CVD remains main cause of death worldwide

No mention that maybe stopping the 5 causes of the neuronal cascade of death in the first week would substantially reduce the 30-day stroke deaths.
http://www.healio.com/cardiology/chd-prevention/news/online/%7B6d94a822-3d48-42fc-b5e0-7499310831e4%7D/cvd-remains-main-cause-of-death-worldwide?utm_source=selligent&utm_medium=email&utm_campaign=cardiology%20news&m_bt=592835816269

Mozaffarian D. J Am Coll Cardiol. 2017;doi:10.1016/j.jacc.2017.05.007.
Roth GA, et al. J Am Coll Cardiol. 2017;doi:10.1016/j.jacc.2017.04.052.

May 30, 2017

One-third of all deaths worldwide are attributed to CVD such as stroke and heart diseases, even with declines in the past 25 years due to sociodemographic changes, according to a study in the Journal of the American College of Cardiology.

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“It is an alarming threat to global health,” Gregory A. Roth, MD, MPH, assistant professor of cardiology at the University of Washington in Seattle, said in a press release. “Trends in CVD mortality are no longer declining for high-income regions, and low- and middle-income countries are also seeing more CVD-related deaths.”
Data analysis
Researchers analyzed data from 133 countries from 1990 to 2015. Ten different causes of CVD-related deaths were reviewed, including ischemic stroke, ischemic heart disease, and hemorrhagic and other stroke.
Disability-adjusted life-years were also analyzed, which combined data on years of life lost and years lived with disability. The researchers developed a sociodemographic index to measure changes in CVD burden as global epidemiologic changes occurred.
An estimated 422.7 million cases of CVD were seen globally in 2015 (95% uncertainty interval [UI], 415.53 million-427.87 million). CVD-related deaths increased from 12.59 million in 1990 (95% UI, 12.38 million-12.8 million) to 17.92 million in 2015 (95% UI, 17.59 million-18.28 million).
After age adjustment, numerous countries did not show significant changes in the prevalence of CVD from 1990 to 2015, which may have been due to minimal data availability. CVD significantly declined after age adjustment in countries such as the United States, Canada, Australia, Brazil, Japan, New Zealand, South Korea, Cambodia, Kenya, India, Laos and those in Western Europe. CVD mortality typically declined in high-income regions, but has leveled out recently, according to the researchers.

• 1
• 2

Perspective

Ian J. Neeland

• These findings provide a much-needed global perspective on CVD prevalence and mortality. It is striking that although CVD mortality rates have generally declined in the last decade in the United States, this seems to be a phenomenon limited to well-developed, high-income populations. Most of the world, including Central Asia and Oceania, continue to have a significant burden of mortality related to CVD. These findings should spur the medical community to look outside of our own “home” and refocus our efforts on battling the global public health burden of CVD.
  Better access to health care and lifesaving and sustaining treatments, especially for those in disadvantaged regions, is certainly one strategy that can help reverse the negative trends in the developing world.
  Obesity, which is growing to be a global epidemic rather than just one localized to North America or well-developed countries, is probably the No. 1 health concern that will slow down our progress in prevention and treatment of CVD. Poor nutrition and lack of physical activity continue to be problems in the modern era of technology and fast food. These major risk factors for obesity will continue to drive the obesity epidemic, especially in the developing world.
• Ian J. Neeland, MD, FAHA
• Cardiology Today Next Gen Innovator
  University of Texas Southwestern Medical Center, Dallas

The Role of Imaging in Clinical Stroke Scales That Predict Functional Outcome: A Systematic Review

Using the Rankin scale for functional outcome measurements is completely stupid. If they are using imaging for prediction they should be using imaging for checking results 
The Role of Imaging in Clinical Stroke Scales That Predict Functional Outcome: A Systematic Review

Show all authors

Fatima Soliman, MD, PhD, Ajay Gupta, MD, Diana Delgado, MLS, ...

First Published May 22, 2017 Research Article

Abstract

Background and Purpose:

Numerous stroke scales have been developed to predict functional outcomes following acute ischemic stroke. The goal of this study was to summarize functional outcome scores in stroke that incorporate neuroimaging with those that don’t incorporate neuroimaging.

Methods:

Searches were conducted in Ovid MEDLINE, Ovid Embase, and the Cochrane Library Database from inception to January 23, 2015. Additional records were identified by employing the “Cited by” and “View References” features in Scopus. We included studies that described stroke prognosis models or scoring systems that predict functional outcome based on clinical and/or imaging data available on presentation. Score performance was evaluated based on area under the receiver operating characteristic curve (AUC).

Results:

A total of 3300 articles were screened, yielding 14 scores that met inclusion criteria. Half (7) of the scores included neuroimaging as a predictor variable. Neuroimaging parameters included infarct size on magnetic resonance diffusion-weighted imaging, infarct size defined by computed tomography hypodensity, and hemodynamic abnormality on perfusion imaging. The modified Rankin Scale at 3 months poststroke was the most common functional outcome reported (13 of 14 scores). The AUCs ranged from 0.64 to 0.84 for scores that included neuroimaging as a predictor and 0.64 to 0.94 for scores that did not include neuroimaging. External validation has been performed for 7 scores.

Conclusions:

Due to the marked heterogeneity in the scores and populations in which they were applied, it is unclear whether current imaging-based scores offer advantages over simpler approaches for predicting poststroke function.

Repetitive reaching training combined with transcranial Random Noise Stimulation in stroke survivors with chronic and severe arm paresis is feasible: a pilot, triple-blind, randomised case series

Never heard of this before so ask your doctor if this chronic therapy might help you.
https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-017-0253-y

• Kathryn S. Hayward,
• Sandra G. Brauer,
• Kathy L. RuddyEmail author,
• David Lloyd and
• Richard G. Carson

Journal of NeuroEngineering and Rehabilitation201714:46

DOI: 10.1186/s12984-017-0253-y

©  The Author(s). 2017

Received: 27 March 2017

Accepted: 15 May 2017

Published: 30 May 2017

Abstract

Background

Therapy that combines repetitive training with non-invasive brain stimulation is a potential avenue to enhance upper limb recovery after stroke. This study aimed to investigate the feasibility of transcranial Random Noise Stimulation (tRNS), timed to coincide with the generation of voluntary motor commands, during reaching training.

Methods

A triple-blind pilot RCT was completed. Four stroke survivors with chronic (6-months to 5-years) and severe arm paresis, not taking any medications that had the potential to alter cortical excitability, and no contraindications to tRNS or MRI were recruited. Participants were randomly allocated to 12 sessions of reaching training over 4-weeks with active or sham tRNS delivered over the lesioned hemisphere motor representation. tRNS was triggered to coincide with a voluntary movement attempt, ceasing after 5-s. At this point, peripheral nerve stimulation enabled full range reaching. To determine feasibility, we considered adverse events, training outcomes, clinical outcomes, corticospinal tract (CST) structural integrity, and reflections on training through in-depth interviews from each individual case.

Results

Two participants received active and two sham tRNS. There were no adverse events. All training sessions were completed, repetitive practice performed and clinically relevant improvements across motor outcomes demonstrated. The amount of improvement varied across individuals and appeared to be independent of group allocation and CST integrity.

Conclusion

Reaching training that includes tRNS timed to coincide with generation of voluntary motor commands is feasible. Clinical improvements were possible even in the most severely affected individuals as evidenced by CST integrity.

Trial registration

This study was registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR) http://www.ANZCTR.org.au/ACTRN12614000952640.aspx. Registration date 4 September 2014, first participant date 9 September 2014.

Study uncovers stroke risk factors for pregnant women with preeclampsia

Be careful out there.
http://www.news-medical.net/news/20170525/Study-uncovers-stroke-risk-factors-for-pregnant-women-with-preeclampsia.aspx

• Download PDF Copy

May 25, 2017

Women with preeclampsia, a common complication of pregnancy, face a heightened risk of stroke during pregnancy and postpartum if they have urinary tract infections, chronic high blood pressure, or clotting or bleeding disorders, according to a study by Columbia University Medical Center (CUMC) and NewYork-Presbyterian researchers.
The study, among the most comprehensive analyses of its kind, was published online today in the journal Stroke.
"We have suspected that certain conditions raise the risk of stroke in women with preeclampsia, but few studies have taken a rigorous look at this issue," said lead author Eliza C. Miller, MD, a postdoctoral vascular neurology fellow in the department of neurology at NewYork-Presbyterian/Columbia University Medical Center. "Since strokes can be so devastating, it is critical to know whether these are just random events or due to modifiable risk factors."
Preeclampsia-;newly elevated blood pressure during pregnancy-;develops in about 3 to 8 percent of all pregnant women, according to the researchers. The cause of preeclampsia is not well understood. While preeclampsia can be mild and symptomless, it can quickly become severe. Left untreated, severe preeclampsia can have serious consequences for both mother and fetus. One of the most dangerous complications is pregnancy-associated stroke, which occurs up to 6 times as often in women with preeclampsia compared with pregnant women overall.
In the study, Dr. Miller and her colleagues analyzed the health records of 197 women who had a preeclampsia-related stroke and 591 women with preeclampsia who did not have a stroke, according to the New York State Department of Health inpatient database. The incidence of stroke in women with preeclampsia was over 200 per 100,000 deliveries, and more than one in 10 women in the study who had a preeclampsia-related stroke died in the hospital.

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"Women with preeclampsia who had chronic hypertension, bleeding or clotting disorders, or infections-;particularly urinary tract infections-;appeared to be at significantly increased risk of stroke," said Dr. Miller.
"The role of infection was perhaps the biggest question mark going into the study," said Dr. Miller. "Infections cause inflammation, which is known to play an important role in triggering stroke, especially in young people. Preeclampsia itself is an inflammatory disorder. Infections may be what pushed some of these women over the edge."
"The take-home message for pregnant women with preeclampsia and their doctors is to pay close attention to these risk factors, as well as to warning signs for stroke," said Dr. Miller. "It's important to note that the risk of stroke in women with preeclampsia doesn't end with delivery, as is commonly thought. About two-thirds of preeclampsia-related strokes occur after birth, when the mother has gone home. With all the stress of having a new baby, mothers sometimes ignore symptoms like headaches that could be a sign of a serious problem. They think, 'I'm tired, I just had a baby-;of course, I have a headache.' But this is not something to take lightly. Call your doctor if you have any signs and symptoms of stroke."

Source:

http://newsroom.cumc.columbia.edu/blog/2017/05/25/stroke-risk-factors-for-pregnant-women-with-preeclampsia-uncovered/

Feature selection for elderly faller classification based on wearable sensors

This would seem to be useful for our therapists to use the information from this to use their fall resiliency protocol to prevent falls.

Feature selection for elderly faller classification based on wearable sensors

• Jennifer Howcroft,
• Jonathan Kofman and
• Edward D. LemaireEmail author

Journal of NeuroEngineering and Rehabilitation201714:47

DOI: 10.1186/s12984-017-0255-9

©  The Author(s). 2017

Received: 20 April 2016

Accepted: 15 May 2017

Published: 30 May 2017

Abstract

Background

Wearable sensors can be used to derive numerous gait pattern features for elderly fall risk and faller classification; however, an appropriate feature set is required to avoid high computational costs and the inclusion of irrelevant features. The objectives of this study were to identify and evaluate smaller feature sets for faller classification from large feature sets derived from wearable accelerometer and pressure-sensing insole gait data.

Methods

A convenience sample of 100 older adults (75.5 ± 6.7 years; 76 non-fallers, 24 fallers based on 6 month retrospective fall occurrence) walked 7.62 m while wearing pressure-sensing insoles and tri-axial accelerometers at the head, pelvis, left and right shanks. Feature selection was performed using correlation-based feature selection (CFS), fast correlation based filter (FCBF), and Relief-F algorithms. Faller classification was performed using multi-layer perceptron neural network, naïve Bayesian, and support vector machine classifiers, with 75:25 single stratified holdout and repeated random sampling.

Results

The best performing model was a support vector machine with 78% accuracy, 26% sensitivity, 95% specificity, 0.36 F1 score, and 0.31 MCC and one posterior pelvis accelerometer input feature (left acceleration standard deviation). The second best model achieved better sensitivity (44%) and used a support vector machine with 74% accuracy, 83% specificity, 0.44 F1 score, and 0.29 MCC. This model had ten input features: maximum, mean and standard deviation posterior acceleration; maximum, mean and standard deviation anterior acceleration; mean superior acceleration; and three impulse features. The best multi-sensor model sensitivity (56%) was achieved using posterior pelvis and both shank accelerometers and a naïve Bayesian classifier. The best single-sensor model sensitivity (41%) was achieved using the posterior pelvis accelerometer and a naïve Bayesian classifier.

Conclusions

Feature selection provided models with smaller feature sets and improved faller classification compared to faller classification without feature selection. CFS and FCBF provided the best feature subset (one posterior pelvis accelerometer feature) for faller classification. However, better sensitivity was achieved by the second best model based on a Relief-F feature subset with three pressure-sensing insole features and seven head accelerometer features. Feature selection should be considered as an important step in faller classification using wearable sensors.

Stroke Rehabilitation: Exercise Improves Cognitive Function

DUH! But the researchers and doctors involved in this don't have enough brains to write this up in a stroke protocol so we don't waste further research dollars and time on this.

Defining Optimal Aerobic Exercise Parameters to Affect Complex Motor and Cognitive Outcomes after Stroke: A Systematic Review and Synthesis Feb. 2016

The latest here:

Stroke Rehabilitation: Exercise Improves Cognitive Function

Just when you’re at your lowest after suffering a stroke, you’ll be asked to do some of the hardest things you’ve ever done in your life. The road to recovery includes a significant amount of rehabilitation. You’ll undergo physical therapy to regain gross motor skills such as walking and maintaining your balance. Occupational therapy will help you relearn how to perform everyday tasks like eating and bathing yourself. Speech therapy supports your ability to communicate, and psychological counseling will help you deal with the emotional stress.
At the top of the list of tough challenges will be incorporating exercise into your recovery. New research shows that exercise may be one of the most important parts of your recovery – not just for your body, but for your mind as well.

What the Research Shows About Exercise After Stroke

Doctors and therapists have long known that exercise is helpful after a stroke, but an analysis of several research studies provides more insight into what exercise actually works best – specifically the type of exercise and the duration.
The biggest takeaway from the analysis is that exercise after a stroke is good not only for the body but for the brain as well. In the simplest terms, a stroke cuts off blood supply to the brain. It can impair cognition, which includes vital mental processes such as thinking, memory, understanding, and learning.
This new research shows that people who exercise after a stroke show greater improvements in cognition than people who do not exercise. And the good news is, that exercise does not need to be intense: Walking on a treadmill at a slow pace was enough to provide a benefit.
The people who have the most significant improvements in cognition after stroke combine this type of moderate aerobic exercise with strength and balance exercises. They see benefits in their working memory, mental processing speed, and attention.
While most people who suffer a stroke will be encouraged to start an exercise program early in the recovery process, the research showed the benefits were seen even if exercise started much later. Stroke patients who began exercising 2.5 years after their stroke still saw benefits in cognition. Additionally, the exercise program did not have to last long; programs that lasted four to 12 weeks were just as effective as longer-term regimens.

Exercise Is Only Part of the Equation

The holistic approach that brings together exercise with other forms of therapy are all important parts of the stroke recovery process. Equally important is making lifestyle changes that may help to ward off another stroke in the future.
These changes should include controlling medical conditions such as atrial fibrillation, high blood pressure, high cholesterol, diabetes, and obesity. You should also make sure that you get the recommended amount of exercise (when and if you’re physically able), and make changes to your diet – including cutting back on the amount of alcohol you drink – to reduce your risks.
Keep in mind that if you or someone you love has suffered a stroke, it’s critical to maintain hope and a positive outlook. Your rehabilitation team will be working hard (Bullshit, they really do nothing at all)to help you live a happy, independent, and healthy life.

MicroTransponder Presents Long Term Stroke Trial Data at INS and Announces a 120 Patient Pivotal Stroke Trial

Ask your doctor if this non-invasive stimulation of the vagus nerve would be better. I don't care that this wasn't tested in stroke yet. Does no one have any brains to rub two neurons together to run this non-invasive one thru stroke clinical trials?

FDA Releases gammaCore®, the First Non-Invasive Vagus Nerve Stimulation Therapy Applied at the Neck for Acute Treatment of Pain Associated with Episodic Cluster Headache in Adult Patients

http://www.marketwired.com/press-release/microtransponder-presents-long-term-stroke-trial-data-ins-announces-120-patient-pivotal-2219173.htm

Late Breaking Long Term Clinical Study Results at the International Neuromodulation Society Conference Show Continued Improvement for Stroke Patients and a New 120 Patient Stroke Trial Will Begin Enrollment this Summer

DALLAS, TX--(Marketwired - May 30, 2017) - MicroTransponder, Inc., (www.microtransponder.com) today unveiled new positive long-term positive clinical trial results from the Vivistim™ Stroke Rehabilitation trial. The objective of this multicenter, double-blind, randomized, active-controlled trial was to improve upper limb mobility in stroke survivors suffering chronic disability. The data was presented by Jesse Dawson M.D., University of Glasgow Hospital, and Teresa Kimberley, PhD, University of Minnesota Hospital. They presented the data to the clinicians gathered at the International Neuromodulation Society (INS) conference in Edinburgh, UK. The data showed 75% of patients had a clinically meaningful response on the Fugl-Meyer Upper Extremity Scale (FMUE) at the end of a six weeks of physical therapy compared to 33% for the control group. 90 days after the six weeks of physical therapy ended 88% of VNS patients had responded compared to 33% in the control arm. And during the long-term portion of the study average FMUE scores continued to increase, with the 6 month and 9 month data showing further gains. All responders indicated they believed their overall health had improved and were satisfied with the therapy.
"We saw remarkable improvement in some patients' upper limb function over the course of this trial," said Dr. Dawson. "For many patients, this included important daily activities such as feeding, grooming, driving, and dressing themselves. Some patients were able to resume their higher-level hobbies, such as photography, practicing piano, hosting large family events, and playing golf. Overall, my patients were able to integrate the at- home-therapy component of the program quite easily into their lives."
The Stroke Rehabilitation trial featured the Vivistim® System, which is a neurostimulation based system with a small implanted battery and wires that internally connect to the vagus nerve in the neck. As the patient performs physical therapy exercises, they receive a small burst of neurostimulation to their vagus nerve. This Paired VNS® (Vagus Nerve Stimulation) method is based on decades of neuroscience research and takes advantage of the brain's ability to rewire itself (neuroplasticity). When stimulated, the vagus nerve causes the release of neurochemicals in the brain that encourage neuroplasticity. More information can be found on www.MicroTransponder.com.
In addition to the presentation of the long-term data, Frank McEachern, CEO of MicroTransponder; also spoke at the INS. McEachern announced that MicroTransponder had received IDE approval from the FDA to run a 120-patient pivotal trial. The stroke rehabilitation trial will include 12 U.S. and 3 UK centers and will begin enrolling patients this Summer. "There are currently very few options for chronic stroke survivors and our committed team of physicians, researchers, and engineers hope to deliver a meaningful option that will make a significant difference for these survivors and their families," noted McEachern. "We experienced an outpouring of interest from many academic centers to participate in our clinical trials once we presented our initial stroke rehabilitation data at the International Stroke Conference earlier this year. We are pleased to announce that our 120-patient clinical trial is now approved and includes many prestigious institutions and some of the best stroke and neurostimulation researchers worldwide. Enrollment will begin this Summer and additional clinical trial information can be found by visiting www.vnsstroketrial.com."
About MicroTransponder, Inc.
MicroTransponder Inc. (www.microtransponder.com) is a medical device development company with a strong neuroscience research focus. An experienced team of scientists and engineers has developed neurostimulation technology platforms to treat various forms of neurological diseases, including post stroke motor rehabilitation and tinnitus. MicroTransponder has a sizeable neurostimulation-focused R&D program which is able to quickly translate scientific discoveries into clinical therapies.

Contact Information

• 
  
  Jordan Curnes
  jordan@microtransponder.com469-225-9268

Care path of person with stroke: from onset to rehabilitation

So rather than focusing on the real problem; lack of interventions that get you to 100% recovery. The focus was on the secondary problems of delivering care. Solve the correct problem and the delivery of care ceases to be a problem. 

Care path of person with stroke: from onset to rehabilitation

Rev. Bras. Enferm. vol.70 no.3 Brasília May/June 2017

http://dx.doi.org/10.1590/0034-7167-2016-0579  

Camino que recorre la persona con accidente vascular encefálico: desde el acontecimiento hasta la rehabilitación

Ana da Conceição Alves Faria^I 

Maria Manuela Ferreira Pereira da Silva Martins^II 

Soraia Dornelles Schoeller^III 

Leandro Oliveira de Matos^IV 

^ICentro Hospitalar do Médio Ave Vila Nova Famalicão. Braga, Portugal.

^IIPorto Nursing School. Porto, Portugal.

^IIIUniversidade Federal de Santa Catarina, Nursing Departament. Florianópolis, Santa Catarina, Brazil.

^IVSecretaria do Estado de Saúde de Santa Catarina. Florianópolis, Santa Catarina, Brazil.

ABSTRACT

Objective:

to describe the care path of the person with stroke goes through and to identify the important events in this path.

Method:

qualitative descriptive exploratory research, using the semi-structured interview technique based on Meleis's Middle-Range Theory. The sample was composed of 13 people who became dependent after a stroke and were admitted to two hospital units in the region of Vale do Ave, Portugal. Data were collected between January and October 2013. Content analysis was used to analyze the data.

Results:

The data revealed that the person's care path goes from recognition of the symptoms to preparation for hospital discharge. Adapting to the new situation of dependence brings the need for new competencies.

Final considerations:

The research aims to contribute to the improvement of nursing care regarding care for people with stroke including onset, recovery and rehabilitation, and home care.

Does Alcohol Thin Your Blood?

Ask your doctor for the exact amount per body weight and sex needed to replace your aspirin regimen. Don't do this on your own, you will never get the right amount. Considering how many social events and parties I go to I think I'm well covered.
https://www.verywell.com/alcohol-can-act-as-a-blood-thinner-67362

By Buddy T

Updated April 14, 2017

Moderate drinking is a two-edged sword. It may have some beneficial effects, but at the same time, those very same effects could be negative in other areas of your health.

Moderate drinking is also a balancing act, of sorts. If you drink exactly the right amount to be "moderate" it may be better in some health effects than not drinking at all, but if you drink just a tad over the guidelines for moderate, it is much more dangerous than not drinking at all.

It's called the J-curve.

Take blood coagulation, for example. If you drink a moderate amount of alcohol—defined in one large study as three to six drinks per week—it may have the benefit of acting as a blood thinner and be protective against clotting in clogged arteries, like aspirin does. At the same time, thinning the blood can hasten bleeding from injured arteries, increasing the risk of bleeding strokes.

Precautions Against Drinking Alcohol While Taking Blood Thinners

You should abstain from alcohol while taking anticoagulant blood thinners such as Coumadin (warfarin) as the blood-thinning effects of alcohol can interact with those of the prescribed drugs. It will be more difficult for your healthcare providers to determine the correct dosage for the prescribed blood thinner if you also drink alcohol. As you will be placed on blood thinners to prevent a significant health threat, such as a deep venous thrombosis, it's best not to take the risk and have an alcoholic beverage.Learn More

Also, consider the other prescriptions that you take. Sometimes they interact with blood thinners and alcohol. Follow the precautions and refrain from drinking if that is recommended.

Don't Substitute Alcohol for Prescription Blood Thinners

Likewise, if you need anticoagulation to reduce a health risk, it is unwise to think that drinking alcohol is a substitute for prescribed blood thinners.

When your doctor prescribes an anticoagulant such as Coumadin, you will also have your blood tested regularly to ensure you are getting just the right amount of blood thinning. Too little and you aren't protected. Too much and you risk bleeding.

Contrasting Effects of Alcohol on Coagulation

Some studies have shown that moderate drinkers tend to have lower rates of heart disease, but higher rates of bleeding-type strokes than abstainers. However, some researchers believe that the ability of moderate drinking to make blood platelets less "sticky" may mediate the negative effects of moderate drinking.
"The contrasting effects of alcohol are similar to the effects of blood thinners like aspirin, which clearly prevent heart attacks but at the expense of some additional bleeding strokes," said Kenneth J. Mukamal, corresponding author for a study on effects of moderate drinking on blood coagulation. "Acting as a blood thinner makes sense, because heart attacks are caused by blood clots that form in clogged arteries, and blood thinners can hasten bleeding from injured arteries. Based on these findings, we speculated that moderate drinking would also act as a blood thinner."

Mukamal said previous research had shown that moderate drinkers tend to have "less sticky" platelets than abstainers, meaning that fewer blood elements cluster to form blood clots.

He studied 5,124 men and women enrolled in the Framingham Offspring Study of risk factors for cardiovascular disease.

"We found that among both men and women, an intake of three to six drinks per week or more was linked to lower levels of stickiness measured by aggregability," said Mukamal. "Among the men, we also found that alcohol intake was linked to lower levels of platelet activation. Together, these findings identify moderate drinking as a potential blood thinner."

No Reason to Start Drinking

"Our findings add to a large body of evidence showing that moderate drinking has effects on blood coagulation, which may have both good and bad effects, but now identify a new avenue by which this effect may occur," said Mukamal.

"By themselves, these findings have more importance for understanding risk factors for vascular disease than any clinical relevance, and should not be used by people as any reason to begin drinking."

Meanwhile, there is increasing skepticism among researchers that moderate drinking has protective health effects for heart disease, according to the CDC. The bottom line is, although moderate drinking may have some health benefits, there is risk involved, too. If you don't drink, the risks of developing other problems associated with alcohol may be too great to begin drinking for its limited benefits.
Sources:
Fact Sheets - Moderate Drinking. CDC. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
Mukamal, KJ, et al. " Alcohol Consumption and Platelet Activation and Aggregation Among Women and Men: The Framingham Offspring Study." Alcoholism: Clinical & Experimental Research October 2005
Taking Warfarin (Coumadin) NIH MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000292.htm

Developing a stroke rehabilitation exercise adherence measure: StREAM : a self-report tool assessing the likelihood of adherence

Once again nothing for your therapist and doctor to do to get you recovered. This allows the medical profession to blame you for your lack of recovery.
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.712524

Author:	Bollen, Jessica Charlotte
Awarding Body:	Exeter and Plymouth Peninsula Medical School
Current Institution:	Exeter and Plymouth Peninsula Medical School
Date of Award:	2017
Availability of Full Text:	Full text unavailable from EThOS. Please contact the current institution’s library for further details.
Abstract:
Adherence is necessary to establish the effectiveness of rehabilitation exercises for those with long term conditions, but measuring it is problematic. Adherence is vital when attempting to measure and understand how an intervention works; without appropriate levels of adherence it is not possible to conduct a fair test of an intervention since failure to find benefit may be due to poor adherence rather than an ineffective intervention. There are no gold standard measures, and objective measurement devices are fallible. Without an accurate way to assess if participants are adherent to their exercise programs the efficacy of the programme cannot be assessed. Therefore the objective of this PhD was to develop a psychometrically valid and reliable self-report adherence measure to assess the likelihood of adherence for stroke survivors called the Stroke Rehabilitation Exercise Adherence Measure, (StREAM). A large systematic review was conducted to synthesise the existing evidence for self-report measures of adherence to prescribed unsupervised exercise programmes. The review found many measures but few possessed acceptable any tested psychometric properties and therefore the need for a psychometrically sound adherence measure to assess the likelihood of adherence was highlighted. To ensure StREAM had robust content validity stroke survivors (n=16), physiotherapists (n=3), and exercise professionals (n=2) were interviewed. Items were created from salient phases in the interviews which were then discussed at two focus groups of stroke survivors. This ensured items in StREAM were suitable and comprehensible to the target population.
Supervisor:	Not available	Sponsor:	Not available
Qualification Name:	Thesis (Ph.D.)	Qualification Level:	Doctoral
EThOS ID:	uk.bl.ethos.712524	DOI:	Not available
Share:	ShareThis Facebook Tweet LinkedIn Email CiteULike Blogger

Marijuana May Be A Weapon Against Brain Aging, Suggests New Study

Don't do this on your own, it was only tested in old mice and at low levels which you would never be able to duplicate with marijuana joints.
https://www.forbes.com/sites/daviddisalvo/2017/05/30/marijuana-may-be-a-weapon-against-brain-aging-suggests-new-study/#68e3107a51ca

David DiSalvo ,  

Contributor

I write about science, technology and the cultural ripples of both.

Opinions expressed by Forbes Contributors are their own.

Since the legalization movement began hitting full stride, new research discoveries about marijuana’s potential health benefits have been surfacing with regularity. Among the most recent, a study shows that the psychoactive chemical in marijuana, THC (tetrahydrocannabinol), restores cognitive function in the brains of mice by rolling back the aging process.
The study builds from a theory that the brain’s endocannabinoid system (home of the receptors that THC binds to) is related to cognitive aging and decline. The older we get, the more the activity in this system slows down; our brains gradually produce fewer naturally occurring endocannabinoids. The outcomes from this slowdown aren’t entirely understood, but there’s enough evidence from animal models to suggest that it’s tied to memory loss and decreased learning ability.
"With increasing age, the quantity of the cannabinoids naturally formed in the brain reduces," quoting Professor Andreas Zimmer, one of the study’s authors. "When the activity of the cannabinoid system declines, we find rapid aging in the brain."
So, if it’s possible to somehow recharge the system, it could be possible to reverse or at least reduce the cognitive slowdown. That’s what the researchers tried with old mice, and the results were remarkable. When they studied the brain tissue and gene activity of the mice after a low-dose THC treatment, they found that the genetic signature no longer looked like that of old mice, but of very young mice. And they found increased nerve links in the brain tissue, which correlates with learning and thinking speed.
Again quoting Zimmer, “It looked as though the THC treatment turned back the molecular clock.”
Yes, these are mice and not humans, and yes, this sort of research would be difficult to perform on humans for obvious ethical reasons–but it’s still extraordinary. It sounds implausible to think that adding low doses of a chemical from a plant could reverse the brain’s aging process, but that’s exactly what this study shows glimpses of in the brain tissue of mice.
While we can’t draw solid conclusions from this study for humans, the results add to a promising list of findings that should continue encouraging cannabis research. It's imperative that that door stays open.
The study was published in the journal Nature Medicine.

Electrical stimulation device helps arm mobility in stroke victims

This makes so much sense that it won't happen. I was always guessing where to place the pads and jolt strength when using the estim device I bought.

https://www.springwise.com/electrical-stimulation-device-helps-arm-mobility-stroke-victims/

Intento, the start up created by Swiss research institutions EPFL and NCCR Robotics, has created a patient-controlled electrical stimulation device to help stroke victims regain mobility in affected arms. A common stroke-rehabilitation method uses functional electrical stimulation, where a therapist places electrodes on the patient’s skin and delivers an electric shock that makes the patient’s muscles move. Studies have shown this therapy works best when patients are involved in moving their own limbs.
Intento’s creation consists of electrode patches, a device the patients control using their working hand, and a tablet software. After selecting one of the tablet programs, it shows where the electrodes need to be placed and automatically configures the electrical pulse settings to generate the desired movement. Patients then move their functioning hand to control the electrical stimulation needed to fulfil the movement, such as picking up a glass or pressing a button.
The ultimate aim is that patients can perform the movements without using the device. A study by Lausanne University Hospital (CHUV) showed that patient mobility significantly bettered after using the device, with 70% of patients showing notable improvement in their motor functions compared with only 30% using conventional therapy.
Stroke rehabilitation has been the subject of different technology trials, with a wearable sleeve to boost stroke recovery rate and a smart glove that uses gaming to help stroke patients recover the use of a hand being among solutions being tested. Will digital wearables ever reach the mainstream in stroke rehabilitation?
Website: www.intento.ch
Contact: info@intento.ch

New Medical Tech Could Revolutionize Stroke Detection

Why use this slow one of up to 10 minutes when these others are so much faster?

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes

https://www.theet.com/news/free/new-medical-tech-could-revolutionize-stroke-detection/article_8efff094-261e-5568-9794-5926be7bb311.html

• by John Dahlia The Preston County News & Journal
• May 28, 2017

You could say all Taura L. Barr ever wanted was to be a nurse.
“I’ve always been drawn to helping people and had a fascination with nature and how the body worked from an early age,” Barr said.
With a little help from her high school science teacher, Barr quickly achieved her lifelong dream, which then lead her to a revolutionary medical discovery that could change the way strokes are diagnosed and treated forever.

REST, or Rapid Evaluation Stroke Triage Test, is an innovative approach that uses a few drops of blood to aid in the preliminary diagnosis of suspected stroke patients within minutes.
According to the American Heart Association and American Stroke Association’s 2017 heart disease and stroke statistics report, someone in the U.S. has a stroke about once every 40 seconds, accounting for one of every 20 deaths in the U.S. Cerebrovascular disease, or stroke, is the third leading cause of death in the nation and the fourth leading cause of death in West Virginia.
One way to detect if someone is having or has had a stroke is by using a visual examination technique called F.A.S.T., which stands for: F — Face Drooping; A — Arm Weakness; S — Speech Difficult; T — Time to call 911.
Barr, who today is a registered nurse, a Ph.D. and chief scientific officer of the biotech startup, Valtari Bio, said her “ah-ha” moment came nearly 10 years ago when she witnessed exactly how a misdiagnosed stroke can have tragic consequences.
“She had a complication from an undiagnosed aneurysm which causes a type of stroke, and she died right there in front of me,” Barr said of a patient. “It was terrible and, honestly, the first time I had ever experienced something so horrifying.”
After that, Barr’s vision was clear. The girl from a family of factory workers in Wheeling quickly pursued a better way to diagnose and treat stroke in a personalized and precise way.
Barr spent many years focused on making her discovery a reality.
“I lived, breathed and slept stroke diagnosis and brought that motivation to my postdoctoral studies and even into my faculty appointment at West Virginia University,” she said.
Barr’s pace, as she put it, was relentless. But that changed in February 2013.
“I was 12 weeks pregnant and developed a pulmonary embolism, lots of complications and almost died,” she said. “That set everything in perspective for me.”
Barr’s baby survived, but she learned an invaluable lesson.
“I was reminded that I wasn’t running a race; I was running a marathon and needed to take better care of myself and this vision I’ve been given,” she said.
In April 2016 Barr’s vision grew with the addition of Richard Giersch who joined Barr and Valerie M. Gionis to form Valtari Bio. The biotech start-up was spun out of the West Virginia University Stroke Center. Today it operates in the West Virginia University Health Sciences Innovation Center in Morgantown.
Valtari Bio is located on the WVU Hospitals campus within the Blanchette Rockefeller Neurosciences Center, and has access to a fully functional biomedical laboratory space with benches, casework and infrastructure.
“Our association and emergence from West Virginia University as a company provided us with a tremendous amount of support,” Giersch said. “Individuals within the state were excited about seeing a potential world-changing technology come out of West Virginia University.”
As CEO of Valtari Bio, Giersch works to keep Barr’s stroke diagnosis and treatment technology moving forward.
“It’s not simply plugging in another type of aspirin to cure a headache where there’s a crowded market,” he said. “This will completely change the way stroke is diagnosed and people are triaged for treatment and potentially recover.”
Giersch said the technology is currently in the clinical trial stages, but the challenge now is to convert the genomic profile taken from blood to a protein profile, which would speed up the process to less than 10 minutes.
“And in less than 10 minutes the machine would say, ‘this person is likely to have a stroke,’ or ‘this person has a very low likelihood of having a stroke,” he said.

Valtari Bio has partnered with the University of Cincinnati Medical Center to conduct a series of clinical trials called the Validation of Sensitivity and Specificity of a Multi-Omic Precision Diagnostic for Acute Stroke Evaluation, or VALISS.
Why the University of Cincinnati? Giersch said UC’s Stroke Center is a world leader when it comes to conducting clinical trial research around stroke.
“That’s the level of expertise they have developed,” he said. “Once we get all the data crunched and we close the next round of funding we’re going to launch clinical trials in up to seven sites across the county.”
The next big step is selecting the perfect enabling technology partner who will provide the handheld device that would actually analyze the drops of blood taken from a potential stroke victim.
“Our intellectual property is around the way to analyze that drop of blood and make a determination of a yes or no stroke,” he said. “It’s essentially the software that makes the hardware valuable.”
Right now, Geirsh and crew are speaking with a few different hardware providers about enabling their profile on their technology.
“We should have that nailed down before the end of summer,” he said.
But bringing Barr’s dream of translating all the science into a handheld point of care test to be used at a patient’s bedside is a costly and time consuming proposition.
“We have about three to five years until we think our product will be on the market,” Barr said.
The investment side continues to be a challenging component. West Virginia investors typically have a low comfort level investing in the biotech industry. Despite that, Giersch said most of the seed money that helped launch Valtari Bio came from Mountain State investors contributing approximately $5 million. Giersch said the total needed is about $25 million.
Regardless of the cost and time concerns, Barr remains confident her stroke test will soon be in small and large hospitals around the nation.
“I know that our test will not prevent all bad outcomes, but even if we save one life it will all be worth it,” Barr said. “I want to impact patient care and until we do so, it won’t really be a reality for me.”

What Your Toilet Paper Reveals About Your Personality

It has to be over because that is the only way you can do the sacred point that motels/hotels use. As written about in 'Motel of the mysteries', Book by David Macaulay.
http://www.spring.org.uk/2017/05/what-your-toilet-paper-reveals-about-your-personality.php?omhide=true 
Do you hang your toilet roll with the end of the paper hanging ‘over’ or with the end hanging ‘under’?
According to a survey by Dr Gilda Carle, ‘over’ people are more assertive.
Assertive people are more likely to be in leadership roles and to have a take-charge attitude, says Dr Carle.
Those hanging the roll ‘under’ are more likely to be submissive.
Submissive people tend to be more agreeable, flexible and empathetic, says Dr Carle.
To create the toilet paper personality test, Dr Carle surveyed around 2,000 people of all ages, asking them whether they rolled the paper over or under.
Some people, Dr Carle has found, actually switched the toilet roll in other people’s houses (around one in five).
Naturally it was those ‘over’ people imposing their dominant personality on submissive ‘unders’.

The rich roll over

Rolling under might also be linked to lower earnings, another survey has found.
73% of those earning under $20,000 rolled under, while 60% of those earning over $50,000 roll over.
(Who knew there were so many surveys on toilet roll alignment?)

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Study opens door to possibility that nutritional intervention could prevent Alzheimer's disease

You likely will get dementia from your stroke. What the hell is your doctor doing to prevent that? ANYTHING AT ALL?
1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.

 Study opens door to possibility that nutritional intervention could prevent Alzheimer's disease

• Download PDF Copy

May 22 2017

The incidence of Alzheimer's disease (AD) is expected to triple in the coming decades and no cure has been found. Recently, interest in dietary approaches for prevention of cognitive decline has increased. In particular, the omega-3 fatty acids have shown anti-amyloid, anti-tau and anti-inflammatory actions in the brains of animals. In a new article published in the Journal of Alzheimer's Disease, researchers have found that for patients with high omega-3 levels, blood flow in specific areas of the brain is increased.
"This study is a major advance in demonstrating the value of nutritional intervention for brain health by using the latest brain imaging," commented George Perry, PhD, Dean and Professor of Biology, The University of Texas at San Antonio, and Editor-in-Chief of the Journal of Alzheimer's Disease.
Single photon emission computed tomography, or SPECT, can measure blood perfusion in the brain. Images acquired from subjects performing various cognitive tasks will show higher blood flow in specific brain regions. When these images were compared to the Omega-3 Index, a measure of the blood concentration of two omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), investigators found a statistically significant correlation between higher blood flow and higher Omega-3 Index. In addition, they evaluated the neuropsychological functions of the subjects and found that omega-3 levels also correlated with various psychological feelings using a standardized test battery (WebNeuro).
This study drew from a random sample of 166 participants from a psychiatric referral clinic for which Omega-3 Index results were available. The participants were categorized into two groups of higher EPA+DHA concentrations (>50th percentile) and lower concentrations (<50th percentile). Quantitative brain SPECT was conducted on 128 regions of their brains and each participant completed computerized testing of their neurocognitive status.

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Results indicated statistically significant relationships between the Omega-3 index, regional perfusion on brain SPECT in areas involved with memory, and neurocognitive testing.
Overall, the study showed positive relationships between omega-3 EPA+DHA status, brain perfusion, and cognition. Lead author Daniel G. Amen, MD, of the Amen Clinics Inc., Costa Mesa, CA, adds, "This is very important research because it shows a correlation between lower omega-3 fatty acid levels and reduced brain blood flow to regions important for learning, memory, depression and dementia."
Co-author William S. Harris, PhD, University of South Dakota School of Medicine. Vermillion, SD, lends this perspective, "Although we have considerable evidence that omega-3 levels are associated with better cardiovascular health, the role of the 'fish oil' fatty acids in mental health and brain physiology is just beginning to be explored. This study opens the door to the possibility that relatively simple dietary changes could favorably impact cognitive function."

Source:

IOS Press

Explore, Dream, Discover.

This along with the Hunter S. Thompson quote are how I'm planning my next 30 years.

"Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do, so throw off the bowlines, sail away from safe harbor, catch the trade winds in your sails. Explore, Dream, Discover."
- Mark Twain

I'm doing the Hunter S. Thompson thing;
“Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a Ride!”

Which #PatientLeader Will You Nominate for "Best in Show: Blog"?

WEGO Health awards.

Which #PatientLeader Will You Nominate for "Best in Show: Blog"?   Who's blog do you absolutely love? Who has the best information, raises awareness, and goes the extra mile for patients and/or caregivers? Which blog do you believe truly raises the bar? This #PatientLeader may be active on numerous social platforms, but their blog is the bread and butter of how they advocate. The winner of this category embodies the essence of what a great blogger should aspire to be.  Visit the WEGO Health Awards website to learn about all 16 award categories and nominate NOW if you haven’t already.

Nominate Now