China 
Africa 
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Tissue Engineering in Reconstruction and Regeneration of Visceral Organs
Published in Rajesh K. Kesharwani, Raj K. Keservani, Anil K. Sharma, Tissue Engineering, 2022
Soma Mondal Ghorai, Sudhanshu Mishra
Regeneration of even 10% kidney function in terminally ill patients with end-stage kidney disease can greatly improve the quality of life in such patients. Though the regeneration of functional kidney still remains a huge challenge, but some advances are being made in kidney regeneration using iPSC (Evan and Kaufman, 1981; Takahashi and Yamanaka, 2006; Takahashi et al., 2007). The kidney is embryologically developed from a ureteric bud, which then follows precisely timed interactions between multiple signals to derive the intermediate mesoderm (IM) and metanephric mesenchyme (MM) (Blake and Rosenblum, 2014). Both IM and MM kidney-specific cells have been generated using nephron progenitor cells with growth factor such as the Wnt agonist CHIR99021 to promote mesoderm differentiation (Taguchi et al., 2014; Takasato et al., 2014; Xia et al., 2013; Mae et al., 2013; Gadue et al., 2006; Lam et al., 2014). Another protocol is developed to induce differentiation of IM cells from human iPSCs (hiPSCs)/hESCs using a combination of activin A and CHIR99021 to generate mesoderm followed by combined treatment with bone morphogenetic protein-7 and CHIR99021 (Mae et al., 2013; Gadue et al., 2006). It should be noted that developing the renal progenitor cells is important as only then it can allow a 3D construct from PSCs with a functional vascular system. Even, with many progresses in this field, a complete functional restructured kidney in in-vivo system has not been achieved.
Care Pathways for the Dying Patients: Physician Perspective
Published in Journal of Housing For the Elderly, 2018
Benyamin Schwarz, Jacquelyn J. Benson
Provision of home-based palliative care varies across the United States, although the development of hospice home services has enabled many terminally ill patients to receive care at home. The availability of home visits by a physician correlates with higher rates of death at home. However, dying at home may present several challenges for family caregivers. Lack of support from the health care system and lack of confidence have been found to be factors for hospitalization and the disruption of the informal caregiving for terminally ill family members. Beside the lack of support from the health care system, which forces families to have to admit their loved ones to the hospital, caregivers struggle with the fragmented services and lack of planning for unanticipated developments that complicate the success of home care (Thomas, 2000). The decision to care for a person in home palliative care has a significant effect on family members (Stajduhar & Davies, 2005). The decision is often influenced by three major factors: “making promises to care for the loved one at home, the desire to maintain as much as possible a ‘normal’ life for the patient and themselves, and negative experience with institutional care” (Davies & Steele, 2010, p. 619). For patients who expressed their wish to die at home, caregiver exhaustion and unalleviated symptoms are predictive of death in hospitals and hospice (Fried, Pollack, Drickamer, & Tinetti, 1999).