The Impact of Community Use of Novel Oral Anticoagulants on an Academic Medical Center

Warfarin has been a mainstay of therapy for treatment and prevention of venous thromboembolic disease (VTED) and prevention of stroke and systemic embolism for over 50 years. Recent FDA approval of several novel oral anticoagulants has offered more extensive treatment options for management of these disease states. The availability of the novel anticoagulants offers an attractive alternative to warfarin therapy for patients due to their convenience of use. In comparison to warfarin, dabigatran, rivaroxaban and apixaban offer: - a fixed dosage regimen - a relatively small potential drug interaction profile - minimal laboratory monitoring - little to no dietary restrictions. Although these agents offer a relatively fixed dose regimen, dosage adjustment is required in moderate renal dysfunction, and use is contraindicated in severe renal dysfunction. Currently there are no specific reversal agents in the event of a nov- el anticoagulant associated bleed. These concerns led to the development of an anticoagulation stewardship program at our institution to monitor and guide the usage of these agents

Diverse Regulation but Conserved Function: SOX9 in Vertebrate Sex Determination

Sex determination occurs early during embryogenesis among vertebrates. It involves the differentiation of the bipotential gonad to ovaries or testes by a fascinating diversity of molecular switches. In most mammals, the switch is SRY (sex determining region Y); in other vertebrates it could be one of a variety of genes including Dmrt1 or dmy. Downstream of the switch gene, SOX9 upregulation is a central event in testes development, controlled by gonad-specific enhancers across the 2 Mb SOX9 locus. SOX9 is a ‘hub’ gene of gonadal development, regulated positively in males and negatively in females. Despite this diversity, SOX9 protein sequence and function among vertebrates remains highly conserved. This article explores the cellular, morphological, and genetic mechanisms initiated by SOX9 for male gonad differentiation

Tropical peatland carbon storage linked to global latitudinal trends in peat recalcitrance

Peatlands represent large terrestrial carbon banks. Given that most peat accumulates in boreal regions, where low temperatures and water saturation preserve organic matter, the existence of peat in (sub)tropical regions remains enigmatic. Here we examined peat and plant chemistry across a latitudinal transect from the Arctic to the tropics. Near-surface low-latitude peat has lower carbohydrate and greater aromatic content than near-surface high-latitude peat, creating a reduced oxidation state and resulting recalcitrance. This recalcitrance allows peat to persist in the (sub)tropics despite warm temperatures. Because we observed similar declines in carbohydrate content with depth in high-latitude peat, our data explain recent field-scale deep peat warming experiments in which catotelm (deeper) peat remained stable despite temperature increases up to 9 degrees C. We suggest that high-latitude deep peat reservoirs may be stabilized in the face of climate change by their ultimately lower carbohydrate and higher aromatic composition, similar to tropical peats.US Department of Energy Office of Biological and Environmental Research under the Terrestrial Ecosystem Sciences program [DE-SC0012272]; NASA Interdisciplinary Studies in Earth Science program [NNX17AK10G]; US Department of Energy Office of Biological and Environmental Research under the Genomic Science program [DE-SC0016440, DE-SC0004632, DE-SC0010580]; Geo. X, the Research Network for Geosciences in Berlin and Potsdam; US Department of Energy, Office of Science, Office of Biological and Environmental Research [DE-SC0012088]; NSF [0628647]; Natural Sciences and Engineering Research Council of Canada; National Research Foundation Singapore through the Singapore-MIT Alliance for Research and Technology's Center for Environmental Sensing and Modeling interdisciplinary research program; USA National Science Foundation [1114155, 1114161]; NASA LaRC POWER ProjectOpen access journal.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Tropical peatland carbon storage linked to global latitudinal trends in peat recalcitrance

Peatlands represent large terrestrial carbon banks. Given that most peat accumulates in boreal regions, where low temperatures and water saturation preserve organic matter, the existence of peat in (sub)tropical regions remains enigmatic. Here we examined peat and plant chemistry across a latitudinal transect from the Arctic to the tropics. Near-surface low-latitude peat has lower carbohydrate and greater aromatic content than near-surface high-latitude peat, creating a reduced oxidation state and resulting recalcitrance. This recalcitrance allows peat to persist in the (sub)tropics despite warm temperatures. Because we observed similar declines in carbohydrate content with depth in high-latitude peat, our data explain recent field-scale deep peat warming experiments in which catotelm (deeper) peat remained stable despite temperature increases up to 9 °C. We suggest that high-latitude deep peat reservoirs may be stabilized in the face of climate change by their ultimately lower carbohydrate and higher aromatic composition, similar to tropical peats.National Science Foundation (Grant 1114155)National Science Foundation (Grant 1114161)NSF (Award 0628647)US Department of Energy, Office of Science, Office of Biological and Environmental Research (contract DE-SC0012088)US Department of Energy Office of Biological and Environmental Research under the Genomic Science program (Award DE-SC0004632)US Department of Energy Office of Biological and Environmental Research under the Genomic Science program (Award DE-SC0010580)US Department of Energy Office of Biological and Environmental Research under the Genomic Science program (Award DE-SC0016440)NASA Interdisciplinary Studies in Earth Science program (Award NNX17AK10G)US Department of Energy Office of Biological and Environmental Research under the Terrestrial Ecosystem Sciences program (Award DE-SC0012272