Obstructive sleep apnea (OSA) is highly prevalent among older adults with type 2 diabetes mellitus (T2DM). Despite the impact of untreated OSA on poor glucose control, an intervention program targeting both conditions is lacking, particularly among veterans with comorbid OSA and T2DM, a high-risk population for increased mortality. This study aimed to describe experiences with managing OSA and T2DM among veterans with both conditions. We analyzed data from ongoing postal surveys of randomly selected 100 veterans who had medical diagnoses of comorbid OSA and T2DM, aged at least 50 years, and received health care at a Veterans Affairs facility in the prior 12 months. Of 22 completed surveys (mean age 69±9.22 years), 15 respondents (68%) were current positive airway pressure (PAP) device users. Self-reported average HbA1c was 6.75±1.00 (range 5.2-9.0). Veterans with higher HbA1c had experience with receiving more various types of diabetes management education (r=0.71, p<0.01). Veterans with less perceived levels of regular PAP use benefit on glucose control reported higher HbA1c levels than those with higher perceived levels of PAP use benefit (HbA1c 7.13±0.93 vs. 5.83±0.42, respectively; p=0.02). Current PAP users showed patterns of higher perceived benefit of the PAP use on improving sleep, sleep apnea, and overall health than the non-users. Only eight (36%) respondents reported receiving support from their family or friends on PAP use. Further studies need to investigate types of strategy addressing both PAP use and diabetes management feasible to this group, particularly those nonadherent to the PAP use and/or with uncontrolled HbA1c.

Corneal disease is the fifth leading cause of blindness, with limbal stem cell deficiency (LSCD) being a contributor. Cultivated limbal stem cells (LSCs) can be transplanted into the corneas of LSCD patients to replenish their LSCs, but the success of cultivated LSCs is highly dependent on the number of LSCs in the graft. Activation of the canonical Wnt/β-Catenin pathway is one conduit to increase the proliferation and maintenance of LSCs, thus improving the probability of success of cultivated LSC transplantation as treatment for LSCD. The transcription factor, PAX6, up-regulates Wnt-inhibitory factors such as sFRP, DKK1 and WIF1 in both murine and human cell lines. These inhibitory factors competitively inhibit the Wnt ligand from binding to the Frizzled and LRP receptors, thereby inhibiting the β-Catenin signaling process. In lens epithelial cells, TGF-β is a repressor of PAX6 expression. Therefore, we aim to characterize the role of PAX6 in modulating the Wnt/ β-catenin signaling process in LSCs. I hypothesize that TGF-β-induced inhibition of PAX6 will decrease expression of Wnt inhibitors and increase expression of LSC phenotype markers. To test my hypothesis, cultivated LSCs were treated with TGF-β1 and TGF-β inhibitor and tested for the expression of Wnt inhibitory factors sFRP, DKK1, and WIF1 as well as LSC phenotypic markers P63α and K12/K14. Preliminary data demonstrates PAX6 is highly expressed in cultivated LSCs compared to primary limbal cells. This suggests a role for PAX6 in cultivated LSCs and further investigation will elucidate PAX6 role in the maintenance of cultivated LSCs.

Being diagnosed with Type 2 diabetes is life changing within itself; working on top of that can present an even bigger challenge. Diabetes at Work is a pilot study that examines the impact that diabetes has on older working adults. This qualitative grounded theory study interviewed six employed adults over the age of 55. They opened up about how diabetes has affected their everyday lives and how it impacts their work lives. This secondary analysis highlights the importance of not just living with diabetes but changing lifestyles and truly embodying one’s diagnosis. Some participants embody their condition by changing eating habits, monitoring blood glucose regularly, taking insulin or medication as necessary, preforming activities to prevent diabetes-related complications, and routinely visiting one’s doctors. Embodying diabetes is much more than just being in control of one’s condition, but being attentive and committed to making diabetes management a constant factor in one’s lives. At the workplace, some participants left their diabetes at the door while others incorporated it into each aspect of their work lives. Managing diabetes as a working adult is not an easy feat, but this study provided valuable insight that could aid other older working adults with Type 2 diabetes.

Carbon dioxide mineralization is a viable alternative carbon dioxide emissions mitigation strategy in which carbon dioxide is sequestered and stored by the precipitation of thermodynamically favorable carbonate phases. For carbon dioxide mineralization, industrial waste streams with large cation concentrations (e.g., Calcium ions [0.01 - 1.0 mol/L]) react with dissolved carbon dioxide under alkaline conditions (pH > 9). An ion-exchange process has previously been proposed to provide the alkalinity required for carbon dioxide mineralization while utilizing industrial waste streams. In this work, thermodynamic simulations were performed using Gibbs Energy Minimization Selektor (GEMS) program to predict yields and purities of calcium carbonate (calcite) formed. The alkaline solution produced via ion-exchange and industrial waste streams was simulated to predict the final compositions of the solution to see how the final composition would affect the overall process. Industrial waste stream compositions were identified using the United States Geological Survey (USGS) database. Simulations were performed at varying CO₂ concentrations (100%, 50% 20%, 12%, 5%) at fixed waste stream compositions to quantify the effect carbon dioxide concentrations have on calcite yields, purities, and final solution compositions. The data collected shows acceptable yields (0.2 - 2.6 g/L calcite) and purities (>90% calcite) for calcite using industrial waste streams at each respective carbon dioxide concentration. Final divalent cation concentrations were predicted following treatment via nanofiltration and reverse osmosis, which resulted in total divalent cation concentrations less than <0.001 mol/L. The low divalent cation concentrations following mineralization and the large yields and purities of calcite simulated confirm that the overall mineralization process is viable using industrial waste streams.

This pilot study aims to investigate whether breathing practices activate interoceptive neural pathways that in turn activate a network of brain structures involved in emotion regulation. The 8 week reduction pilot through breathing practices aims to see whether these brain-physiology relationships change over an 8 week period when doing breathing stress reduction exercise. We will collect physiology data, screen for severity of stress, depression, and anxiety; and collect fMRI data at Week 0 and at post-intervention (Week 8). Subjects are randomized into 1 of 3 groups: GROUP 1: Breathing Awareness (BA),GROUP 2: Paced Breathing (PB) throughout, GROUP 3: Nature sounds (NS). Each group will complete their assigned 10-minute stress reduction intervention (provided via audio clips) 4 times a week for the 8 weeks. Subjects will complete online surveys each day they do a practice which will collect information on sleep, stress, anxiety, and physical activity over the prior 24 hours. BP will also be entered before and after their 10-minute practice. We have reached our minimum recruitment target of 12 participants for the pilot (6 Breathing Awareness, 3 Paced Breathing, 3 Nature sounds). We are currently recruiting more to try to hit our next target of 22 participants (10 BA, 3 PB, 3 NS). We are still working on collecting data and do not have any conclusions at the moment.

Neural injuries often cause lifelong impairment of motor, sensory, and cognitive functions, because the regenerative ability of axons is limited. While peripheral nerves can regenerate, the rate of growth is slow (~1mm/day), leading to long recovery times for patients. To address this issue, we are seeking to accelerate the rate at which axons regenerate. Our previous studies have shown that modulating actin dynamics, through the cofilin/Limk1 pathway, can regulate the growth rate of developing and regenerating axons. We are now developing an adult mouse model to modulate cofilin expression in the sciatic nerve, to determine whether increasing the level of cofilin can accelerate sciatic nerve regeneration. As a first step, we have assessed whether injecting adeno-associated viruses (AAV) carrying different forms of cofilin can alter gene expression in the sciatic nerve. Different AAV serotypes, gene promoters and injection sites were tested, and the prevalence of infection of the different viruses were analyzed in different tissues by immunohistochemistry. We find that direct injection into the sciatic nerve is the most effective method of elevating cofilin levels, but requires a high titer virus. We will next assess whether increasing cofilin levels improves the recovery of motor and sensory function, after a sciatic nerve injury.

Exponential growth in Internet of Things (IoT) devices and wearable sensing technologies has created an unprecedented opportunity to enable personalized medicine through real-time biomonitoring of individuals, enabling actionable feedback. Although commercialized IoT devices and wearable sensors are capable of tracking physical activities and vital signs, they fail to access molecular-level biomarker information to provide insight into the body’s dynamic chemistry. Thus, sweat-based wearable biomonitoring has emerged as one of the most promising candidates to merge this gap due to sweat being a rich source of biomarkers that can be retrieved unobtrusively. By specifically designing and integrating compact and flexible electrochemical sensors into wearable electronic devices, we can non-invasively, and accurately track these biomarkers and provide actionable feedback about users’ health status at molecular level. Additionally, we develop a novel sensor fabrication/integration methodology, which allows seamless and compact integration of electrochemical sensors in highly complex biological media. Our design consists of a battery-free electrochemical skin adhesive and Ion-Selective Electrode (ISE)-based sensor arrays for biomarker monitoring. The electrochemical adhesive utilizes Near Field Communication (NFC) for wireless power delivery and signal processing. The electrochemical sensor array is fabricated on anisotropic adhesive tapes for vertical integration of the sensors into a flexible sensing adhesive. As a result, this design methodology improves signal readout sensitivity by about three times. Thus, we can continuously track and monitor subjects’ biomarkers and underlying health status to provide actionable feedback and personalized prescriptions.