0±80.8, 43.1±9.0, and 48.9±9.5, respectively. Among the strategies, only the avoidance-oriented one had a significant positive relationship with total care burden and all its subscales. Conclusion Caregivers of hemodialysis patients experienced a relatively high care burden. However, they did not use appropriate coping strategies; therefore, they should be trained to select an effective coping strategy. © 2020 Menati et al.Background Primary human hepatocytes (PHHs) are the ideal candidates for studying critical liver functions such as drug metabolism and toxicity. However, as they are isolated from discarded livers that are unsuitable for transplantation, they possess limited expansion ability in vitro and their enzymatic functions deteriorate rapidly because they are often of poor quality. Therefore, there is a compelling reason to find reliable alternative sources of hepatocytes. Methods In this study, we report on efficient and robust differentiation of embryonic stem cells (ESC) from the common marmoset Callithrix jacchus into functional hepatocyte-like cells (HLC) using a simple, and reproducible three-step procedure. ESC-derived HLCs were examined by morphological analysis and tested for their expression of hepatocyte-specific markers using a combination of immunohistochemistry, RT-PCR, and biochemical assays. Primary human hepatocytes were used as controls. Results ESC-derived HLCs expressed each of the hepatocyte-specific markers tested, including albumin; α-fetoprotein; asialoglycoprotein receptor 1; α-1 antitrypsin; hepatocyte nuclear factors 1α and 4; cytokeratin 18; hepatocyte growth factor receptor; transferrin; tyrosine aminotransferase; alkaline phosphatase; c-reactive protein; cytochrome P450 enzymes CYP1A2, CYP2E1 and CYP3A4; and coagulation factors FVII and FIX. They were functionally competent as demonstrated by biochemical assays in addition to producing urea. Conclusion Our data strongly suggest that marmoset HLCs possess characteristics similar to those of PHHs. They could, therefore, be invaluable for studies on drug metabolism and cell transplantation therapy for a variety of liver disorders. Because of the similarities in the anatomical and physiological features of the common marmoset to that of humans, Callithrix jacchus is an appropriate animal model to study human disease conditions and cellular functions. © 2020 Aravalli et al.Background Women's decisions on family planning use have multiple benefits to the family and community at large. In developing countries like Ethiopia, the choice of women to use a contraceptive is challenged by social and environmental factors that mitigate their ability to decide independently and freely. This study therefore determined the level of women's decision-making power on family planning use and associated factors among married women in the study area. Methods A community-based cross-sectional study was conducted in Dinsho woreda from March to April 2017. A simple random sampling technique was used to select 373 married women. A structured and pre-tested questionnaire was used to collect data by trained data collectors under continuous supervision. Multivariable logistic regression was performed to identify factors associated with women's decision-making power on family planning use. Crude and adjusted odds ratios with 95% confidence interval were used and p-value of less then 0.05 was consideredDadi et al.Introduction There are several medical elective programs for low-income countries especially in medically vulnerable places. The Hospital Central de Quelimane (HCQ) is a regional hospital in Quelimane, capital city of the province of Zambezia in Mozambique. The HCQ serves as a regional base hospital for urgent and severe patients. Methods Four emergency medicine (EM) residents participated in our 2017-2018 rotational program for HCQ, to share medical knowledge with the local medical doctors and support the demands of medical equipment skills and educational programs. We determined the current capabilities of HCQ and designed a rotational program in accordance with the demands in the following areas resuscitation, trauma, critical care, and radiology. We also introduced continuous education programs and administrative methods for future development of education. Results Throughout the four rotations of our EM residents, we conducted daily education and several practical lessons based on the demands of the local doctors and equipment operation. The educational program was administered by an educational administrator who was responsible for updating the medical and technical knowledge of doctors. With our programs, the doctors of HCQ were able to perform resuscitation and critical protocols, including manipulating equipment such as mechanical ventilator and defibrillator. Conclusion The rotation program by the four residents was successful, in terms of sharing medical knowledge and equipment management, and filling gaps identified in the operation of a modern hospital. © 2020 Sung et al.Introduction Emergency Department (ED) crowding negatively impacts patient outcomes, patient satisfaction, and patient safety. One solution involves introducing a Concierge Physician (CP) whose sole purpose is to provide a brief initial assessment (BIA) and aid patient navigation through the ED. The goal of this study was to quantify the impact of a CP on patient flow dynamics in an urban ED setting. Methods We performed a retrospective observational cohort study in an urban academic ED over a 6-month period. Initially, the CP was present in the treatment area during weekdays; during the last half of the observation period, an additional CP was added to the waiting room on weekends. We identified four major milestones in the ED visit with regards to patient throughput. Adult patients presenting to the ED with a triage level of Urgent (ESI 3) were analyzed for this study. Data were stratified based on the patient's ultimate disposition (admitted or discharged) and presented as means with predictive analysis. Results Between August 2016 and January 2017, the ED evaluated 42,397 adult patients. Of those, 26,976 (64%) were triage level Urgent (3). Of the level 3 patients, 10,279 (38%) received a BIA from a CP. Patients evaluated by a CP were seen approximately 30 mins faster (40% reduction in Door to Doctor time), but stayed 30 mins longer in the ED on average, because the medical decision-making process took >1 hr longer when the patient was initially evaluated by a CP. Conclusion Adapting a concierge medicine model to rapidly evaluate patients resulted in a dramatically reduced Door to Doctor time, but an increase in overall time spent in the ED. This discrepancy was a direct result of the delay in physician disposition. https://www.selleckchem.com/products/nx-1607.html © 2020 Mandel et al.