Electronic gaming has recently been reported as a precipitant of life-threatening cardiac arrhythmia in susceptible individuals.
The purpose of this study was to describe the population at risk, the nature of cardiac events, and the type of game linked to cardiac arrhythmia associated with electronic gaming.
A multisite international case series of suspected or proven cardiac arrhythmia during electronic gaming in children and a systematic review of the literature were performed.
Twenty-two patients (18 in the case series and 4 via systematic review; aged 7-16 years; 19 males [86%]) were identified as having experienced suspected or proven ventricular arrhythmia during electronic gaming; 6 (27%) had experienced cardiac arrest, and 4 (18%) died suddenly. A proarrhythmic cardiac diagnosis was known in 7 (31%) patients before their gaming event and was established afterward in 12 (54%). Ten patients (45%) had catecholaminergic polymorphic ventricular tachycardia, 4 (18%) had long QT syndrome, 2 (9%) were post-congenital cardiac surgery, 2 (9%) had \"idiopathic\" ventricular fibrillation, and 1 (after Kawasaki disease) had coronary ischemia. In 3 patients (14%), including 2 who died, the diagnosis remains unknown. In 13 (59%) patients for whom the electronic game details were known, 8 (62%) were war games.
Electronic gaming can precipitate lethal cardiac arrhythmias in susceptible children. The incidence appears to be low, but syncope in this setting should be investigated thoroughly. In children with proarrhythmic cardiac conditions, electronic war games in particular are a potent arrhythmic trigger.

暂无摘要。

Recently, electronic gaming has been reported as a precipitant of life-threatening cardiac arrhythmias in susceptible individuals. However, the prevalence of cardiac events in genetic heart diseases (GHDs) in the setting of electronic gaming has not been established.
In this study, we sought to define the prevalence of cardiac events occurring in the setting of electronic gaming in GHDs.
Retrospective review of all patients evaluated and treated at Mayo Clinic\'s genetic heart rhythm clinic from July 2000 to November 2022 was performed to identify patients with a history of playing electronic games at the time of their cardiac event. Cardiac event was used to define events occurring before diagnosis, and breakthrough cardiac event (BCE) was used for events occurring after diagnosis.
Of the 3,370 patients with a GHD (mean age at first evaluation 27 ± 19 years, 55% female), 1,079 (32%) had a cardiac event before diagnosis, with 5 patients (0.5%) having an electronic gaming-associated event (3 catecholaminergic polymorphic ventricular tachycardia, 1 long QT syndrome, and 1 premature ventricular contraction-triggered ventricular fibrillation). After diagnosis and treatment, 431 patients (13%) experienced ≥1 BCE during follow-up, of which 1 electronic gaming-associated BCE (0.2%) occurred in a patient with catecholamine-sensitive right outflow tract ventricular tachycardia.
Although anecdotal cases of electronic gaming-associated life-threatening arrhythmias have been reported, in this largest single-center study to date, we show that these are extremely rare occurrences. While electronic gaming can have adverse health consequences, the threat of electronic gaming-triggered sudden death should not be used to try to curb time spent gaming.

The dominant position of esports game publishers is a fundamental difference between the systemic governance of esports and traditional sports. There are no such equivalent organizations in traditional sports. As for-profit corporations, the publishers develop and market the electronic games as their commercial products and thus, possess exclusive property rights. Publishers control the virtual sporting environment and the rules of the game. In conventional sports, by contrast, non-profit associations administer their sports with the core task of developing the sport by regulations, playing rules, and licensing. There are, however, esports associations which resemble traditional leagues and national governing bodies. Given this, we explore how esports associations pursue legitimacy. This study is empirically motivated by the recent emergence of two esports associations in the insightful case of Germany and examines the pursuit of legitimacy by the World Esports Association (WESA) and the eSport-Bund Deutschland e.V. (ESBD). The study is based on a content analysis of 55 documents and nine interviews with relevant stakeholders. The findings show that the esports associations rely on conformance and manipulation strategies by transferring existing structures from traditional sports to esports. The most effective practices are lobbying for social and public acceptance of esports and creating supportive networks for esports development. While publishers possess an undisputed and taken-for-granted legitimacy based on their product property rights, esports associations struggle for recognition and acceptance. They may still have a long way to go, given that established associations in conventional sports have a history for decades. Yet, esports associations need to accept publisher dominance. Thus, they can only claim partial legitimacy within the esports ecosystem by targeting segments of stakeholders. Management, policy and theoretical implications of this key insight are finally presented.

OBJECTIVE: Prolonged screen time (ST) is a potential concern for poor wellbeing. This study aimed to examine the associations of different types of ST with life satisfaction among adolescents.
METHODS: Data were from 380,446 adolescents (aged 11-15 years, 51% girls) across 37 European and North American countries who completed the 2010 and 2014 Health Behaviour in School-Aged Children surveys. Participants reported h/day during free time spent on television, electronic games, and computer/other devices. Life satisfaction was assessed using a 10-point scale (low life satisfaction ⩽5).
RESULTS: Generalized additive modelling showed non-linear associations for each ST type, with low life satisfaction increasing monotonically for >1 h/day of electronic gaming or computer/other device and >2 h/day of watching television. Multilevel multivariable modelling showed that >4 h/day of watching television was associated with 26% higher odds for boys (OR 1.26; 95% CI:1.21-1.32) and 52% higher odds for girls (1.52; 1.46-1.59) of low life satisfaction than for ⩽1 h/day of television. Electronic gaming >4 h/day was associated with low life satisfaction with odds 42% higher in boys (1.42, 1.36-1.48) and 69% higher in girls (1.69, 1.61-1.76). A similar association was found for >4 h/day of computer/other device for boys (1.43, 1.37-1.49) and girls (1.71, 1.65-1.77).
CONCLUSIONS: Low levels of ST may be beneficial; however, prolonged periods are associated with low life satisfaction among adolescents, in particular among girls. Results support ⩽2 h/day restriction of ST and highlight research is needed to understand underlying mechanisms of ST and wellbeing, which may not reflect active versus passive content.

Physical and psychological effects of playing computer games cannot be ignored. Electronic games are considered to be an influential factor in growth, personality development, and positive sociability of children, and game duration has been associated with increased aggression, reduced mental health, and higher BMI. The aim of the present study was to explore the relationship between electronic gaming and health, social relationships, and physical activity among males aged 16-18 years in Saudi Arabia. An online survey designed by the authors containing 60 items and divided into 5 sections was used during one school semester. The sample was selected randomly from 30 high schools; 90 students were selected from each school, with 30 chosen from each of grades 9, 10, and 11. Respondents were 194 male students, aged 17.23 ± 1.52 years. The questionnaire was presented to six experts to assess validity, with Cronbach\'s α established at 0.87. Results showed that playing electronic games had a negative relation with health, social relationships, and physical activity among males. The most negative significant was the correlation between electronic games and physical activity (r = -.49), followed by that with social relationships (r = -.42) and BMI (r = -.31) . The lowest result was for health (r = .20). More empirical investigations are needed to explore deeper effects of electronic gaming on various groups in Saudi society, including the general population, employees, and different categories of school and university students.

BACKGROUND: Researchers and therapists have increasingly turned to digital games for new forms of treatments and interventions for people suffering from a variety of mental health issues. Yet, the depiction of mental illness within digital games typically promotes stigmatized versions of those with mental health concerns. Recently, more games have attempted to implement more realistic and respectful depictions of mental health conditions.
OBJECTIVE: This paper presents an exploratory analysis of a contemporary game that has the potential to change the way researchers, practitioners, and game designers approach topics of mental health within the context of gaming.
METHODS: A case study of Hellblade: Senua\'s Sacrifice was conducted using frame analysis to show how key design choices for this game present the potential for new ways of approaching games and mental health.
RESULTS: A case study of Hellblade\'s development shows how research-informed collaborative design with mental health practitioners, scientists, and individuals with mental health problems can lead to a realistic depiction of mental illness in games. Furthermore, the use of frame analysis demonstrates how to harness narrative, mechanics, and technology to create embodied experiences of mental health, which has the potential to promote empathetic understanding.
CONCLUSIONS: This paper highlights an exemplary case of collaborative commercial game design for entertainment purposes in relation to mental health. Understanding the success of Hellblade\'s depiction of psychosis can improve serious games research and design. Further research must continue to provide deeper analysis of not only games that depict mental illness, but also the design process behind them.

Adolescents spend a substantial and increasing amount of time using digital media (smartphones, computers, social media, gaming, Internet), but existing studies do not agree on whether time spent on digital media is associated with lower psychological well-being (including happiness, general well-being, and indicators of low well-being such as depression, suicidal ideation, and suicide attempts). Across three large surveys of adolescents in two countries (n = 221,096), light users (<1 h a day) of digital media reported substantially higher psychological well-being than heavy users (5+ hours a day). Datasets initially presented as supporting opposite conclusions produced similar effect sizes when analyzed using the same strategy. Heavy users (vs. light) of digital media were 48% to 171% more likely to be unhappy, to be in low in well-being, or to have suicide risk factors such as depression, suicidal ideation, or past suicide attempts. Heavy users (vs. light) were twice as likely to report having attempted suicide. Light users (rather than non- or moderate users) were highest in well-being, and for most digital media use the largest drop in well-being occurred between moderate use and heavy use. The limitations of using percent variance explained as a gauge of practical impact are discussed.

BACKGROUND: Video and hobby gaming are immensely popular among adults; however, associations between gaming and health have primarily been investigated in children and adolescents. Furthermore, most research has focused on electronic gaming, despite traditional hobby gaming gaining prominence.
OBJECTIVE: To determine whether the number of platforms used, platform preference, and gaming time are associated with obesity, physical activity, sedentary behavior, and cardiovascular risk factors in an adult gaming population.
METHODS: We conducted a cross-sectional analysis using data obtained from 292 participants who attended a large Midwestern gaming convention. We collected data using a computer-based questionnaire that comprised questions on gaming behavior, demographics, physical activity (using the International Physical Activity Questionnaire), and health characteristics. In addition, we used multivariable-adjusted linear and logistic regression to model health outcomes as a function of the number of platforms used, platform preference, and weekday and weekend gaming time quartile.
RESULTS: After adjusting for covariates, we observed a significant linear trend for increasing odds of being obese and higher weekend sitting time by the number of platforms used (P=.03 for both). The platform preference and weekend gaming time quartile exhibited significant associations with odds of meeting physical activity recommendations (P=.047 and P=.03, respectively). In addition, we observed higher odds of being obese among those reporting that they sat most or all of the time while gaming [odds ratio (OR) 2.69 (95% CI 1.14-6.31) and OR 2.71 (95% CI 1.06-6.93), respectively].
CONCLUSIONS: In adult gamers, the number of platforms used, which platforms they prefer to play on, and the amount of time spent gaming on weekends could have significant implications for their odds of being obese and meeting physical activity recommendations.

Concerns have been raised of a potential connection between excessive online activity outside the academic realm and increased levels of psychological distress in young people. Young Minds Matter: the second Australian Child and Adolescent Survey of Mental Health and Wellbeing provides estimates of the prevalence of online activity and allows an exploration of associations between this activity, a range of mental disorders, socio-demographic characteristics and risk taking behaviour.
Based on a randomized nationally representative sample, a household survey of mental health and wellbeing (Young Minds Matter) was conducted in 2013-14. Interviews were conducted with 6,310 parents and carers of 4-17 year-olds (55 % response rate), together with self-report questionnaires completed by 2,967 11-17 year-olds in these households (89 % response rate). The survey identified a range of mental disorders and emotional problems using a variety of diagnostic tools, with the self-report including questions about use of the Internet and electronic games. Five behaviours were measured related to this activity, with \'problem behaviour\' being defined as exhibiting at least four out of five behaviours.
Levels of Internet use (98.9 %, CI 98.5-99.3 %) and electronic gaming (85.3 %, CI 83.9-86.6 %) were high, and 3.9 % (CI 3.2-4.6 %) of young people reported problem behaviour. The proportion of girls with very high levels of psychological distress and problem behaviour (41.8 %,CI 28.8-54.9 %) was twice that for boys (19.4 %, CI 7.7-31.1 %). Those engaging with a range of risk factors reported higher prevalence of problem behaviour than others. Youth who suffered from emotional problems or high levels of psychological distress spent the most time online or playing games. Multivariate analysis showed associations with problem behaviour and having attempted suicide, experiencing high to very high levels of psychological distress, using alcohol, and living in a poorly functioning family. It was not possible to determine the direction of the associations.
There are links between problem behaviours associated with Internet use and electronic gaming, and mental disorders and risk-taking behaviour in young people. Further studies are required to determine whether these are precursors or sequelae.