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Background and aim. Appropriate end of life (EOL) management in Internal Medicine wards is challanging. The aim of this study was to analyze the burden of an educational program on EOL management in a Internal Medicine ward. Materials and methods: We retrospectively analysed characteristics and management of patients consecutively died in an italian Internal Medicine ward along one year. We compared demographic, co-morbidity, pharmacological treatment in the last 48-hours of life and procedures during hospital stay in patients died six months before and after an educational program on palliative cares and EOL management addressed to a team of physicians and nurses. Results. Study population was composed by 354 patients (190 females), with mean age ± DS 83.5 ± 10.6 years, one half admitted after the educational program. Eighty-four percent of deaths was exepected in the last 48 hours before exitus. Demographic characteristics and causes of hospitalization were not different before and after educational program. After the educational program the sharing of palliative care program with patient, relatives and/or caregivers (97.7% vs 85.8%, p=0.0001) and written order to withdrawal vital parameters relevation (39.5% vs 22%, p=0.0005) significantly increased, while difference in pharmacological classes prescribed in the last 48 hours of life was not find. Blood (54.8% vs 67.2%, p=0.0219) and arterial gas analysis (28.8% vs 39.5%, p=0.0435) samples in the last 48 hours of life were significantly reduced. Radiological and/or endoscopic examinations, red cells or platelets transfusion were reduced and palliative therapy was increased, despite difference between the two periods was not statistically significant. Conclusion. Educational program in Internal Medicine wards aimed to improve skills could contribute to make EOL management more appropriate and patient-oriented and it should be strongly encouraged. [ABSTRACT FROM AUTHOR]

On February 6, 2016 at 21:07:19 UT, a very bright fireball was seen over the eastern part of Denmark. The weather was cloudy over eastern Denmark, but many people saw the sky light up—even in the heavily illuminated Copenhagen. Two hundred and thirty three reports of the associated sound and light phenomena were received by the Danish fireball network. We have formed a consortium to describe the meteorite and the circumstances of the fall and the results are presented in this paper. The first fragment of the meteorite was found the day after the fall, and in the following weeks, a total of 11 fragments with a total weight of 8982 g were found. The meteorite is an unbrecciated, weakly shocked (S2), ordinary H chondrite of petrologic type 5/6 (Bouvier et al. 2017). The concentration of the cosmogenic radionuclides suggests that the preatmospheric radius was rather small ~20 cm. The cosmic ray exposure age of Ejby (83 ± 11 Ma) is the highest of an H chondrite and the second highest age for an ordinary chondrite. Using the preatmospheric orbit of the Ejby meteoroid (Spurny et al. 2017) locations of the recovered fragments, and wind data from the date of the fall, we have modeled the dark flight (below 18 km) of the fragments. The recovery location of the largest fragment can only be explained if aerodynamic effects during the dark flight phase are included. The recovery location of all other fragments are consistent with the dark flight modeling. [ABSTRACT FROM AUTHOR]

Introduction: Nucleosynthetic isotope variations, which reflect the heterogeneous distribution of presolar dust in the protoplanetary disk, can be used to constrain the genetic relationships between planetary materials in the solar system. Previous studies identified distinct nucleosynthetic 50Ti and 54Cr compositions in different solar system materials [1-3]. Early solar system processes and asteroid belt dynamics can be investigated using these isotope variations. The disruption of asteroid 2008 TC3 in the atmosphere delivered fragments of chondritic origin, enstatite achondrites and ureilites of varying lithologies collectively described as the Almahata Sitta samples [4,5]. Sample fragments also include four ureilite-related trachyandesites [5], which are thought to originate from the ureilite parent body (UPB) [6]. The nucleosynthetic Ti and Cr isotope composition of these fragments can provide powerful insights into their origin and genetic relationship to other planetary bodies. The diversity of meteorite fragments indicates that the parent body of the Almahata Sitta samples, asteroid 2008 TC3, may be the product of second-generation asteroid accretion [4,5]. This study presents high-precision Ti and Cr isotope compositions for nine Almahata Sitta meteorite fragments, which are representative of non-carbonaceous chondrites (NC) and carbonaceous chondrites (CC). They are linked through the formation of asteroid 2008 TC3. The Ti and Cr isotope data of these samples contributes to the Almahata Sitta meteorite research, evaluating the various meteorite types existing within the parent body (asteroid 2008 TC3), as well as further constraining the composition of the ureilite-related trachyandesites. Methods: The samples were dissolved following the Ti-Cr procedure of [7]. A three-stage ion-exchange chromatographic procedure described in [8] was performed for Ti separation and purification. Chromium was collected in the matrix elution step of the first ion exchange column for Ti separation and then further purified using the Cr separation protocol modified after [7]. Isotopic analyses were performed on a Neptune Plus multi-collector ICP-MS at ETH Zürich. The Ti isotope data was corrected for instrumental mass bias using internal normalisation to a 49Ti/47Ti ratio of 0.749766 [9]. The terrestrial basalt BHVO-2 was analysed to evaluate data precision and accuracy and yielded an external reproducibility (2SD) of ~20 ppm for 46Ti/47Ti, ~10 ppm for 48Ti/47Ti, and ~20 ppm for 50Ti/47Ti. The Cr isotope data were internally normalised to a 50Cr/52Cr ratio of 0.051859 [10]. Repeat analyses of the terrestrial rock standards DTS2-b and JP-1 yielded an external reproducibility (2SD) of ~10 ppm for 54Cr/52Cr and 53Cr/52Cr. Results and Discussion: We analysed Almahata Sitta samples previously classified by [5,11]. They included four ureilites, two enstatite chondrites, one CB and one R-like chondrite. Our nucleosynthetic Ti and Cr isotope data of the analysed samples overlap with those of the respective meteorite groups. Thus, the combined Ti and Cr isotope analysis confirms the petrological determination of the Almahata Sitta sample fragments. For example, the sample fragments proposed to be CB-, R- and enstatite chondrite-like through petrological classification have a Ti and Cr isotope composition identical to the CB-, R- and enstatite chondrites, respectively. Our data also indicates that our ureilitic samples do not contain significant CC clasts because the data is consistent with the average ureilitic composition of [12,13]. The ureilite-related trachyandesite sample MS-MU-011, also called ALM-A, yields 54Cr isotope data that are identical within analytical uncertainties with ALM-A from [13]. Both the Cr and Ti isotope data of ALM-A fall within the ureilite composition field. This confirms that the trachyandesites likely originated from the UPB. Furthermore, our 50Ti and 54Cr isotope data shows that the Almahata Sitta parent body also contains CB-, R- and enstatite chondrites like fragments, which originated from the CC and NC reservoir. This supports the previous conclusion that planetary materials with two distinct isotope compositions (NC and CC) exist within asteroid 2008 TC3 [4,11]. [ABSTRACT FROM AUTHOR]

Introduction: The onset of the Martian silicate differentiation is still a matter of debate. The examination of the short-lived 53Mn-53Cr system (T1/2 = 3.7 Ma) in Martian meteorites showed no resolvable variations for the radiogenic 53Cr [1]. A uniform excess in 53Cr/52Cr with an average of +20.2±1.2 parts-per-million (95% conf.) relative to the terrestrial mantle is observed [1]. This might be explained by an onset of the magma ocean solidification later than 20 Ma after Solar System formation [1]. However, this explanation contradicts models predicting a rapid magma ocean solidification, e.g., [2, 3]. Reliable dating of the magma ocean stage of a planet requires solid-liquid partition coefficients to calculate robust daughter to parent element ratios in minerals that crystallize during the solidification of the magma ocean. Hence, the Mn-Cr model ages depend on suitable partition coefficients for these elements, which are largely absent for Martian conditions. In particular, partition coefficients of Mn and Cr for garnet, clinopyroxene, and spinel are missing. Therefore, the aim of this study is to determine new accurate partition coefficients for Mn and Cr to model Mn/Cr ratios for Martian cumulate piles and to evaluate the 53Cr data in the light of these new values at higher accuracy. Methods: To determine the solid-liquid partition coefficients, we chose melt experiments that cover 0.5-19 GPa with lunar and Martian bulk composition. These aimed to simulate lunar magma ocean fractionation and the liquidus relations of the deep Martian magma ocean. We obtained new electron microprobe (EMPA) measurements of Mn and Cr concentrations in majorite-, garnet-(with 3 Si pfu), olivine-, spinel-, pigeonitic clinopyroxene- and orthopyroxene-melt pair with extended peak counting times of up to 180 seconds for both elements. The partition coefficients were calculated with D = cmineral/cmelt (c = concentration of the mineral). They were applied to the Martian cumulate pile crystallization model after [4] and to the crystallization sequence of [5] using fractional crystallization equations to calculate Mn/Cr ratios. In a final step, we calculated Mn/Cr model ages for magma ocean crystallization. In doing so, we assumed core formation at 4 Ma [6] and 10 Ma [7] after Solar System formation without Mn/Cr fractionation during this process. As Martian building blocks, we tested selected building blocks using carbonaceous and ordinary chondrite data [8] as well as the compositions proposed by [9] and [10]. Results and Discussion: We determined new D-values for garnet, clinopyroxene and spinel for a magma oceanlike composition from 0.5 to 3.5 GPa. Applied to different Martian mantle cumulate packages [4, 5] bulk D(Mn) evolves from 0.4 for the deepest cumulates to 1.1 at the top, while bulk D(Cr) evolves from 1.1 to 2.6. Bulk partition coefficients of Cr applied to the mantle mineral composition of [5] vary between 1.2 and 1.8 at a depth of 3.5 to 10 GPa, although the proportions of olivine, garnet, clino- and orthopyroxene remain similar. This might be caused by a gap in melt experiments, which do not cover pressures between 3.5 and 10 GPa and needs further examination. Including the new D-values into the crystallization models, the 53Cr/52Cr data from [1] matches with models that use all three building block compositions, a crystallization onset at 4 Ma and 10 Ma, and the crystallization sequence of [5]. Crystallization models using the cumulate packages of [4] only match the Cr isotope data with a crystallization onset at 10 Ma and the building block compositions proposed by [9] and [10]. Conclusion and Outlook: We successfully determined new, accurate D-values for Mn and Cr for a range of minerals that are important during magma ocean crystallization. According to our models, the 53Mn-53Cr radionuclide system allows magma ocean solidification before 20 Ma after Solar System formation on Mars. Additional calculations will be carried out considering mixing lines between (i) isotopically depleted mafic cumulates (low Mn/Cr), which result in small radiogenic ingrowth of 53Cr, and (ii) enriched later stage cumulates (high Mn/Cr ratios and 53Cr values). This might help to further determine the proportion of enriched material in Shergottites. [ABSTRACT FROM AUTHOR]

The distribution of γ-aminobutyric acid (GABA) immunoreactivity was studied in the brain of two amphibian species ( Triturus cristatus carnifex, Urodela; Rana esculenta, Anura) by employing a specific GABA antiserum. A noteworthy immunoreactive neuronal system was found in the telencephalic dorsal and medial pallium (primordium pallii dorsalis and primordium hippocampi) and in the olfactory bulbs. In the diencephalic habenular nuclei there was a rich GABAergic innervation, and immunoreactive neurons were observed in the dorsal thalamus. In the hypothalamus the GABA immunoreactivity was found in the preoptic area, the paraventricular organ and in the hypothalamo-hypophysial complex. In the preoptic area of the frog some GABA-immunoreactive CSF-contacting cells were shown. In the optic tectum immunolabeled neurons were present in all the cellular layers. A rich GABAergic innervation characterized both the fibrous layers of the tectum and the neuropil of the tegmentum and interpeduncular nucleus. In the cerebellum, in addition to the Purkinje cells showing a variable immunopositivity, some immunoreactive cell bodies appeared in the central grey. Abundant immunolabeled nerve fibers in the acoustico-lateral area and some immunopositive neurons in the region of the raphe nucleus were observed. In conclusion, the GABAergic central systems, well-developed in the amphibian species studied, were generally characterized by close similarities to the pattern described in mammals. [ABSTRACT FROM AUTHOR]