Performance and blood monitoring in sports: the artificial intelligence evoking target testing in antidoping (AR.I.E.T.T.A.) project.

AIM: Substances and methods used to increase oxygen blood transport and physical performance can be detected in the blood, but the screening of the athletes to be tested remains a critical issue for the International Federations. This project, AR.I.E.T.T.A., aimed to develop a software capable of analysing athletes' hematological and performance profiles to detect abnormal patterns. METHODS: One-hundred eighty athletes belonging to the International Biathlon Union gave written informed consent to have their hematological data, previously collected according to anti-doping rules, used to develop the AR.I.E.T.T.A. software. RESULTS: Software was developed with the included sections: 1) log-in; 2) data-entry: where data are loaded, stored and grouped; 3) analysis: where data are analysed, validated scores are calculated, and parameters are simultaneously displayed as statistics, tables and graphs, and individual or subpopulation profiles; 4) screening: where an immediate evaluation of the risk score of the present sample and/or the athlete under study is obtained. The sample risk score or AR.I.E.T.T.A. score is calculated by a simple computational system combining different parameters (absolute values and intra-individual variations) considered concurrently. The AR.I.E.T.T.A. score is obtained by the sum of the deviation units derived from each parameter, considering the shift of the present value from the reference values, based on the number of standard deviations. CONCLUSION: AR.I.E.T.T.A. enables a quick evaluation of blood results assisting surveillance programs and perform timely target testing controls on athletes by the International Federations. Future studies aiming to validate the AR.I.E.T.T.A. score and improve the diagnostic accuracy will improve the system.

Blood parameters and biathlon performance.

AIM: Biathlon is a sport that combines cross-country skiing with rifle shooting. There is no well-described model of performance in this multi-sport event. This study aimed to identify the parameters influencing biathlon performance. In addition, the study aimed to search for a relationship between performance and measured blood parameters and to determine whether higher hemoglobin concentration [Hb] was associated with improved performance. METHODS: Eighty-three male biathletes underwent pre-competition blood sampling in selected World Cup competitions. For all athletes (N=83) and for a subgroup of top-athletes (N=37), performance parameters identified were related to final standings by univariate and multiple regression analyses and, subsequently, to blood parameters measured on the same day. In athletes tested twice with different [Hb], performance corresponding to competitions with lower and higher [Hb] was compared. RESULTS: Among the parameters considered, the percent variation for both groups in best skiing time and percent of missed targets were independent determinants of performance (R2=0.853, 0.834, respectively) and were not correlated to blood parameters. In athletes with two samples, despite significantly different (Hb), no corresponding changes in performance were observed. CONCLUSIONS: In this study, the determinants of biathlon performance were identified. A relationship between measured blood parameters was not found, and the individual (Hb) variations observed were not associated with improved performance.

Blood tests and fair competition: the biathlon experience.

In recent years, some international sports federations have introduced blood testing procedures that can lead to suspension from competition for athletes whose haematologic values exceed certain established limits. In 1994 the International Biathlon Union initiated a three-phase blood testing program to safeguard athletes' health and ensure fair competition. The first phase, lasting three years, was aimed at measuring the haematocrit values of biathletes in order to determine statistically acceptable limits for participation in competition. The second phase, lasting four years, consisted of pre-race testing for an increasing number of athletes and suspension from competition for those whose haematocrit values exceeded 52 % for males and 48 % for females. The results of this second phase (third phase now in progress) are reported. Progressive increases have been made in the numbers of countries examined, athletes tested, and tests performed. This retrospective study reveals a reassuring trend in average values for haematocrit and haemoglobin in the entire study population, a minimal number of athletes with excessive values and a consequent low risk of false positive results, an acceptable incidence of relatively high values (50 % for males and 45 % for females), and constant non-elevated haematological profiles for elite athletes. The variability in individual haematocrit levels among all biathletes with a minimum of four observations during the four-year period is also evaluated and discussed.

Competition load and stress in sports: a preliminary study in biathlon.

International sports calendars are being increasingly filled with competitive events and fatiguing travel, at the risk of overloading the athletes involved. The Medical Committee of the International Biathlon Union, in order to check for any significant changes, analysed seven recent competitive seasons, calculating the number of races and total and daily numbers of racing kilometers for each season. A theoretical model for stress was subsequently developed, based on identification and quantification of favourable and unfavourable factors, with establishment of average and maximal stress scores for each season. A questionnaire was distributed to athletes to collect data about daily stress levels, and the correspondence between the theoretical model and the athletes' responses was determined. This analysis demonstrates that the biathlon has become more demanding for those athletes in the racing circuit, with significant increases in number of races, total and daily numbers of kilometers raced, and average stress scores for athletes of both sexes. The self-reported daily stress levels for some athletes show an interesting correspondence with the theoretical stress model. If such correspondence is confirmed, this model might constitute an instrument with which international sports federations, considering the concentration of races, related travel and recovery times, could plan sustainable competitive calendars.

The effect of early feeding on the onset of symptoms in celiac disease.

The appearance of celiac disease in infancy has often been related to the time when gluten is introduced into the diet, and more recently, to the kind of milk received in the early months. This retrospective study attempts to clarify the relation between breast-feeding and gluten introduction to the onset of symptoms of the disease. One hundred forty-six children with celiac disease, aged from 4 months to 11 years, were studied. The timing and types of feeds were recorded as well as the presenting symptoms of the disease. Data were analyzed by nonparametric statistical methods, as well as by parametric analysis after appropriate transformation. Children breast-fed for 3 months or more showed a marked delay in the onset of the disease and a longer latency time from gluten introduction to onset of disease, when compared with bottle-fed children. This relationship was present for both statistical analyses and was unrelated to the age at gluten introduction into the diet. Onset of disease was positively correlated to the duration of breast-feeding and not related to the age at gluten introduction.

Evidence that celiac disease is primarily associated with a DC locus allelic specificity.

Sixty patients with celiac disease were typed by radioimmunoassay for the specificities HLA-DR3, HLA-DR7, and for an allelic specificity, DC3, of the HLA-associated DC locus. We found that celiac disease is primarily associated with the DC determinant. The previously described associations with DR3, DR7, B8, B13, and A1 can be explained by decreasing degrees of linkage disequilibrium with DC3.

Does breast feeding protect against the development of clinical symptoms of celiac disease in children?

A retrospective approach has been adopted to investigate the frequency and duration of breast feeding and the time of gluten introduction in the diet in 216 celiac children and their healthy siblings of three different centers--Naples, Milan, and Turin. In this matched case-control study, the selected controls were healthy siblings of the cases. Children formula-fed from birth, or breast-fed for less than 30 days, were found to have a relative risk of developing symptoms of celiac disease four times higher than children breast-fed for more than 30 days (p less than 0.0001). To investigate more deeply the effect of the duration of breast feeding as a possible protecting factor, the linear trend for different periods of breast feeding was tested and found to be highly significant (G1: 18.3 with 1 df). Therefore, increased duration of breast feeding is associated with decreased risk of developing celiac symptoms. On the contrary, there was no apparent relationship between early introduction of gluten into the diet and frequency of celiac disease. Our findings are consistent with the hypothesis that a wider diffusion of breast feeding is a factor underlying the recently reported decrease of the incidence of celiac disease in children.