title: North Wales

text: As of 2020, there as 66 rail stations within the boundaries of the 6 northern principal areas, of which 2 are among the 20 busiest stations in Wales, Rhyl, and Bangor. 41 of the rail stations are stations of the North Wales lines, whereas the remaining 25 are stations of the Mid Wales lines, specifically the Cambrian Line. There is a total of 5 rail routes in North Wales: the North Wales Coast Line, the Shrewsbury—Chester Line, the Conwy Valley Line, the Borderlands Line (all part of the North Wales lines) and the Cambrian Line. All 5 routes together in 2018-19 had approximately 5,295,602 entries and exits through the 66 stations.


title: North Wales

text: The North Wales Coast Line, the main rail line serving the north Wales coast, and connecting with Irish Ferries and Stena Line ferry services to Dublin Port in the Republic of Ireland. The Conwy Valley Line branches off at Llandudno Junction, heading north to Llandudno and south to Blaenau Ffestiniog. The Shrewsbury—Chester line, connects Chester and Shrewsbury via Wrexham, providing the main north Wales and south Wales connection. A former open-access operator Wrexham & Shropshire, used to provide a Wrexham General—London Marylebone service until 2011. The Borderlands Line, intersects the Shrewsbury—Chester line at Wrexham General, branching south to Wrexham Central (where it terminates), and north to Bidston (Birkenhead), and the North Wales Coast Line at Shotton. Bidston connects to the Wirral line, providing Merseyrail services, west to West Kirby, and east to Liverpool Central. The Cambrian Line forms the other west-east line in the region (as the Mid-Wales line), it connects Shrewsbury, westwards with Mid Wales and towns along Cardigan Bay. The line is commonly split into two sections, the section from Shrewsbury to Aberystwyth is sometimes referred to as the Cambrian Main Line, with the Cambrian Coast Line, splitting off from this line at Dovey Junction, heading northwest to Pwllheli. The Welsh Marches Line connects Crewe to Newport, via Shrewsbury, with services from Holyhead usually continuing to Cardiff Central. It forms part of the North Wales South Wales service, along with the Shrewsbury—Chester, North Wales Coast Line, and South Wales Main Line. These lines form the main rail connection between North Wales and South Wales.


title: North Wales

text: Chester provides the main travel connections for the North Wales Coast, as a major transport hub. As part of the North Wales Metro, from Chester "(and Wrexham General at limited times)," via the Halton Curve, direct trains run to Liverpool Lime Street, linking to the Merseyrail. Services to Manchester Piccadilly from Chester, via the Chester—Manchester line for Transport for Wales services, and the Mid—Cheshire line for Northern services, in addition to the Northern service to Leeds, provide North Wales' connections to Northern England. Shrewsbury provides the main travel connections for passengers from the Cambrian line (and those commuting south from other North Wales stations), providing services, in addition to those to South Wales, through England to Crewe, Birmingham International, and Birmingham New Street, and via the Heart of Wales line, services to Llanelli.


title: North Wales

text: There are numerous heritage railways in the region. Most of them are narrow-gauge. Several run on sections of historically longer lines. Heritage railways employ more than 300 people and generate over £50 million per year for the North Wales economy.


title: North Wales

text: Several of these lines connect to the Cambrian line. Stations where the heritage railway uses the same station as Network Rail. At Fairbourne, the Fairbourne Railway connects to Barmouth Ferry and the Ffestiniog Railway connects at . The Talyllyn Railway's station is a short walk from station on the Cambrian line, while on the Cambrian line is across town from on the Welshpool and Llanfair Light Railway.


title: North Wales

text: Many rail and bus lines of the region are part of an improvement project called the North Wales Metro or North East Wales Metro, which proposes improvements to the existing lines (specifically the Borderlands lines), improved connectivity between rail and other modes of transport, and more connections to North West England.


title: North Wales

text: For the Gobowen to Oswestry line, Cambrian Heritage Railways, the line's operator, is working on reopening the line (multiple sections of line), and the Anglesey Central Railway is also proposed to be restored.


title: North Wales

text: In Llandudno, the Great Orme Tramway links to the Great Orme. It is the only remaining cable-operated street tramway in Great Britain, and one of only a few surviving in the world.


title: North Wales

text: North Wales has very diverse and complex geology with Precambrian schists along the Menai Strait and the great Cambrian dome behind Harlech and underlying much of western Snowdonia. In the Ordovician period much volcanism deposited a range of minerals and rocks over the northwestern parts of Gwynedd whilst to the east of the River Conwy lies a large area of upland rolling hills underlain by the Silurian mudstones and grits comprising the Denbigh and Migneint Moors. To the east, around Llangollen, to the north on Halkyn Mountain and the Great Orme and in eastern Anglesey are beds of limestone from which metals have been mined since pre-Roman times. Added to all this are the complexities posed by Parys Mountain and the outcrops of unusual minerals such as Jasper and Mona Marble which make the area of special interest to geologists.


title: North Wales

text: Terms for people from the region include; North Welsh, and North Walian (also spelt as North Walean), or informally as "Gogs" from the Welsh word for North, "Gogledd". This term is mostly only used to distinguish from other parts of Wales (i.e. only used domestically in Wales), a majority of the population consider themselves as just "Welsh", and some additionally or only as "British". Communities along the Wales-England border and northern coast may identify as "English" as they are home to many of those of English ancestry.


title: North Wales

text: According to Statistics for Wales (StatsWales), the North Wales region, consists of the 6 northern principal areas, and statistics provided by StatsWales only include these 6 areas. In 2018, the estimated population of the region was 698,400 people. North Wales exhibits the evenest distribution of population across the local authorities of any of the 4 statistical regions of Wales, with 4 of the 6 authorities home to over 100,000 residents, Flintshire, Wrexham, Gwynedd and Conwy. Flintshire is the most populated principal area of North Wales, home to an estimated 155,600 people, with the Isle of Anglesey being the least populated with an estimated 70,000 people.


title: North Wales

text: In 2018, North Wales has an estimated population density of 113.6 persons per square kilometre. Flintshire is the most densely populated of the 6 areas, at 355.6 persons per km, with Gwynedd being the least dense principal area at 49.0 persons per km. Between 2008, and 2018, the population density of North Wales grew by 2.3%, the third-highest rate of population density growth of the 4 statistical regions of Wales. Gwynedd, with 3.7% growth, had the highest population density growth rate in North Wales, whereas the Isle of Anglesey had the lowest population density growth rate at 0.1% from 2008 to 2018.


title: North Wales

text: The population growth for the region between 1998 and 2018 was 6.3%, however, the rate was lower between 2008 and 2018, than in 1998 and 2008. Conwy was the area with the highest population growth rate for the two decades at 8%, with Isle of Anglesey having the smallest growth rate at just over 3%.


title: North Wales

text: North Wales' largest settlement (locality) is Wrexham, with 65,692 people in the 2011 census. Data from the census details that North Wales has a lower number and proportion of residents living in settlements of 25,000 or more, than South East and South West Wales, but higher than Mid Wales. StatsWales attributes this to North Wales' lack of a settlement of a population higher than 100,000 people.


title: North Wales

text: North Wales has an ageing population, as the proportion of residents over 65 has increased from 18.5% to 23.0%, and the proportion of the population under 15 has decreased from 19.8% to 17.8%.


title: North Wales

text: North Wales has a distinct regional identity. Its dialect of the Welsh language differs from that of other regions, such as South Wales, in some ways: for example ' is used in most of the North instead of ' for "milk"; a simple sentence such as "go upstairs now" might be ' in North Wales, and ' in South Wales. Colloquially, a person from North Wales (especially one who speaks with this dialect or accent) is known as a "North Walian", or a "Gog" (from the Welsh "", meaning "north"). There are Welsh medium schools scattered all across North Wales, ranging from primary to secondary schools.


title: North Wales

text: According to the 2011 census, there were 204,406 Welsh-speakers aged three and over in North Wales. Data from the Annual Population Survey, stated that Gwynedd had the largest proportion of speakers in North Wales and Wales as a whole, with 75.6% of residents aged 3 and over saying they can speak Welsh. Flintshire had the lowest rate of Welsh in North Wales, with only 22.5% saying they can speak it. North Wales is the most Welsh-speaking region of the 4 statistical regions of Wales, at 41.9% of the population speaking Welsh in the year ending September 2019, up approximately 2.4% from September 2009. However, Flintshire is one of 2 principal areas in Wales where the rate of Welsh has decreased over the past decade.


title: North Wales

text: North Wales is home to two universities, Bangor University, and Wrexham Glyndwr University. In 2018-19, in total there were 17,500 enrolments on higher education courses in North Wales, representing 13.2% of student enrolments in all of Wales. Bangor University was home to a majority, 58.3% of these enrolments, with 10,195 enrolments in 2018-19, with Wrexham Glyndwr University following with 5,895 enrolments, and further education college Grŵp Llandrillo Menai providing the remaining 1,410 enrolments.


title: North Wales

text: Further education (FE) in Wales is provided by "colleges" (not to be confused with a university college), these are usually either sixth form colleges, further education colleges, or sixth forms within secondary schools. Further education colleges are the largest further education institutions in North Wales, in which, at present, there are only 2; Grŵp Llandrillo Menai, and Coleg Cambria. Both of these colleges, are amalgamations of smaller further education or sixth form colleges, and are sometimes described as "super colleges". Grŵp Llandrillo Menai is a merger of Coleg Llandrillo, Coleg Menai, and Coleg Meirion-Dwyfor, providing courses for students of the Isle of Anglesey, Conwy County Borough, Denbighshire, and Gwynedd. Coleg Cambria is a merger Deeside College and Yale College, Wrexham, providing courses for students of Denbighshire, Flintshire, and Wrexham County Borough. There are no standalone sixth form colleges (sixth form only) in North Wales, as all colleges providing sixth form courses also provide non-sixth form courses.


title: North Wales

text: The other institutions providing sixth form further education in North Wales are secondary schools, which provide sixth form education themselves. Not all secondary schools in North Wales provide sixth form education, with it being common for students of a secondary school that does not provide sixth form education to study at a further education college.


title: North Wales

text: Grŵp Colegau NPTC Group of Colleges, a further education college formed from the merger of Neath Port Talbot College and Coleg Powys, is the main further education college for Powys, hosting a campus in Newtown.


title: North Wales

text: The 6 counties of North Wales are all part of the Betsi Cadwaladr University Health Board (BCUHB), it is the largest of the local health boards which divide up NHS Wales services in Wales. Formed from the merger of the North Wales NHS Trust (itself a merger of North East Wales, and Conwy & Denbighshire NHS Trusts), the North West Wales NHS Trust, and the Local Health Boards of the six counties of Anglesey, Conwy, Denbighshire, Flintshire, Gwynedd, and Wrexham.


title: North Wales

text: There are 3 main district general hospitals in North Wales; Ysbyty Gwynedd in Bangor, Ysbyty Glan Clwyd Hospital in Bodelwyddan, and Wrexham Maelor Hospital. Each hospital is the main centre of healthcare for the west, central, and east parts of North Wales respectively. North Wales additionally has a network of 22 acute and community hospitals, with patients commonly referred to hospitals in England for rare, more specialised treatment, unavailable under BCUHB, notably to Countess of Chester, Royal Liverpool University, and Royal Shrewsbury hospitals.


title: North Wales

text: According to the Annual Population Survey and Office for National Statistics, the unemployment rate of the six principal areas of North Wales was collectively 3.9% for the population aged 16 and over; the employment rate was 75.9% of those aged 16-64, and the economic inactivity rate (excluding students) for the population aged 16-64 was 17.9%.


title: North Wales

text: In 2016 the UK Government invited North Wales to submit a Growth Deal Bid, to "create thousands of jobs, boost the economy, improve transport and communication links, focus on renewable energy, support tourism and more". A bid was prepared by the North Wales Business Council, which consists of the Leaders and Chief Executives of the 6 councils, the Vice Chancellors of Wrexham Glyndŵr University and Bangor University the Chief Executives of Coleg Cambria and Grwp Llandrillo Menai, and North Wales Mersey Dee Business Council. In the 2018 budget Philip Hammond announced that £120M would be made available by the UK Government to support the Growth Deal. In December 2018, Ken Skates confirmed that the Welsh Government would match the UK Government funding, and also offered to match any additional funding support which the UK Government might make available. In November 2019 the Heads of Terms Agreement for the North Wales Growth Deal was signed by the representatives of the North Wales Economic Ambition Board, Alun Cairns the UK Government Secretary of State for Wales, and Eluned Morgan, Baroness Morgan of Ely on behalf of Welsh Government.


title: North Wales

text: Two daily newspapers are published in the region. The region-wide "North Wales edition" of the "Daily Post", based at Bryn Eirias on Colwyn Bay's Abergele Road, is distributed from Monday to Saturday, whilst "The Leader" (formerly the "Evening Leader") publishes two editions for Wrexham and Flintshire and is based at the headquarters of Newsquest in Mold after NWN Media Ltd dissolved after existing since 1920.


title: North Wales

text: The weekly Aberystwyth-based "Cambrian News" covers southern Gwynedd and publishes separate editions for the Arfon/Dwyfor and Meirionydd districts.


title: North Wales

text: Several hyperlocal websites in the area provide locally sourced news online. In Conwy county, BaeColwyn.com has provided Welsh language coverage of the Colwyn Bay area since 2011 and AbergelePost.com has been serving the Abergele area since 2010. Wrexham.com is a full-time operation covering Wrexham and the surrounding area, and is based at offices in Wrexham city centre. A full-time citizen-led online news site Deeside.com started in early 2013 and covers Connah's Quay, Mancot, Pentre, Shotton, Queensferry, Sealand, Broughton, Hawarden, Ewloe, Sandycroft and parts of Saltney.


title: North Wales

text: Although no BBC local radio stations exist in Wales, the corporation's national services BBC Radio Wales and BBC Radio Cymru cover the region from their broadcasting centres in Bangor, and Wrexham. The Bangor studios produce a large number of Radio Cymru programmes with some music and feature output for Radio Wales originating from Wrexham.


title: North Wales

text: Three commercial radio stations serve the area — Capital North West and Wales broadcasts local drivetime programming for Wrexham, Flintshire, Denbighshire and Conwy county as well as Cheshire and the Wirral with a Welsh language opt-out service for the former Coast FM area on 96.3 FM. Capital Cymru airs an extended local programming service, predominantly in the Welsh language, for Gwynedd and Anglesey. Across the entire region, Heart North Wales also airs local peak-time programming in English, including an extended news programme on weeknights. All three stations broadcast from studios in Gwersyllt on the outskirts of Wrexham.


title: North Wales

text: Three community radio stations broadcast on FM — Calon FM serving Wrexham County Borough and parts of southern Flintshire, Tudno FM broadcasting to Llandudno & surrounding areas and Môn FM across the Isle of Anglesey and parts of Gwynedd. Radio Glan Clwyd - an extension of hospital service Radio Ysbyty Glan Clwyd - broadcasts on 1287 AM in the Bodelwyddan, St Asaph, Rhuddlan, Towyn and Kinmel Bay areas.


title: North Wales

text: Towards the western side of North Wales, local hills mean national BBC FM coverage can be quite poor, often suffering interference from Irish stations from the west.


title: North Wales

text: News coverage of North Wales is generally provided within the BBC's "Wales Today", "Newyddion" and "Ffeil" programmes (the latter two broadcast on S4C) and on ITV's "ITV News Cymru Wales". BBC Cymru Wales news teams are based at the corporation's Bangor and Wrexham studios, while ITV Cymru Wales runs a newsroom in Colwyn Bay.


title: North Wales

text: S4C has an administrative office in Caernarfon, where a cluster of independent production companies are also based or partly based including Rondo Media, Cwmni Da, Antena, Owain Roberts Animations and Tinopolis.


title: North Wales

text: Wrexham A.F.C. play in the English football league system; having been a member of the Football League for over 80 years, in 2008 they were relegated into the Conference National for the first time in their existence. They now play in the Vanarama National League. They play at the Racecourse Ground in Wrexham and train at Colliers Park, Gresford.


title: North Wales

text: Several teams including Connah's Quay Nomads F.C. and Bangor City F.C. have appeared in UEFA competitions, playing within the mostly semi-professional Welsh leagues the Cymru Premier and the Cymru North.


title: North Wales

text: Due to the proximity of North Wales to the North West of England, support for the English clubs of Liverpool F.C., Everton F.C. and Manchester United F.C. has been historically strong.


title: North Wales

text: Wales was represented in the Super League by the Crusaders RL, they re-located to Wrexham for the 2010 season from South Wales. They played at the Racecourse Ground and trained at Stansty Park both in Wrexham before folding in 2011. They have now been replaced by the League 1 side, North Wales Crusaders.


title: North Wales

text: North Wales has its own amateur league, in the fifth tier of the British rugby league system, the North Wales Championship.


title: North Wales

text: In September 2008 it was announced by the Welsh Rugby Union that a development team based in North Wales would be created, with a long-term goal of becoming the fifth Welsh team in the Celtic League. It was envisaged that this would both help the growth of the game in the area, and provide a larger pool of players for the Welsh national team to be selected from. The team was named RGC 1404.


title: Jerry Remy

text: Gerald Peter Remy (November 8, 1952 – October 30, 2021) was an American professional baseball player and sports broadcaster. Remy played in Major League Baseball (MLB) as a second baseman for ten seasons—three with the California Angels (1975–1977) and seven with the Boston Red Sox (1978–1984). After retiring from professional play, he served for 33 years as a color commentator for televised Red Sox games until his death.


title: Jerry Remy

text: Remy began commentating with the cable channel New England Sports Network (NESN) in 1988, and later expanded to over-the-air television in 1995. A native of Somerset, Massachusetts, Remy was a popular local figure, known for his exuberance, humorous non-sequitur game commentary, and thick New England accent that endeared him with Red Sox fans. He was given the nickname "RemDawg" and was elected "President" of Red Sox Nation in 2007. Remy also owned restaurants in the Boston area, and wrote books about baseball.


title: Jerry Remy

text: Gerald Peter Remy was born in Fall River, Massachusetts, on November 8, 1952, and grew up in nearby Somerset. He attended Somerset High School and Roger Williams University in Bristol, Rhode Island. He was of French Canadian descent.


title: Jerry Remy

text: Remy was selected by the Washington Senators in the 19th round of the 1970 MLB draft, but he did not sign. He was then selected in the 8th round of the January supplemental phase of the 1971 MLB draft (129th overall) by the California Angels, and signed with the team.


title: Jerry Remy

text: Remy played four seasons in the Angels' farm system: 1971 with the rookie league Magic Valley Cowboys, 1972 with the Class A Stockton Ports, 1973 with the Class A Quad City Angels (.335, 4 home runs and 36 RBI in 117 games), and 1974 with Double-A El Paso Diablos and the Triple-A Salt Lake City Angels, where he hit a combined .323 with 4 home runs and 67 RBI. Overall, Remy appeared in 421 games in Minor League Baseball, batting .275 with 12 home runs and 152 RBIs.


title: Jerry Remy

text: Remy made his major league debut with the Angels on April 7, 1975. He hit a single off of Steve Busby of the Kansas City Royals in his first at bat and was subsequently picked off. With the 1975 Angels, Remy played 147 games (145 starts) as the Angels' second baseman, batting .258 with one home run and 46 RBIs. He had 34 stolen bases, but was caught stealing a league-leading 21 times. The following year, his average rose slightly to .263, although with no home runs and 28 RBIs. In 1977, he had a career-high four home runs, along with a .252 average and 44 RBIs; he was named team captain of the Angels in June, becoming only the second captain in the team's history.


title: Jerry Remy

text: Overall, in three seasons with the Angels, Remy played in 444 games, batting .258 with five home runs, 118 RBIs, and 110 stolen bases. On December 8, 1977, he was traded to the Boston Red Sox in exchange for pitcher Don Aase and cash considerations.


title: Jerry Remy

text: Remy was the Red Sox's starting second baseman in 1978 and was selected for the MLB All-Star Game, although he did not play in the game. Overall, with the 1978 Red Sox, he batted .278 with 44 RBIs and 30 stolen bases in 148 games. He also had two home runs, the last ones of his career. In the 1978 American League East tie-breaker game against the New York Yankees, Remy was on base in the ninth inning when Carl Yastrzemski made the final out; it was the closest Remy came to the postseason in his MLB career.


title: Jerry Remy

text: Remy continued as Boston's starting second baseman for the next six seasons, although he was often hampered by injuries. In 1979, he played in 80 games and batted .297. In 1980, he batted a career-high .313 but was limited to 63 games; he also appeared in the outfield for the only time in his career, playing the ninth inning in right field during a May loss to the Cleveland Indians. In 1981, Remy played in 88 games while batting .307. On September 3–4, 1981, he accomplished the rare feat of collecting six hits in a game, going 6-for-10 in a 20-inning game against the Seattle Mariners.


title: Jerry Remy

text: In 1982, Remy appeared in a career-high 155 games while batting .280; in 1983, he batted .275 while playing in 146 games. In 1984, a knee injury limited him to 30 games for the season, during which he batted .250; he made his final start at second base on May 5, and his final MLB appearance on May 18 when he flied out as a pinch hitter. Remy was released by the Red Sox on December 10, 1985, and he retired during spring training in 1986. Overall, in seven seasons with the Red Sox, Remy played in 710 games, batting .286 with two home runs, 211 RBIs, and 98 stolen bases.


title: Jerry Remy

text: During his ten-year MLB career, Remy batted .275 with seven home runs, 329 RBIs, and 208 stolen bases in 1154 games. Defensively, he had a .981 fielding percentage. Bill James, in his "Historical Abstract", rated Remy as the 100th greatest second baseman of all time as of 2001.


title: Jerry Remy

text: After 1988, Remy found success in broadcasting, working for the New England Sports Network (NESN), as the regular color commentator for NESN's Red Sox broadcasts. Initially paired with Ned Martin through 1992 and Bob Kurtz from 1993–2000, from 2001 through the end of the 2015 season, he teamed with play-by-play announcer Don Orsillo; starting with the 2016 season, Remy worked with Dave O'Brien. Beginning in 1995, he also replaced former color commentator Bob Montgomery on the over-the-air Red Sox broadcasting team, paired with Sean McDonough for those broadcasts through 2004, when Orsillo took over for McDonough on the over-the-air games as well. He also ran a website, The Remy Report, which covered Boston Red Sox news and information.


title: Jerry Remy

text: Remy owned a hot dog stand, RemDawg's, a nod to the nickname he held amongst Red Sox fans, located just outside Fenway Park, as well as Jerry Remy's Sports Bar & Grill in Terminal C of Logan International Airport. There were three other Bar & Grill locations: one behind Fenway Park on Boylston Street that opened March 9, 2010, which was reported closed in March 2015, and subsequently became a Tony C’s Sports Bar & Grill (named after another former Red Sox player, Tony Conigliaro); a second in the Seaport District of South Boston, which in December 2016 also became a Tony C’s Sports Bar & Grill; and a third in Remy's birthplace of Fall River that opened in October 2012, which in March 2018, "The Herald News" of Fall River reported would be closed.


title: Jerry Remy

text: Remy wrote three books about baseball, and several children's books about Red Sox mascot Wally the Green Monster, which began as an idea based on Remy's storytelling while broadcasting Red Sox games.


title: Jerry Remy

text: In 2012, to commemorate the 100th anniversary of Fenway Park, then-Red Sox second baseman Dustin Pedroia authored a sixth book in the series, "Wally The Green Monster's Journey Through Time".


title: Jerry Remy

text: Remy worked extensively with The Jimmy Fund, a charity that supports the Dana–Farber Cancer Institute. He was known to invite cancer patients in the broadcast booth, visit with patients in hospitals, and participated in their annual telethon.


title: Jerry Remy

text: In November 2008, Remy had surgery to remove a "very small, low-grade cancerous area" from his lung, most likely a result of years of smoking cigarettes. During his recovery from the surgery, he suffered from an infection as well as a bout of pneumonia. Due to fatigue and depression, Remy took an indefinite leave of absence from his broadcast duties for NESN, starting April 30, 2009.


title: Jerry Remy

text: On August 12, 2009, Remy went to Fenway Park and attended Red Sox manager Terry Francona's pre-game press conference. He told both NESN and "The Boston Globe" that he had every intention of returning to broadcasting Red Sox games during the remainder of the 2009 season. He entered the NESN's broadcast booth during the top of the second inning during the night's game to speak with broadcasters Don Orsillo and Dennis Eckersley. It was the first time he had been in the booth since he took his leave of absence in April. In between the top and the bottom of the second inning, Remy, still in the booth, was shown on Fenway's center field scoreboard display, to which he received a standing ovation from the crowd attending the game. He revealed during the visit that he had suffered from depression following his physical problems of 2008 and that he was receiving therapy. On August 19, 2009, Remy released a statement announcing his return to commentating on August 21, 2009, against the New York Yankees. He stated that he would likely skip some road trips. He returned full-time for the 2010 baseball season. In April 2013, he announced that he had suffered a relapse that offseason when cancer was found in a different spot on his lungs during his regular six-month CT scan that January.


title: Jerry Remy

text: Remy took time off starting May 28, 2013, due to a bout of pneumonia. He returned to the booth on June 25, 2013. On August 16, 2013, he announced that he would be taking an indefinite leave of absence after his son was arrested for murder; Remy did not return to the broadcast booth until the beginning of the 2014 season. He had another leave during the 2016–17 off-season, missing most of the 2017 spring training.


title: Jerry Remy

text: On June 12, 2017, Remy announced that his lung cancer had returned. In January 2018, he announced via Twitter that he had completed treatments at Massachusetts General Hospital (MGH). A fourth diagnosis of cancer was announced on August 7, 2018. After undergoing treatments, Remy announced in early November 2018 that he was cancer-free.


title: Jerry Remy

text: On June 11, 2021, Remy left Fenway Park during the third inning of a game he was commentating on, due to shortness of breath, and was admitted to MGH. He was released from the hospital five days later, and returned to broadcasting on June 20. On August 4, Remy announced that he would be stepping away from NESN for lung cancer treatment. On October 5, he appeared at Fenway Park to throw out the ceremonial first pitch before the AL Wild Card Game, in what ended up being his final public appearance.


title: Jerry Remy

text: Remy died of lung cancer on October 30, 2021, nine days before his 69th birthday. A public wake was held in Waltham, Massachusetts, on November 4.


title: Jerry Remy

text: Remy and broadcast partner Don Orsillo won four New England Emmy awards, and Remy was voted Massachusetts' favorite sports announcer in 2004 by "Sports Illustrated". Remy was inducted into the Boston Red Sox Hall of Fame in 2006, and elected honorary President of Red Sox Nation in 2007. NESN and the Red Sox celebrated Jerry Remy Day at Fenway Park on June 24, 2008, in honor of Remy's 20 years of service for the network. He was inducted into the Massachusetts Broadcasters Hall of Fame in 2017.


title: Jerry Remy

text: After his death, Joe Buck, veteran sports broadcaster, called Remy's sports broadcasting career "legendary" and called him a "force in the booth", noting "If Red Sox Nation had an emperor, the ‘RemDawg,’ it would be him." Broadcaster Sean McDonough, who of his own accord has worked with at least 160 different broadcast partners, said of his time with Remy: "nothing felt as special as the nine years I spent with Jerry".


title: Jerry Remy

text: On April 15, 2022, the date of the home opener for the season, the team issued a Tweet showing that the NESN broadcasting booth at Fenway Park was now named the Jerry Remy Booth, in his memory. The booth has also been adorned with a memorial plaque honoring Remy. The team held a ceremony to honor Remy prior to their home game of April 20, including appearances from former teammates Dennis Eckersley, Carl Yastrzemski, Rick Burleson, Dwight Evans, Fred Lynn, Jim Rice, and Bob Stanley.


title: Jerry Remy

text: Remy and his wife Phoebe had three children, Jared, Jordan, and Jenna. Jared worked for the Red Sox as a security guard, but was fired in 2008 after another guard told the State Police that Jared had sold him steroids. On August 16, 2013, Jared was arrested in the fatal stabbing of his girlfriend, Jennifer Martel, a charge he pleaded guilty to on May 27, 2014. Jared Remy was sentenced to life in state prison without the possibility of parole. Jordan was selected by the Red Sox in the 49th round of the 1999 MLB draft, but he did not play professionally.


title: Liposarcoma

text: Liposarcomas are the most common subtype of soft tissue sarcomas, accounting for at least 20% of all sarcomas in adults. Soft tissue sarcomas are rare neoplasms with over 150 different histological subtypes or forms. Liposarcomas arise from the precursor lipoblasts of the adipocytes (i.e. fat cells) in adipose (i.e. fat) tissues. Adipose tissues are distributed throughout the body, including such sites as the deep and more superficial layers of subcutaneous tissues as well as in less surgically accessible sites like the retroperitoneum (i.e. space behind the abdominal cavity) and visceral fat inside the abdominal cavity.


title: Liposarcoma

text: All liposarcomas consist of at least some cells that bear a resemblance to fat cells when examined for their histopathologic appearances under a microscope. However, the liposarcomas do have several forms based on differences in their clinical presentations (e.g. ages, gender preferences, sites of tumors, signs, and symptoms), severities (i.e. potential to invade local tissues, recur after surgical removal, and metastasize to distal tissues), genetic abnormalities, prognoses, and preferred treatment regimens. The World Health Organization in 2020 reclassified liposarcomas into five more or less distinct forms: 1) atypical lipomatous tumor/well-differentiated liposarcoma (WD-LPS); 2) dedifferentiated liposarcoma (DD-LPS); 3) myxoid liposarcoma; 4) pleomorphic liposarcoma; and 5) myxoid pleomorphic liposarcoma. (Pleomorphic indicates the presence of cells that have abnormal and often large variations in their size and shape and/or the size and shape of their nuclei.)


title: Liposarcoma

text: While liposarcoma forms are classified as being aggressive and malignant or, in the case of the atypical lipomatous tumor/well-differentiated liposarcoma, as relatively non-aggressive and benign, all five liposarcoma forms can infiltrate locally to injure nearby tissues and organs, occur in surgically inaccessible sites adjacent to vital organs (e.g. the retroperitoneum), recur after surgical removal, and progress to life-threatening diseases. Studies to date find that all five liposarcoma forms, while usually treatable at least initially by surgical resection, are often only marginally responsive to currently used chemotherapy and radiotherapy regimens. The liposarcomas require a wide range of further studies to determine their responsiveness to various radiotherapy, chemotherapy, and more novel treatment regimens as used individually and in various combinations that would include, where possible, surgical removal.


title: Liposarcoma

text: "fatty tumor" (plural lipomata), 1830, medical Latin, from Greek lipos "fat" (n.), from PIE root *leip- "to stick, adhere", also used to form words for "fat", + -oma.


title: Liposarcoma

text: 1650s, "fleshy excrescence", (plural liposarcomata), Medical Latin, from Latinized form of Greek sarkoma "fleshy substance" (Galen), from sarkoun "to produce flesh, grow fleshy", from sarx (genitive sarkos) "flesh", + -oma.


title: Liposarcoma

text: Liposarcomas are generally large tumors (>10 cm) but can be of almost any size. They occur mainly in adults with only 0.7% of cases occurring in those <16 years old. In adults, liposarcomas occur predominantly in and after middle-age. The very rare cases occurring in children and adolescents are diagnosed predominantly as being the myxoid liposarcoma form.


title: Liposarcoma

text: The five liposarcoma forms must be distinguished not only from each other but also from certain other soft tissue tumors. These other tumors along with some of their distinguishing histopathologic features are: 1) dysplastic lipomas (i.e. benign humors that have sites of tissue necrosis and neoplastic, variably-sized fat cells containing variable sized/shaped nuclei; these neoplastic cells, unlike most neoplastic cell in the liposarcomas, do not overexpress the "MDM2" gene); 2) atypical spindle cell lipomas (i.e. benign tumors with mildly atypical spindle-shaped cells in a fibrous-to-myxoid stroma intermixed with vacuolated lipoblasts and variable-sized adipocytes with atypical nuclei; 3) pleomorphic lipomas (i.e. benign tumors characterized by giant cells with overlapping nuclei); and 4) solitary fibrous tumors (i.e. tumors, up to 22% of which exhibit malignant behavior, consisting of spindle- or ovoid-shape cells within a collagenous background stroma intermixed with blood vessels with a characteristic staghorn shape).


title: Liposarcoma

text: Together, atypical lipomatous tumors (ALTs) and well-differentiated liposarcomas (WDLs) account for 4045% of all liposarcomas. They rarely if ever metastasize and therefore are regarded as benign or premalignant tumors. However, they are locally invasive and may transform to a more aggressive and potentially metastasizing liposarcoma, i.e. a dedifferentiated liposarcoma. Furthermore, a surgically removed atypical lipomatous tumor/well-differentiated liposarcoma may recur as a dedifferentiated liposarcoma.


title: Liposarcoma

text: ALTs and WDLs are considered virtually identical tumors except that by definition ALTs designate tumors that develop in the arms or legs while WDLs designate tumors that develop in less surgically accessible sites such as the deep, centrally-located soft tissues of the retroperitoneum, paratesticular region (i.e. area within the scrotum including the testes, spermatic cord, testicular tunic, epididymis, and appendix of testis), oral cavity, and eye socket. This terminology has prognostic implications: less than 7% of ALT tumors convert to dedifferentiated liposarcomas within a median time of 7 years while 17% of WDL tumors convert to this more malignant liposarcoma within a median time of 8 years. ALT and WDL (hereafter termed ALT/WDL) tumors typically present in middle-aged and older individuals as slowly enlarging masses that tend to be larger and at a more advanced stage when located in deep tissues. These tumors usually are not painful and if located superficially, readily apparent; they can also cause extensive edema (i.e. swelling due to the local accumulation of fluid) in involved areas such as the thigh (see adjacent figure) due to their invasion into the blood and/or lymphatic vessels draining the tumor's site. Deep-seated ALT/WDL tumors may be asymptomatic but, depending on their location, produce serious signs and/or symptoms of disfunction in any one of the various organs which they infiltrate. These organs include those close to or in the retroperitoneum (e.g. intestines, kidney, and the kidney's ureters); the paratesticular region; the mediastinum (e.g. trachea and lung's major bronchi); and the head (e.g. the retrobulbar space behind the globe of the eye).


title: Liposarcoma

text: Histopathologically, ALT/WDL tumors are divided into adipocytic/lipoma-like, sclerosing, and inflammatory variants with adipocyte/lipoma-like being the most common. Adipocytic/lipoma-like ALT/WDL tumors consist of lobules of mature fat cells variably intersected with irregular fibrous septa (see the adjacent H&E stained photomicrograph). Sclerosing ALT/WDL tumors, the second most common variant, develop primarily in the retroperitoneal and paratesticular areas; it consists of scattered, atypical stromal cells within a collagenous (i.e. collagen-containing) stromal tissue background. Rare vacuole-containing lipoblasts populate this tissue. Inflammatory ALT/WDL tumors are the rarest variant. they occur most frequently in the retroperitoneum and consists of chronic inflammatory cells, e.g. lymphocytes and plasma cells plus occasional lymph node-like follicles interspersed throughout a tissue background containing fat cells.


title: Liposarcoma

text: The neoplastic cells in ALT/WDL tumors contain one or more extra ring-shaped small supernumerary marker chromosome (sSMC) or an abnormal giant marker chromosome (i.e. a formerly normal chromosome that is made abnormal by having a duplication of parts of its own or one or more other chromosome's genetic material). These abnormal chromosomes contain extra copies of chromosome 12's long arm (also termed the q arm) at bands 13 through 15. This stretch of chromosome 12 includes the "MDM2" proto-oncogene (a potentially tumor-causing gene when overexpressed) located at band 15 and "CDK4" (a gene that when overexpressed promotes the development of various tumors) located at band 14.1. The amplificiation (i.e. increased copies of a gene without a proportional increase in other genes) of these two genes is a highly sensitive and specific indicator that a liposarcoma is either an ALT/WDL or a dedifferentiated liposarcoma rather than any other liposarcoma or lipoma form. In addition to the "MDM2" and "CDK4" genes, this band 13–15 chromosome area also contains the "TSPAN31" and "HMGA2" genes which, when overexpressed, are associated with various tumors and/or cancers. One or more of these overexpressed genes, it has been suggested, promote and/or contribute to the development and/or progression of ALT/WDL tumors.


title: Liposarcoma

text: The diagnosis of ALT/WDL tumors is made based on the features of their clinical presentations, histopathology, and genetic findings. In particular, detection in the ALT/WDL tumor cells of an overexpressed "MDM2" or "CDK4" gene or the presence of either the specific ALT/WDL-associated sSMC or giant marker chromosome (as defined by next generation DNA sequencing, comparative genomic hybridization, and/or highly specialized cytogenetic G banding analyses) strongly supports the diagnosis of ALT/WDL or dedifferentiated liposarcoma. The clinical presentation and histopathology differences between the latter two liposarcoma forms usually help distinguish between them.


title: Liposarcoma

text: ALT/WDL tumors are treated by radical surgical resection to remove all tumor neoplastic tissues. However, these tumors recur locally in 30–50% of cases. Recurrences occur most often in tumors located in less accessible sites such those in the retroperitoneum, mediastinum, and spermatic cord. These less surgically assessible tumors tend to recur repeatedly and ultimately may cause death due to their injurious effects on vital organs. While ALT/WDL tumors have very little potential to metastasize, about 10% will convert to an overtly malignant and potentially metastasizing liposarcoma form, dedifferentiated liposarcoma. The median time for this malignant transformation is about 7–9 years. In addition, a surgically removed ALT/WDL may recur after a variable interval as a dedifferentiated liposarcoma. A large randomized controlled trial comparing radiotherapy followed by surgery to surgery alone in ALT/WDL tumors found little difference between the two regimens. Smaller studies employing selective inhibitors of the protein products of the "CDK4" or "MDM2" genes implicated in ALT/WDL have shown at best only modest effects. Further studies using these or completely novel treatment regimens are under investigation. A review study in 2012 reported the 5 and 10 year survival rates of individuals with ALT/WDL to be 100% and 87%, respectively.


title: Liposarcoma

text: The novel therapies of ALT/WDL are the same as those listed in the Novel therapies section of Dedifferentiated liposarcoma.


title: Liposarcoma

text: Dedifferentiated liposarcomas are malignant tumors which in ~10% of cases develop in an existing atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) tumor or at the site were an ALT/WPL tumor was surgically removed. Individuals with a "de novo" diagnosis of this tumor may have had an ALT/WDL that progressed to a dedifferentiated liposarcoma but went undetected because it developed asymptomatically in a highly sequestered site such as the retroperitoneum or abdominal cavity. Many of the dedifferentiated liposarcoma tumors' clinical and genetic features are similar to those found in ALT/WDL tumors.


title: Liposarcoma

text: Dedifferentiated lipoosarcomas (DDL) occur most frequently in middle-aged and older adults with a peak incidence in their sixth to eighth decades. Rarely, these tumors have developed in children and adolescents. DDL tumors most commonly occur in the retroperitoneal space but, similar to ALT/WDL, may occur in the extremities, paratesticular area, mediastinum, head, or neck. Less than 1% of all DDLs develop in superficial soft tissues or the eye socket. At presentation, DDL tumors typically are painless, large, may have been slowly and progressively enlarging for years, and on routine X-rays contain areas of calcium deposition (exemplified by Fig. 1 in the Histopathology of liposarcomas section). Less commonly, affected individuals have signs and/or symptoms due to their tumor's impingement on an organ (e.g. abdominal pain caused by blockage of the intestines or urinary tract obstruction caused by blockage of the urethra). Very rarely, individuals with DDL present with one or more signs or symptoms of chronic inflammation (see B symptoms) and/or one of the endrocrine, neurological, mucocutaneous, hematological, or other tissue-related paraneoplastic syndromes. The signs and symptoms of chronic inflammation and the various paraneoplastic syndromes are caused by the tumors' secretion of cytokines, hormones, prostaglandins, and/or other systemically acting agents; they completely disappear after the DDL is successfully treated.


title: Liposarcoma

text: The histopathological appearance of DDL tumors (see Fig. 2 in the below Histopathology of liposarcomas section) varies widely but most frequently exhibits features of undifferentiated pleomorphic sarcomas (which are tumors densely populated with variably sized and shaped cells containing variability sized and shaped nuclei) or spindle cell sarcomas (which are tumors consisting of spindle-shaped cells in a connective tissue background). Different parts of DDL tumors often show variations in the appearances of their background connective tissues: these tissues may be myxoid (i.e. consisting of a clear, mucus-like substance which when stained using a standard H&E stain method appears more blue or purple than the red color of normal tissues) or myxocollagenous (i.e. high collagen fiber content in a myxoid background), and, in ~5% of cases, have areas of osteoid (see Fig. 1 in the below Histopathology of liposarcomas section) or cartilaginous material. The tumors also show large variations in their cell contents. For example, up to 10% of DDL tumors have areas with ALT/WDL histopathology and rare cases of DDL have areas containing meningothelial-like whorls of flat cells.


title: Liposarcoma

text: The neoplastic cells in both DDL and ALT/WDL carry similar small supernumerary marker chromosomes (sSMCs) and/or giant marker chromosomes that contain extra parts of chromosome 12's q arm at bands 13 through 15. This chromosomal area includes two genes associated with tumor development, the "MDM2" and "CDK4" genes. The presence of extra copies of these two genes and/or their overproduced protein products is a highly sensitive and specific indicator that a lipomatous tumor is an ALT/WDL or DDL rather than some other type of lipomatous tumor. Overexpression of the "MDM2" and "CDK" genes, and/or other genetic material in the sSMCs or giant marker chromosomes are suspected of promoting the development and/or progression of DDL as well as ALT/WDL tumors. Other genes in the sMMC and giant marker chromosome that are also overexpressed in ALT/WDL and DDL neoplastic cells include "HMGA2, CPM, YEATS4," and "DDIT3". Compared to ALT/WDL neoplastic cells, however, DDL neoplastic cells: 1) express higher levels of the genes in the two abnormal chromosomes; this may contribute to the progression of ALT/WDL to DDL; and 2) higher levels of gene products on the long arm of chromosome 1 at band 32, the long arm of chromosome 6 at band 33, and, in ~25% of cases, the short arm of chromosome 1 at band 32.2 which contains the "JUN" gene (this gene is overexpressed in DDL but not ALT/WDL). Since the "JUN" gene's product, c-jun, inhibits cell death and promotes cell proliferation, its overproduction may contribute to the progression of ALT/WDL to DDL and/or the malignancy of DDL neoplastic cells. Gene expression profiling (i.e. measurement of the expression of the products of thousands of genes made by cells, tissues, or tumors) have revealed that adipocyte cell differentiation and metabolic pathways in ALT/WDL are upregulated while cell proliferation and DNA damage response pathways are upregulated in DDL.


title: Liposarcoma

text: The histopathological of DDL is often insufficiently clear to make a firm diagnosis. However, the diagnosis of DDL is supported in individuals: whose tumors contain ALT/WDL admixed with DDL histological components; with histories of having a prior ALT/WDL; or who present with a retroperitoneal liposarcoma (DDL constitutes ~57% of all retroperitoneal liposarcomas). DDL tumors only rarely (<1% of cases) present as superficial skin tumors; are almost 5 times less likely than ALT/WDL to occur in the eye socket; and are extremely rare in children. Detection of tumor cell MDM2 amplification is the diagnostic gold standard in distinguishing WDL from lipomas, dysplastic lipomas, atypical spindle cell sarcomas, pleomorphic lipomas, and solitary fibrous tumors. Alternately, detection in the tumor cells of an overexpressed "CDK4" gene or the presence of either the specific ALT/WDL-associated sSMCs or giant marker chromosome strongly support the diagnosis of DDL or ALT/WDL. The clinical presentation, histopathology, and gene differences (e.g. tumor cell overexpression of the "cJUN" gene strongly favors the diagnosis of DDL over ATL/WDL) between the latter two liposarcoma forms usually help distinguish between them.


title: Liposarcoma

text: Complete surgical resection is usually the recommended first-line treatment for localized DDL tumors. However, emerging studies suggest that patients with DDL tumors that are restricted to an extremity or the trunk and have a predicted 10-year tumor-related overall survival of 51% or less have improved outcomes when chemotherapy (e.g. doxorubicin plus ifosfamide) is added to their surgical regimens. For these localized forms of DDL, perioperative radiotherapy following National Comprehensive Cancer Network guidelines may also be considered.


title: Liposarcoma

text: Retroperitoneal DDL is the most common, surgically unassessible and serious form of DDL: it has a recurrence rate of 66% and a five-year overall survival rate of 54%. The primary treatment option for retroperitoneal DDL is surgical resection. A phase III clinical trial found little difference in the results of radiation therapy followed by surgical resection compared to surgical resection alone in the treatment of retroperitoneal DDL. In other phase III clinical trials, DDL patients with inaccessible retroperitoneal and/or metastatic tumors were treated with front-line chemotherapy comparing doxorubicin to doxorubicin plus ifosfamide or doxorubicin to gemcitabine plus docetaxel. Other studies have likewise examined the value of various chemotherapy regimens. These studies often found little difference in the overall survival times in their comparisons but did show some improvements in progression-free survival and other clinical parameters. Based on these studies, a recommended first-line therapy for retroperitoneal and other surgically inassessible or metastatic DDL tumors is treatment with an anthracycline-based chemotherapy regimen or, in tumor-resistant or relapsed cases, eribulin chemotherapy. A review conducted in 2020 reported median survival times for low histopathological grade and high histopathological grade DDL to be 113 months and 48 months, respectively. Further studies are needed to provide evidence on the efficacies of radiotherapy, chemotherapy, and novel therapies in all the varieties of DDL.


title: Liposarcoma

text: Several novel therapy regimens for DDL and the more aggressive or otherwise problematic cases of ALT/WDL are currently undergoing clinical trials. A phase II clinical study investigating abemaciclib is underway in patients with pretreated or untreated DDL. Preliminary analysis showed that this inhibitor of the "CDK4" and "CDK6" genes' product Serine/threonine-specific protein kinase enzymes produced a prolonged median progression-free survival time of 30.4 weeks. A phase III multicenter, randomized, double-blind, placebo-controlled clinical study of abemaciclib is in its active phase and will soon (as stated in July, 2021) begin recruiting 108 individuals with advanced, recurrent, and/or metastatic DDL. The study is sponsored by the Sarcoma Alliance for Research through Collaboration in collaboration with Eli Lilly and Company. Ribociclib, also a "CDK4" and "CDK6" gene inhibitor, in combination with a mTOR inhibitor, everolimus is in a phase II clinical trial in individuals with advanced DDL or leiomyosarcoma. A phase III registration study (i.e. a large confirmatory study meant to establish an acceptable benefit/safety profile in order to gain regulatory approval for a precisely defined indication) is evaluating the safety and efficacy of milademetan compared to trabectedin in patients with unresectable (i.e., resection is deemed to cause unacceptable morbidity or mortality) or metastatic DDL that has progressed on 1 or more prior systemic therapies, including at least 1 anthracycline-based therapy. The sponsor, Rain Therapeutics Inc, is currently recruiting 160 individuals for the trial. Another phase III clinical trial is investigating the MDM2 inhibitor milademetan versus trabectedin, a blocker of the oncogenic transcription factor FUS-CHOP, in MDM2-overexpressing ALT/WDL and DDL. Milademetan has shown manageable toxicity and some activity resulting in stable disease and/or a few partial responses in DDL.


title: Liposarcoma

text: Myxoid liposarcoma (MLS), which includes a type of liposarcoma termed round cell liposarcoma, represents ~30% of all liposarcomas. It has a peak incidence in individuals' fourth and fifth decades with a male predominance in most studies. While uncommon in children and adolescents, MLS is the most common liposarcoma form diagnosed in these age groups. MLS typically presents as a large (1 to 39 cm; average 12 cm), mobile, well-circumscribed, painless mass that developed from 1 week to 15 years prior to diagnosis. MLS tumors are located in deep-seated soft tissues of the thighs (65–80% of cases), lower legs (10–15% of cases), retroperitoneum (8% of cases), and arms (5% of cases). In about one-third of cases, these tumors metastasize to other soft tissue sites (e.g. retroperitoneum, thorax, or other extremity), skeletal bone, and/or lung. Individuals may present with these metastasis, particularly those in bone; it has been recommended that patients should be tested at presentation for bone metastasis by medical imaging, including X-rays, CT scans, and/or magnetic resonance imaging.


title: Liposarcoma

text: Histopathologic analyses of MLS (see Figs. 3 and 4 in the below Histopathology of liposarcomas section) reveals cells scattered throughout a myxoid matrix (i.e. a connective tissue background that appears more blue or purple than the red color of normal connective tissue when these tissues are properly prepared, H&E stained, and viewed microscopically). These cells are lipoblasts, some of which are signet ring-shaped (a shape suggesting that the cell may be neoplastic), oval-shaped, or round-shaped. MLS tumors may be hypercellular and contain solid sheets of round cells that comprise at least 5% of all cells or low cellularity populated with cells that have bland nuclei and <5% round cells in a background of curving capillaries resembling a chicken-wire pattern. Tumors that contain at least 5% round cells are classified as high-grade while those with <5% round cells are classified as low-grade. High-grade MLS tumors typically take a more aggressive clinical course than low-grade MLS tumors.


title: Liposarcoma

text: MLS tumor cells are virtually defined by their expression of a "FUS-DDIT3" fusion gene (also termed a chimeric gene) which occurs in >95% of cases or a "EWSR1-DDIT3" fusion gene which occurs in the remaining <5% of cases. The "FUS-DDIT3" fusion gene forms as a result of a translocation (termed t(12:16)(q13:p11)) between the site of the "DDIT3" gene at band 12 of chromosome 12's q arm and the site of the FUS gene at band 11 on chromosome 16's short arm (also termed the p arm). The fusion protein (also termed chimeric protein) product of this chimeric oncogene gene, FUS-DDIT3, is known to arrest fat cell maturation and promote neoplasia. The "EWSR1-DDIT3" fusion gene (termed t(12;22)(q13;q12)) results from a translocation of the "EWSR1" gene located at band 12.2 on chromosome 22's q arm with the "DDIT2" gene. The fusion protein product of the "EWSR1-DDIT3" gene, like the FUS-DDIT3 fusion protein, promotes neoplasia. In spite of these fusion gene relations, further studies are required to define their contribution to the development and/or maintenance of MLS tumors.


title: Liposarcoma

text: Low-grade and intermediate-grade MLS tumors can be identified histologically by their classic morphology of distinctive chicken-wire vasculature scattered throughout a myxoid stroma. However, high-grade MLS tumors can be difficult to distinguish from other round cell neoplasms, particularly high grade MLS tumors that consist of diffuse cell and/or pure round cell morphology to such an extent as to obscure this classic vascular-myxoid pattern. Detection of a "DDIT3" gene rearrangements with the "FUS" or "EWSR1" gene by in situ hybridization or immunohistochemistry or the RNA fusion transcripts of these genes by real-time polymerase chain reactions confirms the diagnosis of high-grade as well as ambiguous cases of low-grade or intermediate-grade MLS tumors.


title: Liposarcoma

text: MLS has typically been treated by surgical resection but may require more radical interventions, e.g. limb amputation may be needed when a limb's neurovascular bundle is compromised. The post-surgical risk of recurrence within 3 years after surgery has been reported to be ~15% when not all tumor is removed and ~10% when tumor removal is complete. The addition of radiotherapy to surgical resection has improved the local control of MLS tumors and has been recommended to treat unresectable and recurrent MLS. However, further studies are needed to determine the value of radiotherapy in treating the various varieties of MLS. Chemotherapy regimens using ifosfamide, an anthracycline such as daunorubicin, dacarbazine, and/or trabectedin have been found useful: a phase III clinical trial showed progression-free survival times in MLS patients treated with trabectedin or dacarbazine to be 5.6 and 1.5 months, respectively. In 2015 the Food and Drug Administration approved trabectedin for use in unresectable and metastatic liposarcomas.


title: Liposarcoma

text: Overall, the 10-year survival rate of MLS individuals has been 77%, a survival rate appreciably longer than other liposarcoma forms. Compared to low-risk MLS, high-risk MLS (risk defined by tumor round cell content and/or other unfavorable prognostic indicators) is associated with increased rates of metastasis and therefore a shorter survival time. Increased tumor size (≥ 10 cm) is strongly associated with a higher grade MLS and therefore a shorter survival time. Other factors that have been associated with unfavorable outcomes in MLS include presence of tumor necrosis, age >45 years, "P53" gene overexpression, and male gender. The round cell form of myxoid liposarcomas also appears to have a relatively poor prognosis: in various retrospective reviews, myxoid liposarcoma was usually found to be low-grade and therefore relatively responsive to chemotherapy whereas high grade (i.e. round cell) myxoid lipsarcoma had higher rates of metastasis, behaved more aggressively, and did not respond well to chemotherapy. It is important to note, however, that almost all cases of myxoid liposarcomas in pediatric patients have had excellent prognoses.


title: Liposarcoma

text: A PPAR-γ agonist (i.e. activator), efatutazone, was studied in a small phase I trial on individuals with various advanced-stage malignancies. The drug produced a markedly durable response in a person with MLS suggesting that PPAR-γ agonists would be useful for treating this disease. A stage II clinical trial conducted in Italy is examining the effects of a trabectedin plus pioglitazone (another PPAR-γ agonist) in individuals with stable MLS tumors. The study involves two sequential steps. The first step examines the response of patients treated for a minimum of 4 cycles with trabectedin alone. If stable disease is attained, the second step will examine the effects of further treating initially responding patients with a combination of trabectedin and pioglitazone. A stage II clinical trial is nearing completion to evaluate the efficacy of sirolimus (an inhibitor of MTOR; sirolimus is also known as rapamycin) plus cyclophosphamide (a chemotherapy drug) in metastatic or unresectable MLS. A phase II clinical trial is recruiting patients to evaluate sintilimab (a human IgG4 monoclonal antibody directed against the programmed cell death protein 1 located on the surface of cells) in combination with two chemotherapy drugs, doxorubicin and ifosfamide, as first-line treatment of soft tissue sarcomas including MLS.


title: Liposarcoma

text: T cells have been genetically engineered to target the MAGE-A4 antigen expressed on a HLA-A*02 MAGE-A4-containing peptide located on the surface of the neoplastic cells in certain types of tumors. These engineered cells (termed ADP-A2M4-T cells) attacked and killed various cultured human cancer cells bearing this antigen and, in a clinical stage 1 study, shrank various solid tumor types in patients whose tumors' contained neoplastic cells expressing this antigen. A phase II clinical study is now recruiting individuals to investigate the efficacy and safety of ADP-A2M4 T cells (engineered from the recipient's own T cells) in HLA-A*02-positive patients with metastatic or inoperable, advanced-stage MSGE-4-positive MLS tumors.


title: Liposarcoma

text: Pleomorphic liposarcomas (PLS), which account for 5% to 10% of all liposarcoma cases, are fast-growing, usually large (>5 cm), and painless but highly malignant adipocyte tumors. They occur primarily in individuals >50 years old with a predominance in females. PLS tumors are rarely found in children. PLS tumors present in a leg or arm (65% of cases), retroperitoneum or abdomen (15% of cases), or in rare cases the trunk wall, spermatic cord, head and neck areas, chest wall, pelvic cavity, pulmonary pleurae, pericardium, and spine. These tumors are usually localized in deep soft tissues with only 25% of cases presenting in subcutaneous tissues. Rare cases of PLS have presented in individuals with the Li-Fraumeni or Muir–Torre syndromes, two hereditary genetic disorders that predispose affected persons to develop various types of cancer.


title: Liposarcoma

text: The histopathology of PLS tumors often consists of areas resembling myxoid liposarcoma mixed with areas containing undifferentiated cells. These tumors are marked hypercellular and contain at least some variably shaped lipoblasts that have pleomorphic nuclei. Areas of necrosis are common, giant cells, some of which are multinucleated and/or contain engulfed neutrophils, are occasionally present, and hyaline droplets may be seen in some cells as well as scattered extracellularly throughout the tumor. The undifferentiated component of these tumors most often consists of spindle-shaped cells, with 25% of cases showing cells with an epithelioid cell morphology. These tumors have at least some foci with a histopathology similar to high-grade myxofibrosarcoma type histiocytomas, a tumor formerly termed malignant myxoid fibrous histiocytoma.


title: Liposarcoma

text: PLS neoplastic cells contain various gene and chromosome abnormalities: the "TP53" gene is deleted or mutated in 17–60% of cases; the "RB1" gene is deleted in 60% of cases; and the "Neurofibromin 1" gene is lost by inactivating mutations in 8% of cases or in rarer cases by a deletion around its location in band 11.2 on the long arm of chromosome 12. These cells can also show gains in the genetic material around: bands 12–15 on the short arm of chromosome 5; band 21 on the short arm of chromosome 1; and band 22 on the long arm of chromosome 7. The alterations in gene copy numbers induced by these abnormalities are similar to those seen in the myxofibrosarcoma type of the histiocytomas. The role(s) of these changes in gene copy numbers in promoting PLS has not been defined. Thus, PLS is unlike other liposarcomas in that its neoplastic cells have a complex genome without characteristic genomic alterations or identifiable genes that drive the disease. Detection of alterations in the expression of the "TP53, RB1", and "neurofibromin 1" genes, as well as other, less commonly altered genes in PLS (e.g. "PIK3CA, tyrosine-protein kinase SYK, PTK2B, EPHA5", and "ERBB4"), may help support but do not clearly define a tumor as being PLS. Extension of the chromosome telomere ends by pathological mechanisms termed alternative lengthening of telomeres occurs in the neoplastic cells of ~80% of PLS cases but is far less common or not seen in the other four forms of liposarcoma.


title: Liposarcoma

text: The diagnosis of PLS depends on its presentation, histopathology, and genetics. The histopathology of PLS often closely resembles that of myxofibrosarcoma but is distinguished from that tumor by its content of pleomorphic lipoblasts.


title: Liposarcoma

text: Radical surgical resection is the main treatment for PLS; it is also an important palliative intervention to relieve symptoms due to the compression of organs and tissues. Surgery may require removal of an entire compressed organ such as the kidney or colon. Regardless of this surgery, however, local recurrence rates are very high. The uses of chemotherapy and/or radiotherapy in conjunction with radical surgery have not been shown to prolong survival and are regarded as controversial interventions. The National Comprehensive Cancer Network recommends treatment for individuals with high-risk localized PLS by complete surgical resection, when feasible, combined with radiation therapy. Individuals with metastatic disease have been treated with chemotherapy (e.g. doxorubicin plus ifosfamide or eribulin) similar to the regimens used for dedifferentiated liposarcoma (see above section on the treatment of this liposarcoma type) About 20% of PLS tumors metastasize to distant sites, the most common of which are lung (82% of metastases), liver (18% of metastases), and bone or pancreas (18% of metastases). PLS survival rates at 1, 3, and 5 years are reported to be 93%, 75%, and 29%, respectively. Tumors located in the center position of the trunk, larger than 10 cm in size, deeply seated, or containing areas of necrosis have worse prognoses.


title: Liposarcoma

text: Myxoid pleomorphic liposarcoma (originally termed pleomorphic myxoid liposarcoma) was first described in a large 2009 study of the liposarcomas. While initially regarded as a possible variant of the myxoid liposarcomas with pleomorphic features, the World Health Organization (2020) classified it as a new and distinct form of the liposarcomas. This classification was based on findings that the myxoid pleomorphic liposarcomas, while having histopathological features that were similar to myxoid liposarcomas, had clinical and, most importantly, critical genetic and molecular features that differed from the myxoid as well as the other three liposarcoma forms.


title: Liposarcoma

text: Myxoid pleomorphic liposarcoma (MPL) is an exceptionally rare and highly aggressive form of the liposarcomas that develops in children, adolescents, young adults, and, in a more recent study, individuals >50 years old. MPL tumors present as deep soft-tissue masses that are often located in the mediastinum and, less often, the extremities, head and neck, abdominal cavity, or trunk. At least two case of MPL have presented in individuals with the Li–Fraumeni syndrome, an inherited genetic disorder that predisposes individuals to develop various cancers.


title: Liposarcoma

text: On histopathologic analyses, MPL tumors consist of areas resembling conventional myxoid liposarcoma; these areas, which represent 30–50% of the total tumor areas, have an abundant myxoid matrix, a well-developed capillary vasculature, bland cells that are round and/or slightly spindle-shaped, vacuolated lipoblasts, and multinucleated cells shaped like small flowers. However, these areas also contain a scattering of highly pleomorphic cells that show greater degrees of nuclear enlargement and irregularity than the cells seen myxoid liposarcoma tumors. Other areas of MPL tumors are more cellular and consist of rapidly growing and highly pleomorphic lipoblasts.


title: Liposarcoma

text: The neoplastic cells in MPL do not express the "FUS-DDIT3" or "EWSR1-DDIT3" fusion genes that are expressed by the neoplastic cells in >95% or <5%, respectively, of myxoid fibrosarcoma cases. Inactivation of the "RB1" tumor suppressor gene due to its deletion or pathological suppression is found in all cases MPL. MPL neoplastic cells also commonly have other alterations in their chromosomes. They may show abnormal gains in some of the genetic material normally found on chromosomes 1, 6, 7, 8, 19, 21, and/or X and losses in the genetical material normally found on chromosomes 2, 3, 4, 5, 10, 11, 12, 13, 14, 15, 16, 17 and/or 22. The genetic material lost in band 14 on the long arm of chromosome 13 includes not only the "RP1" gene but also the "RCBTB2, DLEU1," and "ITM2B" genes. Due to its rarity and more recent definition, the molecular characteristics and importance of these genetic abnormalities have yet to be fully defined. Nonetheless, studies have suggested that Losses in any one or more of the "RB1, RCBTB2, DLEU1," and "ITM2B" genes, but particularly the "RP1" gene, may be involved in contributing to the development and/or progression of MPL.


title: Liposarcoma

text: The diagnosis of MPL depends on its tumors clinical presentation, histopathological resemblance to myxoid liposarcoma, and, most critically, absence of the "FUS-DDIT3" sn "EWSR1-DDIT3" fusion genes in its neoplastic cells.


title: Liposarcoma

text: While individuals with MPL have been treated with surgical resection to remove their tumors, a 2021 review found that there were no consensus recommendations for the standard of care for MPL with respect to radiation and chemotherapy regimens (when used either alone or combined with surgery) for treating these tumors.


title: Liposarcoma

text: Medical ultrasonography and magnetic resonance imaging (MRI) of liposarcomas are helpful and often essential in determining their extent, surgical accessibility, and relationship to any observed organ dysfunctions. Since ultrasonography is usually unable to distinguish a liposarcoma from a benign lipoma, MRI is the initial imaging of choice to provide evidence relative to making this distinction.


title: Liposarcoma

text: In myxoid liposarcoma, it shows low signal intensity mass with high signal intensity foci on T1-weighted MRI images. The mass shows high signal intensity on T2-weighted images. This is because it contains predominantly mucoid substance (accounts for low signal intensity on T1) and small amount of mature fat (accounts for high signal intensity on T1). The mass is well-defined, lobulated, multiloculated, or oval in shape without any infiltration into surrounding structures.


title: Comrades Marathon

text: The Comrades Marathon is an ultramarathon of approximately which is run annually in the KwaZulu-Natal province of South Africa between the cities of Durban and Pietermaritzburg. It is the world's largest and oldest ultramarathon race. The direction of the race alternates each year between the "up" run (87 km) starting from Durban and the "down" run (now 90.184 km) starting from Pietermaritzburg.


title: Comrades Marathon

text: The 2019 field was capped at 25,000 runners, and the entry process closed after one week. South African runners constitute the greater part of the field, but many entrants hail from the United Kingdom, Zimbabwe, India, the United States, Brazil, Australia, Botswana, Russia and Eswatini. In all but three runnings since 1988, over 10,000 runners have reached the finish within the allowed 11 or 12 hours. With increased participation since the 1980s, the average finish times for both sexes, and the average age of finishers have increased substantially.


title: Comrades Marathon

text: The race was not held from 1941 to 1945 due to World War II, and the in-person edition of the race was cancelled in 2020 and 2021 due to the coronavirus pandemic. It was resumed in 2022 with a field of 15,000 entrants.


title: Comrades Marathon

text: Since 2019 runners over the age of 20 qualify when they are able to complete an officially recognised marathon (42.2 km) in under 4:50 (5 hours before 2019). During the event an athlete must also reach five cut-off points in specified times to complete the race. The spirit of the Comrades Marathon is said to be embodied by attributes of camaraderie, selflessness, dedication, perseverance, and ubuntu.


title: Comrades Marathon

text: The race is run on the roads of KwaZulu-Natal province, marked by "The Big Five" set of hills. On the up run they appear in the following order: Cowies Hill, Fields Hill, Botha's Hill, Inchanga, and Polly Shortts. The highest point of the race, at above sea level, is situated near the Umlaas Road interchange. Approximately 40 official refreshment stations along the route are stocked with soft drinks, water sachets, energy drink sachets, fruit, biscuits, energy bars, cooked potatoes and other refreshments. About eight physiotherapy and first aid stations are also located at strategic points.


title: Comrades Marathon

text: Athletes currently have 12 hours to complete the course, extended from 11 hours in 2003 (including a special 12 hour allowance in the year 2000). The original Comrades cut-off time from 1921 to 1927 was also 12 hours, reduced to 11 hours in 1928. There are a number of cut-off points along the routes which runners must reach by a prescribed time or be forced to retire from the race. A runner who successfully completed nine marathons wears a yellow number, while those who completed ten races wear a green number, permanently allocated to the runner for all future races. Runners running their 20th, 30th and 40th races are also indicated by yellow numbers – differently formatted on different years.


title: Comrades Marathon

text: Medals are awarded to all runners completing the course in under 12 hours. Medals are currently awarded as follows:


title: Comrades Marathon

text: - The Bill Rowan medal was introduced in 2000 and named after the winner of the first Comrades Marathon in 1921. The time limit for this medal was inspired by Rowan's winning time in 1921 of 8hrs 59min.


title: Comrades Marathon

text: - A new copper medal, the Vic Clapham medal (named after the race founder), was added in 2003. This medal coincided with the increase in the time allocation for completing the event from sub 11hrs to sub 12hrs.


title: Comrades Marathon

text: - The Wally Hayward medal, named after five-time winner Wally Hayward, was added in 2007 for runners finishing in under 6hrs, but outside the gold medals. Often there are fewer runners earning a Wally Hayward medal than those earning a gold medal, if any at all.


title: Comrades Marathon

text: - In 2005 the back-to-back medal was created and henceforth was awarded to novice runners who complete an 'up or down run' in succession. Back-to-back medals were automatically awarded to 2005 Comrades Marathon finishers who had completed their first Comrades Marathon in 2004. As with any new innovation, the award was never intended to be retrospective, owing to administrative restrictions. However, in response to popular demand, the back-to-back medal is available for purchase to runners who have previously fulfilled the criteria of completing both an 'up' and a 'down' Comrades Marathon.


title: Comrades Marathon

text: - For 2019 the Isavel Roche-Kelly medal (the same design as the Wally Hayward medal) was introduced for women finishing outside the gold medals, but under 7hrs 30min, effectively eliminating the silver medal for women. Twenty-year old Isavel Roche-Kelly was named the UCT Sportsperson of the Year for 1980. An unknown on the athletics scene, Roche-Kelly set the roads alight that year when she became the first woman to break the 7-hour barrier and win the Comrades Marathon in 7:18:00; well under the silver-medal cut-off of 7:30:00, and in the process shattering the women's record by more than an hour. Earlier that year she also became only the third women in Africa to complete a marathon in under three hours. She went on to win the 1981 Comrades up run in a time of 6:44:35 the following year. Three years later she died in a cycling accident in her native Northern Ireland at the age of 24.


title: Comrades Marathon

text: - Also in 2019, the titanium Robert Mtshali medal was introduced for a time between 9hrs 00min and sub 10hrs 00min. Robert Mtshali was the first unofficial black runner in the 1935 Comrades Marathon, finishing his race in a time of 9 hours and 30 minutes. His efforts were not officially recorded as government and race rules of the time stipulated that, in order to compete in the Comrades Marathon, you had to be a white male. Friday, 24 May 1935, saw Mtshali participating in the 15th Comrades Marathon, a down run, joining the 48 official entrants on the starting line. He ran unofficially, but was warmly welcomed into the Durban finish venue on the then Old Fort Road track grounds (now KE Masinga Road) by the crowds of supporters and spectators. The maverick runner clocked his time of 9:30 and was awarded a special presentation by Councilor V.L. Shearer. He was one of only 35 finishers.


title: Comrades Marathon

text: The Comrades was run for the first time on 24 May 1921 (Empire Day), and with the exception of a break during World War II, as well as the COVID-19 pandemic-impacted 2020, has been run every year since. To date, over 300,000 runners have completed the race.


title: Comrades Marathon

text: The race was the idea of World War I veteran Vic Clapham, to commemorate the South African soldiers killed during the war. Clapham, who had endured a 2,700-kilometre route march through sweltering German East Africa, wanted the memorial to be a unique test of the physical endurance of the entrants. The constitution of the race states that one of its primary aims is to "celebrate mankind's spirit over adversity". Vic Clapham's great-grandson, Antony Clapham, finished the race from 2012 to 2015, earning four Vic Clapham medals.


title: Comrades Marathon

text: From 1962 to 1994 the race was run on Republic Day, 31 May. After this public holiday was scrapped in 1995 by the post-apartheid South African government, the race date was changed to Youth Day on 16 June. In 2007, the race organisers (controversially) bowed to political pressure from the ANC Youth League, who felt that the race diverted attention from the significance of Youth Day, and changed the race date to Sunday 17 June for 2007 and 15 June for 2008. In 2009 and 2010 the date was changed (to 24 May and 30 May respectively) to accommodate football's Confederations Cup (2009) and World Cup (2010) in South Africa. In 2020, the race was cancelled due to the coronavirus pandemic.


title: Comrades Marathon

text: Forty-eight runners entered the first race in 1921, but only thirty-four elected to start. Most of them were former infantrymen. The course at the time was tarred only for the final few kilometres into Durban. A time limit of 12 hours was set and Bill Rowan became the inaugural winner, clocking 08:59 to win by 41 minutes ahead of Harry Phillips. Of the 34 starters, only 16 completed the race.


title: Comrades Marathon

text: Arthur Newton entered and won the race for the first time in 1922. He went on to win the race five times and emerge as the dominant Comrades runner of the 1920s. When he completed the down run in 06:56 in 1923, there were only a handful of spectators on hand to witness the finish because so few thought it possible that the race could be run so quickly. The first woman to run the race was Frances Hayward in 1923, but her entry was refused, so she was an unofficial entrant. She completed the event in 11:35 and although she was not awarded a Comrades medal, the other runners and spectators presented her with a silver tea service and a rose bowl. In 1924 the Comrades had its fewest starters ever, just 24. Four years later, in 1928, the time limit for the race was reduced by an hour to 11 hours.


title: Comrades Marathon

text: In the 1930s, Hardy Ballington emerged as the dominant runner, recording four victories in 1933, 1934, 1936 and 1938. The winner of the 1930 race, Wally Hayward, became one of the greatest legends of the Comrades Marathon, winning a further four times in the fifties, and becoming the oldest man to complete the race in 1989. In 1932 Geraldine Watson, an unofficial entrant, became the first woman to complete both the up run and the down run.


title: Comrades Marathon

text: After Ballington's domination of the 1930s, Comrades was stopped during the war years from 1941 to 1945. In 1948 a Comrades tradition was born when race official Max Trimborn, instead of firing the customary starter's gun, gave a loud imitation of a cock's crow. That tradition continues to the present day with Trimborn's recorded voice played over loudspeakers at the starting line.


title: Comrades Marathon

text: In the 1950s, a full twenty years after he won the race for the first time, Wally Hayward recorded his second victory and followed that up with wins in 1951, 1953 and 1954. He represented South Africa at the 1952 Olympic Games in Helsinki, where he finished tenth in the marathon. Hayward retired from the Comrades after establishing new records for both the up and down runs and equaling the five wins of Newton and Ballington. In 1958, the race was won for the first time by Jackie Mekler, who went on to win the race five times, finishing second twice and third twice.


title: Comrades Marathon

text: In the 1960s, Comrades grew considerably, from 104 starters in 1960 to 703 starters in 1969. Due to the bigger fields, cut-off points were introduced at Drummond and Cato Ridge. Mekler became the first man to break the six-hour barrier in 1960, finishing in 5:56:32. The 1961 winner was George Claassen, a school principal and father of well-known Wynand Claassen, Springbok rugby captain during 1981–83. Claassen junior also finished the Comrades ten times in later years.


title: Comrades Marathon

text: In 1962, the race attracted foreign entries for the first time as the Road Runners Club of England sent over four of the best long-distance runners in Britain. English runner John Smith won the race, an up run, in under six hours, missing out on the course record by 33 seconds. Watching the stragglers come in hours later, Smith commented to former winner Bill Cochrane that the other people completing the race were getting as much applause as he had received. "You are now witnessing the spirit of the Comrades," replied Cochrane.


title: Comrades Marathon

text: In 1967, Manie Kuhn and Tommy Malone were involved in the closest finish in the history of the race. Malone appeared to be on his way to a comfortable win and was handed the traditional message from the Mayor of Pietermaritzburg to the Mayor of Durban at Tollgate with a lead of two minutes over Kuhn. He entered the stadium in the lead with only 80 metres left to go. Suddenly Kuhn appeared only 15 metres behind and closed in quickly. Malone put in a burst for the line, but with only 15 metres left he fell to the ground with cramps. He attempted to get up again, but with the line within reach Kuhn flew past to grab victory. The mayoral message was forgotten as both runners embraced.


title: Comrades Marathon

text: The Comrades had over 1,000 starters for the first time in 1971, with over 3,000 in 1979. The race was widely broadcast on both radio and television. The race was opened to all athletes for the first time in 1975, allowing blacks and women to take part officially. In 1975, the Golden Jubilee of the Comrades, Vincent Rakabele finished 20th to become the first black runner to officially win a medal. Elizabeth Cavanaugh became the first women's winner in a shade over 10 hours.


title: Comrades Marathon

text: 1976 saw the emergence of Alan Robb, who won the first of his four Comrades titles. Robb repeated his win in 1977, 1978 and 1980, including breaking the tape in Durban in 1978 in a record 5:29:14, almost 20 minutes and four kilometres ahead of runner-up Dave Wright.


title: Comrades Marathon

text: During the 1980s the Comrades began with a field of 4,207 in 1980 and topped 5,000 for the first time in 1983.


title: Comrades Marathon

text: In 1980, Olive Anthony became the first black woman finisher of the race in 9:10. She ran the race 22 times, including in 1983 while she was three months pregnant and also in 2010 with her husband and two daughters.


title: Comrades Marathon

text: In 1981, University of the Witwatersrand student Bruce Fordyce won the first of his eventual nine Comrades titles. An outspoken critic of apartheid, Fordyce and a number of other athletes initially decided to boycott the 1981 event when organisers announced that they would associate it with the 20th anniversary of the Republic of South Africa. Fordyce ultimately competed wearing a black armband to signal his protest. He repeated his victories in 1982, 1983, 1984, 1985, 1986 (a record 5:24:07 down run), 1987, 1988 (a record 5:27:42 for the up run), and 1990.


title: Comrades Marathon

text: Schoolteacher Frith van der Merwe won the woman's race in 1988 in a time of 6:32:56. In 1989, Van der Merwe ran 5:54:43, obliterating the women's record and finishing fifteenth overall.


title: Comrades Marathon

text: In the same year Wally Hayward entered the race at the age of 79 and finished in 9:44:15. He repeated the feat in the 1989 Comrades, where he completed the race with only two minutes to spare and at the age of 80 became the oldest man to complete the Comrades.


title: Comrades Marathon

text: During the 1990s the size of the starting fields was in the region of 12,000 to 14,000 runners. In 1995 prize money was introduced, attracting more foreign competitors. The traditional race day of 31 May, formerly Republic Day, was changed to 16 June, the anniversary of the Soweto uprising.


title: Comrades Marathon

text: In 1992 Charl Mattheus, crossed the finish line first, but was later disqualified after testing positive for a banned substance. He claimed it was contained in medicine he had taken for a sore throat, but Jetman Msutu was elevated to the winner, thus becoming the second black winner of the Comrades. In a sad twist for Mattheus, not long after the 1992 race, the substance for which he was banned was removed from the IAAF's banned substance list since all evidence pointed to it having no performance enhancing properties. Mattheus also suffered much negativity in the public eye but later managed to redeem his clean image with an emphatic faultless win in the 1997 down run beating a strong local and international field.


title: Comrades Marathon

text: The 75th anniversary of the Comrades Marathon in 2000 was the largest ever staged, with a massive field of 23,961. An extra hour was allowed to allow runners some recovery time for bronze medal finishers to celebrate the milestone. In 2010, on its 85th anniversary, the race gained a place in the Guinness World Records as the ultramarathon with most runners. 14,343 athletes, the largest field since the turn of the millennium, finished in the allowed 12 hours.


title: Comrades Marathon

text: Russian runner Leonid Shvetsov set both down and up course records in 2007 and 2008, respectively. Stephen Muzhingi became the first non-South African winner from Africa in 2009.


title: Comrades Marathon

text: Russian identical twin sisters Olesya and Elena Nurgalieva won a combined ten Comrades titles from 2003 to 2013. Stephen Muzhingi also became the first athlete to win three races in a row (2009, 2010 and 2011) since Bruce Fordyce won three in a row in the eighties (1981, 1982 and 1983).


title: Comrades Marathon

text: South African supremacy over the men's race was restored when Ludwick Mamabolo won the down run in 2012. David Gatebe shattered the men's down record in 2016, while Bongmusa Mthembu has won three titles. Among the women, the Nurgalieva twins hold on the race was finally broken in 2014 when Ellie Greenwood, GBR, won the downrun after a spectacular finish, taking the lead just 2 km before the end. In 2015 Caroline Wostmann became the first South African woman to win Comrades in 17 years, followed by Charne Bosman in 2016 and Ann Ashworth in 2018. In 2017, American Camille Herron, led from start-to-finish to become only the 3rd American and first in 20 years to win.


title: Comrades Marathon

text: The 2020 in-person edition of the race was cancelled due to the coronavirus pandemic, with foreign registrants given the option of transferring their entry to 2021 or 2022. Similarly, the 2021 in-person edition of the race was also cancelled due to the pandemic.


title: Comrades Marathon

text: The 2022 Comrades down run was the first in-person event following the Covid-19 pandemic. It was the 95th event since its inception in 1921, and the apt event slogan was "The Return – Sishay' Ibuya". Legislation concerning mass participation events limited the number of entrants to 15,000, and preference was given to those who had entered the cancelled 2020 race. The KwaZulu-Natal Sports Department confirmed that 2 athletes died following the race.


title: Comrades Marathon

text: As with every ultramarathon, there are potentially lethal health risks involved in extreme physical events. In the history of the Comrades, there have been 8 deaths up to the 2022 event. In a survey among a sample of 2005 participants, 25% reported cramps, 18% nausea, 8% vomiting, 13% dizziness, 3% diarrhoea, 23% pain, excluding the expected sore legs, and 14% reported fatigue of such a nature that they believed themselves to be incapable of continuing the race. Among silver medalists there was a higher incidence of cramps (42.9%), nausea (21.4%) and diarrhoea (7.1%), though a lower incidence of pain and fatigue than the average runner.


title: Comrades Marathon

text: In 1993, Herman Matthee, a runner from Bellville athletics club, finished in 7th place and was one of the top ten gold medal winners, but he was later stripped of his gold medal and disqualified when video evidence and eyewitness testimony indicated that he entered the race at Kloof and completed less than 30 km of the 89 km down run. As his surname resembled that of top runner Charl Mattheus, he was often mistaken by the public as being the same person, unfairly tainting the image of the 1992 disqualified champion. Consequently, in a Comrades first, 11th-place finisher Simon Williamson was months later promoted to tenth place and awarded the last gold medal by the then South African president FW de Klerk. Williamson had passed another runner, Ephraim Sekothlong, in the last 100 metres to claim 11th spot and, unknowingly, a gold medal.


title: Comrades Marathon

text: In 1999, the Motsoeneng brothers from Bethlehem, Free State, who strongly resembled one another, performed an act of cheating during another down run. By exchanging places with his brother at toilet stops and aided by car lifts at various stages, Sergio Motsoeneng finished ninth, which came as a surprise to Nick Bester and other athletes behind him, who could not recall being overtaken. They were exposed when television footage revealed them to be wearing watches on different arms, and a time pad reading that confirmed that one of the brothers was still trailing Bester at Botha's Hill. The brothers performed well in later years, though Sergio tested positive for a banned substance after finishing third in 2010.


title: Comrades Marathon

text: Use of banned substances is claimed to be endemic among top Comrades athletes, but only a small number have been disqualified. Runners who have tested positive include Sergio Motsoeneng, Rasta Mohloli, Viktor Zhdanov, Lephetesang Adoro and Ludwick Mamabolo. Mamabolo was found not guilty due to "technical irregularities". Erythropoietin (EPO), norandrosterone (a metabolite or precursor of nandrolone), methylhexaneamine and testosterone have been mentioned in connection with Comrades athletes.


title: Comrades Marathon

text: In 2014, an analysis of negative splits by runner and statistician Mark Dowdeswell, suggested that a number of runners in the middle to back half of the field may be taking shortcuts.


title: Comrades Marathon

text: Gold medals were first awarded in 1931, and to the first 6 male finishers. In 1972, this was extended to the first 10 male finishers, as it is today. In 1983 a gold medal was awarded to the female winner for the first time. In 1988, this was extended to the first 3 female finishers, then to the first 5 female finishers from 1995, and from 1998 onward to the first 10 female finishers, on par with the male race.


title: Comrades Marathon

text: The following women have finished in the top 10 of the women's race on 7 or more occasions in the race history. Given the top 10 women only received gold medals from 1998, the gold medals list doesn't fully reflect the history of the women's race as female contenders in the 1980s and early 90s were competing for fewer gold medals relative to the men.


title: Comrades Marathon

text: The following have won 3 or more Wally Hayward medals (for running sub-6 hours, but outside the top 10) since the medal was first awarded in 2007, medal span in brackets.


title: Comrades Marathon

text: When a runner completes their 10th Comrades (or achieves either 5 gold medals or 3 wins) they attain their green number and keep their race number for life, the race number effectively being 'retired' only for use by that athlete. The first time a number is awarded it will be flanked by single laurels. After 20 years a double green number with double laurels is earned, followed by another laurel every next 10 years. A 3-time winner or 5 gold qualifier will not get a second green until they reach 20. The race number may subsequently only be inherited by family members.


title: Comrades Marathon

text: As the race has grown in profile globally, and since the end of sporting isolation, international runners have come to dominate the race for periods of time. As a result, the first South African home each year is also now awarded a separate prize.


title: Comrades Marathon

text: The following have had the distinction of being the first male and female South African across the finish line (overall finishing position in brackets), in years where the winner was an international runner:


title: Comrades Marathon

text: There is a lot of prestige associated with a Comrades Marathon Green Number. As a result, many athletes aim to complete at least 10 races, which is evident as a clear peak in the distribution of medal counts. The introduction of the back-to-back medal (for running two years in succession) resulted in another peak for athletes with 2 medals.


title: Comrades Marathon

text: The Long Run was a 2001 film set in 1999, in which a retired running coach trains a woman for the race. 'Comrades' was a 2008 film about seven diverse runners attempting the race.


title: Anti-Rightist Campaign

text: The Anti-Rightist Campaign () in the People's Republic of China, which lasted from 1957 to roughly 1959, was a political campaign to purge alleged "Rightists" within the Chinese Communist Party (CCP) and the country as a whole. The campaign was launched by Chairman Mao Zedong, but Deng Xiaoping and Peng Zhen also played an important role. The Anti-Rightist Campaign significantly damaged democracy in China and turned the country into a "de facto" one-party state.


title: Anti-Rightist Campaign

text: The definition of rightists was not always consistent, often including critics to the left of the government, but officially referred to those intellectuals who appeared to favor capitalism, or were against one-party rule as well as forcible, state-run collectivization. According to China's official statistics published during the "Boluan Fanzheng" period, the anti-rightist campaign resulted in the political persecution of at least 550,000 people. Some researchers believe that the actual number of persecuted is between 1 and 2 million or even higher. Deng Xiaoping admitted that there were mistakes during the Anti-Rightist Campaign, and most victims have received rehabilitation since 1959.


title: Anti-Rightist Campaign

text: The Anti-Rightist Campaign was a reaction against the Hundred Flowers Campaign which had promoted pluralism of expression and criticism of the government, even though initiation of both campaigns was controlled by Mao Zedong and were integrally connected. Going perhaps as far back as the Long March there had been resentment against "rightists" inside the CCP, for example, Zhang Bojun.


title: Anti-Rightist Campaign

text: The first wave of attacks began immediately following the end of the Hundred Flowers movement in July 1957. By the end of the year, 300,000 people had been labeled as rightists, including the writer Ding Ling. Future premier Zhu Rongji, then working in the State Planning Commission, was purged in 1958. Most of the accused were intellectuals. The penalties included informal criticism, hard labor, and in some cases, execution. For example, Jiabiangou, a notable labor camp in Gansu, held approximately 3,000 political prisoners from 1957 to 1961, of whom about 2,500 died, mostly of starvation.


title: Anti-Rightist Campaign

text: One main target was the independent legal system. Legal professionals were transferred to other jobs; judicial power was exercised instead by political cadres and the police.


title: Anti-Rightist Campaign

text: The second part of the campaign followed the Lushan Conference of July 2 – August 16, 1959, a meeting of top party leaders. The meeting condemned the PRC's defense minister, General Peng Dehuai, a critic of the Great Leap Forward.