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

十年来,每年年初我都会从上一年企业界惊现的胡说八道中评选出个中翘楚。我常常乐此不疲。今年我发现那些委婉语、拧巴话、不知所谓的表达还有赤裸裸的恶心话在水准上普遍很不给力,所以我决定2016年度“金废话奖”(Golden Flannel Awards)要从一个比较来劲的奖项——大白话奖——讲起。
3. The root cause of eczema has finally been identified. Scientists have tracked down a series of proteins and molecular pathways that lead to this insufferable skin problem, revealing that the protein filaggrin isn't the sole culprit we thought it was.
岁末来临,二十多部影片轮番上映(hit cinema)。而今年的贺岁片大战随着《龙门飞甲》和《金陵十三钗》的上映而硝烟四起,一场票房PK战也随之拉开帷幕!December is a golde
BETTER CALL SAUL (AMC, Feb. 8) Vince Gilligan and Peter Gould’s “Breaking Bad” spinoff is probably the most anticipated new series of the winter. Starring Bob Odenkirk as the crooked lawyer Saul Goodman, the show is set before the action of “Breaking Bad,” so any appearances by Bryan Cranston or Aaron Paul would be cameos at best. But the audience favorite Jonathan Banks reprises his role as the phlegmatic enforcer Mike Ehrmantraut.
9. 组建自己的“一流团队”。
Ferreira added that while the entire Brazilian population has suffered during preparations for the World Cup, mostly because of big construction projects that have snarled traffic and extended already long commutes for the poor who live on the outskirts of cities, she feels like only the rich are reaping the benefits of the real World Cup experience.
犹如船长要驾驶一艘船。如果领导曾不知这个工程或公司如何牵头,公司又怎样知道呢?这不仅仅是关于接下来的步骤或者交付的内容这两点,而更是对部门或公司的未来有一个清楚的认识,他/她能够同公司员工一起交流的内容。
“我们从斯雷布雷尼察大屠杀事件了解了荷兰和荷兰人是什么样的,”埃尔多安说起现代荷兰历史上最可耻的一幕,“我们从他们屠杀那里的8000名波斯尼亚人就知道,他们品德败坏到何等地步。”
[slu:]
Gender diversity is increasing among graduates working in the financial industry, according to data collected for the 2017 edition of the Financial Times ranking of masters in finance programmes.
The Peoria, Ill.-based maker of heavy equipment authorized $10 billion in stock repurchases in January and expected to buy back $1.7 billion of its shares in the first quarter this year to complete its previous $7.5 billion repurchase initiative. The ongoing buybacks are "a result of our record cash flow," said CEO Doug Oberhelman.
杜阿·里帕《杜阿·里帕》
WHAT: A Greek Revival with four bedrooms and four and a half bathrooms
银行根本无力赶上这样的薪酬水平。例如,受交易结构性变化和旨在约束冒险行为的新规打击,自2009年以来高盛(Goldman Sachs)的净收入减少了约三分之一。该行试图让薪酬比保持稳定,这意味着发放给典型员工的总薪酬减少。
立场:为禁止员工在家上班进行辩解
Institutions may also fail.
McDonough School of Business at Georgetown University in Washington DC returns to the custom ranking in 15th place after dropping out last year because of a low survey response rate from clients. Only three schools enter the custom ranking for the first time, including London’s Cass Business School in 60th place.
The unemployment rate has plunged over the past three years to 5.8% from 8.6%, but almost nobody, including the Federal Reserve, thinks the labor market is really that healthy.
完成家庭作业,阅读指定的内容,以及其他的事。在网络上查找关于你的学习主题的内容,在图书馆看看书,再看看还可以学到哪些关于主题的内容。
Put succinctly, there was no way to describe or explain the crosscurrents of 2014. And I’m not convinced that the benefit of hindsight will make what happened this year any clearer years from now.
当城市规划部门明年初(2015年——译注)提出初步的建议方案时,布鲁克林的东纽约(East New York)地区将被列为试点。随后,重新区划进程就将在该处全市最穷社区之一内展开。而紧随其后的,将是针对皇后区的西法拉盛(Flushing)的提案。
My grandmother’s favorite poem was Invictus by William Ernest Henley. My father hung a copy of it on our kitchen wall, so I grew up reading it every day: “I am the master of my fate; I am the captain of my soul.” I think the best advice I can give anyone – especially someone just starting out in business – is to embrace your role as master of your own fate. Recognize opportunities when they arise and get comfortable saying “Yes.”
When researchers at the University of Illinois set out to create a device that identifies chemicals by their scent, they didn't settle for the sensitivity of the human nose. Instead, they created an artificial nose that uses the smell of bacteria to identify and diagnose specific diseases.
单词yacht 联想记忆:
This includes ‘qwerty,’ in fourth place, ‘admin,’ in 11th, and ‘login’, in 14th.


截至德葡之战,本届世界杯已经结束了12场比赛,场均进球3.42个。预计尼日利亚对阵伊朗的比赛进球数将拉低这个统计,不过,只要本场比赛或随后的美加之战能够斩获至少一球,世界杯就会迎来场均进球三粒的第六天。历史上,平均达到如此进球数的还要追溯到1958年瑞典世界杯,也是贝利横空出世的一届。其中,12支球队在仅仅35场比赛中,场均进球3.6个。
sen年老+ior表形容词,“较…的”→年长的
他认为,地方政府通过卖地、强拆来追求GDP代价太大,早晚要还。“我愿意用一个政协委员的身份非常严肃地提出问题,我们是不是可以不要那么重视GDP?我们是不是可以选择减缓经济发展的速度?”


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

Summly对这一难题的解决方式是创建文章的“快照”,比起阅读整篇文章,该功能可提高读者的浏览速度。尽管应用将关闭,但达洛伊西奥的技术将整合进雅虎的移动应用。
At the same time, entries for gout jumped by just over a third – a disease associated with "ease and comfort" in Victorian London, now more likely to be linked with deprivation and lack of work.
另一些人则采用一些颇具创意的告别方式。人力资源公司OfficeTeam邀请美国600位人力资源经理透露一下他们最近耳闻目睹的最古怪离职方式。现在就让我们一起来欣赏一下吧:
虽然出现上述下跌,但保费收入同比增长37.3%,至1.88万亿元人民币,保险业资产总量达到14.27万亿元人民币,增长了15.42%。

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. 

第二步 重复标志性动作

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. 

Five programmes feature in the pre-experience ranking for the first time. The highest new entrant is Lee Kong Chian School of Business at Singapore Management University. The school came second in terms of the international mobility of its graduates, and is the first school to feature in both pre-experience and post-experience rankings.
去年12月,中国工业利润降幅达到创纪录的8%,显示中国有针对性的刺激计划未能抑制工业放缓,而工业是中国经济的主要推动力。

Facebook的品牌价值增长44%,该公司增加了新的功能,包括平安信使(Safety Check),让用户迅速通知家人和朋友他们是安全的。Elspeth Cheung表示,这些创新提高了这家媒体集团作为一个不可或缺的全球联络媒介的重要性,同时增加了其对广告商的价值。
1. You became a LinkedIn superstar overnight。
He added that “almost every major Korean company, including Hyundai Motor and AmorePacific, relies heavily on Chinese sales”.
6.伯利兹城
泰勒·斯威夫特(Taylor Swift),《空白空间》(Blank Space), Big Machine
多名网友爆料称,周六日研究生入学考试开考前,部分试题和答案就已经提前被公布了。

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.


鲁班家居学院挂牌成立


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.


1936年诺贝尔和平奖奖牌在美国巴尔的摩的拍卖会上拍出116万美元高价,这枚奖牌是在南美的一家当铺里被发现的。
Margot Wallstrom
11 August
An American actress, author, fashion designer, dancer, producer, and singer Jennifer Lopez hold the second place in the list of 10 most beautiful women of 2015. Lopez's personal relationships have attracted worldwide media attention; she has been married three times. Beside entertainment world, J. Lo enjoyed a highly successful business career, consisting of various clothing lines, accessories, fragrances, a production company, television shows and a charitable foundation among other business interests.
After a run with One Direction, Harry Styles could have gone anywhere he wanted.
男女学员对所攻读项目的优势评价一样。
The image of a smooth-talking, chain-smoking and sexist James Bond may be a thing of the past as the latest 007 novel gives him a politically-correct makeover.
I'm going to disagree on one team you mentioned: the Kings. The West is a bit shallow again, and Sacramento is in the mix for a playoff spot. It's not likely or anything, but so long as they are in the mix, they have to pull out almost all the stops to grab it.
单词modest 联想记忆:
Super Bowl

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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Regulators in other countries will draw lessons from the success or failure of the Japanese model.
In terms of salary three years after graduation, Germany leads the way for masters in management programmes, with three schools in the top four. Graduates of WHU Beisheim have the distinction of earning the highest salary, at $98,123 on average.
2.SpaceX demonstrates a big step towards fully reusable space craft
Hilcorp Energy

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  • Only the first three authors are listed, followed by "et al."
  • 下半年楼市涨幅明显放缓 成交量始现调整迹象
  • 家具建材市场迈入品牌竞争时代


而最终取得压倒性胜利的是福特公司(Ford)的CEO马克?菲尔茨(Mark Fields),去年年初他曾令人沮丧地宣布他的公司正“从一家汽车公司向一家汽车公司兼出行公司转型”。他紧接着声称:“遗产是蕴藏着前景的历史。”他超爱这句话,说了不止一次。这句话被他翻来覆去地说,让我觉得它不像格言反倒更像废话。因此本年度新晋“首席蒙人冠军”(Chief Obfuscation Champion)非菲尔茨先生莫属。
Mr Cook must balance that with the secrecy that surrounds its product development. Already, there are whispers on Apple’s campus about another secret project, on the scale of the iPhone or Watch, which is pulling in talent from across Cupertino.

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