Chicken Rice Bowl of KFC Japan

ケンタ丼 – Rice with two pieces of chicken, sweet potato and shiitake tempura plus sauce.

The bowl is only available at 7 selected stores in the country. The price is 700 yen (tax included).

9 Ways to Maximize Progress When Recovering from a Stroke

For years, neurologists believed that survivors of stroke had a six-month window to recover. After that, they would be stuck with whatever physical and cognitive limitations they had. That view has changed dramatically. “Because of neuroplasticity—the ability of the brain to form new neural pathways after other pathways have been disrupted—patients can keep regaining function,” says Amy Towfighi, MD, associate professor of neurology at the University of Southern California’s Keck School of Medicine.

While patients may not regain all abilities they had before the stroke, they can recover. “The single most important predictor of recovery is the severity of the initial stroke,” says Larry B. Goldstein, MD, FAAN, chair of the neurology department at the University of Kentucky. Time is also crucial: “Clot-busting drugs such as tPA and clot-retrieval procedures can dramatically improve stroke-related deficits, but they need to be used as soon as possible after the onset of symptoms,” Dr. Goldstein emphasizes.

Most stroke survivors experience the most rapid recovery during the first few weeks and plateau after about three months, but “individuals can recover over much longer periods, even if rehabilitation is delayed,” says Dr. Goldstein.

Stroke rehabilitation is “the next frontier in the field,” says Ralph L. Sacco, MD, FAAN, chair of neurology at the Miller School of Medicine at the University of Miami. “We’ve made amazing progress with acute stroke treatment, so much so that the amount of disability is less, and recovery is better,” he says. “And there is clear evidence that physical rehabilitation and speech and cognitive therapy do make a difference.”

Here’s what specialists recommend to maximize progress after a stroke.

Start rehab immediately.

A 2017 study in the journal Stroke found that patients who started intensive rehabilitation three days after being admitted to the hospital had the best outcomes. “The frequency and intensity can maximize the benefit,” says Dr. Goldstein. “Patients can rewire networks and trails in the brain with the right kind of rehabilitation and practice,” says A.M. Barrett, MD, FAAN, executive director of the Center for Visual and Neurocognitive Rehabilitation at the Atlanta VA Healthcare System.

Keep up with physical therapy.

“In an ideal world, patients would be able to continue with physical, occupational, and speech therapy so they could reach their full potential,” says Dr. Towfighi. “The key to recovery is practicing tasks over and over.” Insurance typically pays for only a limited number of sessions, but doing physical therapy exercises on your own, several times throughout the day, can make a significant difference.

Try telehealth.

“Telemedicine works well to guide therapy during the pandemic,” Dr. Goldstein says. A 2018 study in the Journal of Medical Internet Research found no differences in quality of life and improvement between stroke patients who did rehabilitation through video calls and those who did them in person. “The American Stroke Association can help patients and their families navigate the insurance system and craft a plan that is at least partially covered by insurance, whether outpatient or community-based,” says Dr. Barrett.

Incorporate other types of therapy.

Experts also recommend gait and balance training to avoid falls, as well as speech and occupational therapy. “Improvement in speech tends to take longer, but I’ve seen progress years after the initial stroke,” says Dr. Sacco.

Treat depression.

A major roadblock to adjusting to life after stroke is depression. A study in JAMA Psychiatry found that depression in stroke patients was three times as high as in the general population. Brain changes brought on by stroke can contribute to depression, as can going from being completely independent to relying on others. “It’s important for people to get support, whether they see a therapist or focus on things they want to strive for in the future,” Dr. Barrett says. Some studies suggest that treating all stroke patients—not just those known to be depressed—with antidepressants may improve functional movement and even paralysis, along with their quality of life. “Whether or not every stroke patient should be given antidepressants, it’s clear that those who do have depression will benefit from medication,” says Dr. Barrett.

Take the tougher path.

The tendency to avoid doing things that are difficult is counterproductive after a stroke. For example, a patient with limited mobility in one hand who uses only the stronger hand will never strengthen the weaker hand. A rehabilitation technique known as constraint-induced movement therapy is designed to isolate the weaker limb. Patients put their strong limb in a splint and intensively use the weaker limb for many hours a day for several weeks. “It’s hard work,” Dr. Barrett says, “but we’ve seen people progress 20 years after a stroke.”

Embrace technology.

“There are a variety of novel approaches that can supplement stroke rehabilitation therapy,” says Dr. Goldstein. One option is robotic therapy, which allows for remote rehabilitative treatments—for instance, harnesses and braces that use artificial intelligence to correct gait, which have been helpful during the pandemic and for patients who can’t travel.

Reframe expectations.

Although life may change after a stroke, patients can continue with favorite activities but do them in a new way. “It means finding the right therapy, the right equipment, and the right kind of support,” says Dr. Barrett.

Set objectives.

Establish small and realistic short-term goals, says Dr. Towfighi, co-author of What You Must Know About Strokes. “When we work with patients, we ask them, ‘What has meaning for you? What would give you a sense of accomplishment?’ Motivation can help drive the recovery.”

Source: Brain and Life

In Pictures: Breakfast Food Around the World (2)

Avocado toast topped with an egg – Australia

Facturas – Argentina

Eggs and sausage – Germany

Bolo de fuba – Brazil

Lablabi – Tunisia

Popara – Bulgaria

Breakfast spread – Turkey

Scientists Find New Way of Predicting COVID-19 Vaccine Efficacy

The early immune response in a person who has been vaccinated for COVID-19 can predict the level of protection they will have to the virus over time, according to analysis from Australian mathematicians, clinicians, and scientists, and published today in Nature Medicine.

The researchers from UNSW’s Kirby Institute, the Peter Doherty Institute for Infection and Immunity, and the University of Sydney have identified an ‘immune correlate’ of vaccine protection. This has the potential to dramatically cut development times for new vaccines, by measuring neutralising antibody levels as a ‘proxy’ for immune protection from COVID-19.

“Neutralising antibodies are tiny Y-shaped proteins produced by our body in response to infection or vaccination. They bind to the virus, reducing its ability to infect,” says Dr Deborah Cromer from the Kirby Institute.

“While we have known for some time that neutralising antibodies are likely to be a critical part of our immune response to COVID-19, we haven’t known how much antibody you need for immunity. Our work is the strongest evidence to date to show that specific antibody levels translate to high levels of protection from disease.”

The researchers analysed data from seven COVID-19 vaccines to examine the how the response measured soon after vaccination correlated with protection. They then used statistical analysis to define the specific relationship between immune response and protection. Their analysis was remarkably accurate and was able to predict the efficacy of a new vaccine.

Dr Cromer said that this finding has the potential to change the way we conduct COVID-19 vaccine trials in the future.

“Antibody immune levels are much easier to measure than directly measuring vaccine efficacy over time. So, by measuring antibody levels across the range of new vaccine candidates during early phases of clinical trials, we can better determine whether a vaccine should be used to prevent COVID-19.”

Vaccine boosters likely to be required within a year

Another crucial application of this analysis is its ability to predict immunity over time. The researchers predict that immunity to COVID-19 from vaccination will wane significantly within a year, with the level of neutralising antibodies in the blood dropping over the first few months following infection or vaccination.

“Vaccination works very well to prevent both symptoms and severe disease in the short to medium term, but efficacy is predicted to decline over the first few months for most of these vaccines,” says Dr David Khoury, also from the Kirby Institute.

“However, it is very important to understand the difference between immunity against infection and protection from developing severe disease. Our study found that a 6-fold lower level of antibodies is required to protect against severe disease. So even though our analysis predicts that we will start losing immunity to mild infection in the first year after vaccination, protection from severe infection should be longer lived,” says Dr Khoury.

“But ultimately, for optimal protection against moderate disease and transmission of COVID-19, these findings suggest we may be looking at annual vaccine boosters, just like what we have with the flu vaccine.”

Applying the model in the real word

A major global challenge is the evolution of the virus and the emergence of new variants. There is a growing concern, based on laboratory studies, that antibodies developed against the dominant strains are less effective at neutralising these new variants.

“An added advantage of our work is that allows us to predict how protective an immune response will be against different variants,” says Professor Jamie Triccas from the University of Sydney’s Marie Bashir Institute and Faculty of Medicine and Health.

“This analysis shows a very good correlation between the immune response – which is very easy to test for – and the efficacy of a vaccine in preventing infection, which is incredibly hard to test for. This means we can predict how protective an immune response will be against different variants, without having to determine efficacy against each variant in large and costly clinical trials.

“This work can facilitate decision making by providing the necessary data much earlier on in the vaccine development pipeline and in a far more efficient way.”

A limitation of this study is that it analyses the relationship between early immune responses to infection and vaccination and protection from infection (the data that is currently available), and uses this relationship to project how immunity will change in the future and in the response to different viral variants. Future studies should aim to confirm these predictions as data becomes available.

Source: Kirby Institute

Irish-style Smoked Salmon and Spinach Frittata

Ingredients

2 tablespoons vegetable oil, divided
1 medium red onion, diced
1 clove garlic, minced
6 ounces baby spinach
10 eggs
1 teaspoon dried dill weed
1/4 teaspoon salt
1/4 teaspoon black pepper
4 ounces smoked salmon, chopped
4 ounces Dubliner cheese, cut into 1/4-inch cubes

Method

  1. Position oven rack in upper-middle position. Preheat broiler.
  2. Heat 1 tablespoon oil in large ovenproof nonstick skillet. Add onion; cook 7 to 8 minutes or until softened, stirring occasionally.
  3. Add garlic. Cook and stir 1 minute.
  4. Add spinach. Cook and stir 3 minutes or until just wilted.
  5. Transfer mixture to small bowl.
  6. Whisk eggs, dill, salt and pepper in large bowl until blended. Stir in salmon, cheese and spinach mixture.
  7. Heat remaining 1 tablespoon oil in same skillet over medium heat. Add egg mixture. Cook about 3 minutes, stirring gently to form large curds.
  8. Cook undisturbed 5 minutes or until eggs are just beginning to set.
  9. Transfer skillet to oven. Broil 2 to 3 minutes or until frittata is puffed, set and lightly browned. Let stand 5 minutes.
  10. Carefully slide frittata onto large plate or cutting board. Cut into wedges and serve.

Makes 6 ot 8 servings.

Source: Irish Cooking Bible


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