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Macpherson AK, Zagorski B, Saskin R, Howard AW, Harris MA, Namin S, Rothman L. Comparison of the number of pedestrian and cyclist injuries captured in police data compared with health service utilisation data in Toronto, Canada 2016-2021. Inj Prev 2024; 30:161-166. [PMID: 38195658 PMCID: PMC10958284 DOI: 10.1136/ip-2023-044974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/18/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Pedestrian and cyclist injuries represent a preventable burden to Canadians. Police-reported collision data include information on where such collisions occur but under-report the number of collisions. The primary objective of this study was to compare the number of police-reported collisions with emergency department (ED) visits and hospitalisations in Toronto, Canada. METHODS Police-reported collisions were provided by Toronto Police Services (TPS). Data included the location of the collision, approximate victim age and whether the pedestrian or cyclist was killed or seriously injured. Health services data included ED visits in the National Ambulatory Care Reporting System and hospitalisations from the Discharge Abstract Database using ICD-10 codes for pedestrian and cycling injuries. Data were compared from 2016 to 2021. RESULTS Injuries reported in the health service data were higher than those reported in the TPS for cyclists and pedestrians. The discrepancy was the largest for cyclists treated in the ED, with TPS capturing 7.9% of all cycling injuries. Cyclist injuries not involving a motor vehicle have increased since the start of the pandemic (from 3629 in 2019 to 5459 in 2020 for ED visits and from 251 in 2019 to 430 for hospital admissions). IMPLICATIONS While police-reported data are important, it under-reports the burden. There have been increases in cyclist collisions not involving motor vehicles and decreases in pedestrian injuries since the start of the pandemic. The results suggest that using police data alone when planning for road safety is inadequate, and that linkage with other health service data is essential.
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Affiliation(s)
- Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Brandon Zagorski
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Refik Saskin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - M Anne Harris
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Sima Namin
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Linda Rothman
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
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Webber BJ, Whitfield GP, Rose KM, Stowe EW, Zaganjor H, Ederer DJ, Fulton JE. Prevalence of vision zero action plans or strategies: USA, 2021. Inj Prev 2024:ip-2023-044926. [PMID: 38378255 DOI: 10.1136/ip-2023-044926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Vision Zero is a strategy to eliminate traffic fatalities and to promote equitable mobility options for all road users. Using a nationally representative survey, we aimed to estimate the prevalence of Vision Zero action plans or strategies in the USA. METHODS Municipal officials were surveyed in 2021. In this cross-sectional study, we calculated the prevalence of Vision Zero plans or strategies and compared municipalities with adjusted prevalence ratios (PR) to account for region and sociodemographic characteristics. RESULTS Among 1955 municipalities participating in the survey (question-specific response rate: 44.3%), the prevalence of a Vision Zero action plan or strategy was 7.7%; 70.5% responded no and 21.8% don't know. Prevalence was 4.8% in small municipalities (1000-2499 residents), 20.3% in medium-large municipalities (50 000-124 999 residents; PR=4.1), and 37.8% in large municipalities (≥125 000 residents; PR=7.6). CONCLUSION The prevalence of Vision Zero plans and strategies across the USA is low. Additional adoption of Vision Zero plans and strategies could help address traffic fatalities.
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Affiliation(s)
- Bryant J Webber
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Geoffrey P Whitfield
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kenneth M Rose
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ellen W Stowe
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education Research Participation Program, Oak Ridge, Tennessee, USA
| | - Hatidza Zaganjor
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David J Ederer
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet E Fulton
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Osterhage DR, Acolin J, Fishman PA, Dannenberg AL. Economic impact on local businesses of road safety improvements in Seattle: implications for Vision Zero projects. Inj Prev 2024:ip-2023-044934. [PMID: 38378257 DOI: 10.1136/ip-2023-044934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 02/02/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Local transportation agencies implementing Vision Zero road safety improvement projects often face opposition from business owners concerned about the potential negative impact on their sales. Few studies have documented the economic impact of these projects. METHODS We examined baseline and up to 3 years of postimprovement taxable sales data for retail, food and service-based businesses adjacent to seven road safety projects begun between 2006 and 2014 in Seattle. We used hierarchical linear models to test whether the change in annual taxable sales differed between the 7 intervention sites and 18 nearby matched comparison sites that had no road safety improvements within the study time frame. RESULTS Average annual taxable sales at baseline were comparable at the 7 intervention sites (US$44.7 million) and the 18 comparison sites (US$56.8 million). Regression analysis suggests that each additional year following baseline was associated with US$1.20 million more in taxable sales among intervention sites and US$1.14 million more among comparison sites. This difference is not statistically significant (p=0.64). Sensitivity analyses including a random slope, using a generalised linear model and an analysis of variance did not change conclusions. DISCUSSION Results suggest that road safety improvement projects such as those in Vision Zero plans are not associated with adverse economic impacts on adjacent businesses. The absence of negative economic impacts associated with pedestrian and bicycle road safety projects should reassure local business owners and may encourage them to work with transportation agencies to implement Vision Zero road safety projects designed to eliminate traffic-related injuries.
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Affiliation(s)
- Daniel R Osterhage
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Department of Urban Design and Planning, University of Washington, Seattle, Washington, USA
| | - Jessica Acolin
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Paul A Fishman
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Andrew L Dannenberg
- Department of Urban Design and Planning, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
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Utriainen R, Pöllänen M, O'Hern S, Sihvola N. Single- bicycle crashes in Finland - Characteristics and safety recommendations. J Safety Res 2023; 87:96-106. [PMID: 38081727 DOI: 10.1016/j.jsr.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/17/2023] [Accepted: 09/11/2023] [Indexed: 12/18/2023]
Abstract
PROBLEM Increasing the role of cycling is necessary to reduce physical inactivity. While promoting cycling, attention should also be given to traffic safety. Hence, a better understanding on the underlying factors and safety recommendations of cyclist crashes is needed. This study aims to increase knowledge on fatal single-bicycle crashes (SBCs), where other road users are not collided with. METHOD Data from in-depth investigated fatal cyclist crashes in Finland is analyzed from 2010 to 2019. The study presents descriptive analysis of the characteristics, underlying factors, and safety recommendations of SBCs (n = 82) and other cyclist crashes (n = 151). Logistic regression analysis and chi-squared tests were performed to identify significant characteristics for SBCs. RESULTS Fatal SBCs commonly involved people aged 60 or older, males, and cyclist not wearing a helmet. Cyclist's health issues influenced the crash in 62.2% of the SBCs. Compared to other cyclist crashes, health issues, alcohol, males, other crash locations than intersections, and weekends were highlighted in SBCs. Safety recommendations emphasized human factors, such as informing cyclist about underlying factors and the use of safety equipment. DISCUSSION In addition to human factors, the safety recommendations included suggestions regarding the bicycle, the traffic environment, and traffic regulations. This highlights the need to focus on different safety improvement actions to reduce SBCs. This study identified key characteristics of SBCs, which may help traffic safety authorities address this road safety issue and ultimately help to promote cyclist safety. PRACTICAL APPLICATIONS Cooperation between the actors including health care providers and the police is also proposed to address cyclists' health issues that contribute to SBCs.
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Affiliation(s)
- Roni Utriainen
- City of Helsinki, P.O. Box 58200, FI-00099 Helsinki, Finland.
| | - Markus Pöllänen
- Transport Research Centre Verne, Tampere University, P.O. Box 600, FI-33014 Tampere, Finland
| | - Steve O'Hern
- Transport Research Centre Verne, Tampere University, P.O. Box 600, FI-33014 Tampere, Finland; Monash University Accident Research Centre, Monash University, Clayton 3800, Australia
| | - Niina Sihvola
- Finnish Crash Data Institute (OTI), Itämerenkatu 11-13, FI-00180 Helsinki, Finland
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Alizadehsaravi L, Moore JK. Bicycle balance assist system reduces roll and steering motion for young and older bicyclists during real-life safety challenges. PeerJ 2023; 11:e16206. [PMID: 37868045 PMCID: PMC10588700 DOI: 10.7717/peerj.16206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/08/2023] [Indexed: 10/24/2023] Open
Abstract
Bicycles are more difficult to control at low speeds due to the vehicle's unstable low-speed dynamics. This issue might be exacerbated by factors such as aging, disturbances, and multi-tasking. To address this issue, we developed a prototype 'balance assist system' with Royal Dutch Gazelle and Bosch eBike Systems at Delft University of Technology, which includes an electric motor capable of providing additional steering torque. We implemented a speed-adaptive feedback controller to generate the additional steering torque to that of the rider. We conducted a study with 18 older and 14 younger cyclists to first examine the effect of aging, disturbances, and multi-tasking on cycling at lower forward speeds, and evaluate the effectiveness of the system in improving the stability of the rider-bicycle system while facing these challenges. The study consisted of two scenarios: a single-task scenario where participants rode the bicycle on a marked narrow straight-line track, and a multi-task scenario where participants performed a shoulder check task and followed visual cues while tracking the straight-line. We introduced handlebar disturbances using the steer motor in half of the trials in both scenarios. All trials were repeated with and without the balance assist system. We calculated the bicycle mean magnitude of roll and steering rate-as indicators of bicycle balance control and required steering actions, respectively-and the rider's mean magnitude of lean rate with respect to the ground to investigate the effect of the balance assist system on rider's lateral motion. Our results showed that aging, disturbances, and multi-tasking increased the roll rate, and the balance assist system was able to significantly reduce it. The effect size of the balance assist system in reducing the roll rate across all conditions was found to be larger in older cyclists, indicating a more substantial impact compared to younger cyclists. Disturbances and multi-tasking increased the steering rate, which was successfully reduced by the balance assist system. Aging did not significantly affect the steering rate. The rider's lean rate was not significantly affected by age, disturbances, or the balance assist, indicating that the upper body plays a minor role when riders have good steering control authority. Overall, our findings suggest that lateral motion and required steering action can be affected by age, multi-tasking, and handlebar disturbances which can endanger cyclists' safety, and the balance assist system has the potential to improve cycling safety and reduce the incidence of single-actor crashes. Further investigation on riders' contribution to control actions is required.
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Affiliation(s)
- Leila Alizadehsaravi
- Biomechatronic and Human-Machine Control Section, Biomechanical Engineering Department, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Delft, South Holland, The Netherlands
| | - Jason K Moore
- Biomechatronic and Human-Machine Control Section, Biomechanical Engineering Department, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Delft, South Holland, The Netherlands
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Kim D, Park K. Analysis of potential collisions between pedestrians and personal transportation devices in a university campus: an application of unmanned aerial vehicles. J Am Coll Health 2023; 71:2272-2279. [PMID: 34516938 DOI: 10.1080/07448481.2021.1967358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 06/10/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To identify factors that contribute to near-miss collisions between pedestrians and personal transportation devices (PTDs) in a university campus using a novel data collection method, unmanned aerial vehicle (UAV). PARTICIPANTS A total of 3,349 pedestrians and 173 PTD riders were detected through UAV observations. METHODS The researchers employed UAV technology to capture and geocode the interactions and behavior of pedestrians and PTD riders. Then, a multilevel logistic regression model examined factors that contribute to near-miss collisions between pedestrians and PTDs. RESULTS The model outputs indicate that higher speed, non-bicycle PTDs (eg, skateboard and scooter), and some preventive actions, like reducing speed, deviating, and weaving, increase the probability of a PTD rider getting involved in a near-miss collision. CONCLUSIONS Findings can guide campus planners to redesign the streets as a safe environment for all transportation modes and implement appropriate regulations and education programs, especially for non-bicycle PTD riders.
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Affiliation(s)
- Dohyung Kim
- Department of Urban and Regional Planning, California State Polytechnic University, Pomona, California, USA
| | - Keunhyun Park
- Department of Landscape Architecture and Environmental Planning, Utah State University, Logan, Utah, USA
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Troy BM, Fraser Doh K, Linden AF, Xiang Y, Gillespie S, Agarwal M. Changes in pediatric injuries sustained while engaged in activities where helmet usage is recommended during the COVID-19 pandemic. Inj Epidemiol 2023; 10:38. [PMID: 37525250 PMCID: PMC10391761 DOI: 10.1186/s40621-023-00449-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/06/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Unintentional injuries, including traumatic brain injuries (TBI), are the leading cause of pediatric morbidity and mortality in the USA. Helmet usage can reduce TBI incidence and severity; however, the epidemiology of pediatric TBI and helmet use is ever evolving. With lifestyle changes potentially accelerated by the pandemic, we predicted a decrease in helmet utilization with an associated increase in TBI during the pandemic compared to the pre-pandemic period. RESULTS There were 1093 patients that presented with AWHUR injuries from 2018 to 2020 with an annual increase from 263 patients in 2018 up to 492 in 2020. The most frequently implicated mechanisms included bicycles (35.9%), ATVs (20.3%), skateboards (11.6%), scooters (8.3%), and dirt bikes (7.4%). Unhelmeted patients increased from 111 (58.7%) in 2018 to 258 (64.8%) in 2020. There was not a significant difference in the proportion of injuries that were unhelmeted from 38.9% in 2018-2019 to 35.2% in 2020 (p = 0.30), as well as the proportion of head injuries from 2018 to 2019 (24.3%) to 2020 (29.3%) (p = 0.07). A significant increase was seen in neurosurgical consultation from 17 (6.5%) in 2018 to 87 (17.7%) in 2020 (p = 0.02). Notably, there was an increase in the percentage of publicly insured patients presenting with injuries from AWHUR during 2020 (p < 0.001); this group also had suboptimal helmet usage. CONCLUSION This study found an increase in patients presenting with injuries sustained while engaged in AWHUR in relation to the COVID-19 pandemic. Concerningly, there was a trend toward decreased helmet utilization and increased injury severity markers. Further analysis is needed into the communities impacted the most by AWHUR injuries.
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Affiliation(s)
- Brent M Troy
- Division of Emergency Medicine/Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, 1547 Clifton Road NE, 2nd Floor, Atlanta, GA, 30322, USA.
| | - Kiesha Fraser Doh
- Division of Emergency Medicine/Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, 1547 Clifton Road NE, 2nd Floor, Atlanta, GA, 30322, USA
| | - Allison F Linden
- Division of Pediatric Surgery/Children's Healthcare of Atlanta, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Yijin Xiang
- Pediatric Biostatistics Core, Children's Healthcare of Atlanta/Emory University, Atlanta, GA, USA
| | - Scott Gillespie
- Pediatric Biostatistics Core, Children's Healthcare of Atlanta/Emory University, Atlanta, GA, USA
| | - Maneesha Agarwal
- Division of Emergency Medicine/Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, 1547 Clifton Road NE, 2nd Floor, Atlanta, GA, 30322, USA
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Meng S, Ivarsson P, Lubbe N. Evaluation of full-face, open-face, and airbag-equipped helmets for facial impact protection. Accid Anal Prev 2023; 191:107181. [PMID: 37418868 DOI: 10.1016/j.aap.2023.107181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/21/2023] [Accepted: 06/17/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE Two-wheeler riders frequently sustain injuries to the head and face in real-world crashes, including traumatic brain injury, basilar skull fracture, and facial fracture. Different types of helmets exist today, which are recognized as preventing head injuries in general; however, their efficacy and limitations in facial impact protection are underexplored. Biofidelic surrogate test devices and assessment criteria are lacking in current helmet standards. This study addresses these gaps by applying a new, more biofidelic test method to evaluate conventional full-face helmets and a novel airbag-equipped helmet design. Ultimately, this study aims to contribute to better helmet design and testing standards. METHODS Facial impact tests at two locations, mid-face and lower face, were conducted with a complete THOR dummy. Forces applied to the face and at the junction of the head and neck were measured. Brain strain was predicted by a finite element head model taking both linear and rotational head kinematics as input. Four helmet types were evaluated: full-face motorcycle and bike helmets, a novel design called a face airbag (an inflatable structure integrated into an open-face motorcycle helmet), and an open-face motorcycle helmet. The unpaired, two-sided student's t-test was performed between the open-face helmet and the others, which featured face-protective designs. RESULTS A substantial reduction in brain strain and facial forces was found with the full-face motorcycle helmet and face airbag. Upper neck tensile forces increased slightly with both full-face motorcycle (14.4%, p >.05) and bike helmets (21.7%, p =.039). The full-face bike helmet reduced the brain strain and facial forces for lower-face impacts, but not for mid-face impacts. The motorcycle helmet reduced mid-face impact forces while slightly increasing forces in the lower face. SIGNIFICANCE OF RESULTS The chin guards of full-face helmets and the face airbag protect by reducing facial load and brain strain for lower face impact; however, the full-face helmets' influence on neck tension and increased risk for basilar skull fracture need further investigation. The motorcycle helmet's visor re-directed mid-face impact forces to the forehead and lower face via the helmet's upper rim and chin guard: a thus-far undescribed protective mechanism. Given the significance of the visor for facial protection, an impact test procedure should be included in helmet standards, and the use of helmet visors promoted. A simplified, yet biofidelic, facial impact test method should be included in future helmet standards to ensure a minimum level of protection performance.
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Affiliation(s)
- Shiyang Meng
- Autoliv Research, Wallentinsvägen 22, 447 37 Vårgårda, Sweden.
| | | | - Nils Lubbe
- Autoliv Research, Wallentinsvägen 22, 447 37 Vårgårda, Sweden; Department of Mechanics and Maritime Sciences, Chalmers University of Technology, 412 96 Gothenburg, Sweden
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Tischler EH, Krasnyanskiy B, Kong RM, Tracey O, Tsai SHL, Suneja N. E-scooter use continues to rev up fracture diagnoses and hospital admissions compared to other modes of transportation. J Clin Orthop Trauma 2023; 40:102164. [PMID: 37206109 PMCID: PMC10189513 DOI: 10.1016/j.jcot.2023.102164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 02/05/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction The COVID-19 pandemic was associated with an increase in popularity of e-scooter usage and a rise in e-scooter related injuries. Recent studies have elucidated trends within e-scooter injuries but there are few epidemiological studies that evaluate injury rates amongst multiple modes of transportation. This study seeks to investigate trends of e-scooter orthopedic fracture injuries compared to other traditional methods of transportation using a national database. Methods The National Electronic Injury Surveillance System (NEISS) database was queried between 2014 and 2020 for patients who were injured after usage of e-scooters, bicycles, or all-terrain vehicles. Primary analysis included patients with a diagnosis of fracture and utilized univariate/multivariate models to evaluate risk of hospital admission. Secondary analysis included all isolated patients to evaluate the odds of fracture development amongst modes of transportation. Results A total of 70,719 patients with injuries associated with e-scooter, bicycle, or all-terrain vehicle use were isolated. 15997 (22.6%) of these patients had a fracture diagnosis. Both e-scooters and all-terrain vehicles reported increased odds of fracture-related injury and direct hospitalization when compared to bicycles. E-scooter users reported a greater odds of both associated fracture (OR 1.25; 95%CI 1.03-1.51; p = 0.024) and hospital admission (OR: 2.01; 95%CI: 1.26-3.21; p = 0.003) in 2020 compared to 2014-2015. Discussion E-scooter related orthopedic injuries and hospital admissions had the largest incidence rate increase compared to bicycle and all-terrain vehicles between 2014 and 2020. E-scooter fractures were most commonly located in the lower leg in 2014-2017, the wrist in 2018-2019, and the upper trunk in 2020. In comparison, bicycle and all-terrain vehicle fractures was most commonly shoulder and upper trunk within the study period. Further research will help to promote further understanding of the e-scooter health care burden and in prevention of these injuries. Level of evidence 3.
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Affiliation(s)
- Eric H. Tischler
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Benjamin Krasnyanskiy
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Ryan M. Kong
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Olivia Tracey
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sung Huang Laurent Tsai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, 204, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Nishant Suneja
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
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Bejiga G. Bucket-handle mesenteric tear and traumatic abdominal wall hernia following bicycle handlebar injury in an adult: A 'case report'. Int J Surg Case Rep 2023; 105:107981. [PMID: 36948056 PMCID: PMC10040694 DOI: 10.1016/j.ijscr.2023.107981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Bucket-handle mesenteric tear (BHMT) is a type of intestinal mesenteric injury where the intestine separates from its mesentery resulting in ischemia and perforation. Traumatic abdominal wall hernia (TAWH) is a disruption of the abdominal wall muscles and fascia in the presence of intact skin. BHMT and TAWH following bicycle handlebar injury in adults are rare. TAWH and generalized abdominal tenderness led to emergent surgical treatment in our patient. I aim to report these rare clinical entities in an adult patient with the management. This case report can create awareness among primary care physicians to decide on early referral and surgeons on early treatment. CASE PRESENTATION A 55y man presented 4 h after a bicycle handlebar injury to the abdomen. He had generalized abdominal pain but no history of vomiting, smoking, diabetes, or hypertension. Lab results were insignificant. TAWH and generalized tenderness led to the additional diagnosis of hollow-viscus perforation, but laparotomy revealed BHMT of the ileum and transverse colon. We did TAWH repair, bowel resection, and end-to-end anastomosis with excellent results. CLINICAL DISCUSSION BHMT following bicycle handlebar injury is rare in adults, with few case reports. Imaging is less sensitive, and surgery is the definitive diagnosis of BHMT.TAWH in adults after bicycle handlebar injury is rare and can be a sign of serious-intraabdominal injuries, and surgical repair is the treatment. CONCLUSION BHMT and TAWH following bicycle handlebar injury are rare in adults. BHMT can be life-threatening if not detected and treated early.
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Affiliation(s)
- Gosa Bejiga
- Adama Hospital Medical College, Adama, P.O. Box: 84, Ethiopia.
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Spies PE, Fix M, Emmink BL, Schermer TR. Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study. Eur Rev Aging Phys Act 2023; 20:3. [PMID: 36864405 DOI: 10.1186/s11556-023-00315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Deployment of geriatric care would be more sustainable if we could limit geriatric co-management to older hip fracture patients who benefit most from it. We assumed that riding a bicycle is a proxy of good health and hypothesized that older patients with a hip fracture due to a bicycle accident have a more favorable prognosis than patients whose hip fracture was caused by another type of accident. METHODS Retrospective cohort study of hip fracture patients ≥ 70 years admitted to hospital. Nursing home residents were excluded. Primary outcome was length of hospital stay (LOS). Secondary outcomes were delirium, infection, blood transfusion, intensive care unit stay and death during hospitalization. The group with a bicycle accident (BA) was compared to the non-bicycle accident (NBA) group using linear and logistic regression models, with correction for age and sex. RESULTS Of the 875 patients included, 102 (11.7%) had a bicycle accident. BA patients were younger (79.8 versus 83.9 years, p < 0.001), less often female (54.9 versus 71.2%, p = 0.001) and lived independently more often (100 versus 85.1%, p < 0.001). Median LOS in the BA group was 0.91 times the median LOS in the NBA group (p = 0.125). For none of the secondary outcomes the odds ratio favored the BA group, except for infection during hospital stay (OR = 0.53, 95%CI 0.28-0.99; p = 0.048). CONCLUSIONS Although older hip fracture patients who had a bicycle accident appeared more healthy than other older hip fracture patients, their clinical course was not more favorable. Based on this study, a bicycle accident is not an indicator that geriatric co-management can be omitted.
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Scott-Deeter L, Hurwitz D, Russo B, Smaglik E, Kothuri S. Assessing the impact of three intersection treatments on bicyclist safety using a bicycling simulator. Accid Anal Prev 2023; 179:106877. [PMID: 36330919 DOI: 10.1016/j.aap.2022.106877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/28/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Bicyclist safety at urban intersections is a critical element for encouraging an increase in bicycle commuting. With cyclist injury and fatality rates rising due to collisions with vehicles at signalized intersections, increasing the safety of riders continues to be an important consideration when promoting this mode of transportation. Previous research has addressed crash causality and helped to develop several roadway treatments to improve bicyclist safety, but little has been done to compare and contrast the benefits of the various treatment types. This bicycling simulator study examined the impacts of three different intersection treatments (i.e., bike box, mixing zone, and bicycle signals) to better understand their influence on bicyclists' comfort, levels of stress, and riding behaviors. This improved understanding allowed researchers to make recommendations for which of the three designs proved to be most effective for reducing the risk of vehicle-bicycle collisions at signalized intersections. Forty participants successfully completed the study by responding to twenty-four scenarios while riding in the Oregon State University Bicycling Simulator. Time-space measurements revealed that the mixing zone treatment correlated with the most unpredictable riding behaviors. Analysis of the participants' eye-movements revealed a lower rate of recognizing the conflict vehicle when traversing the bicycle signal treatments. Galvanic Skin Response measurements were used to measure participants stress levels but found no statistically significant results, although it was found that the mixing zone elicited slightly larger stress responses. Researchers found the bike box design to be the most versatile, providing a balance of increased safety while also requiring the participant to perceive potential danger and be ready to respond accordingly. The results of this research can provide a better understanding of how to best implement these intersection treatments to increase bicyclists' safety at signalized intersections.
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Affiliation(s)
- Logan Scott-Deeter
- School of Civil and Construction Engineering, Oregon State University, 1491 SW Campus Way, Corvallis, OR 97331, USA.
| | - David Hurwitz
- School of Civil and Construction Engineering, Oregon State University, 1491 SW Campus Way, Corvallis, OR 97331, USA
| | - Brendan Russo
- Department of Civil Engineering, Construction Management, and Environmental Engineering, Northern Arizona University, 2112 S Huffer Ln, Flagstaff, AZ 86011, USA
| | - Edward Smaglik
- Department of Civil Engineering, Construction Management, and Environmental Engineering, Northern Arizona University, 2112 S Huffer Ln, Flagstaff, AZ 86011, USA
| | - Sirisha Kothuri
- Department of Civil and Environmental Engineering, Portland State University, 1930 SW Fourth Avenue, Portland, Oregon, 97201, STE, 200, USA
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Nichols JC, Sorrentino A, Hayslip M, King W, Jones A, Monroe K. Pediatric injury due to wheeled recreational devices: a single-institution retrospective study. Inj Epidemiol 2022; 9:44. [PMID: 36544196 PMCID: PMC9768874 DOI: 10.1186/s40621-022-00395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Injuries are the number one cause of death in children and cause significant morbidity. Common scenarios for injury include wheeled recreational devices (WRDs) that allow children to be mobile and independent (example ATV-all terrain vehicles, dirt bikes, bicycles, skateboards, and scooters). We present a case series review of these external causes of injury. This study aims to evaluate epidemiologic trends in WRD injuries and patterns in usage of protective gear. RESULTS A total of 263 patients were identified as meeting criteria for inclusion with the following causes of injuries-103 bicycle, 73 ATV, 27 dirt bike, 14 skateboard, 13 motorcycle, 7 go carts, 3 hover board, 3 roller skates, 1 dune buggy, 1 motor scooter, 1 rip stick, and 1 tractor toy. Ages of patients ranged from 2 to 18 years of age with the greatest range being noted for bicycles (2-17 years) and motorcycles (3-18 years). The mean age was higher for motorcycle and skateboard (12.9 and 11.6, respectively) and lowest for scooter and bicycle (8.3 and 9.2, respectively). The majority of [overall study (97%) and for each mode of transportation] patients were Caucasian, which is in contrast to our overall ED population, which is only 42% Caucasian. The majority of patients were male [190 (72%)]. Over half of the overall patients, 159 of the 263 (60%), were not wearing a helmet (with only 10 charts having no documentation of helmet use). In regard to ATV riders specifically, 58% were not wearing helmets at the time of injury, with an additional 5 patients who reported their helmet came off. The lowest percentage of riders reporting appropriate helmet use was skateboarders with only 21% wearing helmets, and the highest percentage was dirt bike riders with 74% reporting helmet use. CONCLUSION Common scenarios for injury include WRDs that allow children to be mobile and independent. Most of these injuries were found in Caucasian males between the ages of 9-12 with low rates of helmet use. This study adds to the literature with a description of the breadth of products children use and are injured while using.
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Affiliation(s)
- John Charles Nichols
- grid.265892.20000000106344187University of Alabama School of Medicine, 1670 University Blvd, Birmingham, AL 35233 USA
| | - Annalise Sorrentino
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine University of Alabama Birmingham, Department of Pediatrics, University of Alabama School of Medicine, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
| | - Margaret Hayslip
- grid.265892.20000000106344187University of Alabama School of Medicine, 1670 University Blvd, Birmingham, AL 35233 USA
| | - William King
- grid.265892.20000000106344187Children’s of Alabama University of Alabama Birmingham, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
| | - Angela Jones
- grid.265892.20000000106344187Medical Informatics, Children’s of Alabama University of Alabama Birmingham, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
| | - Kathy Monroe
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine University of Alabama Birmingham, Department of Pediatrics, University of Alabama School of Medicine, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
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Tan JH, Hong CC, Daniels P, Peter L, Murphy D, Sen Kuan W. Bicycle-Related Injuries of the Upper Extremity. Arch Bone Jt Surg 2022; 10:1030-1036. [PMID: 36721652 PMCID: PMC9846725 DOI: 10.22038/abjs.2022.58487.2892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 06/14/2022] [Indexed: 02/02/2023]
Abstract
Background In recent years, the increasing popularity of cycling for commuting and leisure has led to a corresponding increase in bicycle-related injuries. However, there is a lack of extensive analysis of bicycle-related injuries to the upper limb in the literature. Methods A retrospective review of all patients with conventional bicycle-related injuries of the upper limb was performed. Data on demographics, mechanisms of injury, region of injury, fracture type, management type, and length of hospital stay were extracted and analyzed. Results A total of 177 of 733(24%) patients with bicycle-related upper limb injuries were identified. The most common mechanism of injury was a collision with another vehicle (60%). Frequently affected regions were the shoulder (48%), hand (19%), and wrist (19%). Eighty-eight (50%) patients sustained bony injuries, while the remainder (50%) had isolated soft tissue injuries. Fifty-three (30%) patients required a mean of 3.9 days of hospitalization, whereas 13 (25%) patients required high dependency or intensive care unit treatment. Surgical interventions were required in 47 (27%) patients. Conclusion Bicycle-related injuries to the upper limb are common and result in significant morbidity. The most common regions affected are the shoulder, wrist, and hand. Most of the injuries were caused by collisions with other vehicles. A third of affected patients required hospitalization, and a quarter required surgical intervention.
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Affiliation(s)
- Jun-Hao Tan
- Department of Orthopaedic Surgery, National University Hospital, Singapore
| | - Choon Chiet Hong
- Department of Orthopaedic Surgery, National University Hospital, Singapore
| | - Peter Daniels
- Department of Orthopaedic Surgery, National University Hospital, Singapore
| | - Luke Peter
- Department of Orthopaedic Surgery, National University Hospital, Singapore
| | - Diarmuid Murphy
- Department of Orthopaedic Surgery, National University Hospital, Singapore
| | - Win Sen Kuan
- Department of Orthopaedic Surgery, National University Hospital, Singapore
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Venkatachalapathy A, Hamann C, Spears S, Shirtcliff EA, Sharma A. A Naturalistic Study Assessing the Impact of Daytime Running Lights and Vehicle Passing events on Cyclist's Physiological Stress. Transp Res Interdiscip Perspect 2022; 16:10.1016/j.trip.2022.100703. [PMID: 37181281 PMCID: PMC10174271 DOI: 10.1016/j.trip.2022.100703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Bicyclists are vulnerable road users who are at a greater risk for injury and fatality during crashes. Additionally, the "near-miss" incidents they experience during regular trips can increase the perceived risk and deter them from riding again. This paper aims to use naturalistic bicycling data collected in Johnson County, Iowa to: 1) study the effect of factors such as road surface type, parked vehicles, pavement markings and car passing events on cyclists' physiological stress and 2) understand the effect of daytime running lights (DRL) as an on-bicycle safety system in providing comfort to cyclists and highlight of their presence on the road to other vehicles. A total of 37 participants were recruited to complete trips over two weekends, one weekend with DRL and the other without DRL. Recruitment was specifically targeted toward cyclists who expressed discomfort riding in traffic. Data were collected using a front forward facing camera, GPS, and a vehicle lateral passing distance sensor mounted on the bicycle and a Empatica E4 wrist band (providing physiological data such as electrodermal activity; EDA) worn by the cyclist. Data from those sources were cleaned, processed, merged, and aggregated into time windows depicting car passing and no car passing events. Mixed effects models were used to study the cyclists' skin conductance response (phasic EDA) and baseline skin conductance level (tonic EDA). Car passing, parked vehicles, and roads with dashed centerline markings were observed to increase the cyclists stress. The use of DRL had negligible impact on cyclist stress on roads.
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Benhamed A, Gossiome A, Ndiaye A, Tazarourte K. Characteristics and comparison between e-scooters and bicycle-related trauma: a multicentre cross-sectional analysis of data from a road collision registry. BMC Emerg Med 2022; 22:164. [PMID: 36175859 PMCID: PMC9520117 DOI: 10.1186/s12873-022-00719-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urban mobility has drastically evolved over the last decade and micromobility rapidly became an expanding segment of contemporary daily transportation routines. E-scooter riders and bicyclists may share similar trauma characteristics, but this has been little explored. The objective was to describe and compare the characteristics of e-scooter and bicycle-related trauma. METHODS We conducted a cross-sectional analysis of data from the Rhône road collision registry (January 1, 2019 to December 31, 2019). We included all e-scooter or bicycle riders injured in traffic collisions during the study period; there were no exclusion criterion. RESULTS A total of 2,779 patients were included; 825 (29.7%) were e-scooter riders and 1,954 (70.3%) were bicyclists. E-scooter riders were younger (median [IQR]: 24 [20-32] vs 29 [20-45] years, p < 0.001) and less frequently male (64.2% vs 73.4%, p < 0.001). Most e-scooter and bicycle road collisions were consequent to a fall or loss of vehicle control (74.2% vs 67.7%, p < 0.001). E-scooter riders were less frequently wearing a helmet at the time of the road collision (6.1% vs 30.7%, p < 0.001) and had more frequently head (24.2% vs 19.9%, p = 0.01) and face (30.6 vs 20.5%, p < 0.001) injuries compared to bicyclists. The median injury severity score was 2 [1-4] in both groups with no significant difference (p = 0.77). CONCLUSIONS E-scooter and bicycle-related trauma patients were mainly young males with minor injuries and most of them sustained a road collision with no third-party. However, they suffered from different injury patterns; e-scooter riders suffered more frequently face and head injuries than bicycle riders, which may be at least partly the consequence of less frequent helmet use among e-scooter riders compared to bicyclists. Hence the two groups of users should not be considered as a single trauma entity. This issue should be promptly addressed to bring down the incidence of preventable injuries and avoid healthcare costs.
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Affiliation(s)
- Axel Benhamed
- Service SAMU-Urgences, Hospices Civils de Lyon, Centre Hospitalier Universitaire Édouard Herriot, 5 place d'Arsonval, 69003, Lyon, France. .,INSERM U1290 (RESHAPE), Université Claude Bernard Lyon 1, 69003, Lyon, France.
| | - Amaury Gossiome
- Service SAMU-Urgences, Hospices Civils de Lyon, Centre Hospitalier Universitaire Édouard Herriot, 5 place d'Arsonval, 69003, Lyon, France
| | - Amina Ndiaye
- IFSTTAR, Université Gustave Eiffel, 69675, Lyon, France
| | - Karim Tazarourte
- Service SAMU-Urgences, Hospices Civils de Lyon, Centre Hospitalier Universitaire Édouard Herriot, 5 place d'Arsonval, 69003, Lyon, France.,INSERM U1290 (RESHAPE), Université Claude Bernard Lyon 1, 69003, Lyon, France
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17
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Rico Bini R, Canal Jacques T, Hunter J, Figueiredo P. Biomechanical and physiological implications to running after cycling and strategies to improve cycling to running transition: A systematic review. J Sci Med Sport 2022; 25:861-866. [PMID: 35871903 DOI: 10.1016/j.jsams.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/30/2022] [Accepted: 07/09/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This systematic review summarises biomechanical, physiological and performance factors affecting running after cycling and explores potential effective strategies to improve performance during running after cycling. DESIGN Systematic review. METHODS The literature search included all documents available until 14th December 2021 from Medline, CINAHL, SportDiscus, and Scopus. Studies were screened against the Appraisal tool for Cross-sectional Studies to assess methodological quality and risk of bias. After screening the initial 7495 articles identified, fulltext screening was performed on 65 studies, with 39 of these included in the systematic review. RESULTS The majority of studies observed detrimental effects, in terms of performance, when running after cycling compared to a control run. Unclear implications were identified from a biomechanical and physiological perspective with studies presenting conflicting evidence due to varied experimental designs. Changes in cycling intensity and cadence have been tested but conflicting evidence was observed in terms of biomechanical, physiological and performance outcomes. CONCLUSIONS Because methods to simulate cycle to run transition varied between studies, findings were conflicting as to whether running after cycling differed compared to a form of control run. Although most studies presented were rated high to very high quality, it is not possible to state that prior cycling does affect subsequent running, from a physiological point of view, with unclear responses in terms of biomechanical outcomes. In terms of strategies to improve running after cycling, it is unclear if manipulating pedalling cadence or intensity affects subsequent running performance.
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Affiliation(s)
- Rodrigo Rico Bini
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Australia.
| | | | - Jayden Hunter
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Australia
| | - Pedro Figueiredo
- Portugal Football School, Portuguese Football Federation, Portugal; Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Portugal; CIDEFES, Universidade Lusófona, Portugal
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18
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De Wet T, Dzinotyiweyi T, Ellison GTH. Introducing Johannesburg's new cycle lanes to potential student users: experiences, impact and recommendations. J Am Coll Health 2022; 70:1584-1595. [PMID: 33151836 DOI: 10.1080/07448481.2020.1817031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/30/2020] [Accepted: 08/21/2020] [Indexed: 06/11/2023]
Abstract
Objective: The present study evaluated an intervention designed to introduce University students as potential users of Johannesburg's cycle lanes. Participants: A total of 393 undergraduate and postgraduate students from the University of Johannesburg took part. Methods: Following cycling and safety training, participants undertook a 1.2 km supervised cycle ride between University of Johannesburg campuses using loaned bicycles. The evaluation of the intervention drew on quantitative and qualitative data collected using participant questionnaires; and fieldworkers' photographic and reflective accounts. Results: Perceived cycling competency improved following the intervention, though similar proportions of participants became more and less interested in bicycle ownership (7-8%). The physical effort entailed; and flaws in the design and maintenance of cycle lanes (that affected utility and safety) were the strongest themes emerging from the qualitative analyses. Conclusions: The supervised cycle rides improved perceived cycling competency, but also enabled participants to reappraise the potential benefits and desirability of bicycle ownership.
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Affiliation(s)
- T De Wet
- CAT, University of Johannesburg, Gauteng, South Africa
| | | | - G T H Ellison
- CAT, University of Johannesburg, Gauteng, South Africa
- Centre for Data Innovation, University of Central Lancashire, Preston, UK
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Knight A, Charlton SG. Protected and unprotected cycle lanes' effects on cyclists' behaviour. Accid Anal Prev 2022; 171:106668. [PMID: 35413613 DOI: 10.1016/j.aap.2022.106668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/14/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
Previous research has suggested that in countries with low cycling rates, a barrier to cycling is the perception that cycling is unsafe. Unfortunately, this perception is accurate in many places, and protected cycle lanes have been advocated as a possible solution. Although some research shows that people tend to feel safer in them, there have been conflicting results regarding protected cycle lanes' safety benefits. Understanding the reasons protected cycle lanes may actually reduce safety is key to promoting active transport modes. One possible reason crash rates may increase is that cyclists may cycle faster in them due to either a decreased mental workload or from reduced perceptions of risk. In the present research, two studies were conducted to examine cyclists' speeds and perceptions of difficulty and safety in both protected and unprotected cycle lanes, as well as streets with no cycle lanes. The first study was an online questionnaire using short video clips from a cyclist's perspective, and the second study was an on-road experiment with a post-ride questionnaire. The studies found that cyclists felt safer with protected cycle lanes, were more willing to allow their children to bike on them and showed less concern towards hazards. There was no evidence of decreased attentional demand while using the protected cycle lanes, but there was some evidence of higher maximum cycling speeds.
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20
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Gilna GP, Stoler J, Saberi RA, Baez AC, Ramsey WA, Huerta CT, O'Neil CF, Rattan R, Perez EA, Sola JE, Thorson CM. Analyzing pediatric bicycle injuries using geo-demographic data. J Pediatr Surg 2022; 57:915-917. [PMID: 35109994 DOI: 10.1016/j.jpedsurg.2021.12.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/29/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Bicycle accidents are potentially preventable, and helmets can mitigate the severity of injuries. The purpose of the study it to investigate geo-demographic areas to establish prevention policies and targeted programs. METHODS From October 2013 to March 2020 all bicycle injuries at a Level 1 trauma center were collected for ages ≤18 years. Demographics, injuries, and outcomes were analyzed. Incidents were aggregated to zip codes and the Local Indicators of Spatial Association (LISA) statistic was used to test for spatial clustering of injury rates per 10,000 children. RESULTS Over the 8-year time period, 77 cases were identified with an average age of 13±4 years, 83% male and 48% non-Hispanic white. The majority of patients (98%) were not wearing a helmet. Loss of consciousness was reported in 44% and 21% sustained a traumatic brain injury. Twenty-eight percent required ICU care and 36% required operative interventions. There was only 1 mortality in the cohort (<1%).Injuries were more common in lower household income zip codes (Figure 1). Six zip codes encompassing several interstate exits and the connected heavy-traffic roadways comprise a statistically significant cluster of pediatric bicycle accidents (Figure 1). CONCLUSION Low-income neighborhoods and those near major roadways held the highest risk for pediatric bicycle accidents. Use of helmets was extremely low in the patient population, with high rates of traumatic brain injury. With this information, targeted programs to address high-risk intersections, helmet access, and safety education can be implemented locally.
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Affiliation(s)
- Gareth P Gilna
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Justin Stoler
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, Florida, USA
| | - Rebecca A Saberi
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adriana C Baez
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, Florida, USA
| | - Walter A Ramsey
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, Florida, USA
| | - Carlos T Huerta
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, Florida, USA
| | - Christopher F O'Neil
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, Florida, USA
| | - Rishi Rattan
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, Florida, USA
| | - Eduardo A Perez
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan E Sola
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Chad M Thorson
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Terashima T, Kato K, Oga R, Takubo N, Mizuno K. Experimental study on car collisions with bicycles equipped with child seats. Accid Anal Prev 2022; 166:106535. [PMID: 34953429 DOI: 10.1016/j.aap.2021.106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 11/07/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
In Japan, traffic accidents involving bicycles have become a serious problem as a result of the increase in the use of bicycles due to the rising concerns of environmental and health problems. In recent years, bicycles equipped with child seats have become a popular means of transportation for preschool children in urban areas in Japan. Under such adverse circumstances, it is necessary to conduct more studies and evaluations to prevent traffic accidents and the resulting injuries involving bicycles with children. For accident prevention and damage mitigation, this study mainly aims to understand the kinematic behavior and injury risk of children in collisions involving bicycles equipped with child seats through experiments. First, fall tests were conducted to evaluate the effect of the integrated head restraints (also commonly known as headrests) of child seats. It was confirmed that head restraints can reduce the impact of head collisions with the road surface. Second, side collision tests were conducted between a car and a bicycle equipped with a child seat, and the effects of the seat belt and head restraint of the child seat were investigated. It was shown that the kinematic behavior of the child dummy significantly was changed depending on wearing the seat belt. In the condition that the seat belt was not fastened, the child dummy was ejected out of the child seat while rotating toward the hood after the impact with the front of the car. In contrast, when the seat belt was fastened, the child dummy was restrained in the child seat and moved together with the bicycle from the start of the collision until the complete stop. Thus, it was found that using child seats with head restraints and using seat belts can reduce the risk of injury to children during an impact with the road surface, because the child dummy in the tests impacted the road surface only after the bicycle already had contact with the road surface.
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Affiliation(s)
- Takaaki Terashima
- National Research Institute of Police Science, 6-3-1, Kashiwanoha, Kashiwa-shi, Chiba 277-0882, Japan; Nagoya University, Graduate School of Engineering, Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan.
| | - Kenshiro Kato
- National Research Institute of Police Science, 6-3-1, Kashiwanoha, Kashiwa-shi, Chiba 277-0882, Japan
| | - Ryo Oga
- National Research Institute of Police Science, 6-3-1, Kashiwanoha, Kashiwa-shi, Chiba 277-0882, Japan
| | - Nobuaki Takubo
- National Research Institute of Police Science, 6-3-1, Kashiwanoha, Kashiwa-shi, Chiba 277-0882, Japan
| | - Koji Mizuno
- Nagoya University, Department of Mechanical Science and Engineering, Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan
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22
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Kalski L, Wannack M, Wiegand S, Wolfarth B. Comparison of two methods of cardiopulmonary exercise testing for assessing physical fitness in children and adolescents with extreme obesity. Eur J Pediatr 2022; 181:2389-97. [PMID: 35277735 DOI: 10.1007/s00431-022-04434-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/02/2023]
Abstract
It is well-known that children and adolescents with obesity have increased over recent decades which in turn carries greater risk of co-morbidities and poses a preventive as well as a therapeutic challenge. Currently, there are limited recommendations available on proven methods for recording physical fitness in children and adolescents presenting with extreme obesity. In this study, twenty participants, aged 12-17 years, with a body mass index (BMI) above the 99.5th percentile, were comparatively assessed, using a correlation between their physical fitness on a bicycle (BC) and treadmill (TM) cardiopulmonary exercise testing (CPET) with a lactate diagnostic. The results of the BC and the TM were as follows: maximum heart rate (HRmax) 186.4 ± 8.6 beats per minute (bpm) vs. 190.8 ± 8.8 bpm, peak oxygen consumption (VO2peak/kg) 23.5 ± 2.9 ml/min/kg vs. 25.4 ± 3.1 ml/min/kg, and maximum lactate (Lamax) 6.4 ± 1.6 mmol/l vs. 5.6 ± 1.4 mmol/l. The values of HRmax and VO2peak/kg were significantly higher for adolescents tested on the TM. However, no significant difference was observed in either Lamax values or between the genders. Conclusions: The higher values of HRmax and VO2peak/kg could be attributed to the activation of a higher percentage of muscle mass on the TM. Lower Lamax values on the TM suggest maximum physical exertion was not achieved. This could be due to the extreme body weight carried by the participants. Both the BC and the TM CPET could be used for assessing physical fitness in children and adolescents with extreme obesity but should not be used interchangeably. What is Known: • Currently, there are only limited recommendations available on proven methods for recording physical fitness in children and adolescents with extreme obesity available. What is New: • Cardiopulmonary exercise testing with maximum physical exertion has been shown to be feasible in children and adolescents with extreme obesity. The results obtained from this study demonstrated that both a bicycle and a treadmill can be effectively used for assessing the physical fitness levels in children and adolescents with extreme obesity.
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Lopez D, Malloy LC, Arcoleo K. Police narrative reports: Do they provide end-users with the data they need to help prevent bicycle crashes? Accid Anal Prev 2022; 164:106475. [PMID: 34798566 DOI: 10.1016/j.aap.2021.106475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/19/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
Bicycles gained significant popularity among Americans in 2020. Greater investment in adequate bicycle safety facilities will be needed. Crash data from police will undoubtedly play a role in decision-making. This research evaluated the data quality of text narratives in police reports on bicycle crashes. The aims were to identify situations in which police officers wrote more detail in the narrative text, investigate if longer reports translate to more in-depth crash descriptions, examine the extent to which narrative texts cover details useful for those charged with bicycle safety. This is a 4-year retrospective cohort study of vehicle-vs-bicycle crashes that occurred between January 1, 2009, and December 31, 2012, in Boston, Massachusetts (USA). Police reports were matched with the Pedestrian and Bicycle Crash Analysis Tool (PBCAT) to measure how much information was captured and when reports were more likely to capture more information. Police reports only captured most information in one area of the standardized form (Crash Typing), with average total missingness of over 75%. Longer reports did reduce the amount of missingness, and officers were more likely to write longer reports when they were on the crash site, when there was an injury, when the crash involved an extended car door, and during the day. A 100% increase in the report's words was associated with a four-percentage point reduction in PBCAT missingness. While longer reports result in less missingness when measured against the standardized crash form, the average report still misses most of the information that the form would capture. We recommend that police departments adopt a standardized form to facilitate information capture at the scene of bicycle-vehicle crashes.
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Affiliation(s)
| | - Liam C Malloy
- Department of Economics, University of Rhode Island, USA
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Désiré J, Foucart Q, Poveda A, Gourlaouen G, Shimadate Y, Kise M, Proceviat C, Ashmus R, Vocadlo DJ, Jiménez-Barbero J, Kato A, Blériot Y. Synthesis, conformational analysis and glycosidase inhibition of bicyclic nojirimycin C-glycosides based on an octahydrofuro[3,2-b]pyridine motif. Carbohydr Res 2021; 511:108491. [PMID: 34953389 DOI: 10.1016/j.carres.2021.108491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022]
Abstract
A set of bicyclic iminosugar C-glycosides, based on an octahydrofuro[3,2-b]pyridine motif, has been synthesized from a C-allyl iminosugar exploiting a debenzylative iodocycloetherification and an iodine nucleophilic displacement as the key steps. The halogen allowed the introduction of a range of aglycon moieties of different sizes bearing several functionalities such as alcohol, amine, amide and triazole. In these carbohydrate mimics the fused THF ring forces the piperidine to adopt a flattened 4C1 conformation according to NMR and DFT calculations studies. In their deprotected form, these bicycles were assayed on a panel of 23 glycosidases. The iminosugars displaying hydrophobic aglycon moieties proved to be superior glycosidase inhibitors, leading to a low micromolar inhibition of human lysosome β-glucosidase (compound 11; IC50 = 2.7 μM) and rice α-glucosidase (compound 10; IC50 = 7.7 μM). Finally, the loose structural analogy of these derivatives with Thiamet G, a potent OGA bicyclic inhibitor, was illustrated by the weak OGA inhibitory activity (Ki = 140 μM) of iminosugar 5.
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Affiliation(s)
- Jérôme Désiré
- Université de Poitiers, IC2MP, UMR CNRS 7285, Equipe "Synthèse Organique", Groupe Glycochimie, 4 rue Michel Brunet, 86073, Poitiers Cedex 9, France.
| | - Quentin Foucart
- Université de Poitiers, IC2MP, UMR CNRS 7285, Equipe "Synthèse Organique", Groupe Glycochimie, 4 rue Michel Brunet, 86073, Poitiers Cedex 9, France
| | - Ana Poveda
- CIC bioGUNE, Parque technologico de Bizkaia, Edif. 801A-1°, Derio-Bizkaia 48160, and Ikerbasque, Basque Foundation for Science, Maria Lopez de Haro 3, 48013, Bilbao, Spain
| | - Gurvan Gourlaouen
- Université de Poitiers, IC2MP, UMR CNRS 7285, Equipe "Synthèse Organique", Groupe Glycochimie, 4 rue Michel Brunet, 86073, Poitiers Cedex 9, France
| | - Yuna Shimadate
- Department of Hospital Pharmacy, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Maki Kise
- Department of Hospital Pharmacy, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Cameron Proceviat
- Department of Chemistry, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada, V5S 1P6
| | - Roger Ashmus
- Department of Chemistry, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada, V5S 1P6
| | - David J Vocadlo
- Department of Chemistry, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada, V5S 1P6
| | - Jesús Jiménez-Barbero
- CIC bioGUNE, Parque technologico de Bizkaia, Edif. 801A-1°, Derio-Bizkaia 48160, and Ikerbasque, Basque Foundation for Science, Maria Lopez de Haro 3, 48013, Bilbao, Spain
| | - Atsushi Kato
- Department of Hospital Pharmacy, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Yves Blériot
- Université de Poitiers, IC2MP, UMR CNRS 7285, Equipe "Synthèse Organique", Groupe Glycochimie, 4 rue Michel Brunet, 86073, Poitiers Cedex 9, France.
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Holliday W, Swart J. A Dynamic Approach to Cycling Biomechanics. Phys Med Rehabil Clin N Am 2022; 33:1-13. [PMID: 34798992 DOI: 10.1016/j.pmr.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cycling biomechanics is a complex analysis of the cyclist and the bicycle. It is important to assess the cyclist dynamically because kinematics and muscle patterns are influenced by their type of riding and fatigue and intensity. Intrinsic factors such as anthropometrics and flexibility should guide the initial bicycle configuration. Static kinematics are a valid and reliable tool in the process of bike fitting, providing an initial fast and cost-effective method of assessing the cyclist. Dynamic assessment methods should then be used to fine tune the bicycle configuration according to the specific needs and workloads of the cyclist.
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Robidoux CG. A Practical Approach to the Evaluation of a Cyclist with Overuse Injury. Phys Med Rehabil Clin N Am 2021; 33:15-29. [PMID: 34798996 DOI: 10.1016/j.pmr.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cycling has grown in popularity over the past 20 to 30 years, serving as transportation, fitness, and sport. Cycling is unique for several reasons: it is a non-weight-bearing sport, nearly all of the motion is in the sagittal plane, and it is one of the only sports where an individual remains attached to a machine for a long duration. As such, the cycling athlete has unique needs compared with other endurance-based athletes. The complex biomechanical interaction of bicycle and rider requires a systematic process for assessment, which provides the framework for understanding, evaluating, and treating overuse injury in cyclists.
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Affiliation(s)
- C Greg Robidoux
- Cycling Medicine Program, Outpatient Physical Therapy, Spaulding Rehabilitation Hospital, Wellesley, MA, USA.
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Kotler DH, Cushman DM, Rice S, Gilbert C, Bhatnagar S, Robidoux CG, Iaccarino MA. Fear, Anxiety, and Return to Sport After Cycling Crashes: A Survey of Cyclists. Phys Med Rehabil Clin N Am 2021; 33:107-122. [PMID: 34798993 DOI: 10.1016/j.pmr.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
After cycling crashes, orthopedic and neurologic complaints are often the focus of evaluation and management. However, the trauma sustained may not be limited to physical injury; psychological issues brought on by or comorbid with the crash also warrant treatment. In this original research, we evaluated the presence of fear or anxiety after cycling crashes and examined factors associated with this mechanism of injury through a survey. Post-crash fear or anxiety was associated with female gender, a history of depression, and greater crash severity. Few cyclists received treatment and most returned to cycling at their previous level, but the timeline varied.
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Affiliation(s)
- Dana H Kotler
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA; Spaulding Outpatient Center-Wellesley, Wellesley, MA, USA; Newton-Wellesley Hospital, Newton, MA, USA.
| | - Daniel M Cushman
- Division of Physical Medicine and Rehabilitation, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Sarah Rice
- Athletico Physical Therapy, Chicago, IL, USA
| | | | - Saurabha Bhatnagar
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA; US Department of Veterans Affairs, 1722 I St NW, Washington, DC, USA
| | - C Greg Robidoux
- Spaulding Outpatient Center-Wellesley, Wellesley, MA, USA. https://twitter.com/thecyclingpt
| | - Mary Alexis Iaccarino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA. https://twitter.com/iaccarinomd
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De Wet T, Dzinotyiweyi T, Ellison GTH. How might bicycle ownership/access and cycling expertise influence the design of cycling promotion interventions at the University of Johannesburg? J Am Coll Health 2021; 69:842-850. [PMID: 31995454 DOI: 10.1080/07448481.2020.1711761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 11/19/2019] [Accepted: 12/30/2019] [Indexed: 06/10/2023]
Abstract
Objective: The present study examined potential barriers to cycle-based transport amongst undergraduate students, to inform the design of future cycling promotion interventions at the University of Johannesburg (UJ). Participants: A total of 606 first, second and third year UJ undergraduates took part. Methods: Sociodemographic and economic determinants of bicycle/car ownership, cycling competency and behavior were evaluated using data derived from a 9-item questionnaire, before and after adjustment for measured confounders. Results: While 70% of respondents knew how to cycle, only 26% owned/had access to a bicycle, and only 18% had last cycled for transport. Bicycle ownership and competency were far commoner amongst male and older participants, and those whose parents had the means to own a car. Conclusions: Interventions to promote cycle-based transport must address the many (predominantly female) students who: have limited cycling competency; do not own/have access to a bicycle; or have little/no experience of cycling for transport.
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Affiliation(s)
- T De Wet
- CAT, University of Johannesburg, Gauteng, South Africa
| | | | - G T H Ellison
- CAT, University of Johannesburg, Gauteng, South Africa
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), and Leeds Institute for Data Analytics (LIDA), University of Leeds, Leeds, UK
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Bini R, Priego-Quesada J. Methods to determine saddle height in cycling and implications of changes in saddle height in performance and injury risk: A systematic review. J Sports Sci 2021; 40:386-400. [PMID: 34706617 DOI: 10.1080/02640414.2021.1994727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of this systematic review was to assess the methods to determine bicycle saddle height and the effects of saddle height on cycling performance and injury risk outcomes. The key motivator of this review was to update and expand the finding reported by a previous narrative review published in 2011. The literature search included all documents from the following databases: Medline, Scopus, CINAHL, OVID and Google Scholar. Studies were screened against the Appraisal tool for Cross-sectional Studies to assess methodological quality and risk of bias. After screening the initial 29,398 articles identified, full-text screening was performed on 66 studies with 41 of these included in the systematic review. Strong evidence suggests that saddle height should be configured using dynamic measurements of the knee angle, and limb kinematics is influenced by changes in saddle height. However, moderate evidence suggests that changes in saddle height less than 4% of the leg length results in trivial to small changes in lower limb loads, and no effect on oxygen uptake and efficiency. It is also possible to state that there is limited evidence on the effects from changes in saddle height on supramaximal cycling performance or injury risk.
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Affiliation(s)
- Rodrigo Bini
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia.,Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Jose Priego-Quesada
- Research Group in Sports Biomechanics (Gibd), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
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Choi Y, Lee DH, Lee JI. Patterns and clinical outcomes of injuries related to two-wheeled vehicles ( bicycle and motorcycle) in the geriatric population: a nationwide analysis in South Korea (2016-2018). BMC Geriatr 2021; 21:603. [PMID: 34702189 PMCID: PMC8546953 DOI: 10.1186/s12877-021-02505-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background South Korea has a rapidly ageing population. This study aimed to provide epidemiologic data and to identify the characteristics of the patterns and clinical outcomes of two-wheeled vehicle-related injuries (bicycle and motorcycle) in elderly riders. Methods This study retrospectively analyzed data from the National Emergency Department Information System from 2016 to 2018. Adult patients (≥ 20 years old) who were injured while using two-wheeled vehicles were included. Elderly patients were defined as being 65 years and older. The analysis was performed for 65,648 bicycle-related injuries (15,272 elderly patients) and 87,855 motorcycles-related injuries (17,292 elderly patients). Results In emergency departments (EDs), the average injury severity score (ISS) for motorcycle-related accidents was 9.8 ± 11.2 in the younger group and 14.1 ± 14.7 in the elderly group (p = 0.001). In addition, the average ISS of bicycle-related accidents was 7.1 ± 8.9 in the younger group and 10.5 ± 12.3 in the elderly group (p = 0.001). Two-wheeled vehicle accident mortality rates of elderly riders (0.9% for bicycle and 1.8% for motorcycle in the ED; 4.1% for bicycle and 3.8% for motorcycle in the hospital) were more than twice those of younger riders. The elderly stayed in the hospital longer than younger patients (485.2 ± 543.0 h vs 336.8 ± 385.5 h, p = 0.001) for bicycle-related injuries. They also stayed longer for motorcycle-related injuries (529 ± 598.6 h vs 452.0 ± 543.55 h, p = 0.001). The logistic regression analysis showed that age ≥ 65 years was an independent factor associated with severe trauma (ISS ≥ 16) for both bicycle-related injuries (adjusted odds ratio [OR] 2.185 [95% Confidence Interval (CI) 2.072–2.303]) and motorcycle-related injuries (adjusted OR 1.220 [95% CI 1.137–1.287]). Conclusion Two-wheeled vehicle-related injuries in the elderly were associated with higher ISS, length of hospital stay, and mortality than in younger riders. Analysing the characteristics of two-wheeled vehicle-related injuries in the elderly can be the basis for planning to reduce and prevent injuries in elderly riders.
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Affiliation(s)
- Yoonhyung Choi
- Department of Emergency Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Duk Hee Lee
- Department of Emergency Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Jung Il Lee
- Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.
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Gülses A, Klingauf L, Emmert M, Karayürek F, Naujokat H, Acil Y, Wiltfang J, Spille J. Injury patterns and outcomes in bicycle-related maxillofacial traumata: A retrospective analysis of 162 cases. J Craniomaxillofac Surg 2021; 50:70-75. [PMID: 34620537 DOI: 10.1016/j.jcms.2021.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/27/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022] Open
Abstract
The objective of the current study is to retrospectively evaluate cycling related dental and maxillofacial injuries and to gain insight into the epidemiology and results of these accidents. Data of patients who were admitted due to the maxillofacial injuries between April 2018 and September 2020 were retrospectively evaluated regarding the patients' characteristics, helmet wearing, type of radiological assessment required for diagnosis and therapy, injury patterns, duration of hospitalization and concomitant injuries. Data of 162 patients were included. 86 (53.08%) patients presented with at least one maxillofacial fracture. A total of 186 maxillofacial bones were fractured. Zygomatico-maxillary complex was the most commonly affected region (n:103, 55,36%). Analysis of the dental traumata revealed that crown fracture without pulp exposure was the most commonly observed entity (n:37, 32.46%) and upper central incisors (n:61, 53.50%) were the most commonly affected teeth. The overall ratio of the number of the fracture line/fracture case was 2.80. However, this ratio was statistically higher in e-bike cases (4.25) compared to non-e-bike riders (2.34) (p:0.014). Bicycle related maxillofacial injuries could correlate with specific morbidity rates and result in severe injuries of the maxillofacial region.
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Affiliation(s)
- Aydin Gülses
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany.
| | - Livia Klingauf
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany
| | - Marie Emmert
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany
| | - Fatih Karayürek
- Cankiri Karatekin University, Department of Periodontology, Cankiri, Turkey
| | - Hendrik Naujokat
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany
| | - Yahya Acil
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany
| | - Jörg Wiltfang
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany
| | - Johannes Spille
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany
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Standen C, Crane M, Greaves S, Collins AT, Rissel C. How equitable are the distributions of the physical activity and accessibility benefits of bicycle infrastructure? Int J Equity Health 2021; 20:208. [PMID: 34526041 PMCID: PMC8444547 DOI: 10.1186/s12939-021-01543-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cycling for transport provides many health and social benefits - including physical activity and independent access to jobs, education, social opportunities, health care and other services (accessibility). However, some population groups have less opportunity to reach everyday destinations, and public transport stops, by bicycle - owing in part to their greater aversion to riding amongst motor vehicle traffic. Health equity can therefore be improved by providing separated cycleway networks that give more people the opportunity to access places by bicycle using traffic-free routes. The aim of this study was to assess the health equity benefits of two bicycle infrastructure development scenarios - a single cycleway, and a complete network of cycleways - by examining the distributions of physical activity and accessibility benefits across gender, age and income groups. METHODS Travel survey data collected from residents in Sydney (Australia) were used to train a predictive transport mode choice model, which was then used to forecast the impact of the two intervention scenarios on transport mode choice, physical activity and accessibility. The latter was measured using a utility-based measure derived from the mode choice model. The distributions of the forecast physical activity and accessibility benefits were then calculated across gender, age and income groups. RESULTS The modelled physical activity and accessibility measures improve in both intervention scenarios. However, in the single cycleway scenario, the benefits are greatest for the male, high-income and older age groups. In the complete network scenario, the benefits are more equally distributed. Forecast increases in cycling time are largely offset by decreases in walking time - though the latter is typically low-intensity physical activity, which confers a lesser health benefit than moderate-intensity cycling. CONCLUSIONS Separated cycleway infrastructure can be used to improve health equity by providing greater opportunities for transport cycling in population groups more averse to riding amongst motor vehicle traffic. Disparities in the opportunity to access services and economic/social activities by bicycle - and incorporate more physical activity into everyday travel - could be addressed with connected, traffic-free cycleway networks that cater to people of all genders, ages and incomes.
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Affiliation(s)
- Christopher Standen
- Centre for Primary Health Care and Equity, School of Population Health, University of New South Wales, Kensington, NSW 2052 Australia
- Health Equity Research and Development Unit, Sydney Local Health District, Missenden Road, PO Box M30, Camperdown, NSW 2050 Australia
| | - Melanie Crane
- Sydney School of Public Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006 Australia
| | - Stephen Greaves
- Institute of Transport and Logistics Studies, The University of Sydney Business School, The University of Sydney, Darlington, NSW 2006 Australia
| | - Andrew T. Collins
- Institute of Transport and Logistics Studies, The University of Sydney Business School, The University of Sydney, Darlington, NSW 2006 Australia
| | - Chris Rissel
- Sydney School of Public Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006 Australia
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Yasmin S, Bhowmik T, Rahman M, Eluru N. Enhancing non-motorist safety by simulating trip exposure using a transportation planning approach. Accid Anal Prev 2021; 156:106128. [PMID: 33915343 DOI: 10.1016/j.aap.2021.106128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/23/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
Traditionally, in developing non-motorized crash prediction models, safety researchers have employed land use and urban form variables as surrogate for exposure information (such as pedestrian, bicyclist volumes and vehicular traffic). The quality of these crash prediction models is affected by the lack of "true" non-motorized exposure data. High-resolution modeling frameworks such as activity-based or trip-based approach could be pursued for evaluating planning level non-motorist demand. However, running a travel demand model system to generate demand inputs for non-motorized safety is cumbersome and resource intensive. The current study is focused on addressing this drawback by developing an integrated non-motorized demand and crash prediction framework for mobility and safety analysis. Towards this end, we propose a three-step framework to evaluate non-motorists safety: (1) develop aggregate level models for non-motorist generation and attraction at a zonal level, (2) develop non-motorists trip exposure matrices for safety evaluation and (3) develop aggregate level non-motorists crash frequency and severity proportion models. The framework is developed for the Central Florida region using non-motorist demand data from National Household Travel Survey (2009) Florida Add-on and non-motorist crash frequency and severity data from Florida. The applicability of the framework is illustrated through extensive policy scenario analysis.
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Affiliation(s)
- Shamsunnahar Yasmin
- Queensland University of Technology (QUT), Centre for Accident Research & Road Safety - Queensland (CARRS-Q), Australia & Research Affiliate, Department of Civil, Environmental & Construction Engineering, University of Central Florida, USA.
| | - Tanmoy Bhowmik
- Department of Civil, Environmental & Construction Engineering, University of Central Florida, USA.
| | | | - Naveen Eluru
- Department of Civil, Environmental & Construction Engineering, University of Central Florida, USA.
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Shah NR, Aryal S, Wen Y, Cherry CR. Comparison of motor vehicle-involved e-scooter and bicycle crashes using standardized crash typology. J Safety Res 2021; 77:217-228. [PMID: 34092312 DOI: 10.1016/j.jsr.2021.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/28/2020] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The market share of e-scooters in the United States has proliferated in cities: 86 million trips were made on shared e-scooters in 2019, a more than 100% increase compared to 2018. However, the interaction of e-scooters with other road users and infrastructure remains uncertain. METHOD This study scrutinized 52 e-scooter and 79 bicycle police-reported crashes in Nashville, Tennessee, from April 2018 to April 2020 from the Tennessee Integrated Traffic Analysis Network (TITAN) database. We used descriptive analysis and a recent prototype version of the Pedestrian and Bicycle Crash Analysis Tool (PBCAT) to classify crashes based on the locations of the crashes relative to roadway segments or intersections, as well as the maneuver of the motor vehicle and e-scooter/bicycle relative to the motor vehicle. RESULTS Two crash typologies can explain the majority of e-scooter crashes, while bicycle crashes are distributed over several crash typologies. Additionally, 1 in 10 e-scooter- and bicycle-motor vehicle crashes leads to the injury or fatality of the e-scooter rider or bicyclist. Furthermore, we noted statistically significant differences in spatial and temporal distribution, demographics, lighting conditions, and crash distance from home for e-scooter and bicycle crashes. CONCLUSIONS The police crash report provides a comprehensive picture of e-scooter safety complementing existing literature. We found that e-scooter crash characteristics do not fully overlap with features of bicycle crashes. PRACTICAL IMPLICATIONS A generalized engineering, education, and enforcement treatment to reduce and prevent e-scooter and bicycle crashes, injuries, and fatalities might not result in equal outcomes for each mode. More rigorous enforcement could be implemented to deter e-scooters riders under the age of 18 years and e-scooter safety campaigns could target female riders.
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Affiliation(s)
- Nitesh R Shah
- Civil and Environmental Engineering, University of Tennessee, Knoxville, TN, United States.
| | - Sameer Aryal
- Civil and Environmental Engineering, University of Tennessee, Knoxville, TN, United States.
| | - Yi Wen
- Civil and Environmental Engineering, University of Tennessee, Knoxville, TN, United States.
| | - Christopher R Cherry
- Civil and Environmental Engineering, University of Tennessee, Knoxville, TN, United States.
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Higuera-Mendieta D, Uriza PA, Cabrales SA, Medaglia AL, Guzman LA, Sarmiento OL. Is the built-environment at origin, on route, and at destination associated with bicycle commuting? A gender-informed approach. J Transp Geogr 2021; 94:None. [PMID: 34305337 PMCID: PMC8283281 DOI: 10.1016/j.jtrangeo.2021.103120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
There is limited evidence on the gender differences and location-specific built-environment factors associated with bicycling in Latin American cities. This study aimed to assess commuting in Bogotá by (1) analyzing the gender-specific trend of the standardized number of bicycle commuters during 2005-2017; and (2) assessing the socio-demographic, community, built-environment and natural factors associated with bicycle commuting stratified by gender. This secondary-data analysis included data from the Household Travel Surveys and Multipurpose Surveys to calculate the number of bicycle commuters per habitant from 2005 to 2017 by gender. We assessed the socio-demographic and built-environment factors fitting generalized additive models stratified by gender using the 2015 Household Travel Survey. Although both women and men increased the standardized number of bicycle commuters, male commuters show a steeper trend than women, evidencing the widening gender gap in bicycle commuting over time. Bicycle commuting was negatively associated with household motor vehicle ownership, steeper terrain slope, longer commute distance, and scarce low-stress roads at trip origin and route. Among women, the availability of bike paths at the trip destination was positively associated with bicycling, while age and being a student were negatively associated with bicycling. Among men, living in areas with the lowest socio-economic status was positively associated with bicycling, while having a driver's license and living close to bus rapid transit stations were negatively associated with bicycling. In conclusion, bicycle and transport infrastructure play different roles in commuting by bicycle by gender and trip stages (origin - route - destination).
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Affiliation(s)
| | - Pablo Andrés Uriza
- Department of Industrial Engineering, Center for Optimization and Applied Probability, Universidad de los Andes, Bogotá, Colombia
- Industrial Engineering Program, School of Exact Sciences and Engineering, Universidad Sergio Arboleda, Bogotá, Colombia
| | - Sergio A. Cabrales
- Department of Industrial Engineering, Center for Optimization and Applied Probability, Universidad de los Andes, Bogotá, Colombia
| | - Andrés L. Medaglia
- Department of Industrial Engineering, Center for Optimization and Applied Probability, Universidad de los Andes, Bogotá, Colombia
| | - Luis A. Guzman
- Department of Civil and Environmental Engineering, Grupo de Estudios en Sostenibilidad Urbana y Regional – SUR, Universidad de los Andes, Bogotá, Colombia
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Hirose T, Takada T, Oikawa S, Matsui Y. Validation of driver support system based on real-world bicycle and motor vehicle flows. Accid Anal Prev 2021; 156:106131. [PMID: 33873133 DOI: 10.1016/j.aap.2021.106131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/11/2021] [Accepted: 04/07/2021] [Indexed: 06/12/2023]
Abstract
The incidence of traffic accidents in Japan has been decreasing annually. Nineteen percent of all accidents involve bicycles, with 51 % of these accidents being at road crossing intersections. Therefore, to reduce the number of accidents, this study analyses driving and cycling characteristics and proposes suitable collisions prevention methods. First, the study measured traffic environment variables using video cameras at a target non-signalized intersection and analyzed the speed and time to intersection of bicycles and motor vehicles. Thus, 47 dangerous situations were observed via the video analysis, and most of these situations occurred when the vehicle's time to intersection ranged from 0.50 to 0.75 s and the bicycle's speed ranged from 2.0-3.0 m/s. Second, using the results of video camera analysis as experimental parameters (e.g., the speed and timing of the presence of the bicycle), this study conducted an experiment with a driving simulator to investigate the effect of warning drivers about the risk of collision. A driver support system was then utilized to provide acoustic and optical warnings to drivers. The experiments revealed that the motor vehicle time to the anticipated collision point (V-TTC) increased with the use of a driver support system. Significant differences between experiments with and without driver support systems were observed when the calculated time between the bicycle and the motor vehicle was 0.25 and 0.50 s. Therefore, when the calculated time was 0.25 and 0.50 s, a driver support system, indicating the presence of a bicycle, was effective in preventing an intersection collision.
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Affiliation(s)
- Toshiya Hirose
- Department of Engineering Science and Mechanics, Shibaura Institute of Technology, 3‑7‑5 Toyosu, Koto‑ku, Tokyo 135‑8548, Japan; Human Machine System Laboratory, Shibaura Institute of Technology, 3‑7‑5 Toyosu, Koto‑ku, Tokyo 135‑8548, Japan.
| | - Takumi Takada
- Human Machine System Laboratory, Shibaura Institute of Technology, 3‑7‑5 Toyosu, Koto‑ku, Tokyo 135‑8548, Japan.
| | - Shoko Oikawa
- Faculty of System Design, Tokyo Metropolitan University, 6-6, Asahigaoka, Hino-shi, Tokyo, 191-0065, Japan.
| | - Yasuhiro Matsui
- National Traffic Safety and Environment Laboratory, 7-42-27 Jindaiji-Higashi-machi, Chofu, Tokyo, 182-0012, Japan.
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Chandia-Poblete D, Hill RL, Aguilar-Farias N, Heesch KC. Individual and contextual factors associated with bicyclist injury severity in traffic incidents between bicyclists and motorists in Chile. Accid Anal Prev 2021; 154:106077. [PMID: 33721730 DOI: 10.1016/j.aap.2021.106077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/21/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
Bicyclists are vulnerable road users who risk incurring severe injuries from traffic incidents involving motorists. However, the prevalence of severe bicycle injuries varies across countries and is not well-documented in Latin American countries. Studies from developed countries outside of Latin America have shown that individual and contextual factors are associated with severe injuries incurred by bicyclists in road traffic incidents with motorists, but it is not clear whether these factors are the same as those incurred by Latin American bicyclists. Moreover, most studies on bicyclist-motorist traffic incidents have treated injury severity as a binary variable for analysis although injuries range widely in severity. The aims of this study were to determine the prevalence of bicycle injuries from incidents between motorists and bicyclists in Chile and examine the associations between individual and contextual factors and bicyclist injury severity, treated as an ordinal outcome variable, in these incidents. Data on road traffic incidents between bicyclists and motorists from the 2016 Traffic Accident of Bicycle Riders and Consequences database of the Chilean Transport Ministry were analysed. Multilevel mixed-effects ordinal regression models were used to examine associations. In total, 81.2 % of 4093 traffic incidents between bicyclists and motorists resulted in nonfatal injuries to bicyclists and another 2.3 % resulted in fatalities. Most incidents involved collisions (84.3 %), and most were due to a motorist being distracted while driving (50.4 %). Severe bicyclist injuries were more likely when the incident involved a stationary cyclist who was struck, a collision between a moving bicycle and a moving motor vehicle, or an overturning motor vehicle striking a bicyclist (p < 0.001). Other factors included the motorist driving under the influence of alcohol (p = 0.05), the incident taking place in a mid-size community (p = 0.04), the incident occurring between 7:00 pm and 4:59 am (p < 0.01), and the injured bicyclist being under 18 years or 45+ years of age (p < 0.05). These findings suggest the need for educational programs that promote safe driving behaviour in the presence of bicyclists, better enforcement of laws and higher penalties for distracted or drunk driving, and provision of high-quality exclusive bicyclist infrastructure to address the vulnerability of the youngest and oldest bicyclists on shared roads, particularly in mid-size communities, and to provide better lighting on bikeways for evening bicycling, to reduce the high incidence of severe bicyclist injuries in motorist-bicyclist incidents.
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Affiliation(s)
- Damian Chandia-Poblete
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Av Francisco Salazar 01145, 4780000, Chile; Queensland University of Technology (QUT), School of Public Health and Social Work, Victoria Park Road, Brisbane, 4059, Australia; Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation, 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia.
| | - Robert L Hill
- Queensland University of Technology (QUT), School of Public Health and Social Work, Victoria Park Road, Brisbane, 4059, Australia.
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Av Francisco Salazar 01145, 4780000, Chile; UFRO Activate Research Group, Universidad de La Frontera, Av Francisco Salazar 01145, Temuco, 4780000, Chile.
| | - Kristiann C Heesch
- Queensland University of Technology (QUT), School of Public Health and Social Work, Victoria Park Road, Brisbane, 4059, Australia; Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation, 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia.
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Abstract
The objective of this study was to evaluate whether bicycling infrastructure changes in the city of Minneapolis effectively reduced the incidence or severity of traumatic bicycling related injuries sustained by patients admitted to our Level 1 Trauma Center. Data for this retrospective cohort study was obtained from the trauma database at our institution and retrospective chart review. The total number of miles of bikeway in the city on a yearly basis was used to demonstrate the change in cycling infrastructure. Adjusted regression analysis demonstrated a significant reduction in ISS when total bike lane miles increased (Coef. − 0.04, P < 0.001). Increasing bike lane miles was also associated with a significant reduction in severe head injury (OR 0.99, P < 0.001) and ICU LOS (Coef. − 0.17, P = 0.013). The miles of bike lanes were not associated with any significant changes in mortality or mechanical ventilation days when adjusted for other factors. We were able to demonstrate a reduction in the severity of injuries incurred by cyclists in the setting of a significant increase in the total number of bicycle lane miles. Our data lends credence to the existing evidence that the addition of bicycle lane miles increases cyclist safety.
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Affiliation(s)
- Derek Goerke
- Department of Surgery, Hennepin Healthcare, 701 Park Ave S, P5, Minneapolis, MN, USA
| | - Emily Zolfaghari
- Department of Surgery, Hennepin Healthcare Research Institute, Minneapolis, MN, 55415, USA
| | - Ashley P Marek
- Department of Surgery, Hennepin Healthcare, 701 Park Ave S, P5, Minneapolis, MN, USA
| | - Frederick W Endorf
- Department of Surgery, Hennepin Healthcare, 701 Park Ave S, P5, Minneapolis, MN, USA
| | - Rachel M Nygaard
- Department of Surgery, Hennepin Healthcare, 701 Park Ave S, P5, Minneapolis, MN, USA.
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Lefarth TL, Poos HPAM, Juhra C, Wendt KW, Pieske O. [Pedelec users get more severely injured compared to conventional cyclists]. Unfallchirurg 2021. [PMID: 33665719 DOI: 10.1007/s00113-021-00976-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND For years e‑bike (Pedelec) sales have been steadily increasing. Therefore, the incidence of e‑bike-related injuries and deaths has been growing. Due to clinical experience, emergency personnel are suspecting that e‑bikers might be injured more severely compared to conventional bicyclists suffering from an accident. This topic has not yet been analyzed for Germany. OBJECTIVE Analysis of injury severity and mortality following e‑bike and conventional bicycle accidents in a level I trauma center in Germany. MATERIAL AND METHODS Data of patients treated after a bicycle accident at the accident and emergency department as well as the clinic for traumatology and orthopedics of the Evangelical Hospital (Evangelisches Krankenhaus) Oldenburg were gathered from 1 March 2017 to 1 March 2019. RESULTS In this study 59 electric bicycle users (e-bikers) and 164 conventional cyclists were included. The average age of e‑bikers was 62 years compared to 48 years in the group of conventional cyclists. Comorbidities were significantly more frequent in the e‑bike group compared to classical cyclists. The e‑bikers were found to be significantly more severely injured than conventional bicyclists, the mean injury severity scores (ISS) were 5.2 and 3.4, respectively. E‑bikers were admitted to the hospital more often and for longer periods than the control group. There was no significant difference in mortality. CONCLUSION E‑bikers are more severely injured in accidents compared to conventional cyclists. Due to older age and comorbidity they form a sensitive trauma subgroup. Based on demographics, an increase of old age, more frail cyclists and a growing incidence of serious e‑bike accidents is to be expected. Preventive measures, such as helmet usage and riding lessons should be introduced, especially in e‑bikers. E‑bikers in the emergency department should be examined and treated with special care and aggressive diagnostics. A low threshold for an initial interdisciplinary assessment (shock room management) is advised.
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Debnath AK, Haworth N, Heesch KC. Women cycling in Queensland: Results from an observational study. Accid Anal Prev 2021; 151:105980. [PMID: 33482496 DOI: 10.1016/j.aap.2021.105980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 11/13/2020] [Accepted: 01/05/2021] [Indexed: 06/12/2023]
Abstract
Women are less likely to ride than men in low cycling countries such as Australia. In Australia, self-reported cycling participation appears to be declining, particularly for women. This paper examines the rider and road environment correlates of women's cycling. While most earlier studies relied on self-report data to understand gender differences in cycling, this study video-recorded 24,868 riders (22 % female) at 17 sites across Queensland, Australia. The probabilities of an observed rider being female under different circumstances (e.g., speed limit, riding location, time of riding, group riding) at these sites were modelled in a binomial logistic regression framework. The likelihood of a rider being a woman was greater during the day (9am-8pm) than the early morning (5-9 a.m.); on weekends than on weekdays; in groups of two or more riders than among single riders; in lower speed zones than speed zones of 60 km/h or over; on roads with bike lanes or multiple traffic lanes or raised medians than on roads without these, and in urban areas than suburban areas. The likelihood of the rider being a woman was lower among those riding road bikes than other types of bicycles. The use of a naturalistic study design marks the key strength of this paper. Findings of this study should help better understand women's cycling patterns and preferred cycling locations, which cycling communities and organisations can use to advocate for better roads and paths that make female riders feel safe.
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Affiliation(s)
| | - Narelle Haworth
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety-Queensland, Kelvin Grove, 4059, Australia.
| | - Kristiann C Heesch
- Queensland University of Technology (QUT), School of Public Health and Social Work and Institute of Health & Biomedical Innovation, Kelvin Grove, 4059, Australia.
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Abrahams JM, Sagar C, Rickman M. The burden of cycling-related trauma to the orthopaedic and trauma department of a level 1 trauma hospital in Adelaide, South Australia. J Orthop Surg Res 2021; 16:127. [PMID: 33568171 PMCID: PMC7874032 DOI: 10.1186/s13018-021-02242-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/18/2021] [Indexed: 11/26/2022] Open
Abstract
Background With the fourth largest metropolitan population density, motor vehicle drivers in Adelaide, South Australia, record the most number of motor vehicle insurance claims in Australia. Previous studies have shown a rise in cycling-related emergency department presentations from 2005 to 2010. There is no specific data available specifically related to South Australia. Our institution is the largest level 1 trauma centre in South Australia and Northern Territory and has a local geographic pool of the central metropolitan region of Adelaide. The aims of this study were to establish the demographics of cycling-related presentations to our institution that involved the admission of a patient under the Orthopaedic and Trauma service. Secondary aims were to investigate whether there were any common variables among these presentations that could be modified to prevent or reduce the morbidity of cycling-related trauma. Methods A prospective study was performed at our institution from 1 March 2018 until 31 December 2019 of all inpatient admissions under the Orthopaedics and Trauma department, where the patient was injured as a cyclist. We collated patient-reported information about the accident and their cycling habits. Results One hundred and ten patients were included in the study. One hundred and thirty-one injuries were recorded, requiring 89 surgical procedures. Eighty were upper limb injuries (61%), 49 were lower limb (37%), and 2 injuries occurred in either the spine or ribs. The most common reason for the accident was excessive cyclist speed. Conclusions The majority of cyclists admitted to our unit with orthopaedic injuries were male patients who assessed themselves as experienced riders, and yet still were involved in accidents that resulted predominantly from episodes of poor judgement. Speed is a common and avoidable factor involved in the presentation of orthopaedic-related trauma to the public system. Involvement of other vehicles was relatively uncommon, as was poor weather; upper limb injuries predominate in this group.
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Affiliation(s)
- John M Abrahams
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia. .,Discipline of Orthopaedics and Trauma, Faculty of Health Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia. .,Centre for Orthopaedic & Trauma Research (COTR), Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Christopher Sagar
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Mark Rickman
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Orthopaedics and Trauma, Faculty of Health Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.,Centre for Orthopaedic & Trauma Research (COTR), Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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Wagstaff JM, Balmforth M, Lewis N, Dods R, Rowland C, van Rietschoten K, Chen L, Harrison H, Skynner MJ, Dawson M, Ivanova-Berndt G, Beswick P. An Assay for Periplasm Entry Advances the Development of Chimeric Peptide Antibiotics. ACS Infect Dis 2020; 6:2355-2361. [PMID: 32697574 DOI: 10.1021/acsinfecdis.0c00389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The treatment of infection by Gram-negative bacteria is increasingly challenging as resistance to existing antibiotics spreads. Constrained peptides, selected for high target specificity and affinity via library display technologies, are an emerging therapeutic modality in many disease areas and may be a fertile source of new antibiotics. Currently, the utility of constrained peptides and other large molecules as antibiotics is limited by the outer membrane (OM) barrier of Gram-negative bacteria. However, the addition of certain moieties to large molecules can confer the ability to cross the OM; these moieties function as intramolecular trans-OM "vectors". Here, we present a method to systematically assess the carrying capacity of candidate trans-OM vectors using a real-time luminescence assay ("SLALOM", Split Luciferase Assay for Live monitoring of Outer Membrane transit), reporting on periplasmic entry. We demonstrate the usefulness of our tools by constructing a 3800 Da chimeric compound composed of a constrained bicyclic peptide (Bicycle) with a periplasmic target, linked to an intramolecular peptide vector; the resulting chimera is a broad-spectrum inhibitor of pathogenic Gram-negative bacterial growth.
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Affiliation(s)
- James M. Wagstaff
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Matthew Balmforth
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Nick Lewis
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Rachel Dods
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Catherine Rowland
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | | | - Liuhong Chen
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Helen Harrison
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Michael J. Skynner
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | - Michael Dawson
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
| | | | - Paul Beswick
- Bicycle Therapeutics, B900 Babraham Research Campus, Cambridge CB22 3AT, United Kingdom
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Wundersitz DWT, Gordon BA, Lavie CJ, Nadurata V, Kingsley MIC. Impact of endurance exercise on the heart of cyclists: A systematic review and meta-analysis. Prog Cardiovasc Dis 2020; 63:750-761. [PMID: 32663493 DOI: 10.1016/j.pcad.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To compare heart structure and function in endurance athletes relative to participants of other sports and non-athletic controls in units relative to body size. A secondary objective was to assess the association between endurance cycling and cardiac abnormalities. PATIENTS AND METHODS Five electronic databases (CINAHL, Cochrane Library, Medline, Scopus, and SPORTdiscus) were searched from the earliest record to 14 December 2019 to identify studies investigating cardiovascular structure and function in cyclists. Of the 4865 unique articles identified, 70 met inclusion criteria and of these, 22 articles presented 10 cardiovascular parameters in units relative to body size for meta-analysis and five presented data relating to incidence of cardiac abnormalities. Qualitative analysis was performed on remaining data. The overall quality of evidence was assessed using GRADE. Odds ratios were calculated to compare the incidence of cardiac abnormality. RESULTS Heart structure was significantly larger in cyclists compared to non-athletic controls for left ventricular: mass; end-diastolic volume, interventricular septal diameter and internal diameter; posterior wall thickness, and end-systolic internal diameter. Compared to high static and high dynamic sports (e.g., kayaking and canoeing), low-to-moderate static and moderate-to-high dynamic sports (e.g., running and swimming) and moderate-to-high static and low-to-moderate dynamic sports (e.g., bodybuilding and wrestling), endurance cyclists end-diastolic left ventricular internal diameter was consistently larger (mean difference 1.2-3.2 mm/m2). Cardiac abnormalities were higher in cyclists compared to controls (odds ratio: 1.5, 95%CI 1.2-1.8), but the types of cardiac abnormalities in cyclists were not different to other athletes. CONCLUSION Endurance cycling is associated with a larger heart relative to body size and an increased incidence of cardiac abnormalities relative to controls.
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Affiliation(s)
- Daniel W T Wundersitz
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Flora Hill, Australia.
| | - Brett A Gordon
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Flora Hill, Australia
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA, USA
| | | | - Michael I C Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Flora Hill, Australia; Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
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Jeppsson H, Lubbe N. Simulating Automated Emergency Braking with and without Torricelli Vacuum Emergency Braking for cyclists: Effect of brake deceleration and sensor field-of-view on accidents, injuries and fatalities. Accid Anal Prev 2020; 142:105538. [PMID: 32470821 DOI: 10.1016/j.aap.2020.105538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
This study estimates how many additional cyclist accidents, injuries or fatalities are avoided or mitigated by adding a system which increases braking levels, the Torricelli Vacuum Emergency Brake (VEB), to a state-of-the-art Automated Emergency Braking (AEB) system. To obtain a realistic state-of-the-art AEB system, the AEB parameter settings were defined to fulfil but not exceed the performance necessary to achieve a full score in the European New Car Assessment Program (Euro NCAP). The systems are simulated in a simple but realistic simulation model in MATLAB with varying brake deceleration and sensor field-of-view (FoV). This study utilised data from the German In-Depth Accident Study (GIDAS), released in January 2019, and the related Pre-Crash Matrix (PCM), released in February 2019. Cyclist Injury Risk Curves were created from 2,662 GIDAS accidents involving a passenger car and a cyclist. The sample of cyclist accidents from the GIDAS-PCM database used in the final simulations comprised 1,340 collisions between the front of a passenger car and a cyclist. Both data samples were weighted to be representative of Germany as a whole. Adding the VEB was found to avoid over 20% more accidents than the AEB alone. Although increasing the FoV from 75° to 180° for the AEB system increases its accident avoidance rate to a level comparable to the VEB, the VEB remains about 8-20% more effective in reducing fatalities and injuries, and thus offers greater safety benefits than simply increasing AEB FoV. While the initial accidents in the representative simulation sample are fairly evenly distributed over the vehicle front, the remaining accidents (those that cannot be prevented by AEB or VEB) are more concentrated at the vehicle corners and are further characterized by high cyclist speeds. High cyclist speeds and impact to the vehicle corners potentially increase the relative frequency of head impacts to the stiff A-pillars. We therefore recommend that, for passenger cars, VEB and other advanced AEB systems should be combined with in-crash protection, especially in the A-pillar area, to best protect cyclists from injury.
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Affiliation(s)
- Hanna Jeppsson
- Autoliv Research, Wallentinsvägen 22, 44783 Vårgårda, Sweden.
| | - Nils Lubbe
- Autoliv Research, Wallentinsvägen 22, 44783 Vårgårda, Sweden
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Kircher K, Ahlström C. Truck drivers' interaction with cyclists in right-turn situations. Accid Anal Prev 2020; 142:105515. [PMID: 32380238 DOI: 10.1016/j.aap.2020.105515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/24/2020] [Accepted: 03/17/2020] [Indexed: 06/11/2023]
Abstract
One of the more hazardous situations for a bicyclist is to go straight on in an intersection where a motor vehicle is turning right, and especially so when heavy vehicles are involved. The aim of this study was to investigate truck drivers' speed choice, gaze behaviour and interaction strategies in relation to vulnerable road users (VRU) when turning right in signalised and non-signalised intersections. Truck drivers experienced (n = 14) or inexperienced (n = 15) with urban traffic drove a 15 km long test route in an urban environment. To guarantee the presence of VRUs, a confederate cyclist with the task to cycle straight on was present in three intersections. Overall, the results suggest that the specific experience of driving a truck in the city has little effect on the strategies employed when interacting with cyclists in a right turn scenario. Neither gaze nor strategic placement or speed related variables differed significantly between the groups, though the drivers inexperienced with urban traffic tended to be more cautious. Glance and driving behaviour were more related to the preconditions afforded by the infrastructure and to interaction type, which is a combination of those infrastructural preconditions and the truck driver's own choice of action. The likelihood of a favourable interaction should be increased, where the truck remains behind the VRUs on the approach to the intersection, something which eliminates the potential for a collision. Education of truck drivers, infrastructure design and improved traffic light sequences are potential ways to reduce the occurrence of more demanding and dangerous interaction types.
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Affiliation(s)
- Katja Kircher
- The Swedish National Road and Transport Research Institute, Linköping, Sweden.
| | - Christer Ahlström
- The Swedish National Road and Transport Research Institute, Linköping, Sweden
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Ali A, Friedman J, Tatum D, Jones G, Guidry C, McGrew P, Schroll R, Harris C, Duchesne J, Taghavi S. The Association of Payer Status and Injury Patterns in Pediatric Bicycle Injuries. J Surg Res 2020; 254:398-407. [PMID: 32540507 DOI: 10.1016/j.jss.2020.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/09/2020] [Accepted: 05/13/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Bicycle injuries continue to cause significant morbidity in the United States. How insurance status affects outcomes in children with bicycle injuries has not been defined. We hypothesized that payer status would not impact injury patterns or outcomes in pediatric bicycle-related accidents. METHODS The National Trauma Data Bank was used to identify pediatric (≤18 y) patients involved in bicycle-related crashes admitted in year 2016. Patients with private insurance were compared with all others (uninsured, Medicaid, and Medicare). RESULTS There were 5619 patients that met study criteria. Of these, 2500 (44%) had private insurance. Privately insured were older (12 y versus 11, P < 0.001), more likely to be white (77% versus 56%, P < 0.001), and more likely to wear a helmet (26% versus 9%, P < 0.001). On multivariate analysis, factors associated with traumatic brain injury included age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.06-1.08; P < 0.001) and helmet use (OR, 0.64; 95% CI, 0.55-0.74; P < 0.001). Patients without private insurance were significantly less likely to wear a helmet (OR, 0.52; 95% CI, 0.44-0.63; P < 0.001). Uninsured patients had significantly higher odds of a fatal injury (OR, 4.43; 95% CI, 1.52-12.92; P = 0.006). CONCLUSIONS Uninsured children that present to a trauma center after a bicycle accident are more likely to die. Although helmet use reduced the odds of traumatic brain injury, minorities and children without private insurance were less likely to be helmeted. Public health interventions should increase helmet access to children without private insurance, especially uninsured children.
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Affiliation(s)
- Ayman Ali
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Jessica Friedman
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Danielle Tatum
- Department of Surgery, Our Lady of the Lake RMC, Baton Rouge, Louisiana
| | - Glenn Jones
- Department of Surgery, LSU Health Baton Rouge, LSU Medical Education and Innovation Center, Baton Rouge, Louisiana
| | - Chrissy Guidry
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Patrick McGrew
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Rebecca Schroll
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Charles Harris
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Juan Duchesne
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Sharven Taghavi
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
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Cicchino JB, McCarthy ML, Newgard CD, Wall SP, DiMaggio CJ, Kulie PE, Arnold BN, Zuby DS. Not all protected bike lanes are the same: Infrastructure and risk of cyclist collisions and falls leading to emergency department visits in three U.S. cities. Accid Anal Prev 2020; 141:105490. [PMID: 32388015 DOI: 10.1016/j.aap.2020.105490] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Protected bike lanes separated from the roadway by physical barriers are relatively new in the United States. This study examined the risk of collisions or falls leading to emergency department visits associated with bicycle facilities (e.g., protected bike lanes, conventional bike lanes demarcated by painted lines, sharrows) and other roadway characteristics in three U.S. cities. METHODS We prospectively recruited 604 patients from emergency departments in Washington, DC; New York City; and Portland, Oregon during 2015-2017 who fell or crashed while cycling. We used a case-crossover design and conditional logistic regression to compare each fall or crash site with a randomly selected control location along the route leading to the incident. We validated the presence of site characteristics described by participants using Google Street View and city GIS inventories of bicycle facilities and other roadway features. RESULTS Compared with cycling on lanes of major roads without bicycle facilities, the risk of crashing or falling was lower on conventional bike lanes (adjusted OR = 0.53; 95 % CI = 0.33, 0.86) and local roads with (adjusted OR = 0.31; 95 % CI = 0.13, 0.75) or without bicycle facilities or traffic calming (adjusted OR = 0.39; 95 % CI = 0.23, 0.65). Protected bike lanes with heavy separation (tall, continuous barriers or grade and horizontal separation) were associated with lower risk (adjusted OR = 0.10; 95 % CI = 0.01, 0.95), but those with lighter separation (e.g., parked cars, posts, low curb) had similar risk to major roads when one way (adjusted OR = 1.19; 95 % CI = 0.46, 3.10) and higher risk when they were two way (adjusted OR = 11.38; 95 % CI = 1.40, 92.57); this risk increase was primarily driven by one lane in Washington. Risk increased in the presence of streetcar or train tracks relative to their absence (adjusted OR = 26.65; 95 % CI = 3.23, 220.17), on downhill relative to flat grades (adjusted OR = 1.92; 95 % CI = 1.38, 2.66), and when temporary features like construction or parked cars blocked the cyclist's path relative to when they did not (adjusted OR = 2.23; 95 % CI = 1.46, 3.39). CONCLUSIONS Certain bicycle facilities are safer for cyclists than riding on major roads. Protected bike lanes vary in how well they shield riders from crashes and falls. Heavier separation, less frequent intersections with roads and driveways, and less complexity appear to contribute to reduced risk in protected bike lanes. Future research should systematically examine the characteristics that reduce risk in protected lanes to guide design. Planners should minimize conflict points when choosing where to place protected bike lanes and should implement countermeasures to increase visibility at these locations when they are unavoidable.
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Affiliation(s)
| | - Melissa L McCarthy
- George Washington University Milken Institute School of Public Health, Washington, DC, United States
| | - Craig D Newgard
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Stephen P Wall
- Ronald O. Perelman Department of Emergency Medicine, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Charles J DiMaggio
- Department of Surgery, Division of Trauma and Critical Care, New York University School of Medicine, New York, NY, United States
| | - Paige E Kulie
- Department of Emergency Medicine, George Washington University Medical Center, Washington, DC, United States
| | - Brittany N Arnold
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, United States
| | - David S Zuby
- Insurance Institute for Highway Safety, Arlington, VA, United States
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Foley J, Cronin M, Brent L, Lawrence T, Simms C, Gildea K, Ryan J, Deasy C, Cronin J. Cycling related major trauma in Ireland. Injury 2020; 51:1158-1163. [PMID: 31784058 DOI: 10.1016/j.injury.2019.11.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/14/2019] [Accepted: 11/20/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Cycling as a means of transport or recreational activity is increasing in popularity in Ireland. However, increasing numbers of cyclists may lead to an increased number of bicycle collisions and fatalities. The Road Safety Authority is the statutory body for road safety in Ireland but uses police data alone to collate cycling collision statistics. This may lead to an underestimation of cycling injuries in Ireland. Using hospital statistics may provide a greater understanding of cycling trauma in Ireland. OBJECTIVE The present study examines cycling related trauma in Ireland using the Major Trauma Audit (MTA) data collected via the Trauma and Research Network (TARN) from hospitals in Ireland for the period 2014 to 2016. The database was interrogated for demographics, mechanism of injury, injury characteristics and patient outcomes. RESULTS There were 410 cycling collisions recorded in the TARN database which represented 4.4% of trauma captured by TARN for the study period. Of this cohort 79% were male compared with 58% in the overall (TARN) trauma cohort (p < 0.001) and the median (IQR) age was 43.8 years (31.0, 55.7) which is younger than the median (IQR) of 58.9 (36.2, 76.0) years for the overall trauma cohort (p < 0.001). Cycling collisions had a median (IQR) injury severity score (ISS) of 10 (9, 20) which was higher than the overall trauma cohort ISS of 9 (9, 17). Of the mechanisms observed for cycling trauma, 31.7% (n = 130) had a collision with a motor vehicle. Of those who did not wear a helmet, 52.2% (n = 47) sustained a head injury compared with 27.5% (n = 44) in the group who were wearing a helmet (p < 0.001). CONCLUSION The TARN data presented in this paper builds a more complete overview of the burden of cycling collisions in Ireland. Particular points of focus are that serious cycling injuries occur in a predominantly male population, and that only around 30% of cases are recorded as involving a motor vehicle, with the majority having an unknown mechanism of injury. There was an association between helmets and head injuries in this study, but there are likely other contributing factors such as mechanism of injury, velocity or cycling infrastructure. Using hospital data such as the MTA provides valuable information on the injuries sustained by cyclists, but more prospective studies to capture injury mechanism and contributing factors are needed.
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Affiliation(s)
- James Foley
- Department of Emergency Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Marina Cronin
- Major Trauma Audit, National Office of Clinical Audit, Ireland
| | - Louise Brent
- Major Trauma Audit, National Office of Clinical Audit, Ireland
| | - Tom Lawrence
- The Trauma Audit and Research Network, Manchester, United Kingdom
| | - Ciaran Simms
- Centre for Bioengineering & School of Engineering, Trinity College Dublin, Ireland
| | - Kevin Gildea
- Centre for Bioengineering & School of Engineering, Trinity College Dublin, Ireland
| | - John Ryan
- Department of Emergency Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Conor Deasy
- Department of Emergency Medicine, Cork University Hospital, Ireland; Major Trauma Audit, National Office of Clinical Audit, Ireland
| | - John Cronin
- Department of Emergency Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Meredith L, Kovaceva J, Bálint A. Mapping fractures from traffic accidents in Sweden: How do cyclists compare to other road users? Traffic Inj Prev 2020; 21:209-214. [PMID: 32119567 DOI: 10.1080/15389588.2020.1724979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
Introduction: Cyclists account for a large share of injured road users in traffic. The crash data analysis for cyclist safety and protection should be based on a representative dataset of real-world crashes. This manuscript aimed to explore the patterns of cyclists' fractures and factors associated with fractures of higher severity.Methods: This paper exemplifies a methodology that combines injuries from a crash database, including both hospital and police reports and fracture registry database from orthopedic centers nationally in Sweden.Results: Car occupants were most frequently involved in crashes resulting in fractures (37%), followed by motorcyclists (27.6%) and bicyclists (15.4%). Common fracture locations differed by the type of road user, where cyclists were more frequently fractured in the lower arm, compared to other road users, such as car drivers, motorcyclists and pedestrians who suffered mostly of fractures in the lower leg. Within cyclists, injuries also differed by gender, suggesting that combination of different countermeasures may be needed in order to provide sufficient protection for all cyclist. In the analyzed data, male cyclists with an average age of 49 were the most frequently fractured cyclists. Fractures of cyclists to the acetabulum (100%), pelvis (84.2%), vertebra (75%) and tibia (70.3%) were most frequently high energy fractures. Single bicycle incidents (OR = 0.165) and collisions with another bicycle (OR = 0.148) were significantly less likely to result in a high energy fracture than a collision with a car.Conclusions: The results of this study may guide the design of appropriate protective devices for the cyclists based on the different injury mechanisms and provide implications for prioritizing new countermeasures, campaigns, or regulations.
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Affiliation(s)
- Lauren Meredith
- Vehicle Safety, Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Göteborg, Sweden
| | - Jordanka Kovaceva
- Vehicle Safety, Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Göteborg, Sweden
| | - András Bálint
- Vehicle Safety, Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Göteborg, Sweden
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50
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Takeda A, Koh M, Nakanishi T, Hitosugi M. Differences in severity of injuries between motorcyclist and bicyclist fatalities in single vehicle collisions. J Forensic Leg Med 2020; 70:101917. [PMID: 32090972 DOI: 10.1016/j.jflm.2020.101917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/22/2019] [Accepted: 01/26/2020] [Indexed: 11/16/2022]
Abstract
To understand the injury severity of bicyclists and motorcyclists in single vehicle collisions, we performed a retrospective analysis of forensic autopsy cases of 25 motorcyclists and 14 bicyclists performed from 1999 to 2018. Collision details, injury characteristics, and involvement of alcohol were examined. The injury severity between bicyclists and motorcyclists was compared. The average age of victims was 62.3 years. All motorcyclists and no bicyclists wore a helmet. Motorcyclists had more severe injuries than bicyclists (mean Injury Severity Score of 42 and 27, respectively). The motorcyclists had more severe chest injuries but fewer severe facial injuries than bicyclists, owing to the difference in collision velocity or rate of helmet use (p < 0.05). Alcohol was present in the blood of 52.0% of bicyclists but no motorcyclists. The mean blood alcohol concentration of these bicyclists was 1.59 mg/mL. The bicyclists under the influence of alcohol had more severe injuries to neck and upper extremities than non-drunken bicyclists (p < 0.05). Our results may be useful for determining the cause of death and reconstructing the mechanisms of fatal injuries in bicyclists and motorcyclists.
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Affiliation(s)
- Arisa Takeda
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, Japan.
| | - Mirae Koh
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Tomoyuki Nakanishi
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Masahito Hitosugi
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, Japan
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