Medical and Research Library News

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 2, 2025; 1–2 p.m. Bridging Trust and Care: The Unique Role of Community Health Workers in Dementia Efforts.
Join the Association of State and Territorial Health Officials (ASTHO) and the Building Our Largest Dementia (BOLD) Public Health Center of Excellence (PHCOE) for a webinar discussing how community health workers (CHWs) can address brain health and dementias in their communities. During this session, the BOLD PHCOE will showcase a new report, Community health workers: developing roles in public health dementia efforts in the United States. ASTHO will also highlight a new 
e-learning module, Equipping Community Health Workers to Address Alzheimer’s Disease and Related Dementias in Their Communities.

December 8, 2025; 1:30–2:30 p.m. Communicating about Public Health with Policymakers: Barriers, Strategies, and Tested Messages.
In December 2025, the de Beaumont Foundation will release Communicating About Public Health with Policymakers: A Toolkit for Public Health Professionals, a toolkit based on new research with former elected officials and senior aides, which provides tested messages, framing strategies, and practical tools to help public health professionals engage decision-makers with confidence and clarity. The research revealed three main barriers to effective communication with policymakers: public health is often seen as zero-sum, ideological rather than practical, and dismissive of individual agency. Join the de Beaumont Foundation, CityHealth, the National Association of Counties, and the American Public Health Association for a conversation on ways to overcome these barriers, strategic and on-the-ground tips for engaging policymakers, and ways to make every interaction with policymakers more productive, persuasive, and impactful.

December 9, 2025; 11 a.m.–12 p.m. Nicotine and Tobacco Use Among College Students in Texas.
Join this webinar from the Michael & Susan Dell Center for Healthy Living to learn about tobacco and nicotine use among young adults. Using data from large annually repeated cross-sectional samples of Texas college students, Dr. Caroline North will discuss the prevalence and trends in nicotine/tobacco use among Texas college students. Then, using data from the Vaping, Acculturation, and Media Study (Project VAMoS), a longitudinal cohort study of Mexican American college students in Texas, Dr. Bara S. Bataineh will discuss the role of social media in Mexican American young adults’ tobacco/nicotine use.

December 10, 2025; 1–2 p.m. Effective Health Communication and Health Literacy: Understanding the Connection.
How are health communication and health literacy connected? How can you be more effective in providing health information to consumers, patients, clients, and your community?  This one hour webinar from the Network of the National Library of Medicine (NNLM) introduces the concepts of health literacy and health communication, outlines components of clear health communication, and identifies online resources from NLM, government agencies and other recognized resources for health literacy and health communication.

Websites and reports on trending topics

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.

WastewaterSCAN Dashboard is based at Stanford University, in partnership with Emory University and Verily. It is a partnership that monitors diseases through municipal wastewater systems to inform local, regional, and national public health responses and reports findings to the US Centers for Disease Control and Prevention (CDC). WastewaterSCAN tests samples of solids from municipal wastewater for targets associated with infectious diseases.

Journal articles of note

Ayala JC, Hutton SM, Cartee JC, et al. A novel commensal Neisseria species harboring the gonococcal diagnostic marker DR-9 causes false-positive Roche cobas NAAT results. J Clin Microbiol. Published online November 19, 2025. doi:10.1128/jcm.01022-25
Abstract
Neisseria gonorrhoeae (Ng), the etiologic agent of gonorrhea, is the second most reported bacterial sexually transmitted infection globally. In the USA, nucleic acid amplification tests (NAATs) are considered the gold standard for diagnosis. Although NAATs are sensitive and offer high throughput, cross-reactivity with commensal Neisseria can compromise specificity. Here, we report the isolation and characterization of a novel commensal Neisseria sp. from the oropharynx of a patient with suspected gonococcal treatment failure. An initial diagnosis was made using the Roche cobas CT/NG test on the cobas 8800 system, which repeatedly yielded positive results post-treatment. A confirmatory Aptima Combo 2 (AC2, Hologic) test was negative, and multiple culture attempts failed to isolate Ng. Instead, a commensal Neisseria strain was recovered. Whole-genome sequencing revealed this isolate shared partial genomic identity with several Neisseria spp., including Ng, and carried a distinct region encoding the gonococcal diagnostic marker DR-9, the target of cobas assays. Cross-reactivity was confirmed with the cobas 4800 and 6800 platforms, but not with the AC2 assay targeting 16S rRNA. We discuss the possible origins of the DR-9 marker on this strain as well as examine its antimicrobial susceptibility profile and genomic resistance markers. These findings highlight the potential for misdiagnosis and unnecessary treatment when commensal Neisseria species harbor Ng diagnostic targets. Our study underscores the need for genomic surveillance of Ng and commensal Neisseria, not only to monitor diagnostic performance but also to track commensals that may serve as reservoirs of antimicrobial resistance determinants and contribute to the spread of resistance.
Importance
Accurate diagnosis of gonorrhea is critical for effective treatment and antimicrobial stewardship. Nucleic acid amplification tests, the mainstay of gonococcal diagnostic testing, can yield false-positive results due to genetic overlap between Neisseria gonorrhoeae and commensal Neisseria species, especially from extragenital sites like the oropharynx. Prior studies, such as Hopkins et al. (2023), have recognized this limitation and proposed supplemental tests to improve specificity for oropharyngeal specimens. Here, we describe a novel commensal Neisseria strain isolated from a patient with suspected treatment failure that harbors the gonococcal diagnostic marker DR-9. This case highlights the need for confirmatory testing using an alternate gene target in cases where repeated positive tests are obtained with extragenital specimens and demonstrates the need for improved test specificity, particularly for anatomical sites such as the pharynx, which has high commensal diversity. Enhanced molecular surveillance of commensal Neisseria populations will be vital for understanding and minimizing diagnostic cross-reactivity.

Brelsford B, Cravero JC, Telchik C, Phenis RA. Variations in West Nile viral infections across North and Central Texas. Proc (Bayl Univ Med Cent). 2025;38(6):843-850. Published 2025 Sep 4. doi:10.1080/08998280.2025.2555155
Abstract
Background: West Nile virus is a single-stranded RNA arbovirus with variable clinical presentation.
Methods: To better understand the clinical characteristics, diagnostic evaluation, and outcomes, we performed a retrospective analysis of the Baylor Scott & White Health medical records for hospitalized adult patients with West Nile virus from January 1, 2015, to September 1, 2024.
Results: A total of 79 patients were included. Most were male (55.7%) with a mean age of 64.15 years. The highest concentration of cases was reported in Dallas County (34.2%) and Tarrant County (22.8%). Seventy-three patients (92.4%) had neuroinvasive disease, while 6 patients (7.8%) had nonneuroinvasive disease. Presenting symptoms included fever (73.43%), confusion (49.59%), and weakness (40.51%). Six patients (7.6%) were found to have acute ischemic stroke during their admission. Fifteen patients (18.99%) died. Cerebrospinal fluid analysis generally showed elevated protein (mean value 104.7 mg/dL) with either neutrophilic (mean 32%) or lymphocytic pleocytosis (mean 51.6%). None of the treatments analyzed (intravenous immunoglobulin, plasma exchange, and steroids) was found to have any significant effect on morbidity and mortality.
Conclusion: West Nile virus is a common recurring disease across Texas. While some cases progress to neuroinvasive disease, there appears to be no meaningful way to predict these cases based on clinical and demographic data.

Goodwin Cartwright BM, Masters NB, Gilbert KM, Rodriguez PJ, Do D, Stucky N. Early MMR vaccine adoption during the 2025 Texas measles outbreak. JAMA Netw Open. 2025;8(11):e2543002. Published 2025 Nov 3. 
doi:10.1001/jamanetworkopen.2025.43002
Abstract
This cross-sectional study examines early vaccination rates for measles in Texas following updated 2025 guidance from the US Centers for Disease Control and Prevention. As of August 5, 2025, the US has reported 1356 measles cases, the largest number of cases since elimination was declared in 2000. Most of these cases have occurred in Texas. In response to the growing Texas outbreak, the US Centers for Disease Control and Prevention (CDC) issued updated guidelines through the Health Alert Network (HAN) on March 7, 2025, recommending early vaccination (ages 6 to 11 months) for children living in or traveling to affected counties. This study examined whether children in Texas received early measles vaccination following the HAN and assessed shifts in age-related vaccination patterns.

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

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.

November 4, 2025; 12–1 p.m. Nourishing Beginnings: Fueling Healthy Futures in the First 1,000 Days of Life.
This webinar from the Michael & Susan Dell Center for Healthy Living will explore the critical role of optimal nutrition during the first 1,000 days of life, from conception through toddlerhood, in shaping lifelong health, growth, and development.

November 12, 2025; 1–2 p.m. Ask Me Anything: Academic Health Department Partnerships.
Join the Association of State and Territorial Health Officials (ASTHO) and the Public Health Foundation (PHF) for a webinar focused on academic health department (AHD) partnerships. In this webinar, participants will gain a foundational understanding of AHD partnerships, with an introduction to the new AHD Partnerships Toolkit designed to support the development and sustainability of these partnerships. Then, the floor will open for your questions. Whether you're just getting started or looking to strengthen an existing partnership, this is your chance to ask us anything about AHD partnerships.

November 12, 2025; 1–2:30 p.m. How PubMed Works: Medical Subject Headings (MeSH).
Medical Subject Headings (MeSH) is the National Library of Medicine’s controlled vocabulary thesaurus that gives uniformity and consistency to the indexing and cataloging of biomedical literature. Join this webinar from the Network of the National Library of Medicine (NNLM) to explore the MeSH database, describe a controlled vocabulary, explore the four types of MeSH terms, locate and explain entry terms, date introduced, previous indexing, and automatic explosion.

November 19, 2025; 11 a.m.–12:30 p.m. DSHS Grand Rounds - Diabetes' Toll on Mental Health.
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

medRxiv is a free online archive and distribution server for complete but unpublished manuscripts (preprints) in the medical, clinical, and related health sciences.

Our World in Data has a mission to publish research and data to make progress against the world’s largest problems. It includes more than 12,800 interactive charts and interactive visualization tools to explore a wide range of related indicators.

PolicyMap is a mapping tool provided by the Public Health Digital Library (PHDL). It allows users to dig deeper into place-based data and gain insights to help find solutions to the most tractable issues. It combines extensive data indicators with a contemporary, state of the art mapping platform and expanded analytics. As a PHDL consortium member, the DSHS Medical and Research Library provides this tool and many other public health information resources. Access is available through the PHDL portal. First time users will need to register with their DSHS email.

ProQuest Ebook Central is a science and technology ebook collection. It offers more than 28,000 ebooks titles in a diverse range of topics such as chemistry, physics, math, geology, geography, IT, computer science, engineering, agriculture, environmental studies, natural history, medicine, and more. Register here to create an account for access.

Journal articles of note

DeVita TN, Morrison AM, Stanek D, et al. Public health response to the first locally acquired malaria outbreaks in the US in 20 Years. JAMA Netw Open. 2025;8(10):e2535719. Published 2025 Oct 1. doi:10.1001/jamanetworkopen.2025.35719
Abstract
Importance: In 2023, the US reported 10 locally acquired mosquito-transmitted malaria cases of 4 genetic lineages in 4 states, the first such outbreaks detected in 20 years and the largest in 35 years.
Objective: To present the investigations, interventions, and challenges in the public health response to the malaria outbreaks and provide recommendations for future outbreaks.
Design, setting, and participants: This qualitative study was an interdisciplinary public health response to the locally acquired malaria outbreaks in May to December 2023 and included case investigations, enhanced case finding, polymerase chain reaction analysis of captured Anopheles spp mosquitoes for Plasmodium spp parasites, and novel targeted amplicon sequencing of Plasmodium spp in patient blood samples. Public health interventions included incident command activation, clinician outreach, community awareness, and vector control. Patient data were acquired through public health surveillance as part of National Notifiable Disease Surveillance.
Exposure: Plasmodium vivax-infected and Plasmodium falciparum-infected Anopheles spp mosquitoes.
Main outcomes and measures: Confirmed malaria infection via blood film microscopy and polymerase chain reaction, presence of Plasmodium spp in Anopheles spp mosquitoes, and genetic markers associated with an endemic region of origin and parasite strain relatedness via targeted amplicon sequencing.
Results: The study included 10 patients (mean [SD] age of 39.5 [15.0] years; 7 male [70%]) from Florida, Texas, Maryland, and Arkansas with locally acquired mosquito-transmitted malaria and 783 Anopheles spp mosquitoes across 4 states. No patient had a recent history of international travel or blood-borne exposures. Outbreak cases had epidemiologic links within but not across state lines. P vivax was detected in 3 Anopheles crucians in Florida. Sequencing data showed that all Florida P vivax cases shared the same Plasmodium strain. The Texas and Arkansas P vivax cases were genetically distinct from each other and from Florida's cases. All 9 P vivax strains had genetic signatures that were consistent with Central and South American origin. Maryland's P falciparum parasites were consistent with African origin. The outbreaks were contained.
Conclusions and relevance: In this qualitative study of locally transmitted malaria, outbreaks remained contained to individual counties, with Florida's P vivax cases linked to a single strain distinct from those in other states. Sustained Plasmodium spp transmission is unlikely in the US, though increases in global travel and migration, population, temperatures, and persistence of Anopheles spp vectors may increase risk for locally acquired malaria. Clinicians should prescribe chemoprophylaxis for patients traveling to endemic regions, ensure timely diagnosis and treatment, and facilitate public health reporting. Researching US Anopheles spp ecology and control methods while accelerating efforts to reduce malaria globally could mitigate future risk.

Huang W, Harrell MB, Page RL, et al. Nicotine consumption and folate insufficiency in pregnancy: a population-based cross-sectional study.  J Matern Fetal Neonatal Med. 2025;38(1):2577231. doi:10.1080/14767058.2025.2577231
Abstract
Objective: Tobacco smoking and folate insufficiency are both risk factors associated with adverse pregnancy outcomes, but their association in pregnancy remains unclear. This study investigated the association between tobacco smoking and folate insufficiency in pregnant women in the U.S.
Methods: Data from nine consecutive cycles of the National Health and Nutrition Examination Survey (2003-2020) were analyzed. Smoking status was derived from serum cotinine levels, and folate insufficiency was determined based on World Health Organization guidelines. The Rao-Scott test of independence was used to assess the prevalence of smoking and folate insufficiency across sociodemographic subgroups, and survey-weighted logistic regression models were used to evaluate the association between smoking and folate insufficiency.
Results: Both smoking and red blood cell (RBC) folate insufficiency showed high prevalence among non-Hispanic Black subgroups with an education level of high school or less. Compared to pregnant nonsmokers, pregnant smokers faced increased odds of RBC folate insufficiency (OR: 1.87; 95% CI: 1.10, 3.19). Approximately 3.6% (95% CI: 1.4, 6.4%) of cases of RBC folate insufficiency among pregnant women in the U.S. were associated with active smoking.
Conclusions: Tobacco smoking increases the risk of insufficient folate stores among pregnant women. However, healthcare providers should assess the folate status of all pregnant women and consider proactive screening, such as RBC folate testing, complemented by integrated strategies addressing tobacco use and nutritional risk. Proactive screening for smokers should be revisited once the prevalence of insufficient folate stores has been reduced at the population level.

Nelson A, Downey M, Murry M, et al. Emerging tick-borne disease risk in an urban center of Harris County, Texas. Vector Borne Zoonotic Dis. Published online October 20, 2025. doi:10.1177/15303667251386209
Abstract
Background: Tick-borne diseases are an endemic and emerging public health concern in the United States. Ongoing tick range expansion, invasive species, and newly identified pathogens are rapidly altering disease epidemiology. Surveillance is critical to understanding vector ecology and disease risk. Harris County, Texas, with nearly five million residents and diverse ecological zones, offers a unique setting to study local tick dynamics. 
Methods: From January 2021 to December 2022, we conducted weekly tick surveillance across 63 sites in Harris County (City of Houston), Texas. Ticks were morphologically identified and tested for Rickettsia, Borrelia, Ehrlichia, and Anaplasma via real-time PCR. Samples positive by initial screening were confirmed to the species level using endpoint PCR and sequencing. 
Results: We collected 1,219 ticks-primarily Ixodes scapularis and Amblyomma maculatum-with distinct seasonal and spatial patterns. Of 1,195 tested ticks, 61% were positive for Rickettsia, with multiple species identified. Notably, Rickettsia parkeri was detected in 23.1% of Rickettsia-positive A. maculatum ticks. 
Conclusion: Our findings reveal significant tick-borne pathogen activity in Harris County, highlighting the need for continued surveillance and public health efforts in urban and peri-urban Texas.

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   

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 8, 2025; 11 a.m.–12 p.m. Primary Care at a Crossroads: Navigating Recent Policy, Budget, and Regulatory Changes.
Join the Texas Primary Care Consortium for a timely webinar bringing together thought-leaders, advocates, and system stakeholders to unpack the evolving landscape. This session will spotlight critical policy, budget, and regulatory changes affecting primary care delivery, financing, and infrastructure across the state. Together, we’ll explore what has changed, why it matters, who it affects, and what comes next.

October 14, 2025; 1–2 p.m. Scaling up Complex Interventions: Lessons Learned from three Studies.
This webinar from the Michael & Susan Dell Center for Healthy Living will describe a framework for scaling up interventions, explain the value of engaging multi-level partners in scale-up planning, and discuss how to tailor scale-up strategies to target multilevel determinants.

October 27, 2025; 1–2 p.m. Strengthening Academic Health Department Partnerships for Student Success: Vermont Department of Health Environmental Scan.
Join the Association of State and Territorial Health Officials (ASTHO) and the Public Health Foundation (PHF) for their next webinar focused on academic health department (AHD). In this webinar, participants will gain a foundational understanding of AHD partnerships, with an introduction to PHF’s new AHD Partnerships Toolkit designed to support the development and sustainability of these partnerships. Then hear insights from the Vermont Department of Health (VDH) about their past and existing partnerships, highlighting student placement opportunities, and how the Public Health Infrastructure Grant (PHIG) supported work with PHF on an environmental scan to improve student placement experiences for both students and VDH staff.

October 29, 2025; 11 a.m.–12:30 p.m. DSHS Grand Rounds - Assessment, Diagnosis, and Treatment of Substance Use Disorders.
This webinar, offered by the DSHS Office of Practice and Learning Grand Rounds program, will provide an overview of how to evaluate and treat individuals with three of the most common substance use disorders seen in Texas. 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

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 - Provided 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 – This resource 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

Fazal A, Harker EJ, Neelam V, et al. Pediatric influenza-associated encephalopathy and acute necrotizing encephalopathy - United States, 2024-25 influenza Season. MMWR Morb Mortal Wkly Rep. 2025;74(36):556-564. Published 2025 Sep 25. doi:10.15585/mmwr.mm7436a1
Abstract
In January 2025, CDC received several reports of deaths among children aged <18 years with a severe form of influenza-associated encephalopathy (IAE) termed acute necrotizing encephalopathy (ANE). Because no national surveillance for IAE currently exists, CDC requested notification of U.S. pediatric IAE cases from clinicians and health departments during the 2024-25 influenza season, a high-severity season with a record number of pediatric influenza-associated deaths. Among 192 reports of suspected IAE submitted to CDC, 109 (57%) were categorized as IAE, 37 (34%) of which were subcategorized as ANE, and 72 (66%) as other IAE; 82 reports did not meet IAE criteria and were categorized as other influenza-associated neurologic disease. The median age of children with IAE was 5 years and 55% were previously healthy, 74% were admitted to an intensive care unit, and 19% died; 41% of children with ANE died. Only 16% of children with IAE who were vaccination-eligible had received the 2024-25 influenza vaccine. Health care providers should consider IAE in children with encephalopathy or altered level of consciousness and a recent or current febrile illness when influenza viruses are circulating. Annual influenza vaccination is recommended for all children aged ≥6 months to prevent influenza and associated complications, potentially including severe neurologic disease such as IAE and ANE.

Ludorf KL, Benjamin RH, Shumate CJ, Canfield MA, Nguyen J, Agopian AJ. Long-term survival among children with trisomy 13 and trisomy 18 by cytogenetic status. JAMA Netw Open. 2025;8(9):e2529885. Published 2025 Sep 2. 
doi:10.1001/jamanetworkopen.2025.29885
Abstract
Importance: Trisomy 13 (T13) and trisomy 18 (T18) are chromosomal abnormalities with high mortality rates in the first year of life. Understanding differences in long-term survival between children with full vs mosaic or partial trisomy is crucial for prognosis and health care planning.
Objective: To examine the differences in 10-year survival between children with full T13 and T18 vs those with mosaic or partial trisomy.
Design, setting, and participants: This retrospective, population-based cohort study assessed liveborn infants with T13 and T18 in the Texas Birth Defects Registry (deliveries from January 1, 1999, to December 31, 2008). Follow-up was through December 31, 2018 (the last date available at the time of analyses) to allow for 10 years of follow-up for all infants. All analyses were conducted from January 1, 2022, to December 31, 2024.
Exposures: Cytogenetic status (full trisomy vs mosaic or partial trisomy).
Main outcomes and measures: The primary outcome was survival to 10 years of age, assessed using Kaplan-Meier survival estimates. The association between cytogenetic status and mortality by 10 years of age was assessed using Cox proportional hazards regression to generate hazard ratios (HRs). Population attributable fraction was calculated to determine the percentage of survival attributable to mosaic or partial trisomy status.
Results: The study cohort included 798 infants (463 female infants [58.0%]; mean [SD] maternal age, 30.9 [8.0] years) with T13 (n = 295) or T18 (n = 503). Among all cases with T13, 25 infants (8.5%; 95% CI, 5.5%-12.3%) survived to 10 years of age. Similarly, among all infants with T18, 43 (8.6%; 95% CI, 6.3%-11.3%) survived to 10 years of age. Kaplan-Meier survival estimates to 10 years of age were statistically significantly higher among children with mosaic or partial trisomy (13 [25.0%] and 14 [43.8%], respectively) compared with full trisomy (12 [4.9%] and 29 [6.6%], respectively) (both P < .001). Infants with full trisomy had statistically significantly increased 10-year mortality hazards compared with those with mosaic or partial trisomy for both T13 (HR, 2.00; 95% CI, 1.42-2.82) and T18 (HR, 3.34; 95% CI, 2.08-5.38). The results of the calculated proportion of 10-year survival due to the presence of nonfull trisomy status (population attributable fraction) was 41.7% for children with T13 and 27.9% for children with T18.
Conclusions and relevance: The findings of this cohort study of infants with T13 and T18 support differences in long-term survival based on cytogenetic status and emphasize the need to potentially reassess the context of these conditions generally being considered incompatible with life, particularly for those with mosaic trisomies. These findings offer context surrounding treatment decisions, such as withholding interventions, for affected infants in the future.

McCullough LE, Deka A, Newton C, et al. Sensitivity of cancer registry linkage with missing or incomplete social security number and implications for cancer cohorts. Epidemiology. Published online September 9, 2025. doi:10.1097/EDE.0000000000001913
Abstract
Background: Linking cancer cohort participants to state cancer registries typically relies on personally identifiable information, including Social Security Numbers (SSN), which uniquely identify individuals. However, complete SSN collection can be limited due to privacy concerns. This study evaluates the sensitivity of cancer registry linkage using partial or missing SSN and examines differences by demographic characteristics.
Methods: Using data from 284,361 participants in the Cancer Prevention Study-3 (CPS-3), we conducted probabilistic linkages with cancer registries in Georgia, Ohio, and Texas using Match*Pro software. Participants were linked using combinations of personally identifiable information: complete SSN, partial SSN (last four digits), and missing SSN. We compared the sensitivity of linkages before and after manual review and stratified by sex, age, and race-ethnicity.
Results: Before manual review, sensitivity for missing and partial SSN was 92.5%. Sensitivity improved to 98.6% for missing SSN and 98.8% for partial SSN after manual review. We observed no notable heterogeneity by sex, age, or race-ethnicity, with sensitivity exceeding 87% across all subgroups. Manual review substantially reduced uncertain matches, contributing to high linkage accuracy.
Discussion: This study demonstrates that high sensitivity in cancer registry linkage can be achieved without complete SSN, provided other personally identifiable information (e.g., name, date of birth, longitudinal address) is available. These findings support the feasibility of accurate cancer case identification in cohorts with limited SSN data, particularly for historically marginalized populations, and underscore the importance of designing inclusive population-based cancer studies.

Tao J, Albert PS, Gottlieb N, Miller P, Engels EA. Circulating T-cell receptor excision circles at birth and risk of childhood cancers. Cancers (Basel). 2025;17(17):2903. Published 2025 Sep 4. doi:10.3390/cancers17172903
Abstract
Background: T-cell receptor excision circles (TRECs) are measured in newborn screening programs in the United States to identify severe combined immunodeficiency (SCID). We hypothesized that relatively low TREC levels at birth, even within the normal range, could indicate compromised immunity and higher susceptibility to childhood cancers.
Methods: We conducted a case-control study using linked data from the newborn screening programs and cancer registries in California and Texas to examine the association between TREC levels and risk of childhood cancer. The study included 2196 cancer cases and 10,980 controls from California and 1186 cancer cases and 5890 controls from Texas.
Results: In California, acute myeloid leukemia cases had significantly lower TREC levels compared with their matched controls (p = 0.0051), while in Texas, acute lymphocytic leukemia cases had significantly higher TREC levels compared with their matched controls (p = 0.0034). However, each association was not replicated in the other state, and other cancer types did not show significant differences in TREC levels between cases and controls.
Conclusions: We did not observe consistent associations between TREC levels at birth and childhood cancer risk. A possible explanation for the lack of more clear-cut differences in TREC levels between cases and matched controls might be the complex etiology of childhood cancers. The results underscore the need for longitudinal studies that incorporate additional immune biomarkers to understand the immunologic basis of childhood cancer development.

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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