Medical and Research Library News
DSHS Medical and Research Library publishes MRL News, a monthly newsletter that highlights training opportunities, trending topics, and journal articles for public health professionals.
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HHS employees may email the Medical and Research Library to receive research assistance, learn how to access electronic resources featured in the newsletter, or obtain the full text of articles mentioned in this month’s news.
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Medical and Research Library News By Month
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.
October 5, 2023; 1–2 p.m. It’s a Weighty Matter: Exploring PRAMS Weights.
This session presented by the Association of State and Territorial Health Officials (ASTHO) will focus on increasing awareness on how PRAMS weights are constructed, how to properly subset data for weighted analyses, and when health department staff should be worried about over/under estimation. The presenters will provide thoughts and methods for checking assumptions of subgroup estimations, potential bias risks, and how re-weighting is sometimes used for smaller subpopulation assessments.
October 18, 2023; 2–3 p.m. Promoting Outdoor Time in Schools Through SHACs.
Since children spend most of their waking hours in school, it is important that they have an environment that encourages physical activity and stresses outdoor play. Community members, families and others concerned about child health can have an impact on school health decisions by participating on state mandated District School Health Advisory Councils (SHACs). The SHACs address school district policies and programs that impact children’s health and help create a healthy learning environment. Join this webinar from Texas Children in Nature to learn what and how a SHAC works and how you can get involved and connect children playing outside to children’s health and academic success.
October 24, 2023; 2–3 p.m. Applying Laboratory Risk Assessments.
This webinar from the Association of Public Health Laboratories (APHL) will provide attendees with fundamental knowledge regarding the timing and methodology for performing risk assessments within their facilities. Speakers will discuss how effective risk assessments can be towards preventing potential risks and applying laboratory risk assessments in different scenarios. This webinar will be recorded and made available for those unable to listen live.
October 25, 2023; 11 a.m.–12:30 p.m. Health and Safety Issues in Remote Workers.
This webinar is offered by DSHS Office of Practice and Learning Grand Rounds. During the COVID-19 pandemic, a large sector of the workforce moved to remote work. This interactive session will discuss the potential health and wellbeing effects of working remotely, review data from a nationwide survey of 657 remote workers, and discuss potential interventions to improve remote worker health. This is an essential topic for human resource and worksite wellness professionals as remote and hybrid work become commonplace. 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 for Q&A.
October 31, 2023; 1–2 p.m. Harm Reduction in Action: Language as Harm Reduction.
October is Health Literacy Month! In celebration of health literacy month, join the Network of the National Library of Medicine (NNLM) in bringing awareness to health literacy. This webinar views language as the first step to a positive interaction. Focusing on the importance of person-centered language as a gateway into harm reduction practices and technique to build trust with people who use drugs.
Websites and reports on trending topics
Gale Academic OneFile – This TexShare resource lets you access millions
of articles from thousands of scholarly and authoritative sources in the humanities, science, social science, business, and more. The Topic Finder feature is an easy visual to help explore sub-topics of your initial search. Please email the library for remote access to this resource.
MedlinePlus - Produced by the National Library of Medicine, this resource
has extensive information from the National Institutes of Health and other trusted sources on over 975 diseases and conditions. There are directories,
a medical encyclopedia and a medical dictionary, health information in Spanish, extensive information on prescription and nonprescription drugs, health information from the media, and links to thousands of clinical trials.
October is Breast Cancer Awareness Month - Each year in the United States, more than 240,000 women are diagnosed with breast cancer and 42,000 women die from the disease. This website from the CDC will help you recognize symptoms, identify risk factors, and lower your risk.
Toxic Substances Portal from the Agency for Toxic Substances and Disease Registry’s (ASTDR) makes it easy for researchers and individuals to find information about toxic chemicals, understand how these chemicals can affect health, and learn how to prevent exposure. It features a search
engine that facilitates finding substances by substance name, Chemical Abstract Service (CAS) registry number, synonym, or trade name.
Journal articles of note
Ajayi OO, Ajufo A, Ekpa QL, et al. Evaluation of bronchiolitis in the pediatric population in the United States of America and Canada: a ten-year review. Cureus. 2023;15(8):e43393. Published 2023 Aug 12. doi:10.7759/cureus.43393
Abstract
Bronchiolitis is a well-known viral infection among the pediatric population, significantly impacting hospitalization rates. The COVID-19 pandemic profoundly affected respiratory viral infections, including bronchiolitis, as various mitigation measures were implemented. In this study, we analyzed bronchiolitis cases during the pandemic and post-pandemic period, aiming to identify changes in management guidelines and their incidence and management over the last 10 years. Moreover, we explored the relationship between bronchiolitis and COVID-19, a virus that gained rapid notoriety worldwide. By analyzing data from pediatric populations in Canada and the USA, we sought to understand the role of varying seasons in the peak periods of bronchiolitis infections. The comprehensive review's results will provide valuable insights into bronchiolitis dynamics within the context of the COVID-19 pandemic. Our aim is to better comprehend the interplay between bronchiolitis, COVID-19, and seasonal variations, ultimately contributing to a deeper understanding of this respiratory viral infection and informing future management strategies. Furthermore, these findings can assist healthcare professionals in preparing for and responding to potential fluctuations in bronchiolitis cases in the post-pandemic era.
Haas CB, Engels EA, Palefsky JM, et al. Severe anal intraepithelial neoplasia trends and subsequent invasive anal cancer in the United States [published online ahead of print, 2023 Aug 26]. J Natl Cancer Inst. doi:10.1093/jnci/djad176
Abstract
Background: Anal intraepithelial neoplasia grade III (AIN3) is a precursor to squamous cell carcinoma of the anus (SCCA), for which rates are nearly 20-fold higher in people with HIV (PWH) than in the general population in the US. We describe trends in AIN3 diagnosis and risk of SCCA following AIN3 by HIV status and sex.
Methods: We utilized data from a population-based linkage between cancer and HIV registries in 11 US states, Puerto Rico, and Washington DC during 1996-2019. We identified all individuals with a diagnosis of AIN3 and determined their HIV status. We estimated the average annual percentage change (AAPC) of AIN3 using Poisson regression stratified by HIV status and sex. We estimated the 5-year cumulative incidence of SCCA following an AIN3 diagnosis stratified by sex, HIV status, and prior AIDS diagnosis.
Results: Among PWH, AAPCs for AIN3 were 15% (95%CI=12-17%) per year among females 12% (95%CI=11-14%) among males. AAPCs for those without HIV were 8% (95%CI=7-8%) for females and 8% (95%CI=6-9%) for males. Among PWH, a prior AIDS diagnosis was associated with a 2.7-fold (95%CI=2.23-3.40) and 1.9-fold (95%CI=1.72-2.02) increased risk of AIN3 diagnosis for females and males, respectively. 5-year cumulative incidence of SCCA following AIN3 for PWH with a prior AIDS diagnosis were 3.4% and 3.7% for females and males, respectively.
Conclusions: Rates of AIN3 diagnoses have increased since 1996, particularly for PWH, likely influenced by increased screening. A prior AIDS diagnosis was strongly associated with risk of AIN3 diagnosis.
Jibowu M, Driesse K, May S, Wright A, Swate T, Cotter C. Notes from the field: outbreak of norovirus illness caused by consumption of oysters harvested from Galveston Bay, Texas - November-December 2022. MMWR Morb Mortal Wkly Rep. 2023;72(35):968-969. Published 2023 Sep 1. doi:10.15585/mmwr.mm7235a5
On December 7, 2022, the Texas Department of State Health Services (DSHS) Public Health Region 6/5 South (PHR 6/5S) and DSHS Consumer Protection Division were notified by Galveston County Health District of 10 consumer complaints of illness after consumption of raw (nine complaints) and smoked (one) oysters at local restaurants during November 27–December 4. Signs and symptoms began within 8 hours after consumption and included diarrhea, nausea, or vomiting. Initially, no consumers sought medical care. Oyster tags from three associated restaurant inspections determined that oysters were from Oyster Harvest Area TX 1 (TX 1) in Galveston Bay, Texas.
Neelam V, Woodworth KR, Chang DJ, et al. Outcomes up to age 36 months after congenital Zika virus infection-U.S. states [published online ahead of print, 2023 Sep 1]. Pediatr Res. 2023. doi:10.1038/s41390-023-02787-9
Abstract
Background: To characterize neurodevelopmental abnormalities in children up to 36 months of age with congenital Zika virus exposure.
Methods: From the U.S. Zika Pregnancy and Infant Registry, a national surveillance system to monitor pregnancies with laboratory evidence of
Zika virus infection, pregnancy outcomes and presence of Zika associated birth defects (ZBD) were reported among infants with available information. Neurologic sequelae and developmental delay were reported among children with ≥1 follow-up exam after 14 days of age or with ≥1 visit with development reported, respectively.
Results: Among 2248 infants, 10.1% were born preterm, and 10.5% were small-for-gestational age. Overall, 122 (5.4%) had any ZBD; 91.8% of infants had brain abnormalities or microcephaly, 23.0% had eye abnormalities, and 14.8% had both. Of 1881 children ≥1 follow-up exam reported, neurologic sequelae were more common among children with ZBD (44.6%) vs. without ZBD (1.5%). Of children with ≥1 visit with development reported, 46.8% (51/109) of children with ZBD and 7.4% (129/1739) of children without ZBD had confirmed or possible developmental delay.
Conclusion: Understanding the prevalence of developmental delays and healthcare needs of children with congenital Zika virus exposure can inform health systems and planning to ensure services are available for affected families.
Impact: We characterize pregnancy and infant outcomes and describe neurodevelopmental abnormalities up to 36 months of age by presence of Zika associated birth defects (ZBD). Neurologic sequelae and developmental delays were common among children with ZBD. Children with ZBD had increased frequency of neurologic sequelae and developmental delay compared to children without ZBD. Longitudinal follow-up of infants with Zika virus exposure in utero is important to characterize neurodevelopmental delay not apparent in early infancy, but logistically challenging in surveillance models.
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.
Fine print section: 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.
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.
September 6, 2023; 2–3 p.m. Using Nature in Times of Grief.
Join this webinar from Texas Children in Nature to find out how nature can provide a pathway to healing, processing emotions, and as a source of comfort. Feelings of grief are part of life as we move through significant transitions, say goodbye to loved ones, or enter a new season of life. This webinar will help you identify key elements you can use to heal big feelings utilizing the power of nature.
September 13, 2023; 12–1:30 p.m. Making Sense of Numbers.
From the Network of the National Library of Medicine (NNLM), this webinar is an introduction to communicating numerical health information. It is designed for anyone who wants to improve communication of health information that involves numeracy and communicating numbers. Numeracy is the ability to access, use, interpret, and communicate mathematical information and ideas,
to engage in and manage mathematical demands of a range of situations in adult life. Numeracy literacy can be a challenge not only for individuals receiving health information, but also for those providing information. Objectives are to define numeracy, risk, outcome, benefit, statistics, relative risk, and absolute risk as they relate to numerical health information; explain risk and benefit (numeracy) of health information from an individual’s perspective; interpret and evaluate numerical health information; communicate numerical health information to others; and recognize Medline plus as a resource for numerical health information.
September 21, 2023; 1–2 p.m. Michael E. DeBakey Lecture in the History of Medicine - Mrs. Medicine: Doctors’ Wives and the Making of Modern American Health Care.
Marrying a doctor was presented as an aspirational goal for many young women in the twentieth century United States. For those who succeeded in securing a physician husband, however, married life was often hard work. From fundraising for hospital construction to waging political campaigns to answering patients’ phone calls, the doctor’s wife was an essential part of the growth of the American health care system as we know it. Drawing on a wide variety of NLM resources - particularly the publications of medical women’s auxiliary groups - this lecture presented by the National Library of Medicine (NLM) will argue that an understanding of marriage and domestic partnership has been an unfortunately neglected key element in our histories of medicine.
September 27, 2023; 11 a.m.–12:30 p.m. Supporting Nutrition and Health During the First 1,000 Days.
Dr. Beth Widen with Dell Pediatric Research Institute will discuss applying advanced analytic methods and interdisciplinary approaches to improve health during the critical period of the first 1,000 days of development. 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 for Q&A.
Websites and reports on trending topics
The Community Guide: The Guide to Community Preventive Services is a collection of evidence-based findings of the Community Preventive Services Task Force. It is a resource to help you select interventions to improve health and prevent disease in your state, community, community organization, business, healthcare organization, or school.
CAB Direct is the most thorough and extensive source of reference in the applied life sciences, incorporating the leading bibliographic databases CAB Abstracts and Global Health. CABI's bibliographic databases, including the world-renowned CAB Abstracts and Global Health, contain over 11 million bibliographic records, full-text articles, news items and reports across the applied life sciences.
Facts and Comparisons offers detailed information on prescription, over-the-counter and herbal medicines. Offered by the DSHS Medical and Research Library, it includes the same information as the Physician’s Desk Reference, but also compares drugs within a class, such as the different antibiotics. It gives dosage information, adverse effects, has patient information sheets, and much more. Please log out when finished; there is a limited number of logins allowed. For remote access, email library@dshs.texas.gov.
Heat-Related EMS Activation Surveillance Dashboard compiles Emergency Medical Services (EMS) responses to 911 calls for heat-related illnesses
and injuries, helping to pinpoint where resources and interventions, such
as cooling centers and additional tree coverage, should be focused. Updated weekly, major data points in the tracker include the rate of heat-related
EMS calls in a given area, the average time for EMS personnel to reach the patient, and the percentage of patients that EMS transports to a medical facility for additional care.
Journal articles of note
Bascom JT, Stephens SB, Lupo PJ, et al. Scientific impact of the National Birth Defects Prevention Network multistate collaborative publications [published online ahead of print, 2023 Jul 26]. Birth Defects Res. doi:10.1002/bdr2.2225
Abstract
Background: Given the lack of a national, population-based birth defects surveillance program in the United States, the National Birth Defects Prevention Network (NBDPN) has facilitated important studies on surveillance, research, and prevention of major birth defects. We sought to summarize NBDPN peer-reviewed publications and their impact.
Methods: We obtained and reviewed a curated list of 49 NBDPN multistate collaborative publications during 2000-2022, as of December 31, 2022. Each publication was reviewed and classified by type (e.g., risk factor association analysis). Key characteristics of study populations and analytic approaches used, along with publication impact (e.g., number of citations), were tabulated
Results: NBDPN publications focused on prevalence estimates (N = 17), surveillance methods (N = 11), risk factor associations (N = 10), mortality and other outcomes among affected individuals (N = 6), and descriptive epidemiology of various birth defects (N = 5). The most cited publications were those that reported on prevalence estimates for a spectrum of defects and those that assessed changes in neural tube defects (NTD) prevalence following mandatory folic acid fortification in the United States.
Conclusions: Results from multistate NBDPN publications have provided critical information not available through other sources, including US prevalence estimates of major birth defects, folic acid fortification and NTD prevention, and improved understanding of defect trends and surveillance efforts. Until a national birth defects surveillance program is established in the United States, NBDPN collaborative publications remain an important resource for investigating birth defects and informing decisions related to health services planning of secondary disabilities prevention and care.
McGee-Avila JK, Argirion I, Engels EA, et al. Risk of hepatocellular carcinoma in people with HIV in the United States, 2001-2019 [published online ahead of print, 2023 Aug 23]. J Natl Cancer Inst. 2023. doi:10.1093/jnci/djad172
Abstract
Background: People with HIV (PWH) have higher risk of hepatocellular carcinoma (HCC) than the general population, partly due to higher prevalence of coinfection with hepatitis B virus (HBV) or C virus (HCV).
Methods: We calculated standardized incidence ratios for HCC in PWH
by comparing rates from PWH in the HIV/AIDS Cancer Match Study, a population-based HIV and cancer registry linkage, to those in the general population. We used multivariable Poisson regression to estimate adjusted incidence rate ratios (aIRRs) among PWH and linked the Texas HIV registry with medical claims data to estimate adjusted odds ratios (aORs) of HBV
and HCV in HCC cases with logistic regression.
Results: Compared to the general population, HCC rates in PWH were elevated 2.79-fold (n = 1,736; 95%CI 2.66-2.92). HCC rates decreased significantly from 2001-2004 to 2015-2019 (p < 0.001). Compared to men who had sex with men (MSM), HCC risk was elevated 4.28-fold among men who injected drugs (95%CI 3.72-4.93) and 1.83-fold among women who injected drugs (95%CI 1.49-2.26). In Texas, 146 HCC cases amongst PWH were linked to claims data; 25% HBV-positive, 59% HCV-positive, and 13% co-infected with HBV and HCV. Compared to MSM, people who inject drugs (PWID) had 82% decreased odds of HBV (aOR 0.18; 95%CI (0.05 - 0.63), and 2-times the odds of HCV (aOR 20.4; 95%CI 3.32-125.3).
Conclusions: During 2001-2019, HCC risk declined among PWH, though rates remain significantly elevated compared to the general population, particularly among PWID. Prevention and treatment of HBV/HCV are needed to reduce HCC risk among PWH.
Metzger SL, Littlejohn KT, Silva AB, et al. A high-performance neuroprosthesis for speech decoding and avatar control. Nature. 2023;620(7976):1037-1046. doi:10.1038/s41586-023-06443-4
Abstract
Speech neuroprostheses have the potential to restore communication to people living with paralysis, but naturalistic speed and expressivity are elusive. Here we use high-density surface recordings of the speech cortex in a clinical-trial participant with severe limb and vocal paralysis to achieve high-performance real-time decoding across three complementary speech-related output modalities: text, speech audio and facial-avatar animation. We trained and evaluated deep-learning models using neural data collected as the participant attempted to silently speak sentences. For text, we demonstrate accurate and rapid large-vocabulary decoding with a median rate of 78 words per minute and median word error rate of 25%. For speech audio, we demonstrate intelligible and rapid speech synthesis and personalization to the participant's pre-injury voice. For facial-avatar animation, we demonstrate the control of virtual orofacial movements for speech and non-speech communicative gestures. The decoders reached high performance with less than two weeks of training. Our findings introduce a multimodal speech-neuroprosthetic approach that has substantial promise to restore full, embodied communication to people living with severe paralysis.
Utley S, Arunkumar P, Das T, et al. National Association of Medical Examiners position paper: Recommendations for the documentation and certification of disaster-related deaths [published online ahead of print,
2023 Jul 31]. Am J Forensic Med Pathol. 2023. doi:10.1097/PAF.0000000000000859
Abstract
Collecting and reporting accurate disaster mortality data are critical to informing disaster response and recovery efforts. The National Association of Medical Examiners convened an ad hoc committee to provide recommendations for the documentation and certification of disaster-related deaths. This article provides definitions for disasters and direct, indirect, and partially attributable disaster-related deaths; discusses jurisdiction for disaster-related deaths; offers recommendations for medical examiners/coroners (ME/Cs) for indicating the involvement of the disaster on the death certificate; discusses the role of the ME/C and non-ME/C in documenting and certifying disaster-related deaths; identifies existing systems for helping to identify the role of disaster on the death certificate; and describes disaster-related deaths that may require amendments of death certificates. The recommendations provided in this article seek to increase ME/C's understanding of disaster-related deaths and promote uniformity in how to document these deaths on the death certificate.
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.
Fine print section: 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.
Training opportunities
Websites and reports on trending topics
Journal articles of note
Training opportunities
Note: The following webinars and online classes are not affiliated with DSHS or the DSHS Library. They are presented here as opportunities to learn more information of interest to public health personnel. All times listed are in Central Time.
August 3, 2023; 12–1 p.m. The Impact of Climate Change on Child Health.
Join this webinar from the Michael & Susan Dell Center for Healthy Living on the profound implications of climate change on child health. This session will delve into how climate change impacts children's well-being, including increased respiratory illnesses, heat-related conditions, and mental health concerns. Gain valuable insights into the urgent actions needed to protect and promote the health of our youngest generation as we face a changing climate.
August 8, 2023; 1–2 p.m. Maintaining Patient Access to Care in Rural America.
This webinar from the Association of State and Territorial Health Officials (ASTHO) will explore federal priorities related to rural healthcare access, as well as highlight a successful model to ensure rural patients can access hospital services. The webinar will focus on the implementation and successes of the AZ REACH program, which serves as a patient transfer system that can be quickly mobilized during a variety of public health events. The webinar will also include discussion with the HRSA Federal Office of Rural Health Policy and CDC Office of Rural Health.
August 10, 2023; 1–2 p.m. Contextualizing Our Understanding of Mental Health and Substance Use.
Mental health and many mental disorders are shaped to a great extent by life experiences, social, economic, and physical environments in which people live. This webinar from the Bureau of Primary Health Care (BPHC) Behavioral Health (BH) Technical Assistance (TA) will describe a contextual framework for understanding mental and substance use conditions supporting person centered/culturally relevant care.
August 23, 2023; 2-3 p.m. A New Take On Community Gardens: Training Citizen Gardeners.
Across the state, children’s obesity levels continue to increase. During this webinar from Texas Children in Nature, learn what the Dallas County Health and Human Services Department in partnership with Texas A&M AgriLife Extension are doing to mitigate this trend. We will cover county demographics, general information related to the county’s health and chronic diseases, strategies under way to improve the county population’s well-being in food desert areas, and the recently implemented Citizen Gardening Training initiative.
Websites and reports on trending topics
CDC Wonder – The CDC Wide-ranging ONline Data for Epidemiological Research (CDC WONDER) provides access to a wide array of public health information. You can search for and read published documents on public health concerns, including reports, recommendations and guidelines, articles and statistical research data published by CDC. It also has reference materials and bibliographies on health-related topics. You can query numeric data sets on CDC's information systems, via fill-in-the blank webpages. Public-use data sets about mortality (deaths), cancer incidence, HIV and AIDS, TB, natality (births), census data and many other topics are available for query, and the requested data are readily summarized and analyzed.
Learning Express Library – This resource, available through the TexShare Databases, offers interactive training modules. It covers topics like math and writing skills, but also includes training on computer software like the Microsoft Office programs, Adobe Illustrator, and Adobe Photoshop. Please email the library if you need assistance accessing TexShare.
ProQuest Public Health – This database is also available through the TexShare Databases. It is designed to be the ideal starting point for public health information and research. With journals, news, trade publications, reports and more, ProQuest Public Health covers a wide variety of disciplines ranging from social sciences and biological sciences to business. Journal results are indexed from core literature collected from a variety of publishers using appropriate public-health terminology.
Valuing America's Health: Aligning Financing to Award Better Health and Well-Being – This new special publication from the National Academy of Medicine focuses on the urgent need to reckon with shortfalls in the nation’s health system and examines models that promote whole person, whole population health and the financing structures necessary to support them.
Journal articles of note
Li Y, Buendia J, Sears S, et al. Impact of Hurricane Harvey on inpatient asthma hospitalization visits within Southeast Texas, 2016-2019 [published online ahead of print, 2023 Jul 24]. J Occup Environ Med. 2023. doi:10.1097/JOM.0000000000002928
Abstract
Objective: To estimate inpatient asthma hospital visit rates among impacted Texans in Public Health Region 6/5S during the year of and following Hurricane Harvey.
Methods: Asthma inpatient hospitalization discharges were collected from the Texas Health Care Information Collection database (2016-2019).
Results: Females (age-adjusted rates/AARs = 4.8-5.0) and Black Texans (AARs = 5.0-8.1) experienced significantly higher AARs compared to males and White Texans during the year of and following Harvey. During the year of Hurricane Harvey, females were 1.49 times as likely to have an inpatient asthma visit compared to males, while Black Texans were 2.78 times as likely to have an inpatient asthma hospitalization compared to White Texans.
Conclusions: Findings from this study may assist public health professionals and local officials to allocate future resources to the most impacted subgroups as well as establish effective processes to mitigate consequences.
Neo DT, Martin CL, Carmichael SL, et al. Are individual-level risk factors for gastroschisis modified by neighborhood-level socioeconomic factors? [published online ahead of print, 2023 Jul 13]. Birth Defects Res. 2023. doi:10.1002/bdr2.2224
Abstract
Background: Two strong risk factors for gastroschisis are young maternal age (<20 years) and low/normal pre-pregnancy body mass index (BMI), yet the reasons remain unknown. We explored whether neighborhood-level socioeconomic position (nSEP) during pregnancy modified these associations
Methods: We analyzed data from 1269 gastroschisis cases and 10,217 controls in the National Birth Defects Prevention Study (1997-2011). To characterize nSEP, we applied the neighborhood deprivation index and used generalized estimating equations to calculate odds ratios and relative excess risk due to interaction.
Results: Elevated odds of gastroschisis were consistently associated with young maternal age and low/normal BMI, regardless of nSEP. High-deprivation neighborhoods modified the association with young maternal age. Infants of young mothers in high-deprivation areas had lower odds of gastroschisis (adjusted odds ratio [aOR]: 3.1, 95% confidence interval [CI]: 2.6, 3.8) than young mothers in low-deprivation areas (aOR: 6.6; 95% CI: 4.6, 9.4). Mothers of low/normal BMI had approximately twice the odds of having an infant with gastroschisis compared to mothers with overweight/obese BMI, regardless of nSEP (aOR range: 1.5-2.3).
Conclusion: Our findings suggest nSEP modified the association between gastroschisis and maternal age, but not BMI. Further research could clarify whether the modification is due to unidentified biologic and/or non-biologic factors.
Ream MA, Lam WKK, Grosse SD, et al. Evidence and recommendation for guanidinoacetate methyltransferase deficiency newborn screening [published online ahead of print, 2023 Jul 19]. Pediatrics. 2023. doi:10.1542/peds.2023-062100
Abstract
Guanidinoacetate methyltransferase (GAMT) deficiency is an autosomal recessive disorder of creatine biosynthesis due to pathogenic variants in the GAMT gene that lead to cerebral creatine deficiency and neurotoxic levels of guanidinoacetate. Untreated, GAMT deficiency is associated with hypotonia, significant intellectual disability, limited speech development, recurrent seizures, behavior problems, and involuntary movements. The birth prevalence of GAMT deficiency is likely between 0.5 and 2 per million live births. On the basis of small case series and sibling data, presymptomatic treatment with oral supplements of creatine, ornithine, and sodium benzoate, and a protein-restricted diet to reduce arginine intake, appear to substantially improve health and developmental outcomes. Without newborn screening, diagnosis typically happens after the development of significant impairment, when treatment has limited utility. GAMT deficiency newborn screening can be incorporated into the tandem-mass spectrometry screening that is already routinely used for newborn screening, with about 1 per 100,000 newborns screening positive. After a positive screen, diagnosis is established by finding an elevated guanidinoacetate concentration and low creatine concentration in the blood. Although GAMT deficiency is significantly more rare than other conditions included in newborn screening, the feasibility of screening, the low number of positive results, the relative ease of diagnosis, and the expected benefit of presymptomatic dietary therapy led to a recommendation from the Advisory Committee on Heritable Disorders in Newborns and Children to the Secretary of Health and Human Services that GAMT deficiency be added to the Recommended Uniform Screening Panel. This recommendation was accepted in January 2023.
Wong EC, Lupo PJ, Desrosiers TA, et al. Associations between birth defects with neural crest cell origins and pediatric embryonal tumors [published online ahead of print, 2023 Jul 11]. Cancer. 2023. doi:10.1002/cncr.34952
Abstract
Background: There are few assessments evaluating associations between birth defects with neural crest cell developmental origins (BDNCOs) and embryonal tumors, which are characterized by undifferentiated cells having a molecular profile similar to neural crest cells. The effect of BDNCOs on embryonal tumors was estimated to explore potential shared etiologic pathways and genetic origins.
Methods: With the use of a multistate, registry-linkage cohort study, BDNCO-embryonal tumor associations were evaluated by generating hazard ratios (HRs) and 95% confidence intervals (CIs) with Cox regression models. BDNCOs consisted of ear, face, and neck defects, Hirschsprung disease, and a selection of congenital heart defects. Embryonal tumors included neuroblastoma, nephroblastoma, and hepatoblastoma. Potential HR modification (HRM) was investigated by infant sex, maternal race/ethnicity, maternal age, and maternal education.
Results: The risk of embryonal tumors among those with BDNCOs was 0.09% (co-occurring n = 105) compared to 0.03% (95% CI, 0.03%-0.04%) among those without a birth defect. Children with BDNCOs were 4.2 times (95% CI, 3.5-5.1 times) as likely to be diagnosed with an embryonal tumor compared to children born without a birth defect. BDNCOs were strongly associated with hepatoblastoma (HR, 16.1; 95% CI, 11.3-22.9), and the HRs for neuroblastoma (3.1; 95% CI, 2.3-4.2) and nephroblastoma (2.9; 95% CI, 1.9-4.4) were elevated. There was no notable HRM by the aforementioned factors.
Conclusions: Children with BDNCOs are more likely to develop embryonal tumors compared to children without a birth defect. Disruptions of shared developmental pathways may contribute to both phenotypes, which could inform future genomic assessments and cancer surveillance strategies of these conditions.
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