Hoda Hatoum

Contact

hhatoum@mtu.edu
906-487-2852
H-STEM 352

Assistant Professor, Biomedical Engineering
Affiliated Assistant Professor, Mechanical and Aerospace Engineering

PhD, Mechanical Engineering, The Ohio State University
MS, Mechanical Engineering, The Ohio State University
BE, Mechanical Engineering, The American University of Beirut

Biography

Dr. Hoda Hatoum obtained her BS degree in mechanical engineering from the American University of Beirut and her PhD degree from the Ohio State University (OSU). She was awarded the American Heart Association postdoctoral fellowship and right after graduation, she completed her postdoctoral training at the Ohio State University and at Georgia Institute of Technology. Her research focuses on tackling the complexity of: (a) structural heart biomechanics (adult and congenital); (b) patient-specific cardiovascular model development and in-vitro testing; (c) prosthetic heart valve engineering (surgical and transcatheter); (d) structure-function relationships of the heart in health and disease at the pediatric and adult stages; and (e) turbulence in blood flow in relation to blood damage; and (f) impact of arrhythmias and treatment approaches on cardiovascular flows. Dr. Hatoum has published in multiple journals spanning both clinical and bioengineering sides and given oral and poster presentations at national and international conferences. She has received several recognitions including the Presidential Graduate Fellowship from OSU, an invited talk at the Heart Valve Society, the best paper award from the Annals of Biomedical Engineering and she was a finalist in the American College of Cardiology Young Investigator Award 2021.

Biofluids Laboratory

Trainees

Health Research Institute

Venn diagram of biofluids with biomaterials manufacturing 3d printing structural heart defects experimental and computational. — The Biofluids Lab is at the heart of engineering and clinical research. We utilize novel technologies to solve clinical problems, and we benefit from diverse collaborative efforts on the biomaterials, manufacturing, clinical, and translational sides.

Links of Interest

Teaching Experience

BE 4510 and 5510: Cardiovascular Engineering
BE 3350: Introduction to Human Biomechanics

Research Areas

Cardiovascular Biomechanics
Cardiovascular Biofluids
Fluid Mechanics
Medical Devices
Patient-Specific Modeling

Recent Publications

Magen Radke, Fatiesa Sulejmani, Brennan Vogl, and Hoda Hatoum. Integrating Cardiovascular Engineering and Biofluid Mechanics in High School STEM Education: An Experiential Approach. Journal of Biomechanical Engineering, 2024. https://doi.org/10.1115/1.4064822
Gerardo V. Lo Russo, Hasan Alarouri, Abdullah Al-Abcha, Brennan Vogl, Abdulah Mahayni, Agata Sularz, Hoda Hatoum, Jeremy Collins, Juan Crestanello, and Mohamad Alkhouli. Association of Bovine Arch Anatomy with Incident Stroke After Transcatheter Aortic Valve Replacement. Journal of the American Heart Association. 2024. https://doi.org/10.1161/JAHA.123.032963
Brennan J. Vogl, Agata Sularz, Scott Lilly, Vinod H. Thourani, Brian Lindman, Mohamad Alkhouli, and Hoda Hatoum. Effect of blood pressure levels on sinus hemodynamics in relation to calcification after bioprosthetic aortic valve replacement. Annals of Biomedical Engineering. 2023. DOI : 10.1007/s10439-023-03426-4.
Mohamad Alkhouli, Hasan Alarouri, Anders Kramer, Kasper Korsholm, Jeremy Collins, Ole De Backer, Hoda Hatoum, Jens Erik Nielsen-Kudsk. Device-Related Thrombus After Left Atrial Appendage Occlusion Clinical Impact, Predictors, Classification, and Management. JACC: Cardiovascular Interventions. 2023. https://doi.org/10.1016/j.jcin.2023.10.046
Brennan J. Vogl, Alejandra Chavez-Ponce, Adam Wentworth, Eric Erie, Pradeep Yadav, Vinod H. Thourani, Lakshmi Prasad Dasi, Brian Lindman, Mohamad Alkhouli, and Hoda Hatoum. Differential Impact of Blood Pressure Control Targets on Epicardial Coronary Flow after Transcatheter Aortic Valve Replacement. Structural Heart. 2023. https://doi.org/10.1016/j.shj.2023.100230
Asadbeygi, A., Lee, S., Kovalchin, J., & Hatoum, H. (2023). Effect of Beta Blockers on the Hemodynamics and Thrombotic Risk of Coronary Artery Aneurysms in Kawasaki Disease. Journal of Cardiovascular Translational Research, 1-10.
Alkhouli, M., Hatoum, H., & Piazza, N. (2023). Computational Modeling to Guide Structural Heart Interventions: Measure Twice (or Thrice) but Cut Once. Cardiovascular Interventions.
Esmailie, F., Hatoum, H., Thourani, V. H., & Dasi, L. P. (2023). The impact of local blood residence time in neo-sinus on post transcatheter aortic valve replacement subclinical leaflet thrombosis—a commentary. Interdisciplinary CardioVascular and Thoracic Surgery, 36(1), ivad012.
Vogl, Brennan, Rajat Gadhave, Zhenyu Wang, Ahmed El Shaer, Alejandra Chavez Ponce, Mohamad Alkhouli, and Hoda Hatoum. "Effect of Aortic Curvature on Bioprosthetic Aortic Valve Performance." Journal of Biomechanics (2023): 111422.
Alireza Asadbeygi, Simon Lee, John Kovalchin and Hoda Hatoum. Predicting Hemodynamic Indices in Coronary Artery Aneurysms Using Response Surface Method: An Application in Kawasaki Disease. Computer Methods and Programs in Biomedicine. 2022. https://doi.org/10.1016/j.cmpb.2022.107007
Michael Biersmith, Nader Makki, Hoda Hatoum, Breandan Yeats, David Orsinelli, Konstantinos Boudoulas, Lakshmi Dasi, and Scott Lilly. Comparison of Catheterization Versus Echocardiographic Based Gradients in Balloon Expandable Versus Self Expanding Transcatheter Aortic Valve Implantation. The Journal of Invasive Cardiology 2022. https://www.hmpgloballearningnetwork.com/site/jic/comparison-catheterization-versus-echocardiographic-based-gradients-balloon-expandable
Brennan J. Vogl, Yousef M. Darestani, Juan Crestanello, Brian Lindman, Mohamad Alkhouli and Hoda Hatoum. A Preliminary Study on the Usage of a Data-Driven Probabilistic Approach to Predict Valve Performance Under Different Physiological Conditions. Annals of Biomedical Engineering, 2022. DOI: https://doi.org/10.1007/s10439-022-02971-8
Shelley Chee-Mei Gooden, Hoda Hatoum, Konstantinos Dean Boudoulas, Mani A Vannan, Lakshmi P Dasi. Effects of MitraClip Therapy on Mitral Flow Patterns and Vortex Formation: An in vitro Study. Annals of Biomedical Engineering, 2022. DOI: 10.1007/s10439-022-02944-x.
Hoda Hatoum, Milad Samaee, Janarthanan Sathananthan, Stephanie Sellers, Maximillian Kutting, Scott Lilly, Abdul Rahman Ihdayhid, Philipp Blanke, Jonathon Leispic, Vinod Thourani, and Lakshmi Dasi. Comparison of performance of self-expanding and balloon-expandable transcatheter aortic valves. Journal of Thoracic and Cardiovascular Surgery Open, 2022. DOI: 10.1016/j.xjon.2022.04.015.
Zhenyu Wang, Lakshmi Prasad Dasi and Hoda Hatoum. Controlling the Flow Separation in Heart Valves Using Vortex Generators. Annals of Biomedical Engineering (ABME), 2022. https://doi.org/10.1007/s10439-022-02966-5
Brennan Vogl, Ahmed El Shaer, Martin van Zyl, Ammar Killu, Mohamad Alkhouli and Hoda Hatoum. Effect of Catheter Ablation on the Hemodynamics of the Left Atrium. Journal of Interventional Cardiac Electrophysiology. 2022. https://doi.org/10.1007/s10840-022-01191-3
Hatoum H, Ahn S., Lilly S., Maureira P., Crestanello J., Thourani, V. and Dasi LP. Flow Dynamics of surgical and transcatheter aortic valves: Past to Present. Journal of Thoracic and Cardiovascular Surgery Open. 2022. https://doi.org/10.1016/j.xjon.2022.01.017
Brennan J. Vogl, Ahmed El Shaer, Juan A. Crestanello, Mohamad Alkhouli and Hoda Hatoum. Flow Dynamics in the Sinus and Downstream of a Third and Fourth Generation Balloon Expandable Transcatheter Aortic Valve. Journal of the mechanical behavior of biomedical materials (JMBBM) 2022. https://doi.org/10.1016/j.jmbbm.2022.105092
Samaee M, Hatoum H, Biersmith M, Yeats B, Gooden S, Thourani VH, Hahn RT, Lilly SM, Yoganathan A, and Dasi LP. Gradient and Pressure Recovery of a Self-Expandable Transcatheter Aortic Valve Depends on Ascending Aorta Size: An In vitro Study. Journal of Thoracic and Cardiovascular Surgery Open (JTCVS Open), 2021. https://doi.org/10.1016/j.xjon.2022.01.003
Brennan J. Vogl, Yousef M. Darestani, Scott M. Lilly, Mohamad Alkhouli, Vinod Thourani, Brian R. Lindman and Hoda Hatoum. Impact of Blood Pressure on Coronary Perfusion and Valvular Hemodynamics after Aortic Valve Replacement. Catheterization and Cardiovascular Interventions. 2021. http://doi.org/10.1002/ccd.30052.
Brennan J. Vogl, Nicholas R. Niemi, Leigh Griffiths, Mohamad Alkhouli and Hoda Hatoum. Impact of calcific aortic valve disease on valve mechanics. Biomechanics and Modeling in Mechanobiology (BMMB), 2021. https://doi.org/10.1007/s10237-021-01527-4.
Hoda Hatoum, Shelley C.M. Gooden, Janarthanan Sathananthan, Stephanie Sellers, Maximillian Kutting, Philipp Marx, Scott M. Lilly, Abdul R. Ihdayhid, Vinod H. Thourani and Lakshmi Prasad Dasi. Neo-sinus and sinus flow after transcatheter aortic valve replacement of self-expanding and balloon-expandable valves. JACC: Cardiovascular Interventions. 2021. https://doi.org/10.1016/j.jcin.2021.09.013
Hatoum H, Singh-Gryzbon S, Esmailie F, Ruile P, Neumann FJ, Blanke P, Thourani VH, Yoganathan AP and Dasi LP. Predictive Model for Thrombus Formation after Transcatheter Valve Replacement. Cardiovascular Engineering and Technology (CVET), 2021. https://doi.org/10.1007/s13239-021-00596-x.
Hatoum H, Askegaard G., Iyer R and Dasi LP. Atrial and ventricular flows across a transcatheter mitral valve. Interactive CardioVascular and Thoracic Surgery. 2021. DOI: 10.1093/icvts/ivab032.
Hatoum H, Krishnamurthy R, Parthasarathy J, Flemister DC, Krull KM, Walter BA, Mery CM, Molossi S and Dasi LP. Flow Dynamics in Anomalous Aortic Origin of a Coronary Artery in Children: Importance of the Intramural Segment. Seminars in Thoracic and Cardiovascular Surgery. 2020.
Gooden S, Hatoum, H, Zhang, W, Boudoulas D, Dasi LP. “Multiple MitraClips: The Balancing Act between Pressure Gradient and Regurgitation” The Journal of Thoracic and Cardiovascular Surgery (2020). (Accepted)
Hatoum H, Dasi LP, and Vinod H. Thourani. “Surgical Aortic Valve Sizing: Imagine the Benefits of Imaging.” The Annals of Thoracic Surgery (2020). https://doi.org/10.1016/j.athoracsur.2020.03.099.
Hatoum H, Lilly S, Maureira P, Crestanello J and Dasi LP. Hatoum H, Lilly S, Maureira P, Crestanello J, Dasi LP. “Sinus Hemodynamics after Transcatheter Aortic Valve in Transcatheter Aortic Valve”. The Annals of Thoracic Surgery (2020), doi: https://doi.org/10.1016/j.athoracsur.2020.02.016.
Hatoum, Hoda, Shelley Gooden, Megan Heitkemper, Kevin M. Blum, Jason Zakko, Martin Bocks, Tai Yi et al. “Fetal Transcatheter Trileaflet Heart Valve Hemodynamics: Implications of Scaling on Valve Mechanics and Turbulence.” Annals of Biomedical Engineering (2020): 1-11. https://doi.org/10.1007/s10439-020-02475-3.
Heitkemper, Megan, Srikrishna Sivakumar, Hoda Hatoum, Jennifer Dollery, Scott M. Lilly, and Lakshmi Prasad Dasi. “Simple 2D anatomical model to predict risk of coronary obstruction during transcatheter aortic valve replacement.” The Journal of Thoracic and Cardiovascular Surgery (2020). https://doi.org/10.1016/j.jtcvs.2020.01.085.
Hatoum, Hoda, Rebecca T. Hahn, Scott Lilly, and Lakshmi Prasad Dasi. “Differences in Pressure Recovery Between Balloon Expandable and Self-expandable Transcatheter Aortic Valves.” Annals of Biomedical Engineering 48, no. 2 (2020): 860-867. https://doi.org/10.1007/s10439-019-02425-8.

Recent Funding

07/01/2024–06/30/2026: “A Novel Transcatheter Mitral Valve Replacement Device”. The American Heart Association (AHA). Award number: 24IPA1274290.
04/01/2024–03/31/2027: “Classification and Prediction of Thrombus Grades after Left Atrial Appendage Occlusion”. The American Heart Association (AHA). Award number: 24CDA1269661.
05/01/2024–12/31/2024: "Effects of Microgravity on Predisposing Factors for Atrial Fibrillation Thrombosis Risk" Michigan Space Grant Consortium (MSGC) 2024 fellowship, awarded to undergraduate student Grace Hoeppner.
04/01/2023–03/31/2026: “ERI: Fluid dynamics of non-Newtonian blood substitutes in heart valve applications”. $200,000. National Science Foundation (NSF). Award number: 2301649.
05/08/2023–08/27/2023: “Predicting patient prosthesis mismatch after aortic valve replacement”. $10,000. GLRC-ICC Rapid Seedling Award at Michigan Technological University.
06/01/2022–05/31/2023: “Diagnosis and treatment of coronary artery aneurysms using machine learning methods”. Blue Cross Blue Shield of Michigan Foundation, awarded to PhD student Alireza Asadbeygi.
08/29/2022–08/28/2023: “Predicting adverse outcome after atrial fibrillation ablation using patient-specific flow assessment”. Blue Cross Blue Shield of Michigan Foundation, awarded to PhD student Brennan Vogl.
01/01/2022–12/31/2022: “Hemodynamic Factors Associated with Thromboembolic Risk in Kawasaki Disease”. Research Excellence Fund and the Health Research Institute at Michigan Technological University.
2019–2020: “Superhydrophobic leaflets with vortex generators to reduce turbulence in prosthetic heart valves”. $106,532.00. American Heart Association. Grant ID 19POST34380804.

Presentations

Hatoum H. Experimental Fluid Modeling of a Fetal Valve. Heart Valve Society (HVS). February 19, 2024. Boston, MA, USA.
Hatoum H. Predictive Modeling for Cardiovascular Diseases: Where the Rubber Hits the Road. ASME ICEME Conference, October 30 – November 2, 2023. New Orleans, Louisiana, USA.
Vogl BJ, Vitale E, Wang Zhenyu, Sularz A, Chavez Ponce A, Lo Russo GV, Alarouri HS, Alkhouli M, and Hatoum H. Geometric Predictors of Stroke After Transcatheter Aortic Valve Replacement. Transcatheter Cardiovascular Therapeutics TCT 2022. San Franciso, CA. October 23 – 26 2023.
Vogl BJ, Sularz A, Chavez Ponce A, El Shaer A, Kramer A, Jia Christa, Bavo A, De Beule M, Nielsen-Kudsk JE, De Backer O, Alkhouli M, and Hatoum H. Predictors of Device Related Thrombosis After Left Atrial Appendage Occlusion. Transcatheter Cardiovascular Therapeutics TCT 2022. San Franciso, CA. October 23 – 26 2023.
Darestani YM, Vogl BJ, Vitale E, Sularz A, Chavez Ponce A, Alarouri HS, Lilly S, Goel S, Thourani V, Alkhouli M and Hatoum H. A Data-Driven Bayesian Model to Predict Leaflet Thrombosis After Bioprosthetic Aortic Valve Replacement. Transcatheter Cardiovascular Therapeutics TCT 2022. San Franciso, CA. October 23 – 26 2023.
Hatoum H. Hemodynamic interplay of blood pressure, valve performance and epicardial coronary flow. Biomechanics in Vascular Biology and Disease. Gordon Conference, August 6 – 11, 2023.
Hatoum H. TAVR Innovations: Focus on Advances from Women in Valve Science. Cardiovascular Translational Science Seminar Series. August 16, 2023.
Hatoum H. Predicting outcomes after Transcatheter Aortic Valve Replacement. 2022 9th World Congress of Biomechanics (WCB). Taipei, Taiwan, July 10 – 14, 2022.
Hatoum H. Flow Dynamics to Shape Future Aortic Valve Designs. McMaster University, Canada, March 10, 2022.
Hatoum H. Future Valve Designs to Mitigate Valve Thrombosis. Heart Valve Society 2022. Miami, FL.
Hatoum H. Importance of flow dynamics in the assessment of cardiovascular disease and outcomes. Centre for Heart Lung Innovation (Vancouver) Talk. Vancouver, Canada, January 28, 2022.
Hatoum H. Neo-sinus and sinus flow after self-expanding and balloon-expandable transcatheter aortic valve replacement. St. Paul's Hospital Cardiovascular Division Journal Club, Vancouver, Canada, January 19, 2022.
B. Vogl, A. Chavez Ponce, A. El Shaer, A. Bavo, M. De Beule, M. Alkhouli, and H. Hatoum. Predicting device related thrombosis after left atrial appendage occlusion using computational fluid dynamics. SB3C 2023 conference, Vail, Colorado, June 4 – 8, 2023.
B. Vogl, Z. Wang, A. Chavez Ponce, A. El Shaer, M. Alkhouli, and H. Hatoum. A computational assessment of stroke predictors after transcatheter aortic valve replacement. SB3C 2023 conference, Vail, Colorado, June 4 – 8, 2023.
B. Vogl, S. Lilly, V. Thourani, M. Alkhouli, B. Lindman, and H. Hatoum. Impact of Blood Pressure on Coronary and Sinus Flow Dynamics After Aortic Valve Replacement. SB3C 2023 conference, Vail, Colorado, June 4 – 8, 2023.
Vogl BJ, El Shaer A, Chavez Ponce A, Bavo A, De Beule M, Alkhouli M and Hatoum H. Predicting Device Related Thrombosis Using Computational Fluid Dynamics. Transcatheter Cardiovascular Therapeutics TCT 2022. Boston, MA. September 16 – 19 2022.
Asadbeygi A, Lee S, Kovalchin J and Hatoum H. Comparison of Thrombotic Risk Between Coronary Artery Aneurysm and Coronary Ectasia Based on Hemodynamic Parameters. Transcatheter Cardiovascular Therapeutics TCT 2022. Boston, MA. September 16 – 19 2022.
Brennan J. Vogl, Ahmed El Shaer, Alejandra Chavez Ponce, Alessandra Bavo, Matthieu De Beule, Mohamad Alkhouli, and Hoda Hatoum. Predicting Device Related Thrombosis Using Computational Fluid Dynamics. BMES 2022 Conference, San Antonio, TX, 2022.
Vogl B, Darestani Y, Crestanello J, Lindman B, Alkhouli M, and Hatoum H. Predicting Valve Performance Using Logistic Regression. 2022 Summer Biomechanics, Bioengineering, and Biotransport Conference (SB3C2022), Maryland, USA, June 20-23, 2022.
Vogl B, Gadhave R, Wang Z, El Shaer A, Crestanello J, Alkhouli M, Hatoum H. Effect of Aortic Curvature On Bioprosthetic Aortic Valve Performance. 2022 Summer Biomechanics, Bioengineering, and Biotransport Conference (SB3C2022), Maryland, USA, June 20-23, 2022.
Asadbeygi A, Lee S, Kovalchin J and Hatoum H. Predicting Hemodynamic Indices in Coronary Artery Aneurysms Using Response Surface Method: An Application in Kawasaki Disease. SB3C: Summer Biomechanics, Bioengineering, and Biotransport, Maryland, USA, June 20-23, 2022.
Hatoum H, Samaee M, Sathananthan J, Sellers S, Kuetting M, Lilly S, Ihdayhid A, Blanke P, Leipsic J, Thourani V, and Dasi LP. Flow Dynamic Differences Between Self-Expanding and Balloon Expandable Transcatheter Aortic Valves. 2022 Summer Biomechanics, Bioengineering, and Biotransport Conference (SB3C2022), Maryland, USA, June 20-23, 2022.
Vogl BJ, Lilly SM, Thourani VH, Alkhouli MA, Lindman BR and Hatoum H. Impact Of Blood Pressure Conditions On Coronary Perfusion And Hemodynamics After Aortic Valve Replacement. Heart Valve Society Conference (HVS), 2022, Miami, Florida.
Brennan J. Vogl, Ahmed El Shaer, Mohamad A. Alkhouli, and Hoda Hatoum. Hemodynamic Assessment Of The New Generation Balloon Expandable Transcatheter Aortic Valve (BMES 2021, Orlando, Florida, 6 – 9 October, 2021).
Hoda Hatoum, Shelley Gooden, Yasaman Farsiani, Milad Samaee, Janarthanan Sathananthan, Scott Lilly, Abul Rahman Ihdayhid, Vinod Thourani, and Lakshmi Prasad Dasi. Neo-Sinus and Sinus Flows After Transcatheter Aortic Valve Implantation of Evolut, SAPIEN 3, Acurate Neo and Allegra (SB3C 2021, Virtual).
Hatoum, H. Novel Predictive Model For Leaflet Thrombosis in Transcatheter Aortic Valve Replacement. American College of Cardiology (ACC) 2021, Young Investigator Award. April 30, 2021.
Biersmith M, Alston M, Makki N, Hatoum H, Yeats B, Orsinelli D, Boudoulas K, Dasi L, Lilly S. Comparison of Catheterization Versus Echocardiographic Based Gradients in Balloon Expandable Versus Self Expanding TAVR. Society for Cardiovascular Angiography & Intervention (SCAI), 2021, Virtual.
Hoda Hatoum, Shelley Gooden, Megan Heitkemper, Kevin Blum, Jason Zakko, Martin Bocks, Tai Yi, Yen-Lin Wu, Yadong Wang, Christopher Breuer, Lakshmi Dasi. Implications of Hemodynamics on The Sizing of A Fetal Transcatheter Trileaflet Heart Valve. BMES, 2020. (Virtual)
Breandan Yeats, Sri Krishna Sivakumar, Hoda Hatoum, Vinod Thourani, Scott Lilly, Susan O'Neil, Lakshmi Dasi. Quantifying the Relationship Between Aortic Cusp Asymmetry, Aortic Arch And Calcific Aortic Valve Disease. BMES, 2020. (Virtual)
H. Hatoum. Blood damage after transcatheter valve replacement: a fluids perspective. Midwest Heart Valve Day. September 23, 2020.
H. Hatoum, G. Askegaard, R. Iyer, and L.P. Dasi. Atrial and Ventricular Flows Across a Transcatheter Mitral Valve. SB3C 2020. (Virtual)
H. Hatoum, P. Maureira, J. Crestanello, S. Lilly and L.P. Dasi. Fluid Mechanics of Aortic Heart Valves: 70 Years of Evolution. SB3C 2020. (Virtual)
H. Hatoum, S. Gooden, M. Heitkemper, K. Blum, J. Zakko, M. Bocks, T. Yi, Y.L. Wu, Y. Wang, C.K. Breuer and L.P. Dasi. Implications of Scaling on Trileaflet Fetal Valve Hemodynamics. SB3C 2020. (Virtual)
H. Hatoum, R. Krishnamurthy, J. Parthasarathy, D.C. Flemister, C.M. Krull, B.A.Walter, C. Mery, S. Molossi and L.P. Dasi. Patient-Specific Hemodynamic Assessment of Anomalous Aortic Origin of a Coronary Artery (AAOCA) in Children. SB3C 2020. (Virtual)
Hatoum H, Kota A, Bark D, Popat K and Dasi LP. Impact of superhydrophobicity on prosthetic valve hemodynamics and turbulence. The 17th international conference on Biomedical Engineering. Singapore, December 9-12, 2019.
Hatoum H and Dasi LP. Aortic Sinus Vortex Spatio-Temporal Variations With Leaflet Calcification. SB3C: Summer Biomechanics, Bioengineering, and Biotransport, Seven Springs, Pennsylvania, USA, June 25-28, 2019.