KOLAHUN

$75 Per Speeding Ticket

In full disclosure, I've spent hundreds of dollars in fines levied by the NOLA traffic cameras, mostly going a bit over 30mph where the speed limit is 25mph.  My emotional response:  it's fucking annoying.  

More analytically, however, there are two competing interests.  First, do these cameras REDUCE traffic accidents?  Who knows...but anecdotally, they have made me and my neighbor drive slower.  So logically, they probably work.

Second, however, is the question of justice?  Are they being implemented fairly?  To that, I'd say NO.  As per the article, the cameras are placed in somewhat devious ways:

A visit to the hardest-working traffic camera in town makes plain the reason for its success -- and why it has many motorists hopping mad. The camera is positioned about a block down from where Henry Clay, one of New Orleans' smoother streets, widens dramatically into a broad boulevard. The sidewalk on the avenue's uptown side is lined by a tall brick wall, reducing the odds that, say, a child might suddenly run into the street.

In short, drivers judge the street as one where they can safely travel at perhaps 35 mph. But the speed limit is 25 mph. At 31 mph, the camera trips, and a $75 ticket is issued. At 35 mph, the fine jumps to $110.

Plus, the delay in actually receiving the ticket in the mail leaves a latency period where the punitive ticket doesn't change driving behavior - because you haven't gotten the ticket yet!  If you got a ticket by an actual cop, you're much more likely to drive slower for the next few weeks.  But with a camera, you get the ticket in the mail in a couple of weeks, blissfully and ignorantly driving the same in the meanwhile.  

Finally, I'm going to search to see whether the City audits the collections and releases where the funds have been allocated.  Hopefully, this isn't a money-grab to cover under-funded accounts.  

 

10

There are only 10 types of people in the world: those who understand binary, and those who don't.

Clinical Diagnosis of HIV in neonates?

Jaspen et al attempt to find clinical clues which may herald HIV infection in exposed neonates in South Africa:

417 HIV-infected and 125 HIV-exposed, uninfected infants, median age 46 days (IQR 38-55), were included. The median CD4 percentage in HIV-infected infants was 34 (IQR 28-41)%. HIV-infected infants had lower weight-for-age, more lymphadenopathy, oral thrush, and hepatomegaly than exposed uninfected infants (Adjusted Odds Ratio 0.51, 8.8, 5.6 and 23.5 respectively; p<0.001 for all). Sensitivity of individual signs was low (<20%) but specificity high (98-100%). If any one of oral thrush, hepatomegaly, splenomegaly, lymphadenopathy, diaper dermatitis, weight <50th centile are present, sensitivity for HIV infection amongst HIV-exposed infants was 86%. These algorithms performed similarly when used to predict severe immune suppression.

Neonatal HIV can be notoriously hard to diagnose.  In the developed world, we screen patients of all ages for HIV with a rapid, anti-body test, but then confirm it with a more advanced PCR test.  In neonates, however, because they get maternal antibodies in utero and through breast milk, the anti-body tests could be a 'false-positive' - i.e. the test says positive, but it's actually false because it's detecting the mother's transmitted anti-bodies.  So the general strategy in the developed world is to skip the preliminary (less costly) antibody test and go directly to the (more expensive) PCR test.

This strategy fails in the undeveloped world where the (more expensive) PCR tests aren't available.  The two prevailing strategies are a) look for very much cheaper antibody tests and b) look for ways to clinically screen patients and then refer only the higher suspicion ones to get the more expensive tests (as Jaspen et al have done).

Strategy A is the preferred way and some money is being spent on that.  My preference would be that more money be spent on that.  In the meanwhile, those nurses/house officers/doctors have to 'get through the day' with whatever tools they have.  And if they find that more lymphadenopthy can increase the clinical probability that a neonate has HIV, they may feel more confident sending that mother and baby by bus over many kilometers to a more sophisticated testing and treating center.  

It's suboptimal.  But until we get better and cheaper tests, it's the prudent field level strategy.  

Dominos in North Korea

The headlines of the major international news sites and newspapers blared the death of Kim Jong Il today.  He died 2 days ago, but the news was left out of public consumption, presumably to maintain order and choreograph the unveiling of his son.  Good riddance.  

The man was a mass murderer who promoted the deaths of millions of his country's men, women and children.  In the 90s, he ruled during a terrible famine.  He set up labor and death camps.  Death could only have been too kind to him.

And now the question remains - what of the North Koreans? Or simply the 'Koreans' as they were known before the bifurcation of the peninsula at the start of the Korean War in 1950.  They live in fear, in isolation, in brainwashing and in hunger.  The vested international actors are South Korea, China, Japan, the US and Russia.  

China's going through economic hardships themselves, if one were to believe the warnings of Paul Krugman (and I generally do).  The South Koreans have prospered since the 1960s and do they really want the burden of unification that the West Germans went through?  The US is mired in multiple wars across the world and has little interest in this time of divided government and a realpolitik president in getting involved in another conflict or country rebuilding.  Russia seems to be cash-heavy, but is undergoing its own version of public outcry against a kleptocarcy.  

So who's got the incentive to do anything but maintain the status quo and let the hermit kingdom continue?  Meaning, onward continue the silenced suffering of the (North) Koreans.  

Vox Arborum

I had a sneaking suspicion that tree population was linked to voter turnout in the City.

I soon found out, since Golden Gate Park is not a voting precinct, trees living there cannot vote.

Something must be done!

 

Horto in Urbs