139 resultados para DIFFICULTY


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Research into the targeting of drug substances to a specific disease site has enjoyed sustained activity for many decades. The reason for such fervent activity is the considerable clinical advantages that can be gained when the delivery system plays a pivotal role in determining where the drug is deposited. When compared to conventional formulations where no such control exists, such as parenteral and oral systems, the sophisticated targeting device can reduce side effects and limit collateral damage to surrounding normal tissue. No more so is this important than in the area of oncology when dose-limiting side effects are often encountered as an ever present difficulty. In this review, the types of colloidal carrier commonly used in targeted drug delivery are discussed, such as gold and polymeric colloids. In particular, the process of attaching targeting capabilities is considered, with reference to antibody technologies used as the targeting motifs. Nanotechnology has brought together a means to carry both a drug and targeting ligand in self-contained constructs and their applications to both clinical therapy and diagnosis are discussed.

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Democracies are faced increasingly with the challenge of engaging the public on the assumption that such activity will lead to greater understanding of, and enhanced trust in, political institutions. This is a particular difficulty for an institution such as the Northern Ireland Assembly (NIA), established against the backdrop of a historically divided society with high levels of political conflict and which has itself been suspended on several occasions. This article reports the findings from the NIA's first survey of public engagement, conducted as part of the Assembly's broader engagement strategy. It provides a baseline against which future levels of engagement can be judged. Moreover, it highlights a range of challenges that face both the NIA and its Members of the Legislative Assembly if the Assembly is to engage successfully with the public in the aftermath of the 2011 elections.

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Chemical degradations often induce changes in protein conformation and thus influence protein activity and protein stability in solutions. One difficulty in studying of chemical degradations on protein aqueous properties is to obtain sufficient amount of chemically degraded protein which is well characterized. Chemical degradation protocols that are often used may induce also conformation changes and aggregation of the protein. In this article we studied the effect of methionine oxidation on the conformation of recombinant human growth hormone (r-hGH). In literature it is reported that oxidation of methionine residues induces conformation changes on r-hGH. In our study, oxidation of r-hGH was performed by incubation with hydrogen peroxide under mild conditions. Mass spectrometry and chromatographic analysis revealed that oxidation with hydrogen peroxide resulted in more than 90% of oxidized r-hGH. By extensive spectroscopic characterizations no detectable change in conformation and aggregation of r-hGH after oxidation was found. In conclusion, mild oxidation conditions led to selective oxidation of the two more accessible methionine residues of r-hGH (Met(14) and Met(125)) and did not results in any conformation change of the protein. These findings prove that oxidation of human growth hormone does not influence protein conformation and demonstrate the importance of employing mild conditions during production of oxidized protein. (C) 2010 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 100:110-122, 2011

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We propose a hybrid approach to the experimental assessment of the genuine quantum features of a general system consisting of microscopic and macroscopic parts. We infer entanglement by combining dichotomic measurements on a bidimensional system and phase-space inference through the Wigner distribution associated with the macroscopic component of the state. As a benchmark, we investigate the feasibility of our proposal in a bipartite-entangled state composed of a single-photon and a multiphoton field. Our analysis shows that, under ideal conditions, maximal violation of a Clauser-Horne-Shimony-Holt-based inequality is achievable regardless of the number of photons in the macroscopic part of the state. The difficulty in observing entanglement when losses and detection inefficiency are included can be overcome by using a hybrid entanglement witness that allows efficient correction for losses in the few-photon regime.

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Raman spectroscopy with far-red excitation has been used to study seized, tableted samples of MDMA (N-methyl-3,4-methylenedioxyamphetamine) and related compounds (MDA, MDEA, MBDB, 2C-B and amphetamine sulfate), as well as pure standards of these drugs. We have found that by using far-red (785 nm) excitation the level of fluorescence background even in untreated seized samples is sufficiently low that there is little difficulty in obtaining good quality data with moderate 2 min data accumulation times. The spectra can be used to distinguish between even chemically-similar substances, such as the geometrical isomers MDEA and MBDB, and between different polymorphic/hydrated forms of the same drug. Moreover, these differences can be found even in directly recorded spectra of seized samples which have been bulked with other materials, giving a rapid and non-destructive method for drug identification. The spectra can be processed to give unambiguous identification of both drug and excipients (even when more than one compound has been used as the bulking agent) and the relative intensities of drug and excipient bands can be used for quantitative or at least semi-quantitative analysis. Finally, the simple nature of the measurements lends itself to automatic sample handling so that sample throughputs of 20 samples per hour can be achieved with no real difficulty.

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The core difficulty in developmental dyslexia across languages is a "phonological deficit", a specific difficulty with the neural representation of the sound structure of words. Recent data across languages suggest that this phonological deficit arises in part from inefficient auditory processing of the rate of change of the amplitude envelope at syllable onset (inefficient sensory processing of rise time). Rise time is a complex percept that also involves changes in duration and perceived intensity. Understanding the neural mechanisms that give rise to the phonological deficit in dyslexia is important for optimising educational interventions. In a three-deviant passive 'oddball' paradigm and a corresponding blocked 'deviant-alone' control condition we recorded ERPs to tones varying in rise time, duration and intensity in children with dyslexia and typically developing children longitudinally. We report here results from test Phases 1 and 2, when participants were aged 8-10. years. We found an MMN to duration, but not to rise time nor intensity deviants, at both time points for both groups. For rise time, duration and intensity we found group effects in both the Oddball and Blocked conditions. There was a slower fronto-central P1 response in the dyslexic group compared to controls. The amplitude of the P1 fronto-centrally to tones with slower rise times and lower intensity was smaller compared to tones with sharper rise times and higher intensity in the Oddball condition, for children with dyslexia only. The latency of this ERP component for all three stimuli was shorter on the right compared to the left hemisphere, only for the dyslexic group in the Blocked condition. Furthermore, we found decreased N1c amplitude to tones with slower rise times compared to tones with sharper rise times for children with dyslexia, only in the Oddball condition. Several other effects of stimulus type, age and laterality were also observed. Our data suggest that neuronal responses underlying some aspects of auditory sensory processing may be impaired in dyslexia. © 2011 Elsevier Inc.

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Natural environments often generate experiences that combine great emotional and moral power- "charged" experiences. Their characteristics are explored through writings that capture them convincingly. They appear to have a perceptual character. Perception of the scene is invested with a sense of something beyond it, and much bigger. It may be God, or immensity in time or space, or the essence of a nation. This encounter is often connected with moral authority. A recurring theme is the sense that environment and the things in it-including the observer-are a self-similar pattern. People are not passive recipients of these experiences. They seek them out. Evoking, the environment in words can often evoke the charged experience too-at least in part. The material suggests tasks for psychologists-most simply, finding systematic ways to describe these experiences. That may help other environmental disciplines, which face difficulty characterising the dimension of response. Theoretically, the material raises questions about the representations generated by perceptual processes. The observation that powerful moral imperatives seem to be given in the act of perceiving is also suggestive for the psychology of morality. Culture certainly plays a part in charged responses, but landscapes have the power to be invested with an emotional and moral charge where other stimuli may not.

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Many high-risk and preterm infants have difficulty with successful feeding and subsequent optimal growth during their stay in the neonatal intensive care unit as well as in the months after discharge. Environmental, procedural, and medical issues necessary for treatment of the hospitalized infant present challenges for the development of successful eating skills. Emerging data describe eating as a predictable neurodevelopmental process that depends on the infant’s organization of physiologic processes, motor tone and movement, level of arousal, and ability to simultaneously regulate these processes.

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As architects and designers we have a responsibility to provide an inclusive built environment. For the person with Autistic Spectrum Disorder (ASD) however, the built environment can be a frightening and confusing place, difficult to negotiate and tolerate. The challenge of integrating more fully into society is denied by both having difficulty in communication and in an alienating built environment. The following paper therefore firstly outlines the challenge when designing for those with ASD. It then illustrates, by critically examining the school as a 'micro-city' (Hertzberger 2008) that a voice can be given to those with ASD. It then goes onto highlight, through two case studies in an Irish context, some of the lessons that can be learnt from pupils with ASD that are applicable to the city beyond. Finally in conclusion it suggests some of the benefits for an enriched built environment for all, when listening to the pupil with ASD. The objective is twofold; firstly to gain a better understanding of the needs of those with ASD and secondly, to ascertain what can be learnt from those with ASD that can challenge our perception of not just school, but also of the city.

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Clinical studies have linked impulsivity and insomnia in patients, but little is known about this association in non-clinical settings. This study examined whether impulsive temperament is associated with sleep duration and insomnia complaints in a large cohort of hospital employees (535 men and 4014 women). Linear regression models were related to prospective data from two surveys conducted in 1998 and 2000. Adjustments were made for age, marital status, education, shift work, smoking, alcohol consumption, body mass index, physical activity, minor psychiatric morbidity, social support, somatic disease, depression and other psychiatric disease in 1998. In men, higher impulsivity predicted shorter sleep duration and waking up several times per night independent of baseline characteristics. In women, higher impulsivity predicted having difficulty falling asleep and waking up feeling tired after the usual amount of sleep after adjustment for most of covariates. However, these associations turned out to be non-significant after adjustment for somatic and psychiatric disease. These results support the hypothesis that impulsive temperament could be a risk factor for insomnia in men. (c) 2007 Elsevier Ltd. All rights reserved.

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Laser-driven proton and ion acceleration is an area of increasing research interest given the recent development of short pulse-high intensity lasers. Several groups have reported experiments to understand whether a laser-driven beam can be applied for radiobiological purposes and in each of these, the method to obtain dose and spectral analysis was slightly different. The difficulty with these studies is that the very large instantaneous dose rate is a challenge for commonly used dosimetry techniques, so that other more sophisticated procedures need to be explored. This paper aims to explain a method for obtaining the energetic spectrum and the dose of a laser-driven proton beam irradiating a cell dish used for radiobiology studies. The procedure includes the use of a magnet to have charge and energy separation of the laser-driven beam, Gafchromic films to have information on dose and partially on energy, and a Monte Carlo code to expand the measured data in order to obtain specific details of the proton spectrum on the cells. Two specific correction factors have to be calculated: one to take into account the variation of the dose response of the films as a function of the proton energy and the other to obtain the dose to the cell layer starting from the dose measured on the films. This method, particularly suited to irradiation delivered in a single laser shot, can be applied in any other radiobiological experiment performed with laser-driven proton beams, with the only condition that the initial proton spectrum has to be at least roughly known. The method was tested in an experiment conducted at Queen's University of Belfast using the TARANIS laser, where the mean energy of the protons crossing the cells was between 0.9 and 5 MeV, the instantaneous dose rate was estimated to be close to 10(9) Gy s(-1) and doses between 0.8 and 5 Gy were delivered to the cells in a single laser shot. The combination of the applied corrections modified the initial estimate of dose by up to 40%.

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The relationship between changes in retinal vessel morphology and the onset and progression of diseases such as diabetes, hypertension and retinopathy of prematurity (ROP) has been the subject of several large scale clinical studies. However, the difficulty of quantifying changes in retinal vessels in a sufficiently fast, accurate and repeatable manner has restricted the application of the insights gleaned from these studies to clinical practice. This paper presents a novel algorithm for the efficient detection and measurement of retinal vessels, which is general enough that it can be applied to both low and high resolution fundus photographs and fluorescein angiograms upon the adjustment of only a few intuitive parameters. Firstly, we describe the simple vessel segmentation strategy, formulated in the language of wavelets, that is used for fast vessel detection. When validated using a publicly available database of retinal images, this segmentation achieves a true positive rate of 70.27%, false positive rate of 2.83%, and accuracy score of 0.9371. Vessel edges are then more precisely localised using image profiles computed perpendicularly across a spline fit of each detected vessel centreline, so that both local and global changes in vessel diameter can be readily quantified. Using a second image database, we show that the diameters output by our algorithm display good agreement with the manual measurements made by three independent observers. We conclude that the improved speed and generality offered by our algorithm are achieved without sacrificing accuracy. The algorithm is implemented in MATLAB along with a graphical user interface, and we have made the source code freely available. 

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Chronic neutrophilic leukemia (CNL) is a rare disease and can cause considerable diagnostic difficulty. Although the V617F JAK2 mutation has been described by several groups to be associated with classical myeloproliferative disorders (MPD), this same mutation has been detected with a low incidence in atypical MPD, such as CNL. Here we report the presence of the V617F mutation in a CNL patient, who is unusual for having survived for more than 96 months, with little disease progression. It remains to be established what role this mutation, which gives cells a proliferative advantage, might play in the pathogenesis and prognosis of rare atypical MPD.

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It has been suggested that increased intramedullary apoptosis may explain the paradox between peripheral blood cytopenias and the hyper- or normo-cellular bone marrow observed in the myelodysplastic syndromes (MDS). We wished to see if culture performance could be related to the presence of apoptotic cells in a group of patients with MDS (12 patients) and other patients with peripheral blood cytopenias (six patients) which caused diagnostic difficulty. There was no correlation between LTBMC or adherent cell growth and the presence of apoptotic cells in the original marrow sample. A variable degree of apoptosis was observed in both groups of patients. LTBMC profiles correlated well with diagnosis but were unrelated to the extent of intramedullary apoptosis. This suggests that apoptosis is a much more ubiquitous process in disease than previously thought. (C) 1998 Elsevier Science Ltd. All rights reserved.

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Purpose – The purpose of this paper is to identify, clarify and tabulate the various managerial issues encountered, to aid in the management of the complex health and safety concerns which occur within a confined construction site environment.

Design/methodology/approach – This is achieved through conducting extensive qualitative and qualitative research in the form of case studies, interviews and questionnaire survey.

Findings – The leading managerial issues in the management of health and safety on a confined construction site are found to be: “Difficulty to move materials around site safely”; “Lack of adequate room for the effective handling of materials”; “Difficulty in ensuring site is tidy and all plant and materials are stored safely”; “Close proximity of individuals to operation of large plant and machinery”; and joint fifth “Difficulty in ensuring proper arrangement and collection of waste materials on-site” along with “Difficulty in controlling hazardous materials and equipment on site”.

Practical implications – The resulting implication for practice of these results can be summarised by identifying that with sustained development of urban centres on a global scale, coupled with the increasing complexity of architectural designs, the majority of on-site project management professionals are faced with the onerous task of completing often intricate designs within a limited spatial environment, under strict health and safety parameters.

Originality/value – The subsequent value of the findings are such that just as on-site management professionals successfully identify the various managerial issues highlighted, the successful management of health and safety on a confined construction site is attainable.