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

Talk show host and comedian Ellen DeGeneres will host the Oscars ceremony for a second time.
Kathryn Bigelow and screenwriter Mark Boal have been working for a while on a drama about the 1967 police raid in Detroit, which led to one of the largest citizen uprisings in US history. Kaitlyn Dever, John Krasinski, Will Poulter, John Boyega and Jack Reynor star.
2013年排名:14
这种插秧机只需几分钟便能种植数排幼苗。可节省88%的种植时间。
31岁的罗西每天的工作就是计算五角大楼在养老、医疗和教育福利方面未来的成本。但他说,这份工作不仅仅是鼓捣电子表格数据。他还要与其它政府部门进行沟通,并就金融模型与同事举行头脑风暴会议。
要让产品显得很“酷”并不是唯一的目的。科技行业如果想让我们身体的更多部位连上网络,那么安全问题和隐私问题,尤其是顾客数据管理问题,依旧需要慎重考虑。正如《经济学人》(The Economist)所说,蓬勃发展的传感器的魅力,以及可穿戴设备的算法,分散了人们对于其他要素的关注。这些关键的其它要素包括:“标准、互通性、一体化、数据管理”,以及“知识产权、执行标准”。对国家安全局(National Security Administration)而言,这些技术发展都必须以网络安全为前提。
供给侧结构性改革初见成效;
The top 20 comprises 13 US universities, four British and three others.
“我们希望这份榜单会让大家采取措施保护自身的网络安全。”
立场:呼吁结束政府停摆局面
美国选举人团制度已经在两方面失效。
You're talking with him / her late on the phone. When he / she hung up the phone, you still miss him / her, even if the phone just hung up on 2 minutes
commercial
另一方面,10月份工业生产者出厂价格(PPI)连续第3个月同比下降5.9%。
截至7月中旬,约有50,000家商店在Bigcommerce上运营,平台累计销售额近40亿美元。Bigcommerce的客户通常是一个一个累积起来的。但7月初,它与eBay签署了一项协议,eBay从2015年2月将停用的两款Magento产品Go和ProStores优先迁移至Bigcommerce。在此之前,ProStores已有5,000多家商户迁移至Bigcommerce。此项协议可能再带来多达10,000家商户。
The collaboration with business is important, adds Teach First, not just for the funding but to help schools equip students with more of the skills required by modern employers.
“如果听到苹果CEO是同性恋,能帮助一些人努力直面自我,或者给一些感到孤独的人带来慰藉,或者激励人们坚持自己的平等权利,那么这值得我用个人隐私来交换,”他在为《彭博商业周刊》(Bloomberg Businessweek)的10月号撰文时写道。
一定要展现自己过人的智慧,努力地表现出心神不定的样子。把那些社交技巧抛到脑后吧!
The thing about the Mavericks is that this is not at all how Dirk should go out. That team has been so solid his entire career. To have a busted season now is painful. Maybe he ought to have joined Kobe, KG, and Big Fundamental last summer.
adj. 方便的,便利的
美国航天局(Nasa)表示,2015年气温以0.13摄氏度之差,打破了2014年创下的记录。
You are so engaged in thinking of him that you don't notice that there is no No.12.
《大汉情缘之云中歌》
Peace and love for you at New Year from all your students.祝老师新年充满平安和爱。
n. 路线,(固定)线路,途径


Here are the 10 bogies, drones targeting markets, stocks, bonds and the, global economy:
But the change in Wall Street’s — and Silicon Valley’s — appreciation of Mr Cook is down to more than just the 70m iPhones Apple is expected to sell this quarter or the $42bn in sales generated in the previous.
四年前,玛蒂还是一个默默无闻的8岁小女孩,她喜欢跳舞,就读于当地一所小学。


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

来自中国首都北京的北京大学和清华大学,分列2017年亚洲大学排行榜的第二、三名。而新加坡国立大学则位居榜首。
有的时候,老板挺糟糕的。但如果你觉得你的老板一直很差劲,占用了你的时间,是的,你该去找一份新的工作了。
彭博(Bloomberg)软性大宗商品指数上涨21%,工业金属和能源指数则分别上涨24%和1.5%。
请接受我诚挚的新年祝福,顺祝身体健康。

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. 

We learned about a warehouse that is like a mausoleum for endangered species.

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. 

这造成了一种有待填补的身份认同真空。
共管公寓和合作公寓一直在严令整顿,编写警告备忘录,对违规居民罚款。对于租房者来说,打破规则就可能会危及租约。共管公寓正在加强安保措施,要求门卫仔细观察来访者,同时要求居民为来访的客人签署授权表格。这类操作还引起了保险界的关注。

Wishing you happiness during the holidays and throughout the New Year.
But some people might just remember the mustaches.
In an industry enthralled to rehashed stories that strike a familiar chord with audiences, give Pixar credit for often trying something new and pushing their viewers into uncharted territories. Coco, directed by Toy Story 3’s Lee Unkrich, has a visual look based around Mexico’s Dia de los Muertos (Day of the Dead). It’s about a young boy named Miguel who idolises legendary guitar player Ernesto de la Cruz and wants to learn how to play as well as he could. So he goes on a transformative odyssey of self-discovery into the realm of the dead to find his long-deceased idol and learn some lessons about the nature of creativity and originality. Whether it can reach the heights of Pixar’s 2015 masterpiece Inside Out remains to be seen, but Coco should surely be a feast for the eyes. Released November 15 in France, November 22 in the US, Croatia and the Philippines, and November 30 in Israel. (Credit: Disney-Pixar)
伦敦阿格纽艺术品交易所(Agnew’s)的主管安东尼·克赖顿-斯图尔特(Anthony Crichton-Stuart)说:“如果没有意识到我们处在非常危急的关头,那就太天真了。人们的偏好出现了重大转变。但是如果拍卖会上出现一幅18世纪前绘画大师的佳作,而且价位合理,人们还是会感到兴奋。”
Are there any differencesbetween writing a light novel and writing an anime?
Yang Yansui, director of the School of Public Policy And Management at Tsinghua University, said the four-trillion-pension balance was mostly in personal accounts, while the pay-as-you-go pension system was greatly challenged by dependency ratio.

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.


河南楼市最近有点儿“冷”大学生被拉去当“房托儿”


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.


维多利亚的秘密内衣秀刚刚拉开华丽巨幕,今年的秀也是有史以来最奢华复杂的一次。
Newcomers: Among the 15 newcomers on this year’s list are South Korean President Park Guen-hye (No. 11); Lockheed Martin CEO Marillyn Hewson (No. 34); CEO Tory Burch (No. 69); Spanx founder Sara Blakely (No. 90) and Baidu CFO Jennifer Li (No. 98).
请接受我诚挚的新年祝福,顺祝身体健康。
内战发生在奥创事件之后。那时,政府决定超级英雄们必须在政府管理下行事,不能再单独行动。“美国队长”斯蒂夫·罗杰斯表示反对,但“钢铁侠”托尼·斯塔克却赞成政府的做法。两人之间的冲突因此形成。
issue
pol擦亮+ish表动词,“造成…”→擦亮
在这部暑期大片上映40年后,约翰·威廉姆斯的经典原声大碟仍然叫人毛骨悚然。《大白鲨》利用我们对未知的深海的本能恐惧,展示了一个多次受到同一条食人鲨袭击的海滨小镇。近年来,环保人士强调,鲨鱼通常不主动伤人,平均每年只有8人葬身鲨口。
Only Kobe Bryant had played in more games by age 32, and did so with fewer minutes, and that's just including regular-season games.
adj. 不稳定的,易变的
It also said 98 percent of government-sponsored students returned to China. Government-sponsored students who study abroad have chosen to pursue disciplines most needed in China, including engineering, the pure sciences, agriculture and medical science.

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

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毕业于该项目的学员获得的金钱回报遥遥领先,毕业3年后的平均年薪为46.9万美元。
May the New Year be a time of laughter and real enjoyment for you. Best wishes.愿新年不仅是你欢笑的时刻,更是你欣喜的日子。祝福你。
玛戈特·瓦尔斯特伦(Margot Wallstrom)
今年,该学校首次跻身前20强。

In fact, one ancient saying was, "ifyou have Kucha, only one percent of the states in the Western Frontiers remain unsubmissive."

  • Only the first three authors are listed, followed by "et al."
  • 在京无房津冀买房可提公积金
  • 抢占高端家居消费市场 红星美凯龙推自营品牌


In the original casting, Michael Keaton was set to play the character. However, ABC executives begged the writers and producers to keep Jack alive. They believed the character was too likeable to die off so quickly. The writers agreed. Michael Keaton was not interested in signing up for a long-running show. Instead, the role of Jack was given to Matthew Fox. The rest is TV history.
We will improve mechanisms that give incentives and allow for and address mistakes so as to support those who are dedicated to their work and stand behind those who live up to their responsibilities. Every one of us in government must take an active approach to our work and have the courage to tackle the toughest problems, we must work closely with the people, using concrete action to make progress in development, and using genuine hard work to realize a bright future.

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