A foraminiferal sea-level reconstruction from Pauatahanui Inlet, southern North Island, New Zealand

Vertical land movement associated with interseismic subsidence and slow-slip events pose a major complicating factor when understanding how sea-level rise is likely to affect New Zealand's capital city of Wellington. To understand how these factors have affected sea level in the long-term, and thereby gain geological context for these movements, the nearest undisturbed salt marsh (Pauatahanui Inlet) was surface sampled and cored. These samples were used to assess the relationship between species of foraminifera (a group of testate protists) and elevation, then apply these relationships down-core to calculate past sea level. The nearest continuous GPS station (Paekakariki Hill) displays 1.7±0.35 mm/yr subsidence since its installation in the year 2000 (Tenzer and Fadil, 2016). However, according to a variety of transfer functions (statistical techniques which relate foraminiferal assemblage to elevation), our sediment core data indicate that, since the 1855 earthquake (which leaves a very distinct signature in the record), relative sea level has risen at Pauatahanui by ~1.4 to 1.6 mm/yr. This is less than what would be expected from subsidence alone, yet also must incorporate a significant signal from anthropogenic sea-level rise. We therefore interpret that the slow subsidence in the cGPS record likely indicates a short-term signal which, over the course of the past century, has been counteracted by the combined influence of events such as slow-slip associated with the Kapiti Coast source region, post-and co-seismic uplift, and possibly variations in subsidence rate. This, combined with the lower than expected rates of sea-level rise at the Wellington tide gauge from nearby cGPS stations, suggests that it is unwise to base local sea level projections on the observed recent net subsidence alone without factoring in the long-term effect of slow-slip and co-seismic uplif

Long-Term Outcome of Anti-Glomerular Basement Membrane Antibody Disease Treated with Immunoadsorption

<div><p>Background</p><p>Anti-glomerular basement membrane (GBM) antibody disease may lead to acute crescentic glomerulonephritis with poor renal prognosis. Current therapy favours plasma exchange (PE) for removal of pathogenic antibodies. Immunoadsorption (IAS) is superior to PE regarding efficiency of antibody-removal and safety. Apart from anecdotal data, there is no systemic analysis of the long-term effects of IAS on anti-GBM-disease and antibody kinetics.</p><p>Objective</p><p>To examine the long-term effect of high-frequency IAS combined with standard immunosuppression on patient and renal survival in patients with anti-GBM-disease and to quantify antibody removal and kinetics through IAS.</p><p>Design</p><p>Retrospective review of patients treated with IAS for anti-GBM-antibody disease confirmed by biopsy and/or anti-GBM-antibodies.</p><p>Setting</p><p>University Hospital of Vienna, Austria.</p><p>Participants</p><p>10 patients with anti-GBM-disease treated with IAS.</p><p>Measurements</p><p>Patient and renal survival, renal histology, anti-GBM-antibodies.</p><p>Results</p><p>Anti-GBM-antibodies were reduced by the first 9 IAS treatments (mean number of 23) to negative levels in all patients. Renal survival was 40% at diagnosis, 70% after the end of IAS, 63% after one year and 50% at the end of observation (mean 84 months, range 9 to 186). Dialysis dependency was successfully reversed in three of six patients. Patient survival was 90% at the end of observation.</p><p>Conclusion</p><p>IAS efficiently eliminates anti-GBM-antibodies suggesting non-inferiority to PE with regard to renal and patient survival. Hence IAS should be considered as a valuable treatment option for anti-GBM-disease, especially in patients presenting with a high percentage of crescents and dialysis dependency due to an unusual high proportion of responders.</p></div

Cumulative costs of immunoadsorption and plasma exchange.

<p>Circles and triangles depict earliest timepoints of adsorber change due to reduced adsorption capacity (every 25 treatments for Immunosorba, every 35 treatments for Globaffin).</p

Baseline characteristics of patients treated.

<p>Baseline characteristics of patients treated.</p

Extracorporal treatment and concomitant immunosuppression.

<p>Extracorporal treatment and concomitant immunosuppression.</p

Renal function and patient survival.

<p>Renal function and patient survival.</p

Anti-GBM antibody kinetics and renal function in patient #7 (2a) and patient #10 (2b).

<p>Antibody values at diagnosis, before and after IAS, 12 hours in between sessions and up to 6 weeks; arrows depict daily IAS sessions. Grey area depicts negativity of the assay.</p

Dynamics of serum-creatinine of individual patients.

<p>Observation period from start of IAS until 5 years. White coloured time points depict positive anti-GBM antibody testing.</p

Anti-GBM antibody levels from start of immunoadsorption until end of observation.

<p>Mean values ± standard deviation of all patients measured with ELISA depicted. Grey area denotes negativity of the assay.</p