Medical and Research Library News               
March 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.

March 5, 2025; 2–3 p.m. The Dignity of Risk: Making Parks Fully Inclusive.
Join Texas Children in Nature for a webinar with Mark Davison, Park Planning, Design and Construction Manager, City of Boulder, Colorado. The three main outcomes that will emerge from describing his journey are understanding the dignity of risk for youth experiencing disability, overcoming barriers that are both physical and imagined, and employing a sensory input method for design to create fully inclusive parks and play areas.

March 12, 2025; 2–3 p.m. Per- and poly-fluoroalkyl substances (PFAS) and Public Health: An Examination of the Occurrence of PFAS, their Health Effects, and the Evolving Regulatory Environment.
The term "PFAS" or "forever chemicals" is talked about frequently in the news media, but what are these and how are they connected to public health?  This webinar from National Board of Public Health Examiners (NBHPE) will provide an overview of what PFAS are and what they are or were used for, their presence in the environment and consumer products, and their health effects. Current and proposed regulations that are applicable to PFAS (e.g., drinking water standards) will also be discussed.  This webinar will provide an overview of this topic to provide practitioners with a foundation for a better understanding of PFAS, why they have emerged as a defining issue for public health, and what is being done to address it.

March 18, 2025; 12–1 p.m.  Family Meals: Cooking, Connection, and Culture.
Family meals offer numerous benefits that go beyond nutrition—they help develop close-knit relationships, nurture emotional well-being, and create a foundation for healthy, balanced living. Whether it's a simple dinner or a more elaborate weekend gathering, the act of sitting down together is an invaluable practice in any household. Join the Michael & Susan Dell Center for Healthy Living for this insightful webinar as we explore the theme "Food Connects Us All," in celebration of this year's National Nutrition Month. Learn practical tips and strategies to make family mealtimes a cherished tradition in your home.

March 26, 2025; 11 a.m.–12:30 p.m. Improving Maternal Health Through Multiagency Collaboration.
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

National Health Statistics Surveys and Reports is a resource from the National Center for Health Statistics that provides annual data summaries and analyses on many health topics. These reports provide annual data summaries, present analyses of health topics, or present new information on methods or measurement issues. All National Health Statistics Reports (NHSR) that have been released to date are presented in an interactive, searchable, and sortable data tables format.

APA PsycInfo is the American Psychological Association’s (APA) database for abstracts of scholarly journal articles, book chapters, books, and dissertations. It is the largest resource devoted to peer-reviewed literature in behavioral science and mental health and contains records and summaries dating as far back as the 1600s. Access to APA PsycInfo is provided by the DSHS Library & Information Science Program.

PubChem is the National Library of Medicine’s open chemistry database and the largest freely accessible reference tool for chemical information. Search chemicals by name, molecular formula, structure, and other identifiers. Find chemical and physical properties, biological activities, safety and toxicity information, patents, literature citations, and more.

Journal articles of note

Betancourt D, Shumate C, Yantz C, et al. Self-reported access to specialized genetics providers among families of young children with birth defects in Texas. Am J Med Genet A. Published online February 17, 2025. doi:10.1002/ajmg.a.64022
Abstract
Specialized genetics providers can help families of children with birth defects understand their child's condition and guide their medical treatment. The Birth Defects Epidemiology and Surveillance Branch (BDESB) routinely connects young children from the Texas Birth Defects Registry (TBDR) with select birth defects to agency social workers for assistance. Beginning in November 2022, social workers asked parents they reached: "Has the parent or child met with a geneticist or genetic counselor (or visited a genetics clinic)?". Responses were tabulated, overall and by select characteristics of interest. A chi-square test was used to evaluate if these characteristics were associated (p < 0.05) with self-reported access to a specialized genetics provider. Among the 400 families reached, 261 (65%) did not recall accessing specialized genetics providers. Lower access was observed among children with spina bifida or encephalocele, isolated birth defects, children without medical insurance, children meeting CDC developmental milestones, and younger mothers. Lower access was also observed in certain areas of the state, including the Texas-Mexico border. Our findings suggest that, in Texas, more than half (65%) of families of children with select birth defects are not accessing specialized genetics providers, and additional research is needed to work toward increasing access.

Howell R, Allred R, Betancourt D, et al. Enhancing data quality in a statewide birth defects registry: insights from an ongoing quality improvement initiative. J Registry Manag. 2024;51(3):109-119.
Abstract
Background: Since 1999, the Texas Birth Defects Registry (TBDR) has conducted active statewide surveillance of congenital anomalies in Texas. The TBDR has established quality assurance procedures and protocols. With the aim of supplementing these existing procedures with a new approach to proactively identify operational issues impacting data quality, we sought to implement a survey to identify procedural and operational challenges and develop strategies to mitigate the effects of practices (eg, changes in reporting practices at hospitals), external events (eg, pandemics), and other issues that may impact data quality
Methods: An open-text, anonymous survey was developed and distributed to TBDR staff. The survey elicited responses from staff related to TBDR operations, partnerships, and communication with external health care facilities. In years 2 and 3, the survey was abbreviated from 9 to 3 questions.
Results: Completion rates were 45%, 74%, and 49% in years 1, 2, and 3, respectively. Thematic analysis across all 3 years identified 7 primary themes: (1) data timeliness, (2) data quality improvements, (3) workflow optimization, (4) fundamental training needs, (5) specialized or technical training needs, (6) system challenges, and (7) internal communication and coordination.
Conclusions: This project provides a proof-of-concept that active surveillance birth defects registries can collect information on data quality-related staff experiences in a real-time, systematic manner and implement short- and long-term strategies to address data quality. The survey results prompted internal strategic planning, additional employee training initiatives, and data system enhancements. Additional work is needed to monitor the long-term improvements resulting from these strategic actions. The data quality survey results and implemented strategies may be useful to other surveillance programs.

Marushchak LV, Pulscher LA, Oguzie JU, et al. Monitoring for respiratory viruses among wild canids, Texas. One Health. 2025;20:100974. Published 2025 Jan 13. doi:10.1016/j.onehlt.2025.100974
Abstract
The cross-species transmission of respiratory viruses such as SARS-CoV-2 and avian influenza underscores the need for novel respiratory virus surveillance at the human-animal interface. In this 2023 pilot study we examined oral and rectal swab samples from 15 deceased wild animals for novel respiratory viruses. We used virus molecular techniques, culture and next-generation nucleotide sequencing to search for and characterize viruses in the 
Coronaviridae and Orthomyxoviridae families. Through these activities we detected and characterized one canine coronaviruses (CCoVs) each from a gray fox (Urocyon cinereorgenteus) and a feral dog (Canis lupus familiaris). The gray fox CCoV sequence clustered with other CCoVs reported in other canids from other regions of the world. The feral dog CCoV sequence was closely related to CCoVs reported in Brazil and the United Kingdom. This pilot study demonstrated the usefulness of a noninvasive monitoring approach in detecting and characterizing respiratory viruses among wild canids.

Tasnim Y, Rahman MK, Abdul-Hamid C, Awosile B. Beta-lactamase-producing Escherichia coli in migratory geese at West Texas recreational parks. Comp Immunol Microbiol Infect Dis. 2025. doi:10.1016/j.cimid.2025.102320
Abstract
This study aimed to determine the prevalence, and the genomic characteristics of beta-lactamase-Resistant Escherichia coli isolated from the feces of migratory geese at one health interface in West Texas. A descriptive study was conducted. We collected geese feces (n = 165), water (n = 118), and soil (n = 74) from 22 recreational parks in West Texas. We used Chromogenic agar to isolate extended-spectrum beta-lactamase (ESBL)-Resistant-E. coli. We used the whole genome sequencing (WGS) method to determine the genomic characteristics of selected E. coli isolates. Among 357 samples, 12.61 % (95 %CI: 9.34-16.50) were positive for ESBL- Resistant-E. coli. From WGS of 20 E. coli isolates, 19 isolates harbored at least 1 beta-lactamase gene including bla_CTX-M-1, bla_CTX-M-65, bla_CTX-M-14, bla_CTX-M-15, bla_CTX-M-27, bla_CTX-M-55, bla_CTX-M-32, bla_TEM-1A, bla_TEM-1B. Most of the isolates carried genes conferring resistance to tetracyclines-(tet(A), tet(B)), aminoglycosides-(aac(3)-IIa, aph(6)-Id, aph(3')-Ia, aadA1), sulfonamides-(sul1,sul2), amphenicol-(floR), trimethoprim-(dfrA1, dfrA14, dfrA17) and streptogramin-B(MLSB) agent-(mph(A)). 13 isolates showed chromosomal mutations in the promoter region G of the ampC beta-lactamase gene. We detected sixteen incompatibility plasmid groups and 60 virulence genes, which are related to adherence, exotoxin, invasion, and nutrition/metabolic factors. Genome analysis showed that all isolates were genetically similar to human E. coli isolates. The study showed that migratory geese at recreational parks can be reservoirs of resistant bacteria with diverse serotypes and sequence types of E. coli isolates. Based on the findings, the detection of a multidrug-resistant E. coli strain reinforces the importance of adequate hygiene practices for humans and pet animals after visiting recreational parks.

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               
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.

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