Adolescents constitute a vulnerable group in the context of HIV because of early sexual debut and engagement in risk behaviors. Traditional health education methods face significant challenges regarding their effectiveness in altering risk perception and promoting sustainable behavioral changes among youth. In this scenario, serious games (SG)-educational technologies that integrate game mechanics for pedagogical and therapeutic purposes, moving beyond pure entertainment-emerge as an approach for HIV prevention. Our study sought to answer the following: What are the types and themes of SGs produced for the prevention of HIV transmission among adolescents? Thus, the objective of this scoping review was to map the types and themes of these games developed for this purpose in the literature. This scoping review, conducted between June and August 2024, was guided by the Joanna Briggs Institute methodology and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Thirteen databases were searched. The 21 selected studies identified four types of SG (video games, mobile applications, card games, and board games), addressing five central themes (HIV testing, prevention, risk behaviors, affective relationships, and sexual and reproductive health). The digital format predominated (87.5%), specifically for computers (47.6%) and smartphones (38%). Serious games are effective in HIV prevention among adolescents by surpassing conventional health education methods through immersion and empowerment. They reinforce the need for combination prevention by integrating gaming into health promotion strategies to reduce vulnerability.
Mixed reality (MR) technologies enable users to experience computer-generated content within the physical environment through spatial computing and head-mounted displays. By supporting real-time interaction through speech, gesture, gaze, and movement, MR offers new opportunities for game design beyond productivity and educational applications. However, relatively few studies have examined interaction modalities in MR games. In this paper, we present the design and deployment of four MR games on the Microsoft HoloLens 2: three that use monomodal input (speech, gaze, or gesture) and one that uses multimodal input (speech, gaze, and gesture). We conducted a study with ten participants and evaluated player experience using subjective self-reports of task load, emotional engagement, and comfort alongside objective measures, namely brain activity data collected with a five-channel electroencephalogram (EEG) device. Our preliminary findings suggest two clusters of interaction modalities based on subjective measures, a pattern that is also reflected in the objective EEG measures. Our analysis combining subjective and EEG data indicates that interaction modality influences task load and emotional engagement. Additionally, our functional connectivity analysis showed links in activity across the prefrontal, temporal, and occipital brain regions for different input modalities in the MR games.
This article studies privacy-preserving distributed Nash equilibrium (NE) seeking for aggregative games over directed graphs, where agents' cost functions contain sensitive information. A novel differentially private algorithm using decaying Laplace noise is developed to address two key issues: 1) how to design a distributed algorithm over directed graphs that achieves linear convergence while satisfying differential privacy requirements and 2) how to characterize the tradeoff between convergence accuracy and the privacy budget. First, sufficient conditions for linear convergence are established through the appropriate design of constant step sizes and convex combination parameters. Second, the differential privacy properties of the algorithm are analyzed without assuming bounded gradients, and a quantitative relationship between convergence accuracy and privacy budget is characterized. Furthermore, under additional restrictions on adjacent functions, the cumulative privacy budget admits an explicit expression and remains finite over an unbounded horizon, while the proposed algorithm is proven to converge to the exact NE. Finally, the effectiveness of the proposed algorithm is validated through a Nash-Cournot game and comparative simulations, which demonstrate its superior convergence performance compared to existing methods.
Background/Objectives: Caffeinated chewing gum is a practical, rapidly absorbed ergogenic aid increasingly used in team sports, yet its interaction with different small-sided soccer game (SSG) formats in young male players remains unclear. This study evaluated the effects of acute caffeinated (CAF) chewing gum on psychophysiological responses and kinematic profiles during intermittent (INT) and continuous (CON) 3-a-side SSGs. Methods: Twenty-four young male soccer players (18.4 ± 0.5 years) completed four 3-a-side SSG sessions separated by 48 h in a randomized, double-blind, placebo (PLA)-controlled, crossover design (CAF-INT, PLA-INT, CAF-CON, PLA-CON). Participants chewed 300 mg of CAF or PLA gum for 5 min, with mastication completed 5 min before warm-up session. The heart rates and kinematic profiles were recorded during the SSGs, and the ratings of perceived exertion (RPE), exercise enjoyment scale (EES), and visual analogue scale (VAS) to perceived mental fatigue (MF) were assessed post-game. Results: Compared with the PLA, the CAF increased the heart rate responses (HR), EES, total distance (TD), player load (PL), acceleration (ACC), and distances covered in selected speed zones (from Z0 to Z5), while reducing the RPE and MF. Significant format × supplementation interactions indicated that CAF-induced changes in high-intensity kinematic outcomes (TD, PL, ACC, Z2-Z5) and HR responses (HRmean, HRmax) were generally greater in INT, whereas CAF-induced increases in low-intensity running distances (Z0 and Z1) and %HRmax were more pronounced in the CON format (all p < 0.05 for the reported effects; ηp2 = 0.16-0.93 for CAF main effects [large effects]). The EES improvements were more pronounced in the CON format, whereas the MF and RPE reductions were more pronounced in the INT format. Conclusions: CAF chewing gum may be a practical acute strategy for modulating psychophysiological responses and kinematic profiles during SSGs, with the effects depending partly on the game format.
The aim of this study was to analyze the effects of different small-sided game (SSG) formats on internal load, perceived enjoyment, and technical-tactical performance in elite youth water polo players. Twenty male athletes (U16, n = 10; U18, n = 10) performed in three 4 vs. 4 SSG formats with different time of ball possessions and size of field areas. Technical-tactical variables were assessed using the Team Sport Assessment Procedure (TSAP), while internal load and enjoyment were measured through session-RPE (s-RPE) and a 7-point enjoyment Likert scale (ENJ). Data were analyzed using linear mixed-effects models and Spearman correlations. SSG format significantly influenced internal load, with higher RPE values (F = 6.878; p = 0.004) and s-RPE (F = 6.27; p = 0.006) observed in larger formats of the SSG. Technical-tactical indices were also affected, with significant differences found for volume of play (VP) (F = 17.041; p < 0.001) and performance score (PS) (F = 18.574; p < 0.001), showing higher values in the smallest format (SSG1). Enjoyment differed between categories (F = 13.136; p = 0.003), with higher scores in U16 players. No significant correlations were found between final RPE and TSAP indices (p > 0.05). These findings suggest that SSGs are effective tools for simultaneously developing physical and technical-tactical skills. Coaches should manipulate task constraints to balance training intensity and skill development, while also enhancing player motivation and engagement.
To evaluate emergency CT interpretation demand during major sporting events, characterize surge-related backlog and turnaround time, and estimate how threshold-based teleradiology support could affect queue performance during short event-related imaging boluses. We developed a Monte Carlo discrete-event simulation in Python to model an 8-h emergency radiology shift with baseline CT demand and a 2-h event-related surge. CT arrivals followed a Poisson process. Local and teleradiology radiologists were modeled as parallel servers with stochastic interpretation times. Two scenarios were compared across 500 Monte Carlo iterations: local radiologists only and local radiologists supplemented by a rapid-response teleradiology team activated when the unread CT backlog reached 10 cases. Primary outcomes included mean turnaround time, 90th percentile turnaround time, unread queue wait time, maximum unread backlog, number of cases delayed for more than 60 min, and time above the activation threshold. The model generated a mean of 132.7 CT examinations per shift in both scenarios. Local-only coverage resulted in a mean turnaround time of 48.7 min and a 90th percentile turnaround time of 89.6 min. With teleradiology support, the mean turnaround time decreased to 18.0 min, and the 90th percentile to 37.3 min. Mean maximum unread backlog decreased from 27.7 to 16.2 cases, and the mean number of cases delayed longer than 60 min decreased from 47.4 to 2.0. Sensitivity analysis showed that saturation risk increased sharply when surge arrivals rose and local staffing remained limited. Discrete-event simulation can help emergency radiology departments estimate when CT interpretation workflows may become saturated during major sporting events. In this model, threshold-based teleradiology reduced backlog and turnaround time but functioned as a surge buffer rather than a substitute for adequate local staffing and predefined escalation pathways.
This study investigated whether match outcome influences external training load in a rolling three-team small-sided game (SSG) format in semi-professional male football players. Twenty outfield players contributed valid GPS data across five training sessions consisting of repeated 6v6 rolling SSG bouts, where the winning team remained on the pitch and the losing team rotated out. External load variables, total distance (TD), accelerations (ACC), decelerations (DEC), and high-speed running (HSR) were measured using 10 Hz GPS and analysed using repeated-measures ANOVA with Bonferroni corrections, considering both absolute and time-normalised (per-minute) values. Accumulated total distance (TD; F = 18.04, p < .001, η2p = .52), accelerations (ACC; F = 6.05, p = .006, η2p = .27), and decelerations (DEC; F = 8.11, p = .001, η2p = .34) differed significantly between match outcomes, with values decreasing from win to draw to loss conditions. Accumulated high-speed running (HSR) did not reach statistical significance (F = 3.74, p = .055, η2p = .19). No significant effects were observed for any time-normalised variable (TD: F = 1.57, p = .223, η2p = .09; ACC: F = 0.49, p = .620, η2p = .03; DEC: F = 1.72, p = .196, η2p = .10; HSR: F = 0.45, p = .642, η2p = .03). These findings indicate that match outcome was associated with accumulated, but not time-normalised, external load in this rolling SSG format. The winner-stays rule should therefore be considered when interpreting accumulated external load in such training formats.
Ice hockey is a high-intensity intermittent team sport where games of 3 × 20-min periods involve on-ice shifts (typically lasting ∼30-80 s) interspersed with passive recovery periods (2-5 min). Playing requires endurance, speed, strength, and balance in conjunction with technical, tactical, and cognitive abilities. Nutrition can play a valuable role in optimizing physical and mental performance and in maintaining overall health of ice hockey players. The aim of this review is to provide evidence-based nutrition guidelines for elite male ice hockey players. The energy demands during training sessions and games in ice hockey are not well investigated, but elite players typically cover 2.3-6.7 km in their 15-25 min of on-ice time during games. Carbohydrate (primarily muscle glycogen) is the major fuel during training and match play, and match performance has been shown to be associated with the pregame muscle glycogen content. Sweat losses are typically high (2.02 ± 0.74 L/hr) due to the high intensity and the use of protective equipment. Sufficient carbohydrate and fluid intake are therefore the most important nutritional considerations during training sessions, games, and recovery to maintain performance. Protein intake is important after training sessions and games to support muscle repair, growth, and overall recovery. Nutrition plans should be personalized and periodized to meet the demands of training sessions and games, and individual objectives. Players should prioritize food before supplements to meet nutrient requirements. While studies on supplementation are scarce, supplements that might be beneficial to some ice hockey players include Vitamin D, iron, caffeine, and creatine.
To investigate the feasibility of an eight-week immersive virtual reality (VR) intervention using co-produced games for upper limb (UL) rehabilitation in people with multiple sclerosis (pwMS). In this multicentre, two-armed randomised controlled feasibility study, participants were randomised to either an intervention group involving VR co-produced games, 30 min, twice/week, for eight weeks, or to a control group of usual care. A mixed methods approach was undertaken, collecting feasibility data, UL outcome measures, and conducting post-intervention interviews. Nineteen pwMS were recruited (intervention n = 11, control n = 8), with a recruitment rate of 3.2 participants/month. Adherence was good with 87% (±12%) session completed, with two dropouts both in the control group. Only minor adverse events were reported (n = 9), such as fatigue and UL pain. Participants reported high levels of satisfaction and good usability of VR games. Thematic analysis revealed participants enjoyed the distraction and atmospheres that immersive VR provided, and believed the games were fit for purpose with the majority of participants reporting improvements in their UL function. Immersive VR is feasible and safe for pwMS. Future work should refine recruitment strategies, develop VR games for long-term application and explore the clinical and cost effectiveness of this approach.
To characterize the composition and specialty training of sideline medical providers present during National Collegiate Athletic Association (NCAA) Division I (Power 5) college football games. Cross-sectional survey study. Power 5 NCAA Division I football programs during the 2023 to 2024 season. Head team physicians from 69 institutions were contacted; 53 (76.8%) completed the survey.Intervention: A 25-question REDCap survey assessing on-site personnel during home and away football games, including physician specialties, emergency coverage, imaging availability, emergency medicines, and athletic training support. Presence, specialty training, and roles of medical providers on the sideline during football games. All responding programs had orthopedic surgeons (OS) on-site at home games, and all but 1 had a primary care sports medicine physician (SMP). SMPs most commonly trained in family medicine (54.2%), followed by emergency medicine (13.5%) and pediatrics (11.9%). OSs were most frequently fellowship-trained in sports medicine (68.6%). Emergency/airway management physicians were present at 37.7% of schools; neurotrauma-specific providers were present at 15.1%. Away game coverage was reduced, with fewer SMPs and OSs traveling. Athletic trainer coverage remained consistent. Only a minority of schools traveled with additional medical specialists. There is significant variability in sideline medical staffing across Power 5 college football programs. While all schools met or exceeded NCAA minimums, these findings highlight opportunities for standardization and alignment with professional sports models to optimize athlete safety.
Physical inactivity and air pollution are significant global health concerns, yet limited evidence examines how residential air pollution is associated with physical activity behaviours among children. Existing research has mainly focused on adults, older adults, or self-reported activity outcomes. This study examined the association between residential carbon monoxide (CO) exposure, objectively measured physical activity, and children's reported preference for outdoor sports and games using data from the Millennium Cohort Study. This study used a cross-sectional secondary analysis of Sweep 4 Millennium Cohort Study data. Physical activity was measured using accelerometer-derived total steps over one week. Residential CO exposure was derived from linked MEDIx air pollution deciles and categorised into relatively lower and higher exposure groups. Linear regression was used to examine the association between CO exposure and total steps. Logistic regression was used to examine the association between CO exposure and preference for outdoor sports and games. Models were adjusted for sex, ethnicity, and socio-economic position, with survey and non-response weights applied. The analytic sample included 6,281 children. In the adjusted linear regression model, children living in areas with higher CO exposure recorded, on average, 356.26 more steps than those living in areas with lower CO exposure. In the adjusted logistic regression model, higher CO exposure was associated with slightly higher odds of reporting a preference for outdoor sports and games. However, the adjusted step-count model explained only a small proportion of variation in total steps. Higher residential CO exposure was modestly associated with higher total steps and greater reported preference for outdoor sports and games. These findings should be interpreted cautiously because the study was cross-sectional, explanatory power was low, and residual confounding by neighbourhood, household, school travel, and built-environment factors is likely. Future studies should examine multiple pollutants alongside more detailed contextual and environmental measures.
Background/Objectives: Free riding in healthcare occurs when actors benefit from health-related public goods, risk-pooling arrangements, common resources, or cooperative institutions while contributing less than is socially optimal. This review clarifies how free-rider dynamics differ across vaccination, health insurance and universal health coverage, antimicrobial resistance, organ donation and transplant allocation, and global health cooperation. Methods: A narrative review with conceptual synthesis was conducted. Searches of PubMed and Scopus were complemented by citation tracking and targeted inclusion of foundational economics, game theory, public-health ethics, and market-design sources. Sources were mapped by domain, actors, strategies, payoff structure, information conditions, time horizon, enforcement mechanism and policy relevance. Results: Across domains, free riding arises when private payoffs diverge from collective welfare, but the underlying game differs: threshold public-good and coordination games in vaccination, adverse-selection and participation games in insurance, common-pool-resource dilemmas in antimicrobial use, donor-registration and matching-market problems in transplantation, and repeated public-goods games in global health. The review identifies three policy functions: altering payoffs, altering information and beliefs, and changing the structure, repetition, or enforceability of the game. Conclusions: Game theory is most useful as a mechanism-based framework rather than a stand-alone policy prescription. Its policy value depends on empirical calibration, institutional context, ethical legitimacy, and attention to equity, incomplete information, behavioral responses, and enforcement capacity. The synthesis also emphasizes boundary conditions: game-theoretic prescriptions can fail when political economy, asymmetric power, implementation capacity, access barriers, or trust-related drivers are ignored.
While Olympic participation offers elite basketball players international competition, it occurs shortly after a demanding National Basketball Association (NBA) season, limiting recovery time. Condensed scheduling and cumulative physical stress may elevate injury risk in the subsequent professional season. Understanding how Olympic involvement affects player health and performance is essential for optimizing player sustainability within the NBA. NBA players competing in the Summer Olympics will demonstrate higher injury incidence and reduced durability in the subsequent season, without improvement in performance metrics. Descriptive epidemiology study. Publicly available NBA player data from the 2003-2004 to 2024-2025 seasons were reviewed. Inclusion was limited to NBA players who represented the United States in the Olympic Games with documented participation in the NBA season both immediately preceding and immediately following their Olympic appearance. A total of 67 players were included. Variables analyzed included regular season metrics (age, years of NBA experience, number of games played, total minutes played, plus-minus, net rating, game score), injury incidence during the regular season and postseason, and Olympic workload, defined as total minutes played during the Olympic tournament. Data were adjusted for shortened seasons (2011-2012, 2020-2021). Paired t tests and multivariable linear regression were performed. The percentage of games played declined significantly in the NBA season following Olympic participation compared with the preceding NBA season (89.2% ± 10.3% vs 83.2% ± 18.7%; P = .01; d = -0.31). Injury incidence increased in the subsequent NBA season compared with the preceding season (0.7 ± 0.8 vs 0.9 ± 1.0; P = .04; d = 0.25). No significant differences were observed in plus-minus (P = .44; d = 0.096), net rating (P = .65; d = 0.055), game score (P = .49; d = 0.086), or total minutes played (P = .55; d = -0.07). Olympic participation was associated with increased injury incidence and decreased availability in the subsequent NBA season, without meaningful changes in performance metrics or total minutes played. These findings suggest cumulative fatigue and limited offseason recovery may be associated with overuse-related injury and reduced durability, with age and preceding injury history as additional risk factors.
Existing data indicate that an increasing number of adolescents are becoming addicted to online games, while the prevalence of depressive symptoms within this demographic is also on the rise. Depression is a primary comorbidity associated with game addiction, but the influencing factors and mechanisms remain unclear. This study aims to explore the mediating role of game addiction in the relationship between the intellectual-cultural orientation of family environment and adolescent depressive symptoms. A cross-sectional study was conducted on 1,105 pairs of mothers and adolescents in a high school in Henan Province, China, through online investigation from November 17, 2021 to December 11, 2021. The intellectual-cultural orientation, game addiction and adolescent depressive symptoms were measured by the subscale of Intellectual-cultural orientation in Family Environment Scale, Game Addiction Scale for Adolescents and Children's Depression Inventory respectively. The SPSS PROCESS macro 3.3 software was used to analyze the mediating effect. The findings revealed that Intellectual-cultural orientation was negatively correlated with both adolescent game addiction and depressive symptoms. Game addiction served as a significant mediator between Intellectual-cultural orientation and depressive symptoms in adolescents. Furthermore, gender and annual household income significantly associated with the strength of the mediating effect of game addiction on the relationship between Intellectual-cultural orientation and adolescent depressive symptoms. Specifically, boys and adolescents from low-incomefamilies were more likely to suffer from game addiction. These findings suggest that future family based interventions aimed at preventing adolescent depression should specifically target the reduction of game time, particularly among boys and adolescents from low-income families.
While action video games (AVGs) can enhance cognitive control, mechanisms underlying gaming disorder (GD) remain unclear. Using the Dual Mechanisms of Control framework, two task-switching experiments dissociated proactive and reactive control among AVG players with GD, recreational game users (RGU), and non-gamers (NG). Experiment 1 provided initial evidence that, unlike healthy controls, GD players showed difficulty sustaining proactive preparation over extended intervals and tended to rely more on post-response interference resolution. Experiment 2 further supported this reactive dependence: after prolonged delays, switch costs in the GD group dropped to negligible levels, whereas residual costs persisted in RGU and NG groups. These findings provide converging evidence that GD players exhibit relatively fragile proactive control and a compensatory over-reliance on reactive control. Consequently, cognitive impairment in GD reflects a shift in processing mode rather than a generalized deficit, highlighting mechanism-specific targets for clinical interventions.
Diseases during childhood and adolescence such as cancer or attention-deficit/hyperactivity disorder (ADHD) can have an impact on brain development and place children and adolescents at increased risk for cognitive long-term problems. Most cognitive trainings currently available have limited efficacy and show limited transfer to nontrained tasks and everyday functioning. We developed a novel intervention (Mio-Training) aiming to increase metacognitive abilities at the intersection between exercise psychology and cognitive science to strengthen the cognitive development of pediatric patients with atypical brain development in the long term. The study assesses the efficacy of the Mio-Training on the primary (metacognitive abilities) and secondary outcomes (executive functions, processing speed, and memory) before the training, immediately after the training, and at a 3-month follow-up in patients with atypical development and healthy controls. The Mio-Training stimulates metacognition through 38 digital games, which playfully teach mnemonic strategies (ie, rehearsal, chaining, and associations), present intensive verbal and visual working memory training, and motor coordination tasks. The training group will train for 5 weeks, 3 times per week, for 20 minutes. The waiting control group will receive the training after completion of the study procedure. We will evaluate the efficacy of the Mio-Training on metacognitive abilities and cognitive performance in a randomized controlled clinical trial. We expect a long-term increase in metacognitive abilities associated with an increase in subjective and objective cognitive performance. The efficacy of the Mio-Training will be investigated in 3 subgroups (patients with cancer, ADHD, and healthy controls; each group n=40; all aged 8-16 years) using pre-intervention and post-intervention assessments. All participants will be randomly assigned to the Mio-Training or the waiting control group, stratified by age and sex. This study protocol describes the study design of the randomized controlled trial evaluating the efficacy of the Mio-Training. The project is funded from October 2024 to December 2027. Recruitment for healthy controls has been completed (n=40; October 2024-August 2025), recruitment for childhood cancer survivors (n=10, 25% participants recruited) is scheduled from August 2025 to December 2027, and recruitment for participants with ADHD (n=39, 97.5% recruited) is scheduled from October 2025 to September 2026. Data analyses have not yet commenced; first results from the ADHD subgroup are expected in early 2027, with findings from the cancer survivor subgroup anticipated in early 2028 following completion of recruitment. To strengthen cognitive development in young patients with atypical development, it is necessary to address the current lack of effective treatment options. The combination of cognitive and motor training with metacognitive abilities may support patients' cognitive maturation trajectories and will enable transfer of the training effect to everyday and school situations.
Large language models (LLMs) are increasingly deployed to support human decision-making. This use of LLMs has concerning implications, especially when their prescriptions affect the welfare of others. To gauge how LLMs make social decisions, we explore whether five leading models produce sensible strategies in the repeated prisoner's dilemma, which is the main metaphor of reciprocal cooperation. First, we measure the propensity of LLMs to cooperate in a neutral setting, without using language reminiscent of how this game is usually presented. We record to what extent LLMs implement Nash equilibria or other well-known strategy classes. Thereafter, we explore how LLMs adapt their strategies to changes in parameter values. We vary the game's stopping probability, the payoff values, and if the total number of rounds is commonly known. We also study the effect of different framings. In each case, we test whether the adaptations of the LLMs are in line with basic intuition, theoretical predictions of evolutionary game theory, and experimental evidence of human participants. While all LLMs perform well in many of the tasks, none of them exhibit full consistency over all tasks. We also conduct tournaments between the inferred LLM strategies and study direct interaction between LLMs in games over ten rounds with known or unknown last round. Our experiments shed light on how current LLMs instantiate reciprocal cooperation.
Visual-spatial attention (VSA) selects relevant sensory information and supports the preparation of responses to this information. Mental rotation (MR) is the ability to rotate an object seen from a certain perspective to a new orientation in space. Exercise stands out as a promising non-pharmacological treatment for cognitive functions. Balance control is known to be related to the visual system. Therefore, the aim was to investigate the effectiveness of video-based balance games and structured balance exercises on VSA and MR with EEG brain oscillations. 30 healthy participants were included in the study. Participants were divided into two groups (structured balance exercises group (SBEG) and video-based balance exercises group (VBBEG)) by randomization. Both groups received exercise sessions 2 days a week for a total of 6 weeks. The mentioned cognitive functions were evaluated by selecting tests previously used in the literature. For the VSA task, after 6 weeks of exercise, occipital theta (4-7 Hz) power decreased in the VBBEG group, while SBEG increased. In the MR task results, high alpha (11-13 Hz) power decreased in VBBEG and increased in SBEG when centroparietal areas were examined. In conclusion, it is thought that the two different exercise methods may affect visual-spatial attention and mental rotation skills in different ways. The online version contains supplementary material available at 10.1007/s11571-026-10494-4.
Background and Objectives: Water polo (WP) is a high-intensity, intermittent aquatic team sport that has been extensively investigated within sports science. While contemporary literature has examined the body composition and morphological characteristics of elite and international WP players, this study aimed to define the general body composition profile of world-class WP players and determine position-specific differences. Methods: The study involved 72 national team players from Serbia, Croatia, Greece, and Italy who participated in the Olympic Games, World Championships, or European Championships. Participants' body composition was measured using the InBody 720 multichannel bioimpedance method. Ten different variables were examined to assess body structure regarding contractile and ballast components. Results: MANOVA revealed statistically significant differences in body composition across playing positions (Wilks' lambda = 0.239, p < 0.000, η2p = 0.402). The variables that had the greatest impact on the difference were: body mass, body fat and body mass index with the 47.0, 44.4, and 43.7% of explained total variance of the impact on the differences (p = 0.000), respectively. Conclusions: world-class WP players assigned to different playing positions differ significantly in body composition. These positional profiles should be considered in talent identification, selection procedures, training, and nutritional strategies to optimize performance models, considering the future evolution of the game at the highest competitive level. Coaches could use this information to initially select players for different specific positions based on anthropometric and body composition criteria.
Game-based learning (GBL) has gained widespread attention as an innovative pedagogical approach, yet its potential to enhance students' metacognitive learning remains underexplored. Guided by self-regulated learning (SRL) theory, the review investigates how GBL design features, such as goal-setting, real-time feedback, progress visualization, and reflection tools, scaffold students' planning, monitoring, and evaluation strategies. A systematic search across Web of Science, Scopus, and ProQuest identified the studies, which included data from physical classrooms, online learning environments, and mixed settings. This scoping review synthesizes evidence from 11 peer-reviewed studies conducted between 2015 and 2025 to evaluate the impact of GBL on metacognitive learning in primary and junior middle school contexts. Findings reveal that GBL effectively supports metacognitive learning through real-time feedback and progress indicators, though planning and evaluation scaffolds are less comprehensively addressed. Furthermore, digital trace data and behavioral logs are emerging as robust tools for assessing metacognitive processes, offering deeper insights than self-reports alone. However, the review identifies critical gaps, including insufficient focus on junior middle school students, limited representation of non-STEM disciplines, and uneven theoretical grounding across studies. The findings underscore the need for theory-driven design and balanced scaffolding to maximize GBL's potential in fostering metacognitive competence. This study also provides practical insights for educators to foster students' metacognitive learning by effectively integrating games into educational practices.