Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Comparison of the reactivity of β-thiolactones and β-lactones toward ring-opening by thiols and amines.

International audienceAn investigation into the comparative reactivity of simple β-lactones and β-thiolactones toward a thiol and a primary amine is reported. A simple 3-mercaptomethyl-2-oxetanone is found to undergo rearrangement in the presence of aqueous base to give the corresponding thietane-3-carboxylic acid rather than the 3-hydroxymethyl-2-thietanone. Implications for the use of β-thiolactones in bioorganic and medicinal chemistry are discussed

La bio locale, entre volontés et réalités territoriales.Jeux d'acteurs autour de l'approvisionnement de la restauration collective en Sarthe (France)

International audienc

Dynamiques territoriales et jeux d’acteurs dans l’approvisionnement bio-local de la restauration collective ligérienne. L’exemple de Manger bio en Vendée et du Bio d’ici en Sarthe

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Chemistry of the β‑Thiolactones: Substituent and Solvent Effects on Thermal Decomposition and Comparison with the β‑Lactones.

The synthesis of a series of di-, tri-, and tetraalkyl β-thiolactones and β-lactones is described as well as their thermal decomposition with extrusion of carbon oxysulfide and carbon dioxide in two solvents of opposite polarities. The β-thiolactones are considerably more thermally stable than the β-lactones and require higher temperatures for efficient decomposition in both solvents, whatever the degree of substitution. The results are interpreted in terms of a zwitterionic mechanism for fragmentation with a change in the rate-determining step between the two series

Highly Stereoselective Synthesis of Primary, Secondary, and Tertiary α‑<i>S</i>‑Sialosides under Lewis Acidic Conditions

<i>N</i>-Acetyl 4-<i>O</i>,5-<i>N</i>-oxazolidinone protected sialyl phosphates of either anomeric configuration are excellent donors for the formation of α-<i>S</i>-sialosides at −78 °C in dichloromethane with primary, secondary, and tertiary thiols including galactose 3-, 4-, and 6-thiols. The reactions, which proceed under typical Lewis acid promoted glycosylation conditions, are highly α-selective and do not suffer from competing elimination of the phosphate

Self-Reporting Degradable Fluorescent Grafted Copolymer Micelles Derived from Biorenewable Resources

A series of hydrolytically degradable fluorescent poly­(ferulic acid-<i>co</i>-tyrosine)-<i>g</i>-<i>m</i>PEG graft copolymers were synthesized and shown to undergo self-assembly in aqueous media to yield fluorescent micelles. The polymers and their micellar assemblies exhibited greater fluorescence emission intensity than did their small molecular building blocks, which provides a self-reporting character that has potential for monitoring the polymer integrity and also for performing in theranostics applications. The amphiphilic <i>graft</i>-copolymers were synthesized by Cu-assisted azide–alkyne “click” addition of azido-functionalized <i>m</i>PEG polymers onto fluorescent degradable hydrophobic copolymers displaying randomly distributed alkyne side-chain groups along their biorenewably derived poly­(ferulic acid-<i>co</i>-tyrosine) backbones. The morphologies and photophysical properties of the supramolecular assemblies generated in aqueous solutions were evaluated by DLS, TEM, AFM, and steady-state optical spectroscopies. The 15–30 nm sized micelles behaved as broad-band emitters in the 350–600 nm range, which highlights their potential as self-reporting nanomaterials for in vitro studies

Children benefit from morphological relatedness independently of orthographic relatedness when they learn to spell new words

We examined whether French children in Grades 3 and 5 (aged ∼ 8–11 years) benefit from morphological relatedness beyond orthographic relatedness in the implicit learning of new spellings. Children silently read stories that included two target nonwords. One nonword was in an opaque condition in that nothing in the story could justify the spelling of its final sound. The other nonword was in either a morphological condition (for children in the morphological group) or an orthographic condition (for children in the orthographic group). In the morphological condition, the final spelling of the target nonword was justified by two morphologically related nonwords. For example, coirardage, obtained by adding the suffix age to coirard, designates the coirard’s song and justifies the final silent d of coirard. The orthographic condition included two nonwords that were orthographically but not morphologically related to the target. For example, the coirard’s song was coirardume, obtained by adding ume, which is not a suffix, to coirard. Then, 30 min after reading the stories, children were asked to choose the correct spelling of each nonword from among three phonologically plausible alternatives (e.g., coirard, coirars, coirar). In the morphological group, both third and fifth graders more often selected the correct spellings for items presented in the morphological condition than for items presented in the opaque condition. In the orthographic group, the results were very similar in the opaque and orthographic conditions. The findings show that the benefit of morphological relatedness in the implicit learning of new spellings cannot be reduced to orthographic relatedness

Information and communication technology use among children separated from one or both parents: A scoping review

Background:The development and diversification of infor-mation and communication technology (ICT) are chang-ing the way family members communicate with eachother, creating new opportunities for interaction. Whenchildren and parents do not live together on a day-to-daybasis, these technologies may represent privileged meansto keep in touch and maintain a relationship.Objective:This article aims to review the literature on theuse of ICT among children separated from one or bothparents, paying particular attention to two contexts:parental separation and foster care.Method:A scoping review was conducted using the Arkseyand O’Malley (2005) framework and the PRISMA Exten-sion for Scoping Reviews guidelines (Tricco et al., 2018).The data were analyzed using thematic analysis.Results:Of the 847 references identified, 11 were selected(six related to parental separation and five related to fostercare). The literature dated from 1997 to 2020 and was par-ticularly sparse and heterogeneous (e.g., the definition ofICT and characteristics of participants). Three topicsemerged: (a) ICT practices and usage patterns, (b) ICTpractices: opportunities and issues, and (c) sociolegal sup-port issues.Implication:This study highlights the need for all legal andpsychosocial actors to consider the place of digital technol-ogy in family relationships