Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration
Background & purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, và seizures. After trial medication was ceased at 6 months, survivors were followed to lớn 12 months post-randomization. This preplanned secondary analysis aimed khổng lồ determine any sustained or delayed effects of fluoxetine at 12 months post-randomization.
Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 khổng lồ 15 days & persisting neurological deficit who were recruited at 43 hospital stroke units in nước australia (n=29), New Zealand (4), and Vietnam (10) between 2013 & 2019. Participants were randomized to oral fluoxetine đôi mươi mg once daily (n=642) or matching placebo (n=638) for 6 months và followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related chất lượng of life, và safety at 12 months.
Results: Adherence to lớn trial medication was for a mean 167 (SD 48) days & similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine & placebo groups (adjusted common odds ratio, 0.93 <95% CI, 0.76-1.14>; P=0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 <2.18%> versus 29 <4.55%>; P=0.02), & no longer had significantly more falls (27 <4.21%> versus 15 <2.35%>; P=0.08), bone fractures (23 <3.58%> versus 11 <1.72%>; P=0.05), or seizures (11 <1.71%> versus 8 <1.25%>; P=0.64) at 12 months.
Conclusions: Fluoxetine đôi mươi mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. Registration: URL: http://www.anzctr.org.au/; quality identifier: ACTRN12611000774921.
New faculty thành viên Hai “Helen” Li will create a brain-inspired computing research program at mamnongautruc.edu.vn
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Since 1965, the progress of computer giải pháp công nghệ has generally followed Moore’s Law, doubling in processing power while shrinking in size every few years. That trend is about khổng lồ be bucked, however, as the number of transistors that can be packed together is fast approaching fundamental physical limits.
The only way lớn continue the evolution of computing is khổng lồ seek new methods of storing và processing information that lie outside the realm of classical transistors, memory caches & data pathways. Many researchers, including Li, are looking to lớn the human brain for inspiration. It’s a goal that was dubbed a “Grand Challenge” by the white house nhà trắng in 2015; Li was among 15 scientists nationwide invited to participate in a Department of Energy roundtable discussion khổng lồ determine the best paths forward.
“People have been trying to mimic the brain using conventional transistors for decades with very little progress,” said Li, who joins mamnongautruc.edu.vn as an associate professor after four years on the faculty of the University of Pittsburgh. “We are instead trying lớn use emerging công nghệ that can emulate the behaviors of synapses to lớn realize the high complexity and volume of neural connections.”
One example of this work is dubbed a “memristor.” As the name suggests, the evolving electrical component merges properties of memory & resistors. By taking advantage of nanoscale properties, these devices use magnetism as well as electrical currents to lớn store as well as process information, making them much more analogous to lớn a synapse.
With these sorts of advances in hand, Li is working to create “neuromorphic” chips that attempt to model the incredibly large và complex parallel processing nguồn of the human brain. If the individual components can change how they connect with each other in response to lớn stimuli, then the computer cpu can actually learn from its experiences as an actual neural network does.
“We actually have some prototype chips that have demonstrated this capability recently,” said Li, who works with colleagues in HP Labs, the Air Force Office of Scientific Research & the Department of Defense on the project. “Of course they can’t think like a human being yet because they are still very small, but our công nghệ demonstrated the intelligence và complex reasoning needed khổng lồ recognize the patterns of problems.”
Li will find a strong network of collaborators already in place when she arrives at mamnongautruc.edu.vn. She mentions strengths in electronic systems, neuroscience, biomolecular materials, machine learning, computer architecture and technology transfer as reasons for her excitement for her move. Và then there’s the proven track record between mamnongautruc.edu.vn và the mamnongautruc.edu.vn School of Medicine in developing devices for clinical use.
“I get the impression that mamnongautruc.edu.vn is very ambitious and willing khổng lồ take risks with new ideas that could result in significant technological advances,” said Li. “We expect to integrate the local strengths và programs so we’re able to not only deliver the basic hardware itself, but entire environments. The ultimate goal of our research is khổng lồ create general systems for many diverse, specific applications that users are eager & able to lớn access without needing specialized training.”
Li’s eye toward fast integration into actual devices at least partially comes from her experience in industry. Before joining the faculty of the Polytechnic Institute of thành phố new york University in 2009, Li held positions at Qualcomm, Intel & Seagate.
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“I really benefit from my industry experience so much,” said Li, who entered the private job market after earning her Ph
D in electrical and computer engineering from Purdue University. “I’m always thinking about what industry wants and what is realistic khổng lồ deliver. Và on the other side, I’m always learning about what direction their research is going so that I can tailor my pursuits to their future goals.”
One example slightly outside of the realm of brain-inspired computing is Li’s work on emerging memory. Her research into low-power static random-access memory has been used in hãng intel processors. She also led a circuit kiến thiết team on spintronic memory and resistive memory.
“I also introduce a lot of my students lớn potential exchanges & experiences in industry,” said Li. “I always bring students into meetings with industry companies lớn talk about their research. Not only bởi students get khổng lồ learn about what industry is working on, they learn how companies operate, what people really think và how to keep a project moving. This helps them be more prepared for industry jobs when they graduate.”