Nevin Manimala

Clin Transl Oncol. 2025 Feb 12. doi: 10.1007/s12094-025-03862-9. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the prevalence and characteristics of burnout among Radiation Oncology residents in Spain, focusing on its associated risk factors and implications for residency training.

MATERIALS AND METHODS: A cross-sectional online survey was conducted from June to September 2024, using the Maslach Burnout Inventory (MBI) to evaluate emotional exhaustion, depersonalization, and self-fulfillment. Residents from various Spanish regions completed an anonymous questionnaire covering workload and burnout.

RESULTS: Fifty residents, predominantly in their third (38%) and fourth (42%) years of training, participated. High emotional exhaustion was reported by 58%, while 54% exhibited elevated depersonalization. Self-fulfillment scores were low in 32%. Overall, 70% experienced at least one burnout symptom, with 12% meeting criteria for full-burnout syndrome. An inverse correlation between self-fulfillment and emotional exhaustion was observed (p = 0.007). Trends suggested higher burnout risk in senior residents (R3-R4) compared to juniors (R1-R2), though these differences were not statistically significant (OR = 1.682; p = 0.086).

CONCLUSION: The findings reveal a high prevalence of at least one burnout symptom among Radiation Oncology residents in Spain, with emotional exhaustion and depersonalization notably elevated. However, full-burnout syndrome is not prevalent. These findings underscore the need for reforms in residency training programs, emphasizing workload management, well-being initiatives, and support for scientific and professional development.

PMID:39937361 | DOI:10.1007/s12094-025-03862-9

Environ Monit Assess. 2025 Feb 12;197(3):276. doi: 10.1007/s10661-025-13754-8.

ABSTRACT

Air pollution is a significant global issue that impacts public health, particularly in urban areas where pollution levels often exceed safe limits. The Air Quality Index (AQI) serves as a key metric to assess the concentration of harmful pollutants such as particulate matter (PM), ozone, and nitrogen oxides. This study conducts an extreme value analysis (EVA) of AQI data from five major Indian cities-Delhi, Mumbai, Kolkata, Chennai, and Hyderabad-and eight other metropolitan cities worldwide, including Dhaka, Chengdu, and Bogota. The goal is to evaluate the probability of extreme pollution events and compare the seasonal patterns of air quality in these cities. Our findings indicate that cities like New Delhi and Dhaka consistently experience AQI levels that exceed hazardous thresholds, particularly during the winter months and festival seasons. This study provides critical insights into the air quality crisis in India and other regions, emphasizing the need for targeted policy interventions, including stricter emission regulations, adoption of cleaner energy sources, and enhanced public awareness campaigns to mitigate the effects of extreme pollution events.

PMID:39937354 | DOI:10.1007/s10661-025-13754-8

CJEM. 2025 Feb 12. doi: 10.1007/s43678-024-00852-8. Online ahead of print.

ABSTRACT

OBJECTIVES: Emergency department (ED) boarding is a major threat to timely and safe care delivery. Addressing boarding requires an understanding of which patient populations are significantly impacted to formulate solutions. Our objective was to evaluate the median ED boarding time of mental health compared to non-mental health patients.

METHODS: We performed a database analysis using the National Ambulatory Care Reporting System data from 96 EDs from September 1, 2018, to September 30, 2023. International Classification of Diseases 10th Revision codes were used to define mental health and non-mental health subgroups for all patients admitted from the ED who were greater than 18 years old. Boarding was defined as the elapsed time between the admission decision to when patients departed the ED. Descriptive statistics summarized ED visit characteristics and median (IQR) boarding time throughout three study periods. An interrupted time series analysis evaluated boarding trends to account for COVID-19 variation.

RESULTS: During the study period, 887,494 patients were admitted from an ED with mental health (113,209; 13%) or non-mental health (774,285; 87%) diagnoses. The mental health subgroup was younger, with a median age of 40, and predominantly male (57.1%). The median (IQR) barding time for mental health patients was 72% longer (997 min (478-1707)) compared to non-mental health (581 min (337-107)). When comparing the initial and final study periods, mental health patient boarding increased by 76% (199 min), and non-mental health patient boarding increased by 24% (29 min).

CONCLUSION: This is the most extensive Canadian study comparing ED boarding for mental health and non-mental patients. The results demonstrate that mental health patients experience disproportionately longer ED boarding compared to other patient presentations, and the trend remains consistent over time. This emphasizes the need to address inequities in resourcing inpatient beds and adjust the current care model for mental health patients.

PMID:39937334 | DOI:10.1007/s43678-024-00852-8

J Vet Dent. 2025 Feb 12:8987564251316652. doi: 10.1177/08987564251316652. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the distribution and prevalence of dental diseases in dogs from Türkiye and compare their relationships with various factors. The study focused on the impact of age, gender, feeding method, and breed groups on the presence of dental diseases. Results revealed that dental diseases were prevalent among dogs, with variations observed across different factors. Age group analysis indicated that age had a significant influence on the presence of dental diseases, with lower rates observed in the 0 to 9 months and 10 to 18 months age groups. Analysis of feeding methods showed that home-cooked and mixed feeding was associated with a higher prevalence of dental diseases, while dry food feeding demonstrated lower rates. Gender analysis revealed an association between gender and dental diseases, particularly in the incisor and premolar teeth. However, no statistical significance was found in the molar teeth. Analysis of breeds demonstrated variations in the prevalence of dental diseases, with small breeds showing higher rates. In conclusion, this study sheds light on the distribution and factors associated with dental diseases in dogs from Türkiye. The findings highlight the importance of age, feeding method, gender, and breed group as potential risk factors for dental diseases. The results can guide veterinarians and dog owners in implementing effective preventive measures and treatment strategies to maintain optimal dental health in dogs. Further research is warranted to explore additional factors and interventions for improving dental care in canine populations.

PMID:39936379 | DOI:10.1177/08987564251316652

Hum Vaccin Immunother. 2025 Dec;21(1):2465161. doi: 10.1080/21645515.2025.2465161. Epub 2025 Feb 12.

ABSTRACT

In light of the widespread use of rotavirus vaccines, there is a pressing need to perform thorough, large-scale surveillance to actively monitor safety. This study aimed to identify potential adverse events following rotavirus vaccination in infants. Using a nationwide linked database of the national immunization registry and health insurance claims data, we identified infants vaccinated with the first dose of rotavirus vaccine between January 2016 and October 2022. The self-controlled tree-temporal scan statistics method analyzed all incident diagnoses recorded within 56 days post-vaccination and evaluated all temporal risk windows. Among 1,720,778 rotavirus vaccine recipients 64,752 infants contributed to the analysis, yielding 72,970 incident diagnoses. Of these, 28 clusters were categorized as known adverse drug reactions (ADRs), including infection following immunization (Days 1-2, p<.001), viral infection (Days 1-5, p<.001), urticaria and erythema (Days 3-9, p<.001), acute upper respiratory infections (Days 28-42, p<.001), and pneumonia (Days 9-19 or 28-42, p<.001). Seventeen clusters were classified as ADR-related events, such as the ones clinically related to ADR or lower-level diagnostic codes of ADR. The remaining 26 clusters were classified as signals, including sepsis (Days 1-20, p<.001), meningitis (Days 1-23, p<.001), liver disease (Days 4-11, p<.001), and tubulo-interstitial nephritis (Days 11-38, p<.001). A cluster of intussusceptions was only found in monovalent vaccine-stratified analysis (Days 5-8, p = 0.005). This study confirmed known ADRs following rotavirus vaccination, while identifying potential safety signals requiring further investigation. These findings emphasize the importance of active vaccine surveillance and underscore the need for epidemiological studies with validated outcome definitions to confirm causal relationships between rotavirus vaccination and the detected outcomes.

PMID:39936376 | DOI:10.1080/21645515.2025.2465161

J Telemed Telecare. 2025 Feb 12:1357633X251314290. doi: 10.1177/1357633X251314290. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of type 2 diabetes is rising in Australia, particularly in regional areas where access to specialist care is limited. To address this, Queensland Health (Queensland, Australia) established a telehealth network, including the Diabetes Telehealth Service (DTS) at the Princess Alexandra Hospital (PAH). The service facilitates video consultations between city-based endocrinologists and regional health centres, with local clinicians providing in-person support. While telehealth interventions have been evaluated in short-term studies, there is a need for longitudinal data to assess their long-term effectiveness in routine diabetes care. This study aims to describe the clinical characteristics and outcomes of patients with type 2 diabetes accessing care from the PAH DTS.

METHODS: This retrospective cohort study used data from the PAH DTS to follow adults with type 2 diabetes over 24 months. Data was collected as part of routine care and analysed to assess changes in glycated haemoglobin (HbA1c) levels and cardiovascular risk factors. Statistical analyses included descriptive analysis, t-tests, Chi-squared tests, and fixed effects regression models.

RESULTS: The study included 374 patients with type 2 diabetes, with a mean age of 57.9 years and a mean duration of diabetes at enrolment of 11.6 years. Baseline HbA1c levels were available for 86% of the patients, with a median HbA1c of 8.4%. The median number of appointments in the 24-month period was 2, and the average time between a person’s first and last visit was 72 weeks. The average change in HbA1c between these visits was -0.8%. Statistically significant changes were also seen in cholesterol levels, weight, body mass index, and diastolic blood pressure. A linear regression analysis revealed that the greatest decrease in HbA1c levels occurred within the first 3 months since the initial clinic visit. HbA1c levels continued to decrease over the 24-month follow-up period, but the rate of decrease slowed after the first 3 months.

CONCLUSION: This study provides valuable insights into the telehealth model of care for tertiary diabetes in regional, rural, and remote settings. It demonstrates the effectiveness of this model in improving glycaemic control, particularly in the initial months, while also highlighting areas for improvement.

PMID:39936370 | DOI:10.1177/1357633X251314290

J Cosmet Dermatol. 2025 Feb;24(2):e70048. doi: 10.1111/jocd.70048.

ABSTRACT

BACKGROUND: The lip augmentation market is projected to reach a value of 11.6 billion USD by 2030. Hyaluronic acid (HA) fillers are the most common type due to biocompatibility and reversibility. However, there has been an increase in alternative procedures, such as the “lip flip,” involving the injection of botulinum neurotoxin A (BoNT-A) into the superior orbicularis oris muscle.

AIMS: The purpose of this study is to review the current literature and evaluate the general public interest in dermal lip fillers compared to supralabial BoNT-A injections over the past decade.

METHODS: The Google Trends database was used to collect relative monthly search volume for the terms “lip filler” and “lip flip” over a decade-long period (January 1, 2014-January 1, 2024). Google Trends data is automatically normalized with a value of 100 indicating maximal search volume and 1 indicating minimal search volume.

RESULTS: Search volume for lip filler and lip flip increased similarly from 2014 to 2024. Lip filler was consistently more searched and had an average 75% increase in relative search volume per month. Meanwhile, “lip flip” had, on average, a 33% increase in search volume per month.

CONCLUSIONS: Although lip filler was more frequently inquired about than “lip flip,” the latter increased in popularity over time, reaffirming its popularity as a potential alternative to lip filler. Superior obicularis oris BoNT-A injections are rising in popularity and may be a valuable option for patients seeking cosmesis with hesitation toward dermal fillers.

PMID:39936357 | DOI:10.1111/jocd.70048

Eur J Psychotraumatol. 2025 Dec;16(1):2461435. doi: 10.1080/20008066.2025.2461435. Epub 2025 Feb 12.

ABSTRACT

Background: Posttraumatic stress disorder (PTSD) is a prevalent psychiatric condition that significantly increases the risk of suicide.Objective: This study aimed to assess PTSD and its co-occurring conditions among individuals who attempted suicide and to evaluate the relationship between these disorders and suicide reattempts within six months.Method: This prospective cohort study included 2,441 individuals from the French Vigilans programme who attempted suicide between 2015 and 2020. Data on sociodemographic characteristics and suicide attempt (SA) history were collected at baseline, and lifetime psychiatric conditions were assessed via the Mini-International Neuropsychiatric Interview (MINI) during the six-month follow-up telephone interview. Multivariate logistic and linear regression models were used to measure the impact of PTSD and its comorbidities on suicide reattempts within six months, controlling for sex, age, and prior SAs.Results: In total, 11.8% of the individuals (287/2,441) in the cohort were diagnosed with PTSD. Among these, 71.1% (204/287) had major depressive disorder, 36.2% (104/287) had alcohol use disorder, and 35.9% (103/287) had panic disorder. Within six months, we observed higher rates of suicide reattempt in those with PTSD (p < .01; OR 1.71 95% CI 1.14-2.55), regardless of comorbidities. Even higher rates were found in those with PTSD comorbid with panic disorder (p = .02 OR 1.95 95% CI 1.12-3.39) or substance use disorder (p = .01 OR 2.91 95% CI 1.28-6.62). Additionally, PTSD comorbid with panic disorder (p = .02, β = .10) or eating disorders (p = .04, β = .12) was associated with a greater number of suicide reattempts.Conclusion: Approximately one in ten SA survivors experienced PTSD. Individuals with PTSD and comorbid conditions, such as panic disorder, substance use disorder, and eating disorders, are two to three times more likely to reattempt suicide within six months. Despite ongoing preventive efforts, rates of reattempt remain high, highlighting the urgent need for continuous clinical monitoring and personalized therapeutic interventions.Trial registration: ClinicalTrials.gov identifier: NCT03134885.

PMID:39936356 | DOI:10.1080/20008066.2025.2461435

Stat Methods Med Res. 2025 Feb 12:9622802241310326. doi: 10.1177/09622802241310326. Online ahead of print.

ABSTRACT

Simulation models of smoking behaviour provide vital forecasts of exposure to inform policy targets, estimates of the burden of disease, and impacts of tobacco control interventions. A key element of useful model-based forecasts is a clear picture of uncertainty due to the data used to inform the model, however, assessment of this parameter uncertainty is incomplete in almost all tobacco control models. As a remedy, we demonstrate a Bayesian approach to model calibration that quantifies parameter uncertainty. With a model calibrated to Australian data, we observed that the smoking cessation rate in Australia has increased with calendar year since the late 20th century, and in 2016 people who smoked would quit at a rate of 4.7 quit-events per 100 person-years (90% equal-tailed interval (ETI): 4.5-4.9). We found that those who quit smoking before age 30 years switched to reporting that they never smoked at a rate of approximately 2% annually (90% ETI: 1.9-2.2%). The Bayesian approach demonstrated here can be used as a blueprint to model other population behaviours that are challenging to measure directly, and to provide a clearer picture of uncertainty to decision-makers.

PMID:39936347 | DOI:10.1177/09622802241310326

Stat Methods Med Res. 2025 Feb 12:9622802241309750. doi: 10.1177/09622802241309750. Online ahead of print.

ABSTRACT

In stopping the spread of infectious diseases, pathogen genomic data can be used to reconstruct transmission events and characterize population-level sources of infection. Most approaches for identifying transmission pairs do not account for the time passing since the divergence of pathogen variants in individuals, which is problematic in viruses with high within-host evolutionary rates. This prompted us to consider possible transmission pairs in terms of phylogenetic data and additional estimates of time since infection derived from clinical biomarkers. We develop Bayesian mixture models with an evolutionary clock as a signal component and additional mixed effects or covariate random functions describing the mixing weights to classify potential pairs into likely and unlikely transmission pairs. We demonstrate that although sources cannot be identified at the individual level with certainty, even with the additional data on time elapsed, inferences into the population-level sources of transmission are possible, and more accurate than using only phylogenetic data without time since infection estimates. We apply the proposed approach to estimate age-specific sources of HIV infection in Amsterdam tranamission networks among men who have sex with men between 2010 and 2021. This study demonstrates that infection time estimates provide informative data to characterize transmission sources, and shows how phylogenetic source attribution can then be done with multi-dimensional mixture models.

PMID:39936344 | DOI:10.1177/09622802241309750