​The Ron and Joy Paul Kidney Center opened its doors at George Washington University in 2015. Ron Paul developed glomerulosclerosis, а condition that made his kidney fail, forcing him to undergo two transplants. This period made him realize that many don't understand kidney disease or transplants, and thus, he founded the center to promote education.

The center tackles an issue affecting millions of Americans. It focuses on closing the gap between organ supply and demand, encouraging more live kidney donations, and ensuring patients understand their treatment options. The statistics underscore the urgency of the center's mission. One in three American adults can develop kidney disease, yet awareness remains low - only about one in six with the condition knows they have it. Around 26 million American adults also live with chronic kidney disease, which kills more people than many realize.

To educate the masses, the Ron and Joy Paul Kidney Center uses its website as the primary teaching tool. Anyone can visit and learn the basics about how kidney disease. The content discusses kidney functions, from how it filters blood and balances fluids to the various diseases that affect it. Visitors can find clear explanations of symptoms, warning signs, and risk factors. The website relays all this information in plain language that readers can easily understand. 

The organization also promotes kidney education by emphasizing prevention. It focuses on overall health as the best defense. The center, through its website and qualified staff, offers nutrition advice, exercise plans, and lifestyle changes that people can adopt to reduce the risk of developing kidney disease.

Free kidney health screenings by Ron and Joy Paul Kidney Center make prevention accessible to all at no cost. Healthcare workers run these events monthly at places like K Street and Cedar Hill. The whole process takes about 15 minutes. Participants give a urine sample to check for protein, undergo blood pressure measurement, and answer a few questions about their health. Most participants learn their results right away and receive health guidance on the spot. If something looks wrong, the healthcare worker tells them to consult their regular doctor or see a kidney specialist. 

The center also runs public awareness campaigns throughout the Washington, DC area. The campaigns use TV commercials, radio spots, metro bus ads, and online content to reach people where they are. Other than teaching the public about kidney disease symptoms and why testing matters, these initiatives encourage people to act early and quickly by getting help from a healthcare worker before problems get worse.

The Ron and Joy Paul Kidney Center prioritizes increasing live kidney donations as a part of its mission. A living donor kidney starts functioning right away, carries а lower risk of organ rejection, and tends to last longer than one from a deceased person. Choosing to donate a kidney means making a personal decision. The center wants donors to learn all the facts first, including what the transplant entails, its aftermath, and what could happen years later.

Potential donors can find information about the transplant surgery process on the center's website. When a kidney becomes ready, a transplant coordinator notifies the patient. The patient goes to the hospital for medical checks and sometimes dialysis before surgery. Surgeons put the patient to sleep before they start the transplant. After surgery, doctors watch the patient and provide care. Doctors might do regular checkups and tests or change medication to ensure the new kidney functions properly.  

The center also works closely with the GW Hospital Transplant Institute to ensure smooth continuation of care. Doctors can refer people with kidney disease to this Institute. Partnerships with organizations like the National Kidney Foundation permit joint screening events and wider outreach campaigns.

​Regulatory authorities and management use the financial health of a financial institution as a metric to decide on subsequent actions and investors to determine whether to commit funds to the stock. The two commonly used benchmarks financial institutions use are the Net Interest Margin(NIM) and the Net Interest Income (NII). The difference between the two is the mode of presentation - percentage versus numerical value, calculation, and affecting factors.

The NIM  refers to income the financial institution earns by offering financial products like mortgages and lines of credit, such as standard loans. From this income, the financial institution deducts interest paid on saving accounts and certificates of deposits(CD) to obtain the final income. CDs represent a definite type of savings account where the financial institution agrees to pay a fixed amount of interest, typically half or full year, on money deposited by the client. After the period matures, the financial institution pays the principal account plus the accrued interest.

NIM, a percentage, indicates the financial institution's long-term financial health. Investors use NIM to determine whether to invest in a financial institution by using it to calculate the return on investment (ROI).

Several factors affect a financial institution's NIM, specifically financial product characteristics. Institutions with more savings accounts than credits indicate that the financial institution will have to pay more interest and have a low NIM. However, if loans outpace savings accounts, the borrowers will pay more interest to the bank than the interest payments the bank pays out, indicating a higher NIM.

Through monetary policies set by the central banks, the government significantly affects the NIM due to the fluctuating interest rates on savings and loans. For example, people and businesses borrow more when the interest rates drop, creating a favorable environment for higher increased NIM than when the interest rates rise, reducing borrowing.

Thirdly, maturity transformation can affect the NIM, which refers to a process where financial institutions, including banks, borrow funds with short repayment periods and lend them for a long-term duration. It provides the financial institution with cash flow for expenses and customer liquidity and earns the financial institution through the differences in interest between the short and long durations.

Conversely, NII refers to the financial difference metric between the revenue generated from investments through interest payments and the expenses from financial liabilities the financial institution owes, like corporate bonds. NII enables the bank to operate and offer standard and uninterrupted services like loans and survival during harsh economic times, and it also generates revenue.

Financial institutions like banks hold several different assets, including mortgages, commercial, real estate, personal and auto loans, and securities. The liabilities of interest comprise customer accounts requiring interest, like savings accounts. The changes in interest rates for individual assets and liabilities, often based on the central bank, determine the NII earned by the financial institutions.

Therefore, different financial institutions focus on assets and liabilities to maximize the final ROI. For example, a credit card loan often has a higher interest rate than insurance, which typically takes a long time to process claims compared to credit card holders' frequent purchases. Therefore, the ultimate MII depends on the portfolio of assets and liabilities.

Finally, NII serves as the primary financial performance measure for the institution. It helps determine the quality of the loan portfolio, aids the institution in deciding on the quality of the assets that generate interest and reduces or eliminates the non-performing assets. Also, the NII helps investors evaluate the financial health of institutions like banks when deciding whether to purchase stock.

Ronald D. Paul was born and raised in Oceanside, New York, and came from the Washington, D.C., area to attend the University of Maryland, where he earned a BA in accounting in 1980, he began his career in real estate investment, and in 1987, formed his own investment firm, Ronald D. Paul Companies Inc. The company has real estate holdings throughout the Washington Metropolitan area, as well as in Philadelphia, New York, Texas, Florida and Iowa, including office building and multi-family apartment projects. He is active in private investments, which includes serving as Chair of Bethesda Investments, Inc., a private venture capital fund. As President of RDP Management, Inc., he is also engaged in the business of real estate management.

Paul served as Chair of the Board of Directors and Chief Executive Officer of Eagle Bancorp, Inc. and EagleBank, a community bank established in 1998 in Bethesda, Maryland, until his retirement in March 2019. Involved in community banking for 28 years. Paul was one of the founding board members of the Bank and was instrumental in the growth of the Bank’s size. With over $8 billion in assets and over 25 offices, EagleBank is the largest community bank headquartered in the Washington, D.C., Area.

In his late 20s Paul was diagnosed with glomerulosclerosis. The disease ultimately led to kidney failure and, eventually, the need for two kidney donations.

He received a kidney transplant from his broth, Steven B. Paul, at the Washington Hospital Center in 1990. Nineteen years later, he received a second transplant from Kathy McCallum, chief executive officer of Ronald D. Paul Companies.

In November 2015, The Ronald and Joy Paul Foundation, established the GW/Ron and Joy Paul Kidney Transplant Center, through a $2.5 million gift, to address the urgent need for community awareness of kidney diagnosis, treatment and donation.

“Joy and I felt very strongly, that if we could better educate the community, then we could hopefully reduce the amount of kidney failure,” says Ron Paul, chair and chief executive offer of Eagle Bancorp and Eagle Bank. “Should somebody in the end-stage renal failure, we want to be able to educate them on transplantation. It’s all about awareness and education. That’s what we’re going to be promoting through this center.”

​Commercial real estate lending refers to lines of credit to finance business-owned property in various forms of commercial activity. Borrowers include owners of industrial warehouses, real property like malls, and office blocks. The substantial funds required to build, renovate, and remodel commercial buildings often require financing from lenders like banks, private investors, large credit unions, and entities with substantial finances like insurance companies and pension funds. Thus, real commercial estate loans include owner-occupied mortgages, income-producing commercial mortgages, construction loans, and bridge loans.

Owner-occupied mortgages target property owned and occupied by the same business. The business must occupy at least 30 to 50 percent of the property. The mortgage payments emanate from the business's operating cash flow. In most cases, lenders undertake thorough research to establish whether the company's financial status is enough to serve the mortgage. Lenders use the 5C models to determine the company's creditworthiness by measuring the character, capacity, capital, collateral, and condition.

In addition, lenders, especially banks, evaluate the debt service coverage ratio to determine if the borrower's cash flow is sufficient for the loan's annual interest and principal amounts. The condition comprises the primary purpose of the borrowed fund. Compared to other commercial real estate loans, the maturity loans are relatively long and, on a reducing balance, can range between 15 and 25 years.

The second commercial loan is the income-producing commercial mortgage, which enables the property owner to purchase, refinance, renovate, or remodel the property. The cash flow to service the loan depends on the nature of the business and can range from sales to tenants' rental payments for retail property. In this aspect, the lender evaluates the nature and frequency of the cash flow, such as sales flow and the lease on the property. Also, the nature of the company determines the loan period to minimize the risk of default due to business change. For example, generic administrative offices would attract a longer duration than non-volatile companies like specialized factories.

Sometimes, developers and real estate investors come across viable projects but lack the funds for purchase. Construction loans are available for development from the ground or redevelopment of physical structures. Compared to other real estate commercial loans, it poses a high risk and unpredictability to the lender due to limited cash flow. To mitigate the two concerns, lenders typically offer the loan in stages as construction progresses on pre-agreed stages or time. However, the lender remits interest rather than cash payments. Upon development completion, the borrower repays the total amount disbursed in the project stages, plus interest.

Property developers use these loans because they can repay them using the proceeds from the property. However, other parties can still access this loan by using funds from the primary loan, such as the income-producing mortgages, to clear the construction loan.

Lastly, the bridge loan cushions the property owner from the repercussions of default by funding the deficiency. The short-term loan enables the borrower to meet repayment obligations, like servicing an income-mortgage loan during the low-tenancy season to avoid foreclosure. The characteristics include high interest rates and collateral like inventory.

There are four types of bridging loans. The first, the closed bridging loan, includes a predetermined repayment period for serving certainty upon maturity. An open bridged loan lacks a predetermined repayment date. The uncertainty means the lender deducts the interest from the loan advance and imposes higher interest rates than the closed bridge option.

In cases of a high risk of default on the bridge loan, lenders typically employ the first chance option, which means that when the finances stabilize, the funds, such as cash flows, service the bridge loan before other lenders. Another option is the second charge, which differs from the first only in that the borrower services the bridge loan after paying the other lenders.

​An unincorporated community, Bethesda, Maryland, is situated just northwest of the District of Columbia. This vibrant Montgomery County locale has a population of 66,316 and is predominantly residential.

Pedestrian-friendly shopping areas include Pike & Rose, which has various dining options, and a Canopy by Hilton boutique hotel. Bethesda’s Art & Entertainment District features various artist galleries and theaters, with the Imagination Stage combining repertoire theater performances with summer camps and after-school programs for aspiring actors.

The Bethesda Jazz and Supper Club is an art deco theater that has has been transformed into an elegant concert hall that features blues and jazz, while the Round House Theater is known for contemporary ensemble performances. Culinary favorites include the 60-year-old Bethesda Crab House, which offers seasonal soft shell crabs and oysters from the Chesapeake Bay and crabs shipped fresh from Louisiana.

The crown jewel of the community is the Strathmore, an 11-acre property which both serves as an arts destination and houses an historic mansion. The area was originally the site of a toll road connecting the cities of Frederick and Georgetown. With one tollgate situated at the present Strathmore Avenue intersection, a farm here offered amenities for travelers such as blacksmith shop and stagecoach station as early as the 1820s.

Captain James Frederick and Emma Oyster, a prominent Washington DC couple, purchased the property in 1899 and architect Appleton P. Clark, Jr. oversaw the creation of a nine-room summer home in the Colonial Revival style. The property was acquired by the Corby Family a dozen years later and they created a Georgian facade, whole purchasing 2,560 acres surrounding. In its heyday, the property featured a greenhouse complex, working dairy farm, and private golf course.

During the war, President Manuel L. Quezon took residence in the mansion and set up the Commonwealth of the Philippines’ temporary government headquarters here, as his country was under occupation by Japan. The mansion was subsequently transformed into a Catholic convent and the school Saint Angela Hall. Parceled off many years ago, the former property now houses Holy Cross Academy, Garrett Park Estates, and the Grosvenor-Strathmore Metro station.

In 1979, Montgomery County purchased the core acreage around the mansion for use as a nonprofit center for the arts. Since 1983, various concerts and visual arts exhibitions, as well as weddings, have been held at the mansion. In 2005 the landmark 1,976 seat Music Center at Strathmore was built on the grounds and this serves as an enduring home for the Baltimore Symphony Orchestra, CityDance, National Philharmonic, and several other performing arts organizations. The Bloom initiative was launched in 2016 and represents a Montgomery County schools partnership that reaches 23,000 students annually.

Bethesda also offers an attractive business climate, with its convenience to DC coupled with a highly educated population. Its downtown workforce stands in excess of 43,000, with the Bethesda Metro station handling 15,000 passengers daily. Major employers include The National Institutes of Health, Marriott International, Lockheed Martin, and the Johns Hopkins Suburban Hospital. The community is also home to the Naval Support Activity (NSA) Bethesda, which houses the Walter Reed National Military Medical Center.

The Ronald D. Paul Companies maintain multiple commercial properties in the area, including the Highland Park Building, which offers 46,805 square feet of first-class office space. A well-appointed lobby features glass doors and windows on three sides, marble floors, recessed lighting, and ceilings finished with ornate woodwork. Among the tenants are a pediatric neurologist, two law practices, real estate development firms, psychiatry and counseling centers, and a national professional services organization.

With 105 garage spaces, the location fronting East-West Highway is a short walk from the Bethesda Metro station and the Wisconsin Avenue and Old Georgetown Road intersection. Another portfolio property, 830 Old Georgetown Road, is also multi-tenant and pairs 53,165 rentable square feet with parking for 100 cars. The office building features include upscale common areas and an outside terrace with seating.

​The two primary development types in real estate are commercial and residential, which differ in several ways. Both have different purposes, scales, zoning, code requirements, and the professionals involved in the projects. 

Commercial and residential developments have different purposes. The former refers to structures that provide functional working spaces for industries and businesses, including office buildings, warehouses, hotels and restaurants, and production factories. Commercial developments optimize ergonomics, functional layout, energy efficiency, and customization depending on the industry or business needs to achieve the two requirements.

In addition, commercial real estate accommodates the tenant's distinct needs, with varying designs for layout, plumbing, water and sewerage, power, ventilation placement, and security. For example, a building housing data servers may require a more complex heating and cooling system than a simple administrative office due to different temperature control needs.

Conversely, residential developments focus on comfortable and functional living spaces for individuals and families, focusing on floor plans, aesthetics, energy efficiency, landscaping, primary utility, heating, ventilation, and air conditioning (HVAC). The standard utilities in a regular residential development include plumbing, electric wiring, water, and sewerage.

From the basics, any additional features depend on preferred customization requirements, such as extra lighting, swimming pools, and additional security installations. Examples of residential developments include single—and multiple-family homes, apartments, and condominiums.

Next, the scale of the development differentiates the two. Depending on the purpose, commercial structures tend to be middle to large projects with large budgets, longer timelines, stringent and extensive design and planning, and more specialized personnel and professionals than residential development. It features various professionals, including architects, civil, mechanical, and structural engineers, contractors and subcontractors, legal counsel, and project managers.

Some projects may require more specialized expertise, like oil rig engineers. The professionals collaborate in various project stages, including site selection and evaluation, feasibility study, compliance, design, and construction. Once complete, there are minimal allowances for do-it-yourself (DIY) activities.

On the other hand, residential developments are smaller, depending on type, and involve fewer professionals. Most residential projects only require an architect, contractors and subcontractors, and utility professionals like plumbers, electricians, and HVAC technicians. Compared to commercial projects, residential projects have shorter timelines in most cases and less budget, depending on size. The design also allows for customization after the initial construction, and this may range from alterations to DIY projects like extensions and custom cabinetry.

Lastly, regulations, building and zoning codes, and permits differ between commercial and residential developments. The standards relate to design, documentation and drawings, construction materials and techniques, and safety installations. Depending on the industry, commercial developments have more stringent regulatory standards to ensure the safety of the occupants and the surrounding community.

The building codes for commercial development require inclusions like signage, accessibility regulations, structural standards, occupational safety, compliance with disability laws, energy and environmental design, and industry-specific standards. The zoning restrictions typically depend on the structure's purpose, and the local and state authorities provide the zoning mapping. For example, an office complex housing administrative businesses and shopping complexes may sit closer to residential developments for accessibility and convenience than an industrial complex with manufacturing factories; those sit further away from residential property due to safety or noise.

However, residential developments have less stringent zoning and building codes. The primary minimum requirements provide guidelines on construction materials, structural systems, utility availability, and placement, such as plumbing, heating, and air conditioning, and fire safety installations, such as fire escape inclusion.

​According to data from the United Network for Organ Sharing (UNOS), the US recorded 42,887 organ transplants in 2022, a 3.7 percent increase over the 2021 figure. Data shows that other developments in kidney transplants have also occurred, such as gaps between donor organ availability and patient needs for them.

Medical professionals performed 25,000 kidney transplants in 2021, compared to 25,498 in 2022, a 3.4 percent increase. The growing gap between donor organ availability and those who require a transplant and the long-term adverse effects of dialysis, such as limited mobility, infection, and cancer risk, have driven the need to develop alternative approaches to traditional kidney replacement technology.

Donor organ availability severely limits kidney treatment. The standard of care for end-stage renal disease (ERSD) patients is a kidney transplant or, when no organ is available, dialysis. However, kidney replacement technology continues to evolve to benefit those seeking transplants. For example, through the US National Science Foundation (NSF), those on the waiting list for a transplant can find donor matches through a computerized kidney matching system.

The computerized system has expanded the pool of potential live donors who can safely donate a kidney without harming their own health. NSF's mission remains to continue supporting advanced organ matching algorithms and increase successful transplants by improving donor-patient matching.

Significantly, many disruptive innovations have occurred since the first successful kidney transplant many decades ago, resulting in better outcomes in renal replacement therapy. Noteworthy innovations include immunosuppressive drugs, enhanced donor-specific detecting techniques for anti-HLA antibodies, and methodologies for diagnosing and managing viral infections.

These advances notwithstanding, plenty of unmet kidney transplant needs pose a threat to long-term health for the thousands who await a lifesaving transplant. Two recent technological advancements in the field of kidney transplantation field offer some hope. These technologies are implantable bioartificial kidney or BAK and regeneration technology. Both address donor organ shortages and the complications associated with long-term dialysis and immune-suppressants.

Creating an implantable bioartificial kidney can potentially help improve the patient’s quality and length of life. The technology relies on cell-based therapeutics to develop bioartificial kidneys. Specifically, the implantable bioartificial kidney leans on the scientific premise that medical professionals can replace dysfunctional or damaged cells in numerous disease scenarios.

Kidney regeneration technology has transformed kidney care. Developmental biology and stem cell technology advancements aim to create a transplantable kidney using the recipient’s own cells. Scaffolding is the kidney regeneration method currently in use. It provides the patient with structural support for organ vasculature. Further research on the scaffolding technology to facilitate kidney functionality continues.

In January 2024, the National Kidney Foundation (NKF) announced a strategic investment. Facilitated through its NKF Innovation Fund, the investment supports a pioneering biomedical company, ImmunoFree, which dedicates itself to reshaping the organ transplantation landscape. Kidney transplants carry several health risks, some directly connected to the surgical procedure, while others relate to organ rejection and the effect of using immunosuppressants (anti-rejection medications).

The NKF aims to eliminate the need for kidney transplant receivers to rely on immunosuppressive medications. NKF and ImmunoFree seek to enable kidney recipients to live healthier, longer lives free from immunosuppressive medication side effects and without fear of organ rejection.