Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence

none34noopende Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina; Andreose, Suor; Basso, Pasquale; Beneduce, Rossella; Bertolotti, Pietro; Braida, Vanda; Bonelli, Marina; Bongiorno, Fanny; Bussi, Riccardo; Castagno, Elisa; Dominicis, Fabio; Ghersi, Loredana; Greppo, Stefania; Sodano, Alessandro Jaretti; Leporatti, Massimo; Presti, Eleonora Lo; Milone, Valeria; Panigada, Fausto; Pasquadibisceglie, Livia; Rigamonti, Danilo; Rillosi, Lucianade Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina; Andreose, Suor; Basso, Pasquale; Beneduce, Rossella; Bertolotti, Pietro; Braida, Vanda; Bonelli, Marina; Bongiorno, Fanny; Bussi, Riccardo; Castagno, Elisa; Dominicis, Fabio; Ghersi, Loredana; Greppo, Stefania; Sodano, Alessandro Jaretti; Leporatti, Massimo; Presti, Eleonora Lo; Milone, Valeria; Panigada, Fausto; Pasquadibisceglie, Livia; Rigamonti, Danilo; Rillosi, Lucian

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Comparison of experimental and simulated beamlet deflection in a MITICA-like extraction system at BATMAN Upgrade

Abstract: In collaboration with ITER, a MITICA-like extraction was installed at the BATMAN Upgrade test facility in 2021 (BUG-MLE). One main difference to the previous extraction system is the presence of additional deflection compensation magnets which are designed to suppress the row-wise zig-zag deflection of the accelerated negative ions caused by the co-extracted electron suppression magnets, mounted in the second grid of the extraction and acceleration system. The effect of the deflection correction magnets was characterized in dedicated scans with the available beam diagnostic tools (Carbon Fiber Composite tile calorimetry and Beam Emission Spectroscopy). Since the correction magnets are installed only in the upper grid half, the corrected beam can be directly compared to an uncompensated beam. The experimental investigations are accompanied by simulations. IBSimu is used to model the beamlet formation and ion-optics inside the extraction system. The in-house developed BBCNI code is exploited to track the particles towards the CFC and generate synthetic beamlet emission spectra. The work focuses on physics interpretation by directly comparing measured and synthetic data. In particular, after outlining the main theoretical aspects behind the BUG-MLE experiment, a series of simulations is performed with both of the aforementioned codes, allowing a detailed understanding of the expected results and providing insight on both the robustness of the horizontal deflection correction and its impact on the estimated beamlet divergence. Finally, the experimental outcomes are presented and analysed, from both of the diagnostic tools, and compared with the simulations in order to evaluate the action of the additional magnets in different conditions

Preparation of the measurement system for the spatial characterization of SPIDER negative-ion plasma source

Neutral beam injectors are fundamental auxiliary heating systems for nuclear fusion machines. The formation of the negative-ion beam, precursor of the neutral beam, occurs by extracting the ions from a plasma through a multi-aperture, multi-electrode electrostatic accelerator. In the case of the ITER neutral beam injector, to obtain sufficient current, the extraction takes place through 1280 openings distributed over a very large area, which must be illuminated by a sufficiently uniform plasma. The plasma, formed in 8 radio-frequency drivers, passes through an expansion chamber before reaching the extractor. The experimental study of the plasma parameters at the location of the ion extraction, and of its expansion from the driver region, is possible using Langmuir probes on mobile supports. In this dissertation, a preparatory study is conducted for characterizing negative ion plasma in SPIDER negative-ion plasma source. A bibliographic research is performed in order to understand how similar measures were taken in the past in similar devices, at the end of which three different kind of probes are designed and tested: a Mach probe, a double Langmuir probe and a planar Langmuir probe. The Mach probe is composed of 4 cylindrical pins and is designed in order to measure plasma flux and velocity drift. It was tested by assembling it on a rotating system inside an Argon plasma, in order to verify its symmetry and if it is suitable for an RF source like SPIDER. Next, the double probe (named ADEL, i.e. A Double Electrode Langmuir probe) consists of two parallel cylindrical electrodes, and it should give a completely floating measures of the plasma parameters. It was tested inside the CRISPy experiment (Compact RF Ion Source Prototype for emittance scanner testing) in order to give an estimate of electron temperature and plasma density. Regarding the planar Langmuir probe, it is composed of two electrodes: a main electrode and a compensation one. A model in LTSpice is used to simulate its behaviour in an RF plasma, so as to find the optimum capacity to be put in parallel between the two electrodes. Finally, a plan for probes installation and measurements in SPIDER is established in light of the results obtained

Clinical and neuropsychological features of violence in schizophrenia: A prospective cohort study

The increased risk of violence in schizophrenia has been linked to several environmental, clinical and neuropsychological factors, including executive dysfunction. However, data about the nature of these effects are mixed and controversial. The main aim of this study was to investigate the relationship between clinical and neuropsychological factors with violence risk in patients with schizophrenia, taking into account current psychopathology and lifetime alcohol use. We compared a sample of patients living in Residential Facilities (RFs) with schizophrenia and a past history of interpersonal violence (vSZ, N=50) to patients with schizophrenia matched on age, gender and alcohol abuse/dependence but with no violence history (nvSZ, N=37). We then established the association between the clinical and neuropsychological factors that predicted violence over a 1year follow-up period. The results revealed that vSZ patients living in RFs were characterized by greater compulsory hospital admissions, higher anger and less negative symptoms as compared to nvSZ patients. vSZ patients performed better on executive and motor tasks than nvSZ; however, these differences appeared to be explained by the lower negative psychotic symptom in the vSZ group. Both groups were involved in episodes of violence during the follow-up period; among the two, the vSZ patients were more likely to be violent. Negative symptoms predicted less verbal aggression at 1year follow-up. Overall, these findings support a key role of negative rather than positive symptoms in driving violence risk among SZ patients living in RFs, in a manner that negative symptoms are linked to a lower risk of violence

Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence

Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour

Personality, Schizophrenia, and Violence: A Longitudinal Study

The aims of this study were (a) to investigate the presence of clinically significant personality traits and personality disorders (PD) in patients living in residential facilities, with or without a history of violence (69 and 46, respectively); and (b) to investigate any associations between clinically significant personality traits and PDs, aggression, impulsivity, hostility, and violent behavior during a 1-year follow-up. The most frequent primary diagnoses were schizophrenia (58.3%) and PD (20.9%). Those with a history of violence demonstrated more antisocial and alcohol dependence features and lower depressive PD symptoms than the control group. Hostility levels, antisocial symptoms, and drug dependence, as well as a Structured Clinical Interview for DSM-IV Axis II diagnosis of PD, predicted aggressive and violent behavior during follow-up. The study confirms the relevance of assessing PDs both to evaluate the risk of violent behavior and to plan appropriate preventive and treatment intervention

Investigations on Caesium Dispersion and Molybdenum Coating on SPIDER Components

SPIDER is the 100 keV full-size Negative Ion Source prototype of the ITER Neutral Beam Injector, operating at Consorzio RFX in Padova, Italy. The largest Negative Ion Source in the world, SPIDER generates an RF driven plasma from which Deuterium or Hydrogen negative ions are produced and extracted. At the end of 2021, a scheduled long-term shutdown started to introduce major modifications and improvements aiming to solve issues and drawbacks identified during the first three years of SPIDER operations. The first action of the shutdown period was the disassembly and characterization of the SPIDER beam source after removal from the vacuum vessel and its placement inside the clean room. Each component was carefully assessed and catalogued, following a documented procedure. Some source components, i.e., the Plasma Grid, Extraction Grid and Bias Plate, revealed the presence of different and non-uniform red, white and green coatings that might be correlated to back-streaming positive ions impinging on grid surfaces, electrical discharges and caesium evaporation. Thus, several analyses have been carried out to understand the nature of such coatings, with the study still ongoing. The evidence of caesium evaporation and deposition on molybdenum-coated SPIDER components, such as the formation of oxides and hydroxides, is demonstrated through surface characterization analyses with the use of the Scanning Electron Microscope (SEM), X-ray Diffraction (XRD) and X-ray Photoelectron Spectroscopy (XPS)

Investigations on Caesium Dispersion and Molybdenum Coating on SPIDER Components

SPIDER is the 100 keV full-size Negative Ion Source prototype of the ITER Neutral Beam Injector, operating at Consorzio RFX in Padova, Italy. The largest Negative Ion Source in the world, SPIDER generates an RF driven plasma from which Deuterium or Hydrogen negative ions are produced and extracted. At the end of 2021, a scheduled long-term shutdown started to introduce major modifications and improvements aiming to solve issues and drawbacks identified during the first three years of SPIDER operations. The first action of the shutdown period was the disassembly and characterization of the SPIDER beam source after removal from the vacuum vessel and its placement inside the clean room. Each component was carefully assessed and catalogued, following a documented procedure. Some source components, i.e., the Plasma Grid, Extraction Grid and Bias Plate, revealed the presence of different and non-uniform red, white and green coatings that might be correlated to back-streaming positive ions impinging on grid surfaces, electrical discharges and caesium evaporation. Thus, several analyses have been carried out to understand the nature of such coatings, with the study still ongoing. The evidence of caesium evaporation and deposition on molybdenum-coated SPIDER components, such as the formation of oxides and hydroxides, is demonstrated through surface characterization analyses with the use of the Scanning Electron Microscope (SEM), X-ray Diffraction (XRD) and X-ray Photoelectron Spectroscopy (XPS)