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Received — 28 September 2025 ⏭ Favourites

The Impact of Digital Health Interventions on Psychological Health, Self-Efficacy, and Quality of Life in Patients With End-Stage Kidney Disease: Systematic Review and Meta-Analysis

✇Journal of Medical Internet Research
By: Jiayi Zhu · Jianfei Xie · Yating Luo · Xiaoqian Dong · Zitong Lu · Huiyi Zhang · Jingying Wang · Min Liu · Andy SK Cheng
27 September 2025 at 00:00
Background: End-stage kidney disease (ESKD) imposes a significant global health burden, with patients often experiencing poor quality of life (QoL) due to psychological distress and low self-efficacy. Digital health interventions (DHIs) offer potential to address these challenges. However, their effects in this population remain inconsistent, and a comprehensive synthesis of the evidence is lacking. Objective: To assess the impact of DHIs on the psychological health, self-efficacy, and QoL of ESKD patients, and to evaluate engagement, adherence and satisfaction with these interventions. Methods: A comprehensive search was conducted across six electronic databases (PubMed, Web of Science, Cochrane Library, PsycINFO, Embase, and CINAHL) up to January 21, 2025. Randomized controlled trials (RCTs) examining DHIs effects on psychological health, self-efficacy, or QoL in ESKD patients were included. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the RoB 2 tool. Meta-analysis was performed using Review Manager 5.4, with subgroup analyses by treatment modality, intervention type, and duration. Evidence quality was assessed using the GRADE approach. Results: 23 RCTs involving 2407 ESKD patients from 12 countries were included. DHIs significantly improved depression (SMD: -0.41, 95% CI: [-0.63, -0.19], P=.003) and overall QoL (SMD: 0.55, 95% CI: [0.07, 1.03], P=.03). While DHIs did not significantly improve overall self-efficacy (SMD: 0.56, 95% CI: [-0.06, 1.18], P=.08), a benefit was observed in hemodialysis patients (SMD: 0.59, 95% CI: [0.34, 0.83], P<.001 engagement was favorable with completion rates above adherence of and generally positive patient feedback on dhis. application-based interventions improved self-efficacy ci: p overall qol telemedicine depression video-based due to high heterogeneity risk bias evidence quality rated as low for moderate general anxiety very stress self-efficacy. conclusions: dhis can significantly improve the psychological health eskd patients particularly when tailored needs delivered through interactive platforms such applications telemedicine. suggest good acceptability in clinical practice. however warrants cautious interpretation. future research should involve more high-quality rcts design that address unique elderly peritoneal dialysis kidney transplant recipients. trial: prospero crd42024629357 https:>
Received — 10 January 2025 ⏭ Favourites

Global trends and risk factors in gastric cancer: a comprehensive analysis of the Global Burden of Disease Study 2021 and multi-omics data

✇(Multiomics OR Omics) AND (Lung OR gastric OR Hepatocellular)
By: Liqun Zhang · Qian Dong · Yuanhe Wang · Xiaoxi Li · Chunning Li · Fang Li · Jingdong Zhang
9 January 2025 at 19:00

Int J Med Sci. 2025 Jan 1;22(2):341-356. doi: 10.7150/ijms.104437. eCollection 2025.

ABSTRACT

Background: Gastric cancer (GC) remains a significant global health challenge. This study aimed to comprehensively analyze GC epidemiology and risk factors to inform prevention and intervention strategies. Methods: We analyzed the Global Burden of Disease Study 2021 data, conducted 16 different machine learning (ML) models of NHANES data, performed Mendelian randomization (MR) studies on disease phenotypes, dietary preferences, microbiome, blood-based markers, and integrated differential gene expression and expression quantitative trait loci (eQTL) data from multiple cohorts to identify factors associated with GC risk. Results: Global age-standardized disability-adjusted life year rates (ASDR) for GC declined from 886.24 to 358.42 per 100,000 population between 1990 and 2030, with significant regional disparities. Despite this decline, total disability-adjusted life years show a concerning upward trend from 2015, rising from approximately 22.9 million to a projected 24.3 million by 2030. The slope index of inequality shifted from 87 in 1990 to -184 in 2021, indicating a reversal in GC burden distribution, with higher ASDR now associated with lower socio-demographic index countries. The ML models analysis identified higher levels of clinical characteristics such as phosphorus, calcium, eosinophils percent, and triglycerides, as well as lower levels of iron and monocyte percent, may be associated with an increased risk of GC. MR analyses revealed causal associations between GC risk and disease phenotypes such as Helicobacter pylori infection, chronic gastritis, obesity, depression, and dietary preferences such as dairy and processed meats. Gut microbiome analysis showed associations with microbiome such as Phascolarctobacterium and Ruminococcaceae species. Blood-based markers analysis identified protective and risk effects for cortisol, glutamate, nicotinamide, Natural Killer %lymphocyte, CD4-CD8- T cell Absolute Count, Phosphatidylcholine (16:0_18:1), and Interleukin-1-alpha. Integrated genomic analysis identified 10 genes significantly associated with GC risk, with strong evidence for colocalization in genes such as CCR6 and PILRB. Conclusions: This systematic analysis reveals complex global trends in GC burden and identifies novel clinical, disease phenotypes, dietary preferences, microbial, blood-based, and genetic risk factors. These findings provide potential targets for improved risk stratification, prevention, and intervention strategies to reduce the global burden of GC.

PMID:39781526 | PMC:PMC11704698 | DOI:10.7150/ijms.104437

Received — 24 December 2024 ⏭ Favourites
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