Search

Background: In the context of neuromyelitis optica spectrum disorder (NMOSD), there are several measures that serve as a biomarker. However, each of the methods has the intrinsic limitations. While neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have emerged as an additional biomarker for NMOSD, a thorough investigation of their role remains incomplete. Our aim is to provide a comprehensive review of the current literature regarding NfL and GFAP as a biomarker and explore their potential utility in NMOSD. Methods: We performed a comprehensive search using PubMed and Google Scholar to identify peer-reviewed articles investigating NfL and GFAP as a biomarker in NMOSD. Results: Our search identified 13 relevant studies. NfL consistently showed promise in distinguishing NMOSD patients from healthy individuals, although it had limited specificity in distinguishing NMOSD from other demyelinating diseases. NfL offered certain advantages over GFAP, notably its ability to predict disability worsening during attacks. In contrast, GFAP provided valuable insight, particularly in distinguishing NMOSD from multiple sclerosis and identifying clinical relapses. In addition, GFAP showed predictive potential for future attacks. Some studies even suggested that NfL may serve as an indicator of treatment response in NMOSD. Conclusions: NfL and GFAP hold promise as biomarkers for NMOSD, demonstrating their usefulness in distinguishing patients from healthy individuals, assessing disease severity, and possibly reflecting treatment response. However, it is important to recognize that NfL and GFAP may, at some point, have different roles. [ABSTRACT FROM AUTHOR]

Objective: Spinal and bulbar muscular atrophy (SBMA) is characterized by slow, progressive bulbar and limb muscle weakness; however, the pattern of progression of muscle fat infiltration remains unclear. We assessed the progression of muscle involvement in 81 patients with SBMA using whole‐body muscle magnetic resonance imaging (MRI), alongside clinical and laboratory findings. Methods: This prospective study included patients with genetically confirmed SBMA who underwent whole‐body muscle MRI. We analyzed muscle fat infiltration and the pattern of involved muscles using cluster analysis, visualizing the sequential progression of fat infiltration. Muscle clusters demonstrated correlation with clinical scales and laboratory findings. Additionally, linear regression analysis was performed to identify the MRI section most strongly associated with 6‐minute walk test (6MWT). Results: We included 81 patients with SBMA (age = 54.3 years). After categorizing the patients into 6 clusters based on the pattern of muscle fat infiltration, we observed that muscle involvement began in the posterior calf and progressed to the posterior thigh, pelvis, trunk, anterior thigh, medial thigh, anterior calf, and upper extremity muscles. These muscle clusters correlated significantly with disease duration (τ = 0.47, p < 0.001), 6MWT (τ = −0.49, p < 0.001), and serum creatinine level (τ = −0.46, p < 0.001). The whole‐body MRI indicated the thigh as the section most significantly correlated with 6MWT. Interpretation: We used whole‐body muscle MRI to determine the sequential progression of the fat infiltration in SBMA. Our findings may enable the identification of objective and reliable imaging outcome measures in the study of the natural history or future clinical trials of SBMA. ANN NEUROL 2024;95:596–606 [ABSTRACT FROM AUTHOR]

Over five decades, US civil service laws institutionalized federal employees' whistleblower rights through a series of reforms since 1978. In 2012, the Whistleblower Protection Enhancement Act extended statutory protections to employees of the Transportation Security Administration (TSA) for the first time. This quasi-experimental study evaluates whether these legal protections changed the perceptions of TSA employees by enhancing their behavioral control over the opportunity to blow the whistle. Changes in TSA employee perceptions of behavioral control are compared to changes in perceptions in three control agencies, using a difference-in-differences estimation. We further consider whether TSA managers' perceptions change in unique ways, in comparison to the control agencies. The results indicate that providing protection only changed TSA employees' behavioral control over whistleblowing immediately after passage, but not over the long term. Further, the law did enhance TSA managers' perceived behavioral control differentially. Policy implications for reconstructing the shield is provided. [ABSTRACT FROM AUTHOR]

Public administration scholars have provided a variety of theoretical insights to understand bureaucratic whistleblowing, and have emphasized its ethical, legal, and practical rationales in the context of democratic bureaucracy. To enhance our understanding of this principled dissent behavior in the public sector, this study systematically reviews 71 whistleblowing articles and dissertations that address three aspects in the literature: (1) definitions and theories; (2) methods and data, and (3) factors associated with whistleblowing intention and behavior. The findings show public administration whistleblowing research typically uses Near and Miceli's definition, grounded on psychology, ethics, and human resource management (HRM) theories. Methodologically, there is a notable recent trend in the growth of empirical research using survey data, and equal attention has been paid to both whistleblowing intention and behavior variables. Based on the review findings, the study discusses two issues—definitional and theoretical—and presents four research agendas for future bureaucratic whistleblowing scholarship. [ABSTRACT FROM AUTHOR]