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

But that moment, try as Google might, has yet to come. Some reports have named 2014 as the year when wearable devices will hit the mainstream, but a newer study from L2, a digital research firm, confirms what many have been quietly fighting for: wearables are still not socially acceptable, creating a significant hurdle to further sales.
一位来自美国佛罗里达州的少女引起了世人的惊叹,因为她长得酷肖迪士尼动画电影《冰雪奇缘》中的艾丽莎女王。
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。
After an investigation, Rongchang police arrested Zhou on April 29 for endangering public security, according to the Chongqing Morning Post.
不久后,拉塞尔爱上了一名叫菲利普·莫里斯的狱友。莫里斯出狱后,拉塞尔通过给职员办公室打电话再次越狱,还假冒法官,大幅降低了自己的保释金。为了和莫里斯在一起,他又被捕和逃脱了两次,一度假装自己已经离世。他现在被判终身监禁,但表示看到自己的电影形象很激动。
15. An Amazing Coincidence One of the studios with the most on-screen diversity — it released “Trainwreck” and “Straight Outta Compton” (if also “Ted 2”) — and with the most female directors is Universal, which, as of early December, had gobbled up almost 24 percent of the year’s market share.
4. Con Dao Isalsnd, Vietnam-Once the site of the infamous Con Dao prison, Vietnam's isolated archipelago of 16 islands known as the Con Dao Islands is starting to become known for its scenery and fresh seafood.
The report found that students majoring in art, agriculture and engineering were more willing to start businesses, while those majoring in history and science showed relatively low interest.
这张专辑贯穿了新浪潮音乐、电子舞曲和流行舞曲,是清新悦耳又充满乐趣的流行音乐珍品。
Targeted poverty alleviation
Given a choice, Chinese university graduates prefer to find employment rather than start a company.
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。
在这个风云变幻的世界,詹姆斯·邦德俘获了不少铁杆粉丝,是至今为数不多的仍在续拍的电影之一。在人们的意识里,无论发生什么事情,新的007电影依然会拍下去。
The valuation that all this good news is creating for Tesla is truly astonishing. A Tesla watcher named Zoltan Ban, writing in Seeking Alpha, figures that Tesla is already priced as if it sells several hundred thousand cars a year when in reality it will sell only about 35,000 in 2014. Another way of looking at this: At current prices, each car the company sells this year is valued at $1 million.
今年11月,我国网约车司机将须通过考试获得从业资格证。
珍妮·德文表示,“这并不是借口——这是我们经营环境的现实情况。”2012年以来,捷蓝航空公司实施了一系列技术手段,帮助该公司尽快恢复正常,摆脱恶劣天气的影响。她表示,正在使用其他手段来帮助航空公司保证航班准时起降。
Once you grow your hair slightly longish, be sure to play with it at every opportunity.
该榜单囊括了2015年度全球最具影响力、最智慧性感、人气最高、事业最为成功的美丽女性。
但“平均”讲的是以前的情况,不是未来的事实。乐观言论不会让牛市重启,新的警告声音也不会刺破旧的泡沫。周期有自己的生命,该上行的时候上行,该下行的时候下行。这是很自然的事情。
夏奇拉
2. 2012年搞笑诺贝尔奖之和平奖
n. 名人,名誉,社会名流
米尔斯在接受《每日邮报》采访中说,“《老友记》的核心是关于人要如何生活,他们想要怎样的友谊,找一份怎样的工作,以及寻找安定的不易。这些问题都是你在离开家、成长为大人、实现梦想之时所面临的。”而这也是90年代青春文化的主要内容。
如果答案是“是”,那么也许你是D型人格的人。
The Chinese comedy Never Say Die has brought in an impressive $326 million worldwide to date.


“我不知道发生了什么”洛瑞说。“我只知道我被吹罚了一次进攻犯规,就这么发生了。这就是NBA,这就是我想说的。”
“我才17岁——我想留在家人和朋友身边,继续上学,”他说,“在可以预见的未来里,我将留在伦敦。”
经理们在公司会管理等级制度上低于他们的人,但是优秀的经理也有方法管理他们的上级和代表团队的同事。很多时候这意味着有效的交流,管理期望和及时寻求帮助。


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

CPI increase kept around 3 percent.
For all of these films, Ms. Swinton used the same tooth-designing specialist, Chris Lyons of the company Fangs F/X in London. His work has led him to designing all manner of teeth, including gold fangs fitted for a Doberman used in a Kanye West music video.
If 2017 was the year of fake news, 2018 is shaping up to be one of fake data. And just as fake news comes in many varieties — real news dubbed by the US president as fake, as well as nonsense gaining huge audiences on social media — so does fake data.
That an iPhone mini and a LTE license from the Chinese government this year or next could finally persuade China Mobile (CHL), with 700 million subscribers, to cut a deal with Apple.

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. 

Baby Driver recently placed on the National Board of Review’s Top 10 list. The film holds a 93% on Rotten Tomatoes and took in over $100 million dollars at the box office.

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. 

Even if Gibson turns out to be a rental and leaves as a free agent this summer, the Thunder will likely feel good about these trade terms.
他在一则电话采访中向汤森路透基金会透露:“外出打工应该只是一个选择。但是对于2亿人来说,却是没得选择的选择。”

"Students are not suited for starting businesses on their own," said Zhang, adding that vocational students are more eager to start businesses than university undergraduates.
这造成了一种有待填补的身份认同真空。
Sixty Vocab:
In the big closing session of the World Economic Forum in Davos, they recognised risks existed and badly run emerging markets might be vulnerable to shocks, but concluded that the outlook was brighter than it has been for many years.
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.
China's expenditure on technology research and development rose 10.6% to 1.57 trillion yuan in 2016, the fastest annual growth since 2014, as the nation increases its investment in new driving forces to stabilize the economy.

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.


北京市住建委:严打违法群租等违规行为


References

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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.


“我头发都白了,一半为了房价,一半为了(你们)记者。”
2.Show Up, Every Time
8. Sturgill Simpson “Metamodern Sounds in Country Music” (High Top Mountain) A throwback progressive hunkered down with a whip-smart band: country music has seen this before. But on his breakthrough second album, Sturgill Simpson made it a pliable trademark, grounded at every turn by his winning, seen-it-all baritone.
Ford's F-series pickup, the reigning champion for the last quarter-century, held off a strong challenge from Chevrolet's redesigned Silverado to remain the nation's No. 1 selling vehicle. The race to become the best-selling car, an all-Japanese final, belonged again to the Toyota (TM) Camry, which beat out the Honda (HMC) Accord.
We will ensure that foreign trade continues to pick up and register steady growth.
The same seven schools continue to dominate the top half of the ranking. AGSM at UNSW Business School of Australia entered the ranking for the first time in eighth position.
这一奖项于3月14日在阿姆斯特丹公布,是基于对全球上百万名旅客的调查而选出的。
《华胥引》的故事是这样的:卫国公主以身殉国,不久死而复生,从此她改名换姓开始了新的旅程。电视剧改编自唐七公子的同名网络小说,于2015年七月首播,主演林源、郑嘉颖。不过和同类剧集相比,《华胥引》的人气就没那么高了。据网上的评论说,这部戏的主角和服装都不够抓眼。
至于多元化,我乐观地认为,在某个时候,开明的年轻高管崛起将引发董事会突然转变态度。这种情况不会出现在2018年,尽管从科技到媒体行业的性骚扰丑闻所暴露的失衡和权力滥用问题,可能会加速这种变革。
n. 生存,幸存者

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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这个眼光长远的女孩也希望自己在网络上的知名度能够帮助自己跻身演绎界,为她谋取一个在美国广播公司制作的美剧《童话镇》中饰演艾丽莎一角的试镜机会。该剧将在下一季中加入艾丽莎这个角色。
For democrats, the outburst of such primal emotions is disturbing because they are so hard to contain.
眼下,这位大摩新掌门或许意识到了来自零售经纪业务的微薄盈利还不够华尔街薪酬的血盆大口塞牙缝。预计戈尔曼会决定最终要向交易商高盛(Goldman Sachs)看齐。
Neneh Cherry “Blank Project” (Smalltown Supersound)

《今日美国》(USA Today)说,对大多数城市来讲,就业复苏即使能实现,也得是在好几年过后。浏览知名分析师梅瑞迪斯?惠特尼(Meredith Whitney)新书《州的命运》(The Fate of States)时你会看到,她提醒说,“过多的养老金会挤出教育支出等自由派目标,也会挤出保守派希望实现的减税目标”。

  • Only the first three authors are listed, followed by "et al."
  • 湖南整治不动产登记窗口作风问题
  • 中国老龄人口已达2.5亿 当你老了,如何养老?


You qualify as a type D personality if you scored 10 or higher on both Negative Affectivity and Social Inhibition scales.
学会控制自己的情绪,控制自己的想法,克服对被拒绝的恐惧,学会向别人敞开心扉。

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