Comparison of three spot proteinuria measurements for pediatric nephrotic syndrome: based on the International pediatric Nephrology Association 2022 Guidelines.

BACKGROUND: Pediatric nephrotic syndrome (NS) requires routine proteinuria monitoring, which is costly and affects patients' quality of life. The gold-standard 24-h urine protein (UP) measurement is challenging in children, and first-morning urine collection requires specific conditions, making it difficult in outpatient settings. Studies have reported comparability of second or random morning urine sample to the first-morning specimen. This study aimed to compare outcomes of random morning proteinuria measurements to 24-h UP and the roles of the urinary protein creatinine ratio (UPCR) and dipstick tests in pediatric NS, based on International Pediatric Nephrology Association (IPNA) 2022 Guidelines. METHOD: Twenty-four-hour and morning urine samples were collected from 92 pediatric NS patients. These were subjected to automated analyses for 24-h UP, UPCR, and semi-automated dipstick analysis. A blinded doctor performed manual dipstick analysis. RESULTS: UPCR had a stronger correlation with 24-h UP than with automated and manual urine dipstick tests. UPCR had the highest sensitivity and specificity for predicting no remission/relapse and high sensitivity but low specificity for complete remission. The optimal UPCR cutoff for remission was 0.44 mg/mg and for no remission/relapse was 2.08 mg/mg. Automated and manual dipstick tests demonstrated limited sensitivity but high specificity and similar AUC values for remission/relapse. CONCLUSION: UPCR was sensitive and specific for diagnosing no remission/relapse and sensitive but not specific for detecting remission. Manual and automated urine dipstick tests were comparable for remission and no remission/relapse detection. This study supports the IPNA 2022 Guidelines, as 2 mg/mg was the optimal UPCR cutoff for no remission/relapse, while for remission the optimal cutoff was 0.4 mg/mg.

Plastiglomerates from uncontrolled burning of plastic waste on Indonesian beaches contain high contents of organic pollutants.

This study reports on plastiglomerate and other new forms of plastic pollution in the tropical marine continent of Indonesia. Twenty-five samples were collected from an island beach in the Java Sea where plastiglomerate, plasticrusts, and pyroplastic were formed by the uncontrolled burning of plastic waste. The most common plastic types were polyethylene and polypropylene (PE/PP), as shown by ATR-FTIR spectroscopy. However, acrylates/polyurethane/varnish (PU) and a copolymer of styrene and acrylonitrile were found as well. This suggests that plastiglomerates can form from a wider variety of plastic polymers than previously reported. FTIR analysis also indicates thermo-oxidative weathering, making the charred plastic more brittle and susceptible to microplastic formation. A subset of the samples was analyzed for associated chemical contaminants. One plastiglomerate with a PU matrix showed high concentrations of phthalates. All samples had high concentrations of polycyclic aromatic hydrocarbons (PAHs), likely due to the burning of the plastic in open fires. The burning leads to a change in the physical and chemical properties of the plastics contained in the plastiglomerates. Plastiglomerate and plastic waste of similar origin are therefore often more weathered and contaminated with organic pollutants than their parent polymers. The highest PAH concentration was found in a plastitar sample. Plastitar is defined as an agglomerate of tar and plastics that adheres to coastal rocks. In contrast, our study documents a more mobile, clastic plastitar type. This clastic plastitar could pose an additional ecological risk because of its mobility. These new types of plastic pollution could be an important vector for chemical contamination of nearby coastal habitats such as coral reefs, seagrass meadows, and mangroves.

Modern and sub-fossil corals suggest reduced temperature variability in the eastern pole of the Indian Ocean Dipole during the medieval climate anomaly.

We present two 40 year records of monthly coral Sr/Ca ratios from the eastern pole of the Indian Ocean Dipole. A modern coral covers the period from 1968 to 2007. A sub-fossil coral derives from the medieval climate anomaly (MCA) and spans 1100-1140 AD. The modern coral records SST variability in the eastern pole of the Indian Ocean Dipole. A strong correlation is also found between coral Sr/Ca and the IOD index. The correlation with ENSO is asymmetric: the coral shows a moderate correlation with El Niño and a weak correlation with La Niña. The modern coral shows large interannual variability. Extreme IOD events cause cooling > 3 °C (1994, 1997) or ~ 2 °C (2006). In total, the modern coral indicates 32 warm/cool events, with 16 cool and 16 warm events. The MCA coral shows 24 warm/cool events, with 14 cool and 10 warm events. Only one cool event could be comparable to the positive Indian Ocean Dipole in 2006. The seasonal cycle of the MCA coral is reduced (< 50% of to the modern) and the skewness of the Sr/Ca data is lower. This suggests a deeper thermocline in the eastern Indian Ocean associated with a La Niña-like mean state in the Indo-Pacific during the MCA.

Cocrystal construction between the ethyl ester with parent drug of diclofenac: structural, stability, and anti-inflammatory study.

This study aimed to collect the crystallographic data of ethyl diclofenac and discover a cocrystal from this ester with its parent, diclofenac acid, and to investigate their physicochemical properties and anti-inflammation activity. Firstly, ethyl diclofenac single crystal was isolated and continued by the cocrystal screening and isolation. Solid characterization was conducted by thermal analysis, infrared spectroscopy, powder x-ray diffractometry, followed by structural determination using a single crystal x-ray diffractometer. The stability of the cocrystal toward heating and high humidity, followed by the anti-inflammatory activity, was also studied. Ethyl diclofenac and the cocrystal were successfully isolated and subsequently subjected to lattice system determination. Interestingly, the new cocrystal can be generated directly by Fischer equilibrium reaction during esterification of diclofenac acid. Structurally, ethyl diclofenac reveals a P21/c monoclinic and the cocrystal between this ester with its parent drug is a P-1 triclinic system. A hydrophobic interaction -C-Cl-, which is rarely found in a cocrystal, involved in the molecular interaction between ethyl diclofenac and the parent drug, besides the hydrogen bonds. The newly isolated cocrystal has a melting point ±103-104 °C, which is higher than that of ethyl diclofenac (±67.5 °C) but lower than that of diclofenac acid (±173 °C). Hence, this cocrystal is stable towards accelerated stability testing by heating in a microwave, as well as storing in high relative humidity. Moreover, the anti-inflammation test also showed promising activity improvement.