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

“多年以来,我们看到中国增长势如破竹,而美国增长率却在下降,”保险商耆卫(Old Mutual)旗下资产管理公司Old Mutual Global Investors的亚洲股票业务主管乔希?克拉布(Josh Crabb)说,“但是,交易量下降得相当厉害,所以我们并不真的确定当前价格到底如何。看起来,香港市场的基本面展望非常严峻。”
尽管在奥巴马担任美国总统的过去的四年里,美国经济复苏缓慢、失业率居高不下,奥巴马在几个关键的摇摆州获得的选票还是高于罗姆尼。美国选民在两种风格明显迥异的国家发展愿景中做出了自己的决定。
那么多的人视而不见,不承认事实。真相是泡沫无处不在,随时准备爆掉。证据越来越多,结论只有显而易见的一个:泡沫破灭的风险最高可达98%。2014年这次崩盘几乎是铁定要发生的,躲过这枚子弹的概率只有区区2%。
10) You’re Right: Want to get someone’s attention? Tell him that he’s right. Once you yield the high ground, it’s much easier for the other party to swallow that the right plan and sentiment can’t always overcome the absurdities and restraints we face every day.
特朗普与中国的贸易战
本次国考招录共有120多个中央机关及其直属机构参加,计划招录2.7万余人,与上一年度规模基本持平。
5. 《卡罗尔》,导演:托德·海因斯。
游戏平台:Xbox One
v. 降低,婉谢
Best of luck in the year to come.愿你在未来的一年里,吉星高照。
Their inclusion has come at the expense mainly of European companies, signalling the shift in economic power towards the east. There is only one Indian brand in the top 100 ranking — HDFC Bank. Russian, Mexican and Brazilian brands have fallen out of the ranking in the past few years — a sober reflection of the changing fortunes of these emerging markets.
2014年全年工业利润增长3.3%,为2008年以来最慢。
adj. 全国流行的 n. (全国或全世界范围流行的)疾
n. 青少年
“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。”
Turkey’s ministers have been rallying Turkish expat communities across Europe to win support for Erdogan-backed constitutional changes, which will be voted on in a referendum next month.
[plein]
Meanwhile, there are other factors holding back the Asian ETF market that some sceptics fear will hold back development of the retail side.
An ancient Egyptian amulet was uncovered in Jerusalem by a young girl taking part in a family dig in the capital.
黑人小伙克里斯和白人女孩露丝交往到了见家长的一步。露丝邀请男友去北部父母家共度周末。女友的父母对自己甚是热情,起初,克里斯把这种过度热情解读为父母试图面对女儿跨种族爱情的紧张反应,但随后,一连串蛛丝马迹令人越来越不安,克里斯渐渐察觉,背后的真相远非自己所能想象的。
A master class in old-school, super-linear action filmmaking, full of nasty, punk-rock, dystopian Australian humor. Also the best recent eco-feminist-socialist allegory that isn’t a novel by Margaret Atwood. (Read the review)
考克斯说:“没人真正知道末日是什么样子的,上帝又会如何让末日降临。”
答:我的一些作品也来到了美国,自己的作品能够在这里收到喜爱,对此我感到非常的开心和荣幸。
The estimates include earnings from movies, TV and endorsements from cosmetic and other companies. Bollywood star Deepika Padukone is the only newcomer on the list.
Belgium


Mr Cook has added three women to what was previously a white-male-dominated executive team and changed Apple’s board charter to commit to seeking out candidates from minorities when appointing directors.
公司:The Grommet公司
Among 36,000 who have reached celebrity status on the Internet, 74 percent are women and 87.8 percent are between 17 to 33 years old, while 89 percent have a college education. Followers are also getting younger and better educated, with 77.8 percent in the 17-to-33 age group and 75 percent with a higher education.


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

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.
周二在西弗吉尼亚州的贝灵顿一个人在雪地里行走。星期二飓风桑迪使得西弗吉尼亚州的部分地区被超过一英尺的雪所覆盖。
Sweden
Hannah Kuchler is San Francisco correspondent

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. 

Lady Gaga ranks fourth with $59 million, followed by Beyoncé at $54.5 million. The former played 66 shows during our scoring period, also cashing in on deals with Versace and MAC, as well as her own Fame fragrance. The latter’s On The Run tour with husband Jay Z grossed over $100 million for 19 North American dates, giving music’s first couple a nightly average comparable to that of the Rolling Stones.

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. 

节目3 歌曲《十二生肖》,王力宏
开发商:Dontnod Entertainment、Square Enix

The proposed amendment, which is expected to come into force on Jan 1, contains a clause stipulating extended maternity leave and other welfare for couples having children. These are expected to boost the willingness of some couples to have a second child. Many couples have expressed reluctance to have a second child because of the high costs of bringing-up two children and the prejudice they anticipate from employers.
由西班牙IQS商学院、台湾辅仁大学(Fu Jen Catholic University)和旧金山大学(University of San Francisco)三家合办的管理学硕士项目排名升幅最大。其全球创业管理硕士项目的排名上升34位,至第43位,逆转了去年下滑19名的势头。这是唯一一个在三大洲授课的项目,其在国际课程体验方面排名第一。
5) I take a gloomy view of things 0 1 2 3 4
周五,现代和爱茉莉太平洋的股价出现下跌,在首尔下午晚些时候的交易中分别下跌4.4%和12.5%。
vt. 作 ... 姿
'She enjoys it and we don't force her to do anything she doesn't want to do.'

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.


港股IPO“井喷” 新股七成“破发”


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.


For Maddie Ziegler, from Pennsylvania, life couldn't be more different.
For the dynasties that flourished in China around 1,700 years ago "the conquest and effective governance of Kucha would enable them to control all the oasis city-states in the Western Frontiers," the researchers said.
AFI TV Programs of the Year
在可预见的未来,我国会见证第三产业的繁荣发展。该报告称,相关专业,包括法律、新闻传播和管理学,预计将扮演更重要的角色。
The survey by the Public Religion Research Institute in partnership with the Religion News Service found political and religious disagreement on what is behind severe weather, which this year has included extreme heat and drought.
5、邦德具备美女约会种种要求。乐衷于性的女人更喜欢“坏男人”-邦德属于此类。讲究的女人喜欢阳刚男人,寻求一夜情的女人喜欢外型帅气、主动进攻的男人-非邦德莫属。
Wealthy Chinese bought at least seven overseas islands in 2014.
Like any college kid, Evan Wray loved using the tiny pictograms known as emoji. But he hated that there was no emoji to express his Fighting Irish pride with fellow University of Notre Dame students. So, alongside co-founder Sean O’Brien, he built a modest business on that disconnect. TextPride, as it was called, licensed images from brands in the sports and entertainment world and sold them as sticker packs. Within a messaging app like Kik, users could buy a packet of stickers for Disney’s Frozen for $1.99, for example.
11月17日
201012/122342.shtml

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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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.

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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 我们要咬定青山不放松,持之以恒为群众办实事、解难事,促进社会公平正义,把发展硬道理更多体现在增进人民福祉上。 to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

Wishing you all the blessings of a beautiful New Year season.
在这部暂未定名的电影里面,两段交错的三角恋,偏执,背叛等元素与音乐场面相互映衬。参演此片的有克里斯蒂安·贝尔(ChristianBale)、凯特·布兰切特(Cate Blanchett)、迈克尔·法斯宾德(Michael Fassbender)、瑞恩·高斯林(RyanGosling)、鲁妮·玛拉(Rooney Mara)以及娜塔丽·波特曼(Natalie Portman.)。
科技
You are so engaged in thinking of him that you don't notice that there is no No.12.

明年就是这只会说话的萌熊诞生60周年了。为了纪念帕丁顿熊诞生60周年,曾执导2014年口碑和票房都大获成功的电影《帕丁顿熊》的保罗?金回归续集担任导演。在当前这个连儿童娱乐节目都充斥着黑暗和暴力的时代,我们比以往任何时候都需要这种安静地讲述英国普通人生活的片子。这部新电影的情节?事实上,没有太多情节:根据上部电影的结尾,帕丁顿熊现在和温莎花园的布朗一家舒适地生活在一起。他想从一个当地的书商那里给他的姨妈买一本立体书,但发现自己还差几英镑,于是他就穿上了自己的长筒雨靴和粗呢连帽外套,并找到了几份兼职工作——结果却发现这本书在书店被偷了!神秘的破案之旅(其实也没那么严重)就此开始。你在电影中还可以看到关于“橘子酱控”帕丁顿熊的更多笑话。该片将于11月10日在英国上映,11月23日在德国上映,11月30日在柬埔寨和马来西亚上映。(资料来源:欧映嘉纳)

  • Only the first three authors are listed, followed by "et al."
  • 建筑用材新一轮涨价潮来袭
  • 建材市场未能如期迎来金九 需求不理想


All those totals are higher than a year ago, with the largest growth being in market value (up 13% year-over-year). These firms employ 90 million people worldwide.
Most female participants were between 19 and 23.

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