The Musical Heritage of Al-Andalus is a critical account of the history of Andalusian music in Iberia from the Islamic conquest of 711 to the final expulsion of the Moriscos (Spanish Muslims ...converted to Christianity) in the early 17th century. This volume presents the documentation that has come down to us, accompanied by critical and detailed analyses of the sources written in Arabic, Old Catalan, Castilian, Hebrew, and Latin. It is also informed by research the author has conducted on modern Andalusian musical traditions in Morocco, Algeria, Tunisia, Egypt, Lebanon and Syria. While the cultural achievements of medieval Muslim Spain have been the topic of a large number of scholarly and popular publications in recent decades, what may arguably be its most enduring contribution – music – has been almost entirely neglected. The overarching purpose of this work is to elucidate as clearly as possible the many different types of musical interactions that took place in medieval Iberia and the complexity of the various borrowings, adaptations, hybridizations, and appropriations involved.
An astonishingly rich oral epic that chronicles the early history of a Bedouin tribe, the Sirat Bani Hilal has been performed for almost a thousand years. In this ethnography of a contemporary ...community of professional poet-singers, Dwight F. Reynolds reveals how the epic tradition continues to provide a context for social interaction and commentary. Reynolds’s account is based on performances in the northern Egyptian village in which he studied as an apprentice to a master epic-singer. Reynolds explains in detail the narrative structure of the Sirat Bani Hilal as well as the tradition of epic singing. He sees both living epic poets and fictional epic heroes as figures engaged in an ongoing dialogue with audiences concerning such vital issues as ethnicity, religious orientation, codes of behavior, gender roles, and social hierarchies.
Early performance of the Micra transcatheter pacemaker from the global clinical trial reported a 99.2% implant success rate, low and stable pacing capture thresholds, and a low (4.0%) rate of major ...complications up to 6 months.
The purpose of this report was to describe the prespecified long-term safety objective of Micra at 12 months and electrical performance through 24 months.
The Micra Transcatheter Pacing Study was a prospective single-arm study designed to assess the safety and efficacy of the Micra VVIR leadless/intracardiac pacemaker. Enrolled patients met class I or II guideline recommendations for de novo ventricular pacing. The long-term safety objective was freedom from a system- or procedure-related major complication at 12 months. A predefined historical control group of 2667 patients with transvenous pacemakers was used to compare major complication rates.
The long-term safety objective was achieved with a freedom from major complication rate of 96.0% at 12 months (95% confidence interval 94.2%–97.2%; P < .0001 vs performance goal). The risk of major complications for patients with Micra (N = 726) was 48% lower than that for patients with transvenous systems through 12 months postimplant (hazard ratio 0.52; 95% confidence interval 0.35–0.77; P = .001). Across subgroups of age, sex, and comorbidities, Micra reduced the risk of major complications compared to transvenous systems. Electrical performance was excellent through 24 months, with a projected battery longevity of 12.1 years.
Long-term performance of the Micra transcatheter pacemaker remains consistent with previously reported data. Few patients experienced major complications through 12 months of follow-up, and all patient subgroups benefited as compared to transvenous pacemaker historical control group.
Interpreting the Self Kristen E. Brustad; Michael Cooperson; Jamal J. Elias ...
11/2023
eBook
Autobiography is a literary genre which Western scholarship has
ascribed mostly to Europe and the West. Countering this assessment
and presenting many little-known texts, this comprehensive work
...demonstrates the existence of a flourishing tradition in Arabic
autobiography. Interpreting the Self discusses nearly one
hundred Arabic autobiographical texts and presents thirteen
selections in translation. The authors of these autobiographies
represent an astonishing variety of geographical areas,
occupations, and religious affiliations. This pioneering study
explores the origins, historical development, and distinctive
characteristics of autobiography in the Arabic tradition, drawing
from texts written between the ninth and nineteenth centuries c.e.
This volume consists of two parts: a general study rethinking the
place of autobiography in the Arabic tradition, and the translated
texts. Part one demonstrates that there are far more Arabic
autobiographical texts than previously recognized by modern
scholars and shows that these texts represent an established
and-especially in the Middle Ages-well-known category of literary
production. The thirteen translated texts in part two are drawn
from the full one-thousand-year period covered by this survey and
represent a variety of styles. Each text is preceded by a brief
introduction guiding the reader to specific features in the text
and providing general background information about the author. The
volume also contains an annotated bibliography of 130 premodern
Arabic autobiographical texts. In addition to presenting much
little-known material, this volume revisits current understandings
of autobiographical writing and helps create an important
cross-cultural comparative framework for studying the genre.
Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia, but complications associated with conventional transvenous pacing systems are commonly related to the pacing lead ...and pocket. We describe the early performance of a novel self-contained miniaturized pacemaker.
Patients having Class I or II indication for VVI pacing underwent implantation of a Micra transcatheter pacing system, from the femoral vein and fixated in the right ventricle using four protractible nitinol tines. Prespecified objectives were >85% freedom from unanticipated serious adverse device events (safety) and <2 V 3-month mean pacing capture threshold at 0.24 ms pulse width (efficacy). Patients were implanted (n = 140) from 23 centres in 11 countries (61% male, age 77.0 ± 10.2 years) for atrioventricular block (66%) or sinus node dysfunction (29%) indications. During mean follow-up of 1.9 ± 1.8 months, the safety endpoint was met with no unanticipated serious adverse device events. Thirty adverse events related to the system or procedure occurred, mostly due to transient dysrhythmias or femoral access complications. One pericardial effusion without tamponade occurred after 18 device deployments. In 60 patients followed to 3 months, mean pacing threshold was 0.51 ± 0.22 V, and no threshold was ≥2 V, meeting the efficacy endpoint (P < 0.001). Average R-wave was 16.1 ± 5.2 mV and impedance was 650.7 ± 130 ohms.
Early assessment shows the transcatheter pacemaker can safely and effectively be applied. Long-term safety and benefit of the pacemaker will further be evaluated in the trial.
ClinicalTrials.gov ID NCT02004873.
Atrioventricular junction (AVJ) ablation with permanent pacing improves symptoms in selected patients with atrial fibrillation (AF). The optimal pacing modality after AVJ ablation remains unclear. We ...performed a meta-analysis of randomized controlled trials to examine whether cardiac resynchronization therapy (CRT) is superior to right ventricular (RV) pacing in this patient population.
We searched the MEDLINE and EMBASE databases for studies evaluating the effect of CRT vs. RV pacing after AVJ ablation for AF. Pooled risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively, using a random effects model. Five trials involving 686 patients (413 in CRT and 273 in RV pacing group) were included in the analysis. On the basis of the pooled estimate across the studies, CRT resulted in a non-significant reduction in mortality (RR = 0.75, 95% CI 0.43-1.30; P= 0.30) and a significant reduction in hospitalizations for heart failure (RR = 0.38, 95% CI = 0.17-0.85; P= 0.02) compared with RV pacing. Cardiac resynchronization therapy did not improve 6 min walk distance (mean difference 15.7, 95% CI -7.2 to 38.5 m; P= 0.18) and Minnesota Living with Heart Failure quality-of-life score (mean difference -3.0, 95% CI -8.6 to 2.6; P= 0.30) compared with RV pacing. The change in left ventricular ejection fraction between baseline and 6 months favoured CRT (mean change 2.0%, 95% CI 1.5-2.4%; P< 0.001).
Cardiac resynchronization therapy may be superior to RV pacing in patients undergoing AVJ ablation for AF. Further studies, adequately powered to detect clinical outcomes, are required.
Abstract
Sīrat Banī Hilāl (the Epic of the Banī Hilāl) is rooted in the 10th-century invasion of North Africa by the Banī Hilāl Bedouin tribe after they left their homeland of the Najd in the Arabian ...Peninsula. Told in a combination of poetry and prose similar to the style of other epic tales such as that of 'Antar, Sayf ibn Dhī Yazin, and Dhāt al-Himmah, Sīrat Banī Hilāl is nevertheless unique in that it is the only one of the folk epics traditionally to be performed in sung verse to the accompaniment of musical instruments (rather than spoken or read aloud). It is also distinctive for being a tale that recounts the elaborate interactions among a constellation of main figures rather than being primarily about the exploits of a single hero. Among these central characters, however, one in particular deserves notice for his psychological complexity-Abū Zayd al-Hilālī, the black hero of the Banī Hilāl tribe. Abū Zayd, it is argued here, combines many of the features of the 'classic hero' as delineated by Otto Rank, Lord Raglan, and Joseph Campbell, as well as characteristics of the Trickster figures studied by Carl Jung, Paul Radin, M.C. Lyons, and others. He is at times the chivalrous hero, a model of manly virtues, but also capable of cunning and deceptive behavior that borders on the dishonorable, and in a few infamous scenes he kills innocent people and tells outright lies to cover his tracks, leaving modern audiences baffled and conflicted. At the same time, however, for reasons spelled out in this essay, Abū Zayd is the character with whom modern Egyptian audiences most clearly identify: a black hero denigrated for his skin color, capable of great deeds of heroism, chivalry, and religious devotion, as well as acts of an intensely transgressive nature.
Device repositioning during Micra leadless pacemaker implantation may be required to achieve optimal pacing thresholds.
The purpose of this study was to describe the natural history of acute elevated ...Micra vs traditional transvenous lead thresholds.
Micra study VVI patients with threshold data (at 0.24 ms) at implant (n = 711) were compared with Capture study patients with de novo transvenous leads at 0.4 ms (n = 538). In both cohorts, high thresholds were defined as >1.0 V and very high as >1.5 V. Change in pacing threshold (0–6 months) with high (1.0 to ≤1.5 V) or very high (>1.5 V) thresholds were compared using the Wilcoxon signed-rank test.
Of the 711 Micra patients, 83 (11.7%) had an implant threshold of >1.0 V at 0.24 ms. Of the 538 Capture patients, 50 (9.3%) had an implant threshold of >1.0 V at 0.40 ms. There were no significant differences in patient characteristics between those with and without an implant threshold of >1.0 V, with the exception of left ventricular ejection fraction in the Capture cohort (high vs low thresholds, 53% vs 58%; P = .011). Patients with an implant threshold of >1.0 V decreased significantly (P < .001) in both cohorts. Micra patients with high and very high thresholds decreased significantly (P < .01) by 1 month, with 87% and 85% having 6-month thresholds lower than the implant value. However, when the capture threshold at implant was >2 V, only 18.2% had a threshold of ≤1 V at 6 months and 45.5% had a capture threshold of >2 V.
Pacing thresholds in most Micra patients with elevated thresholds decrease after implant. Micra device repositioning may not be necessary if the pacing threshold is ≤2 V.
IMPROVE Brady assessed whether a process improvement intervention could increase adoption of guideline-based therapy in sinus node dysfunction (SND) patients.
/Results: IMPROVE Brady was a ...sequential, prospective, quality improvement initiative conducted in India and Bangladesh. Patients with symptomatic bradycardia were enrolled. In Phase I, physicians assessed and treated patients per standard care. Phase II began after implementing educational materials for physicians and patients. Primary objectives were to evaluate the impact of the intervention on SND diagnosis and pacemaker (PPM) implant. SF-12 quality of life (QoL) and Zarit burden surveys were collected pre- and post-PPM implant.
A total of 978 patients were enrolled (57.7 ± 14.8 years, 75% male), 508 in Phase I and 470 in Phase II. The diagnosis of SND and implantation of PPM increased significantly from Phase I to Phase II (72% vs. 87%, P < 0.001 and 17% vs. 32%, P < 0.001, respectively). Pacemaker implantation was not feasible in 41% of patients due to insurance/cost barriers which was unaltered by the intervention. Both patient QoL and caregiver burden improved at 6-months post-PPM implant (P < 0.001).
A process improvement initiative conducted at centers across India and Bangladesh significantly increased the diagnosis of SND and subsequent treatment with PPM therapy despite the socio-economic constraints.
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