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The purpose of this research was to evaluate the performances of female middle- and long-distance runners before and after the implementation of a new antidoping strategy (the Athlete Biological Passport [ABP]) in a country accused of systematic doping. A retrospective analysis of the results of Russian National Championships from 2008 to 2017 was performed. The 8 best female performances for the 800-m, 1500-m, 3000-m steeplechase, 5000-m, and 10,000-m events from the semifinals and finals were analyzed. The yearly number of athletes fulfilling standard qualifications for international competitions was also evaluated. Overall, numbers of athletes banned for doping in 2008–2017 were calculated. As a result, 4 events (800, 1500, 5000 [all P <.001], and 10,000 m [P <.01]) out of 5 showed statistically significant deterioration in the performances when comparing before and after the introduction of the ABP. The 3000-m steeplechase was the only event that did not show statistically significant change. The highest relative decrease in the number of runners who met standard qualification for international competition was for the 5000-m event (46%), followed by 1500-m (42%), 800-m (38%), 10,000-m (17%), and 3000-m steeplechase (1%). In conclusion, implementation of the ABP was followed by a significant reduction in the performance of female runners in a country accused of systematic doping. It can be reasonably speculated that more stringent antidoping testing, more specifically the introduction of the ABP, is a key reason for this reduction. [ABSTRACT FROM AUTHOR]

Background: We assessed SARS-CoV-2 contamination of random surfaces in football training facilities in an environment with a high prevalence of infections. Methods: In six clubs of the Qatar Stars League, surfaces of random locations (high-touch areas, ventilation systems, toilets, cleaning tools, freezers, pantries) in routinely cleaned training facilities, locker rooms, medical and administrative areas were swabbed for SARS-CoV-2. The swabs were screened for the presence of viral RNA using a SARS-CoV-2 qPCR Probe Assay. Results: None of the 103 swabs reached a cycle threshold (cT) value ≤30 (strong viral presence, suggestive of potential surface transmission). Four samples showed cT values >30 and <35 (low quantity of virus) and 16 swabs returned a cT value ≥35 and <40 (inactive virus remnants). The remaining 83 samples were negative (cT value ≥40). Most samples with viral or viral remnant presence originated from high-touch areas. Conclusion: We did not find evidence for potential surface transmission in football club facilities when routine cleaning procedures are in place despite the presence of infected subjects. [ABSTRACT FROM AUTHOR]

Fluctuations in plasma volume (PV) present potential confounders within the concentration‐based markers of the haematological athlete biological passport (ABP). Here, a multi‐parametric approach involving a simple blood test is applied to the current ABP adaptive model in an attempt to remove the influence of PV expansion, induced by a cycling stage race. Blood samples were obtained from 29 professional cyclists (14 male, 15 female) before, during and after 4–5 consecutive days of racing. Whole blood was analysed in accordance with the World Anti‐Doping Agency ABP guidelines for haemoglobin ([Hb]) concentration and platelets. Serum and plasma were analysed for transferrin, albumin, calcium, creatinine, total protein and low‐density lipoprotein. PV variation (Z‐scores) was estimated using a multi‐parametric model (consisting of the biomarkers mentioned earlier) and compared against calculated variations in PV (measured via CO‐rebreathing). Significant reductions in [Hb] and the OFF‐score were observed in female cyclists after 3 and 4 days of racing, with accompanying increases in PV, which returned to baseline values 4 days post competition. Similarly, a significant increase in PV was observed in male cyclists after 3 and 5 days of racing. When individual estimations of PV variance were applied to the adaptive model, the upper and lower reference predictions for [Hb] and the OFF‐score were refined such that all outliers consistent with racing‐induced PV changes were removed. The PV model appears capable of reducing the influence of PV on concentration‐dependent markers during competition. This is an important step towards the inclusion of the PV correction in the ABP haematological module. [ABSTRACT FROM AUTHOR]

Abstract: Altitude is a confounding factor within the Athlete Biological Passport (ABP) due, in part, to the plasma volume (PV) response to hypoxia. Here, a newly developed PV blood test is applied to assess the possible efficacy of reducing the influence of PV on the volumetric ABP markers; haemoglobin concentration ([Hb]) and the OFF‐score. Endurance athletes (n=34) completed a 21‐night simulated live‐high train‐low (LHTL) protocol (14 h.d‐1 at 3000 m). Bloods were collected twice pre‐altitude; at days 3, 8, and 15 at altitude; and 1, 7, 21, and 42 days post‐altitude. A full blood count was performed on the whole blood sample. Serum was analysed for transferrin, albumin, calcium, creatinine, total protein, and low‐density lipoprotein. The PV blood test (consisting of the serum markers, [Hb] and platelets) was applied to the ABP adaptive model and new reference predictions were calculated for [Hb] and the OFF‐score, thereby reducing the PV variance component. The PV correction refined the ABP reference predictions. The number of atypical passport findings (ATPFs) for [Hb] was reduced from 7 of 5 subjects to 6 of 3 subjects. The OFF‐score ATPFs increased with the PV correction (from 9 to 13, 99% specificity); most likely the result of more specific reference limit predictions combined with the altitude‐induced increase in red cell production. Importantly, all abnormal biomarker values were identified by a low confidence value. Although the multifaceted, individual physiological response to altitude confounded some results, the PV model appears capable of reducing the impact of PV fluctuations on [Hb]. [ABSTRACT FROM AUTHOR]

The article focuses on monitoring of athlete performance in anti-doping. Topics discussed include impact of technological innovations on sporting performance; use of performance data for anti-doping purposes by International Federations and National Anti-Doping Organizations; and maintenance of data quality, and accessibility for the same.

Performance profiling is a new area of research that could potentially open new frontiers in the fight against doping. Even beyond exposing unnatural and pharmacology aided performances, there are other potential applications and benefits of performance modeling for the protection of the integrity of sports. The backbone of performance modeling in anti-doping is the individual tracking of performance through competition results or other metrics of sporting achievements. Since performance improvement is the primary goal of doping, it is expected that doping will affect competition results. Thus, individual tracking of performance could potentially expose suspicious cases that deserve more scrutiny from anti-doping officials and help to adjust targeted testing. On the other hand changes in performance levels could also be used to assess the efficiency of new anti-doping strategies. Another application of performance analysis is to develop unified classifications of athletes according to their level of performance. This classification has numerous practical meanings, but from anti-doping perspective it provides an opportunity to set exact criteria for athletes belonging to national and international testing pools and thus estimate the number of tests needed in different countries based on the number of athletes at ascertain performance level. At themoment, in the absence of unified and comprehensive criteria for national and international testing pools, there are no definitive regulations regarding exact doping test numbers needed. Thus, it creates inequality between nations and affects the credibility of the anti-doping system worldwide. Such classification would allow a more efficient use of anti-doping resources. Since doping is not the only threat to the integrity of sports, performance modeling can also help to reveal cases of other misbehavior in sports, like match fixing or result manipulation. In summary, performance modeling and its application to various fields is a new method to improve the efficiency of systems to safeguard the integrity of sports at different levels. [ABSTRACT FROM AUTHOR]

Plasma volume (PV) can be modulated by altitude exposure (decrease) and periods of intense exercise (increase). Cycle racing at altitude combines both stimuli, although presently no data exist to document which is dominant. Hemoglobin mass (Hbmass), hemoglobin concentration ([Hb]), and percent reticulocytes (%Retics) of altitude (ALT; n = 9) and sea-level (SL; n = 9) residents were measured during a 14-day cycling race, held at 1,146-4120 m, as well as during a simulated tour near sea level (SIM; n = 12). Hbmass was assessed before and on days 9 and 14 of racing. Venous blood was collected on days 0, 3, 6, 10, and 14. PV was calculated from Hbmass and [Hb]. A repeated-measures ANOVA was used to assess the impact of racing at altitude over time, within and between groups. [Hb] decreased significantly in all groups over time (P < 0.0001) with decreases evident on the third day of racing. %Retics increased significantly in SL only (P < 0.0001), with SL values elevated at day 6 compared with prerace (P = 0.02), but were suppressed by the end of the race (P = 0.0002). Hbmass significantly increased in SL after 9 (P = 0.0001) and 14 (P = 0.008) days of racing and was lower at the end of the race than midrace (P = 0.018). PV increased in all groups (P < 0.0001). Multiday cycle racing at altitude induces hemodilution of a similar magnitude to that observed during SL racing and occurs in nonaccli-matized SL residents, despite an altitude-induced increase in Hbmass. Osmotic regulatory mechanisms associated with intense exercise appear to supersede acute enhancement of oxygen delivery at altitude. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the review of the article "Mononucleosis and athletic participation," by M. Putukian and colleagues.

A letter to the editor is presented in response to the article "Testing for Recombinant Human Erythropoietin in Urine: Problems Associated With Current Anti-Doping Testing."

The haematological module of the Athlete's Biological Passport (ABP) has significantly impacted the prevalence of blood manipulations in elite sports. However, the ABP relies on a number of concentration-based markers of erythropoiesis, such as haemoglobin concentration ([Hb]), which are influenced by shifts in plasma volume (PV). Fluctuations in PV contribute to the majority of biological variance associated with volumetric ABP markers. Our laboratory recently identified a panel of common chemistry markers (from a simple blood test) capable of describing ca 67% of PV variance, presenting an applicable method to account for volume shifts within anti-doping practices. Here, this novel PV marker was included into the ABP adaptive model. Over a six-month period (one test per month), 33 healthy, active males provided blood samples and performed the CO-rebreathing method to record PV (control). In the final month participants performed a single maximal exercise effort to promote a PV shift (mean PV decrease -17%, 95% CI -9.75 to -18.13%). Applying the ABP adaptive model, individualized reference limits for [Hb] and the OFF-score were created, with and without the PV correction. With the PV correction, an average of 66% of [Hb] within-subject variance is explained, narrowing the predicted reference limits, and reducing the number of atypical ABP findings post-exercise. Despite an increase in sensitivity there was no observed loss of specificity with the addition of the PV correction. The novel PV marker presented here has the potential to improve the ABP's rate of correct doping detection by removing the confounding effects of PV variance., (Copyright © 2017 John Wiley & Sons, Ltd.)

The Athlete Biological Passport (ABP) detects blood doping in athletes through longitudinal monitoring of erythropoietic markers. Mathematical algorithms are used to define individual reference ranges for these markers for each athlete. It is unclear if altitude and exercise can affect the variables included in these calculations in a way that the changes might be mistaken for blood manipulation. The aim of this study was to investigate the influence of the simultaneous strenuous exercise and low to high altitude exposure on the calculation algorithms of the ABP. 14 sea level (SL) and 11 altitude native (ALT) highly trained athletes participated in a 14-day cycling stage race taking place at an average altitude of 2496 m above sea level (min. 1014 m, max. 4120 m), race distances ranged between 96 and 227 km per day. ABP blood measures were taken on days -1,3,6,10,14 (SL) and -1,9,15 (ALT) of the race. Four results from three samples of two different SL athletes exceeded the individual limits at the 99% specificity threshold and one value at 99.9%. In ALT, three results from three samples of three different athletes were beyond the individual limits at 99%, one at 99.9%. The variations could be explained by the expected physiological reaction to exercise and altitude. In summary, the abnormalities observed in the haematological ABP´s of well-trained athletes during extensive exercise at altitude are limited and in line with expected physiological changes., (Copyright © 2014 John Wiley & Sons, Ltd.)

Background and Objectives: Information derived from blood analyses can assist in the detection and/or deterrence of blood doping in sport. We investigated whether comparing an athlete's hematologic values against his or her own historical baseline rather than population-derived thresholds enhanced the ability to detect blood doping., Design and Methods: We developed an approach whereby an athlete's true baseline value could be estimated with just one prior blood test. We also estimated a universal value for within-subject variability for key hematologic parameters using the highest value obtained among four separate cohorts of male athletes including 80 elite rowers, 124 endurance-trained or team-sport subjects, 288 professional football players and 630 athletes competing at national or international level. The (individual) baseline and (universal) variability were then incorporated so as to define expected thresholds for subsequent blood tests. The sensitivity of our approach was obtained by analyzing data from 49 recreational athletes administered either recombinant human erythropoietin (n=37) or placebo (n=12)., Results: We found that removing within-subject variability by comparing new results against an historical baseline heightened the capacity to detect blood doping. It was possible to delineate the longitudinal changes in either hemoglobin (Hb) or the OFF-hr model score (an algorithm using both Hb and percent reticulocytes) caused by recombinant human erythropoietin treatment from the natural biological fluctuations found in subjects treated with placebo., Interpretation and Conclusions: Our objective data supported the intuitive belief that longitudinal monitoring of athletes' blood profiles will help detect blood doping. This information could be used to instigate target-testing of suspicious athletes, or even warrant the exclusion from competition of athletes with aberrant variations in key hematologic values.