Inducibility of atrial fibrillation after catheter ablation predicts recurrences of atrial fibrillation: a meta-analysis.

BACKGROUND: Pulmonary vein isolation (PVI) is a component of standard care for patients with symptomatic atrial fibrillation (AF). Procedural inducibility of AF following PVI has been suggested as predictor of AF recurrence but is discussed controversially. This meta-analysis aimed at evaluating the relevance of electrophysiological inducibility of AF following PVI for future AF recurrences. METHODS: A literature search of MEDLINE and Web of Science was performed until April 2020. Prospective trials of PVI in patients with AF and post-procedural atrial stimulation to test for inducibility of AF as well as adequate follow-up for AF recurrence (defined as AF >10 s to >10 min at follow-up) were included. Odds ratios (ORs) were analyzed using random-effects models. RESULTS: A total of 11 trials with 1544 patients (follow-up 7-39 months, age 56 ± 6 years, predominantly male 74 ± 6%) were included. Inducibility of AF post-PVI was predictive for AF recurrence during follow-up (OR 2.08; 95% CI 1.25 to 3.46). Prediction for AF recurrence at follow-up was better for patients with paroxysmal AF (OR 4.06; 95% CI 1.39 to 11.91), stimulation in the CS (OR 2.82, 95% CI 1.17 to 6.79). A trend towards higher ORs was seen without the use of isoproterenol (OR 2.43; 95% CI 1.17 to 5.07), as well as few stimulations during induction and a short definition of AF in meta-regression analyses. CONCLUSIONS: Electrophysiological inducibility of AF following PVI was predictive for future recurrence of AF, in particular in patients with paroxysmal AF, stimulation in only CS and no use of isoproterenol.

Peripheral muscle strength is associated with aerobic fitness and use of antibiotics in patients with cystic fibrosis.

AIMS: Individuals with cystic fibrosis (CF) may develop muscle abnormalities, although little is known on its clinical and functional impact. This study aimed to evaluate the association of peripheral muscle strength with aerobic fitness, habitual physical activity, lung function and the use of antibiotics (ATB) in patients with CF. METHODS: A cross-sectional study where individuals aged ≥6 years underwent peripheral muscle strength evaluation (biceps, quadriceps and hamstrings) and performed a cardiopulmonary exercise test. Demographic, anthropometric, genetic, lung function and total days of ATB use within 1 year of tests were also collected. RESULTS: Correlation was found for biceps (r = .45; P = .002) strength with the peak oxygen consumption (VO2 peak). Muscle strength (biceps and quadriceps) also correlated with the ventilatory equivalent for oxygen consumption (VE /VO2 ) at anaerobic threshold (AT) and with the ventilatory equivalent for carbon dioxide production (VE /VCO2 ) both at AT and peak exercise. Negative correlations were found for quadriceps (r = -.39) and hamstrings (r = -.42) with the total days of ATB use in the following year. Patients needing to use ATB presented lower biceps strength (P = .05) and individuals with VO2 peak lower than 37 mL·kg-1 ·min-1 presented lower muscle strength for both biceps (P = .01) and quadriceps (P = .02). CONCLUSIONS: The results have shown that peripheral muscle strength is associated with aerobic fitness and the use of antibiotics in patients with CF.

Action priming suppression by forward masks.

Visual stimuli may produce strong and reliable effects on subsequent actions irrespective of their visibility. This dissociation between action priming and conscious perception of the stimuli suggests two ways of processing of visual stimuli. One way of processing leads to the emergence of conscious visual perception, and another way leads to action priming effects. Here we examined the influence of forward masks that precede the prime on processing for action. In three experiments, we found that forward masks can suppress and even abolish priming effects. Suppression was larger with strong rather than weak forward masks and with short rather than long prime durations. Similar suppression effects occurred with surrounding paracontrast masks and with overlapping pattern masks. Our findings emphasize that processing for action depends crucially on preceding stimuli suggesting that action priming may depend on the initial part of the response to the prime. Results indicate that the use of forward masks to reduce prime visibility may also reduce action priming and potentially other priming effects.

[Sensitivity and Specificity of the Reizdarm-Fragebogen]. / Sensitivität und Spezifität des Reizdarm-Fragebogens.

BACKGROUND: The Reizdarm-Fragebogen (RDF) is the first German questionnaire to assess subjectively perceived symptom severity of irritable bowel syndrome (IBS). Thus far, this was only possible in the context of a medical examination by a practitioner. The goal of the current study was to assess differences in RDF scores among IBS patients and other clinical and non-clinical populations. Further, the study aimed to define a cut-off score for the presence of IBS and thereby, to evaluate the RDF as screening instrument in IBS diagnosis. MATERIALS AND METHODS: The study sample consisted of 372 individuals (62.6% male, mean age=41±17 years). 17.5% (of the sample) were IBS patients, 9.9% received treatment for chronic inflammatory bowel disease, 12.1% of the participants were recruited from a psychosomatic clinic, and 50.5% belonged to a control group. All participants filled out the 13 item RDF. RESULTS: The IBS patients' RDF scores differed significantly from those of other clinical and non-clinical subsamples [t(98.82)=13.61, p<0.001]. Except for the subscale "bloating" this difference was consistently found for all RDF subscales ("diarrhea", "constipation", and "pain and feeling of tension"). With respect to the identification of a cut-off for IBS diagnosis, a score of 32 showed both good sensitivity (90.80%) and specificity (75.56%). DISCUSSION AND CONCLUSION: The RDF is an efficient instrument for the assessment of subjectively perceived symptom severity in IBS. Based on the current findings and its good psychometric properties it can be used as a screening instrument for IBS in both clinical practice and research.

Psychometric properties of the "parental questionnaire: Enuresis/urinary incontinence" (PQ-EnU).

AIMS: The "Parental Questionnaire: Enuresis/Urinary Incontinence" (PQ-EnU) is widely-used in clinical assessment of nocturnal enuresis (NE) and daytime urinary incontinence (DUI). It includes 18 items regarding daytime (DW) and nighttime wetting (NW), 24 items concerning toilet habits (TH), and 14 items regarding behavioral problems (BP). The aim of the study was to evaluate reliability and validity of the PQ-EnU. METHODS: Parents of 490 children (M = 8.7 years [SD = 2.9], 68.2% male) presented in an outpatient incontinence clinic completed the PQ-EnU and the Child Behavior Checklist (CBCL). Internal consistencies, factorial structure, and convergent validity regarding incontinence diagnoses and psychopathology were examined. RESULTS: 84.1% had NE, 38.8% DUI, and 20.8% fecal incontinence (FI). Internal consistencies were good for TH and BP. A factor analysis of the TH scale revealed three subscales ("Lower urinary tract symptoms (LUTS)," "Bowel symptoms," and "Voiding dysfunctions"). The LUTS and "Bowel symptoms" subscales were significantly correlated to clinical diagnoses of DUI and FI, respectively. A factor analysis of the BP scale revealed also three subscales ("attention/school deficits," "impulsive-aggressive behavior" and "internalizing problems," which were all significantly correlated with the CBCL. The questionnaire discriminated significantly between children with and without DUI or FI, and children with and without a clinical CBCL score. CONCLUSIONS: The PQ-EnU is a valid and reliable parental questionnaire to measure incontinence, bladder/bowel symptoms, and behavioral problems in children. Due to its shortness, the PQ-EnU is an efficient measurement, which can be used in clinical settings and also as a screening tool for psychological symptoms.

Design and validation of a German version of the GSRS-IBS - an analysis of its psychometric quality and factorial structure.

BACKGROUND: Currently, a suitable questionnaire in German language is not available to monitor the progression and evaluate the severity of irritable bowel syndrome (IBS). Therefore, this study aimed to translate the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) into German and to evaluate its psychometric qualities and factorial structure. METHODS: This study is based on a total sample of 372 participants [62.6% female, mean age = 41 years (SD = 17 years)]. 17.5% of the participants had a diagnosis of IBS, 19.9% were receiving treatment for chronic inflammatory bowel disease, 12.1% of the participants were recruited from a psychosomatic clinic, and 50.5% belonged to a control group. All participants completed the German version of GSRS-IBS (called Reizdarm-Fragebogen, RDF), as well as the Gießen Subjective Complaints List (GBB-24) and the Hospital Anxiety and Depression Scale - German version (HADS-D). RESULTS: The internal consistency of the RDF total scale was at least satisfactory in all subsamples (Cronbach's Alpha between .77 and .92), and for all subscales (Cronbach's Alpha between .79 and .91). The item difficulties (between .25 and .73) and the item-total correlations (between .48 and .83) were equally satisfactory. Principal axis analysis revealed a four-factorial structure of the RDF items, which mainly resembled the structure of the English original. Convergent validity was established based on substantial and significant correlations with the stomach-complaint scale of the GBB-24 (r = .71; p < .01) and the anxiety (r = .42; p < .01) and depression scales (r = .43; p < .01) of the HADS-D. CONCLUSION: The German version of the GSRS-IBS RDF proves to be an effective, reliable, and valid questionnaire for the assessment of symptom severity in IBS, which can be used in clinical practice as well as in clinical studies.

Central nervous system processing of emotions in children with nocturnal enuresis and attention-deficit/hyperactivity disorder.

AIM: Nocturnal enuresis (NE) and attention-deficit/hyperactivity disorder (ADHD) are common in childhood. We analysed the central processing of emotions in children with NE, ADHD, NE + ADHD and controls. METHODS: We examined 13 children with NE, 13 with ADHD, 14 with NE + ADHD and 14 controls. Acoustic evoked potentials were recorded using standardised methodology. For the event-related potentials, positive, negative and neutral pictures were presented and time intervals of 250-450, 450-650 and 650-850 msec evaluated. Hypotheses were tested with repeated-measures analyses of variance. RESULTS: In the frontal region, children with NE showed more intense responses to positive and negative pictures than controls measured with event-related potentials. Viewing positive pictures, children with NE + ADHD differed from children with ADHD in the central and parietal and for all types of stimuli in the parietal region. Children with NE + ADHD elicited the strongest responses. Children with ADHD did not differ from controls. There was an unspecific interaction effect of the acoustic evoked potentials in children with NE compared to the controls. CONCLUSION: Children with NE processed emotions differently from children with ADHD and controls. Children with NE + ADHD processed emotions the most intense, displaying interaction effects of the central nervous system that cannot be explained by each disorder alone.

Eating problems in young children -- a population-based study.

AIM: To analyse the prevalence of atypical eating problems and their associations with anxious or oppositional behaviours in young children. METHODS: One thousand and ninety children examined in the school enrolment test in a defined geographical region were included (544 boys). The parents completed a 25-item questionnaire regarding their child's eating behaviour and anxious or oppositional behaviours. RESULTS: Half of the parents reported that their child avoids certain foods (53%). Twenty-three percent showed selective eating, 26% showed an aversion against new foods. Children with underweight avoided more types of food and ate smaller amounts than children with normal or overweight. Three groups could be differentiated. Sixty-one percent of the children were 'normal eaters' with avoidance of certain foods, normal weight status and low anxious or oppositional behaviour. Thirty-four percent showed selective and/or restrictive eating, and 5% worried about their weight. Children with selective eating and with weight concerns were more often affected by anxious and oppositional behaviours. CONCLUSION: Atypical eating problems are common in young children. Without accompanying weight loss, behavioural or emotional problems, selective eating should be seen as a normal feature in young eating behaviour. Parents of young children with selective, restrictive eating or with weight worrying and psychological problems should be offered advice/treatment.

How did the beginnings of the global COVID-19 pandemic affect mental well-being?

The present study aims to investigate longitudinal changes in mental well-being as well as the role of individual differences in personality traits (Big Five) and the level of Personality Organisation during the first lockdown of the COVID-19 pandemic in Germany. Overall, 272 adults (Mage= 36.94, SDage= 16.46; 68.62% female, 23.45% male, 0.69% non-binary) took part in our study with four weekly surveys during the lockdown as well as a follow-up one month after restrictions were lifted. To analyse the development of mental well-being during and shortly after the first lockdown in Germany latent growth curve models (LGCM) were calculated. The considered facets of well-being differ by their trajectory. Additionally, results suggest that the lockdown did not affect all facets to the same extent. While Life Satisfaction decreases in the short term as a reaction to the lockdown, Stress and Psychological Strain were reduced after the second week of contact restrictions. When adding personality characteristics, our results showed that Neuroticism and Conscientiousness were the two dimensions associated most strongly with SWB during the first month of the pandemic. Thus, our research suggests that personality traits should be considered when analysing mental well-being.

Impact of asthma on heart rate variability in children and adolescents: Systematic review and meta-analysis.

PURPOSE: Asthma is associated with abnormal autonomic function, and heart rate variability is considered a simple, accurate, and noninvasive tool for monitoring the autonomic system. Thus, the aim of this study was to investigate the impact of asthma on heart rate variability in children and adolescents. METHODS: This systematic review of observational studies and clinical trials evaluated heart rate variability in children and adolescents with asthma compared to healthy controls. The data were extracted independently by two reviewers. The quality of the selected articles was assessed using Agency for Health Care Research and Quality indicators. Random effects meta-analysis was performed for each outcome, with the effect size reported as standardized mean difference. RESULTS: Fifteen studies were included, of which five were classified as having high methodological quality. In the meta-analysis, long-term recording of the standard deviation of all normal-to-normal sinus R-R intervals differed significantly between groups (standardized mean difference [SMD] = -0.46 [95% confidence interval {CI}: -0.79 to -0.14], p < 0.005, I2 = 0%). Moreover, R-R intervals (long-term) were significantly shorter in asthmatic children than controls (SMD = -0.47 [95% CI: -0.68 to -0.25], p < 0.0001, I2 = 0). There were no significant differences between adjacent normal R-R intervals that exceed 50 ms (long-term) and the root mean square of successive differences between normal sinus R-R intervals (short-term). Regarding frequency-domain variables, long-term low frequency measurements differed significantly between groups (SMD = -0.34 [95% CI: -0.58 to -0.10], p < 0.005, I2 = 15%). There were no differences in high frequency measurements or in the ratio between low/high frequency powers (short- or long-term) between groups. CONCLUSION: The results confirm the impact of asthma on heart rate variability in children and adolescents, indicating lower heart rate variability and sympathetic modulation.

A Log File Analysis on the Validity of Partial Solutions in Figural Matrices Tests.

As a component of many intelligence test batteries, figural matrices tests are an effective way to assess reasoning, which is considered a core ability of intelligence. Traditionally, the sum of correct items is used as a performance indicator (total solution procedure). However, recent advances in the development of computer-based figural matrices tests allow additional indicators to be considered for scoring. In two studies, we focused on the added value of a partial solution procedure employing log file analyses from a computer-based figural matrices test. In the first study (n = 198), we explored the internal validity of this procedure by applying both an exploratory bottom-up approach (using sequence analyses) and a complementary top-down approach (using rule jumps, an indicator taken from relevant studies). Both approaches confirmed that higher scores in the partial solution procedure were associated with higher structuredness in participants' response behavior. In the second study (n = 169), we examined the external validity by correlating the partial solution procedure in addition to the total solution procedure with a Grade Point Average (GPA) criterion. The partial solution procedure showed an advantage over the total solution procedure in predicting GPA, especially at lower ability levels. The implications of the results and their applicability to other tests are discussed.

Development and Validation of the Open Matrices Item Bank.

Figural matrices tasks are one of the most prominent item formats used in intelligence tests, and their relevance for the assessment of cognitive abilities is unquestionable. However, despite endeavors of the open science movement to make scientific research accessible on all levels, there is a lack of royalty-free figural matrices tests. The Open Matrices Item Bank (OMIB) closes this gap by providing free and unlimited access (GPLv3 license) to a large set of empirically validated figural matrices items. We developed a set of 220 figural matrices based on well-established construction principles commonly used in matrices tests and administered them to a sample of N = 2572 applicants to medical schools. The results of item response models and reliability analyses demonstrate the excellent psychometric properties of the items. In the discussion, we elucidate how researchers can already use the OMIB to gain access to high-quality matrices tests for their studies. Furthermore, we provide perspectives for features that could additionally improve the utility of the OMIB.

Do Grittier People Have Greater Subjective Well-Being? A Meta-Analysis.

The present study conducted a meta-analysis to examine the relation between grit and subjective well-being (SWB). The association between grit (i.e., overall grit, perseverance of effort, and consistency of interest) and SWB (i.e., positive affect, negative affect, happiness, depression, life satisfaction, job satisfaction, and school satisfaction) were synthesized across 83 studies and 66,518 participants. The results based on a random-effects model showed a substantial correlation between overall grit and SWB (ρ = .46, 95% confidence interval [CI] = [.43, .48]), followed by perseverance of effort (ρ = .38, 95% CI = [.33, .43]) and consistency of interest (ρ = .23, 95% CI = [.17, .28]). The moderator analysis indicated that the correlations between overall grit/consistency of effort and SWB become weaker as age increased, and these links were stronger in affective well-being than in cognitive well-being. Moreover, grit explained unique variance in SWB even after controlling for conscientiousness. Implications and directions for further research are discussed.

The Association of Field Test Outcomes with Peak Oxygen Uptake in Patients with Cystic Fibrosis: A Systematic Review.

The purpose of the study was to evaluate the association of field test outcomes with peak oxygen uptake (VO2peak) in patients with cystic fibrosis (CF) and to describe the main prediction equations available. Data searches were performed in five databases (Pubmed, Embase, LILACs, Scopus and Web of Science) and also in the reference lists of articles included. The following inclusion criteria were used: studies including individuals with CF, presenting both a field test and a cardiopulmonary exercise testing (CPET), and describing a predictive equation or coefficient of correlation/determination. Case studies, abstracts, letters of reply, editorials and duplicate publications were excluded. The methodological quality analysis was performed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies scale. Protocol registration number: CRD42020148363. Ten studies were eligible. Five equations were found to predict VO2peak. Equations derived from the shuttle tests (ST) showed strong correlations with VO2peak (r = 0.79 to 0.95). The six-minute walk test (6MWT) showed moderate associations with VO2peak in participants with moderate disease severity (r = 0.53 to 0.65). Furthermore, patients with lower maximum heart rate on the three-minute step test tended to have a higher percent predicted VO2peak (r = -0.40), and the one-minute sit-to-stand test demonstrated moderate correlations between VO2peak and the number of repetitions (r = 0.52 to 0.66). In conclusion, field test outcomes correlate with oxygen consumption assessed through CPET, although only the ST seems to be valid as a predictor of VO2peak in patients with CF.

Test Preparation in Figural Matrices Tests: Focus on the Difficult Rules.

It is well documented that training the rules employed in figural matrices tests enhances test performance. Previous studies only compare experimental conditions in which all or no rules were trained and therefore ignore the particular influence of knowledge about the easy and difficult rules. With the current study, we wanted to provide some first insights into this topic. Respondents were assigned to four groups that received training for no rules, only the easy rules, only the difficult rules, or for all rules. The results show that a training only for the difficult rules was more effective than the other trainings. This applies also to performance in the easy rules that were actually not part of the training. A possible explanation for this finding is a facilitation of the solution process that is primarily driven by knowledge about the difficult rules. In conclusion, our results demonstrate that taking differences between the rules into account may provide a deeper understanding of the effects of trainings for figural matrices tests.

The modified shuttle test as a predictor of risk for hospitalization in youths with cystic fibrosis: A two-year follow-up study

BACKGROUND: Patients with cystic fibrosis (CF) present exercise intolerance and episodes of pulmonary exacerbations. This study aimed to evaluate the association of the distance covered on the modified shuttle test (MST), as well as other clinical variables (anthropometry, chronic colonization by Pseudomonas aeruginosa, lung function), with the risk of hospitalization for pulmonary exacerbation. METHODS: Cohort study including CF patients older than 6 years, from two specialized CF centers. All patients underwent a MST and a lung function test at the time of inclusion. Demographic, anthropometric and clinical data were collected. Free time until the first hospitalization, total days of hospitalization and use of antibiotics during the two years of follow-up were recorded. RESULTS: Sixty-seven patients with a mean (SD) age of 12.4 (5.2) years and forced expiratory volume in the first second (FEV1) of 78.7% (22.4) were included. The mean distance covered (m) in the MST was 775.6 (255.7) (73.4 ± 19.5% of predicted). The distance achieved (MST) was considered as the main independent variable to predict the risk of hospitalization (Cox HR 0.97, p = 0.029). Patients who walked a distance of less than 80% of predicted in the MST showed an increase of 3.9 (95%CI 1.0-15.3) in the relative risk for hospitalization and significantly higher total number of days of hospitalization (p = 0.022). CONCLUSION: There is an association between the distance covered in the MST and the risk of hospitalization in youths with CF. Patients with reduced exercise capacity presented a 3.9 times increase in the relative risk for hospitalization due to pulmonary exacerbation.

The evidence for pharmacist care in outpatients with heart failure: a systematic review and meta-analysis.

AIMS: Patients with heart failure (HF) have poor outcomes, including poor quality of life, and high morbidity and mortality. In addition, they have a high medication burden due to the multiple drug therapies now recommended by guidelines. Previous reviews, including studies in hospital settings, provided evidence that pharmacist care improves outcomes in patients with HF. Because most HF is managed outside of hospitals, we aimed to synthesize the evidence for pharmacist care in outpatients with HF. METHODS AND RESULTS: We conducted a systematic literature search in PubMed of randomized controlled trials (RCTs) and integrated the evidence on patient outcomes in a meta-analysis. We found 24 RCTs performed in 10 countries, including 8029 patients. The data revealed consistent improvements in medication adherence (independent of the measuring instrument) and knowledge, physical function, and disease and medication management. Sixteen RCTs were included in meta-analyses. Differences in all-cause mortality (odds ratio (OR) = 0.97 [95% CI, 0.84-1.12], Q-statistic, P = 0.49, I2  = 0%), all-cause hospitalizations (OR = 0.86 [0.73-1.03], Q-statistic, P = 0.01, I2  = 45.5%), and HF hospitalizations (OR = 0.89 [0.77-1.02], Q-statistic, P = 0.11, I2  = 0%) were not statistically significant. We also observed an improvement in the standardized mean difference for generic quality of life of 0.75 ([0.49-1.01], P < 0.01), with no indication of heterogeneity (Q-statistic, P = 0.64; I2  = 0%). CONCLUSIONS: Results indicate that pharmacist care improves medication adherence and knowledge, symptom control, and some measures of quality of life in outpatients with HF. Given the increasing complexity of guideline-directed medical therapy, pharmacists' unique focus on medication management, titration, adherence, and patient teaching should be considered part of the management strategy for these vulnerable patients.

Catheter-based renal denervation as adjunct to pulmonary vein isolation for treatment of atrial fibrillation: a systematic review and meta-analysis.

OBJECTIVE: Renal denervation (RDN) can reduce sympathetic activity and blood pressure (BP) in hypertensive patients, which both have an impact on atrial fibrillation. We performed a systematic meta-analysis on the effects of renal denervation (RDN) in addition to pulmonary vein isolation (PVI) in patients with atrial fibrillation. METHODS: All published randomized controlled trials investigating the effects of RDN as adjunctive treatment to PVI for rhythm control of atrial fibrillation were included. Primary endpoint was recurrence of atrial fibrillation after 12 months on average. RESULTS: A total of six randomized controlled studies including 689 patients with hypertension and symptomatic atrial fibrillation were included. In five studies, patients had uncontrolled BP despite prescription of an average of three antihypertensive agents. PVI was performed with irrigated radio-frequency catheters in 387 patients, and in 302 with cryoballoon. Cardiac ablation catheters were used for RDN in 78% of all cases. In the remaining 22%, RDN was performed using a designated, nonirrigated radio-frequency catheter system. After 12 months, the mean odds ratio for recurrence of atrial fibrillation for PVI with RDN compared with PVI alone was 0.43 (95% confidence interval 0.32-0.59). After RDN, BP was reduced significantly whereas no changes were reported in the PVI-only groups. No relevant complications associated to RDN were documented. CONCLUSION: This meta-analysis supports the concept of RDN as an adjunctive treatment for atrial fibrillation. Further studies with standardized PVI and RDN procedures are needed.

Sleep's impact on emotional recognition memory: A meta-analysis of whole-night, nap, and REM sleep effects.

Numerous studies have shown that post-learning sleep enhances visual episodic recognition memory. However, it remains unclear whether this consolidation benefit is moderated by the emotional valence of the learned material. To clarify whether sleep selectively enhances memory for emotional material, we conducted a meta-analysis including N = 1059 post-sleep/wake observations. Overall, our results do not support this hypothesis. When only studies with a sleep group/wake group comparison were included in the analysis (k = 22), the retention advantage for emotional (negative/positive) over neutral material was not significantly different between sleep and wake groups. When studies without wake groups were included in the analysis after statistical estimation of wake-group parameters, the retention advantage for emotional material was significantly larger in wake groups than in sleep groups (k = 34). Interestingly, however, an additional analysis of eight studies investigating the selective effects of rapid-eye-movement sleep and slow-wave sleep on post-interval emotional memory provided evidence for a selective enhancement of emotional over neutral memory performance after rapid-eye-movement sleep compared to slow-wave sleep. These findings suggest that sleep does not generally enhance visual recognition memory for emotional stimuli. However, the result pattern is consistent with the idea that specific sleep stages preferentially enhance consolidation of emotional and neutral material, respectively.

Evaluation of the exercise intensity generated by active video gaming in patients with cystic fibrosis and healthy individuals.

BACKGROUND: Adherence of patients with cystic fibrosis (CF) to exercise is challenging. Here we compared the physiological responses during the use of interactive video games (VG) with the cardiopulmonary exercise test (CPET) in healthy and CF subjects. METHODS: Cross-sectional study including CF and healthy (CON) subjects older than 6 years. Individuals were evaluated in two visits. At visit one, anthropometric measures, spirometry and CPET were performed. In the second visit, a physical activity questionnaire was applied and gas analyses performed during the use (10 min) of both Nintendo Wii (Wii Fit Plus: (1) Obstacle Course, (2) Rhythm Boxing and (3) Free Run) and Xbox One (Just Dance 2015: (1) Love Me Again, (2) Summer and (3) Happy). RESULTS: Twenty-five CON and 30 CF patients were included. The mean FEV1 (%) was significantly lower in the CF group compared to CON. There were no differences between groups at peak exercise (CPET) for heart rate (HR), oxygen consumption (VO2) and minute ventilation (VE). In the CON group, games 2 and 3 (Xbox) and game 3 (Nintendo) increased HR to values similar to the anaerobic threshold (AT), while for the CF group this occurred for games 2 (Xbox) and 3 (Nintendo). As for VO2 and VE, both groups obtained similar responses as compared to AT values in games 2 (Xbox) and 3 (Nintendo). CONCLUSION: The use of VG generated a cardiorespiratory response similar to AT levels found during CPET, indicating that it may be an alternative for exercise training of CF individuals.