Development and operation of the defence COVID-19 lab as a SARS-CoV-2 diagnostic screening capability for UK military personnel.

BACKGROUND: In the face of the COVID-19 pandemic, the Defence Science and Technology Laboratory (Dstl) and Defence Pathology combined to form the Defence Clinical Lab (DCL), an accredited (ISO/IEC 17025:2017) high-throughput SARS-CoV-2 PCR screening capability for military personnel. LABORATORY STRUCTURE AND RESOURCE: The DCL was modular in organisation, with laboratory modules and supporting functions combining to provide the accredited SARS-CoV-2 (envelope (E)-gene) PCR assay. The DCL was resourced by Dstl scientists and military clinicians and biomedical scientists. LABORATORY RESULTS: Over 12 months of operation, the DCL was open on 289 days and tested over 72 000 samples. Six hundred military SARS-CoV-2-positive results were reported with a median E-gene quantitation cycle (Cq) value of 30.44. The lowest Cq value for a positive result observed was 11.20. Only 64 samples (0.09%) were voided due to assay inhibition after processing started. CONCLUSIONS: Through a sustained effort and despite various operational issues, the collaboration between Dstl scientific expertise and Defence Pathology clinical expertise provided the UK military with an accredited high-throughput SARS-CoV-2 PCR test capability at the height of the COVID-19 pandemic. The DCL helped facilitate military training and operational deployments contributing to the maintenance of UK military capability. In offering a bespoke capability, including features such as testing samples in unit batches and oversight by military consultant microbiologists, the DCL provided additional benefits to the UK Ministry of Defence that were potentially not available from other SARS-CoV-2 PCR laboratories. The links between Dstl and Defence Pathology have also been strengthened, benefitting future research activities and operational responses.

The Downrange Acoustic Toolbox: An Active Solution for Combat-Related Acute Acoustic Trauma.

Frontline military personnel are at high risk of acute acoustic trauma (AAT) caused by impulse noise, such as weapon firing or blast. This can result in anatomic disruption of the tympanic membrane and damage to the middle and inner ear, leading to conductive, sensorineural, or mixed hearing loss that may be temporary or permanent. AAT reduces warfighters' operational effectiveness and has implications for future quality of life. Hearing protection devices can mitigate AAT but are not completely protective. Novel therapeutic options now exist; therefore, identification of AAT as soon as possible from point of injury is vital to ensure optimal treatment and fulfillment of the duty of care. Early recognition and treatment of frontline AAT can maintain the deployed team's capabilities, avoid unnecessary case evacuation (CASEVAC), and raise awareness of military occupational AAT. This will help prioritize hearing preservation, maintain the fighting force, and ultimately retain personnel in service. The UK Defence hearWELL research collaboration has developed a frontline protocol for the assessment of AAT utilizing future-facing technology developed by the US Department of Defense: the Downrange Acoustic Toolbox (DAT). The DAT has been operationally deployed since 2019 and has successfully identified AAT requiring treatment, thereby improving casualties' hearing and reducing unnecessary repatriation.

Presence of HTLV-III antibodies in immune serum globulin preparations.

The authors tested 15 immune serum globulin pharmaceutical preparations for antibody reactivity to human T cell lymphotrophic virus type III (HTLV-III) by the Abbott immunoenzymometric assay (IEMA). Although no evidence of HTLV-III infectivity has appeared after injection of similar preparations into humans, the authors found all samples IEMA reactive. Upon dilution, the authors demonstrated parallel decreases of antibody reactivity among two samples of gamma globulin, the Abbott-positive control, and a markedly reactive patient specimen. Gamma globulin isolated from sera of six animal species was nonreactive in the Abbott assay. All samples were nonreactive with the H-9 cell line antigen. Antibody reactivity to HTLV-III was confirmed in 13 of 15 gamma globulin samples when tested by the Electro-Nucleonics IEMA, and 14 samples contained at least the p24 band on Western blot analysis. Although false positivity occurs in IEMA assays possibly because of elevated protein concentrations and nonspecific binding, the authors, results show that in most circumstances immune serum globulin preparations tested do contain true reactivity to HTLV-III.

Scrub typhus in the Eastern Solomon Islands and Northern Vanuatu (New Hebrides).

Rickettsia tsutsugmushi has been isolated from Rattus rattus from Vanua Lava island in Northern Vanuatu (New Hebrides) and from R. exulans and Leptotrombidium akamushi on Ndende island in the Eastern Solomon Islands. The well-known vector mite L. deliense was found on Mota Lava and Vanua Lava in Vanuatu, but no isolation was made from pools of this mite. Serology confirms that R. tsutsugamushi infects humans in the Banks group of islands in Northern Vanuatu and that infection is much more widespread in the Solomon Islands than the limited isolations indicate.

An epidemic of Ross River virus infection in Fiji, 1979.

An explosive epidemic of polyarthritis caused by Ross River virus occurred in the Fijian islands from April to June 1979. Serological results suggest there was a low level of Alphavirus activity throughout Fiji before April 1979, but that following the epidemic up to 90% of the residents of some communities had antibody to Ross River virus. The clinical and laboratory findings in patients from the Fijian outbreak were similar to those seen in Australian cases.

Effects of road transport on indices of stress in horses.

Stress associated with road transport is believed to be a significant contributor to the pathogenesis of post transport respiratory disease in horses. To determine the effects of road transport on pulmonary function, pulmonary aerosol clearance rates were measured in 4 horses 24 h before, and immediately after, 24 h of road transport by delivering aerosolised 99mtechnetium-labelled diethylenetriaminepentacetate (99mTc-DTPA) to the lungs and monitoring its washout. Each horse was transported twice, once while the trailer was equipped with a leaf-spring suspension and bias-ply tyres (trailer's original equipment, smooth ride) and once while the trailer was equipped with a torsion-bar suspension and normal pressure radial tyres (rough ride) in order to generate different ride characteristics. Before transport, blood was drawn from each horse for haematology and measurement of serum cortisol concentration; 24 h rates of hay and water intake and faecal output were recorded for each horse. Horses were then transported, 2 at a time, over a 128 km circular route of predominantly rural freeways at a constant speed of 72 km/h for 24 h. Horses were rested by stopping the trailer every 3.75 h for 0.25 h. During transport, heart rates (continuous 1 min averages), rates of hay and water intake and rates of faecal output were measured. Ammonia (NH3) and carbon monoxide (CO) concentrations were measured within the trailer and temperatures (wet bulb [WB], dry bulb [DB] and black globe [BG]) within the trailer were recorded each minute. Immediately after each experiment blood was drawn for haematology and measurement of pulmonary aerosol clearance rates were measured. For control studies, horses were housed in their stalls while heart rates were measured for 24 h. Slopes calculated from the 99mTc-DTPA clearance curves for pretransport horses were not significantly different from post transport clearance slopes. Pretransport mean 99mTc-DTPA clearance half-lives (T50, left lung mean +/- s.d. 41.7 +/- 15.8 min, right lung 44.6 +/- 19.1 min) were not significantly different from post transport T50 (left lung 53.5 +/- 14.0 min, right lung 52.0 +/- 11.6 min). Heart rates during transport were not affected by suspension type or trip order (the horse's first or second transport experiment) and were not significantly different from stall controls after the first 120 min of the experiment. Horses had increased red blood cell count, packed cell volume, haemoglobin, plasma protein and cortisol concentrations, and decreased body weights immediately post transport, indicating slight dehydration. Water and hay intake rates were significantly lower during transport than pretransport. Temperatures within the trailer were highest in the midafternoon and lowest in the early morning hours, but all temperatures measured in the trailer were within the comfort zone for large homeotherms. Ammonia and CO concentrations in the trailer during the transport period were within acceptable limits for human exposure. However, respirable articulates in the atmosphere were elevated above safe concentrations for human exposure.

A study of acute respiratory disease in the community of Port Chalmers. III. Efficacy of influenza virus subunit vaccines in 1973, 1974 and 1975.

An evaluation of the efficacy of influenza virus subunit vaccine was undertaken during a study of acute respiratory disease in the semi-isolated community of Port Chalmers, New Zealand. In 1973, the administration of a vaccine containing A/England/42/72(H3N2) and B/Roma/1/67 stains was found to produce HI antibody titres greater than or equal to 1:40 to the A and B components in 50 percent of 32 subjects. There was no significant NI antibody response to the A component. During an epidemic of A/Port Chalmers/I/73(H3N2) occurring three to four months after vaccination, vaccinees were not protected from clinical infection. Sixty and ninety-nine subjects received vaccine containing A/Port Chalmers/1/73 and B/Hong Kong/8/73 in 1974 and 1975 respectively. In 1974 all 60 subjects received a second dose of vaccine which was shown to have little effect on the distribution of HI antibody titres. The benefits of annual vaccination in this general practice are unclear.

Lack of effect of helium breathing on catecholamine levels in the adrenal vein blood of the rabbit.

Catecholamine levels were measured in the adrenal vein blood of the chloralose anesthetized rabbit during periods of helium-oxygen breathing (50% He-50% O2) and of air breathing. Blood samples were taken from the T-arm of a venous shunt made by cannulating the renal vein proximally to the orifice of the adrenal vein and connecting the distal end of the cannula to one in the femoral vein. Adrenal vein blood flow varied from 0.09-0.30 g/min in five animals, and catecholamine release from 10-92 ng/min. There were large differences between levels from animal to animal but no significant differences in any one animal between levels measured while breathing helium and levels measured while breathing air. The same held true for respiratory rate, blood pressure, heart rate, and percent change in blood pressure during a simulated valsalva maneuver. Although there were changes seen in catecholamine release during some of these experiments, they could not be related to an effect of gases breathed. It is concluded that if there was an effect of helium breathing on catecholamine release in these anesthetized rabbits it was masked by other conditions with stronger action on the sympatho-adrenal system.

Relationships of collective orientation and cohesion to team outcomes.

The relationships of collective orientation and cohesion to team outcomes were compared for 373 high school students on 12 different types of two-person teams performing simple problems in mathematics. Scores on collective orientation and cohesion were highly correlated with each other and with team outcomes but not statistically distinct from each other.

Peer versus authority as decision maker: are the demographics of the perceiver related to judgements of fairness?

In a role-playing study, 264 university students evaluated the fairness of procedures and outcomes used to punish a student for plagiarizing from a web site. Individuals reading the scenario gave the highest ratings of justice when the decision maker was a group of nonpeers (faculty), compared to when the decision maker was an individual or peer (student). Sex and self reported guilt of individuals reading the scenario also influenced their ratings of justice.

Low back disorders in agriculture and the role of stooped work: scope, potential interventions, and research needs.

Low back disorders (LBDs) continue to be a major occupational health problem facing the agricultural workforce. Working in a flexed or stooped posture is one of several workplace factors associated with occupationally related LBDs and is highly prevalent in many agricultural tasks. The purpose of this article is to evaluate the role of stooped work in the problem of LBDs among agricultural workers by examining the epidemiological literature, evaluating the scope of stooped work in agriculture, and examining current and potential intervention approaches. The literature review indicates that the prevalence of LBDs in agriculture worldwide is considerably high and substantially reported. Workers who are exposed to stooped work in agriculture are estimated to be in the 100s of millions worldwide. However, stooped work has not been specifically investigated as an independent LBD risk factor. Plausible biomechanical and physiological mechanisms of how stooped work may lead to damage to the spinal structures are discussed, and this complements the epidemiological evidence of high prevalence of LBDs in agriculture. However, this study also identifies the need to conduct more thorough epidemiological studies that utilize accurate quantitative exposure and outcome assessment techniques for developing more appropriate dose-response relationships in agricultural stooped work. This will provide better means for evaluating current and future interventions for jobs involving stooped work. Various intervention approaches are summarized to control and abate stooped work in agriculture; however, it must be emphasized that any development of ergonomic interventions for stooped work in agriculture must incorporate a participatory ergonomics approach that integrates the opinions and concerns of workers, managers, and ergonomists.