The connection between hypertension and diabetes and their role in heart and kidney disease development.

Hypertension and diabetes are two common metabolic disorders that often coexist in the same individual. Their concurrence increases the risk of cardiovascular disease, renal dysfunction, and other complications. Cardiovascular disease is the primary cause of morbidity and mortality in individuals with diabetes, and hypertension further aggravates this condition. Interestingly, hypertension and diabetes share several common pathophysiological mechanisms including insulin resistance, vascular inflammation, endothelial dysfunction, obesity, and oxidative stress suggesting a cross-talk between these two conditions that could potentially contribute to the development of other human diseases. Effective management of diabetes should include a multifaceted approach that addresses not only glycemic control but also blood pressure (BP) and lipid control. Treatment plans should be individualized to each patient's needs and should involve a combination of lifestyle modifications and medications to achieve optimal control. With the availability of newer antidiabetic medications such as SGLT inhibitors and GLP1 receptor agonists, it is crucial to consider their potential to reduce BP, enhance kidney function, and lower the risk of cardiovascular diseases when initiating treatment for glycemic control. A more profound comprehension of the shared underlying mechanisms between these conditions could pave the way for the development of innovative therapeutic approaches to tackle them. Our review offers an in-depth analysis of the literature, providing a holistic view of the mechanisms underlying diabetes-hypertension comorbidity and its implications on heart and kidney diseases. The present article concludes by discussing current approaches for managing hypertensive diabetic patients to create a set of comprehensive individualized recommendations.

Financing national scale energy projects in developing countries - An economy-wide evaluation of Ghana's Bui Dam.

Large energy infrastructure can imply special financing arrangements between governments in developing economies and investors or lenders. These arrangements can lead to economy-wide and sector-specific impacts which need to be considered in the project economic evaluation. By considering the case of the Bui Dam in Ghana, we use a macroeconomic approach to determine how the economic performance of critical energy infrastructure manifests during the construction, financing and operation phases. The analysis uses an integrated modelling framework that combines a Computable General Equilibrium (CGE) model of Ghana with a water balance model of the Lower Volta River Basin. The results highlight the importance of including indirect and induced effects, in addition to the direct effects from project operation, as they influence the scale and temporal evolution of the economic impacts. The collateral from the infrastructure loan agreement consisting in cocoa exports to China nearly doubles the project's positive GDP impact and has a significant multiplier effect over urban and rural household income compared to a standard commercial loan. We finish with a discussion of how the proposed investment-oriented modelling framework can contribute to ex-ante strategic assessments of proposed energy infrastructure in developing countries.

Determining the risk of acute kidney injury in patients who underwent total joint replacement: A retrospective study.

OBJECTIVES: Total joint replacement (TJR) is a commonly performed procedure worldwide, and postoperative acute kidney injury (AKI) is one of the complications that determine the overall prognosis in various surgical settings. We aimed to identify the risk of AKI after TJR (primary and revision) and determine the factors associated with postoperative AKI. METHODS: We performed a retrospective study of 1068 patients (>18 years) who underwent TJR between 2014 and 2019 at a tertiary medical center. Patients' demographic, clinical, and laboratory data were reviewed. RESULTS: A total of 1068 patients were included in this study [mean age, 60.5 ± 13 years; 260 men (24.3%); 808 women (75.7%)]. A total of 962 patients (90.1%) underwent primary joint replacement (PJR) and 106 underwent joint revision (9.9%). Sixty-six patients (6.2%) had postoperative AKI. Primary total hip replacement patients had a lower risk of AKI than patients with other types of TJR (3.0%; p = 0.024). The factors associated with AKI (adjusting for known confounders) included male gender [adjusted odds ratio (AOR): 1.751; 95% confidence interval (CI): 1.01-3.03; p = 0.046], diabetes mellitus (DM) [AOR: 2.806; 95% CI: 1.687-5.023; p ≤ 0.001], hypertension (HTN) [AOR: 1.751; 95% CI: 1.159-3.442; p = 0.013], and the use of vancomycin as a prophylactic antibiotic [AOR: 1.691; 95% CI: 1.1-2.913; p = 0.050]. Chronic kidney disease (CKD) [AOR: 1.00; 95% CI: 0.432-2.27; p = 0.981] was not found to be a significant risk factor. CONCLUSION: In this study, the risk of preoperative AKI in patients who underwent TJR was 6.2%. Male gender, preoperative comorbidities such as DM and HTN, and preoperative use of vancomycin were associated with increased risk of postoperative AKI.

Donor site morbidity of the medial plantar artery flap studied with gait and pressure analysis.

BACKGROUND: The medial plantar artery flap (MPA) allows transfer of both glabrous (smooth and free from hair) and sensate tissue. It has been suggested that the non-weight bearing instep area of the foot provides tissue for transfer with minimal donor morbidity. However the abductor hallucis muscle and plantar fascia are dissected during flap harvest which may affect foot mechanics. METHODS: Patients were included who had undergone MPA flap harvest and were walking unaided. The majority of the patients studied had problems with soft tissues of their heels rather than trauma as a starting point. Laboratory normals and the patient's contralateral limb were used as controls. Gait and pressure analysis were performed using 3D gait analysis and high resolution pressure analysis. RESULTS: This study included 6 patients, with 5 chronic wounds (4 ipsilateral, 1 contralateral) and 1 traumatic ankle defect. QUESTIONNAIRE RESULTS: Enneking scores: 67.9% return to function; Foot Function Index scores: 39.1% loss of function. GAIT ANALYSIS: Significant differences were seen in kinetic and kinematic data. PRESSURE ANALYSIS: The donor site group had significantly less pressure in the great toe (38.1kPa vs. 78.1kPa, p=0.013), significantly slower transition through the midfoot (445.2ms vs. 352.07ms, p=0.016) and increased impulse in the heel (3.1kPa/s vs. 11.7kPa/s, p=0.038). CONCLUSIONS: This study demonstrates subjective and objective evidence of MPA donor site morbidity. Comparison to other studies looking at gait and pressure changes seen after flap reconstruction of the plantar region suggest that much of this difference may be attributable to ipsilateral reconstruction. As the majority had chronic problems with the soft tissues over the heel some of these biomechanical responses could be related to learned behaviour preoperatively or continued discomfort in the heel pad. Nonetheless it demonstrates accurately the effect of the technique overall on the function of the foot. The changes in the region of the great toe may be solely attributable to MPA harvest. These results suggest that MPA harvest is not free of donor morbidity.

Incidence and Molecular Detection of Genotypes for Giardia lamblia Isolated From Children in Zakho District, Duhok Province, Kurdistan Region, Iraq.

Giardia lamblia is a significant intestinal protozoan in humans worldwide, with a high incidence of infection in developing countries, particularly among children. Molecular analysis has identified eight assemblages (A to H), with A and B more frequently associated with human infections. Regardless of its importance, to the best of our knowledge, this is the first molecular study on assemblages in Giardia lamblia adopted in the Zakho district, province of Duhok, Iraq. The present study aimed to determine the giardiasis infection rate and identify the assemblages of Giardia lamblia in children from four areas in the Zakho district. We collected fecal samples and conducted a microscopic examination. Genomic DNA was extracted, and assemblage identification was done via amplification of the gdh gene using a semi-nested polymerase chain reaction and restriction fragment length polymorphism (RFLP). Out of 31 Giardia-positive samples, 23 were successfully amplified through semi-nested PCR. Nineteen isolates (82.60%) were assigned to assemblage B, and four (17.40%) to assemblage A. Assemblage B was identified as belonging to sub-assemblages B11 and B1V, while assemblage A was identified as sub-assemblages A1 and A11. This study provides insights about Giardia lamblia assemblages in the Zakho district, Duhok province, Iraq, and may serve as a beginning step toward understanding the molecular characterization of Giardia in the studied area.

One-Pot Synthesis of Amphipathic Esters for Demulsification of Water-in-Crude Oil Emulsions.

The current work aims to synthesize new amphipathic compounds, TGHA and PGHA, and investigate their demulsification performance (DP) in water-in-crude oil emulsions. Their chemical structures, thermal stability, interfacial activity, and micelle formation were investigated by different techniques. The bottle test method was used to investigate the effect of demulsifier concentration, water content, temperature, and demulsification time (DT) on the DP of TGHA and PGHA compared to a commercial demulsifier (CD). The results indicated that these parameters have a noticeable impact on the DP of TGHA and PGHA. The results also showed that TGHA exhibited higher DP than PGHA at all investigated parameters, which could be explained by increasing its hydrophobicity due to lower oxyethylene units in its structure than PGHA. An increase in these units means increased hydrophilicity, which led to obstruction of PGHA molecule diffusion in crude oil as a continuous phase. Moreover, TGHA gave a comparable DP with CD, as it gave a higher DP and shorter DT than CD at a higher water content (50%), while the latter achieved the highest DP and the shortest DT at a low water content (10%).

Efficient Demulsification of Crude Oil Emulsion Using Novel Sugar-based Surfactant.

This study aimed to synthesize ecofriendly and low-cost surfactant-based sugar, HA-ST, under mild conditions and a short route via an opening ring of hexadecylsuccinic anhydride (HA) using starch (ST). HA-ST's chemical structure, thermal behavior, and surface activity were evaluated using Fourier Transform Infrared (FTIR) spectroscopy, thermogravimetric analysis, and a pendant drop technique. The results indicated HA-ST formation, thermal stability, and surface activity. HA-ST's green character, low cost, and surface activity recommended its use as a demulsifier for crude oil emulsions at different affecting parameters such as temperature, seawater ratio (SR), demulsifier concentration, demulsification time (DT), and pH. HA-ST demulsification efficiency (DE) was evaluated and compared with a commercial demulsifier (CD). The results showed improved HA-ST's DE with rising temperature, SR, demulsifier concentration, DT, and pH. The DE of HAST reached 100% at 50% of SR and 250 ppm of demulsifier concentration; the same results were obtained using CD. In contrast, HA-ST gave relatively lower DE at low SR (10%) with a value of 70% than the obtained using CD with a value of 75%. The green character, low cost, and DE of HA-ST make it suitable for demulsifying crude oil emulsions, especially those containing more than 30% seawater, compared with CD, which commonly contains two or more traditional surfactants.

Adsorption and Inhibition Mechanisms of New Pyrazole Derivatives for Carbon Steel Corrosion in Hydrochloric Acid Solutions Based on Experimental, Computational, and Theoretical Calculations.

The study aims to synthesize two green pyrazole compounds, N-((1H-pyrazol-1-yl)methyl)-4-nitroaniline (L4) and ethyl 5-methyl-1-(((4-nitrophenyl)amino)methyl)-1H-pyrazole-3-carboxylate (L6), and test their action as corrosion inhibitors for carbon steel (CS) in a 1 M HCl solution. Both chemical and electrochemical methods, namely, gravimetric measurements (WL), potentiodynamic polarization (PDP), and electrochemical impedance spectroscopy (EIS), were used to assess the efficiency of the investigated molecules. DFT calculations at B3LYP/6-31++G (d, p) and molecular dynamics simulation were used to carry out quantum chemical calculations in order to link their electronic characteristics with the findings of experiments. The organic products exhibited good anticorrosion ability, with maximum inhibition efficiencies (IE %) of 91.8 and 90.8% for 10-3 M L6 and L4, respectively. In accordance with PDP outcomes, L6 and L4 inhibitors act as mixed-type inhibitors. Assessment of the temperature influence evinces that both L4 and L6 are chemisorbed on CS. The adsorption of L4 and L6 on CS appears to follow the Langmuir isotherm. Scanning electron microscopy and UV-visible disclose the constitution of a barrier layer, limiting the accessibility of corrosive species to the CS surface. Theoretical studies were performed to support the results derived from experimental techniques (WL, PDP, and EIS).

Efficient Oil Spill Uptake Using Surface-Modified Magnetite Nanoparticles with PET Waste Derivatives.

This work deals with poly(ethylene terephthalate) waste as a precursor to synthesize new cross-linked poly(ionic liquids) (CLPILs). The newly synthesized CLPILs, VPCT-Cl and VPCT-AA, were used for magnetite nanoparticle surface modification, producing VCL/Fe3O4 and VAA/Fe3O4, respectively. The chemical structures of the CLPILs and surface-modified Fe3O4 were elucidated by Fourier transform infrared and X-ray diffraction. Additionally, the particle size, zeta potential (ζ), contact angle, and magnetic properties of VCL/Fe3O4 and VAA/Fe3O4 were investigated using different techniques. Furthermore, the performance of these nanoparticles for oil spill cleanup was evaluated using various influencing factors, e.g., the contact time and the Fe3O4/crude oil ratio. VCL/Fe3O4 and VAA/Fe3O4 showed excellent performance in oil spill cleanup. The data showed that the performance increased with the contact time and the Fe3O4 ratio. Furthermore, the reusability of VCL/Fe3O4 and VAA/Fe3O4 over four cycles was also explored. The reusability data indicated that reused VCL/Fe3O4 and VAA/Fe3O4 showed promising performance in oil spill cleanup.

Magnesium Bismuth Ferrite Nitrogen-Doped Carbon Nanomagnetic Perovskite: Synthesis and Characterization as a High-Performance Electrode in a Supercapacitor for Energy Storage.

Bismuth ferrite (BiFeO3) is regarded as an important ABO3 perovskite in the areas of energy storage and electronics. A high-performance novel MgBiFeO3-NC nanomagnetic composite (MBFO-NC) electrode was prepared using a perovskite ABO3-inspired method as a supercapacitor for energy storage. The electrochemical behavior of the perovskite BiFeO3 has been enhanced by magnesium ion doping in the basic aquatic electrolyte as the A-site. H2-TPR revealed that the doping of Mg2+ ions at the Bi3+ sites minimizes the oxygen vacancy content and improves the electrochemical characteristics of MgBiFeO3-NC. Various techniques were used to confirm the phase, structure, surface, and magnetic properties of the MBFO-NC electrode. The prepared sample showed an enhanced mantic performance and specific area with an average nanoparticle size of ∼15 nm. The electrochemical behavior of the three-electrode system was shown by cyclic voltammetry to have a significant specific capacity of 2079.44 F/g at 30 mV/s in 5 M KOH electrolyte. GCD analysis at a 5 A/g current density also showed an enhanced capacity improvement of 2159.88 F/g, which is 3.4× higher than that of pristine BiFeO3. At the power density of 5284.83 W/kg, the constructed MBFO-NC//MBFO-NC symmetric cell showed an exceptional energy density of 730.04 W h/kg. The MBFO-NC//MBFO-NC symmetric cell was employed as a direct practical application of the electrode material to entirely brighten the laboratory panel, which had 31 LEDs. This work proposes the utilization of duplicate cell electrodes made of MBFO-NC//MBFO-NC in portable devices for daily use.

Balancing national economic policy outcomes for sustainable development.

The 2030 Sustainable Development Goals (SDGs) aim at jointly improving economic, social, and environmental outcomes for human prosperity and planetary health. However, designing national economic policies that support advancement across multiple Sustainable Development Goals is hindered by the complexities of multi-sector economies and often conflicting policies. To address this, we introduce a national-scale design framework that can enable policymakers to sift through complex, non-linear, multi-sector policy spaces to identify efficient policy portfolios that balance economic, social, and environmental goals. The framework combines economy-wide sustainability simulation and artificial intelligence-driven multiobjective, multi-SDG policy search and machine learning. The framework can support multi-sector, multi-actor policy deliberation to screen efficient policy portfolios. We demonstrate the utility of the framework for a case study of Egypt by identifying policy portfolios that achieve efficient mixes of poverty and inequality reduction, economic growth, and climate change mitigation. The results show that integrated policy strategies can help achieve sustainable development while balancing adverse economic, social, and political impacts of reforms.

Would Africa's largest hydropower dam have profound environmental impacts?

In the face of rapid growth in the global demands for water, energy, and food, building large dams is expected to continue. Due to its potential opportunities and risks for the people of the Eastern Nile Basin, the Grand Ethiopian Renaissance Dam (GERD) on the Nile River has commanded regional and international attention. Once completed, it will rank the largest hydropower dam in Africa and among the largest worldwide. Discourse among scientists and negotiators from Ethiopia, Sudan, and Egypt on the design, initial filling, and long-term operation of the GERD is ongoing since the construction started in 2011, but no agreement has yet been reached. The discourse has hitherto focused on the impacts on hydropower production, water availability, and irrigated agriculture, with little attention to the dam's potential environmental impacts. Here, we communicate our viewpoint on this gap, drawing on knowledge from other dams around the world and some GERD characteristics. The hydrological alterations associated with the GERD could adversely impact fish, aquatic plants, and biodiversity in the downstream due to possible changes in water temperature, salinity, and oxygen content. The GERD's expected flooded area, location at low latitude in the tropics, and the deep turbine intakes could intensify greenhouse gas emissions, whereas the dam's high reservoir depth would abate the emissions. The dam's electricity could also reduce regional greenhouse gas emissions if combined with cleaner intermittent solar and wind energy sources. With a maximum reservoir area of 1904 km2, surface evaporation and consequently local extreme precipitation and humidity could increase. The aforementioned impacts could have transboundary ecological, agricultural, and health implications and, therefore, should be taken into consideration alongside the benefits of the dam.

Collaborative management of the Grand Ethiopian Renaissance Dam increases economic benefits and resilience.

The landscape of water infrastructure in the Nile Basin is changing with the construction of the Grand Ethiopian Renaissance Dam. Although this dam could improve electricity supply in Ethiopia and its neighbors, there is a lack of consensus between Ethiopia, Sudan, and Egypt on the dam operation. We introduce a new modeling framework that simulates the Nile River System and Egypt's macroeconomy, with dynamic feedbacks between the river system and the macroeconomy. Because the two systems "coevolve" throughout multi-year simulations, we term this a "coevolutionary" modeling framework. The framework is used to demonstrate that a coordinated operating strategy could allow the Grand Ethiopian Renaissance Dam to help meet water demands in Egypt during periods of water scarcity and increase hydropower generation and storage in Ethiopia during high flows. Here we show the hydrological and macroeconomic performance of this coordinated strategy compared to a strategy that resembles a recent draft proposal for the operation of the dam discussed in Washington DC.

A quick and easy method of templating full-thickness skin grafts.

The authors would like to present a quick and easy method of templating full-thickness skin graft donor sites.

Sensitivity of Water-Energy Nexus to dam operation: A Water-Energy Productivity concept.

Understanding and modelling the complex nature of interlinkages between water and energy are essential for efficient use of the two resources. Hydropower storage dams represent an interesting example of the water-energy interdependencies since they are often multipurpose. The concept of Water-Energy Productivity (WEP), defined as the amount of energy produced per unit of water lost in the process, is introduced in this study to illustrate the relationship between energy generation and water losses by examining the sensitivity of the Water-Energy Nexus (WEN) to changing dam operation policy. This concept is demonstrated by developing a water allocation model of the White Nile in Sudan, including Jebel Aulia Dam (JAD), using a general river and reservoir simulation software called RiverWare. A number of 77 operation scenarios of JAD are examined for 30 hydrologic years (1980-2009), considering reducing the Full Supply Level (FSL) gradually from its current value to the minimum possible value, increasing the Minimum Operating Level (MOL) gradually to the maximum possible level, and operating the dam at a Constant Operating Level (COL). The results show that raising the operating level does not necessarily increase the WEP. In comparison to the current policy, the analysis shows that a maximum WEP of 32.6GWh/BCM (GWh/Billion Cubic Meters) would be reached by raising the MOL to 375masl (meters above sea level), resulting in an increase in average annual energy generation to 164.6GWh (+18.1%) at the expense of an annual water loss of 5.05BCM (+12.7%). Even though this operation policy results in a more efficient water use compared to the original operation policy, a basin-wide assessment that includes all hydropower storage dams in the Nile basin should be conducted to decide on where and how much energy should be generated. The present analysis and future examination of the multi-dimensions of the WEN in the context of dam operation are imperative to improve the decision making in the quest for efficient resource use and management.

Quantifying and evaluating the impacts of cooperation in transboundary river basins on the Water-Energy-Food nexus: The Blue Nile Basin.

Efficient utilization of the limited Water, Energy, and Food (WEF) resources in stressed transboundary river basins requires understanding their interlinkages in different transboundary cooperation conditions. The Blue Nile Basin, a transboundary river basin between Ethiopia and Sudan, is used to illustrate the impacts of cooperation between riparian countries on the Water-Energy-Food nexus (WEF nexus). These impacts are quantified and evaluated using a daily model that simulates hydrological processes, irrigation water requirements, and water allocation to hydro-energy generation and irrigation water supply. Satellite-based rainfall data are evaluated and applied as a boundary condition to model the hydrological processes. The model is used to determine changes in the long-term economic gain (i.e. after infrastructure development plans are implemented and in steady operation) for each of Sudan and Ethiopia independently, and for the Blue Nile Basin from WEF in 120 scenarios. Those scenarios result from combinations of three cooperation states: unilateral action, coordination, and collaboration; and infrastructure development settings including the Grand Ethiopian Renaissance Dam and planned irrigation schemes in Sudan. The results show that the economic gain of the Blue Nile Basin from WEF increases with raising the cooperation level between Ethiopia and Sudan to collaboration. However, the economic gain of each riparian country does not necessarily follow the same pattern as the economic gain of the basin.

Treatment of novel IL17A inhibitor in glioblastoma implementing 3rd generation co-culture cell line and patient-derived tumor model.

Despite many treatment options, cancer remains a growing problem and has become the second leading cause of death globally. Here, we present fluorescence molecular tomography (FMT) data regarding the reversion of third generation co-cultured U87+DBTRG and patient-derived GBM tumor model after treatment with novel IL17A inhibitor named FLVM and FLVZ (organic derivatives of caffeic acid). FMT was used to determine tumor angiogenesis volume (assessment of number of blood vessel; the expression of angiogenic factors CD34 and other angiogenic cancer bio-markers) in U87+DBTRG and patient-derived gliomas. Immunohistochemistry was used to determine microvessel density [CD34], and cell proliferation [Ki67]. Western blot was used to assess the interleukin 17A [IL17A], vascular endothelial growth factor [VEGF] and hypoxia-inducible factor-1α [HIF-1α]. Antibody array was used to assess the cancer bio-markers in co-cultured U87+DBTRG gliomas. Animal survival was found to be significantly increased (P<0.0001) after FLVM treatment compared with control-IL17A. After FMT detection, FLVM, administered orally, was found to decrease tumor growth (P<0.0001). FLVM and FLVZ administration resulted in significant decreases in tumor hypoxia [HIF-1α (P<0.05)], angiogenesis [CD34 (P<0.05)], VEGF, IL17A and cell proliferation [Ki67 (P<0.05)] and caused a significant increase of Bax, caspase and FasL (P<0.05), compared with untreated animals. Additionally, Leptin, LPL (P<0.01), FFA (P<0.05) and adipogenesis were downregulated and no additive toxicity was found in mice except calorie-restriction like effect. Use of FLVM can be considered as a novel inhibitor of IL17A for the treatment of human gliomas.

Swarming and mating behavior of male Anopheles arabiensis Patton (Diptera: Culicidae) in an area of the Sterile Insect Technique Project in Dongola, northern Sudan.

The problems facing the conventional mosquito control methods including resistance to insecticides have led to the development of alternative methods such as the Sterile Insect Technique (SIT) to suppress populations of the malaria vector Anopheles arabiensis in northern Sudan. This method entails the release of large numbers of irradiated males to compete against wild conspecifics for mating with virgin females in the field. The swarming and mating behaviors of this species were conducted at two field sites during the period 2009-2012 in Dongola, northern Sudan. Observations were made in the field sites and in a contained semi-field enclosure. In addition, participation of released irradiated-marked males in the swarms of wild mosquito was investigated. Swarms were observed on sunset in the vicinity of larval habitats around irrigation channel and stopped with the onset of the darkness about 21-25 min after the start. Swarms were observed above visual markers such as palm trees, bare ground, and manure. Several couples were observed leaving the swarms in copula in the direction of the sunlight. The majority of copulations were observed within 12-15 min of the start of swarming. Relatively low insemination rates (28%) of females collected from coupling pairs were observed. Irradiated-marked males were observed to join the natural swarms regularly, indicating their probable competitiveness with the other wild males. These findings enhance the feasibility of staging an SIT campaign against malaria vector in Northern State-Sudan.