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Total Focus: Make Better Decisions Under Pressure

After just a few conversations, Brandon and I had identified seven key principles, learned in the crucible of the modern battlefield, that applied impeccably to the crucible of business. Seven principles for how to make better decisions under the intense pressures of entrepreneurship and business leadership.

Total Focus: Make Better Decisions Under Pressure


While all of medicine is under pressure to increase transparency and accountability, joint replacement subspecialists will face special scrutiny. Disclosures of questionable consulting fees, a demographic shift to younger patients, and uncertainty about the marginal benefits of product innovation in a time of great cost pressure invite a serious and progressive response from the profession. Current efforts to standardize measures by the National Quality Forum and PQRI will not address the concerns of purchasers, payors, or policy makers. Instead, they will ask the profession to document its commitment to appropriateness, stewardship of resources, coordination of care, and patient-centeredness. One mechanism for addressing these expectations is voluntary development of a uniform national registry for joint replacements that includes capture of preoperative appropriateness indicators, device monitoring information, revision rates, and structured postoperative patient followup. A national registry should support performance feedback and quality improvement activity, but it must also be designed to satisfy payor, purchaser, policymaker, and patient needs for information. Professional societies in orthopaedics should lead a collaborative process to develop metrics, infrastructure, and reporting formats that support continuous improvement and public accountability.

(a) The invention as defined in claim 1 of the patent as granted was not sufficiently disclosed since the disclosure in the patent did not enable the skilled person to perform the invention over the entire scope of the claim, namely to make absorbing agents with diffusing absorbency under pressure considerably above the minimum value included in the claim and using any of the chemicals indicated in the patent as being suitable.

2.3 The original application discloses the preparation of an absorbing agent precursor by polymerisation of an unsaturated carboxylic acid monomer or a salt thereof in the presence of a crosslinking agent and a dispersant in several instances (see page 7, line 16 to page 8, line 17; page 16, line 12 to page 17, line 1; page 20, lines 7-13; page 24, line 7 to page 25, line 1; page 26, line 12 to page 29, line 12; claims 21 and 29; all citations of the original application in the Reasons for the decision refer to the translation of the original Japanese application filed upon entry into the European phase). However, in all occurrences it is clearly specified that "improved" values of diffusing absorbency under pressure and a small amount of water soluble component for the final absorbing agent can be achieved only if a specific crosslinking agent in a specific amount is used in the presence of a dispersant. The kind of crosslinking agent and its amount are those recited in original claim 21, which concerns a process of manufacturing a precursor of an absorbing agent and specifies that an aqueous solution polymerisation of a hydrophilic unsaturated monomer having at least 50 mole percent neutralised acrylic acid as a main component takes place "in a (sic) presence of a dispersant, using a crosslinking agent composed of a main component and a high-boiling component in an amount in a range of not less than 0.05 mole percent and not more than 0.5 mole percent with respect to a total amount of the hydrophilic unsaturated monomer, wherein a ratio in weight of the main component of said crosslinking agent to a high-boiling compound is in a range of 75/25 to 99/1, a main component of said crosslinking agent is composed of an ester compound including a polyhydroxy alcohol having not more than six carbon atoms and at least three hydroxy groups, and an unsaturated carboxylic acid, a ratio in molecular weight of the main component of said crosslinking agent to a standard compound is not less than 0.7 and less than 1.3 based on a molecular weight of the standard compound wherein all hydroxy groups of the polyvalent alcohol are ester-linked to the unsaturated carboxylic acid, and said high-boiling point component includes at least two alcohol structures in a molecule". This corresponds to the conditions in the description on page 18, line 17 to page 19, line 13, page 20, line 14 to page 21, line 2 and page 25, lines 17-21, which specify which amount of crosslinking agent and which composition are meant on page 16, line 12 to page 17, line 1 and page 20, lines 7-13.

On offensive coordinator and quarterbacks coach Paul Petrino moving up to the booth... "I think I like to be kind of in the zone, and I think a lot of times offensively you get distracted by what's happening on the defensive side. I've tried to preset to the guidance of we're on the bench. We need to have complete and total focus on what we do. I had the headset on, so I could completely zone out of what the crowd was doing, what our defense was doing; they were doing a good job. So I liked that aspect of it. I think he could see the field better and make some calls that he wouldn't normally make."

17.4.13. A related point was that those who undertake engagement and consultation are often too far removed from those who make the final decisions on what plans to implement, thus meaning that messages get lost as they move up the management hierarchy. Similarly, it was identified that while planners and designers may take on board feedback during consultations, messages may get lost at construction / implementation stage, especially where contractors and sub-contractors are involved. 041b061a72


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