Background C1q TNF related protein 3 (CTRP3) is a relatively novel hormonal factor primarily derived from adipose tissue and has anti-diabetic properties. To determine if CTRP3 could play a role in early childhood development, the purpose of this study was to establish the presence of CTRP3 in breast milk (BM) and to determine whether CTRP3 levels were correlated with pregravid obesity status of the mother. Methods Breast milk was collected from breast-feeding mothers who had a pregravid body mass index (BMI) classification of normal weight (BMI 18–25 kg/m2, n = 23) or obese (BMI > 30 kg/m2, n = 14). Immunoprecipitation followed by immunoblot analysis confirmed the presence of CTRP3 in BM. The concentration of CTRP3 in BM samples was determined by ELISA. Additional bioactive components were also measured by commercially available assays: ghrelin, insulin, leptin, adiponectin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and glucose. Bioactive components in normal weight and obese mothers were compared using unpaired t-test (parametric) and Mann–Whitney U-test (non-parametric), as appropriate. Results The primary findings of this study are that the adipokine CTRP3 is present in BM and CTRP3 levels are increased with pregravid obesity. Additionally, this study independently confirmed previous work that BM from obese mothers has a higher concentration of insulin and leptin. Further, no differences were observed in BM between obese and normal weight mothers in ghrelin, adiponectin, IL-6, TNF-α, or glucose levels. Conclusion This study identified a novel factor in BM, CTRP3, and showed that BM CTRP3 levels higher in obese mothers. Because of the purported insulin sensitizing effect of CTRP3, it is possible that the elevated levels of CTRP3 in the BM of obese mothers may offset negative effects of elevated leptin and insulin levels in the BM of obese mothers. Future studies will need to be conducted to determine the relevance of CTRP3 in BM and to examine the presence of other adipose tissue-derived hormonal factors.

Abstract available in The FASEB Journal.

The purpose of this research was to determine if significant differences exist between the APACHE II scores of intubated mechanically ventilated patients who ultimately received a tracheostomy and those who did not. In addition to this inquiry, the study also investigated the possibility of a range of APACHE II scores, a particular age group, and the presence of chronic organ insufficiencies and their relationship to the tracheostomy result. Methodology was non-experimental, quantitative, and retrospective. It was observational in that the goal was to simply record and quantify the potential association between these variables. Data was obtained from patients at Bristol Regional Medical Center from January 1- August 31, 2011. Information was calculated using descriptive statistics and the t-test for independent samples. Participants included all intubated mechanically ventilated patients who were at least eighteen years of age with a documented APACHE II score in the allotted time frame. There were 468 total patients, 79 (16.9%) of which received a tracheostomy. The mean APACHE II score for patients who received a tracheostomy was 21.8354 as compared to the mean APACHE II score of 21.6735 for those who were extubated. There was no significant difference between the APACHE II scores of these groups. The tracheostomy group had the highest frequency of patients with APACHE II scores of less than 25 and a range of 20-29. 84.8% of tracheostomy patients had some form of chronic organ dysfunction. Respiratory failure was the most frequent admitting diagnosis for all 468 patients and respiratory insufficiency was the most prevalent co-morbidity for the tracheostomy patients. The age range that included more tracheostomy patients was 65-74. 40% of re-intubated patients eventually received a tracheostomy and 69.6% of tracheostomy patients had the procedure performed early (within the first seven days of intubation). The managerial team of this respiratory therapy department decided to stop calculating the APACHE II score on all intubated patients in an attempt to save time and staff resources.

East Tennessee has one of the most rapidly growing Hispanic population in the country. Further, it has been previously reported that this population is at an increased risk for developing metabolic syndrome (MetS), which is characterized by central obesity, abnormal blood lipids, hypertension, insulin resistance, and glucose intolerance. Our collaborators at the Johnson City Community Health Center (JCCHC) observed these indicators of MetS even in young children, between the ages of two and ten. The principle objective of this research project was to examine the prevalence of risk factors for MetS and establish an expanded metabolic profile of young Hispanic children. These factors have not been previously examined in this population. Our working hypothesis is that even at a young age markers of MetS, specifically dysregulated hormone levels, are present in this pediatric population. Methods: In this cross-sectional analysis, a total of 118 Hispanic children between 2-10 years of age (Mean 6.4 ± 2.7, 45% male) age adjusted anthropometric measurements and blood samples were obtained. Blood samples were analyzed for glucose, and lipids (triglycerides, LDL (low density lipoprotein) and HDL (high density lipoprotein) cholesterol) and C-reactive protein through ETSU clinical labs. Insulin, adiponectin, leptin, ghrelin, CRP, IL-6, and TNF-a levels were measured using commercially available assays (Bio-Rad® Multiplex Immunoassay System). Results: There was a significant positive correlation with leptin and adiponectin levels and BMI. Further, children with 2 or more risk factors for metabolic syndrome (as determined by age- and sex-specific: waist circumference, blood pressure, HDL, and triglyceride measures) had significantly elevated leptin levels. The proportional relationship between these metabolic hormone levels and the central obesity indicator confirms that metabolic abnormalities are present in the pediatric Hispanic population at a young age in Northeast Tennessee. The predisposition for this demographic developing metabolic syndrome is evident with indicators being present so early in life. With Tennessee being ranked third in the nation for Hispanic population growth rate, these findings indicate a need for early age intervention protocols for Hispanic children in order to reduce their risk of developing metabolic syndrome.

Traditional engineering and science teaching methodology has been to train like-minded students within the discipline of their respective majors. Curriculum time constraints, however, limit the number and nature of out of discipline elective courses. As a result, students are well trained within their respective fields of study but lack the breadth of experience in interacting with other diverse disciplines. Industry, particularly technology-based companies, has observed that solutions to problems have a greater probability of success when all interested parties (purchasing, innovation, marketing, sales, manufacturing, etc.) have input in developing a plan to achieve a desired corporate outcome. It is through this collective action of diverse disciplines that unique solutions are conceived. Many times breakthroughs in innovation and product development occur not through the actions of companies in direct competition but through new entrant companies by modifying technology currently residing in different markets and applications. The breakthrough occurs because the new entrants are not bound by the technology paradigms constraining innovation in their particular market arena. Our goal is to take the diversity lessons gleaned from industry and incorporate them into coursework that creates diverse cross-functional teams such that students learn the benefits of cross-discipline diversity. The College of Business and Technology at ETSU is itself a diverse blend of disciplines (Engineering Technology, Entrepreneurship, Human Nutrition, Marketing, Digital Media, etc) and several graduate and undergraduate courses residing in different departments within the college have intentional programs that encourage cross-discipline enrollment. This action is further facilitated through dual course listings between departments for the same course. Examples of diverse discipline teams will be discussed with attention to outcomes and challenges. Through this diverse cooperative program, students from the technology, business, applied human sciences and digital media disciplines gain a perspective for each other’s expertise and learn to develop teams with diverse skills to meet the increasing challenges for managing business and technology.

Infertility is one of the major complications of obesity. Studies have shown that administration of leptin modulated the expression of Β-catenin in the ovary and reversed obesity-induced infertility in rats. Coenzyme Q10 (CoQ10), an antioxidant, supplies the energy used for ovulation, oocyte and embryo development and prevents DNA damage that causes infertility. We hypothesized that leptin when combined with CoQ10 could greatly improve fertility. Twenty-one female Sprague-Dawley rats were used in this study and divided into five treatments groups. Group I rats was fed rat chow diet (RCD) while groups II to V were fed High-fat diet (HFD) for 14 weeks to induce infertility. Group 1 RCD and group II HFD control rats received 1 ml of saline intraperitoneally (i.p.) twice daily for 2 days, group III HFD rats received 1 ml of 100 µg of leptin i.p. twice daily for 2 days, group IV HFD rats received 10 mg/kg of CoQ10 i.p. for 2 weeks plus saline twice daily for 2 days. Group V HFD rats received 1 ml of 100 µg of leptin i.p. twice daily for 2 days plus 10 mg/kg of CoQ1o i.p. for 2 weeks. Estrous cycle was checked daily and food intake and body weight measured twice weekly before and after treatments. Fourteen days post treatment, all the animals were sacrificed. The blood and tissues were collected for analysis. The results show a significant decrease in food intake and body weight and regular estrous cycle restored in groups III and V rats. There was significant (p < 0.05) increase in spleen weight in groups IV and V. FSH level increased significantly (p < 0.05) in the leptin plus CoQ10 treated group while CoQ10 level was increased significantly (p < 0.05) in the leptin-treated group. Β-catenin expression was decreased in group IV and V, suggesting that Β-catenin expression may be downregulated by COQ10 administration. These results indicate that synergistic action of leptin and CoQ10 could delay the onset of obesity-induced infertility exhibited by the reduction of food intake and body weight. In conclusion, combinations of CoQ10 with leptin can improve fertility in obese infertile female rats and could provide a novel therapeutic strategy for the treatment of female infertility.

Technology translation can be achieved through the blending of the sciences and arts in the form of digital imagery. Digital animation and video can be utilized to portray molecular events where the mechanism of action is known but the process occurs at a sub-microscopic level. There needs to be a strong collaboration between scientific advisors and digital artists when creating the animation such that the artistic interpretation of the molecular event conforms to the known and accepted confines of science. The finished animation may be used for information, education or persuasion as entrepreneurial biotechnical companies attempt to find markets, customers and investors interested in their inventions. Educational institutions with programs in the sciences, arts, digital media and medicine need to promote the interaction of students from these disciplines through cross-functional teams and courses. Solutions to problems developed by these teams tend to be broader and more comprehensive than more homogeneous teams.

Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease yet it has been little studied in Hispanic children of rural areas. This pilot study aimed to estimate the prevalence of MetS and its components (high waist circumference (WC), elevated blood pressure (BP), high triglycerides (TRI), low high-density lipoprotein (HDL), and hyperglycemia) in a sample of Hispanic children aged 2 to 10 years from northeast Tennessee (TN). Between June and October 2015, 46 Hispanic children were recruited during their well-child visit at a community health center in Johnson City, TN. Anthropometric data, blood pressure readings, and a blood sample were collected. Descriptive statistics were used to estimate the prevalence of MetS and its components. Chi-squared test or Fisher’s exact test was used to test differences of proportions. Results showed that 41.3% of Hispanic children (mean age:6.8 years; SD:2.5) were overweight or obese (Body Mass index (BMI) for age and sex ≥85th percentile), 15.2% had a high WC (≥90th percentile for age and sex), 30.4% had elevated BP (systolic or diastolic BP for age, sex and height ≥90th percentile), 13.0% had low HDL (≤5th percentile for age and sex), and 45.6% had high TRI (≥95th percentile for age and sex). Overall, 17 (37%) children were negative for every component of MetS, 17 (37%) were positive for one component, 6 (13%) for two components, 5 (11%) for three components, and 1 (2%) for four components. The prevalence of MetS (≥3 components) was 13%. While the prevalence of MetS did not vary by sex, it tended to be higher (33.3%) in children aged 4 or younger than in 5 to 10 (12.1%) year olds (P=0.05). The prevalence of having 2 or more positivities for MetS was significantly higher among overweight/obese children than in children with lean weight (47.4% vs. 11.1%, P=0.03). Findings provide evidence that Hispanic children are at high risk for MetS. Prevention efforts should begin early and target children with elevated BMI.

Background. The diagnosis of metabolic syndrome is currently based on synthesizing measurements on five different biochemical and anthropometric scales. The logistics involved makes it less than an ideal screening test of cardiometabolic risk. Adipocytokines, c-peptide and ghrelin have emerged as important non-traditional biomarkers for understanding cardio-metabolic risk, and offer potential as tests of cardiometabolic risk. However, optimal sensitivity and specificity cut-offs of non-traditional biomarkers for detecting cardiometabolic risk are scarce, especially in pre-adolescent ethnic minorities. Objective. To assess the efficacy of 7 non-traditional biomarkers for detecting 3 or more cardiometabolic risk factors in pre-adolescent Hispanic children. Methods. The study population consisted of a healthy control group of 23 children and an at-risk group of 15 children aged 2-10 years with 3 or more cardiometabolic risk factors (blood pressure>=90th percentile; waist circumference >=90th percentile; triglycerides>=95th percentile; and HDL<5th >percentile) who were recruited as part of a larger pilot study of metabolic syndrome in Hispanic children receiving well-child care at a community health center in Johnson City, TN, from June 2015 to September 2016. T-test, Mann-Whitney U and Chi-squared tests were used to assess differences in characteristics of the two groups. Spearman’s correlation analysis was used to assess the relationship between biomarkers and cardiometabolic risk factors. ROC analysis and the Youden’s J statistic=maximum (sensitivity +(specificity-1)) were used to determine biomarker cut-off for optimal sensitivity and specificity. Data analysis was performed using SAS 9.4. Results. The mean age of the sample was 6.48 years (SD=2.74). About half of the sample were girls (50.5%). The at-risk group had significantly higher systolic blood pressure, triglyceride levels, waist circumference, leptin and C-peptide levels, but significantly lower HDL-C levels than participants in the control group. Leptin [r (38) = 0.3, p

Excerpt: The Cardiopulmonary Science Program at East Tennessee State University is housed within the College of Clinical and Rehabilitative Health Sciences (CCRHS) along with other health care programs including: Dental Hygiene, Imaging Sciences (Radiography, CT, MRI), Nutrition, Speech Language Pathology, Physical Therapy, and Audiology.