Using Discrete Event Simulation (DES) to manage theatre operations in healthcare: An audit-based case study

This paper discusses the application of Discrete Event Simulation (DES) in modelling the complex relationship between patient types, case-mix and operating theatre allocation in a large National Health Service (NHS) Trust in London. The simulation model that was constructed described the main features of nine theatres, focusing on operational processes and patient throughput times. The model was used to test three scenarios of case-mix and to demonstrate the potential of using simulation modelling as a cost effective method for understanding the issues of healthcare operations management and the role of simulation techniques in problem solving. The results indicated that removing all day cases will reduce patient throughput by 23.3% and the utilization of the orthopaedic theatre in particular by 6.5%. This represents a case example of how DES can be used by healthcare managers to inform decision making. © 2008 IEEE.

Short and long peptidoglycan recognition proteins (PGRPs) in zebrafish, with findings of multiple PGRP homologs in teleost fish

Peptidoglycan recognition protein (PGRP) specifically binds to peptidoglycan and is considered to be one of the pattern recognition proteins in the innate immunity of insect and mammals. Using a database mining approach and RT-PCR, multiple peptidoglycan recognition protein (PGRP) like genes have been discovered in fish including zebrafish Danio rerio, Japanese pufferfish TakiFugu rubripes and spotted green pufferfish Tetraodon nigroviridis. They share the common features of those PGRPs in arthropod and mammals, by containing a conserved PGRP domain. Based on the predicted structures, the identified zebrafish PGRP homologs resemble short and long PGRP members in arthropod and mammals. The identified PGRP genes in T. nigroviridis and TakiFugu rubripes resemble the long PGRPs, and the short PGRP genes have not been found in T. nigroviridis and TakiFugu rubripes databases. Computer modelling of these molecules revealed the presence of three alpha-helices and five or six beta-strands in all fish PGRPs reported in the present study. The long PGRP in teleost fish have multiple alternatively spliced forms, and some of the identified spliced variants, e.g., tnPGRP-L3 and tnPGRP-L4 (in: Tetraodon nigroviridis), exhibited no characters present in the PGRP homologs domain. The coding regions of zfPGRP6 (zf: zebrafish), zfPGRP2-A, zfPGRP2-B and zfPGRP-L contain five exons and four introns; however, the other PGRP-like genes including zfPGRPSC1a, zfPGRPSC2, tnPGRP-L1-, tnPGRP-L2 and frPGRP-L (fr: Takifugu rubripes) contain four exons and three introns. In zebrafish, long and short PGRP genes identified are located in different chromosomes, and an unknown locus containing another long PGRP-like gene has also been found in zebrafish, demonstrating that multiple PGRP loci may be present in fish. In zebrafish, the constitutive expressions of zfPGRP-L, zfPGRP-6 and zfPGRP-SC during ontogeny from unfertilized eggs to larvae, in different organs of adult, and the inductive expression following stimulation by Flavobacterium columnare, were detected by real-time PCR, but the levels and patterns varied for different PGRP genes, implying that different short and long PGRPs may play different roles in innate immune response. (c) 2007 Elsevier Ltd. All rights reserved.

A new crystal modification of gutta percha

Single chain and pauci chain single crystals of gutta percha in nanometer size were prepared by a dilute solution spraying method. A new crystal modification of gutta percha was found. The unit cell of the new modification of gutta percha was determined by electron diffraction crystal structure analysis to be a hexagonal form with cell dimensions: a = b = 0.695 nm, c = 0.661 nm, alpha = beta = 90 degrees, gamma =120 degrees; the space group is P6. The molecular packing in the unit cell was determined by computer modelling with Cerius(2) 2.0 software. (C) 1998 Elsevier Science Ltd. All rights reserved.

The synergic effect between Mo species and acid sites in Mo/HMCM-22 catalysts for methane aromatization

The acid properties of Mo/HMCM-22 catalyst, which is the precursor form of the working catalyst for methane aromatization reaction, and the synergic effect between Mo species and acid sites were studied and characterized by various characterization techniques. It is concluded that Bronsted and Lewis acidities of HMCM-22 are modified due to the introduction of molybdenum. We suggest a monomer of Mo species is formed by the exchange of Mo species with the Bronsted acid sites. On the other hand, coordinate unsaturated sites (CUS) are suggested to be responsible for the formation of newly detected Lewis acid sites. Computer modelling is established and coupling with experimental results, it is then speculated that the effective activation of methane is properly accomplished on Mo species accommodated in the 12 MR supercages of MCM-22 zeolite whereas the Bronsted acid sites in the same channel system play a key role for the formation of benzene. A much more pronounced volcano-typed reactivity curve of the Mo/HMCM-22 catalysts, as compared with that of the Mo/HZSM-5, with respect to Mo loading is found and this can be well understood due to the unique channel structure of MCM-22 zeolite and synergic effect between Mo species and acid sites.

Crystal engineering: exploiting variation of sulfur oxidation for the control of the solid state structure of organosulfur compounds

This thesis is focused on the design and synthesis of a diverse range of novel organosulfur compounds (sulfides, sulfoxides and sulfones), with the objective of studying their solid state properties and thereby developing an understanding of how the molecular structure of the compounds impacts upon their solid state crystalline structure. In particular, robust intermolecular interactions which determine the overall structure were investigated. These synthons were then exploited in the development of a molecular switch. Chapter One provides a brief overview of crystal engineering, the key hydrogen bonding interactions utilized in this work and also a general insight into “molecular machines” reported in the literature of relevance to this work. Chapter Two outlines the design and synthetic strategies for the development of two scaffolds suitable for incorporation of terminal alkynes, organosulfur and ether functionalities, in order to investigate the robustness and predictability of the S=O•••H-C≡C- and S=O•••H-C(α) supramolecular synthons. Crystal structures and a detailed analysis of the hydrogen bond interactions observed in these compounds are included in this chapter. Also the biological activities of four novel tertiary amines are discussed. Chapter Three focuses on the design and synthesis of diphenylacetylene compounds bearing amide and sulfur functionalities, and the exploitation of the N-H•••O=S interactions to develop a “molecular switch”. The crystal structures, hydrogen bonding patterns observed, NMR variable temperature studies and computer modelling studies are discussed in detail. Chapter Four provides the overall conclusions from chapter two and chapter three and also gives an indication of how the results of this work may be developed in the future. Chapter Five contains the full experimental details and spectral characterisation of all novel compounds synthesised in this project, while details of the NCI (National Cancer Institute) biological test results are included in the appendix.

Multiphysics modeling and its application to the casting process

A modeling strategy is presented to solve the governing equations of fluid flow, temperature (with solidification), and stress in an integrated manner. These equations are discretized using finite volume methods on unstructured grids, which provide the capability to represent complex domains. Both the cell-centered and vertex-based forms of the finite volume discretization procedure are explained, and the overall integrated solution procedure using these techniques with suitable solvers is detailed. Two industrial processes, based on the casting of metals, are used to demonstrate the capabilities of the resultant modeling framework. This manufacturing process requires a high degree of coupling between the governing physical equations to accurately predict potential defects. Comparisons between model predictions and experimental observations are given.

Predicting optimal process conditions for flip-chip aassembly using copper column bumped dies

Recently, research has been carried out to test a novel bumping method which omits the under bump metallurgy (UBM) forming process by bonding copper columns directly onto the Al pads of the silicon dies. This bumping method could be adopted to simplify the flip chip assembly process, increase the productivity and achieve a higher I/O count. Computer modelling methods are used to predict the shape of solder joints and response of the flip chip to thermal cyclic loading. The accumulated plastic strain energy at the comer solder joints is used as the damage indicator. Models with a range of design parameters have been compared for their reliability. The ranking of the relative importance of these parameters is given. Results from these analyses are being used by our industrial and academic partners to identify optimal design conditions.

Predicting the relationship between reliability and geometric parameters of cu column bumped flip-chips

Cu column bumping is a novel flip chip packaging technique that allows Cu columns to be bonded directly with the dies. It has eliminated the under-bump-metallurgy (UBM) fonnation step of the traditional flip chip manufacturing process. This bumping technique has the potential benefits of simplifying the flip chip manufacturing process, increasing productivity and the UO counts. In this paper, a study of reliability of Cu column bumped flip chips will be presented. Computer modelling methods have been used to predict the shape of solder joints and the response of flip chips to cyclic thermal-mechanical loading. The accumulated plastic strain energy at the corner solder joints has been used as an indicator of the solder joint reliability. Models with a wide range of design parameters have been compared for their reliability. The design parameters that have been investigated are the copper column height and radius, PCB pad radius, solder volume and Cu column wetting height. The relative importance ranking of these parameters has been obtained. The Lead-free solder material 96.5Sn3.5Ag has been used in this modelling work.

Maximising heat transfer efficiency in the cold crucible induction melting process

Induction heating is an efficient method used to melt electrically conductive materials, particularly if melting takes place in a ceramic crucible. This form of melting is particularly good for alloys, as electromagnetic forces set up by the induction coil lead to vigorous stirring of the melt ensuring homogeneity and uniformity in temperature. However, for certain reactive alloys, or where high purity is required, ceramic crucibles cannot be used, but a water-cooled segmented copper crucible is employed instead. Water cooling prevents meltdown or distortion of the metal wall, but much of the energy goes into the coolant. To reduce this loss, the electromagnetic force generated by the coil is used to push the melt away from the walls and so minimise contact with water-cooled surfaces. Even then, heat is lost through the crucible base where contact is inevitable. In a collaborative programme between Greenwich and Birmingham Universities, computer modelling has been used in conjunction with experiments to improve the superheat attainable in the melt for a,number of alloys, especially for y-TiAl intermetallics to cast aeroengine turbine blades. The model solves the discretised form of the turbulent Navier-Stokes, thermal energy conservation and Maxwell equations using a Spectral Collocation technique. The time-varying melt envelope is followed explicitly during the computation using an adaptive mesh. This paper briefly describes the mathematical model used to represent the interaction between the magnetic field, fluid flow, heat transfer and change of phase in the crucible and identifies the proportions of energy used in the melt, lost in the crucible base and in the crucible walls. The role of turbulence is highlighted as important in controlling heat losses and turbulence damping is introduced as a means of improving superheat. Model validation is against experimental results and shows good agreement with measured temperatures and energy losses in the cooling fluid throughout the melting cycle.

Effects of thermal cycling profiles on the performance of chip-on-flex assembly using anisotropic conductive films

Anisotropic conductive films (ACFs) are widely used in the electronic packaging industries because of their fine pitch potential and the assembly process is simpler compared to the soldering process. However, there are still unsolved issues in the volume productions using ACFs. The main reason is that the effects of many factors on the interconnects are not well understood. This work focuses on the performance of ACF-bonded chip-on-flex assemblies subjected to a range of thermal cycling test conditions. Both experimental and three-dimensional finite element computer modelling methods are used. It has been revealed that greater temperature ranges and longer dwell-times give rise to higher stresses in the ACF interconnects. Higher stresses are concentrated along the edges of the chip-ACF interfaces. In the experiments, the results show that higher temperature ranges and prolonged dwell times increase contact resistance values. Close examination of the microstructures along the bond-line through the scanning electron microscope (SEM) indicates that cyclic thermal loads disjoint the conductive particles from the bump of the chip and/or pad of the substrate and this is thought to be related to the increase of the contact resistance value and the failure of the ACF joints.

A hybrid Laplace transform/finite difference boundary element method for diffusion problems

The solution process for diffusion problems usually involves the time development separately from the space solution. A finite difference algorithm in time requires a sequential time development in which all previous values must be determined prior to the current value. The Stehfest Laplace transform algorithm, however, allows time solutions without the knowledge of prior values. It is of interest to be able to develop a time-domain decomposition suitable for implementation in a parallel environment. One such possibility is to use the Laplace transform to develop coarse-grained solutions which act as the initial values for a set of fine-grained solutions. The independence of the Laplace transform solutions means that we do indeed have a time-domain decomposition process. Any suitable time solver can be used for the fine-grained solution. To illustrate the technique we shall use an Euler solver in time together with the dual reciprocity boundary element method for the space solution

Fracture mechanics analysis of cracks in solder joint intermetallic compounds

The trend towards miniaturization of electronic products leads to the need for very small sized solder joints. Therefore, there is a higher reliability risk that too large a fraction of solder joints will transform into Intermetallic Compounds (IMCs) at the solder interface. In this paper, fracture mechanics study of the IMC layer for SnPb and Pb-free solder joints was carried out using finite element numerical computer modelling method. It is assumed that only one crack is present in the IMC layer. Linear Elastic Fracture Mechanics (LEFM) approach is used for parametric study of the Stress Intensity Factors (SIF, KI and KII), at the predefined crack in the IMC layer of solder butt joint tensile sample. Contrary to intuition, it is revealed that a thicker IMC layer in fact increases the reliability of solder joint for a cracked IMC. Value of KI and KII are found to decrease with the location of the crack further away from the solder interfaces while other parameters are constant. Solder thickness and strain rate were also found to have a significant influence on the SIF values. It has been found that soft solder matrix generates non-uniform plastic deformation across the solder-IMC interface near the crack tip that is responsible to obtain higher KI and KII.

Failure mechanisms of ACF joints under isothermal ageing

The possible failure mechanisms of anisotropic conductive film (ACF) joints under isothermal ageing conditions have been identified through experiments. It has been found that ACF joints formed at higher bonding temperatures can prevent increases in the contact resistance for any ageing temperature. The higher the ageing temperature the higher the electrical failure rate is. The formation of conduction gaps between the conductive particles and the pads and damages to the metal coatings of the particle have been identified as the reasons behind the electrical failures during ageing. In order to understand the mechanism for the formation of the conduction gap and damages in metal coatings during the isothermal ageing, computer modelling has been carried out and the results are discussed extensively. The computer analysis shows that stresses concentrate at the edges of the particle–pad interface, where the adhesive matrix meets the particle. This could lead to subsequent damages and reductions in the adhesion strength in that region and it is possible for the conductive particle to be detached from the pad and the adhesive matrix. It is believed that because of this a conduction gap appears. Furthermore, under thermal loading the thermal expansion of the adhesive matrix squeezes the conductive particle and damages the metal coatings. Experimental evidences support this computational finding. It is, therefore, postulated that if an ACF-based electronic component operates in a high temperature aging condition, its electrical and mechanical functionalities will be at risk.

Predictive reliability, prognostics and risk assessment for power modules

This paper describes a framework that is being developed for the prediction and analysis of electronics power module reliability both for qualification testing and in-service lifetime prediction. Physics of failure (PoF) reliability methodology using multi-physics high-fidelity and reduced order computer modelling, as well as numerical optimization techniques, are integrated in a dedicated computer modelling environment to meet the needs of the power module designers and manufacturers as well as end-users for both design and maintenance purposes. An example of lifetime prediction for a power module solder interconnect structure is described. Another example is the lifetime prediction of a power module for a railway traction control application. Also in the paper a combined physics of failure and data trending prognostic methodology for the health monitoring of power modules is discussed.