笃行奖-Topic 4-A11340-甘比精读
>> Digital Healthcare | TE
Day12: Vocabulary
【图例注释】
[→] Day12笔记
[☆ ] Annie
→ 【telemedicine】
noun. the diagnosis and treatment of patients in remote areas using medical information, as x-rays or television pictures, transmitted over long distances, especially by satellite.
"health care provided using electronic communications"
→ When someone goes into cardiac arrest, survival depends on how quickly the heart can be restarted.
【Definition】
From Wikipedia
Cardiac arrest is a sudden stop in effective blood flow due to the failure of the heart to contract effectively. (心脏停搏)
Symptoms include loss of consciousness and abnormal or absent breathing. Some people may have chest pain, shortness of breath, or nausea before this occurs. If not treated within minutes, death usually occurs.
【Word Origin】
equivalent to kardí(a) heart + -akos -ac
→ Enter Amazon's Echo, a voice-driven computer that answers to the name of Alexa, which can recite life-saving instructions about cardiopulmonary resuscitation, a skill taught to it by the American Heart Association.
From Wikipedia Cardiopulmonary resuscitation, commonly known as CPR, is an emergency procedure that combines chest compression often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.
(ventilation: [medicine/medical] to oxygenate (blood) by exposure to air in the lungs or gills; to assist the breathing of (a person), as with a respirator. )
(intact: not altered, broken, or impaired; remaining uninjured, sound, or whole; untouched; unblemished )
(spontaneous: coming or resulting from a natural impulse or tendency; without effort or premeditation; natural and unconstrained; unplanned)
cardiopulmonary: of, relating to, or affecting the heart and lungs
cardio-: a combining form meaning “heart,” used in the formation of compound words
pulmonary: of or relating to the lungs.
resuscitation: to revive, especially from apparent death or from unconsciousness.
→ Alexa in one manifestation of a drive to disrupt an industry that has so far largely failed to deliver on the potential of digital information.
manifestation: outward or perceptible indication
e.g. At first there was no manifestation of the disease.
deliver: to do or carry out as promised
☆ You promised or you are expected to bring certain results around, and you deliver that (= make that happen).
这句是指☆ “目前为止这个工业未能在人们所指望的数据化信息技术前景上做出什么前景，Alexa成为了一种打破僵局的动力的表现之一”。
→ Health care is over-regulated and expensive to innovate in, and has a history of failing to implement ambitious IT projects.
quote: 要想创新的话通过的审批程序很多。医护行业有着严格的监管，准入要求很高，而进行改良革新要花费巨额的成本。对比上一篇能源战争的文章，都绕不开两个话题：资本和技术，这一篇着重讲技术对行业产生的影响。
→ One reason for that is the scale of potential cost-savings.
【词汇延伸】scale (music)
From Wikipedia In music theory, a scale is any set of musical notes ordered by fundamental frequency or pitch. A scale ordered by increasing pitch is an ascending scale, and a scale ordered by decreasing pitch is a descending scale. Some scales contain different pitches when ascending than when descending. For example, the Melodic minor scale.
Chromatic scale full octave ascending and descending on C
C major scale
→ 【pharmaceutical】
Pharmacy, also called pharmaceutics. the art and science of preparing and dispensing drugs and medicines.
【Synonyms】 drug vs. medicine
drug: [pharmacology] a chemical substance used in the treatment, cure, prevention, or diagnosis of disease or used to otherwise enhance physical or mental well-being.
medicine: any substance or substances used in treating disease or illness; medicament; remedy.
→ These buyers are increasingly demanding "value-based" reimbursement—meaning that if a drug or device doesn't function well, it will not be bought.
reimbursement: to make repayment to for expense or loss incurred
☆ reimbursement在这里是保险报销的情境下的用词，意即：没有效果的药品，医生开给了病人，病人的保险公司也不买帐不给报销。这就是为什么说保险公司、公司雇员健康福利主管等是责任者（incumbent)——因为他们付账。
【词汇延伸】[accounting / insurance] reimbursement
Paying back for out-of-pocket expenses, such as by an employer or an insurance company.
(petty cash reimbursement system)
e.g. After going out of town for a conference on technology, Gary had to submit a reimbursement form to get all money back for expenses.
→ Diabetes is an obvious problem for the pharma business in the regard, ……
From Wikipedia Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. 糖尿病
metabolic: [biology, physiology] the sum of the physical and chemical processes in an organism by which its material substance is produced, maintained, and destroyed, and by which energy is made available.
→ Although Fitbits are frequently derided for ending up in the back of a drawer, people can be motivated to get off the sofa.
deride: to laugh at in scorn or contempt; scoff or jeer at; mock.
e.g. Many masterpieces have been considered horrid at some stage and bad art has often been derided as room decoration.
in the back of a drawer
☆ 束之高阁。"在抽屉深处"积灰，用处不多。
→ That is the backdrop to a new firm called Onduo, a joint venture that Google's health-care venture, Verily Life Sciences, and Sanofi, a French drug firm, set up last year
backdrop: also called, especially British, back-cloth. [theater] the rear curtain of a stage setting → the background of an event; setting.
e.g. The core of the story is set against the backdrop of the Iraq invasion, the buildup, and the immediate aftermath.
【词汇延伸】Types of business entity
1. Sole trader / Proprietorship
2. Partnership
3. Company
- Limited liability co.
- Unlimited liability co.
→ The starup is a good hedge for Sanofi, which faces a slowdown in sales of its blockbuster insulin medication, Lantus, which lost patent protection in 2015.
hedge: the act or a method of reducing the risk of financial loss on an investment, bet, etc
【词汇延伸】hedge fund 对冲基金
From Wikipedia A hedge fund is an investment fund that pools capital from accredited individuals or institutional investors and invests in a variety of assets, often with complex portfolio-construction and risk-management techniques.
It is administered by a professional investment management firm, and often structured as a limited partnership, limited liability company, or similar vehicle.
Hedge funds are generally distinct from mutual funds as their use of leverage is not capped by regulators and distinct from private equity funds as the majority of hedge funds invest in relatively liquid assets.
insulin: 胰岛素
→ If the firm can devise an early test for breast cancer, demand for mammograms and the machines that take them would fall, along with the need for expensive drugs and spells in hospital.
mammography: x-ray photography of a breast, especially for detection of tumors.
【熟词新义】spell: A spell of a particular type of weather or a particular activity is a short period of time during which this type of weather or activity occurs.
e.g. You join a barrister for two six-month spells of practical experience.
→ An intriguing recent project has been to stream and analyse live health data……
intrigue: to arouse the curiosity or interest of by unusual, new, or otherwise fascinating or compelling qualities
e.g. If something, especially something strange, intrigues you, it interests you and you want to know more about it.
→ People will monitor their heart conditions, detect concussions, monitor the progress of diseases and check up on moles or ear infections using apps, mobile phones and sensors.
concussion: [pathology] injury to the brain or spinal cord due to jarring from a blow, fall, or the like.
e.g. Never mind that a CAT scan taken after the incident confirmed that he had suffered a concussion.
mole: a small, congenital spot or blemish on the human skin, usually of a dark color, slightly elevated, and sometimes hairy; nevus. 痣
→ Its failure rate for typical use was equivalent to that of popular contraceptive pills.
contraceptive: tending or serving to prevent conception or impregnation.
contra- + (con)ceptive
→ A smartphone may eventually be able to predict the onset of Alzheimer's, Parkinson's or even the menopause(if the information is wanted).
The onset of something is the beginning of it, used especially to refer to something unpleasant.
e.g. The deer often came down to feed near the coast before the onset of winter.
Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a chronic neurodegenerative disease that usually starts slowly and worsens over time. It is the cause of 60% to 70% of cases of dementia.
Parkinson's disease (PD) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms generally come on slowly over time. Early in the disease, the most obvious are shaking, rigidity, slowness of movement, and difficulty with walking.
menopause: the period during which a woman's menstrual cycle ceases, normally occurring at an age of 45 to 50
【Word origin】
C19: from French, from Greek mēn month + pausis halt
→ In emerging economies, where regulations on health data are less onerous and where people often already expect to pay to see a doctor, there is faster growth and innovation.
onerous: If you describe a task as onerous, you dislike having to do it because you find it difficult or unpleasant.
e.g. This is a much more onerous and depressing task.
☆【GPs】
GPs: General Practitioners。也就是家庭医生（百病都看的医生，general嘛，不是专科）。专科医生一般是GP推荐了才能看上 (specialist)，比如癌症专科(oncologist)， 妇产科(ob/gyn)。
→ An app using data from an iPhone or another smartphone might be able to warn users that a sedentary lifestyle will exacerbate a heart condition or that, based on social-media patterns, they are at risk of depression, for example.
sedentary: tending to sit about without taking much exercise
e.g. Jog if you must, he says, but running is too strenuous, especially if you've been leading a sedentary life.
【Word Origin】
C16: from Latin sedentārius, from sedēre to sit
exacerbate: to make (pain, disease, emotion, etc) more intense
e.g If something exacerbates a problem or bad situation, it makes it worse.
→ That suggests a broader worry: that technology companies are too cavalier with their users' data.
If you describe a person or their behaviour as cavalier, you are criticizing them because you think that they do not consider other people's feelings or take account of the seriousness of a situation.
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Day13: Mindmap
Final version
碎碎念：Original version的文件一不小心被final给覆盖了，下午发的是补救版。晚上一想：补救版的多没意思……所以还是发final version好了。
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Day14: 延伸与总结
【背景延伸】Private Health Insurance
[From Mckinsey Report]
The demand for healthcare services, and hence health insurance, is increasing because of population aging and the growing prevalence of chronic disease, as well as rising incomes in the developing world.
Four fundamental forces to reshape the industry’s structure and performance
1. Risk (Uncertainty)
a high proportion of expenditures are for chronic conditions, not random, unpredictable, catastrophic events, which has made insurance in its traditional sense obsolete.
这部分我的理解：保险本质上就是一个被保险人将风险“转移”到保险人身上的概念，而“风险”是一种“不确定性”（Uncertainty）。随着技术不断革新，我们逐渐从“信息不对称”高高翘起的天平的一边与利益相关方相对“平等”，我们对于这种不确定性转移承担的业务需求逐渐降低。当人们怀揣的对未来的不确定性不断降低时，旧的保险模式就面临着革新的挑战。
2. Technological innovation
① Advanced analytics and digitization
② Emerging advances in medical science
这部分正如这次的文章所述：sales-oriented的drug firms，被digital revolution从以前垄断信息不对称状态的天平上拉了下来。这让health insurers和gov都能够了解药物在病人身上是否真正有效，如果没有预期的效用，health insurers作为expense payers可以不为其买单。这也能在一定程度上为health insurers起到cost-saving的作用。
3. Consumerism (Consumer preferences)
物质的充足与信息渐趋透明公开让消费者在自己的健康投资上具有更大的主动权，其多元的需求敦促着health insurers提供更加多元化的保险模式。
4. Regulation
Currently, misalignment between the categories of medical risk and the financing and reimbursement approaches used in many countries is leading to rapid increases in premiums and unsustainable economics. These developments increase the possibility that some governments might impose regulations that eliminate core aspects of the insurance market or else replace the insurance market with public programs, leaving private payors to offer only supplemental products.
【体悟】
这周的两篇文章都体现了“资本”与“技术”在其中的重要作用。Renewable energy体现的是“没有资本突破不了瓶颈”，Digital Healthcare体现的是“雄厚的资本后盾能做成的innovation”。资本在这一程度上就是“资源配置”的方向，正如Production Possibility Frontier所表现：我们能做的只有两件事，一是让资源配置与利用效率最优，二是使同等资源的效用upgrade——即技术革新。也正如Lucas昨天在群里所说，这两篇文章“都绕不开两个话题：资本与技术”。
昨天大家也在群里提到“知识边界”的问题。上了大学以后就一直追求文理兼修，不愿意自己局限于所谓“专业”，所谓“文理”，涉猎地愈多、体悟地愈多，就会发现，这个世界上许多东西的表面之下，有某些暗流相互融通。很惭愧自己曾在精读班开始前给自己限定了所谓“主场”和“非主场”topic，这两周的学习也让我不断发问：你所谓的“主场”究竟为何？若真有所谓明确的“边界”，为什么在涵盖所学的文章中你无法做到游刃有余？知识的学习如此，生活亦是如此——毕竟生活的点滴，对我而言都在学习。在这里也给自己定一个小目标：这28天结束后，把所有topic未拓展的部分都细致地做一回research，包括这周两个topic未读完的行研，最好能写一写综述。
到第四个topic，有一种大脑高速运转思考的快感，同时也有些疲累。不过这半个月让自己处于一种“海绵”的状态不断汲取，虽不能要求自己“脱胎换骨”，但总有许多“醍醐灌顶”的时刻。学习自然讲究“努力”，但我早已不再只追求“努力”这一层次，涉猎的些许历史加之不停歇的实践告诉我学习也讲究悟性。自我定位在从“点悟”到“自悟”的转化过程，同时也想让自己保持着“静心”的状态，观察、体悟、思考。
鲸鱼
2017年3月12日
