Optimizing diagnostic imaging through skills mix: costs and opportunities

YesIncreasing diagnostic capacity is a national priority to expedite the timeliness and appropriateness of patient treatment interventions. Imaging, encompassing a range of technologies including X-ray, Computer Tomography, Magnetic Resonance Imaging and ultrasound, is a key diagnostic service and central to decision making in most, if not all, disease pathways. However, imaging is an expensive discipline accounting for an estimated 3-5% of the annual NHS budget. As a result, it is imperative that we maximize service efficiency while optimizing patient outcomes

Discriminating quantum-optical beam-splitter channels with number-diagonal signal states: Applications to quantum reading and target detection

We consider the problem of distinguishing, with minimum probability of error, two optical beam-splitter channels with unequal complex-valued reflectivities using general quantum probe states entangled over M signal and M' idler mode pairs of which the signal modes are bounced off the beam splitter while the idler modes are retained losslessly. We obtain a lower bound on the output state fidelity valid for any pure input state. We define number-diagonal signal (NDS) states to be input states whose density operator in the signal modes is diagonal in the multimode number basis. For such input states, we derive series formulas for the optimal error probability, the output state fidelity, and the Chernoff-type upper bounds on the error probability. For the special cases of quantum reading of a classical digital memory and target detection (for which the reflectivities are real valued), we show that for a given input signal photon probability distribution, the fidelity is minimized by the NDS states with that distribution and that for a given average total signal energy N_s, the fidelity is minimized by any multimode Fock state with N_s total signal photons. For reading of an ideal memory, it is shown that Fock state inputs minimize the Chernoff bound. For target detection under high-loss conditions, a no-go result showing the lack of appreciable quantum advantage over coherent state transmitters is derived. A comparison of the error probability performance for quantum reading of number state and two-mode squeezed vacuum state (or EPR state) transmitters relative to coherent state transmitters is presented for various values of the reflectances. While the nonclassical states in general perform better than the coherent state, the quantitative performance gains differ depending on the values of the reflectances.Comment: 12 pages, 7 figures. This closely approximates the published version. The major change from v2 is that Section IV has been re-organized, with a no-go result for target detection under high loss conditions highlighted. The last sentence of the abstract has been deleted to conform to the arXiv word limit. Please see the PDF for the full abstrac

Embedding consultant radiographer roles within radiology departments: a framework for success

Introduction: Many organisations struggle to clearly differentiate the radiographer consultant role from advanced or specialist practice, with newly appointed consultant practitioners often ill-prepared for working at this level. This article discusses the design, implementation and validation of an outcomes framework for benchmarking competencies for trainee or new-in-post consultant radiographers. Methods: Five experienced radiographers from different clinical specialisms were seconded to a twelve month consultant trainee post, guided by a locally-devised outcomes framework. A longitudinal qualitative study explored, from the radiographers’ perspective, the impact of the outcomes framework on the transition to consultant practice and beyond. Data collection included semi-structured interviews (months 1, 6 and 12), validation via a focus group (month 18) and a group interview (5 years). Results: Early interactions with framework objectives were mechanistic, but as participants better understood the role more creative approaches emerged. Despite diverse clinical expertise, the framework facilitated parity between participants, promoting transparency and credibility which was important in how the consultant role was perceived. All participants achieved all framework outcomes and were subsequently appointed to substantive consultant radiographer positions. Conclusion: This outcomes framework facilitates experienced radiographers to successfully transition into consultant radiographers, enabling them to meet multiple non-clinical targets while continuing to work effectively within a changing clinical environment. It is the first validated benchmarking tool designed to support the transition to radiographer consultant practice. Adoption of the tool will provide a standardised measure of consultant radiographer outcomes that will promote inter-organisational transferability hitherto unseen in the U

Langmuir Wave Generation Through A Neutrino Beam Instability

A standard version of a kinetic instability for the generation of Langmuir waves by a beam of electrons is adapted to describe the analogous instability due to a beam of neutrinos. The interaction between a Langmuir wave and a neutrino is treated in the one-loop approximation to lowest order in an expansion in $1/M_W^2$ in the standard electroweak model. It is shown that this kinetic instability is far too weak to occur in a suggested application to the reheating of the plasma behind a stalled shock in a type II supernova (SN). This theory is also used to test the validity of a previous analysis of a reactive neutrino beam instability and various shortcomings of this theory are noted. In particular, it is noted that relativistic plasma effects have a significant effect on the calculated growth rates, and that any theoretical description of neutrino-plasma interactions must be based directly on the electroweak theory. The basic scalings discussed in this paper suggest that a more complete investigation of neutrino-plasma processes should be undertaken to look for an efficient process capable of driving the stalled shock of a type II SN.Comment: 23 pages, incl. 5 postscript figure

A method to find unstable periodic orbits for the diamagnetic Kepler Problem

A method to determine the admissibility of symbolic sequences and to find the unstable periodic orbits corresponding to allowed symbolic sequences for the diamagnetic Kepler problem is proposed by using the ordering of stable and unstable manifolds. By investigating the unstable periodic orbits up to length 6, a one to one correspondence between the unstable periodic orbits and their corresponding symbolic sequences is shown under the system symmetry decomposition