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Paul Welford,1 Josefine Östh,1 Sara Hoy,2 Susan L Rossell,3 Michaela Pascoe,4 Vinod Diwan,1 Mats Hallgren1 1Department of Global Public Health, Karolinska Institutet, Solna, Sweden; 2Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden; 3Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia; 4Institute for Health and Sport, Victoria University, Melbourne, Victoria, AustraliaCorrespondence: Mats Hallgren, Department of Global Public Health, Karolinska Institutet, Level 6, 1e Solnavägen, Solna, 11365, Sweden, Tel +46852480000, Email mats.hallgren@ki.sePurpose: To compare the effects on verbal fluency of a supported yoga-based exercise intervention to an aerobic exercise intervention and a wait-list control group.Participants and Methods: Eighty-two physically-inactive but otherwise healthy adults (mean age 72.5 years, range 65– 85, 77% female) were recruited into a 12-week, three-group, parallel randomized controlled trial. Participants were supported to complete ≥ 3 Hatha yoga classes per/week or ≥ 3 structured aerobic exercise sessions/week. A wait-list control group continued usual daily activities only. Verbal fluency, including total-FAS, animals, and verbs, was assessed before and after interventions. Group effects were assessed using analysis of covariance (ANCOVA).Results: Twenty-seven participants were randomized to yoga, 29 to aerobic exercise and 26 to a waitlist. At 12-week follow-up, compared to baseline, there were increases in mean total-FAS in the yoga (+5.0 words, p=0.002) and aerobic exercise groups (+6.6 words, p=0.004). Mean total-FAS in the wait-list control group remained stable (− 0.5 words, p=0.838). There were medium-magnitude estimated treatment effects on total-FAS for yoga versus wait-list control and aerobic exercise versus wait-list control: Hedges’ g=0.51 (p=0.213) and 0.57 (p=0.098) respectively. In addition, small-to-medium magnitude estimated treatment effects were seen on animals and verbs for yoga versus wait-list control and aerobic exercise versus wait-list control: g=0.28 (p=0.155), 0.19 (p=0.766) and 0.50 (p=0.085), 0.59 (p=0.233) respectively.Conclusion: Participation in yoga or aerobic exercise was associated with estimated improvements in verbal fluency compared to a non-active control group. Yoga and aerobic exercise may be promising approaches by which to promote cognitive function among older adults.Trial Registration: DRKS00015093, U1111-1217-4248.Keywords: physical activity, verbal fluency test, executive function, cognitive aging, healthy aging

Alcohol dependence is common, yet highly undertreated. Smartphone applications (apps) have potential to enhance treatment accessibility and effectiveness, however evidence is limited, especially studies focussing on user experiences. The aim was to describe patient perceptions on the usability and acceptability of self-monitoring apps provided as treatment complement for alcohol dependence. Individual semi-structured interviews were conducted through video or phone calls with 21 participants, recruited from a randomized controlled trial at a dependency clinic in Stockholm. The participants had used two specific apps for self-monitoring consumption ("Glasklart" and "iBAC") during 12 wk prior to the interviews. Data was analyzed using Qualitative Content Analysis. Two domains were identified: 1) Smartphone applications as facilitators to treatment, and 2) Barriers to smartphone application use. Using apps within the treatment context was believed to increase the accuracy of the reported consumption. Participants became more aware of their alcohol problem and described the apps as reinforcers that could increase both the motivation to change and the focus on the problem and commitment to treatment. The apps were further described as helpful to control alcohol consumption. However, app usage was constrained by technical problems, unfit app-specific features and procedures, and alcohol-related shame and stigma. Self-monitoring alcohol apps have several beneficial features that can help assess, track, and control alcohol consumption, and improve communication with clinicians. The results indicate they can be useful complements to treatment for patients with alcohol dependence, but their use can be limited by different, foremost technical, issues. Smartphone applications for self-monitoring of alcohol consumption may help provide accurate data, increase consumption awareness, focus, motivation, and perceived control; Smartphone applications for self-monitoring of alcohol consumption are considered helpful complements to alcohol treatment; The use of smartphone applications for self-monitoring of alcohol consumption can be constrained by technical problems, and unfit app-specific features and procedures. [ABSTRACT FROM AUTHOR]

The injury risk in a vehicle crash can depend on occupant specific factors. Virtual crash testing using finite element human body models (HBMs) to represent occupant variability can enable the development of vehicles with improved safety for all occupants. In this study, it was investigated how many HBMs of different sizes that are needed to represent a population crash outcome through a metamodel. Rib fracture risk was used as an example occupant injury outcome. Morphed HBMs representing variability in sex, height, and weight within defined population ranges were used to calculate population variability in rib fracture risk in a frontal and a side crash. Two regression methods, regularized linear regression with second-order terms and Gaussian process regression (GPR), were used to metamodel rib fracture risk due to occupant variability. By studying metamodel predictive performance as a function of training data, it was found that constructing GPR metamodels using 25 individuals of each sex appears sufficient to model the population rib fracture risk outcome in a general crash scenario. Further, by utilizing the known outcomes in the two crashes, an optimization method selected individuals representative for population outcomes across both crash scenarios. The optimization results showed that 5-7 individuals of each sex were sufficient to create predictive GPR metamodels. The optimization method can be extended for more crashes and vehicles, which can be used to identify a family of HBMs that are generally representative of population injury outcomes in future work., (Copyright © 2024 by ASME; reuse license CC-BY 4.0.)

Objective: Real-life car crashes are often preceded by an evasive maneuver, which can alter the occupant posture and muscle state. To simulate the occupant response in such maneuvers, human body models (HBMs) with active muscles have been developed. The aim of this study was to implement an omni-directional rotational head-neck muscle controller in the SAFER HBM and compare the bio-fidelity of the HBM with a rotational controller to the HBM with a translational controller, in simulations of evasive maneuvers. Methods: The rotational controller was developed using an axis-angle representation of head rotations, with x, y, and z components in the axis. Muscle load sharing was based on rotational direction in the simulation and muscle activity recorded in three volunteer experiments in these directions. The gains of the rotational and translational controller were tuned to minimize differences between translational and rotational head displacements of the HBM and volunteers in braking and lane change maneuvers using multi-objective optimizations. Bio-fidelity of the model with tuned controllers was evaluated objectively using CORrelation and Analysis (CORA). Results: The results indicated comparable performance for both controllers after tuning, with somewhat higher bio-fidelity for rotational kinematics with the translational controller. After tuning, good or excellent bio-fidelity was indicated for both controllers in the loading direction (forward in braking, and lateral in lane change), with CORA scores of 0.86-0.99 and 0.93-0.98 for the rotational and translational controllers, respectively. For rotational displacements, and translational displacements in the other directions, bio-fidelity ranged from poor to excellent, with slightly higher average CORA scores for the HBM with the translational controller in both braking and lane changing. Time-averaged muscle activity was within one standard deviation of time-averaged muscle activity from volunteers. Conclusion: Overall, the results show that when tuned, both the translational and rotational controllers can be used to predict the occupant response to an evasive maneuver, allowing for the inclusion of evasive maneuvers prior to a crash in evaluation of vehicle safety. The rotational controller shows potential in controlling omni-directional head displacements, but the translational controller outperformed the rotational controller. Thus, for now, the recommendation is to use the translational controller with tuned gains., Competing Interests: Author BP was employed by Autoliv Research. Author JÖ was employed by Volvo Cars. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Larsson, Iraeus, Pipkorn, Östh, Forbes and Davidsson.)

The COVID-19 pandemic affected travelling in general, and the leisure mobility and the spatial distribution of travellers in particular. In most parts of the world, both domestic and international travel has been replaced by restrictive policies and recommendations on mobility. A modal shift from public transport towards private cars and micro-mobility was also observed. This study seeks to trace the implications of the COVID-19 pandemic for leisure mobility. We use a unique Swedish database containing daily mobility patterns of pseudonymised mobile phone users, combined with a survey on vacation transport behaviour. By contrasting mobility patterns for selected holiday days during the unaffected summer of 2019 with corresponding dates in 2020 and 2021, we are able to model and detect the pandemic effects on tourism and recreational mobility. Moreover, by identifying the general mobility patterns, we analyse whether and how the transport mode has changed. Using data on the spatial distribution of recreational amenities, we identify locations that were favoured during the pandemic. In Sweden, even though the pandemic decreased in spread and severity during the summers, most travel restrictions were still enforced, international vacations uncommon, and larger vacation spots, such as amusement parks and cultural institutions, were closed down. Swedish vacation homes in remote or rural areas were quickly booked. This change in recreational behaviour, where less populated areas, open air and nature recreation were favoured over indoor or crowded urban cultural activities, was more substantial in 2021 than in 2020. This result shows how policies can effectively be developed, so that Swedes respond properly to recommendations and adjust their vacation plans., (© 2023 The Authors.)

During the first months of the COVID-19 outbreak, countries adopted different strategies in order to mitigate the effects of the pandemic, ranging from recommendations to limit individual movement to severe lockdown measures. Regarding higher education, university studies were shifted to digital solutions in most countries. The sudden move to online teaching affected students differently, depending on the overall mitigation strategies applied. Severe lockdown and closure measures caused a disruption of their academic and social interactions. In contrast, recommendations to limit activities probably did not change students' life to a great extent. The heterogeneity of the policies adopted in three countries (Italy, Sweden and Turkey) gives us an opportunity to assess the effects of lockdown measures due to the COVID-19 pandemic on university students' performance. We employ a difference-in-differences approach by exploiting the fact that Italy and Turkey experienced national lockdowns, while Sweden never applied nationwide mandatory restrictive policies. We use administrative data from universities in the three countries to estimate the probability to pass exams after the spread of COVID-19 pandemic (and the shift to distance education), with respect to the previous comparable period. We find that the pass rate decreased with the shift to online teaching. However, lockdown measures, especially if very restrictive as those applied in Italy, helped to compensate such negative effect. A possible explanation is that students took advantage of the huge increase in the time available for their studies, given the impossibility to carry out any activity outside the home., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (© 2023 Published by Elsevier Ltd.)

Finite element human body models (HBMs) are becoming increasingly important numerical tools for traffic safety. Developing a validated and reliable HBM from the start requires integrated efforts and continues to be a challenging task. Mesh morphing is an efficient technique to generate personalized HBMs accounting for individual anatomy once a baseline model has been developed. This study presents a new image registration-based mesh morphing method to generate personalized HBMs. The method is demonstrated by morphing four baseline HBMs (SAFER, THUMS, and VIVA+ in both seated and standing postures) into ten subjects with varying heights, body mass indices (BMIs), and sex. The resulting personalized HBMs show comparable element quality to the baseline models. This method enables the comparison of HBMs by morphing them into the same subject, eliminating geometric differences. The method also shows superior geometry correction capabilities, which facilitates converting a seated HBM to a standing one, combined with additional positioning tools. Furthermore, this method can be extended to personalize other models, and the feasibility of morphing vehicle models has been illustrated. In conclusion, this new image registration-based mesh morphing method allows rapid and robust personalization of HBMs, facilitating personalized simulations., Competing Interests: MF was employed by Mips AB. JO and LJ were employed by Volvo Cars Safety Centre. BP was employed by Autoliv Research. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Li, Yuan, Lindgren, Huang, Fahlstedt, Östh, Pipkorn, Jakobsson and Kleiven.)

In this study, we set out to understand how the changes in daily mobility of people during the first wave of the COVID-19 pandemic in spring 2020 influenced daytime spatial segregation. Rather than focusing on spatial separation, we approached this task from the perspective of daytime socio-spatial diversity - the degree to which people from socially different neighbourhoods share urban space during the day. By applying mobile phone data from Greater Stockholm, Sweden, the study examines weekly changes in 1) daytime social diversity across different types of neighbourhoods, and 2) population groups' exposure to diversity in their main daytime activity locations. Our findings show a decline in daytime diversity in neighbourhoods when the pandemic broke out in mid-March 2020. The decrease in diversity was marked in urban centres, and significantly different in neighbourhoods with different socio-economic and ethnic compositions. Moreover, the decrease in people's exposure to diversity in their daytime activity locations was even more profound and long-lasting. In particular, isolation from diversity increased more among residents of high-income majority neighbourhoods than of low-income minority neighbourhoods. We conclude that while some COVID-19-induced changes might have been temporary, the increased flexibility in where people work and live might ultimately reinforce both residential and daytime segregation., (© 2023 The Authors.)

Objective: The aim of this study was to assess head injury criteria based on their correlation to brain strain in a Finite Element (FE) head model (the KTH Royal Institute of Technology model), by simulation of head kinematics data from frontal and side crash tests with Anthropomorphic Test Devices (ATDs), and from Human Body Model (HBM) accident reconstructions., Methods: Six Degrees of Freedom (DoF) head kinematic data was extracted from 221 crash tests, consisting of frontal impacts with the THOR-50M ATD, near-side and far-side impacts with the WorldSID-50M ATD, and from 19 FE HBM accident reconstructions. The head injury criteria HIC 15 , HIP, BrIC, UBrIC, DAMAGE and CIBIC were calculated, and FE head model simulations were conducted using the six DoF kinematics data. The 100th, 99th, and 95th percentile Maximum Principal Strains (MPS) of the brain were extracted and linear regression models with respect to the injury criteria were created. The injury criteria were then evaluated based on the coefficient of determination, R 2 , and the Normalized Root Mean Square Error (NRMSE) of each regression model., Results: For all the data sets combined and for the WorldSID far-side data, CIBIC had the best goodness of fit, with R 2 of 0.76 and 0.85. For frontal impacts with THOR and the combined ATD data set, DAMAGE had highest R 2 , 0.83 and 0.78, respectively. Injury criteria including translational accelerations were ranked lower, and BrIC were among the three lowest ranked for most data sets evaluated. UBrIC generally ranked after DAMAGE and CIBIC with respect to the goodness of fit but had the lowest NRMSE for all data sets., Conclusions: The two mass-spring-damper brain surrogate model criteria, DAMAGE and CIBIC, were best in capturing the head model MPS response for both the THOR and WorldSID data sets. BrIC had lower correlation to the head model MPS and performed marginally better than the linear acceleration only criteria for all the data sets combined. This study supports the suitability of DAMAGE and CIBIC as brain injury criteria to be used with THOR-50M and WorldSID-50M in vehicle crash test conditions, as they outperform BrIC.

This study examines the COVID-19 vulnerability and subsequent market dynamics in the volatile hospitality market worldwide, by focusing in particular on individual Airbnb bookings-data for six world-cities in various continents over the period January 2020-August 2021. This research was done by: (i) looking into factual survival rates of Airbnb accommodations in the period concerned; (ii) examining place-based impacts of intra-city location on the economic performance of Airbnb facilities; (iii) estimating the price responses to the pandemic by means of a hedonic price model. In our statistical analyses based on large volumes of time- and space-varying data, multilevel logistic regression models are used to trace 'corona survivability footprints' and to estimate a hedonic price-elasticity-of-demand model. The results reveal hardships for the Airbnb market as a whole as well as a high volatility in prices in most cities. Our study highlights the vulnerability and 'corona echo-effects' on Airbnb markets for specific accommodation segments in several large cities in the world. It adds to the tourism literature by testing the geographic distributional impacts of the corona pandemic on customers' choices regarding type and intra-urban location of Airbnb accommodations., (© 2022 The Authors.)

Objective: To compare the effects of yoga and aerobic exercise (AE) on wellbeing in physically inactive, but otherwise healthy older adults. A secondary objective was to assess and compare the frequency of adverse events associated with yoga and AE., Design: Twelve-week, three-group, parallel randomized controlled trial with blinded follow-up assessment., Interventions: Participants were supported to complete ≥ 3 Hatha yoga classes/week or ≥ 3 AE sessions/week. A wait-list control (WLC) group continued usual daily activities., Main Outcome Measure: Change in wellbeing, assessed using the Satisfaction with Life Scale (SWLS) and Life Satisfaction Index-Z (LSI),at baseline and at 12-week follow up., Results: In total, 82 adults (mean age 72.5 years, range 65-85, 77% female) were recruited. Of these, 27 were randomized to yoga, 29 to aerobic exercise and 26 to wait-list control. Medium-magnitude treatment effects (Hedges' g) were seen for yoga versus WLC and AE versus WLC(SWLS, g = 0.65 and 0.56; LSI, g = 0.54 and 0.54, respectively). In per-protocol analyses, larger effect sizes were found (SWLS, g = 0.72 and 0.66; LSI, g = 0.76 and 0.76, respectively). Adverse events were less frequent in the yoga group (6/27; 22%) compared to AE (10/27; 37%)., Conclusions: Among physically inactive older adults, participation in yoga or AE was associated with beneficial effects on subjective wellbeing when compared to a non-active control group. Yoga was associated with fewer injuries and may be especially suitable for older adults (DRKS 00015093)., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Car passengers are frequently sitting in non-nominal postures and are able to perform a wide range of activities since they are not limited by tasks related to vehicle control, contrary to drivers. The anticipated introduction of Autonomous Driven vehicles could allow "drivers" to adopt similar postures and being involved in the same activities as passengers, allowing them a similar set of non-nominal postures. Therefore, the need to investigate the effects of non-nominal occupant sitting postures during relevant car crash events is becoming increasingly important. This study aims to investigate the effect of different postures of passengers in the front seat of a car on kinematic and kinetic responses during intersection crashes. A Human Body Model (HBM) was positioned in a numerical model of the front passenger seat of a midsize Sports Utility Vehicle (SUV) in a total of 35 postures, including variations to the lower and upper extremities, torso, and head postures. Three crash configurations, representative of predicted urban intersection crashes, were assessed in a simulation study; two side impacts, a near-side and a far-side, respectively, and a frontal impact. The occupant kinematics and internal loads were analyzed, and any deviation between the nominal and altered posture responses were quantified using cross-correlation of signals to highlight the most notable variations. Posture changes to the lower extremities had the largest overall influence on the lower extremities, pelvis, and whole-body responses for all crash configurations. In the frontal impact, crossing the legs allowed for the highest pelvis excursions and rotations, which affected the whole-body response the most. In the two side-impacts, leaning the torso in the coronal plane affected the torso and head kinematics by changing the interaction with the vehicle's interior. Additionally, in far-side impacts supporting the upper extremity on the center console resulted in increased torso excursions. Moreover, the response of the upper extremities was consistently sensitive to posture variations of all body regions., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The world's elderly population is growing. Physical activity has positive effects on health and cognition, but is decreasing among the elderly. Interest in yoga-based exercises has increased in this population, especially as an intervention targeting balance, flexibility, strength, and well-being. Recent interest has arisen regarding yoga's potential benefits for cognition., Objective: To systematically review evidence from randomized controlled trials (RCTs) examining the effects of yoga-based interventions on cognitive functioning in healthy adults aged ≥60. A secondary aim was to describe intervention characteristics and, where possible, the extent to which these influenced study outcomes., Method: The review was conducted in accordance with PRISMA guidelines. Searches were performed from inception to June 2020 using the following electronic databases: (1) PubMed (NLM); (2) Embase (Elsevier); (3) Cochrane Central (Wiley); (4) PsycINFO (EBSCOhost); and (5) Cinahl (EbscoHost)., Inclusion Criteria: RCTs of yoga-based interventions assessing cognition in healthy adults ≥60 years. Risk of bias was assessed using the revised Cochrane risk of bias tool., Results: A total of 1466 records were initially identified; six studies (5 unique trials) were included in the review. Four of the six articles reported significant positive effects of yoga-based interventions on cognition, including gross memory functioning and executive functions. Intervention characteristics and assessment methods varied between studies, with a high overall risk of bias in all studies., Conclusion: Yoga-based interventions are associated with improvements in cognition in healthy older adults. Adequately powered RCTs with robust study designs and long-term follow-ups are required. Future studies should explicitly report the intervention characteristics associated with changes in cognitive function., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Traffic safety technologies revolve around two principle ideas; crash avoidance and injury mitigation for inevitable crashes. The development of relevant vehicle injury mitigating technologies should consider the interaction of those two technologies, ensuring that the inevitable crashes can be adequately managed by the occupant and vulnerable road user (VRU) protection systems. A step towards that is the accurate description of the expected crashes remaining when crash-avoiding technologies are available in vehicles. With the overall objective of facilitating the assessment of future traffic safety, this study develops a method for predicting crash configurations when introducing crash-avoiding countermeasures. The predicted crash configurations are one important factor for prioritizing the evaluation and development of future occupant and VRU protection systems. By using real-world traffic accident data to form the baseline and performing counterfactual model-in-the-loop (MIL) pre-crash simulations, the change in traffic situations (vehicle crashes) provided by vehicles with crash-avoiding technologies can be predicted. The method is built on a novel crash configuration definition, which supports further analysis of the in-crash phase. By clustering and grouping the remaining crashes, a limited number of crash configurations can be identified, still representing and covering the real-world variation. The developed method was applied using Swedish national- and in-depth accident data related to urban intersections and highway driving, and a conceptual Autonomous Emergency Braking system (AEB) computational model. Based on national crash data analysis, the conflict situations Same-Direction rear-end frontal (SD-ref) representing 53 % of highway vehicle-to-vehicle (v2v) crashes, and Straight Crossing Path (SCP) with 21 % of urban v2v intersection crashes were selected for this study. Pre-crash baselines, for SD-ref (n = 1010) and SCP (n = 4814), were prepared based on in-depth accident data and variations of these. Pre-crash simulations identified the crashes not avoided by the conceptual AEB, and the clustering of these revealed 5 and 52 representative crash configurations for the highway SD-ref and urban intersection SCP conflict situations, respectively, to be used in future crashworthiness studies. The results demonstrated a feasible way of identifying, in a predictive way, relevant crash configurations for in-crash testing of injury prevention capabilities., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: Our objective was to study the effect on child occupant kinematics and loading by differences in booster cushion designs and attachment in a frontal impact., Methods: Three different booster cushion designs were exposed to a frontal impact in vehicle rear seat interiors. The boosters were selected based on their difference in shape, stiffness, and guiding loop design. Tests were run varying the shoulder belt routing above or under the guiding loop, in addition to with or without attachment of the booster cushion to the vehicle ISOFIX anchorages. Eighteen simulations with the finite element PIPER 6-year-old human body model (HBM) were run investigating all combinations of parameters, in addition to 3 sled tests with a Q10 anthropomorphic test dummy (ATD)., Results: Across 2 different child sizes, using an HBM and an ATD, respectively, consistent sensitivity to the booster design differences were seen. Boosters providing similar initial static belt fit can result in different occupant responses during a crash, due to the design of the boosters and their dynamic performance. Compression of the booster cushion resulted in a delayed pelvis restraint, influencing the upper body kinematics. The guiding loop design as well as the belt routing above or under the guide also influenced the upper body kinematics and shoulder belt interaction., Conclusions: Early pelvis coupling to initiate torso pitch, and thereby an upper torso motion controlled by the shoulder belt, is the preferred occupant protection for booster-seated children. A stable mid-shoulder belt position centered over the chest initially is a prerequisite. Additionally, it was seen that the design of the guiding loops helps provide favorable interaction with the torso during the crash. The option to allow the shoulder belt to be placed above and under the guiding loops will accommodate a larger span of child sizes and adapt to more vehicle seat belt geometries. This study provides evidence that the design of the booster cushion plays an important role in creating an early pelvis coupling, as well as supporting favorable torso-shoulder belt interaction.

Background: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga's effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60-80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied., Discussion: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences., Trial Registration: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051., Competing Interests: The authors declare no conflict of interest.

Introduction: Due to ageing populations worldwide, the burden of disability is increasing. It is therefore important to develop interventions that improve healthy ageing, reduce disability onset and enhance life quality. Physical activity can promote healthy ageing and help maintain independence, yet many older adults are inactive. Yoga is a form of physical activity that aims to improve health and may be particularly suitable for older adults. Research indicates positive effects of yoga on several health-related outcomes; however, empirical studies examining the benefits of yoga on well-being among the elderly remain scarce. This study protocol reports the methodology for a 12-week yoga programme aimed to improve health and well-being among physically inactive older adults., Methods and Analysis: Three group parallel, single-blind randomised controlled trial. Two comparison groups are included: aerobic exercise and a non-active wait-list control. In total, 180 participants aged 65-85 years will be recruited. Assessments will be performed at baseline and postintervention (12-week follow-up). The primary outcome is subjective well-being. Secondary outcomes include physical activity/sedentary behaviour, mobility/fall risk, cognition, depression, anxiety, mood, stress, pain, sleep quality, social support and cardiometabolic risk factors. Data will be analysed using intention-to-treat analyses, with mixed linear modelling., Ethics and Dissemination: This study is approved by the Ethical Review Board in Stockholm (2017/1862-31/2). All participants must voluntarily agree to participate and are free to withdraw from the study at any point. Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. A summary of key results will be publicly available through newspaper articles., Trial Registration Number: DRKS00015093, U1111-1217-4248., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The aim of this study was to investigate the whole spine alignment in automotive seated postures for both genders and the effects of the spinal alignment patterns on cervical vertebral motion in rear impact using a human finite element (FE) model., Methods: Image data for 8 female and 7 male subjects in a seated posture acquired by an upright open magnetic resonance imaging (MRI) system were utilized. Spinal alignment was determined from the centers of the vertebrae and average spinal alignment patterns for both genders were estimated by multidimensional scaling (MDS). An occupant FE model of female average size (162 cm, 62 kg; the AF 50 size model) was developed by scaling THUMS AF 05. The average spinal alignment pattern for females was implemented in the model, and model validation was made with respect to female volunteer sled test data from rear end impacts. Thereafter, the average spinal alignment pattern for males and representative spinal alignments for all subjects were implemented in the validated female model, and additional FE simulations of the sled test were conducted to investigate effects of spinal alignment patterns on cervical vertebral motion., Results: The estimated average spinal alignment pattern was slight kyphotic, or almost straight cervical and less-kyphotic thoracic spine for the females and lordotic cervical and more pronounced kyphotic thoracic spine for the males. The AF 50 size model with the female average spinal alignment exhibited spine straightening from upper thoracic vertebra level and showed larger intervertebral angular displacements in the cervical spine than the one with the male average spinal alignment., Conclusions: The cervical spine alignment is continuous with the thoracic spine, and a trend of the relationship between cervical spine and thoracic spinal alignment was shown in this study. Simulation results suggested that variations in thoracic spinal alignment had a potential impact on cervical spine motion as well as cervical spinal alignment in rear end impact condition.

Several mathematical cervical models of the 50th percentile male have been developed and used for impact biomechanics research. However, for the 50th percentile female no similar modelling efforts have been made, despite females being subject to a higher risk of soft tissue neck injuries. This is a limitation for the development of automotive protective systems addressing Whiplash Associated Disorders (WADs), most commonly caused in rear impacts, as the risk for females sustaining WAD symptoms is double that of males. In this study, a finite element head and neck model of a 50th percentile female was validated in rear impacts. A previously validated ligamentous cervical spine model was complemented with a rigid body head, soft tissues and muscles. In both physiological flexion-extension motions and simulated rear impacts, the kinematic response at segment level was comparable to that of human subjects. Evaluation of ligament stress levels in simulations with varied initial cervical curvature revealed that if an individual assumes a more lordotic posture than the neutral, a higher risk of WAD might occur in rear impact. The female head and neck model, together with a kinematical whole body model which is under development, addresses a need for tools for assessment of automotive protection systems for the group which is at the highest risk to sustain WAD., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Mathematical cervical spine models allow for studying of impact loading that can cause whiplash associated disorders (WAD). However, existing models only cover the male anthropometry, despite the female population being at a higher risk of sustaining WAD in automotive rear-end impacts. The aim of this study is to develop and validate a ligamentous cervical spine intended for biomechanical research on the effect of automotive impacts. A female model has the potential to aid the design of better protection systems as well as improve understanding of injury mechanisms causing WAD. A finite element (FE) mesh was created from surface data of the cervical vertebrae of a 26-year old female (stature 167 cm, weight 59 kg). Soft tissues were generated from the skeletal geometry and anatomical literature descriptions. Ligaments were modeled with nonlinear elastic orthotropic membrane elements, intervertebral disks as composites of nonlinear elastic bulk elements, and orthotropic anulus fibrosus fiber layers, while cortical and trabecular bones were modeled as isotropic plastic-elastic. The model has geometrical features representative of the female cervical spine-the largest average difference compared with published anthropometric female data was the vertebral body depth being 3.4% shorter for the model. The majority the cervical segments compare well with respect to biomechanical data at physiological loads, with the best match for flexion-extension loads and less biofidelity for axial rotation. An average female FE ligamentous cervical spine model was developed and validated with respect to physiological loading. In flexion-extension simulations with the developed female model and an existing average male cervical spine model, a greater range of motion (ROM) was found in the female model.

Human body models (HBMs) for vehicle occupant simulations have recently been extended with active muscles and postural control strategies. Feedback control has been used to model occupant responses to autonomous braking interventions. However, driver postural responses during driver initiated braking differ greatly from autonomous braking. In the present study, an anticipatory postural response was hypothesized, modelled in a whole-body HBM with feedback controlled muscles, and validated using existing volunteer data. The anticipatory response was modelled as a time dependent change in the reference value for the feedback controllers, which generates correcting moments to counteract the braking deceleration. The results showed that, in 11 m/s(2) driver braking simulations, including the anticipatory postural response reduced the peak forward displacement of the head by 100mm, of the shoulder by 30 mm, while the peak head flexion rotation was reduced by 18°. The HBM kinematic response was within a one standard deviation corridor of corresponding test data from volunteers performing maximum braking. It was concluded that the hypothesized anticipatory responses can be modelled by changing the reference positions of the individual joint feedback controllers that regulate muscle activation levels. The addition of anticipatory postural control muscle activations appears to explain the difference in occupant kinematics between driver and autonomous braking. This method of modelling postural reactions can be applied to the simulation of other driver voluntary actions, such as emergency avoidance by steering., (Copyright © 2014. Published by Elsevier B.V.)

The extent to which socioeconomic (dis)advantage is transmitted between generations is receiving increasing attention from academics and policymakers. However, few studies have investigated whether there is a spatial dimension to this intergenerational transmission of (dis)advantage. Drawing on the concept of neighbourhood biographies, this study contends that there are links between the places individuals live with their parents and their subsequent neighbourhood experiences as independent adults. Using individual-level register data tracking the whole Stockholm population from 1990 to 2008, and bespoke neighbourhoods, this study is the first to use sequencing techniques to construct individual neighbourhood histories. Through visualisation methods and ordered logit models, we demonstrate that the socioeconomic composition of the neighbourhood children lived in before they left the parental home is strongly related to the status of the neighbourhood they live in 5, 12 and 18 years later. Children living with their parents in high poverty concentration neighbourhoods are very likely to end up in similar neighbourhoods much later in life. The parental neighbourhood is also important in predicting the cumulative exposure to poverty concentration neighbourhoods over a long period of early adulthood. Ethnic minorities were found to have the longest cumulative exposure to poverty concentration neighbourhoods. These findings imply that for some groups, disadvantage is both inherited and highly persistent.

Mathematical human body models (HBMs) are important research tools that are used to study the human response in car crash situations. Development of automotive safety systems requires the implementation of active muscle response in HBM, as novel safety systems also interact with vehicle occupants in the pre-crash phase. In this study, active muscle response was implemented using feedback control of a nonlinear muscle model in the right upper extremity of a finite element (FE) HBM. Hill-type line muscle elements were added, and the active and passive properties were assessed. Volunteer tests with low impact loading resulting in elbow flexion motions were performed. Simulations of posture maintenance in a gravity field and the volunteer tests were successfully conducted. It was concluded that feedback control of a nonlinear musculoskeletal model can be used to obtain posture maintenance and human-like reflexive responses in an FE HBM.

Objective: The aim of this study is to model occupant kinematics in an autonomous braking event by using a finite element (FE) human body model (HBM) with active muscles as a step toward HBMs that can be used for injury prediction in integrated precrash and crash simulations., Methods: Trunk and neck musculature was added to an existing FE HBM. Active muscle responses were achieved using a simplified implementation of 3 feedback controllers for head angle, neck angle, and angle of the lumbar spine. The HBM was compared with volunteer responses in sled tests with 10 ms(-2) deceleration over 0.2 s and in 1.4-s autonomous braking interventions with a peak deceleration of 6.7 ms(-2)., Results: The HBM captures the characteristics of the kinematics of volunteers in sled tests. Peak forward displacements have the same timing as for the volunteers, and lumbar muscle activation timing matches data from one of the volunteers. The responses of volunteers in autonomous braking interventions are mainly small head rotations and translational motions. This is captured by the HBM controller objective, which is to maintain the initial angular positions. The HBM response with active muscles is within ±1 standard deviation of the average volunteer response with respect to head displacements and angular rotation., Conclusions: With the implementation of feedback control of active musculature in an FE HBM it is possible to model the occupant response to autonomous braking interventions. The lumbar controller is important for the simulations of lap belt-restrained occupants; it is less important for the kinematics of occupants with a modern 3-point seat belt. Increasing head and neck controller gains provides a better correlation for head rotation, whereas it reduces the vertical head displacement and introduces oscillations.