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

7.《大白鲨》
失业率的大幅下降的实际效果将会有所体现
Apple Inc., Alphabet Inc.'s Google, and Coca-Cola Co. topped the list of the world's 100 most valuable brands in 2016, while technology and automotive brands dominated the overall rankings, according to a new report from brand consultancy Interbrand.
"Nobody can stop it. I will keep sending leaflets into North Korea at the risk of my life," Park said, adding he has always prepared to face down the North's threats.
公告宣称:"我们已经报警,并且收集了证据来维护公司的声誉。而那些泄露裸照的人将被按照法律惩处。"
n. 衰微,跌落; 晚年
世界杯锦标赛即将到来。 我想告诉你永葆美丽的一些要诀。
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……
6) I find it hard to start a conversation 0 1 2 3 4
在本周达沃斯年会上,政策制定者、政治人士以及商业领袖达成了这种谨慎乐观的共识,这种局面是自2007年以来历届世界经济论坛所不曾看到的。
So too would be concluding the EU’s own (re)negotiation of its existing trade agreement with Mexico. And there is a good chance Brussels could beat Donald Trump to the finish line on a deal with Mexico.
The state-sponsored purchasing managers' index fell from 50.8 in October to 50.3 in November, the lowest reading since March. Any level above 50 indicates expansion.
Each film Wes Anderson makes seems to exist in its very own universe. And “The Grand Budapest Hotel,” set mainly in the 1930s, uses distinct elements and props to help define its world.
With the second round of (re)negotiations closing on Tuesday we have truly entered the technocratic phase of these trade talks.
Swiss school IMD comes top in the ranking of open-enrolment courses, available to all working managers, and jumps two places to second for customised programmes, which are tailor-made for corporate customers. Iese of Spain holds on to the top spot in the custom ranking and remains second in the open ranking.
Jiang Yiyi at the China Tourism Academy suggests China adopt a long-term national plan to improve the country's image and investment in inbound tourism to attract more visitors.
我们不会越俎代庖,不会超越区域去做不应是中国做的事情。
《秦时丽人明月心》
25 July
愿新年不仅是你欢笑的时刻,更是你欣喜的日子。祝福你。
银行、基金公司和保险公司从内地涌向香港,收购这里的高端写字楼,导致香港政府宣布将释放更多土地,在火爆的城市中心地段进行商业再开发。
农林牧渔和服务业是应届毕业生签约行业中薪资水平较低的行业,月薪分别为3347元和3115元。
在经历了性骚扰丑闻频频曝光(从硅谷开始,蔓延至几乎所有行业)的一年后,女性将试图利用这一势头来推动永久性变革。鉴于科技行业的黑人和拉丁裔雇员少之又少,人们将关注被边缘化的少数族裔的困境。
John Williams's classic score still raises goosebumps over 40 years after this summer blockbuster hit theaters. Jaws preys on our primal fear of the unknown in deep waters, showing a small beach town ravaged by a series of attacks from a single killer shark. In recent years, environmentalists have stressed the generally nonthreatening nature of sharks, which kill an average of just eight swimmers each year.
James Bond Themes 4. "Thunderball" by Tom Jones


6. Will we witness another global epidemic in 2010?
在接受《第一财经》采访时,中国建设银行(CCB)董事长提到,中国各银行面对的最大挑战在于不良贷款不断上升。
A pair of post-mumblecore comedies about self-realization and its limits. Mr. Bujalski’s is a flawless screwball triangle (with Guy Pearce, Cobie Smulders and Kevin Corrigan as the sides) masquerading as an easygoing hangout with the oddballs of Austin, Tex. Ms. Piven surveys the darker territory of mental illness and daytime television. Thanks to Kristen Wiig’s astounding performance (as a lottery winner named Alice Klieg), “Welcome to Me” is a portrait of an American dreamer that is unsettling and inspiring in equal measure.


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

考夫曼和同事加雷思?哈里斯(Gareth Harris)发现,居住在那些人种快速多样化地域的英国白人更倾向于投给右翼的英国国家党(British National Party)。宾夕法尼亚大学政治学教授丹尼尔?霍普金斯(Daniel Hopkins)在美国发现了相似的民族变化导致反移民政策的规律。
Beloved TV show characters enter our lives as friends and impact us in crazy ways. They can make us laugh until our sides hurt, cry when things don't go well for them, and call in sick to work when we just can't stop watching and must know what happens. But through it all, we love them. And yet, there's so much that the audience will never know. Some TV shows have dark secrets. Some almost didn't exist at all. Here are some behind the scenes stories of your favorite TV shows.
n. 委员会,委托,委任,佣金,犯罪
Rachel Bloom burst into tears as she won best lead in a comedy or musical TV show while Amazon show Mozart In The Jungle was another surprise victor at the awards show when it was named best TV comedy.

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. 

"Sure, there are only whites in the stadium. It comes down to money," said Ana Beatriz Ferreira, a 27-year-old parking attendant in Rio de Janeiro, who is black. "Nobody I know could find affordable tickets."

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. 

根据QS的这一排名,使得中国成为入选全球400强学校第二多的国家,仅次于有164所大学的学科入选全球400强的美国。英国排名第3,有78所大学进入榜单。
单词association 联想记忆:

Global warming and a powerful El weather event combined to make 2015 the planet’s hottest year since modern records began in the 1800s, according to scientists, who warned this year could be even warmer.
A pair of post-mumblecore comedies about self-realization and its limits. Mr. Bujalski’s is a flawless screwball triangle (with Guy Pearce, Cobie Smulders and Kevin Corrigan as the sides) masquerading as an easygoing hangout with the oddballs of Austin, Tex. Ms. Piven surveys the darker territory of mental illness and daytime television. Thanks to Kristen Wiig’s astounding performance (as a lottery winner named Alice Klieg), “Welcome to Me” is a portrait of an American dreamer that is unsettling and inspiring in equal measure.
But the demagogue’s exploitation of such grievances threatens democracy.
The dip for the Caixin gauge, which concentrates on smaller and private manufacturers, stands in contrast to a pickup for China’s official manufacturing PMI, which focuses primarily on large, state-owned enterprises. The divergence may indicate that smaller outfits have been hit harder by pollution curbs and other regulatory tightening than their larger, state-run competitors, which also enjoy privileged access to state-run lenders.
adj. 复杂的,复合的,合成的
你有翻白眼的习惯吗?握手时有气无力?不爱进行眼神交流?这些可谓是职业杀手。人们必须意识到行动大于言语,大部分的沟通是通过非语言暗示完成的。你的一些非语言习惯可能会被认为是不礼貌的,不专业的—而这些最终会严重影响你的职业发展。

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.


广州住房公积金吃紧:当月贷款额度半天用光


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.


The truth is, to shut our door to the outside world would not help China do its own things well, so China will continue to open to the outside world, with this opening-up being a gradual process.
她说,“在未来12到24个月,除非这些瓶颈得到解决,否则西得克萨斯中质油价格会跌至每桶50美元,这将促使产油国减产。”
An EMBA also boosts corporate careers. “The skills I acquired were key to my promotion,” said one graduate. A fifth are now chief executives, managing directors or board members three years after graduation. Average salaries were up 52 per cent from $114,000 before the programme to $175,000 five years later.
May the glow of New Year candle fill your heart with peace and pleasure and make your New Year bright.Have a love filled New Year!愿新年的烛光带给你祥和与喜悦,祝你新年充满爱。
That is up from a rise of 11.2 per cent in September.
Yes. Mr Meade is the candidate of the ruling Institutional Revolutionary Party, or PRI. His main rival is the hard leftist Andrés Manuel López Obrador, a passionate orator who can work a crowd. Mr Meade has a lot to overcome: he will have to convince voters that they can trust him, after he put up petrol prices by 20 per cent overnight in January, triggering a surge in inflation. He will also have to reveal himself as his own man, not just a clone of an unpopular government that has failed spectacularly to rein in rampant corruption and crime. But backed by the formidable PRI get-out-the-vote machine, he could prove unstoppable. In Mexico’s one-round-only system, 30 per cent of the vote might be enough.
3 . 《歌剧魅影》( T h e Phantom of the Opera )是 由安德鲁·韦伯(Andrew Webber)作曲的著名音乐剧,剧中的男主人公“魅影”(Phantom)的右脸上戴着一副面具。
circulation
Local educational authorities have since revoked Zhengzhou Boqiang New Idea Life Training School's license and launched an investigation into its record. Hauntingly, the school's website remains online, replete with photos of students in camouflage uniforms performing drills and attending what the site labels "wonderful lectures."
n. 疏忽,忽视

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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['t?nl]
Although no North American cities feature in the top 20, the EIU said the cost of living in New York had risen relative to other places in the United States. It shares 27th position as the most expensive US city with Los Angeles.
中国现代经销商要求赔偿1.35亿美元
北京、上海等城市都存在严重的空气污染问题。北京1月份爆发了近期最为严重的雾霾,而去年12月上海空气污染指数一度爆表。严重的空气污染问题显然无助于吸引更多外国游客前来旅游。

The Post

  • Only the first three authors are listed, followed by "et al."
  • 女子买房后知是“凶宅” 诉房主要求退款170万
  • 4月全国建材家居卖场销售近千亿


Jon Copestake, editor of the EIU Worldwide Cost of Living Index, said one of the most notable changes was the rising costs in Australia, with Sydney third in the list and Melbourne fifth. Sandwiched between them was Oslo in Norway.
和许多评论家一样,我一方面了解清单的便利,一方面也讨厌清单的专横。所以我永远不可能只列出十部――我怎么做得到呢,北美影院一年就要上映900多部影片呢――今年是2015年,所以我挑选了15部,为它们分门别类,计数时做了一点含糊,所以最后其实是20部。其中有两部片名的不代表并列,而是代表有两种特色,可以成对观看,二者的优点相映成趣。

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