Background: Nursing home (NH) residents are at high risk of COVID-19 from exposure to infected staff and other residents. Understanding SARS-CoV-2 viral RNA kinetics in residents and staff can guide testing, isolation, and return to work recommendations. We sought to determine the duration of antigen test and polymerase chain reaction (PCR) positivity in a cohort of NH residents and staff. Methods: We prospectively collected data on SARS-CoV-2 viral kinetics from April 2023 through November 2023. Staff and residents could enroll prospectively or upon a positive test (identified through routine clinical testing, screening, or outbreak response testing). Participating facilities performed routine clinical testing; asymptomatic testing of contacts was performed within 48 hours if an outbreak or known exposure occurred and upon (re-) admission. Enrolled participants who tested positive for SARS-CoV-2 were re-tested daily for 14 days with both nasal antigen and nasal PCR tests. All PCR tests were run by a central lab with the same assay. We conducted a Kaplan-Meier survival analysis on time to first negative test restricted to participants who initially tested positive (day zero) and had at least one test ≥10 days after initially testing positive with the same test type; a participant could contribute to both antigen and PCR survival curves. We compared survival curves for staff and residents using the log-rank test. Results: Twenty-four nursing homes in eight states participated; 587 participants (275 residents, 312 staff) enrolled in the evaluation, participants were only tested through routine clinical or outbreak response testing. Seventy-two participants tested positive for antigen; of these, 63 tested PCR-positive. Residents were antigen- and PCR-positive longer than staff (Figure 1), but this finding is only statistically significant (p=0.006) for duration of PCR positivity. Five days after the first positive test, 56% of 50 residents and 59% of 22 staff remained antigen-positive; 91% of 44 residents and 79% of 19 staff were PCR-positive. Ten days after the first positive test, 22% of 50 residents and 5% of 22 staff remained antigen-positive; 61% of 44 residents and 21% of 19 staff remained PCR-positive. Conclusions: Most NH residents and staff with SARS-CoV-2 remained antigen- or PCR-positive 5 days after the initial positive test; however, differences between staff and resident test positivity were noted at 10 days. These data can inform recommendations for testing, duration of NH resident isolation, and return to work guidance for staff. Additional viral culture data may strengthen these conclusions.

Disclosure: Stefan Gravenstein: Received consulting and speaker fees from most vaccine manufacturers (Sanofi, Seqirus, Moderna, Merck, Janssen, Pfizer, Novavax, GSK, and have or expect to receive grant funding from several (Sanofi, Seqirus, Moderna, Pfizer, GSK). Lona Mody: NIH, VA, CDC, Kahn Foundation; Honoraria: UpToDate; Contracted Research: Nano-Vibronix

Archaeologists have an obligation to conduct research that is relevant and responsive to the desires, interests, values, and concerns of Indigenous descendant communities. Current best practices for collaborative, community-based archaeologies emphasize long-term engagement and “full collaboration,” including the coproduction of knowledge and total stakeholder involvement. The present-day structures and demands of archaeology—especially in CRM and graduate student research contexts—can serve to make such fully collaborative work difficult, if not impossible. Oftentimes, these difficulties result in a complete abdication of collaboration or even consultation beyond the bare minimum required by law. However, professional archaeologists must strive in all instances to work alongside Native communities in respectful, responsive, and mutually beneficial ways even if this work may often fall short of the loftiest ideal. In this article, the authors present two case studies in collaboration from recent projects conducted in the North American midcontinent. These case studies clearly demonstrate how tribal fieldwork monitoring, working with tribal institutional review boards (IRBs), and other related forms of “imperfect” collaboration can still help move us toward a more ethical, inclusive, and respectful future archaeology.

Basal crevasses are macroscopic structural discontinuities at the base of ice sheets and glaciers that arise by fracture. Motivated by observations and by the mechanics of elastic fracture, we hypothesise that spatial variations in basal stress (in the presence of basal water pressure) can promote and localise basal crevassing. We quantify this process in the theoretical context of linear elastic fracture mechanics. We develop a model evaluating the effect of shear-stress variation on the growth of basal crevasses. Our results indicate that sticky patches promote the propagation of basal crevasses, increase their length of propagation into the ice and, under some conditions, give them curved trajectories that incline upstream. A detailed exploration of the parameter space is conducted to gain a better understanding of the conditions under which sticky-patch-induced basal crevassing is expected beneath ice sheets and glaciers.