OR and the challenge to improve the NHS: modelling for insight and improvement in in-patient flows

This paper considers efforts to improve in-patient flows, a particularly urgent issue in the National Health Service (NHS). The context is described and related to reasons why OR has been making relatively little contribution. The paper argues that large complex models may often be unnecessary and even get in the way of providing clear insight and guidance for problem owners. The importance of understanding the generic working of systems to lead to improvement, and the limitations of simply describing them, is stressed. It is demonstrated that some very simple models can be of significant practical value in understanding and managing complex systems, changing mindsets and driving collection and use of operationally valuable data. Recommendations for more effective engagement with the NHS are offered.     

Results of radius scaling experiments and analysis of neon K-shellradiation data from an inductively driven Z-pinch

The K-shell radiated energy (yield) from neon Z-pinch implosions with annular, gas-puff nozzle radii of 1, 1.75, and 2.5 cm was measured for implosion times from 50 to 300 ns while systematically keeping the implosion kinetic energy nearly constant. The implosions were driven by the Hawk inductive-storage generator at the 0.65-MA level. Initial neutral-neon density distributions from the nozzles were determined with laser interferometry. Measured yields are compared with predictions from zero-dimensional (0-D) scaling models of ideal. One-dimensional (1-D) pinch behavior to both benchmark the scaling models, and to determine their utility for predicting K-shell yields for argon implosions of 200 to >300 ns driven by corresponding currents of 4 to 9 MA, such as envisioned for the DECADE QUAD. For all three nozzles, the 0-D models correctly predict the Z-pinch mass for maximum yield. For the 1and 1.75-cm radius nozzles, the scaling models accurately match the measured yields if the ratio of initial to final radius (compression ratio) is assumed to be 8:1. For the 2.5-cm radius nozzle, the measured yields are only one-third of the predictions. Analysis of K-shell spectral measurements suggest that as much as 70% (50%) of the imploded mass is radiating in the K-shell for the 1-cm (1.75-cm) radius nozzle. That fraction is only 10% for the 2.5-cm radius nozzle. The 0-D scaling models are useful for predicting 1-D-like K-shell radiation yields (better than a factor-of-two accuracy) when a nominal (≈10:1) compression ratio is assumed. However, the compression ratio assumed in the models is only an “effective” quantity, so that further interpretations based on the 0-D analysis require additional justification. The lower-than-predicted yield for the 2.5-cm radius nozzle is associated with larger radius and not with longer implosion time, and is probably a result of two-dimensional effects     

Synthesis and characterisation of phosphane-substituted Co3C clusters having a pendant allyl side-chain

Substituted μ₃-carbido-capped tricobalt carbonyl clusters have been synthesised by reaction of [Co₃(μ₃-C(O)OCH₂CHCH₂)(CO)₉] with a range of monodentate and chelating phosphane ligands. The products have been characterised by microanalysis, IR and NMR spectroscopy, mass spectrometry and, in the case of [Co₃(μ₃-CR)(CO)₇(dppe)], [Co₃(μ₃-CR)(CO)₇(dppm)], [Co₃(μ₃-CR)(CO)₇(PPh₃)₂], [Co₃(μ₃-CR)(CO)₇(PMe₃)₂] and [Co₃(μ₃-CR)(CO)₆(PEt₃)₃] (R=C(O)OCH₂CHCH₂), single crystal X-ray diffraction.     

Capillary chromatographic analysis of volatile organic compounds in the indoor environment

The wide variety of volatile organic compounds found in the indoor environment can present a difficult chromatographic problem for the analyst. Capillary-column gas chromatography is required to achieve adequate separation. Thermal desorption/capillary gas chromatography/mass spectrometry is usually the preferred method for broad spectrum analysis of the volatile organics detected indoors. Cryogenic trapping is required for capillary gas chromatographic analysis of the more volatile components.     

Fluorescence Lifetime Spectroscopy of Glioblastoma Multiforme¶

Fluorescence spectroscopy of the endogenous emission of brain tumors has been researched as a potentially important method for the intraoperative localization of brain tumor margins. We investigated the use of time‐resolved, laser‐induced fluorescence spectroscopy for demarcation of primary brain tumors by studying the time‐resolved spectra of gliomas. The fluorescence of human brain samples (glioblastoma multiforme, cortex and white matter: six patients, 23 sites) was induced ex vivo with a pulsed nitrogen laser (337 nm, 3 ns). The time‐resolved spectra were detected in a 360–550 nm wavelength range using a fast digitizer and gated detection. Parameters derived from both the spectral‐ (intensities from narrow spectral bands) and the time domain (average lifetime) measured at 390 and 460 nm were used for tissue characterization. We determined that high‐grade gliomas are characterized by fluorescence lifetimes that varied with the emission wavelength (>3 ns at 390 nm, <1 ns at 460 nm) and their emission is overall longer than that of normal brain tissue. Our study demonstrates that the use of fluorescence lifetime not only improves the specificity of fluorescence measurements but also allows a more robust evaluation of data collected from brain tissue. Combined information from both the spectraland the time domain can enhance the ability of fluorescencebased techniques to diagnose and detect brain tumor margins intraoperatively.     

Magnetic, electronic, and structural characterization of nonstoichiometric iron oxides at the nanoscale

We have investigated the structural, magnetic, and electronic properties of nonstoichiometric iron oxide nanocrystals prepared by decomposition of iron(II) and iron(0) precursors in the presence of organic solvents and capping groups. The highly uniform, crystalline, and monodisperse nanocrystals that were produced enabled a full structural and compositional survey by electron microscopy and X-ray diffraction. The complex and metastable behavior of nonstoichiometric iron oxide (wüstite) at the nanoscale was studied by a combination of Mossbauer spectroscopy and magnetic characterization. Deposition from hydrocarbon solvents with subsequent self-assembly of iron oxide nanocrystals into superlattices allowed the preparation of continuous thin films suitable for electronic transport measurements.     

Chemical and Structural Changes in Blood Undergoing Laser Photocoagulation¶

The treatment of cutaneous vascular lesions (port wine stains etc.) using lasers has been guided by theories based on the “cold” or room‐temperature optical properties of the hemoglobin target chromophore. We have recently presented evidence showing that under the influence of laser irradiation, the optical properties of blood in vitro are time and temperature dependent. Such complications are not currently subsumed into the in vivo theory. Here, we study the time‐domain optical properties of blood undergoing photocoagulation in vitro using two newly developed time‐resolved techniques. We also study the asymptotic effect of laser photocoagulation on the chemical and structural properties of the components of the blood matrix. We present evidence showing that the photocoagulation process involves significant changes in the optical absorption and scattering properties of blood, coupled with photothermally induced chemical and structural changes. We demonstrate the first use of a laser to deliberately generate magnetic resonance imaging contrast in vitro. We show that this technique offers significant potential advantages to in vivo intravenous chemical contrast agent injection.