Men's Participation and Performance in the Boston Marathon from 1897 to 2017.

This study examined men's participation and performance in the Boston Marathon. Data from all 368,940 official male finishers in the Boston Marathon from 1897 through 2017 were analyzed using different analyses and regression models for all runners, annual top hundred finishers, annual top ten finishers and annual winners. Effect of calendar year on race time was examined alone, in a uni-variable model, and together with country of origin and weather conditions (average air temperature and precipitation) in a multi-variable model. The mean race time of all finishers increased across calendar years, in line with the participation, but it decreased when we considered the annual winners, 10 and 100 fastest. Kenyans and Ethiopians were the fastest nationalities (p<0.001) when we considered all finishers and the annual top 100 fastest but not when the annual 10 fastest were considered. Air temperature≤8 °C improved (p<0.001) race times compared to air temperature>8°C. Precipitation (>0 mm) improved performance for the annual 100 fastest and annual 10 fastest (p=0.013-0.031) but not for all finishers. Our findings improved the knowledge about the evolution of male marathoners across calendar years, considering as main effects country of origin and particular weather conditions.

Performance and age of African and non-African runners in World Marathon Majors races 2000-2014.

The age for the fastest marathoners is well investigated, but not the age and nationality of the fastest. We investigated the age of peak marathon performance for the annual top 100 women and men competing in four races of the "World Marathon Majors" (Boston, Berlin, Chicago and New York) and the "Stockholm Marathon" between 2000 and 2014 using mixed-effects regression analyses and one-way ANOVA. Race times of Ethiopian men decreased to 2:14 h:min, but remained unchanged for Kenyan (2:14 h:min), Moroccan (2:15 h:min) and South African (2:18 h:min) men. Race times in Ethiopian (2:34 h:min), Kenyan (2:29 h:min) and South African (2:49 h:min) women showed no changes. Age increased in Ethiopian and South African men to 29.0 ± 5.0 and 32.0 ± 1.0 years, respectively. Age for Kenyan (29.9 ± 2.0 years) and Moroccan (34.9 ± 3.9 years) men remained unchanged. Age remained unchanged for Ethiopian (26.5 ± 2.0 years), Kenyan (30.0 ± 0.8 years) and South African (36.3 ± 7.0 years) women. In summary, Ethiopian men improved marathon race times, but not Ethiopian women. Age increased in Ethiopian men, but not in Ethiopian women. For practical applications, female and male marathoners from Ethiopia were the youngest and the fastest.

Performance Trends in Age Group Triathletes in the Olympic Distance Triathlon at the World Championships 2009-2014.

Performance trends in elite triathletes competing in age group classes have been investigated for Ironman triathlon in 'Ironman Hawaii' but not for short distance triathletes competing at international level in events such as the Olympic distance triathlon at the World Championships. The aim of the present study was to evaluate participation and performance trends of age group triathletes competing in the Olympic distance triathlon at the International Triathlon Union (ITU) World Championships 2009-2014. During this period, the number of participants remained constant. Swimming performance improved in athletes in age groups 25-29 years to 55-59 years, but not in younger (18-24 years) and older (> 60-64 years) age groups. Cycling performance improved in athletes in age groups 18-24 years to 70-74 years, but not in age group 75-79 years. In running, athletes in age groups 18-24 years, 30-34 years, 35-39 years and 65-69 years improved, but not in the other age groups. Overall race time was improved by athletes in age groups 18-24 to 65-69 years, but not in age groups 70-74 years and 75-79 years. Transition times were improved by all age group athletes. Women were slower than men in swimming, cycling, running and overall race time in age groups 18-24 years to 70-74 years, but not in the age group 75-79 years. For transition times, women were slower than men in age groups 18-24 years to 65-69 years, but not in age groups 70-74 years to 75-79 years. In summary, women and men improved performance in most age groups across all years, men were faster than women except in the age group 75-79 years and the sex difference between women and men remained constant. This knowledge should be considered when future age group triathletes train for and compete in Olympic distance triathlons at international level.

Differences in age of peak marathon performance between mountain and city marathon running - The 'Jungfrau Marathon' in Switzerland.

The age of the best marathon performance has been well investigated for flat city marathon running, but not for mountain marathon running. The aim of this study was to determine the age of the best mountain marathon performance and to compare to results of a flat city marathon. Race times and ages of finishers of a mountain marathon with 1,830 m of altitude change (Jungfrau Marathon, Switzerland) and two flat city marathons (Lausanne Marathon and Zurich Marathon, Switzerland) were analysed using linear, non-linear and mixed-effects regression analyses. Race times were slower in the mountain compared to the city marathon. In both the mountain marathon and the city marathons, women and men improved performance and men were faster than women when the fastest per year and all per year were considered. When the fastest runners in 1-year age intervals were considered in the mountain marathon, the fastest man (3:01 h:min) was ~35.6 years and the fastest women (3:28 h:min) ~34.5 years old. When all finishers were considered in 1-year age intervals, the fastest men (4:59 h:min) were ~29.1 years old and the fastest women (5:16 h:min) were ~25.6 years old. In the city marathons in 1-year age intervals, the fastest man (2:10 h:min) was ~23.7 years old and the fastest woman (2:36 h:min) ~32.2 years old. When all finishers were considered in 1-year age intervals, the fastest men (3:41 h:min) were ~35.0 years old and the fastest women (4:00 h:min) ~33.8 years old. In summary, the age of the fastest women and men was higher in the mountain marathon compared to the city marathons when the fastest runners were considered. However, when all finishers were considered the age of the fastest women and men was lower in the mountain marathon compared to the city marathons.

Performance trends in age group breaststroke swimmers in the FINA World Championships 1986-2014.

Performance trends in breaststroke swimmers competing at world class level in pool competitions are well investigated for elite swimmers, but not for age group swimmers. This study investigated trends in participation, performance and sex difference in performance in a total of 35,143 (16,160 women and 18,983 men) age group breaststroke swimmers aged 25-29 to 95-99 years competing in the Fédération Internationale de Natation (FINA) World Masters Championships between 1986 and 2014. Trends in participation were analysed using linear regression analyses and trends in performance were investigated using mixed-effects regression analyses with sex, distance and calendar year as fixed variables. Women and men improved performance in all age groups. For age groups 25-29 to 85-89 years, men were faster than women. For age groups 90-94 to 95-99 years, men were not faster than women. Sex and distance showed a significant interaction for all distances in age groups 25-29 to 80-84 years. In 50 m, women reduced the gap to men in age groups 40-44 to 70-74 years and in 100 m and 200 m, women reduced the gap in age groups 50-54 to 60-64 years. In summary, (i) women and men improved performance in all race distances and in all age groups, (ii) men were faster than women from 25 to 89 years, but not from 90 to 99 years, and (iii), women reduced the gap to men between ~40 and ~75 years, but not in younger (<40 years) or older (>75 years) age groups. Based on these findings for a time period of nearly 30 years, we may assume a further increase in participation and a further improvement in performance in the near future in age group breaststroke swimmers competing at world class level.

Sex Difference in Draft-Legal Ultra-Distance Events - A Comparison between Ultra-Swimming and Ultra-Cycling.

Recent studies reported that the sex difference in performance in ultra-endurance sports such as swimming and cycling changed over the years. However, the aspect of drafting in draft-legal ultra-endurance races has not yet been investigated. This study investigates the sex difference in ultra-swimming and ultra-cycling draft-legal races where drafting - swimming or cycling behind other participants to save energy and have more power at the end of the race to overtake them, is allowed. The change in performance of the annual best and the annual three best in an ultra-endurance swimming race (16-km 'Faros Swim Marathon') over 38 years and in a 24-h ultra-cycling race ('World Cycling Race') over 13 years were compared and analysed with respect to sex difference. Furthermore, performances of the fastest female and male finishers ever were compared. In the swimming event, the sex difference of the annual best male and female decreased non-significantly (P = 0.262) from 5.3% (1976) to 1.0% (2013). The sex gap of speed in the annual three fastest swimmers decreased significantly (P = 0.043) from 5.9 ± 1.6% (1979) to 4.7 ± 3.1% (2013). In the cycling event, the difference in cycling speed between the annual best male and female decreased significantly (P = 0.026) from 33.31% (1999) to 10.89% (2011). The sex gap of speed in the annual three fastest decreased significantly (P = 0.001) from 32.9 ± 0.6% (1999) to 16.4 ± 5.9% (2011). The fastest male swimmer ever (swimming speed 5.3 km/h, race time: 03:01:55 h:min:s) was 1.5% faster than the fastest female swimmer (swimming speed 5.2 km/h, race time: 03:04:09 h:min:s). The three fastest male swimmers ever (mean 5.27 ± 0.13 km/h) were 4.4% faster than the three fastest female swimmers (mean 5.05 ± 0.20 km/h) (P < 0.05). In the cycling event, the best male ever (cycling speed 45.8 km/h) was 26.4% faster than the best female (cycling speed 36.1 km/h). The three fastest male cyclists ever (45.9 km/h) (mean 45.85 ± 0.05 km/h) were 32.1% faster (P < 0.05) than the three fastest female cyclists ever (34.7 km/h) (mean 34.70 ± 1.87 km/h). In summary, in draft-legal ultra-distance events such as swimming and cycling, the sex difference in the annual top and annual top three swimmers and cyclists decreased (i.e. non-linearly in swimmers and linearly in cyclists) over the years. The sex difference of the fastest athletes ever was smaller in swimming (1.5%) than in cycling (26.4%). This finding is different from reports about races where drafting was not possible or even prohibited and where the sex difference remained stable over years.

Improved Race Times in Marathoners Older than 75 Years in the Last 25 Years in the World's Largest Marathons.

Performance trends of elite marathoners are well investigated. However, performance of elderly marathoners (> 75 years) competing in the world's largest city marathons is not well-known. We examined marathon race data of 1,691 marathon finishes (i.e. 218 women and 1,473 men) competing between 1990 and 2014 in 5-year age groups 75-79, 80-84, 85-89, and 95-99 years in four races (Berlin, New York, Chicago and Boston) of the 'World Marathon Majors'. The number of female (r² = 0.50, P < 0.0001) and male (r² = 0.88, P < 0.0001) finishers increased significantly across years. The number of women (r² = 0.36, P = 0.0019) and men (r² = 0.88, P < 0.0001) in age group 75-79 years increased. In age group 80-84 years, the number of women (r² = 0.36, P = 0.0111) and men (r² = 0.54, P < 0.0001) also increased. In age groups 85-89 to 95-99 years, however, the number of female and male finishers remained unchanged. Across years, women (r² = 0.26, P = 0.0090) and men (r² = 0.31, P = 0.0035) reduced their race times. Women and men in age group 75-79 years improved race times. In age groups 80-84 to 90-94 years, women and men were not able to reduce race times. In summary, participation increased and performance improved in female and male marathoners competing in age groups 75-79 to 95-99 years where the largest increases in participation and the largest improvements in performance were found in women and men in age group 75-79 years.

Performance and sex differences in 'Isklar Norseman Xtreme Triathlon'.

The performance and sex differences of long-distance triathletes competing in 'Ironman Hawaii' are well investigated. However, less information is available with regards to triathlon races of the Ironman distance held under extreme environmental conditions (e.g. extreme cold) such as the 'Isklar Norseman Xtreme Triathlon' which started in 2003. In 'Isklar Norseman Xtreme Triathlon', athletes swim at a water temperature of ~13-15°C, cycle at temperatures of ~5-20°C and run at temperatures of ~12-28°C in the valley and of ~2-12°C at Mt. Gaustatoppen. This study analysed the performance trends and sex differences in 'Isklar Norseman Xtreme Triathlon' held from 2003 to 2015 using mixed-effects regression analyses. During this period, a total of 175 women (10.6%) and 1,852 men (89.4%) successfully finished the race. The number of female (r² = 0.53, P = 0.0049) and male (r² = 0.37, P = 0.0271) finishers increased and the men-to-women ratio decreased (r² = 0.86, P < 0.0001). Men were faster than women in cycling (25.41 ± 2.84 km/h versus 24.25 ± 2.17 km/h) (P < 0.001), but not in swimming (3.06 ± 0.62 km/h vs. 2.94 ± 0.57 km/h), running (7.43 ± 1.13 km/h vs. 7.31 ± 0.93 km/h) and overall race time (874.57 ± 100.62 min vs. 899.95 ± 90.90 min) (P > 0.05). Across years, women improved in swimming and both women and men improved in cycling and in overall race time (P < 0.001). In running, however, neither women nor men improved (P > 0.05). In summary, in 'Isklar Norseman Xtreme Triathlon' from 2003 to 2015, the number of successful women increased across years, women achieved a similar performance to men in swimming, cycling and overall race time, and women improved across years in swimming, cycling and overall race time.

Gender difference in cycling speed and age of winning performers in ultra-cycling - the 508-mile "Furnace Creek" from 1983 to 2012.

We analysed (i) the gender difference in cycling speed and (ii) the age of winning performers in the 508-mile "Furnace Creek 508". Changes in cycling speeds and gender differences from 1983 to 2012 were analysed using linear, non-linear and hierarchical multi-level regression analyses for the annual three fastest women and men. Cycling speed increased non-linearly in men from 14.6 (s = 0.3) km · h(-1) (1983) to 27.1 (s = 0.7) km · h(-1) (2012) and non-linearly in women from 11.0 (s = 0.3) km · h(-1) (1984) to 24.2 (s = 0.2) km · h(-1) (2012). The gender difference in cycling speed decreased linearly from 26.2 (s = 0.5)% (1984) to 10.7 (s = 1.9)% (2012). The age of winning performers increased from 26 (s = 2) years (1984) to 43 (s = 11) years (2012) in women and from 33 (s = 6) years (1983) to 50 (s = 5) years (2012) in men. To summarise, these results suggest that (i) women will be able to narrow the gender gap in cycling speed in the near future in an ultra-endurance cycling race such as the "Furnace Creek 508" due to the linear decrease in gender difference and (ii) the maturity of these athletes has changed during the last three decades where winning performers become older and faster across years.

The changes in age of peak swim speed for elite male and female Swiss freestyle swimmers between 1994 and 2012.

This study determined the age and its changes across years of peak swimming performance from 50 to 1,500 m freestyle. Data of 70,059 Swiss freestyle swimmers (33,725 women and 36,334 men) aged 10-40 years and competing from 50 to 1,500 m were analysed. The association between age and swimming speed of the annual ten fastest swimmers was investigated using single and multi-level hierarchical regression analyses. For women, age of peak swimming speed increased in 50 m from 18.9 (s = 2.3) to 20.4 (s = 4.2) years but decreased in 1,500 m from 25.0 (s = 13.1) (1996) to 18.1 (s = 3.7) years. For 100-800 m, age remained at 19.1 (s = 1.1), 19.3 (s = 1.1), 18.7 (s = 1.5) and 18.5 (s = 1.3) years, respectively. For men, age of peak swimming speed decreased in 50 m from 23.0 (s = 4.0) to 23.0 (s = 3.5) but remained for 100-1,500 m at 22.5 (s = 1.4), 21.4 (s = 0.9), 20.3 (s = 0.9), 20.3 (s = 0.9) and 20.3 (s = 1.1) years, respectively. Age was positively associated with swimming speed for 50-800 m, but negatively for 1,500 m. In conclusion, the age of peak swimming speed was younger in women compared to men for 50-800 m freestyle. For women, age of peak swimming speed increased in 50 m but decreased in 1,500 m freestyle across years. For men, age of peak swimming speed decreased in 50 m freestyle.

Participation and performance trends in 100-km ultra-marathons worldwide.

The aims of the present study were to (1) investigate the participation trends for the origin of athletes competing in 100-km ultra-marathons and (2) determine the nationalities of athletes achieving the fastest 100-km race times worldwide. Race times and nationality from 112,283 athletes (15,204 women and 97,079 men) from 102 countries who completed a 100-km ultra-marathon worldwide between 1998 and 2011 were investigated using single- and multi-level regression analyses. The number of finishers increased exponentially, both for women and men. Most of the finishers (73.5%) were from Europe, in particular, France (30.4%). The number of finishers from Japan, Germany, Italy, Poland and the United States of America increased exponentially during the studied period. For women, runners from Canada became slower while those from Italy became faster over time. For men, runners from Belgium, Canada and Japan became slower. Between 1998 and 2011, the ten best race times were achieved by Japanese runners for both women with 457.1 (s = 28.8) min and men with 393.4 (s = 9.6) min. To summarise, most of the finishers in 100-km ultra-marathons originated from Europe, but the best performances belong to Japanese runners. Although East African runners dominate running up to a marathon, Japanese were the best in 100 km.

Enhancing patient safety: detection of in-hospital hazards and effect of training on detection (by training in a low-fidelity simulation Room of Improvement based on hospital-specific CIRS cases).

IMPORTANCE: Adequate situational awareness in patient care increases patient safety and quality of care. To improve situational awareness, an innovative, low-fidelity simulation method referred to as Room of Improvement, has proven effective in various clinical settings. OBJECTIVE: To investigate the impact after 3 months of Room of Improvement training on the ability to detect patient safety hazards during an intensive care unit shift handover, based on critical incident reporting system (CIRS) cases reported in the same hospital. METHODS: In this educational intervention, 130 healthcare professionals observed safety hazards in a Room of Improvement in a 2 (time 1 vs time 2)×2 (alone vs in a team) factorial design. The hazards were divided into immediately critical and non-critical. RESULTS: The results of 130 participants were included in the analysis. At time 1, no statistically significant differences were found between individuals and teams, either overall or for non-critical errors. At time 2, there was an increase in the detection rate of all implemented errors for teams compared with time 1, but not for individuals. The detection rate for critical errors was higher than for non-critical errors at both time points, with individual and group results at time 2 not significantly different from those at time 1. An increase in the perception of safety culture was found in the pre-post test for the questions whether the handling of errors is open and professional and whether errors are discussed in the team. DISCUSSION: Our results indicate a sustained learning effect after 12 weeks, with collaboration in teams leading to a significantly better outcome. The training improved the actual error detection rates, and participants reported improved handling and discussion of errors in their daily work. This indicates a subjectively improved safety culture among healthcare workers as a result of the situational awareness training in the Room of Improvement. As this method promotes a culture of safety, it is a promising tool for a well-functioning CIRS that closes the loop.

No damage of joint cartilage of the lower limbs in an ultra-endurance athlete--an MRI-study.

BACKGROUND: Osteoarthritis is an increasing burden in an ageing population. Sports, especially when leading to an overstress of joints, is under suspicion to provoke or at least accelerate the genesis of osteoarthritis. We present the radiologic findings of a 49-years old ultra-endurance athlete with 35 years of training and competing, whose joints of the lower limbs were examined using three different types of magnetic resonance imaging, including a microscopic magnetic resonance imaging coil. To date no case report exists where an ultra-endurance athlete was examined such detailed regarding overuse-injuries of his joints. CASE PRESENTATION: A 49 years old, white, male ultra-endurance athlete reporting no pain during training and racing and with no significant injuries of the lower limbs in his medical history was investigated regarding signs of chronic damage or overuse injuries of the joints of his lower limbs. CONCLUSION: Despite the age of nearly 50 years and a training history of over 35 years, the athlete showed no signs of chronic damage or overuse injuries in the joints of his lower limbs. This leads to the conclusion that extensive sports and training does not compulsory lead to damages of the musculoskeletal system. This is a very important finding for all endurance-athletes as well as for their physicians.

Age and gender interactions in short distance triathlon performance.

This study investigated the participation and performance trends as well as the age and gender interaction at the Olympic distance 'Zürich Triathlon' (1.5 km swim, 40 km cycle and 10 km run) from 2000 to 2010 in 7,939 total finishers (1,666 females and 6,273 males). Female triathletes aged from 40 to 54 years significantly (P < 0.05) increased their participation while the participation of younger females and males remained stable. Males of 50-54 years of age and females of 45-49 years of age improved their total race time. For elite top five overall triathletes, mean gender differences in swimming, cycling, running and overall race time were 15.2 ± 4.6%, 13.4 ± 2.3%, 17.1 ± 2.5%, and 14.8 ± 1.8%, respectively. For both elite and age group athletes, the gender difference in cycling time was significantly (P <0.001) lower than for swimming and running. The gender difference in overall Olympic distance triathlon performance increased after the age of 35 years, which appeared earlier compared to long distance triathlon as suggested by previous studies. Future investigations should compare gender difference in performance for different endurance events across age to confirm a possible effect of exercise duration on gender difference with advancing age.

A comparison of anthropometric and training characteristics between recreational female marathoners and recreational female Ironman triathletes.

A personal best marathon time has been reported as a strong predictor variable for an Ironman race time in recreational female Ironman triathletes. This raises the question whether recreational female Ironman triathletes are similar to recreational female marathoners. We investigated similarities and differences in anthropometry and training between 53 recreational female Ironman triathletes and 46 recreational female marathoners. The association of anthropometric variables and training characteristics with race time was investigated using bi- and multi-variate analysis. The Ironman triathletes were younger (P < 0.01), had a lower skin-fold thickness at pectoral (P < 0.001), axillar (P < 0.01), and subscapular (P < 0.05) site, but a thicker skin-fold thickness at the calf site (P < 0.01) compared to the marathoners. Overall weekly training hours were higher in the Ironman triathletes (P < 0.001). The triathletes were running faster during training than the marathoners (P < 0.05). For the triathletes, neither an anthropometric nor a training variable showed an association with overall Ironman race time after bi-variate analysis. In the multi-variate analysis, running speed during training was related to marathon split time for the Ironman triathletes (P = 0.01) and to marathon race time for the marathoners (P = 0.01). To conclude, although personal best marathon time is a strong predictor variable for performance in recreational female Ironman triathletes, there are differences in both anthropometry and training between recreational female Ironman triathletes and recreational female marathoners and different predictor variables for race performance in these two groups of athletes. These findings suggest that recreational female Ironman triathletes are not comparable to recreational female marathoners regarding the association between anthropometric and training characteristics with race time.

Comparison of training and anthropometric characteristics between recreational male half-marathoners and marathoners.

Participation in endurance running such as half-marathon (21-km) and marathon (42-km) has increased over the last decades. We compared 147 recreational male half-marathoners and 126 recreational male marathoners to investigate similarities or differences in their anthropometric and training characteristics. The half-marathoners were heavier (P < 0.05), had longer legs (P < 0.001), thicker upper arms (P < 0.05), a thicker thigh (P < 0.01), a higher sum of skinfold thicknesses (P < 0.01), a higher body fat percentage (P < 0.05) and a higher skeletal muscle mass (P < 0.05) than the marathoners. They had fewer years of experience (P < 0.05), completed fewer weekly training kilometers (P < 0.001), and fewer weekly running hours (P < 0.01) compared to the marathoners. For half-marathoners, body mass index (P = 0.011), percent body fat (P = 0.036) and speed in running during training (P < 0.0001) were related to race time (r2 = 0.47). For marathoners, percent body fat (P = 0.001) and speed in running during training (P < 0.0001) were associated to race time (r2 = 0.47). When body mass index was excluded for the half-marathoners in the multi-variate analysis, r2 decreased to 0.45, therefore body mass index explained only 2% of the variance of half-marathon performance. Percent body fat was significantly and negatively related to running speed during training in both groups. To summarize, half-marathoners showed differences in both anthropometry and training characteristics compared to marathoners that could be related to their lower training volume, most probably due to the shorter race distance they intended to compete. Both groups of athletes seemed to profit from low body fat and a high running speed during training for fast race times.

Sex differences in ultra-triathlon performance at increasing race distance.

It has been argued that women should be able to outrun men in ultra-endurance distances. The present study investigated the sex difference in overall race times and split times between elite female and male Ironman triathletes competing in Ironman Hawaii (3.8 km swimming, 180 km cycling, and 42.195 km running) and Double Iron ultra-triathletes (7.6 km swimming, 360 km cycling, and 84.4 km running). Data from 20,638 athletes, including 5,163 women and 15,475 men competing in Ironman Hawaii and from 143 women and 1,252 men competing in Double Iron ultra-triathlon races held worldwide between 1999 and 2011 were analyzed. In Ironman Hawaii, the sex difference in performance of the top three athletes remained unchanged during the period studied for overall race time. For Double Iron ultra-triathletes, the sex difference for the top three athletes remained unchanged for overall race time. Sex differences increased as endurance race distances increased and showed no changes over time. It appears that women are unlikely to close the gap in ultra-endurance performance with men in ultra-triathlons in the near future. Physiological (e.g., maximum oxygen uptake) and anthropometric characteristics (e.g., skeletal muscle mass) may set biological limits for women.

Sex-related trends in participation and performance in the 'Swiss Bike Masters' from 1994-2012.

General participation in contests such as ultra-marathons and ultra-triathlons has increased considerably over the past 30 years, especially among women. This study investigated performance trends in the Swiss Bike Masters, one of the first and most prestigious mountain bike, ultra-endurance races in its class, with comparisons of participation and performance trends to similar races. The development of performance in the Swiss Bike Masters held between 1994 and 2012 was investigated by analysing the number of finishers, their age, sex, and cycling speed. Between 1994 and 2009, the athletes had to cover 120 kilometers with a total difference in altitude of 5,000 meters. Since 2010, the race distance was shortened to 105 kilometers and the total difference in altitude was reduced to 4,400 meters. The total men participating and total finishing decreased significantly, while women's participation has remained low. The age of the annual winners and the annual top three finishers showed no changes over time. Performances of the annual fastest women improved, while performances of the annual fastest men remained unchanged. To summarize, rate of finishing has decreased for men and has been stable, but low, among women. The sex difference in cycling speed for the best cyclists has decreased across the years.

The age-related performance decline in ultraendurance mountain biking.

The age-related changes in ultraendurance performance have been previously examined for running and triathlon but not mountain biking. The aims of this study were (i) to describe the performance trends and (ii) to analyze the age-related performance decline in ultraendurance mountain biking in a 120-km ultraendurance mountain bike race the "Swiss Bike Masters" from 1995 to 2009 in 9,325 male athletes. The mean (±SD) race time decreased from 590 ± 80 min to 529 ± 88 min for overall finishers and from 415 ± 8 min to 359 ± 16 min for the top 10 finishers, respectively. The mean (±SD) age of all finishers significantly (P < 0.001) increased from 31.6 ± 6.5 years to 37.9 ± 8.9 years, while the age of the top 10 remained stable at 30.0 ± 1.6 years. The race time of mountain bikers aged between 25 and 34 years was significantly (P < 0.01) faster compared with the race time of older age groups. The age-related decline in performance in endurance mountain bikers in the "Swiss Bike Masters" appears to start earlier compared with other ultraendurance sports.

Oral transmucosal fentanyl citrate analgesia in prehospital trauma care: an observational cohort study.

BACKGROUND: Pain is one of the major prehospital symptoms in trauma patients and requires prompt management. Recent studies have reported insufficient analgesia after prehospital treatment in up to 43% of trauma patients, leaving significant room for improvement. Good evidence exists for prehospital use of oral transmucosal fentanyl citrate (OTFC) in the military setting. We hypothesized that the use of OTFC for trauma patients in remote and challenging environment is feasible, efficient, safe, and might be an alternative to nasal and intravenous applications. METHODS: This observational cohort study examined 177 patients who were treated with oral transmucosal fentanyl citrate by EMS providers in three ski and bike resorts in Switzerland. All EMS providers had previously been trained in administration of the drug and handling of potential adverse events. RESULTS: OTFC caused a statistically significant and clinically relevant decrease in the level of pain by a median of 3 (IQR 2 to 4) in NRS units (P < 0.0001). Multiple linear regression analysis showed a significant absolute reduction in pain, with no differences in all age groups and between genders. No major adverse events were observed. CONCLUSIONS: Prehospital administration of OTFC is safe, easy, and efficient for extrication and transport across all age groups, gender, and types of injuries in alpine environments. Side effects were few and mild. This could provide a valuable alternative in trauma patients with severe pain, without the delay of inserting an intravenous line, especially in remote areas, where fast action and easy administration are important.