Dog Walker Injuries

Welcome back. Dogs are wonderful pets, as more than half of U.S. households can attest. Walking them is certainly good exercise for both the walker and the dog. Nevertheless, with a dog on one end of a leash and the walker on the other end, injuries occasionally occur. 

Ready for a walk (from www.rspcapetinsurance.org.au/pet-care/training-your-pet/5-ways-to-train-your-dog-to-walk-on-a-leash).

To develop more comprehensive information about these injuries, a team of researchers examined leash-dependent dog-walking injuries to adults (age 18 and older) that were treated in U.S. emergency departments from 2001-2020.

The researchers, affiliated with the Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health, used data derived from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS).

NEISS
For more than 45 years, NEISS has collected data for the Consumer Product Safety Commission to produce nationwide estimates of product-related injuries.

NEISS draws from a nationally representative sample of hospitals in the U.S. and its territories. Each hospital reports patient information for every emergency department visit associated with a consumer product or poisoning to a child younger than five.

NEISS has become an important public health source of data for researchers and consumers throughout the U.S. and around the world. Increasing its importance, in 2000, the Consumer Product Safety Commission expanded NEISS to collect data on all injuries for the Centers for Disease Control and Prevention (CDC) through an interagency agreement.

Data Analysis and Results
The Johns Hopkins researchers conducted a retrospective analysis to generate weighted estimates and 95% confidence intervals of injury incidence, injury characteristics and risk factors for sustaining a fracture or traumatic brain injury (TBI).

Between 2001 and 2020, an estimated 422,659 adults were treated at U.S. emergency departments for injuries related to leash-dependent dog walking. During this period, the annual incidence of injuries increased from 7,282 to 32,306.

Nearly half of all patients were adults age 40 to 64, and 75% of patients were female. Patients commonly injured their upper extremity (51%) while falling, when pulled by, tangled in or tripped by the leash connected to the dog they were walking.

Dog walking problems (from www.wndu.com/content/news/Dog-walking-injuries-on-the-rise-How-to-stay-safe-396715911.html).

Most Common Injuries  

The three most common injuries among all patients were finger fracture (6.9%), TBI (5.6%) and shoulder sprain or strain (5.1%); however, the two most common injuries among patients age 65 and older were TBI and hip fracture.

Older dog walkers were more than three times as likely to experience a fall, more than twice as likely to have a fracture and 60% more likely to sustain a TBI than younger dog walkers.

TBIs consisted of both concussions and non-concussive internal head injuries, which can include brain contusion (a bruise of the brain tissue), epidural hematoma (bleeding between skull and brain’s outer membrane) or subdural hematoma (bleeding beneath the brain’s outer membrane).

Wrap Up
The research team stated its hope that the findings will promote awareness among dog owners as well as clinicians, and that clinicians will discuss the injury potential of leash-dependent dog walking with their patients, especially females and older adults.

Notably, the researchers also analyzed leash-dependent dog walking injuries among children under age 18. They expect those findings to be released in the near future.

Stay safe and thanks for stopping by. Oh, don’t forget, you can always stick with cats.

P.S.
Study of dog-walking injuries in Medicine & Science in Sports & Exercise: journals.lww.com/acsm-msse/Abstract/9900/Epidemiology_of_Dog_Walking_Related_Injuries_Among.259.aspx
Article on study on EurekAlert! website: www.eurekalert.org/news-releases/987219
NEISS: www.cpsc.gov/Research--Statistics/NEISS-Injury-Data

Training for Memory Functioning

Welcome back. Aunt Jeanne, who passed away several years ago at age 100, was stellar at completing crossword puzzles. (She would have told me that a 14-letter word for someone skilled at solving or designing crossword puzzles is cruciverbalist.)

My mother, Frances, Jeanne’s older sister, took credit for getting Jeanne started doing crossword puzzles. It began, she related, when they were in the hospital as Uncle Dave, Jeanne’s husband, was dying of cancer. Unlike Jeanne, Frances used to pick up a newspaper, do a few words in the puzzle if she could find a pencil, then move on to news articles she may have missed.

I share this bit of undocumented family history because a recent study compared training with crossword puzzles versus video games for memory functioning (encoding, storing and retrieving information) in older adults with mild cognitive impairment.

Crossword Puzzles vs. Video Games
I was attracted to the study because the last time I paid attention to the general topic was in 2016, for my blog post, Brain Training Games. Then, the conclusion was if you’re playing brain games because you think it improves your cognitive ability to do more than play the games better or accomplish similar tasks, that may be wishful thinking.

Brain training (from multiple websites and earlier blog post, Brain Training Games).

This new study was conducted at two sites by researchers affiliated with the New York State Psychiatric Institute and Columbia University Medical Center (lead site) and with Duke University and Duke University School of Medicine.

The researchers randomly assigned 107 participants with mild cognitive impairment to either crossword puzzle training (56) or cognitive games training (51). Participants were average age 71, 58% female and 28% minorities. Training was intensive for 12 weeks, followed by booster sessions up to 78 weeks. Over the course of the study, 7 of 56 crossword-group participants and 9 of 51 games-group participants dropped out.

Web-Based Games and Crosswords

Lumos Labs web-based brain training, Luminosity (graphic from www.lumosity.com/en/).

Lumos Labs provided the web-based games and crosswords. Each games session was composed of 6 modules randomly selected from 18 available modules that included memory tasks, matching tasks, spatial recognition tasks and processing speed tasks. Difficulty was scaled over time considering games performance, cognitive area performance and overall cognitive performance. Participants received their overall performance score at the end of each session.

The computerized crosswords were of medium difficulty--comparable to The New York Times’ Thursday crossword puzzles--without performance-based scaling over time. If the puzzle was completed within half of the allotted 30 minutes, a second puzzle was presented. Participants could view the correct answers at the end of the session.

Participants were evaluated in person at five scheduled visits (weeks 0, 12, 32, 52 and 78); research staff conducted three additional phone calls (weeks 20, 42 and 64).

Cognitive Outcomes
The primary measure of cognitive outcome was change from baseline in the 11-item Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog). Scores worsened for games and improved for crosswords at 12 weeks and 78 weeks.

Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) 11-Item. (Praxis is an idea translated into action; Constructional praxis is the neurological process by which cognition directs motor action; Ideational praxis is the brain’s ability to develop an idea for action and plan, organize and execute unfamiliar motor actions) (graphic modified from slideplayer.com/slide/7096620/).

Secondary outcomes included change from baseline in neuropsychological composite score, University of California San Diego Performance-Based Skills Assessment score, and Functional Activities Questionnaire score. The Functional Activities Questionnaire scores worsened more with games than with crosswords at 78 weeks; other secondary outcomes showed no difference.

Magnetic resonance imaging of changes in brain hippocampal volume and cortical thickness were also assessed. Decreases in hippocampal volume and cortical thickness were greater for games than for crosswords.

Wrap Up
The study found crossword puzzles were superior to computerized cognitive games for memory functioning in older adults with mild cognitive impairment. Notably, mild cognitive impairment is associated with high risk for dementia, including Alzheimer’s disease.

While the results were clear, the researchers emphasize the need for replication in a larger trail that includes a control group participating without crosswords or cognitive games. I’ll look forward to those results since I don't do either. Thanks for stopping by.

P.S.
Study of computerized games versus crosswords in NEJM Evidence journal: evidence.nejm.org/doi/10.1056/EVIDoa2200121
Article on study on EurekAlert! website: www.eurekalert.org/news-releases/969320
Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog):
www.ncbi.nlm.nih.gov/pmc/articles/PMC5929311/
www.fda.gov/media/122843/download

Brain Signals to Text

Welcome back. There’s been some fascinating work on brain-computer interfaces (BCIs) aimed at restoring communication to those who have lost the ability to move or speak. While the primary focus has been on restoring gross motor skills--reaching and grasping or point-and-click typing with a computer cursor, a recently published pilot study by researchers affiliated primarily with Stanford and Brown universities described translating neural activity to text in real time. Got that? Converting thoughts about handwriting to computer screen text.

Cataloging the Study
The study report and media summaries appeared about a month ago. As you might expect, the research and development project actually began long before. 

BrainGate2 is NCT00912041 in the National Library of Medicine’s clinical trials database (www.clinicaltrials.gov/ct2/show/NCT00912041).

The U.S. National Library of Medicine, an institute of the National Institutes of Health, maintains a database of worldwide privately and publicly funded clinical studies. There you’ll find BrainGate2: Feasibility Study of an Intracortical Neural Interface System for Persons with Tetraplegia (i.e., paralysis in the upper and lower body). The study is described as an interventional clinical trial to identify the core methods and features for a medical device that could allow people with paralysis to recover a host of abilities that normally rely on the hands. The study began in 2009 with the estimated completion in 2022.

Study Procedures
The investigation focused on a single individual who lost nearly all movement below the neck after a spinal cord injury in 2007. Nine years later, the researchers implanted two BCI chips the size of baby aspirins on the surface of the left side of his brain. Each chip had 100 electrodes to receive electrical signals from neurons firing in the part of the brain’s motor cortex that controls hand and finger movement.

Brain’s motor cortex is in charge of planning, control and execution of voluntary movements (graphic from www.researchgate.net/journal/Frontiers-in-Human-Neuroscience-1662-5161).

The neural signals were transmitted via wires to a computer, where artificial-intelligence algorithms “learned” to decode the signals using a recurrent neural network approach to deduce the individual’s thoughts about handwriting motion.

The algorithm training had the participant mentally write letters of the alphabet on an imaginary legal pad with an imaginary pen, repeating each letter 10 times. Next, in many long sessions, the participant was shown groups of sentences and instructed to mentally handwrite each sentence. Over time, the algorithms improved in differentiating the neural signals of the different characters. 

Graphic of electrodes detecting neural signals of man mentally handwriting (from Howard Hughes Medical Institute video www.youtube.com/watch?v=pcApwQxbagg).

Wrap Up
Although the coupling of BCI with artificial-intelligence software to convert thoughts to screen-displayed text was only tested on one person, the proof-of-concept results were impressive. The participant was eventually able to generate about 18 words per minute with an accuracy of nearly 100% with a general purpose autocorrect. Healthy people of the same age reportedly text about 23 words per minute on a smartphone

When asked to write answers to open-ended questions, which required time for thought, the participant averaged close to 15 words per minute.

What the researchers found especially interesting was that, years after suffering the spinal cord injury and losing hand and finger movement, the neural activity associated with writing was not lost.

Thanks for stopping by.

P.S.
Study of brain to text handwriting in Nature journal: www.nature.com/articles/s41586-021-03506-2
Example articles on study
www.eurekalert.org/pub_releases/2021-05/sm-sss051021.php
www.sciencenews.org/article/brain-implants-translate-handwriting-text
www.axios.com/newsletters/axios-science-07aaba61-f030-4e22-a91c-357935245667.html?chunk=2&utm_term=emshare#story2
National Library of Medicine’s clinical trials database and BrainGate2 entry:
www.clinicaltrials.gov/
www.clinicaltrials.gov/ct2/show/NCT00912041

Household Chores Help Brain

Welcome back. Nine years ago, in a blog post Vacuuming with Cats, I wrote:

[M]y wife takes the lead on fix-it chores in our household. If, instead of cheering “Go, Girl!” you bemoan the lot of the harried wife who, even in this modern age, must still do it all, please search for my older blog posts on laundry and food shopping. You’ll learn that I handle those chores. In fact, in my very first post, I mentioned that I also do the cleaning…This accounting isn’t to seek acclaim or refocus the target of your bemoaning; it’s only so I may get to vacuuming.

Warren’s cleaning tools…well, most of them.

Forgive my reminiscing. I just wanted to explain why there’s a very good chance I have increased the volume of my brain. Oh, sorry again. I should have mentioned a study by researchers affiliated with Canada’s Rotman Research Institute, the Toronto Rehabilitation Institute and the University of Toronto. They found that time spent engaging in household physical activity was positively associated with brain volume in older adults.

May I tell you how they came to that conclusion?

Looking at Physical Activity and Brain Health
It’s well documented that physical activity, especially recreational, is positively associated with brain volume and cognition in older adults. What is less understood is the contribution of other daily activities. The researchers set out to identify associations among household physical activity, brain volume and cognition in older adults that were cognitively unimpaired and free from significant medical, neurological or psychiatric conditions.

Screening of potential study participants included telephoned demographic, medical and cognitive questions in addition to three hospital visits for a health evaluation, cognitive assessment and structural brain imaging (acquired with a Siemens Trio 3T MRI Scanner).

Sixty-six participants were selected (ages 65 to 83; 62% female) and further assessed using Phone-FITT, a telephone questionnaire for collecting information from older adults on the frequency, duration and intensity (based on breathing) of all physical activities performed over the past month. (The questionnaire's developers note that intensity measures tend to decrease response reliability and might be omitted, which the researchers did.)

Phone-FITT accounts for season, allows reporting of activities not specifically listed and categorizes household apart from recreational physical activities. Household physical activity includes light housework (tidying, dusting), meal preparation and clean up, shopping, heavy housework, home maintenance (yard work, home repairs) and care giving.

Analyzing the Data
The researchers extracted estimates of the volumes of intracranial, whole brain, gray matter, white matter, hippocampal and frontal lobe from the structural images of each participant’s head. To account for head size variability, brain volumetric measures were adjusted for intracranial volume.

Brain cross-section, showing gray matter and white matter
(difference.guru/difference-between-white-and-gray-matter/).

Cognitive performance was assessed in four domains: memory, working memory/attention, processing speed and executive function.

Associations among physical activity (household and recreational), brain volume and cognition were investigated with statistical modeling, adjusting for age, gender, Framingham Risk score (estimates 10-year cardiovascular risk) and either intracranial volume or education. Additional analyses examined significant results and associations with hippocampal and frontal lobe volume.

Wrap Up
The study found household, but not recreational, physical activity was positively associated with brain volume measurements, especially gray matter volume. In contrast, no significant associations were observed between household or recreational physical activity and cognition.

Key differences between brain gray matter and white matter (www.developinghumanbrain.org/ graphic modified from www.pinterest.de/pin/457959855860455384/).

The researchers posited that the lack of association between recreational physical activity and brain health indicators could be attributed to the removal of Phone-FITT intensity from the analysis, which might also explain the lack of association with white matter volume.

Above all, the study highlighted the brain benefits associated with household chores and may motivate older adults to be more active by providing a more sustainable, low risk form of physical activity.

Please don’t inquire if I can assist with cleaning. I already have enough to benefit my brain. Many thanks for stopping by.

P.S.
Study of household physical activity and brain volume in BMC Geriatrics journal: bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-021-02054-8
Article on study on EurekAlert! website: eurekalert.org/pub_releases/2021-04/bcfg-sto041521.php
Phone-FITT reference: journals.humankinetics.com/view/journals/japa/16/3/article-p292.xml
Brain size and volume background: en.wikipedia.org/wiki/Neuroscience_and_intelligence