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

Enhancement in Photocatalytic Efficiency of Commercial TiO2 Nanoparticles by Calcination: A Case of Doxycycline Removal

In this study, the pure and calcined forms of Degussa TiO2 were applied for photocatalytic removal of doxycycline - a broad-spectrum tetracycline antibiotic. The calcination of TiO2 at 500 °C enhanced the photocatalytic efficiency of the TiO2 under optimal operational conditions of 5 ppm of doxycycline, 0.25 g/L of TiO2, pH 6.5, 120 min, and room temperature. In addition, the changes in morphology, crystal structure, and optical properties of the materials before and after calcination were observed by scanning electron microscopy, X-ray diffraction, and UV-Visible spectroscopy. The reaction kinetics of the doxycycline removal was also investigated based on the Langmuir-Hinshelwood model with a correlation coefficient R2 of >80%. Results showed that the photocatalytic ability of TiO2 is stable and enhanced after being calcined at a suitable temperature of 500 °C. This opens up the potential application of TiO2 in the treatment of emerging organic pollutants in water. Copyright © 2022 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0).

Serotyping dengue virus with isothermal amplification and a portable sequencer

The recent development of a nanopore-type portable DNA sequencer has changed the way we think about DNA sequencing. We can perform sequencing directly in the field, where we collect the samples. Here, we report the development of a novel method to detect and genotype tropical disease pathogens, using dengue fever as a model. By combining the sequencer with isothermal amplification that only requires a water bath, we were able to amplify and sequence target viral genomes with ease. Starting from a serum sample, the entire procedure could be finished in a single day. The analysis of blood samples collected from 141 Indonesian patients demonstrated that this method enables the clinical identification and serotyping of the dengue virus with high sensitivity and specificity. The overall successful detection rate was 79%, and a total of 58 SNVs were detected. Similar analyses were conducted on 80 Vietnamese and 12 Thai samples with similar performance. Based on the obtained sequence information, we demonstrated that this approach is able to produce indispensable information for etiologically analyzing annual or regional diversifications of the pathogens

Adsorptive Removal of Rhodamine B Using Novel Adsorbent-Based Surfactant-Modified Alpha Alumina Nanoparticles

The objective of the present study is to investigate removal of cationic dye, rhodamine B (RhB), in water environment using a high-performance absorbent based on metal oxide nanomaterials toward green chemistry. The adsorption of sodium dodecyl sulfate (SDS) onto synthesized alpha alumina (α-Al2O3) material (M0) at different ionic strengths under low pH was studied to fabricate a new adsorbent as SDS-modified α-Al2O3 material (M1). The RhB removal using M1 was much higher than M0 under the same experimental conditions. The optimal conditions for RhB removal using M1 were found to be contact time 30 min, pH 4, and adsorbent dosage 5 mg/mL. The maximum RhB removal using M1 achieved 100%, and adsorption amount reached 52.0 mg/g. Adsorption isotherms of RhB onto M1 were well fitted by the two-step adsorption model. The electrostatic attraction between positive RhB molecules and negatively charged M1 surface controlled the adsorption that was evaluated by the surface charge change with zeta potential and adsorption isotherms. Very high RhB removal of greater than 98% after four regenerations of M1 and the maximum removal for all actual textile wastewater samples demonstrate that SDS-modified nano α-Al2O3 is a high-performance and reusable material for RhB removal from wastewater