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

shoulder
adv. 未料到地,意外地
《纽约时报》记者詹姆斯?格尔曼追踪报道了一群科学家,他们试图找到将狼与狗区分开来的基因。为了进行科学研究,饲养小狼崽的人必须每周7天、每天24小时和它们在一起,使它们能够适应社会化,以便进行科学研究。尽管这些幼崽看起来很可爱,它们最终还是会成长为掠食性的狼,而不是人类的忠实伙伴。研究人员希望他们的工作将有助于揭示,究竟是什么因素在历史上让一部分狼演化成人类熟悉的狗。
10Norway
如果上述情况都变成现实,休伯蒂估计苹果在中国智能手机市场上已跌至10%的份额将会提高三倍,达到近30%。
n. 图形,数字,形状; 人物,外形,体型
美国太空探索技术公司在航天器充分回收方面取得重大进展
The number of inbound travelers to Beijing grew after the city hosted the 2008 Olympics until 2012, when it saw a 3.8% decline, followed by the further drop last year.
The cities of Hefei and Xiamen once again led the pack with growth of 48.6 per cent and 45.9 per cent, respectively.
His footballing rival Lionel Messi - who the 31-year-old beat to be crowned the World Player of the Year in January - was second on the list, taking home pound 56 million in 2015/16.
BEIJING: A group of Hyundai Motor Co dealers in China is seeking 800 million-900 million yuan ($120 million-135 million) in compensation from the South Korean automaker, saying Hyundai has cut the flow of models it exports to them, resulting in dealership losses and closures.
!ku79.)#gCKfe
Wages will finally accelerate after years of stagnation
Cambridge Judge Business School also ends the year on a high, appearing for the first time in the rankings for both open and custom executive education, and climbing three places in the MBA ranking and 12 places in the Executive MBA table.
定义自己
In 2013, the yen fell 21% against the U.S. dollar, helping it to attract 10 million overseas tourists--including, despite Sino-Japanese border disputes in the East China Sea, many wealthy travelers from China.
6. “Taxi”(Jafar Panahi)
与比利时接壤的法国已经有大量志愿者出国加入伊斯兰国圣战组织,这个组织占领了伊拉克和叙利亚的大片区域。
5.Create a Study Space
The global battle for the living room continued in Germany with Sony announcing it 2has sold 10 million PlayStation 4s worldwide. To keep that momentum going, Sony announced a number of exclusive new titles at the show, including the action game Hellblade from developer Ninja Theory, the open world adventure game Wild from Rayman creator Michel Ancel, the shooter Alienation from Housemarque, and Q Games genre-bending The Tomorrow Children. Microsoft announced that Square Enix and Crystal Dynamics Rise of the Tomb Raider, the second game in the rebooted Lara Croft franchise, will be an Xbox exclusive in 2015. Xbox will also be getting another big sequel next year with Halo 5: Guardians.
The prices are tough for ordinary Brazilians to afford. The minimum wage in the country is $330 a month, just about what Ferreira said she earns.
Two terrifically entertaining, ensemble-driven, fact-based procedurals about appalling crimes and the institutions — the Roman Catholic Church and Wall Street banks — that allowed corruption to fester. In addition to mustering righteous anger, Mr. McCarthy and Mr. McKay, in very different ways, managed to infuse the routines of modern work (answering phones, typing on keyboards, scrutinizing spreadsheets) with suspense, emotion and moral gravity.
Sales of counterfeit products represent nearly 45% of those cases, 18.2% higher than last year. Bad feedback from consumers, frequent returns of goods, and complaints have been plenty. Some sellers use unreal low price as a business trap to promote their products.
pro在前面+tect盖上+ion→保护
喜剧类最佳女配角:凯特?麦金侬(Kate McKinnon),《周六夜现场》(Saturday Night Live)


“即便人们充分了解了(美联储政策的作用),市场动态也可能相对容易地变得不稳定或不利,”他说,“届时你将陷入一个卖盘压力自我强化的循环。”
Never accept the job immediately. Say you need to think about it overnight. Once you sign on the dotted line there's no room for negotiation.
巴韦贾对全球化不断变化的性质的深度分析显示,全球贸易增长疲软背后的主要因素是投资减速。全球贸易增速曾在很长一段时间内是全球GDP增速的两倍。


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

[?'veil?bl]
"They say: 'I wonder why she kept her head down in the meeting; I wonder why she's not eager to take over that project; I wonder why she's leaving early a couple days a week," Kay says. "You're planting questions in their head."
We will promote a steady increase in consumer spending.
4. We were wrong - the testes are connected to the immune system after all. Researchers have discovered a "very small door" that allows the testes to send one-way signals to the immune system, and it could explain why some men struggle with infertility, and why certain cancer vaccines keep failing.

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. 

3. “Bridge of Spies” Years ago, Steven Spielberg entered the ranks of Pantheon Directors, to borrow the most exalted category in Andrew Sarris’s taxonomic “The American Cinema” — and there he remains.

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. 

Confidence and a good elevator speech can take any pitch to the next level. The first marketing any company experiences comes from its founder. Spend time learning how to share your vision without coming across as “salesy.” Don’t be afraid to ask for the sale, but remember: the client is always the focus.
Tsinghua University holds the No. 1 spot in both computer science and engineering. The Chinese institution overtook MIT for the top computer science rank this year.

所有外出务工人员的年收入据估计达到了3万亿美元,然而大约有85%仍留在雇主国,他们汇款回家的钱,平均不到雇主国GDP的百分之一。
揭露好莱坞流氓的女星发起了MeToo行动,意在揭露高层性侵女性事件,表示性侵者都是“失败者”。
授完奖,在他致谢他的粉丝和MTV之前,他兴奋地说到”首先,我想说我不确定我怎么能得到这个奖,因为我已经好几年没有出过唱片了,但是我得奖了。”另外,Kendrick Lamar获得了最佳录影带奖,尽管这位说唱歌手无法到场,而是他通过视频感谢了他的粉丝。
0=false
汽车销量:2015年,汽车销量将达到1700万辆,但随着皮卡和SUV的走俏,各大厂商也会纷纷调整产能。低油价的压力将导致小型车的利润更加单薄。
最近几个月,大宗商品相关行业受到的冲击尤为严重。采矿业全年利润下降23%。石油和石化炼制企业的利润也出现下滑。尽管油价下跌,但很多炼厂仍要接受在油价暴跌之前签订的协议价格,而它们的出厂价格在下跌。

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.


经济观察:中国房地产行业“动荡”开始?


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.


调查显示,75%的顾客都知道可穿戴技术(无论是作为前卫的时尚潮流,还是新时代的技术工具),但是只有9%的顾客有兴趣使用它们。根据调查,仅有2%的人表示自己拥有可穿戴设备,其中大部分都是健身追踪器或智能手表。
To wish you joy at this holy season. Wishing every happiness will always be with you.
美国就业市场笼罩着重重阴云──特别是遭遇增税、减支双重打击的可能性,即“财政悬崖”。[qh]
The Canadian city of Vancouver remains the most expensive location in North America, ranked 21st in the index.
The Sports Illustrated Swimsuit Issue model Kate Upton stands 8th on the world's most beautiful women of 2015 list. This modern fashion model was at No. 2 in last year list. She also was named the sexiest women by People magazine.
达奇斯说:年底iphone5和迷你ipad的发布,消除了海内外制造业和乔布斯死后遗留影响的争议,这使得苹果成为年度最大的赢家。
“If lenders are too optimistic during market booms and too pessimistic in downturns, that could be a good reason for authorities to set conservative capital requirements,” he suggests. “Higher haircuts might dampen the initial run-ups, but they could also dampen the subsequent fallouts when tides turn.”
Denmark, for instance, is 88 percent white Danish today — hardly a majority in jeopardy. But a generation ago, in 1980, it was 97 percent white. The anti-immigrant Danish People’s Party is now the second-largest party in the Danish Parliament. In Germany, where the foreign-born population shot up by approximately 75 percent between 2011 and 2015, the anti-immigrant, populist Alternative for Germany party is now drawing record support.
Producer prices, which are often regarded as a proxy for medium-term inflation, remained in negative territory, but the pace of decline improved.
Data released by the UK National Health Service last year on patient admissions revealed an alarming rise in various nutritional and communicable diseases in the past decade.

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 为什么会有这样的不同?原因并不是因为双方获得的信息不同。正如库迪斯和沃斯所指,荷兰金融圈里的每个人都知道和了解所发生事件的严重程度。也不是因为Seppenwolde的贷款机构不得不重建自身财务。违约几周后,贷款机构就知道他们没有损失一毛钱。 to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

《巴克斯托姆》(Backstrom),Fox,1月22日播出。去年,福克斯推出根据一部澳大利亚电视剧《法庭浪子》(Rake),由格雷格·金尼尔(Greg Kinnear)主演,讲述一个自毁律师的故事。那部剧没成功,但现在Fox又试着推出了一部根据瑞典系列小说改编的自毁侦探的故事,由《办公室》(The Office)男星雷恩·威尔森(Rainn Wilson)主演。这部剧由Fox的系列剧《识骨寻踪》(Bones)的编剧哈特·汉森(Hart Hanson)主创,但在试播集里,威尔森饰演的巴克斯托姆看上去更像豪斯医生(House),而不像《识骨寻踪》里的角色。
在讲故事的时候,历史片和故事片各有所长,不过,时不时也会出现无法归入其中任何一类的电影。这些故事十分离奇,但字里行间又透着现实。这些电影非常有趣,观众却常常完全不知道,他们正在看的情节真的发生过。好啦,别猜了!读下去,你就能认识几个好莱坞的古怪剧本,都是受到狗血现实生活的启发。
“These students have absolutely no free speech rights that were violated in this context."
自1983年以来,每年的央视春晚就成为了中国人民春节必不可少的重要组成部分,也难怪主办方的每个举动都能成为关注的焦点。

这意味着投资者正为特斯拉的未来前景投下重注,出价要远远高于对其他豪车厂商实际表现的评估。梅塞德斯-奔驰(Mercedes-Benz)的制造商戴姆勒(Daimler)去年售出了超过250万辆车,市值约为850亿美元。所以,尽管戴姆勒的销量是特斯拉的70多倍,但它的市值还不到特斯拉的3倍。

  • Only the first three authors are listed, followed by "et al."
  • 全国二手房市场全面回暖 开发商开始布局二三线
  • 家装行业发布发展报告 整装卫浴将大显身手


但是Gitanjali的便携发明,可以通过一个与手机app连接的传感器,就得出一个确切、及时的分析。
Inside Obama's Chicago campaign headquarters, staffers erupted into cheers and high fives as state after state was called for the president。

BCMJ Guidelines for Authors

Leave a Reply