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

I used to think guff was a product of failure and mediocrity — it existed because the truth was too painful, or because executives had not bothered to ascertain what the truth was.
accomplished
A tender love story between a teenager and an academic, set in Italy.
1870年3月19号,轮滑登上杂志《科学美国人》。它的制作人是伊利诺伊州奥尔尼的托马斯·呂德斯,被称作"佩德速度",后来,轮滑的轮变得小了很多,直径约为36厘米(15英寸)。吕德斯身材高大魁梧,他说自己用轮滑一直滑2个小时也不觉得累,同时他也说每一个人都可以滑轮滑,不论他们是什么体型。另一种轮滑出现在1923年,它的轮子在脚的内侧,而非外侧。(除了轮子的尺寸不一样以外,两种轮滑最主要的差别在于:由战车溜冰公司制作的轮滑,小轮在大轮的后面,增强整个轮滑的稳定性。)
经济衰退可能已有所好转,但是距离就业市场的复苏还有很长一段路要走。并且专家也声称情况在好转之前可能先会恶化。
Annual prices had been rising as much as 9.6 per cent at the start of this year but they've cooled since then as the economy slows and many mid-sized Chinese cities suffer from a glut of apartments.
9.在培养皿中跳动的心脏
3、Negativity
Except your Watson, he thinks it's hot.
入围名单以聚焦科技业的图书为主,Basic Books和Oneworld Publications出版的《机器人的崛起:大规模失业的威胁与科技》最终战胜了强大的对手。
1896年,美国首任总统的夫人玛莎·华盛顿的画像印在一美元银圆券上,此后美元纸币上再没有出现过女性画像。
单词polish 联想记忆:
After IMD in second place, Duke Corporate Education completes the custom programme podium. It is the third year in a row that the US school is in third place, having previously topped this ranking for a record 12 consecutive years to 2014.
Project management.
当时的杜兰特身高6尺9寸,体重只有185磅,我很惊讶在高中赛打到一半时他没有被撞坏。幸运的是,杜兰特不靠在大前锋位置上力量抗衡赚钱,他主要依赖他拿手的急停跳投。
Yes. The government hasn’t won a vertical merger case in decades. According to the Department of Justice’s own review guidelines, “vertical mergers” between content owners like Time Warner and distributors like AT&T are much less worrisome than horizontal ones. Meanwhile, the Fang companies — Facebook, Amazon, Netflix and Google — now dominate the digital entertainment landscape, which makes the government’s argument that the merger of two old-media firms would fundamentally alter competition even harder to make.
继《菲洛梅娜》后,朱迪.丹克和斯蒂芬.弗雷斯这对出色的组合四年后再度联手。该片由李荷担任编剧,讲述了维多利亚女王与年轻印度男仆之间的友情。艾迪.伊扎德看来是官方授意的威尔士亲王人选;演员阵容还包括奥莉维亚.威廉姆斯,蒂姆.皮戈特.史密斯以及同样出演了《总督之房》的西蒙.卡洛和迈克尔.甘本。
Coordinated reform of medical services, medical insurance, and the medicine industry
可口可乐首席运营官詹姆斯?昆西(James Quincey)表示:“我们并未真的假设今年余下时期中国的形势会好转。”他表示,今年第二季度该公司在华果汁销售额降幅达到两位数,可口可乐饮料销售额降幅为个位数。
Taiwan Semiconductor Manufacturing Company (TSMC).” Previous reports have pegged the screen size at just under the 5 inches of Samsung’s Galaxy 4.
If you do much hiring of freelancers, you’ve probably considered outsourcing the outsourcing. There are several great services that can help, each with varying business models. For example, Bolton Remotewill build your team with vetted, offshore contractors. Another provider,Hubstaff, starts with your project in mind and then matches you with project specialists. Using an outsourcing placement service will save time instead of trying to do the recruiting yourself. These firms typically offer free recruiting and placement services but take a cut of the hourly rate.
6. 2012年搞笑诺贝尔奖之文学奖
Rounding out the top three is Fleetwood Mac at $59.5 million. Though the band contains three men, it also boasts two high-profile ladies—Stevie Nicks and the recently-returned Christine McVie—rendering the group eligible for this list. Its On With The Show tour included 86 concerts during our scoring period, grossing well over $1 million per city.
Stanford's Zhenan Baohas has developed a super-flexible, super-durable, and super-sensitive material that can be the basis for future synthetic skin. People have tried developing synthetic skin before, but Baohas's material handles touch sensitivity better than any predecessor. It contains organic transistors and a layer of elastic, letting it stretch without taking damage. And it's self-powered—this skin contains a series of elastic solar cells.
A Chinese Poet’s Unusual Path From Isolated Farm Life to Celebrity


Kristen Stewart definitely did some 'butt' kicking at the Nickelodeon Kids' Choice Awards 2013 on Saturday. The star strutted down the purple carpet in a dazzlingly deep blue and black top and tiny shorts that had a miniscule checkerboard pattern. Kristen was nominated for two awards at the live show - Favorite Movie Actress for The Twilight Saga: Breaking Dawn - Part 2 and Favorite Female Buttkicker for Snow White and the Huntsman.
When it comes to diversity, I am optimistic that at some point the rise of enlightened younger executives will trigger a sudden change of attitude in the boardroom. This will not happen in 2018, though the imbalances and abuses of power evident in sexual harassment scandals, from tech to media, could accelerate change.
Stand: Apple CEO Tim Cook fought for workplace protection for the LGBT community


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

伦敦博蒙特·内森顾问公司(Beaumont Nathan)的联合创始人雨果·内森(Hugo Nathan)说:“新投资者对早期绘画大师的作品有兴趣,不过他们想要的是杜维恩(Duveen)卖给强盗大亨们的作品。他们想要名作。”他指的是英国艺术交易商约瑟夫·杜维恩(Joseph Duveen),他把很多伟大的艺术品带去了美国。
However, we are sceptical that the strength of imports can be sustained given that the delayed impact of policy tightening and a cooling property market are set to weigh on Chinese demand for commodities in coming quarters.
Just 21 millimeters long, 16 millimeters high, and 4 millimeters thick, the amulet, of which part is missing, has a “raised decoration” on it with a loop at one end that allowed it to be worn on a cord around the neck.
But a friend saw a TV report about it and contacted the sorting office. Mr Siddeeq, 74, says he is still eager to read it, despite now being divorced。

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. 

《人物》评选的电影史上35位美人(1)

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. 

像考辛斯这样的超级球星以低廉的价格空降新奥尔良,并不只会帮助鹈鹕在新奥尔良雕刻出更大的运动景观,而且也是杰出的第一步。
网队重建的欲望已经超越了给波士顿另一个高顺位签的不情愿。大坑已经挖好,想要从坑里爬出来,你能做的只有:一步一步地,挑出合适的新秀,交易球员,以及签约。

n. 枝,杆,手杖
这一问题也打击了中国在WTO框架内获得市场经济地位的努力。中国声称,在其加入WTO满15周年的今年12月,应当自动获得市场经济地位。如果中国获得了该地位,那么这可能影响美国等国对中国发起反倾销案的能力,因为这将使他们不能用替代国的价格进行比价。
他说,杂志和作者在这起最近发生的丑闻中都有不可推卸的责任,声明中还说,《肿瘤生物学》在2015年就已经因同行评议过程存在类似问题而撤销一些论文。
在观影从始至终,我都在问自己一个问题:这部电影到底在讲什么……这部电影的主题仿佛一锅杂烩,并不明晰。我希望制片人也在问同样的问题。
Sixty Vocab:
5) I’ve Got Your Back: We’ve all made big mistakes. In those times, step in with a reassurance: “I’m not judging you. You’re going to get through this. You’re not alone. We’ll figure this out together. It’s going to be OK.”

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.


红星美凯龙高速扩张的背后 问题不断存隐忧


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.


单词galaxy 联想记忆:
The index fell from 50.4 in October to a six-month low of 50.0.
The average price for new residential buildings rose 12.3 per cent in October year on year, according to a weighted average from Reuters based on data from the National Bureau of Statistics.
提到MeToo行动,麦高恩说:“他们都是混蛋,不是冠军,一群失败者,我不喜欢他们。”
Two days ago here in Brazil, we were shocked when we spent some time with some children living on the streets. And this is what one child told us: "I wish I was rich and if I were, I would give all the street children food, clothes, medicine, shelter and love and affection." 在巴西,我被2天前见到的情景震惊了,那时我和当地的小孩在玩耍,其中一个小孩说:“我希望我能富裕起来,然后我会给这个街道所有的小孩饭吃,给他们衣服穿,医疗,住房和爱”。
['k?mb?t]
The punctuality rate of China's major airports is still far from satisfactory, according to the latest report published by local aviation statistic company VariFlight.
We will make solid efforts to pursue the Belt and Road Initiative.
We will continue to pursue a proactive fiscal policy and a prudent monetary policy.
尽管外贸额占经济总量的比重逐渐增大,但是相比那些每天都大量采购各种日用品,食品而且随意采纳金融方面建议的欧洲和亚洲的主要竞争者,美国经济更容易免受外部不良因素的冲击,实际上相比与外国的竞争者具有更好的抵御危机的能力。

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.

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[?'lju?]
除非查尔斯-奥克利成功控诉纽约老板詹姆斯-多兰,尼克斯2016-17赛季唯一的亮点将是克里斯塔普斯-波尔津吉斯在全明星周末斩获技巧挑战赛冠军。
['?unip]
Song “The Spring Blossom” (Na Ying)

“我认为随着社会变得更多元化,未来这个情况会在一定程度上得到改善。不过这需要一定的时间。”

  • Only the first three authors are listed, followed by "et al."
  • 上半年市场盘点 北京楼市上半年平稳收官
  • 房企曲线圈钱虚实难辨,多笔住房租赁债被叫停


赖床有了新理由
库苏马诺教授认为,这一切都表明,苹果正在加大开放度,包括允许开发者对其iOS软件进行更多定制。

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