The lithospheric mantle and lower crust-mantle relationships under Scotland: a xenolithic perspective

In the British Isles the majority of volcanic rocks containing upper mantle and lower crustal xenoliths occur in Scotland. Most of the occurrences are of Carboniferous–Permian age. This paper presents new data on the mineral chemistry of spinel lherzolite xenoliths from the five principal Scottish tectonic terranes. Compositional variations among the minerals emphasize the broad lateral heterogeneity of the subcontinental lithospheric mantle across the region. The remarkable range of Al2O3 v. CaO exhibited by the clinopyroxenes compared with data from other ‘xenolith provinces' emphasizes the extremely complex tectonomagmatic history of the Scottish lithosphere. The generalized age increase from southern and central Scotland to the Northern Highland and Hebridean terranes of the north and NW, with concomitant complexity of geological history, is reflected also by trace element and isotopic studies. Reaction relationships in lherzolites from the Hebridean Terrane, owing to pervasive metasomatism, involve secondary growth of sodic feldspar. This, and light REE enrichment of clinopyroxenes, points to involvement of a natro-carbonatitic melt. Most pyroxenitic xenoliths are inferred to form a basal crustal layer with a generally sharp discontinuity above the underlying (dominantly lherzolitic) mantle. A second discontinuity is inferred to separate these ultramafic cumulates from overlying, broadly cognate metagabbroic cumulates

MSWI Fly Ash Multiple Washing: Kinetics of Dissolution in Water, as Function of Time, Temperature and Dilution

Municipal solid waste incineration fly ash (FA) can represent a sustainable supply of supplementary material to the construction industries if it is pre-treated to remove hazardous substances such as chloride, sulfate, and heavy metals. In this paper, the phenomenology associated with a water washing multi-cycle treatment of FA is investigated, focusing attention upon the mineral dissolution process. The efficacy of the treatment is assessed by leaching tests, according to the European Standard, and discussed in light of the occurring mineral phases. The water-to-solid (L/S) ratio is a crucial parameter, along with the number of washing cycles, for removing halite and sylvite, whereas quartz, calcite, anhydrite, and an amorphous phase remain in the solid residue. The sequential extraction method and dissolution kinetics modelling provide further elements to interpret leaching processes, and suggest that dissolution takes place through a two-step mechanism. Altogether, multi-step washing with L/S = 5 is effective in reducing contaminants under the legal limits for non-hazardous waste disposal, while the legal limits for non-reactive or reusable material cannot be completely reached, owing to sulfate and some heavy metals which still leached out from the residue

Cost analysis of GER-induced asthma: a controlled study vs. atopic asthma of comparable severity.

Abstract Bronchial asthma is a costly disease: while the role of pharmaceutical strategies was greatly emphasised in order to alleviate its economic burden,the aetiological approach to asthma has received much less attention from this point of view. The impact of gastro-oesophageal reflux (GER)-related asthma was assessed in comparison to atopic asthma in 262 matched patients,and the corresponding direct and indirect annual costs calculated. All subjects were screened by means of a 95-item self-questionnaire. The overall resource utilisation was calculated for the last 12 months. Drug-induced annual costs were euro 290.4 (interquartile range-iqr 32.8) in atopic and euro 438.4 (iqr 27.8) in GER-related asthma (p<0.001); expenditure for medical consultations and diagnostics were euro 166.1 (iqr 14.8) vs. euro 71.6 (iqr 11.0) (p<0.001),and euro 338.4 (20.0) vs. 186.9 (iqr 26.5) (p<0.001),respectively. Direct costs due to hospital admissions and indirect costs due to absenteeism were also higher in GER-related asthmatics: 2.201.7+/-90.0 vs. euro 567.1+/-11.0 (p<0.001),and euro 748.7+/-94.7 vs. euro 103.6+/-33.9 (p<0.001),respectively. The total annual cost per patient was euro 1246.7 (iqr 1979.6) in atopic and euro 3967.1 (iqr 3751.5) in GER-related asthma,p<0.001. In conclusion,GER-induced asthma has a more relevant economic impact on healthcare resources than atopic asthma. Although further studies are needed,present data tend to demonstrate that when facing difficult asthma (GER-related asthma in this case),the aetiological assessment of the disease plays a critical role in optimising the approach to patients' needs

The Variscan subduction inheritance in the Southern Alps Sub-Continental Lithospheric Mantle: clues from the Middle Triassic shoshonitic magmatism of the Dolomites (NE Italy)

Although often speculated, the link between the Middle Triassic shoshonitic magmatism at the NE margin of the Adria plate and the subduction-related metasomatism of the Southern Alps Sub-Continental Lithospheric Mantle (SCLM) has never been constrained. In this paper, a detailed geochemical and petrological characterization of the lavas, dykes and ultramafic cumulates belonging to the shoshonitic magmatic event that shaped the Dolomites (Southern Alps) was used to model the composition and evolution of the underlying SCLM in the time comprised between the Variscan subduction and the opening of the Alpine Tethys. Geochemical models and numerical simulations enabled us to define that 5–7% partial melting of an amphibole + phlogopite-bearing spinel lherzolite, similar to the Finero phlogopite peridotite, can account for the composition of the primitive Mid-Triassic SiO2-saturated to -undersaturated melts with shoshonitic affinity (87Sr/86Sri = 0.7032–0.7058; 143Nd/144Ndi = 0.51219–0.51235; Mg # ~ 70; ~1.1 wt% H2O). By taking into account the H2O content documented in mineral phases from the Finero phlogopite peridotite, it is suggested that the Mid-Triassic SCLM source was able to preserve a significant enrichment and volatile content (600–800 ppm H2O) for more than 50 Ma, i.e. since the slab-related metasomatism connected to the Variscan subduction. The partial melting of a Finero-like SCLM represents the exhaustion of the subduction-related signature in the Southern Alps lithosphere that predated the Late Triassic-Early Jurassic asthenospheric upwelling related to the opening of the Alpine Tethys

Capsulitis adhesiva del hombro. Comparación entre métodos de tratamiento conservador

Objetivo: Evaluar los resultados funcionales de tres protocolos distintos de tratamiento conservador en pacientes con capsulitis adhesiva del hombro. Materiales y Métodos: Se revisaron las historias clínicas de los pacientes tratados por capsulitis adhesiva en nuestra institución, entre enero de 2016 y enero de 2019. Se compararon tres protocolos diferentes de tratamiento: grupo 1, bloqueo del nervio supraescapular con un anestésico local y corticoide, analgésicos y fisioterapia después del alivio del dolor; grupo 2, bloqueo del nervio supraescapular con anestésico local sin corticoide, analgésicos y fisioterapia; grupo 3, analgésicos y fisioterapia, sin bloqueo del nervio supraescapular. Se determinaron los resultados funcionales con la escala ASES y el resultado subjetivo con el SSV. Resultados: Se dividió en tres grupos a 46 pacientes tratados por capsulitis adhesiva. Los pacientes del grupo 3 tuvieron, en promedio, más sesiones de fisioterapia (30,31 ± 21,07). Los del grupo 2 recibieron la mayor cantidad promedio de bloqueos del nervio supraescapular (3,27 ± 1,22). Los resultados de los puntajes funcionales fueron: grupo 1 (15 pacientes): media 84 ASES y 84 SSV; grupo 2 (15 pacientes): media 93,40 ASES y 91,67 SSV; grupo 3 (16 pacientes): media 79,4 ASES y 80,63 SSV. Conclusiones: Las distintas formas de tratamiento conservador para la capsulitis adhesiva logran excelentes resultados. La analgesia mediante bloqueos seriados del nervio supraescapular con un anestésico y corticoide logró mejores resultados funcionales y subjetivos, y disminuyó la necesidad de administrar analgésicos y de sesiones de fisioterapia (grupo 1). Nivel de Evidencia: I

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams.Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases.Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions.Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive\u2014Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post\u2014Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache.Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper

What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian Consensus Conference on Pain in Neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy