Search Results (137)

Metabolic control is poor in East Africa for youth with type1 diabetes (T1D). Self-monitoring of blood glucose (SMBG) by fingerstick 2–3 times daily is routine care. This randomized controlled trial (RCT) will test the hypothesis that providing continuous glucose monitoring (CGM) to Ugandan youth with T1D will improve glucose time-in-range (TIR glucose 3.9–10.0 mmol/L) and be cost effective in this setting. Ugandan youth with T1D (n = 180, age 4–26 years) will be divided into four 12-month cohorts (August 2022–August 2027). Half will receive unblinded Freestyle Libre 2 Flash CGM for 12 months. For six months, control subjects received sufficient test strips for SMBG three times daily while wearing blinded Freestyle Libre Pro CGM (for endpoint assessment), and then they switch to unblinded CGM for six months. Everyone receives monthly diabetes education. The primary endpoints are as follows: (1) the six-month change from baseline in glucose TIR, unblinded CGM versus SMBG; (2) a cost analysis of CGM versus SMBG. The TIR hypothesis will be tested by linear mixed effects models. Cost analysis assumptions include direct material and indirect costs like hospitalizations, missed school/work, and diabetes complications. The study will inform T1D management guidelines in a low resource setting using evidence-based recommendations. Full article

Over the past two decades, Olympic swimming performance has improved. However, less attention has been given to the evolution of Olympic Qualification Time (OQT) standards. This retrospective observational study analyzed event-specific qualification standards for all male pool swimming events. Data were extracted from publicly available documents and competition reports. Descriptive statistics, percentage change calculations, Pearson correlation analysis, and paired-sample t-tests between Olympic cycles from 2008 to 2028 were performed. For 2028, the OQTs were defined as the 14th fastest entry time from the 2024 Olympic Games. Across all events, the mean cumulative reduction in OQTs between Beijing 2008 and Los Angeles 2028 was 2.86 ± 0.54%, corresponding to an average proportional decrease of 0.6% per Olympic cycle, with trend analysis confirming statistical significance (p < 0.001). Event-level analysis revealed the greatest tightening in the 100 m breaststroke (−3.74%) and 100 m butterfly (−3.25%). When grouped by distance, sprint events (50–100 m) showed the strongest overall tightening (−3.57%), followed by middle-distance (200–400 m, −2.08%) and long-distance (800–1500 m, −2.45%). When grouped by stroke, butterfly (−3.28%) and freestyle (−3.20%) showed the largest decrease, whereas individual medley (−2.29%) demonstrated the smallest decrease. A strong positive correlation was observed between OQT tightening and Olympic performance improvement across events (r = 0.74). These findings indicate that OQTs have become demanding and broadly aligned with elite performance progression, providing applied benchmarks for coaches and performance staff. Full article

High-intensity aquatic sports require athletes to repeatedly produce near-maximal efforts under conditions of constrained ventilation and limited recovery between bouts, placing substantial importance on recovery efficiency. While supplemental oxygen has been proposed as a recovery-targeted strategy to support repeated high-intensity performance, its acute effects in aquatic athletes remain poorly characterized. The purpose of this study was to examine whether brief inhalation of supplemental oxygen during recovery following a maximal swim effort influences subsequent swimming performance and perceived exertion in trained aquatic athletes. Eighteen collegiate-aged male aquatic athletes completed a randomized, placebo-controlled, within-subject crossover protocol. Each condition consisted of a maximal 100-yard (91.44 m) swim followed by a standardized recovery period that included a five second inhalation of either 98% supplemental oxygen or ambient air delivered via an identical portable device, prior to a maximal 50-yard (45.72 m) freestyle sprint. Sprint performance was significantly faster following oxygen-assisted recovery compared with placebo, and perceived exertion was significantly reduced at the post-exercise time point, with no differences observed prior to exercise or mid-protocol. These findings suggest that brief, recovery-targeted hyperoxia may enhance repeated high-intensity swimming performance while attenuating post-exercise perceived exertion in trained aquatic athletes. Full article

Background: Pacing critically influences swimming performance. In master swimmers, aging leads to performance decline, but the age at which pacing becomes unstable, and whether this precedes performance loss, remains unclear. Objective: This cross-sectional retrospective study analyzed sex, distance and stroke-specific age-related breakpoints in pacing variability (CV) and performance (RT) in master swimmers. Methods: A total of 13,822 swimmers (7417 men and 6405 women; age 25–99 years) competing at the World Aquatics Masters Championships (2023–2025) were included. Results: CV showed the strongest association with RT (r = 0.173, p < 0.001). Overall, CV worsened significantly earlier (52 years, +2.82%/year) than RT (82 years, +0.51%/year; p < 0.001). In women, CV deterioration began at ~50 years, while RT was maintained until ~85 years; this was particularly pronounced in short-distance events (pacing breakpoint at 35 years). Men displayed more synchronized decline patterns. Age breakpoints of CV and RT were coincident in freestyle and breaststroke (82 years). Backstroke and butterfly demonstrated RT breakpoints at 47 and 67 years, respectively, with CV occurring at 72 years. Conclusions: These findings indicate that CV generally deteriorates years before RT and represents a stroke, sex and distance-specific marker of accelerated functional decline in elite master swimmers. Monitoring CV may provide early warning of impending performance deterioration informing timely, targeted training interventions to extend athletic longevity. Full article

Background/Objectives: Migraine and diabetes mellitus are highly prevalent chronic diseases, and their comorbidity presents management challenges, particularly when wearable medical technologies are used concurrently. Remote electrical neuromodulation (REN; Nerivio^®) is an FDA-cleared non-pharmacological migraine therapy, and continuous glucose monitoring (CGM) systems are widely used in diabetes care. However, the safety and compatibility of simultaneous co-use have not yet been evaluated. This technical compatibility study aimed to assess whether REN operation affects CGM performance or interferes with glucose measurement integrity in diabetic adults. Methods: Twenty-one adults with diabetes using Dexcom G6/G7 or FreeStyle Libre 2/3 participated in a single-arm interventional study. During a 45 min session, participants operated the REN and CGM devices simultaneously on their smartphones, and the REN device was paused three times to compare CGM readings between REN ON and RED OFF conditions. The primary outcome was the mean absolute relative difference (MARD_{REN ON/OFF}), evaluated against a prespecified 5% threshold. Statistical analysis included the Wilcoxon test, with subgroup analysis by the CGM device family. Results: The median MARD_{REN ON/OFF} across all participants was 1.61% (IQR 0.84–2.44%), significantly below the 5% threshold (p < 0.001). All participants achieved MARD_{REN ON/OFF} < 5%. Subgroup analyses were consistent: the median MARD_{REN ON/OFF} was 1.70% (IQR 0.90–2.45%) for Dexcom and 1.05% (IQR 0.83–1.50%) for Abbott. No technical interference, Bluetooth disruptions, missed data transmission, or adverse events were observed. Conclusions: Simultaneous use of Nerivio^® REN and CGM systems in adults with diabetes is compatible and safe, with no evidence of interference or significant deviations in glucose readings. These findings support the integrated and reliable use of REN and CGM wearables in adults with diabetes managing comorbid conditions. Full article

High sample complexity presents a major challenge in applying multi-agent reinforcement learning (MARL) to dynamic, high-dimensional sports such as basketball. To address this problem, we proposed the knowledge-embedded modular framework (KEMF), which partitions the environment into offense, defense, and loose-ball modules. Each module employs specialized policies and a knowledge-based observation layer enriched with basketball-specific metrics such as shooting success and defensive accuracy. These metrics are also incorporated into a dynamic and dense reward scheme that offers more direct and situation-specific feedback than sparse win/loss signals. We integrated these components into a multi-agent proximal policy optimization (MAPPO) algorithm to enhance training speed and improve sample efficiency. Evaluations using the commercial basketball game Freestyle indicate that KEMF outperformed previous methods in terms of the average points, winning rate, and overall training efficiency. An ablation study confirmed the synergistic effects of modularity, knowledge-embedded observations, and dense rewards. Moreover, a real-world deployment in 1457 live matches demonstrated the robustness of the framework, with trained agents achieving a 52.43% win rate against experienced human players. These results underscore the promise of the KEMF to enable efficient, adaptive, and strategically coherent MARL solutions in complex sporting environments. Full article

Background: This study aimed to explore the effects of neuromuscular electrical stimulation (NMES) combined with water-based resistance training on muscle activation and coordination during freestyle kicking. Methods: Thirty National Level male freestyle swimmers were randomly assigned to an experimental group (NMES + water-based training) or a control group (water-based training only) for a 12-week intervention. The experimental group received NMES pretreatment before each session. Underwater surface electromyography (sEMG) synchronized with high-speed video was used to collect muscle activation data and corresponding kinematic information during the freestyle kick. The sEMG signals were then processed using time-domain analysis, including integrated electromyography (iEMG), which reflects the cumulative electrical activity of muscles, and root mean square amplitude (RMS), which indicates the intensity of muscle activation. Non-negative matrix factorization (NMF) was further applied to extract and characterize muscle synergy patterns. Results: The experimental group showed significantly higher iEMG and RMS values in key muscles during both kicking phases. Within the core propulsion synergy, muscle weighting of vastus medialis and biceps femoris increased significantly, while activation duration of the postural adjustment synergy was shortened. The number of synergies showed no significant difference. Conclusions: NMES combined with water-based resistance training enhances muscle activation and optimizes neuromuscular coordination strategies, offering a novel approach to improving sport-specific performance. Full article

Behavior recognition and multi-object tracking of dairy cows in free-style cow barn environments play a crucial role in monitoring their health status and serve as an essential means for intelligent scientific farming. This study proposes an efficient embedded algorithm, MTW-BYTE, for dairy cow behavior recognition and multi-object tracking. It addresses challenges in free-style cow barn environments, including the impact of lighting variations and common occlusions on behavior recognition, as well as trajectory interruptions and identity ID switching during multi-object tracking. First, the MTW-YOLO cow behavior recognition model is constructed based on the YOLOv11n object detection algorithm. Replacing parts of the backbone network and neck network with MANet and introducing the Task Dynamic Align Detection Head (TDADH). The CIoU loss function of YOLOv11n is replaced with the WIoU loss. The improved model not only effectively handles variations in lighting conditions but also addresses common occlusion issues in cows, enhancing multi-scale behavior recognition capabilities and improving overall detection performance. The improved MTW-YOLO algorithm improves Precision, Recall, mAP50 and F1 score by 4.5%, 0.1%, 1.6% and 2.2%, respectively, compared to the original YOLOv11n model. Second, the ByteTrack multi-object tracking algorithm is enhanced by designing a dynamic buffer and re-detection mechanism to address cow trajectory interruptions and identity ID switching. The MTW-YOLO algorithm is cascaded with the improved ByteTrack to form the multi-target tracking algorithm MTW-BYTE. Compared with the original multi-target tracking algorithm YOLOv11n-ByteTrack (a combination of YOLOv11n and the original ByteTrack), this algorithm improves HOTA by 1.1%, MOTA by 3.6%, MOTP by 0.2%, and IDF1 by 1.9%, reduces the number of ID changes by 11, and achieves a frame rate of 43.11 FPS, which can meet the requirements of multi-target tracking of dairy cows in free-style cow barn environments. Finally, to verify the model’s applicability in real-world scenarios, the MTW-BYTE algorithm is deployed on an NVIDIA Jetson AGX Orin edge device. Based on real-time monitoring of cow behavior on the edge device, the pure inference time for a single frame is 16.62 ms, achieving an FPS of 29.95, demonstrating efficient and stable real-time behavior detection and tracking. The ability of MTW-BYTE to be deployed on edge devices to identify and continuously track cow behavior in various scenarios provides hardware feasibility verification and algorithmic support for the subsequent deployment of intelligent monitoring systems in free-style cow barn environments. Full article

This study examined the effects of contrast water therapy (CWT) on physiological, perceptual, and performance-related recovery in collegiate male swimmers following high-intensity interval training. Fifteen freestyle swimmers (19.3 ± 1.1 years) completed two sessions of five 100 m maximal-effort intervals under two recovery conditions, CWT and passive rest (PAS), in a crossover design. The CWT protocol consisted of 10 alternating immersions in hot (40–41 °C, 60 s) and cold (20–21 °C, 30 s) water. Blood lactate (LA), blood pressure (BP), and subjective fatigue (VAS-FAS) were assessed at multiple time points. Compared with PAS, CWT resulted in significantly lower post-recovery blood LA (7.75 ± 2.08 vs. 10.86 ± 2.86 mmol/L, p = 0.002) and reduced subjective fatigue (6.60 ± 1.30 vs. 7.60 ± 0.91 cm, p = 0.021), whereas no significant differences were observed in BP or 100-m swimming performance. Individual-level analyses revealed heterogeneous responses, with most swimmers demonstrating improved lactate clearance and reduced fatigue following CWT, although performance responses varied among participants. These findings indicate that CWT facilitates physiological and perceptual recovery without producing immediate performance enhancement. CWT may be considered a practical short-term recovery option for competitive swimmers, although its effectiveness likely depends on individual response characteristics. Further research involving larger and more diverse samples is warranted to clarify optimal application parameters and individual recovery profiles. Full article

Purpose: This single-athlete, longitudinal observational study describes training intensity distribution (TID) across two Olympic preparation cycles (Rio 2016 vs. Tokyo 2021) and explores whether differences in high-intensity exposure coincided with performance outcomes. Methods: An elite male 50 m freestyle specialist (personal best 21.27 s; height: 187 cm, weight: 80 kg, body mass index: 22.9 kg·m⁻², fat-free mass: 75.2 kg, and fat mass: 4.8 kg) was monitored across four mesocycle periods. TID is expressed as % of total swim volume in three zones: Z1 (low intensity), Z2 (threshold), Z3 [high intensity/race-pace, including High Intensity Interval Training (HIIT) and Sprint Interval Training (SIT)]. Both the coach and swimmer signed a written informed consent for the use of their data. Results: For Rio 2016, TID (Z1/Z2/Z3) was as follows: General 80/0/20, Specific 60/0/40, Pre-competition 40/30/30, and Taper 50/20/30, indicating a polarized approach. For Tokyo 2021, TID shifted to: General 85/0/15, Specific 60/0/40, Pre-competition 30/30/40, and Taper 40/20/40. Discussion: In this single athlete, a greater proportion of work in Z3 during the Tokyo cycle, particularly in the Pre-competition and Taper phases, probably coincided with improved performance (21.57 vs. 21.79 s). Conclusions: Although clear causal inference is not possible, these observations depict the probability that sprint-swim preparation for 50 m events needs a training volume oriented to Z3 and relatively less in Z1. However, the study’s design, the methods by which the TID was recorded, etc., limit any generalization about the interpretation of the findings. Therefore, future studies should address these limitations, providing more insights into improving the training on that kind of events. Full article

Background: Neuromuscular determinants such as maximal force, maximal velocity, and upper-body power are recognized as key contributors to competitive swimming performance. However, despite the relevance of these dry-land qualities, their relationships with the physiological mechanisms underpinning in-water performance, particularly aerobic and anaerobic capacities, remain insufficiently established. Purpose: This study aimed to investigate the relationships between upper-body load–velocity profile parameters (theoretical maximal force: F₀; theoretical maximal velocity: V₀; and maximal power: P_max), aerobic capacity expressed through critical velocity, and anaerobic capacity in trained swimmers. Methods: Thirty competitive male swimmers (age = 16.50 ± 0.31 years) completed an upper-body load–velocity profile test using the bench press exercise to determine F₀, V₀, and P_max. Swimming performances in the 100, 200, and 400 m freestyle events were used to calculate critical velocity and anaerobic capacity based on a linear distance–time model. Pearson correlation coefficients and linear regression analyses were conducted to examine the relationships between variables. Results: P_max (r = 0.493, p = 0.006) and V₀ (r = 0.697, p < 0.001) showed moderate to strong correlations with critical velocity, whereas F₀ showed no significant association (r = 0.152, p = 0.422). Conversely, anaerobic capacity was strongly correlated with F₀ (r = 0.842, p < 0.001) but not with V₀ (p = 0.119). Regression models indicated that F₀ explained 71% of the variance in anaerobic capacity, while V₀ explained 48% of the variance in critical velocity. Conclusion: The findings demonstrated distinct contributions of neuromuscular qualities: speed and power-oriented parameters are associated with critical velocity, whereas maximal strength strongly associated with anaerobic capacity. Monitoring the upper-body load–velocity profile appears to be a relevant tool for individualizing dry-land training according to the aerobic and anaerobic demands of swimmers. Full article

Elite 50 m freestyle performance demands targeted interventions for events that may be decided by hundredths of a second. This case study assesses the effectiveness of an individualised in-water resistance training intervention informed by load–velocity (LV) profiling in both profiling metrics and competitive performance, while documenting the training characteristics of an elite 50 m freestyle swimmer (male, 24.8 years) over the 18 months culminating in the Paris 2024 Olympic Games. A coach-led, six-week resisted-swim intervention involved three sessions per week with prescribed velocity-decrement zones targeting technical development, speed-strength, and power while preserving the swimmer’s race stroke rate. Post-intervention LV outputs showed likely improvements in maximal swim speed, of +3.4% and theoretical maximal load, of +13.6%, and competition time improved by 1.3% with a 3.5% improvement in free swimming time (15–45 m). Although limited to a single-athlete design, the observed improvements suggest that individualised, LV-informed resisted swimming using accessible equipment may contribute to enhancements in sprint swimming performance. Full article

Objectives: This study aimed to analyze metabolites changes in elite freestyle wrestlers during three specific training phases—pre-training, peak training, and recovery adjustment—through serum metabolomics analyses and biochemical indicator testing, providing preliminary insights for selecting effective functional assessment metrics. Methods: Five male wrestlers (20.40 ± 2.07 years) and five female wrestlers (19.60 ± 0.55 years) were enrolled. Morning fasting venous blood samples were collected before training, at peak training intensity, and after training adjustment and recovery. Serum metabolomic analyses using ¹H nuclear magnetic resonance (¹H NMR) spectroscopy and assessment of biochemical indicators were performed. Results: The metabolomic analysis identified six significantly altered serum biomarkers in male wrestlers and three in females across different training phases. These differential metabolites are primarily implicated in the regulation of energy and amino acid metabolism pathways. Additionally, significant alterations in conventional biochemical indices were observed. Conclusions: Metabolomic markers provide a more accurate and comprehensive reflection of metabolic characteristics in freestyle wrestlers, offering a promising complementary approach to traditional biochemical assessments for monitoring physiological states. Full article

Objectives: The aim of this study was to analyze the utilization of the EO SwimBETTER^® (EoLab, Sydney, Autralia) device for measuring kinetic and kinematic variables during 50 m and 200 m freestyle trials. Methods: Ten swimmers (seven males and three females, 20 ± 3.5 years) participated. Each completed three sets of 50 m using EO SwimBETTER^® on non-consecutive days, with a 200 m test performed during the third session after recovery to complete the Critical Swim Speed Test (CSS-T). All tests were conducted at maximal intensity. Results: The results showed high reliability for both kinetic and kinematic parameters. Regarding validity, the EO SwimBETTER^® demonstrated strong agreement with the reference device in measuring stroke frequency (SF). In addition, higher mean force values were found in the 50 m compared with the 200 m trial (Δ% = 8.75%, p = 0.099), suggesting sensitivity of the device to different exertion demands. Conclusions: Based on these findings, the EO SwimBETTER^® appears to be a useful and promising tool for monitoring technical and performance-related variables in swimming, although further research is needed. Full article

Background and Objectives: Swimmers are repeatedly exposed to overhead shoulder movements, which overload the surrounding soft tissue and may contribute to shoulder pain. These repetitive demands have also been implicated in the development of scapular dyskinesis (SD). This cross-sectional study aimed to determine the prevalence of SD and to examine its associations with extrinsic and intrinsic factors in adult elite swimmers. Materials and Methods: Fifty competitive swimmers (mean age, 23.9 years; mean training experience, 13.6 years) participated in this study. SD was graded using the Scapular Dyskinesis Test. Extrinsic factors included dominant side, breathing side, years of experience, and primary stroke. Intrinsic factors included Lateral Scapular Slide Test (LSST) distance, pectoralis minor length, glenohumeral internal rotation (IR) range of motion (ROM), shoulder pain, and Penn Shoulder Score. Results: SD was identified in 46% of swimmers. Years of experience and primary stroke showed no significant association with SD; however, obvious SD was observed only in butterfly and freestyle specialists. Increasing SD severity was associated with shorter pectoralis minor length (p < 0.001) and reduced IR ROM (p = 0.013), particularly in the obvious group. Although SD was not related to shoulder pain, it was significantly related to lower Penn Shoulder Scores (p = 0.039). Conclusions: SD is common in adult elite swimmers and is associated with shortened pectoralis minor, reduced IR ROM, and impaired shoulder function, but not to pain. Full article