British Journal of Anaesthesia @BJAJournals Twitter profile

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British Journal of Anaesthesia

@BJAJournals

8 months

New randomised trial: In major abdominal surgery, IV lidocaine offers postoperative pain control comparable to thoracic epidural analgesia at 24h. Does IV lidocaine present a viable alternative to epidural analgesia #Anaesthesia

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British Journal of Anaesthesia

@BJAJournals

3 years

#WorldAnaesthesiaDay commemorates the first successful demonstration of ether anaesthesia by Dr. William TG Morton in 1846. Today we celebrate the 175th anniversary of this historic event. #WorldAnesthesiaDay #WAD2021 @ELS_Anesthes @RCoANews @NIAAResearch

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British Journal of Anaesthesia

@BJAJournals

2 years

Defining the role of thoracic spinal anaesthesia. New narrative review by Dr le Roux and colleagues. #anaesthesia #anaesthesia #pain #perioperative

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British Journal of Anaesthesia

@BJAJournals

2 years

How do you decipher the TEG or ROTEM result? Tweet us your department crib sheet! Read our #BJAEd article on POC Viscoelastic testing by @Maddie5789 , Drs Meera Raja and Suehana Rahman. #anaes #anes #MajorHaemorrhage #clotting

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British Journal of Anaesthesia

@BJAJournals

6 years

World Anaesthesia Day 2018 in honour of the first successful demonstration of ether anaesthesia by William Thomas Green Morton (1819–1868) on October 16, 1846 at the Massachusetts General Hospital in Boston #WorldAnaesthesiaDay #WorldAnesthesiaDay

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British Journal of Anaesthesia

@BJAJournals

11 months

What is the optimum algorithm for preventing PONV? New correspondence by Renette et al. #PONV #anaesthesia #perioperative

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British Journal of Anaesthesia

@BJAJournals

6 months

Viscoelastic coagulation monitoring for tranexamic acid: personalised antifibrinolytic dosing? New editorial by Tanaka et al #coagulation #bleeding #TXA #perioperative

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British Journal of Anaesthesia

@BJAJournals

6 months

No patient should receive neuromuscular blockade without quantitative monitoring throughout all phases of anaesthesia. In this month’s #BJAEd article we show you how. @AnaesPK @grantrod0606 #anaesthesia #neuromusculardrugs #perioperative

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British Journal of Anaesthesia

@BJAJournals

2 months

#BJAEd - The difficult #spinal anaesthetic: the key to success? Dr Poots & Prof Chin elegantly describe the #paraspinous approach, why it could work well, and how to do it. An article which could change your every day practice. Read the full article at:

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British Journal of Anaesthesia

@BJAJournals

2 years

Do you extubate children awake or deep? Although awake extubation may seem like the safer option, it is not necessarily appropriate in all situations and increases the risk of adverse reflexes such as coughing #anaesthesia #paedsanaes #BJAEducation

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British Journal of Anaesthesia

@BJAJournals

2 months

#BJAEd - The difficult #spinal anaesthetic: the key to success? Dr Poots & Prof Chin elegantly describe the #paraspinous approach, why it could work well, and how to do it. An article which could change your every day practice. Read the full article at:

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British Journal of Anaesthesia

@BJAJournals

2 years

Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation: New updated Cochrane systematic review and meta-analysis #anaesthesia #anesthesia #perioperative #airway #laryngoscopy

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British Journal of Anaesthesia

@BJAJournals

8 months

Can you describe the pros and cons of double-lumen tubes and bronchial blockers for lung isolation? Then take a look at this month’s #BJAEd article. #anaesthesia #lungisolation #cardiothoracics #airway

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British Journal of Anaesthesia

@BJAJournals

11 months

In #BJAEd - Regional anaesthesia for open thoracotomy - what are the options, studies and controversies? Read this article to find out more. #regional #anaesthesia #thoracics

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British Journal of Anaesthesia

@BJAJournals

1 year

Knowledge of dermatomes, osteotomes, and myotomes is essential to minimise the chance of a failed nerve block. Read more in our #BJAEducation article: #anaesthesia #regional #PatientSafety

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British Journal of Anaesthesia

@BJAJournals

2 years

Happy World Anaesthesia Day from all at BJA, BJA Open & BJA Education! #anaesthesia #perioperative #anesthesia @BJAJournals

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British Journal of Anaesthesia

@BJAJournals

2 years

Pulmonary aspiration remains the commonest cause of anaesthesia-related death and brain damage. What modifications, if any, do you make to the classical RSI? #BJAEducation #anaesthesia #airway

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British Journal of Anaesthesia

@BJAJournals

4 years

COVID-19 Airway Management Principles @doctimcook @RCoANews @dasairway

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British Journal of Anaesthesia

@BJAJournals

1 year

#openaccess Delirium in older patients given propofol or sevoflurane anaesthesia for major cancer surgery. New multicentre randomised trial by Cao et al #anaesthesia #perioperative

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British Journal of Anaesthesia

@BJAJournals

2 years

What is your preferred hand grip position for a difficult airway? @lowebrad and Dr Craig Lyons demonstrate the various techniques in the #BJAEducation article this month #Airway @dastrainees @AirwayHub

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British Journal of Anaesthesia

@BJAJournals

5 years

From everyone at @BJAJournals , we wish you a Merry Christmas!

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British Journal of Anaesthesia

@BJAJournals

11 months

Need a refresher on the anatomy of your different regional techniques for open thoracotomy? Read this month's #BJAEd article by @SachMehta , @DrTimJen , @RBandH #regional #anaesthesia #thoracics

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British Journal of Anaesthesia

@BJAJournals

5 years

Can you describe the ideal characteristics of an ambulatory spinal anaesthetic? #BJAEducation paper on daycare spinal anaesthesia by @effectsite & @DrRobbieErskine #RegionalAnaesthesia #RegionalAnesthesia

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British Journal of Anaesthesia

@BJAJournals

5 months

Editorial by Munis revisits William Harvey's circulatory system model, advocating a holistic approach beyond segmental analysis like pressure-volume loops for comprehensive cardiovascular insight. #Anaesthesia

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British Journal of Anaesthesia

@BJAJournals

4 years

General anaesthesia in the absence of surgery does not result in biomarkers of inflammation or neural injury @BJAJournals @staciedeiner1 @penn

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British Journal of Anaesthesia

@BJAJournals

3 years

Should surgery be postponed if NIBP >180/110 mmHg? Is there sufficient evidence to base your decision upon a specific blood pressure number? Read a detailed review of the problem of preoperative HTN in #BJAEducation #periop #anaesthesia #hypertension

Preoperative hypertension: perioperative implications and management

Systemic arterial hypertension is one of the most important treatable causes of population morbidity and mortality. It is common, affecting one in four adults in England (12.5 million), with a...

www.bjaed.org

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British Journal of Anaesthesia

@BJAJournals

10 months

First up tonight, we discuss Mapleson’s landmark 1954 paper on the classification of anaesthetic breathing systems #bjachat

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British Journal of Anaesthesia

@BJAJournals

2 years

Do you routinely stop Metformin before surgery? Metformin may lower #perioperative mortality and have pleotropic anti-inflammatory effects. New meta-analysis by Tim Jones @Acklandlab #diabetesmellitus #anaesthesia @DiabetesUK @Diabetescouk @BJAJournals

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British Journal of Anaesthesia

@BJAJournals

1 year

How should we define, prevent and treat intraoperative hypotension? Karamchandani et al suggest strategies in this new editorial #hypotension #anaesthesia #perioperative

1

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143

British Journal of Anaesthesia

@BJAJournals

1 year

In our centenary year we review papers that have changed anaesthetic practice. Check out the first description of the Laryngeal Mask Airway (LMA) by Dr Archie Brain in 1983 #anaesthesia #perioperative #bjacentenary #bjaclassics

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British Journal of Anaesthesia

@BJAJournals

4 years

Turning ‘waiting lists’ for elective surgery into ‘preparation lists’ @BJAJournals @DL08OMD

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British Journal of Anaesthesia

@BJAJournals

3 years

Our editor @rupert_pearse was awarded the College Medal by the @RCoANews for his work as founding director of the UK Perioperative Medicine Clinical Trials Network @POMCTN @NHSuk @NIHRtakepart @NIH @NIAAResearch @RosetreesT

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134

British Journal of Anaesthesia

@BJAJournals

1 year

In our centenary year we review papers that have changed anaesthetic practice. Check out the first description of the Laryngeal Mask Airway (LMA) by Dr Archie Brain in 1983 #anaesthesia #perioperative #bjacentenary #bjaclassics

0

66

134

British Journal of Anaesthesia

@BJAJournals

2 years

Tranexamic acid for safer surgery: the time is now. Editorial on new guidance for use of tranexamic acid for surgery. #anaesthesia #perioperative #tranexamicacid @mike_grocott @robsayers17 @CHToh1 @RCSnews @RCoANews @RCSEd @RCPhysicians @CTU_LSHTM

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British Journal of Anaesthesia

@BJAJournals

3 years

Putative antiviral effects of propofol in #COVID19 @BJAJournals

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British Journal of Anaesthesia

@BJAJournals

7 months

Hot off the press! Check out the new ESAIC & BJA joint guidelines on airway management in neonates & infants. #airway #oxygen #paediatrics #pediatrics

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British Journal of Anaesthesia

@BJAJournals

1 year

A suggested flowchart for managing the inadequate nerve block: Read our full article in #BJAEducation for an excellent summary of the key information regarding the success of nerve blocks #anaesthesia #regional

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British Journal of Anaesthesia

@BJAJournals

23 days

In this new #BJAEd article, Pun and colleagues provide a fantastic overview of the innervation of the hip joint and its implications for regional anaesthesia and interventional pain procedures:

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British Journal of Anaesthesia

@BJAJournals

3 years

Why do epidurals make people itchy? A unique mechanism of disinhibition explains a very common side effect of spinal analgesics! @BJAJournals @decouvriez

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125

British Journal of Anaesthesia

@BJAJournals

4 years

Potential therapeutic value of dexmedetomidine in COVID-19 patients admitted to ICU @BJAJournals #COVID19

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122

British Journal of Anaesthesia

@BJAJournals

4 years

Read our narrative review of the relevant pathophysiology and pragmatic management strategies for critically ill #COVID19 patients, including the collective learning accrued at a high volume centre @BJAJournals @PBSherren @ICU_Management @ICS_updates

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British Journal of Anaesthesia

@BJAJournals

4 years

Outbreak of a new coronavirus: what anaesthetists should know @BJAJournals @BJA_Research @HotaSusy #COVID2019

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British Journal of Anaesthesia

@BJAJournals

9 months

A durable VAD may be implanted as a bridge to transplantation (UK), bridge to recovery, or as destination therapy (USA). Understanding VADs for non-cardiac anaesthetists - a #BJAEd article by Richella-Lea Falland and Sara Allen #VentricularAssistDevice

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122

British Journal of Anaesthesia

@BJAJournals

10 months

What is the best #ventilationstrategy for robotic urologic and gynaecological surgery? New review by Chiumello et al #roboticsurgery #narrativereview #perioperative #anaesthesia

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122

British Journal of Anaesthesia

@BJAJournals

9 months

New study by Toni et al: non-experts can interpret EEG for deep and light sedation but struggle with intermediate levels. Training is key. #Anaesthesia #Anesthesia

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British Journal of Anaesthesia

@BJAJournals

3 years

We congratulate our associate editor @doctimcook OBE for his appointment to the Most Excellent Order of the British Empire! This honour is most deserved for his leadership in #anaesthesia and typified by his services during #COVID19 . We are proud to have him as author and editor!

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British Journal of Anaesthesia

@BJAJournals

1 year

What techniques do you employ to minimise the chance of a failed peripheral nerve block? Read our recommendations in this excellent #BJAEducation article: #regional #anaesthesia

3

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British Journal of Anaesthesia

@BJAJournals

2 years

Prehabilitation, enhanced recovery after surgery, or both? A narrative review @BJAJournals @ChelsiaGillis @OlleLjungqvist @mcgillanesth

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British Journal of Anaesthesia

@BJAJournals

1 year

New study by Hight et al showing agreement between five processed EEG monitors in only a third of cases during emergence from #anaesthesia . Is interpretation of EEG a clinical skill that anaesthetists should possess? #anesthesia #perioperative

5

45

115

British Journal of Anaesthesia

@BJAJournals

1 month

#BJAEd - The difficult #spinal anaesthetic: the key to success? Dr Poots & Prof Chin elegantly describe the #paraspinous approach, why it could work well, and how to do it. An article which could change your every day practice. Read the full article at:

2

36

114

British Journal of Anaesthesia

@BJAJournals

1 year

Anaesthetists could benefit from routinely assessing the raw EEG and its spectrogram, rather than relying solely on an index produced by a depth of anaesthesia monitor. New editorial by McCulloch et al #anaesthesia #anesthesia #perioperative

4

34

113

British Journal of Anaesthesia

@BJAJournals

3 years

We are proud to announce our new impact factor of 9.166 for the British Journal of Anaesthesia. Thanks to our international team of authors, editors and reviewers for contributing to our highest #JIF ever. @BJAJournals @ELS_Anesthes @RCoANews @HughHemmings @DaveGLambert

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25

114

British Journal of Anaesthesia

@BJAJournals

8 months

New editorial adds to the debate of TIVA vs inhalational anaesthesia. TIVA in older cancer patients may reduce postoperative delirium, aiding precision medicine in cancer surgery #TIVA #cancer

4

51

114

British Journal of Anaesthesia

@BJAJournals

1 year

Goal-directed haemodynamic therapy: an imprecise umbrella term to avoid. New editorial by Saugel et al #anaesthesia #criticalcare #perioperative

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36

111

British Journal of Anaesthesia

@BJAJournals

4 years

Quick changeover of norepinephrine syringes is associated with less blood pressure lability compared with double pumping changeover @BJAJournals @LaurentPoiroux

2

59

108

British Journal of Anaesthesia

@BJAJournals

5 years

Retrospective cohort study suggests that propofol is associated with longer survival and reduced distant metastasis and local recurrence in hepatectomy for hepatocellular carcinoma compared with desflurane @BJAJournals @BJA_Research Editor @HughHemmings

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110

British Journal of Anaesthesia

@BJAJournals

3 years

Optimisation of airway management strategies: a prospective before-and-after study on events related to airway management @BJAJournals @AirwayHub @AirwayInfo @AirwayMxAcademy @dasairway

3

43

109

British Journal of Anaesthesia

@BJAJournals

1 year

In our centenary year we review landmark papers that have changed anaesthetic practice. Check out Prof Bill Mapelson's classification of semi-closed breathing systems #anaesthesia #perioperative #bjacentenary

1

44

109

British Journal of Anaesthesia

@BJAJournals

4 years

Intermittent epidural bolus provides superior pain control during the first 4 h of epidural placement during labour and reduces the risk of developing breakthrough pain and motor weakness @BJAJournals @Faraj_RegAnesth @ASRA_Society

1

54

107

British Journal of Anaesthesia

@BJAJournals

6 years

Preoperative anxiety is reduced when preschool children are allowed to drive a ride-on car on their way to the OR. @PedsAnesthesia @BJAJournals

4

62

109

British Journal of Anaesthesia

@BJAJournals

4 years

Desflurane has little evidence of patient benefit, considerable environmental impacts at a time of climate crisis, and now appears to have evidence of potential for harm. Do you agree? @BJAJournals @DrCliffShelton @DrRebeccaSutton

6

48

109

British Journal of Anaesthesia

@BJAJournals

4 years

Respiratory protective equipment does not fit females as well as males #COVID19 @BJAJournals @traumakhan @eleanor_des @BSUH_NHS @BJAJournals @Chakladar_A @BSUHgas

6

67

108

British Journal of Anaesthesia

@BJAJournals

1 year

In our centenary year we review papers that have changed anaesthetic practice. Check out the first description of Propofol (ICI 35868) by Dr John Glen in 1980 #anaesthesia #perioperative #bjacentenary #bjaclassics #openarchive

0

51

107

British Journal of Anaesthesia

@BJAJournals

4 months

GLP-1 receptor agonists delay gastric emptying, but aspiration risk is unclear. Caution advised for recent users; although standard fasting times may suffice after 12 weeks of treatment. #Anaesthesia #diabetes

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39

106

British Journal of Anaesthesia

@BJAJournals

4 years

The editors of the British Journal of Anaesthesia are excited to announce the most recent member of the editorial team, Rupert Pearse. Welcome to our team! @BJAJournals @rupert_pearse @ELS_Anesthes @RCoANews @NIAAResearch @BJA_Research

8

20

105

British Journal of Anaesthesia

@BJAJournals

2 years

Lean body weight, ideal body weight and total body weight; Getting drug dosing right in the bariatric population Editor's choice for this Month; Get free access! @SOBAuk #Obesity #Anaesthesia , #CriticalCare , #PeriOpMed . #BJAEducation

3

44

103

British Journal of Anaesthesia

@BJAJournals

1 year

Videolaryngoscopy increases the probability of first-pass success of tracheal intubation in critically ill patients: new subanalysis of the INTUBE study by Russotto et al #anaesthesia #anesthesia #perioperative

1

43

102

British Journal of Anaesthesia

@BJAJournals

4 years

After an accidental dural puncture, what leads you to place an intrathecal catheter vs attempt further epidural placement? #BJAEducation #ObsAnaes #epidural #anaesthesia

1

53

102

British Journal of Anaesthesia

@BJAJournals

3 years

How should patients at risk for perioperative #stroke be managed as they progress through surgery and recovery? Recent literature has provided some answers, but still many unknowns. Free access #BJAEducation @AlanaFlex @askberger #anaesthesia #stroke

1

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100

British Journal of Anaesthesia

@BJAJournals

5 years

Increasing evidence that brief durations of a SAP<100 mmHg and MAP<60–70 mmHg are harmful during non-cardiac surgery - new publication by @PeriOpQI @OutcomesRC @montymythen @mike_grocott @te_miller #anesthesia

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British Journal of Anaesthesia

@BJAJournals

5 years

The most read @BJAJournals article of this month is 'Lung-protective ventilation for the surgical patient', with international consensus recommendations @BJA_Research @WAMM_2019 @AirwayInfo @AirwayHub @Duke_Anesthesia

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British Journal of Anaesthesia

@BJAJournals

2 years

What predisposes to difficult face mask ventilation? @lowebrad and Dr Craig Lyons discuss the various patient, equipment and technique related factors. #Airway @dastrainees @AirwayHub @AirwayInfo

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96

British Journal of Anaesthesia

@BJAJournals

2 months

Always a hot topic - and for good reason! #BJAEd March 2023 by (Drs. Bottomley, Gadsden and West) described the reasons underpinning, and ways to manage, a failed peripheral nerve block - and how to improve initial success through a structured approach.

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100

British Journal of Anaesthesia

@BJAJournals

7 months

In our centenary year we have reviewed landmark papers published in the BJA, as part of our citation classics series. We started the year with this classic by Mapleson, describing his eponymous classification of semi-closed breathing systems. #bjacentenary #bjacitationclassics

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98

British Journal of Anaesthesia

@BJAJournals

6 years

Analysis of 39903 emergency laparotomy patients shows that postoperative geriatric medicine review is associated with substantially lower mortality in older patients @BJAJournals @BJA_Research @GeriSoc @NELANews @ELCSavingLives

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British Journal of Anaesthesia

@BJAJournals

3 years

The outer diameter of many devices currently marketed for cricothyroidotomy is generally oversized for adult airway anatomy, particularly for females @BJAJournals @Moserber @AirwayInfo @AirwayHub @AirwayMxAcademy @dasairway

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95

British Journal of Anaesthesia

@BJAJournals

3 years

A double-curved tube for McGrath® MAC videolaryngoscope-guided tracheal intubation @BJAJournals @AirwayHub @AirwayInfo @AirwayMxAcademy @dasairway

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33

96

British Journal of Anaesthesia

@BJAJournals

2 years

TAP blocks, QL, ilioinguinal/hypogastric, erector spinae, and rectus sheath blocks... what is the ideal regional technique for Caesarean section when central neuraxial techniques have not been used? @Drsambam #obsAnaes #BJAEd

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32

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British Journal of Anaesthesia

@BJAJournals

4 years

If you encounter a patient with delayed return to consciousness after GA, this table provides a thorough identification of pharm, metabolic and other rare causes. #BJAEducation paper by Drs Thomas, Martin and Prof Bollard. #Anaesthesia #Anesthesia

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95

British Journal of Anaesthesia

@BJAJournals

3 years

Heterogeneous impact of hypotension on organ perfusion and outcomes: a narrative review @BJAJournals

0

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94

British Journal of Anaesthesia

@BJAJournals

2 months

Dexmedetomidine use is associated with long recovery time and increased costs in infants and children. The effect is dose-dependent, and magnified in young children undergoing short procedures. #dexmed #anaesthesia #anaesthesia

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24

96

British Journal of Anaesthesia

@BJAJournals

1 year

How does our knowledge of antiarrhythmics help us choose the correct drug? Here is an algorithm showing common perioperative arrythmias and the management. #BJAED by Drs Kim, Lever and Cooper @ Auckland City Hospital

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95

British Journal of Anaesthesia

@BJAJournals

4 years

In our current #BJAEducation article from @prad_rajkumar and colleagues: Revise the heart–lung interactions that underpin the haemodynamic manifestations of pericardial effusion and tamponade. #anaesthesia #POCUS

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42

93

British Journal of Anaesthesia

@BJAJournals

4 years

There are invasive, minimally-invasive, and noninvasive pulse wave analysis monitoring systems that can be classified according to the method used to calibrate the estimated cardiac output values @BJAJournals

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94

British Journal of Anaesthesia

@BJAJournals

2 years

Introducing the new class of BJA #SoMe Fellows... Dr Eoin Kelleher is an Irish anaesthesia trainee, with an interest in #painmedicine . He is undertaking a PhD on the epidemiology of chronic pain at the University of Oxford. @EoinKr

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95

British Journal of Anaesthesia

@BJAJournals

6 years

What are the considerations before performing neuraxial anaesthesia on a patient who takes DOAC medication? #BJAEducation paper on #perioperative anticoagulation:

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British Journal of Anaesthesia

@BJAJournals

2 years

Is Sugammadex better than neostigmine for reducing postoperative pulmonary complications in older patients? A new meta-analysis by Carron et al. #perioperative #anaesthesia #anesthesia

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35

93

British Journal of Anaesthesia

@BJAJournals

9 months

Can you recall the principal ion channels and currents involved in the cardiac action potential? Our succinct article by @profhop et al takes you through the key points in #BJAEducation @profhop #cardiac #physiology

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93

British Journal of Anaesthesia

@BJAJournals

3 years

With an increasing number of older patients presenting for surgery, make use of our #BJAEducation article to optimise your pre-operative assessment and offer the best care: Address #frailty , physiology, and cognitive decline #anaesthesia #anesthesia

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94

British Journal of Anaesthesia

@BJAJournals

4 years

US-guided approaches to sciatic nerve block; Parasacral, Subgluteal, Anterior and Popliteal Learn the techniques, indications and pitfalls @sean_shevlin @LloydTurbitt @davejohnston24 @ajrmacfarlane @RegionalAnaesUK #BJAEducation #Regional

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92

British Journal of Anaesthesia

@BJAJournals

6 months

Sugammadex: Does it really make a difference? Olesnicky et al present a systematic review and meta-analysis of morbidity & quality of recovery #NeuromuscularBlock #Anaesthesia

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92

British Journal of Anaesthesia

@BJAJournals

5 years

"Preoperative pulmonary function tests are poor predictors of postoperative pulmonary complications so their use before elective surgery is rarely indicated" #BJAEducation paper on PFTs & #Anaesthesia

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British Journal of Anaesthesia

@BJAJournals

3 years

Tongue thickness > 6.1cm and a tongue thickness to thyromental distance ratio > 0.87 independent predictors of difficult tracheal intubation @Jamesocarroll @dr_imranahmad @YasminFinally1 #Anaesthesia #BJAEducation #AirwayMOOC

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31

92

British Journal of Anaesthesia

@BJAJournals

3 years

Heparin and low molecular weight heparins; when to do a neuraxial block and when to remove the catheter? @uclhregional @RegionalAnaesUK @uclh @ajrmacfarlane #BJAEducation #regionalanaesthesia #RAUK21 ,

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90

British Journal of Anaesthesia

@BJAJournals

3 years

Read our #BJAEd article by @sarahwallaceslt and @BrendanAMcGrath to understand the extent of laryngeal complications post oral/nasal intubations of the trachea and tracheostomy. @NTSP_UK @AirwayInfo @yourICM @RCSLT

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89

British Journal of Anaesthesia

@BJAJournals

4 years

COVID-19 patients are vulnerable to peripheral nerve injury. Life saving prone positioning may contribute to this complication, so added attention is needed in acute care to mitigate risk. @BJAJournals @ColinFranzMDphd

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91

British Journal of Anaesthesia

@BJAJournals

3 years

Non-standardised colour coding of anaesthetic ampoule labelling: a dangerous practice? @BJAJournals @jamesrichardsk1

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