Solar Forcing of Florida Straits Surface Salinity During the Early Holocene

Previous studies showed that sea surface salinity (SSS) in the Florida Straits as well as Florida Current transport covaried with changes in North Atlantic climate over the past two millennia. However, little is known about earlier Holocene hydrographic variability in the Florida Straits. Here, we combine Mg/Ca-paleothermometry and stable oxygen isotope measurements on the planktonic foraminifera Globigerinoides ruber (white variety) from Florida Straits sediment core KNR166-2 JPC 51 (24° 24.70\u27 N, 83° 13.14\u27 W, 198 m deep) to reconstruct a high-resolution (~25 yr/sample) early to mid Holocene record of sea surface temperature and δ18OSW)(a proxy for SSS) variability. After removing the influence of globalδ18OSW change due to continental ice volume variability, we find that early Holocene SSS enrichments are associated with increased evaporation/precipitation ratios in the Florida Straits during periods of reduced solar forcing, increased ice rafted debris in the North Atlantic and the development of more permanent El Niño-like conditions in the eastern equatorial Pacific. When considered with previous high-resolution reconstructions of Holocene tropical atmospheric circulation changes, our results provide evidence that variations in solar forcing over the early Holocene had a significant impact on the global tropical hydrologic cycle

(Table S1) Age determination of sediment core KNR166-2_51

Previous studies showed that sea surface salinity (SSS) in the Florida Straits as well as Florida Current transport covaried with changes in North Atlantic climate over the past two millennia. However, little is known about earlier Holocene hydrographic variability in the Florida Straits. Here, we combine Mg/Ca-paleothermometry and stable oxygen isotope measurements on the planktonic foraminifera Globigerinoides ruber (white variety) from Florida Straits sediment core KNR166-2 JPC 51 (24° 24.70' N, 83° 13.14' W, 198 m deep) to reconstruct a high-resolution (~25 yr/sample) early to mid Holocene record of sea surface temperature and d18OSW (a proxy for SSS) variability. After removing the influence of global d18OSW change due to continental ice volume variability, we find that early Holocene SSS enrichments are associated with increased evaporation/precipitation ratios in the Florida Straits during periods of reduced solar forcing, increased ice rafted debris in the North Atlantic and the development of more permanent El Niño-like conditions in the eastern equatorial Pacific. When considered with previous high-resolution reconstructions of Holocene tropical atmospheric circulation changes, our results provide evidence that variations in solar forcing over the early Holocene had a significant impact on the global tropical hydrologic cycle

PREVENTion of CLots in Orthopaedic Trauma (PREVENT CLOT): a randomised pragmatic trial protocol comparing aspirin versus low-molecular-weight heparin for blood clot prevention in orthopaedic trauma patients

Introduction Patients who sustain orthopaedic trauma are at an increased risk of venous thromboembolism (VTE), including fatal pulmonary embolism (PE). Current guidelines recommend low-molecular-weight heparin (LMWH) for VTE prophylaxis in orthopaedic trauma patients. However, emerging literature in total joint arthroplasty patients suggests the potential clinical benefits of VTE prophylaxis with aspirin. The primary aim of this trial is to compare aspirin with LMWH as a thromboprophylaxis in fracture patients.Methods and analysis PREVENT CLOT is a multicentre, randomised, pragmatic trial that aims to enrol 12 200 adult patients admitted to 1 of 21 participating centres with an operative extremity fracture, or any pelvis or acetabular fracture. The primary outcome is all-cause mortality. We will evaluate non-inferiority by testing whether the intention-to-treat difference in the probability of dying within 90 days of randomisation between aspirin and LMWH is less than our non-inferiority margin of 0.75%. Secondary efficacy outcomes include cause-specific mortality, non-fatal PE and deep vein thrombosis. Safety outcomes include bleeding complications, wound complications and deep surgical site infections.Ethics and dissemination The PREVENT CLOT trial has been approved by the ethics board at the coordinating centre (Johns Hopkins Bloomberg School of Public Health) and all participating sites. Recruitment began in April 2017 and will continue through 2021. As both study medications are currently in clinical use for VTE prophylaxis for orthopaedic trauma patients, the findings of this trial can be easily adopted into clinical practice. The results of this large, patient-centred pragmatic trial will help guide treatment choices to prevent VTE in fracture patients.Trial registration number NCT02984384