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PaulaJohnson_2013W-_他的和她的_。。。医疗保健_
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| Some of my most wonderful memories of childhood are of spending time with my grandmother, Mamar, in our four-family home in Brooklyn, New York. |
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childhood:n.童年;幼年;孩童时期
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| Her apartment was an oasis . |
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oasis:n.绿洲;舒适的地方;令人宽慰的事物;
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| It was a place where I could sneak a cup of coffee, which was really warm milk with just a touch of caffeine . |
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sneak:v.溜; n.鬼鬼祟祟的人; adj.暗中进行的; caffeine:n.[有化][药]咖啡因;茶精(兴奋剂);
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| She loved life. |
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| And although she worked in a factory, she saved her pennies and she traveled to Europe. |
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| And I remember poring over those pictures with her and then dancing with her to her favorite music. |
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poring:v.熟读;凝视;沉思(pore的ing形式);
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| And then, when I was eight and she was 60, something changed. |
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| She no longer worked or traveled. |
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| She no longer danced. |
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| There were no more coffee times. |
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| My mother missed work and took her to doctors who couldn't make a diagnosis . |
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diagnosis:n.诊断;
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| And my father, who worked at night, would spend every afternoon with her, just to make sure she ate. |
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| Her care became all-consuming for our family. |
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all-consuming:消耗一切的;
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| And by the time a diagnosis was made, she was in a deep spiral . |
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spiral:n.螺旋;旋涡;螺旋形之物;adj.螺旋形的;v.使成螺旋形;vi.盘旋;螺旋形上升;
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| Now many of you will recognize her symptoms . |
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recognize:v.认识;认出;辨别出;承认;意识到; symptoms:n.症状;征候;征兆;(symptom的复数)
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| My grandmother had depression . |
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depression:n.沮丧;洼地;不景气;忧愁;
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| A deep, life-altering depression, from which she never recovered. |
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life-altering:改变生活的;改变人生的;
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| And back then, so little was known about depression. |
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| But even today, 50 years later, there's still so much more to learn. |
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| Today, we know that women are 70 percent more likely to experience depression over their lifetimes compared with men. |
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compared:adj.比较的,对照的; v.相比; (compare的过去式和过去分词)
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| And even with this high prevalence , women are misdiagnosed between 30 and 50 percent of the time. |
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prevalence:n.流行;普遍;广泛; misdiagnosed:v.错误地或判断,断定;(misdiagnose的过去式和过去分词)
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| Now we know that women are more likely to experience the symptoms of fatigue , sleep disturbance , pain and anxiety compared with men. |
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fatigue:n.疲劳;劳累;厌倦;(金属或木材的)疲劳;v.疲劳;使疲乏;(士兵)担任杂役; disturbance:n.干扰;骚乱;忧虑; anxiety:n.焦虑;渴望;挂念;令人焦虑的事;
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| And these symptoms are often overlooked as symptoms of depression. |
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overlooked:n.被忽视;v.忽视(overlook的过去式和过去分词形式);忽略;俯瞰;
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| And it isn't only depression in which these sex differences occur , but they occur across so many diseases . |
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occur:v.发生;出现;存在于;出现在; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
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| So it's my grandmother's struggles that have really led me on a lifelong quest . |
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quest:n.追求;寻找;vi.追求;寻找;vt.探索;
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| And today, I lead a center in which the mission is to discover why these sex differences occur and to use that knowledge to improve the health of women. |
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mission:n.使命,任务;代表团;布道;v.派遣;向…传教; improve:v.改进;改善;
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| Today, we know that every cell has a sex. |
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| Now, that's a term coined by the Institute of Medicine. |
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Institute:v.开始(调查);制定;创立;提起(诉讼);n.学会,协会;学院;
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| And what it means is that men and women are different down to the cellular and molecular levels. |
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cellular:adj.细胞的;多孔的;由细胞组成的;n.移动电话;单元; molecular:adj.[化学]分子的;由分子组成的;
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| It means that we're different across all of our organs . |
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organs:n.[生物]器官;机构;风琴(organ的复数);
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| From our brains to our hearts, our lungs, our joints . |
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joints:n.关节; v.接合,联合; (joint的第三人称单数和复数)
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| Now, it was only 20 years ago that we hardly had any data on women's health beyond our reproductive functions. |
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reproductive:adj.生殖的;再生的;复制的;
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| But then in 1993, the NIH Revitalization Act was signed into law. |
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Revitalization:n.复兴;复苏;新生;
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| And what this law did was it mandated that women and minorities be included in clinical trials that were funded by the National Institutes of Health. |
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mandated:adj.托管的; v.强制执行; (mandate的过去分词和过去式) minorities:n.少数(minority的复数形式);少数民族;少数族裔; clinical:adj.临床的;诊所的; funded:adj.提供资金的;v.提供资金;积存;提供资金偿付的本息;(fund的过去式); Institutes:n.学院(institute的复数);v.建立(institute的第三人称单数形式);
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| And in many ways, the law has worked. |
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| Women are now routinely included in clinical studies, and we've learned that there are major differences in the ways that women and men experience disease. |
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routinely:adv.例行公事地;老一套地;
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| But remarkably , what we have learned about these differences is often overlooked. |
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remarkably:adv.非常;极为;格外;出乎意料地
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| So, we have to ask ourselves the question: |
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| Why leave women's health to chance? |
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| And we're leaving it to chance in two ways. |
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| The first is that there is so much more to learn and we're not making the investment in fully understanding the extent of these sex differences. |
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investment:n.投资;投入;封锁; extent:n.程度;范围;长度;
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| And the second is that we aren't taking what we have learned, and routinely applying it in clinical care. |
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applying:v.申请,请求;使用;应用;(apply的现在分词)
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| We are just not doing enough. |
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| So, I'm going to share with you three examples of where sex differences have impacted the health of women, and where we need to do more. |
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impacted:adj.压紧的;结实的;嵌入的;(人口)稠密的;v.装紧;挤满(impact的过去分词);
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| Let's start with heart disease. |
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| It's the number one killer of women in the United States today. |
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United:adj.联合的; v.联合,团结; (unite的过去分词和过去式)
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| This is the face of heart disease. |
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| Linda is a middle-aged woman, who had a stent placed in one of the arteries going to her heart. |
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middle-aged:adj.中年的;具有中年人特点的;适合于中年人的; stent:n.斯滕特氏印模膏;展伸;adj.扩张的; arteries:n.[解剖]动脉(artery的复数);v.给…提供动脉(artery的单数第三人称);
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| When she had recurring symptoms she went back to her doctor. |
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recurring:v.再发生;反复出现;(recur的现在分词)
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| Her doctor did the gold standard test: a cardiac catheterization . |
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gold standard:n.金本位制;黄金标准;典范; cardiac:n.强心剂;强胃剂;adj.心脏的;心脏病的;贲门的; catheterization:n.[外科]导管插入;
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| It showed no blockages . |
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blockages:n.阻塞物;堵塞;阻塞;(blockage的复数)
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| Linda's symptoms continued. |
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| She had to stop working. |
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| And that's when she found us. |
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| When Linda came to us, we did another cardiac catheterization and this time, we found clues . |
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clues:n.(调查,研究等的)线索;迹象;(故事的)关键情节;(clue的复数)
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| But we needed another test to make the diagnosis. |
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| So we did a test called an intracoronary ultrasound , where you use soundwaves to look at the artery from the inside out. |
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ultrasound:n.超声;超音波; soundwaves:声波; artery:n.动脉;干道;主流;
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| And what we found was that Linda's disease didn't look like the typical male disease. |
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typical:adj.典型的;特有的;象征性的;
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| The typical male disease looks like this. |
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| There's a discrete blockage or stenosis . |
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discrete:adj.离散的,不连续的;n.分立元件;独立部件; stenosis:n.(器官)[病理]狭窄;
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| Linda's disease, like the disease of so many women, looks like this. |
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| The plaque is laid down more evenly , more diffusely along the artery, and it's harder to see. |
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plaque:n.匾;血小板;饰板; evenly:adv.均匀地;平衡地;平坦地;平等地; diffusely:adv.广泛地;扩散地;
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| So for Linda, and for so many women, the gold standard test wasn't gold. |
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| Now, Linda received the right treatment . |
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treatment:n.治疗;疗法;对待;处理;讨论;
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| She went back to her life and, fortunately , today she is doing well. |
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fortunately:adv.幸运地;
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| But Linda was lucky. |
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| She found us, we found her disease. |
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| But for too many women, that's not the case. |
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| We have the tools. |
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| We have the technology to make the diagnosis. |
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technology:n.技术;工艺;术语;
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| But it's all too often that these sex diffferences are overlooked. |
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| So what about treatment? |
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| A landmark study that was published two years ago asked the very important question: |
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landmark:n.[航]陆标; adj.有重大意义或影响的;
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| What are the most effective treatments for heart disease in women? |
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effective:adj.有效的,起作用的;实际的,实在的;给人深刻印象; treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数)
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| The authors looked at papers written over a 10-year period, and hundreds had to be thrown out. |
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| And what they found out was that of those that were tossed out, 65 percent were excluded because even though women were included in the studies, the analysis didn't differentiate between women and men. |
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tossed:v.扔,抛,掷;甩;(使)摇摆,挥动,颠簸;(toss的过去分词和过去式) excluded:v.排除;拒绝;把…除外;驱除;(excluded是exclude的过去分词) analysis:n.分析;分解;验定; differentiate:vi.区分,区别;vt.区分,区别;
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| What a lost opportunity. |
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| The money had been spent and we didn't learn how women fared . |
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fared:n.法依笛(服装品牌);
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| And these studies could not contribute one iota to the very, very important question, what are the most effective treatments for heart disease in women? |
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contribute:v.贡献,出力;投稿;捐献; iota:n.极微小;希腊语的第九个字母;
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| I want to introduce you to Hortense, my godmother , |
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godmother:n.教母;vt.当…的教母;作…的女监护人;
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| Hung Wei, a relative of a colleague , and somebody you may recognize -- |
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relative:adj.相对的;有关系的;成比例的;n.亲戚;相关物;[语]关系词;亲缘植物; colleague:n.同事,同僚;
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| Dana , Christopher Reeve's wife. |
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Dana:n.美国德纳(美国汽车公司);
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| All three women have something very important in common. |
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| All three were diagnosed with lung cancer , the number one cancer killer of women in the United States today. |
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cancer:n.癌症;恶性肿瘤;
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| All three were nonsmokers . |
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nonsmokers:n.不抽烟的人;禁止吸烟列车车厢;
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| Sadly, Dana and Hung Wei died of their disease. |
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| Today, what we know is that women who are nonsmokers are three times more likely to be diagnosed with lung cancer than are men who are nonsmokers. |
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| Now interestingly , when women are diagnosed with lung cancer, their survival tends to be better than that of men. |
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interestingly:adv.有趣地; survival:n.幸存,残存;幸存者,残存物;
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| Now, here are some clues. |
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| Our investigators have found that there are certain genes in the lung tumor cells of both women and men. |
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investigators:n.研究者,调查者(investigator的复数形式); genes:n.基因;(gene的复数) tumor:n.肿瘤;肿块;赘生物;
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| And these genes are activated mainly by estrogen . |
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activated:v.使活动;激活;使活化;(activate的过去式和过去分词) mainly:adv.大多;大部分;主要地;首要地; estrogen:n.雌性激素;
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| And when these genes are over-expressed, it's associated with improved survival only in young women. |
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associated:adj.有关联的; v.联想; (associate的过去分词和过去式) improved:adj.改良的:v.改进:改善(improve的过去分词和过去式)
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| Now this is a very early finding and we don't yet know whether it has relevance to clinical care. |
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relevance:n.关联;适当;中肯;
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| But it's findings like this that may provide hope and may provide an opportunity to save lives of both women and men. |
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findings:n.调查发现;判决;裁决;(finding的复数)
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| Now, let me share with you an example of when we do consider sex differences, it can drive the science. |
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| Several years ago a new lung cancer drug was being evaluated , and when the authors looked at whose tumors shrank , they found that 82 percent were women. |
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evaluated:v.估计;评价;评估;(evaluate的过去分词和过去式) tumors:n.肿瘤(tumor的复数); shrank:v.收缩(shrink的过去式);缩小;
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| This led them to ask the question: Well, why? |
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| And what they found was that the genetic mutations that the drug targeted were far more common in women. |
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genetic:adj.基因的;遗传学的; mutations:n.[遗]突变;变化;转变(mutation的复数形式);
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| And what this has led to is a more personalized approach to the treatment of lung cancer that also includes sex. |
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personalized:v.在…上标明主人姓名; (personalize的过去分词和过去式) approach:n.方法;路径;v.接近;建议;着手处理;
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| This is what we can accomplish when we don't leave women's health to chance. |
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accomplish:v.完成;实现;达到;
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| We know that when you invest in research, you get results. |
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| Take a look at the death rate from breast cancer over time. |
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Take a look at:看一看;检查; death rate:n.死亡率;
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| And now take a look at the death rates from lung cancer in women over time. |
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| Now let's look at the dollars invested in breast cancer -- these are the dollars invested per death -- and the dollars invested in lung cancer. |
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invested:v.投资;投入;(invest的过去分词和过去式)
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| Now, it's clear that our investment in breast cancer has produced results. |
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| They may not be fast enough, but it has produced results. |
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| We can do the same for lung cancer and for every other disease. |
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| So let's go back to depression. |
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| Depression is the number one cause of disability in women in the world today. |
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disability:n.残疾;无能;无资格;不利条件;
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| Our investigators have found that there are differences in the brains of women and men in the areas that are connected with mood . |
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mood:n.情绪,语气;心境;气氛;
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| And when you put men and women in a functional MRI scanner -- that's the kind of scanner that shows how the brain is functioning when it's activated -- so you put them in the scanner and you expose them to stress. |
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functional:adj.功能的; scanner:n.[计]扫描仪;扫描器;光电子扫描装置; expose:v.揭露,揭发;使曝光;显示;
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| You can actually see the difference. |
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| And it's findings like this that we believe hold some of the clues for why we see these very significant sex differences in depression. |
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significant:adj.重大的;有效的;有意义的;值得注意的;意味深长的;n.象征;有意义的事物;
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| But even though we know that these differences occur, 66 percent of the brain research that begins in animals is done in either male animals or animals in whom the sex is not identified . |
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identified:v.确认;认出;找到;发现;说明身份;(identify的过去式和过去分词)
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| So, I think we have to ask again the question: |
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| Why leave women's health to chance? |
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| And this is a question that haunts those of us in science and medicine who believe that we are on the verge of being able to dramatically improve the health of women. |
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haunts:v.出没; n.常去的场所; (haunt的第三人称单数和复数) verge:vi.濒临,接近;处在边缘;n.边缘; dramatically:adv.戏剧地;引人注目地;adv.显著地,剧烈地;
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| We know that every cell has a sex. |
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| We know that these differences are often overlooked. |
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| And therefore we know that women are not getting the full benefit of modern science and medicine today. |
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| We have the tools but we lack the collective will and momentum . |
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collective:adj.集体的;共同的;集合的;集体主义的;n.集团;集合体;集合名词; momentum:n.势头;[物]动量;动力;冲力;
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| Women's health is an equal rights issue as important as equal pay. |
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rights issue:n.有购股权的证券发行(公司以优惠价格向现有股东发售新股);
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| And it's an issue of the quality and the integrity of science and medicine. |
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integrity:n.完整;正直;诚实;廉正;
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| (Applause) |
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| So imagine the momentum we could achieve in advancing the health of women if we considered whether these sex differences were present at the very beginning of designing research. |
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at the very beginning of:在…一开始的时候;
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| Or if we analyzed our data by sex. |
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analyzed:v.分析(analyze的过去式和过去分词);检讨;
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| So, people often ask me: |
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| What can I do? |
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| And here's what I suggest: |
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| First, I suggest that you think about women's health in the same way that you think and care about other causes that are important to you. |
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| And second, and equally as important, that as a woman, you have to ask your doctor and the doctors who are caring for those who you love: |
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| Is this disease or treatment different in women? |
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| Now, this is a profound question because the answer is likely yes, but your doctor may not know the answer, at least not yet. |
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profound:adj.深厚的;意义深远的;渊博的;
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| But if you ask the question, your doctor will very likely go looking for the answer. |
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| And this is so important, not only for ourselves, but for all of those whom we love. |
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| Whether it be a mother, a daughter, a sister, a friend or a grandmother. |
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| It was my grandmother's suffering that inspired my work to improve the health of women. |
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inspired:adj.受到启发的; v.鼓舞; (inspire的过去分词和过去式)
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| That's her legacy . |
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legacy:n.遗赠,遗产;
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| Our legacy can be to improve the health of women for this generation and for generations to come. |
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| Thank you. |
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| (Applause) |
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