Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review

As the evidence base supporting the use of laxatives in children is very limited, we undertook an updated systematic review to clarify the issue. A comprehensive literature search was carried out to identify randomised controlled trials of polyethylene glycol (PEG) versus either placebo or active comparator, in patients aged <18 years with primary chronic constipation. Outcomes were assessed as either global assessments of effectiveness or differences in defaecation rates. Seven qualifying studies involving 594 children were identified. Five were comparisons of PEG with lactulose, one with milk of magnesia and one with placebo. Study duration ranged from 2 weeks to 12 months. PEG was significantly more effective than placebo and either equivalent to (two studies) or superior to (four studies) active comparator. Differences in study design precluded meaningful meta-analysis. Lack of high quality studies has meant that the management of childhood constipation has tended to rely on anecdote and empirical treatment choice. Recent publication of well designed randomised trials now permits a more evidence-based approach, with PEG-based treatments having been proven to be effective and well-tolerated first-line treatment

An Enhanced Nonlinear Critical Gradient for Electron Turbulent Transport due to Reversed Magnetic Shear

The first nonlinear gyrokinetic simulations of electron internal transport barriers (e-ITBs) in the National Spherical Torus Experiment show that reversed magnetic shear can suppress thermal transport by increasing the nonlinear critical gradient for electron-temperature-gradient-driven turbulence to three times its linear critical value. An interesting feature of this turbulence is nonlinearly driven off-midplane radial streamers. This work reinforces the experimental observation that magnetic shear is likely an effective way of triggering and sustaining e-ITBs in magnetic fusion devices.Comment: 4 pages, 5 figure

An Enhanced Nonlinear Critical Gradient for Electron Turbulent Transport due to Reversed Magnetic Shear

The first nonlinear gyrokinetic simulations of electron internal transport barriers (e-ITBs) in the National Spherical Torus Experiment show that reversed magnetic shear can suppress thermal transport by increasing the nonlinear critical gradient for electron-temperature-gradient-driven turbulence to three times its linear critical value. An interesting feature of this turbulence is nonlinearly driven off-midplane radial streamers. This work reinforces the experimental observation that magnetic shear is likely an effective way of triggering and sustaining e-ITBs in magnetic fusion devices.Comment: 4 pages, 5 figure

Model-Based Signal Processing for Laser Ultrasonic Signal Enhancement

The use of laser-based ultrasonics in the testing of materials and structures offers various advantages over more traditional ultrasonic methods, but is often less sensitive when applied to real materials. Although high energy laser pulses can generate large ultrasonic displacements, nondestructive evaluation requires that the ablation regime be avoided, thus limiting the amount of optical energy which may be used. For this reason, signal processing of laser generated ultrasonic waveforms detected using laser interferometers may be required to extract the desired information from a nondestructive laser ultrasonic test. A model-based signal processing technique offers a way to enhance the signal-to-noise ratios significantly for ultrasonic waveforms obtained using laser-based systems with the generation of the ultrasound occurring in the nondestructive thermoelastic regime

Direct multiscale coupling of a transport code to gyrokinetic turbulence codes

Direct coupling between a transport solver and local, nonlinear gyrokinetic calculations using the multiscale gyrokinetic code TRINITY [M. Barnes, Ph.D. thesis, arxiv:0901.2868] is described. The coupling of the microscopic and macroscopic physics is done within the framework of multiscale gyrokinetic theory, of which we present the assumptions and key results. An assumption of scale separation in space and time allows for the simulation of turbulence in small regions of the space-time grid, which are embedded in a coarse grid on which the transport equations are implicitly evolved. This leads to a reduction in computational expense of several orders of magnitude, making first-principles simulations of the full fusion device volume over the confinement time feasible on current computing resources. Numerical results from TRINITY simulations are presented and compared with experimental data from JET and ASDEX Upgrade plasmas.Comment: 12 pages, 13 figures, invited paper for 2009 APS-DPP meeting, submitted to Phys. Plasma

Model-based internal wave processing

A model-based approach is proposed to solve the oceanic internal wave signal processing problem that is based on state-space representations of the normal-mode vertical velocity and plane wave horizontal velocity propagation models. It is shown that these representations can be utilized to spatially propagate the modal (dept) vertical velocity functions given the basic parameters (wave numbers, Brunt-Vaisala frequency profile etc.) developed from the solution of the associated boundary value problem as well as the horizontal velocity components. Based on this framework, investigations are made of model-based solutions to the signal enhancement problem for internal waves

Access to and adequacy of psychological services for adult patients in UK hospices: a national, cross-sectional survey

Abstract Background Providing psychological support to people living with terminal illness is a fundamental part of hospice care. Recent research on delivery of psychological services in hospices in the United Kingdom (UK) on a national level, including inequalities or variation in practice, is limited. A nationwide survey will highlight any differences in provision and in doing so help focus future research and inform best practice both within the UK, and internationally. The specific objectives of this survey are to (1) chart the types of psychological support available to adult patients in hospices in the UK in line with the National Institute for Health and Care Excellence model; (2) explore how services are organised; and (3) gather service perspectives on adequacy of care, and facilitators and barriers to appropriate practice. Methods A cross-sectional online survey emailed to adult hospices in the UK in November–December 2019. One staff member involved in the delivery and/or organisation of psychological support was invited to participate per hospice. Of 193 invited hospices, 116 took part. Results Sixteen percent rated their hospice psychological service as wholly adequate. The majority reported that services can access specialist professionals, but many relied on external referrals. Barriers to best practice included funding and staff capacity; facilitators included clear referral structures, audit and appropriate needs and outcome assessments. Conclusions Access to psychological professionals has improved since the last survey 15 years ago, but the majority of responders felt their overall service was not wholly adequate. Basic emotional support is largely felt to be sufficient, but our results indicate a need for improvements in access to more specialist care. Partnerships with external mental health services may be key. Our findings highlight core facilitators and barriers to providing good psychological care at the end of life that should be considered by services both within the UK and on an international level. </jats:sec

Passive Detection of Narrowband Sources Using a Sensor Array

In this report we derive a model for a highly scattering medium, implemented as a set of MATLAB functions. This model is used to analyze an approach for using time-reversal to enhance the detection of a single frequency source in a highly scattering medium. The basic approach is to apply the singular value decomposition to the multistatic response matrix for a time-reversal array system. We then use the array in a purely passive mode, measuring the response to the presence of a source. The measured response is projected onto the singular vectors, creating a time-reversal pseudo-spectrum. We can then apply standard detection techniques to the pseudo-spectrum to determine the presence of a source. If the source is close to a particular scatterer in the medium, then we would expect an enhancement of the inner product between the array response to the source with the singular vector associated with that scatterer. In this note we begin by deriving the Foldy-Lax model of a highly scattering medium, calculate both the field emitted by the source and the multistatic response matrix of a time-reversal array system in the medium, then describe the initial analysis approach