CoorsTek- Spine Discectomy

The objective is to design improved instrumentation for performing a spine discectomy. In particular, the instrument should remove the nucleus pulposus without damaging the annulus in order to prepare the spine disc for the insertion of an artificial spacer. As more nucleus pulposus is removed from the disc, the spine will fuse more quickly and completely after the artificial spacer is inserted. The current process involves removing the nucleus pulposus piece by piece with pituitary rongeurs. This process is slow and often incomplete

Use of electronic patient data overview with alerts in primary care increases prescribing of lipid-lowering medications in patients with type 2 diabetes

AIMS/HYPOTHESIS: We aimed to assess whether general practices (GPs) using an electronic disease management program (DMP) with population overviews, including alerts when patients failed to receive guideline-recommended prescription medications, increased prescriptions of lipid-lowering drugs for patients with type 2 diabetes with no history of lipid-lowering treatment. METHODS: This observational study included 165 GPs that reached a high level of use of the DMP in 2012 and a control group of 135 GPs who reached a high level of use in 2013 and, hence, who were less exposed to the DMP throughout 2012. A binary measure for having been prescribed and filled lipid-lowering drugs at any time within a 12-month exposure period was derived for all patients with type 2 diabetes who did not receive a prescription for lipid-lowering drugs in the baseline year prior to the study period (i.e. 2011). Results were derived using ORs from multivariate logistic regression analyses. Subgroup stratification based on age, sex, diabetes duration, deprivation status and Charlson Comorbidity Index (CCI) score was conducted and assessed. Placebo tests were carried out to assess bias from selection to treatment. RESULTS: Patients who did not receive a prescription of lipid-lowering drugs in the year prior to being listed with GPs that used the DMP had statistically significant greater odds of receiving a prescription of lipid-lowering medications when compared with individuals who attended control GPs (OR 1.23 [95% CI 1.09, 1.38]). When the analysis period was shifted back by 2 years, no significant differences in lipid-lowering drug prescription between the two groups were found to occur, which indicates that these results were not driven by selection bias. Subgroup analyses showed that the increase in lipid-lowering drug prescriptions was primarily driven by changes among male participants (OR 1.32 [95% CI 1.12, 1.54]), patients aged 60–70 years (OR 1.40 [95% CI 1.13, 1.74]), patients with a diabetes duration of ≤5 years (OR 1.33 [95% CI 1.13, 1.56]), non-deprived patients (OR 1.25 [95% CI 1.08, 1.45]) and patients without comorbidities (CCI score = 0; OR 1.27 [95% CI 1.11, 1.45]). CONCLUSIONS/INTERPRETATION: Access to population overviews using a DMP with alerts of clinical performance measures with regard to adhering to guideline-recommended prescription of medications can increase GP prescriptions of lipid-lowering drugs. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains peer-reviewed but unedited supplementary material available at 10.1007/s00125-021-05598-x

Global Water Governance and Climate Change: Identifying Innovative Arrangements for Adaptive Transformation

A convoluted network of different water governance systems exists around the world. Collectively, these systems provide insight into how to build sustainable regimes of water use and management. We argue that the challenge is not tomake the systemless convoluted, but rather to support positive and promising trends in governance, creating a vision for future environmental outcomes. In this paper, we analyse nine water case studies from around the world to help identify potential ‘innovative arrangements’ for addressing existing dilemmas. We argue that such arrangements can be used as a catalyst for crafting new global water governance futures. The nine case studies were selected for their diversity in terms of location, scale and water dilemma, and through an examination of their contexts, structures and processes we identify key themes to consider in the milieu of adaptive transformation. These themes include the importance of acknowledging socio-ecological entanglements, understanding the political dimensions of environmental dilemmas, the recognition of different constructions of the dillema, and the importance of democratized processes.The research for this paper is a part of the “CADWAGO: Climate change adaptation and water governance—reconciling food security, renewable energy and the provision of multiple ecosystem services” project funded as part of the “Europe and Global Challenges programme” by Compagnia di San Paolo, VolkswagenStiftung and Riksbankens Jubileumsfond.https://www.mdpi.com/2073-4441/10/1/2

Porous titanium manufactured by a novel powder tapping method using spherical salt bead space holders: characterisation and mechanical properties

Porous Ti with open porosity in the range of 70–80% has been made using Ti powder and a particulate leaching technique using porous, spherical, NaCl beads. By incorporating the Ti powder into a pre-existing network of salt beads, by tapping followed by compaction, salt dissolution and “sintering”, porous structures with uniform density, pore and strut sizes and a predictable level of connectivity have been produced, showing a significant improvement on the structures made by conventional powder mixing processes. Parts made using beads with sizes in the range of 0.5-1.0 mm show excellent promise as porous metals for medical devices, showing structures and porosities similar to those of commercial porous metals used in this sector, with inter-pore connections that are similar to trabecular bone. The elastic modulus (0.86GPa) is lower than those for commercial porous metals and more closely matches that of trabecular bone and good compressive yield strength is retained (21MPa). The ability to further tailor the structure, in terms of the density and the size of the pores and interconnections has also been demonstrated by immersion of the porous components in acid

A grounded theory of psychological resilience in Olympic champions

Objective: Although it is well-established that the ability to manage stress is a prerequisite of sporting excellence, the construct of psychological resilience has yet to be systematically examined in athletic performers. The study reported here sought to explore and explain the relationship between psychological resilience and optimal sport performance. Design and Method: Twelve Olympic champions (8 men and 4 women) from a range of sports were interviewed regarding their experiences of withstanding pressure during their sporting careers. A grounded theory approach was employed throughout the data collection and analysis, and interview transcripts were analyzed using open, axial and selective coding. Methodological rigor was established by incorporating various verification strategies into the research process, and the resultant grounded theory was also judged using the quality criteria of fit, work, relevance, and modifiability. Results and Conclusions: Results indicate that numerous psychological factors (relating to a positive personality, motivation, confidence, focus, and perceived social support) protect the world’s best athletes from the potential negative effect of stressors by influencing their challenge appraisal and meta-cognitions. These processes promote facilitative responses that precede optimal sport performance. The emergent theory provides sport psychologists, coaches and national sport organizations with an understanding of the role of resilience in athletes’ lives and the attainment of optimal sport performance

‘Dead people don’t claim’: A psychopolitical autopsy of UK austerity suicides

One of the symptoms of post financial crisis austerity in the UK has been an increase in the numbers of suicides, especially by people who have experienced welfare reform. This article develops and utilises an analytic framework of psychopolitical autopsy to explore media coverage of ‘austerity suicide’ and to take seriously the psychic life of austerity (internalisation, shame, anxiety), embedding it in a context of social dis-ease. Drawing on three distinct yet interrelated areas of literature (the politics of affect and psychosocial dynamics of welfare, post and anti-colonial psychopolitics, and critical suicidology), the article aims to better understand how austerity ‘kills’. Key findings include understanding austerity suicides as embedded within an affective economy of the anxiety caused by punitive welfare retrenchment, the stigmatisation of being a recipient of benefits, and the internalisation of market logic that assigns value through ‘productivity’ and conceptualises welfare entitlement as economic ‘burden’. The significance of this approach lies in its ability to widen analytic framing of suicide from an individual and psychocentric focus, to illuminate culpability of government reforms while still retaining the complexity of suicide, and thus to provide relevant policy insights about welfare reform

ERP correlates of motivating voices: quality of motivation and time-course matters

Here, we conducted the first study to explore how motivations expressed through speech are processed in real-time. Participants listened to sentences spoken in two types of well-studied motivational tones (autonomy-supportive and controlling), or a neutral tone of voice. To examine this, listeners were presented with sentences that either signaled motivations through prosody (tone of voice) and words simultaneously (e.g. ‘You absolutely have to do it my way’ spoken in a controlling tone of voice), or lacked motivationally biasing words (e.g. ‘Why don’t we meet again tomorrow’ spoken in a motivational tone of voice). Event-related brain potentials (ERPs) in response to motivations conveyed through words and prosody showed that listeners rapidly distinguished between motivations and neutral forms of communication as shown in enhanced P2 amplitudes in response to motivational when compared with neutral speech. This early detection mechanism is argued to help determine the importance of incoming information. Once assessed, motivational language is continuously monitored and thoroughly evaluated. When compared with neutral speech, listening to controlling (but not autonomy-supportive) speech led to enhanced late potential ERP mean amplitudes, suggesting that listeners are particularly attuned to controlling messages. The importance of controlling motivation for listeners is mirrored in effects observed for motivations expressed through prosody only. Here, an early rapid appraisal, as reflected in enhanced P2 amplitudes, is only found for sentences spoken in controlling (but not autonomy-supportive) prosody. Once identified as sounding pressuring, the message seems to be preferentially processed, as shown by enhanced late potential amplitudes in response to controlling prosody. Taken together, results suggest that motivational and neutral language are differentially processed; further, the data suggest that listening to cues signaling pressure and control cannot be ignored and lead to preferential, and more in-depth processing mechanisms

Retrospective time-trend study of polybrominated diphenyl ether and polybrominated and polychlorinated biphenyl levels in human serum from the United States.

Six polybrominated diphenyl ethers (PBDEs), one hexabromobiphenyl [polybrominated biphenyl (PBB)], and one hexachlorobiphenyl [polychlorinated biphenyl (PCB)] were measured in 40 human serum pools collected in the southeastern United States during 1985 through 2002 and in Seattle, Washington, for 1999 through 2002. The concentrations of most of the PBDEs, which are commercially used as flame retardants in common household and commercial applications, had significant positive correlations with time of sample collection, showing that the concentrations of these compounds are increasing in serum collected in the United States. In contrast, PCB and PBB levels were negatively correlated with sample collection year, indicating that the levels of these compounds have been decreasing since their phaseout in the 1970s

Expressions 1992

https://openspace.dmacc.edu/expressions/1014/thumbnail.jp