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ThomasInsel_2013X-_对精神疾病的重新认识_
So let's start with some good news, and the good news has to do with what do we know based on biomedical research that actually has changed the outcomes for many very serious diseases ? 讓我們用一些好消息來開始 這些好消息是我們 基於在生物醫學研究裏 一些確實改變了許多嚴重疾病的 成果所得的資訊有關
biomedical:adj.生物医学的; outcomes:n.结果;成果;后果;出路;(outcome的复数) diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
Let's start with leukemia , acute lymphoblastic leukemia , ALL, the most common cancer of children. 我們從白血病談起 急性淋巴性白血病,簡稱ALL 最常見的兒童癌症
leukemia:n.[内科][肿瘤]白血病; acute:adj.严重的,[医]急性的;敏锐的;激烈的;尖声的; lymphoblastic:adj.淋巴母细菌的;成淋巴细胞的; cancer:n.癌症;恶性肿瘤;
When I was a student, the mortality rate was about 95 percent. 在我學生時期 其死亡率約為 95％
mortality:n.死亡数,死亡率;必死性,必死的命运;
Today, some 25, 30 years later, we're talking about a mortality rate that's reduced by 85 percent. 25,30年後的今天 其死亡率已下降 85％
Six thousand children each year who would have previously died of this disease are cured. 每年有6000名 過去將死於這種疾病的兒童獲得治癒
previously:adv.先前;以前;
If you want the really big numbers, look at these numbers for heart disease. 如果你想看到更顯著的進展 請看這些心臟病統計數據
Heart disease used to be the biggest killer, particularly for men in their 40s. 心臟病曾經是健康的頭號殺手 尤其對40多歲的男性而言
particularly:adv.特别地,独特地;详细地,具体地;明确地,细致地;
Today, we've seen a 63-percent reduction in mortality from heart disease -- remarkably , 1.1 million deaths averted every year. 今天,我們發現心臟病死亡率 已下降 63％ 每年死亡人數減少110萬,一個值得注意的數字
reduction:n.减少;缩小;降低;减价;折扣;缩图; remarkably:adv.非常;极为;格外;出乎意料地 averted:v.防止,避免;转移目光;背过脸;(avert的过去分词和过去式)
AIDS, incredibly , has just been named, in the past month, a chronic disease, meaning that a 20-year-old who becomes infected with HIV is expected not to live weeks, months, or a couple of years, as we said only a decade ago, but is thought to live decades, probably to die in his '60s or '70s from other causes altogether. 上個月,愛滋病,難以置信的 被歸類為慢性疾病 意味著遭受愛滋病毒感染的一個20歲年輕人 將不僅存活幾星期,幾個月或幾年 如我們十年前所預期的 而有機會存活數十年 或許在60或70歲死於其他成因
incredibly:adv.难以置信地;非常地; chronic:adj.慢性的;长期的;习惯性的; infected:adj.带菌的; v.传染; (infect的过去分词和过去式) HIV:n.艾滋病病毒;
These are just remarkable , remarkable changes in the outlook for some of the biggest kill ers. 這是相當驚人的改善 對一些致命疾病的前景而言
remarkable:adj.卓越的;非凡的;值得注意的;
And one in particular that you probably wouldn't know about, stroke , which has been, along with heart disease, one of the biggest killers in this country, is a disease in which now we know that if you can get people into the emergency room within three hours of the onset , 尤其是其中一種 你或許不知道－中風 它通常伴隨心臟病 是我國死亡率最高的疾病之一 現在我們知道,以這種疾病來說 如果能及時將病患者送入急診室 在發病三小時內
in particular:尤其,特别; stroke:n.中风;笔画;钟声;抚摩;v.抚摩(动物的毛皮);轻抚;轻挪;轻触; emergency room:n.急诊室; onset:n.开始,着手;发作;攻击,进攻;
some 30 percent of them will be able to leave the hospital without any disability whatsoever . 約 30％的 病患者能平安出院 沒有任何後遺症
disability:n.残疾;无能;无资格;不利条件; whatsoever:pron.无论什么;
Remarkable stories, good-news stories, all of which boil down to understanding something about the diseases that has allowed us to detect early and intervene early. 令人驚嘆的故事 人類的福音 這一切的結果是 瞭解某些關於疾病的資訊,使我們能 早期發現、早期處理
detect:vt.察觉;发现;探测; intervene:vi.干涉;调停;插入;
Early detection , early intervention , that's the story for these successes. 早期發現、早期處理 這是人類對抗疾病的勝利史
detection:n.侦查,探测;发觉,发现;察觉; intervention:n.介入;调停;妨碍;
Unfortunately , the news is not all good. 不幸的是,並非全都是好消息
Unfortunately:adv.不幸地;
Let's talk about one other story which has to do with suicide . 我們談談另一個故事 和自殺有關
suicide:n.自杀;自杀行为;自杀者;adj.自杀的;v.自杀;vi.自杀;
Now this is, of course, not a disease, per se . 這個,當然,本身並非疾病
per se:adv.本身;本质上;
It's a condition, or it's a situation that leads to mortality. 而是導致死亡的 條件或情況
What you may not realize is just how prevalent it is. 你或許不知道這種情形多麼普遍
prevalent:adj.流行的;普遍的,广传的;
There are 38,000 suicides each year in the United States. 美國每年有38,000人自殺
suicides:n.自杀;自毁;自杀者;(suicide的复数) United:adj.联合的; v.联合,团结; (unite的过去分词和过去式)
That means one about every 15 minutes. 意味著大約每15分鐘一位
Third most common cause of death amongst people between the ages of 15 and 25. 它是15至25歲年齡層中 第三大死亡原因
amongst:prep.在…之中;在…当中(等于among);
It's kind of an extraordinary story when you realize that this is twice as common as homicide and actually more common as a source of death than traffic fatalities in this country. 這是令人震驚的故事,當你瞭解 因此死亡的人數為謀殺的兩倍 事實上,以我國來說 這是比交通事故更常見的死因
extraordinary:adj.非凡的;特别的;离奇的;临时的;特派的; homicide:n.杀人;杀人犯; source:n.来源;水源;原始资料; fatalities:n.灾祸;命运;意外的的死亡事故(fatality的复数);
Now, when we talk about suicide, there is also a medical contribution here, because 90 percent of suicides are related to a mental illness: depression , bipolar disorder , schizophrenia , 現在,當我們談到自殺 醫學上對這方面的研究亦有貢獻 因為 90％ 的自殺 是與精神疾病有關 憂鬱症、躁鬱症、精神分裂症
contribution:n.捐款;捐资;定期缴款;贡献;促成作用;稿件; mental:adj.精神的;脑力的;疯的;n.精神病患者; depression:n.沮丧;洼地;不景气;忧愁; bipolar disorder:n.双相型障碍;躁狂抑郁性精神病; schizophrenia:n.[内科]精神分裂症;
anorexia , borderline personality . There's a long list of disorders that contribute , and as I mentioned before, often early in life. 厭食症、邊緣型人格 許多精神疾病與此有關 如我之前提過的這些疾病往往發生於人生早期
anorexia:n.厌食;神经性厌食症; borderline:n.边界线,边界;界线;adj.边界的;暧昧的; personality:n.性格;个性;人格;魅力;气质;名人;特色; disorders:n.无秩序,混乱; v.[电子]扰乱(disorder的单三形式); contribute:v.贡献,出力;投稿;捐献;
But it's not just the mortality from these disorders. 但自殺不僅與這些疾病的死亡率有關
It's also morbidity . 也與其發病率有關
morbidity:n.发病率;病态;不健全;
If you look at disability, as measured by the World Health Organization with something they call the Disability Adjusted Life Years, it's kind of a metric that nobody would think of except an economist, 如果觀察致殘程度 根據世界衛生組織 以所謂的「傷殘調整生命年」所做的衡量 沒人想到它會成為一種度量單位 除了經濟學家
measured:adj.缓慢谨慎的; v.测量; (measure的过去分词和过去式) Organization:n.组织;机构;体制;团体; Adjusted:adj.调整过的,调节了的;v.调整;校正(adjust的过去分词); metric:adj.米制的;公制的;按公制制作的;用公制测量的;
except it's one way of trying to capture what is lost in terms of disability from medical causes, and as you can see , virtually 30 percent of all disability from all medical causes can be attributed to mental disorders, neuropsychiatric syndromes . 它是一種估算健康壽命損失的方法 藉由醫學因素導致的失能 如各位所見 在所有醫學因素導致的失能中,約30％ 歸因於精神障礙 精神症狀
capture:v.俘虏;捕获;攻占;夺得;刻画,描述;n.(被)捕获;(被)俘获 as you can see:正如你所看到的;你是知道的; virtually:adv.事实上,几乎;实质上; attributed:v.归于(attribute的过去式,过去分词);属性化; neuropsychiatric:神经精神系统;神经精神病学的;神经精神性; syndromes:n.综合症(syndrome的复数);
You're probably thinking that doesn't make any sense. 你或許認為這並不合理
I mean, cancer seems far more serious. 我的意思是,癌症似乎更加嚴重
Heart disease seems far more serious. 心臟病似乎更加嚴重
But you can see actually they are further down this list, and that's because we're talking here about disability. 但各位可以看見事實上它們位於這張列表下方 因為我們所討論的是失能
What drives the disability for these disorders like schizophrenia and bipolar and depression? 導致這些疾病產生失能情況的原因是什麽？ 例如精神分裂症、躁鬱症和憂鬱症？
Why are they number one here? 為何它們在這張列表中獨占鰲頭？
Well, there are probably three reasons. 有三個可能原因
One is that they're highly prevalent. 第一,這些疾病非常普遍
highly:adv.高度地;非常;非常赞许地;
About one in five people will suffer from one of these disorders in the course of their lifetime. 大約五分之一的人將罹患其中一種 在人生過程中
in the course of:在…过程中;在…期间;
A second, of course, is that, for some people, these become truly disabling , and it's about four to five percent, perhaps one in 20. 第二,當然,對某些人來說 這會造成真正的失能 比例約為4％～5％,或許20人中即有1人
disabling:v.使不能;使失去能力;致残疾(disable的ing形式);
But what really drives these numbers, this high morbidity, and to some extent the high mortality, is the fact that these start very early in life. 但真正造成這些數據、這種高罹患率 以某種程度來說亦是高死亡率的原因 是在於這些疾病發生於人生早期
extent:n.程度;范围;长度;
Fifty percent will have onset by age 14, 75 percent by age 24, a picture that is very different than what one would see if you're talking about cancer or heart disease, 50％ 病患將在14歲前發病 75％ 病患將在24歲前發病 這是截然不同的情形 相較於癌症或心臟病
different than:不同于;
diabetes , hypertension -- most of the major illnesses that we think about as being sources of morbidity and mortality. 糖尿病、高血壓等大多數主要疾病 即我們一般認為的罹病和死亡原因
diabetes:n.糖尿病;多尿症; hypertension:n.高血压;过度紧张; sources:n.来源;出处;起源;根源;原因;v.(从…)获得(source的第三人称单数和复数)
These are, indeed, the chronic disorders of young people. 這確實是屬於年輕人的慢性病
Now, I started by telling you that there were some good-news stories. 現在,我以一些好消息作開場白
This is obviously not one of them. 顯然這並非其中之一
This is the part of it that is perhaps most difficult, and in a sense this is a kind of confession for me. 這或許是其中最難以啟齒的部分 以某種意義來說,這算是我的告解
in a sense:在某种意义上; confession:n.忏悔,告解;供认;
My job is to actually make sure that we make progress on all of these disorders. 我的工作是確保在這所有疾病上 取得進展
I work for the federal government. 我為聯邦政府工作
federal:adj.联邦的;同盟的;联邦政府的;联邦制的;adv.联邦政府地;
Actually, I work for you. You pay my salary. 事實上是為你們工作,你們付我薪水
And maybe at this point, when you know what I do, or maybe what I've failed to do, you'll think that I probably ought to be fired, and I could certainly understand that. 或許以這點來說,當你們知道我所做的事 或我無法做到的事之後 你們會認為我應該被解僱 我當然明白這一點
But what I want to suggest, and the reason I'm here is to tell you that I think we're about to be in a very different world as we think about these illnesses. 但我想提出的建議和我來在這裡的原因是 告訴你們,我認為我們應該以 截然不同的觀點看待這些疾病
What I've been talking to you about so far is mental disorders, diseases of the mind. 到目前為止我一直使用精神障礙這個詞彙 精神方面的疾病
That's actually becoming a rather unpopular term these days, and people feel that, for whatever reason, it's politically better to use the term behavioral disorders and to talk about these as disorders of behavior. 事實上,現今這已成為一個相當不受歡迎詞彙 人們認為－無論出於何種原因 原則上最好使用行為障礙這個詞彙 稱這些疾病為行為障礙
unpopular:adj.不流行的,不受欢迎的; politically:adv.政治上; behavioral:adj.行为的;
Fair enough . They are disorders of behavior, and they are disorders of the mind. 確實,它們屬於行為障礙 亦屬於精神障礙
Fair enough:同意或接受但有所保留;
But what I want to suggest to you is that both of those terms, which have been in play for a century or more, are actually now impediments to progress, 但我想提出的建議是 這兩個詞彙 使用超過一世紀的詞彙 事實上阻礙了進展
impediments:n.障碍(impediment的复数);妨碍,困难;
that what we need conceptually to make progress here is to rethink these disorders as brain disorders. 我們必須在觀念上取得的進展是 將這些疾病歸類為腦部障礙
conceptually:adv.概念地; rethink:v.重新考虑;再想;n.重新考虑;反思;新想法;
Now, for some of you, you're going to say, "Oh my goodness, here we go again. 現在,有些人會說 「天哪,又來了」
We're going to hear about a biochemical imbalance or we're going to hear about drugs or we're going to hear about some very simplistic notion that will take our subjective experience 「我們將聽到關於生化失衡」 「或關於藥物的知識」 「或聽到一些過度簡化的觀念」 「將我們的主觀經驗」
biochemical:adj.生物化学的; imbalance:n.不平衡;不安定; simplistic:adj.过分简单化的;过分单纯化的; notion:n.观念;信念;理解; subjective:adj.主观的;个人的;自觉的;
and turn it into molecules , or maybe into some sort of very flat, unidimensional understanding of what it is to have depression or schizophrenia. 「轉變成分子層面的理解,或某種」 「單純而簡要的概念」 「說明它與憂鬱症或精神分裂症的關係」
molecules:n.[化学]分子,微粒;[化学]摩尔(molecule的复数); unidimensional:adj.一维的;线性的;
When we talk about the brain, it is anything but unidimensional or simplistic or reductionistic. 當我們談到大腦時,絕非 單純、簡要或可簡化的概念
It depends, of course, on what scale or what scope you want to think about, but this is an organ of surreal complexity , and we are just beginning to understand 當然,這取決於 你打算以何種層面或範圍思考 但大腦是一個相當複雜的器官 我們才剛開始瞭解
scale:n.规模;比例;鳞;刻度;天平;数值范围;v.衡量;攀登;剥落;生水垢; scope:n.能力; v.仔细看; surreal:adj.超现实主义的;离奇的;不真实的; complexity:n.复杂性;难以理解的局势
how to even study it, whether you're thinking about the 100 billion neurons that are in the cortex or the 100 trillion synapses that make up all the connections. 如何去研究它,無論你考量的是 皮層中上百億個神經元 或上千億個 連接神經元的突觸
cortex:n.[解剖]皮质;树皮;果皮; trillion:n.[数]万亿;adj.万亿的;num.[数]万亿; synapses:n.(神经元的)突触(synapse的复数;synapsis的复数)
We have just begun to try to figure out how do we take this very complex machine that does extraordinary kinds of information processing and use our own minds to understand this very complex brain that supports our own minds. 我們才剛開始試著瞭解 如何研究這個複雜至極的機器 它能進行驚人的訊息處理程序 用我們本身的大腦理解 這個掌控人類心智、複雜至極的大腦
processing:v.加工;处理;审核;数据处理;v.列队行进;缓缓前进;(process的现在分词)
It's actually a kind of cruel trick of evolution that we simply don't have a brain that seems to be wired well enough to understand itself. 這可說是演化的殘酷把戲 我們並未擁有 聰明到足以理解它本身的大腦
evolution:n.演变;进化;发展;渐进;
In a sense, it actually makes you feel that when you're in the safe zone of studying behavior or cognition , something you can observe , that in a way feels more simplistic and reductionistic 以某種程度來說,它確實使你感到 當你處於學習行為或認知的安全區域時 你可觀察到某些東西 以某種較為單純和直接的方式感受
cognition:n.认识;知识;认识能力; observe:v.观察;看到;庆祝;监视;
than trying to engage this very complex, mysterious organ that we're beginning to try to understand. 而非試著參與這個複雜而神秘至極的器官運作 我們正開始試著瞭解它
engage:v.吸引,占用;使参加;雇佣;使订婚;预定; mysterious:adj.神秘的;不可思议的;难解的;
Now, already in the case of the brain disorders that I've been talking to you about, depression, obsessive compulsive disorder , post-traumatic stress disorder , while we don't have an in-depth understanding of how they are abnormally processed or what the brain is doing in these illnesses, we have been able to already identify 現在,以腦部障礙為例 如演講中提及的 憂鬱症、強迫症 創傷後壓力症候群 我們尚無法深入瞭解 其運作的異常之處 或大腦和這些疾病的關係 我們已能確定
obsessive compulsive disorder:n.强迫性神经(官能)症; post-traumatic stress disorder:n.创伤后精神紧张性障碍; in-depth:adj.彻底的,深入的; abnormally:adv.反常地;变态地;不规则地; processed:v.加工,处理;审核;列队行进;(process的过去式和过去分词) identify:v.识别:鉴定:确认:发现:
some of the connectional differences, or some of the ways in which the circuitry is different for people who have these disorders. 一些連接上的差異,或某些 通訊線路上的差異 對罹患這些疾病的人來說
circuitry:n.电路;电路系统;电路学;一环路;
We call this the human connectome, and you can think about the connectome sort of as the wiring diagram of the brain. 我們稱之為人類連接組 你可以將連接組想成 類似大腦接線圖
You'll hear more about this in a few minutes. 你將在幾分鐘內聽見更多相關敘述
The important piece here is that as you begin to look at people who have these disorders, the one in five of us who struggle in some way, you find that there's a lot of variation in the way that the brain is wired, 其中一個重要關鍵是,當你開始觀察 罹患這些疾病的人,我們當中的五分之一 以某種程度來說正與其抗爭 你將發現其中存在許多變化 以大腦接線方式而言
variation:n.变异;变体;变奏;变种; in the way:妨碍;挡道;
but there are some predictable patterns, and those patterns are risk factors for developing one of these disorders. 但其中存在一些可預測的模式,這些模式 對這些疾病的發展來說是危險因素
predictable:adj.可预言的; factors:n.因素(factor的复数); v.做代理商;
It's a little different than the way we think about brain disorders like Huntington's or Parkinson's or Alzheimer's disease where you have a bombed-out part of your cortex. 這與我們對腦部障礙的認知稍有不同 例如亨丁頓氏症帕金森氏症或阿爾海默症 其原因在於大腦皮層某部分受到損害
bombed-out:adj.遭受轰炸而无家可归的;
Here we're talking about traffic jams, or sometimes detours , or sometimes problems with just the way that things are connected and the way that the brain functions. 我們所談論的是線路阻塞,有時是繞道而行 有時問題僅在於線路連接方式 及大腦運作方式
detours:n.绕路;便道(detour的复数形式);v.绕路而行(detour的第三人称单数形式);
You could, if you want, compare this to, on the one hand , a myocardial infarction , a heart attack , where you have dead tissue in the heart, versus an arrhythmia , where the organ simply isn't functioning because of the communication problems within it. 如果有興趣,你可以將它與 心肌梗塞、心臟病發作比較 其原因在於心臟組織壞死 想比與心律不整,器官無法正常運作 因為其中存在通訊問題
compare:v.比较;对比;n.比较; on the one hand:一方面; myocardial:adj.心肌的;n.心肌衰弱; infarction:n.梗塞;[病理]梗塞形成,梗死形成; heart attack:n.[医]心肌梗塞 tissue:n.纸巾,手巾纸;(人、动植物细胞的)组织; versus:prep.对;与...相对;对抗; arrhythmia:n.心律不齐,[内科]心律失常;
Either one would kill you; in only one of them will you find a major lesion . 兩者均足以致命但你僅能在其中一種當中 發現主要病變
lesion:n.损害;身体上的伤害;机能障碍;
As we think about this, probably it's better to actually go a little deeper into one particular disorder, and that would be schizophrenia, because I think that's a good case for helping to understand why thinking of this as a brain disorder matters. 當我們思考這一點時,或許最好 稍微深入探討某種特定疾病,即精神分裂症 因為我認為這是很好的例子 有助於理解為何可將其視為一種腦部障礙
These are scans from Judy Rapoport and her colleagues at the National Institute of Mental Health in which they studied children with very early onset schizophrenia, and you can see already in the top there's areas that are red or orange, yellow, are places where there's less gray matter, and as they followed them over five years, comparing them to age match controls, you can see that, particularly in areas like the dorsolateral prefrontal cortex or the superior temporal gyrus , there's a profound loss of gray matter. 這是 Judy Rapoport 和她同事所做的掃描圖 來自美國國家心理衛生研究院 他們研究罹患早發性精神分裂症的兒童 你可以看見上方圖片中 已出現紅色、橙色或黃色區域 這是灰質較少的地方 他們追蹤這些兒童五年 將他們與同齡的控制組比較 你可以看見尤其在這些區域當中,例如 前額葉皮質 或顳葉顳上回,存在嚴重的灰質喪失情況
colleagues:n.同事;同行(colleague的复数); Institute:v.开始(调查);制定;创立;提起(诉讼);n.学会,协会;学院; comparing:v.比较;对比;(compare的现在分词) prefrontal:adj.[解剖]前额的;额叶前部的;n.[解剖]额前骨; superior:n.上级;上司;adj.(在品质上)更好的;占优势的;更胜一筹的; temporal:adj.暂时的;当时的;现世的;n.世间万物;暂存的事物; gyrus:n.[解剖]脑回(形成大脑半球的组织);回转; profound:adj.深厚的;意义深远的;渊博的;
And it's important, if you try to model this, you can think about normal development as a loss of cortical mass , loss of cortical gray matter, and what's happening in schizophrenia is that you overshoot that mark, and at some point, when you overshoot, you cross a threshold , and it's that threshold 這十分重要,如果你試著將其模式化 你可將正常發展視為 皮質喪失、灰質喪失的過程 精神分裂症的情況則是超越這個標度 在某個時刻,當超越這個標度時 相當於跨越一個門檻,而這個門檻
cortical:adj.皮质的;[生物]皮层的;外皮的; mass:n.块,团; adj.群众的,民众的; v.聚集起来,聚集; overshoot:vt.超越; vi.射击越标; n.超越目标; threshold:n.入口;门槛;开始;极限;临界值;
where we say, this is a person who has this disease, because they have the behavioral symptoms of hallucinations and delusions . 即是我們對這些精神分裂症患者的定義 因為他們開始出現行為症狀 例如幻覺和妄想
symptoms:n.症状;征候;征兆;(symptom的复数) hallucinations:n.幻视,幻听;幻觉;幻象;(hallucination的复数) delusions:n.[内科]妄想;错觉(delusion的复数形式);
That's something we can observe. 這是我們可觀察到的部分
But look at this closely and you can see that actually they've crossed a different threshold. 但仔細觀察這張圖,你可以看見事實上他們跨越了另一道門檻
They've crossed a brain threshold much earlier, that perhaps not at age 22 or 20, but even by age 15 or 16 you can begin to see the trajectory for development is quite different at the level of the brain, not at the level of behavior. 他們在相當早期即跨越大腦的門檻 也許不是在22或20歲 而是在15或16歲,你可以開始看見 其發展軌跡截然不同 以大腦層面而言,而非行為層面
trajectory:n.[物]轨道,轨线;[航][军]弹道;
Why does this matter? Well first because, for brain disorders, behavior is the last thing to change. 為何這十分重要？好,主要原因是 對腦部障礙來說行為是最後發生改變的部分
We know that for Alzheimer's, for Parkinson's, for Huntington's. 我們知道阿茲海默症帕金森氏症、亨丁頓症皆是如此
There are changes in the brain a decade or more before you see the first signs of a behavioral change. 大腦發生變化十年或更長時間後 才能看見行為改變的最初跡象
The tools that we have now allow us to detect these brain changes much earlier, long before the symptoms emerge. 目前的工具可使我們早期檢測 這些腦部的變化,遠早於症狀的出現
But most important, go back to where we started. 但最重要的是,回到演講開頭部分
The good-news stories in medicine are early detection, early intervention. 醫學上的福音是 早期發現、早期處理
If we waited until the heart attack, we would be sacrificing 1.1 million lives every year in this country to heart disease. 如果等到心臟病發作 我國每年將因心臟病 損失110萬人的生命
sacrificing:v.牺牲;献出;以(人或动物)作祭献;(sacrifice的现在分词)
That is precisely what we do today when we decide that everybody with one of these brain disorders, brain circuit disorders, has a behavioral disorder. 這正是我們目前的處境 當我們確定每位擁有其中一種腦部障礙 大腦線路異常的病患都將發生行為障礙時
We wait until the behavior becomes manifest . 卻等到行為發生變化才著手處理
manifest:v.表明;显现;使人注意到;adj.明显的;显而易见的;n.旅客名单;
That's not early detection. That's not early intervention. 這並非早期發現、早期處理
Now to be clear, we're not quite ready to do this. 坦白說,我們尚未準備好進行這件事
We don't have all the facts. We don't actually even know what the tools will be, nor what to precisely look for in every case to be able to get there before the behavior emerges as different. 我們還不明白所有事實事實上我們甚至不知道 可使用什麼工具 或如何精確檢測所有病例 在行為發生改變前先行處理
emerges:vi.浮现;摆脱;暴露;
But this tells us how we need to think about it, and where we need to go. 但這讓我們明白思索這一點的必要性 及需要努力的方向
Are we going to be there soon? 我們是否很快就能達成目標？
I think that this is something that will happen over the course of the next few years, but I'd like to finish with a quote about trying to predict how this will happen by somebody who's thought a lot about changes in concepts and changes in technology . 我認為將會有所進展 在未來幾年內,但我想 引用一句話作結語試著預測未來發展的情形 這句話來自某位 對觀念和科技變化擁有精闢見解的人
quote:v.引用;报价;举例说明;开价;为(企业的股份)上市;n.引用; technology:n.技术;工艺;术语;
'"We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next 10." -- Bill Gates. 「我們總是高估」 「未來兩年將發生的變化,低估」 「未來十年將發生的變化」－比爾?蓋茲
overestimate:v.高估;n.过高的评估; occur:v.发生;出现;存在于;出现在; underestimate:v.低估;看轻;n.低估;
Thanks very much. 十分感謝
(Applause) （掌聲）