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

TV soaps regularly top the TV ratings but the highest trending show of 2012 was the BBC kids' show 'Mike The Knight' that beat US terror drama 'Homeland' and 'Towie.'
I'm only a child yet I know we are all part of a family, five billion strong, in fact, 30 million species strong and we all share the same air, water and soil -- borders and governments will never change that. 我只是一个小孩,但我知道我们都是一个大家庭的成员,超过60亿人的大家庭,以及超过三千万物种的大家庭,政府和国界永远都无法改变这个事实。
The government also needs to adopt the Internet Plus governance to ensure that government services will be more easily accessible for our people.
"The longer people sit out of the job market, the harder it's going to be for them to re-enter," Frederickson says.
With another Fast & Furious movie slated to hit theaters next summer, Johnson should have another banner year in 2014. He could do even better thanks to Hercules. The film, about the mythological hero’s life after he completes his famous 12 labors, has franchise potential written all over it. If it’s also a big hit, Johnson’s 2014 box office grosses should be huge.
Mr. Wang, the WeChat user in Beijing, said he was an avid QQ user 11 years ago but stopped using the instant messaging service because 'it didn't look very professional.' But after downloading WeChat on his smartphone he found 'most of my colleagues and friends are on it, and everyone communicates through voicemails now.'
Were you late to work yesterday because you couldn't remember where you put your car keys? Did you completely forget about a coffee date last week with a friend and only remember when you got a text asking, "where are you?" Can you no longer remember the name of your favorite elementary school teacher? Memory problems impact just about everyone to a certain degree, but science suggests you might be able to improve your memory, as well as reduce the likelihood of Alzheimer's and dementia, by engaging in certain activities, eating specific foods, and using certain mnemonic devices.
9. CO2 in the Earth's atmosphere passes 400 parts per million
If 2017 was the year of fake news, 2018 is shaping up to be one of fake data. And just as fake news comes in many varieties — real news dubbed by the US president as fake, as well as nonsense gaining huge audiences on social media — so does fake data.
Imports grew 6.7 per cent year-on-year to $152.2bn after falling 1.4 per cent the previous month, according to China’s General Administration of Customs, defying a median forecast predicting contraction would worsen to 1.9 per cent.
The regulations also specifically stipulate the taxi services.
今年三分之二新上市股票目前的交易价格高于发行价。据旗下管理着专注于IPO的交易所交易基金(ETF)的Renaissance Capital介绍,平均而言,2017年美国新上市股票的股价涨幅大约是标准普尔500指数(S&P 500)的两倍,达到20%。
And, this year, Star Wars found its way onto the list as well, with ‘starwars’ claiming the 16th spot.
若原油供应严重中断,仍可能会推高油价,但潜在的供应过剩会降低这种可能性。Saxo Bank的大宗商品策略部门主管汉森(Ole Hansen)说,新兴市场的需求曾使得供应如此紧张,因而任何一次供应中断都造成了油价的大幅波动。
● “肉桂卷会在人类屁股内爆炸”
It was visible in practically every brand that edged from the 1960s to 1970s for the season currently in stores, including Alberta Ferretti, Pucci and Etro.

底特律居民都不会忘记1999年的暴风雪,当时多架飞机在底特律大都会国际机场的停机坪上滞留了数小时。同样,全美航空公司(US Airways)在2004年至2005年也遭遇了假日事故,当时超过72,000件行李丢失或损坏。
Wallace wrote the book after saying "yes" to everything for a year, a commitment which both advanced his career and landed him in a cult meeting. What the movie didn't show, however, is the sheer number of Internet scams Wallace signed up for. Apparently, saying "yes" all the time has its downfalls in real life.

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

In this 1998 swashbuckler classic, Antonio Banderas plays the protege of a boring nobleman who moonlights as a masked outlaw, saving the Mexican commoners of California from corrupt leaders. While Zorro might sound like a regular old-timey superhero, the story upon which The Mask of Zorro is based pulls heavily from legends surrounding a real-life desperado named Joaquin Murietta.

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. 

But he told Washington's Observer-Reporter paper that he was keen to read it as it was "a testament of the sincerity, interest and innocence of that time".

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. 


Traders heading for the exits: 'Unsustainable trends can survive much longer than most people anticipate, but they do end when their 'time is up, at the culmination of their time cycles.' They analyzed more than 20 cycles: 'Nearly unanimously point to tectonic shifts in the months and years ahead.'
Grains have fallen about 3 per cent.
A child prodigy with an IQ higher than Albert Einstein is celebrating becoming a unique member of Mensa. Nishi Uggalle, ten, is one of the youngest people in the country to score the highest possible mark of 162 in the IQ society's supervised testing.
This founding father argued that the college would both guard against the desire in foreign powers to gain an improper ascendant in our councils and ensure the office of President will never fall to the lot of any man who is not in an eminent degree endowed with the requisite qualifications.

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.

儿子霸占父母房产赚租金 老父母一纸告上法庭


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.

这其中包括麦肯锡(McKinsey)。去年10月,这家咨询机构的500多名高级合伙人汇聚伦敦格罗夫纳豪斯酒店(Grosvenor House Hotel),启动了神神秘秘的领导层选举程序。下一阶段涉及该公司550名高级合伙人于1月对鲍达民(Dominic Barton)继任者的候选名单进行投票,之后在2月份对两名人气最高的候选人进行第二轮投票。鲍达民自2009年起执掌麦肯锡。
Yu Xiuhua, born with cerebral palsy, lived a quiet village life. She is now a literary sensation whose vivid, erotic poems are “stained with blood.”
The report provided in-depth observations on 28 Chinese business and administrative capitals - excluding Beijing and Shanghai - using several indicators.
Yao Zhenhua, the chairman of Baoneng Group and the biggest riser since 2015, saw his wealth shoot up 820 percent to $17.2 billion, elevating him to fourth in the overall list.
本文作者为卡内基国际和平基金会(Carnegie Endowment)高级研究员、世界银行(World Bank)中国业务局前局长,译者/何黎

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 2、《蝙蝠侠大战超人:正义黎明》 to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

In global health, 2016 will be remembered as the year a little known virus made a major impact. It felt strangely familiar, but this time it wasn't Ebola making headlines around the world, it was Zika - a mosquito-borne virus being linked to a huge spike in the number of babies in Brazil born with brain defects.
And, at random, some other highlights from the list:


  • Only the first three authors are listed, followed by "et al."
  • 2月居民中长期贷款环降2489亿 调控预期增加
  • 新年楼市调控风向问答:“房住不炒”目标会不会变?

adj. 肌肉的,肌肉发达的

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