POS0724 GENDER DIFFERENCES IN THROMBOTIC PRIMARY ANTIPHOSPHOLIPID SYNDROME IN A LARGE COHORT OF PATIENTS FROM FOUR EUROPEAN CENTERS

Background:Autoimmune diseases occur more frequently in females and their course and severity can be affected by gender. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder in which antiphospholipid antibodies (aPL) exert a pathogenic role resulting in vascular thrombosis and/or pregnancy morbidities. Data about gender differences in thrombotic APS (t-APS) are still scarce1,2.Objectives:To evaluate the differences in frequency, disease expression and severity between females and males affected by primary t-APS.Methods:Retrospective study enrolling subjects with a formal diagnosis of primary APS (Miyakis 2006) with vascular thrombosis at onset. Women who presented with obstetric events as first aPL-related manifestation were excluded. All the patients were followed from 1967 to 2019 in four European centers: three French centers and one Italian center.Results:The study included 433 patients (68% females, 32% males). Median age at t-APS onset [31 (24-46) vs 41 (29-53) years, p<0.001] and at diagnosis [34 (27-50) vs 46 (34-57) years, p<0.001] was significantly lower in females.The most common presenting manifestations were venous thrombosis (60%) followed by arterial events (37%) and catastrophic APS (3%). Venous events were more frequent in women as compared to men (64% vs 51% p:0.012 OR:1.7 [1.1-2.5]). Sites of venous thrombosis included: limbs (35%), pulmonary (17%), cerebral (3%), portal and inferior cava (2%) and retinal (1%) veins, without gender differences. The arterial events were more frequent among men (43% vs 34% p:0.053). Strokes (27%) and myocardial infarctions (4%) were the most frequent manifestations, followed by thrombosis of limbs (2%), retina (2%) and abdominal organs (1%). Noteworthy, only men presented with visceral ischemia.During the follow-up, new thrombosis occurred in 41% of patients (179/433). 33% out of them had at least two episodes and these occurred especially among males (22% vs 10% p:0.001 OR:2.5 [1.3-4.8]). New events were mostly of the same type, but ⅓ of patients presented a switch from venous to arterial side and viceversa, with no gender differences.Complete aPL profile was available in 357 subjects: 33% had single aPL positivity, 24% double positivity and 43% triple positivity, with no differences between women and men. About 80% of the patients had a concomitant risk factor (RF) for thrombosis. Established cardiovascular RFs were more represented among men as shown in table 1. In women, estrogenic exposure was the main RFs, present in almost 40% of them.Table 1.MALESn= 137FEMALESn= 296POR [IC 95%]Traditional cardiovascular RFs, n (%)Smoke66 (48)81 (27)<0.0012.5 [1.6-3.8]Arterial hypertension59 (43)75 (25)<0.0012.2 [1.5-3.4]Dyslipidemia52 (38)72 (24)0.0041.9 [1.2-2.9]Diabetes16 (12)15 (5)0.0142.5 [1.8-5.1]Obesity13 (10)38 (13)nsOther thrombophilic factors, n (%)Estrogenic stimuli*0116 (39)-Trauma / surgery / immobilization21 (15)32 (11)nsCongenital thrombophilia9/94 (10)33/204 (16)nsData were compared using contingency tables, p value was calculated with Chi-Squared or Fisher exact test. *= hormonal therapy, pregnancy, post-partumConclusion:This gender-oriented analysis of patients with primary t-APS showed that women had the first vascular event at a younger age and mostly on the venous side, while men presented mainly with arterial events, later in life and suffered from more recurrent events. No differences were observed in the distribution of the aPL profile. The different frequency of arterial and venous events in the two groups could be attributed mainly to the presence of additional RFs rather than to biological gender-specific issues. However, it should be underlined that some RFs, such as the use of estrogens or classic cardiovascular RFs, are exclusive or more represented in one gender rather than the other, making it difficult to assess the link of causality between gender and manifestations of t-APS.References:[1]JF de Carvalho. Rheumatol Int. 2011.[2]LJ Jara. Lupus. 2005.Disclosure of Interests:None declare

Scenario-based requirements elicitation for user-centric explainable AI

Explainable Artificial Intelligence (XAI) develops technical explanation methods and enable interpretability for human stakeholders on why Artificial Intelligence (AI) and machine learning (ML) models provide certain predictions. However, the trust of those stakeholders into AI models and explanations is still an issue, especially domain experts, who are knowledgeable about their domain but not AI inner workings. Social and user-centric XAI research states it is essential to understand the stakeholder’s requirements to provide explanations tailored to their needs, and enhance their trust in working with AI models. Scenario-based design and requirements elicitation can help bridge the gap between social and operational aspects of a stakeholder early before the adoption of information systems and identify its real problem and practices generating user requirements. Nevertheless, it is still rarely explored the adoption of scenarios in XAI, especially in the domain of fraud detection to supporting experts who are about to work with AI models. We demonstrate the usage of scenario-based requirements elicitation for XAI in a fraud detection context, and develop scenarios derived with experts in banking fraud. We discuss how those scenarios can be adopted to identify user or expert requirements for appropriate explanations in his daily operations and to make decisions on reviewing fraudulent cases in banking. The generalizability of the scenarios for further adoption is validated through a systematic literature review in domains of XAI and visual analytics for fraud detection

Baroque. 300 years old and as young as ever

The book is in the series "Contemporary Architecture in Turin" reconstructs the complex topography of places, buildings, architects, techniques and styles in Turin throughout the 20th century. A collection of small histories that helps identify future scenarios for a city that has unobtrusively embraced the 21st century.The book study the destiny of the Baroque, from the rigorous design of Italy's first capital city to the discovery of a strategic resource for the future of Turin. In the heart of the contemporary city, the Baroque still acts as the background against which new interventions stand out, the fabric on which new designs for public spaces are laid. the living body on which numerous restorations are compared. Architecture conceived on a European scale investigates ways for transporting into the future a legacy that is crucial for the city's urban identit

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A latere della mostra su Giorgione tenutasi a Casfelfranco Veneto nel 2009-10 si sono individuati degli itinerari territoriali corrispondenti alla presenza di opere del pittore o di altri artisti con lui in relazione

Barocco. Un'architettura giovane di trecento anni

Il volume si colloca nella collana"Architettura contemporanea a Torino" attraverso cui si ricostruisce la complessa topografia di luoghi, edifici, attori, culture tecniche e artistiche che a Torino si sono incrociati lungo tutto il Novecento. Una mappa di storie che aiuta a individuare temi e scenari possibili per il futuro della città entrata senza retorica nel XXI secolo. Nello specifico il volume analizza il Barocco, la sua fortuna, dal disegno rigoroso della città capitale alla "scoperta" di una risorsa strategica per il futuro di Torino. Così, nel cuore della città contemporanea, il Barocco è ancora la tela di fondo sulla quale si stagliano i nuovi interventi, la trama dove incide la nuova progettazione degli spazi pubblici, il corpo vitale su quale si confrontano i numerosi restauri. Si ripropone il tema di un'architettura pensata per una dimensione europea, che spinge a interrogarsi sulle modalità di traghettare verso il futuro un patrimonio cruciale per l'identità urban

Barocco. Un'architettura giovane di trecento anni

Il volume si colloca nella collana"Architettura contemporanea a Torino" attraverso cui si ricostruisce la complessa topografia di luoghi, edifici, attori, culture tecniche e artistiche che a Torino si sono incrociati lungo tutto il Novecento. Una mappa di storie che aiuta a individuare temi e scenari possibili per il futuro della città entrata senza retorica nel XXI secolo. Nello specifico il volume analizza il Barocco, la sua fortuna, dal disegno rigoroso della città capitale alla "scoperta" di una risorsa strategica per il futuro di Torino. Così, nel cuore della città contemporanea, il Barocco è ancora la tela di fondo sulla quale si stagliano i nuovi interventi, la trama dove incide la nuova progettazione degli spazi pubblici, il corpo vitale su quale si confrontano i numerosi restauri. Si ripropone il tema di un'architettura pensata per una dimensione europea, che spinge a interrogarsi sulle modalità di traghettare verso il futuro un patrimonio cruciale per l'identità urbana