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

“此种情形中,宪法还真不适用。宪法限制了政府对言论的压制,但不限制私立学校。”
HSBC said its private reading of China's manufacturing sector was stagnant last month, confirming a "flash" estimate already published.
adj. 全球性的,全世界的,球状的,全局的
《好时光》
3. Tablets meet viruses.
3. 西北大学凯洛格商学院
学员平均年龄:费城班33岁,旧金山班36岁
11月房价环比平均下跌0.5%。
注册人数:511人
今年到目前为止,周星驰的《美人鱼》自二月上旬的贺岁档上映以来,已经取得了5.26亿美元的票房收入。
继Facebook前员工肖恩帕克(Sean Parker)和查马斯帕里哈皮蒂亚(Chamath Palihapitiya)——二人谴责了社交媒体的成瘾性——之后,新的一年将有更多的科技行业工作者发声。
It replaces strollers and big backpack carriers that might even make it heavier or cumbersome for you to take your children out.
The pair stand on opposite sides backstage and memorize the winners to avoid having to write them down and have revealed in the past how they carry out rigorous checks to ensure they have stuffed the envelopes correctly. It is believed Ruiz and Cullinan are ordered to destroy the duplicate cards as the presentation goes on, so by the time Best Picture is awarded, the only envelopes left are the two for Best Picture.
She pointed to equal pay, saying it's not "just a woman's issue" but something that affects everyone. "If you have a wife, a mother, a sister, a daughter who is working and they are not being treated fairly, the whole family suffers," Clinton said.
A New York City restaurant is taking a stab at creating the most decadent pizza on the market with a pie topped in gold flakes, foie gras and even truffles.
有迹象显示,人们对公务员的热情可能正在消减,招聘网在三月底发布的一份报告称,仅仅两个月,已有1万多名公共单位职员通过该网站提交了简历,其中包括公务员和公共机构工作人员。报告还表示,去年同一时期,提交简历的人数比今年高34%。
adj. 奢侈的,浪费的,过度的,大量的
The World Cup, on the other hand, was searched for as both a sporting event and a cultural experience.
大多数人对瑞典的印象是“一个阴冷而美丽的国度”。但这并非概括瑞典的全部。作为斯堪的纳维亚半岛上面积最大的国家,瑞典人口却十分稀少,对于那些厌倦嘈杂、喜爱静谧生活的人来说,瑞典可以说是人间天堂。在这样舒适的环境中,品尝新鲜海鲜、浆果以及特色奶酪等当地美食,是再合适不过了。
The report found that third-tier cities are most livable places.
['p?st]
Wang, the chairman of Dalian Wanda Group, took the top spot with a personal fortune of $32.1 billion, the report said, despite Ma seeing his wealth surge 41 percent from 2015.
Leatrice Eiseman, the executive director of the Pantone Color Institute, said the joining of the two colors reflected “a soothing sense of order and peace” — presumably an attractive thing to incorporate into a product at a time of insecurity and global turbulence. It also implies that there is no line between “us” and “them.”
In the three years after the death of Steve Jobs, Mr Cook, 54, has held his nerve through attacks from activist investors and a loss of faith among some that Apple could succeed without its late founder. This year has seen Apple’s chief step out of the shadows of his predecessor and imprint the company with his own set of values and priorities: bringing in fresh blood, changing how it manages its cash pile, opening Apple up to greater collaboration and focusing more on social issues.
"In the aftermath of recessions, there's always a period of jobless recovery," says John Challenger, CEO of global outplacement firm Challenger Gray & Christmas. "We're certainly not optimistic about seeing much improvement in the unemployment rate in 2010."


500富人榜中20%的富豪来自信息技术行业,而资产投资者正逐渐淡出该榜单。
哈维·韦恩斯坦被指控此后将麦高恩列入了黑名单,同时雇佣莫萨德机构跟踪麦高恩,窃取她的纪念手稿。
联合国表示,菲律宾总统发起的禁毒战争存在人权问题。周日杜特尔特因此向联合国发起抨击,并表示菲律宾可能离开联合国,转而与中国和非洲国家组成一个新机构。


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

它们汇聚为卷土重来的民族主义和仇外主义。
史赛克公司(Stryker)的创始人就是“翻身床”的发明者,借助这个设备,卧床的病人无需挪动身体就能改变在病床上的位置。顺其自然地,这家医疗设备制造商也向自家员工及其家属出借医疗床,分毫不收。
Christmas arrived on schedule for the U.S. auto industry as a spurt of sales put the wrapping on a surprisingly successful year. Analysts predicted that sales in December could hit a seasonally-adjusted rate of 17 million, which would be the first month at that rate in nearly six years. That would push 2013 sales up to a robust 15.7 million units.
Additional reporting by Ma Nan

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. 

"史上最短的明星婚姻"大盘点

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. 

触摸屏主要生产商蓝思科技的周群飞以450亿元的资本净值位列榜单第3。
而在非手术整形中,注射肉毒杆菌和激光脱毛依然是最受欢迎的。

For those outside the scientific community, the response to the retraction has been mixed.
“美联储比外界所预期的更加咄咄逼人,”克普克表示,“让市场感到意外显然并非上策。”(那时美联储尚未建立在货币政策会议后发布公开声明的制度。)
Other engines cited among 2014’s best include turbodiesels in the BMW 5 Series luxury sedan and the compact Chevrolet Cruze, the horizontally opposed 2.7-liter six-cylinder in the Porsche Cayman two-seat sports coupe and the 1.8-liter turbo-four in the compact Volkswagen Jetta sedan.
limited
但是折幅差异持续了整整两年。事实上,Seppenwolde贷款机构的悲观和避险情绪降低了阿姆斯特丹总体可用杠杆。
投资者也关注到了本田的这一困境。尽管在席卷全球的金融危机中,本田是全球少数几家能独善其身、避免严重亏损的汽车厂商之一,但在过去几年中,其普通股股价下跌了17.2%,而同期日经225指数却上涨了7.4%,丰田汽车的股价也上涨了19.5%。

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.


2017地板市场细分化:大势所趋 创新为要


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.


James Bond Themes Honorable Mention: "Surrender" by K.D. Lang
剧烈动荡石油产量—随着更加缓慢增长的世界经济—造成了原油价格从2013年100美元一桶到2014年年末的几乎50美元一桶的大幅下降,而在美国国内2014年初却造成了通货膨胀的相反影响
他做了几次化妆试验,希望能极大改变卡瑞尔的外貌。“我们实际上在创造一个新人,”科森说。
n. 青少年
2015年风头最劲的品牌:在新款切诺基的拉动下,Jeep在2014年的销量惊人地拉高了44%,而斯巴鲁的销量则静悄悄地提高了21%,现已成为美国第十大最受欢迎的汽车品牌。
前“世界小姐”朴雅卡·乔普拉位列2015世界美女榜第九。她是一名印度演员兼歌手,是宝莱坞片酬最高的女演员之一,也是印度最受欢迎、知名度最高的名人之一。她获得过无数荣誉,包括印度国家电影奖的最佳女演员奖项,以及印度电影观众奖的四项大奖。
n. 诱惑力,吸引力
Neneh Cherry “Blank Project” (Smalltown Supersound)
但是,如果《广告狂人》向我们展示了什么的话(除了修身西服看起来多酷,宽领带真的不是男装的点睛之笔),那么,它最主要展示的是,60年代非常复杂,往往不太愉快,偶尔具有破坏性。
腾讯控股有限公司公关部的一名员工、一款直播应用的负责人日前声称,一名男子通过在这个直播平台唱歌接受了一个13岁女孩25万多元(3.64万美元)的打赏,而该女孩在注册时可能隐瞒了年龄。

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 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 adj. 浪漫的 to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

排球拳击乒乓球举重沙滩排球铁人三项艺术体操蹦床篮球射击羽毛球艺术体操足球网球
克普克写道,分析师们常常“认为新兴市场危机易发性的根源在于制度薄弱,这使得这些国家易受经济、金融不稳定的影响。”
Classic cars:Prices plummet as an enormous supply of post-war classics, hidden away on an off-shore island, becomes available for the first time in 50 years. Collectors are especially eager to find Packards, Studebakers, Hudsons, Nashes, Kaisers, and Henry J’s. More’s the surprise because all of the cars are in running condition and are used as daily drivers.
2.你突然变成Twitter上面思想领军人物。

大多数人对瑞典的印象是“一个阴冷而美丽的国度”。但这并非概括瑞典的全部。作为斯堪的纳维亚半岛上面积最大的国家,瑞典人口却十分稀少,对于那些厌倦嘈杂、喜爱静谧生活的人来说,瑞典可以说是人间天堂。在这样舒适的环境中,品尝新鲜海鲜、浆果以及特色奶酪等当地美食,是再合适不过了。

  • Only the first three authors are listed, followed by "et al."
  • 房屋买卖纠纷多发 9成借名购房者为避“限购令”
  • 五位家居大咖分享智慧“干货”


Here are our top picks for games that debuted at Gamescom 2014.
Comic skit “Dance If You Like” (Cai Ming and Pan Changjiang)

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