Congestive heart failure (CHF) is a highly prevalent form of heart disease in which the heart is unable to pump an adequate amount of blood to meet the body’s needs, with characteristic symptoms such as fluid overload, respiratory distress, and fatigue on exertion. Nutrition is an integral part of care for CHF with significant implications on health outcomes such as patient survival and quality of life. The primary goals of medical nutrition therapy (MNT) include preventing malnutrition, meeting patients’ nutritional needs, and managing signs and symptoms. CHF increases the risk of malnutrition. Evidence-based guidelines developed by the Heart Failure Society of America and the American College of Cardiology recommend weight loss for patients with overweight or obesity and weight gain for those with unintentional weight loss or cardiac cachexia, a condition involving fat loss and muscle wasting. The registered dietitian (RD), a key member of the interdisciplinary team, assesses patients’ nutritional needs and provides individualized nutrition care, including appropriate calorie recommendations and potential restrictions on sodium, fluid, and fat. Excessive sodium and fluid can contribute to volume overload, while the recommendations for fat intake address both the type and amount of fat to consume to control cholesterol levels. Despite established guidelines, implementing appropriate nutrition interventions can be complex, particularly in patients with numerous clinical needs. This case report discusses the challenges of balancing nutrition interventions with patient goals of care in a patient with CHF and malnutrition.

Patients with cancer who undergo ileostomy creation are at high risk for dehydration, electrolyte imbalance, malnutrition, and reduced quality of life due to increased gastrointestinal (GI) losses, impaired nutrient absorption, and the complex self-management and physiological demands associated with ostomy care. An ileostomy is an opening in the abdomen where the GI tract is brought to the surface, formed from the ileum. Evidence-based medical nutrition therapy (MNT) guidelines for ileostomy management emphasize a fiber-restricted diet in the early postoperative period (6-8 weeks), small, frequent meals, limitation of hypertonic and excessive hypotonic fluids, use of oral rehydration solutions, close monitoring of ostomy output, and sufficient protein intake to support wound healing. In contrast, evidence-based guidelines for severe chronic disease-related malnutrition prioritize adequate energy and protein provision, oral nutrition supplementation, weight stabilization or gain, correction of micronutrient deficiencies, and consideration of advanced nutrition support when oral intake remains inadequate. However, implementation of these standards becomes complex in the context of advanced malignancy, significant symptom burden, and evolving goals of care. This case report examines the application of evidence-based guidelines in an older adult with metastatic endometrial cancer, severe chronic disease-related malnutrition, and recent ileostomy following small bowel obstruction (SBO), illustrating the importance of individualizing MNT to the patient’s clinical trajectory and goals of care.

Oral health is an essential part of overall well-being, yet many children in underserved communities lack access to dental education and basic hygiene resources. Although cavities are completely preventable, they remain one of the most common chronic diseases affecting both children and adults. Early education is crucial for building lifelong habits and preventing future dental issues. The New Smiles initiative is a student-led outreach program focused on improving oral hygiene awareness and access to care among elementary students in the Fort Worth community.

Through interactive elementary school presentations, the program teaches proper brushing and flossing, healthy eating habits, and the importance of routine dental visits to kids. To reinforce these lessons, hygiene kits containing toothbrushes, toothpaste, floss, and educational materials were assembled in collaboration with Cook Children’s and distributed to participating students. Additionally, a brief survey was administered to assess students’ baseline knowledge of oral hygiene and evaluate the effectiveness of the educational presentation.

By combining hands-on education, community partnerships, and the distribution of essential hygiene supplies, the New Smiles program aims to promote preventive oral health practices at an early age. This initiative seeks to reduce oral health disparities while empowering children with the knowledge and resources needed to maintain lifelong dental health.

Women who are obese have a much higher risk of being diagnosed with breast cancer than women who maintain a healthy body weight. However, excess body fat, even in the absence of excess body weight, a condition referred to as normal weight obesity also increases breast cancer risk. The goal of our study is to determine how serum from human subjects with three distinct obesity phenotypes, metabolically healthy obese, metabolically unhealthy obese, and normal-weight obese, influences breast cancer cell growth and proliferation. We have already collected preliminary data indicating differences in cell viability via NADH measurement, yet metabolic activity alone does not definitively demonstrate growth or vitality because cells may be metabolically active without entering S-phase or replicating. To conclusively show DNA replication (and thus true proliferation/vitality), our plan is to quantitatively measure differences in DNA synthesis using the Click-iT EdU DNA-synthesis assay, which uses a thymidine analog incorporated into newly synthesized DNA which can be detected by the appearance of fluorescent conjugates. Based on our preliminary findings, we expect that the lower rates of metabolic activity in cells grown in serum from obese subjects are not due to reduced rates of cellular proliferation. These findings could be used to inform improved, targeted nutritional and chemotherapeutic strategies for individuals with distinct obesity phenotypes.

Viral stability, replication, and host-virus interactions are all significantly impacted by temperature. Numerous experimental studies have demonstrated that SARS-CoV-2 grows differently at different temperatures, but it is still unknown which specific infection processes are impacted. In this work, we used a mathematical modeling approach to quantify the effects of temperature on the kinetic parameters controlling SARS-CoV-2 replication. Results from previously published experiments were used to determine the viral load from in vitro infections of Vero E6 and human nasal epithelial (hNEC) cells at 33 and 37 C. We fit a mathematical model of viral infections to estimate model parameters at the two temperatures. Vero E6 cells showed evidence of temperature dependence when parameter distributions were compared; the infection rate, eclipse phase transition rate, and infected cell death rate varied between 33 and 37 C. The parameter estimates in hNEC cells, on the other hand, revealed no statistically significant differences and showed a significant overlap in parameter estimates between temperatures. These results imply that the cellular environment has a significant impact on how temperature affects SARS-CoV-2 replication dynamics. The measurement of temperature-dependent variations in viral kinetic parameters sheds light on SARS-CoV-2 replication and could enhance forecasts of infection dynamics under various environmental and physiological circumstances.