ABSTRACT
OBJECTIVE: The aim of this study was to identify a mortality benefit with the use of whole blood (WB) as part of the resuscitation of bleeding trauma patients. BACKGROUND: Blood component therapy (BCT) is the current standard for resuscitating trauma patients, with WB emerging as the blood product of choice. We hypothesized that the use of WB versus BCT alone would result in decreased mortality. METHODS: We performed a 14-center, prospective observational study of trauma patients who received WB versus BCT during their resuscitation. We applied a generalized linear mixed-effects model with a random effect and controlled for age, sex, mechanism of injury (MOI), and injury severity score. All patients who received blood as part of their initial resuscitation were included. Primary outcome was mortality and secondary outcomes included acute kidney injury, deep vein thrombosis/pulmonary embolism, pulmonary complications, and bleeding complications. RESULTS: A total of 1623 [WB: 1180 (74%), BCT: 443(27%)] patients who sustained penetrating (53%) or blunt (47%) injury were included. Patients who received WB had a higher shock index (0.98 vs 0.83), more comorbidities, and more blunt MOI (all P <0.05). After controlling for center, age, sex, MOI, and injury severity score, we found no differences in the rates of acute kidney injury, deep vein thrombosis/pulmonary embolism or pulmonary complications. WB patients were 9% less likely to experience bleeding complications and were 48% less likely to die than BCT patients ( P <0.0001). CONCLUSIONS: Compared with BCT, the use of WB was associated with a 48% reduction in mortality in trauma patients. Our study supports the use of WB use in the resuscitation of trauma patients.
Subject(s)
Acute Kidney Injury , Hemostatics , Venous Thrombosis , Wounds and Injuries , Blood Transfusion , Hemorrhage/etiology , Hemorrhage/therapy , Humans , Resuscitation , Wounds and Injuries/complications , Wounds and Injuries/therapyABSTRACT
Sangiovese is the most widespread Italian red cultivar and constitutes the basis of internationally known wines such as Chianti and Brunello di Montalcino. Outside of Europe, Argentina is the largest producer, followed by the United States. This study sought to define and compare 2016 vintage Sangiovese wine composition from various production regions in California and Italy. Forty-six commercial Sangiovese wines from California and Italy were analyzed for volatile profile, color, phenolic, and elemental content. This study demonstrates that it is possible to determine regional differences among wines based on these chemical profiles. However, some Californian and Italian wine had similar chemical compositions. In order to compare Californian and Italian wines, Californian wine reference models were developed using the chemical parameters from Sangiovese wines, performing a Soft Independent Modeling of Class Analogy (SIMCA). To our knowledge, this is the first time that an extensive regionality study has been attempted for Sangiovese wines.
Subject(s)
Fruit/chemistry , Vitis/chemistry , Wine/analysis , Argentina , California , Gas Chromatography-Mass Spectrometry , Italy , Metals/analysis , Polyphenols/analysis , Volatile Organic Compounds/analysis , Wine/classificationABSTRACT
This work aimed to investigate the evolution of phenolic compounds and elements during the aging of Malbec red wines from different regions of Mendoza (Argentina) and California (United States). The profiles of low molecular weight polyphenols and anthocyanins were analyzed using high-performance liquid chromatography with a diode-array detector (HPLC-DAD), and the elemental composition using microwave plasma-Atomic emission spectrometry (MP-AES). Through uni- and multivariate statistical analyses, the effects of aging time and region on wine were investigated. It was observed that aging time was a significant factor that affected the phenolic compound profile in the studied Malbec wines studied and that after five years of aging, the wines could be differentiated according to region. The results of this study may impact decisions made regarding the storage of Malbec wines in the future.
Subject(s)
Anthocyanins/analysis , Chromatography, High Pressure Liquid/methods , Phenols/analysis , Vitis/chemistry , Wine/analysis , Argentina , CaliforniaSubject(s)
Child Health , Environmental Health/organization & administration , Health Promotion/methods , National Institutes of Health (U.S.)/organization & administration , Biomedical Research , Child , Environmental Exposure/adverse effects , Health Promotion/organization & administration , Humans , United StatesABSTRACT
Open access, open data, open source and other open scholarship practices are growing in popularity and necessity. However, widespread adoption of these practices has not yet been achieved. One reason is that researchers are uncertain about how sharing their work will affect their careers. We review literature demonstrating that open research is associated with increases in citations, media attention, potential collaborators, job opportunities and funding opportunities. These findings are evidence that open research practices bring significant benefits to researchers relative to more traditional closed practices.