ObjectiveThis systematic review aimed to identify and synthesize the scientific evidence on entrepreneurship in digital health in Latin America. Specifically, it sought to characterize the available evidence, identify the countries and types of digital health entrepreneurship investigated, examine the principal challenges and barriers, and synthesize the conclusions and lessons learned reported in the literature.MethodsThe review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A systematic search was conducted in Scopus on August 20, 2026, without publication-year restrictions. The search combined terms related to entrepreneurship, digital health, and innovation. Studies addressing entrepreneurial activities or initiatives associated with digital health in Latin America were considered eligible. The geographic scope was determined using the OECD classification of Latin American countries. Two research groups independently conducted the screening process. Evidence was synthesized qualitatively because of substantial heterogeneity in countries, technologies, entrepreneurial initiatives, and study contexts.ResultsThe search identified 417 records, of which 17 remained after applying the geographic criterion. Thirteen full-text articles were retrieved and assessed for eligibility, and 10 studies were included in the final synthesis. Evidence was strongly concentrated in Brazil, with limited representation from other Latin American countries. The studies examined diverse forms of entrepreneurship, including startups, corporate innovation, business models, technological initiatives, and multisectoral collaborations. Major challenges included inadequate infrastructure and connectivity, cybersecurity, interoperability, regulatory barriers, limited financial resources, shortages of skilled personnel, organizational resistance, digital literacy, and user trust.ConclusionDigital health entrepreneurship in Latin America is an emerging and heterogeneous field. Its development requires coordinated technological, organizational, regulatory, financial, and social conditions. Further research should address underrepresented countries and evaluate long-term sustainability, scalability, economic performance, healthcare outcomes, and regulatory determinants.
BackgroundDigital health tools are increasingly integrated into long-term transplant follow-up, but their value depends on patients' ability to find, understand, appraise, and use electronic health information. Evidence on eHealth literacy and its behavioral context among liver transplant recipients remains limited, particularly in China.MethodsA cross-sectional study was conducted from February to March 2026 among 126 adult liver transplant recipients at West China Hospital, Sichuan University. Participants completed a general information questionnaire, the Chinese eHealth Literacy Scale (eHEALS), and the Health-Promoting Lifestyle Profile II Revised (HPLP-II R). Group comparisons, Spearman correlation analyses, and HC3 heteroscedasticity-robust multiple linear regression were performed. Additional covariate-adjusted models examined total HPLP-II R and its six dimensions; the dimension-level analysis was treated as exploratory and Holm adjustment was used for six dimension-specific tests.ResultsThe mean total eHEALS score was 24.66 ± 9.21. Internal consistency in the current sample was high for total eHEALS (Cronbach's alpha = 0.977) and total HPLP-II R (alpha = 0.907). In the sociodemographic and internet-related model, older age was associated with lower perceived eHealth literacy (B = −0.171 per year, 95% CI −0.272−0.070, beta = −0.190, P = 0.001), and participants who did not search online for disease-related information scored substantially lower than those who did (B = −10.635, 95% CI −13.103−8.166, beta = −0.574, P < 0.001). After adjustment for the same sociodemographic and internet-related covariates, total HPLP-II R remained positively associated with perceived eHealth literacy (B = 0.195, 95% CI 0.078–0.312, beta = 0.233, P = 0.001). In the adjusted dimension-level model, health responsibility remained positively associated with eHealth literacy (B = 0.582, 95% CI 0.189–0.974, beta = 0.235, nominal P = 0.004; Holm-adjusted P = 0.022), whereas the nominal association with spiritual growth did not remain significant after multiplicity adjustment (Holm-adjusted P = 0.188).ConclusionPerceived eHealth literacy varied considerably among liver transplant recipients. Older age and absence of online disease-information seeking were associated with lower eHealth literacy, although the information-seeking association should be interpreted cautiously because of conceptual overlap and possible bidirectionality. Health-promoting lifestyle, particularly health responsibility, remained associated with eHealth literacy after covariate adjustment. These cross-sectional findings identify patient and behavioral characteristics for prospective evaluation rather than causal determinants and should be interpreted in light of single-center convenience sampling and potential selection and non-response bias.
ObjectiveTo characterize HIV-1 subtype distribution, transmission clustering, and associated demographic and temporal risk factors among newly diagnosed young men who have sex with men (MSM) aged <30 years in Hangzhou (2022–2024), comparing student and non-student subgroups.MethodsPol sequences from 857 newly diagnosed, ART-naive young MSM underwent phylogenetic, molecular transmission network, and Bayesian evolutionary analyses; intergroup differences were assessed with chi-square or Fisher’s exact tests and logistic regression.ResultsTwelve subtypes/CRFs were identified, with CRF07_BC (46.67%) and CRF01_AE (35.82%) dominant. At a 1.0% genetic distance, 249 of 857 cases (29.05%) formed 81 clusters; 62 suspected high-transmission-risk cases were predominantly CRF01_AE (54.84%). Both largest clusters were CRF01_AE, with posterior median Re above 1 in 2024 but wide 95% HPDs that included values below 1. Clustering risk was higher among cases registered elsewhere in Zhejiang Province (OR = 1.523, 95% CI: 1.041–2.230) and in the 20–24 years group (OR = 1.501, 95% CI: 1.094–2.061). This age group was also more likely to be classified as suspected high-transmission-risk cases (OR = 2.994, 95% CI: 1.483–6.047), as were cases with CRF01_AE infection relative to others/URFs (OR = 3.471, 95% CI: 1.271–9.479). Household registration in other cities of Zhejiang Province was associated with increased odds of others/URFs relative to CRF01_AE infection (OR = 1.837, 95% CI: 1.130–2.986, p = 0.014), compared with household registration outside Zhejiang Province. Student status was not observed to be associated with clustering or high-transmission-risk classification.ConclusionHangzhou’s young-MSM epidemic is genetically diverse; two CRF01_AE clusters sustained transmission risk (posterior median Re > 1 in 2024) after 3–6 years of local circulation. Prevention should target the broader young MSM population, not students alone.
BackgroundGlobal aging is accompanied by cognitive decline. While the “technological reserve” hypothesis suggests internet use may mitigate this, prior meta-analyses have not clarified the specific effects of different usage patterns. This study aims to systematically evaluate associations between distinct dimensions of internet use and cognitive function in older adults.MethodsConducted in accordance with PRISMA 2020 guidelines, we searched PubMed, Embase, CINAHL, PsycINFO, and Web of Science from inception to March 15, 2026. Two Reviewers independently extracted data. Pooled Odds Ratios (ORs) or Hazard Ratios (HRs) served as primary effect measures; Correlation coefficients (r) or standardized beta coefficients (β) were converted into unified OR-scale estimates for meta-analysis, acknowledging inherent limitations introduced by combining mixed effect measures from original studies.ResultsThirty-one studies comprising 158,648 participants (cross-sectional and longitudinal observational designs) were included. The random-effects meta-analysis of 25 studies yielded a pooled OR of 1.49 (95% CI: 1.31–1.70), indicating general internet use was significantly associated with better cognitive function (z = 5.97, P < 0.001). Substantial heterogeneity was observed (I2 = 99.51%). A 95% prediction interval (1.15–1.93) was further calculated to quantify uncertainty. Subgroup analyses showed significant positive associations for social (OR = 1.55), entertainment (OR = 1.46), and instrumental use (OR = 1.38). However, meta-regression revealed no statistically significant differences among these categories (F(2, 24) = 0.36, P = 0.63). Sensitivity analysis excluding outliers yielded a similar pooled point estimate, although substantial heterogeneity persisted. (pooled OR = 1.46, 95% CI: 1.29–1.67).ConclusionsInternet use was positively associated with better cognitive function among older adults. This positive association was observed across social, entertainment, and instrumental internet use patterns. Given high between study heterogeneity and the observational nature of available evidence, further longitudinal and interventional research is needed to clarify whether diverse digital engagement may support healthy cognitive aging.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/recorddashboard, identifier: CRD420261359423.
ObjectiveTo analyze the nutritional status of community-dwelling older adults and to explore its potential association with metabolic diseases.MethodsThis cross-sectional study enrolled 1,384 older adults who underwent health examinations at the Jingling Community Health Service Center of Baoji City between March 2025 and March 2026. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), and fasting blood glucose, serum lipid profiles, uric acid levels, and anthropometric indicators were measured.ResultsThe prevalence of malnutrition was 1.30 and 7.23% of the older adults were identified as being at risk of malnutrition. Among the metabolic diseases, hypertension had the highest prevalence (40.03%). No significant between-group differences were observed in the prevalence of diabetes, hypertension, hyperuricemia, or coronary heart disease (all p > 0.05). Hyperlipidemia showed a significant between-group difference in univariate analysis (p < 0.05), but this difference was no longer statistically significant after adjustment for covariates (p = 0.08). Multivariable logistic regression revealed that underweight (BMI < 20 kg/m2) was significantly associated with abnormal nutritional status (OR = 22.97, 95% CI: 14.46–36.50, p < 0.001).ConclusionHypertension was notably prevalent among community-dwelling older adults, and underweight was significantly associated with abnormal nutritional status. No clear statistical association was identified between nutritional status and metabolic diseases such as hypertension or hyperuricemia. Dynamic monitoring of body habitus in older adults should therefore be emphasized to facilitate the early identification and intervention of malnutrition, thereby improving their metabolic health.
