Associations between motorized transport access, out-of-home activities, and life-space mobility in older adults in Japan.

BACKGROUND: Motorized transport access and out-of-home activities are two potential correlates of Life-space mobility (LSM), a common research topic in mobility studies of older adults. These correlates remain mostly unexplored in previous literature and relating them with LSM can reveal directions for improving the LSM of older adults. METHODS: The associations between motorized transport access, out-of-home activities, and LSM were examined using data from 1,333 older adults (mean age = 70.63) living in 15 cities and towns in Japan. LSM was assessed using composite life-space assessment (LSA) scores. Motorized transport access was measured using dummies showing whether a person had car access (divided into five levels) and used public transport (bus and railway), and out-of-home activities were measured using the number of various activities that were conducted during the most recent weekday and weekend day. Generalized linear models were used to assess the associations. RESULTS: The sample was dominated by males (74.42%), with more than half of the sample had their own cars. On average, each respondent had four activities during two survey days, and shopping was the most common activity. The results showed that owning a car and using railway, as well as various activities were associated with increased composite LSA scores, whereas no cars or only shared cars in home were associated with decreased composite LSA scores. However, these associations differed between males and females. CONCLUSIONS: In this study, different levels of motorized transport access and different types of out-of-home activities were found to associate differently with composite LSA scores. Based on these findings, we suggest that policymakers should provide more transport access, pay more attention to the LSM of older adults with high clinics/hospital activities, and trigger more shopping and daily leisure activities for older adults to improve the LSM of this population.

Model-Based Prediction of Operation Consequences When Driving a Car to Compensate for a Partially Restricted Visual Field by A-Pillars.

The partial restriction of a driver's visual field by the physical structure of the car (e.g., the A-pillar) can lead to unsafe situations where steering performance is degraded. Drivers require both environmental information and visual feedback regarding operation consequences. When driving with a partially restricted visual field, and thus restricted visual feedback, drivers may predict operation consequences using a previously acquired internal model of a car. To investigate this hypothesis, we conducted a tracking and driving task in which visual information was restricted to varying degrees. In the tracking task, participants tracked a moving target on a computer screen with visible and invisible cursors. In the driving task, they drove a real car with or without the ability to see the distant parts of a visual field. Consequently, we found that the decrease in tracking performance induced by visual feedback restriction predicted the decrease in steering smoothness induced by visual field restriction, suggesting that model-based prediction was used in both tasks. These findings indicate that laboratory-based task performance can be used to identify drivers with low model-based prediction ability whose driving behavior is less optimal in restricted vision scenarios, even before they obtain a driver's license. However, further studies are required to examine the underlying neural mechanisms and to establish the generalizability of these findings to more realistic settings.

Age-related differences in effects of non-driving related tasks on takeover performance in automated driving.

INTRODUCTION: During SAE level 3 automated driving, the driver's role changes from active driver to fallback-ready driver. Drowsiness is one of the factors that may degrade driver's takeover performance. This study aimed to investigate effects of non-driving related tasks (NDRTs) to counter driver's drowsiness with a Level 3 system activated and to improve successive takeover performance in a critical situation. A special focus was placed on age-related differences in the effects. METHOD: Participants of three age groups (younger, middle-aged, older) drove the Level 3 system implemented in a high-fidelity motion-based driving simulator for about 30 min under three experiment conditions: without NDRT, while watching a video clip, and while switching between watching a video clip and playing a game. The Karolinska Sleepiness Scale and eyeblink duration measured driver drowsiness. At the end of the drive, the drivers had to take over control of the vehicle and manually change the lane to avoid a collision. Reaction time and steering angle variability were measured to evaluate the two aspects of driving performance. RESULTS: For younger drivers, both single and multiple NDRT engagements countered the development of driver drowsiness during automated driving, and their takeover performance was equivalent to or better than their performance without NDRT engagement. For older drivers, NDRT engagement did not affect the development of drowsiness but degraded takeover performance especially under the multiple NDRT engagement condition. The results for middle-aged drivers fell at an intermediate level between those for younger and older drivers. Practical Applications: The present findings do not support general recommendations of NDRT engagement to counter drowsiness during automated driving. This study is especially relevant to the automotive industry's search for options that will ensure the safest interfaces between human drivers and automation systems.

Effects of cognitive and visual loads on driving performance after take-over request (TOR) in automated driving.

The present study investigated effects of cognitive and visual loads on driving performance after take-over request (TOR) in an automated driving task. Participants completed automated driving in a driving simulator without a non-driving related task, with an easy non-driving related task, and with a difficult non-driving related task. The primary task was to monitor the environment and the system state. An N-back task and a Surrogate Reference Task (SuRT) were adapted to induce cognitive and visual loads respectively. The system followed a front vehicle automatically. Driving performance was measured by responses to a critical event (appearance of a broken-down car) after the automated system issued TOR and then terminated. High subjective difficulty of the N-back task was related to increased time and increased steering angle variance in the time course from onset of steering control to lane change, while high subjective difficulty of SuRT was related to increased steering angle variance in the time course after lane change. This suggests that both cognitive and visual loads affect driving performance after TOR in automated driving, but the effects appear in different time courses.

Breath analysis using a spirometer and volatile organic compound sensor on driving simulator.

In this study the correlation between the condition of drivers and their expiration was evaluated by analyzing the exhalation of car drivers in a simulation setting using a spirometer and a volatile organic compound (VOC) gas sensor. Participants wore exhalation masks and their expiration was monitored for fluctuations in breath measurements, including VOC concentration, oxygen intake, carbon dioxide excretion, and respiration rate. Participants used a driving simulator on four different courses of varying difficulty for approximately five min each, with the mean and standard deviation (SD) being calculated for each parameter during the cruising section of the course. After driving each course, participants assessed the 'enjoyment' and 'difficulty' of their experience. It was verified whether the state of the participants during driving can be determined from exhalation by comparing the questionnaire results. The mean and SD of all exhalation parameters were analyzed using box-and-whisker plots and any statistical significance between these parameters and driver experience was tested using the analysis of variance. There was no significant difference in the correlation between the questionnaire result of 'difficulty' and each exhalation parameter. By contrast, the low assessment group of 'enjoyment' showed large SDs in all parameters from both the VOC gas sensor and spirometer.

Effects of scheduled manual driving on drowsiness and response to take over request: A simulator study towards understanding drivers in automated driving.

Because current automated vehicles have operational limitations, it is important to ensure that the fallback-ready driver is able to perform appropriately when required to take over control of the vehicle. However, time-related increase in driver drowsiness is well-known, and drowsy driving can affect response to take-over request (TOR). It was previously reported that a scheduled period of manual driving during automated driving was beneficial in maintaining driver arousal level. The present driving simulator study investigates the effects of scheduled manual driving on driver drowsiness and performance, as well as age differences therein. A total of 115 participants, whose gender was balanced and age was distributed uniformly from 20 to 70 years, drove an automated vehicle for 31 min, and a TOR was prompted before a collision event. A between-subjects design comprised two conditions: with versus without a scheduled 10-min interval of manual driving that ended 10 min before TOR. The Karolinska Sleepiness Scale and eyeblink durations estimated from electrooculograms (EOG) were used to subjectively and objectively measure participant's drowsiness. Reaction time, standard deviation of steering wheel angle, and minimum Time-to-Collison (TTC) were extracted to measure driver performance in response to TOR. The alleviating effect on drowsiness of 10-min scheduled manual driving became non-significant after another 10-min period of automated driving. Although the scheduled manual driving had no significant effect for younger drivers, older drivers reacted significantly more slowly in both steering and braking at the critical event. These findings provide essential insights for human-vehicle interactions: Scheduled manual driving cannot maintain drivers' arousal level for 10 min afterwards, and for older drivers, it would be better to avoid unnecessary task-switching between manual and automated driving.

Electrophysiological assessment of driving pleasure and difficulty using a task-irrelevant probe technique.

The amplitude of event-related brain potentials (ERPs) elicited by task-irrelevant auditory probes decreases when more attentional resources are allocated to a visual task. This task-irrelevant probe technique is considered to be useful in assessing the degree of interest in a visual task, as well as task difficulty. The present study examined the amplitude of the N1 and P2 components elicited by task-irrelevant auditory probes during a driving task in a simulated environment. The analysis of ERPs showed that the N1 amplitude decreased when participants drove on the road course that had more frequent and sharper curves, whereas the P2 amplitude decreased when the road contained sharper curves, irrespective of curve frequency. Subjective ratings of driving pleasure and difficulty showed the same variation patterns as the N1 and P2 amplitudes, respectively. These results suggest that use of the task-irrelevant probe technique can assess the degree of driving pleasure and difficulty separately.

Rare case of external dental fistula of the submental region misdiagnosed as inverted follicular keratosis and thyroglossal duct cyst.

INTRODUCTION: Odontogenic cutaneous sinus tract is a relatively rare occurrence that can be complicated to diagnose. The presence of a cutaneous lesion is often not even partly associated with a dental etiology because of the less frequency of occurrence in the case of dental symptoms. Consequently, the underlying dental cause is often missed leading to inappropriate diagnosis and treatment. CASE PRESENTATION: Here, we report the case of a 45-year-old man who presented with a persistent lesion of the cervical region. At the time of presentation, the lesion had been present for approximately one year with a gradual increase in size but no specific symptoms. The patient had previously undergone punch resection under local anesthesia, which resulted in a histopathological diagnosis of inverted follicular keratosis. A diagnosis was made of an odontogenic cutaneous sinus tract secondary to chronic apical periodontitis of the left mandibular second molar. DISCUSSION: Cutaneous sinus tract in the face and neck is most likely to develop intraorally. Root canal treatment or surgical extractions are the common treatment choices. A previously reported review of 137 cases found that 106 (77%) were treated by extraction and 27 (20%) were treated by surgical or conservative nonsurgical endodontic therapy. CONCLUSION: Early diagnosis of cutaneous sinus tract using proper aid is responsible for shortening the treatment duration and avoiding unnecessary treatment.