Optimal method for determining the intraclass correlation coefficients of urinary biomarkers such as dialkylphosphates from imputed data

Association between blood lipid levels in early pregnancy and urinary organophosphate metabolites in the Japan Environment and Children's Study

BACKGROUND

High low-density lipoprotein cholesterol levels (LDL-C) during pregnancy have been associated with adverse pregnancy and offspring outcomes. While previous studies have suggested a potential link between organophosphate pesticide (OPP) exposure and higher LDL-C in the general population and agricultural workers, the relationship in pregnant women and the effect of body mass index on this relationship remain unclear. We examined the association between the urinary concentrations of OPP metabolites (dialkylphosphates) and blood lipid levels in pregnant women.

METHODS

We used data from the Japan Environment and Children's Study, which included 5,169 pregnant women with urinary dialkylphosphate data. We examined the association between urinary concentrations of six dialkylphosphates (DEP, DETP, DEDTP, DMP, DMTP, DMDTP) and blood lipid levels (LDL-C, total cholesterol, high-density lipoprotein cholesterol, and triglycerides) during the first trimester using multiple linear regression under a Bayesian paradigm. We examined the association between high LDL-C, defined as ≥90th percentile of LDL-C, and urinary dialkylphosphate concentrations, using multiple logistic regression under a Bayesian paradigm. These analyses were repeated in underweight, normal-weight, and overweight participants.

RESULTS

DEP, DMP, and DMTP were detected in >50 % of the participants. Multiple linear regression analyses did not show associations between LDL-C and these dialkylphosphates. Stratified analyses showed a positive association between DEP and LDL-C in overweight women (beta coefficient = 2.13, 95 % credible interval = 0.86-3.38, probability of direction (PD) = 100 %); however, the association was not significant (percentage in region of practical equivalence (% in ROPE) = 84.0). Higher DEP was significantly associated with high LDL-C (odds ratio = 1.32, 95 % credible interval = 1.13-1.55, PD = 100 %, % in ROPE = 0.2).

CONCLUSIONS

Among overweight pregnant women in the first trimester, higher urinary DEP concentrations were associated with high LDL-C. The effects of OPP on blood lipid profiles merit further investigation.

Translation and validation of the Comfort Behaviors Checklist in hospitalized children with chronic diseases

BACKGROUND

Different tools have been developed to measure patients' comfort. This study aims to translate, validate, and apply the Comfort Behaviors Checklist to hospitalized children with chronic diseases.

METHODS

Validity and reliability are assessed using face and content validity, construct validity (known-groups technique and Principal Component Analysis), internal consistency, and inter-rater reliability. The study takes place in a children's hospital in Iran, involving 220 children aged 4 to 6.

RESULTS

The Comfort Behaviors Checklist demonstrates acceptable face and content validity. Construct validity is supported by the lack of correlation between behavioral comfort scores in known groups. The Principal Component analysis results in five components, explaining 70.39% of the total variation. The checklist exhibits acceptable reliability, with a total Cronbach's alpha coefficient of 0.86 and an intraclass correlation coefficient of 0.835.

CONCLUSION

The Comfort Behavior Checklist is a valid and reliable tool for assessing the level of comfort in Iranian children with chronic diseases.

Concentrations of Neonicotinoid insecticides and their metabolites in multiple urine samples collected from pregnant women in Japan

Exposure to low doses of neonicotinoid (NEO) insecticides during pregnancy may have a negative impact on the neurodevelopment of children. Biomarkers are frequently used to investigate the exposure and its health effects in environmental epidemiology. In the present study, we aimed to evaluate the utility of urinary biomarkers of NEO exposure by calculating intra-class correlation coefficients (ICCs). Urine samples were collected from 30 pregnant women who were non-smokers and living in a central part of Japan, between 12 and 22 weeks of gestation. We collected first morning voided (FMV) urine and afternoon spot (PM) urine samples on the same day on five occasions within a 2-week period. The urinary concentrations of NEO and their metabolites (NEO/m) were measured by liquid chromatography-tandem mass spectrometry. Normalisation to the specific gravity and creatinine concentration was used in the calculation of ICC. The number of urine samples required to obtain a reliable biomarker estimate of NEO exposure was calculated. The most frequently detected NEO/m was N-desmethyl-acetamiprid (N-dm-ACE), followed by clothianidin (CLO), thiamethoxam (THX) and dinotefuran (DIN), in both FMV and PM urine samples. The ICC calculations showed poor reproducibility for the measurement of CLO and THX concentrations (ICCs ≤0.25) in both FMV and PM urine samples and for DIN (ICC ≤0.29) in the FMV urine samples, and moderate reproducibility was identified for N-dm-ACE (ICC >0.60) in both FMV and PM urine samples and for DIN (ICC >0.40) in the PM urine samples. A minimum of 1-19 spot urine samples per individual was required to provide a reliable biomarker estimate over a 2 week period. These results suggest that pregnant Japanese women are frequently exposed to NEOs, and that, with the exception of urinary N-dm-ACE, a single measurement of urinary NEO concentrations may not be an appropriate method of characterising overall exposure.