution of the typology is a strategic and managerial view on sustainability. Furthermore, the typology shows that sustainability in business is enacted from different areas of competences and fields in the literature (e.g. supply chain management, corporate branding, value...... creation, product innovation and business model innovation). The empirical basis for the typology is an exploratory study of managers' mindsets about sustainability as strategy. Ten top managers involved with integrating sustainability within their companies have been interviewed. In order to reveal...

  7. Fur and Sustainability

    DEFF Research Database (Denmark)

    Skjold, Else; Csaba, Fabian

    2016-01-01

    This paper explores the notion of deeper luxury, which insists that 'real' luxury should involve sustainable practices in the production and consumption of luxury goods. It traces historical and recent developments in the field of fur, to understand the implications, uncertainties and ambiguities...... of luxury’s confrontation with sustainability. Considering fur in relation to future standards for luxury products, we raise questions about moral problematisation and justification of luxury in terms of sustainability. We first examine the encounter of luxury with sustainability and explain...... the significance of the notion of ‘deeper luxury’. After taking stock of the impact of sustainability on luxury and various directions in which sustainable luxury is evolving, we discuss concepts of sustainable development in relation to the history of moral problematisation of luxury. This leads to the case...

  8. Safe and Sustainable: Optimizing Material Flows in a Circular Economy

    DEFF Research Database (Denmark)

    Fantke, Peter

    life cycles.However, a circular economy is only viable if it is both safe and sustainable. The dilemma is that sustainable does not necessarily imply safe and vice versa. When minimizing exposure to harmful chemicals in consumer products (safe), we often use more energy-demanding alternative solutions...... (unsustainable). When maximizing resource use efficiency and reducing carbon and other emissions through recycling (sustainable), direct consumer exposure is often increased through cross-contamination of recycled materials (unsafe). Hence, circular economy currently fails to unite the required expertise...... to imultaneously increase sustainability and reduce exposure to chemicals in materials reused across life cycles of different products. For a way out of this dilemma, a paradigm shift is needed towards a comprehensive and quantitative assessment framework....

  9. Health and sustainability.

    Science.gov (United States)

    Kjӕrgård, Bente; Land, Birgit; Bransholm Pedersen, Kirsten

    2014-09-01

    In the present article, we explore how sustainable development strategies and health promotion strategies can be bridged. The concept of the 'duality of structure' is taken as our starting point for understanding the linkages between health promotion and sustainable development, and for uncovering the structural properties or conditions which either enable or constrain sustainable public health initiatives. We argue that strategies towards health promotion are not sufficiently integrated with strategies for sustainable development, and thus political strategies aimed at solving health problems or sustainability problems may cause new, undesired and unforeseen environmental or health problems. First, we explore how the relation between health and sustainability is articulated in international policy documents. Next, we develop a model for understanding the relation between health promotion and sustainability. Third, we use examples from agriculture and food production to illustrate that health and sustainability are mutually enabling and constraining. We conclude that while the renewed focus on food security and food inequalities has brought the health and sustainability dimensions of the food system onto the political agenda, the conceptualization of duality between health and sustainability could be a new platform for a critical and theoretical stance towards the market-oriented food system strategy. Thinking along the lines of duality means that the integration of health promotion strategies and sustainable development strategies cannot be based on an approach to integration in which either health or sustainability is given precedence over the other. From a duality perspective, integration means conceiving sustainability from a health perspective and health from a sustainability perspective. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Meta-analysis of two randomized controlled trials comparing combined zidovudine and didanosine therapy with combined zidovudine, didanosine, and nevirapine therapy in patients with HIV. INCAS study team.

    Science.gov (United States)

    Raboud, J M; Rae, S; Vella, S; Harrigan, P R; Bucciardini, R; Fragola, V; Ricciardulli, D; Montaner, J S

    1999-11-01

    To extend the range of CD4 counts in which a plasma viral load nadir (pVL) 100,000 copies/ml. Among triple therapy patients, the relative risk of virologic failure was higher for patients with higher baseline pVL (rate ratio [RR] = 2.51/log10 copies/ ml; p = .01), after controlling for compliance and pVL nadir. The relative risks of virologic failure associated with pVL nadir 400 copies/ml. We have extended our earlier results that achieving a pVL nadir <20 copies/ml is important for maintaining virologic suppression. In particular, we have demonstrated that a pVL nadir <20 copies/ml is at least fivefold more protective against virologic failure than achieving a pVL nadir between 20 and 400 copies/ml. Baseline pVL is significantly associated with the probability of achieving and sustaining virologic suppression.

  11. [What is sustainability science?].

    Science.gov (United States)

    Wu, Jian-Guo; Guo, Xiao-Chuan; Yang, Jie; Qian, Gui-Xia; Niu, Jian-Ming; Liang, Cun-Zhu; Zhang, Qing; Li, Ang

    2014-01-01

    Sustainability is the theme of our time and also the grandest challenge to humanity. Since the 1970s, the term, sustainable development, has frequently appeared in the scientific literature, governmental documents, media promotions for public goods, and commercial advertisements. However, the science that provides the theoretical foundation and practical guidance for sustainable development--sustainability science--only began to emerge in the beginning of the 21st century. Nevertheless, the field has rapidly developed in depth and expanded in scope during the past decade, with its core concepts and research methods coalescing. China, as the most populous country in the world and home to the philosophical root of sustainability science-the unity of man and nature, is obligated to take upon the challenge of our time, to facilitate global sustainability while pursuing the Chinese Dream, and to play a leading role in the development of sustainability science. Toward this grandiose goal, this paper presents the first Chinese introduction to sustainability science, which discusses its basic concepts, research questions, and future directions. Sustainability science is the study of the dynamic relationship between humans and the environment, particularly focusing on the vulnerability, robustness, resilience, and stability of the coupled human-environment system. It is a transdisciplinary science that integrates natural sciences with humanities and social sciences. It hinges on the environment-economy-society nexus, and merges basic and applied research. The key components of sustainability often change with time, place, and culture, and thus sustainability science needs to emphasize multi-scale studies in space and time, with emphasis on landscapes and regions over a horizon of 50 to 100 years. It needs to focus on the relationship between ecosystem services and human well-being, as influenced by biodiversity and ecosystem processes as well as climate change, land use

  12. Lopinavir/Ritonavir versus Lamivudine peri-exposure prophylaxis to prevent HIV-1 transmission by breastfeeding: the PROMISE-PEP trial Protocol ANRS 12174

    Directory of Open Access Journals (Sweden)

    Nagot Nicolas

    2012-10-01

    Full Text Available Abstract Background Postnatal transmission of HIV-1 through breast milk remains an unsolved challenge in many resource-poor settings where replacement feeding is not a safe alternative. WHO now recommends breastfeeding of infants born to HIV-infected mothers until 12 months of age, with either maternal highly active antiretroviral therapy (HAART or peri-exposure prophylaxis (PEP in infants using nevirapine. As PEP, lamivudine showed a similar efficacy and safety as nevirapine, but with an expected lower rate of resistant HIV strains emerging in infants who fail PEP, and lower restrictions for future HIV treatment. Lopinavir/ritonavir (LPV/r is an attractive PEP candidate with presumably higher efficacy against HIV than nevirapine or lamivudine, and a higher genetic barrier to resistance selection. It showed an acceptable safety profile for the treatment of very young HIV-infected infants. The ANRS 12174 study aims to compare the risk of HIV-1 transmission during and safety of prolonged infant PEP with LPV/r (40/10 mg twice daily if 2-4 kg and 80/20 mg twice daily if >4 kg versus Lamivudine (7,5 mg twice daily if 2-4 kg, 25 mg twice daily if 4-8 kg and 50 mg twice daily if >8 kg from day 7 until one week after cessation of BF (maximum 50 weeks of prophylaxis to prevent postnatal HIV-1 acquisition between 7 days and 50 weeks of age. Methods The ANRS 12174 study is a multinational, randomised controlled clinical trial conducted on 1,500 mother-infant pairs in Burkina Faso, South Africa, Uganda and Zambia. We will recommend exclusive breastfeeding (EBF until 26th week of life and cessation of breastfeeding at a maximum of 49 weeks in both trial arms. HIV-uninfected infants at day 7 (± 2 days born to HIV-1 infected mothers not eligible for HAART who choose to breastfeed their infants. The primary endpoint is the acquisition of HIV-1 (as assessed by HIV-1 DNA PCR between day 7 and 50 weeks of age. Secondary endpoints are safety (including resistance

  13. decolonising sustainability: subverting and appropriating

    African Journals Online (AJOL)

    magnitude for environmental education. We can speak of sustainable development, sustainable economies, sustainable democracy, a sustainable world order, and sustainable modes of health maintenance, but when we turn to spiritual matters we are faced with the black hole of green· politics: what constitutes sustainable.

  14. SMART SUSTAINABLE ISLANDS VS SMART SUSTAINABLE CITIES

    Directory of Open Access Journals (Sweden)

    D. N. Pantazis

    2017-09-01

    Full Text Available This paper has several aims: a the presentation of a critical analysis of the terms “smart sustainable cities” and “smart sustainable islands” b the presentation of a number of principles towards to the development methodological framework of concepts and actions, in a form of a manual and actions guide, for the smartification and sustainability of islands. This kind of master plan is divided in thematic sectors (key factors which concern the insular municipalities c the creation of an island’s smartification and sustainability index d the first steps towards the creation of a portal for the presentation of our smartification actions manual, together with relative resources, smart applications examples, and, in the near future the first results of our index application in a number of Greek islands and e the presentation of some proposals of possible actions towards their sustainable development and smartification for the municipalities - islands of Paros and Antiparos in Greece, as case studies.

  15. Sustainable Building Operation

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole

    2009-01-01

    Energy-savings in the existing building stock have becomes a main goal in national and international policies. Often focus is on building-renovations, whereas the potential of sustainable building operation to a large extent has been neglected. Nevertheless, international research as well...... as practical experiences from Danish housing estates indicates that there are large potentials for energy savings by focusing on the operation of the buildings. We suggest that in order to achieve sustainability in the existing housing, renovation and operations should be seen as integrated parts...... and that sustainable building operation can pave the way for sustainable building renovation. This paper discusses the use of sustainability building operation in Danish housing estates: Which tools, methods and technologies is being used, where are the barriers and where are the potentials? We define sustainable...

  16. Health and Sustainability

    DEFF Research Database (Denmark)

    Land, Birgit; Pedersen, Kirsten Bransholm; Kjærgård, Bente

    2014-01-01

    In the present article, we explore how sustainable development strategies and health promotion strategies can be bridged. The concept of the ‘duality of structure’ is taken as our starting point for understanding the linkages between health promotion and sustainable development, and for uncovering...... the structural properties or conditions which either enable or constrain sustainable public health initiatives. We argue that strategies towards health promotion are not sufficiently integrated with strategies for sustainable development, and thus political strategies aimed at solving health problems...... or sustainability problems may cause new, undesired and unforeseen environmental or health problems. First, we explore how the relation between health and sustainability is articulated in international policy documents. Next, we develop a model for understanding the relation between health promotion...

  17. Sustainability and Entrepreneurial Action

    DEFF Research Database (Denmark)

    Korsgaard, Steffen T.; Anderson, Alistair

    Abstract Objectives - This paper explores how entrepreneurial action can lead to environmental sustainability. It builds on the assumption that the creation of sustainble practices is one of the most important challenges facing the global society, and that entrepreneurial action is a vital...... instrument in the pursuit of sustainability.  Prior Work - Extant literature identifies two main approaches to sustainable entrepreneurship. (i) traditional exploitation of environmentally relevant opportunities and (ii) institutional entrepreneurship creating opportunities. We identify a novel form......: resource oriented sustainable entrepreneurial action.  Approach - The paper uses a case study approach to build deeper theoretical knowledge of environmentally sustainable entrepreneurship.  Results - The paper identifies and analyses a distinct form of sustainable entrepreneurship -  resource oriented...

  18. At Home with Sustainability

    DEFF Research Database (Denmark)

    Hale, Lara

    2018-01-01

    of default rules in subconscious decision-making, this research finds that, ultimately, awareness drives the demand necessary for the creation of sustainable consumption. Whereas direct appeal to individuals has a disappointing level of influence on sustainability choices, it is understood that green......-fuel-based energy. To act otherwise requires additional effort and is less likely. Motivated by a need to understand how defaults might bridge standards and sustainable consumption, I investigate how organizational processes potentially lead from standardized green default rules to individual awareness that can...... spread and facilitate sustainable consumption. This paper examines the Active House sustainable building demonstrations in Europe in order to understand how (1) communications and market creation and (2) responsible, user-centered experimentation are organized to move from defaults to sustainable...

  19. ICT innovations for sustainability

    CERN Document Server

    Aebischer, Bernard

    2015-01-01

    ICT Innovations for Sustainability is an investigation of how information and communication technology can contribute to sustainable development. It presents clear definitions of sustainability, suggesting conceptual frameworks for the positive and negative effects of ICT on sustainable development. It reviews methods of assessing the direct and indirect impact of ICT systems on energy and materials demand, and examines the results of such assessments. In addition, it investigates ICT-based approaches to supporting sustainable patterns of production and consumption, analyzing them at various levels of abstraction – from end-user devices, Internet infrastructure, user behavior, and social practices to macro-economic indicators.   Combining approaches from Computer Science, Information Systems, Human-Computer Interaction, Economics, and Environmental Sciences, the book presents a new, holistic perspective on ICT for Sustainability (ICT4S). It is an indispensable resource for anyone working in the area of ICT...

  20. Sustainability and substitutability.

    Science.gov (United States)

    Fenichel, Eli P; Zhao, Jinhua

    2015-02-01

    Developing a quantitative science of sustainability requires bridging mathematical concepts from fields contributing to sustainability science. The concept of substitutability is central to sustainability but is defined differently by different fields. Specifically, economics tends to define substitutability as a marginal concept while fields such as ecology tend to focus on limiting behaviors. We explain how to reconcile these different views. We develop a model where investments can be made in knowledge to increase the elasticity of substitution. We explore the set of sustainable and optimal trajectories for natural capital extraction and built and knowledge capital accumulation. Investments in substitutability through knowledge stock accumulation affect the value of natural capital. Results suggest that investing in the knowledge stock, which can enhance substitutability, is critical to desirable sustainable outcomes. This result is robust even when natural capital is not managed optimally. This leads us to conclude that investments in the knowledge stock are of first order importance for sustainability.

  1. Sustainable Concrete Technology

    Directory of Open Access Journals (Sweden)

    Sim J.

    2015-12-01

    Full Text Available The growing concern over global warming and significant ecological changes requires sustainable development in all fields of science and technology. Concrete not only consumes huge amount of energy and natural sources, but also emits large amount of CO2, mainly due to the production of cement. It is evident that such large amount of concrete production has put significant impact on the energy, resource, environment, and ecology of the society. Hence, how to develop the concrete technology in a sustainable way has become a significant issue. In this paper, some of Korean researches for sustainable development of concrete are presented. These are sustainable strengthening for deteriorated concrete structure, sustainable reinforcement of new concrete structure, sustainable concrete using recycled aggregate and supplementary cementing materials and finally application of each technique to precast concrete.

  2. Sustainable fashion: New approaches

    OpenAIRE

    Niinimäki, Kirsi

    2013-01-01

    This publication is intended to be used as a source of inspiration for designers and companies, and all stakeholders whose interest lies in the area of sustainable fashion. While the strategies for sustainability are complex and approaches are many, this publication presents only a few ways to approach sustainable fashion. I hope the publication offers inspiration on how to make positive change in current practices and how to effect new mindsets, creating transformative fashion. Theoretica...

  3. Education for sustainable development

    DEFF Research Database (Denmark)

    Breiting, Søren

    2009-01-01

     An introduction to the idea of sustainable development (SD) and education for sustainable development (ESD) with reference to the international Decade for Education for Sustainable Development . The chapter includes a focus on conflicting interests between present and future generations related...... to the use of natural resources and other matters, and how that kind of issues can be dealt with in education as ESD....

  4. A highly sustainable house

    OpenAIRE

    Cordero, Raúl; Mercader-Moyano, Pilar (Coordinador)

    2017-01-01

    A sustainable house is capable of generating and self-sustaining energy by itself to function autonomously, that is to say, without depending on external supply networks. That is possible by supplying the internal energy consumption through renewable energy. This work describes and analyzes the construction of a sustainable house in Paute, Ecuador. The goal of this house was to achieve selfsustainability in several aspects such as construction techniques, creative and functi...

  5. Sustainability Assessment Circle

    OpenAIRE

    Schlör, H.; Hake, J.-Fr.

    2015-01-01

    Since the nineteen seventies, science and society have been discussing the worldwide ecological, economic, and social problems caused by industrialization and globalization. Sustainable development is perceived as a strategy for coping with these problems. The Rio +20 conference in 2012 confirmed the sustainability concept and introduced the green economy and the life cycle sustainable assessment as its implementation and operationalization strategy and tool.In the following, we will demonstr...

  6. Sustainability assessment and complementarity

    Directory of Open Access Journals (Sweden)

    Hugo F. Alrøe

    2016-03-01

    Full Text Available Sustainability assessments bring together different perspectives that pertain to sustainability to produce overall assessments, and a wealth of approaches and tools have been developed in the past decades. However, two major problems remain. The problem of integration concerns the surplus of possibilities for integration; different tools produce different assessments. The problem of implementation concerns the barrier between assessment and transformation; assessments do not lead to the expected changes in practice. We aim to analyze issues of complementarity in sustainability assessment and transformation as a key to better handling the problems of integration and implementation. Based on a generalization of Niels Bohr's complementarity from quantum mechanics, we have identified two forms of complementarity in sustainability assessment, observer stance complementarity and value complementarity. Unlike many other problems of sustainability assessment, complementarity is of a fundamental character connected to the very conditions for observation. Therefore, complementarity cannot be overcome methodologically, only handled better or worse. Science is essential to the societal goal of sustainability, but these issues of complementarity impede the constructive role of science in the transition to more sustainable structures and practices in food systems. The agencies of sustainability assessment and transformation need to be acutely aware of the importance of different perspectives and values and the complementarities that may be connected to these differences. An improved understanding of complementarity can help to better recognize and handle issues of complementarity. These deliberations have relevance not only for sustainability assessment, but more generally for transdisciplinary research on wicked problems.

  7. Predicting Sustainable Work Behavior

    DEFF Research Database (Denmark)

    Hald, Kim Sundtoft

    2013-01-01

    . Employee characteristics and general attitudes towards safety and work condition are included in the extended model. A survey was handed out to 654 employees in Chinese factories. This research contributes by demonstrating how employee- characteristics and general attitudes towards safety and work...... condition influence their sustainable work behavior. A new definition of sustainable work behavior is proposed.......Sustainable work behavior is an important issue for operations managers – it has implications for most outcomes of OM. This research explores the antecedents of sustainable work behavior. It revisits and extends the sociotechnical model developed by Brown et al. (2000) on predicting safe behavior...

  8. Sustainability needs the geosciences

    Science.gov (United States)

    Grimm, Nancy; van der Pluijm, Ben

    2012-10-01

    Science, Innovation, and Partnerships for Sustainable Solutions: A National Academies Symposium; Washington, D. C., 16-18 May 2012 It is no longer disputed that humanity has drastically changed the face of the planet and its life-support systems. The sustainability challenge is to meet people's needs today and in the future while sustaining life-support systems. This grand challenge demands a new scientific approach: use-inspired, solution-driven research that consciously links scientific research to societal decision-making and action. Sustainability science may help fulfill that need if it can engage communities of expertise across a wide range of disciplines and sectors, including the geosciences.

  9. Sustainable wireless networks

    CERN Document Server

    Zheng, Zhongming; Xuemin

    2013-01-01

    This brief focuses on network planning and resource allocation by jointly considering cost and energy sustainability in wireless networks with sustainable energy. The characteristics of green energy and investigating existing energy-efficient green approaches for wireless networks with sustainable energy is covered in the first part of this brief. The book then addresses the random availability and capacity of the energy supply. The authors explore how to maximize the energy sustainability of the network and minimize the failure probability that the mesh access points (APs) could deplete their

  10. Sustainable Management of Food

    Science.gov (United States)

    To provide information to organizations to help them implement sustainable food management, including joining the Food Recovery Challenge. To provide education and information to communities and concerned citizens.

  11. Sustained induction of cytochrome P4501A1 in human hepatoma cells by co-exposure to benzo[a]pyrene and 7H-dibenzo[c,g]carbazole underlies the synergistic effects on DNA adduct formation

    Energy Technology Data Exchange (ETDEWEB)

    Gábelová, Alena, E-mail: alena.gabelova@savba.sk [Cancer Research Institute, Slovak Academy of Sciences, Vlárska 7, 833 91 Bratislava (Slovakia); Poláková, Veronika [Cancer Research Institute, Slovak Academy of Sciences, Vlárska 7, 833 91 Bratislava (Slovakia); Prochazka, Gabriela [Department of Biosciences and Nutrition, Karolinska Institute, Novum, SE-141 83 Huddinge (Sweden); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, SE-171 77 Stockholm (Sweden); Kretová, Miroslava; Poloncová, Katarína; Regendová, Eva; Luciaková, Katarína [Cancer Research Institute, Slovak Academy of Sciences, Vlárska 7, 833 91 Bratislava (Slovakia); Segerbäck, Dan [Department of Biosciences and Nutrition, Karolinska Institute, Novum, SE-141 83 Huddinge (Sweden)

    2013-08-15

    To gain a deeper insight into the potential interactions between individual aromatic hydrocarbons in a mixture, several benzo[a]pyrene (B[a]P) and 7H-dibenzo[c,g]carbazole (DBC) binary mixtures were studied. The biological activity of the binary mixtures was investigated in the HepG2 and WB-F344 liver cell lines and the Chinese hamster V79 cell line that stably expresses the human cytochrome P4501A1 (hCYP1A1). In the V79 cells, binary mixtures, in contrast to individual carcinogens, caused a significant decrease in the levels of micronuclei, DNA adducts and gene mutations, but not in cell survival. Similarly, a lower frequency of micronuclei and levels of DNA adducts were found in rat liver WB-F344 cells treated with a binary mixture, regardless of the exposure time. The observed antagonism between B[a]P and DBC may be due to an inhibition of Cyp1a1 expression because cells exposed to B[a]P:DBC showed a decrease in Cyp1a1 mRNA levels. In human liver HepG2 cells exposed to binary mixtures for 2 h, a reduction in micronuclei frequency was also found. However, after a 24 h treatment, synergism between B[a]P and DBC was determined based on DNA adduct formation. Accordingly, the up-regulation of CYP1A1 expression was detected in HepG2 cells exposed to B[a]P:DBC. Our results show significant differences in the response of human and rat cells to B[a]P:DBC mixtures and stress the need to use multiple experimental systems when evaluating the potential risk of environmental pollutants. Our data also indicate that an increased expression of CYP1A1 results in a synergistic effect of B[a]P and DBC in human cells. As humans are exposed to a plethora of noxious chemicals, our results have important implications for human carcinogenesis. - Highlights: • B[a]P:DBC mixtures were less genotoxic in V79MZh1A1 cells than B[a]P and DBC alone. • An antagonism between B[a]P and DBC was determined in rat liver WB-F344 cells. • The inhibition of CYP1a1 expression by B[a]P:DBC mixture

  12. Childhood exposure to DEHP, DBP and BBP under existing chemical management systems: A comparative study of sources of childhood exposure in Korea and in Denmark

    DEFF Research Database (Denmark)

    Lee, Jihyun; Lee, Jong-Hyeon; Kim, Chan-Kook

    2014-01-01

    an exposure scenario approach. Then, the scenario based exposure level was compared with back-calculated exposure levels based on biomonitored urinary phthalate metabolite concentrations. The result verifies the existence of varying territorial human background exposure levels and the gap between exposure...... such as the EU REACH need to be strengthened. Moreover, based on the contributions from different exposure sources, national specific risk management tools need to be developed and strengthened, applying a systemic approach to promote sustainable material flows....

  13. Sustaining Education for Sustainability in Turbulent Times

    Science.gov (United States)

    Smith, Gregory A.; Stevenson, Robert B.

    2017-01-01

    A study of two schools in northern Australia demonstrated the impact on Education for Sustainability (EfS) initiatives of a disruptive policy environment set in motion by neoliberal reforms focused on standards, accountability, and international competitiveness. In one of the schools, a culture characterized by trust and an emphasis on cultivating…

  14. Sustainability in Software Engineering

    NARCIS (Netherlands)

    Wolfram, N.J.E.; Lago, P.; Osborne, Francesco

    2017-01-01

    The intersection between software engineering research and issues related to sustainability and green IT has been the subject of increasing attention. In spite of that, we observe that sustainability is still not clearly defined, or understood, in the field of software engineering. This lack of

  15. Engineering Students' Sustainability Approaches

    Science.gov (United States)

    Haase, S.

    2014-01-01

    Sustainability issues are increasingly important in engineering work all over the world. This article explores systematic differences in self-assessed competencies, interests, importance, engagement and practices of newly enrolled engineering students in Denmark in relation to environmental and non-environmental sustainability issues. The…

  16. Education for Sustainable development

    African Journals Online (AJOL)

    The unit-based sustainability assessment tool (USAT) was administered at Masinde Muliro University of. Science and Technology (MMUST), Kenya, between January and March 2012. The assessment focused on establishing to what extent the University integrated sustainability concerns into its core functions of teaching ...

  17. Sustainable consumption and happiness

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2009-01-01

    textabstractOne of the reasons for promoting sustainable consumption is that it may give rise to greater happiness for a greater number, at least in the long run. In this paper I explore the strength of that moral account. I take stock of the assumed effects of sustainable consumption on happiness

  18. Thermodynamics and sustainable development

    NARCIS (Netherlands)

    Cornelissen, Rene

    1997-01-01

    It is the objective of this thesis to demonstrate exergy analysis as a powerful instrument to obtain sustainable development. An important aspect of sustainable development is the minimisation of irreversibilities caused by the use of non-renewables. In order to limit the scope of this thesis

  19. Implementing Sustainable Institutional Practices

    Science.gov (United States)

    Shepard, Joseph; Johnson, Lewis

    2009-01-01

    Recent research has found that few institutions of higher education implemented the necessary strategies to make their campuses sustainable (Thompson and Green 2005). Ironically, universities are the segment of society with the most access to the intellectual capital needed to provide sound sustainable practices and measurements. Having top…

  20. Sustainable Consumption and Happiness

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2004-01-01

    textabstractOne of the reasons for promoting sustainable consumption is that it may give rise to greater happiness for a greater number, at least in the long run. In this paper I explore the strength of that moral account. I take stock of the assumed effects of sustainable consumption on happiness

  1. Aesthetics of sustainable architecture

    NARCIS (Netherlands)

    Lee, S.; Hill, G.; Sauerbruch, M.; Hutton, L.; Knowles, R.; Bothwell, K.; Brennan, J.; Jauslin, D.; Holzheu, H.; AlSayyad, N.; Arboleda, G.; Bharne, V.; Røstvik, H.; Kuma, K.; Sunikka-Blank, M.; Glaser, M.; Pero, E.; Sjkonsberg, M.; Teuffel, P.; Mangone, G.; Finocchiaro, L.; Hestnes, A.; Briggs, D.; Frampton, K.; Lee, S.

    2011-01-01

    The purpose of this book is to reveal, explore and further the debate on the aesthetic potentials of sustainable architecture and its practice. This book opens a new area of scholarship and discourse in the design and production of sustainable architecture, one that is based in aesthetics. The

  2. Sustainability: Cultural Considerations

    Science.gov (United States)

    2006-04-10

    Action for Sustainable Change. New York: American Management Association, 1999. Fullan , Michael . Leadership & Sustainability: System Thinkers...institutional Army. iii ACKNOWLEGMENTS I thank my project advisors, Mr. Michael Cain, Director, US Army Environmental Policy Institute and Mr...U.S. Army Environmental Policy Institute. Interview by author, date, Arlington, VA. 30 Michaels , Ed. “The War for Talent.” Interview by

  3. Leading Sustainability in Schools

    Science.gov (United States)

    Carr, Katie

    2016-01-01

    What is the role of schools, and more specifically school leadership, in the transition to a sustainable future for humankind? What different forms of leadership are needed to enable this role? The challenges are huge and complex and for those of us engaged in promoting sustainability learning, it is clear that the issue has never been more…

  4. Sustainability at BPA 2012

    Energy Technology Data Exchange (ETDEWEB)

    None

    2012-12-01

    BPA’s Sustainability Action Plan is grounded in our commitment to environmental stewardship and Executive Order 13514 that calls on the federal agencies to “lead by example” by setting a 2020 greenhouse gas emissions target, increasing energy efficiency; reducing fleet petroleum consumption; conserving water; reducing waste; supporting sustainable communities; and leveraging federal purchasing power to promoting environmentally responsible products and technologies.

  5. Entrepreneurship, Innovation and Sustainability

    OpenAIRE

    Keijzers, G.; Wempe, J.F.D.B. (Johan)

    2008-01-01

    Today, only a limited number of entrepreneurs and managers are facing up to the relevance of sustainability issues and the ways in which these may affect their own businesses. Even fewer entrepreneurs and managers see sustainability as a potential source of profit. These are the findings resulting from research carried out by Nyenrode Business Universiteit among well over 500 entrepreneurs and managers.

  6. Entrepreneurship, Innovation and Sustainability

    NARCIS (Netherlands)

    Keijzers, G. (Gerard); Wempe, J.F.D.B. (Johan)

    2008-01-01

    Today, only a limited number of entrepreneurs and managers are facing up to the relevance of sustainability issues and the ways in which these may affect their own businesses. Even fewer entrepreneurs and managers see sustainability as a potential source of profit. These are the findings resulting

  7. Sustaining Urban Forests

    Science.gov (United States)

    John F. Dwyer; David J. Nowak; Mary Heather Noble

    2003-01-01

    The significance of the urban forest resource and the powerful forces for change in the urban environment make sustainability a critical issue in urban forest management. The diversity, connectedness, and dynamics of the urban forest establish the context for management that will determine the sustainability of forest structure, health, functions, and benefits. A...

  8. Sustainability and uncertainty

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    The widely used concept of sustainability is seldom precisely defined, and its clarification involves making up one's mind about a range of difficult questions. One line of research (bottom-up) takes sustaining a system over time as its starting point and then infers prescriptions from...... this requirement. Another line (top-down) takes an economical interpretation of the Brundtland Commission's suggestion that the present generation's needsatisfaction should not compromise the need-satisfaction of future generations as its starting point. It then measures sustainability at the level of society...... a clarified ethical goal, disagreements can arise. At present we do not know what substitutions will be possible in the future. This uncertainty clearly affects the prescriptions that follow from the measure of sustainability. Consequently, decisions about how to make future agriculture sustainable...

  9. Sustainable nuclear energy dilemma

    Directory of Open Access Journals (Sweden)

    Afgan Naim H.

    2013-01-01

    Full Text Available Sustainable energy development implies the need for the emerging potential energy sources which are not producing adverse effect to the environment. In this respect nuclear energy has gained the complimentary favor to be considered as the potential energy source without degradation of the environment. The sustainability evaluation of the nuclear energy systems has required the special attention to the criteria for the assessment of nuclear energy system before we can make firm justification of the sustainability of nuclear energy systems. In order to demonstrate the sustainability assessment of nuclear energy system this exercise has been devoted to the potential options of nuclear energy development, namely: short term option, medium term option, long term option and classical thermal system option. Criteria with following indicators are introduced in this analysis: nuclear indicator, economic indicator, environment indicator, social indicator... The Sustainability Index is used as the merit for the priority assessment among options under consideration.

  10. System Innovation for Sustainability

    DEFF Research Database (Denmark)

    System Innovation for Sustainability 2 focuses on change towards sustainable personal mobility based on implemented cases analysed from a system perspective. It examines what changes can be made to help us reduce our need for mobility, or start to make use of more sustainable mobility systems...... in order to provide sustainable solutions to our current ‘lock-in’ problems. Three major problem areas are considered (the ‘three Cs’): carbon emissions (and the growing contribution of mobility to the climate change crisis), congestion, and casualties. And each strategy proposed addresses one or more...... such as governments, manufacturers and consumers to intervene in the complex system to promote sustainable mobility. It concludes with a reflection on problems, trends and action needed. The ‘System Innovation for Sustainability’ series is the fruit of the first major international research network on SCP...

  11. Sustainability Marketing Commitment

    DEFF Research Database (Denmark)

    Tollin, Karin; Bech Christensen, Lars

    2017-01-01

    Corporate sustainability is an important strategy and value orientation for marketing, but scarce research addresses the organizational drivers and barriers to including it in companies’ marketing strategies and processes. The purpose of this study is to determine levels of commitment to corporate...... sustainability in marketing, processes associated with sustainability marketing commitment, drivers of sustainability marketing at the functional level of marketing, and its organizational context. Using survey data from 269 managers in marketing, covering a broad range of industries in Sweden and Denmark, we...... took a structural modelling approach to examine construct relationships, mediation, and moderation effects. Overall, the findings show that marketing capabilities associated with the innovation of new products, services, and business models constitute a strong driver to leverage sustainability...

  12. Sustainable Housing Design

    DEFF Research Database (Denmark)

    Lauring, Gert Michael

    2016-01-01

    Sustainable Housing Design. Integrating technical and housing quality aspects of sustainable architecture in civil engineering education. Summary An integrated design approach to sustainable architecture is outlined that combines concerns for zero energy building, good indoor climate and adequate...... constructions, private and public outdoor space, housing, urban and architectural quality. The educational framework, curriculum and inte-grated design methods are preconditions for optimizing a design process where technical criteria, functional concerns and housing quality are addressed from the initial...... phases. The outcome shows that integrated design further solutions where sustainable urban forms of settlement can be highly energy efficient while also attractive from a user perspective. Key words: Sustainable architecture, integrated design, zero-energy-housing, dense urban living. 1. Introduction...

  13. Sustainable built environments

    CERN Document Server

    Haase, Dagmar

    2013-01-01

    Sustainable design is a collective process whereby the built environment achieves unprecedented levels of ecological balance through new and retrofit construction, with the goal of long-term viability and humanization of architecture. Focusing on the environmental context, sustainable design merges the natural, minimum resource conditioning solutions of the past (daylight, solar heat, and natural ventilation) with the innovative technologies of the present.  The desired result is an integrated “intelligent” system that supports individual control with expert negotiation for resource consciousness. International experts in the field address the fundamental questions of sustainable design and landscape management: How should the sustainability of landscapes and buildings be evaluated? Which targets have to be set and which thresholds should not be exceeded? What forms of planning and governance structures exist and to what extent do they further the goals of sustainability?  Gathering 30 peer-reviewed ent...

  14. Agroecology and Sustainable Agriculture

    Directory of Open Access Journals (Sweden)

    Fabio Caporali

    Full Text Available In the framework of the 16th National Meeting of the Italian Ecological Society (“Global Change, Ecological Diversity and Sustainability”, University of Tuscia, Viterbo, 19-22 September 2006, a symposium was devoted to “Agroecology and Sustainable Development”. A major goal of this symposium was to contribute to keeping the dialogue among the experts of the various disciplines alive. Sustainability of agriculture is a challenge for society world wide. Universities and society as a whole have a responsibility in re-examining current perception of nature, of the world and of human society in the light of natural resources depletion, increasing pollution and social inequalities. The urgency to address sustainability issues is increasingly being reflected in the manner in which institutions of higher education around the world are giving priority to the teaching, research and practice of sustainability. The University of Tuscia is involved in international initiatives concerning teaching and research in Agroecology and Sustainable Agriculture.

  15. Agroecology and Sustainable Agriculture

    Directory of Open Access Journals (Sweden)

    Fabio Caporali

    2011-02-01

    Full Text Available In the framework of the 16th National Meeting of the Italian Ecological Society (“Global Change, Ecological Diversity and Sustainability”, University of Tuscia, Viterbo, 19-22 September 2006, a symposium was devoted to “Agroecology and Sustainable Development”. A major goal of this symposium was to contribute to keeping the dialogue among the experts of the various disciplines alive. Sustainability of agriculture is a challenge for society world wide. Universities and society as a whole have a responsibility in re-examining current perception of nature, of the world and of human society in the light of natural resources depletion, increasing pollution and social inequalities. The urgency to address sustainability issues is increasingly being reflected in the manner in which institutions of higher education around the world are giving priority to the teaching, research and practice of sustainability. The University of Tuscia is involved in international initiatives concerning teaching and research in Agroecology and Sustainable Agriculture.

  16. Exposure Prophylaxis

    African Journals Online (AJOL)

    opsig

    have the potential for exposure to infectious material, for example blood ... body fluid; wound causing bleeding and produced by sharp instrument ... Full blood count. Liver function test. Renal function test. HIV screening. Pregnancy test if EFV is considered. Two weeks. Full blood count. Liver function test. Renal function test.

  17. Sustainable winegrowing: current perspectives

    Directory of Open Access Journals (Sweden)

    Mariani A

    2015-05-01

    Full Text Available Angela Mariani,1 Antonella Vastola2 1Department of Economic and Legal Studies, University Parthenope, Naples, 2School of Agricultural, Forestry, Food and Environmental Sciences, University of Basilicata, Potenza, Italy Abstract: The winegrowing sector worldwide is strongly committed to improving environmental and social sustainability. The aim of this work, based on a literature review, is to highlight current sustainability perspectives and the related main issues. There is a broad consensus that the challenge to achieve a greater spread of sustainable practices is to enhance environmental and social sustainability while maintaining economic viability. From the producers' point of view, the priority is to bridge the still substantial knowledge gaps in terms of perceived environmental benefits, economic benefits, and costs. Thus, an increased research effort focusing on the costs and benefits of different winegrowing practices and technical assistance with implementation might support their diffusion. Moreover, targeted marketing strategies are needed to: enhance consumers' involvement and their attitude toward sustainable wine; improve understanding and use of sustainable labels and claims; and raise awareness of some environmental credentials of wine packaging, mainly with reference to lightweight glass bottles. Keywords: winegrower, sustainability, wine, consumer, marketing strategies

  18. A cross-sectional study of the magnitude, barriers, and outcomes of HIV status disclosure among women participating in a perinatal HIV transmission study, "the Nevirapine Repeat Pregnancy study".

    Science.gov (United States)

    Kiweewa, Flavia M; Bakaki, Paul M; McConnell, Michelle S; Musisi, Maria; Namirembe, Constance; Nakayiwa, Frances; Kusasira, Fiona; Nakintu, Dorothy; Mubiru, Michael C; Musoke, Philippa; Fowler, Mary Glenn

    2015-09-29

    HIV status disclosure is a difficult emotional task for HIV-infected persons and may create the opportunity for both social support and rejection. In this study, we evaluated the proportions, patterns, barriers and outcomes of HIV- 1 status disclosure among a group of women in Uganda. An exit interview was conducted one year post-partum for 85 HIV-infected women who participated in a study of HIV-1 transmission rates among NVP-experienced compared with NVP-naïve women in "The Nevirapine Repeat Pregnancy (NVP-RP) Study" at the Makerere University-Johns Hopkins University Research Collaboration, Kampala-Uganda, between June 2004 and June 2006. Of the 85 women interviewed, 99 % had disclosed their HIV status to at least one other person. Disclosure proportions ranged between 1 % to employer(s) and 69 % to a relative other than a parent. Only 38 % of the women had disclosed to their sex partners. Women with an HIV-infected baby were more likely than those with an uninfected baby to disclose to their sex partner, OR 4.9 (95 % CI, 2.0 -11.2), and women were less likely to disclose to a partner if they had previously disclosed to another relative than if they had not, OR 0.19 (95 % CI, 0.14-0.52). The most common reasons for non-disclosure included fear of separation from the partner and subsequent loss of financial support 34 %, and not living with the partner (not having opportunities to disclose) 26 %. While most women (67 %) reported getting social support following disclosure, 22 % reported negative outcomes (neglect, separation from their partners, and loss of financial support). Following disclosure of HIV status, 9 % of women reported that their partner (s) decided to have an HIV test. Results from this study show high overall HIV disclosure proportions and how this disclosure of HIV status can foster social support. However, proportions of disclosure specifically to male sex partners were low, which suggests the need for interventions aimed at increasing male

  19. Inhibition of CYP2B6 by Medicinal Plant Extracts: Implication for Use of Efavirenz and Nevirapine-Based Highly Active Anti-Retroviral Therapy (HAART in Resource-Limited Settings

    Directory of Open Access Journals (Sweden)

    Nicholas E. Thomford

    2016-02-01

    Full Text Available Highly active antiretroviral therapy (HAART has greatly improved health parameters of HIV infected individuals. However, there are several challenges associated with the chronic nature of HAART administration. For populations in health transition, dual use of medicinal plant extracts and conventional medicine poses a significant challenge. There is need to evaluate interactions between commonly used medicinal plant extracts and antiretroviral drugs used against HIV/AIDS. Efavirenz (EFV and nevirapine (NVP are the major components of HAART both metabolized by CYP2B6, an enzyme that can potentially be inhibited or induced by compounds found in medicinal plant extracts. The purpose of this study was to evaluate the effects of extracts of selected commonly used medicinal plants on CYP2B6 enzyme activity. Recombinant human CYP2B6 was used to evaluate inhibition, allowing the assessment of herb-drug interactions (HDI of medicinal plants Hyptis suaveolens, Myrothamnus flabellifolius, Launaea taraxacifolia, Boerhavia diffusa and Newbouldia laevis. The potential of these medicinal extracts to cause HDI was ranked accordingly for reversible inhibition and also classified as potential time-dependent inhibitor (TDI candidates. The most potent inhibitor for CYP2B6 was Hyptis suaveolens extract (IC50 = 19.09 ± 1.16 µg/mL, followed by Myrothamnus flabellifolius extract (IC50 = 23.66 ± 4.86 µg/mL, Launaea taraxacifolia extract (IC50 = 33.87 ± 1.54 µg/mL, and Boerhavia diffusa extract (IC50 = 34.93 ± 1.06 µg/mL. Newbouldia laevis extract, however, exhibited weak inhibitory effects (IC50 = 100 ± 8.71 µg/mL on CYP2B6. Launaea taraxacifolia exhibited a TDI (3.17 effect on CYP2B6 and showed a high concentration of known CYP450 inhibitory phenolic compounds, chlorogenic acid and caffeic acid. The implication for these observations is that drugs that are metabolized by CYP2B6 when co-administered with these herbal medicines and when adequate amounts of the

  20. Sustainability Infused Curriculum

    Science.gov (United States)

    Ibarra, D. L.

    2015-12-01

    The Independent Schools Foundation Academy (ISF) in Hong Kong established a sustainability policy in 2015, which explicitly states, "an experimentally integrated, environmentally and ethically sustainable system of science education and conservation practices based on the 2012 Jeju Declaration of the World Conservation Congress will be implemented through the school". ISF Academy is a private Chinese bilingual school in Hong Kong serving over 1500 students K-12, following the framework and curriculum of the International Baccalaureate Organization (IBO). The strategy behind the implementation of this policy includes: development of a scientific sustainable curriculum that is age appropriate; establish a culture of sustainability within the ISF community and beyond to the wider HK community; install sustainable infrastructure that allows students to learn; and learn first hand sustainable living practices. It is well understood that solutions to the environmental challenges facing Hong Kong and our planet will require multiple disciplines. The current sustainability programs at ISF include: a) a whole school aerobic food waste composting system and organic farming, b) energy consumption monitoring of existing buildings, c) upcoming installation of an air pollution monitoring equipment that will correlate with the AQHI data collected by the Hong Kong government, d) a Renewable Energy Education Center (REEC) that will teach students about RE and also produce solar energy for classroom consumption, and e) student lead environmental group that manages the paper and used cooking oil recycling on campus. The Shuyuan Science and Sustainability faculty work closely with classroom teachers to ensure that the above mentioned projects are incorporated into the curriculum throughout the school. Interdisciplinary units (IDU) of study are being developed that encourage faculty and students to work across subject areas. Projects include Personal Projects, Extended Essays

  1. Textiles and clothing sustainability nanotextiles and sustainability

    CERN Document Server

    2017-01-01

    This book highlights the sustainability aspects of textiles and clothing sector in light of nanomaterials and technologies. The invasion of nano in every industrial sector has been important and has made remarkable changes as well as posed new challenges, including the textiles and clothing sector. There is quite a great deal of research happening in terms of nano materials for textiles across the globe, some of which are covered in this book. .

  2. Integrating Sustainability in Organisations: An Activity-Based Sustainability Model

    National Research Council Canada - National Science Library

    Ana Rodríguez-Olalla; Carmen Aviles-Palacios

    2017-01-01

    .... Although global integration models address sustainability in organisations, these models present shortcomings and limitations and do not describe how to achieve the integration of sustainability...

  3. Sustainable Entrepreneurial Orientation: A Business Strategic Approach for Sustainable Development

    National Research Council Canada - National Science Library

    Ana Criado-Gomis; Amparo Cervera-Taulet; Maria-Angeles Iniesta-Bonillo

    2017-01-01

    This paper proposes sustainable entrepreneurial orientation (SEO) as a multidimensional construct that offers researchers the possibility of empirically testing their theoretical proposals in the sustainable entrepreneurship field...

  4. Numeracy and sustainability

    Directory of Open Access Journals (Sweden)

    John Cairns Jr.

    2003-11-01

    Full Text Available Sustainable use of the planet is based on the assumption that humankind can maintain conditions suitable for inhabiting the planet indefinitely. No robust evidence supports this assumption nor rejects it, and adequate evidence on this issue may not be available for centuries. Numeracy is the ability to use or understand numerical techniques of mathematics. Even if adequate numerical data were available, the important decisions humankind makes regarding sustainable use of the planet should not be guided by numerical information alone, such as economic numbers, but by eco- and sustainability ethics, which provides a values framework that indicates how the numbers should be used and interpreted.

  5. Strategic corporate sustainability

    DEFF Research Database (Denmark)

    Grewatsch, Sylvia; Rohrbeck, René; Madsen, Henning

    This paper aims to advance the understanding of the circumstances under which corporate sustainability (CS) pays off. On the basis of a review of 129 major papers from both the sustainability and general management literature, we discuss the development of the research field. In addition we discuss...... antecedents and outcomes. To overcome this limitation we propose an integrated typology which may facilitate more research on the link between corporate sustainability performance (CSP) and corporate financial performance (CFP). Our expectation is that the strategy type might play a moderating or mediating...

  6. Sustainability in Materials Education

    Science.gov (United States)

    Fergus, Jeffrey W.; Twigge-Molecey, Christopher; Mcguffin-Cawley, James

    2013-08-01

    Consideration of the environmental and societal impacts of engineering products and processes is becoming increasingly important, so sustainability-related issues need to be addressed in educating engineers. Awareness of sustainability issues is particularly important for materials and metallurgical scientists and engineers because they are involved in both developing processes and selecting materials with low-energy use and low environmental impact. In this article, activities at TMS to identify sustainability-related educational needs and opportunities to address these needs will be discussed.

  7. Sustainable Facilities Management

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Elle, Morten; Hoffmann, Birgitte

    2004-01-01

    The Danish public housing sector has more than 20 years of experience with sustainable facilities management based on user involvement. The paper outlines this development in a historical perspective and gives an analysis of different approaches to sustainable facilities management. The focus...... is on the housing departments and strateies for the management of the use of resources. The research methods used are case studies based on interviews in addition to literature studies. The paper explores lessons to be learned about sustainable facilities management in general, and points to a need for new...

  8. Action Research for Sustainability

    DEFF Research Database (Denmark)

    Egmose, Jonas

    to provide local citizens with a greater say in the future of urban sustainability research, this book shows how action research can make important methodological contributions to processes of social learning between citizens and scientists by enabling free spaces in peoples everyday life and within academia......How can action research further new research orientations towards sustainability? This book, empirically situated in the field of upstream public engagement, involving local residents, researchers and practitioners in bottom-up processes deliberating on urban sustainability, answers this question...

  9. Sustaining Participatory Design Initiatives

    DEFF Research Database (Denmark)

    Iversen, Ole Sejer; Dindler, Christian

    2014-01-01

    While many participatory design (PD) projects succeed in establishing new organisational initiatives or creating technology that is attuned to the people affected, the issue of how such results are sustained after the project ends remains an important challenge. We explore the challenge...... these various forms of sustainability may be pursued in PD practice and how they can become a resource in reflecting on PD activities. Finally, we discuss implications for PD practice, suggesting that a nuanced conception of sustainability and how it may relate to PD practice are useful resources for designers...... and researchers before, during and after design processes. View full text Download full text...

  10. Sustainable Enterprise Excellence

    DEFF Research Database (Denmark)

    Edgeman, Rick; Williams, Joseph; Eskildsen, Jacob Kjær

    Sustainable Enterprise Excellence balances complementary and competing interests of key stakeholder segments, including society and the natural environment and increases the likelihood of superior and sustainable competitive positioning and hence long-term enterprise success that is defined...... by continuously relevant and responsible governance, strategy, actions and performance consistent with high-level organizational resilience, robustness and resplendence (R3). This is accomplished through organizational design and function emphasizing innovation, enterprise intelligence & analytics, operational......, supply chain, customer-related, human capital, financial, marketplace, societal, and environmental performance. Sustainable Enterprise Excellence integrates ethical, efficient and effective (E3) enterprise governance with 3E (equity, ecology, economy) Triple Top Line strategy throughout enterprise...

  11. Experience and Sustainable Consumption

    DEFF Research Database (Denmark)

    Rasmussen, Tove Arendt

    2014-01-01

    . Very often, however, the actual purchase does not live up to the demands of doing good in the sustainable consumption chain, and the individual might end up with a guilty conscience, which again is a possible trigger for lingering in a sentimental mode of guilt. Emotions of sentimentality may actually......Experience understood as experience-based consumption is by now fairly absent from the research agenda of the different theories on sustainable consumption. On the basis of Colin Campbell’s notion of romantic ethics and emotional sentimentality in modern hedonism, I claim that sustainable...

  12. Experience and Sustainable Consumption

    DEFF Research Database (Denmark)

    Rasmussen, Tove Arendt

    . Very often, however, the actual purchase does not live up to the demands of doing good in the sustainable consumption chain, and the individual might end up with a guilty conscience, which again is a possible trigger for lingering in a sentimental mode of guilt. Emotions of sentimentality may actually......Experience understood as experience-based consumption is by now fairly absent from the research agenda of the different theories on sustainable consumption. On the basis of Colin Campbell’s notion of romantic ethics and emotional sentimentality in modern hedonism, I claim that sustainable...

  13. Exposures series

    OpenAIRE

    Stimson, Blake

    2011-01-01

    Reaktion Books’ Exposures series, edited by Peter Hamilton and Mark Haworth-Booth, is comprised of 13 volumes and counting, each less than 200 pages with 80 high-quality illustrations in color and black and white. Currently available titles include Photography and Australia, Photography and Spirit, Photography and Cinema, Photography and Literature, Photography and Flight, Photography and Egypt, Photography and Science, Photography and Africa, Photography and Italy, Photography and the USA, P...

  14. Sovereignty, individuality, and sustainability

    Directory of Open Access Journals (Sweden)

    John Cairns Jr.

    2003-09-01

    Full Text Available Humans must acknowledge that the biosphere is the essential support for all living organisms. In order to achieve sustainable use of the planet, humans must proceed beyond egocentrism, ethnocentrism, homocentrism, and biocentrism to ecocentrism. National states, with present policies, are a major obstacle to sustainable use of the planet. However, there is some evidence that the individual has increasing sovereignty at the expense of both nation states and the environment. Still, the primary obstacle to sustainability is inherent in the present system of sovereign nation states. The basic question is how much sovereignty must nation-states and individuals relinquish to preserve the health of Earth's biospheric life support system. A free and open exchange of thoughts on this subject is long overdue. To acheive sustainable use of the planet, humankind must view its identity within the context of the interdependent web of life.

  15. Sustainable Practices Innovation

    Science.gov (United States)

    Better sustainability means more environmentally conscious and efficient businesses and communities. EPA helps modify the way we consume energy, deal with waste, and grow our economy through programs such as Energy Star, E3, Smart Growth, and WaterSense.

  16. The Sustainable City.

    Science.gov (United States)

    Gangloff, Deborah

    1995-01-01

    Focuses on methods to make cities more sustainable through the processes of energy efficiency, pollution and waste reduction, capture of natural processes, and the merger of ecological, economic, and social factors. (LZ)

  17. Sustainable roadway lighting seminar.

    Science.gov (United States)

    2014-07-01

    The objective of this project was to develop and conduct a half-day educational seminar on sustainable : roadway lighting at three locations within New York State: Rochester, New York City, and Albany. : Primary attendees were engineers from the New ...

  18. Sustainable Enterprise Excellence

    DEFF Research Database (Denmark)

    Edgeman, Rick

    2013-01-01

    Structured Abstract Purpose: Sustainable Enterprise Excellence (SEE) is defined and developed through integration and expansion of business excellence modeling and sustainability thought. The intent is to enable simple yet reliable enterprise assessment of triple bottom line (TBL) performance...... and produce actionable enterprise foresight that can enable next best practices and sources of sustainable competitive advantage through innovation. Methodology: Key elements of SEE are identified from various business excellence and sustainability reporting sources, including the Global Reporting Initiative...... assessment approach similar in structure to those behind established excellence awards are developed that enable enterprise assessment of progress toward SEE. The resulting assessment is delivered in a highly consumable, combined narrative and graphic format referred to as a SEE NEWS Report. Practical...

  19. Strategic sustainability performance plan

    Science.gov (United States)

    2010-06-01

    In October 2009, President Obama signed Executive Order (EO) 13514 that sets sustainability : goals for Federal agencies and focuses on making improvements in environmental, energy and : economic performance. The Executive Order requires Federal agen...

  20. Transport, environment and sustainability

    DEFF Research Database (Denmark)

    Joumard, Robert; Gudmundsson, Henrik; Kehagia, Fotini

    2010-01-01

    This report is the final report of the action COST 356 'EST - Towards the definition of a measurable environmentally sustainable transport'. It tries to answer the following questions: How can environmental impacts of transport be measured? How can measurements be transformed into operational...... indicators? How can several indicators be jointly considered? And how can indicators be used in planning and decision making? Firstly we provide definition of 'indicator of environmental sustainability in transport'. The functions, strengths and weaknesses of indicators as measurement tools, and as decision...... support tools are discussed. We define what "environmental sustainability in transport" may mean through the transport system, the concepts of sustainable development and of environment. The concept of 'chain of causality' between a source and a final target is developed, as a common reference...

  1. Sustainability Principles in Practice

    DEFF Research Database (Denmark)

    Gani, Rafiqul; Wenzel, Henrik; Azapagic, Adisa

    2007-01-01

    generation, transport, heating and cooling, on the other hand, it has a considerable impact on the environment, via its resource consumption, its emissions and the impact of its products. New (sustainable) alternatives, for example, change of raw material base, use of renewable resources, efficient...... manufacture of chemical products and sustainable products and processes that can efficiently manufacture them, will need to be considered to meet the current and future challenges. Some of the important issues in this respect are how to generate/identify sustainable alternatives, how to analyze them, which...... criteria should be used to evaluate them, and how to implement them? The objective of this presentation is to highlight the use of systematic multidisciplinary approaches for generation of sustainable alternatives combined with methods/tools for analysis and evaluation. For generation of alternatives...

  2. Biorefinery Sustainability Analysis

    DEFF Research Database (Denmark)

    J. S. M. Silva, Carla; Prunescu, Remus Mihail; Gernaey, Krist

    2017-01-01

    This chapter deals with sustainability analysis of biorefinery systems in terms of environmental and socio-economic indicators . Life cycle analysis has methodological issues related to the functional unit (FU), allocation , land use and biogenic carbon neutrality of the reference system and of t......This chapter deals with sustainability analysis of biorefinery systems in terms of environmental and socio-economic indicators . Life cycle analysis has methodological issues related to the functional unit (FU), allocation , land use and biogenic carbon neutrality of the reference system...... and of the biorefinery-based system. Socio-economic criteria and indicators used in sustainability frameworks assessment are presented and discussed. There is not one single methodology that can aptly cover the synergies of environmental, economic, social and governance issues required to assess the sustainable...

  3. Social Health and Sustainability

    DEFF Research Database (Denmark)

    Andersen, Heidi Lene

    2015-01-01

    Abstract: This article discusses how to accomplish a transition towards healthy and sustainable futures. Despite political statements and profound theoretical developments, little has happened in the field of practice. This article presents a number of problematics in the theoretical and conceptual...... development within the fields of sustainability and health promotion. With this objective in mind, this article seeks to find solutions to a question raised by the WHO health and sustainability researcher, Illona Kickbusch: ‘What conceptual framing and common language can help move a shared agenda forward...... departments. The article demonstrates that an action research approach including an Aristotelean phronetic perspective can be successful in integrating health and sustainability in research, as well as in practice. There are two main conclusions from the empirical case study. The first is that the common...

  4. Crowdfunding for Sustainability

    DEFF Research Database (Denmark)

    Nielsen, Kristian Roed

    The dissertation sets out to explore the often ignored role of the consumer (end-user) within sustainable innovation by examining the potential of reward-based crowdfunding in enabling sustainable entrepreneurship. It explores under which conditions and to what extent rewardbased crowdfunding could...... benefit entrepreneurs with social and/or environmentally-oriented products. The dissertation employs four articles in order to explore this. The first sets the stage by systematically reviewing the various roles that end-users can adopt within sustainable innovation process. The second serves to present...... access, while paper four introduces the experimental evidence on the role of individual and product details in shaping pledging behavior as it relates to a diversity of (un)sustainable campaigns....

  5. Life Cycle Sustainability Dashboard

    DEFF Research Database (Denmark)

    Traverso, Marzia; Finkbeiner, Matthias; Jørgensen, Andreas

    2012-01-01

    One method to assess the sustainability performance of products is life cycle sustainability assessment (LCSA), which assesses product performance considering the environmental,economic, and social dimensions of the life cycle. The results of LCSA can be used to compare different products...... or to support decision making toward sustainable production and consumption. In both cases, LCSA results could be too disaggregated and consequently too difficult to understand and interpret by decision makers. As non-experts are usually the target audience of experts and scientists, and are also involved...... in decision-making processes, the necessity for a straightforward but comprehensive presentation of LCSA results is becoming strategically important. The implementation of the dashboard of sustainability proposed in this article offers a possible solution. An outstanding characteristic of the dashboard...

  6. Sustainable advanced construction technologies

    CSIR Research Space (South Africa)

    Kuchena, JC

    2009-11-01

    Full Text Available Advanced Construction Technologies (ACTs) are set to become the sustainable mainstay of the construction industry due to the demand for innovative housing solutions. Like most emerging economies, South Africa from a historical perspective and global...

  7. Sustainable Materials Management

    Science.gov (United States)

    To introduce businesses, NGOs, and government officials to the concept of Sustainable Materials Management (SMM). To provide tools to allow stakeholders to take a lifecycle approach managing their materials, & to encourage them to join a SMM challenge.

  8. Packaging for Sustainability

    CERN Document Server

    Lewis, Helen; Fitzpatrick, Leanne

    2012-01-01

    The packaging industry is under pressure from regulators, customers and other stakeholders to improve packaging’s sustainability by reducing its environmental and societal impacts. This is a considerable challenge because of the complex interactions between products and their packaging, and the many roles that packaging plays in the supply chain. Packaging for Sustainability is a concise and readable handbook for practitioners who are trying to implement sustainability strategies for packaging. Industry case studies are used throughout the book to illustrate possible applications and scenarios. Packaging for Sustainability draws on the expertise of researchers and industry practitioners to provide information on business benefits, environmental issues and priorities, environmental evaluation tools, design for environment, marketing strategies, and challenges for the future.

  9. The macroecology of sustainability

    Science.gov (United States)

    Burger, Joseph R.; Allen, Craig D.; Brown, James H.; Burnside, William R.; Davidson, Ana D.; Fristoe, Trevor S.; Hamilton, Marcus J.; Mercado-Silva, Norman; Nekola, Jeffrey C.; Okie, Jordan G.; Zuo, Wenyun

    2012-01-01

    The discipline of sustainability science has emerged in response to concerns of natural and social scientists, policymakers, and lay people about whether the Earth can continue to support human population growth and economic prosperity. Yet, sustainability science has developed largely independently from and with little reference to key ecological principles that govern life on Earth. A macroecological perspective highlights three principles that should be integral to sustainability science: 1) physical conservation laws govern the flows of energy and materials between human systems and the environment, 2) smaller systems are connected by these flows to larger systems in which they are embedded, and 3) global constraints ultimately limit flows at smaller scales. Over the past few decades, decreasing per capita rates of consumption of petroleum, phosphate, agricultural land, fresh water, fish, and wood indicate that the growing human population has surpassed the capacity of the Earth to supply enough of these essential resources to sustain even the current population and level of socioeconomic development.

  10. Food, Globalization and Sustainability

    NARCIS (Netherlands)

    Oosterveer, P.J.M.; Sonnenfeld, D.A.

    2011-01-01

    Food is increasingly traded internationally, thereby transforming the organisation of food production and consumption globally and influencing most food-related practices. This transition is generating unfamiliar challenges related to sustainability of food provision, the social impacts of

  11. The macroecology of sustainability.

    Science.gov (United States)

    Burger, Joseph R; Allen, Craig D; Brown, James H; Burnside, William R; Davidson, Ana D; Fristoe, Trevor S; Hamilton, Marcus J; Mercado-Silva, Norman; Nekola, Jeffrey C; Okie, Jordan G; Zuo, Wenyun

    2012-01-01

    The discipline of sustainability science has emerged in response to concerns of natural and social scientists, policymakers, and lay people about whether the Earth can continue to support human population growth and economic prosperity. Yet, sustainability science has developed largely independently from and with little reference to key ecological principles that govern life on Earth. A macroecological perspective highlights three principles that should be integral to sustainability science: 1) physical conservation laws govern the flows of energy and materials between human systems and the environment, 2) smaller systems are connected by these flows to larger systems in which they are embedded, and 3) global constraints ultimately limit flows at smaller scales. Over the past few decades, decreasing per capita rates of consumption of petroleum, phosphate, agricultural land, fresh water, fish, and wood indicate that the growing human population has surpassed the capacity of the Earth to supply enough of these essential resources to sustain even the current population and level of socioeconomic development.

  12. Sustainable investment: Literature overview

    NARCIS (Netherlands)

    Weda, J.; Kerste, M.; Rosenboom, N.

    2010-01-01

    Corporate Social Responsibility (CSR), or sustainability at the company level, entails incorporating ecological (environmental stakeholders) and social aspects (stakeholders other than shareholders and environmental stakeholders) when doing business. Socially Responsible Investment (SRI) concerns

  13. Regional Sustainable Environmental Management

    Science.gov (United States)

    Regional sustainable environmental management is an interdisciplinary effort to develop a sufficient understanding of the interactions between ecosystems, the economy, law, and technology to formulate effective long-term management strategies on a regional scale. Regional sustai...

  14. Towards Intelligently - Sustainable Cities?

    Directory of Open Access Journals (Sweden)

    Luca Salvati

    2013-04-01

    Full Text Available In the quest for achieving sustainable cities, Intelligent and Knowledge City Programmes (ICPs and KCPs represent cost-efficient strategies for improving the overall performance of urban systems. However, even though nobody argues on the desirability of making cities “smarter”, the fundamental questions of how and to what extent can ICPs and KCPs contribute to the achievement of urban sustainability lack a precise answer. In the attempt of providing a structured answer to these interrogatives, this paper presents a methodology developed for investigating the modalities through which ICPs and KCPs contribute to the achievement or urban sustainability. Results suggest that ICPs and KCPs efficacy lies in supporting cities achieve a sustainable urban metabolism through optimization, innovation and behavior changes.

  15. Sustaining Success in Haiti

    National Research Council Canada - National Science Library

    Oakley, Robert

    1996-01-01

    ... irreversible. The next several months are critical. Sustaining the success of Operation Uphold Democracy requires Haiti--and the international community--to confront, simultaneously, crucial transitions in political leadership, law and order, economic...

  16. Transgovernance: advancing sustainability governance

    National Research Council Canada - National Science Library

    Meuleman, Louis

    2013-01-01

    ... – together characterized as the emergence of a knowledge democracy – may imply for governance for sustainable development, on global and other levels of societal decision making, and the other way around...

  17. Commons, Sustainability, Democratization

    DEFF Research Database (Denmark)

    In nine chapters practical-conceptual drafts of action reserach in relation to sustainability are presented and examples of action research in Scandinavia, England, Nicaragua and Mozambique are described and analyzed....

  18. 2005 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2005 Environmental Sustainability Index (ESI) is a measure of overall progress towards environmental sustainability, developed for 146 countries. The index...

  19. Involving citizens in sustainable development

    DEFF Research Database (Denmark)

    Agger, Annika

    2010-01-01

    Local Environment The International Journal of Justice and Sustainability, Volume 15 Issue 6, 541......Local Environment The International Journal of Justice and Sustainability, Volume 15 Issue 6, 541...

  20. 2002 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2002 Environmental Sustainability Index (ESI) measures overall progress toward environmental sustainability for 142 countries based on environmental systems,...

  1. Genuine savings and sustainability

    OpenAIRE

    Hanley, Nicholas David; Dupuy, Louis Paul; MCLAUGHLIN, Eoin

    2015-01-01

    Genuine Savings has emerged as the leading economic indicator of sustainable economic development at the country level. It derives from the literatures on weak sustainability, wealth accounting and national income accounting. We discuss the theoretical underpinnings of GS, focusing on the relationship between changes in a nation's extended capital stock and the future path of consumption. The indicator has entered widespread use propelled by the World Bank's publications, despite its varying ...

  2. Leadership for Sustainable Installations

    Science.gov (United States)

    2011-04-01

    able_installations/. Accessed 15 April 2011) Leadership for Sustainable Installations By COL Charles Allen (Ret), U.S. Army War College The...number. 1. REPORT DATE APR 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Leadership for Sustainable...of the Army civilian workforce. During that decade, we followed the mandate of A-76 Commercial Sourcing and focused on developing the Most Efficient

  3. Settlement patterns and sustainability

    DEFF Research Database (Denmark)

    Hendriksen, Kåre

    This paper discusses settlement patterns and sustainability. Generally urbanization is recognised as an inevitable development driven by job opportunities, better service supply, education, and health services, and it is argued that this is the main driver for centralisation. Research based...... of utilization of local resources and trade opportunities. Furthermore the growing towns are struggling with an un-sustainable economic situation manly based on public financed jobs or welfare payments and with limited export oriented value creation....

  4. Innovating for sustainability

    DEFF Research Database (Denmark)

    The theme of the articles is innovating for sustainability. Empirically the articles shows how enterprises makes environmental innovations related to their processes and products within the organic dairy industry, the fish processing industry and the car industry.......The theme of the articles is innovating for sustainability. Empirically the articles shows how enterprises makes environmental innovations related to their processes and products within the organic dairy industry, the fish processing industry and the car industry....

  5. Agroecology and Sustainable Agriculture

    OpenAIRE

    Fabio Caporali

    2007-01-01

    In the framework of the 16th National Meeting of the Italian Ecological Society (“Global Change, Ecological Diversity and Sustainability”, University of Tuscia, Viterbo, 19-22 September 2006), a symposium was devoted to “Agroecology and Sustainable Development”. A major goal of this symposium was to contribute to keeping the dialogue among the experts of the various disciplines alive. Sustainability of agriculture is a challenge for society world wide. ...

  6. Assembling Sustainable Territories

    DEFF Research Database (Denmark)

    Vandergeest, Peter; Ponte, Stefano; Bush, Simon

    2015-01-01

    The authors show how certification assembles ‘sustainable’ territories through a complex layering of regulatory authority in which both government and nongovernment entities claim rule-making authority, sometimes working together, sometimes in parallel, sometimes competitively. It is argued...... dynamic in assembling sustainable territories, and that certification always involves state agencies in determining how the key elements that comprise it are defined. Whereas some state agencies have been suspicious of sustainability certification, others have embraced it or even used it to extend...

  7. Seeking sustainability leadership

    OpenAIRE

    Bendell, Jem; Little, Richard

    2015-01-01

    This paper critiques mainstream leadership and leadership development approaches to help inform the emerging field of sustainability leadership. Traditional leadership theory and education is argued to be highly problematic for the pursuit of sustainability leadership. A more critical approach is required, drawing upon insights from social theory, critical discourse analysis and psychology, which is attempted in this paper. Once deconstructed, leadership can be a useful framework for explorin...

  8. SUSTAINABLE TRAILER FLOORING

    OpenAIRE

    John Lu; Marc Chorney; Lowell Peterson

    2009-01-01

    Different trailer flooring materials, including wood-based, aluminum, steel, and synthetic plastic floors, were evaluated in accordance with their durability and sustainability to our natural environment. Wood-based trailer flooring is an eco-friendly product. It is the most sustainable trailer flooring material compared with fossil fuel-intensive steel, aluminum, and plastics. It is renewable and recyclable. Oak, hard maple, and apitong are strong and durable hardwood species that are curren...

  9. A sustainable economy

    OpenAIRE

    Pawlak, J. J.

    2008-01-01

    There exists a direct correlation between improvements in standard of living and the consumption of resources. To be able to maintain the standard of living of a modern developed country, society must adapt to an economy based on sustainable processes, energy, and raw materials. The sustainable economy presents itself as a disruptive technology to the traditional economy, which is based largely on non-renewable resources. The issue seems to be more about when will we switch to a sustainabl...

  10. Predicting sustainable work behavior

    OpenAIRE

    Sundtoft Hald, Kim

    2013-01-01

    Sustainable work behavior is an important issue for operations managers – it has implications for most outcomes of OM. This research explores the antecedents of sustainable work behavior. It revisits and extends the sociotechnical model developed by Brown et al. (2000) on predicting safe behavior. Employee characteristics and general attitudes towards safety and work condition are included in the extended model. A survey was handed out to 654 employees in Chinese factories. This research ...

  11. Sustainability of National Cohesion

    Directory of Open Access Journals (Sweden)

    Andrei Mihai Cristea

    2013-09-01

    Full Text Available In the European Union, cohesion policy is the third country after the domestic and social policy, as this policy is a tool for economic growth and also a balancing factor. Through its solidarity funds contribute to the other sectorial policies: the Common Agricultural Policy, social policy, environmental policy. This article aims to demonstrate the importance of cohesion policy in the national economy and how to improve its implementation by ensuring sustainable development and sustainable economic growth

  12. Sustainability, accounting and reporting

    CERN Document Server

    Balachandran, Kashi

    2011-01-01

    The topic of business sustainability is multidisciplinary in nature, and its complexity calls for putting in place a wide variety of research approaches, such as action research, case studies, surveys, model development etc. The papers presented in this ebook represent a comprehensive overview of recent advances in this area of accounting and reporting research. It contains six papers, covering how leasing can increase environmental benefits, CSR, developing social, environmental and economic indicators for SMEs, sustainability reporting and reputation risk and others.

  13. Sustainability of abrasive processes

    DEFF Research Database (Denmark)

    Aurich, J.C.; Linke, B.; Hauschild, Michael Zwicky

    2013-01-01

    This paper presents an overview of research on sustainability of abrasive processes. It incorporates results from a round robin study on ‘‘energy-efficiency of abrasive processes’’ which has been carried out within the scientific technical committee ‘‘abrasive processes’’ (STC G) of CIRP, the con......This paper presents an overview of research on sustainability of abrasive processes. It incorporates results from a round robin study on ‘‘energy-efficiency of abrasive processes’’ which has been carried out within the scientific technical committee ‘‘abrasive processes’’ (STC G) of CIRP......, the content of technical presentations in STC G, and the results of a comprehensive literature study. The approach to sustainability includes environmental, social, and economic sustainability in accordance with the definition proposed in the Brundtland Report of the United Nations [156]. The main focus...... is on environmental and social sustainability. Economic sustainability will be considered as manufacturing productivity. © 2013 CIRP....

  14. Sustainability at BPA 2013

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-12-01

    THIS IS THE THIRD YEAR BPA has reported on sustainability program accomplishments. The report provides an opportunity to review progress made on sustainability initiatives, evaluate how far we have come and how much we can improve. The program has demonstrated maturation as the concepts of sustainability and resource conservation are communicated and understood. The sustainability program started as an employee-driven “grass roots” effort in 2010. Sustainability is becoming a consideration in how work is performed. The establishment of several policies supporting sustainability efforts proves the positive progress being made. In 2009, BPA became a founder and member of The Climate Registry, a nonprofit collaboration that sets standards to calculate, verify and report greenhouse gas emissions. This year, BPA completed and published our Greenhouse Gas inventory for the years of 2009, 2010 and 2011. The 2012 inventory is currently in the process of third-party verification and scheduled for public release in January 2014. These inventories provide a concrete measure of the progress we are making.

  15. Sustainable Biofuels Development Center

    Energy Technology Data Exchange (ETDEWEB)

    Reardon, Kenneth F. [Colorado State Univ., Fort Collins, CO (United States)

    2015-03-01

    The mission of the Sustainable Bioenergy Development Center (SBDC) is to enhance the capability of America’s bioenergy industry to produce transportation fuels and chemical feedstocks on a large scale, with significant energy yields, at competitive cost, through sustainable production techniques. Research within the SBDC is organized in five areas: (1) Development of Sustainable Crops and Agricultural Strategies, (2) Improvement of Biomass Processing Technologies, (3) Biofuel Characterization and Engine Adaptation, (4) Production of Byproducts for Sustainable Biorefining, and (5) Sustainability Assessment, including evaluation of the ecosystem/climate change implication of center research and evaluation of the policy implications of widespread production and utilization of bioenergy. The overall goal of this project is to develop new sustainable bioenergy-related technologies. To achieve that goal, three specific activities were supported with DOE funds: bioenergy-related research initiation projects, bioenergy research and education via support of undergraduate and graduate students, and Research Support Activities (equipment purchases, travel to attend bioenergy conferences, and seminars). Numerous research findings in diverse fields related to bioenergy were produced from these activities and are summarized in this report.

  16. Social Sciences and Sustainability

    Directory of Open Access Journals (Sweden)

    Shu-Kun Lin

    2011-09-01

    Full Text Available At the time when the journal Sustainability [1] was launched, as a chemist and a scientist, I started to believe that social sciences may be more important to make humans sustainable. The broad journal title Social Sciences presents the opportunity for all social science scholars to have integrated consideration regarding the sustainability of humanity, because I am sure that science and technology alone cannot help. Science and technology may have in fact been contributing to accelerate the depletion of nonrenewable natural resources and putting human sustainability at risk since the industrial revolution about 150 years ago. I hope all intellectuals studying anthropology, archaeology, administration, communication, criminology, economics, education, government, linguistics, international relations, politics, sociology and, in some contexts, geography, history, law, and psychology publish with us to seek a solution to sustain humanity. Sustainability itself will also be a main topic of the journal Social Sciences. In addition to this integrated forum for social sciences, more topic specific journals, such as the already publishing Societies [2], will be launched. [...

  17. Sustainable Water Systems

    Directory of Open Access Journals (Sweden)

    Miklas Scholz

    2013-02-01

    Full Text Available Sustainable water systems often comprise complex combinations of traditional and new system components that mimic natural processes. These green systems aim to protect public health and safety, and restore natural and human landscapes. Green infrastructure elements such as most sustainable drainage systems trap storm water but may contaminate groundwater. There is a need to summarize recent trends in sustainable water systems management in a focused document. The aim of this special issue is therefore to disseminate and share scientific findings on novel sustainable water systems addressing recent problems and opportunities. This special issue focuses on the following key topics: climate change adaptation and vulnerability assessment of water resources systems; holistic water management; carbon credits; potable water savings; sustainable water technologies; nutrient management; holistic storm water reuse; water and wastewater infrastructure planning; ecological status of watercourses defined by the Water Framework Directive. The combined knowledge output advances the understanding of sustainable water, wastewater and storm water systems in the developed and developing world. The research highlights the need for integrated decision-support frameworks addressing the impact of climate change on local and national water resources management strategies involving all relevant stakeholders at all levels.

  18. Biofuels and sustainability.

    Science.gov (United States)

    Solomon, Barry D

    2010-01-01

    Interest in liquid biofuels production and use has increased worldwide as part of government policies to address the growing scarcity and riskiness of petroleum use, and, at least in theory, to help mitigate adverse global climate change. The existing biofuels markets are dominated by U.S. ethanol production based on cornstarch, Brazilian ethanol production based on sugarcane, and European biodiesel production based on rapeseed oil. Other promising efforts have included programs to shift toward the production and use of biofuels based on residues and waste materials from the agricultural and forestry sectors, and perennial grasses, such as switchgrass and miscanthus--so-called cellulosic ethanol. This article reviews these efforts and the recent literature in the context of ecological economics and sustainability science. Several common dimensions for sustainable biofuels are discussed: scale (resource assessment, land availability, and land use practices); efficiency (economic and energy); equity (geographic distribution of resources and the "food versus fuel" debate); socio-economic issues; and environmental effects and emissions. Recent proposals have been made for the development of sustainable biofuels criteria, culminating in standards released in Sweden in 2008 and a draft report from the international Roundtable on Sustainable Biofuels. These criteria hold promise for accelerating a shift away from unsustainable biofuels based on grain, such as corn, and toward possible sustainable feedstock and production practices that may be able to meet a variety of social, economic, and environmental sustainability criteria.

  19. Global sustainability: Toward definition

    Science.gov (United States)

    Brown, Becky J.; Hanson, Mark E.; Liverman, Diana M.; Merideth, Robert W.

    1987-11-01

    Sustainability is increasingly viewed as a desired goal of development and environmental management. This term has been used in numerous disciplines and in a variety of contexts, ranging from the concept of maximum sustainable yield in forestry and fisheries management to the vision of a sustainable society with a steady-state economy. The meaning of the term is strongly dependent on the context in which it is applied and on whether its use is based on a social, economic, or ecological perspective, Sustainability may be defined broadly or narrowly, but a useful definition must specify explicitly the context as well as the temporal and spatial scales being considered. Although societies differ in their conceptualizations of sustainability, indefinite human survival on a global scale requires certain basic support systems, which can be maintained only with a healthy environment and a stable human population. A clearer understanding of global sustainability and the development of appropriate indicators of the status of basic support systems would provide a useful framework for policy making.

  20. Human Capital and Sustainability

    Directory of Open Access Journals (Sweden)

    Garry Jacobs

    2011-01-01

    Full Text Available A study of sustainability needs to consider the role of all forms of capital—natural, biological, social, technological, financial, cultural—and the complex ways in which they interact. All forms of capital derive their value, utility and application from human mental awareness, creativity and social innovation. This makes human capital, including social capital, the central determinant of resource productivity and sustainability. Humanity has entered the Anthropocene Epoch in which human changes have become the predominant factor in evolution. Humanity is itself evolving from animal physicality to social vitality to mental individuality. This transition has profound bearing on human productive capabilities, adaptability, creativity and values, the organization of economy, public policy, social awareness and life styles that determine sustainability. This article examines the linkages between population, economic development, employment, education, health, social equity, cultural values, energy intensity and sustainability in the context of evolving human consciousness. It concludes that development of human capital is the critical determinant of long-term sustainability and that efforts to accelerate the evolution of human consciousness and emergence of mentally self-conscious individuals will be the most effective approach for ensuring a sustainable future. Education is the primary lever. Human choice matters.

  1. Toxicology and Carcinogenesis Studies of Mixtures of 3'-Azido-3'-Deoxythymidine (AZT), Lamivudine (3TC), and Nevirapine (NVP) (CAS Nos. 30516-87-1, 134678-17-4, 129618-40-2) in Genetically Modified C3B6.129F1-Trp53(tm1Brd) N12 Haploinsufficient Mice (in utero and postnatal gavage studies).

    Science.gov (United States)

    2013-10-01

    3'-Azido-3'-deoxythymidine (AZT) is the most widely used and evaluated chemotherapeutic agent for the treatment of persons with acquired immune deficiency syndrome (AIDS). Antiviral therapy is essential for treatment and prevention of AIDS in adults and children infected with human immunodeficiency virus (HIV), and to prevent mother-to-child transmission of HIV during pregnancy and labor. The studies described in this report were designed to determine possible long-term sequelae from AZT treatment, often used in combination with other antiviral drugs, such as lamivudine (3TC) and nevirapine (NVP) in preventing mother-to-child transmission of HIV. Male and female heterozygous F1 p53+/- mice were exposed to AZT, 3TC, NVP, or combinations of the chemicals in utero on gestation days (GD) 12 through 18, then administered the same chemical or combination of chemicals by gavage from postnatal day (PND) 1 through PND 28 and then observed until 45 weeks of age. Vehicle control mice received only an aqueous solution containing 0.2% methylcellulose and 0.1% Tween 80. Mice were dosed twice daily until PND 28. Genetic toxicology studies were conducted in mouse peripheral blood erythrocytes. The study compared three combination doses of AZT, 3TC and NVP (AZT/3TC/NVP-L, AZT/3TC/NVP-M, and AZT/3TC/NVP-H) with the vehicle controls, and compared the individual components with each other at the highest dose (AZT-H, 3TC-H, NVP-H, AZT/3TC-H and AZT/3TC/NVP-H). Because exposure to AZT/3TC/NVP-M and AZT/3TC/NVP-H reduced pup survival, additional litters were required to provide sufficient pups to load the 45-week study. 45-WEEK STUDY: In general, survival was relatively high once the pup exposure phase had been completed, with at least 75% of the mice surviving to terminal sacrifice in all groups. For males, survival was significantly greater in the AZT/3TC/NVP-L and AZT/3TC/NVP-M groups relative to the vehicle control group. There were no significant differences in survival between high

  2. Sustainable IT and IT for Sustainability

    Science.gov (United States)

    Liu, Zhenhua

    Energy and sustainability have become one of the most critical issues of our generation. While the abundant potential of renewable energy such as solar and wind provides a real opportunity for sustainability, their intermittency and uncertainty present a daunting operating challenge. This thesis aims to develop analytical models, deployable algorithms, and real systems to enable efficient integration of renewable energy into complex distributed systems with limited information. The first thrust of the thesis is to make IT systems more sustainable by facilitating the integration of renewable energy into these systems. IT represents the fastest growing sectors in energy usage and greenhouse gas pollution. Over the last decade there are dramatic improvements in the energy efficiency of IT systems, but the efficiency improvements do not necessarily lead to reduction in energy consumption because more servers are demanded. Further, little effort has been put in making IT more sustainable, and most of the improvements are from improved "engineering" rather than improved "algorithms". In contrast, my work focuses on developing algorithms with rigorous theoretical analysis that improve the sustainability of IT. In particular, this thesis seeks to exploit the flexibilities of cloud workloads both (i) in time by scheduling delay-tolerant workloads and (ii) in space by routing requests to geographically diverse data centers. These opportunities allow data centers to adaptively respond to renewable availability, varying cooling efficiency, and fluctuating energy prices, while still meeting performance requirements. The design of the enabling algorithms is however very challenging because of limited information, non-smooth objective functions and the need for distributed control. Novel distributed algorithms are developed with theoretically provable guarantees to enable the "follow the renewables" routing. Moving from theory to practice, I helped HP design and implement

  3. Sustainable Procurement: Integrating Classroom Learning with University Sustainability Programs

    Science.gov (United States)

    Goldschmidt, Kyle; Harrison, Terry; Holtry, Matthew; Reeh, Jeremy

    2013-01-01

    Organizations are facing increased pressure from various stakeholders to address issues of sustainability, resulting in a growing demand for sustainability education and training. Procurement groups remain the key drivers of many sustainability-related strategies, placing pressure on universities to integrate sustainability concepts into the…

  4. Cervical Spinal Injury from Repeated Exposures to Sustained Acceleration.

    Science.gov (United States)

    1999-02-01

    load (51). Also, with arm movements the upper trapezius and the levator scapulae become involved and resist neck movement, thus directly and...proper diet and weight control; 2. Regular strength and aerobic training with stretching and functional respiration training; 3. Massage, sauna and...physical warm-up including stretching neck muscles immediately before taking off while the pilot is in the cockpit. 39 CHAPTER 10 CERVICAL INJURY AND

  5. Proactive sustainability strategy and corporate sustainability performance: The mediating effect of sustainability control systems.

    Science.gov (United States)

    Wijethilake, Chaminda

    2017-07-01

    This study examines to what extent corporations use sustainability control systems (SCS) to translate proactive sustainability strategy into corporate sustainability performance. The study investigates the mediating effect of SCS on the relationship between proactive sustainability strategy and corporate sustainability performance. Survey data were collected from top managers in 175 multinational and local corporations operating in Sri Lanka and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). SCS were observed to only partially mediate the relationship between proactive sustainability strategy and corporate sustainability performance. The mediating effect of SCS is further examined under three sustainability strategies; environmental and social strategies reveal a partial mediation, while the economic strategy exhibits no mediation. The study also finds that (i) a proactive sustainability strategy is positively associated with SCS and corporate sustainability performance and (ii) SCS are positively associated with corporate sustainability performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Towards sustainable development

    Science.gov (United States)

    Munn, R. E.

    Sustainable development is a difficult phrase to define, particularly in the context of human ecosystems. Questions have to be asked, such as "Sustainable for whom?" "Sustainable for what purposes?" "Sustainable at the subsistence or at the luxury level?" and "Sustainable under what conditions?" In this paper, development is taken to mean improving the quality of life. (If development were to mean growth, then it could not be sustained over the long term.) Studies of development must, of course, consider economic factors, particularly in the case of societies who suffer from the pollution of poverty. However, cultural and environmental factors are equally important. In fact, development is not sustainable over the long term if it is not ecologically sustainable. The terms maximum sustainable yield of a renewable resource, carrying capacity of a region and assimilative capacity of a watershed or airshed are discussed. Approaches using these resource management tools are recommended when external conditions are not changing very much. The problem today is that unprecedented rates of change are expected in the next century, not only of environmental conditions such as climate but also of socioeconomic conditions such as renewable resource consumption and populations (of both people and of automobiles)! In rapidly changing situations, policies must be adopted that strengthen resilence and ecosystem integrity; that is, society must increase its ability to adapt. Maintaining the status quo is a long-term prescription for disaster. The problem is of course that little is known about how to design strategies that will increase resilience and ecosystem integrity, and this area of research needs to be strengthened. Some suggestions on appropriate indicators of ecosystem integrity are given in the paper but these need considerable refinement. One of the main problems with long-term environmental policy formulation is the uncertainty to be expected, including the possibility

  7. Sustainable Consumption Dilemmas

    Directory of Open Access Journals (Sweden)

    Kees Vringer

    2017-06-01

    Full Text Available To examine which considerations play a role when individuals make decisions to purchase sustainable product varieties or not, we have conducted a large scale field experiment with more than 600 participating households. Households can vote on whether the budgets they receive should only be spent on purchasing the sustainable product variety, or whether every household in a group is free to spend their budget on any product variety. By conducting several treatments, we tested whether people tend to view sustainable consumption as a social dilemma or as a moral dilemma. We find little support for the hypothesis that social dilemma considerations are the key drivers of sustainable consumption behaviour. Participants seem to be caught in a moral dilemma in which they not only weigh their individual financial costs with the sustainable benefits but they also consider the consequences of restricting other people’s freedom of choice. Complementary survey results further substantiate this claim and show that many people are reluctant to impose restrictions on their peers, but, at the same time, our results also suggest substantial support for the government to regulate the availability of unsustainable product varieties.

  8. Sustainability and sacred values

    Directory of Open Access Journals (Sweden)

    John Cairns Jr.

    2002-09-01

    Full Text Available Successful implementation of the quest for sustainable use of the planet requires that human society both reexamine and expand present views of what is sacred and what is not. The most important aspect will be going beyond a homocentric focus to a biocentric emphasis. A unifying theme would be the desire to leave a habitable planet for human descendants and those of other species. It is unlikely that society can be confident of achieving sustainability until persuasive evidence supporting this belief has existed for several generations. In order for sustainable use of the planet to persist indefinitely, the conditions essential to this state must be morally preserved on sacred grounds. Viewing natural systems as sacred requires not only preventing damage to them but, wherever possible, repairing damage to them caused by humankind.

  9. Sustainability & Organization Design

    DEFF Research Database (Denmark)

    Rasmussen, Morten Bygvraa; Obel, Børge; Kallehave, Pernille

    of global governance to match the new dynamics and consequences of globalization. Governments are re-examining corporate accountability to society and how companies earn their license to operate. Furthermore companies are re-examining their code of conduct and leadership values. Thus, sustainability...... is an important driver in organizations and its impact and effect on organization design is critical. Development of organization design, structure, processes, and human skills and values are needed to create the sustainable organization for the future. This paper discusses the requirements to be a sustainable...... organization. Here we follow the Global Compact criteria. The consequences for processes, structure, and human skills and values are analyzed. In particular the analysis will investigate exploration and exploitation from a holistic perspective using the principles of requisite variety and information...

  10. QUEST for sustainable CPD

    DEFF Research Database (Denmark)

    Nielsen, Birgitte Lund

    2014-01-01

    in the local learning communities we have seen a positive trend from the first to the last course-module, but with great variation between schools. Factors potentially supporting sustainable development seem to be about (1) continuingly scaffolding teachers’ collaborative inquiries by organizing activities......Continuous Professional Development (CPD) can be crucial for reforming science teaching, but more knowledge is needed about how to support sustainability of the effects. The Danish QUEST project is a large scale, long-term collaborative CPD project designed according to widely agreed criteria...... phase. The findings are discussed looking forward to the institutionalization phase identifying factors potentially supporting sustainable development pertaining to local science teachers developing a shared focus on student learning in science, and perceived individual and collective efficacy...

  11. Sustainable urban development

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole; Christensen, Toke Haunstrup; Gram-Hanssen, Kirsten

    Sustainability in urban planning has a long history and it has been a widespread solution to build high and compact in order to minimise the need for transportation, land use and heating. Recent research, however, points towards the need for a supplementary approach which includes the consumer...... behaviour of the household. This approach necessarily has to work from below and include the citizens, as it is their daily practices that have to be challenged. This article reviews the literature of to what extent compact cities are the most sustainable and it use lifestyle interpretations of urbane forms...... to challenge the compact cities approach. As an alternative or supplementary approach the article introduce practice theory as a way to understand consumption and it gives examples on how this approach can be used to inspire local authorities to alternative and supplementary strategies of achieving sustainable...

  12. Sustainable Consumption: Research Challenges

    DEFF Research Database (Denmark)

    Reisch, Lucia A.; Cohen, Maurie J.; Thøgersen, John

    The Board of the Swedish Foundation for Strategic Environmental Research (Mistra) decided in October 2015 that a proposal for a funding application call in the research area of “sustainable consumption” should be drawn up. According to the statutes of Mistra, research funded by the foundation...... for achieving industrial applications shall be taken advantage of.” The funding application call to be developed by Mistra is to be based on an analysis of the current state of the art of research and of society’s knowledge needs regarding sustainable consumption. Mistra commissioned a committee of four...... the orientation of a new research program to be used as draft text for the call for funding applications. The aim of this background report is hence to shed light on future research topics within sustainable consumption from a Swedish perspective. The research pro- moted should help to develop Sweden...

  13. Sustainable Supply Chain Design

    DEFF Research Database (Denmark)

    Bals, Lydia; Tate, Wendy

    A significant conceptual and practical challenge is how to integrate triple bottom line (TBL; including economic, social and environmental) sustainability into global supply chains. Although this integration is necessary to slow down global resource depletion, understanding is limited of how...... to implement TBL goals across the supply chain. In supply chain design, the classic economic perspective still dominates, although the idea of the TBL is more widely disseminated. The purpose of this research is to add to the sustainable supply chain management literature (SSCM) research agenda...... by incorporating the physical chain, and the (information and financial) support chains into supply chain design. This manuscript tackles issues of what the chains are designed for and how they are designed structurally. Four sustainable businesses are used as illustrative case examples of innovative supply chain...

  14. Sustainability in a nutshell.

    Science.gov (United States)

    Silvertown, Jonathan

    2004-06-01

    Sustainable exploitation is widely advocated as a strategy for reconciling economic pressures upon natural habitats with nature conservation. Two recent papers examine different aspects of the sustainability of the nut harvest on wild populations of Brazil nut trees Bertholletia excelsa in Amazonia. Peres et al. find that many populations of the Brazil nut tree lack juvenile trees and are not regenerating. In a socioeconomic study, Escobal and Aldana find that nut-gathering provides insufficient income on its own to support nut-gatherers and that their other income-raising activities damage the forest. The existence of a market for rainforest products is, therefore, not sufficient on its own to prevent habitat destruction or the overexploitation of the resource and a more sophisticated approach to sustainability is required. Development of a market in ethically traded Brazil nuts might be one solution.

  15. TOURISM AND SUSTAINABLE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Gina Ionela Butnaru

    2014-06-01

    Full Text Available Tourism and sustainable development are the subject of many initiatives and public or private debates in Romania. The main problem to which these initiatives try to find an answer is mostly related to the income generation for the local communities by using rationally and efficiently the local potential, in agreement with the economic, social, natural, and cultural factors. Consequently, some measures should be taken, and the tourist sector as a whole needs all the methods of sustainable development: new technologies, change of social behaviour, change of environmental legislation, methods of environmental management, better planning and development of control procedures. In this article, we presented a model of tourism development which should be applied in all the regions of great tourist attraction, and we realised a synthesis of the socio-economic advantages of sustainable tourism.

  16. Is Globalisation Sustainable?

    Directory of Open Access Journals (Sweden)

    Mohsin Raza

    2010-01-01

    Full Text Available It is clear that globalisation is something more than a purely economic phenomenon manifesting itself on a global scale. Among the visible manifestations of globalisation are the greater international movement of goods and services, financial capital, information and people. In addition, there are technological developments, more international cultural exchanges, facilitated by the freer trade of more differentiated products as well as by tourism and immigration, changes in the political landscape and ecological consequences. In this paper, we link the Maastricht Globalisation Index with Sustainability Indices to analyse if more globalised countries are doing better in terms of sustainable development and its dimensions. The results seem to suggest that the process of globalisation may render world development more sustainable.

  17. The Fiction of Sustainability

    DEFF Research Database (Denmark)

    Mubanda Rasmussen, Louise

    at maintaining and attracting new donor funding? Despite this contradiction, various actors in the HIV/AIDS field continuously invoke the doctrine of sustainability (Swidler & Watkins) as the remedy for problems such as 'donor dependency' and 'high turn-over' among volunteers. Based on five months ethnographic...... research with organisations providing help to "Orphans and Vulnerable Children" in Malawi, this paper discusses how donors, international and local NGOs, and CBOs all participate in keeping alive 'the fiction of sustainability', each for their different reasons. Rather than overt resistance to the power...

  18. Environment and sustainability

    DEFF Research Database (Denmark)

    Paavola, Jouni; Røpke, Inge

    2015-01-01

    This chapter reviews socio-economic research on the environment and sustainability. The chapter first explores core aspects of socio-economics, examines how socio-economics has related to the agenda of research on the environment, and assesses how socio-economic research on the environment became...... to a research agenda for ‘socio-ecological economics’. Sustainable consumption and global environmental change are already important areas of research for it. But ecological macroeconomics is also needed to formulate coordinated responses to multiple crises such as economic downturn, climate change and loss...

  19. Developing Ecological Sustainability

    DEFF Research Database (Denmark)

    Hedman, Jonas; Henningsson, Stefan

    2016-01-01

    IS initiatives become part of a firm’s overall strategy and part of the organizational sustainability process. We find that Green IS initiatives are initiated through a bottom-up process where environmentally concerned individuals identify issues and become Green IS champions. They use their authority...... and edification skills to promote Green IS to the organizational agenda. If the issue is aligned with the organizational agenda, it receives management’s endorsement. The empirical case also shows two types of systemic feedback that can fuel a self-reinforcing sustainability process. The first type of feedback...

  20. Sustainability Base Construction Update

    Science.gov (United States)

    Mewhinney, Michael

    2012-01-01

    Construction of the new Sustainability Base Collaborative support facility, expected to become the highest performing building in the federal government continues at NASA's Ames Research Center, Moffet Field, Calif. The new building is designed to achieve a platinum rating under the leadership in Energy and Environment Design (LEED) new construction standards for environmentally sustainable construction developed by the U. S. Green Building Council, Washington, D. C. When completed by the end of 2011, the $20.6 million building will feature near zero net energy consumption, use 90 percent less potable water than conventionally build buildings of equivalent size, and will result in reduced building maintenance costs.

  1. Towards sustainable food production

    DEFF Research Database (Denmark)

    Aramyan, Lusine H; Hoste, Robert; van den Broek, Willie

    2011-01-01

    allocation of pork supply chain activities in Europe. Supply chain production and distribution activities are optimized in various scenarios based on economic and sustainability performance indicators. A mixed integer linear programming (MILP) model, which includes piglet production, fattening, slaughtering......, as minimizing costs will not always lead to an optimal reduction in CO2 equivalent emissions, a differentiated strategy is needed for the European pork sector to move towards more sustainable production......European pork supply chains, like other agri-food supply chains, currently face numerous challenges such as globalization, emerging markets, changing consumer requirements, and new governmental regulations related to issues such as environmental pollution and food safety. These challenges require...

  2. SUSTAINABLE DEVELOPMENT PARADIGM - SYNOPSIS

    Directory of Open Access Journals (Sweden)

    Constantinescu Andreea

    2014-07-01

    Full Text Available Even if sustainable development is a concept that gained quite recently its scientific prestige, through contribution of researchers its content has upgraded to a high degree of conceptual luggage and, through contribution from governance representatives, has gained an impressive good-practice background. Allowing the use of different methodological premises and conceptual tools, sustainable development paradigm is equipped with all the elements that would allow the opening of new horizons of knowledge. Based on the facility which can operate the concept of sustainable development, the European Union aims to develop both a more competitive economy based on environmental protection as well as a new governance of economic policy. This on one hand demonstrates the sustainable development ability to irradiate creativity towards the establishment of interdisciplinary bridges and on the other hand explains the growing interest of researchers interested in the problem of analyzing in detail this fruitful concept. Launched first as a theoretical framework to serve justify actions responsible for weighting economic growth, the concept of Sustainable Development has quickly become a topic of ethical debate circumscribed to the area of perfectibility of human nature to the necessity registry. In this regard, the philosophical content of this paradigm could not remain outside researchers concerns, who want to provide both policy makers and the general public a wide range of evidence to demonstrate the viability of this paradigm. Academia waits until maximization of the contribution of governance to achieve sustainable economic development, which consists in conjunction of this upward path with the momentum given by public policy sync, perfectly adapted for globalization era and all crises to come. However, because this concept based its structure and composition on three pillars, equally important economy, society and environment any attempt to strengthen

  3. Sustainable Buildings in Interaction

    DEFF Research Database (Denmark)

    Elle, Morten

    2007-01-01

    The first attempts to build sustainable buildings in Denmark were typically located on the countryside. The basic idea was to create buildings that were independent of the technical infrastructure. District heating has, however, been the dominating solution to heating in buildings in Denmark......, and the focus on sustainable building have gradually turned from special houses on the countryside to normally looking houses in the urban fabric, integrated in the technical infrastructure. Some new built urban areas in Denmark will, however, not have to be supplied with district heating – these developments...

  4. Sustainability in SMEs

    DEFF Research Database (Denmark)

    Jahanshahi, Asghar Afshar; Brem, Alexander

    2017-01-01

    with their innovativeness and sustainability orientation. To accomplish this, we surveyed 40 TMTs in Iranian small- and medium-sized enterprises (SMEs) at two points in time. We ran a hierarchical multiple regression in order to test the hypotheses of the study. Building a theoretical model based on the Upper......-Echelons framework, we found that the extent to which a TMT is behaviorally integrated is positively and significantly related to TMT innovativeness. Furthermore, our result reveals that a highly behaviorally integrated TMT is more likely to engage in sustainability-oriented actions. Hence, behaviorally integrated...

  5. Nevirapine Babies: A qualitative study about

    African Journals Online (AJOL)

    Laz

    Infant feeding is estimated to be responsible for 5%-20% of the burden of HIV transmission from mother to child. HIV positive women ... lack of milk, lack of control over the feeding situation, felt and enacted stigma as well as poor counselling. Women who .... significant protective effect of EBF against postnatal. HIV infection ...

  6. Nelfinavir and nevirapine side effects during pregnancy

    NARCIS (Netherlands)

    Timmermans, Sarah; Tempelman, Claire; Godfried, Mieke H.; Nellen, Jeanine; Dieleman, Jeanne; Sprenger, Herman; Schneider, Margriet Ee; de Wolf, Frank; Boer, Kees; van der Ende, Marchina E.

    2005-01-01

    BACKGROUND: The risk of vertical transmission of HIV has been substantially reduced since the introduction of highly active antiretroviral therapy (HAART); however, the impact of taking HAART during pregnancy on the woman, the fetus and the infant is not yet understood. OBJECTIVE: To assess and

  7. Nelfinavir and nevirapine side effects during pregnancy

    NARCIS (Netherlands)

    Timmermans, S; Tempelman, C; Godfried, MH; Nellen, J; Sprenger, H; Schneider, MEE; de Wolf, F; Boer, K; van der Ende, Marchina E.

    2005-01-01

    Background: The risk of vertical transmission of HIV has been substantially reduced since the introduction of highly active antiretroviral therapy (HAART); however, the impact of taking HAART during pregnancy on the woman, the fetus and the infant is not yet understood. Objective: To assess and

  8. "They call our children 'Nevirapine Babies'"

    DEFF Research Database (Denmark)

    Østergaard, Lise Rosendal; Bula, Agatha

    2010-01-01

    Infant feeding is estimated to be responsible for 5%-20% of the burden of HIV transmission from mother to child. HIV positive women who cannot afford safe formula feeding are advised to practise exclusive breastfeeding (EBF) followed by prompt weaning. We conducted a qualitative study using...... as well as on EBF but much less knowledge on basic facts about breastfeeding. Despite their inten-tions less than half of the interviewed women managed to practice EBF and the barriers were explained by perceived lack of milk, lack of control over the feeding situation, felt and enacted stigma as well...... as poor counselling. Women who succeeded were older, had the explicit support of their husband and lived without the esence of their mother-in-law. Weaning at the age of 6 months was reported to be as difficult for the women as EBF. Intention itself is not a sufficient determinant of successful EBF unless...

  9. Ecosystem stewardship: sustainability strategies for a rapidly changing planet

    Science.gov (United States)

    F. Stuart Chapin; Stephen R. Carpenter; Gary P. Kofinas; Carl Folke; Nick Abel; William C. Clark; Per Olsson; D. Mark Stafford Smith; Brian Walker; Oran R. Young; Fikret Berkes; Reinette Biggs; J. Morgan Grove; Rosamond L. Naylor; Evelyn Pinkerton; Will Steffen; Frederick J. Swanson

    2010-01-01

    Ecosystem stewardship is an action-oriented framework intended to foster the social-ecological sustainability of a rapidly changing planet. Recent developments identify three strategies that make optimal use of current understanding in an environment of inevitable uncertainty and abrupt change: reducing the magnitude of, and exposure and sensitivity to, known stresses...

  10. Mainstreaming sustainable coffee

    NARCIS (Netherlands)

    Kolk, A.

    2013-01-01

    This overview article examines the various dimensions of sustainable coffee as well as the actors involved and their perceptions of how to advance the market from niche to mainstream. The issues at hand are very complex, with different types of coffee producers, manufacturing/roasting companies and

  11. [Sustainable diet: history lessons].

    Science.gov (United States)

    Fatati, Giuseppe

    2015-11-01

    Global dietary patterns changed dramatically in the past 50 years, presenting both a boom and a threat to the health and well-being of populations everywhere. We need sustainable diets, with low-input, local and seasonal agro-ecological food productions as well as short distance production-consumption nets for fair trade. The development of a global food system able to guarantee everyone a balanced food intake requires health professionals an awareness and a commitment to increasingly complex education. Dietary changes such as the adherence of to the Mediterranean Dietary Pattern can reduce the environmental footprint and thus the use of natural resources. Increased focus on improving the utilization of freshwater fishes and the correct use of the waters of rivers and lakes should also be encouraged. Cultural heritage, food quality and culinary skills are other key aspects determining sustainable dietary patterns and food security. The Mediterranean street food (Mediterraneità), for intrinsic characteristics, can represent valid model to address the main issues concerning the sustainable food system. The issues of sustainability offer a great opportunity to nutritional science and scientists to play a more central role in the political analysis of future food systems. We are confident that preserve the past helps us understand the present and build for the future, the Mediterranean lifestyle is much more than the Mediterranean diet and, finally, the rivers and the lakes may be our future.

  12. Building Sustainability Assessment

    Directory of Open Access Journals (Sweden)

    Heli Koukkari

    2010-07-01

    Full Text Available Although social, economic, and cultural indicators are of substantial importance to the concept of sustainable building, this concept is usually related to environmental characteristics. Any building level assessment method is complex and involves contradictory aspects. Moreover, emphasizing qualitative criteria only increases confusion. R&D and standardization are thus concentrated to transparency and usability of the environmental methods. Other directions of research aim at performance-based design and methods to take regional and cultural aspects into account. In this paper, the perspectives of the sustainability assessment of a whole building are presented, based on a state of the art, feasibility study on performance analysis and the development of an extended life-cycle assessment for buildings. Using various tools, and based on the case studies of building sustainability assessment, environmental indicators were often shown to be of lesser importance than the other, soft ones. The first steps in the development of a building sustainability assessment method for Portuguese residential buildings will be presented and discussed in the end.

  13. Democracy and sustainability

    DEFF Research Database (Denmark)

    Hansen, Hans Peter; Clausen, Laura Tolnov; Tind, Esben

    to nature conservation is setting a new agenda with more emphasis on sustainability than preservation. It thereby challenges the traditional agenda of nature conservation. The public administrations at central, regional and local level, as well as most nature conservation organisations at central level, do...

  14. Sustainability for Shrinking Cities

    Science.gov (United States)

    Shrinking cities are widespread throughout the world despite the rapidly increasing global urban population. These cities are attempting to transition to sustainable trajectories to improve the health and well-being of urban residents, to build their capacity to adapt to changing...

  15. Catalysis for Sustainable Development

    Indian Academy of Sciences (India)

    Issue front cover thumbnail. Volume 126, Issue 2. March 2014, pages 309-532. Catalysis for Sustainable Development. pp 309-309. Foreword · M Lakshmi Kantam K S Rama Rao · More Details Fulltext PDF. pp 311-317. Concept and progress in coupling of dehydrogenation and hydrogenation reactions through catalysts.

  16. Environmental sustainability of beef

    Science.gov (United States)

    A national assessment of the sustainability of beef is being conducted in collaboration with the National Cattlemen’s Beef Association through the support of the Beef Checkoff. This includes surveys and visits to cattle operations throughout the U.S. to gather production information. With this infor...

  17. Sustainability through precision agriculture

    Science.gov (United States)

    As population and standard of living increase in many parts of the world, so will the need for food and other agriculturally-based products. To be sustainable, these increases in production must occur with minimum impact on the environment and with efficient use of production resources, including la...

  18. Paying for sustainability

    DEFF Research Database (Denmark)

    Grebitus, Carola; Steiner, Bodo; Veeman, Michele

    2016-01-01

    Increasing environmental concerns of consumers and global supply chains center on the impacts of carbon dioxide emissions and water usage. This study analyzes consumers’ preferences for sustainable products as indicated by water and carbon footprint labels, enabling a rare cross-cultural comparison...

  19. Sustainability challenges and trends

    NARCIS (Netherlands)

    Ridder, M. de

    2011-01-01

    In the coming decades, increases in population, income and health will put additional pressures on our planet’s biosphere. To meet the needs of future generations, we need to adapt our ways of living and definitions of economic development. A transition to a more sustainable world is imperative if

  20. New Savings through Sustainability

    Science.gov (United States)

    Battise, Laura

    2011-01-01

    After three years of budget cuts, California school district leaders are hard-pressed to find ways to make further reductions without impacting educational quality. However, some seasoned leaders have turned to broad sustainability strategies to find new sources of savings and revenue. This article presents case studies in which three district…

  1. Why sustain oak forests?

    Science.gov (United States)

    David Wm. Smith

    2006-01-01

    A brief overview and some personal thoughts are offered that deal with the implications of our social and political systems on the long-term sustainability of our forest resources. The connection of the most recent climatic events, in a geologic-time context, to the development of present day oak dominated forests of the Eastern United States is discussed. The impacts...

  2. Ecology and Sustainable Development

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 7; Issue 11. Ecology and Sustainable Development. M D Subash Chandran. Book Review Volume 7 Issue 11 November 2002 pp 80-81. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/007/11/0080-0081 ...

  3. HCI and sustainability

    DEFF Research Database (Denmark)

    Møllenbach, Emilie; Hoff, Jens Villiam; Hornbæk, Kasper

    2012-01-01

    Sustained behavior changes are required to reduce the impact of human society on the environment. Much research on how HCI may help to do so focuses on changing behaviour by providing information directed at an individual or a microstructure (e.g. household). We propose societal macrostructures (e...

  4. Sustainable urban environmental quality

    Directory of Open Access Journals (Sweden)

    Tošković Dobrivoje

    2004-01-01

    Full Text Available MEANING as the essential element of urban quality. The role of the three main factors for the urban quality achievement: PLANNING, DEVELOPMENT and PEOPLE. Next to that, it is important to assume the identity of the local CONTEXT as the essential base for designing and shaping of form development. The problems of the quality achievements in the situation of the permanent changes. In such an environment - the RENEWAL of the towns become the basic strategic orientation requiring - evaluation of the development policy instruments. On the road of changes there are PROBLEMS of a strategic nature which should be, firstly, defined and, then, solved before entering in the process of structuring and arrangement. One of these problems is NEW versus OLD. Transition to a new policy of urbanism relying, first of all, on the private investors and international funds of the local authorities - call for a NEW STRATEGY in urbanism, in the context of the sustainability of environment. The sustainability of quality and the categories of the influencing factors. The sustainability of quality as a twofold process of urban design. The quality of environment as an aesthetic phenomenon. The urban situation and environmental quality: feasibility of changes and effects; the environmental capacity as an indicator and quality determinant. The urban quality and international experience. The evaluation of our urban situation. INSTEAD OF CONCLUSION: A general review on the visions and urban quality policy and planning. Toward an evaluation of urban environmental quality: negative and positive indicators; sustainable communities environmental ruling and urban quality planning.

  5. Durable past, sustainable future

    NARCIS (Netherlands)

    Van Hees, R.P.J.; Naldini, S.; Roos, J.

    2014-01-01

    The section Heritage & Architecture of the Faculty of Architecture at Delft University of Technology deals with the built environment in terms of conservation, refurbishment and re-use. Reflecting the department philosophy, this book focuses on the durability and sustainability of existing buildings

  6. Sustainability and the University

    Science.gov (United States)

    Clough, G. Wayne; Chameau, Jean-Lou; Carmichael, Carol

    2006-01-01

    In this article, the authors state that one of the major challenges facing the human race is charting a course for the future that allows economic growth while protecting the fragile planet. The authors discuss the role that higher education must play to help create a vibrant economy and high quality of life, while sustaining natural resources.…

  7. Sustainable Assessment Revisited

    Science.gov (United States)

    Boud, David; Soler, Rebeca

    2016-01-01

    Sustainable assessment has been proposed as an idea that focused on the contribution of assessment to learning beyond the timescale of a given course. It was identified as an assessment that meets the needs of the present in terms of the demands of formative and summative assessment, but which also prepares students to meet their own future…

  8. Outdoor Experiences and Sustainability

    Science.gov (United States)

    Prince, Heather E.

    2017-01-01

    Positive outdoor teaching and learning experiences and sound pedagogical approaches undoubtedly have contributed towards an understanding of environmental sustainability but it is not always clear how, and to what extent, education can translate into action. This article argues, with reference to social learning theory, that role modelling,…

  9. Sustainable consumer behaviour

    NARCIS (Netherlands)

    Antonides, Gerrit

    2017-01-01

    We summarise the contributions in this special issue on sustainable consumer behaviour and place them in perspective. Several studies focus on macro- and meso-issues, and others on micro-issues of consumer behaviour. The studies employ a variety of methods, including surveys, field experiments,

  10. Environmental Education and Sustainability

    Science.gov (United States)

    Chapman, Paul

    2014-01-01

    In the fall of 2013, Inverness Associates conducted a comprehensive national survey of environmental education and sustainability among private independent schools. The National Association of Independent Schools (NAIS) and 14 regional and state associations supported the research. The survey sought to understand how schools' environmental…

  11. Mauritius - a Sustainable Island

    DEFF Research Database (Denmark)

    Larsen, Anders

    2010-01-01

    The Government of Mauritius has a long-term vision of transforming Mauritius into a sustainable Island. One important element towards the achievement of this vision is to increase the country's renewable energy usage and thereby reducing dependence on fossil fuels. Democratisation of energy...

  12. Transport and Sustainability

    DEFF Research Database (Denmark)

    Jørgensen, Kaj

    1997-01-01

    Ph.D. study of the scope for sustainable transport in Denmark, and particularly of the role of the motor vehicle in this context. The distribution of groceries is used as case study of the introduction of the motor vehicle in Denmark, concluding that this has resulted in increases of the transport...

  13. Pathways to urban sustainability

    NARCIS (Netherlands)

    Nijkamp, Peter; Finco, Adele

    2001-01-01

    The concept of sustainable development has become very much "en vogue" in the past decade.We have also observed a shift in the interpretation of this concept from a global perspectiveto a meso perspective, i.e. a local, regional or sectoral level.This paper aims to highlight the urban dimension of

  14. Revealing Curitiba's flawed sustainability

    NARCIS (Netherlands)

    Giacomini Martínez, Joyde; Boas, Ingrid; Lenhart, Jennifer; Mol, Arthur P.J.

    2016-01-01

    The city of Curitiba, Brazil, is considered an exceptional model of sustainable urban planning. It has received praise for its invention of the Bus Rapid Transit System and numerous awards identify Curitiba as one of the world's greenest cities. Controversial elements have, however, been left out

  15. Emergent pedagogy of sustainability

    DEFF Research Database (Denmark)

    Husted, Mia; Frøkjær, Thorleif

    This presentation relates to the overall theme of the conference by highlighting societal and pedagogic deficits to face the challenges from sustainability crisis that is considered as a question of the ability of society to renew its natural and societal living conditions (Sachs 1999, Shiva 2005...

  16. Developing Sustainable Feedback Practices

    Science.gov (United States)

    Carless, David; Salter, Diane; Yang, Min; Lam, Joy

    2011-01-01

    Feedback is central to the development of student learning, but within the constraints of modularized learning in higher education it is increasingly difficult to handle effectively. This article makes a case for sustainable feedback as a contribution to the reconceptualization of feedback processes. The data derive from the Student Assessment and…

  17. Sustainability and Teacher Education

    Science.gov (United States)

    Martin, Ken; Summers, Denise; Sjerps-Jones, Harriet

    2007-01-01

    Sustainability is now a key concept in both government policy and wider global concerns. Issues of climate change and global warming can no longer be ignored in teacher education programs in the post-compulsory education and training sector. Government policy-makers, notably the Department for Education and Skills (DfES), Learning Skills Council…

  18. Partitioning ecosystems for sustainability.

    Science.gov (United States)

    Murray, Martyn G

    2016-03-01

    Decline in the abundance of renewable natural resources (RNRs) coupled with increasing demands of an expanding human population will greatly intensify competition for Earth's natural resources during this century, yet curiously, analytical approaches to the management of productive ecosystems (ecological theory of wildlife harvesting, tragedy of the commons, green economics, and bioeconomics) give only peripheral attention to the driving influence of competition on resource exploitation. Here, I apply resource competition theory (RCT) to the exploitation of RNRs and derive four general policies in support of their sustainable and equitable use: (1) regulate resource extraction technology to avoid damage to the resource base; (2) increase efficiency of resource use and reduce waste at every step in the resource supply chain and distribution network; (3) partition ecosystems with the harvesting niche as the basic organizing principle for sustainable management of natural resources by multiple users; and (4) increase negative feedback between consumer and resource to bring about long-term sustainable use. A simple policy framework demonstrates how RCT integrates with other elements of sustainability science to better manage productive ecosystems. Several problem areas of RNR management are discussed in the light of RCT, including tragedy of the commons, overharvesting, resource collapse, bycatch, single species quotas, and simplification of ecosystems.

  19. The macroecology of sustainability.

    Directory of Open Access Journals (Sweden)

    Joseph R Burger

    Full Text Available The discipline of sustainability science has emerged in response to concerns of natural and social scientists, policymakers, and lay people about whether the Earth can continue to support human population growth and economic prosperity. Yet, sustainability science has developed largely independently from and with little reference to key ecological principles that govern life on Earth. A macroecological perspective highlights three principles that should be integral to sustainability science: 1 physical conservation laws govern the flows of energy and materials between human systems and the environment, 2 smaller systems are connected by these flows to larger systems in which they are embedded, and 3 global constraints ultimately limit flows at smaller scales. Over the past few decades, decreasing per capita rates of consumption of petroleum, phosphate, agricultural land, fresh water, fish, and wood indicate that the growing human population has surpassed the capacity of the Earth to supply enough of these essential resources to sustain even the current population and level of socioeconomic development.

  20. Education for Sustainable development

    African Journals Online (AJOL)

    that sustainability logically necessitates a deep learning response in educational thinking and practice and anticipative education, recognising the new conditions and discontinuities which face present generations. Faculty of Science and Agriculture. These are in fact two faculties, but they were considered as one for the ...

  1. Sustainable consumption dilemmas

    NARCIS (Netherlands)

    Vringer, Kees; Heijden, Eline Van Der; Soest, Daan Van; Vollebergh, Herman; Dietz, Frank

    To examine which considerations play a role when individuals make decisions to purchase sustainable product varieties or not, we have conducted a large scale field experiment with more than 600 participating households. Households can vote on whether the budgets they receive should only be spent on

  2. Sustainability issues in civil engineering

    CERN Document Server

    Saride, Sireesh; Basha, B

    2017-01-01

    This compilation on sustainability issues in civil engineering comprises contributions from international experts who have been working in the area of sustainability in civil engineering. Many of the contributions have been presented as keynote lectures at the International Conference on Sustainable Civil Infrastructure (ICSCI) held in Hyderabad, India. The book has been divided into core themes of Sustainable Transportation Systems, Sustainable Geosystems, Sustainable Environmental and Water Resources and Sustainable Structural Systems. Use of sustainability principles in engineering has become an important component of the process of design and in this context, design and analysis approaches in civil engineering are being reexamined to incorporate the principles of sustainable designs and construction in practice. Developing economies are on the threshold of rapid infrastructure growth and there is a need to compile the developments in various branches of civil engineering and highlight the issues. It is th...

  3. The sustainable company: new challenges and strategies for more sustainability

    Directory of Open Access Journals (Sweden)

    Victor DANCIU

    2013-09-01

    Full Text Available The sustainability becomes a model of development only if countries, industries, businesses and citizens become sustainable. The contribution of the business to a promising future should come from a fully integrated sustainability in its DNA and strategies.This paper focuses on the needed sustainable strategies for scaling up the contribution of the companies to sustainable development in the future. At the beginning, we analyze the main theoretical points of view on sustainability. Then, we explain how companies could achieve the sustainability by following the steps of a difficult process and the present performances in sustainability of large companies around the world. Finally, we suggest four strategies that businesses could design and implement in order to scaling up their sustainability in the future.The research has two important conclusions on sustainability in business. One is that the sustainability pays off if it is integrated in the DNA of the companies. The other conclusion says that the companies will succeed to make the needed transformation for achieving a better sustainability in the future only if they design and perform strategies focused on improving sustainability.

  4. Marketing Sustainable Retail Development

    Directory of Open Access Journals (Sweden)

    Dragan Ilić

    2013-06-01

    Full Text Available One of the primary benefits of sustainable retail over the long run has to be the marketing gain from having something other competitors do not: lower operating costs, a more socially responsible public profile, ease of gaining planning approval for new projects, better access to certain investment pools, higher rents (in the case of developers, ease of recruiting and retaining key people. Each of these benefits needs marketing and public relations support; each benefits from a clear and consistent corporate message that promotes sustainable retail. To date, there are very few retailers or developers who have championed sustainability long enough, consistently enough and with enough actual demonstration of changes in standard operations to gain the benefits of green marketing, but the very paucity of examples serves to underscore the point: the green marketing space is wide open for large retailers and developers. What would be the marketing steps that a company could take to benefit from its “sustainability focus?” The key to any marketing program is to differentiate a company’s actions from those of competitors and to do it along lines that its various stakeholders care about. This practice of differentiation is often expressed as “finding a difference that makes a difference, to someone who makes difference to you.” For retail developers, the first differentiator should be to attract more and better tenants to all of their centers, tenants who value lower operating costs and the developer’s program of sustainable development and corporate social responsibility.

  5. SUSTAINABILITY AND ORGANIZATIONAL CHANGE BY SUSTAINABLE CREDITING THERAPY

    National Research Council Canada - National Science Library

    Dragos Ilie

    2012-01-01

      The objective of this paper is to demonstrate that one of the therapies to achieve sustainability and organizational change in the context of current challenges in the national economies is sustainable crediting...

  6. The Globe Sustained: Shakespeare’s allegory for sustainable development

    NARCIS (Netherlands)

    Casteren van Cattenburch, Iris

    2017-01-01

    Sustainability theory shows that the sustainability problem is a value orientation problem. In a recent study, Klaas van Egmond identified an underlying pattern of a crossed circle, representing affirmative and adversative value orientations, whose disintegration engenders unsustainable tendencies.

  7. SUSTAINABLE LIFESTYLE MARKETING OF INDIVIDUALS: THE BASE OF SUSTAINABILITY

    National Research Council Canada - National Science Library

    Mira Rakic; Beba Rakic

    2015-01-01

      This paper highlights the sustainable lifestyle marketing of an individual (SLMOI). The SLMOI is the activity, a set of institutions and processes for creating, communicating and maintaining the sustainable lifestyle of an individual...

  8. Textiles and clothing sustainability sustainable fashion and consumption

    CERN Document Server

    2017-01-01

    This is the first book to introduce and explain the concept of sustainable consumption with reference to the clothing sector. It uses various case studies to detail sustainable consumption behavior in the industry. Consumption is a key issue and is a major driver when it comes to sustainability in any industry, including clothing sector. Several studies which have highlighted the need for sustainable consumption in the clothing sector are discussed in this book.

  9. Textiles and clothing sustainability sustainable textile chemical processes

    CERN Document Server

    2017-01-01

    This book highlights the challenges in sustainable wet processing of textiles, natural dyes, enzymatic textiles and sustainable textile finishes. Textile industry is known for its chemical processing issues and many NGO’s are behind the textile sector to streamline its chemical processing, which is the black face of clothing and fashion sector. Sustainable textile chemical processes are crucial for attaining sustainability in the clothing sector. Seven comprehensive chapters are aimed to highlight these issues in the book.

  10. Corporate Sustainability Reporting in the BIST Sustainability Index

    OpenAIRE

    Burcu Demirel; Murat Erdogan

    2016-01-01

    In recent years, there is a growing focus on corporate operations especially since the publication of the first environmental reports in 1989. Companies have started to publish information about its environmental, social and sustainability policies. The study examines the sustainability reporting elements of Borsa Istanbul Sustainability Index (BIST) in Turkey and to evaluate which elements is most vital in this context. This study will begin with the sustainability reporting that will be exa...

  11. PATHWAYS TO SUSTAINABLE BANKING MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Dragan (Santamarian Oana Raluca

    2012-12-01

    Full Text Available This paper describes one of the major challenges of the future: the sustainable development of the society. Sustainability is now increasingly recognized as central to the growth of emerging market economies. For the banking sector, this represents both a demand for greater social and environmental responsibility as well as a new landscape of business opportunity. Several years ago, the main part of the banks did not consider the social and environmental problems relevant for their operations. Recently, the banks began to realize the major impact of the sustainable development over the way of ulterior development of the society and, implicitly over the way of creating of the banking value in the future. In this context, the development of a banking management system, based on sustainable principles represents one of the provocations of these days.Starting from literature in the sustainable banking management field in this paper are presented several relevant issues related to risk management in the context of sustainable banking financing: the need to implement the sustainable management principles in financial and banking industry; the role of banks in sustainable development of society; social and environmental risk management policies, events that have shaped the role of the banking sector in sustainable development; international standards regarding sustainable banking management such us: Equator Principles for sustainable investment projects’ financing or GRI principles for sustainable reporting. Furthermore, we developed a practical case study related to the implementation of sustainable banking management at Bank of America.

  12. Sustainable regulation of construction.

    Science.gov (United States)

    2000-11-01

    The seminar examined the role building codes and regulations can have in promoting a more sustainable approach to construction, particularly through their application to non-industrial building materials. A range of building materials such as straw, bamboo, rammed earth, adobe, and cob (a mixture of clay and chopped straw) were described and illustrated by slides to show their building potential. The current codes have a prime concern to protect the health and safety of people from the built environment. They have been developed almost exclusively for mainstream industrial materials and methods of construction, which makes them difficult to use with alternative, indigenous, or non-industrial building materials, even though those materials may be considered more sustainable. The argument was put forward that with only one-third of the world population living in modern industrial buildings today, it is not sustainable to re-house the remaining rapidly expanding population in high technology dwellings. Many of the low technology building materials and methods now used by the majority of people in the world need only incremental improvement to be equal or superior to many of their industrial replacements. Since these can be more sustainable methods of building, there needs to be an acceptance of the use of alternative materials, particularly in the developing parts of the world, where they are being rejected for less sustainable industrial methods. However, many codes make it difficult to use non-industrial materials; indeed, many of the industrial materials would not meet the demands that must be now met if they were now being introduced as new materials. Consequently, there is a need to develop codes to facilitate the use of a wider range of materials than in current use, and research is needed to assist this development. Sustainable regulation should take into account the full range of real impacts that materials and systems have in areas such as resource use and

  13. Sustainable Schools in the UN Decade of Education for Sustainable ...

    African Journals Online (AJOL)

    4carolinebell@gmail.com

    encompasses a vision for global society that is not only ecologically sustainable but also one that is socially and economically sustainable. This paper traces the history of ESD in Victorian schools and analyses the current sustainability policies and initiatives in terms of their achievement of the educational, environmental,.

  14. Critical Sustainabilities: Negotiating Sustainability's Discursive Maze in the Classroom

    Science.gov (United States)

    Weaver, Russell

    2015-01-01

    "Sustainability" features in numerous discourses, each of which frames the issue according to its particular worldview(s). Thus there is no singular sustainability conception, but multiple sustainabilities that compete with one another for prominence in various realms. This article presents a framework to assist students in navigating…

  15. Corporate Sustainability Reporting in the BIST Sustainability Index

    Directory of Open Access Journals (Sweden)

    Burcu Demirel

    2016-11-01

    Full Text Available In recent years, there is a growing focus on corporate operations especially since the publication of the first environmental reports in 1989. Companies have started to publish information about its environmental, social and sustainability policies. The study examines the sustainability reporting elements of Borsa Istanbul Sustainability Index (BIST in Turkey and to evaluate which elements is most vital in this context. This study will begin with the sustainability reporting that will be examined under the roof of corporation sustainability and end with the examination of sustainability reports of 15 firms, which are included in the BIST Sustainability Index in Turkey, and a content analysis. The reports of companies under study were taken from special web site and GRI (Global Reporting Initiative database of companies. Being the first study in examining the sustainability report of companies in BIST Sustainability Index, it is expected to contribute in literature about sustainability reporting recently started to gain importance in Turkey. Overall our findings suggest that the sustainability index established in Turkey is still in development stage, but the enterprises in the endeavor are working day by day to develop the sustainability qualities.

  16. Sustainability Smarts: Applying the Core Principles of Sustainability on Campus

    Science.gov (United States)

    Association of College Unions International (NJ1), 2011

    2011-01-01

    Sustainability, sustainable, green, eco-friendly--these are more than just buzz words. These are words that are now entangled in the daily fabric of life. Kids are learning about sustainability in primary schools, more students are studying environmental concerns in college, and people of all ages are making attempts to be green, from recycling to…

  17. No-Self, Natural Sustainability and Education for Sustainable Development

    Science.gov (United States)

    Wang, Chia-Ling

    2017-01-01

    This article explores the significance of sustainability and several ways in which education for sustainable development (ESD) can be considered. It presents several issues related to the theories of sustainability and ESD, which are generated based on a firm concept of anthropocentrism. ESD has been used for developing a scientific understanding…

  18. decolonising sustainability: subverting and appropriating ...

    African Journals Online (AJOL)

    DECOLONISING SUSTAINABILITY: SUBVERTING AND APPROPRIATING. MYTHOLOGIES OF SOCIAL CHANGE. Noel Gough. This essay explores some possibilities for decolonising the concept of sustainability in southern African dis- courses of ..... stories include commonplace features of green stories. (such as ...

  19. Interpreting Sustainability for Urban Forests

    Directory of Open Access Journals (Sweden)

    Camilo Ordóñez

    2010-06-01

    Full Text Available Incisive interpretations of urban-forest sustainability are important in furthering our understanding of how to sustain the myriad values associated with urban forests. Our analysis of earlier interpretations reveals conceptual gaps. These interpretations are attached to restrictive definitions of a sustainable urban forest and limited to a rather mechanical view of maintaining the biophysical structure of trees. The probing of three conceptual domains (urban forest concepts, sustainable development, and sustainable forest management leads to a broader interpretation of urban-forest sustainability as the process of sustaining urban forest values through time and across space. We propose that values—and not services, benefits, functions or goods—is a superior concept to refer to what is to be sustained in and by an urban forest.

  20. Towards Sustainable Flow Management - Introduction

    DEFF Research Database (Denmark)

    Moss, Timothy; Elle, Morten

    2001-01-01

    Outlines the conditions for the three Local Agenda 21 case-studies in the Sustainable Flow Management project......Outlines the conditions for the three Local Agenda 21 case-studies in the Sustainable Flow Management project...

  1. Sustainable restaurants: A research agenda

    African Journals Online (AJOL)

    transition to more sustainable hotel and catering businesses. ... what the determining factors are in a guest's intention to go to a green .... as hedonistic, and if we assume that a sustainable dish costs .... they have further room for improvement.

  2. Strategies for Sustainable Energy Development

    DEFF Research Database (Denmark)

    Meyer, Niels I

    2009-01-01

    The paper analyses international strategies for establishing a sustainable energy development. Proposals are given for mitigation of global warming.......The paper analyses international strategies for establishing a sustainable energy development. Proposals are given for mitigation of global warming....

  3. Sustainability, Ecojustice, and Adult Education

    Science.gov (United States)

    Griswold, Wendy

    2017-01-01

    Adult education has a significant role to play in creating a just and sustainable world. This chapter explores a continuum of perspectives related to the environment and education and highlights sustainability and ecojustice education theory and practices in this volume.

  4. Sustainability and specialisation

    Directory of Open Access Journals (Sweden)

    John Cairns Jr.

    2004-05-01

    Full Text Available Society depends heavily on its major universities and independent research organisations for new ideas. Arguable, sustainable use of the planet will require conceptual paradigms unprecedented in human history. Educational systems, especially major universities and research organisations, must produce students in all phases of the educational continuum who are capable of transdisciplinary activities. A much larger group of such students will be required to implement these new undertakings. Until the perception of the need for transdisciplinary education becomes widespread, nothing significant is likely to happen. One major obstacle is the lack of employment for transdisciplinary individuals. A commitment to sustainable use of the planet will provide employment and make better use of increasingly scarce resources.

  5. Sustainable Energy for All

    DEFF Research Database (Denmark)

    Energy crisis is one of the most pressing issues of our century. The world currently invests more than $1 trillion per year in energy, much of it going toward the energy systems of the past instead of building the clean energy economies of the future. Effectively, the provision of energy should...... be such that it meets the needs of the present without compromising the ability of future generations to meet their own needs. Investment in sustainable energy is a smart strategy for growing markets, improving competitiveness, and providing greater equity and opportunity. Sustainable energy has two key elements...... - renewable energy and energy efficiency. The promise of renewable energy can only be realised through significant R&D investments on technologies such as solar, biomass, wind, hydropower, geothermal power, ocean energy sources, solar-derived hydrogen fuel coupled with energy storage technologies necessary...

  6. Sustainable Bridge Infrastructure Procurement

    DEFF Research Database (Denmark)

    Safi, Mohammed; Du, Guangli; Simonsson, Peter

    2016-01-01

    The lack of a flexible but systematic approach for integrating lifecycle aspects into bridge investment decisions is a major obstacle hindering the procurement of sustainable bridge infrastructures. This paper addresses this obstacle by introducing a holistic approach that agencies could use to p...... to procure the most “sustainable” (lifecycle-efficient) bridge through a fair design-build (D-B) tendering process, considering all the main aspects: life-cycle cost (LCC), service life-span, aesthetic demands and environmental impacts (LCA).......The lack of a flexible but systematic approach for integrating lifecycle aspects into bridge investment decisions is a major obstacle hindering the procurement of sustainable bridge infrastructures. This paper addresses this obstacle by introducing a holistic approach that agencies could use...

  7. Sustaining a Business

    DEFF Research Database (Denmark)

    Marinova, Svetla Trifonova; Marinov, Marin Alexandrov

    2015-01-01

    The chapter explores how internationalisation accounted for sustained business success during the turbulent time of radical economic, political and social transformation in Eastern Europe. The study adopts a longitudinal approach to exploring the evolution of internationalisation – from a partner...... and the integration of the company into global business structures.......The chapter explores how internationalisation accounted for sustained business success during the turbulent time of radical economic, political and social transformation in Eastern Europe. The study adopts a longitudinal approach to exploring the evolution of internationalisation – from...... system was under way. Dyadic and triadic relationships are investigated by applying sets of theoretical approaches to the creation of an East-West business relationship. They encompass the role of the country’s government, the management of the focal company and the foreign partner. Furthermore, the role...

  8. Sustainable Food Consumption

    DEFF Research Database (Denmark)

    Reisch, Lucia; Scholl, Gerd; Eberle, Ulrike

    and within individual societies. These drivers are the result of national and international policies and regulations, as well as business practices, and in particular values. At present, however, there is no commonly accepted definition for ‘sustainable food production’: rather, existing definitions......Not only can food consumption today not be regarded as sustainable, but the scope of the problem is wide: 1. about 800 million people worldwide are suffering hunger 2. 1 to 1.5 billion people in the world are overweight, 300 to 500 million of them obese, a tendency that is increasing 3. diet...... and lifestyle related health problems such as cardiovascular diseases and diabetes are increasing, the latter in young age groups 4. social cohesion is increasingly in danger since health is closely related to socioeconomic status 5. serious environmental problems related to food production and consumption need...

  9. Sustainable Food Consumption

    DEFF Research Database (Denmark)

    Reisch, Lucia; Eberle, Ulrike; Lorek, Sylvia

    2013-01-01

    Contemporary food production and consumption cannot be regarded as sustainable and raises problems with its wide scope involving diverse actors. Moreover, in the face of demographic change and a growing global population, sus-tainability problems arising from food systems will likely become more...... and globalization of agriculture and food processing, the shift of consumption patterns toward more dietary animal protein, the emergence of modern food styles that entail heavily processed products, the growing gap on a global scale between rich and poor, and the paradoxical lack of food security amid an abundance...... consumption of meat and dairy products (especially beef), to favor organic fruits and vegetables, and to avoid goods that have been transported by air on both individual and institutional levels (e.g., public procurement, public catering). In examining the unsustainability of the current food system...

  10. Fundamentals of sustainable neighbourhoods

    CERN Document Server

    Friedman, Avi

    2015-01-01

    This book introduces architects, engineers, builders, and urban planners to a range of design principles of sustainable communities and illustrates them with outstanding case studies. Drawing on the author’s experience as well as local and international case studies, Fundamentals of Sustainable Neighbourhoods presents planning concepts that minimize developments' carbon footprint through compact communities, adaptable and expandable dwellings, adaptable landscapes, and smaller-sized yet quality-designed housing. This book also: Examines in-depth global strategies for minimizing the residential carbon footprint, including district heating, passive solar gain, net-zero residences, as well as preserving the communities' natural assets Reconsiders conceptual approaches in building design and urban planning to promote a better connection between communities and nature Demonstrates practical applications of green architecture Focuses on innovative living spaces in urban environments

  11. ORNL Sustainable Campus Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Halford, Christopher K [ORNL

    2012-01-01

    The research conducted at Oak Ridge National Laboratory (ORNL) spans many disciplines and has the potential for far-reaching impact in many areas of everyday life. ORNL researchers and operations staff work on projects in areas as diverse as nuclear power generation, transportation, materials science, computing, and building technologies. As the U.S. Department of Energy s (DOE) largest science and energy research facility, ORNL seeks to establish partnerships with industry in the development of innovative new technologies. The primary focus of this current research deals with developing technologies which improve or maintain the quality of life for humans while reducing the overall impact on the environment. In its interactions with industry, ORNL serves as both a facility for sustainable research, as well as a representative of DOE to the private sector. For these reasons it is important that the everyday operations of the Laboratory reflect a dedication to the concepts of stewardship and sustainability.

  12. Sustainable Commuting @Work

    Directory of Open Access Journals (Sweden)

    S. Castellani

    2014-10-01

    Full Text Available Local governments are seeking effective ways to promote sustainable commuting for reducing energy consumption and improving commuters’ experience. They often use so-called “Workplace Travel Plans” as policy interventions to engage work organizations as active players, promoting sustainable commuting amongst their employees. However, it remains difficult to systematically engage work organizations and commuters in such efforts for a number of reasons, ranging from preferences to constraints that they have to deal with. We aim at providing commuters, work organizations, and public administrators with tools that facilitate this engagement. In this paper, we discuss the requirements for the design of technology supporting corresponding services for commuters and work organizations and we shortly illustrate the infrastructure that we are developing to provide such services.

  13. Fur and sustainability

    DEFF Research Database (Denmark)

    Skjold, Else; Ræbild, Ulla; Tanderup, Sisse

    2016-01-01

    the scientific areas represented at the school. Thus, the report departs from a design perspective, which means that the content of the report covers four perspectives of the life-cycle of fur after it has left the auction house of Kopenhagen Fur: • a cultural history perspective that points towards ways...... practices around retail and communication (by Else Skjold, PhD in user studies and business management). On the basis of these four sub-projects, the report concludes the following: Currently, fur is placed very centrally in the moral debates around sustainability, as fur farming highligts environmental...... and moral concerns of the 21st Century. But the practices around fur can be seen as sustainable, wheather one perceives fur farming - or even making use of fur in garments - as morally acceptable or not. If the fur industry is to survive, it needs to hatch on to the debates taking place around...

  14. Sustainable Drainage Systems

    OpenAIRE

    Miklas Scholz

    2015-01-01

    Urban water management has somewhat changed since the publication of The Sustainable Drainage System (SuDS) Manual in 2007 [1], transforming from building traditional sewers to implementing SuDS, which are part of the best management practice techniques used in the USA and seen as contributing to water-sensitive urban design in Australia. Most SuDS, such as infiltration trenches, swales, green roofs, ponds, and wetlands, address water quality and quantity challenges, and enhance the local bio...

  15. Humanitarian logistics and sustainability

    CERN Document Server

    Leeuw, Sander; Regattieri, Alberto; Souza, Robert

    2015-01-01

    This contributed volume combines conceptual and strategic research articles dealing with the "why" and "to what end" of sustainable operations in humanitarian logistics, as well as operational research contributions regarding the "how" from the United Nations as well as from researchers and organizations from different countries (Germany, Australia, Singapore, Italy, Denmark, Jordan). The target audience primarily comprises research experts, decision makers  and practitioners in the field, but the book may also be beneficial for graduate students.

  16. Sustainability and National Security

    Science.gov (United States)

    2012-01-01

    in the UN General Assem- bly’s Millennium Declaration in 2000. 7 In the broadest sense, sustainability can be viewed as the ability of man to live...was the world’s first production PHEV, first offered 317 for sale to business and government buyers in China on December 15, 2008 ( Balfour 2008...Energy Independence. http://www.ameri- canenergyindependence.com/security.aspx (ac- cessed December 15, 2010). Balfour , Frederik. 2008. China’s First

  17. Nanotechnologies for sustainable construction

    DEFF Research Database (Denmark)

    Geiker, Mette Rica; Andersen, Maj Munch

    2009-01-01

    This chapter aims to highlight key aspects and recent trends in the development and application of nanotechnology to facilitate sustainable construction, use and demolition of buildings and infrastructure structures, ‘nanoconstruction’. Nanotechnology is not a technology but a very diverse...... technological field which covers many aspects. The chapter therefore seeks to provide a framework for addressing relevant issues of green nanoconstruction and to bring an overview and illustrative examples of current early developments....

  18. Sustainable Construction in Afghanistan

    Science.gov (United States)

    2010-09-01

    Publishers, 2004), 101–103; Kathryn Rhyner-Pozak, “ Grupo Sofonias: Knowledge in the Hands of the People,” in Building without Borders: Sustainable...10, 1970, http://untreaty.un.org/unts/1_60000/21/35/00041746.pdf. 46 Kathryn ,, “Case Study: Grupo Sofonias: Knowledge in the Hands of the People...Counterinsurgency as “those military, paramilitary, political, economic, psychological , and civic actions taken by a government to defeat insurgency

  19. "Sustainability and Surplus"

    OpenAIRE

    Haider A. Khan

    2007-01-01

    In this paper we present two new concepts for studying sustainability. The first is the idea of an environmentally adjusted surplus(ES). The classical concept of surplus is revised to approximate the total available discretionary income for the society under ordinary (capitalist) growth process.ES is an operationalizable concept. We demonstrate this here via a simplified but illustrative exercise. Work with large data sets employing social and environmental accounting will yield sharper and m...

  20. Maintenance in sustainable manufacturing

    Directory of Open Access Journals (Sweden)

    Vladimir Stuchly

    2014-09-01

    Full Text Available Background: Sustainable development is about reaching a balance between economic, social, and environmental goals, as well as people's participation in the planning process in order to gain their input and support. For a company, sustainable development means adoption of such business strategy and actions that contribute to satisfying present needs of company and stakeholders, as well as simultaneous protection, maintenance and strengthening of human and environmental potential which will be needed in the future. This new approach forces manufacturing companies to change their previous management paradigms. New management paradigm should include new issues and develop innovative methods, practices and technologies striving for solving problem of shortages of resources, softening environment overload and enabling development of environment-friendly lifecycle of products. Hence, its realization requires updating existing production models as they are based on previously accepted paradigm of unlimited resources and unlimited regeneration capabilities. Maintenance plays a crucial role because of its impact on availability, reliability, quality and life cycle cost, thus it should be one of the main pillars of new business running model.  Material and methods: The following paper is a result of research on the literature and observation of practices undertaken by a company within maintenance area. Results and conclusions: The main message is that considering sustainable manufacturing requires considerable expanding range of analysis and focusing on supporting processes. Maintenance offers numerous opportunities of decreasing influence of business processes on natural environment and more efficient resources utilization. The goal of maintenance processes realizing sustainable development strategy is increased profitability of exploitation and optimization of total lifecycle cost without disturbing safety and environmental issues. 

  1. Analyzing sustainable competitive advantage

    OpenAIRE

    Abdul Malek Nurul Aida; Shahzad Khuram; Takala Josu; Bojnec Stefan; Papler Drago; Liu Yang

    2016-01-01

    In today’s dynamic business environment, a key challenge for all companies is to make adaptive adjustments to their manufacturing strategy. This study demonstrates the competitive priorities of manufacturing strategy in hydro-power case company to evaluate the level of sustainable competitive advantage and also to further analyze how business strategies are aligned with manufacturing strategies. This research is based on new holistic analytical evaluation of manufacturing strategy index, sens...

  2. Modeling Sustainment Investment

    Science.gov (United States)

    2015-05-01

    BASIS. CARNEGIE MELLON UNIVERSITY MAKES NO WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, AS TO ANY MATTER INCLUDING, BUT NOT LIMITED TO, WARRANTY...WARRANTY OF ANY KIND WITH RESPECT TO FREEDOM FROM PATENT, TRADEMARK, OR COPYRIGHT INFRINGEMENT . This material has been approved for public release...forecast the consequences of various alternatives? Sustainment Investment: the Problem Operations Supplying the fleet, customer support, etc

  3. Sustainable Enterprise Architecture

    CERN Document Server

    Hausman, Kirk

    2011-01-01

    Providing guidance that can be applied to an enterprise of any scale, this book supplies IT practitioners with the tools needed to present enterprise architecture concepts to non-technical stakeholders. Rather than focusing on a single governance framework, the text explains how to develop successful and sustainable enterprise deployments in any setting. Coverage includes general security practices, common threats, storage mechanisms, and the impact of virtualization. The author presents functional considerations for developing and maintaining extended enterprise networks using practices teste

  4. Chemistry of sustainable energy

    CERN Document Server

    Carpenter, Nancy E

    2014-01-01

    Energy BasicsWhat Is Energy?Energy, Technology, and SustainabilityEnergy Units, Terms, and AbbreviationsElectricity Generation and StorageOther ResourcesReferencesFossil FuelsFormation of Oil and GasExtraction of Fossil FuelsRefiningCarbon Capture and StorageSummaryOther ResourcesOnline Resources Related to Carbon Capture andSequestrationReferencesThermodynamicsIntroductionThe First Law of ThermodynamicsThe Second Law and Thermodynamic Cycles: the Carnot EfficiencyExerg

  5. Communicating forest sector sustainability

    OpenAIRE

    Korhonen, E.; Toppinen, Anne; Lähtinen, K.; Ranacher, L.; Werner, Andrea; Stern, Tobias; Kutnar, Andreja

    2016-01-01

    Communication is an important tool in maintaining legitimacy and acceptability of forest sector operations and activities, and expectations by the general public on the forest sector conduct in Europe are in general very high. Despite this, there is scarce research in crossnational context on how forest sector sustainability is communicated to the general public, and what development areas can be identified in terms of communication content. This study applies a qualitative content analysis i...

  6. Efavirenz decreases etonogestrel exposure: a pharmacokinetic evaluation of implantable contraception with antiretroviral therapy.

    Science.gov (United States)

    Chappell, Catherine A; Lamorde, Mohammed; Nakalema, Shadia; Chen, Beatrice A; Mackline, Hope; Riddler, Sharon A; Cohn, Susan E; Darin, Kristin M; Achilles, Sharon L; Scarsi, Kimberly K

    2017-09-10

    The primary objective of this study was to characterize the pharmacokinetics of etonogestrel (ENG) released from a contraceptive implant in Ugandan women living with HIV who were receiving efavirenz (EFV) or nevirapine (NVP)-based antiretroviral therapy (ART), compared with ART-naive women over 24 weeks. Nonrandomized, parallel-group study with three arms: ART-naive, NVP, or EFV-based ART (N = 20/group). Sparse pharmacokinetic sampling of ENG, NVP, or EFV were performed at screening, entry, and then 1, 4, 12, and 24-week postimplant insertion. The primary endpoint was ENG concentrations at week 24, compared between the ART-naive group and each ART group, using geometric mean ratio (GMR) with 90% confidence intervals. Sixty participants competed the 24-week study and data from 58 participants are included; one participant each was excluded from the NVP group and EFV group because of a sample processing error and ART nonadherence, respectively. At week 24, geometric mean ENG was 362, 341, and 66 pg/ml in the ART-naive, NVP, and EFV groups, respectively [GMR: NVP : ART-naive 0.94 (0.90-1.01); EFV : ART-naive 0.18 (0.17-0.20)]. NVP and EFV concentrations were lower at week 24 compared to preimplant [NVP: geometric mean 5.7 versus 6.8 mg/l, respectively, GMR 0.84 (0.83-0.85); EFV: geometric mean 3.6 versus 4.9 mg/l, respectively, GMR 0.73 (0.69-0.80)]. After 24 weeks of combined use, ENG exposure was 82% lower in women using EFV-based ART compared with ART-naive women. In contrast, NVP did not significantly impact ENG exposure. These results raise concerns about reduced effectiveness of implantable contraception for women taking EFV-based ART.

  7. Sustainability in the food sector

    DEFF Research Database (Denmark)

    Grunert, Klaus G

    2011-01-01

    Consumers have, through their food choices, a major role in bringing about more sustainable food production. However, this presupposes that differences in sustainability are communicated to consumers. Even if food products are eco-labelled and consumers are motivated to support sustainability......, a number of potential barriers may prevent consumers from using the information to make sustainable choices. Six such barriers are discussed in this paper....

  8. Day one sustainability

    Science.gov (United States)

    Orr, John; Ibell, Timothy; Evernden, Mark; Darby, Antony

    2015-05-01

    Emissions reductions targets for the UK set out in the Climate Change Act for the period to 2050 will only be achieved with significant changes to the built environment, which is currently estimated to account for 50% of the UK's carbon emissions. The socio-technological nature of Civil Engineering means that this field is uniquely placed to lead the UK through such adaptations. This paper discusses the importance of interdisciplinary teaching to produce multi-faceted team approaches to sustainable design solutions. Methods for measuring success in education are often not fit for purpose, producing good students but poor engineers. Real-world failures to apply sustainable design present a serious, difficult to detect, and ultimately economically negative situation. Techniques to replace summative examinations are presented and discussed, with the aim of enhancing core technical skills alongside those required for sustainable design. Finally, the role of our future engineers in policy-making is discussed. In addition to carbon, the provision of water and food will heavily influence the work of civil engineers in the coming decades. Leadership from civil engineers with the technical knowledge and social awareness to tackle these issues will be required. This provides both opportunities and challenges for engineering education in the UK.

  9. Transforming Innovation for Sustainability

    Directory of Open Access Journals (Sweden)

    Melissa Leach

    2012-06-01

    Full Text Available The urgency of charting pathways to sustainability that keep human societies within a "safe operating space" has now been clarified. Crises in climate, food, biodiversity, and energy are already playing out across local and global scales and are set to increase as we approach critical thresholds. Drawing together recent work from the Stockholm Resilience Centre, the Tellus Institute, and the STEPS Centre, this commentary article argues that ambitious Sustainable Development Goals are now required along with major transformation, not only in policies and technologies, but in modes of innovation themselves, to meet them. As examples of dryland agriculture in East Africa and rural energy in Latin America illustrate, such "transformative innovation" needs to give far greater recognition and power to grassroots innovation actors and processes, involving them within an inclusive, multi-scale innovation politics. The three dimensions of direction, diversity, and distribution along with new forms of "sustainability brokering" can help guide the kinds of analysis and decision making now needed to safeguard our planet for current and future generations.

  10. Children's television exposure and behavioral and social outcomes at 5.5 years: does timing of exposure matter?

    Science.gov (United States)

    Mistry, Kamila B; Minkovitz, Cynthia S; Strobino, Donna M; Borzekowski, Dina L G

    2007-10-01

    The American Academy of Pediatrics recommends children > or = 2 years of age limit daily media exposure to media exposure influences children's health. Our goal was to examine relations among children's early, concurrent, and sustained television exposure and behavioral and social skills outcomes at 5.5 years. We analyzed data collected prospectively from the Healthy Steps for Young Children national evaluation. Television exposure was defined as > 2 hours of daily use (at 30-33 months and 5.5 years) and television in child's bedroom (at 5.5 years). At 5.5 years, outcomes were assessed by using the Child Behavior Checklist and social skills using the Social Skills Rating System. Linear regression was used to estimate the effect of television exposure on behavioral and social skills outcomes. Sixteen percent of parents reported that their child watched > 2 hours of television daily at 30 to 33 months only, 15% reported > 2 hours of television daily at 5.5 years only, and 20% reported > 2 hours of television daily at both times. Forty-one percent of the children had televisions in their bedrooms at 5.5 years. In adjusted analyses, sustained television viewing was associated with behavioral outcomes. Concurrent television exposure was associated with fewer social skills. For children with heavy television viewing only in early childhood, there was no consistent relation with behavioral or social skills outcomes. Having a television in the bedroom was associated with sleep problems and less emotional reactivity at 5.5 years but was not associated with social skills. Sustained exposure is a risk factor for behavioral problems, whereas early exposure that is subsequently reduced presents no additional risk. For social skills, concurrent exposure was more important than sustained or early exposure. Considering the timing of media exposure is vital for understanding the consequences of early experiences and informing prevention strategies.

  11. Sustainability curricula in design education

    NARCIS (Netherlands)

    Casais, M.; Christiaans, H.H.C.M.; Almendra, R.

    2012-01-01

    While sustainability in Design finds much attention in the literature, the education of sustainability in Design courses lacks discussion regarding curricula and importance. In an attempt to map the way sustainability is taught in Design Bachelor and Master Courses in the European Union, we began

  12. The Business Case for Sustainability

    Science.gov (United States)

    Freese, Walt

    2007-01-01

    Sustainability is an evolving and often misused word in business. As the landscape changes in terms of how resources are evaluated, so does the context of sustainability. In the most general terms, Ben & Jerry's looks at sustainability from the perspective of the social and environmental resources. Improper use of the term has been called…

  13. Deliverable 2 (SustainAQ)

    NARCIS (Netherlands)

    Schneider, O.; Julian, B.; Bosman, R.; Eding, E.

    2009-01-01

    The European Project SustainAQ (Framework 6) aims to identify the limiting factors for the sustainable production of aquatic origin food in Eastern Europe. It focuses on the possible use of Recirculation Aquaculture Systems (RAS) as sustainable method for the production of aquatic animals as

  14. Decision Guidance for Sustainable Manufacturing

    Science.gov (United States)

    Shao, Guodong

    2013-01-01

    Sustainable manufacturing has significant impacts on a company's business performance and competitiveness in today's world. A growing number of manufacturing industries are initiating efforts to address sustainability issues; however, to achieve a higher level of sustainability, manufacturers need methodologies for formally describing, analyzing,…

  15. Sustainability in the Business Case

    NARCIS (Netherlands)

    Ron Schipper; Gilbert Gilbert Silvius

    2012-01-01

    This paper explores the integration of indicators that reflect the concepts of sustainability into business cases and business case evaluation methods. It is based on the observations that sustainability is one of the most important challenges of our time and that sustainable development requires

  16. Sustainability in the textile industry

    CERN Document Server

    2017-01-01

    This book examines in detail key aspects of sustainability in the textile industry, especially environmental, social and economic sustainability in the textiles and clothing sector. It highlights the various faces and facets of sustainability and their implications for textiles and the clothing sector.

  17. The Shift Needed for Sustainability

    Science.gov (United States)

    Smith, Peter A. C.; Sharicz, Carol

    2011-01-01

    Purpose: The purpose of this action research is to begin to assess to what extent organizations have in practice begun to make the shift towards triple bottom line (TBL) sustainability. Design/methodology/approach: A definition of TBL sustainability is provided, and key elements of TBL sustainability considered necessary to success are identified…

  18. Cork for sustainable product design

    NARCIS (Netherlands)

    Mestre, A.C.; Gil, L.

    2011-01-01

    Sustainable Product Design is currently accepted as one of the most promising trends in the “Sustainable Development” movement. It is often seen as a facilitation tool to implement Sustainability in practice, by improving the life cycle and eco-efficiency of products, by promoting dematerialization

  19. ICT4D and sustainability

    CSIR Research Space (South Africa)

    Marais, Mario A

    2015-02-01

    Full Text Available Sustainability is a systems concept, and ICT4D plays a vital role in a sustainable earth, as well as in sustainable communities. The concept of resilience is introduced since rapid change can push a system into another, possibly undesirable state...

  20. Organizational citizenship behavior towards sustainability

    OpenAIRE

    Chowdhury, Dhiman Deb

    2013-01-01

    This article extends literature of Organizational Citizenship Behavior (OCB) in the context of corporate sustainability. The author presents the concept of Organizational Citizenship Behavior towards Sustainability (OCBS) as a variant, contending it's appropriateness for today's much needed behavioral competence to implement sustainability measure at organizational level. The formulation of OCBS espouses Organizational Citizenship Behavior (OCB) with a twist. The viewpoint defended that a for...

  1. Integrating Sustainability in Organisations: An Activity-Based Sustainability Model

    Directory of Open Access Journals (Sweden)

    Ana Rodríguez-Olalla

    2017-06-01

    Full Text Available Organisations have become interested in using integral management systems to increase their sustainable value. Although global integration models address sustainability in organisations, these models present shortcomings and limitations and do not describe how to achieve the integration of sustainability. This paper proposes an Activity-Based Sustainability (ABS integration model that complements other models from an inside-out perspective. Its assessment follows a procedure similar to that proposed by the Activity-Based Costing (ABC model of cost accounting. The model assigns impacts from activities in the value chain of a process to the objects of impact (products, services, clients, or markets that must be managed in terms of sustainability. The main limitations of the ABS model are the need to identify and describe processes, to locate every activity that constitutes the value chain, and to quantify the impacts of these activities. The ABS model is presented as an alternative to link sustainable management accounting and sustainable communication, as well as sustainable management control and sustainability assessment. It connects these sustainable elements through the bilateral identification of the linkages among skills, processes, and practices. It also links these aspects with the contribution to sustainable development and the development of competitive advantages.

  2. Is the concept of sustainable tourism sustainable? Developing the Sustainable Tourism Benchmarking Tool

    OpenAIRE

    Cernat, Lucian; Gourdon, Julien

    2011-01-01

    Given the complexity of the issues surrounding the concept of sustainable tourism, the current paper tries to provide a unified methodology to assess tourism sustainability, based on a number of quantitative indicators. The proposed methodological framework (Sustainable Tourism Benchmarking Tool – STBT) will provide a number of benchmarks against which the sustainability of tourism activities in various countries can be assessed. A model development procedure is proposed: identification of th...

  3. Sustainability in Fashion Business Operations

    Directory of Open Access Journals (Sweden)

    Tsan-Ming Choi

    2015-11-01

    Full Text Available Under the global trend of sustainability, many companies selling fashion products have to reshape their operational strategies. Over the past few years, we have witnessed many fashion companies going green by re-engineering their business processes and establishing their formal sustainability programs. Many important topics, such as closed-loop supply chain management, corporate social responsibility, and economic sustainability, are all related to sustainable fashion business operations management. This paper provides a brief review of these critical topics, introduces the special issue, and proposes future research areas to achieve sustainable operations management in the fashion business.

  4. A New Agenda for Sustainability

    DEFF Research Database (Denmark)

    Aagaard Nielsen, Kurt

    Two decades after the Brundtland Commission's Report "Our Common Future" adopted the concept of 'sustainable development', this book provides a renewal of the concept exploring the potential for new practices and fields for those involved in sustainability activity. The book addresses a number...... on sustainability. The material dealt with in the book offers a wide variety of perspectives on sustainability and reflects the importance of interdisciplinary and transdiciplinary work in the field. Suggesting targets for future analytical and political efforts in achieving global sustainability, this book offers...

  5. Catalysis and sustainable (green) chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Centi, Gabriele; Perathoner, Siglinda [Dipartimento di Chimica Industriale ed Ingegneria dei Materiali, University of Messina, Salita Sperone 31, 98166 Messina (Italy)

    2003-01-15

    Catalysis is a key technology to achieve the objectives of sustainable (green) chemistry. After introducing the concepts of sustainable (green) chemistry and a brief assessment of new sustainable chemical technologies, the relationship between catalysis and sustainable (green) chemistry is discussed and illustrated via an analysis of some selected and relevant examples. Emphasis is also given to the concept of catalytic technologies for scaling-down chemical processes, in order to develop sustainable production processes which reduce the impact on the environment to an acceptable level that allows self-depuration processes of the living environment.

  6. Entrepreneurial action, sustainability and bricolage

    DEFF Research Database (Denmark)

    Korsgaard, Steffen T.

    This paper explores the relation between entrepreneurship and sustainability. It is explored whether bricolage, a specific form of entrepreneurial action, is particularly conducive to the creation of sustainable solutions. This question is investigated through a case study of an entrepreneur who...... has a long history of sustainable entrepreneurship in which bricolage plays a central role. The study identifies six distinct forms of bricolage practised by the entrepreneur. Furthermore, it is found that, while there is no direct link between bricolage and sustainability, the two concepts have...... a potentially synergetic relationship between them so that bricolage skills may enhance a sustainable mindset, and vice versa....

  7. Teaching sustainable solutions in engineering

    DEFF Research Database (Denmark)

    Olsen, Stig Irving; Nielsen, Susanne Balslev; Ejlertsen, Marina

    2015-01-01

    The increasing societal and industrial emphasis on sustainability requests that the next generation engineers needs to be trained in the context of sustainability. One of the means to address students at DTU is the establishment of a course aimed at bachelor students from all of the university......'s study lines. The objectives of the course 'Sustainability in engineering solutions', is for the participants to understand the basic concept of sustainability and its three dimensions (people, profit, planet), as well as to analyse problems and synthesise solutions that are sustainable throughout...

  8. Towards Life Cycle Sustainability Assessment

    Directory of Open Access Journals (Sweden)

    Marzia Traverso

    2010-10-01

    Full Text Available Sustainability is nowadays accepted by all stakeholders as a guiding principle for both public policy making and corporate strategies. However, the biggest challenge for most organizations remains in the real and substantial implementation of the sustainability concept. The core of the implementation challenge is the question, how sustainability performance can be measured, especially for products and processes. This paper explores the current status of Life Cycle Sustainability Assessment (LCSA for products and processes. For the environmental dimension well established tools like Life Cycle Assessment are available. For the economic and social dimension, there is still need for consistent and robust indicators and methods. In addition to measuring the individual sustainability dimensions, another challenge is a comprehensive, yet understandable presentation of the results. The “Life Cycle Sustainability Dashboard” and the “Life Cycle Sustainability Triangle” are presented as examples for communication tools for both experts and non expert stakeholders.

  9. The Aesthetics of Sustainable Design

    DEFF Research Database (Denmark)

    Folkmann, Mads Nygaard; Riisberg, Vibeke

    2017-01-01

    is paper will investigate the aesthetics of sustainable design by exploring di erent strategies of communicating products as being sustainable. It can be questioned how the sustainable element is present and detectable in design: Whether it is a principle of internal construction, operates...... instead of plastic in the 1970s and 1980s, 2) indirect representation and critical-constructive re ec- tion of sustainability as a principle of the design as in newer explo- rations of materials, 3) avant-gardist explorations of the potential of sustainability and 4) the evocation of emotional attachment...... physical manifestation and inner idea of the object in the question of how the speci c meaning content can be physically manifested and re ected in a variety of ways. In this way, the expression and appearance of sustainability in design may be contested along with the notions of sustainability behind...

  10. The Aesthetics of Sustainable Design

    DEFF Research Database (Denmark)

    Folkmann, Mads Nygaard; Riisberg, Vibeke

    is paper will investigate the aesthetics of sustainable design by exploring di erent strategies of communicating products as being sustainable. It can be questioned how the sustainable element is present and detectable in design: Whether it is a principle of internal construction, operates...... instead of plastic in the 1970s and 1980s, 2) indirect representation and critical-constructive re ec- tion of sustainability as a principle of the design as in newer explo- rations of materials, 3) avant-gardist explorations of the potential of sustainability and 4) the evocation of emotional attachment...... physical manifestation and inner idea of the object in the question of how the speci c meaning content can be physically manifested and re ected in a variety of ways. In this way, the expression and appearance of sustainability in design may be contested along with the notions of sustainability behind...

  11. Sustainable healthcare: how to assess and improve healthcare structures' sustainability.

    Science.gov (United States)

    Buffoli, M; Capolongo, S; Bottero, M; Cavagliato, E; Speranza, S; Volpatti, L

    2013-01-01

    Sustainability is a broad and debated subject, often difficult to be defined and applied into real projects, especially when dealing with a complex scenario as the one of healthcare. Many research studies and evaluation systems have handled this topic from different perspectives, but many limits and criticalities still have to be overcome to properly cope with actual needs. The Sustainable Healthcare project has been developed through three main phases: a deep study of the state of the art, unraveling pros and cons of available sustainability scoring systems; an accurate analysis of the stakeholders network and their needs; the realization of an objective evaluation framework, through scientific methods, as the ANP. The newly developed evaluation system takes into consideration all the three pillars of sustainability, analyzing social, environmental and economic sustainability through a set of criteria, specified by measurable indicators. So the system identifies both global sustainability and specific critical areas, pointing out possible strategic solutions to improve sustainability. The evaluation is achieved through technical analyses and qualitative surveys, which eventually allow to quantitatively assess sustainability, through a sound scoring method. This study proposes an innovative evaluation method to determine the sustainability of a hospital, already existing or in the design phase, within the European context. The Sustainable Healthcare system overcomes some of the current evaluation systems' limits by establishing a multidisciplinary approach and being an easy-to-use tool. This protocol is intended to be of support in the identification of the main hospital's weaknesses and in setting priorities for implementation of the solutions.

  12. Sustainable Urban Development and Social Sustainability in the Urban Context

    Directory of Open Access Journals (Sweden)

    Faruq Ibnul Haqi

    2016-08-01

    Full Text Available Social sustainability and sustainable urban developments are major challenges across the world both developed and developing countries. In general there is a conflict between the approach of sustainable development and social sustainability in the urban context. The concept of sustainability brings a key framework for extensive literature on urban design, architecture and planning. Nevertheless there is a considerable overlap between the social dimensions of sustainability and the theories or notions, for instance the ‘sustainable societies’ that are highlighted in the midst of other aspects: social equity and justice. Such society is widely expected to offer a situation for long-term social relations and activities which are sustainable, inclusive and equitable in a wider perception of the term (environmentally, socially and economically. The method adopted to address this aim involves a content analysis of available academic literature, with focus on the planning sustainable development, built environment, social sustainability, and urban planning fields. The findings demonstrate that in spite of some opposing evidence, many studies have confirmed that there has been displacement of the debate on the term of ‘sustainability’ from ‘ecological and environmental aspects into social and economic aspects’. It is related to how the community feel safe and comfortable living in their own communities, how have they felt of proud of the place where they live. The aim of the paper is to improve our understanding of current theories and practices of planning sustainable development and discuss whether the approach of sustainable development aligns with social sustainability objectives.

  13. What is Sustainability?

    Directory of Open Access Journals (Sweden)

    John Farrington

    2010-11-01

    Full Text Available Sustainability as a policy concept has its origin in the Brundtland Report of 1987. That document was concerned with the tension between the aspirations of mankind towards a better life on the one hand and the limitations imposed by nature on the other hand. In the course of time, the concept has been re-interpreted as encompassing three dimensions, namely social, economic and environmental. The paper argues that this change in meaning (a obscures the real contradiction between the aims of welfare for all and environmental conservation; (b risks diminishing the importance of the environmental dimension; and (c separates social from economic aspects, which in reality are one and the same. It is proposed instead to return to the original meaning, where sustainability is concerned with the well-being of future generations and in particular with irreplaceable natural resources—as opposed to the gratification of present needs which we call well-being. A balance needs to be found between those two, but not by pretending they are three sides of the same coin. Although we use up natural resources at the expense of future generations, we also generate capital (including knowledge which raises future well-being. A major question is to what extent the one compensates for the other. This debate centres around the problem of substitutability, which has been cast into a distinction between ‘weak’ and ‘strong’ sustainability. It is argued that these two do not need to be in opposition but complement one another.

  14. Consumerism and sustainable tourism

    DEFF Research Database (Denmark)

    Hjalager, Anne Mette

    2000-01-01

    This article recognises the immense and growing interest for the development of a sustainable tourism. However, it demonstrates a gap between general awareness and preferences on the one hand, and the practices and behaviour of tourists and tourist industries on the other hand. The constraints...... for the development of a consumerism in the fields of tourism are addressed in the article. A particular emphasis is put on a lack of appropriate institutional frameworks that provide individual tourists with reliable information and co-ordinate their purchasing power in order to enhance the issues of environmental...

  15. Measurement in Sustainable Building

    DEFF Research Database (Denmark)

    Hale, Lara

    2018-01-01

    of facing the disparity between the measurement of quantities and the experience of quality, seeks to bridge the gap with thorough evaluation programs and engagement with market and sociological research. Whereas well-being is not technically measureable, these evaluations lead to improvement of the metrics......Measurement is a necessary aspect of planning and constructing buildings. However, recent attempts to integrate the social dimension of sustainable building into building design and specifications demand measurement of non-technical qualities, such as well-being. The Active House Alliance, in lieu...

  16. The sustainable livelihoods approach

    DEFF Research Database (Denmark)

    Oelofse, Myles; Jensen, Henning Høgh

    2008-01-01

    The rapid development of organic agriculture on a global scale has led to an increased inclusion of producers in developing and transitional countries in the organic food chain. In order to enhance the theoretical frame for the analysis and understanding of the impact that inclusion in the organic...... food chain has on producers and their families, an analysis was conducted of the use of the Sustainable Livelihoods Approach (SLA). The SLA provides a holistic and integrative approach which researchers can use as the overriding frame for their research. The application of the approach is recommended...

  17. Sustainable Bridge Infrastructure Procurement

    DEFF Research Database (Denmark)

    Safi, Mohammed; Du, Guangli; Simonsson, Peter

    2016-01-01

    The lack of a flexible but systematic approach for integrating lifecycle aspects into bridge investment decisions is a major obstacle hindering the procurement of sustainable bridge infrastructures. This paper addresses this obstacle by introducing a holistic approach that agencies could use to p...... to procure the most “sustainable” (lifecycle-efficient) bridge through a fair design-build (D-B) tendering process, considering all the main aspects: life-cycle cost (LCC), service life-span, aesthetic demands and environmental impacts (LCA)....

  18. Sustainable assessment revisited

    OpenAIRE

    Boud, David; Soler, Rebeca

    2016-01-01

    Sustainable assessment has been proposed as an idea that focused on the contribution of assessment to learning beyond the timescale of a given course. It was identified as an assessment that meets the needs of the present in terms of the demands of formative and summative assessment, but which also prepares students to meet their own future learning needs. This paper reviews the value of such a notion for assessment; how it has been taken up over the past 15 years in higher education and why ...

  19. Existing Sustainable Renovation Concepts

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Vanhoutteghem, Lies; Gustavsson, Leif

    The Nordic single-family house renovation market is dominated by a craftsman based approach with individual solutions, traditional warehouses ”do-it-yourself-shops” and some actors marketing single products. To speed up the implementation of sustainable renovation of single-family houses...... there is a great need for full-service packages including consulting, contract work, follow-up, financing and operation and maintenance. There are few Nordic examples of such service models for renovation of single-family houses which entered the market recently. The success of these concepts is yet...

  20. Sustainable web ecosystem design

    CERN Document Server

    O'Toole, Greg

    2013-01-01

    This book is about the process of creating web-based systems (i.e., websites, content, etc.) that consider each of the parts, the modules, the organisms - binary or otherwise - that make up a balanced, sustainable web ecosystem. In the current media-rich environment, a website is more than a collection of relative html documents of text and images on a static desktop computer monitor. There is now an unlimited combination of screens, devices, platforms, browsers, locations, versions, users, and exabytes of data with which to interact. Written in a highly approachable, practical style, this boo