Swallowing Safety after Remote sub-total Esophagectomy: How Important is Tongue Pressure?

The factors related to oropharyngeal dysphagia after remote esophagectomy (greater than five months) remain unclear. This study aimed to assess patient perception of dysphagia, maximum anterior isometric pressure (MAIP), maximum posterior isometric pressure (MPIP), lingual swallowing pressure (LSP) and radiographic physiological components of the oral and pharyngeal phases of swallowing in patients who are post remote sub-total esophagectomy (SE). Patient perception of dysphagia was assessed using the Eating Assessment Tool (EAT-10). MAIP, MPIP, and LSP were measured using the Iowa Oral Performance Instrument. Videofluoroscopy was used to assess the physiologic components of swallowing with the Modified Barium Swallow Impairment Profile (MBSImP) and the Penetration-Aspiration Scale (PAS). Ten patients were included in the study (53.2% male; mean age 54.5 ± 18.0). The mean postoperative time was 30 months (range, 5.0-72 months). Seven patients had elevated EAT-10 scores (> 3). All patients demonstrated impaired oropharyngeal swallowing on at least three MBSImP components (range 3-12) and two patients aspirated (PAS 8). There was a significant difference in MAIP values when comparing patients with normal versus impaired laryngeal elevation and epiglottic movement (p < 0.001). MPIP values were significantly different in patients with normal versus impaired epiglottic movement as well as normal versus elevated PAS scores (p < 0.001). Decreased lingual pressure and physiological changes in swallowing coexist after SE. Our results indicate that the decrease in tongue strength may be one of the factors related to unsafe swallow. The assessment of lingual pressure provides diagnostic value and should be incorporated as part of a comprehensive assessment in this population.

Policy evaluation using model over-fitting: the Nordic case.

The interest of this article is to better understand the effects of different public policy alternatives to handle the COVID-19 pandemic. In this work we use the susceptible, infected, recovered (SIR) model to find which of these policies have an actual impact on the dynamic of the spread. Starting with raw data on the number of deceased people in a country, we over-fit our SIR model to find the times ti at which the main parameters, the number of daily contacts and the probability of contagion, require adjustments. For each ti, we go to historic records to find policies and social events that could explain these changes. This approach helps to evaluate events through the eyes of the popular epidemiological SIR model, and to find insights that are hard to recognize in a standard econometric model.

Safety and efficacy of convalescent plasma for severe COVID-19: a randomized, single blinded, parallel, controlled clinical study.

BACKGROUND: Convalescent plasma (CP) has been widely used to treat COVID-19 and is under study. However, the variability in the current clinical trials has averted its wide use in the current pandemic. We aimed to evaluate the safety and efficacy of CP in severe coronavirus disease 2019 (COVID-19) in the early stages of the disease. METHODS: A randomized controlled clinical study was conducted on 101 patients admitted to the hospital with confirmed severe COVID-19. Most participants had less than 14 days from symptoms onset and less than seven days from hospitalization. Fifty patients were assigned to receive CP plus standard therapy (ST), and 51 were assigned to receive ST alone. Participants in the CP arm received two doses of 250 mL each, transfused 24 h apart. All transfused plasma was obtained from "super donors" that fulfilled the following criteria: titers of anti-SARS-CoV-2 S1 IgG ≥ 1:3200 and IgA ≥ 1:800 antibodies. The effect of transfused anti-IFN antibodies and the SARS-CoV-2 variants at the entry of the study on the overall CP efficacy was evaluated. The primary outcomes were the reduction in viral load and the increase in IgG and IgA antibodies at 28 days of follow-up. The per-protocol analysis included 91 patients. RESULTS: An early but transient increase in IgG anti-S1-SARS-CoV-2 antibody levels at day 4 post-transfusion was observed (Estimated difference [ED], - 1.36; 95% CI, - 2.33 to - 0.39; P = 0.04). However, CP was not associated with viral load reduction in any of the points evaluated. Analysis of secondary outcomes revealed that those patients in the CP arm disclosed a shorter time to discharge (ED adjusted for mortality, 3.1 days; 95% CI, 0.20 to 5.94; P = 0.0361) or a reduction of 2 points on the WHO scale when compared with the ST group (HR adjusted for mortality, 1.6; 95% CI, 1.03 to 2.5; P = 0.0376). There were no benefits from CP on the rates of intensive care unit admission (HR, 0.82; 95% CI, 0.35 to 1.9; P = 0.6399), mechanical ventilation (HR, 0.66; 95% CI, 0.25 to 1.7; P = 0.4039), or mortality (HR, 3.2; 95% CI, 0.64 to 16; P = 0.1584). Anti-IFN antibodies and SARS-CoV-2 variants did not influence these results. CONCLUSION: CP was not associated with viral load reduction, despite the early increase in IgG anti-SARS-CoV-2 antibodies. However, CP is safe and could be a therapeutic option to reduce the hospital length of stay. Trial registration NCT04332835.

Temporal signals underlying a cognitive process in the dorsal premotor cortex.

During discrimination between two sequential vibrotactile stimulus patterns, the primate dorsal premotor cortex (DPC) neurons exhibit a complex repertoire of coding dynamics associated with the working memory, comparison, and decision components of this task. In addition, these neurons and neurons with no coding responses show complex strong fluctuations in their firing rate associated with the temporal sequence of task events. Here, to make sense of this temporal complexity, we extracted the temporal signals that were latent in the population. We found a strong link between the individual and population response, suggesting a common neural substrate. Notably, in contrast to coding dynamics, these time-dependent responses were unaffected during error trials. However, in a nondemanding task in which monkeys did not require discrimination for reward, these time-dependent signals were largely reduced and changed. These results suggest that temporal dynamics in DPC reflect the underlying cognitive processes of this task.

The Quantum Geometric Tensor in a Parameter-Dependent Curved Space.

We introduce a quantum geometric tensor in a curved space with a parameter-dependent metric, which contains the quantum metric tensor as the symmetric part and the Berry curvature corresponding to the antisymmetric part. This parameter-dependent metric modifies the usual inner product, which induces modifications in the quantum metric tensor and Berry curvature by adding terms proportional to the derivatives with respect to the parameters of the determinant of the metric. The quantum metric tensor is obtained in two ways: By using the definition of the infinitesimal distance between two states in the parameter-dependent curved space and via the fidelity susceptibility approach. The usual Berry connection acquires an additional term with which the curved inner product converts the Berry connection into an object that transforms as a connection and density of weight one. Finally, we provide three examples in one dimension with a nontrivial metric: an anharmonic oscillator, a Morse-like potential, and a generalized anharmonic oscillator; and one in two dimensions: the coupled anharmonic oscillator in a curved space.

Flow test by the International Dysphagia Diet Standardization Initiative reveals distinct viscosity parameters of three thickening agents.

The International Dysphagia Diet Standardization Initiative (IDDSI) flow test is useful for the global standardization of food consistencies of dysphagia patients. In clinical practice, different compositions of food thickeners are commonly used, directly influencing viscosity parameters and swallowing physiology. We aimed to compare the IDDSI thickness levels, remaining volume in the syringe (RVS), and viscosity parameters of three different food thickeners. As a secondary objective, we compared the cost of preparing 100 mL of thickened drinks using the studied thickeners. Thickeners A (xanthan gum), B (corn starch, tara gum, xanthan gum, and guar gum), and C (corn starch) were prepared in increasing concentrations from 1 to 7 g/100 mL and were assayed in quintuplicate using the IDDSI flow test. Thickeners A, B, and C presented statistically different results for the IDDSI levels, RVS, and viscosity parameters at all concentrations. Thickener A reached higher levels in the IDDSI framework, RVS, and viscosity parameters compared with thickeners B and C. A large range of RVS was observed at different concentrations for thickener B compared with C. Regarding viscosity, thickeners B and C, with corn starch in their composition, showed exponential behavior as concentrations increased, while thickener A presented a linear trend. The thickener composition was significantly influenced by IDDSI classification, RVS, and viscosity parameters. The study shows that xanthan gum thickeners present less variability in IDDSI, RVS, and viscosity compared with starch-based thickeners.

Beta oscillations reflect supramodal information during perceptual judgment.

Previous work on perceptual decision making in the sensorimotor system has shown population dynamics in the beta band, corresponding to the encoding of stimulus properties and the final decision outcome. Here, we asked how oscillatory dynamics in the medial premotor cortex (MPC) contribute to supramodal perceptual decision making. We recorded local field potentials (LFPs) and spikes in two monkeys trained to perform a tactile-acoustic frequency discrimination task, including both unimodal and crossmodal conditions. We studied the role of oscillatory activity as a function of stimulus properties (frequency and sensory modality), as well as decision outcome. We found that beta-band power correlated with relevant stimulus properties: there was a significant modulation by stimulus frequency during the working-memory (WM) retention interval, as well as modulation by stimulus modality-the latter was observed only in the case of a purely unimodal task, where modality information was relevant to prepare for the upcoming second stimulus. Furthermore, we found a significant modulation of beta power during the comparison and decision period, which was predictive of decision outcome. Finally, beta-band spike-field coherence (SFC) matched these LFP observations. In conclusion, we demonstrate that beta power in MPC is reflective of stimulus features in a supramodal, context-dependent manner, and additionally reflects the decision outcome. We propose that these beta modulations are a signature of the recruitment of functional neuronal ensembles, which encode task-relevant information.

Emergence of an abstract categorical code enabling the discrimination of temporally structured tactile stimuli.

The problem of neural coding in perceptual decision making revolves around two fundamental questions: (i) How are the neural representations of sensory stimuli related to perception, and (ii) what attributes of these neural responses are relevant for downstream networks, and how do they influence decision making? We studied these two questions by recording neurons in primary somatosensory (S1) and dorsal premotor (DPC) cortex while trained monkeys reported whether the temporal pattern structure of two sequential vibrotactile stimuli (of equal mean frequency) was the same or different. We found that S1 neurons coded the temporal patterns in a literal way and only during the stimulation periods and did not reflect the monkeys' decisions. In contrast, DPC neurons coded the stimulus patterns as broader categories and signaled them during the working memory, comparison, and decision periods. These results show that the initial sensory representation is transformed into an intermediate, more abstract categorical code that combines past and present information to ultimately generate a perceptually informed choice.

Prevalence and Characterization of Staphylococcus aureus Strains in the Pork Chain Supply in Chile.

The detection of methicillin-resistant Staphylococcus aureus (MRSA) and other emerging strains in meat-producing animals and retail meat has increased the risk of contamination of food. The aim of this study was to determine the prevalence and characterize S. aureus strains isolated from the pork chain supply in Chile. A total of 487 samples were collected: 332 samples from pigs at farms and slaughterhouses (nasal, n = 155; skin, n = 177); 85 samples from carcasses at slaughterhouses; and 70 meat samples at supermarkets and retail stores. The isolation of S. aureus was carried out by selective enrichment and culture media. Biochemical testing (API® Staph) and PCR (detection of the nuc and mecA genes) were used to confirm S. aureus and MRSA strains. The agglutination test was used to determine the protein PBP2'. Enterotoxins (SEA, SEB, SEC, SED) were determined by agglutination test and the se genes by PCR method. Oxacillin and cefoxitin susceptibility testing were carried out using the diffusion method. The overall prevalence of S. aureus in the pork meat supply was 33.9%. A higher prevalence was detected on carcasses (56.5%), in pigs sampled at farms (40.6%) than in pigs sampled at slaughterhouses (23.3%) and in nonpackaged retail meat (43.1%) than packaged retail meat (5.3%) (p ≤ 0.05). No significant differences (p > 0.05) were found between the prevalence in pigs (28.3%) and pork meat (32.9%) and between natural pig farming (33.3%) and conventional production (52.8%). The mecA gene and the protein PBP2' were not detected in S. aureus strains. Two S. aureus strains exhibited oxacillin and cefoxitin resistance, and one S. aureus strain was resistant to cefoxitin. One S. aureus strain isolated from a meat sample was positive for enterotoxin SEB. Although the mecA gene was not detected, oxacillin-resistant and seb-producing S. aureus strains were detected, which represent a risk in the pork chain supply.

Trace element contents in fine particulate matter (PM2.5) in urban school microenvironments near a contaminated beach with mine tailings, Chañaral, Chile.

Air quality in schools is an important public health issue because children spend a considerable part of their daily life in classrooms. Particulate size and chemical composition has been associated with negative health effects. We studied levels of trace element concentrations in fine particulate matter (PM2.5) in indoor versus outdoor school settings from six schools in Chañaral, a coastal city with a beach severely polluted with mine tailings. Concentrations of trace elements were measured on two consecutive days during the summer and winter of 2012 and 2013 and determined using X-ray fluorescence. Source apportionment and element enrichment were measured using principal components analysis and enrichment factors. Trace elements were higher in indoor school spaces, especially in classrooms compared with outdoor environments. The most abundant elements were Na, Cl, S, Ca, Fe, K, Mn, Ti, and Si, associated with earth's crust. Conversely, an extremely high enrichment factor was determined for Cu, Zn, Ni and Cr; heavy metals associated with systemic and carcinogenic risk effects, whose probably origin sources are industrial and mining activities. These results suggest that the main source of trace elements in PM2.5 from these school microenvironments is a mixture of dust contaminated with mine tailings and marine aerosols. Policymakers should prioritize environmental management changes to minimize further environmental damage and its direct impact on the health of children exposed.

Validation of two point-of-care tests against standard lab measures of NO in saliva and in serum.

Nitric oxide (NO) is an endogenous signaling molecule, which plays important roles in cardiometabolic health. A significant source of NO is dietary nitrate (NO3), which is initially metabolized by oral bacteria into nitrite (NO2-) and is subsequently converted into NO once digested in the acidic gastric environment. Inexpensive non-invasive tests for measuring nitrite from saliva have been developed as a means for individuals to monitor their NO bioavailability. However, few studies exist in the literature validating and comparing these products with standard lab assays. The objective of this study was to validate two commonly used commercial strips: Nitric Oxide Test Strips (Berkeley Test) and Nitric Oxide Indicator Strips (Neogenesis) against standard lab measures for saliva and serum nitrite/nitrate. A stratified random sample of 20 non-smoking, overweight or obese participants between 40 to 65 years of age, were selected for this study from the baseline data of the San Juan Overweight Adults Longitudinal Study (SOALS). There was a significant correlation between the measures from the two nitrite-detecting-strips after controlling for the stratification variables (metabolic syndrome, and mouthwash use) (r = 0.75). Measurements from both strips correlated significantly with salivary nitrite levels (r = 0.76 for Berkeley strips; r = 0.59 for Neogenesis). Neither of the strips had a significant correlation with the levels of saliva nitrate, serum nitrite and serum nitrate. In conclusion, commercially available Berkeley and Neogenesis strips provide a reasonable surrogate for salivary, but not for systemic nitrite levels.

Cross-sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis.

AIM: This study assessed the associations of pre-diabetes and insulin resistance with bleeding on probing (BOP) and periodontitis among adults. MATERIALS AND METHODS: We included 1191 Hispanic adults aged 40-65 years, free of diabetes, enrolled in San Juan Overweight Adults Longitudinal Study. Pre-diabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired glycated haemoglobin. Impaired one-hour plasma glucose (1hPG) was defined as levels >155 mg/dl. Insulin resistance was defined using the study population-specific 75th percentile (HOMA-IR ≥ 3.13). High BOP was defined as percentage of teeth with bleeding ≥30%. Periodontitis was defined according to the CDC/AAP definition. RESULTS: After multivariable adjustment for age, gender, education, smoking status, alcohol consumption, physical activity, obesity, HDL-C, and plaque index, pre-diabetes with and without 1hPG, IFG, impaired 1hPG, IGT, and HOMA-IR were significantly associated with high BOP; pre-diabetes, IFG, and impaired 1hPG were significantly associated with severe periodontitis. Most of these associations remained significant when the analyses were restricted to non-smokers. CONCLUSIONS: This study suggests associations between pre-diabetes and insulin resistance with BOP and periodontitis. Given the high prevalence of impaired glucose metabolism and periodontitis, the assessment of the temporal sequence of these associations is of utmost importance.

[Diagnóstico tardío de psoriasis: motivos y consecuencias]. / Late diagnosis of psoriasis: Reasons and consequences.

BACKGROUND: Psoriasis is an autoimmune skin disease that may be associated with articular manifestations, and the most common clinical presentation is the variety "in plaques". In Mexico, in the Centro Dermatológico Pascua, it is the eighth leading cause of consultation. The aim of this study was to determine the diagnostic process of patients in a reference center for diseases of the skin. METHODS: Performing an analytical cross-sectional study that included 100 patients where the diagnostic process was questioned, clinimetric scales were applied and evaluated anthropometric. RESULTS: It was found that 70% of patients had taken over a month to get medical care (median: 3 months; IQR: 11 months), having consulted in 61% to a general physician as a doctor of first contact and 89% being diagnosed by a dermatologist. Eighty-eight percent of the patients were overweight or obese. We found as a factor of delay, a partnership with the variable of having an Institutional Medical Service (p = 0.019; U = 695.5). CONCLUSION: it is necessary to design a system to shorten the diagnostic process, not only in psoriasis, in addition to emphasizing dermatological education.

Lipid-lowering agents use and systemic and oral inflammation in overweight or obese adult Puerto Ricans: the San Juan Overweight Adults Longitudinal Study (SOALS).

UNLABELLED: The effects of lipid-lowering agents (LLA) on reducing systemic and oral inflammation have not been evaluated. OBJECTIVE: To assess the association of LLA use with high-sensitivity C-reactive protein (hs-CRP) and oral inflammation. DESIGN: Cross-sectional analysis using baseline data from 1300 overweight/obese participants aged 40-65 years, recruited for the ongoing San Juan Overweight Adults Longitudinal Study. Serum hs-CRP was measured by ELISA, gingival/periodontal inflammation was evaluated as bleeding upon probing (BOP), and LLA was self-reported. Separate logistic models were performed for systemic and oral inflammation. RESULTS: In all, 24% participants reported history of dyslipidaemia, of which, 50.3% self-reported LLA use. Sixty percent of the participants had elevated hs-CRP (>3 mg/dl) and 50% had high BOP (defined as at or above the median: 21%). After adjusting for age, gender, smoking, HDL-C, physical activity, diabetes, blood pressure medications, and percent body fat composition, LLA users had significantly lower odds of elevated hs-CRP compared to LLA non-users (OR = 0.58; 95% CI: 0.39-0.85). After adjusting for age, gender, smoking status, educational level, mean plaque index and percent body fat, LLA users had significantly lower odds of high BOP compared to LLA non-users (OR = 0.62; 95% CI: 0.42-0.91). CONCLUSIONS: Lipid-lowering agents may reduce both systemic and oral inflammatory responses.

Contribution of Wireless Wi-Fi Intraoral Cameras to the Assessment of Swallowing Safety and Efficiency.

BACKGROUND: Clinical evaluation of swallowing provides important clinical information but is limited in detecting penetration, aspiration, and pharyngeal residue in patients with suspected dysphagia. Although this is an old problem, there remains limited access to low-cost methods to evaluate swallowing safety and efficiency. PURPOSE: The purpose of this technical report is to describe the experience of a single center that recently began using a wireless Wi-Fi intraoral camera for transoral endoscopic procedures as an adjunct to clinical swallowing evaluation. We describe the theoretical structure of this new clinical evaluation proposal. We present descriptive findings on its diagnostic performance in relation to videofluoroscopic swallowing study as the gold standard in a cohort of seven patients with dysphagia following head and neck cancer. We provide quantitative data on intra- and interrater reliability. Furthermore, this report discusses how this technology can be applied in the clinical practice of professionals who treat patients with dysphagia and provides directions for future research. CONCLUSIONS: This preliminary retrospective study suggests that intraoral cameras can reveal the accumulated oropharyngeal secretions and postswallow pharyngolaryngeal residue in patients with suspected dysphagia. Future large-scale studies focusing on validating and exploring this contemporary low-cost technology as part of a clinical swallowing evaluation are warranted.

Timing of CHolecystectomy In Severe PAncreatitis (CHISPA): study protocol for a randomized controlled trial.

Acute pancreatitis is the recurrent reason for gastrointestinal admission in a clinical urgent setting, it happens secondary to a wide array of pathologies out of which biliary disease stands as one of the most frequent causes for its presentation. Approximately 20% of pancreatitis are of moderate or severe severity. Currently, there is not a clear recommendation on timing for cholecystectomy, either early or delayed. CHISPA is a randomized controlled, parallel-group, superior clinical trial. An intention-to-treat analysis will be performed. It seeks to evaluate differences between patients taken to early cholecystectomy during hospital admission (72 hours after randomization) versus delayed cholecystectomy (30±5 days after randomization). The primary endpoint is major complications associated with laparoscopic cholecystectomy defined as a Clavien-Dindo score of over III/V during the first 90 days after the procedure. Secondary endpoints include recurrence of biliary disease, minor complications (Clavien-Dindo score below III/V), days of postoperative hospital stay, and length of stay in an intensive therapy unit postoperatively (if it applies). The CHISPA trial has been designed to demonstrate that delayed laparoscopic cholecystectomy reduces the rate of complications associated to an episode of severe biliary pancreatitis compared to early laparoscopic cholecystectomy.Trial registration number: NCT06113419.

Students' perceptions and experiences of an online well-being programme: a phenomenological study protocol.

BACKGROUND: The pandemic has ensued challenges across all sections of the human population such as livelihood and educational changes, which involve the abrupt shift to online learning, immensely affecting the students' well-being. Negative health consequences of e-learning among students stem from the increased demand for new technological skills, productivity, information overload and restriction of students to spend time with their peers. OBJECTIVE: To explore the experiences of the students from the University of Santo Tomas-College of Rehabilitation Sciences (UST-CRS) who participated in the online well-being programme. METHODOLOGY: A phenomenological design will be used to determine the participants' perceptions and experiences. Purposive sampling will be used to recruit 8-10 undergraduate students from UST-CRS ages 18-22 years, who participated in the well-being programme, and completed the study's quantitative counterpart. Semistructured, in-depth questions will be used to conduct a focus group discussion. The transcripts will be analysed using thematic analysis via the NVivo V.12 software. ETHICS AND DISSEMINATION: The study protocol is approved by the UST-CRS Ethical Review Committee (Protocol Number: SI-2022-034 (V.4)). It will be implemented in accordance with the Declaration of Helsinki and the National Ethical Guidelines for Health and Health-Related Research, and Data Privacy Act. Findings will be published in accredited journals and presented in related scientific fora. REGISTRATION ID: PHRR230214-005419; Philippine Health Research Registry.

Relationship between the polymerization distance of monowave and polywave light-curing units and the irradiance and physical properties of dental resin-based composites.

PURPOSE: To evaluate the influence of the polymerization distance of monowave and polywave light curing units (LCUs) on the measured irradiance relative to the value reported by the manufacturer in relation to the physical properties of resin-based composites (RBCs). METHODS: Four LCUs were used: one monowave and three polywave. The irradiance was measured with a digital radiometer. Depth of cure (DC) and flexural strength (FS) tests were performed according to ISO 4049:2019 at polymerization distances of 0 mm and 5 mm. RESULTS: The irradiance of all LCUs was higher than that reported by the manufacturer (>25-64%). The irradiance of the four LCUs was reduced when polymerization was performed at between 0 to 5 mm (paired t-test, P < 0.001). The DC at 0 mm was similar in all groups but was significantly decreased at 5 mm distance (ANOVA P < 0.001). FS showed differences among the LCUs at 0 mm (ANOVA P < 0.001) and was affected by the polymerization distance. The elastic modulus was unaffected by the LCU used or the distance (ANOVA P > 0.001). CONCLUSIONS: The LCU must be positioned as near as possible to RBCs during the polymerization process, as increased distance negatively affects the depth of cure and flexural strength.

Respiratory support effect on pharyngeal area in patients with amyotrophic lateral sclerosis: A fluoroscopic comparison of NIV, helmet/CPAP, and high-flow nasal cannula.

The global use of noninvasive respiratory support provided by different supportive ventilation delivery methods (SVDMs) has increased, but the impact of these devices on the upper airway structures of patients with amyotrophic lateral sclerosis (ALS) is not known. We aimed to compare the pharyngeal cross-sectional area during spontaneous breathing with four different SVDMs: intranasal masks, oronasal masks, high-flow nasal cannula (HFNC), and helmet in patients with ALS. We compared measures of the pharyngeal area during spontaneous breathing and SVDM use. The greatest increase was observed with intranasal mask use, followed by HFNC, oronasal mask, and helmet respectively. In conclusion, upper airway opening in patients with ALS is enhanced by positive pressure with intranasal masks and HFNC, showing promise for increasing pharyngeal patency. Future studies should explore its applicability and effectiveness in maintaining long-term pharyngeal patency, especially in this population with bulbar weakness.

Perceptions of academic staff and students of senior high school in implementing game-based exercises in physical education classes-a research protocol for a qualitative descriptive study.

BACKGROUND: The COVID-19 pandemic has taken a toll on both physical activity and fitness as several pursuits and activities have been restricted. Coupled with this, increased food intake and sedentary lifestyles have produced poor physical health outcomes. Online physical education classes have been more difficult to conduct given the limitations of the setup. As such, exergaming has been identified as a possible educational tool that could improve students' motivation, participation and fitness levels and reduce negative behaviours in class while contributing to the current curriculum. OBJECTIVES: The study explores the perspectives of both the physical education academic staff and senior high school students from the University of Santo Tomas on the implementation of exergaming to determine the feasibility of exergaming as an educational tool in the Philippines' physical education curriculum. METHODOLOGY: A descriptive qualitative design will be used and participants will be selected through criterion sampling. The authors will conduct a process of question development and pilot FGDs beforehand to ensure smooth proceedings. Once done, they will undergo FGDs conducted through Google Meet. Data will be coded and analysed via thematic analysis using manual coding and NVivo V.12 software to summarise central themes and perceptions. ETHICS AND DISSEMINATION: This study will abide by the Nuremberg Code, Declaration of Helsinki, Belmont Report, Data Privacy Act of 2012 and National Ethical Guidelines (for health-related research) of 2017. The study has received approval from the University of Santo Tomas (UST)-College of Rehabilitation Sciences (CRS) Ethics Review Committee. All participant data will be labelled according to random two-digit computer generated codes to preserve anonymity and stored in password-protected laptops and Google Drive folders to preserve confidentiality. Results will be made available to individual UST physical education academic staff and senior high school students prior to publication in peer-reviewed journal.