Osteoarthritis (OA) is a multifactorial, often progressive, painful disease. OA often progresses with an apparent irreversible loss of articular cartilage, exposing underlying bone, resulting in pain and loss of mobility. This cartilage loss is thought to be permanent due to ineffective repair and apparent lack of stem/progenitor cells in that tissue. However, the adjacent synovial lining and synovial fluid are abundant with mesenchymal progenitor/stem cells (synovial mesenchymal progenitor cells [sMPCs]) capable of differentiating into cartilage both in vitro and in vivo. Previous studies have demonstrated that MPCs can home to factors such as monocyte chemotactic protein 1 (MCP‐1/CCL2) expressed after injury. While MCP‐1 (and its corresponding receptors) appears to play a role in recruiting stem cells to the site of injury, in this study, we have demonstrated that MCP‐1 is upregulated in OA synovial fluid and that exposure to MCP‐1 activates sMPCs, while concurrently inhibiting these cells from undergoing chondrogenesis in vitro. Furthermore, exposure to physiological (OA knee joint synovial fluid) levels of MCP‐1 triggers changes in the transcriptome of sMPCs and prolonged exposure to the chemokine induces the expression of MCP‐1 in sMPCs, resulting in a positive feedback loop from which sMPCs cannot apparently escape. Therefore, we propose a model where MCP‐1 (normally expressed after joint injury) recruits sMPCs to the area of injury, but concurrently triggers changes in sMPC transcriptional regulation, leading to a blockage in the chondrogenic program. These results may open up new avenues of research into the lack of endogenous repair observed after articular cartilage injury and/or arthritis. Stem Cells 2013;31:2253–2265

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Our study suggests that the quality of reporting in the thoracic surgery literature is improving with time and is predicted by factors including number of authors, multicentre trials, type of comparison, time period of publication and industry sponsorship. Ongoing efforts should be made to improve the quality of reporting in thoracic surgery.

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Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common bariatric procedure, but patients often experience extended inpatient stays. Enhanced recovery after surgery (ERAS) protocols aim to expedite recovery and discharge. In the province of Manitoba, Canada, the Centre for Metabolic and Bariatric Surgery (CMBS) is dedicated to providing bariatric care to the population. To enable earlier discharge, an overnight short-stay unit with ERAS protocols was introduced, along with transfer protocols for patients requiring prolonged care. Methods We retrospectively reviewed prospectively collected data on LRYGBs performed from November 2017 to December 2020. Surgical indications included BMI ≥ 35 with comorbidities or BMI 40–55 without comorbidities, approved by a multidisciplinary bariatric team. Postoperative evaluations were conducted 16–21 hours post-surgery. Patients were educated about potential complications and required to reside within one hour of a tertiary center for seven days. This study reports descriptive outcomes: length of stay (LOS), 30-day emergency room (ER) presentations, 7-day readmissions, and 30-day readmissions. Results Among the 439 LRYGB patients, the postoperative day 1 discharge rate was 94.8%, and day 2 discharge rate was 1.8%. A small proportion (2.7%, n = 12) required transfer due to anticipated prolonged LOS, primarily for delayed intraabdominal hemorrhage (66.7%) requiring reoperation and precautionary measures for technically challenging procedures (16.7%). Two brief ICU admissions occurred, with no mortalities. ER presentation rate within 30 days was 10.3% (n = 45), 7-day readmission rate was 2.7% (n = 12), and 30-day readmission rate was 4.1% (n = 18). Gastrointestinal intolerance was the most common reason for readmission. Conclusion Implementing an ERAS protocol for LRYGB enabled safe next-day discharge for 94.8% of patients. ER presentation and readmission rates aligned with existing literature, supporting the feasibility of next-day discharge for appropriately selected bariatric patients. These findings contribute to the evidence base for optimizing postoperative care and enhancing patient outcomes in bariatric surgery.