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This study sought to prospectively assess which factors were related to short-term worsening heart failure (HF) leading to or not to hospital admission, in long-term outpatients followed by cardiologists. The subsequent decision-making process was also analyzed. The study population consisted of 2,701 outpatients enrolled in the registry of the Italian Network on Congestive Heart Failure (IN-CHF) and followed by 133 cardiology centers (19% of all existing Italian cardiology centers). Clinical and follow-up data were collected by local trained clinicians; 215 patients (8%) had short-term decompensation (on average 2 months after the index outpatient visit). Multivariate analysis showed that previous hospitalization, long duration of symptoms, ischemic etiology, atrial fibrillation, higher functional class (New York Heart Association classification III to IV), higher heart rate, and low systolic blood pressure were independently associated with HF destabilization. Poor compliance (21%) and infection (12%) were the most frequent precipitating factors, but a precipitating factor was not identified in 40% of the patients. Poor compliance was more common in women, but no other clinical characteristics emerged as being related with a specific precipitating factor. Fifty-seven percent of the patients with a short-term recurrence of worsening HF required hospital admission; infusion treatment with inotropes and/or vasodilators was necessary in 19% of them. Long-term therapy was changed in 48% of the patients. Thus, in ambulatory HF patients, short-term worsening HF can be predicted according to the clinical characteristics on an outpatient basis. Nearly 1/3 of precipitating factors can be prevented. Patient education and avoidance of inappropriate treatment may reduce the number of relapses.

The noble gases He, Ne and Ar in fluid inclusions from mantle xenoliths at three localities in Northern Victoria Land (Baker Rocks, Greene Point and Handler Ridge), spanning about 300 km, provide new constraints on the nature of the lithospheric mantle beneath the West Antarctic Rift System (WARS). Mantle xenoliths are anhydrous and hydrous spinel-bearing lherzolite and harzburgite samples. The 4He/40Ar* ratios (0.004–0.39) in olivines, two pyroxenes and amphiboles are much lower than those typical of fertile mantle (1–5), suggesting that this lithospheric domain are consistent with a variably depleted mantle, as also indicated by the major- and trace-element compositions of whole rock and minerals. The 3He/4He ratios vary from 2.30 to 19.79 Ra. However, the lowest and highest 3He/4He ratios are related to the post-eruptive accumulation of radiogenic 4He and cosmogenic 3He, respectively. After filtering the data for these secondary effects, we constrain the 3He/4He signature of the subcontinental lithospheric mantle below this area to 7.1 ± 0.4 Ra (mean ± standard deviation). This isotope signature results from mantle metasomatism by asthenospheric melts with a MORB (mid-ocean ridge basalt)-type 3He/4He. The range of 7.1 ± 0.4 Ra is compatible with previous measurements in mantle xenoliths and lavas from other localities of the NVL, as far away as Mount Erebus, evidencing a homogeneous He-isotope signature beneath the entire rift. The He and Ne isotopes support the hypothesis that WARS origin is not related to a plume.

Calc-alkaline and alkaline magmatic activity is generally separated in space and/or in time. The Eastern Transylvanian Basin in Romania is one of the few places where, during Pleistocene, alkaline eruptions occurred contemporaneously with the calc-alkaline activity. Mantle xenoliths entrained in Persani Mts. alkaline volcanic products have been studied in order to investigate the interaction of metasomatic agents of different magmatic affinities with the mantle wedge. Based on mineral major and trace element and noble gases in fluid inclusions, two main events have been recognized. The first was a pervasive, complete re-fertilization of a previously depleted mantle by a calc-alkaline subduction-related melt, causing the formation of very fertile, amphibole-bearing lithotypes. This is shown by the a) increased amounts of modal clinopyroxene up to 21.9 % with Al2O3 contents up to 8.16 wt%, higher than what is expected for clinopyroxene in Primordial Mantle; b) 4He/40Ar* ratios up to 1.2, within the reported range for mantle production; c) 3He/4He in olivine, opx and cpx of 5.8 ± 0.2 Ra, among the most radiogenic values of European mantle, below the typical MORB mantle value (8 ± 1 Ra), reflecting recycling of crustal material in the local lithosphere. The second event is related to later interaction with an alkaline metasomatic agent similar to the host basalts that caused slight LREE enrichment in pyroxenes and disseminated amphiboles and precipitation of vein amphiboles with a composition similar to amphiboles megacrysts also found in the Persani Mts. volcanic deposits. This is highlighted by the 4He/40Ar* and 3He/4He values found in some opx and cpx, up to 2.5 and 6.6 Ra, respectively, more typical of magmatic fluids.

Intrinsic and extrinsic stability of the (Mg, Fe) O solid mixture in the Fe-Mg-Si-O system at high P, T conditions relevant to the Earth's mantle is investigated by the combination of quantum mechanical calculations (Hartree-26 Fock/DFT hybrid scheme), cluster expansion techniques and statistical thermodynamics. Iron in the (Mg, Fe) O binary mixture is assumed to be either in the low spin (LS) or in the high spin (HS) state. Un-mixing at solid state is observed only for the LS condition in the 23-42 GPa pressure range, whereas HS does not give rise to un-mixing. LS (Mg, Fe) O un-mixings are shown to be able to incorporate iron by subsolidus reactions with a reservoir of a virtual bridgmanite composition, for a maximum total enrichment of similar to 0.22 FeO. At very high P (up to 130/3150 GPa/K), a predominant (similar to 0.7 phase proportion), iron-rich Fe-periclase mixture (Mg0.50Fe0.50) O is formed, and it coexists, at constrained phase composition conditions, with two iron-poor assemblages [(Mg0.90Fe0.10) O and (Mg0.825Fe0.175)O]. These theoretical results agree with the compositional variability and frequency of occurrence observed in lower mantle Fe-periclase from diamond inclusions and from HP-HT synthesis products. The density difference among the Fe-periclase phases increases up to similar to 10%, between 24 and 130 GPa. The calculated bulk Fe/Mg partitioning coefficient between the bridgmanite reservoir and Fe-periclase, Kd, is 0.64 at 24 GPa; it then drops to 0.19 at 80 GPa, and becomes quasi-invariant (0.18-0.16) in the lowermost portion of the Earth's mantle (similar to 80-130 GPa). These Kd-values represent an approximate estimate for the Fe/Mg-partitioning between actual bridgmanite and Fe-periclase. Consequently, our Kd-values agree with experimental measurements and theoretical determinations, hinting that iron preferentially dissolves in periclase with respect to all the other iron-bearing phases of the lower mantle. The continuous change up to 80 GPa (similar to 2000 km depth) of the products (compositions and phase proportions) over the MgO-FeO binary causes geochemical heterogeneities throughout the lower mantle, but it does not give rise to any sharp discontinuity. In this view, anomalies like the ULVZs, explained with a local and abrupt change of density, do not seem primarily ascribable to the mixing behavior and reactivity of (Mg, Fe) O at subsolidus. (C) 2017 Elsevier Ltd. All rights reserved.