An EMP and TEM—AEM Study of Margarite, Muscovite and Paragonite in Polymetamorphic Metabauxites of Naxos Cyclades, Greece) and the Implications of Fine-scale Mica Interlayering and Multiple Mica Generations

Coexisting white micas and plagioclase were studied by electron microprobe (EMP), and transmission and analytical electron microscopy (TEM—AEM) in greenschist- to amphibolite-grade metabauxites from Naxos. The TEM—AEM studies indicate that sub-micron scale (0.01-1.0 μm thick) semicoherent intergrowths of margarite, paragonite and muscovite are common up to lower amphibolite conditions. If unrecognized, such small-scale mica interlayering can easily lead to incorrect interpretation of EMP data. Muscovite and paragonite in M2 greenschist-grade Naxos rocks are mainly relics of an earlier high-pressure metamorphism (M1). Owing to the medium-pressure M2 event, margante occurs in middle greenschist-grade metabauxites and gradually is replaced by plagioclase + corundum in amphibolite-grade metabauxites. The margarite displays minor IVAl3 VI(Fe3+, Al) Si-3 VI□--1 and considerable (Na, K) SiCa-1Al-1 substitution, resulting in up to 44 mol% paragonite and 6 mol % muscovite in solution. The compositional variation of muscovite is mainly described by VI(Fe2+, Mg) Si VI Al-1VI Al-1 and VI(Fe3+Al-1) exchanges, the latter becoming dominant at amphibolite grade, Muscovite is significantly richer in Fe than margarite or paragonite. Ca—Na—K partitioning data indicate that margarite commonly has a significantly higher Na/(Na+ K+Ca) value than coexisting muscovite or plagioclase. Exceptions are found in several greenschist-grade rocks, in which M1-formed mussovite may have failed to equilibrate with M2 margarite. The sluggishness of K-rich micas to recrystallize and adjust composidonally to changing P-T conditions is also reflected in the results of mus-covite-paragonite solvus thermometry. Chemical data for Ca—Na micas from this study and literature data indicate that naturally coexisting margarite—paragonite pairs display considerably less mutual solubility than suggested by experimental work. The variable and irregular Na partitioning between margarite and muscovite as observed in many metamorphic rocks could largely be related to opposing effects of pressure on Na solubility in margarite and paragonite and/or non-equilibrium between mica

Cost-effectiveness and budget impact of a lifestyle intervention to improve cardiometabolic health in patients with severe mental illness

Introduction: This study assessed the cost-effectiveness and budget impact of a lifestyle intervention to improve cardiometabolic health in severe mentally ill (SMI) patients in the LION trial.Methods: Patients (n = 244) were randomized to receive either care-as-usual or a lifestyle intervention in which mental health nurses coached patients in changing their lifestyle by using a web tool. Costs and quality of life were assessed at baseline and at 6 and 12 months. Incremental costs per centimeter waist circumference (WC) lost and per Quality-Adjusted Life Year (QALY) gained were assessed. Budget impact was estimated based on three intervention-uptake scenarios using a societal and a third-party payer perspective.Results: Costs and reduction in WC were higher in the intervention (n = 114) than in the control (n = 94) group after 12 months, although not statistically significant, resulting in (sic)1,370 per cm WC lost. QALYs did not differ between the groups, resulting in a low probability of the intervention being cost-effective in cost/QALY gained. The budget impact analysis showed that for a reasonable participation of 43%, total costs were around (sic)81 million over 5 years, or on average (sic)16 million annually (societal perspective).Conclusions: The intervention is not cost-effective at 12 months and the budget impact over 5 years is substantial. Possibly, 12 months was too short to implement the intervention, improve cardiometabolic health, and reduce care costs. Therefore, the incentive for this intervention cannot be found in short-term financial advantages. However, there may be benefits associated with lifestyle interventions in the long term that remain unclear.</p

Maternal Anxiety, Infant Stress, and the Role of Live-Performed Music Therapy during NICU Stay in The Netherlands

Having an infant in the neonatal intensive care unit (NICU) elicits maternal anxiety, which may hamper parent−child bonding. We performed a prospective cohort study to describe anxiety in mothers of infants born before 30 weeks of gestation during NICU stay in The Netherlands, and investigated the influence of infant stress and gestational age. Second, we performed a randomized-controlled live-performed music therapy trial (LPMT trial) to investigate whether music therapy applied to the infant alleviated maternal anxiety. The relation between infant stress, gestational age, and maternal anxiety was measured in 45 mother−infant dyads, using the Neonatal Infant Stressor Scale and the State-Trait Anxiety Inventory (STAI). The effect of LPMT on anxiety was assessed in 21 mothers whose infants were assigned to either LPMT (n = 12) or waitlist (n = 9). Mothers completed the STAI before and after this period. Maternal anxiety decreased over time in all mothers, and was strongly related with infant stress (r = 0.706, p < 0.001), but not with gestational age. Anxiety scores decreased by 12% after LMPT, and increased by 1% after a waitlist period (p = 0.30). Our results indicate that LPMT in the weeks after birth may accelerate the reduction of maternal anxiety. Further research should focus on the effects on mother−child bonding

Study of correlation between the NAT2 phenotype and genotype status among Greenlandic Inuit

N-acetyltransferase 2 (NAT2) is the main enzyme metabolizing isoniazid and genotype-based treatment has been studied for years without becoming common practice. To investigate whether genotype-based isoniazid treatment is feasible in Greenland, we sequenced the coding sequence of NAT2 and determined the NAT2 enzyme-activity by caffeine test. No additional genetic variants were identified in the coding sequence of NAT2, so that genotype status in 260 study participants could be assessed by a well-established 7-SNP panel. Studying the enzyme activity by the ratio of the two caffeine metabolites AFMU and 1X in 260 participants showed a high rate of slow phenotypes with intermediate or rapid genotype. These misclassifications were mainly observed in urine samples with pH<3, a deviation from the standard protocol due to the field work character of the study, where immediate pH adjustment to pH=3.5 was not possible. We excluded these samples. For the remaining 143 individuals with pH>3, we observed a moderate level of discrepancies (19 of the 116 individuals with intermediate or rapid genotype status having a slow phenotype). Further investigation showed that drinking coffee and not tea or cola was the most important factor for high levels of both metabolites. The concordance between phenotype and genotype status with regard to slow metabolism supported the recommendation of lower isoniazid doses in individuals with slow genotype status in order to avoid liver injury, a frequent side effect. The phenotypical variation observed for individuals with intermediate or rapid genotype status warrants further research before increased dosing of isoniazid can be recommended