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(https://medium.com/@rjcc1017/autobio-3c5a387c0a50)"How to be a good surgeon? I, a medical student, asked the first question among the quiet audience full of residents and attending surgeons, after the talk by Dr. Seymour Schwartz, the editor and the co-writer of the milestone textbook of surgery, who visited my university hospital in Taiwan for the 100th anniversary in 1995. That is me, like a voyager who is brave to explore the uncertainty and face challenges. Years later I sailed out of the comfort zones where most of my peers stay, learning biostatistics, practicing cardiothoracic surgery, visiting Harvard, Emory, Indiana, and Ohio State Universities, seeking the solutions for the unmet needs.I played rugby No. 2 hooker in our 7-year medical school for 4 years, regardless wet mud or hot sunshine, fearing no rival and working as a team with the best efforts to touch down. On the field, there were glory and tears, winners and losers, but also sportsmanship. I learned to remain humble when winning and keep abreast when losing, and also respect the rivals and learn from them. Rugby taught me how to deal with failures and frustrations. In 1996, I was not selected to do my clinical clerkship in USA--so heartbroken. In 2000, I failed my NRMP in USA and it hit me so hard. In 2004, I was not promoted to an attending surgeon after my residency training in my home university hospital. Later there were numerous rejections of my manuscripts submitted to journals. In my practice of cardiovascular surgery in the years that followed, I experienced my cases of complication and surgical mortality. Each time I faced the problems, stood back up, learned the lesson, and got better. In my journeys, I do not wait for the sunshine but dance in the storm.In 2004, I joined the team Dr. Jeng Wei, the pioneering surgeon who was trained in Columbia University in New York, and performed the first successful heart transplantation in Taiwan in 1988. We scrubbed in lots of cases together and he mentored me real cardiac surgery and transplant. In 2006, I met Dr. John Puskas in a conference and then he brought me to Emory University in Atlanta where my 1-year clinical fellowship in cardiothoracic surgery initiated my professional career path in USA. Later I practiced in Taiwan and most of my cases were ECMO and TEVAR. In 2016, Dr. I-Wen Wang hired me in Indiana University Methodist Hospital in Indianapolis as a clinical fellow. I stepped into the field of thoracic transplant, mechanical circulatory supports, and thoracic organ procurement. Then my practice re-started in Taiwan with most of my cases being open aortic surgery for type-A aortic dissection, mitral valve replacement, and ECMO. But I still had strong interest in thoracic transplant so I did another clinical fellowship in thoracic transplant in Ohio State University in Columbus in 2020, mentored by Dr. Bryan Whitson. With most of my thoracic procurements were done under supervision, my first independent heart procurement was done in Olathe, Kansas, with SherpaPak as a contract surgeon, for Dr. Dan Meyer in Baylor Dallas in 2021. That case was very successful. Heartfeltly Dr. Joseph Woo hired me as a procurement surgeon for Stanford University near the end of 2021. Motivated and enthusiastic, I am continuing my adventure into thoracic transplant to chart the unknown territories.In August 2021, I brought my 11-year-old son and my wife to visit the CERN (visit.cern) in Geneva, Switzerland, and also Albert Einstein's apartment and museum in Bern. We were all thrilled by the frontiers of science. I believe the solutions to end-stage organ failure can go beyond transplant into stem cells, organ re-generation from somatic cells, artificial organ engineering, and also artificial intelligence. In addition to innovative clinical research, I am also very zealous of teaching young doctors, to pass the torch to the future to shine even brighter.
We expect that the proposed studies will uncover new causes of TAAD, thereby improving patient care, and will potentially provide new insights into vascular physiology.Aim 1: Identify rare de novo or inherited variants in known TAAD genes, and prioritized genes in unexplained TAAD patients by whole genome sequencing.Aim 2: Identify copy number variants.Aim 3: Define dysregulated gene expressions and splicing effects of identified variants by RNAseq.
Theoretically Matrix Metalloproteinase-7 (MMP-7) leads to allograft rejection and A Disintegrin and Metalloproteinase-17 (ADAM-17) results in allograft tolerance. The research proposal utilizes the animal model of knock-out mice to perform transplant surgery and then detect or measure allograft rejection by selected serum biomarker and in situ hybridization. Comparisons will be made for knock-out, wild-type, and wild-type treated with proteinase inhibitors. Methodological and theoretical details will be elucidated and revised as the research goes on.
High-risk group / Cardiovascular Surgery
China Medical University; Harvard Medical School
Full version (https://medium.com/@rjcc1017/current-research-and-scholarly-interests-bfc38bf84371)Practicing over the years, with experience in robotic surgery, transplant surgery, aortic surgery, biostatistics, and artificial intelligence, I’ve co-authored several papers of the outcome prediction models for heart surgery, heart transplant, lung transplant and ECMO by using clinical databases and various regression models. My established expertise is to translate clinical questions and data into practical interpretations. I have a ready-made workflow and framework platform, consisting of PostgreSQL, SAS-9, SAS-Viya, and Stata-17, for data cross-linking, cleansing, analysis, reporting, interpretation, feedback, and re-iterating for revised hypotheses. A colleague may bring some clinical questions and some datasets to me, I will analyze on my statistical platforms, and then interpret them to answer the questions for reporting and publication. This research interest primarily uses parametric and non-parametric statistical comparisons, correlations, and regressions (linear, logistic, or Cox) to generate p-values, confidence intervals, correlation coefficients, regression coefficients, odds ratios, hazard ratios, ROC curves, AUC, Kaplan-Meier curves, etc., to elucidate various relationships among variables or covariates. This is conventional biostatistical analysis on clinical databases.Here are some of the topics of my research proposals:CTA Interpretation and surgical planning of aortic dissections by artificialintelligence deep machine learningArtificial Intelligence Prediction Model of the Outcomes of the Patients with Profound Cardiogenic Shock status post VA-ECMOA Scoring System for Identifying Severe Cases of Influenza-like Illness by Comorbidity and Age — A Nationwide Cohort Analysis (http://dx.doi.org/10.3897/rio.2.e9648)Clinical roles of soluble ST2 for the outcomes of cardiac valve operations — a study of hospital-based data (http://dx.doi.org/10.3897/rio.2.e8849)Bi-directional immuno-modulation by Matrix Metalloproteinase-7 (MMP-7) and A Disintegrin and Metalloproteinase-17 (ADAM-17) as transplantation rejection-tolerance spectrum (http://dx.doi.org/10.3897/rio.2.e9268)Here are some topics of the manuscripts in writing or submission:Impact of the New Allocation Policy Change on Patients with Hypertrophic Cardiomyopathy — a study by UNOS dataSurgical outcomes of pericardiectomy for constrictive pericarditis — a study by national and hospital databasesThe effect of hybrid operation on the outcomes of acute type-A aortic dissection — a study by hospital information systemHere is the topic I have been working on in Indiana University School of Medicine, Indianapolis, Indiana, USA, with Dr. Michael Sturek and Dr. Mouhamad Alloosh, Department of Anatomy, Cell Biology, & Physiology:Calcium Physiology of Coronary Artery Smooth Muscle is Influenced by Atherosclerosis Risk Factors, Ischemic Cardiomyopathy, and Left Ventricular Assist Devices — the First Evidence of Adult Human Hearts from Transplant Cardiectomy (the preliminary results orally presented at ISHLT 2017)Here is the topic I have been working on with Dr. Alireza Haghighi, Departments of Medicine and Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA, and Dr. You-Cian Lin, Division of Cardiovascular Surgery, China Medical University Hospital, Taichung, Taiwan:Discovery of Novel Genetic Causes Underlying Thoracic Aortic Aneurysms and Dissections — Hospital specimens analyzed by whole-genome sequencing and RNAseqTo recap, my current research and scholarly interests are: data science approaches that decipher and interpret, and innovative solutions to the bottlenecks of thoracic transplant. My strength is on the dry lab side. Welcome all experts on the wet lab side but also dry lab as well.