Objective: This study investigated how organizational factors within primary care clinics were associated with the number of patients seen in fever outpatient services during the COVID‑19 pandemic.

Methods: Using a database compiled from administrative claims data submitted by clinics affiliated with the Japan Association for Development of Community Medicine (JADECOM), we conducted group‑based trajectory modeling to classify trends in monthly fever outpatient visits per physician between January 2022 and May 2023. Clinic characteristics were additionally assessed through a questionnaire survey administered from April 10 to 30, 2025, and compared across trajectory groups.

Results: Among 11 eligible clinics, two distinct trajectory groups emerged: a low‑volume group (n=8) and a high‑volume group (n=3). The mean monthly number of fever outpatient visits per physician was 66.2 ± 33.1 for the high‑volume group, compared with 22.9 ± 18.2 for the low‑volume group. High‑volume clinics employed more physicians (3.0 ± 1.0 vs. 1.5 ± 0.7), more often assigned fever cases to physicians other than those handling general outpatient care (100% vs. 0%), imposed fewer restrictions on accepting fever patients (0% vs. 37.5%), and perceived their fever outpatient services as more essential to their community (5.0 ± 0.0 vs. 4.3 ± 1.2).

Conclusion: This study indicates that primary care clinic capacity to manage fever clinics during contagious disease outbreaks is influenced not only by staffing levels but also by workflow design, role allocation, and the operational burden associated with fever clinic services.

Aim/Introduction: Integrating physiological data from continuous glucose monitoring (CGM) with real-world behavioral data may offer new insights into health management. This study examined longitudinal changes in CGM-derived glycemic metrics and characterized patterns in participant-generated communication using a social networking platform.

Patients and Methods: Seven participants (five females, two males; mean age 60.0 ± 4.4 years) using the FreeStyle Libre 2 CGM system and LINE were included. CGM metrics were compared between early (days 2–7) and later (days 8–15) periods. Text data were analyzed for need categories, sentiment (positive, neutral, negative), temporal patterns, and interaction networks. Paired t-tests with Cohen’s d were used for comparisons, and Spearman’s rank correlation assessed associations.

Results: All seven participants were analyzed in both periods. Mean glucose management indicator (GMI) was 6.1% (SD 0.2), and none had diabetes. CGM metrics showed no significant differences between periods, although hAUC and MODD tended to decrease. Total word count was not associated with glycemic metrics. However, the proportion of positive words was negatively correlated with changes in mean glucose (r = −0.809, P = 0.028), while neutral words showed a borderline positive association. Text analysis revealed that a limited number of need categories accounted for most posts, with activity peaking in the evening and on weekends. Network analysis indicated that a few participants played central roles in communication.

Conclusions: While glycemic control remained stable, communication data revealed distinct behavioral patterns. Integrating physiological and digital behavioral data may improve understanding of engagement and support personalized management strategies.

Abstract Technically difficult colonoscopy cases are frequently encountered in clinical practice, most commonly due to loop formation in the sigmoid colon. The combined use of the water-immersion method and an endoscopic insertion-shape monitoring system (ScopeGuide UPD-3) minimizes loop formation, enabling loop reduction while alleviating patient discomfort and pain. In this video, endoscopic images are presented alongside real-time insertion-shape monitoring images obtained with the UPD-3 system, facilitating a clear visual understanding of the loop reduction techniques and scope behavior. Once the key techniques for reducing loops while minimizing discomfort are mastered, colonoscopy can be safely performed without sedation, even in elderly patients and those with cognitive impairments. This method is practical and applicable in resource-limited settings, such as rural primary care clinics.