Sarcopenia, with risk factors such as poor nutrition and physical inactivity, is becoming prevalent among the older population. The aims of this study were (i) to systematically review the existing data on sarcopenia prevalence in the older Chinese population, (ii) to generate pooled estimates of the sex-specific prevalence among different populations, and (iii) to identify the factors associated with the heterogeneity in the estimates across studies. A search was conducted in seven databases for studies that reported the prevalence of sarcopenia in Chinese older adults, aged 60 years and over, published through April 2020. We then performed a meta-analysis to estimate the pooled prevalence, and investigated the factors associated with the variation in the prevalence across the studies using meta-regression. A total of 58 studies were included in this review. Compared with community-dwelling Chinese older adults (men: 12.9%, 95% CI: 10.7–15.1%; women: 11.2%, 95% CI: 8.9–13.4%), the pooled prevalence of sarcopenia in older adults from hospitals (men: 29.7%, 95% CI:18.4–41.1%; women: 23.0%, 95% CI:17.1–28.8%) and nursing homes (men: 26.3%, 95% CI: 19.1 to 33.4%; women: 33.7%, 95% CI: 27.2 to 40.1%) was higher. The multivariable meta-regression quantified the difference of the prevalence estimates in different populations, muscle mass assessments, and areas. This study yielded pooled estimates of sarcopenia prevalence in Chinese older adults not only from communities, but also from clinical settings and nursing homes. This study added knowledge to the current epidemiology literature about sarcopenia in older Chinese populations, and could provide background information for future preventive strategies, such as nutrition and physical activity interventions, tailored to the growing older population.

External ventricular drain (EVD) management is a critical aspect of neurosurgical nursing practice. Nurses play a central role in monitoring patients, iden

Objectives: This retrospective cohort study aimed to assess the efficacy of emergency cervical cerclage (ECC) performed with the combined McDonald‐Shirodkar technique in twin pregnancies between 18 and 26 weeks of pregnancy with painless cervical dilation 1 to 6 cm.Methods: A retrospective cohort study matched with the degree of cervical dilation was conducted. The study group (case group) included women with twin pregnancies undergoing combined McDonald‐Shirodkar approach with cervical dilation ≥1 cm between 18 to 26 weeks of gestation at four institutions, from December 2015 to December 2022. To minimize confounding factors, we elucidated the causality structure using a directed acyclic graph and performed 1:1 case–control matching. A control group underwent the McDonald approach. The primary outcome was gestational age (GA) at delivery. The secondary outcomes were pregnancy latency; the rates of spontaneous preterm birth at <28, <30, <32, and <34 weeks; and neonatal outcomes. Additional subanalysis was performed by dividing the patients into two subgroups of women with cervical dilation ≥3 cm and 0.05). After adjusting for confounders that were represented by a directed acyclic graph, median GA at delivery was significantly higher (30.5 vs 27 weeks; Bate: 3.40 [95% confidence interval (CI), 2.13–4.67], P < 0.001) and median pregnancy latency was significantly longer (56 vs 28 days; Bate: 24.04 [95% CI, 13.31–34.78], P < 0.001) in the case group compared with the control group. Rates of spontaneous preterm birth at <28, <30, <32, and <34 weeks were significantly lower in the case group than in the control group. For neonatal outcomes, there was higher birth weight (1543.75 vs 980 g; Bate: 420.08 [95% CI, 192.18–647.98], P < 0.001) and significantly lower overall perinatal mortality (7.1% vs 31%; adjusted odds ratio, 0.16 [95% CI, 0.04–0.70], P = 0.014) in the case group compared with the control group. When cervical dilation was ≥3 cm, the combined McDonald‐Shirodkar procedure can significantly reduce perinatal mortality (8.3% vs 46.7%; adjusted odds ratio, 0.09 [95% CI, 0.01–0.77], P = 0.028), significantly decrease the risk of delivery at <28 and <30 weeks, and prolong GA at delivery and pregnancy latency compared with the McDonald procedure.Conclusions: ECC performed with the combined McDonald‐Shirodkar procedure in women with twin pregnancies who have cervical dilation 1 to 6 cm in midtrimester pregnancy may reduce the rate of spontaneous preterm birth and improve perinatal and neonatal outcomes compared with the McDonald procedure, especially for twin pregnancies in women with cervical dilation of 3 to 6 cm and prolapsed membranes.

Background: Cognitive frailty (CF) is the coexistence of physical frailty and cognitive impairment. Transition to institutional care (TIC) refers to the move from home to a long‐term care institution and represents a major change in living arrangement and care needs among older adults. Both CF and TIC are pressing challenges in ageing populations; however, evidence on their association remains limited. Objectives: This study aimed to explore the longitudinal relationship between CF and TIC among community‐dwelling older adults, using the Chinese population as an example. Methods: This retrospective cohort study utilised data from four waves (2008–2018) of the Chinese Longitudinal Healthy Longevity Survey. Community‐dwelling participants aged between 65 and 100 years at baseline were included. CF was defined based on the modified Fried criteria and the Chinese version Mini‐Mental State Examination. The Fine‐Grey subdistribution regression models were used, treating mortality and lost to follow‐up as competing risks and controlling for gender, age, living area, marital status, living arrangement, multimorbidity, household income, and preference for institutional care. Results: The baseline prevalence of CF was 2.3% (95% CI: 2.0%–2.6%). During follow‐up, 1.2% (95% CI: 1.0%–1.4%) transitioned to institutional care, 47.1% (95% CI: 46.1%–48.2%) died before TIC and 32.1% (95% CI: 31.1%–33.0%) were lost to follow‐up. Incidence rate of TIC was 2.3 (95% CI: 1.9–2.8) per 1000 person‐years. Individuals with CF had a higher risk of TIC (SHR 3.51, 95% CI: 1.49 to 8.28; p = 0.004) compared to those without physical frailty and cognitive impairment. Conclusion: Our findings demonstrated the positive association between CF and TIC, highlighting the need for appropriate and timely management of CF and personalised interventions for this vulnerable group to delay premature institutionalisation.