122 resultados para Failure to Yield Violation.


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The first part of the paper explores some of the reasons why contemporary border studies understate the full significance of state borders and their global primacy. It is argued that this failing is rooted in a much wider lack of historical reflexivity-a reluctance to acknowledge the historical positioning (the 'where and when') of contemporary border studies themselves. This reluctance encourages a form of pseudohistory, or 'epochal thinking', which disfigures perspective on the present. Among the consequences are (a) exaggerated claims of the novelty of contemporary border change, propped up by poorly substantiated benchmarks in the past; (b) an incapacity to recognise the 'past in the present' as in the various historical deposits of state formation processes; and (c) a failure to recognise the distinctiveness of contemporary state borders and how they differ from other borders in their complexity and globality. The second part of the paper argues for a recalibration of border studies aimed at balancing their spatial emphases with a much greater, and more critical, historical sensitivity. It insists that 'boundedness', and state boundedness in particular, is a variable that must be understood historically. This is illustrated by arguing that a better analysis of contemporary border change means rethinking the crude periodisation which distinguishes the age of empire from the age of nation-states and, in turn, from some putative contemporary era 'beyond nation-states' and their borders.

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Resistance to cisplatin chemotherapy remains a major hurdle preventing effective treatment of many solid cancers. BAX and BAK are pivotal regulators of the mitochondrial apoptosis pathway, however little is known regarding their regulation in cisplatin resistant cells. Cisplatin induces DNA damage in both sensitive and resistant cells, however the latter exhibits a failure to initiate N-terminal exposure of mitochondrial BAK or mitochondrial SMAC release. Both phenotypes are highly sensitive to mitochondrial permeabilisation induced by exogenous BH3 domain peptides derived from BID, BIM, NOXA (which targets MCL-1 and A1), and there is no significant change in their prosurvival BCL2 protein expression profiles. Obatoclax, a small molecule inhibitor of pro-survival BCL-2 family proteins including MCL-1, decreases cell viability irrespective of platinum resistance status across a panel of cell lines selected for oxaliplatin resistance. In summary, selection for platinum resistance is associated with a block of mitochondrial death signalling upstream of BAX/BAK activation. Conservation of sensitivity to BH3 domain induced apoptosis can be exploited by agents such as obatoclax, which directly target the mitochondria and BCL-2 family.

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This is the first in a two-part analysis of Northern Ireland’s engagement with the climate governance regime created by the UK Climate Change Act 2008. It contends that UK devolution has shaped this national regime and may itself be shaped by the national low carbon transition, particularly in the case of the UK’s most devolved region. In essence, while Northern Ireland’s consent to the application of the Act appeared to represent a long-term commitment to share power in the interests of present and future generations and thus to devolution itself, this first article argues that it was also potentially illusory. The second article argues that making an effective commitment to climate governance will require its devolved administration to allow constitutional arrangements designed for conflict resolution to mature. Failure to do so will have important implications for the UK’s putative ‘national’ low carbon transition and the longer term viability of devolution in the region.

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This is the second of a two-part analysis exploring the interaction between UK devolution and governance of the national low carbon transition. It argues that devolution shaped the national climate governance regime created by the Climate Change Act 2008, but will itself be tested and even altered as the traction of the low carbon imperative intensifies. This dynamic is explored in the specific context of the UK’s most devolved region. The first article argued that devolution facilitated and arguably forced Northern Ireland’s devolved administration to give a highly qualified and potentially illusory consent to the regional application of the UK Act. The second article argues that making a more effective commitment to climate governance will be a defining test of its devolution arrangements but will require constitutional arrangements designed for conflict resolution to mature. Failure to do so will have important implications for the UK’s putative ‘national’ low carbon transition and the longer-term viability of devolution in the region.

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The 5'-O-monomethoxytrityl-3'-S-(aryldisulfanyl)-3'-deoxythymidines 7 and 8 have been prepared by the reaction of 5'-O-monomethoxytrityl-3'-thiothymidine with the appropriate arenesulfenyl chloride. These disulfides undergo a Michaelis–Arbusov reaction with simple trialkyl phosphites to yield 5'-O-monomethoxytrityl-3'-thiothymidin-3'-yl O,O-dialkyl phosphorothiolates. More interestingly, 3'-deoxy-3'-S-(2, 4-dinitrophenylsulfanyl)-5'-O-monomethoxytritylthymidine 8 reacts with a variety of thymidin-5'-yl dialkyl phosphites to give dithymidine phosphorothiolate triesters with the phosphorothiolate group protected with either a methyl or a 2-cyanoethyl group. 3'-O-(tert-Butyldimethylsilyl)thymidin-5'-yl triethylammoniumphosphonate 17 is converted into the corresponding bis-(O-trimethylsilyl) phosphite by treatment with bis(trimethylsilyl)trifluoroacetamide. in situ Reaction of this phosphate with disulfide 8 gives, after work-up, the dithymidine phosphorothiolate diester directly. Methylation of compound 17 with methyl chloromethanoate, followed by silylation and subsequent reaction with disulfide 8, gives the methyl-protected dithymidine phosphorothiolate triester.

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The reaction of 1-butylpyrrolidine with dimethyl carbonate to yield the ionic liquid precursor, 1-butyl-1-methylpyrrolidinium methylcarbonate, has been investigated under microwave heating conditions and the reaction parameters optimised to achieve 100% yield of the pyrrolidinium salt with no by-products in under 1 h. The reactions of tributylamine, trioctylphosphine, and 1-butylimidazole with dimethyl carbonate under comparable conditions have also been evaluated, yielding the corresponding methylcarbonate salts which can be used as intermediates for the preparation of halide-free ionic liquids without generating any undesirable salt wastes.

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A new approach to spectroscopy of laser induced proton beams using radiochromic film (RCF) is presented. This approach allows primary standards of absorbed dose-to-water as used in radiotherapy to be transferred to the calibration of GafChromic HD-810 and EBT in a 29 MeV proton beam from the Birmingham cyclotron. These films were then irradiated in a common stack configuration using the TARANIS Nd:Glass multi-terawatt laser at Queens University Belfast, which can accelerate protons to 10-12 MeV, and a depth-dose curve was measured from a collimated beam. Previous work characterizing the relative effectiveness (RE) of GafChromic film as a function of energy was implemented into Monte Carlo depth-dose curves using FLUKA. A Bragg peak (BP) "library" for proton energies 0-15 MeV was generated, both with and without the RE function. These depth-response curves were iteratively summed in a FORTRAN routine to solve for the measured RCF depth-dose using a simple direct search algorithm. By comparing resultant spectra with both BP libraries, it was found that the effect of including the RE function accounted for an increase in the total number of protons by about 50%. To account for the energy loss due to a 20 mu m aluminum filter in front of the film stack, FLUKA was used to create a matrix containing the energy loss transformations for each individual energy bin. Multiplication by the pseudo-inverse of this matrix resulted in "up-shifting" protons to higher energies. Applying this correction to two laser shots gave further increases in the total number of protons, N of 31% and 56%. Failure to consider the relative response of RCF to lower proton energies and neglecting energy losses in a stack filter foil can potentially lead to significant underestimates of the total number of protons in RCF spectroscopy of the low energy protons produced by laser ablation of thin targets.

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Background
Inappropriate polypharmacy is a particular concern in older people and is associated with negative health outcomes. Choosing the best interventions to improve appropriate polypharmacy is a priority, hence interest in appropriate polypharmacy, where many medicines may be used to achieve better clinical outcomes for patients, is growing.

Objectives
This review sought to determine which interventions, alone or in combination, are effective in improving the appropriate use of polypharmacy and reducing medication-related problems in older people.

Search methods
In November 2013, for this first update, a range of literature databases including MEDLINE and EMBASE were searched, and handsearching of reference lists was performed. Search terms included 'polypharmacy', 'medication appropriateness' and 'inappropriate prescribing'.

Selection criteria
A range of study designs were eligible. Eligible studies described interventions affecting prescribing aimed at improving appropriate polypharmacy in people 65 years of age and older in which a validated measure of appropriateness was used (e.g. Beers criteria, Medication Appropriateness Index (MAI)).

Data collection and analysis
Two review authors independently reviewed abstracts of eligible studies, extracted data and assessed risk of bias of included studies. Study-specific estimates were pooled, and a random-effects model was used to yield summary estimates of effect and 95% confidence intervals (CIs). The GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach was used to assess the overall quality of evidence for each pooled outcome.

Main results
Two studies were added to this review to bring the total number of included studies to 12. One intervention consisted of computerised decision support; 11 complex, multi-faceted pharmaceutical approaches to interventions were provided in a variety of settings. Interventions were delivered by healthcare professionals, such as prescribers and pharmacists. Appropriateness of prescribing was measured using validated tools, including the MAI score post intervention (eight studies), Beers criteria (four studies), STOPP criteria (two studies) and START criteria (one study). Interventions included in this review resulted in a reduction in inappropriate medication usage. Based on the GRADE approach, the overall quality of evidence for all pooled outcomes ranged from very low to low. A greater reduction in MAI scores between baseline and follow-up was seen in the intervention group when compared with the control group (four studies; mean difference -6.78, 95% CI -12.34 to -1.22). Postintervention pooled data showed a lower summated MAI score (five studies; mean difference -3.88, 95% CI -5.40 to -2.35) and fewer Beers drugs per participant (two studies; mean difference -0.1, 95% CI -0.28 to 0.09) in the intervention group compared with the control group. Evidence of the effects of interventions on hospital admissions (five studies) and of medication-related problems (six studies) was conflicting.

Authors' conclusions
It is unclear whether interventions to improve appropriate polypharmacy, such as pharmaceutical care, resulted in clinically significant improvement; however, they appear beneficial in terms of reducing inappropriate prescribing.

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Nonadherence to prescribed treatment is an important cause of difficult asthma. Rates of nonadherence amongst asthmatic patients have been shown to range between 30% and 70%. This is associated with poor health care outcomes and increased health care costs. There is no such thing as a "typical" nonadherent patient. The reasons driving nonadherence are multifactorial. Furthermore, adherence is a variable behavior and not a trait characteristic. Adherence rates can vary between the same individual across treatments for different conditions. There is no consistent link between socioeconomic status and nonadherence, and although some studies have shown that nonadherence is more common amongst females, this is not a universal finding. The commonly held perception that better adherence is driven by greater disease severity has been demonstrated to not be the case, in both pediatric and adult patients. Identification of nonadherence is the first step. If adherence is not checked, it is likely that poor adherence will be labeled as refractory disease. Failure to identify poor adherence may lead to inappropriate escalation of therapy, including the potential introduction of complex biological therapies. Surrogate measures, such as prescription counting, are not infallible. Nonadherence can be difficult to identify in clinical practice, and a systematic approach using a variety of tools is required. Nonadherence can be successfully addressed. Therefore, assessment of adherence is of paramount importance in difficult asthma management, in order to reduce exacerbations and steroid-related side effects as well as hospital and intensive care admissions, health care cost, and inappropriate treatment escalation. In this paper, we present an overview of the literature surrounding nonadherence in difficult asthma. We explore the facts and myths surrounding the factors driving nonadherence as well as how it can be identified and addressed.

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Archaeological excavation has provided an alternative source of evidence for the development of the late medieval peasant house. It is argued that whilst there was a significant change in building techniques in the decades around 1200 with the adoption of ground-set timbers, the most important factor which led to the survival of houses was a fall in real wages during the thirteenth century. This encouraged peasants to repair existing buildings, rather than replace them with new ones. Alternative traditions of building are also investigated. Stone construction was adopted in a number of areas of England, but in spite of the durability of the material, few medieval peasant buildings of this type have survived in use because of the failure to use lime mortar. Decisions about whether to invest in a building’s renovation will depend on the capital initially expended upon it. This interpretation is considered against the data from the fifteenth century and found to conform satisfactorily. Its implications are considered for the period between 1200 and 1350. Data collected from archaeological excavations combined with the results of dendrochronology on a growing number of closely dated standing buildings suggest that there was a significant ‘cull’ of houses in the period after 1350 as new dwellings were constructed.

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Various scientific studies have explored the causes of violent behaviour from different perspectives, with psychological tests, in particular, applied to the analysis of crime factors. The relationship between bi-factors has also been extensively studied including the link between age and crime. In reality, many factors interact to contribute to criminal behaviour and as such there is a need to have a greater level of insight into its complex nature. In this article we analyse violent crime information systems containing data on psychological, environmental and genetic factors. Our approach combines elements of rough set theory with fuzzy logic and particle swarm optimisation to yield an algorithm and methodology that can effectively extract multi-knowledge from information systems. The experimental results show that our approach outperforms alternative genetic algorithm and dynamic reduct-based techniques for reduct identification and has the added advantage of identifying multiple reducts and hence multi-knowledge (rules). Identified rules are consistent with classical statistical analysis of violent crime data and also reveal new insights into the interaction between several factors. As such, the results are helpful in improving our understanding of the factors contributing to violent crime and in highlighting the existence of hidden and intangible relationships between crime factors.

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In this paper we seek to develop a ‘relational’ perspective on accountability and on so-called ‘unaccountability.’. We focus on Mark Bovens’s use of the forum metaphor in his accountability model, arguing that his relational perspective is too narrow. We advocate instead a far broader and more fundamental engagement with the idea of relational accountability. Expanding the metaphors, we point to two other accountability spaces: ‘agora,’ a primordial accountability space and ‘bazaar,’ an emergent accountability space rooted in ground-level exchange between different actors. Assertions about ‘unaccountability,’ we argue, very often reflect a failure to appreciate the fundamentally relational nature of accountability: those who use such assertions as bases for action aimed at making situations, processes or people ‘more accountable’ in fact seek to assert or impose a certain form of relationship – one that is hierarchical and monopolistic – and reflect therefore a drive to power and domination.

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PtSi/Si Schottky junctions, fabricated using a conventional technique of Pt deposition with a subsequent thermal anneal, are examined using X-ray diffraction, atomic force microscopy and a novel prism/gap/sample optical coupling system. With the aid of X-ray diffraction and atomic farce microscopy it is shown that a post-anneal etch in aqua regia is essential for the removal of an unreacted, rough surface layer of Pt, to leave a much smoother PtSi film. The prism/gap/sample or Otto coupling rig is mounted in a small UHV chamber and has facilities for remote variation of the gap (by virtue of a piezoactuator system) and variation of the temperature in the range of similar to 300 K - 85 K. The system is used to excite surface plasmon polaritons on the outer surface of the PtSi and thus produce sensitive optical characterisation as a function of temperature. This is performed in order to yield an understanding of the temperature dependence of phonon and interface scattering of carriers in the PtSi.

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Aqueous solutions of CO2 containing tetramethylammonium chloride were photolysed with visible light in the presence of colloidal ZnS to yield tartaric acid, glyoxylic acid, oxalic acid, formic acid and formaldehyde.

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This paper (co-written with Dr Maria Lohan, Dr Carmel Kelly & Professor Laura Lundy) will describe the ethical review process to undertake health research in the UK, and explain an approach that can help researchers deal with ethical and methodological dilemmas in their research. Ethical review is necessary to ensure researchers and participants are protected, yet the requirement to ‘pass’ numerous committees may be challenging particularly for health researchers who work with vulnerable groups and sensitive topics. The inclusion of these groups/topics is crucial if health researchers are to understand health disparities and implement appropriate interventions with health benefits for vulnerable populations. It is proposed that to overcome ethical and methodological challenges and pitfalls, researchers must implement strategies that advocate for, and increase the participation of, vulnerable populations in health research. A ‘children’s rights based approach’ using participatory methodology will be described that draws on the jurisprudence of international law, (United Nations Convention on the Rights of the Child, 1989) and provides a framework that may empower ethics committees to carry out their function confidently. The role of the researcher, framed within the context of doctoral level study, will be reviewed in terms of the investment required and benefits of utilising this approach. It will be argued that adopting this approach with vulnerable groups, not only guarantees their meaningful participation in the research process and permits their voices to be heard, but also offers ethics committees an internationally agreed upon legal framework, ratified by their governing States, from which to fulfil their obligations and resolve their ethical dilemmas. Increasing the representation and participation of vulnerable groups in health research can inform the development of health policy and practice based on ‘insider knowledge’ that better engages with and more adequately reflects their specific needs. This is likely to yield numerous health, social and economic benefits for all of society through the delivery of more equitable, effective and sustainable services.