International Impact of Stroke journal

I consider this to be a complete fucking failure. This chest thumping 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

Stephen M. Davis

,

Werner Hacke

,

Bo Norrving

,

Michael Brainin

,

Kennedy R. Lees

,

Geoffrey A. Donnan

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).

Table. The International Impact of Stroke Over 5 Decades (Web of Science)

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

UCLA indicates University of California, Los Angeles; UK, United Kingdom; and US, United States.

In the early decades of publication, Japan, Canada, and Germany were the highest contributors, outside of the United States. Over the 5 decades, when one considers the top 10 national contributors after the United States, the United Kingdom and Germany have been the highest, followed by Japan, Canada, the Netherlands, France, Australia, Sweden, Italy, and China (Table).
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.

• Download figure
• Download PowerPoint

Figure. WSO Presidents 2006 to 2020. From left, Stephen Davis, Geoffrey Donnan, Werner Hacke, Michael Brainin (current WSO President), and Bo Norrving, at the 2017 World Stroke Day Conference, Moscow. All WSO Presidents and the former European Stroke Organization President Kennedy Lees have made significant editorial contributions to Stroke. The WSO President Elect is Dr Marc Fisher, outgoing Editor-in-Chief of Stroke. WSO indicates World Stroke Organization.

There have also been strong synergies between Stroke and the European Stroke Organization. Werner Hacke, Michael Brainin, and Kennedy Lees have all been Presidents of European Stroke Organization. Michael Brainin is Senior Consulting Editor, and Kennedy Lees serves as an Associate Editor of Stroke. Bo Norrving, a former European Editor of Stroke, is the Editor-in-Chief of the official journal of the European Stroke Organization—the European Stroke Journal.

Looking Ahead

In 1970, there were no proven treatment or prevention strategies for stroke. There has been a steep trajectory in the proof and implementation of evidence-based therapies for stroke over the past 50 years. Stroke is now highly preventable and treatable(FUCKING BULLSHIT!). The journal Stroke remains our craft publication, linking together clinicians and scientists around the world. Under Ralph Sacco, the tradition continues of appointing an Editor-in-Chief of Stroke who is highly distinguished in relation to his own research achievements and leadership, with a major international profile and vision. An exciting future for the field and the journal lies ahead.

Disclosures

Dr Davis reports personal fees from Medtronic and Boehringer Ingelheim outside the submitted work. Dr Hacke reports grants and personal fees from Boehringer Ingelheim and personal fees from Cerenovus outside the submitted work. Dr Lees reports personal fees from Parexel, Boehringer Ingelheim, American Heart Association, and ONO Pharma outside the submitted work. The other authors report no conflicts.

Footnotes

Presented in part at the International Stroke Conference, Los Angeles, CA, February 19–21, 2020.

Correspondence to Stephen M. Davis, MD, FRACP, Melbourne Brain Centre, The Royal Melbourne Hospital, Parkville, Australia. Email stephen.davis@mh.org.au

The WSO vision is 'a life free of stroke' Stephen Davis

What a joke of a vision. You are letting 10 million yearly stroke survivors  from the past suffer the effects of a stroke because you won't even attempt to solve any of these problems in stroke. I don't fucking care that they are BHAGs(Big Hairy Audacious Goals)

The WSO vision is 'a life free of stroke' Stephen Davis  Maybe, just maybe comeuppance will occur for him.

Key New Zealand health target must change, says professor

Wrong, wrong, wrong. This doesn't indicate needing better prevention. It indicates the need to solve all these fucking problems in stroke. I don't care how difficult they are, doing the prevention route is complete fucking laziness and you should be fired for that.
http://www.nzdoctor.co.nz/un-doctored/2016/july-2016/26/Key-New-Zealand-health-target-must-change,-says-professor-.aspx
Media release from Auckland University of Technology
One of New Zealand’s top six priority health targets needs revision, according to the lead author of a study published in Nature Reviews Neurology.
The Ministry of Health is targeting 90 per cent screening for cardiovascular risk, which shares risk factors with other major non-communicable diseases (NCDs) such as stroke, diabetes and dementia. However, the research paper shows that the burden of stroke and other NCDs is increasing rapidly both in New Zealand and internationally, and the high-risk prevention approach being taken globally is inadequate.
“The evidence is clear. Simply screening for high levels of cardiovascular risk, even with some counselling, is not effective in reducing incidence or mortality from cardiovascular disease,” says Valery Feigin, lead author and Professor of Neurology and Epidemiology at Auckland University of Technology (AUT).
He points to findings from the study, which analysed the most recent literature on stroke epidemiology. “There is evidence from 240,000 participants in randomised clinical trials that screening for cardiovascular risk had no effect on health outcomes ten years on. The health target should be a reduction in cardiovascular risk,” he says.
Although global stroke incidence and mortality declined from 1990 to 2013, the absolute numbers of people affected by stroke is rising rapidly throughout the world. This increasing burden of stroke, including the lifelong disability many stroke survivors suffer, indicates deficiencies in current stroke prevention strategies. These deficiencies are further highlighted by significant gender and ethnic disparities, and a trend towards more strokes in younger people.
According to Professor Feigin, current screening measures give false reassurance to people classified as low to moderate risk – the group in which approximately 80 per cent of all strokes occur. Some of these individuals have isolated hypertension and many have other risk factors. With the exception of smoking however, behavioural risk factors such as poor diet, sedentary lifestyle and excessive alcohol intake are not usually included in the cardiovascular risk algorithms that are currently used. This is despite the fact that nearly three quarters of the global burden of stroke is linked to lifestyle choices.
“Stroke is largely a lifestyle disease. With better strategies in place, we could prevent three quarters of all strokes and heart attacks, and extend our stroke, heart attack, dementia and diabetes-free lives by 20-30 years,” he says.
Professor Feigin and his co-authors recommend governments introduce taxation to control nutritional, alcohol and tobacco-related risks – a proven risk mitigation method that would generate funding for population wide prevention initiatives and abolition of the emphasis on high risk individuals.
“Over the last 30 years, New Zealand has experienced a three-fold increase in the number of people affected by stroke and living with stroke consequences, and most have very limited access to rehabilitation services. Developing resources at the same pace as stroke survivors is not feasible. The only solution is primary prevention,” says Professor Feigin.
The President of the World Stroke Organization, Professor Stephen Davis, has welcomed the insights provided by the study. (And you Professor Stephen Davis are a major part of the problem. As WSO head I don't see you doing anything useful for stroke.)
“Given the dramatically increasing global burden of stroke, this call to action in stroke prevention, from Feigin, Norrving and colleagues, is strongly supported by the World Stroke Organization.  They have highlighted the importance of a comprehensive population-based approach to primary stroke prevention, integrated with strategies for other non-communicable diseases with similar risk factors. This should include early life interventions. They have highlighted behavioural, lifestyle and environmental factors and the potential for specific revenue-raising to support these initiatives. They have also indicated the potential of using electronic information technology such as smartphone apps,” he says.
“These strategies could potentially save millions of lives and have a huge impact on the burden of disability after stroke,” says Professor Davis.

Mirror therapy for severe hemiparesis in the acute phase of stroke recovery: A pilot study utilizing a brief interventional protocol

When the fuck are our stroke medical professionals going to take charge and create a publicly written protocol for mirror therapy? This has been circulating for years. Who the hell is going to step up to the plate and write one?
Matt Lopez, president of the NSA?
Dr. Mariel Jessup, president of the ASA?
WSO President - Steve Davis (Australia)?
http://gradworks.umi.com/15/94/1594781.html

by Soles, Will, M.S., STATE UNIVERSITY OF NEW YORK AT BUFFALO, 2015, 76 pages; 1594781

Abstract:
The debilitating effects of strokes continue to be a public health concern. Hemiparesis of the upper extremity (UE) associated with this condition is a disabling long-term result that continues to be a rehabilitation focus for occupational therapy (OT) practitioners. Mirror therapy (MT) is an emerging method used by therapists to address UE hemiparesis. Despite its expanded use, much is still not known about MT, including when in the rehabilitation process it is best to use and what methods will result in a beneficial outcome. This pilot study investigated the effect of a brief (2 week in duration) MT protocol for improving severe hemiparesis, as compared to a control protocol of UE bilateral exercise. Recruitment of participants from an acute population of stroke survivors in an inpatient rehabilitation setting (n=3) was not sufficient to complete the planned statistical comparison. However, information about protocol design was gleaned from this study’s results, which could prove valuable for future studies. From this information, an alternative protocol was developed and is provided to advance research into the use of MT as an intervention in acute inpatient stroke rehabilitation. The proposed MT protocol utilizes a task-based approach well suited to the profession of OT.

Adviser	Mary M. Matteliano
School	STATE UNIVERSITY OF NEW YORK AT BUFFALO
Source Type	Thesis
Subjects	Physical therapy; Occupational therapy; Public health
Publication Number	1594781

Access the complete dissertation:

» Find an electronic copy at your library.

Use the link below to access a full citation record of this graduate work:
http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:1594781
If your library subscribes to the ProQuest Dissertations & Theses (PQDT) database, you may be entitled to a free electronic version of this graduate work. If not, you will have the option to purchase one, and access a 24 page preview for free (if available).

Deciding Factors: Answering the Questions of When, How, and Why When Individualizing Multiple Sclerosis Treatment

I'm sure the hundreds of employees of NSA,ASA, and WSO could put something like this CME together for stroke protocols in no time if their management would direct them. Although YOU probably have to call those presidents directly since I haven't seen any survivor useful initiatives come from any of the stroke associations. The standard reply is: 'All strokes are different, all stroke recoveries are different.' This stroke CME would fit right in with that fuckingly stupid statement.
Matt Lopez, president of the NSA
Dr. Mariel Jessup, president of the ASA
WSO President - Steve Davis (Australia)
Deciding Factors: Answering the Questions of When, How, and Why When Individualizing Multiple Sclerosis Treatment 

Research in mice shows potential value of antidepressant in some stroke victims

Well shit, this has been known since January, 2013, wrong, since 2011.
Antidepressants may help people recover from stroke even if they are not depressed
What the fuck is it going to take to create a stroke protocol on this and help survivors?.
Our stroke associations have obviously done absolutely nothing.
You as a stroke survivor are fucking screwed since  no one is willing to do anything useful for survivors. You may as well  contact each stroke association president and ream them out for their absolute incompetence. Maybe comeuppance will occur to those presidents. We can only hope.
If your hospital doesn't do something about this in the next month you need to call the board of directors and have them fire the president and stroke department head. This needs to be a fireable offense.
Matt Lopez, president of the NSA?
Dr. Mariel Jessup, president of the ASA?
WSO President - Steve Davis (Australia)?  

 http://medicalxpress.com/news/2015-08-mice-potential-antidepressant-victims.html
Working with mice, researchers at Johns Hopkins have added to evidence that a commonly prescribed antidepressant called fluoxetine helps stroke victims improve movement and coordination, and possibly why.Specifically, the researchers say, their experiments suggest the drug, often sold under the trade name Prozac, prolongs the time after a stroke during which physical therapy remains effective for recovering lost motor function.

The study, which may help explain the benefit of selective serotonin reuptake inhibitors already seen in stroke patients, holds potentially great value for those too ill immediately after an ischemic stroke to start the intensive rehabilitation therapy needed to recover lost motor functions. Ischemic strokes are marked by the sudden loss of blood circulation to the brain caused by a clot.
"For rehabilitation to be effective, it needs to start as soon after a stroke as possible," says Steven Zeiler, M.D., Ph.D., assistant professor of neurology at the Johns Hopkins University School of Medicine and lead author of the study reported in the October issue of the journal Stroke. "But with this study, we've shown that in mice, we can extend the time period during which rehabilitative intervention has an effect on meaningful recovery."
An estimated 65 percent of stroke survivors experience some weakness or paralysis of their limbs, and difficulty in walking and moving due to the death of brain cells from lack of blood flow. Rehabilitation involves retraining other parts of the brain to take over and restore lost functions. Zeiler worked with John Krakauer, M.D., who directs the Brain, Learning, Animation and Movement Lab, to show that in mice, such behavioral efforts work best when they begin early and at high dosages. Numerous research studies have reached similar conclusions, Zeiler says.
For the current study, his team tested whether mice with induced strokes given fluoxetine would get the same recovery results even when rehab was delayed.
A 2011 study of patients who took fluoxetine after an ischemic stroke—called "Fluoxetine for motor recovery after acute ischemic stroke," or FLAME—suggested that the strategy could work. "We took the results of the success found in the FLAME study and reverse-engineered it to look at what fluoxetine may be doing," says Zeiler. "Nobody knows how fluoxetine worked in those patients' stroke recovery—only that it did and it does."
The mouse model the researchers used involved training mice to do a task they don't normally do: reach through a slit to grab a food pellet. "As primates, we make this motion all the time," says Zeiler, "but quadrupeds, like cats, dogs and mice, aren't so good at it." Once the trained mice became good at it, the researchers induced a stroke in the motor area that affected the mice's ability to do that task.
To test whether the mice properly modeled human stroke patients, Zeiler started rehab with some of the mice immediately after the induced stroke. As with human stroke patients, early intervention made a difference: Those mice soon recovered the lost motor function. Mice for which rehab was delayed by a week showed incomplete recovery, gaining back a little less than one-half of their former ability.
"For patients," says Zeiler, "incomplete recovery means weakness or a loss of control in the affected body part or region." For the mice, it meant that they knocked the food pellet from the holder, dropped it or otherwise lost control of it.
When the researchers administered fluoxetine daily to the mice beginning 24 hours after inducing stroke, however, the mice recovered the ability to do the learned task even if they started rehab after a week's delay.
Zeiler emphasizes that the precise cause of fluoxetine's effect on stroke recovery is not yet known, but he says that after looking at brain tissue from his study's mice, he thinks the drug changed the way their brains responded to retraining. "We believe the drug is changing plasticity," says Zeiler, "changing the way individual neurons are responding to sensory input after the stroke."
"There are some who believe fluoxetine can reduce the amount of brain tissue that dies after a stroke," says Zeiler, but his team's findings do not bear that out. "In fact," Zeiler says, "there was more—not less—brain tissue death in the animals that got fluoxetine than in those that did not. We didn't predict that, but the fact that the animals actually got better—despite increased cell death—tells us that fluoxetine is having some pretty amazing effects."
"Time still matters; it's key," cautions Zeiler. The mice that fully recovered motor function were started on fluoxetine immediately after the induced stroke; if fluoxetine administration was delayed by one week after stroke, instead of 24 hours, the mice did not fully recover.
Like all drugs, Zeiler notes, fluoxetine can have negative side effects. Still, Zeiler says, stroke doctors at Johns Hopkins recommend it for stroke patients, especially those who suffer motor loss. "But it's not something that a patient would be prescribed forever," he adds.

So much that can be done and no one doing anything to help survivors

If anyone is working to actually solve problems that survivors have it is totally invisible.
So much to do and so many possibilities yet everyone is WAITING FOR SOMEONE ELSE TO SOLVE THE PROBLEM!

This lack of initiative is causing 10 million survivors a year to be badly served.
And I see nothing from the following:
Matt Lopez, president of the NSA?
Dr. Mariel Jessup, president of the ASA?
WSO President - Steve Davis (Australia)?  
 

Clinical neurorestorative progress in amyotrophic lateral sclerosis

Where the fucking hell is the similar article for stroke? My God, I assume that our stroke associations employ at least a few doctors or researchers that are up to date on the latest in stroke research. But maybe that is too much to ask for from our fucking failures of stroke associations.

Your response:

Matt Lopez, president of the NSA?
Dr. Mariel Jessup, president of the ASA?
WSO President - Steve Davis (Australia)?

Clinical neurorestorative progress in amyotrophic lateral sclerosis

BHAG - Big Hairy Audacious Goal

What is a BHAG?

BHAG (pronounced 'bee-hag') stands for 'Big Hairy Audacious Goal' first written about by James Collins and Jerry Porras in their great book 'Built to Last'.
It is a goal that really stretches the organisation way beyond most people's imagination of what is possible. A very good example would be the 'Moon' mission. It should be clear and compelling and act as a great focal point for everyone in the organisation. It should engage people and stimilate them.
It is a powerful mechanism to stimulate progress, but it does carry great risks.
In some ways it is similar to a vision statement.
The following examples come from the site rapid business intelligence success
Here are some examples:

• the creation of the IBM 360 mainframe computer. IBM nearly ran out of money to pay their staff, but it was breakthrogh that lifted IBM into the next era of computing


• the creation by Boeing in the fifties of their large commerical jet aircraft. Up till that point Boeing had just been a military aircraft manufacturer. It was a bold transformation. Again the sixties the built the biggest jet imaginable - the Jumbo jet.


• in the eighties Jack Welch the CEO of General Electric set his company a huge goal - 'To become No. 1 or No. 2 in every market we serve and revolutionise this company to have the speed and agility of a small company.' By the late nineties...he had succeeded.


• In 1990 Sam Walton of Wal-Mart set a new goal: to double the number of stores and increase the sales volume per square foot by 60% (specifically $ 125 billion) by the year 2000. At that time the largest retailer in the world had only reached $30 billion.


• In 1934 Walt Disney aimed to do something that had never been done before: to create a full length animated feature film - Snow White. He committed most of the company's resources. People in the industry called it 'Disney's folly', but history proved them wrong. It created a new industry or market. He later went on to produce 'Bambi', and 'Pinocchio' and 'Fantasia'. All were outstanding box office successes.


• Again in the fifties, Walt Disney set another risky goal(one of 'Walts's screwy ideas') to build a radically new kind of amusement park...known as Disneyland. He repeated again with the EPCOT center in the sixties. Walt Disney's maxim was 'DREAM, BELIEVE, DARE, DO'


It is important to note that from the outside of these companies, these BHAG goals seemed impossible, wild and unachievable, but within these companies they had the confidence in their resouces, know-how, and capability to achieve them, even though they were going to be stretched to the limit.
A BHAG certainly act as a stimulus and unifying force or goal for the people within the organisation.

For stroke the BHAG is 100% recovery for all stroke patients that survive.
There is absolutely no reason this can't be achieved with all the initial research already out there that just needs to be proven in humans and translated into stroke protocols. All you have to do is read my 8000 posts, everything is there, our stroke medical professionals are willfully being blind to the possibilities.
If Matt Lopez, president of the NSA doesn't have this as a goal the board of directors needs to be fired.
If Dr. Mariel Jessup, president of the ASA doesn't have this as a goal the board of directors needs to be fired.
If WSO President - Steve Davis (Australia) doesn't have this as a goal the board of directors needs to be fired.
Once again I am not following 'How to win friends and influence people' by Dale Carnegie.  I don't care, I'm supposedly a psychopath and follow my own drummer.

Bill Gates once said, "Your most unhappy customers are your greatest source of learning."

 Matt Lopez, president of the NSA
 Dr. Mariel Jessup, president of the ASA
WSO President - Steve Davis (Australia)
Have any of you ever talked to any survivors at all about your services to survivors?
I'm incredibly f*cking unhappy about what should be services to survivors from your organizations. 

Mr. Lopez, Dr. Stephen Davis, Dr. Mariel Jessup "What evidence would you need to see to change your mind about how to solve the stroke problem?"

Stroke survivors are not getting anywhere with help for us, so we need to change the conversation from F.A.S.T. and prevention to something more useful.
A great description from Seth Godin;

Seth's Blog : How to win an argument with a scientist

The person you're arguing with now (who might be a scientist during the day, even, but is merely being a person right now) is not going to be swayed from a firmly held opinion by your work to make better science. It's more likely that it will take cultural pressure, shame, passion, humor, connection and a host of unreliable levers to make your point.

Does this place exist to maintain and perpetuate the status quo, or am I here to do the work that the radical founder had in mind when we started?

When the founders of our stroke associations started did they think that the production of press releases was going to become the highest calling? Do YOU want to change that?
Call Matt Lopez, president of the NSA
Call Dr. Mariel Jessup, president of the ASA
Call these WSO Executive Committee Members
President - Steve Davis (Australia)
Vice-President - Michael Brainin (Austria)
Vice-President - Natan Bornstein (Israel)
Immediate Past-president - Bo Norrving (Sweden)
Treasurer - Bernard Yan (Australia)
Co-Treasurer - Marc Fisher (USA)
Secretary - Ka Sing Lawrence Wong (Hong Kong S.A.R.)
Member at large - Erin Lalor (Australia)
Member at large - Sheila Martins (Brazil)
Member at large - Shinichiro Uchiyama (Japan)
Ex Officio Member - Warner Hacke, Chairman of the Congress Oversight Committee
Ex Officio Member - Geoffrey Donnan, Editor of IJS
Ex OOfficio Member - Marc Fisher, Co-Treasurer for the US Accounts

WSO Executive Committee Members

President - Steve Davis (Australia)

Vice-President - Michael Brainin (Austria)

Vice-President - Natan Bornstein (Israel)

Immediate Past-president - Bo Norrving (Sweden)

Treasurer - Bernard Yan (Australia)

Co-Treasurer - Marc Fisher (USA)

Secretary - Ka Sing Lawrence Wong (Hong Kong S.A.R.)

Member at large - Erin Lalor (Australia)

Member at large - Sheila Martins (Brazil)

Member at large - Shinichiro Uchiyama (Japan)

Ex Officio Member - Warner Hacke, Chairman of the Congress Oversight Committee

Ex Officio Member - Geoffrey Donnan, Editor of IJS

Ex OOfficio Member - Marc Fisher, Co-Treasurer for the US Accounts

- See more at: http://www.world-stroke.org/about-wso/wso-board#sthash.NF2lX7KI.dpuf

A disease appears uncurable, so we don't talk about it. It's easier to talk about the little stuff.

A quote from Seth Godin. This is so appallingly true in strokes' case. We never talk about all the problems in stroke. We gladly put out press releases and talk about minor research findings that suggest this intervention or this food might reduce the risk of stroke. Or we promote telemedicine because that allows a few more people to get tPA, even though tPA when looked at objectively is a failure most of the time.

I expect leaders to tackle the toughest problems and we seem to have NO leaders in stroke at all.

The denials all sound the same. They don’t come from stupidity, from people who aren’t smart enough to understand what’s going on. They come from people who won’t look.

As far as I am concerned these people are not leaders:
NSA President - Mr. Lopez
AHA President - Dr. Arnett
WSO President - Dr. Davis   
Someone should be able to prove me wrong with examples of how they are tackling the problems in stroke. Not press releases, actual work to solve these problems by following a strategy. Someday, one of these persons will call me up and invite me to talk to them. 

Ruckusmaker day

Steve Jobs' 60th birthday. So make a ruckus because unless we do, nothing is going to change in the stroke world. There are 10 million survivors a year, We could be deafening enough that even doctors listen to us.
1. Call your stroke hospital president and ask when the hell they will start providing detailed statistics of how good their stroke department is; 30 day deaths, 100% recovery, tPA efficacy, number of updated stroke protocols with efficacy ratings. Who will be fired if those goals are not achieved?
2. Call/email the presidents of the ASA, NSA, WSO.
Do you want to be known as the stroke leaders that did nothing but twiddle your thumbs?
NSA President - Mr. Lopez
AHA President - Dr. Arnett
WSO President - Dr. Davis 
Ask them point blank when they are going to define a strategy with dates to solve the problems in stroke.
And whom is assigned the goal of solving those problems? Specifics only, NO bland appeasement statements allowed.  

Ruckusmaker day by Seth Godin

 

Changing the Trajectory of Alzheimer's Disease

At least the Alzheimers Association has some intelligent people that can put together a report like this. We in stroke however have absolutely nothing like this, which seems odd that with three major stroke organizations, ASA, NSA, WSO; not one has anyone intelligent enough to produce such a report. I'm sure we could prove that stroke will affect more people and have a greater financial impact. But we have NO leaders that are even willing to try to tackle all the problems in stroke.

Do you want to be known as the stroke leaders that did nothing but twiddle your thumbs?

NSA President - Mr. Lopez

AHA President - Dr. Arnett

WSO President - Dr. Davis

Changing the Trajectory of Alzheimer's Disease

Changing the Trajectory of Alzheimer's Disease: How a Treatment by 2025 Saves Lives and Dollars presents information about the current trajectory and economic impact of Alzheimer's disease, and describes an alternate trajectory if, in 2025, a treatment became available to delay the onset of Alzheimer's. > Summary > Quick Facts > Appendices

Summary

Changing the Trajectory of Alzheimer's Disease: How a Treatment by 2025 Saves Lives and Dollars calculates that a treatment introduced in 2025 that delays the onset of Alzheimer's by five years would reduce the number of individuals affected by the disease by 5.7 million by mid-century and save all payers, including Medicare, Medicaid and families, more than $220 billion within the first five years.
The report reinforces the value of reaching the 2025 goal set by the National Plan to Address Alzheimer's Disease under the National Alzheimer's Project Act (NAPA). If the federal government were to invest $2 billion per year as recommended by the scientific community, then it would recoup its investment within the first three years after a treatment became available.
A treatment introduced in 2025 that delays the onset of Alzheimer's would cut the number of people in 2050 who have the disease by 42 percent — from 13.5 million to 7.8 million. The Alzheimer's Association's report also shows the positive impact of adequate funding and the potential consequences of under-funding.

• In 2015, the costs to all payers for the care of people living with Alzheimer's disease and other dementias will total an estimated $226 billion, with Medicare and Medicaid paying 68 percent of the costs. Without a treatment costs are projected to increase to more than $1.1 trillion in 2050.
• Reaching the 2025 goal would save payers $220 billion over the first five years and $367 billion in 2050 alone. Savings to Medicare and Medicaid would account for nearly 60 percent of the savings.
• People living with Alzheimer's and other dementias and their families would save $54 billion over the first five years in their out-of-pocket costs if the 2025 goal is met.

Musical Training May Bolster Brain Plasticity Across A Lifetime

So if we had a decent stroke association we could ask Dr. Bidelman about musical training  helping survivors recover better or have less damage in the first place. But such a simple research project will not occur under current stroke non-leadership.  Deal with it. All the 10 million stroke survivors each year are depressingly on their own. 
NSA President - Mr. Lopez, tell me exactly where I am wrong.
AHA President - Dr. Arnett, tell me exactly where I am wrong.
WSO President - Dr. Davis, tell me exactly where I am wrong. 
http://medicalresearch.com/author-interviews/muscial-training-may-bolster-brain-plasticity-across-a-lifetime/11254/ 

All generalizations are false, including this one.

Mark Twain.  I do tend to generalize a lot, but for some unknown reason not a single stroke medical person has written to me to complain. I wish they would, it would make for an interesting discussion as to why their profession has such a horrible record on getting survivors to recovery.
I'm unrepentant on thinking that my ideas are worth exploring in depth.

ASA - Dr. Mariel Jessup, 

NSA - Mr. Matt Lopez, 

WSO - Dr. Stephen Davis

I challenge you to tell me exactly where I'm wrong, with research backing you up. It will only take you 351 days to read my whole blog. Or you can have your minions read and critique it.

Stem cells for neonatal stroke- the future is here

When is the future for the rest of us survivors?

ASA - Dr. Mariel Jessup,  Whom are you going to assign to this task?

NSA - Mr. Baranski, Whom are you going to assign to this task?

WSO - Dr. Stephen Davis, Whom are you going to assign to this task?

http://journal.frontiersin.org/Journal/10.3389/fncel.2014.00207/full?

Stem Cells

In recent years stem cell therapy has emerged as a potential treatment for neonatal ischemic brain injury. The efficacy of cell- based therapies in restoring damaged brain tissue has been tested in a multitude of models for different CNS diseases. Several different stem and progenitor cell populations have been utilized as cell-based therapy, including neural stem cells, embryonic stem cells, human umbilical cord blood cells (HUBCs), hematopoietic stem and progenitor cells, and mesenchymal stem cells (MSCs). Most stem cell types appear to enhance recovery to some extent (Pimentel-Coelho and Mendez-Otero, 2010). However, because of their low immunogenicity, availability and positive results obtained from preclinical studies, MSCs are a particularly promising candidate to repair the devastating effects that are associated with neonatal stroke. MSCs were first isolated and identified in bone marrow, but can now be isolated from many tissues, including adipose tissue, muscle, skin and extraembryonic tissues like the placenta, umbilical cord and Wharton's jelly. The latter sources are of particular interest for neonates that experience an ischemic event around the time of birth, at which time cells can be harvested and transplanted from an autologous source. MSCs derived from different sources have slightly different characteristics, but as of yet it is unknown whether this influences their therapeutic potential.

Our group and others have shown that administration of MSCs reduces lesion volume, provides positive effects on the white matter and improves motor function (van Velthoven et al., 2012). Numerous studies have been done under the premise that transplanted stem cells contribute to brain repair by directly replacing damaged or lost tissue. While there is evidence that transplanted cells undergo differentiation toward neuronal lineages, improved outcomes have been observed even when survival of transplanted cells is low and engrafted cells are absent. This suggests that rather than replacing damaged cells, transplanted cells may improve outcome via indirect mechanisms. For example, MSCs have been shown to secrete many factors that can influence important processes like apoptosis, neurogenesis, angiogenesis and synaptogenesis.

More pages at link.

What should have been asked in Interview with Dr. Stephan Davis - WSO

An email I sent to

sarah@researchmedia.eu

Every communication with the stroke world should ask what they are doing to solve these problems. If you are going to interview someone like that you could at least ask some decent questions. Which of these 7 major problems in stroke is being worked on and what progress is there? 1. There is no fast, easy and objective way to diagnose a stroke. Maybe when the Qualcomm Tricorder X Prize is available. A number of friends have waited hours in ERs until stroke symptoms have visibly manifested themselves. 2. Only 10% get to almost full recovery. http://www.ninds.nih.gov/disorders/stroke/stroke_rehabilitation.htm 3. 12% tPA efficacy http://wrkf.org/.../more-stroke-patients-now-get-clot-busting-drug 4. Nothing being done to stop the neuronal cascade of death during the first week. http://newswire.rockefeller.edu/2009/01/15/discovery-could-help-scientists-stop-the-death-cascade-after-a-stroke/ 5. No one knows how to cure spasticity. 6. No one knows how to cure fatigue. 7. No one knows how neuroplasticity exactly works to make it repeatable. Every neurologist and stroke doctor should know about all of these and be working to solve them. All the WSO does is issue press releases. I'm just a simple stroke addled 8 year survivor. Cheers, Dean Reinke

Interview - Professor Stephen Davis, President, World Stroke Organization

This was an appalling interview, any survivor could have asked more hard hitting questions. I could have had him blubbering, wondering what hit him.
http://www.research-europe.com/index.php/2013/09/professor-stephen-davis-president-world-stroke-organization/
And you can't comment to tell them how badly they did.