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The assumption here, reinforced by the relative failure of this year's Rio+20 summit, is that political leaders, investors, and the global C-suite proceed at a dangerously relaxed, incremental pace.
Governmental and institutional impediments, not the will of people, has dictated the incremental pace.
Beyond Oh's prescient line, the evening's proceedings were a metaphor for the incremental pace of social change itself: one step forward, two steps back.
The process has occurred at an incremental pace and overtime delivered substantial benefits in terms of significant improvement in morbidity and mortality.
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Rises in LAP in response to incremental pacing were mirrored by LVring-case admittance, which rose significantly from a pre-pacing baseline of 2.8 ± 0.19 (1000/Ω) to 3.22 ± 0.17 (1000/Ω) (15.0%; P<0.001) following 1 week of pacing at 180 bpm and to 3.54 ± 0.17 (1000/Ω) (26.4%; P<0.001) after a further week of pacing at 220 bpm.
Incremental pacing induced progressively severe HF as indicated by rises in LAP from a prepacing baseline of 5.9 ± 0.4 to 15.3 ± 1.0 mmHg following a week of pacing at 180 bpm (P<0.001) and to 24.5 ± 1.6 mmHg after a second week pacing at 220 bpm (P<0.001).
Incremental pacing induced progressively severe HF reflected in increases in LAP (5.9 ± 0.4 to 24.5 ± 1.6 mmHg) and plasma atrial (20 ± 3 to 197 ± 36 pmol/l) and B-type natriuretic peptide (3.7 ± 0.7 to 32.7 ± 5.4 pmol/l) (all P<0.001) levels.
These include the often incremental adverse pace of the phenomenon that does not lend itself to sensational headlines.
If necessary, incremental burst pacing up to cycle lengths of 280 and 200 ms in the RV and atrium, respectively, was performed for VT induction.
In total, 102 episodes of tachyarrhythmia were recorded in 22 patients (incremental ventricular pacing in 100 cases and induced ventricular tachycardia in 2 cases): of these, 79 episodes caused a fall in systolic BP to an absolute value <100 mmHg with a mean fall of 64.9 ± 22.3 mmHg.
My fear is that the nature of change is incremental and the pace of change too slow.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com