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Discheramocephalus traceyae sp. n. (Ptiliidae: Coleoptera) from Peru, the seventh member of the genus to be recorded from the country, is described and figured, and figures of the pronota of all the known South American representatives of the genus are included for reference.

Ptenidium (Matthewsium) coxi, sp. n. (Ptiliidae: Coleoptera), the first species of the genus to be recorded from Chile, is described and illustrated.

The list of genera in the polyphyletic tribe Ptiliini, used as a dumping ground for difficult genera of Ptiliidae by several generations of Coleopterists, is brought up to date with recent additions and omissions, and figures and a key to the genera are provided to aid their determination. 29 new species and 3 new genera are added. It was hoped to be able to determine some generic groups within the tribe but that work must depend on further cladistical and DNA research in the future. The new genera are Cingulum gen.n., Iloptila gen.n. and Numa gen.n. and the new species are Actidium cooteri sp.n., A. minimum sp.n., A. nigrum sp.n., Cingulum orsippus gen.n. sp.n., Dipentium bicolor sp.n., D. punctissimum sp.n., D. spinosum sp.n., Gomyella intricata sp.n., G. nicoya sp.n., G. profunda sp.n., G. tripla sp.n., Greensladella cicra sp.n., G. similata sp.n., Iloptila modica gen.n. sp.n., Micridium circulatum sp.n., M. dembickyi sp.n., M. hirsutum sp.n., M. juara sp.n., M. novum sp.n., Millidium karnatakense sp.n., Numa carmen gen.n. sp.n., Ptiliodes kanchiporam sp.n., Ptiliola bennetti sp.n., P. nigra sp.n., P. peruviensis sp.n., Ptilium lisae sp.n., P. longum sp.n., P. pallidulum sp.n. and P. piceum sp.n.

Objectives: To develop a CT scanning protocol for lung cancer screening which achieved low radiation dose and a high level of objectively assessed image quality. Methods: An anthropomorphic chest phantom and a commercially available lung screening image quality phantom were scanned on a series of scan protocols from a previous UK lung screening pilot and on an alternative protocol. The chest phantom scans were used to assess the CT dose metrics on community-based mobile CT scanners and comparisons were made with published recommended doses. Scans of the image quality phantom were objectively assessed against the RSNA Quantitative Imaging Biomarkers Alliance (QIBA) recommendations. Protocol adjustments were made to ensure that the recommended dose and image quality levels were both achieved. Results: The alternative scan protocol yielded doses up to 72% lower than on the previously used protocols with a CTDIvol of 0.6mGy for the 55 kg equivalent phantom and 1.3mGy with an additional 6 cm of tissue equivalent material in place. Scans on the existing protocols failed on two of the QIBA image quality metrics (edge enhancement and 3D resolution aspect ratio). Following adjustments to the reconstruction parameters of the resulting image quality met all six QIBA recommendations. Radiologist review of phantom images with this scan protocol deemed them suitable for a lung screening trial. Conclusions: Scan protocols yielding low radiation doses and high levels of objectively assessed image quality which meet published criteria can be established through the use of specific anthropomorphic and image quality phantoms, and are deliverable in community-based lung cancer screening. Advances in knowledge: Development of a standard methodology for establishing CT lung screening scanning protocols Use of QIBA recommendations as objective image quality metrics Standardised lung phantoms are essential tools for setting up lung screening protocols

This case report discusses a 76-year-old man who presented with symptomatic diffuse alveolar-septal and tracheobronchial amyloidosis with a low-grade monoclonal gammopathy. This patient had a combination of both symptomatic diffuse alveolar-septal interstitial disease and tracheobronchial amyloidosis, features that contradict the widely accepted presentations seen in this disease. First, tracheobronchial amyloidosis has been documented as localised disease without systemic involvement. Second, diffuse alveolar-septal interstitial disease is rarely identified with clinical symptoms unless there is significant cardiac involvement. This case highlights a number learning points in the diagnosis and management of systemic amyloid light chain amyloidosis;(1) There is a need for a high index of suspicion for diagnosis due to the potential subtlety of a plasma cell clone underlying AL amyloidosis, requiring serum-free light chain assays to increase sensitivity; (2) Haematological response and recovery of organ dysfunction are not a linear relationship due to the slower reversal of amyloid deposition; therefore, ongoing monitoring is required to identify those in need of repeated therapy. However, haematological response is a marker of overall survival and (3) Multisystem assessment and multidisciplinary collaboration are critical in optimising the care of patients with systemic AL amyloidosis.

Ptiliidae collected in Africa (Ivory Coast, Mozambique, São Tomé, Sierra Leone) 2015–2017 under the auspices of the African Natural History Research Trust and the Natural History Museum, London, are determined to 24 species, 9 of which are new to science: Actidium loma sp. n., Actidium milesi sp. n., Actidium takanoi sp. n., Actidium acutum sp. n., Erro goffi sp. n., Ptilium maputense sp. n., Cissidium aristophanousi Darby (in a separate paper in press), Ptinella clio sp. n., and Ptinella euterpe sp. n.. New records are provided for Ptenidium nitidum Heer, Bambara frosti Dybas, Bambara magnifica Darby, Bambara joannis Vuillet, Ptiliola semitaria Darby, Nephanes marchali (Vuillet), Nephanes plurijugosus Darby, Nephanes titan (Newman), Acrotrichis africana Johnson, Acrotrichis africanoides Johnson, Acrotrichis capensis Johnson, Acrotrichis cephalotes Allibert, Acrotrichis discoloroides Johnson, Acrotrichis setigera Johnson and Acrotrichis tersa Johnson. A table is included listing all known species of Acrotrichis from Africa and the countries where they were found.

This paper is based on a collection of Ptiliidae made by W.C. Block in Uganda and Kenya, 1964–1965, and donated to the Natural History Museum, London in 1978. A new genus Nelloptodes gen. n., and nine new species are described and figured: Bambara fragilis sp. n., Bambara lyrae sp. n., Nelloptodes blocki sp. n., Nelloptodes globulus sp. n., Nelloptodes gretae sp. n., Nelloptodes keitai sp. n., Ptinella katyae sp. n., Ptinella mpanga sp. n., Ptinella pygmaea sp. n., and new records and information provided for Pitilium pernix Darby, Bambara frosti Dybas, Bambara gabela Darby, Bambara magnifica Darby, Africoptilium marginatum Johnson, Fenestellidium kakamegaense Grebennikov, Acrotrichis africana Johnson, Acrotrichis alluaudi Johnson and Acrotrichis superba Johnson.

Chapter 5 discusses the malignancies arising in the lung and thorax. It provides background for these diseases, focuses on imaging for diagnosis and staging, and then moves on to discuss the imaging requirements for state-of- the-art radiotherapy planning. This includes principles of advanced radiotherapy planning techniques such as the use of 4D imaging, stereotactic ablative body radiotherapy contouring and planning, volumetric arc therapy, and image guided radiotherapy. We have used non-small cell lung cancers as the main focus as these are the commonest malignancies, but these principles can be applied to all thoracic radiotherapy. Lung cancer screening is also an emerging and important area in improving outcomes for lung cancers. Finally, imaging approaches and protocol for treatment follow-up are covered.

BACKGROUND: Noninvasive ventilation (NIV) is routinely used to treat patients with cystic fibrosis and respiratory failure. However, evidence on its use is limited, with no data on its role in disease progression and outcomes. The aim of this study was to assess the indications of NIV use and to describe the outcomes associated with NIV in adults with cystic fibrosis in a large adult tertiary center. METHODS: A retrospective analysis of data captured prospectively on the unit electronic patient records was performed. All patients with cystic fibrosis who received NIV over a 10-y period were included in the study. A priori, 2 groups were identified based on length of follow-up, with 2 subgroups identified based on duration of NIV treatment. RESULTS: NIV was initiated on 64 occasions. The duration of follow-up was categorized as > 6 months or < 6 months in 31 (48.4%) and 33 (51.6%) occasions, respectively. The most common indications for starting NIV were chronic (48.5%) and acute (32.8%) hypercapnic respiratory failure. Among those with a follow-up > 6 months, subjects who stopped using NIV early showed a steady median (interquartile range) decline in FEV(1) (pre-NIV: –0.04 [–0.35 to 0.03] L/y vs post-NIV: –0.07 [–0.35 to 0.01] L/y, P = .51), while among those who continued using it had an improvement in the rate of decline (pre-NIV: –0.25 [–0.52 to –0.02] L/y vs post-NIV: –0.07 [–0.13 to 0.16] L/y, P = .006). No differences in intravenous antibiotic requirement or pulmonary exacerbations were noted with the use of NIV. Pneumothorax and massive hemoptysis occurred independently in 4 cases. CONCLUSIONS: NIV is being used in cystic fibrosis as adjunct therapy for the management of advanced lung disease in a similar fashion to other chronic respiratory conditions. Adherence to NIV treatment can stabilize lung function but does not reduce pulmonary exacerbations or intravenous antibiotic requirement.

Introduction and Objectives Radiology reporting of low-dose CT (LDCT) scans is a key component of any lung cancer screening (LCS) programme. We reviewed data relating to reporting in the Yorkshire Lung Screening Trial (YLST), an ongoing LCS trial. Methods In YLST, baseline LDCT scans are reported by one of eight thoracic radiologists and assigned an overall category: negative; indeterminate (pulmonary nodule requiring surveillance); or, positive for lung cancer. In addition, scans can be flagged as having a clinically significant incidental finding. Reporting radiologists for YLST do not have access to previous imaging at the time of initial read. We collated data from all baseline YLST scans to date. The number of scans assigned to each category, including incidental findings, was assessed both overall and by reporting radiologist. We reviewed the conclusions from screening review meetings (SRMs) where all indeterminate, positive, or incidental findings are re-evaluated (alongside any previous imaging) by a radiologist and a respiratory physician. Results In total 5520 baseline LDCT scans were reported from November 2018 until October 2020, a mean of 690 per radiologist (range 607–744). Overall, 4093 (74%) scans were reported as negative (range between radiologists 64–80%), 1118 (20%) indeterminate (range between radiologists 9–30%), and 309 (6%) positive (range between radiologists 3–12%). The categorisation of scans before and after review in SRM is outlined in table 1. Of 1427 scans initially reported as either indeterminate or positive, the SRM conclusion was negative for 503 (35%), with 192 (38%) downgraded on the basis of previous imaging. Overall 1087 (20%) scans were reported with an incidental finding (range between radiologists 10–34%). Following review in SRM, 782 (72%) of the incidental findings did not lead to any additional action. This decision was based on review of old imaging in 254 cases (32%). Conclusions The categorisation of scans as negative was reasonably consistent between radiologists with greater variation in the frequency of reporting incidental findings. Review in a SRM often resulted in re-classification of scans, with some (but not all) of this reduction related to availability of previous imaging. This work was funded by Yorkshire Cancer Research (L403/L403B).

Current UK guidelines suggest at least 1 year of follow-up for Unclassifiable Pulmonary Fibrosis (UPF), to identify those who develop progressive lung disease, and require therapeutic intervention. There is no reliable evidence base as to the optimum duration of follow-up. The aim of this study was to determine appropriate follow up duration, and which investigations were most informative. A tertiary Interstitial Lung Disease (ILD) centre, UPF patients over a 8 year period (2011–2019), and a contemporaneous group of IPF patients (diagnosed at ILD MDT) were identified. Parameters collated included lung function (PFTs), oxygen saturations, symptoms, and review duration. Diagnosis revision in the UPF group was recorded, as was its trigger (radiology, serology, symptom/PFT decline). All patient deaths were recorded, and where possible, cause of death. Mean difference in baseline PFT values between IPF and UPF were estimated by t-tests. Linear regression models were used to estimate the mean difference adjusting for baseline values. Kaplan-Meier survival curves were calculated for IPF and UPF patients. Standard deviation and boxplots were used to describe the distribution of PFT parameters in each group. Results are presented (table 1). It can be seen that the difference in the rate of decline in FEV1 (p= 0.002) and FVC ( 19/201 of UPF group had a diagnosis revision, 10/19 had a treatment alteration post revision. 2 year follow up would have missed 2 patients with a management plan alteration post revision. However, the trigger was symptom deterioration in both patients; both were self identifying. We propose UPF follow-up be for 2 years, with periodic PFT and symptom monitoring. After this, further follow-up is not necessitated, as there is not a clinically significant progression, resulting in a beneficial intervention.

IntroductionLung cancer is the world’s leading cause of cancer death. Low-dose computed tomography (LDCT) screening reduced lung cancer mortality by 20% in the US National Lung Screening Trial. Here, we present the Yorkshire Lung Screening Trial (YLST), which will address key questions of relevance for screening implementation.Methods and analysisUsing a single-consent Zelen’s design, ever-smokers aged 55–80 years registered with a general practice in Leeds will be randomised (1:1) to invitation to a telephone-based risk-assessment for a Lung Health Check or to usual care. The anticipated number randomised by household is 62 980 individuals. Responders at high risk will be invited for LDCT scanning for lung cancer on a mobile van in the community. There will be two rounds of screening at an interval of 2 years. Primary objectives are (1) measure participation rates, (2) compare the performance of PLCOM2012(threshold ≥1.51%), Liverpool Lung Project (V.2) (threshold ≥5%) and US Preventive Services Task Force eligibility criteria for screening population selection and (3) assess lung cancer outcomes in the intervention and usual care arms. Secondary evaluations include health economics, quality of life, smoking rates according to intervention arm, screening programme performance with ancillary biomarker and smoking cessation studies.Ethics and disseminationThe study has been approved by the Greater Manchester West research ethics committee (18-NW-0012) and the Health Research Authority following review by the Confidentiality Advisory Group. The results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and on the YLST website.Trial registration numbersISRCTN42704678andNCT03750110.

This paper is based on a collection of 220 Ptiliidae made by M.E. Bacchus of the Coleoptera Section of the Natural History Museum, London (NHM), and others, in Sabah (Borneo) 28 August – 7 November 1977. Ten new species are described and figured: Sindosium bacchusi sp. n., Dipentium latum sp. n., Bambara pumilio sp. n. Baeocrara minima sp. n., Acrotrichis agricola sp. n., Acrotrichis bubalus sp. n., Acrotrichis irregularis sp. n., Acrotrichis kinabaluensis sp. n., Acrotrichis subagricola sp. n. and Acrotrichis telupidensis sp. n., and new records and information provided for Bambara frosti Dybas and Acrotrichis britteni Johnson.

Background Bronchiectasis (BR) is a significant pulmonary morbidity common in people with rheumatoid arthritis (RA). Patients with RA and bronchiectasis (RA-BR) often have severe arthritis but the use of biologics may be difficult in this group of patient due to concerns over safety. There is no data comparing the use of rituximab (RTX) and tumour necrosis factor inhibitors (TNFi) in RA-BR. The objectives of this study were to evaluate effect of rituximab (RTX) in patients with RA-BR and compare 5-year respiratory survival between those treated with RTX and TNFi. Methods A retrospective observational cohort study of RA-BR was conducted in RTX or TNFi-treated RA patients from two UK centres over 10 years. Identical data collection methodologies were used between centres. BR was assessed using number of infective exacerbations/year. Respiratory survival was defined as time from therapy initiation to discontinuation either due to lung exacerbation or lung-related deaths. Results Of 800 RTX-treated RA patients, 68 had RA-BR (prevalence=8.5%). Post-RTX, new BR was diagnosed in 3/735 patients (incidence=0.4%). At 12 months post-Cycle 1 RTX, 21/68 (31%) patients had fewer exacerbations than the year pre-RTX, 36/68 (53%) remained stable and 11/68 (16%) had increased exacerbations. Pseudomonas colonisation at RTX baseline was associated with increased risk of this initial exacerbation [OR 7.23 (95% CI 1.28-40.80)] while older age reduced risk [OR 0.44 (95% CI 0.21-0.90) per 10 years of age]. The rates of exacerbation improved after Cycle 2 RTX and were stable up to 5 cycles. Of patients who received ≥2 RTX cycles (n = 60), increased exacerbations occurred in 7/60 (12%) and were associated with low IgG, aspergillosis and concurrent alpha-1-antitrypsin deficiency. Respiratory survival was compared between RA-BR patients treated with RTX (N = 68) or TNFi (N = 46). Most characteristics were matched between these two groups. However, median (IQR) number of infective exacerbations/year in the previous 12 months pre-bDMARDs was higher in those treated with RTX than TNFi; 3.0 (1-4) and 0 (0-2) respectively. Overall, 8/68 (11.8%) patients discontinued RTX while 15/46 (32.6%) discontinued TNFi due to respiratory causes. Moreover, the 5-year respiratory survival was better in RTX-treated compared to TNFi-treated RA-BR patients; HR 0.40 (95% CI 0.17-0.96); p = 0.041, adjusted for age, gender and centre effect. Distribution of TNFi in those who discontinued therapy due to respiratory causes was etanercept=6, infliximab=6, adalimumab=2 and certolizumab=1. Conclusion The majority RA-BR patients had stable or improved pulmonary symptoms during RTX therapy over a prolonged follow-up period. In isolated cases, worsening of exacerbation after RTX therapy had definable causes. Despite a higher rate of exacerbations pre-biologic, rates of discontinuation or deaths due to respiratory causes were better for RTX than a matched TNFi cohort. RTX appears to be an acceptable therapeutic choice for RA-BR if a biologic is needed. Disclosures M. Md Yusof: None. K. Iqbal: None. M. Darby: None. G. Lettieri: None. E. Vital: Honoraria; Roche. Grants/research support; Roche. P. Beirne: None. S. Dass: Honoraria; Roche. P. Emery: Consultancies; Pfizer, MSD, Abbott. Grants/research support; Roche, Pfizer, MSD, Abbott. C. Kelly: Consultancies; Boehringer-Ingelheim. Honoraria; Boehringer-Ingelheim.

Ptiliidae collected in Africa (Angola, Botswana, Namibia, South Africa) 28 December 1971 – 20 April 1972 by members of a Natural History Museum, London, expedition to south western Africa are determined to 27 species, 15 of which are new to science: Actidium bipustulatum sp. n., Actidium parvum sp. n., Bambara chianga sp. n., Bambara magnifica sp. n., Bambara namibiensis sp. n., Bambara gabela sp. n., Bambara subjoannis sp. n., Ptiliola minutissima sp. n., Ptiliola flava sp. n., Ptiliola problematica sp. n., Ptiliola semitaria sp. n., Ptilium exiguum sp. n., Ptilium pernix sp. n., Nephanes plurijugosus sp. n., Acrotrichis botswanensis sp. n. Information about collecting methods and sites is provided from data kept at the time and figures included to amplify the descriptions of earlier authors. Keys are provided to the subfamilies, tribes and genera.

Some 2,000 Ptiliidae collected in the North and South Islands of New Zealand in 1983/1984 by Peter Hammond of the Natural History Museum, London, are determined to 34 species, four of which are new to the country. As there are very few previous records, most from the Auckland district of North Island, the Hammond collection provides much new distributional data. The three new species: Nellosana insperatus sp. n., Notoptenidium flavum sp. n., and Notoptenidium johnsoni sp. n., are described and figured; the genus Ptiliodes is moved from Acrotrichinae to Ptiliinae, and Ptenidium formicetorum Kraatz recorded as a new introduction. Information is provided to aid separation of the new species from those previously recorded.

BackgroundLung cancer outcomes in the UK are worse than in many other developed nations. Symptom awareness campaigns aim to diagnose patients at an earlier stage to improve cancer outcomes.MethodsAn early diagnosis campaign for lung cancer commenced in Leeds, UK in 2011 comprising public and primary-care facing components. Rates of community referral for chest X-ray and lung cancer stage (TNM seventh edition) at presentation were collected from 2008 to 2015. Linear trends were assessed by χ2 test for trend in proportions. Headline figures are presented for the 3 years pre-campaign (2008–2010) and the three most recent years for which data are available during the campaign (2013–2015).FindingsCommunity-ordered chest X-ray rates per year increased from 18 909 in 2008–2010 to 34 194 in 2013–2015 (80.8% increase). A significant stage shift towards earlier stage lung cancer was seen (χ2(1)=32.2, pInterpretationThis is the largest described lung cancer stage-shift in association with a symptom awareness campaign. A causal link between the campaign and stage-shift cannot be proven but appears plausible. Limitations of the analysis include a lack of contemporary control population.

Background The accuracy of the chest x-ray (CXR) in the identification of lung cancer amongst symptomatic individuals is uncertain. Purpose To determine the diagnostic accuracy of the CXR for the detection of non-small cell carcinomas (NSCLC) and all primary intrathoracic malignancies. Methods A prospective cohort study of consecutive CXR reports obtained within a primary care open access initiative. Eligibility criteria were symptoms specified by National Institute for Clinical Excellence as indicative of possible lung cancer and age over 50-yrs. A positive test was a CXR which led directly or indirectly to investigation with CT. The reference standards were malignancies observed within a one- or two-year post-test period. Results 8,948 CXR outcomes were evaluated. 496 positive studies led to a diagnosis of 101 patients with primary intrathoracic malignancy including 80 with NSCLC. Within two-years, a cumulative total of 168 patients with primary intrathoracic malignancies including 133 NSCLC were observed. The sensitivity and specificity for NSCLC were 76% (95 %CI 68–84) and 95% (95 %CI 95–96) within 1-year and 60% (95 %CI 52–69) and 95% (95 %CI 95–96) within 2-years. The 2-yr positive and negative likelihood ratios were 12.8 and 0.4. The results did not differ for NSCLC compared to all primary malignancies. Within this symptomatic population a negative test reduced the 2-year risk of lung cancer to 0.8%. Conclusions A positive test strongly increases the probability of malignancy whereas a negative test does not conclusively exclude the disease. The findings allow the risk of malignancy following a negative test to be estimated.

ObjectiveTo evaluate rituximab (RTX) in patients with RA-associated bronchiectasis (RA-BR) and compare 5-year respiratory survival between those treated with RTX and TNF inhibitors (TNFi).MethodsA retrospective observational cohort study of RA-BR in RTX or TNFi-treated RA patients from two UK centres over 10 years. BR was assessed using number of infective exacerbation/year. Respiratory survival was measured from therapy initiation to discontinuation either due to lung exacerbation or lung-related deaths.ResultsOf 800 RTX-treated RA patients, 68 had RA-BR (prevalence 8.5%). Post-RTX, new BR was diagnosed in 3/735 patients (incidence 0.4%). At 12 months post-Cycle 1 RTX, 21/68 (31%) patients had fewer exacerbations than the year pre-RTX, 36/68 (53%) remained stable and 11/68 (16%) had increased exacerbations. The rates of exacerbation improved after Cycle 2 and stabilized up to 5 cycles. Of patients who received ≥2 RTX cycles (n = 60), increased exacerbations occurred in 7/60 (12%) and were associated with low IgG, aspergillosis and concurrent alpha-1-antitrypsin deficiency. Overall, 8/68 (11.8%) patients discontinued RTX while 15/46 (32.6%) discontinued TNFi due to respiratory causes. The adjusted 5-year respiratory survival was better in RTX-treated compared with TNFi-treated RA-BR patients; HR 0.40 (95% CI 0.17, 0.96); P =0.041.ConclusionThe majority of RTX-treated RA-BR patients had stable/improved pulmonary symptoms in this long-term follow-up. In isolated cases, worsening of exacerbation had definable causes. Rates of discontinuation due to adverse lung outcomes were better for RTX than a matched TNFi cohort. RTX is an acceptable therapeutic choice for RA-BR if a biologic is needed.

Background:Bronchiectasis (BR) is a significant pulmonary morbidity common in people with rheumatoid arthritis (RA). Patients with RA and bronchiectasis (RA-BR) often have severe arthritis but the use of biologics may be difficult in this group of patient due to concerns over safety. There is no data comparing the use of rituximab (RTX) and tumour necrosis factor inhibitors (TNFi) in RA-BR.Objectives:To evaluate the effect of RTX in patients with RA-BR and compare 5-year respiratory survival between those treated with RTX and TNFi.Methods:A retrospective observational cohort study of RA-BR was conducted in RTX or TNFi-treated RA patients from two UK centres over 10 years. BR was assessed using number of infective exacerbations/year. Respiratory survival was defined as time from therapy initiation to discontinuation either due to lung exacerbation or lung-related deaths.Results:Of 800 RTX-treated RA patients, 68 had RA-BR (prevalence 8.5%). Post-RTX, new BR was diagnosed in 3/735 patients (incidence 0.4%). At 12 months post-Cycle 1 RTX, 21/68 (31%) patients had fewer exacerbations than the year pre-RTX, 36/68 (53%) remained stable and 11/68 (16%) had increased exacerbations. In multivariable analysis, a factor associated with increased risk of this initial exacerbation was pseudomonas colonisation [OR 7.23 (95% CI 1.28-40.80)] while older age reduced risk [OR 0.44 (95% CI 0.21-0.90) per 10 years of age]. The rates of exacerbation improved after Cycle 2 RTX and stabilised up to 5 cycles. Of patients who received ≥2 RTX cycles (n=60), increased exacerbations occurred in 7/60 (12%) and were associated with low IgG, aspergillosis and concurrent alpha-1-antitrypsin deficiency. Respiratory survival was compared between RA-BR patients treated with RTX (N=68) or TNFi (N=46). Most characteristics were matched but median (IQR) number of infective exacerbations/year in the previous 12 months pre-bDMARDs was higher in those treated with RTX than TNFi; 3.0 (1-4) and 0 (0-2) respectively. Overall, 8/68 (11.8%) patients discontinued RTX while 15/46 (32.6%) discontinued TNFi due to respiratory causes. The adjusted 5-year respiratory survival was better in RTX-treated compared to TNFi-treated RA-BR patients; HR 0.40 (95% CI 0.17–0.96); p=0.041.Conclusion:The majority RA-BR patients had stable or improved pulmonary symptoms during RTX therapy over a prolonged follow-up period. In isolated cases, worsening of exacerbation after RTX therapy had definable causes. Despite a higher rate of exacerbations pre-biologic, rates of discontinuation due to adverse lung outcomes were better for RTX than a matched TNFi cohort. RTX appears to be an acceptable therapeutic choice for RA-BR if a biologic is needed.Disclosure of Interests:Md Yuzaiful Md Yusof: None declared, Kundan Iqbal: None declared, Michael Darby: None declared, Giovanni Lettieri: None declared, Edward Vital Grant/research support from: AstraZeneca, Roche/Genentech, and Sandoz, Consultant of: AstraZeneca, GSK, Roche/Genentech, and Sandoz, Speakers bureau: Becton Dickinson and GSK, Paul Beirne: None declared, Shouvik Dass Grant/research support from: Roche and GSK, Paul Emery Grant/research support from: AbbVie, Bristol-Myers Squibb, Merck Sharp & Dohme, Pfizer, Roche (all paid to employer), Consultant of: AbbVie (consultant, clinical trials, advisor), Bristol-Myers Squibb (consultant, clinical trials, advisor), Lilly (clinical trials, advisor), Merck Sharp & Dohme (consultant, clinical trials, advisor), Novartis (consultant, clinical trials, advisor), Pfizer (consultant, clinical trials, advisor), Roche (consultant, clinical trials, advisor), Samsung (clinical trials, advisor), Sandoz (clinical trials, advisor), UCB (consultant, clinical trials, advisor), Clive Kelly Consultant of: Boehringer Ingelheim, Speakers bureau: Boehringer Ingelheim

Tomás, André, Rebelo, Maria Teresa, Valkenburg, Thijs, Darby, Michael, Fonseca, Isabel Pereira da (2018): An Association between the Featherwing Beetle Ptiliolum fuscum (Erichson) (Coleoptera: Ptiliidae) and the Eurasian Griffon Gyps fulvus (Hablizi) (Accipitriformes: Accipitridae) – First Report of a Phoretic Interaction between Beetles and Birds? The Coleopterists Bulletin 72 (4): 662-664, DOI: 10.1649/0010-065X-72.4.662, URL: http://dx.doi.org/10.1649/0010-065x-72.4.662

Purpose The purpose of this study was to compare the use of fluorine-18-fluorodeoxyglucose (18F-FDG) PET with computed tomography (CT) and dynamic contrast-enhanced (DCE) MRI to predict prognosis and monitor treatment in malignant pleural mesothelioma. Patients and methods 18F-FDG PET/CT and DCE-MRI studies carried out as part of the South West Area Mesothelioma Pemetrexed trial were used. 18F-FDG PET/CT and DCE-MRI studies were carried out before treatment, and after two cycles of chemotherapy, on patients treated with pemetrexed and cisplatin. A total of 73 patients were recruited, of whom 65 had PET/CT and DCE-MRI scans. Baseline measurements from 18F-FDG PET/CT (maximum standardized uptake value, metabolic tumour volume and total lesion glycolysis) and DCE-MRI (integrated area under the first 90s of the curve and washout slope) were compared with overall survival (OS) using Kaplan–Meier and Cox regression analyses, and changes in imaging measurements were compared with disease progression. Results PET/CT and DCE-MRI measurements were not correlated with each other. Maximum standardized uptake value, metabolic tumour volume and total lesion glycolysis were significantly related to OS with Cox regression analysis and Kaplan–Meir analysis, and DCE-MRI washout curve shape was significantly related to OS. DCE-MRI curve shape can be combined with 18F-FDG PET/CT to give additional prognostic information. Changes in measurements were not related to progression-free survival. Conclusions 18F-FDG PET/CT and DCE-MRI give prognostic information in malignant pleural mesothelioma. Neither PET/CT nor DCE-MRI is useful for monitoring disease progression.

Objective. To evaluate the effect of rituximab (RTX) in patients with RA-related interstitial lung disease (RA-ILD) and identify factors associated with outcome after treatment. Methods. An observational study of patients with RA-ILD was conducted from a cohort of RTX-treated RA patients in a single centre for >10 years. Progression was defined by any of the following: a decrease of pre-RTX forced vital capacity (FVC) >10% or diffusion capacity of carbon monoxide (DLCO) >15% predicted, worsening of the ILD score or death from progressive ILD. Results. Of 700 RA patients treated with RTX, 56 had RA-ILD (prevalence = 8%). After RTX, new ILD was diagnosed in 3/700 patients (incidence = 0.4%). Data for lung assessment were available for 44/56 patients. The median relative change pre- and post-RTX for FVC were −2.4% and +1.2% (P = 0.025) and for DLCO were −4.4% and −1.3% (P = 0.045). Post-RTX, 23/44 (52%) were stable and 7/44 (16%) had improved. Of the 14 (32%) with ILD that progressed, 9/56 (16%) were deaths due to progressive ILD. Factors associated with ILD progression were radiologic pattern of usual interstitial pneumonia, a previous history of lung progression and pre-RTX DLCO

OBJECTIVE: Diffuse pleural thickening (DPT) refers to extensive visceral pleural fibrosis with adhesion formation to the parietal pleura obliterating the pleural space. The radiological definition of DPT remains controversial with most of the literature requiring the presence of an obliterated costophrenic angle (CPA) for defining DPT. We conducted a study to investigate the variable distributions of DPT and associated lung function deficit. METHODS: 85 patients referred to a pleural clinic with suspected pleural thickening were screened for our study. Data were collected from 37 patients with DPT confirmed on CT by size criteria (≥3 mm thick, ≥5 cm wide and ≥8 cm in length), and 21 controls with pleural plaques but no other pleuroparenchymal pathology. 27 patients were excluded. Groups were matched to age, body mass index and smoking history. RESULTS: The percentage of predicted forced vital capacity showed a gradual decline from 98.9% for the control group to 83.5% in the DPT without CPA obliteration group (p < 0.05), to 79.5% in the unilateral DPT group (p < 0.001) and 66.7% in the bilateral group (p < 0.001). Similar reductions were seen in the percentage of predicted total lung capacity in the DPT with no CPA obliteration group and the bilateral DPT group. CONCLUSION: Our study shows an incremental reduction in the forced vital capacity and total lung capacity in DPT without CPA obliteration, unilateral and bilateral DPT when compared with a matched control group. ADVANCES IN KNOWLEDGE: Different distributions of DPT including no CPA obliteration can cause respiratory impairment, with bilateral DPT being the worst affected.

The six recognised species of the genus Micridium Motschulsky, 1869: M. vittatum (Motschulsky, 1845) M. halidaii (Matthews, 1868), M. angulicolle (Fairmaire, 1858), M. lineatum (Le Conte, 1863). M. rhodeanum (Casey, 1924) and M. groehni Polilov & Perkovsky, 2004 are reviewed and eleven new species: M. attenboroughi sp.n., M. boliviense sp.n., M. elegans sp. n., M. foveatum sp.n., M. inornatum sp.n., M. johnsoni sp.n., M. newtoni sp.n., M. oweni sp.n., M. proprium sp.n., M. quadridens sp.n. and M. thayerae sp.n. are added. The new species are the first records of the genus from South America and Madagascar. The morphological characteristics separating Micridium from other genera in the tribe Ptiliini are discussed and the genus synonymised with the closely related monotypic genus Micridina Johnson, 1969 with its single species M. hilli Johnson, 1969. The synonymy of Dilinium Casey, 1924 with Micridium is confirmed and the type species D. rhodeanum Casey, 1924 re-described. Micridium groehni, described from a single specimen in Baltic amber, does not appear to belong to Micridium as defined here. A key to the new species is provided.

Chaska, a new monotypic genus of Acrotrichinae, Acrotrichini with its single species nawi is described and figured. Superficially similar to the more rounded species of Acrotrichis but distinguished by ventral characters in particular the form of the mesoventral collar and the rounded pronotal hind angles. The insect was collected by Dr Caroline Chaboo and her students at the University of Kansas as part of an inventory of leaf beetles in Peru. The name chosen as the winning entry in a national competition to name a beetle species and raise awareness about cryptic biodiversity.

Peruvium a new subgenus of Ptenidium Erichson with seven new species: P. brevissimum sp. n.; P. carinatum sp. n.; P. capillatum sp. n.; P. contractum sp. n.; P. gibbosum sp. n.; P. inornatum sp. n. and P. grande sp. n. is described and figured. The insects were collected by Dr Caroline Chaboo and her students at the University of Kansas as part of a programme to compile an inventory of leaf beetles in Peru and are the first records of Ptenidium from the country. A key is provided.

Six new species of Discheramocephalus Johnson are described and figured: D. angustus sp. n., D. capac sp. n., D. inretitus sp. n., D. interfusus sp. n., D. malalae sp. n. and D. parvus sp. n.. The insects were collected by Dr Caroline Chaboo and her students at the University of Kansas as part of a programme to compile an inventory of leaf beetles in Peru and are the first records of the genus from the country. A key is provided. The unavailable genus Phytotelmatrichis DarbyChaboo is made available from this publication, with Phytotelmatrichis peruviensis DarbyChaboo 2015 as its type species.

BackgroundThe use of imaging that employs ionising radiation is increasing in the setting of paediatric cardiology. Children's high radiosensitivity and the lack of contemporary radiation data warrant a review of the radiation doses from the latest “state-of-the-art” angiography and computed tomography systems.ObjectivesIn children aged less than 16 years with congenital cardiac disease, we aimed to report: recent trends in the use of diagnostic angiography and cardiac dual-source computed tomography; the characteristics, lesions, and imaging histories of patients undergoing these procedures; and the average radiation doses imparted by each modality.Study designRetrospective review of consecutive cases undergoing cardiac computed tomography or diagnostic angiography in a teaching hospital between January, 2008 and December, 2009. Radiation doses were converted to effective doses (millisievert) using published conversion factors.ResultsAngiography was performed 3.7 times more often than computed tomography. Computed tomography examinations increased by 92.5%, whereas angiography decreased by 26.4% in 2009 compared with 2008. Patients undergoing computed tomography were younger and weighed less than those undergoing angiography, but lesions were similar between the 2 groups. Multiple lifetime angiography was more prevalent than multiple lifetime computed tomography (p < 0.001). The median procedural dose – range – from angiography and computed tomography was 5 (0.2–27.8) and 1.7 (0.5–9.5) millisieverts, respectively (p < 0.001).ConclusionDespite not being completely analogous investigations, computed tomography should be considered prior to angiography and not withheld on radiation dose concerns, given that it imparts lower and more consistent doses than conventional angiography.

Phytotelmatrichis, gen. n. a new genus of Ptiliidae: Acrotrichinae with two species Phytotelmatrichis peruviensis sp. n. and Phytotelmatrichis osopaddington sp. n. is described and illustrated. The new species were found during a survey of insects in the aquatic environments that form in the hollows (phytotelmata) in the leaves and floral bracts of Zingiberales plants. The new taxa were found in the the Zingiberales genera Calathea (Marantaceae), Heliconia (Heliconiaceae), and Alpinia and Renealmia (Zingiberaceae) in southern Peru. Sampling of other habitats in the same areas over five years and using a range of different techniques did not yield more specimens of this new genus. This suggests that the new species are restricted to phytotelmata.

This is the third report on a collection of Ptiliidae from Bolivian forest leaf litter made by Dr Petr Baňař of the Brno Museum (Czech Republic) in 2013. A new species Nossidium katyae, is described and figured on the basis of a single specimen collected in the Amboro National Park. Comparative figures of Nossidium pilosellum Marsham are provided together with a brief synopsis of views on the desirability of establishing a new subfamily within the Ptiliidae to include Nossidium group species.

This is the first report detailing Ptiliidae collected from forest leaf litter by the Moravian Museum expeditions to Madagascar 2010-2011.18 new species in three genera are described and figured: Discheramocephalus bisulcatus sp. n.; D. vasilii sp. n.; Cissidium banari sp. n.; Dacrysoma andasibense sp. n.; D. imitatuin sp. n.; D. delicatum sp. n.; D. denticulatum sp. n.; D. dolorosum sp. n.; D. fabrum sp. n.; D. fusum sp. n.; D. longulum sp. n.; D. nigerrimum sp. n.; D. pilosum sp. n.; D. rahanitriniainae sp. n.; D. ranomafanense sp. n.; D. ravelosoni sp. n.; D. subinsulsum sp. n.; and D. varium sp. n.

This is the second report on a collection of Ptiliidae from Bolivian forest leaf litter made by Dr Petr Baňař of the Brno Museum (Czech Republic) in 2013. A small collection of Bolivian Acrotrichis in the Natural Museum, London, made by H. Mendel and M.V.L. Barclay in 2004 is also included. Two new monotypic genera are described Petrotrichis gen. n. (Acrotrichini), type species P. rotundata sp. n., and Microtrichis gen. n. (Nephanini), type species M. pectana sp. n., together with eight new species of Acrotrichis: A. armillata sp. n., A. cincinna sp. n., A. cornuta sp. n., A. corpulenta sp. n., A. inlecebrosa sp. n., A. linea sp. n., A. nashi sp. n. and A. segmenta sp. n..

This is the first report on a collection of Ptiliidae from Bolivian forest leaf litter made by Dr Petr Baňař of the Brno Museum (Czech Republic). Six new species in the genus Cissidium Motschulsky, are described and figured: C. amboroensis, sp. n., C. globosum, sp. n., C. elongatum, sp. n., C. lisae sp. n., C. petri sp. n. and C. tigrum, sp. n.. The relationship of Cissidium to Dacrysoma Grebennikov and its position in the tribe Discheramocephalini is discussed, and the generic description revised so as to encompass all valid species.

Erro gen. n. a new genus of Ptiliidae (Coleoptera) with the new species impiger sp. n. and angolensis sp. n. is described and figured based on material collected in Angola and Madagascar. Pending further work on the phylogeny of the Ptiliidae the new genus is placed in the subfamily Ptiliinae where it appears to occupy a place close to the tribe Discheramocephalini.

This is the fourth report detailing Ptiliidae collected from forest litter by the Moravian Museum (Brno, Czech Republic) expeditions to Madagascar 2010-2013. Eight new species are described and figured: B. edwardi sp. n.; B. lanquidula sp. n.; B. merina sp.n.; B. opaca sp. n.; B. problematica sp. n.; B. secubita sp. n.; B. thomasi sp. n. and B. verecunda sp. n., and new data recorded for B. dybasi Johnson. Problems concerning the genital morphology and species determination of the parthenogenetic members of the genus are discussed in relation to the findings, and the first blind and apterous species reported.A key to the known species from the island is provided.