A methodology to develop a vascular geometry for in vitro cell culture using additive manufacturing

Today, additive manufacturing (AM) is implemented in medical industry and profoundly revolutionizes this area. This approach consists of producing parts by additions of layers of successive materials and offers advantages in terms of rapidity, complexity of parts, competitive costs that can be exploited and can lead to a significant advancement in biological research. Everything becomes technically feasible and gives way to a “techno-centered” approach. Many parameters must be controlled in this field, so it is necessary to be guided for the development of such a product. This article aims to present a state of the art of existing design methodologies focused on AM to create medical devices. Finally, a development method is proposed that consists of producing vascular geometry using AM, based on patient data, designed for cell culture in vitro studies

Novel feeding interactions amplify the impact of species redistribution on an Arctic food web

Species are redistributing globally in response to climate warming, impacting ecosystem functions and services. In the Barents Sea, poleward expansion of boreal species and a decreased abundance of Arctic species are causing a rapid borealization of the Arctic communities. This borealization might have profound consequences on the Arctic food web by creating novel feeding interactions between previously non co‐occurring species. An early identification of new feeding links is crucial to predict their ecological impact. However, detection by traditional approaches, including stomach content and isotope analyses, although fundamental, cannot cope with the speed of change observed in the region, nor with the urgency of understanding the consequences of species redistribution for the marine ecosystem. In this study, we used an extensive food web (metaweb) with nearly 2,500 documented feeding links between 239 taxa coupled with a trait data set to predict novel feeding interactions and to quantify their potential impact on Arctic food web structure. We found that feeding interactions are largely determined by the body size of interacting species, although species foraging habitat and metabolic type are also important predictors. Further, we found that all boreal species will have at least one potential resource in the Arctic region should they redistribute therein. During 2014–2017, 11 boreal species were observed in the Arctic region of the Barents Sea. These incoming species, which are all generalists, change the structural properties of the Arctic food web by increasing connectance and decreasing modularity. In addition, these boreal species are predicted to initiate novel feeding interactions with the Arctic residents, which might amplify their impact on Arctic food web structure affecting ecosystem functioning and vulnerability. Under the ongoing species redistribution caused by environmental change, we propose merging a trait‐based approach with ecological network analysis to efficiently predict the impacts of range‐shifting species on food webs

Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia

International audienceImportance Severe pneumonia with hyperinflammation and elevated interleukin-6 is a common presentation of coronavirus disease 2019 (COVID-19).Objective To determine whether tocilizumab (TCZ) improves outcomes of patients hospitalized with moderate-to-severe COVID-19 pneumonia.Design, Setting, and Particpants This cohort-embedded, investigator-initiated, multicenter, open-label, bayesian randomized clinical trial investigating patients with COVID-19 and moderate or severe pneumonia requiring at least 3 L/min of oxygen but without ventilation or admission to the intensive care unit was conducted between March 31, 2020, to April 18, 2020, with follow-up through 28 days. Patients were recruited from 9 university hospitals in France. Analyses were performed on an intention-to-treat basis with no correction for multiplicity for secondary outcomes.Interventions Patients were randomly assigned to receive TCZ, 8 mg/kg, intravenously plus usual care on day 1 and on day 3 if clinically indicated (TCZ group) or to receive usual care alone (UC group). Usual care included antibiotic agents, antiviral agents, corticosteroids, vasopressor support, and anticoagulants.Main Outcomes and Measures Primary outcomes were scores higher than 5 on the World Health Organization 10-point Clinical Progression Scale (WHO-CPS) on day 4 and survival without need of ventilation (including noninvasive ventilation) at day 14. Secondary outcomes were clinical status assessed with the WHO-CPS scores at day 7 and day 14, overall survival, time to discharge, time to oxygen supply independency, biological factors such as C-reactive protein level, and adverse events.Results Of 131 patients, 64 patients were randomly assigned to the TCZ group and 67 to UC group; 1 patient in the TCZ group withdrew consent and was not included in the analysis. Of the 130 patients, 42 were women (32%), and median (interquartile range) age was 64 (57.1-74.3) years. In the TCZ group, 12 patients had a WHO-CPS score greater than 5 at day 4 vs 19 in the UC group (median posterior absolute risk difference [ARD] −9.0%; 90% credible interval [CrI], −21.0 to 3.1), with a posterior probability of negative ARD of 89.0% not achieving the 95% predefined efficacy threshold. At day 14, 12% (95% CI −28% to 4%) fewer patients needed noninvasive ventilation (NIV) or mechanical ventilation (MV) or died in the TCZ group than in the UC group (24% vs 36%, median posterior hazard ratio [HR] 0.58; 90% CrI, 0.33-1.00), with a posterior probability of HR less than 1 of 95.0%, achieving the predefined efficacy threshold. The HR for MV or death was 0.58 (90% CrI, 0.30 to 1.09). At day 28, 7 patients had died in the TCZ group and 8 in the UC group (adjusted HR, 0.92; 95% CI 0.33-2.53). Serious adverse events occurred in 20 (32%) patients in the TCZ group and 29 (43%) in the UC group (P = .21).Conclusions and Relevance In this randomized clinical trial of patients with COVID-19 and pneumonia requiring oxygen support but not admitted to the intensive care unit, TCZ did not reduce WHO-CPS scores lower than 5 at day 4 but might have reduced the risk of NIV, MV, or death by day 14. No difference on day 28 mortality was found. Further studies are necessary for confirming these preliminary results.Trial Registration ClinicalTrials.gov Identifier: NCT0433180

Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial

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Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial

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