Integrative Lighting Aimed at Patients with Psychiatric and Neurological Disorders

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The research effectively investigates the impact of circadian lighting on melatonin suppression in patients with psychiatric and neurological disorders in hospital settings. It addresses the relationship between lighting systems and patients' circadian rhythms​​.

The study is original and highly relevant, particularly in the healthcare and lighting technology domain. It fills a critical gap in understanding the influence of indoor lighting on patients' health within hospital environments​​.

Here are some specific aspects the Authors should clarify or elaborate on:

1.  Acknowledge and discuss any limitations of the study's methodology. This could include the equipment used, the sample size, or the generalizability of the findings. Discussing limitations will add depth to the analysis and demonstrate a critical understanding of the research process.

2. Explore the potential implications and practical applications of the findings. Discuss how this research could influence future designs of lighting systems in hospital wards and potentially improve patient outcomes.

3. Suggest areas for future research that could build on the findings of this study. This might include investigating different patient populations, exploring long-term effects, or comparing different types of lighting systems.

4. Conclude the discussion with strong, summarizing statements that encapsulate the main findings and their significance. A compelling conclusion can leave a lasting impression on the reader.

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The study assesses a method for evaluating indoor integrated lighting environments, incorporating point measurements and datalogging. This approach, capturing both artificial and natural lighting conditions, provides insights into lighting distribution, history, zeitgeber strength, and temporal dynamics. The measurement scheme proves valuable for researchers, designers, and indoor professionals, offering critical information for optimizing lighting conditions in terms of human mental and physical health, sleep, and performance. The use of the Luox platform ensures accurate calculations aligned with CIE requirements, and the Canva template facilitates a clear visual presentation for each measurement point. The authors presented a detailed description of the methods and formulas applied in the study and afterwards calculation and data processing.

The study concludes that the proposed measurement scheme, along with the Luox platform and Canva template, is suitable for accurate and satisfactory assessment of integrative lighting, aligning with CIE and widely accepted requirements. Despite limitations, the Gimenez  model serves as a baseline for an MEDI-based metric alternative to the CS model. The study identifies a need for a S-cone melatonin suppression model, a better understanding of the exposure time parameter, and an ideal model supporting retinal illuminance and pupil size variation.

In the perspective and future work section, key factors for evaluating circadian performance in lighting, particularly in care facilities for patients with poor mental health, are highlighted. Approaches, models, and tools are identified and discussed with their respective limitations. Suggestions for future work include datalogging over longer periods at different heights, emphasizing the need for spectrally resolved dosimeters. The development of a S026-based metric alternative to the CS model is  necessary, and ongoing work is reported on the creation of a spectrally resolved and wearable circadian light logger. The study emphasizes the ongoing pursuit of understanding the precise relationship between photometric and circadian indicators and effective changes in human health. Future approaches involve investigating parameters such as nocturnal melatonin suppression, MDER, MILT, or MEDI as metrics for evaluating light in the built environment, addressing limitations highlighted in real-case applications. The comprehensive article provides a thorough analysis of the study's methodology, findings, and future directions, contributing significantly to the field of circadian lighting research, representing an important part of the present research and a starting point for further studies. 

Comments on the Quality of English Language

I have encountered a few typos and some phrases that had an awkward meaning, that I do suggest being reviewed by the authors. 

Author Response

Thank you for your comment, we have proofread the paper several times, and corrected the language and fixed the typos.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I wpuld like to thank the Autors for all improvements they have done. I have no further comments.