Publications by authors named "Macrae C"

BAY 2413555 is a novel selective and reversible positive allosteric modulator of the type 2 muscarinic acetylcholine (M2) receptor, aimed at enhancing parasympathetic signaling and restoring cardiac autonomic balance for the treatment of heart failure (HF). This study tested the safety, tolerability and pharmacokinetics of this novel therapeutic option. REMOTE-HF was a multicenter, double-blind, randomized, placebo-controlled, phase Ib dose-titration study with two active arms.

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Background: Human resource management (HRM) of healthcare organisations plays an important role in improving the continuity of care, managing staff, and ensuring patient safety. During COVID-19, there were several HR-related issues, creating a significant challenging situation for health and social care institutions. This study explored the HRM issues that are associated with the patient safety in homecare, and how homecare providers have responded to these HR-related challenges during the COVID-19 pandemic.

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Interleukin-6 (IL-6) is produced and secreted by skeletal muscle cells during exercise and plays an important role in mediating metabolic responses to exercise. The promoter region of the IL-6 gene contains a common genetic variant (-174 G/C, rs1800795), which may alter responses to exercise training. To isolate the impact of this gene variant on exercise-induced IL-6 expression and skeletal muscle transcription responses following exercise, we generated knock-in mice with a GG or variant CC genotype for the murine homolog of rs1800795.

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  • Heart failure (HF) is linked to the use of NSAIDs, but it's unclear whether they lead more to heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF).
  • Research in mice showed that while COX-2 inhibition didn't affect cardiac function overall, aged female mice experienced signs of diastolic dysfunction and elevated BNP levels while maintaining preserved ejection fraction.
  • The findings suggest that COX-2 deletion specifically leads to HFpEF rather than HFrEF and indicates that calcium handling imbalances may affect heart relaxation in this context.
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  • The study investigates how living alone or with someone who is chronically ill affects outcomes for hip fracture patients aged 50 and older.
  • It found that 56% of 12,089 patients lived alone, who were generally older and had more long-term health conditions compared to those living with a co-resident.
  • Living alone and living with someone with dementia significantly increased the risk of needing care home admission after a hip fracture, but living alone had no substantial effect on the likelihood of emergency hospital admission within 30 days.
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Objectives: System-wide learning for patient safety is a core challenge for the health care sector, despite the prevalence of localised reporting and learning approaches. There is growing interest in how health care services could emulate other safety-critical sectors with the introduction of specialist safety investigation agencies to inform sector-wide safety. This paper reports on a study of the introduction and early operation of one such agency in the English health and care system.

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Background And Aims: The heart is a metabolic organ rich in mitochondria. The failing heart reprograms to utilize different energy substrates, which increase its oxygen consumption. These adaptive changes contribute to increased oxidative stress.

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Background: Optimal guideline-directed medical therapy is rarely attained in practice, resulting in inadequate control of diseases such as hypertension, with poorer results in under-resourced communities. Technology, including artificial intelligence-driven decision support and software-driven workflow transformation, can potentially improve disease outcomes at a reduced cost, although it must be integrated with a holistic approach.

Methods: We describe the design of a software platform that enables rapid iterative remote management of >20 conditions across cardiac-kidney-metabolic disease.

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Introduction: Congenital hypopituitarism (CH) is characterized by the deficiency of pituitary hormones. Among CH patients, 85% lack a molecular diagnosis. Whole Exome Sequencing (WES) identified a homozygous variant (c.

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  • This systemic review examines strategies aimed at reducing hospital and emergency department length of stay (LOS) while analyzing their impact on readmissions and healthcare costs.
  • Eighteen studies were included, highlighting interventions like outpatient parenteral antibiotic therapy (OPAT) and 'hospital at home' programs, which showed potential for lower LOS and costs, though sometimes extended the total care duration.
  • Overall, the findings suggest that many reviewed interventions are cost-effective and safe for children, benefiting families without increasing the risk of negative outcomes compared to traditional hospital care.
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  • Multimorbidity refers to the simultaneous presence of two or more long-term health conditions, posing significant challenges to health systems globally.
  • A systematic review identified 12 place-based risk factors influencing multimorbidity, with area-level deprivation, pollution, and urban/rural context being the most impactful.
  • The study emphasizes the need for more research on additional place-related factors like social cohesion and greenspace, and suggests developing a conceptual framework to better understand these relationships.
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Physical activity or structured exercise is beneficial in a wide range of circumstances. Nevertheless, individual-level data on differential responses to various types of activity are not yet sufficient in scale, duration or level of annotation to understand the mechanisms of discrete outcomes nor to support personalized recommendations. The Apple Heart & Movement Study was designed to passively collect the dense physiologic data accessible on Apple Watch and iPhone from a large real-world cohort distributed across the US in order to address these knowledge gaps.

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Counterstereotypes challenge the deleterious effects that gender-typed beliefs exert on people's occupational aspirations and lifestyle choices. Surprisingly, however, the critical issue of how readily unexpected person-related knowledge can be acquired remains poorly understood. Accordingly, in two experiments in which the facial appearance of targets was varied to manipulate goodness-of-stereotype-fit (i.

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  • LMNA-related dilated cardiomyopathy (DCM) is a rare condition, and the REALM-DCM trial aimed to test a new therapy, but it was halted for being ineffective without safety issues.
  • The trial included 77 patients with stable LMNA-related DCM who had specific heart devices and symptoms rated as Class II or III on the NYHA scale, with an average age of 53 years.
  • Results showed most patients had significant heart-related symptoms, with a notable percentage suffering from atrial fibrillation, and patients with NYHA Class III symptoms had worse heart function measurements compared to those with Class II symptoms.
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Pleural mesothelioma (PM) is an aggressive asbestos-associated thoracic malignancy with a median survival of 12-18 months. Due to continued asbestos use in many nations, global incidence is rising. Causes due to non-occupational, environmental exposure are also rising in many countries despite utilisation bans.

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  • Dilated cardiomyopathy is a rare genetic heart condition, and the study focused on the drug ARRY-371797, showing initial promise in improving walking distance after 12 weeks and maintaining benefits over 144 weeks.
  • The REALM-DCM trial was a phase 3 study involving patients with specific genetic traits and heart failure symptoms, comparing ARRY-371797 against a placebo over 24 weeks with multiple outcomes of interest.
  • The trial was stopped early due to an interim analysis showing that ARRY-371797 did not significantly improve key measures like walking distance or overall heart function compared to placebo, indicating futility in continuing.
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  • Choroid plexus tumors (CPTs) are rare and aggressive brain tumors with specific grading criteria, but recent cases show discrepancies between their histological diagnosis and actual behavior.
  • A study reviewed clinical data from patients diagnosed with CPTs at Boston Children's Hospital and conducted DNA methylation profiling to find correlations with WHO histologic grades and survival outcomes.
  • The results suggest that DNA methylation profiling could enhance clinical decision-making for CPTs by providing better prognostic insights than histologic grading alone, especially due to the uncertainty in treatment options for these tumors.
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  • Cardiovascular disease (CVD) is the top cause of illness and death worldwide, largely due to atherosclerosis, which affects about two-thirds of CVD patients.
  • Atherosclerosis develops over many years, offering a chance for preventive measures to avoid serious events like heart attacks and strokes, especially since early signs are seen in younger people.
  • There's a need for a shift in focus from treating advanced CVD to detecting it early; research should explore using precision medicine and biomarkers to identify atherosclerosis sooner and assess if this could lower healthcare costs globally.
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Cardiovascular disease plays a central role in the electrical and structural remodeling of the right atrium, predisposing to arrhythmias, heart failure, and sudden death. Here, we dissect with single-nuclei RNA sequencing (snRNA-seq) and spatial transcriptomics the gene expression changes in the human ex vivo right atrial tissue and pericardial fluid in ischemic heart disease, myocardial infarction, and ischemic and non-ischemic heart failure using asymptomatic patients with valvular disease who undergo preventive surgery as the control group. We reveal substantial differences in disease-associated gene expression in all cell types, collectively suggesting inflammatory microvascular dysfunction and changes in the right atrial tissue composition as the valvular and vascular diseases progress into heart failure.

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Purpose: The role of healthcare leaders is becoming increasingly complex, and carries great responsibility for patients, employees, and the quality of service delivery. This study explored the barriers and enablers that department leaders in nursing homes encounter when managing the dual responsibilities in Health, Safety and Environment (HSE) and Quality and Patient Safety (QPS).

Methodology: Case study design with data collected through semi structured interviews with 16 department leaders in five Norwegian municipalities.

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  • The text is a 12-part series of essays focusing on family medicine, featuring contributions from physicians and educators globally.
  • Each essay in section VIII covers various clinical themes, including diagnosis, integrative medicine, clinical judgment, team-based care, technology in medicine, and managing patients with multiple conditions.
  • The goal is for readers to appreciate the distinctive nature of family medicine in healthcare.
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Self-relevance has been demonstrated to impair instrumental learning. Compared to unfamiliar symbols associated with a friend, analogous stimuli linked with the self are learned more slowly. What is not yet understood, however, is whether this effect extends beyond arbitrary stimuli to material with intrinsically meaningful properties.

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Background: Diabetic eye screening (DES) represents a significant opportunity for the application of machine learning (ML) technologies, which may improve clinical and service outcomes. However, successful integration of ML into DES requires careful product development, evaluation, and implementation. Target product profiles (TPPs) summarize the requirements necessary for successful implementation so these can guide product development and evaluation.

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