Open versus laparoscopic cholecystectomies in patients with or without type 2 diabetes mellitus in Spain from 2003 to 2013

BACKGROUND: This study aimed to compare the rates of open and laparoscopic cholecystectomies and outcomes in patients with or without type 2 diabetes mellitus (T2DM) in Spain from 2003 to 2013. METHODS: We collected all cases of open and laparoscopic cholecystectomies using national hospital discharge data and evaluated the annual cholecystectomy rates stratiifed by T2DM status. We analyzed tendency for in-hospital mortality (IHM). We also analyzed the impact of T2DM on IHM in patients who underwent cholecystectomies. RESULTS: We identiifed 611 533 cholecystectomies (71.3%laparoscopic) in the patients, in whom 78 227 (12.8%) patients had T2DM. The rates of open cholecystectomies were 3-fold higher (130.0/105 vs 41.1/105) in patients with T2DM than in&nbsp;those without T2DM, and the rate of laparoscopic cholecys-tectomies was almost 2-fold higher (195.2/105 vs 111.8/105) in patients with T2DM. The annual rate of laparoscopic pro-cedures showed an 11-year relative increase of 88.3% (from 117.0/105 to 220.3/105) in T2DM and 49.2% (from 79.2/105 to 118.2/105) in patients without T2DM (P<0.001), whereas the rate of open procedures showed an 11-year relative decrease of 27.6% in patients with T2DM and 37.9% in those without T2DM (P<0.001). The rate of emergency laparoscopic cho-lecystectomy was increased in the 11 years, whereas the rate of emergency open cholecystectomies was decreased (both P<0.001). Multivariate analysis revealed that older age, higher comorbidity and emergency cholecystectomy were associated with a higher IHM. Compared with patients without T2DM, patients with T2DM demonstrated a lower IHM after open cholecystectomy [OR=0.82 (0.78-0.87)], but a higher IHM after laparoscopic cholecystectomy (OR=1.18 (1.03-1.35))Time-trend analyses showed a signiifcant reduction in IHM in patients with or without T2DM after the two procedures. CONCLUSION: The rate of cholecystectomy was higher in patients with T2DM, and laparoscopic cholecystectomy was popularized in the past 11 years both in selective and emer-gency cholecystectomies.

National trends in sexual intercourse and usage of contraception among Korean adolescents

Background The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory.To bridge this gap in knowledge,we conducted a comprehensive,cross-sectional examination of long-term trends in the prevalence of sexual intercourse and usage of contraception among South Korean adolescents from 2006 to 2022.Methods In our research,we drew upon data encompassing 1,138,799 South Korean adolescents aged 12 to 18 years,derived from the Korean Youth Risk Behavior Web-based Survey(KYRBS)over a period spanning from 2006 to 2022.We focused on the prevalence of sexual intercourse,contraception utilization,and the underlying associated factors among this demographic.The KYRBS data was collected using a complex sampling strategy to determine the national prevalence estimates and shifts in prevalence before(2006-2019)and during(2020-2022)the COVID-19 pandemic era.Results During the pre-pandemic period,a decrease in adolescent sexual intercourse was observed(6.34%in 2006,5.53%in 2012,and 5.87%in 2019).However,in the post-pandemic period(2020-2022),there was a surge in sexual intercourse(4.55%in 2020 and 6.20%in 2022).This evident alteration in sexual intercourse trajectory between pre-and post-pandemic periods was statistically significant[βdiff,0.950;95%confidence interval(CI),0.756-1.144].Regarding contraceptive use among South Korean adolescents,there was an increase in the pre-COVID-19 pandemic phase across all demographic segments(14.61%in 2006,22.30%in 2012,and 47.69%in 2022)but a notable decline when compared with the pre-and post-pandemic periods(βdiff,-0.319;95%CI,-0.454 to-0.184).Additionally,during the study period,a decrease in sexual intercourse was observed in the pre-pandemic period(β,-0.129;95%CI,-0.148 to-0.110),followed by an increase in the post-pandemic period(β,0.821;95%CI,0.627 to 1.014).This shift is highlighted by an effect size of 0.96[weighted odds ratio(wOR);95%CI,0.92 to 1.00],indicating a substantial change in adolescent sexual behaviors across study periods.Conclusions The increase in sexual intercourse and decrease in usage of contraception observed in our study between the pre-and post-COVID-19 periods suggests a potential threat to sexual health among South Korean adolescents.This trend emphasizes the ongoing necessity of raising awareness about adolescent sexual behavior in South Korea.

Light at night and lung cancer risk:A worldwide interdisciplinary and time-series study

Background:Light at night(LAN)has become a concern in interdisciplinary research in recent years.This global interdisciplinary study aimed to explore the exposure-lag-response association between LAN exposure and lung cancer incidence.Methods:LAN data were obtained from the Defense Meteorological Satellite Program’s Operational Linescan System.Data of lung cancer incidence,socio-demographic index,and smoking prevalence of populations in 201 countries/territories from 1992 to 2018 were collected from the Global Burden of Disease Study.Spearman correlation tests and population-weighted linear regression analysis were used to evaluate the correlation between LAN exposure and lung cancer incidence.A distributed lag nonlinear model(DLNM)was used to assess the exposure-lag effects of LAN exposure on lung cancer incidence.Results:The Spearman correlation coefficients were 0.286-0.355 and the population-weighted linear regression correlation coefficients were 0.361-0.527.After adjustment for socio-demographic index and smoking preva-lence,the Spearman correlation coefficients were 0.264-0.357 and the population-weighted linear regression correlation coefficients were 0.346-0.497.In the DLNM,the maximum relative risk was 1.04(1.02-1.06)at LAN exposure of 8.6 with a 2.6-year lag time.After adjustment for socio-demographic index and smoking prevalence,the maximum relative risk was 1.05(1.02-1.07)at LAN exposure of 8.6 with a 2.4-year lag time.Conclusion:High LAN exposure was associated with increased lung cancer incidence,and this effect had a specific lag period.Compared with traditional individual-level studies,this group-level study provides a novel paradigm of effective,efficient,and scalable screening for risk factors.

The effect of mixed vaccination rollout strategy:A modelling study

Vaccines have measurable efficacy obtained first from vaccine trials.However,vaccine efficacy(VE)is not a static measure and long-term population studies are needed to evaluate its performance and impact.COVID-19 vaccines have been developed in record time and the currently licensed vaccines are extremely effective against severe disease with higher VE after the full immunization schedule.To assess the impact of the initial phase of the COVID-19 vaccination rollout programmes,we used an extended Susceptible-Hospitalized-Asymptomatic/mild-Recovered(SHAR)model.Vaccination models were proposed to evaluate different vaccine types:vaccine type 1 which protects against severe disease only but fails to block disease transmission,and vaccine type 2 which protects against both severe disease and infection.VE was assumed as reported by the vaccine trials incorporating the difference in efficacy between one and two doses of vaccine administration.We described the performance of the vaccine in reducing hospitalizations during a momentary scenario in the Basque Country,Spain.With a population in a mixed vaccination setting,our results have shown that reductions in hospitalized COVID-19 cases were observed five months after the vaccination rollout started,from May to June 2021.Specifically in June,a good agreement between modelling simulation and empirical data was well pronounced.