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Introduction: The elderly population experiences more postoperative complications. A comprehensive geriatric assessment, which is multidimensional and coordinated, could help reduce these unfavorable outcomes. However, its effectiveness is still uncertain. Methods: We searched multiple online databases, including Medline, PubMed, Web of Science, Cochrane Library, Embase, CINAL, ProQuest, and Wiley, for relevant literature from their inception to October 2023. We included randomized trials of individuals aged 65 and older undergoing surgery. These trials compared comprehensive geriatric assessment with usual surgical care and reported on postoperative outcomes. Two researchers independently screened the literature, extracted data, and assessed the certainty of evidence from the identified articles. We conducted a meta-analysis using RevMan 5.3 to calculate the Odds Ratio (OR) and Mean Difference (MD) of the pooled data. Results: The study included 1325 individuals from seven randomized trials. Comprehensive geriatric assessment reduced the rate of postoperative delirium (28.5% vs. 37.0%; OR: 0.63; CI: 0.47–0.85; I2: 54%; P = 0.003) based on pooled data. However, it did not significantly improve other parameters such as length of stay (MD: -0.36; 95% CI: -0.376, 3.05; I2: 96%; P = 0.84), readmission rate (18.6% vs. 15.4%; OR: 1.26; CI: 0.86–1.84; I2: 0%; P = 0.24), and ADL function (MD: -0.24; 95% CI: -1.27, 0.19; I2: 0%; P = 0.64). Conclusions: Apart from reducing delirium, it is still unclear whether comprehensive geriatric assessment improves other postoperative outcomes. More evidence from higher-quality randomized trials is needed. [ABSTRACT FROM AUTHOR]

Heavy metal pollution is becoming a serious issue in developing countries such as China, and the public is increasingly aware of its adverse health impacts in recent years. We assessed the potential health risks in a lead-zinc mining area and attempted to identify the key exposure pathways. We evaluated the spatial distributions of personal exposure using indigenous exposure factors and field monitoring results of water, soil, food, and indoor and outdoor air samples. The risks posed by 10 metals and the contribution of inhalation, ingestion and dermal contact pathways to these risks were estimated. Human hair samples were also analyzed to indicate the exposure level in the human body. Our results show that heavy metal pollution may pose high potential health risks to local residents, especially in the village closest to the mine (V1), mainly due to Pb, Cd and Hg. Correspondingly, the residents in V1 had higher Pb (8.14 mg/kg) levels in hair than those in the other two villages. Most of the estimated risks came from soil, the intake of self-produced vegetables and indoor air inhalation. This study highlights the importance of site-specific multipathway health risk assessments in studying heavy-metal exposures in China.