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

Issue: BCMJ, 尽管销量大幅增长让人欢欣雀跃,但它并不是汽车业今年最重大的新闻。底特律先是因为通用汽车公司(General Motors)提拔玛丽?芭拉出任汽车业首位女性首席执行官而欢欣鼓舞;紧接着,福特汽车(Ford)首席执行官艾伦?穆拉利在重回波音公司还是加入微软公司(Microsoft)两者间犹豫不决之际,它又紧张得大气都不敢喘。传统的三巨头抱怨现有产能已挖掘到极限,开始制订扩张和聘用新人的计划。特斯拉公司(Tesla)让电动汽车的销量火了一把,而且不肯按行规出牌;而同时谷歌公司(Google)则在自动汽车研制上一马当先。
One of the most discussed potential use cases of the block chain is as a decentralized Uber. Instead of using an app, customers could order a car and pay the driver directly, cutting out the middleman. (Sorry, Travis Kalanick.) The block chain can be utilized for everything from the storage of secure documents (that is, a decentralized Dropbox, too) to “watermarking,” in which a specific coin could contain, say, the deed to your house. “The block chain is going to spawn decades of innovation,” says Ryan Selkis, director of investments at the Digital Currency Group, created by former SecondMarket founder Barry Silbert. “It could lead to things like frictionless share issuance, title transfers, smart contracts. Collectively these things make up the backbone of the economy. If you wanted to create a decentralized Uber, Dropbox, Facebook, you could reinvent the Internet.”
Pages 503-506 Clinical Articles

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。
同期,巴西和俄罗斯分别减持到2617亿美元和1089亿美元。
达洛伊西奥也尽力维持着生活原本的样子。他的女友还是之前的那个女友。而且尽管他不再去学校了──坐在教室里就没空监管Summly的研发──他还是照常去找老师拿作业。他十分庆幸他的朋友不了解他企业家的那一面。而当我采访他的时候,他正准备和一群高中死党去希腊玩上一周。
Heatwaves around the world, including one in India that led to more than 2,000 deaths and another in Iraq that saw the mercury top 50C, helped push temperatures 1C above pre-industrial levels for the first time, US and UK researchers said.
The Chinese mainland had a population of 1.37 billion, an increase of 33.77 million people over the census taken in 2010, meaning the annual growth rate was 0.5 percent.
When Beatty and Dunaway took the stage to announce the Best Picture award, Cullinan and Ruiz realized that they still had two best picture envelopes, meaning that the envelope taken on stage was a duplicate for an award that had already been announced.
目前,大部分围绕比特币的活动都是货币性的,因此,批评者指向其波动性也合乎情理。blockchain.info网站上的市场价格走势图显示,尽管以美元衡量的比特币价值在过去一年缩水了67%,其价值在过去两年则飙升了1879%。因此,投资比特币是好是坏,取决于你的视角。
With an increase of 7 percent over 2013,total spending on medicines will amount to $1.06trillion in 2014, says the report"The Global Use of Medicines: Outlook through2018" from the IMS Institute for Healthcare Informatics, releasedThursday.
ad+(mini小+ster→小人→古代大臣称自己是“小人”→部长,大臣)→做部长→管理,治理+ation→行政,管理
所有这些合数值都比去年同期高,其中市场价值增幅最大(比去年同期增长13%)。这些公司在全球总共雇用了9000万人。
7. 建立声誉。
骑行背带是专为小宝宝设计的,以减轻家长的负担。
Some of these people have instead reached for issues that feel close to their concerns: trade, crime, the war on drugs, controlling the borders, fear of Islamist terrorism. All are significant in their own right, and create very real fears for many people, but they have also become a means to have a public conversation about what society’s changes mean for white majorities.
The impact will also ripple out to some net commodity importers, Mr Williams believes, with higher commodity prices likely to boost the price of resource-intensive manufactured goods such as steel, bolstering the value of exports from the like of South Korea.
adj. 令人厌烦的
Former Disney star-turned-wild child singer Miley Cyrus followed as the number two 'celeb gone good', according to the website. Father-to-be Channing Tatum came in third.
After enjoying a weekend of football in Manchester, David Beckham quickly jetted across the Pond to New York last night to spend Valentine’s Day with his p
You see all kinds of grisly, hairy characters on the Tube but few commuters would've expected to see a pack of pandas on the platform.
The U.S. Congress and the media will go berserk when Goldman announces the size of its 2009 bonus pool. But the outrage will be brief and of little lasting consequence. The 'hate Goldman Sachs' story has been running just too long.
3. Smart laundry peg
另外上榜的有Pink,勒布朗詹姆斯,赛琳娜戈麦斯,伊恩萨默海尔德,Jay-Z和碧昂丝夫妇,本阿弗莱克等明星。
新年可能平淡开场。但在中国不是这样,2016年中国股市的开局相当刺激,交易员们简直要窒息在泡沫中:周一沪市下跌7%,深市跌幅超过了8%。情况本来可能会更糟糕。一项在沪深300指数下跌7%时暂停交易的新机制让这场大戏提早落幕——就这次的情况而言,是提早了一个半小时。
小女孩名叫Neshama Spielman,来自耶路撒冷。她是4年前在“圣殿山筛选项目”中发现这个护符的。该项目旨在检查从神圣犹太教遗址移来,未经考古检测过的泥土。当年,Spielman只有8岁。
除了跳舞,玛蒂还唱歌和表演,她已经出演了电视剧《美女上错身》(Drop Dead Diva)和《奥斯汀与艾丽》(Austin & Ally)。
calculation


7.Taylor Swift
transport(n /v 运输;狂喜),trans转移,port搬运
Attraction: The adventure of a lifetime


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

翻译:译言网虽然面临全球经济衰退,但你依然能看到生生不息的Chanel,“我们依然非常赚钱,”Karl Lagerfeld坚定地说,他犀利的目光从墨镜后透射出来,好像这个事实就像埃
The government is keen to encourage lending to small and medium-sized borrowers, many of whom do not have credit histories. Analysts estimate the number of Chinese consumers who are financially active but without access to credit to be 500m.
到了20世纪下半叶,随着歧视逐渐减少(比如在大学入学方面),白人的正式特权地位也在渐渐丧失。但是工资的增长、社会安全网的扩大以及新的受教育机会有助于弥补他们的损失。大多数成年白人都比父母更富裕、更成功,他们相信子女们会过得更好。
波多黎各人自前任总督的过去4年受到了几十项新税收的影响,还增加了水电费。加西亚·帕迪利亚设法为政府创造更多的收入,他说资金正在用尽。尽管有某些和那些措施,岛上政府已经违约上百万美元的债券付款,数个机构宣布进入紧急状态。

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. 

After Peking University, known as Bei Da, and Tsinghua University, the next highest-placed Chinese university is the University of Science and Technology of China at 15, Fudan University at 16, Shanghai Jiao Tong University at 18 and Zhejiang University at 19 in the top 20.

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. 

持续推进大众创业、万众创新。
对民主主义者而言,此类原始情绪的爆发之所以令人担忧是因为它们很难遏制。

中国旅游研究院的蒋依依建议,中国政府应实行一项长期的国家计划,以提升国家形象并投资于入境旅游以吸引更多游客前来。
It adds up to a pointed reminder that Her Royal Swiftness can reclaim her place at pop's cutting edge whenever she feels like it.
《橘色》,导演:肖恩·贝克(Sean Baker)。
n. 复合体
"Twenty Two" featuring the tales of 22 comfort women became the first Chinese documentary to surpass 100 million yuan at the box office.
报告称,去年销售的手机大部分是预装安卓系统和支持4G的智能手机。

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.


8月家居建材销售额环比上涨 积极因素叠加


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.


n. 补给,供给,供应,贮备
显然相信“更长时间保持较低位”如今意味着“永远保持较低位”的投资者,最近几周已经涌向新兴市场资产。
[pr?'tekn]
但是,贝克?麦坚时律所并购业务主席迈克尔?德佛朗哥(Michael DeFranco)对中国企业在发达经济体投资表示赞赏。
n. 土耳其
在假日期间飞行要采取特殊的策略。这也意味着人们要为重大天气延误做好准备,尤其是美国东北部和中西部的恶劣天气。
And among the GII 2016 leaders, four economies — Japan, the US, the UK, and Germany— stand out in innovation quality.
1. “Timbuktu”(Abderrahmane Sissako)
"People should just never walk away and leave their animals," Ms Lewis said. "Everyone has a legal obligation to look after animals in their care."
达洛伊西奥也尽力维持着生活原本的样子。他的女友还是之前的那个女友。而且尽管他不再去学校了──坐在教室里就没空监管Summly的研发──他还是照常去找老师拿作业。他十分庆幸他的朋友不了解他企业家的那一面。而当我采访他的时候,他正准备和一群高中死党去希腊玩上一周。

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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May the season\'s joy fill you all the year round.
You’re a busy person. At times, it all can feel overwhelming. Asana is a cloud-based project management software that helps you keep it together. (Trust me, I’ve tried them all.) Flexibility is built into Asana’s architecture. Each “task”, or “subtask”, can be associated with a larger “project” and “department.” In addition, you can even assign recurring tasks to yourself or team, which makes life so much easier. Stop trying to remember all the things you’re supposed to do and let Asana structure your life.
Kunis was No. 9 on FHM's list last year.
Bigcommerce在年销售额100万到200万美元的小零售商中大受欢迎。如今年销售额2,000万到3,000万美元的零售商群体也在迅速加入Bigcommerce。它大约70%的现有客户同时拥有线下实体店。过去一年,Bigcommerce大力开发可同时应用于移动平台和桌面电脑的自适应店铺模板(Bigcommerce认为,设计是小型电子商户的头等考量),并积极拓展“相邻”云服务的合作伙伴关系,比如会计、支付、客户关系管理和薪酬管理领域。

v. 从事运

  • Only the first three authors are listed, followed by "et al."
  • 北京住建委副主任:自住房没人买就得降价销售
  • 政府补贴正日渐退出 LED照明行业面临四大变化


adv. 有意地,故意地
Rose Wang

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