Acute kidney injury in patients treated with immune checkpoint inhibitors

BACKGROUND: Immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI) has emerged as an important toxicity among patients with cancer. METHODS: We collected data on 429 patients with ICPi-AKI and 429 control patients who received ICPis contemporaneously but who did not develop ICPi-AKI from 30 sites in 10 countries. Multivariable logistic regression was used to identify predictors of ICPi-AKI and its recovery. A multivariable Cox model was used to estimate the effect of ICPi rechallenge versus no rechallenge on survival following ICPi-AKI. RESULTS: ICPi-AKI occurred at a median of 16 weeks (IQR 8-32) following ICPi initiation. Lower baseline estimated glomerular filtration rate, proton pump inhibitor (PPI) use, and extrarenal immune-related adverse events (irAEs) were each associated with a higher risk of ICPi-AKI. Acute tubulointerstitial nephritis was the most common lesion on kidney biopsy (125/151 biopsied patients [82.7%]). Renal recovery occurred in 276 patients (64.3%) at a median of 7 weeks (IQR 3-10) following ICPi-AKI. Treatment with corticosteroids within 14 days following ICPi-AKI diagnosis was associated with higher odds of renal recovery (adjusted OR 2.64; 95% CI 1.58 to 4.41). Among patients treated with corticosteroids, early initiation of corticosteroids (within 3 days of ICPi-AKI) was associated with a higher odds of renal recovery compared with later initiation (more than 3 days following ICPi-AKI) (adjusted OR 2.09; 95% CI 1.16 to 3.79). Of 121 patients rechallenged, 20 (16.5%) developed recurrent ICPi-AKI. There was no difference in survival among patients rechallenged versus those not rechallenged following ICPi-AKI. CONCLUSIONS: Patients who developed ICPi-AKI were more likely to have impaired renal function at baseline, use a PPI, and have extrarenal irAEs. Two-thirds of patients had renal recovery following ICPi-AKI. Treatment with corticosteroids was associated with improved renal recovery

Nanocomposite of Polyaniline with the photoadduct of potassium hexacyanoferrate and pyridine ligand: Structural, electrical, mechanical and thermal study

This work involves the synthesis of polyaniline nanocomposite with photoadduct of potassium hexacyanoferrate and pyridine achieved through ball milling, photochemical route, and by oxidative polymerization technique using ammonium persulphate as oxidizing agent .The photoadduct has been synthesized by photoirradiation followed by substitution with pyridine ligand. The photoaquation, substitution and successful synthesis has been proved by recording pH, UV–visible spectra, FTIR and XRD. The as synthesized nanocomposite has been subjected to various characterization techniques like elemental analysis, UV–visible spectra, FTIR, XRD, and SEM. XRD of photoadduct shows crystalline structure which has been retained in the nanocomposites also. Parameters like crystallite size, dislocation density, microstrain, d-spacing, were evaluated. Thermal study was carried out by recording TGA/DTG, showing very high thermal stability of nanocomposite as compared to PANI which can be due to strong interaction between polymer chain and photoadduct, hence the material can be used for high temperature applications electrical conductivity was measured by four probe conductivity meter. Conductivity of nanocomposite was found to be many orders of magnitude higher than that of polyaniline. The nanomechanical properties were investigated with an MTS Nano-Indenter XP by using continuous stiffness measurement (CSM) technique. Mechanical properties of pure PANI has improved with doping of photoadduct

An analytical and numerical study for thermosolutal nanofluid convection using revised model

The conservation equations for binary nanofluid system are solved to get eigenvalue equation. Valid approximations are used to simplify the complex expressions for analytical results. Oscillatory motions are not possible and hence mode of convection is invariably through stationary mode. Numerical computations are carried out for water based nanofluids to analyze solutal effects on the stability of the system using the software Mathematica. Higher conductivity and density of copper makes it more stable than alumina

Role of photoadduct of K4 Fe(CN)6 and C3 H4 N2 in improving thermal stability of polyaniline composite

This paper involves the synthesis of polyaniline composite with photoadduct of potassium hexacyanoferrate and imidazole via photochemical route by oxidative polymerization technique by ammonium persulphate. The photoadduct has been synthesized by photoirradiation followed by substitution with imidazole ligand. The photoaquation, substitution and successful synthesis has been proved by recording pH, UV visible spectra before and after irradiation and XRD of photoadduct. The as synthesized composite has been subjected to various characterizations like elemental analysis, UV–Visible spectra, FTIR, XRD, SEM, and TG/DTG. XRD of photoadduct shows crystalline structure which has been retained in the composite, changing the amorphous structure of polyaniline into the crystalline one, hence proving the insertion of photoadduct in the polymer chain. Various parameters like crystallite size (L), interplanar distance (d), micro strain (ε), dislocation density (δ) and distortion parameters (g) were calculated from XRD data. Thermal analysis shows the high thermal stability of composite which can be due to strong interaction between polymer chain and the photoadduct which restricts the thermal motion of polyaniline and thus enhances the thermal stability of composite

Natural Convection Heat Transfer from Inclined Cylinders: a unified correlation

An empirical correlation for predicting the heat transfer coefficient for a cylinder under free convection, inclined at any arbitrary angle with the horizontal has been developed in terms of Nusselt number, Prandtl number and Grashof number. Available experimental data was used to determine the parameters for the proposed correlation. The proposed correlation predicts the available data well within ±10%, for Prandtl number in the range 0.68-0.72 and Grashof number in the range 1.4×104–1.2×1010