Cyclists Research Articles

A clinical briefing of (not so) rare chronic pain syndromes in gynecology: Interstitial cystitis and vulvodynia

Chronic pain has been currently defined as a pain that persists more than six weeks, despite of prescribed treatments. Interstitial cystitis or bladder pain syndrome is a chronic pain syndrome which implies urinary and pelvic pain, accompanied by voiding symptoms. The discomfort persists for more than six weeks and is apparently not related to any infectious or other identifiable causes. Patients complain of different voiding symptoms, which coexists with variable located pelvic pain. The voiding symptoms vary from urinary frequency, urgent need to void to pelvic pressure related filling to emptying of the urinary bladder. The unpleasant sensations described by the patients are: pain, pressure or discomfort and they are inevitably related to the urinary bladder. Many of these patients have associated pain syndromes, like: chronic fatigue syndrome, irritable bowel syndrome, fibromyalgia or other emotional conditions as depression and anxiety. Vulvodynia (or localized vulvar pain syndrome or vestibulodynia or vulvar vestibulitis) is defined as a vulvar pain that lasts for more than three months and has no identifiable cause and is considered a diagnostic of exclusion. Patients present with vulvar pain as major complaint. This pain is related to contact with the vestibular region of the vulva: during intercourse, prolonged sitting, bike riding, tight clothing, tampon insertion. Clinical diagnosis is based on several criteria: pain with vestibular localization (with or without clitoridean pain), provoked by pressure-point testing, with no other established cause and lasts for more than three months.

Long Scarf Related Injuries in Female Bike Riders Reported at Different Tertiary Care Hospitals Karachi

Objective: To determine the frequency of long scarf related injuries in female bike riders.
 Study Design: This is an observational study.
 Setting: This study was conducted in the emergency department of a tertiary care hospital in Karachi and aims to calculate the type of injury due to long scarf in female bike riders. It was conducted during the period of Dec, 2020 to Nov, 2021.
 Materials & Methods: Participants visiting the emergency department due to motor bike accidents and female patients were screened for long scarf related injuries. Statistical analysis was done by SPSS version 21 and descriptive statistics were used.
 Results: For one year time, we received 174 patients due to motor bike accidents and 20.6% injuries were due to long scarf in females. As 36 patients matched our inclusion criteria due to long scarf while riding a motor bike. The mean age of females was found to be 34 years (range 16-55 years). Majority of the patients had more than one site of injury and left leg fracture was the most common injury found in 44.6% of females. Out of 32 patients, 14 patients required admission urgently. 
 Conclusion: A considerable number of injuries and deaths can be prevented by simple interventions and carefulness while riding on motorcycle. We have identified this problem only in a small group of population but this issue needs to be highlighted at a higher place.

Motivation Patterns of Cyclists in the New-Normal Era

This study aimed to determine the motivation pattern of the riders of mountain bikes, road bikes, and folding bikes in the new-normal era. The method used in this study is descriptive quantitative. The participants of this study were 258 cyclists in Bandung. The data was collected through a Sport Motivation Scale-6 questionnaire. This study indicates that there is no significant difference between the motivation of mountain bike, road bike, and folding bike riders. However, there is a substantial difference in income indicators in sociodemography, especially for road bike riders, while mountain bike and folding bike riders do not have any significant differences. This study shows that the motivation patterns of cyclists impact the cycling activities undertaken.

Effects of the Type and Volume of Physical Activity on Leukocyte Telomere Length in Middle-Aged Men

PURPOSE: Leukocyte telomere length (LTL) is a potential indicator of cellular senescence. However, its relationship with the type and volume of regular exercise is unclear. Therefore, we investigated the effects of the type and volume of long-term regular exercise on the LTL in middle-aged men (N=109, mean age=44.7±4.1 years [range: 40-56 years]).METHODS: For all participants, the volume of physical activity (PA) was evaluated using a self-report questionnaire, and blood samples were collected simultaneously. We cross-sectionally examined the associations among the type and volume of PA, LTL, telomerase activity (TA), mitochondrial DNA copy number (mtDNA), and body composition in three groups: 1) bodybuilders (BBs) with at least 5 years of athletic experience (n=36, mean age: 42.3±3.3 years [40-51 years]), 2) cyclists (CCs) with an athletic career similar to that of the BBs (n=37, mean age: 45.4±4.4 years [range: 40-53 years]), and 3) healthy ordinary people (CON; n=36, mean age: 46.3±3.3 years [range: 40-56 years]).RESULTS: The LTL showed a significant positive correlation with the volume of PA (r=.285, p=.003), regardless of the type of PA. Furthermore, the LTLs were longer in the BB (p=.007) and CC (p=.003) groups (who performed moderate-to-vigorous PA for 150 minutes or more per week) than in the CON group. Conversely, the TA was significantly higher in the BB group (p=.009) than in the CON group; however, it only tended to be high in the CC group (p=.115). There were no intergroup differences in both the mtDNA (p=.127) and 8-hydroxydeoxyguanosine (p=.289) levels.CONCLUSIONS: The TA was found to increase, and thus prevent telomere loss, in middle-aged men who performed PA of moderateto-vigorous intensity, regardless of the PA type.

Connectivity Benefits of Small Zero-Emission Autonomous Ferries in Urban Mobility—Case of the Coastal City of Gdańsk (Poland)

An increase in energy-efficient transportation is one way that cities try to mitigate climate change. In coastal cities, public water transit is also undergoing transitions. A small zero-emission autonomous ferry seems to be a cutting-edge technology in this field. This study aims to decrease the knowledge gap in research on the impacts of autonomous passenger ferry development on urban mobility. In particular, the central theme regards the extent to which the new transport solution can help improve sustainable mobility patterns. This study explores the local spatial context of ferry development, land-use patterns, and transport network structure, and moderates the shift in urban mobility practices. Regarding land use patterns, the case of the coastal city of Gdańsk has been documented in secondary qualitative and quantitative data, including in a large body of policy documents, accompanying expert opinions, and scholarly literature. This study strongly emphasises that a typical short river crossing, due to autonomous vessels, can regain a competitive position, which was partially lost due to linear routes along the river. The research identified crucial benefits of autonomous ferry shipping on urban mobility by increasing public transport network connectivity, reducing travel distance, and creating modal shifts towards foot travel and bike riding. It appears as an exciting scalable solution for cities where limited or dispersed demand prevents achievement of economies of scale, therefore diminishing the necessary expenditures.

The potential for bike riding across entire cities: Quantifying spatial variation in interest in bike riding

BackgroundRiding a bike is beneficial for health, the environment and for reducing traffic congestion. Despite this, bike riding participation in the state of Victoria, Australia, is low. To inform planning and practice, there is a need to understand the proportion of the population (the ‘near-market’) that are interested in riding a bike, and how this varies across regions. The Geller typology classifies individuals into one of four groups, based on their confidence to ride a bike in various infrastructure types, and frequency of bike riding. The typology has been used at a city, state and country-wide scale, however not at a smaller spatial scale. We aimed to characterise and quantify the distribution of the Geller typology within Local Government Areas (LGAs) in the state of Victoria, Australia. MethodsAn online survey was conducted in 37 LGAs in Victoria, including all LGAs in Greater Melbourne, and a selection of six key regional centres. Participants were recruited from an opt-in online research company panel with the objective of recruiting a representative sample of adults across each LGA. The Geller typology classified individuals as either: ‘Strong and Fearless, ‘Enthused and Confident’, ‘Interested but Concerned’, or ‘No Way No How’. ‘Interested but Concerned’ participants are those that would ride a bike if protected infrastructure were provided. ResultsThe survey was completed by 3999 individuals. Most participants owned a bike (57%), however only 20% rode at least once per week. The distribution of the Geller groups was: ‘Strong and Fearless’ (3%), ‘Enthused and Confident’ (3%), ‘Interested but Concerned’ (78%), and ‘No Way No How’ (16%). While variation in the distributions of the Geller groups was observed between LGAs within Greater Melbourne., the ‘Interested but Concerned’ group, reflecting people who are comfortable riding only in protected lanes or off-road paths, was high across all LGAs and all demographic sub-groups. Even though the frequency of riding a bike was lower in women, interest in riding a bike was high and comparable to men. Participants who resided in the outer urban fringe regions of Greater Melbourne had high interest, but low participation in bike riding. ConclusionsWhile there was variation in interest in bike riding across an entire metropolitan region and across population groups, interest was high across all areas and demographics. Our results show the potential for substantial increases in cycling participation, but only when high-quality cycling infrastructure is provided. Further research is required to understand the policy and practice barriers to equitable provision of protected infrastructure.

Contribution of motor and proprioceptive information to visuotactile interaction in peripersonal space during bike riding.

The space immediately around the body, known as the peripersonal space (PPS), plays an important role in interactions with the environment. Specific representations are reported to be constructed in the brain. PPS expansion reportedly occurs during whole-body self-motions, such as walking; however, little is known regarding how dynamic cues in proprioceptive/motor information contribute to such phenomena. Thus, we investigated this issue using a pedaling bike situation. We defined PPS as the maximum distance at which a visual probe facilitated tactile detection at the chest. Experiment 1 compared two conditions where participants did or did not pedal the bike at a constant speed while observing an optic flow that simulated forward self-motion (pedaling and no pedaling). Experiment 2 investigated the effect of pedal resistances (high and low) while presenting the same optic flow as in Experiment1. The results revealed that the reaction time (RT) difference (probe RT-baseline RT) was larger for the pedaling than for the no-pedaling condition. However, pedal resistance differences hardly affected the visuotactile interaction, although the participants clearly experienced differences in force. These results suggest that proprioceptive/motor cues can contribute to the modulation of PPS representation, but dynamic information included in these cues may have little influence.

What Makes Us Know We’re Alive

In this narrative medicine essay, a pediatric hematology-oncology fellow weaves the strands of her life—emotional exhaustion from her first year of fellowship, the death of a friend, challenging bike rides, a husband who listens and doesn’t fix—moments that taken together mend her.

Comparison of injuries among motorcycle, moped and bicycle traffic accident victims

Objective Motorcycles, moped scooters and bicycles are commonly involved in traffic accidents and riders often suffer significant morbidity and mortality. The aim of this study is to compare and categorize the different injury patterns and fractures suffered by riders of each vehicle type after a traffic accident. Methods Data from a level 1 trauma center in Las Vegas, Nevada were analyzed. Traffic accident victims riding a motorcycle, moped, or bicycle from 2013 to 2017 were included. Injury location and fracture location were assigned to six and sixteen categorical locations, respectively. Descriptive statistics, including frequency counts for categorical data and mean for continuous data, were calculated for the full sample and for each of the vehicle types. Logistic regression was performed on race, categorized age, vehicle type and helmet use to calculate adjusted odds ratios for injury type between the three groups. Results Of the 2115 patients, 1372 were motorcyclists, 356 were moped scooter riders and 387 were bicyclists. Overall the vast majority of injuries reported were of the extremities or pelvic girdle (62.2%), and this was true regardless of vehicle type. Head and neck injuries were significantly more common in bicyclists (39.5%) and moped riders (34.6%), than in motorcyclists (22.7%). Helmet use was substantially lower in the moped (34%) and bicycle (20%) groups compared to the motorcycle group (85%). The most common fractures regardless of vehicle type were of the skull/face, rib, vertebral, and tibia/fibula with slight variations between vehicle groups. Conclusion Similarities were seen in the most common fracture and injury patterns between the three groups. Head and neck injuries were much more common in moped and bicycle riders compared to motorcyclists. This is most likely due to the significantly higher percentage of motorcycle riders who wore a helmet. Counseling regarding helmet and protective equipment use, especially among moped and bicycle riders is essential to reduce head injuries.

Mining dockless bikeshare data for insights into cyclist behavior and preferences: Evidence from the Boston region

• Studied cyclists’ behavior using en route GPS records from a dockless bikeshare system. Commercial areas have excess origins, while residential areas have excess destinations. • Cyclists often use sidewalks, other footpaths , and parking lot drives. • 36% of trips involve contraflow on a one-way segment. • Due to underdeveloped bike network, only 7% of trips are 100% on low-stress links. Emerging micromobility services provide not only new transportation options, but also valuable sources of data for researchers and planners seeking to understand traveler behavior and preferences and to improve transportation networks. Dockless systems for shared bicycles and electric scooters have recently begun operating in many American cities, providing data not only on trip start and end, but also on the route followed. In this study, we analyze data from more than 110,000 dockless bikeshare trips in Boston’s suburbs. About 15% of trip ends were within 100 m of a transit station, indicating that bikeshare serves many more functions than access to transit. More than 40% ended in a town or village center, suggesting that bikeshare may support the local economy. From examining GPS traces, it was clear that – contrary to the assumptions of common bike routing algorithms – bike riders often use sidewalks, other footways and soft-surfaced paths, parking lots, and driveways, and 36% ride the wrong way on one-way streets. An examination of the streets with high contraflow volumes indicates two common profiles. One is streets whose travel channel is so narrow that either the bike or vehicle has to pull into a parking lane to let the other pass; those streets typically have low traffic speeds and very low traffic volumes. The other is streets whose travel channel is wide enough for a bike and car to pass without either yielding to the other; they typically have greater vehicular speed and volume, but still only one lane. After classifying streets by level of traffic stress, we find that only 7 percent of trips use exclusively low-stress links, and that about 40 percent of bike-miles are ridden on low-stress links. These low percentages are consistent with an underdeveloped bike network that forces riders to use through streets for all except ultra-local trips; it may also reflect a prevalence of sidewalk riding on major arterials.

Development of Automatic Gear Shifting for Bicycle Riding Based on Physiological Information and Environment Sensing

This paper presents the development of an intelligent bicycle system with automatic gear shifting based on the user’s physiological information and environment sensing. The sensor data are collected during the ride, uploaded to the cloud database, and analyzed using random forest to derive the appropriate riding requirement. Our proposed technique performs the automatic gear shifting operation using inexpensive sensor components and embedded system development boards. The gear shifting module is designed and installed as an external device for the off-the-shelf bicycle, without the need to dismantle or modify the body structure. A bicycle riding specific online management interface is developed for web access and administration. It allows the cloud data being displayed and let users acquire and understand their riding behaviors. The experiments and evaluation in the outdoor environment have demonstrated the feasibility of the proposed intelligent gear shifting system.

Exploring the relationship of rush hour period and fatal and non-fatal crash injuries in the U.S.: A systematic review and meta-analysis

Road crashes are preventable causes of morbidity and mortality. In the U.S., substantial crashes occur during the rush hour period. The rush hour represents the period of the day during which the density of humans and vehicles in the road environment is highest. In the U.S., the rush hour period is bi-modal, occurring in the morning and the afternoon, at times that vary by state and urban–rural status. This systematic review and meta-analysis aimed to evaluate the association between the rush hour period and fatal and non-fatal crash injuries. Selected articles were limited to peer-reviewed full-text articles that measured crash injury as an outcome and rush hour as either a predictor, covariate, stratification, or a control variable. A total of 17 articles were identified for systematic review and nine articles were included in the meta-analysis. Across the selected studies, the rush-hour period signified the period of “peak traffic flow.” During the rush hour period, aggressive driving behavior, truck driving, bicycle riding, and precipitation were associated with increased crash events or crash injuries. Across the nine studies included in the meta-analysis, the effective sample size was 236,433. The rush-hour period was associated with a 28% increased risk of fatal crash injury (Pooled RR: 1.28; 95% CI: 1.11–1.45) and the morning rush hour period was associated with 36% increased crash injury risk (Pooled RR: 1.36; 95% CI: 1.13–1.59). The rush hour period, though less commonly studied as a predictor of fatal and non-fatal crash injuries, represents an important domain in need of crash injury prevention attention. The knowledge of the pattern of crash injuries, as it varies across countries, states, regions, and county can inform policy and intervention, in the presence of competing public health needs.

Individual and Team Sports-related Hospitalizations for Traumatic Brain Injuries in Pediatric Patients (104)

Objectives:Pediatric sport participation continues to increase in the United States with a corresponding increase in sports related concussions or traumatic brain injuries (TBIs). Based on this impact, it is important to recognize which sports are at elevated risk, identify patient and hospital-associated risk factors for hospital admission and length of stay, as well as understand billing costs for both individual and team sport participants. Improved awareness may help avoid disproportionate treatments, reduce economic burdens, and allow physicians to more effectively manage these injuries.Methods:Pediatric patients (ages 5-18) from 2008 to 2014 were identified from the Healthcare Cost and Utilization Project (HCUP) National (Nationwide) Inpatient Sample (NIS). ICD-9 CM codes were used to include 894 patients who were hospitalized with a concussion resulting from either participating in an individual (N = 451) or team sport (N = 443) (Figure 1). An adjusted odds ratio was calculated using demographic and hospital information. Welch ANOVA was performed to evaluate differences in length of hospital stay and total charges between cohorts. This was repeated for a loss of consciousness subgroup analysis within each cohort.Results:Younger athletes in individual sports were more likely to have associated loss of consciousness, be self-pay, experience a greater number of procedures, and require an operating room procedure. (Table 1). When compared to team sports, TBI patients in individual sports had significantly longer (p < 0.001) and costlier (p < 0.001) hospital stays (Table 2). The only significant finding that was worse in team sports was that loss of consciousness led to greater total charges (p < 0.001) (Table 2). For team sports, American tackle football, (43.6%) and for individual sports, bike riding, (28.2%) were the most frequent sports associated with TBIs in their respective cohorts (Table 3).Conclusions:Individual sport TBIs may be associated with longer and more expensive hospitalizations. The explanation is likely multifactorial but may be complicated by reduced awareness and reduced compliance with strict return to play protocols in individual sports. Safety education information at a young age, clear discharge instructions, and baseline health assessments when possible may help mitigate these findings.

A retrospective study of spine injuries in electric bicycles related collisions

BackgroundElectric bicycles related collisions could lead to severe consequences in spine injuries, while no study had comprehensively investigated the epidemiology and demography of spine injuries in electric bicycles related collisions. Questions/purposesThe aim of this study is to (1) describe the epidemiological characteristics of spine injuries in electric bicycles related collisions, (2) develop clinical guideline of spine injuries in electric bicycles related collisions and (3) support the new road safety policy for electric bicycle riders. MethodsA retrospective review of spine injuries in electric bicycle related collisions was performed from 86 patients in an urban trauma center between 2018 and 2020. The variables including gender, age, radiographic findings, associated injuries, neurologic injuries, treatment, average length of stay were fully collected. Chi-square test and paired sample mean t-test were used to test for statistically significant differences. All statistical analyses were performed using Statistical Product and Service Solutions 20.0.0 software. A P<0.001 was considered as significant. ResultsA total of 86 cases were involved in electric bicycles related collisions lead to spine injuries. The spine injuries victims were predominantly male (79.07%) and middle-aged (41-60years, 44.19%). The most common spine injuries were L1 fractures (10.48%). The most common fracture type was AO Fracture Classification type A (71.40%). Age and multivertebral fractures had significant difference between patients who suffered from an ASOI and from those who did not (P-value: 0.005, 0.005). There was significant difference between patients who suffered from neurologic injuries and from those who did not in AO Classification, multivertebral fractures and ASOI (P-value: 0.0001, 0.001, 0.032). Age, AO Classification, multivertebral fractures, ASOI and neurologic injuries had significant difference to influence patients’ ISS and ALOS. ConclusionsSpine injuries in electric bicycles related collisions may make patients suffer from severe consequences including their potential permanent disability, economic cost, or even life safety. Patients with spine injuries in electric bicycles related collisions should be paid close attention to avoid missed diagnosis and misdiagnosis. Helmet, protective clothing or other safety gear should be required to use to provide greater protection for electric bicycle riders.

Technique to Prevent Misting Spectacles on Wearing Mask

Abstract: Person wearing spectacle is facing additional issue with already existing pandemic .The issue of misting glasses of spectacle was never before existed other than faced by bike riders while taking ride in rain on their helmet glasses. Due to misting issue people are not able to do their regular activities and they are not allowed to remove mask as well even worse issues like accidents while riding and the breathing problems since they have to struggle for exhaling air .The probable solutions to overcome same issue are discussed in a brief manner since, no one has idea how long will the pandemic will stay and misting issue too .The below techniques are effective and easy with the cheap cost, and can be adopted by anyone from child to old person (no age-restriction) . Keywords: Mask, Spectacle, Soapwater, Misting, Glasses, Pandemic

Impact of alcohol and drug use on bicycle and electric scooter injuries and hospital admissions in the United States

Introduction Bicycles and electric scooters (e-scooters) are convenient and accessible means of transportation. Participant safety is contingent on available infrastructure and safe riding practices including not riding while intoxicated. Understanding national prevalence and injury characteristics of bicycle and e-scooter riders who ride while intoxicated may promote awareness campaigns for safe riding practices and decrease morbidity. Methods The National Electronic Injury Surveillance System (NEISS) provides national estimates of injuries that present to emergency departments across the United States. We obtained case information on admitting status, body part injured, diagnosis of injury, age, sex, alcohol usage, and drug usage. We then queried NEISS for injuries related to bicycles and e-scooters in 2019. Results A weighted total of 270,571 (95% confidence interval (CI): 204,517–336,625) bicycle injuries occurred in the United States during 2019; alcohol and drug use were associated with 7% (95% CI: 6–9) and 2% (95% CI: 2–3) of all injuries, respectively. Twenty-four percent (CI: 18--31) of alcohol- and 29% (95% CI: 20–41) of drug-related bicycle injuries resulted in hospital admissions, compared to 15% (95% CI: 12–17) of non–alcohol- and 15% (95% CI: 13–18) of non–drug-related injuries ( p &lt; .001 and p = .002, respectively). A total of 28,702 (95% CI: 13,975–43,428) e-scooter injuries occurred in 2019; alcohol and drug use were associated with 8% (95% CI: 5–12) and 1% (95% CI: 1–2) of injuries, respectively. Sixty percent (95% CI: 47–72) of alcohol-related e-scooter injuries resulted in head trauma, compared to 28% (95% CI: 24–32) of non–alcohol-related injuries ( p &lt; .001). Conclusions Intoxication is associated with increasingly severe injuries, hospital admissions, and head trauma in bicycle and e-scooter riders. The findings support awareness campaigns to educate riders about risky practices, improve non-auto infrastructure, and promote helmet usage.

The Potential for Bike Riding across Entire Cities: Quantifying Geographical Differences in Bike Riding Interest

The Potential for Bike Riding across Entire Cities: Quantifying Geographical Differences in Bike Riding Interest

Factors related to youth self-efficacy for injury prevention bicycle skills

Introduction: Bicycle riding is a common activity for children, but they are prone to bicycle-related injuries. It is well-established that injury prevention measures such as wearing a helmet and correctly riding a bicycle can reduce the severity of an injury and the likelihood of having an accident. However, how to increase bicycle injury prevention behaviors among children, who collectively fail to engage in injury prevention behaviors, is less well understood. Self-efficacy is consistently predictive of injury prevention behavior, making it an important approach to understanding injury prevention skills among this key population. The objective of this study was to explore and identify factors internal to the child as well as factors about his or her environment that predict a child’s self-efficacy for injury prevention skills. Method: Two generalized linear mixed effects models were created from survey data collected from elementary school students (n = 2,255) as part of a school-based bicycle education program. Models focused on self-efficacy for riding a bicycle and self-efficacy for wearing a helmet correctly. Results: In both models, road safety knowledge, opportunity for skill building through owning appropriate equipment (a bicycle or helmet), and situation through perception of neighborhood safety were predictive. The analyses reveal these variables as key factors for greater confidence, with feeling safe riding in the neighborhood, in particular, emerging as highly predictive of self-efficacy for injury prevention skills. Conclusions: These findings highlight the interplay of individual and environmental factors within confidence for injury prevention behavior. Given self-efficacy’s strong relationship to prevention behavior, these findings indicate actionable strategies. Practical Applications: The key factors highlighted in this study can be used by policymakers to target specific areas (e.g., neighborhood safety) to promote self-efficacy and thus improve injury prevention. These factors can also inform strategies for establishing safety skills in bicycle-safety education programs.

Trends of Road Traffic Accidents: Patterns of Injuries in Road Traffic Accidents Victims: A study from Lady Reading Hospital MTI, Peshawar KPK

Background This study reflects the pattern of road traffic accidents and road traffic injuries sustained by RTA victims reporting to LRH MTI. Traffic volume, single and narrow roads is a big problem, traffic rules violation is another demon, lack of awareness, reluctance for the use of safety gears, underage vehicle drivers or rider with questionable driving/ riding skills and no license has worsen the injury pattern and more severe crashes here, putting pedestrians and biker at high risk. Aim: To know the different trends of road traffic accidents, most common victims and different patterns of injuries Methods This is hospital based analytical comparative study, which was conducted in the trauma section of Accident Emergency lady reading hospital MTI Peshawar KPK, during the tenure from May 2020 to November 2020. In this study 298 victims of road traffic accidents were assessed and analyzed from both genders and of all age groups. Results 298 victims of RTAs evaluated in our study. Most common mechanism involved pedestrian verses vehicle 40.3% followed by vehicle versus vehicle 28.6%, curiously in 5.3% of RTAs mechanism was unknown. Most of victims were males when compared with females, Males 86.3% and females 13.6%. children age group 0 -10 years makes 12.6%. Most common vehicle involved was a bike in 48%, followed by car 30% and then 3-wheelers (auto ricksha and Qing chi) 15.3% followed by crashes involving unknown vehicle 8% which is significantly high with all the victims severely wounded or unknown category. Most common victims were vulnerable road users (pedestrian and bike riders) 35% pedestrians and 31.6% bike riders. 11.3% of victims were passengers. Most common injury sustained was head injury38.5%(n=115), followed by lower limb injuries(n=105) 35.2% and polytrauma victims with chilling percentage of 9.3%. Conclusion There is a rising toll of road traffic injuries in and around Peshawar and majority being reported to emergency department LRH, MTI and it is major public health concern. Not only Pedestrians and bike rider are at threat but children of age group under 10 as well with high pedestrian mortality. If proper preventive steps not taken this will continue to rise causing significant death and disabilities. Keywords: Road traffic injuries, road traffic accidents, safety gears road traffic injury victims

What Does It Take to Complete the Cape Epic?

Reinpõld, K, Bossi, AH, and Hopker, JG. What does it take to complete the cape epic? J Strength Cond Res 36(12): 3513-3520, 2022-This study aimed to describe the racing and training demands of the Cape Epic. Six male mountain bike riders (age: 39 ± 7 years, height: 181 ± 3 cm, and body mass: 78.7 ± 8.1 kg) trained for 4.5 months and took part in the Cape Epic. Training and racing data (prologue, stage 1, and 2) were analyzed, and riders were tested in the laboratory on 3 distinct occasions for maximal oxygen uptake (V̇O 2 max), maximal work rate (Ẇmax), and power output associated with the respiratory compensation point (RCP PO ). Statistical significance was set at p ≤ 0.05. With race durations of 1.5 ± 0.2, 6.5 ± 1.2, and 6.4 ± 1.4 hours for, respectively, prologue, stage 1, and 2, normalized power was higher in prologue (3.73 ± 0.72 W·kg -1 ) compared with stages 1 (3.06 ± 0.59 W·kg -1 , p < 0.001) and 2 (2.94 ± 0.69 W·kg -1 , p < 0.001). Riders spent more time in power zones 1 and 2 (as %RCP PO ) and less time in zones 4 and 5, during stage 2 compared with prologue (all zones p ≤ 0.028). Despite no changes in V̇O 2 max or Ẇmax, RCP PO increased from midtraining (3.89 ± 0.61 W·kg -1 ) to prerace testing (4.08 ± 0.64 W·kg -1 , p = 0.048). No differences were found between base and build training phases for time in power zones. In conclusion, the Cape Epic requires an ability to sustain high submaximal power outputs for several hours as well as an ability to repeat high-intensity efforts throughout the race. A well-balanced program, incorporating a pyramidal intensity distribution, may be used as a starting point for the design of optimal training approaches.