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Chronic kidney disease is a growing global health issue, contributing significantly to morbidity and mortality. The incidence of end-stage renal disease (ESRD) is approximately 100 per million population. Renal transplantation remains the cornerstone treatment for ESRD, with a projected 20-year survival rate of 60%. We aim to define the etiology of renal allograft dysfunction using the Banff 2019 classification by analyzing 200 renal allograft biopsies in correlation with creatinine levels across post-transplant time frames.200 renal allograft biopsies are analyzed using the recent Banff 2019 classification with creatinine levels and post-transplant duration correlation.The study included 150 (75%) male patients and 50 (25%) female patients, with the majority 78 (39%) representing the age group of 16-30 years. 36 (18%) biopsies were within 3-month post-transplant, while 92 (46%) were 2-year post-transplant. According to the Banff 2019 classification, 92 (46.0%) transplant rejection biopsies were identified, with most 54 (27%) exhibiting antibody-mediated rejection (Category 2), including 40 (20%) active acute antibody-mediated rejection (ABMR) and 14 (7.0%) chronic active ABMR. T-cell-mediated rejection (TCMR; Category 4) represented 12 (6%) biopsies, including 10 (5%) acute TCMR and 2 (1%) chronic active TCMR. Category 5, the miscellaneous group, represented 100 (50%) biopsies, out of which 32 (16%) exhibited calcineurin inhibitor (CNI) toxicity, 38 (19%) acute tubular necrosis, and 8 (4%) thrombotic microangiopathy. A notable variation in the dysfunction distribution across different post-transplant time frames indicated a temporal evolution in the underlying causes of allograft dysfunction. Specific Banff categories showed a robust association with renal dysfunction, potentially contributing to the elevation of creatinine levels and renal function deterioration.Our study highlights the intricate pathophysiology of renal allograft dysfunction. Most biopsies were attributed to ABMR whereas one-third of biopsies exhibited mixed lesions (ABMR and TCMR or ABMR and calcineurin inhibitor toxicity (CNIT)). Additionally, this study suggests that renal allograft rejection remains a significant contributor to graft dysfunction. A complex interplay between histological findings, Banff classification, and renal function is noted. A significant difference in the distribution of dysfunction across post-transplant time frames is noted suggesting a temporal evolution in the etiology of allograft dysfunction. Certain Banff categories demonstrate a stronger association with renal dysfunction that may influence creatinine level increase and renal function deterioration. In correspondence to the recent Banff 2019 guidelines for diagnosing ABMR, we emphasize the role of C4d staining on immunofluorescence or immunohistochemistry in allograft biopsies as imperative for timely diagnosis and immunosuppressant therapy adjustment, ultimately enhancing graft survival. Further research is needed to elucidate the underlying mechanisms driving renal dysfunction in different Banff categories, ultimately informing personalized management strategies for patients with renal allograft dysfunction. In line with the Banff 2019 guidelines for diagnosing ABMR, this study highlights the critical role of C4d staining through immunofluorescence or immunohistochemistry in allograft biopsies for early diagnosis and timely adjustment of immunosuppressive therapy, ultimately improving graft survival. [ABSTRACT FROM AUTHOR]

In this paper, four small molecules B1, B2, B3 and B4 based on donor–acceptor–donor–acceptor–donor (D-A-D-A-D) combination were designed by making structural modifications in R. The designed molecules contain 5,10-dihydro-indolo [3,2-b] indole central donor core and different benzo-thiadiazole and fluorine substituted benzothiadiazole (FBT) acceptor units. These molecules have different subunits introduced on 5,10-dihydroindolo [3,2-b] indole central core like benzo [1,2,5] thiadiazole in (B1), 5-Fluoro-benzo [1,2,5] thiadiazole in (B2), 5-Methyl-benzo [1,2,5] thiadiazole in (B3), 2-Fluoro-2-methyl-2-H-benzotriazole unit in (B4), flanked with [2,2',5',2"] terthiophene as spacer (S) and triphenyl amine as a common end-capped donor in all the molecules (B1– B4). The optoelectronic properties of these molecules were studied by performing density functional theory (DFT) at CAM-B3LYP. Among all the designed structures, B2 showed maximum absorption (457 nm) due to its strong electron withdrawing 5-Fluoro-benzo [1,2,5] thiadiazole acceptor unit. Other opto-electronic properties were analyzed through reorganization energies, density of electronic states and transition density matrix (TDM) to estimate the photovoltaic potential of these newly designed molecules. Low exciton binding energies and comparable values of open circuit voltage than R indicate the worth of these candidates to be used in future solar energy driven devices. Four non-fullerene based small organic molecules (B1-B4) have been designed in D-A-D-A-D configuration using various acceptor moieties. The newly investigated chromophores exhibited better photovoltaic properties like charge mobility, dipole moment and open circuit voltage than reference R. [ABSTRACT FROM AUTHOR]

This paper presents the study of heat and mass transfer in two-dimensional magnetohydrodynamic nanofluid flow over a cone/plate. By linearization and finite difference discretization, we numerically solved ordinary differential equations obtained from the partial differential equations (PDEs) by using similarity transformation. The impact of non-dimensional parameters, such as Prandtl number, Dufour number, Schmidt number, and Soret number, on velocity, temperature, and concentration has been examined from the graphs and tables. It has been noted that, compared to the rotating plate, heat and mass transfer properties of the flow over the rotating cone are more promising. [ABSTRACT FROM AUTHOR]

Background: Appropriate management to prevent relapses of acquired, autoimmune thrombotic thrombocytopenic purpura (TTP) is not clear. Rituximab (375 mg/m2 /week × 4) is effective treatment for acute episodes but it is not consistently effective for prevention of relapses. Maintenance rituximab, 375 mg/m2 /3 months for 2 years, is commonly used to prevent progression of follicular lymphoma, but the outcome of maintenance rituximab to prevent TTP relapses has been rarely reported.Case Report: An 8-year-old girl was diagnosed with acquired TTP in 2008; her ADAMTS13 activity was less than 5%, with a functional inhibitor of greater than 8 Bethesda units/mL. She achieved remission with therapeutic plasma exchange, corticosteroids, and rituximab (375 mg/m2 /week × 4). During the following 6 years she had seven additional episodes. Each episode responded to therapeutic plasma exchange, sometimes requiring additional treatments (corticosteroids, rituximab, and cyclophosphamide). However, these treatments, as well as splenectomy and trials of cyclophosphamide and mycophenolate mofetil during clinical remissions, failed to prevent relapses. Her ADAMTS13 activity remained 8% or less throughout all of her remissions. Maintenance rituximab was begun in 2013: 500 mg (313 mg/m2 ) every 2-3 months × 5, then 600 mg (375 mg/m2 ) every 6 months × 2. After 1 year, her ADAMTS13 was 26%; after 2 years, 51%. During the past 3 years since stopping rituximab, she has remained well, with normal ADAMTS13 activity (70%-78%).Conclusion: Maintenance rituximab treatment may be effective for prevention of relapses in patients with acquired, autoimmune TTP, even when splenectomy and intensive immunosuppression, including multiple conventional courses of rituximab, fail to prevent subsequent relapses. [ABSTRACT FROM AUTHOR]