The physiological blind spot corresponds to the optic disc where the retina contains no light-detecting photoreceptor cells. Our perception seemingly fills in this gap in input. Here we suggest that rather than an active process, such perceptual filling-in could instead be a consequence of the integration of visual inputs at higher stages of processing discounting the local absence of retinal input. Using functional brain imaging, we resolved the retinotopic representation of the physiological blind spot in early human visual cortex and (...) measured responses while participants perceived filling-in. Responses in early visual areas simply reflected the absence of visual input. In contrast, higher extrastriate regions responded more to stimuli in the eye containing the blind spot than the fellow eye. However, this signature was independent of filling-in. We argue that these findings agree with philosophical accounts that posit that the concept of filling-in of absent retinal input is unnecessary. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Road to Understanding and Acceptance of the Late Effects of Pediatric Brain Tumors and TreatmentJeanne CarlsonWe had little warning or time to adjust to our daughter’s diagnosis. A call from her third grade teacher reporting that Sarah seemed to be having vision problems rapidly led to eye exams, an MRI, and the discovery of a Germinoma brain tumor in the suprastellar region of Sarah’s brain. We were (...) terrified but began treatment feeling optimistic about the outlook for Sarah’s recovery. Luckily, Sarah’s treatment was relatively non–invasive and quick, chemotherapy and radiation, five months start to finish. We were thrilled to have Sarah’s treatment behind us.As any parent of a child with a life–threatening illness knows, family life is seriously disrupted by the countless doctor, lab, and hospital visits, the worry, and the financial strain that are suddenly added to the demands of everyday life. We did our best to balance our focus on both of our children as Sarah is a twin and we didn’t want her brother Will to suffer as a result of his sister’s illness. It wasn’t easy but we found a way to schedule Will’s usual play dates, baseball practice, and family time. We were all happy and relieved when Sarah’s treatment was completed, yet we would later learn that we had been incredibly naïve in two ways; we thought that our brain tumor journey was over after Sarah’s treatment was completed and we thought that we’d brought Will through the process without effect. We had a lot to learn.At the time of diagnosis we knew that Sarah’s memory and ability to express emotion had already been impacted by the tumor but we didn’t yet know what that would mean to her quality of life. We were virtually unaware however that at age nine the chemotherapy and radiation treatments that Sarah received would result in profound late effects. Following treatment Sarah successfully completed 3rd grade and even received excellent STAR test scores (California state standardized tests). In 4th grade however, Sarah’s performance began to diverge from that of her peers and she found herself struggling in school and unable to make friends. We began looking for ways to help our daughter.What followed was a five year long journey through testing, evaluations, individualized education plans (IEPs), and therapies, which, in the end, left our family needing to accept the fact that although Sarah remains intelligent and artistically talented, she suffers from a constellation of late effects that will always affect her ability to function in the world. As a result of Sarah’s tumor and treatment she struggles with Auditory Processing Disorder, word finding problems, poor executive function, inability to recognize how she feels, significant difficulty making decisions, inability to read social cues, poor memory, slow processing, an emotional age of about nine, and lots of anxiety. She is also panhypopituitary, meaning that she has no remaining pituitary function and must take replacement medications by pill and injection, has hypothalamic obesity (HO), which is primarily controlled by more medication, and Raynaud’s Disease. The HO is an ongoing challenge because if Sarah does gain weight she can’t lose it again and exercise is not an easy solution because, like many pediatric brain tumor survivors, Sarah is easily fatigued. Finally, although Sarah’s vision improved after treatment her vision loss is significant enough to prevent her from driving. We pieced together this understanding of Sarah’s challenges and disabilities slowly so it wasn’t until the end of our children’s middle school years that we finally accepted the magnitude of the damage caused by the tumor and treatment. Thereafter we changed our focus from what Sarah might achieve in life to how to support [End Page 21] her in the activities at which she still excels and how to keep her active, interested in life, and feeling good about herself.It would have been a huge gift if we had been provided with information about the possible late effects that can result from treating the brain of a 9–year–old... (shrink)

Until recently, the ocular surface is thought by many to be sterile and devoid of living microbes. It is now becoming clear that this may not be the case. Recent and sophisticated PCR analyses have shown that microbial DNA‐based “signatures” are present within various ethnic, geographic, and contact lens wearing communities. Furthermore, using a mouse model of ocular surface disease, we have shown that the microbe, Corynebacterium mastitidis (C. mast), can stably colonize the ocular mucosa and that a causal (...) relationship exists between ocular C. mast colonization and beneficial local immunity. While this constitutes proof‐of‐concept that a bona fide ocular microbiome that tunes immunity can exist at the ocular surface, there remain numerous unanswered questions to be addressed before microbiome‐modulating therapies may be successfully developed. Here, the authors will briefly outline what is currently known about the local ocular microbiome as well as microbiomes associated with other sites, and how those sites may play a role in ocular surface immunity. Understanding how commensal microbes affect the ocular surface immune homeostasis has the potential revolutionize how we think about treating ocular surface disease. (shrink)

The limbus is a narrow band of tissue that encircles the cornea, the transparent ‘window’ into the eye. The outermost layer of the cornea is the epithelium, which is necessary for clear vision. The limbus acts as a ‘reservoir’ for limbal stem cells which maintain and regenerate the corneal epithelium. It also functions as a barrier to the conjunctiva and its blood vessels. Limbal stem cell deficiency is a general term for diseases which are characterised by the impairment of (...) the limbus, limbal stem cells and their ability to replenish the corneal epithelium through proliferation and differentiation. Consequently, sufferers experience chronic pain and progressive blindness. This paper will highlight the salient milestones of limbal stem cell biology and potential future treatments for limbal stem cell deficiency. (shrink)

During development of the anterior eye segment, cells that originate from the surface epithelium or the neuroepithelium need to interact with mesenchymal cells, which predominantly originate from the neural crest. Failures of proper interaction result in a complex of developmental disorders such Peters' anomaly, Axenfeld–Rieger's syndrome or aniridia. Here we review the role of transcription factors that have been identified to be involved in the coordination of anterior eye development. Among these factors is PAX6, which is active in both (...) epithelial and mesenchymal cells during ocular development, albeit at different doses and times. We propose that PAX6 is a key element that synchronizes the complex interaction of cell types of different origin, which are all needed for proper morphogenesis of the anterior eye. We discuss several molecular mechanisms that might explain the effects of haploinsufficiency of PAX6 and other transcription factors, and the broad variation of the resulting phenotypes. BioEssays 26:374–386, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

PurposeTo investigate spontaneous brain activity in patients with dry eye and healthy control using the fractional amplitude of low frequency fluctuation technique with the aim of elucidating the relationship between the clinical symptoms of DE and changes in brain function.Material and MethodsA total of 28 patients with DE and 28 matched healthy volunteers were enrolled. Resting-state functional magnetic resonance imaging scans were performed in both groups. Then all subjects were required to complete a comprehensive Hospital Anxiety and Depression Scale. Receiver (...) operating characteristic curve analysis was used to evaluate the differences in fALFF values between the two groups and their diagnostic value. Linear correlations between HADS and fALFF values in different brain regions of DE patients were analyzed using the Pearson correlation coefficient.ResultsPatients with DE had significantly higher fALFF values in the left calcarine sulcus than the HC group, while fALFF values in the bilateral middle frontal gyrus and right MFG/right inferior frontal gyrus were significantly lower in DE patients than in HC group. fALFF values had a high diagnostic value for differentiating patients with DE from the HC group. Right MFG and right MFG/IFG were significantly correlated with HADS values.ConclusionOur study found that DE mainly involved functional disorders in the brain areas of the left CS, bilateral MFG and right MFG/right IFG, which helped us to find possible clinical features of DE disease and reflected the potential pathological mechanism of DE. (shrink)

In this unique and exhilarating autobiography, Allan Jones – Canada’s first blind diplomat – vividly describes how an untreatable eye disease slowly decimated his visual world, most challengingly during his postings in Tokyo and New Delhi, and how he discovered and took to heart the revelatory Indian philosophy that changed his life. Advaita Vedanta, the most iconoclastic and liberating of the classical Indian philosophies, profoundly altered the author’s experience of self and world. He found that the true self, as (...) distinct from the individual ego, far exceeds the boundaries of individuality. It lies beneath sightedness or blindness and is absolutely unaffected by the latter. This welcome shift of perspective was reinforced by startling discoveries in contemporary physics, evolutionary biology, and developmental psychology that are fully consistent with Advaitic metaphysics. As for the practical applications of metaphysics, this book demonstrates step by step how Advaitic insight and practice significantly reduce physical and psychological tension. The most telling examples have to do with adjustments compelled by extreme circumstances. Thus Jones describes how he drew upon Advaitic mindfulness techniques to maintain his white cane mobility skills in the teeth of permanent spinal, nerve, and muscle pain. The arc of Beyond Vision moves from the claustrophobically personal to the openness of the transpersonal. It begins in a dysfunctional family background, breaking out into a full life encompassing an adventurous foreign service career, spiritual exploration, and an unconventional kind of marital love. (shrink)

Objective: The value of spontaneous EEG oscillations in distinguishing patients in vegetative and minimally conscious states was studied. Methods: We quantified dynamic repertoire of EEG oscillations in resting condition with closed eyes in patients in vegetative and minimally conscious states (VS and MCS). The exact composition of EEG oscillations was assessed by the probability-classification analysis of short-term EEG spectral patterns. Results: The probability of delta, theta and slow-alpha oscillations occurrence was smaller for patients in MCS than for VS. Additionally, only (...) patients in MCS demonstrated fast-alpha oscillation occurrence. Depending on the type and composition of EEG oscillations, the probability of their occurrence was either aetiology dependent or independent. The probability of EEG oscillations occurrence differentiated brain injuries with different aetiologies. Conclusions: Spontaneous EEG oscillations have a potential value in distinguishing patients in VS and MCS. Significance: This work may have implications for clinical care, rehabilitative programs and medical–legal decisions in patients with impaired consciousness states following coma due to acute brain injuries. (shrink)

Love, fear, hope, calculus, and game shows-how do all these spring from a few delicate pounds of meat? Neurophysiologist Ian Glynn lays the foundation for answering this question in his expansive An Anatomy of Thought, but stops short of committing to one particular theory. The book is a pleasant challenge, presenting the reader with the latest research and thinking about neuroscience and how it relates to various models of consciousness. Combining the aim of a textbook with the style of a (...) popularization, it provides all the lay reader needs to know to participate in the philosophical debate that is redefining our attitudes about our minds. Drawing on the rich history of neurological case studies, Glynn picks through the building blocks of our nervous system, examines our visual and linguistic systems, and probes deeply into our higher thought processes. The stories of great scientists, like Ramon y Cajal, and famous patients, like Sperry's split-brained epileptics, illuminate the scientific issues Glynn selects as essential for understanding consciousness. Some might argue that his lengthy explorations of natural selection overemphasize evolutionary explanations of psychological phenomena, but they must also agree that evolutionary psychology has distanced itself mightily from social Darwinism in recent years and merits a reappraisal. The great consciousness debate may form the core of the 21st-century Zeitgeist; get ready for it with An Anatomy of Thought. -Rob Lightner From Publishers Weekly How do we know? What do we think? How could a philosophical problem-'the mind-body problem,' say-induce a headache? What can evolutionary theory, molecular biology, the history of medicine and experimental psychology tell us about the features of human consciousness, and (once again) how do we know? Glynn, a physician and Cambridge University professor, meticulously attempts to answer these questions and more, setting forth the results of all sorts of research relevant to our brains-from 19th-century dissections to Oliver Sacks-like case studies, work with monkeys and supercomputers, and the enduring puzzles of philosophy, which he rightly saves for near the end. After explaining evolution by natural selection and 'clearing away much dross,' Glynn lays out the experiments and theories that have shown 'how nerve cells can carry information about the body, how they can interact' and how sense organs work; demonstrates the 'mixture of parallel and hierarchical organization' in our brains and 'the striking localization of function within it'; considers where neuroscience is likely to go; and admits that, among the many fields of exciting research just ahead, 'we can be least confident of progress toward a complete, scientific explanation of our sensations and thoughts and feelings.' Other recent explaining-the-brain books have sometimes advanced simplistic, or implausibly grand, claims about the nature and features of consciousness in general. Instead, Glynn offers a patient, informative, well-laid-out researcher's-eye view of what we have learned, how we figured it out and what we still don't know about neurons, senses, feelings, brains and minds. (Apr.) Copyright 2000 Reed Business Information, Inc. From Library Journal The nature of consciousness, which perennially troubles the minds of scientists and philosophers, is the subject of an ever-growing body of literature. Two of the latest entries approach the topic from different perspectives. Glynn, a professor of physiology and head of the Physiological Laboratory at Cambridge, offers a comprehensive summary of what we know about the brain-both its evolution and its mechanisms. Among the topics he covers are natural selection, molecular evolution, nerves and the nervous system, sensory perception, and the specific structures responsible for our intellect. Using the mechanisms involved in vision and speech as models, Glynn skillfully describes various neurological deficiencies that can lead to 'disordered seeing' and problems with the use of language. He carefully distinguishes what we know through experimental evidence from what we know through the observation of patients with neurological damage. He also describes some of the major theories that attempt to explain why these structures arose. While his book concentrates on the structures that make up the mind, Glynn is well aware that some physical events appear explicable only in terms of conscious mental events-a situation that conflicts with the laws of modern physics. Only briefly, however, does he consider the various approaches that have been taken to deal with the issues of mind/body and free will. In contrast, this is the primary focus of The Physics of Consciousness. After reviewing the fundamentals of classic physics, Walker (who has a Ph.D. in physics) summarizes elements of the new physics in which our knowledge of space, time, matter, and energy are all dependent on the moment of observation. Walker explores the meaning of consciousness as a characteristic of the observer. In this context both the observer and the act of measurement are critical. In essence, Walker leads his reader on a journey through his concept of a 'quantum mind,' which can both affect matter (including other minds) and can be affected by other distant matter/minds. To break up what would otherwise be an extremely dense text, Walker also relates the very touching story of the loss of his high-school sweetheart to leukemia. Indeed, it is his memory of their relationship that drives Walker to seek an understanding of ultimate reality. At times, he has a tendency to be dogmatic-as when he concludes, 'our consciousness, our mind, and the will of God are the same mind.' While An Anatomy of Thought is appropriate for most academic libraries, the Physics of Consciousness will be most accessible to readers with some knowledge of advanced physics. -Laurie Bartolini, Illinois State Lib., Springfield Copyright 2000 Reed Business Information, Inc. From Booklist The codiscoverers of natural selection-Charles Darwin and Alfred Wallace-disagreed over the possibility of finding an evolutionary explanation for the human mind. Glynn here argues Darwin's side of the debate, tracing an eons-long path of development starting from simple amino acids floating in primal seas and extending through the erect hominids in which the powers of a massive brain first manifest themselves. Patiently adducing evidence of an evolutionary origin for the underlying molecular machinery, Glynn dissects the nerve centers that make possible speech and hearing, sight, and reading. Pressing deeper, he lays bare the cortical foundations of personality. But those who deal with the mind must attend also to the arguments advanced by philosophers. And it is when he turns from dendrites to syllogisms (especially the vexing mind-body paradox) that Glynn's empirical reasoning fails him. In the end, he concedes his perplexity in trying to conceive of an evolutionary origin for human consciousness. This concession may set the shade of Alfred Wallace to chortling, but it will draw readers into an honest confrontation with a profound enigma. Bryce Christensen. (shrink)

Amblyopia, or lazy eye, is a neurological vision disorder that studies have shown to affect two to five percent of the population. Current methods of treatment produce the best visual outcome, if the condition is identified early in the patient's life. Several early screening procedures are aimed at finding the condition while the patient is a child, including an automated vision screening system. This paper aims to use artificial intelligence techniques to automatically identify children who are at risk (...) for developing the amblyopic condition and should therefore be referred to a specialist, i.e., pediatric ophthalmologist. Three techniques, namely, decision tree learning, random forest, and artificial neural network, are studied in this paper in terms of their effectiveness, using metrics of sensitivity, specificity, and accuracy. The features used by the techniques are extracted from images of patient eyes and are based on the color information. The efficacy of pixel color data is investigated with respect to the measurement of the rate of change of the color in the iris and pupil, i.e., color slope features. A 10-fold stratified cross validation procedure is used to compare the effectiveness of the three AI techniques in this medical application domain. (shrink)

Visual Agnosia is a comprehensive and up-to-date review of disorders of higher vision that relates these disorders to current conceptions of higher vision from cognitive science, illuminating both the neuropsychological disorders and the nature of normal visual object recognition.Brain damage can lead to selective problems with visual perception, including visual agnosia the inability to recognize objects even though elementary visual functions remain unimpaired. Such disorders are relatively rare, yet they provide a window onto how (...) the normal brain might accomplish the complex task of vision. Visual Agnosia reviews a century of case studies of higher-level visual deficits following brain damage, places them in the general context of current neuroscience, and draws relevant conclusions about the organization of normal visual processing. It is unique in drawing on research in cognitive psychology, computational vision, visual neurophysiology, and neuropsychology to interpret the agnosias and draw inferences from them about visual object recognition.Following a historical account of agnosia research, Visual Agnosia offers a taxonomy of a wide range of agnosia syndromes, describing and interpreting the syndromes in terms of the latest theoretical models of visual processing and ultimately bringing them to bear as evidence on a variety of questions in the study of higher vision.Martha J. Farah is Associate Professor of Psychology at Carnegie Mellon University. Visual Agnosia is included in the Issues in Biology of Language and Cognition series, edited by John Marshall. (shrink)

ObjectiveTo explore alterations in white matter network topology in de novo Parkinson's disease patients with rapid eye movement sleep behavior disorder.Materials and MethodsThis study included 171 de novo PD patients and 73 healthy controls recruited from the Parkinson's Progression Markers Initiative database. The patients were divided into two groups, PD with probable RBD and PD without probable RBD, according to the RBD screening questionnaire. Individual structural network of brain was constructed based on deterministic fiber tracking and analyses were performed (...) using graph theory. Differences in global and nodal topological properties were analyzed among the three groups. After that, post hoc analyses were performed to explore further differences. Finally, correlations between significant different properties and RBDSQ scores were analyzed in PD-pRBD group.ResultsAll three groups presented small-world organization. PD-pRBD patients exhibited diminished global efficiency and increased shortest path length compared with PD-npRBD patients and HCs. In nodal property analyses, compared with HCs, the brain regions of the PD-pRBD group with changed nodal efficiency were widely distributed mainly in neocortical and paralimbic regions. While compared with PD-npRBD group, only increased Ne in right insula, left middle frontal gyrus, and decreased Ne in left temporal pole were discovered. In addition, significant correlations between Ne in related brain regions and RDBSQ scores were detected in PD-pRBD patients.ConclusionsPD-pRBD patients showed disrupted topological organization of white matter in the whole brain. The altered Ne of right insula, left temporal pole and left middle frontal gyrus may play a key role in the pathogenesis of PD-RBD. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female student (...) population is involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female student (...) population is involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

Paul Griffiths and John Matthewson argue that selected effects play the key role in determining whether a state is pathological. In response, it is argued that a selected effects account faces a number of difficulties in light of modern genomic research. Firstly, a modern history approach to selection is problematic as a basis for assigning function to human traits in light of the small population sizes in the hominin lineage, which imply that selection has played a limited role in shaping (...) these genomes in the evolutionarily recent past. Secondly, determining both the genetic basis of disease and selective histories of the various alleles involved may be experimentally intractable. Thirdly, the existence of “selected disorders” is well supported, and yet on the other hand many other common diseases may not reduce evolutionary fitness. In summary, the biological ends promoted by natural selection, as best modeled in recent research, do not adequately ground a concept of dysfunction that aligns well with the interests of human health. (shrink)

As many as two million people in the United Kingdom repeatedly see people, animals, and objects that have no objective reality. Hallucinations on the border of sleep, dementing illnesses, delirium, eye disease, and schizophrenia account for 90% of these. The remainder have rarer disorders. We review existing models of recurrent complex visual hallucinations (RCVH) in the awake person, including cortical irritation, cortical hyperexcitability and cortical release, top-down activation, misperception, dream intrusion, and interactive models. We provide evidence that these (...) can neither fully account for the phenomenology of RCVH, nor for variations in the frequency of RCVH in different disorders. We propose a novel Perception and Attention Deficit (PAD) model for RCVH. A combination of impaired attentional binding and poor sensory activation of a correct proto-object, in conjunction with a relatively intact scene representation, bias perception to allow the intrusion of a hallucinatory proto-object into a scene perception. Incorporation of this image into a context-specific hallucinatory scene representation accounts for repetitive hallucinations. We suggest that these impairments are underpinned by disturbances in a lateral frontal cortex–ventral visual stream system. We show how the frequency of RCVH in different diseases is related to the coexistence of attentional and visual perceptual impairments; how attentional and perceptual processes can account for their phenomenology; and that diseases and other states with high rates of RCVH have cholinergic dysfunction in both frontal cortex and the ventral visual stream. Several tests of the model are indicated, together with a number of treatment options that it generates. Key Words: Blindness; Charles Bonnet; cholinergic; cortical release; delirium; dementia; dream intrusion; hallucination; Perception and Attention Deficit (PAD) model; schizophrenia. (shrink)

Long considered "the noblest of the senses," vision has increasingly come under critical scrutiny by a wide range of thinkers who question its dominance in Western culture. These critics of vision, especially prominent in twentieth-century France, have challenged its allegedly superior capacity to provide access to the world. They have also criticized its supposed complicity with political and social oppression through the promulgation of spectacle and surveillance. Martin Jay turns to this discourse surrounding vision and explores its (...) often contradictory implications in the work of such influential figures as Jean-Paul Sartre, Maurice Merleau-Ponty, Michel Foucault, Jacques Lacan, Louis Althusser, Guy Debord, Luce Irigaray, Emmanuel Levinas, and Jacques Derrida. Jay begins with a discussion of the theory of vision from Plato to Descartes, then considers its role in the French Enlightenment before turning to its status in the culture of modernity. From consideration of French Impressionism to analysis of Georges Bataille and the Surrealists, Roland Barthes's writings on photography, and the film theory of Christian Metz, Jay provides lucid and fair-minded accounts of thinkers and ideas widely known for their difficulty. His book examines the myriad links between the interrogation of vision and the pervasive antihumanist, antimodernist, and counter-enlightenment tenor of much recent French thought. Refusing, however, to defend the dominant visual order, he calls instead for a plurality of "scopic regimes." Certain to generate controversy and discussion throughout the humanities and social sciences, _Downcast Eyes_ will consolidate Jay's reputation as one of today's premier cultural and intellectual historians. (shrink)

Prevention of age-related disorders is increasingly in focus of health policies, and it is hoped that early intervention on processes of deterioration can promote healthier and longer lives. New opportunities to slow down the aging process are emerging with new fields such as personalized nutrition. Data-intensive research has the potential to improve the precision of existing risk factors, e.g., to replace coarse-grained markers such as blood cholesterol with more detailed multivariate biomarkers. In this paper, we follow an attempt to (...) develop a new aging biomarker. The vision among the project consortium, comprising both research and industrial partners, is that the new biomarker will be predictive of a range of age-related conditions, which may be preventable through personalized nutrition. We combine philosophical analysis and ethnographic fieldwork to explore the possibilities and challenges of managing aging through bodily signs that are not straightforwardly linked to symptomatic disease. We document how the improvement of measurement brings about new conceptual challenges of demarcating healthy and unhealthy states. Moreover, we highlight that the reframing of aging as risk has social and ethical implications, as it is generative of normative notions of what constitutes successful aging and good citizenship. (shrink)

Debates about the genuine disease status of controversial diseases rely on intuitions about a range of factors. Adopting tools from experimental philosophy, this paper explores some of the factors that influence judgments about whether low sexual desire should be considered a disease and whether it should be medically treated. Drawing in part on some assumptions underpinning a divide in the literature between viewing low sexual desire as a genuine disease and seeing it as improperly medicalized, we investigate (...) whether health and disease judgments are affected by factors such as an individual’s gender, the cause of the low desire, whether the desire is high or low, and both personal and societal valuations of the condition. Our main findings indicate that (a) the cause of a condition influences whether it is judged a disorder, (b) how the individual values the condition influences whether the condition is seen as a proper target of medical intervention, and (c) perceived dysfunction influences judgments regarding health, disorder classification, medicalization, and medical intervention. Our findings help further illuminate the intricate interplay of factors that influence judgments about health and disease in controversial conditions. (shrink)

PurposeThyroid-associated ophthalmopathy is a vision threatening autoimmune and inflammatory orbital disease, and has been reported to be associated with a wide range of structural and functional abnormalities of bilateral hemispheres. However, whether the interhemisphere functional connectivity of TAO patients is altered still remain unclear. A new technique called voxel-mirrored homotopic connectivity combined with support vector machine method was used in the present study to explore interhemispheric homotopic functional connectivity alterations in patients with TAO.MethodsA total of 21 TAO patients (...) and 21 wellmatched healthy controls, respectively, underwent functional magnetic resonance imaging scanning in the resting state. We evaluated alterations in the resting state functional connectivity between hemispheres by applying VMHC method and then selected these abnormal brain regions as seed areas for subsequent study using FC method. Furthermore, the observed changes of regions in the VMHC analysis were chosen as classification features to differentiate patients with TAO from HCs through support vector machine method.ResultsThe results showed that compared with HCs, TAO patients showed significantly lower VMHC values in the bilateral postcentral gyrus, lingual gyrus, calcarine, middle temporal gyrus, middle occipital gyrus and angular. Moreover, significantly decreased FC values were found between the right postcentral gyrus/lingual gyrus/calcarine and left lingual gyrus/cuneus/superior occipital gyrus, left postcentral gyrus/lingual gyrus/calcarine and right lingual gyrus/ middle temporal gyrus, right middle temporal gyrus and left cerebellum-8/lingual gyrus/middle occipital gyrus/supplementary motor area, left middle temporal gyrus and right middle occipital gyrus, right middle occipital gyrus/angular and left middle temporal pole. The SVM classification model achieved good performance in differentiating TAO patients from HCs.ConclusionThe present study revealed that the altered interhemisphere interaction and integration of information involved in cognitive and visual information processing pathways including the postcentral gyrus, cuneus, cerebellum, angular, widespread visual cortex and temporal cortex in patients with TAO relative to HC group. VMHC variability had potential value for accurately and specifically distinguishing patients with TAO from HCs. The new findings may provide novel insights into the neurological mechanisms underlying visual and cognitive disorders in patients with TAO. (shrink)

Under the light of ancient Western philosophies, our darker moods like grief, anguish, and depression can seem irrational. When viewed through the lens of modern psychology, they can even look like mental disorders. The self-help industry, determined to sell us the promise of a brighter future, can sometimes leave us feeling ashamed that we are not more grateful, happy, or optimistic. Night Vision invites us to consider a different approach to life, one in which we stop feeling bad (...) about feeling bad. -/- In this powerful and disarmingly intimate book, Existentialist philosopher Mariana Alessandri draws on the stories of a diverse group of nineteenth- and twentieth-century philosophers and writers to help us see that our suffering is a sign not that we are broken but that we are tender, perceptive, and intelligent. Thinkers such as Audre Lorde, María Lugones, Miguel de Unamuno, C. S. Lewis, Gloria Anzaldúa, and Søren Kierkegaard sat in their anger, sadness, and anxiety until their eyes adjusted to the dark. Alessandri explains how readers can cultivate “night vision” and discover new sides to their painful moods, such as wit and humor, closeness and warmth, and connection and clarity. -/- Night Vision shows how, when we learn to embrace the dark, we begin to see these moods—and ourselves—as honorable, dignified, and unmistakably human. (shrink)

This chapter examines a question at the intersection of the mind-body problem and the analysis of mental representation: the question of the direction of constraint between psychological fact and theory and neurophysiological or physical fact and theory. Does physiology constrain psychology? Are physiological facts more basic than psychological facts? Or do psychological theories, including representational analyses, guide and constrain physiology? Despite the antireductionist bent of functionalist positions, it has generally been assumed that physics or physiology are more basic than, and (...) hence contraining on, psychological fact and theory. Section 1 sketches the intuitions that would lead one to adopt such a view. The chapter then examines whether one-sided constraint has been and should be found in practice. It argues that philosophical analysis of psychological science shows that rigorous functional analyses can be carried out in advance of physiological knowledge. Indeed, in the investigation of sensory perception, ascription of psychological function leads the way in the individuation and investigation of neurophysiology. We shall look at several cases in visual perception (binocular single vision, stereopsis, and color vision), in which psychological results have provided a basis for physiological research. It is tempting to think that the psychological functions that enable physiological investigation would be Wrightian teleofunctions. It is, thus, natural to suppose that psychologists and neurophysiologists have proceeded with a conception of the purpose of a given neural structure, and have viewed neural anatomy and neural activity as the substrate for or instantiation of various properly psychological functions. For example, neuroscientists surely understand that the eye and visual system are for seeing, rather than for detecting an electric discharge in the vicinity of the retina (which sighted humans can do, via the subjective light produced by such discharges), and they guide their investigations of the eye, visual cortex, and intervening pathways accordingly. As a result, they will view rods and cones in the eye as photoreceptors, even though these structures will produce "output" (will respond with hyperpolarization) to other forms of energy. At the same time, there may be cases in which the functions that have guided research are in fact precisely determined input-output functions, whose teleofunctional status is absent or misdescribed. I will argue that in the case of trichromatic color matches, the psychological function involved is an input-output function, and that this result has implications for the description of color vision as a psychological capacity. (shrink)

Applying a necessary condition communication theory formalism roughly similar to that of Dretske, but focused entirely on the statistical properties of long sequences of signals emitted by the interacting cognitive modules of human biology, we explore the regularities apparent in comorbid psychiatric and chronic physical disorders using an extension of recent perspectives on autoimmune disease. We find that structured psychosocial stress can literally write a distorted image of itself onto child development, resulting in a life course trajectory to (...) characteristic forms of comorbid mind/body dysfunction affecting both dominant and subordinate populations within a pathogenic social hierarchy. (shrink)

The understanding of locomotion in neurological disorders requires technologies for quantitative gait analysis. Numerous modalities are available today to objectively capture spatiotemporal gait and postural control features. Nevertheless, many obstacles prevent the application of these technologies to their full potential in neurological research and especially clinical practice. These include the required expert knowledge, time for data collection, and missing standards for data analysis and reporting. Here, we provide a technological review of wearable and vision-based portable motion analysis tools (...) that emerged in the last decade with recent applications in neurological disorders such as Parkinson's disease and Multiple Sclerosis. The goal is to enable the reader to understand the available technologies with their individual strengths and limitations in order to make an informed decision for own investigations and clinical applications. We foresee that ongoing developments toward user-friendly automated devices will allow for closed-loop applications, long-term monitoring, and telemedical consulting in real-life environments. (shrink)

PurposeThe primary angle-closure glaucoma is an irreversible blinding eye disease in the world. Previous neuroimaging studies demonstrated that PACG patients were associated with cerebral changes. However, the effect of optic atrophy on local and remote brain functional connectivity in PACG patients remains unknown.Materials and MethodsIn total, 23 patients with PACG and 23 well-matched Health Controls were enrolled in our study and underwent resting-state functional magnetic resonance imaging scanning. The regional homogeneity method and functional connectivity method were used to evaluate (...) the local and remote brain functional connectivity. Moreover, support vector machine method was applied to constructing PACG classification model.ResultsCompared with the HC, PACG patients showed increased ReHo values in right cerebellum _8, left CER_4-5, and right CER_8. In contrast, PACG patients showed decreased ReHo values in the bilateral lingual gyrus /calcarine /superior occipital gyrus and right postcentral gyrus. The ReHo value exhibited an accuracy of 91.30% and area under curve of 0.95 for distinguishing the PACG patients from HC.ConclusionOur study demonstrated that the PACG patients showed abnormal ReHo value in the cerebellum, visual cortex, and supplementary motor area, which might be reflect the neurological mechanisms underlying vision loss and eye pain in PACG patients. Moreover, the ReHo values can be used as a useful biomarker for distinguishing the PACG patients from HCs. (shrink)

PurposeThe purpose of this study is to describe the implementation and outcomes of an Eye Movement and Desensitization Reprocessing treatment-program for women with posttraumatic stress disorder after childbirth.MethodsA prospective cohort-study with pre- and post-measurements was carried out in the setting of an academic hospital in the Netherland. Included were women who gave birth to a living child at least 4 weeks ago, with a diagnosis of PTSD, or severe symptoms of PTSD combined with another psychiatric diagnosis. All received up to (...) 8 sessions of EMDR-therapy. The posttraumatic stress disorder Checklist for DSM-5 was administered before and after treatment. Trauma history was assessed before treatment with the Life Events Checklist for the DSM-5, the Childhood Trauma Questionnaire and the Childbirth Perception Scale. Descriptive statistics were used.ResultsForty-four women were referred, 26 met the inclusion criteria. After treatment, none of the women met the criteria for diagnosis of PTSD after on average 5 weekly sessions of EMDR- therapy. These outcomes are promising, as they were achieved in women with relatively high levels of psychiatric comorbidity and high rates of previous mental health treatment.ConclusionImplementing an EMDR-treatment program for women with PTSD after childbirth in the setting of an academic hospital is feasible and effective. Key factors for success include a close collaboration between the relevant hospital departments and a thorough case conceptualization addressing the etiology of the PTSD. (shrink)

Peterson et al. (2023) identify two potential uses of psychedelic drugs in Alzheimer’s disease and related disorders (AD/ADRD). The first is to treat depression and anxiety that commonly occur afte...

Mesopomatian Eye Disease Texts: The Nineveh Treatise. By Markham J. Geller and Strahil V. Panayotov. Die Babylonisch-Assyrische Medizin in Texten und Untersuchungen, vol. 10. Berlin: de Gruyter, 2020. Pp. xii + 454, illus. $181.99.

Applying Behrendt & Young's (B&Y's) model of thalamocortical synchrony to complex visual hallucinations in neurodegenerative disorders, such as dementia with Lewy bodies and progressive supranuclear palsy, leads us to propose that the primary pathology may be cortical rather than thalamic. Additionally, the extinction of active hallucinations by eye closure challenges their conception of the role of reduced sensory input.

An expanded version of the theory of traditional referentiality suggests that the ambiguous glowing eyes of Iliad 1.200 are Achilles', not Athena's. The image "glowing eyes" bifurcates into two syntactic groups, a verb group and an adjective group, with different connotations. The verb group is associated with enraged mortals; the adjective group, vision and the divine. This division suggests that the verbally glowing eyes in Iliad 1.200 belong to Achilles and express his fury. Yet, colored by the adjective group, (...) they also imply Achilles' tragedy by indexing his vision, semi-divinity, and vitality at the moment when he seals his doom. (shrink)

This article gives an overview of what we can learn about face perception from studying its disorders. The term “disorders” is broadly interpreted to include acquired brain injury and disease, neurodevelopmental differences, and neuropsychiatric problems. The article examines the reasons for various opinions about what can be learnt from disorders, ranging from the entire spectrum from “nothing that isn't misleading” to “everything worth knowing.” Cognitive neuropsychology typically operates in a unique way, in which the emphasis is (...) on detailed analysis of individual patients with theoretically interesting impairments. The article then highlights a number of the assumptions that get made, explains why things are often complicated, and emphasizes the value of a pragmatic “converging operations” approach in which evidence from disorders of face perception is brought together with other sources of data and theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Creativity Belongs to the Person, not to DiseaseJuan J. López-Ibor Jr. (bio) and María-Inés López-Ibor (bio)Keywordscreativity, patho-biography, Saint Teresa, visionsIn the paper, “From the Visions of Saint Teresa of Jesus to the Voices of Schizophrenia,” Cangas, Sass, and Pérez-Álvarez (2008) take an original approach to patho-biography that is very welcome.The temptation to designate historical individuals or characters of fiction as suffering from mental disease has always produced disagreeable (...) feelings in me. This sort of abuse of psychiatry and of the people in question is parallel to the abuse by the media or lay citizens when they describe, say, an especially violent murderer as a schizophrenic—forgetting that the vast majority of people with schizophrenia are not in the least violent. Having read Santa Teresa’s writings during my adolescence, well before I even considered entering medicine, I reacted to comments about her alleged psychiatric illnesses with uneasiness, to put it mildly. The Santa Teresa of La Vida de la Santa Madre Teresa de Jesús (her autobiography), of the Camino de Perfección, and of the El Castillo Interior was surely not a mental patient, it seemed to me. The same would apply to San Juan de La Cruz, Jean D’Arc, Don Quijote, Sancho Panza, Edipus, and Clitemnestra, to mention a few. Even van Gogh’s paintings did not seem to me the productions of a patient with schizophrenia or epilepsy. Of course all of them may have suffered, at certain periods of life, symptoms attributable to a mental disorder, but their creativity rested elsewhere, and was often manifest during healthy periods of their lives. After years spent fighting the stigma of mental diseases, and after organizing several exhibitions of works of art of people with mental diseases, we came to the conclusion that creativity and singularity belong to the person, not to the illness. Some of the diseases of these individuals may have being accidents (van Gogh’s hallucinations and psychotic symptoms, for example, were most probably due to intoxications with absinthe, then rich in hallucinogenic alkaloids such as tujone), or, together with other life circumstances, may have had unspecific influences on the person’s condition. In contrast with many other psychiatric disorders that are represented in ancient Greek and Roman literature, there are no descriptions of individuals with schizophrenia in the Greek and Roman literature dating from the fifth century bc to the beginning of the second century Ad (Evans et al. 2003), and several authors have speculated that schizophrenia did not exist before the eighteenth century (Ellard 1987).Caution is important when dealing with mental health and religious issues in contrast with creativity. The creativity of people suffering from bipolar disorders is well recognized (Jamison 1993) and [End Page 277] the same applies to alcohol and drug intoxication. Tellenbach (1986) has also written on the creativity of depressed persons, although he refers more to the disposition of mood (Schwermut) than to clinical depression as such. The link between melancholia and genius put forward by Aristotle has often been misinterpreted. The philosopher was considering the melancholic temperament and not the melancholic illness as we would understand it today. Of the four temperaments, it is in his view only the melancholic that is gifted with creativity. The sanguine person seeks the immediate pleasures of life, the choleric one considers himself powerful and dedicates himself to manifesting this power, and the phlegmatic individual is disconnected from life and seeks to live without effort or pleasure. The melancholic temperament leads to creativity because of the predominance of doubt, reflection, and dissatisfaction with the miseries of life.Freud’s notion of religiosity as a collective obsessive neurosis is totally mistaken, in my view. The three main themes of obsessions are cleanliness, order, and guilt. In none of these cases is the theme the goal of the action; rather, it is a strategy to contain anxiety. As a consequence, patients with obsessions and compulsions about dirt and cleanliness tend to be dirty themselves, because the real purpose of their compulsions is not in fact to be clean but rather to satisfy a ritual. When order... (shrink)

The essay is concentrated on emotional affects caused by representation of violence in the case of Russia’s war against Ukraine and beyond. Instant accessibility to first-hand visual information created fertile soil for planting and then multiplying manipulative strategies of one or another political interest. Meanwhile, the demand for shocking content continues to steadily rise because it guarantees popularity, spectacle and even a form of pleasure. This, in turn, supports a very propagandistic version of reality where violence plays a central role (...) in the overall design and transmission of contents, which is driven by shock as an affective medium. Blind Spot, Gradual Loss of Vision and Speck in the Eye represent a body of works by Mykola Ridnyi, address the question of what potential response(s) could be given by artistic interventions understood as a dialectical and critical framework able to face and make visible the problem of dehumanization through violence? (shrink)

Many current neurophysiological, psychophysical, and psychological approaches to vision rest on the idea that when we see, the brain produces an internal representation of the world. The activation of this internal representation is assumed to give rise to the experience of seeing. The problem with this kind of approach is that it leaves unexplained how the existence of such a detailed internal representation might produce visual consciousness. An alternative proposal is made here. We propose that seeing is a way (...) of acting. It is a particular way of exploring the environment. Activity in internal representations does not generate the experience of seeing. The out- side world serves as its own, external, representation. The experience of seeing occurs when the organism masters what we call the gov- erning laws of sensorimotor contingency. The advantage of this approach is that it provides a natural and principled way of accounting for visual consciousness, and for the differences in the perceived quality of sensory experience in the different sensory modalities. Sev- eral lines of empirical evidence are brought forward in support of the theory, in particular: evidence from experiments in sensorimotor adaptation, visual “filling in,” visual stability despite eye movements, change blindness, sensory substitution, and color perception. (shrink)

This perspective paper aims at discussing theoretical principles that could explain how emotion regulation and physical diseases mutually influence each other in the context of borderline personality disorder (BPD). Furthermore, this paper discusses the clinical implications of the functional relationships between emotion regulation, BPD and medical conditions considering dialectical behavior therapy (DBT) as a well-validated therapeutic intervention, which encompasses these issues. The inflexible use of maladaptive emotion regulation strategies (e.g., suppression, experiential avoidance, and rumination) might directly increase the probability of (...) developing physical diseases through a physiological pathway, or indirectly through a behavioral pathway. Some metabolic and chronic medical conditions could significantly impact emotional functioning through biological alterations involved in emotion regulation. Several empirical studies have shown high co-occurrence rates between BPD and several chronic physical diseases, especially ones linked to emotion-based maladaptive behaviors. DBT addresses physical diseases reported by individuals with BPD reducing problematic behaviors functionally associated to emotion dysregulation and identifying physical health as a goal forBuilding a Life Worth Living. (shrink)

Fahr’s disease is a rare idiopathic degenerative disease characterized by calcifications in the brain, and has also been associated with balance impairment. However, a detailed analysis of balance in these patients has not been performed. A 69-year-old woman with Fahr’s disease presented with a long-lasting subjective imbalance. Balance was analyzed using both clinical and instrumented tests. The patient’s balance was normal during clinical tests and walking. However, during standing, a striking impairment in vestibular control of balance emerged. (...) The balance behavior displayed mixed parkinsonian and cerebellar features, with a discrepancy between the high severity of the static and the low severity of the dynamic balance impairment. The balance impairment characteristics outlined in this study could help neurologists and physiatrists detect, stage, and treat this rare condition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Living with Blindness and Fibromyalgia while Occupying AgingKatherine SchneiderI’m blind from birth and in middle age developed fibromyalgia. I’ve retired from a thirty year career as a clinical psychologist and am working on my third book tentatively titled “Occupying Aging: Delights, Disabilities and Daily Life.” My relationship with medical professionals includes gratitude (without good care I would not be alive) and also frustration for assumptions often made about my (...) abilities. I write from the perspectives of an impatient patient, woman living in the United States, former provider of mental health services, person with both invisible and visible disabilities, and boomer moving into the world of the aged. My stories are mine of course, but when I swap medical stories with blind friends, similar happenings abound.When my mom fell down the stairs at a friend’s house, five months pregnant with me, she was told to go to bed for the next four months to save the pregnancy. Thus began the impact of health care professionals on me. I was born a month premature and spent my first month in an incubator. In 1949 it wasn’t known that the enriched oxygen atmosphere in an incubator would cause blindness. At least one lawsuit was filed against physicians and a hospital by a person blinded in this way. A large out–of–court settlement was received. The way I look at it, the health care community did the best they knew and without enough oxygen, I would have died.Early in my life, my parents took me to several ophthalmologists to see what could be done for my vision. Family folklore has it that I could smell a hospital as we entered and would begin howling. These early traumatic experiences may have led to my current healthy lifestyle so I don’t have to go to doctors much now. By about age five, it was clear that nothing could be done about my vision. For the next twenty years my forays into the health care system were for tonsillitis, sprains, and the usual childhood ills.In my early twenties, I developed acute glaucoma in one eye—caused, I’m convinced, by birth control pills. In seeking treatment for this condition, I encountered the first truly insensitive physician I’d met, who said, “Your eyes aren’t doing you any good; let’s take them out.” I was horrified! They were my eyes. I was attached to them, psychologically as well as physically. It turned out that a simple operation relieved the pressure and allowed me to keep my eyes. True, they are not the best looking big brown eyes around, but they did come with the package.Life with blindness seemed quite straightforward until my early forties, when I developed extreme fatigue and pain all over. I was worried. I knew a blind woman who had developed multiple sclerosis and I admired her, but I did not want to walk in her brave footsteps. Then a college student came to see me with the same symptoms and said that she had recently been diagnosed with fibromyalgia. I am often very empathetic with people’s concerns, but this time she complimented me by saying, “You’re great! You seem to know just how I feel.” I sagely counseled her about portioning out her energy carefully, prioritizing, using short cuts, and taking elevators when possible. Being an adult [End Page 216] student used to overachieving, she did not like what I was saying, but said she’d try to follow my advice because she could no longer do it all.What finally broke through my own denial was the day coiling up a hose and dragging it to the basement for the winter took me an hour. It left me totally exhausted and I figured that even being middle aged couldn’t account for feeling that awful.After a thorough physical and plenty of blood work to rule out Lyme disease and multiple sclerosis, I was diagnosed with fibromyalgia and placed on low doses of antidepressants to help me sleep through the night. The medication worked and I began to feel like myself again. My battle to accept that... (shrink)

An expanded version of the theory of traditional referentiality suggests that the ambiguous glowing eyes of Iliad 1.200 are Achilles', not Athena's. The image "glowing eyes" bifurcates into two syntactic groups, a verb group and an adjective group, with different connotations. The verb group is associated with enraged mortals; the adjective group, vision and the divine. This division suggests that the verbally glowing eyes in Iliad 1.200 belong to Achilles and express his fury. Yet, colored by the adjective group, (...) they also imply Achilles' tragedy by indexing his vision, semi-divinity, and vitality at the moment when he seals his doom. (shrink)

Background: Individuals with Autism Spectrum Disorder (ASD) have pronounced difficulties in attending to relevant visual information during social interactions. Method: We designed and evaluated the feasibility of a novel method to train this ability, by exposing participants to virtual human characters displayed on a screen which was entirely blurred, except for a gaze-contingent viewing window that followed participants’ eyes direction. The goal was to incite participants to direct their gaze towards the facial expressions of the virtual characters. Twenty-one adolescents with (...) ASD who attended ordinary school were randomized to either an experimental group, who was trained during a month and a half, or to a control group. Social communicative abilities were assessed during pre, post and follow-up tests. Results: After training, the experimental group showed significantly more interest in facial expressions on a test which involved understanding a dialogue. Significant differences were not found for the other tests used. Conclusions: This outcome suggests that the training method fostered participants’ awareness of the relevance of facial expressions. (shrink)

This paper presents a general computational treatment of how mammals are able to deal with visual objects and environments. The model tries to cover the entire range from behavior and phenomenological experience to detailed neural encodings in crude but computationally plausible reductive steps. The problems addressed include perceptual constancies, eye movements and the stable visual world, object descriptions, perceptual generalizations, and the representation of extrapersonal space.The entire development is based on an action-oriented notion of perception. The observer is assumed to (...) be continuously sampling the ambient light for information of current value. The central problem of vision is taken to be categorizing and locating objects in the environment. The critical step in this process is the linking of visual information to symbolic object descriptions; this is calledindexing, from the analogy of identifying a book from index terms. The system must also identifysituationsand use this knowledge to guide movement and other actions in the environment. The treatment focuses on the different representations of information used in the visual system.The four representational frames capture information in the following forms: retinotopic, head-based, symbolic, and allocentric. The functional roles of the four frames, the communication among them, and their suggested neurophysiological realization constitute the core of the paper. The model is perforce crude, but appears to be consistent with all relevant findings. (shrink)

The Journal of Medical Ethics can sometimes read part Men Like Gods and part A Brave New World. At times, we learn how all controversies can resolved with reference to four principles. At other times, we learn how “every discovery in pure science is potentially subversive”.1 This issue is no exception. Here, we can read about the utopia of gene editing, manufactured organs, and machine learnt algorithmic decision-making. We can also read about the dystopia of inherited disorders from edited (...) germlines, the testing of xenotransplants on braindead patients, and misdiagnosis by artificial intelligence. What we see in the three papers that I will foreground here is the application of medical ethics to avoid the dystopia while preserving the promises of medical science. But as I seek to explain here, our ability to address the controversies that we anticipate in medical science depend on our ability to refine our understanding of what medical ethics requires of us now. From the diagnosis of eye diseases from fungus images to predicting the risk of imminent risk of suicide attempts, machine learnt medical decision making has, in some high profile instances, outperformed clinicians in medical diagnosis and treatment recommendations. While clinician and machine learnt diagnoses will both involve degrees of uncertainty and fallibility, Thomas Grote2 asks us to consider is how much weight a clinician ought to give an algorithmic diagnosis which she disagreements with. Since a clinician is held to account for …. (shrink)