O átrio esquerdo (AE) pode aumentar de tamanho e massa por sobrecarga de pressão e volume em várias doenças cardíacas, a exemplo da degeneração da valva mitral. O tamanho do AE é de especial interesse na avaliação da gravidade da doença, uma vez que o grau de aumento será um dos parâmetros para a instituição da terapia. A ecocardiografia é o método padrão para a avaliação não invasiva do paciente cardiopata e sempre inclui a mensuração do tamanho do AE. O modo-M convencional tem sido usado para tal avaliação, contudo, o mesmo tem suas limitações, devido à dificuldade em incluir a porção mais ampla do AE, resultando em um diâmetro e índice AE:AO subestimados. No modo bidimensional o AE pode ser mensurado em sua maior amplitude, resultando em uma medida mais acurada. Assim sendo, o objetivo deste estudo foi comparar os dois métodos, utilizando-se de 40 cães adultos sadios, com idade variando de 1,5 a 7 anos. No modo-M, o AE e a aorta (AO) foram medidos conforme normas da American Society of Echocardiography, no corte longitudinal para-esternal direito, e no modo bidimensional realizaram-se medidas lineares em pontos específicos e em momentos estabelecidos do ciclo cardíaco, no corte transverso para-esternal direito. Estabeleceu-se um índice para cada método, dividindo-se o diâmetro do AE com a AO. Observou-se que a diferença de diâmetro do AE no modo bidimensional (AEB) e do AE no modo-M foi estatisticamente significante (p < 0,001). O mesmo ocorreu com o índice AEB:AOB quando comparado ao índice AEM:AOM, sendo que a média do AEB:AOB = 1,379±0,130; I.C. 95%= 1,337-1,422 e a média do AEM:AOM = 1,067±0,064, I.C. 95%= 1,046-1,088. Observou-se correlação alta entre as medidas do AE, nos dois modos, com superfície de área corpórea e peso (coeficiente de correlação = 0,882-0,896). Ocorreu correlação alta também entre as medidas de AE dos sexos masculino e feminino, pelos dois métodos (p=0,003 e coeficiente de correlação = 0,725-0,732). Com relação aos índices, não houve correlação entre os mesmos e a superfície de área e o peso, podendo-se dizer que são, portanto, índices independentes de peso. O modo bidimensional oferece a possibilidade de aferição do AE em sua maior amplitude, superando assim o modo-M convencional. / The left atrium (LA) can become enlarged in size and mass attributable to both pressure and volume overload in various cardiac diseases, an example is the mitral valve degeneration. The size of LA is of special interest for clinical assessment of severity of the disease, once the degree of enlargement will be one of the parameters for therapy institution. The echocardiography is the standard method of noninvasive evaluation of the cardiac patient and often involves the LA size. The M-mode has been used to this evaluation, however it has inherent limitations, due to the difficulty in including the largest portion of the LA, underestimating the LA diameter and LA:AO index. In the two-dimensional (2D) mode, the LA can be measured at its largest portion and it is likely to be more accurate. The purpose of this study was to compare both methods, using 40 healthy adult dogs, and ages between 1,5 and 7 years old. In the M-mode, the LA and the aorta (AO) was measured according to the guidelines from the American Society of Echocardiography, using a right long-axis view and in the 2D-mode, linear measurements were made at specific time and points of the cardiac cycle, using a right short-axis view. LA:AO ratios were established for each method. The difference between the LA diameter in the 2D-mode (LAB) and in the M-mode (LAM) was significant (p < 0,001). The same has occured with the LAB:AOB index when it was compared with the LAM:AOM ratio. The LAB:AOB index was 1,379±0,130; C.I. 95%= 1,337-1,422 and the LAM:AOM index was 1,067±0,064, C.I. 95%= 1,046-1,088. It was observed high association between LA measurements, in both methods, with body weight and body surface area (correlation coefficient = 0,882-0,896) and also a high correlation between the LA in female and male, in both methods (p=0,003 e correlation coefficient = 0,725-0,732). There was no association between both indices with body weight and body surface area, which provides a body weight - independent measurement of LA size. The 2D - mode offers more accurate LA measurement , so it overcomes the M- mode.

O remodelamento cardíaco é uma sequela da hipertensão. Receptores do tipo Toll (TLRs) pertencem a imunidade inata e sua ativação produz moléculas inflamatórias. O objetivo do trabalho foi avaliar a participação do TLR4 no remodelamento cardíaco de ratos espontaneamente hipertensos (SHR). Utilizamos SHR e Wistar de 6 e 21 semanas. O nível do RNAm do TLR4 de SHR de 21 semanas é maior em relação aos outros grupos. Outros grupos de Wistar e SHR de 19 semanas foram tratados com anticorpo anti-TLR4, os controles receberam anticorpo IgG inespecífico. Observamos redução no nível do RNAm do TLR4 e MyD88 e expressão protéica do TLR4, MyD88, TNF-<font face=\"symbol\">a e IL-1<font face=\"symbol\">b de SHR anti-TLR4 em relação aos SHR controle. Não houve alteração nos valores pressóricos. Verificamos redução no nível do RNAm de colágenos I e III, de metaloproteinases 2 e 9, de ANP, BNP e <font face=\"symbol\">a-actina esquelética e de deposição de colágeno, área e diâmetro de cardiomiócitos de SHR anti-TLR4 em relação aos SHR controle. Nossos resultados sugerem que o TLR4 participa do processo de remodelamento cardíaco de SHR adultos. / The cardiac remodeling is a sequel of hypertension. Toll-Like Receptors (TLR) are innate immunity receptor and its activation produces inflammatory molecules. The objective of this study was to evaluate the involvement of TLR4 in cardiac remodeling of spontaneously hypertensive rats (SHR). We used male Wistar and SHR with 6 and 21 weeks. The level of TLR4 mRNA in SHR with 21 weeks is higher than the other groups. Wistar and SHR with 19 weeks were treated with anti-TLR4 or nonspecific IgG antibody (control group). We observed a reduction in the level of TLR4 and MyD88 mRNA and protein expression of TLR4, MyD88, TNF-<font face=\"symbol\">a and IL-1<font face=\"symbol\">b in anti-TLR4 SHR compared to control SHR. There was no change in blood pressure values in SHR after anti-TLR4 treatment. We observed reduction in mRNA level of collagens I and III, metalloproteinases 2 and 9, ANP, BNP, <font face=\"symbol\">a-skeletal actin, collagen deposition, cardiomyocyte area and diameter in anti-TLR4 SHR compared to control SHR. Our results suggest that TLR4 participates of cardiac remodeling process in adults SHR.

Folk music is one of the most popular forms of music today; artists such as Mumford and Sons and the Carolina Chocolate Drops are giving new life to an age-old music. It was not until the 1950s that new popular interest in folk music began. Earlier, folk music was used by leftist organizations as a means to reach the masses. It assumed because of this history that many folk artists are sympathetic to the Left. By looking at the years from 1905-1975 with the end of the Vietnam War, this study hopes to present the notion that even though these artists produced music that promoted leftist ideals, they were not always supportive of the Communist Party and other leftist organizations. Specific artists will be examined, paying close attention to artists who not only produced revolutionary music, but who were also employed by leftist organizations to perform at rallies and meetings.

This quantitative study was designed to determine the extent to which the language of testing in reading and math had a positive effect on 50/50 dual language program Hispanic students' reading and math achievement level as measured by a standardized achievement test. The research questions in this study include: 1. Is there a statistical difference in reading achievement for Hispanic 50/50 English- Spanish dual language program students when testing data is disaggregated linguistically? 2. Is there a statistical difference in math achievement for Hispanic 50/50 English- Spanish dual language program students when testing data is disaggregated linguistically? This study examined the reading and math standardized achievement results for students in grades 2-12 in a school district in Iowa serving students in pre-kindergarten through grade 12 that chooses to offer 50/50 dual language Two-Way Immersion (TWI) (Spanish/English) instruction to its students. The district uses the Iowa Tests of Basic Skills (ITBS) and Iowa Tests of Educational Development (ITED), both presented in English, and the Spanish test Logramos to evaluate student achievement. The reading and math results of 157 Hispanic students enrolled in the dual language program are compared in this study to determine if the Hispanic students, on average, achieve at higher levels as measured by national grade equivalency (NGE) and percentage proficient when testing in Spanish versus English in math and in reading. There was, on average, a two-year gap in reading performance by Hispanic students when testing in English compared to testing in Spanish. The students performed about two years above grade level in Spanish in reading, but rarely performed even at grade level in English as measured by NGE and percentage proficient results. Over the three- to five-year testing window, the reading gap stayed constant at about two years. When comparing English and Spanish math results for the same students by grade level, the students scored at a higher level in Spanish over 97% of the time compared to the English math results. The results show that for the eight graduating cohorts, the average percent proficient is 72% overall when taking the math test in Spanish, but for the math test in English the average percent proficient is only 50.2% proficient. Linguists have argued that Hispanic students' progress in attaining proficiency on standardized reading and math assessments is possible after five to seven years of learning English. This study demonstrates that not all Hispanic students progress to that level of proficiency and that further programming options or interventions might be needed within the TWI program model. Additionally, this study shows that the rate toward proficiency in reading and math on the English and Spanish versions differs over time and that students generally attain proficiency in math prior to reading on both the English and Spanish assessments. Balancing the language acquisition process through models like dual language is supported in research, but implementing a TWI program model and utilizing native language assessments like Logramos must be carefully studied, monitored, and enacted with community support and ongoing professional development for all involved. Dual language programs and native language assessments are a means to address issues presented by No Child Left Behind (NCLB) in relation to Hispanics' and English Language Learners' (EL) academic achievement, but further studies must address other subgroups within the dual language programs.

In this paper, I have examined the political philosophy of a left-libertarian, Michael Otsuka from his book Libertarianism Without Inequality, and a libertarian socialist, Nicholas Vrousalis from his article Libertarian Socialism: A Better Reconciliation between Equality and Self-Ownership. The goal of this examination is partially to explore and present a variety of positions on distributive justice within libertarian theory as well as defend libertarian socialism as a plausible form of libertarianism. The main question motivating this defense is “Can libertarian socialism be truly libertarian in its conception of self-ownership and autonomy?”. In this examination of both left-libertarianism and libertarian socialism I compared both theories to the works of prominent right-libertarian philosophers, primarily John Locke and Robert Nozick, to determine if the theories meet the standards set by traditional libertarianism in promoting individual autonomy as well as to determine if these standards can be reconciled with substantial material equality, either in terms of opportunity or welfare. The results of this examination showed that not only are left-libertarianism and libertarian socialism plausible theories of libertarianism, even exceeding potential for individual autonomy found in right-libertarian theory, but that they both successfully reconcile this autonomy with equality. In defending libertarian socialism, it was determined that it is a successful reconciliation of self-ownership and equality, though this comes at the expense of the potential for minor decreases in self-ownership among individuals when compared to Otsuka’s left-libertarianism. This was defended, however, as libertarian socialism seems more promising a theory for those who hold stronger commitments to equality as well as additional commitments, namely a commitment to democracy.

This document examines Rodney Friend’s approach to violin technique for the left hand, with specific emphasis on the execution of fifths. The application of this technique plays a valuable role in establishing correct hand positioning, creating consistent intonation, improving vibrato, and adding to the palette of colors available to the violinist. Mr. Friend is an esteemed violinist, a perceptive pedagogue, and a dedicated mentor in today’s music world, and, in those roles, he exemplifies the qualities of beauty, truth, and goodness that characterize meaningful engagement in the arts. His thoughtful teaching style is the product of decades of careful observation combined with a devotion to constant personal improvement. As a performer who has toured the world as concertmaster of classical music’s most renowned orchestras, Mr. Friend’s early and continued success could have easily led him to a justifiable sense of arrival. Instead, he continues to hone his craft daily--both as a performer and as a teacher--always striving to remove the roadblocks from the tricky terrain of violin playing. In Mr. Friend’s words, violin playing is “a whole complicated business that we need to make less complicated.” His keen insights into the mechanics of the trade prove that simplification is possible. I firmly believe that his pedagogical innovations will greatly serve the rising generation of violinists. Most recently, Mr. Friend has turned his attention to an area of left hand technique that is commonly avoided by violinists in their practice, and often glossed over by teachers: the study of fifths. For the past six years Mr. Friend has been systematically exploring the benefits of this ignored technique. Other pedagogues have had little to offer in specifically addressing this interval because there is a general lack of understanding about the benefits provided by mastering the execution of fifths. Examples of this omission can be seen in pedagogy books by some of the 20th century’s greatest violinists and teachers. For instance, when Leopold Auer discusses the left hand in his book, Violin Playing as I Teach It, he suggests practicing scales in thirds, fourths, sixths, and octaves, but completely skips over the interval of the fifth. The same omission is also made by Yehudi Menuhin in his instructional text entitled Violin and Viola. Mr. Friend has developed a systematic approach to mastering this difficult technique that is both simple and effective. He plans to publish his method later this year. Some of the benefits provided to the violinist from the consistent practice of this traditionally difficult and neglected interval include better hand positioning, improved vibrato, and more consistent intonation--the continual quest of every violinist. I have experienced the remarkable benefits of his method in my own playing, which motivated me to seek Mr. Friend’s permission to further explore and document his techniques, and with this monograph to share these benefits with the violin community.

Heart failure is a progressive condition that affects over 5.7 million Americans and costs associated with heart failure account for 2-3 % of the national health care budget. The high rates of morbidity and mortality along with increased costs from readmissions associated with advanced heart failure have led to the exploration of advanced treatments such as left ventricular assist devices (LVADs). LVADS have demonstrated morbidity and mortality benefit but cost remains extensive with costs per quality-adjusted years > $400,000. With this in mind, it is important to identify those who are most likely to benefit from an LVAD to avoid unfavorable outcomes and cost. Although general guidelines and criteria for patient eligibility have been established, choosing patients for LVAD implantation remains challenging. A new focus on patient selection involves the presence of frailty. While frailty has been studied in the elderly population and in patients undergoing cardiac surgery, frailty in patients undergoing left ventricular assist device (LVAD) remains controversial. The purpose of this dissertation was to examine measures of frailty in patients undergoing LVAD implantation. The specific aims of this dissertation were to: (1) identify a feasible frailty measure in adults with end-stage heart failure who underwent LVAD implantation by testing the hypothesis that frailty would predict 30 day rehospitalization rates using Fried’s criteria, Short Physical Performance Battery test, handgrip strength, serum albumin and six minute walk test (2) Determine whether frailty measures improve 3 months post LVAD implantation (3) compare sensitivity of these three measures to change in frailty. Surgical approaches, including heart transplantation and LVAD implantation, for patients with end-stage heart failure was discussed in this dissertation. Data from two subsets of participants who underwent LVADS at the University of Kentucky between 2014 and 2017 were included in the analysis for this dissertation. In the first study, we found that none of the measures are good predictors of frailty in patients with advanced heart failure who undergo LVAD implantation. Handgrip was the only marker of frailty that predicted 30 day readmission but the relationship was a negative association. In the second study, six-minute walk and low serum albumin levels reflect short-term improvement in frailty. These simple measures may be used to determine those patients who are responsive to LVAD implantation. The findings of these studies filled some gaps in our understanding of markers of frailty in patients undergoing LVADs. We gained a better understanding of which markers of frailty are likely to improve in most people after LVAD implantation and thus frailty should not preclude candidate selection for an LVAD. Subsequently, more research is needed to investigate these markers and outcomes.

In this thesis I have studied how hypermobile joints affect my violin playing and tried to to find solutions how to cope with hypermobility.  The purpose is to find tools how to change my left-hand technique so that I can play Bach´s Fugue from Solo sonata in g minor in my master concert without pain in my 4th finger and without tension in my left-hand. The goal is to find a way to play with hypermobile joints so that my technique will serve the music in the best possible way.  The biggest questions are: what hypermobility is, how can I cope with it, how to play more relaxed and how to develop a better support for my left-hand little finger, 4th finger.  The thesis will first focus more on the theoretical side of hypermobility in order to get better understanding of what hypermobilty is and how it might affect a violinist. Then I will get more into the aspects of violin playing and my process. After this process I noticed that working with hypermobile joints is a lifelong process. In order to have a good left-hand technique while having hypermobile joints it is crucial to have good muscle control and awareness. The most important thing is to find the right tools that work for yourself while trying to cope with hypermobility.

En Allemagne, en Belgique, en France, en Irlande, en Islande, en Slovénie ou au Portugal, la gauche radicale connaît des poussées électorales, atteignant bien souvent des niveaux là aussi inédits. Dans les pays dans lesquels elle est traditionnellement bien implantée, si elle ne perce pas, elle demeure un acteur important de la vie politique et parlementaire, notamment à Chypre, en République tchèque, en Finlande, en Suède. Il est donc pertinent d’interroger le phénomène : pourquoi ce retour en force des partis de la gauche radicale ? Quelles en sont les causes ? Qui sont les acteurs partisans de ce renouveau ? Apporter des réponses à ces questions ne peut que passer par une analyse comparative.La thèse se fixe comme objectif de répondre à deux questions ayant structuré sa rédaction :1/ pourquoi la gauche radicale européenne se transforme-t-elle, quels sont les facteurs provoquant cette transformation en incitant ses dirigeants à l’opérer, et quelle est la nature de ces transformations ?2/ quels sont les objectifs et les attendus de ces transformations, et comment se traduisent-elles par le ralliement de nouveaux électeurs dans le cadre des échéances électorales ?Nous partons en effet du principe qu’un parti ne se transforme pas en vain. S’il amende son identité, son projet, ses discours ou le mode de fonctionnement de son organisation, c’est qu’il escompte franchir un cap dans son développement. Au travers d'une analyse comparative entre l'Allemagne, l'Espagne, la Grèce et le Portugal, nous verrons qu'émerge et se structure une nouvelle gauche radicale impactant durablement la famille partisane de la gauche radicale européenne. / In Germany, Belgium, France, Ireland, Iceland, Slovenia and Portugal, radical left parties are experiencing electoral surges, often reaching new levels as well. In countries where they are traditionally well established, if they don't break through, they remain an important player in political and parliamentary life, particularly in Cyprus, Czech Republic, Finland and Sweden. It is therefore relevant to question the phenomenon: why this return in force of the radical left parties? What are the causes? Who are the actors in favor of this renewal? Answering these questions can only be done through a comparative analysis.The thesis aims to answer two questions that have structured its writing:1 / why is the european radical left transforming itself, what are the factors causing this transformation by encouraging its leaders to operate it, and what is the nature of these transformations?2 / What are the objectives and expectations of these transformations, and how do they translate into the rallying of new voters in the elections?We start from the premise that a party does not change in vain. If a prty amends its identity, its project, its speeches or the mode of operation of its organization, it is that this party expect to cross a course in its development. Through a comparative analysis between Germany, Spain, Greece and Portugal, we will see the emergence and structuring of a new radical left permanently impacting the partisan family of the European radical left.

This thesis evaluates two theories purporting to explain the rise of right-wing extremism in the Midwest during the farm crisis of the 1980s. The pluralist argument suggests that Midwestern right-wing extremism was rooted in previous episodes of agrarian radicalism. The political tradition perspective, on the other hand, claims that right-wing extremism in the Midwest was rooted in traditional conservatism. To evaluate these theories, an analysis of ten counties was performed. Particular attention was paid to seven variables which theorists argue point agriculturally based communities down political paths of radicalism or conservatism. Regional analyses were also performed on those counties which resided in similar areas of the Midwest. The findings offer stronger support for the political tradition perspective than for the pluralist argument. These finding suggest that those counties in which right-wing extremist activity did not occur were ones which supported past agrarian radical movements while those counties which experienced right-wing extremism were for the most part opponents of past radical agrarian movements. The thesis suggests that future research on rightwing extremism should focus attention on the political traditions of the communities were such movements become established and that a number of alternative variables should be considered.