Crafts and Conversations collaborates with Trinity Terrace and Brookdale assisted living facilities to foster a connection between TCU students and the residents living there. Through monthly meet ups with crafts and music, inter-generational relationships are built between students and residents. Crafts such as painting with mini easels or making yarn octopi provide a base talking point that expands into other natural parts of conversation, such as telling stories. Students that volunteer at crafts gain friendships, valuable interactions that combat stereotypes against the elderly, and improved communication skills. Additionally, students have the opportunity to perform music, enabling them to further expand their creativity. Residents at assisted living facilities also gain valuable friendships and interactions that combat the potential loneliness of at a retirement center. Crafts and Conversations strives to enrich the lives of all those involved through engaging activities that bring people closer together.

Beautiful Feet Clinic, founded by Dr. David Capper, provides free medical, dental, and holistic care for individuals experiencing homelessness in Southside Fort Worth. One of the critical challenges faced by individuals experiencing homelessness is the lack of access to preventive screenings, flu vaccinations, and health education, leading to the late detection of chronic illnesses such as diabetes, hypertension, and cancer. Many patients at Beautiful Feet Clinic do not routinely engage in preventive care, as their immediate survival needs—such as securing food and shelter—often take precedence over long-term health maintenance. Without timely interventions, undiagnosed and unmanaged chronic illnesses contribute to higher emergency department utilization, increased morbidity, and worsening overall health outcomes.

To address this gap, we partnered with Lauren, a medical student at TCOM, to offer flu vaccinations and organize a Community Health Screening Day on March 29th, 2025, offering essential health screenings and practical nutrition education aimed at empowering individuals experiencing homelessness to improve chronic disease management and overall well-being. Patients will learn simple meal modifications to make healthier choices within their available food options through educational pamphlets with a focus on nutritional education to reduce chronic illnesses. The event also enhances medical student training, with efforts to secure an OB-GYN physician to guide manual breast exams and oversee preventive education regarding breast and skin cancer screenings. The initiative also administered 22 flu vaccinations to address gaps in preventive care, reducing the risk of seasonal influenza among unhoused individuals who face significant healthcare barriers. Additionally, in collaboration with Moncrief Cancer Institute, a mobile cancer screening clinic, we will provide free cancer screenings in summer 2025, to promote early detection for at-risk individuals.

Beyond medical care, Beautiful Feet Clinic also faces communication barriers with Spanish-speaking patients, limiting access to critical health services. Many patients and healthcare providers recognize the need for language accessibility and the importance of qualified interpreters in delivering effective care. To address this, we translated the clinic’s intake forms into Spanish and established a list of medical students proficient in Spanish who can assist with interpretation over the phone. This initiative enhances provider-patient communication, ensuring that Spanish-speaking individuals receive accurate medical information and compassionate care.

By integrating screenings, outreach, language accessibility, and hands-on clinical training, this initiative fosters health empowerment and long-term community-based healthcare solutions. It emphasizes collaboration between healthcare institutions, students, and local clinics to bridge gaps in care for vulnerable populations.

Geodesic nets are types of graphs in Riemannian manifolds where each edge is a geodesic segment. One important object used in the construction of geodesic nets is a balanced vertex, where the sum of unit tangent vectors along adjacent edges is zero. We prove the existence of a balanced vertex of a triangle (with three unbalanced vertices) on a general two-dimensional Riemannian surface when all angles measure less than $2\pi/3$, if the length of the sides of the triangle is not too large. This property is a generalization for the existence of the Fermat point of a planar triangle.

The Cheeger’s constant, also known as the isoperimetric number, is a constant that helps describe the bottleneck present in a graph, if any. Some fields, such as computer networks, have an interest in this constant due to the application of the constant in their field. We examined randomly generated connected graphs and their isoperimetric numbers by developing algorithms to calculate it.

One of the major challenges in education is accurately quantifying a student’s knowledge and skills. Since we cannot directly measure a student’s true intelligence, we rely on test performance, which serves as an imperfect representation of their abilities. This issue arises in many statistical applications where the key problem involves a population in which each individual possesses an underlying ability or trait that cannot be directly observed but can only be inferred through proxy variables. However, these proxies are often contaminated, providing only a noisy or imperfect approximation of the true latent variable.
This project focuses on techniques for recovering latent variables from noisy data. In this context, "recovery" refers to estimating the latent variable using indirect observations. Assuming a linear relationship between the latent trait and the observed proxy variables, we can estimate model parameters and subsequently recover the values of the latent variables.
Specifically, we will examine statistical approaches to latent variable recovery when the test contains items that exhibit differential item functioning (DIF). This means that certain test items do not solely measure the intended knowledge or ability but are also biased toward specific groups. The objective is to develop methods that detect the presence of DIF and adjust for it, allowing for a more accurate estimation of the underlying abilities.
To illustrate these methods, we will use the Holzinger-Swineford dataset, a well-known dataset in psychometrics used to analyze cognitive abilities across multiple domains. This dataset includes 88 observations with scores in five areas: Mechanical Comprehension, Verbal or Visual Comprehension, Algebra Operations, Analytical Operations, and Statistical Reasoning. By applying a linear contamination model, we aim to recover each student's latent ability while accounting for DIF.

Oral Reading Accuracy (ORA) is an important metric for evaluating a student's reading proficiency, measuring how accurately a reader can read words aloud. Traditional ORA evaluations performed by human assessors often require significant time and labor. This study explores the potential of integrating a speech recognition system into ORA assessments to improve efficiency. We analyzed ORA data from 507 elementary school students across ten passages of different lengths and difficulties. Both human evaluators and AI systems recorded the number of words read correctly. The misclassification rates of these scores are divided into two components: True Positive (correct words are identified as correct), and True Negative (incorrect words are identified as correct). This second study expands upon Method of Moments method to estimate these misclassification rates. We apply Generalized Method of Moments which incorporates additional variance information. To compare the two approaches' accuracy, we apply the m-out-of-n Bootstrap method to estimate their standard errors and compare their reductions in estimator variance. Additionally, we introduce a Contaminated Data Solution to address real-world scenarios where true count data is unavailable and only contaminated observed data is observed.

Sepsis-induced acute kidney injury (S-AKI) is a critical illness that causes decreased kidney function due to infection. With a prevalence of 40-50% of patients in the intensive care unit developing S-AKI, the illness is strongly associated with a higher risk of mortality, longer hospital stays, and increased risk of kidney failure relapse. S-AKI complicates medical nutrition therapy due to altered protein metabolism, increased metabolic demands, fluid imbalances, increased malnutrition risk, and electrolyte imbalances. Goals of nutrition care include close monitoring and evaluation of fluid, meeting estimated protein needs, maintaining electrolyte and vitamin status, and achieving supplemental nutrition tolerance to optimize kidney recovery and prevent malnutrition. Various nutrition interventions, such as individualized protein needs and enteral nutrition (EN), play a role in managing this illness. Evidence-based guidelines for protein recommendations vary based on the type of renal replacement therapy (RRT) and range from 1.2-2.5 g/kg/day. Patients with declining renal function prior to RRT and at risk for chronic kidney disease have a range of 0.8-1.0 g/kg/day to preserve long-term kidney function. Literature indicates initiation of EN within 24 hours is preferred over parenteral nutrition (PN) if oral intake is not feasible to prevent malnutrition. While there are no standardized fluid intake guidelines for S-AKI, continuous multidisciplinary assessment and adjustment to fluid intake are necessary to prevent volume overload. This case report reviews the importance of proactive individualized nutrition interventions to aid in patient recovery including improved nutritional status and AKI resolution.

Background: Research in animals and humans indicate that the gut microbiome plays a significant role in modulating insulin resistance1,2, while animal studies have demonstrated the gut microbiome's direct involvement in regulating body weight3,4. Furthermore, antibiotic use may impair insulin sensitivity and glucose tolerance in individuals with overweight and obesity5-9. However, no studies to date have evaluated the potential factors influencing this metabolic response.

Methods: This is a randomized clinical trial with a within- and between-subjects comparison. Seventy-five individuals aged 18-50 years (BMI 25.0-40.0 kg/m2), with no Diabetes Mellitus diagnosis, and no recent probiotic or antibiotic intake (3 months) were recruited. Participants were allocated to a synbiotic or placebo group for 12 weeks following a 3-day Vancomycin antibiotic intervention (500 mg every 8 hours). Body weight and fasting blood samples (glucose, insulin, HbA1c) were taken at the first (baseline), second (after antibiotic administration), and third visit (after synbiotic/placebo intervention). HOMA-IR was calculated from fasting insulin and glucose levels. Due to lack of normal distribution of independent variables, Mann-Whitney U tests were performed to evaluate within- and between-group changes over time.

Results: Compiled results for all participants were analyzed, although only 60 completed the study. It is important to highlight that the placebo group was significantly heavier at baseline (91.8 ± 18.1 kg) than the synbiotic group (82.8 ± 14.3 kg) (p=0.046), while the latter had a modest weight gain over time (~0.80 kg, p=.056). Neither fasting glucose nor HbA1C changed significantly between groups over time. HbA1c, insulin, and HOMA-IR slightly increased from baseline in all participants (p<.001 each), which could indicate a decreased insulin sensitivity over time, with no significant differences between groups.

Conclusion: Our unadjusted analysis demonstrates that providing a 12-week next-generation synbiotic supplementation posterior to a 3-day antibiotic intervention did not correct the commonly observed detrimental effect of antibiotics on insulin resistance. Furthermore, it seemed to lead to significant weight gain (~0.80 kg, p=.056).

Implications for future research: We are planning on re-running all our statistical analyses controlling for baseline sex and we are also planning on running an independent third group with synbiotic only for comparison purposes.

Funding Source: Pendulum® and TCU Dean’s Opportunity Grant

References
1. Sergeev IN, Aljutaily T, Walton G, Huarte E. Effects of Synbiotic Supplement on Human Gut Microbiota, Body Composition and Weight Loss in Obesity. Nutrients. Jan 15 2020;12(1)doi:10.3390/nu12010222
2. Wu Z, Zhang B, Chen F, et al. Fecal microbiota transplantation reverses insulin resistance in type 2 diabetes: A randomized, controlled, prospective study. Front Cell Infect Microbiol. 2022;12:1089991. doi:10.3389/fcimb.2022.1089991
3. Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. Sep 6 2013;341(6150):1241214. doi:10.1126/science.1241214
4. Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. Dec 21 2006;444(7122):1027-31. doi:10.1038/nature05414
5. Del Fiol FS, Balcão VM, Barberato-Fillho S, Lopes LC, Bergamaschi CC. Obesity: A New Adverse Effect of Antibiotics? Front Pharmacol. 2018;9:1408. doi:10.3389/fphar.2018.01408
6. Klancic T, Laforest-Lapointe I, Wong J, et al. Concurrent Prebiotic Intake Reverses Insulin Resistance Induced by Early-Life Pulsed Antibiotic in Rats. Biomedicines. Jan 12 2021;9(1)doi:10.3390/biomedicines9010066
7. Park SJ, Park YJ, Chang J, et al. Association between antibiotics use and diabetes incidence in a nationally representative retrospective cohort among Koreans. Sci Rep. Nov 4 2021;11(1):21681. doi:10.1038/s41598-021-01125-5
8. Yuan J, Hu YJ, Zheng J, et al. Long-term use of antibiotics and risk of type 2 diabetes in women: a prospective cohort study. Int J Epidemiol. Oct 1 2020;49(5):1572-1581. doi:10.1093/ije/dyaa122
9. Zhou J, Lin Y, Liu Y, Chen K. Antibiotic exposure and risk of type 2 diabetes mellitus: a systematic review and meta-analysis. Environ Sci Pollut Res Int. Dec 2021;28(46):65052-65061. doi:10.1007/s11356-021-16781-3

Medical nutrition therapy is necessary for individuals at risk of impaired wound healing, such as those with malnutrition, poor circulation, or advanced age. During the acute inflammatory response from wounds, the body enters a catabolic state, increasing energy and protein needs. For those with malnutrition or at risk for malnutrition, calories should be provided at 30-35 kcal/kg body weight and protein at 1.25-1.5 g/kg body weight. Along with increased energy needs, the assessment and management of vitamins and minerals such as vitamins A, vitamin C, vitamin K, and zinc enhance the synthesis of fibroblasts needed for tissue formation. Early diagnosis and intervention for malnourished patients with chronic wounds are critical steps in providing effective patient care. Oral intake is monitored to ensure calorie and protein intake is adequate and oral nutrition supplements may be provided if indicated. For those unable to tolerate oral feeds, enteral nutrition is the next preferred method. If enteral nutrition is contraindicated then parenteral nutrition can be initiated to provide adequate calories and protein. This case report analyzes the care of a 74-year-old female with a non-healing surgical wound with a history of bariatric surgery who has been diagnosed with malnutrition.

Essential fatty acid deficiency (EFAD) is a condition that can occur when the body does not have adequate fats from the diet. EFAD can develop in as quick as 10 days and can present with symptoms such as itchy and flaky skin, poor wound healing, elevated liver function tests, and increased susceptibility to infection. EFAD rarely occurs in individuals who eat a balanced diet with a variety of foods and fat sources and is seen most often in patients unable to eat by mouth or tolerate tube feedings. Patients with prolonged poor nutrition are at increased risk of EFAD due to insufficient fat intake. Risk factors of EFAD are inflammatory bowel disease, pancreatic insufficiency, extreme diet restriction, and long-term parenteral nutrition support with limited fat emulsion supplementation. Preventing EFAD through awareness and proactive measures is essential in medical nutrition therapy. Since clinical markers are challenging to assess in the acute care setting, physical signs and symptoms are used for identifying and treating EFAD. For patients on parenteral nutrition support with no fat, supplementing with 500 mL intralipids per week is recommended to prevent EFAD. This case report reviews the current nutritional guidelines related to EFAD and parenteral nutrition and highlights a patient at risk for EFAD due to her poor intake, who was receiving long-term parenteral nutrition with supplemental oral intake.