Stroke: a scoping review
DOI:
https://doi.org/10.33448/rsd-v10i13.19904Keywords:
Ischemic stroke; Hemorrhagic stroke; Cerebral infarction.Abstract
Stroke is a disease with a high burden of morbidity and mortality nationally and globally. In the United States, it is the fifth leading cause of death, with an overall prevalence of 2.6% in the period between 2009 and 2012. In Brazil, there are an estimated 2,231,000 people with stroke and 568,000 with severe disability. This article seeks to describe characteristics of this acute injury to assist health professionals in finding important information related to this pathology. Risk factors such as hypertension, diabetes, dyslipidemia, atrial fibrillation and carotid stenosis have been associated with increased risk of stroke, with hypertension being the most important. Although clinical signs and symptoms are important, neuroimaging is fundamental to differentiate ischemic stroke from hemorrhagic stroke to guide the most appropriate treatment. Some of the differential diagnoses of stroke are transient ischemic attack (TIA), seizures, headache, hypoglycemia, tumors, vertigo and altered mental status. Some medical complications after stroke are dysphagia, urinary incontinence, pulmonary embolism, deep vein thrombosis (DVT), pneumonia, depression, and pressure ulcers. The correct and early diagnosis of stroke is extremely important to avoid the sequelae of this acute event and the adequate treatment of hypertension, diabetes mellitus and dyslipidemia are of great importance to reduce the high prevalence of stroke.
References
Abbott, A. L. (2009). Medical (Nonsurgical) Intervention Alone Is Now Best for Prevention of Stroke Associated With Asymptomatic Severe Carotid Stenosis. Stroke, 40(10). https://doi.org/10.1161/STROKEAHA.109.556068
Andrews, C. M., Jauch, E. C., Hemphill, J. C., Smith, W. S., & Weingart, S. D. (2012). Emergency Neurological Life Support: Intracerebral Hemorrhage. Neurocritical Care, 17(S1), 37–46. https://doi.org/10.1007/s12028-012-9757-2
Barer, D. H. (1989). The natural history and functional consequences of dysphagia after hemispheric stroke. Journal of Neurology, Neurosurgery & Psychiatry, 52(2), 236–241. https://doi.org/10.1136/jnnp.52.2.236
Barthels, D., & Das, H. (2020). Current advances in ischemic stroke research and therapies. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 1866(4), 165260. https://doi.org/10.1016/j.bbadis.2018.09.012
Beckett, N. S., Peters, R., Fletcher, A. E., Staessen, J. A., Liu, L., Dumitrascu, D., Stoyanovsky, V., Antikainen, R. L., Nikitin, Y., Anderson, C., Belhani, A., Forette, F., Rajkumar, C., Thijs, L., Banya, W., & Bulpitt, C. J. (2008). Treatment of Hypertension in Patients 80 Years of Age or Older. New England Journal of Medicine, 358(18), 1887–1898. https://doi.org/10.1056/NEJMoa0801369
Bensenor, I. M., Goulart, A. C., Szwarcwald, C. L., Vieira, M. L. F. P., Malta, D. C., & Lotufo, P. A. (2015). Prevalence of stroke and associated disability in Brazil: National Health Survey - 2013. Arquivos de Neuro-Psiquiatria, 73(9), 746–750. https://doi.org/10.1590/0004-282X20150115
Brandstater, M. E., Roth, E. J., & Siebens, H. C. (1992). Venous thromboembolism in stroke: literature review and implications for clinical practice. Archives of Physical Medicine and Rehabilitation, 73(5-S), S379-91. http://www.ncbi.nlm.nih.gov/pubmed/1301012
Brocklehurst, J. C., Andrews, K., Richards, B., & Laycock, P. J. (1985). Incidence and Correlates of Incontinence in Stroke Patients. Journal of the American Geriatrics Society, 33(8), 540–542. https://doi.org/10.1111/j.1532-5415.1985.tb04618.x
Broderick, J., Connolly, S., Feldmann, E., Hanley, D., Kase, C., Krieger, D., Mayberg, M., Morgenstern, L., Ogilvy, C. S., Vespa, P., & Zuccarello, M. (2007). Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Out. Circulation, 116(16). https://doi.org/10.1161/CIRCULATIONAHA.107.183689
Camm, A. J., Kirchhof, P., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Van Gelder, I. C., Al-Attar, N., Hindricks, G., Prendergast, B., Heidbuchel, H., Alfieri, O., Angelini, A., Atar, D., Colonna, P., De Caterina, R., De Sutter, J., Goette, A., Gorenek, B., & Zupan, I. (2010). Guidelines for the management of atrial fibrillation. EP Europace, 12(10), 1360–1420. https://doi.org/10.1093/europace/euq350
Caplan, L. R. (2020). Etiology, classification, and epidemiology of stroke.
Carota, A., Berney, A., Aybek, S., Iaria, G., Staub, F., Ghika-Schmid, F., Annable, L., Guex, P., & Bogousslavsky, J. (2005). A prospective study of predictors of poststroke depression. Neurology, 64(3), 428–433. https://doi.org/10.1212/01.WNL.0000150935.05940.2D
Clissold, B., Phan, T. G., Ly, J., Singhal, S., Srikanth, V., & Ma, H. (2020). Current aspects of TIA management. Journal of Clinical Neuroscience, 72, 20–25. https://doi.org/10.1016/j.jocn.2019.12.032
Cordonnier, C., Girot, M., Dorp, E., Rimetz, P., Bouillaguet, S., Hénon, H., Lucas, C., Godefroy, O., & Leys, D. (2000). Stroke Units from Scientific Evidence to Practice: The Experience of the Lille Stroke Unit. Cerebrovascular Diseases, 10(4), 17–20. https://doi.org/10.1159/000047587
Cordonnier, C., Oppenheim, C., Lamy, C., Meder, J.-F., & Mas, J.-L. (2005). Serial diffusion and perfusion-weighted MR in transient hypoglycemia. Neurology, 65(1), 175–175. https://doi.org/10.1212/01.wnl.0000167128.14769.7b
Cucchiara, B., & Kasner, S. E. (2011). Transient Ischemic Attack. Annals of Internal Medicine, 154(1), ITC1. https://doi.org/10.7326/0003-4819-154-1-201101040-01001
Endres, M. (2005). Statins and Stroke. Journal of Cerebral Blood Flow & Metabolism, 25(9), 1093–1110. https://doi.org/10.1038/sj.jcbfm.9600116
Falavigna, A., Teles, A. R., Vedana, V. M., Kleber, F. D., Mosena, G., Velho, M. C., Mazzocchin, T., Silva, R. C. da, Lucena, L. F., Santin, J. T., & Roth, F. (2009). Awareness of stroke risk factors and warning signs in southern Brazil. Arquivos de Neuro-Psiquiatria, 67(4), 1076–1081. https://doi.org/10.1590/S0004-282X2009000600022
Fernandes, P. M., Whiteley, W. N., Hart, S. R., & Al-Shahi Salman, R. (2013). Strokes: mimics and chameleons. Practical Neurology, 13(1), 21–28. https://doi.org/10.1136/practneurol-2012-000465
Giles, M. F., Albers, G. W., Amarenco, P., Arsava, M. M., Asimos, A., Ay, H., Calvet, D., Coutts, S., Cucchiara, B. L., Demchuk, A. M., Johnston, S. C., Kelly, P. J., Kim, A. S., Labreuche, J., Lavallee, P. C., Mas, J.-L., Merwick, A., Olivot, J. M., Purroy, F., & Rothwell, P. M. (2010). Addition of brain infarction to the ABCD2 Score (ABCD2I): a collaborative analysis of unpublished data on 4574 patients. Stroke, 41(9), 1907–1913. https://doi.org/10.1161/STROKEAHA.110.578971
Gordon, C., Hewer, R. L., & Wade, D. T. (1987). Dysphagia in acute stroke. BMJ, 295(6595), 411–414. https://doi.org/10.1136/bmj.295.6595.411
Hacke, W., Kaste, M., Bluhmki, E., Brozman, M., Dávalos, A., Guidetti, D., Larrue, V., Lees, K. R., Medeghri, Z., Machnig, T., Schneider, D., von Kummer, R., Wahlgren, N., & Toni, D. (2008). Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke. New England Journal of Medicine, 359(13), 1317–1329. https://doi.org/10.1056/NEJMoa0804656
Hackett, M. L., Yapa, C., Parag, V., & Anderson, C. S. (2005). Frequency of depression after stroke: a systematic review of observational studies. Stroke, 36(6), 1330–1340. https://doi.org/10.1161/01.STR.0000165928.19135.35
Halliday, A., Mansfield, A., Marro, J., Peto, C., Peto, R., Potter, J., & Thomas, D. (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. The Lancet, 363(9420), 1491–1502. https://doi.org/10.1016/S0140-6736(04)16146-1
Helbok, R., Kurtz, P., Schmidt, J. M., Stuart, R. M., Fernandez, L., Malhotra, R., Presciutti, M., Ostapkovich, N. D., Connolly, E. S., Lee, K., Badjatia, N., Mayer, S. A., & Claassen, J. (2011). Effect of mannitol on brain metabolism and tissue oxygenation in severe haemorrhagic stroke. Journal of Neurology, Neurosurgery & Psychiatry, 82(4), 378–383. https://doi.org/10.1136/jnnp.2009.198754
Hemphill, J. C., Greenberg, S. M., Anderson, C. S., Becker, K., Bendok, B. R., Cushman, M., Fung, G. L., Goldstein, J. N., Macdonald, R. L., Mitchell, P. H., Scott, P. A., Selim, M. H., & Woo, D. (2015). Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke, 46(7), 2032–2060. https://doi.org/10.1161/STR.0000000000000069
Howard, V. J., McCLure, L. A., Meschia, J. F., Pulley, L., Orr, S. C., & Friday, G. H. (2006). High Prevalence of Stroke Symptoms Among Persons Without a Diagnosis of Stroke or Transient Ischemic Attack in a General Population. Archives of Internal Medicine, 166(18), 1952. https://doi.org/10.1001/archinte.166.18.1952
Jahan, R., Saver, J. L., Schwamm, L. H., Fonarow, G. C., Liang, L., Matsouaka, R. A., Xian, Y., Holmes, D. N., Peterson, E. D., Yavagal, D., & Smith, E. E. (2019). Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. JAMA, 322(3), 252. https://doi.org/10.1001/jama.2019.8286
Johnston, K. C., Li, J. Y., Lyden, P. D., Hanson, S. K., Feasby, T. E., Adams, R. J., Faught, R. E., & Haley, E. C. (1998). Medical and Neurological Complications of Ischemic Stroke. Stroke, 29(2), 447–453. https://doi.org/10.1161/01.STR.29.2.447
Kamalian, S., & Lev, M. H. (2019). Stroke Imaging. Radiologic Clinics of North America, 57(4), 717–732. https://doi.org/10.1016/j.rcl.2019.02.001
Kamphuisen, P. W., Agnelli, G., & Sebastianelli, M. (2005). Prevention of venous thromboembolism after acute ischemic stroke. Journal of Thrombosis and Haemostasis, 3(6), 1187–1194. https://doi.org/10.1111/j.1538-7836.2005.01443.x
Kamphuisen, P. W., & Agnelli, G. (2007). What is the optimal pharmacological prophylaxis for the prevention of deep-vein thrombosis and pulmonary embolism in patients with acute ischemic stroke? Thrombosis Research, 119(3), 265–274. https://doi.org/10.1016/j.thromres.2006.03.010
Kelly, J., Hunt, B. J., Lewis, R. R., Swaminathan, R., Moody, A., Seed, P. T., & Rudd, A. (2004). Dehydration and venous thromboembolism after acute stroke. QJM : Monthly Journal of the Association of Physicians, 97(5), 293–296. https://doi.org/10.1093/qjmed/hch050
Kelly, J., Rudd, A., Lewis, R., & Hunt, B. J. (2001). Venous thromboembolism after acute stroke. Stroke, 32(1), 262–267. https://doi.org/10.1161/01.str.32.1.262
Kerber, K. A., Brown, D. L., Lisabeth, L. D., Smith, M. A., & Morgenstern, L. B. (2006). Stroke Among Patients With Dizziness, Vertigo, and Imbalance in the Emergency Department. Stroke, 37(10), 2484–2487. https://doi.org/10.1161/01.STR.0000240329.48263.0d
Krishnamurthi, R. V, Feigin, V. L., Forouzanfar, M. H., Mensah, G. A., Connor, M., Bennett, D. A., Moran, A. E., Sacco, R. L., Anderson, L. M., Truelsen, T., O’Donnell, M., Venketasubramanian, N., Barker-Collo, S., Lawes, C. M. M., Wang, W., Shinohara, Y., Witt, E., Ezzati, M., Naghavi, M., & Murray, C. (2013). Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet Global Health, 1(5), e259–e281. https://doi.org/10.1016/S2214-109X(13)70089-5
Kumar, S., Selim, M. H., & Caplan, L. R. (2010). Medical complications after stroke. The Lancet Neurology, 9(1), 105–118. https://doi.org/10.1016/S1474-4422(09)70266-2
Kvistad, C. E., Novotny, V., Næss, H., Hagberg, G., Ihle-Hansen, H., Waje-Andreassen, U., Thomassen, L., & Logallo, N. (2019). Safety and predictors of stroke mimics in The Norwegian Tenecteplase Stroke Trial (NOR-TEST). International Journal of Stroke, 14(5), 508–516. https://doi.org/10.1177/1747493018790015
Landi, G., D’Angelo, A., Boccardi, E., Candelise, L., Mannucci, P. M., Morabito, A., & Orazio, E. N. (1992). Venous thromboembolism in acute stroke. Prognostic importance of hypercoagulability. Archives of Neurology, 49(3), 279–283. https://doi.org/10.1001/archneur.1992.00530270093024
Liberman, A. L., & Prabhakaran, S. (2017). Stroke Chameleons and Stroke Mimics in the Emergency Department. Current Neurology and Neuroscience Reports, 17(2), 15. https://doi.org/10.1007/s11910-017-0727-0
Lodigiani, C., Iapichino, G., Carenzo, L., Cecconi, M., Ferrazzi, P., Sebastian, T., Kucher, N., Studt, J.-D., Sacco, C., Bertuzzi, A., Sandri, M. T., & Barco, S. (2020). Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thrombosis Research, 191, 9–14. https://doi.org/10.1016/j.thromres.2020.04.024
Lu, J., Kanji, S., Aggarwal, R., Das, M., Joseph, M., Wu, L.-C., Mao, H.-Q., Pompili, V. J., Hadjiconstantinou, M., & Das, H. (2013). Hematopoietic stem cells improve dopaminergic neuron in the MPTP-mice. Frontiers in Bioscience (Landmark Edition), 18, 970–981. https://doi.org/10.2741/4156
Merkler, A. E., Parikh, N. S., Mir, S., Gupta, A., Kamel, H., Lin, E., Lantos, J., Schenck, E. J., Goyal, P., Bruce, S. S., Kahan, J., Lansdale, K. N., LeMoss, N. M., Murthy, S. B., Stieg, P. E., Fink, M. E., Iadecola, C., Segal, A. Z., Cusick, M., … Navi, B. B. (2020). Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza. JAMA Neurology, 77(11), 1366. https://doi.org/10.1001/jamaneurol.2020.2730
Morgenstern, L. B., & Frankowski, R. F. (1999). Brain tumor masquerading as stroke. Journal of Neuro-Oncology, 44(1), 47–52. https://doi.org/10.1023/a:1006237421731
Morgenstern, L. B., Hemphill, J. C., Anderson, C., Becker, K., Broderick, J. P., Connolly, E. S., Greenberg, S. M., Huang, J. N., Macdonald, R. L., Messé, S. R., Mitchell, P. H., Selim, M., & Tamargo, R. J. (2010). Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke, 41(9), 2108–2129. https://doi.org/10.1161/STR.0b013e3181ec611b
Morris, P. L., Shields, R. B., Hopwood, M. J., Robinson, R. G., & Raphael, B. (1994). Are there two depressive syndromes after stroke? The Journal of Nervous and Mental Disease, 182(4), 230–234. https://doi.org/10.1097/00005053-199404000-00007
Moulin, S., & Leys, D. (2019). Stroke mimics and chameleons. Current Opinion in Neurology, 32(1), 54–59. https://doi.org/10.1097/WCO.0000000000000620
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., Das, S. R., de Ferranti, S., Després, J.-P., Fullerton, H. J., Howard, V. J., Huffman, M. D., Isasi, C. R., Jiménez, M. C., Judd, S. E., Kissela, B. M., Lichtman, J. H., Lisabeth, L. D., Liu, S., & Turner, M. B. (2016). Heart Disease and Stroke Statistics—2016 Update. Circulation, 133(4). https://doi.org/10.1161/CIR.0000000000000350
Mulley, G. P. (1982). Avoidable complications of stroke. Journal of the Royal College of Physicians of London, 16(2), 94–97. https://doi.org/7077569
Nakayama, H., Jørgensen, H. S., Pedersen, P. M., Raaschou, H. O., & Olsen, T. S. (1997). Prevalence and Risk Factors of Incontinence After Stroke. Stroke, 28(1), 58–62. https://doi.org/10.1161/01.STR.28.1.58
Ng, F. C., Coote, S., Frost, T., Bladin, C., & Choi, P. M. (2017). CT perfusion predicts tissue injury in TIA and minor stroke. Journal of Neurology, 264(4), 802–803. https://doi.org/10.1007/s00415-017-8423-1
Nor, A. M., Davis, J., Sen, B., Shipsey, D., Louw, S. J., Dyker, A. G., Davis, M., & Ford, G. A. (2005). The Recognition of Stroke in the Emergency Room (ROSIER) scale: development and validation of a stroke recognition instrument. The Lancet Neurology, 4(11), 727–734. https://doi.org/10.1016/S1474-4422(05)70201-5
Organização Mundial da Saúde. (2005). Enfoque passo a passo da OMS para a vigilância de acidentes vascular cerebrais.
Patel, M., Coshall, C., Rudd, A. G., & Wolfe, C. D. A. (2001). Natural History and Effects on 2-Year Outcomes of Urinary Incontinence After Stroke. Stroke, 32(1), 122–127. https://doi.org/10.1161/01.STR.32.1.122
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.
Prabhakaran, S., Ruff, I., & Bernstein, R. A. (2015). Acute Stroke Intervention. JAMA, 313(14), 1451. https://doi.org/10.1001/jama.2015.3058
Redgrave, J. N. E., Coutts, S. B., Schulz, U. G., Briley, D., & Rothwell, P. M. (2007). Systematic review of associations between the presence of acute ischemic lesions on diffusion-weighted imaging and clinical predictors of early stroke risk after transient ischemic attack. Stroke, 38(5), 1482–1488. https://doi.org/10.1161/STROKEAHA.106.477380
Rordorf, G., & McDonald, C. (2021). Spontaneous intracerebral hemorrhage: Treatment and prognosis.
Sarikaya, H., Ferro, J., & Arnold, M. (2015). Stroke Prevention - Medical and Lifestyle Measures. European Neurology, 73(3–4), 150–157. https://doi.org/10.1159/000367652
Smithard, D. G., O’Neill, P. A., England, R. E., Park, C. L., Wyatt, R., Martin, D. F., & Morris, J. (1997). The Natural History of Dysphagia following a Stroke. Dysphagia, 12(4), 188–193. https://doi.org/10.1007/PL00009535
Trejo-Gabriel-Galán, J. M. (2020). Ictus como complicación y como factor pronóstico de COVID-19. Neurología, 35(5), 318–322. https://doi.org/10.1016/j.nrl.2020.04.015
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., & Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Trounson, A., & McDonald, C. (2015). Stem Cell Therapies in Clinical Trials: Progress and Challenges. Cell Stem Cell, 17(1), 11–22. https://doi.org/10.1016/j.stem.2015.06.007
Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., Charlson, F., Davis, A., Degenhardt, L., Dicker, D., Duan, L., Erskine, H., Feigin, V. L., Ferrari, A. J., Fitzmaurice, C., Fleming, T., Graetz, N., Guinovart, C., Haagsma, J., & Murray, C. J. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386(9995), 743–800. https://doi.org/10.1016/S0140-6736(15)60692-4
Wade, D. T., & Hewer, R. L. (1987). Functional abilities after stroke: measurement, natural history and prognosis. Journal of Neurology, Neurosurgery & Psychiatry, 50(2), 177–182. https://doi.org/10.1136/jnnp.50.2.177
Walker, M. D., Marler, J. R., Goldstein, M., Grayd, P. A., Toole, J. F., Baker, Wi. H., Castaldo, J. E., & Chambless, L. E. (1995). Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA, 273(18), 1421–1428. http://www.ncbi.nlm.nih.gov/pubmed/7723155
Whittaker, A., Anson, M., & Harky, A. (2020). Neurological Manifestations of COVID‐19: A systematic review and current update. Acta Neurologica Scandinavica, 142(1), 14–22. https://doi.org/10.1111/ane.13266
Wilson, P. W. F., Hoeg, J. M., D’Agostino, R. B., Silbershatz, H., Belanger, A. M., Poehlmann, H., O’Leary, D., & Wolf, P. A. (1997). Cumulative Effects of High Cholesterol Levels, High Blood Pressure, and Cigarette Smoking on Carotid Stenosis. New England Journal of Medicine, 337(8), 516–522. https://doi.org/10.1056/NEJM199708213370802
Zappella, N., Merceron, S., Nifle, C., Hilly-Ginoux, J., Bruneel, F., Troché, G., Cordoliani, Y.-S., Bedos, J.-P., Pico, F., & Legriel, S. (2014). Artery of Percheron Infarction as an Unusual Cause of Coma: Three Cases and Literature Review. Neurocritical Care, 20(3), 494–501. https://doi.org/10.1007/s12028-014-9962-2
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Mustafa Darwiche; Dilson Fronza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
