Combining downscaled-GRACE data with SWAT to improve the estimation of groundwater storage and depletion variations in the Irrigated Indus Basin (IIB).

The growth of agricultural production systems is a major driver of groundwater depletion worldwide. Balancing groundwater supply and food production requires localized understanding of groundwater storage and depletion variations in response to diverse cropping systems and surface water availability for irrigation. While advances through Gravity Recovery and Climate Experiment (GRACE) have facilitated estimating the groundwater storage (GWS) changes in recent years, the coarse resolution of GRACE data hinders the characterization of GWS variation hotspots. Herein, we present a novel spatial water balance approach to improve the distributed estimation of groundwater storage and depletion changes at a spatial scale that can detect the hotspots of GWS variation. We used a mixed geographically weighted regression (MGWR) model to downscale GRACE Level-3 data from coarse resolution (1° × 1°) to fine scale (1 km × 1 km) based on high resolution environmental variables. We then combined the downscaled GRACE-based GWS variations with results from a calibrated Soil and Water Assessment Tool (SWAT) model. We demonstrate an application of the approach in the Irrigated Indus Basin (IIB). Between 2002 and 2019, total loss of groundwater reserves varied in the IIB's 55 canal command areas with the highest loss observed in Dehli Doab by >50 km3 followed by 7.8-49 km3 in the upstream, and 0.77-7.77 km3 in the downstream canal command areas. GWS declined by -325.55 mm/year at Dehli Doab, followed by -186.86 mm/year at BIST Doab, -119.20 mm/year at BARI Doab, and -100.82 mm/year at JECH Doab. The rate of groundwater depletion is increasing in the canal command areas of Delhi Doab and BIST Doab by 0.21-0.35 m/year. Larger groundwater depletion in some canal command areas (e.g., RACHNA, BIST Doab, and Delhi Doab) is associated with the rice-wheat cropping system, low rainfall, and low flows from tributaries.

Evaluation of the relationship between serum carnitine levels and intradialytic complications in children with kidney failure.

BACKGROUND: Carnitine plays a crucial role in the metabolism of fatty acids as well as energy production. Previous research has suggested a significant decrease in carnitine levels in patients with kidney failure and those undergoing hemodialysis. Therefore, we designed this study to assess the prevalence and characteristics of carnitine deficiency and its association with hemodialysis complications in the pediatric population. METHODS: This research was a pilot study of 29 children undergoing hemodialysis. Before hemodialysis, a 5-mL blood sample was drawn from each patient through a peripheral vein to measure serum-free carnitine levels, complete blood count with differential, blood urea nitrogen (BUN), creatinine, and electrolytes. Each patient was observed for intradialytic complications, including muscle cramps and hypotension, during 12 sessions of hemodialysis. RESULTS: We included 26 participants with a mean age of 14.23 years undergoing hemodialysis. Carnitine deficiency was revealed in 54.8% of our participants. Also, there was no significant correlation between carnitine deficiency and age, gender, and BUN levels (P = 0.698, P = 0.43, and P > 0.05, respectively). Intradialytic complications, including episodes of hypotension and muscle cramps, were more frequent in patients with carnitine deficiency (P = 0.02, P = 0.01, respectively). Other reasons for muscle cramps, such as fluid overload, nutritional status, dialysis regimen, and other important lab results (phosphorus, magnesium, etc.), were ruled out. CONCLUSION: In conclusion, we found a higher prevalence of carnitine deficiency in pediatric hemodialysis patients. Carnitine deficiency was significantly associated with increased intradialytic symptoms, including muscle spasms and hypotension. Our results could support a potential role of carnitine supplementation in pediatric patients with kidney failure for controlling intradialytic complications, but this requires further investigation. A higher resolution version of the Graphical abstract is available as Supplementary information.