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

2016年奥运会和2014年足球世界杯主办城市里约打败了希腊,成为搜索次数最多的旅游目的地。
如果答案是“是”,那么也许你是D型人格的人。
Domestically, an increasingly active middle class is generating pressure for more accountable governance. Mounting inequalities have nurtured a sense of injustice; 200m migrant workers remain second-class citizens and corruption is worsening. Tackling these problems is urgent, but China's economic successes have fostered an unwarranted self-confidence. Instead, motivated by the Arab spring, the system has moved aggressively to contain any social discontent that might spark more politically sensitive movements.
determine
然而,《秦时明月丽人心》并不能让更喜欢真实历史而非虚构故事的观众满意,该剧豆瓣评分仅为4.9分。
赖床有了新理由
President Donald Trump is the nation's first billionaire president -- but he's not as rich as he used to be, according to the Forbes 2017 Billionaires List published last Monday.
《总督之房》
The requirements come from one of two newly issued regulations over the taxi and online ride-hailing services by China's transportation authority. The regulations will take effect in October and November respectively.
At a minimum, it is impossible for most people to get to work in the city, which affects the locus of several industries, including finance, advertising, healthcare and the arts. The city's transportation lines, bridges, and tunnels were shut down for nearly two days, and at the latest report, the subways may be down well into next week.
IT/communications/electronics/Internet offer new graduates the highest pay at 4,867 yuan a month on average, but that's down 826 yuan from last year's level. Finance and transport/logistics/warehousing come second, offering average monthly salaries of 4,692 and 4,457 yuan respectively.
And among the GII 2016 leaders, four economies — Japan, the US, the UK, and Germany— stand out in innovation quality.
Sinta Nuriyah
2016的很多电影都会有很好的票房号召力,但人们迫不及待想要观看的其实只有那么几部。
前“以色列小姐”盖尔·加朵在2015全球十大美女榜中居第六位。她是服装品牌“卡斯特罗”的首席模特。加朵因饰演《速度与激情》系列电影里的吉泽尔· 姬赛儿一角而闻名于世。
10.I thought I already sent that email out. I’m sure I did. – Because telling you that it was a low priority and I forgot would probably hurt our relationship。
这些担忧给周五开幕、为期两天的G20央行行长和财长会议投下了浓重的阴影。本周国际货币基金组织(IMF)已经警告准备下调其对今年全球增长的预测,称主要经济体需要采取更多举措来刺激增长。
答:英雄是一个不想成为英雄的人。英雄是那种明明完全可以选择,但却选择在那个时刻承担起责任的人。那就是英雄所要做的事。举个例子,在911实践中,飞机上的一些乘客曾经和恐怖分子搏斗。在福岛辐射泄露实践中,有些人前往当地试图修理核电站,并且因此而死。但他们必须这么做。他们是英雄。他们想要的并不是“当英雄”,而是承担责任,做正确的事。
na;F(|GWK@bR)
尽管在奥巴马担任美国总统的过去的四年里,美国经济复苏缓慢、失业率居高不下,奥巴马在几个关键的摇摆州获得的选票还是高于罗姆尼。美国选民在两种风格明显迥异的国家发展愿景中做出了自己的决定。
无人驾驶汽车是当下炒作得最火的行业,这类汽车的倡导者已成为冗词赘语的世界级领军人物。埃隆?马斯克(Elon Musk)自称“要在一个安全系数超出人工驾驶数量级倍数的一体化平台上专注于全自动驾驶的实现”。(就是说特斯拉肯定能防止车祸的发生)。
多措并举降成本。
1896年,美国首任总统的夫人玛莎·华盛顿的画像印在一美元银圆券上,此后美元纸币上再没有出现过女性画像。
《美国队长3:内战》将于2016年5月6日在各大影院上映。美国队长与钢铁侠开战,你支持谁?
遗憾的是,随着乌拉圭在当地时间周六(6月28日)被哥伦比亚淘汰出局,本届世界杯决赛将不再是巴西和乌拉圭之间的再次对话。如果巴西杀入7月13日的决赛,对手将可能是墨西哥、荷兰、哥斯达黎加、希腊、美国、比利时、阿根廷和瑞士中的一支(译注:1/8决赛中,墨西哥与希腊分别不敌荷兰与哥斯达黎加,憾别世界杯)。


The company realised that "it was all a mistake and that he did it without thinking," a Google spokeswoman said last Wednesday.
源于pose摆姿势
demo人民+-ic…的→民主的,民主主义的;民主政体的


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

When things do go wrong, Mr Cook takes swift and merciless action. In late 2012, after the premature launch of Apple’s flawed Maps app, he dismissed Scott Forstall, who led the creation of iOS and was a close ally of Jobs, and John Browett, the former Dixons chief who had led Apple retail for less than a year. The actions sent a message that Mr Cook will not tolerate underperformance or internal politics.
impresar,意大利语,意为管理+o表名词,“人,物或状态”→(娱乐圈的)经理人
“‘降温’措施(是)影响香港(住宅)地产市场的最重要问题,”莱坊估价主管林浩文(Thomas Lam)说,“这正是过去两三年里所有大型机构的方案都在关注写字楼市场的原因。”
源于:strike(v 打击;军事进攻;铸造;敲钟;罢工)

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. 

IMD participants praised the way their training pushed them out of their comfort zones and also the one-on-one coaching sessions tailored to their individual business situations. “It was an eye opener about what a good leader is,” commented one participant. “We learnt about ourselves first, what drives us and why, in order to manage others.”

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. 

My arms are wide open for you this New Year.我张开双臂,盼与你共度新春佳节。
加强产权保护制度建设。

11月份以人民币计算的出口也同样上升了,同比上升5.9%。不过,若以美元计算,同比增幅则只有0.1%,达到1968亿美元。不过,这仍然大大超过了下滑5%的预期。在之前的10月份,出口同比跌幅曾为7.3%,跌势有所缓和。
The office predicts the number of football schools will increase to 20,000 this year and reach 50,000 by 2025.
We learned that animals may make choices based on aesthetics.
6. Ipoh, Malaysia-Around 200 kilometers north of Kuala Lumpur, the former British colonial city is now a foodie destination, where local street food and boutique cafes around.
v. 借,供应货款,
Stripping out price, volumes of Chinese imports in October fell a more modest 2.6 per cent from a year earlier, according to estimates from Oxford Economics.

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.


商品房待售面积7亿平米攀新高 各地开药方去库存


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.


上个月,中国贸易顺差增至4962亿元人民币,高于去年12月的3821亿元人民币。经济学家曾预计该数据将略高于3890亿元人民币。以美元计,该月中国贸易顺差从去年12月的600.9亿美元增至632.9亿美元,也超过了606亿美元的预期。
拿比利时来说,理由更为显而易见。该国人口主要由弗拉芒人、瓦隆人和日耳曼人组成,但国家足球队中却有数名非洲裔球星。目前,摩洛哥裔比利时人,包括中场费莱尼和边锋查德利——组成了最大的非欧洲小团体。就像法国队内有北非和加勒比小分队、德国队中有土耳其裔球员一样,比利时国家队也从多元人口结构中受益:一个来自西欧,一个来自非洲,还有一个来自东欧。
This list is composed of—The strongest, intelligent, desirable, popular, attractive, beautiful, successful women in 2015.
詹妮弗劳伦斯也凭借她在《奋斗的乔伊》中的表演喜获最佳女主角奖项。
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美国则在2016年下降为德国的第三大贸易伙伴。
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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:
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据当地媒体报道,这一犯罪团伙设在广西壮族自治区首府南宁,他们向腐肉中注射化学药品,使其增重50%,这样每吨腐肉便可获利16000元人民币(合1750英镑)。
Song “The Sacred Land” (Sun Nan)
East Asia's cinephiles won't have a local favorite to cheer during this year's foreign-language Academy Awards race after the Taiwan epic 'Warr
avail效用。参:availability(n 可用性,实用性)

“Insead enormously boosted our intercultural experience,” said one alumni survey respondent from Switzerland. “It is a place to learn global culture better than anywhere else.”

  • Only the first three authors are listed, followed by "et al."
  • 楼盘摇号名单半数是企业 五城出台措施限制企业买房
  • 高校毕业生租房需慎签合同分清“订金”与“定金”


6.I’m 29. – Because 29 is like 20 years younger than 30.
中国领导人会刺激国有经济。资助更多的扩张性增长项目,比如用以支持城镇化发展的基础建设的投资,包括大量的房屋、学校、公路等方面的建设。

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