Malaria with other antimalarials (known as artemisinin-combination therapy, or ACT), which decreases resistance to any single drug component. These additional antimalarials include: amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine. Another recommended combination is dihydroartemisinin and piperaquine. ACT is about 90% effective when used to treat uncomplicated malaria. To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters). In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia. Infection with "P. vivax", "P. ovale" or "P. malariae" usually do not require
Hard water the effects of hard water on the surfactants. For this reason, water softening is often unnecessary. Where softening is practised, it is often recommended to soften only the water sent to domestic hot water systems so as to prevent or delay inefficiencies and damage due to scale formation in water heaters. A common method for water softening involves the use of ion exchange resins, which replace ions like Ca by twice the number of monocations such as sodium or potassium ions. Washing soda (sodium carbonate - NaCO) is easily obtained and has long been used as a water softener for