We analyzed coastal sediments of the Santa Barbara Basin, California, for historical changes in microplastic deposition using a box core that spanned 1834–2009. The sediment was visually sorted for plastic, and a subset was confirmed as plastic polymers via FTIR (Fourier transform infrared) spectroscopy. After correcting for contamination introduced during sample processing, we found an exponential increase in plastic deposition from 1945 to 2009 with a doubling time of 15 years. This increase correlated closely with worldwide plastic production and southern California coastal population increases over the same period. Increased plastic loading in sediments has unknown consequences for deposit-feeding benthic organisms. This increase in plastic deposition in the post–World War II years can be used as a geological proxy for the Great Acceleration of the Anthropocene in the sedimentary record.

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Objectives: To determine the feasibility and impact of real-time anti-factor Xa (aFXa) level monitoring and enoxaparin dose adjustment in orthopaedic trauma. To examine the adequacy of standard fixed-dose enoxaparin chemoprophylaxis and to examine whether patient-specific factors influence enoxaparin metabolism. Design: Prospective cohort. Setting: Academic Level-I trauma center. Patients: Postoperative adult orthopaedic trauma patients undergoing acute fracture or nonunion surgery of the pelvis, acetabulum, or lower extremity placed on 30 mg of enoxaparin twice daily. Intervention: Peak steady-state aFXa levels were drawn with a goal range of 0.2–0.4 IU/mL. Patients with out-of-range levels underwent a 10-mg dose adjustment followed by repeat aFXa draws. Main Outcome Measures: Peak and trough aFXa levels, 90-day venous thromboembolism, and bleed events. Results: Of 109 enrolled patients, 43% had inadequate initial peak aFXa levels (aFXa < 0.2 IU/mL) with standard dosing. Higher gross weight, acetabular surgery, and operation length predicted low aFXa levels (P < 0.001, 0.006, 0.004, respectively). Dose adjustment increased the proportion of patients with in-range aFXa levels from 53.2% to 87.8% (P < 0.001). Patients with low aFXa levels during hospitalization or at discharge had significantly higher 90-day deep vein thrombosis and pulmonary embolism rates compared to those with adequate aFXa levels (deep vein thrombosis 12% vs. 1.36%; P = 0.023, pulmonary embolism 8% vs. 0%; P = 0.027). There were no major bleed events. Conclusions: Patients receiving inadequate enoxaparin chemoprophylaxis were at significantly increased risk of 90-day venous thromboembolism. Standard fixed-dose enoxaparin provided inadequate chemoprophylaxis in 43% of postoperative orthopaedic trauma patients, which significantly improved with dose adjustment. Weight, acetabular surgery, and operation length predicted inadequate enoxaparin prophylaxis. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.