Assessing mosquito biodiversity is important for disease surveillance and ecosystem health assessments. Such studies are particularly needed in regions like the Caribbean, which have experienced a... Show moreAssessing mosquito biodiversity is important for disease surveillance and ecosystem health assessments. Such studies are particularly needed in regions like the Caribbean, which have experienced a series of recent mosquito borne disease outbreaks but received little attention regarding its invertebrate biodiversity. Here, we report on results from a mosquito survey on the Dutch Leeward Islands (Sint Eustatius, Sint Maarten and Saba), carried out in April and October 2018, which is the first integrative survey since those conducted by Van der Kuyp (1947) and Wagenaar Hummelinck (1949). Moreover, we present a novel key for adults and fourth instar larvae of the mosquitoes of the Dutch Leeward Islands. Overall, eleven species were recorded, eight on Sint Maarten, five on Saba and two on Sint Eustatius. Two new potential disease vectors, Culex nigripalpus and Aedes taeniorhynchus, were recorded on Sint Maarten. One previously recorded species, Cx habilitator, was not retrieved from any of the islands, which is further discussed in the paper. Species indicative of natural forest which previously occurred on all three islands were absent from Sint Eustatius and Sint Maarten but still present on Saba. In contrast, species indicative of human inhabitation, Ae. aegypti and Cx. guinquefasciatus, were highly abundant on Sint Maarten and Sint Eustatius and present in low numbers on Saba. Overall, the results of this study emphasize the importance of biodiversity surveys and indicate that frequent mosquito inventories may contribute to a better understanding of mosquito community composition and distribution of potential vector species. Show less
TRANSFORM (TRANSplant eFficacy and safety Outcomes with an eveRolimus-based regiMen) was a 24-month, prospective, open-label trial in 2037 de novo renal transplant recipients randomized (1:1)... Show moreTRANSFORM (TRANSplant eFficacy and safety Outcomes with an eveRolimus-based regiMen) was a 24-month, prospective, open-label trial in 2037 de novo renal transplant recipients randomized (1:1) within 24 hours of transplantation to receive everolimus (EVR) with reduced-exposure calcineurin inhibitor (EVR + rCNI) or mycophenolate with standard-exposure CNI. Consistent with previously reported 12-month findings, noninferiority of the EVR + rCNI regimen for the primary endpoint of treated biopsy-proven acute rejection (tBPAR) or estimated glomerular filtration rate (eGFR) mL/min per 1.73 m(2) was achieved at month 24 (47.9% vs 43.7%; difference = 4.2%; 95% confidence interval = -0.3, 8.7; P = .006). Mean eGFR was stable up to month 24 (52.6 vs 54.9 mL/min per 1.73 m(2)) in both arms. The incidence of de novo donor-specific antibodies (dnDSA) was lower in the EVR + rCNI arm (12.3% vs 17.6%) among on-treatment patients. Although discontinuation rates due to adverse events were higher with EVR + rCNI (27.2% vs 15.0%), rates of cytomegalovirus (2.8% vs 13.5%) and BK virus (5.8% vs 10.3%) infections were lower. Cytomegalovirus infection rates were significantly lower with EVR + rCNI even in the D+/R- high-risk group (P < .0001). In conclusion, the EVR + rCNI regimen offers comparable efficacy and graft function with low tBPAR and dnDSA rates and significantly lower incidence of viral infections relative to standard-of-care up to 24 months. Clinicaltrials.gov number: NCT01950819. Show less
