['tnl] Pages 503-506 Clinical Articles
New Year comes but once a year. But when it comes it brings good cheer.新年一年只有一次，但每次来临都带来喜悦。
It had hit a record low of 48 in September, and was 49.9 in October.
Puerto Ricans have been hit with dozens of new taxes in the past four years and increases in utility bills as former Gov. Alejandro Garcia Padilla aimed to generate more revenue for a government he said was running out of money. Despite those and other measures, the island’s government has defaulted on millions of dollars’ worth of bond payments and declared a state of emergency at several agencies.
Auto sales: Car sales reach 17 million but manufacturers scramble to adjust capacity as trucks and SUVs soar in popularity. Pressure to hold down corporate fuel averages drives margins on small cars far below break-even.
英国国家电网(National Grid)的教育和技能主管托尼?莫洛尼(Tony Moloney)表示，参与该项目是国家电网旨在鼓励学校学生学习STEM科目（科学，技术、工程和数学）以及熟悉本领域工作的总体计划的一部分。
They were discovered in the modern-day Jiangsu Province near Shanghai inside the ancient tombs belonging to the rich and powerful.
批评人士一直急于指出，库克对新产品开发的参与度不如他前任那样高，而且当他走上舞台介绍新品时，也无法引起同样的兴奋。但库克知道自己的短处，他从健身和时尚界招揽人才，组建了一支新团队，其中包括前博柏利(Burberry)首席执行官安杰拉?阿伦茨(Angela Ahrendts)，以及工业设计师马克?纽森(Marc Newson)。
Philippa Langley, a member of the Richard III Society who coordinated and helped fund the search, said she hoped a new image would emerge of the king and "the two-dimensional character devised by the Tudors will be no more".
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.
Shipments to China cratered by 14.4 per cent year-on-year to Rmb737.5bn in January. That’s from a 4 per cent drop in December, and versus expectations for a 1.8 per cent rise.
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. 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. 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. 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.
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. 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. 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.
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.
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. This research will require the collaboration of clinicians, health researchers, engineers, and computer scientists. 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.
About 40 per cent of entrepreneurs derive most of their income from their company with an average salary of about $194,000 compared to $171,000 for non-entrepreneurs. Entrepreneurs in Asia/Oceania seem to be the most successful. Nearly half (48 per cent) of them earn most of their income from their company and earn the highest salary ($251,000 on average), just ahead of those based in the Middle-East ($244,000).
• Instant Heart Rate by Azumio. 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. 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. 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.
?Women fall for him because he's exciting to be around and this plays a much larger part in a relationship than most think. It's the key to a great first date. Even the femme fatales assigned to kill Bond fall for him. But studies show this isn't surprising at all. 007's character has frequently been accused of being sexist. This is probably true -- and only serves to make him that much more attractive to the ladies.
The People’s Bank of China has long intervened in foreign-exchange markets to hedge against excessive volatility. Since August, however, such intervention has expanded from the domestic spot market, which covers daily transactions, to include the offshore renminbi market in Hong Kong, as well as both onshore and offshore futures markets, traders say.
It has been speculated by varying sources that with MGM back up and running, Sony Entertainment, the company that distributed the last two 007 adventures Casino Royale and Quantum of Solace, will announce their take over of the franchise. Deadline, on the other hand, tend to believe that James Bond 23 may go to Paramount, as they have a very close relationship with Spyglass and are currently working with them to produce Star Trek 2.
British golden girl, Lily Donaldson - who has been a cover girl for the likes of Vogue - showcased her own sultry take on summer style, wearing a white semi-sheer, strapless dress to the event. The 30-year-old model looked simply sensational in the nearly transparent number.
勉强能。民主党需要再赢得24个席位，这意味着他们需要守住特朗普去年胜选的全部12个民主党选区，并拿下23个在大选中投票支持希拉里克林顿(Hillary Clinton)的共和党选区，另外再添上一两个选区。算起来形势对民主党不利，但从历史先例来看形势有利于民主党。历任总统所在的政党几乎总会在中期选举时丢掉一些众议院席位，有时丢得还挺多，特别是当在位总统的支持率低于50%的时候。看一看2010年的巴拉克奥巴马(Barack Obama)就知道了。
• 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.
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. 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.
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.
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.
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.
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.
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.
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.
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.
With a bit of help from Charles Dickens, let’s take a look back at the year in which almost nothing worked:
Comic skit “Dance If You Like” (Cai Ming and Pan Changjiang)
5. Lacking confidence in your career intuition
Whether or not any sort of BlackBerry-Samsung deal actually happens, the development highlights next wave of innovation (and litigation) in mobile technology: one centered on access control methods and containing corporate breachesin an increasingly mobile world.
Sorry, folks, but if you're an investor hoping America's political internecine wars will improve in the near future, just don't invest. The war between Congress with it's abysmal 10% approval rating and the president, the war between the Dems, GOP and the tea party, is going to get even worse, upsetting markets and the economy even more.
After China hawk Steve Bannon’s exit there was a temptation to proclaim the death of the Trump White House’s economic nationalism. But that ignored the presence of Donald Trump, who is instinctually a protectionist. He wants “tariffs” rather than deals when it comes to China, as we’ve learned in recent days. He also sees cracking down on China as key to keeping his “America First” promise to his base.
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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.
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 Hurricane Harvey to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
- Only the first three authors are listed, followed by "et al."
- 房地产三年周期变两年 小年行情明年提前上演？