Cautionary Tale Research Articles

The contribution of Teacher education to universities: a case study for international teacher educators

ABSTRACT This paper reports on the initial stage of a research project which aims to develop deeper understanding of the contribution teacher education, as a sub-discipline within Education, makes to Higher Education in England. The study is located in the intersection between the domains of teacher education and higher education scholarship, which in England represents a contested and ambiguous professional space. Tensions between competing accountability measures, pulling away from university-based to exclusively school-based teacher education, are exacerbated by proposed policy changes arising from the government's recent market review. Findings drawn from analysis of qualitative data from a national survey are discussed in the context of Elizabeth Povinelli's critique of late liberalism and previous scholarship on the nature of teacher educators’ work. Evidence from the study demonstrates numerous benefits to higher education of hosting teacher education departments, including contributions to standard metrics, regional development and knowledge exchange within a strategic social justice agenda. However, teacher educators themselves may find articulating these benefits difficult, because of marginalisation from the dominant ways of achieving and accounting for excellence in the modern university. These findings offer a cautionary tale to international colleagues whose governments may be embarking on equivalent paths of teacher education reform.

Effect of statin use for the primary prevention of cardiovascular disease among older adults: a cautionary tale concerning target trials emulation

ObjectivesEvidence concerning the effect of statins in primary prevention of cardiovascular disease (CVD) among older adults is lacking. Using Quebec population-wide administrative data, we emulated a hypothetical randomized trial including older adults >65 years on April 1, 2013, with no CVD history and no statin use in the previous year. Study Design and SettingWe included individuals who initiated statins and classified them as exposed if they were using statin at least 3 months after initiation and nonexposed otherwise. We followed them until March 31, 2018. The primary outcome was the composite endpoint of coronary events (myocardial infarction, coronary bypass, and percutaneous coronary intervention), stroke, and all-cause mortality. The intention-to-treat (ITT) effect was estimated with adjusted Cox models and per-protocol effect with inverse probability of censoring weighting. ResultsA total of 65,096 individuals were included (mean age = 71.0 ± 5.5, female = 55.0%) and 93.7% were exposed. Whereas we observed a reduction in the composite outcome (ITT–hazard ratio (HR) = 0.75; 95% CI: 0.68–0.83) and mortality (ITT-HR = 0.69; 95% CI: 0.61–0.77) among exposed, coronary events increased (ITT-HR = 1.46; 95% CI: 1.09–1.94). All multibias E-values were low indicating that the results were not robust to unmeasured confounding, selection, and misclassification biases simultaneously. ConclusionWe cannot conclude on the effectiveness of statins in primary prevention of CVD among older adults. We caution that an in-depth reflection on sources of biases and careful interpretation of results are always required in observational studies.

A cautionary tale about the pole of polar coordinates

A cautionary tale about the pole of polar coordinates

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale.

An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the 'gift of life' are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.

A gendered analysis of US decline: a cautionary tale

This article offers an innovative gendered analysis of the thesis of US decline, a prominent theory shared amongst International Relations scholars and US foreign policy experts about the impending end of US hegemony and the US-led international order. Inspired by feminist International Relations, it demonstrates that masculinism underscores the theory in three important ways: the methodologies used to (dis)prove US decline, the values declinism privileges and reinforces, and the way US decline appeals to phallocentric imagery. The article illustrates this argument through a discourse analytical reading of hi/stories of decline since the end of the Cold War in which I argue that US declinism paved the way for ‘Make America Great Again’ (MAGA) and the return to a hybrid masculinity embodied by Donald Trump and his supporters. The article thus acts a cautionary tale against declinism by showing the constitutive effects of alarming scenarios of falling empires. It offers an original inquiry in the thesis of US decline and advances wider studies on declinism, and in so doing, contributes to International Relations scholarship.

Can face recognition be selectively preserved in some cases of amnesia? A cautionary tale

Evidence suggests that some patients with isolated hippocampal damage appear to present with selective preservation of unfamiliar face recognition relative to other kinds of visual test stimuli (e.g., words). Bird and Burgess (2008) formulated a review and secondary analysis of a group of 10 cases all tested on a clinical assessment of word and face recognition memory (RMT, Warrington, 1984), which confirmed the key memory dissociation at the group level. The current work provides an updated secondary analysis of such cases with a larger published sample (N = 52). In addition to group-level analyses, we also re-evaluate evidence using a single case statistical approach (Crawford & Garthwaite, 2005), enabling us to determine how many would make criteria for a ‘classical dissociation’ (Crawford, Garthwaite, & Gray, 2003). Overall, group-level analyses indicated the key pattern of significant differences confined to words was limited to small control sample comparisons. When using the large control sample provided by Bird and Burgess (2008), hippocampal cases as a group were significantly poorer for both classes of items. Furthermore, our single-case approach indicated few had a performance pattern of a relative difference across face > word categories that would meet statistical significance; namely within individual differences across categories that would warrant a significant ‘classical dissociation’. Moreover, these analyses also found several cases with a ‘classical dissociation’ in the reverse direction: namely preserved recognition of words. Such analyses serve to demonstrate the need for a more conservative statistical approach to be undertaken when reporting selective ‘preservation’ of a category in recognition memory. Whilst material specificity has important implications for understanding the role of the hippocampus in memory, our results highlight the need for statistical methods to be unquestionably rigorous before any claims are made. Lastly, we highlight other methodological issues critical to group analyses and make suggestions for future work.

Combined right and left sided endocarditis in a hemodialysis patient: A cautionary tale

IntroductionInfective endocarditis is a potentially life-threatening condition, more prevalent among chronic maintenance hemodialysis patients, as opposed to the general population.AimCombined involvement of both the right and left heart chambers is exceptionally rare.Case studyHerein, we present the case of a patient on long-term maintenance hemodialysis with right and left sided infective endocarditis.Results and discussionWe discuss potential risk factors leading to the widespread infection and emphasize the importance of an early diagnosis and prompt treatment in yielding better outcomes.ConclusionsThe patient was treated successfully by a multidisciplinary team.

A Cautionary Tale: Malaligned Incentives in Total Hip and Knee Arthroplasty Payment Model Reforms Threaten Promising Innovation and Access to Care

Over the past several years, there have been notable changes and controversies involving Medicare reimbursement for total hip (THA) and total knee arthroplasty (TKA). We have seen the development and implementation of experimental bundled payment model pilot programs goals of improving quality and decreasing overall costs of care during the last decade. Many orthopaedic surgeons have embraced these programs and have demonstrated the ability to succeed in these new models by implementing strategies, such as preservice optimization, to shift care away from inpatient or postdischarge settings and reduce postoperative complications. However, these achievements have been met with continual reductions in surgeon reimbursement rates, lower bundle payment target pricings, modest increases in hospital reimbursement rates, and inappropriate valuations of THA and TKA Common Procedural Terminology (CPT) codes. These challenges have led to an organized advocacy movement and spurred research involving the methods by which improvements have been made throughout the entire episode of arthroplasty care. Collectively, these efforts have recently led to a novel application of CPT codes recognized by payers to potentially capture presurgical optimization work. In this paper, we present an overview of contemporary payment models, summarize notable events involved in the review of THA and TKA CPT codes, review recent changes to THA and TKA reimbursement, and discuss future challenges faced by arthroplasty surgeons that threaten access to high-quality THA and TKA care.

Policy Over Practice: A Review of Groundwater Governance Research in Sub-Saharan Africa

Groundwater is increasingly seen as crucial to both agricultural and domestic water supply in sub-Saharan Africa. Citing climate change and growing populations, there is especially a notable shift towards promoting groundwater for irrigation to ensure food security. Increased use of the resource will undoubtedly be accompanied with new questions of governance, with groundwater overexploitation in other parts of the world functioning as a strong cautionary tale. This article provides an overview of the current groundwater governance literature on sub-Saharan Africa. Using a critical water governance lens we analyse how groundwater governance is framed, what terms, categories, and measurements are used to describe and assess groundwater governance, and whose perspectives are considered. We also assess whether groundwater governance research has taken place across sub-Saharan African countries in a balanced way. We find that groundwater governance research in sub-Saharan Africa, even more so than elsewhere, ignores the voices and perspectives of those physically encountering the resource. Instead, it is dominated by the views of formal, technical groundwater experts focusing on the need for more hydrogeological data and formal policies. While the existing contributions to the literature are valuable, the current bias in perspectives calls for others to join the field of groundwater governance and to supplement current conceptualisations and approaches with those of users and others dealing with groundwater management on a daily basis. We argue that groundwater users’ practical governance experiences, locally adapted solutions and knowledges, can add important complementary perspectives and insights towards crafting effective, sustainable and equitable groundwater governance processes across the continent.

The wisdom of claiming ownership of human genomic data: A cautionary tale for research institutions.

This article considers the practical question of how research institutions should best structure their legal relationship with the human genomic data that they generate. The analysis, based on South African law, is framed by the legal position that although a research institution that generates human genomic data is not automatically the owner thereof, it is well positioned to claim ownership of newly generated data instances. Given that the research institution exerts effort to generate the data, it can be argued that it has a moral right to claim ownership of such data. Combined with the fact that it has an interest in having comprehensive rights in such data, it appears that the prudent policy for research institutions is to claim ownership of the human genomic data instances that they generate. This policy is tested against two opposing policy positions. The first opposing policy position is that research participants should own the data that relate to them. However, in light of data protection legislation that already provides extensive protections to research participants, bestowing data ownership on research participants would offer little benefit to such individuals, while leading to significant practical problems for research institutions. The second opposing policy position is that the concept of ownership should be abandoned in favour of data custodianship. This opposing position is problematic, as avoiding reference to ownership is a denial of legal reality and hence not a useful policy. Also, avoiding reference to ownership will leave research institutions with limited legal remedies in the event of appropriation of data by third parties. Accordingly, it is concluded that the wisest policy for research institutions is indeed to explicitly claim ownership of the human genomic data instances that they generate.

Sotrovimab: A Review of Its Efficacy against SARS-CoV-2 Variants.

Among the anti-Spike monoclonal antibodies (mAbs), the S-309 derivative sotrovimab was the most successful in having the longest temporal window of clinical use, showing a high degree of resiliency to SARS-CoV-2 evolution interrupted only by the appearance of the BA.2.86* variant of interest (VOI). This success undoubtedly reflects rational selection to target a highly conserved epitope in coronavirus Spike proteins. We review here the efficacy of sotrovimab against different SARS-CoV-2 variants in outpatients and inpatients, discussing both randomized controlled trials and real-world evidence. Although it could not be anticipated at the time of its development and introduction, sotrovimab's use in immunocompromised individuals who harbor large populations of variant viruses created the conditions for its eventual demise, as antibody selection and viral evolution led to its eventual withdrawal due to inefficacy against later variant lineages. Despite this, based on observational and real-world data, some authorities have continued to promote the use of sotrovimab, but the lack of binding to newer variants strongly argues for the futility of continued use. The story of sotrovimab highlights the power of modern biomedical science to generate novel therapeutics while also providing a cautionary tale for the need to devise strategies to minimize the emergence of resistance to antibody-based therapeutics.

Phase I Study of GS-3583, an FMS-like Tyrosine Kinase 3 Agonist Fc Fusion Protein, in Patients with Advanced Solid Tumors.

GS-3583, an FMS-like tyrosine kinase 3 (FLT3) agonist Fc fusion protein, expanded conventional dendritic cells (cDC) in the periphery of healthy volunteers, suggesting potential for GS-3583 to increase cDCs in the tumor microenvironment and promote T cell-mediated antitumor activity in cancer patients. This phase Ib open-label study assessed GS-3583 in adults with advanced solid tumors. Multiple escalating doses of GS-3583 (standard 3+3 design) were administered intravenously on days 1 and 15 of cycle 1 and day 1 of each subsequent 28-day cycle for up to 52 weeks. Dose-limiting toxicity (DLT) was evaluated during the first 28 days of GS-3583 at each dose level. Thirteen participants enrolled in four dose-escalation cohorts, after which the study was terminated following safety review. Median (range) age was 71 (44-79), and 7 (54%) participants were male. There were no DLTs. Seven participants had grade ≥3 AEs; 2 participants had grade 5 AEs, including a second primary malignancy (acute myeloid leukemia) considered treatment-related. Dose-dependent increase in GS-3583 serum exposure was observed in the dose range of 2-20 mg with GS-3583 accumulation at higher dose levels. Expansions of cDCs occurred at all four doses with a dose-dependent trend in the durability of the cDC expansion. GS-3583 was relatively well tolerated and induced dose-dependent expansion of cDCs in the periphery of patients with advanced solid tumors. However, development of a second primary malignancy provides a cautionary tale for the FLT3 agonist mechanism. See related commentary by Raeder and Drazer, p. 2857.

Lessons Learned from Approval of Aducanumab for Alzheimer's Disease.

When the US Food and Drug Administration used the accelerated approval process to authorize the use of the antiamyloid drug aducanumab to treat Alzheimer's disease (AD), many people hoped this signaled a new era of disease-modifying treatment. But 2 years later, aducanumab's failure to launch provides a cautionary tale about the complexities of dementia and the need for a thorough and transparent review of the role that regulatory agencies and various stakeholders play in approving AD drugs. We highlight the events leading to aducanumab's controversial approval and discuss some of the key lessons learned from the drug's failure to deliver the hoped-for benefits. These lessons include the inherent limitations of antiamyloid strategies for a complex disease in which amyloid is only one of several pathological processes, the need for clinical trials that better reflect the diversity of communities affected by AD, the potential pitfalls of futility analyses in clinical trials, the need for greater transparency and other modifications to the approval process, and the dementia field's unreadiness to move from the highly controlled environment of clinical trials to the widespread and chronic use of resource-intensive, disease-modifying drugs in real-world treatment scenarios. People with dementia desperately need effective therapies. We hope that the aducanumab story will inspire changes to the approval process-changes that restore public trust and improve future efforts to deliver disease-modifying therapies to the clinic.

Creating a Local Notable: Brigadier General Anthony Walton White of New Brunswick

To the extent he is remembered today, Brigadier General Anthony Walton White is hailed as one of New Brunswick, New Jersey’s, most illustrious residents and a reminder of the city’s significance during the American Revolution. This account of White’s career reveals that he was far from successful in the military or in business. Born to wealth on an estate along the Raritan River, White relied on family ties and political connections to gain appointments in the military and government throughout his life. He forswore allegiance to Great Britain in 1775 and sought a position on Gen. George Washington’s staff. Washington interviewed White but was unimpressed and declined to appoint him to his staff. White became a cavalry officer and served throughout the Revolutionary War, but his military record was hardly unblemished, and he faced several inquiries into his conduct and courts-martial proceedings. In the 1790s he served in the suppression of the Whiskey Rebellion and in 1798 was promoted to the rank of brigadier general during the quasi-war against France. George Washington reckoned him one of the least capable and most insufferable officers in the US Army. White fared no better in civilian life or business. After the revolution, he lost his sizeable inheritance in a series of bad investments. He also squandered the wealth inherited by his young bride, a girl he met during his service in South Carolina. White filed for bankruptcy in 1802 and died the following year. White was not a villain, but neither was he a hero. His life, like history generally, offers a complicated and cautionary tale.

A cautionary tale: an evaluation of the performance of treatment switching adjustment methods in a real world case study

BackgroundTreatment switching in randomised controlled trials (RCTs) is a problem for health technology assessment when substantial proportions of patients switch onto effective treatments that would not be available in standard clinical practice. Often statistical methods are used to adjust for switching: these can be applied in different ways, and performance has been assessed in simulation studies, but not in real-world case studies. We assessed the performance of adjustment methods described in National Institute for Health and Care Excellence Decision Support Unit Technical Support Document 16, applying them to an RCT comparing panitumumab to best supportive care (BSC) in colorectal cancer, in which 76% of patients randomised to BSC switched onto panitumumab. The RCT resulted in intention-to-treat hazard ratios (HR) for overall survival (OS) of 1.00 (95% confidence interval [CI] 0.82–1.22) for all patients, and 0.99 (95% CI 0.75–1.29) for patients with wild-type KRAS (Kirsten rat sarcoma virus).MethodsWe tested several applications of inverse probability of censoring weights (IPCW), rank preserving structural failure time models (RPSFTM) and simple and complex two-stage estimation (TSE) to estimate treatment effects that would have been observed if BSC patients had not switched onto panitumumab. To assess the performance of these analyses we ascertained the true effectiveness of panitumumab based on: (i) subsequent RCTs of panitumumab that disallowed treatment switching; (ii) studies of cetuximab that disallowed treatment switching, (iii) analyses demonstrating that only patients with wild-type KRAS benefit from panitumumab. These sources suggest the true OS HR for panitumumab is 0.76–0.77 (95% CI 0.60–0.98) for all patients, and 0.55–0.73 (95% CI 0.41–0.93) for patients with wild-type KRAS.ResultsSome applications of IPCW and TSE provided treatment effect estimates that closely matched the point-estimates and CIs of the expected truths. However, other applications produced estimates towards the boundaries of the expected truths, with some TSE applications producing estimates that lay outside the expected true confidence intervals. The RPSFTM performed relatively poorly, with all applications providing treatment effect estimates close to 1, often with extremely wide confidence intervals.ConclusionsAdjustment analyses may provide unreliable results. How each method is applied must be scrutinised to assess reliability.

Filipin complex-reactive brain lesions: a cautionary tale.

Filipin complex is an autooxidation-prone fluorescent histochemical stain used in the diagnosis of Niemann-Pick Disease Type C (NP-C), a neurodegenerative lysosomal storage disorder. It is also widely used by researchers examining the distribution and accumulation of unesterified cholesterol in cell and animal models of neurodegenerative diseases including NP-C and Sanfilippo syndrome (mucopolysaccharidosis IIIA; MPS IIIA). Recently, it has been suggested to be useful in studying Alzheimer's and Huntington's disease. Given filipin's susceptibility to photobleaching, we sought to establish a quantitative biochemical method for free cholesterol measurement. Brain tissue from mice with MPS IIIA was stained with filipin. Total and free cholesterol in brain homogenates was measured using a commercially available kit and a quantitative LC-MS/MS assay was developed. Gangliosides GM1, GM2 and GM3 were also quantified using LC-MS/MS. As anticipated, the MPS IIIA mouse brain displayed large numbers of filipin-positive intra-cytoplasmic inclusions, presumptively endo-lysosomes. Challenging the prevailing dogma, however, we found no difference in the amount of free cholesterol in MPS IIIA mouse brain homogenates cf. control tissue, using either the fluorometric kit or LC-MS/MS assay. Filipin has previously been reported to bind to GM1 ganglioside, however, this lipid does not accumulate in MPS IIIA cells/tissues. Using a fluorometric assay, we demonstrate for the first time that filipin cross-reacts with both GM2 and GM3 gangliosides, explaining the filipin-reactive inclusions observed in MPS IIIA brain cells. Filipin is not specific for free cholesterol, and positive staining in any setting should be interpreted with caution.

Mundo clásico y ciencia ficción o cómo construir una utopía feminista: The Gate to Women’s Country de Sheri Tepper

This paper offers an analysis of Sheri Tepper’s novel, The Gate to Women’s Country, through the lenses of Classical Reception and feminist reinterpretation, aligning with Hardwick’s theoretical framework and drawing upon the specific conceptual propositions of Ostriker, Keen and Durand. Tepper’s narrative comprises both utopian and dystopian elements. In her utopian projection, a Greek tragedy is reimagined as Iphigenia in Ilium, wherein she introduces a dialogue with the deceased to underscore the inherent violence of men and its consequences for women and children. In the dystopian projection, she indirectly utilises the myth of Persephone and Demeter, with a notable emphasis on the catabatis motif, implicitly employed to depict the harrowing and violent experiences faced by the central character, Stavia. This portrayal of Hades, transposed to Tepper’s envisioned society, serves as a cautionary tale highlighting the perils that women encounter when they lack control, influence or a voice.

Pawns of Empire: Unraveling the Role of Dashnaktsutyun in British Geopolitical Strategy (1890-1922)

This paper examines the instrumental role of Dashnaktsutyun, also known as the Armenian Revolutionary Federation, in the geopolitical strategies of the British Empire during the early 20th century. Initially emerging as a nationalist movement within the Ottoman Empire, Dashnaktsutyun was co-opted by external powers, particularly Britain, to serve broader imperial interests in the Eurasian region. The study delves into the organization’s activities in the Ottoman, Russian, and Iranian territories, highlighting how its operations, under the guise of Armenian nationalism, were significantly influenced by British geopolitical objectives. The paper also explores the complex interplay between nationalist movements and international power politics, particularly in the context of the Great Game between the British and Russian Empires. A critical analysis of Dashnaktsutyun’s role during key historical events, such as the Soviet invasion of Armenia in 1920, reveals a prioritization of foreign directives over national resistance, impacting the trajectory of Armenian history and reflecting the broader dynamics of early 20th-century imperialism. This study serves as a cautionary tale of how nationalist movements can be redirected by external influences, often at the expense of their foundational principles and the welfare of their people. Keywords: Dashnaktsutyun, Armenian Revolutionary Federation, British Geopolitical Strategy, Armenian Nationalism, Imperialism, Soviet Invasion of Armenia, Great Game, Pan-Islamism, Pan-Turanism

A cautionary tale of low-pass sequencing and imputation with respect to haplotype accuracy

BackgroundLow-pass whole-genome sequencing and imputation offer significant cost savings, enabling substantial increases in sample size and statistical power. This approach is particularly promising in livestock breeding, providing an affordable means of screening individuals for deleterious alleles or calculating genomic breeding values. Consequently, it may also be of value in companion animal genomics to support pedigree breeding. We sought to evaluate in dogs the impact of low coverage sequencing and reference-guided imputation on genotype concordance and association analyses.ResultsDNA isolated from saliva of 30 Labrador retrievers was sequenced at low (0.9X and 3.8X) and high (43.5X) coverage, and down-sampled from 43.5X to 9.6X and 17.4X. Genotype imputation was performed using a diverse reference panel (1021 dogs), and two subsets of the former panel (256 dogs each) where one had an excess of Labrador retrievers relative to other breeds. We observed little difference in imputed genotype concordance between reference panels. Association analyses for a locus acting as a disease proxy were performed using single-marker (GEMMA) and haplotype-based (XP-EHH) tests. GEMMA results were highly correlated (r ≥ 0.97) between 43.5X and ≥ 3.8X depths of coverage, while for 0.9X the correlation was lower (r ≤ 0.8). XP-EHH results were less well correlated, with r ranging from 0.58 (0.9X) to 0.88 (17.4X). Across a random sample of 10,000 genomic regions averaging 17 kb in size, we observed a median of three haplotypes per dog across the sequencing depths, with 5% of the regions returning more than eight haplotypes. Inspection of one such region revealed genotype and phasing inconsistencies across sequencing depths.ConclusionsWe demonstrate that saliva-derived canine DNA is suitable for whole-genome sequencing, highlighting the feasibility of client-based sampling. Low-pass sequencing and imputation require caution as incorrect allele assignments result when the subject possesses alleles that are absent in the reference panel. Larger panels have the capacity for greater allelic diversity, which should reduce the potential for imputation error. Although low-pass sequencing can accurately impute allele dosage, we highlight issues with phasing accuracy that impact haplotype-based analyses. Consequently, if accurately phased genotypes are required for analyses, we advocate sequencing at high depth (> 20X).

Thyrotoxicosis Misdiagnosed as Long Covid by Telemedicine - A Cautionary Tale.

Individuals who have had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop post-coronavirus disease conditions, also known as long COVID. The symptoms of long COVID are nonspecific, and there are similarities between the symptoms of long COVID and those of Graves' disease (GD). Therefore, it is important to rule out GD in patients suspected of having long COVID. Telemedicine is widely used to avoid the risk of SARS-CoV-2 infection. However, owing to the lack of in-person examinations, diagnostic errors can occur. A 27-year-old Japanese woman presented complaining of persistent fatigue, dyspnea, and low-grade fever, and after in-person examination was finally diagnosed with GD. She had been diagnosed with SARS-CoV-2 infection four months earlier and her symptoms had resolved within 5 days but then recurred. Subsequently, she had 3 telemedicine visits and had been diagnosed with long COVID. With telemedicine there may be delayed diagnosis of GD in patients with a recent history of SARS-CoV-2 infection. Some symptoms and abnormalities cannot be confirmed in telemedicine visits performed using a simple mobile phone. Therefore it is important to know which findings obtained in telemedicine visits with a simple mobile phone are suggestive of GD. Low-grade fever and tachycardia are often observed in patients with GD, but rarely occur in patients with long COVID. Tachycardia and persistent low-grade fever after SARS-CoV-2 infection, which can be confirmed by telemedicine, can be clues for the diagnosis of GD. Therefore, in-person examination should be added if these symptoms are confirmed by telemedicine. The symptoms of Graves 'disease (GD) and long COVID may overlap.With telemedicine there may be delayed diagnosis of GD, in patients with recent history of severe acute respiratory syndrome mediated by coronavirus 2 (SARS-CoV-2) infections.In telemedicine visits, tachycardia and persistent low-grade fever could be clues for the diagnosis of GD after SARS-CoV-2 infections on telemedicine.