Physical Activity and Health Promotion in Esports and Gaming-Discussing Unique Opportunities for an Unprecedented Cultural Phenomenon.

Due to long periods of sedentary behavior, and unhealthy diets gamers and esports players are at risk for numerous chronic diseases and all-cause mortality. Health research has started addressing the public health implications of the esports phenomenon, drawing a bleak picture of this megatrend. However, instead of just highlighting adverse public health implications of this trend, it is recommended to become involved in this phenomenon and positively influence it. Esports has an enormous potential for physical activity and health-promoting efforts, provides a context for broadly disseminating interventions, and offers new ways of gaining access to an often-neglected population. This paper presents: the potential of the esports phenomenon to promote physical activity, health, and well-being in gamers and esports players; the strategic and preventive solutions to ameliorate esports possible adverse health impacts; and the utilization of esports technology (streams, media platforms, exergames, etc.) as an innovative health promotion tool, especially reaching gamers and esports players with attractive and interactive interventions. This is to encourage systematic scientific research so that evidence-based guidelines and intervention strategies involving regular physical activity, healthy diet, and sleep hygiene for esports will be developed. The goal is to promote public health approaches that move toward a better integration of esports and gaming.

Contrast-Enhanced Ultrasound Patterns for the Non-invasive Diagnosis of Hepatocellular Carcinoma: A Prospective Multicenter Study in Histologically Proven Liver Lesions in a Real-Life Setting Demonstrating the Benefit of Extended Late Phase Observation.

The hallmark for the non-invasive diagnosis of hepatocellular carcinoma (HCC) with contrast-enhanced ultrasound (CEUS) in cirrhosis is arterial phase hyperenhancement (APHE), followed by late-onset (>60 s), mild washout. Large retrospective studies report this pattern of washout to occur in the vast majority of HCCs. However, a prospective multicenter validation of these findings is still missing. Thus, we initiated a prospective multicenter validation study assessing CEUS enhancement patterns in focal liver lesions of patients at risk for HCC. We analyzed lesions that were eventually histology proven in a real-life setting. CEUS patterns were assessed for subgroups of HCC, intrahepatic cholangiocellular carcinoma (iCCA) and non-HCC, non-iCCA lesions. The diagnosis was HCC in 316 lesions (median size: 40 mm), iCCA in 26 lesions (median size: 47.5 mm) and non-HCC, non-iCCA in 53 lesions (median size: 27 mm). Overall, 85.8% of HCCs exhibited APHE. APHE followed by washout occurred in 72.8% of HCCs and 50% of iCCAs and non-HCC, non-iCCA malignancies (p < 0.05). Early and marked washout was associated more commonly with iCCA; HCCs exhibited mostly late and mild washout (onset >4-6 min in 10% of cases). Our prospective data confirm that the typical pattern of APHE followed by late-onset, mild washout occurs in the majority of HCCs.

Accuracy of intracoronary ECG parameters for myocardial ischemia detection.

INTRODUCTION: The electrocardiogram (ECG) is a valuable diagnostic tool for the diagnosis of myocardial ischemia during acute coronary syndrome. Aside from the commonly used ST-segment shift indicative of ischemia, several other ECG parameters are pathophysiologically reasonable. Thus, the goal of this study was to assess the accuracy of different ischemia parameters as obtained by the highly susceptible intracoronary ECG (icECG). METHOD: This was a retrospective observational study in 100 patients with chronic coronary syndrome. From each patient, a non-ischemic as well as ischemic icECG at the end of a one-minute proximal coronary balloon occlusion was available, and analysed twice by three different physicians, as well as once together for consensual results. The evaluated parameters were icECG ST-segment shift (mV), ST-integral (mV*sec), T-wave-integral (mV*sec), T-peak (mV), T-peak-to-end time (TPE; msec) and QTc-time (msec). RESULTS: All six icECG parameters showed significant differences between the non-ischemic and the ischemic recording. Using the icECG recording during coronary patency or occlusion as criterion for absent or present myocardial ischemia, ROC-analysis of icECG ST-segment shift showed an area under the curve (AUC) of 0.963 ± 0.029 (p < 0.0001). AUC for ST-integral was 0.899 ± 0.044 (p < 0.0001), for T-wave integral 0.791 ± 0.059 (p < 0.0001), for T-peak 0.811 ± 0.057 (p < 0.0001), for TPE 0.667 ± 0.068 (p < 0.0001), and for QTc-time 0.770 ± 0.061 (p < 0.0001). The best cut-off point for the detection of ischemia by icECG ST-segment shift was 0.365 mV (sensitivity 90%, specificity 95%). CONCLUSION: When tested in a setting with artificially induced absolute myocardial ischemia, icECG ST-segment shift at a threshold of 0.365 mV most accurately distinguishes between absent and present ischemia.

Use of a New-Generation Mini-Implant and Attachment System for Fabrication of a Maxillary Overdenture.

A new-generation mini-implant system offers a polyether ether ketone matrix and a new-generation surface technology on its patrix. This clinical report describes the treatment of a patient with a new-generation mini-implant-retained maxillary overdenture.

Immediate loading of ø 2,4 mm narrow-diameter implants in the edentulous maxilla and mandible / Implantatsofortbelastung eines zahnlosen Patienten

A 61-year-old healthy patient was referred for prosthetic rehabilitation in the maxilla and mandible. The primary wish of the very anxious patient was to improve the masticatory function and his aesthetic appearance with the least invasiveness and as efficiently as possible. Furthermore, he desired to receive a reliable long-term solution. The patient had no general medical restrictions and was a non-smoker. At the time of the first clinical examination, the patient presented nearly edentulous, with a few root remnants in the mandible and remaining wisdom teeth in the maxilla. The main objective of the treatment, hence, was to improve both his chewing function and the stability of the prostheses without invasive surgeries. After the removal of the root remnants and one of the two wisdom teeth (18), two new complete dentures were fabricated. Thereafter, 6 diameter reduced mini implants (SLA® one-piece self-tapping Straumann® Mini Implants made of Roxolid®, with a diameter of 2.4 mm and a length of 10 mm) were inserted in the maxilla, and 4 mini implants (SLA® one-piece self-tapping Straumann® Mini Implants made of Roxolid®, with a diameter of 2.4 mm and a length of 10 mm) were inserted in the mandible. After the implant insertion with good primary stability, the two new complete dentures were transferred into two implant-supported removable dental prostheses and retained by means of the transmucosal integrated attachment system of the mini implants (Optiloc®). At the 3-month follow-up visit, the patient was very satisfied with the outcomes, both from a functional and aesthetic point of view.

Use of an attachment system with angulated abutments and polyetheretherketone inserts to retain a maxillary overdenture: A clinical report.

This clinical report describes the rehabilitation of a maxillary edentulous arch with a current overdenture attachment system with angulated prefabricated abutments and polyetheretherketone (PEEK) inserts. Prefabricated angulated abutments were used on previously and recently placed diverging implants, which enabled a common path of insertion for the overdenture to be established during fabrication.

Association of a TNFbeta gene polymorphism with complications after major abdominal operations.

In injured patients, it has been shown that a polymorphism of the tumor necrosis factor-beta (TNFbeta) gene is related to the development of sepsis. We investigated the relation of TNFbeta gene polymorphism with the development of severe complications after elective major abdominal operations, and with production of TNFalpha perioperatively. In the present investigation, the Ncol polymorphism was studied in genomic DNA isolated from the blood of 172 patients. Preoperatively and postoperatively, lipopolysaccharide (LPS)-stimulated production of TNFalpha in the patients' whole blood was tested in vitro. Genotypes and TNFalpha production were related to the occurrence of severe complications. Postoperatively, 15% (n = 26) of the patients developed severe complications. The overall mortality was 2% (n = 3). The homozygous TNFB2 genotype was found in 54% of the patients, the homozygous TNFB1 genotype was found in 14% of the patients, and the heterozygous genotype was found in 32% of the patients. In patients with complications, the B2B2 genotype was much more frequent (21/26, 81%) than in those without complications (72/146, 49%; P < 0.003). The development of complications was associated with a lower capacity to produce TNFalpha 3 and 7 days after the operation. In patients without complications, the TNFbeta polymorphism was not related to different levels of TNFalpha production. These data indicate an association between TNFbeta polymorphism and postoperative complications and they suggest the B2/B2 genotype as a high risk factor for the development of sepsis after elective operative trauma.