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Major Strategy (major + strategy)
Selected AbstractsPerspective on Bifurcation PCIJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2009SHAO-LIANG CHEN M.D. Coronary bifurcation lesion is a complex lesion with suboptimal angiographic and clinical results. There has been no satisfactory classification of the lesion that can guide selection of strategies and predict short- and long-term outcomes. The difference between left main (LM) bifurcation lesions and non-LM bifurcation is striking. So many stenting strategies have been proposed and tried in trials. They include the V, T, Y, one-stent, two-stent, crush, mini-crush, DK, and SKS techniques. However, because these techniques are time and labor intensive, dedicated bifurcated stents have been invented and trialed in humans. This review presents a historical perspective of interventions in bifurcated lesions, with the strengths and weaknesses of the major strategies and of the new dedicated stents. [source] Economic analysis of strategies in the prevention of non-steroidal anti-inflammatory drug-induced complications in the gastrointestinal tractALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2004A. Lanas Summary Background :,It is unclear what the best therapeutic approach is in patients who require non-steroidal anti-inflammatory drugs. In clinical practice, choice of prescriptions are often based on drug costs. Aim :,To evaluate costs per upper gastrointestinal bleeding avoided with different prevention strategies. Methods :,Two major strategies have been considered (coxibs vs. non-steroidal anti-inflammatory drugs plus generic/brand gastroprotective agent). The number of patients needed to treat to prevent a bleeding event, the cost of the drug and duration of treatment were used to estimate costs. Results :,Based on hospitalization costs of a bleeding event, no therapeutic strategy is cost-effective in patients without risk factors. All strategies (including omeprazole + coxib) are cost-effective in patients with bleeding ulcer history. With other risk factors, all strategies are cost-effective but prevention of events is twice as expensive in patients <75 years of age. No strategy shows superiority unless the cheapest generics are prescribed or a 50% reduction in the incidence of lower gastrointestinal complications with coxibs is confirmed. Conclusions :,Current prevention strategies to reduce serious non-steroidal anti-inflammatory drug-associated gastrointestinal events are only cost-effective in patients with risk factors. No strategy shows superiority, but coxib strategy would be more cost-effective if it were associated with a reduction of events of the lower gastrointestinal tract. [source] Enhancing Public Accountability for Developing Countries: Major Constraints and StrategiesAUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 2009Pan Suk Kim Many Asian countries are attempting to promote public accountability as a part of public-sector reform, but their situation remains unsatisfactory compared to advanced countries. Except for a few, many Asian developing countries are still struggling with political and socioeconomic weaknesses. Indeed, the nature of public sector reform in many Asian developing countries differs substantially from that of advanced countries. Furthermore, the concept of accountability is not interpreted equally throughout the world. Accordingly, the purpose of this article is to review the major constraints to enhancing public accountability in Asian developing countries and to discuss major strategies to promote such accountability from the perspective of developing countries. This article first reviews the concept of accountability and its development, followed by discussion of constraints in enhancing public accountability and public sector reform, key measures to enhance public accountability, and implications and conclusions. [source] How many cases of Type 2 diabetes mellitus are due to being overweight in middle age?DIABETIC MEDICINE, Issue 1 2007Evidence from the Midspan prospective cohort studies using mention of diabetes mellitus on hospital discharge or death records Abstract Aims To relate body mass index (BMI) in middle age to development of diabetes mellitus. Methods Participants were 6927 men and 8227 women from the Renfrew/Paisley general population study and 3993 men from the Collaborative occupational study. They were aged 45,64 years and did not have reported diabetes mellitus. Cases who developed diabetes mellitus, identified from acute hospital discharge data and from death certificates in the period from screening in 1970,1976 to 31 March 2004, were related to BMI at screening. Results Of Renfrew/Paisley study men 5.4%, 4.8% of women and 5% of Collaborative study men developed diabetes mellitus. Odds ratios for diabetes mellitus were higher in the overweight group (BMI 25 to < 30 kg/m2) than in the normal weight group (BMI 18.5 to < 25 kg/m2) and highest in the obese group (BMI , 30 kg/m2). Compared with the normal weight group, age-adjusted odds ratios for overweight and obese Renfrew/Paisley men were 2.73 [95% confidence interval (CI) 2.05, 3.64] and 7.26 (95% CI 5.26, 10.04), respectively. Further subdividing the normal, overweight and obese groups showed increasing odds ratios with increasing BMI, even at the higher normal level. Assuming a causal relation, around 60% of cases of diabetes could have been prevented if everyone had been of normal weight. Conclusions Overweight and obesity account for a major proportion of diabetes mellitus, as identified from hospital discharge and death records. With recent increases in the prevalence of overweight, the burden of disease related to diabetes mellitus is likely to increase markedly. Primordial prevention of obesity would be a major strategy for reducing the incidence of diabetes mellitus in populations. [source] Ambient pH controls the expression of endopolygalacturonase genes in the necrotrophic fungus Sclerotinia sclerotiorumFEMS MICROBIOLOGY LETTERS, Issue 2 2003Pascale Cotton Abstract In the necrotrophic fungus Sclerotinia sclerotiorum, secretion of polygalacturonases (PGs) and decrease of the environmental pH via oxalic acid production are considered as the main pathogenicity determinants. In order to evaluate the relationship between these two aspects of the infection process, we analyzed the expression of the endoPG-encoding genes pg1,3. Transcription of pg1,3 was not carbon regulated but was strictly controlled by pH and highly favored in a narrow range of acidic pH. During plant infection, a pH gradient was established in relation to oxalic acid secretion. Transcripts of pg1,3 were localized to the zone of colonization of healthy tissues while transcripts of genes encoding other lytic enzymes were restricted to the more acidic zones of the infected tissues. Our results show that progressive acidification of the ambient medium by the fungus is a major strategy for the sequential expression of pathogenicity factors. [source] Effect of plantation design on stem-infecting form of rust in willow biomass coppiceFOREST PATHOLOGY, Issue 2 2002T. HUNTER Planting of genotype mixtures is a major strategy for the non-chemical control of willow rust in short-rotation coppice willows grown for biomass. In 1997 and 1998, the relative severity and spatiotemporal distribution of stem canker damage by Melampsora spp. on Salix viminalis `Bowles Hybrid' in a field trial containing monocultures and two design mixtures (random or regular) of three or five genotypes were assessed. Sphaerellopsis filum, a hyperparasite of Melampsora spp. was detected in all plots during the summer (1998) between the time of the two canker assessments. The percentage of rust pustules with this hyperparasite was initially greater in monoculture plantings than in mixtures in June, but by July, more than 92% of pustules were parasitized, irrespective of plantation design. The stem rust assessments showed that, in general, there were fewer cankers per stool in plots containing mixtures of willow genotypes compared with monoculture plantings. The distribution of rust cankers was different between monocultures and willow mixture designs, with differences between years for monocultures. Effet du type de plantation sur l'infection de la tige par la rouille, dans un taillis de saule Le mélange de clones constitue une stratégie majeure pour controler non chimiquement la rouille du saule dans les taillis à courte rotation en vue de la production de biomasse. En 1997 et 1998, on a évalué la gravité et la répartition spatio-temporelle du chancre de tige provoqué par Melampsora spp. sur Salix viminalis `Bowles Hybrid' dans un essai au champ comprenant des parcelles monoclonales ou deux types de mélange de 3 ou 5 clones (régulier ou aléatoire). Sphaerellopsis filum, un hyperparasite de Melampsora spp. a été détecté dans toutes les parcelles pendant l'été (1998) entre les deux dates d'évaluation du chancre. En juin, le pourcentage initial de pustules de rouille infectées par l'hyperparasite était plus élevé dans les parcelles monoclonales que dans les mélanges; en juillet, plus de 92% des pustules étaient parasitées, quel que soit le type de parcelles. L'évaluation de la rouille de tige a montré qu'en général il y avait moins de chancres par pied-mère dans les parcelles polyclonales que dans les parcelles monoclonales. La répartition des chancres de rouille était différente entre les parcelles mono et polyclonales; des différences existaient aussi entre les années dans les parcelles monoclonales. Der Einfluss des Pflanzschemas auf die Infektion mit Stammrost in Weidenplantagen Sortenmischung ist eine der besten Strategien zur biologischen Bekämpfung des Weidenrosts in Weiden-Energieholz-Plantagen mit kurzer Umtriebszeit. Mischkulturen mit drei oder fünf Genotypen, die nach einem zufälligen oder regelmässigen Muster angelegt wurden, sowie Monokulturen von Salix viminalis `Bowles Hybrid' wurden 1997 and 1998 auf das relative Schadensausmass und die räumlich-zeitliche Verteilung durch von Melampsora spp. verursachten Krebsen in Feldversuchen verglichen. Sphaerellopsis filum, ein Hyperparasit von Melampsora spp., wurde im Sommer 1998 in der Periode zwischen den beiden Erhebungsterminen in allen Versuchsflächen nachgewiesen. Im Juni war der Prozentsatz von Rostpusteln mit Hyperparasitenbefall in den Monokulturen höher als in den Flächen mit mehreren Genotypen, aber ab Juli waren unabhängig von der Kulturform > 92% der Pusteln parasitiert. Die Erhebungen zeigten, dass in Mischkulturen im Vergleich zu den Monokulturen im allgemeinen weniger Krebse pro Stock beobachtet wurden. Die Verteilung der Krebse in Mono- und Mischkulturen waren verschieden. Zudem wurden für die Monokulturen Unterschiede zwischen den beiden Jahren festgestellt. [source] Pepino mosaic virus: a successful pathogen that rapidly evolved from emerging to endemic in tomato cropsMOLECULAR PLANT PATHOLOGY, Issue 2 2010INGE M. HANSSEN SUMMARY Taxonomy:Pepino mosaic virus (PepMV) belongs to the Potexvirus genus of the Flexiviridae family. Physical properties: PepMV virions are nonenveloped flexuous rods that contain a monopartite, positive-sense, single-stranded RNA genome of 6.4 kb with a 3, poly-A tail. The genome contains five major open reading frames (ORFs) encoding a 164-kDa RNA-dependent RNA polymerase (RdRp), three triple gene block proteins of 26, 14 and 9 kDa, and a 25-kDa coat protein. Genome diversity: Four PepMV genotypes, with an intergenotype RNA sequence identity ranging from 78% to 95%, can be distinguished: the original Peruvian genotype (LP); the European (tomato) genotype (EU); the American genotype US1; and the Chilean genotype CH2. Transmission: PepMV is very efficiently transmitted mechanically, and a low seed transmission rate has been demonstrated. In addition, bumblebees have been associated with viral transmission. Host range: Similar to other Potexviruses, PepMV has a rather narrow host range that is thought to be largely restricted to species of the Solanaceae family. After originally being isolated from pepino (Solanum muricatum), PepMV has been identified in natural infections of the wild tomato species S. chilense, S. chmielewskii, S. parviflorum and S. peruvianum. PepMV is causing significant problems in the cultivation of the glasshouse tomato Solanum lycopersicum, and has been identified in weeds belonging to various plant families in the vicinity of tomato glasshouses. Symptomatology: PepMV symptoms can be very diverse. Fruit marbling is the most typical and economically devastating symptom. In addition, fruit discoloration, open fruit, nettle-heads, leaf blistering or bubbling, leaf chlorosis and yellow angular leaf spots, leaf mosaic and leaf or stem necrosis have been associated with PepMV. The severity of PepMV symptoms is thought to be dependent on environmental conditions, as well as on the properties of the viral isolate. Minor nucleotide sequence differences between isolates from the same genotype have been shown to lead to enhanced aggressiveness and symptomatology. Control: Prevention of infection through strict hygiene measures is currently the major strategy for the control of PepMV in tomato production. Cross-protection can be effective, but only under well-defined and well-controlled conditions, and the effectiveness depends strongly on the PepMV genotype. [source] Comparison of dose responses and resistance ratios in four populations of the rice stem borer, Chilo suppressalis (Lepidoptera: Pyralidae), to 20 insecticidesPEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 3 2008Yue Ping He Abstract BACKGROUND: Chemical control is a major strategy for suppressing the rice stem borer, Chilo suppressalis (Walker). Owing to their high toxicity and increasing resistance development in the target insect, many insecticides will be phased out entirely in 2007 in China. Alternatives with relatively low toxicity are urgently needed to replace traditional chemicals for rice stem borer control. In this study, the authors examined four field populations of C. suppressalis for their toxicological responses to more than 20 insecticides, including a few low-toxicity organophosphates and many novel pesticides. Interpopulation resistance levels to 12 conventional insecticides were also compared. RESULTS: Based on LD50 values, the rice stem borer was most sensitive to avermectins and fipronil (LD50 < 1 ng larva,1). The stem borers exhibited the least sensitivity to endosulfan (LD50 > 100 ng larva,1) and monosultap (LD50 > 1000 ng larva,1). Insect growth regulators and chitin synthase inhibitors showed great efficacy against C. suppressalis, especially against populations that had developed resistance to conventional insecticides. Four field populations showed variable tolerance levels to many insecticides. LYG05 was the most susceptible population, only with a low level of resistance to monosultap (RR = 6.6). NC05 and GL05 populations exhibited intermediate tolerance levels with RR values up to 20.4 and 52.8 respectively. RA05 was the most resistant population to many insecticides, with resistance ratios up to 76.2. CONCLUSION: The results from this study provide valuable information for selection and adoption of new alternative insecticides and for resistance management of the rice stem borer. Copyright © 2008 Society of Chemical Industry [source] Treatment of classic Kaposi's sarcoma-associated lymphedema with elastic stockingsTHE JOURNAL OF DERMATOLOGY, Issue 7 2006Lucia BRAMBILLA ABSTRACT Lymphedema of the lower extremities is a frequent complication of Kaposi's sarcoma (KS). Compressive therapy is the basis of treatment for lymphatic disorders, but to the authors' knowledge, there are no controlled trials to evaluate its effectiveness in KS-related lymphedema. Sixty-five patients with classic KS-associated lymphedema limited to below the knee were studied. Fifty patients received below-knee elastic stockings, whereas the remaining 15 did not use any compressive device. Among treated patients, 60% (30/50) experienced a limb volume reduction, while 40% (20/50) had an increase of limb volume. In contrast, all patients (15/15) of the untreated group had an increase of limb volume. No correlation between lymphedema reduction and systemic or local chemotherapy was observed, supporting compressive therapy as the major strategy for the treatment of this condition. Our results suggest that elastic stockings may be important tools for the management of lymphedema associated to classic KS. [source] | |||||||||||||