Effect of the Administration of Cordyceps militaris Mycelium Extract on Blood Markers for Anemia in Long-Distance Runners.

In the present study, we conducted a placebo-controlled, double-blind, parallel-group comparison trial in which an extract of Cordyceps militaris (CM) mycelium was administered to long-distance runners for 16 weeks during the pre-season training period and blood test markers for anemia were investigated. The results indicated that the change rates of serum ferritin levels were moderately increased in the CM group (n = 11) but decreased in the placebo group (n = 11) during the study period, and the levels were significantly increased in the CM group compared with those in the placebo group at 4 weeks and 8 weeks after the test food intake (p < 0.05). Moreover, the change rates of hemoglobin and hematocrit were significantly increased in the CM group compared with those in the placebo group at 8 weeks after the test food intake (p < 0.05). These observations suggest that the intake of test food containing Cordyceps militaris mycelium extract is expected to effectively maintain the hemoglobin and hematocrit levels in long-distance runners, possibly via the suppression of the decrease in iron storage, which is reflected by serum ferritin, during pre-season training. Furthermore, the levels of creatine kinase were increased above the normal range in both the placebo and CM groups at registration. Interestingly, the creatine kinase levels were significantly decreased in the CM group compared with those in the placebo group at 16 weeks after the test food intake (p < 0.05). These results suggest that Cordyceps militaris mycelium extract exhibits a protective action on the muscle damage observed in long-distance runners and may suppress muscle injury. Together, these observations suggest that Cordyceps militaris mycelium extract exhibits an improving effect on the markers for not only anemia, but also muscle injury in long-distance runners during pre-season training.

Light-independent pathway of STN7 kinase activation under low temperature stress in runner bean (Phaseolus coccineus L.).

BACKGROUND: The phosphorylation of the Light-Harvesting Complex of photosystem II (LHCII) driven by STATE TRANSITION 7 (STN7) kinase is a part of one of the crucial regulatory mechanisms of photosynthetic light reactions operating in fluctuating environmental conditions, light in particular. There are evidenced that STN7 can also be activated without light as well as in dark-chilling conditions. However, the biochemical mechanism standing behind this complex metabolic pathway has not been deciphered yet. RESULTS: In this work, we showed that dark-chilling induces light-independent LHCII phosphorylation in runner bean (Phaseolus coccineus L.). In dark-chilling conditions, we registered an increased reduction of the PQ pool which led to activation of STN7 kinase, subsequent LHCII phosphorylation, and possible LHCII relocation inside the thylakoid membrane. We also presented the formation of a complex composed of phosphorylated LHCII and photosystem I typically formed upon light-induced phosphorylation. Moreover, we indicated that the observed steps were preceded by the activation of the oxidative pentose phosphate pathway (OPPP) enzymes and starch accumulation. CONCLUSIONS: Our results suggest a direct connection between photosynthetic complexes reorganization and dark-chilling-induced activation of the thioredoxin system. The proposed possible pathway starts from the activation of OPPP enzymes and further NADPH-dependent thioredoxin reductase C (NTRC) activation. In the next steps, NTRC simultaneously activates ADP-glucose pyrophosphorylase and thylakoid membrane-located NAD(P)H dehydrogenase-like complex. These results in starch synthesis and electron transfer to the plastoquinone (PQ) pool, respectively. Reduced PQ pool activates STN7 kinase which phosphorylates LHCII. In this work, we present a new perspective on the mechanisms involving photosynthetic complexes while efficiently operating in the darkness. Although we describe the studied pathway in detail, taking into account also the time course of the following steps, the biological significance of this phenomenon remains puzzling.

Consecutive Bilateral Iliac Stress Fracture in an Adult Male Runner.

Iliac stress fractures (ISF) are uncommon in sports, particularly among runners, and are attributed to repetitive loading and other predisposing factors. ISF poses diagnostic challenges due to nonspecific symptoms and the limited sensitivity of conventional imaging procedures. The reported case is about a 51-year-old male marathon runner with consecutive bilateral ISF. Initial symptoms included mechanical pain in the right buttock, leading to a diagnosis confirmed via pelvic MRI. Conservative management with eight weeks rest from sport activity was indicated with symptom resolution and return to sport. However, 20 days after returning to sport, the patient developed left-sided symptoms post-resumption of running, with MRI confirming a new ISF. An additional eight weeks of rest was prescribed, allowing the patient to resume sport at preinjury levels. ISF should be considered in runners presenting with gluteal pain, emphasizing the importance of early diagnosis. MRI emerges as a valuable tool for accurate diagnosis, guiding appropriate management strategies. Conservative management focusing on rest is paramount for favorable outcomes and optimizing runners' health and performance.

Effect of 6-Week Sprint Training on Long-Distance Running Performance in Highly Trained Runners.

PURPOSE: Long-distance running performance has been reported to be associated with sprint performance in highly trained distance runners. Therefore, we hypothesized that sprint training could enhance distance running and sprint performance in long-distance runners. This study examined the effect of 6-week sprint training on long-distance running and sprint performance in highly trained distance runners. METHODS: Nineteen college runners were divided into control (n = 8) and training (n = 11) groups. Participants in the training group performed 12 sprint training sessions in 6 weeks, while those in the control group performed 12 distance training sessions. Before and after the interventions, maximal oxygen uptake (V˙O2max), O2 cost during submaximal running (290 m·min-1 and 310 m·min-1 of running velocity), and time to exhaustion (starting at 290 m·min-1 and increased 10 m·min-1 every minute) were assessed on a treadmill. Additionally, the 100-m and 400-m sprinting times and 3000-m running time were determined on an all-weather track. RESULTS: In the control group, no measurements significantly changed after the intervention. In the training group, the time to exhaustion, 100-m and 400-m sprinting times, and 3000-m running time improved significantly, while V˙O2max and O2 cost did not change. CONCLUSIONS: These results showed that 6-week sprint training improved both sprint and long-distance running performance in highly trained distance runners without a change in aerobic capacity. Improvement in the time to exhaustion without a change in V˙O2max suggests that the enhancement of long-distance running performance could be attributable to improved anaerobic capacity.

Unveiling the Obsession: Exercise Addiction among Female Amateur Runners in Delhi-NCR and the Power of Unwavering Commitment.

Aim and Objective: This study was intended for a possible relationship that might exist between exercise addiction and unbending commitment among female amateur runners. Exercise addiction (EA) can be characterized as an obsession with physical activity. Materials and Methods: The "purposive sampling method" was utilized to collect data. The inventories taken for this purpose were "The Exercise Addiction Inventory" and "Commitment Running Scale." The questionnaire was filled out by 100 participants aged between 18 and 50 years from the capital of India and its border area (Delhi and NCR). Results and Conclusion: It was found that 39% of female long-distance runners were exercise addicts, and 72% were highly committed to running, supporting a probable reason for EA.

The impact of the COVID-19 pandemic on the mood and family relationships of runners.

Introduction: The aim of this study was to analyze the impact of the COVID-19 lockdown on the mood of amateur runners and on their relationships with their partners and families. Methods: Adult runners 18 years or older (N = 260) completed an online survey that included demographic information, standardized psychological assessments of Exercise Dependence (EDS-R) and mood (POMS), and, to measure relationship functioning, either the Dyadic Adjustment Scale (DAS) if they did not have children, or the Basic Family Evaluation Questionnaire (CERFB), measuring conjugal and parental relationships. Participants also answered questions about their exercise habits and the coping strategies they adopted during lockdown. Results: The results suggest that runners who saw the largest reductions in time spent exercising during lockdown tended to feel significantly less energetic (p < 0.05) and friendly (p < 0.01). In addition, they recorded significantly lower scores in marital satisfaction with their peers (p < 0.05). The runners with a higher degree of dependence on physical exercise registered significantly higher levels of depression, tension and anger than non-dependent runners (p < 0.001). Runners whose partners were physically active and did not have children had significantly higher scores marital satisfaction than runners whose partners were not physically active and had children (p < 0.05). Discussion: These findings seem to indicate that the psychological approach to athletes in the context of crises such as the pandemic should consider not only individual aspects, but also include the family perspective.

Possible Mechanisms for Adverse Cardiac Events Caused by Exercise-Induced Hypertension in Long-Distance Middle-Aged Runners: A Review.

Sudden cardiac death (SCD) is rare among athletes. However, hypertrophic cardiomyopathy is the leading cause of SCD among those <35 years of age. Meanwhile, coronary artery disease (CAD) is the primary SCD cause among those ≥35 years of age. CAD-induced plaque ruptures are believed to be a significant cause of cardiovascular diseases in middle-aged individuals who participate in extreme long-distance running activities such as marathons. A total of 1970 articles related to EIH were identified using search terms. Out of these, 1946 studies were excluded for reasons such as arterial hypertension, exercise-induced pulmonary hypertension, the absence of exercise stress testing (EST), and a lack of relevance to EIH. The study analyzed 24 studies related to both long-distance runners with exercise-induced hypertension (EIH) and the general public. Among these, 11 studies were quasi-experimentally designed studies used in randomized controlled trials (RCTs) on long-distance runners with EIH. Additionally, 12 studies utilized cohort designs, and one study with a quasi-experimental design was conducted among the general population. Recent studies suggest that an imbalance between oxygen demand and supply due to ventricular hypertrophy may be the actual cause of cardiovascular disease, regardless of CAD. Exercising excessively over an extended period can reduce endothelial function and increase arterial stiffness, which in turn increases afterload and leads to an excessive increase in blood pressure during exercise. Exercise-induced hypertension (EIH), which increases the morbidity rate of resting hypertension and is a risk factor for cardio-cerebro-vascular diseases, is more prevalent in middle-aged long-distance runners than in runners from other age groups, and it increases the prevalence of critical arrhythmias, such as atrial fibrillation or ventricular arrhythmias. EIH is associated with angiotensin II activity, and angiotensin II receptor blockers show promising effects in middle-aged runners. Further, guidelines for preventing excessive participation in races and restricting exercise intensity and frequency would be useful. This review identifies EIH as a potential risk factor for cardiovascular diseases and describes how EIH induces SCD.

Out-of-Mold Sensor-Based Process Parameter Optimization and Adaptive Process Quality Control for Hot Runner Thin-Walled Injection-Molded Parts.

Injection molding is a highly nonlinear procedure that is easily influenced by various external factors, thereby affecting the stability of the product's quality. High-speed injection molding is required for production due to the rapid cooling characteristics of thin-walled parts, leading to increased manufacturing complexity. Consequently, establishing appropriate process parameters for maintaining quality stability in long-term production is challenging. This study selected a hot runner mold with a thin wall fitted with two external sensors, a nozzle pressure sensor and a tie-bar strain gauge, to collect data regarding the nozzle peak pressure, the timing of peak pressure, the viscosity index, and the clamping force difference value. The product weight was defined as the quality indicator, and a standardized parameter optimization process was constructed, including injection speed, V/P switchover point, packing, and clamping force. Finally, the optimized process parameters were applied to the adaptive process control experiments using the developed control system operated within the micro-controller unit (MCU). The results revealed that the control system effectively stabilized the product weight variation and standard deviation of 0.677% and 0.0178 g, respectively.

Analysis of the effect of flow channel structures on the centrifugal accelerated motion of particles in a vacuum state.

In this study, the impact of flow channel structures on the acceleration of metal particles in a vacuum environment is explored, with the aim of enhancinge the acceleration quality in the centrifugal impact molding of metal powders. To assess this phenomenon, three evaluation indices are introduced: the average speed of particles thrown V p , the average speed of the particles V all , and the particle velocity distribution Vf (t). Additionally, the effects of six distinct runner structures on the centrifugal acceleration of the particles are analyzed in this research. The findings indicate that the arc-shaped flow channel structure not only ensures a more consistent acceleration process but also results in a higher ejection speed, leading to an improved acceleration effect. The unique contribution of this study is the examination of the relationship between flow channel designs and particle accelerations in a vacuum.

Identification of runner fatigue stages based on inertial sensors and deep learning.

Introduction: Running is one of the most popular sports in the world, but it also increases the risk of injury. The purpose of this study was to establish a modeling approach for IMU-based subdivided action pattern evaluation and to investigate the classification performance of different deep models for predicting running fatigue. Methods: Nineteen healthy male runners were recruited for this study, and the raw time series data were recorded during the pre-fatigue, mid-fatigue, and post-fatigue states during running to construct a running fatigue dataset based on multiple IMUs. In addition to the IMU time series data, each participant's training level was monitored as an indicator of their level of physical fatigue. Results: The dataset was examined using single-layer LSTM (S_LSTM), CNN, dual-layer LSTM (D_LSTM), single-layer LSTM plus attention model (LSTM + Attention), CNN, and LSTM hybrid model (LSTM + CNN) to classify running fatigue and fatigue levels. Discussion: Based on this dataset, this study proposes a deep learning model with constant length interception of the raw IMU data as input. The use of deep learning models can achieve good classification results for runner fatigue recognition. Both CNN and LSTM can effectively complete the classification of fatigue IMU data, the attention mechanism can effectively improve the processing efficiency of LSTM on the raw IMU data, and the hybrid model of CNN and LSTM is superior to the independent model, which can better extract the features of raw IMU data for fatigue classification. This study will provide some reference for many future action pattern studies based on deep learning.

PLAR: a combined percutaneous and arthroscopic treatment for iliotibial band syndrome description of surgical technique and short-term results: description of surgical technique and short-term results.

INTRODUCTION: Description of a new surgical procedure (percutaneous lengthening and arthroscopic release, PLAR) that combines all the possible interventions on the iliotibial band (ITB), and evaluates its outcomes in a group of distance runners diagnosed with ITBS. METHODS: A prospective observational study was made of distance runners diagnosed with ITBS and operated upon using the PLAR technique between 1 and 2018 and 31 June 2020. The surgical technique is described in detail, and the demographic data and functional outcomes measured by the sports performance scales Activity Rating Scale (ARS) and International Knee Documentation Committee (IKDC) are presented. RESULTS: A total of 14 patients were included, with a mean follow-up of 16 months (range 12-42 months). All the patients resumed their previous sporting activity after an average of 4 (range 2.5-6) months, and no complications were recorded. In all cases, statistically significant improvement was evidenced by the ARS and IKDC scales following PLAR (p < 0.001), with excellent outcomes in 71% of the cases according to the ARS scale and in 86% according to the IKDC scale (mean difference between preoperative and final follow-up scores of 12.1/16 and 34.2/100 points, respectively). CONCLUSION: The PLAR technique is effective in allowing a return to previous sports performance levels in a short period of time among patients with ITBS refractory to conservative management, with a high satisfaction rate and the absence of complications.

Reduced myocardial strain of interventricular septum among male amateur marathon runners: a cardiac magnetic resonance study.

OBJECTIVES: To analyze the long-term effect of multiple marathons on cardiac structure and function in amateur marathon runners compared with healthy controls. DESIGN: Cross-sectional study using male amateur marathon runners (n = 32) and age-matched cohort of male healthy controls (n = 12). METHODS: A total of 32 male amateur marathon runners (age 44 ±â€¯7 years) and 12 male healthy controls (age 42 ±â€¯8 years) underwent cardiac magnetic resonance (CMR). The relevant parameters of cardiac structure and function were studied employing feature-tracking strain analysis. RESULTS: Amateur marathon runners showed lower heart rates, body mass index and body surface area. The left ventricular (LV) mass index, LV end-diastolic volume index and right ventricular end-systolic volume index were significantly higher in amateur marathon runners compared with healthy controls. Furthermore, walls of interventricular septum (IVS) in amateur marathon runners were thicker than healthy controls. There was no significant difference between two groups in the global myocardial strain (MS) in LV. However, the segmental radial and circumferential strains of the LV were lower in amateur marathon runners compared to healthy controls, specifically in the 8th and 9th segments. Finally, we also found as the total running intensity increased, so did global longitudinal strain. CONCLUSIONS: We reported higher wall thickness and lower regional radial and circumferential strain in the IVS region in amateur marathon runners, suggesting that prolonged and high-intensity exercise may cause cardiac remodeling. Further studies are needed to investigate whether this is an adaptive or maladaptive change in amateur marathon runners.

Numerical Simulation of Deformation in Hot Runner Manifold.

This study simulated the deformation of a hot runner manifold and nozzle assembly during operation, aiming to address potential leaks and premature failure. Both thermal and mechanical models were used simultaneously to accurately capture system behavior. A simplified set of boundary conditions was proposed for efficient problem-solving. Analysis of the simulation results revealed that thermal deformation posed a risk of catastrophic failures and leaks. Deformation from melt pressure was relatively small compared to thermal loading, not exceeding 12%. The study provided design recommendations based on the simulation findings, guiding the development of hot runner systems for improved reliability.

Smart Chemical Sensor and Biosensor Networks for Healthcare 4.0.

Driven by technological advances from Industry 4.0, Healthcare 4.0 synthesizes medical sensors, artificial intelligence (AI), big data, the Internet of things (IoT), machine learning, and augmented reality (AR) to transform the healthcare sector. Healthcare 4.0 creates a smart health network by connecting patients, medical devices, hospitals, clinics, medical suppliers, and other healthcare-related components. Body chemical sensor and biosensor networks (BSNs) provide the necessary platform for Healthcare 4.0 to collect various medical data from patients. BSN is the foundation of Healthcare 4.0 in raw data detection and information collecting. This paper proposes a BSN architecture with chemical sensors and biosensors to detect and communicate physiological measurements of human bodies. These measurement data help healthcare professionals to monitor patient vital signs and other medical conditions. The collected data facilitates disease diagnosis and injury detection at an early stage. Our work further formulates the problem of sensor deployment in BSNs as a mathematical model. This model includes parameter and constraint sets to describe patient body characteristics, BSN sensor features, as well as biomedical readout requirements. The proposed model's performance is evaluated by multiple sets of simulations on different parts of the human body. Simulations are designed to represent typical BSN applications in Healthcare 4.0. Simulation results demonstrate the impact of various biofactors and measurement time on sensor selections and readout performance.

Coronary Artery Tortuosity Found in a Marathon Runner.

Coronary artery tortuosity (CAT) is an anatomical anomaly in which the coronary arteries contain kinks or coils. It is usually found incidentally in elderly patients with long-standing uncontrolled hypertension. This case illustrates a 58-year-old female marathon runner who was found to have CAT, originally presenting with chest pain, hypotension, presyncope, and a severe cramping sensation in her legs.

Kinesiophobia Is Associated With Poor Function and Modifiable Through Interventions in People With Patellofemoral Pain: A Systematic Review With Individual Participant Data Correlation Meta-Analysis.

OBJECTIVE: The aim of this systematic review and correlation meta-analysis was to identify factors associated with kinesiophobia in individuals with patellofemoral pain (PFP) and to identify interventions that may reduce kinesiophobia in individuals with PFP. METHODS: Seven databases were searched for articles including clinical factors associated with kinesiophobia or interventions that may reduce kinesiophobia in individuals with PFP. Two reviewers screened articles for inclusion, assessed risk of bias and quality, and extracted data from each study. A mixed-effects model was used to calculate correlations of function and pain with kinesiophobia using individual participant data. Meta-analyses were performed on interventional articles; Grading of Recommendations, Assessment, Development, and Evaluation was used to evaluate certainty of evidence. Results were reported narratively when pooling was not possible. RESULTS: Forty-one articles involving 2712 individuals were included. Correlation meta-analyses using individual participant data indicated a moderate association between self-reported function and kinesiophobia (n = 499; r = -0.440) and a weak association between pain and kinesiophobia (n = 644; r = 0.162). Low-certainty evidence from 2 articles indicated that passive treatment techniques were more effective than minimal intervention in reducing kinesiophobia (standardized mean difference = 1.11; 95% CI = 0.72 to 1.49). Very low-certainty evidence from 5 articles indicated that interventions to target kinesiophobia (psychobehavioral interventions, education, and self-managed exercise) were better in reducing kinesiophobia than physical therapist treatment approaches not specifically targeting kinesiophobia (standardized mean difference = 1.64; 95% CI = 0.14 to 3.15). CONCLUSION: Higher levels of kinesiophobia were moderately associated with poorer function and weakly associated with higher pain in individuals with PFP. Taping and bracing may reduce kinesiophobia immediately after use, and specific kinesiophobia-targeted interventions may reduce kinesiophobia following the full intervention; however, the certainty of evidence is very low. IMPACT: Assessment of kinesiophobia in clinical practice is recommended, on the basis of the relationships identified between kinesiophobia and other important factors that predict outcomes in individuals with PFP.

Is Behavioural Therapy a New Treatment Option for Task-Specific Dystonia in Athletes? A Case Series.

Background: Task-specific dystonia is a movement disorder of the central nervous system characterized by focal involuntary spasms and muscle contractions, which can negatively affect performance of a specific task. It can affect a wide range of fine motor skills, also in athletes. Current management of task-specific dystonia includes mainly prescribing drugs, exercise therapy or botulinum injections to the affected muscles. Psychological interventions for athletes suffering from task-specific dystonia have not been described extensively so far. Methods: We present a case-series of 4 different advanced skill-level athletes with suspected task-specific dystonia, which had a major impact on their performance. They all received treatment consisting of a combination of standardized behavioural therapy and relaxation techniques in the form of hypnosis in a total of 8 sessions in a 16-week time period. Results: After treatment, all athletes returned to their original high level of sport performance without further symptoms of their suspected task-specific dystonia. Discussion: Behavioural therapy in combination with a relaxation technique seems to be a safe and promising treatment for athletes with suspected task-specific dystonia. Further studies in a larger, preferably randomized controlled trial, are warranted to evaluate if this treatment strategy is effective in athletes with suspected task-specific dystonia.

Influence of Different Hot Runner-Systems in the Injection Molding Process on the Structural and Mechanical Properties of Regenerated Cellulose Fiber Reinforced Polypropylene.

The increasing demand for renewable raw materials and lightweight composites leads to an increasing request for natural fiber composites (NFC) in series production. In order to be able to use NFC competitively, they must also be processable with hot runner systems in injection molding series production. For this reason, the influences of two hot runner systems on the structural and mechanical properties of Polypropylene with 20 wt.% regenerated cellulose fibers (RCF) were investigated. Therefore, the material was processed into test specimens using two different hot runner systems (open and valve gate) and six different process settings. The tensile tests carried out showed very good strength for both hot runner systems, which were max. 20% below the reference specimen processed with a cold runner and, however, significantly influenced by the different parameter settings. Fiber length measurements with the dynamic image analysis showed approx. 20% lower median values of GF and 5% lower of RCF through the processing with both hot runner systems compared to the reference, although the influence of the parameter settings was small. The X-ray microtomography performed on the open hot runner samples showed the influences of the parameter settings on the fiber orientation. In summary, it was shown that RCF composites can be processed with different hot runner systems in a wide process window. Nevertheless, the specimens of the setting with the lowest applied thermal load showed the best mechanical properties for both hot runner systems. It was furthermore shown that the resulting mechanical properties of the composites are not only due to one structural property (fiber length, orientation, or thermally induced changes in fiber properties) but are based on a combination of several material- and process-related properties.

The Endocannabinoid System and Physical Exercise.

The endocannabinoid system (ECS) is involved in various processes, including brain plasticity, learning and memory, neuronal development, nociception, inflammation, appetite regulation, digestion, metabolism, energy balance, motility, and regulation of stress and emotions. Physical exercise (PE) is considered a valuable non-pharmacological therapy that is an immediately available and cost-effective method with a lot of health benefits, one of them being the activation of the endogenous cannabinoids. Endocannabinoids (eCBs) are generated as a response to high-intensity activities and can act as short-term circuit breakers, generating antinociceptive responses for a short and variable period of time. A runner's high is an ephemeral feeling some sport practitioners experience during endurance activities, such as running. The release of eCBs during sustained physical exercise appears to be involved in triggering this phenomenon. The last decades have been characterized by an increased interest in this emotional state induced by exercise, as it is believed to alleviate pain, induce mild sedation, increase euphoric levels, and have anxiolytic effects. This review provides information about the current state of knowledge about endocannabinoids and physical effort and also an overview of the studies published in the specialized literature about this subject.

Impact of COVID-19 pandemic on cross-country runners: changes in training, sleep, diet, and mental health.

Objective: Determine the impact of the COVID-19 pandemic on the changes in training, sleep, diet, and mental health of cross-country runners. Participants: Cross-country runners from NCAA Division II institutes. Methods: Wilcoxon signed-rank test was performed to analyze survey responses to ordinal questions on the survey while Spearman's rank correlation analysis (ρ) was used to calculate correlation between after the start of pandemic questions. Data was marked significant at p < 0.05. Results: Analysis of the survey responses revealed that cross-country runners were more likely to experience feelings of depression (p < 0.001), lack of motivation (p < 0.001), and higher daily stress (p < 0.001) after the start of the pandemic. After the start of the pandemic, runners running less days per week were more likely to report an increased feeling of depression (ρ=-0.315, p = 0.008) and lack of motivation (ρ=-0.458, p < 0.001). Conclusions: The present study underscores the importance of training, sleep, diet, and mental health amongst cross-country runners.