Introduction: Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce the risk of developing ARDS, but the effect of aspirin on established ARDS is unknown. Methods: In a single large regional medical and surgical ICU between December 2010 and July 2012, all patients with ARDS were prospectively identified and demographic, clinical, and laboratory variables were recorded retrospectively. Aspirin usage, both pre-hospital and during intensive care unit (ICU) stay, was included. The primary outcome was ICU mortality. We used univariate and multivariate logistic regression analyses to assess the impact of these variables on ICU mortality. Results: In total, 202 patients with ARDS were included; 56 (28%) of these received aspirin either pre-hospital, in the ICU, or both. Using multivariate logistic regression analysis, aspirin therapy, given either before or during hospital stay, was associated with a reduction in ICU mortality (odds ratio (OR) 0.38 (0.15 to 0.96) P = 0.04). Additional factors that predicted ICU mortality for patients with ARDS were vasopressor use (OR 2.09 (1.05 to 4.18) P = 0.04) and APACHE II score (OR 1.07 (1.02 to 1.13) P = 0.01). There was no effect upon ICU length of stay or hospital mortality. Conclusion: Aspirin therapy was associated with a reduced risk of ICU mortality. These data are the first to demonstrate a potential protective role for aspirin in patients with ARDS. Clinical trials to evaluate the role of aspirin as a pharmacological intervention for ARDS are needed.

Age and sex are well-known factors influencing ultra-marathon race performance. The fact that women in older age groups are able to achieve a similar performance as men has been documented in swimming. In ultra-marathon running, knowledge is still limited. The aim of this study was to analyze sex-specific performance in ultra-marathon running according to age and distance. All ultra-marathon races documented in the online database of the German Society for Ultra-Marathon from 1964 to 2017 for 50-mile races (i.e., 231,980 records from 91,665 finishers) and from 1953 to 2017 for 100-mile races (i.e., 107,445 records from 39,870 finishers) were analyzed. In 50-mile races, race times were 11.74 ± 1.95 h for men and 12.31 ± 1.69 h for women. In 100-mile races, race times were 26.6 ± 3.49 h for men and 27.47 ± 3.6 h for women. The sex differences decreased with older age and were smaller in 100-mile (4.41%) than in 50-mile races (9.13%). The overall age of peak performance was 33 years for both distances. In summary, women reduced the performance difference to men with advancing age, the relative difference being smaller in 100-mile compared to 50-mile races. These findings might aid coaches and ultra-marathon runners set long-term training goals considering their sex and age.

Knechtle, B, Di Gangi, S, Rüst, CA, and Nikolaidis, PT. Performance differences between the sexes in the Boston Marathon from 1972 to 2017. J Strength Cond Res 34(2): 566–576, 2020—The differences between the sexes in marathon running have been investigated for athletes competing in world class–level races. However, no information exists about changes in these differences since the first women officially began participating in marathons. We examined trends in participation and performance in the Boston Marathon from 1972 to 2017. A total of 371,250 different finishers (64% men) and 553,890 observations—with 187,998 (34%) being of women and 365,892 (66%) of men—were analyzed using Generalized Additive Mixed Models. The number of finishers increased over the years. Female participation started at 2.81% in 1972 and reached 45.68% in 2016. Considering all finishers, men (03:38:42 ± 00:41:43 h:min:s) were overall faster than women (04:03:28 ± 00:38:32 h:min:s) by 10.7%. Average performance worsened over the years, but the differences between the sexes decreased. For the annual 10 fastest runners, performance improved with a decrease in speed difference (18.3% overall, men: 02:13:30 ± 00:04:08 h:min:s vs. women: 02:37:42 ± 00:17:58 h:min:s). For the annual winners, performance improved with a decrease in speed difference (15.5% overall, men: 02:10:24 ± 00:03:05 h:min:s vs. women: 02:30:43 ± 00:11:05 h:min:s). For the near-elite finishers from the 21st to the 100th place and from the 101st to the 200th place, women's performance improved with a decrease in the difference to men. In summary, the trend in performance over the years depended on the methodological approach (i.e., all vs. annual 10 fastest finishers vs. annual winners), but the difference between the sexes decreased in all instances. Although men were 10.7% faster than women, the fastest men (i.e., top 10 and winners) increased the gap between men and women by an average of 18.3% for the annual 10 fastest and 15.5% for the annual winners.

This study examined the relationship of weather conditions, together with sex and country of origin, with running performance in the Boston Marathon from 1972 to 2018. A total of 580,990 observations from 382,209 different finishers were analyzed using Generalized Additive Mixed Models. Different groups and subgroups were considered such as all runners, near elite 101:200 finishers, near elite 21:100, annual top ten finishers and annual winners. Weather conditions, over the hours of the event, were average air temperature (°C), total precipitations (mm), wet-bulb globe temperature (WBGT) (°C), wind speed (km/h), wind direction (head wind, side wind, tail wind) and barometric pressure (hPa). These effects were examined in a multi-variable model, together with: sex, country of origin, calendar year, an interaction term country:sex and a spline smooth term in function of calendar year and sex. The average temperature, when increasing by 1°C, was related to worsened performance (by 00:01:47 h:min:sec for all finishers and by 00:00:20 h:min:sec for annual winners). Also, the pressure and wet-bulb globe temperature, when increasing, were related to worsened performances. Tail wind improved performances of all groups. Increasing precipitation was significantly (p<0.05) related to worsened performances in all groups except annual winners. Increasing wind speed was also related to worsened performances in all finishers and near elite groups. Kenyans and Ethiopians were the fastest nationalities. The sex differences (men faster than women in all groups) were the largest in near elite groups. Our findings contributed to the knowledge of the performance in Boston Marathon across calendar years, considering as main effects weather conditions, country of origin and sex.

This study investigated the effects of weather conditions on male performance during the Boston Marathon from 1897 to 2018. A total of 383,982 observations from 244,642 different finishers were analysed using Generalized Additive Mixed Models. All runners, annual top 100 finishers and annual top ten finishers were considered. Weather conditions, on race day, were: average air temperature (°C), precipitations (mm), wet-bulb globe temperature (WBGT) (°C), wind speed (km/h), wind direction (N, S, W, E) and pressure (hPa). These effects were examined in multi-variable models with spline smooth terms in function of calendar year. Temperature, when increasing by 1 °C, was related to worsened performance for all groups (i.e., by 00:01:53 h:min:sec for all finishers, p < 0.001). Wind coming from the West, compared to wind coming from other directions, was the most favourable for performance of all groups of finishers. Increasing precipitations worsened performances of top 100 (estimate 00:00:04 h:min:sec, p < 0.001) and top 10 finishers (estimate 00:00:05 h:min:sec, p < 0.001). Wind speed, when increasing by 1 km/h, was related to worsened performance for all finishers (estimate 00:00:19 h:min:sec, p < 0.001), but not for top 100 group, where performances were 00:00:09 h:min:sec faster, p < 0.001. Pressure and WBGT were examined in uni-variable models: overall, performances worsened as pressure and WBGT increased. Our findings contributed to the knowledge about the effect of weather conditions on performance level in male marathon runners.

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 (p8°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.