Healthcare Resource Utilization for Chronic Rhinosinusitis in Older Adults

Objectives: Chronic rhinosinusitis (CRS) is a common and costly health problem in the United States. While often associated with younger adults, CRS can affect the elderly. As the aging population increases in the United States, the cost burden of CRS in older adults is important to assess. The objective of this study is to characterize healthcare resource utilization (HCRU) and healthcare expenditure (HCE) for CRS in this population. Methods: Patients meeting criteria for CRS with three years of continuous data were identified on IBM® Marketscan Research Databases over a five-year period (2013–2017). Medication utilization, outpatient visits, surgery, and expenditures related to CRS were assessed for older adults (>65) and compared with other age groups. As a secondary analysis, multivariable generalized linear models were utilized to compare HCE while adjusting for baseline medication utilization. Results: A total of 238,825 patients met the inclusion criteria, of which 20,927 were older adults. Older adults had the highest overall prevalence of nasal polyps (10%) and asthma (16%) among adult groups. Surgery rate was lower than other adult groups, but medication utilization was the highest. Mean overall HCE at two years was highest in older adults (USD 2545 vs. 2298 in young adults). However, HCE was highest for the young adult group after adjusting for baseline medication usage. Conclusion: Older adults had a higher rate of CRS-related co-morbidities as well as the highest CRS-related medication utilization and unadjusted two-year HCE. Although the reasons for this are unclear, possibilities include greater disease severity and preference for medical versus surgical management. HCE for CRS is expected to increase as the aging population grows

Florigenic and Antiflorigenic Signalling in Plants

The evidence that FLOWERING LOCUS T (FT) protein and its paralog TWIN SISTER OF FT, act as the long distance floral stimulus, or at least that they are part of it in diverse plant species, has attracted much attention in recent years. Studies to understand the physiological and molecular apparatuses that integrate spatial and temporal signals to regulate developmental transition in plants have occupied countless scientists and have resulted in an unmanageably large amount of research data. Analysis of these data has helped to identify multiple systemic florigenic and antiflorigenic regulators. This study gives an overview of the recent research on gene products, phytohormones and other metabolites that have been demonstrated to have florigenic or antiflorigenic functions in plants