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      Synergistic coupling between 3D bioprinting and vascularization strategies

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          Abstract

          Three-dimensional (3D) bioprinting offers promising solutions to the complex challenge of vascularization in biofabrication, thereby enhancing the prospects for clinical translation of engineered tissues and organs. While existing reviews have touched upon 3D bioprinting in vascularized tissue contexts, the current review offers a more holistic perspective, encompassing recent technical advancements and spanning the entire multistage bioprinting process, with a particular emphasis on vascularization. The synergy between 3D bioprinting and vascularization strategies is crucial, as 3D bioprinting can enable the creation of personalized, tissue-specific vascular network while the vascularization enhances tissue viability and function. The review starts by providing a comprehensive overview of the entire bioprinting process, spanning from pre-bioprinting stages to post-printing processing, including perfusion and maturation. Next, recent advancements in vascularization strategies that can be seamlessly integrated with bioprinting are discussed. Further, tissue-specific examples illustrating how these vascularization approaches are customized for diverse anatomical tissues towards enhancing clinical relevance are discussed. Finally, the underexplored intraoperative bioprinting (IOB) was highlighted, which enables the direct reconstruction of tissues within defect sites, stressing on the possible synergy shaped by combining IOB with vascularization strategies for improved regeneration.

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          Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019

          Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
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            3D bioprinting of tissues and organs.

            Additive manufacturing, otherwise known as three-dimensional (3D) printing, is driving major innovations in many areas, such as engineering, manufacturing, art, education and medicine. Recent advances have enabled 3D printing of biocompatible materials, cells and supporting components into complex 3D functional living tissues. 3D bioprinting is being applied to regenerative medicine to address the need for tissues and organs suitable for transplantation. Compared with non-biological printing, 3D bioprinting involves additional complexities, such as the choice of materials, cell types, growth and differentiation factors, and technical challenges related to the sensitivities of living cells and the construction of tissues. Addressing these complexities requires the integration of technologies from the fields of engineering, biomaterials science, cell biology, physics and medicine. 3D bioprinting has already been used for the generation and transplantation of several tissues, including multilayered skin, bone, vascular grafts, tracheal splints, heart tissue and cartilaginous structures. Other applications include developing high-throughput 3D-bioprinted tissue models for research, drug discovery and toxicology.
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              Cellulose nanocrystals: chemistry, self-assembly, and applications.

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                Author and article information

                Contributors
                Journal
                Biofabrication
                Biofabrication
                bf
                BIOFCK
                Biofabrication
                IOP Publishing
                1758-5082
                1758-5090
                01 January 2024
                20 November 2023
                : 16
                : 1
                : 012003
                Affiliations
                [1 ] The Huck Institutes of the Life Sciences, Penn State University , University Park, PA 16802, United States of America
                [2 ] Engineering Science and Mechanics Department, Penn State University , University Park, PA 16802, United States of America
                [3 ] Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research , Kolkata, West Bengal 700054, India
                [4 ] Department of Biomedical Engineering, Penn State University , University Park, PA 16802, United States of America
                [5 ] Materials Research Institute, Penn State University , University Park, PA 16802, United States of America
                [6 ] Department of Neurosurgery, Penn State College of Medicine , Hershey, PA 17033, United States of America
                [7 ] Penn State Cancer Institute, Penn State University , Hershey, PA 17033, United States of America
                [8 ] Biotechnology Research and Application Center, Cukurova University , Adana 01130, Turkey
                Author notes
                [9]

                Authors contributed equally.

                [10 ]Author to whom any correspondence should be addressed.
                Author information
                https://orcid.org/0000-0003-4941-9323
                https://orcid.org/0000-0002-7404-4917
                https://orcid.org/0000-0001-8328-4528
                Article
                bfad0b3f ad0b3f BF-104286.R2
                10.1088/1758-5090/ad0b3f
                10658349
                37944186
                6075d3aa-b080-4c1e-859c-ec59e6d83acb
                © 2023 The Author(s). Published by IOP Publishing Ltd

                Original content from this work may be used under the terms of the Creative Commons Attribution 4.0 license. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.

                History
                : 19 January 2023
                : 27 September 2023
                : 9 November 2023
                : 22 July 2023
                : 20 November 2023
                Page count
                Pages: 32
                Funding
                Funded by: National Institute of Arthritis and Musculoskeletal and Skin Diseases , doi 10.13039/100000069;
                Award ID: R21AR082668
                Funded by: Türkiye Bilimsel ve Teknolojik Araştırma Kurumu , doi 10.13039/501100004410;
                Award ID: 121C359
                Funded by: National Institute of Dental and Craniofacial Research , doi 10.13039/100000072;
                Award ID: R01DE028614
                Funded by: National Institute of Biomedical Imaging and Bioengineering , doi 10.13039/100000070;
                Award ID: R01EB034566
                Funded by: Division of Intramural Research, National Institute of Allergy and Infectious Diseases , doi 10.13039/100006492;
                Award ID: U19AI142733
                Categories
                Topical Review
                Towards 3D Biofabrication of Vascularized Tissues for In Vitro and In Vivo Applications, Towards 3D Biofabrication of Vascularized Tissues
                Custom metadata
                1758-5090/23/012003+32$33.00
                Printed in the UK
                yes

                bioprinting,tissue and organ substitutes,vascularization,vascularized tissues,intraoperative bioprinting

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