I consider this to be a complete fucking failure. This back patting does absolutely nothing to get survivors 100% recovered. Nowhere in here do they discuss how they are solving all these failure points. I actually consider all the previous presidents of the WSO to be complete failures, nothing they did helped survivors one whit towards 100% recovery. That is the ONLY METRIC TO BE USED IN STROKE. But then my opinion is worthless since I'm just a stroke addled survivor, there is zero point in ever listening to the patients. THEY KNOW NOTHING! Your children and grandchildren will have the same fucked up recovery if we don't fire all the existing 'stroke leaders'.
It is simple, solve these problems. Yep they will be hard but leaders tackle the big problems. Are you a leader or a mouse?
1. 30% get spasticity NOTHING THAT WILL CURE IT.
2. At least half of all stroke survivors experience fatigue Or is it 70%?
Or is it 40%?
NOTHING THAT WILL CURE IT.
3. Over half of stroke patients have attention problems.
NOTHING THAT WILL CURE IT.
4. The incidence of constipation was 48%.
NO PROTOCOLS THAT WILL CURE IT.
5. No EXACT stroke protocols that address any of your muscle limitations.
6. Post stroke depression(33% chance)
NO PROTOCOLS THAT WILL ADDRESS IT.
7. Post stroke anxiety(20% chance) NO PROTOCOLS THAT WILL ADDRESS IT.
8. Posttraumatic stress disorder(23% chance) NO PROTOCOLS THAT WILL ADDRESS IT.
9. 12% tPA efficacy for full recovery NO ONE IS WORKING ON SOMETHING BETTER.
10. 10% seizures post stroke NO PROTOCOLS THAT WILL ADDRESS IT.
11. 21% of patients had developed cachexia NO PROTOCOLS THAT WILL ADDRESS IT.
12. You lost 5 cognitive years from your stroke NO PROTOCOLS THAT WILL ADDRESS IT.
13. 33% dementia chance post-stroke from an Australian study?
Or is it 17-66%?
Or is it 20% chance in this research?
NO PROTOCOLS THAT WILL ADDRESS THIS
The useless back patting here, nothing here gets survivors recovered.
International Impact of Stroke journal
Originally published19 Feb 2020https://doi.org/10.1161/STROKEAHA.119.028422Stroke. 2020;51:1036–1039
Origins—an American Journal
With the launch of the new journal Stroke in 1970, the first Editor-in-Chief, Dr Clark Millikan, stated that the journal would cover a wide range of specialties, “to fill a gap and to meet a responsibility.”1 He commented on the kaleidoscope of people who could enter the room of a patient with cerebral infarction including medical specialists, nurses, allied health professionals, even a mortician—in a minor percentage. Stroke was an American journal. The Editor-in-Chief was supported by 2 Associate Editors and a 19-member Editorial Board. They were all from the United States. In the first year, 58 manuscripts were published: 56 from the United States, 1 from Denmark, and 1 from India.Internationalization of Stroke
Over the subsequent 50 years, Stroke has become the standard bearer for the International Stroke Community, the craft journal for our field despite the burgeoning number of publications devoted to stroke and the cerebral circulation. It has become truly international in its scope of editors, authors, institutional affiliations, and readers, with many innovations introduced by successive editors. The journal has also played a major role in the development of the global stroke scene.The second Editor-in-Chief, Fletcher McDowell, highlighted critical developments in stroke diagnosis during his term (1977–1981) that had a huge international impact. These included the widespread introduction of computed tomography in the 1970s, ultrasound, and then magnetic resonance imaging. Perhaps prophetically, he pointed out that “effective treatment remains elusive.”2
Ten years after the first edition, Stroke in 1980 had expanded to a 37-member Editorial Board. It was still chiefly American, with 31 of 37 board members from the United States. However, 6 other international stroke leaders represented the international community, including Henry Barnett (Canada), Cesare Fieschi (Italy), Fumio Gotoh (Japan), Konstantin-Alexander Hossman (Germany), Niels Lassen (Denmark), and Lindsay Symon (United Kingdom). Of the many pivotal papers published in the journal during this era, the early description of the ischemic penumbra and the potential for acute reperfusion strategies by Lindsay Symon’s team in London, United Kingdom, and coauthors Jens Astrup and Bo Siesjö was particularly prophetic.3 We all now know that the ischemic penumbral concept underpins the major treatment strategies for acute stroke used today, namely intravenous thrombolysis and endovascular thrombectomy. How our field has changed! In 1980, there was no proven acute therapy and only very limited stroke prevention strategies. An editorial on impending stroke recommended the use of heparin, coumadin, and aspirin at a dose of 1200 to 1800 mg daily.4 There were no trials of anticoagulants in atrial fibrillation, although their use in cardioembolic stroke was recommended in 1980. Usefully, key stroke abstracts from other journals were being published in Stroke. An indication of the gradual shift toward a more global contribution to the journal is shown in the 1980 volume where 35% of papers were from other parts of the World.
Henry Barnett was a pioneer and brilliant trialist, best known for his work on aspirin in stroke prevention, the validation and selection of patients for carotid endarterectomy, and the extracranial-intracranial bypass trial. He wrote that “the internationalization of the journal was reflected in all successive issues and was a factor in determining expansion.”5 He pointed out that between 1982 and 1987, there was increased enthusiasm on both sides of the Atlantic, in Japan, Taiwan, and down under.
This internationalization further increased over the subsequent decades, under the leadership of Oscar Reinmuth and Mark Dyken. Dr Dyken indicated that Stroke had become “a truly international journal.” By 1999, a remarkable 68% of its submissions were from outside the United States, although constituted only 42% of the subscribers.6 By this time, all the American Heart Association journals were being published online. Importantly, he also promoted the inclusion of women and minorities on the board.
The internationalization of Stroke was then greatly accelerated by the last 2 Editors-in-Chief of Stroke, both with major international research and leadership profiles, Vladimir Hachinski and Marc Fisher. Dr Hachinski is a renowned international leader and particularly recognized for his own research in autonomic dysfunction after stroke and major contributions to cognitive impairment and dementia. He has highlighted the importance of vascular contributions to all forms of dementia including Alzheimer disease and championed interventions to reduce the risk of dementia.7
Marc Fisher is a distinguished translational clinical scientist with particularly important contributions based on preclinical models and imaging of the ischemic penumbra. In the past 10 years under Dr Fisher, the leadership group was significantly expanded, making the impact of the journal even more global in its impact. He has also had a truly international perspective, greatly expanded the scope of the journal and the specialized sections, reflecting the diversity of stroke research and practice. This evolution of the journal has been illustrated by the publication metrics.
When one considers the 50 years of Stroke publications, more than half represent contributions from authors outside the United States. Of the top 15 authors publishing in Stroke over this period, with >100 published papers, 8 are from other countries (Table).
| Top 10 Institutions | No. of Articles | Top 15 Authors | >100 Articles | Top 10 Countries | No. of Articles |
|---|---|---|---|---|---|
| Harvard University | 824 | J.L. Saver (US) | 176 | US | 7111 |
| UCLA | 408 | R.L. Sacco (US) | 145 | UK | 1764 |
| University Utrecht (the Netherlands) | 380 | P.M. Rothwell (UK) | 130 | Germany | 1578 |
| Columbia University | 366 | A.M. Demchuk (Canada) | 123 | Japan | 1359 |
| University of London (UK) | 362 | M.D. Hill (Canada) | 115 | Canada | 1153 |
| University Toronto (Canada) | 362 | K.R. Lees (UK) | 117 | The Netherlands | 831 |
| Pennsylvania | 358 | M. Fisher (US) | 116 | France | 774 |
| Johns Hopkins University | 356 | J.C. Grotta (US) | 113 | Australia | 636 |
| Heidelberg University (Germany) | 340 | J.P. Broderick (US) | 112 | Sweden | 586 |
| Mayo Clinic | 339 | G.W. Albers (US) | 110 | Italy | 582 |
| W. Hacke (Germany) | 107 | China | 569 | ||
| H.S. Markus (UK) | 103 | ||||
| M. Kaste (Finland) | 102 | ||||
| G.A. Donnan (Australia) | 101 | ||||
| D.S. Liebeskind (US) | 101 |
There has been a further change over the past decade. In 2008/2009, 50% of the accepted manuscripts were from the United States (23% of submissions). The United States acceptance rate was followed by submissions of fairly equal proportions (6%–8%) from the United Kingdom, Germany, Canada, the Netherlands, and Japan. Germany and the United Kingdom have always been among the highest international contributors. In 2018/2019, the US proportion of accepted publications had fallen to 30%, while the next most published authors by country were the United Kingdom, the Netherlands, China, Germany, and Korea (all 6%–9%). Notably, the proportion of accepted manuscripts from China has increased substantially, from 2% to 8%, over the past decade.
In the first decade of Stroke, 1970 to 1979, 4 of the top 5 institutions of the published authors were from the United States, and the fifth was Kyushu University in Japan. The proportion of non-US institutions has greatly increased over the years. In the last decade, 2010 to 2019, Harvard and University of California, Los Angeles (UCLA) topped the list but were followed by the Universities of Toronto, Calgary, and Utrecht.
Of the top 10 institutions of the authors published in Stroke over its 5 decades, 4 are from outside the United States (University of Utrecht, University of Toronto, University of London [United Kingdom], and University of Heidelberg [Germany]; Table).
In 2019, the Editorial Board has grown to around 250, about half outside the United States. This is a truly comprehensive and international board, including many of the Section Editors.
Other International Innovations
Over the years, Stroke has been published in a number of languages. Foreign language editions were introduced by Mark Dyken, then in a major initiative of Vladimir Hachinski, expanded to include (at various times) Stroke in Spanish, Russian, Italian, Chinese, Japanese, Portuguese, Indian, Korean, and Turkish. Vladimir Hachinski also expanded the number of European Editors (including Markku Kaste, Werner Hacke, Joanna Wardlaw, Hugh Markus, and Bo Norrving). There were also Asian and Australasian/Oceanian Editors including Lawrence Wong and Graeme Hankey.Vladimir Hachinski devised and chaired a critical meeting for international progress in stroke, a Synergium of global stroke leaders, and this prioritized stroke agenda was published in Stroke in 2010.8 This Synergium was aimed at devising new ways to accelerate and prioritize progress in reducing the risks, effects, and consequences of stroke. It promoted integration of knowledge into programs, coupled with careful evaluation to speed the pace of progress. This represented an important stimulus for the field.
The American Stroke Association/American Heart Association guidelines have been influential internationally and undoubtedly motivated the creation of many regional and national stroke guidelines around the world. They also influenced the development of the World Stroke Organization guidelines. These have cited particularly well over the past 2 decades. For example, the top 10 cited papers in Stroke from 2002 to 2019 were guidelines for management of acute ischemic stroke, stroke prevention, intracerebral hemorrhage, and an expert statement on cognitive impairment and dementia.
Other major journals devoted to stroke have included Cerebrovascular Diseases and the European Stroke Journal, both based in Europe, the International Journal of Stroke, which is published by the World Stroke Organization, Journal of Stroke and Cerebrovascular Diseases (Japan), Journal of Stroke (Korea), and Stroke and Vascular Neurology (China). Some of the editors of these journals have met over the years to establish synergies and periodically jointly publish key papers.
Formation of the World Stroke Organization
In 2006, the 2 previous international stroke bodies (the International Stroke Society and the World Stroke Federation) merged to form a new global body, aimed at representing “One World Voice for Stroke,” the World Stroke Organization (WSO) (Figure). There has been an incredibly close nexus between the leaders of the journal and the WSO. Vladimir Hachinski played a pivotal role and chaired the nominating committee for the first WSO President, and he, together with Geoffrey Donnan, were key drivers in this marriage. Dr Hachinski was the Editor-in-Chief of Stroke at that time, and his successor Marc Fisher is the President Elect of the WSO. Geoffrey Donnan served with Stephen Davis as co-editor of the Controversies section of the journal for a decade. Geoffrey Donnan has just completed 14 successful years as Editor-in-Chief of the International Journal of Stroke—the official journal of the WSO. All the other WSO Presidents have been major contributors to Stroke. Bo Norrving and Werner Hacke served as European Editors, Stephen Davis is a Consulting Editor, and the current President Michael Brainin is a Senior Consulting Editor. The new Editor-in-Chief of Stroke, Ralph Sacco, has contributed to the WSO Board and chaired our research committee for a number of years.
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