Science for Starters: Empowering Future Problem-Solvers in Underserved Communities Through Early STEM Engagement

Type: Undergraduate
Author(s): Saba Anjum Chemistry & Biochemistry Rosangela Boyd Interdisciplinary Grace Conley Interdisciplinary Anisha Sakhare Biology Eric Simanek Chemistry & Biochemistry Jeremiah Tran Chemistry & Biochemistry
Advisor(s): Molly Weinburgh Interdisciplinary

Science for Starters is a student-led outreach initiative that provides weekly after-school STEM programming for elementary grade students at the Como Community Center in a historically underserved neighborhood. Supported by the EPIC (Experiential Projects to Impact the Community) grant, the program aims to address gaps in grade-level STEM skills and limited access to hands-on learning opportunities. TCU undergraduate volunteers lead each session, which includes relationship-building activities, a brief introduction to a STEM concept, and a hands-on, inquiry-based activity that encourages problem-solving and collaboration. Topics explored include chemistry, physics, space exploration, engineering, and the human body. Through these experiences, the program fosters curiosity in STEM while promoting mentorship, leadership development among undergraduate volunteers, and sustainable STEM enrichment within the Como community.

From Education to Action: Preventing Diabetic Foot Complications in the Unhoused Population of Fort Worth

Type: Undergraduate
Author(s): Siri Bejjanki Psychology Saba Anjum Chemistry & Biochemistry Miranda Gonzalez Biology
Advisor(s): David Capper Interdisciplinary

Unhoused individuals with diabetes frequently present to the Beautiful Feet Ministries Medical Clinic with preventable foot complications due to limited access to foot care supplies and limited education on preventive practices. This project addresses these gaps through a combined resource distribution and educational intervention model. Free foot care kits, patient-friendly educational materials, and an instructional video were developed to support preventive foot care and improve recognition of warning signs. Awareness workshops further expand outreach and encourage clinic-based foot screenings. By integrating accessible resources with targeted education, this initiative aims to empower unhoused individuals with diabetes to take a proactive role in their foot health and reduce avoidable complications.

Health Insurance, Social Determinants, and Health Outcomes: An Interdisciplinary Analysis Using Real-World Data

Type: Undergraduate
Author(s): Adrian Cisneros Interdisciplinary
Advisor(s): Keith Whitworth Interdisciplinary

Quantifying the Reach of Social Determinant–Focused Supplemental Benefits in Medicare Advantage: A Health Informatics Approach
Medicare Advantage (MA) plans now offer supplemental benefits that go beyond traditional medical coverage. These include things like transportation to appointments, meal delivery, housing support, utility assistance, and pest control, all of which target the social determinants of health (SDOH) that affect patient outcomes well before a doctor visit ever happens. Federal policy, particularly through the expansion of Special Supplemental Benefits for the Chronically Ill (SSBCI), has given plans more flexibility to offer these services. But offering a benefit and actually getting it to the people who need it are two different things. I wanted to find out how many plans are really providing these benefits, and how many beneficiaries are actually enrolled in them.
Using SAS, I combined multiple CMS administrative datasets, including Plan Benefit Package (PBP) data and MA Enrollment by Plan files from the Centers for Medicare & Medicaid Services, into one analytic dataset. I linked plan-level benefit indicators to enrollment counts so I could estimate both the proportion of MA plans offering specific SDOH-related benefits and the percentage of beneficiaries enrolled in those plans.
What I found early on is a clear gap. Plans may list SDOH benefits on paper, but enrollment in those plans varies sharply depending on the benefit type. That disconnect between what is offered and who it actually reaches matters, because it tells us that expanding policy alone does not guarantee equity. This project shows that publicly available CMS data, when properly organized and integrated through health informatics methods, can expose these gaps and move the conversation from policy language toward something measurable.

The Impact of Sleep, Diet, and Exercise on Perceptions of Stress in the Hispanic and Non-Hispanic Populations

Type: Undergraduate
Author(s): Katelin Jimenez Interdisciplinary
Advisor(s): Glenda Daniels Interdisciplinary Janie Robinson Interdisciplinary

Background: It is estimated that close to 50% of Americans experience stress daily. Research has documented that Latinos report higher levels of stress than other ethnicities. Stress is a normal occurrence and defined as the body and brain's natural, automatic response to any demand, challenge, or perceived threat. There are many factors that can impact stress, including sleep, diet, and exercise which are modifiable risk factors. These factors may affect ethnic groups in different ways. Purpose: The purpose of this integrative literature review is to explore the impact of exercise, diet, and sleep on the stress levels or perceptions of stress in the Hispanic and Non-Hispanic population. Methods: Databases used for this review included: CINAHL, EMBASE, PsycInfo, PubMed, Web of Science, and Scopus. The inclusion criteria were randomized control trials, mixed-method studies, quantitative and qualitative studies, systematic reviews, individuals age 18 or greater, Hispanic and Non-Hispanic populations. The articles reviewed included the years 2006-2026 utilizing the PRISMA extraction system. Conclusion: The findings should help researchers identify strategies to mitigate negative responses to these factors. Based on the increasing Hispanic demographic in the US, future research should address the inclusion of this population to address health disparities and gaps and enhance culturally competent interventions

Key words: exercise, diet, sleep, stress, Hispanic, Non-Hispanic, perceptions, diet quality

Development and Preliminary Evaluation of an AI-Based Multi-Database Clinical Evidence Retrieval Application for Physicians

Type: Undergraduate
Author(s): Caroline Olson Interdisciplinary
Advisor(s): Keith Whitworth Interdisciplinary

Physicians face increasing difficulty accessing relevant clinical evidence due to time constraints and the fragmentation of biomedical literature across multiple databases. Existing search platforms often require separate queries and may prioritize a single source, limiting the breadth and efficiency of evidence retrieval. This project aimed to develop and evaluate an artificial intelligence (AI)-based system designed to aggregate and prioritize clinical information from multiple open-access medical databases.
A multi-source retrieval tool was developed that integrates results from PubMed, Semantic Scholar, Directory of Open Access Journals (DOAJ), CORE, the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), PLOS, and the National Network of Libraries of Medicine (NNLM). The system uses AI-assisted query processing and a source-weighting strategy to prioritize databases based on relevance to the query topic. Design decisions emphasized accessibility, ethical use of open-access content, and integration with clinical workflows.
Preliminary testing using representative clinical queries demonstrated the system’s ability to retrieve evidence from multiple complementary sources, increasing evidence diversity compared to single-database searches. Informal physician feedback highlighted the potential value of integrated retrieval for improving search efficiency and supporting evidence-based decision-making.
This work represents an early-stage clinical informatics approach to addressing information overload in healthcare. Future work will include structured usability testing with physicians, refinement of source prioritization algorithms, and evaluation of time savings and clinical relevance. AI-driven evidence aggregation tools may support more efficient clinical decision-making and improve access to high-quality medical information.

A Systematic Review of Pre-medical Gap Year Literature

Type: Undergraduate
Author(s): Katherine Richey Interdisciplinary
Advisor(s): Christina Ayala Interdisciplinary Matt Chumchal Biology

Frogs Aiding Dragons College Initiative

Type: Undergraduate
Author(s): Katie Robb Interdisciplinary
Advisor(s): Christina Ayala Interdisciplinary

The Frogs Aiding Dragons College Initiative works with the TCU organization Frogs Aiding Immigrants and Refugees (FAIR) to support Fort Worth immigrant and refugee communities, especially through partnerships with the International Newcomer Academy (INA). INA is a school specifically for 6th-9th grade refugee students. Many of these students have had no educational background or don’t fluently read or speak English. So, the goal of Frogs Aiding Dragons College Initiative is to encourage students to continue pursuing an education and convey that college is a possible goal for them. We work with a group of 62 9th graders where we bring them to TCU and host a Thanksgiving feast, campus tour, and panel with TCU immigrant students. We then bring the college experience to INA with presentations and hands-on activities from various students representing various TCU departments, including Chemistry, Pre-Health, the Fine Arts, and Engineering. We assess the effectiveness of this initiative using a survey measuring INA students’ attitudes towards desire to attend college, how much they know about college, and if they feel like they have more resources to apply to and attend college.

Simulation-Based Training for Intraosseous Access Using a 3-D Printed Model: Evaluation of Learner Performance and Confidence

Type: Graduate
Author(s): Jimmy Zaarour Interdisciplinary
Advisor(s): Michael Bernas Interdisciplinary

Background and Hypothesis
Intraosseous (IO) access is a critical emergency procedure used when rapid vascular access cannot be obtained through traditional intravenous routes. Despite its life-saving potential, many trainees have limited opportunities to practice IO placement in clinical settings. Simulation-based training offers a safe environment to develop procedural competency before performing the technique on patients. Advances in 3-D printing technology allow for the creation of realistic, cost-effective procedural models that may enhance hands-on training. We hypothesized that a 3-D printed IO training model would provide an effective and engaging method for novice learners to practice IO placement and would improve learner confidence in performing the procedure.

Methods
We conducted a simulation-based educational study using a custom 3-D printed IO training model designed to replicate relevant bony anatomy. Participants consisted of novice learners undergoing procedural skills training. Learners were provided instruction on IO access followed by hands-on practice using the 3-D printed model. Participants performed IO placement using a standard IO drill system. Following the training session, participants completed a survey evaluating their confidence in performing IO access and their perceptions of the model as a training tool. Descriptive analysis was performed to assess learner experience and perceived educational value.

Results
Participants reported that practicing IO placement on the 3-D printed model was an engaging and effective method for learning the procedure. Learners demonstrated the ability to successfully establish IO access using the simulation model. Post-training surveys indicated increased confidence in performing IO placement and positive perceptions of the realism and educational utility of the model.

Conclusion
Simulation training using a 3-D printed IO model provides an accessible and effective approach for teaching IO access to novice learners. Participants reported improved confidence and positive learning experiences after practicing with the model. These findings support the use of 3-D printed simulation models as a valuable tool for procedural education and informed the development of a follow-up study designed to further investigate procedural complications and technique optimization during IO placement.

Empirical Likelihood Inference for Linear Treatment Effects

Type: Undergraduate
Author(s): Isaac Hernandez Mathematics
Advisor(s): Nelis Potgieter Mathematics

In quantitative studies comparing a treatment and a control group, treatment effect is often viewed simply as the difference in group means. However, any treatment can have an impact beyond simply shifting the mean outcome. In this work, we consider a linear treatment effect (LTE) model, meaning we simultaneously consider the difference in means and the ratio of standard deviations between two populations to better characterize the effect of the treatment. Estimation is done using an empirical likelihood (EL) formulation. The EL framework provides a nonparametric approach for conducting inference without making strong assumptions about the underlying population model. Generally, the EL statistic has a limiting chi-square distribution. However, in small sample settings, the EL statistic can exhibit strong deviations from this ideal. To address this issue, we investigate the use of the Bartlett correction, which is a multiplicative adjustment to the EL statistic to improve the chi-square approximation. This correction has been shown to substantially improve confidence region coverage accuracy, especially for small and moderate sample sizes. Through simulation, we examine the performance of the EL statistic in the LTE model, with and without a Bartlett correction applied. Our results demonstrate that the Bartlett-corrected EL approach provides improved performance, yielding confidence regions with coverage closer to desired nominal levels.

Markov Chain Methods for Sequential Decision-Making in Liar’s Poker

Type: Undergraduate
Author(s): Derek Le Mathematics
Advisor(s): Drew Tomlin Mathematics

In this thesis, we introduce a way to implement Stochastic Processes - particularly Markov chain properties - for analyzing Liar’s Poker, a variant of Poker Texas Hold’Em that incorporates hidden information and a card-switching mechanic. Poker, and in particular Liar's Poker, presents a complex environment in which probabilities evolve as information is revealed and players make sequential decisions under uncertainty, so Markov modeling of this game requires a more flexible state-based representation. The study focuses on two main objectives: first, to construct a state space and transition matrix that are sufficiently compact for analysis while still capturing meaningful changes in hand-strength and game dynamic; and second, to investigate how the game’s exclusive card-switching feature can be incorporated into an optimal decision-making strategy. To address these goals, the thesis models gameplay as a sequence of probabilistic state transitions driven by card draws, hidden information, and strategic actions. By extending Stochastic Process methods to a poker setting with imperfect information and dynamic transition, this thesis aims to provide a structured mathematical framework for evaluating strategy in Liar’s Poker.

Heavy-Tailed Bayesian Models for Estimating Incurred But Not Reported Reserves

Type: Undergraduate
Author(s): Audrey Nguyen Mathematics
Advisor(s): Nelis Potgieter Mathematics

Incurred But Not Reported (IBNR) reserves refer to insurance claims that have already taken place, but have not yet been reported to the insurance provider. This presentation formulates a Bayesian modeling framework to estimate the IBNR reserves. The Bayesian framework allows us to incorporate prior knowledge, typically available from historical data and expert opinions, along with the observed claim data, to estimate model parameters and predict future claim liabilities. We emphasize prior models that have heavy tails and therefore can accommodate extreme, rare losses that can be underestimated otherwise. Specifically, we consider Pareto (Type I) and log-t models for the expected ultimate claim amounts for each insurance period. The data generating mechanisms considered are Poisson, negative binomial, and gamma. The analysis of real data also considers model sensitivity to the choice of the prior parameters. In doing so, we aim to produce more robust reserve estimates and better reflect the uncertainty inherent in unpaid claim liabilities. Ultimately, modeling IBNR reserves is important because it ensures insurance companies set aside sufficient funds to cover future claim obligations and avoid unexpected losses that could impact profitability.

Nutritional Management for Postoperative Chylothorax in a Pediatric Patient with Hypoplastic Left Heart Syndrome: Case Report

Type: Graduate
Author(s): Caroline Barclay Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Chylothorax is the accumulation of chyle within the thoracic or pleural cavity resulting
from thoracic duct leakage. This condition can arise from thoracic duct injury, increased
systemic pressure in the superior vena cava, and following the Fontan procedure for hypoplastic
left heart syndrome. Clinical manifestations include respiratory distress (coughing, shortness of
breath, and chest pain), milky fluid accumulation in the pleural cavity, and elevated triglyceride
and lymphocyte cell counts. Medical Nutrition Therapy (MNT) from registered dietitians is
instrumental in chylothorax management and treatment. Diet initiation is dependent on the
patients' individualized chest tube output, and strict fat restriction is vital to reduce chyle output.
General recommendations for limiting fat include <10 grams per day or <30% of total daily
calories. To prevent essential fatty acid deficiency (EFAD), which can occur within three to four
weeks of restriction, patients need a medium chain triglyceride (MCT) enriched diet and to
maintain two to four percent of calories from essential fatty acids. Signs and symptoms of EFAD
include poor wound healing, dry skin and rash, poor growth, and hair loss. Additional nutrition
concerns include increased protein requirements due to fluid losses, and the monitoring of fat-
soluble vitamins (A, D, E, K) and minerals (Calcium, Zinc) that bind to albumin. The case report
explores the complex nutrition needs, feeding timelines, and goals of care for a postoperative
chylothorax in a pediatric patient with hypoplastic left heart syndrome.

The Health Impacts and Perception of Wellbeing among Older Adults Participating in the Nature Rx

Type: Undergraduate
Author(s): Arikka Chavez Nutritional Sciences Anikka Chavez Nutritional Sciences
Advisor(s): Gina Hill Nutritional Sciences Gina Alexander Interdisciplinary Dennis Cheek Interdisciplinary Morgan Jansing Interdisciplinary Kristi Jarman Mathematics Brendan Lavy Environmental Sciences

Background: Chronic stress among older adults increases risk for depression, anxiety, cardiovascular disease, and cognitive decline. Nature-based interventions may improve psychosocial and physiological stress outcomes, though longitudinal evidence in aging populations remains limited.

Methods: A convenience sample of community-dwelling older adults (N = 21; M age = 74.14 ± 4.59 years; range 65–85) participated in a six-week Nature Rx intervention study conducted in partnership with the Fort Worth Botanic Garden and Texas Christian University. The program included three two-week modules meeting twice weekly: garden yoga, forest bathing, and vegetable gardening. Repeated measures for the Well-Being/Personal Health Index (WPHI), positive and negative affect, nature-relatedness, outdoor activity minutes were assessed at baseline and at three subsequent time points across the program. Measures for handgrip strength (HGS), and salivary cortisol were assessed at the beginning of the first and sixth weeks, respectively. Friedman tests with Bonferroni-adjusted post hoc comparisons evaluated changes in psychosocial outcomes. Paired t-tests and repeated-measures ANOVA assessed physiological outcomes. Analyses were conducted using available cases due to incomplete measurements across time points.

Results: WPHI scores did not significantly change over time, χ²(3, n = 18) = 1.886, p = .596. Positive affect significantly increased, χ²(3, N = 18) = 13.437, p = .004, with higher final scores compared with baseline (padj = .012) and Post 2 (padj = .018). Negative affect also showed a significant overall time effect, χ²(3, N = 18) = 11.131, p = .011, though pairwise differences were not significant after adjustment. Nature-relatedness and outdoor minutes did not change (all p > .05). HGS remained stable, t(18) = −1.08, p = .294, and strength classification did not significantly change (Wilcoxon W = 3.00, p = .157). Salivary cortisol significantly decreased from pre- to post-intervention, t(21) = 7.653, p < .001 (d = 1.63); ANOVA confirmed a significant condition effect, F(1, 12) = 33.09, p < .001, ηp² = .734.

Conclusion: The intervention was associated with increased positive affect and statistically significant reductions in physiological stress, despite minimal changes in global well-being or muscular strength. These findings suggest short-term nature-based programs reduce stress burden in older adults. Larger controlled studies are needed to confirm these preliminary results.

Nutrition Intervention in Critical Care for Small Bowel Obstruction with Underlying Severe Malnutrition: A Case Report

Type: Graduate
Author(s): Caroline Cheney Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Small bowel obstruction (SBO) is a partial or complete blockage of the small intestine preventing normal passage of gastrointestinal (GI) contents. Common causes of SBO include adhesions, hernias, tumors/malignancies, and inflammatory conditions. SBO leads to abdominal pain, distension, nausea, vomiting, malaise, dehydration, and lack of appetite. Persistent vomiting contributes to significant fluid, electrolyte, and nutrient loss, and catabolic stress. In the critical care setting, these effects have a greater significance in patients with underlying severe malnutrition. Reduced intake, nutrient malabsorption, and ongoing GI losses exacerbate energy and protein deficits leading to impaired immune function, delayed wound healing, increased morbidity and risk of excess complications, and increased length of stay. Early identification of nutrition risk and timely intervention are vital to mitigate complications including bowel ischemia, perforation, sepsis, and nutrient depletion. Evidence-based practice suggests parenteral nutrition (PN) as means of nutrition support when GI tract function is compromised or enteral nutrition (EN) is not tolerated or feasible due to excessive vomiting or required bowel rest. Cautious initiation and advancement of nutrition support and careful monitoring of electrolytes are critical to reduce the risk of refeeding syndrome in SBO patients with delayed nutrition support and underlying malnutrition. As the obstruction resolves, gradual reintroduction of oral intake is recommended through low-fiber and high-energy foods to support GI tolerance and nutritional status improvement. This case report explores the complex nutritional needs and goals of care in a patient with a SBO presenting with intractable nausea, vomiting, and pre-existing chronic severe protein-calorie malnutrition.

Nutrition Management for Continuous Renal Replacement Therapy in a Patient with Thyroid Storm and Acute Kidney Injury: A Case Report

Type: Graduate
Author(s): Addison Dart Nutritional Sciences Ashely Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is among the most metabolically complex conditions encountered in the intensive care unit (ICU). Medical nutrition therapy (MNT) plays a critical role in mitigating the consequences of AKI and CRRT, including hypercatabolism, electrolyte shifts, fluid overload, and amino acid losses, ultimately influencing morbidity and length of stay. Evidence-based guidelines support early enteral nutrition (EN) initiation within 24-48 hours of ICU admission in hemodynamically stable patients. Indirect calorimetry (IC) is the gold standard for energy assessment, however in practice, a weight-based predictive equation is commonly utilized due to limited availability of IC equipment. A standard polymeric formula is the first-line option for EN infusion and a renal-specific formula may be indicated when potassium, phosphorus, or magnesium levels are elevated. Protein requirements are substantially elevated in patients receiving CRRT, ranging from 1.5 to 2.5 g/kg/day, reflecting both continuous amino acid losses and the heightened catabolic state. Supplemental protein modulars may be utilized to meet these increased demands without contributing excess fluid or electrolytes. Ongoing monitoring is essential for safe and effective MNT and should include daily renal labs (creatinine, blood urea nitrogen, electrolytes), 24-hour intake, weight trends, and assessment of fluid accumulation. This case report demonstrates the application of evidence-based, individualized MNT emphasizing timely EN initiation, adequate protein delivery, careful electrolyte management, and interdisciplinary collaboration to optimize clinical outcomes in critically ill patients receiving CRRT.

Nutritional Management of Complicated Diverticulitis

Type: Graduate
Author(s): Paige DeBoyes Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Diverticulosis is the formation of several small pouches, called diverticula, within the intestinal lumen. Diverticulitis occurs when these pouches become inflamed. Risk factors for diverticular diseases include a chronically low-fiber diet, genetic predisposition, hypertension, type 2 diabetes, and obesity. Uncomplicated diverticulitis is typically managed through bowel rest and pain management. However, complicated diverticulitis, such as cases involving an abscess or fistula, often require surgical intervention, which can significantly impact nutritional status through subsequent complications during a hospital stay. Patients often experience inadequate oral intake due to prolonged diet restrictions, abdominal pain, nausea, vomiting, and fever. As a result, these patients are at increased risk for malnutrition and unintended weight loss, all of which may negatively impact recovery. The diet recommendations typically begin with complete bowel rest during inflammatory periods, with the eventual goal of gradually progressing to a high-fiber diet to prevent future recurrence. However, in patients with complications, diet progression may be delayed, requiring the initiation of enteral or parenteral nutrition to meet calorie and protein needs. Early nutrition intervention is critical to prevent further weight loss. This case report examines the diet progression following a diverticulitis flare-up with placement of colostomy in a patient who presented with severe, chronic malnutrition.

High Throughput Screening of Novel Small Molecules for the Identification of NRF2 Activators

Type: Undergraduate
Author(s): Megan DeMattia Nutritional Sciences Kayla Green Chemistry & Biochemistry McKale Montgomery Nutritional Sciences
Advisor(s): McKale Montgomery Nutritional Sciences

The transcription factor, Nuclear factor erythroid 2-related factor 2 (NRF2), functions by activating genes that help protect the body against oxidative stress, inflammation, and various toxins. Thus, identification of small molecules that can increase NRF2 activity could be helpful to increase the body’s natural defense system against chronic disease. The goal of this interdisciplinary project is to use cell lines generated by the Montgomery lab (Nutrition) that express a fluorescent NRF2 reporter to test a small library of novel compounds generated by the Green lab (Chemistry) for their NRF2 activation capacity. First, our reporter system will be validated with known NRF2 activators. We will then use a luciferase reporter assay to screen 15 novel compounds for their capacity to activate NRF2 compared to the known standards. These data can then be used to inform both labs about their antioxidant capacity and help optimize their furthered development and utility.

The capacity for chronic low-grade exposure to an oxidative stressor to protect against acute high-dose oxidative stress events in MCF7 breast cancer cells

Type: Graduate
Author(s): Katharine Evans Nutritional Sciences Leila Aguilar Nutritional Sciences
Advisor(s): McKale Montgomery Nutritional Sciences

In vitro studies are critical for elucidating the mechanisms contributing to disease development, such as how diet-induced obesity leads to increased risk and incidence of breast cancer. However, they are often limited to short-term trials which fail to mimic the prolonged exposure to energy excess that contributes to obesity development. This project investigates how acute and chronic exposure to the saturated fatty acid, palmitic acid, affects the oxidative stress response in MCF-7 breast cancer cells. In excess, palmitic acid increases cellular lipid load and can lead to the production of reactive oxygen species (ROS), ultimately resulting in inflammation and cellular damage. However, chronic exposure to low doses of oxidative stressors have been shown to be protective against acute stress events via a biologic process termed hormesis. The study compares short-term and long-term treatments to determine whether continuous exposure amplifies oxidative stress or activates cellular defense mechanisms. To do this, I have already been culturing MCF-7 cells in a low dose of palmitic acid, and will continue to do so for 3 months. Once cells have been chronically exposed to a low dose (50 µM) of palmitic acid, they will be acutely treated with a high dose (250 µM) of palmitic acid for 24-48 hr. Basal ROS production (before high dose treatment) will be compared ROS production after the high dose treatment in cells that have been chronically exposed to palmitic acid. Cells that have not been chronically exposed will serve as our controls. These studies will help us understand how chronic exposure to saturated fats, as occurs with diet-induced obesity, alters oxidative balance in breast cancer cells and contribute to a better understanding of how diet influences cancer progression and cellular stress responses

Ethical Considerations in Nutrition Support for an Older Adult with Dementia and Malnutrition: Case Report

Type: Graduate
Author(s): Jordan Fackler Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Malnutrition is a prevalent concern in older adults with dementia, due to disease progression causing oral feeding difficulties such as lessened interest in food, forgetting how to eat, food hiding behaviors, and dysphagia. Decreased oral intake is part of the natural progression for dementia, but this can be difficult for families to understand, and they often seek more aggressive forms of nutritional intervention, such as enteral nutrition feedings (EN). Although EN is frequently indicated for malnutrition, it has controversial ethical concerns within dementia patients, with little to no clinical benefit shown, and risk of complications. Current guidelines for dementia nutritional care emphasize comfort feedings, removing barriers to eating difficulties when able, and respecting patients’ desires and autonomy. Recognizing that dementia is a progressive, terminal illness that will not improve even with nutrition interventions is vital when making nutritional considerations in care. Educating the patient and family members on comfort centered care, providing favorite foods, and the natural progression of nutritional decline in dementia is essential to guide decisions surrounding whether or not to use EN. This case report explores a clinical dietitian's care plan for a 90-year-old malnourished female with dementia and food hiding behaviors, and the ethical care considerations discussed with her family to promote quality of life.

Optimizing Nutritional Status in a Patient with Severe Dysphagia and Dementia

Type: Graduate
Author(s): Natalia Flores Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Dementia-related dysphagia is a progressive complication of advanced neurocognitive decline characterized by impaired swallowing coordination. As swallowing function deteriorates, individuals are at increased risk for aspiration pneumonia, dehydration, inadequate oral intake, and malnutrition.
Aspiration occurs when food, liquid, or gastric contents enter the airway and lungs, increasing the risk of pneumonia and other respiratory complications. Medical nutrition therapy (MNT) interventions include modification of food and fluid consistencies in accordance with the International Dysphagia Diet Standardization Initiative (IDDSI) framework, in combination with postural and behavioral strategies to reduce aspiration risk. Individuals with dysphagia, are at risk for malnutrition due to difficulties meeting estimated energy and protein requirements, due to feeding difficulties, reduced appetite, and decreased acceptance of texture-modified diets. Percutaneous endoscopic gastrostomy (PEG) placement is generally not recommended in advanced dementia, as current guidelines emphasize comfort-focused feeding and quality-of-life-centered care. However, when oral intake becomes insufficient to maintain hydration and nutritional status, PEG feeding may be considered on an individual basis following careful discussion of prognosis, risks, benefits, and patient-centered goals of care. PEG placement does not alter the progression of dementia or demonstrate improved survival in advanced dementia, however it provides a route for nutrition support and medication delivery when appropriate. A comprehensive nutrition assessment, including anthropometric trends, laboratory data, nutritional needs, fluid balance, and functional status, is essential for formula selection and ongoing monitoring. This case report highlights the complexity of nutritional clinical decision-making and ethical considerations of nutrition interventions, and interdisciplinary collaboration for individuals with dysphagia and dementia.

Acute Effect of a Proprietary Blend Containing L-Arginine and Antioxidants on GLP-1 Release

Type: Graduate
Author(s): Katie Harnen Nutritional Sciences
Advisor(s): Elisa Marroquin Nutritional Sciences Elisa Marroquin Nutritional Sciences Ryan Porter Interdisciplinary

Background: Glucagon-like peptide 1 (GLP-1) is a key gut hormone regulating glucose homeostasis and satiety. This triple-blind, crossover, placebo-controlled randomized study investigated the effect of an L-Arginine-based supplement on active GLP-1 secretion, appetite, and food intake.

Methods: Sixteen participants (N=16) completed three conditions: a placebo and two doses of the supplement (Low-Dose, 5g; High-Dose, 10g). Supplements were consumed at time 0, and an ad libitum meal was consumed at 60 minutes. Serum samples were collected at eight time points over 120 minutes to assess circulating active GLP-1 levels.

Results: Supplementation with L-Arginine significantly augmented circulating GLP-1 levels compared to the control condition. Both doses triggered an immediate, transient rise in GLP-1, followed by a robust and significantly enhanced post-meal response relative to placebo. Analysis of the Area Under the Curve (AUC) confirmed this finding: total GLP-1 exposure was 607% greater in the High-Dose group (~ 340n pg/ml/min, p < 0.0001) and 544% greater in the Low-Dose group (~130 pg/ml/min, p = 0.0076) compared to placebo (~ 50 pg/ml/min). No significant differences in GLP-1 concentrations were observed between the two supplement doses. Secondary analyses found no differences in subsequent food intake or subjective hunger ratings between conditions, a result likely limited by the study’s power for these secondary variables (eta ~ 0.023).

Conclusions: L-Arginine is a potent secretagogue for GLP-1. These findings demonstrate that supplementation significantly increases the body's overall exposure to this crucial gut hormone, suggesting a potential role for L-Arginine in supporting metabolic health.

Nutrition Intervention for Surgical Wound Healing in a Patient with Metastatic Cancer and Obesity

Type: Graduate
Author(s): Amelia Heimerman Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Gastrointestinal (GI) surgical procedures are common interventions to alleviate complications, including obstructions, hernias, and tumor formation. Recovery from these procedures may include total GI tract rest, which affects a patient’s ability to meet their nutrient needs. Post-operative complications, such as a non-healing surgical site can result in the development of a wound, further complicating the nutritional needs of the patient. Unhealed, open wounds remain susceptible to surgical site infection (SSI) and impede a patient’s quality of life. Risk factors associated with impaired wound healing include comorbidities, infection, aging, malnutrition, and immunosuppressive therapy. The wound healing process requires the production and utilization of body proteins to repair damaged tissues, placing the body into a catabolic state. As a result, protein demands increase alongside the needs for micronutrients like vitamin A and C, selenium, zinc, and iron. High nutrient needs in conjunction with contraindications for utilizing the GI tract emphasize the need for non-oral nutrition support through intravenous nutrition, known as parenteral nutrition (PN). A timely, individualized nutrition plan of care with considerations of comorbidities that emphasizes increased protein, micronutrients, and PN is vital for GI surgical patients with wounds to promote healing and decrease the risk of SSI. This case report describes the medical nutrition therapy guidelines to care for a post-operative, non-healing surgical wound for a patient with cancer and obesity.

Utilizing Culinary Medicine to Strengthen Medical Nutrition Therapy to Prevent Progression of Cirrhosis

Type: Graduate
Author(s): Daniella Hernandez Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

Cirrhosis is the advanced stage of chronic liver injury marked by progressive fibrosis and hepatic dysfunction resulting from alcohol-associated liver disease, chronic viral hepatitis, or metabolic dysfunction. It may ultimately progress to decompensation with complications such as portal hypertension, ascites, variceal bleeding, and hepatic encephalopathy. Malnutrition and sarcopenia are highly prevalent in cirrhosis and are associated with increased hospitalization, infection risk, and mortality. Medical nutrition therapy (MNT) is a cornerstone of cirrhosis management that includes alcohol cessation, adequate energy intake, increased protein intake, sodium restriction, and avoidance of prolonged fasting. Despite clear guidelines, adherence is often limited by the practical ability to translate clinical recommendations into sustainable daily eating patterns. This case report explores culinary medicine as a preventative, skill-based intervention to reduce progression from compensated to decompensated cirrhosis by improving nutrition-related behavior change. Based on established cirrhosis guidelines, three culinary medicine targets are proposed: structured meal timing to support alcohol cessation, flavor-forward low-sodium techniques using herbs and spices, and intentional protein distribution to reduce catabolic stress. This framework demonstrates how integrating clinical nutrition with culinary skills may help patients apply nutrition recommendations through everyday meals and represents a feasible approach for incorporating culinary medicine into chronic disease management.

Managing Severe Malnutrition in the Postoperative Emergency Colostomy Patient: A Case Report

Type: Graduate
Author(s): Jaidyn Hooper Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

A colostomy is a procedure in which a portion of the colon is removed, the new end is externalized as a stoma, and an ostomy bag is worn to collect stool. Patients that have undergone a colostomy procedure face heightened risk of dehydration and electrolyte imbalances due to loss of colonic length. Additionally, fear of adverse symptoms can contribute to reduced oral intake and exacerbation of malnutrition. Post-operative ostomy nutrition education with a registered dietitian is beneficial to prevent complications, support recovery, and improve long-term nutritional status. Traditional post operative diet progression involves advancing to clear liquids once stoma output is established, typically on postoperative day (POD) two or later. However, evidence from enhanced recovery after surgery (ERAS) protocols and randomized trials supportsearly diet progression on POD zero or one can safely accelerate return to normal gastrointestinal function and reduce hospital length of stay. Diet tolerance should be monitored by lack of abdominal discomfort, passing of flatulence, and stoma output. Hydration status should also be closely monitored including serum sodium, blood urea nitrogen, and electrolytes. Nutrition education includes counseling on small, frequent meals; a low-fiber diet for approximately six weeks followed by gradual reintroduction to 25-30g of fiber/day; and individualized fluid recommendations with an additional 500-750mL/day to reduce dehydration risk. This case report describes post-operative nutrition management of a colostomy procedure with underlying malnutrition, emphasizing interventions of early diet advancement, nutrition support, and education to mitigate malnutrition exacerbation.

Nutritional Management of End-Stage Renal Disease Status Post Kidney Transplant

Type: Graduate
Author(s): Julia Knipfer Nutritional Sciences Ashley Mullins Nutritional Sciences
Advisor(s): Ashley Mullins Nutritional Sciences

End-stage renal disease (ESRD) represents the final stage of chronic kidney disease and is characterized by progressive loss of renal function, metabolic instability, inflammation, and increased risk of protein-energy wasting. Although kidney transplantation improves survival, the early post-transplant period remains clinically complex due to surgical stress, immunosuppressive therapy, and fluctuating renal function. These factors significantly increase energy expenditure, promote protein catabolism, and predispose patients to electrolyte abnormalities, underscoring the critical role of evidence-based medical nutrition therapy (MNT). Current standards of care recommend comprehensive nutrition assessment by a registered dietitian (RD) within the first 90 days post-transplant and routine monitoring of anthropometrics, intake adequacy, and biochemical markers. For metabolically stable post-transplant patients, energy needs are estimated at 25–35 kcal/kg/day, with higher targets of 30–35 kcal/kg/day in the early post-operative period. Protein recommendations increase to 1.2–2.0 g/kg/day initially to counter negative nitrogen balance and support wound healing. Sodium intake is generally limited to <2.3 g/day for blood pressure and volume control, while potassium and phosphorus are adjusted based on laboratory trends. If oral intake is inadequate beyond several days, enteral nutrition (EN) is recommended when gastrointestinal function permits, with parenteral nutrition (PN) reserved for cases where oral and EN routes cannot meet needs. This case report illustrates the application of evidence-based MNT standards in a post–kidney transplant patient during inpatient rehabilitation and highlights the integral role of RD-led care in supporting metabolic stabilization and clinical recovery.