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Apixaban is a highly selective, orally bioavailable, and reversible direct inhibitor of free and clot-bound factor Xa. Factor Xa catalyzes the conversion of prothrombin to thrombin, the final enzyme in the coagulation cascade that is responsible for fibrin clot formation. [ 27 ]
Side effects may include bleeding, most commonly from the nose, gastrointestinal tract (GI) or genitourinary system. [2] Compared to the risk of bleeding with warfarin use, direct factor Xa inhibitors have a higher risk of GI bleeding, but lower risk of bleeding in the brain . [ 2 ]
A social insurance number (SIN) (French: numéro d'assurance sociale (NAS)) is a number issued in Canada to administer various government programs. The SIN was created in 1964 to serve as a client account number in the administration of the Canada Pension Plan and Canada's varied employment insurance programs.
[40] [41] Numbers with 666 or 900–999 (Individual Taxpayer Identification Number) in the first digit group. [40] Until 2011, the SSA published the last group number used for each area number. [42] Because group numbers were allocated in a regular pattern, it was possible to identify an unissued SSN that contained an invalid group number.
The use of the social insurance number (SIN) as a de facto ID number ended in 2004 with passage of The Personal Information Protection and Electronic Documents Act. [11] There are only certain instances where an organization may ask for a SIN (namely for tax or retirement benefit related issues).
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Full funding is a desirable goal for private pension plans as well, but is often not achieved. Social insurance programs are often not fully funded, and some argue that full funding is not economically desirable. [17] Most international systems of social insurance are funded on an ongoing basis without reference to future liabilities.
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