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  1. Article ; Online: Diagnosis of Peripheral Artery Disease Using Backflow Abnormalities in Proximal Recordings of Accelerometer Contact Microphone (ACM).

    Shokouhmand, Arash / Wen, Haoran / Khan, Samiha / Puma, Joseph A / Patel, Amisha / Green, Philip / Ayazi, Farrokh / Tavassolian, Negar

    IEEE journal of biomedical and health informatics

    2023  Volume 27, Issue 1, Page(s) 274–285

    Abstract: Objective: The development of an accurate, non-invasive method for the diagnosis of peripheral artery disease (PAD) from accelerometer contact microphone (ACM) recordings of the cardiac system.: Methods: Mel frequency cepstral coefficients (MFCCs) ... ...

    Abstract Objective: The development of an accurate, non-invasive method for the diagnosis of peripheral artery disease (PAD) from accelerometer contact microphone (ACM) recordings of the cardiac system.
    Methods: Mel frequency cepstral coefficients (MFCCs) are initially extracted from ACM recordings. The extracted MFCCs are then used to fine-tune a pre-trained ResNet50 network whose middle layers provide streams of high-level-of-abstraction coefficients (HLACs) which could provide information on blood pressure backflow caused by arterial obstructions in PAD patients. A vision transformer is finally integrated with the feature extraction layer to detect PAD, and stratify the severity level. This architecture is coined multi-stream-powered vision transformer (MSPViT). The performance of MSPViT is evaluated on 74 PAD and 21 healthy subjects.
    Results: Sensitivity, specificity, F1 score, and area under the curve (AUC) of 99.45%, 98.21%, 99.37%, and 0.99, respectively, are reported for the binary classification which ensures accurate detection of PAD. Furthermore, MSPViT suggests average sensitivity, specificity, F1 score, and AUC of 96.66%, 97.34%, 96.29%, and 0.96, respectively, for the classification of subjects into healthy, mild-PAD, and severe-PAD classes. The silhouette score is calculated to assess the separability of clusters formed for classes in the penultimate layer of MSPViT. An average silhouette score of 0.66 and 0.81 demonstrate excellent cluster separability in PAD detection and severity classification, respectively.
    Conclusion: The achieved performance suggests that the proximal ACM-driven framework can replace state-of-the-art techniques for PAD detection.
    Significance: This study presents a fundamental step towards prompt and accurate diagnosis of PAD and stratification of its severity level.
    MeSH term(s) Humans ; Peripheral Arterial Disease ; Blood Pressure ; Accelerometry
    Language English
    Publishing date 2023-01-04
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2695320-1
    ISSN 2168-2208 ; 2168-2194
    ISSN (online) 2168-2208
    ISSN 2168-2194
    DOI 10.1109/JBHI.2022.3218595
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Diagnosis of Coexisting Valvular Heart Diseases Using Image-to-Sequence Translation of Contact Microphone Recordings.

    Shokouhmand, Arash / Wen, Haoran / Khan, Samiha / Puma, Joseph A / Patel, Amisha / Green, Philip / Ayazi, Farrokh / Ebadi, Negar

    IEEE transactions on bio-medical engineering

    2023  Volume 70, Issue 9, Page(s) 2540–2551

    Abstract: Objective: Development of a contact microphone-driven screening framework for the diagnosis of coexisting valvular heart diseases (VHDs).: Methods: A sensitive accelerometer contact microphone (ACM) is employed to capture heart-induced acoustic ... ...

    Abstract Objective: Development of a contact microphone-driven screening framework for the diagnosis of coexisting valvular heart diseases (VHDs).
    Methods: A sensitive accelerometer contact microphone (ACM) is employed to capture heart-induced acoustic components on the chest wall. Inspired by the human auditory system, ACM recordings are initially transformed into Mel-frequency cepstral coefficients (MFCCs) and their first and second derivatives, resulting in 3-channel images. An image-to-sequence translation network based on the convolution-meets-transformer (CMT) architecture is then applied to each image to find local and global dependencies in images, and predict a 5-digit binary sequence, where each digit corresponds to the presence of a specific type of VHD. The performance of the proposed framework is evaluated on 58 VHD patients and 52 healthy individuals using a 10-fold leave-subject-out cross-validation (10-LSOCV) approach.
    Results: Statistical analyses suggest an average sensitivity, specificity, accuracy, positive predictive value, and F1 score of 93.28%, 98.07%, 96.87%, 92.97%, and 92.4% respectively, for the detection of coexisting VHDs. Furthermore, areas under the curve (AUC) of 0.99 and 0.98 are respectively reported for the validation and test sets.
    Conclusion: The high performances achieved prove that local and global features of ACM recordings effectively characterize heart murmurs associated with valvular abnormalities.
    Significance: Limited access of primary care physicians to echocardiography machines has resulted in a low sensitivity of 44% when using a stethoscope for the identification of heart murmurs. The proposed framework provides accurate decision-making on the presence of VHDs, thus reducing the number of undetected VHD patients in primary care settings.
    MeSH term(s) Humans ; Heart Valve Diseases/diagnostic imaging ; Heart Murmurs/diagnosis ; Heart Auscultation ; Echocardiography ; Predictive Value of Tests
    Language English
    Publishing date 2023-08-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 160429-6
    ISSN 1558-2531 ; 0018-9294
    ISSN (online) 1558-2531
    ISSN 0018-9294
    DOI 10.1109/TBME.2023.3253381
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Delayed Presentation of a Large Pseudoaneurysm in the Common Femoral Artery After an Electrophysiology Study.

    Ratcliffe, Justin / Berookhim, Joshua / Khullar, Pankaj / Rajper, Naveed / Puma, Joseph

    JACC. Case reports

    2020  Volume 2, Issue 3, Page(s) 454–455

    Abstract: We describe a rare case of an exceptionally large pseudoaneurysm that developed in the right common femoral artery 6 months after an electrophysiological study. Surgical and other conventional methods to treat his pseudoaneurysm were not feasible. ... ...

    Abstract We describe a rare case of an exceptionally large pseudoaneurysm that developed in the right common femoral artery 6 months after an electrophysiological study. Surgical and other conventional methods to treat his pseudoaneurysm were not feasible. Therefore, the pseudoaneurysm was successfully treated via an endovascular approach with a covered stent. (
    Language English
    Publishing date 2020-03-18
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2019.12.035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Venture capital and international entrepreneurship

    LiPuma, Joseph A

    The Routledge companion to international entrepreneurship , p. 186-201

    2015  , Page(s) 186–201

    Author's details Joseph A. LiPuma
    Keywords Risikokapital ; Unternehmensgründung ; Entrepreneurship-Ansatz ; Internationale Betriebswirtschaftslehre
    Language English
    Publisher Routledge
    Publishing place London [u.a.]
    Document type Article
    ISBN 978-0-415-82919-9 ; 0-415-82919-4
    Database ECONomics Information System

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  5. Article ; Online: Development and treatment of two distinct pseudoaneurysms following transradial coronary catheterization in a patient with high bleeding risk: a case report.

    Wu, Lingling / Haddadin, Faris / Berookhim, Joshua / Ratcliffe, Justin / Puma, Joseph

    Journal of medical case reports

    2019  Volume 13, Issue 1, Page(s) 282

    Abstract: Background: A pseudoaneurysm is a rare but serious complication after transradial coronary catheterization. Although different treatment modalities have been proposed to treat post-catheterization pseudoaneurysm, only limited data are available to guide ...

    Abstract Background: A pseudoaneurysm is a rare but serious complication after transradial coronary catheterization. Although different treatment modalities have been proposed to treat post-catheterization pseudoaneurysm, only limited data are available to guide the treatment approach.
    Case presentation: We report a rare case of two distinct pseudoaneurysms complicating transradial percutaneous coronary intervention in a 75-year-old Hispanic woman being treated with dual antiplatelet agents for myocardial infarction and warfarin for atrial fibrillation. The pseudoaneurysms were diagnosed with ultrasound and were successfully treated with a series of Terumo Corporation (TR) band compressions.
    Conclusions: This case demonstrates the efficacy of compression therapy in managing post-catheterization radial artery pseudoaneurysm in patients with high bleeding risk.
    MeSH term(s) Aged ; Aneurysm, False/diagnostic imaging ; Atrial Fibrillation/drug therapy ; Cardiac Catheterization/adverse effects ; Dual Anti-Platelet Therapy ; Female ; Humans ; Myocardial Infarction/drug therapy ; Percutaneous Coronary Intervention ; Radial Artery/diagnostic imaging ; Ultrasonography, Doppler, Duplex
    Language English
    Publishing date 2019-09-08
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2269805-X
    ISSN 1752-1947 ; 1752-1947
    ISSN (online) 1752-1947
    ISSN 1752-1947
    DOI 10.1186/s13256-019-2205-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Transpedal approach for femoral-popliteal chronic total occlusions using the outback® elite re-entry device.

    Gorenchtein, Mike / Rajper, Naveed / Green, Philip / Khullar, Pankaj / Amoruso, Daniel / Bulacan, Christian Franz / Kwan, Tak / Puma, Joseph / Ratcliffe, Justin

    CVIR endovascular

    2021  Volume 4, Issue 1, Page(s) 9

    Abstract: Background: Transpedal access is increasingly utilized for the treatment of peripheral artery disease (PAD). Femoral-popliteal artery chronic total occlusions (CTOs) are some of the most difficult lesion subsets that sometimes require the use of re- ... ...

    Abstract Background: Transpedal access is increasingly utilized for the treatment of peripheral artery disease (PAD). Femoral-popliteal artery chronic total occlusions (CTOs) are some of the most difficult lesion subsets that sometimes require the use of re-entry support devices during percutaneous intervention. Limited data is available on the use of re-entry devices when treating femoral-popliteal CTOs via transpedal access. The aim of this study was to demonstrate the feasibility of using the Outback® Elite re-entry device for the treatment of femoral-popliteal CTOs via the transpedal approach in an outpatient based lab setting.
    Methods: Seventeen patients presented with femoral-popliteal CTOs in which treatment required the use of the Outback® Elite re-entry device. All procedures were performed in a single outpatient based lab. Patients were followed at 1 week and 1 month post-procedure, with lower extremity arterial duplex ultrasound assessment during the 1 month follow-up.
    Results: The average patient age was 78 years-old, with 71% being males. Most patients presented with Rutherford class IV symptoms. Procedural success was achieved in all patients with no requirement to convert to femoral artery access in any of the cases. No immediate post-procedural complications nor at any time during follow-up were observed. Ultrasonography at 1 month follow-up showed patent intervention sites and access site vessels in all patients.
    Conclusion: The use of the Outback® Elite re-entry device for the treatment of femoral-popliteal CTOs via transpedal access is a feasible option and may have potential benefits by avoiding risks associated with traditional femoral artery access.
    Language English
    Publishing date 2021-01-06
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2520-8934
    ISSN (online) 2520-8934
    DOI 10.1186/s42155-020-00203-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Venture capitalist and entrepreneur knowledge of new venture internationalization

    Park, Sarah / LiPuma, Joseph A / Prange, Christiane

    International small business journal Vol. 33, No. 8 , p. 901-928

    a review of knowledge components

    2015  Volume 33, Issue 8, Page(s) 901–928

    Author's details Sarah Park; Joseph A LiPuma and Christiane Prange
    Keywords knowledge classification ; internationalization ; new ventures ; venture capital
    Language English
    Publisher Sage
    Publishing place London
    Document type Article
    ZDB-ID 613488-9 ; 2058559-7
    ISSN 1741-2870 ; 0266-2426
    ISSN (online) 1741-2870
    ISSN 0266-2426
    Database ECONomics Information System

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  8. Article ; Online: Clinical Outcomes of Additional Below-The-Ankle Intervention Compared to Below-The-Knee Intervention Alone: A Post-Hoc Analysis of a Prospective Multicenter Study.

    Metser, Gil / Puma, Joseph / Mustapha, Jihad / Adams, George L / Ratcliffe, Justin / Khullar, Pankaj / Rosero, Joshua H C / Armstrong, Ehrin J / Zayed, Mohamed / Green, Philip

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

    2022  Volume 30, Issue 5, Page(s) 711–720

    Abstract: Purpose: To investigate the clinical implication of additional below-the-ankle (BTA) intervention in patients with chronic limb-threatening ischemia (CLTI) undergoing below-the-knee (BTK) intervention.: Materials and methods: A sub-analysis was ... ...

    Abstract Purpose: To investigate the clinical implication of additional below-the-ankle (BTA) intervention in patients with chronic limb-threatening ischemia (CLTI) undergoing below-the-knee (BTK) intervention.
    Materials and methods: A sub-analysis was performed using data from the LIBERTY trial (
    Results: There were no differences in procedural success or severe angiographic complications between the 2 groups. At 1-year post-procedure, patients in the BTK group had a higher rate of freedom from major amputation (95.0% vs. 86.9%, respectively; HR: 2.87, 95% CI: 1.17-7.03), a higher rate of freedom from TVR (80.1% vs. 66.9%, respectively; HR: 1.94, 95% CI: 1.14-3.32), a higher rate of freedom from MALE-POD (94.6% vs. 86.9%, respectively; HR: 2.65, 95% CI: 1.10-6.41), and a higher rate of freedom from MAE at both 1 (76.0% vs. 60.1%, respectively; HR: 2.00, 95% CI: 1.24-3.22) and 3 years post procedure (67.5% vs. 55.8%, respectively; HR: 1.69, 95% CI: 1.08-2.65). There was a significantly lower rate of survival in the BTK group at 3 years (74.3% vs. 91.1%, respectively; HR: 0.35, 95% CI: 0.14-0.87). After risk adjustment, there was a higher rate of all-cause death in the BTK group at 3 years (19.4% vs. 9.1%, respectively; p=0.023) post-intervention.
    Conclusion: Patients with disease requiring intervention to BTA lesions have a potential increased amputation rate in the short term, but BTA intervention carries a potential survival benefit in the long term when compared to BTK intervention alone.
    MeSH term(s) Humans ; Ankle ; Prospective Studies ; Treatment Outcome ; Lower Extremity/blood supply ; Wound Healing
    Language English
    Publishing date 2022-05-03
    Publishing country United States
    Document type Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2006618-1
    ISSN 1545-1550 ; 1526-6028
    ISSN (online) 1545-1550
    ISSN 1526-6028
    DOI 10.1177/15266028221092981
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Venture capitalists' risk mitigation of portfolio company internationalization

    LiPuma, Joseph A / Park, Sarah

    Entrepreneurship, theory and practice : ET & P Vol. 38, No. 5 , p. 1183-1205

    2014  Volume 38, Issue 5, Page(s) 1183–1205

    Author's details Joseph A. LiPuma; Sarah Park
    Keywords Risikokapital ; Unternehmensgründung ; Portfolio-Investition ; Internationaler Markteintritt
    Language English
    Size graph. Darst.
    Publisher USASBE
    Publishing place Nashville, Tenn
    Document type Article
    ZDB-ID 645949-3
    ISSN 0363-9428
    Database ECONomics Information System

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  10. Article ; Online: Treatment of an external iliac artery chronic total occlusion using alternate access sites.

    Ratcliffe, Justin / Gorenchtein, Mike / Khullar, Pankaj / Casso Dominguez, Abel / Satish, Mohan / Green, Philip / Puma, Joseph

    CVIR endovascular

    2019  Volume 2, Issue 1, Page(s) 42

    Abstract: Background: With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient ... ...

    Abstract Background: With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases.
    Case presentation: A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy. Angiography revealed a chronic total occlusion of the left external iliac artery, which was treated successfully by percutaneous intervention via a primary transpedal approach and with the assistance of the Outback® Elite re-entry device. The patient was discharged 2 h after the procedure and reported significant symptom improvement at follow-up.
    Conclusion: This case highlights a newly adopted endovascular approach through an alternate access site and illustrates how the Outback® Elite device can be used as an adjunctive tool in the treatment of complex lower-extremity vascular lesions.
    Language English
    Publishing date 2019-12-13
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2520-8934
    ISSN (online) 2520-8934
    DOI 10.1186/s42155-019-0089-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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