Fundoscopic Photography With the iPhone 5 and Welch-Allyn PanOptic Opthalmoscope

Although detailed fundoscopic photography is usually the province of the retinal specialist, I think that there is a place for fundus photography in neurology, especially improving on the standard of writing down our documentation of optic disc abnormalities such as atrophy or pailledema. This is especially true with the advent of better quality cameras in our cell phones.

Welch-Allyn has made an adapter for the iPhone4 to allow fundus photography with their excellent Panoptic opthalmoscope, but they do not plan to make one that fits other phones, at least so far. However, there are a number of inexpensive brackets made for microscopes to allow cellular phones to take photomicrographs, and they do allow the Panoptic opthalmoscope to be used with the Welch-Allyn iPhone retinal photography app, called the iExaminer (available for iPhone to go with the iPhone 4 adapter, and not to my knowledge available for Android).

The cell phone/eyepiece bracket I ordered for the purpose arrived yesterday. I'll post about my experience later.

If cetaceans have culture, can the Star Wars universe be said to exist in reality?

Bizzare rhetorical questions make such fun titles, don't you think? Anyway--

As discussed last year, there is good cumulative evidence that whales and dolphins have culture, where culture is defined as non-genetic information passed from animal to animal. Is culture something that exists objectively? Certainly dolphin behavior as it is influenced by dolphin culture is objectively observable. So, dolphin culture, to the biologist who accepts such evidence, is an objectively detectable thing, even if it is not a material object. A neutral monist might say it was a non-material existent component of the dolphins who carry that culture, composed of complexly structured non-material relationships accompanying the material stuff of the dolphin pod and its environment, and perhaps a non-monist like Popper would say it is a part of his "World 3".

What does it mean for culture to exist? If culture exists, can it do so independently of the material artifacts it produces and that in turn produce it? Or is it a supervenient property of such objects? Culture certainly seems more than just a property of brain tissue.

As Brandon of the Siris blog commented recently, fictional characters like those of the Sherlock Holmes or, more popular recently, the Star Wars fictional worlds exist as cultural artifacts that affect our speech and other behavior just as other cultural artifacts such as political laws and boundaries do. The boundary of a state is in one sense a material location, and in another it is a regulation or law as it applies to that location. The boundary can be seen as a nonmaterial thing with a physical location, like the culture of the dolphin pod, which is located with the pod but is not really made of the material stuff of the pod. So, a political boundary is a cultural, non-material property of culture, not a real fence, made by government, and is not a material thing itself, any more than the planet Tatooine in Star Wars becomes a material thing if we locate it "in a galaxy far, far away."

One difference between fictional entities and legal entities is in the link to specific locations in the material world and the causality on our behavior we attribute to a political boundary. Political boundaries, with their institutional and military implications, seem much more powerfully causal than than the locations and characters of fictional stories.

There seems to be a sense in which fictional characters, governmental laws, and other parts of our cultural stories truly exist, but as non-material existences, like the abstract structure of mathematics. Meinong's golden mountain is part of our intellectual culture, and, like dead fish-play dolphin fads and Star wars light swords, such shared imaginings are are a nonphysical part of the cultures on our earth. If such bits of culture exist merely as behavioral aspects of the organisms making up a society, they are far from epiphenomenal ones. Is a hurricane just a property of air and water?

Governmental structures merely seem more firmly linked to the material aspects of our world and as such are more powerfully causal than most fiction. Yes, this seems to be a form of Platonism, unless we claim instead that all culture reduces to information encoded in material objects. Such "encoding" cannot be said to fully exist without its meaning, however, and meaning itself seems to be a paradigm of the non-material existent.

It's 2016, and the USDA just came out with the 2015-2020 dietary guidelines.

Here.

The new guidelines include positive mention of Mediterranean style diets and coffee consumption, both of which may decrease risk of some neurodegenerative illnesses. The pork lobby seems to have won the committee fight over discouraging consumption of bacon, a probable carcinogen (despite that wonderful flavor).

Electronic toys that emit sounds may slow language development in infants.

Electronic toys for infants that produce lights, words and songs were associated with DECREASED development quantity and quality of language compared to playing with books or traditional toys such as a wooden puzzles, shape-sorters or rubber blocks, according to an article published online by JAMA Pediatrics. The study was controlled, with a 15 minute per day session with the toys, infant, and parent. The effect was not small: about a third fewer adult words produced by study's end.

Surprising? Yes. So, for the time being, we should not get electronic toys for infants, and maybe, by extrapolation, preschoolers. It might slightly decrease their speech development. The Luddite mothers win this round :).

================================================================

ABSTRACT

Original Investigation | December 23, 2015

Association of the Type of Toy Used During Play With the Quantity and Quality of Parent-Infant Communication

Anna V. Sosa, PhD

JAMA Pediatr. Published online December 23, 2015. doi:10.1001/jamapediatrics.2015.3753

Importance The early language environment of a child influences language outcome, which in turn affects reading and academic success. It is unknown which types of everyday activities promote the best language environment for children.

Objective To investigate whether the type of toy used during play is associated with the parent-infant communicative interaction.

Design, Setting, and Participants Controlled experiment in a natural environment of parent-infant communication during play with 3 different toy sets. Participant recruitment and data collection were conducted between February 1, 2013, and June 30, 2014. The volunteer sample included 26 parent-infant (aged 10-16 months) dyads.

Exposures Fifteen-minute in-home parent-infant play sessions with electronic toys, traditional toys, and books.

Main Outcomes and Measures Numbers of adult words, child vocalizations, conversational turns, parent verbal responses to child utterances, and words produced by parents in 3 different semantic categories (content-specific words) per minute during play sessions.

Results Among the 26 parent-infant dyads, toy type was associated with all outcome measures. During play with electronic toys, there were fewer adult words (mean, 39.62; 95% CI, 33.36-45.65), fewer conversational turns (mean, 1.64; 95% CI, 1.12-2.19), fewer parental responses (mean, 1.31; 95% CI, 0.87-1.77), and fewer productions of content-specific words (mean, 1.89; 95% CI, 1.49-2.35) than during play with traditional toys or books. Children vocalized less during play with electronic toys (mean per minute, 2.9; 95% CI, 2.16-3.69) than during play with books (mean per minute, 3.91; 95% CI, 3.09-4.68). Parents produced fewer words during play with traditional toys (mean per minute, 55.56; 95% CI, 46.49-64.17) than during play with books (mean per minute, 66.89; 95% CI, 59.93-74.19) and use of content-specific words was lower during play with traditional toys (mean per minute, 4.09; 95% CI, 3.26-4.99) than during play with books (mean per minute, 6.96; 95% CI, 6.07-7.97).

Conclusions and Relevance Play with electronic toys is associated with decreased quantity and quality of language input compared with play with books or traditional toys. To promote early language development, play with electronic toys should be discouraged. Traditional toys may be a valuable alternative for parent-infant play time if book reading is not a preferred activity.

Merry Christmas 2015!

Wishing you peace on your bit of the Earth, wherever you may be!

RANGPUR LIME [LILIKOI] PIE


Makes 1 large (9 inch) pie. For four smaller pies such as with Mi-Go brand 
8 inch gingerbread pie crust, triple filling and quadruple topping amounts.

Ingredients

Crust:
1 1/2 cups graham cracker crumbs or ¾ cup raw mac nuts and ¾ cup graham 
cracker type crumbs, salted to taste 
1/2 cup granulated sugar
4 tablespoons (1/2 stick) butter melted
or a large premade pie crust

Filling:
2 14-ounce cans sweetened condensed milk
1 cup fresh lime Rangpur lime juice
2 whole large eggs or 3 medium eggs
2 tablespoons lime zest

Topping:
1 cup sour cream
2 tablespoons powdered sugar
1 tablespoon lime zest
1/4 teaspoon finely ground vanilla bean

Optional Top Glaze:
¼ cup fresh lilikoi (passionfruit) juice, strained of seeds
1 tbsp powdered sugar
Up to 1 tsp xanthan or carob bean gum

Directions

Preheat the oven to 375 degrees F.

In a bowl, mix the graham cracker crumbs, sugar, and butter with your hands. 

Press the mixture firmly into an 8-inch pie pan, and bake until brown, 
about 20 minutes. 

Remove from the oven and allow to cool to room temperature before filling.

Lower the oven temperature to 325 degrees F. 

In a separate bowl, combine the condensed milk, lime juice, 
the filling portion of the zest, and eggs. 

Whisk until well blended and place the filling in the cooled pie shell. 

Bake in the oven for 15 minutes and allow to chill in the refrigerator 
for at least 2 hours (otherwise the filling will be too runny).
 
Once chilled, combine the sour cream, ground vanilla bean, and powdered sugar. 
Spread over the top of the pie using a spatula. 

Mix the lilikoi juice and powdered sugar, then very gradually 
add the vegetable gum until the mixture begins to thicken 
(you don't need more than this). 

Pour over the sour cream topping and stir lightly into upper topping.

Sprinkle the remaining lime zest as a garnish on top of the sour cream.

Serve chilled.

Dengue on the Big Island 2015: a Worrisome Reporting Change

Dengue in humans is a brief but painful experience, with symptoms that are usually worse, but much less in duration than more common viral infections such as the common cold or influenza. Most symptoms of dengue last 1 to 8 days.

There have been over 150 cases of dengue on Hawai'i Island since September 2015, and this week the health department said it plans to change its reporting from incidence (the cases this year) to prevalence (the number of people with active infection, currently just 5).

This probably seemed like a good way to de-emphasize the risk to the usual influx of tourists this season, and indeed the chance of any one tourist getting dengue on the Big Island is well under one in a thousand. But the very fact that the local dengue statistics are being converted to prevalence worries me.

Prevalence is how we measure endemic (persistent in a region) illnesses. Let's hope that does not happen. Dengue must not become endemic here.

21st Century Phrenology, Part 2: The Argument from Similarity

Here's Science magazine on a study showing that MRIs of male and female subjects overlap in characteristics. The text then talks about how this proves that men and women are more alike than we thought, and uses this to support the current cultural and governmental elitist trend toward redefining gender as a social choice.

The majority of the brains were a mosaic of male and female structures, the team reports online today in the Proceedings of the National Academy of Sciences. Depending on whether the researchers looked at gray matter, white matter, or the diffusion tensor imaging data, between 23% and 53% of brains contained a mix of regions that fell on the male-end and female-end of the spectrum. Very few of the brains—between 0% and 8%—contained all male or all female structures. “There is no one type of male brain or female brain,” Joel says. So how to explain the idea that males and females seem to behave differently? That too may be a myth, Joel says. Her team analyzed two large datasets that evaluated highly gender stereotypical behaviors, such as playing video games, scrapbooking, or taking a bath. Individuals were just as variable for these measures: Only 0.1% of subjects displayed only stereotypically-male or only stereotypically-female behaviors. “There is no sense in talking about male nature and female nature,” Joel says. “There is no one person that has all the male characteristics and another person that has all the female characteristics. Or if they exist they are really, really rare to find.” The findings have broad implications, Joel says. For one, she contends, researchers studying the brain may not need to compare males and females when analyzing their data. For another, she says, the extreme variability of human brains undermines the justifications for single-sex education based on innate differences between males and females, and perhaps even our definitions of gender as a social category.

--Science Magazine, November 30, 2015.

But of course there is overlap between male and female in brain structure. Why should there not be? Measures of height or lifespan in men and women are prime examples of how other generalizations based on secondary sexual characteristics often fail. Yet the early 21st century tendency in Western society to ignore primary sexual characteristics in assignment to places such as locker rooms or bathrooms in our schools is still absurd.

Showing that MRI phrenology fails to give reason to account for sex does not mean we should not account for sex. It means we should not use MRI phrenology in doing so.