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Background Mobile health innovations are well adapted for ambulatory coronavirus disease 2019 (COVID-19) patients who risk clinical deterioration at home during the second week of illness. Methods A short message service (SMS) communication program was implemented by French physicians to monitor COVID-19 patients after discharge from outpatient or emergency care. The aim of the SMS tracking is to advise patients about their need for medical reassessment if reporting worsening of COVID-19 symptoms. A follow-up via SMS to all confirmed positive patients in the Nîmes area (France) was established. Every morning, patients received four follow-up questions. Daily responses were converted to green, orange or red trees, analysed in real time by physicians. “Red” patients were called immediately to check their condition and organise transfer to hospital if needed. “Orange” patients were called within two hours to verify whether the specific instructions following the SMS had been followed. Results From March 21 to June 30, 2020, 1007 patients agreed to sign up to the SMS tracking, 62% were women and the mean age was 41.5 years (standard deviation (SD) 16.0). During follow-up, 649 (64%) became “orange” and 69 (7%) “red”. Ten patients were directly admitted to the Infectious Diseases Department during their follow-up due to clinical worsening, all but one as a result of SMS alerts and subsequent telephone assessment by physicians. Conclusion SMS tracking platforms could be useful as an early warning system to refer patients with worsening clinical status to hospital-based care or additional clinician advice.

We aimed to verify the effect of new low-sodium high-potassium seasonings and processed foods containing poly-γ-glutamic acid on blood pressure in free-living settings. To this end, we conducted a randomized, double-blind controlled trial on 187 Japanese men, aged 35–67 years, who did not use antihypertensives. Participants were randomly allocated to an intervention (n = 93) or a control group (n = 94). They were given a boxed lunch and miso soup (average Na and K content for the intervention group: 1175 and 1476 mg, for the control group: 2243 and 703 mg, respectively). Blood pressure was measured three times every morning for 1 week immediately before and during the final week of the trial. On the day before and the final day of the intervention period, 24 h urine samples were collected. After intervention, the intervention group showed a significantly stronger decrease in the urinary sodium-to-potassium ratio than the control group (p &lt, 0.001). The mean difference in systolic blood pressure change after adjustment for baseline values between the two groups was −2.1 (95% CI: −3.6, −0.6) mmHg. Compliance between the groups was similar, suggesting successful blinding. In conclusion, the use of new seasonings and processed foods aimed at lowering blood pressure in free-living settings may be feasible and effective.

Effects of two different management systems on male dromedary camel hormones, behaviors, and semen parameters were documented. Camels (n=6) were tested under two management systems: (i) housed in single boxes with 1-h freedom (H23); (ii) exposed to females for 17 h (from 3.30 p.m. to 8.30 a.m.) and then housed (ConExF). Blood was collected every morning; camel behavior was recorded twice a day: (i) from 7:00 to 8:00 a.m. to determine the short effects; (ii) from 2:00 to 3:00 p.m. to determine the long effects. Each camel underwent a female parade and semen collection thrice a week; sexual behavior, libido, and semen parameters were assessed. Testosterone and cortisol concentrations were higher in ConExF than H23. Compared to the H23 group, ConExF group spent more time walking, standing tripods, and looking outside their pen/box but they spent less time eating, ruminating, resting, standing, and showing stereotypical behaviors. In the morning, ConExF group spent more time walking, ruminating, and showing typical sexual behaviors compared to themselves during afternoon time and the H23 group. However, in the afternoon time, ConExF camels put more time their heads outside the box through the window and showed higher frequencies of stereotypies, probably due to a higher level of frustration. While the sexual behavioral score was higher and ejaculates showed a higher fraction of milky white and white-colored semen in ConExF than H23 group, their libido was similar. Overall, 17 h of exposure led to an increase in testosterone and cortisol levels, enhancing sexual behavior and semen color, but leading to frustration. Supplementary Information The online version contains supplementary material available at 10.1007/s11250-021-02702-6.

The aim of the present paper is to monitor changes of selected mental and physiological stress indicators in both female and male sportsmen in the subsequent days prior to an International Judo Tournament in Poland and on the competition day. The study included 9 men and 9 women, participants of the training camp that ended with a tournament. Every morning, on the three consecutive days preceding the competition (day -3, -2, -1) and on the competition day (day 0) capillary blood was sampled to determine serum cortisol (C) and testosterone (T) levels, then the subjects assessed their night sleep quality (SQ) with the use of a 5-point Likert scale, and perceived anxiety using the State-Trait Anxiety Inventory questionnaire by Spielberger (STAI - Polish version). SQ insignificantly deteriorated, and C and anxiety levels increased with the time to event. The inter-group analysis for the entire period showed higher scores in average anxiety and higher average level of C in women than men. The relative changes in these biomarkers could indicate higher pre-competitive stress in women, however without taking into account the sports class of the opponents individually for each of the groups one cannot imply gender-specific susceptibility to stress as a general principle.

OBJECTIVE To pilot test a new closed-loop control technology to validate it for a further large clinical trial. RESEARCH DESIGN AND METHODS The t:slim X2 insulin pump with Control-IQ Technology (Tandem Diabetes Care) includes a Dexcom G6 sensor and a closed-loop algorithm implemented in the pump that 1) automates insulin correction boluses, 2) has a dedicated hypoglycemia safety system, and 3) gradually intensifies control overnight, aiming for blood glucose levels of approximately 100–120 mg/dL every morning. RESULTS Five patients with type 1 diabetes (mean age 52.8 years, 2/3 male/female, mean A1C 6.5%) used Control-IQ in an outpatient setting (hotel) for approximately 37 h. During the closed loop, mean glucose was 129 mg/dL (135/121 mg/dL during the day/night), time within target range 70–180 mg/dL was 87% (82%/94% during the day/night), and time CONCLUSIONS Following this pilot trial, Control-IQ was deployed in several studies, including the large-scale National Institutes of Health International Diabetes Closed-Loop (iDCL) Trial.

Every morning began the same. He would check website after website, monitor breaking news, immerse himself fully in what he called the stream of Internet consciousness. There was also Twitter, and the latest videos, and hot new memes. Scan, cull, curate, comment, repeat. All day. Seven days a week.

Objective: The purpose of this study was to document the uF1 + 2 excretion in elderly patients during and after a hip fracture (HF). Methods: The study was a prospective pilot study. Spot urine samples were collected immediately after admission and every morning until surgery. After surgery, urine samples were collected on days 1, 5, 7, 14, and at follow-up on day 90 (±10). Results: A total of 24 women and 7 men with HF completed the study. The median uF1 + 2 level was significantly increased on the day of admission relative to the median level at follow-up. Maximum levels were seen on day 1 with a decreasing tendency until follow-up. Patients treated with a hemiarthroplasty had higher median uF1 + 2 levels on all days compared with patients treated with osteosynthesis. Conclusion: A substantial coagulation activity, indicated by high median levels of uF1 + 2, was seen at admission and during the first week after HF.

Every morning report gives a revealing and sobering glimpse into the workings of a district hospital in Malawi: From Maternity Ward: “…16 SVDs [spontaneous vaginal deliveries], 2 breech deliveries, 3 caesarean sections, 2 vacuum extractions, one set of twins, 2 NNDs [neonatal deaths], one fresh

Pituitary GH secretion is feedback regulated by circulating IGF-I. However, it remains to be determined whether the feedback control is mediated through circulating free or total IGF-I. To study this, we compared the temporal changes in circulating levels of GH vs. free and total IGF-I during fasting. Seventeen healthy normal-weight subjects (body mass index 23.4 +/- 0.6 kg/m(2)) were studied during 80 h of fasting. Serum was assayed for GH every 3 h; total, free, and bioactive IGF-I, IGF binding protein (IGFBP)-1, -2, and -3 as well as IGFBP-1 bound IGF-I were assayed every morning. During fasting, mean 24-h GH levels increased from 1.41 +/- 0.20 to 3.01 +/- 0.46 and 2.09 +/- 0.30 microg/liter (d 1 vs. d 2 and 3; P0.03). After 24 h of fasting, free and bioactive IGF-I had decreased by 40 +/- 5 and 17 +/- 5%, respectively (P0.02), and both concentrations remained suppressed for the rest of the study. In contrast, total IGF-I remained unchanged until the end of d 3, at which levels were slightly reduced (P0.007). IGFBP-1 increased from 38 +/- 2 to 137 +/- 24, 212 +/- 32, and 214 +/- 22 microg/liter (d 1 vs. d 2, d 3, and end of d 3; P0.0001), and these changes closely paralleled those of IGFBP-1-bound IGF-I (P0.0001). IGFBP-2 increased only transiently at d 2 (P0.05), and IGFBP-3 remained unchanged. The increase in mean 24-h GH levels from d 1 to d 2 correlated inversely with the relative reduction in free IGF-I from d 1 to d 2 (r = -0.51; P = 0.04), i.e. the larger the reduction in free IGF-I, the larger the increase in GH. None of the other IGF-related parameters correlated with GH. In conclusion, the temporal relationship between the increase in GH and the reduction in free IGF-I supports the hypothesis that circulating free IGF-I mediates the feedback regulation of GH secretion.

It is common clinical practice to discontinue antibiotic treatment of asymptomatic babies if the blood cultures are negative at 48 hours.1–3 However, if blood culture results are only available during the normal working day, then antibiotic treatment of some babies may continue into the next working day. In our neonatal unit, blood culture results were routinely received from the microbiology laboratory via fax as a list every morning. Extra positive results would be telephoned through, if they became available, during the normal working day. Results could also be checked by the clinical staff telephoning the laboratory during “office hours”. This gave the potential for inadvertent prolongation of antibiotic courses for up to a …

Mometasone furoate (MF) aqueous nasal spray has been shown to be effective and well-tolerated in the treatment of perennial allergic rhinitis (PAR). All of the sudies, however, have been conducted in Canada, UK, and Europe. Therefore, a bridging study is warranted in view of the different climatic conditions in tropical countries. To evaluate the clinical efficacy and tolerability of MF aqueous nasal spray in the treatment of PAR in a tropical country. This study was an open, non comparative, 4-week 3-centre trial in outpatients of 12 to 60 years with moderate to severe PAR of at least 2 years duration. Patients were allergic to at least one major PAR allergen, confirmed by skin prick test. They had total nasal symptom score (TNSS) of ≥ 6 and nasal congestion score (NCS) of ≥ 2 on ≥ 3 diary time points prior to baseline visit and at both screening and baseline visits. Eligible patients received MF aqueous nasal spray at baseline visit, and administered 200 µg mometasone every morning for 4 weeks. The primary clinical efficacy parameter was the mean percentage reduction of TNSS from baseline. Of 100 eligible patients, all completed this 4-week trial. The patient-evaluated TNSS (sum of the Last 3 mornings) decreased signiftcantly from baseline with a mean reduction of 60.9 % (p < 0.0001,) at week-2 and 73.6 % (p < 0.0001) at week-4. The mean reductions in physician-rated TNSS (61.7 % at week-2 and 77.8 % at week-4) were higher than those in the previous studies (43 % and 51 % at week-2, 52 % and 54 % at week-4). Similar trends were observed for nasal congestion score (NCS), other individual symptoms, total symptoms, and clinical efficacy rates. Evening symptoms were reduced similarly as morning symptoms There was no withdrawal due to adverse event. MF aqueous nasal spray, at a dose of 200 µg once daily in the morning for the treatment of moderate to severe PAR in a tropical country, was clinically effective with 24-hour control of PAR symptoms, and was well tolerated. (Med J Indones 2002; 11: 69-80) Keywords : mometasone furoate, nasal spray, perennial allergic rhinitis.

International audience; Carabid beetles were trapped in summer 1987 and spring 1988 in the Plateau des Tailles (ProvinceLuxembourg, Belgium). The traps were checked every morning during 10 trapping sessions (79 days). Temperature and humidity were recorded continuously on the site during the whole period. The influence of these two meteorologica 1 variables was studied using a Stepwise Linear Regression Model in order to study the informationadded by the different variables. ln spring, the higher the Mean daily temperature, and the lower the day-night temperature contrast and the Mean daily humidity, the more Carabus problematicus and C.auronitenswereactive. The activity of Carabus problematicus and C.auronitensin summer, and of C.violaceusinspring was positively correlated with the Meandally temperature.C.violaceusis active in spring mainly in nights during which the humidity at midnight is between 85 and 97%.

To examine the response of the hypothalamic-pituitary-adrenal (HPA) axis to severe surgical stress, we measured the immunoreactive plasma levels of corticotropin-releasing hormone (CRH), corticotropin, cortisol, arginine-vasopressin (AVP), atrial natriuretic factor (ANF), neuropeptide Y (NPY), interleukin-1 (IL-1), IL-6, interferon gamma (INF), and tumor necrosis factor-alpha (TNF-alpha) in eight patients with Zollinger-Ellison syndrome (ZES) or mediastinal parathyroid carcinoma, all undergoing major surgery with a standardized anesthetic technique. Blood samples were drawn the morning before surgery, every 10 to 30 minutes throughout surgery (average, 308.7 +/- 15 minutes), and every morning for the next 4 postoperative days (POD). During surgery, plasma CRH concentrations were slightly but not significantly elevated compared with those before surgery and with those of the next 4 POD. However, the values were within the normal range (less than 2.2 pmol/L) and showed 8.9 +/- 0.6 pulses (one pulse every 34.7 +/- 1.6 minutes). Plasma corticotropin, on the other hand, was quite elevated, but was also released in a pulsatile fashion during the surgical procedure (one pulse every 36.7 +/- 1.6 minutes). Most of these secretory episodes of corticotropin were temporally related to those of CRH. Corticotropin returned to basal levels on the first POD and remained so for all 4 POD. Plasma cortisol concentrations increased steadily during surgery and remained elevated the first POD. Cortisol showed 6.2 +/- 1.1 pulses during the operative sampling period (one pulse every 71.8 +/- 13 minutes). Plasma AVP concentrations were also markedly elevated during surgery, but individual secretory pulses were not detected.(ABSTRACT TRUNCATED AT 250 WORDS)

This report of social work practice in a hospital outpatient medical clinic examines three features: (1) the extent of utilization of social service referrals by medical staff , (2) some common reasons for referral, and (3) follow-up observations on 70 consecutively referred patients. . . . STUDY SETTING . . . The staff holds clinic sessions mornings and afternoons fi ve days a week and on Saturday mornings. Each social worker is available for consultation one morning or afternoon session four days a week, while each physician, except for the clinic head, attends but one half-day session a week. The clinic head attends every morning session. In making a referral the physician customarily brings the patient to the social worker during his session in the clinic. . . . From a review of the interview material a diagnosis of presenting psychological symptoms and referral reason was reached by consensus among the authors. The six-year follow-up observations on the patient’s mortality, medical care services, and social service contacts were obtained from sources both in and outside the clinic. . . .