Thymic epithelial organoids mediate T-cell development.

Although the advent of organoids has opened unprecedented perspectives for basic and translational research, immune system-related organoids remain largely underdeveloped. Here, we established organoids from the thymus, the lymphoid organ responsible for T-cell development. We identified conditions enabling mouse thymic epithelial progenitor cell proliferation and development into organoids with diverse cell populations and transcriptional profiles resembling in vivo thymic epithelial cells (TECs) more closely than traditional TEC cultures.

A cost-effectiveness analysis of reduced viral transmission with baloxavir marboxil versus oseltamivir or no treatment for seasonal and pandemic influenza management in the United Kingdom.

Background: Baloxavir marboxil is an oral, single-dose, cap-dependent endonuclease inhibitor that reduces the duration of influenza symptoms and rapidly stops viral shedding. We developed a susceptible, exposed, infected, recovered (SEIR) model to inform a cost-effectiveness model (CEM) of baloxavir versus oseltamivir or no antiviral treatment in the UK.

Research Design And Methods: The SEIR model estimated the attack rates among otherwise healthy and high-risk individuals in seasonal and pandemic settings.

Rehabilitation interventions delivered via telehealth to support self-management of rheumatic and musculoskeletal diseases: A scoping review protocol.

Background: Telerehabilitation is a term to describe rehabilitation services delivered via information and communication technology. Such services are an increasingly important component for the management of rheumatic and musculoskeletal diseases (RMDs). Telerehabilitation has the potential to expand the long-term self-management options for individuals with RMDs, improve symptoms, and relieve pressures on health care services.

Thymic epithelial cell fate and potency in early organogenesis assessed by single cell transcriptional and functional analysis.

During development, cortical (c) and medullary (m) thymic epithelial cells (TEC) arise from the third pharyngeal pouch endoderm. Current models suggest that within the thymic primordium most TEC exist in a bipotent/common thymic epithelial progenitor cell (TEPC) state able to generate both cTEC and mTEC, at least until embryonic day 12.5 (E12.

Cost-effectiveness analysis of adjuvant atezolizumab in stage II-IIIA non-small cell lung cancer expressing ≥50% PD-L1: A United Kingdom health care perspective.

Objectives: Atezolizumab monotherapy has marketing authorisation by the Medicines and Healthcare products Regulatory Agency as adjuvant treatment following complete resection for adults with stage II-IIIA non-small cell lung cancer (NSCLC) whose tumours have PD-L1 expression on ≥ 50% of tumour cells and whose disease has not progressed following adjuvant platinum-based chemotherapy. This study evaluated the cost-effectiveness of atezolizumab vs best supportive care (BSC) in the licensed patient population from a UK perspective.

Materials And Methods: Patient characteristics and clinical inputs were derived from the global, randomised, open-label, phaseIII IMpower010 trial.

Performance measurement of nonhomogeneous Hong Kong hospitals using directional distance functions.

Cook et al. (Oper Res 61(3):666-676, 2013) propose a DEA-based model for the performance evaluation of non-homogeneous decision making units (DMUs) based on constant returns to scale (CRS), extended by Li et al. (Health Care Manag Sci 22(2):215-228, 2019) to variable returns to scale (VRS).

An induced thymic epithelial cell-based high throughput screen for thymus extracellular matrix mimetics.

Thymic epithelial cells (TECs) are key effectors of the thymic stroma and are critically required for T-cell development. TECs comprise a diverse set of related but functionally distinct cell types that are scarce and difficult to isolate and handle. This has precluded TEC-based screening assays.

Efficacy of acute care pathways for older patients: a systematic review and meta-analysis.

Unlabelled: Meeting the needs of acute geriatric patients is often challenging, and although evidence shows that older patients need tailored care, it is still unclear which interventions are most appropriate. The objective of this study is to systematically evaluate the hospital-wide acute geriatric models compared with conventional pathways. The design of the study includes hospital-wide geriatric-specific models characterized by components including patient-centered care, frequent medical review, early rehabilitation, early discharge planning, prepared environment, and follow-up after discharge.

Correlates of physical activity in adults with spondyloarthritis and rheumatoid arthritis: a systematic review.

Physical activity (PA) is a primary non-pharmacological treatment option for those living with rheumatoid arthritis (RA) and spondyloarthritis (SpA). The aim of this systematic literature review was to summarize and present an updated synthesis of the factors associated with PA in the RA and SpA populations. A tailored search of PubMed (inc.

Measuring work complexity for acute care services.

Case weights capture the resource cost by diagnosis-related group (DRG) but may not fully reflect the complexity of the clinical services provided. This study describes the use of a work complexity index (WCI), for assessing acute care services focusing on those provided by physicians in healthcare systems. The services are classified using relative value units (RVUs) and their point value assigned using the resource-based relative value scale.

Effectiveness of interventions to maintain physical activity behavior (device-measured): Systematic review and meta-analysis of randomized controlled trials.

Physical activity has many physical, mental, and social health benefits. Interventions can be successful at helping people initiate participation, but there is a lack of evidence about the ability of these interventions to help adults maintain their physical activity. This systematic review and meta-analysis aims to address this evidence gap.

Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond.

Information received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood.

Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk.

Objectives: Research demonstrates that sedentary behaviour may contribute towards cardiovascular disease (CVD) risk in rheumatoid arthritis (RA). This study explored diurnal patterns of sedentary time and physical activity (PA) in RA and examined associations with long-term CVD risk.

Methods: 97 RA patients wore an accelerometer for 7 days to assess sedentary time, light-intensity and moderate-to-vigorous-intensity PA.

Canonical Notch signaling controls the early thymic epithelial progenitor cell state and emergence of the medullary epithelial lineage in fetal thymus development.

Thymus function depends on the epithelial compartment of the thymic stroma. Cortical thymic epithelial cells (cTECs) regulate T cell lineage commitment and positive selection, while medullary (m) TECs impose central tolerance on the T cell repertoire. During thymus organogenesis, these functionally distinct sub-lineages are thought to arise from a common thymic epithelial progenitor cell (TEPC).

A modeling framework for the economic evaluation of baricitinib in moderate-to-severe rheumatoid arthritis.

: The approval in more than 50 countries of baricitinib, an oral Janus Kinase inhibitor for the treatment of Rheumatoid Arthritis (RA), warrants a framework for corresponding economic evaluations. To develop a comprehensive economic model assessing the cost-effectiveness of baricitinib for the treatment of moderately-to-severely active RA patients in comparison to other relevant treatments, considering the natural history of the disease, real world treatment patterns, and clinical evidence from the baricitinib trials.: A systematic literature review of previously developed models in RA was conducted to inform the model structure, key modeling assumptions and data inputs.

Testing a self-determination theory-based process model of physical activity behavior change in rheumatoid arthritis: results of a randomized controlled trial.

Physical inactivity is prevalent in rheumatoid arthritis (RA) patients, increasing the risk of poor physical health and compromised well-being. Interventions are therefore required to support physical activity (PA) behavior change in this population. This study examined whether a self-determination theory (SDT) based exercise intervention for people with RA, increased autonomous motivation for PA and in turn, moderate-to-vigorous PA (MVPA) and subjective vitality RA patients (n = 115) were randomized to a 3-month SDT-based psychological intervention + RA-tailored exercise program (experimental group, n = 59) or a RA-tailored exercise program only (control group, n = 56).

Post-Acute Care for Older People Following Injury: A Randomized Controlled Trial.

Objectives: The study sought to determine whether older people, on discharge from hospital and on referral to a supported discharge team (SDT), will have: (1) reduced length of stay in hospital; (2) reduced risk of hospital readmission; and (3) reduced healthcare costs.

Design/intervention: Randomized controlled trial with follow-up at 4 and 12 months of post-acute home-based rehabilitation team (SDT). Programs were delivered by trained healthcare assistants, up to 4 times a day, 7 days a week, under the guidance of registered nurses, allied health, and geriatricians for up to 6 weeks.

Living with ankylosing spondylitis: an open response survey exploring physical activity experiences.

Objective: The aim was to gather in-depth, rich accounts of physical activity experiences of people living with AS, to include symptom management, consequences for symptoms, factors that encourage and disrupt physical activity, and motivations that underpin participation in physical activity.

Methods: Participants ( = 149; 60% female) completed a Bristol Online Survey that consisted of open questions to capture rich qualitative data. In total, 96% of participants self-reported having AS (1% other arthritis; 3% missing), and 51% had this diagnosis for >20 years.

Time-related changes in quality of life in persons with lower limb amputation or spinal cord injury: protocol for a systematic review.

Background: Experiencing a lower limb amputation (LLA) or spinal cord injury (SCI) is a life-changing event, affecting physical and systemic function as well as having psychological and social impacts. However, the severity of the physical impairment and/or motor disability demonstrates a poor relationship with patient-reported quality of life, suggesting that other factors determine such outcomes. As such, holistic health-related quality of life (QoL) assessment is an important tool to monitor long-term outcomes.

Virtual-reality exergaming improves performance during high-intensity interval training.

To determine if: (i) mean power output and enjoyment of high-intensity interval training (HIIT) are enhanced by virtual-reality (VR)-exergaming ( mode) compared to standard ergometry ( mode), (ii) if mean power output of HIIT can be increased by allowing participants to race against their own performance ( mode) or by increasing the resistance ( mode), without compromising exercise enjoyment. Sixteen participants (8 males, 8 females, VOmax: 41.2 ± 10.

A meta-analysis of techniques to promote motivation for health behaviour change from a self-determination theory perspective.

A systematic review and meta-analysis was conducted of the techniques used to promote psychological need satisfaction and motivation within health interventions based on self-determination theory (SDT; Ryan & Deci, 2017. Self-determination theory: Basic psychological needs in motivation, development, and wellness. New York, NY: Guilford Press).

The trade-off between equity and efficiency in population health gain: Making it real.

Two fundamental goals of health systems are to maximise overall population health gain (referred to as efficiency) and to minimise unfair health inequalities (equity). Often there is a trade-off in maximising efficiency vis a vis equity and the relative weight given to one goal over the other is acknowledged to be essentially a value judgement. Health systems necessarily make those value judgements but in making them would benefit from relevant and accurate opportunity cost information.

Home-Based Exercise Enhances Health-Related Quality of Life in Persons With Spinal Cord Injury: A Randomized Controlled Trial.

Objective: To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI).

Design: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.