834 resultados para limitations of therapy


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Radiative pressure exerted by line interactions is a prominent driver of outflows in astrophysical systems, being at work in the outflows emerging from hot stars or from the accretion discs of cataclysmic variables, massive young stars and active galactic nuclei. In this work, a new radiation hydrodynamical approach to model line-driven hot-star winds is presented. By coupling a Monte Carlo radiative transfer scheme with a finite volume fluid dynamical method, line-driven mass outflows may be modelled self-consistently, benefiting from the advantages of Monte Carlo techniques in treating multiline effects, such as multiple scatterings, and in dealing with arbitrary multidimensional configurations. In this work, we introduce our approach in detail by highlighting the key numerical techniques and verifying their operation in a number of simplified applications, specifically in a series of self-consistent, one-dimensional, Sobolev-type, hot-star wind calculations. The utility and accuracy of our approach are demonstrated by comparing the obtained results with the predictions of various formulations of the so-called CAK theory and by confronting the calculations with modern sophisticated techniques of predicting the wind structure. Using these calculations, we also point out some useful diagnostic capabilities our approach provides. Finally, we discuss some of the current limitations of our method, some possible extensions and potential future applications.

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Physiologic indicators reflect the functional consequences of vitamin A deficiency and may be particularly useful for detecting early perturbations in vitamin A status. In conjunctival impression cytology (CIC), epithelial morphology and the presence or absence of mucin spots and goblet cells allow samples, obtained by applying filter paper to the temporal conjunctiva, to be characterized as normal or typical of vitamin A-deficient keratinizing metaplasia. The validity of CIC has been established with reference to other indicators of vitamin A status, and a prevalence of > or =20% abnormal results has been suggested as indicative of a public health problem. However, interpretation of specimens requires considerable training, and nonresponsiveness to supplementation is a frequent problem, which limits the utility of CIC as a method for evaluating the impact of intervention programs. Several simplified field protocols for dark adaptation have been developed, including one in which dark adaptation is assessed by the responsiveness of the pupil to light. Night blind subjects have consistently shown abnormal results on this test, and a significant response to placebo-controlled dosing has been demonstrated for children and pregnant women. Scores have correlated significantly with serum retinol and relative dose response. Pupillary dark adaptation testing is acceptable to most children as young as 2 y old. Limitations of this technique include a time course for recovery after dosing as long as 4-6 wk, a testing time of 20 min, and the need for 1-3 d of training. Given its low cost, noninvasive nature, and lack of the need to transport samples, pupillary dark adaptation offers advantages over other techniques for assessing a population's vitamin A status.

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OBJECTIVE:

To assess the methodologic quality of published studies of the surgical management of coexisting cataract and glaucoma.

DESIGN:

Literature review and analysis.

METHOD:

We performed a systematic search of the literature to identify all English language articles pertaining to the surgical management of coexisting cataract and glaucoma in adults. Quality assessment was performed on all randomized controlled trials, nonrandomized controlled trials, and cohort studies. Overall quality scores and scores for individual methodologic domains were based on the evaluations of two experienced investigators who independently reviewed articles using an objective quality assessment form.

MAIN OUTCOME MEASURES:

Quality in each of five domains (representativeness, bias and confounding, intervention description, outcomes and follow-up, and statistical quality and interpretation) measured as the percentage of methodologic criteria met by each study.

RESULTS:

Thirty-six randomized controlled trials and 45 other studies were evaluated. The mean quality score for the randomized, controlled clinical trials was 63% (range, 11%-88%), and for the other studies the score was 45% (range, 3%-83%). The mean domain scores were 65% for description of therapy (range, 0%-100%), 62% for statistical analysis (range, 0%-100%), 58% for representativeness (range, 0%-94%), 49% for outcomes assessment (range, 0%-83%), and 30% for bias and confounding (range, 0%-83%). Twenty-five of the studies (31%) received a score of 0% in the bias and confounding domain for not randomizing patients, not masking the observers to treatment group, and not having equivalent groups at baseline.

CONCLUSIONS:

Greater methodologic rigor and more detailed reporting of study results, particularly in the area of bias and confounding, could improve the quality of published clinical studies assessing the surgical management of coexisting cataract and glaucoma.

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Globalisation has led to a shift in world order with the rise of the corporate non-state actor. This rise has led to an assumption that Multi-National Corporations (MNCs) must assume responsibilities beyond profit maximisation for shareholders. With the rise of the MNC as a corporate non-state actor there have been discussions around the role of business with regard to human rights.

This article looks at the case of oil extraction in Nigeria. Focussing on the historical dependency of Nigeria and the evolution of the state into a resource-dependent country, it looks at the limitations of existing human rights obligations as they relate to business. This article proposes that corporate social responsibility (CSR) policies of MNCs can act as a preliminary stage in the quest for wider human rights protections. It is in motivating MNCs to design and implement effective CSR policies in dependent states like Nigeria, that the challenge lies.

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The view of Mandeville as a pioneer of laissez-faire is difficultto reconcile with his repeated insistence that private vices were turnedinto public benefits by the ‘dexterous management of the skilfulpolitician’. Even if references to the skilful politician are regarded asshorthand for a legal and institutional framework, there remains thequestion of whether such a framework is a spontaneous order or theproduct of purposeful experiment as Mandeville thought? Mandevillewarned about the harmful effects of meddling but his complaint wasabout the actions of fashionable do-gooders rather than government. Heunderstood that the voluntariness of a transaction could be regarded asa defence against complaints of unfairness but he was quick to pointout the limitations of voluntariness especially in the market for labour.Mandeville’s objective was to teach people what they are not what theyshould be. He pointed to the strengths of the emerging market systembut was not afraid to expose its faults.

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Coastal and estuarine landforms provide a physical template that not only accommodates diverse ecosystem functions and human activities, but also mediates flood and erosion risks that are expected to increase with climate change. In this paper, we explore some of the issues associated with the conceptualisation and modelling of coastal morphological change at time and space scales relevant to managers and policy makers. Firstly, we revisit the question of how to define the most appropriate scales at which to seek quantitative predictions of landform change within an age defined by human interference with natural sediment systems and by the prospect of significant changes in climate and ocean forcing. Secondly, we consider the theoretical bases and conceptual frameworks for determining which processes are most important at a given scale of interest and the related problem of how to translate this understanding into models that are computationally feasible, retain a sound physical basis and demonstrate useful predictive skill. In particular, we explore the limitations of a primary scale approach and the extent to which these can be resolved with reference to the concept of the coastal tract and application of systems theory. Thirdly, we consider the importance of different styles of landform change and the need to resolve not only incremental evolution of morphology but also changes in the qualitative dynamics of a system and/or its gross morphological configuration. The extreme complexity and spatially distributed nature of landform systems means that quantitative prediction of future changes must necessarily be approached through mechanistic modelling of some form or another. Geomorphology has increasingly embraced so-called ‘reduced complexity’ models as a means of moving from an essentially reductionist focus on the mechanics of sediment transport towards a more synthesist view of landform evolution. However, there is little consensus on exactly what constitutes a reduced complexity model and the term itself is both misleading and, arguably, unhelpful. Accordingly, we synthesise a set of requirements for what might be termed ‘appropriate complexity modelling’ of quantitative coastal morphological change at scales commensurate with contemporary management and policy-making requirements: 1) The system being studied must be bounded with reference to the time and space scales at which behaviours of interest emerge and/or scientific or management problems arise; 2) model complexity and comprehensiveness must be appropriate to the problem at hand; 3) modellers should seek a priori insights into what kind of behaviours are likely to be evident at the scale of interest and the extent to which the behavioural validity of a model may be constrained by its underlying assumptions and its comprehensiveness; 4) informed by qualitative insights into likely dynamic behaviour, models should then be formulated with a view to resolving critical state changes; and 5) meso-scale modelling of coastal morphological change should reflect critically on the role of modelling and its relation to the observable world.

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Introduction: Transdermal drug delivery is themovement of drugs across the skin for absorption into the systemic circulation. Transfer of the drug can occur via passive or active means; passive trans- dermal products donot disrupt the stratumcorneumto facilitate deliverywhereas active technologies do. Due to the very specific physicochemical properties necessary for successful passive transdermal drug delivery, this sector of the pharmaceutical industry is relatively small. There are many well-documented benefits of this delivery route however, and as a result there is great interest in increasing the number of therapeutic substances that can be delivered transdermally. Areas Covered: This review discusses the various transdermal products that are currently/have been marketed, and the paths that led to their success, or lack of. Both passive and active transdermal technologies are considered with the advantages and limitations of each high- lighted. In addition to marketed products, technologies that are in the investigative stages by various pharmaceutical companies are reviewed. Expert Opinion: Passive transdermal drug delivery has made limited progress in recent years, however with the ongoing intense research into active technologies, there is great potential for growth within the transdermal delivery market. A number of active technologies have already been translated into marketed products, with other platforms including microneedles, rapidly progressing towards commercialisation.

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Powder-based inkjet three-dimensional printing (3DP) to fabricate pre-designed 3D structures has drawn increasing attention. However there are intrinsic limitations associated with 3DP technology due to the weak bonding within the printed structure, which significantly compromises its mechanical integrity. In this study, calcium sulphate ceramic structures demonstrating a porous architecture were manufactured using 3DP technology and subsequently post-processed with a poly (ε-caprolactone) (PCL) coating. PCL concentration, immersion time, and number of coating layers were the principal parameters investigated and improvement in compressive properties was the measure of success. Interparticle spacing within the 3DP structures were successfully filled with PCL material. Consequently the compressive properties, wettability, morphology, and in vitro resorption behaviour of 3DP components were significantly augmented. The average compressive strength, Young’s modulus, and toughness increased 217%, 250%, and 315%, following PCL coating. Addition of a PCL surface coating provided long-term structural support to the host ceramic material, extending the resorption period from less than 7 days to a minimum of 56 days. This study has demonstrated that application of a PCL coating onto a ceramic 3DP structure was a highly effective approach to addressing some of the limitations of 3DP manufacturing and allows this advanced technology to be potentially used in a wider range of applications.

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The selection of the energy source to power the transport sector is one of the main current concerns, not only relative with the energy paradigm but also due to the strong influence of road traffic in urban areas, which highly affects human exposure to air pollutants and human health and quality of life. Due to current important technical limitations of advanced energy sources for transportation purposes, biofuels are seen as an alternative way to power the world’s motor vehicles in a near-future, helping to reduce GHG emissions while at the same time stimulating rural development. Motivated by European strategies, Portugal, has been betting on biofuels to meet the Directive 2009/28/CE goals for road transports using biofuels, especially biodiesel, even though, there is unawareness regarding its impacts on air quality. In this sense, this work intends to clarify this issue by trying to answer the following question: can biodiesel use contribute to a better air quality over Portugal, particularly over urban areas? The first step of this work consisted on the characterization of the national biodiesel supply chain, which allows verifying that the biodiesel chain has problems of sustainability as it depends on raw materials importation, therefore not contributing to reduce the external energy dependence. Next, atmospheric pollutant emissions and air quality impacts associated to the biodiesel use on road transports were assessed, over Portugal and in particular over the Porto urban area, making use of the WRF-EURAD mesoscale numerical modelling system. For that, two emission scenarios were defined: a reference situation without biodiesel use and a scenario reflecting the use of a B20 fuel. Through the comparison of both scenarios, it was verified that the use of B20 fuels helps in controlling air pollution, promoting reductions on PM10, PM2.5, CO and total NMVOC concentrations. It was also verified that NO2 concentrations decrease over the mainland Portugal, but increase in the Porto urban area, as well as formaldehyde, acetaldehyde and acrolein emissions in the both case studies. However, the use of pure diesel is more injurious for human health due to its dominant VOC which have higher chronic hazard quotients and hazard indices when compared to B20.

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In this paper I look into the life and art of May Stevens, an American working class artist, feminist and committed political activist. I am particularly interested in how Stevens' artwork is inextricably interwoven with her politics, constituting, as I will argue, an assemblage of artpolitics. The discussion draws on Jacques Rancière's analyses of the politics of aesthetics and particularly his notion of ‘the distribution of the sensible’. What I argue is that although Rancière's approach to the politics of aesthetics illuminates an understanding and appreciation of Stevens' art, his idea about the redistribution of the sensible is problematic. It is here that the notion of artpolitics as an assemblage opens up possibilities for a critical project that goes beyond the limitations of Rancière's proposition.

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Observation-based slicing is a recently-introduced, language-independent, slicing technique based on the dependencies observable from program behaviour. Due to the wellknown limits of dynamic analysis, we may only compute an under-approximation of the true observation-based slice. However, because the observation-based slice captures all possible dependence that can be observed, even such approximations can yield insight into the limitations of static slicing. For example, a static slice, S that is strictly smaller than the corresponding observation based slice is guaranteed to be unsafe. We present the results of three sets of experiments on 12 different programs, including benchmarks and larger programs, which investigate the relationship between static and observation-based slicing. We show that, in extreme cases, observation-based slices can find the true static minimal slice, where static techniques cannot. For more typical cases, our results illustrate the potential for observation-based slicing to highlight unsafe static slices. Finally, we report on the sensitivity of observation-based slicing to test quality.

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This editorial discusses strengths and limitations of Koch's postulates reviews modifications that have been used over time, and provides a brief introductory comment to the four papers that comprise the themed section herein.

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This paper discusses the role of enterprise architecture representation, in the context of ERP (Enterprise Resource Planning) information systems, as an instrument for an organization to reflect on itself and develop its business strategies and respective alignment with Information Systems. The paper proposes a representation model of enterprise architecture, as a tool for recommending good practices, and it emerges from a case study undertaken in the context of and investigation on advantages and limitations of ERP systems in the hospitality industry. The proposed approach is also inspired on other academic or market propositions suitable for the objectives of the investigation. It consists on a set of items representing the steps that must be taken by top managers and IS managers.

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Thesis (Ph. D.)--University of Washington, 2005.

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Tese de doutoramento, Farmácia (Biotecnologia Farmacêutica), Universidade de Lisboa, Faculdade de Farmácia, 2014