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Quantitative physicochemical models of human acid–base physiology filled a void between clinical acid–base analysis and general fluid physiology. Established approaches centred on the Henderson–Hasselbalch (HH) equation allow satisfactory bedside exploration of respiratory perturbations, but do not fully elucidate mechanisms of common non-respiratory ‘metabolic’ components. Though useful at the bedside, commonly used ‘rules of thumb’ that classify disturbances based on quantification of bicarbonate relative to CO2 have also fostered a language that often misrepresents bicarbonate physiology. The physicochemical model is frequently perceived as too complex for bedside use, however a set of simplified screening questions based on Stewart's model can be utilized to aid acid-base interpretation. Examples using this approach are included in an online appendix. Emphasis is placed on understanding the consequences of hypoalbuminaemia, volume status, tonicity and chloride derangements as these are common in ICU patients.

In this chapter, we consider key advances in the understanding of mass movements between c. 1965 and c. 2000. This period saw a burgeoning need for a greater level of understanding of mass-movement processes in response to a series of high-impact mass-movement events, and because of the need to develop infrastructure safely. A series of step changes were enabled through hillslope geomorphology (broadly defined) being open to overarching and consolidating concepts, methods and models from cognate disciplines, whilst seizing opportunities to gain insight from rapidly advancing methods increasingly focused at a scale of investigation relevant to landsliding. By c. 2000, geomorphologists had made significant contributions to our understanding of mass-movement processes and ultimately led many key conceptual advances, notably relating to: bridging across scales of hillslope investigation; linking and developing understanding of process, form and mechanisms of slope stability; and articulating the temporal characteristics of slope stability and mass movement.

Stratigraphic data from salt marshes provide accurate reconstructions of Holocene relative sea-level (RSL) change and necessary constraints to models of glacial isostatic adjustment (GIA), which is the dominant cause of Late-Holocene RSL rise along the U.S. mid-Atlantic coast. Here, we produce a new Mid- to Late-Holocene RSL record from a salt marsh bordering Great Bay in southern New Jersey using basal peats. We use a multi-proxy approach (foraminifera and geochemistry) to identify the indicative meaning of the basal peats and produce sea-level index points (SLIPs) that include a vertical uncertainty for tidal range change and sediment compaction and a temporal uncertainty based on high precision Accelerator Mass Spectrometry radiocarbon dating of salt-marsh plant macrofossils. The 14 basal SLIPs range from 1211 ± 56 years BP to 4414 ± 112 years BP, which we combine with published RSL data from southern New Jersey and use with a spatiotemporal statistical model to show that RSL rose 8.6 m at an average rate of 1.7 ± 0.1 mm/year (1σ) from 5000 years BP to present. We compare the RSL changes with an ensemble of 1D (laterally homogenous) and site-specific 3D (laterally heterogeneous) GIA models, which tend to overestimate the magnitude of RSL rise over the last 5000 years. The continued discrepancy between RSL data and GIA models highlights the importance of using a wide array of ice model and viscosity model parameters to more precisely fit site-specific RSL data along the U.S. mid-Atlantic coast. Ministry of Education (MOE) National Research Foundation (NRF) Published version The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: JSW was funded by the David and Arleen McGlade Foundation and a Cushman Foundation for Foraminiferal Research Student Research Award. JSW and REK were also supported by US National Science Foundation awards OCE-1804999 and OCE-2002437. BPH, TL, and TS are supported by the Singapore Ministry of Education Academic Research Fund MOE2019-T3-1-004 and MOE-T2EP50120-0007, the National Research Foundation Singapore, and the Singapore Ministry of Education, under the Research Centres of Excellence initiative. NC is supported by the A4 project. A4 (Grant-Aid Agreement no. PBA/CC/18/01) is carried out with the support of the Marine Institute under the Marine Research Programme funded by the Irish Government. DCB receives support from the H.F. Alderfer Fund for Environmental Studies at Bryn Mawr College.

High-resolution rockfall inventories captured at a regional scale are scarce. This is partly owing to difficulties in measuring the range of possible rockfall volumes with sufficient accuracy and completeness, and at a scale exceeding the influence of localised controls. This paucity of data restricts our ability to abstract patterns of erosion, identify longterm changes in behaviour and assess how rockfalls respond to changes in rock mass structural and environmental conditions. We have addressed this by developing a workflow that is tailored to monitoring rockfalls and the resulting cliff retreat continuously (in space), in 3D and over large spatial scales (> 10 4 m). We tested our approach by analysing rockfall activity along 20.5 km of coastal cliffs in North Yorkshire (UK), in what we understand to be the first multi-temporal detection of rockfalls at a regional scale. We show that rockfall magnitude-frequency relationships, which often underpin predictive models of erosion, are highly sensitive to the spatial extent of monitoring. Variations in rockfall shape with volume also imply a systemic shift in the underlying mechanisms of detachment with scale, leading us to question the validity of applying a single probabilistic model to the full range of rockfalls observed here. Finally, our data emphasise the importance of cliff retreat as an episodic process. Going forwards, there will a pressing need to understand and model the erosional response of such coastlines to rising global sea levels as well as projected changes to winds, tides, wave climates, precipitation and storm events. The methodologies and data presented here are fundamental to achieving this, marking a step-change in our ability to understand the competing effects of different processes in determining the magnitude and frequency of rockfall activity and ultimately meaning that we are better placed to investigate relationships between process and form/erosion at critical, regional scales.

Tide-gauge measurements in the western North Atlantic Ocean show coherent, multi-decadal relative sea-level (RSL) trends across multiple spatial scales. Proxy reconstructions developed from salt-marsh sediment can extend this instrumental record. However, the degree of coherence in proxy reconstructions is underexamined through within-region replication. To explore within-region replication, we developed a new RSL reconstruction from Fox Hill Marsh, Rhode Island to complement similar records at nearby sites. We established the elevation of former sea level from assemblages of foraminifera and bulk-sediment δ13C values using a Bayesian transfer function. We employed radiocarbon dating and recognition of pollution horizons to construct a core chronology. Since ∼1200 BCE, RSL rose by ∼3.7 m at Fox Hill Marsh. After correction for glacial isostatic adjustment, application of a statistical model intended to quantify (multi-) century-scale trends showed that the fastest rate of rise in at least the past 3000 years was 1.71 ± 0.84 mm/yr (95% credible interval) in 2020 CE. This result replicates regional tide-gauge measurements and other proxy reconstructions. Using an alternative statistical model constructed to identify sub-centennial sea-level changes, we examined if there was a hotspot of 18th century rise in the northeastern United States and found no spatially-coherent trend (i.e., occurring at all or most sites). This lack of replication indicates that accelerated rise during the 18th century is likely local (site-specific) in scale, or an artifact of individual reconstructions. Continued efforts to replicate RSL reconstructions will increase confidence in the accuracy of records and their subsequent interpretation.

Earthquakes trigger widespread landsliding in tectonically-active landscapes. The effects of strong ground shaking on hillslope stability persist into the post-seismic stage; rates of landsliding remain elevated in the years following an earthquake. The mechanisms that control the spatial pattern and rate of ongoing landsliding are poorly constrained, hindering our ability to reliably forecast how landscapes and landslide hazard evolve. To address this, we undertook a detailed geotechnical investigation in which we subjected representative rock samples to dynamic loading, simulating the effects of earthquake ground shaking on hillslopes of different configuration. Our results indicate that post-seismic hillslope strength is not an intrinsic rock property; rather, it responds to the amplitude of imposed dynamic loads and the degree of pre-existing shear surface formation within the rock. This path-dependent behaviour results from differences in the character of fractures generated by dynamic loads of different amplitude, and the ways in which apertures are mobilised or degraded in subsequent (post-seismic) shearing. Sensitivity to dynamic loading amplitude is greater in shallow landslides in which shear surfaces are yet to fully form; such hillslopes can be strengthened or weakened by earthquake events, depending on their characteristics. In contrast, deeper landslides on steeper hillslopes in which shear surfaces have largely developed are less likely to display differences in behaviour in response to dynamic loading because strain accumulation along pre-existing fractures is dominant. Our results demonstrate the need to consider path-dependent hillslope stability in numerical models used to forecast how landscapes respond to earthquakes and how post-seismic hazard evolves.

The frequency distribution of rockfall sizes ('magnitude-frequency') is important for erosion and hazard modeling. This typically follows a power law, with few larger rockfalls compared to more numerous small events. Advances in LiDAR hardware and algorithms have improved our ability to detect small rockfalls, which in sum contribute significantly to overall erosion. However, improvements in spatial resolution have outstripped improvements in the temporal resolution of monitoring. If the interval between surveys exceeds the return interval of rockfalls, neighbouring rockfalls within a single interval are incorrectly recorded as one. We examined the timescales of rockfall occurrence to identify suitable monitoring intervals to discretize rockfalls. Monitoring interval has a considerable impact on the frequency distribution of measured rockfall volumes. An order of magnitude increase in rockfall numbers and a threefold decrease in mean volume is observed over hourly intervals, compared to 30 d. Below ~12 h, these changes increase nonlinearly with more frequent monitoring. Similarly, average rockfall size measured over timescales < 4 h falls is comparable to the scale of individual discontinuities, indicating that fragmented detachments may drive much of the increase in small events. Such analysis is required to constrain the timescales of rockfall evolution and to attribute specific drivers.

The reduction of soil suction and consequent loss of shear strength due to infiltration is known to trigger shallow landslides during periods of concentrated rainfall. In the mountainous terrain of Nepal, the risk of shallow rainfall-induced landsliding is further exacerbated by the non-engineered hillslope excavation for the construction of local roads. To better understand the combined effect of rainfall and road cutting on landsliding, a detailed investigation of a shallow landslide was conducted, on a site with a steep road cut that failed due to rainfall infiltration in July 2018. An integrated investigation approach was adopted, combining field and laboratory testing, and field monitoring with a series of coupled hydro-mechanical analyses with the finite element code PLAXIS 2D. The field and laboratory tests were performed to characterise the subsoil condition and determine the soil parameters for the hydro-mechanical analyses. Further, a field monitoring program was set up to obtain real-time measurements of rainfall and volumetric water content of the soil. The monitored data was used for calibration of the numerical model to assess the reliability of its predictions. Results of the numerical back-analysis suggest that the landslide was triggered by rainfall infiltration causing a gradual reduction of soil suction at the shallow depths of ≤1.7m and the presence of the steep road cut promoted slope failure by allowing larger displacements to occur in the hillslope. Without the road cut, the slope was found to have ~35% greater initial factor of safety and under the landslide- triggering rainfall, the slope was found to remain stable with ~170% greater factor of safety than that in the slope with the road cut. This indicates that the presence of a road cut increases the likelihood of landslide during rainfall and lowers the minimum level of rainfall needed for its initiation. Hence, rainfall-induced roadside slope failures could become more frequent and extensive if roads continue to be built using informal slope excavation, without adopting suitable interventions, some examples of which are presented in this study.

Sea-level budgets account for the contributions of processes driving sea-level change, but are predominantly focused on global-mean sea level and limited to the 20th and 21st centuries. Here we estimate site-specific sea-level budgets along the U.S. Atlantic coast during the Common Era (0–2000 CE) by separating relative sea-level (RSL) records into process-related signals on different spatial scales. Regional-scale, temporally linear processes driven by glacial isostatic adjustment dominate RSL change and exhibit a spatial gradient, with fastest rates of rise in southern New Jersey (1.6 ± 0.02 mm yr−1). Regional and local, temporally non-linear processes, such as ocean/atmosphere dynamics and groundwater withdrawal, contributed between −0.3 and 0.4 mm yr−1 over centennial timescales. The most significant change in the budgets is the increasing influence of the common global signal due to ice melt and thermal expansion since 1800 CE, which became a dominant contributor to RSL with a 20th century rate of 1.3 ± 0.1 mm yr−1., 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 and increased storminess are anticipated to lead to increases in coastal erosion. However, assessing if and how rocky coasts will respond to changes in marine conditions is difficult due to current limitations of monitoring and modelling. Here, we measured cosmogenic 10Be concentrations across a sandstone shore platform in North Yorkshire, UK, to model the changes in coastal erosion within the last 7 kyr and for the first time quantify the relative long-term eros0ive contribution of landward cliff retreat, and down-wearing and stripping of rock from the shore platform. The results suggest that the cliff has been retreating at a steady rate of 4.5 ± 0.63 cm yr−1, whilst maintaining a similar profile form. Our results imply a lack of a direct relationship between relative sea level over centennial to millennial timescales and the erosion response of the coast, highlighting a need to more fully characterise the spatial variability in, and controls on, rocky coast erosion under changing conditions., 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.

Predicted sea-level rise and increased storminess are anticipated to lead to increases in coastal erosion. However, assessing if and how rocky coasts will respond to changes in marine conditions is difficult due to current limitations of monitoring and modelling. Here, we measured cosmogenic 10Be concentrations across a sandstone shore platform in North Yorkshire, UK, to model the changes in coastal erosion within the last 7 kyr and for the first time quantify the relative long-term erosive contribution of landward cliff retreat, and down-wearing and stripping of rock from the shore platform. The results suggest that the cliff has been retreating at a steady rate of 4.5 ± 0.63 cm yr−1, whilst maintaining a similar profile form. Our results imply a lack of a direct relationship between relative sea level over centennial to millennial timescales and the erosion response of the coast, highlighting a need to more fully characterise the spatial variability in, and controls on, rocky coast erosion under changing conditions. 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.

Sediment cores from Staten Island's salt marsh contain multiple historical oil spill events that impact ecological health. Microtox solid phase bioassay indicated moderate to high toxicity. Multiple spikes of TPH (6524 to 9586 mg/kg) and Σ16 PAH (15.5 to 18.9 mg/kg) were co-incident with known oil spills. A high TPH background of 400–700 mg/kg was attributed to diffuse sources. Depth-profiled metals Cu (1243 mg/kg), Zn (1814 mg/kg), Pb (1140 mg/kg), Ni (109 mg/kg), Hg (7 mg/kg), Cd 15 (mg/kg) exceeded sediment quality guidelines confirming adverse biological effects. Changes in Pb206/207 suggested three metal contaminant sources and diatom assemblages responded to two contamination events. Organic and metal contamination in Saw Mill Creek Marsh may harm sensitive biota, we recommend caution in the management of the 20–50 cm sediment interval because disturbance could lead to remobilisation of pre-existing legacy contamination into the waterway.

Several processes contributing to coastal relative sea-level (RSL) change in the North Atlantic Ocean are observed and/or predicted to have distinctive spatial expressions that vary by latitude. To expand the latitudinal range of RSL records spanning the past ∼3000 years and the likelihood of recognizing the characteristic fingerprints of these processes, we reconstructed RSL at two sites (Big River and Placentia) in Newfoundland from salt-marsh sediment. Bayesian transfer functions established the height of former sea level from preserved assemblages of foraminifera and testate amoebae. Age-depth models constrained by radiocarbon dates and chronohorizons estimated the timing of sediment deposition. During the past ∼3000 years, RSL rose by ∼3.0 m at Big River and by ∼1.5 m at Placentia. A locally calibrated geotechnical model showed that post-depositional lowering through sediment compaction was minimal. To isolate and quantify contributions to RSL from global, regional linear, regional non-linear, and local-scale processes, we decomposed the new reconstructions (and those in an expanded, global database) using a spatio-temporal statistical model. The global component confirms that 20th century sea-level rise occurred at the fastest, century-scale rate in over 3000 years (P > 0.999). Distinguishing the contributions from local and regional non-linear processes is made challenging by a sparse network of reconstructions. However, only a small contribution from local-scale processes is necessary to reconcile RSL reconstructions and modeled RSL trends. We identified three latitudinally-organized groups of sites that share coherent regional non-linear trends and indicate that dynamic redistribution of ocean mass by currents and/or winds was likely an important driver of sea-level change in the North Atlantic Ocean during the past ∼3000 years.

Salt-marsh sediments provide precise and near-continuous reconstructions of Common Era relative sea level (RSL). However, organic and low-density salt-marsh sediments are prone to compaction processes that cause post-depositional distortion of the stratigraphic column used to reconstruct RSL. We compared two RSL reconstructions from East River Marsh (Connecticut, USA) to assess the contribution of mechanical compression and biodegradation to compaction of salt-marsh sediments and their subsequent influence on RSL reconstructions. The first, existing reconstruction ('trench') was produced from a continuous sequence of basal salt-marsh sediment and is unaffected by compaction. The second, new reconstruction is from a compaction-susceptible core taken at the same location. We highlight that sediment compaction is the only feasible mechanism for explaining the observed differences in RSL reconstructed from the trench and core. Both reconstructions display long-term RSL rise of ~1 mm/yr , followed by a ~19th Century acceleration to ~3 mm/yr. A statistically-significant difference between the records at ~1100 to 1800 CE could not be explained by a compression-only geotechnical model. We suggest that the warmer and drier conditions of the Medieval Climate Anomaly (MCA) resulted in an increase in sediment compressibility during this time period. We adapted the geotechnical model by reducing the compressive strength of MCA sediments to simulate this softening of sediments. 'Decompaction' of the core reconstruction with this modified model accounted for the difference between the two RSL reconstructions. Our results demonstrate that compression-only geotechnical models may be inadequate for estimating compaction and post-depositional lowering of susceptible organic salt-marsh sediments in some settings. This has important implications for our understanding of the drivers of sea-level change. Further, our results suggest that future climate changes may make salt marshes more susceptible to the impacts of RSL rise by enhancing sediment compressibility. We stress, however, that the cause of the softening remains enigmatic. Until this is better constrained, it is premature to widely extrapolate our findings to existing core-based reconstructions of Holocene RSL.

Earthquakes trigger landslides in mountainous regions. Recent research suggests that the stability of hillslopes during and after a large earthquake is influenced by legacy effects of previous seismic activity. However, the mechanisms that control hillslope stability in response to ground shaking are poorly constrained in ductile hillslope materials, inhibiting our ability to fully explain the nature of earthquake-triggered landslides. We used geotechnical laboratory testing to simulate earthquake loading of hillslopes and to assess how different sequences of ground shaking influence hillslope stability prior to, during and following an earthquake ‘mainshock’. Ground-shaking events prior to a mainshock that do not result in high landslide strain accumulation can increase bulk density and interparticle friction. This strengthens a hillslope, reducing landslide displacement during subsequent seismicity. By implication, landscapes in different tectonic settings will likely demonstrate different short- and long-term responses to single earthquakes due to differences in the magnitude, frequency and sequencing of earthquakes.

BACKGROUND It is widely accepted that early discussions about goals of care (GOC) should occur during a hospital admission. Whilst rapid response systems such as Medical Emergency Team (MET) calls were designed to identify patients at risk of deterioration early enough in their illness to intervene, it is becoming apparent that these teams frequently diagnose the dying patient. AIMS To determine how frequently Launceston General Hospital MET doctors are involved in discussions surrounding GOC. METHODS A retrospective audit of all MET calls and Code Blues at the Launceston General Hospital over an 18 month period was performed. RESULTS 50% of MET calls occurred in patients with no valid GOC form completed prior. At 3% of events, the GOC form was completed for the first time, and at 3% it was modified. At a further 3% the notes implied there had been a modification to the GOC but the form had not been completed. CONCLUSIONS This audit confirms that documentation surrounding GOC is inadequate, and that at 9% of MET calls, MET doctors are involved in discussions surrounding treatment limitations. This suggests that further education and training is required for doctors working in inpatient care, including those who staff the MET.

Background Rapid response teams (RRT) were first proposed as a means of reducing inpatient morbidity and mortality. Modifying RRT activation triggers poses a potential risk for delayed recognition of a deteriorating patient. Trigger modifications have not been validated for safety. Aims To determine if RRT trigger modifications are associated with: increased frequency of recurrent RRT activation; increased length of stay (LOS); increased intensive care admission; and increased in-hospital mortality. Methods A retrospective audit of all RRT activations occurring at the Launceston General Hospital (LGH) over an 18-month period was performed. Results Rate of recurrent RRT activations did not decrease with the use of trigger modifications around the time of RRT activation, and for patients with two modifications, the frequency increased (1.98 vs 1.32, P = 0.007). LGH LOS increased for patients with any trigger modifications compared to those with none (11 vs 9, P = 0.0002), and for patients with two modifications (11.5 vs 9, P = 0.010). Total hospital LOS increased for patients with any modifications compared to patients with none (12 vs 10, P = 0.002). There was no significant association between trigger modifications and frequency of intensive care unit admission. The relative risk of in-hospital death increased with increasing numbers of trigger modifications (relative risk 1.38-4.89). Conclusions Trigger modifications are associated with increased hospital LOS and increased rate of in-hospital death and do not reduce the number of recurrent events. For patients in whom escalation of care is not appropriate, the presence of multiple trigger modifications at the time of an RRT activation may be a useful trigger for conversations around goals of care.

Weathering reduces the strength of rocks and so is a key control on the stability of rock slopes. Recent research suggests that the geotechnical response of rocks to weathering varies with ambient stress conditions resulting from overburden loading and/or stress concentrations driven by near-surface topography. In addition, the stress history experienced by the rock can influence the degree to which current weathering processes cause rock breakdown. To address the combined effect of these potential controls, we conducted a set of weathering experiments on two sedimentary lithologies in laboratory and field conditions. We firstly defined the baseline geotechnical behaviour of each lithology, characterising surface hardness and stress-strain behaviour in unconfined compression. Weathering significantly reduced intact rock strength, but this was not evident in measurements of surface hardness. The ambient compressive stress applied to samples throughout the experiments did not cause any observable differences in the geotechnical behaviour of the samples. We created a stress history effect in sub-sets of samples by generating a population of microcracks that could be exploited by weathering processes. We also geometrically modified groups of samples to cause near-surface stress concentrations that may allow greater weathering efficacy. However, even these pronounced sample modifications resulted in insignificant changes in geotechnical behaviour when compared to unmodified samples. The observed reduction in rock strength changed the nature of failure of the samples, which developed post-peak strength and underwent multiple stages of brittle failure. Although weakened, these samples could sustain greater stress and strain following exceedance of peak strength. On this basis, the multi-stage failure style exhibited by weaker weathered rock may permit smaller-magnitude, higher-frequency events to trigger fracture through intact rock bridges as well as influencing the characteristics of pre-failure deformation. These findings are consistent with patterns of behaviour observed in field monitoring results.

Shore platforms control wave energy transformation which, in turn, controls energy delivery to the cliff toe and nearshore sediment transport. Insight into shore platform erosion rates has conventionally been constrained at mm-scales using micro-erosion metres, and at m-scales using cartographic data. On apparently slowly eroding coasts, such approaches are fundamentally reliant upon long-term observation to capture emergent erosion patterns. Where in practise timescales are short, and where change is either below the resolution or saturates the mode of measurement, the collection of data that enables the identification of the actual mechanisms of erosion is hindered. We developed a method to monitor shore platform erosion at millimetre resolution within metre-scale monitoring plots using Structure-from-Motion photogrammetry. We conducted monthly surveys at 15 0.25 m2 sites distributed across the Hartle Loup platform in North Yorkshire, UK, over one year. We derived topographic data at 0.001 m resolution, retaining a vertical precision of change detection of 0.001 m. We captured a mean erosion rate of 0.528 mm yr-1, but this varied considerably both across the platform and through the year. We characterised the volume and shape of eroded material. The detachment volume-frequency and shape distributions suggest that erosion happens primarily via removal of shale platelets. We identify that the at-a-point erosion rate can be predicted by the distance from the cliff and the tidal level, whereby erosion rates are higher closer to the cliff and at locations of higher tidal duration. The size of individual detachments is controlled by local micro-topography and rock structure, whereby larger detachments are observed on more rough sections of the platform. Faster erosion rates and larger detachments occur in summer months, rather than in more energetic winter conditions. These results have the potential to form the basis of improved models of how platforms erode over both short- and long-timescales.

Late Holocene sea-level changes can be reconstructed from salt-marsh sediments with decimetre-scale precision and decadal-scale resolution. These records of relative sea-level changes comprise the net sea-level contributions from mechanisms that act across local, regional and global scales. Recent efforts help to constrain the relative significance of these mechanisms that include sediment dynamics and isostasy, which cause relative sea-level changes via vertical land motion, ocean-atmosphere processes that influence regional-scale ocean mass redistribution, and ocean-cryosphere and steric interactions that drive global scale ocean-volume changes. There remains a paucity of high-resolution Late Holocene sea-level data from eastern Canada. This precludes an interrogation of the mechanisms that define sea-level changes over recent centuries and millennia in a region sensitive to oceanic (Atlantic Multidecadal Variability, Atlantic Meridional Overturning Circulation), atmospheric (North Atlantic Oscillation, Arctic Oscillation) and cryospheric (ice-mass balance) changes. We present new relative sea-level data that span the past three millennia from Baie des Chaleurs in the Gulf of St. Lawrence generated using salt-marsh foraminifera supported with plant macrofossil analyses. The accompanying chronology is based on radiocarbon and radionuclide analyses, which are independently verified using trace metal and microcharcoal records. Relative sea level has risen at a mean rate of 0.93 ± 1.25 mm yr−1 over the past ∼1500 years. Residual structure within the reconstruction (‘internal variability’) has contributed up to an additional 0.61 ± 0.46 mm yr−1 of short-lived RSL rise prior to 1800 CE. Following a sea-level low stand during the Little Ice Age, acceleration in relative sea-level rise is identified between 1800 and 1900 CE within the estimates of internal variability and from 1950 CE to present in both the secular and residual trends. Phases of relative sea-level changes in the Gulf of St. Lawrence are concomitant with periods of glacier mass loss following the Little Ice Age, phase periods of the North Atlantic Oscillation and the Atlantic Meridional Overturning Circulation and Northern Hemisphere warming. Quantifying the individual effects of these different mechanisms is important for understanding how ocean-atmosphere processes redistribute ocean-mass upon larger scale background ocean-volume changes.

Quantitative physicochemical models of human acid–base physiology filled a void between clinical acid–base analysis and general fluid physiology. Established approaches centred on the Henderson–Hasselbalch (HH) equation allow satisfactory bedside exploration of respiratory perturbations, but do not fully elucidate mechanisms of common non-respiratory ‘metabolic' components. Though useful at the bedside, commonly used ‘rules of thumb' that classify disturbances based on quantification of bicarbonate relative to CO 2 have also fostered a language that often misrepresents bicarbonate physiology. The physicochemical model is frequently perceived as too complex for bedside use, however a set of simplified screening questions based on Stewart's model can be utilized to aid acid–base interpretation. Examples using this approach are included in an online appendix. Emphasis is placed on understanding the consequences of hypoalbuminaemia, volume status, tonicity and chloride derangements as these are common in ICU patients.

Compaction describes a range of natural syn- and post-depositional processes that reduce the volume of sediments deposited in low-lying coastal areas, causing land-level lowering and a distortion of stratigraphic sequences. Compaction affects our reconstructions and understanding of historic sea levels, influences how relative sea level changes in the future and can act as a catalyst for rapid, widespread changes in coastal geomorphology. Rates of compaction-induced relative sea-level rise vary across space and through time in response to a range of natural and anthropogenically accelerated processes and conditions. This paper provides a summary of our understanding of the causes and effects of compaction, considering findings from key palaeoenvironmental and stratigraphic studies, sea-level reconstructions and recent observational data. It then considers the implications of these findings for our ability to project compaction-induced relative sea-level and associated coastal changes into the future.

The co-seismic and post-seismic behaviour of pyroclastic ash deposits and its influence on slope stability remains as a challenging subject in engineering geology. Case studies in volcanic areas of the world suggest that soil structural changes caused by seismic shaking results in landslide activity. It is critical to constrain how this kind of soil behaves during coseismic ground shaking, as well as the effects of dynamic loading on shear strength parameters after shaking. Direct shear tests carried out on cineritic volcanic materials from the Pudahuel Ignimbrite formation in central Chile show a direct effect of cyclic loading on the shear strength and in a minor extent on the rheology. A high apparent cohesion found in monotonic shear tests, likely attributed to suction and cementation, is destroyed by dynamic loading. At the same time, the internal friction angle rises. This defines a differential post-dynamic behaviour depending on normal effective stress conditions, which favour the occurrence of shallow landslides. These results show how the use of shear strength parameters obtained from standard monotonic direct shear tests may produce misleading results when analysing seismic slope stability in this type of soils.

Swirad Z.M.; Rosser, N.J.; Brain, M.J., and Vann Jones, E.C., 2016. What controls the geometry of rocky coasts at the local scale? In: Vila-Concejo, A.; Bruce, E.; Kennedy, D.M., and McCarroll, R.J. (eds.), Proceedings of the 14th International Coastal Symposium (Sydney, Australia). Journal of Coastal Research, Special Issue, No. 75, pp. 612–616. Coconut Creek (Florida), ISSN 0749-0208. There is a need to understand the controls on rocky coastal form in order to predict the likely response to climate changes and sea-level rise. Spatial variations in coastal geometry result from inheritance and contemporary processes, notably erosive wave intensity and rock resistance. We studied a 4.2 km long section of coastline (Staithes, North Yorkshire, UK) using LiDAR point cloud data and ortho-photographs. We represented the coast as a series of densely-spaced (25 m) and resampled (0.2 m) 2D cross-sections. GIS-based statistical analysis allowed us to identify relationships between coastal morphology, geolo...

Rainfall and slope-cutting for road construction are two key landslide causative factors in Nepal, but how they interact to cause failures is poorly understood. To improve understanding of the effects of cut slopes during rainfall, geotechnical investigations and field monitoring were conducted in a mountainous district, Sindhupalchowk, located in central Nepal. This paper presents the results of the field-investigations and the measurements of volumetric water content obtained from the sensors installed in the study-site. Field-based evidence suggests that the slope that was cut for road construction during the dry period remained stable due to the presence of soil suction, which imparted additional strength to the soil. At the start of the monsoon, infiltration of rainwater caused saturation of the soil at shallow depth, consequently causing loss of suction and reduction of the soil strength. The presence of the road-cut in the hillslope resulting in steeper slopes then promoted the failure. These observations suggest that the presence of road-cuts in the hillslopes can cause landslides even during non-exceptional rainfall events.

We present a monitoring technique tailored to analysing change from near-continuously collected, high-resolution 3-D data. Our aim is to fully characterise geomorphological change typified by an event magnitude–frequency relationship that adheres to an inverse power law or similar. While recent advances in monitoring have enabled changes in volume across more than 7 orders of magnitude to be captured, event frequency is commonly assumed to be interchangeable with the time-averaged event numbers between successive surveys. Where events coincide, or coalesce, or where the mechanisms driving change are not spatially independent, apparent event frequency must be partially determined by survey interval.The data reported have been obtained from a permanently installed terrestrial laser scanner, which permits an increased frequency of surveys. Surveying from a single position raises challenges, given the single viewpoint onto a complex surface and the need for computational efficiency associated with handling a large time series of 3-D data. A workflow is presented that optimises the detection of change by filtering and aligning scans to improve repeatability. An adaptation of the M3C2 algorithm is used to detect 3-D change to overcome data inconsistencies between scans. Individual rockfall geometries are then extracted and the associated volumetric errors modelled. The utility of this approach is demonstrated using a dataset of ∼ 9 × 103 surveys acquired at ∼ 1 h intervals over 10 months. The magnitude–frequency distribution of rockfall volumes generated is shown to be sensitive to monitoring frequency. Using a 1 h interval between surveys, rather than 30 days, the volume contribution from small (3) rockfalls increases from 67 to 98 % of the total, and the number of individual rockfalls observed increases by over 3 orders of magnitude. High-frequency monitoring therefore holds considerable implications for magnitude–frequency derivatives, such as hazard return intervals and erosion rates. As such, while high-frequency monitoring has potential to describe short-term controls on geomorphological change and more realistic magnitude–frequency relationships, the assessment of longer-term erosion rates may be more suited to less-frequent data collection with lower accumulative errors.

Predictive models used to assess the magnitude of coseismic landslide strain accumulation in response to earthquake ground shaking typically consider slope-parallel ground accelerations only and ignore both the influence of coseismic slope-normal ground accelerations and the phase relationship between dynamic slope-normal and slope-parallel accelerations. We present results of a laboratory study designed to assess the significance of the phase offset between slope-normal and slope-parallel cyclic stresses on the generation of coseismic landslide displacements. Using a dynamic back-pressured shearbox that is capable of simulating variably phased slope-normal and slope-parallel dynamic loads, we subjected sediment samples to a range of dynamic loading scenarios indicative of earthquake-induced ground shaking. We detail the variations in strain accumulation observed when slope-normal and slope-parallel stresses occur independently and simultaneously, both in and out of phase, using a range of dynamic stress amplitudes. Our results show that the instantaneous phasing of dynamic stresses is critical in determining the amount of coseismic landslide displacement, which may vary by up to an order of magnitude based solely on wave-phasing effects. Instantaneous strain rate is an exponential function of the distance normal to the Mohr Coulomb failure envelope in plots of shear stress against normal effective stress. This distance is strongly controlled by the phase offset between dynamic normal and shear stresses. Our results demonstrate that conditions considered by conventional coseismic slope stability models can either overestimate or underestimate earthquake-induced landslide displacement by up to an order of magnitude. This has important implications for accurate assessment of coseismic landslide hazard.

Linking hard rock coastal cliff erosion to environmental drivers is challenging, with weak relationships commonly observed in comparisons of marine and subaerial conditions to the timing and character of erosion. The aim of this paper is to bring together datasets to explore how best to represent conditions at the coast and to test relationships with erosion, which on this coast is primarily achieved via rockfalls. On the N. Yorkshire coast in the UK we compare a continuously monitored microseismic dataset, regionally monitored coastal environmental conditions, modelled at-cliff conditions and periodic high-resolution 3D monitoring of changes to the cliff face over a 2-year period. Cliff-top microseismic ground motions are generated by a range of offshore, nearshore and at-cliff sources. We consider such ground motions as proxies for those conditions that promote the occurrence of rockfalls and erosion. Both these data and modelled at-cliff water levels provide improved insight into conditions at, and wave energy transfer to, the cliff. The variability in microseismic, modelled and regionally-monitored environmental data derives statistically significant relationships with increases in the occurrence of rockfalls. The results demonstrate a marine control on the total volume and size characteristics of rockfalls. The strongest relationships found are with rockfalls sourced from across the entire cliff, rather than just at the toe, indicating that the marine influence, albeit indirectly, extends above and beyond the area inundated. These results identify failure mechanisms driving erosion, where a range of processes unique to the coast trigger failure, but in a manner beyond purely wave action at the cliff toe. Greater erosion occurs at the cliff toe. However, comparing water level inundation frequency, microseismic energy transfer and erosion, we observe that heights up the cliff that correspond with water levels associated with low frequency, high energy storms, or more frequent inundation, do not experience increased erosion. Our results describe the relationship between inundation duration, energy transfer and erosion of hard rock cliffs, and illustrate the relative intensity of erosion response to variations in these conditions. Implicitly our data suggests that in future, cliffed rocky coasts may be relatively quick to respond to changes in environmental forcing.

Salt-marsh sediments provide accurate and precise reconstructions of late Holocene relative sea-level changes. However, compaction of salt-marsh stratigraphies can cause post-depositional lowering (PDL) of the samples used to reconstruct sea level, creating an estimation of former sea level that is too low and a rate of rise that is too great. We estimated the contribution of compaction to late Holocene sea-level trends reconstructed at Tump Point, North Carolina, USA. We used a geotechnical model that was empirically calibrated by performing tests on surface sediments from modern depositional environments analogous to those encountered in the sediment core. The model generated depth-specific estimates of PDL, allowing samples to be returned to their depositional altitudes. After removing an estimate of land-level change, error-in-variables changepoint analysis of the decompacted and original sea-level reconstructions identified three trends. Compaction did not generate artificial sea-level trends and cannot be invoked as a causal mechanism for the features in the Tump Point record. The maximum relative contribution of compaction to reconstructed sea-level change was 12%. The decompacted sea-level record shows 1.71 mm yr− 1 of rise since AD 1845.

We present a monitoring technique tailored to analysing change from near-continuously collected, high-resolution 3D data. Our aim is to fully characterise geomorphological change typified by an event magnitude frequency relationship that adheres to an inverse power law or similar. While recent advances in monitoring have enabled changes in volume across more than seven orders of magnitude to be captured, event frequency is commonly assumed to be interchangeable with the time-averaged event numbers between successive surveys. Where events coincide, or coalesce, or where the mechanisms driving change are not spatially independent, apparent event frequency must be partially determined by survey interval. The data reported has been obtained from a permanently installed terrestrial laser scanner, which permits an increased frequency of surveys. Surveying from a single position raises challenges, given the single viewpoint onto a complex surface and the need for computational efficiency associated with handling a large time series of 3D data. A workflow is presented that optimises the detection of change by filtering and aligning scans to improve repeatability. An adaptation of the M3C2 algorithm is used to detect 3D change, to overcome data inconsistencies between scans. Individual rockfall geometries are then extracted and the associated volumetric errors modelled. The utility of this approach is demonstrated using a dataset of ~ 9 × 10 3 surveys acquired at ~ 1 hour intervals over 10 months. The magnitude-frequency distribution of rockfall volumes generated is shown to be sensitive to monitoring frequency. Using a 1 h interval between surveys, rather than 30 days, the volume contribution from small ( 3 ) rockfall increases from 67 % to 98 % of the total, and the number of individual rockfall observed increases by over three orders of magnitude. High frequency monitoring therefore holds considerable implications for magnitude-frequency derivatives, such as hazard return intervals and erosion rates. As such, while high frequency monitoring has potential to describe short-term controls on geomorphological change and more realistic magnitude-frequency relationships, the assessment of longer-term erosion rates may be more suited to less frequent data collection with lower accumulative errors.

We characterise and analyse the detachment (scar) surfaces of rockfalls to understand the mechanisms that underpin their failure. Rockfall scars are variously weathered and comprised of both discontinuity release surfaces and surfaces indicative of fracturing through zones of previously intact rock, known as rock bridges. The presence of rock bridges and pre-existing discontinuities is challenging to quantify due to the difficulty in determining discontinuity persistence below the surface of a rock slope. Rock bridges form an important control in holding blocks onto rockslopes, with their frequency, extent and location commonly modelled from the surface exposure of daylighting discontinuities. We explore an alternative approach to assessing their role, by characterising failure scars. We analyse a database of multiple rockfall scar surfaces detailing the areal extent, shape, and location of broken rock bridges and weathered surfaces. Terrestrial laser scanning and gigapixel imagery were combined to record the detailed texture and surface morphology. From this, scar surfaces were mapped via automated classification based on RGB pixel values. Our analysis of the resulting data from scars on the North Yorkshire coast (UK) indicates a wide variation in both weathering and rock bridge properties, controlled by lithology and associated rock mass structure. Importantly, the proportion of rock bridges in a rockfall failure surface does not increase with failure size. Rather larger failures display fracturing through multiple rock bridges, and in contrast smaller failures fracture occurs only through a single critical rock bridge. This holds implications for how failure mechanisms change with rockfall size and shape. Additionally, the location of rock bridges with respect to the geometry of an incipient rockfall is shown to determine failure mode. Weathering can occur both along discontinuity surfaces and previously broken rock bridges, indicating the sequential stages of progressively detaching rockfall. Our findings have wider implications for hazard assessment where rock slope stability is dependent on the nature of rock bridges, how this is accounted for in slope stability modelling, and the implications of rock bridges on long-term rock slope evolution.

Background Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. Methods A systematic review and meta-analysis was performed by searching Pubmed (MEDLINE) and Ovid EMBASE libraries from inception to 29th February 2016 for all studies with a comparator or independent variable relating to CRRT circuits and reporting filter life. Included studies documented filter life in hours with a comparator other than anti-coagulation intervention. All studies comparing anticoagulation interventions were searched for regression or hazard models pertaining to other sources of variation in filter life. Results Eight hundred nineteen abstracts were identified of which 364 were selected for full text analysis. 24 presented data on patient modifiers of circuit life, 14 on vascular access modifiers and 34 on circuit related factors. Risk of bias was high and findings are hypothesis generating. Ranking of vascular access site by filter longevity favours: tunnelled semi-permanent catheters, femoral, internal jugular and subclavian last. There is inconsistency in the difference reported between femoral and jugular catheters. Amongst published literature, modality of CRRT consistently favoured continuous veno-venous haemodiafiltration (CVVHD-F) with an associated 44% lower failure rate compared to CVVH. There was a trend favouring higher blood flow rates. There is insufficient data to determine advantages of haemofilter membranes. Patient factors associated with a statistically significant worsening of filter life included mechanical ventilation, elevated SOFA or LOD score, elevations in ionized calcium, elevated platelet count, red cell transfusion, platelet factor 4 (PF-4) antibodies, and elevated fibrinogen. Majority of studies are observational or report circuit factors in sub-analysis. Risk of bias is high and findings require targeted investigations to confirm. Conclusion The interaction of patient, pathology, anticoagulation, vascular access, circuit and staff factors contribute to CRRT filter life. There remains an ambiguity from published data as to which site and side should be the first choice for vascular access placement and what interaction this has with patient factors and timing. Early consideration of tunnelled semi-permanent access may provide optimal filter life if longer periods of CRRT are anticipated. There remains an absence of robust evidence outside of anti-coagulation strategies despite over 20 years of therapy delivery however trends favour CVVHD-F over CVVH.

This paper considers the role that microseismic ground displacements may play in fracturing rock via cyclic loading and subcritical crack growth. Using a coastal rock cliff as a case study, we firstly undertake a literature review to define the spatial locations that may be prone to microseismic damage. It is suggested that microseismic weakening of rock can only occur in ‘damage accumulation zones’ of limited spatial extent. Stress concentrations resulting from cliff height, slope angle and surface morphology may nucleate and propagate a sufficiently dense population of microcracks that can then be exploited by microseismic cyclic loading. We subsequently examine a 32-day microseismic dataset obtained from a coastal cliff-top location at Staithes, UK. The dataset demonstrates that microseismic ground displacements display low peak amplitudes that are punctuated by periods of greater displacement during storm conditions. Microseismic displacements generally display limited preferential directivity, though we observe rarely occurring sustained ground motions with a cliff-normal component during storm events. High magnitude displacements and infrequently experienced ground motion directions may be more damaging than the more frequently occurring, reduced magnitude displacements characteristic of periods of relative quiescence. As high magnitude, low frequency events exceed and then increase the damage threshold, these extremes may also render intervening, reduced magnitude microseismic displacements ineffective in terms of damage accumulation as a result of crack tip blunting and the generation of residual compressive stresses that close microcracks. We contend that damage resulting from microseismic ground motion may be episodic, rather than being continuous and in (quasi-)proportional and cumulative response to environmental forcing. A conceptual model is proposed that describes when and where microseismic ground motions can operate effectively. We hypothesise that there are significant spatial and temporal limitations on effective microseismic damage accumulation, such that the net efficacy of microseismic ground motions in preparing rock for fracture, and hence in enhancing erosion, may be considerably lower than previously suggested in locations where high magnitude displacements punctuate ‘standard’ displacement conditions. Determining and measuring the exact effects of microseismic ground displacement on damage accumulation and as a trigger to macro-scale fracture in the field is not currently possible, though our model remains consistent with field observations and conceptual models of controls on rockfall activity.

[1] A two-year dataset of coastal cliff microseismic ground motions is used to explore energy transfer to a cliff. The long-term dataset enables us to characterise cliff motion responses to a wide range of environmental processes and examine whether short-term characteristics are representative of the long-term. We examine whether cliff-top motions are reliable proxies for environmental processes to inform future investigations into the drivers of erosion. The study is based at an actively eroding, macrotidal, hard rock cliffed coast where considerable intra-annual variability in wave, tide, and storm conditions permit the examination of a full range of environmental permutations. Three frequency bands of ground motion are identified that represent wind and wave processes that transfer energy to the cliff. Examining mean energy transfer by aggregating the frequency bands by sea water elevation reveals a notable departure from tidal inundation duration alone, of relevance to understanding the timing, duration and intensity of effective processes of erosion. Peak energy transfer to the cliff face occurs during the largest storms where water levels significantly exceed those of tidal inundation rather than at locations most frequently inundated by tides. We anticipate it is therefore these conditions that are likely to be most effective in eroding hard rock coasts, rather than periods which accrue energy transfer associated with still or calm waters, and hence tidally modulated inundation may not relate well to coastal erosion. Promisingly, despite signal overlap and noise, cliff-top motions can be used as proxies for the processes that transfer energy to the coast.

The quantitative physicochemical model of human acid–base physiology filled a void that had developed between clinical acid–base analysis and general fluid physiology. Established approaches centred on the Henderson–Hasselbach (HH) equation allow a satisfactory exploration of respiratory perturbations but do not fully elucidate mechanisms of common non-respiratory ‘metabolic' components. Though useful at the bedside, commonly used ‘rules of thumb' that classify disturbances based on quantification of bicarbonate relative to CO 2 have also fostered a language that often misrepresents bicarbonate physiology. The physicochemical model is frequently perceived as too complex for bedside use, however a set of simplified screening questions based on Stewart's model can be utilized to aid acid–base interpretation. Examples using this approach are included in an online appendix. Emphasis is placed on understanding the consequences of hypoalbuminaemia, volume, tonicity and chloride derangements as these are common in the care of intensive care unit patients. Aetiologies of acid–base disturbances are well described elsewhere and are not repeated here.

The most commonly used methods for detecting and characterising regional-scale changes in cliff morphology involve differencing high resolution Digital Elevation Models. An inherent assumption of this 2D method is that the cliff can be reduced to a planar surface, which becomes invalid where cliffs change aspect. In this paper we examine the relative benefits of 2D and 3D methods of change detection, the latter of which draw on raw point cloud data, for deriving inventories of change. In our analysis we test both methods of change detection on two high resolution point clouds derived from Terrestrial Laser Scanning of the coastal cliffs at Staithes, North Yorkshire (UK). The analysis highlights the importance of the chosen method for accurately constraining the size distributions of rockslope failures, as well as the geometry of the failures themselves. We conclude by considering the implications of 3D techniques for defining rockfall geometry and inferring different processes of change.

Extracorporeal life support (ECLS) describes several advancing technologies of broadening scope that support severe cardiorespiratory dysfunction in critically ill patients. ECLS provides alternatives when mechanical ventilation does not suffice to deliver adequate oxygenation or carbon dioxide clearance. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supports gas exchange in venous blood returning to the right heart. ECLS can also be configured to provide mechanical support of the failing circulation; veno-arterial extracorporeal membrane oxygenation (VA-ECMO) augments systemic blood flow utilising the extracorporeal blood pump. As patients can be critically dependent on these supports, a thorough understanding of the systems and their interaction with the body is essential in applying ECLS and in preventing or ameliorating problems that can arise.

We model cliff erosion using an approach based upon the negative power law scaling properties of rockfall magnitude–frequency distributions. These are derived from an extensive, high resolution, rockfall inventory for a series of sea cliffs near Staithes, North Yorkshire. A comparison between observed volumetric erosion and that produced by the model yields a statistically significant correlation. However, we note that the temporal resolution of the inventory can have an influence on results. Our data indicate that monthly inventories are capable of producing magnitude–frequency relations that model erosion in good correlation with observed events. However, for months that experience high magnitude events, seasonal inventories are more appropriate. Furthermore, increasing the return period between surveys has the effect of increasing the superimposition of rockfall events thereby reducing the slope of the power law, giving an incorrect picture of the scaling properties of rockfalls at this site. Applying observed variations in the negative power law scaling parameters to a probabilistic simulation model of cliff retreat provides a new means of assessing the most likely erosional scenarios and indicates that the current dataset may not be indicative of long term cliff evolution. This may provide a quantitative means of establishing an appropriate time window for characterizing rockfall erosion over decadal time scales.

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.

Despite much research on the myriad processes that erode rocky coastal cliffs, accurately predicting the nature, location, and timing of coastline retreat remains challenging, and is confounded by the apparently episodic nature of cliff failure. The dominant drivers of coastal erosion, marine and subaerial forcing, are anticipated to increase in the future, so understanding their present and combined efficacy is fundamental to improving predictions of coastline retreat. We captured change using repeat laser scanning across 2.7 × 104 m2 of near-vertical rock cliffs on the UK North Sea coast over 7 yr to determine the controls on the rates, patterns, and mechanisms of erosion. For the first time we document that progressive upward propagation of failure dictates the mode and defines the rate at which marine erosion of the toe can accrue retreat of coastline above; this is a failure mechanism not conventionally considered in cliff stability models. Propagation of instability and failure operates at these sites at 10 yr time scales and is moderated by local rock mass strength and the time dependence of rock fracture. We suggest that once initiated, failure propagation can operate ostensibly independently to external environmental forcing, and so may not be tightly coupled to prevailing subaerial and oceanographic conditions. Our observations apply to coasts of both uniform and complex lithology, where failure geometry is defined by rock mass strength and structure, and not intact rock strength alone, and where retreat occurs via any mode other than full cliff collapse.

Advances in the collection and analysis of landslide inventory data have allowed for greater understanding of spatial distributions of landslides triggered by earthquakes. However, current approaches to analysing and modelling these phenomena do not account for the response of the individual potential landslide masses and their temporally evolving stability. This stems, in part, from the lack of a conceptual model describing the effect of seismic waves on the strength and stability of hillslopes, which can be applied at the regional scale and over long (multiple earthquake) time scales. Here we present such a conceptual model linking weakening via progressive failure, inertial displacements driven by seismic ground accelerations, and the repeating failure of sections of hillslopes through time. We explore the implications of the model for how various characteristics of earthquake-triggered landslide distributions are interpreted and understood. These include the apparently stochastic nature of spatial landslide occurrence, spatial patterns of landsliding, landslide magnitude-frequency distributions, global variability in numbers of landslides triggered by earthquakes, and in particular why in any earthquake smaller areas of hillslope fail than do not, even in regions of apparently high landslide susceptibility. Finally, we also propose means of testing the validity of this model relative to alternative hypotheses.

Existing geotechnical approaches that describe volumetric changes in intertidal sediments in response to applied vertical effective stresses are limited by a lack of empirical research into their one-dimensional compression behaviour. In this paper we address this deficiency by presenting the results of an investigation into the compression behaviour of minerogenic low marsh and tidal flat sediments. We have tested samples of these sediment types obtained from Greatham Creek (Cowpen Marsh, Tees Estuary, UK). Analysis of physical properties and oedometer compression tests demonstrates that, contrary to the implicit assumptions of existing models, the surface sediments studied are overconsolidated. Structural variability between samples arises due to sedimentological factors, notably variations in organic content. We attribute overconsolidation to tidal exposure and falls in groundwater level that permit desiccation and cause capillary suction stresses. Greater rates of compression with respect to effective stress occur in sediments with higher initial voids ratios and more open, unstable initial structures. Variability in structure decreases with application of higher effective stresses due to the destructuration of the sediments, which also creates increased homogeneity of compression behaviour under higher effective stresses. We subsequently develop a new conceptual framework to describe compression behaviour in minerogenic intertidal sediments that incorporates overconsolidation. We advocate a statistical approach that accounts for structural variability and variations in compression behaviour at effective stresses less than and greater than the yield stress. We argue that our conceptual framework is broadly applicable to minerogenic intertidal sediments at different locations and burial depths within Holocene stratigraphic sequences providing site-specific compression data are collected. Inter-site transfer and application of measured material properties should not be undertaken due to local variations in compression behaviour resulting from varying ecological, sedimentological, geochemical, climatic, geomorphic and hydrographic conditions. The individual characteristics of different field locations should be carefully considered before the suggested framework is routinely applied.