Climbing cacti with edible fruits have been proposed as new dryland fruit crops because their high water-use efficiency reduces water requirement. One lineage of climbers in the cactus family, the Hylocereus group of Selenicereus, includes several species that produce edible fruits and is currently cultivated around the world. Fruits are known as pitahayas, pitayas or dragon fruit. Here, by means of ecological niche-based modelling and analytical hierarchical modelling, the optimal areas for cultivating the three main species of this group in Mesoamerica – Selenicereus costaricensis, Selenicereus ocamponis and Selenicereus undatus – are identified. Data on distribution, physiological requirement and host preferences are taken into account to carry out ecological modelling for current and future scenarios of climate and determine its impact on cultivation. Two MIROC climatic future models, one optimistic (ssp216) and a pessimistic (ssp585) were selected and 554 records from Mexico and Central America were gathered. For all three species, temperature and precipitation seasonality, and solar radiation were the most significant variables in the niche modelling. In addition, for S. undatus the most important hosts, three species of mesquite legume trees were significant to forecast suitable areas for planting. Large areas on the Pacific side from Sinaloa to Costa Rica were predicted as favourable for cultivating the studied three species. Future scenarios of climate change predicted increase of suitable areas for two species and in particular for S. undatus the increment was the largest. Therefore, dragon fruits are corroborated as promising fruits in view of climate change.

OBJECTIVES/GOALS: The goal of this project was to assess the scientific impact of Miami CTSI’s Mentored Career Development (KL2) Program using bibliometric tools and network visualization in addition to the traditional metrics used to provide a comprehensive evaluation. METHODS/STUDY POPULATION: Scholarly productivity of KL2 scholars were tracked using REDCap. For bibliometric data analysis and visualization, publications were queried using iCite (NIH Office of Portfolio Analysis) and Web of Science database. A total of 173 publications produced by eight KL2 scholars from 2013-2018 were analyzed and categorized into pre-award, during award, and post-award periods. iCite was used to assess scientific influence and translation. Scientific networks and collaboration were visualized using VOSviewer (Centre for Science and Technology Studies, Leiden University). CTSA Common Metrics were tracked using the Results Based Accountability framework. RESULTS/ANTICIPATED RESULTS: Albeit of modest size, the Miami CTSI’s KL2 Program had significant scientific productivity and impact in its first five years. Our KL2 scholars’ publications were cited twice as frequently as other papers in their fields. Further, 48% of publications post KL2 award were above the NIH 50th percentile and had higher citation impact compared to the average NIH-funded paper; 11% were in the top 10% NIH citation ranking. In contrast, only 20% of the publications pre-KL2 award were above the NIH 50th percentile. The program also promoted research collaboration; network visualizations indicate larger co-authorship and organization networks of KL2 scholars post-award. DISCUSSION/SIGNIFICANCE OF IMPACT: Bibliometric and data visualization approaches helped us better identify trends and gauge effectiveness of the KL2 program. These findings provided useful insight into the scientific influence and impact of our scholars’ work.

Schizophrenic patients have a standardized mortality rate that more than doubles the expected rate for the rest of the population. A substantial percentage of the morbidity and mortality in these patients is due to cardiovascular disease. The metabolic syndrome is highly prevalent among schizophrenics and produces a 2-4-fold increase in coronary risk. The objective of the present poster was to analyze the few reports published on the prevalence of metabolic syndrome in the schizophrenic patients and the associated sociodemographic, anthropometric, clinical and psychopharmacological variables.

Most reports concur on the high prevalence of the metabolic sybdroem in schizophrenic patients and, therefore, the prevention, diagnosis and treatment of its components is essential to reduce cardiovascular risk in these individuals.

The possibilities of suffering from a depression increase as we get older. The medical profile of a depression is very varied on elderly patients and the fact that the cognitive deterioration may organize a pathoplasty is also to be taken into account so we must be very precise when making the differential diagnosis as the possibility of an organic pathology is higher.

It is highly more likely for women than for men to suffer this pathology, but the possibilities tend to equalize as people get older.

Depression affects between 5 and 15% of people older than 65 who live in our community (NIH, 1992) (3 - 5% Major Depressive Disorder; Disthymia 10 – 12%); the 15%-50% of elderly persons who live in an old people's home suffer from a certain depressive disorder, and 10% - 20%of hospitalized are depressed. Aethiologycal factors are multifactoral and can be classified in genetic, biological or psychosocial groups.

Regarding the treatment it is very important to make a global valuation as well as assuring the compatibilities and interactions of all the medicines to be taken, we must be careful at the beginning of the treatment and give the patient a progressive dosification of the medicines.

This report describes the main characteristics of depression on old people that may be useful to distinguish it from the affective pathology that affects another group of age, but it also deals with the therapeutic-non medical approaches that the family or others may use to help the patient.

As the patient gets older, the medical treatment for the depression gets more and more complicated as the number of possible interactions between these drugs increases.

An average elderly person of 65 years takes around 8 pills a day, and whenever they have 2 or more pills simultaneously the possibility of creating an adverse reaction increases again enormously. Generally, medical interactions depend on the dose. A good advice would be “start slowly and continue slowly” in order to obtain the better result taking the shortest possible dose.

It is very important to reduce the amount of drugs, to adjust the dose and to choose the right medicine in order to avoid adverse reactions. We should also take into account the documented medical interactions concerning the wide variety of antidepressants and specific medicines of each type.

Each depression requires an individualized treatment, adjusted to each case, especially those of elderly patients. There is not yet a medicine effective for all the cases. Sometimes people are given a treatment which has already been proved and that may show different results, as the individual response depends on a lot of factors.

We introduce here the principal characteristics, of the main antidepressants used nowadays for elderly patients, as well as their medical interactions, and their pros and cons.

In this exhibition we aim to describe a clinical case and the different consequences that may present additional problems with eating disorders, focusing with emphasis on development and clinical picture. This disorder usually occurs in non-obese adolescents accused, showing symptoms significantly related to interpersonal functioning of these adolescents, who tend to be isolated or seek company of younger guys. They are characteristic of obsessive-compulsive disorders related or unrelated to the food. Dietary restriction involves biological and physical changes, highlighting the alteration of hypothalamic and endocrine system, leading to signs and symptoms such as amenorrhea, cold intolerance, hypotension … Neurochemical changes have also been attributed to malnutrition.

The present case is a 31 year old woman. Initiates contact with Mental Health at age 15 by anorexia nervosa. Patient requests for worsening nutritional status, family relationships, and alcohol consumption, being the turning point and main motivation, the birth of his daughter. 8 months ago gave birth, being an unexpected delivery at home. Unaware that pregnancy, justifying as secondary amenorrhea eating disorder and abdominal inflammation malnutrition. Daughter born seven months income requires low weight and withdrawal symptoms during pregnancy as continuous with anxiolytic and antidepressant treatment.

It has a favorable, always maintaining therapeutic commitment announced at the beginning of tratamiento. Currently still in out patient reviews with Psychiatry, Clinical Psychology, Nursing and Nutrition.

The aim of this essay is to point out the relevance of psychosocial rehabilitation treatment in the course of a person's life. In order to get this purpose, we shall present and analyse the progress and development in treatment lived by a patient diagnosed with severe mental disorder during her early teens. Several mental health devices have been involved in her treatment.

The patient is a 25 years old woman, her treatment started at the age of fourteen when she was diagnosed with Hebephrenic Schizophrenia by the medical team of the child and adolescence Outpatient Surgery Centre of Huelva. It was developed a multidisciplinary work with the patient, setting out the following objectives to reach:

• Clinical stabilization

• Social and family integration.

• Social abilities acquisition.

• Self-care adaptation.

• Self-awareness of the mental disorder

• social and working reintegration

The treatment was carried out in the Outpatient Surgery Centre till she was eighteen years old. At this age, she was derived to the USMC to go on with her rehabilitation. Thanks to the treatment the patient got the clinical stabilization (no more medical admissions were required), and she was able not just to take up again her studies, but also to reach a good family integration though she lived the dead of her mother along the treatment.

Currently, the patient is under treatment in the USMC. She gets over the difficulties associated with her mental disorder, living a normalized social, family and working life.

This study focuses on the rehabilitation treatment in a Day Hospital of Children and Adolescents. This Hospital consists of a psychiatrist, three nurses, five nursing assistants, an occupational therapist, a schoolteacher, a part-time endocrine, a social worker and an administrative assistant, who are responsible for carrying out the therapeutic process whose notable aspects consist of psychosocial treatment aimed at the reintegration of child-adolescent to the social and/or labour normalized circuit through discussion groups and workshops.

As a working example, we are talking about a patient who starts treatment at the age of 15. He was referred to this unit to assess the benefit of a psychopharmacological treatment, from his USMC of reference, where he had been going two years. It's in the Day Hospital where he was diagnosed as bipolar affective disorder, requiring adequate control of his psychopharmacological treatment and a socio-familiar situation as stable as possible. This is due to the family dysfunction detected which may influence the evolution of the underlying pathology. After two years of monitoring, manic disorder appears requiring hospitalization, which when stabilized returns to be referred to the Day Hospital to continue rehabilitation process. This unit has tried to integrate him in his area and to get awareness of illness and treatment adherence, proposed objectives of the individual treatment plan.

Today is euthymic, following the treatment properly, has regained his school activities and has adapted best to the family dynamics. All this was possible thanks to the multidisciplinary approach undertaken in the Day Hospital.

Addressing the psychosocial rehabilitation of mental health patients, can be approached in various ways. In this case illustrates how a multidisciplinary approach so early impact on rehabilitation os psychiatric illness.

Patient is a woman of 45 years, starting in mental health in 1989 and with five entries in the inpatient psychiatric unit between 2006–2011, with a diagnosis of bipolar disorder. During this period has come to irregularly shaped mental health unit, with poor adherence therapeutics and instability in their symtoms, without being able to normalize their mood. Has presented several manic episodes with psychotic symptoms and depressive episodes.

Treatment begins with a comprehensive approach: psychiatry, psychology, social work, and assistant nursing.

Treatment objectives were: raise awareness of disease, adherence and development and expansion of social skills in order to reduce the number of admissions and achieve clinical stabilization.

Included in the treatment psychoeducational group therapy, activities and social skills workshops and home visits. Therefore, we emphasize the importance of integrative treatment in the rehabilitation of this patient and the approach of this type of intervention to detect these cases.

The potential suicide is a person with intense suffering and is always a serious patient, for whom by their despair, future expectations do not exceed a painful present.

Expose more carefully try this idea by describing a case of a patient with highly lethal suicide attempts, severe, recurrent (repeated blows with a hammer to the skull, incised wound in the abdomen after a knife stab, multiple cuts with a knife upper and lower limbs …). Besides these aspects, point out the risk factors found in this patient and further foster suicide problem. Borderline personality disorder and depressive disorder, in which we highlight a high difficulty in solving problems and hopelessness, the harmful use of cocaine and alcohol, and demographic factors such as age, gender and part of socially minority group. The profile of temperament and personality point out a tendency to novelty seeking and harm avoidance, coupled with aggressive and impulsive behavior, without a clear definition of objectives and targets, and low capacity for cooperation which is observed by manipulative attitude posing in repeated hospital admissions.

Therefore, we emphasize that suicide is a complex entity and their pricing strategies, risk detection and prevention, are hampered by the lack of a definition and classification operative. That said, and considering that you have to work in a comprehensive manner, we considered what we should prioritize in the treatment of this patient to prevent another attempted suicide, is the psychiatric disorder, substance use, social status risk that found, or suicidal symptoms itself?