Do differences in religious affiliation explain high levels of excess mortality in the UK?

Background: High levels of mortality not explained by differences in socioeconomic status (SES) have been observed for Scotland and its largest city, Glasgow, compared with elsewhere in the UK. Previous cross-sectional research highlighted potentially relevant differences in social capital, including religious social capital (the benefits of social participation in organised religion). The aim of this study was to use longitudinal data to assess whether religious affiliation (as measured in UK censuses) attenuated the high levels of Scottish excess mortality. Methods: The study used the Scottish Longitudinal Study (SLS) and the ONS Longitudinal Study of England and Wales. Risk of all-cause mortality (2001–2010) was compared between residents aged 35 and 74 years of Scotland and England and Wales, and between Glasgow and Liverpool/Manchester, using Poisson regression. Models adjusted for age, gender, SES and religious affiliation. Similar country-based analyses were undertaken for suicide. Results: After adjustment for age, gender and SES, all-cause mortality was 9% higher in Scotland than in England and Wales, and 27% higher in Glasgow than in Liverpool or Manchester. Religious affiliation was notably lower across Scotland; but, its inclusion in the models did not attenuate the level of Scottish excess all-cause mortality, and only marginally lowered the differences in risk of suicide. Conclusions: Differences in religious affiliation do not explain the higher mortality rates in Scotland compared with the rest of the UK. However, it is possible that other aspects of religion such as religiosity or religious participation which were not assessed here may still be important

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Laser-assisted vacuum arc extreme ultraviolet source: a comparison of picosecond and nanosecond laser triggering

Extreme ultraviolet (EUV) light generation by hybrid laser-assisted vacuum arc discharge plasmas, utilizing Sn-coated rotating-disc-electrodes, was investigated. The discharge was initiated by localized ablation of the liquid tin coating of the cathode disc by a laser pulse. The laser pulse, at 1064 nm, was generated by Nd:YAG lasers with variable energy from 1 to 100 mJ per pulse. The impact of shortening the laser pulse from 7 ns to 170 ps on the EUV generation has been investigated in detail. The use of ps pulses resulted in an increase in emission of EUV radiation. With a fixed discharge energy of ~4 J, the EUV conversion efficiency tends to plateau at ~2.4  ±  0.25% for the ps laser pulses, while for the ns pulses, it saturates at ~1.7  ±  0.3%. Under similar discharge and laser energy conditions, operating the EUV source with the ps-triggering resulted also in narrower spectral profiles of the emission in comparison to ns-triggering. The results indicate an advantage in using ps-triggering in laser-assisted discharges to produce brighter plasmas required for applications such as metrology