Surficial Geologic Map of the Flaherty 7.5-Minute Quadrangle, Kentucky

The Flaherty 7.5-minute quadrangle is located southwest of Louisville and northwest of Elizabethtown along the boundary between Hardin and Meade Counties. The quadrangle includes mostly the Pennyroyal region of the Mississippian Plateau and also smaller areas of the Mammoth Cave plateau and the highly dissected Dripping Springs escarpment in the western half of the map area (McDowell, 1986). Topography is mostly characterized by pervasive sinkhole development in a lower elevation and low-relief plain, and high-relief plateaus, ridges, and knobs of the Dripping Springs escarpment scattered along the west side of the quadrangle. Swadley (1963) mapped the bedrock geology of the quadrangle, which was later digitized by Crawford (2002). Mississippian bedrock is exposed throughout the quadrangle and is cut by several normal faults in the south. The St. Louis Limestone and overlying Ste. Genevieve Limestone are the oldest and lowest (stratigraphy and elevation) map units in Flaherty, and underlie the Pennyroyal region. The higher elevation landforms characterizing the Dripping Springs escarpment are predominantly underlain by the Paoli Limestone, Beaver Bend Limestone, and Sample Sandstone, from oldest to youngest respectively. The Mooretown Formation is stratigraphically above the Paoli Limestone and below the Beaver Bend Limestone, and is only exposed along Sand Ridge, a prominent landform in the quadrangle trending northeast to southwest. Previously mapped surficial deposits include alluvium in Otter Creek, Flippin Creek, and a large karst basin, and “slumped sandstone” (colluvium) along Sand Ridge and other smaller areas throughout the quadrangle (Swadley, 1963)

Surficial Geologic Map of the Big Clifty 7.5-Minute Quadrangle, Kentucky

The Big Clifty 7.5-minute quadrangle is located south of Louisville and west of Elizabethtown along the boundary between Hardin and Grayson Counties. The quadrangle lies within the Mammoth Cave plateau of the Mississippian Plateau physiographic region (McDowell, 1986). Topography is characterized by a low relief plain sitting at elevations between 650 to 850 ft above sea level, which is dissected and incised by Rough River, Meeting Creek, Clifty Creek, and their tributaries to below 500 ft. Swadley (1962) mapped the bedrock geology of the quadrangle, which was later digitized by Conley (2002). Mississippian bedrock is exposed throughout the quadrangle and is cut by several vertical faults in the southeast. The oldest bedrock units include the Beaver Bend and Paoli Limestones, Sample Sandstone, and Reelsville Limestone from oldest to youngest, respectively, and are exposed in the lowest sections of river valleys on the west side of the quadrangle. The Golconda Formation (Beech Creek Limestone, Big Clifty Sandstone, and Haney Limestone Members) is primarily exposed along steep slopes of those same river valleys, which lead up to the top of the plateau. The majority of the broad Mammoth Cave plateau is underlain by Hardinsburg Sandstone with local exposures of Glen Dean Limestone and Leitchfield Formation occurring in the southwest corner of the quadrangle. Previously mapped surficial deposits include scattered areas of alluvium in Meeting Creek, Little Meeting Creek, and Clifty Creek (Swadley, 1962)

Surficial Geologic Map of the Millerstown 7.5-Minute Quadrangle, Kentucky

The Millerstown 7.5-minute quadrangle is located south of Louisville and southwest of Elizabethtown along the boundaries between Hardin, Grayson, and Hart Counties and within the Mississippian Plateau physiographic region (McDowell, 1986). Topography is characterized by the low relief Pennyroyal plain that sits at altitudes below about 650 ft above sea level, the low relief Mammoth Cave plateau at altitudes above about 650 ft, and steep slopes of and isolated knobs of the incised Dripping Springs escarpment that separates the two plains. Moore (1965) mapped the bedrock geology of the quadrangle, which was later digitized by Johnson (2006). Mississippian bedrock and local areas of Pennsylvanian bedrock are exposed throughout most of the quadrangle, all, of which, are cut by several vertical faults. The Ste. Genevieve Limestone is the oldest lithology and underlies the Pennyroyal region in the northeast and southwest corners of the quadrangle, and locally along the Nolin River. The Beaver Bend Limestone, Mooretown Formation, Paoli Limestone, Sample Sandstone, and Reelsville Limestone stratigraphic sequence underlie most of the remaining Pennyroyal plain and several steep slopes of the Dripping Springs escarpment. The Beech Creek Limestone, Big Clifty Sandstone, and Haney Limestone Members of the Golconda Formation are exposed along the Dripping Springs escarpment the edges of the Mammoth Cave plateau region. Most of the Mammoth Cave plateau is underlain by the Hardinsburg Limestone, and, locally in the southwest corner of the quadrangle, the Glen Dean Limestone, Leitchfield Formation, and Pennsylvanian Caseyville Formation. Previously mapped surficial deposits include minor areas of alluvium in tributaries across the Millerstown quadrangle (Moore, 1964)

Surficial Geologic Map of the Summit 7.5-Minute Quadrangle, Kentucky

The Summit 7.5-minute quadrangle is located south of Louisville and west of Elizabethtown along the boundary between Hardin and Grayson Counties and within the Mississippian Plateau physiographic region (McDowell, 1986). Topography is characterized by the low relief Pennyroyal region that sits at elevations between 560 to 650 ft above sea level, the low relief Mammoth Cave plateau at elevations between 750 to 900 ft, and the steep Dripping Springs escarpment that separates the two plains. Moore (1964) mapped the bedrock geology of the quadrangle, which was later digitized by Conley (2002). Mississippian bedrock is exposed throughout the quadrangle and is cut by several vertical faults. The St. Louis Limestone and overlying Ste. Genevieve Limestone underlie the Pennyroyal region and are the oldest bedrock units in the quadrangle. The Beaver Bend and Paoli Limestones, Sample Sandstone, Reelsville Limestone, and Beech Creek Limestone Member of the Golconda Formation are exposed along the Dripping Springs escarpment. The Mammoth Cave plateau region is underlain by the Big Clifty Sandstone and, locally, Haney Limestone Members of the Golconda Formation east of the Summit Fault, and Hardinsburg Sandstone west of the fault. Previously mapped surficial deposits include minor areas of alluvium in tributaries across the Summit quadrangle, and areas of “slumped sandstone” (colluvium) in the Pennyroyal region (Moore, 1964)

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The value of open-source clinical science in pandemic response: lessons from ISARIC

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