Biomedical subjects

Suojin Wang

Publications and source records attributed to Suojin Wang.

At least 19 recordsLinked to original sources

PubMed2006

Interactions among genomic structure, function, and evolution revealed by comprehensive analysis of the Arabidopsis thaliana genome.

The genome in a higher organism consists of a number of types of nucleotide sequence-specialized components, with each having tens of thousands of members or elements. It is crucial for our understanding of how a genome as an entity is organized, functions, and evolves to determine how these components are organized in the genome and how they relate with each other; however, no such knowledge is available. Here, we report a comprehensive analysis of the organization and interaction of all 40 components constituting the genome of the plant model species, Arabidopsis thaliana, at the whole-genome and chromosome levels. The 40 components include (i) 6 genome structural components consisting of GC%, genes, retrotransposons, DNA transposons, simple repeats, and low complex repeats; (ii) 3 evolutionarily critical features consisting of recombination rate, nucleotide substitutions, and nucleotide insertions/deletions; and (iii) 31 categories of genes with different functions and numbers of functions. We show that the distributions of 39 of the 40 components of the genome (excepting GC%) deviate significantly from the random distribution model and different types of the genome components are significantly correlated. These results remained to be true even when the genomic regions, such as centromeric regions, where transposable and repeat elements are abundant were excluded from the analyses. These findings suggest that DNA molecules contained in the Arabidopsis genome are each organized and structured from their constituting components in an unambiguous manner and that different types of the components that constitute or characterize the genome interact. The analysis also showed that each chromosome consists of a similar set of the components at similar densities, suggesting that the unique organization and interaction pattern of the components in each chromosome may represent, at least in part, the identity of a chromosome or a genome at the genome level, thus partly accounting for the phenotypic variation among different species. The data also provide comprehensive and new insights into many phenomena significant in genome biology, with which we particularly discuss the variation of genetic recombination. The variation of genetic recombination rate along a chromosomal arm is shaped, not only by the distribution of simple repeats, retrotransposons, DNA transposons, and nucleotide substitutions, but also by the functions of genes contained, especially those with multiple functions, suggesting that variation of genetic recombination along a chromosomal arm is the result of interactions among the components constituting local genome structure, function, and evolution.

Arabidopsis↗

PubMed2006

Recent trends in advance directives at nursing home admission and one year after admission.

PURPOSE: Advance directives are important planning and decision-making tools for individuals in nursing homes. DESIGN AND METHODS: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. RESULTS: The prevalence of having any advance directive at admission declined slightly from 2000 to 2004, whereas the prevalence of having any advanced directive at 12 months after admission increased slightly during the same period. Compared with admissions, residents at 12 months post-admission were more likely to have their decisions made by family members and to have advance directives of any type. IMPLICATIONS: The results suggest that greater use of advance directives in nursing homes may depend on additional information and support from nursing facility personnel and the health and social services professionals who are in contact with individuals moving toward nursing home admission, as well as those who remain in facilities over time.

Advance Directives↗

PubMed2006

Satisfaction with mental health care among people with multiple sclerosis in urban and rural areas.

OBJECTIVES: This study explored urban and rural differences in mental health needs and treatments among people with multiple sclerosis, as well as their satisfaction with access to and quality of mental health care. METHODS: Data were collected in a nationwide survey of 1,518 people with multiple sclerosis. RESULTS: More than 40 percent of people with multiple sclerosis in each urban or rural area had received a diagnosis of depression, and more than 90 percent of them received mental health services, regardless of location of residence. However, rural residents were significantly less likely than their urban counterparts to receive the recommended combined medication and psychotherapy for treatment of depression. CONCLUSIONS: Current mental health care systems, even in rural areas, are capable of reaching out to patients with neuromedical illnesses, such as multiple sclerosis. Patients perceive some limitations in quality and accessibility, and recommended treatment differs between urban and rural areas.

Adult↗

PubMed2006

Racial analyses of longer-stay nursing home residents with multiple sclerosis.

OBJECTIVES: Compare profiles of African Americans with multiple sclerosis (MS) to White residents with MS one year after admission to a nursing facility. METHODS: We used all admission assessments recorded in the national Minimum Data Set (MDS) from 1999 to 2001 as well as all MDS annual assessments recorded from 2000 to 2002. We matched admission assessments with first annual assessment for 3632 White residents with MS and 461 African-American residents with MS. RESULTS: African Americans with MS were admitted at a significantly younger age and with more aid to daily living (ADL) dependence and cognitive dysfunction than Whites with MS one year after admission. Despite significantly poorer physical performance, cognitive function, and more medical comorbidities, African Americans with MS did not receive significantly more therapies or medications than White residents with MS after one year in the facility. CONCLUSIONS: Basic differences in MS expression and progression in African Americans appear to have to do with both genetic and environmental factors. Further study will help to clarify the reasons for these differences.

Adult↗

PubMed2005

Estimating misclassification error with small samples via bootstrap cross-validation.

MOTIVATION: Estimation of misclassification error has received increasing attention in clinical diagnosis and bioinformatics studies, especially in small sample studies with microarray data. Current error estimation methods are not satisfactory because they either have large variability (such as leave-one-out cross-validation) or large bias (such as resubstitution and leave-one-out bootstrap). While small sample size remains one of the key features of costly clinical investigations or of microarray studies that have limited resources in funding, time and tissue materials, accurate and easy-to-implement error estimation methods for small samples are desirable and will be beneficial. RESULTS: A bootstrap cross-validation method is studied. It achieves accurate error estimation through a simple procedure with bootstrap resampling and only costs computer CPU time. Simulation studies and applications to microarray data demonstrate that it performs consistently better than its competitors. This method possesses several attractive properties: (1) it is implemented through a simple procedure; (2) it performs well for small samples with sample size, as small as 16; (3) it is not restricted to any particular classification rules and thus applies to many parametric or non-parametric methods.

Algorithms↗

PubMed2005

Patterns of therapeutic prescription medication category use among community-dwelling homebound older adults.

PURPOSE: The measurement of prescription medication use is usually through a simple count of medications, which tends to ignore therapeutic categories. This research investigated prescription medication use among homebound older adults, by documenting the therapeutic prescription medication categories used by these individuals and identifying the factors associated with use of multiple therapeutic categories. METHODS: Baseline Nutrition and Function Study (2000-2001) data from 326 homebound older persons who completed the medication review component (visual inspection of medications) of the baseline in-home interview and used > or =1 prescribed medication were included in this analysis. RESULTS: More than 40% (n = 133) regularly took medications from three to four different therapeutic categories and 31.6% (n = 103) used > or =5 different therapeutic categories. The use of respiratory medications declined with increasing age, and more women than men used diuretic and thyroid replacement medications. Independent of other factors, increased use of multiple therapeutic categories was associated with sociodemographic characteristics (gender, age, living arrangement, marital status and medication coverage), medical conditions (diabetes, heart problems and lung disease) and inability to self-manage medications. CONCLUSIONS: Our findings suggest that individual characteristics and medical conditions may help identify homebound elders at high risk for using prescription medications from an increased number of different therapeutic categories. This observation may help clinicians and community-based providers of services to older persons to be aware of differences in therapeutic medication use within an older population, and how patterns of use may alter service needs.

Age Factors↗

PubMed2005

Nursing home residents with multiple sclerosis and dementia compared to other multiple sclerosis residents.

Cognitive impairment may be a significant symptom in multiple sclerosis (MS), affecting about one half of MS patients in study samples similar to the general MS population. An interesting question is what role dementia, of any aetiology, plays in the cognitive ability of people with MS. The objective of this research is to learn more about nursing home residents with MS and dementia, identifying how they differ from other residents with MS. We developed profiles of MS residents with dementia using the Minimum Data Set and compared these profiles to other residents with MS. Nursing home residents with MS and dementia are admitted to nursing facilities at an older age and seem less likely to have physical impairments but more mood and behaviour problems than other MS residents at admission. A cortical variant of MS may be more prevalent than previously suspected and may be a factor responsible leading to nursing home admission in this subgroup of patients. Further clinical analysis of this subgroup would be necessary to support this contention.

Adult↗

PubMed2004

Analyses of gender differences in profiles of nursing home residents with Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD), a progressive, neurodegenerative disorder characterized by memory loss, language deterioration, impairment of visuospatial skills, poor judgment, and indifference, but preserved motor function, is the most common type of dementia, accounting for two thirds or more of all cases of dementia. The identification of differences between men and women with AD might present opportunities to improve the quality of AD-related care provided by nursing facilities, as well as lead to additional analyses of nursing home residents with AD. OBJECTIVE: The objectives of this study were to gain additional insight into gender differences in nursing home residents with AD in the United States, and to provide a better understanding of their health status and the care they receive in nursing facilities. METHODS: All admission assessments recorded in the Minimum Data Set (MDS) throughout the United States during 2000 were analyzed. P values for all significant differences were <0.001. RESULTS: A total of 49,607 residents with a diagnosis of AD (67.9% women) were identified. Female residents with AD were more likely to be older and widowed, whereas male residents with AD were more likely to be married. We found minimal gender differences in cognitive impairment among these residents with AD, although women were more likely to understand and be understood by others. Male residents with AD were more likely to exhibit behavioral symptoms, whereas female residents with AD tended to be more physically impaired and dependent on others for activities of daily living. Significant differences in comorbidities were found between the sexes, with greater proportions of male residents with AD having cardiac-related conditions, stroke, cancer, and other life-threatening chronic conditions. Male residents with AD were more likely to receive care in AD special-care units; daily antipsychotic medications; and intervention programs for mood, behavior, and cognitive loss than female residents with AD. CONCLUSIONS: In this study of nursing home residents identified using the MDS, key differences were found between male and female residents with AD, including age; cognitive and communicative abilities; and mental health, mood, and behavioral patterns.

Activities of Daily Living↗

PubMed2004

End-of-life care in nursing homes: residents in hospice compared to other end-stage residents.

OBJECTIVE: To compare residents in hospice care at admission to the nursing facility to end stage residents not in hospice at admission. DESIGN AND METHODS: We analyzed 18,211 admission assessments recorded in the Minimum Data Set (MDS) during the year 2000 throughout the United States for residents classified as having an end-stage disease (6 or fewer months to live). Fifty-nine percent (n = 10,656) of these residents were in hospice care at the time of their admission assessment. We used these MDS admission assessments to compare residents in hospice care to other end-stage residents not in hospice for demographic characteristics, health status, and treatments. RESULTS: Hospice residents at admission were significantly more likely to be female, older, white, and widowed than other end-stage residents at admission. There were significant differences between hospice residents and other residents at end stage in the use of advanced directives at admission. Hospice residents at admission experienced significantly more frequent and more intense pain than other end-stage residents at admission, while these hospice residents also showed greater impairment in cognitive ability and physical function. While cancer was the most common disease among these end-stage residents, it was significantly more prevalent among hospice residents. IMPLICATIONS: Many end-stage residents may not be receiving adequate palliative care in nursing facilities; further study of this is warranted. The MDS should be revised to record minimum standards for palliative care with or without the use of hospice to improve end-of life care in nursing facilities.

Activities of Daily Living↗

PubMed2004

Rural-urban comparisons of nursing home residents with multiple sclerosis.

CONTEXT: Multiple sclerosis (MS) is the most common neurologic disease that disables younger adults, affecting as many as 350,000 Americans. PURPOSE: The objectives of this study are to develop profiles of nursing home residents with MS from rural areas and compare them to residents with MS who lived in urban areas, suburban areas, and large towns. METHODS: We analyzed all admission assessments for residents with MS (13,357 assessments) in the Minimum Data Set between June 23, 1998, and December 31, 2000, that also had the resident's ZIP code of primary residence before admission. FINDINGS: Urban and rural comparisons of residents with MS demonstrate a range of significant demographic differences. Significantly greater proportions of MS residents from rural areas exhibited a sense of initiative or involvement in activities of the nursing facility compared with residents with MS from urban and suburban areas. The differences in the utilization of physical and occupational therapies were striking, with MS residents from rural areas averaging significantly fewer minutes of these therapies. We also found that MS residents from rural areas averaged fewer minutes of psychological therapy in the nursing facility and also were less likely to have seen a licensed mental health specialist than MS residents from urban areas. CONCLUSIONS: Nursing home residents with MS from rural areas receive fewer therapies and less mental health care than residents with MS from other areas.

Female↗

PubMed2004

Urban/rural differences in decision making and the use of advance directives among nursing home residents at admission.

CONTEXT: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. PURPOSE: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural areas. METHODS: A total of 551,208 admission assessments in the Minimum Data Set were analyzed for all residents admitted to a nursing facility in 2001. Using the Rural Urban Commuting Areas (RUCA) methodology and ZIP code of primary residence before admission, these residents were classified into 4 urban/rural areas. FINDINGS: Residents from rural areas were significantly more likely to have executed a durable power of attorney for health care or for financial decisions than residents admitted from the other areas, with the largest differences observed between residents admitted from urban and rural areas. Almost 6 residents in 10 from urban areas had no advance directives in place at admission compared with only 4 residents in 10 admitted from rural areas. CONCLUSIONS: Health providers and social workers in both rural and urban areas should advise patients about the value of advance directives.

Advance Directives↗

PubMed2004

Nursing home residents with multiple sclerosis: comparisons of African American residents to white residents at admission.

This research profiles African American residents with multiple sclerosis (MS) at admission to the nursing facility and compares them to profiles of white residents with MS using the Minimum Data Set (MDS). We analysed MDS admission assessments for 1367 African Americans with MS and 9294 whites with MS. African American residents with MS were significantly younger at admission than white residents with MS, with almost one half of these African Americans 50 years or younger compared to only one quarter of these whites. African American residents with MS were significantly more physically disabled and cognitively impaired at admission than white residents with MS. Although there were significant racial differences in disability, there were no significant racial differences among these MS residents in the use of various therapies provided by qualified therapists. These observed racial differences among MS residents in disease manifestations, severity, progression and disability are due to multiple variables and point out the need for more research. By combining discoveries from genetics, immunology, epidemiology and virology we can gain a better understanding of the complex pathophysiology of MS and develop more effective treatments and preventive measures. Our findings also indicate potential racial disparities in the use of MS-related care, illustrating that a greater outreach effort may be needed to evaluate and treat African Americans with MS.

Adult↗

PubMed2004

Analyses of nursing home residents with multiple sclerosis at admission and one year after admission.

This research compares profiles of residents with multiple sclerosis (MS) at admission to the nursing facility with profiles of these same residents one year later using the Minimum Data Set (MDS) to determine how their health and care received changed after one year in the facility. We matched MDS admission assessments with their first annual assessment for 1309 residents with MS. These residents with MS demonstrated deterioration in cognitive performance, communication skills, motor performance and bladder/bowel continence after one year in the facility. However, the proportion of residents with urinary tract infections and the proportion of residents with pressure ulcers declined after one year. A significantly larger proportion of these MS residents had a diagnosis of depression one year after admission, with significantly increased use of antipsychotic and antidepressant medications but little and declining use of psychological therapy after one year in the facility. In addition, there was a significant decline after one year in the use of physical, occupational, and speech therapies. These longer stay residents with MS may benefit from support services directed toward mental health and increased use of physical, occupational and psychological therapies provided in the nursing facility.

Aged↗

PubMed2003

Profiles of nursing home residents with traumatic brain injury using the Minimum Data Set.

OBJECTIVE: To present comprehensive profiles of nursing home residents with TBI at admission. METHODS: Over 12,300 assessments from the Minimum Data Set were analysed to create these profiles. RESULTS: Residents with TBI were overwhelmingly male and averaged 53.1 years of age at admission, with almost 30% being 40 years or younger. They tended to have substantial physical disability and severe cognitive impairment at admission. Compared to other residents at admission, residents with TBI tended to receive more treatments and rehabilitation therapies. CONCLUSION: Caring for residents with TBI presents major challenges for the staff in the traditional nursing home.

Activities of Daily Living↗

PubMed2003

Analyses of nursing home residents with multiple sclerosis and depression using the Minimum Data Set.

Depression is the most common psychiatric condition among people with multiple sclerosis (MS). A total of 14009 people with MS at admission to a nursing facility were analyzed using the Minimum Data Set and 36% also had depression. This study developed profiles of nursing home residents with MS who also had depression and compared them with other residents with MS. MS residents with depression were significantly more likely to be female and younger than other MS residents, with significant racial differences as well. MS residents with depression were significantly more likely than other MS residents to have a history of mental health conditions, exhibit mood indicators, and have unsettled relationships. Both groups of MS residents had high levels of physical disability, although MS residents with depression tended to be slightly less disabled. MS residents with depression were more likely than other MS residents to experience daily pain and more likely to have the diseases common to all residents with MS. This research found that most MS residents with depression did not receive mental health services, demonstrating that nursing facilities must improve the mental healthcare provided to residents with MS with depression.

Adaptation, Psychological↗

PubMed2003

Co-morbidity and treatment needs among nursing home residents receiving alcohol and drug treatment.

This study profiles nursing home residents receiving alcohol and drug treatment, describing their sociodemographic, health, and treatment characteristics. We analyzed 3,662 admission assessments in the Minimum Data Set for people receiving alcohol/drug treatment from June, 1998 through September, 2000. These residents were likely to be male and under age 50. More than half were White and 29 percent were African American. Typically, these residents were not physically or cognitively impaired. However, more than 39 percent had unstable health patterns and almost 21 percent had HIV disease. Thirty-eight percent had a history of mental health conditions, with 24 percent having depression and almost 18 percent having schizophrenia. At least 75 percent received no psychological therapy in the previous 7 days and a majority did not receive antipsychotic, antianxiety, or antidepressant medications. These analyses indicate that most recently admitted residents receiving alcohol/drug treatment did not receive mental health therapy in nursing homes.

Activities of Daily Living↗

PubMed2003

Gender analyses of nursing home residents with multiple sclerosis.

OBJECTIVE: To present gender comparisons of residents with multiple sclerosis (MS) at admission to nursing facilities, including demographic characteristics, health measures, and treatments. METHODS: We analyzed 13,998 admission assessments in the Minimum Data Set for residents with MS recorded between June 23, 1998 and December 31, 2000. RESULTS: Although both male and female residents with MS tended to have severe disability, there were significant gender differences in measures of activities of daily living (ADL) dependency and disability, with males slightly more likely to exhibit total ADL dependence and greater loss of voluntary movement. Females with MS tended to have significantly better cognitive performance and better communication abilities than males with MS. There were significant gender differences in pain symptoms among residents, with one-third of females and one-fifth of males experiencing daily pain. Depression was the most common comorbidity among residents with MS, with females significantly more likely to have this diagnosis. Although females with MS were slightly more likely to have depression or anxiety disorder, males with MS were slightly more likely to receive mental health services. CONCLUSIONS: These analyses demonstrate that many nursing facilities need to improve pain management and mental health care provided to residents with MS, especially to females.

Activities of Daily Living↗

PubMed2002

Analyses of nursing home residents with Parkinson's disease using the minimum data set.

This study profiles over 79,000 nursing home residents with Parkinson's disease (PD) at admission using the 'minimum data set'. Results show that residents with PD averaged 79.7 years of age at admission and 48.4% were male. They tended to be physically dependent, as well as cognitively impaired. More than one in three had fallen in the prior 30 days. There was a high prevalence of dementia and depression. Ninety percent of these residents did not receive active or passive range of motion care and less than 10% had been recently evaluated by a licensed mental health specialist. To enhance the quality of life for nursing home residents with PD, appropriate and adequate rehabilitative, mental health, and cognitive care need to be implemented.

Activities of Daily Living↗