Airway events in obese vs. non-obese elective surgical patients: a cross-sectional observational study

Obesity is an increasingly prevalent comorbidity within the UK population. The aim of this study was to determine the proportion of obese patients in an elective surgical population. The second aim was to determine the choice of airway equipment and incidence of airway events in obese vs. non-obese patients. We conducted a cross-sectional observational study over two 24-h periods in March 2018 across 39 hospitals in the greater London area. Data were collected regarding 1874 patients. The incidence of obesity was 32% in the study population compared with 26% in the general UK population (p < 0.0001). Minor airway events were defined as: desaturation to Sp O2 < 90%; failed mask ventilation; supraglottic airway device problem; aspiration; airway trauma and difficult intubation; or recognised oesophageal intubation. Major airway events were defined as: unrecognised oesophageal intubation; a 'cannot intubate cannot oxygenate' emergency; the need for unplanned front-of-neck airway; cardiac arrest; or unplanned intensive care unit admission due to an airway event. In total, 89 minor and two major airway events were recorded. Obese patients were more likely to experience a minor airway event (RR 2.39, 95%CI 1.60-3.57), the most common being desaturation (Sp O2 < 90%). The use of a supraglottic airway device in obese vs. non-obese patients was associated with increased airway events (RR 3.46 [1.88-6.40]). Tracheal intubation vs. supraglottic airway device use increased with obesity class but was not associated with a decrease in airway events (RR 0.90 [0.53-1.55]). Our data suggest that obesity is more common in the elective surgical vs. general population and minor airway events are more common in obese vs. non-obese elective patients

Sex-specific variation in facial masculinity/femininity associated with autistic traits in the general population

Reports linking prenatal testosterone exposure to autistic traits and to a masculinized face structure have motivated research investigating whether autism is associated with facial masculinization. This association has been reported with greater consistency for females than for males, in studies comparing groups with high and low levels of autistic traits. In the present study, we conducted two experiments to examine facial masculinity/femininity in 151 neurotypical adults selected for either low, mid-range, or high levels of autistic traits. In the first experiment, their three-dimensional facial photographs were subjectively rated by 41 raters for masculinity/femininity and were objectively analysed. In the second experiment, we generated 6-face composite images, which were rated by another 36 raters. Across both experiments, findings were consistent for ratings of photographs and composite images. For females, a linear relationship was observed where femininity ratings decreased as a function of higher levels of autistic traits. For males, we found a U-shaped function where males with mid-range levels of traits were rated lowest on masculinity. Objective facial analyses revealed that higher levels of autistic traits were associated with less feminine facial structures in females and less masculine structures in males. These results suggest sex-specific relationships between autistic traits and facial masculinity/femininity

The response of ordered alloys to electron irradiation

Imperial Users onl

Geologic Controls on Interaction Between the Edwards and Trinity Aquifers, Balcones Fault System, Texas

Faults of the Balcones fault system exert important controls on the groundwater hydrology of the Edwards and Trinity Aquifers, including the following: (i) faults juxtapose permeable and relatively impermeable hydrogeologic units, (ii) the normal fault system causes structural thinning of the Edwards and Trinity Aquifer strata, and (iii) faults provide potential pathways for infiltration of water into the groundwater systems and for lateral and vertical movement of groundwater. We present examples of these structural geologic controls on aquifer properties using data and observations from the Helotes 7.5-minute quadrangle and the Hidden Valley fault exposed in Canyon Lake Gorge. Geologic framework modeling of the Helotes quadrangle illustrates the strong potential for direct communication between the Edwards Group and Glen Rose Formation in this area. The 100+ m displacement of the Haby Crossing fault is responsible for dropping the Edwards Aquifer from hilltop exposures north of the fault to mostly buried (confined) on the south side of the fault. Consequently, the area designated as Edwards Aquifer recharge zone is at its narrowest in this part of the Balcones Fault Zone. The Hidden Valley fault has an estimated 60-70 m of throw (vertical component of displacement) along the approximately 800 m of Upper Glen Rose Limestone exposure at Canyon Lake Gorge. Water ponds on the fault zone in some places, sinks into the fault along other stretches, and discharges laterally from the fault zone in yet another. These examples of locally high permeability of an exhumed fault show the importance of map-scale faults for groundwater flow. They also cast doubt on interpretations that such faults would act as barriers to across-fault flow in cases where such faults juxtapose Glen Rose Limestone with Glen Rose Limestone or the more permeable Edwards Limestone with Glen Rose Limestone. High permeability zones under and near stream channels may serve as fast pathways of communication from the Trinity to Edwards Aquifers. Direct

Geologic Controls on Interaction Between the Edwards and Trinity Aquifers, Balcones Fault System, Texas

Faults of the Balcones fault system exert important controls on the groundwater hydrology of the Edwards and Trinity Aquifers, including the following: (i) faults juxtapose permeable and relatively impermeable hydrogeologic units, (ii) the normal fault system causes structural thinning of the Edwards and Trinity Aquifer strata, and (iii) faults provide potential pathways for infiltration of water into the groundwater systems and for lateral and vertical movement of groundwater. We present examples of these structural geologic controls on aquifer properties using data and observations from the Helotes 7.5-minute quadrangle and the Hidden Valley fault exposed in Canyon Lake Gorge. Geologic framework modeling of the Helotes quadrangle illustrates the strong potential for direct communication between the Edwards Group and Glen Rose Formation in this area. The 100+ m displacement of the Haby Crossing fault is responsible for dropping the Edwards Aquifer from hilltop exposures north of the fault to mostly buried (confined) on the south side of the fault. Consequently, the area designated as Edwards Aquifer recharge zone is at its narrowest in this part of the Balcones Fault Zone. The Hidden Valley fault has an estimated 60-70 m of throw (vertical component of displacement) along the approximately 800 m of Upper Glen Rose Limestone exposure at Canyon Lake Gorge. Water ponds on the fault zone in some places, sinks into the fault along other stretches, and discharges laterally from the fault zone in yet another. These examples of locally high permeability of an exhumed fault show the importance of map-scale faults for groundwater flow. They also cast doubt on interpretations that such faults would act as barriers to across-fault flow in cases where such faults juxtapose Glen Rose Limestone with Glen Rose Limestone or the more permeable Edwards Limestone with Glen Rose Limestone. High permeability zones under and near stream channels may serve as fast pathways of communication from the Trinity to Edwards Aquifers. Direct

Structural framework of the Edwards Aquifer recharge zone in south-central Texas

The Edwards Aquifer, the major source of water for many communities in central Texas, is threatened by population growth and development over its recharge zone. The location of the recharge and confined zones and the flow paths of the aquifer are controlled by the structure of and deformation processes within the Balcones fault system, a major system of predominantly down-to-the-southeast normal faults. We investigate the geologic structure of the Edwards Aquifer to assess the large-scale aquifer architecture, analyze fault offset and stratigraphic juxtaposition relationships, evaluate fault-zone deformation and dissolution and fault-system architecture, and investigate fault-block deformation and scaling of small-scale (intrablock) normal faults. Characterization of fault displacement shows a pattern of aquifer thinning that is likely to influence fault-block communication and flow paths. Flow-path constriction may be exacerbated by increased fault-segment connectivity associated with large fault displacements. Also, increased fault-zone deformation associated with larger-displacement faults is likely to further influence hydrologic properties. Overall, faulting is expected to produce strong permeability anisotropy such that maximum permeability is subhorizontal and parallel to fault-bedding intersections. At all scales, aquifer permeability is either unchanged or enhanced parallel to faults and in many cases decreased perpendicular to faults