Gonorrhoea cases in women have been rising in Australia in the 2010s but the cause of the increase is not well understood. This cross-sectional study aimed to describe the characteristics of genital gonorrhoea infection in women attending the Melbourne Sexual Health Centre, Australia. Gonorrhoea cases were diagnosed by nucleic acid amplification test (NAAT) and/or culture. Genitourinary specimens were obtained in 12 869 clinic visits in women aged 16 years or above between August 2017 and August 2018. Genital gonorrhoea was detected in 142 (1.1%) of the visits. Almost half of the cases were asymptomatic, 47.9% [95% confidence interval (CI) 39.8–56.1%]; yellow, green or pus-like vaginal discharge was present in 11.3% (95% CI 7.0–17.6%) and other genital symptoms in 40.8% (95% CI 33.1–49.1%) of the cases. The mean time between last sexual contact and onset of symptoms was 7.3 days and between the onset of symptoms to presentation to the clinic was 12.1 days. Half of the cases of genital gonorrhoea among women are asymptomatic and these cases would have been missed by testing of only symptomatic women. Further epidemiological and behavioural research is required to understand the temporal changes in sexual practices among women in Australia.

Introduction: Aligning health systems appropriately to the needs of the elderly is an urgent global priority, according to the WHO. In Canada, ED length of stay has risen 16% for elderly patients in the last year. Agitation requiring chemical restraint is a common, high-risk problem for elderly in the ED. Improving outcomes in this heterogeneous population remain difficult due to inability to effectively identify and evaluate delirium, frailty, multi-morbidity, and incompatibility with the ED system. A data-driven approach to complex health problems is a recognized emerging tool for healthcare innovation. New opportunities for targeted quality improvement in the ED will be uncovered by identifying the clinical characteristics of elderly patients with agitation, and the system process factors that influence their outcomes. Methods: We studied 400 patients in a case-control study at two tertiary-care EDs over five years. Patients were randomly selected if age was greater than 75 years. 200 cases of patients who received an intravenous dose of haloperidol, midazolam and/or lorazepam were selected as a surrogate data marker for having agitation. Controls were randomly matched by age and ED diagnosis. Standardized clinical, systems and process variables were collected. We conducted a univariate analysis. Results: Elderly given intravenous medications for agitation had increased mortality (OR 3.8 CI: 1.6-10.7, p<0.001) and ED length of stay (27 vs. 15 hours, p<0.001). No statistical significance was found in clinical characteristics, CTAS scores, PRISMA7 frailty scores nor sentinel or return visits. There was no statistical difference in median hospital length of stay (8 vs. 6 days, p<0.70). No differences were found in median time from ED physician seeing a patient to first consultant request (73 vs. 83 mins, p=0.75). The largest time intervals contributing to ED length of stay were from first consultant request to hospital request (15 vs. 12 hours, p=0.056) and hospitalization delay (13 vs. 7 hours, p=0.45). Conclusion: Identification of high-risk elderly patients for targeted intervention through a data-driven approach is feasible and informative. Traditional clinical characteristics remain unhelpful in identifying and evaluating outcomes in elderly with agitation. We have identified a process factor that is clinically relevant and pragmatic to evaluate in our ED system. Future research focused on optimizing systems process factors to improve quality of elderly care should be prioritized.

Pepper & Nettle's theory of the behavioral constellation of deprivation (BCD) would benefit from teasing apart the conceptually distinct – although related – constructs of predictability and control. Our commentary draws from prior research conducted in the learning domain to demonstrate that predictability moderates the effects of control and independently exerts a powerful influence on outcomes relevant to the BCD.

Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007–2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.

Repeat rectal chlamydia infection is common in men who have sex with men (MSM) following treatment with 1 g azithromycin. This study describes the association between organism load and repeat rectal chlamydia infection, genovar distribution, and efficacy of azithromycin in asymptomatic MSM. Stored rectal chlamydia-positive samples from MSM were analysed for organism load and genotyped to assist differentiation between reinfection and treatment failure. Included men had follow-up tests within 100 days of index infection. Lymphogranuloma venereum and proctitis diagnosed symptomatically were excluded. Factors associated with repeat infection, treatment failure and reinfection were investigated. In total, 227 MSM were included – 64 with repeat infections [28·2%, 95% confidence interval (CI) 22·4–34·5]. Repeat positivity was associated with increased pre-treatment organism load [odds ratio (OR) 1·7, 95% CI 1·4–2·2]. Of 64 repeat infections, 29 (12·8%, 95% CI 8·7–17·8) were treatment failures and 35 (15·4%, 95% CI 11·0–20·8) were reinfections, 11 (17·2%, 95% CI 8·9–28·7) of which were definite reinfections. Treatment failure and reinfection were both associated with increased load (OR 2·0, 95% CI 1·4–2·7 and 1·6, 95% CI 1·2–2·2, respectively). The most prevalent genovars were G, D and J. Treatment efficacy for 1 g azithromycin was 83·6% (95% CI 77·2–88·8). Repeat positivity was associated with high pre-treatment organism load. Randomized controlled trials are urgently needed to evaluate azithromycin's efficacy and whether extended doses can overcome rectal infections with high organism load.

In this paper the development and flight testing of flapping-wing propelled, radio-controlled micro air vehicles are described. The unconventional vehicles consist of a low aspect ratio fixed-wing with a trailing pair of higher aspect ratio flapping wings which flap in counterphase. The symmetric flapping-wing pair provides a mechanically and aerodynamically balanced platform, increases efficiency by emulating flight in ground effect, and suppresses stall over the main wing by entraining flow. The models weigh as little as 11g, with a 23cm span and 18cm length and will fly for about 20 minutes on a rechargeable battery. Stable flight at speeds between 2 and 5ms–1 has been demonstrated, and the models are essentially stall-proof while under power. The static-thrust figure of merit for the device is 60% higher than propellers with a similar scale and disk loading.

The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007–2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6–14] days and 14 (IQR 7–30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64–256) was higher than in primary syphilis (median 4, IQR 1–32) and in early latent syphilis (median 32, IQR 4–64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.

There is little known regarding the transmissibility of human papillomavirus (HPV) between different sites in men who have sex with men (MSM) and heterosexual individuals. We conducted a retrospective analysis investigating all new patients attending the Melbourne Sexual Health Centre in Australia between 2002 and 2013. We describe the prevalence and ratio of the first episode of anogenital warts in MSM and heterosexual males and females. The proportion of new MSM clients with anal and penile warts was 4·0% (362/8978) and 1·6% (141/8978), respectively; which gave an anal-to-penile wart ratio of 1:2·6. About 13·7% (1656/12112) of heterosexual males had penile warts and 10·0% (1121/11166) of females had vulval warts, which yielded a penile-to-vulval wart ratio of 1:0·7. Penile–anal transmission has a higher ratio than penile–vulval transmission, suggesting that the anal epithelium may be more susceptible to HPV infection than the vulval epithelium in females; these ratios are important in modelling the control of HPV in MSM.

The prevalence of the digenean Plagiorchis sp. was investigated in a natural wood mouse population (Apodemus sylvaticus) in a periaquatic environment. Classical identification was complemented with the use of molecular differentiation to determine prevalence and verify species identity. Use of the complete ITS1-5.8S rDNA-ITS2 and partial 28S rDNA gene sequences have confirmed that the species reported at this location was Plagiorchis elegans and not Plagiorchis muris as reported previously. This underlines the difficulties in identification of these morphologically similar parasites. Plagiorchis elegans is typically a gastrointestinal parasite of avian species but has also been reported from small mammal populations. Although the occurrence of this digenean in A. sylvaticus in the UK is rare, in the area immediately surrounding Malham Tarn, Yorkshire, it had a high prevalence (23%) and a mean worm burden of 26.6 ± 61.5. The distribution of P. elegans followed a typically overdispersed pattern and both mouse age-group and sex were determined to be two main factors associated with prevalence. Male mice harboured the majority of worms, carrying 688 of 717 recovered during the study, and had a higher prevalence of 32.4% in comparison to only 8.7% in the small intestine of female mice. A higher prevalence of 43% was also observed in adult mice compared to 14% for young adults. No infection was observed in juvenile mice. These significant differences are likely to be due to differences in the foraging behaviour between the sexes and age cohorts of wood mice.

A layer of massive and lineated hornblende-biotite-gneiss has fractured along ac-joints (perpendicular to the layering and b–lineation), at regular intervals along its lower surface in contact with a thin marble bed. The joints have been opened from below and the marble has penetrated upwards to form intrusive tongues caused by extremely plastic flow folding, as shown by the unbroken banding in the marble. The structure constitutes a variety of one-sided boudinage involving segmentation in the lowest metre or so of the hornblendic rock, while the extreme marble deformation is all accommodated in a few centimetres thickness. The structures must have developed at relatively high temperatures to allow contemporaneous segregation of quartz-feldspar pegmatite veins from the hornblendic rock, and of diopside reaction skarns at the marble junctions.

The derivation of gene-transport equations is re-examined. Fisher's assumptions for a sexually reproducing species lead to a Huxley reaction-diffusion equation, with cubic logistic source term for the gene frequency of a mutant advantageous recessive gene. Fisher's equation more accurately represents the spread of an advantaged mutant strain within an asexual species. When the total population density is not uniform, these reaction-diffusion equations take on an additional non-uniform convection term. Cubic source terms of the Huxley or Fitzhugh-Nagumo type allow special nonclassical symmetries. A new exact solution, not of the travelling wave type, and with zero gradient boundary condition, is constructed.

Characteristics of strained layer superlattices (SLS) consisting of alternating layers InxGa1-xAs and GaAs1-yPy are examined for use in high efficiency solar cells. The effects of SLS quantum barrier widths on tunneling probability and short circuit current are discussed through analysis of J-V and spectral response measurements. Results indicate a threshold barrier thickness for which tunneling effects are deleterious. Effect of the number of SLS periods incorporated into a p-i-n structure and maximum number of periods are presented through spectral response and CV analysis. It is demonstrated that SLS show increasing responsivity with increasing number of periods due to higher absorption. CV analysis is performed to determine zero bias depletion widths for verifying appropriate number of SLS periods and fully depleted SLS region.

InGaAs can be used to enhance the response of solar cells past the 1.43 eV cutoff of GaAs. Strained-layer superlattice (SLS) structures with high indium and phosphorus compositions (up to 35% and 68% respectively) have been grown successfully. SLS solar cells with indium and high phosphorus compositions (up to 15% and 85% respectively) have been grown successfully. The spectral response of the solar cells has been extended to as low as 1.27 eV. This enhancement is also shown by an increase in the short circuit current, with a small reduction in the short circuit voltage as compared to standard GaAs p-n junction for AM1.5 and one sun.

Dark current curves show the extent of recombination in the superlattice. The reverse saturation current in the recombination region (0.2-0.8 V) was determined using a non-linear least squares fitting routine. An Arrhenius plot was generated by finding the reverse saturation current over a temperature range of 300-370 K. The low recombination devices show non-ideality constants of 1.7 with activation energies of 1.3-1.4 eV. The high recombination devices have non-ideality constants (˜2.3) and lower activation energies of 1.1 eV.

The response of a well-developed turbulent boundary layer to suddenly applied convex surface curvature is investigated, using conditional-sampling techniques so that the turbulent and non-turbulent regions of the flow can be clearly distinguished. The conclusion of this and the companion paper by Hoffmann, Muck & Bradshaw (1985) is that the effects of convex (stabilizing) and concave (destabilizing) curvature on boundary layers – and presumably on other shear layers – are totally different, even qualitatively: mild convex curvature, with a radius of curvature of the order of 100 times the boundary-layer thickness, tends to attenuate the pre-existing turbulence, apparently without producing large changes in statistical-average eddy shape, while concave curvature results in the quasi-inviscid generation of longitudinal (‘Taylor-Görtler’) vortices, together with significant changes in the turbulence structure induced directly by the curvature and indirectly by the vortices.

From the point of view of calculation methods, the implication is that, although stabilizing and destabilizing curvature are connected by a common dimensional analysis, the differences are such that the one cannot be regarded as a useful guide to the treatment of the other. Specifically, rates of change of turbulence-structure parameters with curvature parameter are likely to be nearly discontinuous at zero curvature, and in particular the time of response of a turbulent boundary layer to convex curvature, implying mere attenuation, is very much less than the time of response to concave curvature, implying reorganization of the eddy structure.

The response of a turbulent boundary layer to suddenly applied concave surface curvature with δ/R = 0.01–0.02 is investigated. The main conclusion of this and the companion paper by Muck, Hoffmann & Bradshaw (1985) is that the effects of concave (destabilizing) and convex (stabilizing) curvature on boundary layers – and presumably on other shear layers – are totally different, even qualitatively. As shown in Muck, Hoffmann & Bradshaw (1985), convex curvature tends to attenuate the pre-existing turbulence and, at least in the case of mild curvature, there are no large changes in statistical average eddy shape. Concave curvature, on the other hand, can lead to the quasi-inviscid generation of longitudinal (‘Taylor–Görtler’) vortices, and we show that significant changes in the turbulence structure are induced both directly by the curvature and indirectly by the vortices.