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

Septum electrochemical photovaltic cells

Septum electrochemical photovaltic cells employing electrodeposited cdse spectrum of 25 cm2 area have been studied. A Vsc of 1.62V, Jsc of 7-9 mA.cm2, FF of 0.59and n of 8.97% were obtained

Current losses in a bipolar cell-II: An analysis of the Butler-Volmer regime

The effects of anodic and cathodic overvoltages given by Butler-Volmer expressions on the determination of bypass parasitic currents are studied in detail, as a function of several design parameters like the bypass resistance and the number of plates as well as other electrochemical parameters like the cell current, the anodic/cathodic exchange currents and the transfer coefficients. The failure of Tafel approximation in the middle plates (even when the cell current is large)is illustrated. Exact expressions for an approximate model are compared with our calculations

Strategic renewal during crises - a pragmatist proposition for multinational enterprises in a globalized world

Unforeseen environmental shocks, such as the Covid-19 pandemic, often throw organizations into disarray and chaos. Although some organizations can successfully navigate these crises by implementing effective coping strategies, others need more knowledge on crisis management. This paper proposes strategic renewal for multinational enterprises (MNEs) facing such challenges and emphasizes the importance of developing knowledge acquisition, exploitation capabilities, and ambidextrous leadership. Based on an integrative literature review and adopting a pragmatist paradigm approach, we present a multivariate process map for strategic renewal during crises. This can be a valuable tool for MNE practitioners to prepare for future crises preemptively

Development of molten carbonate fuel cells (MCFC)

Molten carbonate fuel cells (MCFC) are considered as the second generation fuel cell technology. They are characterized by high temperature of operation 923k and high efficiency for energy conversion. Hydrogen derived from steam reformation of natural gas and coal can be used as a fuel. The heat generated from the cells can be utilized in the reformation reaction of the fuel. The essential components of the MCFC are porous nickel electrodes, matrix for holding the electrolyte mixture, cell assembly hardwares etc. Lithium aluminate (y - liAIO2)is used as the matrix. Y - LiAIO2 powder was prepared by high temperature solid state reaction of Li2Co3 with AI2O3 at 1273K. The y - variety initially obtained at 873 k was transformed into the Y - from on 1273k on prolonged heating. These powders were characterized by x-ray diffraction techniques. Porrous nickel electrodes were fabricated by loose powder sintering technique. Small prototype cells consisting of 10 and 20 cm2 area electrodes were assembled. Lithium aluminate tiles were prepared by cold compaction and sintering and slurry casting techniques for the above. Current densities in the 40-75 mA. cm-2 were obtained at a cell voltage of 0.7v at 923k for short duration. A programme has been initiated to demonstrate higher capacity cells (10 watts per cell)