Objectives
Redo sternotomy and explantation of left ventricular assist devices (LVAD) for heart transplantation (HT) involve prolonged dissection, potential injury to mediastinal structures and/or ...bleeding. Our study compared a complete expanded polytetrafluoroethylene (ePTFE) wrap versus minimal or no ePTFE during LVAD implantation, on outcomes of subsequent HT.
Methods
Between July 2005 and July 2018, 84 patients underwent a LVAD implant and later underwent HT. Thirty patients received a complete ePTFE wrap during LVAD implantation (Group 1), and 54 patients received either a sheet of ePTFE placed in the anterior mediastinum or no ePTFE (Group 2).
Results
Baseline characteristics were similar between Groups 1 and 2. Surgeons reported subjective improvements in speed, predictability, and safety of dissection with complete ePTFE compared with minimal or no ePTFE. Time from incision to initiation of cardiopulmonary bypass (CPB) were similar between groups (97 ± 38 vs. 89 ± 29 min, p = .3). Injury to mediastinal structures during the dissection was similar between groups (10% vs. 11%, p > .9). While surgeons reported less intraoperative bleeding in Group 1 (43% vs. 61%), this trend did not reach significance (p = .1). In‐hospital mortality, intensive care unit length of stay and hospital length of stay were similar between both groups.
Conclusions
In patients undergoing LVAD explant‐HT, there was a trend toward reduced surgeon reported intraoperative bleeding with ePTFE placement. Despite qualitatively reported greater ease and speed of mediastinal dissection with ePTFE membrane placement, time to initiation of CPB did not differ, likely because surgeons remained cautious, allowing extra time for unanticipated difficulties.
Over the last two decades, much attention has been paid to the area of goal-oriented requirements engineering (GORE), where goals are used as a useful conceptualization to elicit, model, and analyze ...requirements, capturing alternatives and conflicts. Goal modeling has been adapted and applied to many sub-topics within requirements engineering (RE) and beyond, such as agent orientation, aspect orientation, business intelligence, model-driven development, and security. Despite extensive efforts in this field, the RE community lacks a recent, general systematic literature review of the area. In this work, we present a systematic mapping study, covering the 246 top-cited GORE-related conference and journal papers, according to Scopus. Our literature map addresses several research questions: we classify the types of papers (e.g., proposals, formalizations, meta-studies), look at the presence of evaluation, the topics covered (e.g., security, agents, scenarios), frameworks used, venues, citations, author networks, and overall publication numbers. For most questions, we evaluate trends over time. Our findings show a proliferation of papers with new ideas and few citations, with a small number of authors and papers dominating citations; however, there is a slight rise in papers which build upon past work (implementations, integrations, and extensions). We see a rise in papers concerning adaptation/variability/evolution and a slight rise in case studies. Overall, interest in GORE has increased. We use our analysis results to make recommendations concerning future GORE research and make our data publicly available.
The 2000 Presidential election ended in a collision of history, law, and the courts. It produced a deadlock that dragged out the result for over a month, and consequences--real and imagined--that ...promise to drag on for years. In the first in-depth study of the election and its litigious aftermath, Judge Posner surveys the history and theory of American electoral law and practice, analyzes which Presidential candidate ''really'' won the popular vote in Florida, surveys the litigation that ensued, evaluates the courts, the lawyers, and the commentators, and ends with a blueprint for reforming our Presidential electoral practices.The book starts with an overview of the electoral process, including its history and guiding theories. It looks next at the Florida election itself, exploring which candidate ''really'' won and whether this is even a meaningful question. The focus then shifts to the complex litigation, both state and federal, provoked by the photo finish. On the basis of the pragmatic jurisprudence that Judge Posner has articulated and defended in his previous writings, this book offers an alternative justification for the Supreme Court's decision in Bush v. Gore while praising the Court for averting the chaotic consequences of an unresolved deadlock.Posner also evaluates the performance of the lawyers who conducted the post-election litigation and of the academics who commented on the unfolding drama. He argues that neither Gore's nor Bush's lawyers blundered seriously, but that the reaction of the legal professoriat to the litigation exposed serious flaws in the academic practice of constitutional law. While rejecting such radical moves as abolishing the Electoral College or creating a national ballot, Posner concludes with a detailed plan of feasible reforms designed to avoid a repetition of the 2000 election fiasco.Lawyers, political scientists, pundits, and politicians are waiting to hear what Judge Posner has to say. But this book is written for and will be welcomed by all who were riveted by the recent crisis of presidential succession.
Objective:
To compare voice-related outcomes of type 1 thyroplasty using Gore-Tex® between patients with and without augmentation injection laryngoplasty (IL) prior to surgery.
Methods:
Forty-five ...patients who underwent Gore-Tex® thyroplasty at a single institution by a single surgeon between November 2016 and February 2019 were identified as those who previously had IL (n = 20) and those without IL (n = 25). Pre- and post-operative voice-related primary outcomes were evaluated using the GRBAS, and CAPE-V auditory-perceptual rating scales and secondary outcome were evaluated using the VRQOL. Pre- and post-operative voice samples were blinded, randomized, and analyzed by 3 voice-specialized speech pathologists to obtain CAPE-V scores. The VRQOL and GRBAS scores were obtained from retrospective chart review. Student’s t test with a paired one-tailed distribution was used for comparisons within groups and 2-sample equal variance for comparisons between groups. Intraclass correlation coefficient determined interrater agreement.
Results:
GRBAS, and VRQOL significantly improved post Gore-Tex® thyroplasty. There was no difference in improvement between patients who received pre-surgery IL and those who did not in either GRBAS or VRQOL scores, but CAPE-V showed significant improvement in the IL group. A strongly positive correlation was demonstrated between the severity of CAPE-V pre-op score and the overall improvement following surgery for both groups combined.
Conclusion:
Patients with vocal fold paralysis have a significantly better voice after Gore-Tex® thyroplasty by self-report (VRQOL) and assessment by trained voice professionals (GRBAS). Having IL prior to surgery does not adversely affect later surgical outcomes. This paper represents one of the largest analyses of voice quality outcomes of Gore-Tex® thyroplasty using validated patient scales and randomized blinded analyses.
Samuel M. Gore Gauntt, Barbara; Waters, Wyatt
2015
eBook
Born in Coolidge, Texas, Samuel Marshall Gore was the sixth of ten children born to a Baptist preacher and a mother described as "an angel." From early childhood, Samuel Gore remembers enjoying ...making things, and gives credit to his mother and grandmother for his interest in art. Gore went on to be an art teacher and professor for more than fifty years, mostly at Mississippi College in Clinton, Mississippi. He has shown work in exhibitions and galleries for more than forty years. In 2012 the Mississippi Institute of Arts and Letters honored him with its Lifetime Achievement Award. In the first part of this volume, Barbara Gauntt traces how a concept in the mind of the artist comes to execution. Gore uses sketches on scraps of paper to inform studies in clay, as the piece Christ, Fulfillment of the Law begins to take its inspired shape. The project, expected to take about a year, lasts nearly two as Gore works to capture the constantly changing image forming in his mind. The 12' x 8' bronze, bas relief sculpture, a sister piece to Moses, Deliverer of the Law commissioned for the Mississippi College School of Law, moves from a small work area in the sculptor's home to a shop on his property. There he builds the full-size piece on an armature of wood, foam board, and netting covered with clay. From chaos arises the beauty of detailed faces and a work of art that tells a story. The second section of the book covers the artist's career from the late 1940s into the twenty-first century. Superb photographs of both two- and three- dimensional pieces show the artist's diverse style and talent. Gore says that he "wants people to put their hands on his sculpture" because that is how he experiences his art. Gore sees no end in sight to his work. Moses started preaching at the age of eighty, so Gore figures that he is just getting started. This volume features detailed information about all of the artwork included; an interview with Samuel Gore in which the artist discusses his career, technique, and philosophy; a timeline of his life and career; and foreword by noted Mississippi artist and former student, Wyatt Waters.
The Gore Excluder iliac branch endoprosthesis (IBE; W.L. Gore & Associates, Flagstaff, AZ) is the only iliac branch device approved in the United States to preserve blood flow to the external and ...internal iliac arteries (IIAs). Some surgeons have used the Gore Viabahn VBX balloon expandable endoprosthesis (VBX; W.L. Gore & Associates) in the IIA rather than the self-expanding endograft designed for the IBE, the internal iliac component (IIC). The objective of the present study was to examine the outcomes for patients treated for aortoiliac artery aneurysms using the IBE with either the IIC or VBX stent.
We performed a retrospective, single-center review of patients treated for aortoiliac artery aneurysms using the Gore IBE device, with either the IIC or VBX stent into the IIA, from February 2016 to March 2021. The patient demographics, procedure details, 30-day morbidity and mortality, and 6-month and 1-year outcomes and mortality were analyzed. The categorical factors are summarized using frequencies and proportions. Continuous measures are summarized as the mean ± standard deviation. A significance level of P = .05 was assumed for all test results. The analyses were performed using SAS software, version 9.4 (SAS Institute, Cary, NC).
A total of 62 patients (64 arteries) had undergone elective aortoiliac artery aneurysm repair with the IBE. The IIC was used exclusively in 35 cases (55%) and the VBX in 29 (45%). The patients who had received the VBX had had a higher American Society of Anesthesiologists class (P = .006). Upper extremity access was used for VBX delivery in 24.1% of the procedures. No return to the operating room was required in either group. No differences were found in technical success (IIC, 97.1%; VBX, 93.1%; P = .59), the presence of endoleak on completion (20.0% vs 6.9%; P = .17), readmission (97.1% vs 93.1%; P = .59), or mortality (1.6% vs 0%; P = .45) at 30 days. No differences were found in the requirement for any IBE reintervention after 30 days. No type Ia, Ib, or III endoleaks had occurred in either group at any follow-up point. No significant difference was found in internal iliac limb primary patency (IIC, 100%; VBX, 96.3%) between groups. A nonstatistically significant trend was found toward fewer trunk–ipsilateral leg type II endoleaks in the VBX group during follow-up.
These data suggest that the VBX is a reasonable substitute for the IIC, with a comparable safety and efficacy profile. Given its inherent conformability, greater range of diameters, and longer working length, the VBX stent offers expanded IIA branch options with the IBE.
This is the first dedicated biography of the extraordinary Irish woman, Eva Gore-Booth. Gore-Booth rejected her aristocratic heritage choosing to live and work amongst the poorest classes in ...industrial Manchester. Her work on behalf of barmaids, circus acrobats, flower sellers and pit-brow lasses is traced in this book. During one impressive campaign Gore-Booth orchestrated the defeat of Winston Churchill. Gore-Booth published volumes of poetry, philosophical prose and plays, becoming a respected and prolific author of her time and part of W.B. Yeats' literary circle. The story of Gore-Booth's.
Final Arbiter, The Banks, Christopher P; Cohen, David B; Green, John C
2005
eBook
The resolution of the 2000 presidential election by the U.S. Supreme Court’s Bush v. Gore decision generated an extraordinary outpouring of literature in a very short period of time. Now that the ...initial furor over the decision has subsided, The Final Arbiter presents a sober consideration of the consequences of the decision for the law, the presidency, and the legitimacy of the American political system. The contributors include well-established names in law and political science, as well as up-and-coming scholars, offering a broad understanding of Bush v. Gore’s long-term impact. This book will be useful as a classroom text in both survey courses on elections and the courts and for advanced courses that consider the impact of judicial rulings on the government and political process.
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