Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Monetary Policy, Cash Flow and Corporate Investment: Empirical Evidence from Vietnam

This paper examines the relationships between macroscopic determinants (typically, monetary policies) and microscopic factors (mainly, cash flows and other controlling variables) on corporate investment. By employing system-GMM estimation for the 250 Vietnamese non-financial firms, the authors find that the expansionary monetary policy not only encourages the borrowing activities but also results in more corporate investment activities over the period from 2006 to 2016. Noticeably, the internal cash flow is also significant factor, which enhances the activities of corporate investment. Finally, there are differences between internal cash flow effects on corporate investments between two groups, divided by three theoretical criteria. To recapitulate, our implications highlight the importance of monetary policy stability for sustainable growth in corporate investment in Vietnam

Hepatoprotection and Phytochemistry of the Vietnamese Herbs Cleome chelidonii and Cleome viscosa Stems

The study aims to determine the hepatoprotective effect of n-hexane, ethyl acetate, and methanol extracts of the leaves and stems of two Cleome species against carbon tetrachloride- (CCl4-) induced liver toxicity both in vitro using human hepatoma (HepG2) cells and in vivo in rats as well as the hepatoprotective property of all isolated compounds on HepG2. After 72 h of treatment, at the concentrations of 25, 50, and 100 μg/mL, the methanol of C. chelidonii stems (CCSM) ranged from 18.6% to 20.8%, whereas the methanol of C. chelidonii stems (CVSM) increased from 12.3% to 17.2% cell viability. The results show that CCSM and CVSM significantly expressed in vitro hepaprotective activity on HepG2. Therefore, the animals were daily treated with these extracts at the doses of 15, 30, and 45 mg/kg body weight for 5 days, and CCl4 was injected (2 ml/kg body weight, i.p.) on the 2nd and 3rd days. Levels of aspartate aminotransferase (ALT) and alanine aminotransferase (AST) in the blood were measured and compared to the silymarin control. The treatments with CCSM and CVSM (30, and 45 mg/kg) possessed significant hepatoprotection and were comparable with the activity of silymarin. Further, phytochemical studies of these ones were conducted and led to the identification of eight flavonoids: visconoside A (1), visconoside B (2), quercetin 3-O-β-D-glucopyranoside 7-O-α-L-rhamnopyranoside (3), kaempferol 3-O-β-D-glucopyranoside 7-O-α-L-rhamnopyranoside (4), cleomeside A (5), cleomeside B (6), cleomeside C (7), and quercetin-3-O-[β-D-glucopyranosyl-(1⟶2)]-α-L-rhamnopyranoside 7-O-α-L-rhamnopyranoside (8). Two major flavonoids (1 and 4) displayed significant hepatoprotective property (at the concentration of 100 μM, the prevention percentage values were 66.5% and 74.2%, respectively, compared to the quercetin control, with value of 80.3%)

To lead through change : – A case study of the internal management during a major organizational change

I samband med avregleringen av den svenska postmarknaden är PostNord AB ett företag som de senaste decennierna stått inför många utmaningar. Syftet med denna studie är att studera PostNords interna styrning under en större omorganisation. Detta sker i dagsläget inom PostNords verksamhet i samband med omstruktureringen av enheterna för distribution av paket och pallgods i Stockholmsområdet och vi har därför valt att basera vår studie på denna process. För att uppfylla syftet har vi genomfört ett flertal kvalitativa intervjuer, vilka även har underbyggts av företagets offentliga och interna dokument. Genom att använda oss av en teoretisk referensram med utgångspunkt i nyinstitutionell teori och organisationskommunikation framträder en bild av fallföretagets interna styrning. Med utgångspunkt i vår tolkning blir slutsatsen att PostNord är ett företag som genom rationella förändringar klarar av att anpassa sig till en föränderlig omvärld. Därmed kommer de troligtvis även i fortsättningen att behålla sin starka position på den svenska postmarknaden.PostNord AB is a company that in recent decades has faced many challenges becuase of the changes in market demands evolving from the reformation of the Swedish Postal Service. The purpose of this study is to investigate an organization’s internal management during a major reorganization. The focus of this paper is the current process in which PostNord is reconstructing their facilities of distribution for parcels and goods in the Stockholm area. To reach our aims for this paper we conducted a number of interviews, which in turn has been supported by the company's public and internal documents. Through the use of a theoretical framework based on new institutionalism and organizational communication emerges an understanding of the company's internal management. Based on our interpretations we draw the conclusion that PostNord is an organisation that will continue to thrive with their abillity to adapt and make rational decisions in a continously changing environment

Effect of calophyllolide on myeloperoxidase (MPO) activity.

<p>All mice were sacrificed on day 1 and day 5 post-operation, and skin tissue samples were collected to assess MPO activity (n = 3 mice per group per experiment). Data are represented as mean ± SEM and compared by one-way ANOVA. *** P<0.001.</p

Effect of calophyllolide (CP) on acceleration of wound closure.

<p>Effect of calophyllolide (CP) on acceleration of wound closure.</p

Anti-inflammatory and wound healing activities of calophyllolide isolated from <i>Calophyllum inophyllum</i> Linn

<div><p>Due to the high-cost and limitations of current wound healing treatments, the search for alternative approaches or drugs, particularly from medicinal plants, is of key importance. In this study, we report anti-inflammatory and wound healing activities of the major calophyllolide (CP) compound isolated from <i>Calophyllum inophyllum</i> Linn. The results showed that CP had no effect on HaCaT cell viability over a range of concentrations. CP reduced fibrosis formation and effectively promoted wound closure in mouse model without causing body weight loss. The underlying molecular mechanisms of wound repair by CP was investigated. CP markedly reduced MPO activity, and increased M2 macrophage skewing, as shown by up-regulation of M2-related gene expression, which is beneficial to the wound healing process. CP treatment prevented a prolonged inflammatory process by down-regulation of the pro-inflammatory cytokines—IL-1β, IL-6, TNF-α, but up-regulation of the anti-inflammatory cytokine, IL-10. This study is the first to indicate a plausible role for CP in accelerating the process of wound healing through anti-inflammatory activity mechanisms, namely, by regulation of inflammatory cytokines, reduction in MPO, and switching of macrophages to an M2 phenotype. These findings may enable the utilization of CP as a potent therapeutic for cutaneous wound healing.</p></div