Ultraviolet (UV) B effects on growth and yield of three contrasting sweet potato cultivars

Ground-level UV-B will stay at a high level in the next several decades and influence sweet potato growth and yield because of the remaining chlorofluorocarbons in the atmosphere. The study explored three UV-B (none, ambient, and elevated/projected) levels on three contrasting sweet potato cultivars (Beauregard, Hatteras, and Louisiana 1188) using sunlit plant growth chambers at Mississippi State University. The results showed that UV-B influenced three cultivars differently. Growth, photosynthetic rate, epidermal and leaf structure of Beauregard were negatively influenced under ambient and elevated UV-B. On the contrary, Hatteras was positively influenced, and Louisiana 1188 was influenced by elevated UV-B positively on leaf thickness and waxes content, but negatively on the vine length, dry mass, and leaf area. In summary, Beauregard, Louisiana 1188, and Hatteras were UV-B sensitive, moderately sensitive, and tolerant, respectively. Developing UV-B tolerant cultivars will benefit under both current and projected UV-B exposures

Utilization, costs, and outcomes for patients receiving publicly funded hemodialysis in India

Every year about 150,000 people develop end stage kidney disease (ESKD) in India, most of whom die without receiving treatment. In 2008, the state of Andhra Pradesh started public funding for hemodialysis (HD). We evaluated the coverage pattern, cost of care and outcomes of patients treated under this scheme. Unique identifiers and billing codes for HD, vascular access and hospitalisation were identified from claims database to construct utilisation, cost and outcome for subjects from 2008 to 2012. Outcomes were classified as death, dialysis discontinuation and kidney transplantation. Costs of HD, vascular access, and hospitalizations were calculated. A total of 13,118 beneficiaries (1.36% of all claimants, mean age 44 years, 73% males) received HD during the study period. The number of people who received HD increased from 29.5 pmp in 2008-09 to 122.2 pmp in 2012-13. Of all patients, 10% died and 37% dropped out in first 6 months. Median time on HD was 170 and 198 days for females and males respectively (p=0.0059). Mortality increased with age and was higher in women and in public hospitals. The average per patient annual expenditure on HD was US$ 4,820. Costs of HD as a proportion of the total healthcare spend increased from 0.78% in 2008-09 to 5.15% in 2011-12. Progressive increase in uptake confirms a high unmet need for renal replacement therapy. High mortality and dropouts suggest the contribution of factors beyond user fees to outcomes. Insurance coverage does not address all inequities in access and the barriers to maintaining long term dialysis care

Utilization, costs, and outcomes for patients receiving publicly funded hemodialysis in India

Every year about 150,000 people develop end stage kidney disease (ESKD) in India, most of whom die without receiving treatment. In 2008, the state of Andhra Pradesh started public funding for hemodialysis (HD). We evaluated the coverage pattern, cost of care and outcomes of patients treated under this scheme. Unique identifiers and billing codes for HD, vascular access and hospitalisation were identified from claims database to construct utilisation, cost and outcome for subjects from 2008 to 2012. Outcomes were classified as death, dialysis discontinuation and kidney transplantation. Costs of HD, vascular access, and hospitalizations were calculated. A total of 13,118 beneficiaries (1.36% of all claimants, mean age 44 years, 73% males) received HD during the study period. The number of people who received HD increased from 29.5 pmp in 2008-09 to 122.2 pmp in 2012-13. Of all patients, 10% died and 37% dropped out in first 6 months. Median time on HD was 170 and 198 days for females and males respectively (p=0.0059). Mortality increased with age and was higher in women and in public hospitals. The average per patient annual expenditure on HD was US$ 4,820. Costs of HD as a proportion of the total healthcare spend increased from 0.78% in 2008-09 to 5.15% in 2011-12. Progressive increase in uptake confirms a high unmet need for renal replacement therapy. High mortality and dropouts suggest the contribution of factors beyond user fees to outcomes. Insurance coverage does not address all inequities in access and the barriers to maintaining long term dialysis care

Immunohistochemical analysis of anti-phospholipase A2 receptor antibody on renal biopsies: A single tertiary care center study

Membranous nephropathy (MN) is one of the common cause of nephrotic syndrome. The discrimination between primary MN (iMN) and secondary MN is essential because of treatment implications. Immunohistochemical (IHC) evaluation with the help of anti-phospholipase A2 receptor (PLA2R) antibody helps in tissue evaluation of iMN, which is an easy, cost-effective, and pathologist-friendly technique. The study included 82 cases of MN over a period of 3 years. IHC using PLA2R antibody was performed on iMN and secondary cases with adequate tissue. Cases of minimal change disease (MCD) were included as control. Granular staining along the basement membrane in the absence of staining of podocytes was considered positive. Medical records were verified for clinical information, baseline biochemical parameters, details of viral markers, connective tissue disease profile, and basic imaging workup. Of the 82 cases of MN, 51 were iMN and 31 secondary MN (sMN). Thirteen MCD cases were included as control. IHC with PLA2R antibody showed a sensitivity of 91.8% and specificity of 95.1%, positive predictive value of 95.7%, and negative predictive value of 90.7% in the diagnosis of iMN. The other parameters, either clinical or laboratory, did not show significant differences between iMN and sMN groups. The results of PLA2R staining by IHC were comparable with other studies and showed a higher sensitivity (91.8%) and specificity (95.1%). IHC with anti-PLA2R antibody can be considered as the standard diagnostic approach to identify iMN and offer scope for individualized treatment