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

《为奴十二年》导演史蒂夫?麦奎因(Steve McQueen)在登台领奖时说:我有点吓到了。然后他微微耸肩,引用片中福音歌曲的歌词,说了句“翻涌吧,约旦河,翻涌吧”("Roll, Jordan, roll")。
当城市规划部门明年初(2015年——译注)提出初步的建议方案时,布鲁克林的东纽约(East New York)地区将被列为试点。随后,重新区划进程就将在该处全市最穷社区之一内展开。而紧随其后的,将是针对皇后区的西法拉盛(Flushing)的提案。
During the 40 days of Chunyun period, the inter-city transportation faces great challenges. The demand for tickets far exceeds the supply. Various measures are adopted to alleviate the problem by opening many temporary trains (numbers starting with letter L), extending the working hours of booking office and opening up more booths.
As a result, in the first 10 months of 2016, the year-on-year decline in EM exports in dollar terms was just 6.6 per cent, according to calculations by Capital Economics, a marked improvement on the 11.6 per cent contraction seen in 2015, as the third chart illustrates.
201001/93725.shtmlNews trumpedcelebrities in 2010 as the BP oil spill in the Gulf of Mexico and World Cup soccer in South Africa topped the list of most-searched items of 2010, according to Yahoo!
10月,政府宣布准备终结数十年之久的“独生子女政策”。此项政策限制了已婚夫妇的孩子人数。新规定要到明年才会生效。
People walk in the rain along the swollen Potomac River in the Georgetown neighborhood of Washington, DC, on Tuesday.
一切始于比蒂打开信封准备念出最佳影片得主的那刻,他看上去很困惑,停顿了很长时间,然后望向唐纳薇。“来吧!”比蒂把信封交给唐纳薇,后者宣布道:“《爱乐之城》!”
credit
葡萄牙诺瓦商业与经济学院(Nova School of Business and Economics)巩固了去年的强劲表现,排名进一步攀升14个位置,排在了第17位。
失业率的大幅下降的实际效果将会有所体现
Inflation (and deflation) won't rear its ugly head Surging oil production — along with slower global growth — has caused the price of petroleum to collapse from more than $100 a barrel last summer to barely $50 a barrel at the end of 2014. The effect has been to reverse an uptick in U.S. inflation earlier in the year.
['heivn]
中国银行业监管机构的数据显示,去年中国商业银行的净利润总量增长了2.4%。中小银行的利润增长继续加速,而大型银行的利润增长则放慢了。
该学院还在国际课程体验方面排名第二。在最新的毕业生当中,逾五分之四的人有过国外实习经历,逾一半学员有过在另一个国家学习超过一个月的经历。
In his report of Global Market of Industrial Robots, Junji Tsuda, president of International Federation of Robotics (IFR), noted that about 387,000 industrial robots were sold in 2017 worldwide, up 31% year-on-year, creating $50 billion in revenue, with China as one of key drivers behind the strong growth.
《日落》
Ranked 10th position, Industrial and Commercial Bank of China is the highest ranking Chinese company on the list.
China's economic prowess is also seen by outsiders as having stimulated nationalism in a generation removed from the Cultural Revolution. Beijing's belligerent responses to overlapping maritime claims have heightened worries about its security objectives in a region already wary of its economic clout. This is one factor in Japan's decision to relax its ban on weapons exports; to China's dismay, it has also driven its neighbours to support a stronger US presence in Asia and has complicated regional trade integration.
St. Vincent “Digital Witness” (Loma Vista/Republic)
Are you heading to Rio for the Olympics? Will you leverage the Google Maps app on Android or iOS? I think you already have the answer.
In 2013, the total number of applicants who qualified for the national service exam reached a record 1.52 million. In 2014, the total number decreased for the first time in four years to 1.41 million, the People's Daily website said.
康涅狄格州斯托宁顿(STONINGTON, CONN.)
Despite an abortive attempt in August to devalue the renminbi — a move that rocked global markets and was quickly abandoned by Beijing — China’s trade-weighted exchange rate was 8.5 per cent stronger in September than a year earlier, making Chinese exports less competitive.
“微博等新媒体让每个人都拥有了发言平台,如果你不能直面批评,与百姓合作,是不能做好工作的。”


苹果(Apple)本周将考验客户的忠诚度、购买力以及对创新的热情,发布第一款售价高达1000美元的iPhone。
identified
它把孩子的重量从您的后背转移到肩膀和腰腹部。


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

['pre]
"This is something we believe is really important for the future of our country,"Facebook (FB, Fortune 500) CEO Mark Zuckerberg said in August.
现在iPhone又夺回声势,对Apple Watch的期待也在升温,库克似乎重新赢得了苹果员工的信任。分析师表示,这一点从他在今年产品发布会上的表现就可以看出来。
supervision

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. 

10月份,中国社会消费品零售总额增长放缓。另一方面,尽管上月出口走弱,中国规模以上工业增加值和全国固定资产投资增长仍大致保持平稳。

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. 

These contraptions, including a nano-sized car, are so small that they’re invisible to the human eye.
他有能力向球迷们展示接下来的计划吗?——不管是什么计划。在又一个无论场内场外都丑陋的赛季后,尼克斯球迷当然有理由知道上述两个问题的答案。

The untitled movie revolves around two intersecting love triangles, obsession and betrayal, set against the music scene. It stars Christian Bale, Cate Blanchett, Michael Fassbender, Ryan Gosling, Rooney Mara and Natalie Portman.
And despite exports having fallen 7.3 per cent during the same period.
Recipient: Their Royal Highnesses The Duke and Duchess of Cambridge (joint winners)
时间:2009-11-19 编辑:vicki
bene好+fic做+ial表形容词,“有…的”→有好处的
Polls indicate that the Dutch election will be extremely tight. Mr Rutte’s centre-right VVD sits atop most polls, just 3 percentage points ahead of the PVV. Most polls show a large percentage of voters remain undecided.

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.


金九银十季 家居制造业“普工荒”成高悬之剑


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.


尽管有少数人坚持这种说法,但绝大多数研究气候的科学家表示,地球正在经历一个长期变暖的趋势,这种趋势给人类带来深刻的威胁,而且几乎完全是由人类活动造成的。
No matter whether you’re looking for big international events, delicious food, natural wonders or simply relaxation on a beach, these places should be on your checklist.
There are merely citizens whose choices not only may, but surely will, change.
9.微笑
公司的运营情况不好。
产品看起来并不太像一个鼻子,而是一个瓶子,装满了培养细菌的营养液体。但是给这个“鼻子”一个血液样本,让它嗅上一段时间,这个瓶子的斑点会改变颜色来表示它鉴别出的细菌种类。
Scarlett Johansson of Captain America: Civil War was third at $25 million, down nearly 30 percent from 2015.
《被撕破的芭蕾舞鞋和突变的生活》(Torn Ballet Shoes, and a Life Upended)
Stanford Graduate School of Business in California rises from fifth place in 2016 to second, a position it last held in 2014. The Wharton School of the University of Pennsylvania is in third place.
em进入,brace胳膊-拥抱

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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这位官员表示,相比其他职位来说,那些对教育背景或工作经历没有特殊要求的职位更受欢迎,近些年报名人数达到数千人的基本上都是这种职位。
And while there is still a long way to go before airplanes designed and made in China compete on the world stage with the likes of the Boeing 737 or Airbus A320, the momentum is there, and the country’s aerospace industry is entering a new phase of development and maturity.
Horowitz, speaking to radio station RTE, said he was keen to keep the new Bond true to the 1950s creation.
都柏林大学学院(UCD)迈克尔?斯墨菲特商业研究生院(Michael Smurfit Graduate School of Business)的总体进步最大,排名攀升21位至第48名。北京大学(Peking University)光华管理学院(Guanghua School of Management)重回排行榜第38名,去年该院因学员调查反馈率低而未上榜。

中国已经成为世界上电影银幕最多的国家。

  • Only the first three authors are listed, followed by "et al."
  • 百城价格指数继续上涨 楼市回暖态势有望延续
  • 电商时代已来 门窗企业急需转变思维经营


This quiet, intense Israeli film unfolds like a psychological thriller. A poetry-loving teacher discovers that one of her young pupils is a literary prodigy, and takes increasingly extreme measures to protect his gift from an indifferent world. As the story unfolds, it becomes clear that Mr. Lapid is engaged in a stealthy, ferocious critique of a society that has sacrificed its spiritual values and its cultural inheritance on the altar of power and materialism.
《美国谍梦》(The Americans):FX频道的这部电视剧以里根时代为背景,它和剧中两位伪装成美国郊区夫妻的克格勃间谍一样具有欺骗性:第二季表面上看是冷战惊悚剧,实际上是关于爱情、家庭、友谊和猜忌的情节剧。

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