Reflex Research Articles

‘Are we famous or something?’ Participatory Health Research with children using photovoice

ABSTRACT Photovoice is a child-friendly method used in Participatory Health Research (PHR) to put children in a subject position to drive the research and social change. Little is known about the actual experiences of doing photovoice related to health issues in a primary school context regulated by adults. The purpose of this article is to explore how children’s voices can be genuinely taken into account in research and social change, and what the potentials and tensions are when using photovoice in schools. We present a case example of a PHR with primary school children using photovoice, and will focus on the lessons learned. Participating children were eager to tell their photostories, proud of their achievements, and felt ‘seen’ by adults, expressed in the phrase ‘Are we famous or something?’ Playful activities and concrete instructions helped children to create their own narrative. For the development of the children’s critical consciousness reflexive participatory actions and photo-elicitation were crucial. Their visuals prompted discussion and led to actions and plans taking into account their perspectives. Tensions included the struggle to find a right balance between guidance and control, protection and respect for autonomy and preset system requirements. Reflexivity and creativity are required to handle such tensions.

Total laparoscopic distal gastrectomy for gastric cancer: uncut Roux-en-Y anastomosis versus Billroth II anastomosis

Objective To compare the advantages and disadvantages between Uncut Roux-en-Y anastomosis and Billroth Ⅱ anastomosis in total laparoscopic distal gastrectomy (TLDG) for gastric cancer. Methods The clinical data of 132 patients with distal gastric cancer, who underwent TLDG with Uncut Roux-en-Y anastomosis or Billroth Ⅱ anastomosis in the Affiliated Hospital, Medical School of Ningbo University from February 2015 to December 2017, were retrospectively analyzed. There were 52 patients receiving TLDG with uncut Roux-en-Y anastomosis (RA group) and 80 patients receiving TLDG with Billroth Ⅱ anastomosis (BA group). Results Compared with BA group,the RA group had a longer operation time [(240.6±49.6) min vs. (202.2±36.4) min, F=2.356, P=0.000]and anastomosis time[(49.1±5.9) min vs. (47.3±4.2) min, F=4.45, P=0.043], more intraoperative blood loss[(128.9±130.0)ml vs. (79.2±62.5) ml, F=5.66, P=0.004]; and short times to first flatus[(2.7±0.8)d vs.(3.0±0.6) d, F=6.61,P=0.031],for liquid diet[(3.7±0.8) d vs.(4.0±0.6) d, F=7.35, P=0.022] and semifluid diet[(4.7±0.8)d vs. (5.0±0.6) d, F=6.43, P=0.013]. No perioperative death occurred in two groups; there were no significant differences in length of postoperative hospital stay [(9.4±4.2)d vs. (10.9±6.4) d, F=0.83, P=0.117]and the incidence of postoperative complication[5.8%(3/52) vs. 8.8%(7/80), χ2=0.40, P=0.527)]. Compared to BA group,alkaline reflex gastritis rate [3.8%(2/52) vs. 52.5%(42/80), χ2=40.04, P=0.000]and marginal ulcer rate were lower[0(0/52) vs. 11.3%(9/80), χ2=6.28,P=0.012]. There was no significant difference in dumping syndrome rate[0(0/52) vs. 3.8%(3/80), χ2=0.20, P=0.158] between two groups. Conclusion Uncut Roux-en-Y anastomosis can prevent alkaline reflex gastritis, marginal ulcer and Roux-en-Y stasis syndrome, it may be the preferable technique for reconstruction after total laparoscopic distal gastrectomy. Key words: Stomach neoplasms; Carcinoma; Laparoscopy; Gastrectomy; Anastomosis, Roux-en-Y

A Comparative Study on the Neural and Mechanical Properties of Spastic Medial Gastrocnemius Muscle before and after Twelve Months of Illness in Patients with Stroke

Introduction: Stroke is the most important cause of disability in adult people. Spasticity is a common motor disorder that develops secondary to upper motor neuron lesions such as stroke. Spasticity can cause changes in skeletal muscle, and affects both the neural and mechanical properties of skeletal muscles. The aim of this study was to compare neural and mechanical properties of spastic muscle between two groups of patients with stroke based on the duration of disease. Materials and Methods: In this study, 45 patients with stroke were divided into two groups of less and more than twelve months of stroke onset. Clinical assessment including muscle tone, achilles deep tendon reflex, and range of motion of ankle joint were measured using Modified Ashworth Scale, hammer, and goniometer, respectively. Neural properties, including H-reflex latency and Hmax/Mmax ratio, were acquired with electromyography (EMG) machine, and mechanical properties, including fascicle length, pennation angle, and muscle thickness in the spastic medial gastrocnemius muscle, were evaluated using ultrasonography instrument. To compare between two groups, we used t-test. Results: Except for the duration of the disease (P < 0.001), there were not any significant differences in others parameters between the two groups. Conclusion: The results of this study showed that there was no significant difference in neural and mechanical parameters between the patients with stroke before and after 12 months of onset.

PECULIARITIES OF PHILOLOGY STUDENTS’ SUBJECT-MATTER COMPETENCES FORMATION TECHNOLOGY ADOPTION WHILE HUMANITARIAN DISCIPLINES STUDYING

The article deals with the conceptual and pragmatic aspects of philological specialties students’ subject-matter competences formation technology adoption in the process of humanitarian disciplines studying. The aim of the article is to introduce the technology of philological specialties students’ subject-matter competences formation, corresponding to it didactic conditions. The technology consists of six stages (the stage of goal-setting and immersion, the stage of philological specialties students’ subject-matter competences successful formation motivational ensuring, the stage of educational information rationalization and didactic facilitation, the operational stage, the stage of promoting reflexive actions and the stage of determining correlations between the expected and the consequences of subject-matter formation, the self-presentation of the achieved. The varieties of educational activity, which were realized in six stages of the subject-matter competences formation technology based on parallel-concentric allocation, are presented.The research was conducted by applying the following methods: theoretical: analysis and synthesis of scientific, popular scientific, methodical and educational literature on the problems of higher school didactics and intensification of students’ training to research the specific use of competency approach as didactic paradigm; empirical: poll (questionnaire, interview) of students and faculty of humanities departments, monitoring the manifestation of the dynamics of students’ learning process ranking to identify best forms of educational work for the aim of solving research problems based on competence approach.It is determined that the main result of the development and adoption of philological specialties students’ subject-matter competences formation technology in the process of humanitarian disciplines studying is the increase of students' subject-matter competence formation level, provided that the technology and its corresponding didactic conditions are implemented in the educational process.

The effect of estradiol on sevoflurane-induced epileptiform cortical EEG waves in neonatal rats

Objective To investigate the effect of estradiol on sevoflurane-induced epileptiform cortical EEG waves in neonatal rats. Methods Forty neonatal rats, aged 4-6 days, weighting 8-15 g, were divided into 5 groups according to random number table: normal saline control group (group C), estradiol group (group E), ICI182780 (group I), Formestane group (group O) and estradiol + ICI182780 (group EI). After establishing the monitoring model of cortical electroencephalogram in neonatal rats, EEG was recorded continuously for 30 minutes, then different treatment drugs were given according to different groups. After 30 minutes of continuous recording of EEG, anesthesia induction was started with inhalation of 6% sevoflurane for 3 minutes, followed by inhalation of 2.1% sevoflurane to maintain anesthesia. Sevoflurane anesthesia lasted for 1 hour.The righting reflex disappearance time was recorded after sevoflurane anesthesia.The total duration, single duration and frequency of EEG convulsion waves were recorded.Spike frequencies were recorded at different periods.Animal respiratory rate was recorded after sevoflurane induction. Results One rat in group I and one rat in group EI showed convulsion wave before treatment, which were excluded from the study.The righting reflex disappearance time of group S, group E, group I, group O and group EI were (24.4±2.5)s, (16.4±4.2)s, (31.8±5.2)s, (29.8±1.8)s, (24.8±2.7)s respectively, and there were statistically significant differences among the 5 groups (F=16.693, P 0.05). Compared with group S, the total duration, single duration and frequency of convulsion wave were significantly increased in group E during anesthesia, and the differences were statistically significant (P<0.05). Compared with group E and group S, the total duration, single duration and frequency of convulsion wave during anesthesia were significantly reduced in group I, group O and group EI, and the differences were statistically significant (P<0.05). Compared with group S, the spike frequency of group E increased significantly in each period, and the differences were statistically significant (P<0.05). The frequency of spike wave in group I, group O and group EI at 65-70 min and 90-95 min were lower than that in group S, and the differences were statistically significant (P<0.05). The frequency of spike wave between group O and group EI during 115-120 min was statistically different with group S and group E(P<0.05). Conclusion The mechanism of epileptiform EEG wave induced by sevoflurane anesthesia may be related with neuroactive steroidal estradiol. Key words: Sevoflurane; Neonatal rats; Epileptiform electroencephalography; Estradiol

Effect of sevoflurane combined with propofol anesthesia on postoperative expression of hnRNPA2 in brain tissues of rats with mild cognitive impairment

Objective To evaluate the effect of sevoflurane combined with propofol anesthesia on the postoperative expression of nuclear heterogeneous ribonucleoprotein A2 (hnRNPA2) in brain tissues of rats with mild cognitive impairment (MCI). Methods Male Sprague-Dawley rats, aged 16-18 months, were anesthetized with pentobarbital sodium.MCI was induced by ligation of bilateral common carotid arteries after anesthesia.Forty-eight rats with MCI were divided into 4 groups (n=12 each) using a random number table method: sham operation group (SH group), sevoflurane anesthesia group (S group), propofol anesthesia group (P group), and sevoflurane combined with propofol anesthesia group (SP group). Group S inhaled 3% sevoflurane.Propofol was intravenously infused at a rate of 40 mg·kg-1·h-1 in group P. In group SP, 1.7% sevoflurane was inhaled, and propofol 20 mg·kg-1·h-1 was intravenously infused.The anesthesia time was 3 h in the three groups.After disappearance of eyelash reflex, open reduction and internal fixation was performed after tibial fracture was induced.Y-maze test was performed at 7 days after operation, and the percentage of time of staying at novel arm was calculated.The open field test was performed, and the total activity distance and time of staying at the central region were recorded.Then the rats were sacrificed, and brain tissues were obtained for determination of the expression of hnRNAP2 and γ-aminobutyric acid receptor A1 subunit (GABAA-α1) in hippocampus by immunofluorescence and Western blot, respectively. Results Compared with SH group, the percentage of time of staying at novel arm was significantly decreased, the expression of hnRNPA2 in the hippocampus was up-regulated, and the expression of GABAA-α1 was down-regulated in S and P groups, and the expression of hnRNPA2 in the hippocampus was up-regulated (P 0.05). Compared with S group or P group, the percentage of time of staying at novel arm was significantly increased, the expression of hnRNPA2 in the hippocampus was down-regulated, and the expression of GABAA-α1 was up-regulated in SP group (P 0.05). Conclusion The mechanism by which sevoflurane combined with propofol anesthesia does not aggravate the postoperative cognitive dysfunction may be related to up-regulating the expression of hnRNPA2 in brain tissues and maintaining GABAA-α1 stable in rats with MCI. Key words: Anesthetics, inhalation; Propofol; Cognition disorders; Heterogeneous nuclear ribonucleoprotein A2

Unilateral congenital microphthalmia in newborn: a case report

Here, we reported a case of term infant with unilateral congenital microphthalmia (CM). Physical examination conducted on 2 d after birth showed that the left eye was barely open and the eye socket was deeper than the right. Meanwhile, the cornea of the left eye was not completely exposed and the light reflex could not be elicited. Ophthalmology consultation, ultrasound and CT scan were conducted, and CM was finally diagnosed since the infant was found to have a small eyeball and shortened axial length, accompanying by pathological changes in the lens, vitreous body and retina. This case suggested that detailed physical examination should be carried out, especially for the eyes, including orbit and eyelid, presence or absence of secretion or concealed eyeball, together with medical imaging techniques technology, to ensure an early detection and diagnosis of CM in neonates. Key words: Microphthalmos; Infant, newborn

Insucesso empresarial e dimensão de aprendizagem empreendedora: estudo com empreendedores de micro e pequenas empresas

From a dynamic learning perspective, the development of comprehensive entrepreneurship takes into account that entrepreneurs learn during the creation and management of their enterprises. This study aims to analyze the dimension of entrepreneurial learning of entrepreneurs of micro and small-size companies that had business failure and have created new businesses. The methodology consists in a qualitative and exploratory study, with cross-section approach and longitudinal perspective. Three entrepreneurs were selected to participate in the study based on convenience and availability. Data were collected through interview in depth, using a standard protocol. Content analysis was used having the narrative as a basis for the research. The results showed that all entrepreneurs, at the time that they had business failure, presented an immediate and spontaneous reflexive action because they did not remain inactive when facing the challenges that had led them to stop theirs activities. In consideration of the dimension of entrepreneurial learning, we suggest that the acquisition of knowledge related to the overcoming of adversities and obstacles is able to stimulate and enable entrepreneurs to create a new venture.

Application of endoscopic selective posterior rhizotomy in the treatment of limb spasticity following brain injury

Objective To evaluate the efficacy and safety of endoscopic selective posterior/dorsal rhizotomy (SPR) in the treatment of limb spasticity following brain injury in adults. Methods A total of 88 patients with limb spasticity following brain injury treated with SPR from January 2015 to August 2016 at Department of Neurosurgery, Xinxiang Central Hospital were retrospectively enrolled into this study. Russman-Gage standard and Ashworth standard were used to evaluate the degree of limb spasticity and muscle tension after operation. Surface electromyography (SMG) and evoked potential (EP) were used to measure the sensory and motor nerve conduction velocities of affected limbs 3 weeks after operation. Lower extremity motor function was assessed with the Fugl-Meyer scale in lower extremity (FMA-L) at 3 and 8 weeks after operation. Walking ability was assessed with the Functional ambulation category (FAC) scale, and parameters of patients' stride, stride distance, stride speed and toe deflection angle distance were measured. All patients were followed up clinically after operation. The follow-up included observing the remission of limb spasticity and reviewing the lumbar spine radiographs. Results The spasticity of extremities was alleviated in 88 patients after operation. Three weeks after operation, the integrated electromyogram (iEMG) of tibialis anterior muscle in 88 patients was higher than that before operation (1.5±0.2 mV vs. 0.5±0.2 mV, P<0.001), while the gastrocnemius muscle was lower than that before operation (0.7±0.3 mV vs. 1.2±0.2 mV, P<0.001). After detection, latency of cortical somatosensory evoked potential (SEEP) in the dorsomedian part of the head(39.7±3.1 ms) and L2 (18.5±3.5 ms) was longer than that before operation (34.9 ±3.5 ms, 13.3 ±2.3 ms, both P<0.001). The sensory nerve conduction velocities in head (4.9±1.1 cm/ms) and popliteal region to L2(4.8±1.3 cm/ms) region were lower than those before operation (6.6±1.4 cm/ms, 6.3±1.5 cm/ms, both P<0.001). At 3-8 weeks post operation, the scores of FMA-L and FAC scales, stride length, stride distance and stride speed of 88 patients were higher than those before operation (all P<0.05), while the deflection angle of toes was lower (P<0.01). The rising trend time of 88 patients ranged from 6.2 to 26.6 months, with an average of 12.2±6.4 months. There were 83 (83/88, 94.3%) patients who had relief of spasticity in lower limbs and 74 (74/79, 93.7%) whose Achilles tendon reflex disappeared. No spinal deformity was found in the reexamination. Conclusion The neuroendoscopic SPR treatment for limb spasticity after brain injury could effectively relieve the symptoms of limb spasticity and promote the recovery of motor function. It seems safe and worthy of clinical application and promotion. Key words: Natural orifice endoscopic surgery; Craniocerebral trauma; Muscle spasticity; Extremities; selective posterior/dorsal rhizotomy

COMPARISON OF DIVER-OPERATED UNDERWATER PHOTOGRAMMETRIC SYSTEMS FOR CORAL REEF MONITORING

Abstract. Underwater photogrammetry is a well-established technique for measuring and modelling the subaquatic environment in fields ranging from archaeology to marine ecology. While for simple tasks the acquisition and processing of images have become straightforward, applications requiring relative accuracy better then 1:1000 are still considered challenging. This study focuses on the metric evaluation of different off-the-shelf camera systems for making high resolution and high accuracy measurements of coral reefs monitoring through time, where the variations to be measured are in the range of a few centimeters per year. High quality and low-cost systems (reflex and mirrorless vs action cameras, i.e. GoPro) with multiple lenses (prime and zoom), different fields of views (from fisheye to moderate wide angle), pressure housing materials and lens ports (dome and flat) are compared. Tests are repeated at different camera to object distances to investigate distance dependent induced errors and assess the accuracy of the photogrammetrically derived models. An extensive statistical analysis of the different systems is performed and comparisons against reference control point measured through a high precision underwater geodetic network are reported.

Enhancement of apneic reflex induced by sumatriptan: Role of bronchopulmonary C‐fibers in rats

Sumatriptan (Imigran®), an agonist of 5‐hydroxytryptophan (5HT)1B and 5HT1D receptors, is widely and effectively used to alleviate migraine headaches. Two of the most frequent side effects reported by patients are somatic hyperalgesia and chest discomfort. The chest syndromes are represented by chest tightness and dyspnea. Bronchopulmonary sensory C‐fibers innervate all levels of respiratory tract. Stimulation of the sensory fibers elicit airway reflexes including bronchoconstriction, shortness of breath, and dyspnea. This study was carried out to determine the effect of intravenous infusion of sumatriptan on sensitivity of ventilatory reflexes and bronchopulmonary sensory C‐fibers. In anesthetized, spontaneously breathing Brown‐Norway rats, the apneic response to right‐atrial injection of capsaicin was markedly enhanced 3 min after termination of sumatriptan infusion, which returned toward baseline within 80 min. In contrast, infusion of vehicle of sumatriptan failed to cause the enhancing effect. In our electrophysiological study, sumatriptan infusion did not influence the baseline activity of bronchopulmonary sensory C‐fibers in open‐chest, and artificially ventilated rats. However, these C‐fiber responses to right atrial injection of capsaicin were markedly potentiated 3 min after termination of sumatriptan infusion. The results suggest that sumatriptan enhances the excitability of bronchopulmonary sensory C‐fibers, which may, in turn, contribute to airway hypersensitivity.Support or Funding InformationSupported in part by grants TMU105‐AE1‐B17, MOST‐107‐2320‐B‐038‐041 and MOST‐107‐2320‐B‐038‐049‐MY3This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

A mechanism for the formation of unconditioned reflexes

The paper considers a possible mechanism for the formation of unconditioned reflexes in organisms with the nervous system before their birth, that is, before the environmental impact on a certain organism. The effect of the environment is detected by receptors. It generates signals coming from the receptors into the nervous system, which organizes the organism’s reaction to the environmental effect. Inter-neuronal connections, which carry out unconditioned reflexes, realize input of signals about the environmental effect from the receptors in the nervous system.

Branding in the Online Space: The Emerging Frontier of New-Age Marketing

Technology is proving to be both an enabler and a disabler as far as meaningful and effective brand experience is concerned. As humankind continues to march towards an elusive and illusive utopia of technological advancement, the personal touch of the brand experience is fast becoming a thing of the past. While it cannot be denied that the modern methods of marketing are leaving no stone unturned in ‘connecting’ with the customer, but, ironically enough, it is the ‘customer connect’ itself, which is getting lost in the process. Modern marketing, in general, and its digital avatar, in particular, are creating what can be called an ‘imaginary intimacy’ with the customer. The poor Alice-like customer is being led into a Wonderland of false promises. The clueless customer is being hoodwinked into believing that the gadget on his palm or his lap or his desk is the repository of remedies for all maladies. The biggest demerit of the digital revolution in marketing is that it has reduced consumer behaviour to a set of split-second reflex actions. The ‘thinking consumer’ is an endangered species now. This is a casualty of phenomenal proportions, which the marketer will realize to his detriment in the long run.

Analysis on risk factors for hydrocephalus after traumatic brain injury

Objective To investigate the risk factors for post-traumatic hydrocephalus (PTH) after traumatic brain injury (TBI). Methods A retrospective case control analysis was made on the clinical data of 794 patients with acute TBI admitted to Shenzhen Second People's Hospital between January 2007 and January 2017. There were 639 males and 155 females, aged 1-90 years [(40.5±18.6)years]. All patients were followed up for 1 years, and the patients were divided into PTH group (n=46) and non-PTH group (n=748) according to their prognosis. The following information including Glasgow coma score (GCS) on admission, pupil reflex, midline shift and cistern compression, subarachnoid hemorrhage (SAH), operation method, decompressive craniectomy, hydrocephalus after operation, intracranial infection, timing of cranioplasty were analyzed using univariate analysis and Logistic regression. Results PTH occurred in 46 patients (5.8%). Univariate analysis showed that GCS, midline shift, decompressive craniectomy, subdural effusion, timing of cranioplasty and SAH were significantly related to PTH (P<0.05 or 0.01). Logistic regression identified low GCS (OR=3.778), decompressive craniectomy (OR=2.508), subdural effusion (OR=2.269), timing of cranioplasty (≥3 months)(OR=10.478) and SAH (OR=23.391) as the independent risk factors for PTH (P<0.05 or 0.01). Conclusion PTH is a common serious complication of traumatic brain injury, affected by low GCS, decompressive craniectomy, subdural effusion, delayed cranioplasty and SAH. Key words: Brain injuries; Hydrocephalus; Risk factors

Unsilencing the silent South African HIV-positive RESEARCHER: An HIV-positive researcher’s reflection on negotiating insider- outsider positionalities whilst conducting a HIV study in eThekwini, KwaZulu-Natal, South Africa

The research study that informed this article’s discussion, critically interrogates an HIV-infected research team’s positionality whilst conducting a mixed-methods’ study on HIV-positive patients’ experiences of the public ART programme at four ARV clinics in KwaZulu-Natal, South Africa. It primarily utilises the principal investigator’s (PI) narrative to explore insider/outsider positionality, reflexivity, bracketing and participatory action research through exposure of feelings, emotions, challenges, engagements, relationships and observations. The fluid positionality of the HIV-positive research team presented both challenges and opportunities. However, the opportunities for more HIV-infected researchers to engage in HIV-related research to assist with destigmatising HIV, close research gaps and the creation of a trustworthy research environment to achieve an ethical and reliable health science study, far outweigh the challenges. Further, such research can improve patients’ support and healthcare, healthcare workers’ perceptions of patients, and provide a guide for policymakers to better understand the recipients of HIV policies. Lastly, the term ‘HIV reflexivity’ is coined as a result.

Clinical trial of acupuncture treatment of gastroesophageal reflux cough by needling dorsal segment of the Governor Vessel

To observe the curative effect of acupuncture stimulation of the back segment (10 spots below the spinous processes from T3 to T12) of the Governor Vessel in the treatment of gastroesophageal reflux cough (GERC). A total of 60 cases of GERC patients were randomly divided into acupuncture and medication groups (n＝30 in each). For patients of the acupuncture group, the depression spots below the spinous processes from T3 to T12, including acupoints Shenzhu (GV12), Shendao (GV11), Lingtai (GV10), Zhiyang (GV9), Jinsuo (GV8) and non-acupoints (T4, T8, T12) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were ordered to take omeprazole capsules (20 mg/time), twice a day for 8 weeks. The therapeutic effect was assessed by using "Reflux Diagnostic Questionnaire"(RDQ, scores of symptoms of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0－40 points), cough symptom score (0－3 points) and "Leicester Cough Questionnaire" (LCQ, scores of physiological, psychological and social functions, 0－21 points), respectively. Following the treatment, RDQ score and cough symptom scores during both daytime and night were significantly decreased in both groups (P<0.05)，and the scores of physiological status, psychological health and social function of LCQ were significantly increased in both acupuncture and medication groups in comparison with their own pre-treatment (P<0.05). The therapeutic effect of acupuncture was markedly superior to that of medication in lowering RDQ score and cough symptom scores of daytime and night, and in raising LCQ scores of the physiological status, psychological health and social function (P<0.05). Acupuncture stimulation of the dorsal segment of the Governor Vessel is effective in improving clinical symptoms and living quality of GERC patients.

Optical coherence tomography angiography characteristics of choroidal neovascularizaiton in eyes with flat irregular pigment epithelial detachments

Objective To assess the occurrence of CNV in patients presenting with flat irregular pigment epithelial detachments (FIPED). Methods Forty-five patients (49 eyes) with FIPED on OCT were enrolled in this retrospective study. There were 25 males (28 eyes) and 20 females (21 eyes). The mean age was 61.022±9.292 years. FFA, ICGA, spectral domain OCT and OCT angiography (OCTA) were performed in all patients during the same period. The FIPED was defined as an irregular elevation of the RPE allowing distinct visualization of Bruch’s membrane on OCT B-scan. The abnormal vascular signals from the deep retinal layer to the choroid layer on OCTA was defined as CNV. The CNV was classified into a type 1 CNV and a type 2 CNV according to the OCT characteristics. The CNV was classified into a typical and occult CNV according to the characteristics of the FFA image. Of all 49 eyes, fundus angiography revealed 18 eyes (36.7%) with CNV, and 31 eyes (63.3%) with no characteristic signs of CNV. FFA examination found that CNV in 8 eyes (classic CNV in 1 eyes, occult CNV in 7 eyes), which confirmed by OCT were type 1 CNV; transmitted fluorescence in 41 eyes. ICGA examination showed that CNV-like hyperfluorescence spots in 18 eyes, suspicious hyperfluorescence spots in late stage in 20 eyes, and choroidal high permeability in 11 eyes, respectively; and 18 CNV eyes were confirmed to be type 1 CNV by OCT. To compare the detection of CNV by OCTA and fundus angiography. Results Of the 49 eyes with FIPED, OCTA detected 36 eyes (73.5%) of type 1 CNV, and full or partial strong reflex signals were seen in FIPED; 13 eyes (26.5%) were not associated with CNV, and some strong reflection signals were found in FIPED in 9 eyes, 4 eyes with weak reflection signal. The FFA was examined for 1, 7 eyes of the classic and occult CNV, which confirmed to be type 1 CNV by OCTA. Among the 18 eyes with CNV which detected by ICGA, OCTA also found type 1 CNV. Among the 20 eyes with ICGA’s late suspicious strong fluorescent spots, OCTA showed 17 eyes of type 1 CNV; in 11 eyes with high choroidal permeability, OCTA showed type 1 CNV in 1 eye. Among the 36 eyes with CNV which detected by OCT, there were SRD in 32 eyes, no SRD in 2 eyes and retinal interlamellar cavities in 2 eyes. Conclusion OCTA can detect 73.5% of FIPED eyes with CNV. Compared with traditional fundus angiography, OCTA has a higher detection rate of CNV under FIPED. The FIPED of the internal strong reflection signal has a certain diagnostic value for the type 1 CNV. Key words: Flat irregular pigment epithelial detachments; Choroidal Neovascularization/diagnosis; Tomography, optical coherence; Fluorescein angiography; Indocyanine green/diagnostic use

The Role of Chemical Factors in the Inflammation and Infection of Cervico-facial Actinomicosis

Inflammation is a reflex reaction of the body to the action of some harmful agents, a reaction that manifests itself as a complex of functional and structural modifications of a vasculo-tisular nature, this reaction has occurred in the process of evolution. The intensity of the inflammatory reaction depends on the reactive properties of the body, the location of the inflammatory process, the anatomo-physiological particularities of the damaged tissue, and the conditions in which the inflammation develops. As accurate as dental technique and the practitioner�s skill, if the specific conditions of each patient are not taken into account, the benefit medical cannot rise to a higher level, with the final result being compromised by complications with unpredictable risks. Actinomycosis is a specific infection with subacute or chronic evolution, common to humans or animals, caused by microorganisms of the actinomycete family. The location of the affection in the cervico-facial sphere is four times bigger than the rest of the body; the disease is manifested by rough nodules, red in the cheek or sub-maxillary region, fistulas and scars on which new lesions appear. In order to achieve the proposed objectives, we conducted a study on a representative human sample of 158 patients, from the Oral and Maxillofacial Clinic, between 1.01.2013-31.12.2017. Risk factors (gender, age, area, dental anxiety score), our findings are unlikely to define separately the potential for the risk of installing actinomycosis. The level of dental anxiety as well as the general status of the patient are the markers that require the greatest attention from the practitioner in order to prevent a dental problem.

Hipertensi Pada Kehamilan Dan Kejadian BBLR di RSUD Kota Tasikmalaya

Bayi BBLR yang seringkali menjadikan berisiko tidak saja karena komplikasi neonatal yang dialami (misal hiperbilirubinemia dan sindrom gawat nafas) tetapi juga oleh faktor resiko lainnya (misal anomali bawaan yang dikaitkan dengan BBLR). BBLR memerlukan penatalaksanaan yang tepat oleh seorang perawat karena apabila tidak mendapatkan perawatan yang adekuat, BBLR akan menimbulkan dampak terhadap sistem pernafasan, sistem penglihatan, refleks, gerakan-gerakan motorik bahkan dampak jangka panjang yaitu kesulitan belajar dan tingkah laku (neurobehaviour). Penelitian dilatarbelakangi oleh tingginya angka kejadian BBLR di RSUD Kota Tasikmalaya pada setiap tahunnya sehingga diperlukan adanya penelusuran dari penyebab kejadian BBLR yang dialami. Tujuan penelitian untuk mengetahui adanya hubungan antara hipertensi pada kehamilan dengan kejadian BBLR di RSUD Dr. Soekardjo Kota Tasikmalaya. Hipotesis penelitian ada hubungan antara hipertensi pada kehamilan dengan kejadian BBLR. Manfaat penelitian memberikan dasar praktek berbasis bukti ilmiah (evidences based practice) kepada praktisi keperawatan, bahwa ada hubungan antara hipertensi pada kehamilan dengan kejadian BBLR. Metode penelitian kuantitatif dengan pendekatan cross sectional. Pengolahan data menggunakan analisis univariat dan bivariat. Hasil penelitian tidak ada hubungan yang signifikan antara hipertensi pada kehamilan dengan kejadian BBLR di RSUD Kota Tasikmalaya dengan p value&gt;0,05. Saran hendaknya perawat lebih meningkatkan pendidikan kesehatan pada masyarakat agar masyarakat lebih memahami tentang resiko terjadinya BBLR.

A Pesquisa Histórica em Administração: uma Proposta para Práticas de Pesquisa

Desde a última década, o uso da História vem se consolidando como uma perspectiva legítima nas pesquisas no campo da Administração, de forma geral, e nos Estudos Organizacionais de forma mais específica. Entretanto, apesar do amadurecimento, esse tipo de pesquisa ainda carece de maiores explicações a respeito de conceitos e procedimentos que possibilitem a operacionalização da pesquisa histórica dentro do campo da Administração. Nesse sentido, este artigo tem como objetivo discutir os caminhos da Pesquisa Histórica em Administração como método de pesquisa. Para atingir esse objetivo, procuramos revisitar a retomada da pesquisa histórica em Administração para, em seguida, discutir três dos principais conceitos norteadores da pesquisa histórica: fato histórico, fontes e documentos históricos e a operação histórica, inseridos em um percurso e operacionalização metodológica, considerando as diferentes etapas da pesquisa histórica e suas particularidades. Pretendemos, com essa discussão, abrir caminhos para que pesquisadores da área de Administração possam assumir uma atuação crítica e reflexiva capaz de romper com o pensamento tradicional que percebe as organizações como estruturas estáticas, regulares e constituídas a partir de relacionamentos causais cujos padrões e leis universais buscam explicar e predizer, historicamente, o que acontece no mundo social.