Computational neurorehabilitation: modeling plasticity and learning to predict recovery

Once again going down the prediction route and ignoring all the problems in stroke that need solving? Survivors don't give a shit about predictions. Give us the protocols that will get us to recovery you dipshits. Compute all you want as long as you come up with ways to get results.

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke "leader" will ream me out for being negative, I look forward to that day.

 

Computational neurorehabilitation: modeling plasticity and learning to predict recovery

• David J. ReinkensmeyerEmail author,
• Etienne Burdet,
• Maura Casadio,
• John W. Krakauer,
• Gert Kwakkel,
• Catherine E. Lang,
• Stephan P. Swinnen,
• Nick S. Ward and
• Nicolas Schweighofer

Journal of NeuroEngineering and Rehabilitation201613:42

DOI: 10.1186/s12984-016-0148-3

©  Reinkensmeyer et al. 2016

Received: 19 November 2015

Accepted: 13 April 2016

Published: 30 April 2016

Abstract

Despite progress in using computational approaches to inform medicine and neuroscience in the last 30 years, there have been few attempts to model the mechanisms underlying sensorimotor rehabilitation. We argue that a fundamental understanding of neurologic recovery, and as a result accurate predictions at the individual level, will be facilitated by developing computational models of the salient neural processes, including plasticity and learning systems of the brain, and integrating them into a context specific to rehabilitation. Here, we therefore discuss Computational Neurorehabilitation, a newly emerging field aimed at modeling plasticity and motor learning to understand and improve movement recovery of individuals with neurologic impairment. We first explain how the emergence of robotics and wearable sensors for rehabilitation is providing data that make development and testing of such models increasingly feasible. We then review key aspects of plasticity and motor learning that such models will incorporate. We proceed by discussing how computational neurorehabilitation models relate to the current benchmark in rehabilitation modeling – regression-based, prognostic modeling. We then critically discuss the first computational neurorehabilitation models, which have primarily focused on modeling rehabilitation of the upper extremity after stroke, and show how even simple models have produced novel ideas for future investigation. Finally, we conclude with key directions for future research,(You are updating the stroke strategy with these ideas, Aren't you?) anticipating that soon we will see the emergence of mechanistic models of motor recovery that are informed by clinical imaging results and driven by the actual movement content of rehabilitation therapy as well as wearable sensor-based records of daily activity.

European research network sets up tool to measure brain blood flow, identifying tell-tale signs of dementia and Alzheimer's very early on

This should be able to be repurposed to identify lack of blood flow post-stroke so an objective diagnosis can tell where the dead and dying areas are. Then use that knowledge to create protocols that address those problem areas. But since we have NO stroke leadership or strategy this will fall thru the cracks like all stroke research. There is never any followup. You will need to hire your own researchers to address this. 

European research network sets up tool to measure brain blood flow, identifying tell-tale signs of dementia and Alzheimer's very early on

A network of over 200 scientists, clinicians and industry partners developed a cost-effective diagnostic tool for measuring the tell-tale signs of dementia and Alzheimer’s. The tool uses a new, non-invasive technique to measure blood flow to the brain, known as Arterial Spin Labelling (ASL). The network set a reference for the best possible way of measuring blood flow, allowing all researchers using ASL in neurodegeneration to compare the network’s results. The three main vendors of MRI machines – GE Healthcare, Siemens Healthcare, and Philips Healthcare – have already taken up the tool.  A company spinning out of the network has raised £1.1 million from the UK’s National Health Service to improve the calibration of ASL devices in order to ensure consistent and reliable results.
Dementia is a major brain disease associated with memory loss, personality changes and confusion. It can rob people of their independence and cause profound distress for individuals and their families.
The condition also represents a significant economic burden. Caring for people affected by dementia accounts for around 1% of global GDP. In Europe, where the number of people aged over 65 is growing, the impact of neurodegenerative diseases could rise.
While the pharmaceutical industry continues to work on therapies that could stem the progression of the illness, imaging experts are developing technologies that can diagnose dementia – even before patients notice classic symptoms such as memory loss .
MRI machines can show anatomical changes in the brain, such as the loss of dying neurones due to Alzheimer’s disease. A technique, known as Arterial Spin Labelling (ASL) , offers something new: a non-invasive way to measure blood flow to the brain.
By magnetising blood in major arteries and following its path to the brain, experts can deduce whether brain cells are being nourished with the oxygen and glucose they need to survive. Low rates of blood flow – known as perfusion – to neuronal cells suggests something may be wrong.
COST Action BM1103 brought together a network of over 200 scientists and clinicians, working alongside industry partners, to develop this cost-effective diagnostic tool that uses the ASL technique. The key was to provide researchers and clinicians with a reliable and comparable way to measure the tell-tale signs of dementia .
“After 15 years of developing ASL around the world, there were a plethora of methodologies and techniques,” says Professor Xavier Golay of University College London. “It was a nightmare for anyone who wanted to work in this field because they did not know where to start or how to achieve the best results .”
Through a COST-funded meeting in Amsterdam in October 2012, members of the COST Action joined forces to find the best possible method to measure perfusion , based on a thorough analysis of the literature. This led to a paper aimed at people working in this area. It was finally published in January 2015 and has become a reference for scientists in the field .
“It has really changed the field, reshaping it in amazing way,” says Professor Golay. “This allows all of us using ASL in neurodegeneration to compare our results and it has even been taken up by the three main vendors of MRI machines – GE Healthcare, Siemens Healthcare, and Philips Healthcare. In terms of impact this is huge.”
As another outcome of the Action, Professor Golay’s spin-out company– Gold Standard Phantoms Limited –has raised £1.1 million from the UK’s National Health Service to improve the calibration of ASL devices in order to ensure consistent and reliable results.
Members of this Action are working with the Quantitative Imaging Biomarkers Alliance (QIBA) to have ASL recognised globally as a biomarker for dementia , and members continue to collaborate through the ASL Network.
http://www.cost.eu/media/cost_stories/measuring-brain-blood-flow-helps-diagnose-dementia

Sub-sensory vibratory noise augments the physiologic complexity of postural control in older adults

What is your doctor doing to determine if this would make you walk better and have better balance? How long before s/he updates your walking protocol? 

Sub-sensory vibratory noise augments the physiologic complexity of postural control in older adults

• Junhong ZhouEmail author,
• Lewis Lipsitz,
• Daniel Habtemariam and
• Brad Manor

Journal of NeuroEngineering and Rehabilitation201613:44

DOI: 10.1186/s12984-016-0152-7

©  Zhou et al. 2016

Received: 23 December 2015

Accepted: 22 April 2016

Published: 3 May 2016

Abstract

Background

Postural control requires numerous inputs interacting across multiple temporospatial scales. This organization, evidenced by the “complexity” contained within standing postural sway fluctuations, enables diverse system functionality. Age-related reduction of foot-sole somatosensation reduces standing postural sway complexity and diminishes the functionality of the postural control system. Sub-sensory vibrations applied to the foot soles reduce the speed and magnitude of sway and improve mobility in older adults. We thus hypothesized that these vibration-induced improvements to the functionality of the postural control system are associated with an increase in the standing postural sway complexity.

Method

Twelve healthy older adults aged 74 ± 8 years completed three visits to test the effects of foot sole vibrations at 0 % (i.e., no vibration), 70 and 85 % of the sensory threshold. Postural sway was assessed during eyes-open and eyes-closed standing. The complexity of sway time-series was quantified using multiscale entropy. The timed up-and-go (TUG) was completed to assess mobility.

Results

When standing without vibration, participants with lower foot sole vibratory thresholds (better sensation) had greater mediolateral (ML) sway complexity (r ² = 0.49, p < 0.001), and those with greater ML sway complexity had faster TUG times (better mobility) (r ² = 0.38, p  < 0.001). Foot sole vibrations at 70 and 85 % of sensory threshold increased ML sway complexity during eyes-open and eyes-closed standing (p  < 0.0001). Importantly, these vibration-induced increases in complexity correlated with improvements in the TUG test of mobility (r ² = 0.15 ~ 0.42, p < 0.001 ~ 0.03).

Conclusions

Sub-sensory foot sole vibrations augment the postural control system functionality and such beneficial effects are reflected in an increase in the physiologic complexity of standing postural sway dynamics.

One Step Closer to First Human Use of DBS for Stroke Recovery - Cleveland Clinic

So instead of going for the easy and simple possibilities they are going for one of the moon shots. All because we have NO stroke leadership enforcing a realistic stroke strategy.
Maybe these 31 hyperacute options  in the first week.
https://consultqd.clevelandclinic.org/2016/07/one-step-closer-first-human-use-dbs-stroke-recovery/?

Cleveland Clinic is ready to begin the first human trial of deep brain stimulation (DBS) for post-stroke physical rehabilitation. So announced the trial’s leader, Andre Machado, MD, PhD, Chairman of Cleveland Clinic’s Neurological Institute, this week. The news follows Cleveland Clinic’s recent approval from the FDA to conduct the pioneering trial, as reported earlier this year on Consult QD.

Will promising rodent findings translate?

The go-ahead from the FDA came after 10 years of research by Dr. Machado and his team using a rodent model of stroke. That work showed that stimulation of a novel brain pathway promoted motor recovery along with neurogenesis and angiogenesis in the thalamus and perilesional cortex, as reported last year.
“Our findings suggested that DBS of the cerebello-thalamo-cortical pathway may enhance the brain’s plasticity and ability to form new neural connections during recovery from stroke,” says Dr. Machado, a neurosurgeon (shown in surgery in the photo above) who will perform the DBS procedures in the newly launched trial. “The expectation is that stimulation may augment the effects of physical rehabilitation for stroke.”
He notes that the cerebellum, which controls voluntary muscle movements, was part of the region targeted for stimulation in the hope of reestablishing flow of neurological input to the brain hemisphere affected by stroke.

An adjunct to rehab therapy

Candidates for the new trial will be ischemic stroke patients who suffered a stroke 12 to 24 months previously and have residual severe weakness affecting one arm despite treatment with physical therapy. Key questions the trial will seek to address include:

• Who are the best candidates for DBS therapy, given the heterogeneity of stroke survivors?
• At what point in post-stroke recovery would DBS be most beneficial?
• Is continuous DBS needed, or do benefits endure without ongoing stimulation?

Dr. Machado notes that the goal of DBS in this setting is to augment, not replace, the effects of physical rehabilitation. “The proposition here is to make that recovery greater,” he told Time magazine in a new exclusive interview.
In the same interview he noted what most distinguishes this latest application of DBS from prior uses of the technology, such as for movement disorders: “The big difference is that when we are treating the motor symptoms of Parkinson’s disease, we’re trying to make the symptom, like a tremor, go away. When we are treating stroke, we are really trying to make movement come back. There is something inherently different about that.”

How do you get on with life after a stroke? Stroke Association UK

This is still the wrong focus. Focusing on compensating the effects of the stroke rather than solving the problems in stroke. First by vastly reducing the dead and damaged neurons by stopping the neuronal cascade of death by these 5 causes in the first week. Yes, this is a long term project but if we never start it we will never help stroke survivors to the best of our ability.

How do you get on with life after a stroke? Stroke Association UK

Stroke changes lives. It can have a huge effect on you and your family.
But there is life after stroke.
With the right help and support your stroke doesn't have to stop you from doing anything that you want to do.

We can help you find the information and advice you need to:

• cope with the impact stroke has on your relationships
• go back to driving, or get out and about if you don’t
• make sure that you get the financial help you’re entitled to
• return to work
• continue enjoying your hobbies or take up new ones
• go on holiday.

Dementia: 9 Warning Signs Everyone Should Know

If your doctor doesn't even know your risk of dementia post-stroke then I guess you are on your own for diagnosing yourself.
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.

Dementia: 9 Warning Signs Everyone Should Know

…and the type of memory problems that are nothing to worry about.

Almost everyone has memory glitches from time-to-time — they are usually not a sign of dementia.

Here are a few perfectly normal memory problems:

• Being unable to remember the word for something.
• After putting something down, being unable to remember where you left it.
• Having to think for a few minutes to remember where you left the car.
• Going upstairs, then forgetting why you are there.
• Forgetting something relatively unimportant someone has told you.

These are nothing to worry about.
Memory is also affected by poor sleep, stress and depression.
Most people who think they have some memory problems, actually do not.
The reason is that people who are having more serious memory problems are usually not aware of them.
Often it is friends and relatives who suggest a person having memory problems should get checked out.

Somewhat worrying memory problems to watch out for include:

1. Forgetting the name of a close friend or relative.
2. Regularly putting objects back in the wrong places and not remembering having left them there.
3. Asking someone the same question again 30 minutes later.
4. Trouble recognising words, faces, shapes or colours.
5. Finding it difficult to get around very familiar places, like the local area.
6. Difficulty doing multiple automated tasks. For example, a good cook who starts finding it hard to manage a very familiar recipe.
7. A large change in personality, such as becoming very introverted after being an outgoing, social person.

The signs above are slightly more worrying but could still be the result of stress, poor sleep or grief.

The warning signs

The following signs, though, are more serious and would probably warrant being checked out by a physician:

1. Not recognising close friends and relatives.
2. Getting disorientated about time and space.
3. Inability to tell the function of an everyday object — like a teapot.
4. Poor everyday judgement: like wearing summer clothes in winter.
5. Totally forgetting how to perform everyday tasks like using the washing machine.
6. Leaving things in strange places, like putting a handbag in the freezer.
7. Getting confused about the family structure. For example, being unable to match the grandchild to the right family.
8. Asking for something that has just been had, like a cup of coffee.
9. Having vivid memories from childhood, but faltering memories for very familiar recent memories.

Comeback Trail - Your Trial [sic], Your Way - National Stroke Association

Once again, a lazy awareness event rather than focusing their efforts on actually solving problems that survivors have due to their stroke. Damn the board of directors for not setting the proper goals and objectives for the stroke organization.  Failure once again. You will always be on your own until these stroke organizations are run by survivors.
Dear dean,

Last September, National Stroke Association launched Comeback Trail - Your Trial, Your Way.  This free, virtual event offered stroke survivors and friends of the stroke community the opportunity to hit their favorite sidewalk or walking trail in celebration of stroke survivorship and come back strong journeys, all while raising awareness for the fifth leading cause of death in the U.S.

Register Now

Nearly 1,000 people from 49 states (and even the United Kingdom!) came together for our inaugural event. As we look forward to this fall, we need you to help us double our number of virtual trailblazers and encourage you to share your own come back strong story through a personal event fundraising page.

Mark your calendar and join us on Sept. 10, 2016, for the second annual Comeback Trail—Your Trail, Your Way. It’s easy to get started! Register for this free event today and invite all of your friends and family to join you in person, or from afar, as you walk around your neighborhood or along your favorite trail, wherever that may be.

Happy Trails,

Betsy Hailstone
Sr. Coordinator, Developmen

The Benefits of Music Therapy for Alzheimer’s and Dementia

And stroke. And I bet your doctor has NO music stroke protocol because s/he hasn't read a single stroke research article in 10 years. And you are paying them for their stroke rehab expertise?
https://dementiaandalzheimerscare.com/2016/07/25/the-benefits-of-music-therapy-for-alzheimers-and-dementia/?blogsub=confirming#blog_subscription-3
You’re driving down the highway, and suddenly a song from your childhood comes on the radio. Before you know it, the words are coming automatically out of your mouth, and you are awash in memories of old high school friends and epic teenage adventures. Music is deeply connected to memory and to the soul. It can sweep us into the past or lift our spirits in the present. It can also deeply touch those who have Alzheimer’s or dementia.

The Power of Music

Though it may be a struggle for a loved one with dementia or Alzheimer’s to remember what they had for breakfast yesterday or the name of their new neighbor, you may be surprised when they easily recall the words of their favorite songs. Earlier memories stay the longest, which means the music a person grew up with can hold power and nostalgia long after other interests and memories fade.
If you want to share a fun activity with a loved one with dementia, ask them about their favorite songs growing up. Put together a playlist and listen to it together. Not only will your loved one have a great time singing the lyrics and hearing the familiar rhythms again, but the songs may also spark memories. Music can sparks fascinating stories, and you may learn something about your family member that you never knew before.
This is an activity you can do with your loved one even in the intermediate stages of dementia.

Rhythmic Cues

Even new or unknown music can have a profound impact on someone with dementia. Have you ever heard a brand new song that got your feet tapping or made your heart soar? That’s because any type of music has the power to affect our emotions, reduce stress, and stimulate positive feelings. According to the Alzheimer’s Foundation of American (AFA), “A person’s ability to engage in music, particularly rhythm playing and singing, remains intact late into the disease process because…these activities do not mandate cognitive functioning for success.”
In other words, the mind is naturally wired to pick up on rhythm. We don’t need to remember how to do it in order for music to move our souls.

Music Therapy

Music’s ability to change a person’s mood and to stimulate memories makes it a fantastic tool when interacting with a person with dementia. This disease often leaves its victims agitated, confused, and frustrated when they cannot remember a word or suddenly don’t know where they are. Soothing music can help ease tensions and encourage a loved one to relax. On the opposite end of the spectrum, if you are looking for something fun to do with your loved one, happy music will have them smiling and itching to dance. Put on a dance party, or simply play happy music throughout the day to add energy to the environment. Spice things up with your loved one’s favorite tunes to encourage mental stimulation and encourage them to tell you about the feelings and memories the old songs bring to the surface.

Music Therapy at Sunshine Care

At Sunshine Care, we appreciate the power of music to engage our residents. We embrace music therapy in many forms. For example, our Older, Wiser Learners Society (OWLS) program usually includes music therapy as a component. We might sing a song together in a class that relates to that day’s topic. If you visit our activity calendar, you’ll also see that we host regular music-related activities. In July, we put on a Judy Garland concert, and many of our residents loved hearing the songs of one of their favorite musical personalities.
We are always looking for new ways to make music a continual part of the experience of our residents at Sunshine Care. Want to learn more about our music therapy programs? If you live in Southern California, schedule a tour of our facility.

Secondhand Marijuana Smoke May Damage Blood Vessels More Than Secondhand Cigarette Smoke

But do the benefits outweigh the harm? Or does this mean we should get it in foods? Your doctors thoughts on this? Cancer drugs cause problems which are alleviated by other drugs. I'm sure with a bit of thought this can be overcome.
My 13 reasons for marijuana use post-stroke.  
Seems like trying to demonize marijuana any way possible. 
http://www.biosciencetechnology.com/news/2016/08/secondhand-marijuana-smoke-may-damage-blood-vessels-more-secondhand-cigarette-smoke?

Inhaling any type of smoke is bad for you, researchers of a new study say. But inhaling secondhand marijuana for one minute may cause even more damage to blood vessels than one minute of exposure to secondhand cigarette smoke.
The study, performed on rats, was published in the Journal of the American Heart Association and could have important implications considering there are a number of states legalizing both recreational and medicinal marijuana.
According to the findings when rats inhaled secondhand marijuana smoke for one minute, their blood vessels took at least three times longer to return to normal function than rats who inhaled secondhand tobacco smoke.  Tobacco smoke caused blood vessel impairment for 30 minutes, compared to 90 minutes for rats exposed to marijuana smoke.
Lead study author Matthew Springer, Ph.D., professor of medicine at the University of California, San Francisco, said that the rats’ response is likely a good model for how human arteries would respond to secondhand marijuana smoke as it is already known that rats’ arteries respond similarly to secondhand cigarette smoke.
He also noted that while the blood vessel impairment is temporary and function is restored after a period of time, it can become a long-term problem with repeated exposure and increase the risk of developing hardened and clogged arteries.
“There is a widespread belief that unlike tobacco smoke, maijurana smoke is benign,” Springer said in a press release. “We in public health have been telling the public to avoid secondhand tobacco smoke for years, but we don’t tell them to avoid secondhand marijuana smoke, because until now we haven’t had evidence that it can be harmful.”
Interestingly, neither burning of the rolling papers nor chemicals such as nicotine or tetrahydrocannabinol (THC) caused the blood vessel damage. Researchers found that burning of the actual plant material caused of the impairment.

Joshua Gordon Named New Head of NIMH - National Institute of Mental Health

And if survivors had anything even remotely approaching a great stroke association we would be approaching him to see what science is needed to prevent the likely depression from stroke. But we don't and the opportunity will be fucking lost like everything to do with stroke research. And the boards of directors don't have enough sense to make this an objective of the president.
https://danablog.org/2016/08/01/joshua-gordon-named-new-head-of-nimh/
In late July, the National Institutes of Health (NIH) announced that it had finally completed its nearly year-long search for a new director of the National Institute of Mental Health (NIMH). Francis Collins, M.D., Ph.D., said that the agency had selected Joshua Gordon, M.D., Ph.D., currently an associate professor of psychiatry at Columbia University, to take the helm of the $1.5 billion federal agency governing mental health research, replacing former director Thomas Insel. He is expected to start in September.

In the press release announcing the selection, Collins said, “Josh is a visionary psychiatrist and neuroscientist with deep experience in mental health research and practice. He is exceptionally well qualified to lead the NIMH research agenda to improve mental health and treatments for mental illnesses. We’re thrilled to have him join the NIH leadership team.
Gordon, whose research program focused on integrative genetic models of psychiatric disease, spoke with the Dana Foundation about why he wanted to take on this new role in his career, the importance of collaboration and communication, and where he hopes to see the agency go under his leadership.

You’ve had quite a bit of success in academia. Why throw your hat in the ring to lead NIMH?
It’s a really exciting time in psychiatric neuroscience. And such an exciting time comes with a lot of possibilities—but also a lot of responsibilities for the field. In order to pursue those possibilities, with attention to tailoring neuroscience and basic research to really make a difference in people’s lives, requires a lot of thought and planning. So playing a role in how best to do that thought and planning moving forward is an exciting thing to take part in.

More at link.

Car rentals

Since I am on the road again I get to rent cars each week. Usually small ones like the Fiesta, Rio, Accent, Elantra, Sonic, Focus.

I am good enough now to reach over the steering wheel to put on the turn signals. The worst rental was the mid-size pickup Nissan Frontier. Couldn't tell where the front of the truck was and didn't have a backup camera. I have tall legs and could barely get my butt on the seat to slide in.

Music Therapy Lifts Spirits

But I see no protocol on music therapy on the National Stroke Association site. Without  that protocol 10 million yearly stroke survivors  are not getting the most appropriate therapy. It would be dangerous to do this without a protocol and your doctors prescription. So ask for a ET(Evaluate and Treat) prescription written to the caregivers by the doctor. I bet you too could write ET on a prescription pad.

Music Therapy Lifts Spirits

Music therapy can help stroke survivors with speech and language cognition, lift their moods, and improve coordination by having stroke survivors walk to the beat of the music.
Why can music be such a powerful tool in a stroke survivor’s recovery?
As Erin Wegener, a music therapist at Spectrum Health in Michigan, explains, music accesses the whole brain.
"Researchers examining music and cognitive neuroscience tell us that music actually activates the whole brain.  The elements of music such as pitch, timbre (sound qualities), melody, rhythmic processing, rhythmic execution (playing or moving to rhythm), activate various neural networks throughout the brain,” Wegener says.
“So when specific areas of the brain are damaged, such as Broca's area which controls expressive speech, the brain may be able to draw from the other networks which are active when we play music sing, hum, process or listen to rhythm in order to form new connections.  Because music is complex and activates various networks throughout the brain, there is great potential for neuroplasticity."

A stroke survivor need not have a musical background to benefit from a music therapy.
Moving to the beat of the music is beneficial to stroke survivors as well.

“It’s helpful to them to walk to music, if they can exercise and move within a rhythmic pulse. It can help to coordinate movement,” Wegener says.

To find a music therapist near you visit the American Music Therapy Association website and click on “Find a Music Therapist.”  To check if a professional is a board-certified therapist, visit the Certification Board of Music Therapists website.
Looking to incorporate music for a stroke survivor at home?
Wegener suggests singing and playing “over-learned” songs such “You Are My Sunshine” and “Twinkle, Twinkle Little Star.” Favorite songs of a stroke survivor or songs from their teenage years may also be a big hit.
Aaron Russell, 39, has been helped immensely from music therapy.
“When the music therapist came, with the first strum of his guitar, he lit up,” recalls Norma Russell, Aaron’s mother. “Music is his heart.”
Russell played in two different bands prior to his stroke two years ago.

“He can sing a lot more than he can say and that in itself is a big, big blessing,” says Hastings of her son, who plays in praise band in a chapel near where they live in Texas.
“Music helps him with his spirit and everything he is.”

CMS announces new initiative for MI, stroke prevention

So rather than tackle ANY of the problems in stroke you decide to go the lazy route and do press releases and awareness campaigns.  NOT UP FOR THE CHALLENGE YOU CHICKENSHITS? 

CMS announces new initiative for MI, stroke prevention

 

CMS has announced 516 awardees in 47 U.S. states, Puerto Rico and the District of Columbia to help reduce the risks for MI and stroke among millions of Medicare fee-for-service beneficiaries, according to a press release.

The Million Hearts Cardiovascular Disease Risk Reduction Model will use data-driven predictive modeling to generate personalized risks scores for individual patients, which will allow participating health care professionals to develop specific plans to apply prevention interventions to reduce the risk for MI or stroke, according to the release.
Health care professionals in the intervention group will work with beneficiaries on an individual basis to identify the best approach or approaches to reduce their risk for MI or stroke — for example, smoking-cessation interventions, BP management, or cholesterol-lowering drugs or aspirin — and will explain the benefits of each approach. All beneficiaries will receive a personalized risk-modification plan that will target their specific risk factors. Organizations in the intervention group will be paid for reducing the absolute risk for CVD or stroke among their high-risk interventions, according to the release.
CMS estimates that nearly 20,000 health care professionals and more than 3.3 million Medicare fee-for-service beneficiaries will participate in the 5-year model.
“This initiative will enhance patient-centered care and give practitioners the resources to invest the time and in staff to address and manage patients who are at high risk for heart attacks and strokes,” Patrick Conway, MD, chief medical officer of CMS, stated in the release. – by Cassie Homer
Reference:
Million Hearts Cardiovascular Risk Reduction Model. innovation.cms.gov/initiatives/Million-Hearts-CVDRRM/.
Disclosure: Conway is chief medical officer of CMS.

Eating more plant protein associated with lower risk of death

And just when the fuck will your doctor and nutritionist come up with a diet stroke protocol? Or are they going to sit on their asses until they retire leaving you in the lurch? Call your hospital president and ask why they continue to employ such patently incompetent persons.

Eating more plant protein associated with lower risk of death

The largest study to examine the effects of different sources of dietary protein found that a high intake of proteins from animal sources - particularly processed and unprocessed red meats - was associated with a higher mortality rate, while a high intake of protein from plant sources was associated with a lower risk of death. Results from the study - which analyzed data from two long-term epidemiologic studies - appears in the August 1 issue of JAMA Internal Medicine.

"Overall, our findings support the importance of the sources of dietary protein for long-term health outcomes," says Mingyang Song, MD, ScD, a research fellow in the Massachusetts General Hospital (MGH) Clinical and Translational Epidemiology Unit (CTEU) and Division of Gastroenterology and corresponding author of the report. "While previous studies have primarily focused on the overall amount of protein intake - which is important - from a broad dietary perspective, the particular foods that people consume to get protein are equally important. Our findings also have public health implications and can help refine current dietary recommendations about protein intake, in light of the fact that it is not only the amount of protein but the specific food sources that is critical for long-term health."
While several studies have suggesting that substituting proteins for carbohydrates in the diet has several health benefits - including weight management, reducing blood pressure and other cardiovascular risk factors - the authors note, few studies have examined the specific sources of protein. Those that have were relatively small and based on one-time assessment of participants' diets. The current study analyzes data from the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS), which have compiled comprehensive health data on more than 170,000 participants since the 1980s. In addition to completing overall health questionnaires every two years, participants provide information on their dietary intake - specifically how often they consumed portions of particular types of food during the preceding year - every four years.
The researchers analyzed more than 30 years of data for NHS participants and 26 years of data for HPFS participants, totaling more than 3.5 million person-years. During those time periods more than 36,000 deaths were documented among study participants - almost 9,000 from cardiovascular disease, around 13,000 from cancer and about 14,000 from other causes. After adjustment for lifestyle and other dietary risk factors, a high consumption of protein from animal sources - any types of meat, eggs or dairy - was weakly associated with an increased rate of death, while high consumption of protein from plant sources - breads, cereals, pasta, beans, nuts and legumes - was associated with a lower mortality rate.
More careful analysis revealed that the association of animal protein intake with an elevated mortality risk only applied to participants with at least one factor associated with an unhealthy lifestyle - being either obese or underweight, heavy alcohol consumption, a history of smoking, or physical inactivity. In fact, the association disappeared in participants with a healthy lifestyle. Analysis based on specific sources of protein indicated that the animal-protein-associated mortality risk applied primarily to processed and unprocessed red meats, which include both beef and pork products, and not to protein from fish or poultry.
"While we expected we might find the associations to be weaker in the healthy lifestyle group, we did not expect them to completely disappear," says Song. "But when we looked deeper into the data, we found that - at similar levels of animal protein intake - those in the unhealthy lifestyle group consumed more red meats, eggs and high-fat dairy, while the healthy lifestyle group consumed more fish and poultry. So we suspect the different sources of animal protein between the two groups may contribute to the stronger results in the unhealthy lifestyle group."
He adds, "Our findings suggest that people should consider eating more plant proteins than animal proteins, and when they do choose among sources of animal protein, fish and chicken are probably better choices. Future studies should examine the mechanisms underlying the different effects of plant and animal proteins - along with different sources of animal proteins - on overall health."

Explore further: More red meat consumption appears to be associated with increased risk of death

More information: JAMA Intern Med. Published online August 1, 2016. DOI: 10.1001/jamainternmed.2016.4182

Journal reference: JAMA Internal Medicine
Provided by: The JAMA Network Journals

Using Intel’s Xeon Phi for Brain Research Visualization

Your doctor should be using this to show you exactly where your damage occurred and then map the stroke protocols needed to fix that damage. But that is light years beyond your doctors current understanding and expertise. We are still in the Dark Ages in stroke and will be until we completely destroy the existing stroke medical establishment and start over with survivors in charge.
https://www.top500.org/news/using-intels-xeon-phi-for-brain-research-visualization/

Napping: Do's and don'ts for healthy adults - Mayo Clinic

You're perpetually exhausted after your stroke. Has your doctor done ANYTHING about a napping protocol for you? I used to fall asleep in the 5 minutes between therapy sessions. I'd pour myself into bed with shoes on and immediately fall asleep. The transport aide would have to wake me. I heard absolutely nothing from my doctor on napping or sleeping. I don't think he even knew how to spell stroke, that's why I had a CVA, not a stroke.
http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/napping/art-20048319/?

Magnetic No-Tie Shoelaces

I may have to try these, I dislike the elastic curly laces.
http://www.drgrab.com/collections/Others/products/2-pairs-of-magnetic-no-tie-shoelaces?

Differences in cognitive profiles between traumatic brain injury and stroke: a comparison of the Montreal Cognitive Assessment and Mini-Mental State Examination

What is your doctor going to do with this to get you cognitively back to normal?

Differences in cognitive profiles between traumatic brain injury and stroke: a comparison of the Montreal Cognitive Assessment and Mini-Mental State Examination

• Hao Zhang^a,
• Xiao-Nian Zhang^a,
• Hui-Li Zhang^b,
• Qian-Qian Chi^a,
• Xin Zhang^a,
• Xiao-Ping Yun^{b, ,}

 Show more

doi:10.1016/j.cjtee.2015.03.007

Get rights and content

Open Access funded by Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

Under a Creative Commons license

---

Abstract

Purpose

To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in patients with chronic traumatic brain injury (TBI) or stroke and to evaluate the sensitivity of the two scales in patients with TBI.

Methods

In this cohort study, a total of 230 patients were evaluated, including TBI group (n=103) and stroke group (n=127). The cognitive functions of two groups were evaluated by designated specialists using Moca (Beijing version) and MMSE (Chinese version).

Results

Compared with the patients with stroke, the patients with TBI received significantly lower score in orientation subtest and recall subtest in both tests. MoCA abnormal rates in the TBI group and stroke group were 94% and 87% respectively, while MMSE abnormal rates were 70% and 57%, respectively. In the TBI group, 87% patients with normal MMSE score had abnormal MoCA score and in the stroke group, about 70% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, respectively.

Conclusion

In our rehabilitation center, patients with TBI may have more extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post-TBI cognitive impairment, MoCA tends to be more sensitive than MMSE.

Avoid This Dietary Fat Because It Destroys Cognitive Function - saturated fat

Well, there seems to be other research out there that doesn't point directly to cognition but other health measures that saturated fat is not bad for you. If your doctors were any good at all they would have all the hospital nutritionists get together and create a stroke diet protocol.  There are two variables here; saturated fat and fish oil; bad research because you don't know which one caused the effect. Is it that fish oil is so good for you? Or that saturated fat is that bad? You can't tell from this research anything at all. You should never have more than one variable in research.

For decades, the government steered millions away from whole milk. Was that wrong?

 

Trans fats, not saturated fats, linked to increased mortality, CHD risks

 

FENS Satellite Symposium reveals beneficial health effects of regular fat dairy foods

No Evidence to Support Dietary Fat Recommendations, Meta-Analysis Finds

Dietary Saturated Fat Has Undeserved Bad Reputation, Says Review 

 

But the negative one here:

 Avoid This Dietary Fat Because It Destroys Cognitive Function

Some fats have an amazing negative effect on cognitive function and, potentially, eating habits.

Diets high in saturated fats can slow brain function, new research finds.

Saturated fats have a direct effect on the hypothalamus, an area of the brain which is critical for regulating hunger.
Eating saturated fats could, therefore, make it difficult to control your eating habits.
They can make it difficult to control how much you eat, the types of foods you choose to consume and when to stop eating.
Saturated fats are typically found in:

• lard,
• butter,
• or fried food.

Unsaturated fats are typically found in:

• fish,
• avocado,
• or olive oil.

Professors Marianna Crispino and Maria Pina Mollica, two of the study’s authors, said:

“These days, great attention is dedicated to the influence of the diet on people’s wellbeing. Although the effects of high fat diet on metabolism have been widely studied, little is known about the effects on the brain.”

The study on rats compared the effects of feeding them fish oils or a lardy diet over a period of six weeks.
Professors Crispino and Mollica said:

“The difference was very clear and we were amazed to establish the impact of a fatty diet onto the brain.
Our results suggest that being more aware about the type of fat consumed with the diet may reduce the risk of obesity and prevent several metabolic diseases.”

The study was published in the journal Frontiers in Cellular Neuroscience (Viggiano et al., 2016).

 

 

Resveratrol appears to restore blood-brain barrier integrity in Alzheimer's disease

So how much red wine should stroke patients be drinking to maybe solve this cause of the neuronal cascade of death?  Does this also restore blood brain barrier integrity in stroke? Inquiring minds want to know.

Resveratrol appears to restore blood-brain barrier integrity in Alzheimer's disease

Georgetown University Medical Center News

Resveratrol, given to Alzheimer’s patients, appears to restore the integrity of the blood–brain barrier, reducing the ability of harmful immune molecules secreted by immune cells to infiltrate from the body into brain tissues, say researchers at Georgetown University Medical Center. The reduction in neuronal inflammation slowed the cognitive decline of patients, compared to a matching group of placebo–treated patients with the disorder. The laboratory data provide a more complete picture of results from a clinical trial studying resveratrol in Alzheimer’s disease that was first reported in 2015. The new findings will be presented at the Alzheimer’s Association International Conference 2016 in Toronto on July 27th. According to the researchers, this study suggests that some of the immune molecules that can cause inflammation in the blood can enter the brain through a leaky blood–brain barrier. “These findings suggest that resveratrol imposes a kind of crowd control at the border of the brain. The agent seems to shut out unwanted immune molecules that can exacerbate brain inflammation and kill neurons,” says neurologist Charbel Moussa, MD, PhD, scientific and clinical research director of the GUMC Translational Neurotherapeutics Program. “These are very exciting findings because it shows that resveratrol engages the brain in a measurable way, and that the immune response to Alzheimer’s disease comes, in part, from outside the brain.” In this new study, Moussa and Turner found that treated patients had a 50 percent reduction in matrix metalloproteinase–9 (MMP–9) levels in the cerebrospinal fluid. MMP–9 is decreased when sirtuin1 (SIRT1) is activated. High levels of MMP–9 cause a breakdown in the blood–brain barrier, allowing proteins and molecules from the body to enter the brain. Normally low MMP–9 levels maintain the barrier, say the researchers.