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First, building your next product, service or campaign around tolerance and celebration of difference will earn you criticism – even hate – as well as love. If you don’t want to weather the storm, don’t drive into it. Our take? Short-term, you may lose some customers. Long-term, this truth is a solid foundation on which to build a brand. Do it because it’s right – and know you have the future on your side.

Second, in 2016, millions in the US, Europe and elsewhere moved against a more open, connected, and yes, tolerant world. What’s more, for them decades of rising exposure to difference and diversity did not cause them to embrace tolerance. Indeed, in some cases it seemed to actively exacerbate prejudice.

The takeaway? A more open and connected world will only reliably increase tolerant attitudes when people feel that the benefits are being shared fairly. The last three decades of globalization left millions behind, materially and culturally. Anger grew. ‘The other’ became a target for that anger.

Brands must play a role in that. You can’t advance tolerance with in tolerance. Taking easy shots – like Alexandra Neel LaceAccented Satin Pumps free shipping Inexpensive low cost cheap online order online visit new online EbSCnpe
that says it won’t sell products to Trump supporters – won’t help.

So yes, right now there are millions (the majority?) around the world who don’t prioritise tolerance. We’re NOT saying you should ignore them! Quite the opposite: it’s only by listening to their legitimate concerns – while still always challenging toxic views – that we’ll build a sustainably tolerant world.

This truth feels:


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Fig 1

Angina-free survival of Cypher versus minimally invasive direct coronary artery bypass (MIDCAB) groups by Kaplan-Meier analysis.

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Fig 2

Major adverse cardiac event (MACE)-free survival of patients undergoing Cypher to the left anterior descending artery versus minimally invasive direct coronary artery bypass (MIDCAB) by Kaplan-Meier analysis.

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To determine whether the difference between groups in reangina and reinterventions was affected by the difference in preoperative characteristics, we performed multivariable analysis (Cox model) with patient group (PCI or MIDCAB) as an independent variable. We first included the significantly different variables between the groups to be controlled: poor ejection fraction, total occlusion, and preprocedure PCI to LAD, and then the treatment group. The Cox model showed that after controlling for these risk factors, the only independent predictor for reangina was treatment with PCI (Cypher group, HR 6.17; 95% CI, 2.46 to 15.4). Treatment with PCI was also the only independent predictor for reintervention (HR, 8.26; 95% CI, 1.68 to 40).

Most symptomatic patients with isolated stenosis of the LAD are treated today percutaneously with stents [ 10 ]. The risk of late morbidity and reintervention when the proximal segment of the LAD is involved [, ] was recently decreased with the introduction of drug-eluting stents [ 6 ]. The MIDCAB technique enables surgical revascularization of the LAD through a small left anterior thoracotomy [ 13 ]. The reported patency rate of the anastomosis from the left internal mammary artery to the LAD is more than 90% and is not significantly different than that reported for surgical revascularization incorporating midsternotomy [, , , ]. This procedure has a relatively low rate of complications and restenosis. It reduces surgical trauma and gives a satisfactory cosmetic effect [, , , ].

Several recently published reports comparing MIDCAB with stents have documented superior clinical and angiographic outcome of surgical treatment over stenting in LAD revascularization [, , ]. However, MIDCAB in these reports was compared with PCI of the LAD with bare-metal stents. In our study, all PCI patients were treated with Cypher drug-eluting stents.

To control for differences between groups in preoperative characteristics, treatment groups were compared only after matching for age, sex and extent of coronary artery disease, and the Cox proportional hazard model was used to define independent predictors of adverse outcome events like reangina, reintervention, and MACE. After a mean follow-up of almost 2 years, which is long enough for the development of in-stent restenosis [ 22 ], survival was similar; however, less than 60% of the Cypher patients were angina-free, and 11 (13.2%) required one or two reinterventions. Target vessel (LAD) reintervention in the Cypher-treated group was 8.4% (7 patients) compared with 1.2% (1 patient) in the MIDCAB group. After a mean follow-up period of almost 2 years, only 79% of the Cypher group was free of MACE compared with 94% of the MIDCAB group.

Despite the relatively high incidence of incomplete revascularization in both groups, the only independent predictor for angina recurrence and reintervention in our study was assignment to the Cypher group. Assignment to the Cypher group was not the only predictor of MACE, however. Other predictors were incomplete revascularization and prior PCI.

Important covariates (mainly technical), such as vessel diameter or lesion length, were not included in the analysis. These variables, which are less important in the surgical group, may affect restenosis, reangina, and reintervention in the PCI group. Owing to the exclusion criteria for drug-eluting stents, only type A and type B lesions were addressed by PCI in this study. If one would focus on the entire patient population with all types of LAD lesions, the results might have been more definitive in favor of the surgical group. Larger prospective multicenter studies are required to determine the effect of lesion morphology in patients selected for PCI or surgery in this evolving era of drug-eluting stents.

Another limitation of this study is the relatively limited mean follow-up period of 22 months. Evidence is growing that drug-eluting stents may develop delayed thrombosis related to delayed endothelialization, hypersensitivity to the stent polymer, or discontinuation of antiplatelet treatment [, ]. Longer follow-up is therefore required.

In conclusion, mid-term clinical outcome of MIDCAB patients was better than that of patients treated with percutaneous intervention with a Cypher drug-eluting stent to the LAD. The reangina and reintervention gap [ 24 ] between surgery and percutaneous interventions may further be reduced by better patient selection and avoiding lone PCI to the LAD in patients with multi-vessel disease or patients with prior PCI to this vessel.


© 2006 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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For more information about reconsidering your claims, evidence, and counter–arguments, check out our resources on Revising an Argumentative Paper .

The authors of The Craft of Research approach revision from the standpoint of the anticipated reader. Readers, they argue, "don't read word by word, sentence by sentence, as if they were adding up beads on a string" (Booth et al. 204). Readers want a sense of the whole. Booth et al. offer questions writers can answer to check if their organization will help readers understand and conceptualize their argument.

Readers look for key terms in each section to help relate each section to the overall project. Looking for and circling key terms will help you notice if a section is connected effectively to the main argument. Adding a key term to a paragraph can signal the relationship of a paragraph to a main argument.

Readers need to recognize where sections start and end. Checking to make sure you have inserted clear headings or language that signals the logic of your order will help the reader more easily follow your points.

Asking yourself how a section supports your argument (e.g., explaining context, summarizing a theory, providing context) will not only help you articulate how a section relates to an argument with a very effective topic sentence, but it will also help you to evaluate the significance of each point.

Each point of an argument should be foregrounded so that the reader can anticipate the organization.

Funneling is an approach to revision in which you review your work as whole, review each section, review each paragraph, and finally review each sentence. In her Guardian article "How to Edit your Dissertation," Stella Klein describes funneling and how to work through each section.

As you review your work as a whole, you might try to answer: "Have you developed a clear argument in response to your central question?" or "Have you defined key words and concepts early on?"

Evaluating each section involves checking to see if all the points are relevant to the discussion at hand, but also it is the point at which you scrutinize your evidence and analysis. In addition, check all chapter and subsection titles to make sure the points are directly relevant.

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Editing effectively for grammar, style, and punctuation requires reading carefully through each sentence. See the Writing Center’s guide to Editing for a quick checklist of common grammar mistakes and how to spot and fix them.

Below are accounts of revising from two recent dissertator—Edgardo, a Bio Biological Systems Engineering PhD and Sarah, an English Literature PhD. As you'll notice from their reflections, neither uses just one approach, but rather employs a combination of the four strategies mentioned above.

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