Monday, September 2, 2019

Seven minutes in stroke - Dr Xia Wang

Dr Xia Wang in collaboration with Dr Tom Moullaali and Professor Rustam Salman at the University of Edinburgh submitted the article 
‘Who will benefit more from low - dose alteplase in acute ischaemic stroke?’ to the International Journal of Stroke. Dr Wang answered our Seven minutes in stroke giving us a little insight into where our stroke researchers and clinicians began their relationship with stroke.

1. What inspired you towards neuroscience?
Neuroscience is pretty cool! It is one of the last great frontiers of knowledge spanning from molecules, through cells and pathways, all the way up to complex human behaviour. Clever neuroscience tricks have been applied to all the aspects of our lives. For example, Instagram used it in the logo design to appeal to human being’s subconscious minds. The thick white line of the camera on the logo against the rich colourful background creates high levels of eye-catching visual saliency. Designs that are visually salient get looked at earlier, more often, and for longer.

2. Why stroke?
Stroke is the leading cause of death in China, with the country accounting for roughly one third of worldwide stroke mortality. Stroke burden is much higher in northern rural area where I am from. Compared with other parts of China, the prevalence of major risk factors for stroke remains high; the salt intake is much higher; tobacco use is highly prevalent; the awareness rate, treatment rate, and control rate of hypertension and diabetes are low. After stroke, stroke care quality and secondary prevention are all in a very low quality therefore the recurrent stroke rate is higher. Stroke research could help me to understand this area more and helpful to tackle the great challenge in my hometown.

3. What have been the highs so far?
I have produced 20 publications in the last 2 years including in lead international journals – NEJM, Lancet, Lancet Neurology, and JAMA Neurology.  The new knowledge I produced has been recognised by 39 countries across 5 continents of Asia, Europe, North America, South America, and Australia.  It has been adopted by 160 academic institutes/industries and influenced beyond medicine area in other 12 area including Engineering, Agricultural and Biological Sciences, and Computer Science.

The paper I co-authored – from the ENhanced Control of Hypertension And Thrombolysis strokE stuDy (ENCHANTED) – has been cited by multiple clinical practice guidelines including the American Heart Association (AHA)/American Stroke Association (ASA). Australian Commission on Safety and Quality in Health Care found a profound reduction of healthcare cost of ADU $50 million per year through improvements in patient outcomes by applying ENCHANTED findings in Australia ( I presented a subgroup analysis in the plenary session in European Stroke Conference in Milan in May.

4. What have been the lows?
Pressure from multiple applications including grants and fellowship to do every year, hard feelings from rejections and insecurity of funding.

5. How do you balance work life with the needs of home life?
I like cooking and swimming in my spare time, really look forward to hanging out with friends on the weekend.

6. Who are your most important mentors and how did you find them?
Professor Craig Anderson.
An email attached my resume with emphasis on excellent statistical skills reached Professor Craig Anderson in 2012. Then he decided to offer me an opportunity to be the statistician for INTERACT2, moved me from HIV research to stroke.

7. What are your most important collaborations and how have you built them?
Collaboration with Dr Tom Moullaali and Professor Rustam Salman at the University of Edinburgh
I co-supervised Dr Tom Moullaali while he was undertaking the visiting scholar at the George Institute Australia in 2016 and 2018. We worked on individual patient data (IPD) meta analysis on blood pressure (BP) lowering treatment for acute intracerebral haemorrhage and the paper has been accepted by Lancet Neurology. Prof Rustam Salman, the supervisor of Dr Tom Moullaali, worked closely with me during his sabbatical leave at the George Institute Australia in 2014. We have co-authored some papers. I have applied an exchange award from the National Heart Foundation, if successful, it would be a great opportunity to visit them and immerse myself in a different research institute environment.

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