ESCMID* guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients.

This part of the EFISG guidelines focuses on non-neutropenic adult patients. Only a few of the numerous recommendations can be summarized in the abstract. Prophylactic usage of fluconazole is supported in patients with recent abdominal surgery and recurrent gastrointestinal perforations or anastomotic leakages. Candida isolation from respiratory secretions alone should never prompt treatment. For the targeted initial treatment of candidaemia, echinocandins are strongly recommended while liposomal amphotericin B and voriconazole are supported with moderate, and fluconazole with marginal strength. Treatment duration for candidaemia should be a minimum of 14 days after the end of candidaemia, which can be determined by one blood culture per day until negativity. Switching to oral treatment after 10 days of intravenous therapy has been safe in stable patients with susceptible Candida species. In candidaemia, removal of indwelling catheters is strongly recommended. If catheters cannot be removed, lipid-based amphotericin B or echinocandins should be preferred over azoles. Transoesophageal echocardiography and fundoscopy should be performed to detect organ involvement. Native valve endocarditis requires surgery within a week, while in prosthetic valve endocarditis, earlier surgery may be beneficial. The antifungal regimen of choice is liposomal amphotericin B +/- flucytosine. In ocular candidiasis, liposomal amphotericin B +/- flucytosine is recommended when the susceptibility of the isolate is unknown, and in susceptible isolates, fluconazole and voriconazole are alternatives. Amphotericin B deoxycholate is not recommended for any indication due to severe side effects.

Small-scale non-industrial private forest ownership in the United States : rationale and implications for forest management

Abstract

Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants.

Perioperative management of patients treated with the non-vitamin K antagonist oral anticoagulants is an ongoing challenge. Due to the lack of good clinical studies involving adequate monitoring and reversal therapies, management requires knowledge and understanding of pharmacokinetics, renal function, drug interactions, and evaluation of the surgical bleeding risk. Consideration of the benefit of reversal of anticoagulation is important and, for some low risk bleeding procedures, it may be in the patient's interest to continue anticoagulation. In case of major intra-operative bleeding in patients likely to have therapeutic or supra-therapeutic levels of anticoagulation, specific reversal agents/antidotes would be of value but are currently lacking. As a consequence, a multimodal approach should be taken which includes the administration of 25 to 50 U/kg 4-factor prothrombin complex concentrates or 30 to 50 U/kg activated prothrombin complex concentrate (FEIBA®) in some life-threatening situations. Finally, further studies are needed to clarify the ideal therapeutic intervention.

Expanding the Customer Relationship Management scope to the non-profit organizations : an analysis focused on the e-university domain

Peer-reviewed

Application of the scrum framework in non-software project management

Scrum is an agile project management approach that has been widely practiced in the software development projects. It has proven to increase quality, productivity, customer satisfaction, transparency and team morale among other benefits from its implementation. The concept of scrum is based on the concepts of incremental innovation strategies, lean manufacturing, kaizen, iterative development and so on and is usually contrasted with the linear development models such as the waterfall method in the software industry. The traditional approaches to project management such as the waterfall method imply intensive upfront planning and approval of the entire project. These sort of approaches work well in the well-defined stable environments where all the specifications of the project are known in the beginning. However, in the uncertain environments when a project requires continuous development and incorporation of new requirements, they do not tend to work well. The scrum framework was inspiraed by Nonaka’s article about new product developement and was later adopted by software development practitioners. This research explores conditions for and benefits of the application of scrum framework beyond software development projects. There are currently a few case studies on the scrum implementation in non-software projects, but there is a noticeable trend of it in the scrum practitioners’ community. The research is based on the real-life context multiple case study analysis of three different non-software projects. The results of the research showed that in order to succeed within scrum projects need to satisfy certain conditions – necessary and sufficient. Among them the key factors are uncertainty of the project environment, not well defined outcomes, commitment of the scrum teams and management support. The top advantages of scrum implementation identified in the present research include improved transparency, accountability, team morale, communications, cooperation and collaboration. Further researches are advised to be carried out in order to validate these findings on a larger sample and to focus on more specific areas of scrum project management implementation.

Receivable Management in Non Banking Finance Companies with Special Reference to Vehicle Financing

In the absence of entry barrier or regulatory restrictions, Non Banking Financial Companies frantically grew and accessed the public deposit without any regulatory control. The deposit of NBFCs grew from Rs. 41.9 crore in 1971 to 53116.0 crore in 1997. This growth was the result of a combined effect of increase in the number of NBFCs and increase in the amount of deposits. The deposits amazed as above was invested in various assets especially that in motor vehicles by these asset financing NBFCs. Various tactics were adopted by these NBFCs and their agents for recovering the receivable outstanding from such assets. Both central government and RBI were concerned about the protection of depositors‘ interest and various committees were set up to frame a comprehensive regulation for the functioning of these NBFCs.

Strategic management of non-point source pollution from sewage sludge

In the UK, the recycling of sewage sludge to land is expected to double by 2006 but the security of this route is threatened by environmental concerns and health scares. Strategic investment is needed to ensure sustainable and secure sludge recycling outlets. At present, the security of this landbank for sludge recycling is determined by legislation relating to nutrient rather than potentially toxic elements (PTEs) applications to land - especially the environmental risk linked to soil phosphorus (P) saturation. We believe that not all land has an equal risk of contributing nutrients derived from applications to land to receiving waters. We are currently investigating whether it is possible to minimise nutrient loss by applying sludge to land outside Critical Source Areas (CSAs) regardless of soil P Index status. Research is underway to develop a predictive and spatially-sensitive, semi-distributed model of critical thresholds for sludge application that goes beyond traditional 'end-of-pipe" or "edge-of-field" modelling, to include hydrological flow paths and delivery mechanisms to receiving waters from non-point sources at the catchment scale.

The rodent species of the Ifugao Rice Terraces, Philippines - Target or non-target species for management?

We investigated the species diversity and habitat use of rodents in the Ifugao Rice Terraces (IRT), Luzon, Philippines, as a first step in their assessment either as pest species of rice or as potential non-target species of rodent control practice. Trapping was carried out in caneland and forest habitats adjacent to rice cropland using trap lines of 10 - 15 cage-traps. Four trapping rounds, each consisting of 5 nights trapping, were replicated at two sites during the months of May and June. A diverse rodent fauna was recorded, including the non-native pest species, Rattus tanezumi, and the native species, Rattus everetti and Chrotomys mindorensis. Results from trapping and spool-and-line tracking suggested that these native species do not contribute to rice damage and that several may actually be beneficial in the ricefield ecosystem as vermivores that feed on invertebrate pests. Control should therefore be directed at the pest species, R. tanezumi, minimising non-target effects on the non-pest rodent species.

Combining physical, cultural and biological methods: prospects for integrated non-chemical weed management strategies

Physical, cultural and biological methods for weed control have developed largely independently and are often concerned with weed control in different systems: physical and cultural control in annual crops and biocontrol in extensive grasslands. We discuss the strengths and limitations of four physical and cultural methods for weed control: mechanical, thermal, cutting, and intercropping, and the advantages and disadvantages of combining biological control with them. These physical and cultural control methods may increase soil nitrogen levels and alter microclimate at soil level; this may be of benefit to biocontrol agents, although physical disturbance to the soil and plant damage may be detrimental. Some weeds escape control by these methods; we suggest that these weeds may be controlled by biocontrol agents. It will be easiest to combine biological control with. re and cutting in grasslands; within arable systems it would be most promising to combine biological control (especially using seed predators and foliar pathogens) with cover-cropping, and mechanical weeding combined with foliar bacterial and possibly foliar fungal pathogens. We stress the need to consider the timing of application of combined control methods in order to cause least damage to the biocontrol agent, along with maximum damage to the weed and to consider the wider implications of these different weed control methods.

Design and management optimization of trickle irrigation systems using non-linear programming

A non-linear model is presented which optimizes the lay-out, as well as the design and management of trickle irrigation systems, to achieve maximum net benefit. The model consists of an objective function that maximizes profit at the farm level, subject to appropriate geometric and hydraulic constraints. It can be applied to rectangular shaped fields, with uniform or zero slope. The software used is the Gams-Minos package. The basic inputs are the crop-water-production function, the cost function and cost of system components, and design variables. The main outputs are the annual net benefit and pipe diameters and lengths. To illustrate the capability of the model, a sensitivity analysis of the annual net benefit for a citrus field is evaluated with respect to irrigated area, ground slope, micro-sprinkler discharge and shape of the field. The sensitivity analysis suggests that the greatest benefit is obtained with the smallest microsprinkler discharge, the greatest area, a square field and zero ground slope. The costs of the investment and energy are the components of the objective function that had the greatest effect in the 120 situations evaluated. (C) 1996 Academic Press Limited

Clinical applications of non-culture based methods for the diagnosis and management of opportunistic and endemic mycoses

Nonculture based methods for the detection of infections caused by fungal pathogens are becoming more important tools in the management of infected patients. Detection of fungal antigens and DNA appear to be the most promising in this respect for both opportunistic and endemic mycoses. In this article we present an overview of the most recent developments in nonculture based methods and examine their value in clinical practice.

A logical approach to the management of object identifiers in non-conventional database management systems

Non-conventional database management systems are used to achieve a better performance when dealing with complex data. One fundamental concept of these systems is object identity (OID), because each object in the database has a unique identifier that is used to access and reference it in relationships to other objects. Two approaches can be used for the implementation of OIDs: physical or logical OIDs. In order to manage complex data, was proposed the Multimedia Data Manager Kernel (NuGeM) that uses a logical technique, named Indirect Mapping. This paper proposes an improvement to the technique used by NuGeM, whose original contribution is management of OIDs with a fewer number of disc accesses and less processing, thus reducing management time from the pages and eliminating the problem with exhaustion of OIDs. Also, the technique presented here can be applied to others OODBMSs. © 2011 IEEE.