久坐行为对12~17岁青少年眼健康的影响

doi:10.3969/j.issn.1006-9771.2022.08.001

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (8): 869-878.doi: 10.3969/j.issn.1006-9771.2022.08.001

• 专题儿童与青少年功能康复 • 上一篇下一篇

久坐行为对12~17岁青少年眼健康的影响

杨剑^1,²(),吴铭³

1.华东师范大学青少年健康评价与运动干预教育部重点实验室,上海市 200241
2.华东师范大学体育与健康学院,上海市 200241
3.郑州大学体育学院（校本部）,河南郑州市 450001

收稿日期:2022-04-27 出版日期:2022-08-25 发布日期:2022-08-30
通讯作者: 杨剑 E-mail:yangjianxz@sina.com
作者简介:杨剑(1970-),男,汉族,江苏徐州市人,博士,教授,世界卫生组织国际分类家族合作中心专家委员,主要研究方向：儿童青少年体育与健康,ICF,康复科学,锻炼心理学,康复心理学。
基金资助:
上海高校"立德树人"人文社科重点研究基地子项目(1100-41222-16057);青少年体育教育研究上海市社会科学创新研究基地子项目(11001-412321-17006);华东师范大学青少年运动促进健康研究院子项目

Influence of sedentary behavior on eye health in adolescents aged twelve to 17

YANG Jian^1,²(),WU Ming³

1. Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China
2. College of Physical Education and Health, East China Normal University, Shanghai 200241, China
3. School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan 450001, China

Received:2022-04-27 Published:2022-08-25 Online:2022-08-30
Contact: YANG Jian E-mail:yangjianxz@sina.com
Supported by:
Sub-project of Shanghai University "Strengthening Morality" Humanities and Social Sciences Key Research Base(1100-41222-16057);Sub-project of Adolescents Physical Education Research Shanghai Social Science Innovation Research Base(11001-412321-17006);Sub-project of East China Normal University Adolescents Sports and Health Promotion Research Institute

摘要/Abstract

摘要：

目的探讨不同类型久坐行为与青少年眼健康的关系。

方法采用主、客观久坐行为测量方法对12~17岁青少年(主观352名,客观331名)进行两个阶段(间隔14周)调查,探讨不同久坐行为对青少年视力不良发生率的影响。

结果青少年久坐时间普遍偏长,其中教育类久坐时间、视频类久坐时间占比较大,低久坐组/低教育类久坐组青少年视力不良检出率低于高久坐组/高教育类久坐组青少年(|t| > 3.422, P < 0.01)。客观测量显示,第一阶段日均久坐时间与视力水平呈负相关(r = -0.176, P < 0.001)。主观测量显示,第一阶段教育类久坐时间与视力水平呈负相关(r = -0.188, P < 0.001),第二阶段教育类久坐时间与视力水平呈负相关(r = -0.141, P < 0.001)。控制中高强度身体活动时间后,客观测量的日均久坐时间对青少年视力不良的预测作用不显著,主观测量的教育类久坐时间能够显著负向预测青少年视力水平(β = -0.124, P = 0.026),但二者不存在交叉滞后效应。阈值分析显示,约登指数的最大值为0.206,对应教育类久坐时间为3 445 min/周,敏感性为0.738,特异性为0.467。

结论高久坐组青少年视力不良检出率较高,教育类久坐对青少年视力水平具有显著负向预测作用。青少年每周教育类久坐时间长于3 445 min (约每天8.2 h)时,视力不良检出率较高。

关键词: 青少年, 久坐行为, 眼健康, 阈值, 视力不良

Abstract:

Objective To explore the relationship between adolescents' sedentary behavior and poor vision.

Methods Both subjective (352 adolescents) and objective (331 adolescents) methods were used to measure the sedentary behaviors of adolescents aged twelve to 17 years in two phases with an interval of 14 weeks, to investigate the influence of different sedentary behaviors on the incidence of poor vision acuity in adolescents.

Results The sedentary time of adolescents was generally long, among which educational sedentary time and screen sedentary time accounted for a higher proportion. The detection rate of poor visual acuity among adolescents was significantly lower in low sedentary group/low education sedentary group than in high sedentary group/high education sedentary group (|t| > 3.422, P < 0.01). The objective measurement showed that the average daily sedentary time was significantly negatively correlated with the eyesight level in the first phase (r= -0.176, P < 0.001). The subjective measurement showed that the educational sedentary time was significantly negatively correlated with the eyesight level both in the first phase (r= -0.188, P < 0.001) and the second phase (r= -0.141, P <0.001). After controlling for moderate to vigorous physical activity, the objectively measured average daily sedentary time had no significant predictive effect on the poor vision of adolescents, and the subjectively measured educational sedentary time could significantly negatively predict the eyesight level of adolescents (β= -0.124, P= 0.026), however, there was no cross-lag effect between the two variables. The critical value analysis showed that the maximum value of Youden index was 0.206, corresponding to the educational sedentary time of 3 445 minutes a week, the sensitivity was 0.738, and the specificity was 0.467.

Conclusion Adolescents with high sedentary group have higher detection rate of poor vision. Educational sedentary has a significantly negative predictive effect on the eyesight level of adolescents. The detection rate of poor vision would increase if the educational sedentary time of adolescents is longer than 3 445 minutes a week.

Key words: adolescents, sedentary behavior, eye health, critical value, poor vision

中图分类号:

R778

杨剑,吴铭. 久坐行为对12~17岁青少年眼健康的影响[J]. 《中国康复理论与实践》, 2022, 28(8): 869-878.

YANG Jian,WU Ming. Influence of sedentary behavior on eye health in adolescents aged twelve to 17[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 869-878.

图/表 12

表1

表2

表3

表4

图1

图2

表5

表6

图3

表7

图4

表8

参考文献 34

[1]	World Health Organization. Health for the World's Adolescents: a Second Chance in the Second Decade[R]. Geneva: World Health Organization, 2014.
[2]	周晟, 张萌, 邱卓英, 等. 将身体活动融入基于学校的眼健康服务:政策与发展研究[J]. 中国康复理论与实践, 2021, 27(12): 1374-1383.
	ZHOU S, ZHANG M, QIU Z Y, et al. Integrating physical activity into school-based eye health services: a policy and development study[J]. Chin J Rehabil Theory Pract, 2021, 27(12): 1374-1383.
[3]	张萌, 邱卓英, 蔡赓, 等. 世界卫生组织和联合国教科文组织健康促进学校的政策架构与核心内容[J]. 中国康复理论与实践, 2022, 28(1): 111-118.
	ZHANG M, QIU Z Y, CAI G, et al. Framework and core contents of World Health Organization and United Nations Educational, Scientific and Cultural Organization health-promoting schools[J]. Chin J Rehabil Theory Pract, 2022, 28(1): 111-118.
[4]	World Health Organization. Update from the Seventy-fourth World Health Assembly-27 May 2021 [EB/OL]. (2021-05-27)[2022-04-01]. https://www.who.int/news/item/27-05-2021-update-from-the-seventy-fourth-world-health-assembly-27-may-2021.
[5]	中国学生体质与健康研究组. 2014年中国学生体质与健康调研报告[M]. 北京: 高等教育出版社, 2016.
	Chinese Student Physical Fitness andHealth Research Group. Report on the Physical Fitness and Health Surveillance of Chinese School Students in 2014[M]. Beijing: Higher Education Press, 2016.
[6]	中华人民共和国教育部. 2018年国家义务教育质量监测数学、体育与健康监测结果报告发布[EB/OL]. (2019-11-20)[2022-7-26]. http://www.moe.gov.cn/jyb_xwfb/gzdt_gzdt/s5987/201911/t20191120_409046.html.
[7]	马军. 中国儿童青少年主要健康问题及应对策略[J]. 中国学校卫生, 2015, 36(6): 801-804.
	MA J. Major health problems of Chinese children and adolescents and coping strategies[J]. Chin J Sch Health, 2015, 36(6): 801-804.
[8]	中华人民共和国中央人民政府. 国务院印发«中国妇女发展纲要(2021-2030年)»和«中国儿童发展纲要(2021-2030年)»[EB/OL]. (2021-09-27)[2022-03-25]. http://www.gov.cn/xinwen/2021-09/27/content_5639545.htm.
[9]	刘映海. "用眼负荷管理"是近视防控的关键[J]. 人民教育, 2021(9): 35-39.
	LIU Y H. "Eye load management" is the key to myopia prevention and control[J]. People Educ, 2021(9): 35-39.
[10]	HU Y, XU Q, SHI J, et al. Poor uncorrected visual acuity and association with sleep duration and screen time: a dose-response relationship study[J]. Dose Response, 2021, 19(4): 15593258211042161.
[11]	WONG C, TSAI A, JONAS J, et al. Digital screen time during the COVID-19 pandemic: risk for a further myopia boom?[J]. Am J Ophthalmol, 2021, 223: 333-337. doi: 10.1016/j.ajo.2020.07.034
[12]	张雪平, 廖炽媚, 张威, 等. 静坐和运动时间与视网膜血管管径的相关性[J]. 中华眼视光学与视觉科学杂志, 2017, 19(11): 650-655.
	ZHANG X P, LIAO C M, ZHANG W, et al. Effects of sedentary behavior and physical activity on the caliber of retinal microvessels in chinese adults[J]. Chin J Ophthalmol Vis Sci, 2017, 19(11): 650-655.
[13]	HANSEN M, LAIGAARD P, OLSEN E, et al. Low physical activity and higher use of screen devices are associated with myopia at the age of 16‐17 years in the CCC2000 Eye Study[J]. Acta Ophthalmol, 2020, 98(3): 315-321. doi: 10.1111/aos.14242
[14]	LUNDBERG K, SUHR THYKJÆR A, SØGAARD HANSEN R, et al. Physical activity and myopia in Danish children: the CHAMPS Eye Study[J]. Acta Ophthalmol, 2018, 96(2): 134-141.
[15]	KARTHIKEYAN S, ASHWINI D, PRIYANKA M, et al. Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: an overview of systematic reviews and meta-analyses[J]. Indian J Ophthalmol, 2022, 70(3): 728-739. doi: 10.4103/ijo.IJO_1564_21
[16]	姜静远, 李安巧, 邱服冰, 等. 基于ICF-CY儿童青少年身体活动指南的内容分析与比较[J]. 中国康复理论与实践, 2020, 26(9): 993-1004.
	JIANG J Y, LI A Q, QIU F B, et al. Content analysis and comparison of physical activity guidelines for children based on ICF-CY[J]. Chin J Rehabil Theory Pract, 2020, 26(9): 993-1004.
[17]	吴铭, 杨剑, 王国祥, 等. 基于ICF-CY影响青少年久坐行为相关环境因素Scoping综述[J]. 中国康复理论与实践, 2020, 26(6): 621-630.
	WU M, YANG J, WANG G X, et al. Effects of relavant environmental factors on adolescent sedentary behavior using ICF-CY: a scoping review[J]. Chin J Rehabil Theory Pract, 2020, 26(6): 621-630.
[18]	EVENSON K R, CATELLIER D J, GILL K, et al. Calibration of two objective measures of physical activity for children[J]. J Sports Sci, 2008, 26(14): 1557-1565. doi: 10.1080/02640410802334196
[19]	HARDY L L, BOOTH M L, OKELY A D. The reliability of the Adolescent Sedentary Activity Questionnaire (ASAQ)[J]. Prev Med, 2007, 45(1): 71-74. doi: 10.1016/j.ypmed.2007.03.014
[20]	郭强. 中国儿童青少年身体活动水平及其影响因素的研究[D]. 上海: 华东师范大学, 2016.
	GUO Q. The influencing factors on physical activity level among children and adolescents in China[D]. Shanghai: East China Normal University, 2016.
[21]	CRAIG C L, MARSHALL A L, SJOSTROM M, et al. International physical activity questionnaire: 12-country reliability and validity[J]. Med Sci Sports Exerc, 2003, 35: 1381-1395. doi: 10.1249/01.MSS.0000078924.61453.FB
[22]	疾病预防控制局. 国家卫生健康委办公厅关于印发儿童青少年近视防控适宜技术指南的通知[EB/OL]. (2019-10-14)[2022-03-18]. http://www.nhc.gov.cn/jkj/s5898bm/201910/c475e0bd2de444379402f157523f03fe.shtml.
[23]	ZWEIG M H, CAMPBELL G C, Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine[J]. Clin Chem, 1993, 39(4): 561-577. doi: 10.1093/clinchem/39.4.561
[24]	LI C, CHEN J, QIN G. Partial Youden index and its inferences[J]. J Biopharm Stat, 2019, 29(2): 385-399. doi: 10.1080/10543406.2018.1535502
[25]	GENOLINI C, FALISSARD B. KmL: k-means for longitudinal data[J]. Comput Stat, 2010, 25(2): 317-328. doi: 10.1007/s00180-009-0178-4
[26]	孙凯丽. 中小学生近距离工作现况与视力不良关系及预防对策的研究[D]. 天津: 天津医科大学, 2017.
	SUN K L. A study on the relationship between near work and poor eyesight in primary and middle school students and the preventive countermeasures[D]. Tianjin: Tianjin Medical University, 2017.
[27]	罗春燕, 齐文娟, 何鲜桂, 等. 上海市中小学生近视相关因素分析[J]. 中国学校卫生, 2021, 42(2): 185-189.
	LUO C Y, QI W J, HE X G, et al. Analysis of myopia related factors among primary and secondary school students in Shanghai[J]. Chin J Sch Health, 2021, 42(2): 185-189.
[28]	WOJCIECHOWSKI R. Nature and nurture: the complex genetics of myopia and refractive error[J]. Clin Genetics, 2011, 79(4): 301-320. doi: 10.1111/j.1399-0004.2010.01592.x
[29]	高鑫, 万宇辉, 曹秀菁. 教育因素与儿童青少年近视关系的研究进展[J]. 中国学校卫生, 2020, 41(11): 1753-1756.
	GAO X, WAN Y H, CAO X J. Research progress on the relationship between educational factors and myopia in children and adolescents[J]. Chin J Sch Health, 2020, 41(11): 1753-1756.
[30]	董晓鹏, 刘盛鑫, 王奇凡, 等. 天津市小学生使用电子产品对视力不良的影响[J]. 中国学校卫生, 2018, 39(1): 16-18, 22.
	DONG X P, LIU S X, WANG Q F, et al. Effect of electronic products on poor eyesight among primary school students in Tianjin[J]. Chin J Sch Health, 2018, 39(1): 16-18, 22.
[31]	BIDDLE S J, GARCIA B E, WIESNER G. Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality[J]. Int J Behav Nutr Phys, 2017, 14(1): 43. doi: 10.1186/s12966-017-0497-8
[32]	刘静, 邱芬, 邱卓英, 等. 世界卫生组织身体活动政策和指南的架构与核心内容研究[J]. 中国康复理论与实践, 2021, 27(12): 1402-1411.
	LIU J, QIU F, QIU Z Y, et al. Framework and core content of World Health Organization policy and guidelines of physical activity[J]. Chin J Rehabil Theory Pract, 2021, 27(12): 1402-1411.
[33]	CHAPUT J, WILLUMSEN J, BULL F, et al. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5-17 years: summary of the evidence[J]. Int J Behav Nutr Phy, 2020, 17: 1-9. doi: 10.1186/s12966-019-0902-6
[34]	李培林, 陈光金, 王春光, 等. 2021年中国社会形势分析与预测[M]. 北京: 社会科学文献出版社, 2020.
	LI P L, CHEN G J, WANG C G, et al. Society of China Analysis and Forecast (2021)[M]. Beijing: Social Sciences Academic Press (China), 2020.

项目		上学日			休息日
项目		男	女	合计	男	女	合计
客观	日均久坐	605.75±120.92	653.34±143.91	626.17±133.18	641.97±138.86	676.41±168.87	656.75±153.17
客观	日均MVPA	31.35±13.42	25.28±13.54	28.74±13.78	27.14±17.29	20.17±11.36	24.15±15.41
主观	教育类久坐	3101.89±676.26	3138.54±733.24	3117.51±700.32	858.13±405.42	833.71±380.57	847.72±394.65
	交通类久坐	38.03±65.90	37.43±64.43	37.78±65.18	25.79±39.90	30.69±43.98	27.88±41.69
	文化类久坐	162.60±190.66	144.81±143.57	155.02±172.18	85.15±95.24	95.93±93.902	89.74±94.69
	社交类久坐	326.39±244.05	325.32±188.12	325.93±221.66	142.03±124.93	139.73±127.76	141.05±125.96
	视频类久坐	102.09±181.19	100.59±202.90	101.45±190.47	251.79±281.21	259.67±290.42	255.14±284.79

变量		重度		中度		轻度		正常		F值	P值
变量		n	数值	n	数值	n	数值	n	数值	F值	P值
客观	日均久坐	109	640.81±91.96	76	678.32±132.02	35	634.82±131.11	111	597.87±123.97	7.255	< 0.001
主观	教育类久坐	71	4172.94±889.37	112	4044.59±943.03	77	4018.52±837.83	92	3663.73±925.10	5.021	0.002
主观	视频类久坐	71	372.89±381.38	112	361.40±317.14	77	286.04±315.36	92	397.23±449.30	1.366	0.253

变量		第一阶段		第二阶段		t值^a	P值^a	t值^b	P值^b
变量		n	数值	n	数值	t值^a	P值^a	t值^b	P值^b
客观	高久坐组	165	2.17±1.22	165	1.91±1.09	-4.096	< 0.001	-3.422	0.001
客观	低久坐组	166	2.72±1.24	166	2.33±1.51	-4.096	< 0.001	-3.422	0.001
主观	高教育类久坐组	151	2.27±1.08	151	2.11±1.03	-4.109	< 0.001	-3.810	< 0.001
主观	低教育类久坐组	201	2.74±1.05	201	2.54±1.04	-4.109	< 0.001	-3.810	< 0.001

模型		第一层			第二层			第三层
模型		Beta	t值	P值	Beta	t值	P值	Beta	t值	P值
I	性别	-0.007	-0.133	0.894	0.000	-0.006	0.995	0.013	0.241	0.809
I	学段	-0.383	-7.468	< 0.001	-0.378	-7.223	< 0.001	-0.357	-6.546	< 0.001
II	MVPA-T1				0.024	0.436	0.663	0.016	0.304	0.762
III	久坐行为-T1				-0.076	-1.398	0.163	-0.074	-1.360	0.175
模型摘要	R²			0.146			0.147			0.151
	F			28.077			18.735			14.550
	P			< 0.001			< 0.001			< 0.001
	△R²			0.146			< 0.001			0.005
	△F			28.077			0.190			1.851
	△P			< 0.001			0.663			0.175

模型		第一层			第二层			第三层
模型		Beta	t值	P值	Beta	t值	P值	Beta	t值	P值
I	性别	0.021	0.408	0.684	0.028	0.519	0.604	0.029	0.554	0.580
I	学段	-0.225	-4.299	< 0.001	-0.215	-3.970	< 0.001	-0.174	-3.042	0.003
II	MVPA-T1				0.038	0.694	0.488	0.032	0.581	0.562
III	教育类久坐-T1							-0.124	-2.240	0.026
模型摘要	R²			0.052			0.053			0.066
	F			9.431			6.439			6.139
	P			< 0.001			< 0.001			< 0.001
	△R²			0.052			0.001			0.014
	△F			9.431			0.482			5.017
	△P			< 0.001			0.448			0.026

久坐行为对12~17岁青少年眼健康的影响

Influence of sedentary behavior on eye health in adolescents aged twelve to 17

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 12

参考文献 34

相关文章 15

Metrics

本文评价

推荐阅读 0

方法	性别	年龄/岁	第一阶段/n					第二阶段/n					流失/n
方法	性别	年龄/岁	初一	初二	高一	高二	合计	初一	初二	高一	高二	合计	流失/n
客观	男	15.40±1.38	39	53	55	62	209	34	48	47	60	189	20
	女	14.99±1.42	56	33	36	36	161	47	29	30	36	142	19
	合计	-	95	86	91	98	370	81	77	77	96	331	39
主观	男	15.00±1.67	47	55	72	64	238	40	51	58	53	202	36
	女	14.75±1.38	57	34	46	41	178	48	28	41	33	150	28
	合计	-	104	89	118	105	416	88	79	99	86	352	64

检验变量	面积	SE	P值	95%CI
检验变量	面积	SE	P值	下限	上限
教育类久坐	0.631	0.034	< 0.001	0.564	0.699

教育类久坐时间/min	敏感性	1-特异性	约登指数
……	……	……	……
3405.00	0.758	0.598	0.160
3415.00	0.750	0.587	0.163
3430.00	0.746	0.565	0.181
3445.00	0.738	0.533	0.206
3455.00	0.735	0.533	0.202
3465.00	0.731	0.533	0.198
……	……	……	……

[1]	谢浩宇, 李岩, 谢皓, 王楚怀. 噪声前庭电刺激对青少年特发性脊柱侧凸患者椎旁肌激活与姿势控制的即时效应[J]. 《中国康复理论与实践》, 2026, 32(2): 222-232.
[2]	杨同念, 任杰, 肖辉. 儿童青少年身体活动对焦虑的效果：系统综述的系统综述[J]. 《中国康复理论与实践》, 2025, 31(8): 883-888.
[3]	冯海洋. 足功能指数在儿童和青少年扁平足中的信度和效度[J]. 《中国康复理论与实践》, 2025, 31(6): 729-735.
[4]	刘东斐, 颜会义, 杨帆, 张帅. 运动干预对唐氏综合征儿童青少年多维健康结局影响的Meta分析[J]. 《中国康复理论与实践》, 2025, 31(12): 1398-1413.
[5]	赵英楠, 郑鑫彤, 刘俊玲, 王紫丹, 吴泓悦, 李冰, 李燕. 阈值吸气肌训练对肺癌术后患者肺康复影响的Meta分析[J]. 《中国康复理论与实践》, 2025, 31(10): 1164-1171.
[6]	张郝琪, 刘华, 孙璞, 温艳飞, 张霁月, 杨露. 基于ICF-CY的学龄期儿童基本运动技能评估量表结构内容和心理测量特性的系统综述[J]. 《中国康复理论与实践》, 2025, 31(10): 1172-1180.
[7]	杨文睿, 崔思栋, 曾莉. 虚拟与增强现实对孤独症谱系障碍儿童青少年认知、情绪和适应性行为干预效果的系统综述[J]. 《中国康复理论与实践》, 2024, 30(9): 1026-1033.
[8]	魏晓微. 数字赋能技术促进智力与发展性残疾儿童身体活动和健康的系统综述[J]. 《中国康复理论与实践》, 2024, 30(5): 497-504.
[9]	王红志, 杨剑. 虚拟现实技术在脑性瘫痪儿童青少年身体活动和健康中的应用：系统综述的系统综述[J]. 《中国康复理论与实践》, 2024, 30(5): 505-512.
[10]	苏如峰, 钟晓珂, 高晓妍, 蒋长好. 人工智能在儿童青少年焦虑和抑郁中应用的Scoping综述[J]. 《中国康复理论与实践》, 2024, 30(5): 513-519.
[11]	吴佳洺, 张青, 武爱红. 智力与发展性残疾儿童青少年音乐干预的功能、健康和发展效益：系统综述的系统综述[J]. 《中国康复理论与实践》, 2024, 30(5): 543-553.
[12]	喜悦, 杨剑. 不同身体活动对脑性瘫痪儿童青少年健康效益的系统综述[J]. 《中国康复理论与实践》, 2024, 30(2): 157-167.
[13]	黄兆欣, 唐乐天, 肖晓飞, 娄彦涛. 矫形鞋垫干预柔韧性扁平足儿童青少年下肢功能的Scoping综述[J]. 《中国康复理论与实践》, 2024, 30(11): 1343-1350.
[14]	张边疆, 杨剑. 身体活动对智力与发展性残疾儿童青少年的动作技能和平衡功能的效果：系统综述的系统综述[J]. 《中国康复理论与实践》, 2024, 30(10): 1117-1124.
[15]	颜景飞, 戴圣婷. 儿童青少年身体活动的心理和行为健康效应：系统综述的系统综述[J]. 《中国康复理论与实践》, 2024, 30(10): 1125-1132.