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Sample records for sustained virologic response

  1. Declining sustained virological response in hepatitis c

    International Nuclear Information System (INIS)

    Batool, U.; Qureshi, S.

    2006-01-01

    Objective: To determine the response of treatment with standard interferon and Ribazole in treatment naive hepatitis C infected patients, with different grades of activity. Design: A quasi-experimental study. Place and Duration of Study: This study was carried out at the Department of Medicine, KRL General Hospital, Islamabad, from January 2001 to September 2004. Patients and Methods: A total of 300 patients were enrolled. All patients were anti-HCV positive confirmed by device method, PCR positive and had 3a genotype. A specially-designed proforma containing the patient profile, family transmission, and baseline laboratory values was filled. All patients were treated according to a set protocol of Interferon plus ribavirin therapy (IFN alpha 2a, 3MU t.i.w 24 weeks plus ribavirin 1000 to 1200 mg/day) for six months. Chi-square tests were used to analyze the data. Primary end point was a sustained virological response (SVR) that is response assessed after six months of completion of treatment. Results: Over a period of four years response rates to standard Interferon plus Ribazole therapy were studied. Out of the total 300 patients data was available for 161 patients as 60 patients were excluded and 79 patients are currently under treatment. Treatment was stopped in 3 patients due to serious side effects. In the 161 patients, 135 (83.8%), achieved response at the end of treatment at six months; End of Treatment Complete Response (EOTCR); and 26 (16.14%) were non-responders (NR). Out of the complete responders, 68 patients had been followed completely up to six months after the treatment to asses Sustained Viral Response (SVR) defined as undetectable HCV RNA in serum at the end of six months post treatment follow-up. Sustained viral response was seen in 46 patients Le. 68% ( CI: 57-79%) and 22(32.3%) were relapsers (those who developed recurrence of viremia after having achieved eradication at the end of six months treatment). Response rates are co-related with

  2. Sustained virologic response following HCV eradication in two brothers with X-linked agammaglobulinaemia.

    LENUS (Irish Health Repository)

    Houlihan, Diarmaid D

    2009-08-21

    X-linked agammaglobulinaemia (XLA) is a humoral immunodeficiency syndrome characterized from childhood by the absence of circulating B lymphocytes, absent or reduced levels of serum immunoglobulin and recurrent bacterial infections. For many affected patients, regular treatment with immunoglobulin is life saving. Hepatitis C viral (HCV) infection acquired through contaminated blood products is widely described in this patient cohort. The natural history of HCV infection in patients with XLA tends to follow a more rapid and aggressive course compared to immunocompetent individuals. Furthermore, standard anti-viral therapy appears to be less efficacious in this patient cohort. Here we report the cases of two brothers with XLA who contracted HCV through contaminated blood products. They were treated with a six month course of Interferon alpha-2b and Ribavirin. We report a sustained virologic response five years after completing treatment.

  3. Fatty liver in hepatitis C patients post-sustained virological response with direct-acting antivirals

    Science.gov (United States)

    Noureddin, Mazen; Wong, Micaela M; Todo, Tsuyoshi; Lu, Shelly C; Sanyal, Arun J; Mena, Edward A

    2018-01-01

    AIM To determine steatosis and fibrosis prevalence in hepatitis C patients after a sustained virological response achieved with direct-acting antivirals. METHODS Transient elastography with controlled attenuation parameter (CAP) was used to assess hepatic steatosis post-sustained virological response (SVR); the CAP technology was not available in the United States at study initiation. Liver stiffness/fibrosis was measured before and 47 wk after treatment completion. Patients with genotype 3 and patients with cirrhosis were excluded. RESULTS One hundred and one patients were included in the study. Post-SVR there were decreases from baseline in alanine aminotransferase (ALT) (63.1 to 17.8 U/L), aspartate aminotransferase (51.8 to 21.5 U/L) and fibrosis score (7.4 to 6.1 kPa) (P steatosis on CAP; of these, 6.25% had advanced fibrosis. Patients with steatosis had higher body mass index (29.0 vs 26.1 kg/m2), glucose (107.8 vs 96.6 mg/dL), ALT (20.4 vs 15.3 mg/dL), CAP score (296.3 vs 212.4 dB/m) and fibrosis score (7.0 vs 5.3 kPa); P steatosis had change in fibrosis score post-SVR (7.7 kPa vs 7.0 kPa and 7.0 kPa vs 5.3 kPa); alternatively, (P steatosis continued to have clinically significant stiffness (≥ 7 kPa). CONCLUSION Fatty liver is very common in hepatitis C virus (HCV) patients post-SVR. These patients continue to have elevated mean fibrosis score (≥ 7 kPa) compared to those without fatty liver; some have advanced fibrosis. Long term follow up is needed to assess steatosis and fibrosis in HCV patients post-SVR. PMID:29568207

  4. Lower liver stiffness in patients with sustained virological response 4 years after treatment for chronic hepatitis C

    DEFF Research Database (Denmark)

    Andersen, Ellen Sloth; Moessner, Belinda Klemmensen; Christensen, Peer Brehm

    2011-01-01

    Transient elastography (TE) is a noninvasive and well validated method for measurement of liver stiffness. The aim of this study was to use TE to evaluate whether patients with sustained virological response (SVR) have lower liver stiffness than patients with non-SVR after treatment for chronic...

  5. Is sustained virological response a marker of treatment efficacy in patients with chronic hepatitis C viral infection with no response or relapse to previous antiviral intervention?

    DEFF Research Database (Denmark)

    Gurusamy, Kurinchi S; Wilson, Edward; Koretz, Ronald L

    2013-01-01

    Randomised clinical trials (RCTs) of antiviral interventions in patients with chronic hepatitis C virus (HCV) infection use sustained virological response (SVR) as the main outcome. There is sparse information on long-term mortality from RCTs.......Randomised clinical trials (RCTs) of antiviral interventions in patients with chronic hepatitis C virus (HCV) infection use sustained virological response (SVR) as the main outcome. There is sparse information on long-term mortality from RCTs....

  6. Fatty liver in hepatitis C patients post-sustained virological response with direct-acting antivirals.

    Science.gov (United States)

    Noureddin, Mazen; Wong, Micaela M; Todo, Tsuyoshi; Lu, Shelly C; Sanyal, Arun J; Mena, Edward A

    2018-03-21

    To determine steatosis and fibrosis prevalence in hepatitis C patients after a sustained virological response achieved with direct-acting antivirals. Transient elastography with controlled attenuation parameter (CAP) was used to assess hepatic steatosis post-sustained virological response (SVR); the CAP technology was not available in the United States at study initiation. Liver stiffness/fibrosis was measured before and 47 wk after treatment completion. Patients with genotype 3 and patients with cirrhosis were excluded. One hundred and one patients were included in the study. Post-SVR there were decreases from baseline in alanine aminotransferase (ALT) (63.1 to 17.8 U/L), aspartate aminotransferase (51.8 to 21.5 U/L) and fibrosis score (7.4 to 6.1 kPa) ( P < 0.05). Post-SVR, 48 patients (47.5%) had steatosis on CAP; of these, 6.25% had advanced fibrosis. Patients with steatosis had higher body mass index (29.0 vs 26.1 kg/m 2 ), glucose (107.8 vs 96.6 mg/dL), ALT (20.4 vs 15.3 mg/dL), CAP score (296.3 vs 212.4 dB/m) and fibrosis score (7.0 vs 5.3 kPa); P < 0.05. Interestingly, compared to baseline, both patients with and without steatosis had change in fibrosis score post-SVR (7.7 kPa vs 7.0 kPa and 7.0 kPa vs 5.3 kPa); alternatively, ( P < 0.05) and therefore patients with steatosis continued to have clinically significant stiffness (≥ 7 kPa). Fatty liver is very common in hepatitis C virus (HCV) patients post-SVR. These patients continue to have elevated mean fibrosis score (≥ 7 kPa) compared to those without fatty liver; some have advanced fibrosis. Long term follow up is needed to assess steatosis and fibrosis in HCV patients post-SVR.

  7. Effect of HFE gene polymorphism on sustained virological response in patients with chronic hepatitis C and elevated serum ferritin

    Directory of Open Access Journals (Sweden)

    Silvia Coelho-Borges

    2012-03-01

    Full Text Available CONTEXT: Abnormal serum ferritin levels are found in approximately 20%-30% of the patients with chronic hepatitis C and are associated with a lower response rate to interferon therapy. OBJECTIVE: To determine if the presence of HFE gene mutations had any effect on the sustained virological response rate to interferon based therapy in chronic hepatitis C patients with elevated serum ferritin. METHODS: A total of 44 treatment naÏve patients with histologically demonstrated chronic hepatitis C, all infected with hepatitis C virus genotype non-1 (38 genotype 3; 6 genotype 2 and serum ferritin above 500 ng/mL were treated with interferon (3 MU, 3 times a week and ribavirin (1.000 mg, daily for 24 weeks. RESULTS: Sustained virological response was defined as negative qualitative HCV-RNA more than 24 weeks after the end of treatment. Serum HCV-RNA was measured by qualitative in house polymerase chain reaction with a limit of detection of 200 IU/mL. HFE gene mutation was detected using restriction-enzyme digestion with RsaI (C282Y mutation analysis and BclI (H63D mutation analysis in 16 (37% patients, all heterozygous (11 H63D, 2 C282Y and 3 both. Sustained virological response was achieved in 0 of 16 patients with HFE gene mutations and 11 (41% of 27 patients without HFE gene mutations (P = 0.002; exact Fisher test. CONCLUSION: Heterozigozity for H63D and/or C282Y HFE gene mutation predicts absence of sustained virological response to combination treatment with interferon and ribavirin in patients with chronic hepatitis C, non-1 genotype and serum ferritin levels above 500 ng/mL.

  8. Effect of HFE gene polymorphism on sustained virological response in patients with chronic hepatitis C and elevated serum ferritin.

    Science.gov (United States)

    Coelho-Borges, Silvia; Cheinquer, Hugo; Wolff, Fernando Herz; Cheinquer, Nelson; Krug, Luciano; Ashton-Prolla, Patricia

    2012-01-01

    Abnormal serum ferritin levels are found in approximately 20%-30% of the patients with chronic hepatitis C and are associated with a lower response rate to interferon therapy. To determine if the presence of HFE gene mutations had any effect on the sustained virological response rate to interferon based therapy in chronic hepatitis C patients with elevated serum ferritin. A total of 44 treatment naÏve patients with histologically demonstrated chronic hepatitis C, all infected with hepatitis C virus genotype non-1 (38 genotype 3; 6 genotype 2) and serum ferritin above 500 ng/mL were treated with interferon (3 MU, 3 times a week) and ribavirin (1.000 mg, daily) for 24 weeks. Sustained virological response was defined as negative qualitative HCV-RNA more than 24 weeks after the end of treatment. Serum HCV-RNA was measured by qualitative in house polymerase chain reaction with a limit of detection of 200 IU/mL. HFE gene mutation was detected using restriction-enzyme digestion with RsaI (C282Y mutation analysis) and BclI (H63D mutation analysis) in 16 (37%) patients, all heterozygous (11 H63D, 2 C282Y and 3 both). Sustained virological response was achieved in 0 of 16 patients with HFE gene mutations and 11 (41%) of 27 patients without HFE gene mutations (P = 0.002; exact Fisher test). Heterozigozity for H63D and/or C282Y HFE gene mutation predicts absence of sustained virological response to combination treatment with interferon and ribavirin in patients with chronic hepatitis C, non-1 genotype and serum ferritin levels above 500 ng/mL.

  9. Slower Fibrosis Progression Among Liver Transplant Recipients With Sustained Virological Response After Hepatitis C Treatment

    Science.gov (United States)

    Habib, Shahid; Meister, Edward; Habib, Sana; Murakami, Traci; Walker, Courtney; Rana, Abbas; Shaikh, Obaid S.

    2015-01-01

    Background The natural course of hepatic fibrosis in HCV allograft recipients with sustained virological response (SVR) after anti-HCV therapy remains debatable. The aim of this study was to examine the progression of fibrosis in a cohort of patients who achieved SVR compared with those without treatment. Methods The 167 patients who met the inclusion and exclusion criteria were chosen from a transplant database. All patients were required to have histological evidence of recurrent HCV infection post-liver transplantation and a follow-up biopsy. The 140 of these patients had received anti-viral therapy. Twenty-seven patients were identified as controls and were matched with the treatment group in all respects. The patients were categorized into four groups based on treatment response: 1) no treatment (control) (n = 27); 2) non-responders (n = 81); 3) relapsers (n = 32); and 4) SVR (n = 27). The endpoint was the stage of fibrosis on the follow-up liver biopsy. Results The treated and untreated groups were similar in clinical characteristics at the time of transplantation and prior to the initiation of treatment. The 72% of the cohort showed a fibrosis progression of ≥ 1 stage; this change did not significantly differ between the patient groups. Nonetheless, the fibrosis progression rate was the highest in the untreated group and lowest in the patients who achieved SVR. A coefficient of determination was used. Improvements in fibrosis scores were found with greater treatment duration. These improvements were most evident with the achievement of SVR. Conclusions In conclusion, SVR after anti-viral therapy for recurrent hepatitis C infection post-transplantation was associated with slower fibrosis progression and significantly improved graft survival. PMID:27785303

  10. Sustained virologic response to interferon-free therapies ameliorates HCV-induced portal hypertension.

    Science.gov (United States)

    Mandorfer, Mattias; Kozbial, Karin; Schwabl, Philipp; Freissmuth, Clarissa; Schwarzer, Rémy; Stern, Rafael; Chromy, David; Stättermayer, Albert Friedrich; Reiberger, Thomas; Beinhardt, Sandra; Sieghart, Wolfgang; Trauner, Michael; Hofer, Harald; Ferlitsch, Arnulf; Ferenci, Peter; Peck-Radosavljevic, Markus

    2016-10-01

    We aimed to investigate the impact of sustained virologic response (SVR) to interferon (IFN)-free therapies on portal hypertension in patients with paired hepatic venous pressure gradient (HVPG) measurements. One hundred and four patients with portal hypertension (HVPG ⩾6mmHg) who underwent HVPG and liver stiffness measurement before IFN-free therapy (baseline [BL]) were retrospectively studied. Among 100 patients who achieved SVR, 60 patients underwent HVPG and transient elastography (TE) after antiviral therapy (follow-up [FU]). SVR to IFN-free therapies significantly decreased HVPG across all BL HVPG strata: 6-9mmHg (BL: 7.37±0.28 vs. FU: 5.11±0.38mmHg; -2.26±0.42mmHg; pportal hypertension across all BL HVPG strata. However, changes in HVPG seemed to be more heterogeneous among patients with BL HVPG of ⩾16mmHg and a HVPG decrease was less likely in patients with more advanced liver dysfunction. TE might be useful for the non-invasive evaluation of portal hypertension after SVR. We investigated the impact of curing hepatitis C using novel interferon-free treatments on portal hypertension, which drives the development of liver-related complications and mortality. Cure of hepatitis C decreased portal pressure, but a decrease was less likely among patients with more pronounced hepatic dysfunction. Transient elastography, which is commonly used for the non-invasive staging of liver disease, might identify patients without clinically significant portal hypertension after successful treatment. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  11. Weight loss, leukopenia and thrombocytopenia associated with sustained virologic response to Hepatitis C treatment

    Science.gov (United States)

    Suwantarat, Nuntra; Tice, Alan D.; Khawcharoenporn, Thana; Chow, Dominic C.

    2010-01-01

    OBJECTIVE: To identify apparent adverse effects of treatment of chronic hepatitis C and their relationship to sustained virologic response (SVR). METHODS: A retrospective study was conducted of all Hepatitis C virus (HCV)-infected patients treated with pegylated interferon and ribavirin in an academic ambulatory infectious disease practice. Clinical and laboratory characteristics were compared between patients with SVR and without SVR. RESULTS: Fifty-four patients completed therapy with the overall SVR rate of 76%. SVR was associated with genotype non-1 (P=0.01), weight loss more than 5 kilograms (P=0.04), end of treatment leukopenia (P=0.02) and thrombocytopenia (P=0.05). In multivariate analysis, SVR was significant associated with HCV genotype non-1 (Adjusted Odd Ratio [AOR] 15.22; CI 1.55 to 149.72; P=0.02), weight loss more than 5 kilograms, (AOR 5.74; CI 1.24 to 26.32; P=0.04), and end of treatment white blood cell count level less than 3 X 103 cells/µl (AOR 9.09; CI 1.59 to 52.63; P=0.02). Thrombocytopenia was not significant after adjustment. Other factors including age, gender, ethnicity, injection drug use, viral load, anemia, alanine transaminase level, and liver histology did not reach statistical significance. CONCLUSION: Besides non-1 genotype, SVR was found to be independently associated with weight loss during therapy, and leukopenia at the end of HCV treatment. These correlations suggest continuation of therapy despite adverse effects, may be of benefit. PMID:20107528

  12. Patient Characteristics Associated with HCV Treatment Adherence, Treatment Completion, and Sustained Virologic Response in HIV Coinfected Patients

    Directory of Open Access Journals (Sweden)

    Glenn Wagner

    2011-01-01

    Full Text Available Background. Hepatitis C (HCV treatment efficacy among HIV patients is limited by poor treatment adherence and tolerance, but few studies have examined the psychosocial determinants of treatment adherence and outcomes. Methods. Chart abstracted and survey data were collected on 72 HIV patients who had received pegylated interferon and ribavirin to assess correlates of treatment adherence, completion, and sustained virologic response (SVR. Results. Nearly half (46% the sample had active psychiatric problems and 13% had illicit drug use at treatment onset; 28% reported <100% treatment adherence, 38% did not complete treatment (mostly due to virologic nonresponse, and intent to treat SVR rate was 49%. Having a psychiatric diagnosis was associated with nonadherence, while better HCV adherence was associated with both treatment completion and SVR. Conclusions. Good mental health may be an indicator of HCV treatment adherence readiness, which is in turn associated with treatment completion and response, but further research is needed with new HCV treatments emerging.

  13. Predictors of sustained virological response in Greek and Egyptian patients with hepatitis C genotype 4: does ethnicity matter?

    Science.gov (United States)

    Papastergiou, Vasilios; Dimitroulopoulos, Dimitrios; Skorda, Lamprini; Lisgos, Philippos; Ketikoglou, Ioannis; Kostas, Nikolaos; Karatapanis, Stylianos

    2012-08-01

    Hepatitis C virus genotype 4 (HCV-4) is spreading beyond Africa and the Middle East but data regarding treatment with pegylated interferon alpha and ribavirin of European populations infected with HCV-4 remains limited. Interestingly, European (vs. Egyptian) origin has been associated with lower sustained virological response rates. Hence the aim of this study was to investigate the treatment outcomes of Greek (vs. Egyptian), treatment-naïve patients infected with HCV-4 (subtype a) and to identify factors influencing response rates. One hundred seventy-seven consecutive patients (mean age: 44.6 ± 10.2, males: 143/177; 80.8%, Egyptians: 76/177; 42.9%) treated over a 7-year period at the Hepatology clinics of three tertiary care hospitals in Greece were retrospectively evaluated. Overall, sustained virological response was achieved in 75/177 (42.4%) of the cohort without a significant difference between the two ethnic groups [Greek: 44/101 (43.6%); Egyptian 31/76 (40.8%), P = 0.7598]. In multivariate analysis, it was found that ethnicity was not associated with an impaired response but age ≥45 years [odds ratio (OR): 0.4225, 95% confidence interval (CI): 0.2135-0.8133; P = 0.0134], diabetes (OR: 0.2346, 95% CI: 0.0816-0.0674; P = 0.0071), advanced liver fibrosis (OR: 0.3964, 95% CI: 0.1933-0.8133; P = 0.0116), and treatment suspension (OR: 0.1738, 95% CI: 0.0482-0.6262; P = 0.0075) showed an independent negative association with response to antiviral treatment. In contrast to previous European data suggesting Egyptian ethnicity to be a positive predictor for a sustained virological response, there was no influence of Greek versus Egyptian ethnicity on treatment outcomes. Higher age, advanced liver fibrosis, and diabetes have been shown to reduce significantly response rates in patients infected with HCV-4. Copyright © 2012 Wiley Periodicals, Inc.

  14. Interferon-γ-inducible protein-10 in chronic hepatitis C: Correlations with insulin resistance, histological features & sustained virological response.

    Science.gov (United States)

    Crisan, Dana; Grigorescu, Mircea Dan; Radu, Corina; Suciu, Alina; Grigorescu, Mircea

    2017-04-01

    One of the multiple factors contributing to virological response in chronic hepatitis C (CHC) is interferon-gamma-inducible protein-10 (IP-10). Its level reflects the status of interferon-stimulated genes, which in turn is associated with virological response to antiviral therapy. The aim of this study was to evaluate the role of serum IP-10 levels on sustained virological response (SVR) and the association of this parameter with insulin resistance (IR) and liver histology. Two hundred and three consecutive biopsy proven CHC patients were included in the study. Serum levels of IP-10 were determined using ELISA method. IR was evaluated by homeostasis model assessment-IR (HOMA-IR). Histological features were assessed invasively by liver biopsy and noninvasively using FibroTest, ActiTest and SteatoTest. Predictive factors for SVR and their interrelations were assessed. A cut-off value for IP-10 of 392 pg/ml was obtained to discriminate between responders and non-responders. SVR was obtained in 107 patients (52.70%). Area under the receiver operating characteristic curve for SVR was 0.875 with a sensitivity of 91.6 per cent, specificity 74.7 per cent, positive predictive value 80.3 per cent and negative predictive value 88.7 per cent. Higher values of IP-10 were associated with increasing stages of fibrosis (P<0.01) and higher grades of inflammation (P=0.02, P=0.07) assessed morphologically and noninvasively through FibroTest and ActiTest. Significant steatosis and IR were also associated with increased levels of IP-10 (P=0.01 and P=0.02). In multivariate analysis, IP-10 levels and fibrosis stages were independently associated with SVR. Our findings showed that the assessment of serum IP-10 level could be a predictive factor for SVR and it was associated with fibrosis, necroinflammatory activity, significant steatosis and IR in patients with chronic HCV infection.

  15. Association between insulin resistance and sustained virologic response in hepatitis C treatment, genotypes 1 versus 2 and 3: systematic literature review and meta-analysis.

    Science.gov (United States)

    Laurito, Marcela Pezzoto; Parise, Edison Roberto

    2013-01-01

    Controversial results have been found in literature for the association between insulin resistance and sustained virologic response to standard chronic hepatitis C treatment. This study aims to provide a systematic literature review with meta-analysis, in order to evaluate if insulin resistance interferes with sustained virologic response in patients infected by the HCV genotype 1 versus HCV genotypes 2 and 3, undergoing treatment with interferon and ribavirin or pegylated interferon and ribavarin. Systematic search was performed on main electronic databases until May 2012. Primary outcome was sustained virologic response, defined as undetectable levels of HCV-RNA six months after the end of treatment. Meta-analytic measure was estimated using Dersimonian and Laird's method, using Stata software. Thirteen studies involving 2238 infected patients were included. There was a statistically significant association between insulin resistance and lower sustained virologic response rate, and this difference occurred in HCV genotype G1 (OR: 2.23; 95% CI: 1.59-3.13) and G2/G3 (OR: 4.45; 95% CI: 1.59-12.49). In addition, a difference was seen in the cut-offs used for defining insulin resistance by Homeostasis Model Assessment of Insulin Resistance. To minimize this limitation, sub-analysis that excluded the studies that did not use 2 as a cut-off value was performed and the results still demonstrated association between insulin resistance and sustained virologic response, for both genotypic groups. This meta-analysis provides evidence that elevated Homeostasis Model Assessment of Insulin Resistance is associated with a lower sustained virologic response rate in patients with hepatitis C treated with interferon and ribavirin or pegylated interferon and ribavarin, regardless of their genotype. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  16. Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    Tseng CW

    2016-03-01

    Full Text Available Chih-Wei Tseng,1,2 Ting-Tsung Chang,3,4 Shinn-Jia Tzeng,5 Yu-Hsi Hsieh,1,2 Tsung-Hsing Hung,1,2 Hsiang-Ting Huang,6 Shu-Fen Wu,7 Kuo-Chih Tseng1,2 1Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, 2School of Medicine, Tzuchi University, Hualien, 3Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, 4Infectious Disease and Signaling Research Center, National Cheng Kung University, Tainan, 5Department of Agronomy, National Chiayi University, 6Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 7Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan Objective: We studied the effect of sustained virologic response (SVR after treatment with pegylated-interferon (PEG-IFN plus ribavirin on the development of liver cirrhosis in elderly patients with chronic hepatitis C (CHC. Patients and methods: This retrospective study enrolled 145 elderly CHC patients (aged ≥65 years who were treatment-naïve and were treated with PEG-IFN plus ribavirin for 6 months between January 2005 and December 2011. Abdominal sonography was performed and liver biochemistry was studied at baseline, at the end of treatment, and every 3–6 months thereafter. The development of liver cirrhosis and related complications was evaluated at the follow-ups. The aspartate aminotransferase-to-platelet ratio index was used as a noninvasive maker for fibrosis. Results: The mean patient age was 69.1±3.3 years, and the average follow-up time was 5.5 years (standard deviation: 2.5 years, range: 1.1–12.3 years. Ninety-five patients (65.5% achieved SVR, and 26 (17.9% discontinued treatment. Twenty-seven patients (18.6% developed liver cirrhosis after treatment. Patients without SVR had significantly greater risk of liver cirrhosis than those with SVR (hazard ratio [HR]: 3.39, 95% confidence interval [CI]: 1.312–8.761, P=0.012. The

  17. Factors predictive of sustained virological response following 72 weeks of combination therapy for genotype 1b hepatitis C.

    Science.gov (United States)

    Chayama, Kazuaki; Hayes, C Nelson; Yoshioka, Kentaro; Moriwaki, Hisataka; Okanoue, Takashi; Sakisaka, Shotaro; Takehara, Tetsuo; Oketani, Makoto; Toyota, Joji; Izumi, Namiki; Hiasa, Yoichi; Matsumoto, Akihiro; Nomura, Hideyuki; Seike, Masataka; Ueno, Yoshiyuki; Yotsuyanagi, Hiroshi; Kumada, Hiromitsu

    2011-04-01

    Treatment of genotype 1b chronic hepatitis C virus (HCV) infection has been improved by extending peg-interferon plus ribavirin combination therapy to 72 weeks, but predictive factors are needed to identify those patients who are likely to respond to long-term therapy. We analyzed amino acid (aa) substitutions in the core protein and the interferon sensitivity determining region (ISDR) of nonstructural protein (NS) 5A in 840 genotype 1b chronic hepatitis C patients with high viral load. We used logistic regression and classification and regression tree (CART) analysis to identify predictive factors for sustained virological response (SVR) for patients undergoing 72 weeks of treatment. When patients were separately analyzed by treatment duration using multivariate logistic regression, several factors, including sex, age, viral load, and core aa70 and ISDR substitutions (P = 0.0003, P = 0.02, P = 0.01, P = 0.0001, and P = 0.0004, respectively) were significant predictive factors for SVR with 48 weeks of treatment, whereas age, previous interferon treatment history, and ISDR substitutions (P = 0.03, P = 0.01, and P = 0.02, respectively) were the only significant predictive factors with 72 weeks of treatment. Using CART analysis, a decision tree was generated that identified age, cholesterol, sex, treatment length, and aa70 and ISDR substitutions as the most important predictive factors. The CART model had a sensitivity of 69.2% and specificity of 60%, with a positive predictive value of 68.4%. Complementary statistical and data mining approaches were used to identify a subgroup of patients likely to benefit from 72 weeks of therapy.

  18. Costs of telaprevir-based triple therapy for hepatitis C: $189,000 per sustained virological response.

    Science.gov (United States)

    Bichoupan, Kian; Martel-Laferriere, Valerie; Sachs, David; Ng, Michel; Schonfeld, Emily A; Pappas, Alexis; Crismale, James; Stivala, Alicia; Khaitova, Viktoriya; Gardenier, Donald; Linderman, Michael; Perumalswami, Ponni V; Schiano, Thomas D; Odin, Joseph A; Liu, Lawrence; Moskowitz, Alan J; Dieterich, Douglas T; Branch, Andrea D

    2014-10-01

    In registration trials, triple therapy with telaprevir (TVR), pegylated interferon (Peg-IFN), and ribavirin (RBV) achieved sustained virological response (SVR) rates between 64% and 75%, but the clinical effectiveness and economic burdens of this treatment in real-world practice remain to be determined. Records of 147 patients who initiated TVR-based triple therapy at the Mount Sinai Medical Center (May-December 2011) were reviewed. Direct medical costs for pretreatment, on-treatment, and posttreatment care were calculated using data from Medicare reimbursement databases, RED Book, and the Healthcare Cost and Utilization Project database. Costs are presented in 2012 U.S. dollars. SVR (undetectable hepatitis C virus [HCV] RNA 24 weeks after the end of treatment) was determined on an intention-to-treat basis. Cost per SVR was calculated by dividing the median cost by the SVR rate. Median age of the 147 patients was 56 years (interquartile range [IQR] = 51-61), 68% were male, 19% were black, 11% had human immunodeficiency virus/HCV coinfection, 36% had advanced fibrosis/cirrhosis (FIB-4 scores ≥3.25), and 44% achieved an SVR. The total cost of care was $11.56 million. Median cost of care was $83,721 per patient (IQR = $66,652-$98,102). The median cost per SVR was $189,338 (IQR = $150,735-$221,860). Total costs were TVR (61%), IFN (24%), RBV (4%), adverse event management (8%), professional fees (2%), and laboratory tests (1%). TVR and Peg-IFN accounted for 85% of costs. Pharmaceutical prices and the low (44%) SVR rate, in this real-world study, were major contributors to the high cost per SVR. © 2014 by the American Association for the Study of Liver Diseases.

  19. Rapid virological response assessment by Abbott RealTime hepatitis C virus assay for predicting sustained virological responses in patients with hepatitis C virus genotype 1 treated with pegylated-interferon and ribavirin

    Directory of Open Access Journals (Sweden)

    Pei-yuan Su

    2016-07-01

    Full Text Available The lower limits of virus detection of hepatitis C virus (HCV RNA detection assays are continuously improving. We aimed to assess the utility of more precise definition of 4th week viral load [rapid virological response (RVR] in predicting sustained virological response (SVR in HCV genotype 1 patients treated with pegylated-interferon (PEG-IFN and ribavirin. Clinical data of treatment-naïve HCV genotype 1 patients were retrospectively collected from 2009 to 2014. Patients were grouped according to 4th week viral load as follows: undetectable (n = 90 and detectable but not quantifiable (< 12 IU/mL, n = 27. All patients received PEG-IFNα-2a or -2b and ribavirin for 24 weeks. Serum HCV RNA levels were measured by Abbott RealTime (ART; Abbott Molecular, Abbott Park, IL, USA HCV assay. SVR was 95.5% and 63% in the undetectable group and < 12 IU/mL group of 4th week viral load, respectively. The between-group difference in SVR was significant (p < 0.001. We determined 4th week viral load was independently associated with SVR (odds ratio = 19.28; p = 0.002 and a good predictor of SVR [area under the curve (AUC = 0.775; p = 0.001]. ART HCV assays had a stronger SVR predictive value in HCV genotype 1 patients, indicating that only the undetectable group of 4th week viral load patients measured by ART HCV assay should be considered for shorter treatment time (24 weeks with PEG-IFN and ribavirin.

  20. Estimating the clinical and economic benefit associated with incremental improvements in sustained virologic response in chronic hepatitis C.

    Science.gov (United States)

    McEwan, Phil; Ward, Thomas; Bennett, Hayley; Kalsekar, Anupama; Webster, Samantha; Brenner, Michael; Yuan, Yong

    2015-01-01

    Hepatitis C virus (HCV) infection is one of the principle causes of chronic liver disease. Successful treatment significantly decreases the risk of hepatic morbidity and mortality. Current standard of care achieves sustained virologic response (SVR) rates of 40-80%; however, the HCV therapy landscape is rapidly evolving. The objective of this study was to quantify the clinical and economic benefit associated with increasing levels of SVR. A published Markov model (MONARCH) that simulates the natural history of hepatitis C over a lifetime horizon was used. Discounted and non-discounted life-years (LYs), quality-adjusted life-years (QALYs) and cost of complication management were estimated for various plausible SVR rates. To demonstrate the robustness of projections obtained, the model was validated to ten UK-specific HCV studies. QALY estimates ranged from 18.0 years for those treated successfully in fibrosis stage F0 to 7.5 years (discounted) for patients in fibrosis stage F4 who remain untreated. Predicted QALY gains per 10% improvement in SVR ranged from 0.23 (F0) to 0.64 (F4) and 0.58 (F0) to 1.35 (F4) in 40 year old patients (discounted and non-discounted results respectively). In those aged 40, projected discounted HCV-related costs are minimised with successful treatment in F0/F1 (at approximately £ 300), increasing to £ 49,300 in F4 patients who remain untreated. Validation of the model to published UK cost-effectiveness studies produce R2 goodness of fit statistics of 0.988, 0.978 and of 0.973 for total costs, QALYs and incremental cost effectiveness ratios, respectively. Projecting the long-term clinical and economic consequences associated with chronic hepatitis C is a necessary requirement for the evaluation of new treatments. The principle analysis demonstrates the significant impact on expected costs, LYs and QALYs associated with increasing SVR. A validation analysis demonstrated the robustness of the results reported.

  1. Four weeks of paritaprevir/ritonavir/ombitasvir plus dasabuvir encountering dengue fever resulted in sustained virological response in an HCV patient: A case report.

    Science.gov (United States)

    Huang, Chung-Feng; Jang, Tyng-Yuan; Lu, Po-Liang; Yu, Ming-Lung

    2016-11-01

    Direct antiviral agent (DAA) has been the standard of care for patients with hepatitis C virus (HCV) infection. Twelve weeks of paritaprevir/ritonavir/ombitasvir plus dasabuvir (PROD) with or without ribavirin has shown to have a sustained virological response at post-treatment 12 weeks (SVR12) rate of >90% in HCV genotype 1 (HCV-1) patients. We report a HCV-1b patient who received only 25 days of PROD treatment. The patient early terminated treatment due to dengue fever but eventually achieved SVR12. It may attribute to low baseline viral loads and extraordinarily rapid suppression of HCV after treatment day1. The finding may shed light for possible response-guided-therapy for so-called ultra-super-responders in the DAA era. Whether the dengue virus, the Flaviviridae family as with HCV, enhanced the HCV clearance remains unclear and needs further exploration.

  2. Clinical outcome of HIV-infected patients with sustained virologic response to antiretroviral therapy: long-term follow-up of a multicenter cohort.

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    Félix Gutierrez

    Full Text Available BACKGROUND: Limited information exists on long-term prognosis of patients with sustained virologic response to antiretroviral therapy. We aimed to assess predictors of unfavorable clinical outcome in patients who maintain viral suppression with HAART. METHODS: Using data collected from ten clinic-based cohorts in Spain, we selected all antiretroviral-naive adults who initiated HAART and maintained plasma HIV-1 RNA levels <500 copies/mL throughout follow-up. Factors associated with disease progression were determined by Cox proportional-hazards models. RESULTS: Of 2,613 patients who started HAART, 757 fulfilled the inclusion criteria. 61% of them initiated a protease inhibitor-based HAART regimen, 29.7% a nonnucleoside reverse-transcriptase inhibitor-based regimen, and 7.8% a triple-nucleoside regimen. During 2,556 person-years of follow-up, 22 (2.9% patients died (mortality rate 0.86 per 100 person-years, and 40 (5.3% died or developed a new AIDS-defining event. The most common causes of death were neoplasias and liver failure. Mortality was independently associated with a CD4-T cell response <50 cells/L after 12 months of HAART (adjusted hazard ratio [AHR], 4.26 [95% confidence interval {CI}, 1.68-10.83]; P = .002, and age at initiation of HAART (AHR, 1.06 per year; 95% CI, 1.02-1.09; P = .001. Initial antiretroviral regimen chosen was not associated with different risk of clinical progression. CONCLUSIONS: Patients with sustained virologic response on HAART have a low mortality rate over time. Long-term outcome of these patients is driven by immunologic response at the end of the first year of therapy and age at the time of HAART initiation, but not by the initial antiretroviral regimen selected.

  3. Peginterferon alpha-2a is associated with higher sustained virological response than peginterferon alfa-2b in chronic hepatitis C: systematic review of randomized trials

    DEFF Research Database (Denmark)

    Awad, Tahany; Thorlund, Kristian; Hauser, Goran

    2010-01-01

    ) is most effective. We performed a systematic review of head-to-head randomized trials to assess the benefits and harms of the two treatments. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and LILACS through July 2009. Using standardized forms, two reviewers independently...... extracted data from each eligible trial report. We statistically combined data using a random effects meta-analysis according to the intention-to-treat principle. We identified 12 randomized clinical trials, including 5,008 patients, that compared peginterferon alpha-2a plus ribavirin versus peginterferon...... alfa-2b plus ribavirin. Overall, peginterferon alpha-2a significantly increased the number of patients who achieved a sustained virological response (SVR) versus peginterferon alfa-2b (47% versus 41%; risk ratio 1.11, 95% confidence interval 1.04-1.19; P = 0.004 [eight trials]). Subgroup analyses...

  4. Moderate Sustained Virologic Response Rates With 6-Week Combination Directly Acting Anti-Hepatitis C Virus Therapy in Patients With Advanced Liver Disease.

    Science.gov (United States)

    Kattakuzhy, Sarah; Wilson, Eleanor; Sidharthan, Sreetha; Sims, Zayani; McLaughlin, Mary; Price, Angie; Silk, Rachel; Gross, Chloe; Akoth, Elizabeth; McManus, Maryellen; Emmanuel, Benjamin; Shrivastava, Shikha; Tang, Lydia; Nelson, Amy; Teferi, Gebeyehu; Chavez, Jose; Lam, Brian; Mo, Hongmei; Osinusi, Anuoluwapo; Polis, Michael A; Masur, Henry; Kohli, Anita; Kottilil, Shyamasundaran

    2016-02-15

    Treatment of genotype 1 hepatitis C virus (HCV) infection with combination directly acting antivirals (DAA) for 8-24 weeks is associated with high rates of sustained virologic response (SVR). We previously demonstrated that adding a third DAA to ledipasvir and sofosbuvir (LDV/SOF) can result in high SVR rates in patients without cirrhosis. In this study, we investigated whether a similar regimen would yield equivalent rates of cure in patients with advanced liver fibrosis. Fifty patients were enrolled at the Clinical Research Center of the National Institutes of Health and associated healthcare centers. Enrollment and follow-up data from April 2014 to June 2015 are reported here. Eligible participants were aged ≥18 years, had chronic HCV genotype 1 infection (serum HCV RNA ≥2000 IU/mL), and stage 3-4 liver fibrosis. HCV RNA was measured using a reverse-transcription polymerase chain reaction assay. Of patients treated with LDV, SOF, and the NS3/4A protease inhibitor GS-9451 for 6 weeks, 76% (38 of 50; 95% confidence interval, 60%-85%) had SVR achieved 12 weeks after the end of treatment. There was no statistically significant difference in treatment efficacy between treatment-naive patients (72%, 18 of 25) and those with treatment experience (80%; 20 of 25) (P = .51). Overall, 11 patients (22%) experienced virologic relapse, and 1 (2%) was lost to follow-up at 4 weeks after treatment. No serious adverse events, discontinuations, or deaths were associated with this regimen. Adding a third DAA to LDV/SOF may result in a moderate SVR rate, lower than that observed in patients without cirrhosis. Significant liver fibrosis remains an impediment to achieving SVR with short-duration DAA therapy. CT01805882. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. Predictors Associated with Increase in Skeletal Muscle Mass after Sustained Virological Response in Chronic Hepatitis C Treated with Direct Acting Antivirals

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    Kazunori Yoh

    2017-10-01

    Full Text Available Aims: We aimed to examine changes in skeletal muscle mass in chronic hepatitis C (CHC patients undergoing interferon (IFN-free direct acting antivirals (DAAs therapy who achieved sustained virological response (SVR. Patients and methods: A total of 69 CHC patients treated with DAAs were analyzed. We compared the changes in skeletal muscle index (SMI using bio-impedance analysis at baseline and SMI at SVR. SMI was calculated as the sum of skeletal muscle mass in upper and lower extremities divided by height squared (cm2/m2. Further, we identified pretreatment parameters contributing to the increased SMI at SVR. Results: SMI in males at baseline ranged from 6.73 to 9.08 cm2/m2 (median, 7.65 cm2/m2, while that in females ranged from 4.45 to 7.27 cm2/m2 (median, 5.81 cm2/m2. At SVR, 36 patients (52.2% had increased SMI as compared with baseline. In the univariate analysis, age (p = 0.0392, hyaluronic acid (p = 0.0143, and branched-chain amino acid to tyrosine ratio (BTR (p = 0.0024 were significant pretreatment factors linked to increased SMI at SVR. In the multivariate analysis, only BTR was an independent predictor linked to the increased SMI at SVR (p = 0.0488. Conclusion: Pretreatment BTR level can be helpful for predicting increased SMI after SVR in CHC patients undergoing IFN-free DAAs therapy.

  6. Liver-related morbidity and mortality in patients with chronic hepatitis C and cirrhosis with and without sustained virologic response

    DEFF Research Database (Denmark)

    Hallager, Sofie; Ladelund, Steen; Christensen, Peer Brehm

    2017-01-01

    Background: Chronic hepatitis C (CHC) causes liver cirrhosis in 5%-20% of patients, leading to increased morbidity and mortality. This study aimed to estimate liver-related morbidity and mortality among patients with CHC and cirrhosis in Denmark with and without antiviral treatment and sustained......, and 233 of 519 treated patients achieved SVR. Alcohol overuse and hepatitis C virus genotype 3 were associated with an increased incidence rate (IR) of HCC, whereas diabetes and alcohol overuse were associated with increased IRs of decompensation. Achieving SVR reduced all-cause mortality (adjusted...... elevated in patients with alcohol overuse after SVR. Conclusion: Alcohol overuse, hepatitis C genotype 3, and diabetes were associated with liver-related morbidity in patients with CHC and cirrhosis. SVR markedly reduced liver-related morbidity and mortality; however, special attention to patients...

  7. Improvement of liver stiffness in patients with hepatitis C virus infection who received direct-acting antiviral therapy and achieved sustained virological response.

    Science.gov (United States)

    Tada, Toshifumi; Kumada, Takashi; Toyoda, Hidenori; Mizuno, Kazuyuki; Sone, Yasuhiro; Kataoka, Saki; Hashinokuchi, Shinichi

    2017-12-01

    There is insufficient research on whether direct-acting antiviral (DAA) therapy can improve liver fibrosis in patients with chronic hepatitis C virus (HCV). We evaluated sequential changes in liver stiffness using shear wave elastography in patients with HCV who received DAA therapy. A total of 210 patients with HCV who received daclatasvir and asunaprevir therapy and achieved sustained virological response (SVR) were analyzed. Liver stiffness, as evaluated by shear wave elastography, and laboratory data were assessed before treatment (baseline), at end of treatment (EOT), and at 24 weeks after EOT (SVR24). Alanine aminotransferase levels (ALT) decreased over time, and there were significant differences between baseline and EOT and between EOT and SVR24. Although platelet counts did not significantly differ between baseline and EOT, they increased significantly from EOT to SVR24. The median (interquartile range) liver stiffness values at baseline, EOT, and SVR24 were 10.2 (7.7-14.7), 8.8 (7.1-12.1), and 7.6 (6.3-10.3) kPa, respectively (P liver) and Fibrosis-4 index > 2.0 (n = 75), the liver stiffness values at baseline, EOT, and SVR24 were 9.6 (7.7-15.2), 9.2 (7.3-12.1), and 7.7 (6.3-10.1) kPa, respectively (P liver stiffness starts during the administration of DAAs in patients who achieve SVR, and this effect is particularly pronounced in patients with progressive liver fibrosis. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  8. Protein pathway activation associated with sustained virologic response in patients with chronic hepatitis C treated with pegylated interferon (PEG-IFN) and ribavirin (RBV).

    Science.gov (United States)

    Younossi, Zobair M; Limongi, Dolores; Stepanova, Maria; Pierobon, Mariaelena; Afendy, Arian; Mehta, Rohini; Baranova, Ancha; Liotta, Lance; Petricoin, Emanuel

    2011-02-04

    Only half of chronic hepatitis C (CH-C) patients treated with pegylated interferon and ribavirin (PEG-IFN+RBV) achieve sustained virologic response) SVR. In addition to known factors, we postulated that activation of key protein signaling networks in the peripheral blood mononuclear cells (PBMCs) may contribute to SVR due to inherent patient-specific basal immune cell signaling architecture. In this study, we included 92 patients with CH-C. PBMCs were collected while patients were not receiving treatment and used for phosphoprotein-based network profiling. Patients received a full course of PEG-IFN+RBV with overall SVR of 55%. From PBMC, protein lysates were extracted and then used for Reverse Phase Protein Microarray (RPMA) analysis, which quantitatively measured the levels of cytokines and activation levels of 25 key protein signaling molecules involved in immune cell regulation and interferon alpha signaling. Regression models for predicting SVR were generated by stepwise bidirectional selection. Both clinical-laboratory and RPMA parameters were used as predictor variables. Model accuracies were estimated using 10-fold cross-validation. Our results show that by comparing patients who achieved SVR to those who did not, phosphorylation levels of 6 proteins [AKT(T308), JAK1(Y1022/1023), p70 S6 Kinase (S371), PKC zeta/lambda(T410/403), TYK2(Y1054/1055), ZAP-70(Y319)/Syk(Y352)] and overall levels of 6 unmodified proteins [IL2, IL10, IL4, IL5, TNF-alpha, CD5L] were significantly different (P < 0.05). For SVR, the model based on a combination of clinical and proteome parameters was developed, with an AUC = 0.914, sensitivity of 92.16%, and specificity of 85.0%. This model included the following parameters: viral genotype, previous treatment status, BMI, phosphorylated states of STAT2, AKT, LCK, and TYK2 kinases as well as steady state levels of IL4, IL5, and TNF-alpha. In conclusion, SVR could be predicted by a combination of clinical, cytokine, and protein signaling

  9. Sustained virological response halts fibrosis progression: A long-term follow-up study of people with chronic hepatitis C infection.

    Directory of Open Access Journals (Sweden)

    Swee Lin G Chen Yi Mei

    Full Text Available Long-term follow-up studies validating the clinical benefit of sustained virological response (SVR in people with chronic hepatitis C (CHC infection are lacking. Our aim was to identify rates and predictors of liver fibrosis progression in a large, well characterized cohort of CHC patients in whom paired liver fibrosis assessments were performed more than 10 years apart.CHC patients who had undergone a baseline liver biopsy pre-2004 and a follow up liver fibrosis assessment more than 10 years later (biopsy or liver stiffness measurement (LSM using transient elastography [FibroScan] were identified. Subjects who had undergone a baseline liver biopsy but had no follow up fibrosis assessment were recalled for LSM. Fibrosis was categorised as mild-moderate (METAVIR F0-2 / LSM result of ≤ 9.5 kPa or advanced (METAVIR F3-4/ LSM >9.5 kPa. The primary objective was to assess the association between SVR and the rate of liver fibrosis progression over at least 10 years, defined as an increase from mild-moderate fibrosis at baseline liver biopsy (METAVIR F0-2 to advanced fibrosis at follow-up liver fibrosis assessment.131 subjects were included in this analysis: 69% male, 82% Caucasian, 60% G1 HCV, 25% G3 HCV. The median age at F/U fibrosis staging was 57 (IQR 54-62 years with median estimated duration of infection 33-years (IQR 29-38. At F/U, liver fibrosis assessment was performed by LSM in 86% and liver biopsy in 14%. The median period between fibrosis assessments was 14-years (IQR 12-17. 109 (83% participants had received interferon-based antiviral therapy. 40% attained SVR. At F/U, there was a significant increase in the proportion of subjects with advanced liver fibrosis: 27% at baseline vs. 46% at F/U (p = 0.002. The prevalence of advanced fibrosis did not change among subjects who attained SVR, 30% at B/L vs 25% at F/U (p = 0.343. However, advanced fibrosis became more common at F/U among subjects with persistent viremia: 10% at B/L vs 31% at F

  10. Sustained virological response halts fibrosis progression: A long-term follow-up study of people with chronic hepatitis C infection.

    Science.gov (United States)

    Chen Yi Mei, Swee Lin G; Thompson, Alexander J; Christensen, Britt; Cunningham, Georgina; McDonald, Lucy; Bell, Sally; Iser, David; Nguyen, Tin; Desmond, Paul V

    2017-01-01

    Long-term follow-up studies validating the clinical benefit of sustained virological response (SVR) in people with chronic hepatitis C (CHC) infection are lacking. Our aim was to identify rates and predictors of liver fibrosis progression in a large, well characterized cohort of CHC patients in whom paired liver fibrosis assessments were performed more than 10 years apart. CHC patients who had undergone a baseline liver biopsy pre-2004 and a follow up liver fibrosis assessment more than 10 years later (biopsy or liver stiffness measurement (LSM) using transient elastography [FibroScan]) were identified. Subjects who had undergone a baseline liver biopsy but had no follow up fibrosis assessment were recalled for LSM. Fibrosis was categorised as mild-moderate (METAVIR F0-2 / LSM result of ≤ 9.5 kPa) or advanced (METAVIR F3-4/ LSM >9.5 kPa). The primary objective was to assess the association between SVR and the rate of liver fibrosis progression over at least 10 years, defined as an increase from mild-moderate fibrosis at baseline liver biopsy (METAVIR F0-2) to advanced fibrosis at follow-up liver fibrosis assessment. 131 subjects were included in this analysis: 69% male, 82% Caucasian, 60% G1 HCV, 25% G3 HCV. The median age at F/U fibrosis staging was 57 (IQR 54-62) years with median estimated duration of infection 33-years (IQR 29-38). At F/U, liver fibrosis assessment was performed by LSM in 86% and liver biopsy in 14%. The median period between fibrosis assessments was 14-years (IQR 12-17). 109 (83%) participants had received interferon-based antiviral therapy. 40% attained SVR. At F/U, there was a significant increase in the proportion of subjects with advanced liver fibrosis: 27% at baseline vs. 46% at F/U (p = 0.002). The prevalence of advanced fibrosis did not change among subjects who attained SVR, 30% at B/L vs 25% at F/U (p = 0.343). However, advanced fibrosis became more common at F/U among subjects with persistent viremia: 10% at B/L vs 31% at F/U (p

  11. Ribavirin Concentrations Do Not Predict Sustained Virological Response in HIV/HCV-Coinfected Patients Treated with Ribavirin and Pegylated Interferon in the Swiss HIV Cohort Study.

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    Helen Kovari

    Full Text Available Ribavirin (RBV is an essential component of most current hepatitis C (HCV treatment regimens and still standard of care in the combination with pegylated interferon (pegIFN to treat chronic HCV in resource limited settings. Study results in HIV/HCV-coinfected patients are contradicting as to whether RBV concentration correlates with sustained virological response (SVR.We included 262 HCV treatment naïve HIV/HCV-coinfected Swiss HIV Cohort Study (SHCS participants treated with RBV and pegIFN between 01.01.2001-01.01.2010, 134 with HCV genotype (GT 1/4, and 128 with GT 2/3 infections. RBV levels were measured retrospectively in stored plasma samples obtained between HCV treatment week 4 and end of therapy. Uni- and multivariable logistic regression analyses were used to evaluate the association between RBV concentration and SVR in GT 1/4 and GT 2/3 infections. The analyses were repeated stratified by treatment phase (week 4-12, 13-24, >24 and IL28B genotype (CC versus CT/TT.SVR rates were 35.1% in GT 1/4 and 70.3% in GT 2/3 infections. Overall, median RBV concentration was 2.0 mg/L in GT 1/4, and 1.9 mg/L in GT 2/3, and did not change significantly across treatment phases. Patients with SVR had similar RBV concentrations compared to patients without SVR in both HCV genotype groups. SVR was not associated with RBV levels ≥2.0 mg/L (GT 1/4, OR 1.19 [0.5-2.86]; GT 2/3, 1.94 [0.78-4.80] and ≥2.5 mg/L (GT 1/4, 1.56 [0.64-3.84]; GT 2/3 2.72 [0.85-8.73], regardless of treatment phase, and IL28B genotype.In HIV/HCV-coinfected patients treated with pegIFN/RBV, therapeutic drug monitoring of RBV concentrations does not enhance the chance of HCV cure, regardless of HCV genotype, treatment phase and IL28B genotype.

  12. Therapy of chronic hepatitis C: Virologic response monitoring

    Directory of Open Access Journals (Sweden)

    Kuljić-Kapulica Nada

    2010-01-01

    Full Text Available Background/Aim. Virological testing is considered to be essential in the management of hepatitis C virus (HCV infection in order to diagnose infection, and, most importantly, as a quide for treatment decisions and assess the virological response to antiviral therapy. The aim of this study was to determine the rate of a sustained virological response (SVR and various factors associated with response rates in chronic hepatitis C infected patients treated with pegiinterferon alpha (PEGINF and ribavirin (RBV combination therapy. Methods. A total of 34 patients, treated with PEG-IFN and RBV were studied. Serum HCV-RNA was measured before the treatment, 12 weeks following the start of the therapy and 6 weeks after the treatment cessation. SVR was defined as undetectable serum HCV-RNA 6 months of post-treatment follow-up, virologic relapse (VR as relapse of HCV-RNA during the post-treatment follow-up. Serum HCV-RNA was measured with the Cobas Amplicor test. Results. At the end of post-treatment follow-up 19 (55.8% patients demonstrated a SVR. The majority of the patients were genotype 1 (27, and the other were genotype 3 (5 patients and genotype 4 (2 patients. There was VR in 6 patients 6 months after the therapy. In 9 patients HCV-RNA was positive after 12 weeks. Conclusion. We demonstrated that patients with chronic HCV infection can be successfully treated with combination of PEG-INF and RBV. This result emphasizes also that post-treatment follow-up to identify patients with SVR or VR could be important.

  13. Heterogeneity of HVR-1 quasispecies is predictive of early but not sustained virological response in genotype 1b-infected patients undergoing combined treatment with PEG- or STD-IFN plus RBV.

    Science.gov (United States)

    Abbate, I; Cappiello, G; Lo Iacono, O; Longo, R; Ferraro, D; Antonucci, G; Di Marco, V; Di Stefano, R; Craxì, A; Solmone, M C; Spanò, A; Ippolito, G; Capobianchi, M R

    2003-01-01

    ISDR mutation pattern and HVR-1 quasispecies were analyzed in HCV genotype 1b-infected patients treated with either PEG- or STD-IFN plus ribavirin, in order to find virological correlates of therapy outcome. ISDR region analysis, performed at baseline (T0) and at 4 weeks of therapy (T1), indicated that ISDR mutation pattern was not predictive of response to treatment. Moreover, no selection of putative resistant strains in the first month of therapy was observed. Viral load was not correlated with any parameter of HVR-1 heterogeneity. Among the HVR-1 heterogeneity parameters considered, complexity was inversely correlated to viral load decline at T1. In univariate analysis, complexity, proportion of non synonymous substitutions (NS) and NS/S ratio were lower in patients showing virological response at 6 months of treatment. Complexity was the only parameter independently associated with both decline of viral load at T1 and virological response after 6 months, even after adjustment for confounding variables. At the end of treatment or later, these correlations were lost. Evolution pattern of the HVR-1 quasispecies indicated a strong selective pressure in sustained responders, with complete substitution of pre-existing quasispecies, while minor changes occured in non responders. In relapsers both patterns were present at a similar rate. In conclusion, this study shows that HVR-1 heterogeneity may be involved in the early response to combined IFN-RBV therapy. The loss of correlation between viral heterogeneity and therapy outcome at 6 months of therapy, or later, suggests that other factors may play a role in maintaining sustained response to treatment.

  14. Role of IL-28B polymorphisms in virologic response to combined ...

    African Journals Online (AJOL)

    Amira Youssef Shaala

    2014-10-17

    Oct 17, 2014 ... of cirrhosis showed higher risk of failed response at 3 and 6 months (p = 0.016 and 0.020 respec- tively). Also .... Sustained virologic response is defined as non .... nicity, body mass index, insulin resistance, hepatic steatosis,.

  15. Performance of immunological response in predicting virological failure.

    Science.gov (United States)

    Ingole, Nayana; Mehta, Preeti; Pazare, Amar; Paranjpe, Supriya; Sarkate, Purva

    2013-03-01

    In HIV-infected individuals on antiretroviral therapy (ART), the decision on when to switch from first-line to second-line therapy is dictated by treatment failure, and this can be measured in three ways: clinically, immunologically, and virologically. While viral load (VL) decreases and CD4 cell increases typically occur together after starting ART, discordant responses may be seen. Hence the current study was designed to determine the immunological and virological response to ART and to evaluate the utility of immunological response to predict virological failure. All treatment-naive HIV-positive individuals aged >18 years who were eligible for ART were enrolled and assessed at baseline, 6 months, and 12 months clinically and by CD4 cell count and viral load estimations. The patients were categorized as showing concordant favorable (CF), immunological only (IO), virological only (VO), and concordant unfavorable responses (CU). The efficiency of immunological failure to predict virological failure was analyzed across various levels of virological failure (VL>50, >500, and >5,000 copies/ml). At 6 months, 87(79.81%), 7(5.5%), 13 (11.92%), and 2 (1.83%) patients and at 12 months 61(69.3%), 9(10.2%), 16 (18.2%), and 2 (2.3%) patients had CF, IO, VO, and CU responses, respectively. Immunological failure criteria had a very low sensitivity (11.1-40%) and positive predictive value (8.3-25%) to predict virological failure. Immunological criteria do not accurately predict virological failure resulting in significant misclassification of therapeutic responses. There is an urgent need for inclusion of viral load testing in the initiation and monitoring of ART.

  16. Virological response without CD4 recovery | Madide | Southern ...

    African Journals Online (AJOL)

    The objective of antiretroviral therapy (ART) is to suppress viral replication so that immune restoration can occur. Failure of immune restoration is usually associated with poor virological suppression. In children a good immunological and clinical response to ART is often achieved despite incomplete viral suppression.

  17. Five-year follow-up of patients with chronic C hepatitis and sustained virological response Seguimiento a 5 años de pacientes con hepatitis crónica C y respuesta viral sostenida

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    I. Puig-del-Castillo

    2011-02-01

    Full Text Available Objective: to assess persistence of sustained viral response at 5 years of follow-up in patients with chronic viral hepatitis C treated with pegylated interferon and ribavirin. Design: a descriptive study. Patients: from August 2001 to May 2004, all patients treated at our center with pegylated interferon and ribavirin who achieved a sustained viral response were consecutively enrolled (93 patients. Demographic, histological, biochemical, and virological data were collected during treatment and 5 years after achievement of the sustained viral response. Eighty-six percent of patients enrolled (n = 80 attended the control visit at 5 years. Results: mean age of enrolled patients was 41 years (standard deviation = 10 years, and 30.1% (n = 28 were women. Liver biopsy had been performed before treatment in 68.8% of patients (n = 64, showing no or mild fibrosis in 62.3% (F0 and F1 and significant fibrosis and cirrhosis in 37.7% (F ≥ 3. Genotype distribution was: 58.1% genotype 1 (n = 54; 8.6% genotype 2 (n = 8; 24.7% genotype 3 (n = 23; 7.5% genotype 4 (n = 7, and indeterminate in one patient. Only one patient experienced virological recurrence. All other patients had negative HCV RNA levels and, in the absence of other liver diseases, normal ALT levels. Conclusion: in patients treated with pegylated interferon and ribavirin with sustained viral response, long-term recurrence rate was very low.Objetivo: evaluar la persistencia de respuesta viral sostenida a los 5 años de seguimiento en pacientes con hepatitis crónica por virus C tratados con interferón pegilado y ribavirina. Diseño: estudio descriptivo. Pacientes: desde agosto de 2001 hasta mayo de 2004, se incluyeron de forma consecutiva todos los pacientes de nuestro centro tratados con interferón pegilado y ribavirina que alcanzaron respuesta viral sostenida (93 pacientes. Se recogieron datos demográficos, histológicos, bioquímicos y virológicos durante el tratamiento y a los 5 años de

  18. Pegylated interferon alfa and ribavirin for 14 versus 24 weeks in patients with hepatitis C virus genotype 2 or 3 and rapid virological response

    DEFF Research Database (Denmark)

    Dalgard, Olav; Bjøro, Kristian; Larsen, Helmer Ring

    2008-01-01

    A recent nonrandomized pilot trial showed that hepatitis C virus (HCV) patients with genotype 2/3 and rapid virological response (RVR) had a 90% sustained virological response (SVR) rate after 14 weeks of treatment. We aimed to assess this concept in a randomized controlled trial. In the trial, 428...

  19. Effect of abacavir on sustained virologic response to HCV treatment in HIV/HCV co-infected patients, Cohere in Eurocoord

    DEFF Research Database (Denmark)

    Smit, Colette; Arends, Joop; Peters, Lars

    2015-01-01

    BACKGROUND: Contradicting results on the effect of abacavir (ABC) on hepatitis C virus (HCV) treatment responses in HIV/HCV co-infected patients have been reported. We evaluated the influence of ABC on the response to pegylated interferon (pegIFN) and ribavirin (RBV)-containing HCV treatment in H...

  20. Regional changes over time in initial virologic response rates to combination antiretroviral therapy across Europe

    DEFF Research Database (Denmark)

    Bannister, Wendy P; Kirk, Ole; Gatell, Jose M

    2006-01-01

    : Virologic response (viral load SIDA patients. Analyses were stratified by region (south, central west, north, east) or time started cART (early, 1996-1997; mid, 1998-1999; late, 2000-1904). RESULTS: Virologic...

  1. Regional changes over time in initial virological response rates to combination antiretroviral therapy across Europe

    DEFF Research Database (Denmark)

    Bannister, W; Kirk, O; Gatell, J

    2006-01-01

    : Virologic response (viral load SIDA patients. Analyses were stratified by region (south, central west, north, east) or time started cART (early, 1996-1997; mid, 1998-1999; late, 2000-1904). RESULTS: Virologic...

  2. The cost of treatment failure: resource use and costs incurred by hepatitis C virus genotype 1-infected patients who do or do not achieve sustained virological response to therapy.

    Science.gov (United States)

    Backx, M; Lewszuk, A; White, J R; Cole, J; Sreedharan, A; van Sanden, S; Diels, J; Lawson, A; Neal, K R; Wiselka, M J; Ito, T; Irving, W L

    2014-03-01

    Chronic hepatitis C virus (HCV) infection places a considerable economic burden on health services. Cost-effectiveness analyses of antiviral treatment for patients with chronic HCV infection are dependent on assumptions about cost reductions following sustained virological response (SVR) to therapy. This study quantified the medium-term difference in health resource usage and costs depending on treatment outcome. Retrospective chart review of patients with HCV genotype 1 infection who had received at least 2 months pegylated interferon and ribavirin therapy, with known treatment outcome was conducted. Disease status was categorized as chronic hepatitis, cirrhosis or decompensated liver disease. Health resource use was documented for each patient in each disease state. Unit costs were from the NHS 'Payment by Results' database and the British National Formulary. One hundred and ninety three patients (108 SVR, 85 non-SVR) with mean follow-up of 3.5 (SVR) and 4.9 (non-SVR) years were enrolled. No SVR patient progressed to a more severe liver disease state. Annual transition rates for non-SVR patients were 7.4% (chronic hepatitis to cirrhosis) and 4.9% (cirrhosis to decompensated liver disease). By extrapolation of modelled data over a 5-year post-treatment period, failure of patients with chronic hepatitis to achieve SVR was associated with a 13-fold increase (roughly £2300) in costs, whilst for patients who were retreated, the increase was 56-fold, equating to more than £10 000. Achievement of an SVR has significant effects on health service usage and costs. This work provides real-life data for future cost-effectiveness analyses related to the treatment for chronic HCV infection. © 2013 John Wiley & Sons Ltd.

  3. Drug resistance in HIV patients with virological failure or slow virological response to antiretroviral therapy in Ethiopia

    DEFF Research Database (Denmark)

    Abdissa, Alemseged; Yilma, Daniel; Fonager, Jannik

    2014-01-01

    BACKGROUND: The ongoing scale-up of antiretroviral therapy (ART) in sub-Saharan Africa has prompted the interest in surveillance of transmitted and acquired HIV drug resistance. Resistance data on virological failure and mutations in HIV infected populations initiating treatment in sub-Saharan Af...... mutations among failing patients justify increased vigilance by improving the availability and systematic use of VL testing to monitor ART response, and underlines the need for rapid, inexpensive tests to identify the most common drug resistance mutations....

  4. Virologic response at week 8 of combined treatment as a predictor of ...

    African Journals Online (AJOL)

    Ali Monis

    2012-04-16

    Apr 16, 2012 ... in non rapid virologic response, chronic HCV genotype 4 infected patients .... Other liver diseases as alcoholic liver disease, non alco- holic fatty liver disease .... penses and limit the side-effects associated with drug exposure.

  5. Sustainable responsibilities?

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    2015-01-01

    , which have pervaded all areas of daily life, including the world of business. At local, national, international and global levels, policies have been formulated to encourage corporations to take responsibility for their social and environmental performance (Laszlo, 2007). In the European Union, the EU......, people and the natural environment have traditionally been viewed as available resources, which are taken for granted and, thus, treated as externalities (Livesey & Graham, 2007). But the last decade has seen increasing recognition of environmental problems such as climate change and resource depletion...

  6. Regional changes over time in initial virological response rates to combination antiretroviral therapy across Europe

    DEFF Research Database (Denmark)

    Bannister, W; Kirk, O; Gatell, J

    2006-01-01

    BACKGROUND: Changes in virologic response to initial combination antiretroviral therapy (cART) over calendar time may indicate improvements in cART or emergence of primary resistance. Regional variations may identify differences in available antiretroviral drugs or patient management. METHODS.......026) and time (P changes were observed (south, P = 0.061; central west, P ....001; north: P = 0.070; east, P = 0.001). CONCLUSIONS: There was some evidence of regional differences in initial virologic response to cART. Improvements over time were observed, suggesting that so far, the effect of primary resistance has not been of sufficient magnitude to prevent increasing suppression...

  7. Regional changes over time in initial virologic response rates to combination antiretroviral therapy across Europe

    DEFF Research Database (Denmark)

    Bannister, Wendy P; Kirk, Ole; Gatell, Jose M

    2006-01-01

    BACKGROUND: Changes in virologic response to initial combination antiretroviral therapy (cART) over calendar time may indicate improvements in cART or emergence of primary resistance. Regional variations may identify differences in available antiretroviral drugs or patient management. METHODS: Vi...... rates Udgivelsesdato: 2006/6...

  8. Risk factors of virologic failure and slow response to art among HIV ...

    African Journals Online (AJOL)

    Risk factors of virologic failure and slow response to art among HIV-infected children and adolescents in Nairobi. J. M. Kabogo, S. Gupta, A. K. Maina, M. Ochwoto, R. W. Omange, R. N. Musoke, R. W. Lihana, E. Muniu, F. W. Wamunyokoli, B. Liang, E. M. Songok ...

  9. Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy

    Directory of Open Access Journals (Sweden)

    Adriana Weinberg

    2009-01-01

    Full Text Available HIV-infected pregnant women with undetectable plasma HIV RNA concentrations at delivery pose a minimal risk of vertical transmission. We studied the kinetics and the determinants of the virologic response to antiretroviral therapy in 117 consecutive pregnancies. Patients who initiated therapy during pregnancy had a VL decrease of 2 and 2.5 log10 after 4 and 24 weeks, respectively. Therapeutic drug monitoring (TDM of the protease inhibitors administered in doses recommended for nonpregnant adults resulted in below-target concentrations in 29%, 35%, and 44% of 1st, 2nd, and 3rd trimester measurements, respectively, but low drug concentrations did not correlate with virologic failure. Demographic characteristics, antiretroviral experience prior to pregnancy, baseline VL, or use of specific antiretrovirals did not affect the virologic response. Adherence to ≥95% of prescribed doses and utilization of psychosocial services were associated with undetectable plasma HIV RNA at delivery. In conclusion, the virologic responses of pregnant and nonpregnant adults share similar charactersitics.

  10. Transplantation of a Liver Allograft From a Hepatitis C Virus Seropositive Donor With Previous Sustained Virologic Response to an Uninfected Recipient Suffering Steroid Refractory Acute Graft Rejection With No Evidence of HCV Transmission

    Directory of Open Access Journals (Sweden)

    Robert A. Mitchell, MD

    2018-03-01

    Conclusions. To the best of our knowledge, this is the first reported case of an HCV seropositive liver allograft transplanted into an HCV-negative recipient who subsequently received intense immunosuppression. This case, therefore, is an encouraging and novel step in liver transplantation, and demonstrates that SVR may be closer to a true “cure” of HCV in the donor population and that, even in circumstances of very potent immunosuppression in the recipient, this SVR is sustained.

  11. Rates of sustained virological response 12 weeks after the scheduled end of direct-acting antiviral (DAA)-based hepatitis C virus (HCV) therapy from the National German HCV registry: does HIV coinfection impair the response to DAA combination therapy?

    Science.gov (United States)

    Bischoff, J; Mauss, S; Cordes, C; Lutz, T; Scholten, S; Moll, A; Jäger, H; Cornberg, M; Manns, M P; Baumgarten, A; Rockstroh, J K

    2018-04-01

    The European Association for the Study of the Liver (EASL) treatment recommendations for hepatitis C no longer discriminate between HIV/hepatitis C virus (HCV)-coinfected and HCV-monoinfected patients. However, recent data from Spain are questioning these recommendations on the basis of the findings of higher relapse rates and lower cure rates in HIV/HCV-infected subjects. The aim of our study was to compare HCV cure rates in monoinfected and coinfected patients from Germany. Data acquired from the Deutsches Hepatitis C-Registry were analysed. A total of 5657 HCV-monoinfected subjects and 488 HIV/HCV-coinfected patients were included in the study. Rates of sustained virological response 12 weeks after the scheduled end of therapy (SVR12) were collected in both subgroups and in cirrhotic and noncirrhotic patients. HIV/HCV-coinfected patients were more frequently male (84.6% vs. 56.4%, respectively; P  350 cells/μL in 63.1% of HIV-positive subjects and 88.7% were on antiretroviral therapy. SVR12 rates were 90.3% (5111 of 5657) in our HCV-monoinfected cohort and 91.2% (445 of 488) in our coinfected patients. Liver cirrhosis was confirmed in 1667 of 5657 (29.5%) monoinfected patients and 84 of 488 (17.2%; P < 0.001) coinfected patients. SVR12 rates did not differ between HCV-monoinfected and HIV/HCV-coinfected patients with liver cirrhosis (87.8% vs. 89.3%, respectively; P = 0.864). A treatment duration of 8 weeks did not reduce the percentage of patients with SVR12 in either subgroup (93.7% in both groups). We found high SVR12 rates in monoinfected as well as coinfected individuals. No differences were detected between the two subgroups regardless of whether there was accompanying liver cirrhosis or a shortened treatment duration. © 2018 British HIV Association.

  12. Virological response and safety of 24-week telaprevir alone in Japanese patients infected with hepatitis C virus subtype 1b

    Science.gov (United States)

    Toyota, J; Ozeki, I; Karino, Y; Asahina, Y; Izumi, N; Takahashi, S; Kawakami, Y; Chayama, K; Kamiya, N; Aoki, K; Yamada, I; Suzuki, Y; Suzuki, F; Kumada, H

    2013-01-01

    Hepatitis C virus (HCV) subtype 1b, which infects approximately 70% of Japanese carriers, is likely to be more eradicable by a telaprevir regimen than subtype 1a because of the higher genetic barrier of Val36 and Arg155 substitutions. The aims of this exploratory study were to evaluate the virological response and safety of 24-week oral administration of telaprevir alone in chronic HCV subtype 1b infection. Fifteen treatment-naïve patients were treated with telaprevir 750 mg every 8 h for 24 weeks. All patients were Japanese whose median age was 58.0 years (range: 45–68), and six patients (40%) were men. Median baseline HCV RNA level was 6.80 log10 IU/mL (range: 3.55–7.10). The HCV RNA levels decreased to undetectable in five patients (33%) within 8 weeks. Three patients (20%) with negative HCV RNA by Week 4 achieved end of treatment response. One patient (7%) who achieved sustained virological response had a low baseline viraemia of 3.55 log10 IU/mL. Most of the adverse events including anaemia and skin disorders were mild to moderate. Developed variants were T54A and A156V/T/F/Y with or without secondary substitutions rather than V36M ± R155K. Telaprevir alone for 24 weeks in Japanese patients with HCV subtype 1b resulted in an sustained viral response rate of 7% (1/15) and was well tolerated for 24 weeks. These results will support the implementation of further studies on oral combination of telaprevir with other direct-acting antiviral agents in patients infected with HCV subtype 1b. PMID:23383655

  13. Prediction of week 4 virological response in hepatitis C for making decision on triple therapy: the Optim study.

    Directory of Open Access Journals (Sweden)

    Manuel Romero-Gómez

    Full Text Available Virological response to peginterferon + ribavirin (P+R at week 4 can predict sustained virological response (SVR. While patients with rapid virological response (RVR do not require triple therapy, patients with a decline <1 log10 IU/ml HCVRNA (D1L should have treatment discontinued due to low SVR rate.To develop a tool to predict first 4 weeks' viral response in patients with hepatitis C genotype 1&4 treated with P+R.In this prospective and multicenter study, HCV mono-infected (n=538 and HCV/HIV co-infected (n=186 patients were included. To develop and validate a prognostic tool to detect RVR and D1L, we segregated the patients as an estimation cohort (to construct the model and a validation cohort (to validate the model.D1L was reached in 509 (80.2% and RVR in 148 (22.5% patients. Multivariate analyses demonstrated that HIV co-infection, Forns' index, LVL, IL28B-CC and Genotype-1 were independently related to RVR as well as D1L. Diagnostic accuracy (AUROC for D1L was: 0.81 (95%CI: 0.76 ̶ 0.86 in the estimation cohort and 0.71 (95%CI: 0.62 ̶ 0.79 in the validation cohort; RVR prediction: AUROC 0.83 (95%CI: 0.78 ̶ 0.88 in the estimation cohort and 0.82 (95%CI: 0.76 ̶ 0.88 in the validation cohort. Cost-analysis of standard 48-week treatment indicated a saving of 30.3% if the prognostic tool is implemented.The combination of genetic (IL28B polymorphism and viral genotype together with viral load, HIV co-infection and fibrosis stage defined a tool able to predict RVR and D1L at week 4. Using this tool would be a cost-saving strategy compared to universal triple therapy for hepatitis C.

  14. Detection of resistance mutations and CD4 slopes in individuals experiencing sustained virological failure

    DEFF Research Database (Denmark)

    Schultze, Anna; Paredes, Roger; Sabin, Caroline

    2014-01-01

    during the episode were included. Mutations were identified using the IAS-US (2013) list, and were presumed to be present from detection until the end of an episode. Multivariable linear mixed models with a random intercept and slope adjusted for age, baseline CD4 count, hepatitis C, drug type, RNA (log...... mutations on CD4 slopes in patients undergoing episodes of viral failure. MATERIALS AND METHODS: Patients from the EuroSIDA and UK CHIC cohorts undergoing at least one episode of virological failure (>3 consecutive RNA measurements >500 on ART) with at least three CD4 measurements and a resistance test......-scale), risk group and subtype were used to estimate CD4 slopes. Individual mutations with a population prevalence of >10% were tested for their effect on the CD4 slope. RESULTS: A total of 2731 patients experiencing a median of 1 (range 1-4) episodes were included in this analysis. The prevalence of any...

  15. 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,

  16. Clinical, immunological and virological response to different antiretroviral regimens in a cohort of HIV-2-infected patients

    NARCIS (Netherlands)

    van der Ende, Marchina E.; Prins, Jan M.; Brinkman, Kees; Keuter, Monique; Veenstra, Jan; Danner, Sven A.; Niesters, Hubert G. M.; Osterhaus, Albert D. M. E.; Schutten, Martin

    2003-01-01

    Objective: To assess the clinical, immunological and virological response and the emergence of resistance towards antiretroviral therapy (ART) in a cohort of HIV-2-infected patients. Design: Observational study. Patients: HIV-2-infected patients residing in the Netherlands. Results: From 1995 to

  17. Rapid virological response of telaprevir and boceprevir in a Brazilian cohort of HCV genotype 1 patients: a multicenter longitudinal study

    Directory of Open Access Journals (Sweden)

    Borba HHL

    2017-01-01

    had an influence on the RVR rate (odds ratio [OR] =0.011; 95% confidence interval [CI]: 0.001–0.119; P<0.001/OR =13.004; 95% CI: 1.522–111.115; P=0.019, respectively.Conclusion: In this longitudinal multicenter cohort study conducted from the Brazilian perspective, differences were found in the RVR rates, favoring telaprevir over boceprevir for genotype 1 HCV-infected patients. In addition, the baseline viral load was associated with RVR achievement in both evaluated groups. As RVR is also reported in the literature as a predictor of the sustained virological response (SVR, further analyses of RVR as predictor of SVR outcomes should be further evaluated in Brazil. Keywords: hepatitis C, rapid virological response, protease inhibitors, telaprevir, boceprevir, multicenter

  18. The role of biochemical variations and genotype testing in determining the virological response of patients infected with hepatitis C virus

    Directory of Open Access Journals (Sweden)

    Abid Shoukat

    2018-01-01

    Full Text Available Background: In hepatitis C virus (HCV, infection viral and IL28B genotype along with many clinical and biochemical factors can influence response rates to pegylated interferon plus ribavirin (Peg-IFN-a/R therapy and progression to chronic hepatitis C (CHC. Aims: The present study was conducted to determine the effect of biochemical and risk factors on treatment outcome in CHC patients in relation to their viral and host genotype. Settings and Design: The present study was a prospective Pe- IFN efficacy study consisting of Peg-IFN-a/R therapy for 24–48 weeks including 250 HCV infected patients. Materials and Methods: Biochemical parameters were determined by Beckman Coulter AU680 automated analyzer. HCV and Interleukin 28B (IL28B genotyping were carried out by polymerase chain reaction-restriction fragment length polymorphism and viral load was determined by quantitative real-time PCR. Results: Wild outnumbered the variant genotypes in rs 12979860, rs 12980275, and rs 8099917 SNP of IL28B gene. Sustained virological response (SVR SVR and viral genotype were significantly associated with age, hepatic steatosis, low-grade varices, and serum aspartate transaminase levels (at the end of treatment (P < 0.05. In addition, SVR was significantly influenced by body mass index (BMI, insulin resistance, serum low-density lipoprotein , and ferritin levels (P < 0.05. Viral genotype 1 infected patients had higher serum cholesterol and triglyceride levels (P < 0.05. Conclusions: Although the IL28B sequence variation is the major factor that can influence response rates to antiviral therapy, viral and biochemical factors also have a definite role to play in the diagnosis, etiology, and treatment outcome in HCV-infected patients.

  19. Hydroxychloroquine augments early virological response to pegylated interferon plus ribavirin in genotype-4 chronic hepatitis C patients.

    Science.gov (United States)

    Helal, Gouda Kamel; Gad, Magdy Abdelmawgoud; Abd-Ellah, Mohamed Fahmy; Eid, Mahmoud Saied

    2016-12-01

    The therapeutic effect of pegylated interferon (peg-IFN) alfa-2a combined with ribavirin (RBV) on chronic hepatitis C Egyptian patients is low and further efforts are required to optimize this therapy for achievement of higher rates of virological response. This study aimed to evaluate the safety and efficacy of hydroxychloroquine (HCQ) in combination with pegylated interferon plus ribavirin on early virological response (EVR) in chronic hepatitis C Egyptian patients. Naïve 120 Egyptian patients with chronic hepatitis C virus infection were divided into two groups. Group 1 have administered the standard of care therapy (pegylated interferon alfa-2a plus ribavirin) for 12 weeks, (n = 60). Group 2 have administered hydroxychloroquine plus standard of care therapy for 12 weeks, (n = 60). Therapeutics included hydroxychloroquine (200 mg) oral twice daily, peginterferon alfa-2a (160 μg) subcutaneous once weekly and oral weight-based ribavirin (1000-1200 mg/day). Baseline characteristics were similar in the two groups. The percentage of early virological response was significantly more in patients given the triple therapy than in patients given the standard of care [54/60 (90%) vs. 43/60 (71.7%); P = 0.011; respectively]. Biochemical response at week 12 was also significantly higher in patients given the triple therapy compared with the standard of care [58/60 (96.7%) vs. 42/60 (70%); P hydroxychloroquine to pegylated interferon plus ribavirin improves the rate of early virological and biochemical responses in chronic hepatitis C Egyptian patients without an increase in adverse events. J. Med. Virol. 88:2170-2178, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. HIV multi-drug resistance at first-line antiretroviral failure and subsequent virological response in Asia

    Science.gov (United States)

    Jiamsakul, Awachana; Sungkanuparph, Somnuek; Law, Matthew; Kantor, Rami; Praparattanapan, Jutarat; Li, Patrick CK; Phanuphak, Praphan; Merati, Tuti; Ratanasuwan, Winai; Lee, Christopher KC; Ditangco, Rossana; Mustafa, Mahiran; Singtoroj, Thida; Kiertiburanakul, Sasisopin

    2014-01-01

    Introduction First-line antiretroviral therapy (ART) failure often results from the development of resistance-associated mutations (RAMs). Three patterns, including thymidine analogue mutations (TAMs), 69 Insertion (69Ins) and the Q151M complex, are associated with resistance to multiple-nucleoside reverse transcriptase inhibitors (NRTIs) and may compromise treatment options for second-line ART. Methods We investigated patterns and factors associated with multi-NRTI RAMs at first-line failure in patients from The TREAT Asia Studies to Evaluate Resistance – Monitoring study (TASER-M), and evaluated their impact on virological responses at 12 months after switching to second-line ART. RAMs were compared with the IAS-USA 2013 mutations list. We defined multi-NRTI RAMs as the presence of either Q151M; 69Ins; ≥2 TAMs; or M184V+≥1 TAM. Virological suppression was defined as viral load (VL) Malaysia and Philippines were included. There were 97/105 (92%) patients harbouring ≥1 RAMs at first-line failure, 39/105 with multi-NRTI RAMs: six with Q151M; 24 with ≥2 TAMs; and 32 with M184V+≥1 TAM. Factors associated with multi-NRTI RAMs were CD4 ≤200 cells/µL at genotyping (OR=4.43, 95% CI [1.59–12.37], p=0.004) and ART duration >2 years (OR=6.25, 95% CI [2.39–16.36], p<0.001). Among 87/105 patients with available VL at 12 months after switch to second-line ART, virological suppression was achieved in 85%. The median genotypic susceptibility score (GSS) for the second-line regimen was 2.00. Patients with ART adherence ≥95% were more likely to be virologically suppressed (OR=9.33, 95% CI (2.43–35.81), p=0.001). Measures of patient resistance to second-line ART, including the GSS, were not significantly associated with virological outcome. Conclusions Multi-NRTI RAMs at first-line failure were associated with low CD4 level and longer duration of ART. With many patients switching to highly susceptible regimens, good adherence was still crucial in achieving

  1. HIV multi-drug resistance at first-line antiretroviral failure and subsequent virological response in Asia.

    Science.gov (United States)

    Jiamsakul, Awachana; Sungkanuparph, Somnuek; Law, Matthew; Kantor, Rami; Praparattanapan, Jutarat; Li, Patrick C K; Phanuphak, Praphan; Merati, Tuti; Ratanasuwan, Winai; Lee, Christopher K C; Ditangco, Rossana; Mustafa, Mahiran; Singtoroj, Thida; Kiertiburanakul, Sasisopin

    2014-01-01

    First-line antiretroviral therapy (ART) failure often results from the development of resistance-associated mutations (RAMs). Three patterns, including thymidine analogue mutations (TAMs), 69 Insertion (69Ins) and the Q151M complex, are associated with resistance to multiple-nucleoside reverse transcriptase inhibitors (NRTIs) and may compromise treatment options for second-line ART. We investigated patterns and factors associated with multi-NRTI RAMs at first-line failure in patients from The TREAT Asia Studies to Evaluate Resistance - Monitoring study (TASER-M), and evaluated their impact on virological responses at 12 months after switching to second-line ART. RAMs were compared with the IAS-USA 2013 mutations list. We defined multi-NRTI RAMs as the presence of either Q151M; 69Ins; ≥ 2 TAMs; or M184V+≥ 1 TAM. Virological suppression was defined as viral load (VL) failure and (2) factors associated with virological suppression after 12 months on second-line. A total of 105 patients from 10 sites in Thailand, Hong Kong, Indonesia, Malaysia and Philippines were included. There were 97/105 (92%) patients harbouring ≥ 1 RAMs at first-line failure, 39/105 with multi-NRTI RAMs: six with Q151M; 24 with ≥ 2 TAMs; and 32 with M184V+≥ 1 TAM. Factors associated with multi-NRTI RAMs were CD4 ≤ 200 cells/µL at genotyping (OR=4.43, 95% CI [1.59-12.37], p=0.004) and ART duration >2 years (OR=6.25, 95% CI [2.39-16.36], pfailure were associated with low CD4 level and longer duration of ART. With many patients switching to highly susceptible regimens, good adherence was still crucial in achieving virological response. This emphasizes the importance of continued adherence counselling well into second-line therapy.

  2. Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?

    Science.gov (United States)

    Pernas, Berta; Grandal, Marta; Pertega, Sonia; Cañizares, Angelina; Castro-Iglesias, Ángeles; Mena, Álvaro; Rodriguez-Osorio, Iria; Tabernilla, Andrés; Pedreira, José D; Poveda, Eva

    2016-04-01

    The objective of this study was to evaluate the prevalence of blips and risk of virological failure (VF) among HIV-infected patients with sustained virological suppression (HIV-RNA ART. Newly diagnosed (2004-13) HIV-infected patients with sustained virological suppression on ART (minimum follow-up of 3 months) were identified. Risk of VF was evaluated according to different plasma HIV-RNA quantification values based on the limits of quantification/detection of current commercial assays (20 copies/mL). Kaplan-Meier and Cox proportional hazards models were used to compare the cumulative incidence of VF. A total of 565 newly diagnosed HIV-infected patients were identified: 453 started ART and 354 achieved virological suppression. Prevalence of blips (isolated HIV-RNA ranging from 50 to 200 copies/mL) and VF (HIV-RNA ≥50 copies/mL) was 22.7% and 8.8%, respectively (mean follow-up of 42 months). Multivariate analysis identified differences between HIV-RNA values as an independent predictor of VF (P = 0.008); risk of VF was higher for patients with blips [HR 2.500 (95% CI 0.524-11.926)] and for those with at least three consecutive detected, but not quantified, HIV-RNA determinations (HIV-RNA 200 copies/mL [33.7% at 24 and 60 months versus ART. HIV patients with blips and at least three consecutive detected, but not quantified, HIV-RNA determinations (<20 copies/mL) had a higher risk of VF. These findings highlight the relevance of maintaining HIV-RNA levels below the limits of quantification of current assays (<20 copies/mL). © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Characterization of Hepatitis C Virus genotype 3a Hypervariable region 1 in patients achieved rapid virological response to alpha interferon and Ribavirin Combination therapy

    Directory of Open Access Journals (Sweden)

    Badar Sadaf

    2011-05-01

    Full Text Available Abstract Background Hepatitis C virus roots a chronic liver disease. Currently approved treatment strategy includes administration of alpha interferon and ribavirin combined therapy for 24-48 weeks. One of the predictor of sustained virological response is an early virological response to treatment characterized as rapid response. Hyper variable region 1 (HVR1 of E2 protein is responsible for viral entry and acts as a target for neutralizing antibodies. Any mutation in this region would effect virus interaction with target cell and viral persistence. Methods Thirty one clones of six pre-treatment samples subjected to combination therapy were investigated. Three of the patients were rapid responders (R1, R2 and R3 and two were breakthrough responders (BT1 and BT2. Envelope 2 gene was amplified, cloned and sequenced. Amino acid substitution, frequency, composition and antigenic properties of HVR 1 of E2 protein were studied. Results In both rapid responders (R.R (14 amino acid sites and breakthrough responders (BT.R (13 amino acid sites half of the amino acid sites were either conserved or resistant to any physiochemical change due to amino acid substitution. It also indicated that average composition of hydrophilic and basic amino acids were comparatively lower in rapid responders than other samples affecting probable interaction of virus with target cells. A central non antigenic region was constant among the breakthrough responders but differed in length significantly among rapid responders reflecting the adaptive nature of HVR1 to the immune response. Conclusions We observed that although HVR1is quite variable region in HCV 3a patients responding differently to treatment it still maintains its physiochemical properties for its proper functioning and viability.

  4. Early virologic response and IL28B polymorphisms in patients with chronic hepatitis C genotype 3 treated with peginterferon alfa-2a and ribavirin.

    Science.gov (United States)

    Scherzer, Thomas-Matthias; Hofer, Harald; Staettermayer, Albert Friedrich; Rutter, Karoline; Beinhardt, Sandra; Steindl-Munda, Petra; Kerschner, Heidrun; Kessler, Harald H; Ferenci, Peter

    2011-05-01

    Polymorphisms of the IL28B gene (rs12979860 and rs8099917) are associated with high sustained virological response (SVR) rates in HCV genotype 1 patients. This study analyzes the impact of these IL28B polymorphisms on early treatment response (weeks 2 and 4) and SVR in HCV genotype 3 patients. rs12979860 and rs8099917 were analyzed by the Step-OnePlus Real-time PCR system in 71 out of 72 Caucasian HCV genotype 3 patients participating, at our center, in a randomized study comparing 400mg with 800 mg ribavirin/day. HCV RNA was determined at weeks 2 and 4 of 180 μg/week peginterferon alfa-2a/ribavirin treatment. Sixty-nine patients completed the treatment and follow-up. rs12979860 genotyping revealed that 27 (37.5%) patients had C/C, 39 (54.2%) T/C, and 5 (6.9%) T/T. Thirteen patients (18.1%) became HCV RNA negative at week 2 and an additional 30 (41.7%) at week 4 (rapid virologic response; RVR); thus a total of 43 had a RVR (C/C: 77.8%; T/C or T/T: 50.0%). Irrespective of the ribavirin dose, the viral load decline was larger than in those with the T allele (T/C or T/T) (week 2: 4.46; [0.36-6.02] median; [range] vs. 3.50; [0.14-5.62]; log IU HCV-RNA/ml; p<0.001; week 4: 4.97; [1.21-6.20] vs. 4.49; [1.16-6.23]; p=0.003). Despite the faster initial viral response in C/C carriers, SVR rates were not different compared to T-allele carriers. Results of the SNP in the rs8099917 region were similar. IL28B polymorphisms modulate early virologic response to peginterferon/ribavirin treatment. In contrast to HCV genotype 1 patients, no effect on SVR rates was observed in genotype 3 patients. The clinical relevance of an earlier viral decline in C/C patients needs to be determined. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  5. Long-term clinical outcome of human immunodeficiency virus-infected patients with discordant immunologic and virologic responses to a protease inhibitor-containing regimen.

    Science.gov (United States)

    Piketty, C; Weiss, L; Thomas, F; Mohamed, A S; Belec, L; Kazatchkine, M D

    2001-05-01

    Within a prospective cohort of 150 human immunodeficiency virus (HIV)-infected patients who began first-line protease inhibitor therapy in 1996, the outcome of 42 patients with discrepant virologic and immunologic responses to antiretroviral treatment at 12 months was analyzed at 30 months of treatment. The incidence of AIDS-defining events and deaths (14%) in the group of patients with immunologic responses in the absence of a virologic response was higher than that in full-responder patients (2%); yet, the incidence in this group was lower than that in patients with no immunologic response, despite a virologic response (21%), and was lower than that in patients without an immunologic or virologic response (67%; P<.0001, log-rank test). Differences in outcome were significant (relative risk, 6.9; 95% confidence interval, 1.9-39.3) when factors for progression were compared with those of responder patients. The results support the relevance of the CD4 cell marker over plasma HIV load for predicting clinical outcome in patients who do not achieve full immunologic and virologic responses.

  6. Clinical, virological and immunological responses in Danish HIV patients receiving raltegravir as part of a salvage regimen

    Directory of Open Access Journals (Sweden)

    Frederik N Engsig

    2010-05-01

    Full Text Available Frederik N Engsig1, Jan Gerstoft1, Gitte Kronborg2, Carsten S Larsen3, Gitte Pedersen4, Anne M Audelin5, Louise B Jørgensen5, Niels Obel11Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark; 2Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; 3Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; 4Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; 5Department of Virology, Statens Serum Institute, Copenhagen, DenmarkBackground: Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses.Methods: From a Danish population-based nationwide cohort of HIV patients we identified the individuals who initiated a salvage regimen including raltegravir and a matched cohort of HIV-infected patients initiating HAART for the first time. We compared these two cohorts for virological suppression, gain in CD4 count, and time to first change of initial regimen.Results: We identified 32 raltegravir patients and 64 HIV patients who initiated HAART for the first time in the period 1 January 2006 to 1 July 2009. The virological and immunological responses in the raltegravir patients were comparable to those seen in the control cohort. No patients in the two cohorts died and no patients terminated raltegravir treatment in the observation period. Time to first change of initial regimen was considerably shorter for HAART-naïve patients.Conclusion: We conclude that salvage regimens including raltegravir have high effectiveness in the everyday clinical setting. The effectiveness of the regimens is comparable to that observed for patients initiating HAART for the first time. The risk of change in the salvage regimens after initiation of raltegravir is low.Keywords: HIV, raltegravir, salvage regime, efficacy, matched cohort

  7. Hepatocellular Carcinoma after Sustained Viral Response to Interferon and Ribavirin Therapy in Cirrhosis Secondary to Chronic Hepatitis C

    International Nuclear Information System (INIS)

    Khokhar, N.; Qureshi, M.U.; Niazi, T.K.

    2013-01-01

    Objective: To determine the frequency of development of hepatocellular carcinoma in patients with chronic liver disease secondary to hepatitis C who had achieved sustained virological response with Interferon and Ribavirin therapy. Study Design: Retrospective descriptive study. Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan, from January 2007 to January 2012. Methodology: Hepatitis C related chronic liver disease patients who were treated with interferon and ribavirin, after they achieved sustained virological response, they were followed for a mean of 42 A+- 17 months. During this time, development of hepatocellular carcinoma was ascertained. All underwent surveillance with alpha-feto-protein and ultrasonography every 6 months. Results: Out of the 58 patients who had achieved sustained virological response, 3 developed hepatocellular carcinoma after a mean follow-up of 38 A+- 14 months. It was multifocal in 2 cases and was single lesion in the 3rd. Two patients ultimately died, one with upper GI bleeding and the other with hepatic encephalopathy, while 3rd patient with single lesion is still surviving. Conclusion: Three out of 58 patients of hepatitis C related chronic liver disease developed hepatocellular carcinoma during follow-up in patients who had achieved sustained virological response. These patients need closer follow-up, for development of complications, even if they have achieved sustained viral response. (author)

  8. Responsible marketing for sustainable tourism

    Directory of Open Access Journals (Sweden)

    Jegdić Vaso

    2014-01-01

    Full Text Available The biggest challenge associated with the concept of sustainable tourism is its operationalisation and perception as a process to be applied through development plans, projects and ongoing activities of tour operators. The traditional approach to marketing, focused on a limited idea of maximising profit businesses, was not able to respond to a number of social and environmental requirements imposed by the concept of sustainable development. This paper discusses the ways in which marketing could play a more important role in the sustainable development of tourism. This refers to the determination of consumer needs and preferences, the formation of certain products and pricing, product information and advertising to consumers of their benefits in a sustainable manner, as well as adequate distribution channels used by businesses to deliver products to consumers. Environmental and social marketing are now being confirmed as important elements of a much broader marketing perspective. In order to develop tourism with sustainable outcomes, responsible marketing can be crucial. The concept of marketing mix for sustainable tourism was used as a starting point to explore the specific role of responsible marketing in tourism.

  9. Corporate Social Responsibility for Sustainability

    Directory of Open Access Journals (Sweden)

    Wojciech Przychodzeń

    2014-06-01

    Full Text Available Purpose: The purpose of this paper is to is to provide insights on implementing corporate social responsibility for sustainability (CSRS concept and show how it differs from basic corporate social responsibility (CSR. Methodology: The paper discusses major issues with references to existing literature and real business cases from S&P500 consumer discretionary sector. Findings: The main fi nding of this paper is that CSRS could provide the company with a competitive advantage as a growing number of consumers become more sustainable conscious. It could also help to overcome the increasing consumers’ skepticism towards corporate social responsibility practices. Finally, it can also be seen as a step forward in defi ning what types of corporate activities are associated with desirable social and environmental gains. Research limitations: Our sample was restricted to the U.S. fi rms from the consumer discretionary sector. Therefore, conclusions should not be generalized to other markets. Our study is based on the analysis of environmental and social responsibility statements and assumes that they accurately represent corporate commitment in majority of the cases. Practical implications: CSRS offers corporations the opportunity to use their unique skills, culture, values, resources, and management capabilities to lead social progress by making sustainability part of its internal corporate logic. Originality: The paper raises the importance of the different conditions necessary for making sustainable development concept an important part of corporate strategy.

  10. Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults

    DEFF Research Database (Denmark)

    Marzolini, Catia; Sabin, Caroline; Raffi, François

    2015-01-01

    OBJECTIVE: The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens...... individuals had significantly higher CD4 cell count at baseline, CD4 cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals. CONCLUSION: Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting...

  11. Circulating sCD14 is associated with virological response to pegylated-interferon-alpha/ribavirin treatment in HIV/HCV co-infected patients.

    Directory of Open Access Journals (Sweden)

    Giulia Marchetti

    Full Text Available Microbial translocation (MT through the gut accounts for immune activation and CD4+ loss in HIV and may influence HCV disease progression in HIV/HCV co-infection. We asked whether increased MT and immune activation may hamper anti-HCV response in HIV/HCV patients.98 HIV/HCV patients who received pegylated-alpha-interferon (peg-INF-alpha/ribavirin were retrospectively analyzed. Baseline MT (lipopolysaccharide, LPS, host response to MT (sCD14, CD38+HLA-DR+CD4+/CD8+, HCV genotype, severity of liver disease were assessed according to Early Virological Response (EVR: HCV-RNA <50 IU/mL at week 12 of therapy or ≥2 log(10 reduction from baseline after 12 weeks of therapy and Sustained Virological Response (SVR: HCV-RNA <50 IU/mL 24 weeks after end of therapy. Mann-Whitney/Chi-square test and Pearson's correlation were used. Multivariable regression was performed to determine factors associated with EVR/SVR.71 patients displayed EVR; 41 SVR. Patients with HCV genotypes 1-4 and cirrhosis presented a trend to higher sCD14, compared to patients with genotypes 2-3 (p = 0.053 and no cirrhosis (p = 0.052. EVR and SVR patients showed lower levels of circulating sCD14 (p = 0.0001, p = 0.026, respectively, but similar T-cell activation compared to Non-EVR (Null Responders, NR and Non-SVR (N-SVR subjects. sCD14 resulted the main predictive factor of EVR (0.145 for each sCD14 unit more, 95%CI 0.031-0.688, p = 0.015. SVR was associated only with HCV genotypes 2-3 (AOR 0.022 for genotypes 1-4 vs 2-3, 95%CI 0.001-0.469, p = 0.014.In HIV/HCV patients sCD14 correlates with the severity of liver disease and predicts early response to peg-INF-alpha/ribavirin, suggesting MT-driven immune activation as pathway of HIV/HCV co-infection and response to therapy.

  12. Antiretroviral therapy initiation before, during, or after pregnancy in HIV-1-infected women: maternal virologic, immunologic, and clinical response.

    Directory of Open Access Journals (Sweden)

    Vlada V Melekhin

    2009-09-01

    Full Text Available Pregnancy has been associated with a decreased risk of HIV disease progression in the highly active antiretroviral therapy (HAART era. The effect of timing of HAART initiation relative to pregnancy on maternal virologic, immunologic and clinical outcomes has not been assessed.We conducted a retrospective cohort study from 1997-2005 among 112 pregnant HIV-infected women who started HAART before (N = 12, during (N = 70 or after pregnancy (N = 30.Women initiating HAART before pregnancy had lower CD4+ nadir and higher baseline HIV-1 RNA. Women initiating HAART after pregnancy were more likely to receive triple-nucleoside reverse transcriptase inhibitors. Multivariable analyses adjusted for baseline CD4+ lymphocytes, baseline HIV-1 RNA, age, race, CD4+ lymphocyte count nadir, history of ADE, prior use of non-HAART ART, type of HAART regimen, prior pregnancies, and date of HAART start. In these models, women initiating HAART during pregnancy had better 6-month HIV-1 RNA and CD4+ changes than those initiating HAART after pregnancy (-0.35 vs. 0.10 log(10 copies/mL, P = 0.03 and 183.8 vs. -70.8 cells/mm(3, P = 0.03, respectively but similar to those initiating HAART before pregnancy (-0.32 log(10 copies/mL, P = 0.96 and 155.8 cells/mm(3, P = 0.81, respectively. There were 3 (25% AIDS-defining events or deaths in women initiating HAART before pregnancy, 3 (4% in those initiating HAART during pregnancy, and 5 (17% in those initiating after pregnancy (P = 0.01. There were no statistical differences in rates of HIV disease progression between groups.HAART initiation during pregnancy was associated with better immunologic and virologic responses than initiation after pregnancy.

  13. Transmitted drug resistant HIV-1 and association with virologic and CD4 cell count response to combination antiretroviral therapy in the EuroSIDA Study

    DEFF Research Database (Denmark)

    Bannister, Wendy P; Cozzi-Lepri, Alessandro; Clotet, Bonaventura

    2008-01-01

    OBJECTIVES: To investigate prevalence of transmitted drug-resistant human immunodeficiency virus (TDR) and factors associated with TDR and to compare virological and CD4 count response to combination antiretroviral therapy. METHODS: In this study, 525 mostly chronically infected EuroSIDA patients...

  14. HIV Stigma and Depressive Symptoms are Related to Adherence and Virological Response to Antiretroviral Treatment Among Immigrant and Indigenous HIV Infected Patients

    NARCIS (Netherlands)

    Sumari-de Boer, I. Marion; Sprangers, Mirjam A. G.; Prins, Jan M.; Nieuwkerk, Pythia T.

    2012-01-01

    We compared adherence to cART and viro-logical response between indigenous and immigrant HIV-infected patients in the Netherlands, and investigated if a possible difference was related to a difference in the psychosocial variables: HIV-stigma, quality-of-life, depression and beliefs about

  15. Impact of HIV-1 reverse transcriptase polymorphism F214L on virological response to thymidine analogue based regimens in ART-naïve and experienced patients

    DEFF Research Database (Denmark)

    Silberstein, F; Cozzi-Lepri, A; Ruiz, L

    2007-01-01

    BACKGROUND: A negative association between the polymorphism F214L and type 1 thymidine analogue (TA) mutations (TAMs) has been observed. However, the virological response to TAs according to the detection of F214L has not been evaluated. METHODS: We studied 590 patients from EuroSIDA who started ...... were observed in patients with M41L/T215Y and mixed TAM profiles detected before the initiation of cART. CONCLUSIONS: This study provides evidence that the detection of polymorphism F214L is associated with a favorable virological response to TA-based cART.......BACKGROUND: A negative association between the polymorphism F214L and type 1 thymidine analogue (TA) mutations (TAMs) has been observed. However, the virological response to TAs according to the detection of F214L has not been evaluated. METHODS: We studied 590 patients from EuroSIDA who started TA...... therapy for the first time as part of potent combination antiretroviral therapy (cART) and who were tested for genotypic resistance within the past 6 months. End points were median reduction in the week 24 viral load and time to virological failure (2 consecutive VL measurements >400 copies/mL after...

  16. Virological and immunological response to antiretroviral regimens containing maraviroc in HIV type 1-infected patients in clinical practice: role of different tropism testing results and of concomitant treatments.

    Science.gov (United States)

    Rossetti, Barbara; Bianco, Claudia; Bellazzi, Lara Ines; Bruzzone, Bianca; Colao, Grazia; Corsi, Paola; Monno, Laura; Pagano, Gabriella; Paolucci, Stefania; Punzi, Grazia; Setti, Maurizio; Zazzi, Maurizio; De Luca, Andrea

    2014-01-01

    We assessed the immunovirological response to antiretroviral regimens containing maraviroc in HIV-infected viremic patients with viral tropism predicted by different assays. We selected antiretroviral treatment-experienced HIV-1-infected patients initiating regimens containing maraviroc after different phenotypic or genotypic viral tropism assays, with at least one HIV-1 RNA determination during follow-up. Survival analysis was employed to assess the virological response as time to HIV-1 RNA immunological response as time to a CD4 cell count increase of ≥ 100/μl from baseline. Predictors of these outcomes were analyzed by multivariate Cox regression models. In 191 treatments with maraviroc, virological response was achieved in 65.4% and the response was modestly influenced by the baseline viral load and concomitant drug activity but not influenced by the type of tropism assay employed. Immunological response was achieved in 58.1%; independent predictors were baseline HIV-1 RNA (per log10 higher: HR 1.29, 95% CI 1.05-1.60) and concomitant therapy with enfuvirtide (HR 2.05, 0.96-4.39) but not tropism assay results. Of 17 patients with baseline R5-tropic virus and available tropism results while viremic during follow-up on maraviroc, seven (41%) showed a tropism switch to non-R5 virus. A significant proportion of experienced patients treated with regimens containing maraviroc achieved virological response. The tropism test type used was not associated with immunovirological response and concomitant treatment with enfuvirtide increased the chance of immunological response. More than half of virological failures with maraviroc were not accompanied by tropism switch.

  17. FibroTest is an independent predictor of virologic response in chronic hepatitis C patients retreated with pegylated interferon alfa-2b and ribavirin in the EPIC³ program.

    Science.gov (United States)

    Poynard, Thierry; Munteanu, Mona; Colombo, Massimo; Bruix, Jordi; Schiff, Eugene; Terg, Ruben; Flamm, Steven; Moreno-Otero, Ricardo; Carrilho, Flair; Schmidt, Warren; Berg, Thomas; McGarrity, Thomas; Heathcote, E Jenny; Gonçales, Fernando; Diago, Moises; Craxi, Antonio; Silva, Marcelo; Boparai, Navdeep; Griffel, Louis; Burroughs, Margaret; Brass, Clifford; Albrecht, Janice

    2011-02-01

    EPIC-3 is a prospective, international study that has demonstrated the efficacy of PEG-IFN alfa-2b plus weight-based ribavirin in patients with chronic hepatitis C and significant fibrosis who previously failed any interferon-alfa/ribavirin therapy. The aim of the present study was to assess FibroTest (FT), a validated non-invasive marker of fibrosis in treatment-naive patients, as a possible alternative to biopsy as the baseline predictor of subsequent early virologic (EVR) and sustained virologic response (SVR) in previously treated patients. Of 2312 patients enrolled, 1459 had an available baseline FT, biopsy, and complete data. Uni- (UV) and multi-variable (MV) analyses were performed using FT and biopsy. Baseline characteristics were similar as in the overall population; METAVIR stage: 28% F2, 29% F3, and 43% F4, previous relapsers 29%, previous PEG-IFN regimen 41%, high baseline viral load (BVL) 64%. 506 patients (35%) had undetectable HCV-RNA at TW12 (TW12neg), with 58% achieving SVR. The accuracy of FT was similar to that in naive patients: AUROC curve for the diagnosis of F4 vs F2=0.80 (p<0.00001). Five baseline factors were associated (p<0.001) with SVR in UV and MV analyses (odds ratio: UV/MV): fibrosis stage estimated using FT (4.5/5.9) or biopsy (1.5/1.6), genotype 2/3 (4.5/5.1), BVL (1.5/1.3), prior relapse (1.6/1.6), previous treatment with non-PEG-IFN (2.6/2.0). These same factors were associated (p ≤ 0.001) with EVR. Among patients TW12neg, two independent factors remained highly predictive of SVR by MV analysis (p ≤ 0.001): genotype 2/3 (odds ratio=2.9), fibrosis estimated with FT (4.3) or by biopsy (1.5). FibroTest at baseline is a possible non-invasive alternative to biopsy for the prediction of EVR at 12 weeks and SVR, in patients with previous failures and advanced fibrosis, retreated with PEG-IFN alfa-2b and ribavirin. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  18. Partiality of Responsibility: Ethics in Sustainability Consulting

    NARCIS (Netherlands)

    Earhart, R.S.

    2011-01-01

    Sustainability, Socially Responsible Investment (SRI) and Corporate Social Responsibility (CSR) are both highly normative fields of professional practice, framed by various narratives: capitalist versus environmentalist, waste versus respect for the planet, consumerism versus responsibility;

  19. 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...

  20. Modelled in vivo HIV fitness under drug selective pressure and estimated genetic barrier towards resistance are predictive for virological response

    DEFF Research Database (Denmark)

    Deforche, Koen; Cozzi-Lepri, Alessandro; Theys, Kristof

    2008-01-01

    landscapes (nelfinavir [NFV] and zidovudine [AZT] plus lamivudine [3TC]) to predict week 12 viral load (VL) change for 176 treatment change episodes (TCEs) and probability of week 48 virological failure for 90 TCEs, in treatment experienced patients starting these drugs in combination. RESULTS: A higher...

  1. Impact of HIV-1 reverse transcriptase polymorphism F214L on virological response to thymidine analogue-based regimens in antiretroviral therapy (ART)-naive and ART-experienced patients

    DEFF Research Database (Denmark)

    Ceccherini-Silberstein, Francesca; Cozzi-Lepri, Alessandro; Ruiz, Lidia

    2007-01-01

    A negative association between the polymorphism F214L and type 1 thymidine analogue (TA) mutations (TAMs) has been observed. However, the virological response to TAs according to the detection of F214L has not been evaluated....

  2. Responsible marketing for sustainable tourism

    OpenAIRE

    Jegdić Vaso

    2014-01-01

    The biggest challenge associated with the concept of sustainable tourism is its operationalisation and perception as a process to be applied through development plans, projects and ongoing activities of tour operators. The traditional approach to marketing, focused on a limited idea of maximising profit businesses, was not able to respond to a number of social and environmental requirements imposed by the concept of sustainable development. This paper discusses the ways in which marketing cou...

  3. Immunological dynamics associated with rapid virological response during the early phase of type I interferon therapy in patients with chronic hepatitis C.

    Science.gov (United States)

    Lee, Jae-Won; Kim, Won; Kwon, Eun-Kyung; Kim, Yuri; Shin, Hyun Mu; Kim, Dong-Hyun; Min, Chan-Ki; Choi, Ji-Yeob; Lee, Won-Woo; Choi, Myung-Sik; Kim, Byeong Gwan; Cho, Nam-Hyuk

    2017-01-01

    Type I interferons (IFNs) play an important role in antiviral immunity as well as immunopathogenesis of diverse chronic viral infections. However, the precise mechanisms regulating the multifaceted effects of type I IFNs on the immune system and pathological inflammation still remain unclear. In order to assess the immunological dynamics associated with rapid viral clearance in chronic hepatitis C patients during the acute phase of type I IFN therapy, we analyzed multiple parameters of virological and immunological responses in a cohort of 59 Korean hepatitis C patients who received pegylated IFN-α and ribavirin (IFN/RBV). Most of the Korean patients had favorable alleles in the IFN-λ loci for responsiveness to IFN/RBV (i.e., C/C in rs12979860, T/T in rs8099917, and TT/TT in rs368234815). Rapid virological response (RVR) was determined mainly by the hepatitis C virus genotype. Among the cytokines analyzed, higher plasma levels of IL-17A and FGF were observed in non-RVR patients infected with viral genotype 1 and IP-10 was consistently elevated in RVR group infected with genotype 2 during the early phase of antiviral therapy. In addition, these three cytokines were correlated each other, suggesting a functional linkage of the cytokines in antiviral responses during IFN/RBV therapy. A low baseline frequencies of regulatory T cells and γδ T cells, but high level of group 2 innate lymphoid cells, in peripheral bloods were also significantly associated with the RVR group, implicating a potential role of the cellular immunity during the early phase of IFN/RBV therapy. Therefore, the immunological programs established by chronic hepatitis C and rapid disruption of the delicate balance by exogenous type I IFN might be associated with the subsequent virological outcomes in chronic hepatitis C patients.

  4. Economics, Corporate Sustainability and Social Responsibility

    OpenAIRE

    Tisdell, Clement A.

    2008-01-01

    It is often argued that corporate sustainability requires a corporation to make a profit, to act in a socially responsible manner and to engage in policies that are environmentally sustainable. This is sometimes called the corporation’s triple bottom line. In this paper it is argued that in practice profitability or more general maintaining economic variability constitutes a corporation’s bottom line and that it is limited by this consideration in showing social responsibility and in acting w...

  5. Responsible and sustainable business in the context of sustainable development

    Directory of Open Access Journals (Sweden)

    Gheorghe Săvoiu

    2013-11-01

    Full Text Available Businesses in the contemporary world, detached from the classic entrepreneurial paradigm in keeping with which a business appears, grows and matures, are undergoing a process of adjustment to the new concept of sustainability, focusing on reconciling global, regional, national and local economic development and the quality of the environment. The practical organization of a responsible and sustainable business, the results of which are ever new products and services, which creates new jobs, and contributes, by aggregating systematically, to assessing new macroeconomic results, from GDP or NDP to import and export, and especially to sustainable economic development, requires the presence of both the three classical factors, i.e., capital, labour and location (land, and the other three essential new factors, which are called technology, information and the specific skills of the business owner, or simply of the entrepreneur.

  6. No impact of HIV-1 protease minority resistant variants on the virological response to a first-line PI-based regimen containing darunavir or atazanavir.

    Science.gov (United States)

    Perrier, Marine; Visseaux, Benoit; Landman, Roland; Joly, Véronique; Todesco, Eve; Yazdanpanah, Yazdan; Calvez, Vincent; Marcelin, Anne-Geneviève; Descamps, Diane; Charpentier, Charlotte

    2018-01-01

    To evaluate, in a clinical cohort of HIV-1-infected patients, the prevalence of PI minority resistant variants (MRV) at ART baseline and their impact on the virological response to a first-line PI-based regimen. In an observational single-centre cohort, we assessed all ART-naive patients initiating a first-line regimen including two NRTI and one boosted PI, darunavir/ritonavir or atazanavir/ritonavir, between January 2012 and March 2015. Ultra-deep sequencing of the pol gene was performed using Illumina® technology. Protease mutations were identified using the WHO transmitted drug resistance list and major PI resistance mutations (IAS-USA drug resistance mutations list). Ninety-four and 16 patients initiating a darunavir/ritonavir-based regimen and an atazanavir/ritonavir-based regimen, respectively, were assessed. Twenty-eight percent of the patients were HIV-1 subtype B, 39% CRF02_AG and 33% other non-B subtypes. Thirteen patients (13.8%) in the darunavir group and three patients (18.8%) in the atazanavir group experienced a virological failure (VF). Overall, 13 (11.8%) subjects had PI MRV at baseline in the median proportion of 1.3% (IQR = 1.1-1.7). The most prevalent PI MRV were G73C (n = 5) and M46I (n = 3). The proportion of patients harbouring baseline PI MRV was similar between those with virological success (10.6%) and those experiencing VF (18.8%) (P = 0.40). No difference was observed in the rate of PI MRV by viral subtype (P = 0.51) or by PI drug (P = 0.40). This study showed a prevalence of 11.8% of PI MRV among 110 ART-naive subjects, without significant impact on the virological response to a first-line PI-based regimen containing darunavir or atazanavir. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Immunological responses during a virologically failing antiretroviral regimen are associated with in vivo synonymous mutation rates of HIV type-1 env

    DEFF Research Database (Denmark)

    Mens, Helene; Jørgensen, Louise Bruun; Kronborg, Gitte

    2009-01-01

    BACKGROUND: Little is known about the underlying causes of differences in immunological response to antiretroviral therapy during multidrug-resistant (MDR) HIV type-1 (HIV-1) infection. This study aimed to identify virological factors associated with immunological response during therapy failure...... for analysis. In a longitudinal mixed-effects model, plasma HIV-1 RNA only tended to predict immunological response (P=0.06), whereas minor protease inhibitor (PI) and nucleoside reverse transcriptase (NRTI) mutations at baseline correlated significantly with CD4+ T-cell count slopes (r= -0.56, P=0.04 and r......= -0.64, P=0.008, respectively). Interestingly, synonymous mutations of env correlated inversely with CD4+ T-cell count slopes (r=-0.60; P=0.01) and individuals with codons under positive selection had significantly better CD4+ T-cell responses than individuals without (0.42 versus -5.34; P=0...

  8. Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected Zulu/Xhosa in South Africa.

    Directory of Open Access Journals (Sweden)

    Boris Julg

    Full Text Available Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI, tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42% and 83% (95% CI:79%-86% of patients on antiretroviral therapy failed to restore CD4 cell counts ≥ 200 cells/mm(3 after 12 and ≥ 500 cells/mm(3 after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001 and nadir CD4 cell count at ART initiation (p<0.0001, while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age.

  9. Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected Zulu/Xhosa in South Africa.

    Science.gov (United States)

    Julg, Boris; Poole, Danielle; Ghebremichael, Musie; Castilla, Carmen; Altfeld, Marcus; Sunpath, Henry; Murphy, Richard A; Walker, Bruce D

    2012-01-01

    Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI), tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42%) and 83% (95% CI:79%-86%) of patients on antiretroviral therapy failed to restore CD4 cell counts ≥ 200 cells/mm(3) after 12 and ≥ 500 cells/mm(3) after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001) and nadir CD4 cell count at ART initiation (p<0.0001), while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age.

  10. Response-guided telaprevir combination treatment for hepatitis C virus infection

    NARCIS (Netherlands)

    Sherman, Kenneth E.; Flamm, Steven L.; Afdhal, Nezam H.; Nelson, David R.; Sulkowski, Mark S.; Everson, Gregory T.; Fried, Michael W.; Adler, Michael; Reesink, Hendrik W.; Martin, Marie; Sankoh, Abdul J.; Adda, Nathalie; Kauffman, Robert S.; George, Shelley; Wright, Christopher I.; Poordad, Fred; Adler, M.; Delwaide, Jean; Horsmans, Y.; van Vlierberghe, H.; Richter, C.; Afdhal, N.; Araya, V.; Arora, S.; Balart, L.; Bennett, M.; Berk, B.; Bernstein, D.; Bloomer, J.; Brown, R.; Bzowej, N.; Chasen, R.; Cochran, J.; Crippin, J.; Davis, G.; Davis, M.; Dejesus, E.; Di Bisceglie, A.; Dieterich, D.; Esposito, S.; Everson, G.; Flamm, S. L.; Franco, J.; Freilich, B.; Fried, M. W.; Ghalib, R.; Godofsky, E.; Gordon, S.; Howell, C.; Hutson, W.

    2011-01-01

    Patients with chronic infection with hepatitis C virus (HCV) genotype 1 often need 48 weeks of peginterferon-ribavirin treatment for a sustained virologic response. We designed a noninferiority trial (noninferiority margin, -10.5%) to compare rates of sustained virologic response among patients

  11. Effect of HIV type 1 subtype on virological and immunological response to combination antiretroviral therapy: evidence for a more rapid viral suppression for subtype A than subtype B-infected Greek individuals.

    Science.gov (United States)

    Paraskevis, Dimirios; Touloumi, Giota; Bakoyannis, Giorgos; Paparizos, Vassilios; Lazanas, Marios; Gargalianos, Panagiotis; Chryssos, Georgios; Antoniadou, Anastasia; Psichogiou, Mina; Panos, Georgios; Katsarou, Olga; Sambatakou, Helen; Kordossis, Theodoros; Hatzakis, Angelos

    2013-03-01

    Whether response to combination antiretroviral therapy (cART) differs between those infected with HIV-1 subtype A or B remains unclear. We compared virological and immunological response to cART in individuals infected with subtype A or B in an ethnically homogeneous population. Data derived from the Athens Multicenter AIDS Cohort Study (AMACS) and analysis were restricted to those of Greek origin. Time to virological response (confirmed HIV-RNA 500 copies/ml at any time or no response by month 6) were analyzed using survival models and CD4 changes after cART initiation using piecewise linear mixed effects models. Of the 571 subjects included in the analysis, 412 (72.2%) were infected with subtype B and 159 (27.8%) with subtype A. After adjusting for various prognostic factors, the rate of virological response was higher for those infected with subtype A versus B (adjusted HR: 1.35; 95% CI: 1.08-1.68; p=0.009). Subtype A was also marginally associated with a lower hazard of virological failure compared to subtype B (HR=0.73; 95% CI: 0.53-1.02; p=0.062). Further adjustment for treatment adherence did not substantially changed the main results. No significant differences were observed in the rates of CD4 increases by subtype. The overall median (95% CI) CD4 increase at 2 years of cART was 193 (175, 212) cells/μl. Our study, based on one of the largest homogeneous groups of subtype A and B infections in Europe, showed that individuals infected with subtype A had an improved virological but similar immunological response to cART compared to those infected with subtype B.

  12. Responses of intestinal virome to silver nanoparticles: safety assessment by classical virology, whole-genome sequencing and bioinformatics approaches

    Directory of Open Access Journals (Sweden)

    Gokulan K

    2018-05-01

    Full Text Available Kuppan Gokulan,1,* Aschalew Z Bekele,1,* Kenneth L Drake,2 Sangeeta Khare1 1Division of Microbiology, US Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA; 2Seralogix, Inc., Austin, TX, USA *These authors contributed equally to this work Background: Effects of silver nanoparticles (AgNP on the intestinal virome/phage community are mostly unknown. The working hypothesis of this study was that the exposure of pharmaceutical/nanomedicine and other consumer-use material containing silver ions and nanoparticles to the gastrointestinal tract may result in disturbance of the beneficial gut viruses/phages. Methods: This study assesses the impact of AgNP on the survival of individual bacteriophages using classical virology cultivation and electron microscopic techniques. Moreover, how the ingested AgNP may affect the intestinal virus/phages was investigated by conducting whole-genome sequencing (WGS. Results: The viral cultivation methods showed minimal effect on selected viruses during short-term exposure (24 h to 10 nm AgNP. However, long-term exposure (7 days resulted in significant reduction in the viral/phage population. Data obtained from WGS were filtered and compared with a nonredundant viral database composed of the complete viral genomes from NCBI using KRAKEN (confidence scoring threshold of 0.5. To compare the relative differential changes, the sequence counts in each treatment group were normalized to account for differences in DNA sequencing library sizes. Bioinformatics techniques were developed to visualize the virome comparative changes in a phylogenic tree graph. The computed data revealed that AgNP had an impact on several intestinal bacteriophages that prey on bacterial genus Enterobacteria, Yersinia and Staphylococcus as host species. Moreover, there was an independent effect of nanoparticles and released ions. Conclusion: Overall, this study reveals that the small-size AgNP could lead to

  13. SUSTAINABLE DEVELOPMENT AND ECOLOGICAL RESPONSIBILITY OF BUSINESS

    Directory of Open Access Journals (Sweden)

    Viktoria Krykun

    2016-11-01

    Full Text Available Today sustainable development is a widely used term, which has been increasingly influential in recent years. Debates about sustainability no longer consider sustainability solely as an environmental concern, but also incorporate economic and social dimensions. However, while a social and economic dimensions of sustainable development are widely discussed, environmental degradation becomes more and more crucial each year and is likely to reduce human well-being all across the world within the next few decades. The purpose of the paper is to analyse ecological ‘pillar’ of sustainable development, its historical background, main steps towards implementation of ‘new global environmental rules for society. Methodology. The paper is based on statistical information from public sources, reports of different international organizations and institutions, which are used to stress and underline main crucial points of research. Results of the survey show, that environmental quality, economic development and social well-being are interdependent and the main aim of international institutions, independent countries, businesses and society is to achieve environmentally sustainable development. Environmental issues make strong impact on modern economy. Responsible global strategy of development provides the whole society with rules, how ‘wise’ technological changes and economic policy can make industrial production processes less polluting and less resource intensive but yet more productive and profitable. Practical implications. Strategy of sustainable development and it’s three basic dimensions have found practical implication in one complex model, which illustrates the level of development of each country – the Human Development Index, which is focusing on three basic dimensions of human development: life expectancy at birth, mean years of schooling and expected years of schooling and gross national income per capita. Another data, which is

  14. Haemangioma with coagulopathy: sustained response to prednisone.

    Science.gov (United States)

    Evans, J; Batchelor, A D; Stark, G; Uttley, W S

    1975-01-01

    Two cases of giant haemangioma with thrombocytopenia are described. A satisfactory and sustained response to prednisone was achieved in respect of both coagulation abnormalities and tumour size. It is proposed that prednisone is effective by enhancement of thrombosis and reduction of fibrinolysis within the tumour, thus promoting a natural form of resolution. It is suggested that prednisone therapy should be first-choice treatment of complicated haemangiomas. Images Fig. 1 Fig. 3 PMID:147646

  15. Determinants of virological response to antiretroviral therapy: socio-economic status still plays a role in the era of cART. Results from the ANRS-VESPA 2 study, France.

    Science.gov (United States)

    D'Almeida, Kayigan W; Lert, France; Spire, Bruno; Dray-Spira, Rosemary

    2016-01-01

    Disparities in combined antiretroviral therapy (cART) outcomes have been consistently reported among people living with HIV (PLWHIV). The present study aims at investigating the mechanisms underlying those disparities among PLWHIV in France. We used data from the Vespa2 survey, a large national cross-sectional survey, representative of HIV-infected people followed at hospitals in 2011. Among participants diagnosed ≥1996, HIV treatment-naive at the time of cART initiation and on cART for at least 12 months, the frequency of sustained virological suppression (SVS; undetectable viral load [accounting for clinical and biological determinants of response to cART. Among 1,246 participants, 77.7% had achieved SVS. SVS was less frequent among those unemployed (0.6 [range 0.3-1.0]) and those with the lowest level of education (0.4 [range 0.2-0.9]). The late presenters, diagnosed at a CD4 + T-cell count 200 but initiating cART at CD4 + T-cell count issues should also be investigated.

  16. Potential Impact of a Free Online HIV Treatment Response Prediction System for Reducing Virological Failures and Drug Costs after Antiretroviral Therapy Failure in a Resource-Limited Setting

    Directory of Open Access Journals (Sweden)

    Andrew D. Revell

    2013-01-01

    Full Text Available Objective. Antiretroviral drug selection in resource-limited settings is often dictated by strict protocols as part of a public health strategy. The objective of this retrospective study was to examine if the HIV-TRePS online treatment prediction tool could help reduce treatment failure and drug costs in such settings. Methods. The HIV-TRePS computational models were used to predict the probability of response to therapy for 206 cases of treatment change following failure in India. The models were used to identify alternative locally available 3-drug regimens, which were predicted to be effective. The costs of these regimens were compared to those actually used in the clinic. Results. The models predicted the responses to treatment of the cases with an accuracy of 0.64. The models identified alternative drug regimens that were predicted to result in improved virological response and lower costs than those used in the clinic in 85% of the cases. The average annual cost saving was $364 USD per year (41%. Conclusions. Computational models that do not require a genotype can predict and potentially avoid treatment failure and may reduce therapy costs. The use of such a system to guide therapeutic decision-making could confer health economic benefits in resource-limited settings.

  17. Immunological and virological response to antiretroviral treatment in migrant and native men and women in Western Europe; is benefit equal for all?

    Science.gov (United States)

    2018-01-01

    The aim of the study was to evaluate differences in immunovirological response to combination antiretroviral therapy (cART) in migrant and native men and women within a European collaboration of HIV cohorts Collaboration of Observational HIV Epidemiological Research in Europ (COHERE) in EuroCoord, 2004-2013. Migrants were defined as those with geographical origin (GO) different from the reporting country and were grouped as originating from Western Europe and Western Countries (WEWC), Eastern Europe (EE), North Africa and the Middle East (NAME), sub-Saharan Africa (SSA), Latin America (LA), Caribbean (CRB) and Asia/Oceania (ASIA/OCE). Native (NAT) individuals were defined as those originating from the reporting country. CD4 cell counts were modelled using piecewise linear mixed-effects models with two slopes, whereas models to estimate subdistribution hazard ratios (sHRs) were used for time to virological response (VR) (i.e. time from cART initiation to the first of two successive HIV RNA measurements response to cART in Western Europe varies by GO and sex of patients. ART benefits are not equal for all, underlining the point that efforts need to prioritize those most in need. © 2017 British HIV Association.

  18. Prediction value of serum HBV large surface protein in different phases of HBV infection and virological response of chronic hepatitis B patients.

    Science.gov (United States)

    Liu, Can; Wu, Wennan; Shang, Hongyan; Lin, Sheng; Xun, Zhen; Huang, Er; Lin, Jinpiao; Yang, Bin; Ou, Qishui

    2018-06-01

    Serum HBV large surface protein (HBV-LP) is an envelope protein that has a close relationship with HBV DNA level. This study is to explore the prediction value of HBV-LP in different phase of HBV infection and during antiviral therapy in chronic hepatitis B (CHB) patients. A retrospective study was conducted in 2033 individuals, which included 1677 HBV infected patients in different phases and 356 healthy controls. HBV-LP, HBV serum markers and HBV DNA were detected by ELISA, CMIA and qRT-PCR, respectively. 85 CHB patients receiving PegIFNα or ETV were divided into virological response (VR) and partial virological response (PVR). The dynamic changes of HBV DNA and HBV-LP were observed. The level of HBV-LP in 2033 individuals was shown as: HBeAg-positive hepatitis > HBeAg-positive infection > HBeAg-negative hepatitis > HBeAg-negative infection > healthy controls. HBV-LP was positive in all patients whose HBV DNA > 1.0E + 06 IU/ml. When HBsAg was 1000 IU/ml, HBV DNAs were all negative if HBV-LP HBV-LP with HBV DNA was 100% in case of HBV-LP > 4.0 S/CO in HBeAg-positive patients and HBV-LP > 2.0 S/CO in HBeAg-negative ones. During antiviral therapy, baseline HBV-LP was lower in VR patients than that in PVR patients. The optimal cut-off points to predict VR by baseline HBV-LP were 32.4 and 28.6 S/CO for HBeAg-positive and HBeAg-negative hepatitis patients, respectively. HBV-LP may be a useful marker for distinguishing the different phases of HBV infection. Moreover, baseline HBV-LP level can be used for predicting VR of CHB patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Virological response and resistance among HIV-infected children receiving long-term antiretroviral therapy without virological monitoring in Uganda and Zimbabwe: Observational analyses within the randomised ARROW trial.

    Directory of Open Access Journals (Sweden)

    Alexander J Szubert

    2017-11-01

    receiving first-line ART in sub-Saharan Africa without real-time VL monitoring had good virological and resistance outcomes over 4 years, regardless of CD4 monitoring strategy. Many children with detectable low-level viraemia spontaneously resuppressed, highlighting the importance of confirming virological failure before switching to second-line therapy. Children experiencing rebound ≥5,000 copies/ml were much less likely to resuppress, but NRTI resistance increased only slowly. These results are relevant to the increasing numbers of HIV-infected children receiving first-line ART in sub-Saharan Africa with limited access to virological monitoring.ISRCTN Registry, ISRCTN24791884.

  20. Mucosal immunology and virology

    National Research Council Canada - National Science Library

    Tyring, Stephen

    2006-01-01

    .... A third chapter focuses on the proximal end of the gastrointestinal tract (i.e. the oral cavity). The mucosal immunology and virology of the distal end of the gastrointestinal tract is covered in the chapter on the anogenital mucosa. Mucosa-associated lymphoid tissue (MALT) plays a role in protection against all viral (and other) infections except those that enter the body via a bite (e.g. yellow fever or dengue from a mosquito or rabies from a dog) or an injection or transfusion (e.g. HIV, Hepatitis B). ...

  1. Evaluation of the genotypic prediction of HIV-1 coreceptor use versus a phenotypic assay and correlation with the virological response to maraviroc: the ANRS GenoTropism study.

    Science.gov (United States)

    Recordon-Pinson, Patricia; Soulié, Cathia; Flandre, Philippe; Descamps, Diane; Lazrek, Mouna; Charpentier, Charlotte; Montes, Brigitte; Trabaud, Mary-Anne; Cottalorda, Jacqueline; Schneider, Véronique; Morand-Joubert, Laurence; Tamalet, Catherine; Desbois, Delphine; Macé, Muriel; Ferré, Virginie; Vabret, Astrid; Ruffault, Annick; Pallier, Coralie; Raymond, Stéphanie; Izopet, Jacques; Reynes, Jacques; Marcelin, Anne-Geneviève; Masquelier, Bernard

    2010-08-01

    Genotypic algorithms for prediction of HIV-1 coreceptor usage need to be evaluated in a clinical setting. We aimed at studying (i) the correlation of genotypic prediction of coreceptor use in comparison with a phenotypic assay and (ii) the relationship between genotypic prediction of coreceptor use at baseline and the virological response (VR) to a therapy including maraviroc (MVC). Antiretroviral-experienced patients were included in the MVC Expanded Access Program if they had an R5 screening result with Trofile (Monogram Biosciences). V3 loop sequences were determined at screening, and coreceptor use was predicted using 13 genotypic algorithms or combinations of algorithms. Genotypic predictions were compared to Trofile; dual or mixed (D/M) variants were considered as X4 variants. Both genotypic and phenotypic results were obtained for 189 patients at screening, with 54 isolates scored as X4 or D/M and 135 scored as R5 with Trofile. The highest sensitivity (59.3%) for detection of X4 was obtained with the Geno2pheno algorithm, with a false-positive rate set up at 10% (Geno2pheno10). In the 112 patients receiving MVC, a plasma viral RNA load of <50 copies/ml was obtained in 68% of cases at month 6. In multivariate analysis, the prediction of the X4 genotype at baseline with the Geno2pheno10 algorithm including baseline viral load and CD4 nadir was independently associated with a worse VR at months 1 and 3. The baseline weighted genotypic sensitivity score was associated with VR at month 6. There were strong arguments in favor of using genotypic coreceptor use assays for determining which patients would respond to CCR5 antagonist.

  2. Sustaining responsible tourism – The case of Kerala.

    OpenAIRE

    Kokkranikal, Jithendran; Chettiparamb, Angelique

    2015-01-01

    Responsible tourism is a concept that overlaps significantly with concepts of sustainable tourism, ethical tourism, pro-poor tourism and integrated tourism (Chettiparamb and Kokkranikal, 2012). Responsible tourism emphasises the role of businesses in achieving sustainability and can be seen as yet another concept within the sustainable tourism genre, which comprises many forms of tourism such as ecotourism, ethical tourism, alternative tourism, green tourism, soft tourism, etc. Responsible to...

  3. Practices of corporate social responsibility and sustainable systems work in Peruvian companies issuing sustainability reports

    OpenAIRE

    Prialé, María Angela; Fuchs, Rosa María; Sáenz, Manuel

    2014-01-01

    Through a literature review, this exploratory study seeks to determine whether the practices related to its colaborators, who report as part of its action responsible Peruvian companies issuing sustainability reports can be considered sustainable management practices of human resources. To this end, it was used the approach of sustainable work systems as a general approach. It was found that some of the practices of responsible management of human resources that implement the analyzed compani...

  4. Novel use of surveillance data to detect HIV-infected persons with sustained high viral load and durable virologic suppression in New York City.

    Directory of Open Access Journals (Sweden)

    Arpi S Terzian

    Full Text Available Monitoring of the uptake and efficacy of ART in a population often relies on cross-sectional data, providing limited information that could be used to design specific targeted intervention programs. Using repeated measures of viral load (VL surveillance data, we aimed to estimate and characterize the proportion of persons living with HIV/AIDS (PLWHA in New York City (NYC with sustained high VL (SHVL and durably suppressed VL (DSVL.Retrospective cohort study of all persons reported to the NYC HIV Surveillance Registry who were alive and ≥12 years old by the end of 2005 and who had ≥2 VL tests in 2006 and 2007. SHVL and DSVL were defined as PLWHA with 2 consecutive VLs ≥100,000 copies/mL and PLWHA with all VLs ≤400 copies/mL, respectively. Logistic regression models using generalized estimating equations were used to model the association between SHVL and covariates. There were 56,836 PLWHA, of whom 7% had SHVL and 38% had DSVL. Compared to those without SHVL, persons with SHVL were more likely to be younger, black and have injection drug use (IDU risk. PLWHA with SHVL were more likely to die by 2007 and be younger by nearly ten years, on average.Nearly 60% of PLWHA in 2005 had multiple VLs, of whom almost 40% had DSVL, suggesting successful ART uptake. A small proportion had SHVL, representing groups known to have suboptimal engagement in care. This group should be targeted for additional outreach to reduce morbidity and secondary transmission. Measures based on longitudinal analyses of surveillance data in conjunction with cross-sectional measures such as community viral load represent more precise and powerful tools for monitoring ART effectiveness and potential impact on disease transmission than cross-sectional measures alone.

  5. THE STRATEGIC IMPORTANCE OF CORPORATE RESPONSIBILITY AND SUSTAINABILITY IN BANKING

    Directory of Open Access Journals (Sweden)

    DRĂGAN (SÂNTĂMARIAN OANA RALUCA

    2013-02-01

    Full Text Available The paper aims to highlight the strategic implication of corporate social responsibility (CSR and sustainable development for the banking sector. A few years ago, banks did not give much importance to the social and environmental problems. 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 banking system. In this context, the development of a bank management system based on sustainable principles is one of the current challenges. For this purpose this paper focuses on issues such as the importance and advantages of implementing sustainability bank management, international standards regarding sustainable banking management such as: Equator Principles for sustainable investment projects’ financing or GRI principles for sustainable reporting. In addition, we have developed a practical case study about the implementation of sustainable banking management; the case study presents Romanian Commercial Bank as an example of good practice in the Romanian banking sector.

  6. Responsible Purchasing Network - Sustainable Purchasing Guidance Profile

    Science.gov (United States)

    To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

  7. Practices of corporate social responsibility and sustainable systems work in Peruvian companies issuing sustainability reports

    Directory of Open Access Journals (Sweden)

    María Angela Prialé

    2015-12-01

    Full Text Available Through a literature review, this exploratory study seeks to determine whether the practices related to its colaborators, who report as part of its action responsible Peruvian companies issuing sustainability reports can be considered sustainable management practices of human resources. To this end, it was used the approach of sustainable work systems as a general approach. It was found that some of the practices of responsible management of human resources that implement the analyzed companies address the human dimensions of sustainability, although not all dimensions are considered equally or similar depth.

  8. Consumer Sustainability and Responsibility: Beyond Green and Ethical Consumption

    Directory of Open Access Journals (Sweden)

    Maja Hosta

    2016-12-01

    Full Text Available Purpose – Most literature regarding sustainable behavior is based on the assumption that the reduction of consumption is inherently positive (mainly in the form of positive environmental consequences and based on ethical considerations. However, the issue of the social consequences of this reduction and self-interested intentions in consumption is not generally open to debate. This paper aims to identify dimensions of sustainable and responsible consumer behavior, distinguish between the two concepts, and present consumer obstacles to acting responsibly in all aspects that a sustainability agenda would suggest. Design/Methodology/Approach – The paper includes a literature review, proposes a framework of responsible and sustainable consumption (RSCB, and offers a set of propositions to achieve responsible and sustainable consumption. Insights from personal interviews with consumers are added for the sake of additional understanding of the concepts presented. Findings and implications – Through the RSCB framework, we show the potential trade-off decisions consumers have to make in order to implement sustainability and responsibility issues in everyday consumer decision processes. Struggles between doing what is good for them and what is good for the environment and society could be a reason why consumers have difficulties achieving responsible and sustainable consumption. Limitations – Qualitative study based on a small sample of personal interviews does not allow for generalizations. Originality – A research gap in understanding the dimensions of sustainable and responsible consumer actions in terms of their emphasis (environmental and social and intentions (self-interest and other-interest is addressed. By understanding those two dimensions of behavior, managers and consumers can resolve consumer sustainability and responsibility dilemmas that arise from a one-dimensional view in order to move sustainability research and practice

  9. Sustainable Logistics Responses to a Global Challenge

    CERN Document Server

    Bretzke, Wolf-Rüdiger

    2013-01-01

    Currently the notion of "sustainability" is used in an inflationary manner. Therefore the authors start with a definition which is stable to serve as an anchor for further research as well as for discussions among scientists, managers and politicians, ideally across different disciplines. The character of this book is purely conceptual. The argumentation is based on comparison of new and demanding requisites with existing models (process and network architectures in the field of logistics). Formerly neglected impacts on the environment will be included. Main features of a new approach will be developed which are capable to avoid these impacts and to align logistics with the requirements of sustainability. In order to make logistics sustainable large parts will have to be reinvented. The focus needs to be on decoupling transportation activities from economic growth rates.

  10. Corporate Social Responsibility and Sustainability: Tourist Enterprises of Cantabria

    OpenAIRE

    Garrido Palacio, Fernando

    2011-01-01

    Currently, corporate social responsibility is seen as a factor to take into account for the sustainable development of the enterprises. This research provides an approach on this matter, defining the socially responsible activities developed in the tourism industry through sustainable development theory and stakeholder's theory. This study is made on a qualitative research methodology, based on case study. The analysis shows that corporate social responsibility is a multidimensional const...

  11. Corporate Social Responsibility and Sustainability in Scandinavia

    DEFF Research Database (Denmark)

    Strand, Robert; Freeman, R. Edward; Hockerts, Kai

    2015-01-01

    Scandinavia including the claim that the recent concept of “creating shared value” has Scandinavian origins, institutional and cultural factors that encourage strong CSR and sustainability performances, and the recent phenomenon of movement from implicit to explicit CSR in a Scandinavian context and what...

  12. Virological responses to lamivudine or emtricitabine when combined with tenofovir and a protease inhibitor in treatment-naïve HIV-1-infected patients in the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort.

    Science.gov (United States)

    Rokx, C; Gras, L; van de Vijver, Damc; Verbon, A; Rijnders, Bja

    2016-09-01

    Lamivudine (3TC) and emtricitabine (FTC) are considered interchangeable in recommended tenofovir disoproxil-fumarate (TDF)-containing combination antiretroviral therapies (cARTs). This statement of equivalence has not been systematically studied. We compared the treatment responses to 3TC and FTC combined with TDF in boosted protease inhibitor (PI)-based cART for HIV-1-infected patients. An observational study in the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort was carried out between 2002 and 2013. Virological failure rates, time to HIV RNA suppression treatment failure were analysed using multivariable logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. A total of 1582 ART-naïve HIV-1-infected patients initiated 3TC or FTC with TDF and ritonavir-boosted darunavir (29.6%), atazanavir (41.5%), lopinavir (27.1%) or another PI (1.8%). Week 48 virological failure rates on 3TC and FTC were comparable (8.9% and 5.6%, respectively; P = 0.208). The multivariable adjusted odds ratio of virological failure when using 3TC instead of FTC with TDF in PI-based cART was 0.75 [95% confidence interval (CI) 0.32-1.79; P = 0.51]. Propensity score-adjusted models showed comparable results. The adjusted hazard ratio (HR) for treatment failure of 3TC compared with FTC was 1.15 (95% CI 0.58-2.27) within 240 weeks after cART initiation. The time to two consecutive HIV RNA measurements treatment failure after suppression treatment-naïve HIV-1-infected patients starting either 3TC/TDF or FTC/TDF and a ritonavir-boosted PI. © 2016 British HIV Association.

  13. Sustainable Development and Corporate Social Responsibility: Linking Goals to Standards

    Directory of Open Access Journals (Sweden)

    Radostina Bakardjieva

    2016-12-01

    Full Text Available Corporate social responsibility (CSR is the core of sustainable development of companies. On one hand, the corporate social responsibility of companies is a prerequisite for sustainable business, on the other - sustainable development sets specific requirements for the development of businesses in the context of increasing requirements to the degree of quality and reliability of financial information. In recent years, sustainable development has become a strategic issue for companies and this trend applies to Bulgarian companies too. Development of non-financial reporting is a very dynamic process, whose peak is the establishment of an integrated system of accountability. Current paper makes analyses of advantages of CSR linking it to the implementation of sustainable development goals through the integrated reporting following the requirements of the standards of the Global Reporting Initiative (GRI.

  14. Prevalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in HIV-infected children - a EuroCoord-CHAIN-EPPICC joint project

    DEFF Research Database (Denmark)

    Ngo-Giang-Huong, Nicole; Wittkop, Linda; Judd, Ali

    2016-01-01

    BACKGROUND: Few studies have evaluated the impact of pre-treatment drug resistance (PDR) on response to combination antiretroviral treatment (cART) in children. The objective of this joint EuroCoord-CHAIN-EPPICC/PENTA project was to assess the prevalence of PDR mutations and their association...... algorithm to infer resistance to prescribed drugs. Time to virological failure (VF) was defined as the first of two consecutive HIV-RNA > 500 copies/mL after 6 months cART and was assessed by Cox proportional hazards models. All models were adjusted for baseline demographic, clinical, immunology.......7-5.7). Of 37 children (7.8 %, 95 % confidence interval (CI), 5.5-10.6) harboring a virus with ≥1 PDR mutations, 30 children had a virus resistant to ≥1 of the prescribed drugs. Overall, the cumulative Kaplan-Meier estimate for virological failure was 19.8 % (95 %CI, 16.4-23.9). Cumulative risk for VF tended...

  15. Sustainable and responsible supply chain governance: challenges and opportunities

    NARCIS (Netherlands)

    Boström, M.; Jönsson, A.M.; Lockie, S.; Mol, A.P.J.; Oosterveer, P.J.M.

    2015-01-01

    This paper introduces the Special Volume on sustainable and responsible supply chain governance. As globalized supply chains cross multiple regulatory borders, the firms involved in these chains come under increasing pressure from consumers, NGOs and governments to accept responsibility for social

  16. Hospitableness and sustainable development: New responsibilities ...

    African Journals Online (AJOL)

    the environmental and social aspects in day-to-day business ... responsibility of the host, in which the host not only takes care of the actual guest, but does so in a more ..... implementation of this into hospitality service skills will provide.

  17. Corporate Social Responsibility and Sustainability in Danish Public Procurement

    DEFF Research Database (Denmark)

    Andrecka, Marta

    2017-01-01

    understand the continuously developing concepts of SPP, as well as to identify the drivers and barriers that promote or hinder its further implementation. This article firstly deals with the relationship between the concepts of sustainability, Corporate Social Responsibility (CSR) and public procurement....... Secondly, as Denmark has been known as a pioneer in sustainable development, including implementation of it in public purchasing this article focuses on recent developments in the areas of CSR and sustainable public procurement in Denmark, and analyses relevant Danish Public Procurement Complaints Board...

  18. What does sustainability mean in the HIV and AIDS response?

    Science.gov (United States)

    Oberth, Gemma; Whiteside, Alan

    2016-01-01

    Immense progress has been made in the fight against HIV and AIDS. Achieving and exceeding the AIDS targets for the Millennium Development Goals (MDGs) was accomplished, in large part, due to an unprecedented financial investment from the international community. Following an $800 million dip in donor disbursements in 2010, the discourse has since shifted to the need for greater sustainability of funding. But what does sustainability mean? Current efforts focus heavily on fiscal imperatives such as increasing domestic funding. This is important - needs are increasing at a faster rate than donor funding, especially with increased treatment coverage. The problem is that measures of financial sustainability tell very little about the actual sustainability of specific programmes, disease trajectories or enabling environments. Recognising that current definitions of sustainability lack clarity and depth, we offer a new six-tenet conceptualisation of what sustainability means in the HIV and AIDS response: (1) financial, (2) epidemiological, (3) political, (4) structural, (5) programmatic, and (6) human rights. Based on these, we examine examples of donor transitions for their approach to sustainability, including PEPFAR in South Africa, the Global Fund in Eastern Europe, and the Bill and Melinda Gates Foundation in India (Avahan). We conclude that sustainability must be understood within a broader framework beyond funding stability. We also recommend that certain interventions, such as programming for key populations, may have to continue to receive external support even if affected countries can afford to pay.

  19. From Corporate Social Responsibility to Corporate Sustainability: Features of Financing Sustainable Development

    Directory of Open Access Journals (Sweden)

    Vasylchuk Irуna P.

    2018-03-01

    Full Text Available The theoretical basis of the concepts of corporate social responsibility and sustainable development are studied. It is revealed that scientists mainly distinguish two main stages in the evolution of the concept of corporate social responsibility. There argued the expediency of singling out the third stage of the development of the concept (version CSR 2.0, which is characterized by the integration of the theoretical and practical foundations of the concepts of CSR and sustainable development as well as by their implementation into activities of corporations. The presence of the necessary prerequisites for singling out the new stage in the evolution of these concepts (version CSR 3.0, which is based on the provisions of the collaborative theory and provides for the cooperation of social enterprises and sustainable corporations in achieving the goals of sustainable development, is revealed, its expediency is justified. The determinant of the stage is the use of opportunities for sustainable development, the dominant is the social orientation, and its content is characterized by the slogan “doing common good to do common well”. Using generalization, there identified the features of the established models of sustainable development of corporations by key aspects (goals, principles, methods. On this basis, the features of approaches to financing sustainable development at the macro and micro levels are determined, and the principles for financing the activities of corporations in the new conditions are defined. It is concluded that achieving sustainability requires an effective system of financing corporate measures aimed at sustainable development, for the creation of which in Ukraine it is necessary to use the experience of “best practices” at the national, local and corporate levels.

  20. WHERE DOES CORPORATE SOCIAL RESPONSIBILITY STAND IN RELATION TO SUSTAINABILITY?

    Directory of Open Access Journals (Sweden)

    Nancy Diana Panta

    2018-03-01

    Full Text Available The business competitive landscape of today is shaped by new challenges. In order to outperform their peers, companies seek to seize opportunities and manage the risks associated with the challenges that arise. To this adds the pressure of societies on organizations to be more transparent, ethical and responsible. Corporate Social Responsibility (CSR and sustainability come in response to this increasing demand of societies by being a pivotal tool in the business area. Organizations of the 21st century can no longer ignore CSR and sustainability and should follow the steps of integrating them across all departments as part of their strategic policy. Sustainable organizations are required to direct their interest beyond the economical factor and extend their goals towards environmental and social aspects. By integrating environmental and social concerns in the daily operations of a company, new models of doing business emerge and a synergy with various stakeholder groups takes place. Although a significant amount of attention has been headed towards the conceptualisation of CSR and sustainability, they both remain contested concepts. Therefore, the present paper depicts the effort to follow the emergence and conceptualization of CSR and sustainability from their origins, to introduce the changing meaning of CSR and to bridge the gap between the two concepts. Through literature review, the paper will provide relevant theoretical underpinnings that link CSR and sustainability.

  1. Corporate Sustainable Development Assessment Base on the Corporate Social Responsibility

    OpenAIRE

    Sun Mei; Nagata Katsuya; Onoda Hiroshi

    2011-01-01

    With the resource exhaustion, bad affections of human activities and the awakening of the human rights, the corporate social responsibility became popular corporate strategy achieving sustainable development of both corporation and society. The issue of Guideline of Chinese Corporate Social Responsibility Report promotes greatly corporation to take social responsibility. This paper built the index system according to this guideline and takes the textile industry as an exa...

  2. Value Creation in the Context of Sustainable Corporate Social Responsibility

    Science.gov (United States)

    Šmida, Ľubomír; Sakál, Peter

    2014-12-01

    Under the influence of the new rules of the economy and the society, companies are achieving a notional line of a necessary change in the approach to creating new value, wealth. Implementation of changes in the system of wealth creation requires a review of existing assumptions of unlimited growth of the global economy and wealth creation in the environment accepting economic interests, society and the environment as a holistic unit. The main purpose of this paper is the clarification of a new requirements for business, presentation of the questionnaire survey Sustainable Corporate Social Responsibility and inform on value creation in the context of Sustainable Corporate Social Responsibility.

  3. Value Creation in the Context of Sustainable Corporate Social Responsibility

    Directory of Open Access Journals (Sweden)

    Šmida Ľubomír

    2014-12-01

    Full Text Available Under the influence of the new rules of the economy and the society, companies are achieving a notional line of a necessary change in the approach to creating new value, wealth. Implementation of changes in the system of wealth creation requires a review of existing assumptions of unlimited growth of the global economy and wealth creation in the environment accepting economic interests, society and the environment as a holistic unit. The main purpose of this paper is the clarification of a new requirements for business, presentation of the questionnaire survey Sustainable Corporate Social Responsibility and inform on value creation in the context of Sustainable Corporate Social Responsibility.

  4. SUSTAINABILITY AS A STRATEGY OF RESPONSIBLE AND COMPETITIVE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    José G. Vargas-Hernández

    2012-12-01

    Full Text Available The aim of this paper is to analyze a competitiveness strategy based on sustainability to lead the way to a model of responsible and competitive development. The analysis takes as its starting point the assumption that the maturity of a sustainable business strategy positively affects competitiveness. The used method is the critical analysis. Among other results of this analysis concludes that the current business strategy seeks a system ecologically appropriate, economically viable and socially fair to reach sustainable equilibrium. This strategy based on sustainability must be promoted by the institutions and strengthened by the capabilities and resources that each company counts on to develop advantages to foster the overall development and achieve the maximization of benefits from the tangible and intangible perspectives

  5. Durability of virologic response, risk of de novo hepatocellular carcinoma, liver function and stiffness two years after treatment with Ombitasvir/Paritaprevir/Ritonavir ±Dasabuvir ±Ribavirin in the AMBER, real-world experience study.

    Science.gov (United States)

    Flisiak, Robert; Janczewska, Ewa; Łucejko, Mariusz; Karpińska, Ewa; Zarębska-Michaluk, Dorota; Nazzal, Khalil; Bolewska, Beata; Białkowska, Jolanta; Berak, Hanna; Fleischer-Stępniewska, Katarzyna; Tomasiewicz, Krzysztof; Karwowska, Kornelia; Simon, Krzysztof; Piekarska, Anna; Tronina, Olga; Tuchendler, Ewelina; Garlicki, Aleksander

    2018-06-11

    We followed for 2 years patients treated with Direct Acting Agents (DAA) to assess long-term durability of virologic response, improvement of liver function, reduction of liver stiffness (LS), and risk of hepatocellular carcinoma (HCC).The study included patients from 16 hepatologic centers involved in the AMBER, investigators initiated study on treatment of chronic hepatitis C patients within a programme preceding EU registration of Ombitasvir/Paritaprevir/ritonavir±Dasabuvir±Ribavirin. A total of 204 patients among 209 from the primary study were enrolled; 200 with available testing at 2 years follow-up (2yFU) with undetectable HCV RNA (198 responders and 2 non-responders retreated). During 2yFU 4 patients died, 17 had hepatic decompensation and 3 needed liver transplantation. De novo hepatocellular carcinoma was diagnosed in 4 and its recurrence in 3 patients. Significant decreases in bilirubin, MELD, Child-Pugh scores and liver stiffness, and increases in albumin level were observed during 2yFU. Strengths of the study were a fixed period of post treatment follow-up, prospective character of the study and high proportion of available patients from the primary study. The major weaknesses was lack of a comparative arm and relatively insufficient number of patients for subsets analysis. In conclusion, two-years follow-up confirmed durability of virologic response after treatment of HCV infection with Ombitasvir/Paritaprevir/ritonavir±Dasabuvir±Ribavirin. It was accompanied by significant improvement of major measures of hepatic function and reduction of hepatic stiffness. Successful therapy did not prevent hepatic decompensation, HCC or death in cirrhotics, that support the need for longer than 2-year monitoring for possible disease progression. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Genetic variants in the apoptosis gene BCL2L1 improve response to interferon-based treatment of hepatitis C virus genotype 3 infection

    DEFF Research Database (Denmark)

    Clausen, Louise Nygaard; Weis, Nina; Ladelund, Steen

    2015-01-01

    Genetic variation upstream of the apoptosis pathway has been associated with outcome of hepatitis C virus (HCV) infection. We investigated genetic polymorphisms in the intrinsic apoptosis pathway to assess their influence on sustained virological response (SVR) to pegylated interferon-α and ribav......Genetic variation upstream of the apoptosis pathway has been associated with outcome of hepatitis C virus (HCV) infection. We investigated genetic polymorphisms in the intrinsic apoptosis pathway to assess their influence on sustained virological response (SVR) to pegylated interferon...

  7. Lesion Neuroanatomy of the Sustained Attention to Response Task

    Science.gov (United States)

    Molenberghs, Pascal; Gillebert, Celine R.; Schoofs, Hanne; Dupont, Patrick; Peeters, Ronald; Vandenberghe, Rik

    2009-01-01

    The Sustained Attention to Response task is a classical neuropsychological test that has been used by many centres to characterize the attentional deficits in traumatic brain injury, ADHD, autism and other disorders. During the SART a random series of digits 1-9 is presented repeatedly and subjects have to respond to each digit (go trial) except…

  8. Responsible and Sustainable Tourism : Strengthening Small-Scale ...

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

    Responsible and Sustainable Tourism : Strengthening Small-Scale ... to work with the Costa Rican association of small and medium tourism enterprises of the ... as the hub of a network of small service providers operating within the model. ... marketing and outreach, distance learning, and the integration of services that are ...

  9. A Collaborative Programme in Sustainability and Social Responsibility

    Science.gov (United States)

    Albareda Tiana, Silvia; Alférez Villarreal, Azul

    2016-01-01

    Purpose: The purpose of this paper is to collect methodological strategies used in the training of future teachers to develop competences in sustainability and social responsibility (SSR). The proposal in this paper is to show how students learn and develop competences by performing practical activities and through a collaborative experience,…

  10. Mapping of the US Domestic Influenza Virologic Surveillance Landscape.

    Science.gov (United States)

    Jester, Barbara; Schwerzmann, Joy; Mustaquim, Desiree; Aden, Tricia; Brammer, Lynnette; Humes, Rosemary; Shult, Pete; Shahangian, Shahram; Gubareva, Larisa; Xu, Xiyan; Miller, Joseph; Jernigan, Daniel

    2018-07-17

    Influenza virologic surveillance is critical each season for tracking influenza circulation, following trends in antiviral drug resistance, detecting novel influenza infections in humans, and selecting viruses for use in annual seasonal vaccine production. We developed a framework and process map for characterizing the landscape of US influenza virologic surveillance into 5 tiers of influenza testing: outpatient settings (tier 1), inpatient settings and commercial laboratories (tier 2), state public health laboratories (tier 3), National Influenza Reference Center laboratories (tier 4), and Centers for Disease Control and Prevention laboratories (tier 5). During the 2015-16 season, the numbers of influenza tests directly contributing to virologic surveillance were 804,000 in tiers 1 and 2; 78,000 in tier 3; 2,800 in tier 4; and 3,400 in tier 5. With the release of the 2017 US Pandemic Influenza Plan, the proposed framework will support public health officials in modeling, surveillance, and pandemic planning and response.

  11. Molecular virology of feline calicivirus.

    Science.gov (United States)

    Pesavento, Patricia A; Chang, Kyeong-Ok; Parker, John S L

    2008-07-01

    Caliciviridae are small, nonenveloped, positive-stranded RNA viruses. Much of our understanding of the molecular biology of the caliciviruses has come from the study of the naturally occurring animal caliciviruses. In particular, many studies have focused on the molecular virology of feline calicivirus (FCV), which reflects its importance as a natural pathogen of cats. FCVs demonstrate a remarkable capacity for high genetic, antigenic, and clinical diversity; "outbreak" vaccine resistant strains occur frequently. This article updates the reader on the current status of clinical behavior and pathogenesis of FCV.

  12. Sustainability.

    Science.gov (United States)

    Chang, Chein-Chi; DiGiovanni, Kimberly; Mei, Ying; Wei, Li

    2016-10-01

    This review on Sustainability covers selected 2015 publications on the focus of Sustainability. It is divided into the following sections : • Sustainable water and wastewater utilities • Sustainable water resources management • Stormwater and green infrastructure • Sustainability in wastewater treatment • Life cycle assessment (LCA) applications • Sustainability and energy in wastewater industry, • Sustainability and asset management.

  13. Role of IL-28B polymorphisms in virologic response to combined pegylated interferon and ribavirin therapy in genotype 4 chronic HCV infected patients with and without cirrhosis

    Directory of Open Access Journals (Sweden)

    Amira Youssef Shaala

    2015-09-01

    Conclusion: In Egypt, where chronic HCV genotype 4 and schistosoma coinfection predominate, both schistosoma infection and cirrhosis are more potent than IL28B polymorphisms as strong baseline negative predictors of hepatitis C treatment response.

  14. Detecting virological failure in HIVinfected Tanzanian children ...

    African Journals Online (AJOL)

    Background. The performance of clinical and immunological criteria to predict virological failure in HIV-infected children receiving antiretroviral therapy (ART) is not well documented. Objective. To determine the validity of clinical and immunological monitoring in detecting virological failure in children on ART. Methods.

  15. Efficient Customer Selection for Sustainable Demand Response in Smart Grids

    Energy Technology Data Exchange (ETDEWEB)

    Zois, Vasileios; Frincu, Marc; Chelmis, Charalambos; Saeed, Muhammad Rizwan; Prasanna, Viktor K.

    2014-11-03

    Regulating the power consumption to avoid peaks in demand is a common practice. Demand Response(DR) is being used by utility providers to minimize costs or ensure system reliability. Although it has been used extensively there is a shortage of solutions dealing with dynamic DR. Past attempts focus on minimizing the load demand without considering the sustainability of the reduced energy. In this paper an efficient algorithm is presented which solves the problem of dynamic DR scheduling. Data from the USC campus micro grid were used to evaluate the efficiency as well as the robustness of the proposed solution. The targeted energy reduction is achieved with a maximum average approximation error of ≈ 0.7%. Sustainability of the reduced energy is achieved with respect to the optimal available solution providing a maximum average error less than 0.6%. It is also shown that a solution is provided with a low computational cost fulfilling the requirements of dynamic DR.

  16. Sustainability Ethics Emergency and Media Responsibility in the Consumption Society

    Directory of Open Access Journals (Sweden)

    Rogério Bianchi de Araujo

    2008-08-01

    Full Text Available In this article, it is discussed the sustainable development and the importance of the environmental cause, in order to create models of development that consider the sustainability and environmental preservation for the future generations. The participation of all society is essential in this debate. The establishment of new habits that do not compromise the subsistence and the conscience of the real self-destruction possibility must be studied and analysed; they consist in challenging intentions, which detach the relevance and the moral duty of the media to restore a new ethics and a new way to understand the reality, as well as to divulge the impact of this different perception in the human life. Therefore occurs the requirement of a responsible compromise relating to the development, by way of understanding the biosphere as the social life basis, considering that, in these ecosystems, the human being is only one of the many species that live in an interdependence relationship.

  17. Immunological and virological response to antiretroviral treatment in migrant and native men and women in Western Europe; is benefit equal for all?

    DEFF Research Database (Denmark)

    Obel, Niels; Kirk, Ole

    2018-01-01

    OBJECTIVES: The aim of the study was to evaluate differences in immunovirological response to combination antiretroviral therapy (cART) in migrant and native men and women within a European collaboration of HIV cohorts Collaboration of Observational HIV Epidemiological Research in Europ (COHERE) ...

  18. Immunological and virological response to antiretroviral treatment in migrant and native men and women in Western Europe; is benefit equal for all?

    NARCIS (Netherlands)

    Monge, S.; Mocroft, A.; Sabin, A.; Touloumi, G.; Sighem, A.; Abgrall, S.; Dray-Spira, R.; Spire, B.; Castagna, A.; Mussini, C.; Zangerle, R.; Hessamfar, M.; Anderson, J.; Hamouda, O.; Ehren, K.; Obel, N.; Kirk, O.; Antinori, A.; Girardi, E.; Saracino, A.; Calmy, A.; Wit, S.; Wittkop, L.; Bucher, C.; Montoliu, A.; Raben, D.; Prins, M. [= Maria; Meyer, L.; Chene, G.; Burns, F.; Amo, J.; Judd, Ali; Zangerle, Robert; Touloumi, Giota; Warszawski, Josiane; Meyer, Laurence; Dabis, François; Krause, Murielle; Ghosn, Jade; Leport, Catherine; Wittkop, Linda; Reiss, Peter; Wit, Ferdinand; Bucher, Heiner; Gibb, Diana; Fätkenheuer, Gerd; Amo, Julia; Obel, Niels; Thorne, Claire; Mocroft, Amanda

    2018-01-01

    The aim of the study was to evaluate differences in immunovirological response to combination antiretroviral therapy (cART) in migrant and native men and women within a European collaboration of HIV cohorts Collaboration of Observational HIV Epidemiological Research in Europ (COHERE) in EuroCoord,

  19. SUSTAINABILITY AND COMPANY’S CORPORATE SOCIAL RESPONSIBILITY NEED

    Directory of Open Access Journals (Sweden)

    MONICA VIOLETA ACHIM

    2012-05-01

    Full Text Available The company is a living organism, is an entity and its analysis should be made taking into account the whole system. The company is a dynamic environment, which has as a mainly aims to add value for all participants in the economic life. In the organizations, the achievement of the concept of sustainable development is achieved through the concept of societal responsibility of the organizations. For this scope we need to use the term introduced by Elkington namely “The Triple Bottom Line” which involve economic prosperity, environmental compliance and improve social cohesion. [11]. So, “The Triple Bottom Line” can be defined as an approach for measuring the overall performance of an organization according to its triple contribution to the three aspects mentioned above. The new conceptual framework change radically the final aim of a company because it is not anymore maximizing the value of shares held by shareholders, but it is maximizing value for all stakeholders, where shareholders are just another category of stakeholders. Sustainable development and globalization require new performance standards that exceed the economic field, for both national company and international ones. As a consequence, these standards must be integrated into the company's development strategy, to ensure sustainability of activities carried, by the harmonization of economic, social and environmental objectives.

  20. Sustainable Eco Coastal Development Through Corporate Social Responsibility (CSR) Program

    Science.gov (United States)

    Rakhmanissazly, Arsi; Mursito Ardy, Yong; Abdullah

    2017-02-01

    Besides technical problems the company’s operational constraints that may effect high deficiency for the company is the company - community conflicts. Company - community conflict can also arise depends on the geographic conditions and characteristics of the community itself. Some studies has show that coastal community have higher level of social risk when compared to non-coastal community. Also, the coastal community ussually only rely on what sea provides as their main livelihood. Because of the level of education still contemtible the community couldn’t optimized the potential of their own area. Corporate Social Responsibility (CSR) har emerged as an important approach for addressing the social and environmental impact of company activities. Through CSR program, PT Pertamina EP Asset 3 Tambun Field (PEP) try to form value integration by utilizing resources from the community and the company by making sustainable eco - coastal living in Desa Tambaksari, Karawang, one of PEP working area. Using sustainable livelihood approach begin with compiling data by doing social mapping PEP has initiate the area to becoming Fish Processing Industry Centre. By implementing PDCA in every steps of the program, PEP has multiplied some other programs such as Organic Fish Feed Processing, Seaweed Farming and Waste Bank for Green Coastal Village. These program is PEP’s effort to create a sustainability environment by enhancing the community’s potentials as well as resolving social problems around Tambaksari. The most important result besides getting our license to operate from the community, is the community itself can grow into an eco coastal sustainable system.

  1. Integrated Platform for Automated Sustainable Demand Response in Smart Grids

    Energy Technology Data Exchange (ETDEWEB)

    Zois, Vassilis [Univ. of Southern California, Los Angeles, CA (United States). Dept. of Computer Science; Frincu, Marc [Univ. of Southern California, Los Angeles, CA (United States). Dept. of Electrical Engineering; Prasanna, Viktor K. [Univ. of Southern California, Los Angeles, CA (United States). Dept. of Electrical Engineering

    2014-10-08

    Demand Response(DR) is a common practice used by utility providers to regulate energy demand. It is used at periods of high demand to minimize the peak to average consumption ratio. Several methods have been Demand Response(DR) is a common praon using information about the baseline consumption and the consumption during DR. Our goal is to provide a sustainable reduction to ensure the elimination of peaks in demand. The proposed system includes an adaptation mechanism for when the provided solution does not meet the DR requirements. We conducted a series of experiments using consumption data from a real life micro grid to evaluate the efficiency as well as the robustness of our solution.

  2. Dietary Enterococcus faecium NCIMB 10415 and Zinc Oxide Stimulate Immune Reactions to Trivalent Influenza Vaccination in Pigs but Do Not Affect Virological Response upon Challenge Infection

    Science.gov (United States)

    Wang, Zhenya; Burwinkel, Michael; Chai, Weidong; Lange, Elke; Blohm, Ulrike; Breithaupt, Angele; Hoffmann, Bernd; Twardziok, Sven; Rieger, Juliane; Janczyk, Pawel; Pieper, Robert; Osterrieder, Nikolaus

    2014-01-01

    Swine influenza viruses (SIV) regularly cause significant disease in pigs worldwide. Since there is no causative treatment of SIV, we tested if probiotic Enterococcus (E.) faecium NCIMB 10415 or zinc (Zn) oxide as feed supplements provide beneficial effects upon SIV infection in piglets. Seventy-two weaned piglets were fed three different diets containing either E. faecium or different levels of Zn (2500 ppm, Znhigh; 50 ppm, Znlow). Half of the piglets were vaccinated intramuscularly (VAC) twice with an inactivated trivalent SIV vaccine, while all piglets were then infected intranasally with H3N2 SIV. Significantly higher weekly weight gains were observed in the E. faecium group before virus infection, and piglets in Znhigh and E. faecium groups gained weight after infection while those in the control group (Znlow) lost weight. Using ELISA, we found significantly higher H3N2-specific antibody levels in the E. faecium+VAC group 2 days before and at the day of challenge infection as well as at 4 and 6 days after challenge infection. Higher hemagglutination inhibition (HI) titers were also observed in the Znhigh+VAC and E. faecium+VAC groups at 0, 1 and 4 days after infection. However, there were no significant differences in virus shedding and lung lesions between the dietary groups. Using flow cytometry analysis significantly higher activated T helper cells and cytotoxic T lymphocyte percentages in the PBMCs were detected in the Znhigh and E. faecium groups at single time points after infection compared to the Znlow control group, but no prolonged effect was found. In the BAL cells no influence of dietary supplementation on immune cell percentages could be detected. Our results suggest that feeding high doses of zinc oxide and particularly E. faecium could beneficially influence humoral immune responses after vaccination and recovery from SIV infection, but not affect virus shedding and lung pathology. PMID:24489827

  3. Dietary Enterococcus faecium NCIMB 10415 and zinc oxide stimulate immune reactions to trivalent influenza vaccination in pigs but do not affect virological response upon challenge infection.

    Science.gov (United States)

    Wang, Zhenya; Burwinkel, Michael; Chai, Weidong; Lange, Elke; Blohm, Ulrike; Breithaupt, Angele; Hoffmann, Bernd; Twardziok, Sven; Rieger, Juliane; Janczyk, Pawel; Pieper, Robert; Osterrieder, Nikolaus

    2014-01-01

    Swine influenza viruses (SIV) regularly cause significant disease in pigs worldwide. Since there is no causative treatment of SIV, we tested if probiotic Enterococcus (E.) faecium NCIMB 10415 or zinc (Zn) oxide as feed supplements provide beneficial effects upon SIV infection in piglets. Seventy-two weaned piglets were fed three different diets containing either E. faecium or different levels of Zn (2500 ppm, Zn(high); 50 ppm, Zn(low)). Half of the piglets were vaccinated intramuscularly (VAC) twice with an inactivated trivalent SIV vaccine, while all piglets were then infected intranasally with H3N2 SIV. Significantly higher weekly weight gains were observed in the E. faecium group before virus infection, and piglets in Zn(high) and E. faecium groups gained weight after infection while those in the control group (Zn(low)) lost weight. Using ELISA, we found significantly higher H3N2-specific antibody levels in the E. faecium+VAC group 2 days before and at the day of challenge infection as well as at 4 and 6 days after challenge infection. Higher hemagglutination inhibition (HI) titers were also observed in the Zn(high)+VAC and E. faecium+VAC groups at 0, 1 and 4 days after infection. However, there were no significant differences in virus shedding and lung lesions between the dietary groups. Using flow cytometry analysis significantly higher activated T helper cells and cytotoxic T lymphocyte percentages in the PBMCs were detected in the Zn(high) and E. faecium groups at single time points after infection compared to the Zn(low) control group, but no prolonged effect was found. In the BAL cells no influence of dietary supplementation on immune cell percentages could be detected. Our results suggest that feeding high doses of zinc oxide and particularly E. faecium could beneficially influence humoral immune responses after vaccination and recovery from SIV infection, but not affect virus shedding and lung pathology.

  4. Dietary Enterococcus faecium NCIMB 10415 and zinc oxide stimulate immune reactions to trivalent influenza vaccination in pigs but do not affect virological response upon challenge infection.

    Directory of Open Access Journals (Sweden)

    Zhenya Wang

    Full Text Available Swine influenza viruses (SIV regularly cause significant disease in pigs worldwide. Since there is no causative treatment of SIV, we tested if probiotic Enterococcus (E. faecium NCIMB 10415 or zinc (Zn oxide as feed supplements provide beneficial effects upon SIV infection in piglets. Seventy-two weaned piglets were fed three different diets containing either E. faecium or different levels of Zn (2500 ppm, Zn(high; 50 ppm, Zn(low. Half of the piglets were vaccinated intramuscularly (VAC twice with an inactivated trivalent SIV vaccine, while all piglets were then infected intranasally with H3N2 SIV. Significantly higher weekly weight gains were observed in the E. faecium group before virus infection, and piglets in Zn(high and E. faecium groups gained weight after infection while those in the control group (Zn(low lost weight. Using ELISA, we found significantly higher H3N2-specific antibody levels in the E. faecium+VAC group 2 days before and at the day of challenge infection as well as at 4 and 6 days after challenge infection. Higher hemagglutination inhibition (HI titers were also observed in the Zn(high+VAC and E. faecium+VAC groups at 0, 1 and 4 days after infection. However, there were no significant differences in virus shedding and lung lesions between the dietary groups. Using flow cytometry analysis significantly higher activated T helper cells and cytotoxic T lymphocyte percentages in the PBMCs were detected in the Zn(high and E. faecium groups at single time points after infection compared to the Zn(low control group, but no prolonged effect was found. In the BAL cells no influence of dietary supplementation on immune cell percentages could be detected. Our results suggest that feeding high doses of zinc oxide and particularly E. faecium could beneficially influence humoral immune responses after vaccination and recovery from SIV infection, but not affect virus shedding and lung pathology.

  5. Finding our roots and celebrating our shoots: Plant virology in Virology, 1955-1964.

    Science.gov (United States)

    Scholthof, Karen-Beth G

    2015-05-01

    To celebrate the sixtieth anniversary of Virology a survey is made of the plant viruses, virologists and their institutions, and tools and technology described in the first decade of plant virus publications in Virology. This was a period when plant viruses increasingly became tools of discovery as epistemic objects and plant virology became a discipline discrete from plant pathology and other life sciences. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Sustainable Enterprise Excellence and the Continuously Relevant and Responsible Organization

    DEFF Research Database (Denmark)

    Edgeman, Rick; Bøllingtoft, Anne; Eskildsen, Jacob Kjær

    2013-01-01

    Innovation and sustainability are critical to the design, activities, results, and financial viability of organizations. These support one another, with “sustainable innovation” addressing economic sustainability, and “innovating for sustainability” addressing societal and environmental...... sustainability. Both sustainable innovation and innovation for sustainability have gained traction as partial means of confronting economic, environmental and societal challenges. Although garnering footholds is promising, the growth rate of these challenges has thus far exceeded trajectory, scale, and velocity...... issues surrounding enterprise innovation and sustainability efforts and capabilities. Innovation and sustainability of the necessary trajectory, scale, and velocity are strategically integrated to deliver what we refer to as innovating sustainability. This provides an accelerated means path toward...

  7. Impact of corporate social responsibility on sustainable enterprise development

    Directory of Open Access Journals (Sweden)

    Danubianu Mirela

    2017-06-01

    Top management endorsement and nomination of a complex CSR teamDeveloping formal company CSR policy documentsSelecting and engaging the company’s stakeholders as early as possible.Building a Project Advisory Board – useful in every modern managerial tool application should guide the progress toward CSR.An external facilitator would help solve internal conflicts.An audit of what CSR represents for the Company, what are the CSR options, e.g., promoting a “green company” profile, what would be the best impact of philanthropy and community volunteering, etc.Generate a CSR portfolio of actions, setting deadlines, responsibilities and allocating resources, establishing communication, reporting, monitoring and corrective proceduresupgrading the sustainable enterprise strategy.

  8. Optimization of sustained release aceclofenac microspheres using response surface methodology

    Energy Technology Data Exchange (ETDEWEB)

    Deshmukh, Rameshwar K.; Naik, Jitendra B., E-mail: jitunaik@gmail.com

    2015-03-01

    Polymeric microspheres containing aceclofenac were prepared by single emulsion (oil-in-water) solvent evaporation method using response surface methodology (RSM). Microspheres were prepared by changing formulation variables such as the amount of Eudragit® RS100 and the amount of polyvinyl alcohol (PVA) by statistical experimental design in order to enhance the encapsulation efficiency (E.E.) of the microspheres. The resultant microspheres were evaluated for their size, morphology, E.E., and in vitro drug release. The amount of Eudragit® RS100 and the amount of PVA were found to be significant factors respectively for determining the E.E. of the microspheres. A linear mathematical model equation fitted to the data was used to predict the E.E. in the optimal region. Optimized formulation of microspheres was prepared using optimal process variables setting in order to evaluate the optimization capability of the models generated according to IV-optimal design. The microspheres showed high E.E. (74.14 ± 0.015% to 85.34 ± 0.011%) and suitably sustained drug release (minimum; 40% to 60%; maximum) over a period of 12 h. The optimized microspheres formulation showed E.E. of 84.87 ± 0.005 with small error value (1.39). The low magnitudes of error and the significant value of R{sup 2} in the present investigation prove the high prognostic ability of the design. The absence of interactions between drug and polymers was confirmed by Fourier transform infrared (FTIR) spectroscopy. Differential scanning calorimetry (DSC) and X-ray powder diffractometry (XRPD) revealed the dispersion of drug within microspheres formulation. The microspheres were found to be discrete, spherical with smooth surface. The results demonstrate that these microspheres could be promising delivery system to sustain the drug release and improve the E.E. thus prolong drug action and achieve the highest healing effect with minimal gastrointestinal side effects. - Highlights: • Aceclofenac microspheres

  9. Influence of Hepatitis C Virus Sustained Virological Response on Immunosuppressive Tryptophan Catabolism in ART-Treated HIV/HCV Coinfected Patients

    NARCIS (Netherlands)

    Jenabian, Mohammad-Ali; Mehraj, Vikram; Costiniuk, Cecilia T.; Vyboh, Kishanda; Kema, Ido; Rollet, Kathleen; Ramirez, Robert Paulino; Klein, Marina B.; Routy, Jean-Pierre

    2016-01-01

    Background: We previously reported an association between tryptophan (Trp) catabolism and immune dysfunction in HIV monoinfection. Coinfection with HIV is associated with more rapid evolution of hepatitis C virus (HCV)-associated liver disease despite antiretroviral therapy (ART), possibly due to

  10. Sustainable palm oil as a public responsibility? : On the governance capacity of Indonesian standard for sustainable palm oil (ISPO)

    NARCIS (Netherlands)

    Hidayat, Nia; Offermans, Astrid; Glasbergen, Pieter

    2017-01-01

    This paper is motivated by the observation that Southern governments start to take responsibility for a more sustainable production of agricultural commodities as a response to earlier private initiatives by businesses and non-governmental organizations (NGOs). Indonesia is one of the leading

  11. Factors influencing the virological testing of cornea donors.

    Science.gov (United States)

    Röck, Tobias; Beck, Robert; Jürgens, Stefan; Bartz-Schmidt, Karl Ulrich; Bramkamp, Matthias; Thaler, Sebastian; Röck, Daniel

    2017-11-01

    To assess the influence of donor, environment, and logistical factors on the results of virological testing of blood samples from cornea donors.Data from 670 consecutive cornea donors were analyzed retrospectively. Logistic regression analysis was used to assess the influence of different factors on the results of virological testing of blood samples from cornea donors.The mean annual rate of donors with serology-reactive or not evaluable result was 14.8% (99 of 670) (range 11.9%-16.9%). The cause of donor death by cancer increased the risk of serology-reactive or not evaluable result (P = .0300). Prolonged time between death and post mortem blood removal was associated with a higher rate of serology-reactive or not evaluable result (P donors, sex, and donor age had no significant impact on the results of virological testing of blood samples from cornea donors.The cause of donor death by cancer and a prolonged time between death and post mortem blood removal seem to be mainly responsible for serology-reactive or not evaluable result of blood samples from cornea donors. The percentage of discarded corneas caused by serology-reactive or not evaluable result may be reduced by shortening the period of time between death and post mortem blood removal. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  12. Virologic response to tipranavir-ritonavir or darunavir-ritonavir based regimens in antiretroviral therapy experienced HIV-1 patients: a meta-analysis and meta-regression of randomized controlled clinical trials.

    Directory of Open Access Journals (Sweden)

    Asres Berhan

    Full Text Available The development of tipranavir and darunavir, second generation non-peptidic HIV protease inhibitors, with marked improved resistance profiles, has opened a new perspective on the treatment of antiretroviral therapy (ART experienced HIV patients with poor viral load control. The aim of this study was to determine the virologic response in ART experienced patients to tipranavir-ritonavir and darunavir-ritonavir based regimens.A computer based literature search was conducted in the databases of HINARI (Health InterNetwork Access to Research Initiative, Medline and Cochrane library. Meta-analysis was performed by including randomized controlled studies that were conducted in ART experienced patients with plasma viral load above 1,000 copies HIV RNA/ml. The odds ratios and 95% confidence intervals (CI for viral loads of <50 copies and <400 copies HIV RNA/ml at the end of the intervention were determined by the random effects model. Meta-regression, sensitivity analysis and funnel plots were done. The number of HIV-1 patients who were on either a tipranavir-ritonavir or darunavir-ritonavir based regimen and achieved viral load less than 50 copies HIV RNA/ml was significantly higher (overall OR = 3.4; 95% CI, 2.61-4.52 than the number of HIV-1 patients who were on investigator selected boosted comparator HIV-1 protease inhibitors (CPIs-ritonavir. Similarly, the number of patients with viral load less than 400 copies HIV RNA/ml was significantly higher in either the tipranavir-ritonavir or darunavir-ritonavir based regimen treated group (overall OR = 3.0; 95% CI, 2.15-4.11. Meta-regression showed that the viral load reduction was independent of baseline viral load, baseline CD4 count and duration of tipranavir-ritonavir or darunavir-ritonavir based regimen.Tipranavir and darunavir based regimens were more effective in patients who were ART experienced and had poor viral load control. Further studies are required to determine their consistent

  13. CORPORATE SOCIAL RESPONSIBILITY IMPACTS ON SUSTAINABLE HUMAN DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Kerstin Anstätt

    2016-06-01

    Full Text Available The goal of this article is to critically analyze the findings of the first, recently published, studies about Corporate Social Responsibility (CSR impacts on Sustainable Human Development (SHD. We aim at deriving conclusions for effective CSR strategies and at identifying consequences for management and research. As CSR claims to create value for corporations and for society, we argue that the people-centered Capability Approach (CA is promising to provide neglected and much needed insights how corporate activities affect individuals and communities. Based on a survey of recent literature addressing CSR impacts on SHD, we highlight CSR potentials to improve average well-being in multiple dimensions of SHD. Moreover, we critically assess challenges and limitations of CSR as a strategy to preserve and foster SHD. For instance, studies have shown that, despite CSR-driven well-being increases, social capital, relational capabilities and collective agency may become challenged by corporate strategies. Moreover, corporate environmental impacts have been found to be less often addressed by both, companies and SHD researchers. Resulting inequality and fairness issues have been identified as causes of violence against corporations even in the presence of total well-being improvements. We conclude that companies should strategically take into account a comprehensive range of factors driving and hampering SHD to account for their whole portfolio of corporate opportunities and risks. This requires evaluating CSR impacts instead of only focusing on CSR inputs and outputs. Thereby, corporations can mitigate their risks, improve their stakeholder trust and strengthen their competitiveness.

  14. Diagnostic virology laboratory within a microbiology setting.

    Science.gov (United States)

    Rubin, S J

    1984-01-01

    The virology section at St. Francis Hospital and Medical Center, Connecticut, is not a separate laboratory division but is a part of the microbiology division and is supervised by the same personnel who supervise bacteriology, mycology, mycobacteriology, and serology. Current volume is over 1,000 cultures yearly with 12 to 24 percent positive. Isolates are confirmed and typed by the Connecticut State Health Department Laboratory. Specimen distribution, percentage positive specimens, and distribution of viral isolates are similar to those reported from microbiology laboratories with separate virology laboratories directed by a full-time doctoral-level virologist. Our seven years' experience demonstrates that a microbiology laboratory without a full-time doctoral-level virologist can provide clinically useful virologic information.

  15. Taking Responsibility: The integration of Sustainability and Project Management

    NARCIS (Netherlands)

    Jasper van den Brink; Gilbert Gilbert Silvius

    2011-01-01

    Sustainability is one of the most important challenges of our time. How can we develop prosperity, without compromising the life of future generations? Companies are integrating ideas of sustainability in their marketing, corporate communications, annual reports and in their actions. Projects as

  16. Predicting HIV RNA virologic outcome at 52-weeks follow-up in antiretroviral clinical trials. The INCAS and AVANTI Study Groups.

    Science.gov (United States)

    Raboud, J M; Rae, S; Montaner, J S

    2000-08-15

    To determine the ability of intermediate plasma viral load (pVL) measurements to predict virologic outcome at 52 weeks of follow-up in clinical trials of antiretroviral therapy. Individual patient data from three clinical trials (INCAS, AVANTI-2 and AVANTI-3) were combined into a single database. Virologic success was defined to be plasma viral load (pVL) <500 copies/ml at week 52. The sensitivity and specificity of intermediate pVL measurements below the limit of detection, 100, 500, 1000, and 5000 copies/ml to predict virologic success were calculated. The sensitivity, specificity, and positive and negative predictive values of a pVL measurement <1000 copies/ml at week 16 to predict virologic outcome at week 52 were 74%, 74%, 48%, and 90%, respectively, for patients on double therapy. For patients on triple therapy, the sensitivity, specificity, and positive and negative predictive values of a pVL measurement <50 copies/ml at week 16 to predict virologic outcome were 68%, 68%, 80%, and 47%, respectively. For patients receiving double therapy, a poor virologic result at an intermediate week of follow-up is a strong indicator of virologic failure at 52 weeks whereas intermediate virologic success is no guarantee of success at 1 year. For patients on triple therapy, disappointing intermediate results do not preclude virologic success at 1 year and intermediate successes are more likely to be sustained.

  17. Sustainability Management in Agribusiness: Challenges, Concepts, Responsibilities and Performance

    Directory of Open Access Journals (Sweden)

    Nina Friedrich

    2012-12-01

    Full Text Available The idea of sustainable management has recently gained growing attention in the agribusiness sector. This is mainly due to a widespread discontent with the industrialization of agricultural production and food processing and growing public pressure on agribusiness firms to implement more sustainable management practices. In this paper we present the results of an explorative empirical study of sustainability management in German agribusiness firms. The study shows that agribusiness firms have developed a broad understanding of sustainability management and perceive a multi-facetted spectrum of societal demands they have to meet. The most important arguments for implementing more sustainable management practices are that companies have to make sure that they are trusted by society in the long run and that the perception of a company by external stakeholders has become more and more important. The companies surveyed know quite a number of sustainability programmes and standards, but the number of companies that actually participate in these initiatives is much smaller. Nonetheless, the majority of the respondents feels that their company is more successful with regard to sustainability management than industry average.

  18. Sustainable bonuses: Sign of corporate responsibility or window dressing?

    NARCIS (Netherlands)

    Kolk, A.; Perego, P.

    2014-01-01

    Despite a strong plea for integrating sustainability goals into traditional corporate bonus schemes, a comprehensive implementation of these systems has been lacking until recently. This article explores four illustrative cases from the Netherlands, where several multinationals started to pioneer

  19. Corporate social responsibility, a strategy to create and consolidate sustainable businesses

    Directory of Open Access Journals (Sweden)

    Mariana Cristina GANESCU

    2012-11-01

    Full Text Available To highlight the strategic importance of CSR, this paper starts with a study of specialized literature in order to identify the role of these strategies in the creation and strengthening of sustainable business. Using Dunphy's model as a start point, we attempted to draft typologies for social responsibility strategies that support organizations in creating and strengthening sustainable business. An empirical study of the European automobile industry has sought to highlight the impact CSR strategies have on sustainable business. Selection and implementation of appropriate social responsibility strategies are important in achieving added value through the creation and strengthening of sustainable business.

  20. Sustainable occupational responses to climate change through lifestyle choices.

    Science.gov (United States)

    Hocking, Clare; Kroksmark, Ulla

    2013-03-01

    Abstract Occupational therapists and occupational scientists are increasingly aware of the relationship between occupation and global climate change, with some working to raise awareness of the issues and others proposing that an occupational perspective can make a valuable contribution to understanding and addressing the issues. In this discussion paper the United Nations Global Survey on Sustainable Lifestyles ( 1 ), which reports young adults' beliefs about everyday occupations that have a substantial impact on the environment (food, housekeeping, and transportation) is introduced. The authors argue that the survey findings are a valuable resource for occupational therapists who are concerned about global climate change and work with young adults (age 18-35), providing valuable insights into their concerns and preferences in relation to sustainability. To illustrate the insights contained in the reports, findings from four countries are presented: New Zealand and Sweden, the authors' countries of origin, and the Philippines and Lebanon which have people living in New Zealand and Sweden. Application to individual and community-based interventions to promote more sustainable lifestyles is suggested, along with studies to examine the perspectives of young adults with a disability, as their concerns and sustainability preferences might differ due to the barriers that limit their participation in educational and vocational occupations.

  1. THE ROLE OF SOCIAL RESPONSIBILITY STRATEGIES EMPLOYED BY EUROPEAN AUTOMOTIVE CORPORATIONS IN DEVELOPING SUSTAINABLE BUSINESSES

    Directory of Open Access Journals (Sweden)

    Cristina Gănescu

    2013-01-01

    Full Text Available Corporate social responsibility strategies are a topic of great interest for both researchers and practitioners, and require the development of interdisciplinary approaches: economic, ethical and social. The paper analyses the social responsibility strategies employed by European automotive businesses and highlights their impact on business sustainability. From a theoretical perspective, applying the content analysis method on sustainability or social responsibility reports revealed a variety of social responsibility strategies. The utility of the research is supported by formulating a typology of social responsibility strategies, based on objectives of sustainable development and by establishing arguments concerning the impact of these strategies on automotive businesses’ sustainability in the following areas: social and societal, ecological and environmental, distribution chains and suppliers, corporate image, position in relation to competitors and financial performance.

  2. Pulmonary vascular responses during acute and sustained respiratory alkalosis or acidosis in intact newborn piglets.

    Science.gov (United States)

    Gordon, J B; Rehorst-Paea, L A; Hoffman, G M; Nelin, L D

    1999-12-01

    Acute alkalosis-induced pulmonary vasodilation and acidosis-induced pulmonary vasoconstriction have been well described, but responses were generally measured within 5-30 min of changing pH. In contrast, several in vitro studies have found that relatively brief periods of sustained alkalosis can enhance, and sustained acidosis can decrease, vascular reactivity. In this study of intact newborn piglets, effects of acute (20 min) and sustained (60-80 min) alkalosis or acidosis on baseline (35% O2) and hypoxic (12% O2) pulmonary vascular resistance (PVR) were compared with control piglets exposed only to eucapnia. Acute alkalosis decreased hypoxic PVR, but sustained alkalosis failed to attenuate either baseline PVR or the subsequent hypoxic response. Acute acidosis did not significantly increase hypoxic PVR, but sustained acidosis markedly increased both baseline PVR and the subsequent hypoxic response. Baseline PVR was similar in all piglets after resumption of eucapnic ventilation, but the final hypoxic response was greater in piglets previously exposed to alkalosis than in controls. Thus, hypoxic pulmonary vasoconstriction was not attenuated during sustained alkalosis, but was accentuated during sustained acidosis and after the resumption of eucapnia in alkalosis-treated piglets. Although extrapolation of data from normal piglets to infants and children with pulmonary hypertension must be done with caution, this study suggests that sustained alkalosis may be of limited efficacy in treating acute hypoxia-induced pulmonary hypertension and the risks of pulmonary hypertension must be considered when using ventilator strategies resulting in permissive hypercapnic acidosis.

  3. Diagnostic virology laboratory within a microbiology setting.

    OpenAIRE

    Rubin, S. J.

    1984-01-01

    The virology section at St. Francis Hospital and Medical Center, Connecticut, is not a separate laboratory division but is a part of the microbiology division and is supervised by the same personnel who supervise bacteriology, mycology, mycobacteriology, and serology. Current volume is over 1,000 cultures yearly with 12 to 24 percent positive. Isolates are confirmed and typed by the Connecticut State Health Department Laboratory. Specimen distribution, percentage positive specimens, and distr...

  4. Artificial Intelligence and Virology - quo vadis.

    Science.gov (United States)

    Shapshak, Paul; Somboonwit, Charurut; Sinnott, John T

    2017-01-01

    Artificial Intelligence (AI), robotics, co-robotics (cobots), quantum computers (QC), include surges of scientific endeavor to produce machines (mechanical and software) among numerous types and constructions that are accelerating progress to defeat infectious diseases. There is a plethora of additional applications and uses of these methodologies and technologies for the understanding of biomedicine through bioinformation discovery. Therefore, we briefly outline the use of such techniques in virology.

  5. When not every response to climate change is a good one: identifying principles for sustainable adaptation

    CSIR Research Space (South Africa)

    Eriksen, S

    2011-01-01

    Full Text Available to the need for sustainable adaptation strategies and measures that contribute to social justice and environmental integrity. This paper presents four normative principles to guide responses to climate change and illustrates the significance...

  6. Influential Factors and Strategy of Sustainable Product Development under Corporate Social Responsibility in Taiwan

    Directory of Open Access Journals (Sweden)

    Jui-Che Tu

    2013-01-01

    Full Text Available This study aimed to adopt the perspective of corporate social responsibility (CSR to explore the intention of sustainable product development in Taiwan, as well as leading to the creation of influential factors that affect corporate sustainable product development intention. In this research, the induction analysis was conducted to understand the implementation of sustainable product development, and this was supplemented with questionnaire surveys and in-depth interviews to evaluate developmental intention. In addition, principal component analysis was used for factor analysis and content analysis in the 6 W expression method, leading to the creation of the influential factors. The research results have demonstrated that the factors affecting the intention of corporate sustainable product development include having a sustainable design and a development purpose, a corporate development purpose, sustainable development concepts, a sustainable design value, a sustainability concept, and a manufacturing process quality. For sustainable product development, corporate social responsibility needs to be most concerned with the added value of products, regulation requirements, and accommodation of the industrial chain, costs, and quality.

  7. Comparative virology and AIDS (review).

    Science.gov (United States)

    Kodama, M; Kodama, T

    1996-03-01

    The scientific debate between pros and cons of the HIV criminal theory of AIDS still remains unsettled. The purpose of this review is to promote resolution of the problem by extracting a common principle of the host-virus relation using data resources for each of 4 viruses as follows: a) polyoma virus, b) Marek's disease virus, c) Ebola virus, d) Korean hemorrhagic fever virus. Conclusions drawn from this study are given as follows: i) Environment emerged as the cardinal factor to modify the process of virus infection in all of the 4 viruses studied. Above all, an accelerating effect of environmental stress on the progression of virus infection was noted in vivo in the majority of viral diseases. ii) Evidence is available to indicate that a healthy cell (or a healthy individual) may harbor virus genes of multiple species without manifesting any pathologic sign. iii) Evidence also suggests that the biological property as well as morphological structure of a virus may vary in reponse to a change of the bioenvironment. On the basis of the above information, we propose to renounce 2 assumptions of classical infection model: a) the hereditarily determined virulence of a microorganism (including virus) be the sole determinant of infection to the effect that its invasion into the host should automatically complete the programmed course of infection; b) virus, a quasi-living creature, should reserve its behavioral independence irrespective of a change of the bioenvironment. The new infection model was constructed on the basis of the selfish gene concept that had been invented by Richard Dawkins to explain the altruistic behavior of an individual. That is, the fate of an exogenous or endogenous virus is under the dual control of the host genome (selfish gene) and the outer environment. The progression of virus infection is conditioned by a crosstalk between them. The selfish gene may use virus (a lifeless substance) as a magic bullet to induce a designated host response. In

  8. Sustainable water future with global implications: everyone's responsibility.

    Science.gov (United States)

    Kuylenstierna, J L; Bjorklund, G; Najlis, P

    1997-01-01

    The current use and management of freshwater is not sustainable in many countries and regions of the world. If current trends are maintained, about two-thirds of the world's population will face moderate to severe water stress by 2025 compared to one-third at present. This water stress will hamper economic and social development unless action is taken to deal with the emerging problems. The Comprehensive Assessment of the Freshwater Resources of the World, prepared by the UN and the Stockholm Environment Institute, calls for immediate action to prevent further deterioration of freshwater resources. Although most problems related to water quantity and quality require national and regional solutions, only a global commitment can achieve the necessary agreement on principles, as well as financial means to attain sustainability. Due to the central and integrated role played by water in human activities, any measures taken need to incorporate a wide range of social, ecological and economic factors and needs. The Assessment thus addresses the many issues related to freshwater use, such as integrated land and water management at the watershed level, global food security, water supply and sanitation, ecosystem requirements, pollution, strengthening of major groups, and national water resource assessment capabilities and monitoring networks. Governments are urged to work towards a consensus regarding global principles and guidelines for integrated water management, and towards their implementation in local and regional water management situations. The alternative development options available to countries facing water stress, or the risk thereof, needs to be considered in all aspects of development planning.

  9. Predictors of sustained response to rivastigmine in patients with Alzheimer's disease: a retrospective analysis.

    Science.gov (United States)

    Sadowsky, Carl H; Grossberg, George T; Somogyi, Monique; Meng, Xiangyi

    2011-01-01

    The cholinesterase inhibitor rivastigmine is approved for the treatment of mild to moderate Alzheimer's disease. However, it is not possible to predict which individuals will benefit from treatment. This retrospective analysis of an international, 24-week, randomized, double-blind trial aimed to identify the percentage of persons with Alzheimer's disease who have a sustained response with rivastigmine patch, rivastigmine capsules, or placebo; to determine the magnitude of the sustained treatment response; and to investigate baseline patient characteristics predictive of the observed sustained response. Patients who improved on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL) at week 16 and maintained at least the week 16 improvement at week 24 were identified as sustained responders. Treatment differences and baseline predictive factors were assessed in patients demonstrating a 1-, 2-, 3-, 4-, or 5-point sustained improvement. The first patient was screened in November 2003 and the last patient completed the study in January 2006. More persons with Alzheimer's disease had sustained improvements on the ADAS-cog and ADCS-ADL with rivastigmine versus placebo. Sustained improvements of 4 or 5 points on the ADAS-cog or ADCS-ADL were demonstrated in the 9.5-mg/24-h rivastigmine patch (24% and 36% of patients, respectively) and 12-mg/d capsule groups (28% on both outcome measures). Factors predictive of a sustained response to treatment included baseline Mini-Mental State Examination, ADAS-cog, and ADCS-ADL scores and treatment, country of treatment, and time since first symptom was diagnosed by a physician. Understanding factors predictive of sustained cholinesterase inhibitor treatment response should help to optimize Alzheimer's disease management and encourage compliance by allowing more realistic expectations of treatment effects.

  10. Sustainable Development and Corporate Social Responsibility in Sub-Saharan Africa: Evidence from Industries in Cameroon

    Directory of Open Access Journals (Sweden)

    Oyewole Simon Oginni

    2016-05-01

    Full Text Available Present technological innovations and social organizations continue to impose risks and limitations on the efficient performance of the biosphere. Human activities have increasingly short-lived sustainable natural endowments, to the extent that, the multiplier effects have ripples beyond the traditional benefits of economic production and consumption. Therefore, this study addressed practical concerns on how industries in Sub-Saharan Africa promote sustainable development in their corporate social responsibility models, using industries in Cameroon as a case study; it examined economic, social, and environmental components of sustainable development and corporate social responsibility (CSR. Our sample consists of 335 business enterprises from the last Censure Survey of Enterprises in Cameroon. The study adopted a systematic analysis through the Adjusted Residual Test, and the Phi and Cramer’s V tests. Findings revealed that industries in Cameroon prioritize environmental and social dimensions over economic dimensions. However, a few large enterprises implement a broad CSR that promotes sustainable business practices, whereas smaller ones do not; industries in Cameroon implement environmental dimensions of CSR as a safe buffer and a social dimension as philanthropy. Hence, there is no concrete evidence that industries promote sustainable development via CSR in Cameroon. The implementation of a sustainable business model is a precondition for promoting sustainable development via CSR. Industries should realize the concrete value in implementing a sustainable business model that helps to adjust to the complex and increasingly changing business environment.

  11. Challenges, responses and partnership for achieving sustainable tourism and heritage preservation

    Directory of Open Access Journals (Sweden)

    Maksin Marija

    2010-01-01

    Full Text Available The process of globalization has created the situation where the expectations of tourists are the same both with respect to the quality of services in all destinations and with respect to the authencity based on local attractions and experiences, which should be unique and different for each destination. The key element in maintaining destination attractiveness is the protection and presentation of natural and cultural heritage and its sustainable utilization for tourism development. The sustainability concept is of equal importance for long-term tourism development, destination competitiveness and heritage protection. The paper deals with the main challenges to achieving sustainable tourism and points to some key responses to them. Participation, cooperation and partnership should be a vital prerequisite for the implementation and performance of sustainable tourism and heritage protection. This attitude has been tested on several examples of good practice in heritage protection and the sustainable development of tourism destinations in Serbia. .

  12. Environmentally Responsible Trade and Its Importance for Sustainable Forestry

    Directory of Open Access Journals (Sweden)

    Olena Maxymets

    2006-06-01

    Full Text Available This article focuses on the environmental component of trade, primarily foreign trade, which concerns the interests of many countries. It examines the reciprocal influence of foreign trade and the environment. The author defines environmentally responsible trade and formulates its main principles. She examines the development of trade in forest products globally and in Ukraine and evaluates the impact of different trade restrictions on the condition of forests and the forestry industry. Indicators of the efficiency of foreign trade from the economic and environmental perspectives are proposed. Underlining the need for enterprises to switch over to environmentally responsible trade, the author proposes instruments to achieve this end.

  13. Sustained CD8+ T-cell responses induced after acute parvovirus B19 infection in humans

    DEFF Research Database (Denmark)

    Norbeck, Oscar; Isa, Adiba; Pöhlmann, Christoph

    2005-01-01

    Murine models have suggested that CD8+ T-cell responses peak early in acute viral infections and are not sustained, but no evidence for humans has been available. To address this, we longitudinally analyzed the CD8+ T-cell response to human parvovirus B19 in acutely infected individuals. We...... observed striking CD8+ T-cell responses, which were sustained or even increased over many months after the resolution of acute disease, indicating that CD8+ T cells may play a prominent role in the control of parvovirus B19 and other acute viral infections of humans, including potentially those generated...

  14. Introductory analysis of sustainable consumption and production : Factors of corporate social responsibility management in Japan

    OpenAIRE

    八木, 迪幸; 國部, 克彦

    2017-01-01

    As an introductory analysis of sustainable consumption and production, this paper examines what factors influence corporate social responsibility management in Japan. Following some underlying theories (management control system; the neo-institutional theory; performance measurement systems; the stakeholder theory; the resource dependence theory), this paper conducts empirical studies using firm-level data. The first three studies examine what factors encourage corporate social responsibility...

  15. FREEDOM CHOICE OF THE ROMANIAN ENTERPRISES TO CORPORATE RESPONSIBILITY & SUSTAINABILITY COMPETITIVENESS

    Directory of Open Access Journals (Sweden)

    Lucretia Mariana Constantinescu

    2013-12-01

    Full Text Available The declared aim of this paper is to be an attempt to analyze the opinions regarding the corporate sustainability and responsibility that’s providing to formulate a combination of diagnosis and prognosis, assessing the past and present conditions of corporate responsibility and the way ahead by the investors of the Romanian economy during the last economic recession crisis years.

  16. Corporate sustainability, social responsibility and environmental management : an introduction to theory and practice with case studies

    OpenAIRE

    Camilleri, Mark Anthony

    2017-01-01

    Responsible behaviours are increasingly being embedded into new business models and strategies that are designed to meet environmental, societal and governance deficits. Therefore, the notions of Corporate Sustainability, Social Responsibility and Environmental Management have become very popular among academia as corporations are moving beyond transparency, business ethics and stakeholder engagement. This book provides business students and scholars with a broad analysis on the subject ...

  17. Speaking of Sustainable Development and Values... A Response to ...

    African Journals Online (AJOL)

    ... we can discuss our environmental concerns and our (educational) responses to them, but rather because we should be self-consciously aware of the assumptions and implications hidden in the language that we choose to discuss these matters, thus enabling us to disect and evaluate these assumptions and implications ...

  18. Eco-innovation, Responsible Leadership and Organizational Change for Corporate Sustainability

    Directory of Open Access Journals (Sweden)

    Dorel Mihai Paraschiv

    2012-06-01

    Full Text Available Creating a sustainable development strategy is essential for organizations that seek to reduce risks associated with tightening legislation, increased energy prices and natural resources and growing customer demands. Sustainability requires the full integration of social and environmental aspects into the vision, culture and operations of an organization, a profound process of organizational change being essential. The purpose of this paper is to present the main drivers of corporate sustainability, illustrating – after a thorough literature review – the link between the following elements: corporate sustainability – a necessity in the current global context; eco-innovation – as a way to implement sustainability in an organization; responsible leadership – as the art of building and maintaining strong and moral relationships with all stakeholders; organizational culture and organizational change – the basic elements through which organizations continuously renew their processes and products, adapting them to the new context. Furthermore, the paper provides an overview of organizations active in Romania in terms of sustainability practices, in general, and the ecological component of sustainable development, in particular, by presenting the results of an exploratory questionnaire-based research. The research reflects the importance of visionary management in adopting and implementing sustainability in the responding organizations.

  19. How and When Retailers’ Sustainability Efforts Translate into Positive Consumer Responses: The Interplay Between Personal and Social Factors

    NARCIS (Netherlands)

    Hofenk, D.; Birgelen, M.J.H. van; Bloemer, J.M.M.; Semeijn, J.

    2017-01-01

    This study aims to address how (through which mechanisms) and when (under which conditions) retailers’ sustainability efforts translate into positive consumer responses. Hypotheses are developed and tested through a scenario-based experiment among 672 consumers. Retailers’ assortment sustainability

  20. Paediatric Virology in the Hippocratic Corpus

    Science.gov (United States)

    Mammas, Ioannis N.; Spandidos, Demetrios A.

    2016-01-01

    Hippocrates (Island of Kos, 460 B.C.-Larissa, 370 B.C.) is the founder of the most famous Medical School of the classical antiquity. In acknowledgement of his pioneering contribution to the new scientific field of Paediatric Virology, this article provides a systematic analysis of the Hippocratic Corpus, with particular focus on viral infections predominating in neonates and children. A mumps epidemic, affecting the island of Thasos in the 5th century B.C., is described in detail. ‘Herpes’, a medical term derived from the ancient Greek word ‘ἕρπειν’, meaning ‘to creep’ or ‘crawl’, is used to describe the spreading of cutaneous lesions in both childhood and adulthood. Cases of children with exanthema ‘resembling mosquito bites’ are presented in reference to varicella or smallpox infection. A variety of upper and lower respiratory tract viral infections are described with impressive accuracy, including rhinitis, pharyngitis, tonsillitis, laryngitis, bronchiolitis and bronchitis. The ‘cough of Perinthos’ epidemic, an influenza-like outbreak in the 5th century B.C., is also recorded and several cases complicated with pneumonia or fatal outcomes are discussed. Hippocrates, moreover, describes conjunctivitis, otitis, lymphadenitis, meningoencephalitis, febrile convulsions, gastroenteritis, hepatitis, poliomyelitis and skin warts, along with proposed treatment directions. Almost 2,400 years later, Hippocrates' systematic approach and methodical innovations can inspire paediatric trainees and future Paediatric Virology subspecialists. PMID:27446241

  1. Leptin regulates dopamine responses to sustained stress in humans

    OpenAIRE

    Burghardt, Paul R; Love, Tiffany M; Stohler, Christian S.; Hodgkinson, Colin; Shen, Pei-Hong; Enoch, Mary Ann; Goldman, David; Zubieta, Jon-Kar

    2012-01-01

    Neural systems that identify and respond to salient stimuli are critical for survival in a complex and changing environment. In addition, interindividual differences, including genetic variation, hormonal, and metabolic status likely influence the behavioral strategies and neuronal responses to environmental challenges. Here we examined the relationship between leptin allelic variation and plasma leptin levels with DAD2/3R availability in vivo as measured with [11C]raclopride Positron Emissio...

  2. Environmentally Responsible Trade and Its Importance for Sustainable Forestry

    OpenAIRE

    Olena Maxymets

    2006-01-01

    This article focuses on the environmental component of trade, primarily foreign trade, which concerns the interests of many countries. It examines the reciprocal influence of foreign trade and the environment. The author defines environmentally responsible trade and formulates its main principles. She examines the development of trade in forest products globally and in Ukraine and evaluates the impact of different trade restrictions on the condition of forests and the forestry industry. Indic...

  3. Leptin regulates dopamine responses to sustained stress in humans.

    Science.gov (United States)

    Burghardt, Paul R; Love, Tiffany M; Stohler, Christian S; Hodgkinson, Colin; Shen, Pei-Hong; Enoch, Mary-Anne; Goldman, David; Zubieta, Jon-Kar

    2012-10-31

    Neural systems that identify and respond to salient stimuli are critical for survival in a complex and changing environment. In addition, interindividual differences, including genetic variation and hormonal and metabolic status likely influence the behavioral strategies and neuronal responses to environmental challenges. Here, we examined the relationship between leptin allelic variation and plasma leptin levels with DAD2/3R availability in vivo as measured with [(11)C]raclopride PET at baseline and during a standardized pain stress challenge. Allelic variation in the leptin gene was associated with varying levels of dopamine release in response to the pain stressor, but not with baseline D2/3 receptor availability. Circulating leptin was also positively associated with stress-induced dopamine release. These results show that leptin serves as a regulator of neuronal function in humans and provides an etiological mechanism for differences in dopamine neurotransmission in response to salient stimuli as related to metabolic function. The capacity for leptin to influence stress-induced dopaminergic function is of importance for pathological states where dopamine is thought to play an integral role, such as mood, substance-use disorders, eating disorders, and obesity.

  4. New-onset ascites as a manifestation of virologic relapse in patients with hepatitis C cirrhosis

    Directory of Open Access Journals (Sweden)

    Chua DL

    2014-01-01

    Full Text Available Deborah Lim Chua, Thomas Hahambis, Samuel H SigalDivision of Gastroenterology, Department of Medicine, New York University School of Medicine, New York, NY, USABackground: Chronic hepatitis C is the most common cause of cirrhosis in industrialized countries. Successful treatment of chronic hepatitis C in patients with advanced fibrosis or cirrhosis has significant benefits, including improvements in inflammation, fibrosis, and portal hypertension, with prevention of esophageal varices and clinical decompensation.Case: In this report, we present two patients with well-compensated hepatitis C cirrhosis who achieved an end-of-treatment response on a direct-acting antiviral therapy-based triple regimen for hepatitis C virus, but subsequently presented with new-onset ascites associated with virologic relapse.Conclusion: We propose that the development of ascites in this setting is due to the adverse impact of inflammation of the virologic relapse on portal hypertension. Our observation that ascites formation can be a manifestation of virologic relapse has potentially important clinical implications, as it highlights not only the importance of close monitoring of cirrhotic patients after achieving end-of-treatment response but also the impact of active inflammation on the severity of portal hypertension.Keywords: chronic hepatitis C, cirrhosis, virologic relapse, portal hypertension, ascites

  5. Virological Mechanisms in the Coinfection between HIV and HCV

    Directory of Open Access Journals (Sweden)

    Maria Carla Liberto

    2015-01-01

    Full Text Available Due to shared transmission routes, coinfection with Hepatitis C Virus (HCV is common in patients infected by Human Immunodeficiency Virus (HIV. The immune-pathogenesis of liver disease in HIV/HCV coinfected patients is a multifactorial process. Several studies demonstrated that HIV worsens the course of HCV infection, increasing the risk of cirrhosis and hepatocellular carcinoma. Also, HCV might increase immunological defects due to HIV and risk of comorbidities. A specific cross-talk among HIV and HCV proteins in coinfected patients modulates the natural history, the immune responses, and the life cycle of both viruses. These effects are mediated by immune mechanisms and by a cross-talk between the two viruses which could interfere with host defense mechanisms. In this review, we focus on some virological/immunological mechanisms of the pathogenetic interactions between HIV and HCV in the human host.

  6. Sustainable Ergonomic Program - Basic Condition for Implementation of Corporate Social Responsibility

    Science.gov (United States)

    Marková, Petra; Beňo, Rastislav; Hatiar, Karol

    2012-12-01

    Gradually increasing pressure on companies to start to behave socially responsible is a response to social, environmental and economic requirements. The society faces a period of changes that have occurred since the beginning of the crisis and revealing weaknesses in the economy. We become witnesses of rapid changes and challenges posed by globalization, lack of resources, demographic structure and innovation. Objective necessity becomes a corporate social responsibility (CSR) already at the companies’ level, which is supported by the approach of the EU institutions and the Slovak Republic. One of the possible appliance through which we can contribute to the sustainability of CSR are sustainable ergonomic programs. When we want to talk about sustainable ergonomic program is important to focus on three key areas. The first area is the Impact of technic and technology to employees at work, the second area is the Importance and impact of socially responsible HR in ergonomics and last area is the Creation of the work environment in relation to environmental sustainability. Ergonomic programs sustainability requires to apply appropriate methods for evaluation of their cost benefit and health effect.

  7. Sustainable Entrepreneurship Orientation: A Reflection on Status-Quo Research on Factors Facilitating Responsible Managerial Practices

    Directory of Open Access Journals (Sweden)

    Sascha Kraus

    2018-02-01

    Full Text Available With the global financial system having undergone vast changes since the financial crisis of 2007, scientific research concerning the investor’s point of view on sustainable investments has drastically increased. However, there remains a lack of research focused on the entrepreneur’s angle regarding sustainable oriented investments. The aim of this paper is to contribute to the understanding of sustainable financial markets by bringing together entrepreneurial and financial research. This paper provides a structured literature review, based on which the authors identify three relevant levels that they believe have an effect on the successful implementation of managerial sustainable practices; these are the individual, the firm, and the contextual levels. The results show that on the individual level sustainable entrepreneurs tend to derive their will to act more sustainably from their personal values or traits. On the organizational level, though, it can be concluded that an small and medium sized enterprise’s internal culture and the reconfiguration of resources are critical determinants for adopting a sustainable entrepreneurial orientation. Finally, on the contextual level, researchers have focused on a better understanding of how entrepreneurs can help society and the environment through sustainable entrepreneurship, and how they can act as role models or change agents in light of the fact that the choice of investing or financing based on sustainability is still in its infancy. By providing an overview on facilitating factors for responsible managerial practices on the entrepreneur’s side, this research contributes to a better understanding for both theory and practice on how sustainable practices can be implemented and facilitated.

  8. 寨卡病毒病毒学特征及其引发异常免疫应答机制的研究进展%Virological characteristics of Zika virus and abnormal immune responses induced by Zika virus

    Institute of Scientific and Technical Information of China (English)

    曹璐; 王鑫; 张志刚; 赵勤俭

    2016-01-01

    Zika fever is a self-limiting and acute infectious disease caused by Zika virus infection. It is mainly transmitted through the bite of mosquitoes of the Aedes type. It can also be spread through verti-cal transmission. There is evidence that it can also be sexually transmitted from a man to his sex partners due to the presence of the virus in semen. The re-emergence of the virus in 2015 as a major endemic in the South American countries ( which may spread further) warrants better understanding of Zika virus. The outbreaks, transmission routes, virological characteristics and the diagnosis and treatment of Zika virus infection will be summarized in this review. Moreover, the potential correlations between newborn microcephaly and Zika vi-rus infection as well as the possible molecular mechanisms for causing microcephaly such as cell autophagy will also be discussed.%由寨卡病毒感染引起的寨卡病毒病是一种自限性急性传染病,主要通过伊蚊叮咬传播,也可以垂直传播,最近也有性传播的一些证据。随着寨卡病毒的暴发,对寨卡病毒的认识具有重要的意义。本文就寨卡病毒的传播与暴发史、病原学特征、诊断与治疗、寨卡病毒感染与新生儿小头症的潜在相关性、引发细胞自噬等异常免疫应答的研究进展进行了综述。

  9. IL-10 and IL-28B gene variants as predictors of sustained response to peginterferon and ribavirin therapy in chronic HCV infection.

    Science.gov (United States)

    Sghaier, Ikram; Mouelhi, Leila; Rabia, Noor A; Ghazoueni, Ezzedine; Almawi, Wassim Y; Loueslati, Besma Yacoubi

    2017-04-05

    Interleukin-10 (IL-10) plays an important role in the immunity to hepatitis C virus (HCV). Insofar as IL-10 variants are associated with altered levels of IL-10, previous studies that examined the association of IL-10 polymorphisms with the susceptibility to and progression of chronic HCV, and response to anti-viral treatment were inconsistent. We investigated the association between common IL-10 variants in the intron and the promotor region with HCV and associated features. Study subjects comprised 120 patients infected with HCV-1b, and treated with Peg-IFN/RBV. Genotyping of six IL-10 promoter variants in the intron region (rs1878672, rs1554286, rs1518111) and promotor region (rs1800872, rs1800871, rs1800896) were done by real-time PCR. Compared to G/G, carriage of IL-10 rs1800896 (-1082A/G) A/A genotype was more frequent in patients with sustained virological response (SVR). The decline in viral load over the first 12weeks of treatment was more pronounced in rs1800896 A/A genotype carriers, compared to G/G genotype carriers, and was irrespective of the treatment dosage. Carriage of rs1800896 A/A genotype was positively associated with improvement in viral load decline, which was simultaneous, with and without carriage of the common favourable IL-28B variant. Carriage of both IL-10 rs1800896 G/G and IL-28B non-favourable genotype was associated with twice the risk of getting slow decline of viral load during treatment. Haploview analysis identified ACGCTA and CCGCTG haplotypes to be linked with excellent PegIFN/RBV cure rate, and complete HCV eradication. On the other hand, ACGCTG and CCGCTA haplotypes were associated with resistance to PegIFN/RBV treatment. IL-10 rs1800896 variant markedly influences the clinical outcome of HCV infection, and is a determinant of the response to HCV treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Social responsibility and sustainability in Spanish university libraries: questioning the discourse from critical analysis perspectives

    Directory of Open Access Journals (Sweden)

    M. Engracia Martin Valdunciel

    2018-03-01

    Full Text Available The paper focus on a critical analysis of a discursive formation in Spanish academic libraries: social responsibility and sustainability. The concepts that make up the discourse are historically contextualized in order to clarify their origin and social affiliation. Although the enunciation of social responsibility and sustainability content is formulated ambiguously, its articulation as a discursive practice within the framework of the new corporate management university libraries leads us to infer bias in their rhetorical formulation. We consider that, from a fuzzy concept and its integration into technocratic practices, the discourse can be used as a tool for legitimizing the deregulation of public educational institutions.

  11. Entomologic and virologic investigation of Chikungunya, Singapore.

    Science.gov (United States)

    Ng, Lee-Ching; Tan, Li-Kiang; Tan, Cheong-Huat; Tan, Sharon S Y; Hapuarachchi, Hapuarachchige C; Pok, Kwoon-Yong; Lai, Yee-Ling; Lam-Phua, Sai-Gek; Bucht, Göran; Lin, Raymond T P; Leo, Yee-Sin; Tan, Boon-Hian; Han, Hwi-Kwang; Ooi, Peng-Lim S; James, Lyn; Khoo, Seow-Poh

    2009-08-01

    Local transmission of chikungunya, a debilitating mosquito-borne viral disease, was first reported in Singapore in January 2008. After 3 months of absence, locally acquired Chikungunya cases resurfaced in May 2008, causing an outbreak that resulted in a total of 231 cases by September 2008. The circulating viruses were related to East, Central, and South African genotypes that emerged in the Indian Ocean region in 2005. The first local outbreak was due to a wild-type virus (alanine at codon 226 of the envelope 1 gene) and occurred in an area where Aedes aegypti mosquitoes were the primary vector. Strains isolated during subsequent outbreaks showed alanine to valine substitution (A226V) and largely spread in areas predominated by Ae. albopictus mosquitoes. These findings led to a revision of the current vector control strategy in Singapore. This report highlights the use of entomologic and virologic data to assist in the control of chikungunya in disease-endemic areas.

  12. Considerations in choosing a primary endpoint that measures durability of virological suppression in an antiretroviral trial.

    Science.gov (United States)

    Gilbert, P B; Ribaudo, H J; Greenberg, L; Yu, G; Bosch, R J; Tierney, C; Kuritzkes, D R

    2000-09-08

    At present, many clinical trials of anti-HIV-1 therapies compare treatments by a primary endpoint that measures the durability of suppression of HIV-1 replication. Several durability endpoints are compared. Endpoints are compared by their implicit assumptions regarding surrogacy for clinical outcomes, sample size requirements, and accommodations for inter-patient differences in baseline plasma HIV-1-RNA levels and in initial treatment response. Virological failure is defined by the non-suppression of virus levels at a prespecified follow-up time T(early virological failure), or by relapse. A binary virological failure endpoint is compared with three time-to-virological failure endpoints: time from (i) randomization that assigns early failures a failure time of T weeks; (ii) randomization that extends the early failure time T for slowly responding subjects; and (iii) virological response that assigns non-responders a failure time of 0 weeks. Endpoint differences are illustrated with Agouron's trial 511. In comparing high with low-dose nelfinavir (NFV) regimens in Agouron 511, the difference in Kaplan-Meier estimates of the proportion not failing by 24 weeks is 16.7% (P = 0.048), 6.5% (P = 0.29) and 22.9% (P = 0.0030) for endpoints (i), (ii) and (iii), respectively. The results differ because NFV suppresses virus more quickly at the higher dose, and the endpoints weigh this treatment difference differently. This illustrates that careful consideration needs to be given to choosing a primary endpoint that will detect treatment differences of interest. A time from randomization endpoint is usually recommended because of its advantages in flexibility and sample size, especially at interim analyses, and for its interpretation for patient management.

  13. Hepatitis C Prevalence and Responses to Pegylated Interferon + Ribavirin Treatment Among Prisoners

    Directory of Open Access Journals (Sweden)

    Hasan Selçuk ÖZGER

    2017-12-01

    Full Text Available Objective: The aim of our study was to identify the hepatitis C prevalence in prisoners and to share experiences of pegylated interferon (peg-IFN + ribavirin (RBV treatment. Materials and Methods: The study was conducted by assessing the records of prisoners between January 2014 and 2016, retrospectively. Patients in whom planned treatments were applied in a given time were determined and, virologic responses at the end of treatment and 6 months after treatment were evaluated. Chi-square test was used and a p value of less than 0.05 was considered statistically significant. Results: Among prisoners, the anti-hepatitis C virus (HCV positivity rate was 7.82% and HCV-RNA positivity rate was 5.72%. The most common genotype was genotype 3a (66 of 99 patients. End-of-treatment and 6th month sustained virologic response rates were 84.6% and 80.5%, respectively. In genotype 3a group, end-of-treatment and 6th month sustained virologic response rates were found to be higher than other genotypes but not statistically significant. Conclusion: In our study, which assessed prisoners, the rate of HCV positivity was higher than hepatitis C in the general population in Turkey. In accordance with the literature, genotype 3 was the most common genotype among prisoners. Sustained virologic response rates obtained with peg-IFN+RBV treatment suggested that peg-IFN treatment should be used with current treatment combinations in prisoners infected with HCV genotype 3.

  14. Social Responsibility as a Means for the Sustainable Development in the Lower Danube River Basin

    Directory of Open Access Journals (Sweden)

    Tzvetelin Gueorguiev

    2014-08-01

    Full Text Available Sustainable development of the world and the EU in particular is a priority outlined in a number of strategic documents. Social responsibility is an important topic covered by standards such as SA 8000:2001 and ISO 26000:2010. This paper presents a case study of the practical implementation of corporate social responsibility activities in a Bulgarian company. Several key initiatives have been undertaken to prove the company‘s commitment to all interested parties including local communities as well. Social responsibility is where the interests and benefits for all stakeholders meet, namely employers, employees, contractors, academics, authorities and society as a whole. This paper presents a critical and original point of view on the advantages of using standards for social responsibility as a means for sustainable development.

  15. Incorporating Corporate Social Responsibility and Sustainability into a Business Course: A Shared Experience

    Science.gov (United States)

    Persons, Obeua

    2012-01-01

    The author discusses how corporate social responsibility (CSR) and sustainability were incorporated into a business course by using 4 assignments, a project with a CSR question, 7 ethics cases, and 17 ethics scenarios tied to a corporate code of ethics. The author also discusses student evaluation of CSR learning experience, strengths and…

  16. Corporate social responsibility in China: an analysis of domestic and foreign retailers' sustainability dimensions

    NARCIS (Netherlands)

    Kolk, A.; Hong, P.; van Dolen, W.

    2010-01-01

    In the past decade, a sizeable body of literature has built up on the concept and characteristics of corporate social responsibility (CSR) in Western countries, where it has also been referred to as sustainability. More recently, attention has grown for CSR in emerging countries. Remarkably, China

  17. Sustained response to weekly vinblastine in 2 children with pilomyxoid astrocytoma associated with diencephalic syndrome.

    Science.gov (United States)

    Singh, Gurpreet; Wei, Xing Chang; Hader, Walter; Chan, Jennifer A; Bouffet, Eric; Lafay-Cousin, Lucie

    2013-03-01

    Diencephalic syndrome (DS) related to hypothalamic/chiasmatic region tumor has mainly been reported with low-grade glioma. We described 2 young children with DS related to pilomyxoid astrocytoma. Despite the recognized more agressive clinical behavior of this histologic subtype, we report successful resolution of DS and sustained tumor response with prolonged use of single-agent vinblastine.

  18. 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…

  19. Counteracting Educational Injustice with Applied Critical Leadership: Culturally Responsive Practices Promoting Sustainable Change

    Science.gov (United States)

    Santamaría, Lorri J.; Santamaría, Andrés P.

    2015-01-01

    This contribution considers educational leadership practice to promote and sustain diversity. Comparative case studies are presented featuring educational leaders in the United States and New Zealand who counter injustice in their practice. The leaders' leadership practices responsive to the diversity presented in their schools offer…

  20. Sustained major molecular response on interferon alpha-2b in two patients with polycythemia vera

    DEFF Research Database (Denmark)

    Larsen, T.S.; Pallisgaard, N.; Andersen, M.T.

    2008-01-01

    with a JAK2 V617F allele burden below 1.0% in two patients with polycythemia vera treated with interferon alpha-2b (IFN-2b). Discontinuation of IFN-2b in one of the patients was followed by a sustained long-lasting (12 months of follow-up) major molecular response Udgivelsesdato: 2008/10...

  1. Granulomatous cheilitis: sustained response to combination of intralesional steroids, metronidazole and minocycline

    International Nuclear Information System (INIS)

    Dar, N.R.; Raza, N.; Nadeem, A.; Manzoor, A.

    2007-01-01

    Various conservative methods for treatment of labial swelling in patients with granulomatous cheilitis have been attempted, often with only moderate success. We report a case of granulomatous cheilitis who showed excellent sustained response to combination of intralesional steroids, metronidazole and minocycline for initial one month followed by prolonged maintenance treatment with minocycline alone. (author)

  2. Responsible software: A research agenda to help enterprises become more sustainable

    NARCIS (Netherlands)

    Espana Cubillo, S.; Brinkkemper, S.

    [BACKGROUND] Responsible enterprises are key to reaching a sustainable economy that cares about the people and the planet. Their spectrum is wide and it encompasses, among others, non-profit non-governmental organisations, social economy enterprises and companies with a committed corporate social

  3. Governance through learning: making corporate social responsibility in dutch industry effective from a sustainable development perspective

    NARCIS (Netherlands)

    Cramer, J.M.; Loeber, A.

    2004-01-01

    An increasing number of firms try to implement corporate social responsibility (CSR) from the perspective of sustainable development. This article considers these efforts in the light of the changing relation between the state, society and the corporate sector, as a result of which governance

  4. Market efficiency of traditional stock market indices and social responsible indices: the role of sustainability reporting

    OpenAIRE

    Henry Mynhardt; Inna Makarenko; Alex Plastun

    2017-01-01

    Corporate social responsibility, disclosed in sustainability reporting, influences the financial performance of companies. As a result, traditional stock market indices (TI) are expanded with the social responsible stock market indices (SRI). The aim of this study was to establish whether there are any differences in the behavior of the TI and SRI. To do this, the authors analyzed their efficiency. They used R/S analysis to calculate the Hurst exponent as a measure of persistence (long-term m...

  5. Virologic outcomes in early antiretroviral treatment: HPTN 052.

    Science.gov (United States)

    Eshleman, Susan H; Wilson, Ethan A; Zhang, Xinyi C; Ou, San-San; Piwowar-Manning, Estelle; Eron, Joseph J; McCauley, Marybeth; Gamble, Theresa; Gallant, Joel E; Hosseinipour, Mina C; Kumarasamy, Nagalingeswaran; Hakim, James G; Kalonga, Ben; Pilotto, Jose H; Grinsztejn, Beatriz; Godbole, Sheela V; Chotirosniramit, Nuntisa; Santos, Breno Riegel; Shava, Emily; Mills, Lisa A; Panchia, Ravindre; Mwelase, Noluthando; Mayer, Kenneth H; Chen, Ying Q; Cohen, Myron S; Fogel, Jessica M

    2017-05-01

    The HIV Prevention Trials Network (HPTN) 052 trial demonstrated that early antiretroviral therapy (ART) prevented 93% of HIV transmission events in serodiscordant couples. Some linked infections were observed shortly after ART initiation or after virologic failure. To evaluate factors associated with time to viral suppression and virologic failure in participants who initiated ART in HPTN 052. 1566 participants who had a viral load (VL) > 400 copies/mL at enrollment were included in the analyses. This included 832 in the early ART arm (CD4 350-550 cells/mm 3 at ART initiation) and 734 in the delayed ART arm (204 with a CD4  1000 copies/mL > 24 weeks after ART initiation. Overall, 93% of participants achieved viral suppression by 12 months. The annual incidence of virologic failure was 3.6%. Virologic outcomes were similar in the two study arms. Longer time to viral suppression was associated with younger age, higher VL at ART initiation, and region (Africa vs. Asia). Virologic failure was strongly associated with younger age, lower educational level, and lack of suppression by three months; lower VL and higher CD4 at ART initiation were also associated with virologic failure. Several clinical and demographic factors were identified that were associated with longer time to viral suppression and virologic failure. Recognition of these factors may help optimize ART for HIV treatment and prevention.

  6. The impact of luminance on tonic and phasic pupillary responses to sustained cognitive load.

    Science.gov (United States)

    Peysakhovich, Vsevolod; Vachon, François; Dehais, Frédéric

    2017-02-01

    Pupillary reactions independent of light conditions have been linked to cognition for a long time. However, the light conditions can impact the cognitive pupillary reaction. Previous studies underlined the impact of luminance on pupillary reaction, but it is still unclear how luminance modulates the sustained and transient components of pupillary reaction - tonic pupil diameter and phasic pupil response. In the present study, we investigated the impact of the luminance on these two components under sustained cognitive load. Fourteen participants performed a novel working memory task combining mathematical computations with a classic n-back task. We studied both tonic pupil diameter and phasic pupil response under low (1-back) and high (2-back) working memory load and two luminance levels (gray and white). We found that the impact of working memory load on the tonic pupil diameter was modulated by the level of luminance, the increase in tonic pupil diameter with the load being larger under lower luminance. In contrast, the smaller phasic pupil response found under high load remained unaffected by luminance. These results showed that luminance impacts the cognitive pupillary reaction - tonic pupil diameter (phasic pupil response) being modulated under sustained (respectively, transient) cognitive load. These findings also support the relationship between the locus-coeruleus system, presumably functioning in two firing modes - tonic and phasic - and the pupil diameter. We suggest that the tonic pupil diameter tracks the tonic activity of the locus-coeruleus while phasic pupil response reflects its phasic activity. Besides, the designed novel cognitive paradigm allows the simultaneous manipulation of sustained and transient components of the cognitive load and is useful for dissociating the effects on the tonic pupil diameter and phasic pupil response. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. A holistic approach to corporate social responsibility as a prerequisite for sustainable development: Empirical evidence

    Directory of Open Access Journals (Sweden)

    Zlatanović Dejana

    2015-01-01

    Full Text Available The growing importance of sustainable development and corporate social responsibility (CSR for contemporary organizations demands appropriate holistic tools. The paper highlights how Soft Systems Methodology (SSM, a relevant holistic, i.e., soft systems approach, supports the conceptualization and management of the complex issues of CSR and sustainable development. The SSM’s key methodological tools are used: rich picture, root definitions, and conceptual models. Empirical research compares a selected sample of enterprises in the automotive industry in the Republic of Serbia, to identify possible systemically desirable and culturally feasible changes to improve their CSR behaviour through promoting their sustainable development. Some limitations of this research and of SSM application are discussed. Combining SSM with some other systems approaches, such as System Dynamics or Critical Systems Heuristics, is recommended for future research.

  8. Linking public sector corporate social responsibility with sustainable development: lessons from India

    Directory of Open Access Journals (Sweden)

    Subhasis Ray

    2013-12-01

    Full Text Available Economic think tanks predict India to be the world’s largest economy by 2050. This would require India to accelerate its industrial and infrastructure development. Industrialization based economic development will have a negative impact on the environment and hence sustainable development. Such steps could affect the social and environmental bottom line of the national economy. In recent years, a number of regulatory measures have been proposed by the Indian government to ensure corporate support to the goals of sustainable and inclusive development. The objective of these regulations is to achieve triple bottom line based growth. Notable among them is the mandatory Corporate Social Responsibility (CSR guidelines for public sector undertakings, first issued in April, 2010. I study the possibility and problems created by this effort by analyzing the policy documents and interviewing managers responsible for implementing CSR programmers in Indian public sector. Managers interviewed came from hydropower, coal, power distribution and shipping industries. Based on the study, four areas are identified that requires attention for effective linking between sustainable development and CSR; stakeholder engagement, institutional mechanisms, capacity building and knowledge management. Both government-public sector and public sector-community engagements have to be more streamlined. Institutional mechanisms have to be developed to see that CSR projects are effective and delivering. Importantly, managers at all levels need a better understanding of CSR and sustainable development. Since most projects are in rural areas, understanding of rural issues and sustainability is very important. Finally, such a large scale exercise in CSR should have a knowledge management mechanism to learn from the achievements and mistakes of the early years. I discuss the implication of the findings on India and other emerging economies many of which are struggling to balance

  9. Responsibility and Sustainability in a Food Chain: A Priority Matrix Analysis

    Directory of Open Access Journals (Sweden)

    Francesco Caracciolo

    2011-12-01

    Full Text Available  This paper shows the results of empirical research conducted to assess the sustainability of a typical food supply chain, suggesting feasible solutions to satisfy inter-dimensional requisites of durable development. The analysis was conducted with reference to the supply chain of the San Marzano tomato (SMZ, a typical local food. The product is endowed with an origin certification label (PDO, meeting demand within high-value market niches. The SMZ is a flagship product in the Italian region of Campania and has benefited from several regionally funded interventions, such as genetic research and support for the application for EU certification of origin. Two key findings emerged from the research. First, the results allowed us to define a Stakeholder Priority and Responsibilities’ Matrix (SPRM, and monitor the sustainability trend of SMZ food supply chains. Second, the consistency between the adoption of quality strategy (brand of origin and sustainable development of the sector was evaluated. Despite its intrinsic characteristics and its organized, well-defined structure, the SMZ food supply chain is unable to address sustainable objectives without considerable public intervention and support. In terms of sustainability, to be able to show desirable food chain characteristics, the existence of a fully collaborative relationship between the actors has to be ascertained. Identifying shared goals is essential to assign and implement coordinated actions, pooling responsibility for product quality into social and environmental dimensions.

  10. Keeping kids in care: virological failure in a paediatric antiretroviral ...

    African Journals Online (AJOL)

    A retrospective file audit determined the cumulative virological failure rate, that is, the sum of all ... Interviews were conducted with a purposive sample of 12 staff members and a random sample of 21 caregivers and 4 children attending care.

  11. Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.

    Science.gov (United States)

    Onoya, Dorina; Sineke, Tembeka; Brennan, Alana T; Long, Lawrence; Fox, Matthew P

    2017-07-17

    We assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa. This is a retrospective cohort study of 6306 HIV-positive women aged 15-49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa. The incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling. The rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1-2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4 cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1-3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4 cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7-1.1) and those who initiated ART in pregnancy. The risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART.

  12. CORPORATE SOCIAL RESPONSIBILITY AS AN INSTRUMENT OF SUSTAINABLE DEVELOPMENT OF PRODUCTION ENTERPRISES

    Directory of Open Access Journals (Sweden)

    Ewelina GAWEŁ

    2015-07-01

    Full Text Available The paper deals with the issue of corporate social responsibility as an instrument of operationalising the paradigm of sustainable development on the microeconomic level in the sector of production enterprises. It presents a genesis and importance of CSR and indicates the most relevant essential instruments of CSR implementation on an enterprise level. The paper also analyses endogenous and exogenous benefits from implementing CSR into the business practice.

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

    OpenAIRE

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

    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 fourth-year students at a university in the Southeastern US, we employ Seeming Unrelated Regression to analyze the impact of perceived legitimacy and context o...

  14. The Social Construction of the Responsible Corporate Citizen: Sustainability Reports of the Global Automotive Firms

    OpenAIRE

    Shinkle, George; Spencer, J. William

    2008-01-01

    The constitutive meanings of responsible corporate environmental citizenship are to be found in global discourses. We use Gubrium and Holstein‘s framework on interpretive practice to study the Corporate Sustainability Reports of multinational automotive companies regarding global warming. We observe three common themes – recognizing the issue of greenhouse gases, acknowledging stakeholders, and being role models for society. However, these themes take on unique meanings vis-à-vis each corpora...

  15. Validation of Sustainable Development Practices Scale Using the Bayesian Approach to Item Response Theory

    Directory of Open Access Journals (Sweden)

    Martin Hernani Merino

    2014-12-01

    Full Text Available There has been growing recognition of the importance of creating performance measurement tools for the economic, social and environmental management of micro and small enterprise (MSE. In this context, this study aims to validate an instrument to assess perceptions of sustainable development practices by MSEs by means of a Graded Response Model (GRM with a Bayesian approach to Item Response Theory (IRT. The results based on a sample of 506 university students in Peru, suggest that a valid measurement instrument was achieved. At the end of the paper, methodological and managerial contributions are presented.

  16. Corporate Social Responsibility as a tool to ensure sustainability and competitiveness of the monotowns

    Directory of Open Access Journals (Sweden)

    Sechina Asya

    2016-01-01

    Full Text Available Learning the basics and trends of the development of corporate social responsibility is connected with the need to identify the reasons for its humanization and globalization in today’s business environment. Sustainability and competitiveness is one of the important characteristics of the company today. The characteristic of the Russian practice of corporate social responsibility highlights its features, levels and forms of development. Monotowns are a highly vulnerable category of Russian communities; they are in constant risk due to their specific characteristics and largely the underdeveloped economic base. The problems of monoprofile towns usually do not have simple solutions. They require a comprehensive approach and taking account of the existence and development of each monotown. The article deals with the concept of a monoprofile town, stages of formation and evolution of this phenomenon in the Russian economy. There is the problem of application of corporate social responsibility in the practice of Russian monotowns. There is the characteristic advantage of social responsibility in the monotowns. There is the influence of the organizations activities operating in a monotown on the quality of life of the population. There is the necessity of the use of corporate social responsibility in monotowns to enhance their sustainability and improve competitiveness.

  17. Special issue on"social responsibility accounting and reporting in times of ‘sustainability Downturn/crisis

    Directory of Open Access Journals (Sweden)

    Carmen Correa-ruiz

    2011-08-01

    Full Text Available At a time when sustainability performance does not seem to match the expectations raised by the sustainable development concept and, moreover, when the economic downturn and crisis could be further eroding social and environmental concerns and values, the notion of sustainability crisis provides an interesting starting point to reflect on the role of Social and Environmental Accounting Research. Lack of humanity and values, short term economic approach, institutional capture and misunderstanding and misuse of democracy, have all served as catalysts of sustainability downturn and crisis. Thus, this editorial attempts to advance public interest accounting by discussing the controversy around Sustainability and Corporate Social Responsibility, expecting that the constitutive effects of researchers’ words in this special issue and in future research agendas, will result in more transformative power relations able to enhance a healthy democracy inspired by the capacity to do things and to transform individuals’ attitudes and behaviours, as well as the institutional response to the sustainability crisis.

  18. Paediatric Virology as a new educational initiative: An interview with Nobelist Professor of Virology Harald zur Hausen.

    Science.gov (United States)

    Mammas, Ioannis N; Spandidos, Demetrios A

    2017-10-01

    Born in Gelsenkirchen-Buer in Germany on March 11th, 1936, Professor Harald zur Hausen, Emeritus Professor of Virology at the University of Freiburg and 2008 Nobel Prize Laureate in Physiology or Medicine for his discovery of human papillomavirus (HPV), which causes cervical cancer, believes that good knowledge of virological methods and diagnostic possibilities are an asset for all young paediatricians. Professor zur Hausen considers that the creation of an educational platform on Paediatric Virology is definitely very beneficial for young paediatricians, as this will greatly enhance their knowledge in the field of Virology. He very actively advocates the vaccination of boys for the eradication of HPV infection and emphasises that male HPV vaccination should be included into the current vaccination programmes. He would have certainly considered Dr George N. Papanicolaou (Kyme, Island of Euboea, Greece, 1883 - Miami, Florida, USA, 1962) as an excellent candidate for the Nobel Prize, stating that the contribution of Dr Papanicolaou did not find sufficient recognition in the past. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor zur Hausen will give his plenary lecture on 'Paediatric Virology and Oncology: Virus persistence and the important first years of life'.

  19. Pretreatment HIV drug resistance results in virological failure and accumulation of additional resistance mutations in Ugandan children

    NARCIS (Netherlands)

    Kityo, Cissy; Boerma, Ragna S.; Sigaloff, Kim C. E.; Kaudha, Elizabeth; Calis, Job C. J.; Musiime, Victor; Balinda, Sheila; Nakanjako, Rita; Boender, T. Sonia; Mugyenyi, Peter N.; Rinke de Wit, Tobias F.

    2017-01-01

    Background: Pretreatment HIV drug resistance (PDR) can impair virological response to ART, jeopardizing effective treatment for children. Methods: Children aged <12 years initiated first-line ART in Uganda during 2010-11. Baseline and 6 monthly viral load (VL) and genotypic resistance testing if VL.

  20. Appeals to consumer responsibility and improving structural conditions as means to promote sustainable consumer behavior

    DEFF Research Database (Denmark)

    Thøgersen, John

    for their acts or (b) structural conditions determined by governments? In field experiments with large samples of ordinary consumers, the behavioral effects of perceptions of responsibility/personal moral norms and of altering an important structural condition are quantified by measuring a relevant behavior......-developed public transit service. The results suggest that there is often more to gain from changing structural conditions to be more facilitating for the desired behavior than from a campaign targeting consumer feelings of responsibility.......Environmental policy-makers increasingly emphasize consumers' responsibility for environmental side effects of their acts, but is this justified? This paper investigates which is the most important limiting factor for sustainable consumption: (a) the extent to which consumers assume responsibility...

  1. A Designed Model of Sustainable Competitiveness for Slovak Industrial Companies in the Global Context of Sustainable Corporate Social Responsibility

    Science.gov (United States)

    Božiková, Lucia; Šnircová, Jana

    2016-06-01

    In this article we introduce a model of sustainable competitiveness, which we created on the basis of a long term study of literature and analysis. This article is divided into several parts. In the first part, we will introduce the problem of competitiveness and sustainable competitiveness. The second part is focused on the basic aspects for the creation of the model. In the third part the model itself is introduced and also an explanation and description of the mode is given.

  2. Company, Sustainability and Social Responsibility: Origins, Motivations, Critical and Practical Aspects.

    Directory of Open Access Journals (Sweden)

    Mariana Ribeiro Santiago

    2015-12-01

    Full Text Available The present paper analyzes the sustainability and its historical aspects, the emergence of global concern about the subject, with sustainable economic development and its major initiatives, from the effective involvement of the States in the discussions in the search for consensus in the quality of life on the planet, rationality in the exploitation of natural resources and concern for future generations. We research also the context of social responsibility (business, starting at historical aspect to following analyze its interrelationship as an instrument to combat the problem of social inequality and poverty, was discoursing on the possibility of state action while inducing corporate behavior on this theme, describing the concrete experience revealed in the actions of the Federal Public Ministry, through award-winning design that became known as "Green Cities / Meat Legal".

  3. Withholding and withdrawing life-sustaining treatment: criminal responsibility for established medical practice?

    Science.gov (United States)

    White, Ben; Willmott, Lindy; Allen, John

    2010-05-01

    The law recognises the right of a competent adult to refuse medical treatment even if this will lead to death. Guardianship and other legislation also facilitates the making of decisions to withhold or withdraw life-sustaining treatment in certain circumstances. Despite this apparent endorsement that such decisions can be lawful, doubts have been raised in Queensland about whether decisions to withhold or withdraw life-sustaining treatment would contravene the criminal law, and particularly the duty imposed by the Criminal Code (Qld) to provide the "necessaries of life". This article considers this tension in the law and examines various arguments that might allow for such decisions to be made lawfully. It ultimately concludes, however, that criminal responsibility may still arise and so reform is needed.

  4. Responsible tourism as an agent of sustainable and socially-conscious development

    Directory of Open Access Journals (Sweden)

    Pierluigi Musarò

    2014-10-01

    Full Text Available Despite the variety of banalities that are often associated with trips and vacations as mass consumption, the study of tourism – due to the commitment of social, economic, political and cultural energy - remains one of the predominant inputs for understanding contemporary society and the new social hierarchies that distinguish it. Tourism, which is  increasingly seen as a process that has become integral to social and cultural life, also plays an essential role in the social and spatial dialectic that gives meaning to the places. Focusing tourism through the lens of "productive consumption" developed by Cultural Studies, the paper moves from the assumption that responsible tourism can be analyzed in the broader paradigm of relational goods to explore the role of responsible tourism as a possible way of sustainable and responsible development.

  5. Pivotal role of cardiomyocyte TGF-β signaling in the murine pathological response to sustained pressure overload

    NARCIS (Netherlands)

    Koitabashi, Norimichi; Danner, Thomas; Zaiman, Ari L.; Pinto, Yigal M.; Rowell, Janelle; Mankowski, Joseph; Zhang, Dou; Nakamura, Taishi; Takimoto, Eiki; Kass, David A.

    2011-01-01

    The cardiac pathological response to sustained pressure overload involves myocyte hypertrophy and dysfunction along with interstitial changes such as fibrosis and reduced capillary density. These changes are orchestrated by mechanical forces and factors secreted between cells. One such secreted

  6. Clay Nanoparticles Elicit Long-Term Immune Responses by Forming Biodegradable Depots for Sustained Antigen Stimulation.

    Science.gov (United States)

    Chen, Weiyu; Zuo, Huali; Li, Bei; Duan, Chengcheng; Rolfe, Barbara; Zhang, Bing; Mahony, Timothy J; Xu, Zhi Ping

    2018-05-01

    Nanomaterials have been widely tested as new generation vaccine adjuvants, but few evoke efficient immunoreactions. Clay nanoparticles, for example, layered double hydroxide (LDH) and hectorite (HEC) nanoparticles, have shown their potent adjuvanticity in generating effective and durable immune responses. However, the mechanism by which clay nanoadjuvants stimulate the immune system is not well understood. Here, it is demonstrated that LDH and HEC-antigen complexes form loose agglomerates in culture medium/serum. They also form nodules with loose structures in tissue after subcutaneous injection, where they act as a depot for up to 35 d. More importantly, clay nanoparticles actively and continuously recruit immune cells into the depot for up to one month, and stimulate stronger immune responses than FDA-approved adjuvants, Alum and QuilA. Sustained antigen release is also observed in clay nanoparticle depots, with 50-60% antigen released after 35 d. In contrast, Alum-antigen complexes show minimal antigen release from the depot. Importantly, LDH and HEC are more effective than QuilA and Alum in promoting memory T-cell proliferation. These findings suggest that both clay nanoadjuvants can serve as active vaccine platforms for sustained and potent immune responses. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Sustained major molecular response on interferon alpha-2b in two patients with polycythemia vera

    DEFF Research Database (Denmark)

    Larsen, Thomas Stauffer; Bjerrum, O W; Pallisgaard, N

    2008-01-01

    Quantitative assessment of the JAK2 V617F allele burden during disease evolution and ongoing myelosuppressive treatment is likely to be implemented in the future clinical setting. Interferon alpha has demonstrated efficacy in treatment of both chronic myeloid leukemia and the Philadelphia chromos...... with a JAK2 V617F allele burden below 1.0% in two patients with polycythemia vera treated with interferon alpha-2b (IFN-2b). Discontinuation of IFN-2b in one of the patients was followed by a sustained long-lasting (12 months of follow-up) major molecular response....

  8. Sustainability as Social Contract: Textile and Apparel Professionals’ Value Conflicts within the Corporate Moral Responsibility Spectrum

    Directory of Open Access Journals (Sweden)

    Rachel LoMonaco-Benzing

    2016-12-01

    Full Text Available Current discussions of sustainability in the textile and apparel (T&A supply chain tend to focus on consumer behavior or methods of production. Few studies investigate how T&A supply chain members experience corporate sustainability initiatives within their own moral value spectrum. This study was designed to describe the gaps that might exist between personal and corporate moral values of T&A supply chain members, and how individuals manage such gaps to align personal and corporate identities. The researchers investigated the views of ten T&A supply chain members residing in the United States, both as employees and consumers of T&A companies, through semi-structured interviews. Dunfee’s extant social contracts and Schwartz’s theory of basic values were used as theoretical frameworks to better understand the participants’ lived experiences in negotiating personal and corporate expectations. The findings revealed three themes: (a nature of the value gap; (b frustration due to the value gap; and (c strategies to manage the value gap. The strategies used to realign values split into either those that held sustainability as their responsibility and worked to move corporate values toward their personal values; or those that shifted the blame to others so that their values could remain untouched.

  9. "Omics" of maize stress response for sustainable food production: opportunities and challenges.

    Science.gov (United States)

    Gong, Fangping; Yang, Le; Tai, Fuju; Hu, Xiuli; Wang, Wei

    2014-12-01

    Maize originated in the highlands of Mexico approximately 8700 years ago and is one of the most commonly grown cereal crops worldwide, followed by wheat and rice. Abiotic stresses (primarily drought, salinity, and high and low temperatures), together with biotic stresses (primarily fungi, viruses, and pests), negatively affect maize growth, development, and eventually production. To understand the response of maize to abiotic and biotic stresses and its mechanism of stress tolerance, high-throughput omics approaches have been used in maize stress studies. Integrated omics approaches are crucial for dissecting the temporal and spatial system-level changes that occur in maize under various stresses. In this comprehensive analysis, we review the primary types of stresses that threaten sustainable maize production; underscore the recent advances in maize stress omics, especially proteomics; and discuss the opportunities, challenges, and future directions of maize stress omics, with a view to sustainable food production. The knowledge gained from studying maize stress omics is instrumental for improving maize to cope with various stresses and to meet the food demands of the exponentially growing global population. Omics systems science offers actionable potential solutions for sustainable food production, and we present maize as a notable case study.

  10. A Designed Model of Sustainable Competitiveness for Slovak Industrial Companies in the Global Context of Sustainable Corporate Social Responsibility

    Directory of Open Access Journals (Sweden)

    Božiková Lucia

    2016-06-01

    Full Text Available In this article we introduce a model of sustainable competitiveness, which we created on the basis of a long term study of literature and analysis. This article is divided into several parts. In the first part, we will introduce the problem of competitiveness and sustainable competitiveness. The second part is focused on the basic aspects for the creation of the model. In the third part the model itself is introduced and also an explanation and description of the mode is given.

  11. A sustained hypothalamic-pituitary-adrenal axis response to acute psychosocial stress in irritable bowel syndrome.

    Science.gov (United States)

    Kennedy, P J; Cryan, J F; Quigley, E M M; Dinan, T G; Clarke, G

    2014-10-01

    Despite stress being considered a key factor in the pathophysiology of the functional gastrointestinal (GI) disorder irritable bowel syndrome (IBS), there is a paucity of information regarding the ability of IBS patients to respond to acute experimental stress. Insights into the stress response in IBS could open the way to novel therapeutic interventions. To this end, we assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS. Thirteen female patients with IBS and 15 healthy female age-matched control participants underwent a single exposure to the TSST. Salivary cortisol, salivary C-reactive protein (CRP), skin conductance level (SCL), GI symptoms, mood and self-reported stress were measured pre- and post-exposure to the TSST. The hypothalamic-pituitary-adrenal (HPA) axis response to the TSST was sustained in IBS, as shown by a greater total cortisol output throughout (p = 0.035) and higher cortisol levels measured by an area under the curve with respect to ground (AUCG) analysis (p = 0.044). In IBS patients, GI symptoms increased significantly during the recovery period following exposure to the TSST (p = 0.045). Salivary CRP and SCL activity showed significant changes in relation to stress but with no differential effect between experimental groups. Patients with IBS exhibit sustained HPA axis activity, and an increase in problematic GI symptoms in response to acute experimental psychosocial stress. These data pave the way for future interventional studies aimed at identifying novel therapeutic approaches to modulate the HPA axis and GI symptom response to acute psychosocial stress in IBS.

  12. Corporate social responsibility: a real options approach to the challenge of financial sustainability.

    Science.gov (United States)

    Bosch-Badia, Maria-Teresa; Montllor-Serrats, Joan; Tarrazon-Rodon, Maria-Antonia

    2015-01-01

    In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying those CSR projects

  13. Corporate social responsibility: a real options approach to the challenge of financial sustainability.

    Directory of Open Access Journals (Sweden)

    Maria-Teresa Bosch-Badia

    Full Text Available In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR.The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying

  14. Sustainable responsible business conscience as derived from the Chumash: Hermeneutic henomenological perspective

    Directory of Open Access Journals (Sweden)

    Sivave Mashingaidze

    2015-07-01

    Full Text Available The Chumash (Five books of Moses has potential from which conventional models and theories could leverage for public wellbeing. Considering the moral and ethical magnitude of business/corporate social responsibility (CSR or Sustainable Responsible Business, understanding this concept from the religious stand-point could help strengthen CSR compliance, where religions play direct and indirect role in corporate governance and people’s lifestyle. This article explores epigraphic sources to provide answer to the questions: Does CSR have theological foundation from the Chumash? Can faith strengthen CSR and fortify compliance? The researcher sourced the required qualitative data from journal articles, Judaic sources and Chumash (Bible texts as well as relevant online resources on the subject. The extractions from epigraphic sources were critically and methodically examined carefully using hermeneutic from which answers to the two questions were established. The findings indicate that CSR has theological foundation in the Chumash, and religious ethics and values have great influence for strengthening CSR.

  15. Plant response-based sensing for control starategies in sustainable greenhouse production

    International Nuclear Information System (INIS)

    Kacira, M.; Sase, S.; Okushima, L.; Ling, P.P.

    2005-01-01

    The effect of environmental variability is one of the major concerns in experimental design for both research in plant systems and greenhouse plant production. Microclimates surrounding plants are not usually uniform. Therefore, many samples and sensors are required to obtain a true representation of the plant population. A plant monitoring system capable of reducing the required number of samples by reducing environmental variability would be more advantageous. To better understand plant-environment interaction, it is essential to study plants, microclimate surrounding the plants and the growth media. To achieve this, the monitoring system must be equipped with proper instrumentation. To achieve proper management practices and sustainable greenhouse production, it is essential first to understand plants and their interactions with their surroundings and then establish plant response-based sensing and control strategies for greenhouse processes. Therefore, an effort was conducted to review and discuss current sensing and control strategies in greenhouse research and plant production and provide recommendations on plant response-based sensing and control strategies for sustainable greenhouse production

  16. Towards strategic stakeholder management? Integrating perspectives on sustainability challenges such as corporate responses to climate change

    International Nuclear Information System (INIS)

    Kolk, A.; Pinkse, J.

    2007-01-01

    The strategic management of corporate sustainability tends to be approached from one theoretical perspective in academic research and publications in mainstream journals simultaneously. In corporate practice, however, a sustainability issue has different dimensions that cannot be captured if only one such lens is taken. The purpose of this article is to develop a more integrated perspective, embedded in a stakeholder view. This paper uses climate change as an example to illustrate how institutional, resource-based, supply chain and stakeholder views are all important to characterize and understand corporate strategic responses to one issue. This is subsequently linked to the climate strategies and related capabilities of companies, reckoning with societal and competitive contexts. Findings - What a corporate climate strategy looks like depends on the type of stakeholders that a company manages more proactively, which is in turn determined by the extent to which these stakeholders control critical resources. While empirical literature usually adopts a particular theoretical perspective, this article has attempted to develop a more integrative approach on corporate responses to climate change

  17. Time-of-use based electricity demand response for sustainable manufacturing systems

    International Nuclear Information System (INIS)

    Wang, Yong; Li, Lin

    2013-01-01

    As required by the Energy Policy Act of 2005, utility companies across the U.S. are offering TOU (time-of-use) based electricity demand response programs. The TOU rate gives consumers opportunities to manage their electricity bill by shifting use from on-peak periods to mid-peak and off-peak periods. Reducing the amount of electricity needed during the peak load times makes it possible for the power grid to meet consumers' needs without building more costly backup infrastructures and help reduce GHG (greenhouse gas) emissions. Previous research on the applications of TOU and other electricity demand response programs has been mainly focused on residential and commercial buildings while largely neglected industrial manufacturing systems. This paper proposes a systems approach for TOU based electricity demand response for sustainable manufacturing systems under the production target constraint. Key features of this approach include: (i) the electricity related costs including both consumption and demand are integrated into production system modeling; (ii) energy-efficient and demand-responsive production scheduling problems are formulated and the solution technique is provided; and (iii) the effects of various factors on the near-optimal scheduling solutions are examined. The research outcome is expected to enhance the energy efficiency, electricity demand responsiveness, and cost effectiveness of modern manufacturing systems. - Highlights: • We propose a TOU based demand response approach for manufacturing systems. • Both electricity consumption and demand are integrated into the system modeling. • Energy-efficient and demand-responsive production scheduling problems are formulated. • The meta-heuristic solution technique is provided. • The effects of various factors on the scheduling solutions are examined

  18. Variant allele frequency enrichment analysis in vitro reveals sonic hedgehog pathway to impede sustained temozolomide response in GBM.

    Science.gov (United States)

    Biswas, Nidhan K; Chandra, Vikas; Sarkar-Roy, Neeta; Das, Tapojyoti; Bhattacharya, Rabindra N; Tripathy, Laxmi N; Basu, Sunandan K; Kumar, Shantanu; Das, Subrata; Chatterjee, Ankita; Mukherjee, Ankur; Basu, Pryiadarshi; Maitra, Arindam; Chattopadhyay, Ansuman; Basu, Analabha; Dhara, Surajit

    2015-01-21

    Neoplastic cells of Glioblastoma multiforme (GBM) may or may not show sustained response to temozolomide (TMZ) chemotherapy. We hypothesize that TMZ chemotherapy response in GBM is predetermined in its neoplastic clones via a specific set of mutations that alter relevant pathways. We describe exome-wide enrichment of variant allele frequencies (VAFs) in neurospheres displaying contrasting phenotypes of sustained versus reversible TMZ-responses in vitro. Enrichment of VAFs was found on genes ST5, RP6KA1 and PRKDC in cells showing sustained TMZ-effect whereas on genes FREM2, AASDH and STK36, in cells showing reversible TMZ-effect. Ingenuity pathway analysis (IPA) revealed that these genes alter cell-cycle, G2/M-checkpoint-regulation and NHEJ pathways in sustained TMZ-effect cells whereas the lysine-II&V/phenylalanine degradation and sonic hedgehog (Hh) pathways in reversible TMZ-effect cells. Next, we validated the likely involvement of the Hh-pathway in TMZ-response on additional GBM neurospheres as well as on GBM patients, by extracting RNA-sequencing-based gene expression data from the TCGA-GBM database. Finally, we demonstrated TMZ-sensitization of a TMZ non-responder neurosphere in vitro by treating them with the FDA-approved pharmacological Hh-pathway inhibitor vismodegib. Altogether, our results indicate that the Hh-pathway impedes sustained TMZ-response in GBM and could be a potential therapeutic target to enhance TMZ-response in this malignancy.

  19. Serological and Virological Study of Newcastle Disease and Avian ...

    African Journals Online (AJOL)

    Serological survey on the prevalence of Newcastle disease (NCD) virus antibodies using haemagglutination inhibition test (HI) and virological detection by RT-PCR of highly pathogenic avian influenza (HPAI) H5N1, were carried out in 6 regions of Senegal from June to November 2008. Rural chickens were raised in free ...

  20. A Biosafety Level 2 Virology Lab for Biotechnology Undergraduates

    Science.gov (United States)

    Matza-Porges, Sigal; Nathan, Dafna

    2017-01-01

    Medical, industrial, and basic research relies heavily on the use of viruses and vectors. Therefore, it is important that bioscience undergraduates learn the practicalities of handling viruses. Teaching practical virology in a student laboratory setup presents safety challenges, however. The aim of this article is to describe the design and…

  1. Quantum virology : improved management of viral infections through quantitative measurements

    NARCIS (Netherlands)

    Kalpoe, Jaijant Satishkumar

    2007-01-01

    Real-time monitoring of PCR has strongly supported the increased diagnostic use of nucleic acid detection assays in clinical virology. Particularly the improvements in the ability to quantify target nucleic acid sequences offer new opportunities in the management of viral infections. Real-time PCR

  2. Virologic responses and tolerance of peginterferon alfa plus ribavirin ...

    African Journals Online (AJOL)

    The efficacy and safety outcomes were compared between groups. ... heavy social and economic burden worldwide over the past ... others to remix, tweak, and build upon the work non-commercially, as long as the ... [7] A survey in the United States has revealed an .... reduction or complete absence of HCV RNA at week 12.

  3. [Sustainability and excellence of the Catalan health system. New paradigms, challenges and responses].

    Science.gov (United States)

    Fernández i Alegre, Roser; Argenter i Giralt, Miquel; Rodríguez i Guasch, Xavier

    2015-11-01

    The aim of a health system and the priority of any government is to anticipate problems before they appear, provide an innovative response to these new needs and healthcare models, improve access of the general public and patients to health care, especially care for the most vulnerable groups, improve healthcare results and implement the structural reforms necessary to maintain a viable and sustainable quality public healthcare system for everyone. In the current environment, health systems are facing new economic, demographic, care, social, technological and political paradigms to which health policy must respond. Faced with these challenges, health systems, especially in the case of Catalonia, are challenged to take decisions on how best to approach the implementation of structural reform designed to facilitate the necessary economic and fiscal sustainability in the service of fresh and innovative health policies and patient-centred care within a system marked by excellence and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  4. Enhancing the Australian healthcare sector's responsiveness to environmental sustainability issues: suggestions from Australian healthcare professionals.

    Science.gov (United States)

    Dunphy, Jillian L

    2013-05-01

    Identify strategies to implement change across the Australian healthcare sector to better support social and natural environments. Methods. Qualitative analysis of semi-structured interviews with Australian healthcare professionals. Interviewees described multiple barriers to implementing change and numerous strategies to overcome these barriers. They argued that action must be taken at the individual and systemic levels to produce substantial and effective change. The strategies recommended fall into four main categories: altering workplace cultures and professional identities, community engagement, political activity, and change from within. The overarching goals of these strategies are to reduce negative impacts on the natural environment, and increase social equity within and across generations. By implementing the strategies described, a more cohesive effort to address sustainability issues across the sector can be made. This may improve local and global health, within current and future generations. WHAT IS KNOWN ABOUT THE TOPIC? Healthcare has a significant impact on the natural and social environments, which in turn have a significant impact upon health and healthcare. WHAT DOES THIS PAPER ADD? This paper describes strategies to alter healthcare to better support environmental sustainability. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Collective implementation of the described strategies may allow a more cohesive and effective response across the Australian healthcare sector, to enhance local and global health for current and future generations.

  5. Sustained release of antibiotics from injectable and thermally responsive polypeptide depots.

    Science.gov (United States)

    Adams, Samuel B; Shamji, Mohammed F; Nettles, Dana L; Hwang, Priscilla; Setton, Lori A

    2009-07-01

    Biodegradable polymeric scaffolds are of interest for delivering antibiotics to local sites of infection in orthopaedic applications, such as bone and diarthrodial joints. The objective of this study was to develop a biodegradable scaffold with ease of drug loading in aqueous solution, while providing for drug depot delivery via syringe injection. Elastin-like polypeptides (ELPs) were used for this application, biopolymers of repeating pentapeptide sequences that were thermally triggered to undergo in situ depot formation at body temperature. ELPs were modified to enable loading with the antibiotics, cefazolin, and vancomycin, followed by induction of the phase transition in vitro. Cefazolin and vancomycin concentrations were monitored, as well as bioactivity of the released antibiotics, to test an ability of the ELP depot to provide for prolonged release of bioactive drugs. Further tests of formulation viscosity were conducted to test suitability as an injectable drug carrier. Results demonstrate sustained release of therapeutic concentrations of bioactive antibiotics by the ELP, with first-order time constants for drug release of approximately 25 h for cefazolin and approximately 500 h for vancomycin. These findings illustrate that an injectable, in situ forming ELP depot can provide for sustained release of antibiotics with an effect that varies across antibiotic formulation. ELPs have important advantages for drug delivery, as they are known to be biocompatible, biodegradable, and elicit no known immune response. These benefits suggest distinct advantages over currently used carriers for antibiotic drug delivery in orthopedic applications. (c) 2008 Wiley Periodicals, Inc.

  6. From Customer to Stakeholder Management: Quality Managers perceptions of Sustainability and Social Responsibility concepts, motivations and impacts

    OpenAIRE

    Fonseca, Luis

    2013-01-01

    57Th EOQ Congress, Quality Renaissance - Co-creating a Viable Future" The research proves that under certain conditions: The economic, environmental and social dimensions are key to organizational sustainable success; Stakeholder satisfaction is significantly higher when a Social Responsibility program is present and it is relevant for the organizational sustainable success and competitive position, as suggested by Freeman (1984) Stakeholder Theory and in line with ISO...

  7. The innovation of the subspecialty of Paediatric Virology: An interview with Research Professor of Molecular Virology Anna Kramvis.

    Science.gov (United States)

    Mammas, Ioannis N; Spandidos, Demetrios A

    2017-10-01

    Professor Anna Kramvis, Research Professor of Molecular Virology at the University of the Witwatersrand in Johannesburg, South Africa, talks about direct-acting antiviral treatments against hepatitis C virus (HCV), as well as the perspective of the development of an effective vaccine against HCV. She emphasises the necessity of vaccination against hepatitis B virus (HBV), highlighting that it is very important that vaccination should be administered at birth in order to prevent mother-to-child transmission (MTCT) of HBV. Professor Kramvis states that vaccination against HBV is safe and that HBV and HCV infections are not contraindications for breastfeeding. Regarding the challenge of Paediatric Virology, she believes that it is a field that during the last years is increasing exponentially, while she concurs that Paediatric Virology subspecialty will be a popular choice for infectious diseases subspecialists. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens on October 7th, 2017, Professor Kramvis will give her key lecture on MTCT of HBV and HCV.

  8. Incorporating Human Rights into the Sustainability Agenda: A Commentary on "Corporate Responsibility to Respect Human Rights and Business Schools' Responsibility to Teach It"

    Science.gov (United States)

    Andrew, Jane

    2013-01-01

    In her commentary of McPhail's 2013 article "Corporate Responsibility to Respect Human Rights and Business Schools' Responsibility to Teach It: Incorporating Human Rights into the Sustainability Agenda," Jane Andrew begins by highlighting a number of McPhail's primary arguments. She points out that McPhail sets out to achieve two things…

  9. 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.

  10. Orienting-defense responses and psychophysiological reactivity in isolated clinic versus sustained hypertension.

    Science.gov (United States)

    García-Vera, María Paz; Sanz, Jesús; Labrador, Francisco J

    2007-04-01

    This study sought to determine whether patients with white-coat or isolated clinic hypertension (ICH) show, in comparison to patients with sustained hypertension (SH), a defense response pattern to novel stimuli and an enhanced psychophysiological reactivity to stress. Forty-three patients with essential hypertension were divided into two groups after 16 days of self-monitoring blood pressure (BP): ICH (24 men; self-measured BP men; self-measured BP >or= 135/85 mmHg). Defense responses were measured as the cardiac changes to phasic non-aversive auditory stimuli. Psychophysiological reactivity (heart and breath rate, blood volume pulse, electromyography, and skin conductance) was measured during mental arithmetic and video game tasks. The standard deviation of self-measured BPs and the difference between mean BPs at work and at home were used as indicators of cardiovascular reactivity to daily stress. No significant differences were seen in defense responses or psychophysiological reactivity to laboratory or naturally occurring stressors. These results do not support the hypothesis that ICH can be explained in terms of a generalized hyperreactivity to novel or stressful stimuli.

  11. Arctic plants are capable of sustained responses to long-term warming

    Directory of Open Access Journals (Sweden)

    Robert T. Barrett

    2016-05-01

    Full Text Available Previous studies have shown that Arctic plants typically respond to warming with increased growth and reproductive effort and accelerated phenology, and that the magnitude of these responses is likely to change over time. We investigated the effects of long-term experimental warming on plant growth (leaf length and reproduction (inflorescence height, reproductive phenology and reproductive effort using 17–19 years of measurements collected as part of the International Tundra Experiment (ITEX at sites near Barrow and Atqasuk, Alaska. During the study period, linear regressions indicated non-significant tendencies towards warming air temperatures at our study sites. Results of our meta-analyses on the effect size of experimental warming (calculated as Hedges’ d indicated species generally responded to warming by increasing inflorescence height, increasing leaf length and flowering earlier, while reproductive effort did not respond consistently. Using weighted least-squares regressions on effect sizes, we found a significant trend towards dampened response to experimental warming over time for reproductive phenology. This tendency was consistent, though non-significant, across all traits. A separate analysis revealed significant trends towards reduced responses to experimental warming during warmer summers for all traits. We therefore propose that tendencies towards dampened plant responses to experimental warming over time are the result of regional warming. These results show that Arctic plants are capable of sustained responses to warming over long periods of time but also suggest that, as the region continues to warm, factors such as nutrient availability, competition and herbivory will become more limiting to plant growth and reproduction than temperature.

  12. Predictive value of early viriological response for sustained viriological response in chronic hepatitis c with conventional interferon therapy

    International Nuclear Information System (INIS)

    Awan, A.; Umar, M.; Khaar, H.T.B.; Kulsoom, A.; Minhas, Z.; Ambreen, S.; Habib, N.; Mumtaz, W.; Habib, F.

    2016-01-01

    Background: Hepatitis is a major public health problem in Pakistan due to its strong association with liver failure and hepatocellular carcinoma. In Pakistan, conventional interferon therapy along with Ribavirin is favoured especially in Government funded programs for treatment of Hepatitis C, over the more expensive Pegylated Interferon and Ribavirin combination therapy as recommended by Pakistan society of Gastroenterology and GI endoscopy due to its favourable results observed in genotype 3 which is the dominant genotype of this region. Objective of our study was to assess the viriological responses with standard interferon therapy and to determine the predictive values of early viriological response (EVR) for Sustained Viriological Response (SVR) in chronic hepatitis C patients treated with standard interferon therapy. Methods: A cross sectional study was conducted on patients with chronic hepatitis C having received standard interferon and ribavirin therapy for six months. EVR and SVR were noted for analysis. Positive and negative predictive values of EVR on SVR were calculated. Results: Out of the total sample (N=3075), 1946 (63.3 percentage) patients were tested for EVR. 1386 (71.2 percentage) were positive while 560 (28.8 percentage) were negative while 516 (16.8 percentage) were tested for SVR. Two hundred and eighty-five (55.2 percentage) were positive while 231 (44.8 percentage) were negative. EVR and SVR tested were N=117. Positive predictive value of EVR on SVR was 67.1 percentage and negative predictive value was 65.8 percentage. Statistically significant association between EVR and SVR was determined with Chi square statistic of 11.8 (p-value <0.0001). Conclusion: EVR is a good predictor of response of patients to standard interferon and ribavirin therapy. In the absence of an EVR, it seems imperative to stop further treatment. Virilogical responses with conventional interferon therapy are comparable to those of pegylated interferon therapy so

  13. Hepatitis C Virus: Virology and Genotypes

    KAUST Repository

    Abdelaziz, Ahmed

    2017-12-01

    Hepatitis C virus (HCV) is a major causative agent of chronic liver disease worldwide. HCV is characterized by genetic heterogeneity, with at least six genotypes identified. The geographic distribution of genotypes has shown variations in different parts of the world over the past decade because of variations in population structure, immigration, and routes of transmission. Genotype differences are of epidemiologic interest and help the study of viral transmission dynamics to trace the source of HCV infection in a given population. HCV genotypes are also of considerable clinical importance because they affect response to antiviral therapy and represent a challenging obstacle for vaccine development.

  14. Tools of Realization of Social Responsibility of Industrial Business for Sustainable Socio-economic Development of Mining Region's Rural Territory

    Science.gov (United States)

    Jurzina, Tatyana; Egorova, Natalia; Zaruba, Natalia; Kosinskij, Peter

    2017-11-01

    Modern conditions of the Russian economy do especially relevant questions of social responsibility of industrial business of the mining region for sustainable social and economic development of rural territories that demands search of the new strategy, tools, ways for positioning and increase in competitiveness of the enterprises, which are carrying out the entrepreneurial activity in this territory. The article opens problems of an influence of the industrial enterprises on the territory of presence, reasons the theoretical base directed to the formation of practical tools (mechanism) providing realization of social responsibility of business for sustainable social and economic development of rural territories of the mining region.

  15. Tools of Realization of Social Responsibility of Industrial Business for Sustainable Socio-economic Development of Mining Region's Rural Territory

    Directory of Open Access Journals (Sweden)

    Jurzina Tatyana

    2017-01-01

    Full Text Available Modern conditions of the Russian economy do especially relevant questions of social responsibility of industrial business of the mining region for sustainable social and economic development of rural territories that demands search of the new strategy, tools, ways for positioning and increase in competitiveness of the enterprises, which are carrying out the entrepreneurial activity in this territory. The article opens problems of an influence of the industrial enterprises on the territory of presence, reasons the theoretical base directed to the formation of practical tools (mechanism providing realization of social responsibility of business for sustainable social and economic development of rural territories of the mining region.

  16. Initial and sustained brain responses to threat anticipation in blood-injection-injury phobia

    Directory of Open Access Journals (Sweden)

    Leonie Brinkmann

    2017-01-01

    Full Text Available Blood-injection-injury (BII phobia differs from other subtypes of specific phobia in that it is associated with elevated disgust-sensitivity as well as specific autonomic and brain responses during processing of phobia-relevant stimuli. To what extent these features play a role already during threat anticipation is unclear. In the current fMRI experiment, 16 female BII phobics and 16 female healthy controls anticipated the presentation of phobia-specific and neutral pictures. On the behavioral level, anxiety dominated the anticipatory period in BII phobics relative to controls, while both anxiety and disgust were elevated during picture presentation. By applying two different models for the analysis of brain responses to anticipation of phobia-specific versus neutral stimuli, we found initial and sustained increases of activation in anterior cingulate cortex (ACC, insula, lateral and medial prefrontal cortex (PFC, thalamus and visual areas, as well as initial activation in the amygdala for BII phobics as compared to healthy controls. These results suggest that BII phobia is characterized by activation of a typical neural defense network during threat anticipation, with anxiety as the predominant emotion.

  17. Sustained negative BOLD response in human fMRI finger tapping task.

    Directory of Open Access Journals (Sweden)

    Yadong Liu

    Full Text Available In this work, we investigated the sustained negative blood oxygen level-dependent (BOLD response (sNBR using functional magnetic resonance imaging during a finger tapping task. We observed that the sNBR for this task was more extensive than has previously been reported. The cortical regions involved in sNBR are divided into the following three groups: frontal, somatosensory and occipital. By investigating the spatial structure, area, amplitude, and dynamics of the sNBR in comparison with those of its positive BOLD response (PBR counterpart, we made the following observations. First, among the three groups, the somatosensory group contained the greatest number of activated voxels and the fewest deactivated voxels. In addition, the amplitude of the sNBR in this group was the smallest among the three groups. Second, the onset and peak time of the sNBR are both larger than those of the PBR, whereas the falling edge time of the sNBR is less than that of the PBR. Third, the long distance between most sNBR foci and their corresponding PBR foci makes it unlikely that they share the same blood supply artery. Fourth, the couplings between the sNBR and its PBR counterpart are distinct among different regions and thus should be investigated separately. These findings imply that the origin of most sNBR foci in the finger-tapping task is much more likely to be neuronal activity suppression rather than "blood steal."

  18. Sustained negative BOLD response in human fMRI finger tapping task.

    Science.gov (United States)

    Liu, Yadong; Shen, Hui; Zhou, Zongtan; Hu, Dewen

    2011-01-01

    In this work, we investigated the sustained negative blood oxygen level-dependent (BOLD) response (sNBR) using functional magnetic resonance imaging during a finger tapping task. We observed that the sNBR for this task was more extensive than has previously been reported. The cortical regions involved in sNBR are divided into the following three groups: frontal, somatosensory and occipital. By investigating the spatial structure, area, amplitude, and dynamics of the sNBR in comparison with those of its positive BOLD response (PBR) counterpart, we made the following observations. First, among the three groups, the somatosensory group contained the greatest number of activated voxels and the fewest deactivated voxels. In addition, the amplitude of the sNBR in this group was the smallest among the three groups. Second, the onset and peak time of the sNBR are both larger than those of the PBR, whereas the falling edge time of the sNBR is less than that of the PBR. Third, the long distance between most sNBR foci and their corresponding PBR foci makes it unlikely that they share the same blood supply artery. Fourth, the couplings between the sNBR and its PBR counterpart are distinct among different regions and thus should be investigated separately. These findings imply that the origin of most sNBR foci in the finger-tapping task is much more likely to be neuronal activity suppression rather than "blood steal."

  19. Sustained Magnetic Responses in Temporal Cortex Reflect Instantaneous Significance of Approaching and Receding Sounds.

    Directory of Open Access Journals (Sweden)

    Dominik R Bach

    Full Text Available Rising sound intensity often signals an approaching sound source and can serve as a powerful warning cue, eliciting phasic attention, perception biases and emotional responses. How the evaluation of approaching sounds unfolds over time remains elusive. Here, we capitalised on the temporal resolution of magnetoencephalograpy (MEG to investigate in humans a dynamic encoding of perceiving approaching and receding sounds. We compared magnetic responses to intensity envelopes of complex sounds to those of white noise sounds, in which intensity change is not perceived as approaching. Sustained magnetic fields over temporal sensors tracked intensity change in complex sounds in an approximately linear fashion, an effect not seen for intensity change in white noise sounds, or for overall intensity. Hence, these fields are likely to track approach/recession, but not the apparent (instantaneous distance of the sound source, or its intensity as such. As a likely source of this activity, the bilateral inferior temporal gyrus and right temporo-parietal junction emerged. Our results indicate that discrete temporal cortical areas parametrically encode behavioural significance in moving sound sources where the signal unfolded in a manner reminiscent of evidence accumulation. This may help an understanding of how acoustic percepts are evaluated as behaviourally relevant, where our results highlight a crucial role of cortical areas.

  20. Writing About Past Failures Attenuates Cortisol Responses and Sustained Attention Deficits Following Psychosocial Stress

    Science.gov (United States)

    DiMenichi, Brynne C.; Lempert, Karolina M.; Bejjani, Christina; Tricomi, Elizabeth

    2018-01-01

    Acute stress can harm performance. Paradoxically, writing about stressful events—such as past failures—has been shown to improve cognitive functioning and performance, especially in tasks that require sustained attention. Yet, there is little physiological evidence for whether writing about past failures or other negative events improves performance by reducing stress. In this experiment, we studied the effects of an acute psychosocial stressor, the Trier Social Stress Test, on attentional performance and salivary cortisol release in humans. Additionally, we investigated whether an expressive writing task could reduce the detrimental effects of stress, both on performance and physiological response. We found that when individuals were asked to write about a past failure before experiencing a stressor, they exhibited attenuated stress responses. Moreover, those who wrote about a past failure before being exposed to stress also exhibited better behavioral performance. Our results suggest that writing about a previous failure may allow an individual to experience a new stressor as less stressful, reducing its physiological and behavioral effects. PMID:29628878

  1. Sustained ERK inhibition maximizes responses of BrafV600E thyroid cancers to radioiodine.

    Science.gov (United States)

    Nagarajah, James; Le, Mina; Knauf, Jeffrey A; Ferrandino, Giuseppe; Montero-Conde, Cristina; Pillarsetty, Nagavarakishore; Bolaender, Alexander; Irwin, Christopher; Krishnamoorthy, Gnana Prakasam; Saqcena, Mahesh; Larson, Steven M; Ho, Alan L; Seshan, Venkatraman; Ishii, Nobuya; Carrasco, Nancy; Rosen, Neal; Weber, Wolfgang A; Fagin, James A

    2016-11-01

    Radioiodide (RAI) therapy of thyroid cancer exploits the relatively selective ability of thyroid cells to transport and accumulate iodide. Iodide uptake requires expression of critical genes that are involved in various steps of thyroid hormone biosynthesis. ERK signaling, which is markedly increased in thyroid cancer cells driven by oncogenic BRAF, represses the genetic program that enables iodide transport. Here, we determined that a critical threshold for inhibition of MAPK signaling is required to optimally restore expression of thyroid differentiation genes in thyroid cells and in mice with BrafV600E-induced thyroid cancer. Although the MEK inhibitor selumetinib transiently inhibited ERK signaling, which subsequently rebounded, the MEK inhibitor CKI suppressed ERK signaling in a sustained manner by preventing RAF reactivation. A small increase in ERK inhibition markedly increased the expression of thyroid differentiation genes, increased iodide accumulation in cancer cells, and thereby improved responses to RAI therapy. Only a short exposure to the drug was necessary to obtain a maximal response to RAI. These data suggest that potent inhibition of ERK signaling is required to adequately induce iodide uptake and indicate that this is a promising strategy for the treatment of BRAF-mutant thyroid cancer.

  2. Writing About Past Failures Attenuates Cortisol Responses and Sustained Attention Deficits Following Psychosocial Stress

    Directory of Open Access Journals (Sweden)

    Brynne C. DiMenichi

    2018-03-01

    Full Text Available Acute stress can harm performance. Paradoxically, writing about stressful events—such as past failures—has been shown to improve cognitive functioning and performance, especially in tasks that require sustained attention. Yet, there is little physiological evidence for whether writing about past failures or other negative events improves performance by reducing stress. In this experiment, we studied the effects of an acute psychosocial stressor, the Trier Social Stress Test, on attentional performance and salivary cortisol release in humans. Additionally, we investigated whether an expressive writing task could reduce the detrimental effects of stress, both on performance and physiological response. We found that when individuals were asked to write about a past failure before experiencing a stressor, they exhibited attenuated stress responses. Moreover, those who wrote about a past failure before being exposed to stress also exhibited better behavioral performance. Our results suggest that writing about a previous failure may allow an individual to experience a new stressor as less stressful, reducing its physiological and behavioral effects.

  3. Social responsibility and sustainable development: a strategy to be practice; Responsabilidade social e desenvolvimento sustentavel - estrategias que conduzem a pratica

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcia Amaral Estevao dos [PETROBRAS, Rio de Janeiro, RJ (Brazil); Said, Nagib Albuquerque [Fundacao Gorceix, Ouro Preto, MG (Brazil)

    2004-07-01

    This work presents the strategy adopted by the Research and Development Center of PETROBRAS - CENPES to disseminate the culture of social responsibility and sustainable development. It is associated to the strategic objectives of the company and is based on the integration of diagnosis, sensibility and training actions of CENPES manpower. The objective is to promote appropriate postures toward sustainability which will be manifested from individual attitudes in daily actions inside the company - as for instance the responsible consumption of paper and water - until the election of sustainability criteria, with emphasis in the social and environmental variables that will contribute to research and basic engineer projects evaluation. The diagnosis phase considers two fundamental actions: to check the 'state of the art' of the internal culture and to map the several relationship groups or stakeholders. In the sensibility stage, the objective is to offer knowledge and information about the theme using different approaches some times continued, other times segmented, through specific and appropriate media. Finally, the training of the researchers and sustainability concepts promoter and multiplier agents will close the virtuous cycle that will lead to practice the values proposed in the social responsibility and sustainable development agenda. (author)

  4. Next-Generation Sequencing and Genome Editing in Plant Virology

    Directory of Open Access Journals (Sweden)

    Ahmed Hadidi

    2016-08-01

    Full Text Available Next-generation sequencing (NGS has been applied to plant virology since 2009. NGS provides highly efficient, rapid, low cost DNA or RNA high-throughput sequencing of the genomes of plant viruses and viroids and of the specific small RNAs generated during the infection process. These small RNAs, which cover frequently the whole genome of the infectious agent, are 21-24 nt long and are known as vsRNAs for viruses and vd-sRNAs for viroids. NGS has been used in a number of studies in plant virology including, but not limited to, discovery of novel viruses and viroids as well as detection and identification of those pathogens already known, analysis of genome diversity and evolution, and study of pathogen epidemiology. The genome engineering editing method, clustered regularly interspaced short palindromic repeats (CRISPR-Cas9 system has been successfully used recently to engineer resistance to DNA geminiviruses (family, Geminiviridae by targeting different viral genome sequences in infected Nicotiana benthamiana or Arabidopsis plants. The DNA viruses targeted include tomato yellow leaf curl virus and merremia mosaic virus (begomovirus; beet curly top virus and beet severe curly top virus (curtovirus; and bean yellow dwarf virus (mastrevirus. The technique has also been used against the RNA viruses zucchini yellow mosaic virus, papaya ringspot virus and turnip mosaic virus (potyvirus and cucumber vein yellowing virus (ipomovirus, family, Potyviridae by targeting the translation initiation genes eIF4E in cucumber or Arabidopsis plants. From these recent advances of major importance, it is expected that NGS and CRISPR-Cas technologies will play a significant role in the very near future in advancing the field of plant virology and connecting it with other related fields of biology.Keywords: Next-generation sequencing, NGS, plant virology, plant viruses, viroids, resistance to plant viruses by CRISPR-Cas9

  5. Blackcurrant Alters Physiological Responses and Femoral Artery Diameter during Sustained Isometric Contraction

    Directory of Open Access Journals (Sweden)

    Matthew David Cook

    2017-05-01

    Full Text Available Blackcurrant is rich in anthocyanins that may affect exercise-induced physiological responses. We examined tissue oxygen saturation, muscle activity, cardiovascular responses and femoral artery diameter during a submaximal sustained isometric contraction. In a randomised, double-blind, crossover design, healthy men (n = 13, age: 25 ± 4 years, BMI: 25 ± 3 kg·m−2, mean ± SD ingested New Zealand blackcurrant (NZBC extract (600 mg∙day−1 CurraNZ™ or placebo (PL for 7-days separated by 14-days washout. Participants produced isometric maximal voluntary contractions (iMVC and a 120-s 30%iMVC of the quadriceps with electromyography (EMG, near-infrared spectroscopy, hemodynamic and ultrasound recordings. There was no effect of NZBC extract on iMVC (NZBC: 654 ± 73, PL: 650 ± 78 N. During the 30%iMVC with NZBC extract, total peripheral resistance, systolic, diastolic, and mean arterial pressure were lower with increased cardiac output and stroke volume. With NZBC extract, EMG root mean square of the vastus medialis and muscle oxygen saturation were lower with higher total haemoglobin. During the 30%iMVC, femoral artery diameter was increased with NZBC extract at 30 (6.9%, 60 (8.2%, 90 (7.7% and 120 s (6.0%. Intake of NZBC extract for 7-days altered cardiovascular responses, muscle oxygen saturation, muscle activity and femoral artery diameter during a 120-s 30%iMVC of the quadriceps. The present study provides insight into the potential mechanisms for enhanced exercise performance with intake of blackcurrant.

  6. Sustained and transient oscillations and chaos induced by delayed antiviral immune response in an immunosuppressive infection model.

    Science.gov (United States)

    Shu, Hongying; Wang, Lin; Watmough, James

    2014-01-01

    Sustained and transient oscillations are frequently observed in clinical data for immune responses in viral infections such as human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. To account for these oscillations, we incorporate the time lag needed for the expansion of immune cells into an immunosuppressive infection model. It is shown that the delayed antiviral immune response can induce sustained periodic oscillations, transient oscillations and even sustained aperiodic oscillations (chaos). Both local and global Hopf bifurcation theorems are applied to show the existence of periodic solutions, which are illustrated by bifurcation diagrams and numerical simulations. Two types of bistability are shown to be possible: (i) a stable equilibrium can coexist with another stable equilibrium, and (ii) a stable equilibrium can coexist with a stable periodic solution.

  7. Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial.

    Science.gov (United States)

    Brakemeier, Eva-Lotta; Merkl, Angela; Wilbertz, Gregor; Quante, Arnim; Regen, Francesca; Bührsch, Nicole; van Hall, Franziska; Kischkel, Eva; Danker-Hopfe, Heidi; Anghelescu, Ion; Heuser, Isabella; Kathmann, Norbert; Bajbouj, Malek

    2014-08-01

    Although electroconvulsive therapy (ECT) is the most effective acute antidepressant intervention, sustained response rates are low. It has never been systematically assessed whether psychotherapy, continuation ECT, or antidepressant medication is the most efficacious intervention to maintain initial treatment response. In a prospective, randomized clinical trial, 90 inpatients with major depressive disorder (MDD) were treated with right unilateral ultra-brief acute ECT. Electroconvulsive therapy responders received 6 months guideline-based antidepressant medication (MED) and were randomly assigned to add-on therapy with cognitive-behavioral group therapy (CBT-arm), add-on therapy with ultra-brief pulse continuation electroconvulsive therapy (ECT-arm), or no add-on therapy (MED-arm). After the 6 months of continuation treatment, patients were followed-up for another 6 months. The primary outcome parameter was the proportion of patients who remained well after 12 months. Of 90 MDD patients starting the acute phase, 70% responded and 47% remitted to acute ECT. After 6 months of continuation treatment, significant differences were observed in the three treatment arms with sustained response rates of 77% in the CBT-arm, 40% in the ECT-arm, and 44% in the MED-arm. After 12 months, these differences remained stable with sustained response rates of 65% in the CBT-arm, 28% in the ECT-arm, and 33% in the MED-arm. These results suggest that ultra-brief pulse ECT as a continuation treatment correlates with low sustained response rates. However, the main finding implicates cognitive-behavioral group therapy in combination with antidepressants might be an effective continuation treatment to sustain response after successful ECT in MDD patients. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Ethics, Corporate Social Responsibility, and Sustainability Education in AACSB Undergraduate and Graduate Marketing Curricula: A Benchmark Study

    Science.gov (United States)

    Nicholls, Jeananne; Hair, Joseph F., Jr.; Ragland, Charles B.; Schimmel, Kurt E.

    2013-01-01

    AACSB International advocates integration of ethics, corporate social responsibility, and sustainability in all business school disciplines. This study provides an overview of the implementation of these three topics in teaching initiatives and assessment in business schools accredited by AACSB International. Since no comprehensive studies have…

  9. The influences of task repetition, napping, time of day, and instruction on the Sustained Attention to Response Task

    NARCIS (Netherlands)

    Schie, M.K.M. van; Alblas, E.E.; Thijs, R.D.; Fronczek, R.; Lammers, G.J.; Dijk, J.G. van

    2014-01-01

    Introduction: The Sustained Attention to Response Task (SART) helps to quantify vigilance impairments. Previous studies, in which five SART sessions on one day were administered, demonstrated worse performance during the first session than during the others. The present study comprises two

  10. Responsible tourism: A guide for tourism and sustainability in small-scale fisheries and agri-food

    OpenAIRE

    Ford, Adriana; Acott, Timothy

    2015-01-01

    Responsible Tourism: a guide for tourism and sustainability in small-scale fisheries and agri-food’ is a product of TourFish, a project funded by the EU INTERREG IVA 2 Seas programme. The aim of TourFish was to explore opportunities for coastal areas through developing responsible tourism that draws together food, small-scale inshore fisheries, regional branding and place-based marketing opportunities.

  11. Complete and sustained response of adult medulloblastoma to first-line sonic hedgehog inhibition with vismodegib.

    Science.gov (United States)

    Lou, Emil; Schomaker, Matthew; Wilson, Jon D; Ahrens, Mary; Dolan, Michelle; Nelson, Andrew C

    2016-08-12

    Medulloblastoma is an aggressive primitive neuroectodermal tumor of the cerebellum that is rare in adults. Medulloblastomas fall into 4 prognostically significant molecular subgroups that are best defined by experimental gene expression profiles: the WNT pathway, sonic hedgehog (SHH) pathway, and subgroups 3 and 4 (non-SHH/WNT). Medulloblastoma of adults belong primarily to the SHH category. Vismodegib, an SHH-pathway inhibitor FDA-approved in 2012 for treatment of basal cell carcinoma, has been used successfully in the setting of chemorefractory medulloblastoma, but not as a first-line therapy. In this report, we describe a sustained response of an unresectable multifocal form of adult medulloblastoma to vismodegib. Molecular analysis in this case revealed mutations in TP53 and a cytogenetic abnormality, i17q, that is prevalent and most often associated with subgroup 4 rather than the SHH-activated form of medulloblastoma. Our findings indicate that vismodegib may also block alternate, non-canonical forms of downstream SHH pathway activation. These findings provide strong impetus for further investigation of vismodegib in clinical trials in the first-line setting for pediatric and adult forms of medulloblastoma.

  12. Impaired hypoxic ventilatory response following neonatal sustained and subsequent chronic intermittent hypoxia in rats.

    Science.gov (United States)

    Mayer, C A; Ao, J; Di Fiore, J M; Martin, R J; MacFarlane, P M

    2013-06-15

    Neonatal chronic intermittent hypoxia (CIH) enhances the ventilatory sensitivity to acute hypoxia (acute hypoxic ventilatory response, HVR), whereas sustained hypoxia (SH) can have the opposite effect. Therefore, we investigated whether neonatal rats pre-treated with SH prior to CIH exhibit a modified HVR. Rat pups were exposed to CIH (5% O2/5min, 8h/day) between 6 and 15 days of postnatal age (P6-15) after pre-treatment with either normoxia or SH (11% O2; P1-5). Using whole-body plethysmography, the acute (5min, 10% O2) HVR at P16 (1 day post-CIH) was unchanged following CIH (67.9±6.7% above baseline) and also SH (58.8±10.5%) compared to age-matched normoxic rats (54.7±6.3%). In contrast, the HVR was attenuated (16.5±6.0%) in CIH exposed rats pre-treated with SH. These data suggest that while neonatal SH and CIH alone have little effect on the magnitude of the acute HVR, their combined effects impose a synergistic disturbance to postnatal development of the HVR. These data could provide important insight into the consequences of not maintaining adequate levels of oxygen saturation during the early neonatal period, especially in vulnerable preterm infants susceptible to frequent bouts of hypoxemic events (CIH) that are commonly associated with apnea of prematurity. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Sustainability strategies for real-estates. Thinking long-term and shoulder entrepreneurial responsibility; Nachhaltigkeitsstrategien fuer Immobilien. Langfristig denken und unternehmerische Verantwortung wahrnehmen

    Energy Technology Data Exchange (ETDEWEB)

    Kaeding, Uta; Sigg, Rene [Intep - Integrale Planung GmbH, Hamburg (Germany); Intep - Integrale Planung GmbH, Muenchen (Germany)

    2011-07-01

    On the basis of their corporate strategy and sustainability strategy responsible companies set suitable objectives for their real-estate portfolio. The companies recognized that sustainable real-estates offer long-term economic advantages and reduced risks. For the development and conversion of a sustainability strategy for real-estates innovative tools and aids are available today which make the life cycle costs or the surplus value of sustainable real-estates transparent.

  14. Visions for a sustainable world: A conference on science, technology and social responsibility. Conference report

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-31

    This report summarizes the organization, activities, and outcomes of Student Pugwash USA`s 1992 International Conference, Visions for a Sustainable World: A Conference on Science, Technology and Social Responsibility. The conference was held June 14--20, 1992 at Emory University, and brought together 94 students and over 65 experts from industry, academe, and government. The conference addressed issues ranging from global environmental cooperation to the social impacts of the Human Genome Project to minority concerns in the sciences. It provided a valuable forum for talented students and professionals to engage in critical dialogue on many interdisciplinary issues at the juncture of science, technology and society. The conference challenged students -- the world`s future scientists, engineers, and political leaders -- to think broadly about global problems and to devise policy options that are viable and innovative. The success of the conference in stimulating interest, understanding, and enthusiasm about interdisciplinary global issues is clearly evident from both the participants` feedback and their continued involvement in Student Pugwash USA programs. Six working groups met each morning. The working group themes included: environmental challenges for developing countries; energy options: their social and environmental impact; health care in developing countries; changing dynamics of peace and global security; educating for the socially responsible use of technology; ethics and the use of genetic information. The conference was specifically designed to include mechanisms for ensuring its long-term impact. Participants were encouraged to focus on their individual role in helping resolve global issues. This was achieved through each participant`s development of a Personal Plan of Action, a plan which mapped out activities the student could undertake after the conference to continue the dialogue and work towards the resolution of global and local problems.

  15. Long-term effectiveness of unboosted atazanavir plus abacavir/lamivudine in subjects with virological suppression

    DEFF Research Database (Denmark)

    Llibre, Josep M; Cozzi-Lepri, Alessandro; Pedersen, Court

    2016-01-01

    Effectiveness data of an unboosted atazanavir (ATV) with abacavir/lamivudine (ABC/3TC) switch strategy in clinical routine are scant.We evaluated treatment outcomes of ATV + ABC/3TC in pretreated subjects in the EuroSIDA cohort when started with undetectable plasma HIV-1 viral load (p......VL), performing a time to loss of virological response (TLOVR analysis at 48, 96, and 144 weeks. Virological failure (VF) was defined as confirmed pVL >50 copies/mL.We included 285 subjects, 67% male, with median baseline CD4 530 cells, and 44 months with pVL ≤50 copies/mL. The third......%/67%/59% (snapshot analysis), respectively. The rates of VF were 8%/8%/6%. Rates of adverse events leading to study discontinuation were 0.4%/1%/2%. The multivariable adjusted analysis showed an association between VF and nadir CD4+ (hazard ratio [HR] 0.63 [95% confidence interval [CI]: 0.42-0.93] per 100 cells...

  16. Social Responsibility and Sustainability: Multidisciplinary Perspectives through Service Learning. Service Learning for Civic Engagement Series

    Science.gov (United States)

    McDonald, Tracy, Ed.

    2011-01-01

    This concluding volume in the series presents the work of faculty who have been moved to make sustainability the focus of their work, and to use service learning as one method of teaching sustainability to their students. The chapters in the opening section of this book-- Environmental Awareness--offer models for opening students to the awareness…

  17. Responses of the sustainable yield of groundwater to annual rainfall and pumping patterns in the Baotou Plain, North China

    Science.gov (United States)

    Liao, Z.; LONG, Y., Sr.; Wei, Y.; Guo, Z.

    2017-12-01

    Serious water deficits and deteriorating environmental quality are threatening the sustainable socio-economic development and the protection of the ecology and the environment in North China, especially in Baotou City. There is a common misconception that groundwater extraction can be sustainable if the pumping rate does not exceed the total natural recharge in a groundwater basin. The truth is that the natural recharge is mainly affected by the rainfall and that groundwater withdrawal determines the sustainable yield of the aquifer flow system. The concept of the sustainable yield is defined as the allowance pumping patterns and rates that avoid adverse impacts on the groundwater system. The sustainable yield introduced in this paper is a useful baseline for groundwater management under all rainfall conditions and given pumping scenarios. A dynamic alternative to the groundwater sustainable yield for a given pumping pattern and rate should consider the responses of the recharge, discharge, and evapotranspiration to the groundwater level fluctuation and to different natural rainfall conditions. In this study, methods for determining the sustainable yield through time series data of groundwater recharge, discharge, extraction, and precipitation in an aquifer are introduced. A numerical simulation tool was used to assess and quantify the dynamic changes in groundwater recharge and discharge under excessive pumping patterns and rates and to estimate the sustainable yield of groundwater flow based on natural rainfall conditions and specific groundwater development scenarios during the period of 2007 to 2014. The results of this study indicate that the multi-year sustainable yield only accounts for about one-half of the average annual recharge. The future sustainable yield for the current pumping scenarios affected by rainfall conditions are evaluated quantitatively to obtain long-term groundwater development strategies. The simulation results show that sufficient

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

    NARCIS (Netherlands)

    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

    2015-01-01

    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

  19. Long term effectiveness of once-daily unboosted atazanavir plus abacavir/lamivudine as a switch strategy in subjects with virological suppression

    DEFF Research Database (Denmark)

    Llibre, Josep M; Cozzi-Lepri, Alessandro; La Rosa, Jorge Antonio Valencia

    2014-01-01

    routine however are scant. METHODS: We evaluated treatment outcomes of ATV400+ABC/3TC in pre-treated subjects in the EuroSIDA cohort with undetectable HIV-1 RNA, and previous ABC experience or assumed previous HLA B57*01 testing. We performed a time to loss of virologic response (TLOVR below 50 c...

  20. Corporate social responsibility for regional sustainability after mine closure: a case study of mining company in Indonesia

    Science.gov (United States)

    Syarif, Andi Erwin; Hatori, Tsuyoshi

    2017-06-01

    Creating a soft-landing path for mine closure is key to the sustainability of the mining region. In this research, we presents a case of mine closure in Soroako, a small mining town in the north-east of South Sulawesi province, in the center of Sulawesi Island in Indonesia. Especially we investigates corporate social responsibility (CSR) programs of a mining company, PT Vale Indonesia Tbk (PTVI), towards a soft-landing of mine closure in this region. The data of the CSR programs are gathered from in-depth interviews, the annual reports and managerial reports. Furthermore we presents an integrated view of CSR to close mining in a sustainable manner. We then evaluate CSR strategies of the company and its performance from this viewpoint. Based on these steps, the way to improve the CSR mine closure scenario for enhancing the regional sustainability is discussed and recommended.

  1. From corporate social responsibility (CSR to sustainability – Trend of social reporting in banking organization

    Directory of Open Access Journals (Sweden)

    Shirley Mo-Ching Yeung

    2014-11-01

    Full Text Available Riding on the key findings of Yeung (2011 for the four main factors for a framework of CSR for banks: (1 internal management –implementing meaningful strategy, (2 external management – accountability for creditability, (3 internal management - process and people management; and (4 external management – consideration of stakeholders, this paper has reviewed the sustainability-related activities of a major bank in Hong Kong for the past eight years to build a framework for sustainability via qualitative and quantitative analysis of N’ vivo in this research. Five main dimensions are identified for fulfilling the principles of sustainability and the seven dimensions of CSR: 1 community – caring and disclosure, 2 consumers – products and services, 3 environmental issues – certification and schemes, 4 staff issues – talent development and 5 supply chain – performance. There is a growing emphasis on community issues of caring which embed talent development of staff issues (e.g. impacts on skill strengthening and supply chain issues of performance which embed the environmental concerns and services issues (e.g. impacts on safety and risk-reducing policy. By understanding the reporting elements of sustainability-related reports, it is expected that transparency of community, staff and supply chain issues is needed to gain trust from the public for sustainability. This research is managerially and strategically relevant and topical. However, more sustainability-related reports from banks of other countries are required to generate a holistic picture for managing and reporting sustainability and CSR related activities.

  2. A model based on Copula Theory for sustainable and social responsible investments

    Directory of Open Access Journals (Sweden)

    Amelia Bilbao-Terol

    2016-01-01

    Full Text Available In this paper, a model is proposed that allows us to obtain a portfolio made up of sustainable and socially responsible (SR investment funds. This portfolio tracks the one that investors might have chosen if they had not taken into account social, ethical and ecological (SEE issues in their investment decisions. Therefore, in the first stage, reference portfolio exclusively made up of conventional funds is obtained. For the construction of the conventional portfolio the Prospect Theory has been used: net profits as the financial objective and error function as the utility function. In the second stage, a portfolio consisting exclusively of SR-funds is built. To do so, the reference portfolio is used as an ideal point, with the objectives of the SR-investor being the relative wealth with respect to the reference portfolio and the SEE quality of the portfolio. The relative wealth will be manipulated by a downside-risk measure, the Conditional Value at Risk (CVaR, and the periodic values of the portfolio. The second objective is the SR Quality of the portfolio, taking into account the personal values of a particular investor. This is built using Fuzzy Set Theory tools. We are faced with a multi-objective problem which is solved by using Goal Programming methodology. The estimation of both conventional and SR markets has been carried out by a semi-parametric approach by using the Copula Theory for modeling the dependence structure of the assets’ returns. The approach has been applied to a set of 38 conventional and 12 ethical funds domiciled in Spain.

  3. Plasma response to sustainment with imposed-dynamo current drive in HIT-SI and HIT-SI3

    Science.gov (United States)

    Hossack, A. C.; Jarboe, T. R.; Chandra, R. N.; Morgan, K. D.; Sutherland, D. A.; Penna, J. M.; Everson, C. J.; Nelson, B. A.

    2017-07-01

    The helicity injected torus—steady inductive (HIT-SI) program studies efficient, steady-state current drive for magnetic confinement plasmas using a novel experimental method. Stable, high-beta spheromaks have been sustained using steady, inductive current drive. Externally induced loop voltage and magnetic flux are oscillated together so that helicity and power injection are always positive, sustaining the edge plasma current indefinitely. Imposed-dynamo current drive (IDCD) theory further shows that the entire plasma current is sustained. The method is ideal for low aspect ratio, toroidal geometries with closed flux surfaces. Experimental studies of spheromak plasmas sustained with IDCD have shown stable magnetic profiles with evidence of pressure confinement. New measurements show coherent motion of a stable spheromak in response to the imposed perturbations. On the original device two helicity injectors were mounted on either side of the spheromak and the injected mode spectrum was predominantly n  =  1. Coherent, rigid motion indicates that the spheromak is stable and a lack of plasma-generated n  =  1 energy indicates that the maximum q is maintained below 1 during sustainment. Results from the HIT-SI3 device are also presented. Three inductive helicity injectors are mounted on one side of the spheromak flux conserver. Varying the relative injector phasing changes the injected mode spectrum which includes n  =  2, 3, and higher modes.

  4. Myxovirus resistance, osteopontin and suppressor of cytokine signaling 3 polymorphisms predict hepatitis C virus therapy response in an admixed patient population: comparison with IL28B.

    Science.gov (United States)

    Angelo, Ana Luiza Dias; Cavalcante, Lourianne Nascimento; Abe-Sandes, Kiyoko; Machado, Taísa Bonfim; Lemaire, Denise Carneiro; Malta, Fernanda; Pinho, João Renato; Lyra, Luiz Guilherme Costa; Lyra, Andre Castro

    2013-10-01

    Suppressor of cytokine signaling 3, myxovirus resistance protein and osteopontin gene polymorphisms may influence the therapeutic response in patients with chronic hepatitis C, and an association with IL28 might increase the power to predict sustained virologic response. Our aims were to evaluate the association between myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 gene polymorphisms in combination with IL28B and to assess the therapy response in hepatitis C patients treated with pegylated-interferon plus ribavirin. Myxovirus resistance protein, osteopontin, suppressor of cytokine signaling 3 and IL28B polymorphisms were analyzed by PCR-restriction fragment length polymorphism, direct sequencing and real-time PCR. Ancestry was determined using genetic markers. We analyzed 181 individuals, including 52 who were sustained virologic responders. The protective genotype frequencies among the sustained virologic response group were as follows: the G/G suppressor of cytokine signaling 3 (rs4969170) (62.2%); T/T osteopontin (rs2853744) (60%); T/T osteopontin (rs11730582) (64.3%); and the G/T myxovirus resistance protein (rs2071430) genotype (54%). The patients who had ≥3 of the protective genotypes from the myxovirus resistance protein, the suppressor of cytokine signaling 3 and osteopontin had a greater than 90% probability of achieving a sustained response (pC/C IL28B genotype was present in 58.8% of the subjects in this group. The sustained virological response rates increased to 85.7% and 91.7% by analyzing C/C IL28B with the T/T osteopontin genotype at rs11730582 and the G/G suppressor of cytokine signaling 3 genotype, respectively. Genetic ancestry analysis revealed an admixed population. Hepatitis C genotype 1 patients who were responders to interferon-based therapy had a high frequency of multiple protective polymorphisms in the myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 genes. The combined

  5. Viral Response to Specifically Targeted Antiviral Therapy for Hepatitis C and the Implications for Treatment Success

    Directory of Open Access Journals (Sweden)

    Curtis L Cooper

    2010-01-01

    Full Text Available Currently, hepatitis C virus (HCV antiviral therapy is characterized by long duration, a multitude of side effects, difficult administration and suboptimal success; clearly, alternatives are needed. Collectively, specifically targeted antiviral therapy for HCV (STAT-C molecules achieve rapid viral suppression and very high rapid virological response rates, and improve sustained virological response rates. The attrition rate of agents within this class has been high due to various toxicities. Regardless, several STAT-C molecules are poised to become the standard of care for HCV treatment in the foreseeable future. Optimism must be tempered with concerns related to the rapid development of drug resistance with resulting HCV rebound. Strategies including induction dosing with interferon and ribavirin, use of combination high-potency STAT-C molecules and an intensive emphasis on adherence to HCV antiviral therapy will be critical to the success of this promising advance in HCV therapy.

  6. On the front line of HIV virological monitoring: barriers and facilitators from a provider perspective in resource-limited settings.

    Science.gov (United States)

    Rutstein, S E; Golin, C E; Wheeler, S B; Kamwendo, D; Hosseinipour, M C; Weinberger, M; Miller, W C; Biddle, A K; Soko, A; Mkandawire, M; Mwenda, R; Sarr, A; Gupta, S; Mataya, R

    2016-01-01

    Scale-up of viral load (VL) monitoring for HIV-infected patients on antiretroviral therapy (ART) is a priority in many resource-limited settings, and ART providers are critical to effective program implementation. We explored provider-perceived barriers and facilitators of VL monitoring. We interviewed all providers (n = 17) engaged in a public health evaluation of dried blood spots for VL monitoring at five ART clinics in Malawi. All ART clinics were housed within district hospitals. We grouped themes at patient, provider, facility, system, and policy levels. Providers emphasized their desire for improved ART monitoring strategies, and frustration in response to restrictive policies for determining which patients were eligible to receive VL monitoring. Although many providers pled for expansion of monitoring to include all persons on ART, regardless of time on ART, the most salient provider-perceived barrier to VL monitoring implementation was the pressure of work associated with monitoring activities. The work burden was exacerbated by inefficient data management systems, highlighting a critical interaction between provider-, facility-, and system-level factors. Lack of integration between laboratory and clinical systems complicated the process for alerting providers when results were available, and these communication gaps were intensified by poor facility connectivity. Centralized second-line ART distribution was also noted as a barrier: providers reported that the time and expenses required for patients to collect second-line ART frequently obstructed referral. However, provider empowerment emerged as an unexpected facilitator of VL monitoring. For many providers, this was the first time they used an objective marker of ART response to guide clinical management. Providers' knowledge of a patient's virological status increased confidence in adherence counseling and clinical decision-making. Results from our study provide unique insight into provider

  7. Applying Sustainability and Responsible Investment on Islamic Equity Investment: An Analysis of FTSE Shariah and FTSE4GOOD Indices

    OpenAIRE

    Rizki, Reza

    2015-01-01

    2015 dissertation for MSc Islamic Banking and Finance. Selected by academic staff as a good example of a masters level dissertation. \\ud \\ud Shariah-compliant Investment and Sustainability Responsible Investment (SRI) are the slternative asset classes and they are growing rapidly leaving their counterparts behind. Nonetheless, there are some criticisms against the screening criteria which are applied by Islamic equity investment because they exclude the environment, social and human rights is...

  8. The Impacts of Social Responsibility and Ownership Structure on Sustainable Financial Development of China’s Energy Industry

    Directory of Open Access Journals (Sweden)

    Ye Feng

    2018-01-01

    Full Text Available In the analysis, we integrated stakeholder and agency theories to explore the connection between corporate social responsibility (CSR and sustainable financial development by considering the moderating effect of ownership structure. After empirical analysis, we found the following conclusions. First, the short-term and long-term economic performance is positively affected by CSR, which leads to sustainable financial development. Second, ownership circulation has a positive relationship with economic performance in the short run, which short-term profit increases as ownership circulation strengthens. Third, the effect of CSR on short-term economic performance is moderated by ownership structure. Excessive concentrated ownership may lead to decisions that do not satisfy all key stakeholders and may reduce the positive effect of CSR on economic performance. Finally, we suggest that Chinese energy companies should pay more attention to improving corporate social responsibility to maintain good economic performance and develop sustainable competitive advantage. Meanwhile, companies should optimize ownership concentration to avoid weakening the positive effects of social responsibility on short-term economic performance.

  9. Responsibilities and Limits of Local Government Actions against Users of Public Services of Planning and Sustainable Territorial Development in Romania

    Directory of Open Access Journals (Sweden)

    Bogdan Suditu

    2014-02-01

    Full Text Available In the context of the changes that have occurred in the Romanian society, the public authorities are required to play a coordinating role in providing the framework for a sustainable and balanced development of the national territory, and to ensure the quality of life of the citizens. In order to achieve these goals of social responsibility, the public administration authorities must build and adapt the tools of public territorial action based on their specificity and within the existing legal framework and resources,. Thus, the study shows the national and European context that frames the actions of public administration for what concerns the sustainable territorial development. It analyzes the characteristics of administrative-territorial structures of Romania, highlighting their socio-demographic diversity and the territorial forms of institutional cooperation. The approach of these issues is based in the first instance on an analysis of the European strategic documents in the field, as well as on the national regulations concerning the organization and functioning of public administration and territorial planning. The implementation of decentralization and local public autonomy has led to the capitalization of the local potential of some administrative divisions and caused a competition and a difficult cooperation between them. By analogy with the provisions of the quality standards regarding the responsibilities of the organizations towards customers, the study illustrates and analyzes the responsibilities and limits of public administration authorities in promoting sustainable development, territorial equity and the quality of life for the users of public services, i.e. the community members.

  10. 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...

  11. Governance, corporate social responsibility and cooperation in sustainable tourist destinations: the case of the island of Fuerteventura

    Directory of Open Access Journals (Sweden)

    Olga González-Morales

    2016-11-01

    Full Text Available This paper reflects on governance, corporate social responsibility (CSR and public-private cooperation in sustainable tourist destinations. The empirical analysis focuses on the island of Fuerteventura (the Canary Islands, where a process of coordinated decision making has begun, as well as putting in place plans to modernize the destination. Those responsible for tourism hotel and non-hotel accommodation were surveyed to assess the importance given to CSR in their companies. In particular, CSR’s environmental dimension and its relation with the public sector and other socio-economic factors, bearing in mind that Fuerteventura is a tourist destination in a Biosphere Reserve.

  12. 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.

  13. Economic Dimensions of Sustainable Development, the Fight against Poverty and Educational Responses

    Science.gov (United States)

    Ahmed, Manzoor

    2010-01-01

    The arguments in the article are based on the ongoing discourse in the academic community and among stakeholders, which has contributed to the articulation of the concepts and premises of sustainable development and the role of learning modalities, technologies and networks. The article draws on this discourse to explore the economic aspects of…

  14. Shared responsibility at the regional level: the building of sustainable industrial estates

    NARCIS (Netherlands)

    Brand, Ellis; de Bruijn, Theo

    1999-01-01

    The long felt contrast between economic growth and environmental protection is dissipating in environmental and industrial policy in Europe. Sustainable development has become the leading motive in environmental policy in this regard. In trying to give meaning to this abstract concept, current

  15. Twenty First Century Education: Transformative Education for Sustainability and Responsible Citizenship

    Science.gov (United States)

    Bell, David V. J.

    2016-01-01

    Many ministries of education focus on twenty-first century education but unless they are looking at this topic through a sustainability lens, they will be missing some of its most important elements. The usual emphasis on developing skills for employability in the current global economy begs the question whether the global economy is itself…

  16. Practicing joint responsibility for sustainable regional development: introducting the concept of regional management

    CSIR Research Space (South Africa)

    Lawrence, F

    2006-03-01

    Full Text Available of additional factors should be taken into account if real sustainable change is to take place over the medium to long term. It introduces the concept of regional management as a complimentary approach to district development and builds on key national debates...

  17. Social and Environmental Responsibility and Local Sustainable Development: The Case of the Environmental Education Project and Asset – PEAP

    Directory of Open Access Journals (Sweden)

    Eugênia Rosa Cabral

    2015-04-01

    Full Text Available The study analyzes the actions of social responsibility expressed by the Environmental and Heritage Education Project (PEAP, which has been  implemented in the Boa Vista and Moura communities, both located in Oriximiná, State of Pará. This project purported to promote the rescue and preservation of environmental and cultural heritage in local communities, developed in a partnership between the Museu Paraense Emilio Goeldi (Emilio Goeldi [a painter] Pará Museum] (MPEG, the private company Mineração Rio do Norte (Rio do Norte Mining (MRN and representatives of local communities. This study examines to what extent the actions of PEAP can be considered drivers of sustainable local development. To answer this question, the research focused on the implementation of the PEAP actions and their effects on the two communities under study. Specifically, we sought to identify potential social, cultural and economic impacts of the actions of PEAP on both communities, and to identify future expectations of social subjects involved. This is a case study that follows a qualitative approach. The data collected in documents and interviews were analyzed according to the concepts of sustainable local development, corporate social responsibility and tri-sector partnership. The study identified that the actions taken by the PEAP result of management practices and participatory social planning, and reflecting the redemption of traditional practices, socialization of information and income generation, which together contribute to sustainable local development.

  18. Risk of triple-class virological failure in children with HIV: a retrospective cohort study

    DEFF Research Database (Denmark)

    Castro, Hannah; Judd, Ali; Gibb, Diana M

    2011-01-01

    In adults with HIV treated with antiretroviral drug regimens from within the three original drug classes (nucleoside or nucleotide reverse transcriptase inhibitors [NRTIs], non-NRTIs [NNRTIs], and protease inhibitors), virological failure occurs slowly, suggesting that long-term virological...... failure to the three original drugs classes in children....

  19. Applications of Next-Generation Sequencing Technologies to Diagnostic Virology

    Directory of Open Access Journals (Sweden)

    Giorgio Palù

    2011-11-01

    Full Text Available Novel DNA sequencing techniques, referred to as “next-generation” sequencing (NGS, provide high speed and throughput that can produce an enormous volume of sequences with many possible applications in research and diagnostic settings. In this article, we provide an overview of the many applications of NGS in diagnostic virology. NGS techniques have been used for high-throughput whole viral genome sequencing, such as sequencing of new influenza viruses, for detection of viral genome variability and evolution within the host, such as investigation of human immunodeficiency virus and human hepatitis C virus quasispecies, and monitoring of low-abundance antiviral drug-resistance mutations. NGS techniques have been applied to metagenomics-based strategies for the detection of unexpected disease-associated viruses and for the discovery of novel human viruses, including cancer-related viruses. Finally, the human virome in healthy and disease conditions has been described by NGS-based metagenomics.

  20. Special Issue on "Social Responsibility Accounting and Reporting in Times of ‘Sustainability Downturn/Crisis’

    Directory of Open Access Journals (Sweden)

    Carmen Correa-Ruiz

    2011-12-01

    Full Text Available At a time when sustainability performance does not seem to match the expectations raised by the sustainable development concept and, moreover, when the economic downturn and crisis could be further eroding social and environmental concerns and values, the notion of sustainability crisis provides an interesting starting point to reflect on the role of Social and Environmental Accounting Research. Lack of humanity and values, short term economic approach, institutional capture and misunderstanding and misuse of democracy, have all served as catalysts of sustainability downturn and crisis. Thus, this editorial attempts to advance public interest accounting by discussing the controversy around Sustainability and Corporate Social Responsibility, expecting that the constitutive effects of researchers’ words in this special issue and in future research agendas, will result in more transformative power relations able to enhance a healthy democracy inspired by the capacity to do things and to transform individuals’ attitudes and behaviours, as well as the institutional response to the sustainability crisis.En una época en la que el desempeño en materia de sostenibilidad parece no cumplir las expectativas creadas por el concepto de desarrollo sostenible y, en la que además, la recesión y la crisis económica podría estar erosionando aún más los valores y preocupaciones sociales y medioambientales, la noción de crisis de sostenibilidad proporciona un interesante punto de partida para reflexionar sobre el papel de la investigación en Contabilidad Social y Medioambiental. La falta de humanidad y la ausencia de valores, el enfoque económico cortoplacista, la captura institucional y la democracia mal entendida y su uso incorrecto, han servido como catalizadores de la crisis y la recesión de la sostenibilidad. Así, el presente editorial pretende avanzar en la contabilidad como interés general, debatiendo sobre la controversia existente

  1. Europe's global responsibility to govern trade and investment sustainability: climate, capital, CAP and Cotonou

    International Nuclear Information System (INIS)

    Ruddy, T.F.

    2005-01-01

    This paper examines the progress made towards forging a Sustainable Development Strategy of the European Union on the basis of three structures of the global economy: Trade, Investment and Knowledge Generation. It identifies deficits in all three, and cites alternatives for improvement such as acknowledging ecological debt and setting up a Global Marshall Plan. It outlines how, over the medium term, compatibility with trade law could be maintained, and how Sustainability Impact Assessments (SIA) could cushion the effects of the current governance regimes. It then considers alternatives such as encouraging the EU's African, Caribbean and Pacific (ACP) partners to form Regional Trade Areas among themselves. Guidance is given regarding reform of the Common Agricultural Policy and the question as to whether the investment regime can be governed multilaterally and, if so, at which venue. (author)

  2. THE SOCIAL RESPONSIBILITY OF MOROCCAN ENTERPRISES TOWARDS SUSTAINABLE PERFORMANCE:CSR STUDY COSUMAR SIDI BENNOUR

    OpenAIRE

    EL Gueddar O.E; Sahib-Eddine A.

    2017-01-01

    The globalization of the economy imposes a new order on the Moroccan company marked by the opening of markets and the appearance of new international competitors. One of the factors of differentiation is technological and organizational innovation. The company is then obliged to improve its management to ensure the necessary balance between these various expectations and the imperative need to sustain its performance to establish its legitimacy and creates lasting value. In this context, ...

  3. Towards a more responsible sustainable innovation assessment and management culture in Europe

    Directory of Open Access Journals (Sweden)

    Popper Rafael

    2017-12-01

    Full Text Available This article presents new concepts and practical approaches resulting from the piloting of CASI-F - a common framework for the assessment and management of sustainable innovation (SI. Based on lessons learned from action research carried out in the context of the EU funded CASI project, the article focuses on the meta-analysis of 46 action roadmaps produced with 43 innovators supporting the practical application of CASI-F. The applied methodology helped to demonstrate that a multi-level and multi-actor advice approach promotes a shift towards improved understanding of innovations-related critical issues (barriers, drivers, opportunities and threats and stakeholders’ relations, as well as their management, thus promoting the sustainable resilience and transformation of socio-technical systems. This paper first reflects on how we arrived to managerial lessons from the actions roadmaps and how could these lessons be used to assess the current state of affairs and potential way forward for European initiatives and instruments promoting sustainable innovation.

  4. Sustainability in global commodity trade: successful responsible entrepreneurship or fallacious market capture?

    NARCIS (Netherlands)

    Vermeulen, W.J.V.

    2011-01-01

    In western countries NGOs have increasingly been pressing spearheaded firms to bring their corporate social responsibility into practice, especially in this international context. In response to this European and American producers and retailers are increasingly applying new forms of cooperation

  5. The quest for predicting sustained shunt response in normal pressure hydrocephalus: an analysis of the callosal angle's utility.

    Science.gov (United States)

    Grahnke, Kurt; Jusue-Torres, Ignacio; Szujewski, Caroline; Joyce, Cara; Schneck, Michael; Prabhu, Vikram; Anderson, Douglas

    2018-04-30

    Diagnosing normal pressure hydrocephalus (NPH) and selecting patients who will experience a sustained benefit from fluid diversion surgery remains challenging. This study seeks to evaluate the association between the callosal angle (CA) and the long-term post-operative response to ventriculoperitoneal shunt (VPS) surgery in a different subgroup population than previously studied to assess its generalizability. We studied 73 patients with idiopathic NPH who underwent VPS surgery and had at least 18 months of follow-up between 2000-2016. We recorded their pre and postoperative symptoms according to the NPH Eide scale and their comorbidities with the Kiefer index. Their CA, as well as Evan's Index, ventricular height, and transependymal signal were measured. Multivariable statistical models were used to determine which factors were associated with postoperative improvement, while controlling for the presence of the NPH triad. Fifty-nine patients (82%) demonstrated a successful response to surgery at their first postoperative follow-up. However, this declined to 54 patients (75%) at one year and 45 (62.5%) patients at their last follow-up. When controlling for the presence of the triad of symptoms, the CA significantly predicted a good, sustained response to surgery; for every degree decrease in the CA, a patient is 4% more likely to experience benefit from surgery. The CA is a useful preoperative prognostic tool for predicting which patients will experience a sustained benefit from surgery. Further studies are required to clarify this disease in the context of old age, comorbidity, and possible concomitant neurodegenerative diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Mechanisms of repetitive retrograde contractions in response to sustained esophageal distension: a study evaluating patients with postfundoplication dysphagia.

    Science.gov (United States)

    Carlson, Dustin A; Kahrilas, Peter J; Ritter, Katherine; Lin, Zhiyue; Pandolfino, John E

    2018-03-01

    Repetitive retrograde contractions (RRCs) in response to sustained esophageal distension are a distinct contractility pattern observed with functional luminal imaging probe (FLIP) panometry that are common in type III (spastic) achalasia. RRCs are hypothesized to be indicative of either impaired inhibitory innervation or esophageal outflow obstruction. We aimed to apply FLIP panometry to patients with postfundoplication dysphagia (a model of esophageal obstruction) to explore mechanisms behind RRCs. Adult patients with dysphagia after Nissen fundoplication ( n = 32) or type III achalasia ( n = 25) were evaluated with high-resolution manometry (HRM) and upper endoscopy with FLIP. HRM studies were assessed for outflow obstruction and spastic features: premature contractility, hypercontractility, and impaired deglutitive inhibition during multiple-rapid swallows. FLIP studies were analyzed to determine the esophagogastric junction (EGJ)-distensibility index and contractility pattern, including RRCs. Barium esophagram was evaluated when available. RRCs were present in 8/32 (25%) fundoplication and 19/25 (76%) achalasia patients ( P esophageal outflow obstruction, as a predictor for RRCs. RRCs in response to sustained esophageal distension appear to be a manifestation of spastic esophageal motility. Although future study to further clarify the significance of RRCs is needed, RRCs on FLIP panometry should prompt evaluation for a major motor disorder. NEW & NOTEWORTHY Repetitive retrograde contractions (RRCs) are a common response to sustained esophageal distension among spastic achalasia patients when evaluated with the functional luminal imaging probe. We evaluated patients with postfundoplication dysphagia, i.e., patients with suspected mechanical obstruction, and found that RRCs occasionally occurred among postfundoplication patients, but often in association with manometric features of esophageal neuromuscular imbalance. Thus, RRCs appear to be a manifestation of

  7. Social responsibility and environmental sustainability. The case study of Vale (Brazil)

    OpenAIRE

    Figueredo, I.; Filipe, J. A.

    2011-01-01

    Corporate social responsibility deals with companies' actions aiming a positive impact namely on environment, consumers, employees or communities, for example. It requires a set of duties and obligations, in relation to the society and to the communities in which the organization is operating. In Brazil, the corporate social responsibility is still a big challenge, since the actions of social responsibility have not contributed effectively to improve the living conditions of society and the t...

  8. Are People Responsive to a More Sustainable, Decentralized, and User-Driven Management of Urban Metabolism?

    Directory of Open Access Journals (Sweden)

    Lorenzo Chelleri

    2016-03-01

    Full Text Available Smart, green, and resilient city paradigms have been mainly promoted through top-down and technocratic approaches. However, based on the notion to return to “the right to the city”, emerging community-driven initiatives are providing self-managed infrastructures contributing to urban sustainability transitions. This paper explores the relevance of the behavioral aspects of people-centered approaches in dealing with two different facets of urban metabolism: physical infrastructure (involvement with the management of decentralized infrastructures and consumption patterns (involvement in proactive reduction of resources used. In the first case we assessed community perceptions about the roles, benefits, and willingness to proactively engage in the management of decentralized green infrastructures in Bogotá City, Colombia. For the second facet, we measured the effectiveness of change agents in re-shaping energy consumption decisions within urban social networks in South Africa and Saudi Arabia. This paper’s results show that pre-determined and standardized strategies do not guarantee positive, nor homogeneous, results in terms of meeting sustainability targets, or promoting community involvement. Hence, a better integration of people-centered and top-down approaches is needed through context-dependent policies, for enhancing both users’ appreciation of and commitment to urban metabolism participative management.

  9. Creating Sustainable Competitive Advantage: A Corporate Socialenvironmental Responsibility in the Light of the Resource-Based View

    Directory of Open Access Journals (Sweden)

    Débora Prazeres Balbino

    2013-03-01

    Full Text Available From the perspective of a greater concern with respect to corporate social and environmental aspects viewed in society, the Corporate Social-Environmental Responsibility (CSER is understood as a new management perspective to be used, no longer restricted to meet the aspirations of profit shareholders, but seeks include in your analysis other stakeholders such as society and the environment. According to the Resource-Based View (RBV, the CSER is regarded as an organizational capacity, because it involves a set of resources and depending on how it is integrated with business planning, could be a source of Sustainable Competitive Advantage (SCA. The objective of the study is to analyze the likely social and environmental responsibility as a sustainable competitive advantage for an organization in light of the Resource-Based View . From the discussion held to theoretical essay, we identified some aspects of CSER that can be elevated to the level of a SCA, namely: the generation of a good reputation and organizational image, and corporate citizenship in favor of the practice of CSER. It is appropriate therefore to carry out empirical studies, qualitative and/or quantitative, that can confirm and extend the arguments of this discussion, from the development of constructs, development of measurement instruments and proposing models, on CSER.

  10. Standards of socially responsible management – Impact on sustainable development of the organization, the social and natural environment

    Directory of Open Access Journals (Sweden)

    Anton Peršič

    2016-01-01

    Full Text Available The purpose of this paper is to outline the results of a study on the importance of the introduction/implementation of standards of socially responsible management and their impact on the business performance of organizations as well as to confirm the correlations with the sustainable development of the broader social and natural environment. The research included a population of medium-sized and large organizations (over 50 employees in the fields of marketing services in the Republic of Slovenia. Research results confirmed a direct link of understanding the management standards in organizations with a larger number of employees and the achieved higher income from operations. Research participants are familiar with the requirements of the Quality Management System Standard ISO 9001 and the Environmental Management System Standard ISO 14001, which is particularly significant for older business executives with many years of work experience in the company they run. The hypothesis that the implementation of the principles of social responsibility has a positive impact on sustainable development and the financial indicators of the organization – higher profits, business growth, productivity and cost-effectiveness in operations – has been confirmed.

  11. 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.

  12. European Policy for Corporate Social Responsibility: Governance Context, Linkage with Sustainable development and Crisis as a Policy Factor

    Directory of Open Access Journals (Sweden)

    Taliouris, Evangelos

    2018-01-01

    Full Text Available Political prerequisites for sustainable development (SD in European Union (EU and its member states are environmental innovation as well as transparency, social welfare, good governance and responsible entrepreneurship. The Europe 2020 Strategy and its indicators were a significant step in order EU, its member states and the social stakeholders to deal with crisis negative socioeconomic and environmental outcomes, but also to improve social trust. An important stakeholder towards these is European business sector. Therefore, responsible entrepreneurship via corporate social responsibility (CSR is a policy topic in EU in parallel with other policy topics such as transparency (e.g. non-financial reporting and good governance (e.g. political framework for CSR. The European business community was always a crucial stakeholder for development, but since 2001 CSR is explicitly part of European policy agenda through topics such as public procurement, responsible supply chains, anti-corruption policies, employment generation, reporting and disclosure etc. In EU the applied policy for CSR indicates different approaches and policy tools within the common policy framework and definitions. Moreover, the crisis evolution became an accelerator for CSR policy evolution and convergence between perspectives and member states. The renewed strategy in 2011, the report for CSR public policies in 2014 and the EU steps towards SD Agenda for 2030 in 2015 indicated issues such as corporate citizenship and responsible entrepreneurship as an ongoing policy process that focuses both on EU political convergence at member states level and the European business sector excellence.

  13. High Virologic Failure Rates with Maraviroc-Based Salvage Regimens Among Indian Patients: A Preliminary Analysis-Maraviroc Effectiveness in HIV-1 Subtype C.

    Science.gov (United States)

    Pujari, Sanjay; Gaikwad, Sunil; Bele, Vivek; Joshi, Kedar; Dabhade, Digamber

    2018-01-01

    There is no information on the clinical effectiveness of Maraviroc (MVC) amongst People Living with HIV (PLHIV) in India infected with HIV-1 Subtype C viruses. We conducted a retrospective chart review of adult PLHIV on MVC based Antiretroviral (ARV) regimens for at least 6 months. Maraviroc was initiated amongst PLHIV with documented R5 tropic viruses (determined by in-house population sequencing of the V3 loop in triplicate and interpreted using the Geno2Pheno algorithm) in combination with an Optimized Background regimen (designed using genotypic resistance testing and past ARV history). Plasma viral loads (PVL) are performed 6 months post-initiation and annually thereafter. Primary outcome d. Median duration on MVC treatment was 1.8 years (range 1-2.9 years) while median duration of ART prior to switching to MVC was 13 years. Maraviroc was combined with Darunavir/ritonavir (DRV/r) (n=10), Atazanavir/r (ATV/r) (n=2) and Lopinavir/r (LPV/r) (n=1). All PLHIV were infected with HIV-1 Subtype C. Only 23.3% PLHIV achieved virologic suppression at 6 months and sustained it for 2.3 years. Median CD4 count change from baseline was +117 (n=13), +228 (n=10), +253 (n=9), and +331 (n=4) at 6, 12, 18 and 24 months respectively. Repeat tropism among patients with virologic failure demonstrated R5 virus. High rates of virologic failure was seen when MVC was used amongst treatment experienced PLHIV infected with HIV-1 Subtype C in India. was the proportion of PLHIV with virologic success (PVL<50 copies/ml) at last follow up visit. Data on 13 PLHIV were analyze.

  14. Geoengineering Responses to Climate Change Selected Entries from the Encyclopedia of Sustainability Science and Technology

    CERN Document Server

    Vaughan, Naomi

    2013-01-01

    Failure by the international community to make substantive progress in reducing CO2 emissions, coupled with recent evidence of accelerating climate change, has brought increasing urgency to the search for additional remediation approaches.  This book presents a selection of state-of-the-art geoengineering methods for deliberately reducing the effects of anthropogenic climate change, either by actively removing greenhouse gases from the atmosphere or by decreasing the amount of sunlight absorbed at the Earth’s surface.  These methods contrast with more conventional mitigation approaches which focus on reducing emissions of greenhouse gases, especially carbon dioxide. Geoengineering technologies could become a key tool to be used in conjunction with emissions reduction to limit the magnitude of climate change.  Featuring authoritative, peer-reviewed entries from the Encyclopedia of Sustainability Science and Technology, this book presents a wide range of climate change remediation technologies. Examines th...

  15. Transcription controls growth, cell kinetics and cholesterol supply to sustain ACTH responses

    Directory of Open Access Journals (Sweden)

    Robert I Menzies

    2017-09-01

    Full Text Available Chronic ACTH exposure is associated with adrenal hypertrophy and steroidogenesis. The underlying molecular processes in mice have been analysed by microarray, histological and immunohistochemical techniques. Synacthen infused for 2 weeks markedly increased adrenal mass and plasma corticosterone levels. Microarray analysis found greater than 2-fold changes in expression of 928 genes (P 4-fold and cross-sectional area of fasciculata cells was 2-fold greater. In contrast, genes associated with apoptosis (eg Casp12, Clu, were downregulated and apoptotic cells (Tunel staining were fewer (P < 0.001 and more widely distributed throughout the cortex. In summary, long-term steroidogenesis with ACTH excess is sustained by genes controlling cholesterol supply and adrenal mass. ACTH effects on adrenal morphology and genes controlling cell hypertrophy, proliferation and apoptosis suggest the involvement of different cell types and separate molecular pathways.

  16. The empowerment of sustainable design in food packaging as designer responsibilities

    Science.gov (United States)

    Setiadi, V.

    2018-01-01

    The purpose of this paper is emphasized on the empowerment of sustainable design in providing the dual function of a food packaging. Which can extend the life of paper, cardboard, plastic, aluminum foil so as to reduce the contribution of waste on earth. The methodology used in this research is using qualitative research. With the main approach taken on the layout of the packaging design, the approach that relies heavily on the data in the form of packaging design. For the process of observation, the authors should compare with the forms of food packaging designs that are contained in the diversity of food packaging types from products outside Indonesia. The purpose of this study is also intended as a recommendation through observation of data interviews and survey related products. Conclusion through material exploration, packaging structure exploration, efficient exploration of ink usage and packaging usage patterns.

  17. Transcription controls growth, cell kinetics and cholesterol supply to sustain ACTH responses.

    Science.gov (United States)

    Menzies, Robert I; Zhao, Xin; Mullins, Linda J; Mullins, John J; Cairns, Carolynn; Wrobel, Nicola; Dunbar, Donald R; Bailey, Matthew A; Kenyon, Christopher J

    2017-10-01

    Chronic ACTH exposure is associated with adrenal hypertrophy and steroidogenesis. The underlying molecular processes in mice have been analysed by microarray, histological and immunohistochemical techniques. Synacthen infused for 2 weeks markedly increased adrenal mass and plasma corticosterone levels. Microarray analysis found greater than 2-fold changes in expression of 928 genes ( P  4-fold and cross-sectional area of fasciculata cells was 2-fold greater. In contrast, genes associated with apoptosis (eg Casp12, Clu, ) were downregulated and apoptotic cells (Tunel staining) were fewer ( P  < 0.001) and more widely distributed throughout the cortex. In summary, long-term steroidogenesis with ACTH excess is sustained by genes controlling cholesterol supply and adrenal mass. ACTH effects on adrenal morphology and genes controlling cell hypertrophy, proliferation and apoptosis suggest the involvement of different cell types and separate molecular pathways. © 2017 The authors.

  18. An equity- and sustainability-based policy response to global climate change

    International Nuclear Information System (INIS)

    Byrne, J.; Wang, Y.-D.; Kim, Jong-dall

    1998-01-01

    In the debate over policy options for the reduction of greenhouse gas emissions, two precautionary approaches, 'no regrets' and 'insurance' have been proposed. An alternative to these is put forward which adopts an equity and sustainability based approach. It will not be easy to meet the challenge which this approach demands. From wealthy countries it will require a strong commitment to a social policy at home and an economic policy abroad that aims at sharing the ability of humankind to meet the needs of the present without compromising the ability of future generations to meet their needs. In developing countries the necessary improvement in lives and livelihoods must be achieved without repeating the unsustainable environmental and social legacy of the industrial era. (UK)

  19. Language related differences of the sustained response evoked by natural speech sounds.

    Directory of Open Access Journals (Sweden)

    Christina Siu-Dschu Fan

    Full Text Available In tonal languages, such as Mandarin Chinese, the pitch contour of vowels discriminates lexical meaning, which is not the case in non-tonal languages such as German. Recent data provide evidence that pitch processing is influenced by language experience. However, there are still many open questions concerning the representation of such phonological and language-related differences at the level of the auditory cortex (AC. Using magnetoencephalography (MEG, we recorded transient and sustained auditory evoked fields (AEF in native Chinese and German speakers to investigate language related phonological and semantic aspects in the processing of acoustic stimuli. AEF were elicited by spoken meaningful and meaningless syllables, by vowels, and by a French horn tone. Speech sounds were recorded from a native speaker and showed frequency-modulations according to the pitch-contours of Mandarin. The sustained field (SF evoked by natural speech signals was significantly larger for Chinese than for German listeners. In contrast, the SF elicited by a horn tone was not significantly different between groups. Furthermore, the SF of Chinese subjects was larger when evoked by meaningful syllables compared to meaningless ones, but there was no significant difference regarding whether vowels were part of the Chinese phonological system or not. Moreover, the N100m gave subtle but clear evidence that for Chinese listeners other factors than purely physical properties play a role in processing meaningful signals. These findings show that the N100 and the SF generated in Heschl's gyrus are influenced by language experience, which suggests that AC activity related to specific pitch contours of vowels is influenced in a top-down fashion by higher, language related areas. Such interactions are in line with anatomical findings and neuroimaging data, as well as with the dual-stream model of language of Hickok and Poeppel that highlights the close and reciprocal interaction

  20. Language related differences of the sustained response evoked by natural speech sounds.

    Science.gov (United States)

    Fan, Christina Siu-Dschu; Zhu, Xingyu; Dosch, Hans Günter; von Stutterheim, Christiane; Rupp, André

    2017-01-01

    In tonal languages, such as Mandarin Chinese, the pitch contour of vowels discriminates lexical meaning, which is not the case in non-tonal languages such as German. Recent data provide evidence that pitch processing is influenced by language experience. However, there are still many open questions concerning the representation of such phonological and language-related differences at the level of the auditory cortex (AC). Using magnetoencephalography (MEG), we recorded transient and sustained auditory evoked fields (AEF) in native Chinese and German speakers to investigate language related phonological and semantic aspects in the processing of acoustic stimuli. AEF were elicited by spoken meaningful and meaningless syllables, by vowels, and by a French horn tone. Speech sounds were recorded from a native speaker and showed frequency-modulations according to the pitch-contours of Mandarin. The sustained field (SF) evoked by natural speech signals was significantly larger for Chinese than for German listeners. In contrast, the SF elicited by a horn tone was not significantly different between groups. Furthermore, the SF of Chinese subjects was larger when evoked by meaningful syllables compared to meaningless ones, but there was no significant difference regarding whether vowels were part of the Chinese phonological system or not. Moreover, the N100m gave subtle but clear evidence that for Chinese listeners other factors than purely physical properties play a role in processing meaningful signals. These findings show that the N100 and the SF generated in Heschl's gyrus are influenced by language experience, which suggests that AC activity related to specific pitch contours of vowels is influenced in a top-down fashion by higher, language related areas. Such interactions are in line with anatomical findings and neuroimaging data, as well as with the dual-stream model of language of Hickok and Poeppel that highlights the close and reciprocal interaction between

  1. Corporate sustainability and responsibility : creating value for business, society and the environment

    OpenAIRE

    Camilleri, Mark Anthony

    2017-01-01

    Today’s corporations are increasingly implementing responsible behaviours as they pursue profit-making activities. A thorough literature review suggests that there is a link between corporate social responsibility (CSR) or corporate social performance (CSP) and financial performance. In addition, there are relevant theoretical underpinnings and empirical studies that have often used other concepts, including corporate citizenship, stakeholder management and business ethics. In this light, thi...

  2. Maternal programming of defensive responses through sustained effects on gene expression.

    Science.gov (United States)

    Zhang, Tie-Yuan; Bagot, Rose; Parent, Carine; Nesbitt, Cathy; Bredy, Timothy W; Caldji, Christian; Fish, Eric; Anisman, Hymie; Szyf, Moshe; Meaney, Michael J

    2006-07-01

    There are profound maternal effects on individual differences in defensive responses and reproductive strategies in species ranging literally from plants to insects to birds. Maternal effects commonly reflect the quality of the environment and are most likely mediated by the quality of the maternal provision (egg, propagule, etc.), which in turn determines growth rates and adult phenotype. In this paper we review data from the rat that suggest comparable forms of maternal effects on defensive responses stress, which are mediated by the effects of variations in maternal behavior on gene expression. Under conditions of environmental adversity maternal effects enhance the capacity for defensive responses in the offspring. In mammals, these effects appear to 'program' emotional, cognitive and endocrine systems towards increased sensitivity to adversity. In environments with an increased level of adversity, such effects can be considered adaptive, enhancing the probability of offspring survival to sexual maturity; the cost is that of an increased risk for multiple forms of pathology in later life.

  3. Intermittent sustained swimming in 'matrinxã' Brycon amazonicus (Bryconidae: Bryconinae: hematological and metabolic responses

    Directory of Open Access Journals (Sweden)

    Fernando Fabrizzi

    Full Text Available In fish, studies on a wide variety of physiological effects of exercise have been reported since a long time. It has been attributed special attention to some types of exercise, however, its application as a healthful practice in the rearing and welfare of farming fish is rising in last few years. In this particular, long-term intermittent sustained swimming (ISS has been not yet explored. In this work, the freshwater fish Brycon amazonicus was submitted to (ISS for 30 days at velocity of 1.0 body-length sec-1 for 12h interspaced by 12h under still water. Hematology and metabolism were evaluated. Exercised fish decreased 30% the erythrocyte number and hemoglobin was unvaried. The stores of liver glycogen and muscular triacylglycerol (TAG were increased and the metabolic profile was typically aerobic. The slight decrease of liver (TAG plus the full metabolic and hematic trait allow investing in this kind of exercise a beneficial practice in the rearing of fish species

  4. Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

    DEFF Research Database (Denmark)

    Laut, Kamilla; Shepherd, Leah; Radoi, Roxana

    2018-01-01

    BACKGROUND: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. AIM: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA ...-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA....

  5. Protection and conservation of tourism potential. Essential conditions for a sustainable and responsible development of tourism.

    OpenAIRE

    Nicolae Neacsu

    2012-01-01

    Tourism is considered a rapidly growing phenomenon and it has become one of the largest industries in the world and its impact is extremely varied. This paper presents the many aspects of responsible tourism considering the importance of this approach for the economic and social development

  6. Sustainable Transportation

    DEFF Research Database (Denmark)

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

    2014-01-01

    The transportation system is the backbone of economic and social progress and the means by which humans access goods and services and connect with one another. Yet, as the scale of transportation activities has grown worldwide, so too have the negative environmental, social, and economic impacts...... 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...... sector’s significant contribution to global challenges such as climate change, it is often said that sustainable development cannot be achieved without sustainable transportation....

  7. Acute Stress Dysregulates the LPP ERP Response to Emotional Pictures and Impairs Sustained Attention: Time-Sensitive Effects.

    Science.gov (United States)

    Alomari, Rima A; Fernandez, Mercedes; Banks, Jonathan B; Acosta, Juliana; Tartar, Jaime L

    2015-05-20

    Stress can increase emotional vigilance at the cost of a decrease in attention towards non-emotional stimuli. However, the time-dependent effects of acute stress on emotion processing are uncertain. We tested the effects of acute stress on subsequent emotion processing up to 40 min following an acute stressor. Our measure of emotion processing was the late positive potential (LPP) component of the visual event-related potential (ERP), and our measure of non-emotional attention was the sustained attention to response task (SART). We also measured cortisol levels before and after the socially evaluated cold pressor test (SECPT) induction. We found that the effects of stress on the LPP ERP emotion measure were time sensitive. Specifically, the LPP ERP was only altered in the late time-point (30-40 min post-stress) when cortisol was at its highest level. Here, the LPP no longer discriminated between the emotional and non-emotional picture categories, most likely because neutral pictures were perceived as emotional. Moreover, compared to the non-stress condition, the stress-condition showed impaired performance on the SART. Our results support the idea that a limit in attention resources after an emotional stressor is associated with the brain incorrectly processing non-emotional stimuli as emotional and interferes with sustained attention.

  8. The Proposal Concept of Development and Implementation in Strategy of Sustainable Corporate Social Responsibility in the Context of the HCS Model 3E

    Science.gov (United States)

    Sakál, Peter; Hrdinová, Gabriela

    2016-06-01

    This article is the result of a conceptual design methodology for the development of a sustainable strategy of sustainable corporate social responsibility (SCSR) in the context of the HCS model 3E formed, as a co-author within the stated grants and dissertation. On the basis of the use of propositional logic, the SCSR procedure is proposed for incorporation into the corporate strategy of sustainable development and the integrated management system (IMS) of the industrial enterprise. The aim of this article is the proposal of the concept of development and implementation strategy of SCSR in the context of the HCS model 3E.

  9. Treatment response in HCV related chronic hepatitis

    International Nuclear Information System (INIS)

    Hussain, A.B.; Hussain, T.; Hussain, S.; Masood, A.; Kazmi, Y.; Tariq, W.Z.; Karamat, K.A.

    2004-01-01

    Objective: To evaluate the virological response to treatment with interferon and ribavirin in-patients with hepatitis C related liver disease. Material and Methods: Two hundred seventy-nine patients were included in the study. These patients had taken interferon and ribavirin treatment for HCV related chronic hepatitis, and were referred to AFIP for HCV RNA testing by polymerase chain reaction (PCR) between January 2002 and September 2002. Out of 279 cases, 229 had taken the treatment for 06 or 12 months and were tested for end-of-treatment response (ETR). Fifty patients had completed there treatment regimens of 6 or 12 months treatment, at least 24 weeks before their PCR test and were having follow-up testing for sustained viral response (SVR). The sera of these patients were tested for HCV RNA by PCR, using a commercial kit of Amplicor (Roche) for qualitative detection of HCV RNA. Results: Out of 229 cases tested for end-of-treatment response, 198 (86.5%) had no detectable HCV RNA (responders) and 31 (13.50%) were PCR positive (non-responders). Thirty-eight out of 50 cases, tested for a sustained viral response, had a negative result for HCV PCR thus showing sustained response rate of 76%. Conclusion: The viral remission/response to interferon and ribavirin combination therapy in our patients was better than that quoted in other regions. (author)

  10. Sustained Complete Response after Maintenance Therapy with Topotecan and Erlotinib for Recurrent Cervical Cancer with Distant Metastases

    Directory of Open Access Journals (Sweden)

    Donato Callegaro-Filho

    2014-01-01

    Full Text Available Introduction: Recurrent cervical cancer is associated with a poor prognosis. Most treatment responses are partial and of short duration. The development of new therapies is vital to improve treatment for recurrent disease. Epidermal growth factor receptor (EGFR inhibitors may have a role in this setting. Case Description: A 53-year-old woman with stage IB2 squamous cell carcinoma of the cervix was initially treated with chemoradiation. Six months after completing treatment, she developed a recurrence in the common iliac and para-aortic lymph nodes above the previous radiation field and was treated with additional radiation therapy. Two years later, she developed recurrent disease in the left supraclavicular lymph nodes and was treated with chemoradiation followed by 3 cycles of adjuvant cisplatin and topotecan. She had a complete response and was placed on maintenance therapy with topotecan and erlotinib, which was well tolerated and produced minimal side effects. After 20 months of maintenance therapy, it was discontinued given the long interval without evidence of disease. The patient is currently without evidence of disease 5 years after completing the topotecan-erlotinib treatment. Conclusion: We noted a sustained response in a patient with recurrent metastatic cervical cancer treated with radiotherapy, cisplatin, and topotecan followed by maintenance therapy with topotecan and erlotinib. Further evaluation of the role of EGFR inhibitors in this setting should be considered given their favorable toxicity profile and biological relevance.

  11. Virological and immunological failure of HAART and associated risk factors among adults and adolescents in the Tigray region of Northern Ethiopia.

    Science.gov (United States)

    Hailu, Genet Gebrehiwet; Hagos, Dawit Gebregziabher; Hagos, Amlsha Kahsay; Wasihun, Araya Gebreyesus; Dejene, Tsehaye Asmelash

    2018-01-01

    Human immunodeficiency virus/Acquired immunodeficiency syndrome associated morbidity and mortality has reduced significantly since the introduction of highly active antiretroviral therapy. As a result of increasing access to highly active antiretroviral therapy, the survival and quality of life of the patients has significantly improved globally. Despite this promising result, regular monitoring of people on antiretroviral therapy is recommended to ensure whether there is an effective treatment response or not. This study was designed to assess virological and immunological failure of highly active antiretroviral therapy users among adults and adolescents in the Tigray region of Northern Ethiopia, where scanty data are available. A retrospective follow up study was conducted from September 1 to December 30, 2016 to assess the magnitude and factors associated with virological and immunological failure among 260 adults and adolescents highly active antiretroviral therapy users who started first line ART between January 1, 2008 to March 1, 2016. A standardized questionnaire was used to collect socio-demographic and clinical data. SPSS Version21 statistical software was used for analysis. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated to virological and immunological failure. Statistical association was declared significant if p-value was ≤ 0.05. A total of 30 (11.5%) and 17 (6.5%) participants experienced virological and immunological failure respectively in a median time of 36 months of highly active antiretroviral therapy. Virological failure was associated with non-adherence to medications, aged < 40 years old, having CD4+ T-cells count < 250 cells/μL and male gender. Similarly, immunological failure was associated with non-adherence, tuberculosis co-infection and Human immunodeficiency virus RNA ≥1000 copies/mL. The current result shows that immunological and virological failure is a problem in a setting

  12. Effect of pretreatment HIV-1 drug resistance on immunological, virological, and drug-resistance outcomes of first-line antiretroviral treatment in sub-Saharan Africa: a multicentre cohort study

    NARCIS (Netherlands)

    Hamers, Raph L.; Schuurman, Rob; Sigaloff, Kim C. E.; Wallis, Carole L.; Kityo, Cissy; Siwale, Margaret; Mandaliya, Kishor; Ive, Prudence; Botes, Mariette E.; Wellington, Maureen; Osibogun, Akin; Wit, Ferdinand W.; van Vugt, Michèle; Stevens, Wendy S.; de Wit, Tobias F. Rinke

    2012-01-01

    Background The effect of pretreatment HIV-1 drug resistance on the response to first-line combination antiretroviral therapy (ART) in sub-Saharan Africa has not been assessed. We studied pretreatment drug resistance and virological, immunological, and drug-resistance treatment outcomes in a large

  13. Distinct phasic and sustained brain responses and connectivity of amygdala and bed nucleus of the stria terminalis during threat anticipation in panic disorder.

    Science.gov (United States)

    Brinkmann, L; Buff, C; Feldker, K; Tupak, S V; Becker, M P I; Herrmann, M J; Straube, T

    2017-11-01

    Panic disorder (PD) patients are constantly concerned about future panic attacks and exhibit general hypersensitivity to unpredictable threat. We aimed to reveal phasic and sustained brain responses and functional connectivity of the amygdala and the bed nucleus of the stria terminalis (BNST) during threat anticipation in PD. Using functional magnetic resonance imaging (fMRI), we investigated 17 PD patients and 19 healthy controls (HC) during anticipation of temporally unpredictable aversive and neutral sounds. We used a phasic and sustained analysis model to disentangle temporally dissociable brain activations. PD patients compared with HC showed phasic amygdala and sustained BNST responses during anticipation of aversive v. neutral stimuli. Furthermore, increased phasic activation was observed in anterior cingulate cortex (ACC), insula and prefrontal cortex (PFC). Insula and PFC also showed sustained activation. Functional connectivity analyses revealed partly distinct phasic and sustained networks. We demonstrate a role for the BNST during unpredictable threat anticipation in PD and provide first evidence for dissociation between phasic amygdala and sustained BNST activation and their functional connectivity. In line with a hypersensitivity to uncertainty in PD, our results suggest time-dependent involvement of brain regions related to fear and anxiety.

  14. Sustainable Corporate Social Responsibility - An Alternative for a Paradigm Change of Business in the 21St Century

    Science.gov (United States)

    Hrdinová, Gabriela; Sakál, Peter

    2012-12-01

    The critical system analysis of the current status of all areas of human activity on the planet Earth (in Europe and the Slovak Republic) convinces us, that this development is unsustainable. Many prominent personalities of scientific, cultural, social and political life stated that our planet Earth and mankind with it, and all that man has created during its existence is only one step finds itself on the brink of disaster and it will turn against man. Many theoretical concepts, based on the historical development and experience notes that this status is natural and inevitable. However, we hold a different opinion. If the man is team, that is declared, it must show (now at the turning point) themselves and future generations, that it thinks with its existence on planet Earth seriously and responsibly. Given by the current global crisis and also our belief that the fundamental problem of humanity is unfair creation and distribution of wealth on planet Earth, we maintain opinion for changing the paradigm of thinking in this area. As the only alternative for solving this problem we see in the application of the concept of sustainable corporate social responsibility. The article presents our idea.

  15. Social responsibility (SR) of nuclear research and its practice for pursuing integrity and sustainability of nuclear research with society

    International Nuclear Information System (INIS)

    Tetsuo, Sawada; Naoki, Yamano; Yoshiko, Aoyama; Akiko, Shioda; Junichi, Mizuo; Yasuhiko, Fujii

    2007-01-01

    Corporate Social Responsibility (CSR), which includes compliance, engineering and business ethics, safety and security, and corporate governance, is being widely applied not only in the field of business administrations but also in academia and research communities. The basic 3 ideals of CSR are sustainability, stakeholder dialogue (stakeholder include consumers, suppliers, employees, investors and local communities) and triple basic constraints (be environment-friendly, competitive and beneficial for the society as a whole). A typical aspect of this trend is that most electric power company publishes documents such as Corporate Social Responsibility (CSR) reports which are the improved version of social-environmental reports. CSR reflects the very expectations from the society that how far the corporations and organizations including universities can resolve the issues in which the society is necessarily involved. The nuclear power generations and related facilities are sorts of societal systems and not merely technological systems. This paper describes the concept of CSR, its basic prerequisites and the framework of the civic forum that is a part of the practices of Nuclear CSR

  16. Public Sector Responses to Sustainable Haze Management in Upper Northern Thailand

    Directory of Open Access Journals (Sweden)

    Yongyut Tiyapairat

    2012-06-01

    Full Text Available This research focuses on urban haze in Upper Northern Thailand (UNT, where smoke haze often produce impacts on human health, tourism, and transportation. The objective was to better understand how the public sector responded to the haze impacts in policy review interviews and analyses of compiled haze-related data during 2007-2011. Moreover, integration of haze adaptation policy and coherency was also explored. The results revealed that Thailand has mainly implemented three National Haze Action Plans since 1997, together with laws and regulations for haze management. Further examination of haze policy at all levels of governance disclosed only vertical integration, whereas cross-boundary integration was reported only with the data and budget. Practically, manpower and function have not yet brought satisfactory outcomes. Moreover, the extent of state responses has been centralized –not decentralized from their centralized political structure. Low participation of people living in both urban and rural areas and cooperative efforts were identified as the main factors contributing to failures in combating smoke haze. Therefore, individuals are of utmost importance for effective solutions. There is a continuous need for prevention campaigns to enhance local people's understanding and participation as well as local communities' networking for solutions to the haze problem.

  17. Sustained visual-spatial attention produces costs and benefits in response time and evoked neural activity.

    Science.gov (United States)

    Mangun, G R; Buck, L A

    1998-03-01

    This study investigated the simple reaction time (RT) and event-related potential (ERP) correlates of biasing attention towards a location in the visual field. RTs and ERPs were recorded to stimuli flashed randomly and with equal probability to the left and right visual hemifields in the three blocked, covert attention conditions: (i) attention divided equally to left and right hemifield locations; (ii) attention biased towards the left location; or (iii) attention biased towards the right location. Attention was biased towards left or right by instructions to the subjects, and responses were required to all stimuli. Relative to the divided attention condition, RTs were significantly faster for targets occurring where more attention was allocated (benefits), and slower to targets where less attention was allocated (costs). The early P1 (100-140 msec) component over the lateral occipital scalp regions showed attentional benefits. There were no amplitude modulations of the occipital N1 (125-180 msec) component with attention. Between 200 and 500 msec latency, a late positive deflection (LPD) showed both attentional costs and benefits. The behavioral findings show that when sufficiently induced to bias attention, human observers demonstrate RT benefits as well as costs. The corresponding P1 benefits suggest that the RT benefits of spatial attention may arise as the result of modulations of visual information processing in the extrastriate visual cortex.

  18. Ancestry explains the blunted ventilatory response to sustained hypoxia and lower exercise ventilation of Quechua altitude natives.

    Science.gov (United States)

    Brutsaert, Tom D; Parra, Esteban J; Shriver, Mark D; Gamboa, Alfredo; Rivera-Ch, Maria; León-Velarde, Fabiola

    2005-07-01

    Andean high-altitude (HA) natives have a low (blunted) hypoxic ventilatory response (HVR), lower effective alveolar ventilation, and lower ventilation (VE) at rest and during exercise compared with acclimatized newcomers to HA. Despite blunted chemosensitivity and hypoventilation, Andeans maintain comparable arterial O(2) saturation (Sa(O(2))). This study was designed to evaluate the influence of ancestry on these trait differences. At sea level, we measured the HVR in both acute (HVR-A) and sustained (HVR-S) hypoxia in a sample of 32 male Peruvians of mainly Quechua and Spanish origins who were born and raised at sea level. We also measured resting and exercise VE after 10-12 h of exposure to altitude at 4,338 m. Native American ancestry proportion (NAAP) was assessed for each individual using a panel of 80 ancestry-informative molecular markers (AIMs). NAAP was inversely related to HVR-S after 10 min of isocapnic hypoxia (r = -0.36, P = 0.04) but was not associated with HVR-A. In addition, NAAP was inversely related to exercise VE (r = -0.50, P = 0.005) and ventilatory equivalent (VE/Vo(2), r = -0.51, P = 0.004) measured at 4,338 m. Thus Quechua ancestry may partly explain the well-known blunted HVR (10, 35, 36, 57, 62) at least to sustained hypoxia, and the relative exercise hypoventilation at altitude of Andeans compared with European controls. Lower HVR-S and exercise VE could reflect improved gas exchange and/or attenuated chemoreflex sensitivity with increasing NAAP. On the basis of these ancestry associations and on the fact that developmental effects were completely controlled by study design, we suggest both a genetic basis and an evolutionary origin for these traits in Quechua.

  19. A Newsboy Model with Quick Response under Sustainable Carbon Cap-N-Trade

    Directory of Open Access Journals (Sweden)

    Jinpyo Lee

    2018-05-01

    Full Text Available In this study, we consider a carbon emission cap-and-trade system in which the policymaker decides the cap for carbon emissions for each company and also has the power to regulate the carbon price in the carbon trading market for the purpose of minimizing total carbon emissions. We assume that there are n companies regulated in terms of carbon emissions by the policymaker, each of which emits carbon when producing its own product. After learning the carbon cap and carbon price regulated by the policymaker, each company makes simultaneous pricing and production decisions using the quick response strategy, and can trade some of its carbon emissions in the carbon market at the carbon price set by the policymaker, if the carbon emissions are below the cap. We model this non-cooperative game between the policymaker and companies as a Stackelberg game in which the policymaker is the leader and the companies are the followers. We show that there exists an equilibrium for the policymaker’s carbon pricing decisions and each company’s production and pricing decisions. From this equilibrium, we derive a carbon cap for the company at which the amount of traded carbon emissions is zero. This implies that some company’s production and pricing decisions, even under carbon emission restrictions, will be equal to those without the carbon emission restrictions. Also, we find that companies participating in the carbon cap-and-trade system would reduce their carbon emissions through reduced production, but can have a chance to improve profit through control of the product’s selling price.

  20. Responses to Environmental & Societal Challenges for our Unstable Earth (RESCUE) foresight initiative - towards a European response to grand challenges in sustainability research and learning

    Science.gov (United States)

    Avril, B.; et al.

    2012-04-01

    The "Responses to Environmental and Societal Challenges for our Unstable Earth" (RESCUE; www.esf.org/rescue) foresight initiative - a joint COST-ESF "Frontiers of Science" initiative - aimed to help Europe address the societal and scientific challenges related to global environmental change and the related resilience issues. In RESCUE, the focus of attention was on people and the goal was to stimulate an integrated, innovative response from natural, social and human sciences. The RESCUE foresight initiative began in September 2009 and has recently been completed. RESCUE had the following key objectives: 1. To propose a strategic process for natural, social and human sciences to improve their ability and capacity to work together to address global environmental change through interdisciplinary synergy and to respond effectively to societal and policy-relevant needs; 2. To articulate new scientific issues related to global environmental change and the related resilience issues, especially those of transdisciplinary nature and of major relevance to society; 3. To explore new approaches towards truly integrated, interdisciplinary science, and to facilitate the 'revolution' in education and capacity building it requires. The work of RESCUE focused on the following themes: · Contributions from social sciences and humanities in developing responses to challenges of the Anthropocene; · Collaboration between the natural, social and human sciences in global environmental change and resilience studies; · Requirements for research methodologies and data; · Education and capacity building - towards a 'revolution'; · The interface between science and policy, communication and outreach. The RESCUE recommendations include the following issues to be addressed by science-funders, science policy-makers, researchers, practitioners, educators and a range of other societal actors: · develop an institutional framework for an open knowledge society, · re-organise research so

  1. Netrin-1 Protects Hepatocytes Against Cell Death Through Sustained Translation During the Unfolded Protein Response.

    Science.gov (United States)

    Lahlali, Thomas; Plissonnier, Marie-Laure; Romero-López, Cristina; Michelet, Maud; Ducarouge, Benjamin; Berzal-Herranz, Alfredo; Zoulim, Fabien; Mehlen, Patrick; Parent, Romain

    2016-05-01

    Netrin-1, a multifunctional secreted protein, is up-regulated in cancer and inflammation. Netrin-1 blocks apoptosis induced by the prototypical dependence receptors deleted in colorectal carcinoma and uncoordinated phenotype-5. Although the unfolded protein response (UPR) triggers apoptosis on exposure to stress, it first attempts to restore endoplasmic reticulum homeostasis to foster cell survival. Importantly, UPR is implicated in chronic liver conditions including hepatic oncogenesis. Netrin-1's implication in cell survival on UPR in this context is unknown. Isolation of translational complexes, determination of RNA secondary structures by selective 2'-hydroxyl acylation and primer extension/dimethyl sulfate, bicistronic constructs, as well as conventional cell biology and biochemistry approaches were used on in vitro-grown hepatocytic cells, wild-type, and netrin-1 transgenic mice. HepaRG cells constitute a bona fide model for UPR studies in vitro through adequate activation of the 3 sensors of the UPR (protein kinase RNA-like endoplasmic reticulum kinase (PERK)), inositol requiring enzyme 1α (IRE1α), and activated transcription factor 6 (ATF6). The netrin-1 messenger RNA 5'-end was shown to fold into a complex double pseudoknot and bear E-loop motifs, both of which are representative hallmarks of related internal ribosome entry site regions. Cap-independent translation of netrin 5' untranslated region-driven luciferase was observed on UPR in vitro. Unlike several structurally related oncogenic transcripts (l-myc, c-myc, c-myb), netrin-1 messenger RNA was selected for translation during UPR both in human hepatocytes and in mice livers. Depletion of netrin-1 during UPR induces apoptosis, leading to cell death through an uncoordinated phenotype-5A/C-mediated involvement of protein phosphatase 2A and death-associated protein kinase 1 in vitro and in netrin transgenic mice. UPR-resistant, internal ribosome entry site-driven netrin-1 translation leads to

  2. 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.

  3. Public Administration, Social Responsibility and Sustainability, the Commitment of Public Education Institutions: Instituto Federal Fluminense Case Study

    Directory of Open Access Journals (Sweden)

    Isabel Grigorio Freitas

    2015-05-01

    Full Text Available School is part of the community and as such should provide ongoing discussions which are conducive to creating a more just society, striving to provide educational and vocational training in order to educate citizens who are free, able to think critically, and supportive of each other. In pursuit of this objective, education emerges as a springboard for sustainable development with social inclusion, bringing down certain barriers created by the need to meet government targets, and discussing the options associated to local characteristics, empowering people who are looking for a more dignified life.The objectives of this research are to analyse the commitment of public teaching institutions in the area of social development and sustainability; identify the main difficulties of implementing social projects according to federal government guidelines, considering not only the general characteristics, but also those given by local communities; and understand the importance of education for improving communal living conditions, helping strengthen collaboration between communities and schools in tackling these social issues and identifying practices currently adopted. This will be done by reviewing the literature and case studies available, aiming to improve the management of future actions.The method employed to answer the research question included the use of questionnaires and interviews, direct observation by the author, literature review and a study of best practices dentified throughout the research process, the use of the concept of social responsibility and sustainability to analyse public policies focused on education, and the case study of the Instituto Federal de Educação, Ciência e Tecnologia to improve the handling and understanding of research data.It became apparent that the biggest difficulties encountered in the projects created by the federal government and operated by the Instituto Federal Fluminense had to do with lack of

  4. Hot News: Impact of Low-level Viremia on Treatment Outcomes During ART - Is it Time to Revise the Definition of Virological Failure?

    Science.gov (United States)

    Poveda, Eva; Crespo, Manuel

    2018-01-01

    The level of HIV-RNA in plasma (HIV viral load) is the main marker used to monitor the virological response to antiretroviral therapy (ART) in HIV-infected patients. The threshold used to define virological suppression has historically been dictated by the limits of detection of the commercial assays used to quantify the plasma viral load. Thus, as more sensitive assays have proliferated and become more widely available, the definition has shifted from ART is to maintain virological suppression below 200 cop/mL, or even > 1000 cop/mL according to the WHO guidelines for low-income and middle-income countries. Several studies have evaluated the impact of low-level viremia as intermittent episodes (blips) or persistent detectable low-level viremia (50-1000 cop/mL) on treatment outcomes during ART. Some of these studies have suggested a potential role for low-level viremia as a predictor of virological failure, although up to now the data have been insufficient and controversial to guide clinical management. Hermans et al. have recently published the results of a large (n = 70.930 HIV-infected patients) multicenter study (57 clinical sites in South Africa) with a median follow-up for more than 2 years, to evaluate the incidence and impact of low-level viremia (defined as HIV-RNA viral load of 51-999 cop/mL) and its association with virological failure (Hermans et al., Lancet Infect Dis 2018;18:188-97). This large cohort study concludes that overall, patients with low-level viremia are predisposed to subsequent virological failure. The risk of virological failure was 5 times higher for patients with low-level viremia ranging 400-999 cop/mL, and 2 times higher for those with viremia ranging 51-199 cop/mL, compared with patients maintaining viral load suppression (ART should be recognized and considered in clinical decision-making. Furthermore, current WHO guidelines for low-income and middleincome countries should be revised and updated. Although substantial differences

  5. Do, but Don't Tell: The Search for Social Responsibility and Sustainability in the Websites of the Top-100 US MBA Programs

    Science.gov (United States)

    Hart, Timothy A.; Fox, Corey J.; Ede, Kenneth F.; Korstad, John

    2015-01-01

    Purpose: The purpose of this study is to investigate the degree to which business schools, in particular MBA programs, have developed academic programs and centers specifically focused on corporate social responsibility and sustainability (CSRS) and, for those that have, promote them on their Web sites. The instruction of CSRS in institutions of…

  6. Enhancing the ethical behaviour of sustainable entrepreneurs through responsible innovation – the case of new technology-based firms in Europe

    NARCIS (Netherlands)

    Long, Thomas B.; Blok, Vincent

    2018-01-01

    To solve societal challenges, such as climate change, socio-ethical issues must be integrated into innovations and managed during the sustainable entrepreneurship process. Responsible innovation aims to align and incorporate socio-ethical factors into innovations. However, there are questions over

  7. Future of industry. Part 4. Sustainable entrepreneurship in the Dutch construction industry. Institutional context and strategic responses

    Energy Technology Data Exchange (ETDEWEB)

    Klein Woolthuis, R; De Boer, S.

    2009-12-15

    TNO developed a methodology to identify sector specific opportunities by examining bottlenecks and drivers for sustainable innovation. Research results are presented in 4 reports: the first report explores the highly innovative chemicals sector and how it deals with opportunities and bottlenecks in sustainable innovation. The second report examines the project driven construction industry and how entrepreneurs and incumbent firms develop strategies to deal with the bottlenecks of sustainable innovation. The third report extends the second report by highlighting the role of the incumbent firms in this process, and this (fourth) report deepens the second report by illuminating the strategies of entrepreneurs in the transition to sustainable construction.

  8. An audit on virological efficacy of anti-retroviral therapy in a specialist infectious disease clinic.

    LENUS (Irish Health Repository)

    Reyad, A

    2009-06-01

    We have assessed the efficacy of anti retroviral therapy (ART) using undetectable viral load (VL) (<50 RNA copies\\/ml) as a marker of virological success, in patients who have Human Immunodeficiency Virus (HIV) attending the Department of Infectious Disease. A cross-sectional review of patients\\' case notes was used to obtain their demographics and treatment details. 79% (253) of the hospital case notes of clinic population was available for analysis, which represents 90% of those receiving ART in the clinic. 166\\/253 of the cohort were receiving treatment at the time of this study and 95% (157\\/166) of these were on treatment for greater than 6 months. The total virological success rate is 93%, which is comparable to other centres and are as good as those from published clinical trials. 56% of those on therapy who have virological failure were Intravenous Drug Users (IVDUs). Case by case investigation for those with treatment failure is warranted.

  9. Characterization of HIV-1 from patients with virological failure to a boosted protease inhibitor regimen

    DEFF Research Database (Denmark)

    Lillemark, Marie Rathcke; Gerstoft, Jan; Obel, Niels

    2011-01-01

    The use of highly active antiretroviral treatment (HAART) regimens with unboosted protease inhibitors (PIs) has resulted in a high level of virological failure primarily due to the development of resistant virus. Current boosted PI regimens combine successfully low-dose ritonavir (r) with a second.......3%) experienced virological failure, of whom 19 (83%) started PI/r treatment before 2001. Patients from Copenhagen (n=19) were selected to study the development of protease (PR) and gag cleavage site (CS) mutations during PI/r treatment and PI plasma levels at the time of virological failure. Three patients (16......%) developed major PI resistance mutations. Mutations in the p7/p1 and p1/p6 gag CS only developed in patients with major or minor mutations in PR. Drug concentrations were low or undetectable in 10 out of the 19 patients. In total PR resistance mutations and low drug levels could account for 12 (63...

  10. High rate of virologic suppression with darunavir/ritonavir plus optimized background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    José Ernesto Vidal

    Full Text Available OBJECTIVES: To assess the virologic and immunological response of darunavir/ritonavir plus optimized background therapy in highly antiretroviral-experienced HIV-infected patients in Brazil. METHODS: Prospective cohort study carried out in a tertiary center in Sao Paulo, Brazil. Three-class antiretroviral-experienced patients with confirmed virologic failure began darunavir/ritonavir plus optimized background therapy (nucleoside/tide reverse transcriptase inhibitors ± raltegravir ± enfuvirtide ± maraviroc after performing a genotypic resistance assay. Clinical evaluation and laboratory tests were collected at baseline and at weeks 12, 24, and 48. Multivariate analysis was performed to identify predictors of virologic response at 48 weeks. RESULTS: Ninety-two patients were included. The median of darunavir resistant mutation was 1 (range 0-6. The median genotypic sensitivity score in the optimized background therapy was 2 (interquartile range 1-2. At week 48, 83% (95% CI: 75-90% had an HIV RNA level 100 000 copies/mL was inversely associated with virologic success at week 48 (HR: 0.22, 95% CI: 0.06-0.85, p = 0.028. CONCLUSIONS: Darunavir/ritonavir plus optimized background therapy was a highly effective salvage regimen under clinical routine conditions in a referral center in Brazil, which is similar to the reported in high-income countries.

  11. High rate of virologic suppression with darunavir/ritonavir plus optimized background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    José Ernesto Vidal

    2013-02-01

    Full Text Available OBJECTIVES: To assess the virologic and immunological response of darunavir/ritonavir plus optimized background therapy in highly antiretroviral-experienced HIV-infected patients in Brazil. METHODS: Prospective cohort study carried out in a tertiary center in Sao Paulo, Brazil. Three-class antiretroviral-experienced patients with confirmed virologic failure began darunavir/ritonavir plus optimized background therapy (nucleoside/tide reverse transcriptase inhibitors ± raltegravir ± enfuvirtide ± maraviroc after performing a genotypic resistance assay. Clinical evaluation and laboratory tests were collected at baseline and at weeks 12, 24, and 48. Multivariate analysis was performed to identify predictors of virologic response at 48 weeks. RESULTS: Ninety-two patients were included. The median of darunavir resistant mutation was 1 (range 0-6. The median genotypic sensitivity score in the optimized background therapy was 2 (interquartile range 1-2. At week 48, 83% (95% CI: 75-90% had an HIV RNA level 100 000 copies/mL was inversely associated with virologic success at week 48 (HR: 0.22, 95% CI: 0.06-0.85, p = 0.028. CONCLUSIONS: Darunavir/ritonavir plus optimized background therapy was a highly effective salvage regimen under clinical routine conditions in a referral center in Brazil, which is similar to the reported in high-income countries.

  12. Virologic outcome among patients receiving antiretroviral therapy at five hospitals in Haiti.

    Directory of Open Access Journals (Sweden)

    Frantz Jean Louis

    Full Text Available Viral load (VL assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy (ART. We conducted a retrospective cross-sectional study to evaluate the virologic suppression rate among patients on ART for ≥6 months in five hospitals around Port-au-Prince, Haiti.Plasma VL was measured and patients with VL <1,000 copies/mL were defined as virologically suppressed. A second VL test was performed within at least six months of the first test. Factors associated with virologic suppression were analyzed using logistic regression models accounting for site-level clustering using complex survey procedures.Data were analyzed for 2,313 patients on ART for six months or longer between July 2013 and February 2015. Among them, 1,563 (67.6% achieved virologic suppression at the first VL test. A second VL test was performed within at least six months for 718 (31.0% of the patients. Of the 459 patients with an initial HIV-1 RNA <1,000 copies/mL who had a second VL performed, 394 (85.8% maintained virologic suppression. Virologic suppression was negatively associated with male gender (adjusted odds ratio [aOR]: 0.80, 95% CI: 0.74-0.0.86, 23 to 35 months on ART (aOR:0.72[0.54-0.96], baseline CD4 counts of 201-500 cells/mm3 and 200 cells/mm3 or lower (aORs: 0.77 [0.62-0.95] and 0.80 [0.66-0.98], respectively, poor adherence (aOR: 0.69 [0.59-0.81], and TB co-infection (aOR: 0.73 [0.55-0.97].This study showed that over two-thirds of the patients in this evaluation achieved virologic suppression after ≥ six months on ART and the majority of them remained suppressed. These results reinforce the importance of expanding access to HIV-1 viral load testing in Haiti for monitoring ART outcomes.

  13. Differences in Virological and Immunological Risk Factors for Non-Hodgkin and Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Shepherd, Leah; Ryom, Lene; Law, Matthew

    2018-01-01

    Background: Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) are increased in populations with immune dysfunction, including people living with HIV; however, there is little evidence for to what degree immunological and virological factors differently affect NHL and HL risk. Methods: Data from...... the Data Collection on Adverse events of Anti-HIV Drugs Study cohort were analyzed to identify independent risk factors for NHL and HL using hazard ratios (HRs), focusing on current and cumulative area under the curve (AUC) measures of immunological and virological status. Variables with different...

  14. Baseline natural killer and T cell populations correlation with virologic outcome after regimen simplification to atazanavir/ritonavir alone (ACTG 5201.

    Directory of Open Access Journals (Sweden)

    John E McKinnon

    Full Text Available Simplified maintenance therapy with ritonavir-boosted atazanavir (ATV/r provides an alternative treatment option for HIV-1 infection that spares nucleoside analogs (NRTI for future use and decreased toxicity. We hypothesized that the level of immune activation (IA and recovery of lymphocyte populations could influence virologic outcomes after regimen simplification.Thirty-four participants with virologic suppression ≥ 48 weeks on antiretroviral therapy (2 NRTI plus protease inhibitor were switched to ATV/r alone in the context of the ACTG 5201 clinical trial. Flow cytometric analyses were performed on PBMC isolated from 25 patients with available samples, of which 24 had lymphocyte recovery sufficient for this study. Assessments included enumeration of T-cells (CD4/CD8, natural killer (NK (CD3+CD56+CD16+ cells and cell-associated markers (HLA-DR, CD's 38/69/94/95/158/279.Eight of the 24 patients had at least one plasma HIV-1 RNA level (VL >50 copies/mL during the study. NK cell levels below the group median of 7.1% at study entry were associated with development of VL >50 copies/mL following simplification by regression and survival analyses (p = 0.043 and 0.023, with an odds ratio of 10.3 (95% CI: 1.92-55.3. Simplification was associated with transient increases in naïve and CD25+ CD4+ T-cells, and had no impact on IA levels.Lower NK cell levels prior to regimen simplification were predictive of virologic rebound after discontinuation of nucleoside analogs. Regimen simplification did not have a sustained impact on markers of IA or T lymphocyte populations in 48 weeks of clinical monitoring.ClinicalTrials.gov NCT00084019.

  15. Influence of IL28B polymorphisms on response to a lower-than-standard dose peg-IFN-α 2a for genotype 3 chronic hepatitis C in HIV-coinfected patients.

    Directory of Open Access Journals (Sweden)

    Luis F López-Cortés

    Full Text Available Data on which to base definitive recommendations on the doses and duration of therapy for genotype 3 HCV/HIV-coinfected patients are scarce. We evaluated the efficacy of a lower peginterferon-α 2a dose and a shorter duration of therapy than the current standard of care in genotype 3 HCV/HIV-coinfected patients.Pilot, open-label, single arm clinical trial which involved 58 Caucasian HCV/HIV-coinfected patients who received weekly 135 µg peginterferon-α 2a plus ribavirin 400 mg twice daily during 20 weeks after attaining undetectable viremia. The relationships between baseline patient-related variables, including IL28B genotype, plasma HCV-RNA, ribavirin dose/kg, peginterferon-α 2a and ribavirin levels with virological responses were analyzed. Only 4 patients showed lack of response and 5 patients dropped out due to adverse events related to the study medication. Overall, sustained virologic response (SVR rates were 58.3% by intention-to-treat and 71.4% by per protocol analysis, respectively. Among patients with rapid virologic response (RVR, SVR and relapses rates were 92.6% and 7.4%, respectively. No relationships were observed between viral responses and ribavirin dose/kg, peginterferon-α 2a concentrations, ribavirin levels or rs129679860 genotype.Weekly 135 µg pegIFN-α 2a could be as effective as the standard 180 µg dose, with a very low incidence of severe adverse events. A 24-week treatment duration appears to be appropriate in patients achieving RVR, but extending treatment up to just 20 weeks beyond negativization of viremia is associated with a high relapse rate in those patients not achieving RVR. There was no influence of IL28B genotype on the virological responses.ClinicalTrials.gov NCT00553930.

  16. The Association between Organisational Commitment And Corporate Social Responsibility-Environmental Performance Within an Integrated Sustainability Balanced Scorecard Framework

    Directory of Open Access Journals (Sweden)

    Kirsten Rae

    2015-03-01

    Full Text Available This study investigates whether organisational commitment is associated with organisations‘CSR performance within sustainability aspects of their internal process. A structural equation model (SEM tested two sequential direct associations between: (1 senior management employees‘ affective and continuance organisational commitment and organisations‘ conventional value-creating internal processes; (2 conventional value-creating internal processes and organisations‘ CSR performance within sustainability value-creating internal process. The SEM results show an indirect association between affective commitment and CSR performance within sustainability value-creating internal process, which is mediated by the conventional value-creating internal processes. The findings support an integrated sustainability internal process within a sustainability balanced scorecard (SBSC as depicted in Kaplan and Norton‘s strategy map. Organisations may develop internal processes that promote CSR outcome characteristics when employees possess higher levels of affective organisational commitment. Future research could investigate a broader  range of environmental outcomes within CSR performance.

  17. Functional difference between sustained and transient modulations of cognitive control in the simon task: evidence from false alarm responses on no-go trials.

    Science.gov (United States)

    Hasegawa, Kunihiro; Takahashi, Shin'ya

    2013-01-01

    Cognitive control in response compatibility tasks is modulated by the task context. Two types of contextual modulations have been demonstrated; sustained (block-wise) and transient (trial-by-trial). Recent research suggests that these modulations have different underlying mechanisms. This study presents new evidence supporting this claim by comparing false alarm (FA) responses on no-go trials of the Simon task between the sustained and transient contexts. In Experiment 1, the sustained context was manipulated so that a block included a larger number of incongruent trials. Results showed that participants made more FA responses by the hand opposite to the stimulus location. This suggests a generation of response bias in which the task-irrelevant location information is utilized in a reversed manner (i.e., to respond with the right hand to a stimulus presented on the left side and vice versa). Next, Experiment 2 examined the effect of the transient context and found that overall FA rate was lower when a no-go trial was preceded by an incongruent trial than by a congruent trial, whereas such response bias as that shown in Experiment 1 was not demonstrated. This suggests that the transient conflict context enhances inhibition of the task-irrelevant process but does not make the task-irrelevant information actively usable. Based on these results, we propound two types of cognitive control modulations as adaptive behaviors: response biasing based on utilization of the task-irrelevant information under the sustained conflict context and transient enhancement of inhibition of the task-irrelevant process based on the online conflict monitoring.

  18. The influences of task repetition, napping, time of day, and instruction on the Sustained Attention to Response Task.

    Science.gov (United States)

    van Schie, Mojca K M; Alblas, Eva E; Thijs, Roland D; Fronczek, Rolf; Lammers, Gert Jan; van Dijk, J Gert

    2014-01-01

    The Sustained Attention to Response Task (SART) helps to quantify vigilance impairments.Previous studies, in which five SART sessions on one day were administered, demonstrated worse performance during the first session than during the others. The present study comprises two experiments to identify a cause of this phenomenon. Experiment 1, counting eighty healthy participants, assessed effects of repetition,napping, and time of day on SART performance through a between-groups design. The SART was performed twice in the morning or twice in the afternoon; half of the participants took a 20-minute nap before the second SART. A strong correlation between error count and reaction time (RT) suggested effects of test instruction. Participants gave equal weight to speed and accuracy in Experiment 1; therefore, results of 20 participants were compared to those of 20 additional participants who were told to prefer accuracy (Experiment 2). The average SART error count in Experiment 1 was 10.1; the median RT was 280 ms. Neither repetition nor napping influenced error count or RT. Time of day did not influence error count, but RT was significantly longer for morning than for afternoon SARTs. The additional participants in Experiment 2 had a 49% lower error count and a 14% higher RT than the participants in Experiment 1. Error counts reduced by 50% from the first to the second session of Experiment 2, irrespective of napping or time of day. Preferring accuracy over speed was associated with a significantly lower error count. The data suggest that a worse performance in the first SART session only occurs when instructing participants to prefer accuracy, which is caused by repetition, not by napping or time of day. We advise that participants are instructed to prefer accuracy over speed when performing the SART and that a full practice session is included.

  19. Sustained exercise-trained juvenile black carp (Mylopharyngodon piceus at a moderate water velocity exhibit improved aerobic swimming performance and increased postprandial metabolic responses

    Directory of Open Access Journals (Sweden)

    Xiuming Li

    2018-02-01

    Full Text Available The objectives of this study were to examine whether sustained exercise training at four water velocities, i.e. nearly still water (control, 1 body length (BL s−1, 2 BL s−1 and 4 BL s−1, has effects on swimming performance and digestive metabolism in juvenile black carp (Mylopharyngodon piceus. The results demonstrated that fish subjected to sustained training at 2 and 4 BL s−1 showed significantly higher critical swimming speed (Ucrit and maximum metabolic rate (MMR over the control group. Fish subjected to sustained training at 1 and 2 BL s−1 showed a significantly (30 and 54% prolonged duration, 14 and 17% higher postprandial ṀO2 increment (i.e. ṀO2peak, and 62 and 92% more energy expended on specific dynamic action (SDA, respectively, after consuming a similar meal over fish kept in nearly still water. These results suggest that (1 sustained exercise training at a higher speed (2 or 4 BL s−1 had a positive influence on the aerobic swimming performance of juvenile M. piceus, which may be associated with improved aerobic metabolism; and (2 sustained exercise training at a lower speed (1 or 2 BL s−1 resulted in elevated postprandial metabolic responses in juvenile M. piceus.

  20. Comparison of HIV-1 genotypic resistance test interpretation systems in predicting virological outcomes over time

    NARCIS (Netherlands)

    D. Frentz (Dineke); C.A.B. Boucher (Charles); M. Assel (Matthias); A. de Luca (Andrea); M. Fabbiani (Massimiliano); F. Incardona (Francesca); P. Libin (Pieter); N. Manca (Nino); V. Müller (Viktor); B.O. Nualláin (Breanndán); R. Paredes (Roger); M. Prosperi (Mattia); E. Quiros-Roldan (Eugenia); L. Ruiz (Lidia); P.M.A. Sloot (Peter); C. Torti (Carlo); A.M. Vandamme (Anne Mieke); K. Laethem (Kristel); M. Zazzi (Maurizio); D.A.M.C. van de Vijver (David)

    2010-01-01

    textabstractBackground: Several decision support systems have been developed to interpret HIV-1 drug resistance genotyping results. This study compares the ability of the most commonly used systems (ANRS, Rega, and Stanford's HIVdb) to predict virological outcome at 12, 24, and 48 weeks.

  1. The value of Institute of Human Virology meeting abstracts and beyond

    Directory of Open Access Journals (Sweden)

    Jeang Kuan-Teh

    2005-12-01

    Full Text Available Abstract This month Retrovirology publishes the meeting abstracts from the 10th annual Institute of Human Virology conference held August 29th to September 2nd, 2005 in Baltimore, Maryland, USA. In this editorial, the rationale for publishing meeting abstracts is discussed.

  2. Rift Valley fever outbreak, Mauritania, 1998: seroepidemiologic, virologic, entomologic, and zoologic investigations.

    Science.gov (United States)

    Nabeth, P; Kane, Y; Abdalahi, M O; Diallo, M; Ndiaye, K; Ba, K; Schneegans, F; Sall, A A; Mathiot, C

    2001-01-01

    A Rift Valley fever outbreak occurred in Mauritania in 1998. Seroepidemiologic and virologic investigation showed active circulation of the Rift Valley fever virus, with 13 strains isolated, and 16% (range 1.5%-38%) immunoglobulin (Ig) M-positivity in sera from 90 humans and 343 animals (sheep, goats, camels, cattle, and donkeys). One human case was fatal.

  3. Managing Supplier Sustainability Risk

    OpenAIRE

    Harilainen, Hanna-Riitta

    2014-01-01

    Supply chains are increasingly global, often reaching to developing regions. The media pressure brand owners to be responsible, but a product is only as sustainable as the practices of all the companies involved in manufacturing it are. It’s not enough that the brand owner acts responsibly; sustainable practices have to reach component and raw material suppliers upstream. Image risk has often been recognized as reason for investing in sustainability. In the supply chain context, supplier m...

  4. Sustained long-term immune responses after in situ gene therapy combined with radiotherapy and hormonal therapy in prostate cancer patients

    International Nuclear Information System (INIS)

    Fujita, Tetsuo; Teh, Bin S.; Timme, Terry L.; Mai, W.-Y.; Satoh, Takefumi; Kusaka, Nobuyuki; Naruishi, Koji; Fattah, Elmoataz Abdel; Aguilar-Cordova, Estuardo; Butler, E. Brian; Thompson, Timothy C.

    2006-01-01

    Purpose: To explore long-term immune responses after combined radio-gene-hormonal therapy. Methods and Materials: Thirty-three patients with prostate specific antigen 10 or higher or Gleason score of 7 or higher or clinical stage T2b to T3 were treated with gene therapy that consisted of 3 separate intraprostatic injections of AdHSV-tk on Days 0, 56, and 70. Each injection was followed by 2 weeks of valacyclovir. Intensity-modulated radiation therapy was delivered 2 days after the second AdHSV-tk injection for 7 weeks. Hormonal therapy was initiated on Day 0 and continued for 4 months or 2.3 years. Blood samples were taken before, during, and after treatment. Lymphocytes were analyzed by fluorescent antibody cell sorting (FACS). Results: Median follow-up was 26 months (range, 4-48 months). The mean percentages of DR + CD8 + T cells were increased at all timepoints up to 8 months. The mean percentages of DR + CD4 + T cells were increased later and sustained longer until 12 months. Long-term (2.3 years) use of hormonal therapy did not affect the percentage of any lymphocyte population. Conclusions: Sustained long-term (up to 8 to 12 months) systemic T-cell responses were noted after combined radio-gene-hormonal therapy for prostate cancer. Prolonged use of hormonal therapy does not suppress this response. These results suggest the potential for sustained activation of cell-mediated immune responses against cancer

  5. Consumer response to packaging design: The role of packaging materials and graphics in sustainability perceptions and product evaluations

    NARCIS (Netherlands)

    Steenis, N.D.; Herpen, E. van; Lans, I.A. van der; Ligthart, T.N.; Trijp, H.C.M. van

    2017-01-01

    Building on theories of cue utilization, this paper investigates whether and how packaging sustainability influences consumer perceptions, inferences and attitudes towards packaged products. A framework is tested in an empirical study among 249 students using soup products varying in packaging

  6. Effectiveness of Ritonavir-Boosted Protease Inhibitor Monotherapy in Clinical Practice Even with Previous Virological Failures to Protease Inhibitor-Based Regimens.

    Directory of Open Access Journals (Sweden)

    Luis F López-Cortés

    Full Text Available Significant controversy still exists about ritonavir-boosted protease inhibitor monotherapy (mtPI/rtv as a simplification strategy that is used up to now to treat patients that have not experienced previous virological failure (VF while on protease inhibitor (PI -based regimens. We have evaluated the effectiveness of two mtPI/rtv regimens in an actual clinical practice setting, including patients that had experienced previous VF with PI-based regimens.This retrospective study analyzed 1060 HIV-infected patients with undetectable viremia that were switched to lopinavir/ritonavir or darunavir/ritonavir monotherapy. In cases in which the patient had previously experienced VF while on a PI-based regimen, the lack of major HIV protease resistance mutations to lopinavir or darunavir, respectively, was mandatory. The primary endpoint of this study was the percentage of participants with virological suppression after 96 weeks according to intention-to-treat analysis (non-complete/missing = failure.A total of 1060 patients were analyzed, including 205 with previous VF while on PI-based regimens, 90 of whom were on complex therapies due to extensive resistance. The rates of treatment effectiveness (intention-to-treat analysis and virological efficacy (on-treatment analysis at week 96 were 79.3% (CI95, 76.8-81.8 and 91.5% (CI95, 89.6-93.4, respectively. No relationships were found between VF and earlier VF while on PI-based regimens, the presence of major or minor protease resistance mutations, the previous time on viral suppression, CD4+ T-cell nadir, and HCV-coinfection. Genotypic resistance tests were available in 49 out of the 74 patients with VFs and only four patients presented new major protease resistance mutations.Switching to mtPI/rtv achieves sustained virological control in most patients, even in those with previous VF on PI-based regimens as long as no major resistance mutations are present for the administered drug.

  7. Formulation development and optimization of sustained release matrix tablet of Itopride HCl by response surface methodology and its evaluation of release kinetics.

    Science.gov (United States)

    Bose, Anirbandeep; Wong, Tin Wui; Singh, Navjot

    2013-04-01

    The objective of this present investigation was to develop and formulate sustained release (SR) matrix tablets of Itopride HCl, by using different polymer combinations and fillers, to optimize by Central Composite Design response surface methodology for different drug release variables and to evaluate drug release pattern of the optimized product. Sustained release matrix tablets of various combinations were prepared with cellulose-based polymers: hydroxy propyl methyl cellulose (HPMC) and polyvinyl pyrolidine (pvp) and lactose as fillers. Study of pre-compression and post-compression parameters facilitated the screening of a formulation with best characteristics that underwent here optimization study by response surface methodology (Central Composite Design). The optimized tablet was further subjected to scanning electron microscopy to reveal its release pattern. The in vitro study revealed that combining of HPMC K100M (24.65 MG) with pvp(20 mg)and use of LACTOSE as filler sustained the action more than 12 h. The developed sustained release matrix tablet of improved efficacy can perform therapeutically better than a conventional tablet.

  8. Immuno-Virological Discordance and the Risk of NonAIDS and AIDS Events in a Large Observational Cohort of HIV-Patients in Europe

    DEFF Research Database (Denmark)

    Zoufaly, Alexander; Cozzi-Lepri, Alessandro; Reekie, Joanne

    2014-01-01

    The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated....

  9. Electronic medication monitoring-informed counselling to improve adherence to combination antiretroviral therapy and virologic treatment outcomes: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Nienke eLangebeek

    2015-05-01

    Full Text Available Background: Adherence to combination antiretroviral therapy (cART for HIV infection is a primary determinant of treatment success, but is often suboptimal. Previous studies have suggested that electronic medication monitoring-informed counselling is among the most effective adherence intervention components. Our objective was to review available evidence about the effectiveness of monitoring-informed counselling and to aggregate findings into quantitative estimates of the effect of such intervention on medication adherence and virologic treatment outcomes.Methods: We searched PubMed for papers reporting on randomized controlled trials (RCTs comparing intervention groups receiving monitoring-informed counselling as one of the intervention components versus control groups not receiving such counselling for their effect on medication adherence and viral load concentrations. The standardized mean difference (SMD in adherence and the odds ratio (OR of undetectable HIV RNA in intervention versus control groups were the common effect sizes. Random-effect models with inverse variance weights were used to aggregate findings into pooled effect estimates with 95% confidence limits. Results: A total of 13 studies were included. Adherence was significantly higher in intervention groups than in control groups (SMD 0.51, 95% CI 0.31 to 0.71. Patients in intervention groups were significantly more likely to have undetectable HIV RNA concentrations than patients in control groups (OR 1.35, 95% CI 1.12 to 1.63. However, in studies in which monitoring-informed counselling was the only intervention component, the difference in adherence and virologic response between intervention and control groups was not statistically significant.Conclusion: Electronic monitoring-informed counselling improved adherence and virologic response compared with control groups not receiving such counselling in studies in which it was one out of multiple intervention components, but not

  10. Electronic medication monitoring-informed counseling to improve adherence to combination anti-retroviral therapy and virologic treatment outcomes: a meta-analysis.

    Science.gov (United States)

    Langebeek, Nienke; Nieuwkerk, Pythia

    2015-01-01

    Adherence to combination anti-retroviral therapy for HIV infection is a primary determinant of treatment success, but is often suboptimal. Previous studies have suggested that electronic medication monitoring-informed counseling is among the most effective adherence intervention components. Our objective was to review available evidence about the effectiveness of monitoring-informed counseling and to aggregate findings into quantitative estimates of the effect of such intervention on medication adherence and virologic treatment outcomes. We searched PubMed for papers reporting on randomized controlled trials comparing intervention groups receiving monitoring-informed counseling as one of the intervention components versus control groups not receiving such counseling for their effect on medication adherence and viral load concentrations. The standardized mean difference (SMD) in adherence and the odds ratio (OR) of undetectable HIV RNA in intervention versus control groups were the common effect sizes. Random-effect models with inverse variance weights were used to aggregate findings into pooled effect estimates with 95% confidence limits (CI). A total of 13 studies were included. Adherence was significantly higher in intervention groups than in control groups (SMD 0.51, 95% CI 0.31-0.71). Patients in intervention groups were significantly more likely to have undetectable HIV RNA concentrations than patients in control groups (OR 1.35, 95% CI 1.12-1.63). However, in studies in which monitoring-informed counseling was the only intervention component, the difference in adherence and virologic response between intervention and control groups was not statistically significant. Electronic monitoring-informed counseling improved adherence and virologic response compared with control groups not receiving such counseling in studies in which it was one out of multiple intervention components, but not in studies where it was the only intervention component.

  11. Faktor-Faktor yang Mempengaruhi Pengungkapan Corporate Social Responsibility di dalam Laporan Sustainability (Studi Empiris Pada Perusahaan yang listing di Bursa Efek Indonesia Tahun 2010-2013

    Directory of Open Access Journals (Sweden)

    Dita Rohmah

    2016-01-01

    Full Text Available The study aims to examine the effect of corporate governance, firm size, and profitability to corporate social responsibility disclosure in sustainability report. The mechanism of corporate governance used are independent commissioner, institutional ownership, and foreign ownership.This research is a quantitative study using scientific research in the form of positive economics. The nature and type of this research is descriptive with the method used by literature survey. Data used is secondary data obtained from www.idx.co.id and corporate websites. The analytical method used is multiple linear regression analysis with SPSS version 22. The populations in this study are all companies listed on the Indonesia Stock Exchange during the period 2010 until 2013. Samples are taken by purposive sampling method amount 21companies with 4 years observation. Based on the results of multiple regression analysis with a significant level of 5%, the results of this study concluded that: (1 Independent Commissary does not signicantly influence the effect on the disclosure of CSR in the sustainability report with the significant value 0.390 > 0.05. (2 Institutional Ownership has a significant effect on the disclosure of CSR in the sustainability report with the significant value 0.003 < 0.05. (3 Foreign Ownership does not signicantly influence the effect on the disclosure of CSR in the sustainability report with the significant value 0.221 > 0.05. (4 Firm Size has a significant effect on the disclosure of CSR in the sustainability report with the significant value 0.000 < 0.05. (5 Profitability has a significant effect on the disclosure of CSR in the sustainability report with the significant value 0.001< 0.05.DOI: 10.15408/ess.v5i2.2347

  12. Sustainable development as a challenge for undergraduate students: the module "Science bears responsibility" in the Leuphana bachelor's programme : commentary on "a case study of teaching social responsibility to doctoral students in the climate sciences".

    Science.gov (United States)

    Michelsen, Gerd

    2013-12-01

    The Leuphana Semester at Leuphana University Lüneburg, together with the module "Science bears responsibility" demonstrate how innovative methods of teaching and learning can be combined with the topic of sustainable development and how new forms of university teaching can be introduced. With regard to module content, it has become apparent that, due to the complexity of the field of sustainability, a single discipline alone is unable to provide analyses and solutions. If teaching in higher education is to adequately deal with this complexity, then it is necessary to develop inter- and transdisciplinary approaches that go beyond a purely specialist orientation.

  13. Grassland Sustainability

    Science.gov (United States)

    Deborah U. Potter; Paulette L. Ford

    2004-01-01

    In this chapter we discuss grassland sustainability in the Southwest, grassland management for sustainability, national and local criteria and indicators of sustainable grassland ecosystems, and monitoring for sustainability at various scales. Ecological sustainability is defined as: [T]he maintenance or restoration of the composition, structure, and processes of...

  14. Hepatitis C treatment response kinetics and impact of baseline predictors

    DEFF Research Database (Denmark)

    Lindh, M; Arnholm, B; Eilard, A

    2011-01-01

    Summary. The optimal duration of treatment for hepatitis C virus (HCV) infections is highly variable but critical for achieving cure (sustained virological response, SVR). We prospectively investigated the impact of age, fibrosis, baseline viraemia and genotype on the early viral kinetics...... above 400 000 IU/mL were strongly associated with slower second phase declines of HCV RNA. Genotype 2/3 infections responded more rapidly than genotype 1, reaching week 4 negativity (RVR) in 59%vs 22%. We conclude that baseline response predictors such as age, fibrosis and viral load were well reflected...... by the early viral kinetics as assessed by repeated HCV RNA quantifications. The kinetic patterns and the high relapse rate in genotype 2/3 patients without RVR suggest that this group might benefit from treatment durations longer than 24 weeks....

  15. School Facilities and Sustainability-Related Concepts: A Study of Hellenic Secondary School Principals’, Teachers’, Pupils’ and Parents’ Responses

    Directory of Open Access Journals (Sweden)

    Vasiliki Zepatou

    2016-03-01

    Full Text Available Effective building environment sustainability frameworks and practices need to take users’ opinions into account. For this purpose, a survey questionnaire was developed and the “Panhellenic survey of school spaces, materials and environmental-comfort conditions in secondary schools and perceptions, stances and attitudes of pupils, teachers, principals and parents towards sustainable construction and the selection and use of materials in schools that are friendly to the environment and human health” was conducted nationwide with a random stratified sample of 170 Hellenic public secondary schools. Selected findings are presented and discussed here. These show that existing school facilities are primarily rated as good and that selection and use of materials friendly to the environment and human health are extremely important. User groups believe that they should participate in planning/selecting sustainable solutions for schools. An Index of 10 School Environment Desired Outcomes associated with environmentally friendly and health-friendly materials selection and use was devised. Relevant factors were extracted and interpreted. The research establishes users’ subjective opinions that may be considered and integrated into procedures for improving school buildings, assessing and selecting environmentally friendly materials and implementing strategies for sustainable school design, building and operation.

  16. Nevirapine Concentration in Hair Samples Is a Strong Predictor of Virologic Suppression in a Prospective Cohort of HIV-Infected Patients.

    Directory of Open Access Journals (Sweden)

    Sanjiv M Baxi

    Full Text Available Effective antiretroviral (ARV therapy depends on adequate drug exposure, yet methods to assess ARV exposure are limited. Concentrations of ARV in hair are the product of steady-state pharmacokinetics factors and longitudinal adherence. We investigated nevirapine (NVP concentrations in hair as a predictor of treatment response in women receiving ARVs. In participants of the Women's Interagency HIV Study, who reported NVP use for >1 month from 2003-2008, NVP concentrations in hair were measured via liquid-chromatography-tandem mass-spectrometry. The outcome was virologic suppression (plasma HIV RNA below assay threshold at the time of hair sampling and the primary predictor was nevirapine concentration categorized into quartiles. We controlled for age, race/ethnicity, pre-treatment HIV RNA, CD4 cell count, and self-reported adherence over the 6-month visit interval (categorized ≤ 74%, 75%-94% or ≥ 95%. We also assessed the relation of NVP concentration with changes in hepatic transaminase levels via multivariate random intercept logistic regression and linear regression analyses. 271 women contributed 1089 person-visits to the analysis (median 3 of semi-annual visits. Viral suppression was least frequent in concentration quartile 1 (86/178 (48.3% and increased in higher quartiles (to 158/204 (77.5% for quartile 4. The odds of viral suppression in the highest concentration quartile were 9.17 times (95% CI 3.2-26, P < 0.0001 those in the lowest. African-American race was associated with lower rates of virologic suppression independent of NVP hair concentration. NVP concentration was not significantly associated with patterns of serum transaminases. Concentration of NVP in hair was a strong independent predictor of virologic suppression in women taking NVP, stronger than self-reported adherence, but did not appear to be strongly predictive of hepatotoxicity.

  17. The Virological and Immunological Characteristics of the HIV-1-Infected Population in Brazil: From Initial Diagnosis to Impact of Antiretroviral Use.

    Directory of Open Access Journals (Sweden)

    Ricardo Sobhie Diaz

    Full Text Available Immunological and virological status of HIV-infected individuals entering the Brazilian public system over time was analyzed. We evaluated the impact of ART on virological, immunological and antiretroviral resistance over time.CD4+ T cell counts, viral loads and genotypes from patients over 13 years old from 2001-2011 were analyzed according to demographic data. We compared groups using parametric t-tests and linear regression analysis in the R statistical software language.Mean baseline CD4+ T cell counts varied from 348 (2003 to 389 (2009 and was higher among women (p = 1.1 x 10(-8, lower in older patients (p< 1 x 10(-8 and lower in less developed regions (p = 1.864 x 10(-5. Percentage of treated patients with undetectable viral loads increased linearly from 46% (2001 to 77% (2011, was lower among women (p = 2.851 x 10(-6, younger ages (p = 1 x 10(-3, and in less developed regions (p = 1.782 x 10(-4. NRTI acquired resistance was 86% in 2001-3 and decreased over time. NNRTI resistance increased from 2001-3(50% to 2006-9 (60%, PI resistance decreased from 2001-3 (60% to 2009 (40%, and 3-class resistance was stable over time around 25%. Subtype prevalence comprised B (75.3%, B/F recombinants (12.2%, C (5.7%, F (5.3% and B/C recombinants (1.5%, with regional variations. Three-class resistance was 26.5% among Bs, 22.4% among Fs and 17.2% among Cs.HIV diagnosis occurs late, especially among elderly Brazilians. Younger individuals need special attention due to poor virological response to treatment. Antiretroviral Resistance profile is subtype related.

  18. Antiretroviral treatment interruptions induced by the Kenyan postelection crisis are associated with virological failure.

    Science.gov (United States)

    Mann, Marita; Diero, Lameck; Kemboi, Emmanuel; Mambo, Fidelis; Rono, Mary; Injera, Wilfred; Delong, Allison; Schreier, Leeann; Kaloustian, Kara W; Sidle, John; Buziba, Nathan; Kantor, Rami

    2013-10-01

    Antiretroviral treatment interruptions (TIs) cause suboptimal clinical outcomes. Data on TIs during social disruption are limited. We determined effects of unplanned TIs after the 2007-2008 Kenyan postelection violence on virological failure, comparing viral load (VL) outcomes in HIV-infected adults with and without conflict-induced TI. Two hundred and one patients were enrolled, median 2.2 years after conflict and 4.3 years on treatment. Eighty-eight patients experienced conflict-related TIs and 113 received continuous treatment. After adjusting for preconflict CD4, patients with TIs were more likely to have detectable VL, VL >5,000 and VL >10,000. Unplanned conflict-related TIs are associated with increased likelihood of virological failure.

  19. A pH- and temperature-responsive bioresorbable injectable hydrogel based on polypeptide block copolymers for the sustained delivery of proteins in vivo.

    Science.gov (United States)

    Turabee, Md Hasan; Thambi, Thavasyappan; Duong, Huu Thuy Trang; Jeong, Ji Hoon; Lee, Doo Sung

    2018-02-27

    Sustained delivery of protein therapeutics is limited owing to the fragile nature of proteins. Despite its great potential, delivery of proteins without any loss of bioactivity remains a challenge in the use of protein therapeutics in the clinic. To surmount this shortcoming, we report a pH- and temperature-responsive in situ-forming injectable hydrogel based on comb-type polypeptide block copolymers for the controlled delivery of proteins. Polypeptide block copolymers, composed of hydrophilic polyethylene glycol (PEG), temperature-responsive poly(γ-benzyl-l-glutamate) (PBLG), and pH-responsive oligo(sulfamethazine) (OSM), exhibit pH- and temperature-induced sol-to-gel transition behavior in aqueous solutions. Polypeptide block copolymers were synthesized by combining N-carboxyanhydride-based ring-opening polymerization and post-functionalization of the chain-end using N-hydroxy succinimide ester activated OSM. The physical properties of polypeptide-based hydrogels were tuned by varying the composition of temperature- and pH-responsive PBLG and OSM in block copolymers. Polypeptide block copolymers were non-toxic to human embryonic kidney cells at high concentrations (2000 μg mL -1 ). Subcutaneous administration of polypeptide block copolymer sols formed viscoelastic gel instantly at the back of Sprague-Dawley (SD) rats. The in vivo gels exhibited sustained degradation and were found to be bioresorbable in 6 weeks without any noticeable inflammation at the injection site. Anionic characteristics of hydrogels allow efficient loading of a cationic model protein, lysozyme, through electrostatic interaction. Lysozyme-loaded polypeptide block copolymer sols readily formed a viscoelastic gel in vivo and sustained lysozyme release for at least a week. Overall, the results demonstrate an elegant approach to control the release of certain charged proteins and open a myriad of therapeutic possibilities in protein therapeutics.

  20. Knowledge-based Economy, an Appropriate Response to Organizational Change Pressures, with a View to Sustainable Development

    Directory of Open Access Journals (Sweden)

    Cristina Mihaela Lazar

    2012-06-01

    Full Text Available The sustainable development of organizations within knowledge-based economy, in which knowledge represents the main priority, should focus on finding solutions for the intelligent management of the limited resources, especially through organizational change and its constant assessment as a long-term impact solution. The transition of organizations to the principles of knowledge-based economy involves a major change in organizational culture. The dynamism and complexity of the new type of society, which implies a higher and more diverse level of training, together with a continuous superior training of the workforce, increasing investment in research and development and, not least, a growing volume and a diversification of information, all these represent, chained together, an element of well-being for the future generations. The introductory section summarizes the concept of sustainability and places the development of companies and economies they aggregate, in a contemporary context of organizational change pressures, on the principles of the knowledge-based economy as the only resource, virtually inexhaustible in the long-term, and which leads to a sustainable development. There follows a methodological section, consisting in the instrumental description of the method of work and in reference to the database, thus providing the theoretical and practical foundation for the confrontation between the sustainable development index (SDI in Romania and in the European Union (EU. The results and discussion section of the paper includes a confrontation between the sustainable development of Romania and that of the European Union, drawing on the SDI for each case. This statistical tool was calculated starting from the values of several statistical indicators (available in EUROSTAT statistics, issued from four information subsystems (an economic one, a social one and an environment one as major subsystems of sustainable development, to which was added

  1. Association of HIV diversity and virologic outcomes in early antiretroviral treatment: HPTN 052.

    Directory of Open Access Journals (Sweden)

    Philip J Palumbo

    Full Text Available Higher HIV diversity has been associated with virologic outcomes in children on antiretroviral treatment (ART. We examined the association of HIV diversity with virologic outcomes in adults from the HPTN 052 trial who initiated ART at CD4 cell counts of 350-550 cells/mm3. A high resolution melting (HRM assay was used to analyze baseline (pre-treatment HIV diversity in six regions in the HIV genome (two in gag, one in pol, and three in env from 95 participants who failed ART. We analyzed the association of HIV diversity in each genomic region with baseline (pre-treatment factors and three clinical outcomes: time to virologic suppression after ART initiation, time to ART failure, and emergence of HIV drug resistance at ART failure. After correcting for multiple comparisons, we did not find any association of baseline HIV diversity with demographic, laboratory, or clinical characteristics. For the 18 analyses performed for clinical outcomes evaluated, there was only one significant association: higher baseline HIV diversity in one of the three HIV env regions was associated with longer time to ART failure (p = 0.008. The HRM diversity assay may be useful in future studies exploring the relationship between HIV diversity and clinical outcomes in individuals with HIV infection.

  2. Association of HIV diversity and virologic outcomes in early antiretroviral treatment: HPTN 052.

    Science.gov (United States)

    Palumbo, Philip J; Wilson, Ethan A; Piwowar-Manning, Estelle; McCauley, Marybeth; Gamble, Theresa; Kumwenda, Newton; Makhema, Joseph; Kumarasamy, Nagalingeswaran; Chariyalertsak, Suwat; Hakim, James G; Hosseinipour, Mina C; Melo, Marineide G; Godbole, Sheela V; Pilotto, Jose H; Grinsztejn, Beatriz; Panchia, Ravindre; Chen, Ying Q; Cohen, Myron S; Eshleman, Susan H; Fogel, Jessica M

    2017-01-01

    Higher HIV diversity has been associated with virologic outcomes in children on antiretroviral treatment (ART). We examined the association of HIV diversity with virologic outcomes in adults from the HPTN 052 trial who initiated ART at CD4 cell counts of 350-550 cells/mm3. A high resolution melting (HRM) assay was used to analyze baseline (pre-treatment) HIV diversity in six regions in the HIV genome (two in gag, one in pol, and three in env) from 95 participants who failed ART. We analyzed the association of HIV diversity in each genomic region with baseline (pre-treatment) factors and three clinical outcomes: time to virologic suppression after ART initiation, time to ART failure, and emergence of HIV drug resistance at ART failure. After correcting for multiple comparisons, we did not find any association of baseline HIV diversity with demographic, laboratory, or clinical characteristics. For the 18 analyses performed for clinical outcomes evaluated, there was only one significant association: higher baseline HIV diversity in one of the three HIV env regions was associated with longer time to ART failure (p = 0.008). The HRM diversity assay may be useful in future studies exploring the relationship between HIV diversity and clinical outcomes in individuals with HIV infection.

  3. Virological and bacteriological quality of drinking water in Ethiopia

    Science.gov (United States)

    Bedada, Tesfaye Legesse; Mezemir, Walelign Dessie; Dera, Firehiwot Abera; Sima, Waktole Gobena; Gebre, Samson Girma; Edicho, Redwan Muzeyin; Biegna, Almaz Gonfa; Teklu, Dejenie Shiferaw; Tullu, Kassu Desta

    2018-05-01

    Since unsafe water is responsible for many illness, deaths, and economic failure, water quality monitoring is essential. A cross-sectional study was conducted on 218 drinking waters samples collected between February and June 2016 to assess water quality using phages by the help of CB390 E. coli host, plaque assay; multiple tube fermentation for coliforms and pour plate for heterotrophic bacteria at Ethiopian Public Health Institute. Heterotrophic plate count greater than 100 cfu/ml was noted in 41 samples and detections of total and thermotolerant coliforms and E. coli in 38, 24, and 10 samples, respectively, and no phages detection in chlorinated waters. While heterotrophic plate count greater than 100 cfu/ml was observed in 100 samples and detections of total and thermotolerant coliforms, E. coli, and phages in 75, 60, 42, and 5 samples, respectively, for untreated waters. The majority of the waters contained indicators above standard limits. This indicates that the sources are contaminated and they are potential threats for health. Hence, regular water monitoring should be a priority agenda.

  4. Gender-specific risk factors for virologic failure in KwaZulu-Natal: automobile ownership and financial insecurity.

    Science.gov (United States)

    Hare, Anna Q; Ordóñez, Claudia E; Johnson, Brent A; Del Rio, Carlos; Kearns, Rachel A; Wu, Baohua; Hampton, Jane; Wu, Peng; Sunpath, Henry; Marconi, Vincent C

    2014-11-01

    We sought to examine which socioeconomic indicators are risk factors for virologic failure among HIV-1 infected patients receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa. A case-control study of virologic failure was conducted among patients recruited from the outpatient clinic at McCord Hospital in Durban, South Africa between October 1, 2010 and June 30, 2012. Cases were those failing first-line ART, defined as viral load >1,000 copies/mL. Univariate logistic regression was performed on sociodemographic data for the outcome of virologic failure. Variables found significant (p ownership was a risk factor among males, while variables of financial insecurity (unemployment, non-spouse family paying for care, staying with family) were risk factors for women. In this cohort, financial insecurity among women and automobile ownership among men were risk factors for virologic failure. Risk factor differences between genders demonstrate limitations of generalized risk factor analysis.

  5. History of viral suppression on combination antiretroviral therapy as a predictor of virological failure after a treatment change

    DEFF Research Database (Denmark)

    Reekie, J; Mocroft, A; Ledergerber, B

    2010-01-01

    OBJECTIVES: HIV-infected persons experience different patterns of viral suppression after initiating combination antiretroviral therapy (cART). The relationship between such differences and risk of virological failure after starting a new antiretroviral could help with patient monitoring strategi...

  6. Association of Suboptimal Antiretroviral Therapy Adherence With Inflammation in Virologically Suppressed Individuals Enrolled in the SMART Study

    DEFF Research Database (Denmark)

    Castillo-Mancilla, Jose R; Phillips, Andrew N; Neaton, James D

    2018-01-01

    Suboptimal (ie, <100%) antiretroviral therapy (ART) adherence has been associated with heightened inflammation in cohort studies, even among people with virologic suppression. We aimed to evaluate this association among participants in the Strategies for Management of Antiretroviral Therapy (SMAR...

  7. 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

  8. 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.

  9. Using System Inflammatory Response Syndrome as an Easy-to-Implement, Sustainable, and Automated Tool for All-Cause Deterioration Among Medical Inpatients.

    Science.gov (United States)

    Fogerty, Robert L; Sussman, L Scott; Kenyon, Kathleen; Li, Fangyong; Sukumar, Nitin; Kliger, Alan S; Acker, Kurt; Sankey, Christopher

    2018-01-23

    Clinical deterioration detection among adult inpatients is known to be suboptimal, and many electronic health record tools have been developed to help identify these patients. Many of these tools are focused on sepsis spectrum disorders, but the evolution of the definition of sepsis is moving toward increased specificity, which may make automated detection of clinical deterioration from nonsepsis-related conditions less likely. The objectives of this study were to develop and to examine the use of a low-cost, highly sustainable deterioration detection tool based on systemic inflammatory response syndrome (SIRS) criteria. Using existing resources, a SIRS-based electronic health record monitoring and intervention tool was developed with a focus on ease of implementation and high sustainability. This tool was used to monitor 15,739 adult inpatients in real time during their admission. The SIRS-based tool, created with focus on ease of implementation and high sustainability, identified patients with higher risk of clinical deterioration. The project was rapidly deployed for a 4-month period at a 900-bed campus of an academic medical center with minimal additional resources required. Whereas the definition of sepsis moves away from SIRS, SIRS-based criteria may still have clinical benefit as an easy-to-automate detection tool for all-cause clinical deterioration among medical inpatients.

  10. The early supra-additive apoptotic response of R3327-G prostate tumors to androgen ablation and radiation is not sustained with multiple fractions

    International Nuclear Information System (INIS)

    Pollack, Alan; Ashoori, Faramarz; Sikes, Charles; Lim Joon, Daryl; Eschenbach, Andrew C. von; Zagars, Gunar K.; Meistrich, Marvin L.

    2000-01-01

    Purpose: The treatment of R3327-G tumor-bearing rats with androgen ablation (AA) via castration results in a supra-additive increase in apoptosis when 2-8 Gy γ-irradiation (RT) is given as a single dose 3-14 days afterwards. We report here the dose response and effect of multiple fractions on this supra-additive apoptotic response. Materials and Methods: Dunning R3327-G tumors were grown in the flanks of Copenhagen rats and the experiments were initiated at a tumor volume of 1.0-1.5 cc. Androgen ablation was achieved by castration 3 days prior to γ-irradiation. Apoptosis was measured with a terminal deoxynucleotidyl transferase dUTP-biotin nick end-labeling assay 6-h after RT, unless otherwise specified. Results: The dose response of the supra-additive apoptotic response was assessed by irradiating castrated animals with single doses of 2, 4, 8, or 16 Gy (n = 5 per group); tumor cell apoptosis at 6-h following irradiation was 2.4% ± 0.7% (± SEM), 4.2% ± 0.8%, 6.5% ± 1.4%, and 1.6% ± 0.3%, respectively. The RT only and AA only controls had < 1% apoptosis. The effect of fractionated RT on apoptosis was investigated to determine if the supra-additive apoptotic response was sustained with repeated 2-8 Gy fractions. When tumor-bearing animals were treated with repeated daily 2-Gy fractions, there was a reduction in the level of the supra-additive apoptotic response. After five 2-Gy fractions at 24-h intervals, apoptosis in the combined treated tumors was at levels seen in the AA controls. This raised the possibility that more than 24 h are required for recovery of the high supra-additive apoptotic levels seen after one fraction. When the interfraction interval was extended to 96 h, there was no significant increase in apoptosis over the additive effect of AA and RT. Although there was a decline in supra-additive apoptosis with repeated fractions, a dose response for tumor growth delay was evident for RT alone using 2.5-Gy fractions. Moreover, the combination of

  11. 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

    2014-01-01

    Background Malnutrition may impact the pharmacokinetics (PK) of antiretroviral medications and virologic responses in HIV-infected children. We 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. Methods Sparse dried blood spot (DBS) samples from Ugandan children were used to estimate plasma concentrations. Historical PK data from children from three resource-rich countries (RRC) were utilized to develop the PK models. Results Concentrations in 330 DBS 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 (Pmalnutrition 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 assessements, to further assess causes of virologic failure in Ugandan children. PMID:25742090

  12. Long term protection after immunization with P. berghei sporozoites correlates with sustained IFNγ responses of hepatic CD8+ memory T cells.

    Directory of Open Access Journals (Sweden)

    Krystelle Nganou-Makamdop

    Full Text Available Protection against P. berghei malaria can successfully be induced in mice by immunization with both radiation attenuated sporozoites (RAS arresting early during liver stage development, or sporozoites combined with chloroquine chemoprophylaxis (CPS, resulting in complete intra-hepatic parasite development before killing of blood-stages by chloroquine takes place. We assessed the longevity of protective cellular immune responses by RAS and CPS P. berghei immunization of C57BL/6j mice. Strong effector and memory (T(EM CD8+ T cell responses were induced predominantly in the liver of both RAS and CPS immunized mice while CD4+ T cells with memory phenotype remained at base line levels. Compared to unprotected naïve mice, we found high sporozoite-specific IFNγ ex vivo responses that associated with induced levels of in vivo CD8+ T(EM cells in the liver but not spleen. Long term evaluation over a period of 9 months showed a decline of malaria-specific IFNγ responses in RAS and CPS mice that significantly correlated with loss of protection (r(2 = 0.60, p<0.0001. The reducing IFNγ response by hepatic memory CD8+ T cells could be boosted by re-exposure to wild-type sporozoites. Our data show that sustainable protection against malaria associates with distinct intra-hepatic immune responses characterized by strong IFNγ producing CD8+ memory T cells.

  13. How transformational learning promotes caring, consultation and creativity, and ultimately contributes to sustainable development: Lessons from the Partnership for Education and Research about Responsible Living (PERL) network

    Science.gov (United States)

    Thoresen, Victoria Wyszynski

    2017-12-01

    Oases of learning which are transformative and lead to significant behavioural change can be found around the globe. Transformational learning has helped learners not only to understand what they have been taught but also to re-conceptualise and re-apply this understanding to their daily lives. Unfortunately, as many global reports indicate, inspirational transformational learning approaches for sustainable development are rare and have yet to become the norm - despite calls for such approaches by several outstanding educators and organisations. This article examines three learning approaches developed by the network of the Partnership for Education and Research about Responsible Living (PERL). These approaches are structured around core elements of transformative learning for sustainable development, yet focus particularly on the ability to care, consult with others and be creative. They seem to depend on the learners' ability to articulate their perceptions of sustainable development in relation to their own values and to identify how these are actualised in their daily life. Together with other core elements of transformative learning, an almost magical (not precisely measurable) synergy then emerges. The intensity of this synergy appears to be directly related to the individual learner's understanding of the contradictions, interlinkages and interdependencies of modern society. The impact of this synergy seems to be concurrent with the extent to which the learner engages in a continual learning process with those with whom he/she has contact. The findings of this study suggest that mainstreaming transformational learning for sustainable development in ways that release the "magic synergy of creative caring" can result in the emergence of individuals who are willing and able to move from "business as usual" towards more socially just, economically equitable, and environmentally sensitive behaviour.

  14. Education for Sustainable development

    African Journals Online (AJOL)

    ESD (education for sustainable development) planning and implementation, and regular ... between the environment and socio-economic issues of poverty and ..... capacity to make informed decisions (T7) and a sense of responsibility (T9), ...

  15. HVR-1 quasispecies modifications occur early and are correlated to initial but not sustained response in HCV-infected patients treated with pegylated- or standard-interferon and ribavirin.

    Science.gov (United States)

    Abbate, Isabella; Lo Iacono, Oreste; Di Stefano, Rosa; Cappiello, Giuseppina; Girardi, Enrico; Longo, Roberta; Ferraro, Donatella; Antonucci, Giorgio; Di Marco, Vito; Solmone, Mariacarmela; Craxì, Antonio; Ippolito, Giuseppe; Capobianchi, Maria R

    2004-05-01

    HVR-1 quasispecies composition and evolution were investigated in patients chronically infected with genotype 1b HCV, treated with PEG-IFN alpha 2b or STD-IFN alpha 2b plus RBV. HVR-1 heterogeneity was assessed by calculating nucleotidic complexity, diversity, synonymous (S) and non-synonymous (NS) substitutions at baseline, after 4 weeks of therapy (T1) and at follow-up (T18). Evolution of viral quasispecies was analysed by constructing phylogenetic trees. No correlation of baseline viremia with heterogeneity was observed. Nucleotidic complexity was lower in patients showing early virological response, and tended to be inversely correlated to viral load decline at 4 weeks of treatment. In the majority of SR, profound changes of quasispecies composition occurred during 4 weeks of treatment, while in NR virtually no major changes of pre-therapy variants were observed. Relapse showed both patterns of quasispecies evolution. Virus quasispecies after follow-up was similar to that found at T1 in both Relapsers and NR patients. Baseline parameters of HVR-1 heterogeneity seem to be involved in the early response to treatment, and early response is associated with profound variations in the HVR-1 quasispecies. Viral quasispecies surviving early therapeutic pressure are most likely able to give rise to either virus rebound or persistence at T18.

  16. The development of artificial neural networks to predict virological response to combination HIV therapy

    NARCIS (Netherlands)

    Larder, Brendan; Wang, Dechao; Revell, Andrew; Montaner, Julio; Harrigan, Richard; de Wolf, Frank; Lange, Joep; Wegner, Scott; Ruiz, Lidia; Pérez-Elías, Maria Jésus; Emery, Sean; Gatell, Jose; D'Arminio Monforte, Antonella; Torti, Carlo; Zazzi, Maurizio; Lane, Clifford

    2007-01-01

    When used in combination, antiretroviral drugs are highly effective for suppressing HIV replication. Nevertheless, treatment failure commonly occurs and is generally associated with viral drug resistance. The choice of an alternative regimen may be guided by a drug-resistance test. However,

  17. 36 CFR 219.20 - Ecological sustainability.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Ecological sustainability... Sustainability § 219.20 Ecological sustainability. To achieve ecological sustainability, the responsible official... diversity and species diversity are components of ecological sustainability. The planning process must...

  18. Engineering students' sustainability approaches

    Science.gov (United States)

    Haase, S.

    2014-05-01

    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 empirical base of the article is a nation-wide, web-based survey sent to all newly enrolled engineering students in Denmark commencing their education in the fall term 2010. The response rate was 46%. The survey focused on a variety of different aspects of what can be conceived as sustainability. By means of cluster analysis, three engineering student approaches to sustainability are identified and described. The article provides knowledge on the different prerequisites of engineering students in relation to the role of sustainability in engineering. This information is important input to educators trying to target new engineering students and contribute to the provision of engineers equipped to meet sustainability challenges.

  19. Responsabilidad corporativa y desarrollo sostenible: una perspectiva histórica y conceptual Corporate responsibility and sustainable development: a historical and conceptual view

    Directory of Open Access Journals (Sweden)

    Emmanuel Raufflet

    2010-06-01

    Full Text Available En la primera década del siglo XXI, los conceptos de responsabilidad corporativa y la noción de desarrollo sostenible han sido ampliamente difundidos tanto en los círculos de investigadores como en los de profesionales de la gestión y de la administración. El objetivo de este trabajo es proponer algunos elementos aclaratorios con relación a estos dos conceptos y su relación con el contexto actual. Este artículo incluye tres partes: inicialmente se presenta una perspectiva histórica y la evolución conceptual de la noción de responsabilidad corporativa. Luego, se plantea una explicación acerca de la actual difusión de este concepto y se identifican los vínculos entre los aspectos de desarrollo sostenible y la responsabilidad social corporativa. Por último, se proponen algunas ideas con relación a la investigación sobre la responsabilidad empresarial en el contexto colombiano.Over the last decade, the concepts of corporate responsibility and the notion of sustainable development have been widely disseminated both in the circles of both researchers and professionals in management. The purpose of this paper is to propose some elements of clarification with regard to these two concepts and in relation to the current context. This article includes three parts. First, it introduces a historical and conceptual evolution of the concept of corporate responsibility. Second, it maps an explanation of the current spread of this concept and identifies the linkages between dimensions of sustainable development and corporate responsibility. Finally, it proposes some ideas in relation to research on corporate responsibility in the specific context of Colombia.

  20. Long term protection after immunization with P. berghei sporozoites correlates with sustained IFNγ responses of hepatic CD8+ memory T cells.

    Science.gov (United States)

    Nganou-Makamdop, Krystelle; van Gemert, Geert-Jan; Arens, Theo; Hermsen, Cornelus C; Sauerwein, Robert W

    2012-01-01

    Protection against P. berghei malaria can successfully be induced in mice by immunization with both radiation attenuated sporozoites (RAS) arresting early during liver stage development, or sporozoites combined with chloroquine chemoprophylaxis (CPS), resulting in complete intra-hepatic parasite development before killing of blood-stages by chloroquine takes place. We assessed the longevity of protective cellular immune responses by RAS and CPS P. berghei immunization of C57BL/6j mice. Strong effector and memory (T(EM)) CD8+ T cell responses were induced predominantly in the liver of both RAS and CPS immunized mice while CD4+ T cells with memory phenotype remained at base line levels. Compared to unprotected naïve mice, we found high sporozoite-specific IFNγ ex vivo responses that associated with induced levels of in vivo CD8+ T(EM) cells in the liver but not spleen. Long term evaluation over a period of 9 months showed a decline of malaria-specific IFNγ responses in RAS and CPS mice that significantly correlated with loss of protection (r(2) = 0.60, pmemory CD8+ T cells could be boosted by re-exposure to wild-type sporozoites. Our data show that sustainable protection against malaria associates with distinct intra-hepatic immune responses characterized by strong IFNγ producing CD8+ memory T cells.

  1. A comparison of computational models with and without genotyping for prediction of response to second-line HIV therapy

    NARCIS (Netherlands)

    Revell, A. D.; Boyd, M. A.; Wang, D.; Emery, S.; Gazzard, B.; Reiss, P.; van Sighem, A. I.; Montaner, J. S.; Lane, H. C.; Larder, B. A.

    2014-01-01

    We compared the use of computational models developed with and without HIV genotype vs. genotyping itself to predict effective regimens for patients experiencing first-line virological failure. Two sets of models predicted virological response for 99 three-drug regimens for patients on a failing

  2. Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016.

    Science.gov (United States)

    Medland, Nicholas A; Nicholson, Suellen; Chow, Eric P F; Read, Timothy R H; Bradshaw, Catriona S; Denham, Ian; Fairley, Christopher K

    2017-11-13

    Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016. We examined the time from HIV infection to virological suppression in MSM who were first diagnosed at Melbourne Sexual Health Centre between 2007 and 2016. Retrospective cohort. Date of infection was imputed from the testing history or serological evidence of recent infection (negative or indeterminate western blot) or baseline CD4 cell count. Date of virological suppression was determined using clinical viral load data. We analysed predictors of diagnosis with serological evidence of recent infection (logistic regression) and time from diagnosis to suppression and from infection to suppression (Cox regression) using demographic, clinical, and behavioral covariates. Between 2007 and 2016, the median time from HIV infection to diagnosis fell from 6.8 to 4.3 months (P = 0.001), from diagnosis to suppression fell from 22.7 to 3.2 months (P < 0.0001), and from infection to suppression fell from 49.0 to 9.6 months (P < 0.0001). Serological evidence of recent infection increased from 15.6 to 34.3% (P < 0.0001) of diagnoses. In the multivariate analyses, age, being recently arrived from a non-English speaking country, history of IDU, other sexually transmitted infections, and sexual risk were not associated with any of these measures. The duration of infectiousness in MSM diagnosed with HIV infection at Melbourne Sexual Health Centre in Victoria has fallen dramatically between 2007 and 2016 and the proportion diagnosed with serological evidence of recent infection has increased. This effect is observed across all population subgroups and marks a positive milestone for the treatment as prevention paradigm.

  3. Illness Representations of HIV Positive Patients Are Associated with Virologic Success.

    Science.gov (United States)

    Leone, Daniela; Borghi, Lidia; Lamiani, Giulia; Barlascini, Luca; Bini, Teresa; d'Arminio Monforte, Antonella; Vegni, Elena

    2016-01-01

    Introduction: It is important for HIV positive patients to be engaged in their care and be adherent to treatment in order to reduce disease progression and mortality. Studies found that illness representations influence adherence through the mediating role of coping behaviors. However, no study has ever tested if patient engagement to the visits mediate the relationship between illness perceptions and adherence. This study aimed to explore illness representations of HIV positive patients and test the hypothesis that illness representations predict adherence through the mediating role of a component of behavioral engagement. Methods: HIV-positive patients treated with highly active antiretroviral therapy (HAART) for at least one year and presenting to a check-up visit were eligible to participate in the study. Patients completed the Illness Perception Questionnaire-Revised. Behavioral engagement was measured based on the patients' clinical attendance to the check-up visits; adherence to HAART was measured by viral load. Undetectable viral load or HIV-RNA perception that the disease does not have serious consequences on patient's life and the prevalence of negative emotions toward HIV were associated with virologic success. On the contrary, the patient's perception that the disease has serious consequences on his/her life and the prevalence of positive emotions were associated with virologic failure. This model showed good fit indexes (CFI = 1; TLI = 1; RMSEA = 0.00; and WRMSR = 0.309). Discussion: Results do not support the mediating role of behavioral engagement in the relationship between illness representations and adherence. As perception of serious consequences coupled with positive emotions are directly associated with virologic failure, clinicians should take them into account to promote treatment adherence.

  4. Impact of previous virological treatment failures and adherence on the outcome of antiretroviral therapy in 2007.

    Directory of Open Access Journals (Sweden)

    Marie Ballif

    Full Text Available BACKGROUND: Combination antiretroviral treatment (cART has been very successful, especially among selected patients in clinical trials. The aim of this study was to describe outcomes of cART on the population level in a large national cohort. METHODS: Characteristics of participants of the Swiss HIV Cohort Study on stable cART at two semiannual visits in 2007 were analyzed with respect to era of treatment initiation, number of previous virologically failed regimens and self reported adherence. Starting ART in the mono/dual era before HIV-1 RNA assays became available was counted as one failed regimen. Logistic regression was used to identify risk factors for virological failure between the two consecutive visits. RESULTS: Of 4541 patients 31.2% and 68.8% had initiated therapy in the mono/dual and cART era, respectively, and been on treatment for a median of 11.7 vs. 5.7 years. At visit 1 in 2007, the mean number of previous failed regimens was 3.2 vs. 0.5 and the viral load was undetectable (4 previous failures compared to 1 were 0.9 (95% CI 0.4-1.7, 0.8 (0.4-1.6, 1.6 (0.8-3.2, 3.3 (1.7-6.6 respectively, and 2.3 (1.1-4.8 for >2 missed cART doses during the last month, compared to perfect adherence. From the cART era, odds ratios with a history of 1, 2 and >2 previous failures compared to none were 1.8 (95% CI 1.3-2.5, 2.8 (1.7-4.5 and 7.8 (4.5-13.5, respectively, and 2.8 (1.6-4.8 for >2 missed cART doses during the last month, compared to perfect adherence. CONCLUSIONS: A higher number of previous virologically failed regimens, and imperfect adherence to therapy were independent predictors of imminent virological failure.

  5. From Efficiency to Sustainability. Training responsible engineers in the new educational scene; De la Eficacia a la Sostenibilidad. Formar ingenieros responsables en el nuevo escenario educativo

    Energy Technology Data Exchange (ETDEWEB)

    Zamora-Polo, F.; Roman-Suero, S.; Sanchez-Martin, J.

    2010-07-01

    Terms like Sustainable Development and Professional Business Ethics are more and more often used in Engineering professional exercise. The Professional Associations as regulatory organisms of the profession have to take care that the professional activity is made involving no detrimental effect to the natural and social environment, thus meeting the needs of the present without compromising the ability of future generations. In the article the relevancy of including transversal ethical and social competence in the engineering studies has been highlighted. For this task, the authors describe their experience in the subject of extractive metallurgy, developed in the Industrial Engineering School of Badajoz. Achieving a proper way of approaching these contents requires a very fluid relation university-business activities. In the same way, based on these first studies, inter university and interdisciplinary working networks might be created in order to study the optimal way for developing these competence. (Author) 21 refs.

  6. 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

  7. Individual Microentrepreneurs: A Study of Their Actions and Perceptions in Response to the Requirements of Sustainable Development

    Directory of Open Access Journals (Sweden)

    Nilton dos Santos Portugal

    2017-05-01

    Full Text Available This paper describes the actions and perceptions of small individual entrepreneurs and is justified by the socioeconomic importance of this new business characterization and the projection of the growth of its formalization, which depicts figures and percentages of significant contribution to the development of the country. In order to understand the sustainable management standards, the study was characterized as descriptive, quantitative, opting for the survey, with the application of structured questionnaires in a sample of 391 entrepreneurs in the micro region of Varginha (MG. From the results it was possible to show a low involvement of small individual entrepreneurs with social and environmental issues. They showed a lack of guidelines aimed at environmental preservation and a lack of interest in volunteering. However, perceptions of the adoption of actions aimed at preserving the environment being able to ensure better living conditions for future generations were frequent; so were the belief that attitudes towards the improvement and welfare of the human being may provide advantages for the company.

  8. An acid-sensing ion channel from shark (Squalus acanthias) mediates transient and sustained responses to protons.

    Science.gov (United States)

    Springauf, Andreas; Gründer, Stefan

    2010-03-01

    Acid-sensing ion channels (ASICs) are proton-gated Na(+) channels. They are implicated in synaptic transmission, detection of painful acidosis, and possibly sour taste. The typical ASIC current is a transient, completely desensitizing current that can be blocked by the diuretic amiloride. ASICs are present in chordates but are absent in other animals. They have been cloned from urochordates, jawless vertebrates, cartilaginous shark and bony fish, from chicken and different mammals. Strikingly, all ASICs that have so far been characterized from urochordates, jawless vertebrates and shark are not gated by protons, suggesting that proton gating evolved relatively late in bony fish and that primitive ASICs had a different and unknown gating mechanism. Recently, amino acids that are crucial for the proton gating of rat ASIC1a have been identified. These residues are completely conserved in shark ASIC1b (sASIC1b), prompting us to re-evaluate the proton sensitivity of sASIC1b. Here we show that, contrary to previous findings, sASIC1b is indeed gated by protons with half-maximal activation at pH 6.0. sASIC1b desensitizes quickly but incompletely, efficiently encoding transient as well as sustained proton signals. Our results show that the conservation of the amino acids crucial for proton gating can predict proton sensitivity of an ASIC and increase our understanding of the evolution of ASICs.

  9. Strategic Leadership of Corporate Sustainability

    DEFF Research Database (Denmark)

    Strand, Robert

    2014-01-01

    Strategic leadership and corporate sustainability have recently come together in conspicuously explicit fashion through the emergence of top management team (TMT) positions with dedicated corporate sustainability responsibilities. These TMT positions, commonly referred to as 'Chief Sustainability......? What effects do corporate sustainability TMT positions have at their organizations? We consider these questions through strategic leadership and neoinstitutional theoretical frameworks. Through the latter, we also engage with Weberian considerations of bureaucracy. We find that the reasons why...

  10. The Engagement Continuum Model Using Corporate Social Responsibility as an Intervention for Sustained Employee Engagement: Research Leading Practice

    Science.gov (United States)

    Valentin, Marie Anttonitte; Valentin, Celestino C.; Nafukho, Fredrick Muyia

    2015-01-01

    Purpose: The purpose of this paper is to explore implications of motivational potential that are highly correlated to the self-determination theory (SDT) (intrinsic motivating factors), in relation to corporate social responsibility (CSR). This paper specifies key antecedents of engagement within the theoretical framework of the self-determination…

  11. Integration of population genetic structure and plant response to climate change: sustaining genetic resources through evaluation of projected threats

    Science.gov (United States)

    Bryce A. Richardson; Marcus V. Warwell; Mee-Sook Kim; Ned B. Klopfenstein; Geral I. McDonald

    2010-01-01

    To assess threats or predict responses to disturbances, or both, it is essential to recognize and characterize the population structures of forest species in relation to changing environments. Appropriate management of these genetic resources in the future will require (1) understanding the existing genetic diversity/variation and population structure of forest trees...

  12. Clinical correlates of sustained response to individual drugs used in naturalistic treatment of patients with bipolar disorder

    NARCIS (Netherlands)

    Post, Robert M.; Leverich, Gabriele S.; Kupka, Ralph; Keck, Paul E.; McElroy, Susan L.; Altshuler, Lori L.; Frye, Mark A.; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Nolen, Willem A.

    Objective: To report use and treatment success rates of medications for bipolar disorder as a function of patients' clinical characteristics. Method: Outpatients with bipolar illness diagnosed by SCID were rated by research assistants on the NIMH-LCM and those who had an good response for at least 6

  13. Intact nitric oxide production is obligatory for the sustained flow response during hypercapnic acidosis in guinea pig heart.

    Science.gov (United States)

    Heintz, Anke; Koch, Thea; Deussen, Andreas

    2005-04-01

    The mechanisms underlying hypercapnic coronary dilation remain unsettled. This study tests the hypothesis that flow dependent NO production is obligatory for the hypercapnic flow response. In isolated, constant pressure (CP) perfused guinea pig hearts a step change of arterial pCO(2) from 38.6 to 61.4 mm Hg induced a bi-phasic flow response with an early transient (maximum 60 s) and a consecutive persisting flow rise (121.6+/-6.6 (S.D.) % after 10 min). In contrast, when perfused with constant flow (CF), perfusion pressure only transiently (2 min) fell by 7.4+/-4.8 % following the step change of arterial pCO(2). In CP perfused hearts L-NAME (100 micromol/l) specifically abolished the delayed flow rise during hypercapnic acidosis (102.37+/-2.9% after 10 min), whereas the inhibitor had no effect on perfusion pressure response in CF perfused hearts. Under CP perfusion arterial hypercapnia resulted in a transient rise of coronary cGMP release (from 0.69+/-0.35 to 1.12+/-0.68 pmol/ml), which was abolished after L-NAME. Surprisingly, the K(+)ATP channel blocker glibenclamide did not have any significant effect on the hypercapnic flow response but largely blunted reactive hyperemia after a 20 s flow stop. The delayed steady state hypercapnic flow response in guinea pig heart requires intact NO production. The absence of a persisting decrease in coronary resistance under CF perfusion points to an important role of shear stress dependent NO production.

  14. Sustainable Development in China’s Coastal Area: Based on the Driver-Pressure-State-Welfare-Response Framework and the Data Envelopment Analysis Model

    Directory of Open Access Journals (Sweden)

    Song Wang

    2016-09-01

    Full Text Available The economic development of China’s coastal areas is being constrained by resources and the environment, with sustainable development being the key to solving these problems. The data envelopment analysis (DEA model is widely used to assess sustainable development. However, indicators used in the DEA model are not selected in a scientific and comprehensive manner, which may lead to unrepresentative results. Here, we use the driver-pressure-state-welfare-response (DPSWR framework to select more scientific and comprehensive indicators for a more accurate analysis of efficiency in China’s coastal area. The results show that the efficiencies of most provinces and cities in China’s coastal area have a stable trend. In the time dimension, efficiency was rising before 2008, after which it decreased. In the spatial dimension, China’s coastal provinces and cities are divided into three categories: high efficiency, low efficiency, and greater changes in efficiency. By combining DPSWR and DEA, we produce reliable values for measuring efficiency, with the benefit of avoiding the incomplete selection of DEA indicators.

  15. Response of Mid-Rotation Loblolly Pine (Pinus taeda L. Physiology and Productivity to Sustained, Moderate Drought on the Western Edge of the Range

    Directory of Open Access Journals (Sweden)

    Adam Maggard

    2016-09-01

    Full Text Available The productivity of the approximately 11 million ha of loblolly pine plantations in the southeastern USA could be threatened by decreased water availability in a future climate. To determine the effects of sustained drought on leaf gas exchange, whole-tree water use, and individual tree growth, we examined the response of loblolly pine trees to 100% throughfall exclusion cumulatively spanning the sixth and seventh growing seasons of a plantation in southeastern Oklahoma. Throughfall exclusion reduced volumetric soil water content for 0–12 cm soil depth from 10.8% to 4.8% and for 12–45 cm soil depth from 24.2% to 15.6%. Compared to ambient throughfall trees, leaf water potential of the throughfall exclusion trees became more negative, −0.9 MPa vs. −1.3 MPa for predawn measurements and −1.5 MPa vs. −1.9 MPa for midday measurements. Throughfall exclusion did not significantly reduce leaf gas exchange or tree water use. However, throughfall exclusion significantly reduced leaf biomass by 21% and stem volume growth by 23%. These results indicate that sustained drought may cause downward shifts in leaf quantity to conserve water rather than reducing leaf-level water use.

  16. Econometric Approach of the Scenarios regarding the Impact of the Consumer’s Empowerment and Companies’ Responsibility for Environment Sustainability on the Electricity Market Performance

    Directory of Open Access Journals (Sweden)

    Camelia I. Lungu

    2014-02-01

    Full Text Available Energy is a major component of the economy, both as a sector in itself and as an input factor to all other economic activities. This sector is facing major challenges regarding increasing oil prices, severity of climate change or extremely complex implications of the global financial crisis. Organized as an empirical study, based on econometric analysis supported by a rigorous literature review, the paper studies possible correlations between the performance of electricity market, renewable resource consumption, consumers’ behaviour, the influence of economic environment and economic development. It also aims to encourage a new and wider research framework regarding the implications of economic policies’ use on consumers’ perception. The results of the study indicate that the early stage of renewable energy use and the prospect of influencing the consumer behaviour in a way to increase the market performance, through the development of strategies oriented towards sustainable energy consumption, can have a positive impact on companies’ responsibility. It is concluded that consumers’ empowerment stimulates competition, raises efficiency and rethinks companies’ strategies for environment sustainability.

  17. The proposal of Paediatric Virology and its perspectives: An interview with Professor of Paediatrics Maria Theodoridou.

    Science.gov (United States)

    Mammas, Ioannis N; Spandidos, Demetrios A

    2017-10-01

    Professor Maria Theodoridou, Emeritus Professor of Paediatrics at the University of Athens, is one of the few paediatricians in Greece, who have experienced almost all the infectious diseases of the second half of the 20th century and their severe consequences, prior to the widespread adoption of immunisations. A milestone during her career was the establishment of a specialised National Reference Unit for the care of paediatric patients with acquired immune deficiency syndrome (AIDS) at the 'Aghia Sophia' Children's Hospital in Athens, Greece. According to Professor Theodoridou, training on the prevention, management and treatment of neonatal and paediatric viral infections represents a new educational challenge for both community as well as hospital-based paediatric health professionals. The debate of the potential strategically principal role of Paediatric Virology subspecialists in the primary, secondary and tertiary clinical practice is definitely necessary and needs further discussion and evaluation, she adds. She describes the difficulties that Greece, a country under a long-standing financial crisis, faces for the hospital-based management of paediatric viral infections and refers to the future advances, which are expected in the field of diagnosis and treatment of viral infections in neonates and children. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens on October 7th, 2017, Professor Theodoridou will focus on the immigration crisis and vaccination policy.

  18. The educational challenge of Paediatric Virology: An interview with Professor of Neonatology Anne Greenough.

    Science.gov (United States)

    Mammas, Ioannis N; Spandidos, Demetrios A

    2017-10-01

    According to Professor Anne Greenough, Professor of Neonatology and Clinical Respiratory Physiology at the King's College London (London, UK), Paediatric Virology is indeed a rapidly increasing educational challenge. Professor Greenough, who in 1992 wrote her book on congenital, perinatal and neonatal infections, believes that during the past 3 decades, paediatric health professionals are becoming increasingly involved in specialised care and follow-up of paediatric patients with viral diseases, who require advanced medical care and innovative technological services. Moreover, she highlights the expected role of new vaccines and antiviral agents that are currently under investigation, as well as the impact of emerging viral diseases that require novel prevention strategies and therapeutic protocols. However, she notes that the number of Paediatric Virologists in any one country is likely to be small; hence, a separate paediatric subspecialty needs to be considered carefully. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor Greenough will give her plenary lecture on the impact of viral infections on the long term outcomes of prematurely born infants.

  19. Are three generations of quantitative molecular methods sufficient in medical virology? Brief review.

    Science.gov (United States)

    Clementi, Massimo; Bagnarelli, Patrizia

    2015-10-01

    In the last two decades, development of quantitative molecular methods has characterized the evolution of clinical virology more than any other methodological advancement. Using these methods, a great deal of studies has addressed efficiently in vivo the role of viral load, viral replication activity, and viral transcriptional profiles as correlates of disease outcome and progression, and has highlighted the physio-pathology of important virus diseases of humans. Furthermore, these studies have contributed to a better understanding of virus-host interactions and have sharply revolutionized the research strategies in basic and medical virology. In addition and importantly from a medical point of view, quantitative methods have provided a rationale for the therapeutic intervention and therapy monitoring in medically important viral diseases. Despite the advances in technology and the development of three generations of molecular methods within the last two decades (competitive PCR, real-time PCR, and digital PCR), great challenges still remain for viral testing related not only to standardization, accuracy, and precision, but also to selection of the best molecular targets for clinical use and to the identification of thresholds for risk stratification and therapeutic decisions. Future research directions, novel methods and technical improvements could be important to address these challenges.

  20. Diagnostic value of different adherence measures using electronic monitoring and virologic failure as reference standards.

    Science.gov (United States)

    Deschamps, Ann E; De Geest, Sabina; Vandamme, Anne-Mieke; Bobbaers, Herman; Peetermans, Willy E; Van Wijngaerden, Eric

    2008-09-01

    Nonadherence to antiretroviral therapy is a substantial problem in HIV and jeopardizes the success of treatment. Accurate measurement of nonadherence is therefore imperative for good clinical management but no gold standard has been agreed on yet. In a single-center prospective study nonadherence was assessed by electronic monitoring: percentage of doses missed and drug holidays and by three self reports: (1) a visual analogue scale (VAS): percentage of overall doses taken; (2) the Swiss HIV Cohort Study Adherence Questionnaire (SHCS-AQ): percentage of overall doses missed and drug holidays and (3) the European HIV Treatment Questionnaire (EHTQ): percentage of doses missed and drug holidays for each antiretroviral drug separately. Virologic failure prospectively assessed during 1 year, and electronic monitoring were used as reference standards. Using virologic failure as reference standard, the best results were for (1) the SHCS-AQ after electronic monitoring (sensitivity, 87.5%; specificity, 78.6%); (2) electronic monitoring (sensitivity, 75%; specificity, 85.6%), and (3) the VAS combined with the SHCS-AQ before electronic monitoring (sensitivity, 87.5%; specificity, 58.6%). The sensitivity of the complex EHTQ was less than 50%. Asking simple questions about doses taken or missed is more sensitive than complex questioning about each drug separately. Combining the VAS with the SHCS-AQ seems a feasible nonadherence measure for daily clinical practice. Self-reports perform better after electronic monitoring: their diagnostic value could be lower when given independently.

  1. 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.

  2. Sustained, Controlled and Stimuli-Responsive Drug Release Systems Based on Nanoporous Anodic Alumina with Layer-by-Layer Polyelectrolyte

    Science.gov (United States)

    Porta-i-Batalla, Maria; Eckstein, Chris; Xifré-Pérez, Elisabet; Formentín, Pilar; Ferré-Borrull, J.; Marsal, Lluis F.

    2016-08-01

    Controlled drug delivery systems are an encouraging solution to some drug disadvantages such as reduced solubility, deprived biodistribution, tissue damage, fast breakdown of the drug, cytotoxicity, or side effects. Self-ordered nanoporous anodic alumina is an auspicious material for drug delivery due to its biocompatibility, stability, and controllable pore geometry. Its use in drug delivery applications has been explored in several fields, including therapeutic devices for bone and dental tissue engineering, coronary stent implants, and carriers for transplanted cells. In this work, we have created and analyzed a stimuli-responsive drug delivery system based on layer-by-layer pH-responsive polyelectrolyte and nanoporous anodic alumina. The results demonstrate that it is possible to control the drug release using a polyelectrolyte multilayer coating that will act as a gate.

  3. Early myeloma-related death in elderly patients: development of a clinical prognostic score and evaluation of response sustainability role.

    Science.gov (United States)

    Rodríguez-Otero, Paula; Mateos, María Victoria; Martínez-López, Joaquín; Martín-Calvo, Nerea; Hernández, Miguel-Teodoro; Ocio, Enrique M; Rosiñol, Laura; Martínez, Rafael; Teruel, Ana-Isabel; Gutiérrez, Norma C; Bargay, Joan; Bengoechea, Enrique; González, Yolanda; de Oteyza, Jaime Pérez; Gironella, Mercedes; Encinas, Cristina; Martín, Jesús; Cabrera, Carmen; Palomera, Luis; de Arriba, Felipe; Cedena, María Teresa; Paiva, Bruno; Puig, Noemí; Oriol, Albert; Bladé, Joan; Lahuerta, Juan José; San Miguel, Jesús F

    2018-02-23

    Although survival of elderly myeloma patients has significantly improved there is still a subset of patients who, despite being fit and achieving optimal responses, will die within 2 years of diagnosis due to myeloma progression. The objective of this study was to define a scoring prognostic index to identify this group of patients. We have evaluated the outcome of 490 newly diagnosed elderly myeloma patients included in two Spanish trials (GEM2005-GEM2010). Sixty-eight patients (13.8%) died within 2 years of diagnosis (early deaths) due to myeloma progression. Our study shows that the use of simple scoring model based on 4 widely available markers (elevated LDH, ISS 3, high risk CA or >75 years) can contribute to identify up-front these patients. Moreover, unsustained response (<6 months duration) emerged as one important predictor of early myeloma-related mortality associated with a significant increase in the risk of death related to myeloma progression. The identification of these patients at high risk of early death is relevant for innovative trials aiming to maintain the depth of first response, since many of them will not receive subsequent lines of therapy.

  4. Collagen-induced arthritis in C57BL/6 mice is associated with a robust and sustained T-cell response to type II collagen.

    Science.gov (United States)

    Inglis, Julia J; Criado, Gabriel; Medghalchi, Mino; Andrews, Melanie; Sandison, Ann; Feldmann, Marc; Williams, Richard O

    2007-01-01

    Many genetically modified mouse strains are now available on a C57BL/6 (H-2b) background, a strain that is relatively resistant to collagen-induced arthritis. To facilitate the molecular understanding of autoimmune arthritis, we characterised the induction of arthritis in C57BL/6 mice and then validated the disease as a relevant pre-clinical model for rheumatoid arthritis. C57BL/6 mice were immunised with type II collagen using different protocols, and arthritis incidence, severity, and response to commonly used anti-arthritic drugs were assessed and compared with DBA/1 mice. We confirmed that C57BL/6 mice are susceptible to arthritis induced by immunisation with chicken type II collagen and develop strong and sustained T-cell responses to type II collagen. Arthritis was milder in C57BL/6 mice than DBA/1 mice and more closely resembled rheumatoid arthritis in its response to therapeutic intervention. Our findings show that C57BL/6 mice are susceptible to collagen-induced arthritis, providing a valuable model for assessing the role of specific genes involved in the induction and/or maintenance of arthritis and for evaluating the efficacy of novel drugs, particularly those targeted at T cells.

  5. 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...

  6. 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.

  7. Sustainable Universities

    DEFF Research Database (Denmark)

    Grindsted, Thomas Skou

    2011-01-01

    Declarations on Sustainability in Higher Education (SHE) can be viewed as a piece of international regulation. Over the past 30 years research at universities has produced convincing data to warn about deterioration of the environment, resource scarcity and the need for sustainability. This in turn....... 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...

  8. Gender parity trends for invited speakers at four prominent virology conference series.

    Science.gov (United States)

    Kalejta, Robert F; Palmenberg, Ann C

    2017-06-07

    Scientific conferences are most beneficial to participants when they showcase significant new experimental developments, accurately summarize the current state of the field, and provide strong opportunities for collaborative networking. A top-notch slate of invited speakers, assembled by conference organizers or committees, is key to achieving these goals. The perceived underrepresentation of female speakers at prominent scientific meetings is currently a popular topic for discussion, but one that often lacks supportive data. We compiled the full rosters of invited speakers over the last 35 years for four prominent international virology conferences, the American Society for Virology Annual Meeting (ASV), the International Herpesvirus Workshop (IHW), the Positive-Strand RNA Virus Symposium (PSR), and the Gordon Research Conference on Viruses & Cells (GRC). The rosters were cross-indexed by unique names, gender, year, and repeat invitations. When plotted as gender-dependent trends over time, all four conferences showed a clear proclivity for male-dominated invited speaker lists. Encouragingly, shifts toward parity are emerging within all units, but at different rates. Not surprisingly, both selection of a larger percentage of first time participants and the presence of a woman on the speaker selection committee correlated with improved parity. Session chair information was also collected for the IHW and GRC. These visible positions also displayed a strong male dominance over time that is eroding slowly. We offer our personal interpretation of these data to aid future organizers achieve improved equity among the limited number of available positions for session moderators and invited speakers. IMPORTANCE Politicians and media members have a tendency to cite anecdotes as conclusions without any supporting data. This happens so frequently now, that a name for it has emerged: fake news. Good science proceeds otherwise. The under representation of women as invited

  9. Calendar time trends in the incidence and prevalence of triple-class virologic failure in antiretroviral drug-experienced people with HIV in Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Lodwick, Rebecca; Costagliola, Dominique

    2012-01-01

    Despite the increasing success of antiretroviral therapy (ART), virologic failure of the 3 original classes [triple-class virologic failure, (TCVF)] still develops in a small minority of patients who started therapy in the triple combination ART era. Trends in the incidence and prevalence of TCVF...

  10. A randomized controlled trial comparing the effects of counseling and alarm device on HAART adherence and virologic outcomes.

    Directory of Open Access Journals (Sweden)

    Michael H Chung

    2011-03-01

    Full Text Available Behavioral interventions that promote adherence to antiretroviral medications may decrease HIV treatment failure. Antiretroviral treatment programs in sub-Saharan Africa confront increasing financial constraints to provide comprehensive HIV care, which include adherence interventions. This study compared the impact of counseling and use of an alarm device on adherence and biological outcomes in a resource-limited setting.A randomized controlled, factorial designed trial was conducted in Nairobi, Kenya. Antiretroviral-naïve individuals initiating free highly active antiretroviral therapy (HAART in the form of fixed-dose combination pills (d4T, 3TC, and nevirapine were randomized to one of four arms: counseling (three counseling sessions around HAART initiation, alarm (pocket electronic pill reminder carried for 6 months, counseling plus alarm, and neither counseling nor alarm. Participants were followed for 18 months after HAART initiation. Primary study endpoints included plasma HIV-1 RNA and CD4 count every 6 months, mortality, and adherence measured by monthly pill count. Between May 2006 and September 2008, 400 individuals were enrolled, 362 initiated HAART, and 310 completed follow-up. Participants who received counseling were 29% less likely to have monthly adherence <80% (hazard ratio [HR] = 0.71; 95% confidence interval [CI] 0.49-1.01; p = 0.055 and 59% less likely to experience viral failure (HIV-1 RNA ≥5,000 copies/ml (HR 0.41; 95% CI 0.21-0.81; p = 0.01 compared to those who received no counseling. There was no significant impact of using an alarm on poor adherence (HR 0.93; 95% CI 0.65-1.32; p = 0.7 or viral failure (HR 0.99; 95% CI 0.53-1.84; p = 1.0 compared to those who did not use an alarm. Neither counseling nor alarm was significantly associated with mortality or rate of immune reconstitution.Intensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and

  11. Response to combination antiretroviral therapy: variation by age

    DEFF Research Database (Denmark)

    Lundgren, Jens

    2008-01-01

    -naive individuals starting combination antiretroviral therapy from 1998 to 2006. OUTCOME MEASURES: Time from combination antiretroviral therapy initiation to HIV RNA less than 50 copies/ml (virological response), CD4 increase of more than 100 cells/microl (immunological response) and new AIDS/death were analysed...... response. The probability of virological response was lower in those aged 6-12 (adjusted hazard ratio: 0.87) and 13-17 (0.78) years, but was higher in those aged 50-54 (1.24), 55-59 (1.24) and at least 60 (1.18) years. The probability of immunological response was higher in children and younger adults...... and reduced in those 60 years or older. Those aged 55-59 and 60 years or older had poorer clinical outcomes after adjusting for the latest CD4 cell count. CONCLUSION: Better virological responses but poorer immunological responses in older individuals, together with low precombination antiretroviral therapy...

  12. 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.

  13. Evaluating Emergency Response Solutions for Sustainable Community Development by Using Fuzzy Multi-Criteria Group Decision Making Approaches: IVDHF-TOPSIS and IVDHF-VIKOR

    Directory of Open Access Journals (Sweden)

    Junling Zhang

    2016-03-01

    Full Text Available Emergency management is vital in implementing sustainable community development, for which community planning must include emergency response solutions to potential natural and manmade hazards. To help maintain such solution repository, we investigate effective fuzzy multi-criteria group decision making (FMCGDM approaches for the complex problems of evaluating alternative emergency response solutions, where weights for decision makers and criteria are unknown due to problem complexity. We employ interval-valued dual hesitant fuzzy (IVDHF set to address decision hesitancy more effectively. Based on IVDHF assessments, we develop a deviation maximizing model to compute criteria weights and another compatibility maximizing model to calculate weights for decision makers. Then, two ideal-solution-based FMCGDM approaches are proposed: (i by introducing a synthesized IVDHF group decision matrix into TOPSIS, we develop an IVDHF-TOPSIS approach for fuzzy group settings; (ii when emphasizing both maximum group utility and minimum individual regret, we extend VIKOR to develop an IVDHF-VIKOR approach, where the derived decision makers’ weights are utilized to obtain group decision matrix and the determined criteria weights are integrated to reflect the relative importance of distances from the compromised ideal solution. Compared with aggregation-operators-based approach, IVDHF-TOPSIS and IVDHF-VIKOR can alleviate information loss and computational complexity. Numerical examples have validated the effectiveness of the proposed approaches.

  14. Regulatory on the corporate social responsibility in the context of sustainable development by mandatory in the world trade organization law perspective (case study in Indonesia

    Directory of Open Access Journals (Sweden)

    SH. M. Hum. TAUFIQURRAHMAN

    2013-12-01

    Full Text Available Regulatory on the Corporate Social Responsibility (CSR by mandatory in Indonesia as stipulated in Article 74 of Law No. 40/2007 on the Limited Liability Company (hereafter the Company Law raises a contradiction. Those who agree argue that the company is not solely for profit, but more than that are participating in social issues and the preservation of the environment within the framework of sustainable development. Conversely, those who disagree view that social issues and the environment are the full responsibility of state. The involvement of a corporation in social and environmental activities is voluntary. Verdict of the Indonesian Constitutional Court in case no. 53/PUU-VI / / 2008 dated 13 April 2009 which rejected a requesting of material test of the Article 74 paragraph (1, (2 and (3 of the Company Law confirms the existence of the CSR by mandatory in international trade traffic today. The analytical results indicates that mandatory CSR regulation in the Company Law is not a form of a state intervention to the private activities. In addition, the arrangement is not contrary to the principles of free trade within the framework of the General Agreement on Tariffs and Trade (GATT / World Trade Organization (WTO.

  15. Efficacy and safety of sustained-delivery fluocinolone acetonide intravitreal implant in patients with chronic diabetic macular edema insufficiently responsive to available therapies: a real-life study

    Directory of Open Access Journals (Sweden)

    Massin P

    2016-07-01

    Full Text Available Pascale Massin, Ali Erginay, Bénédicte Dupas, Aude Couturier, Ramin Tadayoni Ophthalmology Department, Lariboisière Hospital, Paris, France Purpose: To evaluate the efficacy and safety of sustained-delivery fluocinolone acetonide (FAc intravitreal implant for diabetic macular edema (DME. Patients and methods: Prospective study in patients with DME insufficiently responsive to laser and anti-vascular endothelial growth factor (anti-VEGF. Patients with history of rise of intraocular pressure after intravitreal corticosteroids were excluded. Results: The macular edema rapidly decreased both in group 1 (prior laser only; n=7 eyes and group 2 (prior laser and ≥3 monthly anti-VEGF therapy; n=10 eyes and central subfield thickness was reduced by -299 µm (P=0.008 and -251 µm (P=0.016 at 12 months, respectively. Mean area under the curve from baseline to last value for pseudophakic eyes was +4.2 letters in group 1 and +9.5 letters in group 2. Overall, the FAc implant was well tolerated. Conclusion: This prospective study confirms the efficacy of the FAc implant in DME patients insufficiently responsive to laser and anti-VEGF. Moreover, with a careful patient selection, our safety results would support an earlier use of FAc in the DME treatment pathway. Keywords: diabetic macular edema, intravitreal corticosteroid, corticosteroid intravitreal implant, fluocinolone acetonide

  16. Allodynia Is Associated With Initial and Sustained Response to Acute Migraine Treatment: Results from the American Migraine Prevalence and Prevention Study.

    Science.gov (United States)

    Lipton, Richard B; Munjal, Sagar; Buse, Dawn C; Bennett, Alix; Fanning, Kristina M; Burstein, Rami; Reed, Michael L

    2017-07-01

    In a population sample of persons with migraine treating with a single category of acute migraine medication, to identify rates and factors associated with acute treatment outcomes, including 2-hour pain freedom (2hPF), 24-hour pain response (24hPR), and 24-hour sustained pain response (24hSPR). Key predictors include acute treatment type (triptans and other medication categories), the influence of allodynia on response to medication, and the interaction between medication category and presence of allodynia in response to treatment among people with migraine. Cutaneous allodynia was previously associated with inadequate 2hPF, 24hPR, and 24hSPR (sustained response at 24 hours among those with adequate 2hPF) among people with migraine in the American Migraine Prevalence and Prevention (AMPP) Study. The AMPP Study obtained data from a representative US sample of persons with migraine by mailed questionnaire. The 2006 survey included 8233 people with migraine aged 18 or over who completed the Migraine Treatment Optimization Questionnaire (mTOQ). mTOQ was used to assess acute treatment outcomes including 2hPF, 24hPR, and 24hSPR. Eligible individuals used only a single category of acute prescription migraine treatments (n  =  5236, 63.6%). This sample was stratified into 5 categories of type of acute prescription headache medication used (triptans, nonsteroidal anti-inflammatory drugs, barbiturate-combinations, opioids, and opioid combinations and ergot alkaloids). Separate binary logistic regression models evaluated: (1) triptans vs other medication types; (2) presence of allodynia vs no allodynia; and (3) the interaction of medication category with allodynia. Sociodemographic variables, health insurance status, over-the-counter and preventive medication use were included as covariates. Odds ratios (OR) and 95% confidence intervals (CI) were generated for each acute treatment outcome. Among eligible participants, the mean age was 46 years, and 82.5% were women

  17. Single histidine button in cardiac troponin I sustains heart performance in response to severe hypercapnic respiratory acidosis in vivo.

    Science.gov (United States)

    Palpant, Nathan J; D'Alecy, Louis G; Metzger, Joseph M

    2009-05-01

    Intracellular acidosis is a profound negative regulator of myocardial performance. We hypothesized that titrating myofilament calcium sensitivity by a single histidine substituted cardiac troponin I (A164H) would protect the whole animal physiological response to acidosis in vivo. To experimentally induce severe hypercapnic acidosis, mice were exposed to a 40% CO(2) challenge. By echocardiography, it was found that systolic function and ventricular geometry were maintained in cTnI A164H transgenic (Tg) mice. By contrast, non-Tg (Ntg) littermates experienced rapid and marked cardiac decompensation during this same challenge. For detailed hemodymanic assessment, Millar pressure-conductance catheterization was performed while animals were treated with a beta-blocker, esmolol, during a severe hypercapnic acidosis challenge. Survival and load-independent measures of contractility were significantly greater in Tg vs. Ntg mice. This assay showed that Ntg mice had 100% mortality within 5 min of acidosis. By contrast, systolic and diastolic function were protected in Tg mice during acidosis, and they had 100% survival. This study shows that, independent of any beta-adrenergic compensation, myofilament-based molecular manipulation of inotropy by histidine-modified troponin I maintains cardiac inotropic and lusitropic performance and markedly improves survival during severe acidosis in vivo.

  18. Understanding plant defence responses against herbivore attacks: an essential first step towards the development of sustainable resistance against pests.

    Science.gov (United States)

    Santamaria, M Estrella; Martínez, Manuel; Cambra, Inés; Grbic, Vojislava; Diaz, Isabel

    2013-08-01

    Plant-herbivore relationships are complex interactions encompassing elaborate networks of molecules, signals and strategies used to overcome defences developed by each other. Herbivores use multiple feeding strategies to obtain nutrients from host plants. In turn, plants respond by triggering defence mechanisms to inhibit, block or modify the metabolism of the pest. As part of these defences, herbivore-challenged plants emit volatiles to attract natural enemies and warn neighbouring plants of the imminent threat. In response, herbivores develop a variety of strategies to suppress plant-induced protection. Our understanding of the plant-herbivore interphase is limited, although recent molecular approaches have revealed the participation of a battery of genes, proteins and volatile metabolites in attack-defence processes. This review describes the intricate and dynamic defence systems governing plant-herbivore interactions by examining the diverse strategies plants employ to deny phytophagous arthropods the ability to breach newly developed mechanisms of plant resistance. A cornerstone of this understanding is the use of transgenic tools to unravel the complex networks that control these interactions.

  19. Bioinformatics Meets Virology: The European Virus Bioinformatics Center's Second Annual Meeting.

    Science.gov (United States)

    Ibrahim, Bashar; Arkhipova, Ksenia; Andeweg, Arno C; Posada-Céspedes, Susana; Enault, François; Gruber, Arthur; Koonin, Eugene V; Kupczok, Anne; Lemey, Philippe; McHardy, Alice C; McMahon, Dino P; Pickett, Brett E; Robertson, David L; Scheuermann, Richard H; Zhernakova, Alexandra; Zwart, Mark P; Schönhuth, Alexander; Dutilh, Bas E; Marz, Manja

    2018-05-14

    The Second Annual Meeting of the European Virus Bioinformatics Center (EVBC), held in Utrecht, Netherlands, focused on computational approaches in virology, with topics including (but not limited to) virus discovery, diagnostics, (meta-)genomics, modeling, epidemiology, molecular structure, evolution, and viral ecology. The goals of the Second Annual Meeting were threefold: (i) to bring together virologists and bioinformaticians from across the academic, industrial, professional, and training sectors to share best practice; (ii) to provide a meaningful and interactive scientific environment to promote discussion and collaboration between students, postdoctoral fellows, and both new and established investigators; (iii) to inspire and suggest new research directions and questions. Approximately 120 researchers from around the world attended the Second Annual Meeting of the EVBC this year, including 15 renowned international speakers. This report presents an overview of new developments and novel research findings that emerged during the meeting.

  20. Virology: The Next Generation from Digital PCR to Single Virion Genomics

    Energy Technology Data Exchange (ETDEWEB)

    White, Richard A.; Brazelton De Cardenas, Jessica N.; Hayden, Randall T.

    2015-10-01

    In the past 25 years, virology has had major technology breakthroughs stemming first from the introduction of nucleic acid amplification testing, but more recently from the use of next-generation sequencing, digital PCR, and the possibility of single virion genomics. These technologies have and will improve diagnosis and disease state monitoring in clinical settings, aid in environmental monitoring, and reveal the vast genetic potential of viruses. Using the principle of limiting dilution, digital PCR amplifies single molecules of DNA in highly partitioned endpoint reactions and reads each of those reactions as either positive or negative based on the presence or absence of target fluorophore. In this review, digital PCR will be highlighted along with current studies, advantages/disadvantages, and future perspectives with regard to digital PCR, viral load testing, and the possibility of single virion genomics.

  1. Una Perspectiva sobre la Situación Actual de la Virología

    Directory of Open Access Journals (Sweden)

    Domingo Solans, Esteban

    2001-02-01

    Full Text Available Not available

    La Virología se ha desarrollado durante la última parte del siglo XX en paralelo con las nuevas técnicas de análisis y manipulación genética y con el auxilio de técnicas físicas e informáticas. En España se han formado núcleos activos tanto en genética viral como en virus patógenos de animales y plantas. Contrariamente a predicciones de hace tan solo tres décadas, las enfermedades víricas siguen siendo un importante problema en medicina, veterinaria y agricultura. Un gran número de enfermedades víricas emergentes constituyen un importante desafío para el siglo XXI.

  2. [Caprine arthritis-encephalitis: trial of an adjuvant vaccine preparation. I. Clinical and virological study].

    Science.gov (United States)

    Russo, P; Vitu, C; Fontaine, J J; Vignoni, M

    1993-04-01

    In purpose to protect goats against caprine arthritis encephalitis virus (CAEV), the first group of kids (I) was inoculated with purified, inactivated and adjuvant-treated virions, the second group (II) with adjuvant and the third one (III) with culture medium. 2-4 months later, the three groups were challenged with virulent CAEV by intraarticular route. On the clinical level, vaccinated and challenged kids show more early and severe arthritis than other groups. On the virological level, isolation of lentivirus from white blood cells and different organs is more important in group I than groups II and III. Therefore, vaccinations with inactivated and adjuvant-treated virions do not protect against a virulent challenge; there is an enhancement of lesions. We note that the adjuvant elicits a mild non-specific protection against virulent challenge.

  3. Porting of Bio-Informatics Tools for Plant Virology on a Computational Grid

    International Nuclear Information System (INIS)

    Lanzalone, G.; Lombardo, A.; Muoio, A.; Iacono-Manno, M.

    2007-01-01

    The goal of Tri Grid Project and PI2S2 is the creation of the first Sicilian regional computational Grid. In particular, it aims to build various software-hardware interfaces between the infrastructure and some scientific and industrial applications. In this context, we have integrated some among the most innovative computing applications in virology research inside these Grid infrastructure. Particularly, we have implemented in a complete work flow, various tools for pairwise or multiple sequence alignment and phylogeny tree construction (ClustalW-MPI), phylogenetic networks (Splits Tree), detection of recombination by phylogenetic methods (TOPALi) and prediction of DNA or RNA secondary consensus structures (KnetFold). This work will show how the ported applications decrease the execution time of the analysis programs, improve the accessibility to the data storage system and allow the use of metadata for data processing. (Author)

  4. Sustainability in Fashion Business Operations

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    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.

  5. Wood Anatomy and Insect Defoliator Systems: Is there an anatomical response to sustained feeding by the western spruce budworm (Choristoneura occidentalis) on Douglas-fir (Pseudotusga menziesii)?

    Science.gov (United States)

    Axelson, Jodi; Gärtner, Holger; Alfaro, René; Smith, Dan

    2013-04-01

    The western spruce budworm (Choristoneura occidentalis Freeman) is the most widespread and destructive defoliator of coniferous forests in western North America, and has a long-term coexistence with its primary host tree, Douglas-fir (Pseudotsuga menziesii Franco). Western spruce budworm (WSB) outbreaks usually last for several years, and cause reductions in annual growth, stem defects, and regeneration delays. In British Columbia, the WSB is the second most damaging insect after the mountain pine beetle, and sustained and/or severe defoliation can result in the mortality of host trees. Numerous studies have used tree rings to reconstruct WSB outbreaks across long temporal scales, to evaluate losses in stand productivity, and examine isotope ratios. Although some studies have looked at the impacts of artificial defoliation on balsam fir in eastern North America, there has been no prior research on how WSB outbreaks affect the anatomical structure of the stem as described by intra-annual wood density and potential cell size variations. The objective of this study was to anatomically examine the response of Douglas-fir to sustained WSB outbreaks in two regions of southern British Columbia. We hypothesize that the anatomical intra-annual characteristics of the tree rings, such as cell wall thickness, latewood cell size, and/or lumen area changes during sustained WSB outbreaks. To test this hypothesis we sampled four permanent sample plots in coastal and dry interior sites, which had annually resolved defoliation data collected over a 7-12 year period. At each site diameter-at-breast height (cm), height (m), and crown position were recorded and three increment cores were extracted from 25 trees. Increment cores were prepared to permit anatomical and x-ray density analyses. For each tree, a 15µm thick micro section was cut from the radial plane. Digital images of the micro sections were captured and processed. In each annual ring, features such as cell lumen area (µm2

  6. 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...

  7. 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 rebuil...

  8. Sustainability Labeling

    NARCIS (Netherlands)

    Dam, van Y.K.

    2017-01-01

    Sustainability labeling originated from a need to protect the identity of alternative systems of food production and to increase market transparency. From the 1980s onwards sustainability labeling has changed into a policy instrument replacing direct government regulation of the food market, and a

  9. Quantitative sensory response of the SCM muscle on sustained low level activation simulating co-contractions during bruxing.

    Science.gov (United States)

    Eberhard, Lydia; Terebesi, Sophia; Giannakopoulos, Nikolaos Nikitas; Hellmann, Daniel; Schindler, Hans-Jürgen; Schmitter, Marc; Pfau, Doreen

    2018-02-01

    Bruxism is discussed as an etiological factor in the pathogenesis of orofacial and cervical pain. As the sternocleidomastoid muscle (SCM) is co-activated during clenching, our aim was to investigate, whether the muscle loading leads to peripheral or central sensitizations. In twenty-one healthy female volunteers, somatosensory profiles of the SCM were recorded according to the test battery of the German Research Network on Neuropathic Pain (DFNS) prior to and after an isometric muscle exercise. QST comprised thermal and mechanical stimuli. A submaximal activation of the SCM (15% MVC) was kept for 10min in sitting position. In separate test sessions one month apart, one sham and one verum experiment were conducted in randomized order. During the muscle loading, the parameters cold detection threshold (CDT), mechanical pain sensitivity (MPS) and pressure pain treshold (PPT) were tested and experimental pain recorded by visual analogoue scales (VAS). All test sessions were performed during the follicular phase of the menstrual cycle (day 5), to avoid effects on pain perception. Data were analyzed with Repeated Measures ANOVA (SPSS 22.0) RESULTS: No significant changes were found during or after (sham) loading except for stimulus-response-function (SR, P=0.01) and PPT (P=0.02) in the sham test. No effect was observed in the verum experiment (P=0.12 up to 1.0). Prolonged low level contraction of the SCM does not evoke painful sensitization. In contrast, submaximal muscle activation seems to have a protective effect corresponding to a training effect preventing sensitization. Copyright © 2017. Published by Elsevier Ltd.

  10. Afterschool Sustainability

    Directory of Open Access Journals (Sweden)

    Hilary D. Joyce

    2014-12-01

    Full Text Available Youth participation in quality extended learning opportunities (ELOs results in positive academic, physical, mental health, and social/emotional outcomes. Funding is essential to implementing and sustaining quality ELOs; however multiple funding barriers and challenges exist. Understanding the types of funds available for ELOs and the factors that influence sustainability is critical. Through surveys and telephone interviews of ELO providers, this descriptive study identified and examined ELO funding streams, the ways ELO providers use these funding streams, and the barriers and challenges to sustainability. ELO programs often relied on one major funding stream coupled with nutrition supports as well as in-kind resources. Barriers to sustainability included year-to-year funding, transportation costs, reducing community partnerships, and difficulty in diversifying funds. Recommendations to enhance ELO sustainability are offered, particularly in relation to overcoming the challenges to diversification of funding resources and establishing mutually supportive partnerships and collaboration.

  11. Evolution of drug resistance in HIV infected patients remaining on a virologically failing cART regimen

    DEFF Research Database (Denmark)

    Cozzi-Lepri, A; Phillips, AN; Ruiz, L

    2007-01-01

    OBJECTIVE: To estimate the extent of drug resistance accumulation in patients kept on a virologically failing regimen and its determinants in the clinical setting. DESIGN: The study focused on 110 patients of EuroSIDA on an unchanged regimen who had two genotypic tests performed at two time points...

  12. Predictors of having a resistance test following confirmed virological failure of combination antiretroviral therapy: data from EuroSIDA

    DEFF Research Database (Denmark)

    Fox, Zoe V; Cozzi-Lepri, Alessandro; D'Arminio Monforte, Antonella

    2011-01-01

    these recommendations. Methods: In EuroSIDA, virological failure (VF) was defined as confirmed VL>1,000 copies/ml after =4 months continuous use of any antiretroviral in a =3-drug regimen started during or after 2002. We assessed whether a resistance test was performed around VF (from 4 months before to 1 year after VF...

  13. Impact of CD4 and CD8 dynamics and viral rebounds on loss of virological control in HIV controllers

    DEFF Research Database (Denmark)

    Chereau, Fanny; Madec, Yoann; Sabin, Caroline

    2017-01-01

    OBJECTIVE: HIV controllers (HICs) spontaneously maintain HIV viral replication at low level without antiretroviral therapy (ART), a small number of whom will eventually lose this ability to control HIV viremia. The objective was to identify factors associated with loss of virological control. MET...

  14. The effect of efavirenz versus nevirapine-containing regimens on immunologic, virologic and clinical outcomes in a prospective observational study

    NARCIS (Netherlands)

    Collaboration, H.-C.; Koopmans †, P.P.; Brouwer, A.M.; Dofferhoff, A.S.M.; Flier, M. van der; Groot, R. de; Hofstede, H.J.M. ter; Keuter, M.; Ven, A.J.A.M. van der; et al.,

    2012-01-01

    OBJECTIVE: To compare regimens consisting of either efavirenz or nevirapine and two or more nucleoside reverse transcriptase inhibitors (NRTIs) among HIV-infected, antiretroviral-naive, and AIDS-free individuals with respect to clinical, immunologic, and virologic outcomes. DESIGN: Prospective

  15. Factors associated with HIV-1 virological failure in an outpatient clinic for HIV-infected people in Haiphong, Vietnam

    DEFF Research Database (Denmark)

    Huong, D T M; Bannister, W; Phong, P T

    2011-01-01

    starting ART, 23% had detectable HIV-1 viral load (= 400 copies/mL). Patients who had developed a World Health Organization (WHO) clinical stage 4 condition at the time of initiation of ART were more likely to experience virological failure than those in stages 1-3, odds ratio (OR): 5.20 (95% confidence...

  16. Clinical Outcomes of Virologically-Suppressed Patients with Pre-existing HIV-1 Drug Resistance Mutations Switching to Rilpivirine/Emtricitabine/Tenofovir Disoproxil Fumarate in the SPIRIT Study.

    Science.gov (United States)

    Porter, Danielle P; Toma, Jonathan; Tan, Yuping; Solberg, Owen; Cai, Suqin; Kulkarni, Rima; Andreatta, Kristen; Lie, Yolanda; Chuck, Susan K; Palella, Frank; Miller, Michael D; White, Kirsten L

    2016-02-01

    Antiretroviral regimen switching may be considered for HIV-1-infected, virologically-suppressed patients to enable treatment simplification or improve tolerability, but should be guided by knowledge of pre-existing drug resistance. The current study examined the impact of pre-existing drug resistance mutations on virologic outcomes among virologically-suppressed patients switching to Rilpivirine (RPV)/emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF). SPIRIT was a phase 3b study evaluating the safety and efficacy of switching to RPV/FTC/TDF in virologically-suppressed HIV-1-infected patients. Pre-existing drug resistance at baseline was determined by proviral DNA genotyping for 51 RPV/FTC/TDF-treated patients with known mutations by historical RNA genotype and matched controls and compared with clinical outcome at Week 48. Drug resistance mutations in protease or reverse transcriptase were detected in 62.7% of patients by historical RNA genotype and in 68.6% by proviral DNA genotyping at baseline. Proviral DNA sequencing detected 89% of occurrences of NRTI and NNRTI resistance-associated mutations reported by historical genotype. Mutations potentially affecting RPV activity, including E138A/G/K/Q, Y181C, and H221Y, were detected in isolates from 11 patients by one or both assays. None of the patients with single mutants had virologic failure through Week 48. One patient with pre-existing Y181Y/C and M184I by proviral DNA genotyping experienced virologic failure. Nineteen patients with K103N present by historical genotype were confirmed by proviral DNA sequencing and 18/19 remained virologically-suppressed. Virologic success rates were high among virologically-suppressed patients with pre-existing NRTI and NNRTI resistance-associated mutations who switched to RPV/FTC/TDF in the SPIRIT study. While plasma RNA genotyping remains preferred, proviral DNA genotyping may provide additional value in virologically-suppressed patients for whom historical resistance

  17. Netrin-1 Protects Hepatocytes Against Cell Death Through Sustained Translation During the Unfolded Protein ResponseSummary

    Directory of Open Access Journals (Sweden)

    Thomas Lahlali

    2016-05-01

    Full Text Available Background & Aims: Netrin-1, a multifunctional secreted protein, is up-regulated in cancer and inflammation. Netrin-1 blocks apoptosis induced by the prototypical dependence receptors deleted in colorectal carcinoma and uncoordinated phenotype-5. Although the unfolded protein response (UPR triggers apoptosis on exposure to stress, it first attempts to restore endoplasmic reticulum homeostasis to foster cell survival. Importantly, UPR is implicated in chronic liver conditions including hepatic oncogenesis. Netrin-1's implication in cell survival on UPR in this context is unknown. Methods: Isolation of translational complexes, determination of RNA secondary structures by selective 2’-hydroxyl acylation and primer extension/dimethyl sulfate, bicistronic constructs, as well as conventional cell biology and biochemistry approaches were used on in vitro–grown hepatocytic cells, wild-type, and netrin-1 transgenic mice. Results: HepaRG cells constitute a bona fide model for UPR studies in vitro through adequate activation of the 3 sensors of the UPR (protein kinase RNA–like endoplasmic reticulum kinase (PERK, inositol requiring enzyme 1α (IRE1α, and activated transcription factor 6 (ATF6. The netrin-1 messenger RNA 5'-end was shown to fold into a complex double pseudoknot and bear E-loop motifs, both of which are representative hallmarks of related internal ribosome entry site regions. Cap-independent translation of netrin 5' untranslated region–driven luciferase was observed on UPR in vitro. Unlike several structurally related oncogenic transcripts (l-myc, c-myc, c-myb, netrin-1 messenger RNA was selected for translation during UPR both in human hepatocytes and in mice livers. Depletion of netrin-1 during UPR induces apoptosis, leading to cell death through an uncoordinated phenotype-5A/C–mediated involvement of protein phosphatase 2A and death-associated protein kinase 1 in vitro and in netrin

  18. Lactobacillus acidophilus induces a slow but more sustained chemokine and cytokine response in naïve foetal enterocytes compared to commensal Escherichia coli

    Directory of Open Access Journals (Sweden)

    Nellemann Christine

    2010-01-01

    Full Text Available Abstract Background The first exposure to microorganisms at mucosal surfaces is critical for immune maturation and gut health. Facultative anaerobic bacteria are the first to colonise the infant gut, and the impact of these bacteria on intestinal epithelial cells (IEC may be determinant for how the immune system subsequently tolerates gut bacteria. Results To mirror the influence of the very first bacterial stimuli on infant IEC, we isolated IEC from mouse foetuses at gestational day 19 and from germfree neonates. IEC were stimulated with gut-derived bacteria, Gram-negative Escherichia coli Nissle and Gram-positive Lactobacillus acidophilus NCFM, and expression of genes important for immune regulation was measured together with cytokine production. E. coli Nissle and L. acidophilus NCFM strongly induced chemokines and cytokines, but with different kinetics, and only E. coli Nissle induced down-regulation of Toll-like receptor 4 and up-regulation of Toll-like receptor 2. The sensitivity to stimulation was similar before and after birth in germ-free IEC, although Toll-like receptor 2 expression was higher before birth than immediately after. Conclusions In conclusion, IEC isolated before gut colonisation occurs at birth, are highly responsive to stimulation with gut commensals, with L. acidophilus NCFM inducing a slower, but more sustained response than E. coli Nissle. E. coli may induce intestinal tolerance through very rapid up-regulation of chemokine and cytokine genes and down-regulation of Toll-like receptor 4, while regulating also responsiveness to Gram-positive bacteria.

  19. 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.

  20. Environmentally Sustainable Economic Growth

    Directory of Open Access Journals (Sweden)

    Stelian Brad

    2016-05-01

    Full Text Available Economic growth and sustainable development are important issues for social prosperity. Sustainable development strives for moderate and responsible use within the economic activity of the limited resources of our planet, whereas economic growth does not limit the resource exploitation and energy, being mainly focused on productivity increase. From this perspective, both conceptual and operational contradictions occur between the two pillars of prosperity. This paper looks to these contradictions and proposes some streams of intervention such as economic growth and environmental sustainability to operate in harmony. A structured framework for innovative problem solving is considered in this respect. Results of this research show that it is possible to induce smart measures in the economic system for directing businesses towards new paradigms where economic growth is possible without negative effects on environmental sustainability.

  1. Socioeconomic position and ten-year survival and virologic outcomes in a Ugandan HIV cohort receiving antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Andrew G Flynn

    Full Text Available Lifelong ART is essential to reducing HIV mortality and ending the epidemic, however the interplay between socioeconomic position and long-term outcomes of HIV-infected persons receiving antiretroviral therapy (ART in sub-Saharan Africa is unknown. Furthering the understanding of factors related to long-term ART outcomes in this important region will aid the successful scale-up of ART programs. We enrolled 559 HIV-infected Ugandan adults starting ART in 2004-2005 at the Infectious Diseases Institute in Kampala, Uganda and followed them for 10 years. We documented baseline employment status, regular household income, education level, housing description, physical ability, and CD4 count. Viral load was measured every six months. Proportional hazard regression tested for associations between baseline characteristics and 1 mortality, 2 virologic failure, and 3 mortality or virologic failure as a composite outcome. Over ten years 23% (n = 127 of participants died, 6% (n = 31 were lost-to-follow-up and 23% (107/472 experienced virologic treatment failure. In Kaplan-Meier analysis we observed an association between employment and mortality, with the highest cumulative probability of death occurring in unemployed individuals. In univariate analysis unemployment and disease severity were associated with mortality, but in multivariable analysis the only association with mortality was disease severity. We observed an association between higher household income and an increased incidence of both virologic failure and the combined outcome, and an association between self-employment and lower incidence of virologic failure and the combined outcome when compared to unemployment. Formal education level and housing status were unrelated to outcomes. It is feasible to achieve good ten-year survival, retention-in-care, and viral suppression in a socioeconomically diverse population in a resource-limited setting. Unemployment appears to be related to adverse 10

  2. Persistence of hepatocellular carcinoma risk in hepatitis C patients with a response to IFN and cirrhosis regression.

    Science.gov (United States)

    D'Ambrosio, Roberta; Aghemo, Alessio; Rumi, Maria Grazia; Degasperi, Elisabetta; Sangiovanni, Angelo; Maggioni, Marco; Fraquelli, Mirella; Perbellini, Riccardo; Rosenberg, William; Bedossa, Pierre; Colombo, Massimo; Lampertico, Pietro

    2018-01-27

    In patients with HCV-related cirrhosis, a sustained virological response may lead to cirrhosis regression. Whether histological changes translate into prevention of long-term complications, particularly hepatocellular carcinoma is still unknown. This was investigated in a cohort of histological cirrhotics who had been prospectively followed-up for 10 years after the achievement of a sustained virological response to IFN. In all, 38 sustained virological response cirrhotics who underwent a liver biopsy 5 years post-SVR were prospectively followed to assess the impact of cirrhosis regression on clinical endpoints. During a follow-up of 86 (30-96) months from liver biopsy, no patients developed clinical decompensation, whilst 5 (13%) developed hepatocellular carcinoma after 79 (7-88) months. The 8-year cumulative probability of hepatocellular carcinoma was 17%, without differences between patients with or without cirrhosis regression (19% [95% CI 6%-50%] vs 14% [95% CI 4%-44%], P = .88). Patients who developed or did not an hepatocellular carcinoma had similar rates of residual cirrhosis (P = 1.0), collagen content (P = .48), METAVIR activity (P = .34), portal inflammation (P = .06) and steatosis (P = .17). At baseline, patients who developed an hepatocellular carcinoma had higher γGT (HR 1.03, 95% CI 1.00-1.06; P = .014) and glucose (HR 1.02, 95% CI 1.00-1.02; P = .012) values; moreover, they had increased Forns Score (HR 12.8, 95% CI 1.14-143.9; P = .039), Lok Index (HR 6.24, 95% CI 1.03-37.6; P = .046) and PLF (HR 19.3, 95% CI 1.72-217.6; P = .016) values. One regressor died of lung cancer. The 8-year cumulative survival probability was 97%, independently on cirrhosis regression (96% vs 100%, P = 1.0) or hepatocellular carcinoma (100% vs 97%, P = 1.0). Post-SVR cirrhosis regression does not prevent hepatocellular carcinoma occurrence. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. 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....../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...

  4. Educating Professionals for Sustainable Futures

    Directory of Open Access Journals (Sweden)

    Hille Janhonen-Abruquah

    2018-02-01

    Full Text Available The recent discourse on sustainability science calls for interdisciplinary research. The home economics science approach ranges from individual actions to the involvement of communities and societies at large, and thus it can provide important perspectives on cultural sustainability. The aim of the research is to study the linkage between cultural sustainability and service sector education to support the creation of sustainable professions. In the present small-scale empirical study, the food service degree curriculum of a Finnish vocational college and teachers’ group interview data were analyzed to find how cultural sustainability is presented in the curriculum and how it is understood by teachers and integrated into teaching practices. Previous cultural sustainability research identifies four perspectives of cultural sustainability: (1 vitality of cultural traditions; (2 economic starting point; (3 diversity together with maintenance of local culture; and (4 possible influence on the balance between human actions and environment. Findings indicate that sustainability, including cultural sustainability, is integrated in the curriculum and considered important by teachers. Translating these into practice remains a challenge. The balance between human and nature was mostly understood as recycling, use of public transport, sustainable consumption, and taking trips to the nature nearby. Cultural sustainability as a concept is not well known, although themes such as multicultural issues, equality, charity, and environmental responsibility were included in teachers’ practical lessons daily. Feasts and celebrations in learning were opportunities to view cultural sustainability widely. This paper provides a way forward for the teachers to develop further their pedagogical practices.

  5. Failure to achieve immunological recovery in HIV-infected patients with clinical and virological success after 10 years of combined ART: role of treatment course.

    Science.gov (United States)

    Raffi, François; Le Moing, Vincent; Assuied, Alex; Habak, Sofiane; Spire, Bruno; Cazanave, Charles; Billaud, Eric; Dellamonica, Pierre; Ferry, Tristan; Fagard, Catherine; Leport, Catherine

    2017-01-01

    We assessed factors, including treatment course, associated with failure to obtain a 10 year immunological response after starting first-generation PI-containing combined ART (cART). In the prospective COPILOTE cohort of HIV-infected patients started on a first-generation PI-containing regimen in 1997-99, the impact of cART history on the failure to achieve immunological response measured at 10 years was assessed by multivariate logistic regression models in the 399 patients with clinical and virological success of cART. Failure of CD4 response (CD4 >500/mm 3 ) was associated with age ≥40 years at baseline (P failure to achieve complete immunological response (CD4 >500/mm 3 and CD4:CD8 ratio >1) were CD4:CD8 ratio ≤0.8 at month 8 (P success. Lack of treatment interruption may improve long-term immunological outcome in HIV infection. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  6. the legal status of sustainable development in the nigerian

    African Journals Online (AJOL)

    RAYAN_

    implementing and enforcing sustainable development in environmental governance ..... the principles of state responsibility for extra-territorial environmental harm and ..... sustainable development: the economic, social and environmental.53.

  7. A Randomized Controlled Trial of a Text Messaging Intervention to Promote Virologic Suppression and Retention in Care in an Urban Safety-Net HIV Clinic: The Connect4Care (C4C) Trial.

    Science.gov (United States)

    Christopoulos, Katerina A; Riley, Elise D; Carrico, Adam W; Tulsky, Jacqueline; Moskowitz, Judith T; Dilworth, Samantha; Coffin, Lara S; Wilson, Leslie; Peretz, Jason Johnson; Hilton, Joan F

    2018-02-21

    Text messaging is a promising strategy to support HIV care engagement, but little is known about its efficacy in urban safety-net HIV clinic populations. We conducted a randomized controlled trial of a supportive and motivational text messaging intervention, Connect4Care (C4C), among viremic patients who had a history of poor retention or were new to clinic. Participants were randomized (stratified by new HIV diagnosis status) to receive one of the following for 12 months: 1) thrice-weekly intervention messages, plus texted primary care appointment reminders and a monthly text message requesting confirmation of study participation, or; 2) texted reminders and monthly messages alone. Viral load was assessed at 6 and 12 months. The primary outcome was virologic suppression (<200 copies/mL) at 12 months, estimated via repeated measures log-binomial regression, adjusted for new diagnosis status. The secondary outcome was retention in clinic care. Between August 2013-November 2015, 230 participants were randomized. Virologic suppression at 12 months was similar between intervention and control participants (48.8% vs. 45.8%), with negligible change from 6-month estimates, yielding RR 1.07 (95% CI: 0.82, 1.39). Suppression was higher in the newly diagnosed (78.3% vs. 45.3%). There were no intervention effects on the secondary outcome. Exploratory analyses suggested that patients with more responses to study text messages had better outcomes, regardless of arm. The C4C text messaging intervention did not significantly increase virologic suppression or retention in care. Response to text messages may be a useful way for providers to gauge risk for poor HIV outcomes. NCT01917994.

  8. 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.

  9. 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...

  10. Sustainable Futures

    Science.gov (United States)

    Sustainable Futures is a voluntary program that encourages industry to use predictive models to screen new chemicals early in the development process and offers incentives to companies subject to TSCA section 5.

  11. 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......, that it can be adapted to changing functional needs, and that it has an architectural and cultural value. A specific proposal for a transformation that enhances the architectural qualities and building heritage values of an existing building forms the empirical material, which is discussed using different...... 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...

  12. Sustainable Consumption

    DEFF Research Database (Denmark)

    Røpke, Inge

    2015-01-01

    The intention of this chapter is to explore the role of consumption and consumers in relation to sustainability transition processes and wider systemic transformations. In contrast to the individualistic focus in much research on sustainable consumption, the embeddedness of consumption activities...... 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...

  13. 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...

  14. Seeking Sustainability

    OpenAIRE

    Clive L. Spash

    2014-01-01

    What does sustainability research do to help the environment? One might well wonder when observing the annual conference season with various academics and professors in sustainability science, ecological economics or environmental ethics driving to the airport to fly off to international meetings to discuss how bad things are getting, what should been done about it, and how time is running out for action. In fact, singling out a few academic groups is highly unfair because the link between pr...

  15. Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria.

    Science.gov (United States)

    Qi, Xiao-Wen; Zhang, Jun-Ling; Zhao, Shu-Ping; Liang, Chang-Yong

    2017-10-02

    In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager's prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches.

  16. Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria

    Directory of Open Access Journals (Sweden)

    Xiao-Wen Qi

    2017-10-01

    Full Text Available In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager’s prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches.

  17. Response of Seismically Isolated Steel Frame Buildings with Sustainable Lead-Rubber Bearing (LRB Isolator Devices Subjected to Near-Fault (NF Ground Motions

    Directory of Open Access Journals (Sweden)

    Jong Wan Hu

    2014-12-01

    Full Text Available Base isolation has been used as one of the most wildly accepted seismic protection systems that should substantially dissociate a superstructure from its substructure resting on a shaking ground, thereby sustainably preserving entire structures against earthquake forces as well as inside non-structural integrities. Base isolation devices can operate very effectively against near-fault (NF ground motions with large velocity pulses and permanent ground displacements. In this study, comparative advantages for using lead-rubber bearing (LRB isolation systems are mainly investigated by performing nonlinear dynamic time-history analyses with NF ground motions. The seismic responses with respects to base shears and inter-story drifts are compared according to the installation of LRB isolation systems in the frame building. The main function of the base LRB isolator is to extend the period of structural vibration by increasing lateral flexibility in the frame structure, and thus ground accelerations transferred into the superstructure can dramatically decrease. Therefore, these base isolation systems are able to achieve notable mitigation in the base shear. In addition, they make a significant contribution to reducing inter-story drifts distributed over the upper floors. Finally, the fact that seismic performance can be improved by installing isolation devices in the frame structure is emphasized herein through the results of nonlinear dynamic analyses.

  18. Oslo Art and Design Education (University College 1966–1994 – An educational institution with corporate responsibility and sustainability in focus

    Directory of Open Access Journals (Sweden)

    Randi Veiteberg Kvellestad

    2015-12-01

    Full Text Available The artile chronicles the Department of Art, Design and Drama at Oslo and Akershus University College ca. 1950 to 1990. The school bore the name Oslo Art and Design Education College (SLFO from 1966 to 1975 and Oslo Art and Design Education University College from 1975 to 1994. The institution had a clear teaching focus while running extensive programs on professional training, pilot projects and guidance service. The tradition of quality in the choice of material as well as work with engineering and design was strong, but greater emphasis was eventually placed on experimentation with material, tools and techniques. The students were both encouraged and challenged to be creative and rely on their own ideas in experimentation. The article set its focus on change and training in textiles needlework teacher education. The source materials are annual reports, published texts found in the Institute's history collection and interviews of seven employees who worked at the school in part or the whole period. Informants’ arguments and the analysis of texts are related to recent research in Sweden and Norway. The article shows that the institution once stood for attitudes that one would today call sustainable, with strong quality requirements. Thus, the institution showed social responsibility through education and industrial initiatives.

  19. A Rationally Designed TNF-α Epitope-Scaffold Immunogen Induces Sustained Antibody Response and Alleviates Collagen-Induced Arthritis in Mice.

    Directory of Open Access Journals (Sweden)

    Li Zhang

    Full Text Available The TNF-α biological inhibitors have significantly improved the clinical outcomes of many autoimmune diseases, in particular rheumatoid arthritis. However, the practical uses are limited due to high costs and the risk of anti-drug antibody responses. Attempts to develop anti-TNF-α vaccines have generated encouraging data in animal models, however, data from clinical trials have not met expectations. In present study, we designed a TNF-α epitope-scaffold immunogen DTNF7 using the transmembrane domain of diphtheria toxin, named DTT as a scaffold. Molecular dynamics simulation shows that the grafted TNF-α epitope is entirely surface-exposed and presented in a native-like conformation while the rigid helical structure of DTT is minimally perturbed, thereby rendering the immunogen highly stable. Immunization of mice with alum formulated DTNF7 induced humoral responses against native TNF-α, and the antibody titer was sustained for more than 6 months, which supports a role of the universal CD4 T cell epitopes of DTT in breaking self-immune tolerance. In a mouse model of rheumatoid arthritis, DTNF7-alum vaccination markedly delayed the onset of collagen-induced arthritis, and reduced incidence as well as clinical score. DTT is presumed safe as an epitope carrier because a catalytic inactive mutant of diphtheria toxin, CRM197 has good clinical safety records as an active vaccine component. Taken all together, we show that DTT-based epitope vaccine is a promising strategy for prevention and treatment of autoimmune diseases.

  20. Local Sustainability

    International Nuclear Information System (INIS)

    Carrizosa Umana, Julio

    1998-01-01

    The current polemic about the possibilities of sustainable development has led to a renovated interest for the topic of the sustainability of the communities and the local sustainability. In front of the global sustainability whose conditions have been exposed by systemic ecologists and for macro economists, the sustainability of specific places arises in the planet whose conditions are object of study of the ecology of landscapes, of the ecological economy, of the cultural anthropology, of the environmental sociology and naturally, of the integral environmentalism. In this discussion the Colombian case charges unusual interest to be one of the few countries of Latin America, where a very dense net of municipalities exists, each one with its urban helmet and with a position and some functions defined by the political constitution of the nation. This net of municipalities and of urban helmets it also constitutes net of alternative to the current macro-cephalic situation. As well as Bogota grew, in a hundred years, of less than a hundred thousand inhabitants to six million inhabitants, each one of these municipalities contains a potential of growth that depends on the characteristics of its ecological, social, economic and politic sustainability

  1. 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.

  2. Virological and clinical characteristics of hepatitis delta virus in South Asia

    Directory of Open Access Journals (Sweden)

    Moatter Tariq

    2011-06-01

    Full Text Available Abstract Background & Aims There is a paucity of data on the impact of hepatitis D virus (HDV in patients with hepatitis B virus (HBV infection from South Asia. We studied the impact of HDV co-infection on virological and clinical characteristics. Methods We collected data of 480 patients with HBsAg positive and a detectable HBV DNA PCR, who presented to the Aga Khan University, Karachi and Isra University in Hyderabad, Pakistan in the last 5 years. HDV co-infection was diagnosed on the basis of anti-HDV. ALT, HBeAg, HBeAb and HBV DNA PCR quantitative levels were checked in all patients. We divided all patients into two groups based on anti-HDV, and compared their biochemical, serological & virological labs and clinical spectrum. Clinical spectrum of disease included asymptomatic carrier (AC, chronic active hepatitis (CAH, immuno-tolerant phase (IP, and compensated cirrhosis (CC. Results HDV co-infection was found in 169 (35.2%. There were 164 (34.6% HBeAg positive and 316 (65.4% HBeAg negative patients. Mean ALT level was 66 ± 73 IU. 233 (48.5% had raised ALT. HBV DNA level was ≥ 10e5 in 103(21.5% patients. Overall, among HBV/HDV co-infection, 146/169 (86.4% had suppressed HBV DNA PCR as compared to 231/311 (74.3% patients with HBV mono-infection; p-value = 0.002. Among HBeAg negative patients 71/128(55.5% had raised ALT levels among HBV/HDV co-infection as compared to 71/188 (37.8% with HBV mono-infection (p-value = 0.002; levels of HBV DNA were equal in two groups; there were 27/128 (21% patients with CC among HBV/HDV co-infection as compared to 23 (12% in HBV mono-infection (p-value = 0.009; there were less AC (p-value = 0.009 and more CAH (p-value = 0.009 among HBV/HDV co-infection patients. Among HBeAg positive patients, serum ALT, HBV DNA levels and the spectrum of HBV were similar in the two groups. Conclusions HBV/HDV co-infection results in the suppression of HBV DNA. A fair proportion of HBV/HDV co-infected patients with HBe

  3. Superior virologic and treatment outcomes when viral load is measured at 3 months compared to 6 months on antiretroviral therapy.

    Science.gov (United States)

    Kerschberger, Bernhard; Boulle, Andrew M; Kranzer, Katharina; Hilderbrand, Katherine; Schomaker, Michael; Coetzee, David; Goemaere, Eric; Van Cutsem, Gilles

    2015-01-01

    Routine viral load (VL) monitoring is utilized to assess antiretroviral therapy (ART) adherence and virologic failure, and it is currently scaled-up in many resource-constrained settings. The first routine VL is recommended as late as six months after ART initiation for early detection of sub-optimal adherence. We aimed to assess the optimal timing of first VL measurement after initiation of ART. This was a retrospective, cohort analysis of routine monitoring data of adults enrolled at three primary care clinics in Khayelitsha, Cape Town, between January 2002 and March 2009. Primary outcomes were virologic failure and switch to second-line ART comparing patients in whom first VL done was at three months (VL3M) and six months (VL6M) after ART initiation. Adjusted hazard ratios (aHR) were estimated using Cox proportional hazard models. In total, 6264 patients were included for the time to virologic failure and 6269 for the time to switch to second-line ART analysis. Patients in the VL3M group had a 22% risk reduction of virologic failure (aHR 0.78, 95% CI 0.64-0.95; p=0.016) and a 27% risk reduction of switch to second-line ART (aHR 0.73, 95% CI 0.58-0.92; p=0.008) when compared to patients in the VL6M group. For each additional month of delay of the first VL measurement (up to nine months), the risk of virologic failure increased by 9% (aHR 1.09, 95% CI 1.02-1.15; p=0.008) and switch to second-line ART by 13% (aHR 1.13, 95% CI 1.05-1.21; p<0.001). A first VL at three months rather than six months with targeted adherence interventions for patients with high VL may improve long-term virologic suppression and reduce switches to costly second-line ART. ART programmes should consider the first VL measurement at three months after ART initiation.

  4. Factors Affecting Entrepreneurship and Business Sustainability

    Directory of Open Access Journals (Sweden)

    Ana Tur-Porcar

    2018-02-01

    Full Text Available Sustainability is becoming increasingly important for society, and the creation of business ventures is one area where sustainability is critical. We examined the factors affecting actions that are designed to foster business sustainability. These factors are related to the environment, behavior, human relations, and business activity. Based on questionnaire responses from experts, the Analytic Hierarchy Process (AHP method was used to rank sustainable business criteria according to their importance for entrepreneurs starting sustainable businesses. The results indicate that the most important drivers of sustainable entrepreneurship are behavioral factors and business factors. Ethical principles and values, together with competitive intelligence, are crucial for undertaking actions that lead to sustainability.

  5. Comparative therapeutic response to pegylated interferon plus ribavirin versus interferon alpha-2b in chronic hepatitis C patients

    International Nuclear Information System (INIS)

    Ali, S.; Nazir, G.; Khan, S.A.; Fatima, F.; Iram, S.

    2010-01-01

    Background: Hepatitis C is an epidemic worldwide since discovery in 1989. Conventional interferon alpha-2b plus Ribavirin therapy was started in 1998 but over all sustained viral response (SVR) rates are much below the desired rates to eradicate the diseases and stopping its epidemic. This study was conducted to access the therapeutic and cost-effectiveness of long acting pegylated interferon alpha-2b plus Ribavirin therapy verses conventional interferon alpha-2b plus Ribavirin. Methods: This comparative study was done at PAF Hospital Shorkot Cantt from July 2005 to July 2008. One hundred anti-HCV positive patients were selected randomly for the study according to willingness due to cost afford ability of the patients for conventional interferon. Group-A was labelled as pegylated interferon alpha-2b plus Ribavirin group, and Group-B interferon alpha-2b plus Ribavirin group. Both groups were given treatment for 24 weeks. Early virological response (EVR) was accessed at 12 weeks of the treatment. Sustained virological response (SVR) in both the groups was done at 24 week during the treatment and 6 monthly after treatment for 2 years. Initially non-responders and relapsed patients within 2 years of treatment were re-treated for 24 weeks with the same treatment. In both groups non-responders and relapsed patients were labelled as resistant patients. Both groups were followed with same protocol for 2 years. Results: Out of 100 patients included in the study, 34% were females and 66% were males. Group-A patients over all showed 94% SVR as compare to 80% in Group-B in 2 year follow-up. Group-A showed 6% resistant patients as compare to Group-B (20%). Conventional interferons were better tolerated. Higher incidence of side-effects was seen in Group-A. Conclusion: Pegylated interferon plus Ribavirin showed 94% SVR in 2 years. Pegylated interferon plus Ribavirin is the treatment of choice.

  6. Dynamics of Pathological and Virological Findings During Experimental Calpox Virus Infection of Common Marmosets (Callithrix jacchus

    Directory of Open Access Journals (Sweden)

    Anne Schmitt

    2017-11-01

    Full Text Available Experimental intranasal infection of marmosets (Callithrix jacchus with calpox virus results in fatal disease. Route and dose used for viral inoculation of the test animals mimics the natural transmission of smallpox, thus representing a suitable model to study pathogenesis and to evaluate new vaccines against orthopoxvirus infection. However, the pathogenic mechanisms leading to death are still unclear. Therefore, our study aimed at investigating the kinetics of pathological alterations to clarify the pathogenesis in calpox virus infection. Following intranasal inoculation with two different viral doses, common marmosets were sacrificed on days 3, 5, 7, 10 and 12 post inoculation. Collected tissue was screened using histopathology, immunohistochemistry, transmission electron microscopy, and virological assays. Our data suggest that primary replication took place in nasal and bronchial epithelia followed by secondary replication in submandibular lymph nodes and spleen. Parallel to viremia at day 7, virus was detectable in many organs, mainly located in epithelial cells and macrophages, as well as in endothelial cells. Based on the onset of clinical signs, the histological and ultrastructural lesions and the immunohistochemical distribution pattern of the virus, the incubation period was defined to last 11 days, which resembles human smallpox. In conclusion, the data indicate that the calpox model is highly suitable for studying orthopoxvirus-induced disease.

  7. Personal historical chronicle of six decades of basic and applied research in virology, immunology, and vaccinology.

    Science.gov (United States)

    Hilleman, M R

    1999-08-01

    The sciences of vaccinology and of immunology were created just two centuries ago by Jenner's studies of prevention of smallpox by inoculation with cowpox virus. This rudimentary beginning was expanded greatly by the giants of late 19th and early 20th centuries biomedical sciences. The period from 1930 to 1950 was a transitional era with the introduction of chick embryos and minced tissues for propagating viruses and rickettsiae in vitro for vaccines. Modern era vaccinology began about 1950 as a continuum of notable advances made during the 1940s and World War II. Present vaccinology is based largely on breakthroughs in cell culture, bacterial polysaccharide chemistry, molecular biology, and immunology. By invitation, the author, who is a microbe hunter in fact, was asked to chronicle his six decades of pioneering achievements in basic and applied virology, bacteriology, immunology, molecular biology, epidemiology, and cancer, with special reference to the pioneering creation of most of the present day vaccines. Knowledge of the past may guide the present and future. This chronicle will have achieved its legacy if it helps others to understand the why and how of the past that may help to create the substance of the future.

  8. Multiple proviral integration events after virological synapse-mediated HIV-1 spread

    International Nuclear Information System (INIS)

    Russell, Rebecca A.; Martin, Nicola; Mitar, Ivonne; Jones, Emma; Sattentau, Quentin J.

    2013-01-01

    HIV-1 can move directly between T cells via virological synapses (VS). Although aspects of the molecular and cellular mechanisms underlying this mode of spread have been elucidated, the outcomes for infection of the target cell remain incompletely understood. We set out to determine whether HIV-1 transfer via VS results in productive, high-multiplicity HIV-1 infection. We found that HIV-1 cell-to-cell spread resulted in nuclear import of multiple proviruses into target cells as seen by fluorescence in-situ hybridization. Proviral integration into the target cell genome was significantly higher than that seen in a cell-free infection system, and consequent de novo viral DNA and RNA production in the target cell detected by quantitative PCR increased over time. Our data show efficient proviral integration across VS, implying the probability of multiple integration events in target cells that drive productive T cell infection. - Highlights: • Cell-to-cell HIV-1 infection delivers multiple vRNA copies to the target cell. • Cell-to-cell infection results in productive infection of the target cell. • Cell-to-cell transmission is more efficient than cell-free HIV-1 infection. • Suggests a mechanism for recombination in cells infected with multiple viral genomes

  9. Type A viral hepatitis: A summary and update on the molecular virology, epidemiology, pathogenesis and prevention.

    Science.gov (United States)

    Lemon, Stanley M; Ott, Jördis J; Van Damme, Pierre; Shouval, Daniel

    2017-09-05

    Although epidemic jaundice was well known to physicians of antiquity, it is only in recent years that medical science has begun to unravel the origins of hepatitis A virus (HAV) and the unique pathobiology underlying acute hepatitis A in humans. Improvements in sanitation and the successful development of highly efficacious vaccines have markedly reduced the worldwide prevalence and incidence of this enterically-transmitted infection over the past quarter century, yet the virus persists in vulnerable populations and remains a common cause of food-borne disease outbreaks in economically-advantaged societies. Reductions in the prevalence of HAV have led to increases in the median age at which infection occurs, often resulting in more severe disease in affected persons and paradoxical increases in disease burden in some developing nations. Here, we summarize recent advances in the molecular virology of HAV, an atypical member of the Picornaviridae family, survey what is known of the pathogenesis of hepatitis A in humans and the host-pathogen interactions that typify the infection, and review medical and public health aspects of immunisation and disease prevention. Copyright © 2017. Published by Elsevier B.V.

  10. Epidemiological and virological studies into the poliomyelitis in Valencia (1959-1969

    Directory of Open Access Journals (Sweden)

    Báguena Cervellera, María José

    2009-06-01

    Full Text Available Studies into the polio virus began in Valencia in 1959 with the work undertaken by the microbiologist Vicente Sanchis-Bayarri Vaillant. After his education at the Rochester University and at the Pasteur Institute, Sanchis-Bayarri Vaillant established a laboratory of cell cultures at the Faculty of Medicine in Valencia, where he developed a new diagnostic technique for the poliomyelitis virus. In addition, epidemiological studies were carried out both prior to and post the 1963 vaccination campaign, which proved that Sabin’s oral vaccine was both effective and safe for use.

    Los estudios sobre el virus de la polio comenzaron en Valencia en 1959 de la mano del microbiólogo Vicente Sanchis-Bayarri Vaillant. Tras su formación en virología en la Universidad de Rochester y en el Instituto Pasteur, puso en marcha un laboratorio de cultivos celulares en la Facultad de Medicina de Valencia, en donde desarrolló una técnica diagnóstica nueva para el virus de la polio. Por otra parte, se llevaron a cabo estudios epidemiológicos antes y después de la campaña de vacunación de 1963, que demostraron la eficacia de la vacuna oral de Sabin y su inocuidad.

  11. Metagenomic approaches for direct and cell culture evaluation of the virological quality of wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Aw, Tiong Gim; Howe, Adina; Rose, Joan B.

    2014-12-01

    Genomic-based molecular techniques are emerging as powerful tools that allow a comprehensive characterization of water and wastewater microbiomes. Most recently, next generation sequencing (NGS) technologies which produce large amounts of sequence data are beginning to impact the field of environmental virology. In this study, NGS and bioinformatics have been employed for the direct detection and characterization of viruses in wastewater and of viruses isolated after cell culture. Viral particles were concentrated and purified from sewage samples by polyethylene glycol precipitation. Viral nucleic acid was extracted and randomly amplified prior to sequencing using Illumina technology, yielding a total of 18 million sequence reads. Most of the viral sequences detected could not be characterized, indicating the great viral diversity that is yet to be discovered. This sewage virome was dominated by bacteriophages and contained sequences related to known human pathogenic viruses such as adenoviruses (species B, C and F), polyomaviruses JC and BK and enteroviruses (type B). An array of other animal viruses was also found, suggesting unknown zoonotic viruses. This study demonstrated the feasibility of metagenomic approaches to characterize viruses in complex environmental water samples.

  12. HIV-1 DNA predicts disease progression and post-treatment virological control

    Science.gov (United States)

    Williams, James P; Hurst, Jacob; Stöhr, Wolfgang; Robinson, Nicola; Brown, Helen; Fisher, Martin; Kinloch, Sabine; Cooper, David; Schechter, Mauro; Tambussi, Giuseppe; Fidler, Sarah; Carrington, Mary; Babiker, Abdel; Weber, Jonathan

    2014-01-01

    In HIV-1 infection, a population of latently infected cells facilitates viral persistence despite antiretroviral therapy (ART). With the aim of identifying individuals in whom ART might induce a period of viraemic control on stopping therapy, we hypothesised that quantification of the pool of latently infected cells in primary HIV-1 infection (PHI) would predict clinical progression and viral replication following ART. We measured HIV-1 DNA in a highly characterised randomised population of individuals with PHI. We explored associations between HIV-1 DNA and immunological and virological markers of clinical progression, including viral rebound in those interrupting therapy. In multivariable analyses, HIV-1 DNA was more predictive of disease progression than plasma viral load and, at treatment interruption, predicted time to plasma virus rebound. HIV-1 DNA may help identify individuals who could safely interrupt ART in future HIV-1 eradication trials. Clinical trial registration: ISRCTN76742797 and EudraCT2004-000446-20 DOI: http://dx.doi.org/10.7554/eLife.03821.001 PMID:25217531

  13. Emergent pedagogy of sustainability

    DEFF Research Database (Denmark)

    Husted, Mia; Frøkjær, Thorleif

    of societal life. Most often, the experimental activities tends to favor learning about responsible behavior, but the intension was formation of critical curiosity. While the difficulties to find pedagogical forms to present sustainability frustrate the participating pedagogues, the teachers teaching student.......S. Nielsen, N. Sriskandarajah, & E. Gunnarsson (eds) (2016). Commons, Sustainability, Democratization: Action Research and the Basic Renewal of Society. New York. RoutledgeLewin, K. (1948). Resolving Social Conflicts. New York, Harper and RowSachs, W. (1999). Planet dialectics. Explorations in Environment...

  14. Managing Sustainable Information Systems Development

    DEFF Research Database (Denmark)

    Kautz, Karlheinz

    2013-01-01

    Sustainable information systems development (ISD) in the context of this paper is not about products that support sustainability at large with its environmental, economic and social dimensions and little about the development of sustainable products, which are both without doubt important topics....... This paper is about a prerequisite for such products, namely, a sustainable ISD process, a process which exhibits reasonable and responsible stewardship and utilisation of the existing resources for ISD—people and information in the context of scope, time/schedule, budget/cost, quality and risk....

  15. The World of Microbes 2002: scientific advances and challenges--impressions and highlights from the 12th Congress of Virology.

    Science.gov (United States)

    Becker, Yechiel

    2002-12-01

    Thousands of scientists participated in the World of Microbes Congress, which was organized by the International Union of the Microbiological Societies (IUMS) and took place in the Palais de Congres in Paris, France from 27 July to 1 August 2002. The attendees were members of the IUMS divisions of Bacteriology and Applied Microbiology, Mycology, and Virology. In addition to the symposia that were organized by each division, joined plenary symposia were held, which encompassed subjects of common interest to all microbiologists. The activities at the 12th Congress of Virology's plenary lectures, symposia, and poster sessions were organized to accommodate the presentation of over 1500 presentations. These brief comments are aimed to provide a sample of only a few presentations that dealt with subjects of emerging and re-emerging virus diseases, which are of general interest.

  16. Roundtabling Sustainability

    DEFF Research Database (Denmark)

    Ponte, Stefano

    2014-01-01

    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...... and procedures to meet ‘good practice’ in standard setting and management. This is opening space for competing initiatives that are less democratic, quicker, and more aligned with industry interests to establish substantial presence in the market for sustainability certifications. These tend to more easily...

  17. HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact.

    Science.gov (United States)

    Martin, N K; Foster, G R; Vilar, J; Ryder, S; Cramp, M E; Gordon, F; Dillon, J F; Craine, N; Busse, H; Clements, A; Hutchinson, S J; Ustianowski, A; Ramsay, M; Goldberg, D J; Irving, W; Hope, V; De Angelis, D; Lyons, M; Vickerman, P; Hickman, M

    2015-04-01

    Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37-48% HCV chronic prevalence among PWID), East London (37-48%), Manchester (48-56%), Nottingham (37-44%), Plymouth (30-37%), Dundee (20-27%) and North Wales (27-33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33-57%] and 61% genotypes 2/3 [95%CI 47-76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence. © 2014 The Authors Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

  18. Metabolic Adaptation, a Specialized Leaf Organ Structure and Vascular Responses to Diurnal N2 Fixation by Nostoc azollae Sustain the Astonishing Productivity of Azolla Ferns without Nitrogen Fertilizer.

    Science.gov (United States)

    Brouwer, Paul; Bräutigam, Andrea; Buijs, Valerie A; Tazelaar, Anne O E; van der Werf, Adrie; Schlüter, Urte; Reichart, Gert-Jan; Bolger, Anthony; Usadel, Björn; Weber, Andreas P M; Schluepmann, Henriette

    2017-01-01

    Sustainable agriculture demands reduced input of man-made nitrogen (N) fertilizer, yet N 2 fixation limits the productivity of crops with heterotrophic diazotrophic bacterial symbionts. We investigated floating ferns from the genus Azolla that host phototrophic diazotrophic Nostoc azollae in leaf pockets and belong to the fastest growing plants. Experimental production reported here demonstrated N-fertilizer independent production of nitrogen-rich biomass with an annual yield potential per ha of 1200 kg -1 N fixed and 35 t dry biomass. 15 N 2 fixation peaked at noon, reaching 0.4 mg N g -1 dry weight h -1 . Azolla ferns therefore merit consideration as protein crops in spite of the fact that little is known about the fern's physiology to enable domestication. To gain an understanding of their nitrogen physiology, analyses of fern diel transcript profiles under differing nitrogen fertilizer regimes were combined with microscopic observations. Results established that the ferns adapted to the phototrophic N 2 -fixing symbionts N. azollae by (1) adjusting metabolically to nightly absence of N supply using responses ancestral to ferns and seed plants; (2) developing a specialized xylem-rich vasculature surrounding the leaf-pocket organ; (3) responding to N-supply by controlling transcripts of genes mediating nutrient transport, allocation and vasculature development. Unlike other non-seed plants, the Azolla fern clock is shown to contain both the morning and evening loops; the evening loop is known to control rhythmic gene expression in the vasculature of seed plants and therefore may have evolved along with the vasculature in the ancestor of ferns and seed plants.

  19. Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B

    Directory of Open Access Journals (Sweden)

    Han Ah Lee

    2016-09-01

    Full Text Available Background/Aims Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV off-treatment response. Methods This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031. When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5, while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11 and >3 log10 IU/mL (n=28, respectively. Conclusion The off-treatment HBsAg level is closely related to clinical relapse after treatment

  20. Factors Influencing Antiretroviral Adherence and Virological Outcomes in People Living with HIV in the Highlands of Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Janet Gare

    Full Text Available Adherence to antiretroviral therapy (ART is paramount for virological suppression and positive treatment outcomes. ART has been rapidly scaled up in Papua New Guinea (PNG in recent years, however clinical monitoring of HIV+ individuals on ART is limited. A cross-sectional study was conducted at two major sexual health clinics in high HIV prevalence provinces in the Highlands Region of PNG to assess ART adherence, factors affecting adherence and the relationship between ART adherence and virological outcomes. Ninety-five HIV+ individuals were recruited and administered a questionnaire to gather demographic and ART adherence information whilst clinical data and pill counts were extracted from patient charts and blood was collected for viral load testing. Bivariate analysis was performed to identify independent predictors of ART adherence. Fourteen percent (n = 12 of participants showed evidence of virological failure. Although the majority of participants self-reported excellent ART adherence in the last seven days (78.9%, 75/91, pill count measurements indicated only 40% (34/84 with >95% adherence in the last month. Taking other medications while on ART (p = 0.01 and taking ART for ≥1 year (p = 0.037 were positively associated with adherence by self-report and pill count, respectively. Participants who had never heard of drug resistance were more likely to show virological failure (p = 0.033. Misconception on routes of HIV transmission still persists in the studied population. These findings indicate that non-adherence to ART is high in this region of PNG and continued education and strategies to improve adherence are required to ensure the efficacy of ART and prevent HIV drug resistance.