Checklist of Bloodfeeding Mites (Acari: Spinturnicidae) from the Wings of Bats (Mammalia: Chiroptera) in the Manú Biosphere Reserve, Peru

A survey collection of mites of the family Spinturnicidae from Peruvian bats includes 11 species of Periglischrus (acutisternus, gameroi, grandisoma, herrerai, hopkinsi, iheringi, micronycteridis, ojasti, paracutisternus, paravargasi, and ramirezi) and 2 Spinturnix (americanus and bakeri); almost all represent new locality records. This survey collection is available for further study at the following repositories: The Harold W. Manter Laboratory of Parasitology, University of Nebraska–Lincoln; the Field Museum of Natural History, Chicago; and the Laboratório de Espeleobiologia y Acarologia, Universidad Nacional Autónoma de México. When spinturnicid mites are collected to avoid cross-contamination by mites among species of bats, parasitic associations are consistently host specific, with Periglischrus spp. distributed exclusively on phyllostomid bats, and Spinturnix spp. on vespertilionids. Notable disjunctions within the Manú Reserve include an absence of spinturnicids on bats of the genus Carollia (Phyllostomidae), or with Chiroderma villosum (Stenodermatinae). Mites of the family Spinturnicidae are not normally associated with bats of the families Emballonuridae, Molossidae, or Noctilionidae. Resumen En una colección de ácaros de la familia Spinturnicidae en murciélagos peruanos se encontraron 11 especies de Periglischrus (acutisternus, gameroi, grandisoma, herrerai, hopkinsi, iheringi, micronycteridis, ojasti, paracutisternus, paravargasi, y ramirezi) y 2 Spinturnix (americanus y bakeri); la mayoría representan nuevos registros de localidad. Esta colección está disponible para su posterior estudio en las siguientes instituciones: Laboratorio de Parasitología Harold W. Manter, Universidad de Nebraska–Lincoln, Field Museum of Natural History, Chicago, y Laboratorio de Espeleobiología y Acarología, Universidad Nacional Autónoma de México. Si los espinturnicidos se recolectan evitando la contaminación cruzada de los ácaros, entre las especies de murciélagos, las asociaciones parasitarias son consistentemente específicas al hospedador, con Periglischrus spp. distribuido exclusivamente en murciélagos phyllostomidos y Spinturnix spp. en vespertilionidos. Las disyunciones notables dentro de la Reserva de Manu incluyen una ausencia de espinturnicidos en los murciélagos del género Carollia (Phyllostomidae), o con Chiroderma villosum (Stenodermatinae). Los ácaros de la familia Spinturnicidae normalmente no están asociados con murciélagos de las familias Emballonuridae, Molossidae, y Noctilionidae

Arthropods infesting small mammals (Insectivora and Rodentia) near Cedar Point Biological Station in southwestern Nebraska

Cedar Point Biological Station (CPBS) is located in the mixed grass prairie of the central Great Plains, at the transition between the subregions known as the “tall grass” and “short grass” prairies. Adding to the habitat diversity, there are wetlands and riparian habitats associated with the North Platte River and the edge of the Sandhills region of north central Nebraska. This concurrence of habitats supports a diverse small mammal community. The purpose of this paper is to assemble all published information on ectoparasites associated with small mammals (Insectivora, Rodentia) of southwestern Nebraska, and to report the results of an intensive survey carried out by students of the Parasitology field course during two summers at CPBS. In 2012 and 2013, 27 species of mammal-associated arthropods were collected, including five species of sucking lice (Anoplura), a chewing louse (Ischnocera), six species of fleas (Siphonaptera), thirteen species of mesostigmatic mites (Laelapidae, Macronyssidae, Macrochelidae), and two species of metastigmatic ticks (Ixodidae). These specimens were brushed from the pelage of 11 species of small mammals that were captured in a variety of habitats around CPBS. The arthropod list includes 17 new records for the State of Nebraska. This collection is housed in the Harold W. Manter Laboratory of Parasitology (HWML), University of Nebraska State Museum, at the University of Nebraska-Lincoln, and serves as a taxonomic base for our continued efforts to establish a long-term catalog of parasites associated with small mammals in southwestern Nebraska

Brigatinib Versus Crizotinib in ALK Inhibitor–Naive Advanced ALK-Positive NSCLC: Final Results of Phase 3 ALTA-1L Trial

Introduction: In the phase 3 study entitled ALK in Lung cancer Trial of brigAtinib in 1st Line (ALTA-1L), which is a study of brigatinib in ALK inhibitor–naive advanced ALK-positive NSCLC, brigatinib exhibited superior progression-free survival (PFS) versus crizotinib in the two planned interim analyses. Here, we report the final efficacy, safety, and exploratory results. Methods: Patients were randomized to brigatinib 180 mg once daily (7-d lead-in at 90 mg once daily) or crizotinib 250 mg twice daily. The primary end point was a blinded independent review committee–assessed PFS. Genetic alterations in plasma cell-free DNA were assessed in relation to clinical efficacy. Results: A total of 275 patients were enrolled (brigatinib, n = 137; crizotinib, n = 138). At study end, (brigatinib median follow-up = 40.4 mo), the 3-year PFS by blinded independent review committee was 43% (brigatinib) versus 19% (crizotinib; median = 24.0 versus 11.1 mo, hazard ratio [HR] = 0.48, 95% confidence interval [CI]: 0.35–0.66). The median overall survival was not reached in either group (HR = 0.81, 95% CI: 0.53–1.22). Posthoc analyses suggested an overall survival benefit for brigatinib in patients with baseline brain metastases (HR = 0.43, 95% CI: 0.21–0.89). Detectable baseline EML4-ALK fusion variant 3 and TP53 mutation in plasma were associated with poor PFS. Brigatinib exhibited superior efficacy compared with crizotinib regardless of EML4-ALK variant and TP53 mutation. Emerging secondary ALK mutations were rare in patients progressing on brigatinib. No new safety signals were observed. Conclusions: In the ALTA-1L final analysis, with longer follow-up, brigatinib continued to exhibit superior efficacy and tolerability versus crizotinib in patients with or without poor prognostic biomarkers. The suggested survival benefit with brigatinib in patients with brain metastases warrants future study

Continued use of afatinib with the addition of cetuximab after progression on afatinib in patients with EGFR mutation-positive non-small-cell lung cancer and acquired resistance to gefitinib or erlotinib

Objectives: In a phase Ib trial, afatinib plus cetuximab demonstrated promising clinical activity (objective response rate [ORR]: 29%; median progression-free survival [PFS]: 4.7 months) in patients with epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC) with acquired resistance to erlotinib or gefitinib. Here, a separate cohort exploring afatinib plus cetuximab after progression on afatinib is reported. Materials and methods: Patients with EGFR mutation-positive NSCLC who progressed on erlotinib or gefitinib received afatinib 40 mg daily until progression, followed by afatinib daily plus cetuximab 500 mg/m(2) every 2 weeks until progression or intolerable adverse events (AEs). Endpoints included safety, ORR, and PFS. Results: Thirty-seven patients received afatinib monotherapy. Two (5%) patients responded; median PFS was 2.7 months. Thirty-six patients transitioned to afatinib plus cetuximab. Four (11%) patients responded; median PFS was 2.9 months. Median PFS with afatinib plus cetuximab for patients who received afatinib monotherapy for >= 12 versus <12 weeks was 4.9 versus 1.8 months (p = 0.0354), and for patients with T790M-positive versus T790M-negative tumors was 4.8 versus 1.8 months (p = 0.1306). Fifty percent of patients receiving afatinib plus cetuximab experienced drug-related grade 3/4 AEs. The most frequent drug-related AEs (any grade) were diarrhea (70%), rash (49%), and fatigue (35%) with afatinib monotherapy and rash (69%), paronychia (39%), and dry skin (36%) with afatinib plus cetuximab. Conclusion: Sequential EGFR blockade with afatinib followed by afatinib plus cetuximab had a predictable safety profile and demonstrated modest activity in patients with EGFR mutation-positive NSCLC with resistance to erlotinib or gefitinib

Supporting mental health, wellbeing and study skills in Higher Education:an online intervention system

Abstract Background Dealing with psychological and study skill difficulties can present a challenge for both Higher Education (HE) students, who suffer from them, but also for HE Institutions and their support services. Alternative means of support, such as online interventions, have been identified as cost-effective and efficient ways to provide inclusive support to HE students, removing many of the barriers to help-seeking as well as promoting mental health and wellbeing. Case presentation The current case study initially outlines the rigorous approach in the development of one such online intervention system, MePlusMe. It further highlights key features that constitute innovative delivery of evidence-based psychological and educational practice in the areas of mental health, promotion of wellbeing, support of mood and everyday functioning, and study-skills enhancement. Conclusions This case study aims to present the innovative features of MePlusMe in relation to current needs and evidence-basis. Finally, it presents future directions in the evaluation, assessment, and evidence of the fitness-for-purpose process

'The terrible twos': Gaining control in the nursery?

'The terrible twos' are often described as a time of 'gaining control', usually thought of as adults asserting control over children, who learn to control themselves. However, toddlerhood is as much about children learning to take control for themselves. This paper is an attempt to detail something of the social geography in the toddler room of a Scottish nursery, considering both styles of adult control and the ways in which toddlers attempt to appropriate and reconfigure space and time for themselves. That is, the ways in which space and time are negotiated in the course of day-to-day nursery life

Brigatinib versus Crizotinib in ALK-Positive Non-Small-Cell Lung Cancer.

Background Brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor, has robust efficacy in patients with ALK-positive non-small-cell lung cancer (NSCLC) that is refractory to crizotinib. The efficacy of brigatinib, as compared with crizotinib, in patients with advanced ALK-positive NSCLC who have not previously received an ALK inhibitor is unclear.Methods In an open-label, phase 3 trial, we randomly assigned, in a 1:1 ratio, patients with advanced ALK-positive NSCLC who had not previously received ALK inhibitors to receive brigatinib at a dose of 180 mg once daily (with a 7-day lead-in period at 90 mg) or crizotinib at a dose of 250 mg twice daily. The primary end point was progression-free survival as assessed by blinded independent central review. Secondary end points included the objective response rate and intracranial response. The first interim analysis was planned when approximately 50% of 198 expected events of disease progression or death had occurred.Results A total of 275 patients underwent randomization; 137 were assigned to brigatinib and 138 to crizotinib. At the first interim analysis (99 events), the median follow-up was 11.0 months in the brigatinib group and 9.3 months in the crizotinib group. The rate of progression-free survival was higher with brigatinib than with crizotinib (estimated 12-month progression-free survival, 67% [95% confidence interval {CI}, 56 to 75] vs. 43% [95% CI, 32 to 53]; hazard ratio for disease progression or death, 0.49 [95% CI, 0.33 to 0.74]; P<0.001 by the log-rank test). The confirmed objective response rate was 71% (95% CI, 62 to 78) with brigatinib and 60% (95% CI, 51 to 68) with crizotinib; the confirmed rate of intracranial response among patients with measurable lesions was 78% (95% CI, 52 to 94) and 29% (95% CI, 11 to 52), respectively. No new safety concerns were noted.Conclusions Among patients with ALK-positive NSCLC who had not previously received an ALK inhibitor, progression-free survival was significantly longer among patients who received brigatinib than among those who received crizotinib. (Funded by Ariad Pharmaceuticals; ALTA-1L ClinicalTrials.gov number, NCT02737501 .)

A multidisciplinary consensus on the morphological and functional responses to immunotherapy treatment

The implementation of immunotherapy has radically changed the treatment of oncological patients. Currently, immunotherapy is indicated in the treatment of patients with head and neck tumors, melanoma, lung cancer, bladder tumors, colon cancer, cervical cancer, breast cancer, Merkel cell carcinoma, liver cancer, leukemia and lymphomas. However, its efficacy is restricted to a limited number of cases. The challenge is, therefore, to identify which subset of patients would benefit from immunotherapy. To this end, the establishment of immunotherapy response criteria and predictive and prognostic biomarkers is of paramount interest. In this report, a group of experts of the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Medical Radiology (SERAM), and Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM) provide an up-to-date review and a consensus guide on these issues