Part 2: Health apps, wearables, and sensors: The advancing frontier of digital health

单词bent 联想记忆:
谁也不愿意自己的家门口整天闹个不停。
According to Oliver Cooke, a financial-services recruiter at Selby Jennings in New York, banks have been stressing what they call “internal mobility”, or redeploying staff from one department to another. If a bank facing sluggish conditions in debt trading, for example, can convert a trader to a risk analyst or a compliance officer, it can keep people interested — and it can save a bundle on severance.
1.Nepal
狄更斯在《双城记》中描写法国大革命时,距离事件发生已有近一个世纪。而我则是在今年12月就回顾盘点这一年。因此,我在此描述的某些趋势,可能将在可预见的未来继续存在,而另一些趋势则可能已经开始减弱。作为当今时代“最哗众取宠的权威人士”之一,我只要求各位在阅读这篇评论文章时记住一点:过去的业绩并不能保证将来的表现。
今年,竞争最激烈的职位--中国民主同盟中央委员会接待处--有大约10000人参与竞争。
在《渴望生活》这张专辑的第一首歌《爱》中,拉娜·德雷唱着“过去的一切造就了今天的你,但未来由你决定”。
经济衰退可能已有所好转,但是距离就业市场的复苏还有很长一段路要走。并且专家也声称情况在好转之前可能先会恶化。
DIHK's foreign business chief Volker Treier said the volume of goods exported to China from Germany grew rapidly in the latter part of 2016, Chinanews.com reported.
从碧昂丝和珍妮弗·洛佩兹的红毯着装来看,“短”是这次娱乐盛典的主题。这两位女歌手都选择及大腿的裙子来露出她们的美腿,策略性地减去领口,并注重肩膀的细节设计,但碧昂丝选择穿消防车红色从中脱颖而出,而珍妮弗·洛佩兹选择了柔和的有缎子般光泽的褐土色。
Comparatively, the increase rate is higher than income rise of urban residents for the same time period, which is 17.4%.
The 1.48 million people who qualified to take the exam marked an increase of 90,000 over last year, while the number of positions offered - 27,000 - remained almost the same.
Not because I am happy to see the end of what was one of television’s smartest series, a pioneer of what is now generally accepted as the current golden age of small-screen serials.
我们将尚未生长成型的水果放进模子里。
1.你一夜之间成了领英平台的香饽饽。
约翰奥瑟兹(John Authers)
PwC公司的管理人员立刻意识到有问题,但一切都太迟了,他们没法纠正错误了,唐纳薇已经念出《爱乐之城》的名字,而那张卡片本来是为最佳女演员准备的。那天晚上稍早些时候,就已经宣布过爱玛?斯通因为在《爱乐之城》中的表演而获得了最佳女演员奖。
impresario
"The scenes in the TV adaptation are beautiful, and also consistent with the original work," a Douban user Banchengyansha said.
乔布斯在苹果博览会上手持iPhone ,2007年,1月9日,旧金山
Read about successful businesses. Take in the wealth of knowledge that’s been provided by successful entrepreneurs such as Steve Jobs and the personalities from Shark Tank. A successful business plan does not have to be a book. A 10-page plan is digestible yet long enough to include everything you need to start.
说到这一点,你要注意的是,不要影响其他的人。没有人想每隔十分钟就听到你提问一次。如果你实在是不懂的话,可以在课后约上老师再讨论。
issue
桑尼伯恩说他不仅对特朗普的错误决定和无知时期感到失望,同时也因为总统对8月在弗吉尼亚州夏洛茨维尔举行的白人种族主义集会上反抗者被杀害后做出的回应感到失望——这也更加坚定了桑尼伯恩竞选州长的决心。
美国的排放量在经过了最近几年的持续下降后,提高了2.9%。


这种迅速放缓的势头如果延续下去,可能会阻碍更广泛的增长。观察人士认为,制造业企业活动的持续扩张源于国内需求的增长。
别人可能会告诉你“在面试中展示真正的自我。” 但是,真的别随便展示。这是最烂的一条建议。我们不需要一些神经古怪的人,我们关心的只有你的的技术和经验。
自从18个月前在亚洲设立业务以来,克拉布一直没有涉足香港房地产市场,因为他表示,价格太高了,可担负性太差。


With the increasing proliferation and sophistication of mobile phones, wearable devices such as smart watches, and sensors that can measure and gather a variety of data, public interest is growing in using consumer electronics to take ownership of personal health and wellness. A 2015 survey found that 66% of Americans age 66 and older want to use mobile technologies to improve their health by receiving medication reminders and tracking diet and nutrition, physical activity, and symptoms.[1

这是5年来非合办EMBA项目首次跻身前5名,全球EMBA项目前5名的名次非常稳定。
One of the more unique games announced at Gamescom was Silent Hills, the latest sequel in Konami’s bestselling horror franchise (which has also spawned two films). The world of gaming and movies combine in this new game, which is being developed by Metal Gear Solid V: The Phantom Pain creator Hideo Kojima and Pacific Rim director Guillermo del Toro. The game will star The Walking Dead’s Norman Reedus.
感谢和凯尔特人的选秀权交换,他们没有理由摆烂。他们或许会从参选球员中选到一个最佳安慰奖以推动球队前行。
据英国《卫报》报道,在去年的伦敦时装周期间,有250名反皮草抗议者,2月份的玛丽卡特兰佐秀场也受到了抗议者激烈的抵制。

Health apps and wearables
Health apps and wearables can unobtrusively gauge physiological and emotional states and collect, quantify, and monitor data regarding a user’s day-to-day behaviors. This “quantified self” can increase users’ self-awareness regarding their behavior and encourage positive changes to their overall health and well-being.[2] These commercially available devices also integrate an array of features to provide motivation through reward systems, opportunities for social in-teraction, tools for self-improvement, and prompts. The novelty, affordability, practicality, and ease of use have resulted in increased consumer enthusiasm and the pervasiveness of these devices.[3,4] With this growing interest in personal health, members of the general public are becoming more involved in monitoring and improving their own health habits.[5-10

Undoubtedly, merely tracking data through a device is not enough to maintain good health-related behaviors long-term, and the software must also incorporate motivational constructs important for the adoption and habituation of behaviors. For instance, a systematic review of studies that considered the use of electronic activity monitor systems found short-term changes in physical activity with self-monitoring, but no demonstration of superiority when the systems were compared with other interventions.[11] Another review of studies on the viability of using mobile technology for measuring and influencing physical activity found that most apps allow users to document their activity, set goals, review real-time feedback, connect to a social support network, and access online expertise.[12] However, less common among these apps were prompts to act and opportunities for problem solving and action planning, which are crucial constructs that translate intention into long-term behavior change.[13]

Sensor technologies
Sensor technologies have begun to enter the telehealth landscape and are primarily focused on continuous monitoring and precise diagnostics to inform management of various health conditions and diseases.[14-17] Sensors can be integrated into a watch or arm band or adhesive bandages and clothing, and then programmed to collect data on cardiac rhythm, heart rate, blood pressure, respiration, oxygen saturation, galvanic skin response, glucose levels, body temperature, body motions, ambient temperature, and global positioning. For health care providers, sensor inputs can permit remote monitoring, real-time teleconferencing, and timely care for patients with chronic diseases. For both patients and clinicians, telehealth supported by sensors can have profound implications. Clinicians can provide timely and patient-centred care to those living at a distance with chronic disease and can coordinate care when multiple providers are involved, reducing costs to the health care system.

A current clinical example is the management of paroxysmal atrial fibrillation with a mobile ECG and app that monitors the patient’s electrical rhythm to detect frequency and patterns of arrhythmias, and may even allow patients to share ultrasound and electrocardiogram data with their health care provider.[18-20] Telemonitoring with sensors can also support self-management of chronic diseases and detect early signs of deterioration in health requiring immediate treatment and advice.[21] Studies to date have demonstrated some clinical promise for the use of home telemonitoring in the context of heart failure and diabetes. A recent Cochrane review found that telemonitoring was an effective way to lower levels of glycated hemoglobin and low-density lipoprotein.[22] Although several studies on heart failure have produced conflicting results regarding the overall benefits of home monitoring,[23-26] systematic reviews have suggested that home telemonitoring reduces all-cause mortality and hospitalizations, and improves quality of life compared with usual care.[22,27] In addition, features such as automated and mobile telemonitoring appear to be more effective compared with other forms of home telemonitoring.[27]

Further studies are needed to determine how home health monitoring can improve patient safety during the transition from acute care to community care, and to examine the impact of home monitoring on health care costs. TEC4Home (Telehealth for Emergency-Community Continuity of Care Connectivity via Home Tele-monitoring), an initiative of the University of British Columbia and Vancouver Coastal Health, is seeking to do this with prospective trials designed to uncover how telemonitoring can support the safety of heart failure patients discharged from hospital to home.[28]

Mobile apps, wearables, and sensors in the clinical setting
Even though mobile apps, wearables, and sensor technologies are promising, further research is needed to validate their use and long-term impact.[29] This research will require the collaboration of clinicians, health researchers, engineers, and computer scientists.[30] Understanding the possible risks of using these technologies, from physiological harm to breaching of privacy and confidentiality with insecure devices, and how to mitigate any risks is also important. Other important issues to consider include patient anxiety with overuse of technologies, health data piracy, self-diagnosis resulting from overreliance on self-monitoring, and patients not seeking help appropriately. These technologies should be used only as complementary tools in the treatment and prevention of health conditions and disease and should not be used in isolation by patients who self-diagnose and self-manage without consulting a health professional. 

智能开瓶器

Instant Heart Rate by Azumio.[31] A free app downloadable to both Apple and Android operating systems that measures heart rate and displays a monitoring strip. As well as helping users accurately track their heart rates, the app is capable of detecting irregular rhythms when palpitations occur. 

Sleep Time by Azumio.[32] A free app that monitors sleep patterns, sleep efficiency, and also acts as an alarm clock. Users can know how often they go into light and deep sleep, and recognize how much of these types of sleep will be necessary for them to feel rested, thereby quantifying the amount of true sleep they need and not just how long they should stay in bed. 

Bellybio Interactive Breating by RelaxLine.[33] A free app that helps users pace their breathing to achieve calmness. Placing the mobile phone against the abdomen, users can follow the sounds emitted to practise deep, abdominal breathing using this simple yet surprisingly effective tool. 

"While most Chinese brands remain unknown to the outside world, within China they are establishing themselves with ever more sophisticated campaigns," said Rupert Hoogewerf, Hurun Report chairman and chief researcher.
库克必须在开放与围绕其产品开发的神秘感间寻找平衡。在苹果内部已经有关于另一个秘密项目的传闻,它规模与iPhone或Apple Watch相当,正在整个库比提诺招兵买马。

The consequences are more parochial than those of Chinese data distortion. British law requires the ONS to produce the RPI and, given that it refuses to improve the measure, its fiddling affects hundreds of billions of pounds of contracts which continue to be linked to the RPI.
5) I’ve Got Your Back: We’ve all made big mistakes. In those times, step in with a reassurance: “I’m not judging you. You’re going to get through this. You’re not alone. We’ll figure this out together. It’s going to be OK.”
欧洲工商管理学院(Insead)领衔2017年英国《金融时报》全球MBA百强榜。这是这所拥有多个校区的国际商学院连续第二年高居榜首,去年该学院首次摘得桂冠。
n. 制作人,经理人,主办者
[spu:n]
Regulators in other countries will draw lessons from the success or failure of the Japanese model.

Discernment to determine whether a particular app, wearable, or sensor can be effective.
Expertise and experience to guide patients on the use of technology.
Partnership with patients in pursuit of optimal health through technology use.
Trials to closely monitor benefits and drawbacks.
Humility to recognize that patients may know and invest much more time than physicians in looking for these tools.34

Conclusions
Based on today’s rapid pace of development and public enthusiasm for the technology marketplace, health apps, wearables, and sensors will soon become integral to our patients’ pursuits of good health and will need to be integrated in clinical practice. Physicians must be active agents in these evolutionary times, guiding patients, advocating for evidence to support the use of technologies, and participating in the development and incorporation of technology in patient wellness journeys. Through clinical stewardship and partnership with patients, physicians can use their expertise and experience to guide the growth of innovations into mainstream health care.

Competing interests
Dr Ho receives no personal financial compensation as the principal investigator of TEC4Home (Telehealth for Emergency-Community Continuity of Care Connectivity via Home Tele-monitoring), a project funded by a Canadian Institutes of Health Research grant. This grant is matched by the Michael Smith Foundation for Health Research and the BC Ministry of Health, with additional support provided by TELUS Health and Sentrian. TELUS Health, Cisco, and Avizia have also provided equipment for display in Dr Ho’s Demonstration and Simulation Studio for Health (DaSSH) at UBC. Mr Yao and Dr Lauscher have no competing interests to declare.


北京发改委:北京建材及家具企业外迁消息不实


References

1. Cision PR Newswire. Fifth annual Pulse of Online Health survey finds 66% of Americans eager to leverage digital tools to manage personal health. Posted 24 February 2015. Accessed 28 August 2017. www.prnewswire.com/news-releases/fifth-annual-pulse-of-online-health-survey-finds-66-of-americans-eager-to-leverage-digital-tools-to-manage-personal-health-300039986.html.

2. Swan M. Emerging patient-driven health care models: An examination of health social networks, consumer personalized medicine and quantified self-tracking. Int J Environ Res Public Health 2009;6:492-525.

3. Gao Y, Li H, Luo Y. An empirical study of wearable technology acceptance in healthcare. Ind Manag Data Syst 2010;115:1704-1723.

4. Kim KJ, Shin DH. An acceptance model for smart watches: Implications for the adoption of future wearable technology. Internet Res 2015;25:527-541.

5. West JH, Hall PC, Hanson CL, et al. There’s an app for that: Content analysis of paid health and fitness apps. J Med Internet Res 2012;14:e72.

6. Abroms LC, Padmanabhan N, Thaweethai L, Phillips T. iPhone apps for smoking cessation: A content analysis. Am J Prev Med 2011;40:279-285.

7. Cowan LT, Van Wagenen SA, Brown BA, et al. Apps of steel: Are exercise apps providing consumers with realistic expectations? A content analysis of exercise apps for presence of behavior change theory. Health Educ Behav 2013;40:133-139.

8. Azar KM, Lesser LI, Laing BY, et al. Mobile applications for weight management. Am J Prev Med 2013;45:583-589.

9. Breland JY, Yeh VM, Yu J. Adherence to evidence-based guidelines among diabetes self-management apps. Transl Behav Med 2013;3:277-286.

10. Lyons EJ, Lewis ZH, Mayrsohn BG, Rowland JL. Behavior change techniques implemented in electronic lifestyle activity monitors: A systematic content analysis. J Med Internet Res 2014;16:e192.

11. Lewis ZH, Lyons EJ, Jarvis JM, Baillargeon J. Using an electronic activity monitor system as an intervention modality: A systematic review. BMC Public Health 2015;15:585.

12. Bort-Roig J, Gilson ND, Puig-Ribera A, et al. Measuring and influencing physical activity with smartphone technology: A systematic review. Sports Med 2014;44:671-686.

13. Rhodes RE, Yao CA. Models accounting for intention-behavior discordance in the physical activity domain: A user’s guide, content overview, and review of current evidence. Int J Behav Nutr Phys Act 2015;12:1-14.

14. Chen M, Gonzalez S, Vasilakos A, et al. Body area networks: A survey. Mob Networks Appl 2011;16:171-193.

15. Appelboom G, Camacho E, Abraham ME, et al. Smart wearable body sensors for patient self-assessment and monitoring. Arch Public Health 2014;72:28.

16. Chan M, Estève D, Fourniols JY, et al. Smart wearable systems: Current status and future challenges. Artif Intell Med 2012;56:137-156.

17. Alemdar H, Ersoy C. Wireless sensor networks for healthcare: A survey. Comput Networks 2010;54:2688-2710.

18. Haberman ZC, Jahn RT, Bose R, et al. Wireless smartphone ECG enables large-scale screening in diverse populations. J Cardiovasc Electrophysiol 2015;26:520-526.

19. Ferdman DJ, Liberman L, Silver ES. A smartphone application to diagnose the mechanism of pediatric supraventricular tachycardia. Pediatr Cardiol 2015;36:1452-1457.

20. Baquero GA, Banchs JE, Ahmed S, et al. Surface 12 lead electrocardiogram recordings using smart phone technology. J Electrocardiol 2015;48:1-7.

21. Wootton R. Twenty years of telemedicine in chronic disease management—An evidence synthesis. J Telemed Telecare 2012;18:211-220.

22. Flodgren G, Rachas A, Farmer A, et al. Interactive telemedicine: Effects on professional practice and health care outcomes. Cochrane Database System Rev 2015;(9):CD002098.

23. Mortara A, Pinna GD, Johnson P, et al. Home telemonitoring in heart failure patients: The HHH study (Home or Hospital in Heart Failure). Eur J Heart Fail 2009;11:312-318.

24. Dar O, Riley J, Chapman C, et al. A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: Results of the Home-HF study. Eur J Heart Fail 2009;11:319-325.

25. Chaudhry SI, Mattera JA, Curtis JP, et al. Telemonitoring in patients with heart failure. N Engl J Med 2010;363:2301-2309.

26. Koehler F, Winkler S, Schieber M, et al. Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: The Telemedical Interventional Monitoring in Heart Failure study. Circulation 2011;123:1873-1880.

27. Kitsiou S, Pare G, Jaana M. Effects of home telemonitoring interventions on patients with chronic heart failure: An overview of systematic reviews. J Med Internet Res 2015;17:e63.

28. TEC4Home Healthcare Innovation Community. Supporting heart failure patient transitions from acute to community care with home telemonitoring technology: A protocol for a provincial randomized controlled trial (TEC4Home). JMIR Res Protoc 2016;5:e198. 

29. Yao C, Ho K. Mobile sensors and wearable technologies. In: Amelung VE, Stein V, Goodwin N, et al., editors. Handbook integrated care. Cham, Switzerland: Springer; 2017.

30. Ho K, Borycki E, Kushniruk A, et al. The health perspective in using digital media for health and wellness. Presented at the IEEE International Digital Media Industry Forum, Boston, MA, 4-6 July 2016.

31. Azumio Inc. Instant heart rate. Accessed 28 August 2017. www.azumio.com/s/instantheartrate/index.html. 

32. Azumio Inc. Sleep time. Accessed 28 August 2017. www.azumio.com/s/sleeptime/index.html. 

33. RelaxLine. BellyBio. Accessed 28 August 2017. https://itunes.apple.com/ca/app/bellybio-interactive-breathing/id353763955?mt=8.

34. Ho K. How health information technologies are enhancing health of patients and their doctors. Presentation at the Alberta Medical Association 2015 Spring Representatives Forum, Edmonton, AB, 13 March 2015.


BETTER CALL SAUL (AMC, Feb. 8) Vince Gilligan and Peter Gould’s “Breaking Bad” spinoff is probably the most anticipated new series of the winter. Starring Bob Odenkirk as the crooked lawyer Saul Goodman, the show is set before the action of “Breaking Bad,” so any appearances by Bryan Cranston or Aaron Paul would be cameos at best. But the audience favorite Jonathan Banks reprises his role as the phlegmatic enforcer Mike Ehrmantraut.
《前第一夫人要求伊斯兰教变得宽容并支持女权》(A Former First Lady Presses On for a Tolerant, Feminist Islam)
The show was a potent reminder that the sexual revolution and women entering the work force and the rise of consumerism and the Age of Aquarius (all that) had a dark side, and claimed their own victims. That’s part of why it was such a powerful show.
Other European cities have seen increases in costs, pushing them up the rankings. London rose five points, bringing it into the top 10.
排名:第四
2. Wells Fargo
Shipments to China cratered by 14.4 per cent year-on-year to Rmb737.5bn in January. That’s from a 4 per cent drop in December, and versus expectations for a 1.8 per cent rise.
AIG CEO Robert Benmosche will be voted CEO of the Year.
On our increasingly human-dominated planet we can still learn much from the lives of other species. The discovery this year that the Greenland shark lives for 400 years, making it the longest-living vertebrate, puts our hectic lives into perspective.
SplashData公司称,在娱乐网站上使用和邮箱及社交网站相同的密码尤其不安全。

Kendall Ho, MD, FRCPC, Christopher Yao, MSc, Helen Novak Lauscher, PhD. Part 2: Health apps, wearables, and sensors: The advancing frontier of digital health. BCMJ, Vol. 59, No. 10, December, 2017, Page(s) 503-506 - Clinical Articles.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the 联合国下属的国际农业发展基金会(IFAD)上周三表示,2016年,约有2亿名打工人员--其中一半是女性--向他们在亚洲、拉美和非洲的家人汇款4450亿美元。 to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

基准原油价格上周跌破每桶40美元大关,至六年最低位,导致投资者对大宗商品相关企业和出口国家(包括巴西、俄罗斯和南非)情绪更加黯淡。
Many analysts may be surprised at the suggestion that they have underplayed the Fed. The two factors most often cited in relation to EM assets these days are the Fed and China, and the risk that they will deliver a negative shock.
10) I often make a fuss about unimportant things 0 1 2 3 4
n. 运动,活动,战役,竞选运动

While the real Rain Man never counted cards, his mental abilities were just as unbelievable. Kim Peek was a uniquely talented savant who possessed a nearly perfect memory. Among his many skills, Peek memorized every road on the map, the composers and dates of countless songs, and incredibly detailed historic facts. After Rain Man, he spent his life touring the country and campaigning for the disabled, to the delight of many who were able to witness his unique gift in person.

  • Only the first three authors are listed, followed by "et al."
  • 世界最大直径高钢级弯管试制成功
  • 4月1日“开好票” 5月1日“报好税”——我国深化增值税改革进入冲刺


awkward
The Harry Potter star Emma Watson hold fifth position in the list of ten most beautiful women of 2015. The English actress, model, and activist, Watson took the top spot on the AskMen “Top 99 Outstanding Women 2015″ list and at number 26 on the TIME 100 list of the world's most influential people.

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