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Willinger L, Böhm B, Schweizer F, Reimer LM, Jonas S, Scheller DA, Oberhoffer-Fritz R, Müller J. KIJANI App to Promote Physical Activity in Children and Adolescents: Protocol for a Mixed Method Evaluation. JMIR Res Protoc 2024; 13:e55156. [PMID: 38700911 PMCID: PMC11102032 DOI: 10.2196/55156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The prevalence of physical inactivity among children and adolescents is alarmingly high despite the well-documented and comprehensive benefits of regular physical activity (PA). Therefore, PA promotion should start early in childhood and adolescence. Although reducing recreational screen time in children and adolescents is an urgent concern, digital approaches have the potential to make activity promotion attractive and age appropriate for the target group. KIJANI is a mobile app approach to promote PA in children and adolescents via gamification and augmented reality. OBJECTIVE This study protocol aims to describe the KIJANI intervention in detail, as well as the evaluation approach. METHODS KIJANI is based on the concept that virtual coins can be earned through PA, for example, in the form of a collected step count. With these coins, in turn, blocks can be bought, which can be used to create virtual buildings and integrate them into the player's real-world environment via augmented reality. PA of users is detected via accelerometers integrated into the smartphones. KIJANI can be played at predefined play locations that were comprehensively identified as safe, child-friendly, and attractive for PA by the target group in a partner project. The evaluation process will be divided into 2 different stages. The phase-I evaluation will be a mixed methods approach with one-on-one semistructured interviews and questionnaires to evaluate the user experience and receive feedback from the target group. After the implementation of results and feedback from the target group, the phase-II evaluation will proceed in the form of a 2-arm randomized controlled trial, in which the effectiveness of KIJANI will be assessed via objectively measured PA as well as questionnaires. RESULTS The study received ethical approval from the ethical board of the Technical University of Munich. Participants for the phase-I evaluation are currently being recruited. CONCLUSIONS The study will help to determine the efficacy, applicability, and user experience of a gamified activity promotion application in children and adolescents. Overall, digital health approaches provide easy and wide reachability at low cost and are age appropriate and attractive for the target group of adolescents. Strategies have to be developed to apply digital health approaches in the best possible way for activity promotion. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55156.
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Affiliation(s)
- Laura Willinger
- Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Birgit Böhm
- Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Florian Schweizer
- Department of Informatics, Technical University of Munich, Munich, Germany
| | - Lara Marie Reimer
- Department of Informatics, Technical University of Munich, Munich, Germany
- Department of Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Department of Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Daniel A Scheller
- Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Munich, Germany
| | | | - Jan Müller
- Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
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Li DL, Ding XY, Long J, He QL, Zeng QX, Lu N, Zou MC. Identification of autophagy-related genes in diabetic foot ulcer based on bioinformatic analysis. Int Wound J 2023; 21:e14476. [PMID: 37909396 PMCID: PMC10898398 DOI: 10.1111/iwj.14476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
Diabetic foot ulcer (DFU) complications involve autophagy dysregulation. This study aimed to identify autophagy-related bioindicators in DFU. Differentially expressed genes (DEGs) between DFU and healthy samples were analysed from the Gene Expression Omnibus (GEO) datasets, GSE7014 and GSE29221. The roles of autophagy-related DEGs were investigated using protein-protein interaction (PPI) networks, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, Gene Ontology (GO) enrichment, and Gene Set Enrichment Analysis (GSEA). Immune cell infiltration's correlation with these DEGs was also assessed. From the Human Autophagy Database (HADB), 232 autophagy-related genes (ARGs) were identified, with an intersection of 17 key DEGs between GSE7014 and GSE29221. These genes are involved in pathways like autophagy-animal, NOD-like receptor signalling, and apoptosis. In the protein network, epidermal growth factor receptor (EGFR) and phosphatase and tensin homologue (PTEN) showed significant interactions with ARGs. Survival analysis indicated the prognostic importance of calpain 2 (CAPN2), integrin subunit beta 1 (ITGB1), and vesicle-associated membrane protein 3 (VAMP3). Lower immune scores were observed in the type 2 diabetes mellitus (DM2) group than in controls. Autophagy and ARGs significantly influence DFU pathophysiology.
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Affiliation(s)
- Dong-Ling Li
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xin-Yi Ding
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Juan Long
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiao-Ling He
- Department of Endocrinology, Central Hospital of Zengcheng District, Guangzhou, China
| | - Qing-Xiang Zeng
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Na Lu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Meng-Chen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Xie K. A biomarker and molecular mechanism investigation for thyroid cancer. Cent Eur J Immunol 2023; 48:203-218. [PMID: 37901864 PMCID: PMC10604643 DOI: 10.5114/ceji.2023.132163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/06/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction This study aimed to reveal the potential molecular mechanism associated with thyroid cancer (THCA) prognosis, and investigate promising biomarkers for THCA. Material and methods Differentially expressed genes (DEGs) were compared between THCA samples (THCA group) and normal samples (N group). Then, enrichment analysis and protein-protein interaction (PPI) network analysis were performed, followed by prognostic hub gene exploration from the PPI network. Furthermore, the prognostic and mutation analysis was performed on these hub genes. Finally, the associations of the hub gene with immune cells were investigated. Results A total of 802 DEGs were obtained between the THCA group and the N group. These DEGs were mainly enriched in pathways such as lysine degradation. From the PPI network, 20 hub genes, including CD44, CCND1, SNAI1, and KIT, were investigated. The survival analysis showed that the up-regulation of CD44 and down-regulation of SNAI1 contributed to the favorable and unfavorable outcomes of patients with THCA, respectively. Meanwhile, the diagnostic analysis showed that the AUC of KIT in THCA was larger than 0.9. Furthermore, the gene mutation analysis showed that the alternated CCND1 participated in the cell cycle pathway. Finally, the correlation analysis showed that prognostic genes such as CD44 were positively correlated with immune cells such as M1 macrophages. Conclusions A total of 20 hub genes including CCND1, CD44, SNAI1, and KIT were revealed as potential biomarkers for the differential diagnosis, prognosis, and development of drug targets of THCA. The lysine degradation pathway and cell cycle pathway might take part in the progression of THCA.
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Affiliation(s)
- Keju Xie
- Department of Plastic Surgery, Affiliated Hospital of Shaoxing University (The Shaoxing Municipal Hospital), China
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Willinger L, Oberhoffer-Fritz R, Ewert P, Müller J. Digital Health Nudging to increase physical activity in pediatric patients with congenital heart disease: A randomized controlled trial. Am Heart J 2023; 262:1-9. [PMID: 37030491 DOI: 10.1016/j.ahj.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Digital nudging is a modern e-health approach to increase physical activity (PA) in younger age groups. As activity promotion is particularly important in adolescents with congenital heart disease (CHD) this randomized-controlled trail examines if Digital Health Nudging via daily smartphone messages increases PA, activity-related self-efficacy (ArSE) and health-related quality of life (HrQoL) in adolescents with CHD. METHODS From May 2021 to April 2022, 97 patients (15.1 ± 2.0 years, 50% girls) with moderate or severe CHD were randomly allocated 1:1 to intervention (IG) or control group (CG). Daily PA was objectively assessed in minutes of moderate-to-vigorous PA (MVPA) by the wearable "Garmin Vivofit jr. 2" over the entire study period. The IG received daily smartphone messages based on Bandura's social cognitive theory on the subject of PA over a period of 12-weeks. RESULTS According to the linear mixed model, the change of MVPA over the study period did not significantly differ between IG and CG when taking baseline MVPA into account (b = 0.136, 95%-CI [-0.355; 0.627], P = .587). Activity level was comparably high and showed only minor variability in both groups with 73.7 [62.3; 78.8] min/day in IG and 78.4 [66.6; 93.9] min/d in CG throughout the whole 12-weeks. Emotional well-being significantly increased over the study period in the IG (IG: Δ1.60 [-0.2; 6.3] vs CG: Δ0.0 [-12.5; 6.3], P = .043), but not total HrQoL (P = .518) and ArSE (P = .305). CONCLUSIONS 12-weeks, of Digital Health Nudging did not increase PA, but improved feelings of emotional well-being in adolescents with CHD. TRIAL REGISTRATION Clinical Trials Identifier NCT04933786.
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Affiliation(s)
- Laura Willinger
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany.
| | - Renate Oberhoffer-Fritz
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Jan Müller
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
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Mendonça G, Prazeres Filho A, Crochemore-Silva I, Farias Júnior JCD. Reliability, validity and internal consistency of social support and self-efficacy scales for physical activity in adolescents with 10 to 14 years of age. ACTA ACUST UNITED AC 2021; 40:e2020274. [PMID: 34495275 PMCID: PMC8432148 DOI: 10.1590/1984-0462/2022/40/2020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/29/2020] [Indexed: 12/05/2022]
Abstract
Objective: To analyze the reliability, validity and internal consistency of the physical activity social support (SSS) and self-efficacy (SES) scales among adolescents aged 10–14 years. Methods: The reliability study included 171 adolescents (mean age=12.3±1.0 years, 59.6% female) and validity and consistency study with 1,107 (mean age=12.0±1.0 years, 52.7% female). The SSS had 15 items and the SES eight items. Reliability was determined by Spearman's correlation analysis (rho) and validity and internal consistency by factor analysis (exploratory — EFA and confirmatory — CFA) and the composite reliability (CR), respectively. Results: The reliability of SSS (father: rho=0.80; p<0.001 | mother: rho=0.76; p<0.001 | friends: rho=0.75; p<0.001) and SES (rho=0.72; p<0.001) were considered high. In the EFA, three factors were identified for the SSS (father, mother and friends — five items each) and one factor for SES (five items), confirmed in the CFA. Quality parameters of adjustment in the final models were satisfactory for SSS (chi-square=240.5 [p<0.001]; root mean square residual — RMR=0.05; root mean square error of approximation — RMSEA=0.04 [90%CI 0.04–0.05]; goodness of fit index — GFI=0.97; adjusted goodness of fit index — AGFI=0.96 and comparative fit index — CFI=0.97) and SES (chi-square=5.4 [p=0.07]; RMR=0.01; RMSEA=0.04 [90%CI 0.00–0.08]; GFI=0.99; AGFI=0.99 and CFI=0.97). Internal consistency was considered satisfactory for SSS (CR: father=0.79, mother=0.77, friends=0.78) and low for SES (CR=0.38). Conclusions: The scales showed satisfactory levels of reliability and of construct validity. However, only the SSS showed adequate levels of internal consistency.%
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Affiliation(s)
- Gerfeson Mendonça
- Universidade Federal de Alagoas e Centro Universitário Cesmac, Maceió, AL, Brasil
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Zurita-Ortega F, Lindell-Postigo D, González-Valero G, Puertas-Molero P, Ortiz-Franco M, Muros JJ. Analysis of the psychometric properties of the five-factor self-concept questionnaire (AF-5) in Spanish students during the COVID-19 lockdown. CURRENT PSYCHOLOGY 2021; 42:1-10. [PMID: 34092986 PMCID: PMC8165503 DOI: 10.1007/s12144-021-01856-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 12/04/2022]
Abstract
The present research aims to analyse the psychometric properties of the AF5 questionnaire for its adaptation for use with young people during a lockdown period. Research was conducted with a sample of 534 students aged between 13 and 17 years (M = 14.49; SD = 1.805). Exploratory factor analysis was conducted using the FACTOR program and confirmatory factor analysis was conducted using the M-PLUS 7 program. Results indicate that a four-dimensional model is most appropriate for bringing together the emotional and physical dimensions. Further, 11 items were removed due to poor factor loadings. The majority of factors were directly and positively correlated (99%; p < .01). The data obtained supports conclusions that the AF-5 meets validity and reliability requirements for it to be considered a useful instrument for use with young people during the COVID-19 lockdown period.
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Affiliation(s)
- Félix Zurita-Ortega
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, Campus de Cartuja, s/n 18071, Granada, Spain
| | - David Lindell-Postigo
- Teacher of Novaschool Sunland International, Carretera de Cártama Estación a Pizarra, s/n 29580, Estación de Cártama, Málaga, Spain
| | - Gabriel González-Valero
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, Campus de Cartuja, s/n 18071, Granada, Spain
| | - Pilar Puertas-Molero
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, Campus de Cartuja, s/n 18071, Granada, Spain
| | - Manuel Ortiz-Franco
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, Campus de Cartuja, s/n 18071, Granada, Spain
| | - José Joaquín Muros
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, Campus de Cartuja, s/n 18071, Granada, Spain
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Bachner J, Sturm DJ, García-Massó X, Molina-García J, Demetriou Y. Physical Activity-Related Profiles of Female Sixth-Graders Regarding Motivational Psychosocial Variables: A Cluster Analysis Within the CReActivity Project. Front Psychol 2020; 11:580563. [PMID: 33262728 PMCID: PMC7686241 DOI: 10.3389/fpsyg.2020.580563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Adolescents' physical activity (PA) behavior can be driven by several psychosocial determinants at the same time. Most analyses use a variable-based approach that examines relations between PA-related determinants and PA behavior on the between-person level. Using this approach, possible coexistences of different psychosocial determinants within one person cannot be examined. Therefore, by applying a person-oriented approach, this study examined (a) which profiles regarding PA-related psychosocial variables typically occur in female sixth-graders, (b) if these profiles deliver a self-consistent picture according to theoretical assumptions, and (c) if the profiles contribute to the explanation of PA. Materials and Methods The sample comprised 475 female sixth-graders. Seventeen PA-related variables were assessed: support for autonomy, competence and relatedness in PE as well as their satisfaction in PE and leisure-time; behavioral regulation of exercise (five subscales); self-efficacy and social support from friends and family (two subscales). Moderate-to-vigorous PA was measured using accelerometers. Data were analyzed using the self-organizing maps (SOM) analysis, a cluster analysis including an unsupervised algorithm for non-linear models. Results According to the respective level of psychosocial resources, a positive, a medium and a negative cluster were identified. This superordinate cluster solution represented a self-consistent picture that was in line with theoretical assumptions. The three-cluster solution contributed to the explanation of PA behavior, with the positive cluster accumulating an average of 6 min more moderate-to-vigorous PA per day than the medium cluster and 10 min more than the negative cluster. Additionally, SOM detected a subgroup within the positive cluster that benefited from a specific combination of intrinsic and external regulations with regard to PA. Discussion The results underline the relevance of the assessed psychosocial determinants of PA behavior in female sixth-graders. The results further indicate that the different psychosocial resources within a given person do not develop independently of one another, which supports the use of a person-oriented approach. In addition, the SOM analysis identified subgroups with specific characteristics, which would have remained undetected using variable-based approaches. Thus, this approach offers the possibility to reduce data complexity without overlooking subgroups with special demands that go beyond the superordinate cluster solution.
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Affiliation(s)
- Joachim Bachner
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - David J Sturm
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain.,AFIPS Research Group, University of Valencia, Valencia, Spain
| | - Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain.,AFIPS Research Group, University of Valencia, Valencia, Spain
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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