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

他说:“黄金披萨奢华至极。如果你想享受一顿奢侈大餐,那么这份披萨就是为你准备的。”
In a blog post announcing the deal, Mr Cahan said although mobile devices were shifting our daily routines, “most articles and web pages were formatted for browsing with mouse clicks. The ability to skim them on a phone or a tablet can be a real challenge – we want easier ways to identify what’s important to us.”
他们先在伦敦中心广场上开了个熊猫聚会,接着来到特拉法加广场打太极。这一切都是第一届"感受熊猫"周的特别活动。
ownership
今年初,麦基在接受媒体采访时说:“虽然似乎有悖于直觉,但尽可能提高长期利润的最佳途径就是不要把利润作为公司的首要目标。”
买家和卖家
价格:205万美元(约合人民币1312万元)
According to the National Business Daily, the 16 listed banks plan to return 356.2 billion yuan to shareholders as cash dividends in 2015, a decrease of 8.3 billion yuan from the previous year.
泰晤士高等教育世界大学排名的编辑菲尔·巴蒂说,“学校的全球发展前景是一个名牌大学的重要标志之一。顶尖大学聘请来自世界各地的教师,吸引来自全球有极高天分的学生,并能与所有的一流专业合作——不管是哪个国家的。”
For a few years, Namibia's dollar has been depreciating against many currencies, providing affordable opportunities for travel. The best-priced flights generally avoid South African and European school-holiday times, especially late December and January.
adj. 最初的,原始的,有独创性的,原版的
如果不是看作有利可图的投资的话,人们依然喜欢欣赏早期绘画大师的作品,从中获得愉悦。苏富比称,6000人参观了12月5日至9日的早期绘画大师作品拍卖会预展,而6月份的印象派和当代艺术品拍卖会的参观人数为6400人。很多历史悠久的画作的确在低端价位上找到了市场,在12月9日至10日的早期绘画大师作品日间拍卖会上,佳士得和苏富比的售出比例都很高,分别是67%和65%。
Consumer Electronics Show
在10月份的第三场总统大选辩论中,两位总统候选人没教养地拒绝与对方握手问好或道别。
科学家们在赋予人体器官原本能力方面投入很深,但是为何要仅限于此呢?
adj. 荒谬的,可笑的
另一名学员表示:这个项目让我的事业获得了巨大飞越,为我在毕业后马上就担任一个战略最高层管理职位做好了准备。
在你醒着的时候,肝可以扩大将近一半。新的研究指出,在白天的时候,肝有能力扩大近50%,然后在夜间则会缩回到原始尺寸。肝是我们所知道到的唯一一个可以这样变化的器官。
The United Kingdom ranks No. 3 overall. It ranks No. 4 in Power and No. 5 in Cultural Influence.
original
跳水游泳花样游泳篮球小轮车曲棍球田径
当时,Spielman正在耶路撒冷Emek Tzurim国家公园橄榄山的斜坡上检查泥土。突然就注意到了这个小小的矩形物件。
Subdivided flats smaller than 100 square feet (9 square meters) can rent for $385 in the Asian city.
谁会与一位王室成员击掌呢?尽管他年龄不大。
7.助听器


Lawrence Yun, the trade group's chief economist, expects the average 30-year fixed-rate mortgage to hit 5.5% at year-end, up from 4.5% late last year and 3.5% in the first half of 2013. That's a sharp runup in a short period of time, one that could harm affordability and spook even more buyers.
我是否有从一天当中能抽出时间来给自己?我们都需要一点“自我时间”。每天留出一些时间放松一下,做你喜欢做的事情——阅读、冥想、看电视、烹饪、跟你爱的人共享黄金时光等等。
如果你是一个工薪阶层的白人,担心这个充满国际性的新世界会摧毁或贬抑你所珍视的身份认同,那么你并没有一种在文化上能够被接受的方式,去阐明自己内心感受到的危机。


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

And a few stopped to change a tire for an elderly French couple.
comfort
愿你拥有新年所有美好的祝福。
"Twenty Two" featuring the tales of 22 comfort women became the first Chinese documentary to surpass 100 million yuan at the box office.

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. 

Perhaps the biggest domestic threat to the 3% growth scenario would be a surprisingly swift hike in interest rates, but from all indications a dovish Federal Reserve is unlikely to take aggressive action in 2015.

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. 

在牵手其他领域的精英这一点上,谷歌并非独家。今年早些时候,英特尔(Intel)便宣布与美国时尚设计师协会(Council of Fashion Designers of America,CFDA)和奢侈品零售商Opening Ceremony合作,设计智能手镯。时尚品牌汤丽柏琦(Tory Burch)也与Fitbit携手设计了与可穿戴技术创业公司Misfit Wearables的无线运动跟踪器Shine Tracker类似的吊坠与手镯。而苹果(Apple)也发掘了各行各业的人才,包括博柏利(Burberry)前任首席执行官安吉拉o阿伦德茨(担任零售主管)、伊夫o圣o洛朗(Yves Saint Laurent)前任首席执行官保罗o丹尼佛以及耐克(Nike)的前任设计主管本o谢弗。
But that recovery has also seen the size of bonuses drop: last year the average payout was Rmb12,821 ($1,861), about Rmb2,000 more than in 2015 but still roughly Rmb800 below the 2014 average. More than a quarter of those surveyed who saw their bonus shrink last year blamed the decrease on poor company performance.

D1t]!J^-6h=kwFS)I
What Mr Ravenscroft liked about it when he was choosing his graduate career path was that it of-fered the best of two worlds. He would be fast-tracked into the classroom, earning a salary, being mentored by an executive from the private sector and making contacts with business; in return, he would commit to teaching for two years and complete a teacher training qualification.
斯德哥尔摩经济学院(Stockholm School of Economics)是今年排行榜上的大赢家,该学校的排名攀升16个位次,排在第28位,不仅排名晋升速度为年度最快,而且扭转了去年排名下滑11位的局面。
Homeowners in neighborhoods like the Grand Concourse in the Bronx or Elmhurst in Queens could enjoy new attention from buyers eager to find the next untapped market. “When have you heard talk about Kingsbridge in the Bronx?” asked Ms. Ramirez of Halstead. “The people who are smart are getting out there and buying it up at wonderful prices.”
n. 生存,幸存者
首尔坚称这些活动分子有派发单张的民主权利,但要求他们不要过度激怒北韩。

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.


收购补贴冬奥会 连锁反应促LED行业进入新常态


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.


去年,伊斯兰国激进分子在土耳其驻摩苏尔领事馆扣押了49名土耳其人质,三个多月后才释放他们。人质中包括外交官、军人和儿童。
当然,那时候,伦勃朗是大热门。但是如今,这位荷兰画家和他的同辈大师已经过气,不再是收藏家和投资者渴望的对象。
8.表达感激之情
Tencent, with an estimated value of $44.7 billion, was crowned this year's Most Valuable Chinese brand on a list released by the Hurun Institute on Thursday, marking the second time in a row it came up on top.
《性别之战》
在最近一连串的几场比赛之前,史蒂芬·库里真的没有想到能够创造这么多的NBA历史纪录。
单词check 联想记忆:
n. 谣言,传闻
一份产业报告显示,随着国内手机制造商加快创新,国产品牌手机仍占据国内手机出货量的主要份额。
Overall, starting a company ranked lowest among reasons cited for undertaking an EMBA (rated 5.5 out 10). Students’ main motivations were learning about management (9.1), networking (8.3) and increasing earnings (8.1).

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 Consumer Electronics Show to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

Best chances: Best film, and best original screenplay recognition looks certain, and Frances McDormand is currently the favorite for the best actress Oscar.
《极盗车神》特别有趣,虽然它未必会使你一直捧腹大笑,但全片都很欢乐。
8、邦德并不是个喜剧演员 但他懂得合适的时候来点小幽默。女性很容易被有趣的男人吸引,因为幽默标志着智慧。可以这么讲,一个人多有趣,可以来推断他与多少女人风流过。
在上周二晚上放学后,孙轶潇乘坐电梯回家,可是电梯突然故障停止运行。

Deepening reform in major sectors and key links

  • Only the first three authors are listed, followed by "et al."
  • 天津市内户口迁移?取决于是否有可供落户房产
  • 武汉大学生8折购房政策曾遭质疑 落地后走向清晰


2014年1月,我在达沃斯亲身感受到了这种悲观情绪。几位著名西方学者问我中国和日本之间是否会爆发战争。我非常有信心东亚不会发生战争,以至于我提出以1赔10的赔率与西方知名记者们打赌。两位记者接受了我的赌约。今年1月回到达沃斯时,我将收取他们的赌注。
Yahoo CEO Marissa Mayer

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