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Background Posttraumatic stress disorder (PTSD) has been shown to be elevated among first responders (Emergency Medical Services, fire service, police force) compared to the general population. Examining the prevalence of mental health issues in a work force with an elevated occupational risk is fundamental towards ensuring their wellbeing and implementing safeguard measures. The goal of this study is therefore to report the prevalence of depression, anxiety, posttraumatic development, and PTSD in Norwegian ambulance personnel. Methods This study is a cross-sectional, anonymous, web-based survey (Questback®), performed among operative personnel employed in the Emergency Medical Services in the Regional Health Trust of Central Norway between 18. February and 9. April 2021. The study was sent to 1052 eligible participants. Questions reported demographic data, a traumatic events exposure index, Patient Health Questionnaire-9 (Depression), Generalized Anxiety Disorder-7 scale, Posttraumatic symptom scale (PTSD) and Posttraumatic change scale. Results The response rate in this study was 45.5% (n = 479/1052). The mean age of respondents was 37.1 years (std. 11.1) and 52.8% (n = 253) were male. Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. In this study, 5% (n = 24) showed a prevalence of manifest posttraumatic stress disorder symptoms, while 8.6% (n = 41) reported moderate to severe depression and 2.9% (n = 14) presented moderate to severe symptoms of general anxiety. Of the respondents, 77.2% (n = 370) reported personal growth because of their work experiences. Conclusions This study indicates that Norwegian ambulance personnel report a prevalence of posttraumatic stress symptoms and depression, which is slightly higher for men, and lower for the female proportion in this study, when compared to an adult Norwegian population. The vast majority of respondents reported personal growth because of their work experience, and both the degree of peer support and having a partner seem to influence levels of posttraumatic stress and -development.

Background: The 2015 forest fire disaster affected almost 2.6 million hectares of land in Indonesia, and Riau was among the worst. Firefighters were the first responders to deal with the disaster, but a little was known about the influence of extinguishing forest fire activities with their health. This study aimed to evaluate respiratory symptoms and lung function among firefighters 6 months after forest fire exposure.Methods: Interviews were conducted regarding sociodemographic factors, respiratory symptoms, and history of forest fire exposure during the disaster. Spirometry and chest X-ray were also carried out with standard techniques. Statistical analysis was performed based on the existing data. Ninety firefighters participated in this study, most were male with mean age of 33 years old. About 66% were smoker, had been working as firefighters for 2 to 10 years, and had been on extinguishing forest fire duty around 2–5 hours/day during the disaster.Results: All firefighters reported respiratory symptoms after 3 months. Pulmonary function was abnormal in 50% of subjects with mild restrictive characteristic. The analysis showed that body mass index (BMI) and duration of exposure had a significant correlation with pulmonary function abnormality.Conclusion: Pulmonary function was found abnormal in most subjects 6 months after forest fire exposure in Riau.

Rabies vaccines are lifesaving in human post animal exposure. However, the compliance to the complete course of vaccine is found to be only 60%. Hence, there is a need for safe and immunogenic, shorter course vaccine that can enhance the compliance and effectively prevent the disease.To establish a noninferiority of a novel three-dose recombinant rabies G protein vaccine to be administered as simulated postexposure prophylaxis when compared to five-dose WHO prequalified vaccine for better safety and immunogenicity.A multi-centric, open label, assessor blind, center-specific block randomized, parallel design, phase III clinical study was conducted among 800 subjects. The eligible subjects were randomized in 2:1 ratio for recombinant rabies G protein vaccine and the reference vaccine. Subjects in recombinant rabies G protein vaccine arm received three doses of vaccine on days 0, 3, and 7, while subjects in reference vaccine arm received five doses of WHO prequalified vaccine on days 0, 3, 7, 14, and 28.The socio-demographic characteristics of the two arms were comparable. About 9.9% subjects in recombinant rabies G protein vaccine arm and 17.2% subjects in reference arm reported adverse events. The sero-protection on day 14 was found to be 99.24% and 97.72% in recombinant rabies G protein vaccine arm and reference vaccine arm respectively and the difference was statistically nonsignificant.The novel three-dose recombinant rabies G protein vaccine administered as simulated postexposure prophylaxis was noninferior to five dose WHO prequalified vaccine in terms of safety and immunogenicity.

The novel Coronavirus Disease 2019 (COVID-19) is a pandemic of great public health and clinical concern due to its high rate of infectivity, and subsequent morbidity and mortality. The objectives of the study were to 1) assess individual experiences with testing and symptoms of COVID-19 infection; 2) determine the extent to which individuals experienced COVID-19 post-exposure symptoms; and 3) determine if an association exists between pre-existing conditions and severity of COVID-19 symptoms with post-exposure symptoms. One hundred and twenty-one (N= 121) New York State residents who had COVID-19 symptoms and were tested positive for the virus participated in this study. The survey was created in Qualtrics, and the link was posted online (Facebook, Twitter, Snap Chat), and sent to New Yorkers via email and WhatsApp to gather data. Data were exported from Excel spreadsheet to Statistical Package for the Social Sciences (SPSS), version 25, where Chi-Square tests were conducted. Results indicated that most of the participants were between ages 18-35 (54.5%), African Americans (50.4%), non- Hispanic (65%), female (69.4%), had less than a college degree (51%), and made an income in 2019 of less than $55,000 per year (62%). Eighty-seven (approximately 73%) of the participants reported that getting access to testing was easy/very easy. More than one-half reported that they experienced fatigue (66.9%), lack of energy (61.2%), headache (57.9%), muscle ache (53.7%), cough (50.4%), and loss of smell (50.4%) while infected with COVID-19. Participants who experienced symptoms described their most bothersome symptom as severe (37%), followed by mild (33%), and moderate (27%). There was a statistically significant relationship between severity of symptoms and post-exposure problems experienced by participants (X2 = 13.69; df = 2; p = .001); as well as between pre-existing conditions and post-exposure problems experienced by participants (X2 = 10.53; df = 1; p = .001). Information from this study could benefit public health practitioners and clinicians by improving their knowledge about COVID-19 and its impacts on survivors.

Background: Nurses are most vulnerable group for having Hepatitis B Virus (HBV) infection from blood and body fluids. These infections are prevent­able if the nurses have proper knowledge regarding Post Exposure Prophy­laxis (PEP) for hepatitis B virus infections and utilize the PEP services. This study aimed to find out the nurses’ knowledge on PEP for HBV infection. Methods: A descriptive survey design was carried out among 116 random­ly selected nurses working in different wards of tertiary care hospital. Data was collected from July 8th 2018 to 21st July 2018 using pre-tested self-administered questionnaire. Descriptive statistics was used to describe the variables and chi-square test was applied to explore the association between variables. Results: Results of the study revealed that only 22.4% nurses had good, 21.6% had average, and 56.0% had poor knowledge on PEP for HBV. Majority (68.1%) of the nurses knew about the testing of HBsAg serum antigen after exposure. However, few nurses had knowledge on risk per­centage of getting infection (29.3%), contact person for risk assessment (33.6%), constituents of PEP (29.9%), and PEP treatment for unvaccinat­ed/incompletely vaccinated nurse in case of positive (38.8%) and negative (34.5%) sources. Moreover, working unit (p=0.037) and working experi­ence (p=0.027) were the significant variables associated with the level of knowledge on PEP. Conclusions: More than half of nurses’ have poor knowledge on PEP for hepatitis B virus. Hence, there is need of regular in-service education and training for nurses on PEP for HBV to enhance their knowledge and to pre­vent potential infections.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), exhibits high levels of mortality and morbidity and has dramatic consequences on human life, sociality and global economy. Neutralizing antibodies constitute a highly promising approach for treating and preventing infection by this novel pathogen. In the present study, we characterize and further evaluate the recently identified human monoclonal MD65 antibody for its ability to provide protection against a lethal SARS-CoV-2 infection of K18-hACE2 transgenic mice. Eighty percent of the untreated mice succumbed 6–9 days post-infection, while administration of the MD65 antibody as late as 3 days after exposure rescued all infected animals. In addition, the efficiency of the treatment is supported by prevention of morbidity and ablation of the load of infective virions in the lungs of treated animals. The data demonstrate the therapeutic value of human monoclonal antibodies as a life-saving treatment for severe COVID-19 infection., Here, using the K18-hACE2 transgenic mice model, the authors report the in vivo efficacy of a fully human neutralizing antibody against SARS-CoV-2 and show that when administered before or up to 3 days post infection, treated mice do not exhibit disease symptoms while 80% of control animals succumb to the infection.

High dose ionizing radiation exposure is associated with myelo-depression leading to pancytopenia and the expected clinical manifestations of acute radiation syndrome (ARS). Herein, we evaluated the efficacy of sargramostim (LeukineA randomized and blinded nonhuman primate (NHP) study was conducted to assess the effects of sargramostim treatment on ARS. NHPs were exposed to total body radiation (LDDelayed sargramostim treatment at 48 h post-irradiation significantly reduced mortality (In a NHP ARS model, sargramostim administered starting at 48 h post-radiation was effective to improve survival, while beneficial hematological effects were observed with sargramostim initiated up to 120 h post exposure.

Fish blood is being used for assessing the health of the fish to changing environmental conditions due to heavy metals which are regularly released by anthropogenic activities. This study assesses the effects of lead (Pb) on the Differential Leucocyte Counts (DLC) of fresh water teleost Heteropneustes fossilis. The acclimatized fish were exposed to different concentrations of lead [2.25ppm (Group B), 2.65ppm (Group C), and 2.85ppm (Group D)] and the values were compared with the control (Group A). The time interval of examination was 7, 14, 21 and 28 days post exposure. DLC showed changes in small lymphocytes resulting in the fall of 41% to 31% at 2.65 ppm of Pb during 28 days of exposure period. The large lymphocyte counts also decreased of 39% to 27% at maximum concentration and maximum exposure period (2.85 ppm Pb; 28 days). The neutrophils increased (14%) to maximum (26%) at 2.65 ppm of Pb during 28 days exposure period. The monocyte counts increased 3% to 7% during 7 and 28 days exposure period at 2.65 ppm of Pb. The counts of eosinophils increased against the toxicity of lead from 2% to 6% at maximum concentration (2.85 ppm) during 14 and 28 days exposure period. Basophils increased (1%) to 3% at 2.65 ppm of Pb at 28 days exposure period. Our studies indicated that exposure to lead results in altered leucocyte counts.

Patients with diabetes mellitus are susceptible to active tuberculosis (TB) and latent TB infection (LTBI) [1–3]. Close contact with patients with infectious TB is associated with an increased risk of having coprevalent TB or developing incident TB [4, 5]. However, information on the burden of incident TB in contacts with underlying diabetes is limited. Considering post-exposure TB in patients with diabetes, metformin has demonstrated anti-TB effects in preclinical studies and association with a low LTBI prevalence in a cross-sectional survey [6, 7]. Despite metformin's wide use and correlation with a lower TB risk in patients with type 2 diabetes (T2D) [8], the impact of metformin use during TB exposure on subsequent TB risk has not been thoroughly investigated. We aimed to obtain the rate of post-exposure incident TB, but not coprevalent TB, in T2D patients and evaluate whether TB risk can be modified by metformin use during the TB-exposure period., This TB contact cohort study showed that the risk of incident TB, not coprevalent TB, was highest in the diabetes group without metformin use during TB exposure, followed by the nondiabetes population, and was lowest in the diabetes group with metformin use https://bit.ly/3fpJyF0

Introduction. Occurrence of occupational exposure is a current problem among medical personnel. Nurses are considered to be a special occupational group exposed to risk of infection with pathogenic microorganisms. An important element of prevention is raising the workers’ knowledge and awareness in the field of occupational hazards and the possibilities of their reduction. Staff education, knowledge of infection prevention methods, and knowledge of safe procedures can reduce the number of exposures to biological material or, if they occur, limit the health consequences. Aim. The aim of the research was to assess the knowledge of nurses employed on the operating block on the risk of occupational exposure and post-exposure proceedings. Material and methods. The research after obtaining the consent of the Bioethical Commission was carried out at the turn of 2017 and 2018 in a group of 100 anesthesia nurses employed on operating blocks of two hospitals in the Podkarpackie Voivodeship. The author’s questionnaire was used for the research. Obtained results were subjected to statistical analysis, in which the Mann-Whitney U test, the Kruskal-Wallis test and the correlation of Spearman’s rank order were used. During the statistical verification of the collected material, p Results and conclusions. The examined anesthesia nurses had knowledge about post-exposure procedures at a very good level (the average number of correct answers in the conducted test of knowledge was 14.41 out of 18, which constituted 80.06% of correct answers). The level of knowledge of the examined nurses was not dependent on such factors as: seniority, education, postgraduate education, training during the adaptation period on the operating block, adherence to epidemiological procedures, work on the post in which the procedure for occupational exposure is implemented and followed. The age of the nurses significantly influenced their level of knowledge.

To assess and describe the use of rabies post-exposure prophylaxis (PEP) related to mass bat exposures (MBEs) in the literature and in the state of Rhode Island. Data on MBE events occurring between 2010 and 2016 from the Rhode Island Department of Health (RIDOH) were reviewed to determine PEP usage. For comparison, a systematic review was also performed by searching PubMed, EMBASE, Cochrane Library and Web of Science using the keywords 'rabies,' 'bat' and 'exposure.' There were three MBE events in Rhode Island between 2010 and 2016 in which groups of individuals were asleep during the potential exposure. As a result, RIDOH provided PEP to those involved in the event. In a systematic review of 12 published reports, a variety of settings were involved in MBEs: camping sites, a domestic flight, a neonatal intensive care unit and dormitories. The number of potential rabies exposures ranged from five to 1,429 people. PEP recommendations for assessed persons ranged from 0% to 100% across events (median 21%). The variation in PEP recommendations following a MBE may be dependent on medical need, past precedent or preference. Federal guidance for MBE is needed to add clarity and to minimize the variability in PEP recommendations for such events in the future.

This study investigates whether knowledge gains from news post exposure are different when scrolling through a social media newsfeed on a smartphone compared to a desktop PC. While prior research has mostly focused on new platforms people receive news on (e.g., social media) for political learning, first indications exist that device modality (i.e. exposure on smartphone vs. desktop PC) itself alters news exposure patterns. With the help of mobile eye-tracking, this study investigates cognitive processes that enable learning from exposure among a student sample (n = 122). We extend prior research on the mediating role of attention for learning by investigating whether different frames of political news posts can attenuate this indirect relationship. The study uses a 2 × 2 mixed-subjects design, with the device being a between-subjects condition and news frames (episodic vs thematic) being a within-subjects condition. We find smaller knowledge gains from smartphone news exposure, which cannot be explained by differences in visual attention.

INTRODUCTION: The development of therapeutics and vaccines to combat Risk Group 4 pathogens, which are associated with high case-fatality rates, is a high priority. Post-exposure prophylactic vaccines have the potential to bridge classical therapeutic and vaccine applications, but little progress has been reported to date. AREAS COVERED: This review provides an overview of post-exposure prophylactic vaccine candidates against Risk Group 4 pathogens. EXPERT OPINION: A few candidate post-exposure prophylactic vaccines protect experimental animals infected with a few Risk Group 4 pathogens, such as filoviruses or hantaviruses, but efficacy of candidate vaccines has not been similarly reported for most other high-consequence pathogens. A major drawback for the further development of existing candidates is the lack of understanding of their mechanisms of action, knowledge of which could help to identify focused paths forward in vaccine development and licensure. These drawbacks to further development ultimately slow progress toward post-exposure prophylactic vaccine licensure.

Exposure to high level of noise, may cause the permanent cochlear synaptic degeneration. In present study, a model of noise induced cochlear synaptopathy was established and the electrophysiological and histological metrics for its assessment was designed. 6 Guinea pigs were subjected to a synaptopathic noise (octave band of 4 kHz at 104 dB SPL, for 2-h). The amplitude growth curve of Auditory Brainstem Response (ABR) wave-I and wave-III latency shift in presence of noise were calculated. These indexes were considered in pre-exposure, 1 day post exposure (1DPE), 1 week post exposure (1WPE) and 1 month post exposure (1MPE) to noise. Finally, the samples were histologically analyzed. ABR wave-I amplitude was different between pre and 1DPE (p-value � 0.05). However, at 1WPE, it was recovered at low intensities but at 70 dB SPL and above, the differences persisted even till 1MPE. In masked ABR, the latency shift of wave-III was different between pre and 3 post exposure assessments (p-value � 0.05). Electro-microscopic analysis confirmed the synaptic degeneration, as the ribbons were larger than normal, hollow inside, and spherical and irregular in shape, also, the post synaptic density was abnormally thick and missed its flat orientation. These data revealed that noise at level below that can produce permanent hearing loss, can incur synaptic injury. So, noise is considered to be more damaging than previously thought. Accordingly, designing tools for clinical assessment of synaptopathy is beneficial in comprehensive auditory evaluation of those with history of noise exposure and also in hearing protection planning. © 2020 Tech Science Press. All rights reserved.

Exposure to either natural or simulated hypoxia induces hematological adaptations that may affect the parameters of the Athlete Biological Passport (ABP). The aim of the present study was to examine the effect of a novel, mixed hypoxic dose protocol on the likelihood of producing an atypical ABP finding. Ten well-trained middle-distance runners participated in a "live high, train low and high" (LHTLH) altitude training camp for 14 days. The participants spent ˜6 hr.d-1 at 3000-5400 m during waking hours and ˜10 h.d-1 overnight at 2400-3000 m simulated altitude. Venous blood samples were collected before (B0), and after 1 (D1), 4 (D4), 7 (D7), and 14 (D14) days of hypoxic exposure, and again 14 days post exposure (P14). Samples were analyzed for key parameters of the ABP including reticulocyte percentage (Ret%), hemoglobin concentration ([Hb]), and the OFF-score. The ABP adaptive model was administered at a specificity of 99% to test for atypical findings. We found significant changes in [Hb] and Ret% during the hypoxic intervention. Consequently, this led to ABP threshold deviations at 99% specificity in three participants. Only one of these was flagged as an "atypical passport finding" (ATPF) due to deviation of the OFF-score. When this sample was evaluated by ABP experts it was considered "normal". In conclusion, it is highly unlikely that the present hypoxic exposure protocol would have led to a citation for a doping violation according to WADA guidelines.

Graphical abstract, Highlights • Aircraft engine oils 4 h dermal exposures induced slight skin irritation in rabbits. • Used oils enhanced irritation under semi-occlusive conditions compared to new oils. • Test site occlusive dressing less irritating compared to semi-occlusive dressing. • Data suggest irritation enhancement under semi-occlusive dressing as the oils age., There is little data available on toxicity levels of used aircraft engine oils relative to their unused (new) versions. This study was conducted to determine if new engine oils and their used versions have the potential to induce dermal irritation. Twelve male New Zealand White rabbits (Oryctolagus cuniculus, 19 weeks old) were used to determine the acute dermal toxicity potential of four aircraft turbine oils including MIL-PRF-7808 Grades 3 and 4 and MIL-PRF-23699 Grade 5 High Thermal Stability (HTS) and a Grade 5 experimental aircraft engine oil in their unused and used or laboratory stressed states. Five fur-free test sites (6 cm2 each) located lateral to the midline of the back were treated with two undiluted (0.5 ml) new engine oils and their used versions. The fifth site received reverse osmosis deionized (RODI) water as a control. Each treatment was repeated 3 times (3 rabbits/oil type). Each oil was tested under both semi-occluded and occluded conditions. The 4 h exposure was followed by gauze plus wrappings removal, and gentle cleaning of sites prior to scoring for erythema and edema at 0.5–1, 24, 48 and 72 h post exposure based on Draize (1959). E-collars were placed on each animal for at least 72 h to prevent ingestion of the test substance and/or gauze and wrappings and/or disturbance of site recovery. Additional observations were made on days 7, 10 and 14 to determine recovery. Exposure to both used and new oils produced dermal irritation consisting of no more than very slight to well-defined erythema and very slight edema. The calculated Primary Dermal Irritation Index (PDII) indicated that all the oils were slightly irritating (means ranged from 0.42 to 1.08). Although the PDII values for new oils and their used versions were not significantly different from each other, they were all statistically higher (p

As it is known the progression of COPD of occupational etiology occurs mostly after the termination of work under harmful conditions. Thus, the studying of the cellular immunity state and its role in the processes of sanogenesis and pathogenesis of the disease within different terms after termination of work under harmful working conditions in this category of patients is relevant. The object and methods of research. There were examined 69 employees of mining industry with COPD of occupational etiology. The average age of workers was 56.2 ± 2.1 years, their work record under harmful conditions was about 18.4 ± 0.6 years. Group I consisted of 27 workers with a post-exposure period of up to 5 years, Group II therefore – 20 workers with a post-exposure period of 5-10 years, Group III – 22 workers with a post-exposure period of more than 10 years. The control group comprised 21 (for hemogram indicators) and 10 (for systemic cellular immunity indicators) virtually healthy employees of mining industry. Results of the research and their discussion. The dynamics of cellular element indicators of general immunity was studied for objective assessing the features of the pathogenesis of COPD of occupational etiology among employees of mining industry in the post-exposure period. It has been defined that in some hemogram indices in the post-exposure period, there is a tendency to increasing the number of leukocytes, lymphocytes, relative number of bacillonuclear neutrophils, whose indices have a maximum value in patients with a post-exposure period of more than 10 years, and in relation to lymphocytes – in the early post-contact period (under 5 years). At the same time, direction towards a decrease in the relative number of monocytes and segmented neutrophils is observed primarily in the group with a post-exposure period of 5-10 years. Also according to the indices of cellular immunity the main subpopulations of T-lymphocytes are tended to decreasing with the increased time of post-exposure period. Thus, the lowest indices of CD3 + , CD19 and CD3 + , CD56 + were detected in patients with the highest post-exposure period (more than 10 years), respectively 72.3 ± 2.6% and 5.9 ± 0.7%, and indices CD14 and CD3 - , CD56 + were the smallest in the group with a post-exposure period of 5-10 years, respectively 5.9 ± 0.6% and 10.5 ± 1.8%. On the contrary, an increase of the post-exposure period led in this group to an increase in other T-cell indices – the general immunity link – CD4 + , CD8 - and CD4 -, CD8 + , respectively, up to 44.8 ± 2.1% and up to 24.6 ± 2.6%, and CD4 +, CD8 - \ CD4 -, CD8 + up to 2.2 ± 0.3. The revealed changes should be assessed as signs of chronic inflammation in the bronchial mucosa with symptoms of a slight activation of the T-helper subpopulation of lymphocytes, which indicates more “strong” immune response in patients with a post-exposure period of 5-10 years, with a tendency to “decrease” its activity in patients with a post-exposure period over 10 years and the formation of the normoergic state of the cellular link of general immunity in this category of patients. The content of CD3 + , CD56 + tended to increase, reaching maximum values in patients with a post-exposure period of 5-10 years (to 7.2 ± 2.0%) with a subsequent decrease in employees with post-contact period over 10 years (to 5.9 ± 0.7%) and, on the contrary, CD3 - , CD56 + (up to 14.1 ± 2.4%) had the maximum values in the group of employees with a post-exposure period over 10 years. The content of CD14 after termination of work under harmful conditions decreased to 5.9 ± 0.6% (in the group of 5-10 years), and the level of total leukocyte antigen did not change significantly. Conclusions. The revealed changes in the cellular link of the general immunity indicate that in the post-exposure period in patients with COPD of occupational etiology the processes of its activation occur, a tendency to decreasing in the content of monocytes / macrophages indicates the prolongation of the chronic inflammatory bronchopulmonary process. At the same time, the constant content of the total leukocyte antigen indicates the activation of differentiation of hematopoietic cells from immature to mature forms. The obtained results require the further developing effective methods for the treatment and prevention of COPD of occupational etiology in mining employees in the post-exposure period. Perspectives for further investigations. The data obtained require the further research aimed on development of effective therapy methods and prevention of COPD of occupational etiology among mining employees in postexposure period.

There was executed the examination of patients with occupational chronic mercury intoxication in the post-exposure period after the exposure to metallic mercury vapor. 47 persons with an established diagnosis of chronic mercury intoxication (HMI) passed the laboratory and immunological examination in the period of exposure to metallic mercury vapor in a production environment. The average age of men accounted for 49.2±1.2 years. The experience of work in hazardous working conditions amounted of 21.65±1.61 years (1 observation). All these same cases were observed in the institute clinic again after 5 years (2 observation) and 10 years (3 observation). A control group of healthy men consisted of 47 cases included persons of representative both age and general work experience, without a professional route of contact with hazardous substances. The level of such cytokines as IL-1β, IL-2, IL-4, IL-6, TNF-a, INF-y and neurotropic IgG class antibodies directed to proteins of the nervous tissue (NF-200, GFAP, MBP, B-dependent Ca-channel, Glu-R, DA-R, R-GABA, Ser-R, R-Chol, DNA, B2GP) in serum were determined by enzyme linked immunosorbent assay. There was established the gain in the imbalance of inflammatory mediators and production ofneural antibodies in dynamics after the termination of the production in conditions of metallic mercury vapors. Revealed features of the regulatory relationship between the level of cytokines and the severity of the autoimmune process were shown to contribute to the maintenance and progression of neurodegenerative processes. There was recommended the identification of immunoregulatory markers (IL-1β, IL-4, TNF-a, NF-AT to 200, GFAP, S-100) as an additional criteria for the diagnosis of health disorders in operating and monitoring the course of the progredient professional mercury intoxication.

DOI: https://doi.org/10.3126/bjhs.v4i1.23935 Introduction: Studies have shown different views regarding the effect of music in vitals e.g Heart rate (HR), Blood pressure (BP) and atiention. The effect of preferred music with lyrics in vitals and reaction time in stroop test has not been performed in Nepalese students so, we conducted the study. Objective: To find out the change in HR, BP and reaction time in Stroop test before and after their preferred music with lyrics. Methodology Thirty male medical and paramedical students aged 25.27 ± 2.0 participated in study. The vital signs and reaction time in Stroop test before and after music was taken. Results Paired-t test was used to compare means before and after exposure to music. The means are expressed as Mean ± SD. Heart rate (HR) increased after exposure to music (66.33±9.51 Vs 67.2±8.44) (p

Introduction: This study was conducted to evaluate the knowledge, attitudes and practices (KAP) of patients attending the general outpatient department in Malda Medical College about rabies.Methods: A structured questionnaire was answered by 161 participants. The KAP score was calculated according to the response of the participant.Results: Compared to adults, children in the 10-15year age group scored much less in all components of rabies prevention and post exposure management.Conclusion: There was lack of awareness about post exposure prophylaxis of rabies in children. Awareness campaigns especially focusing on children are required to provide better medical care.

Francisella tularensis is a virulent bacterium which hijacks the host’s immune response, turning cells usually tasked with killing foreign organisms as nutrient-rich receptacles for rapid multiplication. It is designated a Tier 1 Select Agent by the US CDC due to its potential to cause widespread mortality upon deliberate release. In this study, the key biological mechanisms of host infection are modelled as a continuous-time Markov chain (CTMC) and solved via discrete event simulation (DES). The efficacy of various medication strategies at the behest of public health authorities are investigated. Without treatment, the median lethal dose–not previously considered in humans–is estimated at approximately 1,000 organisms. Results suggest that fatality can be averted if antibiotics are administered for at least 7 days, no later than 10 days post exposure. In a mass casualty setting, this can reduce symptomatic cases by 18% from the baseline involving no medication. Reductions of 59% are possible if medication can be disseminated no later than 5 days post exposure, mitigating otherwise severe pressure on healthcare services. Novel use of CTMC and DES highlight the potential for OR in the field of immunology, where further opportunities may present in a post COVID-19 world.

Rabies is a zoonosis caused by Lyssavirus, with progressive development and a high lethality rate. In Brazil, rabies and accidents caused by animals potentially transmitting the disease are mandatory notification injuries. Exposure to rabies infection places a high financial burden on public health systems, especially for the care of people who are exposed and have a high risk of death. We aimed to define the epidemiological profile of human rabies post-exposure assistance in the municipality of Santa Maria, Rio Grande do Sul, Brazil, from 2010 to 2015. Data from Brazil's Notifiable Diseases Information System were obtained and analyzed; these data were acquired by the completion of individual inquiry forms querying human anti-rabies assistance. A total of 55% (1,898/3,453) of anti-rabies assistance cases involved women and 45% (1,555/3,453) men. The highest occurrence (54.5%–1,882/3,453) was in the age group of 20–59 years. Most registered cases (87.5%–3,024/3.453) were caused by dogs, followed by cats (10.9%–378/3,453). The lower limb (22.1%–617/2,790) was the area of the body with the highest number of canine bites. We observed incorrect indications for the treatment. We suggest further training for health professionals involved in rabies post-exposure prophylaxis care, and dissemination of information aimed at educating users about the importance of animal-related injuries. A raiva é uma zoonose causada por Lyssavirus, com desenvolvimento progressivo e alta taxa de letalidade. No Brasil, a raiva e os acidentes causados por animais potencialmente transmissores da doença, são agravos de notificação obrigatória. A exposição à infecção por raiva coloca um alto ônus financeiro para o sistema público de saúde, especialmente para o atendimento de pessoas expostas e com alto risco de morte. O objetivo deste estudo foi definir o perfil epidemiológico da assistência pós-exposição à raiva humana no município de Santa Maria, Rio Grande do Sul, Brasil, de 2010 a 2015. Foram obtidos e analisados os dados do Sistema de Informações sobre Doenças Notificáveis do Brasil (SINAM); adquiridos por meio do preenchimento de formulários de consulta individuais, verificando a assistência antirrábica humana. Um total de 55% (1.898/3.453) e 45% (1.555/3.453) dos casos de assistência anti-rábica envolveu mulheres e homens respectivamente, com maior ocorrência na faixa etária de 20 a 59 anos (54,5% - 1.882/3.453). A maioria dos casos registrados (87,5% - 3.024/3.453) foi causada por cães e 10,9% (378/3.453) por gatos. O membro inferior (22,1% - 617/2.790) foi a área do corpo com o maior número de agressões por cães. Desta forma, sugere-se o treinamento para profissionais de saúde envolvidos no tratamento profilático da raiva após a exposição e disseminação de informações destinadas a educar os usuários sobre a importância das lesões relacionadas a animais.

BackgroundTesting asymptomatic contacts of confirmed COVID-19 cases for the presence of SARS-CoV-2 could reduce onward transmission by improving case ascertainment and lessen the impact of self-isolation on un-infected individuals. This study investigated the feasibility and acceptability of implementing a ‘test to enable approach’ as part of England’s tracing strategy.MethodsContacts of confirmed COVID-19 cases were offered serial testing as an alternative to self-isolation using daily self-performed lateral flow device (LFD) tests for the first 7 days post exposure. Asymptomatic participants with a negative LFD result were given 24 hours of freedom from self-isolation between each test. A self-collected confirmatory PCR test was performed on testing positive or at the end of the LFD testing period.ResultsOf 1,760 contacts, 882 consented to daily testing, with 812 within 48 hours of exposure sent testing packs. Of those who declined to participate, 39.1% stated they had already accessed PCR testing. Of the 812 who were sent packs, 570 (70.2%) reported one or more LFD results; 102 (17.9%) tested positive. Concordance between reported LFD result and a supplied LFD image was 97.1%. 82.8% of PCR positive samples and 99.6% of PCR negative samples were correctly detected by LFD. The proportion of secondary cases from contacts of those who participated in the study and tested positive (6.3%; 95% CI: 3.4-11.1%) were comparable to a comparator group who self-isolated (7.6%; 95% CI: 7.3-7.8%).ConclusionThis study shows a high acceptability, compliance and positivity rates when using self-administered LFDs among contacts of confirmed COVID-19 cases. Offering routine testing as a structured part of the contact tracing process is likely to be an effective method of case ascertainment.

PurposeNext generation sequencing has expanded our understanding of many disease processes, including trauma and critical illness. Many studies focus identifying a small set of genes or proteins that are aberrantly expressed. Our objective was to determine whether global differences in pre-mRNA processing entropy, or disorder, could offer novel insights in the setting of critical illness.MethodsWe used an established murine model of trauma that consisted of hemorrhagic shock and cecal ligation and puncture. In our first experiment mice exposed to trauma were compared to controls. In our second experiment, survival 14 days after exposure to trauma was studied. Using deep RNA sequencing we determined entropy values for every pre-mRNA processing event identified. We then used principal component analysis (PCA) to conduct unsupervised classification of the data.ResultsMice exposed to trauma separated from controls using PCA. Similarly, mice that did not survive 14 days post exposure clustered closely together on PCA.ConclusionOur results suggest that there is a substantial difference in global pre-mRNA processing entropy in mice exposed to trauma vs. controls, and that pre-mRNA processing entropy may be helpful in predicting mortality. The method introduced here is easily transferrable to other disease processes and samples.

There have been notable advances in the development of vaccines against active tuberculosis (TB) disease for adults and adolescents. Using mathematical models, we seek to estimate the potential impact of a post-exposure TB vaccine, having 50% efficacy in reducing active disease, on global rifampicin-resistant (RR-) TB burden. In 30 countries that together accounted for 90% of global RR-TB incidence in 2018, a future TB vaccine could avert 10% (95% credible interval: 9.7–11%) of RR-TB cases and 7.3% (6.6–8.1%) of deaths over 2020–2035, with India, China, Indonesia, Pakistan, and the Russian Federation having the greatest contribution. This impact would increase to 14% (12–16%) and 31% (29–33%) respectively, when combined with improvements in RR-TB diagnosis and treatment relative to a scenario of no vaccine and no such improvements. A future TB vaccine could have important implications for the global control of RR-TB, especially if implemented alongside enhancements in management of drug resistance., Vaccines preventing tuberculosis disease progression have shown promising results in recent trials. Here, the authors use mathematical modelling to estimate that this type of vaccine could avert 10% of cases of rifampicin-resistant tuberculosis and 7% of deaths from 2020-2035.

Sixteen full-time office-based workers were exposed to extended periods working with regularly sit-stand changing table surface. The angular adduction and flexion deviations of upper arms (mousing and keying), thighs and shins were measured with 2-D inclinometers and average value calculated over one hour. Comparing average segmental deviation from standing neutral showed significant variations across the study population. Mousing arm was affected by exposure, reducing average deviation significantly from Pre to Post exposure to regular sit-stand changes. Only right shin adduction varied significantly across Pre, Post and 0% standing conditions, whereas more lower limb segment deviations changed significantly across the different standing durations. Left (but not right) thigh adduction and flexion deviations varied significantly across sit-stand conditions varying from 0% to 50% standing. Flexion of both right and left shins varied significantly, but only right shin adduction varied significantly across these same sit-stand conditions. Considering Pre-Post, Pre-Post-0% standing and five alternating sit-stand periods, shin flexion and left thigh abduction conditions significantly varied but differently. The greatest number of significant segmental angular variations occurred when considering 0% to 50% standing, although those have been ignored by previous studies which report only upper body and trunk posture angles.

BACKGROUND Leprosy contacts are sensitive indicator of the magnitude of severity, and a high risk for infection and disease, especially if the individuals are exposed to the bacillus with multibacillary cases, which reinforces the need for chemoprophylactic measures, such as the use single-dose rifampicin (SDR) combined with BCG vaccine. OBJECTIVE Our study will analyze the serological response of anti-NDO-LID, HO-1/HMOX and serum IFN-γ concentration as a prophylactic measure after the use of single-dose rifampicin (SDR) combined with the Bacillus Calmette-Guérin vaccine (BCG) among multibacillary leprosy household contacts. METHODS Intervention study based on a prospective cohort of household contacts of new cases of multibacillary leprosy diagnosed and registered in the Information System on Diseases of Compulsory Declaration (SINAN – Sistema de Informação de Agravos de Notificação) and residents in the municipalities of Cuiabá and Cáceres, Mato Grosso, in the years 2019 and 2020. Contacts with no signs and symptoms compatible with the disease of the intervention group will receive single-dose rifampicin (SDR) combined with BCG vaccine and will be compared to the control group. The follow-up of the cohort will last 12 months. The analyses of the anti-NDO-LID, HO-1/HMOX and serum concentration of IFN-γ tests as immunological markers before, 6 and 12 months after the intervention will be conducted in a reference laboratory (FIOCRUZ). RESULTS The study is still recruiting participants and is expected to be completed in September 2020. CONCLUSIONS Our study seeks to analyze the response of anti-NDO-LID, HO-1/HMOX tests and serum IFN-γ concentration as a prophylactic measure after the use of single-dose rifampicin (SDR) combined with the Bacillus Calmette-Guérin vaccine (BCG) in home contacts of multibacillary leprosy cases. CLINICALTRIAL Brazilian Registry of Clinical Trials (ReBEC), RBR-6yg2z9. Retrospectively registered on 3 de Out. de 2019.

Background: Instruments used in the operative area are colonised by various microbial organisms during usage. Sterilization is an important prerequisite to avoid cross contamination. Purpose of the study: The purpose of this study was to evaluate whether presterilization has any influence on conservative and endodontic material sterility, immediately after unpacking and post exposure to clinical environment for 15 days. Methods: Gutta percha cones, Rubber dam clamps, Impression trays, Dental burs (#245 bur, Access opening bur) were tested.Materials were randomly sampled at 2 time points (t0, at package opening; t1, at 15days) during their clinical usage. Vortexing, centrifuging, streak and inoculation was done. Colony formation under aerobic conditions was observed on media before and after presterilization. Statistical analysis: Wilcoxon matched pairs test was done for comparison of data before and after pre sterilization with status of aerobic organisms at to (immediately after opening) and t1 (during clinical usage). Conclusion: Presterilization effectively eliminates cross contamination of various aerobic microorganisms in conservative and endodontic material immediately unpacked and post exposure to clinical environment for 15 days.

The minimum effective dose of intramuscular polyvalent immune globulin for prevention of hepatitis A post-exposure is unknown. In Australia current dosing is according to weight category.The peak concentration and decay of hepatitis A antibodies after intramuscular dosing of immune globulin in adults was modeled utilizing published parameters. Models simulated dosing according to current Australian guidelines, then adjusted the dose in clinically relevant increments to estimate the optimal dose of hepatitis A antibodies for post-exposure prophylaxis of nonimmune individuals. Optimal dosing assumed a target serum concentration of hepatitis A antibodies of the correlate of protection plus a 10% margin of error at an incubation period. The effect of weight on hepatitis A antibody concentration at an incubation period under current guidelines was examined by fixing weight in 5 kg increments.Current dosing guidelines in Australia may underdose people who weigh in excess of 85 kg. The optimal dose of hepatitis A-specific antibodies according to the model was 3.6, 2.5, and 1.9 IU/kg assuming 50%, 75% and 100% bioavailability respectively.For individuals in Australia recommended passive immunization as post-exposure prophylaxis and weighing in excess of 85 kg, conservative management would include dosing between 2.5 and 3.6 IU hepatitis A antibodies/kg.

The 2013–2016 Ebola virus (EBOV) disease epidemic demonstrated the grave consequences of filovirus epidemics in the absence of effective therapeutics. Besides EBOV, two additional ebolaviruses, Sudan (SUDV) and Bundibugyo (BDBV) viruses, as well as multiple variants of Marburg virus (MARV), have also caused high fatality epidemics. Current experimental EBOV monoclonal antibodies (mAbs) are ineffective against SUDV, BDBV, or MARV. Here, we report that a cocktail of two broadly neutralizing ebolavirus mAbs, FVM04 and CA45, protects nonhuman primates (NHPs) against EBOV and SUDV infection when delivered four days post infection. This cocktail when supplemented by the anti-MARV mAb MR191 exhibited 100% efficacy in MARV-infected NHPs. These findings provide a solid foundation for clinical development of broadly protective immunotherapeutics for use in future filovirus epidemics., Current experimental monoclonal antibodies (mAbs) for Ebola virus (EBOV) post-exposure immunotherapy are ineffective against Sudan (SUDV) or Marburg virus (MARV). Here, authors develop cocktails of mAbs that protect nonhuman primates against EBOV, SUDV, and MARV infection when given four days post infection.

From 2007 to 2017 sixty-three (63) new cases of human rabies have been identified in Mali on an estimated total population in 2017 of 17,650,195 inhabitants. This is an incidence of 0.32 cases for 100,000 inhabitants. All these cases occurred in urban areas and involved the two sexes. The age group most affected was the one less than 20 years old. The majority of the victims (73.1%) were pre-schools, school-aged pupils and housewives. In 97% of the cases, the animal in question was a dog and the type of exposure of the bite. Eighty-two percent (82%) of the victims had received no local medical treatment or the post exposure quasi prophylaxis treatment. The median duration between the first symptoms and death among the cases of human rabies was 3 to 7 days. The median duration between the occurrence of the first signs and death was four (4) days. No virological confirmation had been conducted on the patients. The rage disease is retained as a priority disease, since the adoption of the strategy of “integrated monitoring of the disease and response” in 2008. However, in spite of the efforts made, progress still remains to be effected to assess the actual impact of rabies in Mali.

As part of a series of studies to determine frequency-dependent susceptibility to temporary hearing threshold shifts (TTS), two female harbor seals (F01 and F02) were exposed for 60 min to a one-sixth-octave noise band centered at 40 kHz at mean sound pressure levels ranging from 126 to 153 dB re 1 μPa [mean received sound exposure level (SEL) range: 162–189 dB re 1 μPa2s]. TTSs were quantified at 40, 50, and 63 kHz within 1–4 min of the exposure for F02 and within 12–16 min of the exposure for F01. In F02, significant TTS1–4 (1–4 min post exposure) occurred at 40 kHz with SELs of ≥183 dB re 1 μPa2s and at 50 kHz with SELs of ≥174 dB re 1 μPa2s. At 63 kHz, TTS1–4 occurred with SELs ≥186 dB re 1 μPa2s. In F01, significant TTS12–16 (12–16 min post exposure) occurred only at 50 kHz with SELs of ≥177 dB re 1 μPa2s. The highest TTSs (27.5 dB in F02, 29.8 dB in F01) occurred at 50 kHz, one-third of an octave above the fatiguing sound's center frequency (SEL = 189 dB re 1 μPa2s); recovery took 2 days in F02 and 4 days in F01. In most other cases, recovery was within 1 h. The seals have a similar susceptibility to TTS from 4 to 40 kHz.

The health of the working population is an important characteristic of the economic and social state of the country. Occupational diseases according to WHO is the cause of 1.7 million deaths in the world. The third place in the structure of occupational morbidity is occupied by vibration-noise pathology (5-18%). In this group, cases of vibration disease (VD) make up 60-70%. In the structure of diseases of the circulatory system (DCS) among the adult population, cerebrovascular diseases (CVD) rank third after hypertension and coronary heart disease and make up 16.8%. Death rate from CVD takes the 4th place in the world. To develop a forecast for the emergence of CVD in patients with VD caused by whole-body vibration, we analyzed a number of anthropometric and physiological indicators. There was performed a profound in patient examination of 179 patients with VD (149 workers of mining enterprise with surface mining operations with VD caused by whole-body vibration without CVD and 30 patients with diagnosed CVD in addition to CVD). The diagnostic value of individual anthropometric indicators and indicators of systemic hemodynamics (arterial pressure) in VD caused by whole-body vibration and CVD in these patients was proved. Increased body weight with fat distribution by the abdominal type increases the risk of early VD and CVD occurrence. The regularity of dependence of arterial hypertension onset (increase of blood pressure above the level of 140/86 mm Hg) with the duration of the harmful effect of vibration was determined. At the same time, the share of workers with optimal blood pressure figures decreases with increasing duration of the action of the whole-body vibration. Thus, the metabolic and blood pressure indicators can be used to further construct predictive models for the development of CVD in patients with VD caused by whole-body vibration.

Our aim was to prospectively manage 22 Brucella-exposed individuals and identify the lapses in laboratory practices that lead to the exposure. The exposed individuals were risk-stratified, assessed for post-exposure prophylaxis (PEP), counselled to self-monitor symptoms and followed-up with three serology tests. Staff laboratory practices were recorded. Ten out of 13 high-risk individuals received PEP within 48 h of exposure. Compliance with PEP and serology monitoring was 90 and 96 %, respectively. No brucellosis cases were documented. A single handler manipulated the Brucella isolate on the open bench. Movement of the isolate was tracked in detail, highlighting various points of laboratory non-conformance. Early PEP intervention is effective in preventing acquired brucellosis. Our pragmatic post-exposure management achieved high PEP and serology compliance. We experience first-hand how regular staff engagement motivated PEP adherence and interval blood sampling attendance. The enforcement of practical strategies and safety practices was also implemented without compromising our laboratory processing times.

Several workers were internally exposed to 7Be particles following their dispersion in air from a damaged electrodeposited source. A series of in vivo measurements performed with one worker up to 108 days post exposure determined that retention of 7Be in the thoracic region of the respiratory tract was best described by a two-component exponential function with half-lives of ~0.4 and ~109 days. The initial deposition in the thoracic region was estimated to be 6.8 kBq. The concentration of 7Be in single void urine samples collected from this worker up to 3 days post intake ranged from 1 to 10 Bq/l. In the absence of specific knowledge about the physical and chemical characteristics of the inhaled particles, the committed effective dose was estimated to be 0.3 μSv.

The data presented here detail the changes in size, cellular content, and neuronal density of the developing brain over time with respect to sex in C57Bl/6 mice following neonatal exposure to isoflurane, carbon monoxide, or their combination. Specifically, brain weight- and brain volume-to-body weight ratios are presented, representative immunoblots of whole brain cell-specific protein content are depicted, and quantification of the number of neurons in the primary somatosensory cortex and CA3 region of the hippocampus are shown. Three discrete postnatal time points are represented: P7 (prior to exposure), P14 (one-week post exposure), and P42-56 (5–7 weeks post exposure). Major findings from the data presented here are reported in the manuscript “Carbon Monoxide Incompletely Prevents Isoflurane-induced Defects in Murine Neurodevelopment" (Wang et al., in press) [1] .

Anaesthetic efficacy of eugenol was investigated on Pterophyllum scalare. A total of 130 fish with average weights of 1.0 ± 0.5, 5.0 ± 1.0 and 10.0 ± 1.0 g were subjected to 1.25, 2.5, 4.0, 5.5 and 7.0 mg/L eugenol, and behavioural responses were observed. Induction and recovery times were significantly affected by the interactive effect of eugenol concentration and fish weight (p

BackgroundTimely diagnosis of SARS-CoV-2 infection is the prerequisite for treatment and preventive quarantine. The serology characteristics and complement diagnosis value of antibody test to RNA test needs to be demonstrated.MethodA patient cohort study was conducted at the first affiliated hospital of Zhejiang University, China. Serial plasma of COVID-19 patients and were collected and total antibody (Ab), IgM and IgG antibody against SARS-CoV-2 were detected. The antibody dynamics during the infection were described.ResultsThe seroconversion rate for Ab, IgM and IgG in COVID-19 patients was 98.8% (79/80), 93.8% (75/80) and 93.8% (75/80), respectively. The first detectible serology marker is total antibody and followed by IgM and IgG, with a median seroconversion time of 15, 18 and 20 day post exposure (d.p.e) or 9, 10 and 12 days post onset, separately. The antibody levels increased rapidly since 6 d.p.o and accompanied with the decline of viral load. For patients in the early stage of illness (0-7d.p.o),Ab showed the highest sensitivity (64.1%) compared to the IgM and IgG (33.3% for both, pConclusionsTypical acute antibody response is induced during the SARS-CoV-2 infection. The serology testing provides important complementation to RNA test for pathogenic specific diagnosis and helpful information to evaluate the adapted immunity status of patient. It should be strongly recommended to apply well-validated antibody tests in the clinical management and public health practice to improve the control of COVID-19 infection.Take-Home MessageAntibody responses are induced after SARS-CoV-2 infection and complement diagnosis value of antibody test to RNA test was observed. Antibody tests are critical tools in clinical management and control of SARS-CoV-2 infection and COVID-19.

OBJECTIVE: To develop an approach for a retrospective analysis of post-exposure serum samples using diverse molecular profiles. METHODS: The 236 molecular profiles from 800 de-identified human serum samples from the Department of Defense Serum Repository were classified as smokers or non-smokers based on direct measurement of serum cotinine levels. A machine-learning pipeline was used to classify smokers and non-smokers from their molecular profiles. RESULTS: The refined supervised support vector machines with recursive feature elimination predicted smokers and non-smokers with 78% on the independent held-out set. Several of the identified classifiers of smoking status have previously been reported and four additional miRNAs were validated with experimental tobacco smoke exposure in mice, supporting the computational approach. CONCLUSIONS: We developed and validated a pipeline that shows retrospective analysis of post-exposure serum samples can identify exposures to environmental exposures.

We investigated how the processing parameters, including post exposure baking (PEB), and resist film thickness (FT) influence the dose and line width roughness (LWR) of different types of EUV resists, targeted for the high-NA EUV lithography. We compared the dose and LWR of molecular, inorganic and CAR resists at half-pitch (HP) of 16 and 14 nm for different PEB temperatures. The results show that without PEB or at lower PEB temperature, resists require higher doses, as expected. We also observed the different behavior of various resist platforms in response to variation of the film thickness. The results showed that there is a room for the optimization of the processing parameters to improve dose and LWR of molecular, inorganic and CAR resists for line/space printing at high resolution.

Blast overpressure exposure has been linked to transient, but measurably deteriorated performance and symptomatologies in law enforcement and military personnel. Overlapping sub-concussive symptomatology associated with the very low level blast overpressures (vLLB) but high sound pressure (

Regulatory authorities, including the US Food and Drug Administration (FDA), have accelerated diagnostic and therapeutic approvals during the coronavirus disease 2019 (COVID-19) pandemic. Accelerated clinical development and approvals have resulted in vaccine programs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, some individuals remain at high risk for the progression of COVID-19. In the US, the FDA has given Emergency Use Authorization (EUA) for two neutralizing therapeutic monoclonal antibody 'cocktails,' casirivimab and imdevimab (REGEN-COV), bamlanivimab and etesevimab, and one monotherapy, bamlanivimab, for prophylactic post-exposure therapy in individuals at high risk of progressing to severe COVID-19. Preclinical and clinical studies showed consistent effectiveness of REGEN-COV against current variants of SARS-CoV-2. On 21st November 2020, the FDA approved an initial EUA for REGEN-COV to treat mild to moderate COVID-19 in adults and in children 12 years or older with exposure to SARS-CoV-2 at high risk for progression to severe COVID-19. On 30th July 2021, the FDA updated its EUA for REGEN-COV for emergency use as post-exposure prophylactic to prevent COVID-19 progression in adults and children aged 12 years or older. This Editorial aims to provide an update on accelerated regulatory authorization for post-exposure prophylactic neutralizing monoclonal antibodies to SARS-CoV-2 for individuals at high risk for COVID-19.