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Andra H James,1 Barbara A Konkle,2,3 Kenneth A Bauer4 1Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia, 2Puget Sound Blood Center, Seattle, Washington, 3Department of Medicine, University of Washington, Seattle, Washington, 4Department of Medicine, Beth Israel Deaconess Medical Center and VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts, USA Objective: The aims of the study reported here were to provide data from six pregnant subjects who were enrolled in a clinical trial of antithrombin (AT) concentrate, discuss other published case series and case reports, and provide general guidance for the use of AT concentrate for inherited AT deficiency in pregnancy. Methods: In the late 1980s, 31 AT-deficient subjects were enrolled in a prospective treatment trial of the plasma-derived AT concentrate Thrombate III®. Herein, newly available treatment data about the six pregnant subjects in the trial is tabulated and summarized. Results: All six experienced venous thromboembolism (VTE) during pregnancy, were dosed according to a weight-based protocol, and were treated concomitantly with anticoagulation. Loading doses of AT concentrate of 54–62 units/kg were followed by maintenance doses of 50%–100% of the loading dose for 3–10 days. At the time of labor, loading doses of 46–50 units/kg were followed by maintenance doses of 50%–75% of the loading dose for 5–7 days. None of the six experienced recurrent thrombosis while receiving treatment with AT concentrate. Conclusion: Currently we suggest that women with AT deficiency who are pregnant or postpartum and have a personal history of VTE or current VTE receive AT concentrates. Keywords: thrombophilia, thrombosis, plasma-derived concentrate, labor, delivery, heparin. A Letter to the Editor has been received and published for this article.

The effects of heating Ilford types G and K emulsion prior to exposure or processing have been studied. Samples were heated at 55-60 °C for times up to 16 days, and other samples were assembled into stacks in which a temperature gradient (-20° to +100°C) was maintained., http://archive.org/details/photographicndme109459610, Lieutenant, United States Naval Reserve, Lieutenant Commander, United States Navy, Approved for public release; distribution is unlimited.

There are few comprehensive surveys addressing the evolution of China’s grassland policies, particularly with respect to fencing. As a necessary prologue to such an inquiry, this paper presents the national-level laws and regulations that have structured contemporary property regimes and affected the rate and extent of the enclosure movement in pastoral western China, with a focus on Tibetan areas. Based on this review of the legal and political framework of enclosure on the Tibetan Plateau, I will argue that the intent and sequencing of development policies in pastoral areas has been based on the overriding logic of modernization, privatization, and intensification (Yeh 2005). This logic, in turn, has been used to promote enclosure and rationalize heavy investments in technologies of control – policies that reflect the state’s political goals in Tibetan areas and which may have unintended consequences, including increased grazing pressure on, and degradation of, the very rangeland resources that are putatively being protected by enclosures. Rather than addressing critical socio-economic constraints in pastoral areas such as population pressures and market distortions (Shen 2004), policy makers have focused instead on technical interventions (e.g., reseeding, improving the genetics of livestock breeds) without recognizing the integrated nature of the challenges confronting Tibetan pastoralists amidst ongoing and rapid shifts in their socio-economic situation.

BACKGROUND: Prophylaxis for venous thromboembolism is recommended for at least 10 days after total knee arthroplasty; oral regimens could enable shorter hospital stays. We aimed to test the efficacy and safety of oral rivaroxaban for the prevention of venous thromboembolism after total knee arthroplasty. METHODS: In a randomised, double-blind, phase III study, 3148 patients undergoing knee arthroplasty received either oral rivaroxaban 10 mg once daily, beginning 6-8 h after surgery, or subcutaneous enoxaparin 30 mg every 12 h, starting 12-24 h after surgery. Patients had mandatory bilateral venography between days 11 and 15. The primary efficacy outcome was the composite of any deep-vein thrombosis, non-fatal pulmonary embolism, or death from any cause up to day 17 after surgery. Efficacy was assessed as non-inferiority of rivaroxaban compared with enoxaparin in the per-protocol population (absolute non-inferiority limit -4%); if non-inferiority was shown, we assessed whether rivaroxaban had superior efficacy in the modified intention-to-treat population. The primary safety outcome was major bleeding. This trial is registered with ClinicalTrials.gov, number NCT00362232. FINDINGS: The primary efficacy outcome occurred in 67 (6.9%) of 965 patients given rivaroxaban and in 97 (10.1%) of 959 given enoxaparin (absolute risk reduction 3.19%, 95% CI 0.71-5.67; p=0.0118). Ten (0.7%) of 1526 patients given rivaroxaban and four (0.3%) of 1508 given enoxaparin had major bleeding (p=0.1096). INTERPRETATION: Oral rivaroxaban 10 mg once daily for 10-14 days was significantly superior to subcutaneous enoxaparin 30 mg given every 12 h for the prevention of venous thromboembolism after total knee arthroplasty. FUNDING: Bayer Schering Pharma AG, Johnson & Johnson Pharmaceutical Research & DevelopmentBACKGROUND: Prophylaxis for venous thromboembolism is recommended for at least 10 days after total knee arthroplasty; oral regimens could enable shorter hospital stays. We aimed t