First report of multi-drug resistant tuberculosis in a systemic lupus erythematosus patient.

BackgroundTreatment of a multi-drug resistant tuberculosis (MDR-TB) patient is clinically challenging, requiring a minimum of 18 months of therapy. Its occurrence in a systemic lupus erythromatosus (SLE) patient may complicate management of both MDR-TB and SLE. This is the first descriptive report of MDR-TB in an SLE patient.Case presentationA 19-year old female receiving long-term prednisolone for SLE was diagnosed with MDR-TB. She was started on MDR-TB treatment regimen and prednisolone was replaced with azathioprine. After an initial response to therapy, patient experienced a flare of lupus symptoms. Imaging studies revealed avascular necrosis of right femoral head. She was then treated with intravenous methyl-prednisolone, followed by maintenance corticosteroid. Azathioprine was discontinued due to hematological toxicity and failure to control SLE. Her symptoms of lupus regressed and did not re-occur for the duration of her MDR-TB treatment. Patient was declared cured of MDR-TB after 18 months of ATT. She is currently scheduled for a total hip replacement surgery.ConclusionsThis case highlights the challenges of simultaneously managing MDR-TB and SLE in a patient due to their over-lapping signs and symptoms, drug-drug interactions, and the need for use of immunomodulatory agents in the absence of standard guidelines and documented previous experiences. Our experience underscores the importance of appropriate selection of treatment regimens for both MDR-TB and SLE

Prevalence and Correlates of Primary Infertility in Mysore, India

Background & objectives: There are sparse data on the prevalence of primary infertility in India and almost none from Southern India. This study describes the correlates and prevalence of primary infertility among young women in Mysore, India. Methods: The baseline data were collected between November 2005 through March 2006, among 897 sexually active women, aged 15-30 yr, for a study investigating the relationship of bacterial vaginosis and acquisition of herpes simplex virus type-2 (HSV-2) infection. A secondary data analysis of the baseline data was undertaken. Primary infertility was defined as having been married for longer than two years, not using contraception and without a child. Logistic regression was used to examine factors associated with primary infertility. Results: The mean age of the women was 25.9 yr (range: 16-30 yr) and the prevalence of primary infertility was 12.6 per cent [95% Confidence Interval (CI): 10.5-15.0%]. The main factor associated with primary infertility was HSV-2 seropositivity (adjusted odds ratio: 3.41; CI: 1.86, 6.26). Interpretation & conclusions: The estimated prevalence of primary infertility among women in the study was within the range reported by the WHO and similar to other estimates from India. Further research is needed to examine the role of HSV-2 in primary infertility

Logic regression-derived algorithms for syndromic management of vaginal infections.

BACKGROUND: Syndromic management of vaginal infections is known to have poor diagnostic accuracy. Logic regression is a machine-learning procedure which allows for the identification of combinations of variables to predict an outcome, such as the presence of a vaginal infection. METHODS: We used logic regression to develop predictive models for syndromic management of vaginal infection among symptomatic, reproductive-age women in south India. We assessed the positive predictive values, negative predictive values, sensitivities and specificities of the logic regression procedure and a standard WHO algorithm against laboratory-confirmed diagnoses of two conditions: metronidazole-sensitive vaginitis [bacterial vaginosis or trichomoniasis (BV/TV)], and vulvovaginal candidiasis (VVC). RESULTS: The logic regression procedure created algorithms which had a mean positive predictive value of 61 % and negative predictive value of 80 % for management of BV/TV, and a mean positive predictive value of 26 % and negative predictive value of 98 % for management of VVC. The results using the WHO algorithm were similarly mixed. CONCLUSIONS: The logic regression procedure identified the most predictive measures for management of vaginal infections from the candidate clinical and laboratory measures. However, the procedure provided further evidence as to the limits of syndromic management for vaginal infections using currently available clinical measures

A general lower bound for collaborative tree exploration

We consider collaborative graph exploration with a set of $k$ agents. All agents start at a common vertex of an initially unknown graph and need to collectively visit all other vertices. We assume agents are deterministic, vertices are distinguishable, moves are simultaneous, and we allow agents to communicate globally. For this setting, we give the first non-trivial lower bounds that bridge the gap between small ($k \leq \sqrt n$) and large ($k \geq n$) teams of agents. Remarkably, our bounds tightly connect to existing results in both domains. First, we significantly extend a lower bound of $\Omega(\log k / \log\log k)$ by Dynia et al. on the competitive ratio of a collaborative tree exploration strategy to the range $k \leq n \log^c n$ for any $c \in \mathbb{N}$. Second, we provide a tight lower bound on the number of agents needed for any competitive exploration algorithm. In particular, we show that any collaborative tree exploration algorithm with $k = Dn^{1+o(1)}$ agents has a competitive ratio of $\omega(1)$, while Dereniowski et al. gave an algorithm with $k = Dn^{1+\varepsilon}$ agents and competitive ratio $O(1)$, for any $\varepsilon > 0$ and with $D$ denoting the diameter of the graph. Lastly, we show that, for any exploration algorithm using $k = n$ agents, there exist trees of arbitrarily large height $D$ that require $\Omega(D^2)$ rounds, and we provide a simple algorithm that matches this bound for all trees

Welfare and Homelessness in Indianapolis: Populations at Risk and Barriers to Self-Sufficiency, Indianapolis

Who are the homeless in Indianapolis? How has welfare reform affected Indianapolis families who rely on public support? What barriers are preventing these populations from becoming self-sufficient? Two recent studies help answer these questions for policymakers and service providers. This issue brief summarizes the studies’ demographic findings, and the problems that erect barriers to self-sufficiency among the poor in Indianapolis

Drawing Trees with Perfect Angular Resolution and Polynomial Area

We study methods for drawing trees with perfect angular resolution, i.e., with angles at each node v equal to 2{\pi}/d(v). We show: 1. Any unordered tree has a crossing-free straight-line drawing with perfect angular resolution and polynomial area. 2. There are ordered trees that require exponential area for any crossing-free straight-line drawing having perfect angular resolution. 3. Any ordered tree has a crossing-free Lombardi-style drawing (where each edge is represented by a circular arc) with perfect angular resolution and polynomial area. Thus, our results explore what is achievable with straight-line drawings and what more is achievable with Lombardi-style drawings, with respect to drawings of trees with perfect angular resolution.Comment: 30 pages, 17 figure

Harry Edward\u27s Nostalgia

Until fairly recently, the work of people who thought and wrote about the law in its broadest cultural sense, and the work of those who thought and wrote about the law as it was practiced, did not intersect very much. The broad cultural issues tended to be the province of philosophers or political theorists or other academic social critics, while traditional legal scholarship - as it appeared in law school journals - remained firmly rooted in lawyers\u27 questions. This is not to suggest that legal academics wrote nothing but practice manuals, but it is true that until the last twenty years or so most legal academic effort went into texts that were of direct use to practicing lawyers. Law reviews were a common starting place for lawyers\u27 legal research, and lawyers and judges who subscribed to law reviews could expect to find useful articles that routinely touched on their areas of practice or that influenced their thinking. As Judge Harry Edwards recently complained,1 except for student notes, or an occasional symposium issue, that is no longer the case. Today\u27s journals are filled with a very different kind of scholarship, written by a different species of law professor and targeted at a different audience. Edwards is surely correct that most legal scholarship nowadays has little to offer to practicing lawyers, to judges, or to legislators.

Harry Edward\u27s Nostalgia

Until fairly recently, the work of people who thought and wrote about the law in its broadest cultural sense, and the work of those who thought and wrote about the law as it was practiced, did not intersect very much. The broad cultural issues tended to be the province of philosophers or political theorists or other academic social critics, while traditional legal scholarship - as it appeared in law school journals - remained firmly rooted in lawyers\u27 questions. This is not to suggest that legal academics wrote nothing but practice manuals, but it is true that until the last twenty years or so most legal academic effort went into texts that were of direct use to practicing lawyers. Law reviews were a common starting place for lawyers\u27 legal research, and lawyers and judges who subscribed to law reviews could expect to find useful articles that routinely touched on their areas of practice or that influenced their thinking. As Judge Harry Edwards recently complained,1 except for student notes, or an occasional symposium issue, that is no longer the case. Today\u27s journals are filled with a very different kind of scholarship, written by a different species of law professor and targeted at a different audience. Edwards is surely correct that most legal scholarship nowadays has little to offer to practicing lawyers, to judges, or to legislators.

Essay: Recent Trends in American Legal Education

An American law professor in Japan has much more to learn than to teach. A foreigner like me - who comes to Japan on short notice, with no knowledge of Japanese culture and institutions, and with no Japanese language skills - sets himself a formidable task. Happily, the courtesy of my hosts, the patience of my colleagues, and the devotion of my students, have made for a delightful visit. I thank all of you. You asked me to talk about American legal education. As you surely know, the system of legal education in the U.S. is very different from the system of legal education in Japan. In this talk I will start with a little history. Then I will describe the present legal education system in some detail, to give you an overview of its structure, and of the core curriculum as it is taught at most law schools. Next I will discuss recent developments in legal education, to bring you up to date. I will end with some of the problems that face U.S. law schools, and in particular I will address a unique problem that confronts my own school, the University of Michigan Law School

From Low-Distortion Norm Embeddings to Explicit Uncertainty Relations and Efficient Information Locking

The existence of quantum uncertainty relations is the essential reason that some classically impossible cryptographic primitives become possible when quantum communication is allowed. One direct operational manifestation of these uncertainty relations is a purely quantum effect referred to as information locking. A locking scheme can be viewed as a cryptographic protocol in which a uniformly random n-bit message is encoded in a quantum system using a classical key of size much smaller than n. Without the key, no measurement of this quantum state can extract more than a negligible amount of information about the message, in which case the message is said to be "locked". Furthermore, knowing the key, it is possible to recover, that is "unlock", the message. In this paper, we make the following contributions by exploiting a connection between uncertainty relations and low-distortion embeddings of L2 into L1. We introduce the notion of metric uncertainty relations and connect it to low-distortion embeddings of L2 into L1. A metric uncertainty relation also implies an entropic uncertainty relation. We prove that random bases satisfy uncertainty relations with a stronger definition and better parameters than previously known. Our proof is also considerably simpler than earlier proofs. We apply this result to show the existence of locking schemes with key size independent of the message length. We give efficient constructions of metric uncertainty relations. The bases defining these metric uncertainty relations are computable by quantum circuits of almost linear size. This leads to the first explicit construction of a strong information locking scheme. Moreover, we present a locking scheme that is close to being implementable with current technology. We apply our metric uncertainty relations to exhibit communication protocols that perform quantum equality testing.Comment: 60 pages, 5 figures. v4: published versio