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

Yes — by an eyelash. Democrats will need to win an additional 24 seats, meaning they will have to hold on to all 12 Democratic districts that Mr Trump won last year and pick up the 23 Republican districts that voted for Hillary Clinton, plus one or two more for good measure. The math is not on the Democrats’ side, but history is. The president’s party almost always loses some House seats in the midterms, and sometimes loses big, especially when the president has an approval rating below 50 per cent. See Barack Obama in 2010.
The 16-year-old surnamed Zhou on April 24 poured pesticide into the water dispenser in the classroom, apparently in an act of revenge against classmates who disturbed the class and affected Zhou's studies, the Chongqing Morning Post said.
德布勒森是继首都布达佩斯之后的第二大城市,也是消费水平较低的匈牙利的中心地带。
11月18日
*最佳真人秀主持:鲁保罗?查尔斯(RuPaul Charles),《鲁保罗变装皇后秀》(RuPaul’s Drag Race, Logo)
陆金所是最大的一家。它是中国平安保险(Ping An Insurance)的子公司,平安也是陆金所最大的股东。
Paddington 2
'I just want to stay professional. I don't want them to think I'm a fangirl. I'm one of the performers and I'm not just a background dancer, I'm the dancer.'
锁定一个品牌,它擅长于制作你想要的类型的车,这样可以高效地购买并找到对你来说最好的车。2016美国新闻最佳汽车品牌奖从四个类别挑选了最佳的品牌:轿车、SUV、卡车和豪车。
He admitted to having mixed emotions about the letter as he and Vonnie are now divorced.
"Martial arts are highlighted in the TV series. The actors performed real kung fu," a Douban user Weishenmeyaoxuefa said.
单词channel 联想记忆:
Federica Mogherini, the EU’s foreign policy chief, and Johannes Hahn, the bloc’s enlargement commissioner, have also weighed in, criticising Mr Erdogan’s proposed constitutional changes and his recent rhetoric.
A major disruption still could push oil higher, but potential oversupply makes even that less likely. Emerging-market demand once kept supply so tight that any disruptions led to striking price moves, said Ole Hansen, head of commodity strategy at Saxo Bank.
3.1 用改革的办法深入推进“三去一降一补”。
另一条推文发表于美国总统就职日,奥巴马称:“能够为你们服务是我毕生的荣幸,你们使我成为了更好的领袖和更好的人。”
People on both sides of the Taiwan Strait are brothers and sisters, and no matter how the situation on the island evolves, the mainland is determined to maintain Cross-Strait stability.
大部分岛主为意在开发旅游业的企业,但也有私人岛主,他们买岛则是为了在岛上建私人会所招待朋友。
n. 利益,津贴,保险金,义卖,义演
10.Be Dedicated and balanced
[ri'vi?in]
●"Man shoots off his own penis taking selfies with gun"
不会。傻子才会去预测足球比赛的结果。最好是作事后诸葛亮。目前已经举办过20届世界杯。其中,巴西(5次捧杯)和德国(4次捧杯)是决赛常客。主场优势有所帮助,东道国赢得了6次奖杯。但是明年的世界杯将在俄罗斯举行,而这位东道主在参赛队伍中排名垫底。
他们两个自称拥有着世界上最大的两个粉丝基础。但是周日晚上,在伦敦温布利SSE竞技场上举行的2017年欧洲音乐大奖中,Shawn Mendes夺得桂冠, Taylor Swift在她参选的五个奖项中纷纷落选。
The 2017 grads of Tsinghua University earn an average salary of 9,065 yuan per month, according to the survey released by xinchou.cn, an internet salary survey and report provider.


Today, the Financial Times reveals the fake gross domestic product data routinely released from many northern Chinese regions. There, solid alternative evidence suggests the authorities have “smoothed” the economic growth figures. They artificially boosted growth figures between 2012 and 2016, masking a real downturn, and last year covered up a genuine recovery.
*最佳真人秀主持:鲁保罗?查尔斯(RuPaul Charles),《鲁保罗变装皇后秀》(RuPaul’s Drag Race, Logo)
According to a notice jointly issued by the Ministry of Human Resources and Social Security and the Ministry of Finance, the average monthly payments for both enterprise and institution retirees will be increased by about 5.5% from the 2016 level.


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

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。”
除了深圳、广州和北京,上海也是毕业生就业找工作最受欢迎的城市。此外,中部和西部的省会城市也是毕业生就业的首选之地。
Rounding out the top three is Chrissy Teigen, 31, who joins the list for the first time after raking in $13.5 million over the past 12 month-period.
We will promote coordinated urban development above and below the ground, and begin construction on at least another 2,000 kilometers of underground utility tunnels in cities. A three-year initiative will be launched to remove the risk of flooding in highly vulnerable urban areas; and further progress will be made in the development of sponge cities. All these efforts will make our cities more attractive and function better.

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. 

据称,索尼影业极有可能负责新一集的电影的发行工作,之前,他们也负责了最近两部《007》电影的分销职责。与此同时,与望远镜娱乐关系交好的派拉蒙影业也有可能担当发行公司,目前,这两届公司正联手拍摄《星际迷航2》。

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. 

Gongloff piles on the bad news about 2014: GDP 'grew at a 1.8% annualized pace in the first quarter ... revising down its earlier estimate of 2.4% growth ... The first quarter's dismal growth was at least better than the 0.4% GDP growth of the fourth quarter of 2012. But it was still far from healthy, and economists don't see it getting much stronger any time soon.' And that's real bad news for the markets going into 2014.
In my adolescent years on the foothills of Himalayas, I had a friend we all referred to as the "dreamy guy." He would spend his days enjoying the smallest of things – color-tagging butterflies, counting peaks on the horizon, making stories out of cloud formations. He was a happy soul, deeply receptive to life's beauties and easily excited. I knew this guy many years ago and I thought about him today as I sat down to write this piece for you, dear class of 2013.

《前第一夫人要求伊斯兰教变得宽容并支持女权》(A Former First Lady Presses On for a Tolerant, Feminist Islam)
据《每日经济新闻》网报道,经过一项最新调查显示,经济和金融类院校毕业生最有'钱'途。国内5大财经类高校毕业生的平均月薪在1万元以上。
Song “Friends Forever” (Yang Kun and Zhang Liangying)
Among the amenities spread through its three terminals are two 24-hour movie theaters screening the latest blockbusters for free, a rooftop swimming pool and a butterfly garden.
Fund shareholders weren’t wasting any time reacting to this year of disappointment. Collectively, they’ve added just $35 billion to active stock-picking funds in the last 11 months, less than a quarter of the $162 billion they added in 2013, which was the first year of positive flows for the industry since 2007. This is not to say that they were sitting still. ETFs and passive index funds took in over $206 billion in net deposits through Thanksgiving, and Vanguard surpassed the $3 trillion mark sometime in late summer. Investors seem to have decided that they’d rather bet on the horses than the jockeys, after all.
有人会认为卡莉·西蒙演唱的《海底城》的主题曲最好听。他们可能有自己的理由,可能是因为这是"邦德电影中最好听的歌曲"。曲调欢快、充满吸引力、浪漫抒情,卡莉西蒙的演唱打动人心。但是这些对詹姆斯·邦德、他的冒险旅程、他的来历甚至他的电影没有任何特殊引导作用。尽管《没人做得更好》被认为是一首好歌,但是由于上述原因它并没能进入榜单前五名。

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.


广州实施“租购并举” 已批准三家住房租赁企业


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.


俄罗斯和北约(Nato)都呼吁缓和土耳其与荷兰的争执。
suc下面,cumb躺-躺下去-屈从
Xu said at a press conference that by 10:20 am, 97 bodies have been retrieved.
那么,这对2015年的油价意味着什么呢?人们对此各执己见。然而,今后12个月的油价走势将由下列五大因素(排名不分先后)决定。
我是否玩儿得太high了?缺乏实现某些事情的动机会让你失去平衡或者稍后会让你感到筋疲力尽,很有压力。休息一下是非常有必要的,但是如果你休息得过了头从而使生产力降低,或者你养成了太过拖拉的习惯,那么或许就需要时间来平衡你的时间安排,以便你可以完成大量的事情而仍有时间休息娱乐。
斯威夫特今年也收获颇丰,以8千万位居第二。在1989(2014年排名第一的专辑,卖出超过3.6百万份)的发行超过一年后,通过斯科特.伊斯特伍德拍摄的MV,她的最新单曲“最疯狂的梦”一跃成为排行榜第一位。但这只是起始,她的史诗1989世界巡回演唱会最终使她极近收入最高女星榜首。
n. 路线,(固定)线路,途径
Consumer Electronics Show
从技术上来说,这是东盟(ASEAN)十个成员国将本地区所有贸易协议纳入一个整体框架的计划。它也没有TPP在许多方面的雄心。
Last year was especially striking because global heat records were broken or tied in every month except January and April, researchers said.

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 单词campaign 联想记忆: to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

三严三实:既严以修身、严以用权、严以律己,又谋事要实、创业要实、做人要实
loan
James Bond Themes 2. "GoldenEye" by Tina Turner
中国首先要把自己的事情办好,但关起门来也办不好自己的事情。所以我们的开放大门会越开越大。

v. 改革,改造,革新

  • Only the first three authors are listed, followed by "et al."
  • 2014建材行业格局分析
  • 北京公租房首试“老年公寓”


Investigators have arrested one youth and one 18-year-old in connection to the July 9th shooting death, which occurred inside a Jamestown Cres. home.
5.Britons love bleak humour: that's why all the hire bikes are branded with the name of a bank currently being investigated for fixing interest rates. It's supposed to be funny.

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