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

但是,权先生警告年轻人在欲进行手术时应三思。
Everyone has both, but people tend to be most attached to their “best” identity — the one that offers the most social status or privileges. Successful professionals, for example, often define their identities primarily through their careers.
谎言8:我写了5页的简历,那是因为我足够好。说谎原因:我就是个不折不扣的话唠!
More than 80 percent of Chinese students returned to the country after completing their studies abroad, and the country has sent 544,500 students in 2016 to study abroad.
Joseph Keller、Raymond Goldstein、Patrick Warren和Robin Ball获此殊荣,他们的研究课题是“人类马尾辫中头发的运动及受力平衡”。
问:最后一个问题——在你的许多作品中,你总以强烈的感情质疑正义,质疑英雄主义是否道德。那么你对于成为英雄这种事是怎么看的呢?
“These kinds of questions are really front and center, even though they’re not necessarily verbalized.”
2015年期间,难民源源不断涌入希腊、保加利亚、意大利,西班牙、马耳他和塞浦路斯,其中绝大多数,超过80万人是经海路抵达希腊的,大约3600人在横穿北非和意大利间的地中海危险旅途中丧生或失踪。
1. “暂时没有名字的泡沫”引发30年来的最大规模崩盘
“Someone left for lunch and never came back.”
"How many patients do Chinese doctors see a day? It can be more than 50," he told China Daily. "How can we have the time and energy to do research or publish papers?"
最佳女歌手:米兰达·兰伯特
王斌表示,去年母婴传播率也达到了历史最低点,从2012年的7.1%下降到2017年的4.9%。
《泰晤士高等教育》专刊的编辑菲尔·巴蒂说道:“中国采取了强有力的政策,且背后又有雄厚的资金支持,才能打造这些世界一流的大学。2015年,中国就宣布将实施‘卓越计划',计划在2020年之前打造六所可以跻身世界一流行列的高校。”
我不了解你是什么样的情况,但是如果我根据工作,生活和生活各自准备一个日历,我会手忙脚乱的。如果你生活中所有的事都记在一个日历上,在一个计划中,你就不能重复安排任何事了,就像一个重要的测试或者和老板的晚餐一样。
通常冷静的分析师们早已习惯了汽车行业的缓慢增长,但是遇到特斯拉,他们就丢掉了一贯的谨慎。德意志银行(Deutsche Bank)的分析师罗德o拉切给该股设定了310美元的目标价格。无独有偶,摩根士丹利(Morgan Stanley)的分析师亚当o乔纳斯也将特斯拉的目标股价定为320美元,并称它是“世界上最重要的汽车公司”。
这也是这座大都市连续第8年保持全国最大消费城市地位。
研究集团龙洲经讯(Gavekal Dragonomics)的陈龙表示,如今分析师们认为,中国银行业的盈利性增长机会差不多用完了。
Average age: 37
23% of wealthy Chinese women work in real estate and 18% of them are involved in finance and investment, followed by manufacturing accounting for 14%.
It is a struggle for power contained by understandings and institutions.
Who can forget Prince Harry's unprecedented communique to the media a few months ago over the then speculation over his girlfriend Meghan Markle?
韩国最大的整形医院之一,由权株创立的JK整形手术中心,近期开了一家旅馆来更好地服务顾客。这些顾客每次看病人均花费17675美元。
恭祝健康、幸运,新年快乐。
公司:(Wonderbag)Natural Balance公司


The survey by the Public Religion Research Institute in partnership with the Religion News Service found political and religious disagreement on what is behind severe weather, which this year has included extreme heat and drought.
Wages will finally accelerate after years of stagnation
7.Yes, John was with me last night. – Because that’s what friends do… we agree and ask questions later。


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

学员非常有经验,一位毕业生说,所有学员之间的交往和互动是这个项目的重要方面。
Baoneng’s raid has been bitterly resisted by Wang Shi, Vanke’s founder who has sought out white knights in a so far successful effort to retain control of the management-led company. The takeover battle fuelled a surge both in the price of Vanke’s Shenzhen-traded shares and Mr Yao’s known worth.
[n?t]
Exports fell 6.6 per cent year-on-year in January to Rmb1.14tn, following a 2.3 per cent gain in December. Economists expected a gain of 3.6 per cent. It was the biggest fall in exports since an 8.9 per cent drop in July last year.

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. 

[h?b]

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. 

Wonder Woman
We will improve the property rights protection system.

Weaker demand from emerging markets made 2015 the worst year for world trade since the aftermath of the global financial crisis, highlighting rising fears about the health of the global economy.
今年中国经济成V字形强劲复苏,随之而来的是许多关于城市房价疯涨的报道。
As for Dirk, nobody should ever go out the way they do, but it happens all the time. In some ways, maybe it's easier if the reckoning is this painful.
里奥斯工作非常努力。她很小的时候就从萨尔瓦多来到了美国。以优异成绩从高中毕业后,她一边养家,一边读完大学。成立Nation Waste Inc.公司的时候,她并没有感到害怕。22岁的时候,里奥斯刚刚从休斯敦大学(the University of Houston)毕业几个月就贷款购买了两辆卡车,毅然投身由男性主导的垃圾处理行业。目前,这家位于休斯敦的公司有24名全职员工。里奥斯说:“回头看看过去的经历,总是让我感到吃惊。我很小的时候就跟着父母来到美国,现在我正在实现我的美国梦。”
In 55th place, University of Edinburgh Business School regains the rank it held two years ago. The school dropped down the tables last year after failing to make it into the Masters in Management ranking. The University of Bradford School of Management recorded its best progression, aided by the school’s first appearance in the ranking of the top 100 Executive MBAs.
中国的创新表现有所改善,在"创新质量"方面排名第17,这是个考量高校水平、科学出版物数量和国际专利申请量的指标。

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.


第七督查组就吉林棚改安置不到位等问题密集约谈


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.


2016年中国迅猛发展的网红经济可能会达到87亿美元
We’ve all had them: bosses and managers who make our work lives terrible and couldn’t manage a stack of paper clips, let alone a team of employees. I’ve written about the traits that make for bad bosses before, and in that article, a thoughtful commenter came up with his own list of what makes a good boss。
智能床垫
信任感依然会是商业领域中唯一且最关键的问题。
“有个人在Facebook上公开辞职。”
2. American shale.By the end of 2014, the U.S. was producing more than 9 million barrels of oil per day, an 80 percent increase from 2007. That output went a long way to creating a glut of oil, which helped send oil prices to the dumps in 2014. Having collectively shot themselves in the foot, the big question is how affected U.S. drillers will be by sub-$60 WTI. Rig counts continue to fall, spending is being slashed, but output has so far been stable. Whether the industry can maintain output given today’s prices or production begins to fall will have an enormous impact on international supplies, and as a result, prices.
3、全面放开二孩政策
"Well, I believe I am a feminist because I believe that women deserve the same rights as men in every aspect of our economy and our society, here at home and around the world," Clinton said to applause. "You know, I've devoted a lot of my public life to advocating for women's rights being human rights, and making the case that we have to do everything we can, through laws, regulations, culture, to change the still-existing stereotypes that hold women back."
core
He had been stranded for five hours by the time help arrived.

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.

About the ICMJE and citation styles

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 8. Across the world,China will continue to flex its might with acquisitions and transactions. Theone million Chinese in Africa will continue their efforts to lock up naturalresources. to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

Those falls came despite a rise in insurance premium income of 37.3 per cent year-on-year to Rmb1.88tn, while total assets reached Rmb14.27tn, up 15.4 per cent.
"In addition, universities have paid a lot of attention to cultivating innovation instead of starting up companies. This is another reason for the low desire on campus to found startups."
6. Lighting
"I'm excited about the opportunity to return to China, enjoy the country's culture, and bring the excitement of live NBA games directly to Chinese fans," he added.

reflection

  • Only the first three authors are listed, followed by "et al."
  • 广东省鼓励建设租赁住房和人才公寓
  • 中消协:已向华帝公司发出约谈函 约谈工作在准备中


问:对于你的作品在西方广受欢迎一事,你是怎么看的?
Managers are able to reward their subordinates in unique, personalized ways thanks to the budget they receive from corporate. Two examples of past bonuses: free trail rides at an equestrian stadium and a barbeque with lassoing and horseshow throwing lessons.

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