Mixing methodologies to enhance the implementation of healthcare operational research

Healthcare Operational Research (OR) has had limited success in achieving a sufficient level of stakeholder acceptance to lead to implementation of results. This research study is aimed at combining OR methodologies to achieve greater acceptance of results for organizational change. Patient flow delays in the Paediatric intensive care unit (PICU) at Children's Hospital of Wisconsin were identified using case studies. Patient flow was modelled using hard OR (simulation) using case study findings, with active stakeholder participation, and enhanced with outcomes research. Outcomes research allowed achieving greater clinical relevance of OR findings. Results from hard OR, particularly for politically sensitive issues, were persuasive but inadequate to result in change. Soft OR (cognitive mapping) was used to identify new issues and enhance results. Consequently, the planned PICU expansion was deferred, and resources focused on improving staffing strategies identified independently from both hard and soft OR. These findings suggest that: (1) Outcomes research can play a unique role to enhance results in healthcare OR. (2) After obtaining a holistic understanding of the system using hard and soft OR, stakeholders are willing to implement results from each independently, supporting the development of a common form of knowledge, which is consistent with Mixed-Mode Modelling. (3) Hard OR, enhanced with outcomes research, with active stakeholder participation, and combined with soft OR, results in greater acceptance and sustained organizational change.     

Generalization of Einstein relation for doped organic semiconductors

Under the assumption of Gaussian energy distributions of the lowest unoccupied molecular orbital (LUMO) and the highest occupied molecular orbital (HOMO), analytical expressions of generalized Einstein relation for electron and hole transport in doped organic semiconductor thin films are developed. Numerical calculations show that, although traditional Einstein relation still holds for low carrier concentrations, that is, the diffusion-coefficient-to-mobility ratio in units of k_BT/q, with k_B the Boltzmann’s constant, T the temperature and q the elementary charge, equals 1. But when the electron (hole) concentration is high, the diffusion-coefficient-to-mobility ratio for electrons (holes) changes strongly with the electron (hole) concentration, the doping level, the mean energy of LUMOs (HOMOs) of the dopant E_Ld (E_Hd) and the host E_L (E_H), as well as their variances. Dopants with E_Ld<E_L (E_Hd>E_H) affect the diffusion-coefficient-to-mobility ratio mainly in the range of low and middle carrier concentrations, while those with E_Ld>E_L (E_Hd<E_H) have significant effect only in the range of high carrier concentrations. It was found that there can be a maximum in the dependence of the diffusion-coefficient-to-mobility ratio on the quasi-Fermi energy or carrier concentration exist, for appropriate values of the doping level, the mean energy and variance of LUMO or HOMO states of the dopant. PACS 71.20.Rv; 72.90.+y; 73.50.-h     

The essential Lagrangian-Grassmannian and the homotopy type of the Fredholm Lagrangian-Grassmannian

Let H be a separable infinite dimensional Hilbert space endowed with a symplectic structure and let L₀⊂H be a Lagrangian subspace. Using the results of [A. Abbondandolo, P. Majer, Infinite dimensional Grassmannians, math.AT/0307192], we show that the Fredholm Lagrangian-Grassmannian FL₀(Λ) has the homotopy type of Gc(L₀), the Grassmannian of all Lagrangian subspaces of H that are compact perturbations of L₀. It is well known that the latter has the homotopy type of the quotient U(∞)/O(∞). As a corollary, we recover a result by B. Booss-Bavnbek and K. Furutani (see [B. Booss-Bavnbek, K. Furutani, Symplectic functional analysis and spectral invariants, Contemp. Math. 242 (1999) 53-83; K. Furutani, Fredholm-Lagrangian-Grassmannian and the Maslov index, J. Geom. Phys. 51 (2004) 269-331]) that the L₀-Maslov index is an isomorphism between the fundamental group of FL₀(Λ) and the integers.     

A real time method for surface cleanliness measurement

The measurement of surface cleanliness is a significant problem in many industrial and technological processes. Existing methods are based on laboratory procedures, that are not performed in real time, can not be automated, and usually are restricted to a small portion of the sample. In this study we describe a new method for real time measurement of the amount of surface dirt or contamination deposited on a surface. It relies on the ablation of the surface dirt film by means of a short laser pulse, and the subsequent measurement of the emitted sound. The intensity of the sound is proportional to the amount of surface dirt and provides a direct measurement of the cleanliness of the surface. We also developed a reference sample for calibration, based on a uniform distribution of dots printed on white paper. The density and the dot size can be easily modified providing a homogeneous, uniform and reproducible standard for the measurement. Based on this method, we designed, developed and patented the first industrial instrument for on-line determination of the degree of cleanliness of manufactured cold rolled steel plate bobbins. PACS 79.20.D; 81.70.C; 42.62.     

Advances in constant-velocity Mössbauer instrumentation

A prototype of a programmable constant-velocity scaler is presented. This instrument allows the acquisition of partial Mössbauer spectra in selected energy regions using standard drivers and transducers. It can be fully operated by a remote application, thus data acquisition can be automated. The instrument consists of a programmable counter and a constant-velocity reference. The reference waveform generator is amplitude modulated with 13-bit resolution, and is programmable in a wide range of frequencies and waveforms in order to optimize the performance of the transducer. The counter is compatible with most standard SCA, and is configured as a rate-meter that provides counts per selectable time slice at the programmed velocity. As a demonstration of the instrument applications, a partial Mössbauer spectrum of a natural iron foil was taken. Only positive energies were studied in 512 channels, accumulating 20 s per channel. A line width of 0.20 mm/s was achieved, performing with an efficiency of 80%.     

Critical dynamics of the Potts model in several dimensionalities

We study critical dynamics of general q-state Potts models on d-dimensional hypercubic lattices. The master equation is formulated according to a theory recently presented by the author. A simple bond moving technique, followed by decimation, is used to obtain the dynamical exponents. Although this approximation yields poor results for the static exponents, the dynamic behaviour is closer to Monte Carlo simulations. We compare our results with those obtained with a different formulation of dynamics. A final discussion is included.     

Comment on breakup densities of hot nuclei

In [V.E. Viola et al., Phys. Rev. Lett. 93 (2004) 132701, D.S. Bracken et al., Phys. Rev. C 69 (2004) 034612] the observed decrease in spectral peak energies of IMFs emitted from hot nuclei was interpreted in terms of a breakup density that decreased with increasing excitation energy. Subsequently, Raduta et al. [Ad. Raduta et al., Phys. Lett. B 623 (2005) 43] performed MMM simulations that showed decreasing spectral peaks could be obtained at constant density. In this Letter we point out that this apparent inconsistency is due to a selective comparison of theory and data that overlooks the evolution of the fragment multiplicities as a function of excitation energy.     

Epimerization, diastereoselectivity and hemilability in dicationic chiral ruthenium complexes with bidentate (PS) bisphosphine monosulfide ligands

The binding of heterobidentate P^∧S ligands introduces metal-centered chirality to the planar chiral parent complex Ru(η⁶:η¹-NMe₂C₆H₄C₆H₄PCy₂)Cl₂. Observed diastereomeric ratios for the kinetic product vary dramatically depending upon ring size of the chelate formed with the P^∧S ligand. The complexes epimerize very slowly to thermodynamic product ratios that are substantially different from the kinetic product ratios.     

Robustness and exponentiality in redundant repairable systems

A redundant system of independent repairable components with general failure time and repair time distributions is considered. It is shown that the system failure time has an expectation dependent only on the mean failure times and mean repair times of the components and not on their distributions. An intuitive argument is provided, based on the time of onset of the quasi-stationary distribution on the set of working states, to show that for highly reliable systems, the system failure time is exponentially distributed to good approximation. The argument also justifies a simple figure of merit for the quality of the exponential approximation. A key ingredient in the analysis is the system relaxation time, an informal review of which is provided.     

Effect of crack tip sharpness on the strength of vulcanized rubbers

The effect of crack tip sharpness on crack propagation in vulcanized rubbers has been studied. For very sharp cracks, tearing is found to occur on a small scale at very low energies not far above the threshold required for the onset of mechanical crack growth. The “small-scale” tearing energies show relatively little variation for rubbers that differ widely in tear strength as normally measured. Thus the latter property appears to be strongly influenced by variations in the ability of rubbers to promote tip blunting. The small-scale tear behavior is of relevance to other fracture phenomena, including cutting by sharp objects and tensile failure. Natural variations in tip sharpness occur during cyclic or time-dependent mechanical crack growth and influence the form of the crack growth characteristics.