Ethical analysis examining the prioritisation of living donor transplantation in times of healthcare rationing

The transplant community has faced unprecedented challenges balancing risks of performing living donor transplants during the COVID-19 pandemic with harms of temporarily suspending these procedures. Decisions regarding postponement of living donation stem from its designation as an elective procedure, this despite that the Centers for Medicare and Medicaid Services categorise transplant procedures as tier 3b (high medical urgency—do not postpone). In times of severe resource constraints, health systems may be operating under crisis or contingency standards of care. In this manuscript, the United Network for Organ Sharing Ethics Workgroup explores prioritisation of living donation where health systems operate under contingency standards of care and provide a framework with recommendations to the transplant community on how to approach living donation in these circumstances.To guide the transplant community in future decisions, this analysis suggests that: (1) living donor transplants represent an important option for individuals with end-stage liver and kidney disease and should not be suspended uniformly under contingency standards, (2) exposure risk to SARS-CoV-2 should be balanced with other risks, such as exposure risks at dialysis centres. Because many of these risks are not quantifiable, donors and recipients should be included in discussions on what constitutes acceptable risk, (3) transplant hospitals should strive to maintain a critical transplant workforce and avoid diverting expertise, which could negatively impact patient preparedness for transplant, (4) transplant hospitals should consider implementing protocols to ensure early detection of SARS-CoV-2 infections and discuss these measures with donors and recipients in a process of shared decision-making.

Pesticide Exposure Risks to Chiropteran Species and the Impacts on Emerging Zoonotic Diseases

Neonicotinoids have been in the spotlight in the pollinator community as they persist in the soil, have high water solubility, and have been associated with negative health implications on insect pollinators. The risk of new novel pesticides, including neonicotinoids, to bats are largely unknown. Bats have unique physiology as they are the only mammals capable of true and sustained flight, and have physiological adaptations including echolocation and torpor which under current protocols for acute and chronic toxicity studies in birds and terrestrial animals are not assessed. Due to these characteristics, some have argued that bats may serve as important bioindicators for ecosystem health and pesticide use. This chapter will focus on pesticides, and discuss the increased risk of exposure, morbidity, and mortality of bats species due to their unique physiology and natural life history. Special emphasis will be on potential increased risk of zoonotic disease transmission in bats exposed to emerging contaminants that suppress their immune system or cause increased biological stress.

Metabolomic and bioenergetic responses of human hepatocellular carcinoma cells following exposure to commercial copper hydroxide nanopesticide

Copper hydroxide (Cu(OH)2) nanopesticide formulas are becoming more frequently used in agriculture, however human exposure risks are not completely characterized. Here, the effect of Cu(OH)2 nanopesticide exposure on cell metabolism...

Meteorological and climatic variables predict the phenology of Ixodes ricinus nymphs activity in France, accounting for habitat heterogeneity

Ixodes ricinus ticks (Acari: Ixodidae) are the most important vector for Lyme borreliosis in Europe. As environmental and climate changes might affect the distribution and activity of tick populations, this study aimed to determine the effects of environmental factors, i.e., meteorological, bioclimatic, and habitat characteristics on questing activity of I. ricinus nymphs across diverse climatic types in France over an 8-year period. Questing activity was observed using a repeated removal sampling design with a cloth-dragging technique in 11 sampling sites from 7 tick observatories from 2014 to 2021 at approximately 1-month intervals, involving 631 sampling campaigns. Three phenological patterns were observed, potentially following a climatic gradient. The mixed-effects negative binomial regression revealed that observed nymph counts were driven by different interval-average meteorological variables, including one-month average temperature, previous-season average temperature, and half-year average minimum relative humidity. The interaction effects indicated that the phenology in colder climates peaked differently from that of warmer climates. Also, the land cover characteristics that support the highest baseline abundance were moderate forest fragmentation with transition borders with agricultural areas. Finally, our model could potentially be used to predict seasonal human-tick exposure risks in France that could contribute to mitigating Lyme borreliosis risks.

Insect Resistance to Neonicotinoids - Current Status, Mechanism and Management Strategies

Pesticides are any substance used for controlling, preventing, destroying, repelling, or mitigating of pests. Neonicotinoids have been the most commonly used insecticide since the early 1990s, current market share of more than 25% of total global insecticide sales. Neonicotinoid insecticides are highly selective agonists of insect nicotinic acetylcholine receptors (nAChRs) that exhibit physicochemical properties, rendering them more useful over other classes of insecticides. This includes having a wide range of application techniques and efficacy in controlling sucking and biting insects. Although neonicotinoids are applied as foliar insecticides with possible direct exposure risks to honeybees, a large part of neonicotinoid use consists of seed coating or root drench application. There are three major detoxification enzymes involved in the development of resistance against insecticides viz., cytochrome P450 monooxygenases, carboxylesterases, and glutathione S-transferases. The repeatedly used use of compounds of the same active ingredients and application of excessive organophosphates (OPs) and pyrethroids in Bemisia tabaci. Resistance to insecticides resulting in loss of efficacy of many older insecticides has placed excessive pressure on novel products. One of the major limitations to resistance management is the occurrence of cross-resistance. This review briefly summarizes the current status of neonicotinoid resistance, the biochemical and mechanisms involved, and the implications for resistance management.