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RogerStein_2013S-_资助新药研究的一条大胆创新之_
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| So this is a picture of my dad and me at the beach in Far Rockaway , or actually Rockaway Park. |
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Rockaway:n.(美)四轮轻便马车;
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| I'm the one with the blond hair. |
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blond:adj.(头发)亚麻色的;白肤金发碧眼的;(家具等)浅色的;n.白肤金发碧眼人;
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| My dad's the guy with the cigarette. |
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| It was the '60s. A lot of people smoked back then. |
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| In the summer of 2009, my dad was diagnosed with lung cancer . |
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diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式) cancer:n.癌症;恶性肿瘤;
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| Cancer is one of those things that actually touches everybody. |
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| If you're a man in the United States of the America, you've got about a one in two chance of being diagnosed with cancer during your lifetime. |
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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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| If you're a woman, you've got about a one in three chance of being diagnosed with cancer. |
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| Everybody knows somebody who's been diagnosed with cancer. |
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| Now, my dad's doing better today, and part of the reason for that is that he was able to participate in the trial of an experimental new drug that happened to be specially formulated and very good for his particular kind of cancer. |
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participate:v.参加;参与; experimental:adj.实验的;根据实验的;试验性的; formulated:v.制订;规划;准备;确切表达;(formulate的过去分词和过去式)
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| There are over 200 kinds of cancer. |
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| And what I want to talk about today is how we can help more people like my dad, because we have to change the way we think about raising money to fund cancer research. |
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fund:n.基金;资金;存款;v.投资;资助;
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| So a while after my dad was diagnosed, |
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| I was having coffee with my friend Andrew Lo. |
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| He's the head of the Laboratory for Financial Engineering at MIT, where I also have a position, and we were talking about cancer. |
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Laboratory:n.实验室,研究室; Financial:adj.金融的;财政的,财务的; Engineering:n.工程;工程学;v.密谋策划;设计制造;改变…的基因;(engineer的现在分词)
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| And Andrew had been doing his own bits of research, and one of the things that he had been told and that he'd learned from studying the literature was that there's actually a big bottleneck . |
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literature:n.文学;文献;文艺;著作; bottleneck:n.瓶颈;障碍物;
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| It's very difficult to develop new drugs, and the reason it's difficult to develop new drugs is because in the early stages of drug development, the drugs are very risky, and they're very expensive. |
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| So Andrew asked me if I'd want to maybe work with him a bit, work on some of the math and the analytics and see if we could figure out something we could do. |
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analytics:n.[化学][数]分析学;解析学;
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| Now I'm not a scientist. |
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| You know, I don't know how to build a drug. |
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| And none of my coauthors , Andrew Lo or Jose Maria Fernandez or David Fagnan -- none of those guys -- are scientists either. |
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coauthors:n.共同执笔者,合著者;vt.合著; Maria:n.母驴;母马;[天文学]海(指月亮,火星表面的阴暗部分);
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| We don't know the first thing about how to make a cancer drug. |
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| But we know a little bit about risk mitigation and a little bit about financial engineering, and so we started thinking, what could we do? |
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mitigation:n.减轻;缓和;平静;
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| What I'm going to tell you about is some work we've been doing over the last couple years that we think could fundamentally change the way research for cancer and lots of other things gets done. |
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fundamentally:adv.从根本上;基础地;重要地
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| We want to let the research drive the funding , not the other way around. |
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funding:n.基金;资金;提供资金;v.为…提供资金;拨款给;(fund的现在分词)
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| So in order to get started, let me tell you how you get a drug financed. |
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| Imagine that you're in your lab -- you're a scientist, you're not like me -- you're a scientist, and you've developed a new compound that you think might be therapeutic for somebody with cancer. |
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compound:v.合成; adj.混合; n.大院; therapeutic:adj.治疗的;治疗学的;有益于健康的;n.治疗剂;治疗学家;
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| Well, what you do is, you test in animals, you test in test tubes, but there's this notion of going from the bench to the bedside , and in order to get from the bench, the lab, to the bedside , to the patients , you've got to get the drug tested. |
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notion:n.观念;信念;理解; bedside:n.床边,床旁;adj.床旁的,枕边的; patients:n.接受治疗者,病人;(patient的复数)
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| And the way the drug gets tested is through a series of, basically , experiments, through these large, they're called trials, that they do to determine whether the drug is safe and whether it works and all these things. |
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series:n.系列,连续;[电]串联;级数;丛书; basically:adv.主要地,基本上; determine:v.决定;确定;测定;查明;形成;影响;裁决;安排;
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| So the FDA has a very specific protocol . |
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specific:adj.特殊的,特定的;明确的;详细的;[药]具有特效的;n.特性;细节;特效药; protocol:n.协议;草案;礼仪;vt.拟定;vi.拟定;
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| In the first phase of this testing, which is called testing for toxicity , it's called Phase I. |
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phase:n.阶段;时期;月相;(月亮的)盈亏;v.分阶段进行;逐步做; toxicity:n.[毒物]毒性;
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| In the first phase, you give the drug to healthy people and you see if it actually makes them sick. |
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| In other words, are the side effects just so severe that no matter how much good it does, it's not going to be worth it? |
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severe:adj.极为恶劣的;十分严重的;严厉的;苛刻的;
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| Does it cause heart attacks, kill people, liver failure, this kind of thing? |
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liver:n.肝;(动物供食用的)肝;
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| And it turns out, that's a pretty high hurdle . |
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hurdle:n.障碍;栏;跳栏;vt.克服;vi.克服;跳过;
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| About a third of all drugs drop out at that point. |
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| In the next phase, you test to see if the drug's effective , and what you do there is you give it to people with cancer and you see if it actually makes them better. |
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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;
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| And that's also a higher hurdle. People drop out. |
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| And in the third phase, you actually test it on a very large sample, and what you're trying to determine is what the right dose is, and also, is it better than what's available today? |
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dose:n.剂量;一剂,一服;v.服药;给药;给…服药;
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| If not, then why build it? |
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| When you're done with all that, what you have is a very small percentage of drugs that start the process actually come out the other side. |
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percentage:n.百分比;百分率;利润的分成;提成; process:v.处理;加工;列队行进;n.过程,进行;方法,adj.经过特殊加工(或处理)的;
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| So those blue bottles, those blue bottles save lives, and they're also worth billions, sometimes billions a year. |
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| So now here's a question: if I were to ask you, for example, to make a one-time investment of, say, 200 million dollars to buy one of those bottles, so 200 million dollars up front, one time, to buy one of those bottles, |
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one-time:adj.以前的;古时的;adv.一度(等于onetime);从前; investment:n.投资;投入;封锁;
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| I won't tell you which one it is, and in 10 years, I'll tell you whether you have one of the blue ones. |
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| Does that sound like a good deal for anybody? |
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| No. No, right? |
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| And of course, it's a very, very risky trial position, and that's why it's very hard to get funding, but to a first approximation , that's actually the proposal . |
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approximation:n.[数]近似法;接近;[数]近似值; proposal:n.提议,建议;求婚;
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| You have to fund these things from the early stages on. It takes a long time. |
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| So Andrew said to me, he said, " What if we stop thinking about these as drugs? |
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What if:如果…怎么办?
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| What if we start thinking about them as financial assets ?" |
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assets:n.资产;宝贵的人材;(一项)财物;资产;(asset的名词复数)
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| They've got really weird payoff structures and all that, but let's throw everything we know about financial engineering at them. |
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weird:adj.奇怪的;奇异的;离奇的;n.命运;宿命;命运女神; payoff:n.报酬;结果;发工资;结算;adj.支付的;决定性的;产生结果的; structures:n.结构; v.建造(structure的第三人称单数形式);
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| Let's see if we can use all the tricks of the trade to figure out how to make these drugs work as financial assets? |
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| Let's create a giant fund. |
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giant:n.巨人;伟人;巨兽;adj.巨大的;特大的
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| In finance , we know what to do with assets that are risky. |
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finance:n.财政,财政学;金融;v.负担经费,供给…经费;
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| You put them in a portfolio and you try to smooth out the returns. |
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portfolio:n.公文包;文件夹;证券投资组合;部长职务; smooth out:消除;使平滑;
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| So we did some math, and it turned out you could make this work, but in order to make it work, you need about 80 to 150 drugs. |
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| Now the good news is, there's plenty of drugs that are waiting to be tested. |
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| We've been told that there's a backlog of about 20 years of drugs that are waiting to be tested but can't be funded . |
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backlog:n.[管理]积压的工作;积压待办的事务;大木材;vt.储备;把…积压起来; 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);
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| In fact, that early stage of the funding process, that Phase I and pre-clinical stuff , that's actually, in the industry, called the Valley of Death because it's where drugs go to die. |
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stuff:n.东西:物品:基本特征:v.填满:装满:标本:
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| It's very hard to for them to get through there, and of course, if you can't get through there, you can't get to the later stages. |
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| So we did this math, and we figured out, okay, well, you know, you need about 80 to, say, 150, or something like that, drugs. |
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| And then we did a little more math, and we said, okay, well that's a fund of about three to 15 billion dollars. |
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| So we kind of created a new problem by solving the old one. |
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| We were able to get rid of the risk, but now we need a lot of capital, and there's only one place to get that kind of capital, the capital markets. |
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| Venture capitalists don't have it. Philanthropies don't have it. |
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Venture:v.敢于;冒险;投机;n.企业;风险;冒险; capitalists:n.资本家(capitalist的复数); Philanthropies:n.博爱,慈善;慈善事业;
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| But we have to figure out how we can get people in the capital markets, who traditionally don't invest in this stuff, to want to invest in this stuff. |
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traditionally:adv.传统上;习惯上;传说上;
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| So again, financial engineering was helpful here. |
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| Imagine the megafund actually starts empty, and what it does is it issues some debt and some equity , and that generates cash flow . |
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issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) debt:n.债务;借款;罪过; equity:n.公平,公正;衡平法;普通股;抵押资产的净值; generates:[计]生成;发生; cash flow:现金流转;
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| That cash flow is used, then, to buy that big portfolio of drugs that you need, and those drugs start working their way through that approval process, and each time they go through a next phase of approval, they gain value. |
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approval:n.批准;认可;赞成;
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| And most of them don't make it, but a few of them do, and with the ones that gain value, you can sell some, and when you sell them, you have money to pay the interest on those bonds, but you also have money to fund the next round of trials. |
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| It's almost self-funding. |
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| You do that for the course of the transaction , and when you're done, you liquidate the portfolio, pay back the bonds, and you can give the equity holders a nice return. |
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transaction:n.处理;业务;办理; liquidate:v.清算;变卖;清盘;偿还(债务);消灭; holders:n.[专利]持有人(holder的复数);
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| So that was the theory, and we talked about it for a bit, we did a bunch of experiments, and then we said, let's really try to test it. |
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a bunch of:一群;一束;一堆;
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| We spent the next two years doing research. |
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| We talked to hundreds of experts in drug financing and venture capital . |
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venture capital:风险投资;
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| We talked to people who have developed drugs. |
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| We talked to pharmaceutical companies. |
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pharmaceutical:adj.制药(学)的;n.药物;
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| We actually looked at the data for drugs, over 2,000 drugs that had been approved or denied or withdrawn , and we also ran millions of simulations . |
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approved:adj.被正式接受的,被正式认可的; v.赞成; (approve的过去分词和过去式) denied:v.否认;拒绝;否定;不承认;(deny的过去分词和过去式) withdrawn:adj.偏僻的;沉默寡言的;孤独的;v.取出;撤退(withdraw的过去分词); simulations:n.[计]模拟(simulation的复数);[计]仿真;
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| And all that actually took a lot of time. |
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| But when we were done, what we found was something that was sort of surprising. |
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| It was actually feasible to structure that fund such that when you were done structuring it, you could actually produce low-risk bonds that would be attractive to bond holders, |
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feasible:adj.可行的;可能的;可实行的; structuring:v.使形成体系;系统安排;精心组织;(structure的现在分词) low-risk:adj.低危的,低风险的; attractive:adj.吸引人的;有魅力的;引人注目的;
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| that would give you yields of about five to eight percent, and you could produce equity that would give equity holders about a 12-percent return. |
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yields:n.生产量,投资效益(yield的复数形式); v.[经]生产;
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| Now those returns aren't going to be attractive to a venture capitalist. |
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| Venture capitalists are those guys who want to make those big bets and get those billion dollar payoffs . |
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bets:v.下赌注(于);用…打赌;敢说;八成儿(bet的第三人称单数) payoffs:n.[会计]支付,偿付;报酬(payoff复数形式);
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| But it turns out, there are lots of other folks that would be interested in that. |
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| That's right in the investment sweet spot of pension funds and 401(k) plans and all this other stuff. |
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sweet spot:n.(球拍或球棒的)最佳击球点;最有效点;所有特点的完美组合; pension:n.养老金;退休金;抚恤金;adj.有关退休金的;v.给…养老金[恤金,津贴等]; funds:n.[会计]资金,现金(fund的复数);基金;v.资助(fund的三单形式);提供资金;
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| So we published some articles in the academic press. |
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academic:adj.学术的;理论的;学院的;n.大学生,大学教师;学者;
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| We published articles in medical journals . |
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journals:n.学术期刊(journal的复数);日记;日记账;
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| We published articles in finance journals. |
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| But it wasn't until we actually got the popular press interested in this that we began to get some traction . |
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traction:n.牵引;[机][车辆]牵引力;
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| We wanted to do something more than just make people aware of it, though. |
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| We wanted people to get involved . |
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involved:adj.有关的; v.涉及; (involve的过去式和过去分词)
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| So what we did was, we actually took all of our computer code and made that available online under an open-source license to anybody that wanted it. |
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open-source:adj.(计算机)开放源代码; license:v.许可;批准;
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| And you guys can download it today if you want to run your own experiments to see if this would work. |
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| And that was really effective, because people that didn't believe our assumptions could try their own assumptions and see how it would work. |
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assumptions:n.假定;假设;承担;获得;(assumption的复数)
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| Now there's an obvious problem, which is, is there enough money in the world to fund this stuff? |
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obvious:adj.明显的;显著的;平淡无奇的;
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| I've told you there's enough drugs, but is there enough money? |
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| There's 100 trillion dollars of capital currently invested in fixed-income securities. |
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trillion:n.[数]万亿;adj.万亿的;num.[数]万亿; currently:adv.当前;一般地; invested:v.投资;投入;(invest的过去分词和过去式)
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| That's a hundred thousand billion. |
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| There's plenty of money. |
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| (Laughter) |
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| But what we realized was that it's more than just money that's required. |
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| We had to get people motivated , people to get involved, and people had to understand this. |
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motivated:adj.有动机的; v.使产生动机;
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| And so we started thinking about all the different things that could go wrong. |
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| What are all the challenges to doing this that might get in the way ? |
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get in the way:妨碍;挡道;挡住去路;阻碍;
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| And we had a long list, and so what we did was we assigned a bunch of people, including ourselves, different pieces of this problem, and we said, could you start a work stream on credit risk? |
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assigned:v.分配(某物);分派;指定;委派;(assign的过去分词和过去式)
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| Could you start a work stream on the regulatory aspects ? |
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regulatory:adj.管理的;控制的;调整的; aspects:n.方面;相位;面貌(aspect的复数);
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| Could you start a work stream on how you would actually manage so many projects? |
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| And we had all these experts get together and do these different work streams, and then we held a conference . |
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get together:聚会 conference:n.会议;研讨会;商讨会;体育协会(或联合会)
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| The conference was held over the summer, this past summer. |
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| It was an invitation-only conference. |
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| It was sponsored by the American Cancer Society and done in collaboration with the National Cancer Institute . |
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sponsored:adj.(活动或比赛)为慈善筹款而举办的; v.赞助(活动、节目等); (sponsor的过去式和过去分词) collaboration:n.合作;勾结;通敌; 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 we had experts from every field that we thought would be important, including the government, including people that run research centers and so on, |
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| and for two days they sat around and heard the reports from those five work streams, and they talked about it. |
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| It was the first time that the people who could actually make this happen sat across the table from each other and had these conversations. |
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| Now these conferences , it's typical to have a dinner, and at that dinner, you kind of get to know each other, sort of like what we're doing here. |
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conferences:n.会议(conference的复数形式); typical:adj.典型的;特有的;象征性的;
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| I happened to look out the window, and hand on my heart, I looked out the window on the night of this conference -- it was the summertime -- and that's what I saw, it was a double rainbow . |
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summertime:n.夏季; rainbow:n.彩虹
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| So I'd like to think it was a good sign. |
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| Since the conference, we've got people working between Paris and San Francisco, lots of different folks working on this to try to see if we can really make it happen. |
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| We're not looking to start a fund, but we want somebody else to do this. |
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| Because, again, I'm not a scientist. |
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| I can't build a drug. |
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| I'm never going to have enough money to fund even one of those trials. |
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| But all of us together, with our 401(k)'s, with our 529 plans, with our pension plans, all of us together can actually fund hundreds of trials and get paid well for doing it and save millions of lives like my dad. |
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| Thank you. |
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| (Applause) |
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