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The Norwegian Food Safety Authority (NFSA) and Norwegian Environmental Authority (NEA) asked the Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) for an opinion on factors associated with the introduction of Chronic Wasting Disease (CWD) to Norway. VKM appointed a working group consisting of two members of the Panel on Biological Hazards, one member of Panel on Animal Health and Welfare, and two external experts to prepare the answer to the questions. The Panel on Biological Hazards has reviewed and revised the draft prepared by the working group and approved the opinion. CWD was diagnosed in March 2016 in a wild reindeer (Rangifer tarandus) from the Nordfjella mountain area in Norway and in May and June in two mooses (Alces alces) in Selbu in South Trøndelag County, approximately 300 km north from the first case. There is currently no information to determine the origin(s) of CWD agents in Norway. However, the sporadic or genetic (somatic mutation) occurrence of prion disease in cervids cannot be excluded, nor can introduction from North America or other countries. Furthermore, there is no evidence that it has not been circulating at low levels in the Norwegian cervid populations for years, but has not previously been identified. In this scientific opinion, information on prion diseases in general, and CWD in particular, is presented in the light of experiences with this disease in North America. Prions are among the most resilient pathogens known and dissemination of prions into ecosystems is likely to result in long-term problems. Prions bind strongly to soil and remain infectious. In CWD, prions are present in most peripheral organs and also shed into the environment via saliva, faeces, and urine, as well as with the placenta. CWD transmits easily among cervids, either through direct contact, or indirectly via the environment. Migration of animals is relevant for the spread between areas. Strain diversification might occur in CWD and may influence transmission properties of the agents. Clinical signs of CWD are non-specific and do not alone enable confirmation of the diagnosis. Analysis of tissue from the brainstem at the level of the obex by approved methods is necessary for diagnosis of CWD. Prion infectivity is assessed by bioassays, often involving transgenic mice. In vitro conversion assays, like protein misfolding cyclic amplification (PMCA), provide sensitive quantification of converting activity, which is a good approximation of infectivity. Genetic variation (polymorphisms) in the gene that encodes PrP (PRNP) can modulate sensitivity towards CWD. The level of such genetic variation in Norwegian wild and semi-domesticated cervids is currently unknown. Cattle and sheep are at very low risk of developing CWD and it is highly unlikely that prion diseases in sheep or cattle are the origin of CWD. Although transmission of CWD to humans has never been known to occur, and animals other than cervids have not been found to be infected, indicating a species barrier, this possibility cannot be excluded. Thus, measures for reduction of human exposure are recommended. Taking into account uncertainties regarding the plasticity of the CWD agents and the lack of transmission data from the Norwegian isolates, this scientific opinion considers the zoonotic risk of CWD to be very low.
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Objective To evaluate the standardization of Meta-analyses on nephropathy published in Chinese journals.Methods By searching in WANFANG,VIP,CNKI databases and Chinese Biomedical Literature Database(CBM) as well as related Chinese journals,eligible Meta-analyses were enrolled and analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement and the MOOSE (Meta-analysis of Observational Studies in Epidemiology) Checklist.Results A total of 217 Meta-analyses were enrolled with 166 on randomized controlled trials (RCT) and 51 on observational studies.Based on the PRSIMA Statement,of the 166 Meta-analyses on RCT,51.8％(86 papers) were found with the complete research hypothesis,13.9％ (23) with the literature screening flow chart,15.7％ (26) with the subgroup analysis,53.0％ (88) with the publication bias analysis and 28.3％ (47) with the sensitivity analysis.According to the MOOSE Checklist,of the 51 Meta-analyses on observational studies,only 9.8％ (5) had done the statistical stability calculation,54.9％ (28) with the outlook of application,45.1％ (23) with the limitation of the study,2.0％ (1) with the quantitative analysis on potential bias and 17.6％ (9) with the suggestion for future studies.Conclusions Unclear hypothesis,limited methodological description,lack of in-depth analysis on heterogeneity and bias are the common defects in Meta-analyses published in Chinese journals on nephrology.
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Quality of medical research reports should be evaluated before they are applied to clinical practice. Since 1990s, several guidelines on research reports were suggested. Most recently published Consolidated Standards of Reporting Trials statement 2010 consists of 25 checklists and flow diagram for reporting an randomized controlled trial. Strengthening the reporting of observational studies in epidemiology statement is a checklist of items that should be addressed in articles reporting on the observational studies in epidemiology. TREND statement for the reporting of nonrandomized designs consists of 22 checklists. The Quality of Reporting of Meta-analyses checklist proposes to provide checklist and flow diagram for reporting of meta-analyses. The Meta-analysis of Observational Studies in Epidemiology statement proposes a checklist for compensating the study errors about observational studies in epidemiology. After development of reporting guidelines, improvements in the quality of reports are continuously reported, so using guidelines in the medical research will be expected to be more generalized.