133 research outputs found
VMJ775593_Supplementary_Table – Supplemental material for Adjunctive stent use during endovascular intervention to the femoropopliteal artery with drug coated balloons: Insights from the XLPAD registry
No full textSupplemental material, VMJ775593_Supplementary_Table for Adjunctive stent use during endovascular intervention to the femoropopliteal artery with drug coated balloons: Insights from the XLPAD registry by Damianos G Kokkinidis, Haekyung Jeon-Slaughter, Houman Khalili, Emmanouil S Brilakis, Nicolas W Shammas, Subhash Banerjee and Ehrin J Armstrong in Vascular Medicine</p
A novel method for modeling skidding for systems with nonholonomic constraints
No full textIn this paper, the effect of wheel skidding on the steering motion of a simple vertical rolling disk is investigated. By modifying the nonholonomic constraints, two novel dynamic models are proposed. The first model rotates the constraints and enforces them along a plane correlated to the skid angle. It then relates the skidding in a wheel to the Lagrange multipliers associated with the kinematic constraints of that wheel. The second model relaxes the no-skidding constraint, allowing its transgression and relates the skidding to the generalized velocities of the actuated degrees of freedom of the system. To validate our model, we compare it to one in the literature and we analyze the motion of the disk on icy and snowy road conditions, where skidding can be significant. © 2014 Springer Science+Business Media Dordrecht.Bakker E., 1987, SAE PAPER; Corradini M. L., 1999, P 1999 IEEE INT AM C, V6, P3935, DOI 10.1109-ACC.1999.786255; Corradini ML, 2002, J ROBOTIC SYST, V19, P177, DOI 10.1002-rob.10032; d'Andr'ea Novel B., 1995, INT J ROBUST NONLIN, V5, P243; de Castro R., 2010, 2010 IEEE VEH POW PR, P1, DOI 10.1109-MEDHOCNET.2010.5546867; de Wit C. C., 1995, P 3 EUR CONTR C ROM, P2630; Ding W., 2012, SELF EXCITED VIBRATI; Greenwood D. T., 1987, PRINCIPLES DYNAMICS; Liu CQ, 2008, NONLINEAR DYNAM, V51, P465, DOI 10.1007-s11071-007-9225-2; Low CB, 2007, IEEE INT CONF ROBOT, P2355, DOI 10.1109-ROBOT.2007.363671; Low C.B., 2008, ROBOT IEEE T, V24, P676; Low CB, 2008, IEEE-ASME T MECH, V13, P480, DOI 10.1109-TMECH.2008.2000827; Low CB, 2008, IEEE T CONTR SYST T, V16, P340, DOI 10.1109-TCST.2007.903100; Motte I, 2000, IEEE T ROBOTIC AUTOM, V16, P875, DOI 10.1109-70.897800; MURRAY RM, 1993, IEEE T AUTOMAT CONTR, V38, P700, DOI 10.1109-9.277235; OReilly OM, 1996, NONLINEAR DYNAM, V10, P287, DOI 10.1007-BF00045108; Pars L. A., 1979, TREATISE ANAL DYNAMI; Shammas E, 2006, IEEE INT CONF ROBOT, P1630; Shammas E. A., 2006, THESIS CARNEGIE MELL; Shammas E.A., 2005, P ROB SCI SYST CAMBR; Sidek N., 2008, 3 INT C SYST ICONS 0, V35-40, P13; Spong M. W., 2006, ROBOT MODELING CONTR; Udwadia FE, 2004, J APPL MECH-T ASME, V71, P615, DOI 10.1115-1.1767844; Wong J. Y., 2001, THEORY GROUND VEHICL1
Ten-year outcome of intraoperative treatment of atrial fibrillation using radiofrequency ablation
No full textNour Boulad,1 Nicolas W Shammas,1 Gerald Early,2 Shauna Roberts,3 Gail A Shammas,1 Yuhning Linda Hu,1 Holly Park,1 Michael Jerin1 1Midwest Cardiovascular Research Foundation, Bettendorf, IA, 2Cardiac and Thoracic Surgery, Pullman Hospital, Pullman, WA, 3Truman Medical Center-Hospital Hill, Kansas City, MO, USA Background: Intraoperative radiofrequency ablation (RFA) has been advocated to treat atrial fibrillation (AF). This report examines the long-term effects of intraoperative RFA in the prevention of recurrence of AF when used as an adjunctive treatment in patients undergoing cardiac procedures for primary indications unrelated to their arrhythmia.Methods: The study reviewed the records of patients from a tertiary medical center which had 2 cardiac surgeons performing an intraoperative adjunctive RFA procedure. A total of 20 patients undergoing RFA between April 11, 2003 and May 10, 2005 were included and followed for up to 10 years. The primary effectiveness outcome of the study was the recurrence of AF during the follow-up period. Data were collected from office or hospital medical records.Results: A total of 20 patients were included (mean age 69.4 years, males 40%). Eight patients were followed for 10 years and 2 patients for 9 years; 7 patients died during the 10-year follow-up period and 3 patients were lost to follow-up. As their primary procedures, the patients underwent valve surgery (65%), bypass surgery (15%), or both (20%). Intraoperative RFA failed to restore sinus rhythm in 2 patients. In the remaining 18 patients, AF recurred in 10 patients within 2 months of surgery, in 1 patient at 5 months, in 1 patient at 7 months, and in 6 patients after 1 year.Conclusion: AF had recurred in 100% of patients by the end of the long-term follow-up period. The adjunctive intraoperative RFA and postoperative interventions employed in this early study failed to maintain sinus rhythm. Keywords: radiofrequency ablation, cardiac surgery, intraoperative, long-term outcom
Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
No full textNicolas W Shammas,1,2 Gail A Shammas,1 Susan Jones-Miller,1,2 Mileah Rose Gumpert,1 Miranda Jade Gumpert,1 Christine Harb,1 Majid Z Chammas,1 W John Shammas,1 Rommy A Khalafallah,1 Amy Barzgari,1 Bassel Bou Dargham,1 Ghassan E Daher,1 Rayan Jo Rachwan,1 Andrew N Shammas1 1Midwest Cardiovascular Research Foundation, 2Cardiology Division, Genesis Heart Institute, Davenport, IA, USA Background: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure.Methods: We retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure.Results: A total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500).Conclusion: Patients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure. Keywords: access site, common femoral artery, complications, oral anticoagulan
Outcomes of patients treated with the everolimus-eluting stent versus the zotarolimus-eluting stent in a consecutive cohort of patients at a tertiary medical center
No full textNicolas W Shammas, Gail A Shammas, Elie Nader, Michael Jerin, Luay Mrad, Peter Marogil, Courtney Henn, Alex Dvorak, Archana Chintalapani, Susan MerinerMidwest Cardiovascular Research Foundation, Davenport, IA, USABackground: In this study we compared the outcomes of the everolimus-eluting stent (EES) versus the zotarolimus-eluting stent (ZES) in patients treated at a tertiary medical center, with up to one year of follow-up.Methods: Unselected consecutive patients were retrospectively recruited following stenting with the ZES (n = 197) or EES (n = 190). The first 100 consecutive patients in each cohort underwent syntax scoring. The primary endpoint of the study was target vessel failure, defined as the combined endpoint of cardiac death, non-fatal myocardial infarction, or target vessel revascularization. Secondary endpoints included target lesion revascularization, target lesion failure, acute stent thrombosis, total death, cardiac death, and non-fatal myocardial infarction.Results: The two groups were similar, including for Syntax scores (19.6 &plusmn; 12.8 versus 20.6 &plusmn; 13.6), number of stents per patient (2.9 &plusmn; 1.9 versus 2.9 &plusmn; 2.1), and cardiovascular risk factors. By one year, the primary outcome occurred in 20.8% EES versus 26.7% ZES (P = 0.19) patients. The secondary endpoints were as follows: target lesion revascularization (8.9% versus 20.6%, P = 0.003), target vessel revascularization (18.9% versus 25.6%, P = 0.142), definite and probable stent thrombosis (0% versus 2.5%), non-fatal myocardial infarction (2.7% versus 3.6%), and mortality (3.2% versus 5.1%) for the EES versus the ZES, respectively.Conclusion: EES had similar target vessel failure to ZES, but superior target lesion revascularization and target lesion failure at one year of follow-up in an unselected cohort of patients.Keywords: coronary stent, drug eluting stent, zotarolimus, everolimus, outcome, target lesion revascularization, stent thrombosi
Epidemiology, classification, and modifiable risk factors of peripheral arterial disease
No full textNicolas W ShammasMidwest Cardiovascular Research Foundation, Cardiovascular Medicine, PC, Davenport, IA, USAAbstract: Peripheral arterial disease (PAD) is part of a global vascular problem of diffuse atherosclerosis. PAD patients die mostly of cardiac and cerebrovascular-related events and much less frequently due to obstructive disease of the lower extremities. Aggressive risk factors modification is needed to reduce cardiac mortality in PAD patients. These include smoking cessation, reduction of blood pressure to current guidelines, aggressive low density lipoprotein lowering, losing weight, controlling diabetes and the use of oral antiplatelet drugs such as aspirin or clopidogrel. In addition to quitting smoking and exercise, cilostazol and statins have been shown to reduce claudication in patients with PAD. Patients with critical rest limb ischemia or severe progressive claudication need to be treated with revascularization to minimize the chance of limb loss, reduce symptoms, and improve quality of life.Keywords: peripheral arterial disease, epidemiology, risk factors, classificatio
A Regional Health System Journey from Volume to Value: Roadmap to the Recognition as a 15 Top Health System in the USA for Quality Excellence
No full textNidal H Harb,1,2 Patricia A Said,1 Shirley L Gusta,1 Amanda M Wesson,1 Jordan D Brautigam,1 Jon H Lemke,1 Stephen T DeLessio,1 Douglas P Cropper,1 Nicolas W Shammas1,3 1Quality and Safety Department, Genesis Health System, Davenport, IA, USA; 2Cardiovascular Division, University of Iowa Hospitals and Clinics, Iowa City, IA, USA; 3Cardiology Research Unit, Midwest Cardiovascular Research Foundation, Davenport, IA, USACorrespondence: Nicolas W Shammas, Midwest Cardiovascular Research Foundation, 630 E 4th Street, Davenport, IA, 52801, USA, Tel +1 563-320-0263, Email [email protected]: The 15 Top Health System program, an IBM Watson study, objectively measures health systems’ performance overall on an annual basis using publicly reported data available from the Center for Medicare and Medicaid Services (CMS) and state data banks. Genesis Health System was recognized as an IBM Watson Health 15 Top Health System for two consecutive years in 2020 and 2021. A system-based approach with a “physician-lead, professionally-managed” framework, led to accomplishing the 15 Top Health System. The steps needed included adoption of the IBM Watson database to determine current status of certain key performance indicators, establishing a clinical effectiveness program and governance structure, and adopting Lean methodologies to analyze and determine appropriate interventions with long-term solution. The desire and willingness to accomplish this ambitious goal start with adoption by the Board and the administration of the health system while supplying appropriate financial and human resources that are dedicated to the success of the journey. In this manuscript, we describe the journey and steps implemented to accomplish the outcomes that led to the recognition as a 15 Top Health System for quality excellence.Keywords: 15 Top Health System, physician lead, clinical effectiveness, Lean methodology, Value of car
Reassembling a World Literature: Anton Shammas\u27s Arabesques between Iowa and the Galilee
No full text The paper explores how the novel Arabesques (1986) by Israeli Palestinian author Anton Shammas (b. 1950) uses the Iowa International Writers Program in to interrogate and even relocate the consecration of world literature. Both creative writing programs and the concept and canons of world literature have become central issues in literary studies over the last two decades. My paper seeks to combine these two concerns with a view from outside Anglophone literature but in a way that comments on it and its institutions. It will do so through a critique of world literature and creative writing that can be found in the Anton Shammas’s writings. Arabesques is partly set in the University of Iowa’s International Writers Program and deals with the question of where the world’s literature is to be assembled and consecrated. The common assumption is that this process happens in big cities. But the novel (along with documents written by the founders of the Iowa program) shows how this program tries to mobilize the world’s wealth of literature into this new Midwestern location in Iowa. This is done through the movement of people and artifacts by way of international networks of cultural and technological mediation. The novel uses Iowa’s bid for centrality in the network of world literature to show how the canon and concept of world literature can also be assembled in the peripheral location of a small Galilee village. The mobility of texts and people turn out to have a potential for unsettling the global center/periphery and East/West dichotomies, even if only for the duration of the novel’s reading
Narrative Wayfinding: Author-izing Arab and Afghan Migration across Morphing Borderscapes
No full textNarrative Wayfinding: Author-izing Arab and Afghan Migration across Morphing Borderscapes takes a multidisciplinary approach to the study of narrative in the context of clandestine migration from the Arab world and Afghanistan to the EU. The dissertation argues that narration serves as a navigational tool for migrants as they traverse hostile locales and temporalities. Narrative craft allows migrants to captivate listeners and gain access to spaces and resources, and it also helps them process their own chaotic experiences. Drawing on Mikhail Bakhtin’s concept of the chronotope, Narrative Wayfinding highlights migrant tales that reveal a breadth of spatiotemporal, cultural-linguistic, and psychospiritual transmutations. Each chapter addresses a specific type of morphing, from the issue of extraterritorial sovereignty to the phenomenon of passing as a member of an identity group that is not one’s own to questions of translation. Using the tools of close reading and comparative analysis, the dissertation considers both recent migration literature and a collection of interviews gleaned from my 2019-20 fieldwork in which I volunteered with asylum aid organizations in Greece.
Chapter One centers on Anthems of Salt, a 2019 Arabic-language memoir. Algerian author Larbi Ramdani narrates his failed attempt at passing as a Syrian refugee after he migrates clandestinely to Greece. I read Ramdani’s shapeshifting as a tactic (in Michel de Certeau’s sense) undertaken in response to the morphing of the EU borderscape, which selectively expands and contracts to facilitate the passage of goods and wealthy travelers while excluding poor migrants with “inferior” passports.
The second chapter explores temporal disruption in two recent works of Arabic fiction: Hoda Barakat’s Night Mail (2018) and Yousri Alghoul’s Gallows of Darkness (2021). In this chapter, I make a literary-studies contribution to existing anthropological scholarship that demonstrates the ways migrant temporalities are stretched and squeezed by state and international actors in attempts to quell unauthorized migration. I argue that narrative revelations of these temporal manipulations, along with migrant resistance to them, constitute a challenge to the nationalist temporality of triumphalism. Fiction provides a way to represent temporal experiences that migrants themselves are typically barred from articulating.
Chapter Three centers on stories of Afghan men who come of age throughout their migrant journeys. It compares Dari short stories by Asef Soltanzadeh and Sayed Eshaq Shojai to the lived experiences of two young Afghan interlocutors whom I interviewed in Greece. Focusing on the theme of separation from and reintegration into society and on interrogations of masculinity, I liken these narratives to the structure of the classical Arabic ode (qaṣidah), and particularly to brigand (ṣuʿlūk) poetry as theorized by Suzanne Stetkevych. I argue that these coming-of-age tales demonstrate the formation of a subject (in the Althusserian sense) that cannot be neatly attached to a modern nation-state.
The final chapter tackles issues of translation from the perspective of refugees who serve as interpreters for their fellow travelers. Drawing heavily on interviews I conducted in Greece, this chapter asks to what extent scholarship on literary translation theory can borrow from the rough-and-ready practices of “good-enough” interpretation that are common among those whom I call refugee-translators.
While Walter Benjamin’s essay “The Storyteller” posits that movement produces narrative, my dissertation makes an inverse assertion: that migrant narration can facilitate increased mobility. By forging new narrative pathways through violent and ever-morphing obstacles, unauthorized migrants unearth hidden connections between supposedly divided worlds.PhDComparative LiteratureUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/177753/1/gliddell_1.pd
BASIC HYDROLOGY, WATER RESOURCES AND DAF BOAT PLANT FOR LAKE RESTORATION
No full textDEDICATION: This technical paper is published in memory of our senior author, Dr. Donald B. Aulenbach, who worked closely with Professors Lawrence K. Wang, Mu-Hao Sung Wang, Nazih K. Shammas, William A. Selke, Milos Krofta and Daniel Guss from 1981 to 2019 for developing a humanitarian engineering program at the Lenox Institute of Water Technology (LIWT; formerly Lenox Institute for Research), teaching/researching there as an Adjunct Professor for almost two decades, and publishing many research papers and textbooks for academic contribution to the humanity. We salute and will forever remember Don. ----------ABSTRACT: This chapter introduces the basic hydrology, water resources and a dissolved air flotation (DAF) boat plant for lake water treatment. Specific coverage includes: special features of water and their relationship to life on earth, hydrology, evaporation, transpiration, evapotranspiration, infiltration, percolation, runoff, ground water, impact of pollution on lakes, thermal impacts on the aquatic environment, toxics in water resources, goals of water pollution control, dissolved air flotation boat plant for lake restoration, glossary, and a list of senior author’s recent publication
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