Thursday, February 02, 2023

DeSantis Takes On the Education Establishment, and Builds His Brand

Stephanie Saul, Patricia Mazzei and Trip Gabriel
Wed, February 1, 2023 

Patricia Okker, facing camera, president of New College of Florida in Sarasota, is embraced by a supporter on Tuesday, Jan. 31, 2023.
(Todd Anderson/The New York Times)

Gov. Ron DeSantis of Florida, as he positions himself for a run for president next year, has become an increasingly vocal culture warrior, vowing to take on liberal orthodoxy and its champions, whether they are at Disney, on Martha’s Vineyard or in the state’s public libraries.

But his crusade has perhaps played out most dramatically in classrooms and on university campuses. He has banned instruction about gender identity and sexual orientation in kindergarten through third grade; limited what schools and employers can teach about racism and other aspects of history; and rejected math textbooks en masse for what the state called “indoctrination.” Most recently, he banned the College Board’s Advanced Placement courses in African American studies for high school students.

On Tuesday, DeSantis, a Republican, took his most aggressive swing yet at the education establishment, announcing a proposed overhaul of the state’s higher education system that would eliminate what he called “ideological conformity.” If enacted, courses in Western civilization would be mandated; diversity and equity programs would be eliminated; and the protections of tenure would be reduced.

His plan for the state’s education system is in lockstep with other recent moves — banning abortions after 15 weeks of pregnancy, shipping a planeload of Venezuelan migrants to Martha’s Vineyard in Massachusetts and stripping Disney, a once politically untouchable corporate giant in Florida, of favors it has enjoyed for half a century.

His pugilistic approach was rewarded by voters, who reelected him by a 19 percentage-point margin in November.

Appearing on Tuesday at the State College of Florida, Manatee-Sarasota, one of the state’s 28 publicly funded state and community colleges, DeSantis vowed to turn the page on agendas that he said were “hostile to academic freedom” in Florida’s higher education system. The programs “impose ideological conformity to try to provoke political activism,” DeSantis said. “That’s not what we believe is appropriate for the state of Florida.”

He had already moved to overhaul the leadership of the New College of Florida, a small liberal arts school in Sarasota that has struggled with enrollment but calls itself a place for “freethinkers.” It is regarded as among the most progressive of Florida’s 12 public universities.

DeSantis pointed to low enrollment and test scores at New College as part of the justification for seeking change there.

“If it was a private school, making those choices, that’s fine, I mean, what are you going to do,” he said. “But this is paid for by your tax dollars.”

The college’s board of trustees, with six new conservative members appointed by DeSantis, voted in a raucous meeting Tuesday afternoon to replace the president and agreed to appoint Richard Corcoran, a former state education commissioner, as the interim president beginning in March.

Corcoran will replace Patricia Okker, a longtime English professor and college administrator who was appointed in 2021.

While expressing her love for the college and its students, Okker called the move a hostile takeover. “I do not believe that students are being indoctrinated here at New College,” she said. “They are taught. They read Marx and they argue with Marx. They take world religions. They do not become Buddhists in February and turn into Christians in March.”

DeSantis also announced Tuesday that he had asked the Legislature to immediately free up $15 million to recruit new faculty and provide scholarships for New College.

In all, he requested from the Legislature $100 million a year for state universities.

“We’re putting our money where our mouth is,” he said.

New College is small, with nearly 700 students, but the shake-up reverberated throughout Florida, as did DeSantis’ proposed overhaul.

Andrew Gothard, president of the state’s faculty union, said the governor’s statements on the state’s system of higher education were perhaps his most aggressive yet.

“There’s this idea that Ron DeSantis thinks he and the Legislature have the right to tell Florida students what classes they can take and what degree programs,” said Gothard, who is on leave from his faculty job at Florida Atlantic University. “He says out of one side of his mouth that he believes in freedom and then he passes and proposes legislation and policies that are the exact opposite.”

At the board meeting, students, parents and professors defended the school and criticized the board members for acting unilaterally without their input.

Betsy Braden, who identified herself as the parent of a transgender student, said her daughter had thrived at the school.

“It seems many of the students that come here have determined that they don’t necessarily fit into other schools,” Braden said. “They embrace their differences and exhibit incredible bravery in staking a path forward. They thrive, they blossom, they go out into the world for the betterment of society. This is well documented. Why would you take this away from us?”

Corcoran, a DeSantis ally, had been mentioned as a possible president of Florida State University, but his candidacy was dropped following questions about whether he had a conflict of interest or the appropriate academic background.

A letter from Carlos Trujillo, the president of Continental Strategy, a consulting firm where Corcoran is a partner, said the firm hoped that his title at New College would become permanent.

Not since George W. Bush ran in 2000 to be “the education president” has a Republican seeking the Oval Office made school reform a central agenda item. That may have been because, for years, Democrats had a double-digit advantage in polling on education.

But since the pandemic started in 2020, when many Democratic-led states kept schools closed longer than Republican states did, often under pressure from teachers unions, some polling has suggested that education now plays better for Republicans. And Glenn Youngkin’s 2021 victory in the Virginia governor’s race, after a campaign focused on “parents’ rights” in public schools, was seen as a signal of the political potency of education with voters.

DeSantis’ attack on diversity, equity and inclusion programs coincides with the recent criticisms of such programs by conservative organizations and think tanks.

Examples of such initiatives include campus sessions on “microaggressions” — subtle slights usually based on race or gender — as well as requirements that candidates for faculty jobs submit statements describing their commitment to diversity.

“That’s basically like making people take a political oath,” DeSantis said Tuesday. He also attacked the programs for placing a “drain on resources and contributing to higher costs.”

Supporters of diversity, equity and inclusion programs and diverse curricula say they help students understand the broader world as well as their own biases and beliefs, improving their ability to engage in personal relationships as well as in the workplace.

DeSantis’ embrace of civics education, as well as the establishment of special civics programs at several of the state’s 12 public universities, dovetails with the growth of similar programs around the country, some partially funded by conservative donors.

The programs emphasize the study of Western civilization and economics, as well as the thinking of Western philosophers, frequently focusing on the Greeks and Romans. Critics of the programs say they sometimes gloss over the pitfalls of Western thinking and ignore the philosophies of non-Western civilizations.

“The core curriculum must be grounded in actual history, the actual philosophy that has shaped Western civilization,” DeSantis said. “We don’t want students to go through, at taxpayer expense, and graduate with a degree in zombie studies.”

The shake-up of New College, which also included the election of a new board chair, may be ongoing and dramatic, given the six new board members appointed by DeSantis.

They include Christopher Rufo, a senior fellow at Manhattan Institute who is known for his vigorous attacks on “critical race theory,” an academic concept that historical patterns of racism are ingrained in law and other modern institutions.

At the time of his appointment, Rufo, who lives and works in Washington state, tweeted that he was “recapturing” higher education.

Another new board member is Eddie Speir, who runs a Christian private school in Florida. He had recommended in a Substack posting before the meeting that the contracts of all the school’s faculty and staff be canceled.

The other new appointees include Matthew Spalding, dean of the Washington, D.C., campus of Hillsdale College, a private college in Michigan known for its conservative and Christian orientations. An aide to the governor has said that Hillsdale, which says it offers a classical education, is widely regarded as the governor’s model for remaking New College.

In addition to the governor’s six new appointees, the university system’s board of governors recently named a seventh member, Ryan T. Anderson, the head of a conservative think tank, the Ethics and Public Policy Center, which applies the Judeo-Christian tradition to contemporary questions of law, culture and politics. His selection was viewed as giving DeSantis a majority vote on the 13-member board.

© 2023 The New York Times Company
ECOCIDE
Brazil Wants to Abandon a 34,000-Ton Ship at Sea. It Would be an Environmental Disaster

Ciara Nugent
Tue, January 31, 2023 

Brazilian aircraft carrier Sao Paulo (A12) seen in Rio de Janeiro on Aug. 11, 2016. 
Credit - Benoit Tessier—Reuters

Somewhere in the South Atlantic ocean right now, a 34,000-ton, 870-ft. aircraft carrier is floating aimlessly on the waves. The vessel, caught in an international dispute over its toxic contents, is about to become one of the biggest pieces of trash in the ocean.

The São Paulo, the only aircraft carrier in the Brazilian navy’s fleet, has been stuck in limbo for five months. Brazil sold the 60-year-old vessel for scrap to a Turkish shipyard in 2021, and in August 2022, it set off for Turkey from a naval base in Rio de Janeiro. But while it was on the move, Turkey rescinded its permission to enter, saying Brazil hadn’t been able to prove that the São Paulo was free of asbestos—a toxic mineral used in the construction of many 20th century ships. So, the boat turned around.

Brazil doesn’t want it back, though. In September, a port on the coast of Pernambuco state blocked the ship from docking. The port argued there was too big a risk that the ship would be abandoned, leaving port authorities to pick up the tab for moving it and dealing with the asbestos. That left the São Paulo circling off the Brazilian coast, until Jan. 20, when Brazil’s navy announced that it had pushed the ship out to international waters, where it remains. The navy says it had to do so because the aging ship, which incurred damage to its hull during its odyssey, could have run aground or sank on the Brazilian coast, threatening other boats and coastal wildlife.

The navy’s solution is to abandon the São Paulo at sea. On Saturday, military sources told Brazil’s Folha de São Paulo newspaper that the navy planned to use explosive to sink the vessel on Wednesday, seeing it as the only way to put an end to its controversial saga.

But on Tuesday night, responding to concerns from a federal environmental agency, Brazil’s public prosecutor filed a civil case against the navy, asking a federal court to order an immediate halt to any plans to detonate the ship.

The court’s decision will determine whether or not the São Paulo becomes an extreme case of vessel abandonment—a problem that plagues marine conservationists and coastal communities around the world. Ocean watchdogs say sinking a boat as big and old as the São Paulo would be an environmental disaster; as well as the asbestos, the ship contains hundreds of metric tons of other toxic substances in its electrical wiring, paints, and fuel stores, according to the Basel Action Network (BAN), an NGO.

Abandoning it at sea would constitute “gross negligence” and violate three separate international environmental conventions, says Jim Puckett, BAN’s executive director. “We’re talking about a ship containing both hazardous materials and valuable materials—it’s supposed to be brought into the territory of Brazil and managed in an environmentally sound way,” Puckett says. “You can’t just sink it.”

Approached for comment, the Brazilian navy directed TIME to its official announcements, which say only that the navy will not allow the São Paulo to return to Brazil.


Turkey's various opposition political parties, labour unions, and non-governmental organisations held a mass rally against the dismantle of Brazilian aircraft carrier Nae Sao Paulo in Aliaga district in Izmir, Turkey, on Aug. 4, 2022.Berkcan Zengin—GocherImagery/Reuters

It’s not uncommon for boats to be abandoned. Because they are expensive to maintain and to dispose of properly, tens of thousands of unwanted vessels—normally much smaller than an aircraft carrier—are left in harbors, on beaches, or at sea every year. In Nigeria, thousands of wrecked cargo ships and commercial fishing vessels litter the coast, destroying beach ecosystems and making waterways dangerous to pass for local communities. In Venice, around 2,000 abandoned small recreational boats are clogging up a local wetland. In the U.S., the Government Accountability Office estimates that from 2013 to 2016, there were 5,600 boats abandoned in U.S. waters—likely a very lowball estimate, according to Nancy Wallace, director of the National Oceanic and Atmospheric Administration’s marine debris program.

The problem is, what’s left onboard those boats doesn’t stay onboard. “Anytime there’s a vessel that’s left at sea, the first thing to think about is toxic chemicals, which can be very impactful to wildlife,” Wallace says. Abandoned boats of any size can cause oil spills and leach paint chemicals and microplastics into the water, while debris such as nets can come loose, trapping fish.

Older vessels can also contain so-called PCBs, a group of highly carcinogenic chemicals that were often used in electrical wiring before the 1970s and were globally banned under the 2001 Stockholm convention. When dumped in the ocean, scientists say PCBs work their way up the marine food chain, affecting everything from small crustaceans to orcas. BAN estimates that the São Paulo, which was built in France in the 1960s, contains around 300 metric tons of PCBs, based on analysis of its sister ship, the Clemencau. The NGO says leaving the vessel at sea would violate both the Stockholm convention and the 1996 London Protocol.

In Brazil, the face of the ship abandonment problem is Guanabara Bay in Rio de Janeiro state, where some 200 vessels, including cargo ships and oil tankers, have been left to rot by owners caught up in financial or legal troubles. Local NGOs say the resulting oil and chemical pollution has dramatically reduced native mangrove, tortoise, and dolphin populations, and has hurt the livelihoods of local fishermen. The bay made national headlines in November, when a storm caused a 660-ft. cargo ship to come loose from its moorings and crash into the Rio-Niteroi—Latin America’s longest over-water bridge.

Remains of abandoned ships are seen on the shores of the Guanabara Bay in Niteroi, Brazil, on Dec. 28, 2022.Pilar Olivares—Reuters

Removing such vessels is a major headache for governments. Hauling them out can cost anywhere from $8,000 (the per-boat cost for 14 recreational boats recently lifted out of the water in South Carolina) to $1.8 million (the cost for removing an 83-ft. fishing boat in Saipan in 2021, which had been degrading a nearby coral reef in the Northern Mariana Islands for six years after a 2015 storm left it too damaged for its owners to repair.)

But, thankfully, it is highly unusual for a ship as large as the São Paulo to be deliberately abandoned. That’s because large boats like cruise ships, container ships, and aircraft carriers contain vast amounts of high-quality valuable metals, especially steel, which can be salvaged and resold. (Recycling is also beneficial for the environment, since manufacturing new steel is extremely carbon-intensive.)

Puckett, from BAN, says the idea of sinking the São Paulo doesn’t make financial sense for Brazil. “It’s got millions of dollars worth of steel to be recycled, which far outweighs the cost of managing those hazardous materials,” he says. “I’ve never seen such a valuable ship being deliberately sunk.”

BAN is calling on Brazil’s new leftist President Luiz Inácio Lula da Silva to step in. To comply with international treaties, including the Basel Convention restricting the export of toxic waste, Puckett says the navy must tow the São Paulo into a naval base, repair the damage to the hull, and then offer the recycling contract to new shipyards in Europe, which can safely remove the asbestos before dismantling the ship.

The case brought by Brazil’s public prosecutor’s office opens a last minute door to that happening. It asks the court to compel the navy to carry out a technical assessment of all the options for disposing of the ship, and find a way of doing so “”without risk to the environment and public health.” That might just save the São Paulo from a toxic watery grave.
Israel jail crackdown sets up showdown with Palestinian prisoners
BEN-GVIR WILL DECLARE THEM ALL TERRORISTS 
AND EXECUTE THEM

Protest in solidarity with Palestinian prisoners held in Israel jails, at Erez crossing in the northern Gaza Strip

Thu, February 2, 2023 
By Ali Sawafta and Nidal al-Mughrabi

RAMALLAH, West Bank/GAZA (Reuters) - Soon after sirens sounded in Israel as rockets were fired from Gaza on Wednesday, hardline Security Minister Itamar Ben-Gvir said he would press on with a crackdown on Palestinian prisoners that could further inflame tensions despite U.S. calls for calm.

Ben-Gvir this week ordered a halt to Palestinian security prisoners working in bread bakeries in two Israeli jails, saying he was cancelling "benefits and indulgences". He added: "The death penalty should be enacted for terrorists but until then, they should be treated as terrorists."

On Thursday, a state of heightened alert with reinforced staffing levels was imposed, a spokesperson for the prison service said. She said authorities had received intelligence that prisoners were planning to harm prison staff.

The looming showdown between the prisoners and Ben-Gvir comes days after U.S. Secretary of State Antony Blinken called on both sides to do everything to lower tensions following weeks of violence in Jerusalem and the Israeli-occupied West Bank, as well as exchanges of cross-border fire with Gaza.

As a relatively unified group that largely transcends the factional divisions among Palestinian political and militant movements, the prisoners wield significant influence and Ben-Gvir's decision to take them on risks wider confrontation.

"He thinks that the prisoners issue is the easiest issue to show he is a serious leader," said Kadora Fares, head of the Palestinian Prisoners Society.

"He thinks that because 4,000 prisoners are in their jails he can do what he wants, but he will be choked because they affect the situation outside the jails."

Unless the standoff is resolved, he said, Palestinian prisoners will hold a mass hunger strike from March 22, at the start of the Muslim holy month of Ramadan, traditionally a time of heightened tensions.

Added to stricter measures imposed in a number of jails and reports of clashes after guards confiscated electronic devices belonging to some women prisoners this week, Ben-Gvir's tough approach sets up a confrontation with a group that enjoys strong popular support among Palestinians.

BOILING POINT


Israel holds about 4,700 political prisoners, around 30 of them women, according to the Palestinian Addameer organisation that supports prisoner rights. The number includes convicted inmates as well as so-called administrative detainees, held without charge or trial.

One inmate reached by telephone, who did not want to be named for fear of reprisal by authorities in the prison where he is serving an extended sentence, said the situation in the jails had reached "boiling point", with male prisoners closely following what had happened to their female counterparts.

Hanan Al-Khatib, a lawyer for the Palestinian Agency for Prisoners and Ex-prisoners, said prison guards had conducted "provocative searches" in the rooms of three women inmates on Monday leading to protests in which two rooms were set on fire.

She said the measures against female prisoners led to "rebellion in all jails and the tension is escalating".

A spokesperson for Israel's prison service said two women had been put in solitary confinement after prisoners cheered the news that a lone Palestinian gunman had shot seven people near a synagogue on the outskirts of Jerusalem on Jan. 27.

"There were no clashes or use of tear gas or whatever they described there, there wasn't," said spokesperson Hana Herbst. "In solitary you don't have access to electronics, maybe that's what they were talking about."

Israeli prison authorities have allowed some leeway to political prisoners in exchange for cooperation in turning out for roll calls, cleaning their own corridors and vacating cells when guards come for checks. If inmates stopped doing these things in protest, running prisons smoothly would get harder.

But Ben-Gvir has made clear that he has little interest in such arrangements, opening the way for a confrontation, Palestinian groups warn, stoking an already tense situation close to eruption after months of raids in the West Bank.

"We are heading towards an intifada (uprising) unless mediators intervene and end the criminal policies of Ben-Gvir that are driving the region to an explosion," Hamas official Mushir Al-Masri told a Gaza rally in support of women prisoners.

(Additional reporting by Emily Rose in Jerusalem; writing by James Mackenzie; editing by Mark Heinrich)
House GOP votes to oust Democrat Omar from major committee
RACIST ISLAMOPHOBIC MISOGYNISTS HIDING BEHIND FAKE ANTI-SEMITISM OUTRAGE

Rep. Ilhan Omar, D-Minn., speaks during a news conference on Capitol Hill in Washington, Jan. 25, 2023, in Washington. House Republicans are preparing to oust Omar from the House Foreign Affairs Committee. (AP Photo/Manuel Balce Ceneta, File) 


KEVIN FREKING and LISA MASCARO
Wed, February 1, 2023 

WASHINGTON (AP) — The Republican-led House voted after raucous debate Thursday to oust Democrat Ilhan Omar from the chamber's Foreign Affairs Committee, citing her anti-Israel comments, in a dramatic escalation after Democrats last session booted far-right GOP lawmakers over incendiary remarks.

House Speaker Kevin McCarthy was able to solidify Republican support against the Somali-born Muslim woman in the new Congress although some GOP lawmakers had expressed reservations. Removal of lawmakers from House committees was essentially unprecedented until the Democratic ousters two years ago of hard-right Republican Reps. Marjorie Taylor Greene of Georgia and Paul Gosar of Arizona.

The 218-211 vote, along party lines, came after a heated, voices-raised debate in which Democrats accused the GOP of targeting Omar based on her race. Omar defended herself on the House floor, asking if anyone was surprised she was being targeted, “because when you push power, power pushes back." Democratic colleagues hugged and embraced their colleague during the vote.

“My voice will get louder and stronger, and my leadership will be celebrated around the world,” Omar said in a closing speech.

Republicans focused on six statements Omar has made that “under the totality of the circumstances, disqualify her from serving on the Committee of Foreign Affairs,” said Rep. Michael Guest, R-Miss.

“All members, both Republicans and Democrats alike who seek to serve on Foreign Affairs, should be held to the highest standard of conduct due to the international sensitivity and national security concerns under the jurisdiction of this committee,” Guest said.

The resolution proposed by Rep. Max Miller, R-Ohio, a former official in the Trump administration, declared, “Omar’s comments have brought dishonor to the House of Representatives.”

Democratic leader Hakeem Jeffries of New York said Omar has at times “made mistakes" and used antisemitic tropes that were condemned by House Democrats four years ago. But that's not what Thursday's vote was about, he said.

“It's not about accountability, it’s about political revenge," Jeffries said.

Rep. Alexandria Ocasio-Cortez, went took it one step further, saying that the GOP's action was one of the “disgusting legacies after 9/11," a reference to he Sept. 11, 2001, attack — "the targeting and racism against Muslim-Americans throughout the United States of America. And this is an extension of that legacy."

She added, “This is about targeting women of color."

Omar is one of the first two Muslim women elected to Congress. She is also the first to wear a hijab in the House chamber after floor rules were changed to allow members to wear head coverings for religious reasons.

She quickly generated controversy after entering Congress in 2019 with a pair of tweets that suggested lawmakers who supported Israel were motivated by money.

In the first, she criticized the American Israel Public Affairs Committee, or AIPAC. “It’s all about the Benjamins baby,” she wrote, invoking slang about $100 bills.

Asked on Twitter who she though was paying members of Congress to support Israel, Omar responded, “AIPAC!”

The comments sparked a public rebuke from then House Speaker Nancy Pelosi and other Democrats who made clear that Omar had overstepped.

She soon apologized.

“We have to always be willing to step back and think through criticism, just as I expect people to hear me when others attack me about my identity,” Omar tweeted. “This is why I unequivocally apologize.”

Democrats rallied in a fiery defense of Omar and the experiences she brings to the Congress.

Black, Latino and progressive lawmakers in particular spoke of her unique voice in the House and criticized Republicans for what they called a racist attack.

“Racist gaslighting,” said Rep. Cori Bush, D-Mo. A “revenge resolution,” said Rep. Primila Jayapal of Washington, the chair of the progressive caucus.

“It’s so painful to watch,” said Rep. Rashida Tlaib, D-Mich., who joined Congress with Omar in 2019 the first two female Muslims elected to the House.

“To Congresswoman Omar, I am so sorry that our country is failing you today through this chamber,” Tlaib said through tears. “You belong on that committee.”

Omar’s previous comments were among several remarks highlighted in the resolutions seeking her removal from the Foreign Affairs Committee.

The chairman of the committee, Rep. Michael McCaul of Texas, argued for excluding Omar from the panel during a recent closed-door meeting with fellow Republicans.

“It’s just that her worldview of Israel is so diametrically opposed to the committee’s,” McCaul told reporters in describing his stance. “I don’t mind having differences of opinion, but this goes beyond that.”

McCarthy has already blocked Reps. Adam Schiff and Eric Swalwell, both California Democrats, from rejoining the House Intelligence Committee once the GOP took control of the chamber in January. While appointments to the intelligence panel are the prerogative of the speaker, the action on Omar requires a House vote.

Several Republicans skeptical of removing Omar wanted “due process” for lawmakers who face removal. McCarthy said he told them he would work with Democrats on creating a due process system, but acknowledged it’s still a work in progress.

Bone marrow transplant may halt brain blood vessel disease in adults with sickle cell disease

American Stroke Association International Stroke Conference 2023, Abstract 35

Reports and Proceedings

AMERICAN HEART ASSOCIATION

Research Highlights:

  • Among adults with sickle cell disease, bone marrow transplants halted or reversed damage to blood vessels in the brain, according to a new study.
  • Comparing brain images before and after bone marrow transplantation, researchers noted improvements in blood vessels and brain tissue over time.

DALLAS, Feb. 2, 2023 — Bone marrow transplants prevented or improved blood vessel disease in the brains of adults with sickle cell disease, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2023. The meeting, to be held in person in Dallas and virtually Feb. 8-10, 2023, is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

“Sickle cell disease is a group of inherited disorders caused by mutations in hemoglobin and is a major risk factor for stroke in children and adults. It causes abnormally shaped (sickled) red blood cells that interact with the inner lining of blood vessels and can lead to blockages in blood vessels,” said John K. Lynch, D.O., M.P.H., lead author of the study and an associate research physician in the Stroke Branch at the National Institute of Neurological Disorders and Stroke (NINDS), a division of the National Institutes of Health in Bethesda, Maryland.

“The two main brain blood vessel complications of sickle cell disease are vasculopathy – where some vessels may become enlarged like an aneurysm, or some vessels may narrow and block; silent brain injuries can occur throughout the brain as a result of vasculopathy,” Lynch said.

Abnormal narrowing or bulging of blood vessels in the brain may lead to stroke, a major cause of death and disability in children and adults with sickle cell. Bone marrow is found in the center of most bones and contains stem cells that may transform into red blood cells, white blood cells or platelets. Previous research on bone marrow transplantation in children has been shown to be helpful. In this study, researchers explored the impact of bone marrow transplantation on the development and progression of blood vessel irregularities in adults with sickle cell.

“We were surprised that bone marrow transplant reversed some of the changes in brain vessels. We thought that bone marrow transplantation would stop the changes from getting worse, however, we did not think it would reverse the changes,” Lynch said. “The focus of our study was to determine if receiving stem cell transplants may lead to positive changes in blood vessels in the brain among those with sickle cell disease.”

Researchers examined a National Institutes of Health study population of adults with sickle cell disease who had received bone marrow transplants between 2004 and 2019. The patients received pre- and post-op MRI/MRA imaging that was reviewed by two independent imaging professionals and were scored for narrowing vessels in eight arteries of the brain and for any presence of aneurysms. Researchers then compared changes in blood vessels before and after bone marrow transplantation in 87 people (58% men, average age 32 years), during a follow-up period of more than 3 years.

The study found:

  • 28% of the people had evidence of blood vessel issues in the brain – 17% had narrowing vessels and 13% had bulging vessels that were present at the time of their bone marrow transplants.
  • Comparing blood-vessel abnormalities before and after bone marrow transplantation, researchers noted none of the participants without vessel abnormalities developed narrowing or bulging after the transplant.
  • A review of the brain imaging scans indicated that narrowing improved after the bone marrow transplant in 62% of patients with vessel abnormalities.

“Our study is unique in that we examined adults with sickle cell disease for a long period of time, and we were able to compare the differences in blood vessels and brain tissue over time,” Lynch said.

“We suspect that the reduction in the number of sickle cells and the improvement of the cells’ oxygen-carrying capacity led to a reduction in the number of strokes after bone marrow transplantation,” Lynch said.

Limitations of the study were that it did not include a comparison group of patients who did not receive bone-marrow transplants. In addition, some patients were followed for a short time while others were followed for longer periods. “We would need a more uniform follow-up time for all study participants to help us understand if it takes time for the vasculopathy to stop or get better, or if this happens quickly,” Lynch said.

“Our hope is that bone-marrow transplantation may be considered more often for people with sickle cell disease and that other less invasive and potentially life-saving treatments may be developed for people with sickle cell disease.”

Co-authors are Nathan Lightfoot, D.O.; Pranusha Pinna, D.O.; Nathan Bicher, M.D.; Matthew Hsieh, M.D.; Gina Norato, M.D.; and John F. Tisdale, M.D.  Authors’ disclosures are listed in the abstract.

The study was funded by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NINDS) and the National Heart, Lung, and Blood Institute (NHLBI), divisions of the National Institutes of Health.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

Additional Resources:

The American Stroke Association’s International Stroke Conference (ISC) is the world’s premier meeting dedicated to the science and treatment of cerebrovascular disease. ISC 2023 will be held in person in Dallas and virtually, Feb. 8-10, 2023. The three-day conference will feature more than a thousand compelling presentations in categories that emphasize basic, clinical and translational sciences as research evolves toward a better understanding of stroke pathophysiology with the goal of developing more effective therapies. Engage in the International Stroke Conference on social media via #ISC23.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit stroke.org. Follow us on FacebookTwitter.


Novel celery seed-derived medicine given after clot treatment may improve stroke outcomes

American Stroke Association International Stroke Conference 2023, Abstract 90

Reports and Proceedings

AMERICAN HEART ASSOCIATION

Research Highlights:

  • Ninety days after a clot-caused stroke, people who received a celery seed-derived medication in addition to prompt treatment for the clot had less severe neurological symptoms and better functioning in comparison to those who received clot treatment and a placebo medication.
  • The celery seed-derived medication, called butylphthalide, may help protect brain tissue from damage when the supply of oxygenated blood is cut off.
  • Butylphthalide is approved and available for use in China, where the study was conducted; however, it has not been approved for use in the United States.


DALLAS, Feb. 2, 2023 — People who had an ischemic (clot-caused) stroke and were treated with a clot-busting medication and/or mechanical clot removal and also received butylphthalide, a medication initially compounded from celery seed, experienced milder neurological symptoms with better functioning at three months after the stroke, compared to stroke patients who had their clots treated but received a placebo medication, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference  2023. The meeting, to be held in person in Dallas and virtually Feb. 8-10, 2023, is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

In previous studies in China, butylphthalide has shown the potential to safely protect and preserve the brain from possible damage related to stroke in animal models with a clot-caused stroke. The current study evaluated whether treatment with butylphthalide may improve the outcomes of people who initially received the intravenous clot-busting medication tissue plasminogen activator (tPA) and/or a mechanical clot removal procedure to physically remove the clot plus butylphthalide. In China, butylphthalide is licensed for use in treating ischemic stroke; however, it is not currently approved by the U. S. Food and Drug Administration.

“This is the first trial to show the benefit of using a medication that protects the brain from damage caused by a lack of oxygen to brain tissue. The medication was given to patients with acute ischemic stroke who were also receiving treatment to restore blood flow to the brain,” said Baixue Jia, M.D., co-author of the study, an attending physician in interventional neuroradiology in the department of neurology in the Beijing Tiantan Hospital of Capital Medical University and a faculty member at the China National Clinical Research Center for Neurological Diseases, both in Beijing.

The researchers studied 90-day outcomes in 1,216 adults (average age of 66 years; 68% men) after they suffered a stroke that was initially treated with tPA or mechanical clot removal therapy. The participants were treated between 2018 and 2022 at one of 59 medical centers in China. People who had minimal stroke symptoms on their initial exam (defined as 0-3 on the National Institutes of Health Stroke Scale, or NIHSS) or had severe stroke symptoms (defined as >26 on the NIHSS) were excluded from this study.

Along with their physician-chosen initial treatment, participants were randomly selected to receive either butylphthalide or a look-alike placebo administered by daily intravenous injection for the first 14 days, followed by 76 days of oral capsules. The patients were randomly assigned to the butylphthalide treatment group (607 adults) or the placebo group (609 adults). Neither the patients nor the research team knew which participants were assigned to which treatment.

Outcomes were deemed favorable if an individual had the following markers at 90-days post-stroke:

  • an initially mild to moderate stroke (4-7 on the NIHSS) and had no symptoms (0 on the modified Rankin Scale, a scale that measures disability and dependence) after treatment;
  • an initially moderate to serious stroke (8-14 on the NIHSS) and had no residual symptoms or mild symptoms that did not impair their ability to perform routine activities of daily living without assistance (0-1 on the disability scale); or
  • an initially serious to severe stroke (15-25 on the NIHSS) had no remaining symptoms or a slight disability that impaired some activities yet still allowed a person to conduct their own affairs without assistance (0-2 on the disability scale).

The study found:

  • Participants in the butylphthalide group were 70% more likely to have a favorable 90-day outcome compared to the placebo group.
  • Butylphthalide improved function equally well in the subsets of patients who initially received tPA, those who received endovascular therapy or those who received both tPA and endovascular treatment.
  • Secondary events, such as recurrent stroke and intracranial hemorrhage (brain bleeds), were not significantly different between the butylphthalide and placebo groups.

“Patients who received butylphthalide had less severe neurological symptoms and a better living status at 90-days post-stroke compared to those who received the placebo. If the results are confirmed in other trials, this may lead to more options to treat strokes caused by clots,” Jia said.

How butylphthalide works isn’t clear, with animal studies suggesting various possible mechanisms. “The next step should be investigating the exact mechanisms of butylphthalide in humans,” Jia said.

The study is limited by being based on participants who all received initial treatment with clot-busting intravenous medication or a procedure to remove the clot or both, so the results may not be generalizable to stroke patients who received other treatments. Results from this trial conducted in China may not be generalizable to other populations. In addition, butylphthalide is not approved by the FDA for any use in the U.S.

“While these are interesting results, this is only one relatively small study on a fairly select population in China. Butylphthalide, a medication initially compounded from celery seed, is not ready for use in standard stroke treatment; however, these results warrant further study consideration,” said American Stroke Association volunteer expert and EPI and Stroke Council member Daniel T. Lackland, Dr.P.H., FAHA, professor and director, in the Division of Translational Neurosciences and Population Studies and the department of neurology at the Medical University of South Carolina in Charleston, South Carolina. “The medication used in this study is not the same as celery seed or celery seed extract supplements. Stroke survivors should always consult with their neurologist or health care professional regarding diet after a stroke.” Dr. Lackland was not involved in this study.

Co-authors are lead author Anxin Wang, Ph.D.; Xuelei Zhang, M.D.; Yilong Wang Sr., M.D., Ph.D.; and Zhongrong Miao, M.D., Ph.D. Authors’ disclosures are listed in the abstract.

The study was funded by the National Key Technology Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China and Shijiazhuang Pharmaceutical Group dl-3-butylphtahalide Pharmaceutical.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

Additional Resources:

The American Stroke Association’s International Stroke Conference (ISC) is the world’s premier meeting dedicated to the science and treatment of cerebrovascular disease. ISC 2023 will be held in person in Dallas and virtually, Feb. 8-10, 2023. The three-day conference will feature more than a thousand compelling presentations in categories that emphasize basic, clinical and translational sciences as research evolves toward a better understanding of stroke pathophysiology with the goal of developing more effective therapies. Engage in the International Stroke Conference on social media via #ISC23.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit stroke.org. Follow us on FacebookTwitter.


Smartphone app may help identify stroke symptoms as they occur


American Stroke Association International Stroke Conference 2023, Abstract WMP120

Reports and Proceedings

AMERICAN HEART ASSOCIATION

Research Highlights:

  • A new smartphone application called FAST.AI may recognize common stroke symptoms as they are happening.
  • Preliminary research suggests the app might be as accurate at diagnosing stroke as a neurologist.
  • Early recognition of stroke symptoms may result in more timely treatment, which may minimize the long-term effects of a stroke and improve chances for a full recovery.


DALLAS, Feb. 2, 2023 — A new smartphone application called FAST.AI may help people who are having a stroke or their family and caregivers recognize common stroke symptoms in real time, prompting them to quickly call 9-1-1, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2023. The meeting, to be held in person in Dallas and virtually Feb. 8-10, 2023, is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

According to the American Heart Association, stroke is the No. 5 cause of death and a leading cause of disability in the U.S. About 85% of all strokes in the U.S. are ischemic strokes, which are caused by a blood clot in a blood vessel that blocks the flow of blood to the brain.

FAST.AI is a fully automated smartphone application for detection of severe stroke using machine learning algorithms to recognize facial asymmetry (drooping of the muscles in the face), arm weakness and speech changes – all common stroke symptoms. This study is ongoing, and the mobile application is still in development and not available to the public.

The smartphone application uses a facial video of the patient to examine 68 facial landmark points; sensors that measure arm movement and orientation; and voice recordings detect speech changes. Information from each test was sent to a database server for analysis.

Researchers validated FAST.AI’s performance by testing nearly 270 patients with a diagnosis of acute stroke (41% women; average age of 71 years) within 72 hours of hospital admission at four major metropolitan stroke centers in Bulgaria (St. Anna University Hospital in Sofia; University Hospital Haskovo in Haskovo; University Hospital Pulmed in Plovdiv; and University Hospital “Prof. Dr. Stoyan Kirkovich” in Stara Zagora) from July 2021 to July 2022. Neurologists who examined the patients tested the app then compared the FAST.AI results with their clinical impressions.

The analysis found:

  • The smart phone app accurately detected stroke-associated facial asymmetry in nearly 100% of patients.
  • The app accurately detected arm weakness in more than two-thirds of the cases.
  • And while the slurred speech module remains to be fully validated and tested, preliminary analyses confirmed that it may be able to reliably detect slurred speech, according to the researchers.

Clot-busting medication should be administered within three hours (up to four-and-a-half hours in certain eligible patients) after symptoms begin. And the faster the treatment is administered, the more likely for a better recovery: on average, 1.9 million brain cells die every minute that a stroke goes untreated, according to the American Stroke Association, a division of the American Heart Association. Previous research has found that stroke patients who are treated within 90 minutes of their first symptoms were almost three times more likely to recover with little or no disability in comparison to those who received treatment more than 90 minutes after symptoms begin.

“Many stroke patients don’t make it to the hospital in time for clot-busting treatment, which is one reason why it is vital to recognize stroke symptoms and call 9-1-1 right away,” said study author Radoslav I. Raychev, M.D., FAHA, a clinical professor of neurology and a vascular neurologist at the University of California, Los Angeles. “These early results confirm the app reliably identified acute stroke symptoms as accurately as a neurologist, and they will help to improve the app’s accuracy in detecting signs and symptoms of stroke.”

A limitation of the study is that neurologists (not the individuals, family members or caregivers) conducted the screenings and taught patients how to use the application.

American Stroke Association volunteer expert and EPI and Stroke Council member Daniel T. Lackland, Dr.P.H., FAHA, professor and director of the Division of Translational Neurosciences and Population Studies in the department of neurology at the Medical University of South Carolina in Charleston, South Carolina, applauded the research as a promising tool to address a major health challenge – how to prompt individuals with stroke symptoms to seek care in a short window of opportunity.

“This abstract describes a validated approach for an easy assessment of signs of a stroke and the prompt to seek care. The app may help individuals assess the signs of a stroke without the need to recall the warning signs, ” said Lackland, who was not involved in the study.

Co-authors are Jeffrey L. Saver, M.D., FAHA; David S. Liebeskind, M.D., FAHA; Svetlin Penkov, Ph.D.; Daniel Angelov, Ph.D.; Krasimir Stoev; Todor Todorov; Teodora Sakelarova, M.D.; Dobrinka Kalpachka, M.D.; Hristiana Pelyova, M.D.; Rostislava Ruseva, M.D.; Svetlana Velcheva, M.D.; Emanuela Kostadinova, M.D.; Denislav Dimov, M.D.; Kolarova Anna, M.D.; Teodora Manolova, M.D.; Filip Alexiev, M.D., Ph.D.; and Ivan Milanov, M.D., Ph.D.  Authors’ disclosures are listed in the abstract.

The app is owned by Neuronics Medical, of which Raychev is a co-founder. Boehringer Ingelheim funded the study through a research grant with no app ownership. The Bulgarian Society of Neurology helped with study organization. Study senior author, Ivan Milanov is president of the Bulgarian Society of Neurology.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

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IT HAPPENED TO ME

Stroke symptoms, even if they disappear within an hour, need emergency assessment


A new American Heart Association scientific statement discusses rapid evaluation for transient ischemic attack (TIA) due to high risk of future stroke

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

Statement Highlights:

  • Diagnosing a transient ischemic attack (TIA), sometimes called a “warning stroke,” is challenging because symptoms often disappear within an hour.
  • A new American Heart Association scientific statement describes how to assess patients who experience a TIA, with specific guidance for health care professionals in rural areas.
  • Nearly one in five people who have a suspected TIA will have a full-blown stroke within three months, and two in five, given the appropriate scan, will learn they have actually had a stroke instead of a TIA.
  • Comprehensive evaluation of suspected TIA patients with imaging and use of risk assessment scoring may help determine which patients should be hospitalized because they are at the highest risk for a full-blown stroke.

DALLAS, January. 19, 2023 — Stroke symptoms that disappear in under an hour, known as a transient ischemic attack (TIA), need emergency assessment to help prevent a full-blown stroke, according to a new American Heart Association scientific statement published today in the Association’s journal Stroke. The statement offers a standardized approach to evaluating people with suspected TIA, with guidance specifically for hospitals in rural areas that may not have access to advanced imaging or an on-site neurologist.

TIA is a temporary blockage of blood flow to the brain. Each year, about 240,000 people in the U.S. experience a TIA, although this estimate may represent underreporting of TIA because symptoms tend to go away within an hour. While the TIA itself doesn’t cause permanent damage, nearly 1 in 5 of those who have a TIA will have a full-blown stroke within three months after the TIA, almost half of which will happen within two days. For this reason, a TIA is more accurately described as a warning stroke rather than a “mini-stroke,” as it’s often called.

TIA symptoms are the same as stroke symptoms, only temporary. They begin suddenly and may have any or all of these characteristics:

  • Symptoms begin strong then fade;
  • Symptoms typically last less than an hour;
  • Facial droop;
  • Weakness on one side of the body;
  • Numbness on one side of the body;
  • Trouble finding the right words/slurred speech; or
  • Dizziness, vision loss or trouble walking.

The F.A.S.T. acronym for stroke symptoms can be used to identify a TIA: F ― Face drooping or numbness; A ― Arm weakness; S ― Speech difficulty; T ― Time to call 9-1-1, even if the symptoms go away.

“Confidently diagnosing a TIA is difficult since most patients are back to normal function by the time they arrive at the emergency room,” said Hardik P. Amin, M.D., chair of the scientific statement writing committee and associate professor of neurology and medical stroke director at Yale New Haven Hospital, St. Raphael Campus in New Haven, Connecticut. “There also is variability across the country in the workup that TIA patients may receive. This may be due to geographic factors, limited resources at health care centers or varying levels of comfort and experience among medical professionals.”

For example, Amin said, “Someone with a TIA who goes to an emergency room with limited resources may not get the same evaluation that they would at a certified stroke center. This statement was written with those emergency room physicians or internists in mind – professionals in resource-limited areas who may not have immediate access to a vascular neurologist and must make challenging evaluation and treatment decisions.”

The statement also includes guidance to help health care professionals tell the difference between a TIA and a “TIA mimic” – a condition that shares some signs with TIA but is due to other medical conditions such as low blood sugar, a seizure or a migraine. Symptoms of a TIA mimic tend to spread to other parts of the body and build in intensity over time.

Who is at risk for a TIA?

People with cardiovascular risk factors, such as high blood pressure, diabetes, obesity, high cholesterol and smoking, are at high risk for stroke and TIA. Other conditions that increase risk of a TIA include peripheral artery disease, atrial fibrillation, obstructive sleep apnea and coronary artery disease. In addition, a person who has had a prior stroke is at high risk for TIA.

Which tests come first once in the emergency room?

After assessing for symptoms and medical history, imaging of the blood vessels in the head and neck is an important first assessment. A non-contrast head CT should be done initially in the emergency department to rule out intracerebral hemorrhage and TIA mimics. CT angiography may be done as well to look for signs of narrowing in the arteries leading to the brain. Nearly half of people with TIA symptoms have narrowing of the large arteries that lead to the brain.

A magnetic resonance imaging (MRI) scan is the preferred way to rule out brain injury (i.e., a stroke), ideally done within 24 hours of when symptoms began. About 40% of patients presenting in the ER with TIA symptoms will actually be diagnosed with a  stroke based on MRI results. Some emergency rooms may not have access to an MRI scanner, and they may admit the patient to the hospital for MRI or transfer them to a center with rapid access to one.

Blood work should be completed in the emergency department to rule out other conditions that may cause TIA-like symptoms, such as low blood sugar or infection, and to check for cardiovascular risk factors like diabetes and high cholesterol.

Once TIA is diagnosed, a cardiac work-up is advised due to the potential for heart-related factors to cause a TIA. Ideally, this assessment is done in the emergency department, however, it could be coordinated as a follow-up visit with the appropriate specialist, preferably within a week of having a TIA. An electrocardiogram to assess heart rhythm is suggested to screen for atrial fibrillation, which is detected in up to 7% of people with a stroke or TIA. The American Heart Association recommends that long-term heart monitoring within six months of a TIA is reasonable if the initial evaluation suggests a heart rhythm-related issue as the cause of a TIA or stroke.

Early neurology consultation, either in-person or via telemedicine, is associated with lower death rates after a TIA. If consultation isn’t possible during the emergency visit, the statement suggests following up with a neurologist ideally within 48 hours but not longer than one week after a TIA, given the high risk of stroke in the days after a TIA. The statement cites research that about 43% of people who had an ischemic stroke (caused by a blood clot) had a TIA within the week before their stroke.

Assessing stroke risk after TIA

A rapid way to assess a patient’s risk of future stroke after TIA is the 7-point ABCD2 score, which stratifies patients into low, medium and high risk based on Age, Blood pressure, Clinical features (symptoms), Duration of symptoms (less than or greater than 60 minutes) and Diabetes. A score of 0-3 indicates low risk, 4-5 is moderate risk and 6-7 is high risk. Patients with moderate to high ABCD2 scores may be considered for hospitalization.

Collaboration among emergency room professionals, neurologists and primary care professionals is critical to ensure the patient receives a comprehensive evaluation and a well-communicated outpatient plan for future stroke prevention at discharge.

“Incorporating these steps for people with suspected TIA may help identify which patients would benefit from hospital admission, versus those who might be safely discharged from the emergency room with close follow-up,” Amin said. “This guidance empowers physicians at both rural and urban academic settings with information to help reduce the risk of future stroke.”

This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Emergency Neurovascular Care Committee of the Stroke Council and the Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists, and it is endorsed by the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS).

American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Co-authors are Vice Chair Tracy E. Madsen, M.D., Ph.D.; Dawn M. Bravata, M.D.; Charles R. Wira, M.D.; S. Claiborne Johnston, M.D., Ph.D.; Susan Ashcraft, D.N.P.; Tamika Marquitta Burrus, M.D.; Peter David Panagos, M.D.; Max Wintermark, M.D., M.A.S.; and Charles Esenwa, M.D., M.S.

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers, and the Association’s overall financial information are available here.

Additional Resources: