Those people who are mesmerised by the cuts to come misread the last two-and-a-half years, and fail to acknowledge the very real difficulty of knowing where we will be in 2015.
However, before this targeted therapy can be investigated in an appropriate clinical trial, there remains the very real difficulty of how to identify these rare gene rearrangements in a common malignancy in a cost-effective and practical manner.
Manhattan is a supply-constrained market particularly the East Side and the Upper East Side of Manhattan simply because of the very real difficulty of assembling sites.
We became aware that the principal barriers to a study would not be the very real difficulties in reaching parts of this mountainous country, with its tough terrain and unreliable transport, but the potential barriers to communication between interviewers and prospective participants, which would be less linguistic (in a country with more than 100 languages) than sociocultural.
As for the relationship between phenomenal and objective durations, there no doubt are very real difficulties in establishing a precise metric relating the two, and more work on this problem is very much needed, but for only an approximate estimate such a metric may not be needed.
It was apparent even then, however, that for all the nation's progress, it faced very real difficulties.
But the arrival of that 60th vote, in the person of Al Franken of Minnesota, is not likely to make the party's very real difficulties in advancing contentious legislation disappear.
We all understand Gaddafi's repeated disregard of previous ceasefires, his continuing use of brutal repression, and the very real difficulties that would be involved in trying to translate any "freezing" of the present situation on the ground into a durable self-enforcing stability.
Ongoing cuts are being made to services, causing very real difficulties for people.
While this is clearly great news for borrowers, it creates very real difficulties for those reliant on income from their savings.
