Accommodative Facility Research Articles

Digital Challenges: Investigating Computer Vision Syndrome in Thai Esports Through a Case-Control Approach.

To determine the factors associated with eyestrain in esports athletes in Bangkok compared with controls. A cross-sectional descriptive study was conducted between April and June 2023, involving 160 male participants (aged 20-35 years) who used digital devices, consisting of esports athletes and a control group. Data were collected using a general information questionnaire, Computer Vision Syndrome Questionnaire (CVS-Q), and Depression anxiety stress scale-21 (DASS-21). Ophthalmic instruments were used for the eye examinations by an optometrist. Seventy-six esports athletes showed significantly lower visual performance than controls in logMAR visual acuity (p < 0.020), phoria (p < 0.001), negative fusional vergence (blur, break, and recovery) (p < 0.012, p < 0.004 and p < 0.039), positive fusional vergence (blur, break, and recovery) (p < 0.005, p < 0.001 and p < 0.005), monocular estimation method (p < 0.001), monocular and binocular accommodative facility (p < 0.001), and vergence facility (p < 0.001). A study on risk factors for CVS found that esports athletes were significantly more likely to have CVS (p < 0.001). Work environments with high-intensity lighting significantly increase the risk of CVS compared to low-intensity lighting (p < 0.001). The use of a digital device for >4 h/day, having a history of alcohol consumption, and stress significantly increased the risk of CVS (p < 0.001, p < 0.023, p < 0.048). This study found that esports athletes experienced vision health problems, indicating the need to prevent eyestrain caused by the use of digital devices.

The role of accommodation facility in promoting girls education: a study of Njombe ward secondary schools in Tanzania

The role of accommodation facility in promoting girls education: a study of Njombe ward secondary schools in Tanzania

Management of the 4 A’s of Tourism: Addressing Shortcomings and Enhancing Services in Gebong Memarong Traditional Village

Air Abik hamlet, situated in Gunung Muda village, Belinyu Sub-District, Bangka Regency, Bangka Belitung Islands Province, Indonesia, is renowned for its rich cultural heritage embodied by the Lom tribe, holding immense potential for tourism development as a vibrant tourist village. However, the management of Gebong Memarong, a traditional accommodation facility in the area, faces challenges hindering its optimal operation. This research adopts a descriptive qualitative approach, utilizing observation, interviews, and documentation analysis to understand the management practices surrounding Gebong Memarong comprehensively. The findings reveal deficiencies in amenities and ancillary services, indicating a critical need for stakeholders’ attention to bolstering support facilities within the tourism village. Furthermore, this research advocates for enhanced managerial competencies to address operational gaps and ensure the sustainable management of homestay facilities. It offers valuable insights into improving accommodation management within culturally significant tourism destinations, with implications for sustainable tourism development strategies in similar contexts.

Optimizing the algorithm for assessing the efficacy of treatment for amblyopia in astigmats through the investigation of the features of meridional acuity characteristics as vector quantities

Background: Refractive asymmetry associated with astigmatism may cause a special form of amblyopia, meridional amblyopia (MA). MA manifests itself as alterations in selective mechanisms of visual stimulus processing during recognition of contours of a certain orientation. Current routine examination of amblyopes does not include meridional acuity assessment and thus does not allow determining whether MA is present or not, as well as performing a more detailed evaluation of the efficacy of treatment for amblyopia in astigmats. Purpose: To optimize the algorithm for assessing the efficacy of stand-alone and complex methods of treatment for amblyopia in astigmats through the determination of the features of changes in visual acuities in orthogonal retinal meridians as vector quantities. Material and Methods: Twenty-four hyperopic astigmats with amblyopia (48 eyes) aged 5 to 12 years were involved in the study. Patients were treated by accommodative facility training only and, in 3 months, by complex therapy (accommodative facility training plus the use of device-based methods). Treatment course duration was 10 days. The results were assessed by changes in best-corrected visual acuity (Sivtsev Chart) and meridional separable visual acuity (MSVA) determined with the software which generates Landolt ring optotypes. Results: The study sample was found to be heterogeneous regarding the features of asymmetries in MSVA. Separable visual acuity in the horizontal meridian was equal in magnitude to that in the vertical meridian in 16.65% of patients. Asymmetries in separable visual acuity that may be considered MA were found in dominant and non-dominant (fellow) eyes in 83.35% of astigmats with amblyopia. Two different clusters were determined in the group with asymmetries in MSVA. Separable visual acuity in the horizontal meridian was higher than that in the vertical meridian in 35.45% of eyes in cluster 1, and lower than that in the vertical meridian in 47.85% of eyes in cluster 2. After treatment, mean separable visual acuity value in the vertical meridian was practically similar to that in the horizontal meridian in both groups for the dominant and fellow eyes, which allowed concluding that both methods were equally effective in treating the disease. However, the number of eyes with the same MSVA in orthogonal meridians increased by 10.41% after MA treatment with accommodative facility training only versus 18.75% after complex treatment. Conclusion: Assessing the features of changes in visual acuities in orthogonal retinal meridians as vector quantities enables obtaining principally new information on the performance of sensory functions in patients with amblyopia and assessing more reliably the efficacy of stand-alone and complex pleoptic methods as methods of treatment for MA.

Energy Analyses and Optimization Proposals for Hotels in Sicily: A Case Study

The recent post-pandemic period has economically affected many business sectors. One of these is the hotel industry. As a result of this economic crisis, it is necessary to act on the economic costs of running energy-intensive buildings such as a hotel. The thermal and electrical energy consumption of an accommodation facility weighs heavily on the economic balance. Governments around the globe have moved to help those activities in need. To improve the sustainability of the hospitality sector from an environmental and economic point of view, the introduction of energy retrofit solutions is mandatory. Following European sustainability laws, the impact and efficiency of the building were calculated using smart readiness indicators. The purpose of this paper is to present a case study of a 5-star hotel located in southern Italy characterized by high energy consumption. Precisely these consumptions are due to air conditioning, lighting, hot water, catering, and all other utilities. The entire building and the systems serving it were characterized by means of software that studies consumption with dynamic models, Trnsys. The same software made it possible to model the case study by replacing the existing air conditioning system with one supplied by renewable energies. Two energy retrofit hypotheses were chosen to obtain the best economic and environmental results. First, the choice was to install solar cooling powered by flat solar panels, and the second choice was solar cooling powered by evacuated tube collectors. This paper reports the technical and economic characteristics of both proposed solutions, quantifying the energy and economic savings to identify the best solution.

Слабость конвергенции как причина астенопии после лазерных рефракционных операций

Purpose. To evaluate the frequency of astenopia and effect of refractive surgery on muscle balance and accommodation in patients with convergence insufficiency (CI). Methods. This study prospectively evaluated 240 eyes (120 patients) with myopia. CI was found in 15 patients (12.5 %), 91 patients with normal binocular vision were included in control group. Accommodative amplitude and facility, positive and negative relative accommodation, binocular vision, near point of convergence (NPC), phoria measurement for near and distance, positive and negative fusion vergence, AC/A ratio were assessed, symptoms were measured by Convergence Symptom Survey (CISS) before, 1 month and 1 year after LASIK. Results. Asthenopia was found in 7.5 % of patients in 1 month after surgery. It was related with CI in 5 %. There was a statistically significant improvement of near exodeviation from 13.2±3.9 to 8.4±3.7 pd and of NPC from 12.2±2.7 to 8.3±2.3 сm which remained unchanged within 1 year. CISS score improved from 24.3±4.8 to 13.5±2.5 in 1 month after surgery and to 9.6±2.8 within 1 year. 1 patient had deterioration of exodeviation in 1 month. 6 patients needed in-office vergence/accommodative therapy after surgery. None of the patients in control group presented postoperative asthenopia, worsening in muscle balance and binocular vision. Conclusions. Laser refractive surgery does not cause asthenopia in patients with normal accommodation and vergence. CI is not a contraindication for refractive surgery, leading to a decrease in exodeviation. In cases of accurate fusion vergence lack, patients will experience asthenopia. In patients with CI it is necessary that positive fusion vergence exceed the exophoria by two times before surgery and overlap presbyopia addition which will be required in future. Key words: refractive surgery; asthenopia; convergence insufficiency.

Visual Performance of Two Designs of Myopia Management Soft Contact Lenses Compared with a Monofocal One in Young Adults.

To compare the visual performance of two distinct types of soft contact lenses (CL) aimed at slowing down myopia progression with the performance of a monofocal soft CL. In a prospective double-masked, crossover trial, 18 myopic adults (aged 18-30 years old) were fitted in a randomized order with three types of disposable CL: MiSight (dual-focus), Mylo (extended depth of focus -EDOF-), and Clariti (single distance vision). Measurements were taken after wearing the CL for five days with five days off in between at two different optometry centers. High contrast distance visual acuity (VA) with spectacles and for each of the different CL, subjective refraction, slit lamp exam, aberrometry, stereopsis, monocular and binocular amplitude of accommodation and accommodative facility, and horizontal phorias were measured. The high contrast distance VAwas better for the single vision CL compared to the myopia control CL. No significant differences were observed between the r two myopia control CL. The overall root mean square (RMS) was higher for the double focus CL (RMS = 1.18 0.29 µm), followed by the EDOF CL (RMS = 0.76 0.35 µm) and then the single vision CL (RMS = 0.50 0.19 µm). The primary spherical aberration (SA) mean value was low for all of the three CL, without statistical differences among them. No other significant differences were detected. The overall RMS resulted in a higher value for the dual-focus than the EDOF CL, but no differences in high contrast distance VA and binocularity were detected between them. The monofocal CL's performance was better than the myopia control CL.

생활숙박시설의 법적 쟁점에 관한 헌법적 연구

In Korea, a house is meaningful as a basic place in people's lives. People put all their effort into purchasing housing that is equivalent to food, clothing, and shelter. For that reason, in our country, the price of real estate, especially housing, fluctuates depending on people's needs over time. Korea has achieved economic development through industrialization, but with the urban concentration phenomenon and the rapid increase in urban housing demand, housing supply and demand has become an important national task.&#x0D; Economic development brought about changes in residential culture, giving rise to various housing types, with the emergence of single-family homes, townhouses, and apartment-type apartment complexes. However, as it could not cope with the overwhelming demand, officetel, a combination of an office and a hotel, which was popular abroad, was introduced. This officetel was also resolved after the Oran controversy by separating officetels for office use and residential use. Similar to this issue, controversy arose over residential lodging facilities, which are residential-type lodging facilities.&#x0D; Accommodation facilities are for people to stay for a short period of time, and there are various types. Among them, there are condos where you can stay for a while and cook, but most of them are short-term lodging facilities. Then, the form of residential accommodation emerged as a way to solve the problem of surplus accommodation and insufficient housing in cities. Living accommodation facilities, which began in the early 21st century, were initially used for long-term stays like officetels, with cooking facilities installed, and used for residential purposes.&#x0D; Living accommodation facilities are lodging facilities, but as people live there for a long period of time, they are used like houses, and their number gradually increases. However, because there was no legal basis, it spread indiscriminately, and from the public's perspective, it came to be perceived as purchasing housing at a low price. It was only in 2012 that living accommodation facilities gained their basis in the Enforcement Decree of the Public Sanitation Management Act. However, living accommodations were only a type of accommodation and not housing.&#x0D; Since the legal basis for living accommodation facilities is that only one type of accommodation facility is specified in the Enforcement Decree of the Public Health Management Act, there are no regulations regarding this, so in reality, they are continuously built and sold. Meanwhile, in 2020, the legal status of residential lodging facilities, a type of lodging facility, became an issue, and issues began to be raised about the fact that these facilities were being used for residential purposes rather than lodging facilities. As a result, it became a problem as it was regulated through a two-year transition provision.&#x0D; Living accommodation facilities are equivalent to housing for citizens who live there. This will not be resolved by postponing administrative dispositions for two years and an additional year without fundamentally resolving the issue. Rather than allowing people who purchased it for residential purposes to change its use to officetel, which is impossible, we need to find appropriate standards that fit the reality, guarantee property rights, and protect trust. Therefore, we need to actively work to guarantee the basic rights of people who are users of living accommodation facilities. There must be action.

Influence of Online Reviews on Hotel Reservation Intentions: Insights from Bangladeshi Travellers

The primary objective of this research is to undertake an empirical investigation of the overall influence of online reviews on hotel booking intentions within the context of Bangladesh. The study involved the execution of semi-structured interviews with a sample of 25 individuals with a recent history of frequent travel and hotel stays. Subsequently, a thematic analysis of the responses was conducted with the goal of elucidating the outcomes and ascertaining the influence of online reviews on individuals' predispositions towards booking a hotel for their accommodation facility. The findings of the study revealed that positive reviews wield the most substantial influence among the various dimensions of tourists' reviews. Notably, the idea of "trust" appeared within the identified indicators as a mediating variable in the association between reviews and the intention to book a hotel. Moreover, this empirical study also showed that unfavorable online reviews significantly influence individuals ‘intents to reserve hotels, whereas positive reviews do not yield an equivalent impact. Considering these outcomes, the authors draw a series of management implications, including the need to use this information to promote stakeholder engagement and collaboration, to use these indicators for the management of hotels to adopt a more holistic approach to address the service gap in the hospitality industry, and to focus on resilient planning for sustainable smart tourism development.

The Effects of Table Tennis, Basketball, and Athletics on the Prevention and Control of Myopia in Elementary School Students

Background and Aim: The visual acuity of children and adolescents is declining, which seriously affects the physical health of children and adolescents with the continuous integration and development of sports and health fields, many studies have shown that sports are closely related to the eye health of children and adolescents. Therefore, this study conducts table tennis, basketball, and athletics research on the prevention and control of myopia in elementary school students, and compares the effects. Materials and Methods: This study conducted a 24-week exercise experiment intervention on children with low vision, selected 80 experimental samples that meet the requirements of the experimental research, and divided the 80 students into 4 groups on average using random grouping, set up 1 control group and 3 experimental groups. One-way repeated measures analysis of variance was performed on the data of the three experimental groups and control groups. Results: The facility of accommodation and relative accommodation ability of the three experimental groups were significantly improved, while those of the control group were significantly decreased, indicating that the experimental intervention of table tennis, basketball, and athletics can improve the facility of accommodation and relative accommodation functions of the eyes. From the results of the change of the equivalent spherical mirror degree, it can be shown that the table tennis group has the best control effect, followed by basketball, and the third is athletics. Conclusions: (1) Professionally designed table tennis, basketball, and athletics have a preventive effect on myopia diopter, and can control and slow down the progression of myopia to a certain extent. (2) Designing exercise programs related to the principles of eye movement is more effective in preventing and controlling elementary school students’ myopia than traditional physical education courses. And (3) The intervention methods of table tennis, basketball, and athletics in this study to prevent myopia can be promoted and used in physical education classes in elementary and secondary schools.

Visual parameter status as a predictive factor for the outcomes of occlusion therapy in anisometropic amblyopia.

The purpose is to compare visual parameters between normal and amblyopic eyes in anisometropic amblyopia and to find predictive factors for occlusion therapy. Sixty patients with anisometropic amblyopia between the ages of 5 and 25 years were enrolled in the prospective, longitudinal, and interventional study. Patients were selected based on no improvement with spectacle correction alone after 1 month of follow-up. Baseline parameters such as LogMAR visual acuity, LEA contrast sensitivity, TNO stereopsis test, online Farnsworth D-15 test for color vision, accommodation with RAF ruler, +2.00/-2.00 flipper test, and dynamic retinoscopy were recorded. All patients were treated with occlusion therapy depending on their grades of amblyopia. After 6 months of follow-up, improvement in visual acuity was recorded with a LogMAR chart and correlated with initial visual parameters. Paired "t" test, Chi-square test, independent "t" test, analysis of variance test were used as statistical analysis. Visual functions such as contrast sensitivity, accommodative facility, near point of accommodation, and accommodative amplitude showed a statistically significant difference between normal and amblyopic eyes of anisometropic amblyopia patients, whereas color vision did not differ significantly between normal and amblyopic eyes. Sixty-seven percentage of patients had poor stereopsis. Eighty percentage of patients who were younger had improvement in final best-corrected visual acuity and these patients had better stereopsis, contrast sensitivity, and mild-to-moderate amblyopia on initial testing. The age of the patient, degree of anisometropia, spherical equivalent in amblyopic eyes, stereopsis, contrast sensitivity values at initial presentation, and compliance to occlusion therapy were found to be positive predictive factors of occlusion therapy.

Immediate Effects of Vergence Exercises Using Automatic Dual Rotational Risley Prisms on Accommodative Lag and Facility.

This study evaluated novel automatic dual rotational Risley prisms (ADRRPs) as a vergence exercise tool for patients with myopia to improve accommodative lag and accommodative facility. Participants with myopia aged 20-24years were recruited. After vergence exercises with prisms (treatment group) or plano lenses (control group) using ADRRPs for 10min, measurements were taken using an open-field autorefractor (Grand Seiko WAM-5500) at viewing distances of 0.4m and 6.0m. We measured accommodative facility using a ± 2.00D accommodative flipper. A total of 56 participants (treatment group, 39; control group, 17) performed vergence exercises using ADRRPs. Participants in the treatment group showed improvements in accommodative lag at a 0.4m viewing distance, with measurements of 0.57D (right eye; OD) and 0.53D (left eye; OS) and 0.21D (OD) and 0.27D (OS) before and after the exercises, respectively (p < 0.001). Over-refractions using an open-field autorefractor with spherical equivalent contact lenses at a 6.0m viewing distance were - 0.01 ± 0.30D (OD) and 0.03 ± 0.34D (OS) and 0.15 ± 0.32D (OD) and 0.19 ± 0.28D (OS) before and after the exercises, respectively (difference + 0.16D; p < 0.001). Accommodative facility values before and after exercises were 14.88 ± 3.36 and 15.59 ± 3.60cpm, respectively (p < 0.01). No significant differences in accommodative lag, relaxation, and accommodative facility before and after exercise were observed in the control group. Using ADRRPs in vergence exercises can improve accommodative lag, accommodative facility, and accommodative relaxation in adults with myopia. Further research to evaluate persistent and long-term effects is needed.

Accommodative Facility and Response Time before and after Computer Task of Varying Durations in Young Adults.

To investigate the changes in near accommodative facility and response time in young adults following computer work of 30 minutes and 1 hour in duration. A total of 50 young adults (37 females, 13 males) with mean age of 20.68 ± 1.33 years were included in this experimental study. Monocular near accommodative facility was measured using ±2.00 Dioptre Sphere (DS) flipper at 40 cm using the N6 (the smallest print size that can be read by an individual with normal visual acuity) target before and after two reading tasks. Both pre- and post-task measurements were video recorded using a smart phone and the number of cycles per minute, positive response time (time taken to stimulate accommodation), and negative response time (time taken to relax accommodation) were calculated from the video recording. Data were analysed using SPSS Version 22.0. Out of the 50 participants, 29 were emmetropes (Mean SER: 0.16 ± 0.29 D), and 21 were myopes (Mean SER: -1.89 ± 1.16 D). The mean pre-task accommodative facility was 6.79 ± 3.52 cycles per minute, and the post-task accommodative facility was 6.25 ± 3.65 cycles per minute (p = 0.10) for the 30-minutes task and 5.76 ± 3.89 cycles per minute (p = 0.01) for 1-hour task. The mean pre-task positive response time was 2.87 ± 1.55 seconds, and the post-task positive response times for 30 minutes and 1 hour were 2.86 ± 1.67 seconds (p = 0.88) and 2.98 ± 2.33 seconds (p = 0.42), respectively. The mean pre-task negative response time was 8.77 ± 8.83 seconds, and the post-task negative response times for 30 minutes and 1 hour task were 11.83 ± 14.28 seconds (p = 0.16) and 14.72 ± 17.32 seconds (p = 0.03), respectively. Monocular near accommodative facility was significantly reduced, and negative response time was delayed following 1 hour of computer work.

Effectiveness of Clinic-Based Vision Therapy for Non-Strabismic Binocular Vision Anomalies (NSBVA) Among Adults

Background: To assess the effectiveness of clinic-based vision therapy in adults with non-strabismic binocular vision anomalies. Methods: This retrospective study was conducted between January 2018 and December 2021 at a tertiary eye care center in Southern India. Elec-tronic medical records of adults aged 30 years and above diagnosed with non-strabismic binocular vision anomalies, and who underwent a mini-mum of five sessions of clinic-based vision therapy (VT), were reviewed. Clinical parameters of vergence and accommodation were analyzed pre and post-therapy. Results: A total of 44 participants meeting the inclusion criteria were included in the study, with a mean (SD) age of 36 (±6) years. The partic-ipants were categorized into two groups based on the completion of either five sessions (Group A) or ten sessions (Group B) of vision therapy (VT). The overall median (IQR) for near phoria was -4 (-8 to 0) PD, the near point of convergence break point was 8 (4 to 12) cm, fusional conver-gence amplitude for near was 25 (14 to 30) PD, and binocular accommo-dative facility and amplitude were 3 (0 to 6) cpm and 9 (7 to 10) D, respectively. Conclusion: Clinic-based vision therapy is efficacious in managing non-strabismic binocular vision anomalies in adult.

Life cycle assessment to address the environmental impacts of tourism in a Spanish tourist destination: The case of Rias Baixas (Galicia) holidays

Tourism has grown steadily in recent decades, becoming a strategic sector for the economy in many countries. However, the environmental impacts associated with tourism have also experienced an upward trend. In this sense, innovation is needed in the tourism sector, to move towards new models and strategies that integrate environmental sustainability with the social aspects of the sector. In this study, a holistic assessment of the environmental impact of tourism has been carried out using the Life Cycle Assessment (LCA) method, considering all stages of tourism activity: transportation from the place of origin to destination and back, accommodation, catering, and activities conducted. For this purpose, a case study has been carried out based on a typical trip made from Madrid to Rías Baixas (Galicia), considering a four-night stay and the performance of two activities (music festival and cultural museum) at the destination. Two alternative transportation scenarios (train or plane) have been defined to analyze the influence of the type of transportation on the overall impact. Other touristic activities such as visiting gardens or thermal baths instead of visiting a cultural museum or attending a music festival have been analyzed and it has been found that the thermal baths and the museum have the greatest environmental impacts.Transportation was the biggest contributor to most of the environmental impacts in the selected categories. On the other hand, the stay at the destination has stood out due to the impact of the consumption of food and energy used at the accommodation facility. The impact of the activities conducted at the destination is also worth highlighting. Finally, alternative scenarios for transportation have shown that the mode of transportation selected is key for lowering the overall environmental impact of the stay at the destination, highlighting the public transportation alternative, such as the train, as the most environmentally friendly option.

Effects of physical activity combined with different visual target presentation durations of ciliary-muscle training on visual acuity in children.

This study aimed to identify the effect of different durations of visual target presentation during ciliary-muscle training on children's kinetic visual acuity (KVA), uncorrected distance visual acuity (UDVA), axial length, and accommodative facility. Based on the ciliary-muscle regulation mechanism, an intervention program involving ciliary-muscle training with different durations of visual target presentation combined with physical education classes was designed. The intervention aimed to determine the effect of different ciliary-muscle training durations on children's visual acuity. A total of 153 children aged 10-11 years from a school in Suzhou (a major city located in southeastern Jiangsu Province, East China) were enrolled as participants in this 32-week intervention study. This study measured the participants' UDVA and KVA before, during (after the 16th week), and after (after the 32nd week) the experimental intervention. The accommodative facility was measured during and after the intervention. After 32 weeks of the intervention, the KVA and UDVA of each experimental group were significantly improved (p < 0.05). A high percentage in the improvement of KVA was observed in the 3-s and 1-s groups (25.53%, 21.74%), and the highest percentage in the improvement of UDVA was observed in the 3-s group (2.96%). Axial length increased significantly in all groups (p < 0.05), and there was a low percentage increase in the 1-s and 3-s groups (0.82%). The accommodative facility was significantly improved in all experimental groups, with a higher improvement percentage in the 3-s and 1-s groups (3.01% and 2.61%, respectively). After dividing the children in each group according to their visual acuity, the KVA of children in the 1-s group was significantly improved, the UDVA of children with myopia was significantly increased, and the accommodative facility of children with mild and moderate myopia was significantly improved. Moreover, the KVA, UDVA, and accommodative facility of children with mild and moderate myopia in the 3-s group were significantly improved. The KVA of children with emmetropia and the accommodative facility of children with mild and moderate myopia in the 5-s group were also significantly increased. In school physical education classes, the 1-s, 3-s, and 5-s ciliary-muscle regulating exercise could effectively improve the kinetic visual acuity, uncorrected distance visual acuity, and accommodative facility of children aged 10-11 years. Among them, the effects of the 1-s and 3-s durations are better than that of the 5-s duration, as it can reduce the growth rate of axial length and achieve better effects among children with mild and moderate myopia.

Prognostic Utility of Oculomotor Assessments in Determining Return-to-Learn Time in Acutely Concussed College Student-Athletes: A Pilot Study.

We sought to discover which oculomotor test (King-Devick [KD], near point of convergence [NPC], and accommodative facility [AF]) would best produce a prognostic model for an RTL time frame. An observational cohort design was used to longitudinally track division I and III student-athletes with concussion at a private university in New York State. Measurements included pre-RTL oculomotor testing (NPC, KD, and AF), along with daily text messages and phone calls. Participants were considered returned-to-learn once they had returned to baseline symptoms and had attended 2 days of classes. Our data promote KD score and class attendance as the best-fit prognostic model, with every second accrued on the KD test equating to 5.29 h of RTL time. Further, attending class throughout recovery, versus not, shortened RTL time by a mean 170.50 h, or 7.1 days. Five variables produced a significant attenuating association with concussion symptoms: time post-injury (p = 0.01); caffeine (p = 0.05); alcohol (p = 0.01); music (p = 0.01); and physical activity (p = 0.01). Three variables produced a significant worsening association with concussion symptoms: screen time (p = 0.05); music (p = 0.01); and class attendance (p = 0.01). The findings present a preliminary evidence-based model to prognosticate RTL time. To our knowledge, this is the second longitudinal study, and the first overall, to present objective data for guiding and prognosticating RTL, respectively. Correspondingly, these data should assist clinicians with objectively steering RTL in-clinic.

Accommodation in Children after 4.7 Years of Multifocal Contact Lens Wear in the BLINK Study Randomized Clinical Trial.

When worn for myopia control in children, soft multifocal contact lenses with a +2.50 D add reduced the accommodative response over a 3-year period, but wearing them for more than 4 years did not affect accommodative amplitudes, lag, or facility. This study aimed to compare the accommodative response to a 3D stimulus between single-vision, +1.50-D add, and +2.50-D add multifocal contact lens wearers during 3 years of contact lens wear and then to compare accommodative amplitude, lag, and facility between the three groups after an average of 4.7 years of wear. Bifocal Lenses In Nearsighted Kids study participants aged 7 to 11 years old were randomly assigned to wear single-vision, +1.50-D add, or +2.50-D add soft contact lenses (CooperVision, Pleasanton, CA). The accommodative response to a 3D stimulus was measured at baseline and annually for 3 years. After 4.7 years, we measured objective accommodative amplitudes, lead/lag, and binocular facility with ±2.00-D flippers. We compared the three accommodative measures using multivariate analysis of variance (MANOVA), adjusting for clinic site, sex, and age group (7 to 9 or 10 to 11 years). The +2.50-D add contact lens wearers exhibited lower accommodative response than the single-vision contact lens wearers for 3 years, but the +1.50-D add contact lens wearers exhibited only lower accommodative response than did the single-vision contact lens wearers for 2 years. After adjustment for clinic site, sex, and age group, there were no statistically significant or clinically meaningful differences between the three treatment groups for accommodative amplitude (MANOVA, P = .49), accommodative lag (MANOVA, P = .41), or accommodative facility (MANOVA, P = .87) after an average of 4.7 years of contact lens wear. Almost 5 years of multifocal contact lens wear did not affect the accommodative amplitude, lag, or facility of children.

Tourism Sector: The Supply Chain Social Footprint of an Italian Accommodation Facility

In Italy, as in the rest of the world, the COVID-19 pandemic had an important impact on tourism. In particular, in the Abruzzo region, there was a decrease of circa 60% in tourist arrivals from 2019 to 2021. A driving force for the recovery of the tourism sector may be investment in sustainability activities, especially those connected to social aspects, which appear to be less considered. Social sustainability can be investigated through the Social Life Cycle Assessment methodology, thus allowing the assessment of the social risks that are connected to the life cycle of a delivered service. This study aims at providing a social footprint of the supply chain of one overnight stay at an accommodation facility using the Social Hotspot Database. The main results show that electricity consumption has the greatest impact within the life cycle, and it is the “Health and Safety” category that is the most influenced, followed by “Labour Rights and Decent Work”, “Governance” and “Human Rights”. Finally, at a subcategory level, “Occupational Toxics and Hazards” is the most influenced one, followed by “Occupational Injuries and Deaths”, “High Conflict”, “Corruption” and “Legal System”. These findings allow us to understand the overall main social risks related to the sector in Italy, since the assessment of the foreground system was conducted at a country and a sector level.

The diagnostic accuracy of the IFLIP system for binocular visual function anomalies assessment.

This study aimed to evaluate the diagnostic accuracy of the intelligent flipper (IFLIP) system in identifying binocular vision anomalies. This study comprised 70 participants aged 18 to 22. Participants underwent comprehensive eye assessments, including measurement of visual acuity, refraction, far and near cover test, stereopsis, and worth four dot test. The manual accommodation amplitude and facility, as well as the IFLIP system test, were also evaluated. The correlation between the indices of the IFLIP and manual accommodation tests was analyzed using multiple regression models, and the diagnostic ability of the IFLIP was characterized using Receiver Operating Curve (ROC) analysis. The significance level was 0.05. The mean age of the 70 participants was 20.03±0.78 years. The mean manual and IFLIP accommodation facilities were 12.00±3.70 cycle per minute (CPM) and 10.01±2.77 CPM, respectively. No correlation was found between the indices of the IFLIP system and manual accommodative amplitude. However, the regression model showed that the contraction/relaxation ratio of the IFLIP system was positively correlated to the manual accommodation facility, and the average contraction time was negatively correlated with the manual accommodation facility. The ROC analysis proposed a cut-off of 10.15 CPM monocularly for the IFLIP accommodation facility assessment. This study indicated that the parameters obtained by the IFLIP system and the manual accommodation facility were comparable, and the IFLIP system had good sensitivity and specificity in the assessment of the accommodation facility, thus may serve as a promising tool for screening and diagnosis of binocular visual function anomalies in clinical and community settings.