Beat Knechtle

Sex- and nationality-based participation and performance trends in the Swissman Xtreme Triathlon (2019–2025)

Participation and performance trends are well investigated for the IRONMAN® triathlon. For Xtreme Triathlons (XTri World Tour) races, only one study has examined participation and performance trends for the ‘Norseman Xtreme Triathlon’ in Norway, but not for other XTri World Tour events. Therefore, the aim of the present study was to investigate participation and performance trends in the ‘Swissman Xtreme Triathlon’ as part of the XTri World Tour. Finisher data from all ‘Swissman Xtreme Triathlon’ editions (2019–2025) were analyzed. DNS, DNF, missing information, and implausible finishing times were excluded. Participation patterns were described by sex and nationality. Sex differences in race time were evaluated using Mann–Whitney U tests. Differences among the ten most represented nationalities were tested using Welch’s ANOVA with Dunnett’s T3 post-hoc comparisons. Temporal changes in performance were assessed with quantile regression at the 0.25, 0.50, and 0.75 quantiles (p < 0.05). A total of 1,032 finishers were included, of whom 13.5% were women. Switzerland had the highest participation (n = 431). Performance was similar across most nationalities, with slower times observed only among athletes from the United States compared with Switzerland (p = 0.01), Germany (p = 0.02), and Norway (p = 0.03). No sex-based differences were found in any edition (overall p = 0.4922; r = −0.02). Quantile regression revealed clear temporal changes in performance. At the median (0.50), race time increased by 715 s·year ⁻ ¹ (95% CI: 434–997; p < 0.0001), and a similar rise occurred at the 0.75 quantile (β = 727 s·year ⁻ ¹; 95% CI: 498–955; p < 0.0001). In contrast, the 0.25 quantile showed a smaller and non-significant increase (β = 345 s·year ⁻ ¹; p = 0.0626), indicating that intermediate and slower athletes were primarily responsible for the overall temporal decline. Sex-specific analyses confirmed this pattern: significant increases at the median and 0.75 quantiles for men, and a significant increase only at the median quantile for women. Swiss athletes formed the largest portion of competitors in ‘Swissman Xtreme Triathlon’, while performance was comparable across most nationalities. Women and men performed similarly throughout all editions. Race times increased across years, particularly among intermediate and slower finishers. These findings provide an updated overview of participation and performance trends in this major XTri World Tour event. Future studies need to investigate more races of the XTri World Tour.

Brescia Art Marathon

The Brescia Art Marathon (BAM) is one of the most popular running events in northern Italy and took place on March 8, 2026. With around 8,000 participants, it was a record-breaking year, and as always, the event offered three main distances: 42 km, 21 km, and 10 km.

The route passed through UNESCO World Heritage sites such as the Capitolium, Piazza Paolo VI, the Duomo Vecchio and Nuovo, and Piazza della Loggia.

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Examining attention- deficit/ hyperactivity disorder in endurance and ultra-endurance runners

Background: Attention-deficit hyperactivity disorder (ADHD) is a multifactorial and complex neurodevelopmental disorder. Prevalence of ADHD in the general adult population is around 3.1 %, with little data available in athlete population suggesting rates of between 7 %-8 %. No data are available for endurance and ultra-endurance runners. Methods: Cross-sectional survey study in endurance (≥21.1 km to 42.2 km) and ultra-endurance runners (≥42.2 km), using the Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale (ASRS-5) for screening for ADHD and assessing associated risk factors and sex differences using statistical and machine learning (ML) techniques. Results: A total of 601 runners participated (female n = 222; male n = 379; mean age 42.8 ± 10.1 years). Overall, 9.7 % of runners returned screening results above the cut off score from the ASRS-5 for ADHD, particularly half-marathon runners (14.8 %; n.s.) compared to marathon (8.0 %) and ultramarathon runners (8.7 %). No significant sex differences (female 10.8 % versus men 9.0 %) or differences in performance levels (elite (0.0 %) versus non-elite (10.1 %) runners) were observed. Age was the only statistically significant associated factor (p = 0.03), particularly in younger runners (under the age of 40 years). Conclusion: This study provides novel essential screening data on ADHD among endurance and ultra-endurance runners. The screening rates for ADHD traits exceed those found in previous studies with elite athletes and the general population. Clinical evaluation, using standard clinical criteria to verify the responses for a definitive diagnosis of ADHD is recommended, as well as increasing awareness of ADHD, education, support services and targeted interventions. Sports organizations, health professionals, and policymakers should implement systematic screening and education programs to address these concerns.