应用微视野仪对眼底损伤者进行视敏度的评估

目的探讨眼底损伤者的微视野检测指标与视敏度的相关性,及微视野仪评估视功能的应用价值。方法应用MP-1型微视野仪,对100名眼底损伤者进行视网膜光敏感度、固视稳定性检查,获得黄斑中心2°视网膜平均光敏感度、全视野视网膜平均光敏感度、固视中心2°固视率、固视中心4°固视率等微视野检测指标数值,将其与视敏度进行Spearman相关分析及多元回归分析。结果黄斑中心2°视网膜平均光敏感度、全视野视网膜平均光敏感度、固视中心2°和4°固视率与视敏度均呈正相关,其相关系数分别为0.676、0.693、0.670、0.665（p〈0.05）。散点图显示各微视野指标与视敏度间具有直线相关趋势,由此得出多元线性回归方程为：Y=2.543＋0.043×X2＋0.017×X4（X2全视野视网膜平均光敏感度,X4固视中心4°固视率）。结论微视野检测指标与视敏度之间有良好的正相关性,具有法医学应用价值。     

视敏度与固视性质检查的相关性

目的 探讨固视性质检查在客观评估视敏度方面的可行性.方法 应用MP-1微视野仪检查75例眼底损伤者的固视性质,将受检者分为中心固视组、不确定组、偏心固视组.分析三组间视敏度的差异,同时对视敏度与微视野视网膜平均光敏感度的相关性进行Pearson相关、回归分析.结果 （1）视敏度检测显示,中心固视组为4.80±0.16,不确定组为4.20±0.45,偏心固视组为3.40±0.57.单因素方差分析提示,三组间视力水平的差异具有统计学意义（P＜0.05）.（2）视敏度（y）与视网膜平均光敏感度（x）之间均存在线性关系：y=-18.76＋6.21x,Pearson相关系数为0.707（P＜0.05）.结论 视敏度与固视性质检查之间存在统计学意义上的正相关,固视性质检查具有客观预估视敏度区间的法医学价值.     

微视野仪在视功能评估中的应用

微视野仪是一种在直视眼底的条件下,能定量、定位地测量黄斑区域的视网膜光敏感度,同时可以全程记录被检查眼的固视轨迹,自动分析固视位置、固视稳定性,并能将微视野图与眼底像点对点重合,实现功能和结构上的组合。微视野仪的各项研究指标与主观视力有良好相关性,为定量评估视力提供了新手段,在法医学视功能的评定中将具有一定的应用潜力。本文综述了微视野仪的原理、方法及研究指标,并着重探讨微视野仪在视功能评估中的作用,以期为法医学视功能评估提供参考。     

眼损伤图形刺激对比度视诱发电位

目的研究眼损伤者对比度视诱发电位的特征。方法选取本中心行法医临床学鉴定的60例眼损伤者,根据最佳矫正视力分为0.2~0.3(A组)、0.3~0.5(B组)、≥0.5(C组)三组。分别观察100%、25%、10%对比度条件下的对比度视诱发电位波的振幅及潜伏期变化特征,并行统计学分析。结果 (1)相同对比度时,P_(100)波振幅随刺激视角的减小而降低;(2)相同刺激视角时,P_(100)波振幅随对比度降低而降低,组间差异有统计学意义(P0.05);(3)100%、25%对比度时,相同刺激视角(100%7′视角除外),A组与B组差异无统计学意义(P0.05);A组与C组、B组与C组随视力提高,P_(100)波振幅增高(P0.05);10%对比度15′刺激视角,P_(100)波振幅随视力提高而增高(P0.05);(4)相同对比度下,相同刺激视角时,P_(100)波潜伏期随视力提高而缩短,但组间差异无统计学意义(P0.05)。相同刺激视角时,随对比度降低,P_(100)波潜伏期延长,但差异无统计学意义(P0.05)。结论对比度视诱发电位有望成为评估对比度视力的方法之一。     

正常人模式脉冲与模式翻转多焦视诱发电位的比较

目的比较正常人模式脉冲多焦视诱发电位(pattern-pulse multifocal visual evoked potential,PPmf VEP)与模式翻转多焦视诱发电位(pattern-reversal multifocal visual evoked potential,PRmf VEP)的优缺点,观察多焦视诱发电位(mf VEP)的双眼对称性。方法采用Vision Monitor多焦视觉电生理仪检测系统行mf VEP检查,应用t检验和方差分析对两种VEP的主波(P1)、波幅、信噪比及双眼对称性进行统计分析。结果 PPmf VEP与PRmf VEP P1波幅和信噪比均在中央视野最大,并随离心度的增加呈减小趋势,下降速度由快渐趋平缓。在中央视网膜PPmf VEP波幅的变异系数明显小于PRmf VEP,而在周围视网膜则与之相反;PPmf VEP与PRmf VEP双眼对称象限的P1波幅及信噪比差异均无统计学意义(P0.05),双眼同侧象限的波幅差异均大于对称象限。结论 mf VEP能准确、客观地反映视网膜不同部位的视功能;PPmf VEP较PRmf VEP能更好地反映中央视网膜的视功能状况,而在周边视网膜没有优势;在中央视网膜,PPmf VEP较PRmf VEP稳定;而在外周视网膜,PRmf VEP较PPmf VEP稳定;mf VEP在同一个体双眼之间存在对称性。     

法医学视野客观评定范式研究——以视网膜、视神经及高位视路损伤致视野缺损为例

目的视野的客观评估是法庭科学、眼科学界迄今面临的疑难问题。本文旨在探讨视网膜、视神经及高位视路损伤所致视野缺损的客观评定范式。方法选择外伤性视网膜病变、视神经损伤及高位视路损伤所致视野缺损典型案例,分别进行闪光视觉诱发电位(FVEP)、多焦视网膜电图(mfERG)、多焦视觉诱发电位(mfVEP)检查及颅脑CT、视网膜OCT检查,并对上述视觉电生理指标及形态结构指标进行综合分析。结果视网膜病变可表现为特定区域视网膜神经纤维层(RNFL)厚度变薄等形态学改变,其所致视野损害的电生理学表现为相应部位的mfERG异常及mfVEP异常,FVEP正常或异常。视神经损伤后期可出现视盘RNFL厚度明显变薄,视野损害的电生理学表现为mfVEP异常,FVEP异常,而mfERG正常。高位视路损伤,常伴有颅脑CT枕叶脑软化灶形成,其所致视野损害的电生理学表现为双眼偏盲型mfVEP异常,FVEP无明显异常,mfERG正常。结论 mfVEP联合mfERG、FVEP视觉电生理检测范式,结合颅脑CT、视网膜视盘OCT,有助于全面、客观评价视野,并有望实现视野损害的损伤定位(即明确损伤部位在视网膜、视神经,还是高位视路)。     

应用PRVEP P_(100)空间频率阈值客观评定视力的价值分析

目的研究图形翻转视觉诱发电位(PRVEP)P100波空间频率阈值在不同眼损伤情况下预估视力的价值,以期指导相关法医临床学鉴定。方法选取诊断明确、主观视力准确,另眼矫正视力基本正常(≥4.9)的法医学鉴定案例74例,共148眼别。分为4组:屈光间质混浊组(23眼别)、视网膜病变组(31眼别)、视神经病变组(20眼别)、健眼正常对照组(74眼别)。对上述案例进行图形翻转视觉诱发电位检查,记录P100空间频率阈值,并对空间频率阈值与视力的对数值,两者进行线性相关分析。结果184眼PRVEP空间频率阈值与视力的对数值之间呈显著的正相关(r=0.84,P<0.01),说明PRVEP P100空间频率阈值是客观评定视力的良好指标。但不同部位病变或损伤对PRVEP检测结果的影响不同,视神经病变组PRVEP空间频率阈值与主观视力两者间无统计学相关性(r=0.4,P>0.05)。结论PRVEP P100空间频率阈值是客观评定视力水平的良好手段,但不适用于严重的视神经病变等伴有视野显著缺损时的视力评定。     

正常视野与实验性暗区的多焦视诱发电位特征分析

目的分析正常眼不同视野区域的mfVEP波形特征及实验性暗区对结果的影响,探讨mfVEP用于客观评定视野的可行性。方法以正常青年男性51眼为实验对象,应用四通道mfVEP记录系统进行mfVEP检测,30眼行实验性暗区测试。统计组合反应波振幅、峰时及振幅密度的均数、标准差。组间比较采用单因素方差分析,不同刺激野遮盖前、后mfVEP振幅比较采用配对t检验。结果正常眼mfVEP各位点均能引出较明确的VEP波:其中鼻下、颞下象限组合反应波振幅密度(8.68±3.67、7.84±3.32nV/deg2)较鼻上、颞上象限(5.55±2.22、5.08±1.85nV/deg2)大;反应波从黄斑中心凹向周边逐渐降低(240.36±96.60nV/deg2~1.83±0.73nV/deg2)。遮盖颞下象限及外周3个环刺激野造成形成实验性暗区时,对应区域mfVEP组合反应波多数呈熄灭型(70%及80%);而遮盖鼻下方某两个位点时,对应区域波振幅显著降低(P0.05)。结论 mfVEP能较准确、客观反映视野不同区域的视功能差异,有望成为法医学客观视野检测手段。     

注视程度对视诱发电位检查结果的影响

目的 探讨法医临床鉴定视诱发电位(visual evoked potential,VEP)检测中注视程度对结果的影响.方法 选取110名视力或矫正视力正常(视力范围为4.8～5.2)、年龄在20～30岁的受试者作为实验对象,分别进行图形视诱发电位(pattern visual evoked potential,PVEP...     

微视野“固视稳定性”与视敏度相关性分析

目的探讨微视野检查中的"固视稳定性"与视敏度的相关性及其法医学价值。方法应用国际标准对数视力表对64名眼底损伤者进行视敏度检测,应用MP-1微视野仪行固视稳定性检查。将受检者按固视性质分为3组:固视稳定组、固视相对不稳定组、固视不稳定组;分别统计3组间视敏度的差异。结果①视敏度均值及标准差:稳定组为4.8±0.3;相对稳定组为4.4±0.3;不稳定组为4.0±0.16。单因素方差分析结果,F值19.244,P<0.05;提示3组间的视力水平存在统计学上的显著性差异。②视敏度与2°、4°范围固视百分率之间均有相关性,Pearson相关系数分别为0.631、0.732,P<0.05。③视敏度与2°、4°范围固视百分率之间均有线性关系,其一元线性回归方程分别为:Y=3.520+1.521X1;Y=2.487+2.389X2(Y为视敏度,X1、X2分别为2°、4°范围固视百分率)。结论微视野检查中的"固视稳定性"具有客观预估视敏度区间的法医临床学实用价值。     

Immigration,intermarriage and the changing face of Europe in the post war period

In this article we compare the propensity to intermarry of various migrant groups and their children who settled in Germany, France, England, Belgium and the Netherlands in the post-war period, using a wide range of available statistical data. We try to explain different intermarriage patterns within the framework of Alba and Nee's assimilation theory and pay special attention to the role of religion, colour and colonial background. We therefore compare colonial with non colonial migrants and within these categories between groups with ‘European’ (Christian) and non-European (Islam, Hinduism) religions. First of all, religion appears to be an important variable. Migrants whose faith has no tradition in Western Europe intermarry at a much lower rate than those whose religious backgrounds correspond with those that are common in the country of settlement. The rate of ethnic endogamous marriages in Western Europe are highest in Hindu and Muslim communities, often regardless if they came as guest workers or colonial migrants. Whereas differences in religion diminish the propensity to intermarry, colour or ‘racial’ differences on the other hand seem to be less important. This is largely explained by the pre-migration socialisation. Furthermore, the paper argues that the attention to institutions, as rightly advocated by Richard Alba and Victor Nee, needs a more refined and layered elaboration. Institutions, often as barriers to intermarriage, do not only emanate from the receiving society, but also—be it less formalized—within migrant communities. Especially religions and family systems, but also organized nationalist feelings, can have a profound influence on how migrants think about endogamy. Finally, strong pressures to assimilate, often through institutionalized forms of discrimination and stigmatization, not only produce isolation and frustrate assimilation (with resulting low intermarriage rates), but can also stimulate assimilation by 'passing' mechanisms. These factors, together with a more comparative perspective, are not completely ignored in the new assimilation theory, but—as this study of Western European intermarriage patterns stresses—deserve to be included more systematically in historical and social scientist analyses.     

What similes in Sāṃkhya do: a comparison of the similes in the Sāṃkhya texts in the Mahābhārata, the Sāṃkhyakārikā and the Sāṃkhyasūtra

In Sāṃkhya similes are an important means to communicate basic philosophical teachings. In the texts similes are frequently used, especially in the Sāṃkhya passages in the Mahābhārata, in the Sāṃkhyakārikā and in the Sāṃkhyasūtra. This paper compares the similes in these three texts and analyses changes in the philosophy as revealed in the similes. A comparison of the similes of Sāṃkhya texts produced over more than one thousand years reveals changes in the emphasis in this philosophical system. The purpose of the similes in the Sāṃkhya passages of the Mahābhārata is to produce an intuitive understanding of the separateness of puruṣa and prakṛti. The similes are designed to lead the listener to understand this basic dualism. In the Sāṃkhyakārikā the most difficult issues are the relationship between prakṛti and puruṣa and the idea of prakṛti working for the salvation of puruṣa. One whole chapter of the Sāṃkhyasūtra is devoted to similes.     

The Brahman and the Word Principle (Śabda)

The literature of Bhartṛhari and Maṇḍana attention in contemporary times. The writings of the prominent linguistic philosopher and grammarian Bhartṛhari and of Manḍana, an encyclopedic scholar of later seventh century and most likely a senior contemporary of Śaṅkara, shape Indian philosophical thinking to a great extent. On this premise, this study of the influence of Bhartṛhari on Maṇḍana’s literature, the scope of this essay, allows us to explore the significance of Bhartṛhari’s writings, not only to comprehend the philosophy of language, but also to understand the contribution of linguistic philosophy in shaping Advaita philosophy in subsequent times. This comparison is not to question originality on the part of Maṇḍana, but rather to explore the interrelationship between linguistic philosophy and the monistic philosophy of the Upaniṣadic tradition. Besides excavating the role of Bhartṛhari writings on the texts of Maṇḍana, analysis this will reveal the interrelatedness of the Advaita school of Śaṅkara often addressed as ‘pure non-dualism’ (Kevalādvaita) and the Advaita of Bhartṛhari, identified as ‘non-dualism of the word-principle’ (Śabdādvaita).     

The Realism of Universals in Plato and Nyāya

It has become commonplace in introductions to Indian philosophy to construe Plato’s discussion of forms (εἶδος/ἰδέα) and the treatment in Nyāya and Vaiśeṣika of universals (sāmānya/jāti) as addressing the same philosophical issue, albeit in somewhat different ways. While such a comparison of the similarities and differences has interest and value as an initial reconnaissance of what each says about common properties, an examination of the roles that universals play in the rest of their philosophical enquiries vitiates this commonplace. This paper draws upon the primary texts to identify the following metaphysical, epistemological, semantic and soteriological roles that universals play in the philosophy of Plato and of Nyāya and Vaiśeṣika:

Metaphysical: causal of the existence of x Metaphysical: constitutive of the identity/essence of x Epistemological: cognitively causal (i.e. of the cognition of one over many) Epistemological: epistemically causal (i.e. of knowledge of x) Semantic: necessary condition of speech and reason Epistemological: vindicatory of induction (Nyāya only) Metaphysical: explanatory of causation (Nyāya only) Soteriological: cathartic contemplation (Plato only)

These roles provide us with motivations or reasons to believe that universals exist. As we examine these motivations, we find pressures mounting against our assimilating Platonic forms and the universals of Nyāya and Vaiśeṣika in the discourse about common properties. It is especially when we appreciate the utterly different contribution that universals make in securing our highest welfare that we realize how Plato and the two sister schools are not so much talking somewhat differently about the same thing, but talking somewhat similarly about different things. This better understanding of this difference in these philosophies opens a route for our better understanding of their unique contributions in the ongoing dialogue of philosophy.     

Best practices for structuring a family court parenting plan evaluation under the 2022 AFCC Guidelines

Evaluation appointment orders provide enforceable scaffolding for conduct of family court parenting plan evaluations, and use of the evaluator's reports, feedback, file, and testimony. Unlike a contract, a stipulated or adjudicated appointment order is directly enforceable by the family court. It unambiguously positions the evaluator as the family court's appointee – answerable directly to the court and, in some jurisdictions, protected by quasi-judicial immunity from damages claims. A well-crafted appointment order governs the roles and expectations of the court, the evaluator, the parties, the lawyers, and the collateral witnesses. An appointment order mandates the legal duties, rights, powers, and responsibilities of the professionals, the parties, and the collateral witnesses. At minimum, an appointment order articulates the legal basis for the appointment, the purpose and scope of the evaluation, compensation of evaluator, and the duty of the parties to participate in the process. A written evaluation protocol or procedures statement discloses in advance the methods of investigation and assessment that the evaluator intends to use. Together, the appointment order and written protocol help the evaluator, lawyers, parents, and judge manage the complexity of the evaluation process.     

Illumination,Imagination, Creativity: Rājaśekhara,Kuntaka, and Jagannātha on <Emphasis Type="Italic">Pratibhā</Emphasis>

Sanskrit poeticians make the visionary faculty of pratibhā a necessary part of the professional poet’s make-up. The term has a pre-history in Bhartṛhari’s linguistic metaphysics, where it is used to explain the unitary perception of meaning. This essay examines the relation between pratibhā and possible theories of the imagination, with a focus on three unusual theoreticians—Rājaśekhara, Kuntaka, and Jagannātha Paṇḍita. Rājaśekhara offers an analysis of pratibhā that is heavily interactive, requiring the discerning presence of the bhāvaka listener or critic; he also positions pratibhā in relation to Bildung (vyutpatti) and practice. For Kuntaka, pratibhā, never an ex nihilo creation by a poet, serves as the basis for the peculiar forms of intensified insight and experience that constitute poetry; these may also involve the creative scrambling and re-articulation of the object in terms of its systemic composition. At times, Kuntaka’s pratibhā comes close to a strong notion of imaginative process. But the full-fledged thematization of the imagination, and of pratibhā as its support and mechanism, is best seen in the seventeenth-century debates preserved for us by Jagannātha. A link is suggested between the discourse of poetic imagination in Jagannātha and similar themes that turn up in Indo-Persian poets such as Bedil.     

Preventing Homelessness for System‐Involved Youth

Too many youth and young adults find themselves on the streets, couch‐surfing with friends, in emergency shelters or worse, after exiting the child welfare and juvenile justice systems. In some circumstances, youth have had court hearings until their exit from the legal system, but those hearings have not focused on long‐range plans of youth and emergencies youth may encounter. In other circumstances, there has been little or no planning prior to discharge, especially for young people who leave the juvenile justice system. Courts can and should prevent, alleviate or end youth homelessness for youth who appear before them through strategies that are enumerated in the recently‐passed NCJFCJ resolution. This article expounds on three of these strategies – coordinating transition and re‐entry plans, insisting on effective legal representation of youth, and utilizing sound judicial leadership. It also describes the concurrent efforts of the Coalition for Juvenile Justice and the American Bar Association's Homeless Youth Legal Network to remove legal barriers and improve outcomes for youth and young adults experiencing homelessness.     

The Descent of Power: Possession,Mysticism, and Initiation in the Śaiva Theology of Abhinavagupta

This paper surveys the key terms śaktipāta and samāveśa (both of which refer to religious experience) in the primary sources of Tantric Śaivism over several centuries of textual development, building up a theory as to their range of meanings. It specifically focuses on their usage by Abhinavagupta (Kāshmīr, 10th century) by presenting a complete translation of chapter 11 of his Tantrasāra. The paper thus serves to (a) illuminate the nature of spiritual experience and the qualifcations for religious praxis in Śaivism, (b) give insight into the worldview of the Tantric Śaivas, and (c) help in pinpointing a specific and significant issue in the phenomenological study of religion generally. An earlier version of this paper has been published in a somewhat different form in Evam: Forum on Indian Representations vol. 4, published by Samvad India, New Delhi, India. This paper could not have been written without two years of intensive study with Professor Alexis Sanderson of All Souls College, Oxford, whose scholarship has proved essential in advancing my understanding of Śaivism. Also very helpful was Dr. Somadeva Vasudeva, now of Columbia University, whose database and encyclopedic knowledge have been invaluable. The germ of the idea for this article was suggested to me when Professor Paul Muller-Ortega (University of Rochester) first pointed out to me the passage beginning at MVT 2.14.     

Without Negative Origins and Absolute Ends: A Jurisprudence of the Singular

This paper is a preparatory analysis for a jurisprudence of the singular. Through a critical analysis of the negativity and the absolving character of the transcendental metaphysics of law and justice it reads mainly through M. Heidegger, Heraclitus, G. Agamben and J-L. Nancy a realignment of the questioning of justice that takes its provisional name in ‘dike’, at thepoint where the routes of ontology, the juridical and the political intersect and reveal the pseudo-propriety of their presuppositions. Without the transcendental dialectical discourse of the origin and its absolving-absolute ‘ends’, this paper re-poses the urgency of thinking the singular-multiple ‘right’ otherwise. This revised version was published online in July 2006 with corrections to the Cover Date.     

<Emphasis Type="Italic">Anyathākhyāti</Emphasis>: A Critique by Appaya Dīkṣita in the <Emphasis Type="Italic">Parimala</Emphasis>

In this paper, the problem of illusory perception, as approached by the Nyāya and Advaita Vedānta schools of philosophy, is discussed from the standpoint of the Parimala. This seminal work belonging to the Bhāmatī tradition of Advaita Vedānta was composed in the sixteenth century by the polymath Appaya Dīk?ita. In the context of discussing various theories of illusion, Dīk?ita dwells upon the Nyāya theory of anyathākhyāti, and its connection with jñānalak?a?apratyāsatti as a causal factor for perception, and closely examines if such an extraordinary (alaukika) perception is tenable to explain illusory perception. He then proceeds to point out the deficiencies of this model and thereby brings to the fore the anirvacanīyakhyāti of Advaitins as the only theory which stands scrutiny.