Publications by authors named "Heidi Chen"

Background: Calcific rotator cuff (RTC) tendinopathy is a self-limited, atraumatic cause of shoulder pain. Ultrasound-guided percutaneous needling and aspiration (USPNA) can be used when other nonoperative treatments fail.

Objective: To determine if there is an association between morphology of RTC calcifications on imaging and the ability to aspirate calcifications.

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Introduction: Combination chemoimmunotherapy including pemetrexed and a PD(L)1 inhibitor is a common first-line systemic therapy approach for patients with metastatic nonsquamous NSCLC. Patients often discontinue maintenance pemetrexed due to adverse effects, and little is known about the impact of maintenance pemetrexed cessation on real-world progression-free survival (rwPFS) and overall survival (OS).

Methods: A total of 121 patients with stage IV or recurrent, metastatic nonsquamous NSCLC treated at Vanderbilt University Medical Center (VUMC) were included in this retrospective analysis.

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Objectives: Small studies of extracorporeal membrane oxygenation (ECMO) support for children with refractory septic shock (RSS) suggest that high-flow (≥ 150 mL/kg/min) venoarterial ECMO and a central cannulation strategy may be associated with lower odds of mortality. We therefore aimed to examine a large, international dataset of venoarterial ECMO patients for pediatric sepsis to identify outcomes associated with flow and cannulation site.

Design: Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) database from January 1, 2000, to December 31, 2021.

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Article Synopsis
  • The ileovesicostomy (IV) is a surgical option for children with bladder dysfunction who can't manage other treatments, but long-term outcomes weren't well studied before this research.
  • A retrospective review of patient records at a children's hospital showed a low rate of complications (0.11 per year) over an average follow-up of 6.4 years, with most complications occurring much later (average 84 months).
  • The study concludes that IV not only presents a low risk of surgical issues but also helps preserve kidney function, although it has limitations like a small sample size and being retrospective.
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A critical question in biology is how new traits evolve, but studying this in wild animals remains challenging. Here, we probe the genetic basis of trait gain in sea robin fish, which have evolved specialized leg-like appendages for locomotion and digging along the ocean floor. We use genome sequencing, transcriptional profiling, and interspecific hybrid analysis to explore the molecular and developmental basis of leg formation.

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Background: Radiomics has shown promise in improving malignancy risk stratification of indeterminate pulmonary nodules (IPNs) with many platforms available, but with no head-to-head comparisons. This study aimed to evaluate transportability of radiomic models across platforms by comparing performances of a commercial radiomic feature extractor (HealthMyne) with an open-source extractor (PyRadiomics) on diagnosis of lung cancer in IPNs.

Methods: A commercial radiomic feature extractor was used to segment IPNs from computed tomography (CT) scans, and a previously validated radiomic model based on commercial features was used as baseline (ComRad).

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Background: High-frequency ultrasound (HFUS) can safely and efficiently visualize cutaneous tumour characteristics including depth.

Objectives: We aimed to evaluate its accuracy in measuring melanoma depth against the gold standard, histopathology, for treatment planning.

Methods: A review of publications was conducted in March 2023 through five electronic databases.

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Obesity is a leading risk factor for progression and metastasis of many cancers, yet can in some cases enhance survival and responses to immune checkpoint blockade therapies, including anti-PD-1, which targets PD-1 (encoded by PDCD1), an inhibitory receptor expressed on immune cells. Although obesity promotes chronic inflammation, the role of the immune system in the obesity-cancer connection and immunotherapy remains unclear. It has been shown that in addition to T cells, macrophages can express PD-1.

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Background: We recently found that epiplakin 1 (EPPK1) alterations were present in 12% of lung adenocarcinoma (LUAD) cases and were associated with a poor prognosis in early-stage LUAD when combined with other molecular alterations. This study aimed to identify a probable crucial role for EPPK1 in cancer development.

Methods: EPPK1 mRNA and protein expression was analyzed with clinical variables.

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Background: Large community cohorts are useful for lung cancer research, allowing for the analysis of risk factors and development of predictive models.

Objective: A robust methodology for (1) identifying lung cancer and pulmonary nodules diagnoses as well as (2) associating multimodal longitudinal data with these events from electronic health record (EHRs) is needed to optimally curate cohorts at scale.

Methods: In this study, we leveraged (1) SNOMED concepts to develop ICD-based decision rules for building a cohort that captured lung cancer and pulmonary nodules and (2) clinical knowledge to define time windows for collecting longitudinal imaging and clinical concepts.

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Objective: To assess impact of participation in a positive psychology coaching program on trainee burnout and well-being.

Background: Coaching using principles of positive psychology can improve well-being and reduce physician burnout. We hypothesized that participation in a coaching program would improve pediatric surgery trainee well-being.

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Background: Robotic-assisted bronchoscopy has recently emerged as an alternative to electromagnetic navigational bronchoscopy for the evaluation of peripheral pulmonary lesions. While robotic-assisted bronchoscopy is proposed to have several advantages, such as an easier learning curve, it is unclear if it has comparable diagnostic utility as electromagnetic navigational bronchoscopy.

Methods: Robotic versus Electromagnetic bronchoscopy for pulmonary LesIon AssessmeNT (RELIANT) is an investigator-initiated, single-center, open label, noninferiority, cluster randomized controlled trial conducted in two operating rooms at Vanderbilt University Medical Center.

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Objectives: To evaluate the reliability of a novel segmentation-based volume rendering approach for quantification of benign central airway obstruction (BCAO).

Design: A retrospective single-center cohort study.

Setting: Data were ascertained using electronic health records at a tertiary academic medical center in the United States.

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Article Synopsis
  • Scientists want to understand how animals develop new traits, both by losing old ones and gaining new ones.
  • Sea robins, a type of fish, have grown new legs and special features in their brains to help them move.
  • This study uses advanced techniques to discover the genes that help sea robins form their unique legs and shows how these traits differ between species of sea robins.
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Article Synopsis
  • The study aims to identify proteins that can help determine which individuals are at high risk for developing lung cancer by analyzing bronchial cells from different risk groups.
  • Researchers validated 55 candidate proteins associated with lung cancer risk using sensitive techniques in both a smaller and larger group of participants.
  • They found that two proteins, ALDH3A1 and AKR1B10, were consistently overexpressed in high-risk individuals, supporting their potential as biomarkers for lung cancer risk assessment.
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Fins are major functional appendages of fish that have been repeatedly modified in different lineages. To search for genomic changes underlying natural fin diversity, we compared the genomes of 36 percomorph fish species that span over 100 million years of evolution and either have complete or reduced pelvic and caudal fins. We identify 1,614 genomic regions that are well-conserved in fin-complete species but missing from multiple fin-reduced lineages.

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Article Synopsis
  • Robotic assisted bronchoscopy is being compared to electromagnetic navigational bronchoscopy in a study at Vanderbilt University to see if it has similar effectiveness for diagnosing peripheral pulmonary lesions.
  • The RELIANT trial is a randomized controlled trial that involves two operating rooms, each assigned to one of the bronchoscopy methods, with measures to ensure blinding until randomization is revealed.
  • The study aims to evaluate the diagnostic yield, procedure duration, and complications, enrolling about 400 patients and expected to conclude by March 2024.
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Article Synopsis
  • - Lung adenocarcinoma (LUAD) is a common and aggressive form of lung cancer, with its recurrence risk poorly understood, leading researchers to explore the role of immune response in tumor growth as a factor affecting patient outcomes.
  • - The study analyzed immune cell density in tumors from 100 LUAD patients (stages I and II), using advanced techniques to assess T-cell and mast cell presence in relation to recurrence-free survival (RFS).
  • - Findings indicate that higher densities of T-cells and mast cells in tumors are associated with significantly reduced recurrence risk, emphasizing the potential role of the immune environment in cancer prognosis, though further research is needed due to the small sample size.
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Background: There is a need for biomarkers that improve accuracy compared with current demographic risk indices to detect individuals at the highest lung cancer risk. Improved risk determination will enable more effective lung cancer screening and better stratification of lung nodules into high or low-risk category. We previously reported discovery of a biomarker for lung cancer risk characterized by increased prevalence of TP53 somatic mutations in airway epithelial cells (AEC).

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Objective: The frequency of humanitarian surgical mission trips has grown over recent decades. Unfortunately, research on patient outcomes from these trips has not increased proportionately. We aim to analyze the safety and efficacy of surgeries in a low- and middle-income country missions-based surgery center in Guatemala City, Guatemala, and identify factors that influence surgical outcomes.

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Background: Benign airway stenosis (BAS) represents a significant burden on patients, providers, and healthcare systems. Spray cryotherapy (SCT) has been proposed as an adjunctive treatment to reduce BAS recurrence. We sought to examine safety and practice variations of the latest SCT system when used for BAS.

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Chronic graft-versus-host disease (cGVHD) is a severe complication in long-term survivors of allogeneic hematopoietic stem cell transplantation. This disease is challenging to manage clinically due to a lack of validated tools to quantitatively measure skin sclerosis. The current gold standard for measuring skin sclerosis is the NIH Skin Score which has only moderate agreement among clinicians and experts.

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