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

It was the first "real" James Bond song (again, the first two films only opened with orchestral music), and it's still the best. Shirley Bassey got an opportunity to sing her soul out and she accepted the challenge with obvious pleasure. This is a song that makes the villain Auric Goldfinger seem a lot more threatening (and attractive) than he actually is, but that's part of the miracle of Bassey's work here. It's proud and heroic and enticing and it's kind of a lie, but who cares? The music is pure James Bond, the lyrics are pure machismo, and the performance is perfect.
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007系列电影荣誉主题曲之一:路易斯·阿姆斯特朗--《我们拥有世界上的所有时间》
Having earned a living for the last four years while her contemporaries go to school every day, she has been forced to mature quickly.
然而专家却在西方当前的乱象之下看到一种白人身份危机。
吕特回应称:“这就是坐在沙发上发推特与治理国家的区别。如果你在治理这个国家,你就得做明智的决定,而驱逐大使是不明智的。”
Some 18.1 million people, for example, want a good full-time job but can't find one, an unusually high number 5 1/2 years into a recovery. And despite a sharp decline in the number of people out of work six months or longer, that figure is still higher than at any time before the 2007-09 recession.
The EU is making clear it wants to use the void in US leadership on trade to nail down new trade agreements. The negotiations with the Mercosur trade bloc in Latin America have been going on in fits and starts for more than a decade. But the EU and key Mercosur members like Argentina are now pushing to conclude a deal by the end of this year. That would be a big statement planted right in the US’s backyard.
The THE Asia University Rankings for 2017 rated Peking University and Tsinghua University, both in the Chinese capital of Beijing, as the second and third best universities in the continent. National University of Singapore is ranked the best.
If there are nine or 10 best picture nominees, it could grab a spot. Jordan Peele's screenplay looks certain to be recognized.
Although Downey has a few movies coming out next year, they’re much smaller than his superhero films. He won’t see another huge payday until 2015 when Avengers: Age of Ultron hits theaters.
The expansion would be considered impressive in most markets, but it represents an ongoing slowdown for China, the world's second-largest film territory and a continual source of growth for Hollywood for the better part of a decade.
Many grand and spectacular museums are located in picturesque cities like Bruges, Antwerp and Brussels. Art lovers can fully engage themselves in the numerous treasures dating back to the medieval period. Exploring the quiet towns and appreciating their Gothic architecture is also an opportunity not to be missed. As the hometown of the world’s best beers, chocolates and fries, everyone can be a gourmet here. With the 100th anniversary of the outbreak of World War I approaching, Belgium is set to draw many tourists in the coming years.
I formerly had an Android device (even though I have had a MacBook since 2009 – weird, I know). After switching this summer, I quickly realized the power of iPhone “Reminders.” Each time a reminder is due, your iPhone buzzes and displays a pop-up. You can snooze it or mark as completed. In addition, you can set up recurring reminders, which are perfect for remembering to mail estimated quarterly tax payments, renewing subscriptions, running payroll and other things you tend to forget.
However the prolonged period of contraction fits with the overall pattern of the slowing Chinese economy.
以人民币计算,12月份出口环比成功增长0.6%,超过了收缩0.1%的预期,不过仍大大低于11月份5.9%的增幅。以人民币计的进口增长10.8%,是预期4.8%的增幅的两倍以上,不过仍比上个月低2.2个百分点。
“温家宝总理强调指出,中国有效应对了全球金融危机的严重影响,经济保持稳定快速增长。因此中国成为全球第二大经济体,在五年内GDP几乎翻番。”Luis Schmidt Montes, Chilean ambassador
unexpectedly
但现实远比他想象的艰难。雷文斯克罗夫特表示:“我曾以为这就是一个机会,要花掉两年,但现实是严峻的,因为这活不好干。”此外,他的导师在雷曼兄弟(Lehman Brothers)工作,这家银行于2008年破产。他大笑着说:“这段指导关系持续的时间没有我希望的那么长。”
Even if Gibson turns out to be a rental and leaves as a free agent this summer, the Thunder will likely feel good about these trade terms.
The area is close to the city centre and the demolition contractors had to make sure that when they brought down the buildings they did not damage a light rail viaduct nearby or a shopping mall and electricity sub-station.
《雷神3:诸神黄昏》的搞笑程度远远超出你的想象。这都要感谢杰夫?戈德布卢姆与塔伊加?维迪提两位天才的合作。维迪提不仅是本片导演,他还在电影中饰演了一个极其真诚的石头人战士Korg。
单词entertainment 联想记忆:
Finally, in the EMBA ranking, excluding joint programmes delivered with non-European schools, IMD of Switzerland, with an average salary of $261,397, is well ahead of Business School in second and IE Business School in third place.
在选择毕业后的职业道路的时候,雷文斯克罗夫特青睐Teach First的原因是,它兼具两个世界的好处。他能够快速当上教师,领取薪水,接受私人部门高管的指导,并与企业接触;相应地,他将承诺任教两年,完成教师资格培训认证。


Most entrepreneurs (78 per cent)used savings or relied on friends and family to raise all or part of their start-up funds. Angel financing was also a source for a quarter of entrepreneurs.
技术在法律界并不是一个新现象——许多律所已经与人工智能和机器学习企业建立了合作伙伴关系,有些律所还建立了自己的“孵化器”,或者投资了法律科技初创公司。但这一趋势已经达到临界水平,并将在2018年急剧加速。
For the students interested in comparing school options around the world, US News released the fourth edition of its annual Best Global Universities rankings.


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

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1. 仅根据薪水选工作
目前全国11个省的52所高校配备了自动售货机,出售艾滋病检测试剂以供学生自查。
A heartfelt coming-of-age story that perfectly captures the bittersweet transition from adolescence to dawning adulthood...

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. 

10. The 2012 Ig Nobel Prize in Medicine

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. 

“Brands that are known for going it alone are partnering with unexpected allies,” Gilbert says. “If you dig into Apple’s investment, the special projects team reads like a who’s who list of some of the best talent in the world coming from every sector imaginable.”
2016年空前的海外收购潮消耗了中国大量外汇储备,随后监管部门开始严格限制境外交易。今年8月,中国政府出台了新框架,鼓励那些符合北京战略重点的交易,并限制涉及娱乐、体育和豪宅等方面的交易。

Farewell to Don and his perfect suits, to Peggy and her plaids, to Joan and her jewel tones and sheaths.
但1998年的记录现已被每四、五年一次的新记录多次打破,而2014年的记录是在没有显著厄尔尼诺现象发生的年度创下的。加文·A·施密特(Gavin A. Schmidt)是位于曼哈顿的美国宇航局戈达德太空研究所的所长,他说,下一次的强厄尔尼诺现象可能会打破所有的温度记录。
现在对于宣传单张的内容还没有详细的介绍,但之前投放的传单都包含谴责北韩统治者家族的言论。
伦敦商学院在所有这4项排名上表现强劲,包括全日制MBA课程排名第一,合办EMBA(与美国哥伦比亚商学院(Columbia Business School)合办)和定制高管教育课程均排名第三。
They are also less likely to seek employment in a different sector after graduation. Only 30 per cent changed industry sector compared with nearly two-thirds of full-time MBA students.
中国旅游研究院国际旅游研究所(Institute of International Tourism)副所长蒋依依认为,外国游客数量下降的部分原因在于人民币的升值。

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.


深圳深入推进住宅区垃圾分类


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.


单词manifesto 联想记忆:
[f]
Wang Dengfeng, director of the Physical Education, Health and Art Department under the Ministry of Education (MOE) and Vice Chairman of the China Football Association, was quoted as saying that football experts are designing curriculums for more than 360 training programs in primary and secondary schools.
They were discovered in the modern-day Jiangsu Province near Shanghai inside the ancient tombs belonging to the rich and powerful.
“现在关注‘星二代’、‘富二代’的比较多,但是‘农民工二代’更需要人们关注。”
We will strive to boost employment and business startups.
《星球大战:侠盗一号》预计2016年12月16日上映。
Had the North Koreans not set off another nuclear test at the weekend the big story this week on the Korean peninsula might have been the Trump administration’s odd timing in announcing its plans to pull out of a trade deal with Seoul.
高效老板和经理们趋向于:
In a statement given to the website Kotaku, Epic Games said the lawsuit was a result of Mr Rogers "filing a DMCA counterclaim to a takedown notice on a YouTube video that exposed and promoted Fortnite Battle Royale cheats and exploits."

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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马克?高恩洛夫(Mark Gongloff)在《赫芬顿邮报》(Huffington Post)上警告说:“一季度美国经济增长的大幅降级揭示了经济体挥之不去的疲弱,暴露了华盛顿执迷于财政紧缩的愚蠢,并给美联储最新的乐观打了一记响亮的耳光。”而随着政治局势的恶化,增长速度还会进一步放缓。
卓越雇主排名:11
"This is something we believe is really important for the future of our country,"Facebook (FB, Fortune 500) CEO Mark Zuckerberg said in August.
In June this year, a collaboration between universities and industry announced that it had discovered a huge reserve of helium gas in Tanzania, using a new exploration technique.

在大选结果公布后,罗姆尼竞选阵营暂时没有发表言论。

  • Only the first three authors are listed, followed by "et al."
  • 未来十年中国大城市畅想:东京纽约式的轨道生活
  • 红星美凯龙H股通过聆讯 最快有望6月底登陆港交所


vt.
The bigger Tesla gets, the more complex its operations become. Since it sells directly to customers and eschews franchised dealers, it will have to develop a network of service centers to handle repairs on the cars it sells. Its unusually generous warranty, which obligates it to buy back used cars for 50% of their original base price after three years, could create a second channel of used Teslas. “Tesla will be eating a lot of three-year-old cars that aren’t as sexy or rare as they were a year ago,” wrote one Seeking Alpha blogger. ‘To me, it sounds like a potential mess.”

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