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A comprehensive guide to reflexology that covers the principles, benefits, techniques, and health concerns of the practice; and includes photographs.

Granulite facies rocks frequently show a large spread in their zircon ages, the interpretation of which raises questions: Has the isotopic system been disturbed? By what process(es) and conditions did the alteration occur? Can the dates be regarded as real ages, reflecting several growth episodes? Furthermore, under some circumstances of (ultra-)high-temperature metamorphism, decoupling of zircon U–Pb dates from their trace element geochemistry has been reported. Understanding these processes is crucial to help interpret such dates in the context of the P–T history. Our study presents evidence for decoupling in zircon from the highest grade metapelites (> 850 °C) taken along a continuous high-temperature metamorphic field gradient in the Ivrea Zone (NW Italy). These rocks represent a well-characterised segment of Permian lower continental crust with a protracted high-temperature history. Cathodoluminescence images reveal that zircons in the mid-amphibolite facies preserve mainly detrital cores with narrow overgrowths. In the upper amphibolite and granulite facies, preserved detrital cores decrease and metamorphic zircon increases in quantity. Across all samples we document a sequence of four rim generations based on textures. U–Pb dates, Th/U ratios and Ti-in-zircon concentrations show an essentially continuous evolution with increasing metamorphic grade, except in the samples from the granulite facies, which display significant scatter in age and chemistry. We associate the observed decoupling of zircon systematics in high-grade non-metamict zircon with disturbance processes related to differences in behaviour of non-formula elements (i.e. Pb, Th, U, Ti) at high-temperature conditions, notably differences in compatibility within the crystal structure.

Background This pilot trial aimed to study the feasibility and effects on quality of life (QOL) and well-being of short-term fasting (STF) during chemotherapy in patients with gynecological cancer. Methods In an individually-randomized cross-over trial patients with gynecological cancer, 4 to 6 planned chemotherapy cycles were included. Thirty-four patients were randomized to STF in the first half of chemotherapies followed by normocaloric diet (group A; n  = 18) or vice versa (group B; n  = 16). Fasting started 36 h before and ended 24 h after chemotherapy (60 h-fasting period). QOL was assessed by the FACIT-measurement system. Results The chemotherapy-induced reduction of QOL was less than the Minimally Important Difference (MID; FACT-G = 5) with STF but greater than the MID for non-fasted periods. The mean chemotherapy-induced deterioration of total FACIT-F was 10.4 ± 5.3 for fasted and 27.0 ± 6.3 for non-fasted cycles in group A and 14.1 ± 5.6 for non-fasted and 11.0 ± 5.6 for fasted cycles in group B. There were no serious adverse effects. Conclusion STF during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy. Larger studies should prove the effect of STF as an adjunct to chemotherapy. Trial registration This trial was registered at clinicaltrials.gov: NCT01954836 .

Olivine-hosted melt inclusions are commonly used to determine pre-eruptive storage conditions. However, this approach relies on the assumption that co-erupted olivines have a simple association with their carrier melts. We show that primitive olivine crystal cargoes and their melt inclusions display a high degree of geochemical disequilibrium with their carrier melts at Kīlauea Volcano, Hawai’i. Within a given eruption, melt inclusions trapped in primitive olivine crystals exhibit compositional diversity exceeding that in erupted lava compositions since 1790 CE. This demonstrates that erupting liquids scavenge crystal cargoes from mush piles accumulating diverse melt inclusion populations over timescales of centuries or longer. Entrainment of hot primitive olivines into cooler, evolved carrier melts drives post-entrapment crystallization and sequestration of CO 2 into vapour bubbles, producing spurious barometric estimates. While scavenged melt inclusion records may not be suitable for the investigation of eruption-specific processes, they record timescales of crystal storage and remobilization within magmatic mush piles. The increasingly prevalent view of magmatic systems as mush-dominated challenges the common assumption that melt inclusions record the pre-eruptive storage and processing of the melts they were erupted with. Here, the authors show that melt inclusions from Kīlauea Volcano, Hawai'i exhibit extreme compositional diversity, consistent with the accumulation of inclusion-bearing crystals in magmatic mush zones for >170 years before their eventual eruption in unrelated carrier melts.

Aluminosilicates (kyanite, sillimanite and andalusite) are useful pressure–temperature (P–T) indicators that can form in a range of rock types through different mineral reactions, including those that involve partial melting. However, the presence of xenocrystic or inherited grains may lead to spurious P–T interpretations. The morphologies, microtextural positions, cathodoluminescence responses and trace element compositions of migmatite-hosted kyanite from Eastern Bhutan were investigated to determine whether sub-solidus kyanite could be distinguished from kyanite that crystallised directly from partial melt, or from kyanite that grew peritectically during muscovite dehydration reactions. Morphology and cathodoluminescence response were found to be the most reliable petrogenetic indicators. Trace element abundances generally support petrographic evidence, but protolith bulk composition exerts a strong control over absolute element abundance in kyanite. Sample-normalised concentrations show distinctive differences between petrogenetic types, particularly for Mg, Ti, V, Cr, Mn, Fe and Ge. LA-ICP-MS element maps, particularly combined to show Cr/V, provide additional information about changing geochemical environments during kyanite growth. Most kyanite in the studied migmatitic leucosomes is of sub-solidus origin, with less widespread evidence for peritectic crystallisation. Where present, grain rims commonly crystallised directly from the melt; however, entire grains crystallised exclusively from melt are rare. The presence of kyanite in leucosomes does not, therefore, necessarily constrain the P–T conditions of melting, and the mechanism of growth should be determined before using kyanite as a P–T indicator. This finding has significant implications for the interpretation of kyanite-bearing migmatites as representing early stages of melting during Himalayan evolution.

During the late Palaeozoic, lithospheric thinning in part of the Alpine realm caused high-temperature low-to-medium pressure metamorphism and partial melting in the lower crust. Permian metamorphism and magmatism has extensively been recorded and dated in the Central, Eastern, and Southern Alps. However, Permian metamorphic ages in the Western Alps so far are constrained by very few and sparsely distributed data. The present study fills this gap. We present U/Pb ages of metamorphic zircon from several Adria-derived continental units now situated in the Western Alps, defining a range between 286 and 266 Ma. Trace element thermometry yields temperatures of 580–890 °C from Ti-in-zircon and 630–850 °C from Zr-in-rutile for Permian metamorphic rims. These temperature estimates, together with preserved mineral assemblages (garnet–prismatic sillimanite–biotite–plagioclase–quartz–K-feldspar–rutile), define pervasive upper-amphibolite to granulite facies conditions for Permian metamorphism. U/Pb ages from this study are similar to Permian ages reported for the Ivrea Zone in the Southern Alps and Austroalpine units in the Central and Eastern Alps. Regional comparison across the former Adriatic and European margin reveals a complex pattern of ages reported from late Palaeozoic magmatic and metamorphic rocks (and relics thereof): two late Variscan age groups (~330 and ~300 Ma) are followed seamlessly by a broad range of Permian ages (300–250 Ma). The former are associated with late-orogenic collapse; in samples from this study these are weakly represented. Clearly, dominant is the Permian group, which is related to crustal thinning, hinting to a possible initiation of continental rifting along a passive margin.

Granulites and associated dykes from the less well-studied southern Ivrea–Verbano Zone (around Ivrea town) are characterized by combining field, macro, micro and chemical (major and trace-element mineral composition) data to identify chemical and rheological variations in the lower crust that could be relevant for geodynamic implications. The Ivrea granulites are similar to those in the Lower Mafic Complex of the central Ivrea–Verbano Zone. The mafic lithologies experienced stealth metasomatism (pargasitic amphibole and An-rich plagioclase) that occurred, at suprasolidus conditions, by a pervasive reactive porous flow of mantle-derived orogenic (hydrous) basaltic melts infiltrated along, relatively few, deformation-assisted channels. The chemical composition of the metasomatic melts is similar to that of melts infiltrating the central and northern Ivrea–Verbano Zone. This widespread metasomatism, inducing a massive regional hydration of the lowermost Southalpine mafic crust, promoted a plastic behavior in the lowermost part of the crust during the Early Mesozoic and, ultimately, the Triassic extension of the Variscan crust and the beginning of the Alpine cycle.

Granulites and associated dykes from the less well-studied southern Ivrea–Verbano Zone (around Ivrea town) are characterized by combining field, macro, micro and chemical (major and trace-element mineral composition) data to identify chemical and rheological variations in the lower crust that could be relevant for geodynamic implications. The Ivrea granulites are similar to those in the Lower Mafic Complex of the central Ivrea–Verbano Zone. The mafic lithologies experienced stealth metasomatism (pargasitic amphibole and An-rich plagioclase) that occurred, at suprasolidus conditions, by a pervasive reactive porous flow of mantle-derived orogenic (hydrous) basaltic melts infiltrated along, relatively few, deformation-assisted channels. The chemical composition of the metasomatic melts is similar to that of melts infiltrating the central and northern Ivrea–Verbano Zone. This widespread metasomatism, inducing a massive regional hydration of the lowermost Southalpine mafic crust, promoted a plastic behavior in the lowermost part of the crust during the Early Mesozoic and, ultimately, the Triassic extension of the Variscan crust and the beginning of the Alpine cycle.

Magmas with matrix glass compositions ranging from basalt to dacite erupted from a series of 24 fissures in the first 2 weeks of the 2018 Lower East Rift Zone (LERZ) eruption of Kīlauea Volcano. Eruption styles ranged from low spattering and fountaining to strombolian activity. Major element trajectories in matrix glasses and melt inclusions hosted by olivine, pyroxene and plagioclase are consistent with variable amounts of fractional crystallization, with incompatible elements (e.g., Cl, F, and H2O) becoming enriched by 4–5 times as melt MgO contents evolve from 6 to 0.5 wt%. The high viscosity and high H2O contents (∼2 wt%) of the dacitic melts erupting at Fissure 17 account for the explosive Strombolian behavior exhibited by this fissure, in contrast to the low fountaining and spattering observed at fissures erupting basaltic to basaltic‐andesite melts. Saturation pressures calculated from melt inclusion CO2‐H2O contents indicate that the magma reservoir(s) supplying these fissures was located at ∼2–3 km depth, which is in agreement with the depth of a dacitic magma body intercepted during drilling in 2005 (∼2.5 km) and a seismically imaged low Vp/Vs anomaly (∼2 km depth). Nb/Y ratios in erupted products are similar to lavas erupted between 1955 and 1960, indicating that melts were stored and underwent variable amounts of crystallization in the LERZ for >60 years before being remobilized by a dike intrusion in 2018. We demonstrate that extensive fractional crystallization generates viscous and volatile‐rich magma with potential for hazardous explosive eruptions, which may be lurking undetected at many ocean island volcanoes. Plain Language Summary During the first 2 weeks of the 2018 eruption of Kīlauea Volcano, Hawai'i, a wide variety of magma compositions were erupted from 24 separate fissures. Of particular interest is the magma erupted at Fissure 17, which was much more explosive than nearby fissures, throwing large pieces of molten rock several 100 m into the air, causing a serious injury. The explosivity of volcanic eruptions is partially controlled by the viscosity of the magma (how easily it can flow), and partially by the amount of dissolved H2O and CO2 (which exsolve like bubbles in a carbonated beverage as the melt ascends to the surface). We show that melts erupted at Fissure 17 were significantly more viscous and H2O‐rich than the melts erupted more passively at nearby fissures. These two factors account for the explosive eruptive style of this fissure. Using the relationship between the amount of dissolved H2O and CO2 and pressure, we show that erupted magmas were stored at ∼2 km depth below the surface since at least 1955–1960 CE. Key Points The first 2 weeks of the 2018 Kīlauea eruption tapped melts undergoing variable amounts of fractionation at ∼2–3 km depth over >60 years Saturation pressures calculated from melt inclusion volatile contents align with drilling encounters and seismic anomalies The strombolian explosions at Fissure 17 result from the high viscosity and the high H2O contents of these dacitic melts

A growing number of biopharmaceutical companies have been implementing patient-centric initiatives (PCIs). The Drug Information Association (DIA) and the Tufts Center for the Study of Drug Development (CSDD) collaborated on a study to gather data on the usage and impact of these PCIs to characterize company experience and impact. DIA and Tufts CSDD collaborated with 17 organizations to define PCIs used in clinical research and development and to quantify their use, and to define metrics in use to document impact and return on engagement (ROE) for these PCIs. The study used a mixed methods approach that consisted of an online survey, in-depth interviews, and literature review. Twenty-two unique companies responded to an on-line survey on the use of 23 PCIs identified by the study working group. PCIs most frequently implemented included patient organization landscape analysis, support of patient advocacy groups, use of patient advisory boards, and use of home nursing networks. Seven additional PCIs were found through a literature search and included in the group of PCIs for which impact measures were assessed. A total of 121 cases of use of the 30 PCIs and associated impact measures and impact data were gathered through literature review, in-depth interviews with the study companies, and in-depth interviews with organizations identified in the literature as having experience with patient engagement in clinical research as well as with patients who had participated in clinical trials. Analysis of the 121 case studies resulted in a list of 666 measures of impact (metrics) in use for 13 of the PCIs. Assessment of overall ROE for these PCIs found that PCIs such as support of patient advocacy groups and use of patient advisory boards indicated the greatest ROE, whereas costlier, more complex PCIs such as digital medicine and gaming indicated relatively low ROE. Activity around PCIs among the companies studied was widespread, with initiatives more frequently planned and piloted than implemented at the time of this study. Measures of impact have been identified and can be used to assess ROE, providing insights to facilitate the adoption of PCIs of highest impact for patients and biopharmaceutical research organizations.