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BACKGROUND: Sports competitions present a highly stressful environment for the athletes. The stress that is produced because of physiological or psychological demands could influence athletes' performance. This study aimed to understand the dynamics of stress biomarkers during official national bouldering climbing competition. METHODS: Twelve sport climbers ([6 females] average age: 20.3±5.21 years, body height: 174.0±10.27 cm, body mass: 64.7±10.80 kg, training age: 10.3±2.40 years) took part in this study. Their saliva cortisol (C) and alpha-amylase (AA) were sampled during the official climbing competition (qualification and final). RESULTS: The results showed that C had higher values post- (qualification, 1.02±0.43 µg/dL; final, 0.46±0.27 µg/dL) than precompetition (0.45±0.24 µg/dL; 0.29±0.68 µg/dL, respectively). A similar trend can be observed in AA, with higher values post- (qualification, 156.07±133.24 U/dL; final, 199.09±51.24 U/dL) than precompetition (88.18±80.24 U/dL; 88.72±51.24 U/dL, respectively). Furthermore, C had a significantly higher response prequalification (0.45±0.24 µg/dL) than prefinal (0.29±0.19 µg/dL), with the same response post both competition rounds (qualification, 1.02±0.43 µg/dL; final, 0.46±0.27 µg/dL). CONCLUSIONS: Overall, the results showed a strong endocrine and nervous system response. These findings lead to the conclusion that sports climbing competitions present a highly stressful environment for athletes, both physically and psychologically.

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Stress was previously defined as a response to any demand for change. These demands are noticeable during sport events, not only in athletes but also in coaches. Therefore, this study aimed to determine the influence of slow-paced breathing (SPB) on acute stress to handball coaches during official matches. One professional handball coach, aged 37 (height, 180 cm; weight, 80 kg), took part in the study. His salivary cortisol (C) concentration and alpha-amylase (AA) activity were measured, and his heart rate (HR) was monitored during six official matches. In the first three matches the SPB training protocol was not followed. From match four to match six, the coach performed SPB training every day and directly before the match. The decrease observed in AA was statistically significant with a large effect size (1.80). The trend of change in HR is visible and similar for matches with and without SPB. However, for SPB matches, there is a lower starting point compared to matches without SPB (89.81 ± 6.26 and 96.62 ± 8.10, respectively). Moreover, values of AA on SPB matches were smaller before the match (93.92 ± 15.89) compared to the same time point in non-SPB matches (115.30 ± 26.00). For AA, there is a significant effect size in the half-time (2.00) and after the match (-2.14). SPB matches showed a lower increase in AA. SPB might be used as one of the possible tools that could help coaches in achieving a desirable mental state during the match.

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A variety of loads are placed upon an athlete in team sports (e.g., training, match, or competitions). However, the volume of the training load plays an important role in match success. Therefore, the aim of this study was to compare the differences in biomarker dynamics during the match and during training, and to evaluate if such training represents a good stimulus for an athlete to adapt to match stress. Ten male handball players (average age of 24.1 ± 3.17 years, body height of 1.88 ± 0.64 m, and body mass of 94.6 ± 9.6 kg) took part in this study. Their saliva cortisol, testosterone, and alpha-amylase were sampled during the match and training (sessions of 90 min duration, respectively). The results showed that cortisol had higher values after the match (0.65 µg/dL) than after training (0.32 µg/dL) (p = 0.05; ES = 0.39). Testosterone concentrations had a steeper increase during a match (65%) than after training (37%). Alpha-amylase levels did not differ significantly between the match and training (p = 0.77; ES = -0.06). Overall, the results showed that the environment of a match was more stressful for the athletes; therefore, a match provoked a stronger endocrine response in the studied markers. Therefore, we concluded that a match seemed to be a stronger trigger for all of the measured biomarker responses.

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BACKGROUND: This study evaluated endocrine responsiveness (ER) to physical stress (contact vs. non-contact nature of play) during team handball matches, according to the playing positions, thereby contextualizing the contact nature of the handball match. METHODS: The participants were ten male team handball players (24.1±3.17 years, 188.2±6.42 cm, 94.6±9.6 kg) divided into two groups: contact playing positions (CPP) and non-contact playing positions (NCPP). To evaluate the ER, the salivary cortisol (C), testosterone (T), and alpha-amylase (AA) concentrations were assessed before the game, during the halftime break, and after the match. Moreover, playing time (PT) and the number of contacts (NC) were counted post-match by video analysis. To determine possible differences between PT and the NC in the first and second halves of the match, a paired-sample t-test was used. The differences among ER-measures were calculated by the magnitude-based Cohen's effect size. Possible associations between NC and ER were analyzed by comparing CPP and NCPP in C, T, and AA. RESULTS: The CPP group performed significantly more physical contacts, while there was no difference in playing time between the groups. A stronger C response was evidenced in players with a longer playing time. During the game, the C response was directly determined by physical contact, with CPP players showing a stronger C response than NCPP players. CONCLUSIONS: This study provided evidence of the importance of contact actions during matches and training sessions, as a parameter of calculating training loads and preparing strategies for recovery and injury prevention. Further studies examining larger samples are warranted.

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Stress plays a significant role in competitions and in the training of sports participants, and coaches are no exception. To better cope with stressful situations, close monitoring of coaches' stress levels before, during, and after training and competitions is recommended. According to studies, the use of cortisol (C) and alpha-amylase (AA) as biomarkers for monitoring acute stress is recommended. Therefore, the aim of our study was to compare HR, salivary C and AA, and STAI scores before, during, and after handball matches and training sessions. The study examined one professional handball coach, aged 37, in stress markers (salivary cortisol (C) and alpha-amylase (AA) concentrations), heart rate (HR), and the State-Trait Anxiety Inventory (STAI) scores in five matches/training sessions in the First Qatar Handball League. Statistical analysis included the calculation of descriptive statistic parameters, Mann-Whitney U test for differences between match-training time points, and the effect size analysis (Cohen's d) to calculate the magnitude of differences between match-training time points. Presented markers (C and AA) had statistically stronger reactions before, during, and after the matches than the corresponding time points of the training sessions, similar to HR data and STAI scores. Results indicate that, before and during the matches, the analyzed markers of stress increased, which might lead to the conclusion that coaches are more anxious than frightened before and during matches. Thus, stress-coping strategies for handball coaches should be more focused on stress anticipation and anxiety control.

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BACKGROUND: Diverticular disease remains one of the most common conditions in the western world. Up to 25% of patients with diverticular disease require hospitalization, 15-30% of those of which require surgical intervention. CT scoring systems have been proposed as means to drive assessment and stratify patients necessitating hospital intervention. To assess and correlate CT scoring systems with clinical and surgical outcomes. METHODS: Retrospective cohort analysis at a single institution. Single institutional assessment with patients presenting to emergency with a CT diagnosed episode of acute diverticulitis. One hundred and eighty-nine patients were included in the study, 61% of which were male. Patient demographics, comorbidities, medications, biochemistry and inflammatory markers, type of complication following acute diverticulitis, operative/procedural intervention, hospital outcome and mortality were measured. CT scoring systems assessed included modified Hinchey, modified Neff, World Society of Emergency Surgery (WSES) and modified Siewert scoring systems. RESULTS: Majority of patients had left-sided diverticulitis (91%) with localized air (88%) and pericolic abscess (49%) the most common radiological findings. 28% of patients required radiological and/or surgical management with 12% requiring intensive care unit (ICU) admission. There was a general trend for surgical/radiological intervention as the scores increased in severity. The four scoring systems were found to be statistically significant predictors of any intervention and of ICU admission with minimal statistical differences across the different scoring systems. CONCLUSION: Radiological CT scores for complicated diverticulitis are at best, moderate predictors of clinical and surgical outcomes and may serve to guide management with minimal statistical differences across different scores.

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Over the past two decades, scientists have attempted to evaluate whether the point of maximal fat oxidation (FATmax) and the aerobic threshold (AerT) are connected. The existence of such a relationship would allow a more tailored training approach for athletes while improving the efficacy of individualized exercise prescriptions when treating numerous health-related issues. However, studies have reported conflicting results, and this issue remains unresolved. This systematic review and meta-analysis aimed: (i) to examine the strength of the association between FATmax and AerT by using the effect size (ES) of correlation coefficient (r) and standardized mean difference (SMD); (ii) to identify potential moderators and their influence on ES variability. This study was registered with PROSPERO (CRD42021239351) and ClinicalTrials (NCT03789045). PubMed and Google Scholar were searched and fourteen articles, consisting of overall 35 ES for r and 26 ES for SMD were included. Obtained ESs were analyzed using a multilevel random-effects meta-analysis. Our results support the presence of a significant association between FATmax and AerT exercise intensities. In conclusion, due to the large ES variance caused by clinical and methodological differences among the studies, we recommend that future studies follow strict standardization of data collection and analysis of FATmax and AerT-related outcomes.

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Regular exercise at the intensity matching maximal fat oxidation (FATmax) has been proposed as a key element in both athletes and clinical populations when aiming to enhance the body's ability to oxidize fat. In order to allow a more standardized and tailored training approach, the connection between FATmax and the individual aerobic thresholds (AerT) has been examined. Although recent findings strongly suggest that a relationship exists between these two intensities, correlation alone is not sufficient to confirm that the intensities necessarily coincide and that the error between the two measures is small. Thus, this systematic review and meta-analysis aim to examine the agreement levels between the exercise intensities matching FATmax and AerT by pooling limits of agreement in a function of three parameters: (i) the average difference, (ii) the average within-study variation, and (iii) the variation in bias across studies, and to examine the influence of clinical and methodological inter- and intra-study differences on agreement levels. This study was registered with PROSPERO (CRD42021239351) and ClinicalTrials (NCT03789045). PubMed and Google Scholar were searched for studies examining FATmax and AerT connection. Overall, 12 studies with forty-five effect sizes and a total of 774 subjects fulfilled the inclusion criteria. The ROBIS tool for risk of bias assessment was used to determine the quality of included studies. In conclusion, the overall 95% limits of agreement of the differences between FATmax and AerT exercise intensities were larger than the a priori determined acceptable agreement due to the large variance caused by clinical and methodological differences among the studies. Therefore, we recommend that future studies follow a strict standardization of data collection and analysis of FATmax- and AerT-related outcomes.

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BACKGROUND: chicken meat extract is a popular functional food in Asia. It is rich in the bioactive compounds carnosine and anserine, two histidine-containing dipeptides (HCD). Studies suggest that acute pre-exercise ingestion of chicken extracts has important applications towards exercise performance and fatigue control, but the evidence is equivocal. This study aimed to evaluate the ergogenic potential of the pre-exercise ingestion of a homemade chicken broth (CB) vs a placebo soup on a short-lasting, high-intensity cycling exercise. METHODS: fourteen men participated in this double-blind, placebo-controlled, crossover intervention study. Subjects ingested either CB, thereby receiving 46.4 mg/kg body weight of HCD, or a placebo soup (similar in taste without HCD) 40 min before an 8 min cycling time trial (TT) was performed. Venous blood samples were collected at arrival (fasted), before exercise and at 5 min recovery. Plasma HCD were measured with UPLC-MS/MS and glutathione (in red blood cells) was measured through HPLC. Capillary blood samples were collected at different timepoints before and after exercise. RESULTS: a significant improvement (p = 0.033; 5.2%) of the 8 min TT mean power was observed after CB supplementation compared to placebo. Post-exercise plasma carnosine (p <  0.05) and anserine (p <  0.001) was significantly increased after CB supplementation and not following placebo. No significant effect of CB supplementation was observed either on blood glutathione levels, nor on capillary blood analysis. CONCLUSIONS: oral CB supplementation improved the 8 min TT performance albeit it did not affect the acid-base balance or oxidative status parameters. Further research should unravel the potential role and mechanisms of HCD, present in CB, in this ergogenic approach.

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BACKGROUND: Over the last half-century, different stoichiometric equations for calculating the energy cost of exercise based upon the combustion of mixtures of carbohydrates, fats, and proteins have been proposed and modified. With the means of indirect calorimetry, while measuring oxygen uptake, carbon dioxide production, and urinary urea nitrogen excretion, the contribution of specific substrates to overall energy production can be estimated. However, even with their long history of application, no previous studies have evaluated whether the use of different stoichiometric equations provides similar or distinct maximal fat oxidation rate (MFO) responses and information regarding MFO location (FATmax) in male athletes. METHODS: Twenty healthy male athletes performed graded exercise testing (GXT) cycle ergometry using breath by breath gas analysis to assess fat oxidation and maximal oxygen uptake. Analysis of variance followed by within-equation effects, within-equation factors, and post hoc pairwise comparisons were used to examine within-equation differences. RESULTS: Compared stoichiometric equations demonstrated significant differences in the mean and maximal fat oxidation rates, varying up to nearly 7%. FATmax differences, however, were not noticed. CONCLUSIONS: Our findings suggest that for within-study designs, the equation used appears to be less important, but when inter-study comparisons are planned, caution is in order due to the presence of inter-equation differences.

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In this study, we aimed to determine the exercise intensities eliciting the highest (FATmax) and the lowest (FATmin) fat oxidation rate in male cyclists and to compare these intensities with their individual aerobic (AeT) and anaerobic (AnT) thresholds, respectively. Twenty-two moderately trained male cyclists performed a 2-min stage graded exercise test until exhaustion using breath-by-breath gas analysis to determine maximal oxygen consumption (VO2max). The fat oxidation rate was calculated using a stoichiometric equation, with metabolic thresholds being determined by ventilatory gas analysis. In the present group of subjects, FATmax was found at a 21.34 ± 3.64 ml·kg-1·min-1 corresponding to 45.05 ± 7.68% VO2max. AeT occurred at an exercise intensity of 22.15 ± 4.84 ml·kg-1·min-1, matching 46.76 ± 10.24% VO2max. AnT and FATmin were located at intensities equivalent to 32.56 ± 5.52 ml·kg-1·min-1 and 32.30 ± 5.35 ml·kg-1·min-1 which corresponded to 68.74 ± 11.65 and 68.19 ± 11.29% VO2max, respectively. The correlation between FATmax and AeT was strong (r = 0.80, p < 0.05). No statistical difference was observed between FATmin and AnT (r = 0.99, p < 0.05). The strong relationship between observed indices can be used to provide a more tailored exercise approach.

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This study evaluated dynamics of testosterone, cortisol and alpha-amylase during a handball match in high-level male players. Ten male professional players (24.1 ± 3.1 years, 188.2 ± 6.4 cm, 94.6 ± 9.6 kg) were tested on salivary-testosterone, -cortisol and -alpha-amylase levels before (prematch), at halftime, and immediately after the game. Analysis of variance for repeated measurements (ANOVA) with consecutive post-hoc analyses and effect-size differences were calculated to identify differences between measurements. The associations among biomarkers were determined by Pearson's product moment correlation (Pearson's r). The ANOVA indicated significant differences in testosterone (F: 14.31, p < 0.01; significant post-hoc differences between prematch and remaining two measurements), and alpha-amylase (F: 9.78, p < 0.01; significant post-hoc differences between all measurements). Significant correlations were evidenced between: (i) alpha-amylase- and testosterone-changes during 1st halftime (Pearson's r: 0.81, p < 0.01), and (ii) alpha-amylase- and cortisol-changes during 2nd halftime (Pearson's r: 0.76, p < 0.05). The results indicated specific dynamics of biomarkers during the handball match, with significant increase in alpha-amylase during the entire match and significant increase in the testosterone level during the first half of the match. Further studies are needed to evaluate the associations between real-game performance and changes in hormonal responses.

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Although the role of vitamin D in calcium and bone metabolism is well documented, there is little clarity regarding the implications of low vitamin D status for inflammation, endothelial function, and antioxidant status in adolescent athletes. A prospective cohort study was conducted, and 44 male adolescent athletes, training at a sports academy in the Middle East, were assigned to either the intervention group (VitDs), consisting of vitamin D deficient athletes [twenty-five hydroxyvitamin D (25(OH)D) <20 ng/ml; n = 22], or the comparison group, consisting of vitamin D sufficient athletes [25(OH)D >30 ng/ml; n = 22]. Vitamin D status, inflammatory cytokines, endothelium-related variables, and antioxidant enzymes were measured twice during a nine-week training period. At the baseline, the athletes in the VitDs group had significantly lower concentrations of 25(OH)D, vascular endothelial growth factor (VEGF), and glutathione peroxidase (GPx), and higher levels of parathyroid hormone (PTH), interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1ra), and nitrite (NO2) (p < 0.05), in comparison to the athletes in the sufficient group. After vitamin D supplementation for the VitDs group, the two cohorts differed considerably in vitamin D binding protein (VDBP) and PTH concentrations (p < 0.05). Our data suggest that the low levels of vitamin D possibly induced alterations in the investigated biochemical parameters of athletes in the VitDs group at the beginning of the monitoring period. Furthermore, while the vitamin D supplementation was effective in increasing 25(OH)D status, it may have concurrently positively influenced variables that are related to inflammation, endothelial function, and enzymatic antioxidants.

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Autologous blood transfusion (ABT) has been frequently abused in endurance sport and is prohibited since the mid-1980s by the International Olympic Committee. Apart from any significant performance-enhancing effects, the ABT may pose a serious health issue due to aging erythrocyte-derived "red cell storage lesions." The current study investigated the effect of blood storage in citrate phosphate dextrose adenine (CPDA1) on the red blood cell (RBC) membrane proteome. One unit of blood was collected in CPDA1 blood bags from 6 healthy female volunteers. RBC membrane protein samples were prepared on days 0, 14, and 35 of storage. Proteins were digested in gel and peptides separated by nanoliquid chromatography coupled to tandem mass spectrometry resulting in the confident identification of 33 proteins that quantitatively change during storage. Comparative proteomics suggested storage-induced translocation of cytoplasmic proteins to the membrane while redox proteomics analysis identified 14 proteins prone to storage-induced oxidation. The affected proteins are implicated in the RBC energy metabolism and membrane vesiculation and could contribute to the adverse posttransfusion outcomes. Spectrin alpha chain, band 3 protein, glyceraldehyde-3-phosphate dehydrogenase, and ankyrin-1 were the main proteins affected by storage. Although potential biomarkers of stored RBCs were identified, the stability and lifetime of these markers posttransfusion remain unknown. In summary, the study demonstrated the importance of studying storage-induced alterations in the erythrocyte membrane proteome and the need to understand the clearance kinetics of transfused erythrocytes and identified protein markers.

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The purpose of this study was to observe and report variations in several haematological and biochemical markers throughout an entire athletic season in a large cohort of adolescent athletes of Arab origin. Blood samples were collected from 72 adolescent male athletes at 4 selected time points during their training season. Results expressed in relation to plasma volume were corrected accordingly and significant variations in several variables emerged. Initial uncorrected haematological results revealed that haematocrit (Hct) and mean cell volume (MCV) concentrations noticeably increased at the competitive period (T3) and before the start of the following preseason (T4), whereas reticulocytes equivalent (Ret-He) only rose at T4 phase (p < 0.01). Conversely, corrected red blood cells (RBC), haemoglobin (Hb) and mean cell haemoglobin concentration (MCHC) progressively decreased over the year (p < 0.001). From the electrolytes panel, sodium and chloride considerably reduced at the peak of the training period (T2) to the start of the next preseason (T4), while a significant fall in potassium was mainly observed during the competitive period (T3) (p < 0.001). Coaches and sport scientists could use the results of this study to evaluate typical variations of each age group in order to diagnose potential adverse effects of high training loads, assist in the design of training programs and/or clinical interventions that will safeguard athletes' health, and consider the important role of plasma volume for the interpretation of results.

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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.

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BACKGROUND: The aim of this study was to identify the exercise intensity that elicited the highest rate of fat utilization (FATmax) and to assess its relationship with the aerobic threshold (AeT) in male athletes. We hypothesized existence of high correlation of these two parameters when a short-staged graded treadmill test with AeT identified through breath-by-breath gas exchange analysis was used. METHODS: Fifty-six trained male athletes (age 25.6±3.4 y, height 197.8±5.6 cm, body mass 98.5±6.6 kg) participated in the study. Pearson correlation coefficient (r) and effect size (R2) were used to evaluate the existence of connection between VO2 at AeT and at FATmax. Maximal oxygen consumption (VO2max) and substrate oxidation were determined using breath-by-breath indirect calorimetry during a short-staged graded treadmill test to exhaustion. RESULTS: Mean VO2max was 52.12±9.02 mL·kg-1·min-1. FATmax and AeT occurred at 47.47±10.59% of VO2max and 45.95±10.21% of VO2max, respectively. Fat utilization at FATmax was 0.59±0.24 g·min-1. A high correlation was found between VO2 at FATmax and at AeT (r=0.88, P<0.01, 95% CI: 0.80 to 0.93). The effect size was 77.44%. CONCLUSIONS: Our results confirm the hypothesis of an existence of a high correlation between AeT and FATmax allowing implementation of more accurate training approach.

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PURPOSE: To examine the effects of 3 d of intermittent fasting (3d-IF: abstaining from eating/drinking from dawn to sunset) on physical performance and metabolic responses to repeated sprints (RSs). METHODS: Twenty-one active males performed an RS test (2 sets: 5 × 5-s maximal sprints with 25 s of recovery between and 3 min of recovery between sets on an instrumented treadmill) in 2 conditions: counterbalanced fed/control session (CS) and fasting session (FS). Biomechanical and biochemical markers were assessed preexercise and postexercise. RESULTS: Significant main effects of IF were observed for sprints: maximal speed (P = .016), mean speed (P = .015), maximal power (P = .035), mean power (P = .049), vertical stiffness (P = .032), and vertical center-of-mass displacement (P = .047). Sprint speed and vertical stiffness decreased during the 1st (P = .003 and P = .005) and 2nd sprints (P = .046 and P = .048) of set 2, respectively. Postexercise insulin decreased in CS (P = .023) but not in FS (P = .230). Free-fatty-acid levels were higher in FS than in CS at preexercise (P < .001) and at postexercise (P = .009). High-density lipoprotein cholesterol (HDL-C) was higher at postexercise in FS (1.32 ± 0.22 mmol/L) than in CS (1.26 ± 0.21 mmol/L, P = .039). The triglyceride (TG) concentration was decreased in FS (P < .05) compared with CS. CONCLUSIONS: 3d-IF impaired speed and power through a decrease in vertical stiffness during the initial runs of the 2nd set of RS. The findings of the current study confirmed the benefits of 3d-IF: improved HDL-C and TG profiles while maintaining total cholesterol and low-density lipoprotein cholesterol levels. Moreover, improving muscle power might be a key factor to retain a higher vertical stiffness and to partly counteract the negative effects of intermittent fasting.

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BACKGROUND: The aim of this study is to determine whether multidisciplinary team (MDT) meetings alter the length of time to treatment (LOTT) for patients with colorectal cancer. METHODS: We conducted a retrospective audit of all patients with colorectal cancer from the Geelong Hospital (TGH) mandatory colorectal database from 1 January 2006 to 3 February 2011. To be included, patients had to have had elective surgical intervention for primary colorectal adenocarcinoma. A comparison of historical controls was conducted between patients discussed in MDT meetings and those managed prior to the introduction of MDT meetings (3 October 2006) to determine the LOTT in days from definitive diagnosis (colonoscopy) to definitive management (surgery, radiotherapy or chemotherapy). RESULTS: In total, the median LOTT for the historical control and MDT era patient populations were 19.5 and 20 days, respectively. Within the MDT era, we noticed significantly longer times to treatment for patients with rectal cancer who were seen in an MDT meeting prior to definitive management than patients who did not have an intervening MDT meeting (P < 0.001). With a difference of 7.5 days, the clinical significance of these findings remains contentious. However, it is worthwhile recognizing this trend in patients who are exhibiting symptoms due to near obstruction or significant bleeding. The LOTT for colon cancer patients remained unchanged. CONCLUSION: The introduction of MDT meetings to TGH has prolonged the LOTT for patients with rectal cancer. These findings pave the way for further revision of the efficiency of MDT meeting at TGH.

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Plasma volume and red cell mass are key health markers used to monitor numerous disease states, such as heart failure, kidney disease, or sepsis. Nevertheless, there is currently no practically applicable method to easily measure absolute plasma or red cell volumes in a clinical setting. Here, a novel marker for plasma volume and red cell mass was developed through analysis of the observed variability caused by plasma volume shifts in common biochemical measures, selected based on their propensity to present with low variations over time. Once a month for 6 months, serum and whole blood samples were collected from 33 active males. Concurrently, the CO-rebreathing method was applied to determine target levels of hemoglobin mass (HbM) and blood volumes. The variability of 18 common chemistry markers and 27 Full Blood Count variables was investigated and matched to the observed plasma volume variation. After the removal of between-subject variations using a Bayesian model, multivariate analysis identified two sets of 8 and 15 biomarkers explaining 68% and 69% of plasma volume variance, respectively. The final multiparametric model contains a weighting function to allow for isolated abnormalities in single biomarkers. This proof-of-concept investigation describes a novel approach to estimate absolute vascular volumes, with a simple blood test. Despite the physiological instability of critically ill patients, it is hypothesized the model, with its multiparametric approach and weighting function, maintains the capacity to describe vascular volumes. This model has potential to transform volume management in clinical settings. Am. J. Hematol. 92:62-67, 2017. © 2016 Wiley Periodicals, Inc.

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