Financial bootstrapping and social capital: how technology-based start-ups fund innovation

Innovation requires more than technological expertise. It is a time consuming activity requiring access to a range of resources including finance. Yet, innovators involved in start-ups rarely have direct access to significant financial resources. Instead, they turn to a variety of forms of financial bootstrapping. Defined as access to resources not owned or controlled by the individual innovator, bootstrapping involves imaginative and parsimonious strategies for marshalling and gaining control of resources. This paper reports on research into bootstrapping using case studies, drawn from biographies of well-known innovators. The study found that bootstrapping was widespread and innovators showed great ingenuity in obtaining finance without recourse to conventional financial institutions. Not only were ranges of bootstrapping techniques employed, the study also provided valuable insights into the importance of social capital, in the form of networks of friends, colleagues and other contacts, in providing innovators with access to bootstrapping finance

Using computers to identify non-compliant people at increased risk of osteoporotic fractures in general practice: a cross-sectional study.

National guidelines recommend bisphosphonates for secondary prevention of osteoporotic fractures; however, poor compliance may result in sub-optimal prevention

Citizen Science and Open Design: Workshop Findings

An inherent link exists between making things and designing things, often relying on skills, knowledge, and tools, and working together to achieve outcomes. Conventional design and manufac- ture to date has been a closed system requiring professional skills. Traditional manufacture has required a significant initial financial investment for “tooling” to produce large volumes of product (i.e., for “mass production”). In contrast, Digital Manufacture (DM) or Rapid Manufacture (RM) is “the ability to manufacture parts of vir- tually any complexity [and] geometry entirely without the need for tooling.” The latter offers lower financial entry-points and the ability to create bespoke products.1 The following article weaves Open design, Digital Manufacture and Citizen Science together present- ing findings from territory exploring workshops with lay users signposting opportunities and perceived detrimental factors

Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: Randomized controlled trial

Abstract Objective To assess whether interspinous process device implantation is more effective in the short term than conventional surgical decompression for patients with intermittent neurogenic claudication due to lumbar spinal stenosis. Design Randomized controlled trial. Setting Five neurosurgical centers (including one academic and four secondary level care centers) in the Netherlands. Participants 203 participants were referred to the Leiden-The Hague Spine Prognostic Study Group between October 2008 and September 2011; 159 participants with intermittent neurogenic claudication due to lumbar spinal stenosis at one or two levels with an indication for surgery were randomized. Interventions 80 participants received an interspinous process device and 79 participants underwent spinal bony decompression. Main outcome measures The primary outcome at short term (eight weeks) and long term (one year) follow-up was the Zurich Claudication Questionnaire score. Repeated measurements were made to compare outcomes over time. Results At eight weeks, the success rate according to the Zurich Claudication Questionnaire for the interspinous process device group (63%, 95% confidence interval 51% to 73%) was not superior to that for

A Typology of Factors Influencing Seniors' Participation in Strength Training in Gyms and Fitness Centers

Older people are less likely to engage in strength training than their younger counterparts, despite the substantial benefits of this form of exercise for preventing and addressing age-related physical decline. In many countries, strength training programs are available for older people yet are undersubscribed. The aim of this study was to identify the factors influencing older people's participation in strength training at gyms and fitness centers to provide insights into potentially effective recruitment and retention strategies for this population. A total of 79 individuals from four stakeholder groups (seniors, fitness center instructors and managers, health practitioners, and those involved in policy) were interviewed to identify and explicate relevant factors. A detailed typology was developed that provides insights into potential strategies at five ecological system levels: intrapersonal, interpersonal, organizational, social, and policy. The typology can be used as a tool for identifying opportunities to encourage strength training participation among older people

Observation of magnetic circular dichroism in Fe L_{2,3} x-ray-fluorescence spectra

We report experiments demonstrating circular dichroism in the x-ray-fluorescence spectra of magnetic systems, as predicted by a recent theory. The data, on the L_{2,3} edges of ferromagnetic iron, are compared with fully relativistic local spin density functional calculations, and the relationship between the dichroic spectra and the spin-resolved local density of occupied states is discussed

Introducing Adaptive Flood Risk Management in England, New Zealand, and the Netherlands: The Impact of Administrative Traditions

Climate change adaptation creates significant challenges for decision makers in the flood risk-management policy domain. Given the complex characteristics of climate change, adaptive approaches(which can be adjusted as circumstances evolve) are deemed necessary to deal with a range of uncertainties around flood hazard and its impacts and associated risks. The question whether implementing adaptive approaches is successful highly depends upon how the administrative tradition of a country enable or hinder applying a more adaptive approach. In this article, we discern how the administrative tradition in the Netherlands, England, and New Zealand impact upon the introduction of adaptive flood risk management approaches. Using the concept of administrative traditions, we aim to explain the similarities and/or differences in how adaptive strategies are shaped and implemented in the three different state flood management regimes and furthermore, which aspects related to administrative traditions are enablers or barriers to innovation in these processe

Inhibition of Phosphodiesterase 3A by Cilostazol Dampens Proinflammatory Platelet Functions

Objective: platelets possess not only haemostatic but also inflammatory properties, which combined are thought to play a detrimental role in thromboinflammatory diseases such as acute coronary syndromes and stroke. Phosphodiesterase (PDE) 3 and -5 inhibitors have demonstrated efficacy in secondary prevention of arterial thrombosis, partially mediated by their antiplatelet action. Yet it is unclear whether such inhibitors also affect platelets’ inflammatory functions. Here, we aimed to examine the effect of the PDE3A inhibitor cilostazol and the PDE5 inhibitor tadalafil on platelet function in various aspects of thromboinflammation. Approach and results: cilostazol, but not tadalafil, delayed ex vivo platelet-dependent fibrin formation under whole blood flow over type I collagen at 1000 s−1. Similar results were obtained with blood from Pde3a deficient mice, indicating that cilostazol effects are mediated via PDE3A. Interestingly, cilostazol specifically reduced the release of phosphatidylserine-positive extracellular vesicles (EVs) from human platelets while not affecting total EV release. Both cilostazol and tadalafil reduced the interaction of human platelets with inflamed endothelium under arterial flow and the release of the chemokines CCL5 and CXCL4 from platelets. Moreover, cilostazol, but not tadalafil, reduced monocyte recruitment and platelet-monocyte interaction in vitro. Conclusions: this study demonstrated yet unrecognised roles for platelet PDE3A and platelet PDE5 in platelet procoagulant and proinflammatory responses

The QICKD study protocol: a cluster randomised trial to compare quality improvement interventions to lower systolic BP in chronic kidney disease (CKD) in primary care.

BACKGROUND: Chronic kidney disease (CKD) is a relatively newly recognised but common long-term condition affecting 5 to 10% of the population. Effective management of CKD, with emphasis on strict blood pressure (BP) control, reduces cardiovascular risk and slows the progression of CKD. There is currently an unprecedented rise in referral to specialist renal services, which are often located in tertiary centres, inconvenient for patients, and wasteful of resources. National and international CKD guidelines include quality targets for primary care. However, there have been no rigorous evaluations of strategies to implement these guidelines. This study aims to test whether quality improvement interventions improve primary care management of elevated BP in CKD, reduce cardiovascular risk, and slow renal disease progression DESIGN: Cluster randomised controlled trial (CRT) METHODS: This three-armed CRT compares two well-established quality improvement interventions with usual practice. The two interventions comprise: provision of clinical practice guidelines with prompts and audit-based education. The study population will be all individuals with CKD from general practices in eight localities across England. Randomisation will take place at the level of the general practices. The intended sample (three arms of 25 practices) powers the study to detect a 3 mmHg difference in systolic BP between the different quality improvement interventions. An additional 10 practices per arm will receive a questionnaire to measure any change in confidence in managing CKD. Follow up will take place over two years. Outcomes will be measured using anonymised routinely collected data extracted from practice computer systems. Our primary outcome measure will be reduction of systolic BP in people with CKD and hypertension at two years. Secondary outcomes will include biomedical outcomes and markers of quality, including practitioner confidence in managing CKD. A small group of practices (n = 4) will take part in an in-depth process evaluation. We will use time series data to examine the natural history of CKD in the community. Finally, we will conduct an economic evaluation based on a comparison of the cost effectiveness of each intervention. CLINICAL TRIALS REGISTRATION: ISRCTN56023731. ClinicalTrials.gov identifier