Search

Background: Nocturia, the most common lower urinary tract symptom (LUTS), significantly impacts socioeconomic factors and individuals' quality of life and is closely related to many diseases. This study utilized data from NHANES 2005–2010 to explore the relationship between family income to poverty ratio (PIR) and the presence of nocturia symptoms in adults aged 20 or older in the United States. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) in 2005–2010, including 6,662 adults aged 20 or older, were utilized for this cross-sectional study. The baseline data was used to display the distribution of each characteristic visually. Multiple linear regression and smooth curve fitting were used to study the linear and non-linear correlations between PIR and nocturia. Subgroup analysis and interaction tests were conducted to examine the stability of intergroup relationships. Results: Out of the 6,662 adult participants aged 20 or older, 1,300 households were categorized as living in poverty, 3,671 households had a moderate income, and 1,691 households were classified as affluent. Among these participants, 3,139 individuals experienced nocturia, representing 47.12% of the total, while 3,523 individuals were nocturia-free, constituting 52.88% of the total population. After adjusting for all other covariates, it was found that PIR was significantly negatively correlated with nocturia (OR: 0.875, 95%CI: 0.836–0.916 P<0.0001). This trend persisted when PIR was divided into three groups (PIR <1, PIR 1–4, PIR > 4) or quartiles. There was a non-linear negative correlation between PIR and nocturia. Conclusion: Our findings indicated that lower PlR was associated with a higher risk of nocturia in adults aged 20 or older in the United States. These findings highlight the importance of considering socioeconomic factors in preventing and managing nocturia. Nonetheless, further exploration of the causal nexus between these factors was precluded due to the constraints of a cross-sectional design. [ABSTRACT FROM AUTHOR]

Field-evolved resistance of the western corn rootworm (WCR), Diabrotica virgifera virgifera LeConte, to Bacillus thuringiensis Berliner (Bt) proteins Cry3Bb1 and Cry34/35Ab1 (now classified as Gpp34Ab1/Tpp35Ab1) expressed in the pyramid SmartStax® has been documented in areas of the United States (U.S.) Corn Belt. SmartStax® PRO is a recently registered rootworm-active pyramid containing the same Bt proteins expressed in SmartStax® plus DvSnf7 dsRNA. Little to no published data is available comparing efficacy of the technologies or potential effects of dietary exposure on adult WCR fitness. Therefore, experiments were conducted to compare effects of adult WCR dietary exposure to SmartStax® and SmartStax® PRO on life history parameters and efficacy of the technologies in the field with both Bt-susceptible and Bt-resistant WCR populations. WCR life history parameters evaluated included adult longevity, head capsule width, egg production, and egg viability. Results of small-plot field trials indicated that both technologies provided a high level of root protection when a Bt-susceptible WCR population was present. Root protection was reduced on SmartStax® but maintained on SmartStax® PRO when WCR Bt resistance occurred. Lifetime egg production was the key life history parameter that was significantly reduced when either Bt-susceptible or Bt-resistant adult WCR were fed SmartStax® or SmartStax® PRO diet. A potential fitness advantage was apparent as egg production was significantly higher in the Bt-resistant than Bt-susceptible population. The similar response by the Bt-susceptible WCR population to SmartStax® and SmartStax® PRO indicates that results were caused by sublethal dietary exposure to Bt proteins. Adult size (males < females) and egg viability (high: >95%) were not significantly different among treatments but longevity results were inconsistent between years. Collectively, the field efficacy and life history parameter data expand existing knowledge of SmartStax® and SmartStax® PRO technologies, which will inform practical WCR resistance management programs. [ABSTRACT FROM AUTHOR]

Purpose: Although circumcision is the most commonly performed surgery in males, less is known about the incidence and indications of adult circumcision. In this study, we aim to present the incidence of adult circumcision across the United States. Methods: Using IBM MarketScan® Commercial Database from 2015 to 2018, we obtained claims for circumcision in men between 18 and 64 years of age. We calculated the incidence of adult circumcision over the study period and across the United States. We also collected data on indications for surgery using International Classification of Diseases codes. Results: We identified a total of 12,298 claims for adult circumcisions. The mean age was 39 (±12.9) years. The average incidence rates remained relatively constant from 98.1 per 100,000 person-years in 2015 to 98.2 per 100,000 person-years in 2018 (Δ+0.1%). The age-standardized incidence rates varied significantly across the United States (from 0 to 194.8 per 100,000 person-years) with South Dakota having the highest rate. The most common indications for adult circumcision were phimosis (52.5%), routine/ritual circumcision (28.7%), phimosis + balanitis/balanoposthitis (6.8%), balanitis (3.8%) and balanoposthitis (2.6%), and significantly varied by age groups. Conclusion: This study suggested a wide geographic variation in rates of adult circumcision between states with highest incidences in the Northeast United States. Future studies can identify the underlying causes for the observed variations. [ABSTRACT FROM AUTHOR]

Recent clinical guidelines have emphasized non-opioid treatments in lieu of prescription opioids for chronic non-cancer pain, exempting cancer patients from these recommendations. In this study, we determine trends in opioid and non-opioid treatment among privately insured adults with chronic non-cancer pain (CNCP) or cancer. Using administrative claims data from IBM MarketScan Research Databases, we identified privately-insured adults who were continuously enrolled in insurance for at least one calendar year from 2012 to 2019. We identified individuals with CNCP diagnosis, defined as a diagnosis of arthritis, headache, low back pain, and/or neuropathic pain, and a individuals with cancer diagnosis in a calendar year. Outcomes included receipt of any opioid, non-opioid medication, or non-pharmacologic CNCP therapy and opioid prescribing volume, MME-per-day, and days' supply. Estimates were regression-adjusted for age, sex, and region. Between 2012 and 2019, the proportion of patients who received any opioid decreased across both groups (CNCP: 49.7 to 30.5%, p<0.01; cancer: 86.0 to 78.7%, p<0.01). Non-opioid pain medication receipt remained steady for individuals with CNCP (66.7 to 66.4%, p<0.01) and increased for individuals with cancer (74.4 to 78.8%, p<0.01), while non-pharmacologic therapy use rose among individuals with CNCP (62.4 to 66.1%, p<0.01). Among those prescribed opioids, there was a decrease in the receipt of at least one prescription with >90 MME/day (CNCP: 13.9% in 2012 to 4.9% in 2019, p<0.01; Cancer: 26.2% to 7.6%, p<0.01); >7 days of supply (CNCP: 56.3% to 30.7%, p <0.01; Cancer: 47.5% to 22.7%, p<0.01), the mean number of opioid prescriptions (CNCP: 5.2 to 3.9, p<0.01; Cancer: 4.0 to 2.7, p<0.01) and mean MME/day (CNCP: 49.9 to 38.0, p<0.01; Cancer: 62.4 to 44.7, p<0.01). Overall, from 2012–2019, opioid prescribing declined for CNCP and cancer, with larger reductions for patients with CNCP. For both groups, reductions in prescribed opioids outpaced increases in non-opioid alternatives. [ABSTRACT FROM AUTHOR]

The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility—moving into a different socioeconomic position than one's parents—among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis. [ABSTRACT FROM AUTHOR]