Opportunities and recommendations for improved international shipment of live insects. / Opportunities and recommendations for improved international shipment of live insects.

While the information on live insect shipments provided in this thematic issue of the Scientific and Technical Review could not be exhaustive, it clearly represents a broad variety of trade, of substantial value, involving many stakeholders throughout the world. The contributions to this issue demonstrate that most of the trade in insects is carried out safely and efficiently. The concerns related to shipping insects described within this issue fall broadly into four categories: risks to human, animal and environmental health; delays and loss of quality; refusal of carriage; and high and variable costs. Some opportunities for improvements to insect shipping for diverse stakeholders are shown across these four areas of concern, with specific recommendations and a general call for further collaboration among stakeholders.

À défaut d'être exhaustives, les informations fournies dans ce numéro thématique de la Revue scientifique et technique consacré aux expéditions d'insectes vivants recouvrent clairement un très large éventail de ces échanges, qui représentent une valeur importante et auxquels participent de nombreux intervenants dans le monde entier. Les contributions réunies dans ce numéro montrent que l'essentiel des échanges d'insectes se déroule sans risques associés et de manière efficiente. Les sujets de préoccupation relatifs aux expéditions d'insectes mis en avant dans ce numéro relèvent, en général, de l'une des quatre catégories suivantes : risques pour la santé humaine, animale et environnementale ; retards et perte de qualité ; refus de transport ; coüts élevés et sujets à variations. Les auteurs font état des perspectives d'amélioration des expéditions d'insectes qui s'offrent à plusieurs parties prenantes, pour chacune de ces catégories, et présentent des recommandations spécifiques ainsi qu'un appel général à renforcer la collaboration pluri-acteurs.

Aunque la información presentada en este número temático de la Revista científica y técnica sobre el transporte de insectos vivos no puede ser exhaustiva, sí da clara cuenta de diversos tipos de comercio que revisten importancia y convocan a numerosos interlocutores del mundo entero. Los artículos de este número evidencian que el comercio de insectos discurre la mayor parte del tiempo con eficacia y en condiciones seguras. Los problemas ligados al transporte de insectos que se exponen en este número corresponden, en líneas generales, a cuatro clases: riesgos para la salud humana, animal o ambiental; retrasos y pérdida de calidad; denegación de transporte; y costos elevados y variables. En relación con estos cuatro ámbitos problemáticos, aquí se apuntan algunas posibilidades para que distintas partes introduzcan mejoras en el transporte de insectos, se presentan recomendaciones específicas y se hace una exhortación general a una mayor colaboración entre los interlocutores del sector.

Can there be a common, risk-based framework for decisions around live insect trade?

A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.

À l'occasion d'une réunion d'experts, un réseau de chercheurs travaillant sur l'expédition d'insectes vivants a produit un ensemble d'articles traitant des questions liées au transport des insectes vivants. Ce réseau est diversifié et représente un large éventail d'intérêts privés et de programmes de lutte biologique à grande échelle menés par les pouvoirs publics, en plus du secteur de la recherche biomédicale et de nombreux acteurs intervenant dans des applications de plus petite envergure relevant de la recherche, de l'enseignement ou du secteur privé. Un grand nombre d'espèces d'insectes sont transportées en toute sécurité avec un niveau de risque minimal, y compris lors des fréquentes expéditions internationales. Un exemple de ces expéditions régulières concerne l'espèce la plus utilisée par la recherche biomédicale en tant qu'organisme modèle, à savoir Drosophila melanogaster. Les exemples réussis d'expéditions à grande échelle provenant de fournisseurs d'agents de lutte biologique et de pollinisateurs produits par le secteur privé offrent également un relevé documenté des diverses catégories d'expéditions à faible risque pour des livraisons d'insectes vivants en grandes quantités et répondant à des normes de qualité élevées. Les décideurs politiques devraient pouvoir accéder à plus d'informations (à travers des publications ou des articles officiels) décrivant en détail les risques réels associés aux insectes eux-mêmes ou à leurs contaminants éventuels, et proposer en connaissance de cause des niveaux de gestion proportionnels à ces risques. La récolte d'insectes prélevés directement de la nature peut être dommageable aussi bien pour les environnements source que pour ceux de destination. Plusieurs cadres fondés sur le risque intègrent désormais les insectes dans leurs directives. Par ailleurs, nombre d'organismes internationaux de coordination ont acquis une expérience dans l'élaboration de lignes directrices face à ces risques. Il serait bénéfique pour toutes les parties prenantes de disposer d'une vue d'ensemble intégrée des directives applicables aux expéditions d'insectes, qui recense les différents types de risque et leurs ordres de grandeur sans se prononcer sur une approche unique qui nécessiterait une adhésion universelle. Ni les propositions visant à gérer l'incertitude ni l'insuffisance des données disponibles sur les expéditions d'insectes en petits nombres ou occasionnelles ne doivent perturber les échanges commerciaux d'insectes vivants en grandes quantités, échanges qui participent aujourd'hui aux objectifs stratégiques de nombreux secteurs.

Una red de científicos relacionados de un modo u otro con el transporte de insectos vivos mantuvo un encuentro y generó una serie de artículos en torno a la cuestión. En la red, muy heterogénea, convergen desde intereses comerciales de gran calado hasta programas públicos de lucha biológica en grandes territorios, pasando por la investigación biomédica y por numerosas aplicaciones de menor dimensión en ámbitos como la investigación, la enseñanza u otros usos privados. Muchas especies de insectos cuentan con un buen historial de seguridad en el transporte, presentan un riesgo mínimo y son expedidas a menudo de un país a otro. Buen ejemplo de ello son los envíos sistemáticos de ejemplares de Drosophila melanogaster, que es el insecto utilizado con más frecuencia como organismo modelo en la investigación biomédica. Otro precedente de envíos voluminosos cuyo transporte y entrega se ajusta a los más exigentes criterios de calidad lo sientan las remesas de grandes cantidades de polinizadores y agentes de control biológico remitidos por proveedores comerciales. Los responsables de adoptar decisiones deben disponer de más y más detallada información (publicaciones o documentos oficiales) sobre los riesgos reales derivados de los propios insectos o sus posibles contaminantes para proponer a partir de ahí medidas de gestión proporcionadas. Los perjuicios ambientales pueden darse tanto en origen (cuando hay captura salvaje de insectos, o sea recolección directa en el medio) como en destino. Hay varios sistemas de determinación del riesgo que incluyen a los insectos y también existen diversos organismos de coordinación internacional que ya tienen experiencia en sentar pautas sobre los riesgos en la materia. Todos los interlocutores del sector se beneficiarían de una visión global e integrada del transporte de insectos, que remita a diferentes tipos de riesgo y categorías de magnitud, sin necesidad de buscar un sistema único que exija consenso universal. Las propuestas para gestionar la incertidumbre y la falta de información en el caso de envíos infrecuentes o de pequeñas dimensiones, por ejemplo, no deben interferir en el transporte de grandes cantidades de insectos vivos, que ya está sirviendo a objetivos estratégicos en varios sectores.

Issues and gaps in international guidance and national regulatory systems affecting international live insect trade.

International trade in live insects involves the shipping of many different species, for various purposes, with a variety of handling requirements regulated by numerous authorities with varying objectives. The diversity of factors at play has both created and been subject to a complex regulatory landscape. A review of global production, shipping and use experiences from a range of perspectives has shown gaps and inconsistencies in international guidance and national implementation. Private carriers add another layer of uncertainty that is disproportionate to risks, resulting in variable practices and charges. Many benefits can come from international trade in insects, including pollinator services, control of pests and of disease vectors, and enhanced international scientific research and innovation. These benefits will be better achieved through a more evidence-based and efficient approach to regulating trade. This change in approach will in turn require an improved and widely accepted risk-management landscape for insect trade.

Le commerce international d'insectes vivants s'appuie sur les expéditions de nombreuses espèces différentes à diverses fins, assorties de multiples exigences relatives à la manutention régies par des autorités différentes poursuivant des objectifs distincts. La diversité des facteurs en jeu a rendu nécessaire la création d'un paysage normatif complexe, avec les contraintes qui lui sont associées. L'examen à l'échelle mondiale de la production, du transport et des expériences dans ce domaine depuis diverses perspectives a révélé un certain nombre de lacunes et d'incohérences au niveau des directives internationales et de leurs applications concrètes dans les pays. Les transporteurs privés ajoutent une dimension d'incertitude supplémentaire qui est disproportionnée par rapport aux risques, ce qui entraîne une forte variabilité des pratiques et des charges. Les échanges internationaux d'insectes génèrent nombre d'activités bénéfiques, parmi lesquelles les services de pollinisation, la lutte contre les ravageurs et les vecteurs de maladie, et l'accroissement de la recherche scientifique internationale et de l'innovation. Les objectifs attendus seront mieux atteints en adoptant une approche de la réglementation des échanges qui s'appuie davantage sur des éléments factuels et sur les gains d'efficacité. Ce changement méthodologique nécessitera à son tour la mise en place d'un cadre amélioré et plus largement accepté de la gestion des risques dans le domaine du commerce des insectes.

El comercio internacional de insectos vivos, que supone el transporte de muchas especies diferentes con fines diversos, se acompaña de requisitos de manipulación que dictan numerosas autoridades con todo tipo de objetivos. La diversidad de los factores que entran en juego ha sido a la vez causa y consecuencia de un complejo panorama reglamentario. Los autores, tras describir un estudio a escala mundial de la experiencia de producción, transporte y utilización de insectos vivos desde diferentes puntos de vista, exponen las carencias e incoherencias observadas en las directrices internacionales y su traslación a escala nacional. Los transportistas privados añaden otro factor de incertidumbre que tiene un peso desproporcionado en relación con el nivel de riesgo y se traduce en procedimientos y precios heterogéneos. El comercio internacional de insectos puede traer consigo muchos beneficios, en particular servicios de polinización, control de plagas y de vectores de enfermedad, y avances de la investigación e innovación científica a escala internacional. Pero obtener esos beneficios será más fácil si se aborda la regulación del comercio de manera más eficaz y científicamente fundamentada, operando un cambio de lógica que exigirá, a su vez, la aplicación al comercio de insectos de un régimen más sofisticado y ampliamente aceptado de gestión de los riesgos.

International live insect trade: a survey of stakeholders.

There are significant numbers of transboundary shipments of live insects for pollination, pest management, industrial processes, research and other uses, but data collection and analysis have proved difficult. The World Organisation for Animal Health and Collectif TIS (Technique de l'Insecte Stérile), a French think tank, carried out a stakeholder survey to understand the nature of the live insect trade and potential challenges to safety and efficiency. Target respondents had experience in the areas of biocontrol, sterile insect technique, entomological research and regulatory affairs. Although the survey was sent globally, the responses were unintentionally biased towards Europe, where interest is high, since this region is developing a comprehensive framework to promote the use of beneficial insects to replace pesticides. The survey also explored respondents' knowledge of several international agreements on the movement and risk management of beneficial or invasive insects. Knowledge of the various regulations was generally poor, and respondents highlighted a perceived lack of clarity regarding live insect shipments in the existing international regulations and guidelines. Almost two-thirds of participants reported reluctance by carriers to accept live insects for shipment, and three-quarters described occasional to systematic delays that resulted in a reduction of quality or viability. Some respondents reported that they instead hand-carry live insects, mostly in small quantities. Participants described being directly involved in trade covering 70 species of live insects and ticks transported among 37 countries, with volumes ranging from fewer than ten insects to over a million per shipment. Of these, 30% were potential vectors of pathogens to humans or animals, 42% were potential plant pest species (including some used for biocontrol), and 17% were classical biocontrol agents. The results of this survey begin to define the current scope, scale and issues for those involved in shipping live insects and ticks across political boundaries. The survey's aim is to persuade regulatory bodies and shipping operators to facilitate safety, efficiency and consistency in this underdeveloped sector.

Les insectes vivants font l'objet d'un nombre important d'expéditions transfrontalières à des fins de pollinisation, de gestion des nuisibles, d'utilisation dans des processus industriels et de recherche, parmi d'autres emplois ; or, la collecte et l'analyse de données sur le sujet se sont révélées difficiles. L'Organisation mondiale de la santé animale et le Collectif TIS (Technique de l'insecte stérile), groupe de réflexion français, ont mené une enquête auprès de parties prenantes afin de comprendre la nature du commerce international d'insectes vivants ainsi que les éventuels problèmes de sécurité et d'efficacité qui lui sont associés. Les répondants sont des acteurs expérimentés dans les domaines du contrôle biologique, de la technique de l'insecte stérile, de la recherche entomologique et des questions réglementaires. Si le questionnaire a été distribué dans toutes les régions du monde, les réponses ont toutefois présenté un biais involontaire privilégiant l'Europe, région où l'intérêt pour cette question est élevé compte tenu du cadre réglementaire qui y est actuellement mis en place pour promouvoir l'utilisation des insectes utiles en replacement des pesticides. L'enquête visait également à déterminer le niveau de connaissance des répondants sur les divers accords internationaux relatifs aux mouvements d'insectes utiles ou envahissants, ainsi que sur la gestion des risques en la matière. Il en ressort que les diverses réglementations sont généralement méconnues, les répondants mettant en avant leur perception d'un manque de clarté des réglementations et directives internationales applicables aux expéditions d'insectes vivants. Près des deux tiers des participants ont fait état des réticences des transporteurs à accepter des cargaisons d'insectes vivants et les trois quarts d'entre eux ont rapporté des retards occasionnels ou systématiques se traduisant par une perte de qualité ou de viabilité. Certains répondants ont déclaré qu'ils préféraient transporter eux-mêmes les insectes vivants, la plupart du temps en petites quantités. Les répondants ont décrit leur participation directe dans des échanges couvrant au total 70 espèces de tiques et d'insectes vivants transportés dans 37 pays, avec des volumes allant de moins de dix insectes à plus d'un million d'insectes par cargaison. Parmi les espèces transportées, 30 % étaient potentiellement vectrices d'agents pathogènes pour les humains ou les animaux, 42 % étaient des nuisibles potentiels pour les végétaux (y compris certaines espèces utilisées à des fins de lutte biologique) et 17 % étaient des agents classiques de la lutte biologique. Les résultats de cette enquête permettent d'esquisser la portée et l'échelle des expéditions transfrontalières d'insectes vivants et de tiques, ainsi que la teneur des problèmes rencontrés par ceux qui y prennent part. L'objectif de l'enquête est de convaincre les organismes chargés de la réglementation ainsi que les transporteurs internationaux de la nécessité d'apporter de meilleures conditions de sécurité et d'efficacité à ce secteur sous-développé et d'en assurer la cohérence.

Pese al importante número de envíos transfronterizos de insectos vivos que se realizan con fines de polinización, gestión de plagas, procesos industriales, investigación u otros usos, hasta ahora ha resultado difícil reunir y analizar datos al respecto. La Organización Mundial de Sanidad Animal y el grupo de reflexión francés Collectif TIS (Technique de l'Insecte Stérile) hicieron una encuesta entre las partes interesadas con el fin de conocer mejor las características del comercio de insectos vivos y los factores que pueden amenazar su seguridad y eficacia. La encuesta iba dirigida a personas con experiencia en materia de control biológico, uso de la técnica del insecto estéril, investigaciones entomológicas o aspectos reglamentarios. Aunque la encuesta fue distribuida por todo el mundo, las respuestas presentaban un involuntario sesgo «europeo¼ debido al gran interés que el tema suscita en Europa, donde se está elaborando un marco reglamentario para promover el uso de insectos beneficiosos en sustitución de los plaguicidas. La encuesta indagaba asimismo en el grado de conocimiento que tenían los participantes de varios acuerdos internacionales relativos al desplazamiento de insectos beneficiosos o invasores y a la gestión de los riesgos conexos. En términos generales, los encuestados conocían poco las diversas reglamentaciones y destacaban lo que a su juicio era falta de claridad de las vigentes normativas y directrices internacionales por lo que respecta a los cargamentos de insectos vivos. Casi dos tercios de los participantes afirmaron que los transportistas eran reacios a aceptar cargamentos de insectos vivos y tres cuartas partes refirieron demoras ocasionales o sistemáticas que mermaban la calidad o viabilidad de las remesas. Algunos dijeron haber optado a cambio por el transporte manual de insectos vivos, casi siempre en pequeñas cantidades. Los encuestados afirmaron tomar parte directamente en un comercio que mueve 70 especies de insectos o ácaros vivos por 37 países, en cantidades que van desde menos de diez insectos a más de un millón de ejemplares por envío. De esas especies, un 30% correspondía a posibles vectores de patógenos humanos o animales, un 42% a posibles plagas vegetales (algunas de ellas utilizadas con fines de control biológico) y un 17% a agentes clásicos de control biológico. Los resultados permiten empezar a acotar el alcance, la escala y la naturaleza de los problemas a que se enfrentan quienes intervienen en el envío transfronterizo de insectos y ácaros vivos. La encuesta tiene por objetivo convencer a organismos de reglamentación y transportistas de que procuren fomentar la seguridad, eficiencia y coherencia de este infradesarrollado sector.

Preparing an Insectary in Burkina Faso to Support Research in Genetic Technologies for Malaria Control.

The Institut de Recherche en Sciences de la Santé (IRSS) of Burkina Faso, West Africa, was the first African institution to import transgenic mosquitoes for research purposes. A shift from the culture of mosquito research to regulated biotechnology research and considerable management capacity is needed to set up and run the first insectary for transgenic insects in a country that applied and adapted the existing biosafety framework, first developed for genetically modified (GM) crops, to this new area of research. The additional demands arise from the separate regulatory framework for biotechnology, referencing the Cartagena Protocol on Biosafety, and the novelty of the research strain, making public understanding and acceptance early in the research pathway important. The IRSS team carried out extensive preparations following recommendations for containment of GM arthropods and invested efforts in local community engagement and training with scientific colleagues throughout the region. Record keeping beyond routine practice was established to maintain evidence related to regulatory requirements and risk assumptions. The National Biosafety Agency of Burkina Faso, Agence Nationale de Biosécurité (ANB), granted the permits for import of the self-limiting transgenic mosquito strain, which took place in November 2016, and for conducting studies in the IRSS facility in Bobo-Dioulasso. Compliance with permit terms and conditions of the permits and study protocols continued until the conclusion of studies, when the transgenic colonies were terminated. All this required close coordination between management and the insectary teams, as well as others. This article outlines the experiences of the IRSS to support others undertaking such studies. The IRSS is contributing to the ongoing development of genetic technologies for malaria control, as a partner of Target Malaria. The ultimate objective of the innovation is to reduce malaria transmission by using GM mosquitoes of the same species released to reduce the disease-vectoring native populations of Anopheles gambiae s.l.

Auditing Preparedness for Vector Control Field Studies.

The value of baseline entomological data to any future area-wide release campaign relies on the application of consistent methods to produce results comparable across different times and places in a stepwise progression to larger releases. Traditionally, standard operating procedures (SOPs) and operational plans support this consistency and, thus, the validity of emergent data. When release plans include transgenic mosquitoes for vector control or other novel beneficial insects, additional factors come into play such as biosafety permits, stakeholder acceptance, and ethics approval, which require even greater coordination and thoroughness. An audit approach was developed to verify the correct use of SOPs and appropriate performance of tasks during mosquito mark, release, recapture (MRR) studies. Audit questions matched SOPs, permit terms and conditions, and other key criteria, and can be used to support subsequent "spot check" verification by field teams. An external team of auditors, however, was found to be effective for initial checks in this example before the use of a transgenic strain of laboratory mosquitoes. We recommend similar approaches for field studies using release of novel beneficial insects, to ensure useful and valid data as an outcome and to support confidence in the rigor of the step-wise process.

Effects of the removal or reduction in density of the malaria mosquito, Anopheles gambiae s.l., on interacting predators and competitors in local ecosystems.

New genetic control methods for mosquitoes may reduce vector species without direct effects on other species or the physical environment common with insecticides or drainage. Effects on predators and competitors could, however, be a concern as Anopheles gambiae s.l. is preyed upon in all life stages. We overview the literature and assess the strength of the ecological interactions identified. Most predators identified consume many other insect species and there is no evidence that any species preys exclusively on any anopheline mosquito. There is one predatory species with a specialisation on blood-fed mosquitoes including An. gambiae s.l.. Evarcha culicivora is a jumping spider, known as the vampire spider, found around Lake Victoria. There is no evidence that these salticids require Anopheles mosquitoes and will readily consume blood-fed Culex. Interspecific competition studies focus on other mosquitoes of larval habitats. Many of these take place in artificial cosms and give contrasting results to semi-field studies. This may limit their extrapolation regarding the potential impact of reduced An. gambiae numbers. Previous mosquito control interventions are informative and identify competitive release and niche opportunism; so while the identity and relative abundance of the species present may change, the biomass available to predators may not.

Drug use among men who have sex with men in Ireland: Prevalence and associated factors from a national online survey.

BACKGROUND: Little is known about the prevalence and determinants of drug use among men who have sex with men (MSM) in Ireland. The aims of this study were to measure the prevalence of recreational drug use among MSM in a national sample, and to identify sub-groups of MSM who may benefit from targeted preventive interventions. METHODS: The MSM Internet Survey Ireland (MISI) 2015 was a community-recruited, nationally-promoted, self-completed online survey for MSM. MISI 2015 included standardised questions on recreational drugs, poppers, and drugs associated with chemsex (i.e. crystal methamphetamine, GBL/GHB, mephedrone, ketamine). Multivariable-adjusted logistic regression was used to identify factors associated with use of these substances. RESULTS: In the previous year, 36% of MSM used recreational drugs, 33% used poppers, and 7% used drugs associated with chemsex. Five percent were diagnosed HIV-positive. Recreational drug users were significantly younger than non-users (median = 27 vs. 32 years; p < 0.001); popper users were significantly older than non-users (median = 34 vs. 28 years; p < 0.001). The odds of recreational drug use were higher among MSM diagnosed HIV-positive (vs. never tested; AOR 2.27, 95%CI 1.39-3.70). Use of poppers, and use of drugs associated with chemsex, were also higher among MSM diagnosed HIV-positive (vs. never tested; AOR 3.77, 95%CI 2.41-5.90, and AOR 5.87, 95%CI 3.08-11.18 respectively). CONCLUSIONS: The prevalence of recreational drug use is higher among MSM than in the general population in Ireland, and it is particularly high among MSM diagnosed HIV-positive. Targeted harm reduction messages and preventive interventions are warranted to complement population-based approaches to reducing drug use in this population.

Inequalities in HIV testing uptake and needs among men who have sex with men living in Ireland: findings from an internet survey.

OBJECTIVES: HIV disproportionately affects men who have sex with men (MSM) in Ireland. The aim of this study was to improve understanding of HIV testing among MSM living in Ireland to inform prevention and testing initiatives. METHODS: We used data from the MSM Internet Survey Ireland 2015 (MISI 2015), a cross-sectional survey of MSM living in Ireland. We identified factors associated with never having tested for HIV using univariable and multivariable logistic regression. We identified preferred sites for future tests and examined the relationships between unmet HIV testing needs and socio-demographic groups. RESULTS: More than one-third (n = 1006; 36%) of MSM had never tested for HIV. Multivariable logistic regression showed that untested men were more likely to be aged 18-24 years, live outside Dublin, have a lower level of education, be born in Ireland, identify as bisexual, be out to fewer people, and not have had sex with a man in the previous 12 months. The same groups of men also had the least knowledge about HIV and were least confident in accessing an HIV test. Men who had never tested for HIV were more likely to prefer testing by their general practitioner (GP) or using home sampling HIV kits and less likely to prefer testing in a sexual health clinic. CONCLUSIONS: HIV prevention and testing programmes for MSM should be targeted towards younger men, those living outside Dublin and those with lower levels of education. We recommend increased promotion and availability of free HIV testing services in a range of clinical and nonclinical settings (including self-sampling and home testing).

Miniaturised percutaneous nephrolithotomy versus flexible ureteropyeloscopy: a systematic review and meta-analysis comparing clinical efficacy and safety profile.

PURPOSE: This study aims to comparatively evaluate clinical outcomes of mini-PCNL and FURS for treating urinary tract calculi in a single session. METHODS: A systematic search using electronic databases was performed for studies comparing mini-PCNL and FURS for the treatment of urinary tract calculi. The primary outcome measurements were stone-free rates (SFRs) and complication rates for both techniques. Secondary outcome measurements were to compare patient demographics, operative duration, and inpatient stay. Meta-analysis was performed with Review Manager version 5.3 software. RESULTS: Sixteen studies on 1598 patients (n = 877 for mini-PCNL and n = 721 for FURS) met inclusion criteria. Demographics including age (p = 0.26), body mass index (BMI) (p = 0.51), and gender ratio (p = 0.6), were similar in both groups. Overall, SFR was significantly greater in the mini-PCNL group compared to the FURS group (n = 763/877, 89.3 ± 8.4% versus n = 559/721, 80.1 ± 13.3% [OR 2.01; 95% CI 1.53-2.64; p < 0.01]). Duration of inpatient stay was significantly greater in the mini-PCNL group compared to the FURS group (n = 877, 4 ± 1.6 days versus n = 721, 2.5 ± 2.2 days, respectively [WMD: 1.77; 95% CI 1.16-2.38, p < 0.01]. Overall complication rates were not significantly different between mini-PCNL and FURS (n = 171/877, 19.5 ± 19.1% versus n = 112/721, 15.5 ± 18.9%, respectively [OR 1.43; 95% CI 0.85-2.4, p = 0.18]). CONCLUSIONS: Mini-PCNL is associated with greater SFRs and longer inpatient stay compared to FURS. Complication rates were similar for both techniques. The advantages and disadvantages of both technologies should be familiar to urologists and conveyed to patients prior to urological intervention for nephrolithiasis.

Biomaterials and Regenerative Medicine in Urology.

Autologous gastrointestinal tissue is the gold standard biomaterial for urinary tract reconstruction despite its long-term neuromechanical and metabolic complications. Regenerative biomaterials have been proposed as alternatives; however many are limited by a poor host derived regenerative response and deficient supportive elements for effective tissue regeneration in vivo. Urological biomaterials are sub-classified into xenogenic extracellular matrices (ECMs) or synthetic polymers. ECMs are decellularised, biocompatible, biodegradable biomaterials derived from animal organs. Synthetic polymers vary in chemical composition but may have the benefit of being reliably reproducible from a manufacturing perspective. Urological biomaterials can be 'seeded' with regenerative stem cells in vitro to create composite biomaterials for grafting in vivo. Mesenchymal stem cells are advantageous for regenerative purposes as they self-renew, have long-term viability and possess multilineage differentiation potential. Currently, tissue-engineered biomaterials are developing rapidly in regenerative urology with many important clinical milestones achieved. To truly translate from bench to bedside, regenerative biomaterials need to provide better clinical outcomes than current urological tissue replacement strategies.

Maintaining Quality of Candidate Strains of Transgenic Mosquitoes for Studies in Containment Facilities in Disease Endemic Countries.

Transgenic mosquitoes are being developed as novel components of area-wide approaches to vector-borne disease control. Best practice is to develop these in phases, beginning with laboratory studies, before moving to field testing and inclusion in control programs, to ensure safety and prevent costly field testing of unsuitable strains. The process of identifying and developing good candidate strains requires maintenance of transgenic colonies over many generations in containment facilities. By working in disease endemic countries with target vector populations, laboratory strains may be developed and selected for properties that will enhance intended control efficacy in the next phase, while avoiding traits that introduce unnecessary risks. Candidate strains aiming toward field use must consistently achieve established performance criteria, throughout the process of scaling up from small study colonies to production of sufficient numbers for field testing and possible open release. Maintenance of a consistent quality can be demonstrated by a set of insect quality and insectary operating indicators, measured over time at predetermined intervals. These indicators: inform comparability of studies using various candidate strains at different times and locations; provide evidence of conformity relevant to compliance with terms of approval for regulated use; and can be used to validate some assumptions related to risk assessments covering the contained phase and for release into the environment.

Studies of Transgenic Mosquitoes in Disease-Endemic Countries: Preparation of Containment Facilities.

Novel approaches to area-wide control of vector species offer promise as additional tools in the fight against vectored diseases. Evaluation of transgenic insect strains aimed at field population control in disease-endemic countries may involve international partnerships and should be done in a stepwise approach, starting with studies in containment facilities. The preparations of both new-build and renovated facilities are described, including working with local and national regulations regarding land use, construction, and biosafety requirements, as well as international guidance to fill any gaps in regulation. The examples given are for containment categorization at Arthropod Containment Level 2 for initial facility design, classification of wastes, and precautions during shipping. Specific lessons were derived from preparations to evaluate transgenic (non-gene drive) mosquitoes in West and East African countries. Documented procedures and the use of a non-transgenic training strain for trial shipments and culturing were used to develop competence and confidence among the African facility staff, and along the chain of custody for transport. This practical description is offered to support other research consortia or institutions preparing containment facilities and operating procedures in conditions where research on transgenic insects is at an early stage.

Containment Studies of Transgenic Mosquitoes in Disease Endemic Countries: The Broad Concept of Facilities Readiness.

Genetic strategies for large scale pest or vector control using modified insects are not yet operational in Africa, and currently rely on import of the modified strains to begin preliminary, contained studies. Early involvement of research teams from participating countries is crucial to evaluate candidate field interventions. Following the recommended phased approach for novel strategies, evaluation should begin with studies in containment facilities. Experiences to prepare facilities and build international teams for research on transgenic mosquitoes revealed some important organizing themes underlying the concept of "facilities readiness," or the point at which studies in containment may proceed, in sub-Saharan African settings. First, "compliance" for research with novel or non-native living organisms was defined as the fulfillment of all legislative and regulatory requirements. This is not limited to regulations regarding use of transgenic organisms. Second, the concept of "colony utility" was related to the characteristics of laboratory colonies being produced so that results of studies may be validated across time, sites, and strains or technologies; so that the appropriate candidate strains are moved forward toward field studies. Third, the importance of achieving "defensible science" was recognized, including that study conclusions can be traced back to evidence, covering the concerns of various stakeholders over the long term. This, combined with good stewardship of resources and appropriate funding, covers a diverse set of criteria for declaring when "facilities readiness" has been attained. It is proposed that, despite the additional demands on time and resources, only with the balance of and rigorous achievement of each of these organizing themes can collaborative research into novel strategies in vector or pest control reliably progress past initial containment studies.

The impact of a structured clinical training course on interns' self-reported confidence with core clinical urology skills.

BACKGROUND: Undergraduate training in core urology skills is lacking in many Irish training programmes. AIMS: Our aim was to assess newly qualified doctors' experience and confidence with core urological competencies. METHODS: A questionnaire survey covering exposure to urology and confidence with core clinical skills was circulated to all candidates. The group then attended a skills course covering male/female catheterisation, insertion of three-way catheters, bladder irrigation and management of long-term suprapubic catheters. The groups were re-surveyed following the course. RESULTS: Forty-five interns completed the pre-course questionnaire (group 1) and 27 interns completed the post-course questionnaire (group 2). 24/45 (53%) had no experience of catheter insertion on a patient during their undergraduate training. 26/45 (58%) were unsupervised during their first catheter insertion. 12/45 (27%) had inserted a female catheter. 18/45 (40%) had inserted a three-way catheter. 12/45 (27%) had changed a suprapubic catheter. 40/45 (89%) in group 1 reported 'good' or 'excellent' confidence with male urinary catheterisation, compared to 25/27 (92.5%) in group 2. 18/45 (40%) in group 1 reported 'none' or 'poor' confidence with female catheterisation, compared to 7/27 (26%) in group 2. 22/45 (49%) in group 1 reported 'none' or 'poor' confidence with insertion of three-way catheters, compared to 2/27 (7%) in group 2. 32/45 (71%) in group 1 reported 'none' or 'poor' confidence in changing long-term suprapubic catheters, falling to 3/27 (11%) in group 2. CONCLUSION: This study raises concerns about newly qualified doctors' practical experience in urology. We suggest that this course improves knowledge and confidence with practical urology skills and should be incorporated into intern induction.

Single-use flexible ureteropyeloscopy: a systematic review.

PURPOSE: Data assessing the effectiveness of single-use flexible ureteropyeloscopy (FURS) are limited. This study evaluates and compares single-use FURS with conventional reusable FURS. METHODS: A systematic search using electronic databases (Pubmed and Embase) was performed for studies evaluating single-use FURS in the setting of urinary tract stone disease. Outcome measures included a comparative evaluation of their mechanical, optical and clinical outcomes. RESULTS: Eleven studies on 466 patients met inclusion criteria. In vitro comparative data were available on three single-use flexible ureteropyeloscopes (LithoVue™, Polyscope™ and SemiFlex™) and clinical data were available on two (LithoVue™ and Polyscope™). The overall stone-free rate and complication rate associated with single-use FURS was 87 ± 15% and 9.3 ± 9%, respectively. There were no significant differences in procedure duration, stone size, stone clearance and complication rates when single-use FURS and reusable FURS were compared (duration: 73 ± 27 versus 74 ± 13 min, p = 0.99; stone size: 1.36 ± 0.2 versus 1.34 ± 0.18 cm, p = 0.93; stone-free rate: 77.8 ± 18 versus 68.5 ± 33%, p = 0.76; complication rate 15.3 ± 10.6 versus 15 ± 1.6%, p = 0.3). CONCLUSIONS: Single-use FURS demonstrates comparable efficacy with reusable FURS in treating renal calculi. Further studies on clinical efficacy and cost are needed to determine whether single-use FURS will reliably replace its reusable counterpart.

Bayesian Networks to Compare Pest Control Interventions on Commodities Along Agricultural Production Chains.

The production of an agricultural commodity involves a sequence of processes: planting/growing, harvesting, sorting/grading, postharvest treatment, packing, and exporting. A Bayesian network has been developed to represent the level of potential infestation of an agricultural commodity by a specified pest along an agricultural production chain. It reflects the dependency of this infestation on the predicted level of pest challenge, the anticipated susceptibility of the commodity to the pest, the level of impact from pest control measures as designed, and any variation from that due to uncertainty in measure efficacy. The objective of this Bayesian network is to facilitate agreement between national governments of the exporters and importers on a set of phytosanitary measures to meet specific phytosanitary measure requirements to achieve target levels of protection against regulated pests. The model can be used to compare the performance of different combinations of measures under different scenarios of pest challenge, making use of available measure performance data. A case study is presented using a model developed for a fruit fly pest on dragon fruit in Vietnam; the model parameters and results are illustrative and do not imply a particular level of fruit fly infestation of these exports; rather, they provide the most likely, alternative, or worst-case scenarios of the impact of measures. As a means to facilitate agreement for trade, the model provides a framework to support communication between exporters and importers about any differences in perceptions of the risk reduction achieved by pest control measures deployed during the commodity production chain.