Publications by authors named "Austin Lam"

Importance: Despite the favorable prognosis for HPV-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC), efforts to de-escalate treatment intensity, while maintaining low recurrence and mortality rates, have proven challenging. Identifying appropriate prognostic factors remains elusive; however, the association of pretreatment circulating tumor tissue viral-modified HPV (TTMV-HPV) DNA level with known characteristics of disease burden-clinical staging, characteristics of pretreatment imaging, and aggressive histopathologic features of surgical specimen-may offer insights that could shift treatment paradigms for HPV+ OPSCC.

Objective: To investigate the association of pretreatment TTMV-HPV DNA levels with clinical, radiologic, histopathologic, and outcome metrics in patients with HPV+ OPSCC.

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Objective: The aim of this study was to compare the incidence of positive surgical margins (PSMs) between different races and sexes in a national cohort.

Materials And Methods: In this study, we analyzed the association between race and sex disparities and the incidence of PSMs based on data from the 2004-2016 National Cancer Database (NCDB). The NCDB includes deidentified data collected from over 1500 hospitals as part of the Commission on Cancer approvals program and represents over 70% of new cancer cases in the United States.

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Background: The reverse flow technique describes flap revascularization via anastomoses at the distal pedicle. The technique has been described for various indications but rarely as a means of flap salvage. To our knowledge, there are no previously reported cases where the reverse flow concept was utilized as a means of salvage of an osteocutaneous fibula free flap with severe atherosclerosis of the proximal peroneal artery.

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Objective: The aim of this study was to assess the utility of ultrasound (US) imaging for diagnosis of abnormal tracheal morphology, such as tracheal cartilaginous sleeves (TCS), in patients with syndromic craniosynostosis (SC).

Study Design: Age-matched cohort study.

Setting: Tertiary pediatric hospital.

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Background: Public stigma and fear are heightened in cases of extreme violence perpetrated by persons with serious mental illness (SMI). Prevention efforts require understanding of illness patterns and treatment needs prior to these events unfolding.

Aims: To examine mental health service utilisation by persons who committed homicide and entered into forensic care, to investigate the adequacy of mental healthcare preceding these offences.

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The role of serious mental illness among those who sexually offend is not well understood. We investigated clinical and risk-related areas of difference between male forensic psychiatric patients with ( = 86) and without ( = 245) a sexual offense history, including the age at which indications of mental disorder and criminal offending first emerged, from a registry of Ontario patients adjudicated Not Criminally Responsible on account of Mental Disorder (NCRMD) from 1999-2012. We further explored motivations for offending among a subset of patients deemed NCRMD for a sexual offense specifically ( = 41).

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Live cell microscopy has become a common technique for exploring dynamic biological processes. When combined with fluorescent markers of cellular structures of interest, or fluorescent reporters of a biological activity of interest, live cell microscopy enables precise temporally and spatially resolved quantitation of the biological processes under investigation. However, because living cells are not normally exposed to light, live cell fluorescence imaging is significantly hindered by the effects of photodamage, which encompasses photobleaching of fluorophores and phototoxicity of the cells under observation.

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Article Synopsis
  • The study aimed to analyze trends in the incidence of positive surgical margins in patients with cT1-T2 oral cavity squamous cell carcinoma, assessing the factors influencing this condition from a large dataset.
  • From 2004 to 2016, out of nearly 40,000 patients, 7.95% had positive surgical margins, but there was a trend of decreasing incidence over time, with notable factors like tumor stage and lymphovascular invasion contributing to higher odds of positive margins.
  • The study concludes that treatment at high-volume and academic centers leads to lower rates of positive surgical margins, indicating the importance of treatment quality in outcomes for oral cavity cancer patients.
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Objectives: To evaluate the performance of 4-dimensional computed tomography (4D-CT) in assessing upper airway obstruction (UAO) in patients with Robin sequence (RS) and compare the accuracy and reliability of 4D-CT and flexible fiber-optic laryngoscopy (FFL).

Study Design: Prospective survey of retrospective clinical data.

Setting: Single, tertiary care pediatric hospital.

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Objectives/hypothesis: A tracheal cartilaginous sleeve (TCS) is a rare anomaly characterized by anterior fusion of tracheal cartilages. TCS is associated with syndromic craniosynostoses including Apert, Crouzon and Pfeiffer syndromes and FGFR2, FGFR3, and TWIST1 variants. This study presents a 30-year review of patients with syndromic craniosynostosis and TCS and describes diagnostic methods, genetic variants, surgical interventions, and long-term outcomes.

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Apoptosis, the programmed and intentional death of senescent, damaged, or otherwise superfluous cells, is the natural end-point for most cells within multicellular organisms. Apoptotic cells are not inherently damaging, but if left unattended, they can lyse through secondary necrosis. The resulting release of intracellular contents drives inflammation in the surrounding tissue and can lead to autoimmunity.

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Unlabelled: Our goal was to standardize intraoperative analgesic regimens for pediatric ambulatory tonsillectomy by eliminating local anesthetic use and to determine its impact on postoperative pain measures, while controlling for other factors.

Methods: We assembled a quality improvement team at an ambulatory surgery center. They introduced a standardized anesthetic protocol, involving American Society of Anesthesiologists Classification 1 and 2 patients undergoing adenotonsillectomy.

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Thorough assessment of dynamic upper airway obstruction (UAO) in Robin sequence (RS) is critical, but traditional evaluation modalities have significant limitations. Four-dimensional computed tomography (4D-CT) is promising in that it enables objective and quantitative evaluation throughout all phases of respiration. However, there exist few protocols or analysis tools to assist in obtaining and interpreting the vast amounts of obtained data.

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Objectives/hypothesis: To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency (VPI) resolution or improvement.

Methods: Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol.

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Objectives: To characterize tracheal cartilage morphology in mouse models of fibroblast growth factor receptor (Fgfr2)-related craniosynostosis syndromes. To establish relationships between specific Fgfr2 mutations and tracheal cartilaginous sleeve (TCS) phenotypes in these mouse models.

Methods: Postnatal day 0 knock-in mouse lines with disease-specific genetic variations in the Fgfr2 gene (Fgfr2 , Fgfr2 , Fgfr2 , Fgfr2 , and Fgfr2 ) as well as line-specific controls were utilized.

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The tracheal cartilaginous sleeve (TCS) is a rare, difficult to diagnose airway malformation in which segmented tracheal rings are replaced by a solid sheath of cartilage. TCS is a significant cause of morbidity and mortality in patients with syndromic craniosynostosis, and early diagnosis is essential. We report a case in which ultrasound (US) was used to diagnose TCS in a patient with Pfeiffer syndrome.

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Using multiple imaging modalities while performing independent experiments in parallel can greatly enhance the throughput of microscopy-based research, but requires the provision of appropriate experimental conditions in a format that meets the optical requirements of the microscope. Although customized imaging chambers can meet these challenges, the difficulty of manufacturing custom chambers and the relatively high cost and design inflexibility of commercial chambers has limited the adoption of this approach. Herein, we demonstrate the use of 3D printing to produce inexpensive, customized, live-cell imaging chambers that are compatible with a range of imaging modalities, including super-resolution microscopy.

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Despite a growing body of research on the association between psychosis and homicide and between psychosis and sexual offending, research on psychosis and sexual homicide is limited. The objective of this review was to estimate the prevalence of psychosis in sexual homicide and to explore the extent to which prior research has investigated symptoms of psychosis as a motivating or causal variable leading to incidents of sexual homicide. We hypothesized that psychosis is present in a minority of sexual homicide cases.

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One of the major challenges of RNA-based therapeutics is the method for delivery of RNA molecules. In a recent article (Nat Commun 9(1):2359), we described a novel delivery platform for RNA-based drugs using red blood cell extracellular vesicles which can efficiently deliver both small and large RNAs to solid and liquid tumours. Our RBCEVs platform features exceptional merits over conventional RNA delivery methods in biosafety, biocompatibility, efficiency, accessibility, and cost effectiveness.

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Background: Stigma remains a reality for many people living with HIV. Stigma bears on mental health, but we hypothesized that it might also affect cognition, in turn affecting function.

Methods: We estimated the impact of HIV-related stigma on brain health and everyday functioning among 512 older white men living with HIV in Canada, using the International Classification of Functioning, Disability and Health as a comprehensive framework to integrate biopsychosocial perspectives.

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Study Objectives: Although efficacious in the treatment of obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP) can be difficult to tolerate, with long-term adherence rates approaching 50%. CPAP alternatives clinics specialize in the evaluation and treatment of CPAP-intolerant patients; yet this population has not been studied in the literature. To better understand these patients, we sought to assess insomnia, sleep-related functional status, sleepiness, and nasal obstruction, utilizing data from validated instruments.

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Objective To assess the practice characteristics of adult sleep otolaryngologists within US otolaryngology residency training programs. Study Design Cross-sectional online survey. Setting Otolaryngology residency training programs.

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