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Background Continuous remote monitoring of vital signs on the hospital ward gained popularity during the Severe Acute Respiratory Syndrome coronavirus 2 pandemic due to its ability to support early detection of respiratory failure, and the possibility to do so without physical contact between patient and clinician. The effect of continuous monitoring on patient room visits has not been established yet. Objectives To assess the impact of continuous monitoring on the number of patient room visits for patients suspected of Corona Virus Disease 2019 (COVID-19) and the use of personal protection equipment. Design and methods We performed a before-after study at a ward with private rooms for patients suspected of COVID-19 at a tertiary hospital in Nijmegen, The Netherlands. Non-participant observers observed hospital staff during day, evening and night shifts to record patient room visits and personal protection equipment usage. After eleven days, wearable continuous vital sign monitoring was introduced. An interrupted time series analysis was applied to evaluate the effect of continuous monitoring on the number of patient room visits, visits for obtaining vital signs (Modified Early Warning Score visits) and the amount of personal protection equipment used. Results During the 45 day study period, 86 shifts were observed. During each shift, approximately six rooms were included. A total of 2347 patient room visits were recorded. The slope coefficient for the number of patient room visits did not change after introducing continuous vital sign monitoring (B -0.003, 95% confidence interval -0.022/0.016). The slope coefficients of the number of Modified Early Warning Score visits and the amount of personal protection equipment used did not change either (B -0.002, 95% confidence interval -0.021/0.017 and B 0.046, 95% confidence interval -0.008/0.099). The number of Modified Early Warning Score visits did show a decline over the entire study period, however this decline was not influenced by the intervention. Evening and night shifts were associated with fewer patient room visits compared to day shifts. Conclusion Introduction of continuous vital sign monitoring at a general ward for patients with suspected COVID-19 did not reduce the number of patient room visits or the usage of personal protection equipment by hospital staff. The number of Modified Early Warning Score visits declined over time, but this was not related to the introduction of continuous monitoring. Detailed analysis of the influence of continuous monitoring on the workflow of hospital staff reveals key points to increase efficacy of this intervention.

The International Agency for Research on Cancer (IARC) and the US National Cancer Institute (NCI) have initiated a series of cancer-focused seminars [Scelo G, Hofmann JN, Banks RE et al. International cancer seminars: a focus on kidney cancer. Ann Oncol 2016; 27(8): 1382-1385]. In this, the second seminar, IARC and NCI convened a workshop in order to examine the state of the current science on esophageal squamous cell carcinoma etiology, genetics, early detection, treatment, and palliation, was reviewed to identify the most critical open research questions. The results of these discussions were summarized by formulating a series of 'difficult questions', which should inform and prioritize future research efforts.

The objective of this research was to develop a non-invasive method to detect an emotional response of a horse to novelty during physical activity. Two horses performed 20 trials each, in which the horse's heart rate (HR) and physical activity were continuously measured. The relationship between the horse's physical activity and HR was described by a mathematical model allowing online decomposition of the horse's HR into a physical component and a component containing information about its emotional state. Exposure to the novel object resulted in an increase in the emotional component of HR, which allowed automatic detection of an emotional response of the horse in 33/40 trials. In the remaining seven trials no stable model could be built or data were missing. The results show that model-based decomposition of HR can be a useful tool for quantification of certain aspects of temperament.

Altered respiratory rate is one of the first symptoms of medical conditions that require timely intervention, e.g., sepsis or opioid-induced respiratory depression. To facilitate continuous respiratory rate monitoring on general hospital wards a contactless, non-invasive, prototype monitor was developed using frequency modulated continuous wave radar. We aimed to study whether radar can reliably measure respiratory rate in postoperative patients. In a diagnostic cross-sectional study patients were monitored with the radar and the reference monitor (pneumotachograph during mechanical ventilation and capnography during spontaneous breathing). Eight patients were included; yielding 796 min of observation time during mechanical ventilation and 521 min during spontaneous breathing. After elimination of movement artifacts the bias and 95 % limits of agreement for mechanical ventilation and spontaneous breathing were −0.12 (−1.76 to 1.51) and −0.59 (−5.82 to 4.63) breaths per minute respectively. The radar was able to accurately measure respiratory rate in mechanically ventilated patients, but the accuracy decreased during spontaneous breathing. Electronic supplementary material The online version of this article (doi:10.1007/s10877-015-9777-5) contains supplementary material, which is available to authorized users.

Recombinant human growth hormone (r-hGH) is given as substitution therapy to growth hormone-deficient children at 0.01–0.025 mg/kg/day. Higher doses are used for short stature due to Turner’s syndrome and for idiopathic short stature (approximately 0.05 mg/kg/day). For metabolic indications such as AIDS-associated wasting and severe burns, even higher doses are required, up to 0.2 mg/kg/day. Worldwide experience with low and medium doses of r-hGH is well documented. Data on long-term treatment with pharmacological doses of r-hGH are scarce. Serono’s clinical program for AIDS-associated wasting provides placebo-controlled data on 355 treated patients. The total experience in clinical trials covers more than 100 person-years of treatment on approximately 600 patients. The most common side effects were tissue turgor complex and musculoskeletal discomfort. Leukopenia was found more frequently in placebo patients. Neoplasm, hyperglycemia, hypertriglyceridemia, carpal tunnel syndrome, pseudotumor cerebri and hypercalcemia were not found to be more significant than with substitution therapy.

Human gonadotrophins are follicle stimulating hormone (FSH), luteinizing hormone (LH) and human chorionic gonadotrophin (HCG). All three gonadotrophins are new produced in vitro by recombinant DNA technology. Being complex heterodimeric proteins, an eukaryotic cell line, has been selected for expression and large scale production (Chinese hamster ovary cells). The advantages of producing the gonadotrophins in vitro rather than extracting them from human fluids are : (i) a fully controlled production process from bulk to finished product; (ii) high purity and specific activity; (iii) batch-to-batch consistency; and (iv) complete absence of contamination by the other gonadotrophins. Pharmacokinetic characterization of recombinant human gonadotrophins has shown that this first generation have pharmacokinetic characteristics very similar to the extractive gonadotrophins with an apparent terminal half-life after s.c. administration of ∼37 h, 12 h and 32 h for recombinant FSH (rHFSH), recombinant LH (rhLH) and recombinant HCG (rhHCG) respectively. Clinical efficacy and safety have been demonstrated in several randomized, well-controlled studies, comparing rhFSH administered s.c. with uhFSH administered i.m. for stimulating follicular development prior to assisted reproductive technology and in WHO Group II anovulation. To date, ∼1300 patients have been treated with rhFSH. Moreover, rhLH has recently been successfully used in association with rhFSH for inducing ovulation and pregnancy in WHO I anovulatory patients and rhCG has been successfully used for triggering final follicular maturation prior to assisted reproductive technology.

e14026 Background: Patients with colorectal cancer are often highly motivated to seek information about lifestyle and dietary changes which may optimize outcomes. Using data from two large National...