The effect of video games, exergames and board games on executive functions in kindergarten and 2nd grade: An explorative longitudinal study

We examined the relation between different kinds of play behavior (video games, exergames, board games) in kindergarten (T1) and components of executive function (EF; inhibition, switching, verbal and visuospatial updating) in kindergarten and second grade (T1 and T2). Ninety-seven children participated in this longitudinal study. Parents were asked to complete a questionnaire regarding children's play behavior, reporting frequency, duration, and game type. The results indicate that play behavior is associated with EF development in children; however, only exergames, electronic puzzle games, and board games predicted EF at T2. Additionally, the time spent on electronic games was negatively related to visuospatial updating at T1 but did not predict EF at T2. The results support further investigation of a potential link between board game and exergame play behavior and EF development

Inverse photoemission from electronic surface states: intensity, angular and polarization dependence

SIGLEITItal

In-hospital outcome in octogenarians with acute coronary syndrome undergoing invasive coronary procedures

Background: Limited data are available in octogenarian patients, and most of these studies excluded older patients with significant co morbid conditions. This is an observational study of octogenarians admitted for acute coronary syndrome (ACS). Purpose: We sought to investigate clinical characteristics, treatment and outcome of octogenarian patients during hospital stay for ACS in transitional country. Methods: Data were collected in the ISACS-TC registry (ClinicalTrials.gov,NCT01218776) from October 2010 to February 2015: there were 992 patients ≥80 years old, consecutive admitted with a diagnosis of ACS at 58 hospitals in 11 Eastern European countries. Patients who had undergone fibrinolysis and coronary artery bypass grafting (CABG), were also excluded. In-hospital mortality was the primary end-point. Results: Octogenarian patients represent 7.5% of ISACS-CT population. Among these, 56.7% were admitted with a diagnosis of ST segment elevation myocardial infarction (STEMI). The mean age of the study population was 83.5±3.5 years and 51.6% of the patients were women. Female, less frequently than male, had history of myocardial infarction, peripheral artery disease (PAD), prior CABG and chronic kidney disease. They were less likely to have smoking and former smoking status. There was no difference in the rates of death between male (18.5%) and female (19.2%) patients. Octogenarian patients undergoing invasive coronary procedures had significantly lower rate of death (12.5% vs 22.2 P<0.001). In multivariable regression analysis, cardiovascular death in the octogenarians was associated (p<0.05) with age ≥85 years (odds ratio [OR] 1.82), prior PAD (OR: 4.92) and Killip class ≥2 (OR 4.41). Invasive coronary procedures was an independent significant protective factor on hospital mortality (OR 0.43). Conclusions: Octogenarian ACS patients have a high mortality rate which can be reduced by invasive coronary procedures. Age is relevant in the prognosis of ACS, but its importance should be considered not secondary to other clinical factors

Acute coronary syndromes without typical chest pain: the role of comorbidities

Background: Not all patients exhibit the classic symptoms of chest pain. Patients who present with acute coronary syndrome (ACS) without typical chest pain have a very high in-hospital mortality. Purpose: To investigate the impact of atypical symptoms on management and outcomes of ACS patients. Methods: Between 2010 and 2016, 11458 ACS patients were admitted at 57 hospitals included in the network of the ISACS-TC registry (ClinicalTrials.gov, NCT01218776). Of these patients 8.7% did not have typical chest pain at the initial evaluation. Results: More women (10.5%) than men (7.8%) exhibit ACS without typical presentation. ACS patients with atypical presentation were older (67.8\ub112.2 vs 62.9\ub112.1, p<0.001). Patients with comorbidities were not equally distributed: 38.7% were with typical presentation and 55.2% without typical presentation, (p<0.001). The probability of having ACS without typical presentation was greater as the number of comorbidities increased (OR: 1.64 for one comorbid; OR: 2.52 for two comorbidities; and OR: 4.57 for three or more comorbidities). Stepwise logistic analysis showed that the absence of ST elevation (OR 2.98), Killip class 652 (OR 2.12, history of stroke (OR 1.78), peripheral artery disease (OR 1.68), chronic kidney disease (OR 1. 56), diabetes mellitus (OR 1.36), age (OR 1.02 per year) were all independent predictors of ACS without typical presentation. Conversely smoking habit (OR 0.75) and hypercholesterolemia (OR 0.72) had protective effect (p<0.01). In-hospital mortality rate was much higher in patients without typical presentation than in patients with the typical presentation (15.5% versus 6.3%, p<0.001). The presence of atypical presentation increased the risk of death either in non ST segment elevation acute coronary syndrome (NSTE-ACS) (OR 2.57, 95% CI 1.91\u20133.47) or ST segment elevation myocardial infarction (STEMI) patients (OR 3.48, 95% CI 2.70\u20134.49). The presence of comorbidities was also independently associated with an increased risk of death, both in NSTE ACS (OR 2.24, 95% CI 1.70\u20132.93) and in STEMI (OR 2.22, 95% CI 1.56\u20132.63) patients. Conclusions: Patients with ACS who present without typical chest pain are at increased risk of dying. Atypical presentation is frequently found in patients with comorbidities. The unfavorable outcomes of ACS without chest pain may be partly attributable to concomitant diseases

Atypical presentation and comorbidities mutually influence management of ACS patients

Background: Limited data are available on the association between comorbidities and acute myocardial ischemia with atypical presentation. Purpose: The aim of this study was to investigate the impact of comorbidities on the management and outcomes of ACS patients with atypical presentation (i.e. ACS without chest pain). Methods: Between 2010 and 2016, 11458 ACS patients were admitted at 57 hospitals included in the network of the ISACS-TC registry (ClinicalTrials.gov, NCT01218776). There were 1394 (12.2%) patients with unstable angina, 2855 (24.9%) with NSTEMI, and 7203 (62.9%) with STEMI. Results: 995 (8.7%) ACS patients have atypical presentation at the initial evaluation, and the 40.2% of the overall study population have comorbidities (diabetes mellitus, heart failure, CKD, COPD, stroke, PAD, GERD or active cancer). Patients with comorbidities were not equally distributed: 38.7% were with typical presentation and 55.2% without typical presentation, (p<0.001). In-hospital mortality rate was much higher in patients with atypical presentation than in patients with the typical one (15.5% vs 6.3%, p<0.001). As well, mortality rate was lower for ACS patients with no-comorbidities than for ACS patients with comorbidities (5.1% versus 10.1%, p<0.001). Stratifying the population by the presence/absence of comorbiditis and the presence/absence typical presentation, we found a decreasing trend in use of evidence base treatment (aspirin, beta-blocker, statin and reperfusion) and invasive procedure. Compare to patients with typical presentation and no-comorbidities (OR: 1, referent), patients with typical presentation and comorbidities (OR: 0.70), as well as those with atypical presentation and no-comorbidities (OR: 0.23), and those with atypical presentation and comorbidities (OR: 0.18) had a significant (p<0.001) lower probability to undergo in-hospital cardiac catheterization. On the opposite, there was an increasing trend (p<0.001) over subgroups in the risk of death (OR:1 referent, typical ACS presentation and no-comorbid; OR:2.00 typical ACS presentation and comordidities; OR: 2.52 atypical ACS presentation and no-comorbid; OR: 4.83 atypical ACS presentation and comordidities). Conclusions: The presence of comorbidities and atypical ACS presentation dramatically influence the process of care. Patients with atypical presentation and comorbidities are those who receive the lowest treatment and those who have the highest risk of in-hospital death