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Medical and Research Library News - May 2022

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

May 2022                

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 Daylight Time.

May 10, 2022; 10-11 a.m. Tackling Inclusivity and the Future of Oral Health. Oral health is key to overall health, and yet for many Americans and people around the world disparities in outcomes is a reality. In this presentation from the Network of the National Library of Medicine (NNLM), we will consider how to tackle inclusivity around oral health, addressing workforce and population-health outcomes, challenges in science and methodologies which limit the degree to which we can advance equity in research, and finally, the barrier of inclusivity in translational science. https://nnlm.gov/training/class/tackling-inclusivity-and-future-oral-health

May 10, 2022; 1-2 p.m. Strategies to Increase Access to PACE: Findings from the NASHP State PACE Action Network. The goal of the Program of All Inclusive Care for the Elderly (PACE) is to enable frail elders to stay in their communities for as long as safely possible by providing PACE members a comprehensive, integrated package of Medicare and Medicaid benefits. This webinar from The National Academy for State Health Policy (NASHP) highlights efforts in Massachusetts to improve its PACE enrollment process and Maryland’s approach to its process for selecting and onboarding new PACE organizations, including those in rural areas. https://www.nashp.org/webinar-strategies-to-increase-access-to-pace-findings-from-the-nashp-state-pace-action-network/

May 16, 2022; 12-1 p.m. Strategies for Addressing Health Disparities in Medication-Assisted Treatment for Patients with Opioid Use Disorder. This webinar will briefly review how MAT fits within an integrated care model and focus on strategies to enhance access to all treatment services, including buprenorphine and naloxone along with methadone. This webinar is presented by The Bureau of Primary Health Care (BPHC) Behavioral Health (BH) Technical Assistance (TA). https://us06web.zoom.us/webinar/register/WN_T9OPutuxRzG9dANbnUGDEg

May 19, 2022; 12-1 p.m. State-Funded Texas Programs Address Youth Mental Health Crisis. Pediatric mental illness is at an all-time high. The pandemic has worsened the mental health crisis, and resources for providers and patients can be hard to navigate, let alone find. Primary care physicians and schools are in a prime position in a patient’s healthcare journey to address the mental health gap. In this webinar from the Michael & Susan Dell Center for Healthy Living, you will learn about the Texas Child Mental Health Care Consortium state-funded programs, the Child Psychiatry Access Network (CPAN), and the Texas Child Health Access Through Telemedicine (TCHATT). https://register.gotowebinar.com/register/4410548380791964685

Websites and reports on trending topics

AGRICOLA - A bibliographic resource with millions of citations relating to the field of agriculture for journal articles, book chapters, theses, patents, and technical reports to support agricultural research. This database and others can be accessed through TexShare databases. Please contact the library for remote access instructions. https://texshare.net/auth.php?db=eagricola&org=

Dental Care Utilization Among Adults Aged 1864: United States, 2019 and 2020 – This NCHS data brief uses data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe recent changes in the prevalence of dental visits among adults aged 1864. https://www.cdc.gov/nchs/data/databriefs/db435.pdf

eCLIPSE Ultimate Access - This DSHS library resource provides access to The Clinical and Laboratory Standards Institute’s (CLSI) full library of standards. eCLIPSE Ultimate Access is an enhanced, premium platform with advanced features to help you access standards quickly and easily. Please contact the library for remote access instructions. http://clsi.edaptivedocs.biz/Login.aspx

Lessons Learned from the COVID-19 Pandemic to Improve Diagnosis: Proceedings of a Workshop–in Brief - The National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop focused on examining changes to diagnostic paradigms in response to the COVID-19 pandemic and considering the lessons learned and opportunities for improving diagnosis within the U.S. health care system. The workshop highlighted the pandemic's impact on diagnostic pathways, the exacerbation of inequities, diagnostic responsibilities for public health, and the novel diagnostic strategies and tools that have been developed since COVID-19 emerged. https://nap.nationalacademies.org/read/26567/chapter/1

Journal articles of note

Boxall AM. What does the State Innovation Model experiment tell us about states' capacity to implement complex health reforms? [published online ahead of print, 2022 Mar 29]. Milbank Q. 2022;10.1111/1468-0009.12559. doi:10.1111/1468-0009.12559
Policy Points To make progress implementing payment and delivery system reforms, state governments need to make genuine stakeholder engagement routine business, develop reforms that build on past successes, and ensure health reform is a top priority for bureaucrats and political leaders. To support state-led reform initiatives, the federal government needs to provide financial support directly to state governments; build bureaucratic capability in supporting state officials with policy design and implementation; develop more flexible, outcome-focused funding programs; reform its own programs, particularly Medicare; and commit to a long-term strategy for progressing payment and delivery system reforms.
Context: For decades, Americans have debated whether the states need federal government support to reform health care. The Affordable Care Act has allowed the federal government to trial innovative ways of accelerating state-led reform initiatives through the State Innovation Model (SIM), which was run by the Centers for Medicare and Medicaid Services Innovation Center between 2013 and 2019. This study assesses states' progress implementing health reforms under SIM and examines how well the federal government supported them.
Methods: Detailed case studies were conducted in six states: Arkansas, Connecticut, Oregon, New York, Tennessee, and Washington. Data was collected from SIM evaluation and annual reports and through semistructured interviews with 39 expert informants, mostly state or federal officials involved in SIM. Preliminary findings were tested and refined through an online forum with health policy experts, facilitated by the Milbank Memorial Fund.
Findings: States that made the most progress implementing reforms had a strong track record and managed to sustain stakeholder, bureaucratic, and political support for their reform agenda. There was a clear correlation between past reform success and success under SIM, which raises questions about the value of federal government support beyond providing funding. State officials said the federal government could better support states, particularly those with less reform experience, by providing tailored advice that helped state officials overcome problems designing and implementing reforms. State officials also said the federal government could better support them by reforming their own programs, particularly Medicare, and committing to a long-term strategy for health system reform.
Conclusions: States can make some progress reforming health care on their own, but real progress requires long-term cooperation between state and federal governments. Federal initiatives like SIM that foster cooperation between governments should be continued but refined so they provide better support to states.

Cavallo L, Kovar EM, Aqul A, et al. The epidemiology of biliary atresia: exploring the role of developmental factors on birth prevalence [published online ahead of print, 2022 Mar 29]. J Pediatr. 2022;S0022-3476(22)00288-8. doi:10.1016/j.jpeds.2022.03.038
Objectives: To identify key epidemiological factors relevant to fetal development that are associated with biliary atresia STUDY DESIGN: This population-based registry study examined infants born in Texas between 1999 and 2014. Epidemiological data relevant to fetal development was compared between cases of biliary atresia identified in the Texas Birth Defects Registry (n=305) versus all live births (n=4,689,920), and Poisson regression was used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs).
Results: The prevalence of BA was 0.65 per 10,000 live births over the study period. BA was positively associated with female sex (adjusted PR 1.68, 95% CI: 1.33-2.12), delivery before 32-37 weeks gestation (adjusted PR 1.64, 95%CI 1.18-2.29), delivery before 32 weeks gestation (adjusted PR 3.85, 95%CI 2.38-6.22), and non-Hispanic Black versus non-Hispanic White maternal race/ethnicity (adjusted PR 1.54, 95%CI 1.06-2.24), and BA was inversely associated with season of conception in the fall relative to spring (adjusted PR 0.62, 95%CI 0.45-0.86). In addition, BA was associated with maternal diabetes (adjusted PR 2.34, 95%CI 1.57-3.48), with a stronger association with pre-gestational compared with gestational diabetes. In sub-group analyses, these associations were present in isolated BA cases which do not have any additional birth defects.
Conclusions: BA is associated with multiple factors related to fetal development, including pre-gestational maternal diabetes, female sex, and preterm birth. These associations were also observed in isolated cases of biliary atresia without other malformations or laterality defects. Our results are consistent with early life events influencing the pathogenesis of biliary atresia, and support further studies investigating in utero events to better understand the etiology and time of onset.

Chavez S, Huebinger R, Chan HK, et al. The impact of COVID-19 on incidence and outcomes from out-of-hospital cardiac arrest (OHCA) in Texas [published online ahead of print, 2022 Apr 13]. Am J Emerg Med. 2022;57:1-5. doi:10.1016/j.ajem.2022.04.006
Introduction: Emerging research demonstrates lower rates of bystander cardiopulmonary resuscitation (BCPR), public AED (PAD), worse outcomes, and higher incidence of OHCA during the COVID-19 pandemic. We aim to characterize the incidence of OHCA during the early pandemic period and the subsequent long-term period while describing changes in OHCA outcomes and survival.
Methods: We analyzed adult OHCAs in Texas from the Cardiac Arrest Registry to Enhance Survival (CARES) during March 11-December 31 of 2019 and 2020. We stratified cases into pre-COVID-19 and COVID-19 periods. Our prehospital outcomes were bystander cardiopulmonary resuscitation (BCPR), public AED use (PAD), sustained ROSC, and prehospital termination of resuscitation (TOR). Our hospital survival outcomes were survival to hospital admission, survival to hospital discharge, good neurological outcomes (CPC Score of 1 or 2) and Utstein bystander survival. We created a mixed effects logistic regression model analyzing the association between the pandemic on outcomes, using EMS agency as the random intercept.
Results: There were 3619 OHCAs (45.0% of overall study population) in 2019 compared to 4418 (55.0% of overall study population) in 2020. Rates of BCPR (46.2% in 2019 to 42.2% in 2020, P < 0.01) and PAD (13.0% to 7.3%, p < 0.01) decreased. Patient survival to hospital admission decreased from 27.2% in 2019 to 21.0% in 2020 (p < 0.01) and survival to hospital discharge decreased from 10.0% in 2019 to 7.4% in 2020 (p < 0.01). OHCA patients were less likely to receive PAD (aOR = 0.5, 95% CI [0.4, 0.8]) and the odds of field termination increased (aOR = 1.5, 95% CI [1.4, 1.7]).
Conclusions: Our study adds state-wide evidence to the national phenomenon of long-term increased OHCA incidence during COVID-19, worsening rates of BCPR, PAD use and survival outcomes.

Deka MA, Marston CK, Garcia-Diaz J, Drumgoole R, Traxler RM. Ecological niche model of Bacillus cereus group isolates containing a homologue of the pXO1 anthrax toxin genes infecting metalworkers in the United States. Pathogens. 2022;11(4):470. Published 2022 Apr 14. doi:10.3390/pathogens11040470
While Bacillus cereus typically causes opportunistic infections in humans, within the last three decades, severe and fatal infections caused by isolates of the B. cereus group harboring anthrax toxin genes have been reported in the United States. From 1994 to 2020, seven cases of anthrax-like illness resulting from these isolates have been identified. With one exception, the cases have occurred in the Gulf States region of the United States among metalworkers. We aimed to develop an ecological niche model (ENM) to estimate a spatial area conducive to the survival of these organisms based on the presence of known human infections and environmental variables. The estimated ecological niche for B. cereus was modeled with the maximum entropy algorithm (Maxent). Environmental variables contributing most to the model were soil characteristics (cation exchange capacity, carbon content, soil pH), temperature, enhanced vegetation index (EVI), and land surface temperature (LST). Much of the suitable environments were located throughout the Gulf Coast Plain, Texas Backland Prairies, East Central Texas Plains, Edwards Plateau, Cross Timbers, Mississippi Alluvial Plain, and Central Great Plains. These findings may provide additional guidance to narrow potential risk areas to efficiently communicate messages to metalworkers and potentially identify individuals who may benefit from the anthrax vaccine.

Rao AK, Schulte J, Chen TH, et al. Monkeypox in a traveler returning from Nigeria - Dallas, Texas, July 2021. MMWR Morb Mortal Wkly Rep. 2022;71(14):509-516. Published 2022 Apr 8. doi:10.15585/mmwr.mm7114a1
Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000.

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Last updated May 4, 2022