Computer Modelling Study of Volume Kinetics in Intraocular Segments Following Airbag Impact Using Finite Element Analysis.

Background: We have previously studied the physiological and mechanical responses of the eye to blunt trauma in various situations using finite element analysis (FEA). In this study, we evaluated the volume kinetics of an airbag impact on the eye using FEA to sequentially determine the volume change rates of intraocular segments at various airbag deployment velocities. Methods: The human eye model we created was used in simulations with the FEA program PAM-GENERISTM (Nihon ESI, Tokyo, Japan). Different airbag deployment velocities, 30, 40, 50, 60 and 70 m/s, were applied in the forward direction. The volume of the deformed eye impacted by the airbag was calculated as the integrated value of all meshes in each segment, and the decrease rate was calculated as the ratio of the decreased volume of each segment at particular timepoints to the value before the airbag impact. Results: The minimum volume of the anterior chamber was 63%, 69% and 50% at 50, 60 and 70 m/s airbag impact velocity, respectively, showing a curve with a sharp decline followed by gradual recovery. In contrast to the anterior chamber, the volume of the lens recovered promptly, reaching 80-90% at the end of observation, except for the case of 60 m/s. Following the decrease, the volume increased to more than that of baseline at 60 m/s. The rate of volume change of the vitreous was distributed in a narrow range, 99.2-100.4%. Conclusion: In this study, we found a large, prolonged decrease of volume in the anterior chamber, a similar large decrease followed by prompt recovery of volume in the lens, and a time-lag in the volume decrease between these tissues. These novel findings may provide an important insight into the pathophysiological mechanism of airbag ocular injuries through this further evaluation, employing a refined FEA model representing cuboidal deformation, to develop a more safe airbag system.

Long-Term Observation of Prognostic Factors and Clinical Outcome of Vernal Keratoconjunctivitis in Childhood.

Purpose: Vernal keratoconjunctivitis (VKC) is a refractory ocular allergic disorder that mainly affects boys. Long-term follow-up has been rarely reported for VKC. We investigated the long-term clinical outcome of VKC to identify relevant clinical features of prognostic value based on follow-up for a median of 70 months. Methods: In total, 45 consecutive patients clinically diagnosed with VKC aged 4 to 12 years at onset at the Department of Ophthalmology of Fukuoka University Hospital were included. Patients were treated with immunosuppressive eye drops without simultaneous corticosteroid eye drops, except for the occurrence of exacerbations. Collated variables were gender, age at onset, clinical score of ocular lesions (conjunctival giant papillae, limbal edema and corneal epithelial lesions) at the first visit, and clinical score of atopic dermatitis (AD) at baseline. Cumulative cure rate was estimated using Kaplan-Meier method. A binomial logistic predictive model was used to determine the most reliable clinical predictors of VKC outcome. Results: The observation period ranged from 24 to 188 months, with median of 70 months. Among the 45 cases enrolled, all non-cured cases (14 cases) observed clinically were complicated by AD. Cumulative cure rate was 74.5% and 84.9% at eight- and ten-year follow-up, respectively. Ten-year cumulative cure rates of cases with and without AD were 50.5% and 100%, respectively, and a significant difference was found between these cumulative cure curves. Binomial regression analysis revealed that AD and gender were significantly related to worse outcome, and this binomial regression model had high sensitivity and specificity. Conclusion: This study demonstrated that th eclinical outcomeof VKC might be predicted by several factors that can beobtained in the early clinical phase. Information on the long-term prognosis of VKC patients might play an important role for precision medicine for VKC in childhood.

Affective Exercise Experience in Childhood and Psychological Determinants of Exercise Among Japanese Older Adults.

Japan faces significant challenges associated with its super-aged society. Exercise and physical activity are recommended strategies to promote healthy aging and quality of life in older age. However, what determines exercise behavior among Japanese older adults is relatively unknown. The principle aim of this study was to explore exercise determinants and their relation to exercise behavior among Japanese older adults. Completed self-report questionnaires were received from 1,000 Japanese older adults aged between 65 and 74 years who resided in the Kansai area. A cross-sectional maximum likelihood path analysis was used to test the relationships between variables, where it was hypothesized that affective experiences in childhood had an indirect association with the exercise behavior of Japanese older adults through the seven psychological determinants of exercise. Demographic factors were also included in the model as potential influences of all factors. Knowledge held the largest significant direct association with exercise behavior (ß = .539, p = <.001), particularly more intense forms of exercise such as resistance exercise (ß = .725, p = <.001) and moderate to strenuous exercise (ß = .420, p = <.001), whilst affective exercise experience in childhood (B = 3.749, p = <.001) and gender (B = 5.183, p = .003) held significant indirect associations. This paper emphasizes the importance of exercise-related knowledge among Japanese older adults and future research is warranted to further explore the role of positive affective exercise experiences in childhood and their influence on exercise behavior, especially amongst girls.

Walking trail access, exercise behavior, and going out-of-home among older adults: Examining longitudinal associations and mediators.

AIM: Although the presence of a walking trail within a neighborhood would be an important environmental determinant of health behaviors, such as exercise and going out-of-home, their longitudinal associations and mediators are still unconfirmed. This study examined the longitudinal associations of walking trail access with exercise behavior and going out-of-home and mediating roles of awareness and use of walking trails on their associations among older adults. METHODS: A four-wave questionnaire-based longitudinal survey was conducted among Japanese older adults (Wave 1: baseline; Wave 2: after one year; Wave 3: after three years; and Wave 4: after five years). Each survey measured weekly exercise time and frequency of going out-of-home. Wave 4 survey also measured awareness and use of walking trails. This study calculated distance to nearest walking trail using geographic information systems. This study analyzed the data from all waves (n = 834) for longitudinal associations and the data from Wave 4 (n = 567) for mediated associations. RESULTS: Latent growth modeling showed insignificant longitudinal associations of walking trail access with weekly exercise time and frequency of going out-of-home. The path analyses showed that a shorter distance to the walking trail was indirectly and significantly associated with longer weekly exercise time (standardized indirect effect=-0.03, p<.001) and a higher weekly frequency of going out-of-home (standardized indirect effect=-0.03, p<.001), mediated by awareness and use of walking trails. CONCLUSIONS: These findings indicate that the influence of walking trail access on exercise behavior and going out-of-home would be attenuated by awareness and use of walking trails among older adults.

Simulation of Changes in Tensile Strain by Airbag Impact on Eyes After Trabeculectomy by Using Finite Element Analysis.

Purpose: We studied the kinetic phenomenon of an airbag impact on eyes after trabeculectomy using finite element analysis (FEA), a computerized method for predicting how an object reacts to real-world physical effects and showing whether an object will break, to sequentially determine the responses at various airbag deployment velocities. Methods: A human eye model was used in the simulations using the FEA program PAM-GENERISTM (Nihon ESI, Tokyo, Japan). A half-thickness incised scleral flap was created on the limbus and the strength of its adhesion to the outer sclera was set at 30%, 50%, and 100%. The airbag was set to hit the surface of the post-trabeculectomy eye at various velocities in two directions: perpendicular to the corneal center or perpendicular to the scleral flap (30° gaze-down position), at initial velocities of 20, 30, 40, 50, and 60 m/s. Results: When the airbag impacted at 20 m/s or 30 m/s, the strain on the cornea and sclera did not reach the mechanical threshold and globe rupture was not observed. Scleral flap lacerations were observed at 40 m/s or more in any eye position, and scleral rupture extending posteriorly from the scleral flap edge and rupture of the scleral flap resulting from extension of the corneal laceration through limbal damage were observed. Even in the case of 100% scleral flap adhesion strength, scleral flap rupture occurred at 50 m/s impact velocity in the 30° gaze-down position, whereas in eyes with 30% or 50% scleral flap adhesion strength, scleral rupture was observed at an impact velocity of 40 m/s or more in both eye positions. Conclusion: An airbag impact of ≥40 m/s might induce scleral flap rupture, indicating that current airbags may induce globe rupture in the eyes after trabeculectomy. The considerable damage caused by an airbag on the eyes of short-stature patients with glaucoma who have undergone trabeculectomy might indicate the necessity of ocular protection to avoid permanent eye damage.

Finite Element Analysis of Changes in Deformation of Intraocular Segments by Airbag Impact in Eyes of Various Axial Lengths.

Background: We studied the kinetic phenomenon of an airbag impact on eyes with different axial lengths using finite element analysis (FEA) to sequentially determine the physical and mechanical responses of intraocular segments at various airbag deployment velocities. Methods: The human eye model we created was used in simulations with the FEA program PAM-GENERISTM. The airbag was set to impact eyes with axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 20, 30, 40, 50 and 60 m/s. The deformation rate was calculated as the ratio of the length of three segments, anterior chamber, lens and vitreous, to that at the baseline from 0.2 ms to 2.0 ms after the airbag impact. Results: Deformation rate of the anterior chamber was greater than that of other segments, especially in the early phase, 0.2-0.4 ms after the impact (P < 0.001), and it reached its peak, 80%, at 0.8 ms. A higher deformation rate in the anterior chamber was found in hyperopia compared with other axial length eyes in the first half period, 0.2-0.8 ms, followed by the rate in emmetropia (P < 0.001). The lens deformation rate was low, its peak ranging from 40% to 75%, and exceeded that of the anterior chamber at 1.4 ms and 1.6 ms after the impact (P < 0.01). The vitreous deformation rate was lower throughout the simulation period than that of the other segments and ranged from a negative value (elongation) in the later phase. Conclusion: Airbag impact on the eyeball causes evident deformation, especially in the anterior chamber. The results obtained in this study, such as the time lag of the peak deformation between the anterior chamber and lens, suggest a clue to the pathophysiological mechanism of airbag ocular injury.

Physical Activity Components that Determine Daily Life Satisfaction Among Older Adults: An Intensive Longitudinal Diary Study.

BACKGROUND: Although previous studies have shown that engaging in physical activity can elevate daily life satisfaction, few studies have identified the specific aspects that can result in this. This study examined whether enjoying moderate-to-vigorous intensity exercises with others for a longer time, but not any aspects of non-exercise physical activity, was associated with higher daily life satisfaction among older adults. METHOD: We conducted an intensive longitudinal diary survey of 182 individuals for 1 week and obtained valid data for 853 person-days. The time spent engaging in light and moderate-to-vigorous physical activity at 8:00-11:59, 12:00-15:59, and 16:00-19:59 h was measured using an accelerometer. Duration, intensity, timing, social context, and enjoyment of the exercises were assessed based on diary entries. Stratified by non-exercise and exercise days, we conducted multilevel models. RESULTS: On non-exercise days, longer duration of light physical activity from 12:00 to 15:59 at the within-person level was associated with higher daily life satisfaction. On exercise days, longer duration of moderate-to-vigorous physical activity from 12:00 to 15:59 at the within-person level, longer exercise duration at the within-person level, exercising with moderate-to-vigorous intensity, and enjoyment of exercise at both the within- and between-person levels were associated with higher daily life satisfaction. CONCLUSION: These findings indicate that enjoying moderate-to-vigorous intensity exercise for a longer duration than usual and engaging in non-exercise physical activity in the afternoon are important for elevating older adults' daily life satisfaction.

Relationship Between Habitual Use and Degree of Emotion Regulation: Age Differences in Cognitive Reappraisal and Expressive Suppression.

BACKGROUND: The present study examined age differences in and the relationship between two indices of cognitive reappraisal and expressive suppression: the degree of emotion regulation and the habitual use of emotion-regulation strategies. METHOD: In total, 101 younger and 99 older participants were included in this study. The degree of emotion regulation was measured using an experimental task in which participants were presented with negative or positive pictures and required to regulate their emotions. Habitual use of emotion regulation strategies was measured using an emotion regulation questionnaire. RESULTS: The results showed that younger adults regulated their emotions to a greater extent than older adults in both reappraisal and suppression. Younger adults were more likely to use reappraisal than were older adults, although there were no age differences in the use of suppression. No significant correlations were found between the degree of emotion regulation and the habitual use of emotion regulation strategies. CONCLUSION: These results suggest that age differences in emotion regulation depend on the regulation strategy and that the degree of emotion regulation and habitual use of emotion regulation strategies are independent and quite different indicators in nature.

Cross-sectional associations of weekly time, social context, and motivation of exercise with mental health among workers.

PURPOSE: Exercise is considered a strategy to promote mental health among workers. However, the optimal exercise conditions that promote mental health benefits for workers are still unclear. This study examined the cross-sectional associations of weekly exercise time duration, social context of exercise, and exercise motivation levels with the mental health among Japanese workers. METHODS: A web-based cross-sectional questionnaire survey was conducted among 18,902 workers, aged 20-59 years. The mental health variables (psychological distress, psychological stress reaction, physical stress reaction, job satisfaction, and work engagement), exercise participation (non-exercisers, exercisers), and demographic factors of all responders were measured. Weekly exercise time, social context of exercise (alone only, with others only, both alone and with others), and exercise motivation (non-regulation, external/introjected regulation, identified regulation, integrated regulation, and internal regulation) were also measured amongst exercisers. After adjusting for demographic factors, multiple regression analyses were conducted. RESULTS: Exercisers had significantly lower psychological distress, lower psychological and physical stress reactions, higher job satisfaction, and higher work engagement than non-exercisers. Among exercisers, while weekly exercise time duration and social context of exercise were not clearly and robustly associated with mental health variables, respondents with intrinsic regulation had significantly lower psychological distress, lower psychological and physical stress reaction, higher job satisfaction, and higher work engagement than those with lower self-determined motivations. CONCLUSIONS: This study found that more self-determined exercise motivation is closely associated with advantageous mental health variables, than the duration or the social context of exercise among Japanese workers.

Between- and Within-Couple Concordance for Health Behaviors Among Japanese Older Married Couples: Examining the Moderating Role of Working Time.

BACKGROUND: Although previous studies report spousal concordance for health behaviors at between-couple levels, concordance at within-couple levels remains unconfirmed. To clarify the behavioral mechanisms of spousal concordance for health behaviors among older couples at both levels, it is necessary to examine the moderators (effect modifiers) of spousal concordance. This study examined (1) whether spousal concordance for dietary variety, exercise behavior, and TV viewing behavior was observed at both the between-couple and the within-couple levels and (2) whether this spousal concordance was moderated by working time among older Japanese couples. METHOD: This study analyzed data obtained from a questionnaire-based, three-wave longitudinal survey (baseline, 1-year follow-up, 3-year follow-up) among 210 Japanese older couples. Each spouse's dietary variety, exercise time, TV viewing time, the couple's working time, and demographic factors were investigated by multi-level analyses. RESULTS: One spouse's dietary variety and TV viewing time, but not exercise time, were significantly associated with the other spouse's corresponding behaviors at both levels. The regressions of the wife's TV viewing time on the husband's TV viewing time were moderated by working time at the within-couple level; the regressive effects of wife's TV viewing time on husband's TV viewing time were more relevant as working time was lower. CONCLUSION: This study found that spousal concordance for dietary variety and TV viewing was observed at within-couple and between-couple levels among older Japanese couples. In addition, shorter working time partly moderates the wife's influence on the husband's TV viewing among older couples at the within-couple level.

Leisure-time management and subjective well-being among older adults: A three-wave longitudinal survey.

AIM: As older adults have longer leisure time and the types and influences of leisure activities they participate in are diverse, appropriate management of their leisure time would be important to optimize their subjective well-being. Although greater use of time management in educational and occupational settings is associated with better job performance, academic achievement, and the well-being of workers and students, few studies have investigated time management in leisure settings. This study aimed to examine the longitudinal association between leisure-time management and subjective well-being among older adults. METHODS: Data on 879 individuals in Nada Ward, Kobe, Japan were obtained from a three-wave questionnaire-based longitudinal survey (Wave 1: December 2017 to January 2018; Wave 2: after one year; Wave 3: after three years). In each survey, leisure-time management (newly developed in this study) and subjective well-being (simplified Japanese version of the World Health Organization Five Well-Being Index) were measured. This study used a cross-lagged model to analyze the longitudinal association between leisure-time management and subjective well-being after considering their inverse association. RESULTS: The cross-lagged model indicated that that the standardized path coefficients from leisure-time management in Wave 1 to subjective well-being in Wave 2 (0.13, p<0.001) and from leisure-time management in Wave 2 to subjective well-being in Wave 3 (0.06, p=0.042) were positive and significant. CONCLUSIONS: This study found that leisure-time management is a determinant of subjective well-being among older adults. This finding indicates that the management of leisure time elevates one's subjective well-being among them.

Classification of Subtypes of Vernal Keratoconjunctivitis by Cluster Analysis Based on Clinical Features.

Background: Vernal keratoconjunctivitis (VKC) is a refractory ocular allergic disorder that mainly affects boys. A few studies have attempted to develop a classification of subtypes of VKC. In this study, we investigated a computational approach called cluster analysis to separate VKC cases into groups based on clinically relevant characteristics. Methods: In total, 41 consecutive patients clinically diagnosed with VKC at the Department of Ophthalmology of Fukuoka University Hospital were included. Patients were treated with immunosuppressive eye drops without simultaneous corticosteroid eye drops, except for the occurrence of exacerbations. Collated variables were age at onset, clinical score of ocular lesions at baseline, clinical score of ocular lesions at final visit, clinical score of atopic dermatitis (AD) at baseline, frequency of exacerbations of VKC, serum total IgE level and peripheral blood eosinophil count. Results: VKC patients were grouped into three clusters by cluster analysis, and cluster 1, 2, and 3 comprised 25, 9 and 7 cases, respectively. There were differences in the incidence of complications of AD and age at onset among the clusters; therefore, we named the three clusters for better understanding as traditional VKC (cluster 1), early-onset atopic keratoconjunctivitis (AKC)/VKC (cluster 2) and puberty-onset AKC (cluster 3). Conclusion: We found in this study that VKC in childhood has three phenotypes which were previously unknown. Our findings may help to establish precision medicine by focusing on the phenotype of each case to develop individualized medicine to prevent exacerbations.

Does Future Time Perspective Moderate Associations of Instrumental and Affective Attitude With Exercise Behavior? A Three-Wave Longitudinal Survey Among Japanese Older Adults.

OBJECTIVES: To develop effective promotion strategies for exercise behavior in older adults, it is essential to identify the psychological determinants. Previous studies investigated affective and instrumental attitudes as determinants. However, from the conceptual assumptions of socioemotional selectivity theory, affective attitudes might be more influential on the exercise behavior of older adults with an expansive future time perspective, whereas instrumental attitudes would be more influential on those with limited perspectives. This study examined whether the associations of affective and instrumental attitudes with behavioral intention and exercise behavior differed according to future time perspective among older Japanese adults. METHODS: Data were obtained from a 3-wave longitudinal questionnaire survey of 886 individuals (Wave 1: December 2017-January 2018; Wave 2, 1-year follow-up; Wave 3, 3-year follow-up). Using the data on exercise behavior, affective and instrumental attitudes, and behavioral intention at each wave, and the data of future time perspective and demographic factors at Wave 1, this study performed multiple regression analyses and a multigroup cross-lagged model. RESULTS: Affective attitude was a significant predictor of behavioral intention regardless of future time perspective. Although instrumental attitude significantly predicted behavioral intention among those with a lower future time perspective, it did not predict behavioral intention among those with middle-to-higher future time perspective. Regardless of future time perspective, affective attitude, but not instrumental attitude, significantly predicted exercise behavior. DISCUSSION: Unlike the socioemotional selectivity theory, this study found that affective attitude was more influential on exercise behavior than instrumental attitude regardless of future time perspective among them.

A non-pharmacological multidomain intervention of dual-task exercise and social activity affects the cognitive function in community-dwelling older adults with mild to moderate cognitive decline: A randomized controlled trial.

The present study aimed to determine the impact of a 10-month multidomain program using dual-task exercise and social activity conducted at a community-based facility on improved cognitive function in older adults with mild to moderate cognitive decline. The participants included 280 community-dwelling older adults (age 71-91 years) with mild to moderate cognitive decline. The intervention group exercised for 90 min/day, once a week. Their routine included aerobic exercise and dual-task training which cognitive tasks were performed in combination with exercise. The control group attended health education classes thrice. Before and after the intervention, we measured their cognitive function, physical function, daily conversation, and physical activity. The mean adherence rate of the intervention class was 83.0%. According to a repeated-measures multivariate analysis of covariance in an intent-to-treat analysis, logical memory and 6-min walking distance demonstrated a significant time and group interaction effect. Regarding daily physical activities, we observed significant differences in the daily step count and moderate-to-vigorous physical activity in the intervention group. Our non-pharmacological multidomain intervention resulted in a modest improvement in the cognitive or physical function and building health behavior. It may be a helpful program with a potential role in preventing dementia. Clinical Trial Registration: http://clinicaltrials.gov Identifier ID: UMIN000013097.

Social network and health behaviors among Japanese older adults: a three-wave longitudinal study.

Identifying modifiable determinants of behavior is essential for developing effective strategies to promote health behaviors among older adults. Although social networks are potentially modifiable determinants of health behaviors, their longitudinal associations have not been established in previous studies. The present study examined whether a larger social network is associated with higher dietary variety, longer time spent exercising and shorter time spent viewing TV among older adults. This is a longitudinal study. The data of 908 Japanese older adults were obtained through a three-wave questionnaire survey (Wave 1, December 2017 to January 2018; Wave 2, after 1 year; Wave 3, after 3 years) and analyzed. In each wave of the survey, dietary variety (dietary variety score), exercise time (hours per day), TV viewing time (hours per day) and social network (family and friend subscales of the Japanese version of the abbreviated Lubben Social Network Scale) were measured. The present study used latent growth, cross-lagged and simultaneous effect models to investigate the longitudinal associations of family and friend social networks with dietary variety, exercise time and TV viewing time. However, these models did not show clear and robust associations. Whether social networks are determinants of health behaviors among older adults remains inconclusive.

The importance of promoting health behaviors among older adults is obvious. Identifying the modifiable determinants of health behaviors is essential for developing effective strategies to promote health behaviors. Although social networks are potentially modifiable determinants of health behaviors, their longitudinal associations have not been established in previous studies. This study examined the longitudinal associations between social networks and health behaviors among older adults. To address this issue, we conducted a three-wave questionnaire. However, we failed to find clear and robust associations between social networks and health behaviors. Whether social networks are determinants of health behaviors among older adults remains inconclusive.

Abnormal Gait Pattern Examination Screening for Physical Activity Level after One Year in Patients with Knee Osteoarthritis.

This study examined the relationship between abnormal gait pattern and physical activity level one year later in patients with knee osteoarthritis (KOA) and determined the clinical utility of the abnormal gait pattern examination. Initially, the patients' abnormal gait pattern was assessed using seven items, based on the scoring system reported in a previous study. The grading was based on a three-criteria system with 0: no abnormality, 1: moderately abnormal, and 2: severely abnormal. The patients were then classified into three groups according to physical activity level one year after gait pattern examination: low, intermediate, and high physical activity groups, respectively. Cut-off values for physical activity levels were calculated based on abnormal gait pattern examinations results. On follow-ups with 24 of the 46 subjects, age, abnormal gait pattern, and gait speed showed significant differences among the three groups according to the amount of physical activity. Effect size of abnormal gait pattern was higher than age and gait speed. Patients with KOA with physical activity < 2700 steps/day and <4400 steps/day at one year had abnormal gait pattern examination scores of ≥8 and ≥5, respectively. Abnormal gait pattern is associated with future physical activity. The results suggested that abnormal gait pattern examinations in patients with KOA could be used to screen for the possibility of physical activity being <4400 steps one year later.

Does health literacy moderate the psychological pathways of physical activity from guideline awareness to behavior? A multi-group structural equation modeling.

BACKGROUND: Awareness, knowledge, beliefs, and behavioral intentions of physical activity (PA) guidelines may be important mediating factors for promoting PA. However, these pathways of the psychological process to PA behavior have not been examined. These pathways may differ depending on health literacy levels. This study investigated the pathways to PA, from guideline awareness to behavior, and further examined whether they differed by health literacy. METHODS: A cross-sectional study was conducted with 7,000 Japanese participants aged 20-69 years. The participants were registered with an Internet survey company. Participants' awareness, knowledge, beliefs, and behavioral intentions regarding the PA guidelines of Japan, the volume of moderate-to-vigorous intensity PA, activity level, and health literacy were examined through a questionnaire. The PA pathways, from guideline awareness to behavior, were examined by structural equation modeling (SEM), with PA behavior as the dependent variable. Multi-group SEM was conducted to examine the moderating effect of health literacy on PA pathways. Health literacy scores were dichotomized into high and low groups in multi-group modeling by the median split. RESULTS: SEM revealed that PA guideline awareness directly affects PA behavior and has certain indirect effects through the mediation of knowledge, beliefs, and behavioral intentions. Furthermore, the multi-group SEM showed that the proportion of indirect effects (path coefficient [PC]: 0.11, 95% confidence interval [CI]: 0.10-0.13) was higher than direct effects (PC: 0.07, 95%CI: 0.03-0.11) in the high-health literacy group. In contrast, the proportion of direct effects (PC: 0.22, 95%CI: 0.15-0.30) was higher than indirect effects (PC: 0.06, 95%CI: 0.05-0.07) in the low-health literacy group. CONCLUSIONS: PA guideline awareness is both directly and indirectly associated with PA behavior, mediated by psychological pathways of knowledge, beliefs, and behavioral intentions, and influenced by health literacy. These results suggest that health literacy should be considered when implementing PA guideline-based interventions.

Finite element analysis of changes in tensile strain and deformation by airbag impact in eyes of various axial lengths.

PURPOSE: Airbags have substantially reduced mortality and morbidity, while ocular injuries caused by airbags have been reported. We applied a three-dimensional finite element analysis (FEA) model we have established for evaluation of the deformation of an intact eyeball of various axial lengths induced by an airbag impact at various impact velocities. METHODS: A model human eye we have created was used in simulations with an FEA program, PAM-GENERIS™ (Nihon ESI, Tokyo, Japan). The airbag was set to impact eyes with various axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 30, 40, 50 and 60 m/s. Changes in the shape of the eye and the strain induced were calculated. Deformation of the eye in a cross-sectional view was displayed sequentially in slow motion. RESULTS: We found that considerable damage, such as corneal or scleral lacerations, was observed especially at higher impact velocities, such as 50 or 60 m/s, in eyes with any axial length. Deformation was most evident in the anterior segment. The decrease rate of axial length was greatest in the hyperopic eye, followed by the myopic eye, and the emmetropic eye. CONCLUSIONS: It was shown that hyperopic eyes are most susceptible to deformation by an airbag impact in this simulation. The considerable deformation by an airbag impact on the eye during a traffic accident shown in this study might indicate the necessity of ocular protection to avoid permanent eye damage.

Emotional valence of self-defining memories in older adults: A longitudinal study.

The present study aimed to evaluate the pleasantness bias and fading affect bias in self-defining memories (SDMs) and to examine the relationship between their emotional valence of SDMs and cognitive function and serotonin transporter polymorphisms (5-HTTLPR) with a prospective longitudinal method. Ninety-two older adults recalled SDMs twice at an interval of one year (T1 and T2). The results showed a pleasantness bias and a fading affect bias in SDMs. The higher the working memory was, the higher the vividness of SDMs and the higher the concordance rate of SDMs between T1 and T2. Meanwhile, cognitive performance had no effect on the emotional valence of SDMs. Additionally, the repeatedly recalled SDMs in the S/S allele carriers of the 5-HTTLPR polymorphism changed with a lower negative valence at T2 than at T1. The 5-HTTLPR polymorphism may be a plasticity factor that predicts positive outcomes in positive situations.