An organoid biobank for childhood kidney cancers that captures disease and tissue heterogeneity

Kidney tumours are among the most common solid tumours in children, comprising distinct subtypes differing in many aspects, including cell-of-origin, genetics, and pathology. Pre-clinical cell models capturing the disease heterogeneity are currently lacking. Here, we describe the first paediatric cancer organoid biobank. It contains tumour and matching normal kidney organoids from over 50 children with different subtypes of kidney cancer, including Wilms tumours, malignant rhabdoid tumours, renal cell carcinomas, and congenital mesoblastic nephromas. Paediatric kidney tumour organoids retain key properties of native tumours, useful for revealing patient-specific drug sensitivities. Using single cell RNA-sequencing and high resolution 3D imaging, we further demonstrate that organoid cultures derived from Wilms tumours consist of multiple different cell types, including epithelial, stromal and blastemal-like cells. Our organoid biobank captures the heterogeneity of paediatric kidney tumours, providing a representative collection of well-characterised models for basic cancer research, drug-screening and personalised medicine

Productivity and quality of Dutch hospitals during system reform

This study addresses the productivity of Dutch hospitals since the start of the health systems reform in 2005. We consider DEA based measures, which include efficiency and quality for the complete set of Dutch hospitals and present cross-sectional and longitudinal analysis. In particular, we consider how hospital efficiency has developed. As the reform created an environment of regulated competition, we pay special attention to relative efficiency. Our results suggest that the differences in efficiency among hospitals have become larger. In the years 2009–2010, the number of hospitals identified as (close to) efficient by DEA analysis decreased

Snake Venom Gland Organoids

Wnt dependency and Lgr5 expression define multiple mammalian epithelial stem cell types. Under defined growth factor conditions, such Adult Stem Cells (ASCs) grow as 3D organoids that recapitulate essential features of the pertinent epithelium. Here, we establish long-term expanding venom gland organoids from several snake species. The newly assembled transcriptome of the Cape coral snake reveals that organoids express high levels of toxin transcripts. Single cell RNA sequencing of both organoids and primary tissue identifies distinct venom-expressing cell types as well as proliferative cells expressing homologs of known mammalian stem cell markers. A hard-wired regional heterogeneity in the expression of individual venom components is maintained in organoid cultures. Harvested venom peptides reflect crude venom composition and display biological activity. This study extends organoid technology to reptilian tissues and describes an experimentally tractable model system representing the snake venom gland

The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals

The healthcare sector in general and hospitals in particular represent a main application area for Data Envelopment Analysis (DEA). This paper reviews 262 papers of DEA applications in healthcare with special focus on hospitals and therefore closes a gap of over ten years that were not covered by existing review articles. Apart from providing descriptive statistics of the papers, we are the first to examine the research purposes of the publications. These research goals can be grouped into four distinct clusters according to our proposed framework. The four clusters are (1) Pure DEA efficiency analysis, i.e. performing a DEA on hospital data, (2) Developments or applications of new methodologies, i.e. applying new DEAy approaches on hospital data, (3) Specific management question, i.e. analyzing the effects of managerial specification, such as ownership, on hospital efficiency, and (4) Surveys on the effects of reforms, i.e. researching the impact of policy making, such as reforms of health systems, on hospital efficiency. Furthermore, we analyze the methodological settings of the studies and describe the applied models. We analyze the chosen inputs and outputs as well as all relevant downstream techniques. A further contribution of this paper is its function as a roadmap to important methodological literature and publications, which provide crucial information on the setup of DEA studies. Thus, this paper should be of assistance to researchers planning to apply DEA in a hospital setting by providing information on a) what has been published between 2005 and 2016, b) possible pitfalls when setting up a DEA analysis, and c) possible ways to apply the DEA analysis in practice. Finally, we discuss what could be done to advance DEA from a scientific tool to an instrument that is actually utilized by managers and policymakers