Evidence to Support a Putative Role for Insulin Resistance in Chronic Kidney Disease

Introduction: The primary cause of morbidity and mortality in the renal patient is a cardiovascular event. Insulin resistance (IR) contributes to this event by increasing cardiovascular disease (CVD) and accelerating rates of decline in kidney function. Here we review the historical background of IR in patients with chronic kidney disease (CKD) and present evidence for a role of IR in accelerating cardiovascular and renal diseases. Review: The high prevalence of IR in CKD patients is well documented. It is suggested that increased IR in the renal patient is caused by uremia as well as by other known factors in the general population. Patients with CKD have an alarmingly high risk for cardiovascular morbidity and mortality. There is overwhelming evidence to support a role for IR in increased CVD morbidity and mortality in the general population, which is likely to extend to CKD patients. Some of the traditional treatment measures for IR, such as metformin, may not be applicable to the renal patient. Other options include weight reduction, exercise, treatment of anemia to improve exercise tolerance, treatment of vitamin D deficiency, thiazolidinediones, and dialysis. IR is estimated by studying the relationship between blood glucose and the concomitant insulin level. Such measurement may help identify patients at increased risk for future cardiovascular events and guide treatment measures. Conclusion: Sufficient evidence supports the increased prevalence of IR in kidney patients. Treating IR may retard the progression of CKD and decrease the incidence of cardiovascular events in this high risk population. Keywords: chronic kidney diseass, cardiovascular disease, insulin resistanc

One-Year Results of Simultaneous Topography-Guided Photorefractive Keratectomy and Corneal Collagen Cross-Linking in Keratoconus Utilizing a Modern Ablation Software

Purpose. To evaluate effectiveness of simultaneous topography-guided photorefractive keratectomy and corneal collagen cross-linking in mild and moderate keratoconus. Methods. Prospective nonrandomized interventional study including 20 eyes of 14 patients with grade 1-2 keratoconus that underwent topography-guided PRK using a Custom Ablation Transition Zone (CATz) profile with 0.02% MMC application immediately followed by standard 3 mw/cm2 UVA collagen cross-linking. Maximum ablation depth did not exceed 58 μm. Follow-up period: 12 months. Results. Progressive statistically significant improvement of UCVA from 0.83±0.37 logMAR preoperative, reaching 0.25±0.26 logMAR at 12 months (P<0.001). Preoperative BCVA (0.27±0.31 logMAR) showed a progressive improvement reaching 0.08±0.12 logMAR at 12 months (P=0.02). Mean Kmax reduced from 48.9±2.8 to 45.4±3.1 D at 12 months (P<0.001), mean Kmin reduced from 45.9±2.8 D to 44.1±3.2 D at 12 months (P<0.003), mean keratometric asymmetry reduced from 3.01±2.03 D to 1.25±1.2 D at 12 months (P<0.001). The safety index was 1.39 at 12 months and efficacy index 0.97 at 12 months. Conclusion. Combined topography-guided PRK and corneal collagen cross-linking are a safe and effective option in the management of mild and moderate keratoconus. Precis. To our knowledge, this is the first published study on the use of the CATz ablation system on the Nidek Quest excimer laser platform combined with conventional cross-linking in the management of mild keratoconus

Evaluation of the Antimicrobial Activity of Four Plant Essential Oils against Some Food and Phytopathogens Isolated from Processed Meat Products in Egypt

Synthetic preservatives are widely utilized by the food industry to inhibit the microbial contamination and increase food safety and shelf life. The excessive utilization of synthetic preservatives can have a negative impact on human health and the environment. There is a great interest to find out natural substances as possible food-preservatives. The consumers' preference for food products with natural ingredients prompted food manufacturers to utilize natural-based preservatives in their production. It is worth noting that plant essential oils (EOs) among the natural-based substances have been efficiently used as antimicrobial agents against phyto- and food pathogens. The current study was conducted to evaluate the microbial contamination of three industrial meat products from five governorates in Egypt, identify the predominant bacterial and fungal isolates and determine the antimicrobial efficacy of some EOs (thyme, fennel, anise and marjoram) against the most predominant microbial isolates. A sensory test was also performed to estimate the customer preferences for specific organoleptic aspects of meat products after EOs treatment. Results showed that there is a promising antimicrobial activity of all studied EOs against some microbial isolates in a dose-dependent manner. In particular, thyme EO showed the highest significant antibacterial activity against P. fluorescence and E. coli. Whereas the marjoram EO showed the highest activity against P. aeruginosa. In addition, the sensory test revealed that the treatment with anise and marjoram EOs showed the highest acceptability by the testers and did not show significant differences on the organoleptic properties with respect to control. As overall, the obtained results of the current research are promising and proved feasibility of employing plant EOs as possible preservatives for processed meat products

Study of an Optimized Micro-Grid’s Operation with Electrical Vehicle-Based Hybridized Sustainable Algorithm

Recently, the expansion of energy communities has been aided by the lowering cost of storage technologies and the appearance of mechanisms for exchanging energy that is driven by economics. An amalgamation of different renewable energy sources, including solar, wind, geothermal, tidal, etc., is necessary to offer sustainable energy for smart cities. Furthermore, considering the induction of large-scale electric vehicles connected to the regional micro-grid, and causes of increase in the randomness and uncertainty of the load in a certain area, a solution that meets the community demands for electricity, heating, cooling, and transportation while using renewable energy is needed. This paper aims to define the impact of large-scale electric vehicles on the operation and management of the microgrid using a hybridized algorithm. First, with the use of the natural attributes of electric vehicles such as flexible loads, a large-scale electric vehicle response dispatch model is constructed. Second, three factors of micro-grid operation, management, and environmental pollution control costs with load fluctuation variance are discussed. Third, a hybrid gravitational search algorithm and random forest regression (GSA-RFR) approach is proposed to confirm the method’s authenticity and reliability. The constructed large-scale electric vehicle response dispatch model significantly improves the load smoothness of the micro-grid after the large-scale electric vehicles are connected and reduces the impact of the entire grid. The proposed hybridized optimization method was solved within 296.7 s, the time taken for electric vehicle users to charge from and discharge to the regional micro-grid, which improves the economy of the micro-grid, and realizes the effective management of the regional load. The weight coefficients λ1 and λ2 were found at 0.589 and 0.421, respectively. This study provides key findings and suggestions that can be useful to scholars and decisionmakers

A New CuSe-TiO2-GO Ternary Nanocomposite: Realizing a High Capacitance and Voltage for an Advanced Hybrid Supercapacitor

A high capacitance and widened voltage frames for an aqueous supercapacitor system are challenging to realize simultaneously in an aqueous medium. The severe water splitting seriously restricts the narrow voltage of the aqueous electrolyte beyond 2 V. To overcome this limitation, herein, we proposed the facile wet-chemical synthesis of a new CuSe-TiO2-GO ternary nanocomposite for hybrid supercapacitors, thus boosting the specific energy up to some maximum extent. The capacitive charge storage mechanism of the CuSe-TiO2-GO ternary nanocomposite electrode was tested in an aqueous solution with 3 M KOH as the electrolyte in a three-cell mode assembly. The voltammogram analysis manifests good reversibility and a remarkable capacitive response at various currents and sweep rates, with a durable rate capability. At the same time, the discharge/charge platforms realize the most significant capacitance and a capacity of 920 F/g (153 mAh/g), supported by the impedance analysis with minimal resistances, ensuring the supply of electrolyte ion diffusion to the active host electrode interface. The built 2 V CuSe-TiO2-GO||AC-GO||KOH hybrid supercapacitor accomplished a significant capacitance of 175 F/g, high specific energy of 36 Wh/kg, superior specific power of 4781 W/kg, and extraordinary stability of 91.3% retention relative to the stable cycling performance. These merits pave a new way to build other ternary nanocomposites to achieve superior performance for energy storage devices

Effects of administration of 10 nm or 50 nm gold nanoparticles (AuNPs) on blood profile, liver and kidney functions in male albino rats

This work aimed to investigate the effect of acute and chronic administration of gold nanoparticles (GNPs) on liver and kidney functions, blood glucose concentration, lipid profile, and haematological parameters in male albino rats. Two experiments were conducted. In acute study: Fifty-four adult mature male rats were randomly assigned into three equal groups (18 per group). Group 1 (control group): in which rats were received intramuscular (i.m) injection of 1 ml normal saline 0.9%. Group 2 (50 nm GNPs group): rats were i.m. injected with a single dose of 75 µg 50 nm GNPs/kg body weight (bwt). In Group 3 (10 nm GNPs group): rats were i.m. injected with a single dose of 75 µg 10 nm GNPs/kg bwt. In chronic study: Eighteen adult male rats were randomly divided into three equal groups (6 per group). Group І (control): rats were intramuscular (i.m) repeatedly injected with 1 ml normal saline 0.9% once/week 5 for weeks. Group 2 (50 nm GNPs): rats were i.m. injected with once/week with a dose of 75 µg 50 nm GNPs/kg bwt) for 5 weeks. In Group 3 (10 nm GNPs): male rats were i.m. injected with once/week with a dose of 75 µg 50 nm GNPs/kg bwt for 5 weeks, followed by 3 weeks washout period for all groups. Blood was collected at 3, 7, and 60 days in acute experiment, while, they were collected only before and after 2 months in chronic experiment. Acute and chronic administration of GNPs (10 or 50 nm size) in male albino rats induced no significant alterations for liver and kidney functions, lipid profile parameters and different haematological parameters at days 3 and 60 of the study. However, on day-7 post-treatment, GNPs-treated rats showed significantly (P &lt;0.05) higher serum ALT, AST, ALP, urea, creatinine, glucose, and different lipid profile and decreased HDL level. Chronic administration of 10 nm or 50 nm GNPs significantly (P &lt;0.05) decreased serum glucose levels. In conclusion acute or chronic administration of 10 nm or 50 nm GNPs could alter the liver, kidney functions and blood profile on day 7 post-treatment, however, these values returned to the normal levels on day 60 post- injection. Also, the chronic administration of GNPs induced a hypoglycemic effect in male albino rats

Excess Spin and the Dynamics of Antiferromagnetic Ferritin

Temperature-dependent magnetization measurements on a series of synthetic ferritin proteins containing from 100 to 3000 Fe(III) ions are used to determine the uncompensated moment of these antiferromagnetic particles. The results are compared with recent theories of macroscopic quantum coherence which explicitly include the effect of this excess moment. The scaling of the excess moment with protein size is consistent with a simple model of finite size effects and sublattice noncompensation.Comment: 4 pages, 3 Postsript figures, 1 table. Submitted to PR

Patient Frailty: Key Considerations, Definitions and Practical Implications

By 2020, the elderly (≥65-year-old) world population is projected to exceed one billion individuals. This demographic megatrend has brought topics such as physiological age and frailty to the forefront of medical research efforts around the globe. The concept of frailty has evolved significantly since the mid-twentieth century. The outdated stereotype of a “thin, stooped, slow octogenarian” has transitioned to a more scientific and objective understanding of the problem. Still, a comprehensive and concise definition of “frailty” remains elusive. Until such a definition is firmly established and universally agreed upon, clinicians continue to rely on the somewhat subjective conceptual framework of today. In this chapter, the authors review key issues pertaining to clinical management of frail patients, including diagnosis/identification, preventive strategies, therapeutic approaches, and common pitfalls. The relationship between frailty, various domains of life, and functional status is also discussed. Finally, we will touch upon the concepts of end-of-life and goals of care, focusing on their relationship to frailty