The impact of accommodation function on the difference between noncycloplegic and cycloplegic refraction in adult myopes.

PURPOSE: To investigate the impact of accommodation function on the difference between cycloplegic and noncycloplegic subjective and automatic refraction in adult myopes. METHODS: Myopic patients between 18 and 50 years old evaluated at Peking University Third Hospital who underwent cycloplegic and noncycloplegic automatic and subjective refraction were enrolled. Accommodation function, including negative and positive relative accommodation (PRA/NRA) and accommodation response (binocular cross cylinder, BCC) was examined. RESULTS: Of the 3268 individuals enrolled, the mean age was 27.3 ± 6.9 years, and 34.8% of participants were male. The noncycloplegic spherical equivalent (SE) was 0.23 ± 0.29 D and 0.64 ± 0.61 D more myopic than cycloplegic subjective and automatic refraction. Adjusting for associated factors, participants with at least 0.50 D of more myopia SE refraction by noncycloplegic subjective refraction were more likely to be older (odds ratio [OR], 1.029; 95% confidence interval [CI], 1.013-1.045) and with insufficient (OR, 1.514; 95% CI, 1.093-2.096) and excessive (OR, 2.196; 95% CI, 1.538-3.137) NRA value. The automatic refraction SE difference of at least 1.00 D more myopia was more likely to be found in individuals with older age (OR, 1.036; 95% CI, 1.022-1.050) and accommodative lead (OR, 1.255; 95% CI, 1.004-1.568). CONCLUSION: A quarter of adult myopes had at least 0.50 and 1.00 D of subjective and automatic SE difference with cycloplegia. The accommodation function significantly affects the difference between cycloplegic and noncycloplegic refraction. Investigating the differences in refraction measurement guarantees the proper use of cycloplegia in adults for myopia correction.

Recent advancements in battery thermal management system (BTMS): A review of performance enhancement techniques with an emphasis on nano-enhanced phase change materials.

Because of their numerous benefits such as high charge cycle count, low self-discharge rate, low maintenance requirements, and tiny footprint, Li-batteries have been extensively employed in recent times. However, mostly Li-batteries have a limited lifespan of up to three years after production, may catch fire if the separator is damaged, and cannot be recharged when they are fully depleted. Due to the significant heat generation that li-batteries produce while they are operating, the temperature difference inside the battery module rises. This reduces the operating safety of battery and limits its life. Therefore, maintaining safe battery temperatures requires efficient thermal management using both active and passive. Thermal optimization may be achieved battery thermal management system (BTMS) that employs phase change materials (PCMs). However, PCM's shortcomings in secondary heat dissipation and restricted thermal conductivity still require development in the design, structure, and materials used in BTMS. We summarize new methods to control temperature of batteries using Nano-Enhanced Phase Change Materials (NEPCMs), air cooling, metallic fin intensification, and enhanced composite materials using nanoparticles which work well to boost their performance. To the scientific community, the idea of nano-enhancing PCMs is new and very appealing. Hybrid and ternary battery modules are already receiving attention for the li-battery life span enhancement ultimately facilitating their broader adoption across various applications, from portable electronics to electric vehicles and beyond.