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

《为奴十二年》导演史蒂夫?麦奎因(Steve McQueen)在登台领奖时说:我有点吓到了。然后他微微耸肩,引用片中福音歌曲的歌词,说了句“翻涌吧,约旦河,翻涌吧”("Roll, Jordan, roll")。
"Many companies operating with reduced staff levels are bringing in reinforcements to relieve their overworked teams," notes Max Messmer, Robert Half's chairman and CEO. "While some firms are backfilling positions out of necessity, businesses are also hiring to accommodate anticipated growth in 2011."
WHAT: A riverfront contemporary with three bedrooms and three and a half bathrooms
Here are four memorable designs from the year, including commentary from some of the artists who helped shape the looks.
The Killing of a Sacred Deer
尽管销量大幅增长让人欢欣雀跃,但它并不是汽车业今年最重大的新闻。底特律先是因为通用汽车公司(General Motors)提拔玛丽?芭拉出任汽车业首位女性首席执行官而欢欣鼓舞;紧接着,福特汽车(Ford)首席执行官艾伦?穆拉利在重回波音公司还是加入微软公司(Microsoft)两者间犹豫不决之际,它又紧张得大气都不敢喘。传统的三巨头抱怨现有产能已挖掘到极限,开始制订扩张和聘用新人的计划。特斯拉公司(Tesla)让电动汽车的销量火了一把,而且不肯按行规出牌;而同时谷歌公司(Google)则在自动汽车研制上一马当先。
这款智能产品的使用可以追溯到1800年,但在2016年它才变得“智能”。 Meet Peggy,这种洗衣挂钩能够“帮助你减轻负担”,它会在洗衣机洗好衣服的时候提醒你,并告诉你天气是否适宜晾晒衣服。该装置连接到您的手机,它会在天气变化或是需要转移晾衣服的地方时发消息提醒你。
“This could be just the beginning,” said Michael Na, a strategist in Seoul with Nomura.?“They have so many options to punish Korean businesses.”
Despite the confusion, executive producer Ed Razek has commended the Chinese partners as “wonderful and enthusiastic hosts.”
The cemetery was first found in July 2007and was excavated by the Xinjiang Institute of Cultural Relics and Archaeology,with assistance from local authorities. The research team, led by Zhiyong Yu,director of the Xinjiang Archaeological Institute, published the findings in Chinese in the journal Wenwu. The article was recently translated into Englishand published in the journal Chinese Cultural Relics.
清华大学(Tsinghua)与欧洲工商管理学院(Insead University)合办的Tiemba项目排名上升两位,在2015年全球EMBA排行榜中摘得桂冠,而Trium项目的排名回落至第三,仅在头名位置维持一年时间。
单词continuous 联想记忆:
CareerCast.com是Adicio Inc.旗下的求职网站。该网站基于体能要求、工作环境、收入、工作压力和职业前景这五项因素,对200种职业进行了先后排名。在确定排名次序时,网站采用的是美国劳工统计局(Bureau of Labor Statistics)等政府部门的数据。与前些年一样,之所以选择这200个职业,是因为考虑到它们在当前劳动力市场的需求程度以及是否能获得相关可靠数据。
Amazon founder Jeff Bezos rose to No. 3 on the list for the first time, thanks to the jump in in Amazon shares, which boosted his net worth to $72.8 billion.
With this in mind, he does anticipate a pick-up in US investment “because it has been so weak — we don’t normally see it grow at a lower pace than consumption except in a recession”.
2. 2012年搞笑诺贝尔奖之和平奖
Porto is nearly synonymous to port wine, and also its rich history. The city's historic center and the Alto Douro Wine Region have been listed as UNESCO World Heritage Sites.
Fortunately for Honda, it benefits from a deep reservoir of customer goodwill and loyalty in the U.S., as well as a reputation for building high-quality vehicles that are rated highly by objective third parties for their low cost of ownership. The reservoir was drained somewhat by a product defect controversy resulting from airbag deployments that scattered shrapnel on its victims.

瑞士洛桑国际管理发展学院(IMD)和西班牙Iese商学院(Iese Business School)稳坐英国《金融时报》两份高管教育榜单榜首。英国《金融时报》2017年高管教育排行榜开放招生课程和定制课程两份排名的头两名,均由这两所学校包揽。
"If it (transforming the economic development mode) only results in empty talk instead of being implemented, then economic development cannot be promoted in a sound and rapid way, and may even not be sustained." LI YIZHONG, member of the CPPCC National Committee and former minister of industry and information technology

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

“尽管我本质上是一名工程师和分析人员,但迄今为止我所做过的最重要的决定都与此无关,它们永远是基于直觉,”他去年在曾就读MBA的杜克大学(Duke University)对一名采访者表示。

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. 


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. 

Li Xiaojin, a professor at Civil Aviation University of China's Economics and Management College, said that rapidly increasing numbers of flights and limited airspace for civil aviation are the major reasons for delays.
朱克斯提醒,我们目前正处于第四次超级大泡沫之中,它是美联储在保守经济学兴起以来的30年时间里吹起来的。他将这个泡沫称为“暂时没有名字的泡沫”(Bubble With No Name Yet)。好,大家来给这个新泡沫命名吧。但不管你叫它什么,都要快点起名,因为它马上就要爆了,就像过去30年相继破灭的亚洲泡沫、互联网泡沫和信贷泡沫一样。

In this emotional comedic drama, a selfish car dealer named Charlie Babbitt learns that he has a brother after his estranged father dies. He is upset to learn that said brother, Raymond, received his father's $3 million estate despite living with severe autism that has left him in a mental institution. Charlie learns that Raymond is a savant with outstanding capabilities for mental math and takes advantage of this skill by using Raymond to count cards in Vegas.
8. Smart bottle opener
On the subject of #MeToo, she said: 'I just think they're douche bags. They're not champions. I just think they're losers. I don't like them.
Despite the confusion, executive producer Ed Razek has commended the Chinese partners as “wonderful and enthusiastic hosts.”
He took out his textbooks and busied himself with his daily homework routine.
It is a timely warning. His findings, he writes, “point to a heightened risk of emerging market crises in the coming years as the Fed continues to normalise interest rates”.

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

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.

住房租赁市场火爆 全国租房价格连续七个月上涨


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.

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. 

32. Azumio Inc. Sleep time. Accessed 28 August 2017. 

33. RelaxLine. BellyBio. Accessed 28 August 2017.

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.

Mr Ravenscroft believes he would have had a narrower perspective if he had become a management consultant. Teaching also helped him develop a willingness to take risks — the hard way. “If you stand in front of 30 teenagers who won’t hold back when you’re doing something wrong it makes you willing to try things.”
Master of None
Be Professional

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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“We sell cars+ , if you don’t give us cars, naturally we won’t be able to go on, we’ll close,” Wang said in an interview, estimating import dealers are losing between 3 million and 10 million yuan a year each. The group seeking compensation represents 30 of the roughly 40 remaining imported Hyundai dealers in the country.
An industry insider said the survey indicated that China was in the process of an industrial upgrade and a high value-added service sector was on the rise. This is leading to a thriving Internet industry, which needs science and engineering professionals, and a booming finance industry, which requires finance and economics professionals.
下载量紧随《权力的游戏》之后的是美剧《绝命毒师》和《行尸走肉》。以下是根据BT下载网站 TorrentFreak和BitTorrent 数据统计的2013年被下载次数最多的美剧排名:

We will ensure that foreign trade continues to pick up and register steady growth.

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