Citations

Abstract Date Presented 04/03/2025 The goal of this study is to identify current successes, limiting barriers, and overarching trends in knowledge translation, specifically as they relate to OT doctoral capstone students. Primary Author and Speaker: Christopher Taylor

Abstract Tisagenlecleucel (tisa-cel) is a CD19-directed chimeric antigen receptor T-cell therapy for relapsed/refractory precursor B-cell acute lymphoblastic leukemia (R/R B-ALL). We report infectious complications for 100 days (D100) following tisa-cel therapy in 471 pediatric and young adults (median age 13.8 years) with R/R B-ALL reported from September 2017 to June 2022. By D100, 137 (29%) patients had an infectious event, with an infection density of 0.542 per 100 person-days at risk. D100 cumulative incidences of bacterial, viral, and fungal infections were 14.1%, 11.6%, and 1.3%, corresponding to infection density scores of 0.296, 0.213, and 0.033 per 100 person-days at risk, respectively. In a multivariable analysis, receipt of ≥3 lines of therapy before tisa-cel (hazard ratio [HR], 1.86; 95% confidence interval [CI], 1.13-3.08; P = .015), any-grade cytokine release syndrome (HR, 1.78; 95% CI, 1.17-2.71; P = .007), and lack of neutrophil recovery (HR, 2.63; 95% CI, 1.47-4.69; P = .001) were associated with an increased risk for any infection. Similar associations were observed for bacterial infections, with the addition of younger age as an adverse risk (<6 vs 6-15 years; HR, 2.38; 95% CI, 1.23-4.61; P = .01). Risk factors for viral infections included increasing age (1-year increase; HR, 1.05; 95% CI, 1.01-1.09; P = .016), prior history of any infection (HR, 2.76, 95% CI, 1.40-5.46; P = .004), and prior hematopoietic cell transplant (HR, 2.10; 95% CI, 1.18-3.71; P = .011). D100 infection-related mortality (IRM) rate was low at 0.2% (95% CI, 0.0-0.8). In this multicenter real-world study, we observed a high incidence of infectious complications but a low IRM following tisa-cel for R/R B-ALL.

Background: Functional dyspepsia (FD), a disease of the gastroduodenal tract, is one of the functional gastrointestinal disorders (FGID) characterized by postprandial fullness and epigastric pain not attributed to any underlying organic diseases. Sleep quality refers to individuals’ satisfaction with their overall sleep, including sleep initiation, maintenance, duration, and feeling refreshed upon waking. Despite frequent associations between sleep disorders and FGID, comprehensive data on poor sleep quality (PSQ) in FD patients is lacking. Therefore, this study was conducted to investigate the occurrence of PSQ in patients with PSQ. Methods: PubMed, Scopus, and Web of Science were systematically searched to identify relevant literature. All studies reporting PSQ prevalence in FD patients or sufficient data to calculate it were included. Pooled prevalence was calculated for all studies, and an odds ratio was determined for studies with a healthy control group. Meta-regression and subgroup analyses assessed the moderating effects of different variables. Publication bias was examined using funnel plots and Egger’s test p-value. The work has been reported in line with AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines. Results: To the best of our knowledge, this is the first study that pooled the estimate of prevalence of patients with FD with PSQ. Based on 2138 FD patients, the pooled prevalence of poor sleep quality is 57.2% (95% CI: 37%–75.2%), I 2 = 98.4%. The asymmetric funnel plot and Egger’s test P-value indicated a significant publication bias for the pooled prevalence estimate. FD patients are at higher risk for poor sleep, with an odds ratio of 2.39 (95% CI: 1.86–3.06), I 2 = 1.73%. Conclusion: Poor sleep is highly prevalent among FD patients, who are more susceptible to poor sleep than healthy individuals. The findings of the study should be interpreted with caution owing to the high heterogeneity and the publication bias observed for the pooled prevalence. Future research should standardize diagnostic parameters and investigate other confounding factors like anxiety and depression to achieve more accurate estimates.

INTRODUCTION: Treatment of celiac disease (CeD) requires a strict gluten-free diet (GFD). Adherence is difficult to assess and influenced by many factors. Identification of potential gluten exposures is essential, but no validated screening measures exist in pediatrics. The aim of this study was to develop and validate a measure screening for gluten exposure risk in pediatric patients with CeD. METHODS: The Gluten Exposure Risk Assessment (GERA) was developed in 3 phases. First, items were generated and refined by a modified Delphi process. Next, psychometrics, factor structure, and validity were examined in a sample of caregivers of pediatric patients younger than 18 years with CeD at 12 pediatric celiac centers. Finally, the final measure was tested on an independent sample population using confirmatory factor analysis and test-retest data. RESULTS: A total of 134 items were generated representing up to 6 domains, with 36 items selected for initial testing. Based on psychometrics and confirmatory factor analysis data from 484 caregivers, the final measure included a total of a single screening question and 9 validated items representing 2 domains (Home, Outside). Repeat testing on a separate sample (N = 369) confirmed factor structure and validity of the final measure (Comparative Fit Index = 0.96, Tucker–Lewis index = 0.95, root mean square error of approximation = 0.06). DISCUSSION: The GERA is a valid screening measure, completed by caregivers, for assessment of gluten exposure in children and adolescents with CeD following a GFD. GERA is a useful tool for evaluating the potential of risk of gluten exposure and potential need for intervention.

Abstract Introduction The prevalence of pre‐pregnancy obesity, including pre‐pregnancy class 3 obesity, has increased over time, with significant implications for maternal and neonatal well‐being. Regular physical activity may mitigate these risks. Available data suggest that most pregnant individuals do not meet the recommended physical activity guidelines of accumulating at least 150 min of moderate‐intensity exercise per week. Importantly, limited data are available regarding physical activity patterns in individuals with higher body mass index (BMI), particularly for those with class 3 obesity (BMI ≥ 40 kg/m 2 ). The aim of this study was to evaluate whether pregnant individuals are meeting physical activity guidelines. We assessed self‐reported physical activity across BMI categories including those with class 3 obesity, further subdivided into BMI of 40–49.9 and ≥ 50 kg/m 2 . Methods This is a retrospective cohort study of individuals at an academic hospital system who delivered between May 1, 2018 and May 1, 2023. To be included, individuals had to respond to the following two‐item physical activity questionnaire early in pregnancy: (1) “On average, how many days per week do you engage in moderate to strenuous exercise?” And (2) “On average, how many minutes do you engage in exercise at this level?” From these two questions, total minutes per week of activity were calculated. Individuals met physical activity guidelines if they engaged in ≥ 150 min of physical activity per week. Data were analyzed using Kruskal–Wallis and Chi‐square tests. Results A total of 6884 individuals were incl uded in the cohort. A total of 510 individuals met the criteria for class 3 obesity, with 61 having a pre‐pregnancy BMI ≥ 50 kg/m 2 . Among normal weight individuals (BMI 18.5–24.9 kg/m 2 ), 34% met physical activity guidelines. Overweight and obese individuals were significantly less physically active than those with normal BMI ( p < 0.05). Only 22% of those with BMI 40–49.9 kg/m 2 and 18% of those with BMI ≥ 50 kg/m 2 reported sufficient physical activity. Conclusion Our results are consistent with existing data, showing that pregnant individuals are not meeting physical activity goals. Pregnant individuals who are overweight or obese engage in significantly less physical activity compared to those with a BMI in the normal range, with the lowest levels of activity observed among individuals with class 3 obesity. More data are needed on physical activity among pregnant individuals with class 3 obesity, including evaluation of potential interventions to increase activity as well as barriers to participation. Increasing physical activity in this group may positively impact both maternal and neonatal health.

ABSTRACT Osteoporosis is a chronic disease mainly prevalent in older people. A hip fracture, its most devastating complication, is associated with a one in five chance of mortality in the first year. This review discusses emerging risk factors for bone fragility including diabetes, sarcopenia, and bariatric surgery. Recency of fracture represents an imminent risk that deserves prompt recognition. The new FRAXplus calculator accounts for additional risk factors to refine existing risk stratification. Advances in imaging techniques such as trabecular bone score and radiofrequency echographic multi-spectrometry may have potential roles in specific populations. Treatment of osteoporosis requires a multifaceted approach. Non-drug interventions include fall prevention and resistance exercises, supplementation with calcium, vitamin D and possibly vitamin K, and effective bridging of care gaps with fracture liaison services. An overview of drug therapy is provided, drawing attention to the importance of sequential therapy starting with potent anabolic agents for the patients at the highest risk, as opposed to a traditional step-up approach. An individualized, goal directed care plan is necessary for a treat-to-target approach, with total hip bone mineral density being the best specific target. Future research in cellular senescence points to the role of senolytics and senomorphics to alleviate osteoporosis, among other age related conditions.

Background Sex-based differences may influence the clinical management, complication risks, and healthcare resource utilization of hospitalized end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD). Understanding these disparities is essential for optimizing patient care and informing healthcare policy. Methods This study was conducted using the National Inpatient Sample to identify hospitalized adult ESKD patients receiving PD from the year 2003 to 2018. The outcomes included 1) PD-related outcomes, defined as a composite of peritonitis, mechanical complications, catheter removal or revision, and adequacy issues, 2) non-PD-related outcomes, defined as a composite of sepsis, cardiac arrest, and need for mechanical ventilation 3) transfer to hemodialysis, and 4) in-hospital mortality. The associations between sex and in-hospital outcomes were analyzed using multivariable logistic regression and were adjusted for demographic factors, comorbidities, primary diagnoses, admission types, and hospital characteristics. Discharge weights were applied to generate nationally representative estimates. Results Of 97,036 hospitalized ESKD patients receiving PD analyzed, 48,906 (50.4%) were females. In adjusted analyses, there were no overall sex differences in PD-related outcomes, non-PD-related outcomes, or in-hospital mortality. However, age- and comorbidity-based variations were observed in PD-related outcomes. Female sex was associated with lower odds of transfer to hemodialysis, particularly among younger patients and those without heart failure or peripheral vascular disease. Notably, sex differences in in-hospital mortality were observed only among patients with elective admissions. Conclusion There were sex-based disparities in the outcomes and healthcare utilization of hospitalized ESKD patients receiving PD. These findings underscore the need for sex-specific, individualized strategies to improve PD care and inform clinical and policy decisions.