16 research outputs found

    Reference case for estimating the costs of global health services and Interventions

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    Estimates of the costs of implementing health interventions are required for informing a wide range of decisions in global health. Costs are used in economic evaluations, such as benefit-cost or cost-effectiveness analysis, and other economic analyses to inform priority setting. Cost interventions are also needed for financial planning and management, and the formulation of resource requirements and budgets. In addition, cost estimates can provide additional detail on how interventions are implemented, which can be useful for assessing the efficiency of service delivery. Costs are typically estimated using a range of approaches and assumptions, often combining data obtained as part of research studies with data collected as part of routine program implementation. While numerous textbooks and guideline documents exist, analysts apply and interpret such guidance based on their prior training, professional experience, and context. However, there is no widely agreed-upon common guidance on principles, methods, and reporting standards specifically aimed at cost estimation across global health. The variation in applying the methods and reporting of costs for global health interventions has long been recognized. This variation can have an impact on estimates of cost-effectiveness, which should be comparable across interventions. A review of economic evaluations in the Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry found a high level of variation in costing methods, although the review noted an improvement in consistency over time. Differences in data collection methods and in the application of analytic methods, a general lack of comprehensiveness, and inconsistent compliance to existing guidance were all observed. As a result, reviews of global health costs conclude that methodological heterogeneity and lack of transparency make it impossible to compare studies over setting and time, and several papers point to the need to develop standardized methods for cost estimation in global health

    Identification of human nephron progenitors capable of generation of kidney structures and functional repair of chronic renal disease

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    Identification of tissue-specific renal stem/progenitor cells with nephrogenic potential is a critical step in developing cell-based therapies for renal disease. In the human kidney, stem/progenitor cells are induced into the nephrogenic pathway to form nephrons until the 34 week of gestation, and no equivalent cell types can be traced in the adult kidney. Human nephron progenitor cells (hNPCs) have yet to be isolated. Here we show that growth of human foetal kidneys in serum-free defined conditions and prospective isolation of NCAM1(+) cells selects for nephron lineage that includes the SIX2-positive cap mesenchyme cells identifying a mitotically active population with in vitro clonogenic and stem/progenitor properties. After transplantation in the chick embryo, these cells—but not differentiated counterparts—efficiently formed various nephron tubule types. hNPCs engrafted and integrated in diseased murine kidneys and treatment of renal failure in the 5/6 nephrectomy kidney injury model had beneficial effects on renal function halting disease progression. These findings constitute the first definition of an intrinsic nephron precursor population, with major potential for cell-based therapeutic strategies and modelling of kidney disease
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