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Extensive research has delved into the impact of environmental circumstances on the pacing and performance of professional marathon runners. However, the effects of environmental conditions on the pacing strategies employed by marathon participants in general remain relatively unexplored. This study aimed to examine the potential associations between various environmental factors, encompassing temperature, barometric pressure, humidity, precipitation, sunshine, cloud cover, wind speed, and dew point, and the pacing behavior of men and women. The retrospective analysis involved a comprehensive dataset comprising records from a total of 668,509 runners (520,521 men and 147,988 women) who participated in the 'Berlin Marathon' events between the years 1999 and 2019. Through correlations, Ordinary Least Squares (OLS) regression, and machine learning (ML) methods, we investigated the relationships between adjusted average temperature values, barometric pressure, humidity, precipitation, sunshine, cloud cover, wind speed, and dew point, and their impact on race times and paces. This analysis was conducted across distinct performance groups, segmented by 30-minute intervals, for race durations between 2 hours and 30 minutes to 6 hours. The results revealed a noteworthy negative correlation between rising temperatures and declining humidity throughout the day and the running speed of marathon participants in the 'Berlin Marathon.' This effect was more pronounced among men than women. The average pace for the full race showed positive correlations with temperature and minutes of sunshine for both men and women. However, it is important to note that the predictive capacity of our model, utilizing weather variables as predictors, was limited, accounting for only 10% of the variance in race pace. The susceptibility to temperature and humidity fluctuations exhibited a discernible increase as the marathon progressed. While weather conditions exerted discernible influences on running speeds and outcomes, they did not emerge as significant predictors of pacing. [ABSTRACT FROM AUTHOR]

Background: The sex difference in athletic performance has been thoroughly investigated in single sport disciplines such as swimming, cycling, and running. In contrast, only small samples of long-distance triathlons, such as the IRONMAN® triathlon, have been investigated so far. Aim: The aim of the study was to examine potential sex differences in the three split disciplines by age groups in 5-year intervals in a very large data set of IRONMAN® age group triathletes. Methods: Data from 687,696 (553,608 men and 134,088 women) IRONMAN® age group triathletes (in 5-year intervals from 18–24 to 75+ years) finishing successfully between 2002 and 2022 an official IRONMAN® race worldwide were analyzed. The differences in performance between women and men were determined for each split discipline and for the overall race distance. Results: Most finishers were in the age group 40–44 years. The fastest women were in the age group 25–29 years, and the fastest men were in the age group 30–34 years. For all split disciplines and overall race time, men were always faster than women in all groups. The performance difference between the sexes was more pronounced in cycling compared to swimming and running. From the age group 35–39 years until 60–64 years, the sex differences were nearly identical in swimming and running. For both women and men, the smallest sex difference was least significant in age group 18–24 years for all split disciplines and increased in a U-shaped manner until age group 70–74 years. For age groups 75 years and older, the sex difference decreased in swimming and cycling but increased in running. Considering the different characteristics of the race courses, the smallest performance gaps between men and women were found in river swimming, flat surface cycling and rolling running courses. Conclusions: The sex difference in the IRONMAN® triathlon was least significant in age group 18–24 years for all split disciplines and increased in a U-shaped manner until age group 70–74 years. For 75 years and older, the sex difference decreased in swimming and cycling but increased in running. [ABSTRACT FROM AUTHOR]

Given the increasing popularity of CrossFit® as a high-intensity functional training program and the potential benefits of citrulline malate (CM) in enhancing exercise performance through its role as a precursor to L-arginine and nitric oxide production, this study aimed to investigate the acute effects of CM supplementation on CrossFit® performance and cardiovascular function. Using a randomized, double-blind, placebo-controlled, cross-over design, 21 recreationally active participants (mean age 22.2 ± 2.6 years, mean body weight 75.9 ± 10.4 kg) with CrossFit® experience completed the "Cindy" workout under CM and placebo conditions. Participants consumed 4.4 g of CM or a placebo 60 min before the workout, and the performance was measured by the number of rounds completed. Secondary outcomes included heart rate response, time spent in different heart rate intensity zones, and post-exercise recovery time. The results indicated no significant difference in the number of rounds completed between the CM and placebo conditions (13.5 ± 5.2 vs. 13.8 ± 6.7 rounds, respectively; p = 0.587). However, the time spent in zone 4 (80–90% of HR max) was significantly increased in the CM condition (527 ± 395 s vs. 453 ± 334 s; p = 0.017), suggesting a potential benefit for aerobic capacity and anaerobic threshold. No significant differences in post-exercise recovery time were observed (6.6 ± 4.7 h vs. 6.9 ± 4.7 h; p = 0.475). This study highlights the need for further research with larger sample sizes, both genders, and different CM dosages to clarify these findings and better understand CM's role in enhancing athletic performance. [ABSTRACT FROM AUTHOR]

The majority of participants in Ironman triathlon races are age group athletes. We have extensive knowledge about recreational athletes' training and competition participation. Nonetheless, Ironman age group triathletes must achieve fast race times to qualify for the Ironman World Championship in Hawaii. They can, therefore, benefit from knowing where the fastest Ironman racecourses in the world are. The aim of the present study was to investigate where the fastest Ironman racecourses for age group triathletes are located in the world. Data from 677,702 Ironman age group finishers' records (544,963 from men and 132,739 from women) originating from 228 countries and participating in 444 events across 66 different Ironman race locations between 2002 and 2022 were analyzed. Data was analyzed through traditional descriptive statistics and with machine learning regression models. Four algorithms were tested (Random Forest Regressor, XG Boost Regressor, Cat Boot Regressor, and Decision Tree Regressor). The models used gender, age group, country of origin, environmental factors (average air and water temperatures), and the event location as independent variables to predict the final overall race time. Despite the majority of successful Ironman age group triathletes originating from the USA (274,553), followed by athletes from the United Kingdom (55,410) and Canada (38,264), these countries exhibited average overall race times that were significantly slower compared to the fastest countries. Most of the triathletes competed in Ironman Wisconsin (38,545), followed by Ironman Florida (38,157) and Ironman Lake Placid (34,341). The fastest overall race times were achieved in Ironman Copenhagen (11.68 ± 1.38 h), followed by Ironman Hawaii (11.72 ± 1.86 h), Ironman Barcelona (11.78 ± 1.43 h), Ironman Florianópolis (11.80 ± 1.52 h), Ironman Frankfurt (12.03 ± 1.38 h) and Ironman Kalmar (12.08 ± 1.47 h). The fastest athletes originated from Belgium (11.48 ± 1.47 h), followed by athletes from Denmark (11.59 ± 1.40 h), Switzerland (11.62 ± 1.49 h), Austria (11.68 ± 1.50), Finland (11.68 ± 1.40 h) and Germany (11.74 ± 15.1 h). Flat running and cycling courses were associated with faster overall race times. Three of the predictive models identified the 'country' and 'age group' variables as the most important predictors. Environmental characteristics showed the lowest influence regarding the other variables. The origin of the athlete was the most predictive variable whereas environmental characteristics showed the lowest influence. Flat cycling and flat running courses were associated with faster overall race times. The fastest overall race times were achieved mainly in European races such as Ironman Copenhagen, Ironman Hawaii, Ironman Barcelona, Ironman Florianópolis, Ironman Frankfurt and Ironman Kalmar. The fastest triathletes originated from European countries such as Belgium, Denmark, Switzerland, Austria, Finland, and Germany. [ABSTRACT FROM AUTHOR]

The six‐minute walking test (6MWT) is commonly used to measure functional capacity in field settings, primarily through the distance covered. This study aims to establish reference curves for the six‐minute walking distance (6MWD) and peak heart rate (PHR) and develop a predictive equation for cardiovascular capacity in Tunisian children and adolescents. A total of 1501 participants (706 boys and 795 girls), aged 10–18 years, were recruited from schools in Tunisia. The Lambda (L), Mu (M), and Sigma (S) methods (LMS method) were employed to develop smoothed percentile curves for 6MWD and PHR. Multivariate linear regression was utilized to formulate a prediction equation for 6MWD. Smoothed percentiles (3rd, 10th, 25th, 50th, 75th, 90th, and 97th) for 6MWD and PHR were presented with age. All variables showed a strong positive correlation (p < 0.001) with a six‐minute walking distance (r ranged from 0.227 to 0.558 for girls and from 0.309 to 0.610 for boys), except resting heart rate, which showed a strong negative correlation (girls: r = −0.136; boys: r = −0.201; p < 0.001). Additionally, PHR showed a weak correlation (p > 0.05). The prediction equations, based on age as the primary variable, were established for both genders. For boys: 6MWD = 66.181 + 38.142 × Age (years) (R2 = 0.372; Standard Error of Estimate (SEE) = 122.13), and for girls: 6MWD = 105.535 + 28.390 × Age (years) (R2 = 0.312; SEE = 103.66). The study provides normative values and predictive equations for 6MWD and PHR in Tunisian children and adolescents. These findings offer essential tools for identifying, monitoring, and interpreting cardiovascular functional deficits in clinical and research settings. Highlights: Established reference curves for six‐minute walking distance (6MWD) and peak heart rate (PHR) from the data of 1501 children and adolescents aged 10–18 years were recruited from multicenter schools in Tunisia.Developed predictive equations for 6MWD based on age using multivariate linear regression.Provides normative values and predictive equations for 6MWD and PHR, offering valuable tools for identifying and monitoring cardiovascular functional deficits in clinical and research settings. [ABSTRACT FROM AUTHOR]

Copyright of Praxis (16618157) is the property of Aerzteverlag medinfo AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Despite the established positive association between patient experience and patient volume, the relationship between patient experience and the financial performance of hospitals has not been studied thoroughly. Methods: To investigate this relationship, we used longitudinal data from 132 Swiss acute-care hospitals from 2016 to 2019 to examine the associations between patient experience and the proportion of elective patients, revenue, costs, and profits of hospitals. To account for a potential time lag effect, we utilized annual patient experience data and employed multilevel mixed-effects regression modeling to investigate its association with the aforementioned financial performance indicators for the following year. Results: Data for private and public hospitals were analyzed both separately and in combination, to account for the different proportions of elective patients in these types of hospitals. The resulting mixed models, revealed that for each year studied, the previous year's patient experience was positively associated with the current year's proportion of elective patients (β = 0.09, p = 0.004, all hospitals) and revenue (β = 1789.83, p = 0.037, private hospitals only), and negatively associated with costs (β = − 1191.13, p = 0.017, all hospitals); but not significantly associated with future profits (β = 629.12, p = 0.240, all hospitals). Conclusions: This analysis showed that better patient experience is associated with a higher proportion of elective patients, greater revenue, and lower costs. Our findings may assist hospital managers and regulators in identifying strategies to increase revenue and reduce costs. [ABSTRACT FROM AUTHOR]

Copyright of Praxis (16618157) is the property of Aerzteverlag medinfo AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cardiovascular diseases (CVD) represent a significant health problem worldwide and in Switzerland. Despite preventive measures and advances in treatment, cardiovascular diseases still lead to a significant number of hospitalizations in Switzerland (133 000 in 2021) and are for responsible for almost 1/3 of all deaths (19 600 in 2021). Emergency care for acute cardiovascular events now has a very high standard in Switzerland compared to other countries. However, there is a large discrepancy between evidence and daily practice (evidence-performance gap) in cardiovascular risk factor control, because a large percentage of patients do not achieve the goals of the guideline recommendations: 55% of hypertensives, 81% of patients with elevated LDL cholesterol and 44% of diabetics. In addition, 21% of people in Switzerland currently smoke, 42% are considered obese and 24% of people are sedentary. Therefore, primary and secondary prevention offers great potential for reducing the morbidity and mortality of cardiovascular diseases. Sub-optimal control of cardiovascular risk factors leads to preventable cardiovascular events and associated economic costs. Thus, cardiovascular diseases not only affect life expectancy, but also influence the years with reduced quality of life (disability-adjusted life years, DALY). In Switzerland, the main risk factors of cardiovascular diseases lead to a loss of 311 332 DALYs in total, 45 454 DALYs lost by hypertension, 64 445 DALYs lost due to hyperlipidema, 24 283 DALYs due to diabetes mellitus, 47 639 DALYs due to smoking, 21 170 DALYs lost by obesity)and 4 669 DALYs lost due to a lack of exercise. Assuming that one DALY is associated with a socioeconomic burden of CHF 99 417, the total socioeconomic cost of all cardiovascular diseases is 4% of gross domestic product (GDP). Furthermore, cardiovascular diseases caused a cost burden of CHF 27,8 billion in direct and indirect healthcare costs in 2021. [ABSTRACT FROM AUTHOR]