Evidence for the effects of neonicotinoids used in arable crop production on non-target organisms and concentrations of residues in relevant matrices: a systematic map protocol

Background Neonicotinoid insecticides (NNIs) have been routinely used in arable crop protection since their development in the early 1990s. These insecticides have been subject to the same registration procedures as other groups of pesticides, thus meet the same environmental hazard standards as all crop protection products. However, during the last 10 years the debate regarding their possible detrimental impact on non-target organisms, particularly pollinators, has become increasingly contentious and widely debated. Against this background, legislators and politicians in some countries, have been faced with a need to make decisions on the future registration of some or all of this class of insecticides, based on published evidence that in some areas is incomplete or limited in extent. This has created much concern in agricultural communities that consider that the withdrawal of these insecticides is likely to have significant negative economic, socio-economic and environmental consequences. Methods The proposed systematic map aims to address the following primary question: What is the available evidence for the effects of neonicotinoids used in arable crop production on non-target organisms and concentrations of residues in relevant matrices? The primary question will be divided into two sub-questions to gather research literature for (1) the effect of NNIs on non-target organisms (2) the occurrence of concentrations of NNIs in matrices of relevance to non-target organisms (i.e. exposure routes). The systematic map will focus on NNIs used in arable crop production: imidacloprid, clothianidin, thiamethoxam, acetamiprid, thiacloprid and dinotefuran. Separate inclusion criteria have been developed for each sub-question. Traditional academic and grey literature will be searched for in English language and a searchable databases containing extracted meta-data from relevant included studies will be developed

Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer

IntroductionSentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance.MethodsA Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability.ResultsSeventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach alpha=0.88).ConclusionSpecific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.Cervix cance