Monday, August 12, 2019
The broken tower Research Paper Example | Topics and Well Written Essays - 1750 words
The broken tower - Research Paper Example Craneââ¬â¢s poetry manifested a lot of treats of death and rebirth of love (Hazo, 1963). The modern perfection of death showed a lot of impossibilities in motion while having some resurrection of some kind though giving a very pessimistic message (Quinn, 1963). In his poem, A Broken Tower, Hart Crane uses a lot of biblical allusions and echoes to describe the creative process and the difficulties that come with it forcing the artists to be bound by it. There are several metaphors used in the poem. In the poem, crane used a lot of metaphors and references to referring to God and the church bells directly. This makes it possible to give a religious interpretation to the poem. It is also argued that both arts and religion have metaphors that are similar making the works of the poet both a way of spiritual expression while at the same time making it possible to search for the truth (Hazo, 1963). The tittle, ââ¬Å"A Broken Towerâ⬠has been used continuously to allude to the fact that there is a continuous deconstruction of the existing paradigms making it critical for artistic progress. Crane in the poem talks of destroying a stone tower in a continuous manner while building a new one within himself. There is also the change of tone from negative to positive making the poem a stylistically simple with abab rhyming pattern of ten quatrains (Quinn, 1963). At the beginning of the poem, crane uses the bell which is one of the predominant metaphors. The bell has a lot of religious importance as it is use to refer to the morning call that is normally made for people to go for morning prayers (Hazo, 1963). In this poem however, Craneââ¬â¢s bell is not used to call people for morning prayers but used to gather God. There is also a strange fact in stanza one as the tone is negative despite being used to regard to dawn and God which have traditionally been positive. The angelus bells in stanza one is imagery used to treat the resurrection of Crane from hell as the images suggest in the poem. This is show by the falling stone tower with some stony and hellish (Quinn, 1963). The death that Crane is dealing with was caused by modernity that has caused a lot of pessimist by ostensibly that is nearly inescapable. These towers would be guessed as the one of the modern world. The bells of resurrection are used to open the breaking bonds of the first four stanzas making it possible to bring back the poet to the broken world. As the poem proceeds, the bells become a metaphor of poetry which makes the poet sing. The same is true for the coming of the word of God and the divine revelation that bring love. The same revelation of love is brought in according to the poet. External towers of love forms one of Craneââ¬â¢s poetic projects which broken and inner ones are building (Hazo, 1963). The poet has his ââ¬Ëfeet chill on steps from hellââ¬â¢ and ââ¬Ëdropped down the knell of spent dayââ¬â¢. This portrays a lot of curious negativity showi ng how crane has rejected the traditional region that is established. Going ââ¬Ëfrom pit to crucifixââ¬â¢ as always been positive and used to symbolize the movement towards God. The first stanza is however decidedly negative manifesting a disdain of tradition (Hazo, 1963). Some of the Biblical allusions like the angelus bell commemorated the incarnation of Jesus Christ, the alternating melodies that overlapped played on the bells while the papal documents eluded the divinely inspired messages. The bell-towers and campaniles represented the Italian cathedrals
Sunday, August 11, 2019
BUS499-Module 1 - Case- The Financial Perspective Essay
BUS499-Module 1 - Case- The Financial Perspective - Essay Example It is a service based company which offers services like marketing and promotional strategies, advertising scripts and advertising production for media channels, market research as well as forecasting. It is a globally recognized brand which represents global brands like Procter & Gamble, Toyota/Lexus, Visa International, and General Mills/Pillsbury. Charles and Maurice Saatchi, two brothers, founded the eponymous organization and after that in a decade the company grew phenomenally through mergers and acquisition. This company became popular because of its efficient and creative services to the clients. From the phenomenal growth in 80s the company came to recession in the early 1990 and in 1995 the company went bankrupt. To get better competitive advantages the agencies were linked with common ownership. The management of the company had decided to make changes in two areas of balanced scorecard; these are customer perspective and financial perspective. In terms of financial perspective, the management made the structural changes of the top hierarchy of the organization. In 1995, the joint directors i.e. the two Saatchi brothers quit this company and Bob Seelert, a senior official of P&G joined as a chairman of the company. Kevin Robert who was a top official of General Foods joined as CEO of in 1997 (Business-Intelligence, 2006, p.3). After this reformulation in the top level, the company started de-merging and publicly announced the next three years strategies of companyââ¬â¢s comeback. Those goals were; growing company revenue more than market revenue, 30% of incremental revenue converting to operating revenue, doubling the EPS of the company. These goals were well accepted by the existing shareholders and become interested to the new investors (Business-Intelligence, 2006, p.3). The new management team found that the different business unit of the company did not have a common goal. They did financial health check by financial prospective analysis of
Saturday, August 10, 2019
Information Technology Outsourcing in Airlines Essay
Information Technology Outsourcing in Airlines - Essay Example The changing IT environment at overseas branches and operations of firms has such a big impact on the IT related decision making process. Airlines have increasingly been attracted to IT outsourcing companies mostly based in India. Airlines can be regarded as institutions that strive to provide their customers with safety and service quality by making use of certain kinds of IT in their activities. While big airlines have been making use of IT as the main investment related strategic policy alternative, smaller airlines like budget airlines too have been making use of it in order to achieve positive synergies in IT. However while the former have been able to increase their net investment expenditure on IT on a larger scale, the latter have only been able to increase IT related investment on a smaller scale. As a result a clear dichotomy between the two entities can be noticed. Larger airlines have adopted growth oriented information and communication technology (ICT) policy measures primarily with the intention of enhancing growth drivers such as merger and acquisition (M&A) related synergies while smaller organizations have basically relied on capturing niche market segments. IT outsourcing theories are many in number though very few of them successfully capture the essence of the growth pattern of this industry. The impact of IT outsourcing on global airlines has attracted the attention of many researchers and analysts. Particularly in modern industry situations such strategies have become more relevant against the backdrop of rapid competitive and changing environment. The available literature on the impact of IT outsourcing on airlines' corporate strategies suggests different analytical and conceptual frameworks based on modern IT investment programs that are already being put into practice at some big airlines across the world. As the available literature on the subject suggests there is a substantial amount of empirical evidence to support the ICT related operations and their positive impact on growth drivers such as revenues, profits, market share, share price and integration across a number of market segments without truncation at airlines (Glaser, 2002). Independent analysts have identified three forces that determine the ultimate growth prospects of companies. (a). Differences in the local business environmentThe application of processes and procedures in identifying differences in the local business environment is connected with the overall global business strategy of the firm. ICT is a single aspect of this global strategy. If the firm were unable to identify and isolate the important elements in the global operational environment, there would be much less of an opportunity for the
Friday, August 9, 2019
Origins of American History Essay Example | Topics and Well Written Essays - 1500 words
Origins of American History - Essay Example It is only knowledge from these primary sources that can possibly give us reliable evidence on the effects of slavery on the Atlantic civilization. The Flourishing of the Slave Trade The first effect of the slave trade on the Atlantic world was the expansion of the trade itself. Much of the information concerning this was exposed through the publication of the journals of John Barbot, a French Royal African Company agent who made voyages from the West Coast of Africa back to the Atlantic world, two of these documented in 1678 and 1682. Based on the Slave Trade documents by John Barbot, which were published in 1732, it was rather easy to obtain slaves from Africa because ââ¬Å"in times of dearth and famine, abundance of those people will sell themselves, for a maintenance, and to prevent starvingâ⬠. Moreover, according to John Barbot, the main consequence of the great supply of slaves from Africa going to the Atlantic civilization is the lesser demand for them and more important ly, the cruelty and inhumane treatment that is afforded these slaves. According to John Barbot, the masters of these slaves ââ¬Å"subsist them poorly and beat them inhumanlyâ⬠. ... Also, when the slaves die, the masters ââ¬Å"never bury them but case out the bodies into some by place, to be devoured by birds or beasts of preyâ⬠. This is rather one of the cruelest acts done by the masters on the slaves, which is not to afford dignity to the slaves even in death. Lastly, these slaves have been subjected to torture as Barbot himself admits ad confesses: ââ¬Å"And thoââ¬â¢ I must say I am naturally compassionate, yet have I been necessitated sometimes to cause the teeth of those wretches to be broken, because they would not open their mouthsâ⬠. From these accounts of John Barbot, one can clearly see the maltreatment of the slaves in the Atlantic civilization, whether in Europe or in America. This dominated the market during those times. Fusion of African and Atlantic Cultures The account of Olaudah Equiano, who was born in Benin in the late 1700s and kidnapped from there by the European slave traders, somehow opposed the idea of Barbot that it was ra ther easy to obtain slaves because they would sell themselves to prevent starving. On the other hand, it is possible that not all places would be the same all the time. Nevertheless, according to Equiano, when he arrived in England, he thought ââ¬Å"the languages of different nations did not totally differ, nor were they so copious as those of the Europeans, particularly the English [and] they were therefore easily learned; and while I was journeying thus through Africa [probably on board the slave ship], I acquired two or three different tonguesâ⬠. This is therefore a sign that the cultures of Africa have Formation of Anti-Slavery Organizations As early as 1790, there have been calls for anti-slavery in the Atlantic world, like the Society of the Friends of Blacks, who called for the abolition of
Thursday, August 8, 2019
'Self-determination is irrelevant in the 21st Century'. Discuss Essay
'Self-determination is irrelevant in the 21st Century'. Discuss - Essay Example It is accordingly, protected by various international human rights bodies that ensure all people get their rights. This concept has evolved during the 20th century following secessionist movements during and after World War I and II allowing for decolonization of countries from the 1960's onwards. The start of the famous European colonization of the Americas started around 1940's following the Spanish expedition headed by Christopher Columbus5. This followed a conquest that was featured by large-scale exploration, migration and eventually colonization in order to take full advantage of the resources in those foreign countries. Rebellions were the first characteristics of the determination to self-rule that was witnessed in the mid 1770's. Because of the explicit invocations of natural law, the natural right of man and the absence of consent from the people who were being governed, people began to revolt against colonial rule6. In the United Stated Declaration of Independence, the pro motion of the notion that the will of the people is supreme made significant contributions to the aspect of self-determination. These and some other notions are what led to the acceptance of the principle of self-determination. ... These treaties both held that people had a right to freely pursue their economic and political interests following self-determination. Previously, self-determination was considered a political principle with no legal effect. But following WW2, self-determination became a legal principle and a right in International Law. And because of its adoption by several treaties and charters it received worldwide recognition under International Law. The concept of self-determination is thus still relevant because of the number of cases in the International Court of Justice that have received ruling in favor of the concept of self-determination. Self-determination has thus achieved the status of erga omnes which requires the rest of the international community to respect it. Other jurists and scholars have also argued that the principle of self-determination has acquired the status of jus cogens making it the superior rule of international law. As such, the rest of the community has the mandate t o strictly obey it at all times and in all circumstances in their relations with each other. However, the UN Charter10 had no provisions for the enforcement of the right to self-determination outside the context of decolonization. It simply provided that countries be allowed to govern themselves but it did not provide other stipulations for how this was to take place. This allowed the legal doctrine of uti possidetis juris11 to thrive. This meant that old administrative boundaries became the international boundaries without taking into consideration the linguistic, ethical and cultural boundaries that had previously existed. Despite the fact that people of one culture were torn apart by international boundaries, nations succeeded in freeing themselves from colonial rule.
Wednesday, August 7, 2019
Impact of New Technologies Assignment Example | Topics and Well Written Essays - 500 words
Impact of New Technologies - Assignment Example This fact is applicable to art as well and not only in the disciplines. Just like conventional methods of creating art, digital artists require time fulfil their goals and accomplish masterpieces. For instance, Andrew Liszewski reveals how 3-D scanning can upgrade Renaissance cultures. Liszewski describes the entire creation as a ââ¬Å"painstakingly long computer-controlled milling procedureâ⬠(Liszewski 2014). The same description is relatively applicable to traditional artworks such as Leonardo da Vinciââ¬â¢s ââ¬Å"Monalisaâ⬠and Michelangeloââ¬â¢s painting ââ¬Å"The Creation of Adam,â⬠which took several years to complete. Tangibility has often been a pivotal aspect of art but is no longer a main concern. Digital techniques are a disruptive innovation in the field of art ITN (Source 2007). However, this technology does not disrupt their fineness in comparison with traditional methods of creating art. One can easily compare 3-D scanning and conventional methods of creating art to achieve a critical analysis both formal arts. However, competing both forms of art makes it difficult to justify the digital methods of creating art. Barry X Ballââ¬â¢s final product is helpful because original sculpture lost a number of elements over the years (Museum of Arts and Design 2013). This effort makes the ready scanning artistââ¬â¢s creation and almost necessary endeavor for admirers of the original sculpture. Whether the above artistsââ¬â¢ works are used in graphic projects or for commercial reasons is important. When 3-D scanning or digital methods are used to create art, the products are considered applied arts. As a result, proponents of traditional methods of creating art would argue that such applied arts are not at par with traditional works of art. For example, Barry X Ball employs a different style of art with different methods in contrast to the creator of the original sculpture. Ball uses art concepts used
Studies Cardiovascular Disease (CVD) Essay Example for Free
Studies Cardiovascular Disease (CVD) Essay Introduction Cardiovascular disease (CVD) has long been considered a disorder which principally affects men in our society; consideration of the occurrence of heart attacks in females, for example, has been largely an afterthought. In the past few years, however, it has become increasingly obvious that this is not a problem limited to males, but that it occurs with great frequency in women. We now know that CVD is the cause of death more than any condition in women over the age of 50, including cancer (1) and in fact is responsible for more than a third of all deaths in women (2). It is estimated that 370,000 women in the United States die from heart disease each year. However, our knowledge base regarding CVD in African American (AA) women has not kept pace with the accumulation of data on white females. Thus, there is a deficit of information about this subgroup and the prevalence of CVD despite the fact that black women have more risk factors for CVD than do white women (3). The purpose of this paper is to review the subject of CVD in African American women and to focus upon four principal CVD categories: Coronary artery disease (CAD), hypertension, stroke, and congestive heart failure (CHF).The impact of gender and race on each of these entities will be examined in comparison to white women, and a determination will be made as to whether a different approach to the management of these disorders should be made based on ethnicity and sex. Coronary Artery Disease It has long been held that men have much more of a problem with CAD than women do; the belief has been that men are more susceptible to the disease, whereas women enjoy the benefits of hormonal protection. Gender differences in the occurrence of heart attacks have been noted, especially in the younger years of adult life. However, as each decade passes, the gap between prevalence rates for males and females progressively narrows to the point where there is essentially no difference by the seventh and eighth decades (4). Thus, although heart attack rates in women lag behind that for men by approximately ten years in the early years of adult life, equivalency is achieved later. Clinical features of CAD have also been shown to differà substantially between men and women. The Framingham Study (5) demonstrated that CAD presented much more frequently as myocardial infarction in men than in women (49 vs. 29 percent), but women developed angina pectoris more frequently than men (47 vs. 26 percent). Risk factors for CAD such as dyslipidemia, hypertension, cigarette smoking, diabetes mellitus, family history, obesity, and sedentary lifestyle have about the same incidence in men and women. However, the effect that certain risk factors have is more adverse in women. For instance, the risk of developing CAD is much greater in diabetic women. Another risk factor with substantially greater impact on females is hypertriglyceridemia (6). African American women are especially affected by CAD in a negative manner. They have a higher mortality and morbidity than African American men and white women under the age of 55. In the age group 25-44, African American women have 2.5 times the coronary heart disease mortality risk of white women. The mortality rate from CAD for black women is about 69 percent higher than that for white women (7). Overall, in 1995, the CAD death rate for African American males was 133.1 per 1000 compared to 124.4 per 1000 for white males, or 7 percent higher for black males. Comparative rates for black and white women were 81.6 and 60.3 per 1000, respectively, indicating a 35 percent higher mortality rate for black women over white women. A study at West Virginia University stated that, compared to the overall national death rate from CVD in women of 401 per 100,000, the rate for black women in New York City was the highest among all major racial groups at 587 per 100,000. Rates for white and Hispanic women were 559 and 320 per 100,000, respectively. Mississippi had the h ighest black female CVD death rate in the nation at 686 per 100,000. The heart attack event rate is more than twice as high for black women than for white women in the age group 65-74 years (8), indicating that the impact of having a higher number of risk factors over time is more deleterious in black women. Despite a lower coronary artery disease prevalence in black women based on angiographic studies, mortality rates are higher in this group than in white women. This inverse relationship between angiographic evidence of CAD and CAD mortality represents what may be termed the paradox of CAD in African American women (9). Post-infarction mortality is also higher than that for black men and white men and women (10). It should be emphasized that first myocardial infarction occurs at an earlier age with anà earlier death in African American women. Certain risk factors are indeed more frequently seen in African American as compared to white women. There is a significantly higher incidence of hypertension and stroke in black women with myocardial infarct ion (11), and other risk factors which occur more frequently in this group include physical inactivity, higher mean body mass index (BMI) (12), and greater consumption of cholesterol and saturated fat (13). Cigarette smoking and obesity represent risks which have been documented to increase cardiovascular disease in black women. Smoking negates the advantage against CAD induced by estrogen in pre-menopausal women (14). Diabetes mellitus is of particular concern in black women as a risk factor; the death rate among diabetic blacks is 2.5 times higher than in diabetic whites (15), and black women have a higher prevalence of this disease. Diabetes completely eliminates the pre-menopausal protection that women have against CAD, and this would appear to be more of a problem for African American women. Access to preventive medical attention for CAD has been noted to be deficient for African American women. A classic example is the study performed by Schulman et al (16). Eight actors were used, of whom 4 were black, 4 were white, 4 were male, 4 were female, and the age range was from younger to older. All had videotaped interviews which were presented to more than 700 predominately white male primary care physicians attending a medical conference. The doctors were asked which patients they would be likely to refer for cardiac catheterization, based on a suggestive CAD profile which all of the patients possessed. Univariate analysis of the physiciansââ¬â¢ responses revealed that both men (90.6 percent) and whites (90.6 percent) were more likely to be referred for cardiac catheterization than women (84.7 percent) and blacks (84.7 percent). A race-gender analysis also showed that black women in particular were referred for this diagnostic procedure 40 percent less often than white men. This study has been interpreted as demonstrating racial and gender bias against African American women by white male physicians regarding referral for a critical cardiovascular procedure designed to detect CAD. The use of hormone or estrogen replacement therapy (HRT or ERT) has been investigated intensively in the past several years regarding their possible reduction of CVD risk in post-menopausal women. Several clinical trials including PEPI, ERA, and HERS have been performed, producing results which do not show a clear CADà mortality benefit derived from hormone use in post-menopausal women with CAD. There is still a possibility that they may be advantageous for primary prevention, and the ongoing Womenââ¬â¢s Health Initiative should provide useful information when it is concluded. There is no indication that black women respond differently than white women to HRT/ERT regarding the impact on CVD risk. Hypertension Pre-menopausal women who are hypertensive have a CAD mortality risk which is ten times greater than normal (17). In the United States there are more hypertensive women than there are men with high blood pressure (18), and the prevalence of hypertension is greater among African American women than among white women. Specifically, the prevalence of hypertension in blacks twenty years of age or older is in excess of that for the population of the nation as a whole. The percentages are 35 for black males and 34.2 for black females, compared to 24.4 for white males and 19.3 for white females (19). Hypertension is the most important risk factor for stroke and is easily the most modifiable one. In addition, it is the largest contributor to CVD morbidity and mortality in blacks. Comparative death rates for hypertension per 100,000 population are 29.6 for black males (355 percent higher than for white males), and 21.7 for black females (352 percent higher than for white females). The third National Health and Nutrition Examination Survey (NHANES III) also found that blacks have a higher prevalence of severe or stage III hypertension compared to non-blacks (20). Several differences in the pathogenesis of hypertension have been documented to exist between blacks and whites (21). African Americans are characterized by low-renin hypertension accompanied by salt sensitivity, e.g., poor toleration of salt-loading, and greater volume expansion as a consequence. These characteristics tend to make blacks less responsive to drugs which impact on the renin-angiotensin-aldosterone system (RAAS) such as angiotensin-converting enzyme (ACE) inhibitors and beta-blockers in the treatment of hypertension, and relatively more responsive to medications which decrease plasma volume, such as diuretics. Their salt sensitivity also renders them more susceptible to the hypertensive effects of a high-salt diet. It is estimated that over 70 percent of African Americans have low-renin h ypertension as compared to about half of whites. Although moreà than 90 percent of blacks have essential, or primary, hypertension, the discovery of a high renin level in a black patient, for instance, an elderly African American female, is so unusual that it strongly suggests a secondary cause for the blood pressure elevation. Black patients also tend to be more responsive to dihydropyridine calcium-channel blockers (CCBs) and alpha-1 blockers. However, there are some mitigating factors. For instance, although ACE inhibitors and beta-blockers may not be as effective as other drugs when used as monotherapy in blacks, they do have an antihypertensive result similar to that seen in whites when these drugs are administered in combination with diuretics. In addition, many black patients who do not respond to monotherapy treatment with these drugs used in conventional doses may respond to higher doses, although there is a risk of more side-effects. ACE inhibitors are also indicated in the treatment of congestive heart failure and for the deadly combination of hypertension and diabetes, especially if proteinuria is present. Other pathophysiological characteristics which are different between hypertensive blacks and whites are altered vascular reactivity, increased sodium retention, increased potassium excretion, and decreased kallikrein excretion seen in blacks, as well as more nephrosclerosis. Decreases in vasodilatory substances in blacks such as kinins, prostaglandins, and dopamine are also seen. Black hypertensives have also been noted to have increased intracellular sodium and calcium concentration, decreased membrane sodium transport, and decreased red-cell sodium-potassium transport activity. These changes are believed to render the African American patient more prone to vascular, renal and circulatory alterations which result in elevated blood pressure. Complications of hypertension have an earlier age of onset and a later age of detection in blacks than in their white counterparts. The principal complications are CAD, stroke, left ventricular hypertrophy, end-stage renal disease, and congestive heart failure. Because of these facts, it is important to treat hypertension in blacks more aggressively, e.g., early, thoroughly, and with multiple drugs as necessary. In addition, non-pharmacological measures such as diet, attention to obesity, increased physical exercise, and avoidance of excess alcohol intake are essential components of a well-rounded therapeutic approach to the black hypertensive. Stroke Stroke is the third leading cause of death in the United States after coronary heart disease and cancer. There are about 500,000 strokes each year of which 150,000 are fatal. Stroke is also a major cause of physical impairment and the cost of acute and chronic care exceeds $30 billion a year in this country. A so-called ââ¬Å"stroke beltâ⬠exists in the Southeastern part of the country, where almost 60 percent of the African American population resides (22). Although stroke is generally thought of as a disorder primarily affecting the elderly, it should be recognized that 28 percent of the victims are under age 65. African Americans have a stroke mortality which is twice that of whites (23). Age-adjusted stroke mortality rates are 76 percent higher among African American than among white men, and 54 percent higher among African American than white women (24). Although the rate of decline for stroke mortality has increased since the 1970s, there has been a recent slowdown in thi s decline. This has been especially true for African Americans, in whom stroke mortality is actually increasing. Since it is very difficult to treat stroke once the process is initiated, much of the focus has been on primary prevention. Hypertension is the most powerful predictor of stroke and is found to be a factor in 70 percent of cases (25). Control of hypertension therefore represents the best strategy to prevent stroke, and in fact a meta-analysis showed that when all studies of the association between treatment to lower blood pressure and stroke were reviewed, there was a 42 percent reduction in the incidence of stroke and a 45 percent reduction in fatal stroke when the diastolic blood pressure was reduced by 5-6 mmHg (26). In addition, the Systolic Hypertension in the Elderly Program (SHEP) demonstrated that a 36 percent decrease in stroke risk resulted from mean blood pressure reduction of 11/3.4 mmHg. This benefit was seen in all ages, races, and genders. These data and other information support the need for vigorous drug therapy of hypertension for the primary prevention of stroke. This is especially important for African American patients, particularly women. Congestive Heart Failure Congestive heart failure (CHF) is the only cardiovascular disease whose incidence is increasing. There are great differences between blacks and whites in the etiology of CHF. Hypertension is the principal precursor ofà CHF in African Americans, whereas ischemic heart disease more commonly precedes CHF in whites. Mortality due to heart failure is about 2.5 times higher in blacks than in whites less than 65 years of age. Additionally, in 1990 the age-adjusted death rate for CHF among patients older than 65 years of age was 143.9 for black men compared with 117.8 for white men, and 113.4 for black women compared with 97.5 for white women (27). In a study of racial differences in heart failure, Afzal et al (28) prospectively analyzed 163 consecutive patients admitted to Henry Ford Hospital in Detroit, Michigan with a diagnosis of CHF. They found that compared with whites, blacks were younger in age (mean age 63.8 vs. 70.8, p=0.0003), and had a higher prevalence of hypertension (86 vs. 66 percent, p=0.0004), left ventricular hypertrophy (24 vs. 8 percent, p=0.02), ejection fraction
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