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Background: Respiratory rate (RR) is used for the diagnosis and management of medical conditions and can predict clinical changes. Heavy workload, understaffing, and errors related to poor recording make it underutilized. Wearable devices may facilitate its use. Methods: RR measurements using a wearable photoplethysmography-based monitor were compared with medical grade devices in complementary clinical scenarios: Study one included a comparison to a capnograph in 35 healthy volunteers; Study two included a comparison to a ventilator monitor in 18 ventilated patients; and Study three included a comparison to capnograph in 92 COVID-19 patients with active pulmonary disease. Pearson's correlations and Bland-Altman analysis were used to assess the accuracy and agreement between the measurement techniques, including stratification for Body Mass Index (BMI) and skin tone. Statistical significance was set at p ≤ 0.05. Results: High correlation was found in all studies (r = 0.991, 0.884, and 0.888, respectively, p < 0.001 for all). 95% LOA of ±2.3, 1.7-(-1.6), and ±3.9 with a bias of < 0.1 breaths per minute was found in Bland-Altman analysis in studies 1,2, and 3, respectively. In all, high accordance was found in all sub-groups. Conclusions: RR measurements using the wearable monitor were highly-correlated with medical-grade devices in various clinical settings. [ABSTRACT FROM AUTHOR]

There are no clear guidelines for diuretic administration in heart failure (HF), and reliable markers are needed to tailor treatment. Continuous monitoring of multiple advanced physiological parameters during diuresis may allow better differentiation of patients into subgroups according to their responses. In this study, 29 HF patients were monitored during outpatient intravenous diuresis, using a noninvasive wearable multi-parameter monitor. Analysis of changes in these parameters during the course of diuresis aimed to recognize subgroups with different response patterns. Parameters did not change significantly, however, subgroup analysis of the last quartile of treatment showed significant differences in cardiac output, cardiac index, stroke volume, pulse rate, and systemic vascular resistance according to gender, and in systolic blood pressure according to habitus. Changes in the last quartile could be differentiated using k-means, a technique of unsupervised machine learning. Moreover, patients' responses could be best clustered into four groups. Analysis of baseline parameters showed that two of the clusters differed by baseline parameters, body mass index, and diabetes status. To conclude, we show that physiological changes during diuresis in HF patients can be categorized into subgroups sharing similar response trends, making noninvasive monitoring a potential key to personalized treatment in HF. [ABSTRACT FROM AUTHOR]

Introduction: Elective clerkships in low income countries have been an integral part of the curriculum in the majority of medical schools worldwide. These programs expose students to global challenges, to a diversity of cultures and healthcare systems, and have been shown to improve medical knowledge, as well as clinical and communication skills. In 2018 and 2019, the Faculty of Medicine at the Technion, in cooperation with the Department for Infectious Diseases in the Rambam Health Care campus and the "Brit Olam" nonprofit organization, offered a clinical clerkship in Kiboga hospital, Uganda. The elective took place in a public governmental hospital located in one of the poorest districts of Uganda. During a three-week period, the students accompanied by Israeli and Uganda tutors, participated in clinical rounds and other clinical activities in various departments of the hospital. This manuscript, describes the students' experiences in Kiboga. During the short elective, students had a unique opportunity to observe a different culture, immerse in a completely different healthcare system, learn about how a detailed medical history and a thorough physical examination can lead to diagnosis (without extensive diagnostic tests), and closely observe ethical challenges and difficult clinical decisions. The elective helped students develop personally and professionally and solidify their commitment to medicine. Currently, in Israeli medical schools, there are a few programs which expose students to medicine in low-resource countries. We believe that expanding the understanding of Global Health through courses and overseas opportunities in long-term partnerships, can improve the students' medical education.