The Effect of Sustained Compression on Oxygen Metabolic Transport in the Intervertebral Disc Decreases with Degenerative Changes

Intervertebral disc metabolic transport is essential to the functional spine and provides the cells with the nutrients necessary to tissue maintenance. Disc degenerative changes alter the tissue mechanics, but interactions between mechanical loading and disc transport are still an open issue. A poromechanical finite element model of the human disc was coupled with oxygen and lactate transport models. Deformations and fluid flow were linked to transport predictions by including strain-dependent diffusion and advection. The two solute transport models were also coupled to account for cell metabolism. With this approach, the relevance of metabolic and mechano-transport couplings were assessed in the healthy disc under loading-recovery daily compression. Disc height, cell density and material degenerative changes were parametrically simulated to study their influence on the calculated solute concentrations. The effects of load frequency and amplitude were also studied in the healthy disc by considering short periods of cyclic compression. Results indicate that external loads influence the oxygen and lactate regional distributions within the disc when large volume changes modify diffusion distances and diffusivities, especially when healthy disc properties are simulated. Advection was negligible under both sustained and cyclic compression. Simulating degeneration, mechanical changes inhibited the mechanical effect on transport while disc height, fluid content, nucleus pressure and overall cell density reductions affected significantly transport predictions. For the healthy disc, nutrient concentration patterns depended mostly on the time of sustained compression and recovery. The relevant effect of cell density on the metabolic transport indicates the disturbance of cell number as a possible onset for disc degeneration via alteration of the metabolic balance. Results also suggest that healthy disc properties have a positive effect of loading on metabolic transport. Such relation, relevant to the maintenance of the tissue functional composition, would therefore link disc function with disc nutrition

Reactions to organizational identity threats in times of change: Illustrations from the German police.

Change projects can affect core features of an organization's identity, because changes made to the managerial practices of an organization can result in misalignments with existing organizational culture. Such misalignments produce threats to organizational identity generating uncertainty and evoking distrust among members of the organization. Faced with projects that introduce changes to managerial practices, people engage in search-and-adjustment processes in order to confirm that organizational identity is intact, producing second-order changes, the pathways of which cannot be predicted and might also undermine the intentions of change leaders. Using case-study evidence, we show how change projects in the German police force produced violations of cultural norms that were central to the continuity and stability of the police. We argue that the change enthusiasm of organizations be tempered given the potentially negative outcomes for individual employees faced with excessive change, and also because of the threats to organizational identity that can result from inherently unpredictable change processes