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1.
There is little objective evidence about the extent older drivers’ are involved in speeding or factors that may influence this behaviour. Particular concern exists for the increasing number of older drivers with poor or declining cognitive and visual function. This study investigates whether a reduction in speeding forms part of the self-restrictive driving behaviour evident when older drivers experience poor cognitive and visual function. Driving data over 12 months were collected from 182 volunteers aged 75–94 years. Driving speed was estimated using Global Positioning System location, and speed limit data was based on a service-provider database. Speed events were defined as driving 1 km/h or more, with 3% tolerance, above a single speed limit, averaged over 30 s. Almost all participants (99%) were involved in speed events. While, 16–31% of participants experienced a meaningful decline in cognitive or visual function during the 12-months, these declines were not predictive of a change in speed events. Our results indicate speeding behaviour in this age group was highly prevalent, but less so for the oldest drivers whereby the rate of speed events was 7% lower per year older (IRR = 0.93, 95%CI = 0.89–0.96). Older drivers with worse function were less involved in speed events (unadjusted for distance driven) during 12 months of observation. Weekly distance driven decreased over the year by approximately 0.45 km with every week of monitoring for these older drivers. When distance driven was taken into account, decreased function was not predictive of involvement in speed events, indicating the reduction in speed events may be achieved by older drivers with lower function reducing distance driven. These results are important for developing policy to address speeding behaviour of the growing population of older drivers to reduce the incidence of crashes and resulting casualties.  相似文献   

2.
Our purpose was to determine visual and cognitive predictors for older drivers’ failure to stop at stop signs. 1425 drivers aged between ages 67 and 87 residing in Salisbury Maryland were enrolled in a longitudinal study of driving. At baseline, the participants were administered a battery of vision and cognition tests, and demographic and health questionnaires. Five days of driving data were collected with a Driving Monitoring System (DMS), which obtained data on stop signs encountered and failure to stop at stop signs. Driving data were also collected 1 year later (round two). The outcome, number of times a participant failed to stop at a stop sign at round two, was modeled using vision and cognitive variables as predictors. A negative binomial regression model was used to model the failure rate. Of the 1241 who returned for round two, 1167 drivers had adequate driving data for analyses and 52 did not encounter a stop sign. In the remaining 1115, 15.8% failed at least once to stop at stop signs, and 7.1% failed to stop more than once. Rural drivers had 1.7 times the likelihood of not stopping compared to urban drivers. Amongst the urban participants, the number of points missing in the bilateral visual field was significantly associated with a lower failure rate. In this cohort, older drivers residing in rural areas were less likely to stop at stop-sign intersections than those in urban areas. It is possible that rural drivers frequent areas with less traffic and better visibility, and may be more likely to take the calculated risk of not stopping. In this cohort failure to stop at stop signs was not explained by poor vision or cognition. Conversely in urban areas, those who have visual field loss appear to be more cautious at stop signs.  相似文献   

3.
Nighttime driving and fatal crash involvement of teenagers   总被引:4,自引:0,他引:4  
Data from the 1977 National Personal Transportation Survey and from the Fatal Accident Reporting System were used to compute mileage-based fatal crash involvement rates of drivers, by age, sex, and time of day. Teenagers drive less than older drivers but do more of their driving at night. They have much higher numbers of drivers in fatal crashes based on miles driven than do older drivers; their nighttime rates are particularly high. Sixteen year olds, especially males, have by far the highest fatal crash rates per mile, both nighttime and daytime. More widespread adoption of driving curfew laws would very likely produce substantial reductions in fatalities involving 16 yr old drivers.  相似文献   

4.
OBJECTIVES: To evaluate the association between chronic medical conditions, functional, cognitive, and visual impairments and driving difficulty and habits among older drivers. DESIGN: Cross-sectional study. SETTING: Mobile County, Alabama. PARTICIPANTS: A total of 901 residents of Mobile County, Alabama aged 65 or older who possessed a driver's license in 1996. MEASUREMENTS: Information on demographic characteristics, functional limitations, chronic medical conditions, driving habits, and visual and cognitive function were collected via telephone. The three dependent variables in this study were difficulty with driving, defined as any reported difficulty in > or = 3 driving situations (e.g. at night), low annual estimated mileage, defined as driving less than 3000 miles in 1996, and low number of days ( < or = 3) driven per week. RESULTS: A history of falls, kidney disease or stroke was associated with difficulty driving. Older drivers with a history of kidney disease were more likely to report a low annual mileage than subjects without kidney disease. Low annual mileage was also associated with cognitive impairment. In general, older drivers with a functional impairment were more likely to drive less than 4 days per week. Older drivers with a history of cataracts or high blood pressure were more likely to report a low number of days driven per week, while subjects with visual impairment were at increased risk of experiencing difficulty driving as well as low number of days driven per week. CONCLUSIONS: The results underscore the need to further understand the factors negatively affecting driving independence and mobility in older drivers, as well as the importance of improved communication between older adults and health care professionals regarding driving.  相似文献   

5.
Older drivers have a high crash rate per vehicle mile of travel. Coupled with the growth of the number of older drivers on the road, this has generated interest in the identification of factors which place older drivers at increased risk. However, much of the existing research on medical and functional risk factors for crash involvement has generally been inconsistent. Methodological differences between studies have been hypothesized as being partly responsible for such inconsistencies. The source of information used to identify crash-involved drivers has been identified as one such difference. This paper reports on the agreement between self-report and state record for identifying crash involved-older drivers. We also sought to determine whether the prevalence of visual and cognitive impairment differs across crash-involved drivers identified by either or both sources. Finally, we assessed whether risk factors for crash involvement differed when crash-involved drivers were identified by either self-report or state records. Results indicated that there was a moderate level of agreement between self-reported and state-recorded crash involvement (kappa=0.45). However, we did find significant differences between crash-involved drivers identified via state records and/or self-report with respect to demographic (age, race), driving (annual mileage, days per week driven), and vision impairment (acuity, contrast sensitivity, peripheral visual field sensitivity, useful field of view). We also found that the possibility for biased measures of association is real. Useful field of view impairment was associated with both self-reported and state-recorded crash involvement; however, the magnitude of the associations was disparate. Moreover, glaucoma was identified as a significant risk factor when considering state-recorded crashes but not self-reported crashes. While validation of these findings is required, research designed to identify risk factors for crash involvement among older drivers should carefully consider the issue of case definition, particularly if self-report is used to identify crash-involved older drivers.  相似文献   

6.
The current study investigated the relationship between drivers’ abilities in various cognitive and psychomotor domains and their driving performance. The goal was to identify test measures that could be used to develop a fitness-for-driving test battery, particularly for older drivers. Licensed drivers over 40 years of age (M = 65.56 years, SD = 13.02) were recruited from university leisure courses (n = 18) and drivers under 40 (M = 22.20 years, SD = 3.79) were recruited from undergraduate and graduate courses (n = 44). Participants were given a battery of standard neuropsychological tests used to assess ability in the domains of cognitive processing speed, psychomotor functioning, visuospatial performance, sustained attention, and executive functioning. Participants’ driving ability was assessed in a simulator with data collected in three categories of driving performance: (a) driver control maintenance behaviors, (b) accidents and violations, and (c) attention and reaction time. Younger participants outperformed older participants in 4 out of the 5 domains of neuropsychological testing (all but sustained attention). Age differences were found in simulator driving accidents and violations and driving performance was significantly correlated with neuropsychological test performance. The results are discussed in terms of the potential to use these tests to assess older drivers seeking license renewal or for selecting professional drivers for the transportation industry.  相似文献   

7.
In the context of driving, the reported experiment examines compensatory processes for age-related declines in cognitive ability. Younger (26–40 years) and older (60+ years) participants (n = 22 each group) performed a car following task in a driving simulator. Several performance measures were recorded, including assessments of anticipation of unfolding traffic events. Participants also completed a range of measures of cognitive ability – including both fluid and crystallised abilities. Three examples of age-related compensation are reported: (i) older drivers adopted longer headways than younger drivers. Data were consistent with this being compensation for an age-related deficit in complex reaction time; (ii) older drivers with relatively higher cognitive ability anticipated traffic events more frequently, whereas the reverse pattern was found for younger drivers; and, (iii) older drivers with greater crystallised ability were less reliant on spatial ability to maintain lane position. Consistent with theories of ‘cognitive reserve’, interactions between crystallised ability and age for self-report workload suggested that compensation for age-related cognitive ability deficits required investment of additional effort. Results are considered in the context of the prospects of further assessment of older drivers.  相似文献   

8.
Accidents, mileage, and the exaggeration of risk   总被引:4,自引:2,他引:2  
The usual interpretation of accidents per mile as a measure of risk exaggerates the apparent risk of low-mileage groups--for example, teenagers and the elderly. The assumption of a linear proportional relationship between mileage and accidents is shown not to fit obtained data. Neither would it be expected to fit hypothetical data derived from a "standard driver" or a group of equally competent drivers driving different numbers of miles. People driving low mileages tend to accumulate much of their mileage on congested city streets with two-way traffic and no restriction of access, while high-mileage drivers typically accumulate most of those miles on freeways or other divided multilane highways with limited access. Because the driving task is simpler, the accident rate per mile is much lower on freeways, and beyond a certain point, a person driving half as many miles as another would be expected to have considerably more than half as many accidents. This and other considerations lead to the suggestion that an induced exposure approach would be a more valid method of correcting accident rates for mileage.  相似文献   

9.
Eighty-five volunteer drivers, 65–85 years old, without cognitive impairments impacting on their driving were examined, in order to investigate driving errors characteristic for older drivers. In addition, any relationships between cognitive off-road and on-road tests results, the latter being the gold standard, were identified. Performance measurements included Trail Making Test (TMT), Nordic Stroke Driver Screening Assessment (NorSDSA), Useful Field of View (UFOV), self-rating driving performance and the two on-road protocols P-Drive and ROA. Some of the older drivers displayed questionable driving behaviour. In total, 21% of the participants failed the on-road assessment. Some of the specific errors were more serious than others. The most common driving errors embraced speed; exceeding the speed limit or not controlling the speed. Correlations with the P-Drive protocol were established for NorSDSA total score (weak), UFOV subtest 2 (weak), and UFOV subtest 3 (moderate). Correlations with the ROA protocol were established for UFOV subtest 2 (weak) and UFOV subtest 3 (weak). P-Drive and self ratings correlated weakly, whereas no correlation between self ratings and the ROA protocol was found. The results suggest that specific problems or errors seen in an older person's driving can actually be “normal driving behaviours”.  相似文献   

10.
The purpose of this study was to investigate the effects of participation in an exercise program on several abilities associated with driving performance in older adults. Thirty-two subjects were randomly assigned to either an exercise group (60-81 years, n = 16) or a control group (60-82 years, n = 16). The exercise program was planned to stress perceptive, cognitive, and physical abilities. It lasted 12 weeks with a periodicity of three sessions of 60 min per week. Assessments were conducted before and after the intervention on behavioral speed (in single- and dual-task conditions), visual attention, psychomotor performance, speed perception (time-to-contact), and executive functioning. Significant positive effects were found at 12-week follow-up resulting from participation in the exercise program. Behavioral speed improvements were found in reaction time, movement time, and response time (both in single- and dual-task conditions); visual attention improvements took place in speed processing and divided attention; psychomotor performance improvements occurred in lower limb mobility. These results showed that exercise is capable of enhancing several abilities relevant for driving performance and safety in older adults and, therefore, should be promoted.  相似文献   

11.
AimsOur purpose was to explore the effect of navigation instruction on older drivers’ driving performance at left turn intersections. Left turns at intersections are particularly complex because they require many perceptive and cognitive abilities under considerable time pressure.MethodsFifty-four participants were recruited: 18 drivers with early-stage Alzheimer’s disease (AD), 18 neurologically healthy older drivers and 18 younger individuals. Various cognitive processes were measured, and 9 left turn maneuvers with or without navigation instruction were evaluated during an in-traffic road test. The psychomotor, planning and decision-making components involved in left turn were also analyzed closely.ResultsOnly older drivers (both healthy drivers and those with AD) were negatively affected by navigation instruction during the maneuver. The planning and decision-making components were more likely to be affected by the navigation instruction.ConclusionThis finding highlights the importance of carefully considering the use of navigation instructions when developing navigation systems. Adapting this instruction is necessary to simplify our understanding of the real-world driving environment and to avoid increasing the cognitive load of older drivers.  相似文献   

12.
With age, a decline in attention capacity may occur and this may impact driving performance especially while distracted. Although the effect of distraction on driving performance of older drivers has been investigated, the moderating effect of attention capacity on driving performance during distraction has not been investigated yet. Therefore, the aim was to investigate whether attention capacity has a moderating effect on older drivers’ driving performance during visual distraction (experiment 1) and cognitive distraction (experiment 2). In a fixed-based driving simulator, older drivers completed a driving task without and with visual distraction (experiment 1, N = 17, mean age 78 years) or cognitive distraction (experiment 2, N = 35, mean age 76 years). Several specific driving measures of varying complexity (i.e., speed, lane keeping, following distance, braking behavior, and crashes) were investigated. In addition to these objective driving measures, subjective measures of workload and driving performance were also included. In experiment 1, crash occurrence increased with visual distraction and was negatively related to attention capacity. In experiment 2, complete stops at stop signs decreased, initiation of braking at pedestrian crossings was later, and crash occurrence increased with cognitive distraction. Interestingly, for a measure of lane keeping (i.e., standard deviation of lateral lane position (SDLP)), effects of both types of distraction were moderated by attention capacity. Despite the decrease of driving performance with distraction, participants estimated their driving performance during distraction as good. These results imply that attention capacity is important for driving. Driver assessment and training programs might therefore focus on attention capacity. Nonetheless, it is crucial to eliminate driver distraction as much as possible given the deterioration of performance on several driving measures in those with low and high attention capacity.  相似文献   

13.
BackgroundUsing in-vehicle audio technologies such as audio systems and voice messages is regarded as a common secondary task. Such tasks, known as the sources of non-visual distraction, affect the driving performance. Given the elderly drivers’ cognitive limitations, driving can be even more challenging to drivers. The current study examined how listening to economic news, as a cognitively demanding secondary task, affects elderly subjects’ driving performance and whether their comprehension accuracy is associated with these effects.MethodsParticipants of the study (N = 22) drove in a real condition with and without listening to economic news. Measurements included driving performance (speed control, forward crash risk, and lateral lane position) and task performance (comprehension accuracy).ResultsThe mean driving speed, duration of driving in unsafe zones and numbers of overtaking decreased significantly when drivers were engaged in the dual-task condition. Moreover, the cognitive secondary task led to a higher speed variability. Our results demonstrate that there was not a significant relationship between the lane changes and the activity of listening to economic news. However, a meaningful difference was observed between general comprehension and deep comprehension on the one hand and driving performance on the other. Another aspect of our study concerning the drivers’ ages and their comprehension revealed a significant relationship between age above 75 and comprehension level. Drivers aging 75 and older showed a lower level of deep comprehension.ConclusionOur study demonstrates that elderly drivers compensated driving performance with safety margin adoption while they were cognitively engaged. In this condition, however, maintaining speed proved more demanding for drivers aging 75 and older.  相似文献   

14.
A study sponsored by the National Highway Traffic Safety Administration performed functional assessments on approximately 700 drivers age 70 and older who presented for license renewal in urban, suburban, and rural offices of the Maryland Motor Vehicle Administration. This volunteer sample received a small compensation for study participation, with an assurance that their license status would not be affected by the results. A comparison with all older drivers who visited the same sites on the same days indicated that the study sample was representative of Maryland older drivers with respect to age and prior driving safety indices. Relationships between drivers’ scores on a computer touchscreen version of the Maze Test and prospective crash and serious moving violation experience were analyzed. Results identified specific mazes as highly significant predictors of future safety risk for older drivers, with a particular focus on non-intersection crashes. Study findings indicate that performance on Maze Tests was predictive of prospective crashes and may be useful, as a complement to other, established cognitive screening tools, in identifying at-risk older drivers.  相似文献   

15.
Motor vehicle crashes (MVCs) are the leading cause of death among teenagers in the US. The present study examines how crash rates and crash characteristics differed among drivers aged 16-21 in the state of Maryland from 1996 to 1998. The results show that, based on police reports. the youngest drivers have the highest rate of MVCs per licensed driver and per annual miles driven. Furthermore, crash characteristics suggest that inexperience rather than risky driving may account for the differing rates. Drivers closer to the age of 16 had their crashes under the safest conditions: during the day in clear weather while drinking less.  相似文献   

16.

Objective

Previous research has shown that fatal crash involvement rates per licensed driver aged 70 and older declined significantly more per year in the United States than rates for middle-aged drivers aged 35–54 during 1997–2008, and per vehicle mile traveled from 1995–1996 to 2001–2002. Analyses of police-reported crash data during 1997–2005 indicated that the greater declines for older drivers were due to decreases in crash involvement and in the risk of dying in the crashes that occurred. The current study examined if trends in crash rates, crash involvements, and survivability persisted into more recent years.

Methods

Trends for drivers 70 and older were compared with trends for drivers aged 35–54 for U.S. national fatal passenger vehicle crash involvements per 100,000 licensed drivers during 1997–2012 and for U.S. national fatal passenger vehicle crash involvements per vehicle miles traveled in 1995–1996, 2001–2002, and 2008. Using police-reported crash data during 1997–2008 from 20 U.S. states, trends in involvement rates in non-fatal crashes of various severities per 100,000 licensed drivers and changes in the odds of death and the odds of death or serious injury in a crash were compared between older and middle-aged drivers.

Results

During 2007–2012, declines in national fatal crash involvement rates per licensed driver were similar for drivers 70 and older and middle-aged drivers (18 percent each). However, when considering the entire study period, fatal crash involvement rates continued to reflect a substantially larger decline for drivers 70 and older than for middle-aged drivers (42 vs. 30 percent per licensed driver during 1997–2012, 39 vs. 26 percent per vehicle mile traveled from 1995–2006 to 2008). When analyses of police-reported crash data were extended through 2008, non-fatal injury crash involvement rates per licensed driver declined more for older than for middle-aged drivers (39 vs. 30 percent), and unlike in prior research, average annual declines were significantly larger for drivers 80 and older. Property damage-only crash involvement rates similarly declined significantly more for older than for middle-aged drivers (15 vs. 3 percent). Drivers 70 and older in 1997 were 3.5 times more likely than middle-aged drivers to die in a crash, and this ratio declined to 3.2 by 2008.

Conclusions

Although declines in fatal crash involvement rates in recent years have not differed between older and middle-aged drivers, this did not undo earlier gains for older drivers. The recent slowing in the relative magnitude of the decline for older drivers may be related to the differential effect of the U.S. recession on fatal crash involvements of drivers in these age groups. The decreased likelihood of being involved in a crash of any severity and increased survivability when a crash occurred held when examining data through 2008, and for drivers 80 and older, significant declines in crash involvement relative to middle-aged drivers extended to non-fatal injury crashes.  相似文献   

17.
Using structural equation modeling techniques, this study examines causal models of driving avoidance and exposure among older adults. Prior studies have revealed that past incidence of falls, Useful Field of View (UFOV) test performance, and Trails Making test performance are predictive of subsequent motor vehicle crash involvement [Owsley, C., Ball, K., McGwin Jr., G., Sloane, M.E., Roenker, D.L., White, M.F., Overley, E.T., 1998. Visual processing impairment and risk of motor vehicle crash among older adults. J. Am. Med. Assoc. 279 (14), 1083-1088; Sims, R.V., McGwin, G., Pulley, L., Roseman, J.M., 2001. Mobility impairments in crash-involved older drivers. J. Aging Health 13 (3), 430-438; Stutts, J.C., 1998. Do older drivers with visual nd cognitive impairments drive less? J. Am. Geriatr. Soc. 46, 854-861]. Data analyses used these indices, along with age, health, measures of physical functioning, and additional measures of cognitive functioning, to examine driving exposure and avoidance behaviors. A field sample of 4,234 drivers, 55 years of age and older, were recruited from the Maryland Motor Vehicles Administration after renewing their driver's licenses. A performance-based assessment, which included the Gross Impairment Screening battery and task 2 of the UFOV test, was completed by participants. A sub-sample of participants (n=815) were interviewed by telephone about their health and mobility 3-6 months following the initial assessment at a renewal center. In addition to age and gender, latent variables for health status, physical functioning, cognitive functioning, driving exposure, and driving avoidance were created. Direct and indirect causal paths were specified. Age, gender, health status, and cognitive functioning had direct effects on both driving exposure and driving avoidance; physical functioning did not have a direct effect on driving exposure or avoidance. The implications of these findings are discussed as they relate to designing interventions to promote mobility.  相似文献   

18.

Objective

Older drivers are at increased risk of crash involvement per mile traveled. The purpose of this study was to examine older driver errors in serious crashes to determine which errors are most prevalent.

Methods

The National Highway Traffic Safety Administration’s National Motor Vehicle Crash Causation Survey collected in-depth, on-scene data for a nationally representative sample of 5470 U.S. police-reported passenger vehicle crashes during 2005–2007 for which emergency medical services were dispatched. There were 620 crashes involving 647 drivers aged 70 and older, representing 250,504 crash-involved older drivers. The proportion of various critical errors made by drivers aged 70 and older were compared with those made by drivers aged 35–54.

Results

Driver error was the critical reason for 97% of crashes involving older drivers. Among older drivers who made critical errors, the most common were inadequate surveillance (33%) and misjudgment of the length of a gap between vehicles or of another vehicle’s speed, illegal maneuvers, medical events, and daydreaming (6% each). Inadequate surveillance (33% vs. 22%) and gap or speed misjudgment errors (6% vs. 3%) were more prevalent among older drivers than middle-aged drivers. Seventy-one percent of older drivers’ inadequate surveillance errors were due to looking and not seeing another vehicle or failing to see a traffic control rather than failing to look, compared with 40% of inadequate surveillance errors among middle-aged drivers. About two-thirds (66%) of older drivers’ inadequate surveillance errors and 77% of their gap or speed misjudgment errors were made when turning left at intersections. When older drivers traveled off the edge of the road or traveled over the lane line, this was most commonly due to non-performance errors such as medical events (51% and 44%, respectively), whereas middle-aged drivers were involved in these crash types for other reasons. Gap or speed misjudgment errors and inadequate surveillance errors were significantly more prevalent among female older drivers than among female middle-aged drivers, but the prevalence of these errors did not differ significantly between older and middle-aged male drivers. These errors comprised 51% of errors among older female drivers but only 31% among older male drivers.

Conclusions

Efforts to reduce older driver crash involvements should focus on diminishing the likelihood of the most common driver errors. Countermeasures that simplify or remove the need to make left turns across traffic such as roundabouts, protected left turn signals, and diverging diamond intersection designs could decrease the frequency of inadequate surveillance and gap or speed misjudgment errors. In the future, vehicle-to-vehicle and vehicle-to-infrastructure communications may also help protect older drivers from these errors.  相似文献   

19.
A survey of drivers carried out in Ontario in 1988 has provided data on time spent driving as well as the distances driven for licensed drivers of both sexes in six age groups and three regions. Substantial differences were found in times, distances, and distance/time ratios among these groups. Men drove 50% greater distances, but spent only 30% more time driving than women; speed, averaged over each day's driving, was lower for older drivers than for younger drivers. Differences in speed reflect differences in the driving done in urban or rural areas, and differences in the opportunity for road crashes; such differences, whether based on units of time or distance, will also affect both the comparisons of accident rates and the perceptions of risk among different groups of drivers. A definition of exposure to risk of road crash is required that considers both time and distance appropriately.  相似文献   

20.
Driving is a complex task, which can be broken down into specific cognitive processes. In order to determine which components contribute to drowsy driving impairments, the current study examined simulated driving and neurocognitive performance after one night of sleep deprivation. Nineteen professional drivers (age 45.3 ± 9.1) underwent two experimental sessions in randomised order: one after normal sleep and one after 27 h total sleep deprivation. A simulated driving task (AusEd), the psychomotor vigilance test (PVT), and neurocognitive tasks selected from the Cognitive Drug Research computerised neurocognitive assessment battery (simple and choice RT, Stroop Task, Digit Symbol Substitution Task, and Digit Vigilance Task) were administered at 10:00 h in both sessions. Mixed-effects ANOVAs were performed to examine the effect of sleep deprivation versus normal sleep on performance measures. To determine if any neurocognitive tests predicted driving performance (lane position variability, speed variability, braking RT), neurocognitive measures that were significantly affected by sleep deprivation were then added as a covariate to the ANOVAs for driving performance. Simulated driving performance and neurocognitive measures of vigilance and reaction time were impaired after sleep deprivation (p < 0.05), whereas tasks examining processing speed and executive functioning were not significantly affected by sleep loss. PVT performance significantly predicted specific aspects of simulated driving performance. Thus, psychomotor vigilance impairment may be a key cognitive component of driving impairment when sleep deprived. The generalisability of this finding to real-world driving remains to be investigated.  相似文献   

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