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5. Impressions of the GDMC AI Settlement Generation Challenge in Minecraft

Author

Salge, Christoph, Aranha, Claus, Brightmoore, Adrian, Butler, Sean, Canaan, Rodrigo, Cook, Michael, Green, Michael Cerny, Fischer, Hagen, Guckelsberger, Christian, Hadley, Jupiter, Hervé, Jean-Baptiste, Johnson, Mark R, Kybartas, Quinn, Mason, David, Preuss, Mike, Smith, Tristan, Thawonmas, Ruck, and Togelius, Julian

Subjects
Computer Science - Other Computer Science
Abstract

The GDMC AI settlement generation challenge is a PCG competition about producing an algorithm that can create an "interesting" Minecraft settlement for a given map. This paper contains a collection of written experiences with this competition, by participants, judges, organizers and advisors. We asked people to reflect both on the artifacts themselves, and on the competition in general. The aim of this paper is to offer a shareable and edited collection of experiences and qualitative feedback - which seem to contain a lot of insights on PCG and computational creativity, but would otherwise be lost once the output of the competition is reduced to scalar performance values. We reflect upon some organizational issues for AI competitions, and discuss the future of the GDMC competition., Comment: 28 pages, 5 figures

Published
2021

8. Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy: A study of the ESC EORP PPCM registry

Author

Sliwa, Karen, van der Meer, Peter, Viljoen, Charle, Jackson, Alice M., Petrie, Mark C., Mebazaa, Alexandre, Hilfiker-Kleiner, Denise, Maggioni, Aldo P., Laroche, Cecile, Regitz-Zagrosek, Vera, Tavazzi, Luigi, Roos-Hesselink, Jolien W., Hamdan, Righab, Frogoudaki, Alexandra, Ibrahim, Bassem, Farhan, Hasan Ali Farhan, Mbakwem, Amam, Seferovic, Petar, Böhm, Michael, Pieske, Burkert, Johnson, Mark R., and Bauersachs, Johann

Published
2024
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12. Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care

Author

Foster, Damon, Shabbir, Nadia, Connolly, Simon, Cartier, Andrea, Jaffer, Sajjida, Winpenny, Carmen, Daby, Doris, Pepper, Samuel, Adamson, Christine, Carungcong, Jamie, Nundlall, Kribashnie, Fedele, Serge, Samson-Fessale, Pardina, Schoolmeesters, Alexandra, Gomes de Almeida Martins, Laura, Bull, Rhian, Correia Da Costa, Patricia, Bautista, Carina, Eleanor Flores, Maria, Maheswaran, Shameera, Macabodbod, Lester, Houseman, Rosalie, Svensson, Marie-Louise, Sayan, Amrinder, Fung, Carrie, Garner, Justin, Lai, Dilys, Nelson, Mark, Moore, Luke, Gidwani, Shewta, Davies, Gary, Ouma, Beatrice, Salinos, Clovis, Salha, Jad, Yassein, Redasaad, Abbasi, Abdul, Oblak, Metod, Steward, Angelica, Thankachen, Mini, Barker, Amy, Fernandes, Candida, Beatriz, Veronica, Flores, Leah, Soler-Carracedo, Alfredo, Rocca, Alessandra, Martella, Carmela, Lloyd, Charlotte, Nolan, Ciara, Horsford, Latoya, Martins, Laura, Thomas, Lervina, Winstanley, Mark, Bourke, Miriam, Branch, Nicholas, Orhan, Orhan, Morton, Richard, Saunder, Sangeetha, Patil, Shashank, Hughes, Stephen, Zhe, Wu, De Leon, Ashley, Farah, Ayaan, Rya, Grace, Alizadeh, Katrin, Leong, Kirsty, Trepte, Laure, Goel, Nupur, McGown, Patrick, Kirwan, Ursula, Vilela Baião, Tamiris, Marins, Luana, Nazer, Sandro, Malaguthi de Souza, Raquel, Feitosa, Marcella, Lessa, Flavia, Silva de Magalhães, Elizabeth, Costenaro, Jamile, de Cassia Alves Lira, Rita, Carolina, Ana, Cauduro de Castro, Andréa, Machado Da Silva, Andre, Kliemann, Dimas, De Cassia Alves Lira, Rita, Walker, Gemma, Norton, Donna, Lowthorpe, Vicki, Ivan, Monica, Lillie, Patrick, Easom, Nicholas, Sierra Madero, Juan, López Iñiguez, Álvaro, Patricia Muñuzuri Nájera, Guadalupe, Paola Alarcón Murra, Claudia, Alanis Vega, Audelia, Muñoz Trejo, Teresa, Pérez Rodríguez, Olivia, Shah, Pallav L, Orton, Christopher M, Grinsztejn, Beatriz, Donaldson, Gavin C, Crabtree Ramírez, Brenda, Tonkin, James, Santos, Breno R, Cardoso, Sandra W, Ritchie, Andrew I, Conway, Francesca, Riberio, Maria P D, Wiseman, Dexter J, Tana, Anand, Vijayakumar, Bavithra, Caneja, Cielito, Leaper, Craig, Mann, Bobby, Samson, Anda, Bhavsar, Pankaj K, Boffito, Marta, Johnson, Mark R, Pozniak, Anton, and Pelly, Michael

Published
2023
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15. The safety, acceptability, and success rates of amniocentesis in the context of preterm prelabor rupture of membranes and threatened preterm labor: a systematic review and meta-analysis.

Author

Short, Daniel J., Sheth, Shreya, Kelleher, Meredith, Shah, Nishel M., Male, Victoria, Kallapur, Suhas, David, Anna L., and Johnson, Mark R.

Subjects
MEDICAL subject headings, PREMATURE labor, AMNIOTIC liquid, CHILD mortality, MICROBIAL invasiveness, AMNIOCENTESIS
Abstract

Introduction: Preterm birth, defined as birth before 37 weeks of gestation, is the leading cause of death of children under the age of five years worldwide. Globally there has been no change in the preterm birth rate between 2010 and 2020, when rates were calculated to be 9.8% and 9.9% of all livebirths, respectively. The analysis of amniotic fluid has been advocated by many to identify the mechanisms driving threatened preterm labor. Amniocentesis is largely considered to be safe, but care provider concerns about complications in the setting of threatened preterm labor (tPTL) exist. This systematic review will critically review the data regarding safety and outcomes of amniocentesis in cases of PPROM and tPTL and help in the counseling and clinical decision-making of patients and care providers alike. Methods: This systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA). All English language, peer-reviewed human studies where amniocentesis was used to sample the amniotic fluid of patients presenting with tPTL or PPROM and published between January 1990 and March 2022 were included. Data on the uptake rates, success rates, and safety profile associated with amniocentesis in this context of tPTL or PPROM were analyzed as part of the systematic review. Included studies compromised of randomized control trials, cohort studies, and case-control studies. Conference abstracts and abstracts with no full text were excluded. Results: 10,215 studies were returned after searches were conducted in MEDLINE, EMBASE, EMCARE, Web of Science, and SCOPUS databases using free text and Medical Subject Headings (MESH). 399 studies were assessed for eligibility with 15 studies being included in the final review. The main reason for exclusion from the review was an absence of safety data. Four studies gave information on uptake rates of amniocentesis in cases of PPROM and tPTL, with a range of 55% in an observational study to >99% in centers offering it as part of routine care. Eleven studies detailed success rates of amniocentesis, with all centers reporting >90% success rates. However, in some centers, a "successful" amniocentesis was deemed to be a retrieval of >0.5 ml. Three studies reported risks associated with amniocentesis. There were four reported complications (all transitory) in a series of 1119 cases (0.35%). Discussion: This systematic review found that amniocentesis in cases of PPROM or threatened preterm labor is a safe and feasible procedure. These data should give care providers confidence to counsel patients appropriately. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Living with peripartum cardiomyopathy: A statement from the Heart Failure Association and the Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology.

Author

Sliwa, Karen, Rakisheva, Amina, Viljoen, Charle, Pfeffer, Tobias, Simpson, Maggie, Jackson, Alice M., Petrie, Mark C., van der Meer, Peter, Al Farhan, Hasan, Jovanova, Silvana, Mbakwem, Amam, Sinagra, Gianfranco, Van Craenenbroeck, Emeline, Hoevelmann, Julian, Johnson, Mark R., Mindham, Richard, Chioncel, Ovidiu, Kahl, Kai G., Rosano, Giuseppe, and Tschöpe, Carsten

Subjects
CARDIOVASCULAR nurses, SOCIAL workers, HEART failure, EXTENDED families, QUALITY of life
Abstract

This statement focuses on the fact that women with peripartum cardiomyopathy (PPCM) have a substantial mortality and morbidity rate. Less than 50% of patients have full recovery of their cardiac function within 6 months of diagnosis. Also, patients with recovered cardiac function often suffer from comorbidities, such as hypertension or arrhythmias, which require long‐term treatment. This has major implications which extend beyond the life of the patient, as it may also substantially impact her family. Women with a new diagnosis of PPCM should be involved in the decision‐making processes regarding therapies, e.g. the recommendation to abstain from breastfeeding, or the use of cardiac implantable electronic devices. Women living with PPCM face the uncertainty of not knowing for some time whether their cardiac function will recover to allow them a near‐to‐normal life expectancy. This not only impacts their ability to work, which may have financial implications, but may also affect mental health and quality of life for the extended family. Women living with PPCM must be informed that a future pregnancy always carries a substantial risk and, in case of poor cardiac recovery, is associated with a high morbidity and mortality. Patients with PPCM are best managed by an interdisciplinary and multiprofessional approach including e.g. a cardiologist, a gynaecologist, nurses, a psychologist, and social workers. The scope of this document encompasses contemporary challenges and approaches for the management of women diagnosed with PPCM. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Congenital heart disease in the ESC EORP Registry of Pregnancy and Cardiac disease (ROPAC)

Author

Hall, Roger, Roos-Hesselink, Jolien, Stein, Joerg, Parsonage, William Anthony, Budts, Werner, De Backer, Julie, Grewal, Jasmin, Marelli, Ariane, Kaemmerer, Harald, Jondeau, Guillaume, Johnson, Mark, Maggioni, Aldo P., Tavazzi, Luigi, Thilen, Ulf, Elkayam, Uri, Otto, Catherine, Sliwa, Karen, Aquieri, A., Saad, A., Vega, H. Ruda, Hojman, J., Caparros, J.M., Blanco, M. Vazquez, Arstall, M., Chung, C.M., Mahadavan, G., Aldridge, E., Wittwer, M., Chow, Y.Y., Parsonage, W.A., Lust, K., Collins, N., Warner, G., Hatton, R., Gordon, A., Nyman, E., Stein, J., Donhauser, E., Gabriel, H., Bahshaliyev, A., Guliyev, F., Hasanova, I., Jahangirov, T., Gasimov, Z., Salim, A., Ahmed, C.M., Begum, F., Hoque, M.H., Mahmood, M., Islam, M.N., Haque, P.P., Banerjee, S.K., Parveen, T., Morissens, M., De Backer, J., Demulier, L., de Hosson, M., Budts, W., Beckx, M., Kozic, M., Lovric, M., Kovacevic-Preradovic, T., Chilingirova, N., Kratunkov, P., Wahab, N., McLean, S., Gordon, E., Walter, L., Marelli, A., Montesclaros, A.R., Monsalve, G., Rodriguez, C., Balthazar, F., Quintero, V., Palacio, W., Cadavid, L.A. Mejía, Ortiz, E. Munoz, Hoyos, F. Fortich, Guerrero, E. Arevalo, Ricardo, J. Gandara, Penagos, J. Velasquez, Vavera, Z., Prague, Popelova, J., Vejlstrup, N., Grønbeck, L., Johansen, M., Ersboll, A., Elrakshy, Y., Eltamawy, K., Abd-El Aziz, M. Gamal, El Nagar, A., Ebaid, H., Elenin, H. Abo, Saed, M., Farag, S., Makled, W., Sorour, K., Ashour, Z., El-Sayed, G., Meguid Mahdy, M. Abdel, Taha, N., Dardeer, A., Shabaan, M., Ali, M., Moceri, P., Duthoit, G., Gouton, M., Nizard, J., Baris, L., Cohen, S., Ladouceur, M., Khimoud, D., Iung, B., Berger, F., Olsson, A., Gembruch, U., Merz, W.M., Reinert, E., Clade, S., Kliesch, Y., Wald, C., Sinning, C., Kozlik-Feldmann, R., Blankenberg, S., Zengin-Sahm, E., Mueller, G., Hillebrand, M., Hauck, P., von Kodolitsch, Y., Zarniko, N., Baumgartner, Muenster H., Schmidt, R., Hellige, A., Tutarel, O., Kaemmerer, H., Kuschel, B., Nagdyman, N., Motz, R., Maisuradze, D., Frogoudaki, A., Iliodromitis, E., Anastasiou-Nana, M., Marousi, Triantafyllis, D., Bekiaris, G., Karvounis, H., Giannakoulas, G., Ntiloudi, D., Mouratoglou, S.A., Temesvari, A., Balint, H., Kohalmi, D., Merkely, B., Liptai, C., Nemes, A., Forster, T., Kalapos, A., Berek, K., Havasi, K., Ambrus, N., Shelke, A., Kawade, R., Patil, S., Martanto, E., Aprami, T.M., Purnomowati, A., Cool, C.J., Hasan, M., Akbar, R., Hidayat, S., Dewi, T.I., Permadi, W., Soedarsono, D.A., Ansari-Ramandi, M.M., Samiei, N., Tabib, A., Kashfi, F., Ansari-Ramandi, S., Rezaei, S., Farhan, H. Ali, Al-Hussein, A., Al-Saedi, G., Mahmood, G., Yaseen, I.F., Al-Yousuf, L., AlBayati, M., Mahmood, S., Raheem, S., AlHaidari, T., Dakhil, Z., Thornton, P., Donnelly, J., Bowen, M., Blatt, A., Elbaz-Greener, G., Shotan, A., Yalonetsky, S., Goland, S., Biener, M., Assenza, G. Egidy, Bonvicini, M., Donti, A., Bulgarelli, A., Prandstraller, D., Romeo, C., Crepaz, R., Sciatti, E., Metra, M., Orabona, R., Ali, L. Ait, Festa, P., Fesslova, V., Bonanomi, C., Calcagnino, M., Lombardi, F., Colli, A.M., Ossola, M.W., Gobbi, C., Gherbesi, E., Tondi, L., Schiavone, M., Squillace, M., Carmina, M.G., Maina, A., Macchi, C., Gollo, E., Comoglio, F.M., Montali, N., Re, P., Bordese, R., Todros, T., Donvito, V., Marra, W. Grosso, Sinagra, G., D'Agata Mottolese, B., Bobbo, M., Gesuete, V., Rakar, S., Ramani, F., Niwa, K., Mekebekova, D., Mussagaliyeva, A., Lee, T., Mirrakhimov, E., Abilova, S., Bektasheva, E., Neronova, K., Lunegova, O., Žaliūnas, R., Jonkaitienė, R., Petrauskaitė, J., Laucevicius, A., Jancauskaite, D., Lauciuviene, L., Gumbiene, L., Lankutiene, L., Glaveckaite, S., Laukyte, M., Solovjova, S., Rudiene, V., Chee, K.H., Yim, C.C.-W., Ang, H.L., Kuppusamy, R., Watson, T., Caruana, M., Estensen, M.-E., Kayani, M.G.A. Mahmood, Munir, R., Tomaszuk-Kazberuk, A., Sobkowicz, B., Przepiesc, J., Lesniak-Sobelga, A., Tomkiewicz-Pajak, L., Komar, M., Olszowska, M., Podolec, P., Wisniowska-Smialek, S., Lelonek, M., Faflik, U., Cichocka-Radwan, A., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Cruz, C., Ribeiro, V., Jovanova, S., Petrescu, V., Jurcut, R., Ginghina, C., Coman, I. Mircea, Musteata, M., Osipova, O., Golivets, T., Khamnagadaev, I., Golovchenko, O., Nagibina, A., Ropatko, I., Gaisin, I.R., Shilina, L. Valeryevna, Sharashkina, N., Shlyakhto, E., Irtyuga, O., Moiseeva, O., Karelkina, E., Zazerskaya, I., Kozlenok, A., Sukhova, I., Jovovic, L., Prokšelj, K., Koželj, M., Askar, A.O., Abdilaahi, A.A., Mohamed, M.H., Dirir, A.M., Sliwa, K., Manga, P., Pijuan-Domenech, A., Galian-Gay, L., Tornos, P., Subirana, M.T., T, M., Subirana, Oliver, J.M., Garcia-Aranda Dominguez, B., Gonzalez, I. Hernandez, Jimenez, J.F. Delgado, Subias, P. Escribano, Murga, N., Elbushi, A., Suliman, A., Jazzar, K., Murtada, M., Ahamed, N., Dellborg, M., Furenas, E., Jinesjo, M., Skoglund, K., Eriksson, P., Gilljam, T., Thilen, U., Tobler, D., Wustmann, K., Schwitz, F., Schwerzmann, M., Rutz, T., Bouchardy, J., Greutmann, M., Lopes, B.M. Santos, Meier, L., Arrigo, M., de Boer, K., Konings, T., Wajon, E., Wagenaar, L.J., Polak, P., Pieper, E.P.G., Roos-Hesselink, J., van Hagen, I., Duvekot, H., Cornette, J.M.J., De Groot, C., van Oppen, C., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Mondo, C., Ingabire, P., Nalwanga, B., Semu, T., Salih, B.T., Almahmeed, W.A.R., Wani, S., Farook, F.S. Mohamed, Ain, Al, Gerges, F., Komaranchath, A.M., Al bakshi, F., Al Mulla, A., Yusufali, A.H., Al Hatou, E.I., Bazargani, N., Hussain, F., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Money-Kyrle, A., Clifford, P., Ramrakha, P., Firoozan, S., Chaplin, J., Bowers, N., Adamson, D., Schroeder, F., Wendler, R., Hammond, S., Nihoyannopoulos, P., Norfolk, Norwich, Hall, R., Freeman, L., Veldtman, G., Kerr, J., Tellett, L., Scott, N., Bhatt, A.B., DeFaria Yeh, D., Youniss, M.A., Wood, M., Sarma, A.A., Tsiaras, S., Stefanescu, A., Duran, J.M., Stone, L., Majdalany, D.S., Chapa, J., Chintala, K., Gupta, P., Botti, J., Ting, J., Davidson, W.R., Wells, G., Sparks, D., Paruchuri, V., Marzo, K., Patel, D., Wagner, W., Ahanya, S.N., Colicchia, L., Jentink, T., Han, K., Loichinger, M., Parker, M., Longtin, C., Yetman, A., Erickson, K., Cramer, J., Tsai, S., Fletcher, B., Warta, S., Cohen, C., Lindblade, C., Puntel, R., Nagaran, K., Croft, N., Gurvitz, M., Otto, C., Talluto, C., Murphy, D., Perlroth, M.G., Ramlakhan, Karishma P., Johnson, Mark R., Lelonek, Malgorzata, Saad, Aly, Gasimov, Zaur, Sharashkina, Natalia V., Thornton, Patrick, Arstall, Margaret, and Roos-Hesselink, Jolien W.

Published
2021
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25. Diuretics in pregnancy:Data from the ESC Registry of Pregnancy and Cardiac disease (ROPAC)

Author

van der Zande, Johanna A., Greutmann, Matthias, Tobler, Daniel, Ramlakhan, Karishma P., Cornette, Jerome M.J., Ladouceur, Magalie, Collins, Nicholas, Adamson, Dawn, Paruchuri, Vijaya P., Hall, Roger, Johnson, Mark R., Roos-Hesselink, Jolien W., van der Zande, Johanna A., Greutmann, Matthias, Tobler, Daniel, Ramlakhan, Karishma P., Cornette, Jerome M.J., Ladouceur, Magalie, Collins, Nicholas, Adamson, Dawn, Paruchuri, Vijaya P., Hall, Roger, Johnson, Mark R., and Roos-Hesselink, Jolien W.

Abstract

Aims: Data on diuretic use in pregnancy are limited and inconsistent, and consequently it remains unclear whether they can be used safely. Our study aims to evaluate the perinatal outcomes after in-utero diuretic exposure. Methods and results: The Registry Of Pregnancy And Cardiac disease (ROPAC) is a prospective, global registry of pregnancies in women with heart disease. Outcomes were compared between women who used diuretics during pregnancy versus those who did not. Multivariable regression analysis was used to assess the impact of diuretic use on the occurrence of congenital anomalies and foetal growth. Diuretics were used in 382 (6.7%) of the 5739 ROPAC pregnancies, most often furosemide (86%). Age >35 years (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2–2.0), other cardiac medication use (OR 5.4, 95% CI 4.2–6.9), signs of heart failure (OR 1.7, 95% CI 1.2–2.2), estimated left ventricular ejection fraction <40% (OR 2.9, 95% CI 2.0–4.2), New York Heart Association class >II (OR 3.4, 95% CI 2.3–5.1), valvular heart disease (OR 6.3, 95% CI 4.7–8.3) and cardiomyopathy (OR 3.9, 95% CI 2.6–5.7) were associated with diuretic use during pregnancy. In multivariable analysis, diuretic use during the first trimester was not significantly associated with foetal or neonatal congenital anomalies (OR 1.3, 95% CI 0.7–2.6), and diuretic use during pregnancy was also not significantly associated with small for gestational age (OR 1.4, 95% CI 1.0–1.9). Conclusions: Our study does not conclusively establish an association between diuretic use during pregnancy and adverse foetal outcomes. Given these findings, it is essential to assess the risk–benefit ratio on an individual basis to guide clinical decisions.

Published
2024

26. Perinatal outcomes after in-utero exposure to beta-blockers in women with heart disease:Data from the ESC EORP registry of pregnancy and cardiac disease (ROPAC)

Author

Ramlakhan, Karishma P., Roos-Hesselink, Jolien W., Basso, Thomas, Greenslade, Jaimi, Flint, Robert B., Krieger, Eric V., Shotan, Avraham, Budts, Werner, De Backer, Julie, Hall, Roger, Johnson, Mark R., Parsonage, William A., Ramlakhan, Karishma P., Roos-Hesselink, Jolien W., Basso, Thomas, Greenslade, Jaimi, Flint, Robert B., Krieger, Eric V., Shotan, Avraham, Budts, Werner, De Backer, Julie, Hall, Roger, Johnson, Mark R., and Parsonage, William A.

Abstract

Background: Beta-blockers are commonly used drugs during pregnancy, especially in women with heart disease, and are regarded as relatively safe although evidence is sparse. Differences between beta-blockers are not well-studied. Methods: In the Registry of Pregnancy And Cardiac disease (ROPAC, n = 5739), a prospective global registry of pregnancies in women with structural heart disease, perinatal outcomes (small for gestational age (SGA), birth weight, neonatal congenital heart disease (nCHD) and perinatal mortality) were compared between women with and without beta-blocker exposure, and between different beta-blockers. Multivariable regression analysis was used for the effect of beta-blockers on birth weight, SGA and nCHD (after adjustment for maternal and perinatal confounders). Results: Beta-blockers were used in 875 (15.2%) ROPAC pregnancies, with metoprolol (n = 323, 37%) and bisoprolol (n = 261, 30%) being the most frequent. Women with beta-blocker exposure had more SGA infants (15.3% vs 9.3%, p < 0.001) and nCHD (4.7% vs 2.7%, p = 0.001). Perinatal mortality rates were not different (1.4% vs 1.9%, p = 0.272). The adjusted mean difference in birth weight was −177 g (−5.8%), the adjusted OR for SGA was 1.7 (95% CI 1.3–2.1) and for nCHD 2.3 (1.6–3.5). With metoprolol as reference, labetalol (0.2, 0.1–0.4) was the least likely to cause SGA, and atenolol (2.3, 1.1–4.9) the most. Conclusions: In women with heart disease an association was found between maternal beta-blocker use and perinatal outcomes. Labetalol seems to be associated with the lowest risk of developing SGA, while atenolol should be avoided.

Published
2024

27. ACE Inhibitor and Angiotensin Receptor Blocker Use During Pregnancy:Data from the ESC Registry Of Pregnancy and Cardiac Disease (ROPAC)

Author

van der Zande, Johanna A., Ramlakhan, Karishma P., Prokselj, Katja, Muñoz-Ortiz, Edison, Baroutidou, Amalia, Lipczynska, Magdalena, Nagy, Edit, Rutz, Tobias, Franx, Arie, Hall, Roger, Johnson, Mark R., Roos-Hesselink, Jolien W., van der Zande, Johanna A., Ramlakhan, Karishma P., Prokselj, Katja, Muñoz-Ortiz, Edison, Baroutidou, Amalia, Lipczynska, Magdalena, Nagy, Edit, Rutz, Tobias, Franx, Arie, Hall, Roger, Johnson, Mark R., and Roos-Hesselink, Jolien W.

Abstract

Angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) are not recommended during the second and third trimester because of the significant risk of congenital anomalies associated with their use. However, data are scarce, especially regarding their use in the first trimester and about the impact of stopping just before pregnancy. Our study illustrates the profile of the women who used ACE-Is or ARBs during pregnancy and evaluates the impact on perinatal outcomes. The Registry of Pregnancy and Cardiac Disease is a prospective, global registry of pregnancies in women with structural heart disease. Outcomes were compared between women who used ACE-Is or ARBs and those who did not. Multivariable regression analysis was performed to assess the effect of ACE-I or ARB use on the occurrence of congenital anomalies. ACE-Is (n = 35) and/or ARBs (n = 8) were used in 42 (0.7%) of the 5,739 Registry of Pregnancy and Cardiac Disease pregnancies. Women who used ACE-Is or ARBs more often came from a low-or-middle-income country (57% vs 40%, p = 0.021), had chronic hypertension (31% vs 6%, p <0.001), or a left ventricular ejection fraction <40% (33% vs 4%, p <0.001). In the multivariable analysis, ACE-I use during the first trimester was associated with an increased risk of congenital anomaly (odds ratio 3.2, 95% confidence interval 1.0 to 9.6). Therefore, ACE-Is should be avoided during pregnancy, also in the first trimester, because of a higher risk of congenital anomalies. However, there is no need to stop long before pregnancy. Preconception counseling is crucial to discuss the potential risks of these medications, to evaluate the clinical condition and, if possible, to change or stop the medication.

Published
2024

28. Pregnancy in patients with the Fontan operation

Author

Montanaro, Claudia, Boyle, Siobhan, Wander, Gurleen, Johnson, Mark R., Roos-Hesselink, Jolien W., Patel, Roshni, Rafiq, Isma, Silversides, Candice K., Gatzoulis, Michael A., Montanaro, Claudia, Boyle, Siobhan, Wander, Gurleen, Johnson, Mark R., Roos-Hesselink, Jolien W., Patel, Roshni, Rafiq, Isma, Silversides, Candice K., and Gatzoulis, Michael A.

Abstract

Improved survival rates for patients with a Fontan circulation has allowed more women with this complex cardiac physiology to contemplate pregnancy. However, pregnancy in women with a Fontan circulation is associated with a high risk of adverse maternal and foetal outcomes, high rates of miscarriage, and preterm delivery. Factors associated with a successful pregnancy outcome are younger age, normal body weight, absence of significant functional limitation, no Fontan-related complications, and well-functioning single ventricle physiology. Appropriate care with timely preconception counselling and regular, frequent clinical reviews by a multidisciplinary team based at a tertiary centre improves the chance of a successful pregnancy. Empowerment of patients with education on their specific congenital cardiac condition and its projected trajectory helps them make informed choices regarding their health, reproductive choices, and assists them to achieve their life goals.

Published
2024

29. Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy:A study of the ESC EORP PPCM registry

Author

Sliwa, Karen, van der Meer, Peter, Viljoen, Charle, Jackson, Alice M., Petrie, Mark C., Mebazaa, Alexandre, Hilfiker-Kleiner, Denise, Maggioni, Aldo P., Laroche, Cecile, Regitz-Zagrosek, Vera, Tavazzi, Luigi, Roos-Hesselink, Jolien W., Hamdan, Righab, Frogoudaki, Alexandra, Ibrahim, Bassem, Farhan, Hasan Ali Farhan, Mbakwem, Amam, Seferovic, Petar, Böhm, Michael, Pieske, Burkert, Johnson, Mark R., Bauersachs, Johann, Sliwa, Karen, van der Meer, Peter, Viljoen, Charle, Jackson, Alice M., Petrie, Mark C., Mebazaa, Alexandre, Hilfiker-Kleiner, Denise, Maggioni, Aldo P., Laroche, Cecile, Regitz-Zagrosek, Vera, Tavazzi, Luigi, Roos-Hesselink, Jolien W., Hamdan, Righab, Frogoudaki, Alexandra, Ibrahim, Bassem, Farhan, Hasan Ali Farhan, Mbakwem, Amam, Seferovic, Petar, Böhm, Michael, Pieske, Burkert, Johnson, Mark R., and Bauersachs, Johann

Abstract

Background: Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes. Methods: In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]). Results: 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment.Conclusions: Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.

Published
2024

31. Diuretics in pregnancy: Data from the ESC Registry of Pregnancy and Cardiac disease (ROPAC).

Author

van der Zande, Johanna A., Greutmann, Matthias, Tobler, Daniel, Ramlakhan, Karishma P., Cornette, Jerome M. J., Ladouceur, Magalie, Collins, Nicholas, Adamson, Dawn, Paruchuri, Vijaya P., Hall, Roger, Johnson, Mark R., and Roos‐Hesselink, Jolien W.

Subjects
PERIPARTUM cardiomyopathy, HEART failure, SMALL for gestational age, DIURETICS, HEART valve diseases, HEART diseases in women, CARDIOVASCULAR agents
Abstract

Aims: Data on diuretic use in pregnancy are limited and inconsistent, and consequently it remains unclear whether they can be used safely. Our study aims to evaluate the perinatal outcomes after in‐utero diuretic exposure. Methods and results: The Registry Of Pregnancy And Cardiac disease (ROPAC) is a prospective, global registry of pregnancies in women with heart disease. Outcomes were compared between women who used diuretics during pregnancy versus those who did not. Multivariable regression analysis was used to assess the impact of diuretic use on the occurrence of congenital anomalies and foetal growth. Diuretics were used in 382 (6.7%) of the 5739 ROPAC pregnancies, most often furosemide (86%). Age >35 years (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2–2.0), other cardiac medication use (OR 5.4, 95% CI 4.2–6.9), signs of heart failure (OR 1.7, 95% CI 1.2–2.2), estimated left ventricular ejection fraction <40% (OR 2.9, 95% CI 2.0–4.2), New York Heart Association class >II (OR 3.4, 95% CI 2.3–5.1), valvular heart disease (OR 6.3, 95% CI 4.7–8.3) and cardiomyopathy (OR 3.9, 95% CI 2.6–5.7) were associated with diuretic use during pregnancy. In multivariable analysis, diuretic use during the first trimester was not significantly associated with foetal or neonatal congenital anomalies (OR 1.3, 95% CI 0.7–2.6), and diuretic use during pregnancy was also not significantly associated with small for gestational age (OR 1.4, 95% CI 1.0–1.9). Conclusions: Our study does not conclusively establish an association between diuretic use during pregnancy and adverse foetal outcomes. Given these findings, it is essential to assess the risk–benefit ratio on an individual basis to guide clinical decisions. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Multigenerational diabetes mellitus

Author

Thornton, Jennifer M., primary, Shah, Nishel M., additional, Lillycrop, Karen A., additional, Cui, Wei, additional, Johnson, Mark R., additional, and Singh, Natasha, additional

Published
2024
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39. The Management of Labour and the Post-partum Period in CHD

Author

Cauldwell, Matt, Cox, Mark, Monteiro, Roisin, Johnson, Mark R., Chessa, Massimo, Series editor, Baumgartner, Helmut, Series editor, Eicken, Andreas, Series editor, Giamberti, Alessandro, Series editor, Roos-Hesselink, Jolien W., editor, and Johnson, Mark R., editor

Published
2017
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44. Magnetic Lattice Dynamics of the Oxygen-Free FeAs Pnictides: How Sensitive are Phonons to Magnetic Ordering?

Author

Zbiri, Mohamed, Mittal, Ranjan, Rols, Stephane, Su, Yixi, Xiao, Yinguo, Schober, Helmut, Chaplot, Samrath L., Johnson, Mark R., Chatterji, Tapan, Inoue, Yasunori, Matsuishi, Satoru, Hosono, Hideo, and Brueckel, Thomas

Subjects
Condensed Matter - Superconductivity, Condensed Matter - Materials Science
Abstract

To shed light on the role of magnetism on the superconducting mechanism of the oxygen-free FeAs pnictides, we investigate the effect of magnetic ordering on phonon dynamics in the low-temperature orthorhombic parent compounds, which present a spin-density wave. The study covers both the 122 (AFe2As2; A=Ca, Sr, Ba) and 1111 (AFeAsF; A=Ca, Sr) phases. We extend our recent work on the Ca (122 and 1111) and Ba (122) cases by treating computationally and experimentally the 122 and 1111 Sr compounds. The effect of magnetic ordering is investigated through detailed non-magnetic and magnetic lattice dynamical calculations. The comparison of the experimental and calculated phonon spectra shows that the magnetic interactions/ordering have to be included in order to reproduce well the measured density of states. This highlights a spin-correlated phonon behavior which is more pronounced than the apparently weak electron-phonon coupling estimated in these materials. Furthermore, there is no noticeable difference between phonon spectra of the 122 Ba and Sr, whereas there are substantial differences when comparing these to CaFe2As2 originating from different aspects of structure and bonding.

Published
2010
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45. Humour and Comedy in Digital Game Live Streaming.

Author

Johnson, Mark R

Subjects
*VIDEO games, *VIRTUAL communities, *COMEDY, *POWER (Social sciences), *STREAMING video & television, *LAUGHTER
Abstract

This article considers the nature and functions of humour in digital game live streaming on Twitch. Most streamers and viewers seem uncomfortable with 'serious' in-game narrative content, resulting in weighty or emotional moments in games becoming sources of comedy and humour. Many also subvert the platform's power dynamics by mocking community standards or the possibility of being banned, while some go even further and treat streamers themselves as fair game for mockery. This article thus examines how the humour of play, games and the Internet combine and evolve in an emerging and distinctive 'stream-humour', which can be sometimes playful and supportive yet sometimes shade into antagonism, rule-bending and hostility. Examining these dynamics on Twitch, in turn, provides a valuable window into how platform infrastructures and cultures generate norms and cultures of humour and amusement, and strengthens our understanding of online communities and platform power in this and similar contexts. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Multifaceted Fontan Patients and Their Response to Pregnancy

Author

Wander, Gurleen, primary, Breviario, Susanna, additional, Krishnathasan, Kaushiga, additional, Patel, Roshni R., additional, Habibi, Hajar, additional, Li, Wei, additional, Johnson, Mark R., additional, Gatzoulis, Michael A., additional, Dimopoulos, Konstantinos, additional, and Rafiq, Isma, additional

Published
2023
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49. Cardiogenic shock in pregnancy

Author

Greer, Orene Y. O., primary, Anandanadesan, Rathai, additional, Shah, Nishel M., additional, Price, Susanna, additional, and Johnson, Mark R., additional

Published
2023
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