THE GRAND ALLIANCE: FROM NECESSITY TO SUSPICION, DEVELOPMENT TO DECLINE

This thesis analyzes the development and decline of the relationship among the members of the Grand Alliance during World War II. The primary questions I answer are: what led to the creation of the Grand Alliance, and what caused the alliance to begin to decline at the peak of its effectiveness? To answer these questions, I begin with the events that took place prior to the war and describe how world leaders addressed Hitler’s aggression as individuals in lieu of an alliance; thereby showing the importance of an alliance after the war began. The study then proceeds chronologically, analyzing the correspondence among Roosevelt, Churchill, and Stalin to identify how these men worked together, despite their ideological differences to achieve victory over Hitler. Primary sources are used as both evidence and as a means of understanding public opinion to show how the decisions made by the two leaders of democratic nations may have been swayed by public opinion. Understanding the dynamics of the relationship leads to a better understanding of the irreconcilable differences among the objectives of the Big Three that ultimately led to the Cold War, despite their effectiveness as partners in terms of war planning. Ultimately, bargaining power varied among the members throughout the war, and created an atmosphere in which postwar plans were made by individuals with the best military position at the time of the decision making

The predictive value of the epicardial adipose thickness in the rate of expansion of the aortic root Dicke des epikardialen Fettgewebes als Prädiktor für die Ausdehnung der Aortenwurzel

Background: Epicardial adipose tissue (ECAT) is metabolically active and is involved in the development of atherosclerosis. The thickness of ECAT has been positively correlated with the dimensions of the ascending aorta. We aimed to examine whether ECAT thickness predicted the expansion of the aortic dimensions. Methods: The imaging results of patients who had undergone transthoracic echocardiographic (TTE) examinations more than twice during the period 2005�2015 were surveyed. We included adult patients who had undergone TTE examinations at least 1 year apart. The ECAT was measured in the parasternal long-axis view from the index TTE study. End-diastolic dimensions in three consecutive beats were averaged for all measurements. The annulus, root, and sinotubular junction (STJ) were also measured. The amount of increase (if any) in aortic dimensions per year was calculated and the correlation of this increase with the initial thickness of the ECAT was analyzed. Results: In total, 429 examinations were performed with 197 patients (17 females), from which 394 examinations were analyzed. The ECAT thickness was 8.6�± 3.6�mm. In the initial examinations, the annulus, STJ, and root measured 23�± 4, 28�± 4, and 34�± 4�mm, respectively. In univariate analysis, for every 1�mm of ECAT thickness, the STJ expanded 0.056 (95 CI: 0.001�0.112�mm/year; p�= 0.030) and the aortic root expanded 0.088�mm/year (p�< 0.001). In multivariate analysis, ECAT thickness remained an independent predictor of the aortic root expansion. For every 1�mm increase in ECAT thickness, the aortic root expanded by 0.036�mm (95 CI: 0.010�0.062) per year (p�= 0.007). Conclusion: The thickness of the ECAT is a predictor of more rapid increases in the dimensions of the aortic root. Further studies of patients with established aortic aneurysm are warranted. © 2019, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply