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Objective: Describe the epidemiology of cluster headache (CH) using Veterans Health Administration (VHA) Electronic Health Record (EHR) data. Background: Epidemiologic studies of CH at the population level are difficult because it has a prevalence of ~0.1%. Hospital system‐wide studies are an attractive alternative as they have large numbers of patients and broader populations than headache or neurology clinic‐based studies. The VHA is an ideal hospital‐based system in which to study CH because it is nationwide, predominantly male, has a strong focus on mood disorders and suicidality, and has accessible individual medical records. Here, we report the first headache study based on an ongoing longitudinal cohort of patients with CH using VHA EHR data. Methods: The VHA EHR data were accessed from Fiscal Year 2008 to 2019. Patients with CH consisted of all patients with at least one outpatient visit containing a CH diagnosis code from the International Classification of Diseases (ICD)‐9 or ‐10. We extracted data on demographic features, incidence, and prevalence, as well as pain and psychiatric comorbidities. Results: Of the 1,524,960 distinct patients who presented for headache treatment in the VHA between Fiscal Year 2008–2019, 24,131 had at least one visit with a CH diagnosis. The 1‐year period prevalence of a CH diagnosis in the VHA ranges from 0.08% to 0.10% for women and 0.10% to 0.18% for men. A larger proportion of women versus men received a diagnosis of unspecified CH (59.6% [1412/2368] vs. 53.6% [11,663/21,763], p < 0.001). Most patients with CH had both comorbid headache and non‐headache pain diagnoses. Headache not‐otherwise‐specified was the most common comorbid headache disorder at 70.0% (16,885/24,131) and was more common in women (76.1%, 1801/2368) compared to men (69.3%, 15,084/21,763). Other common comorbidities included migraine, depression, tobacco use, and obstructive sleep apnea. Rates of suicidal ideation or attempt were almost 50% higher in women (5‐year proportion 9.4%, 222/2368) with CH compared to men (6.6%, 1433/21,763). Conclusions: To our knowledge this is the largest hospital system study of CH to date and reinforces several previous studies. Pain, mental health, and sleep disorders comorbidities are particularly prevalent in this group and were often more common in women compared to men with CH. Future work should examine gender and race stratified prevalence estimates within the VHA and other healthcare systems. Plain Language Summary: This study describes the epidemiology of cluster headache among all Veterans Health Administration (VHA) enrollees using electronic medical record data from the VHA. We found that during any given 1‐year period, between 0.08–0.10% of women and 0.10–0.18% of men in the VHA were treated for cluster headache. Many of these patients also had co‐occurring disorders including other headache disorders and depression, so more research is needed to find the best ways to treat these patients. [ABSTRACT FROM AUTHOR]

Background We investigated patients with potential severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection in the United States during May–July 2020. Methods We conducted case finding for patients with potential SARS-CoV-2 reinfection through the Emerging Infections Network. Cases reported were screened for laboratory and clinical findings of potential reinfection followed by requests for medical records and laboratory specimens. Available medical records were abstracted to characterize patient demographics, comorbidities, clinical course, and laboratory test results. Submitted specimens underwent further testing, including reverse transcription polymerase chain reaction (RT-PCR), viral culture, whole genome sequencing, subgenomic RNA PCR, and testing for anti-SARS-CoV-2 total antibody. Results Among 73 potential reinfection patients with available records, 30 patients had recurrent coronavirus disease 2019 (COVID-19) symptoms explained by alternative diagnoses with concurrent SARS-CoV-2 positive RT-PCR, 24 patients remained asymptomatic after recovery but had recurrent or persistent RT-PCR, and 19 patients had recurrent COVID-19 symptoms with concurrent SARS-CoV-2 positive RT-PCR but no alternative diagnoses. These 19 patients had symptom recurrence a median of 57 days after initial symptom onset (interquartile range: 47–76). Six of these patients had paired specimens available for further testing, but none had laboratory findings confirming reinfections. Testing of an additional 3 patients with recurrent symptoms and alternative diagnoses also did not confirm reinfection. Conclusions We did not confirm SARS-CoV-2 reinfection within 90 days of the initial infection based on the clinical and laboratory characteristics of cases in this investigation. Our findings support current Centers for Disease Control and Prevention (CDC) guidance around quarantine and testing for patients who have recovered from COVID-19. [ABSTRACT FROM AUTHOR]

Lean as a business strategy is used to improve quality and service, eliminate waste, reduce time and costs, and enhance overall organizational effectiveness. Heightening challenges in competition in recent years have prompted many small and medium-sized enterprises (SMEs) to adopt lean to enhance firms' competitiveness. This paper attempts to present an all-inclusive study and it examines various factors associated with the implementation of lean in SMEs in the U.S. The findings suggest that most of SMEs have a relatively accurate understanding of lean concept and philosophy. The primary reasons to implement lean are mainly internal, including reduce cost, improve profit margin, improve utilization of plant/facility, and maintain competitive position. A hierarchical cluster analysis was conducted to investigate lean status. It was discovered that both advanced adopters and beginners of lean are discovered. ANOVA test results show that there exist quite significant differences in terms of the degrees of lean implementation in SMEs. Varied lean tools and programs have been applied and they are positively related with firms' performance. Lastly, the paper provides evidences that major lean barriers are encountered by SMEs regarding management or people related factors as well as key knowledge and know-how. [ABSTRACT FROM AUTHOR]

Abstract: The licensed live attenuated influenza A vaccine (LAIV) in the United States is created by making a reassortant containing six internal genes from a cold-adapted master donor strain (ca A/AA/6/60) and two surface glycoprotein genes from a circulating/emerging strain (e.g., A/CA/7/09 for the 2009/2010 H1N1 pandemic). Technologies to rapidly create recombinant viruses directly from patient specimens were used to engineer alternative LAIV candidates that have genomes composed entirely of vRNAs from pandemic or seasonal strains. Multiple mutations involved in the temperature-sensitive (ts) phenotype of the ca A/AA/6/60 master donor strain were introduced into a 2009 H1N1 pandemic strain rA/New York/1682/2009 (rNY1682-WT) to create rNY1682-TS1, and additional mutations identified in other ts viruses were added to rNY1682-TS1 to create rNY1682-TS2. Both rNY1682-TS1 and rNY1682-TS2 replicated efficiently at 30°C and 33°C. However, rNY1682-TS1 was partially restricted, and rNY1682-TS2 was completely restricted at 39°C. Additionally, engineering the TS1 or TS2 mutations into a distantly related human seasonal H1N1 influenza A virus also resulted pronounced restriction of replication in vitro. Clinical symptoms and virus replication in the lungs of mice showed that although rNY1682-TS2 and the licensed FluMist®-H1N1pdm LAIV that was used to combat the 2009/2010 pandemic were similarly attenuated, the rNY1682-TS2 was more protective upon challenge with a virulent mutant of pandemic H1N1 virus or a heterologous H1N1 (A/PR/8/1934) virus. This study demonstrates that engineering key temperature sensitive mutations (PB1-K391E, D581G, A661T; PB2-P112S, N265S, N556D, Y658H) into the genomes of influenza A viruses attenuates divergent human virus lineages and provides an alternative strategy for the generation of LAIVs. [Copyright &y& Elsevier]

This study examines the US house mortgage finance in the context of the financial transformation of the entire credit market. It finds that the nation's credit market shifted away from less creditworthy borrowers under the macroeconomic dislocation and financial stress of the 1970s and 1980s, and returned to these borrowers amid the favourable macroeconomic conditions and a transformed financial industry during the 1990s. This pattern is generally confirmed by a simple simulation, in that gaps in the growth of ability to finance between the white/higher-income family and the African American/lower-income family widened during the 1970s' and 1980s' economic expansion, and narrowed during the 1990s' economic expansion. The simulation model also shows the interplay between two dimensions of the portfolio factors, mortgage interest rates and family income. During the 1970s and 1980s, disadvantages in mortgage interest rates for white/higher-income families were more than compensated for by their advantage in terms of income over African American/lower-income families. During the 1990s, the African American advantage in income growth was further aided by advantage in mortgage interest rates for the African American/lower-income family over the white/higher-income family. [ABSTRACT FROM AUTHOR]

Background: Incidence and mortality of lung cancer have dramatically decreased during the last decades, yet still approximately 160,000 deaths per year occurred in United States. Smoking intensity, duration, starting age, as well as environmental cofactors including air-pollution, showed strong association with major types of lung cancer. Lung squamous cell carcinoma is a subtype of non-small cell lung cancer, which represents 25% of the cases. Thus, exploring the molecular pathogenic mechanisms of lung squamous cell carcinoma plays crucial roles in lung cancer clinical diagnosis and therapy. Results: In this study, we performed integrative analyses on 299 comparative datasets of RNA-seq and methylation data, collected from 513 lung squamous cell carcinoma cases in The Cancer Genome Atlas. The data were divided into high and low smoking groups based on smoking intensity (Numbers of packs per year). We identified 1002 significantly up-regulated genes and 534 significantly down-regulated genes, and explored their cellular functions and signaling pathways by bioconductor packages GOseq and KEGG. Global methylation status was analyzed and visualized in circular plot by CIRCOS. RNA-and methylation data were correlatively analyzed, and 24 unique genes were identified, for further investigation of regional CpG sites' interactive patterns by bioconductor package coMET. AIRE, PENK, and SLC6A3 were the top 3 genes in the high and low smoking groups with significant differences. Conclusions: Gene functions and DNA methylation patterns of these 24 genes are important and useful in disclosing the differences of gene expression and methylation profiling caused by different smoking levels. [ABSTRACT FROM AUTHOR]

[Display omitted] • Effects of a novel process aid, SGL, in lettuce safety and quality were evaluated. • Laboratory testing resulted in a 3.15 log reduction in E. coli O157:H7. • Pilot-plant confirmed significant reduction in E. coli population. • Quality and shelf life of washed lettuce were unaffected by application of SGL. • SGL shows promise for improving the efficacy of the leafy green washing process. Outbreaks and product recalls involving romaine and iceberg lettuce are frequently reported in the United States. Novel technologies are needed to inactivate pathogens without compromising product quality and shelf life. In this study, the effects of a process aid composed of silver dihydrogen citrate, glycerin, and lactic acid (SGL) on Escherichia coli and Listeria monocytogenes concentrations on lettuce immediately after washing and during cold storage were evaluated. Sensory and quality attributes of fresh-cut iceberg lettuce were also evaluated. Laboratory results indicated that application of SGL solution for 30 s as a first step in the washing process resulted in a 3.15 log reduction in E. coli O157:H7 immediately after washing. For E. coli O157:H7 a significant difference between SGL treatment and all other treatments was maintained until day 7. On day zero, SGL led to a 2.94 log reduction of L. monocytogenes. However, there was no significant difference between treatments with or without SGL regardless of storage time. Pilot-plant results showed that samples receiving SGL spray followed by chlorinated flume wash exhibited a greater reduction (1.48 log) in nonpathogenic E. coli populations at the end of shelf life than other treatments (p < 0.05). Additional pilot plant tests were conducted to investigate the hypothesis that SGL residues could continue to impact microbial survival on the final washed lettuce. Results show that pathogens introduced subsequent to flume washing of lettuce pretreated with SGL solution were not affected by antimicrobial residues. The final quality and shelf life of flume washed lettuce were also unaffected by pretreatment with SGL. In conclusion, the results of this study demonstrate that this new technology has the potential to accelerate E. coli die-off on fresh-cut lettuce during cold storage and improve product safety, while not affecting quality throughout the shelf life of the finished products. [ABSTRACT FROM AUTHOR]

The EPA''s current and forthcoming coal generation regulations present enormous challenges for both utilities and state regulators because of their scope, the uncertainty regarding their final form, and the substantial costs they entail. Utilities need to develop a strategy that is compliant with environmental regulations, acceptable to state regulators, and leaves the utility financially sound. [Copyright &y& Elsevier]

The rise in the U.S. prison population over the past 40 years has heightened scrutiny of the incarceration of children and adolescents. Correlates of later reincarceration in this group, especially correlates relating to psychiatric and substance use disorders, are understudied in the U.S. population. We aimed to establish the prevalence and correlates of the reincarceration as adults of people incarcerated before age 18. Data were derived from clinical interviews and from validated diagnostic and psychometric instruments. They were obtained as part of a cross-sectional representative survey of the civilian U.S. population, the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). We identified 1,543 adults (4.3% of the NESARC sample) who had been incarcerated before they were 18. Of these, 55.9 percent had subsequently been incarcerated as adults. In addition to variables that have been repeatedly identified in criminological research (less education, past antisocial behavior, and parental imprisonment), substance use disorder, bipolar disorder, and longer childhood incarceration were independently associated with incarceration as an adult. The possibility that psychiatric treatment could reduce reincarceration in this group warrants longitudinal and experimental research., (© 2024 American Academy of Psychiatry and the Law.)

This study investigates the potential correlation between urinary caffeine levels and the occurrence of stroke, a serious cerebrovascular disease that can lead to disability or death. The data used in this study was obtained from the National Health and Nutrition Examination Survey conducted between 2009 and 2014. The study analyzed a total of 5,339 individuals, divided into a control group (n = 5,135) and a stroke group (n = 162). The researchers utilized multiple logistic regression and smoothed curve fitting to examine the relationship between urinary caffeine and caffeine metabolites and the incidence of stroke. The study found that higher urinary caffeine levels were associated with a lower risk of stroke in Mexican American participants (odds ratio [OR] = 0.886, 95% confidence interval [CI]: (0.791, 0.993), P = 0.037). After adjusting for certain participant characteristics, it was also found that higher urinary paraxanthine levels were associated with a lower risk of stroke incidence (OR = 0.991, 95% CI (0.984, 0.999), P = 0.027). Meanwhile, the highest urinary paraxanthine levels group had 43.7% fewer strokes than the lowest level group (OR = 0.563, 95% CI (0.341, 0.929), P = 0.025). In this study, we showed a negative link between urine paraxanthine levels and the risk of stroke. Meanwhile, urinary caffeine levels were negatively associated with the incidence of stroke in Mexican Americans, but no correlation in other populations. Our findings may have predictive and diagnostic implications in clinical practice. Further extensive prospective investigations are still needed to validate our conclusions., (© 2023. The Author(s).)

American foulbrood (AFB) is a cosmopolitan bacterial disease that affects honey bee (Apis mellifera) larvae and causes great economic losses in apiculture. Currently, no satisfactory methods are available for AFB treatment mainly due to the difficulties to eradicate the tenacious spores produced by the etiological agent of AFB, Paenibacillus larvae (Bacillales, Paenibacillaceae). This present review focused on the beneficial bacteria that displayed antagonistic activities against P. larvae and demonstrated potential in AFB control. Emphases were placed on commensal bacteria (genus Bacillus and lactic acid bacteria in particular) in the alimentary tract of honey bees. The probiotic roles lactic acid bacteria play in combating the pathogenic P. larvae and the limitations referring to the application of these beneficial bacteria were addressed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Entomological Society of America.)

The global emergence of many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants jeopardizes the protective antiviral immunity induced after infection or vaccination. To address the public health threat caused by the increasing SARS-CoV-2 genomic diversity, the National Institute of Allergy and Infectious Diseases within the National Institutes of Health established the SARS-CoV-2 Assessment of Viral Evolution (SAVE) programme. This effort was designed to provide a real-time risk assessment of SARS-CoV-2 variants that could potentially affect the transmission, virulence, and resistance to infection- and vaccine-induced immunity. The SAVE programme is a critical data-generating component of the US Government SARS-CoV-2 Interagency Group to assess implications of SARS-CoV-2 variants on diagnostics, vaccines and therapeutics, and for communicating public health risk. Here we describe the coordinated approach used to identify and curate data about emerging variants, their impact on immunity and effects on vaccine protection using animal models. We report the development of reagents, methodologies, models and notable findings facilitated by this collaborative approach and identify future challenges. This programme is a template for the response to rapidly evolving pathogens with pandemic potential by monitoring viral evolution in the human population to identify variants that could reduce the effectiveness of countermeasures., (© 2022. Springer Nature Limited.)

Introduction: The number of hematopoietic stem cell transplants (HSCTs) performed in the United States and worldwide is increasing. Cardiac events have been well described in HSCT, and the incidence and type of cardiac events have not changed over recent decades., Patients and Methods: This study adds to the body of evidence in describing the incidence and type of cardiac events experienced by an allogeneic and autologous HSCT population at a single institution from 2012 to 2017., Results: Sixty-five (9.8%) patients experienced cardiac events, including atrial arrhythmia (N = 39), acute heart failure (N = 9), acute coronary syndrome (N = 7), and new onset hypertension (N = 9), with a few instances of bradycardia, ventricular arrhythmia, pericardial effusion, and pericarditis. Our multivariable regression analysis identified age (older), creatinine (higher), and history of coronary artery disease to significantly correlate with risk of cardiac event (P = .005, P = .039, and P = .038, respectively). A subgroup analysis of those patients experiencing a cardiac event found pre-transplant atrial dilation by trans-thoracic echocardiogram to correlate with increased risk of atrial arrhythmia (33.8% vs. 9.7%; P = .03). Patients developing a CE had an increased risk of death within 1 year (11% vs. 32%; P < .001)., Conclusion: We review our results in context of other important HSCT cardiac studies to illuminate the most relevant factors of medical history, laboratory data, and cardiac measurements that will identify patients at higher risk, allowing for intervention to improve HSCT outcomes., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: For almost 50 y, the US National Health and Nutrition Examination Survey (NHANES) has measured the caloric consumption, and body heights and weights of Americans. The aim of this study was to determine, based on that data, how macronutrient consumption patterns and the weight and body mass index in the US adult population have evolved since the 1960s., Methods: We conducted the first comprehensive analysis of the NHANES data, documenting how macronutrient consumption patterns and the weight and body mass index in the US adult population have evolved since the 1960s., Results: Americans in general have been following the nutrition advice that the American Heart Association and the US Departments of Agriculture and Health and Human Services have been issuing for more than 40 y: Consumption of fats has dropped from 45% to 34% with a corresponding increase in carbohydrate consumption from 39% to 51% of total caloric intake. In addition, from 1971 to 2011, average weight and body mass index have increased dramatically, with the percentage of overweight or obese Americans increasing from 42% in 1971 to 66% in 2011., Conclusions: Since 1971, the shift in macronutrient share from fat to carbohydrate is primarily due to an increase in absolute consumption of carbohydrate as opposed to a change in total fat consumption. General adherence to recommendations to reduce fat consumption has coincided with a substantial increase in obesity., (Copyright © 2015 Elsevier Inc. All rights reserved.)