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d University Press on behalf of the European Society of Human Reproduction and Embryology.While better outcomes at high-volume surgical centers have driven the regionalization of complex surgical care, access to high-volume centers often requires travel over longer distances. We sought to evaluate the travel patterns among patients undergoing esophagectomy to assess willingness of patients to travel for surgical care. The California Office of Statewide Health Planning database was used to identify patients who underwent esophagectomy between 2005 and 2016. Total distance traveled, as well as whether a patient bypassed the nearest hospital that performed esophagectomy to get to a higher volume center, was assessed. Overall 3,269 individuals underwent an esophagectomy for cancer in 154 hospitals; only five hospitals were high volume according to Leapfrog standards. Median travel time to a hospital that performed esophagectomy was 26 minutes (IQR 13.1-50.7). The overwhelming majority of patients (85%) bypassed the nearest providing hospital to seek care at a destination hospital. Among patients who bypassed a closer hospital, only 36% went to a high-volume hospital. Of the 2,248 patients who underwent esophagectomy at a low-volume center, 1,491 patients had bypassed a high-volume hospital. Of the remaining 757 patients who did not bypass a high-volume hospital, half of the individuals would have needed to travel less than an additional hour to reach a high-volume center. Nearly two-thirds of patients undergoing an esophagectomy for cancer received care at a low-volume center; 85% of patients either bypassed a high-volume hospital or would have needed to travel less than an additional hour to reach a high-volume center. © The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail [email protected] As treatments, management strategies, and the role of advanced practice providers (APPs) have evolved in recent years, the Crohn's & Colitis Foundation sought to understand the educational and resource needs of clinicians caring for patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe the self-identified IBD knowledge and resource gaps of clinicians to inform the development of future programming. S3I-201 METHODS A survey containing 19 questions created by the foundation's Professional Education Committee, a subset of its National Scientific Advisory Committee, was conducted from September 7, 2018 to October 15, 2018. Responses were included from providers if they were currently seeing any IBD patients in a clinical setting. The foundation distributed the survey by email and various social media channels to encourage a diverse response. The survey included questions on comfort levels around diagnosis, treatment, and management of patients with IBD, in addition to preferenng opportunities that offer CME are needed in the areas of therapeutic decision-making and treating IBD in special subsets (eg, prior malignancy, pregnancy, elderly). © 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail [email protected] the last two decades, bed bugs (Cimex lectularius L. and Cimex hemipterus F.) have become perennial and difficult to control indoor pests. Current pest control options are severely constrained by high prevalence of insecticide resistance and availability and relatively high costs of alternative interventions. Among various measures to counter the drawbacks of insecticide resistance include efforts to diversify the modes of action of insecticides with residual applications of combinations of insecticides, which include a juvenile hormone analog (JHA). JHAs, such as hydroprene and methoprene, have a desirable safety profile and are effective against a variety of indoor pests. We evaluated the potential of hydroprene and methoprene to be incorporated into an ingestible bait, with dose-response studies on fifth-instar male and female bed bugs. Females were more susceptible than males to both JHAs, and methoprene was more effective by ingestion than hydroprene at inducing both lethal and sublethal effects. Ingestion of ≥10 µg/ml blood of either JHA by last instar nymphs reduced oviposition; untreated females that mated with males exposed to high concentrations of either JHA also exhibited lower oviposition. We suggest that methoprene could be incorporated into integrated pest management programs in liquid baits and residual sprays in combination with other active ingredients. © The Author(s) 2020. Published by Oxford University Press on behalf of Entomological Society of America.All rights reserved. For permissions, please e-mail [email protected] & AIMS Vedolizumab (VDZ) is a monoclonal antibody directed against α4β7 integrin heterodimer, approved for patients with inflammatory bowel diseases (IBD). This study aimed at identifying immunological variables associated with response to vedolizumab in patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS This is a phase-IV explorative prospective interventional trial. IBD patients received open-label VDZ at weeks 0, 2, 6 and 14. Patients with a clinical response at week 14 were maintained with VDZ up to week 54. At week 0 and 14 their peripheral blood was obtained and endoscopy with biopsies was performed. The week-14 clinical response and remission, week-54 clinical remission, and week-14 endoscopic response were evaluated as endpoints of the study. The expression of surface markers, chemokine receptors and α4β7 heterodimer on peripheral blood and lamina propria lymphocytes was assessed by flow cytometry. A panel of soluble mediators were assessed in sera at baseline and at weions, please email [email protected] The detection of gene fusion events is important for the diagnosis and management of malignancies. In this study, we describe the validation of a next-generation sequencing assay for multiplex detection of gene fusions. METHODS Based on previously described gene fusion events that occur in pediatric oncology, a custom anchored multiplex next-generation sequencing assay was designed to target 93 genes. RESULTS A total of 24 previously characterized specimens were examined. Twenty specimens had 1 or more previously described fusion events, and 4 specimens were negative for fusion events. The accuracy across specimens was 100% (20 of 20 specimens). The analytical sensitivity and specificity were both 100%. Interday reproducibility for fusion events was 94%; in comparison, intraday reproducibility was 90%. CONCLUSION This multiple-gene fusion assay demonstrated appropriate sensitivity, specificity, and accuracy for clinical use. We anticipate that this assay will improve the diagnosis and management of patients with pediatric solid tumors.
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