XNAT-PIC: Extending XNAT to Preclinical Imaging Centers

Molecular imaging generates large volumes of heterogeneous biomedical imagery with an impelling need of guidelines for handling image data. Although several successful solutions have been implemented for human epidemiologic studies, few and limited approaches have been proposed for animal population studies. Preclinical imaging research deals with a variety of machinery yielding tons of raw data but the current practices to store and distribute image data are inadequate. Therefore, standard tools for the analysis of large image datasets need to be established. In this paper, we present an extension of XNAT for Preclinical Imaging Centers (XNAT-PIC). XNAT is a worldwide used, open-source platform for securely hosting, sharing, and processing of clinical imaging studies. Despite its success, neither tools for importing large, multimodal preclinical image datasets nor pipelines for processing whole imaging studies are yet available in XNAT. In order to overcome these limitations, we have developed several tools to expand the XNAT core functionalities for supporting preclinical imaging facilities. Our aim is to streamline the management and exchange of image data within the preclinical imaging community, thereby enhancing the reproducibility of the results of image processing and promoting open science practices

SY30-3THE USE OF SOPHISMS IN SUSTAINING DISULFIRAM

Disulfiram's use is not supported by scientific evidence but nevertheless largely advocated and used. This would be less odd in case of lacking or just preliminary evidence. What is peculiar in the case of disulfiram's prescription is its persistence against evidence. Hence arise the question how it is possible that its use can be supported, i.e. by what type of arguments. The goal of an argument is to persuade, the goal of logic and argumentation is additionally to persuade for good reasons. In this sense, a good argument would give good reasons to believe the conclusion. Fallacies are bad arguments, either because they have weak logic, or because they rely on a false premise. Sophisms are intentionally used fallacies, an attempt to persuade opponents that a specific conclusion is true, by means other than by proposing relevant evidence. Proponents of fallacious arguments may use them either because they are incapable or because they are unwilling to accept their arguments to be fallacious. We therefore formulate the hypothesis that the frequency use of fallacious arguments within our otherwise supposedly evidence based discipline may be indicative of (a) a scientifically immature discipline, and/or (b) a moralistically intermingled disciplin

A Case of Abruptio Placentae due to the Torsion of Gravid Uterus

Torsion of a gravid uterus is a rare obstetric emergency potentially lethal for the fetus and the mother. Some of the cases described in literature are associated with preexisting gynecologic conditions related to pelvic and uterine anatomy, even if most of cases remain unexplained. We report a case of acute 180-degree torsion of uterus at 33 weeks of gestation associated with abruptio placentae in a young Asian woman without apparent risk factors

Modelling birthweight as a function of gestational age at delivery in hypertensive disorder of pregnancy

Introduction Pre-eclampsia (PE) is a multifactorial syndrome with different clinical phenotypes. To address this heterogeneity, the syndrome has been subdivided, according to gestational age (GA), into early and late PE, but this classification is not completely satisfying [1]. The most-studied clinical phenotype is that caused by shallow trophoblastic invasion of the spiral arteries, with oxidative stress and release of placental factors, which lead to endothelial dysfunction and organ damage [2]. Doppler velocimetry of the uterine arteries (UtA-PI) and measurement of vascular growth factors can be used to screen for early vascular damage, associated with reduced placental growth and intrauterine growth restriction (IUGR) later in pregnancy [3]. This clinical phenotype is predominant in cases prior to 34 wks of GA, thus early PE can be regarded as a proxy for cases affected by this sequence of events. Anyhow, the disease does not end at 34 wks of GA, and less severe cases represent a large proportion of syndromic manifestations of PE in late gestation [1]. Cases affected by hypertensive disorders of pregnancy (HDP) including PE are frequently found to have normal neonates and placentas [4]. In these cases, endothelial dysfunction can be ascribed to the placental pro-inflammatory response, dyslipidemia or other pro-inflammatory conditions resulting in low-grade inflammation due to pre-existing maternal conditions, such as maternal metabolic syndrome and cardiovascular risk factors. These risk factors are not suppposed to operate only from 34 wks of GA onwards. The aim of this presentation is to verify whether a classification based only on fetal abdomen circumference (AC) and UtA-PI is suitable for defining two internally homogeneous subgroups of women affected by HDP, characterized by different effects on fetal growth, as can be inferred from the outcome, in terms of birthweight conditional on GA, and whether GA at the onset of HDP has a role in determining fetal growth. Data and methods This multicentre study includes all eligible cases of HDP consecutively admitted over a 12-month period (from December 2013) to seven Italian tertiary referral centres for maternal-fetal medicine. To be eligible for inclusion, the clinical records of each patient had to report two \u201ckey items\u201d: fetal assessment of abdomen circumference (AC) and mean UtA-PI. Women with multiple pregnancy and with chromosomal or structural fetal abnormalities were excluded. A total of 902 patients met these inclusion/exclusion criteria. Data concerning maternal characteristics, pregnancy complications and outcome were retrieved from the archived clinical records [5]. Pregnant women were grouped into two phenotypes, independently of GA at the onset of HDP. The first phenotype, which was named HDP-IUGR (n=124) [5], is characterized by maternal HDP associated with fetal AC at admission below the 5th centile of Todros et al reference [6], and an abnormal UtA-PI, defined as mean of right and left UtA-PI>95th centile of Gomez et al reference [7]. The second phenotype, which was named HDP-AGA, i.e. fetuses whose AC is appropriate-for-gestational age (n=205), is characterized by maternal HDP associated with fetal AC 655th centile and UtA-PI 6495th centile. The group was then subdivided in early and late-onset HDP, depending whether GA at the onset of disease was 95th centile, or AC at admission. Results Figure 1 shows birthweight as a function of GA at delivery in neonates classified by sex, maternal phenotype and GA at the onset of HDP. When the model includes only the term accounting for the effect of sex, birthweight of males is estimated to be higher than that of females by 4% (95%CL: 1%, 7%; p=0.0158). The introduction of the term expressing the effect of phenotype into the model consistently improves the goodness of fit: the coefficient of determination increased from 0.86 to 0.91 and the residual standard deviation decreased from 366 to 294 g. The children of women with phenotype HDP-IUGR show a birthweight lower by 23% (95%CL: 20%, 26%; p. Conclusions The use of the parametric nonlinear model presented in this study yielded a synthetic and faithful description of the relationship between birthweight and GA in over 3 hundred babies born to women suffering with hypertensive disorders of pregnancy, and delivered between the 25th and the 42nd week of GA. Furthermore the model provided estimates of the separate effects that sex, HDP phenotype, and GA at the onset of HDP exert on birthweight. Among babies born to HDP mothers, birthweight of males was found to be higher than that of by 4%: an identical difference was observed in the reference set used to trace INeS charts [10], this suggest that HDP impairs fetal growth independently of sex. The babies born to mothers with phenotype HDP-IUGR were found to have birthweight lower by about 25% than those born to mothers with phenotype HDP-AGA: this is not unexpected, fetal weight being partly determined by abdomen volume. Nonetheless, since delivery occurred, on the average, 3 weeks after the assessment of abdomen circumference, such a difference suggests the persistence of conditions unfavourable to fetal growth up to end of pregnancy. The third hypothesis that the model could test was whether GA at the onset of HDP affects the severity of fetal growth impairment. In this case we would expect that birthweight of babies born to mothers with early onset of HDP is considerably lower. Results showed that fetal growth follows the same pattern, independently of GA at the onset of HDP. References 1. Verlohren S, Melchiorre K, Khalil A, et al. Uterine artery Doppler, birth weight and timing of onset of pre-eclampsia: providing insights into the dual etiology of late-onset pre-eclampsia. Ultrasound Obstet Gynecol 2014; 44:293-298. 2. Cindrova-Davies T. Gabor Than Award Lecture 2008: pre-eclampsia \u2013 from placental oxidative stress to maternal endothelial dysfunction. Placenta 2009; 30:S55\u2013S65. 3. Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of pre-eclampsia. N Engl J Med 2004; 350:672-683. 4. Conde-Agudelo A, Belizan JM. Risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women. BJOG 2000; 107:75-83. 5. Ferrazzi E, Zullino S, Stampalija T, et al. Bedside diagnosis of two major clinical phenotypes of hypertensive disorders of pregnancy. Ultrasound Obstet Gynecol 2016; 48:224-231 6. Todros T, Ferrazzi E, Nicolini U, et al. Fitting growth curves to head and abdomen measurements of the fetus: A multicentric study. J Clin Ultrasound 1987; 15:95-105. 7. Gomez O, Figueras F, Fernandez S, et al. Reference ranges for uterine artery mean pulsatility index at 11\u201341 weeks of gestation. Ultrasound Obstet Gynecol 2008; 32:128-132. 8. von Bertalanffy L. Quantitative laws in metabolism and growth. Q Rev Biol 1957; 32:217-231 9. Marubini E. Mathematical handling of long-term longitudinal data. In Human Growth, vol.1: Principles and Prenatal Growth; Falkner F, Tanner JM(eds). Plenum Press: New York 1978; 209-225 10. Bertino E, Spada E, Occhi L, et al. Neonatal anthropometric charts: the Italian neonatal study compared with other European studies. J Pediatr Gastroenterol Nutr 2010; 51:353-361

SY09-3HARM REDUCTION IN NON-SUBSTANCE RELATED ADDICTIONS

Behavioral addictions (gambling, gaming, internet use) are new challenges for policy makers, and the question arises if harm reduction is an applicable concept. Gambling addiction policies are trying to include harm reduction models (limitation of the amount of money you can bet, limitation in access to gambling venues). We will discuss if these models are valid in gaming addiction. I.E. If we only consider the classical policy models applied for reducing substances harm: supply reduction, demand reduction and harm reduction, limitations arise: for example: applying these concepts to gaming addiction is impossible. If heroin is an identified substance, games are heterogeneous in nature and are described from cognitive enhancers to highly addictive. The concept of supply should include the complex nature of video games. Reducing demand could be considered as a censure directly in conflict with human nature to produce the best and most attractive games (should unattractive cars be produced to reduce global warming). And finally harm reduction concepts in gaming will be discusse

SY38-2IMPULSIVITY, MOTIVATIONS AND ADDICTION TO ONLINE GAMES

Introduction. Problematic engagement in online video gaming has been considered recently in the appendix of the DSM-5. Underpinning psychological factors are yet to be clarified, mostly in adult populations. We present data from two studies investigating links between motives to play and impulsivity in one hand and excessive gaming in another hand. Methods. Online studies have been conducted on adult gamers in France (n = 516) and Switzerland (n = 1057). Problematic engagement has been assessed in France by DSM-IV-TR adapted substance dependence criteria (DAS) and by IAT in Switzerland. Motivations have been investigated using Yee's model. Impulsivity has been evaluated using respectively BIS-10 and UPPS-P. The French sample has been compared to heroin users and to healthy controls regarding impulsivity. In the Swiss study, cluster analysis has been conducted to identify subgroups of players regarding their engagement in-game, their motivations to play and their impulsivity. Results. DAS has been found to be predicted by BIS high scores as well as by competition and advancement. Problematic gamers presented higher levels of impulsivity than controls but less than heroin dependents. Three of five clusters were identified to be problematic and linked to high levels of impulsivity, achievement and escapism. Conclusion. Achievement motives to play and high impulsivity have been linked to problematic engagement in online videogames in two different samples evaluated by two different methods. Addiction to online gaming showed a difference in impulsivity traits with substance dependence and healthy controls and subgroups of problem gamers has been characterized. These data could help to design tailored treatments for excessive online gamer

SY09-2HARM REDUCTION IN SUBSTANCE RELATED ADDICTIONS

The concept of harm reduction has for a long time been discussed mainly related to opiate injection. The objective of the present paper is to review the application of the concept regarding several other substances: alcohol, tobacco, cannabis, and party drug

Two decades of the Swiss program based on the prescription of Diacetylmorphine, from a public health intervention to a treatment option

The medical prescription of diacetyl morphine (heroin) treatment is an addition to the therapeutic arsenal for patients gravely dependent or addicted to heroin use and for whom other forms of therapy have failed. In Switzerland, the Federal Office of Public Health SFOPH) has established directives and recommendations concerning prescription and administration of diacetyl- morphine