Background: Amid the COVID-19 pandemic, healthcare systems were stretched thin, with staffing shortages posing substantial challenges. Limiting spread of COVID-19 among healthcare professionals (HCP) is paramount to preventing exacerbation of such shortages, but strategies are highly dependent on HCP self-screening for symptoms and isolating when present. We examined HCP perceptions of barriers and factors that facilitate staying home when experiencing respiratory symptoms. Methods: At an academic tertiary-care referral center, in inpatient and ambulatory settings, we conducted an anonymous electronic survey between March 11, 2022, and April 12, 2022. Using logistic regression analysis, we analyzed predictors of employees reporting to work with respiratory symptoms using STATA and SAS software. Results: In total, 1,185 individuals including 829 clinical staff and 356 nonclinical staff responded to the survey. When excluding participants who reported working “remotely” (N = 381) and those who reported being unsure of whether they had worked with symptoms (N = 14), the prevalence of working with respiratory symptoms was 63%. There was no significant difference between clinical and nonclinical staff (OR, 1.1; 95% CI, 0.8–1.5; P = .60). Increasing number of years of service was protective against working with symptoms, achieving statistically significance in multivariable analysis after 16 years. Compared to those having worked <1 year, the odds ratios of working with symptoms were 0.32 (95% CI, 0.16–0.65; P = .002), 0.33 (95% CI, 0.15–0.74; P = .007), and 0.32 (95% CI, 0.13–0.79; P = .007) for those working 16–20 years, 21–25 years, and ≥26 years, respectively. More than half of HCP who worked with symptoms identified being understaffed (56.9%), having mild symptoms (55.3%), and sense of responsibility (55.1%) as reasons to work with respiratory symptoms. The following barriers, or reasons to work with symptoms, were more commonly identified as significant by those who worked with symptoms compared to those who did not: being understaffed (OR, 1.87; 95% CI, 1.35–2.58; P ≤ .001), having mild symptoms (OR, 1.96; 95% CI, 1.42–2.71; P < .001), and lack of support from management (OR, 1.84; 95% CI, 1.07–3.18; P = .03). Conclusions: Working with respiratory symptoms is prevalent in clinical and nonclinical HCP. Those with fewer years of work experience appear to be more susceptible to misconceptions and pressures to work despite respiratory symptoms. Messaging should stress support from leadership and the significance of even mild respiratory symptoms and should emphasize responsibility to patients and colleagues to stay home with respiratory symptoms. Strategies to ensure adequate staffing and sick leave may also be high yield.

Disclosures: None

We reviewed the electronic health records of 1,419 inpatients with anterior nares (AN) and oropharynx (OP) MRSA PCR tests. Concordance was 96.5%. In discordant cases, AN negative–OP positive results increased detection of probable MRSA pneumonia by only 0.3%. A dual testing approach has limited utility in detecting MRSA pneumonia and increases resource utilization.

IPCC predictions for Honduras indicate that temperature will increase by up to 3–6°C and precipitation will decrease by up to 7–13% by the year 2050. To better understand how fern and lycophyte communities might be affected by climate change, we comprehensively surveyed the community compositions of ferns and lycophytes at Celaque National Park, the highest mountain in Honduras. We surveyed a total of 80 20 × 20 m2 plots along an altitudinal gradient of 1249–2844 m a.s.l., identifying all species and estimating their abundances. We recorded a total of 11,098 individuals from 160 species and 61 genera. Community composition was strongly influenced by changes in altitude, precipitation and the abundance of bryophytes (a proxy for air humidity). Of the 160 species, 63 are expected, under a RCP2.6 scenario for the year 2050, to shift their range fully or partially above the maximum altitude of the mountain. Of these, 65.1% are epiphytes. We found that species with narrow altitudinal ranges at high altitudes were more at risk. Our study indicated that conservation efforts should prioritise higher altitudinal sites, focusing particularly on preserving the vulnerable epiphytic fern species, which are likely to be at greater risk.

The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.

This study obtained calendar dates by radiocarbon accelerator mass spectrometry (14C AMS) dating sequential tree-rings of wooden support posts from the buried remains of traditional Kitkahahki Pawnee earthlodges preserved at an archaeological site on the Central Great Plains, USA. The tree-ring segments from the site were dendrochronologically analyzed prior to this study, but the cross-matched site chronology could not be definitively cross-dated and was thus “floating” in time. Our study represents the first floating tree-ring chronology from the Great Plains to be anchored in time by means of independent radiocarbon analysis. Three specimens were analyzed and dated to 1724–1774 CE (82.0% probability), 1774–1794 CE (95.4% probability), and 1800–1820 CE (95.4% probability). These dates correspond to the hypothetical timing of Kitkahahki ethnogensis, the main phase of village growth in the area, and a later reoccupation during a turbulent period in regional history. The results of this study conform to a scenario in which chaotic social conditions correspond to an increase in residential mobility between the core of Pawnee territory and a southern frontier in the Republican River valley.

Background: In the state of Wisconsin, 3%–4% of bats submitted for rabies testing are positive. Inpatient bat encounters at 2 affiliated healthcare facilities at nearly the same time were brought to the attention of the infection prevention and control (IPC) team. The first bat was captured in a patient room and was submitted for testing. Postexposure prophylaxis (PEP) was initiated for 1 patient before the bat testing results came back negative. The second bat was found in a transplant unit hallway and was released before we could request testing. We observed significant variations in responses, including decision to administer PEP and submission of bats for rabies testing. The IPC team developed a protocol to minimize unnecessary PEP, to prevent nosocomial rabies infection from bat exposure, and to limit associated panic. Methods: A systematic literature review of multiple databases was performed. A search of nonscientific articles using Google was also performed to assess unpublished inpatient bat encounters. A workgroup was established including IPC staff, physicians, and facilities management. The county animal services department and the state public health department veterinarian were consulted to aid in development of a protocol. Results: Literature review yielded a single report of a bat discovered in a neonatal intensive care unit (NICU). A lack of protocol resulted in PEP administration to 7 neonates without observed exposure after the bat was released instead of being submitted for testing. Of the first 100 articles retrieved via Google search of “bat in hospital,” 9 pertained to nosocomial discovery of bats in 5 different states over the past 7 years. Encounters included infestations requiring unit shutdowns and PEP administration. One tertiary-care referral center reported 10 encounters per year but did not elaborate on associated procedures. The county animal services staff assisted in training maintenance and engineering services (MES) personnel on how to secure bats for testing and helped develop a “bat kit” with protective gear and equipment to do so safely. In the new protocol, an inpatient bat encounter prompts personnel to capture the bat and begin an investigation into known or potential occult exposure. Known or potential exposures merit submission of the bat for rabies testing, the results of which guide PEP recommendations. All encounters are investigated for point of entry or roost. Conclusions: Inpatient bat encounters are not uncommon. Encounters should prompt systematic assessment for exposures and an investigation of the root cause. Following a protocol may limit unnecessary PEP administration, prevent nosocomial transmission of rabies from bat to patient, and attenuate associated anxiety.

Funding: None

Disclosures: None