Management of hypertension and renin-angiotensin-aldosterone system blockade in adults with diabetic kidney disease: Association of British Clinical Diabetologists and the Renal Association UK guideline update 2021

People with type 1 and type 2 diabetes are at risk of developing progressive chronic kidney disease (CKD) and end-stage kidney failure. Hypertension is a major, reversible risk factor in people with diabetes for development of albuminuria, impaired kidney function, end-stage kidney disease and cardiovascular disease. Blood pressure control has been shown to be beneficial in people with diabetes in slowing progression of kidney disease and reducing cardiovascular events. However, randomised controlled trial evidence differs in type 1 and type 2 diabetes and different stages of CKD in terms of target blood pressure. Activation of the renin-angiotensin-aldosterone system (RAAS) is an important mechanism for the development and progression of CKD and cardiovascular disease. Randomised trials demonstrate that RAAS blockade is effective in preventing/ slowing progression of CKD and reducing cardiovascular events in people with type 1 and type 2 diabetes, albeit differently according to the stage of CKD. Emerging therapy with sodium glucose cotransporter-2 (SGLT-2) inhibitors, non-steroidal selective mineralocorticoid antagonists and endothelin-A receptor antagonists have been shown in randomised trials to lower blood pressure and further reduce the risk of progression of CKD and cardiovascular disease in people with type 2 diabetes. This guideline reviews the current evidence and makes recommendations about blood pressure control and the use of RAAS-blocking agents in different stages of CKD in people with both type 1 and type 2 diabetes.

Morphological factors associated with giant vacuoles with I-pores in Schlemm's canal endothelial cells of human eyes: A serial block-face scanning electron microscopy study

Increased intraocular pressure (IOP) is the main risk factor for primary open-angle glaucoma and results from impaired drainage of aqueous humor (AH) through the trabecular outflow pathway. AH must pass the inner wall (IW) endothelium of Schlemm's canal (SC), which is a monolayer held together by tight junctions, to exit the eye. One route across the IW is through giant vacuoles (GVs) with their basal openings and intracellular pores (I-pores). AH drainage through the trabecular outflow pathway is segmental. Whether more GVs with both basal openings and I-pores are present in the active flow areas and factors that may influence formation of GVs with I-pores have not been fully elucidated due to limitations in imaging methods. In this study, we applied a relatively new technique, serial block-face scanning electron microscopy (SBF-SEM), to investigate morphological factors associated with GVs with I-pores in different flow areas. Two normal human donor eyes were perfused at 15 mmHg with fluorescent tracers to label the outflow pattern followed by perfusion-fixation. Six radial wedges of trabecular meshwork including SC (2 each from high-, low-, and non-flow areas) were imaged using SBF-SEM (total: 9802 images). Total GVs, I-pores, basal openings, and four types of GVs were identified. Percentages of GVs with I-pores and basal openings and number of I-pores/GV were determined. Overall, 14.4% (477/3302) of GVs had I-pores. Overall percentage of GVs with both I-pores and basal openings was higher in high- (15.7%), than low- (12.6%) or non-flow (7.3%) areas. Of GVs with I-pores, 83.2% had a single I-pore; 16.8% had multiple I-pores (range: 2-6). Additionally, 180 GVs (90 with I-pores and 90 without I-pores) were randomly selected, manually segmented, and three-dimensionally (3D) reconstructed to determine size, shape, and thickness of the cellular lining. Size of GVs (including median volume, surface area, and maximal cross-sectional area) with I-pores (n = 90) was significantly larger than GVs without I-pores (n = 90) using 3D-reconstructed GVs (P ≤ 0.01). Most I-pores (73.3%; 66/90) were located on or close to GV's maximal cross-sectional area with significant thinning of the cellular lining. Our results suggest that larger size and thinner cellular lining of GVs may contribute to formation of GVs with I-pores. More GVs with I-pores and basal openings were observed in high-flow areas, suggesting these GVs do provide a channel through which AH passes into SC and that increasing this type of GV may be a potential strategy to increase aqueous outflow for glaucoma treatment.

Gapless Quantum Spin Liquid in the Triangular System Sr_{3}CuSb_{2}O_{9}

We report gapless quantum spin liquid behavior in the layered triangular Sr_{3}CuSb_{2}O_{9} system. X-ray diffraction shows superlattice reflections associated with atomic site ordering into triangular Cu planes well separated by Sb planes. Muon spin relaxation measurements show that the S=1/2 moments at the magnetically active Cu sites remain dynamic down to 65 mK in spite of a large antiferromagnetic exchange scale evidenced by a large Curie-Weiss temperature θ_{CW}≃-143  K as extracted from the bulk susceptibility. Specific heat measurements also show no sign of long-range order down to 0.35 K. The magnetic specific heat (C_{m}) below 5 K reveals a C_{m}=γT+αT^{2} behavior. The significant T^{2} contribution to the magnetic specific heat invites a phenomenology in terms of the so-called Dirac spinon excitations with a linear dispersion. From the low-T specific heat data, we estimate the dominant exchange scale to be ∼36  K using a Dirac spin liquid ansatz which is not far from the values inferred from microscopic density functional theory calculations (∼45  K) as well as high-temperature susceptibility analysis (∼70  K). The linear specific heat coefficient is about 18  mJ/mol K^{2} which is somewhat larger than for typical Fermi liquids.

Hopping-Induced Ground-State Magnetism in 6H Perovskite Iridates

Investigation of elementary excitations has advanced our understanding of many-body physics governing most physical properties of matter. Recently spin-orbit excitons have drawn much attention, whose condensates near phase transitions exhibit Higgs mode oscillations, a long-sought-after physical phenomenon [A. Jain, et al., Nat. Phys. 13, 633 (2017)NPAHAX1745-247310.1038/nphys4077]. These critical transition points, resulting from competing spin-orbit coupling (SOC), local crystalline symmetry, and exchange interactions, are not obvious in iridium-based materials, where SOC prevails in general. Here, we present results of resonant inelastic x-ray scattering on a spin-orbital liquid Ba_{3}ZnIr_{2}O_{9} and three other 6H-hexagonal perovskite iridates that show magnetism, contrary to the nonmagnetic singlet ground state expected due to strong SOC. Our results show that substantial hopping between closely placed Ir^{5+} ions within Ir_{2}O_{9} dimers in these 6H iridates modifies spin-orbit coupled states and reduces spin-orbit excitation energies. Here, we are forced to use at least a two-site model to match the excitation spectrum going in-line with the strong intradimer hopping. Apart from SOC, low-energy physics of iridates is thus critically dependent on hopping and may not be ignored even for systems having moderate hopping, where the excitation spectra can be explained using an atomic model. SOC, which is generally found to be 0.4-0.5 eV in iridates, is scaled in effect down to ∼0.26  eV for the 6H systems, sustaining the hope of achieving quantum criticality by tuning Ir-Ir separation.

First principles study of the electronic structure and magnetic properties of spin chain compounds: Ca3ZnMnO6 and Ca3ZnCoO6

We have studied the electronic structure and magnetism of the spin chain compounds Ca3ZnMnO6 and Ca3ZnCoO6 using density functional theory with generalised gradient approximation (GGA). In agreement with experiment our calculations reveal that high spin (HS) state for Mn(4+) ion and low spin (LS) state for Co(4+) ion stabilize the magnetic structure of the respective compounds. The magnetic exchange paths, calculated using Nth order muffin-tin orbital downfolding method, shows dominant intra-chain exchange interaction between the magnetic ions (Mn, Co) is antiferromagnetic for Ca3ZnMnO6 and ferromagnetic for Ca3ZnCoO6. The magnetic order of both the compounds is in accordance with the Goodenough-Kanamori-Anderson rules and is consistent with the experimental results. Finally we have investigated the importance of spin-orbit coupling (SOC) in these compounds. While SOC practically has no effect for the Mn system, it is strong enough to favor the spin quantization along the chain direction for the Co system in the LS state.

Evaluation of virus resistance and agronomic performance of rice cultivar ASD 16 after transfer of transgene against Rice tungro bacilliform virus by backcross breeding

Severe losses of rice yield in south and southeast Asia are caused by Rice tungro disease (RTD) induced by mixed infection of Rice tungro bacilliform virus (RTBV) and Rice tungro spherical virus (RTSV). In order to develop transgene-based resistance against RTBV, one of its genes, ORF IV, was used to generate transgenic resistance based on RNA-interference in the easily transformed rice variety Pusa Basmati-1, and the transgene was subsequently introgressed to rice variety ASD 16, a variety popular in southern India, using transgene marker-assisted selection. Here, we report the evaluation of BC3F4 and BC3F5 generation rice plants for resistance to RTBV as well as for agronomic traits under glasshouse conditions. The BC3F4 and BC3F5 generation rice plants tested showed variable levels of resistance, which was manifested by an average of twofold amelioration in height reduction, 1.5-fold decrease in the reduction in chlorophyll content, and 100- to 10,000-fold reduction in the titers of RTBV, but no reduction of RTSV titers, in three backcrossed lines when compared with the ASD 16 parent. Agronomic traits of some of the backcrossed lines recorded substantial improvements when compared with the ASD 16 parental line after inoculation by RTBV and RTSV. This work represents an important step in transferring RTD resistance to a susceptible popular rice variety, hence enhancing its yield in areas threatened by the disease.

Observation of S = 1/2 quasi-1D magnetic and magneto-dielectric behavior in a cubic SrCuTe2O6

We investigate the magnetic, thermal, and dielectric properties of SrCuTe2O6, which is isostructural to PbCuTe2O6, a recently found, Cu-based 3D frustrated magnet with a corner-sharing triangular spin network having dominant first and second nearest neighbor (nn) couplings (Koteswararao et al 2014 Phys. Rev. B 90 035141). Although SrCuTe2O6 has a structurally similar spin network, the magnetic data exhibit the characteristic features of a typical quasi-1D magnet, which mainly resulted from the magnetically dominant third nn coupling, uniform chains. The magnetic properties of this system are studied via magnetization (M), heat capacity (C p ), dielectric constant ([Formula: see text]), and measurements along with ab initio band structure calculations. The magnetic susceptibility [Formula: see text] data show a broad maximum at 32 K and the system orders at low temperatures [Formula: see text] K and [Formula: see text] K, respectively. The analysis of the [Formula: see text] data gives an intra-chain coupling, [Formula: see text], to be about  ≈  -  42 K with non-negligible frustrated inter-chain couplings ([Formula: see text] and [Formula: see text]). The hopping parameters obtained from the LDA band structure calculations also suggest the presence of coupled uniform chains. The observation of simultaneous anomalies in [Formula: see text] at [Formula: see text] and [Formula: see text] suggests the presence of a magneto-dielectric effect in SrCuTe2O6. A magnetic phase diagram is also built based on the M, C p , and [Formula: see text] results.

Phylogenetic analysis and biolistic infectivity of a cloned Sri Lankan cassava mosaic virus DNA-A from Tamil Nadu, India on Nicotiana benthamiana

The complete nucleotide sequence of Sri Lankan cassava mosaic virus (SLCMV) DNA-A isolated from cassava in southern India was analyzed, a phylogenetic analysis with other begomoviral nucleotide sequences was performed and an efficient inoculation method of Nicotiana benthamiana with the cloned DNA was developed utilizing a biolistic device. The nucleotide sequence showed the conservation of all functional begomoviral protein domains and aligned most closely with begomoviruses reported from the Indian subcontinent, except for begomoviruses of cucurbits and legumes. Upon biolistic inoculation of N. benthamiana with the cloned DNA, most plants became symptomatic and showed the accumulation of viral DNA within 21-28 days post-inoculation.

Measurement of arterial stiffness in subjects with and without renal disease: Are changes in the vessel wall earlier and more sensitive markers of cardiovascular disease than intima media thickness and pulse pressure?

There is increased cardiovascular (CV) mortality in subjects with chronic kidney disease (CKD). Arterial stiffness in these subjects is increased when compared to a healthy population. Markers of arterial stiffness and intima media thickness (IMT) are predictors of CV mortality. The aim of this study was to investigate whether there is any difference in markers of arterial stiffness and IMT between subjects with normal renal function and those with mild renal disease. The arterial distension waveform, IMT, diameter, and brachial blood pressure were measured to calculate Young's modulus (E) and elastic modulus (Ep) in the common carotid arteries of subjects with normal kidney function (estimated glomerular filtration rate [eGFR] >90) and those mild CKD (stage 2, eGFR 89–60). Data were available for 15 patients with normal kidney function and 29 patients with mild CKD. The subjects with mild CKD were older, but other co-variables were not significantly different. Both arterial wall stiffness parameters (E and Ep), but not IMT were significantly higher in the mild CKD group. Logistic regression demonstrated that only the arterial wall stiffness parameters (Ep and E) were independently associated with mild renal disease compared with normal, in a model adjusting for sex, age and diabetes and history of cardiovascular disease (CVD). E and Ep may be early markers of CVD in subjects with mild CKD that may manifest change before other more recognized markers such as IMT and pulse pressure.

NiS--an unusual self-doped, nearly compensated antiferromagnetic metal

NiS, exhibiting a text-book example of a first-order transition with many unusual properties at low temperatures, has been variously described in terms of conflicting descriptions of its ground state during the past several decades. We calculate these physical properties within first-principle approaches based on the density functional theory and conclusively establish that all experimental data can be understood in terms of a rather unusual ground state of NiS that is best described as a self-doped, nearly compensated, antiferromagnetic metal, resolving the age-old controversy. We trace the origin of this novel ground state to the specific details of the crystal structure, band dispersions and a sizable Coulomb interaction strength that is still sub-critical to drive the system in to an insulating state. We also show how the specific antiferromagnetic structure is a consequence of the less-discussed 90° and less than 90° superexchange interactions built in to such crystal structures.

PbCu3TeO7: an S = 1/2 staircase kagome lattice with significant intra-plane and inter-plane couplings

We have synthesized polycrystalline and single-crystal samples of PbCu3TeO7 and studied its properties via magnetic susceptibility, χ(T), and heat-capacity, Cp(T), measurements and also electronic structure calculations. Whereas the crystal structure is suggestive of the presence of a quasi-2D network of Cu(2+) (S = 1/2) buckled staircase kagome layers, the χ(T) data show magnetic anisotropy and three magnetic anomalies at temperatures TN1 ∼ 36 K, TN2 ∼ 25 K, and TN3 ∼ 17 K. The χ(T) data follow the Curie-Weiss law above 200 K and a Curie-Weiss temperature θCW ∼- 150 K is obtained. The data deviate from the simple Curie-Weiss law below 200 K, which is well above TN1, suggesting the presence of competing magnetic interactions. The magnetic anomaly at TN3 appears to be of first order from magnetization measurements, although our Cp(T) results do not display any anomaly at TN3. The hopping integrals obtained from our electronic structure calculations suggest the presence of significant intra-kagome (next-nearest neighbor and diagonal) and inter-kagome couplings. These couplings take the PbCu3TeO7 system away from a disordered ground state and lead to long-range order, in contrast to what might be expected for an ideal (isotropic) 2D kagome system.

Analysis of full-length sequences of two Citrus yellow mosaic badnavirus isolates infecting Citrus jambhiri (Rough Lemon) and Citrus sinensis L. Osbeck (Sweet Orange) from a nursery in India

Citrus yellow mosaic badna virus (CMBV), a member of the Family Caulimoviridae, Genus Badnavirus is the causative agent of mosaic disease among Citrus species in southern India. Despite its reported prevalence in several citrus species, complete information on clear functional genomics or functional information of full-length genomes from all the CMBV isolates infecting citrus species are not available in publicly accessible databases. CMBV isolates from Rough Lemon and Sweet Orange collected from a nursery were cloned and sequenced. The analysis revealed high sequence homology of the two CMBV isolates with previously reported CMBV sequences implying that they represent new variants. Based on computational analysis of the predicted secondary structures, the possible functions of some CMBV proteins have been analyzed.

Magnetic behavior of Ba3Cu3Sc4O12

The chain-like system Ba(3)Cu(3)Sc(4)O(12) has potentially interesting magnetic properties due to the presence of Cu(2+) and a structure-suggested low dimensionality. We present magnetization M versus magnetic field H and temperature T, T- and H-dependent heat-capacity C(p), (45)Sc nuclear magnetic resonance (NMR), muon spin rotation (μSR), neutron diffraction measurements and electronic structure calculations for Ba(3)Cu(3)Sc(4)O(12). The onset of magnetic long-range antiferromagnetic (AF) order at T(N) ∼ 16 K is consistently evidenced from the whole gamut of our data. A significant sensitivity of T(N) to the applied magnetic field H (T(N) ∼ 0 K for H = 70 kOe) is also reported. Coupled with a ferromagnetic Curie-Weiss temperature (θ(CW) ∼ 65 K) in the susceptibility (from a 100 to 300 K fit), it is indicative of competing ferromagnetic and antiferromagnetic interactions. These indications are corroborated by our density functional theory based electronic structure calculations, where we find the presence of significant ferromagnetic couplings between some copper ions whereas AF couplings were present between some others. Our experimental data, backed by our theoretical calculations, rule out the one-dimensional magnetic behavior suggested by the structure and the observed long-range order is due to the presence of non-negligible magnetic interactions between adjacent as well as next-nearest chains.

Analysis of the complete DNA sequence of rice tungro bacilliform virus from southern India indicates it to be a product of recombination

The complete nucleotide sequence of an isolate of rice tungro bacilliform virus (RTBV), collected from Kanyakumari, India, where RTBV was reported recently for the first time, has been analyzed. Sequence comparison revealed that the RTBV isolate from Kanyakumari (RTBV-KK) has a high degree of identity to the two previously reported RTBV sequences from India, RTBV-AP and RTBV-WB, which had been collected from field locations about 10 years ago and 1000-2000 km away from the collection site of RTBV-KK. Most of the sequence domains reported previously in other RTBV isolates were found to be conserved in RTBV-KK. Closer inspection revealed RTBV-KK to be a possible recombinant between RTBV-AP and RTBV-WB in the genomic region encompassing the coat protein gene.

Third-Generation TB-LMTO

We describe the screened Korringa-Kohn-Rostoker (KKR) method and the third-generation linear muffin-tin orbital (LMTO) method for solving the single-particle Schrödinger equation for a MT potential. In the screened KKR method, the eigenvectors CRL,i are given as the non-zero solutions, and the energies εi as those for which such solutions can be found, of the linear homogeneous equations: , where Ka (ε) is the screened KKR matrix. The screening is specified by the boundary condition that, when a screened spherical wave is expanded in spherical harmonics YR′L′ (ȓR′) about its neighboring sites R′, then each component either vanishes at a radius, rR′=aR′L′, or is a regular solution at that site. When the corresponding “hard” spheres are chosen to be nearly touching, then the KKR matrix is usually short ranged and its energy dependence smooth over a range of order 1 Ry around the centre of the valence band. The KKR matrix, K (εν), at a fixed, arbitrary energy turns out to be the negative of the Hamiltonian, and its first energy derivative, K (εν), to be the overlap matrix in a basis of kinked partial waves, φRL (εν, rR), each of which is a partial wave inside the MT-sphere, tailed with a screened spherical wave in the interstitial, or taking the other point of view, a screened spherical wave in the interstitial, augmented by a partial wave inside the sphere. When of short range, K (ε) has the two-centre tight-binding (TB) form and can be generated in real space, simply by inversion of a positive definite matrix for a cluster. The LMTOs, χRL (εν), are smooth orbitals constructed from φRL(εν, rR) and φRL(εν, rR), and the Hamiltonian and overlap matrices in the basis of LMTOs are expressed solely in terms of K (εν) and its first three energy derivatives. The errors of the single-particle energies εi obtained from the Hamiltonian and overlap matrices in the φ(εν)- and χ(εν) bases are respectively of second and fourth order in εi – εi. Third-generation LMTO sets give wave functions which are correct to order εi – εν, not only inside the MT spheres, but also in the interstitial region. As a consequence, the simple and popular formalism which previously resulted from the atomic-spheres approximation (ASA) now holds in general, that is, it includes downfolding and the combined correction. Downfolding to few-orbital, possibly short-ranged, low-energy, and possibly orthonormal Hamiltonians now works exceedingly well, as is demonstrated for a high-temperature superconductor. First-principles sp3 and sp3d5 TB Hamiltonians for the valence and lowest conduction bands of silicon are derived. Finally, we prove that the new method treats overlap of the potential wells correctly to leading order and we demonstrate how this can be exploited to get rid of the empty spheres in the diamond structure.

High glucose causes dysfunction of the human glomerular endothelial glycocalyx

The endothelial glycocalyx is a gel-like layer which covers the luminal side of blood vessels. The glomerular endothelial cell (GEnC) glycocalyx is composed of proteoglycan core proteins, glycosaminoglycan (GAG) chains, and sialoglycoproteins and has been shown to contribute to the selective sieving action of the glomerular capillary wall. Damage to the systemic endothelial glycocalyx has recently been associated with the onset of albuminuria in diabetics. In this study, we analyze the effects of high glucose on the biochemical structure of the GEnC glycocalyx and quantify functional changes in its protein-restrictive action. We used conditionally immortalized human GEnC. Proteoglycans were analyzed by Western blotting and indirect immunofluorescence. Biosynthesis of GAG was analyzed by radiolabeling and quantified by anion exchange chromatography. FITC-albumin was used to analyze macromolecular passage across GEnC monolayers using an established in vitro model. We observed a marked reduction in the biosynthesis of GAG by the GEnC under high-glucose conditions. Further analysis confirmed specific reduction in heparan sulfate GAG. Expression of proteoglycan core proteins remained unchanged. There was also a significant increase in the passage of albumin across GEnC monolayers under high-glucose conditions without affecting interendothelial junctions. These results reproduce changes in GEnC barrier properties caused by enzymatic removal of heparan sulfate from the GEnC glycocalyx. They provide direct evidence of high glucose-induced alterations in the GEnC glycocalyx and demonstrate changes to its function as a protein-restrictive layer, thus implicating glycocalyx damage in the pathogenesis of proteinuria in diabetes.

A Geminivirus-Satellite Complex is Associated with Leaf Deformity of Mentha (Mint) Plants in Punjab

A widespread leaf deformity disease of mentha (mint), accompanied by whiteflies, the vectors of begomoviruses, was observed in Punjab in the last few years. The presence of begomovirus was indicated by DNA dot-blot analysis using the conserved coat protein and replication-associated protein genes of another begomovirus, Sri Lankan cassava mosaic virus (SLCMV). A DNA fragment (2.0 kb), representing a partial genomic DNA of a begomovirus, amplified from the symptomatic mentha leaves was used to design end-primers and further amplify an additional 0.9 kb fragment, representing the remaining portion of the resident viral DNA. The two sequences, assembled together (2.7 kb), showed that they represented the complete sequence of an isolate of Tomato leaf curl Karnataka virus (ToLCKV) DNA. Using universal betasatellite primers, a 1.4 kb fragment was amplified from the same sample. This cloned DNA fragment showed complete sequence identity with the previously reported Cotton leaf curl Multan betasatellite (CLCuMB). Majority of the symptomatic mentha leaf samples, collected from four districts of Punjab, showed cross-hybridization in DNA dot-blot using cloned SLCMV and CLCuMB DNA, indicating the presence of one or more begomoviruses related to SLCMV and the betasatellite, CLCuMB. The begomovirus and betasatellite could be mechanically transmitted to Nicotiana benthamiana. Whitefly transmission of the resident begomovirus could also be demonstrated on mentha. The evidence indicates the association of ToLCKV and CLCuMB, a hitherto new combination of a begomovirus and a betasatellite associated with a leaf deformity disease in mentha in Punjab.

Electronic structure of Na(2)CuP(2)O(7): a nearly 2D Heisenberg antiferromagnetic system

We have employed first principles calculations to study the electronic structure and the implications for the magnetic properties of Na(2)CuP(2)O(7). Using the self-consistent tight-binding linearized muffin-tin orbital method and the Nth-order muffin-tin orbital downfolding method, we have calculated the various intrachain and interchain hopping parameters between the magnetic Cu(2+) ions. Our calculations for Na(2)CuP(2)O(7) reveal dominant intrachain hopping, but in contrast to the typical quantum spin chains the interchain hoppings are not negligible. The Wannier function plot of the Cu d(x(2)-y(2)) orbitals shows that the exchange interactions are primarily mediated by the oxygens and the distance between the oxygens in Na(2)CuP(2)O(7) is favorable for both intrachain and interchain interactions, suggesting the inapplicability of the one-dimensional Heisenberg model for this system, in agreement with recent experimental results.

"Benign" hypertensive nephrosclerosis

BACKGROUND

Whether benign hypertensive nephrosclerosis (BHN) causes end-stage renal failure (ESRF) is controversial. One reason for this is the lack of biopsy evidence confirming the clinical diagnosis in most cases.

AIM

To investigate whether biopsy-proven BHN leads to ESRF.

DESIGN

Retrospective analysis.

METHODS

We analysed all cases of biopsy-proven BHN from a single centre over a period of 20 years (n = 60), followed-up for a mean +/- SD 6.7 +/- 5.5 years.

RESULTS

Patients were divided into those with stable renal function (n = 17) and those with declining function (n = 43). Mean eGFR at the time of biopsy was lower in the declining function group (29 +/- 3 vs. 44 +/- 4 ml/min/1.73 m(2), serum creatinine 280 +/- 165 vs. 161 +/- 89 mumol/l, p < 0.001), of whom 72% progressed to ESRF. Median renal survival for the whole group was 6.8 years, with 5- and 10-year survivals of 56% and 35%, respectively. Renal survival was significantly affected by initial serum creatinine, and mean systolic and diastolic blood pressures during follow-up period. Mean protein excretion was higher in the declining group, but not significantly so. On multivariate analysis, only diastolic blood pressure during follow-up predicted renal survival (p = 0.017). Median patient survival for the whole group was 9.95 years post renal biopsy, with 5- and 10-year survivals of 70% and 49% respectively. Survival was affected by initial serum creatinine, initial serum albumin and mean systolic blood pressure during follow-up. On multivariate analysis, only initial serum creatinine was significantly correlated with survival (p = 0.017).

DISCUSSION

Biopsy-proven BHN led to ESRF in a high percentage of our patients, and was associated with significant mortality.

Biodiversity and recombination of cassava-infecting begomoviruses from southern India

Cassava mosaic disease (CMD) is caused by various begomoviruses of the family Geminiviridae leading to considerable crop losses in Africa and Asia. Recombination between their genomic components has generated new pathotypes with enhanced virulence in Africa. Here, we report about a survey on the biodiversity of begomoviruses in cassava from southern India (Tamil Nadu and Kerala states) performed in 2001 and 2002. Viral DNA A components from stem cuttings were analysed using polymerase chain reaction and restriction fragment length polymorphism. Eight representative examples were completely sequenced. The majority of DNA sequences (7 of 8) obtained were more closely related to that of Sri Lankan cassava mosaic virus (SLCMV) than of Indian cassava mosaic virus (ICMV). Only one sequence collected in Kerala was related to ICMV. The diversity of the SLCMV-like sequences was rather low compared to the variability of African viruses associated with cassava mosaic disease. Based on DNA A sequence data, all of these isolates should be classified as variants of SLCMV or ICMV. Phylogenetic analysis revealed mosaic structures within the DNA sequences which may indicate footprints of recombination events between ancestors of SLCMV and ICMV.

Identification of a second begomovirus, Sri Lankan cassava mosaic virus, causing cassava mosaic disease in India

The DNA A and DNA B components of a begomovirus associated with cassava mosaic disease (CMD) originating from Kerala, India, were cloned. Biolistically inoculated clones induced symptoms typical of CMD in cassava. Sequence comparisons showed the virus to be an isolate of Sri Lankan cassava mosaic virus (SLCMV). This is the first time this begomovirus species has been identified in India and only the second species shown to cause CMD in the country. The implication of these findings on our understanding of the diversity and geographic distribution of CMD-associated begomoviruses in the region and on efforts to obtain resistance to CMD are discussed.

Both Indian cassava mosaic virus and Sri Lankan cassava mosaic virus are found in India and exhibit high variability as assessed by PCR-RFLP

The biodiversity of geminiviruses associated with the Cassava Mosaic Disease (CMD) in India was investigated using PCR to specifically amplify the DNA of Indian cassava mosaic virus (ICMV) or Sri Lankan cassava mosaic virus (SLCMV) and also by using PCR to amplify specific viral genes, followed by digestion with different restriction endonucleases to obtain polymorphic patterns (PCR-RFLP). Results showed that both ICMV and SLCMV were present in mosaic-affected cassava; ICMV was geographically restricted to certain regions, whereas SLCMV was widespread. PCR-RFLP analysis showed that, in addition to ICMV-type and SLCMV-type patterns, a high proportion (40%) of the samples displayed novel patterns, some of which were localized in certain areas, whereas others were widely distributed.

Molecular analysis of two complete rice tungro bacilliform virus genomic sequences from India

The complete genomic sequences of two geographically distinct isolates of rice tungro bacilliform virus (RTBV) from India were determined. Both the sequences showed equal divergence from previously reported Southeast Asian isolates. Numerous insertions, deletions and substitutions, mostly in the intergenic regions, were found. The genome sizes were 7907 and 7934 bp respectively, 95 and 68 residues short of an infectious clone reported earlier. Between them, both the isolates showed high homology all along the genome, except for a 30-nucleotide insertion/deletion close to the 3' end of ORF III in one of them. Both the isolates indicated an unconventional start codon in ORF I, similar to the type isolate. In addition, as novel features, both the Indian isolates showed an unconventional start codon for ORF IV. Considering the low amounts of genome variability noticed in other RTBV isolates, the Indian isolates show that they have diverged sufficiently from the rest and should be considered belonging to a distinct strain.

Band-structure trend in hole-doped cuprates and correlation with T(c max)

By calculation and analysis of the bare conduction bands in a large number of hole-doped high-temperature superconductors, we have identified the range of the intralayer hopping as the essential, material-dependent parameter. It is controlled by the energy of the axial orbital, a hybrid between Cu 4s, apical-oxygen 2p(z), and farther orbitals. Materials with higher T(c max) have larger hopping ranges and axial orbitals more localized in the CuO2 layers.

Management of hypertension in patients developing end-stage renal failure

The benefits of treating hypertension include preventing or delaying the progression of chronic renal failure, and reducing the cardiovascular complications of patients with renal disease. We examined how well hypertension had been managed in all 145 patients from a single health district who started dialysis during a 3-year period. Data relating to management of hypertension, including all blood pressure readings, were obtained from their general practice and hospital case notes. The anonymized data were reviewed by two independent assessors against a set of standards based on the British Hypertension Society guidelines. There was close agreement between the assessors. Complete records were obtained in 98.5% of cases. Of the 145 patients, 107 (76.4%) were hypertensive before developing end-stage renal failure. There were departures from standards in all categories of care: 24.3% in detection/diagnosis, 29% in investigation, 22.4% in referring to a nephrologist, and 17% in follow-up. The British Hypertension Society recommended standard for diastolic blood pressure of 90 mmHg was achieved in only 45%. In 32%, the assessors independently concluded that poor blood pressure control might have affected adversely the progression of renal failure. New methods of dealing with these problems are required and possible approaches are discussed.

Variation in the genome of rice tungro bacilliform virus: molecular characterization of six isolates

The DNA genomes of isolates of rice tungro bacilliform virus from Bangladesh, India, Indonesia, Malaysia and Thailand were cloned and compared with that of the type isolate from the Philippines. Restriction endonuclease maps revealed differences between the isolates and cross-hybridization showed that they fell into two groups, those from the Indian subcontinent and those from south-east Asian countries. The genomes of isolates from the Indian subcontinent contained a deletion of 64 bp when compared with those from south-east Asia. The implications of this variation are discussed.

Detection of rice tungro bacilliform virus in field and glasshouse samples from India using the polymerase chain reaction

Rice tungro bacilliform virus (RTBV) together with rice tungro spherical virus (RTSV) is the causal agent for the rice tungro disease. A rapid technique was developed to detect RTBV DNA in the crude extract of freshly collected leaf samples by polymerase chain reaction (PCR). This technique can detect the viral DNA in 1000-fold diluted leaf extract. Detection has been possible in samples stored upto 5 days after the collection. This technique may have wide application for the field diagnosis of RTBV infection.