Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there. Did your doctor somehow miss the recovery protocol that Pedro Bach-y-Rita used to recover fully back in 1958 with only a partial brain?

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label The way forward. Show all posts
Showing posts with label The way forward. Show all posts

Thursday, February 14, 2019

HIMSS19: IBM Watson teams with Brigham, Vanderbilt on $50M AI research initiative

I still want Dr. Watson to tackle creating a strategy for the way forward to solve everything in stroke. No human can put together the tens of thousands of research articles and analyze the way forward.  When the hell will our

fucking failures of stroke associations acknowledge they know nothing about stroke and let smarter people lead the way?


Other uses by Dr. Watson:

VA partners with IBM to use supercomputer Watson to treat cancer

 

MD Anderson Cancer Center to Use IBM Watson

 

IBM Watson, Boston Children’s team on rare pediatric diseases

 

Multiple Sclerosis @Point of Care app with Dr. Watson

 

Fighting Diabetes with Watson: Medtronic & IBM Watson Health 

IBM Watson Makes a Treatment Plan for Brain-Cancer Patient in 10 Minutes; Doctors Take 160 Hours

 

HIMSS19: IBM Watson teams with Brigham, Vanderbilt on $50M AI research initiative


IBM Watson Health is making $50 million investment in healthcare artificial intelligence with the aim of exploring how the technology can be used to improve patient safety and health equity.
The company announced a 10-year investment in collaboration with Brigham and Women’s Hospital—which is a teaching hospital of Harvard Medical School—and Vanderbilt University Medical Center to research the use of AI to address major public health issues.
The collaborations will focus on critical health problems that are ideally suited for AI solutions such as improving the utility of electronic health records (EHRs) and claims data to address patient safety, precision medicine and health equity, IBM officials said in a release.

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The research will also explore physician and patient user experience and interactions with AI technologies.
Kyu Rhee, M.D., vice president and chief health officer at IBM Watson Health, said physicians are spending an average of two hours with their EHRs and deskwork for every hour of patient care. It's an issue the American Medical Association said is leading to a steady increase in physician burnout.
"AI is the most powerful technology we have today to tackle issues like this one, but there is still a great deal of work to be done to demystify the real role of AI in healthcare with practical, proven results and clear-cut best practices," Rhee said in a statement. "By putting the full force of our clinical and research team together with two of the world’s leading academic medical centers, we will dramatically accelerate the development of real-world AI solutions that improve workflow efficiencies and outcomes."
RELATED: IBM and MIT launch $240M AI research lab with a focus on healthcare applications
The collaborations enable IBM Watson Health scientists the opportunity to work with leading health informatics researchers to advance the field in the areas of artificial intelligence, clinical decision support and implementation science, said Gretchen Purcell Jackson, M.D., IBM Watson Health's vice president and chief science officer.
Medical data is expected to double every 73 days by 2020, Jackson noted.
"As a practicing surgeon, I often had to make critical decisions about children’s lives without time to dig for information buried in electronic health records or sift through thousands of studies in the literature. Our collaborative research will unlock new insights that affect broad health stakeholders: from providers, payers, governments, and life science companies to ultimately the most important stakeholder, patients, and seek to improve health around the globe," she said.

David Bates, M.D., chief of general internal medicine at Brigham and Women's Hospital and professor of medicine at Harvard Medical School, said researchers are aiming to find new ways to leverage AI to improve the utility of the EHR and claims data to address major public health issues like patient safety.

Predicting cardiovascular disease

IBM Watson Health and the Broad Institute, which consists of MIT, Harvard and Harvard-affiliated hospitals, also announced a three-year project to use genomics, clinical data and AI to better predict the possibility of serious cardiovascular diseases.
Announced at the Healthcare Information and Management Sytems Society's (HIMSS) annual conference and exhibition on Wednesday, project leaders hope to help provide doctors with tools to tap into the potential of genomics data and better understand the intrinsic possibility an individual has for a certain disease.
With these insights, health professionals can potentially intervene and help to reduce this risk.
The initiative will incorporate population-based and hospital-based biobank data, genomic information and EHRs to build upon and expand the predictive power of genetic risk scoring.
Researchers plan to develop AI tools to produce models that bring together and analyze a multitude of genetic risk factors within an individual’s genome along with existing health records and biomarkers to help clinicians more accurately predict the onset of complex and often fatal conditions in patients, such as heart attacks, sudden cardiac death and atrial fibrillation.
The developed AI technologies will require innovation on three fronts: the ability to integrate several disparate types of health data for modeling; the potential to transfer and apply models on patients from different health systems; and communicating generated insights and analysis results to patients and doctors in a way that is meaningful and actionable.

Saturday, May 16, 2015

Stroke - The Way Forward #2

A slightly disorganized compilation of various part of stroke that can be solved with some judicious use of research funds. And why EXACTLY is your hospital NOT following up on any of these? Are they that incompetent that they don't read research and look for ways to apply it to their patients? Or are they so f*cking lazy that they are waiting for someone else to solve the problem?  I suggest calling the hospital president and asking these questions. People need to be fired for this lack of initiative.

1. Treatment in the ambulance:
Can using a simple blood-pressure cuff limit damage from strokes caused by decreased blood supply to the brain? On the way to the hospital.

Feasibility of an Ambulance-Based Stroke Trial, and Safety of Glyceryl Trinitrate in Ultra-Acute Stroke
Hypothermia?  Maybe, maybe not; More research needed
Study of Brain Cooling and Clot-Busting Drug Therapy for Stroke Receives FDA OK to Expand
The ultimate comeback: Bringing the dead back to life

1. liposome-encapsulated hemoglobin written in Feb. 2010
2.
bat saliva - Draculin  written in May, 2011, up to 9 hours
3.
cardiac glycosides written in Feb. 2006 - up to 6 hours
4.
inhalation of nitric oxide written in March, 2012 - 48 hours to 7 days
5.
Nitric oxide written in 2006, to be tested in humans yet.
6.
xenon gas written in Feb. 2006, to be tested yet
7.
caffeinol irish coffee injection written in April 2003 to be tested in humans
8.
Docosahexaenoic acid (DHA), a component of fish oil written in Nov. 2010, up to 5 hours
9.
nicotine written in July 2005, to be tested in humans
10.
Viagra written in 2002, to be tested in humans,  for 7 days
11.
12.
Enzogenol  written in Nov. 2011 for New Zealand
13.
edaravone approved in Japan since 2001
14.
nitroglycerin instructions
15. benzodiazepine inverse agonist  written in Nov. 2010
16. Leg compressions may enhance stroke recovery Doubles tPA efficacy.

You could easily ask for donations to research whichever part the donor would like the answer to. I personally like caffeinol, bat saliva and Viagra. And a great stroke association would answer and solve these questions if we had one.



Thursday, May 14, 2015

Stroke - The way forward

Since I haven't seen any strategy or planning from any stroke association or person I figure I'm more qualified than most to provide a step by step plan for solving the f*cking problems in stroke. I was going to call this a manifesto but that would recall the Unabomber.
1. No fast, easy, accurate and objective way to diagnose a stroke, both ischemic and hemorrhagic. This is easy to solve; you fund researchers to test out these 17 possibilities to find out which one is the best. Or maybe the Qualcomm Xprize for the tricorder. No installing scanners in the ambulance, that is a waste of money.
The goal is to deliver tPA while still in the ambulance. None of this lazy door-to-needle time.
2. Replace tPA. It only completely works to clear the stroke 12% of the time. This has been known almost since the beginning  but no one was willing to identify the emperor as naked. As a result we've wasted 19 years trying to make the world believe tPA works. And lost 19 years of research time. What a FUCKING waste. Everyone associated with this failure should have their medical license removed.
3. Solve the neuronal cascade of death. I bet this is more important than replacing tPA. We know the 
5 causes of neuronal cascade of death We just need to fund researchers to solve them. Maybe a good start would be to talk to Dr. Michael Tymianski, of the Toronto Western Hospital Research Institute in Canada who talked about 1000+ failed neuroprotective drugs years ago. That talk could establish a basis for why those drugs failed and speed up the solutions needed.  Dr. Michael A. Moskowitz in 2010 had some great ideas needing followup;
The Science of Stroke: Mechanisms in Search of Treatments This is not rocket science, you state exactly the problem and fund researchers to solve that problem. Maybe a few billionaires might want to chip in a few bucks for their self preservation in case they have a stroke.
I will be asking my doctor to do  these 31 hyperacute possibilities I'm going to insist my doctor give me the first week after my next stroke. I don't give a shit if they haven't been clinically proven. I want the kitchen sink and all the mice and rats that gave their lives for stroke research to be thrown at my stroke.  These 177 hyperacute therapies that need more research.
4.  Get an accurate 3d damage diagnosis both dead brain and penumbra. Without this it will be impossible to correlate stroke protocols to recovery. And finally have physiatrists stop giving out stupid prescriptions like ET(Evaluate and treat).  I expect my doctor to know what protocols to prescribe to fix the damage that was just accurately diagnosed rather than throwing every bit of recovery responsibility onto the therapists.  A 3d MRI mapping of dead brain is possible, I had one from James R. Carey, PhD, PT, FAPTA at the University of Minnesota in a research program.  Penumbra damage can be evaluated via PET scans
5. Establish stroke protocols for everything in the first weeks. This requires that our stroke medical professionals have to become professional and drop this blastedly stupid idea that 'All strokes are different, all stroke recoveries are different'' This has been used as a crutch for too fucking long as to why stroke survivors can't be helped to recover.
   a. Diet protocols. Stroke prevention, dementia prevention and stroke recovery. There is plenty of research out there that this should be easy to compile. These are my ideas.

What would a post-stroke diet look like?

  b.  Music protocols. This is a complete no-brainer, your doctor is completely incompetent if this hasn't already been implemented in their hospital.

      1.  Exploring a Neuroplasticity Model of Music Therapy


      2.  Revealed: The Type of Music That Makes You Feel Most Powerful


       3. 11 Problems Music Can Solve


       4. How playing an instrument benefits your brain - Anita Collins


        5. Why does music therapy work? The Science Behind the Music.


        6. Musical Training Can Increase Blood Flow in Bra/in


        7.  Listening to classical music ameliorates unilateral neglect after stroke


         8. Music brings memories back to the brain injured 


         9.  Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study


          10.  Moderating variables of music training-induced neuroplasticity: a review and discussion


           11. Hand-Clapping Songs Improve Motor and Cognitive Skills, Research Shows


         12. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke


         13. Intensive musical therapy may help improve speech in stroke patients 


The classical music one;


           Classical Music’s Surprising Effect on Genes Vital to Memory and Learning

c. Cognitive training protocols.  Survivors need as much brain power as they can muster to recover so give them some training in this. 

        1. Mind expanding: 7 ways to fine-tune your brain


         2. Improving fluid intelligence with training on working memory


         3. Gaming improves multitasking skills Study reveals plasticity in age-related cognitive decline.


         4. NUS study revealed that Vajrayana meditation techniques associated with Tibetan Buddhism can enhance brain performance


         5. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence 


         6. Video Game Training Improves Cognitive Control in Older Adults


         7. The Art and Science of Cognitive Rehabilitation Therapy


         8. Towards a Smart Population: A Public Health Framework for Cognitive Enhancement


          9. Want to Slow Mental Decay? Play a Video Game

d. Meditation protocols.   This is a no-brainer also, Amy has proven this multiple times. The breathwork will generate NO, nitric oxide. Breathing exercises create nitric oxide which relaxes the arterial walls  lowering your blood pressure.
If your doctor doesn't know this, run run far away.

See Amys' posts here:


        Kundalini Yoga


        Why I Do What I Do Part Two…..Meditation


         Meditation and Breathwork


         Meditation and Chanting


         Yoga Breathing

e.  Action observation protocol gifs for every possible muscle movement.

The actual amount of therapy each day is appallingly low, this could be used to fill those empty hours.

           1.  New research supporting stroke rehabilitation   Nov. 2014.


            2.  Plasticity and Response to Action Observation   Oct. 2014.


             3.  Motor imagery during action observation modulates automatic imitation effects in rhythmical actions   Mar. 2014.


            4.  Clinical feasibility of action observation training for walking function of patients with post-stroke hemiparesis: a randomized controlled trial   Mar. 2014.


             5.  Training Videos Help Restore Motor Function, May Aid in Stroke Rehabilitation Mar. 2014.


             6.  Using action observation to study superior motor performance: a pilot fMRI study  Jan. 2014.


              7.  Multiple roles of motor imagery during action observation  Jan. 2014.


              8.  Motor imagery ability in stroke patients: the relationship between implicit and explicit motor imagery measures  Dec. 2013.


               9.  From action representation to action execution: exploring the links between cognitive and biomechanical levels of motor control  Oct. 2013.


               10.  Action observation as a stroke therapy  June 2013.

   

                11.  Action-Observation In Stroke Rehabilitation  June 2013.


                12.  Exercise for stroke patients' brains  June 2013.


                 13.  Watching object related movements modulates mirror-like activity in parietal brain regions  March 2013.


                 14.  Watching object related movements modulates mirror-like activity in parietal brain regions  May 2012.


                  15.  Action observation and mirror neuron network: a tool for motor stroke rehabilitation.  April 2012.


                   16.  Modulating the motor system by action observation: Implications for stroke rehabilitation  Feb. 2012.

 I challenge the following with their staffs to produce something better than this without referring to my blog.
Matt Lopez, president of the NSA
Dr. Mariell Jessup, president of the ASA
WSO President - Steve Davis (Australia)

A separate followup post will delineate where research needs to be done for some physical problems.