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Cell migration during specialized stages of osteoclast precursors, mononuclear preosteoclasts, and multinucleated mature osteoclasts remain uncertain. M-CSF- and osteopontin-induced osteoclastic cell migration was inhibited by function-blocking monoclonal antibodies specific to the integrin αv and β3 subunits, suggesting that integrin αvβ3 mediates migratory signaling induced by M-CSF and osteopontin. M-CSF and osteopontin stimulation was shown to regulate two branched signaling processes, PI3K/PKCα/RhoA axis and PI3K/PKCδ/Rac1 axis. Interestingly, inactivation of RhoA or Rac1 blocked preosteoclast and mature osteoclast migration but not osteoclast precursor migration in a transwell-based cell migration assay. Moreover, the inhibitory effect on preosteoclast and mature osteoclast migration induced by Rac1 inactivation was more effective than that by RhoA inactivation. Collectively, our findings suggest that osteoclast precursor migration depends on PI3K/PKCα-PKCδ signaling mediated via integrin αvβ3 bypassing RhoA and Rac1, whereas preosteoclast and mature osteoclast migration relies on PI3K/PKCα-PKCδ/RhoA-Rac1 axis signaling mediated via integrin αvβ3 with increased dependency on PKCδ/Rac1 signaling route as differentiation progresses. [ABSTRACT FROM AUTHOR]

Central venous catheterization is a preferred method for intensive care patients who require total parenteral nutrition (TPN). TPN can cause tissue damage due to osmotic effects and the presence of ions. We report a case of TPN extravasation into the pleural cavity due to a shift in position of a subclavian central vein catheter. In this report, we discuss the importance of serial follow up of chest X-ray examination in patients with central vein catheterization. [ABSTRACT FROM AUTHOR]

To examine the correlates of life-support treatment (LST) preferences from attitudes toward advance directives (ADs), perceived susceptibility, symptom frequency, symptom burden, and global health among low-income community-dwelling cancer management recipients, controlling for age, sex, education, and duration after cancer diagnosis. A cross-sectional, correlational study design was used to assess LST preferences and correlates. Data were collected from low-income cancer survivors during nurses' home visits. Survivors who had mostly solid cancer participated (N = 107, mean age = 67.39 ± 11.57 years, 32.7% males). Hospice care was the most desired (66.4%), while aggressive treatments were less preferred: cardiopulmonary resuscitation (15.9%), ventilation support (15.0%), hemodialysis (18.7%), or chemotherapy (12.1%). Higher symptom frequency was associated with a greater likelihood of preferring all aggressive treatments (odds ratios = 1.44–1.75). In addition, longer cancer duration was associated with a greater likelihood of preferring ventilation support; females had a lesser likelihood of preferring hemodialysis and chemotherapy. Higher education was associated with a lesser likelihood of preferring chemotherapy. More positive attitudes (B = 0.15, p =.001) were associated with a greater likelihood of preferring hospice care, and greater symptom burden of pain (B = −0.03, p =.047) was associated with a lesser likelihood. Results support the feasibility of incorporating ADs into cancer management among community-dwelling cancer survivors, with consideration of AD attitudes and symptom monitoring. An integration of AD discussion into the home visiting service could be a liaison for the quality and continuity of cancer survivorship care that guides and manages patients' survivorship issues. • Two-thirds of low-income cancer survivors preferred hospice care; less than one-fifth favored aggressive treatments. • Higher symptom frequency was associated with preferring aggressive life-support treatments. • More positive advance directive (AD) attitudes and less symptom burden of pain were associated with preferring hospice. • AD discussion seemed feasible in cancer survivors, considering these modifiable factors, attitudes and symptom monitoring. • An integration of ADs into the home visiting could be a liaison for the quality and continuity of cancer survivorship care. [ABSTRACT FROM AUTHOR]