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We provide an assessment of the Infinity Two fusion pilot plant (FPP) baseline plasma physics design. Infinity Two is a four-field period, aspect ratio $A = 10$, quasi-isodynamic stellarator with improved confinement appealing to a max-$J$ approach, elevated plasma density and high magnetic fields ($ \langle B\rangle = 9$ T). Here $J$ denotes the second adiabatic invariant. At the envisioned operating point ($800$ MW deuterium-tritium (DT) fusion), the configuration has robust magnetic surfaces based on magnetohydrodynamic (MHD) equilibrium calculations and is stable to both local and global MHD instabilities. The configuration has excellent confinement properties with small neoclassical transport and low bootstrap current ($|I_{bootstrap}| \sim 2$ kA). Calculations of collisional alpha-particle confinement in a DT FPP scenario show small energy losses to the first wall (${\lt}1.5 \,\%$) and stable energetic particle/Alfvén eigenmodes at high ion density. Low turbulent transport is produced using a combination of density profile control consistent with pellet fueling and reduced stiffness to turbulent transport via three-dimensional shaping. Transport simulations with the T3D-GX-SFINCS code suite with self-consistent turbulent and neoclassical transport predict that the DT fusion power$P_{{fus}}=800$ MW operating point is attainable with high fusion gain ($Q=40$) at volume-averaged electron densities $n_e\approx 2 \times 10^{20}$ m$^{-3}$, below the Sudo density limit. Additional transport calculations show that an ignited ($Q=\infty$) solution is available at slightly higher density ($2.2 \times 10^{20}$ m$^{-3}$) with $P_{{fus}}=1.5$ GW. The magnetic configuration is defined by a magnetic coil set with sufficient room for an island divertor, shielding and blanket solutions with tritium breeding ratios (TBR) above unity. An optimistic estimate for the gas-cooled solid breeder designed helium-cooled pebble bed is TBR $\sim 1.3$. Infinity Two satisfies the physics requirements of a stellarator fusion pilot plant.
In this work, we present a detailed assessment of fusion-born alpha-particle confinement, their wall loads and stability of Alfvén eigenmodes driven by these energetic particles in the Infinity Two Fusion Pilot Plant baseline plasma design, a four-field-period quasi-isodynamic stellarator to operate in deuterium–tritium fusion conditions. Using the Monte Carlo codes, SIMPLE, ASCOT5 and KORC-T, we study the collisionless and collisional dynamics of guiding-centre and full-orbit alpha-particles in the core plasma. We find that core energy losses to the wall are less than 4 %. Our simulations shows that peak power loads on the wall of this configuration are approximately 2.5 MW m-$^2$ and are spatially localised, toroidally and poloidaly, in the vicinity of x-points of the magnetic island chain $n/m = 4/5$ outside the plasma volume. Also, an exploratory analysis using various simplified walls shows that shaping and distance of the wall from the plasma volume can help reduce peak power loads. Our stability assessment of Alfvén eigenmodes using the STELLGAP and FAR3d codes shows the absence of unstable modes driven by alpha-particles in Infinity Two due to the relatively low alpha-particle beta at the envisioned 800 MW operating scenario.
Transport characteristics and predicted confinement are shown for the Infinity Two fusion pilot plant baseline plasma physics design, a high field stellarator concept developed using modern optimization techniques. Transport predictions are made using high-fidelity nonlinear gyrokinetic turbulence simulations along with drift kinetic neoclassical simulations. A pellet-fuelled scenario is proposed that enables supporting an edge density gradient to substantially reduce ion temperature gradient turbulence. Trapped electron mode turbulence is minimized through the quasi-isodynamic configuration that has been optimized with maximum-J. A baseline operating point with deuterium–tritium fusion power of $P_{{fus,DT}}=800$ MW with high fusion gain $Q_{{fus}}=40$ is demonstrated, respecting the Sudo density limit and magnetohydrodynamic stability limits. Additional higher power operating points are also predicted, including a fully ignited ($Q_{{fus}}=\infty$) case with $P_{{fus,DT}}=1.5$ GW. Pellet ablation calculations indicate it is plausible to fuel and sustain the desired density profile. Impurity transport calculations indicate that turbulent fluxes dominate neoclassical fluxes deep into the core, and it is predicted that impurity peaking will be smaller than assumed in the transport simulations. A path to access the large radiation fraction needed to satisfy exhaust requirements while sustaining core performance is also discussed.
The magnetohydrodynamic (MHD) equilibrium and stability properties of the Infinity Two fusion pilot plant baseline plasma physics design are presented. The configuration is a four-field period, aspect ratio $A = 10$ quasi-isodynamic stellarator optimised for excellent confinement at elevated density and high magnetic field $B = 9\,T$. Magnetic surfaces exist in the plasma core in vacuum and retain good equilibrium surface integrity from vacuum to an operational $\beta = 1.6 \,\%$, the ratio of the volume average of the plasma and magnetic pressures, corresponding to $800\ \textrm{MW}$ deuterium–tritium fusion operation. Neoclassical calculations show that a self-consistent bootstrap current of the order of ${\sim} 1\ \textrm{kA}$ slightly increases the rotational transform profile by less than 0.001. The configuration has a magnetic well across its entire radius. From vacuum to the operating point, the configuration exhibits good ballooning stability characteristics, exhibits good Mercier stability across most of its minor radius and it is stable against global low-n MHD instabilities up to $\beta = 3.2\,\%$.
There is increasing recognition of the crucial need for robust community engagement in health research and clinical trials. Despite this awareness, challenges persist in bridging the gap between researchers and communities. Much of the current discourse focuses on addressing issues such as cultural humility and equitable partnerships. To expand this conversation, we conducted community engagement studios, following the model by Joosten et al. We wanted to gather perspectives on research involvement across New Mexico. This process and resultant findings offer valuable insights into effective community engagement practices and advance clinical and translational science by amplifying community voices and needs.
Mental Health problems and substance misuse during pregnancy constitute a serious social problem due to high maternal-fetal morbidity (Cook et al, 2017; JOCG, 39(10) ,906-915) and low detection and treatment rates (Carmona et al. Adicciones. 2022;34(4):299-308)
Objectives
Our study aimed to develop and test the feasibility and acceptability of a screening and treatment clinical pathway in pregnancy, based on the combination of e-Health tools with in-person interventions and, secondly, describe the prevalence of mental illness and substance use problems in this population.
Methods
1382 pregnant women undergoing her first pregnancy visit were included in a tailored clinical pathway and sent a telematic (App) autoapplied questionnaire with an extensive battery of measures (WHO (Five) Well-Being [WHO-5],Patient Health Questionnaire [PHQ-9], General Anxiety Disorder [GAD-7], Alcohol Use Disorders Identification Test [AUDIT], Drug Abuse Screening Test [DAST], Columbia Suicide Severity Rating Scale [C-SSRS] and specifically designed questions on self-harm and psychopharmacological drugs).
Patients who did not respond to the questionnaire on their own received a counseling call.
Based on the screening results, patients were classified into five groups according to severity (Figure 1) and assigned a specific action pathway (Figure 2) that included a range of intervention intensity that goes from an individual psychiatric appointment to no intervention.
Results
Of the 1382 women included in the clinical pathway, 565(41%) completed the evaluation questionnaires. Of these, 205 (36%) were screened as positive (Grades III,IV or V. Table 1) and 3(0.5%) were classified as needing urgent care. Of the patients offered on-line groups (100), 40% (40) were enrolled in them.Table 1:
Grade distribution of those screened as positives
Grade III
97 (17,2%)
Grade IV
105 (18,6%)
Grade V
3 (0,5%)
Concerning prevalence rates, 73 (12,9%) patients endorsed at least moderate anxiety according to GAD-7 (≥10), 65 (11,5%) endorsed at least moderate depression according to PHQ-9 (≥ 10), 17 were positive on DAST (3%) and 63 (11%) patients scored above the threshold in AUDIT-C(≥ 3) for alcohol use.
Image:
Image 2:
Conclusions
High prevalence rates suggest that effective detection and treatment mechanisms should be integrated into usual care. The use of standardized clinical pathways can help with this aim, allowing better clinical management and referral to treatment, but still face challengues to increase retention. The use of e-health tools offers the opportunity to improve accessibility and therapeutic outcomes through online interventions.
Depressive disorders represent the main cause of disability in the world, due to its prevalence, its impact on the patient’s quality of life and its role as one of the main risk factors for suicide. Current antidepressant treatments can take weeks to take effect and months to achieve response and remission.It is estimated that up to 30% of patients with major depressive disorder (MDD) are resistant to antidepressant treatment, in addition, approximately 30-45% of patients with depression do not achieve an adequate response to the first antidepressant treatment.According to the STAR*D study, the more lines of treatment are required, the lower remission rates are estimated, as well as higher relapse rates during the follow-up phase.With the appearance of intranasal dosage esketamine allows the release directly to the central nervous system, the mechanism of action of esketamine is based on the antagonism of the NMDA receptor, which entails the modulation of the excitatory transmission of glutamate and the release of BDNF,activating neurotrophic signaling and synaptogenesis.
Objectives
The objective is to expose the response after treatment with intranasal esketamine in a case of resistant depression.
Methods
A 55-year-old female patient, diagnosed with resistant recurrent depressive disorder.The patient had undergone treatment with different therapeutic lines with antidepressants, and potentiations with antipsychotics, observing little response in the current episode, for which reason we evaluated the indication of intranasal Esketamine. Scales: MADRS (Montgomery Asberg Depression rating scale) =37, Hamilton Depression Scale=25, PHQ-9=20, indicating severe depression.
Results
After starting treatment with intranasal esketamine, an early response was observed. After the first month of treatment, mild depression was scored at MADRS=10 and moderate depression at Hamilton=14, PHQ-9=12, and at week 14 of treatment, it was scored mild depression in both MADRS and Hamilton. Intranasal 56mg esketamine plus 20mg escitalopram, 30mg mirtazapine and 5mg aripiprazole.
Conclusions
Intranasal esketamine offers a rapid reduction in depressive symptoms maintained over time, reducing the risk of relapse and with a favorable tolerability profile, so its use in depression resistant to treatment presents a great advance.
In recent years, there is a growing interest in microbiota and how certain dietary patterns affect our brain.
We know that diet has an important impact in physical and mental health. The mecanism that underlies is already unknown, but there is emerging evidence that diet modulates brain gut microbiota and has implications in mental problems.
Objectives
The aim of this poster is highlight the importance of diet in mental health and the link with microbiota.
Methods
Review of recent literature about diet, microbiota and psychiatry. The studies were collected of the electronic databases PubMed.
Results
New researches highlight the importance of adequate nutrition for mental health. Several studies link healthy diet with a minor risk of mental illnesses or with the improvement of depressive symptoms. Likewise, poor dietary habits could aggravate cognitive decline and increased risk of developing anxiety, depression or other mental illnesses.
It has been shown that a diet rich in fiber, polyphenols and micronutrients improve gut microbial composition and can reduce metabolic endotoxemia and neuroinflammation, and this has been associated with improvements in brain health. Also, prebiotic and probiotics have positive effects.
Therefore, dietary interventions could be a complementary therapeutic approach for patients with mental problems. This is what nutritional psychiatry focuses on.
Conclusions
Microbiota as a potential therapeutic target for mental illness is a hot topic in psychiatry, but also, its interaction with dietary change or the use of probiotics and prebiotics. This action is easy to implement in our clinical practice and could be part of a biopsychosocial treatment to improve or prevent some psychiatric disorders.
Nutritional psychiatry is a new field that needs to be developed and the knowledge in microbiota, diet and mental health could help. Hopefully, the research about this topic continues expanding.
The evolution of texture, structure and chemical composition of chloritic clays in coeval pairs of metabasites and metapelites of a prograde sequence from the Bükk Mountains has been investigated using electron microscopy techniques. Samples are from the Bükkium (innermost Western Carpathians, Hungary) that underwent Alpine metamorphism, ranging from late diagenesis to epizone for pelites and from prehnite-pumpellyite to greenschist facies for the metabasites.
Although bulk-rock compositions, textures and primary minerals are different, chlorite evolved at similar rates in coeval metabasites and metasediments, but along different paths. The principal similarities in the prograde sequence are a decrease in the percentage of interstratified material in both dioctahedral and trioctahedral phyllosilicates and increase in thicknesses of chlorite and illite crystallites. The principal difference is in the type of interstratification in chlorite, with berthierine in metapelites, and smectite (saponite) in metabasites, although smectitic mixed layers also occur in the former. The evolution of trioctahedral phyllosilicates is marked by a decrease in the number of mineral species with increasing grade, chlorite, sensu stricto, being the only trioctahedral mineral at higher grades. This is consistent with the trend in reaction progress where both metastable systems (metabasites and metapelites) tend toward the same end-member, thermodynamically stable chlorite, as well as texture (crystal size), and where all intermediate states are metastable, and determined by the Ostwald step rule.
A 30-item confrontation naming test was developed in Argentina for Spanish speakers, The Cordoba Naming Test (CNT). The Boston Naming Test is an established confrontation naming task in the United States. Researchers have used the Boston Naming Test to identify individuals with different clinical pathologies (e.g., Alzheimer’s disease). The current literature on how Spanish speakers across various countries perform on confrontational naming tasks is limited. To our knowledge, one study investigated CNT performance across three Spanish-speaking countries (i.e., Argentina, Mexico, and Guatemala). Investigators found that the Guatemalan group underperformed on the CNT compared to the Argentine and Mexican groups. The purpose of this study was to extend the current literature and investigate CNT performance across five Spanish-speaking countries (i.e., Argentina, Mexico, Guatemala, Colombia, United States). We predicted that the Argentine group would outperform the other Spanish-speaking countries.
Participants and Methods:
The present study sample consisted of 502 neurologically and psychologically healthy participants with a mean age of 29.06 (SD = 13.41) with 14.75 years of education completed (SD = 3.01). Participants were divided into five different groups based on their country of birth and current country residency (i.e., United States, Mexico, Guatemala, Argentina, & Colombia). All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in Spanish. The CNT consisted of 30 black and white line drawings, ranging from easy to hard in difficulty. An ANCOVA, controlling for gender, education, and age, was used to evaluate CNT performance between the five Spanish-speaking country groups. Meanwhile, a Bonferroni post-hoc test was utilized to evaluate the significant differences between Spanish-speaking groups. We used a threshold of p < .05 for statistical significance.
Results:
Results revealed significant group differences between the five Spanish speaking groups on the CNT, p = .000, np2 = .48. Bonferroni post-hoc test revealed that the United States group significantly underperformed on the CNT compared to all the Spanish-speaking groups. Next, we found the Guatemalan group underperformed on the CNT compared to the Argentinian, Mexican, and Colombian groups. Additionally, we found the Argentinian group outperformed the Mexican, Guatemalan, and United States groups on the CNT. No significant differences were found between the Argentinian group and Colombian group or the Mexican group and Colombian group on the CNT.
Conclusions:
As predicted, the Argentinian group outperformed all the Spanish-speaking groups on the CNT except the Colombian group. Additionally, we found that the United States group underperformed on the CNT compared to all the Spanish-speaking groups. A possible explanation is that Spanish is not the official language in the United States compared to the rest of the Spanish-speaking groups. Meanwhile, a possible reason why the Argentinian and Colombian groups demonstrated better CNT performances might have been that it was less culturally sensitive than the United States, Mexican, and Guatemalan groups. Further analysis is needed with bigger sample sizes across other Spanish-speaking countries (e.g., Costa Rica, Chile) to evaluate what variables, if any, are influencing CNT performance.
We present a novel method for numerically finding quasi-isodynamic stellarator magnetic fields with excellent fast-particle confinement and extremely small neoclassical transport. The method works particularly well in configurations with only one field period. We examine the properties of these newfound quasi-isodynamic configurations, including their transport coefficients, particle confinement and available energy for trapped-electron-instability-driven turbulence, as well as the degree to which they change when a finite pressure profile is added. We finally discuss the differences between the magnetic axes of the optimized solutions and their respective initial conditions, and conclude with the prospects for future quasi-isodynamic optimization.
About the term cognitive-behavioral minority disease or rare disease are a group of diseases that affect between 6-8% of the populatio. It is estimated that there are more than 7000 in the world, the majority with a genetic basis and affect various organs and systems, they also present psychiactric comorbidities and cause a physical or mental disability. Given its definition, it is difficult to see a large number of these patients in our usual clinical activity, so their management can be complicated.
Objectives
To evaluate the prevalence of psychiatric comorbidity and the prevalence of psyhcopharmacological treatment in children and adolescents whe present a minority disease.
Methods
This is a descriptive, controlled, retrospective cross-sectional study of a sample obtained by non-probabilistic sampling, which is representative of the study population.
The statistical analysis was made using the statistical program SPSS V22 (2013).
Results
With a sample of 114 patients, of which 26,6% presented fragile X syndrome, secondly 25,3% presented Prader-Willi Syndrome and 48,1% other chromosomal abnormalities.
By subgroups (male:female): in Prader-Willi syndrome 6:14 (30%:70%), in Fragile X syndrome 12:9 (57,14%: 42,86%) and in other diseases 25:13 (75,69%: 34,21%).
Conclusions
The creation of clinical expert units makes the possibility to increase knowledge of diseases whose prevalence in the population, thanks to technological advances, is increasing and where scientific knowledge is still limited.
These units are also important, in order to be able to offer personalized intensive treatments in order to reduce polypharmacy. There is not a great difference between the minority diagnosis and polypharmacy, although there is less polypharmacy than expected, which may be the result of the success of the most intensive and personal psychotherapeutic intervention in the unit.
One of the most important functions of sleep may be the promotion of brain development. The non-REM and REM sleep sequences show the succession of cerebral processing phenomena that underlie memory consolidation. The negative consequences of sleep loss on neural and behavioral plasticity has been examined. On the other hand, sleep disruption can be a crucial symptom to develop depression disorders. Recent literature suggests that maintenance insomnia may be a risk factor for dementia. It would be important to elucidate which factors may increase the risk of developing dementia and aggravating its progression.
Objectives
The aim of this scoping review is to point out the increased risk of developing dementia related to insomnia and depression.
Methods
Relevant literature was searched with PUBMED as electronic database. We used and combined the following MeSH terms: depression, insomnia, cognitive impairment and dementia. We chose sixteen recent studies from 2009 to 2021. Four of them were ruled out because the methodology and conclusions were not enough evident.
Results
We underlined an interesting research which was carried out with Chinese population in 2021. A total of 256 patients with insomnia disorder were diagnosed by neurologists, 45 of whom were diagnosed with amnesic mild cognitive impairment (aMCI) and 45 participants with intact cognition were chosen as controls matched for age and education. A case-control study was conducted to compare sleep structure between aMCI and control patients with insomnia disorder. An American prospective research in 2016 founded a statistically significant association with a higher MCI/dementia risk in women with either short (≤6 hours/night) or long (≥8 hours/night) sleep duration (vs.7 hours/night). The relationships between depression, cognitive function, serum brain-derived neurotrophic factor (BDNF) and volumetric MRI measurements in older adults were investigated. A total of 4352 individuals aged 65 years or older (mean age 72 years) participated in this Japanese study.
Conclusions
According to these researches, we emphasize the importance of detecting sleep disturbances as potential risk factors for MCI and dementia. All of them provide evidences that future studies should investigate dementia prevention among elderly individuals through the management of insomnia. At that point we have to consider personalized medicine and machine learning techniques for sleep and cognitive or mood symptoms.
Burnout syndrome or professional exhaustion is defined as feeling burned out, exhausted, overloaded, exhausted. It is a syndrome characterized by emotional exhaustion, depersonalization and low personal fulfillment. This clinical syndrome was first described in 1974 by Herbert Freudenberger, a psychiatrist, who defined burnout as “the depletion of energy experienced by professionals when they feel overwhelmed by the problems of others.” Mental Health is one of the specialties with the greatest emotional exposure due to all the circumstances that surround these professions, to maintain health in its 3 axes: physical, mental and social well-being as defined by the WHO
Objectives
The objective of the study is to determine the presence of Burnout Syndrome in Mental Health professionals through the Maslach Burnout Inventory (MBI) questionnaire.
Methods
An observational, descriptive and cross-sectional study is carried out. The people included in the study were the health personnel of the Mental Health Clinical Management Unit (psychiatrists, administrative personnel, nursing assistants, nursing personnel, social workers and psychologists, and training personnel) who wanted to participate in the study. Carrying out the MBI questionnaire and sociodemographic data.
Results
In our study we have a sample of 59 people. Regarding the sociodemographic data, we have 45 women and 14 men. Regarding the results after correcting the MBI questionnaire, we found that 4 professionals presented Burnout Syndrome (a psychiatrist and a 4th year psychiatry resident intern of psychiatry), 35 professionals presented tendency to suffer from Burnout since one of the three areas measured by the questionnaire was affected and 15 did not suffer from Burnout. Regarding the domains, we obtain that emotional exhaustion is the area, together with low personal achievement, that is most affected in the professionals of the community mental health unit, 23 and 22 professionals, respectively. Depersonalization is present at 12. Professionals with temporary contracts presented greater emotional exhaustion and low personal accomplishment. Professionals with permanent contracts show greater emotional exhaustion. Among the professionals in training, low personal achievement and depersonalization stand out. The 4 professionals who present burnout syndrome are married women and 3 of them with temporary contracts.
Conclusions
The results obtained show the presence of Burnout Syndrome and a high tendency to develop it among the professionals of the Mental Health Unit. In relation to the data, we must reassess the care systems for professionals and prevent the causes that can lead professionals who are starting their professional career to develop burnout in normal situations that can lead to collapse in extraordinary circumstances such as the COVID-19 pandemic.
CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.
Objectives
To assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.
Methods
An extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.
Results
The main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.
Conclusions
In general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.
The metaverse is a digital world created using different technologies like virtual reality (VR), augmented reality (AR), cryptocurrency and the internet.
Interest in the metaverse has grown in recent months in different fields and it could have potential application in the treatment of mental health disorders.
Objectives
To gain a better understanding of metaverse and to explore its possible applications on mental health.
Methods
Review of recent literature about the implications of the metaverse users in mental health.
Results
Metaverse is a virtual universe where people can interact with other users, objects, and environments personifying an avatar. VR, AR and mixed reality (MR) have been used in the treatment and diagnosis of various mental health disorders for last years.
Attention deficit hyperactivity disorder, eating disorders, anxiety, phobias and post-traumatic stress disorder have been already benefited from VR. Also, there are results to treat persecutory delusions in psychosis. On the other hand, we know that to spend a significant amount of time playing 3D immersive games and using social media, could lead to insecurity, anxiety, depression and behavioural addiction.
The lack of evidence and these risks could be limitations to implement Metaverse for the therapeutic management of mental health.
Many companies have already started to develop virtual mental health clinics with mental health professionals serving patients in real time, some spaces have already offer group therapy sessions. Other immersive spaces have also been created for practising mindfulness, meditation, or yoga.
Conclusions
The new technologys have changed the way that we socialise, work, and interact, even the way that we receive medical treatment. The metaverse could prove useful in the management of the mental health disorders that have already benefited from VR, but at the same time we could potentially lead to the worsening of others.
A single-field-period quasi-isodynamic stellarator configuration is presented. This configuration, which resembles a twisted strip, is obtained by the method of direct construction, that is, it is found via an expansion in the distance from the magnetic axis. Its discovery, however, relied on an additional step involving numerical optimization, performed within the space of near-axis configurations defined by a set of adjustable magnetic field parameters. This optimization, completed in 30 s on a single CPU core using the SIMSOPT code, yields a solution with excellent confinement, as measured by the conventional figure of merit for neoclassical transport, effective ripple, at a modest aspect ratio of eight. The optimization parameters that led to this configuration are described, its confinement properties are assessed and a set of magnetic field coils is found. The resulting transport at low collisionality is much smaller than that of W7-X, and the device needs significantly fewer coils because of the reduced number of field periods.
Dyskinesias are motor disorders that occur as a side effect to treatment with typical and less frequently with atypical antipsychotic drugs. They are more frequents in child population. Treatment usually consists of decrease the dose of drug or replace it with a better profile tolerability antipsychotic. Clozapine is an antipsychotic drug indicated as second-generation treatment of motor disorders that appear as side effects to treatment with neuroleptics.
Objectives
Demonstrate the efficacy and tolerability of clozapine in the treatment of dyskinesias in childhood.
Methods
The patient 12 year-old boy, has episodes of psychomotor agitation once a month. This will alternate with quiet moments in which dyskinetic movements are observed in upper limbs, without being able to detect any type triggering environmental factor. Personal history: hydrocele, diagnosed at 8 years becomes neurodevelopmental disorder considered. Neurosurgery tracking for Subarachnoid cyst. Psychopathological examination: Child presents psychomotor restlessness, disruptive behavior, impairments in communication, movement disorder, stereotypies and dyskinetic movements in shoulder and neck.
Results
In the patient suffering from an autistic disorder, stereotypies and other motor symptoms were observed, the predominant and most relevant being dyskinetic movements in the shoulder and neck, which appeared one month after starting treatment with risperidone and worsening psychomotor skills. Treatment of dyskinesia with clozapine improved the motor symptoms presented by the patient.
Conclusions
Clozapine should be the treatment of choice in the event of dyskinesias as a secondary effect to other antipsychotic treatments, proving effective in controlling them as well as well tolerated in both adults and children.
Stigma has been associated with various groups, based on certain attributes or characteristics, such as; Race or health status is a complex and dynamic process, a universal phenomenon that is part of all social groups and is maintained by its functions related to the establishment of one’s own identity and the facilitation of socialization processes. Many societies throughout history have identified people with a mental health problem as part of a minority group considered inferior to the rest. What has made this population an object of social stigma. With the beginning of community psychiatry, and with the need to integrate people with a serious mental disorder into it, it becomes even more valuable to be able to assess the social stigma towards mental illness in the community.
Objectives
The goal is to examine community attitudes towards people with mental illness.
Methods
Cross-sectional study of 228 people through an anonymous online survey. Sociodemographic variables and questionnaires were collected, such as the Community Attitudes Questionnaire towards people with Mental Illness (CAMI).
Results
65% of respondents are women and 35% men. 74% have university studies. 18% do not agree that mental illness is an illness like any other. 1% believe that not all people can develop a mental illness. 7% of those surveyed are afraid that people with mental illness reside in their neighborhood and 14% believe that they are more dangerous people than the general population.
Conclusions
Given the results obtained, we observe that the stigma towards people with mental illness is still present in society.
Suicide is a global health problem. The elderly is the range with the highest suicide rate and suicidal behaviors are more lethal, with greater planning and less possibility of rescue. In the elderly, Major Depressive Disorder is the diagnosis most frequently associated with suicidal behavior. 15% of the elderly with a depressive picture commit suicide. Loneliness, the main cause of suicides in the elderly population.
Objectives
The objective of the clinical case presented is to address the risk factors for suicide in the elderly.
Methods
80-year-old patient, widower who makes a suicide attempt by ingesting glyphosate. Personal history: Acute myocardial infarction 1 month ago. Not mental illness. Family stressors: illness of his granddaughter, loss of his son’s job. Personal stressors: Loss of autonomy due to ischemic heart disease. The patient was admitted to the Intensive Care Unit with acute pulmonary edema secondary to the suicide attempt. Psychopathological exploration: Conscious, oriented and collaborative. Depressive mood in relation to the stressors presented. Makes partial criticism of the suicide attempt, recognizes its seriousness and planning.
Results
Diagnosis: Moderate depressive episode. SAD PERSONS scale: 9 High risk.
Conclusions
The risk factors for suicide in older people can be medical, psychiatric, psychological, family environment and social - environmental factors. There are hardly any specific action protocols that allow early intervention and suicide prevention in the elderly. As social health professionals, we must work on the elaboration and application of these, since consummated suicide represents a major public health problem throughout the world.