Patrolling monocytes control tumor metastasis to the lung

The immune system plays an important role in regulating tumor growth and metastasis. Classical monocytes promote tumorigenesis and cancer metastasis, but how nonclassical "patrolling" monocytes (PMo) interact with tumors is unknown. Here we show that PMo are enriched in the microvasculature of the lung and reduce tumor metastasis to lung in multiple mouse metastatic tumor models. Nr4a1-deficient mice, which specifically lack PMo, showed increased lung metastasis in vivo. Transfer of Nr4a1-proficient PMo into Nr4a1-deficient mice prevented tumor invasion in the lung. PMo established early interactions with metastasizing tumor cells, scavenged tumor material from the lung vasculature, and promoted natural killer cell recruitment and activation. Thus, PMo contribute to cancer immunosurveillance and may be targets for cancer immunotherapy

Savannahs of Asia: Antiquity, biogeography, and an uncertain future

The savannahs of Asia remain locally unrecognized as distinctive ecosystems, and continue to be viewed as degraded forests or seasonally dry tropical forests. These colonial-era legacies are problematic, because they fail to recognize the unique diversity of Asian savannahs and the critical roles of fire and herbivory in maintaining ecosystem health and diversity. In this review, we show that: the palaeo-historical evidence suggests that the savannahs of Asia have existed for at least 1 million years, long before widespread landscape modification by humans; savannah regions across Asia have levels of C4 grass endemism and diversity that are consistent with area-based expectations for non-Asian savannahs; there are at least three distinct Asian savannah communities, namely deciduous broadleaf savannahs, deciduous fine-leafed and spiny savannahs and evergreen pine savannahs, with distinct functional ecologies consistent with fire- and herbivory-driven community assembly. Via an analysis of savannah climate domains on other continents, we map the potential extent of savannahs across Asia. We find that the climates of African savannahs provide the closest analogues for those of Asian deciduous savannahs, but that Asian pine savannahs occur in climates different to any of the savannahs in the southern continents. Finally, we review major threats to the persistence of savannahs in Asia, including the mismanagement of fire and herbivory, alien woody encroachment, afforestation policies and future climate uncertainty associated with the changing Asian monsoon. Research agendas that target these issues are urgently needed to manage and conserve these ecosystems. This article is part of the themed issue ‘Tropical grassy biomes: linking ecology, human use and conservation’

Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis

Background and purpose Little is known about the long-term outcome of cemented metal-on-metal hip arthroplasties. We evaluated a consecutive series of metal-on-metal polyethylene-backed cemented hip arthroplasties implanted in patients under 60 years of age

Data from: Savannahs of Asia: evidence for antiquity, biogeography and an uncertain future

The savannahs of Asia remain locally unrecognized as distinctive ecosystems, and continue to be viewed as degraded forests or seasonally dry tropical forests. These colonial-era legacies are problematic, because they fail to recognize the unique diversity of Asian savannahs and the critical roles of fire and herbivory in maintaining ecosystem health and diversity. In this review, we show that: the palaeo-historical evidence suggests that the savannahs of Asia have existed for at least 1 million years, long before widespread landscape modification by humans; savannah regions across Asia have levels of C4 grass endemism and diversity that are consistent with area-based expectations for non-Asian savannahs; there are at least three distinct Asian savannah communities, namely deciduous broadleaf savannahs, deciduous fine-leafed and spiny savannahs and evergreen pine savannahs, with distinct functional ecologies consistent with fire- and herbivory-driven community assembly. Via an analysis of savannah climate domains on other continents, we map the potential extant of savannahs across Asia. We find that the climates of African savannahs provide the closest analogues for those of Asian deciduous savannahs, but that Asian pine savannahs occur in climates different to any of the savannahs in the Southern Hemisphere. Finally, we review major threats to the persistence of savannahs in Asia, including the mismanagement of fire and herbivory, alien woody encroachment, afforestation policies and future climate uncertainty associated with the changing Asian monsoon. Research agendas that target these issues are urgently needed to manage and conserve these ecosystems

Surgeon Assessment of Gapping versus Kinetic Loading using Intraoperative Sensors during TKA

Purpose: The purpose of this study was to determine if using a sensor-equipped tibial insert would reduce medial (MED) and lateral (LAT) gapping and create more equivalent compressive forces in the MED and LAT compartments. Methods: 7 orthopedic surgeons each performed bilateral TKA on complete lower extremity cadaveric specimens. Left TKA was performed first without the use of the instrumented tibial insert. With trial components placed, the patella was reduced and joint capsule closed with towel clips. Surgeons performed varus and valgus stress tests on each knee and the mm of MED and LAT gapping were recorded. Compressive forces in the MED and LAT compartment were measured at 10°, 45°, and 90° of flexion. Sensor-assisted TKA was then performed on the right knee and compressive forces and gapping were again recorded. MED, LAT, and total mediolateral (ML) gapping and MED and LAT compressive forces were compared between conventional TKA and sensor-assisted TKA with paired t-tests. Results: Sensor-assisted TKA resulted in significantly reduced MED (1.2 vs. 1.9 mm, p<.001), LAT (0.8 vs. 1.4 mm, p = 0.003), and total ML gapping (2.0 vs. 3.4 mm, p<.001). There were no differences in the MED and LAT compressive forces between conventional and sensor-assisted TKA. However, sensor-assisted TKAs demonstrated greater MED compartment forces as the knee was flexed whereas conventional TKAs had greater LAT forces. Conclusions: Sensor-assisted TKA significantly reduced MED and LAT gapping with the knee in 20° of flexion. Future clinical studies are needed to determine the most appropriate compressive forces in the MED and LAT compartments

Reproducible fixation with a tapered, fluted, modular, titanium stem in revision hip arthroplasty at 8-15 years follow-up

The use of tapered, fluted, modular, distally fixing stems has increased in femoral revision surgery. The goal of this retrospective study was to assess mid-term to long-term outcomes of this implant. Seventy-one hips in 70 patients with a mean age of 69 years were followed for an average of 10 years. Preoperative HHS averaged 50 and improved to 87 postoperatively. Seventy-nine percent hips had Paprosky type 3A or more bone-loss. All stems osseointegrated distally (100%). Two hips subsided \u3e5 mm but achieved secondary stability. Sixty-eight percent hips had evidence of bony reconstitution and 21% demonstrated diaphyseal stress-shielding. One stem fractured near its modular junction and was revised with a mechanical failure rate of 1.4%. Distal fixation and clinical improvement were reproducibly achieved with this stem design. Published by Elsevier Inc