ABOUT THE SPEAKER
Daniel Kraft - Physician scientist
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.

Why you should listen

Dr. Daniel Kraft is a Stanford and Harvard trained physician-scientist with more than 25 years of experience in clinical practice, biomedical research and innovation. He is Faculty Chair for Medicine at Singularity University and is the founder and chair for Exponential Medicine, a program which explores convergent, rapidly developing technologies and their potential to reshape the future of health and biomedicine.

After medical school at Stanford, Kraft was board certified in both Internal Medicine and Pediatrics following residency at the Massachusetts General Hospital & Boston Children's Hospital, and he completed Stanford fellowships in hematology/oncology & bone marrow transplantation. He is a member of the inaugural class of Aspen Institute Health Innovators Fellows.

Kraft has extensive research in stem cell biology and regenerative medicine with multiple scientific publications, medical device, immunology and stem cell-related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at University of California San Francisco. 

Kraft recently founded IntelliMedicine, focused on connected, data-driven and integrated personalized medicine. He is the inventor of the MarrowMiner, an FDA-approved device for the minimally invasive harvest of bone marrow, and he founded RegenMed Systems, a company developing technologies to enable adult stem cell-based regenerative therapies. He is an advisor the XPRIZE (having conceived of the Medical Tricorder XPRIZE and is helping lead a new Cancer focused prize), and advises several digital health and technology companies.

Kraft is an avid pilot and served for 14 years as an officer and flight surgeon with F-15 and F-16 fighter squadrons in the Air National Guard. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.

More profile about the speaker
Daniel Kraft | Speaker | TED.com
TED Salon Optum

Daniel Kraft: The pharmacy of the future? Personalized pills, 3D printed at home

丹尼爾克拉夫特: 未來的藥房會是怎樣?透過 3D 列印,在家印出個人化藥錠

Filmed:
1,746,534 views

醫生丹尼爾克拉夫特述說我們需要改變開處方的方式。太常發生用錯藥物劑量的狀況會有害或是完全沒療效。在這場演說兼概念展示中,克拉夫特分享他的遠景:個人化藥物的未來。他還揭示一台原型 3D 列印機,可以根據個人需求來設計藥錠。
- Physician scientist
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio

Double-click the English transcript below to play the video.

00:13
We live生活 in a medication藥物治療 nation國家.
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我們住在藥物治療的國度。
00:16
Four point five billion十億 drug藥物 prescriptions處方
will be prescribed規定 by doctors醫生 like me
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今年,光是在美國,
像我這樣的醫生
就開出了 45 億張藥物處方。
00:21
this year, in the United聯合的 States狀態 alone單獨.
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男性、女性、小孩都算進來,
平均一人 15 張。
00:23
That's 15 for every一切 man, woman女人 and child兒童.
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00:25
And for most of us,
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對我們大部分人來說,
我們對於藥物的經驗通常是
00:27
our experience經驗 with this medication藥物治療
is often經常 confusing撲朔迷離 number of pills,
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搞不懂要吃幾顆藥、用藥指示、
00:30
instructions說明, side effects效果,
one-size-fits-all一個尺寸適合所有人 dosing劑量,
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副作用、適用所有人的統一劑量,
00:34
which哪一個 all too often經常
we aren't taking服用 as prescribed規定.
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我們經常會不依照處方來吃藥。
00:36
And this comes at tremendous巨大 expense費用,
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這樣造成的代價非常大,
00:38
costing成本核算 us our time,
our money and our health健康.
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成本是我們的時間、
我們的金錢,及我們的健康。
00:41
And in our now exponential指數,
connected連接的, data-driven數據驅動 age年齡,
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在這個指數成長、相互連結、
資料驅動的時代,
00:44
I think we can and we must必須 do better.
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我認為我們可以且必須要做得更好。
00:47
So let's take a dive潛水
at some of the challenges挑戰 we have
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所以,我們來探討
一些我們面臨的困難
00:51
and some potential潛在 solutions解決方案.
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以及一些可能的解決方案。
00:54
Let's start開始 with the fact事實
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咱們先來談一項事實:
00:55
that many許多 drugs毒品 don't work
for those who are prescribed規定 to them.
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許多藥物對於拿到
處方的人並不見得有用。
00:58
The top最佳 10 grossing票房 drugs毒品
in the United聯合的 States狀態 this year,
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今年,美國總量排名前十名的藥物,
01:03
they only benefit效益 one in four
to one in 23 of who take them.
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只對 1/4 到 1/23 的用藥者有效。
01:06
That's great if you're number one,
but what about everybody每個人 else其他?
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如果剛好對你有效,那很好,
但其他人怎麼辦?
01:11
And what's worse更差, drugs毒品,
when they sometimes有時 don't work,
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更糟糕的是,藥物即使沒有效用,
有時仍然會引發副作用。
01:14
can still cause原因 side effects效果.
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比如,阿斯匹靈——服用阿斯匹靈
01:15
Take aspirin阿司匹林 -- about one in four of us
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來減少心血管疾病的人當中有 1/4
01:17
who take aspirin阿司匹林 to reduce減少
our risk風險 of cardiovascular心血管 disease疾病,
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並不知道自己有阿斯匹靈抗性。
01:20
are unknowingly不知 aspirin-resistant抗阿司匹林.
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01:22
And still have the same相同 risks風險
of gastrointestinal胃腸道 bleeds出血
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他們仍然有同樣的風險
會發生消化道出血,
01:25
that kill thousands數千 every一切 year.
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每年有數千人因消化道出血而死。
01:28
It's adverse不利的 drug藥物 reactions反應 like these
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像這樣的藥物不良反應,
01:31
that are, by some estimates估計,
the number four leading領導 cause原因 of death死亡
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估計是美國排名第四的死因。
01:34
in the United聯合的 States狀態.
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我自己的祖父過世了,
01:35
My own擁有 grandfather祖父 passed通過 away
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原因是一劑抗生素讓他的腎臟衰竭。
01:36
after a single dose劑量 of antibiotic抗生素
caused造成 his kidneys腎臟 to fail失敗.
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01:40
Now, adverse不利的 drug藥物 reactions反應
and side effects效果
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藥物不良反應和副作用
01:43
are often經常 tied to challenges挑戰 in dosing劑量.
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通常都和劑量選擇的困難有關。
01:46
I trained熟練 in pediatrics兒科 -- little people,
internal內部 medicine醫學 -- big people,
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我受的訓練是兒童的小兒科
和大人的內科,
01:49
so one night I might威力 have been
on call in the NICUNICU,
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所以我可能會在一晚
被找去新生兒重症監護室,
01:52
carefully小心 dosing劑量
to the fraction分數 of a milligram毫克,
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小心地給了一毫克的藥,
給新生兒重症監護室的寶寶。
01:54
a medication藥物治療 for a NICUNICU baby寶寶.
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隔天晚上——則被找去急診室,
01:55
The next下一個 night --
on call in the emergency room房間,
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01:58
treating治療 a 400-pound-磅 lineman前鋒
or a frail脆弱 nursing-home養老院 patient患者,
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治療四百磅重的架線工人
或是虛弱的護理之家病人,
02:01
who, by most accounts賬戶, usually平時
would get the same相同 dose劑量 of medications藥物治療
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大部分的說法都認為他們應該接受
同樣劑量的處方藥物。
02:05
from the formulary規定.
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02:07
Which哪一個 would mean, most of the time
I would be underdosing給藥 the lineman前鋒,
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那就表示,大部分的時候,
我給架線工的劑量是不足的,
02:10
and overdosing過量 the nursing-home養老院 patient患者.
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給護理之家病人的劑量是過多的。
02:13
And beyond age年齡 and weight重量,
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除了年齡和體重,
02:14
we tend趨向 to ignore忽視 differences分歧
in sex性別 and race種族 in dosing劑量.
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我們在決定劑量時
也傾向會忽略性別和種族。
02:18
Now, beyond this, we know
we have a massive大規模的 challenge挑戰
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除此之外,我知道
我們有個很大的困難,
02:22
with noncompliance違規 or low adherence附著.
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就是不順從性和低依順性。
02:25
Many許多 of us who need
to take our medications藥物治療
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許多需要服藥的人不願服藥,
02:27
aren't taking服用 them
or are taking服用 them incorrectly不正確.
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或以不正確的方式服藥。
02:30
You know, 40 percent百分
of adults成年人 in the US over 65
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在美國,有 40% 65 歲以上的人
02:32
are on five or more
prescription處方 medications藥物治療.
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通常服用 5 種以上的藥物。
有時甚至到 15 種以上。
02:35
Sometimes有時 15 or more.
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02:36
And even small improvements改進 in adherence附著
can dramatically顯著 save保存 dollars美元 and lives生活.
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只要依順性能有小小的改善,
就能省下很多錢、拯救很多性命。
02:43
So, as we think into the future未來,
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所以,在我們遙想未來時,
你認為我們現今的狀況,
02:46
you think that where we are today今天,
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02:48
as we often經常 hear about smart聰明,
personalized個性化, targeted針對 drugs毒品,
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我們通常會聽到智慧型、
個人化的標靶藥物,
物聯網、基因治療法、人工智慧,
02:52
Internet互聯網 of Things, gene基因 therapy治療, AIAI,
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02:54
that we'd星期三 already已經 arrived到達
in this era時代 of precision精確 medicine醫學.
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好像我們已經到了
精準用藥的時代。
02:57
In reality現實, we still live生活 in an age年齡
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在現實中,我們仍然處在
02:58
of empiric經驗, trial-and-error試錯
imprecision不精確 medicine醫學.
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靠經驗主義和試誤法的
不精準用藥時代。
03:01
I think we can do better.
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我認為我們能做得更好。
03:03
What if we could reimagine重新構想 ways方法
to help make your medicine-taking吃藥 easier更輕鬆?
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如果我們能重新想像其他方式,
讓服藥變得更容易,會如何?
03:07
To get the right doses劑量
and combinations組合 to match比賽 you?
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依你的狀況,選擇正確的劑量和組合?
03:11
What if we could move移動 beyond
today's今天的 literal文字 cutting切割 edge邊緣
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如果我們能夠超越現今先進的
03:13
of pill cutters切割機 and fax傳真 machines,
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切藥器和傳真機,
03:16
to an era時代 where we could have
better outcomes結果, lower降低 costs成本,
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進入一個新時代,有更好的結果、
更低的成本、拯救人命、
03:19
saving保存 lives生活 and space空間
in your medicine醫學 cabinet內閣?
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節省藥櫃中的空間,會如何?
03:23
Well, I think part部分 of the solution
is all the emerging新興 ways方法
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我認為,解決方案有一部分在於
我們可以用來測量和連結
健康照護資訊的新興方式。
03:26
that we can measure測量 and connect
our health健康 care關心 information信息.
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03:29
Today今天, we pretty漂亮 much live生活
in a reactive反應, sick-care生病護理 world世界,
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現今,我們算得上是住在
一個反應式、病人照護的世界,
03:32
siloed孤立 information信息 that doesn't flow.
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資訊被儲存起來,不會流動。
03:35
We have the potential潛在 to move移動
into more continuous連續, real-time即時的
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我們有潛力可以做到更連續、即時、
03:38
proactive主動 world世界 of true真正 health健康 care關心.
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主動式、真正健康照護的世界。
03:40
And part部分 of that starts啟動 with
the emerging新興 world世界 of quantified量化 self,
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其中一部分開端是
量化自我的新興世界,
03:43
we can measure測量 so much
of our physiology生理 and behaviors行為 today今天,
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現今我們可以測量我們
許多生理狀況和行為,
03:46
and often經常 it's siloed孤立
on our phones手機 and scales,
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這些資訊通常都儲存在
我們的手機和測量計當中,
03:49
but it's starting開始 to connect
to our clinicians臨床醫生, our caregivers護理人員,
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但這些資訊已經開始連結到
我們的臨床醫生、照護者,
讓他們可以把預防、
診斷、治療做到最好。
03:52
so they can better optimize優化 prevention預防,
diagnostics診斷 and therapy治療.
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03:56
And when we can do that,
we can do some interesting有趣 things.
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當我們能做到這些時,
我們就能實行一些有趣的做法。
03:59
Take, for example, hypertension高血壓.
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以高血壓為例。
04:01
It's the number one risk風險 factor因子
for early death死亡 and morbidity發病率 worldwide全世界.
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在全世界,它是早死
和發病的第一名風險因子。
04:05
Half of adult成人 Americans美國人,
on approximation近似, have hypertension高血壓,
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大約一半的成年美國人有高血壓,
04:09
less than half have it well-controlled良好控制.
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不到一半的人有做好控制。
04:11
It's often經常 because it takes two
or three different不同 classes of medications藥物治療,
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通常是因為他們需要服用
兩、三種不同類的藥物,
04:14
it's tough強硬 to do adherence附著 and adjust調整
your blood血液 pressure壓力 medications藥物治療.
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很難做到依順和調整
你的血壓藥物。
在美國,每天就有 500 件
因為高血壓未控制好
04:17
We have 500 preventable預防的 deaths死亡
from noncontrolled不受控制 hypertension高血壓
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04:20
in the US, every一切 day.
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而致死的案例是可以避免的。
04:22
But now we're in the era時代
of connected連接的 blood血液 pressure壓力 cuffs袖口 --
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但我們現在所處的時代
已經發明出了脈壓帶——
04:25
the FDAFDA just approved批准
a blood血液 pressure壓力 cuff袖口
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食品及藥物管理局(FDA)核准了
一種能和手錶結合的脈壓帶,
04:27
that can go into your watch.
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04:29
There are now prototypes原型 of cuffless庫弗利斯
radar-based以雷達為基礎 blood血液 pressure壓力 devices設備
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現在還有無帶式
雷達血壓裝置的原型,
04:33
that can continuously一直 stream
your blood血液 pressure壓力.
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可以持續提供你的血壓資訊。
04:35
So, in the future未來, I could --
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所以,在未來,我可以
04:37
instead代替 of spot-checking抽查
my blood血液 pressure壓力 in the clinic診所,
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不用到診所去檢測我的血壓,
我的醫生仍然可以知道
我的即時數據和趨勢,
04:39
my doctor醫生 could see
my real-time即時的 numbers數字 and my trends趨勢,
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04:42
and adjust調整 them as necessary必要,
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並依需要來做調整,
04:44
with the help of a blood血液 pressure壓力
dosing劑量 algorithm算法,
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只要有血壓劑量
演算法的協助就能辦到,
04:47
or using運用 the Internet互聯網 of Things.
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或是使用物聯網也可以。
04:49
Now, technology技術 today今天 can do even more.
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現今的技術能做的還不只如此。
04:52
My smartwatch斯特沃特, already已經 today今天,
has an EKGEKG built內置 in,
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我現在的智慧手錶就
已有內建的心電圖,
04:55
that can be read
by artificial人造 intelligence情報.
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可以用人工智慧來解讀。
04:58
I'm wearing穿著 a small, Band-Aid-sized帶助手大小 patch補丁,
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我戴著一塊小型的 OK 繃尺寸貼片,
05:01
that is live-streaming即時串流
my vital重要 signs跡象 right now.
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它現在就在即時傳輸
我的生命特徵資訊。
05:03
Let's take a look.
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咱們來看看。
05:05
They're actually其實 a little
concerning關於 at the moment時刻.
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現在的這些數字
其實有點讓人憂心。
05:07
(Laughter笑聲)
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(笑聲)
05:09
Now, it's not just my real-time即時的 vitals命脈
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我的醫療團隊或我自己能看到的
並不只有我的即時生命特徵資訊,
05:12
that can be seen看到
by my medical team球隊 or myself,
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還能看到我的回溯資料,
05:14
it could be my retrospective回顧 data數據,
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05:16
and again, that'd那會 be used to modify修改
dosing劑量 and medication藥物治療 going forward前鋒.
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可以參考這些資料來調整
後續的劑量和用藥選擇。
05:20
Even my weight重量 can be super-quantified超級量化.
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連我的體重也可以被超級量化。
05:22
My weight重量, now my shape形狀,
how much body身體 mass, fat脂肪,
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我的體重、體型、
身體質量、脂肪、肌肉質量,
05:27
muscle肌肉 mass I might威力 have,
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用這些資訊來將我的
預防或治療做到最好。
05:28
and use that to optimize優化
my prevention預防 or therapy治療.
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05:32
And it's not just for the tech-savvy技術嫻熟.
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並不只有精通技術的人能用。
05:34
Now, MITMIT engineers工程師 have modified改性 wi-fi無線上網
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麻省理工學院的工程師
已經修改了無線上網,
05:37
so we can seamlessly無縫
connect and collect蒐集 our vital重要 signs跡象,
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讓我們可以做到無縫連結,
從連線的戒指和智慧床墊,
05:41
from our connected連接的 rings戒指
and smart聰明 mattresses床墊,
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收集我們的生命特徵資訊,
05:43
we can start開始 to share分享
this digital數字 exhaust排氣, our digitome迪托梅,
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我們能開始分享這些數位產出,
個人專屬的數位資料集,
05:46
and even potentially可能 crowdsource眾包 it,
sharing分享 our health健康 information信息,
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甚至有可能將它做群眾外包,
分享我們的健康資訊,
05:49
just like we share分享
with our Google谷歌 Maps地圖 and driving主動,
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就如同我們分享 Google 地圖和駕駛,
05:52
to improve提高 our -- not our driving主動,
but our health健康 experience經驗 globally全球.
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來改善我們的——不是我們的駕駛,
而是我們全球的健康體驗。
05:56
So, that's great.
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那很棒。
05:58
We can potentially可能 now
collect蒐集 this information信息.
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我們現在可能可以收集這些資訊。
06:00
What if your labs實驗室
can go from the central中央 lab實驗室
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若你的實驗室能從中央實驗室轉到
06:04
to your home, to your phone電話,
to even inside our bodies身體
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你的家中、你的手機上,
甚至你的體內,
06:07
to measure測量 drug藥物 levels水平 or other varieties品種?
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來測量藥物濃度
或其他變數,會如何?
06:10
And of course課程,
we're in the age年齡 of genomics基因組學.
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當然,現在是基因組學的時代。
06:12
I've been sequenced測序,
it's just less than 1,000 dollars美元 today今天.
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我們已經能做定序,
現今的價格不到一千美元。
我能開始了解我的藥物基因體學,
06:15
And I can start開始 to understand理解
my pharmacogenomics藥物基因組學 --
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我的基因會如何影響
我需要的劑量高低,
06:17
how my genes基因 impact碰撞
whether是否 I need high dose劑量, low dose劑量,
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或是根本要換一種藥物。
06:20
or maybe a different不同
medication藥物治療 altogether.
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咱們來想像一下,
如果你的醫生或藥師
06:22
Let's imagine想像 if your physician醫師
or your pharmacist藥劑師,
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06:25
had this information信息
integrated集成 into their workflow工作流程,
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能把這些資訊整合到
他們的工作流程中,
06:27
augmented增強 with artificial人造 intelligence情報,
AIAI, or as I like to refer參考 to it, IAIA --
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用人工智慧(AI)來增強,
我喜歡把它稱為 IA,
06:31
intelligence情報 augmentation增強,
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即:智慧式增強,
06:33
to leverage槓桿作用 that information信息,
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以發揮那些資訊,
06:34
to understand理解 of the 18,000
or more approved批准 drugs毒品,
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來了解在一萬八千種以上的
被核准藥物中,
06:37
which哪一個 would be the right dose劑量
and combination組合 for you.
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你需要的藥物組合和劑量是什麼。
06:40
So great, now maybe we can
optimize優化 your drugs毒品 and your doses劑量,
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很好,現在也許我們能幫你
把藥物和劑量最佳化,
06:43
but the problem問題 today今天 is,
we're still using運用 this amazing驚人 technology技術
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但現今的問題是,
我們仍然在用這項了不起的技術
持續追蹤我們的藥物。
06:46
to keep track跟踪 of our drugs毒品.
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06:48
And of course課程, these technologies技術 evolve發展,
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當然,這些技術會演進,
06:51
there's connected連接的 dispensers掌櫃,
reminder提醒 apps應用,
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有連線的智慧藥盒、
提醒專用的應用程式、
06:54
smart聰明 pill bottle瓶子 caps帽子 that can text文本
or tweet鳴叫 you or your mother母親
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智慧藥瓶蓋,如果你還沒有吃藥,
就會傳簡訊或推特訊息
給你或你母親。
06:57
if you haven't沒有 taken採取 your medications藥物治療.
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06:59
PillPack柱套 was just acquired後天 by Amazon亞馬遜,
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PillPack 才剛被亞馬遜併購,
07:01
so soon不久 we may可能 have same-day同一天 delivery交貨
of our drugs毒品, delivered交付 by drone無人駕駛飛機.
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很快我們就會有藥品當日
遞送服務,由無人機送達。
07:05
So, all these things are possible可能 today今天,
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所有這些在現今都是可能的,
07:08
but we're still taking服用 multiple pills.
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但我們卻仍然在吃多種藥物。
07:09
What if we can make it simpler簡單?
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如果我們能把它簡化呢?
07:11
I think one of the solutions解決方案
is to make better use of the polypill波利皮勒.
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我認為其中一個解決方案
就是善用複方製劑。
複方製劑是把多種藥物
整合到單一藥錠中。
07:14
A polypill波利皮勒 is the integration積分 of multiple
medications藥物治療 into a single pill.
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07:18
And we have these today今天 in common共同,
over-the-counter在櫃檯 cold and flu流感 remedies補救措施.
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現今我們在一般的無處方
傷風感冒藥物中就有用複方製劑。
07:21
And there have been
prevention預防 polypill波利皮勒 studies學習 doneDONE,
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已經有人做過了
預防藥複方製劑的研究,
結合了施德丁、血壓、阿斯匹靈,
07:24
giving combinations組合
of statins他汀類藥物, blood血液 pressure壓力, aspirin阿司匹林,
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07:26
which哪一個 in randomized隨機 studies學習
have been shown顯示
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在隨機研究中已經發現這些組合
相對於安慰劑,能大大減少風險。
07:28
to dramatically顯著 reduce減少 risk風險,
compared相比 to placebo安慰劑.
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07:31
But these polypills波利皮爾斯 weren't personalized個性化,
they weren't optimized優化 to the individual個人.
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但這些複方製劑並沒有被個人化,
沒有針對個人做最佳化。
若我們為你製作最好的
個人化複方製劑,如何?
07:35
What if we could optimize優化
your personalized個性化 polypill波利皮勒?
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07:37
So it would be built內置 for you,
based基於 on you, it could adapt適應 to you,
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它會是為你打造的,
以你為基礎,它適合你,
07:41
even every一切 single day.
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且可以每天取得。
07:42
Well, we're now in the era時代 of 3D printing印花,
you can print打印 personalized個性化 braces背帶,
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在這 3D 列印的時代,你能列印出
個人化的支架、
助聽器、骨科用裝置,
07:46
hearing聽力 aids艾滋病, orthopedic骨科 devices設備,
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07:48
even I've been scanned掃描
and had my jeans牛仔褲 tailored量身定制 to fit適合 to me.
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我甚至接受掃瞄之後
取得了客製化的牛仔褲。
07:52
So this got me thinking思維,
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這讓我去思考,
07:53
what if we could 3D print打印
your personalized個性化 polypill波利皮勒?
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如果我們能把個人化的複方製劑
列印出來,會如何?
07:56
So instead代替 of taking服用
six medications藥物治療, for example,
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比如,就不用一次吃六種藥物,
07:59
I could integrate整合 them into one.
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我可以把它們整合成一種。
08:00
So it would be easier更輕鬆 to take,
improve提高 adherence附著
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這樣吃藥就更容易了,
依順性也能改善,
08:03
and potentially可能, it could even
integrate整合 in supplements補品,
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還有可能把補給品也整合進來,
08:05
like vitamin維他命 D or CoQcoq10.
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比如維生素 D 或輔酶 Q10。
08:09
So with some help --
I call these "IntelliMeds英泰利梅茲" --
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靠著一些協助——我稱它們為
「智慧藥物(IntelliMeds)」——
08:12
and with the help of my
IntelliMedicine智慧醫療 engineering工程 team球隊,
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靠著我的智慧藥物工程團隊協助,
我們打造了第一台
智慧藥物原型列印機。
08:14
we built內置 the first
IntelliMedicine智慧醫療 prototype原型 printer打印機.
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08:17
And here's這裡的 how it works作品:
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它的運作方式是:用微型藥物,
而非完整的藥錠,
08:19
instead代替 of full充分 tablets平板電腦,
we have small micromeds,
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08:21
one or two milligrams毫克 each,
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每個只有一或二毫克,
08:23
which哪一個 are sorted分類 and selected
based基於 on the dose劑量 and combination組合
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會根據個人所需要的
劑量和藥物組合來挑選。
08:26
needed需要 for an individual個人.
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08:27
And of course課程, these would be
doses劑量 and combinations組合
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當然,這些是你本來就能
一起服用的劑量和組合,
FDA 核准的藥物。
08:30
you could already已經 take together一起,
FDA-approvedFDA批准 drugs毒品.
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我們能改變藥物代謝動力學,
08:32
We could change更改 the pharmacokinetics藥 代 動力學
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08:34
by professionally專業 layering分層 on different不同
elements分子 to the individual個人 micromeds.
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做法是針對個別的微型藥物,
將不同元素以專業方式層疊上去。
08:39
And when we hit擊中 print打印,
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當我們按下列印鍵,
08:41
you print打印 your combination組合 of medications藥物治療
that might威力 be needed需要 by you
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你就能印出你在任何一天
可能需要的藥物組合。
08:44
on any individual個人 day.
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08:46
And we'd星期三 start開始 with, again, generic通用 drugs毒品
for the most common共同 problems問題.
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同樣的,我們也是從治療
最常見問題的非專利藥物做起。
08:50
About 90 percent百分 of prescribed規定 drugs毒品 today今天
are low-cost低成本 generics仿製藥.
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現今有 90% 的處方藥
都是低成本的非專利藥物。
08:53
And once一旦 we've我們已經 printed印刷的 the pill,
we can do some fun開玩笑 bells鐘聲 and whistles口哨.
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一旦我們把藥錠列印出來,
我們就能再做些有趣的額外功能。
08:57
We could print打印 the name名稱 of the patient患者,
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我們能列印出病人的名字、
08:59
the date日期, the day of the week, a QRqr code.
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日期、星期幾、一個 QR 碼。
09:02
We could print打印 different不同 meds吃藥 for tapering尖細
for a patient患者 on a steroid類固醇 taper錐體,
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我們能為在做類固醇減藥
或止痛藥減藥的病人
09:06
or tapering尖細 from pain疼痛 medications藥物治療.
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列印出不同的藥物供減藥用。
09:08
So, this is actually其實 a look at our
prototype原型 IntelliMedicine智慧醫療 printer打印機.
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讓各位看看我們的
原型智慧藥物列印機。
09:13
See, unveil揭開 it here.
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在此揭幕。
09:15
It has about 16 different不同 silos筒倉,
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它有 16 個不同的筒倉,
09:18
each containing individual個人 micromeds.
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每個當中都裝有個別的微型藥物。
09:22
And I can now adjust調整 on the software軟件
individual個人 dosings劑量.
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我可以透過軟體
來調整個別的劑量。
09:26
And when I do that,
the robotic機器人 arm will adjust調整
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當我操作軟體時,
機械手臂就會調整
09:30
the height高度 of these spansules斯帕努萊斯
and the micromeds will release發布.
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這些長效膠囊的長度,
微型藥物就會被釋出。
09:33
I can now --
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我現在可以——
09:35
The automated自動化 process處理
would rotate迴轉 and cycle週期 through通過,
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它會自動旋轉和輪轉,
確保微型藥物有被裝載上去。
09:37
to make sure the micromeds are loaded.
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當我按下列印鍵,
09:39
And when I hit擊中 print打印,
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09:41
these will all fall秋季 through通過 the device設備,
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這些都會透過裝置落下,
09:43
I now pull out my
personalized個性化 printed印刷的 polypill波利皮勒,
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現在我可以取出我的
個人化列印複方製劑,
09:47
with the doses劑量
and medications藥物治療 meant意味著 for me.
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它的劑量和內含藥物
都是針對我做的。
09:51
And we can take a look,
if you look back to the slides幻燈片,
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我們可以回頭看一下投影片,
09:54
you can see the whole整個 process處理,
we can see the drug藥物 silos筒倉 being存在 selected,
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你們可以看到整個過程,
我們能看到藥物筒倉被選取,
09:58
the pills doing down the different不同 silos筒倉,
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藥錠從不同的筒倉落下,
10:00
and being存在 collected
in the individual個人 capsule膠囊.
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被收集放入個別的膠囊。
10:02
Now, this is great,
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這很棒,
10:04
I can potentially可能
print打印 my meds吃藥 based基於 on me,
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我可以依我個人需求
來列印我的藥物,
10:06
instead代替 of taking服用 six pills.
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不用吃六種藥物。
10:08
I can now be looking
at my individual個人 dosing劑量,
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我現在可以察看我的個別劑量,
10:11
my smartwatch斯特沃特 is looking
at my blood血液 pressure壓力,
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我的智慧手錶在看我的血壓,
10:13
I needed需要 an adjustment調整
in my blood血液 pressure壓力 medicines藥品,
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我需要調整我的血壓藥物,
我的華法林濃度,我的血液太稀,
10:16
my coumadin香豆 level水平, my blood血液 is too thin,
218
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10:18
so I lower降低 my micromed米梅德
dose劑量 of coumadin香豆, a blood血液 thinner更薄.
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所以我降低了我的華法林
微型藥物劑量,它會稀釋血液。
10:22
So, this could be
smartly巧妙 adapted適應, day to day,
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可以智慧地做調整,
配合每天的狀況,
10:24
programmed程序 by my physician醫師
or cardiologist心髒病.
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由我的內科醫生
或心臟科醫生來製訂計畫。
10:27
And you can imagine想像 that larger printers打印機,
fast快速 printers打印機 like this,
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你們可以想像像這樣的
列印機,但更大、更快,
10:30
could be in your corner pharmacy藥店,
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擺放在你家附近街角的藥房裡、
10:33
in your doctor's醫生 office辦公室,
in a rural鄉村 clinic診所.
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你的醫生的辦公室裡、
鄉村的診所裡。
10:35
But it could eventually終於 merge合併 and shrink收縮
to small ones那些, that could be in your home,
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最終,它可以被合併和縮小,
成為小型個人家用列印機,
10:39
with integrated集成 cartridges墨盒 like this,
that are delivered交付 by drone無人駕駛飛機.
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有像這樣的整合藥筒,
由無人機來遞送。
10:43
Could print打印 your personalized個性化 polypill波利皮勒,
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放在你的廚房或是浴室儲存櫃中,
10:45
each morning早上 on your kitchen廚房
or your bathroom浴室 cabinet內閣.
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每天列印出你的個人化複方製劑。
10:48
And this could evolve發展, I think,
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我認為,這有可能會演進,
10:50
into an incredible難以置信 way to improve提高
adherence附著 in medications藥物治療 across橫過 the globe地球.
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成為一種很棒的方式,
來改善全球的依順性。
10:54
So, I hope希望 we can reimagine重新構想
the future未來 of medicine醫學 in new ways方法,
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我希望我們能夠以新的方式
來重新想像藥物的未來,
10:58
moving移動 from polypharmacy聚藥業,
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從多重用藥、所有人通用的劑量、
10:59
one-size-fits-all一個尺寸適合所有人,
low adherence附著, complications並發症
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低順從性、複雜混亂,
11:03
to an era時代 of personalized個性化,
precise精確, on-demand一經請求 medications藥物治療,
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轉變為個人化、精確、
依需要來供應的藥物,
11:07
that can take us
and individualize賦予個性 our own擁有 health健康
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將我們自己的健康給個人化,
11:10
and health健康 and medicine醫學 around the planet行星.
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也將世界各地的健康
和藥物給個人化。
11:13
Thank you very much.
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非常謝謝。
11:14
(Applause掌聲)
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(掌聲)
11:21
Host主辦: Daniel丹尼爾, that's kind of awesome真棒.
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主持人:丹尼爾,那真的很棒。
11:23
Really cool.
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非常酷。
11:25
Question for you, though雖然.
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但,有問題想請教。
11:26
How long is it until直到, say, that
nursing-home養老院 patient患者 that you mentioned提到
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還要多久才能讓,
比如,你提到的護理之家病人,
11:30
is able能夠 to print打印
their pills in their home?
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能夠在他們自己的家中
列印他們的藥錠?
11:32
Daniel丹尼爾 Kraft卡夫: Well, again,
this is just a prototype原型.
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丹尼爾克拉夫特:
再次強調,它只是樣本機。
11:35
We think that the regulatory監管 route路線
be automated自動化 compounding複利,
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我們認為還有待改善的部分
是使其能夠自動合成,
11:38
and especially特別 in nursing看護 homes家園,
folks鄉親 are taking服用 multiple medications藥物治療,
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特別是在護理之家,
那裡的人會服用多種藥物,
他們常常會搞混,
11:41
and they're often經常 mixed up,
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護理之家是這些技術
最完美的起始點。
11:43
so it would be a perfect完善 place地點
to start開始 with these technologies技術.
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這些技術不可能從你浴室
櫃台上的列印機開始和演進。
11:46
These aren't going to evolve發展 and start開始
with printers打印機 on your bathroom浴室 counter計數器.
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我們必須要以很聰明的方式
來推出這些東西,
11:50
We need to be intelligent智能 and smart聰明
about how we roll these things out,
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但要知道,在劑量、依順性,
和精準度上都還有許多困難挑戰,
11:53
but realizing實現 there's so many許多 challenges挑戰
with dosing劑量, adherence附著 and precision精確,
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現在我們有這麼多了不起的
新技術,可以被用來整合,
11:57
and now that we have
all these amazing驚人 new technologies技術
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11:59
that can integrate整合 and be leveraged槓桿,
I think we need approaches方法 like this
to really catalyze催化 and foster培育
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我認為我們需要這樣的新方法,
12:01
I think we need approaches方法 like this
to really catalyze催化 and foster培育
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來真正催化
和促進健康和藥物的真正未來。
12:04
a true真正 future未來 of health健康 and medicine醫學.
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主持人:好極了,謝謝你。
丹尼爾:謝謝。
12:06
Host主辦: Great, thank you.
DKDK: Thanks謝謝.
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(掌聲)
12:08
(Applause掌聲)
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Translated by Lilian Chiu
Reviewed by Yanyan Hong

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ABOUT THE SPEAKER
Daniel Kraft - Physician scientist
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.

Why you should listen

Dr. Daniel Kraft is a Stanford and Harvard trained physician-scientist with more than 25 years of experience in clinical practice, biomedical research and innovation. He is Faculty Chair for Medicine at Singularity University and is the founder and chair for Exponential Medicine, a program which explores convergent, rapidly developing technologies and their potential to reshape the future of health and biomedicine.

After medical school at Stanford, Kraft was board certified in both Internal Medicine and Pediatrics following residency at the Massachusetts General Hospital & Boston Children's Hospital, and he completed Stanford fellowships in hematology/oncology & bone marrow transplantation. He is a member of the inaugural class of Aspen Institute Health Innovators Fellows.

Kraft has extensive research in stem cell biology and regenerative medicine with multiple scientific publications, medical device, immunology and stem cell-related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at University of California San Francisco. 

Kraft recently founded IntelliMedicine, focused on connected, data-driven and integrated personalized medicine. He is the inventor of the MarrowMiner, an FDA-approved device for the minimally invasive harvest of bone marrow, and he founded RegenMed Systems, a company developing technologies to enable adult stem cell-based regenerative therapies. He is an advisor the XPRIZE (having conceived of the Medical Tricorder XPRIZE and is helping lead a new Cancer focused prize), and advises several digital health and technology companies.

Kraft is an avid pilot and served for 14 years as an officer and flight surgeon with F-15 and F-16 fighter squadrons in the Air National Guard. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.

More profile about the speaker
Daniel Kraft | Speaker | TED.com