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

adj. 毁灭性的,令人震惊的,强有力的
追踪中国服务业增长的财新PMI指数将于下周二发布。
From maintenance to flip taxes, condo and co-op owners often complain of boards bleeding them dry. Unfortunately, the cost of running a building will not get any cheaper anytime soon.
"The autonomous region has invested 4 billion yuan (around 600 million US dollars) to promote industries with local features in poor areas, and relocated 77,000 poor people last year," said Lu Huadong, deputy director with the office.
The mattress comes with sensors inside the bed that can detect pressure and send messages to the app, which spares no details. The app not only detects movement on the bed, but also records the intensity and speed at which people are getting it on.
年龄:39岁
The rise of populism, even in countries such as the US and UK where plenty of people are in work, has made politicians realise that the quality of jobs is as important as their quantity.
拥抱世界
“狗屎。都在说谎,都是权宜之计,他们不过是想让自己好受些,我知道这些人都是胆小鬼,只要表面上看起来能凑合,对他们来说这就够了。”
This is second major English-language role for the French actress, who co-stars opposite Daniel Craig in Skyfall as the enigmatic Severine. The movie opens Nov. 9 in North America but already is shattering records internationally.
飓风厄玛
She has modelled for numerous clothing companies including Glitzy Girl, Sally Miller and Purple Pixies and featured in magazines including Teen Vogue, Cosmopolitan, Elle and Seventeen.
‘I Could Not Forget What Happened to Me That Night With Him’
undeniable
至于英国,官方虚构数据同样盛行。英国国家统计局(Office For National Statistics)周二公布,以由来已久的零售价格指数(RPI)衡量,去年12月英国通胀率上升至4.1%。该数字纯属胡扯,英国国家统计局对此心知肚明。该机构告诉人们RPI“没有达到规定标准”,不能作为合格的通胀指标,但自2012年以来该机构一直拒绝采取措施来改善该指标并使之贴近3%的整体通胀率。
针对那些对比较世界各地的学校有兴趣的学生,《美国新闻与世界报道》近日发布了第四版全球最佳大学年度排行榜。
James Bond Themes 6. "A View to a Kill" by Duran Duran
appear出现+ance表名词,“性质,状况”→出现;外表
8月12日,港口城市天津的一座非法储存危险化学品的仓库发生一连串爆炸,导致173人死亡,数百人受伤,造成的破坏景象仿佛末日来袭。此次爆炸事件提出了有关中国在快速工业化进程中安全监管松懈的严肃问题。
只有公民,而他们的选择不仅可能、而且必然会改变。
10月份,中国居民消费价格总水平(CPI)同比涨幅降至1.3%,为今年5月以来的最低涨幅;环比下降0.3%,为今年5月以来的首次环比下降。
1. Apple. Brand love: 57% / Rank: 32
眼见克莱斯勒的市场份额呈现死亡式螺旋下降,菲亚特会最终认识到这个不中用的公司还真就是不中用了。预计菲亚特会在8月前扬言彻底和克莱斯勒分道扬镳,除非全美汽车工人联合会(UAW)和美国纳税人作出更多让步。
Q=Dd[(U=ze~+vR_uAR%
[.tr?nsp?'tein]


在这场新闻发布会上,国家卫生健康委员会负责疾病预防的官员王斌称,中国已经在预防和控制艾滋病方面取得了进展。
Yes, it happens. Print all application materials from home, the library, a print shop – anywhere besides your current company's office。
他告诉记者说:“我认为,韩国对于美的定义很苛刻狭隘,因为我们是一个种族单一的国家,每个人看上去都差不多。整容也和自卑情绪有关。”


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

8. Your appendix might not be a useless evolutionary byproduct after all. Unlike your wisdom teeth, your appendix might actually be serving an important biological function - and one that our species isn't ready to give up just yet.
The U.S. is set to add nearly 3 million jobs in 2014 — the biggest increase since 1999. The burst in job creation, expected to continue in 2015, is sure to fuel consumer spending. So, too, will a plunge in gasoline prices that's given households extra cash to spare on other goods and services. See: Americans saved $14 billion as gasoline prices declined in 2014.
中国最高质量监督部门日前表示,去年通过网购平台出口到中国的消费品,超过40%是不合格的。
无论你是否认为Snapchat配得上Facebook开出的30亿美元报价,有一点确定无疑:所谓的“阅后即焚”(内容被接收数秒后自动消失)社交网络拥有广阔的市场应用空间。此外,与流行的看法相反,Snapchat传播的内容不仅仅是色情短信和限制级的自拍照片,尽管它也的确是传播这类信息的最佳平台。随着主流社交平台的内容变得越来越商品化,以Snapchat为代表的“阅后即焚”平台在某种程度上重新恢复了社交媒体本应具备的趣味性和自发性。就像现实生活中的互动交流一样——创意自由流动,一般不用担心一切事情都被记录下来留给子孙后代观瞻,传遍整个世界——SnapChat提供了一个真实的、未经过滤的交流渠道。孩子们真的很喜欢它。Facebook公司自己的首席财务官上个月已正式承认,青少年使用Facebook的次数正在下降.而据坊间传言,驻足于Snapchat的青少年数量正在呈爆炸式增长。

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. 

Current prosthetic hands do little beyond filling the arm-shaped space between your body and the air. Sure, they can grasp things all right, and they help in balance, but they lack one of the human hand's most important abilities—the sense of touch. People with prosthetics can't detect if they're in contact with an object without looking at it directly.

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. 

"This year's prize concerns a central economic problem: how to match different agents as well as possible," the academy said.
But what drives the underlying optimism or pessimism? Koudijs, working with Hans-Joachim Voth at the UniversitatPompeuFabra in Barcelona, found surprising answers.

According to a 2014 survey it conducted, 86 per cent of respondents who finished the two years said they were taking action to end educational in-equality through their work and 65 per cent outside of their work.
《财富》美国500强公司美国电话电报公司(AT&T))也于3月份批准了回购至多3亿股股票的计划,价值约105亿美元。这项回购计划是它过去三年中宣布的第四项回购计划。这家公司自从2012年开始股票回购至今,总计已经回购了7.75亿股的股票。
2017已经是詹姆斯在联盟中的第十四个赛季,但他的场均助攻和篮板竟然还创下了职业新高。在这个赛季的前两个月里,他拿出了整个职业生涯最好的三分表现,但鉴于这已经被各方专家们讨论和剖析,并且被媒体广泛的报道了,我在这里就不加赘述了。
The very best bosses I’ve seen are passionate about their work; they live and breathe their jobs and strive to do the best work possible. Yet at the same time, they have lives outside of work. They understand the need to balance family and work or play and work. And they set a good example of how to do that for their employees。
17. 最复杂的障碍。根据Box Office Mojo网站统计,截止到12月7日,今年发行的20部票房最高的影片中,有7部是由女性主导的。与之形成对照的是,20部由女性为主导的影片中,有五部在全球票房领先,而海外票房占据了电影业收入的70%。这看上去可能很糟,但是比近年的数据要好一点。
教育部还表示,公费留学学生的归国率达到了98%。公费留学生一般选择中国急需的专业,包括工程学、纯科学、农业和医学科学等。

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.


宁波LED照明受推崇 三国外交官来甬抛“绣球”


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.


这家Post-it即时贴和思高(Scotch)胶带制造商在2月份授权进行120亿美元的股票回购,取代当前75亿美元的回购计划。《财富》美国500强公司3M公司(3M) 遵循了去年末发表的声明行动。这项声明称,公司在之后4年准备投入100亿美元用于收购,最多将投入220亿美元用于回购。
vt. 使流通
国内航空统计公司飞常准发布的最新报告显示,我国主要机场的准点率仍然远未让人满意。
噢,卡梅隆,真希望你还有高中时的风采,因为那时的你是史诗般的存在。
Foreign investment in emerging markets has dropped to the lowest level since the financial crisis as investors are braced for the fallout of the first US interest rate rise in nearly a decade.
the Dutch lender that is a leading financier to farmers and agribusinesses around the world.
“有些人说自己去吃午饭了,然后一去不回。”
“It suggests that people put more weight on what happened to themselves and less weight on other information that might be available,”Koudijs says. The more personally removed people are from an important event, the less it is to affect their appetite for risk.
如果你失业已经有一段很长的时间了,可能该是时候考虑一份你以前没有考虑过的工作了。
"There are close to 70 French citizens or residents in France who have died in Syria and Iraq in the ranks of the terrorists," he added.

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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While China remains the largest holder of American government securities, it cut down exposure to USD 1.25 trillion in October.
待售房产:一栋带有四间卧室与四间半浴室的希腊复兴式房屋
对于一种色彩潮流(又或说两种色彩潮流)而言,要包含的和不同话题有关的信息传递太多了,但潘通在声明中称,体现社会潮流并用一种颜色捕捉它们,是公司的工作。和往常一样,这种颜色将会进入我们生活中使用的面料。
The US and European steel industries have accused China’s heavily subsidised sector of flooding the global market with steel, “dumping” it by selling below production costs and driving down international prices. The collapse in steel prices in recent years has caused the closure of mills across the world from Australia to the UK and parts of the US industrial heartland.

“考虑到8月贬值行动引发负面反应,我们认为近期不会出台进一步的贬值,”常驻香港的牛津经济研究院经济学家高路易(Louis Kuijs)表示。“我们认为10月的贸易数据将继续(使政府)面临压力,要求其在国内出台更多宽松政策。”

  • Only the first three authors are listed, followed by "et al."
  • 轻智能时代 智能家居其实比你想象中要简单得多
  • 遏制“假退房”!合肥房产交易再出新规!


Among dozens of small, technology-focused acquisitions, the $3bn purchase of Beats Electronics, the celebrity-endorsed headphones and music streaming service, stands out as Apple’s largest ever deal. The acquisition still bemuses many Apple analysts, but in Jimmy Iovine and Dr Dre, Beats’ founders, Mr Cook has instantly regained credibility with the music industry after years of neglecting the iTunes download store. If Mr Cook is guilty of missing the rapid growth of subscription services such as Spotify, he has moved swiftly to compensate for it — though for a high price.
It was also the first time Shanghai witnessed a decrease in its permanent population since China adopted the policy of reform and opening-up in 1978, Guo Feng, a research fellow at Shanghai Finance Institute, was quoted by news site wallstreetcn.com as saying on Tuesday.

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