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Abstract Background Pterospermum rubiginosum has been traditionally used by the tribal inhabitants of Southern India for treating bone fractures and as a local anti-inflammatory agent; however, experimental evidence to support this traditional usage is lacking. The present study aimed to investigate the phytochemical characterization, in silico and in vitro anti-inflammatory evaluation, followed by in vivo toxicological screening of P. rubiginosum methanolic bark extract (PRME). Results The LCMS evaluation revealed the presence of 80 significant peaks; nearly 50 molecules were identified using the LCMS database. In silico analysis showed notable interactions with inducible nitric oxide synthase (iNOS) and interleukin-6 (IL-6). In vitro gene expression study supported the docking results with significant down-regulation of iNOS, IL-6, and IL-10. PRME was administered orally to the SD rats and was found to be non-toxic up to 1000 mg/kg body weight for 14 days. The antioxidant enzymes catalase and sodium dismutase exhibited an increased value in PRME-administered groups, possibly due to the diverse phytochemical combinations in bark extract. Conclusions PRME administration significantly downregulated the gene expression of inflammatory markers, such as iNOS, IL-6, and IL-10. The molecular docking analysis of iNOS and IL-6 supports the in vitro study. In vivo toxicological study of PRME in SD rats was found to be non-toxic up to a concentration of 1000 mg/kg body weight for 14 days. Graphical abstract

Sarath S Nair,1,2 V N Meena Devi,1 Krishna Sharan,2 Jyothi Nagesh,2 Brahmaiah Nallapati,2 Shambhavi Kotian3 1Department of Physics, Noorul Islam Centre for Higher Education Kumaracoil, Tamilnadu, India; 2Department of Radiotherapy & Oncology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India; 3Department of Medical Physics, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, IndiaCorrespondence: Sarath S Nair, Email sarathshyam007@gmail.comObjective: To analyze whether deep inspiratory breath hold (DIBH) would be dosimetrically beneficial irrespective of radiotherapy planning techniques for patients with left breast cancers requiring adjuvant radiotherapy.Methods: Planning CT scans were taken in free-breathing (FB) as well as deep-inspiration breath hold (DIBH) for patients requiring adjuvant radiotherapy for left breast cancers. After registration, three radiotherapy plans – 3D-conformal radiotherapy (3DCRT), intensity modulated RT (IMRT), and volumetric modulated arc-therapy (VMAT) – were generated for both FB and DIBH scans for each patient. The dose-volume parameters were collected from the dose-volume histogram and analyzed. A paired t-test is used for statistical analysis of the parameters.Findings: The study was conducted on thirteen patients. The mean dose of the left lung was reduced with DIBH by 32%, 24%, and 6% (8.6 Gy, 6.6 Gy, and 6.4 Gy) with 3DCRT, IMRT, and VMAT, respectively. The mean heart dose was reduced by 3.3 Gy (2.2 vs 5.5 Gy), 2.2 Gy (7.5 vs 9.7 Gy), and 1.2 Gy (5.8 vs 7 Gy) with 3DCRT, IMRT, and VMAT with DIBH. Similarly, the left anterior descending artery (LAD) mean dose was relatively reduced by 80%, 34%, and 20% when compared with the FB scans for 3DCRT, IMRT, and VMAT respectively, with max dose in the 3DCRT plan.Novelty/Applications: DIBH appears to have maximum benefit in achieving a better sparing of organs-at-risk for patients being considered for 3DCRT, and to a lesser extent with even IMRT and VMAT techniques.Keywords: deep inspiration breath hold, DIBH, active breath coordinator, ABC, volumetric modulated arc therapy, VMAT, intensity modulated radiation therapy, IMRT, left anterior descending coronary artery, LAD

The current study is related to the United Nations Sustainable Development Goal 13, “Climate action”. As a consequence of environmental variations caused by global climate change, turf-forming algae supposedly tend to replace dominant foundation species, resulting in loss of marine biodiversity. Hypnea brasiliensis, H. cervicornis and H. spinella are three turf-forming species widely distributed along the Brazilian coast with a problematic taxonomic history. Specimens from the warm temperate region are morphologically similar, and their correct identification is only possible based on molecular markers. In the present study, specimens- were cultivated in the laboratory, and temperature gradient experiments (20, 24, 28 and 32°C) were carried out for 21 days. At 28°C, the growth rate, branching ratio, and photosynthetic pigment content were higher in all species, however in vivo chlorophyll fluorescence parameters were at the lowest. Moreover, no species survived at the warmest temperature 32°C. The effects of temperature on the three Hypnea species revealed that useful morphological characters for species identification were only observed in specimens cultured at 28°C, and the morphology of the three species was basically identical in low temperature treatments of 20 and 24°C. The annual average temperature of the sea surface in the Brazilian warm temperate region is 24°C, which may explain the current difficulty of distinguishing the three Hypnea species from this region using only morphology. Furthermore, our findings show that these turf-forming Hypnea species are negatively impacted by rising temperatures, emphasizing the importance of species-specific research to better understand the effects of global climate change. Consequently, predictions of the replacement of dominant foundation species by turf-forming seaweed in an elevated sea surface temperature scenario are less certain. The negative impact of temperature increases raises awareness of the importance of public policies to mitigate the future degradation of marine ecosystems.

Seaweeds play an important role for the environment, since they are photosynthetic organisms, contributing to the cycling of nutrients and to the protection and feeding of several animals. The potential for biotechnological applications of marine macroalgae biomass is enormous, and to attend the demand of the current market, the knowledge of the physiological characteristics of these organisms is essential to ensure a high productivity in cultivation systems. In this review, we contribute to the knowledge about the photosynthetic characteristics of seaweeds, describing relevant aspects of marine macroalgae and photosynthesis, and the biotechnological use of these organisms.

ObjectiveTo compare the relative efficacy of current and investigational biologic and oral small molecule (OSM) treatments for active ankylosing spondylitis (AS).MethodsA systematic literature review was conducted to identify all phase 2/3 randomized trials of interest in patients with AS. Outcomes assessed were ≥ 20% improvement in the Assessment of Spondyloarthritis International Society Criteria (ASAS20) and change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) and C-reactive protein (CRP) at weeks 12-16. Bayesian network meta-analyses were conducted for outcomes using a random effects model. Baseline-risk adjustment was also conducted to account for differences in placebo response across studies. Surface Under the Cumulative Ranking curve (SUCRA) values are reported, reflecting the relative probability that intervention was the best of all interventions.ResultsThe investigational agent tofacitinib 5 mg was the top-ranked treatment (SUCRA, 93%) for ASAS20 response, followed by intravenous (IV) golimumab 2 mg/kg (90%). Golimumab IV 2 mg/kg and infliximab 5 mg/kg were the top two ranked treatments for change from baseline in BASFI (golimumab IV, 81%; infliximab, 80%) and change from baseline in CRP (infliximab, 90%; golimumab IV, 82%).ConclusionsTwo approved therapies (golimumab IV, infliximab) and one investigational product ranked highest for efficacy in AS. Key Points • Although golimumab IV, infliximab, and tofacitinib ranked highest for efficacy in AS, differences in efficacy between approved and investigational therapies were not statistically significant.

Amaresh Vydyanathan,1 Priya Agrawal,2 Naveen Shetty,3 Singh Nair,1 Nancy Shilian,4 Naum Shaparin1 1Department of Anesthesiology and Pain Management, Montefiore Medical Center, Bronx, NY, USA; 2Sutter Health System, Oakland, CA, USA; 3Department of Anesthesiology, New York University, New York, NY, USA; 4Department of Family Medicine, Mount Sinai South Nassau Hospital, Oceanside, NY, USACorrespondence: Amaresh Vydyanathan, 1250 Waters Place, Tower II, 8th Floor, Bronx, NY, USA, Tel +216-702-5965, Fax +929-263-3950, Email avydyana@montefiore.orgPurpose: Ultrasound guidance during nerve blockade poses the challenge of maintaining in-plane alignment of the needle tip. The needle guidance device maintains needle alignment and assists with in-plane needle visualization. The purpose of this study is to evaluate the utility of this device by comparing procedure performance during brachial plexus blockade with the conventional approach.Methods: After the Institutional Review Board approval and obtaining informed consent, 70 patients receiving either interscalene or supraclavicular nerve blocks were randomly assigned into 2 groups, a conventional approach versus utilizing the needle guidance device. An independent observer recorded: total procedure time; needle insertion time; number of unplanned redirections; and number of reinsertions. Additionally, physician satisfaction and ease of needle visualization were assessed.Results: Data from seventy patients were analyzed. The median [25th percentile-75th percentile] time to complete the block by the device assisted needle guidance group was 3 (2– 3.75) minutes and 4 (3– 6) minutes in the conventional approach group (p < 0.001). Additionally, subgroup analyses were performed in the supraclavicular block and interscalene block. Supraclavicular blockade, needle insertion time (median [25th percentile-75th percentile] in seconds) (106 [92– 162] vs 197 [140– 278]), total procedure time (3 [2– 3] vs 4.5 [4– 6] in minutes) and unplanned needle redirections (2 [1– 5] vs 5.5 [3– 9]) were significantly lower in needle guidance group (p < 0.001). With interscalene blockade, needle insertion time (86 [76– 146] vs 126 [94– 295]) and unplanned needle redirections (2 [1– 3] vs 4 [2– 8.5]) were significantly lower with needle guidance (p < 0.001), but total procedure time was similar. All the physicians reported that they would use the needle guidance again, and 90% would prefer it for in-plane blocks.Conclusion: Performing regional blocks using the needle guidance device reduces needle insertion time and unplanned needle redirections in brachial plexus blockade. Moreover, physician satisfaction also improved compared to the use of the conventional technique.Keywords: brachial plexus blockade, ultrasound guidance, peripheral nerve blockade, needle guidance, needle visualization