Association between C-reactive protein-albumin-lymphocyte index and stroke: an NHANES analysis (1999–2010)

So you found an association. WHAT THE FUCK NEEDS TO BE DONE TO PREVENT THE PROBLEMS? That is what good stroke research should be doing. This is useless for stroke recovery or prevention! I'd have the mentors and senior researchers fired for such crapola!

 Association between C-reactive protein-albumin-lymphocyte index and stroke: an NHANES analysis (1999–2010)

Yizhou Chen^1†, Meifang Liu^2,3†, Yi Zhang⁴, Xiaolin Yang¹, Mengqi Yue¹, Xu Chen¹, Haiqiang Wang¹, Zirong Wang¹, Haocheng Yu¹ and Jing Shi^1,2,3*

¹Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China

²First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China

³Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China

⁴Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shangdong, China

Edited by
Guanghua Zhai, Nanjing Medical University, China

Reviewed by
Aditya Yashwant Sarode, Columbia University, United States
Gestter Willian Lattari Tessarin, University Center in the North of São Paulo (UNORTE), Brazil
Neel Patel, Staten Island University Hospital, United States

*Correspondence
Jing Shi, 2662831291@qq.com

^†These authors have contributed equally to this work

Received 07 January 2025
Accepted 20 March 2025
Published 02 April 2025

Citation
Chen Y, Liu M, Zhang Y, Yang X, Yue M, Chen X, Wang H, Wang Z, Yu H and Shi J (2025) Association between C-reactive protein-albumin-lymphocyte index and stroke: an NHANES analysis (1999–2010). Front. Neurol. 16:1548666. doi: 10.3389/fneur.2025.1548666

Objective: This cross-sectional study is based on the NHANES (1999–2010) database and aims to explore the potential relationship between the CALLY index and stroke in the U.S. population.

Methods: This cross-sectional study utilized data from NHANES (1999–2010), including 17,511 American participants after data cleaning. Laboratory markers related to the CALLY index were obtained through standardized biological sample collection and analysis procedures performed by trained professionals. Stroke status was determined based on self-reported questionnaires. Various statistical methods were employed to examine the association between the CALLY index and stroke, as well as its predictive efficacy for stroke risk, including multivariable logistic regression, subgroup analysis, RCS analysis, and ROC analysis.

Results: Among the 17,511 participants analyzed, our findings revealed a nonlinear L-shaped negative association between the CALLY index and stroke risk. In Model 3, a higher CALLY index was significantly associated with a lower stroke risk (OR: 0.99, 95% CI: 0.98–0.99, p = 0.045). Additionally, participants in the highest quartile (Q4) of the CALLY index had a 25% lower likelihood of stroke compared to those in the lowest quartile (Q1) (OR: 0.75, 95% CI: 0.58–0.97, p = 0.030). Furthermore, ROC analysis demonstrated that the CALLY index had superior predictive performance for stroke risk compared to the SIRI and SII indices.

Conclusion: A reduced CALLY index may be linked to a higher risk of stroke. Furthermore, the CALLY index demonstrates superior predictive performance compared to the SIRI and SII indices. The association between the CALLY index and stroke risk provides valuable insights for future stroke prevention and management strategies.

More at link.

An innovative model based on machine learning and fuzzy logic for tracking lower limb exercises in stroke patients

 This just measures something. Nothing here will EXACTLY GET YOU RECOVERED!

An innovative model based on machine learning and fuzzy logic for tracking lower limb exercises in stroke patients

• April 2025
• 15(1)

DOI:10.1038/s41598-025-90031-1

• License
• CC BY 4.0

Authors:

Utpal Chandra Das

Ngoc Thien Le

Timporn Vitoonpong

Chalermdej Prapinpairoj

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References (37)

Figures (22)

Abstract and Figures

Rehabilitation after a stroke is vital for regaining functional abilities. However, a shortage of rehabilitation professionals(It's not the shortage of professionals. It's that the 'professionals' haven't created EXACT 100% RECOVERY PROTOCLOLS! Don't you people have two functioning neurons to rub together to understand how to solve stroke?) leads to many patients with severe disabilities. Traditional rehabilitation methods can be time-consuming and hard to measure for progress. This study introduces an innovative machine learning (ML) approach for lower limb rehabilitation in stroke patients. The proposed methodology integrates two models: a fuzzy logic rule-based system and a K-Nearest Neighbor(K-NN) machine learning model. The rule-based model utilizes the Fugl-Meyer Assessment to evaluate lower limb angles during exercises using a camera without human intervention. The hybrid fuzzy logic-based ML model continuously tracks the desired angle, counts exercise repetitions, and provides real-time feedback on patient progress. Furthermore, it measures the Range of Motion (ROM) for each repetition, presenting a graphical visualization of ROMs for ten repetitions simultaneously. The model facilitates real-time evaluation of rehabilitation progress by clinicians, with the lowest observed error rate of $0.34^{\circ }$ of angle measurement. The K-NN model assesses rehabilitation exercise accuracy levels, presenting results graphically, with machine learning accuracy rates of $97\mathrm{\%}$, $92\mathrm{\%}$, and $91\mathrm{\%}$ for hip flexion, hip external rotation, and knee extension rehabilitation exercises. Model training utilized data from 30 experienced physical therapists at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, garnering positive evaluations from rehabilitation doctors. The proposed ML-based models offer real-time and prerecorded video capabilities, enabling telerehabilitation applications. This research highlights the potential of ML-based methodologies in stroke rehabilitation to enhance accuracy, efficiency, and patient outcomes.

Hip Flexion Status.

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Hip External Rotation.

… 

The overall components of our proposed ML-Driven rehabilitation approach for lower limb exercises.

… 

The Fugl-Meyer Assessment (FMA) assessment function of lower limb part for stroke rehabilitation⁵.

… 

+17

From left to right sub-figures: Example hip flexion exercise on left leg.

… 

Figures - available from: Scientific Reports

Association of neutrophil-to-lymphocyte ratio with stroke morbidity and mortality: evidence from the NHANES 1999–2020

We don't need more useless prediction of bad outcomes. Do the damn research that prevents those outcomes!

 Association of neutrophil-to-lymphocyte ratio with stroke morbidity and mortality: evidence from the NHANES 1999–2020

Xin Xu1†, Guoqiang Zhang2,3,4†, Fei Liu3,4,5†, Jingwei Zheng2,3,4, Zhijie Jiang2,3,4, Si Hu6, Xudan Shi7, Wei Wang1, Liang Xu2,3,4* and Zixin Wang1*

1Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China

2Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

3Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China

4State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China

5Neuroscience Intensive Care Unit, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China

6Department of Neurosurgery, Affiliated Huzhou FuYin Hospital of Huzhou University, Huzhou, China

7Department of Anesthesiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

Edited by

Md. Mohaimenul Islam, The Ohio State University, United States

Reviewed by

Rizaldy Taslim Pinzon, Duta Wacana Christian University, Indonesia

Medha Sharath, Bangalore Medical College and Research Institute, India

Dhrumil Shah, Super Metro Specialized Medical Center, Kuwait

Luis E. Fernández-Garza, Mexican Institute of Social Security, Mexico>

*Correspondence

Liang Xu, drliangxu@zju.edu.cn; Zixin Wang, zixinwang@zju.edu.cn

†These authors have contributed equally to this work

Received 04 February 2025

Accepted 21 March 2025

Published 02 April 2025

Citation

Xu X, Zhang G, Liu F, Zheng J, Jiang Z, Hu S, Shi X, Wang W, Xu L and Wang Z (2025) Association of neutrophil-to-lymphocyte ratio with stroke morbidity and mortality: evidence from the NHANES 1999–2020. Front. Med. 12:1570630. doi: 10.3389/fmed.2025.1570630

Background: 

Stroke is closely linked to inflammation, with the neutrophil-to-lymphocyte ratio (NLR) emerging as a promising inflammatory marker. This study aims to investigate the association between NLR and both morbidity and mortality in stroke patients.

Methods: 

Data from the National Health and Nutrition Examination Survey (NHANES) 1999–2020 were analyzed, including adults with complete neutrophil and lymphocyte count records. Multivariate logistic regression was used to examine the relationship between NLR and both stroke morbidity and all-cause mortality. Restricted cubic spline regression was employed to assess potential nonlinearity in these associations. Subgroup analyses were performed to identify influencing factors.

Results: 

After adjusting for confounders, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for stroke in the higher NLR quartiles, compared to the lowest quartile, were 1.28 (1.07–1.52) and 1.36 (1.12–1.65), respectively. The restricted cubic spline curve indicated a nonlinear positive association between NLR and stroke risk. Additionally, an elevated NLR was positively associated with an increased risk of all-cause mortality.

Conclusion: 

The findings underscore the potential use of NLR in stratifying and predicting mortality risk in stroke patients, suggesting its relevance in clinical practice. (I'd have you all fired for useless research!)

More at link.

Barlow patents groundbreaking frontline stroke treatment

 This would seem to be making the process that Margaret Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke' automatic.

 Of course your competent? doctor put together somatosensory protocols from this earlier research a long time ago, right? Oh no, you DON'T have a functioning stroke doctor, do you? Too bad, it's your problem to solve since your stroke hospital board of directors is fucking incompetent in running their hospital!

electrical somatosensory stimulation (2 posts to October 2018)

Barlow patents groundbreaking frontline stroke treatment

     By Deann Gayman | University Communication and Marketing

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Loren Rye | Pixel Lab

Steven Barlow, Corwin Moore Professor in special education and communication disorders, attaches the pTACS' thermoplastic tactile "touch" capsules to the hand of Jacob Greenwood, doctoral candidate in biological systems engineering.

Every year, more than 795,000 American adults suffer a stroke, and one in four adults worldwide will suffer a stroke in their lifetime. Early action can reduce rates of death and disability. 

Now, a group of Husker researchers, led by Steven Barlow, has patented a groundbreaking frontline treatment — the pTACS Somatosensory Biomedical Device — for cerebrovascular accidents that is portable, making it a versatile product for use in rehabilitation clinics, emergency rooms and, potentially, transport ambulances.

“It's a very low-cost device,” said Barlow, Corwin Moore Professor in special education and communication disorders, affiliate faculty in biological systems engineering and resident faculty in the Center for Brain, Biology and Behavior. “That means centers and rehabilitation facilities all over the country and beyond will be able to use this technology. Stroke is the number one health problem worldwide, now surpassing other types of diseases.”

The device includes a “smart” pneumatic controller and a microprocessor that is packaged inside a small black toolbox case and runs on rechargeable lithium-ion batteries — the same type and size of battery in a smartphone. The pTACS is a more compact, portable and precise successor to the Galileo, which Barlow’s team developed more than a decade ago to research how somatosensory treatment employing micro pulses of air could aid in stroke therapy. With funding from the National Institutes of Health, American Heart Association, Barkley Trust and Nebraska Research, Barlow was able to develop and fine-tune the somatosensory therapy protocols through individualized research trials at the University of Nebraska–Lincoln.

The success of those clinical trials led Barlow and team member Jacob Greenwood, a doctoral candidate in biomedical engineering, to focus the design of the device on performance, portability and usability. Barlow and Greenwood share inventor status on the U.S. patent. 

Loren Rye | Pixel Lab

“We take advantage of the inherent anatomy of the human brain — the way these sensory pathways are laid out — and by placing these cells on different parts of the body, we can selectively drive different parts of the brain with tremendous precision.

Steven Barlow

Corwin Moore Professor in special education and communication disorders

The pTACS biomedical device is a non-invasive method of brain stimulation. It utilizes rapidly compressed air pulses that are delivered through small plastic tubes into thermoplastic tactile "touch" capsules adhered to the hands, face, feet or other area of the skin to evoke repeated volleys of nerve responses. The pTACS stimulation has been shown to increase blood flow in tissues of the cerebral cortex that are near the damaged area of the brain. Animal models developed in the Frostig laboratory at the University of California, Irvine (Lay, Davis, Chen-Bee, Frostig, 2010) have shown that repeated somatosensory stimulation delivered during critical periods of recovery has the potential to save brain cells from death, preventing the formation of cerebral infarct. 

“We take advantage of the inherent anatomy of the human brain — the way these sensory pathways are laid out — and by placing these cells on different parts of the body, we can selectively drive different parts of the brain with tremendous precision,” Barlow said.

The toolbox containing the pTACS hardware and firmware is attached to a small laptop containing the software to run the machine, delivering a programmed set of air pulses based on research Barlow and his students have conducted in the Barkley Speech-Language and Hearing Clinic and the Center for Brain, Biology and Behavior, and at other area institutions.

“The connected computer allows the user to select the protocol you want to run, and once that protocol is selected, it does everything,” Greenwood said.

Receiving a patent for the pTACS is a step in the process of getting FDA approval for the device. Barlow said he expects to receive an additional patent for his stroke treatment protocol and is working with NUtech Ventures to create a biomedical startup to manufacture and commercialize the device. Barlow has previous success with developing and commercializing groundbreaking medical devices. He developed and commercialized the NTrainer System 2.0, now sold and marketed internationally by Cardinal Health as the Kangaroo NTrainer System.

Frontline stroke treatment could be just one of the pTACS’ therapeutic possibilities. Barlow and his team are developing and seeking funding to further research treatment protocols for post-stroke injury and speech-language therapy functions, including for those on the autism spectrum disorder.

Loren Rye | Pixel Lab

Jacob Greenwood (front) and Steven Barlow are co-inventors of the recently patented pTACS Somatosensory Biomedical Device.

“We’ve had some patients in the clinic, and they're at least six months post injury. Some of them are two and three years after their stroke, and we're still able to generate very significant improvements in their function,” Barlow said. “This therapy could be administered by a speech-language pathologist, physical therapist, nurse practitioner or someone with a neuroscience background.

“In a current MRI study in collaboration with UNO Department of Biomechanics (Dr. Mukul Mukherjee) and UNMC Department of Neurology (Dr. Pierre Fayad), we use the pTACS device to drive mechanosensory nerve endings in the feet to stimulate the balance and gait system and activate related brain pathways.”

Barlow anticipates more therapeutic uses for the pTACS device will be uncovered through additional research.

“It's got a really good trajectory,” he said. “And we have a vibrant team. We have a lot of investigators, and many students interested in this.” 

What Stroke Recovery Looks Like Today

 Stroke recovery today is a shitshow! Nobody knows one damn thing about 100% recovery!

What Stroke Recovery Looks Like Today

Though it can vary significantly, Tufts medical experts share what patients can expect after they’ve had a stroke

Grace van Deelen

April 2, 2025

Tags: Health , Health Care , School of Medicine

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You may be familiar with the common signs and symptoms of a stroke: loss of vision, drooping face, weak limbs, and slurred speech. But what happens during the recovery phase, once a patient has spent time in the hospital and their brain has begun to recover?

Lester Leung, a vascular neurologist at Tufts Medical Center and associate professor at Tufts University School of Medicine, Gabriele Moriello, a physical therapist and associate professor in the Department of Rehabilitation Sciences at the School of Medicine, and David Thaler, a vascular neurologist at Tufts Medical Center and professor at the School of Medicine, recently shared how stroke patients recover and what factors may help or hinder the process.

The Shape of Recovery

There are two main categories of strokes: ischemic strokes and hemorrhagic strokes. Most strokes, about 87%, are ischemic strokes, caused by the blockage of a blood vessel in the brain. Hemorrhagic strokes, about 13% of strokes, are caused by bleeding in the brain.

Both types of strokes can damage healthy brain tissue. But the two types have slightly different trajectories of recovery. A patient with an ischemic stroke will see their brain function and mobility drop down after a stroke, then begin to improve starting as soon as 24 hours after their stroke.

A person with a hemorrhagic stroke also loses brain function quickly after a stroke. But because there is blood in the brain, hindering its function, it takes longer for that person’s function to return. As blood reabsorbs into the brain, “there’s a very steep potential incline in terms of regaining function, but it’s delayed,” Leung said.

For both ischemic and hemorrhagic strokes, the potential for improvement is high, Thaler said. The “shape” of recovery is also similar: People improve quickly early on, then their progress begins to slow. And while the severity of a stroke doesn’t typically change the shape of recovery, it does affect the extent to which a person will ultimately improve, he said—a person with a mild stroke may regain all their functions, while someone with a severe stroke, such as one that paralyzed them, may not ever recover completely.

“Recovery is different for every single person,” Moriello said.(What a fucking excuse for not knowing how to get survivors recovered! I'd have you fired for that defeatist attitude!)

The Exciting Frontier of Neuroplasticity: Innovations in Brain Health and Recovery

How can it be exciting if neuroplasticity is not repeatable on demand?

We don't SPECIFICALLY know why a neuron gives up its' current job and takes on a neighbors.  Thus nothing on neuroplasticity is scientifically repeatable on demand. So, DEMAND your doctor give you EXACT PROTOCOLS to use. Don't allow your doctor to give you generalities or guidelines. 

The latest here:

 The Exciting Frontier of Neuroplasticity: Innovations in Brain Health and Recovery

Rishabh Saha
Advanced Surgery Center, Rockville, MD, USA.
DOI: 10.4236/jbbs.2025.153003   PDF    HTML   XML   15 Downloads   96 Views  

Abstract

Neuroplasticity is the brain’s ability to reshape itself by constructing new neural connections throughout life, enabling adaptation to change, learning new information, and recovering from injuries. Neuroplasticity mechanisms underline a range of neurologic and psychiatric disorders, including Alzheimer’s disease, Parkinson’s disease, stroke, traumatic brain injury, depression, anxiety, and Schizophrenia. In any given year, approximately 20% of adult humans in the United States experience mental illness. The modification of structural and functional activities in the brain, encompassing synaptic plasticity, dendritic remodeling, neurogenesis, and shifts in neurotransmitter systems, significantly influence the progression of these diseases and the manifestation of their symptoms. Clinical trials evaluating therapeutics and biologics are crucial for advancing mental health care, while personalized medicine enhances treatment efficacy for individual patients. These developments hold substantial promise for improving mental health outcomes. Continued research into neuroplasticity is vital for the evolution of therapeutic strategies. This review delves into synaptic, structural, and functional plasticity and its impact on brain injury, neurodegenerative diseases, and psychiatric disorders.(This said absolutely NOTHING USEFUL!)