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

本周四公布的一项最新调查显示,近四成美国居民表示,最近发生的桑迪飓风等自然灾害的严重性正是世界末日即将到来的证据,就像《圣经》中预言的那样。而超过六成的受访者认为这是气候变化所致。
一些银行仍然给予股东高额回报。中国招商银行十分“大方”,其分红占净利润的30.16%。
7. Love is like two people holding two ends of a rubber band: it’s always the one who doesn’t let go who gets hurt more.
但是,这些进展也指向美国和欧盟在利用此类案件上的巨大差异,欧盟目前正在讨论是否要赋予中国世界贸易组织(WTO)框架下的“市场经济”地位——这一让步会使对中国提起反倾销案变难。
Falling global demand for personal computers (PC) saw shipments fall by a record 10.6% in the fourth quarter from a year ago, according to market research firm IDC.
2.The Tianjin Explosions
Ben McLannahan is US banking editor
全世界的目光都在聚焦巴西,因为这个国度将举办最令人期待的两大体育盛事——2014年世界杯足球赛和2016年夏季奥运会。在巴西,你不仅可以观看精彩赛事,为你最喜欢的队伍及运动员欢呼,还可以前往“地球之肺”——亚马逊雨林旅行,体验“与世隔绝,拥抱自然”。不管你如何安排行程,巴西之行必定是一次难忘之旅。
“有个人请妻子跟自己老板打电话说他不会再来上班了。”
《大唐荣耀》
伦敦商学院今年在英国《金融时报》每年发布的4项排名中的表现,令其在欧洲最优秀的81所商学院中拔得头筹,这4项排名是:MBA、高管MBA(EMBA)、管理硕士(MiM)以及高管教育。(有两所商学院因得分相同并列第80位。)
4. Fiat. Brand love: -7% / Rank: 85
尽管2016年受调查机场的平均准点率同比提高7%至70.4%,但航班平均延误时长为33分钟。
Song “Happiness” (Mao A’Min)
v. 决定,决心,确定,测定
库苏马诺教授认为,这一切都表明,苹果正在加大开放度,包括允许开发者对其iOS软件进行更多定制。
At age 20, the teen prodigy of "Royals" raised the bar, marrying the massive vistas of electronic music alongside the human-scaled and handmade on her second LP, with help from co-producer Jack Antonoff.
在几代人之中,工薪阶层的白人受到双重赐福:他们既拥有种族所带来的特权地位,也受惠于经济的繁荣发展。
The dollar value of China’s exports and imports grew in November after two months of contraction and in the face of a rally by the greenback that followed last month’s US presidential election.
The report by iResearch Consulting Group and Sina Weibo, China's most popular microblogging platform, was released at a forum in Shanghai, co-organized by Weibo and telecom giant Huawei .
For almost everyone else, it was a year of frustration against a backdrop of better-than-average returns for the most popular index in the land.
Antarctic
你如何知道你需要喝水了?这有一系列的诱因:嘴唇发干、头晕、头痛、尿量低和口渴。然而,这种智能瓶能在你的身体意识到缺水前就提醒你。
Lecent was with an unknown number of other youth when she was killed by a single bullet inside a home in a public-housing complex near Martin Grove Rd. and Finch Ave W.
Vo said with each plane flying 12 to 16 segments a day, one late flight can easily cascade into several delays in a single day. To offset that, the airline’s systems operation and control center makes adjustments when needed. That can involve inserting spare planes and extra crews into the schedule to make sure flights stay on time.


周三,北京市发改委主任卢彦在新闻发布会上说:“我们将会在通州开展297个项目,例如建设地铁线和高速路及改善生态环境。”
In the past two decades, several campus poisoning incidents have sparked mass debates and concerns about students' psychological development and support.
3.贫穷


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

vt. (烹饪时把鱼
The Dutch case involved sophisticated financial professionals, people accustomed to analyzing financial and economic trends. Yet, they too focused on their personal experience.
[?'mendm?nt]
《小可爱与拳击手》(Cutie and the Boxer)几乎没有受到观影公众的注意,但好电影名单并非票房大片的罗列。这部达到正片长度的纪录片是扎克利?海因策林(Zachary Heinzerling)的处女作,其影响与感悟同样出色。表面上它只是讲述了一段勉力维持了40年的问题婚姻。然而在表面之下,又惊人地暴露出来的是一段有关竞争(夫妻双方都是艺术家)、怨恨、不情愿的奉献以及持久的爱(这是最让人震惊的)的历史。

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. 

After enjoying a weekend of football in Manchester, David Beckham quickly jetted across the Pond to New York last night to spend Valentine’s Day with his p

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. 

但3D版吉祥猴的形象却未能避开炮击,挑剔的网友纷纷吐槽:“这让我想起红绿灯!”;“水墨画的精髓全然不见”;“耳朵下面的两个球是什么呀,太抢镜了……”;“已被它丑哭。”
《ScreamRide》

Developer activity is also at a fever pitch. According to the contributor graph at GitHub, the total number of contributions to bitcoin’s master code in November was the highest it had been since spring 2012. Bitcoin is also the 31st “most forked repository” on GitHub—”forks” are basically proposed or in-progress alterations to core code—out of more than 900,000. In other words, for developers, bitcoin is trending. The number of open jobs currently posted at bitcoin companies also underscores developer interest: it’s at 105, which is close to the all-time high in September of 137, according to Bitcoin Pulse, which monitors such trends.
5. Starbucks. Brand love: 26% / Social Business Index Rank: 26
The latest survey also showed the country had a narrower gap between genders in 2015. As to the structure of genders, the male-to-female ratio last year was 105.02, lower than the 2010 ratio of 105.2.
所以我不知道2014会发生什么——谁也不知道。但在我的想象中,它会是这样的:
但同比而言,厦门涨幅为43.9%,排在第二位,仅落后于安徽省会合肥,后者为47.6%。65个城市同比上涨,5个城市同比下跌,这表明虽然房价可能不会像以前一样迅速攀升,但上涨仍然具有普遍性而且较有韧性。
Europe is finally recovering. Japan is also making significant progress. And emerging economies like India, China as well as Indonesia and others, their economic growth rates is likely to be maintained at high levels or likely to accelerate,” he said.

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.


城市落户政策再松绑,一策多利值得期待


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.


在其他地方,澳大利亚最近推出了提高基金定价透明度的改革措施,这推动了ETF的快速增长。
As the first of its kind, these monkey stamps are sought-after items, with a single stamp fetching 12,000 yuan, much more than its original face value of 0.8 yuan. The complete set of stamps is priced at 1.5 million yuan.
2013年,勇士队曾在中国与洛杉矶湖人队打过季前赛,而森林狼队则是首次来华。
n. 火
在数年的停滞之后薪酬将会加速提升
In 2013, the total number of applicants who qualified for the national service exam reached a record 1.52 million. In 2014, the total number decreased for the first time in four years to 1.41 million, the People's Daily website said.
Callabro,喜欢唱歌剧的男孩组合在经过不懈努力之后成功成为了本年度的英国达人秀冠军,最具天赋的歌唱组合。
报告提供了对除北京和上海之外的28个国内商业和行政中心城市进行的深入考察。
“He’s informal, candid and approachable,” says Ginni Rometty, chief executive of IBM, who praises him as “very authentic. It’s the hallmark of a modern CEO. What you see is what you get.”
1. World Health Organisation declares a public emergency of international concern over Zika

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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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.

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The data measure how successful alumni have been in their career in terms of salary, seniority and achievements since graduating.
Forbes found 1,810 billionaires this year, down from last year's record of 1,826. The aggregate net worth of the billionaires was 6.48trillion dollars, 570billion dollars less than last year.
在假日期间飞行要采取特殊的策略。这也意味着人们要为重大天气延误做好准备,尤其是美国东北部和中西部的恶劣天气。
它们大多来自50个不同的行业,包括食品和饮料、汽车和汽车零部件、媒体、零售、能源和互联网。

adj. 令人厌烦的

  • Only the first three authors are listed, followed by "et al."
  • 吉林省宏大防水销售经理战凌云:解决渗漏问题需要企业责任
  • 陶瓷企业与供应商的“智斗”内幕


但是她的成功也来之不易。精美的舞台装和参赛的全程费用已经让她母亲花费了5000英镑的费用。
Experts say that 2016 was a remarkable year for the Chinese film industry as it realized growth while facing multiple challenges including the rapid development of the internet, the increasingly sophisticated tastes of Chinese audiences, and the economic downturn in the country.

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