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
Tonic (music) so on. In western European tonal music (key-based music) of the 18th and 19th centuries, the tonic center was the most important of all the different tone centers which a composer used in a piece of music, with most pieces beginning and ending on the tonic, usually modulating to the dominant (the fifth above the tonic, or the fourth note down from the tonic) in between. Two parallel keys have the same tonic. For example, in both C major and C minor, the tonic is C. However, relative keys (two different scales that share a key signature) have different tonics.