Accumulation of LMWH is a concern in severe chronic kidney disease (CKD)  28 subjects with severe CKD received prophylactic tinzaparin for up to 8 days  All had undetectable trough anti-Xa levels; half had undetectable peak levels  Prophylactic tinzaparin dosing did not incur clinically significant bioaccumulation

For decades, Ottawa and Washington have been agreeing to disagree on the question of the legal status of the Northwest Passage. One argument which has been consistently raised on the U.S. side and which has precluded any attempts to end the deadlock has been the fear of creating a negative precedent. This article assesses whether U.S. concerns are warranted: Could coastal States elsewhere in the world rely on an eventual recognition of Canadian sovereignty over the Northwest Passage to bolster their claims over a local strait?

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For more than half a century, Canada has affirmed that all of the waters within its Arctic archipelago, including the Northwest Passage, are Canadian historic internal waters over which it exercises sovereign control. Canada’s detractors have qualified the Canadian position as excessive, arguing that the Northwest Passage is an international strait and that international legal regimes guarantee the preservation of the Arctic waterway. It is this contention, that international legal tools exist—specifically Article 234 of the LOSC and the IMO’s PSSA mechanism—and that they would adequately protect the Northwest Passage even if it came to be recognized as an international strait, which is the subject of investigation.