Publications by authors named "Andrew Lim"

Purpose: To report outcomes of a 3-fraction HDR brachytherapy boost for the treatment of locally advanced cervical cancer (LACC) at a large safety net hospital.

Methods And Materials: A retrospective review of 93 patients with FIGO 2018 Stage IA2 to IVB cervical cancer treated with HDR brachytherapy boost in 3 fractions between 2017 and 2022 was conducted. The 2-year local control (LC), progression-free survival (PFS), and overall survival (OS) was estimated using Kaplan-Meier estimators.

View Article and Find Full Text PDF
Article Synopsis
  • Several new therapies, including biologics and JAK inhibitors, have been approved for treating atopic dermatitis (AD) in Singapore since 2016, leading to an update of treatment guidelines for moderate-to-severe cases.
  • A modified Delphi panel with 12 dermatologists conducted surveys to reach consensus on treatment statements, resulting in agreement on 43 statements across different treatment categories.
  • The study highlights dupilumab and JAK inhibitors as potential first-line treatments for certain patients with moderate-to-severe AD, and indicates that further updates to the guidelines may be necessary as new information emerges.
View Article and Find Full Text PDF

The Canadian Consortium on Neurodegeneration in Aging (CCNA) was created by the Canadian federal government through its health research funding agency, the Canadian Institutes for Health Research (CIHR), in 2014, as a response to the G7 initiative to fight dementia. Two five-year funding cycles (2014-2019; 2019-2024) have occurred following peer review, and a third cycle (Phase 3) has just begun. A unique construct was mandated, consisting of 20 national teams in Phase I and 19 teams in Phase II (with research topics spanning from basic to clinical science to health resource systems) along with cross-cutting programs to support them.

View Article and Find Full Text PDF

Aims: Congenital pseudarthrosis of the tibia (CPT) has traditionally been a difficult condition to treat, with high complication rates, including nonunion, refractures, malalignment, and leg length discrepancy. Surgical approaches to treatment of CPT include intramedullary rodding, external fixation, combined intramedullary rodding and external fixation, vascularized fibular graft, and most recently cross-union. The current study aims to compare the outcomes and complication rates of cross-union versus other surgical approaches as an index surgery for the management of CPT.

View Article and Find Full Text PDF

Optical coherence tomography angiography (OCT-A) retinal imaging enables visualization of the retinal microvasculature that is developmentally related to the brain and can offer insight on cerebrovascular health. We investigated retinal phenotypes and neuroimaging markers of small vessel disease (SVD) in individuals with obstructive sleep apnoea (OSA). We enrolled 44 participants (mean age 50.

View Article and Find Full Text PDF

Radiation causes damage to normal tissues that leads to increased oxidative stress, inflammation, and fibrosis, highlighting the need for the selective radioprotection of healthy tissues without hindering radiotherapy effectiveness in cancer. This study shows that adiponectin, an adipokine secreted by adipocytes, protects normal tissues from radiation damage invitro and invivo. Specifically, adiponectin (APN) reduces chronic oxidative stress and fibrosis in irradiated mice.

View Article and Find Full Text PDF
Article Synopsis
  • * Using a water tank system, dosimetric parameters such as percentage depth dose (PDD), peak to valley dose ratios (PVDR), and output factors (OFs) were measured and compared with planning system calculations, showing notable changes in PDD across different energies.
  • * Findings indicate significant variations in GRID fields based on energy, with two Truebeam linacs showing less than 2% difference in PVDRs, while a set of equations and reference tables for GRID therapy are proposed for
View Article and Find Full Text PDF

Literature is sparse on outcome comparisons between different trochleoplasty techniques in the treatment of patella instability. To date, it is unclear whether there is a technique that offers superior outcomes. This systematic review and meta-analysis aims to compare and evaluate the outcomes of trochleoplasty techniques in the treatment of patellofemoral instability in trochlea dysplasia to establish whether there is an ideal choice of trochleoplasty technique for superior outcomes.

View Article and Find Full Text PDF
Article Synopsis
  • This study aims to harmonize and aggregate self-reported sleep data to support pooled analyses and improve replicability across different studies, addressing the complexities of sleep data.
  • A multi-phase framework was developed to standardize sleep data collection, resulting in 14 harmonized items drawn from 190 unique sleep metrics across several cohorts in the US and Netherlands.
  • The results showed varying degrees of harmonizability, highlighting the need for standardized measures in sleep research and advocating for broader initiatives to promote common data elements for better integration across studies.*
View Article and Find Full Text PDF

Summary: RNA (ribonucleic acid) molecules have secondary and tertiary structures in vivo which play a crucial role in cellular processes such as the regulation of gene expression, RNA processing and localization. The ability to investigate these structures will enhance our understanding of their function and contribute to the diagnosis and treatment of diseases caused by RNA dysregulation. However, there are no mature pipelines or packages for processing and analyzing complex in vivo RNA structural data.

View Article and Find Full Text PDF

Background Diabetic ketoacidosis (DKA) is a life-threatening metabolic emergency due to insulin deficiency in patients with diabetes mellitus. The United Kingdom national survey and local audits of the management of DKA have revealed several areas of suboptimal care, and room for improvement, necessitating the need for intensified education, updating local guidelines, and increased recruitment of seven-day working inpatient diabetes specialist nurses. Therefore, this project aimed to re-audit our adherence to the DKA treatment guidelines.

View Article and Find Full Text PDF

The advent of SARS-CoV-2 variants with defined mutations that augment pathogenicity and/or increase immune evasiveness continues to stimulate global efforts to improve vaccine formulation and efficacy. The extraordinary advantages of lipid nanoparticles (LNPs), including versatile design, scalability, and reproducibility, make them ideal candidates for developing next-generation mRNA vaccines against circulating SARS-CoV-2 variants. Here, we assess the efficacy of LNP-encapsulated mRNA booster vaccines encoding the spike protein of SARS-CoV-2 for variants of concern (Delta, Omicron) and using a predecessor (YN2016C isolated from bats) strain spike protein to elicit durable cross-protective neutralizing antibody responses.

View Article and Find Full Text PDF

Sexual and gender minority (SGM) individuals are disproportionately affected by cancer. Health care professional (HCP) and health sciences education rarely includes content on cancer screening in this population. This article aims to synthesize literature on educational programs for HCPs and health sciences students related to cancer screening for SGM individuals.

View Article and Find Full Text PDF

Objectives: The Asian PEONY trial showed that add-on pertuzumab to trastuzumab and chemotherapy significantly improved pathological complete response in the neoadjuvant treatment of patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC). This study evaluated the cost-effectiveness of pertuzumab as an add-on therapy to trastuzumab and chemotherapy for neoadjuvant treatment of patients with HER2+ EBC in Singapore.

Methods: A six-state Markov model was developed from the Singapore healthcare system perspective, with a lifetime time horizon.

View Article and Find Full Text PDF

Purpose: There are limited studies that have reported the middle- to long-term outcomes of combined procedures consisting of more than two procedures for patellofemoral instability. The current study aims to investigate and report the middle- to long-term outcomes of a combination procedure of tibial tubercle transfer, medial patellofemoral ligament reconstruction, trochleoplasty and lateral release for patellofemoral instability in patients aged 18 years and below.

Methods: In the cohort study, all patients aged 18 years old or younger who underwent a combination procedure of tibial tubercle transfer, medial patellofemoral ligament reconstruction, trochleoplasty and lateral release for recurrent patellofemoral instability were included.

View Article and Find Full Text PDF

Acyclovir is a widely used antiviral agent used to treat viral meningitis. Although well tolerated, on rare occasions, it can cause severe nephrotoxicity and neurotoxicity. It is recommended that the dose of intravenous acyclovir be calculated based on the ideal body weight for height rather than the actual weight in obese patients to avoid excessive dosage.

View Article and Find Full Text PDF

Introduction: Although universal screening by neonatal clinical examination with Ortolani and Barlow manoeuvres is widely adopted, its role as a sole screening tool is controversial due to its poor sensitivity and failure in identifying hip joints that eventually require surgical intervention.

Hypothesis: This study aims to identify risk factors for a false negative Ortolani and Barlow examination in neonatal screening for DDH. The hypothesis is that risk factors for developmental dysplasia of the hips could similarly be risk factors for a false negative Ortolani and Barlow examination.

View Article and Find Full Text PDF

Background: Prior research has demonstrated that low- and low-middle-income countries (LLMICs) bear a higher burden of critical illness and have a higher rate of mortality from critical illness than high-income countries (HICs). There is a pressing need for improved critical care delivery in LLMICs to reduce this inequity. This systematic review aimed to characterise the range of critical care interventions and services delivered within LLMIC health care systems as reported in the literature.

View Article and Find Full Text PDF

Purpose: Artificial intelligence (AI)-based autocontouring in radiation oncology has potential benefits such as standardization and time savings. However, commercial AI solutions require careful evaluation before clinical integration. We developed a multidimensional evaluation method to test pretrained AI-based automated contouring solutions across a network of clinics.

View Article and Find Full Text PDF

Objectives: We examined within-individual changes in self-reported sleep health as community-dwelling older adults age as well as potential differences in these changes by self-reported sex and racial identity.

Methods: Participants were from the United States and enrolled in the Rush Memory and Aging Project, Minority Aging Research Study, or Religious Orders Study (N = 3539, 20% Black, 75% female, mean 78years [range 65-103]), and they received annual, in-person clinical evaluations (median 5 visits [range 1-27]). A sleep health composite score measured the number of poor sleep characteristics among satisfaction, daytime sleepiness, efficiency, and duration.

View Article and Find Full Text PDF

Purpose: Dose heterogeneity within a tumor target is likely responsible for the biologic effects and local tumor control from spatially fractionated radiation therapy (SFRT). This study used a commercially available GRID-pattern dose mudulated nonuniform radiation therapy (GRID) collimator to assess the interplan variability of heterogeneity dose metrics in patients with various bulky tumor sizes and depths.

Methods And Materials: The 3-dimensional heterogeneity metrics of 14 bulky tumors, ranging from 155 to 2161 cm in volume, 6 to 23 cm in equivalent diameter, and 3 to 13 cm in depth, and treated with GRID collimator-based SFRT were studied.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the impact of the t(11;14) genetic anomaly in multiple myeloma patients to guide future treatment strategies.
  • Researchers examined data from 74 patients with t(11;14), comparing them to two other groups with different genetic profiles (IgH HR-MM and Hyperdiploid-MM), finding no significant differences in demographics or initial treatment patterns.
  • While overall progression-free survival was similar across groups, patients with t(11;14) showed poorer outcomes, highlighting the potential for using targeted therapies like venetoclax to improve treatment effectiveness for these patients.
View Article and Find Full Text PDF