Increased expression of the chemokine CCL2 in tumor cells correlates with enhanced metastasis, poor prognosis, and recruitment of CCR2 + Ly6C hi monocytes. However, the mechanisms driving tumor cell extravasation through the endothelium remain elusive. Here, we describe CCL2 upregulation in metastatic UICC stage IV colon carcinomas and demonstrate that tumor cell-derived CCL2 activates the CCR2 + endothelium to increase vascular permeability in vivo. CCR2 deficiency prevents colon carcinoma extravasation and metastasis. Of note, CCR2 expression on radio-resistant cells or endothelial CCR2 expression restores extravasation and metastasis in Ccr2 À/À mice. Reduction of CCR2 expression on myeloid cells decreases but does not prevent metastasis. CCL2-induced vascular permeability and metastasis is dependent on JAK2-Stat5 and p38MAPK signaling. Our study identifies potential targets for treating CCL2-dependent metastasis.

Key Points ECs express Tlr4 and Myd88 and, after in vivo LPS or E coli stimulation, are the prime sources of G-CSF. ECs are sensors of systemically spread pathogens and subsequent drivers of BM emergency granulopoiesis.

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Because of the high diagnostic yield of 36.8% and the possibility of identifying treatable diseases or the coexistence of several disease-causing variants, using exome sequencing as a first-line diagnostic approach in consanguineous families with neurodevelopmental disorders is recommended. Furthermore, the literature is enriched with 52 convincing candidate genes that are awaiting confirmation in independent families.

Aim:  To determine the prevalence of malnutrition in Queensland public acute and residential aged care facilities, and explore effects of variables associated with malnutrition in these populations. Methods:  A multicentre, cross‐sectional audit of a convenience sample of subjects was carried out as part of a larger audit of pressure ulcers in Queensland public acute and residential aged care facilities in 2002 and again in 2003. Dietitians in 20 hospitals and six aged care facilities conducted single‐day nutritional status audits of 2208 acute and 839 aged care subjects using the Subjective Global Assessment, in either or both audits. Subjects excluded were obstetric, same‐day, paediatric and mental health patients. Weighted average proportions of nutritional status categories for acute and residential aged care facilities across the two audits were determined and compared. The effects of gender, age, facility location and medical specialty on malnutrition were determined via logistic regression. Results:  A mean of 34.7 ± 4.0% and 31.4 ± 9.5% of acute subjects and a median of 50.0% and 49.2% of residents of aged care facilities were found to be malnourished in Audits 1 and 2, respectively. Variables found to be significantly associated with an increased odds risk of malnutrition included: older age groups, male (in residential aged care facilities), metropolitan location of facility and medical specialty, in particular, oncology and critical care. Conclusion:  Malnutrition is significant in public acute and residential aged care facilities in Queensland. Action must be taken to increase the recognition, prevention and treatment of malnutrition especially in high‐risk groups.

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The objective of this study was to design a valid and reliable questionnaire to measure patient satisfaction with acute care hospital foodservices. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire was administered to a convenience sample of 2347 acute care hospital inpatients and postdischarge patients from two public hospitals (total 1050 beds) and one 360‐bed private hospital in Queensland, Australia. A factor analysis and evaluation of Cronbach's alpha revealed that the final questionnaire contained 16 statements relating to four factors describing food quality (α = 0.89), meal service quality (α = 0.72), staff/service issues (α = 0.65) and the physical environment (α = 0.61). Questions requesting demographic data were included. Results indicated that the survey is an accurate, reliable measure of patient foodservice satisfaction. It differentiates the foodservice into four factors and collects detailed information about foodservice attributes within these factors. This allows the application of systematic measures to improve foodservice quality and provides a tool for the continuous assessment of foodservice quality and measurement of changes in patient foodservice satisfaction over time in a variety of acute care settings.

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