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

教育水平的提高,反映了我国教育体制的发展。教育部部长袁贵仁今年3月表示,根据对中国教育现状的自主探究显示,去年我国的总体教育发展水平要比世界平均水平更好。
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For co-founder Harper, a top priority for the next 12 months is shoring up Bigcommerce’s internal technical talent and creating services that help merchants build closer customer relationships. One example is offering data that helps store managers track “abandoned carts” and offer deals that help turn browsers into buyers. This can help merchants quickly add 15% to their monthly sales, he said.
In this Sept. 18, 1990, file photo, Steve Jobs, president and CEO of NeXT Computer Inc., shows off his company's new NeXTstation after an introduction to the public in San Francisco
7. Pumping Iron Could Enhance Long-Term Memory
adj. 社会的,社交的
“One person had his wife call to tell his boss he was not coming back.”
[.ent?'teinm?nt]
"The Constitution really doesn't apply here. The Constitution limits how much government can suppress speech, not a private university," she said.
2.The Tianjin Explosions
中国外汇储备出现史无前例的下跌,已经引发市场担心:如果资本外流持续下去,而央行继续捍卫汇率,外储可能迅速蒸发。多数分析师相信,中国央行将被迫缩减干预力度,以免外汇储备进一步枯竭。
“我们现在从中国看到的情况不仅仅是巴西一国的现象,我们在整个拉美都看到了同样的情况,中国对所有市场的出口都在下降,”负责马士基航运在巴西、巴拉圭、乌拉圭和阿根廷业务的执行董事安东尼奥?多明格斯(Antonio Dominguez)表示,“已经连续几个季度出现这种情况,但随着我们进入(2016)年,这种局面变得越来越明显了。”
去年,韩国教育部发布了一本手册就整形手术综合症对韩国高中生发出了警告,引用了迈克尔?杰克逊以及一个韩国女性因对整形上瘾导致脸部怪异浮肿的案例。
Supporting Actress in a Comedy: Kate McKinnon, “Saturday Night Live”
国内生产总值达到74.4万亿元,增长6.7%;
It's lightweight and rolls up easily for travel.
学员平均年龄:37岁
美国电影学会选出了十部本年度最佳电影和电视剧。这些影片排名按字母表顺序排列,美国电影学院评审团选出这些影片的标准是促进了活动图像的艺术化、提升了美国艺术形式文化遗产的魅力、对观众和艺术者有所启发、在美国社会上占有一席之地。
One key thing the best bosses seem to have in common is that they are all consummate problem solvers. They can not only spot them, but brainstorm successful and innovative ways to fix them。
《灾难艺术家》一部分是关于好朋友的电影。一部分是娱乐业的新片,还有一部分是幕后的电影短片。
We will work to ensure that our people have access to equitable and quality education.
考虑到波士顿咨询集团(Boston Consulting Group)管理合伙人理查德莱塞(Richard Lesser)的第二任期将于10月结束,该公司可能也将引来变化。然而,由于该公司拒绝就其选举流程及领导人最多可以有几个任期置评,莱塞的未来尚不明确。
Subdivided flats smaller than 100 square feet (9 square meters) can rent for $385 in the Asian city.
贝拉是该榜单上最年轻的模特,她上个月刚满21岁。
挖掘者认为这个墓地可追溯到1700年前,在当时的中国,库车在控制西部前线(西域)上扮演着关键的角色。由于丝绸之路的路线有经过西域,所以控制这个关键的区域对中国统治者来说是非常重要的。


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Stripping out price, volumes of Chinese imports in October fell a more modest 2.6 per cent from a year earlier, according to estimates from Oxford Economics.
The government also needs to adopt the Internet Plus governance to ensure that government services will be more easily accessible for our people.


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

摩洛克位于非洲北部地区,被称为通往非洲的一扇大门,主要旅游城市包括首都拉巴特、最大城市卡萨布兰卡、马拉喀什以及阿加迪尔市。
China purchased 141,000 industrial robots in 2017, up 58.1% year-on-year, but foreign brands accounted for nearly three quarters of that, showing that the gap is still widening between Chinese robot makers and their foreign peers.
The year’s most compelling makeup and hair designs have been almost characters themselves (and are certainly more dynamic than some of those who appear on-screen). But while physical features are obvious right away, they can also give shape and nuance to the performances of those who assume them. Sometimes, a big nose creates a window of understanding.
For both, opponents are enemies rather than fellow citizens who think differently.

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. 

According to the annual Global Trade Protection Report, companies in the US launched 43 anti-dumping cases in 2015 and a further 22 anti-subsidy investigations aimed at securing countervailing duties. The US took the lead in both areas, overtaking India and Brazil, which launched the most cases in 2014 and 2013.

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. 

现年22岁的劳伦斯是《饥饿游戏》电影系列的女主角,她还可能凭借在电影《乌云背后的幸福线》中的表现获得奥斯卡提名。
awkward

The impact of sluggish growth on year-end payouts may have peaked in 2015, however, when 66 per cent of white-collar workers received no year-end bonus. And the 2016 level actually represents an improvement from 2014, when 61 per cent had to go without.
那么2015年最好的职业是什么?保险精算师高居榜首,他们是分析财务风险方面的专业人员。
1. glitterati / n . 知名人 士,国际上层社会人士。
胡须的神奇之处
“Why did this happen to my daughter?” she said. “There’s been so many deaths because of the guns. I don’t know how many people have to die.”
THE BRIDGE (Hulu, Friday) The second season of this Danish-Swedish crime drama (the source for FX’s recently canceled series of the same name) once again involves the Oresund Bridge connecting the two countries.

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.


根治天价学区房须平衡教育资源


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 film pulls heavily from the life of Arthur Bremer, who shot presidential candidate and segregationist George Wallace in 1972. Similarly to his film counterpart, Bremer shot Wallace shortly after being rebuffed by a young girl. Overall, though, his life was much less exciting than that of De Niro's character, with the biggest commonality between the two being that neither actually succeeds in killing a politician.
Though the 60-year-old Microsoft head is 4.2 billion dollars poorer than 2015, his net worth of 75 billion dollars has put him in the top spot of the spot on Forbes' World Billionaires list for the third year in a row, after overcoming Mexico's Carlos Slim Helu in 2014.
The soaring prices of 2008, when oil reached more than $140 a barrel, will repeat, though not likely in 2014, Mr. Hummel said. The price 'is going to go higher.'
China’s outbound non-financial investment fell 40.9 per cent during the ten months through October, according to official figures, reflecting the enduring impact of strict capital controls.
8.A New iPhone
"The guy must have weighted the pros and cons of the situation: he had a great chance to survive a stranded elevator, but would have been doomed if he left homework undone," joked @Zealshifang.
"The autonomous region has invested 4 billion yuan (around 600 million US dollars) to promote industries with local features in poor areas, and relocated 77,000 poor people last year," said Lu Huadong, deputy director with the office.
2010年中国的计生政策将发生变化吗?
扎实推进“一带一路”建设。
还有哪对系列电影的荧幕情侣可以像《暮光之城》的克里斯汀?斯图尔特和罗伯特?帕丁森这样成功开创戏路呢?两个人都成为了影坛名角。帕丁森在最新作品《好时光》中延续了他近年来这种让人几乎认不出的造型风格。在《迷失Z城》中,他把自己打扮成胡子蓬乱的眼镜男,如今他又把头发染成亚麻色,变身为一个试图在纽约完美做案,结果却让患有发育性残疾的弟弟(本?萨弗迪饰)被捕的银行抢劫犯。他试图用盗取的钱来给弟弟交保释金,结果麻烦接踵而至。很多的麻烦。除了饰演弟弟一角外,本?萨弗迪还和自己的哥哥约书亚?萨弗迪共同执导了这部电影。《好时光》入围了今年戛纳电影节的主竞赛单元,参与角逐金棕榈奖。该片于11月3日在日本上映,11月17日在英国和爱尔兰上映,11月23日在希腊上映。(资料来源:A24制片公司)

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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'It is most probably from a mine in South Africa known as Premier mine and now as Cullinan, where most of the blue diamonds are from. Probably in the last 30 years,' Mr Lunel said.
您只需轻轻一挥将它们放飞,泡沫气球就会自己飘向空中。
commission
For: Well-received by both audiences and critics, it tells a crucial slice of history.

世界卫生组织宣布小头症及其他神经系统紊乱疾病的爆发构成国际关注的公共卫生紧急事件,呼吁国际社会联手应对。

  • Only the first three authors are listed, followed by "et al."
  • 楼市真回暖?2015销售额达8.73万亿刷历史新高
  • 2017年中国卫生洁具行业发展现状分析


考辛斯的交易有资格作为一枚重磅炸弹,猛龙用两笔大交易确立了他们东部冠军挑战者的位置,以及,在另外的故事情节中,西部最后一个季后赛席位的争夺将愈演愈烈。
As early as 2008, wearable technology—which can range in anything from measuring your heart rate to curating music based on your mood—has been touted as the next big moment in consumer electronics.

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