The Drawing Book. A survey of drawing: the primary means of expression

‘The Drawing Book’ was conceived and edited by Kovats. Other invited authors included Kate Macfarlane and Katherine Stout (The Drawing Room, London), and Charles Darwent (art historian and writer). The publication sought to survey drawing as the primary means of expression. The book explored whether it was possible to employ a renaissance model, the commonplace book, which is primarily a text-based model, visually. Drawings were gathered together to explore certain themes that then form a visual narrative rather than a text-based one. The book was also an exploration of the subjective nature of visual memory, a journey into the imagination of an individual, in itself a model of the form of drawing, as a personal and subjective cosmology of drawing. The vast collection of drawings span the history of art and design, including the rich dynamic state of contemporary drawing today. This book examines the relationship between drawing and thinking, and looks at what drawings do, as well as how they look. It is organized into thematic chapters based on the form of a commonplace book. The selected drawings trace the continuous line flowing through detailing how artists, scientists, architects, designers, philosophers understand our world and our experience in it. Originally printed as a hardback copy (January 2006), the book has subsequently been reprinted in paperback (June 2007). The book has been reviewed in Blueprint (Andrew Ross, No. 242, May 2006) and Varoom Magazine - The Journal of Illustration and Made Images (Ian Massey, Issue 2, November 2006)

Early and empirical high-dose cryoprecipitate for hemorrhage after traumatic injury: The CRYOSTAT-2 randomized clinical trial

Critical bleeding is associated with a high mortality rate in patients with trauma. Hemorrhage is exacerbated by a complex derangement of coagulation, including an acute fibrinogen deficiency. Management is fibrinogen replacement with cryoprecipitate transfusions or fibrinogen concentrate, usually administered relatively late during hemorrhage. To assess whether survival could be improved by administering an early and empirical high dose of cryoprecipitate to all patients with trauma and bleeding that required activation of a major hemorrhage protocol. CRYOSTAT-2 was an interventional, randomized, open-label, parallel-group controlled, international, multicenter study. Patients were enrolled at 26 UK and US major trauma centers from August 2017 to November 2021. Eligible patients were injured adults requiring activation of the hospital's major hemorrhage protocol with evidence of active hemorrhage, systolic blood pressure less than 90 mm Hg at any time, and receiving at least 1 U of a blood component transfusion. Patients were randomly assigned (in a 1:1 ratio) to receive standard care, which was the local major hemorrhage protocol (reviewed for guideline adherence), or cryoprecipitate, in which 3 pools of cryoprecipitate (6-g fibrinogen equivalent) were to be administered in addition to standard care within 90 minutes of randomization and 3 hours of injury. The primary outcome was all-cause mortality at 28 days in the intention-to-treat population. Among 1604 eligible patients, 799 were randomized to the cryoprecipitate group and 805 to the standard care group. Missing primary outcome data occurred in 73 patients (principally due to withdrawal of consent) and 1531 (95%) were included in the primary analysis population. The median (IQR) age of participants was 39 (26-55) years, 1251 (79%) were men, median (IQR) Injury Severity Score was 29 (18-43), 36% had penetrating injury, and 33% had systolic blood pressure less than 90 mm Hg at hospital arrival. All-cause 28-day mortality in the intention-to-treat population was 26.1% in the standard care group vs 25.3% in the cryoprecipitate group (odds ratio, 0.96 [95% CI, 0.75-1.23]; P = .74). There was no difference in safety outcomes or incidence of thrombotic events in the standard care vs cryoprecipitate group (12.9% vs 12.7%). Among patients with trauma and bleeding who required activation of a major hemorrhage protocol, the addition of early and empirical high-dose cryoprecipitate to standard care did not improve all cause 28-day mortality. ClinicalTrials.gov Identifier: NCT04704869; ISRCTN Identifier: ISRCTN14998314

Get with the guidelines: management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub‐optimal

International audienc