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

Flow structure effects on turbulent transport using computations

Turbulent flow is the most typical flow in various fields such as biological, chemical and industrial applications and atmospheric phenomena. The main goal of this research is to investigate the fundamental effects of the very large-scale structures of turbulence on convective transport and the effects of the interplay between molecular diffusion and flow structure on turbulent transport. Applying Lagrangian computations in conjunction with direct numerical simulations for turbulent flow in channel and Couette flow, it could explore the effects of the very large-scale turbulent fluid motions on scalar transport and determine the mechanism by which they contribute to transport. From that we can develop a predictive model for turbulent scalar transfer and control this. One of our applications is the effect of turbulent flow in cardiovascular devices such as blood pumps, ventricular assist devices (VADs) and even heart valves. According to clinical findings, VAD patients often suffer from acquired von Willebrand disease after VAD implantation. Indeed, the von Willebrand Factor protein is susceptible to supraphysiological shear stress and extensional stress which leads to the conformational change of vWF. Apart from that, the detailed measurement of stresses in a hemodynamic velocity field is difficult, especially in-situ for turbulent flow conditions. In such cases, the use of computational methods has become critical for both the probing of the hemodynamic conditions and for device design. Therefore, recognizing advantages of Direct Numerical Simulation (DNS) and Lagrangian Scalar Tracking (LST) we applied it to the case of vascular assist devices and indicate (i) the development of a numerical methodology for obtaining the history of the stresses on vWF molecules as they move in a flow field; (ii) the detailed calculation of shear and extensional stress statistical distributions on the vWF molecules showcasing the importance of the tails of the distributions in addition to average values; and (iii) the investigation of the importance of the flow field configuration and of the location of vWF injection on the distribution of stresses over time. This study’s contribution is the statistical data for hydrodynamic stress on vWF along the trajectories of protein particles that could contribute to design the medical devices and reduce the cost of experiments. The second application is to investigate the role of helicity in turbulent transport in channel and Couette flow and the interplay between helicity with scalar transport and coherent structures. Helicity is also important for understanding the relationship between coherent structures and turbulent kinetic energy. There has been a hypothesis that coherent structures at different scales are associated with regions in which helicity is large and dissipation of turbulent kinetic energy is low. Low dissipation means that these coherent structures could survive for a long time leading to significant impacts on the flow. In this study, Direct Numerical Simulation (DNS) of turbulent Poiseuille and Couette flow were used in combination with Lagrangian Scalar Tracking (LST) at various Schmidt numbers of 0.7, 6 and infinite (i.e., fluid particles), and the friction Reynolds number for both simulations was 300 to probe the correlation between helicity and dissipation, and the role of helicity in the regions of coherent structures in anisotropic turbulence. Our Lagrangian Scalar Tracking could provide the fluid velocity at each marker location with time. From these data, one can compute turbulent kinetic energy dissipation, vorticity, and helicity along these trajectories. The autocorrelation coefficients, the cross-correlation coefficients and the joint probability density function are employed to investigate the relation between helicity and dissipation, and helicity and vorticity and with the vertical velocity in the Lagrangian framework. In addition, conditional statistics for scalar markers are evaluated in flow regions of high dissipation or coherent structure regions based on vortex identification criteria. In addition, scalar markers that dispersed most or least in the flow field were also calculated to provide more evidence for the role of helicity in transport in turbulent flow

Overview Research on Teacher Training Evaluation Based on Scopus Data from 2000 to 2024

This study aims to provide an overview of teacher training evaluation based on Scopus data from January 2000 to January 2024. The PRISMA model is used to guide the selection of articles. After selection and review, 34 scientific articles are included in the analysis. The author group analyzes information such as the number of research articles, countries, authors, citations, keywords, fields, models, and evaluation methods. The results show that in the last 5 years, the number of research articles on teacher training evaluation has significantly increased. The evaluation fields are relatively diverse, with a focus on English language professional development. There are three groups of evaluation models, among which the evaluation model is increasingly perfected with additional evaluation content. The evaluation methods used include survey research, in-depth interview methods, observational methods, Q-Methodology, process evaluation methods, and self-assessment. Through this overview study, educational researchers and teachers can identify important information about the evaluation of teacher professional development to guide appropriate teacher training activities or select future research topics. Keywords: evaluation, overview, professional development, teachers, Scopus. DOI: 10.7176/JEP/15-3-01 Publication date:March 31st 202

A novel synthesis of core/shell Co0.5Ni0.5Fe2O4/SiO2 nanomaterial and the effect of SiO2 on its magnetic properties

Co0.5Ni0.5Fe2O4 nanoparticles have been synthesized by a stearic acid method. Core/shell Co0.5Ni0.5Fe2O4/SiO2 nanomaterials at varying amount of SiO2 are prepared by hydrolysis and condensation of tetraethyl orthosilicate (TEOS) precursor. The composition phase and average crystallite size have been characterized by means of X-ray diffraction. The particle structure and morphology of the core-shell nanoparticles are determined using transmission electron microscopy (TEM). The presence of Si-O-Si bonds for both coated samples is confirmed through Fourier transform infrared spectroscopic. Results show a decreasing saturation magnetization (Ms) when amount of TEOS is increased. The addition of SiO2 at first instance enhance the coercivity (Hc), and maximum Hc is observed when 0.4 mL TEOS is added. However, adding more SiO2 decrease the coercivity because the domain wall motion on the surface of nanoparticles is limited. © 2019, National Institute of Science Communication and Information Resources (NISCAIR). All rights reserved

Impact of metal stress on the production of secondary metabolites in Pteris vittata L. and associated rhizospherebacterial communities

International audiencePlants adapt to metal stress by modifying their metabolism including the production of secondary metabolites in plant tissues. Such changes may impact the diversity and functions of plant associated microbial communities. Our study aimed to evaluate the influence of metals on the secondary metabolism of plants and the indirect impact on rhizosphere bacterial communities. We then compared the secondary metabolites of the hyperaccumulator Pteris vittata L. collected from a contaminated mining site to a non-contaminated site in Vietnam and identified the discriminant metabolites. Our data showed a significant increase in chlorogenic acid derivatives and A-type procyanidin in plant roots at the contaminated site. We hypothesized that the intensive production of these compounds could be part of the antioxidant defense mechanism in response to metals. In parallel, the structure and diversity of bulk soil and rhizosphere communities was studied using high-throughput sequencing. The results showed strong differences in bacterial composition, characterized by the dominance of Proteobacteria and Nitrospira in the contaminated bulk soil, and the enrichment of some potential human pathogens, i.e., Acinetobacter, Mycobacterium, and Cupriavidus in P. vittata's rhizosphere at the mining site. Overall, metal pollution modified the production of P. vittata secondary metabolites and altered the diversity and structure of bacterial communities. Further investigations are needed to understand whether the plant recruits specific bacteria to adapt to metal stress

Synergy of indium doping and hydrogenation for good-performance and high-mobility ZnO electrode films

We successfully synthesized hydrogenated In-doped ZnO films with a low resistivity of 5 × 10−4 Ωcm and a good transmittance of 80% in the visible region. Furthermore, the electron mobility of the films achieves as high as 45.6 cm2/Vs, which is enhanced by more than 100% compared to the singly In-doped ZnO (IZO) and pristine ZnO films. The analysis of temperature-dependent mobility indicates lattice scattering as the dominant mechanism disturbing carrier transport in the hydrogenated film. According to the Drude model theory, the optical carrier concentration and mobility determined from plasma wavelength also exhibit a significant role of lattice defects. As a result, the reduction in lattice defects is demonstrated to remarkably enhance the mobility and transparent-conducting performance of the hydrogenated IZO films. Specifically, hydrogen passivation and compensation of indium doping significantly decrease Zn-related defects (vacancy and interstitial) as carrier traps and scattering centers in the films

Propyl Gallate

The title compound, propyl gallate (III), is an important substance popularly used in the food, cosmetic and pharmaceutical industries. Current chemical syntheses of this compound are based on the acylation supported by thionyl chloride, DIC/DMAP or Fischer esterification using a range of homogenous and heterogenous catalysts. In this paper, an efficient, green, straightforward, and economical method for synthesizing propyl gallate using potassium hydrogen sulfate, KHSO4, as the heterogenous acidic catalyst has been developed for the first time. In addition, this paper provides a comprehensive spectral dataset for the title compound, especially the new data on DEPT and 2D NMR (HSQC and HMBC) spectra which are not currently available in the literature

Efflux Pump Inhibitors in Controlling Antibiotic Resistance: Outlook under a Heavy Metal Contamination Context

Multi-drug resistance to antibiotics represents a growing challenge in treating infectious diseases. Outside the hospital, bacteria with the multi-drug resistance (MDR) phenotype have an increased prevalence in anthropized environments, thus implying that chemical stresses, such as metals, hydrocarbons, organic compounds, etc., are the source of such resistance. There is a developing hypothesis regarding the role of metal contamination in terrestrial and aquatic environments as a selective agent in the proliferation of antibiotic resistance caused by the co-selection of antibiotic and metal resistance genes carried by transmissible plasmids and/or associated with transposons. Efflux pumps are also known to be involved in either antibiotic or metal resistance. In order to deal with these situations, microorganisms use an effective strategy that includes a range of expressions based on biochemical and genetic mechanisms. The data from numerous studies suggest that heavy metal contamination could affect the dissemination of antibiotic-resistant genes. Environmental pollution caused by anthropogenic activities could lead to mutagenesis based on the synergy between antibiotic efficacy and the acquired resistance mechanism under stressors. Moreover, the acquired resistance includes plasmid-encoded specific efflux pumps. Soil microbiomes have been reported as reservoirs of resistance genes that are available for exchange with pathogenic bacteria. Importantly, metal-contaminated soil is a selective agent that proliferates antibiotic resistance through efflux pumps. Thus, the use of multi-drug efflux pump inhibitors (EPIs) originating from natural plants or synthetic compounds is a promising approach for restoring the efficacy of existing antibiotics, even though they face a lot of challenges

A novel diagnostic model for tuberculous meningitis using Bayesian latent class analysis

Abstract Background Diagnosis of tuberculous meningitis (TBM) is hampered by the lack of a gold standard. Current microbiological tests lack sensitivity and clinical diagnostic approaches are subjective. We therefore built a diagnostic model that can be used before microbiological test results are known. Methods We included 659 individuals aged $$\ge 16$$ ≥ 16 years with suspected brain infections from a prospective observational study conducted in Vietnam. We fitted a logistic regression diagnostic model for TBM status, with unknown values estimated via a latent class model on three mycobacterial tests: Ziehl–Neelsen smear, Mycobacterial culture, and GeneXpert. We additionally re-evaluated mycobacterial test performance, estimated individual mycobacillary burden, and quantified the reduction in TBM risk after confirmatory tests were negative. We also fitted a simplified model and developed a scoring table for early screening. All models were compared and validated internally. Results Participants with HIV, miliary TB, long symptom duration, and high cerebrospinal fluid (CSF) lymphocyte count were more likely to have TBM. HIV and higher CSF protein were associated with higher mycobacillary burden. In the simplified model, HIV infection, clinical symptoms with long duration, and clinical or radiological evidence of extra-neural TB were associated with TBM At the cutpoints based on Youden’s Index, the sensitivity and specificity in diagnosing TBM for our full and simplified models were 86.0% and 79.0%, and 88.0% and 75.0% respectively. Conclusion Our diagnostic model shows reliable performance and can be developed as a decision assistant for clinicians to detect patients at high risk of TBM. Summary Diagnosis of tuberculous meningitis is hampered by the lack of gold standard. We developed a diagnostic model using latent class analysis, combining confirmatory test results and risk factors. Models were accurate, well-calibrated, and can support both clinical practice and research