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

The OJ Simpson trial proved that nothing gets the masses as excited as murder and celebrity. Throw in Flight 253 and the ambitions of dozens of terrorists, trial lawyers, prosecutors, politicians and aggrieved 9-11 families and you have a story that will run and run.
It has now entered the top 20 for the first time.
9月,苹果iPhone 6s和6s Plus发售,在中国创下销售记录。中国占苹果公司总营收的逾四分之一。在这里,苹果的产品往往被视为地位的象征,它的竞争对手不仅有来自韩国的劲敌三星(Samsung),还有日益流行的中国智能手机品牌华为和小米。
“When I started in this business, Brooklyn was the alternative. Now it is a choice,” said Diane M. Ramirez, the chief executive of Halstead Property. “I see Queens becoming that way. The Bronx is not that far down the line.”
The top 20 comprises 13 US universities, four British and three others.
2. Staying too long in a job that you want to leave
The Norwegian Nobel Committee made the announcement Friday in Oslo, saying the three women will split the coveted award for "their nonviolent struggle for the safety of women and for women's rights."
15. 《旅行终点》(The End of the Tour) ,导演:詹姆斯·庞索特(James Ponsoldt)。
Seven schools made it back into the top 100 after having missed out in the past year or two.
A Chinese Poet’s Unusual Path From Isolated Farm Life to Celebrity
adj. 连续的,继续的,连绵不断的
James Bond Themes 8. "You Only Live Twice" by Nancy Sinatra
In the true-crime drama “Foxcatcher,” the actor Steve Carell, best known for comedy, loses himself behind a prosthetic facade in portraying the multimillionaire John E. du Pont. The standout in the makeup package is the beaklike nose he sports.
Gitanjali Rao是从10名参加决赛的选手们中被选出来的,他们花了三个月的时间与科学家们进行合作,来实现自己的想法。

The nearest star, Proxima Centauri, has a planet orbiting it not much bigger than Earth. Its "year" is only 11 days. But it's in the habitable zone because Proxima Centauri is a red dwarf star about 100 times fainter than the sun. And there's hot news that a similar star, 40 light years away, may have three planets in its habitable zone.
9.Be Honest
楼市终于出现反弹。S&P/Case-Shiller指数显示,2012年前九个月全国房价上涨7%。与此同时,住宅建筑业正在发力,给建筑工人、承包商和建筑商带来了更多工作机会。5月份以来建筑工作增加了2.9万个左右。券商Miller Tabak & Co.经济学家威尔金森(Andrew Wilkinson)指出,建筑市场的就业环境已经明显解冻。解冻的不只是建筑业。为装修住宅的美国人提供服务的零售企业也将需要招人。[qh]

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

Honda has recalled more than 10 million vehicles in the U.S. to fix a potentially fatal defect in air bags made by Japanese supplier, Takata. The air bag inflators can rupture after a crash and injure occupants with shards of metal. Honda has confirmed three deaths and 48 injuries in connection with such incidents.
《拉里·威尔莫夜间秀》(The Nightly Show with Larry Wilmore),Comedy Central,1月19日播出。威尔莫的主题喜剧秀将取代《科尔伯特报告》(The Colbert Report)在夜间11:30播出,这是深夜节目多样化的最新尝试。完全没有压力!
Will oil finish 2018 above $70 a barrel

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. 

The estimates include earnings from movies, TV and endorsements from cosmetic and other companies. Bollywood star Deepika Padukone is the only newcomer on the list.
MasterCard says its index reflects the interconnectedness of major global cities and tracks the ways in which business and leisure jet-setters spend their money.

ESCP Europe and MIT Sloan School of Management in the US also performed well. Both schools climbed five places into third and fifth place respectively.
We will improve planning for regional development.
During the same period, Braziland Russia slashed their holdings to USD 261.7 billion and USD 108.9 billion,respectively.
时间:2012-02-02 编辑:Jasmine
Comic skit “Happiness Of Today II” (Shen Teng, Ma Li etc)

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.



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.

《一名拍摄黑手党的西西里摄影师和她的“鲜血档案”》(A Sicilian Photographer of the Mafia and Her ‘Archive of Blood’)
Will the BoJ tighten monetary policy
What’s in a shade? If you are Pantone, the “color authority” and the dominant color trend forecaster, and you get to choose a “color of the year” every year, potentially a lot. It could include determining fashion’s direction (these are the hues that inform the fabrics that get bought by designers that get made into your clothes), influencing interiors, and even affecting how food appears. Still, I don’t think I’ve ever seen quite so much political and philosophical import attached to a color decision as I have for the 2016 “Color of the Year.”
James Kynge
7.Manage up, down, and sideways

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 A Honda executive privately attributed much of its troubles on “bad luck,” as opposed to shoddy business practices or deliberate misbehavior on anyone’s part. Perhaps. The company’s leadership is certain to check, double-check and lock down its systems and processes to ensure the level sinks no lower on its reservoir of good will. to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

However, its alumni are the most mobile internationally, with 85 per cent of the class of 2014 having worked abroad.
“许多公司在过去几年中大量裁员,不少团队超负荷运转,为了减轻它们的负担,公司纷纷开始招兵买马,”罗伯特哈夫公司董事会主席兼首席执行官麦克斯?麦斯默尔(Max Messmer)指出。“有些机构是出于眼下的需要才增加人手,但很多企业也是在为2011年有望出现的经济增长做好人才储备。”

But even in a bad economy some jobs are just not worth it. Are there any telltale signs you should be looking for when trying to decide if you throw in the towel? Here are ten signs to look for to determine if it's time to find a new job:

  • Only the first three authors are listed, followed by "et al."
  • 增值税增幅同比回落 个人所得税同比下降 一季度减税效应持续显现
  • 住宅投资逼近零增长 楼市对经济拉动再临考验

The dumbest 'smart' objects of 2016

BCMJ Guidelines for Authors

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