Medicine and Health Sciences Commons^™

Machine Learning-Enabled Maternal Risk Assessment For Women With Pre-Eclampsia (The Piers-Ml Model): A Modelling Study, Tünde Montgomery-Csobán, Kimberley Kavanagh, Paul Murray, Chris Robertson, Sarah J E Barry, U Vivian Ukah, Beth A Payne, Kypros H Nicolaides, Argyro Syngelaki, Olivia Ionescu, Ranjit Akolekar, Jennifer A Hutcheon, Laura A Magee, Peter Von Dadelszen, Piers Consortium

Faculty, Staff and Student Publications

BACKGROUND: Affecting 2-4% of pregnancies, pre-eclampsia is a leading cause of maternal death and morbidity worldwide. Using routinely available data, we aimed to develop and validate a novel machine learning-based and clinical setting-responsive time-of-disease model to rule out and rule in adverse maternal outcomes in women presenting with pre-eclampsia.

METHODS: We used health system, demographic, and clinical data from the day of first assessment with pre-eclampsia to predict a Delphi-derived composite outcome of maternal mortality or severe morbidity within 2 days. Machine learning methods, multiple imputation, and ten-fold cross-validation were used to fit models on a development dataset (75% of …

Seamark: Phase Ii Study Of First-Line Encorafenib And Cetuximab Plus Pembrolizumab For Msi-H/Dmmr Brafv600e-Mutant Mcrc, Elena Elez, Scott Kopetz, Josep Tabernero, Tanios Bekaii-Saab, Julien Taieb, Takayuki Yoshino, Gulam Manji, Kathrine Fernandez, Antonello Abbattista, Xiaosong Zhang, Van K Morris

Faculty, Staff and Student Publications

Patients with both BRAF V600E mutations and microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) metastatic colorectal cancer (mCRC) have poor prognosis. Currently, there are no specifically targeted first-line treatment options indicated for patients with mCRC whose tumors harbor both molecular aberrations. Pembrolizumab is a checkpoint inhibitor approved for the treatment of MSI-H/dMMR mCRC, and the BRAF inhibitor encorafenib, in combination with cetuximab, is approved for previously treated BRAF V600E-mutant mCRC. Combination of pembrolizumab with encorafenib and cetuximab may synergistically enhance antitumor activity in patients with BRAF V600E-mutant, MSI-H/dMMR mCRC. SEAMARK is a randomized phase II study comparing the efficacy of the combination …

Dietary Magnesium Replacement For Prevention Of Hypomagnesemia In Patients With Ovarian Cancer Receiving Carboplatin-Based Chemotherapy, Wenli Liu, Larissa Meyer, Meroë Morse, Yisheng Li, Juhee Song, Rosalinda Engle, Gabriel Lopez, Santhosshi Narayanan, Pamela T Soliman, Lois Ramondetta, Eduardo Bruera, Lorenzo Cohen

Faculty, Staff and Student Publications

Purpose: Hypomagnesemia is a common side effect of platinum-based chemotherapy and predicts poor overall survival in some cancers. Standard magnesium replacement strategies are often inadequate for maintaining magnesium levels. We hypothesized that a daily dietary magnesium replacement approach through magnesium-rich foods would help maintain adequate magnesium levels during platinum-based treatment.

Materials and methods: We conducted a prospective feasibility study of magnesium-rich diets in patients 18 years and older with previously untreated ovarian cancer scheduled to receive carboplatin-containing chemotherapy of at least six consecutive cycles. Education about magnesium-rich diets was provided at enrollment and then weekly during chemotherapy. Feasibility was defined …

A Randomized, Non-Comparative Phase 2 Study Of Neoadjuvant Immune-Checkpoint Blockade In Retroperitoneal Dedifferentiated Liposarcoma And Extremity/Truncal Undifferentiated Pleomorphic Sarcoma, Christina L Roland, Elise F Nassif Haddad, Emily Z Keung, Wei-Lien Wang, Alexander J Lazar, Heather Lin, Manoj Chelvanambi, Edwin R Parra, Khalida Wani, B Ashleigh Guadagnolo, Andrew J Bishop, Elizabeth M Burton, Kelly K Hunt, Keila E Torres, Barry W Feig, Christopher P Scally, Valerae O Lewis, Justin E Bird, Ravin Ratan, Dejka Araujo, M Alexandra Zarzour, Shreyaskumar Patel, Robert Benjamin, Anthony P Conley, J Andrew Livingston, Vinod Ravi, Hussein A Tawbi, Patrick P Lin, Bryan S Moon, Robert L Satcher, Bilal Mujtaba, Russell G Witt, Raymond S Traweek, Brandon Cope, Rossana Lazcano, Chia-Chin Wu, Xiao Zhou, Mohammad M Mohammad, Randy A Chu, Jianhua Zhang, Ashish Damania, Pranoti Sahasrabhojane, Taylor Tate, Kate Callahan, Sa Nguyen, Davis Ingram, Rohini Morey, Shadarra Crosby, Grace Mathew, Sheila Duncan, Cibelle F Lima, Jean-Yves Blay, Wolf Herman Fridman, Kenna Shaw, Ignacio Wistuba, Andrew Futreal, Nadim Ajami, Jennifer A Wargo, Neeta Somaiah

Faculty, Staff and Student Publications

Based on the demonstrated clinical activity of immune-checkpoint blockade (ICB) in advanced dedifferentiated liposarcoma (DDLPS) and undifferentiated pleomorphic sarcoma (UPS), we conducted a randomized, non-comparative phase 2 trial ( NCT03307616 ) of neoadjuvant nivolumab or nivolumab/ipilimumab in patients with resectable retroperitoneal DDLPS (n = 17) and extremity/truncal UPS (+ concurrent nivolumab/radiation therapy; n = 10). The primary end point of pathologic response (percent hyalinization) was a median of 8.8% in DDLPS and 89% in UPS. Secondary end points were the changes in immune infiltrate, radiographic response, 12- and 24-month relapse-free survival and overall survival. Lower densities of regulatory T cells …

Tp53 Mutation Is Frequent In Mantle Cell Lymphoma With Ezh2 Expression And Have Dismal Outcome When Both Are Present, Do Hwan Kim, Saima Siddiqui, Preetesh Jain, Michael Wang, Beenu Thakral, Shaoying Li, Roberto Miranda, Francisco Vega, L Jeffrey Medeiros, Chi Young Ok

Faculty, Staff and Student Publications

Enhancer of zeste homolog 2 (EZH2) expression is found in about 40% of mantle cell lymphoma (MCL) patients, which is associated with aggressive histology, high Ki-67 proliferation rate, p53 mutant pattern and inferior overall survival (OS). We conducted 11-gene (ATM, BIRC3, CCND1, KMT2C, KMT2D, NOTCH1, NOTCH2, RB1, TP53, TRAF2 and UBR5) next generation sequencing panel to shed more light on MCL with EZH2 expression (EZH2+ MCL). EZH2+ MCL more frequently harbor TP53 mutation compared to EZH2(-) MCL (41.2% vs. 19.1%, respectively, p = 0.045). TP53 mutation and EZH2 expression demonstrated overlapping features including aggressive histology, high Ki-67 proliferation rate and …

Tp53 Mutation Is Frequent In Mantle Cell Lymphoma With Ezh2 Expression And Have Dismal Outcome When Both Are Present, Do Hwan Kim, Saima Siddiqui, Preetesh Jain, Michael Wang, Beenu Thakral, Shaoying Li, Roberto Miranda, Francisco Vega, L Jeffrey Medeiros, Chi Young Ok

Faculty, Staff and Student Publications

Enhancer of zeste homolog 2 (EZH2) expression is found in about 40% of mantle cell lymphoma (MCL) patients, which is associated with aggressive histology, high Ki-67 proliferation rate, p53 mutant pattern and inferior overall survival (OS). We conducted 11-gene (ATM, BIRC3, CCND1, KMT2C, KMT2D, NOTCH1, NOTCH2, RB1, TP53, TRAF2 and UBR5) next generation sequencing panel to shed more light on MCL with EZH2 expression (EZH2+ MCL). EZH2+ MCL more frequently harbor TP53 mutation compared to EZH2(-) MCL (41.2% vs. 19.1%, respectively, p = 0.045). TP53 mutation and EZH2 expression demonstrated overlapping features including aggressive histology, high Ki-67 proliferation rate and …

Thematic Analysis Of Alzheimer's Medication Management Discussion In A Non-Moderated Online Forum, Jia Liu, Kylie Meyer, Ashlie Glassner, Mitzi Gonzales, Rebecca J Bartlett Ellis, Hyejin Park, Lixin Song, Neela Patel, Jing Wang

Faculty, Staff and Student Publications

Background: Managing medications for Alzheimer's disease and related dementias is challenging for caregivers. Information about caregivers' strategies to manage these challenges is needed to inform intervention development.

Objective: This study aimed to understand caregivers' medication management experiences by analyzing online community discussions.

Methods: Posts were extracted from the ALZConnected® Forum using keywords "medication" and "drug" via web scraping. The researchers applied thematic analysis.

Results: Four major themes emerged: (1) role transition of medication management responsibilities, (2) caregivers' uncertainty about medication purpose and values, (3) conflicts between the care recipients and caregivers, and (4) difficulty accessing and affording medications.

Conclusions: The …

The Value Of Global Collaborations, Chris Trauernicht, Laurence Court

Faculty, Staff and Student Publications

No abstract provided.

A Pilot Intervention For Adolescent Adoptees: The Interoception Curriculum, Francie X. Bailey

Capstone Projects

This pilot study sought to evaluate the efficacy of Mahler’s (2019) Interoception Curriculum on increasing emotional regulation and interoceptive awareness among adolescent adoptees. A pre - posttest design was employed to assess changes in emotional regulation and interoceptive awareness following a condensed, 10 - week version of the curriculum. Six participants, and their respective parent, completed pretest and posttest assessments following the completion of the weekly intervention. Results demonstrated minimal improvements in both parent and adolescent perceived emotional regulation competency but significant improvement in adolescents’ ability to notice and attend to their bodily sensations, listen to their body cues, and …

Program Development For Group Interventions Targeting Loneliness In Older Adults, Antoinette Cave

Capstone Projects

The topic of loneliness is complex and subjective in nature, and treatment of the condition requires the client-centered approach that occupational therapy encompasses within its scope of practice. Using an occupation-based, mental health approach to develop the program, weekly focus groups were created based on participant-preferred activities to decrease loneliness among older adults at PACE InnovAge’s outpatient and assisted living locations in Thornton, Colorado. Education was provided to participants and staff throughout the 14-week experience. Further training and sustainability efforts were created and distributed among participants and staff at the end of the experience through an occupation-based handout with external …

A How-To Guide For Implementing Level I Faculty-Facilitated Fieldwork Sites: A Western Michigan University Model, Jordyn Diaz

Capstone Projects

Since the Covid-19 pandemic, community partners and fieldwork educators have been overwhelmed by the demand of occupational therapy (OT) students seeking fieldwork placements. The faculty-facilitated model is a desirable option to relieve this burden and provide services for the community. Faculty-facilitated sites have a 1:6 fieldwork educator- to-student ratio. These sites can occur on-campus, within a community organization, or virtually as demonstrated by Western Michigan University (WMU). However, barriers to implementing this model include financial concerns, time constraints, space limitations, and the associated workload required to sustain these sites.

The focus of this doctoral capstone experience was to create a …

Enhancing Self-Regulation Skills With The Zones Of Regulation, Sara Hayes

Capstone Projects

It has been highlighted that children with Autism Spectrum Disorder (ASD), Cognitive Impairments, Emotional Impairments, and other Sensory Processing Disorders. often lack the ability to self-regulate appropriately. Self-regulation is defined as the ability to control one’s emotions and behaviors, get along with others and engage in learning. Self-regulation helps children learn effectively, obtain, and maintain relationships, and communicate appropriately. A tool proven to teach and implement appropriate self-regulation is Leah Kupyers’ Zones of Regulation curriculum. The purpose of this literature review is to analyze the potential for OT involvement in the implementation of the Zones of Regulation curriculum within the …

Inclusive Yoga Programming For Children With Diverse Needs, Allison H. Hansel

Capstone Projects

Limited research exists to support the use of yoga as an occupational therapy intervention for children with disabilities. In the studies that are available, yoga is primarily used to target children with autism spectrum disorder (ASD). Currently there is no research available that explores use of yoga in a group of children with a variety of disabilities and diagnoses. The aim of my doctoral capstone experience was to design and implement an inclusive yoga group for children with diverse needs. Objectives were created to guide this capstone project such as creating intake forms, pre/post surveys, weekly yoga curriculum and weekly …

Integrative Sensory Room For General Education And Special Education 3rd-5th, Julia Henderson

Capstone Projects

Everyone has a unique sensory system that continues to change and adapt throughout their lifespan. In an 8-hour school day, children take in so much information with very little consideration of how their sensory systems may be reacting in response to varying environments and social situations. The gap within the school system remains to be seen as a lack of understanding of sensory systems and how they affect children’s learning capabilities. The objective throughout my capstone experience was to support Greyhound Intermediate School by creating a sensory room for both special education and general education students. This was done by …

Trauma Informed Care Resources For Foster And Adoptive Families, Nitasha Cooper

Capstone Projects

Trauma informed care is meeting the needs of children who have undergone trauma by addressing the direct impact caused by the trauma the child experienced. My objectives looked to assist parents in the carryover from the occupational therapy clinic to home by providing videos on techniques to address behaviors occurring in and out of the home and building a connected relationship between child and caregiver as well as resources such as books for children and caregivers; podcasts; social media personnel; support groups; and a respite list. These objectives resulted in a plethora of resources for caregivers and families to access …

Friends At Work: Creating A Peer-To-Peer Program For Individuals With Disabilities In The Workplace, Claire Johnson

Capstone Projects

Students with disabilities face social isolation, loneliness, mental health conditions, and unemployment rates at a disproportionately high rate compared to their typically developing peers (Choiseul-Praslin et al., 2019). Peer support programs and transition to work organizations have the ability to combat these factors. The following Doctoral Capstone Experience depicts the development and implementation of a peer-to-peer program within a transition to work program to increase social participation amongst transitional students with disabilities. The program was implemented at Project SEARCH at Corewell Health Beaumont Troy Hospital. Additionally, this project attempts to quantitatively qualify the effectiveness of the Project SEARCH program in …

The Integration Of Occupational Therapy In Transition Programs To Improve Outcomes For Students, Morgan Jagiela

Capstone Projects

Numerous studies exist depicting the benefit and efficacy of an occupational therapy (OT) presence within post-secondary transition programs. Both transition programs and occupational therapists aim to help students with disabilities improve independent living skills, vocational skills, and social/communication skills, so they may live functional adult lives with as few supports as possible. Despite this success and the overlap in scope, OT is rarely found in transition programs. The purpose of this doctoral capstone experience (DCE) was to develop a program that would implement occupational therapy into the Empower U transition program. Through the creation and completion of objectives, success and …

Grant Funding For Non-Profit Organizations And Community Focused Entrepreneurship, Tyler Turnquist

Capstone Projects

The primary objective of this Capstone project was centered around developing grant writing skills and the ways it aids both nonprofits and small businesses to promote increased opportunities within the community. One facet of this project focused on researching and writing grants for the nonprofit, Renew Mobility to increase their operation budget, as well as creating a central database of their funding sources. This database fills the need for better organization of deadlines, interactions, and documents that can reduce the number of missed grant opportunities and increase overall funding. The second objective of this capstone was writing a grant for, …

Development Of Occupation-Based And Trauma-Informed Care Resources To Promote Successful Reentry Following Release From Prison, Anna Burch

Capstone Projects

This 14-week capstone project focused on program development and education to establish occupational therapy-based resources into the Region 4 OS Reentry program through Michigan Department of correction (MDOC). The project was based out of Kent County Parole Office with the target population focusing on people who are actively on parole. Region 4 OS Reentry provides those on parole with many resources including bus cards, transitional housing, food vouchers, clothing/self-care assistance, trauma counseling and more. The purpose of this project was to utilize an occupational therapy lens to create resources revolving around ADL/IADLs, mental health, connecting the program with other community …

Occupational Therapy Health & Wellness Promotion For Adults Living With Intellectual/Developmental Disabilities, Sydni Rodriguez

Capstone Projects

Based on educational principles and program development, this occupational therapy doctoral capstone experience (DCE) was centered on addressing the health and wellness needs of adults living with intellectual/developmental disabilities (I/DD) at Self-Help Alternative Living Opportunities Michigan (SHALOM), a Christian non-profit organization. Research has shown that adults living with I/DD have an increased chance of having health complications related to health disparities when compared to the general population of adults. Occupational therapists have a profound role in health and wellness as it relates to access and engagement in daily occupations. This DCE was accomplished through development of a recurrent monthly walking …

Improving The Care Of Individuals With Neurogenic Bowel And Bladder Dysfunction In An Inpatient Rehabilitation Setting, Brooke Loucks

Capstone Projects

Neurogenic bladder and bowel dysfunction can lead to serious health complications and negatively impacts one’s mental health and quality of life (Kurze et al., 2022l; Borsh et al., 2019 ). Despite the abundance of research on the topic concerning the spinal cord injury population, there is limited generalization to other neurologic conditions with similar presentation. There is also a need for practical implementation and clinical guidelines in health care systems (Kurze et al., 2022l; Borsh et al., 2019). Toileting is one of the main activities of daily living listed in the Occupational Therapy Practice Framework ( AOTA, 2020) yet the …

Student Comprehension Of Addressing Acote Standards Related To Fieldwork Educators And Level I Fieldwork Sites, Baileigh Grabow

Capstone Projects

Accreditation Council of Occupational Therapy Education (ACOTE) standards are the rules and procedures occupational therapy academic programs across the country are mandated to follow and uphold (ACOTE, 2018). The standards are the framework to ensure quality education of the same rigor across OT/OTA programs preparing the future practitioners of occupational therapy. The ACOTE Standards (2018) have an “A” section related the resources, faculty experience, public policies, curriculum framework, and strategic plan requirements, a “B” section related to didactic program content requirements, a “C” section for fieldwork requirements, and a “D” section related to capstone requirements.

The purpose of this doctoral …

Occupational Therapy's Role In Post-Secondary Transition Programing For Young Adults With Disabilities, Mallory Rubley

Capstone Projects

Post-secondary transition programs for young adults with intellectual or developmental disabilities (IDD) are designed to support young adults with IDD in areas of independent living, academics, relationships, financial management, health and safety, and employment. All of which are within the scope of occupational therapy (OT). Within the limited post-secondary transition programs that exist for these young adults, OT is rarely included as a provided service, creating an unintentional disadvantage to the students and clients. The purpose of this Doctoral Capstone Experience (DCE) was program development and advocacy for the role of occupational therapy within Ready for Life (RFL), a post-secondary …

The Development Of An 8-Week Neurodiversity-Affirming Caregiver Co-Regulation Coaching Program., Carissa Heestand

Capstone Projects

The realm of pediatric care is witnessing the rapid emergence of two innovative practices centered on nurturing safety within a child's nervous system. This program development endeavors to synergize these practices to optimize occupational balance within the familial unit. The first pioneering approach involves Neurodiversity (ND) affirming care, which is seamlessly integrated into therapy sessions. Here, therapists honor and embrace the diverse nature of each child's brain, while acknowledging and celebrating their unique abilities. The second innovative practice involves caregiver coaching sessions, with a primary focus on educating caregivers about co-regulation techniques. Previous research has highlighted the efficacy of such …

Recollection-Based Occupational Therapy: An Activities Program For Catholic Dominican Sisters With Dementia, Alyssa J. Visockis

Capstone Projects

Recollection-based occupational therapy is a nonpharmacological approach to dementia, involving five categories of activities: horticultural, physical, art, musical, and instrumental activities of daily living (IADLs). The purpose of this approach is to incorporate memories of a person’s childhood, adulthood, and older adulthood before dementia in activities. Furthermore, the Grand Rapids Catholic Dominican sisters at Aquinata Hall needed a method to gather psychosocial history on their residents as well as new activity programming on the dementia- care unit that had meaningful purpose. Therefore, during this capstone experience, a psychosocial history assessment was created and conducted with the sisters. Using the results …

Utilizing The Functional Mobility Assessment/Uniform Data Set (Fma/Uds) Registry To Conduct Research Related To Wheelchair Repair Frequency, Brooke Wilson

Capstone Projects

Issues with wheelchair equipment is a common experience for users, but access to repairs and maintenance isn’t always the most efficient process. A large portion of occupational therapy’s (OT) patient population includes wheelchair users, so it’s important to consider the impact of wheelchair breakdown on a patient’s daily function. There has been a lack of research on wheelchair repair frequency during the first year of ownership, so this capstone project focused on developing a manuscript for journal submission on this topic. This was achieved utilizing data from the Functional Mobility Assessment/Uniform Data Set (FMA/UDS) Registry. Client characteristics were extracted from …

Implementing The Positive Approach To Care® Methods As An Effective Training Curriculum For Staff At An Adult Day Center, Delaney Acri

Capstone Projects

Dementia, a neurodegenerative disorder affecting multiple brain regions, significantly disrupts daily life (Feurich, 2023). Occupational therapists, guided by the Occupational Therapy and Performance Framework (OTPF-4), address cognitive and functional challenges in individuals with dementia (American Occupational Therapy Association, 2020). Therapists employ compensatory strategies to enhance quality of life of people with dementia, as well as their family caregivers. Adult day centers serve as valuable resources for family caregivers, offering respite care during working hours. Despite regulations in most states, Michigan lacks specific dementia training laws in some healthcare settings (Burke & Orlowski, 2015). As a result, many facilities that serve …

The Role Of Occupational Therapy In Transition Programs For High School Students With Disabilities, Kara Hutchison

Capstone Projects

Students with disabilities frequently experience a gap in services as they grow older and after exiting the public education system. During school, students have Individualized Education Plans (IEPs) to support their education, but once they graduate, the services they were receiving expire. Occupational therapy is under- utilized in transition planning for students after graduating high school and entering adulthood. The purpose of this DCE was program development and advocacy with the Project SEARCH transition program while exploring the role of occupational therapy has in transition planning for high school students with disabilities. The goal of this project was to improve …

Combating Social Isolation Among Older Adults Through Intergenerational Relationships With Children; Facilitating Meaningful Connection During Intergenerational Interactions By Improving Sensory Environment And Increasing Engagement During Group Activities, Lillian John

Capstone Projects

The following capstone project focused on the enhancement of meaningful engagement among all participants of an intergenerational care center. The interventions implemented within the intergenerational program were put in place to facilitate communication, improve behavioral regulation, modify sensory environment, create the just right challenge for group activities, and increase independence to promote meaningful engagement and social connection. The implementation of the interventions was completed through on-site education to the employees, the creation of various educational binders to support the participants individually, and adjustments to the environment and group activities. This capstones projects’ primary goal was to improve the efficacy of …

Enhancing Pre-Vocational Programs For High School Students With Disabilities: The Impact Of Occupational Therapy And Support Staff Education, Maria Calzada

Capstone Projects

Pre-vocational programs in high school serve as a crucial platform for supporting students in the transition from education to the workplace. These programs provide classroom instruction, hands-on training, and practical experiences to maximize students’ vocational skills post-high school. Pre-vocational programs provide a crucial platform for the development of IADL skills, task analysis, and the promotion of occupational engagement among diverse populations. The purpose of this DCE was program development within the pre-vocational program and provide additional education for the support staff at the high school setting. The goal was to improve vocational skills, including problem solving, self-advocacy, sequencing, and sustained …