Browsing by Author "Wang, Yang"
Results Per Page
Sort Options
Item Open Access A widespread length-dependent splicing dysregulation in cancer.(Science advances, 2022-08) Zhang, Sirui; Mao, Miaowei; Lv, Yuesheng; Yang, Yingqun; He, Weijing; Song, Yongmei; Wang, Yongbo; Yang, Yun; Al Abo, Muthana; Freedman, Jennifer A; Patierno, Steven R; Wang, Yang; Wang, ZefengDysregulation of alternative splicing is a key molecular hallmark of cancer. However, the common features and underlying mechanisms remain unclear. Here, we report an intriguing length-dependent splicing regulation in cancers. By systematically analyzing the transcriptome of thousands of cancer patients, we found that short exons are more likely to be mis-spliced and preferentially excluded in cancers. Compared to other exons, cancer-associated short exons (CASEs) are more conserved and likely to encode in-frame low-complexity peptides, with functional enrichment in GTPase regulators and cell adhesion. We developed a CASE-based panel as reliable cancer stratification markers and strong predictors for survival, which is clinically useful because the detection of short exon splicing is practical. Mechanistically, mis-splicing of CASEs is regulated by elevated transcription and alteration of certain RNA binding proteins in cancers. Our findings uncover a common feature of cancer-specific splicing dysregulation with important clinical implications in cancer diagnosis and therapies.Item Open Access Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city.(Int J Equity Health, 2015-12-21) Liu, Yalan; Jiang, Yi; Tang, Shenglan; Qiu, Jingfu; Zhong, Xiaoni; Wang, YangBACKGROUND: Due to reform of the economic system and the even distribution of available wealth, emergency medical services (EMS) experienced greater risks in equity. This study aimed to assess the equity of EMS needs, utilisation, and distribution of related resources, and to provide evidence for policy-makers to improve such services in Chongqing city, China. METHODS: Five emergency needs variables (mortality rate of maternal, neonatal, cerebrovascular, cardiovascular, injury and poisoning) from the death surveillance, and two utilisation variables (emergency room visits and rate of utilisation) were collected from Chongqing Health Statistical Year Book 2008 to 2012. We used a concentration index (CI) to assess equality in the distribution of needs and utilisation among three areas with different per-head gross domestic product (GDP). In each area, we randomly chose two districts as sample areas and selected all the medical institutions with emergency services as subjects. We used the Gini coefficient (G) to measure equity in population and geographic distribution of facilities and human resources related EMS. RESULTS: Maternal-caused (CI: range -0.213 to -0.096) and neonatal-caused (CI: range -0.161 to -0.046)deaths declined in 2008-12, which focusing mainly on the less developed area. The maternal deaths were less equitably distributed than neonatal, and the gaps between areas gradually become more noticeable. For cerebrovascular (CI: range 0.106 to 0.455), cardiovascular (CI: range 0.101 to 0.329), injury and poisoning (CI: range 0.001 to 0.301) deaths, we documented a steady improvement of mortality; the overall equity of these mortalities was lower than those of maternal and neonatal mortalities, but distinct decreases were seen over time. The patients in developed area were more likely to use EMS (CI: range 0.296 to 0.423) than those in less developed area, and the CI increased over the 5-year period, suggesting that gaps in equity were increasing. The population distribution of facilities, physicians and nurses (G: range 0.2 to 0.3) was relatively equitable; the geographic distribution (G: range 0.4 to 0.5) showed a big gap between areas. CONCLUSIONS: In Chongqing city, equity of needs, utilization, and resources allocation of EMS is low, and the provision of such services has not met the needs of patients. To narrow the gap of equity, improvement in the capability of EMS to decrease cerebrovascular, cardiovascular, injury and poisoning cases, should be regarded as a top priority. In poor areas, allocation of facilities and human resources needs to be improved, and the economy should also be enhanced.Item Open Access Applying Urinary Biomarkers of 11-dehydrothromboxane B2 and 8-isoprostane to Understand the Health Effects of PM2.5 and Ozone Exposure(2020-04-23) Wang, YangBackground: Using urine has many advantages over using other biological specimens for biomonitoring of exposure and health effects. Urinary 8-isoprostane can reflect lipid oxidation damage and 11-dehydrothromboxane B2 (11dhTxB2) can reflect platelet activation. Urinary 11dhTxB2 and urinary 8-isoprostane have rarely been applied to studies of air pollution exposure and its health effects. Lipid oxidation and platelet activation are the potential pathophysiological mechanisms by which air pollution exposure causes various respiratory and cardiovascular diseases. This study applies the two urinary biomarkers to assess the health effect of short term PM2.5 and ozone exposure. Method: 89 healthy individuals (age>18years old) were recruited and divided into 2 groups. During the study, air purifiers were manipulated differently based on the group. Each participant's pollutant exposure was calculated using time-activity data and the concentration of pollutants. The urine samples were collected before and after each manipulation of air purifiers. The concentration of two urinary biomarkers were analyzed by HPLC coupled with mass spectrometers and normalized by urine specific gravity. The data of both biomarkers, exposures, and other information of the participants were analyzed using the R statistical software. Results: 12-hour, 24-hour and 2-week ozone (O3) exposure showed significant correlations with the level of urinary 8-isoprostane. One IQR (5.69µg/m3) increase of 12-h ozone exposure was associated with an increase in 8-isoprostane level by 28.48% ( 95% Cl: 18.79%, 38.32%, p-value <0.01). One IQR (6.98 µg/m3) incremental change of 24-h O3 exposure was associated with a 27.54% ( 95% Cl: 15.66%, 39.62%, p-value <0.05) increase in 8-isoprostane level. One IQR (4.47 µg/m3) incremental change of 2-week ozone exposure was associated with a 55.28% ( 95% Cl: 38.95%,72.16%, p-value <0.05 ) increase in urinary concentration of 8-isoprostane. One IQR (4.47 µg/m3) incremental change of 2-week ozone exposure was associated with an increase in 11dhTxB2 level by 22.33% ( 95% Cl: 13.64%,31.18%, p-value <0.01 ). PM2.5 exposure showed no significant correlation with either biomarker. Conclusion: Short-term ozone exposure was associated with lipid peroxidation and platelet thromboxane generation, reflected by increased concentrations of urinary 8-isoprostane and 11dhTxB2 associated with increasing exposure.Item Restricted Are mature smokers misinformed?(J Health Econ, 2009-03) Khwaja, Ahmed; Silverman, Dan; Sloan, Frank; Wang, YangWhile there are many reasons to continue to smoke in spite of its consequences for health, the concern that many smoke because they misperceive the risks of smoking remains a focus of public discussion and motivates tobacco control policies and litigation. In this paper we investigate the relative accuracy of mature smokers' risk perceptions about future survival, and a range of morbidities and disabilities. Using data from the survey on smoking (SOS) conducted for this research, we compare subjective beliefs elicited from the SOS with corresponding individual-specific objective probabilities estimated from the health and retirement study. Overall, consumers in the age group studied, 50-70, are not overly optimistic in their perceptions of health risk. If anything, smokers tend to be relatively pessimistic about these risks. The finding that smokers are either well informed or pessimistic regarding a broad range of health risks suggests that these beliefs are not pivotal in the decision to continue smoking. Although statements by the tobacco companies may have been misleading and thus encouraged some to start smoking, we find no evidence that systematic misinformation about the health consequences of smoking inhibits quitting.Item Open Access Bacterial‐Mediated Tumor Therapy: Old Treatment in a New Context(Advanced Science) Liu, Yao; Niu, Lili; Li, Nannan; Wang, Yang; Liu, Mingyang; Su, Xiaomin; Bao, Xuhui; Yin, Bo; Shen, ShunItem Open Access Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China.(Journal of the American Heart Association, 2016-04-22) Jin, Chen; Li, Wei; Qiao, Shu-Bin; Yang, Jin-Gang; Wang, Yang; He, Pei-Yuan; Tang, Xin-Ran; Dong, Qiu-Ting; Li, Xiang-Dong; Yan, Hong-Bing; Wu, Yong-Jian; Chen, Ji-Lin; Gao, Run-Lin; Yuan, Jin-Qing; Dou, Ke-Fei; Xu, Bo; Zhao, Wei; Zhang, Xue; Xian, Ying; Yang, Yue-JinTransradial percutaneous coronary intervention (PCI) has been increasingly adopted in clinical practice, given its potential advantages over transfemoral intervention; however, the impact of different access strategies on costs and clinical outcomes remains poorly defined, especially in the developing world.Using data from a consecutive cohort of 5306 patients undergoing PCI in China in 2010, we compared total hospital costs and in-hospital outcomes for transradial intervention (TRI) and transfemoral intervention. Patients receiving TRI (n=4696, 88.5%) were slightly younger (mean age 57.4 versus 59.5 years), less often women (21.6% versus 33.1%), more likely to undergo PCI for single-vessel disease, and less likely to undergo PCI for triple-vessel or left main diseases. The unadjusted total hospital costs were 57 900 Chinese yuan (¥57 900; equivalent to 9190 US dollars [$9190]) for TRI and ¥67 418 ($10,701) for transfemoral intervention. After adjusting for all observed patient and procedural characteristics using the propensity score inverse probability weighting method, TRI was associated with a lower total cost (adjusted difference ¥8081 [$1283]). More than 80% of the cost difference was related to lower PCI-related costs (adjusted difference -¥5162 [-$819]), which were likely driven by exclusive use of vascular closure devices in transfemoral intervention, and lower hospitalization costs (-¥1399 [-$222]). Patients receiving TRI had shorter length of stay and were less likely to experience major adverse cardiac events or post-PCI bleeding. These differences were consistent among clinically relevant subgroups with acute myocardial infarction, acute coronary syndrome, and stable angina.Among patients undergoing PCI, TRI was associated with lower cost and favorable clinical outcomes compared with transfemoral intervention.Item Open Access Do Chinese Investors Get What They Don’t Pay For? Expense Ratios, Loads, and The Returns to China's Open-End Mutual Funds(2015) Wang, YangIn this paper we analyze the performance of China's open-end mutual funds by different approaches. Using the data of 467 open-end mutual funds from 60 fund families from Jan 2010 to Apr 2015, we find that the performance of most mutual funds does not beat the collection of indexes that most closely track the fund, and the fund families with high expense ratios serve investors less well than those with low expense ratios. Investors would earn higher returns by investing in mutual funds with low expenses and low front end loads.
Item Open Access Effect of Lifestyle Changes after Percutaneous Coronary Intervention on Revascularization.(BioMed research international, 2020-01) Wang, Yang; Xian, Ying; Chen, Tao; Zhao, Yanyan; Yang, Jinggang; Xu, Bo; Li, WeiObjective:Whether optimal cardiovascular health metrics may reduce the risk of cardiovascular events in secondary prevention is uncertain. The study was conducted to evaluate the influence of lifestyle changes on clinical outcomes among the subjects underwent percutaneous coronary intervention (PCI). Methods:The study group consists of 17,099 consecutive PCI patients. We recorded data on subject lifestyle behavior changes after their procedure. Patients were categorized as ideal, intermediate, or poor CV health according to a modified Life's Simple 7 score (on body mass, smoking, physical activity, diet, cholesterol, blood pressure, and glucose). Multivariable COX regression was used to evaluate the association between CV health and revascularization event. We also tested the impact of cumulative cardiovascular health score on reoccurrence of cardiovascular event. Results:During a 3-year median follow-up, 1,583 revascularization events were identified. The observed revascularization rate was 8.0%, 9.3%, and 10.6% in the group of patients with optimal (a modified Life's Simple 7 score of 11-14), average (score = 9 or 10), or inadequate (less or equal than 8) CV health, respectively. After multivariable analysis, the adjusted hazard ratios were 0.83 (95% CI: 0.73-0.94) and 0.89 (95% CI: 0.79-0.99) for patients with optimal and average lifestyle changes comparing with the inadequate tertile (P for trend = 0.003). In addition, each unit increase in above metrics was associated with a decrease risk of revascularization (HR, 0.96; 95% confidence interval, 0.93-0.98; P for trend = 0.003). In addition, each unit increase in above metrics was associated with a decrease risk of revascularization (HR, 0.96; 95% confidence interval, 0.93-0.98. Conclusion:Ideal CV health related to lower incidence of cardiovascular events, even after the percutaneous coronary intervention. Revascularization can be reduced by lifestyle changes. The cardiovascular health metrics could be extrapolated to secondary prevention and need for further validation.Item Open Access Essays on Health Economics(2009) Wang, YangIn this dissertation, I discuss two important factors in individuals' decision-making processes: subjective expectation bias and time-inconsistent preferences. In Chapter I, I look at how individuals' own subjective expectations about certain future events are different from what actually happens in the future, even after controlling for individuals' private information. This difference, which is defined as the expectation bias in this paper, is found to have important influence on individuals' choices. Specifically, I look into the relationship between US elderly's subjective longevity expectation biases and their smoking choices. I find that US elderly tend to over-emphasize the importance of their genetic makeup but underestimate the influence of their health-related choices, such as smoking, on their longevity. This finding can partially explain why even though US elderly are found to be more concerned with their health and more forward-looking than we would have concluded using a model which does not allow for subjective expectation bias, we still observe many smokers. The policy simulation further confirms that if certain public policies can be designed to correct individuals' expectation biases about the effects of their genes and health-related choices on their longevity, then the average smoking rate for the age group analyzed in this paper will go down by about 4%.
In Chapter II, my co-author, Hanming Fang, and I look at one possible explanation to the under-utilization of preventive health care in the United States: procrastination. Procrastination, the phenomenon that individuals postpone certain decisions which incur instantaneous costs but bring long-term benefits, is captured in economics by hyperbolic discount factors and the corresponding time-inconsistent preferences. This chapter extends the semi-parametric identification and estimation method for dynamic discrete choice models using Hotz and Miller's (1993) conditional choice probability approach to the setting where individuals may have hyperbolic discounting time preferences and may be naive about their time inconsistency. We implement the proposed estimation method to US adult women's decisions of undertaking mammography tests to evaluate the importance of present bias and naivety in the under-utilization of mammography, controlling for other potentially important explanatory factors such as age, race, household income, and marital status. Preliminary results show evidence for both present bias and naivety in adult women's decisions of undertaking mammography tests. Using the parameters estimated, we further conduct some policy simulations to quantify the effects of the present bias and naivety on the utilization of preventive health care in the US.