Efficacy, Safety, and Timing of Anticoagulant Thromboprophylaxis for the Prevention of Venous Thromboembolism in Patients With Acute Spinal Cord Injury: A Systematic Review

Study Design: Systematic review. Objectives: The objective of this study was to answer 5 key questions: What is the comparative effectiveness and safety of (1a) anticoagulant thromboprophylaxis compared to no prophylaxis, placebo, or another anticoagulant strategy for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) after acute spinal cord injury (SCI)? (1b) Mechanical prophylaxis strategies alone or in combination with other strategies for preventing DVT and PE after acute SCI? (1c) Prophylactic inferior vena cava filter insertion alone or in combination with other strategies for preventing DVT and PE after acute SCI? (2) What is the optimal timing to initiate and/or discontinue anticoagulant, mechanical, and/or prophylactic inferior vena cava filter following acute SCI? (3) What is the cost-effectiveness of these treatment options? Methods: A systematic literature search was conducted to identify studies published through February 28, 2015. We sought randomized controlled trials evaluating efficacy and safety of antithrombotic strategies. Strength of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Nine studies satisfied inclusion criteria. We found a trend toward lower risk of DVT in patients treated with enoxaparin. There were no significant differences in rates of DVT, PE, bleeding, and mortality between patients treated with different types of low-molecular-weight heparin or between low-molecular-weight heparin and unfractionated heparin. Combined anticoagulant and mechanical prophylaxis initiated within 72 hours of SCI resulted in lower risk of DVT than treatment commenced after 72 hours of injury. Conclusion: Prophylactic treatments can be used to lower the risk of venous thromboembolic events in patients with acute SCI, without significant increase in risk of bleeding and mortality and should be initiated within 72 hours. © 2017, © The Author(s) 2017

Determinants of heart rate in Svalbard reindeer reveal mechanisms of seasonal energy management

Funding. This study was supported by Norges Miljø- og Biovitenskape- lige Universitet (PhD Grant to L.M.T.) and Norges Forskningsråd (KLIMAFORSK project no. 267613). Acknowledgements. We thank two anonymous reviewers for constructive, detailed and insightful feedback that helped to strengthen our manuscript. We thank Mads Forchhammer and the logistics department at the University Centre in Svalbard for supporting the field campaigns. We also thank DVM Amanda Høyer Boesen for assistance with surgeries in 2018. Åshild Ø. Pedersen and Stein Tore Pedersen contributed to successful field campaigns. We are grateful for the technical support received from Ásgeir Bjarnason at StarOddi Ltd during logger programming and validations of recordings. Finally, we thank Lucy Hawkes, Andreas Fahlman and Katsufumi Sato for inviting us to contribute to the theme issue ‘Measuring physiology in free-living animals’.Peer reviewedPublisher PD

Fat storage influences fasting endurance more than body size in an ungulate

The fasting endurance hypothesis (FEH) predicts strong selection for large body size in mammals living in environments where food supply is interrupted over prolonged periods of time. The Arctic is a highly seasonal and food restricted environment, but contrary to predictions from the FEH, empirical evidence shows that Arctic mammals are often smaller than their temperate conspecifics. Intraspecific studies integrating physiology and behaviour of different‐sized individuals, may shed light on this paradox. We tested the FEH in free‐living Svalbard reindeer (Rangifer tarandus platyrhynchus). We measured daily energy expenditure (DEE), subcutaneous body temperature (Tsc) and activity levels during the late winter in 14 adult females with body masses ranging from 46.3 to 57.8 kg. Winter energy expenditure (WEE) and fasting endurance (FE) were modelled dynamically by combining these data with body composition measurements of culled individuals at the onset of winter (14 years, n = 140) and variation in activity level throughout winter (10 years, n = 70). Mean DEE was 6.3±0.7 MJ day−1. Lean mass, Tsc and activity had significantly positive effects on DEE. Across all 140 individuals, mean FE was 85±17 days (range 48–137 days). In contrast to the predictions of the FEH, the dominant factor affecting FE was initial fat mass, while body mass and FE were not correlated. Furthermore, lean mass and fat mass were not correlated. FE was on average 80% (45 days) longer in fat than lean individuals of the same size. Reducing activity levels by ~16% or Tsc by ~5% increased FE by 7%, and 4%, respectively. Our results fail to support the FEH. Rather, we demonstrate that (i) the size of fat reserves can be independent of lean mass and body size within a species, (ii) ecological and environmental variation influence FE via their effects on body composition, and (iii) physiological and behavioural adjustments can improve FE within individuals. Altogether, our results suggest that there is a selection in Svalbard reindeer to accumulate body fat, rather than to grow structurally large. he Arctic, activity, biologging, daily energy expenditure, doubly labelled water, intraspecific scaling, subcutaneous body temperature, Svalbard reindeer to accumulate body fat, rather than to grow structurally large. </ol

F.A.R.O.G. FORUM, Vol. 3 No. 3

https://digitalcommons.library.umaine.edu/francoamericain_forum/1051/thumbnail.jp

Optimizing the colour and fabric of targets for the control of the tsetse fly Glossina fuscipes fuscipes

Background: Most cases of human African trypanosomiasis (HAT) start with a bite from one of the subspecies of Glossina fuscipes. Tsetse use a range of olfactory and visual stimuli to locate their hosts and this response can be exploited to lure tsetse to insecticide-treated targets thereby reducing transmission. To provide a rational basis for cost-effective designs of target, we undertook studies to identify the optimal target colour. Methodology/Principal Findings: On the Chamaunga islands of Lake Victoria , Kenya, studies were made of the numbers of G. fuscipes fuscipes attracted to targets consisting of a panel (25 cm square) of various coloured fabrics flanked by a panel (also 25 cm square) of fine black netting. Both panels were covered with an electrocuting grid to catch tsetse as they contacted the target. The reflectances of the 37 different-coloured cloth panels utilised in the study were measured spectrophotometrically. Catch was positively correlated with percentage reflectance at the blue (460 nm) wavelength and negatively correlated with reflectance at UV (360 nm) and green (520 nm) wavelengths. The best target was subjectively blue, with percentage reflectances of 3%, 29%, and 20% at 360 nm, 460 nm and 520 nm respectively. The worst target was also, subjectively, blue, but with high reflectances at UV (35% reflectance at 360 nm) wavelengths as well as blue (36% reflectance at 460 nm); the best low UV-reflecting blue caught 3× more tsetse than the high UV-reflecting blue. Conclusions/Significance: Insecticide-treated targets to control G. f. fuscipes should be blue with low reflectance in both the UV and green bands of the spectrum. Targets that are subjectively blue will perform poorly if they also reflect UV strongly. The selection of fabrics for targets should be guided by spectral analysis of the cloth across both the spectrum visible to humans and the UV region

Morality and progress:IR narratives on international revisionism and the status quo

Scholars debate the ambitions and policies of today’s ‘rising powers’ and the extent to which they are revising or upholding the international status quo. While elements of the relevant literature provide valuable insight, this article argues that the concepts of revisionism and the status quo within mainstream International Relations (IR) have always constituted deeply rooted, autobiographical narratives of a traditionally Western-dominated discipline. As ‘ordering narratives’ of morality and progress, they constrain and organize debate so that revisionism is typically conceived not merely as disruption, but as disruption from the non-West amidst a fundamentally moral Western order that represents civilizational progress. This often makes them inherently problematic and unreliable descriptors of the actors and behaviours they are designed to explain. After exploring the formations and development of these concepts throughout the IR tradition, the analysis is directed towards narratives around the contemporary ‘rise’ of China. Both scholarly and wider political narratives typically tell the story of revisionist challenges China presents to a US/Western-led status quo, promoting unduly binary divisions between the West and non-West, and tensions and suspicions in the international realm. The aim must be to develop a new language and logic that recognize the contingent, autobiographical nature of ‘revisionist’ and ‘status quo’ actors and behaviours

Understanding water losses from irrigated pastures on loess-derived hillslopes

Irrigation is likely to increase water losses from hillslopes, particularly on loess-derived soils with impeded drainage. This is important as irrigation of these soils in New Zealand is increasing. A field site was established to monitor runoff from a pasture hillslope irrigated by a centre-pivot in South Canterbury. Between November and March, 161 and 199 mm of irrigation was applied, 23% more at the bottom of the slope. Runoff varied with position in the hillslope, 3.5 times greater on the bottom plot (52 mm) compared to the top. Over the length of the slope (40 m) this represents a potential loss of 9% of precipitation, or 21% of the irrigation. Evidence for both saturation excess and infiltration excess runoff was observed, with antecedent soil moisture conditions being a key factor. Pasture production and water use efficiency (WUE) also varied with slope, the least (4.6 t DM/ha or 12 kg DM/ha/mm) observed at the middle and most at the top of the slope (10.1 t DM/ha or 23 kg DM/ha/mm). This was likely due to a combination of differences in radiation and soil conditions. There was indication that pasture growth was limited by water availability at the top and potentially excess at the bottom of the slope. Our results indicate potential for improving irrigation practices

Timing of decompression in patients with acute spinal cord injury: a systematic review

Study Design: Systematic review. Objective: To conduct a systematic review and synthesis of the literature to assess the comparative effectiveness, safety, and cost-effectiveness of early (24 hours) in adults with acute spinal cord injury (SCI). Methods: A systematic search was conducted of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar to identify studies published through November 6, 2014. Studies published in any language, in humans, and with an abstract were considered for inclusion. Included studies were critically appraised and the overall strength of evidence was determined using methods proposed by the Grading of Recommendation Assessment, Development and Evaluation working group. Results: The search yielded 449 potentially relevant citations. Sixteen additional primary studies were identified through other sources. Six studies met inclusion criteria. All but 2 studies were considered to have moderately high risk of bias. Across studies and injury levels, the impact of early surgical decompression (<= 24 hours) on clinically important improvement in neurological status was variable. Isolated studies reported statistically significant and clinically important improvements at 6 months (cervical injury, low strength of evidence) and following discharge from inpatient rehabilitation (all levels, very low strength of evidence) but not at other time points; another study observed a statistically significant 6 point improvement in ASIA Impairment Scale (AIS) among patients with AIS B, C, or D, but not for those with AIS A (very low strength of evidence). In one study of acute central cord syndrome without instability, a clinically and statistically meaningful improvement in total motor scores was reported at 6 and 12 months in patients treated early (versus late). There were, however, no significant differences in AIS improvement between early and late surgical groups at 6- or 12-months (very low strength of evidence). One of 3 studies found a shorter length of hospital stay associated with early surgical decompression. Of 3 studies reporting on safety, no significant differences in rates of complications (including mortality, neurologic deterioration, pneumonia or pressure ulcers) were noted between early and late decompression groups. Conclusions: Results surrounding the efficacy of early versus late decompressive surgery, as well as the quality of evidence available, were variable depending on the level of SCI, timing of follow-up, and specific outcome considered. Existing evidence supports improved neurological recovery among cervical SCI patients undergoing early surgery; however, evidence regarding remaining SCI populations and clinical outcomes was inconsistent

An Observationally Constrained Evaluation of the Oxidative Capacity in the Tropical Western Pacific Troposphere

Hydroxyl radical (OH) is the main daytime oxidant in the troposphere and determines the atmospheric lifetimes of many compounds. We use aircraft measurements of O3, H2O, NO, and other species from the Convective Transport of Active Species in the Tropics (CONTRAST) field campaign, which occurred in the tropical western Pacific (TWP) during January–February 2014, to constrain a photochemical box model and estimate concentrations of OH throughout the troposphere. We find that tropospheric column OH (OHCOL) inferred from CONTRAST observations is 12 to 40% higher than found in chemical transport models (CTMs), including CAM-chem-SD run with 2014 meteorology as well as eight models that participated in POLMIP (2008 meteorology). Part of this discrepancy is due to a clear-sky sampling bias that affects CONTRAST observations; accounting for this bias and also for a small difference in chemical mechanism results in our empirically based value of OHCOL being 0 to 20% larger than found within global models. While these global models simulate observed O3 reasonably well, they underestimate NOx (NO + NO2) by a factor of two, resulting in OHCOL ~30% lower than box model simulations constrained by observed NO. Underestimations by CTMs of observed CH3CHO throughout the troposphere and of HCHO in the upper troposphere further contribute to differences between our constrained estimates of OH and those calculated by CTMs. Finally, our calculations do not support the prior suggestion of the existence of a tropospheric OH minimum in the TWP, because during January–February 2014 observed levels of O3 and NO were considerably larger than previously reported values in the TWP