Analysis of over 1 million race records shows runners from East African countries as the fastest in 50-km ultra-marathons.

The 50-km ultra-marathon is a popular race distance, slightly longer than the classic marathon distance. However, little is known about the country of affiliation and age of the fastest 50-km ultra-marathon runners and where the fastest races are typically held. Therefore, this study aimed to investigate a large dataset of race records for the 50-km distance race to identify the country of affiliation and the age of the fastest runners as well as the locations of the fastest races. A total of 1,398,845 50-km race records (men, n = 1,026,546; women, n = 372,299) were analyzed using both descriptive statistics and advanced regression techniques. This study revealed significant trends in the performance of 50-km ultra-marathoners. The fastest 50-km runners came from African countries, while the fastest races were found to occur in Europe and the Middle East. Runners from Ethiopia, Lesotho, Malawi, and Kenya were the fastest in this race distance. The fastest 50-km racecourses, providing ideal conditions for faster race times, are in Europe (Luxembourg, Belarus, and Lithuania) and the Middle East (Qatar and Jordan). Surprisingly, the fastest ultra-marathoners in the 50-km distance were found to fall into the age group of 20-24 years, challenging the conventional belief that peak ultra-marathon performance comes in older age groups. These findings contribute to a better understanding of the performance models in 50-km ultra-marathons and can serve as valuable insights for runners, coaches, and race organizers in optimizing training strategies and racecourse selection.

Cycling is the most important predictive split discipline in professional Ironman® 70.3 triathletes.

Introduction: Our study examined 16,611 records of professional triathletes from 163 Ironman® 70.3 races across 97 countries (2004-2020). The aim was to identify the most predictive discipline-swim, bike, or run-for overall race time. Methods: We used correlation matrices to compare the dependent variable "finish time" with independent variables "swim time," "bike time," and "run time." This analysis was conducted separately for male and female athletes. Additionally, univariate and multiple linear regression models assessed the strength of these associations. Results: The results indicated that "bike time" had the strongest correlation with finish time (0.85), followed by "run time" (0.75 for females, 0.82 for males) and "swim time" (0.46 for females, 0.63 for males). Regression models confirmed "bike time" as the strongest predictor of overall race time (R² = 0.8), with "run time" and "swim time" being less predictive. Discussion: The study concludes that in Ironman 70.3 races, "bike time" is the most significant predictor of overall race performance for both sexes, suggesting a focus on cycling in training and competition strategies. It also highlights a smaller performance gap between genders in swimming than in cycling or running.

Endophyte genomes support greater metabolic gene cluster diversity compared with non-endophytes in Trichoderma.

Trichoderma is a cosmopolitan genus with diverse lifestyles and nutritional modes, including mycotrophy, saprophytism, and endophytism. Previous research has reported greater metabolic gene repertoires in endophytic fungal species compared to closely-related non-endophytes. However, the extent of this ecological trend and its underlying mechanisms are unclear. Some endophytic fungi may also be mycotrophs and have one or more mycoparasitism mechanisms. Mycotrophic endophytes are prominent in certain genera like Trichoderma, therefore, the mechanisms that enable these fungi to colonize both living plants and fungi may be the result of expanded metabolic gene repertoires. Our objective was to determine what, if any, genomic features are overrepresented in endophytic fungi genomes in order to undercover the genomic underpinning of the fungal endophytic lifestyle. Here we compared metabolic gene cluster and mycoparasitism gene diversity across a dataset of thirty-eight Trichoderma genomes representing the full breadth of environmental Trichoderma's diverse lifestyles and nutritional modes. We generated four new Trichoderma endophyticum genomes to improve the sampling of endophytic isolates from this genus. As predicted, endophytic Trichoderma genomes contained, on average, more total biosynthetic and degradative gene clusters than non-endophytic isolates, suggesting that the ability to create/modify a diversity of metabolites potential is beneficial or necessary to the endophytic fungi. Still, once the phylogenetic signal was taken in consideration, no particular class of metabolic gene cluster was independently associated with the Trichoderma endophytic lifestyle. Several mycoparasitism genes, but no chitinase genes, were associated with endophytic Trichoderma genomes. Most genomic differences between Trichoderma lifestyles and nutritional modes are difficult to disentangle from phylogenetic divergences among species, suggesting that Trichoderma genomes maybe particularly well-equipped for lifestyle plasticity. We also consider the role of endophytism in diversifying secondary metabolism after identifying the horizontal transfer of the ergot alkaloid gene cluster to Trichoderma.

A Hybrid Online Off-Policy Reinforcement Learning Agent Framework Supported by Transformers.

Reinforcement learning (RL) is a powerful technique that allows agents to learn optimal decision-making policies through interactions with an environment. However, traditional RL algorithms suffer from several limitations such as the need for large amounts of data and long-term credit assignment, i.e. the problem of determining which actions actually produce a certain reward. Recently, Transformers have shown their capacity to address these constraints in this area of learning in an offline setting. This paper proposes a framework that uses Transformers to enhance the training of online off-policy RL agents and address the challenges described above through self-attention. The proposal introduces a hybrid agent with a mixed policy that combines an online off-policy agent with an offline Transformer agent using the Decision Transformer architecture. By sequentially exchanging the experience replay buffer between the agents, the agent's learning training efficiency is improved in the first iterations and so is the training of Transformer-based RL agents in situations with limited data availability or unknown environments.

Comparing the Performance Gap Between Males and Females in the Older Age Groups in IRONMAN® 70.3: An Internet-Based Cross-Sectional Study of More Than 800,000 Race Records.

BACKGROUND: The sex difference in the three split disciplines (swimming, cycling, and running) and overall race times in triathlon races has mainly been investigated for the Olympic distance and IRONMAN® triathlon formats, but not for the half IRONMAN® distance, i.e., the IRONMAN® 70.3. The aim of the present study was to investigate the sex differences in IRONMAN® 70.3 by age group in 5-year intervals for the split disciplines of this race. Data from 823,459 records (625,393 males and 198,066 females) of all age group finishers (in 5-year intervals) competing in all official IRONMAN® 70.3 races held worldwide between 2004 and 2020 were analyzed, and sex differences by age group and split disciplines were evaluated. RESULTS: Males were faster than females in all split disciplines and all age groups. The sex difference was lower in swimming than in cycling and running and less pronounced for triathletes between 20 and 50 years of age. After the age of 60 years, females were able to reduce the sex difference to males in swimming and cycling, but not in running, where the reduction in the sex difference started after the age of 70 years. The lowest sex difference was in the age group 75 + years for swimming and cycling and in the age group 30-34 years for running. Across age groups, the sex difference was U-shaped in swimming and running, with an increase after 18-24 years in swimming and after 40-44 years in running. In contrast, the sex difference decreased continuously with the increasing age for cycling. CONCLUSIONS: In conclusion, the study found that the sex difference in performance decreases with age in the IRONMAN® 70.3 race distance. However, females did not outperform males at older ages. Notably, sex differences were observed across different disciplines, with swimming displaying lower differences compared to cycling and running. These findings underscore the complex interplay between age, sex, and performance in endurance sports, emphasizing the need for additional research to understand the factors influencing these differences.

Elderly female ultra-marathoners reduced the gap to male ultra-marathoners in Swiss running races.

Recent studies showed that female runners reduced the performance gap to male runners in endurance running with increasing age and race distance. However, the investigated samples were generally small. To investigate this further, the present study examined sex differences by age across various race distances (5, 10 km, half-marathon, marathon, and ultra-marathon) using a large dataset of over 1,100,000 race records from Switzerland over two decades (1999-2019). The study explored performance and participation disparities between male and female runners by employing diverse methods, such as descriptive statistics, histograms, scatter and line plots, correlations, and a predictive machine learning model. The results showed that female runners were more prevalent in shorter races (5, 10 km, half-marathon) and outnumbered male runners in 5 km races. However, as the race distance increased, the male-to-female ratio declined. Notably, the performance gap between sexes reduced with age until 70 years, after which it varied depending on the race distance. Among participants over 75 years old, ultra-marathon running exhibited the smallest sex difference in performance. Elderly female ultra-marathoners (75 years and older) displayed a performance difference of less than 4% compared to male ultra-marathoners, which may be attributed to the presence of highly selected outstanding female performers.

Predicting overall performance in Ironman 70.3 age group triathletes through split disciplines.

Knowing which discipline contributes most to a triathlon performance is important to plan race pacing properly. To date, we know that the running split is the most decisive discipline in the Olympic distance triathlon, and the cycling split is the most important discipline in the full-distance Ironman® triathlon. However, we have no knowledge of the Ironman® 70.3. This study intended to determine the most crucial discipline in age group athletes competing from 2004 to 2020 in a total of 787 Ironman® 70.3 races. A total of 823,459 athletes (198,066 women and 625,393 men) from 240 different countries were analyzed and recorded in 5-year age groups, from 18 to 75 + years. Correlation analysis, multiple linear regression, and two-way ANOVA were applied, considering p < 0.05. No differences in the regression analysis between the contributions of the swimming, cycling, and running splits could be found for all age groups. However, the correlation analysis showed stronger associations of the cycling and running split times than the swimming split times with overall race times and a smaller difference in swimming performance between males and females in age groups 50 years and older. For age group triathletes competing in Ironman® 70.3, running and cycling were more predictive than swimming for overall race performance. There was a progressive reduction in the performance gap between men and women aged 50 years and older. This information may aid triathletes and coaches in planning their race tactics in an Ironman® 70.3 race.

A Machine Learning Approach to Finding the Fastest Race Course for Professional Athletes Competing in Ironman® 70.3 Races between 2004 and 2020.

Our purpose was to find the fastest race courses for elite Ironman® 70.3 athletes, using machine learning (ML) algorithms. We collected the data of all professional triathletes competing between 2004 and 2020 in Ironman 70.3 races held worldwide. A sample of 16,611 professional athletes originating from 97 different countries and competing in 163 different races was thus obtained. Four different ML regression models were built, with gender, country of origin, and event location considered as independent variables to predict the final race time. For all the models, gender was the most important variable in predicting finish times. Attending to the single decision tree model, the fastest race times in the Ironman® 70.3 World Championship of around ~4 h 03 min would be achieved by men from Austria, Australia, Belgium, Brazil, Switzerland, Germany, France, the United Kingdom, South Africa, Canada, and New Zealand. Considering the World Championship is the target event for most professional athletes, it is expected that training is planned so that they attain their best performance in this event.

First Report of Colletotrichum sansevieriae Causing Anthracnose of Snake Plant (Dracaena trifasciata) in Ohio and its Draft Genome.

Dracaena trifasciata (Prain) Mabb. is a popular houseplant in the United States. In September 2021, two diseased samples from two Ohio homeowners were received by the Ornamental Pathology Laboratory at The Ohio State University. Each sample included one or two detached leaves displaying circular gray water-soaked lesions scattered throughout the lamina and blighted areas with concentric rings bearing brown to black acervuli. Lesions covered between 25 and 50% of the leaf surface. Isolations were made by excising small portions of leaf tissue from the margin of the lesions, surface-disinfesting in 10% bleach for 45 s, rinsing in sterile water, and plating on potato dextrose agar (PDA). Plates were incubated at 23°C for one week. Two representative isolates, one per sample (FPH2021-5 and -6), were obtained by transferring hyphal tips to fresh PDA plates. Mycelia of both isolates were aerial, cottony, grayish-white, producing spores in a gelatinous orange matrix, and appeared gray to olivaceous-gray on the plate underside. Conidia produced by both isolates were cylindrical, single-celled, hyaline, measuring 12.02 to 18.11 (15.51) × 5.03 to 7.29 (6.14) µm (FPH2021-5; n=50) and 15.58 to 20.90 (18.39) × 5.63 to 8.27 (7.05) µm (FPH2021-6; n=50). Appressoria were globose to subglobose, single-celled, dark brown to sepia, measuring 6.62 to 13.98 (8.97) × 5.05 to 6.58 (6.58) µm (FPH2021-5; n=50), and 6.54 to 11.32 (8.63) × 4.54 to 8.94 (7.09) µm (FPH2021-6; n=50). Genomic DNA (gDNA) samples were extracted from both isolates and the internal transcribed spacer (ITS) region was amplified using primers ITS1F/ITS4 (Gardes and Bruns, 1993; White et al. 1990). GenBank BLAST sequence analysis resulted in 99.83% (FPH2021-5; GenBank Acc. No. OP410918.1) and 100% (FPH2021-6; OP410917.1) identity with 100% query coverage to the type strain of Colletotrichum sansevieriae Miho Nakam. & Ohzono MAFF239721 or Sa-1-2 (NR_152313.1; Nakamura et al. 2006). Whole genome sequencing was conducted for FPH2021-6 and the assembly was deposited in GenBank (JAOQIF000000000.1). The glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and ß-tubulin (ß-tub) regions were either extracted from the genome of FPH2021-6 (OP414603.1 and OP414601.1, respectively) or amplified from FPH2021-5 gDNA using primers GDF/GDR (OP414604.1) and Bt-2b/T1 (OP414602.1), respectively (Templeton et al. 1992; Glass and Donaldson 1995; O'Donnell and Cigelnik 1997). A multilocus partitioned analysis (Chernomor et al. 2016) based on concatenated sequences of ITS, GAPDH, and ß-tub using ModelFinder (Kalyaanamoorthy et al. 2017) was performed to build a maximum likelihood tree (IQ-TREE v2.0.3; Nguyen et al. 2015), suggesting that these two isolates are phylogenetically closer to the type strain from Japan than to a previously reported isolate 1047 from Florida (Palmateer et al. 2012). To fulfill Koch's postulates, two parallel leaf sections from one 10-inch D. trifasciata 'Laurentii' plant maintained in a 1.3-liter container were selected. Three wounds were made in each section using a sterile syringe needle. A 10-µl drop of either a 1×106 conidia/ml suspension of isolate FPH2021-6 or sterile water was placed on each wound. The plant was covered with a plastic bag for two days post-inoculation (DPI) and maintained in a greenhouse at 25°C with a 12- h photoperiod. The experiment was conducted twice. Grayish water-soaked lesions, acervuli, and leaf blight were observed on the inoculated sections 3, 10, and 14 DPI, respectively, while no symptoms appeared on the sections treated with sterile water. C. sansevieriae was re-isolated from the lesions and confirmed to be identical to the original isolate based on ITS sequencing and morphological examinations. To the best of our knowledge, this is the first report of C. sansevieriae on D. trifasciata in Ohio and the first genome draft of an isolate from the United States. Availability of whole-genome sequence data is paramount for resolving species identification in this highly diverse fungal genus, and a powerful tool to conduct comparative genomic analyses in the future.

Relationship between running performance and weather in elite marathoners competing in the New York City Marathon.

It is well known that weather and pacing have an influence on elite marathon performance. However, there is limited knowledge about the effect of weather on running speed in elite marathoners. The aim of the present cross-sectional study was to investigate potential associations between running speed and weather variables in elite runners competing in the 'New York City Marathon' between 1999 and 2019. Data from all official female and male finishers with name, sex, age, calendar year, split times at 5 km, 10 km, 15 km, 20 km, 25 km, 30 km, 35 km, 40 km and finish and hourly values for temperature (°Celsius), barometric pressure (hPa), humidity (%) and sunshine duration (min) between 09:00 a.m. and 04:00 p.m. were obtained from official websites. A total of 560,731 marathon runners' records were available for analysis (342,799 men and 217,932 women). Pearson and Spearman correlation analyses were performed between the average running speed and the weather variables (temperature, pressure, humidity and sunshine). Ordinary Least Squares (OLS) regressions were also performed. The runner´s records were classified into four performance groups (all runners, top 100, top 10 and top 3) for comparison. Differences in running speed between the four performance groups were statistically significant (p < 0.05) for both men and women. Pearson (linear) correlation indicated a weak and positive association with humidity in the top 10 (r = 0.16) and top 3 (r = 0.13) performance groups that the running speed of the elite runners was positively correlated with humidity. Regarding sunshine duration, there was a weak and positive correlation with the running speed of the elite groups (r = 0.16 in the top 10 and r = 0.2 in the top 3). Spearman correlation (non-linear) identified a weak but negative correlation coefficient with temperature in all runners' groups. Also, non-linear positive correlation coefficients with humidity and sunshine can be observed in the Spearman matrixes. A Multivariate Ordinary Least Squares (OLS) regression analysis showed no predictive power of weather factors. For elite runners competing in the 'New York City Marathon' between 1999 and 2019, the main findings were that elite runners became faster with increasing humidity and sunshine duration while overall runners became slower with increasing temperature, increasing humidity and sunshine duration. Weather factors affected running speed and results but did not provide a significant predictive influence on performance.

Whole-Genome Sequence Data for the Holotype Strain of Diaporthe ilicicola, a Fungus Associated with Latent Fruit Rot in Deciduous Holly.

Diaporthe ilicicola is a newly described fungal species that is associated with latent fruit rot in deciduous holly. This announcement provides a whole-genome assembly and annotation for this plant pathogen, which will inform research on its parasitism and identification of gene clusters involved in the production of bioactive metabolites.

The Influence of Environmental Conditions on Pacing in Age Group Marathoners Competing in the "New York City Marathon".

Background: The two aspects of the influence of environmental conditions on marathon running performance and pacing during a marathon have been separately and widely investigated. The influence of environmental conditions on the pacing of age group marathoners has, however, not been considered yet. Objective: The aim of the present study was to investigate the association between environmental conditions (i.e., temperature, barometric pressure, humidity, precipitation, sunshine, and cloud cover), gender and pacing of age group marathoners in the "New York City Marathon". Methodology: Between 1999 and 2019, a total of 830,255 finishes (526,500 males and 303,755 females) were recorded. Time-adjusted averages of weather conditions for temperature, barometric pressure, humidity, and sunshine duration during the race were correlated with running speed in 5 km-intervals for age group runners in 10 years-intervals. Results: The running speed decreased with increasing temperatures in athletes of age groups 20-59 with a pronounced negative effect for men aged 30-64 years and women aged 40-64 years. Higher levels of humidity were associated with faster running speeds for both sexes. Sunshine duration and barometric pressure showed no association with running speed. Conclusion: In summary, temperature and humidity affect pacing in age group marathoners differently. Specifically, increasing temperature slowed down runners of both sexes aged between 20 and 59 years, whereas increasing humidity slowed down runners of <20 and >80 years old.

Elite Marathoners Run Faster With Increasing Temperatures in Berlin Marathon.

The influence of environmental conditions has been investigated for different marathon races, but not for the Berlin Marathon, the fastest marathon race course in the world. The aim of this study was to investigate the potential influence of environmental conditions such as temperature, precipitation, sunshine, and atmospheric pressure on marathon race times in the Berlin Marathon since its first event in 1974-2019. A total of n = 882,540 valid finisher records were available for analysis, of which 724,135 correspond to male and 158,405 to female runners. We performed analyses regarding performance levels considering all finishers, the top 3, the top 10, and the top 100 women and men. Within the 46 years of Berlin marathons under study, there was some level of precipitation for 18 years, and 28 years without any rain. Sunshine was predominant in 25 of the events, whilst in the other 21, cloud cover was predominant. There was no significant trend with time in any of the weather variables (e.g., no increase in temperature across the years). Overall runners became slower with increasing temperature and sunshine duration, however, elite runners (i.e., top 3 and top 10) seemed to run faster and improved their race times when the temperature increased (with women improving more than men). Top 10 women seemed to benefit more from increasing temperatures than top 10 males, and male top 100 runners seemed to benefit more from increasing temperatures than female top 100 runners. In the top three sub-group, no differences were observed between male and female correlations. In summary, in marathoners competing in the Berlin Marathon between 1974 and 2019, increasing temperatures and sunshine duration showed a different effect on different performance levels where overall runners (i.e., the general mass of runners) became slower with increasing temperature and sunshine duration, but elite runners (i.e., top 3, top 10) became faster with increasing temperatures where sex differences exist.

The Optimal Ambient Conditions for World Record and World Class Performances at the Berlin Marathon.

The "Berlin Marathon" is the fastest marathon racecourse in the world and has witnessed 11 world records (WRs; eight in men and three in women). Weather conditions can have an important impact on race time and we therefore examined the influence of environmental conditions (i.e., temperature, sunshine, precipitation, barometric pressure, and cloud cover) on WRs and elite (i.e., winner, top three and top 10 finishers) marathon performances of men and women at the "Berlin Marathon" between 1974 and 2019. Average world record marathon times in men were 2:03:52 ± 0:01:19 h:min:s and 2:25:05 ± 0:08:25 h:min:s in females (p < 0.05). Male competitions were held 44 times (mean winning time: 2:09:48 ± 0:09:15 h:min:s) and female competitions 41 times (mean winning time: 02:30:35 ± 0:19:09 h:min:s; p < 0.05). World record performances were set at mean temperatures of 18.61 ± 2.59°C for men and 13.07 ± 4.01°C for women (p > 0.05). The ideal environmental conditions for world record performances for men were temperatures of 18.61°C (p > 0.05), sunny, mostly dry days, with higher atmospheric pressure and little cloud cover (all p > 0.05). In women, ideal conditions for world records performances were temperatures of 13.07°C (p > 0.05), with low atmospheric pressure (p > 0.05), but significantly more rain (p < 0.05), and with no sunshine (p < 0.05) and cloud cover (p < 0.05). With elite performances, the ideal temperatures were of 17.36 ± 4.33°C for men and 17.93 ± 4.07°C for women (p > 0.05), with little to no rain, and moderate cloud cover and sunshine (p > 0.05). In summary, novel findings are, that environmental conditions in world records performances differ between men and women, with women obtaining world records in bad weather (with rain, cloud cover, and no sunshine) and men in good weather (sunny, mostly dry days, with little cloud cover). Larger sample sizes are needed to examine sex differences and environmental conditions on world record marathon performances.

Trends in Weather Conditions and Performance by Age Groups Over the History of the Berlin Marathon.

The effect of different environmental conditions such as temperature, wind, barometric pressure, and precipitation has been well investigated in elite marathoners, but not by age categories (i.e., age group marathoners). The aim of the study was to investigate the potential influence of environmental conditions such as temperature, precipitation, and atmospheric pressure on marathon performance in age group marathoners competing in the 'Berlin Marathon' from 1974 to 2019. A total of 869,474 valid finisher records were available for analysis, of which 711,136 correspond to males and 158,338 to females. The influence of temperature, atmospheric pressure, and precipitation on marathon race times was investigated in age group marathoners grouped in 5-year-intervals. Within the 46 years of Berlin marathons under investigation, there was some level of precipitation for 18 years, and 28 years without any rain. Sunshine was predominant in 25 of the events, whilst in the other 21 years, cloud cover was predominant. Marathon race times were significantly and positively correlated with age (i.e., older runners were slower than younger runners) where the correlation was higher for males than for females. Marathon race times were significantly and positively correlated with both the hours of sunshine and the daily maximum temperature. The fastest marathon runners (meaning the minimum times) achieved the fastest race times on race days with higher maximum temperatures (i.e., 15-30°C). Daily maximum temperatures showed an influence on age group marathoners from age group 35-40 years and older. Higher precipitation levels impaired performance across most age groups. In summary, higher daily maximum temperatures (i.e., >15°C) and higher precipitation levels impaired performance of master marathoners (i.e., 35-40 years and older) competing in the 'Berlin Marathon' in the last 45 years. Master marathoners should start in marathon races with temperatures < 15°C and no precipitation in order to achieve a fast marathon race time.

Serum uric acid and outcomes in patients with chronic heart failure through the whole spectrum of ejection fraction phenotypes: Analysis of the ESC-EORP Heart Failure Long-Term (HF LT) Registry.

BACKGROUND: Retrospective analyses of clinical trials indicate that elevated serum uric acid (sUA) predicts poor outcome in heart failure (HF). Uric acid can contribute to inflammation and microvascular dysfunction, which may differently affect different left ventricular ejection fraction (LVEF) phenotypes. However, role of sUA across LVEF phenotypes is unknown. OBJECTIVES: We investigated sUA association with outcome in a prospective cohort of HF patients stratified according to LVEF. METHODS: Through the Heart Failure Long-Term Registry of the European Society of Cardiology (ESC-EORP-HF-LT), 4,438 outpatients were identified and classified into: reduced (<40% HFrEF), mid-range (40-49% HFmrEF), and preserved (≥50% HFpEF) LVEF. Endpoints were the composite of cardiovascular death/HF hospitalization, and individual components. RESULTS: Median sUA was 6.72 (IQ:5.48-8.20) mg/dl in HFrEF, 6.41 (5.02-7.77) in HFmrEF, and 6.30 (5.20-7.70) in HFpEF. At a median 372-day follow-up, the composite endpoint occurred in 648 (13.1%) patients, with 176 (3.6%) deaths and 538 (10.9%) HF hospitalizations. Compared with lowest sUA quartile (Q), Q-III and Q-IV were significantly associated with the composite endpoint (adjusted HR 1.68: 95% CI 1.11-2.54; 2.46: 95% CI 1.66-3.64, respectively). By univariable analyses, HFrEF and HFmrEF patients in Q-III and Q-IV, and HFpEF patients in Q-IV, showed increased risk for the composite endpoint (P<0.05 for all); after model-adjustment, significant association of sUA with outcome persisted among HFrEF in Q-IV, and HFpEF in Q-III-IV. CONCLUSIONS: In a large, contemporary-treated cohort of HF outpatients, sUA is an independent prognosticator of adverse outcome, which can be appreciated in HErEF and HFpEF patients.

The Impact of the COVID-19 Pandemic on Endurance and Ultra-Endurance Running.

Background and objectives: The COVID-19 outbreak has become a major health and economic crisis. The World Health Organization declared it a pandemic in March 2020, and many sporting events were canceled. Materials and Methods: We examined the effects of the COVID-19 pandemic on endurance and ultra-endurance running (UER) and analyzed finishes and events during the COVID-19 pandemic (observation period March 2020-October 2020) to the same time period pre-COVID-19 outbreak (March 2019-October 2019). Results: Endurance finishes decreased during the pandemic (459,029 to 42,656 (male: 277,493 to 25,582; female 181,536 to 17,074; all p < 0.001). Similarly, the numbers of endurance events decreased (213 vs. 61 events; p < 0.001). Average marathon finishing times decreased during the pandemic in men (5:18:03 ± 0:16:34 vs. 4:43:08 ± 0:25:08 h:min:s (p = 0.006)) and women (5:39:32 ± 0:19:29 vs. 5:14:29 ± 0:26:36 h:min:s (p = 0.02)). In UER, finishes decreased significantly (580,289 to 110,055; p < 0.001) as did events (5839 to 1791; p < 0.001). Popular event locations in United States, France, UK, and Germany decreased significantly (p < 0.05). All distance and time-limited UER events saw significant decreases (p < 0.05). Conclusions: The COVID-19 pandemic has had a significant effect on endurance and UER, and it is unlikely that running activities return to pre-pandemic levels any time soon. Mitigation strategies and safety protocols should be established.

Retraction: A descriptive study on health, training and social aspects of adults that participated in ultra endurance running as youth athletes.

The paper entitled "A descriptive study on health, training and social aspects of adults that participated in ultra endurance running as youth athletes" by Volker Scheer et al, which was published online on September 03 2020, has been withdrawn by the Publisher due to an internal dispute between the authors.

Hiperpotasemia en pacientes con insuficiencia cardiaca en España y su impacto en las recomendaciones. Registro ESC-EORP-HFA Heart Failure Long-Term / Hyperkalemia in heart failure patients in Spain and its impact on guidelines and recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry

INTRODUCCIÓN Y OBJETIVOS: La hiperpotasemia es una preocupación creciente en el tratamiento de los pacientes con insuficiencia cardiaca y fracción de eyección reducida, pues limita el uso de fármacos eficaces. Este trabajo ofrece estimaciones de la magnitud de este problema en la práctica clínica habitual en España, los cambios en las concentraciones de potasio en el seguimiento y los factores asociados. MÉTODOS: Pacientes con insuficiencia cardiaca aguda (n=881) y crónica (n=3.587) seleccionados en 28 hospitales españoles del registro europeo de insuficiencia cardiaca de la European Society of Cardiology y seguidos 1 año para diferentes desenlaces, incluidos cambios en las cifras de potasio y su impacto en el tratamiento. RESULTADOS: La hiperpotasemia (K+> 5,4 mEq/l) está presente en el 4,3% (IC95%, 3,7-5,0%) y el 8,2% (6,5-10,2%) de los pacientes con insuficiencia cardiaca crónica y aguda; causa el 28,9% de todos los casos en que se contraindica el uso de antagonistas del receptor de mineralocorticoides y el 10,8% de los que no alcanzan la dosis objetivo. Del total de 2.693 pacientes ambulatorios con fracción de eyección reducida, 291 (10,8%) no tenían registrada medición de potasio. Durante el seguimiento, 179 de 1.431 (12,5%, IC95%, 10,8-14,3%) aumentaron su concentración de potasio, aumento relacionado directamente con la edad, la diabetes mellitus y los antecedentes de ictus e inversamente con los antecedentes de hiperpotasemia. CONCLUSIONES: Este trabajo destaca el problema de la hiperpotasemia en pacientes con insuficiencia cardiaca de la práctica clínica habitual y la necesidad de continuar y mejorar la vigilancia de este factor en estos pacientes por su interferencia en el tratamiento óptimo

INTRODUCTION AND OBJECTIVES: Hyperkalemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction because it limits the use of effective drugs. We report estimates of the magnitude of this problem in routine clinical practice in Spain, as well as changes in potassium levels during follow-up and associated factors. METHODS: This study included patients with acute (n=881) or chronic (n=3587) heart failure recruited in 28 Spanish hospitals of the European heart failure registry of the European Society of Cardiology and followed up for 1 year. Various outcomes were analyzed, including changes in serum potassium levels and their impact on treatment. RESULTS: Hyperkalemia (K+> 5.4 mEq/L) was identified in 4.3% (95%CI, 3.7%-5.0%) and 8.2% (6.5%-10.2%) of patients with chronic and acute heart failure, respectively, and was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonist use and for 10.8% of all cases of failure to reach the target dose. Serum potassium levels were not recorded in 291 (10.8%) of the 2693 chronic heart failure patients with reduced ejection fraction. During follow-up, potassium levels increased in 179 of 1431 patients (12.5%, 95%CI, 10.8%-14.3%). This increase was directly related to age, diabetes, and history of stroke and was inversely related to history of hyperkalemia. CONCLUSIONS: This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment

Hyperkalemia in heart failure patients in Spain and its impact on guidelines and recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry.

INTRODUCTION AND OBJECTIVES: Hyperkalemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction because it limits the use of effective drugs. We report estimates of the magnitude of this problem in routine clinical practice in Spain, as well as changes in potassium levels during follow-up and associated factors. METHODS: This study included patients with acute (n=881) or chronic (n=3587) heart failure recruited in 28 Spanish hospitals of the European heart failure registry of the European Society of Cardiology and followed up for 1 year. Various outcomes were analyzed, including changes in serum potassium levels and their impact on treatment. RESULTS: Hyperkalemia (K+> 5.4 mEq/L) was identified in 4.3% (95%CI, 3.7%-5.0%) and 8.2% (6.5%-10.2%) of patients with chronic and acute heart failure, respectively, and was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonist use and for 10.8% of all cases of failure to reach the target dose. Serum potassium levels were not recorded in 291 (10.8%) of the 2693 chronic heart failure patients with reduced ejection fraction. During follow-up, potassium levels increased in 179 of 1431 patients (12.5%, 95%CI, 10.8%-14.3%). This increase was directly related to age, diabetes, and history of stroke and was inversely related to history of hyperkalemia. CONCLUSIONS: This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment.