There is a need for a blood biomarker of disease activity in ALS. This marker needs to measure the loss of motor neurones. Phosphorylated neurofilament heavy chain (pNfH) in the serum is a biomarker of axonal injury. Previous studies have found that levels of pNfH are elevated in ALS. We have performed a serial study of pNfH levels in 98 subjects from our ALS clinic. There was significant elevation of levels of pNfH in subjects with ALS compared to controls, although there was considerable variability. In studies of individuals who had two or more serial samples, we found that the levels of pNfH increased over time in the early stage of disease. Levels were low in subjects with long survival. The rate of rise of pNfH was inversely correlated with survival. We suggest that the initial level of pNfH is a marker of disease severity and that changes in pNfH levels are markers of disease progression.

Introduction With over 1 billion monthly users globally, a third of whom are under 14 years, TikTok's popularity is indisputable. Publicly available cannabis‐related content on this platform may influence perceptions of cannabis use. We aimed to examine how cannabis‐related videos are portrayed on TikTok. Methods Data were collected from TikTok using hashtag‐based keywords on cannabis‐related videos (n = 1377). Seven researchers documented video metrics (i.e. views, likes, comments) and independently coded videos for sentiment and theme. Results After removing duplicates and non‐related content, the final sample contained 881 videos. These videos had a median view count of 518 700 (SD = ±1 082 905), median likes count of 99 900 (SD = ±206 647) and median comment count of 931 (SD = ±2977). Many videos portrayed cannabis use positively (54.14%; collectively viewed 417 million times), with 15.84% of this subset actively depicting cannabis or administration products. The thematic analysis identified seven non‐mutually exclusive themes. Content portraying cannabis use as entertaining or humorous accounted for 71.74% of videos, with a further 42.90% discussing personal cannabis use experiences and 24.63% promoting the social and cultural acceptability of cannabis use. Discussion and Conclusions Our sample revealed over half of videos portrayed cannabis use positively and none were age restricted. All were publicly accessible through standard web and smartphone applications. With previous research demonstrating that exposure to cannabis‐related content can influence adolescents' attitudes and problematic cannabis use, it is important more effective age restrictions and regulations are introduced to social media platforms.

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Among individuals with religious affiliations, those who reported more religiosity on four of five indices had increased odds of PEs. Focussed and more qualitative research will be required to unravel the interrelationship between religiosity and PEs.