Understanding the burden of idiopathic generalized epilepsy in the United States, Europe, and Brazil: An analysis from the National Health and Wellness Survey.

The aim of this study was to understand the current burden of primary generalized tonic-clonic seizures (PGTCS) associated with idiopathic generalized epilepsy (IGE) as a function of seizure frequency. We analyzed data for (IGE) as a proxy measure of PGTCS. Little is known about the quality of life (QoL), health utility, productivity, healthcare resource utilization (HRU), and cost burden of PGTCS or IGE. Patients were identified from the US (2011, 2012, & 2013), 5EU (2011 & 2013), and Brazil (2011 & 2012) National Health and Wellness Survey, a nationally representative, internet-based survey of adults (18+ years). Patients that self-reported a diagnosis of IGE were categorized into seizure frequencies of: ≥1 seizure per week, 1-3 seizures per month, 1-4 seizures per year, or <1 seizure per year. QoL was measured using the SF-36v2 Mental (MCS) and Physical Component Summary (PCS) scores, health utilities with the SF-6D, productivity with the Work Productivity and Activity Impairment (WPAI) questionnaire, and HRU as reported in the past six months. Unit costs were estimated from the literature and multiplied against HRU values to calculate direct costs and WPAI values to calculate indirect costs. Generalized linear regression was utilized to examine the relationship between seizure frequency and each measure of burden with adjustment for covariates. Out of the general population surveyed, IGE was self-reported in 782 of 176,093 (US), 172 of 30,000 (UK), 106 of 30,001 (Germany), 87 of 30,000 (France), 31 of 12,011 (Spain), 22 of 17,500 (Italy), and 34 of 24,000 (Brazil). Persistent seizures (≥1 per year) were reported in over 40% of patients with IGE (10-15% with ≥1 seizure per week, 10-15% with 1-3 seizures per month, 20-25% with 1-4 seizures per year). Over 75% were treated with antiepileptic drugs (AEDs). Compared with those having <1 seizure per year (reference group), patients in the two most frequent seizure categories reported worse MCS and PCS scores. Patients in the three highest seizure frequency groups consistently reported worse health utility scores, and greater presenteeism (attending work while not physically or mentally capable of working), overall work impairment, activity impairment, HRU, indirect costs, and direct costs than the reference group. Despite the availability of AEDs during the year surveyed, a substantial number of patients experienced persistent seizures. Increasing seizure frequency was clearly associated with worse outcomes. The burden of PGTCS and IGE may be proportionally reduced by newer AEDs which may increase the proportion of seizure-free patients or shift more patients into lower seizure frequency categories

Three-dimensional coupled mode analysis of internal-wave acoustic ducts

A fully three-dimensional coupled mode approach is used in this paper to describe the physics of low frequency acoustic signals propagating through a train of internal waves at an arbitrary azimuth. A three layer model of the shallow water waveguide is employed for studying the properties of normal modes and their coupled interaction due to the presence of nonlinear internal waves. Using a robust wave number integration technique for Fourier transform computation and a direct global matrix approach, an accurate three-dimensional coupled mode full field solution is obtained for the tonal signal propagation through straight and parallel internal waves. This approach provides accurate results for arbitrary azimuth and includes the effects of backscattering. This enables one to provide an azimuthal analysis of acoustic propagation and separate the effects of mode coupled transparent resonance, horizontal reflection and refraction, the horizontal Lloyd's mirror, horizontal ducting and anti-ducting, and horizontal tunneling and secondary ducting.United States. Office of Naval Research (Grant N00014-11-1-0195)United States. Office of Naval Research (Grant N00014-11-1-0701

Low-frequency broadband sound source localization using an adaptive normal mode back-propagation approach in a shallow-water ocean

Author Posting. © Acoustical Society of America, 2012. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 131 (2012): 1798-1813, doi:10.1121/1.3672643.A variety of localization methods with normal mode theory have been established for localizing low frequency (below a few hundred Hz), broadband signals in a shallow water environment. Gauss-Markov inverse theory is employed in this paper to derive an adaptive normal mode back-propagation approach. Joining with the maximum a posteriori mode filter, this approach is capable of separating signals from noisy data so that the back-propagation will not have significant influence from the noise. Numerical simulations are presented to demonstrate the robustness and accuracy of the approach, along with comparisons to other methods. Applications to real data collected at the edge of the continental shelf off New Jersey, USA are presented, and the effects of water column fluctuations caused by nonlinear internal waves and shelfbreak front variability are discussed.The SW06 experiment was supported by the Office of Naval Research

Stochastic Energetics of Quantum Transport

We examine the stochastic energetics of directed quantum transport due to rectification of non-equilibrium thermal fluctuations. We calculate the quantum efficiency of a ratchet device both in presence and absence of an external load to characterize two quantifiers of efficiency. It has been shown that the quantum current as well as efficiency in absence of load (Stokes efficiency) is higher as compared to classical current and efficiency, respectively, at low temperature. The conventional efficiency of the device in presence of load on the other hand is higher for a classical system in contrast to its classical counterpart. The maximum conventional efficiency being independent of the nature of the bath and the potential remains the same for classical and quantum systems.Comment: To be published in Phys. Rev.

Three-dimensional sound propagation models using the parabolic-equation approximation and the split-step Fourier method

Author Posting. © IMACS, 2012. This article is posted here by permission of World Scientific Publishing for personal use, not for redistribution. The definitive version was published in Journal of Computational Acoustics 21 (2013): 1250018, doi:10.1142/S0218396X1250018X.The split-step Fourier method is used in three-dimensional parabolic-equation (PE) models to compute underwater sound propagation in one direction (i.e. forward). The method is implemented in both Cartesian (x, y, z) and cylindrical (r, θ, z) coordinate systems, with forward defined as along x and radial coordinate r, respectively. The Cartesian model has uniform resolution throughout the domain, and has errors that increase with azimuthal angle from the x axis. The cylindrical model has consistent validity in each azimuthal direction, but a fixed cylindrical grid of radials cannot produce uniform resolution. Two different methods to achieve more uniform resolution in the cylindrical PE model are presented. One of the methods is to increase the grid points in azimuth, as a function of r, according to nonaliased sampling theory. The other is to make use of a fixed arc-length grid. In addition, a point-source starter is derived for the three-dimensional Cartesian PE model. Results from idealized seamount and slope calculations are shown to compare and verify the performance of the three methods.This work was sponsored by the Office of Naval Research under the grants N00014-10-1-0040 and N00014-11-1-0701

Horizontal coherence of low-frequency fixed-path sound in a continental shelf region with internal-wave activity

Author Posting. © Acoustical Society of America, 2012. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 131 (2012): 1782-1797, doi:10.1121/1.3666003.Sound at 85 to 450 Hz propagating in approximately 80-m depth water from fixed sources to a joint horizontal/vertical line array (HLA/VLA) is analyzed. The data are from a continental shelf area east of Delaware Bay (USA) populated with tidally generated long- and short-wavelength internal waves. Sound paths are 19 km in the along-shore (along internal-wave crest) direction and 30 km in the cross-shore direction. Spatial statistics of HLA arrivals are computed as functions of beam steering angle and time. These include array gain, horizontally lagged spatial correlation function, and coherent beam power. These quantities vary widely in magnitude, and vary over a broad range of time scales. For example, correlation scale can change rapidly from forty to five wavelengths, and correlation-scale behavior is anisotropic. In addition, the vertical array can be used to predict correlation expected for adiabatic propagation with cylindrical symmetry, forming a benchmark. Observed variations are in concert with internal-wave activity. Temporal variations of three coherence measures, horizontal correlation length, array gain, and ratio of actual correlation length to predicted adiabatic-mode correlation length, are very strong, varying by almost a factor of ten as internal waves pass.This work was supported by Office of Naval Research (ONR) Grants Nos. N00014-05-1-0482 and N00014-11-1- 0194 to T.F.D., ONR Grant No. N00014-04-1-0146 to J.F.L., and an ONR Ocean Acoustics Postdoctoral Fellowship awarded to J.M.C. under Professor William Carey at Boston University

Observations of sound-speed fluctuations on the New Jersey continental shelf in the summer of 2006

Author Posting. © Acoustical Society of America, 2012. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 131 (2012): 1733-1748, doi:10.1121/1.3666014.Environmental sensors moored on the New Jersey continental shelf tracked constant density surfaces (isopycnals) for 35 days in the summer of 2006. Sound-speed fluctuations from internal-wave vertical isopycnal displacements and from temperature/salinity variability along isopycnals (spiciness) are analyzed using frequency spectra and vertical covariance functions. Three varieties of internal waves are studied: Diffuse broadband internal waves (akin to waves fitting the deep water Garrett/Munk spectrum), internal tides, and, to a lesser extent, nonlinear internal waves. These internal-wave contributions are approximately distinct in the frequency domain. It is found that in the main thermocline spicy thermohaline structure dominates the root mean square sound-speed variability, with smaller contributions coming from (in order) nonlinear internal waves, diffuse internal waves, and internal tides. The frequency spectra of internal-wave displacements and of spiciness have similar form, likely due to the advection of variable-spiciness water masses by horizontal internal-wave currents, although there are technical limitations to the observations at high frequency. In the low-frequency, internal-wave band the internal-wave spectrum follows frequency to the −1.81 power, whereas the spice spectrum shows a −1.73 power. Mode spectra estimated via covariance methods show that the diffuse internal-wave spectrum has a smaller mode bandwidth than Garrett/Munk and that the internal tide has significant energy in modes one through three.This work was supported by the Office of Naval Research, and Professor Colosi gratefully acknowledges his additional support from the Naval Postgraduate School’s Undersea Warfare Chair that he holds

Stochastic pump effect and geometric phases in dissipative and stochastic systems

The success of Berry phases in quantum mechanics stimulated the study of similar phenomena in other areas of physics, including the theory of living cell locomotion and motion of patterns in nonlinear media. More recently, geometric phases have been applied to systems operating in a strongly stochastic environment, such as molecular motors. We discuss such geometric effects in purely classical dissipative stochastic systems and their role in the theory of the stochastic pump effect (SPE).Comment: Review. 35 pages. J. Phys. A: Math, Theor. (in press