Regarding the Question of Postoperative Asthenopia

Relevance. It is well known that asthenopic complaints, such as increased visual fatigue when working at close range, lacrimation, eye pain and headache after corneal refractive operations in recent years are increasingly common at routine ophthalmological practice. They cause significant subjective discomfort in patients and reduce the satisfaction of the surgery. The pathogenesis of asthenopia is a violation of the coordinated work of the accommodation and binocular systems as a result of their overstrain with excessive visual loads.Purpose. To study the role of the lack of adequate optical correction before surgery in the development of asthenopia in patients with mild and moderate myopia after ReLEx SMILE surgery, as well as to evaluate the effectiveness of drug correction of this condition.Patients and methods. This study included 84 patients (128 eyes) who spend more than 8 hours at a computer due to their professional activity, without pathology of the visual organ that prevents keratorefractive operations, whose average age was 33.2 ± 1.9 years.Results and discussion. The ReLEx SMILE operations in all patients were carried out without complications with the achievement of uncorrected visual acuity equal to the preoperative values of the maximum corrected visual acuity in the period of 1 week and 1 month. In the group with a preoperative lack of adequate optical correction, signs of asthenopia were more often manifested than in patients using full eyeglass or contact correction before surgery. The appointment of the drug Mydrimax® allows to improve the subjective state of patients with asthenopia and leads to the normalization of functional parameters.Conclusion. Corneal refractive operations in patients with the lack of adequate correction of refractive disorders before surgery leads to a significantly significant increase in the initially impaired functional parameters compared to preoperative values, however, it does not reach normal values in most cases and is accompanied by a greater probability of developing postoperative asthenopia.

Leg Amputation due to Buerger’s Disease: Management with Combined Korean Medicine

In this Case Report, a patient with Buerger’s disease who had a leg amputation below his lower right knee and a vascular bypass of right leg, developed a wound caused by his prosthetic leg and subjective discomfort. The patient received skin flap surgery but the wound did not heal properly. He was admitted to the Korean Medicine Hospital where his wound, right leg coldness, and phantom pain were treated with combined Korean medicine. The patient was hospitalized again where he underwent micro-drilling surgery. The patient was re-admitted to the Korean Medicine Hospital where he received combined Korean medicine treatment (CKMT) and carbon arc light treatment (CALT) for his wound, leg coldness, stiffness, and hypoplasia. The temperature of his right leg increased, the numeric rating scale score for assessing pain fell from 5 to 1.5, and subjective discomfort was reduced (< 20%) suggesting this may be an effective treatment.

An Integrated Model for User State Detection of Subjective Discomfort in Autonomous Vehicles

The quickly rising development of autonomous vehicle technology and increase of (semi-) autonomous vehicles on the road leads to an increased demand for more sophisticated human–machine-cooperation approaches to improve trust and acceptance of these new systems. In this work, we investigate the feeling of discomfort of human passengers while driving autonomously and the automatic detection of this discomfort with several model approaches, using the combination of different data sources. Based on a driving simulator study, we analyzed the discomfort reports of 50 participants for autonomous inner city driving. We found that perceived discomfort depends on the driving scenario (with discomfort generally peaking in complex situations) and on the passenger (resulting in interindividual differences in reported discomfort extend and duration). Further, we describe three different model approaches on how to predict the passenger discomfort using data from the vehicle’s sensors as well as physiological and behavioral data from the passenger. The model’s precision varies greatly across the approaches, the best approach having a precision of up to 80%. All of our presented model approaches use combinations of linear models and are thus fast, transparent, and safe. Lastly, we analyzed these models using the SHAP method, which enables explaining the models’ discomfort predictions. These explanations are used to infer the importance of our collected features and to create a scenario-based discomfort analysis. Our work demonstrates a novel approach on passenger state modelling with simple, safe, and transparent models and with explainable model predictions, which can be used to adapt the vehicles’ actions to the needs of the passenger.

Impact of a Vibrotactile Belt on Emotionally Challenging Everyday Situations of the Blind

Spatial orientation and navigation depend primarily on vision. Blind people lack this critical source of information. To facilitate wayfinding and to increase the feeling of safety for these people, the “feelSpace belt” was developed. The belt signals magnetic north as a fixed reference frame via vibrotactile stimulation. This study investigates the effect of the belt on typical orientation and navigation tasks and evaluates the emotional impact. Eleven blind subjects wore the belt daily for seven weeks. Before, during and after the study period, they filled in questionnaires to document their experiences. A small sub-group of the subjects took part in behavioural experiments before and after four weeks of training, i.e., a straight-line walking task to evaluate the belt’s effect on keeping a straight heading, an angular rotation task to examine effects on egocentric orientation, and a triangle completion navigation task to test the ability to take shortcuts. The belt reduced subjective discomfort and increased confidence during navigation. Additionally, the participants felt safer wearing the belt in various outdoor situations. Furthermore, the behavioural tasks point towards an intuitive comprehension of the belt. Altogether, the blind participants benefited from the vibrotactile belt as an assistive technology in challenging everyday situations.

Exploring Shank Circumference by Stretching after Training among Volleyball Players

This preliminary study examined the effects of a stretching intervention after training and its duration (15 vs. 30 min) on participants’ shank circumference (SC) reduction and subjective discomfort score. Ten male volleyball players underwent a routine 3 h training. A two-way analysis of variance revealed that the stretching intervention had significant effects on SC reduction (p < 0.01) and subjective discomfort scores (p < 0.001). Stretching after training could help eliminate shank strain, and a slighter discomfort in shanks when stretching was also seen (score, 20.1/100). An independent-samples t test revealed a significantly higher SC reduction (p < 0.01) with 30 min of stretching (5.6 mm) than with 15 min of stretching (2.7 mm); both stretching durations reduced SC significantly more than the no-stretching condition did. The findings of this study can serve as a reference for volleyball players to alleviate shank strain after daily routine training.

Effects of simulated prolonged restrained sitting on physical and physiological states

Introduction: Advancement in aerospace technology, and resultant change in operational capabilities has posed unique challenges on the aircrew, who is required to operate for prolonged periods seated and restrained. Examination of the effects of prolonged restrained sitting on physical and physiological states was the desired objective of the study. Material and Methods: Longitudinal evaluation of subjective appreciation of physical discomfort and pain, and physiological parameters, namely, heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), skin temperature, and calf girth changes across 6-h of simulated prolonged restrained sitting was undertaken among 15 healthy male non aircrew volunteers with mean age of 31.2 ± 3.63 years. Subjective discomfort was assessed by Category Partitioning Scale (CPS) and pain by Short-Form McGill Pain Questionnaire (SF-MPQ). Results: Prolonged restraint sitting of 6-h resulted in a significant increase in calf girth. Significant changes were also observed in CPS and SF-MPQ scores indicating an increase perception of discomfort and pain. Changes in HR, MAP, SpO2, and lower limb skin temperature were also observed even though these changes were lower in magnitude. Conclusion: The pain and discomfort following 6-h of prolonged restraint sitting were found to be appreciable by the subjects. This, along with a significant change in the calf circumference and other physiological parameters were possibly due to effects of venous pooling as a result of sitting for prolonged periods. The effects so observed could have potential flight safety implications and affect mission effectiveness. However, these findings need to be examined in actual cockpit conditions where the seat is more ergonomically designed; yet the aircrew is subjected to a wide spectrum of additional aeromedical stressors.

Effects of prolonged use of virtual reality smartphone-based head-mounted display on visual parameters: a randomised controlled trial

We investigated the effects of using a virtual reality smartphone-based head-mounted display (VR SHMD) device for 2 h on visual parameters. Fifty-eight healthy volunteers were recruited. The participants played games using VR SHMD or smartphones for 2 h on different days. Visual parameters including refraction, accommodation, convergence, stereopsis, and ocular alignment and measured choroidal thickness before and after the use of VR SHMD or smartphones were investigated. Subjective symptoms were assessed using questionnaires. We analyzed the differences in visual parameters before and after the use of VR SHMD or smartphones and correlations between baseline visual parameters and those after the use of the devices. Significant changes were observed in near-point convergence and accommodation, exophoric deviation, stereopsis, and accommodative lag after the use of VR SHMD but not after that of smartphones. The subjective discomfort associated with dry eye and neurologic symptoms were more severe in the VR group than in the smartphone group. There were no significant changes in refraction and choroidal thickness after the use of either of the two devices. The poorer the participants’ accommodation and convergence ability the greater the resistance to changes in these visual parameters, and participants with a large exophoria were more prone to worsening of exophoria than those with a small exophoria.

Application Of The Preparation Floxal In Treatment Of Acute And Chronic Diseases Of The Lid And Conjunctives

The problem of treating inflammatory diseases of the anterior segment of the eye, in particular chronic allergic conjunctivitis, blepharoconjunctivitis , continues to be relevant. In addition to the pronounced subjective discomfort, cosmetic defect, these diseases pose a danger to the cornea. Our study was aimed at studying the effectiveness of Floxal antibacterial ophthalmic ointment - in the treatment of acute and chronic diseases of the eyelids and conjunctiva.

Placebo and nocebo effects in youth: subjective thermal discomfort can be modulated by a conditioning paradigm utilizing mental states of low and high self-efficacy

Introduction: Conditioning is a key mechanism of placebo and nocebo effects in adults, but little is known about these effects in youth. This study investigated whether personalized verbal cues evoking a sense of high or low self-efficacy can induce conditioned placebo and nocebo effects on subjective discomfort of noxious heat in youth. Methods: In a structured interview, 26 adolescents (13–18 years) described personal situations in which they experienced a sense of high, low or neutral self-efficacy. Participants were then asked to recall these memories during a conditioning paradigm, in which a high thermal stimulus applied to the forearm was repeatedly paired with a low self-efficacy cue and a low thermal stimulus with a high self-efficacy cue. In a testing phase, high, low and neutral self-efficacy cues were paired with the same moderate temperature. We hypothesized that conditioned high and low self-efficacy cues would induce conditioned placebo and nocebo responses to moderate temperatures. Results: Moderate temperatures were rated as more uncomfortable when paired with the conditioned low compared with the neutral self-efficacy cue (nocebo effect). While in the whole-group analysis, there was no significant difference between ratings of moderate thermal stimuli paired with high compared with neutral self-efficacy cues (placebo effect), a sub-group of participants with a greater range of emotional valence between high and neutral self-efficacy cues revealed a significant placebo effect. The strength of the nocebo effect was associated with higher anxiety and lower hope. Conclusion: Conditioned associations using internal self-efficacy states can change subjective discomfort of thermal sensations.

Guidelines for Working Heights of the Lower-Limb Exoskeleton (CEX) Based on Ergonomic Evaluations

The aim of this study was to evaluate the muscle activities and subjective discomfort according to the heights of tasks and the lower-limb exoskeleton CEX (Chairless EXoskeleton), which is a chair-type passive exoskeleton. Twenty healthy subjects (thirteen males and seven females) participated in this experiment. The independent variables were wearing of the exoskeleton (w/ CEX, w/o CEX), working height (6 levels: 40, 60, 80, 100, 120, and 140 cm), and muscle type (8 levels: upper trapezius (UT), erector spinae (ES), middle deltoid (MD), triceps brachii (TB), biceps brachii (BB), biceps femoris (BF), rectus femoris (RF), and tibialis anterior (TA)). The dependent variables were EMG activity (% MVC) and subjective discomfort rating. When wearing the CEX, the UT, ES, RF, and TA showed lower muscle activities at low working heights (40–80 cm) than not wearing the CEX, whereas those muscles showed higher muscle activities at high working heights (100–140 cm). Use of the CEX had a positive effect on subjective discomfort rating at lower working heights. Generally, lower discomfort was reported at working heights below 100 cm when using the CEX. At working heights of 100–140 cm, the muscle activity when wearing the CEX tended to be greater than when not wearing it. Thus, considering the results of this study, the use of the lower-limb exoskeleton (CEX) at a working height of 40–100 cm might reduce the muscle activity and discomfort of whole body and decrease the risk of related disorders.