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

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”。
1. Battle of the Sexes
星期三,枪手在伊拉克首都绑架了18名土耳其工人。
我国经济基本面好,商业银行资本充足率、拨备覆盖率比较高,可动用的工具和手段多。对守住不发生系统性金融风险的底线,我们有信心和底气、有能力和办法。
你经常烦躁吗?
Zhang Guoli to host 2014 Spring Festival Gala
明星们的私家飞机刚停稳,“老爹身材”一词便在互联网上走红。男性微胖的身材成为潮流,荧幕上不少这样的例子。法新社(AFP)Deborah Cole(黛博拉?科尔)写道:“杰拉尔?德帕迪约(Gerard Depardieu)在《爱之谷》中的形象便是“大汗淋漓、气喘吁吁地打着赤膊”, 华金?菲尼克斯 (Joaquin Phoenix)在 伍迪?艾伦(Woody Allen)的新片《非理性的人》(Irrational Man)中也露出了他那胖胖的肚子。科林?法瑞尔(Colin Farrell)出席《龙虾》(The Lobster)的首映红毯时,看起来如往常一般衣冠楚楚,然而在剧中他却大腹便便。为了给荒诞主义者欧格斯?兰斯莫斯(Yorgos Lanthimos)的黑色喜剧中的孤独主角增肥,法瑞尔大量进食高热量食品,其中包括融化了的冰淇淋。他告诉《好莱坞报道》(Hollywood Reporter),“在早晨10点享用2个芝士汉堡、薯条和可乐可不那么有趣,”他补充道,“不过我喜欢芝士汉堡。”
As institutions are brought under dictatorial control, the opposition is driven into rebellion or acquiescence.
福布斯表示,如果不扣除管理费和税费,在2015年6月1日到2016年6月1日期间,全球收入最高的10位女星共入账2.05亿美元。
纸筒插秧机可以让一名使用者在几分钟内在85英尺(约合26米)长的一块田地里种植264棵幼苗。这在以前通常耗时数小时,如今只需几分钟。使用者在种植农作物上花费的时间更少,可以节省出更多的时间做其他的事,比如农田改进、市场销售、或者干脆休息休息。
n. 生存,幸存者
The Fifa World Cup is close by. Let me give you a few rules that will preserve your beauty.
New Year should be a time of banked-up fines, the scent of flowers and wine, good talk, good memories and loyalties renewed. But if all else is lacking - love will do.
The Australian pop star Sia noticed Maddie on the programme and last year she tweeted her to ask if she would appear in one of her videos... the rest is history.
10月份,日本工业产出环比增长1.4%,是自1月份出现4.1%的增幅以来增长最快的一次。这一数字高于9月份1.1%的增幅,不过仍低于经济学家1.8%的增长预期。
第一种看法是,油价本质上具有周期性。下跌之后必然会回升。这道波谷越深,下一个山峰就越高。
That put outbound investment for October at $8.3bn, according to FT calculations based on official data, for a year-on-year fall of 26.5 per cent.
Kevin Durant
我认为这篇文章是上篇文章“成为一个足球寡妇”的完美续篇,在这篇文章里面我分享了八大规则,其中我觉得第六条最重要。
n. 示范,实证,表达,集会
葡萄牙的成就说明这种转变是可行的,它为各国政府和能源公司提供了一个实实在在的范例,也告诉他们为什么现在应该投资太阳能、风能、波浪能和其他可再生技术。
v. 戴面具,掩饰,遮
Super Bowl
中国力争达成自己的亚太区协议
由西班牙IQS商学院、台湾辅仁大学(Fu Jen Catholic University)和旧金山大学(University of San Francisco)三家合办的管理学硕士项目排名升幅最大。其全球创业管理硕士项目的排名上升34位,至第43位,逆转了去年下滑19名的势头。这是唯一一个在三大洲授课的项目,其在国际课程体验方面排名第一。


在这个力求避免任何歧视的态度的年代,年轻一代开始不满邦德的大男子主义态度和不健康的生活方式,因此赫洛维兹引入了一系列会指出邦德错误的新人物。
支持:奥德曼塑造的战时领袖丘吉尔收获一致好评,而这对他似乎是手到擒来的。
New York City, now ranked seventh, has gone up 15 places since last year. It has seen a big jump in costs over recent years, moving up 42 spots since 2011.


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

Perhaps my favorite profile this year was Kiki Zhao’s stirring depiction of the remarkable Yu Xiuhua, now one of China’s most read poets, a woman with cerebral palsy who lived most of her 41 years on a farm, writing at a low table. She never finished high school, and says she “could write before she could read.” Now, she is invited to places like Stanford University and fends off comparisons to Emily Dickinson.
"Producer prices remain in deflation because of falling commodity prices," said Moody's Analytics before the report.
But the runaway winner was Ford CEO Mark Fields, who began the year with the depressing news that his company was “transitioning from an auto company to an auto company and a mobility company”. He then went on to declare: “Heritage is history with a future.” He was so chuffed with this, he said it more than once. On hearing it repeated, I’ve concluded it is less gnomic than downright moronic. Mr Fields is thus my new Chief Obfuscation Champion.
“Total new business increased at a modest pace that was little-changed from October. However, November data indicated that foreign demand continued to soften, with the latest expansion of new export business the slowest since June. ”

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. 

Don't ever tell me that you have to have this job because you're going to lose your house, your kids have nothing to eat, your mother has cancer. Companies aren't a charity.

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. 

今年领跑美国股市的标普500公司的行业组合有些奇特,出现了一些令人意想不到的黑马。就算基金经理预见到了医疗保健行业今年将上涨27%,难道他们也能猜到公用事业行业将位列第二,上涨23%?不大可能。
[di't?:min]

Emma Morano
能够再次主持奥斯卡我感到非常激动和荣幸。你知道有句老话:第三次总是幸运的。
The programme entered the ranking in second place in 2006 and was ranked top in 2008.
改变思想
expansion
李说,记者职业排名靠后已经有一段时间了(去年在200个职业中排名第196位)。他说,这次被挤到最后一位很可能是因为有些情况更糟了,如职业前景变差、平均薪资继续下滑、工作时间持续增加等,而且这些因素也让记者的压力更大。

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.


2月70城房价:15个热点城市近七成环比下降


References

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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.


《大汉情缘之云中歌》改编自桐华网络小说《云中歌》。它以西汉时期(公元前206年-公元220年)为背景,讲诉了名为云歌的女子、贵族公子孟珏和汉昭帝刘弗陵之间的传奇爱情。该剧和《琅琊榜》同月播出,风头却几乎被《琅琊榜》完全盖过。它也因历史漏洞广受诟病。对某些观众而言,杨颖的颜值恐怕是该剧吸引他们的唯一亮点。
在纽约,任何人不得将多户建筑中的一套没有租户的公寓单间以短于30天的租期出租,这是非法的。然而,几乎每周都有人写信给“房地产答疑”专栏,咨询如何绕开这些规定。如果我交换公寓呢?如果没有书面形式的约定呢?
10.Shakira
如果你热爱生存,那么脑死亡是一件不美好的事。而且,如果你想用空闲的大脑来替换,那你是绝对找不到的。当然,也许有一天,我们能将大脑放入头骨中,但是大脑跟别的器官不同。它装有你所有的思想和记忆。人们能在你头里放一个新的大脑,但是你还是不存在,所以人造大脑这种想法看起来很荒谬。
He and his girlfriend wrote to each other when he was studying science, he said.They did eventually marry and have four children.
《拉里·威尔莫夜间秀》(The Nightly Show with Larry Wilmore),Comedy Central,1月19日播出。威尔莫的主题喜剧秀将取代《科尔伯特报告》(The Colbert Report)在夜间11:30播出,这是深夜节目多样化的最新尝试。完全没有压力!
You might think Hawaiian has it relatively easy, since its flights rarely have to contend with the kind of challenging weather conditions found on the mainland. Hawaiian perennially rates high in on-time performance rankings, topping the most recent DOT list i n September. It recently announced it will branch well beyond its island home with non-stop service to Beijing.
该报道称,并没有老师和学生喝了有毒的水。
单词intended 联想记忆:
唉。

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.



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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 “我是一个医生。说实话,一个人的健康首先与吃、喝与空气有关,如果这三样不好,再提什么样的发展都没有用!” to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

The implosion of a giant subprime mortgage lender in 2007?The collapse of Lehman Brothers in 2008?
用这个背带背孩子更加方便舒适。
大银行已经或多或少地放弃了用高薪留住人才的尝试。自金融危机以来,有一件事很清楚:如果你想暴富,就得去硅谷。露丝波拉特(Ruth Porat)在2015年树立了一个标杆,她放弃了摩根士丹利(Morgan Stanley)首席财务官约1300万美元的年薪,跳槽谷歌(如今的Alphabet)获得五倍于此的薪酬。
This year they looked at the use of negative strategies such as anger or stonewalling responses to conflict, and found that these predicted health-related changes over time in specific ways.

就国内而言,日益活跃的中产阶层正形成压力,要求得到问责制度更健全的治理。愈演愈烈的不平等滋生了一种不公正感;两亿农民工仍然受到二等公民的待遇,腐败也有增无减。对付这些问题的任务十分紧迫,但中国的经济成就助长了一种无端的自信。于是,在阿拉伯之春的刺激下,中国的体制采取激进举措,压制可能引发政治敏感运动的任何社会不满。

  • Only the first three authors are listed, followed by "et al."
  • 展望:2016卫浴行业流行趋势
  • 《杭州长租公寓白皮书》发布 租赁用地供应充足,长租公寓进入扩张期


Teach First补充称,与企业的合作非常重要,这不仅是因为资金问题,还因为这能帮助学校让学生掌握现代雇主所需要的更多技巧。
Insead is top of the 2017 Financial Times global ranking of the best 100 MBA programmes. It is the second year that the multi-campus international business school has taken the number one spot, after claiming it for the first time last year.

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