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.

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.

Wednesday, September 30, 2026

Mind after stroke: staff perceptions of psychological needs in stroke rehabilitation

 You ARE that blitheringly stupid that the only need in stroke is 100% recovery AND YOU DON'T KNOW THAT PSYCHOLICAL NEED?

Psychological need is incredibly easy to solve! EXACT 100% RECOVERY PROTOCOLS! Your patient will gladly do the millions of reps needed because they are looking forward to recovery! Can't see that? YOU'RE FIRED!

Mind after stroke: staff perceptions of psychological needs in stroke rehabilitation

Research output: Contribution to journal › Article › peer-review


Abstract

 Background:  

Stroke recovery involves significant psychological as well as physical challenges; however, the extent to which psychological needs are recognised and supported may vary across rehabilitation settings. 

Aims:  

To explore rehabilitation professionals’ perceptions of stroke survivors’ psychological needs and factors influencing their ability to respond. 

Methods:  

Semi-structured interviews were conducted with seven rehabilitation professionals and analysed using reflexive thematic analysis. 

Findings:  

Four themes were generated: Psychological Distress Beyond Functional Recovery, Losing the Self Through Loss of Doing, Psychological Care as Relational Practice, and Negotiating Psychological Care in Constrained Systems. Participants described psychological wellbeing as important, but support was often provided through therapeutic relationships and everyday interactions rather than structured psychological pathways. Time pressures, limited specialist psychological input, and role ambiguity were identified as barriers. 

Conclusion:  

Psychologically informed multidisciplinary care may require clearer roles, staff training, and accessible specialist psychological support.
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Tuesday, September 29, 2026

Coffee's Optimal Liver-Protective Dose

 Since no one can guarantee how much coffee will prevent Parkinsons and dementia I will continue my 12 cup pot of coffee daily! And this covers my social drinking which is vastly increasing my social connections that are going to prevent dementia!

How coffee protects against Parkinson’s Aug. 2014 

Coffee May Lower Your Risk of Dementia Feb. 2013

Coffee drinkers rejoice! Drinking coffee could lower the risk of Alzheimer’s disease 

And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018

New research suggests drinking coffee may reduce the risk of frailty May 2025

I think I'm in this category:  I never get the jitters or flushed skin.

Genetics determine how much coffee you can drink before it goes wrong

I'm doing a 12 cup pot of coffee a day with full fat milk to lessen my chances of dementia and Parkinsons. Tell me EXACTLY how much coffee to drink for that and I'll change. Yep, that is a lot more than the 400mg. suggested limit, I don't care! Preventing dementia and Parkinsons is vastly more important than whatever problems it can cause! 

Of course, your fuckingly incompetent? doctor did nothing with this from 3+ years ago! And still hasn't created a 24 hour coffee station

Dementia risk could drop by drinking just one shot daily of common beverage  August 2023

Coffee's Optimal Liver-Protective Dose

This transcript has been edited for clarity. 

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at the Eastern Virginia Medical School/Macon & Joan Brock Health Sciences at Old Dominion University in Norfolk, Virginia. 

Coffee is one of the most widely consumed beverages in the world. We enjoy it, as I suspect many of our patients do too. 

Article Key Points
  • 2-4 cups coffee/day captured most liver benefit signal.
  • Cohort: 350k UK Biobank; 13-year follow-up; observational data.
  • Coffee intake linked to ↓ cirrhosis, HCC, and liver-related death.
  • MRI: higher coffee intake associated with ↓ hepatic fat, iron, fibroinflammation.
  • Benefit seen with caffeinated + decaffeinated coffee; sugar/sweeteners unchanged clinical outcomes.
What mechanisms link coffee to reduced hepatic fibrosis?
How does coffee affect MASLD progression longitudinally?
Which coffee compounds drive liver-protective effects?

It's been long associated with certain adverse outcomes. I remember when I was a resident in 1981, a report was published in the New England Journal of Medicine suggesting that coffee was strongly associated with pancreatic cancer. So, the word was: Coffee is bad. 

Since then, observational studies have suggested that coffee may have some health benefits, particularly as we look at inverse associations (more may be better) related to liver diseases. Both cross-sectional and retrospective studies have shown an association between coffee consumption and reduced risks for cirrhosis and hepatocellular carcinoma.

In 2025, the American College of Gastroenterology (ACG) published its most recent guideline on malnutrition and nutritional recommendations in liver disease, which I reviewed on Medscape earlier this year. In that review, I highlighted the ACG’s recommendation of two or more cups of coffee daily to reduce the risk for fibrosis progression or development of hepatocellular carcinoma. That was a conditional recommendation based on a low level of evidence. 

New Study Strengthens the Coffee-Liver Link

Most recently, a report published in Clinical Gastroenterology and Hepatology looked at approximately 350,000 participants in the UK Biobank over a median follow-up of 13 years. The investigators excluded participants diagnosed with cirrhosis or hepatocellular carcinoma at or within a year of enrollment. They also evaluated daily coffee intake, and what they found, I think, was striking. 

For incident cirrhosis, they observed a 20% risk reduction associated with 1-2 cups a day, 35% with 3-4 cups, and 32% with five or more cups.

For incident hepatocellular carcinoma, the risk reductions were 24% with 1-2 cups, 35% with 3-4 cups, and 47% with five or more cups a day. 

Then they looked at liver-related death. The risk reductions were 31% with 1-2 cups, 41% with 3-4 cups, and, not notably greater, 42% with five or more cups. 

Now, why does this make sense? 

Coffee has hundreds of compounds, and it's unclear exactly which specific ones may account for the benefit. They may include polyphenols and other antioxidants that decrease oxidative stress, hepatic cell activation, collagen deposition, and fibrogenesis. 

This particular UK Biobank study looked at some very interesting things beyond the clinical outcomes. The investigators looked at imaging outcomes using MRI. They assessed proton density fat fraction as a measure of hepatic fat and iron-corrected T1 as a marker of hepatic fibroinflammation. Higher coffee intake was associated with lower hepatic fat, iron, and fibroinflammation. 

Then they further backed this up with proteomic profiling. The markers they analyzed consistently changed in a favorable direction with coffee consumption. Higher coffee intake was associated with higher levels of proteins related to hepatocellular synthesis and complement proteins associated with hepatic health and regeneration, and lower levels of fibrogenic and macrophage-activation markers associated with fibrosis and progression. All of these changes were favorable.

Importantly, caffeine did not appear to be solely responsible. The favorable associations were similar with caffeinated and decaffeinated coffee. 

The investigators also looked at the addition of sugar or artificial sweeteners, not something we would endorse if it can be avoided, particularly for our patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Nonetheless, adding sugar or artificial sweeteners did not significantly alter the associations with incident cirrhosis, hepatocellular carcinoma, or liver-related death.

There were some differences in MRI measures, including iron-corrected T1, but not in the three clinical outcomes I just mentioned. 

When I talk to my patients about this and ask them about coffee, some will say, "Well, I don't drink coffee.” So, then I will ask them about tea.

There is some evidence regarding tea, and a benefit is biologically plausible. A 2025 UK Biobank study suggested favorable associations with hepatic fat and other imaging measures, but not necessarily with clinical fibrotic liver disease.

Let’s return to the recommendations. Neither the 2025 ACG guideline nor the 2024 European Association for the Study of the Liver recommendations suggest tea as an alternative. 

Coffee is really the beverage that should be at the forefront of this discussion.

How Much Should We Emphasize Coffee?

It's important to tell patients that coffee may be helpful, but it's also important for them to understand that it is not the entire treatment. 

For fatty liver disease, we're talking about metabolic risk factors and weight reduction, and perhaps targeted treatment of MASLD. We now have therapies and lifestyle interventions that really go hand in hand. Coffee does not treat MASLD, nor does coffee reverse fibrosis. 

These impressive clinical data are observational, and residual confounding remains possible. 

But what does the data suggest? Certainly, 2-4 cups of coffee a day appear to capture much of the observed benefit. The ACG recommendation is for two or more cups, and the more recent data recommend perhaps 3-4 cups a day. 

Coffee seems to have an impressive association with a reduced risk for cirrhosis and other adverse liver outcomes. So, more is less. If you like coffee, java up. 

Put this in perspective however, when you talk with your patients. We need to look comprehensively at the other factors that may be influencing their liver disease and related outcomes. 

I’m Dr David Johnson. Thanks again for listening.

David A. Johnson, MD, a regular contributor to Medscape, is professor of medicine and chief of gastroenterology at Eastern Virginia Medical School/Macon & Joan Brock Virginia Health Sciences at Old Dominion University in Norfolk, Virginia, and a past president of the American College of Gastroenterology. His primary focus is the clinical practice of gastroenterology. He has published extensively in the internal medicine/gastroenterology literature, with principal research interests in esophageal and colon disease, and more recently in sleep and microbiome effects on gastrointestinal health and disease. 


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Monday, September 28, 2026

Experts link kindness, friendship to better health and longer life

 My social connections/friendships are extensive after dumping the ex and moving to Michigan.  I've got this covered.

Experts link kindness, friendship to better health and longer life

Experts link kindness, friendship to better health and longer life

Why connection matters: Studies link strong social ties to longer life, reduced disease risk, and better mental health, rivaling benefits of diet and exercise.

Friendship as remedy: Supportive friendships especially help childless older adults and can ease loneliness more than self-care, research shows.

Practical solutions grow: Apps, community frameworks, and small acts of kindness are being deployed to foster belonging and combat isolation.

References

How a UCLA professor uncovered the science behind loneliness | UCLA | ucla.edu
Dr. Julianne Holt-Lunstad | julianneholtlunstad.com
Friendship can be an important lifeline for older adults without children | Medical Xpress
Loneliness, friendship and the secret to living longer in America | Thy Black Man
This is the biggest lifestyle change a longevity expert has made to his life to increase his chances of living longer | Fit&Well
What’s the secret to a longer life? Experts say this is the single best thing you can do. | HuffPost
A Sociologist’s Six Essential Tips for College Friendships | Faculty of Arts and Sciences | fas.dartmouth.edu
U. alum launches new app to increase social connection on campuses worldwide - The Daily Targum | Daily Targum
Epley Reveals the Power of Friendship in New Documentary - Roman Family Center | Chicago Booth | chicagobooth.edu
UCLA partners with professor-designed friendship app to combat student loneliness - Daily Bruin | dailybruin.com
10 stories that show kindness and empathy can reach someone even when loneliness makes them feel invisible | Bright Side
13 moments of wisdom that prove loneliness teaches us the value of kindness | 5-Minute Crafts
Beyond loneliness and social isolation: Why belonging matters for public health - Healthy Debate | Healthy Debate

Lack of social connection linked to increased risks of heart disease, dementia, and early death

According to Dr. Julianne Holt-Lunstad, lacking social connection is associated with higher risks of developing heart disease, dementia, and experiencing premature death. These associations highlight the serious health consequences of social isolation.

References

How a UCLA professor uncovered the science behind loneliness | UCLA | ucla.edu
Dr. Julianne Holt-Lunstad | julianneholtlunstad.com
Longevity researchers link strong social ties to prevention of age-related diseases
 
Longevity researchers, including Dr. Matt Kaeberlein, emphasize that maintaining strong social connections can help prevent age-related diseases. This underscores the health-protective effects of social relationships in later life.

References

Friendship can be an important lifeline for older adults without children | Medical Xpress
Loneliness, friendship and the secret to living longer in America | Thy Black Man
This is the biggest lifestyle change a longevity expert has made to his life to increase his chances of living longer | Fit&Well

Anecdotal evidence from rural communities on daily social rituals and longevity
©Photo by Fan Xiaoheng/China News Service/VCG via Getty Images. XINXIANG, CHINA - SEPTEMBER 08: Villagers play chess outdoors on September 8, 2026 in Xinxiang, Henan Province of China. The village has improved public service facilities including education, healthcare, elderly care and culture while developing its collective economy and specialty industries. (Photo by Fan Xiaoheng/China News Service/VCG via Getty Images)
Observations from rural communities indicate that daily social rituals among residents may contribute to exceptional longevity. These rituals provide consistent opportunities for social interaction and support.

References

Friendship can be an important lifeline for older adults without children | Medical Xpress
Loneliness, friendship and the secret to living longer in America | Thy Black Man
This is the biggest lifestyle change a longevity expert has made to his life to increase his chances of living longer | Fit&Well

Potential to build strong social ties later in life

Experts note that it is never too late for individuals to develop strong social connections. This suggests that even in later stages of life, building friendships can contribute to improved well-being and health.

References

Friendship can be an important lifeline for older adults without children | Medical Xpress
Loneliness, friendship and the secret to living longer in America | Thy Black Man
This is the biggest lifestyle change a longevity expert has made to his life to increase his chances of living longer | Fit&Well

University of New Hampshire study on friendship and loneliness in childless older adults
©Photo by Maxine Wallace/The Washington Post via Getty Images. WASHINGTON,DC - MAY 5: Carlene Meheux (left), 39, and Tuere Marshall (right), 74, hold hands as they sit in the courtyard of the Martin Luther King Jr. Memorial Library on Tuesday May 5, 2026 in Washington, DC. The friendship bench connects older adults with young people who are seeking a listening ear and companionship. (Photo by Maxine Wallace/The Washington Post via Getty Images)
Research from the University of New Hampshire found that childless older adults with strong friendships experience a 20% greater reduction in loneliness compared to parents who have similar levels of social support. This suggests that friendships can play a particularly significant role in mitigating loneliness for older adults without children.

References

Friendship can be an important lifeline for older adults without children | Medical Xpress
Loneliness, friendship and the secret to living longer in America | Thy Black Man
This is the biggest lifestyle change a longevity expert has made to his life to increase his chances of living longer | Fit&Well

Loneliness as a public health crisis

The accounts and framework discussions frame loneliness as a public health crisis. This characterization emphasizes the widespread and serious nature of social isolation, requiring coordinated community-level interventions. Recognizing loneliness in this way elevates its importance in policy and social discourse.

References

10 stories that show kindness and empathy can reach someone even when loneliness makes them feel invisible | Bright Side
13 moments of wisdom that prove loneliness teaches us the value of kindness | 5-Minute Crafts
Beyond loneliness and social isolation: Why belonging matters for public health - Healthy Debate | Healthy Debate

Impact of small acts of kindness on social isolation
©Photo by Sebastian Gollnow/picture alliance via Getty Images. 22 December 2021, Hessen, Frankfurt/Main: Kristina Gerstenberger (l), volunteer of Malteser Hilfsdienst, and senior Helga chat over coffee and cake during a visit in the living room. Photo: Sebastian Gollnow/dpa (Photo by Sebastian Gollnow/picture alliance via Getty Images)
Personal accounts describe how small acts of kindness, such as a waiter showing empathy or receiving anonymous gifts, can disrupt feelings of isolation. These gestures create lasting bonds and help individuals feel seen and valued. Such acts demonstrate the power of interpersonal connection in countering loneliness.

References

10 stories that show kindness and empathy can reach someone even when loneliness makes them feel invisible | Bright Side
13 moments of wisdom that prove loneliness teaches us the value of kindness | 5-Minute Crafts
Beyond loneliness and social isolation: Why belonging matters for public health - Healthy Debate | Healthy Debate

Kindness as a bridge across social divides

Stories highlight that kindness and shared humanity can bridge divides between people from different backgrounds. Acts of empathy can foster connections even when individuals feel invisible due to loneliness. These connections can counteract the fragmentation of communities.

References

10 stories that show kindness and empathy can reach someone even when loneliness makes them feel invisible | Bright Side
Beyond loneliness and social isolation: Why belonging matters for public health - Healthy Debate | Healthy Debate

Deep conversations and small social moments enhance connection

Marisa Franco and Nicholas Epley suggest that engaging in deep conversations and seizing small social moments can significantly enhance interpersonal connections. These actions counteract the common underestimation of others’ willingness to connect.

References

What’s the secret to a longer life? Experts say this is the single best thing you can do. | HuffPost
A Sociologist’s Six Essential Tips for College Friendships | Faculty of Arts and Sciences | fas.dartmouth.edu
U. alum launches new app to increase social connection on campuses worldwide - The Daily Targum | Daily Targum
Epley Reveals the Power of Friendship in New Documentary - Roman Family Center | Chicago Booth | chicagobooth.edu

Encouragement to seize small social moments

Experts suggest taking advantage of small, everyday social opportunities to connect with others. This practice helps counteract the common underestimation of others’ openness to interaction.

References

What’s the secret to a longer life? Experts say this is the single best thing you can do. | HuffPost
A Sociologist’s Six Essential Tips for College Friendships | Faculty of Arts and Sciences | fas.dartmouth.edu
U. alum launches new app to increase social connection on campuses worldwide - The Daily Targum | Daily Targum
Epley Reveals the Power of Friendship in New Documentary - Roman Family Center | Chicago Booth | chicagobooth.edu

Marisa Franco's recommendation to reconnect with old friends

The stroke caused me to reconnect with old college friends
Marisa Franco advises individuals to reach out to old friends as a practical strategy for building connections. This approach is intended to counteract the tendency to underestimate others’ openness to reconnect. Reestablishing past relationships can help strengthen social bonds and reduce feelings of isolation.

References

What’s the secret to a longer life? Experts say this is the single best thing you can do. | HuffPost
A Sociologist’s Six Essential Tips for College Friendships | Faculty of Arts and Sciences | fas.dartmouth.edu
U. alum launches new app to increase social connection on campuses worldwide - The Daily Targum | Daily Targum
Epley Reveals the Power of Friendship in New Documentary - Roman Family Center | Chicago Booth | chicagobooth.edu
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Resetting the body clock could help the brain recover after stroke

 Your incompetent? doctor and hospital will fail at doing further research and human testing to change 'could' to will! And I'm sure they didn't create sleep or glymphatic clearance protocols.

NOT DOING EITHER ONE IS PURE INCOMPETENCE!

Resetting the body clock could help the brain recover after stroke

 Scientists at the University of Rochester Medicine have found that strengthening the body's natural daily rhythms to improve sleep may help the brain recover after a stroke. The work points to a possible new way to support brain waste clearance and improve recovery well after the initial injury. Published in the Journal of Clinical Investigation, the study showed that interventions designed to reinforce circadian rhythms improved recovery in mouse models of stroke. These improvements were accompanied by stronger activity in the glymphatic system, the brain's waste-clearing network, along with lower levels of inflammatory molecules that can persist after a stroke. 

How the Brain Clears Waste

The findings build on more than a decade of research led by URochester Medicine neuroscientist Maiken Nedergaard, MD, DMSc. Her laboratory discovered the glymphatic system in 2012. This system moves cerebrospinal fluid through the brain, helping remove waste products and other debris. Later studies found that glymphatic activity is especially strong during sleep and plays an important role in maintaining brain health.Neuroscientist Lauren Hablitz, PhD, later helped show that glymphatic activity is influenced not only by sleep, but also by circadian rhythms, the body's internal 24-hour clock. In a landmark 2020 study, Hablitz, Nedergaard, and colleagues demonstrated that glymphatic function follows daily cycles even independently of sleep, establishing a direct link between circadian biology and the brain's waste-clearing system. 

Stroke May Disrupt the Brain's Timing

"The discussion of stroke recovery really starts with the idea that stroke is not just a vascular event, but also a disorder of timing," said Hablitz, lead author of the new study. Scientists have long known that strokes tend to follow distinct time-of-day patterns. They occur more often during the morning and are frequently more severe near the end of the sleep period. After a stroke, many patients also develop disrupted sleep-wake cycles. Those disturbances have been linked with worse recovery, depression, and reduced quality of life. "That led us to ask a simple question," said Hablitz. "If timing is broken after a stroke, can we improve recovery by reinforcing the biological clock?" 

When the Brain's Cleanup System Slows Down

 In a healthy brain, the glymphatic system carries cerebrospinal fluid along blood vessels and through brain tissue. This process delivers nutrients while helping remove waste products and inflammatory signals. Earlier research has shown that glymphatic function becomes impaired after stroke. That disruption may reduce the brain's ability to clear harmful molecules that accumulate during recovery. Stroke research has traditionally focused on separating beneficial inflammation from harmful inflammation and finding ways to suppress the damaging forms. Hablitz and her colleagues suggest that another part of the problem may be that the brain is no longer clearing inflammatory signals effectively. "We think part of the problem may be a failure of cleaning," she said. "If the system responsible for clearing signaling molecules isn't working properly, everything builds up."Under this model, stroke damages both brain tissue and the pathways responsible for removing inflammatory signals. As those molecules accumulate, they may contribute to continued damage and slower recovery. 

Resetting the Body Clock

To test whether stronger circadian rhythms could improve recovery, the researchers examined several interventions known to affect the body's internal clock. These included timed light exposure, melatonin, a clock-targeting drug called KL001, and time-restricted feeding. The team first showed that each of these interventions could improve glymphatic function in healthy animals. They then selected the most promising strategies, KL001 and time-restricted feeding, and tested them in mouse models of stroke. Treatment did not begin until three days after the stroke, far beyond the narrow window used for clot-busting drugs and other acute stroke treatments. Even with that delay, mice that received either intervention showed better motor recovery, smaller lesion volumes, improved glymphatic flow, and lower levels of inflammatory cytokines in the brain. "All of the cytokines moved in the same direction," Hablitz said. "That suggests we may not be targeting one specific inflammatory pathway. Instead, we may be helping the brain clear inflammatory signals more effectively." One of the most promising approaches was time-restricted feeding, a behavioral intervention that is already being investigated for obesity, diabetes, cardiovascular disease, and other conditions. That could make the findings especially relevant for stroke rehabilitation because such an approach might eventually be easier to use outside specialized medical settings. "One of the exciting aspects of this work is that we're studying interventions that could potentially be implemented not only in hospitals but also at home," Hablitz said. 

What Researchers Need to Test Next

 The researchers emphasize that the findings so far are limited to animal models. More studies will be needed to determine exactly how circadian rhythms, glymphatic function, and inflammation influence one another after stroke. Future work will also examine whether improved glymphatic flow directly causes better recovery and whether circadian-based interventions can eventually be tested in clinical trials. More broadly, the study reflects a growing view in neuroscience that sleep, circadian rhythms, and fluid movement through the brain are central to brain health. By learning more about how the brain's internal clock regulates the glymphatic system, researchers hope to uncover new ways to improve recovery not only after stroke, but also in other neurological conditions involving inflammation and poor waste clearance. "Understanding how circadian regulation shapes glymphatic clearance will help us develop more targeted therapies," said Hablitz. "Ultimately, our goal is to find ways to improve the brain's ability to clear waste, reduce inflammation, and recover after injury." Health & Medicine Diabetes Heart Disease Mental Health Research Pharmacology Depression Mental Health Stroke Consumer Behavior RELATED TERMS

Story Source:

Materials provided by University of Rochester Medical Center. Note: Content may be edited for style and length.

Journal Reference:

  1. Emma Waight, Yuxi Zhu, Ashley Caudell, Velia S. Vizcarra, Evan Newbold, Michael J. Giannetto, Evalien Duyvestyn, Estephanie Balbuena, Wei Song, Tanzil M. Arefin, Yuki Mori, Maiken Nedergaard, Lauren M. Hablitz. Chronotherapy to reinforce circadian rhythms improves poststroke outcomes and glymphatic function in mice. Journal of Clinical Investigation, 2026; 136 (12) DOI: 10.1172/JCI201800

Cite This Page:

University of Rochester Medical Center. "Resetting the body clock could help the brain recover after stroke." ScienceDaily. ScienceDaily, 28 September 2026. <www.sciencedaily.com/releases/2026/09/260924020407.htm>.

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