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Sea-level rise is an important part of climate change, but most sea-level budgets are global and cannot capture important regional changes. Here the authors estimate sea-level budgets along the U.S. Atlantic coast, finding a faster rate of rise during the 20th century than any time in the past 2000 years.

Predicted sea-level rise is widely anticipated to lead to increased coastal erosion, however, assessing how rocky coasts will respond to changes in marine conditions is difficult to constrain. Here, the authors find that a North Yorkshire rocky cliff has been eroding at a similar rate over the last 7 kyr, and they do not observe an increase in erosion rates in response to modern sea level rise.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

BackgroundIt is widespread practice during citrate anticoagulated renal replacement therapy to monitor circuit ionised calcium (iCa2+) to evaluate the effectiveness of anticoagulation. Whether the optimal site to sample the blood path is before or after the haemofilter is a common question.MethodsUsing a prospectively collected observational dataset from intensive care patients receiving pre-dilution continuous veno-venous haemodiafiltration (CVVHD-F) with integrated citrate anticoagulation we compared paired samples of pre and post filter iCa2+ where the target range was 0.3-0.5 mmol.L-1 as well as concurrently collected arterial iCa2+. Two nested mixed methods linear models were fitted to the data describing post vs pre filter iCa2+, and the relationship of pre, post and arterial samples.SettingAn 11 bed general intensive care unit.Participants450 grouped samples from 152 time periods in seven patients on CRRT with citrate anticoagulation.ResultsThe relationship of post to pre-filter iCa2+ was not 1:1 with post = 0.082 + 0.751 x pre-filter iCa2+ (95% CI intercept: 0.015-0.152, slope 0.558-0.942). Variation was greatest between patients rather than between circuits within the same patient or citrate dose. Compared to arterial iCa2+ there was no significant difference between pre and post-filter sampling sites (F-value 0.047, p = 0.827).ConclusionThese results demonstrate that there is minimal difference between pre and post filter samples for iCa2+ monitoring of circuit anticoagulation in citrate patients relative to the arterial iCa2+ in CVVHD-F however compared to pre-filter sampling, post filter sampling has a flatter response and greater variation.