Medical and Research Library News

Medical and Research Library News               
February 2025

Training opportunities
Websites and reports on trending topics
Journal articles of note

Training opportunities

The webinars and online classes listed here are shared solely as opportunities to learn more information of interest to public health personnel. All times listed are in Central Time.

February 5, 2025; 2–3 p.m. Data is a Driver, a Common Language, and a Decision Maker
Join Texas Children in Nature for a webinar exploring how Texan by Nature (TxN) bridges gaps between business and conservation by using data as a driver, a common language, and a decision-maker through calculating and reporting Return on Conservation™ (ROC™), which TxN defines as "the total return realized by investing in conservation, encompassing all variables - financial, human, and natural resources." 

February 12, 2025; 12–1 p.m. Working Towards Positive Outcomes in the Postpartum Period Through Screening, Education, and Care Coordination
This webinar from the Health Resources and Services Administration (HRSA) will review the medical needs of postpartum individuals, how to screen for these needs, how to educate the patient, and how to use community support services to reduce morbidity and mortality in this critical fourth trimester. This webinar aligns with the Health Center Performance Improvement domain of Quality, Patient Care, and Safety as it discusses direct patient care strategies to mitigate complications
in the postpartum period.

February 20, 2025; 11 a.m. –12 p.m. Health Promotion for Children in Rural Settings
This session from Michael & Susan Dell Center for Healthy Living will detail current challenges and opportunities related to health promotion efforts for children living in rural settings in the United States. Viewers will learn about current health-related statistics (physical activity, screen time, sleep, and healthy eating) for children in rural areas, compared to those living in suburban and urban areas, how we define “rural” in the United States and what impact that may have on health promotion programs/research, and some of the new ways in which we can address health-related disparities for children in rural communities.

February 26, 2025; 11 a.m.–12:30 p.m. Neural Tube Defects
This webinar is offered by the DSHS Office of Practice and Learning Grand Rounds program. DSHS Grand Rounds explores the science and practice of population health and awards continuing education credits/contact hours for various disciplines. Visit the Grand Rounds calendar to see information on upcoming sessions. Held monthly on the fourth Wednesday, sessions last 90 minutes with the final 20 minutes reserved for Q&A.

Websites and reports on trending topics

ClinicalTrials.gov – This resource from the National Library of Medicine is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. Learn more about clinical studies and about this site, including relevant history, policies, and laws.

LactMed - This database from the National Library of Medicine contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on levels of substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate. All data are derived from the scientific literature and fully referenced.

Occupational Safety and Health Administration Establishment Specific Injury and Illness Data (Injury Track) is OSHA collected work-related injury and illness data from establishments that meet specific industry and employment size specifications through the Injury Tracking Application (ITA). The data for a given calendar year from 2016 can be downloaded in CVS format. The data provide information for each individual establishment for that year. A data dictionary that provides a list of the data fields and their definitions can be downloaded from the website.

PrePubMed - In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset version available free, before and/or after a paper is published in a journal. PrePubMed indexes preprints from arXiv q-bio, PeerJ Preprints, bioRxiv, F1000Research, preprints.org, The Winnower, Nature Precedings, and Wellcome Open Research. Articles are not stored on PrePubMed, but you will be linked to the article at the respective site.

Journal articles of note

Gao Y, Zhao Y, Liu M, et al. Antiviral medications for treatment of nonsevere influenza: a systematic review and network meta-analysis. JAMA Intern Med. Published online January 13, 2025. doi:10.1001/jamainternmed.2024.7193
Abstract
Importance: The optimal antiviral drug for treatment of nonsevere influenza remains unclear.
Objective: To compare effects of antiviral drugs for treating nonsevere influenza.
Data sources: MEDLINE, Embase, CENTRAL, CINAHL, Global Health, Epistemonikos, and ClinicalTrials.gov were searched from database inception to September 20, 2023.
Study selection: Randomized clinical trials comparing direct-acting influenza antiviral drugs to placebo, standard care, or another antiviral drug for treating people with nonsevere influenza.
Data extraction and synthesis: Paired reviewers independently performed data extraction and risk of bias assessment. A frequentist network meta-analysis was performed to summarize the evidence and the certainty of evidence was evaluated using the GRADE approach.
Main outcomes and measures: Mortality, admission to hospital, admission to the intensive care unit, duration of hospitalization, time to alleviation of symptoms, emergence of resistance, and adverse events.
Results: Overall, 73 trials with 34,332 participants proved eligible. Compared with standard care or placebo, all antiviral drugs had little or no effect on mortality for low-risk patients and high-risk patients (all high certainty). All antiviral drugs (no data for peramivir and amantadine) had little or no effect on hospital admission for low-risk patients (high certainty). For hospital admission in high-risk patients, oseltamivir (risk difference [RD], -0.4%; 95% CI, -1.0 to 0.4; high certainty) had little or no effect and baloxavir may have reduced risk (RD, -1.6%; 95% CI, -2.0 to 0.4; low certainty); all other drugs may have had little or uncertain effect. For time to alleviation of symptoms, baloxavir probably reduced symptom duration (mean difference [MD], -1.02 days; 95% CI, -1.41 to -0.63; moderate certainty); umifenovir may have reduced symptom duration (MD, -1.10 days; 95% CI, -1.57 to -0.63; low certainty); oseltamivir probably had no important effect (MD, -0.75 days; 95% CI, -0.93 to -0.57; moderate certainty). For adverse events related to treatment, baloxavir (RD, -3.2%; 95% CI, -5.2 to -0.6; high certainty) had few or no adverse events; oseltamivir (RD, 2.8%; 95% CI, 1.2 to 4.8; moderate certainty) probably increased adverse events.
Conclusions and relevance: This systematic review and meta-analysis found that baloxavir probably reduced risk of hospital admission for high-risk patients and may reduce time to alleviation of symptoms, without increasing adverse events related to treatment in patients with nonsevere influenza. All other antiviral drugs either probably have little or no effect, or uncertain effects on patient-important outcomes.

Garg S, Reinhart K, Couture A, et al. Highly pathogenic avian influenza A(H5N1) virus infections in humans. N Engl J Med. Published online December 31, 2024. doi:10.1056/NEJMoa2414610
Abstract
Background: Highly pathogenic avian influenza A(H5N1) viruses have caused widespread infections in dairy cows and poultry in the United States, with sporadic human cases. We describe characteristics of human A(H5N1) cases identified from March through October 2024 in the United States.
Methods: We analyzed data from persons with laboratory-confirmed A(H5N1) virus infection using a standardized case-report form linked to laboratory results from the Centers for Disease Control and Prevention influenza A/H5 subtyping kit.
Results: Of 46 case patients, 20 were exposed to infected poultry, 25 were exposed to infected or presumably infected dairy cows, and 1 had no identified exposure; that patient was hospitalized with nonrespiratory symptoms, and A(H5N1) virus infection was detected through routine surveillance. Among the 45 case patients with animal exposures, the median age was 34 years, and all had mild A(H5N1) illness; none were hospitalized, and none died. A total of 42 patients (93%) had conjunctivitis, 22 (49%) had fever, and 16 (36%) had respiratory symptoms; 15 (33%) had conjunctivitis only. The median duration of illness among 16 patients with available data was 4 days (range, 1 to 8). Most patients (87%) received oseltamivir; oseltamivir was started a median of 2 days after symptom onset. No additional cases were identified among the 97 household contacts of case patients with animal exposures. The types of personal protective equipment (PPE) that were most commonly used by workers exposed to infected animals were gloves (71%), eye protection (60%), and face masks (47%).
Conclusions: In the cases identified to date, A(H5N1) viruses generally caused mild illness, mostly conjunctivitis, of short duration, predominantly in U.S. adults exposed to infected animals; most patients received prompt antiviral treatment. No evidence of human-to-human A(H5N1) transmission was identified. PPE use among occupationally exposed persons was suboptimal, which suggests that additional strategies are needed to reduce exposure risk.

Schraw JM, Tark JY, Desrosiers TA, et al. Risk of carcinomas among children and adolescents with birth defects. Cancer Epidemiol. Published online January 22, 2025. doi:10.1016/j.canep.2025.102748
Abstract
Background: Birth defects are associated with childhood cancer, but little is known regarding pediatric carcinomas, a group of especially rare tumors.
Methods: We used Cox proportional hazards regression to estimate the hazard ratio (HR) and 95 % confidence interval (CI) for any carcinoma, as well as thyroid, hepatocellular, and renal carcinoma specifically, up to 18 years of age among children with major, non-syndromic anomalies or chromosomal/genetic syndromes, relative to unaffected children.
Results: Our registry-linkage study included nine states and 21,933,476 children between 1990 and 2018: 641,827 with non-syndromic anomalies, and 49,619 with syndromes. Carcinomas were diagnosed in 833 children, including 35 with non-syndromic anomalies and eight with syndromes. The hazard of carcinoma was increased both among children with non-syndromic anomalies (HR: 1.7, CI: 1.2-2.4; N = 35) and syndromes (HR: 4.7, CI: 2.3-9.5; N = 7). Hepatocellular carcinoma was associated with non-syndromic anomalies (HR: 4.6, CI: 2.2-9.7; N = 8) and syndromes (HR: 8.0, CI: 1.1-58.1; N < 5). The hazard of renal carcinoma was markedly increased in children with tuberous sclerosis (HR 59.6, CI: 23.7-149.5; N = 5), a known cause of renal cancer. Thyroid carcinoma was not associated with non-syndromic anomalies or syndromes.

Yantz C, Shumate C, Betancourt D, et al. Epidemiology of colpocephaly in the Texas Birth Defects Registry, 1999 to 2020. Am J Perinatol. Published online January 31, 2025. doi:10.1055/a-2516-1967
Abstract
Objective: Colpocephaly is a congenital brain defect characterized by enlargement of the occipital horns of the lateral ventricles. Few population-based studies have focused on this central nervous system (CNS) defect. This study aimed to evaluate the birth prevalence and survival of Texas infants with colpocephaly delivered between 1999 and 2020.
Study design: Cases from the Texas Birth Defects Registry (TBDR) with a diagnosis of colpocephaly were identified. Unadjusted birth prevalence, 1-year survival estimates, and crude hazard ratios with 95% confidence intervals (CIs) were calculated from data collected from the medical record abstraction and linked vital records. Select maternal and infant variables were assessed overall and across four medical classification groups (presence of isolated, chromosomal, syndromic, or multiple major defects).
Results: From 1999 to 2020, 1,146 cases with colpocephaly were identified. The overall birth prevalence of colpocephaly was 1.36/10,000 live births (95% CI: 1.28-1.44). Significantly higher prevalence was noted for male infants, infants with low birth weight (<2,500 g), and very preterm (<32 weeks) infants. Overall, 1-year survival was 89.5%, with statistically significant differences observed in each medical classification group (e.g., isolated) across levels of maternal education, Texas/Mexico border maternal residence at delivery, infant birth weight, and gestational age.
Conclusion: These findings have important implications for pediatric neurology and future research, such as counseling on the prevalence and prognosis of colpocephaly. Additionally, these findings highlight that the population burden of CNS defects may be higher than previously believed, supporting the expansion of research of rare brain defects.
Key points: · The overall birth prevalence of colpocephaly for Texas infants delivered between 1999 and 2020 was 1.36/10,000 live births.. · Statistically significant differences in 1-year survival were observed across select maternal and infant variables.. · Longitudinal studies are necessary to fully ascertain the prevalence of colpocephaly beyond the first year of life..

For more information, employees may email the Medical and Research Library at library@dshs.texas.gov to receive research assistance, learn how to access electronic materials, or to obtain the full text of articles mentioned in this month’s news.

The Medical and Research Library News is sent out once a month or when important library news or events occur. Recent issues of the MRL News are online. If any of the links do not open for you, please email library@dshs.texas.gov and we will send you what you need. Thank you!

If you would like to subscribe, please send an email to library@dshs.texas.gov with Subscribe in the subject line.

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Medical and Research Library News               
January 2025

Happy New Year!

Training opportunities
Websites and reports on trending topics
Journal articles of note

Training opportunities

The webinars and online classes listed here are shared solely as opportunities to learn more information of interest to public health personnel. All times listed are in Central Time.

January 15, 2025; 1–2 p.m. Supporting Work-Life Balance During Staffing Transitions.
Join the Health Resources and Services Administration (HRSA) for a webinar on the importance of effective succession and transition planning to support work life balance. Participants will learn how proactive planning can support healthy workloads, enhance professional growth opportunities, and strengthen positive workplace culture.

January 15, 2025; 1–2 p.m. Mental Health in the Workplace.
Many of us spend 40 or more hours a week at work, so it is not surprising that the workplace affects our mental health and well-being. The first half of this 1-hour webinar from the Network of the National Library of Medicine (NNLM) will look at how to improve workplace mental health and wellbeing following the U.S. Surgeon General framework of 5 essential components for workplace mental health and wellbeing. The second half will explore the 8 dimensions of health we can use as individuals to improve our mental health and well-being.

January 22, 2025; 2–3 p.m. A Tale of Two Urban Trails: Promoting Physical Activity and Active Transportation on the Texas Border.
This session from Texas Children in Nature will delve into how the Caracara Trails in Brownsville and the Paso del Norte Trail in El Paso promote physical activity and active transportation in these communities. Urban trails offer an accessible and inviting environment for residents to engage in physical activity outdoors and offer practical and environmentally friendly alternatives to driving. Participants will learn how these trails provide vital opportunities for walking, jogging, and cycling, leading to improved health and overall wellness. Additionally, they will learn the role of urban trails in promoting active transportation by connecting key neighborhoods, public transit hubs, and commercial areas. Finally, we will discuss plans and strategies to help mitigate extreme heat on the trails.

January 29, 2025; 11 a.m.–12:30 p.m. Trending Street Drugs in Texas.
This webinar is offered by the DSHS Office of Practice and Learning Grand Rounds program. DSHS Grand Rounds explores the science and practice of population health and awards continuing education credits/contact hours for various disciplines. Visit the Grand Rounds calendar to see information on upcoming sessions. Held monthly on the fourth Wednesday, sessions last 90 minutes with the final 20 minutes reserved for Q&A.

Websites and reports on trending topics

The Cochrane Library consists of a collection of evidence-based medicine databases, including the Cochrane Database of Systematic Reviews. It provides up-to-date information on the effects of interventions in health care and evidence to support decisions taken in health care and to inform those receiving care. Search for systematic reviews, protocols, trials, methods studies, and more.

eBooks at EBSCOhost offers full-text of thousands fiction and nonfiction books on a variety of topics. It also hosts the ebook titles that the DSHS Library has purchased. When logged in through DSHS, you will find the Library’s ebooks on public health and management topics in addition to the titles TexShare provides.

DSHS Library TDNet site – Use this site to access journals and other DSHS Library subscription resources. As an example, here are the top 10 most accessed DSHS Library journal titles for 2024:
1. JAMA
2. AJOT: American Journal of Occupational Therapy
3. Lancet
4. International Journal of Tuberculosis and Lung Disease
5. The New England Journal of Medicine
6. Child Abuse and Neglect
7. Nature
8. Clinical Microbiology Reviews
9. Journal of Public Health Management and Practice
10. Journal of the American Medical Directors Association

Journal articles of note

Ansah H, Mayfield H, & Davila V. The moderating influence of community social support on the association between adverse childhood experiences and persistent feelings of sadness among adolescents in Texas. Texas Public Health Journal. 2024;76(4).
Abstract
Background: Adverse childhood experiences (ACEs) have long-lasting effects on adolescents' mental health, impacting their ability to form healthy relationships and lifestyles later in life. Social support may act as a resource that helps adolescents cope with stress and provides a sense of community, support, and hope. However, few studies have explored the moderating role of perceived community social support on the impact that ACEs have on poor mental health among adolescents in Texas.
Methods: The 2021 Texas Youth Risk Behavior Surveillance System (YRBS) survey data were used to address this gap. Unadjusted and adjusted bivariate and multivariable logistic regression models were used to examine the association between self-reported ACEs and feelings of sadness, adjusting for sociodemographic variables, and assessing community social support as a potential moderator.
Results: The sample included 1,259 students (49.8% female). Overall, 87.4% of Texas adolescents experienced one or more ACEs, 50.1% of students reported past-year persistent feelings of sadness, and 42.1% of Texas adolescents reported perceived community social support. The top three most reported ACEs were verbal abuse (65.3%), followed by physical abuse (37.6%) and household mental illness (33.0%). Total ACE score was found to be associated with feelings of sadness in both crude (odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.49-1.78) and adjusted (aOR = 1.60, 95% CI = 1.47- 1.74) models. While the magnitude of the odds of persistent feelings of sadness was higher among those who reported no community social support (aOR = 1.68, 95% CI = 1.51-1.87) compared to those who received community social support (aOR = 1.47, 95% CI = 1.30-1.67), there was no significant difference between the groups.
Conclusions: The results suggest that community social support may impact the relationship between ACEs and adolescent's emotional well-being; however, more research is needed to determine this effect.

Haas CB, Shiels MS, Pfeiffer RM, et al. Cancers with epidemiologic signatures of viral oncogenicity among immunocompromised populations in the United States. J Natl Cancer Inst. 2024;116(12):1983-1991. doi:10.1093/jnci/djae159
Abstract
Background: Immunosuppressed individuals have elevated risk of virus-related cancers. Identifying cancers with elevated risk in people with HIV and solid organ transplant recipients, 2 immunosuppressed populations, may help identify novel etiologic relationships with infectious agents.
Methods: We used 2 linkages of population-based cancer registries with HIV and transplant registries in the United States. Cancer entities were systematically classified according to site and histology codes. Standardized incidence ratios were used to compare risk in people with HIV and solid organ transplant recipients with the general population. For selected cancer entities, incidence rate ratios were calculated for indicators of immunosuppression within each population.
Results: We identified 38,047 cancer cases in solid organ transplant recipients and 53,592 in people with HIV, yielding overall standardized incidence ratios of 1.66 (95% confidence interval [CI] = 1.65 to 1.68) and 1.49 (95% CI = 1.47 to 1.50), respectively. A total of 43 cancer entities met selection criteria, including conjunctival squamous cell carcinoma (people with HIV standardized incidence ratio = 7.1, 95% CI = 5.5 to 9.2; solid organ transplant recipients standardized incidence ratio = 9.4, 95% CI = 6.8 to 12.6). Sebaceous adenocarcinoma was elevated in solid organ transplant recipients (standardized incidence ratio = 16.2, 95% CI = 14.0 to 18.6) and, among solid organ transplant recipients, associated with greater risk in lung and heart transplant recipients compared with recipients of other organs (incidence rate ratio = 2.3, 95% CI = 1.7 to 3.2). Salivary gland tumors, malignant fibrous histiocytoma, and intrahepatic cholangiocarcinoma showed elevated risk in solid organ transplant recipients (standardized incidence ratio = 3.9, 4.7, and 3.2, respectively) but not in people with HIV. However, risks for these cancers were elevated following an AIDS diagnosis among people with HIV (incidence rate ratio = 2.4, 4.3, and 2.0, respectively).
Conclusions: Elevated standardized incidence ratios among solid organ transplant recipients and people with HIV, and associations with immunosuppression within these populations, suggest novel infectious causes for several cancers including conjunctival squamous cell carcinoma, sebaceous adenocarcinoma, salivary gland tumors, malignant fibrous histiocytoma, and intrahepatic cholangiocarcinoma.

Ludorf KL, Benjamin RH, Canfield M, et al. Low Apgar score and risk of neonatal mortality among infants with birth defects. Am J Perinatol. Published online November 25, 2024.
doi:10.1055/a-2452-0047
Abstract
Objective: The Apgar score is a clinical tool to assess newborn health at delivery and has shown utility in predicting neonatal mortality in the general population, but its predictive ability in neonates with birth defects remains unexplored. As such, we aimed to investigate the performance of the 5-minute Apgar score in predicting neonatal mortality among neonates with a spectrum of major birth defects.
Study design: Data for neonates with birth defects born between 1999 and 2017 were obtained from the Texas Birth Defect Registry. We generated receiver operating characteristic curves and corresponding area under the curve (AUC) values for neonatal mortality (death within the first 28 days of life) by 5-minute Apgar score (<7 vs. ≥7) to measure discrimination capacity. We performed secondary analyses to determine the predictive ability of the Apgar score: (1) among infants with an isolated birth defect and (2) separately in preterm and term neonates
Results: Low Apgar score yielded substantial predictive ability for neonatal mortality, with 25 out of 26 AUC values > 0.70 across a spectrum of defect categories. High predictive ability was consistent among neonates with isolated defects, and preterm and term neonates.
Conclusion: The Apgar score is likely useful for predicting neonatal mortality among most neonates with birth defects. Despite small sample sizes limiting some secondary analyses, the findings emphasize the potential continued use of the Apgar score as a rapid clinical assessment tool for newborns with birth defects. Continued research may refine the Apgar score's application in this important population, both in clinical practice and population health research.

Ludorf KL, Benjamin RH, Canfield MA, Swartz MD, Agopian AJ. Prediction of preterm birth among infants with orofacial cleft defects. Cleft Palate Craniofac J. 2025;62(1):35-43.doi:10.1177/10556656231198945
Abstract
Objective: To develop risk prediction models for preterm birth among infants with orofacial clefts.
Design: Data from the Texas Birth Defects Registry for infants with orofacial clefts born between 1999-2014 were used to develop preterm birth predictive models. Logistic regression was used to consider maternal and infant characteristics, and internal validation of the final model was performed using bootstrapping methods. The area under the curve (AUC) statistic was generated to assess model performance, and separate predictive models were built and validated for infants with cleft lip and cleft palate alone. Several secondary analyses were conducted among subgroups of interest.
Setting: State-wide, population-based Registry data.
Patients/participants: 6774 infants with orofacial clefts born in Texas between 1999-2014.
Main outcome measure(s): Preterm birth among infants with orofacial clefts.
Results: The final predictive model performed modestly, with an optimism-corrected AUC of 0.67 among all infants with orofacial clefts. The optimism-corrected models for cleft lip (with or without cleft palate) and cleft palate alone had similar predictive capability, with AUCs of 0.66 and 0.67, respectively. Secondary analyses had similar results, but the model among infants with delivery prior to 32 weeks demonstrated higher optimism-corrected predictive capability (AUC = 0.74).
Conclusions: This study provides a first step towards predicting preterm birth risk among infants with orofacial clefts. Identifying pregnancies affected by orofacial clefts at the highest risk for preterm birth may lead to new avenues for improving outcomes among these infants.

For more information, employees may email the Medical and Research Library at library@dshs.texas.gov to receive research assistance, learn how to access electronic materials, or to obtain the full text of articles mentioned in this month’s news.

The Medical and Research Library News is sent out once a month or when important library news or events occur. Recent issues of the MRL News are online. If any of the links do not open for you, please email library@dshs.texas.gov and we will send you what you need. Thank you!

If you would like to subscribe, please send an email to library@dshs.texas.gov with Subscribe in the subject line.

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Medical and Research Library News               
December 2024

Training opportunities
Websites and reports on trending topics
Journal articles of note

Training opportunities

The webinars and online classes listed here are shared solely as opportunities to learn more information of interest to public health personnel. All times listed are in Central Time.

December 4, 2024; 11 a.m.–2 p.m. Maternal Health - The Rising Incidence of Maternal Syphilis and What We Need to Do About It.
This webinar hosted by Renaye James Healthcare Advisors will discuss how to evaluate individuals at higher risk for becoming infected with syphilis and reviews the screening tests, diagnosis, and treatment for pregnant individuals to minimize the risk of the fetus acquiring congenital syphilis. This webinar aligns with the Health Center Performance Improvement domain of Quality, Patient Care, and Safety as it discusses direct patient care strategies to mitigate complications in the postpartum period.

December 5, 2024; 12.–2:30 p.m. Effective Models to Address Mental Health and Substance Use Disorders.
Join this webinar from the National Academies of Sciences, Engineering, and Medicine (NASEM) to learn about effective models to address mental health and substance use disorders. Discussion topics may include policy implications of selected abatement interventions, effective care models for opioid use disorder and substance use disorder, and addressing issues in access to effective, affordable, and appropriate treatments.

December 10, 2024; 12–1 p.m. Empowering Tobacco Cessation: How Motivational Interviewing Supports Every Stage of Change.The National Center for Farmworker Health (NCFH) is hosting an interactive webinar focusing on the importance of tobacco use screening and self-help education tools. The webinar will cover the stages of change in patients and how motivational interviewing (MI) can empower individuals in their journey to quit tobacco. Attendees will see scenario-based examples of MI in action and receive resources to improve tobacco cessation initiatives for their patient populations.

December 17, 2024; 11 a.m.–12 p.m. Supporting CHWs with Technology to Achieve Value: Hearing from CHWs on Challenges and Successes of Joining the Team.
Hosted by the Health Information and Technology, Evaluation and Quality (HITEQ), this training will feature a conversation with community health workers (CHWs), sharing their challenges and successes in becoming team members in the current landscape of value-based care.

Websites and reports on trending topics

FDA Adverse Event Reporting System (FAERS) is a database that contains adverse event reports, medication error reports, and product quality complaints resulting in adverse events that were submitted to FDA.

speechBITE is a database of intervention studies across the scope of speech pathology practice. It includes evidence-based practices for speech pathologists, including systematic reviews, trials, clinical practice guidelines and more.

STAT!Ref is a DSHS Medical and Research Library resource that provides full text access to key medical reference sources. It includes Red Book, AMA coding manuals, medical dictionaries, drug guides, and many other medical reference books.

Trip is a clinical search engine of evidence-based content designed to support clinical practice and care. It includes research evidence and other content types including images, videos, patient information leaflets, educational courses, and news.

Journal articles of note

Allred RP, Aguilar-Martinez J, Howell R, et al. Epidemiology of macrocephaly in the Texas Birth Defects Registry, 1999-2019. Birth Defects Res. 2024;116(11):e2415. doi:10.1002/bdr2.2415
Abstract
Background: Macrocephaly is a clinical observation denoted as an occipitofrontal head circumference exceeding two standard deviations above same age and sex norms. By its definition, macrocephaly occurs in approximately 3% of the population. Descriptive epidemiologic evaluations of macrocephaly are lacking in the literature. The primary objective of this study was to describe the prevalence of macrocephaly captured by the Texas Birth Defects Registry (TBDR) by infant sex, rural/urban residence, and select maternal characteristics.
Methods: Cases of TBDR between 1999 and 2019 with a six-digit Centers for Disease Control modified-British Pediatric Association (BPA) code of 742.400 (enlarged brain/head, large head, macrocephaly, megalencephaly) were identified. All pregnancy outcomes and diagnostic certainties were included. Prevalence (per 10,000 live births) and 95% confidence intervals (CIs) were calculated using a Poisson table by rural/urban residence, infant sex, maternal age, education, race/ethnicity, history of diabetes, and body mass index (BMI). Prevalence calculations were repeated across multiple sensitivity analyses including (1) definite, isolated cases excluding those with indication of being either "benign" or "familial", (2) definite, non-isolated cases, (3) definite non-isolated cases excluding chromosomal and syndromic cases, and (4) definite, proportionate (at birth) cases. A secondary objective was to describe the most common co-occurring congenital defects among definite, non-isolated cases.
Results: Overall, between 1999 and 2019, 14,637 cases of macrocephaly were identified in the TBDR resulting in a prevalence of 18.12/10,000 live births (95% CI: 17.83-18.42). Most cases were live born (99%), had a definite diagnosis (87%), and were non-isolated (57%). Prevalence was significantly higher among males, among those with an urban residence, and among mothers who were older, Non-Hispanic White, who had greater than high school education, who had a history of diabetes, and who were obese. Prevalence patterns remained consistent across all sensitivity analyses. The most common co-occurring congenital defects among definite, non-isolated cases were minor and primarily included skull and facial bone anomalies (e.g., plagiocephaly [18%]).
Conclusions: To our knowledge, this is the first epidemiologic evaluation of macrocephaly in a birth defects registry. The long-term clinical impact of isolated macrocephaly is not well understood and should be the focus of future investigations.

Luo Q, Horner MJ, Haas CB, et al. Differences in trends in cancer incidence rates among people with HIV during 2001-2019 by race and ethnicity and by risk group in the United States. Clin Infect Dis. Published online November 7, 2024. doi:10.1093/cid/ciae555
Abstract
Background: Cancer risk among people with HIV (PWH) has declined over time as a result of antiretroviral therapy, but it is unclear whether all racial/ethnic groups and transmission risk groups have experienced equal declines.
Methods: We used data on PWH aged ≥20 years old from the HIV/AIDS Cancer Match Study during 2001-2019. We used Poisson regression to assess time trends in incidence rates for each cancer site by racial/ethnicity and risk group, adjusting for age, registry, and sex. We also estimated adjusted rate ratios across racial and ethnic and risk groups in 2001-2004 and 2015-2019.
Results: Trends in age-standardized rates differed across Black, White, and Hispanic PWH, and across risk groups for some cancers. For example, liver cancer rates declined 23% per 5-year period among White PWH, 11% in Black PWH, and 18% in Hispanic PWH. Anal cancer rates declined among men who have sex with men, were stable among people who inject drugs, and increased among other risk groups. Between 2001-2004 and 2015-2019, relative difference in cancer incidence rates by race/ethnicity increased for HL and liver cancer, but decreased for NHL; by risk group, relative differences increased for NHL and liver cancer, and decreased for HL, lung and anal cancers.Conclusions: Among PWH in the US, during 2001-2019, HL, lung, liver, and cervical cancer rate trends were different across racial/ethnic groups. HL, lung, anal, and liver cancer rates trends were different across risk groups. Future work should examine underlying causes of the differences in trends.

Mitchell DL, Chambers TM, Agopian AJ, et al. Epidemiology of coloboma: prevalence and patterns in Texas, 1999-2014. Birth Defects Res. 2024;116(11):e2413. doi:10.1002/bdr2.2413
Abstract
Background: Coloboma is a rare congenital malformation in which part of the tissue that makes up the eye is missing and may cause visual impairment or blindness. Little is known about the epidemiology of this condition. Therefore, we obtained data from the Texas Birth Defects Registry on children identified with coloboma for the period 1999-2014.
Methods: Using information on all live births from the same period, prevalence ratios (PRs) for selected demographic and clinical factors were used to estimate associations using Poisson regression among cases with coloboma. Coloboma cases were divided into subgroups to explore patterns of co-occurring defects and syndromes. All variables significant in unadjusted models (p < 0.05) were included in multivariable models to evaluate adjusted PRs (aPRs).
Results: We identified 1587 cases with coloboma, of whom 934 (58.8%) were nonsyndromic, and 474 (29.9%) were isolated. When considering all identified cases, factors associated with significant differences in prevalence included plurality (multiple vs. singleton aPR = 1.4, 95% CI: 1.1-1.8); maternal education (college or greater vs. less than high school aPR = 0.7, 95% CI: 0.6-0.9); maternal race/ethnicity (Hispanic vs. non-Hispanic White aPR = 0.9, 95% CI: 0.8-1.0); and maternal diabetes (yes vs. no aPR = 1.3, 95% CI: 1.0-1.6). There was a notable increase in the birth prevalence of coloboma during the study period (p-for-trend < 0.001). Effect estimates were similar across the different subgroups.
Conclusion: In our large population, we identified several factors associated with the prevalence of coloboma. These findings may help define subgroups of women more likely to have children affected by coloboma, which could inform improved screening efforts.

Zhong L, Smith ML, Lyu N, et al. The opioid public health crisis in Texas: characterizing real-world healthcare resource utilization and economic burden in different clinical settings. J Opioid Manag. 2024;20(5):393-409.
Abstract
Background and aims: Given the national opioid public health crisis, this study aimed to characterize the real-world healthcare resource utilization pattern and to quantify the economic burden associated with opioid misuse in Texas.
Methods: A retrospective cross-sectional study was conducted using Texas state-wide Inpatient, Outpatient, and Emergency Department (ED) administrative data. International Classification of Diseases, 10th Revision (ICD-10-CM) codes related to opioid abuse, adverse effects, dependence, and poisoning identified opioid-related clinical encounters. High-sensitivity and high-specificity definition criteria were used to capture the range of opioid-related clinical encounters. Descriptive statistics were applied to evaluate the resource utilization and economic burden in different clinical settings and by different types of opioid misuse. Multivariable logistic regression models were applied to identify the association with patients' characteristics.
Results: The high-sensitivity definition identified three to six times more opioid-related clinical encounters related as compared to the high-specificity definition (31,901 vs 10,423 outpatient visits and 47,021 vs 7,444 inpatient visits). A greater proportion of these patients were aged 18-44, White, non-Hispanic, living in metro areas, and uninsured as compared to all-cause visits. EDs were heavily utilized with the outpatient visits predominantly through the ED (>90 percent) and between 49 and 78 percent of inpatient hospitalizations admitted through ED. The multivariable association between patient characteristics and opioid-related clinical encounters varied with clinical settings and the two definitions. High-sensitivity opioid-related clinical encounters were generally associated with higher charges as compared to high-specificity encounters. The total healthcare charge related to opioid misuse in 2016 was estimated to be USD 0.27 billion using the high-specificity definition and USD 2.6 billion using the high-sensitivity definition.
Conclusions: Findings indicate opioid-related clinical encounters impose significant clinical and economic burdens in Texas. Study findings can help healthcare policymakers, professionals, and clinicians better classify opioid use disorder as a major but underreported condition in Texas.

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