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

节目32 歌曲《给我你的爱》,张杰 林宥嘉
科学家周日表示,2013年,全球温室气体排放量增加了2.3%,达到历史新高。这个最新迹象表明,在控制全球变暖方面,国际社会的努力仍远远不够。
赖特是英国浪漫主义画派的鼻祖之一。这幅作品从1840年起一直由德比郡的一个家族私藏。考虑到目前的行情,它的最低估价仅为10万英镑,还有一个重要因素是它的拍卖款将用于救济叙利亚难民。结果,至少有三位竞拍人把价格推高至66.5万英镑(含佣金)。
Coke's Kent is not the only chief executive who spoke out in 2013 about the merits of immigration reform for big business.
请接受我们对你及你全家的美好祝福,祝你们新年快乐。
与此同时,中国首富王健林等人士对中国国有企业在欧洲投资的事情表示担忧,声称它们缺乏国际管理标准。
麻省理工学院(MIT)最近发表了一份白皮书。虽然该报告的题目听起来不免有些不吉利——《你是否已为供应链人才危机做好准备?》(Are You Prepared for the Supply Chain Talent Crisis?),却一语中的。这项研究表明,供应链经理需要掌握先进的技术技能,同时还得具备“高度的外交手腕”,精通总体业务战略,能娴熟地解决各类问题,要能在混沌状态中求生存。
根据公安部的声明,自2015年9月以来,我国在放宽外国人居留、入境政策方面取得了巨大进步,帮助吸引了更多海外人才、促进了国际交流和经济发展。
A major disruption still could push oil higher, but potential oversupply makes even that less likely. Emerging-market demand once kept supply so tight that any disruptions led to striking price moves, said Ole Hansen, head of commodity strategy at Saxo Bank.
“The steady and now record-breaking rise in average global temperatures is not an issue for another day,” Michael R. Bloomberg, the former New York mayor who is spending tens of millions of dollars of his personal fortune to battle climate change, said in a statement. “It’s a clear and present danger that poses major economic, health, environmental and geopolitical risks.”
在1991年至2010年之间,癌症死亡率显著下降了20%,这比过去十年下降总和的10%还要多。总有一天,我们会跟癌症说再见。
单词entertainment 联想记忆:
A shortage of qualified supply chain managers right now, especially in global companies that must coordinate far-flung operations, can be traced to two factors.
约60%的学员尚未参加工作,另有30%的学员拥有不到两年的工作经验。
May the season\'s joy fill you all the year round.
整形美容长期以来一直在美国盛行,而如今这个潮流正席卷亚洲。
Erle Spratt, who manages M&G’s Asia property fund, an open-ended investment vehicle, says it is risky to invest directly because assets are not easy to find and price. “It is a very difficult market to buy assets in for investors like us, because developers have very substantial holdings and they tend not to sell,” he says.
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。
With the momentum now back behind the iPhone and anticipation growing for the Watch, Mr Cook seems to have won back the confidence of Apple employees, something that analysts say was obvious in his demeanour at this year’s product launches.
The public prosecutor has decided to release several individuals and will proceed with the prosecution of at least five others.
At the time of the third presidential debate in October both candidates churlishly refused to greet or bid farewell to the other in the custom of the handshake.
But Mr Stevenson said “this might reflect that the US is being bolder than the EU in protecting domestic steel producers”.
Similarly, Katy Perry was initially granted a visa to perform at the show in Shanghai but Chinese officials soon changed their mind. This, it has been claimed, is because the singer carried a Taiwanese flag and wore a dress covered in sunflowers during a 2015 concert in Taiwan.
China’s handling of its state reserves of raw materials such as cotton and sugar will be a key factor shaping the direction of agricultural commodities in 2017, according to a major lender to agribusinesses.
“中国银行业面临的逆风将延续很长时间,”他说。“除了盈利来源减少,它们还将不得不为坏账带来的亏损做好准备。”


荷兰合作银行是面向全球农户和农业企业的领先融资机构。
玛戈特·瓦尔斯特伦在20多岁时结束了一段充满暴力的感情。作为外交部长,她正在一个传统上属于男性的领域里挑战各种假定。
INDOORS: The two-story stucco contemporary was built in 2005. The interior is an airy open space; white walls contrast with red tile floors. Walls of sliding glass doors face live oaks and marshland on the Wilmington River.


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

3. Jia Junpeng, your mom wants you to go home for dinner.”
Google's brand is now worth more than 109 billion U.S. dollars, around 2 billion dollars more than Apple, making it the most lucrative in the world.
吉尔伯特表示,对可穿戴设备的不断试验十分重要,但是现在短期内,人们还需要探讨一下:“技术的演进以及企业的研发力量共同推动了现有可穿戴产品的发展,但它们是否真的能够满足用户的需求;各公司又是否需要探索不同的合作模式,让可穿戴设备不仅限于早期使用者的圈子,而是被主流人群所接受”。
北弗罗里达大学的一个有趣的实验证明光脚跑步比穿鞋跑步更能提高记忆力。和那些在实验室和室内坐在桌子边进行的试验不同,在这个实验中,研究人员们引入了一些有趣的观点来探索提高记忆力的奥秘。实验的研究对象为“工作记忆”,即人们加工信息和回顾生活细节的能力。科学家们发现,光脚跑步比起穿鞋跑步来说,可以对记忆力产生轻微的提高。在试验中,年龄为18-44周岁的参与者们被要求跑两轮,一次穿鞋,一次不穿鞋。

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. 

中国政府鼓励向中小规模的借款人放贷,其中很多贷款者没有信用纪录。分析师预计,在金融上表现活跃但没有信贷渠道的中国消费者有5亿之多。

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. 

['traigl]
China’s trade surplus grew to Rmb496.2bn last month from Rmb382.1bn in December. Economists expected it to inch higher to Rmb389bn. In dollar terms, China’s trade surplus rose to $63.29bn from $60.09 in December and versus expectations of $60.6bn.

6. The 2012 Ig Nobel Prize for Literature
来源:前十网
4.Noses That Smell Diseases
experienced
2015年末,中国银行业不良贷款率从1.25%升至1.67%,商业银行所持不良贷款额达到1.27万亿元人民币。
住在气球发射场附近的边境民众投诉活动分子将他们的生命置于危险之中,因为他们是北韩反击的潜在受害者。

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.


城市落户政策再松绑,一策多利值得期待


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.


“我亲眼见到一个女人死了,并且我看到美国总统拒绝明确谴责杀害她的人。”
Wang Chunfa, executive secretary of the China Association for Science and Technology, has expressed deep concern over the retraction, which came just days after he met in Beijing with Arnout Jacobs, the head of Springer Nature for Greater China.
让自己坐的舒适。在弄了这么多之后,最重要的一点是要让自己感觉到很舒适。
While French and Spanish institutions dominate the top of the pre-experience ranking, UK business schools are the real powerhouses in this category accounting for 17 schools out of 50, ahead of the US (eight) and France (six). Two UK institutions, LBS and Judge Business School at the University of Cambridge, top the post-experience ranking.
Based on the children's books that goes by the same name, this movie follows the adventures of Mowgli through the Jungle as he tries to discover himself. He comes across several creatures in the Jungle, played by various actors, who make his journey difficult.
但是,当今年12月WTO成员国聚集在布宜诺斯艾利斯召开两年一度的部长级会议时,我们将一尝世界新秩序的味道。一如既往的是,目前尚不清楚WTO此次能否产生一些实质性内容。但真正的考验在于,WTO有史以来第一次不由美国牵头讨论。中国或欧盟会取而代之吗?印度会像过去一样一心阻挠任何协议吗?
8.软件工程师
200亿美元的数额会让任何一位投资垂涎,但这笔钱需要在回购和派息之间进行分配。与2014年其他公司宣布的股票回购相比,这笔钱只能算是零花钱。
“阅后即焚”社交网络的兴起
迷你剧集/电影类最佳男配角:斯特林?K?布朗(Sterling K Brown),《美国罪案故事:公诉辛普森》(The People v. O. J. Simpson: American Crime Story)

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 当大脑没有得到充分休眠时,它确实就开始自噬了。在我们睡觉的时候,“清除”程序通常就会启动,但长期缺乏睡眠会使该程序处于高速运转状态,促使大脑清除大量神经元连接和突触连接。 to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

这位名叫波比·博伊登的小选美冠军穿着一身黑色的连衣裤,带着鬈曲的假发,非常熟练的跳着扭臀舞,向观众们飞吻。
这表明,一般而言,大学教育从长期看来收益良多。
收集了一些明星们挑选南瓜的相片。看看这些照片,然后告诉我们:你准备好庆祝周三的万圣节了吗
3. Portugal is entirely powered by renewable energy for four days

Rankings for Greece, Italy, Portugal and Spain fell dramatically because of the impact of the eurozone crisis, while Egypt, Myanmar and Saudi Arabia registered large falls in the wake of recent political and civil turmoil.

  • Only the first three authors are listed, followed by "et al."
  • 冰封的二手房:成交低迷、价格回落、持续低温
  • 房贷利率降息 一月月供会因分段计息不降反升


move动+ment表名词,“行为或结果”→运动
2. Marc Faber's Doomsday warning on Bernanke's disastrous QE scheme

BCMJ Guidelines for Authors

Leave a Reply