Competitive organized electronic video gaming, termed "esports," has become an international industry. The physiological and cognitive health results of prolonged esport practice and competition have not been adequately studied. The current study examined physiological and cognitive changes after a session of esport gameplay for two types of games, first-person shooter and multiplayer online battle arena games. Increases in systolic blood pressure, increases in speed, and decreases in accuracy and inhibitory processes were found for esport gamers overall. For peak heart rate change, first-person shooter games elicited a larger change than did multiplayer online battle arena games. These results have implications for the management of esport player cognitive and physical health as well as for the optimization of performance in competitive esport tournaments.

ObjectiveThe effect of prolonged sitting on executive function and performance in competitive esports players are unknown. This study aimed to evaluate executive function following a 6 min bout of walking or rest during prolonged gaming in competitive esports players.Methods12 men and 9 women completed three separate 2-hour gaming session days assigned in randomised order consisting of a 6 min walk break, 6 min rest break and continuous before and after each session. Postintervention participant exit survey data were also collected.ResultsThe walk condition produced a significantly faster mean solution time (7613.6±3060.5 min, p=0.02) and planning time (5369.0±2802.09, p=0.04) compared with the resting condition (9477±3547.4; 6924±3247.7) and continuous play (8200.0±3031.6; 5862.7±2860.7). The rest condition resulted in the slowest mean solution time (9477.0±3547.4) and planning time (6924.0±3247.7), with the continuous play resulting in a faster mean solution time (8200.1±3031.6) and planning time (5862.7±2860.7) than the rest condition. There was no impact on game performance in any of the conditions. However, over 70% of participants felt that the walk break improved esports performance.ConclusionsReducing sit time and breaking up prolonged sitting have acute and chronic health benefits. This study provides evidence that a 6 min walking break in the middle of 2 hours of gameplay allows gamers to have these health benefits while improving processing speed and executive function.Trial registration numberNCT04674436.

Sacral neuromodulation (SNM) and onabotulinumtoxinA (BONT/A) are well-established treatments for refractory overactive bladder (OAB) syndrome. SNM inhibits urination by stimulating the sacral portion of the spinal court, and BONT/A inhibits acetylcholine by causing detrusor muscle paralysis. Both have been shown to be effective; however, their costeffectiveness is unclear. The aim of this study is to determine which of these treatments-SNM or BONT/A-is more cost-effective in treating OAB.This was a systematic review of the medical literature, using PubMed Medline, EMBASE, Web of Science, Cochrane, and ClinicalTrails.gov, to identify eligible studies. Included were studies that analyzed the cost-effectiveness and cost-utility of SNM versus BONT/A in adult women with nonneurogenic refractory OAB through modeled data or results of randomized controlled trials. Incremental cost-effectiveness ratios (ICERs) were reported as quality-adjusted life years (QALYs).A total of 5 studies were included in this analysis. In 3 studies, ICERs between SNM and BONT/A were reported as primary outcomes; in the other 2 studies, ICERs were calculated based on data. Of the 5 studies, 2 moderate-quality studies favored SNM over BONT/A for cost-effectiveness at the 10-year time horizon (range, $3717/QALY to €15,226/QALY). The remaining 3 studies-all rated as high quality-favored BONT/A versus SNM. Of these 3 studies, one suggested BONT/A would be dominant because SNM was not cost-effective with an ICER of $116,427 at 2 years. Another study favored BONT/