Z-scores-based methods and their application to biological monitoring: an example in professional soccer players.

The clinical and biological follow-up of individuals, such as the biological passport for athletes, is typically based on the individual and longitudinal monitoring of hematological or urine markers. These follow-ups aim to identify abnormal behavior by comparing the individual's biological samples to an established baseline. These comparisons may be done via different ways, but each of them requires an appropriate extra population to compute the significance levels, which is a non-trivial issue. Moreover, it is not necessarily relevant to compare the measures of a biomarker of a professional athlete to that of a reference population (even restricted to other athletes), and a reasonable alternative is to detect the abnormal values by considering only the other measurements of the same athlete. Here we propose a simple adaptive statistic based on maxima of Z-scores that does not rely on the use of an extra population. We show that, in the Gaussian framework, it is a practical and relevant method for detecting abnormal values in a series of observations from the same individual. The distribution of this statistic does not depend on the individual parameters under the null hypothesis, and its quantiles can be computed using Monte Carlo simulations. The proposed method is tested on the 3-year follow-up of ferritin, serum iron, erythrocytes, hemoglobin, and hematocrit markers in 2577 elite male soccer players. For instance, if we consider the abnormal values for the hematocrit at a 5% level, we found that 5.57% of the selected cohort had at least one abnormal value (which is not significantly different from the expected false-discovery rate). The approach is a starting point for more elaborate models that would produce a refined individual baseline. The method can be extended to the Gaussian linear model, in order to include additional variables such as the age or exposure to altitude. The method could also be applied to other domains, such as the clinical patient follow-up in monitoring abnormal values of biological markers.

Understanding how outcomes are measured in workplace physical activity interventions: a scoping review.

BACKGROUND: An inverse relationship exists between physical activity and many non-communicable diseases, such as obesity. Given the daily time spent, a logical domain to reach an adult population for intervention is within and around the workplace. Many government bodies, including the World Health Organization (WHO), include worksite health promotions (WHPs) targeted at increasing physical activity as a public health intervention. The aim of this scoping review was to determine what was measured (outcomes) and how they were measured (evaluation tools) during workplace physical activity interventions in order to identify gaps and implications for policies and practice. METHODS: A scoping review was executed in April 2017 via PubMed, SPORTDiscus, EBSCOhost and the Cochrane Library. This search included articles published between January 2008 to February 2017 in order to coincide with the WHO's Global Plan of Action on Worker's Health. Extracted information was arranged into data collection grids. Cross-analysis of measured outcomes with their corresponding evaluation tools was completed. A quality assessment based on study design was executed. RESULTS: Identification of 732 records was made and ultimately 20 studies and reviews that met criteria were selected. Researchers themed 9 primary measured outcomes. Studies utilized various forms of both objective and subjective evaluation methods. Three primary evaluation methods were categorized: biologic, electronic and declarative tools. The researchers discovered 92 unique tools: 27 objective and 65 subjective, within these parameters. CONCLUSION: Study quality, measurement tools and data collection were heterogeneous making analysis of effect comparisons problematic and unreliable. Much of the published research does not employ robust statistical analysis making effects difficult to ascertain. Considering the variety of both measured outcomes and evaluation tools, only educated inferences can be made as to the effectiveness and efficiency of WHPs. More standardized measurement practices are therefore suggested for assessment efficiency.

Mortality of French participants in the Tour de France (1947-2012).

AIMS: In the context of recent concerns regarding performance enhancing techniques and potential negative health effects of high-level physical activity, data on the long-term outcomes and causes of death in elite endurance cyclists are of particular interest. METHODS AND RESULTS: Characteristics and vital status of all French participants in the Tour de France were collected for the 1947-2012 period. Causes of death were obtained from 1968. Overall and disease-specific mortalities were compared with the French male population using overall and specific standardized mortality ratios (SMRs) with their 95% confidence intervals (CIs). Among the 786 French cyclists who participated at least once between 1947 and 2012, 208 (26%) died by 1 September 2012. Neoplasms and cardiovascular diseases accounted for 61% of deaths. We observed a 41% lower mortality in French cyclists (SMR: 0.59, 95% CI: 0.51-0.68, P < 0.0001), which did not change over time (P = 0.70). It was observed for main mortality causes: for neoplasms (SMR: 0.56; 95% CI: 0.42-0.72, P < 0.0001) and for cardiovascular death (SMR: 0.67; 95% CI: 0.50-0.88, P = 0.004), except mortality related to external causes (SMR: 1.06, 95% CI: 0.71-1.53, P = 0.80). CONCLUSION: We observed a substantially and significantly lower mortality in participants in the Tour de France, compared with the general male population. However, our results do not allow us to assess in detail the balance between positive effects of high-level sports activity and selection of healthy elite athletes, vs. any potential deleterious effects of excessive physical exercise or alleged doping.

Secular trend: morphology and performance.

In a context of morphological expansion of the general population, how do athletes follow such a pattern of anthropometric growth? Is there any relation to performance? Biometric data including mass, height, body mass index (BMI) and age were collected for 50,376 American athletes representing 249,336 annual performers playing in professional baseball, football, ice hockey and basketball. Distributions by mass in National Football League (NFL) players are described by periods. Field goals have been studied in relation to players' height in the National Basketball Association (NBA). Between 1871 and 2011, athletes from the four sports have increased significantly in mass, height and BMI, following a multi-exponential function series. Consequently, biometric differences between athletes and the general population are increasing gradually. Changes in the mass distribution within the NFL show the emergence of a biometrical specificity in relation to the field position. At the professional level, performance remains structured around precise biometric values. In the NBA, a height-attractor at 201.3 ± 6.3 cm for the best scorers is invariant, regardless of the level of play. These results suggest that laws of growth and biometrics drive high-level sport and organise performance around the specific constraint of each field position. Discrepancies between some mass and height developments question the (disproportionate) large mass increase (relative to the height increase) during the 1980s and 1990s.

Marathon progress: demography, morphology and environment.

As opposed to many other track-and-field events, marathon performances still improve. We choose to better describe the reasons for such a progression. The 100 best marathon runners archived from January 1990 to December 2011 for men and from January 1996 to December 2011 for women were analysed. We determined the impact of historical, demographic, physiological, seasonal and environmental factors. Performances in marathons improve at every level of performance (deciles). In 2011, 94% of the 100 best men athletes were African runners; among women athletes they were 52%. Morphological indicators (stature, body mass and Body Mass Index (BMI)) have decreased. We show a parabolic function between BMI and running speed. The seasonal distribution has two peaks, in spring (weeks 14 to 17) and autumn (weeks 41 to 44). During both periods, the average temperature of the host cities varies close to optimal value for long distance race. African men and women runners are increasingly dominating the marathon and pushing its record, through optimal eco-physiological conditions.

Transport collapse in dynamically evolving networks.

Transport in complex networks can describe a variety of natural and human-engineered processes including biological, societal and technological ones. However, how the properties of the source and drain nodes can affect transport subject to random failures, attacks or maintenance optimization in the network remain unknown. In this article, the effects of both the distance between the source and drain nodes and the degree of the source node on the time of transport collapse are studied in scale-free and lattice-based transport networks. These effects are numerically evaluated for two strategies, which employ either transport-based or random link removal. Scale-free networks with small distances are found to result in larger times of collapse. In lattice-based networks, both the dimension and boundary conditions are shown to have a major effect on the time of collapse. We also show that adding a direct link between the source and the drain increases the robustness of scale-free networks when subject to random link removals. Interestingly, the distribution of the times of collapse is then similar to the one of lattice-based networks.

A random walk model that accounts for space occupation and movements of a large herbivore.

Animal movement has been identified as a key feature in understanding animal behavior, distribution and habitat use and foraging strategies among others. Large datasets of invididual locations often remain unused or used only in part due to the lack of practical models that can directly infer the desired features from raw GPS locations and the complexity of existing approaches. Some of them being disputed for their lack of biological justifications in their design. We propose a simple model of individual movement with explicit parameters, based on a two-dimensional biased and correlated random walk with three forces related to advection (correlation), attraction (bias) and immobility of the animal. These forces can be directly estimated using individual data. We demonstrate the approach by using GPS data of 5 red deer with a high frequency sampling. The results show that a simple random walk template can account for the spatial complexity of wild animals. The practical design of the model is also verified for detecting spatial feature abnormalities and for providing estimates of density and abundance of wild animals. Integrating even more additional features of animal movement, such as individuals' interactions or environmental repellents, could help to better understand the spatial behavior of wild animals.

A systematic review on methodological variation in acute:chronic workload research in elite male football players.

Objectives: To investigate and evaluate the methodological variation in research on acute:chronic workload ratio (ACWR) and injury in elite male football players.Methods: Relevant literature was electronically searched on PubMed, Web of Science, ScienceDirect, and Embase. Additional literature was obtained from studies' bibliographies and authors. Cohort studies investigating the effects of ACWR on male elite footballer injuries were included. Information regarding study population, time frame, protocol, injury classification, and statistical analysis were elucidated.Results: Database searches led to 2,689 articles. After full text screening, twelve articles remained. All studies were of poor quality. Five studies had GPS-derived workload measures with consideration of running intensity zones, though little consensus over zone thresholds were found. Nine studies incorporated rated perceived exertion data; heterogeneity in exposure type and data collection timing was observed. All studies applied rolling average ACWRs, exploring 1:2, 1:3, and 1:4-week load ratio windows. Differences in data grouping, inference or regression analysis, and other statistical methods were noted.Conclusion: Existing literature displayed methodological heterogeneity. Future studies should consider consulting guidelines for developing prognostic studies and further examine causal links between workload and injury. From that basis, decisions around ACWR definitions, workload measures, and statistical methods may be more appropriately made.

Tour de France, Giro, Vuelta, and classic European races show a unique progression of road cycling speed in the last 20 years.

Road cycling ranks among the most intense endurance exercises. Previous studies and mathematical models describing road cycling have not analysed performances per se. We describe the evolution of road cycling performance over the past 116 years. We studied the top ten cyclists' mean speeds in eight famous classic races and three European Grand Tours, using a previously published multi-exponential model that highlights the different progression periods of an event during the century. In addition, we measured an indicator of difficulty for the Tour de France by calculating the climbing index (i.e. the total altitude climbed over total distance). The eleven races' mean speed increased progressively from 23.13 km . h(-1) in 1892 to 41.19 +/- 2.03 km . h(-1) in 2008. Road cycling development, like other quantifiable disciplines, fits a piecewise progression pattern that follows three periods: before, between, and after the two World Wars. However, a fourth period begins after 1993, providing a speed progression of 6.38% from the third one. The Tour de France's climbing index also provided insight into a recent paradoxical relationship with speeds: when the climbing index increased, the winner's speed also increased. Our results show a major improvement (6.38%) in road cycling performance in the last 20 years and question the role of extra-physiological parameters in this recent progression.

Local muscular endurance and prediction of 1 repetition maximum for bench in 4 athletic populations.

The aim of this study was to determine a predictive equation of 1 repetition maximum (1RM) from local muscular endurance. Different athletic male populations were assessed: racket/ball games players (n = 31), power lifters (n = 22), swimmers (n = 28), and rowers (n = 29). After the 1RM assessment for the bench press, the maximum number of repetitions (MNR) relative to the 1RM (85%, 75%, 60%, 40%, and 20%) was tested. No significant differences in strength evolution from 20% to 100% of the 1RM was found between power lifters and racket/ball games players and between swimmers and rowers. However, differences in the strength evolution appeared between these 2 mixed groups (p < 0.01), with differences appearing from 75% of 1RM to lesser relative strength (p < 0.05). Nonlinear equations fitted best with the actual data for the capacity to repeat lifts. The evolution of strength from 100% to 20% of 1RM was better described when the groups' specific equations were used as demonstrated by r, and residuals range between the predicted minus the measured 1RM. The strength endurance competences for high loads (100%-75%) were adequately modelled by the equation based on the total population. The accuracy of the 1RM prediction was better when a reduced number of lifts was performed. For untrained or novice subjects, the use of group-specific equations for the all evolutionary profile of strength allows a good estimate of 1RM and provides adequate numbers of lifts for all levels of strength, thus optimizing the training programs.

Women and Men in Sport Performance: The Gender Gap has not Evolved since 1983.

Sex is a major factor influencing best performances and world records. Here the evolution of the difference between men and women's best performances is characterized through the analysis of 82 quantifiable events since the beginning of the Olympic era. For each event in swimming, athletics, track cycling, weightlifting and speed skating the gender gap is fitted to compare male and female records. It is also studied through the best performance of the top 10 performers in each gender for swimming and athletics. A stabilization of the gender gap in world records is observed after 1983, at a mean difference of 10.0% ± 2.94 between men and women for all events. The gender gap ranges from 5.5% (800-m freestyle, swimming) to 18.8% (long jump). The mean gap is 10.7% for running performances, 17.5% for jumps, 8.9% for swimming races, 7.0% for speed skating and 8.7% in cycling. The top ten performers' analysis reveals a similar gender gap trend with a stabilization in 1982 at 11.7%, despite the large growth in participation of women from eastern and western countries, that coincided with later- published evidence of state-institutionalized or individual doping. These results suggest that women will not run, jump, swim or ride as fast as men. Key pointsSex is a major factor influencing best performances and world records.A stabilization of the gender gap in world records is observed after 1983, at a mean difference of 10.0% ± 2.94 between men and women for all events.The gender gap ranges from 5.5% (800-m freestyle, swimming) to 36.8% (weight lifting).The top ten performers' analysis reveals a similar gender gap trend with a stabilization in 1982 at 11.7%.Results suggest that women will not run, jump, swim or ride as fast as men.

Pseudo-Darwinian evolution of physical flows in complex networks.

The evolution of complex transport networks is investigated under three strategies of link removal: random, intentional attack and "Pseudo-Darwinian" strategy. At each evolution step and regarding the selected strategy, one removes either a randomly chosen link, or the link carrying the strongest flux, or the link with the weakest flux, respectively. We study how the network structure and the total flux between randomly chosen source and drain nodes evolve. We discover a universal power-law decrease of the total flux, followed by an abrupt transport collapse. The time of collapse is shown to be determined by the average number of links per node in the initial network, highlighting the importance of this network property for ensuring safe and robust transport against random failures, intentional attacks and maintenance cost optimizations.

Morphological organization of point-to-point transport in complex networks.

We investigate the structural organization of the point-to-point electric, diffusive or hydraulic transport in complex scale-free networks. The random choice of two nodes, a source and a drain, to which a potential difference is applied, selects two tree-like structures, one emerging from the source and the other converging to the drain. These trees merge into a large cluster of the remaining nodes that is found to be quasi-equipotential and thus presents almost no resistance to transport. Such a global "tree-cluster-tree" structure is universal and leads to a power law decay of the currents distribution. Its exponent, -2, is determined by the multiplicative decrease of currents at successive branching points of a tree and is found to be independent of the network connectivity degree and resistance distribution.

The age-performance relationship in the general population and strategies to delay age related decline in performance.

The age-performance relationship describes changes in the organism's structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that characterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framework ought to be integrated into public health programs, embedding the beneficial (such as physical or cognitive training) or adverse effects (such as chronic diseases or injuries) that respectively sustain or limit capabilities. The maintenance of physical or cognitive performances at older ages would result in both optimal health and promote resistance to disabling conditions and chronic diseases, such as obesity and type 2 diabetes. The causes of accelerated degeneration of health optima are mainly: sedentary and unhealthy lifestyles -including poor nutrition-, exposure to environmental pollutants, and heterogeneity in aging. Better knowledge of optima, compatible with or required for good health, should also allow for establishing ideal conditions for longevity.

Age-Related Upper Limits in Physical Performances.

Maximal physical performances are powerful and accurate biomarkers in the understanding of age-related changes during the aging process. Previous studies have characterized age-related changes from Caenorhabditis elegans to Homo sapiens. We characterized changes in this pattern for H. sapiens, decade by decade, from 1970 to 2017. Using 286,916 performances related to age from the world's best performances in each age group, we measured the relative change of 10 different running and jumping events for both women and men. We compared the change in sexual dimorphism with age and showed that the gender gap in maximal performance regarding age increases gradually, especially after the age of 50. Between 1970 and 2017, the performances for all age groups in all events have slightly progressed. However, during the last decades, the relative progression of the best performances for all age groups has decreased in both range and frequency, suggesting that age-related maximal physical performances for H. sapiens are reaching their physiological limits.

An integrative modeling approach to the age-performance relationship in mammals at the cellular scale.

Physical and cognitive performances change across lifespan. Studying cohorts of individuals in specific age ranges and athletic abilities remains essential in assessing the underlying physiological mechanisms that result in such a drop in performance. This decline is now viewed as a unique phenotypic biomarker and a hallmark of the aging process. The rates of decline are well documented for sets of traits such as running or swimming but only a limited number of studies have examined the developmental and senescent phases together. Moreover, the few attempts to do so are merely descriptive and do not include any meaningful biological features. Here we propose an averaged and deterministic model, based on cell population dynamics, replicative senescence and functionality loss. It describes the age-related change of performance in 17 time-series phenotypic traits, including human physical and cognitive skills, mouse lemur strength, greyhound and thoroughbred speed, and mouse activity. We demonstrate that the estimated age of peak performance occurs in the early part of life (20.5% ± 6.6% of the estimated lifespan) thus emphasizing the asymmetrical nature of the relationship. This model is an initial attempt to relate performance dynamics to cellular dynamics and will lead to more sophisticated models in the future.

Are We Reaching the Limits of Homo sapiens?

Echoing scientific and industrial progress, the Twentieth century was an unprecedented period of improvement for human capabilities and performances, with a significant increase in lifespan, adult height, and maximal physiological performance. Analyses of historical data show a major slow down occurring in the most recent years. This triggered large and passionate debates in the academic scene within multiple disciplines; as such an observation could be interpreted as our upper biological limits. Such a new phase of human history may be related to structural and functional limits determined by long term evolutionary constraints, and the interaction between complex systems and their environment. In this interdisciplinary approach, we call into question the validity of subsequent forecasts and projections through innovative and related biomarkers such as sport, lifespan, and height indicators. We set a theoretical framework based on biological and environmental relevance rather than using a typical single-variable forecasting approach. As demonstrated within the article, these new views will have major social, economical, and political implications.

Age-Related Changes in Locomotor Performance Reveal a Similar Pattern for Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens.

Locomotion is one of the major physiological functions for most animals. Previous studies have described aging mechanisms linked to locomotor performance among different species. However, the precise dynamics of these age-related changes, and their interactions with development and senescence, are largely unknown. Here, we use the same conceptual framework to describe locomotor performances in Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens. We show that locomotion is a consistent biomarker of age-related changes, with an asymmetrical pattern throughout life, regardless of the type of effort or its duration. However, there is variation (i) among species for the same mode of locomotion, (ii) within species for different modes of locomotion, and (iii) among individuals of the same species for the same mode of locomotion. Age-related patterns are modulated by genetic (such as selective breeding) as well as environmental conditions (such as temperature). However, in all cases, the intersection of the rising developmental phase and the declining senescent phase reveals neither a sharp transition nor a plateau, but a smooth transition, emphasizing a crucial moment: the age at peak performance. This transition may define a specific target for future investigations on the dynamics of such biological interactions.

Learning From Leaders: Life-span Trends in Olympians and Supercentenarians.

Life-span trends progression has worldwide practical implications as it may affect the sustainability of modern societies. We aimed to describe the secular life-span trends of populations with a propensity to live longer-Olympians and supercentenarians-under two hypotheses: an ongoing life-span extension versus a biologic "probabilistic barrier" limiting further progression. In a study of life-span densities (total number of life durations per birth date), we analyzed 19,012 Olympians and 1,205 supercentenarians deceased between 1900 and 2013. Among most Olympians, we observed a trend toward increased life duration. This trend, however, decelerates at advanced ages leveling off with the upper values with a perennial gap between Olympians and supercentenarians during the whole observation period. Similar tendencies are observed among supercentenarians, and over the last years, a plateau attests to a stable longevity pattern among the longest-lived humans. The common trends between Olympians and supercentenarians indicate similar mortality pressures over both populations that increase with age, scenario better explained by a biologic "barrier" forecast.

Mortality in female and male French Olympians: a 1948-2013 cohort study.

BACKGROUND: Whereas intense physical activity has been associated with deleterious effects on elite athletes' health, in particular due to cardiovascular anomalies, long-term follow-ups have suggested lower mortality rates among elite athletes. Causes of death for French Olympic athletes and female elite athletes have not been studied. HYPOTHESIS/PURPOSE: We aimed to measure overall and disease-specific mortality of French female and male Olympians compared with the French general population. We hypothesize that Olympians, both women and men, have lower mortality rates. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: French elite athletes (601 women and 1802 men) participating in summer or winter Olympic Games from 1948 to 2010 had their vital status verified by national sources and were followed until 2013. Causes of death were obtained via the National Death registry from 1968 to 2012. Overall and disease-specific mortalities of Olympians were compared with those of the French general population through standardized mortality ratios (SMRs) and 95% CIs. Olympians' observed and expected survivals were illustrated by Kaplan-Meier curves. RESULTS: At the endpoint of the study, 13 women and 222 men had died. Overall mortality in Olympians compared with that of their compatriots was 51% lower (SMR, 0.49; 95% CI, 0.26-0.85) among women and 49% lower (SMR, 0.51; 95% CI, 0.45-0.59) among men. Olympic athletes' survival is significantly superior to that of the French general population (women, P = .03; men, P < .001). According to the total deaths occurring from 1968 to 2012 (12 among women, 202 among men), female Olympians died from neoplasm (50.0%), external causes (33.3%), and cardiovascular diseases (16.6%). The main causes of death among men were related to neoplasms (36.1%), cardiovascular diseases (24.3%), and external causes (14.4%). Regarding the main causes of mortality among male Olympic athletes, the SMRs were as follows: 0.55 for neoplasms (95% CI, 0.43-0.69), 0.55 for cardiovascular diseases (95% CI, 0.41-0.73), and 0.66 for external causes (95% CI, 0.44-0.94). CONCLUSION: French Olympians live longer than their compatriots: A lower overall mortality of similar magnitude is observed among male and female athletes compared with the general population. The main causes of death in French Olympians are neoplasms, cardiovascular diseases, and external causes.