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Background: Early water intake has gained widespread attention considering enhanced recovery after surgery (ERAS). In the present systematic evaluation and meta-analysis, we assessed the effects of early water intake on the incidence of vomiting and aspiration in adult patients who received general anaesthesia on regaining consciousness during the resuscitation period. Objective: To systematically analyse the results of randomised controlled trials on early postoperative water intake in patients who underwent different types of surgery under general anaesthesia, both at home and abroad, to further explore the safety and application of early water intake and provide an evidence-based foundation for clinical application. Design: Systematic review and meta-analysis. Methods: To perform the systematic evaluation and meta-analysis, we searched the Web of Science, CINAHL, Embase, PubMed, Cochrane Library, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang, and Vipshop databases to identify randomised controlled trial studies on early water intake in adult patients who received general anaesthesia. Results: Herein, we included 10 publications with a total sample size of 5131 patients. Based on statistical analysis, there was no statistically significant difference in the incidence of vomiting (odds ratio [OR] = 0.81; 95% confidence interval [CI] [0.58–1.12]; p = 0.20; I-squared [I2] = 0%) and aspiration (OR = 0.78; 95%CI [0.45–1.37]; p = 0.40; I2 = 0%) between the two groups of patients on regaining consciousness post-general anaesthesia. Conclusion: Based on the available evidence, early water intake after regaining consciousness post-anaesthesia did not increase the incidence of adverse complications when compared with traditional postoperative water abstinence. Early water intake could effectively improve patient thirst and facilitate the recovery of gastrointestinal function. [ABSTRACT FROM AUTHOR]

Objectives: The proportion of older people with dementia in China is gradually increasing with the increase in the aging population over recent years. Hypertension and diabetes are common non‐communicable diseases among rural populations in China. However, it remains unclear whether these conditions affect the occurrence and development of cognitive impairment as there is limited research on cognitive status and its risk factors among residents of rural areas. Methods: A multi‐stage stratified cluster random sampling method was used to select 5400 participants from rural permanent residents. A self‐designed structured questionnaire was used to investigate demographic data of the participants. Cognitive function was assessed using the Montreal Cognitive Function Assessment Scale (MoCA). The results were analyzed using chi‐square test, ANOVA and multiple linear regression analysis. Results: A total of 5028 participants returned the survey, giving a response rate of 93.1%. Higher education (odds ratio (OR) = 3.2, 95% confidence interval (CI) 2.87–3.54, p < 0.001), higher income (OR = 1.61, 95% CI 1.16–2.07, p < 0.001), and dietary control (OR = 0.66, 95%CI 0.34–0.98, p < 0.001) were protective factors. A visual representation of the relationship between annual income and MoCA score showed an inverted U‐curve, the group with an annual income of 6000–7999 RMB had a maximum OR of 1.93 (95%CI 0.12–2.74, p < 0.001). While difficulty in maintaining sleep were risk factors for cognitive impairment (OR = −2.28, 95% CI–4.18–0.39, p = 0.018). Conclusions: Participants with middle incomes had better cognitive status than those with the highest incomes. Higher education, proper diet control and good sleep are beneficial to the cognitive status of residents in rural areas. Key points: Higher education level, higher income level and diet control are protective factors for the development of cognitive dysfunction.Cognitive dysfunction is more likely to occur in women and in people who have difficulty maintaining sleep.There were no significant differences in the demographic characteristics of patients with hypertension, diabetes, the combination of hypertension and diabetes, and healthy residents in low‐income rural areas.The cognitive status of middle‐income people is better than that of high‐income people than that of low‐income people, a visual representation of the relationship between annual income and MoCA score showed an inverted U‐curve. [ABSTRACT FROM AUTHOR]

Aim: To estimate the incidence and identify risk factors of postpartum hemorrhage (PPH) after vaginal delivery. Methods: A systematic review and meta‐analysis was conducted. PubMed, Cochrane Library, CINAHL, Web of Science, EMBASE, and ClinicalTrials.gov databases were systematically searched from inception to April 30th, 2022. Cross‐sectional, cohort, case–control, and secondary analysis of randomized controlled studies that reported the incidence of PPH and the related risk factors in vaginal delivery were eligible through screening of 2343 articles. The incidence, associated standard error, adjusted odds ratios, relative risks and associated 95% confidence intervals were combined in the meta‐analysis. Results: Thirty‐six articles were included in the descriptive review. The incidence of PPH (blood loss ≥500 mL and blood loss ≥1000 mL) was 17% and 6%, respectively. Forty‐one identified risk factors were divided into five categories under two criteria: history and demographics; maternal comorbidity; pregnancy‐related factors; labor‐related factors; delivery‐related factors. Conclusions: With the increasing incidence of PPH globally, obstetric health care providers need to improve their awareness of these multi‐factorial risks to optimize obstetric care and reduce maternal morbidity. This systematic review and meta‐analysis have raised important questions about the nature of vaginal delivery, such as the duration of prolonged labor, details on the use of oxytocin, and the presence of genital tract trauma. There should be highlighted by obstetric personnel on these factors during a patients' labor process. [ABSTRACT FROM AUTHOR]

Background Pharmacological treatments are very common to be used for alleviating neuropsychiatric symptoms (NPS) in dementia. However, decision on drug selection is still a matter of controversy. Aims To summarise the comparative efficacy and acceptability of currently available monotherapy drug regimens for reducing NPS in dementia. Method We searched PubMed, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials between inception and 26 December 2022 without language restrictions; and reference lists scanned from selected studies and systematic reviews. Double-blind randomised controlled trials were identified from electronic databases for reporting NPS outcomes in people with dementia. Primary outcomes were efficacy and acceptability. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). Results We included 59 trials (15,781 participants; mean age, 76.6 years) and 15 different drugs in quantitative syntheses. Risperidone (standardised mean difference [SMD] −0.20, 95% credible interval [CrI] −0.40 to −0.10) and galantamine (−0.20, −0.39 to −0.02) were more effective than placebo in short-term treatment (median duration: 12 weeks). Galantamine (odds ratio [OR] 1.95, 95% CrI 1.38–2.94) and rivastigmine (1.87, 1.24–2.99) were associated with more dropouts than placebo, and some active drugs. Most of the results were rated as low or very low according to CINeMA. Conclusions Despite the scarcity of high-quality evidence, risperidone is probably the best pharmacological option to consider for alleviating NPS in people with dementia in short-term treatment when considering the risk–benefit profile of drugs. [ABSTRACT FROM AUTHOR]

Simple Summary: The history of the treatment of APL has shown remarkable success. However, it is not clear whether it is necessary to monitor long-term toxicity in "cured" patients who survive for more than five years, which is critical to ensuring maximum survival in APL patients. To answer this question, we performed a comprehensive analysis of 1952 APL 5-year survivors and 5973 non-APL acute myeloid leukemia (AML) 5-year survivors from the Surveillance, Epidemiology, and End Results (SEER) database. We found that the overall mortality risk in >5-year survivors of APL was 1.41 times than that of the general population due to a significant increase in mortality from AML (SMR, 87.67) and other second malignant neoplasms (SMR, 1.56) only at 60–119 months. This result indicated long-term survivors of APL are safe after 10 years, which may help clinicians make future risk assessment, health guidance, and follow-up plans for APL long-term survivors. Background: Acute promyelocytic leukemia (APL) is a highly curable cancer, but it is not clear whether it is also necessary to monitor long-term toxicity in "cured" patients who survive for more than five years, which is critical to ensuring maximum survival in APL patients. Methods: A total of 1952 APL 5-year survivors and 5973 non-APL acute myeloid leukemia (AML) 5-year survivors were included from the Surveillance, Epidemiology, and End Results (SEER) database. The standardized mortality ratio (SMR) was calculated to measure the risk of death. Cumulative mortality is calculated as the incidence of specific causes of death under competing risk events. Results: The SMR of all causes of death in >5-year survivors of APL was higher than that of the general population only at 60–119 months (SMR, 1.41). This was mainly because a significant increase in mortality from AML (SMR, 87.67) and second malignant neoplasms (SMNs) (SMR, 1.56) was found only at 60–119 months. However, there was no higher risk of death from non-cancer-related disease in >5-year survivors of APL than that of the general population (SMR, 0.89). The SMR of all-cause deaths in >5-year survivors of non-APL AML decreased year by year and was no higher than that of the general population until after 216 months. The cumulative incidence of AML-related death, SMN-related death, and non-cancer-related death was significantly lower in APL patients than in non-APL AML patients throughout the follow-up period. Conclusions: Compared with the general population, the risk of death of patients with APL was higher within 5 to 10 years but not higher over 10 years. Therefore, we believe that long-term survivors of APL are safe after 10 years. [ABSTRACT FROM AUTHOR]

Aim: To determine the level of critical cultural competence (CCC) among Chinese clinical nurses and explore its influencing factors. Background: Previous research has only focused on the theoretical model of CCC and the development of assessment tools; however, no large‐scale study has been conducted on the level of clinical nurses' CCC and its influencing factors. Method: Clinical nurses in 14 Level A tertiary hospitals (n = 3858) were surveyed using Almutairi's critical cultural competence scale (CCCS). Descriptive, univariate and multivariate analyses were performed. Results: The mean score of CCC was 4.44 (SD = 0.33). Critical empowerment (M = 4.85, SD = 0.58) and critical awareness (M = 3.57, SD = 0.99) had the highest and lowest scores, respectively. Female nurses, nurses in the nursing department and nurses with higher positions had higher CCC. Conclusion: The CCC of clinical nurses can be strengthened through targeted training, especially considering the fact that male and low‐ranking nurses who had the lower level of CCC work in different departments. Implications for Nursing Management: Hospital administrators should pay attention to the importance of culture and cultural differences among different countries or ethnic groups. Creating an equal and fair nursing environment and encouraging nurses to provide critical cultural nursing is important. [ABSTRACT FROM AUTHOR]

Objectives: We performed this meta-analysis to estimate the association between vitamin B6 intake and colorectal cancer risk. Methods: Prospective cohort studies on vitamin B6 intake and colorectal cancer risk were identified by searching databases from the period of 1960 to 2016. Results from individual studies were synthetically combined using Stata 13.0 software. Results: A total of 10 prospective cohort studies including 13 data sets were included in our meta-analysis, containing 7,817 cases and 784,550 subjects. The combined relative risks (RR) of colorectal cancer for the highest vitamin B6 intake compared with the lowest vitamin B6 intake was 0.88 [95% confidence intervals (CIs): 0.77-1.02]. Dose-response meta-analysis based on five eligible studies showed that for each additional 3 and 5 mg of vitamin B6 intake, the risk would decrease by 11% (RR: 0.89, 95%CI: 0.81-0.98) and 17% (RR: 0.83, 95%CI: 0.71-0.97), respectively. Little evidence of publication bias was found. Conclusion: This meta-analysis provides evidence of a nonsignificant decrease in colorectal cancer risk associated with the high level of vitamin B6 intake, but the risk in dose-response analysis is significant. However, the latter finding is based on a limited number of studies, which should be interpreted with caution. [ABSTRACT FROM AUTHOR]