Evaluation of an Unfractioned Heparin Pharmacy Dosing Protocol for the Treatment of Venous Thromboembolism in Nonobese, Obese, and Severely Obese Patients

Background: Despite large interpatient variability in dose response, heparin is utilized for treatment of venous thromboembolism (VTE). Current data on the optimal heparin dosing in obese patients are conflicting. Objective: The objective was to evaluate the time and dose required to achieve a therapeutic activated partial thromboplastin time (aPTT) in nonobese, obese, and severely obese patients using a pharmacist-directed heparin dosing protocol. Methods: This was a retrospective cohort study in a single-center community hospital inpatient setting. Adult patients receiving heparin for VTE treatment from July 1, 2013, to July 31, 2015, were evaluated. Patients were categorized into 3 groups: nonobese (BMI \u3c 30 kg/m2), obese (BMI = 30-39.9 kg/m2), and severely obese (BMI ≥ 40 kg/m2). Data on height, weight, initial bolus dose, initial infusion rate, time to therapeutic aPTT, and therapeutic infusion rate were collected. Dosing body weight (DBW) was utilized for patients 20% over their ideal body weight (IBW). The primary outcome was time to therapeutic aPTT. Results: Analysis included 298 patients. Median times to therapeutic aPTT (hours:minutes) in the nonobese, obese, and severely obese were 15:00 (interquartile range [IQR] = 8:05-23:21), 15:40 (IQR = 9:22-25:10), and 15:22 (IQR = 7.54-23:40), respectively (P = 0.506). There was no difference in bleeding among the nonobese (14%), obese (13.9%), or severely obese groups (7.9%; P = 0.453). No adverse thrombotic events occurred during hospitalization. Conclusion: Using a DBW for heparin dosing in patients 20% over their IBW resulted in similar times to therapeutic aPTT and adverse events in the nonobese, obese, and severely obese

Anthropogenic Habitats Facilitate Dispersal of an Early Successional Obligate: Implications for Restoration of an Endangered Ecosystem

Landscape modification and habitat fragmentation disrupt the connectivity of natural landscapes, with major consequences for biodiversity. Species that require patchily distributed habitats, such as those that specialize on early successional ecosystems, must disperse through a landscape matrix with unsuitable habitat types. We evaluated landscape effects on dispersal of an early successional obligate, the New England cottontail (Sylvilagus transitionalis). Using a landscape genetics approach, we identified barriers and facilitators of gene flow and connectivity corridors for a population of cottontails in the northeastern United States. We modeled dispersal in relation to landscape structure and composition and tested hypotheses about the influence of habitat fragmentation on gene flow. Anthropogenic and natural shrubland habitats facilitated gene flow, while the remainder of the matrix, particularly development and forest, impeded gene flow. The relative influence of matrix habitats differed between study areas in relation to a fragmentation gradient. Barrier features had higher explanatory power in the more fragmented site, while facilitating features were important in the less fragmented site. Landscape models that included a simultaneous barrier and facilitating effect of roads had higher explanatory power than models that considered either effect separately, supporting the hypothesis that roads act as both barriers and facilitators at all spatial scales. The inclusion of LiDAR-identified shrubland habitat improved the fit of our facilitator models. Corridor analyses using circuit and least cost path approaches revealed the importance of anthropogenic, linear features for restoring connectivity between the study areas. In fragmented landscapes, human-modified habitats may enhance functional connectivity by providing suitable dispersal conduits for early successional specialists

Maternal fluoxetine exposure alters cortical hemodynamic and calcium response of offspring to somatosensory stimuli

Epidemiological studies have found an increased incidence of neurodevelopmental disorders in populations prenatally exposed to selective serotonin reuptake inhibitors (SSRIs). Optical imaging provides a minimally invasive way to determine if perinatal SSRI exposure has long-term effects on cortical function. Herein we probed the functional neuroimaging effects of perinatal SSRI exposure in a fluoxetine (FLX)-exposed mouse model. While resting-state homotopic contralateral functional connectivity was unperturbed, the evoked cortical response to forepaw stimulation was altered in FLX mice. The stimulated cortex showed decreased activity for FLX versus controls, by both hemodynamic responses [oxyhemoglobin (Hb

Study of effects of space power satellites on life support functions of the earth's magnetosphere

The effects of the Satellite Solar Power System (SSPS) on the life support functions of the earth's magnetosphere were investigated. Topics considered include: (1) thruster effluent effects on the magnetosphere; (2) biological consequences of SSPS reflected light; (3) impact on earth bound astronomy; (4) catastrophic failure and debris; (5) satellite induced processes; and (6) microwave power transmission. Several impacts are identified and recommendations for further studies are provided

Submillimeter observations of solar limb-brightening in the total solar eclipse of 31 July 1981

Eight flights of the Kuiper Airborne Observatory (KAO) were devoted to solar observation. The successful observation of a total solar eclipse was accomplished. The observations were made simultaneously at 30, 50, 100, and 200 microns. The successful adaptation of the KAO for solar observations thus provided the most detailed data to date in this spectral band. The results from a preliminary analysis of the KAO data are summarized: (1) the 200 micron limb is extended about 3 arc sec above the 30 micron limb, indicating the prescence of cool dense material up to the altitudes of spicules; (2) strong radial darkening of the quiet sun intensity profile appeared at 200 microns, probably an indication that hot material in the low chromosphere is recessed into vertical magnetic flux tubes embedded in a cooler nonmagnetic substrate, which obscures the heated material approaching the limb; (3) active regions were observed to undergo a strong increase in contrast above the quiet sun background at wave lengths of 100 microns and longer; and (4) the moon was mapped for use as a photometric standard for determining the absolute intensity of the sun in all four wavelength bands

Prolonged Rehabilitation of Jones Fracture in Division I-A Collegiate American Football Player: A Case Report

Objective: To describe the prolonged rehabilitation program for a Jones fracture in a Division I-A American football player. Background: A 21 year old, African American, collegiate football player (body mass= 264 lb; height= 76.5 in; body fat= 16.0%) complained of a sharp pain at the dorsal aspect of the left foot. The athlete experiences a compressive force to the fifth metatarsal and upon evaluation, mild swelling was present along the lateral aspect of the foot. Differential Diagnosis: Jones fracture, metatarsal fracture, bone contusion. Treatment: An intramedullary fixation surgery was scheduled two weeks post injury, to correct and stabilize the fracture. Intramedullary fixation is a method of mending the bone internally with a screw, wire, or metal plate along the fractured bone length wise. Following surgery the athlete continued use of crutches for ambulation and was placed in a removable walking boot for 5 weeks. Uniqueness: This case presented a unique challenge in the rehabilitation program, as the athlete experienced slow formation of the bone callus and therefore a prolonged rate of recovery. The athlete was in a walking boot longer than expected (2 weeks longer than anticipated) which inhibited advancement in his rehabilitation due to a slow bone callus formation. A soft callus usually begins to form at day 5 following injury, but documentation was incomplete, and a hypothesis for slow bone callus formation could be secondary to lengthened time between injury occurrence and injury reporting. The athlete may have been weight bearing during the early callus formation, but healing may have been prohibited. Also, vascularization in the area is already limited and may also have played a role in delayed bone growth. Conclusions: Although the return to participation was longer than expected, the rehabilitation program was successful in returning the athlete to competition

Assuming Elder Care Responsibility: Am I a Caregiver?

Caregivers of the elderly face conflicting legal demands; they must make certain the elder’s needs are being met while not forcing undesired care on an adult capable of informed decisions. This dichotomy may be a reason a large volume of reported elder abuse derives from unintentional neglect on behalf of informal familial caregivers. The current research examines this possibility with exploratory interviews and an experiment. The interviews between elders and their family (30 dyads) revealed that many did not intend for the living arrangements to become permanent, and the nonelders were largely unprepared for the magnitude of changes and responsibilities that would result. The elders often expressed a sense of loss for their former life and feeling supernumerary in the family. In the experiment, we examined whether a person recognizes when a caregiving relationship exists and the factors that contribute to notions of being a caregiver. Results suggest that potential caregivers (124 community members) focus on the relationship with the elder more than the elder’s physical and financial needs, and generally have stronger feelings of moral responsibility rather than legal responsibility to provide care

Four Decades of the Journal \u3ci\u3eLaw and Human Behavior\u3c/i\u3e: A Content Analysis

Although still relatively young, the journal Law and Human Behavior (LHB) has amassed a publication history of more than 1300 full-length articles over four decades. Yet, no systematic analysis of the journal has been done until now. The current research coded all full-length articles to examine trends over time, predictors of the number of Google Scholar citations, and predictors of whether an article was cited by a court case. The predictors of interest included article organization, research topics, areas of law, areas of psychology, first-author gender, first-author country of institutional affiliation, and samples employed. Results revealed a vast and varied field that has shown marked diversification over the years. First authors have consistently become more diversified in both gender and country of institutional affiliation. Overall, the most common research topics were jury/judicial decision-making and eyewitness/memory, the most common legal connections were to criminal law and mental health law, and the most common psychology connection was to social-cognitive psychology. Research in psychology and law has the potential to impact both academic researchers and the legal system. Articles published in LHB appear to accomplish both

Extreme limb profiles of the sun at far-infrared and submillimeter wavelengths

Thirty, 50, 100, and 200 microns solar limb intensity profiles determined with arcsecond resolution from airborne observations of the occultation of the solar limb during the total eclipse of 1981 July 31 are presented. Two points of particular importance emerge: (1) the longer-wavelength (100 and 200 micron) limbs are significantly brighter than disk center. At 200 microns the extreme limb is about 1.22 times the brightness of disk center. This is consistent with the 6000 K temperature-plateau structure of the model chromospheres of Vernazza, Avrett, and Loeser (1973, Ap. J., 184, 605; 1981; Ap. J. Suppl., 45, 635;) and (2) the longer wavelength limbs are extended significantly further above the visible limb than Vernazza, Avrett, and Loeser predict. These results provide a strong basis for modeling of the solar chromosphere free from the assumption of gravitational-hydrostatic equilibrium

Submillimeter extensions of the solar limb determined from observations of the total eclipse of 1981 July 31

First results are presented of observations of a lunar occultation of the solar limb made from the Kuiper Airborne Observatory in the 30 micrometr, 50 micrometer, 100 micrometer, and 200 micrometer continuum during the total solar eclipse of 1981 July 31. The solar limb was extended at the longer wavelengths up to 1000 km higher than predicted from smooth plane-parallel chromospheric models. Results at both second and third contact show the infrared limb extensions to be approximately 0".8, 1"5, 2".5 and 3".0 above the visible limb in the observed bands, respectively. A possible interpretation proposes chromospheric fine structure inhomogeneities of greater density than presently incorporated in models of the middle chromosphere