Persistence of an outbreak of gonorrhoea with high-level resistance to azithromycin in England, November 2014‒May 2018

Between November 2014 and May 2018, 118 laboratory-confirmed cases of high-level azithromycin resistant Neisseria gonorrhoeae were identified in England. Cases emerged among heterosexuals in Leeds but spread across England and into sexual networks of men who have sex with men as the outbreak progressed. The few epidemiological links identified indicate substantial under-diagnosis of cases and this, along with the upturn in cases in 2017, highlights the difficulties in controlling the outbreak

Time to negative throat culture following initiation of antibiotics for pharyngeal group A Streptococcus: a systematic review and meta-analysis up to October 2021 to inform public health control measures

Background: Public health guidance recommending isolation of individuals with group A streptococcal (GAS) infection or carriage for 12–24 h from antibiotic initiation to prevent onward transmission requires a strong evidence base. Aim: To estimate the pooled proportion of individuals who remain GAS culture-positive at set intervals after initiation of antibiotics through a systematic literature review (PROSPERO CRD42021290364) and meta-analysis. Methods: We searched Ovid MEDLINE (1946–), EMBASE (1974–) and Cochrane library. We included interventional or observational studies with ≥ 10 participants reporting rates of GAS throat culture positivity during antibiotic treatment for culture-confirmed GAS pharyngitis, scarlet fever and asymptomatic pharyngeal GAS carriage. We did not apply age, language or geographical restrictions. Results: Of 5,058 unique records, 43 were included (37 randomised controlled studies, three non-randomised controlled trials and three before-and-after studies). The proportion of individuals remaining culture-positive on day 1, day 2 and days 3–9 were 6.9% (95% CI: 2.7–16.8%), 5.4% (95% CI: 2.1–13.3%) and 2.6% (95% CI: 1.6–4.2%). For penicillins and cephalosporins, day 1 positivity was 6.5% (95% CI: 2.5–16.1%) and 1.6% (95% CI: 0.04–42.9%), respectively. Overall, for 9.1% (95% CI: 7.3–11.3), throat swabs collected after completion of therapy were GAS culture-positive. Only six studies had low risk of bias. Conclusions: Our review provides evidence that antibiotics for pharyngeal GAS achieve a high rate of culture conversion within 24 h but highlights the need for further research given methodological limitations of published studies and imprecision of pooled estimates. Further evidence is needed for non-beta-lactam antibiotics and asymptomatic individuals

Role of carbon allocation efficiency in the temperature dependence of autotroph growth rate

To predict how plant growth rate will respond to temperature requires understanding how temperature drives the underlying metabolic rates. Although past studies have considered the temperature dependences of photosynthesis and respiration rates underlying growth, they have largely overlooked the temperature dependence of carbon allocation efficiency. By combining a mathematical model that links exponential growth rate of a population of photosynthetic cells to photosynthesis, respiration, and carbon allocation; to an experiment on a freshwater alga; and to a database covering a wide range of taxa, we show that allocation efficiency is crucial for predicting how growth rates will respond to temperature change across aquatic and terrestrial autotrophs, at both short and long (evolutionary) timescales

Bridge distress caused by approach embankment settlement

Surtees Bridge, which carries the A66(T) over the River Tees near Thornaby-on-Tees in the UK, has been showing signs of distress that predate its opening in 1981. Subsequent investigations have shown that the bridge distress is related to unexpectedly large settlement of the eastern approach embankment. Recent ground investigations prompted by a proposed widening of the river crossing have produced many new data on the alluvial deposits underlying the site, and explain why embankment settlement was so much larger than originally anticipated. Comparison of the geotechnical parameters obtained from the original and more recent ground investigations suggests that the original investigation significantly underestimated the thickness of an alluvial clay layer underlying the site, and that its coefficient of consolidation was overestimated. Settlement analyses using geotechnical data from the original ground investigations predict moderate embankment settlements occurring principally during construction. Settlement analyses based on all the available data predict far larger embankment settlements occurring over extended time periods. The latter analyses predict an embankment settlement similar to that observed and of sufficient magnitude to cause the observed lateral displacement of the bridge due to lateral loading of its piled foundation

Consciousness and the Physical World

The main file in this deposition is a pdf file containing the scanned pages of the Proceedings. Additional files OCR.txt and OCR.pdf (the latter having the same pagination as the book) are included to simplify search, etc. Because of their automated creation using software, the accuracy of the OCR files cannot be guaranteed, though some checking has been carried out. In the scanned version, entering 'go to page n' in a pdf reader will access the pair of pages 2n and 2n+1. Alternatively, go to the contents pages (accessible via 'go to page', entering 'contents' at the prompt) for the numbers to use with 'go to' for specific chapters. © By arrangement with the publishers, the editors (Brian D Josephson and Vilayanur S Ramachandran) are the present copyright holders. They grant permission for the use of the material in this book in accord with the terms of the CC licence below.Edited proceedings of an interdisciplinary symposium on consciousness held at the University of Cambridge in January 1978. The purpose of the Cambridge conference was to encourage distinguished scientists to express their views on the relationship of conscious experience to the physical world.The conference was supported by a grant from Research Corporation of New York