Evaluating the ability of non-tuberculous mycobacteria to induce non-specific reactions in bovine tuberculosis diagnostic tests in guinea pigs and cattle.

Limitations in diagnostic test performance are one of the major challenges hampering the eradication of bovine tuberculosis (bTB). Non-tuberculous mycobacteria (NTM) are considered one of the main causes of non-specific reactions in the intradermal tuberculin test, the most widely used bTB diagnostic test. To determine the role of NTMs in bTB misdiagnosis in Spain, an experimental study including the NTM species most commonly found in bTB-positive animals from bTB-free farms in the country (M. avium subsp. avium (Maa), "Mycobacterium avium subsp. hominissuis" (Mah), M. bourgelatii, M. intermedium, M. kansasii and M. nonchromogenicum) was carried out on guinea pigs and cattle. First, guinea pigs were sensitized with the selected NTMs, and six weeks post-sensitization four antigen mixtures (bovine-PPD, avian-PPD, P22 and ESAT6-CFP10) were inoculated intradermally and their effect was measured 24- and 48-h post-inoculation. Larger erythematous reactions were observed in guinea pigs sensitized with Mah, M. kansasii, and Maa, with significant differences in the reactions measured at the bovine-PPD inoculation site for the two first bacteria compared with other NTMs. The sensitization process was repeated in cattle, and five months post-sensitization the same antigen mixtures were inoculated in the cervical region and responses were measured at 48- and 72-h post-inoculation. A significantly higher increase in the skinfold thickness measured at the bovine-PPD inoculation site was observed in calves sensitized with Mah, Maa, M. intermedium and M. kansasii. These results demonstrate that certain NTM species may play a more significant role in bTB diagnostic interferences and show that results obtained in guinea pig and bovine models do not always coincide.

Initial Upper Palaeolithic lithic industry at Cueva Millán in the hinterlands of Iberia.

The extended period of coexistence between Neanderthals and Homo sapiens in Europe coincided with the emergence of regionally distinctive lithic industries, signalling the onset of the Upper Palaeolithic. The Iberian Peninsula was on the periphery of pioneering Upper Palaeolithic developments, with archaeological remains primarily found in northern territories. We report the discovery of an initial Upper Palaeolithic lithic industry at Cueva Millán in the hinterlands of Iberia. This industry, termed here Arlanzian, not only represents the earliest and southernmost evidence of such industries in Iberia but also lacks a direct counterpart. However, it exhibits chronological and technological parallels with the lithic industries associated with the earliest expansion of Homo sapiens throughout Eurasia. We interpret this as potential evidence of its intrusive nature, but not necessarily associated with a migration event, as more complex scenarios derived from inter-population connectivity must be also considered. The biological identity of the Arlanzian makers remains unknown, but they coexisted with declining Neanderthal groups from neighbouring territories.

Compact Class-conditional Attribute Category Clustering: Amino Acid Grouping for Enhanced HIV-1 Protease Cleavage Classification.

Categorical attributes are common in many classification tasks, presenting certain challenges as the number of categories grows. This situation can affect data handling, negatively impacting the building time of models, their complexity and, ultimately, their classification performance. In order to mitigate these issues, this research proposes a novel preprocessing technique for grouping attribute categories in classification datasets. This approach combines the exact representation of the association between categorical values in a Euclidean space, clustering methods and attribute quality metrics to group similar attribute categories based on their contribution to the classification task. To estimate its effectiveness, the proposal is evaluated within the context of HIV-1 protease cleavage site prediction, where each attribute represents an amino acid that can take multiple possible values. The results obtained on HIV-1 real-world datasets show a significant reduction in the number of categories per attribute, with an average reduction percentage ranging from 74% to 81%. This reduction leads to simplified data representations and improved classification performances compared to not preprocessing. Specifically, improvements of up to 0.07 in accuracy and 0.19 in geometric mean are observed across different datasets and classification algorithms. Additionally, extensive simulations on synthetic datasets with varied characteristics are carried out, providing consistent and reliable results that validate the robustness of the proposal. These findings highlight the capability of the developed method to enhance cleavage prediction, which could potentially contribute to understanding viral processes and developing targeted therapeutic strategies.

Functional structure of a high resolution thyroid nodule unit. Economic impact and results of its implementation in an Endocrinology department.

BACKGROUND AND OBJECTIVE: The high incidence of nodular thyroid pathology has led to growing concern about the economic impact that this pathology represents on the healthcare system. There are conclusive data about the cost-effectiveness of high-resolution units for nodular thyroid pathology; however, their implementation is not homogeneous in the Endocrinology and Nutrition services of our country. The objective of the present study was to evaluate the economic impact of the implementation of the high-resolution thyroid nodule unit (HRTNU) in our center. PATIENTS AND METHODS: The present work is a prospective, observational and descriptive study carried out in 1314 patients (82% women, mean age 58 years ds = 11) evaluated at the HRTNU during the period of August 2022-August 2023. Demographic data (age and sex) were analyzed, referral center and consultation type, number of total consultations and neck ultrasound performed, number of fine needle aspiration (FNAB) performed, and cytology results were analyzed. RESULTS: In the period from August 2022 to August 2023, a total of 1314 patients were evaluated (neck ultrasound and clinical consultation) and a total of 133 FNAB were performed, of which only 2.26% were non-diagnostic. Compared to the percentage of unsatisfactory FNAB from the previous year August 2021-July 2022 of 25%, a mean saving of 9931.43 euros was estimated. 84.47% of the patients evaluated for the first time by the HRTNU were discharged, estimating a mean saving of 133,200 euros. CONCLUSIONS: The implementation of a HRTNU at the Endocrinology and Nutrition departments, coordinated with primary and specialized care, is a cost-effectiveness alternative, as it reduces the number of medical consultations and is accompanied by a higher rate of diagnostic FNAB.

Psychometric Analysis of the Spanish-Language Version of the Instrument for the Evaluation of Handovers in Critically Ill Patients in Urgent and Emergency Care Settings.

Background/Objectives: Patient handover is the process by which the responsibility for care is transferred from one health care professional to another. Given the lack of validated scales to assess the handover of critically ill patients, our aim was to evaluate the reliability and validity of the Instrumento de Evaluación de la Transferencia de Enfermos Críticos (IETEC) (English: Instrument for the Evaluation of Handovers in Critically Ill Patients). Methods: Psychometric analysis of the reliability and validity (construct, convergent, and discriminant) of the IETEC. This single-center study included professionals (nurses, physicians, and emergency medical technicians) involved in the care of the critically ill in urgent care and emergency situations. Results: We evaluated 147 handovers of critically ill patients. The KR-20 score was 0.87, indicting good internal consistency. Of the 147 handovers, 117 (79.6%) were classified as unsafe and 30 (20.4%) as safe. The model fit showed an acceptable construct validity (24 items and four factors: Identification, Communication, Quality, and Family). The Communication domain had the strongest correlation with the total scale (r = 0.876) while Family had the weakest (r = 0.706). The Communication and Family domains were closely correlated (r = 0.599). The IETEC reliably differentiated between safe and unsafe handovers, with a mean (SD) score of 26.3 (1.2) versus 19.0 (4.8), respectively. No significant differences (p = 0.521) in mean IETEC scores were observed between the physicians and nurses. Conclusions: These results show that the IETEC presents adequate psychometric properties and is, therefore, a valid, reliable tool to evaluate handovers in critically ill patients in urgent care and emergency settings.

Design and construct of an assessment tool for the handover of critical patient the in urgent care and emergency setting.

OBJECTIVES: To design and construct an assessment tool for the handover of critical patients in the urgent care and emergency setting. RESEARCH METHODOLOGY: This metric and descriptive study comprised two phases in accordance with the Clinical practice guidelines for A Reporting Tool for Adapted Guidelines in Health Care: The RIGHT-Ad@pt Checklist. In the first phase, the identification and selection of items related to the handover of critical patients were performed by consensus of a group of experts. The second phase consisted of two stages. In the first stage, the items were selected by applying the e-Delphi technique across two assessment rounds and in the second stage, the items were subjected a pilot test in a real critical patient handover scenario. Professionals from different disciplines and work areas (hospital and prehospital) caring for critically ill patients in the urgency and emergency setting participated in each of the phases. RESULTS: A total of 58 critical patient care, and urgent and emergency care professionals participated in the design and construction of the assessment tool. The initial list consisted of 14 categories and 57 items, which were reduced to 28 items grouped into five categories after the intervention of the participants. The content validity index (CVI) of the instrument was 0.966. CONCLUSIONS: This study describes an assessment tool developed in Spanish-language designed to assess the handover of critical patients in the urgent care and emergency setting. This tool has a high CVI, and is the only currently available tool that consider all of the dimensions and characteristics of the handover process. IMPLICATIONS FOR CLINICAL PRACTICE: The assessment tool developed in this study could enable critical care professionals in their clinical practice to work in a systematic way, universalizing the handover of critically ill patients in the urgent care and emergency setting through scientifically proven guidelines.

Duodeno-ileal diversion with self-forming magnets in a sutureless neodymium anastomosis procedure (SNAP) for weight recidivism after sleeve gastrectomy: feasibility and 9-month results.

BACKGROUND: The sleeve gastrectomy (SG) has become the most common bariatric procedure worldwide. However, insufficient weight loss or weight recidivism is frequent, which may require effective and safe revisional procedures. OBJECTIVE: To determine the technical feasibility and safety of a minimally invasive, duodeno-ileal side-to-side anastomosis using a Sutureless Neodymium Anastomosis Procedure (SNAP) for patients with weight recidivism or inadequate weight loss following SG. METHODS: This is a prospective, single-arm, open-label pilot study that enrolled patients with obesity to assist in weight reduction following an SG performed > 12 months prior. For the SNAP, self-assembling magnets were deployed into the ileum (laparoscopically) and duodenum (per-oral endoscopy). Magnets were coupled under laparoscopic and fluoroscopic guidance to create a compression anastomosis. The primary endpoints were technical feasibility, weight loss, and rate of serious adverse events (SAEs). RESULTS: Successful duodeno-ileal diversions were created with SNAP in 27 participants (mean age: 50.6 ± 9.1, mean BMI: 38.1 ± 4.6 kg/m2) with no device-related serious adverse events. Upper endoscopy at 3 months confirmed patent, healthy anastomoses in all patients. At 9 months, patients (n = 24) experienced 11.9 ± 6.2%, 14.5 ± 10.8%, and 17.0 ± 13.9% TBWL at 3, 6, and 9 months, respectively. There were no device-related SAEs. CONCLUSION: The SNAP is technically feasible and relatively safe, with all patients presenting widely patent anastomosis at 3 months. Patients experienced a progressive, clinically meaningful weight loss. Further studies are needed to confirm our findings.

A Predictive Model of the Start of Annual Influenza Epidemics.

Influenza is a respiratory disease that causes annual epidemics during cold seasons. These epidemics increase pressure on healthcare systems, sometimes provoking their collapse. For this reason, a tool is needed to predict when an influenza epidemic will occur so that the healthcare system has time to prepare for it. This study therefore aims to develop a statistical model capable of predicting the onset of influenza epidemics in Catalonia, Spain. Influenza seasons from 2011 to 2017 were used for model training, and those from 2017 to 2018 were used for validation. Logistic regression, Support Vector Machine, and Random Forest models were used to predict the onset of the influenza epidemic. The logistic regression model was able to predict the start of influenza epidemics at least one week in advance, based on clinical diagnosis rates of various respiratory diseases and meteorological variables. This model achieved the best punctual estimates for two of three performance metrics. The most important variables in the model were the principal components of bronchiolitis rates and mean temperature. The onset of influenza epidemics can be predicted from clinical diagnosis rates of various respiratory diseases and meteorological variables. Future research should determine whether predictive models play a key role in preventing influenza.

Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators.

Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient's requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.

Training Characteristics, Performance, and Body Composition of Three U23 Elite Female Triathletes throughout a Season.

(1) Background: There is a lack of data on the long-term training characteristics and performance markers of elite young female endurance athletes. The aim of this study was to present the training load (ECOs), as well as the evolution of the anthropometric values and performance of three elite U23 female triathletes over a season. (2) Methods: General training data and performance data relating to the swimming, cycling, and running legs of the 2021 season were described. The training intensity distribution (TID) was presented using the triphasic model, while the training load was based on the ECO model. An anthropometric analysis was also conducted in accordance with the ISAK standards. (3) Results: Triathletes increased their VO2max in cycling (6.9-10%) and running (7.1-9.1%), as well as their power and speed associated with the VO2max (7.7-8.6% in cycling and 5.1-5.3% in running) and their swimming speed associated with the lactate thresholds (2.6-4.0% in LT2 and 1.2-2.5% in LT1). The triathletes completed more than 10 h of weekly average training time, with peak weeks exceeding 15 h. The average TID of the three triathletes was 82% in phase 1, 6% in phase 2, and 12% in phase 3. A decrease in the sum of skinfolds and fat mass percentage was observed during the season in the three triathletes, although the last measurement revealed a stagnation or slight rise in these parameters. (4) Conclusions: The triathletes performed a combination of two training periodization models (traditional and block periodization) with a polarized TID in most of the weeks of the season. Improvements in performance and physiological parameters were observed after the general preparatory period as well as a positive body composition evolution throughout the season, except at the end, where the last measurement revealed stagnation or a slight decline. This study can be useful as a general guide for endurance coaches to organize a training season with female U23 triathletes.

Effect of Abiotic Treatments on Agricultural Plastic Waste: Efficiency of the Degradation Processes.

In this study, four different plastic materials usually used in the agricultural sector (polystyrene film (PS), polyethylene terephthalate film (PET), low-density polyethylene film (LDPE) and linear low-density polyethylene film (LLDPE)) were subjected to different abiotic treatments, including photo-oxidation (ultraviolet and e-beam radiation) and thermochemical treatments, to enhance polymer degradation. The extensive use of these polymers leads to large amounts of plastic waste generation, including small plastic pieces, known as microplastics, which affect the quality of the agricultural environment, including soil fertility and quality. Therefore, polymer degradation strategies are needed to effectively reduce plastic waste to protect the agricultural sector. The degree of polymer degradation was assessed by the use of thermal and spectroscopic analyses, such as TGA and FTIR. In addition, efficiency, cost-benefits, and potential side-effects were also evaluated to propose the optimal degradation strategy to reduce plastic waste from the point of view of efficiency. The results obtained showed that the pre-treatments based on photo-oxidation (ultraviolet B and C and e-beam radiation) were more efficient and had a better cost-benefit for the degradation of the polymers studied in relation to the thermochemical treatments. Specifically, ultraviolet photo-oxidation worked well for PS and PET, requiring low energy and medium times. However, e-beam radiation was recommended for PE (LDPE and LLDPE) degradation, since high energy and long times were needed when ultraviolet energy was applied to this polymer. Furthermore, the overall efficiency of the plastic degradation of pre-treatments should be studied using a multicriteria approach, since FTIR assessments, in some cases, only consider oxidation processes on the plastic surface and do not show the potential integrity changes on the plastic probes.

Non-tuberculous mycobacteria: occurrence in skin test cattle reactors from official tuberculosis-free herds.

Non-tuberculous mycobacteria (NTM) are considered a relevant cause of non-specific reactions to the most widely applied bovine tuberculosis (bTB) test, the intradermal tuberculin test. In order to establish which NTM species might act as a potential source of such diagnostic interference, a collection of 373 isolates obtained from skin test positive cows from 359 officially tuberculosis-free (OTF) herds, culled in the framework of the bTB eradication campaign in Spain, were identified at the species level through PCR and Sanger sequencing of the 16S rDNA, hsp65 and rpoB genes. Of the 308 isolates for which a reliable identification was achieved, 32 different mycobacterial species were identified, with certain species being most represented: among M. avium complex members (n = 142, 46.1%), M. avium subsp. hominissuis (98; 69.0%) was the most abundant followed by M. avium subsp. avium (33, 23.2%), and M. intracellulare (7, 4.9%). Among non-MAC members (n = 166, 53.9%), M. nonchromogenicum (85; 27.6%) and M. bourgelatii (11; 5.6%) were the predominant species. In addition, mixed results were obtained in 53 isolates presenting up to 30 different genotypes, which could be indicative of new mycobacterial species. Our results represent a first step toward characterizing the diversity of NTM species that could interfere with official diagnostic tests for bTB eradication in Spain.

Functional paraganglioma, an uncommon cause of seminoma metastasis, diagnostic and therapeutic management.

We report a 62-year-old male, with history of uncontrolled hypertension (3 drugs) in who, it was found an incidentally left retroperitoneal hypervascular tumor (5.7 x 3.5 cm) in the CT. It was demonstrated contact between tumor and left renal artery and ureter, without regional lymphadenopathy. The patient was asymptomatic, but had increased of norepinephrine (1141.1 pg/mL), epinephrine (93.3 pg/mL) and serotonin blood levels (264.1 g/L). The MRI confirm the tumor, with serotonin affinity in the 68Galium-Edotreotide PET/CT (DOTATATE) but not in the MIBG/Scan. Therefore, a paraganglioma was the suspected diagnosis. Tumor board recommended excision, due to the risk of being a functional paraganglioma. The tumor was resected through laparoscopic approach after alpha-beta-adrenergic blockade. Postoperatively, hypertension and norepinephrine blood levels were normalized. The histological report surprisingly showed a Seminoma (positivity for PLAP, OCT ¾, c-kit, MDM2) and the surgical margins were free.

A Five-Week Periodized Carbohydrate Diet Does Not Improve Maximal Lactate Steady-State Exercise Capacity and Substrate Oxidation in Well-Trained Cyclists compared to a High-Carbohydrate Diet.

There is a growing interest in studies involving carbohydrate (CHO) manipulation and subsequent adaptations to endurance training. This study aimed to analyze whether a periodized carbohydrate feeding strategy based on a daily training session has any advantages compared to a high-carbohydrate diet in well-trained cyclists. Seventeen trained cyclists (VO2peak = 70.8 ± 6.5 mL·kg-1·min-1) were divided into two groups, a periodized (PCHO) group and a high-carbohydrate (HCHO) group. Both groups performed the same training sessions for five weeks. In the PCHO group, 13 training sessions were performed with low carbohydrate availability. In the HCHO group, all sessions were completed following previous carbohydrate intake to ensure high pre-exercise glycogen levels. In both groups, there was an increase in the maximal lactate steady state (MLSS) (PCHO: 244.1 ± 29.9 W to 253.2 ± 28.4 W; p = 0.008; HCHO: 235.8 ± 21.4 W to 246.9 ± 16.7 W; p = 0.012) but not in the time to exhaustion at MLSS intensity. Both groups increased the percentage of muscle mass (PCHO: p = 0.021; HCHO: p = 0.042) and decreased the percent body fat (PCHO: p = 0.021; HCHO: p = 0.012). We found no differences in carbohydrate or lipid oxidation, heart rate, and post-exercise lactate concentration. Periodizing the CHO intake in well-trained cyclists during a 5-week intervention did not elicit superior results to an energy intake-matched high-carbohydrate diet in any of the measured outcomes.

Multifunctional polylactic acid sensing fabric based on biomass flame retardants for intelligent fire early-warning.

Today, building materials emit many hazardous gases in the event of a fire, causing great harm to human health and the environment. Therefore, it is of great significance to develop bio-based flame retardant materials and to realize preventive measures to reduce fires or their damage. In this work, we fabricated a novel multifunctional fire early-warning polylactic acid-based fabric (MFR-PBF) by coating MXene nanosheet, phytic acid @ furfurylamine (PA@FA) and ammonium polyphosphate (APP) via an eco-friendly layer-by-layer assembly method. MFR-PBF showed outstanding flame retardancy including a limiting oxygen index value of 35 % and better char formation capacity. More importantly, MFR-PBF exhibited sensitive fire early-warning capability (∼1 s) and excellent cyclic alarm stability (>15 cycles) due to the excellent semiconductor responsiveness (light and heat) and the significant catalytic char formation effect. Moreover, MFR-PBF is comfortable, flexible and strong enough to sew onto firefighter uniform to detect a variety of human motions, which can be monitored in the internet by using a LoRa emitter and a gateway. In addition, the controllable heating performance rendered MFR-PBF as a potential portable heater. This work provides new insights into the preparation and application of intelligent fire early-warning fabrics in the smart fire protection and Internet of Things.

Enhancing earthworm (Lumbricus terrestris) tolerance to plastic contamination through gut microbiome fortification with plastic-degrading microorganisms.

Microorganisms from L. terrestris gut previously exposed to different types of plastic (PET, LDPE, LLDPE, and PS) were studied to be used as probiotics of earthworms in plastic-contaminated soils (LDPE, LLDPE and recycled mulching film) at mesocosm-scale trials. The most abundant morphotypes with enzymatic capacities of interest were identified. Pseudomonas alkylphenolica (PL4) and Pseudomonas putida (PL5) strains were selected to be used as inoculants using Morus alba leaves as carriers to strengthen the intestinal microbiota of earthworms. Culture (selective cetrimide agar medium) and molecular (qPCR) techniques were used to trace the presence of the inoculum in the intestine of the earthworms. Additionally, a metataxonomic analysis was carried out to study the biodiversity and functionality of the earthworm microbiome, and their measure of survival and weight. Probiotics improved the survival rates of earthworms exposed to plastics, which also increased the abundance of microbial groups of interest in plastic bioremediation tasks.

Clinical value of a tool for managing oral anticoagulation in nonvalvular atrial fibrillation in primary health care. Randomized clinical trial.

INTRODUCTION AND OBJECTIVES: The management of atrial fibrillation is complex and requires improvement at strategic points, such as in the control of patients treated with vitamin K antagonists. The aim of this study was to evaluate the impact on health outcomes of a nonvalvular atrial fibrillation decision support tool based on visualization of the time in therapeutic range in primary care. METHODS: The present randomized clinical trial was conducted in 2018 with a 1-year follow-up in 325 primary care centers in Catalonia. In the intervention centers, the decision support tool was installed to control the time in therapeutic range of patients treated with vitamin K antagonists. The tool was not visualized in the control group. This clinical trial was registered with ClinicalTrials.gov (NCT03367325). RESULTS: In total, 44 556 patients were studied. The intervention protected against admission for stroke (adjusted odds ratio [OR], 0.70; 95% confidence interval [95%CI], 0.55-0.88). The number needed to treat was 3502 (95%CI, 3305-3725) while the number of admissions for stroke avoided was 12.63 (95%CI, 11.88-13.38). The intervention also protected against mortality (adjusted OR, 0.78; 95%CI, 0.67-0.90), with a number needed to treat of 13 687 (95%CI, 10 789-18 714) and number of deaths avoided of 3.23 (95%CI, 2.36-4.10). CONCLUSIONS: The decision support tool was associated with slight reductions in the numbers of admissions for ischemic stroke and mortality. Although the follow-up time was short and the effect of the intervention was small, the results are valuable and could improve implementation of the tool.

Does Pool Performance of Elite Triathletes Predict Open-Water Performance?

The capacity of laboratory tests to predict competition performance has been broadly researched across several endurance sports. The aim of the present study was to analyse how pool swimming performance can predict the result of the swimming segment in triathlon competitions and compare predictability differences based on competition level and distance. Eighteen male triathletes participated in the study. Three were ranked world-class, ten elite/international level, and five highly trained/national level. A total of sixty-one graded multi-stage swimming tests were conducted. Blood lactate was measured to calculate the following hypothetical predictor variables: speed at lactate threshold 1 (LT1), speed at lactate threshold 2 (LT2), and speed in the last repetition of the test (SL200). The following data were collected for a total of 75 races: time in the swimming leg (TSL); position after the swimming leg (PSL); time difference with the first triathlete after the swimming leg (DFT); and final race position. The race levels were divided according to participant levels as follows: world series (WS) (n = 22); World Cup (WC) (n = 22); Continental Cup (CC) (n = 19); national championship (N) (n = 5); and local race (L) (n = 5). Based on distance, they were divided into Olympic distance (OD) (n = 37) and sprint distance (SD) (n = 38). A moderate to strong positive association was found between LT1, LT2, SL200 and PSL and TSl at all race levels except for the SD CC, SD WC, and OD CC races, where no or weak-to-moderate correlations were found. The present study demonstrated that performance measured in a graded multi-stage pool lactate test can predict performance in a triathlon swimming segment. This finding is highly useful for coaches as it can help them to obtain a reliable measure of the triathlete's specific capabilities in the swimming leg.