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

8. 杰西卡?戈麦斯
Deepening reform in major sectors and key links
Second, McDermott, a career 39.9% three-point shooter, addresses Oklahoma City's biggest roster weakness—a lack of perimeter options around Russell Westbrook—and remains on a bargain rookie deal through the end of next season.
Life's ups and downs
门票很快销售一空,只是大多却不是落到铁杆球迷的手中。
It even featured in the March 19, 1870, issue of Scientific American magazine. Made by Thomas Luders from Olney, Illinois, and called a "pedespeed," the wheels then were much smaller, measuring around 36 centimeters (15 in) in diameter. Luders also said the skates could be used by anybody, irrespective of their physique. He himself was a large, heavy man, and he claimed he could use them for two straight hours without getting tired. Another version of wheel skates, appearing in 1923, had its tires on the inside of the foot rather than outside. (Other than the size of the wheels, the main improvement made by Chariot Skates is the small tire at the back of the bigger tire for increased stability.)
荷兰首相马克?吕特(Mark Rutte)最近由于对安卡拉立场强硬而在民调中排名上升。吕特所属的自由民主人民党(VVD)在民调中略微领先自由党。周二,他将埃尔多安的言论称为“对历史令人恶心的歪曲”,还称“我们不会自甘堕落至这种水平。这完全不可接受”。
7. 2012年搞笑诺贝尔奖之物理学奖
据外媒体育网站sbnation.com报道,德国战车在刚刚结束的比赛中以四粒进球完胜葡萄牙。比赛结果令人震惊,多数观察员原本希望葡萄牙的攻势能更猛烈些。但这是否是本届世界杯又一场比分悬殊的比赛?的确不足为奇。
Yes Man is a heartwarming blockbuster that explores what would happen if you answered "yes" to every question in your life. Jim Carrey's character takes on this challenge and ends up learning Korean, taking flying lessons, and getting promoted. He goes from being a pessimistic divorced man to an exciting trendsetter and finds a new girlfriend in the process. It might sound like fiction, but this movie is loosely based on a memoir of the same name by freelance radio producer Danny Wallace.
9.在培养皿中跳动的心脏
All kinds of companies say they plan to add senior systems analysts, whose base pay is projected to rise 5% over this year's levels, to as high as $85,500; financial analysts, whose salaries will start at $81,500 at large companies, 4.8% more than in 2010; and experienced administrative assistants, at starting salaries of up to $41,750, a 3.1% increase.
Length of program: 19 months
2. “Inside Out” (Pete Docter)
其中有一支队伍我不大赞同:国王队。今年西部各队实力都有所下降,并且萨克拉门托还在季后赛席位的竞争之列,倒不是说摆烂不可能,但是只要他们还在这一队列里,他们就该全速前进,进入季后赛。
n. 贷款,借出,债权人
如今,蓬勃发展的互联网经济在支撑我国信息技术(IT)行业财富增长方面正发挥着越来越重要的作用。
巴黎法新社-1400法国人已经加入圣战组织或者打算这么做,总理ManuelValls周一说。
On the occasion of the New Year, may my wife and I extend to you and yours our warmest greetings, wishing you a happy New Year, your career greater success and your family happiness.
While the debate was supposed to be solely about foreign policy, domestic concerns were never far from the surface and the candidates took every opportunity to pivot to their stump speech attacks over the economy and tax. The same was true in the spin room afterwards where both campaign teams dispensed quickly with debate comments and moved instead to analysis of the state of the race in swing states.
With the compliments of the season.
我冒死地想一想,湖人队在几周后会不会也加入这一阵列呢?照目前这情况,他们必须打出史诗级别烂地比赛才能留住他们的选秀权(给费城的前三保护签位),问题取决于他们是会围绕现有阵容继续缓慢地重建呢还是为了得到下一个巨星扔掉一两个年轻球员呢。
It is not hard to think of recent examples, from Hugo Chávez to Viktor Orban and Vladimir Putin.
Hope you enjoy the happiness of New Year and all the trimmings.
不过,随着纽约人日益习惯于共享经济,各处楼盘可能最终也不得不接受它。


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.
肯达尔·詹娜首次击败了15年里世界上收入最高的模特吉赛尔·邦辰。
There should be no more arbitrary use of government power and that requires that the government must no longer overreach itself and we must eliminate any possible room for rent-seeking behaviors. This reform must be persistently pursued by the central government and all local governments at varies levels.


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

但是亚利桑那州的经济前景现在已经大为好转,随着住房市场的稳定,失业率在5月份降至7.8%,创下经济衰退后的新低。为了评选今年的美国最适宜经商的州,我们评估了35项指标以判断哪些州的经商条件最佳,哪些最差,这些指标中就包括就业预期。根据穆迪分析公司(Moody’s Analytics)的统计,在今后五年中,亚利桑那州的就业增长速度预计将达到每年3%。到2017年,亚利桑那州增长的就业岗位预计每年将把家庭收入提高3.6%,在全美各州中位居第二,仅次于伊利诺伊州。亚利桑那州的就业增长和经济增长保持同步,穆迪预计该州的经济增长速度为每年4.6%,达到美国的最佳水平。
v. 降低,婉谢
5Japan
最佳电影奖和最佳导演奖。让人意外的是,诺兰从未获得过奥斯卡奖最佳导演提名。

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. 

如下是我们对中国2014年的10个预测

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. 

Mr Baweja’s extensive analysis on the changing nature of globalisation suggests the prime factor behind the weakness of global trade growth (which for a long time expanded at twice the rate of global GDP) has been a slowdown in investment.
This year's lift was slower than the 6.5% rise in 2016, which is attributed to moderating economic growth and a rapidly aging society.

无论你相信与否,今年的搞笑文学奖被授予美国政府审计总署(GAO),以表彰他们发表的有关如何准备一份报告的报告的报告的报告……
The cyclical theory depends on a dearth of new investment creating a supply crunch in two, three or five years. A lot of projects are being postponed but postponement is no more than a signal to project managers to find a way of cutting costs. Many are doing exactly that.
If you think Kevin Durant is scrawny now, just take a look at his tiny physique back when he played at Montrose Christian.
1950年世界杯决赛,巴西1比2不敌乌拉圭,与冠军失之交臂。对现在的巴西球迷来说,那依然是一段令人痛楚的耻辱史。如今,贝尔蒙特老爷子已经85岁高龄,他希望能够看到祖国重拾桑巴荣耀。“我希望巴西再次夺冠。”他说。“这是我们的复仇之战,我很想去看。”
The registered urban unemployment rate stood at 4.02 percent at year-end 2016, the lowest level in years.
James Franco’s new movie about the making of The Room will make you belly-laugh, but its comedy is also deeper and richer than mere mockery.

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.


西门子面临股价大缩水 欧司朗经营战略受质疑


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.


而关于小牛这支球队,问题并不全是司机该怎么让位。在老司机的整个职业生涯中,这一直是一直有实力的球队。德克今年这样支离破碎的赛季实在令人痛苦。或许下个夏天他就会加入科比、KG和大基本功先生的队伍中去。
Among the amenities spread through its three terminals are two 24-hour movie theaters screening the latest blockbusters for free, a rooftop swimming pool and a butterfly garden.
“These are turbulent economic times, and yet we see Chinese companies acting with confidence and continue to make major moves in Europe and North America,” he said.
2013年北京入境游客的减少可谓出乎意料。此前北京市出台了72小时过境免签等多项新政策,其目的正是为了促进旅游产业发展。
“有个人说自己去上厕所,然后就再没回来。”
Gisele, 37, came in second place, having earned $17.5 million, marking the first year she has not headed up the line-up since 2002.
“The First Amendment’s Free Speech protections apply only to violations by public entities, and since Harvard is a private university the First Amendment does not apply,” she said.
达奇斯说:2012年菲亚特销售不旺。销售疲软体现在社交活动低迷,网络上大都是负面的讨论。
最佳歌曲:
“我都不知道要怎么解释拿了年度风云人物奖之后,还是没有女性杂志和组织支持我的事。”

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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在中国版推特新浪微博上,很多网民为男孩危急情况下的勇敢、淡定点赞。
你一直感到压力很大
ICBC said net profits increased 0.5 per cent for the year to December 31 2015 — the smallest increase since it listed. Returns on average total assets declined 0.1 percentage points to 1.30 per cent.
?备用发电机的失败使得纽约大学医院分部的Langone医学中心被迫撤离。大约200名病人被迫转移。官员们正在调查备用电源失败的原因。

最近两年你都没有涨薪水

  • Only the first three authors are listed, followed by "et al."
  • 定制家具正陷入低利润“陷阱
  • 贾康称用房贷利息抵个税是个人主张


[iks'tend]
我们首先得明白我们所有人都不知道这次选秀会怎么发展,毕竟大学联赛还在进行。但当所有的这些新鲜的血液都齐聚乐透区,这看起来当然美如画。

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