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Bats subject to high rates of fatalities at wind-energy facilities are of high conservation concern due to the long-term, cumulative effects they have, but the impact on broader bat populations can be difficult to assess. One reason is the poor understanding of the geographic source of individual fatalities and whether they constitute migrants or more local individuals. Here, we used stable hydrogen isotopes, trace elements and species distribution models to determine the most likely summer geographic origins of three different bat species ( Lasiurus borealis , L. cinereus , and Lasionycteris noctivagans ) killed at wind-energy facilities in Ohio and Maryland in the eastern United States. In Ohio, 41.6%, 21.3%, 2.2% of all individuals of L. borealis , L. cinereus , and L. noctivagans , respectively, had evidence of movement. In contrast, in Maryland 77.3%, 37.1%, and 27.3% of these same species were classified as migrants. Our results suggest bats killed at a given wind facility are likely derived from migratory as well as resident populations. Finally, there is variation in the proportion of migrants killed between seasons for some species and evidence of philopatry to summer roosts. Overall, these results indicate that the impact of wind-energy facilities on bat populations occurs across a large geographic extent, with the proportion of migrants impacted likely to vary across species and sites. Similar studies should be conducted across a broader geographic scale to understand the impacts on bat populations from wind-energy facilities., Competing Interests: David M. Nelson is an Academic Editor for PeerJ. C.J. Campbell is employed by Bat Conservation International., (©2024 Wieringa et al.)

In collaboration with the American College of Veterinary Pathologists.

Objectives: To design a low-cost 3D printable powered air-purifying respirator (PAPR) that meets National Institute for Occupational Safety and Health (NIOSH) standard for flow rate and Occupational Safety and Health Administration (OSHA) standard for particle filtration for loose-fitting PAPRs and that can be made with a 3D printer and widely available materials., Design: Detailed description of components, assembly instructions and testing of a novel PAPR design in an academic laboratory following respective protocols. The assembled PAPR must meet NIOSH standards of flow rate, 170 L/min; OSHA fit factor for particle filtration, ≥250 and maintain positive pressure during regular and deep breathing., Main Outcome Measures: The PAPR design was run through a series of tests: air flow (L/min), particle filtration (quantitative and qualitative) and positive pressure measured inside the helmet (mm Hg)., Results: Flow rate was 443.32 L/min (NIOSH standard: minimum 170 L/min) and overall fit factor for particle filtration was 1362 (OSHA pass level: ≥500), n=1. The device passed qualitative particle filtration, n=2, and measured peak pressure of 6mm Hg (>0 mm Hg indicates positive pressure) in the helmet, n=1., Conclusions: The Hygieia PAPR is a low-cost, easily accessible, just-in-time 3D printable PAPR design that meets minimum NIOSH and OSHA standards for flow-rate and particle filtration for loose-fitting PAPR devices to be made and used when industry-made designs are unavailable., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Antimicrobial stewardship programs (ASPs) are recommended by the Centers for Disease Control and Prevention and World Health Organization and mandated by the Joint Commission to curb antimicrobial resistance. However, <50% of institutions have optimal ASPs in place. Building on its experience of antimicrobial stewardship (AMS) advocacy, the Infectious Diseases Society of America (IDSA) developed the AMS Centers of Excellence (CoE) program, which will serve as a conduit to share best practices and highlight the standards for other hospitals to achieve in order to advance the field of AMS. A designation of CoE signifies that these institutions deliver high-quality care consistently, serve as the "gold" standard for executing novel AMS principles, and demonstrate commitment to their ASP. Here, we describe the process and purpose of designating institutions as AMS CoEs, provide awareness to clinicians on opportunities available through IDSA with this CoE designation, and discuss the evolution of the program., (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

A high per centage of reported cases of tetanus and diphtheria in the United States occurs in persons over 60 years old. The sera of 69 elderly persons, mean age 80 years, were tested for prevalence of tetanus and diphtheria antibodies, and only 51% and 59%, respectively, had protective levels (greater than or equal to .01 AU/ml). In a prospective study 27 elderly volunteers were given 0.5 ml tetanus-diphtheria (Td) toxoid twice, seven months apart. Before toxoid 26% and 59% of persons had protective antitoxin levels against tetanus and diphtheria. After one dose the per cent protected rose to 42 and 88. After the second dose all persons immunized had protective levels. No subjects had significant side effects after either dose. These data demonstrate that many elderly persons lack protection against tetanus and diphtheria and document that two doses of Td toxoid would confer immunity to virtually all such persons.

Current revival of interest in quality control of bacteriological culture media prompted this laboratory to develop and implement a system of quality control testing of media purchased from commercial manufacturers. During 8 months we tested more than 900 lots of 46 different media representing 350,000 units of culture media purchased from two major and one minor supplier(s). Only 17 lots were found to be unsatisfactory. This experience raised a question about the real necessity for extensive retesting by users of commercially prepared, quality-assured media. It is suggested that primary responsibility for quality control be placed on the relatively few manufacturer-vendors rather than on the multiple purchaser-users, who may not possess either the expertise or the resources for quality control programs.