Bmc Med
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Randomized Controlled Trial Multicenter Study
Effect of intravenous urokinase vs best medicine treatment on functional outcome for patients with acute minor stroke (TRUST): a randomized controlled trial.
The benefits of intravenous thrombolysis in patients with acute minor stroke remain controversial. For the aim of providing a better therapeutic strategy, high-quality trials are required to validate the efficacy of thrombolytic medicine other than intravenous recombinant tissue plasminogen and tenecteplase. In the trial, we evaluate the efficacy and safety of urokinase (UK) in acute minor stroke. ⋯ For patients with acute minor stroke treated within 6 h of symptom onset, UK intravenous thrombolysis treatment was not found to be beneficial in terms of excellent functional outcome at 90 days, whereas it was safe.
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Randomized Controlled Trial
Effectiveness and feasibility of a theory-informed intervention to improve Mediterranean diet adherence, physical activity and cognition in older adults at risk of dementia: the MedEx-UK randomised controlled trial.
Despite an urgent need for multi-domain lifestyle interventions to reduce dementia risk, there is a lack of interventions which are informed by theory- and evidence-based behaviour change strategies, and no interventions in this domain have investigated the feasibility or effectiveness of behaviour change maintenance. We tested the feasibility, acceptability and cognitive effects of a personalised theory-based 24-week intervention to improve Mediterranean diet (MD) adherence alone, or in combination with physical activity (PA), in older-adults at risk of dementia, defined using a cardiovascular risk score. ⋯ The intervention was successful in initiating and maintaining dietary behaviour change for up to 12 months which resulted in cognitive benefits. It provides a framework for future complex behaviour change interventions with a range of health and well-being endpoints.
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Randomized Controlled Trial
The benefit of inhibitory control training for insomnia with short sleep duration phenotype: a pilot randomized trial.
Two phenotypes of insomnia disorder (ID) have been identified based on objective total sleep duration (TST): one with short sleep duration (ISSD) and another with normal sleep duration (INSD). Recent proposals suggested that insomnia with objective short-sleep duration (TST < 7 h) is associated with impaired inhibitory function, leading to a dysregulation of cortical inhibition, which may underlie its prevalence. This study investigated the status of impaired response inhibition in these two phenotypes and examined the potential different effect of response inhibition training on these two phenotypes. ⋯ Impaired response inhibition is a characteristic of ISSD, potentially indicating dysfunctional cortical inhibition, whereas INSD pathogenesis may be related to cognitive-emotional arousal. Response inhibition training effectively alleviates sleep problems in ISSD. These findings provide new insights for developing precise intervention strategies in ID.
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Randomized Controlled Trial
Cognitive benefits of folic acid supplementation during pregnancy track with epigenetic changes at an imprint regulator.
The human ZFP57 gene is a major regulator of imprinted genes, maintaining DNA methylation marks that distinguish parent-of-origin-specific alleles. DNA methylation of the gene itself has shown sensitivity to environmental stimuli, particularly folate status. However, the role of DNA methylation in ZFP57's own regulation has not been fully investigated. ⋯ While numbers in the current RCT were small and require further validation in larger cohorts, the results nevertheless suggest a molecular mechanism by which maternal folic acid supplementation during pregnancy may help to counteract the effects of folate depletion and positively influence cognitive development in the offspring.
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Randomized Controlled Trial
Efficacy of melatonin for prolonged disorders of consciousness: a double-blind, randomized clinical trial.
Sleep is essential for the recovery of patients with disorders of consciousness (DoC). However, few approaches targeting sleep were applied. Melatonin has been shown to enhance sleep efficiency with virtually no side effects. This study explored melatonin's benefits for patients with prolonged DoC, as well as the underlying mechanisms involved. ⋯ ClinicalTrials.gov: NCT05285124.