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April 29, 2013

Personalized Photo Jigsaw Puzzle


Aryeh Abramovitz's Cool Tools review follows.


My family is addicted to jigsaw puzzles. When a special birthday came up for one of my daughters, I prepared a photo collage using paint.net and ordered a photo jigsaw puzzle from Venus Puzzle.

The puzzle comes in a custom box, shrink-wrapped and with a copy of the submitted photo on the cover, commercial quality. Puzzle pieces and printing was of excellent quality.

Since you can submit any image with the suggested proportions and dpi, this service can replace or improve upon the previously reviewed Hometown Puzzle.

The advantage to this site is that it ships internationally with the same DHL charges anywhere in the world.

For my next daughter I didn't want to use DHL, and Venus Puzzle referred me to their sister site Piczzle, which has the same product range and quality, also shipping worldwide (but with regular post instead of DHL).

Base prices are a little cheaper on the Venus Puzzle site, but for my country, DHL added customs service charges that made it unattractive. The order from Piczzle arrived in about a week, instead of in 4 days.

Note that both sites are slightly clunky, and only the Venus Puzzle site has the necessary information on the recommended proportions and resolution: In my case I purchased the 550 piece puzzle which uses a 1:1.25 ratio and minimum dpi of 150.


550-piece Venus Puzzle: $38.

550-piece Piczzle Puzzle: $55.

April 29, 2013 at 08:01 PM | Permalink | Comments (1) | TrackBack

BehindTheMedspeak: Lyme Disease in Virginia


From the Virginia Department of Health's email to all doctors in the state:


As the weather gets warmer, Virginians will spend more time outdoors and this may increase their exposure to ticks and tickborne diseases, including Lyme disease.  Early treatment for Lyme disease and other tickborne diseases depends upon clinical suspicion based on exposure history, symptom history, and findings from the physical exam. Most patients, when treated with antibiotics in the early stages of these infections, quickly recover.



The Virginia Department of Health is committed to providing up-to-date, evidence-based information regarding the epidemiology and prevention of Lyme disease and other tickborne diseases to help you diagnose and prevent these infections among your patients.  Lyme disease continues to evolve epidemiologically in Virginia.  In 2012, there were an estimated 1,110 confirmed or probable cases of Lyme disease (an increase of about 9% from 2011).

Cases were reported in all regions of the state (see map).  While Lyme disease continues to be the most commonly reported tickborne illness in Virginia, there were approximately 460 cases of spotted fever group rickettsioses ,which may include some cases of Rocky Mountain spotted fever (RMSF), and approximately 150 cases of ehrlichiosis/anaplasmosis (about 88% were determined to be ehrlichiosis) reported in Virginia in 2012.



During the spring and summer, you may see patients who present with signs and symptoms of Lyme disease.  Lyme disease and other tickborne diseases should be considered in any patient who presents with a febrile illness during warm weather months.  In many instances, these patients may not recall a tick bite.  Some patients may present with a rash, while others may describe symptoms such as fatigue, chills, fever, headaches, myalgias, or arthralgias.  If they do present with a history of a tick bite, remember that an infected tick must be attached to the skin for at least 36 hours to transmit the Lyme bacterium Borrelia burgdorferi, 24 hours to transmit ehrlichiosis/anaplasmosis, and only 10 to 20 hours to transmit RMSF. Also, remember that the blacklegged tick Ixodes scapularis is the only tick that can transmit Lyme disease in Virginia.


Laboratory Testing

Laboratory testing can be a useful tool in the diagnosis of tickborne disease, aiding decisions regarding the initiation of prompt and effective treatment.  For Lyme disease, the Centers for Disease Control and Prevention (CDC) recommends a two-tiered process for testing blood for evidence of antibodies against Lyme disease bacteria (see graphic).  This two-step method consists of an enzyme immunoassay (EIA) or immunofluorescent assay (IFA), which, if positive or equivocal, is followed by a Western blot.  IgM Western blots as part of this method are valid only for patients with illness onset within 30 days.  IgG Western blots are more specific for patients with older infections. With many laboratories, you can order an EIA with reflex to Western blot.


Some of your patients may express concern regarding the accuracy of Lyme testing. Serological testing for Lyme disease can yield false negatives if blood is collected too early in the course of illness. It can also yield false positives due to non-specific reactivity of EIA, IFA and IgM Western blot when these methods are used individually. IgG Western blot tests interpreted by the standard criteria are highly specific and unlikely to yield false positives, but may remain positive in some patients for many years.

While laboratory blood tests are not perfect, they can be helpful when used correctly and performed with validated methods.  Laboratory tests are not recommended for patients who do not have symptoms typical of Lyme disease.  Just as it is important to correctly diagnose Lyme disease when a patient has it, it is important to avoid misdiagnosis and treatment of Lyme disease when the true cause of the illness is something else.  For more information about laboratory testing used in the diagnosis of Lyme disease, please refer to CDC guidelines.



One of the most important things to remember about Lyme disease is that it is preventable.  To assist your patients in preventing tickborne diseases, remind them to reduce their exposure to ticks by encouraging them to use insect repellent, wear protective clothing, and regularly check for and remove ticks.

April 29, 2013 at 04:01 PM | Permalink | Comments (4) | TrackBack

Spike Ice Cube Tray


From the website:



Is your drink a little warm... punk?


Skip the cutesy ice cubes and chill it down with frozen ice spikes forged within this cool new Spiked! Ice Tray.

Just fill this badass silicone ice tray with water, toss it in the freezer, crack your knuckles and sneer while you wait, remove, and fix yourself the coldest and toughest beverage in town... your town now.




[via The Green Head]

April 29, 2013 at 12:01 PM | Permalink | Comments (0) | TrackBack

Blast from the Past — bookofjoeTV first surfaced February 3, 2006


A lot of readers think I'm just talking through my hat when I remark from time to time that my imminent adoption of Google Glass will likely light the long fuse of my dream since I began boj in August of 2004: that eventually bookofjoeTV would be my platform.

Well, guess what?

A reader drilled down in my archives — what, you've got nothing better to do? But I regress (heh) — and brought back a post dated February 3, 2006 — over 7 years ago — which contained a graphic (top) sent to me by a reader whose name I've either forgotten or never knew.

No matter: the dream is alive.

April 29, 2013 at 08:01 AM | Permalink | Comments (0) | TrackBack

There is NO aspect of a CAT that is Not PERFECT


Flautist, grand panjandrum and principal of Motley Apricot Paintworks, has outdone herself: about 8 p.m. last night the original painting above appeared in her Etsy store.

A snip at $75.

I will be very surprised when I wake up today and visit the store if the piece hasn't been sold.

Fair warning.

April 29, 2013 at 04:01 AM | Permalink | Comments (0) | TrackBack

BehindTheMedspeak: Is your nephrologist a quack?

Screen Shot 2013-04-28 at 3.58.52 PM

You be the judge.

[via Richard Kashdan]

April 29, 2013 at 12:01 AM | Permalink | Comments (0) | TrackBack

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