Impact and Recovery of VHA Epilepsy Care Services During the COVID-19 Pandemic.

Background: The Epilepsy Centers of Excellence (ECoE) is a network of facilities within the Veterans Health Administration that evaluates and treats veterans with epilepsy and seizure disorders. This article outlines how the COVID-19 pandemic impacted ECoE services and recovery.

Methods: Directors of 17 ECoEs were surveyed 4 times between May 2020 and July 2022 on 5 domains: functioning of outpatient epilepsy clinics, outpatient electroencephalogram, epilepsy monitoring unit, anticipated permanent operational changes, and utility of national and local recommendations.

The Epilepsy Centers of Excellence at the Veterans Health Administration.

Introduction: The Veterans Health Administration (VHA) Epilepsy Centers of Excellence (ECoE) was established in 2008 to provide specialized care for veterans with epilepsy. Although established more than a decade ago, there has been no systematic evaluation of the ECoE's performance in key mission areas. We evaluated their performance in several key mission areas-clinical care, research, education, and outreach-since inception to evaluate their success in meeting the initial mandate.

Distinct comorbidity phenotypes among post-9/11 Veterans with epilepsy are linked to diverging outcomes and mortality risks.

Objective: To investigate phenotypes of comorbidity before and after an epilepsy diagnosis in a national cohort of post-9/11 Service Members and Veterans and explore phenotypic associations with mortality.

Methods: Among a longitudinal cohort of Service Members and Veterans receiving care in the Veterans Health Administration (VHA) from 2002 to 2018, annual diagnoses for 26 conditions associated with epilepsy were collected over 5 years, ranging from 2 years prior to 2 years after the year of first epilepsy diagnosis. Latent class analysis (LCA) was used to identify probabilistic comorbidity phenotypes with distinct health trajectories.

Hydrodynamic Mechanism for Clumping along the Equatorial Rings of SN1987A and Other Stars.

An explanation for the origin and number of clumps along the equatorial ring of Supernova 1987A has eluded decades of research. Our linear analysis and hydrodynamic simulations of the expanding ring prior to the supernova reveal that it is subject to the Crow instability between vortex cores. The dominant wave number is remarkably consistent with the number of clumps, suggesting that the Crow instability stimulates clump formation.

Role of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post-9/11 Era US Veterans.

Background And Objectives: Traumatic brain injury (TBI) is a well-established epilepsy risk factor and is common among service members. Deployment-related TBI, where combat/blast may be more common, may have different outcomes than nondeployment-related TBI. This work examined associations of all TBI exposures (not just combat), and epilepsy, while adjusting for comorbidities associated with epilepsy, among veterans by deployment status.

Space-time POD and the Hankel matrix.

Time-delay embedding is an increasingly popular starting point for data-driven reduced-order modeling efforts. In particular, the singular value decomposition (SVD) of a block Hankel matrix formed from successive delay embeddings of the state of a dynamical system lies at the heart of several popular reduced-order modeling methods. In this paper, we show that the left singular vectors of this Hankel matrix are a discrete approximation of space-time proper orthogonal decomposition (POD) modes, and the singular values are square roots of the POD energies.

The Grande Ronde Model Watershed: Integrating Science into Restoration Implementation and Adaptive Management.

Watershed conservation groups throughout the Pacific Northwest coordinate and implement watershed and habitat restoration to recover Pacific salmon Oncorhynchus spp. Many watershed organizations struggle with implementing an adaptive management process that integrates monitoring data and the latest science into their restoration programs. We describe the evolution and lessons learned from the Grande Ronde Model Watershed (GRMW), one of the longest running watershed organizations coordinating fish habitat restoration projects.

Utilization of epilepsy care among Women Veterans: A population-based study.

Objective: Higher healthcare utilization in epilepsy correlates with better clinical and quality of life outcomes. Women Veterans with epilepsy (WVE) have unique characteristics that may affect access and utilization of care. This study investigates epilepsy care in WVE, with respect to utilization of outpatient, inpatient, and emergency room care.

Psychiatric co-morbidity of drug-resistant epilepsy in Veterans.

Objective: Psychiatric conditions are frequently co-morbid in epilepsy and studies examining Veterans with epilepsy suggest this population may present with unique psychiatric and clinical features Drug-resistant epilepsy (DRE) may confer a greater risk of psychiatric dysfunction; however, there is a paucity of literature documenting this. To expand our clinical understanding of Veterans with DRE, we assessed a comprehensive Veterans Health Administration (VHA)-wide sample, describing psychiatric conditions, medications, and healthcare utilization.

Methods: Psychiatric and hospitalization data were collected on 52,579 Veterans enrolled in VHA healthcare between FY2014-2ndQtr.

In vitro activity of cysteamine against SARS-CoV-2 variants.

Global COVID-19 pandemic is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Continuous emergence of new variants and their rapid spread are jeopardizing vaccine countermeasures to a significant extent. While currently available vaccines are effective at preventing illness associated with SARS-CoV-2 infection, these have been shown to be less effective at preventing breakthrough infection and transmission from a vaccinated individual to others.

Resolvent-based modeling of turbulent jet noise.

Resolvent analysis has demonstrated encouraging results for modeling coherent structures in jets when compared against their data-educed counterparts from high-fidelity large-eddy simulations (LES). We formulate resolvent analysis as an acoustic analogy that relates the near-field resolvent forcing to the near- and far-field pressure. We use an LES database of round, isothermal, Mach 0.

Naturally occurring cancer-associated mutations disrupt oligomerization and activity of protein arginine methyltransferase 1 (PRMT1).

Protein arginine methylation is a posttranslational modification catalyzed by the protein arginine methyltransferase (PRMT) enzyme family. Dysregulated protein arginine methylation is linked to cancer and a variety of other human diseases. PRMT1 is the predominant PRMT isoform in mammalian cells and acts in pathways regulating transcription, DNA repair, apoptosis, and cell proliferation.

An azimuthal Fourier domain formulation of the Ffowcs Williams and Hawkings equation.

The acoustic field of high-speed turbulent jets is dominated by a small number of low-wavenumber azimuthal Fourier modes. Accordingly, it is of interest to directly obtain individual azimuthal modes of the acoustic field from simulation data or models of the jet near-field. To this end, we manipulate the Ffowcs Williams and Hawkings (FW-H) equation to obtain a new formulation that lives entirely in the azimuthal Fourier domain-it delivers individual azimuthal modes of the acoustic field as a function of the same azimuthal modes of the near-field FW-H source term or, upon linearization of the source terms, as a function of the same azimuthal modes of the near-field flow variables.

The Military Injuries: Understanding Post-Traumatic Epilepsy Study: Understanding Relationships among Lifetime Traumatic Brain Injury History, Epilepsy, and Quality of Life.

Understanding risk for epilepsy among persons who sustain a mild (mTBI) traumatic brain injury (TBI) is crucial for effective intervention and prevention. However, mTBI is frequently undocumented or poorly documented in health records. Further, health records are non-continuous, such as when persons move through health systems (e.

Treatment of Refractory Convulsive Status Epilepticus: A Comprehensive Review by the American Epilepsy Society Treatments Committee.

Purpose: Established tonic-clonic status epilepticus (SE) does not stop in one-third of patients when treated with an intravenous (IV) benzodiazepine bolus followed by a loading dose of a second antiseizure medication (ASM). These patients have refractory status epilepticus (RSE) and a high risk of morbidity and death. For patients with convulsive refractory status epilepticus (CRSE), we sought to determine the strength of evidence for 8 parenteral ASMs used as third-line treatment in stopping clinical CRSE.

Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography.

Purpose: Epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) are difficult to differentiate when based on a patient's self-reported symptoms. This study proposes review of objective data captured by a surface electromyography (sEMG) wearable device for classification of events as ES or PNES. This may help clinicians accurately identify ES and PNES.

"Chance Takers Are Accident Makers": Are Patients With Epilepsy Really Taking a Chance When They Drive?

This review compiles scientific data about the real dangers faced by people with epilepsy (PWE) who drive. Those include risks of motor vehicle accidents (MVA) in PWE as compared with controls (individuals without epilepsy) and as compared with persons with other medical conditions that impact fitness to drive. Data regarding Accident rates as related to seizure free intervals (SFI), single vs.

Self-Management in Epilepsy Care: Untapped Opportunities.

Constant accessibility, rapid scalability, and modest costs make digital and mobile epilepsy self-management platforms an attractive alternative to resource-intensive in-person programs.

A Gα12-specific Binding Domain in AKAP-Lbc and p114RhoGEF.

AKAP-Lbc is a Rho-activating guanine nucleotide exchange factor (RhoGEF) important in heart development and pro-fibrotic signaling in cardiomyocytes. Heterotrimeric G proteins of the G12/13 subfamily, comprising Gα12 and Gα13, are well characterized as stimulating a specialized group of RhoGEFs through interaction with their RGS-homology (RH) domain. Despite lacking an RH domain, AKAP-Lbc is bound by Gα12 through an unknown mechanism to activate Rho signaling.

The prevalence of epilepsy and association with traumatic brain injury in veterans of the Afghanistan and Iraq wars.

Objective: To examine the association of epilepsy with traumatic brain injury (TBI) in Afghanistan and Iraq (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) Veterans.

Design: Cross-sectional observational study.

Participants: A total 256 284 OEF/OIF Veterans who received inpatient and outpatient care in the Veterans Health Administration in fiscal years 2009-2010.

Parkinson's disease and forced exercise: a preliminary study.

Objective. The concept of forced exercise has drawn attention for the treatment of Parkinson's disease symptoms with anecdotal reports of success. This study sought to ascertain any significant effect of forced exercise using a motorized stationary bicycle when compared to controls on Parkinson's disease symptoms in a blinded, randomized, and controlled setting.

Baby lost and found: mothers' experiences of infants who cry persistently.

Introduction: The purpose of this study was to describe mothers' experiences of parenting an irritable infant. Although "colic" is regarded as a "self-limiting" condition that usually disappears by 3 to 4 months of age, the entire family is affected by the infant's crying; no definitive cause or cure has been identified.

Sample And Setting: Twelve middle-class married mothers (mean age=27.

Comparisons of the mortality and clinical presentations of status epilepticus in private practice community and university hospital settings in Richmond, Virginia.

We prospectively compared the clinical course of 119 patients treated for status epilepticus (SE) in private practice community hospitals and 344 SE patients treated in the VCU university hospitals in Richmond, Virginia USA over a 2-year period to test the hypothesis that SE presents with the same mortality and clinical patterns in both clinical settings. Of the patients reviewed, the major etiologies for SE were cerebrovascular disease, decreased anti-epileptic drug levels in epileptic patients, anoxia-hypoxia, and remote symptomatic. The other etiologies included were alcohol related, trauma, central nervous system infections, tumors, systemic infection, metabolic disorders, idiopathic, and hemorrhage.