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

adj. 不稳定的,易变的
蓝天在未来不会也不应该成为奢侈品。
可穿戴设备通常分为三大类:像健身追踪器这样的复杂设备;像智能手表这样的智能配件(由于它们可以运行第三方应用);还有像谷歌眼镜这样完全自主、可以直接联网的智能可穿戴设备。
杨金秀(Olive Yang)
Neighborhoods
不过,日本央行(BoJ)仍决定不加大货币政策刺激力度。该行指出,工业产出是日本经济疲软的领域之一。当然,就业市场等日本经济的其他领域,表现要好得多。
A New Year greeting to cheer you from your daughters.
值得一提的是,优步和特斯拉也未能上榜。“优步和特斯拉都在创新,但用专利数量、成功、全球化和影响力进行衡量,都不足以上榜,”Stembridge说道。“还有,这两家公司在2010-2014年这段时间也没有获得超过100项的专利技术,从而达到该榜单要求。”
洛德《情景剧》
"To make the world a better place, I invented a transformative water purifier," Google quoted Zhang as saying. "It takes in dirty and polluted water from rivers, lakes and even oceans, then massively transforms the water into clean, safe and sanitary water. When humans and animals drink this water, they will live a healthier life."
5. Mother Nature
But once again, Bryant said he's fine, that his health is fine, that his shot is fine, and he diverted the conversation elsewhere, largely to his teammates and the team's overall scheme.
The manufacturing purchasing managers’ index published by China’s National Bureau of Statistics slipped to 51.6 in October, coming in below a median forecast of 52 from economists surveyed by Reuters and closer to the 50-point line delineating expansion from contraction.
苹果公司可以推出一款售价2,000元人民币(330美元)的迷你iPhone,这样就能和联想(Lenovo)、华为(Huawei)、中兴(ZTE)和酷派(Coolpad)的旗舰产品相抗衡了。
Consumer prices rose 2.3 per cent year-on-year, more than expectations of 1.8 per cent. That is the biggest rise since July 2014. They had risen 1.8 per cent in January.
Jennifer Lawrence also took home the gong for best actress in a movie for her role in the critical darling Joy.
自从2010年开通运营以来,12306票务系统已多次升级以修复漏洞,并在春运期间提供更好的服务。
2012年,科学家开始认真寻找他的遗体。考古学家根据史书记载和地理线索,在一个市政停车场开始挖掘,并最终发现了遗骨。这里就是史书记载中埋葬查理三世的教堂的地点。
China’s reserves have fallen for nine of 11 months this year and stand at $3.43tn, as investors sell renminbi assets to protect themselves against depreciation and the central bank sells dollars from its reserves to curb renminbi weakness. Falling interest rates in China and expectations of an imminent rate rise by the US Federal Reserve have also fuelled outflows. Reserves rebounded mildly in October, suggesting outflows had diminished.
彭博(Bloomberg)软性大宗商品指数上涨21%,工业金属和能源指数则分别上涨24%和1.5%。
而诺贝尔物理学奖则颁给了三位生于英国、目前正在美国工作的科学家,肯定了他们对极端状态下物质的特异属性所做的原子级研究。
201110/156988.shtml
Statistics showed that Tibet had around 590,000 rural poor by the end of 2015.
Do you routinely roll your eyes? Do you have a weak handshake? Do you avoid making eye contact? These could all be career killers. People must understand that actions speak louder than words. And the majority of our communication is done through non-verbal cues. People could perceive some of your non-verbal communication habits as rude or unprofessional—and these things could eventually have a significant impact on the advancement of your career.
confident


不过,对韩国和东盟(Asean)国家的出口都下滑了约3%,而对香港的转口贸易下滑幅度逾16%。
"She gave her surname as Han when registering, which is also different from the name Su in media reports," the employee said.
Emma Morano’s singular achievement in life may have been perseverance. She lived for 117 years, crediting her longevity to raw eggs and her lack of a husband. She died on April 15.


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

沃克排名第六,得益于他演艺生涯中最卖座的影片《速度与激情6》。在因车祸悲剧丧生之前,他已经完成了《速度与激情7》的大部分拍摄工作。据称环球影业(Universal)不会重新拍摄该片,而会对后续拍摄作出相应调整。
Everybody has heard by now that health care companies are promising hunting grounds for job seekers, and the New Year will see hiring perk up elsewhere, too.
Granted, it is easier to remake something than to make something new. Anyone who has faced a blank page knows that. But if fashion’s ubiquitous default to the 1960s over the last seven years has exposed anything, it is its own lack of imagination, not only about clothes and consumers, but about the relationship of culture and dress.
《请以你的名字呼唤我》

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. 

奖项:尽管大众的高尔夫GTI先拔头筹,但偏向自家人的2015年北美汽车大奖的评审员们还是对福特的野马和F-150皮卡不吝溢美之辞。

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. 

Care about them, but don't let on mkay?
"There's a new type of wealth creation coming out," he told Reuters, adding China was having to adapt as the wider economy was "very materially slowing down".

“Even though there is significant awareness [of the role of Fed policy], market dynamics can become unstable or unfavourable relatively easily,” he says. “Then you get into a self-reinforcing cycle of selling pressure.”
"This year promises to bring Australia and China closer and provide more opportunities for further engagement, be it in tourism and travel or more broadly in trade, sport and culture or social and academic exchanges," says Ciobo.
她对“广告狂人狂热症”的定义是“想像《广告狂人》中的人物那样着装”,不过,我想把它的定义改为,大众时装公司认为所有的消费者都想穿成《广告狂人》中的人物那样。该剧的视觉冲击力非常强大,以病毒级传播,仿佛重组了设计师们的创意DNA。
根据康奈尔大学、英士国际商学院和世界知识产权组织联合发布的这一份报告,这使得中国成为中等收入经济体中该指标的领先者,紧随其后的是已经超过巴西的印度。
A person walks through snow Tuesday in Belington, West Virginia. Superstorm Sandy buried parts of West Virginia under more than a foot of snow on Tuesday.
Bad news for newspaper reporters: Your job has been named the worst in the U.S. for 2015, according to rankings released by job search site CareerCast.com. Two other media positions are also high on the list, along with professions that are physically taxing.

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.


国税总局公布新个人所得税法预扣预缴方法


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.


Prof Cusumano sees all this as evidence that the company is opening up more, including in allowing developers to customise more of its iOS software.
中国为世界人口最大国,总体排名为二十,被视为第三大强国,“创业最佳国”里排名第二。
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Influenced by the current economic situation, and resource relocation in China's financial market, the banking industry is away from the high-speed growth period, the expert added.
《财富》美国500强公司苹果(Apple))已宣布,将从现金中拿出300亿美元用于股票回购。这个消息让投资者很高兴:股价暴涨,甚至在消息发布一周后,这只股票相对于标准普尔指数在这7天上涨了12%。苹果有一项规模更大、总额高达1300亿美元的资本回报计划,将一直延续到2015年,而这些回购就是这项计划的一部分。
The contiguous United States set a temperature record in 2012, a year of scorching heat waves and drought. But, mostly because of the unusual chill in the East, 2014 was only the 34th warmest year on record for the lower 48 states.
两队将于10月5日抵达深圳并将在深圳大运中心进行比赛。
But John Davies, head of institutional investment in the Hong Kong team at CBRE, the property services business, says that lower prices should make the market more reliable. “The market is showing characteristics of a mature market, which institutional investors understand better,” he says.
我们必须牢牢抓住就业这一民生之本,让人们在劳动中创造财富,在奋斗中实现人生价值。
China is committed to denuclearization of the Korean Peninsula, the peace and stability in the Korean Peninsula, and resolving issues through dialogue and consultation. That is China’s consistent and clear-cut position.

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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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 The fundamentals of the Chinese economy remain sound, the capital adequacy ratio and provision coverage of commercial bans remain high, and we have many financial tools and instruments that can be used. We have the confidence, the ability, and the means to forestall systemic risks. to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

accurate
(G.I. Joe: Retaliation)以及两部小规模电影,加起来在全球的票房收入总计13亿美元。
澳大利亚管理研究生院的一名毕业生表示:“最初,我对攻读在线课程颇有疑虑,但沟通和在线互动非常棒。”
美国谷歌搜索2017排名前十

……叫错面试官的名字。

  • Only the first three authors are listed, followed by "et al."
  • 冯焱东:房地产库存增长有望在年内出现逆转
  • 同一城市两家具展PK 厮杀还是共赢?


A chain connects the umbrella to a collar or harness.
Hurun Chairman Rupert Hoogewerf said: "Those entrepreneurs should be called 'super wealth creators' instead of simply 'rich people', which could highlight their contribution to China's society and economy."

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