我個人認為這篇文章是講得最透徹的。疫苗相關的醫藥審核制度,核准藥證/緊急授權,本身其實真的沒有一個硬標準,歸根究柢還是視時空環境、利害權衡之下,做出來的道德抉擇。
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原作者:iamlam2005(山風)
這些問題從EUA還沒通過到現在,已經很多人講過了,我也懶得再複述一次。但你會吵這些,代表你根本沒想通醫藥審查的本質。
你就先想一個問題:如果三期這麼香,AZ幹嘛不做傳統三期?BNT幹嘛不做傳統三期?莫德納幹嘛不做傳統三期?如果做了傳統三期,監測個三年五年,我們就會知道原來目前的疫苗根本沒辦法防止感染,防止傳播,也不能打疫苗之後就脫口罩、停止NPI,這些檯面上的疫苗(可能包括高端)通通應該退回去重做,我們就不用浪費這麼多錢來買一堆半成品!
你一邊想,我們一邊來看看2009年的國光H1N1疫苗:
1. 只做了相當於傳統一、二期合併的人體實驗,受試者480人。是高端的1/10。
2. 從選病毒株之後只過了半年就拿到藥證,還不是EUA。
3. 沒有保護力數據。當時是跟諾華疫苗比抗體,沒錯就是免疫橋接。同時血清陽轉率的要求是是70%,今年聯亞89%都被刷掉了。
當年的新聞稿:https://reurl.cc/r18OaN
所以你說什麼「全世界首例,免疫橋接EUA」,這太小兒科了,當年是免疫橋接直接給藥證欸!這支疫苗,大家還不是打得很香,每年打。而從2016年開始,國光公司改成用重組蛋白技術來做Flublok Quadrivalant疫苗,不再需要搶購雞蛋了。核准依據就是「與其他四
價流感疫苗的比對性臨床試驗」,也沒有做傳統三期。
然後2015年,藥事法修法,才多了一個緊急使用許可的條款,也就是現在我們看到的藥事法48-2第二款。否則在那之前只有「拿到藥證」跟「失敗重做」兩種選擇。
三期並不是什麼科學標準,它跟「手放開蘋果會往下掉」「水在攝氏零度會結冰」不一樣,不是什麼顛撲不破的物理定律。到底要不要許可一個新藥、新疫苗,它本質上就是一種道德選擇:
「在怎樣的情況下,我們允許自己的同胞接受一個新藥的使用風險」
這很明顯是一個道德抉擇,科學資料只是幫助我們進行判斷而已。
你拿癌症用藥的審查來看就會很清楚。為什麼癌症化療用藥的副作用都那麼強?生物學上的原因當然是:因為癌細胞是人體自己的細胞,你要攻擊癌細胞就會攻擊到有同樣特徵(複製旺盛)的正常細胞。
可是從制度的角度來看,之所以癌症用藥副作用這麼強也會通過審查,就是因為我們認為它過比不過要好。比起掉頭髮、嘔吐這些副作用,讓病人無藥可用最後走向死亡,更讓人難以忍受。反過來,如果今天審查的是感冒用藥,我們大概就不能接受比頭痛更強的副作用。
甚至很多藥不是因為它「更有效」而被許可的。比如說乳癌的化療用藥,第二代小紅莓,它的療效並沒有比第一代要好。它之所以被許可是因為它的副作用少的多,可以顯著提升患者的QoL(生命品質)。有效性從來就不是通過與否的唯一指標。
當年翁啟惠的新藥在浩鼎解盲失敗。也有人說它可能是選錯了指標。因為它用腫瘤尺寸當做指標,但是免疫藥物會引起免疫反應攻擊腫瘤,反而會讓它發炎腫大。因此就算它有效,在實驗期間腫瘤尺寸並沒有下降太多。有人在猜測,如果用的是最終生存率(overall
survival)或是其他指標,搞不好解盲就過了。
這就是為什麼免疫橋接會被稱作「替代性指標」,因為原本的「有效性試驗」(也就是所謂的保護力數據,efficiency)也只不過是另外一個比較常用的指標。你到另一個時空背景底下重做一次,不會得到相同的數字。他們都是指標。這些所有的科學資料,不管是有
效性試驗、副作用、抗體濃度....他們都只是一個指標而已,是拿來讓審查委員參考用的。
神靈你就是眼睛裡面都看不到人,只看到理想的社會模型。不符合這個模型的你就認為是德性有所欠缺,或是執政黨的問題。而且不管哪個議題都一樣。但實際上並沒有一個神奇的機器,你把數字輸入進去,它就會自己跑出一個核准與否的答案出來。國家是人組成的,不是神,也不是AI。答案要自己去找。
你如果有去看高端或聯亞的審查會議紀錄,你會發現在會議一開始,主席都會宣布「目前(根據若干理由)認定有緊急公衛需求,請各位專家在這個前提下進行審查」。這個宣布就完美解釋了我上面講到的,一種新藥要不要核准,它是一個道德選擇。你必然是在一個特定的時空背景底下做選擇。你不可能開上帝視角知道說這個藥半年、一年、十年之後會不會有更好的替代品。如果你現在只有一個療效50%的藥,你也只能用,你不可能說十年後會出一個療效90%的藥,所以我們就先等十年。不管是EUA還是藥證都是這樣,而EUA「道德選擇」的性格又更強烈許多。
回到一開始的問題,如果你真的要問為什麼沒有三期就要人打,那我也可以反問,為什麼沒有傳統三期就要人打?為什麼不追蹤打疫苗之後半年、一年、兩年的保護力跟副作用?只追蹤兩個月就解盲做期中報告?腸病毒疫苗做了17年,為什麼不能跟他一樣嚴謹?為什麼要核准一個施打半年之後抗體濃度會下降的疫苗?如果我們使用的是正確的疫苗,搞不好真的可以達成群體免疫!
而你也知道答案是什麼,就是時間不夠。你要在時間不夠的前提下做選擇。痛苦的選擇。以色列核准BNT的時候也不知道會有變種病毒,也不知道它的效力會下降的那麼快。但它不可能等到三期先做一年看看疫苗效力會不會下降再來決定要不要核准。否則這一年之內可能會多死很多人。
就跟2009年一樣,當年沒有緊急使用許可的條款,如果當時的審查委員宣布H1N1失敗不給發藥證,那台灣就要面臨外購一劑難求(當時是真的一劑難求,比現在還誇張),國內又自己生不出疫苗的窘境。審查委員唯一需要擔心的問題就是「核准是不是比不核准還要好?」,而不是在那邊糾結為什麼沒做完三期,為什麼沒有有效性試驗。因為就是沒有,而你現在就要做決定。
而對武漢肺炎疫苗來說,台灣當然是時間不夠加上外購不穩的雙重困境(而有些人還在幻想多下單就會多到貨),我們是在這個前提下認定它有緊急使用需求。
EUA的重點就是緊急使用需求,而不是要做出一支完美的疫苗。你沒有緊急使用需求,後面有再多資料都不用談。所以AZ在美國也拿不到EUA,因為美國已經不缺疫苗了,並不是因為AZ資料不夠。
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做為題外話,今天這些疫苗要走什麼流程通過,不會是蔡英文可以決定的。就是專家提議,她點頭,就這樣而已。她唯一可以選擇的就是做不做國產疫苗。就好像當年H1N1疫苗那如今看起來很陽春的流程,也不會是馬英九決定的。
重點是,不管是什麼流程,審這些疫苗的都是同一群人。當年叫衛生署食品藥物管理局,如今叫衛福部食藥署。他們就是陳時中後面的人,也是全台灣最懂疫苗的一群人。現在你看到的張上淳、李秉穎、陳建仁、黃立民這些人,當時也都參與其中。數十年如一日。當年幫馬英九扛砲火,如今幫蔡英文扛砲火。當年還有多一個李慶雲,今年六月過世了。所以現在李秉穎會被叫小李P,不是要裝可愛,是他上面還有一個大李P。
如果你要做政治判斷,就不該把這個疫苗流程當成是蔡英文的問題(或是政績)。你唯一可以問的就是,我到底相不相信這群專家。因為AZ進來的EUA,也是他們審的。Moderna進來的EUA,也是他們審的。BNT進來的EUA,也是他們審的。一但疫苗有任何狀況,不會是天邊的「國際認證」來幫你負責。連正式藥證的藥害救濟都很困難了,怎麼還有人會幻想自己在EUA的情況下打「國際疫苗」就會有「國際保證」?不管你是打國際疫苗還是國產疫苗,通通都是你看到的這群食藥署的專家來處理,也只有他們可以處理。
李慶雲當年把自己的女兒找去試驗麻疹鼻噴劑疫苗;把自己的兒子找去試驗日本腦炎疫苗。如今連加恩把自己的三個小孩送去做臨床實驗。陳建仁自己也參與高端疫苗的人體實驗。發現自己打了兩劑之後,都是安慰劑,沒有要求補打,而是自告奮勇繼續參與第三劑--也是安慰劑組的試驗。換言之,陳建仁到現在還沒打(真的)疫苗。
你可以自己決定要不要相信這群燃燒自己生命的人。還是說你寧願相信他們是為了炒股、為了試驗疫苗故意放毒進來強迫台灣人去打疫苗、給蔡英文打假針、給一般民眾打食鹽水。雖然我對你的判斷力沒什麼信心就是了。
同時也有1部Youtube影片,追蹤數超過2,250的網紅Benjamin Man — iBenTV,也在其Youtube影片中提到,[3/3] This piece took around 10-11 months to compose, thANKFULLY I GOT FULL MARKS SO HARD WORK PAID OFF!!! I was lucky enough to be able to work with ...
「overall survival」的推薦目錄:
overall survival 在 國立臺灣大學 National Taiwan University Facebook 的最佳解答
【國立臺灣大學 109學年度畢業典禮 貴賓致詞】
Commencement Address, National Taiwan University Commencement 2021
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巨大集團 羅祥安前執行長
Giant Group Former CEO Anthony Lo
管校長,羅副校長,各位貴賓,畢業生的家長跟朋友們,還有今天最重要的2021年臺大的畢業生,大家早安、大家好!
首先恭喜你們,今天從全世界最優秀大學之一的臺灣大學畢業了!
在過去幾年,在管校長,以「大學教改」和「國際化」的理念,率領全體師生的努力之下,臺大在全世界的能見度,和各項排名,都有顯著的進步,也讓身為校友的我們倍感光榮。
是不是我們大家一起鼓掌,給自己鼓勵一下好不好!
你們今天剛剛畢業,但是你們已經創造了臺大一項新的紀錄:第一次,沒有傳統畢業典禮的畢業生。這將是你們人生一個非常特別的回憶,也預表了你們未來將會有與眾不同的表現,和非凡的成就。
現在的世界,局勢是在東方跟西方的勢力,彼此對抗而動盪不安。而全世界的經濟活動,也因為科技的突破性創新,而受到很大的影響。不盡理想的、不盡公平的全球化,也將逐漸地變成 全球在地化。而COVID-19肆虐全球的結果,使得臺灣跟全世界,大家的生活型態、社會的結構、經濟活動的節奏都被打亂了,而必須要加以全面的整理跟重新的架構。這當然是一個危機,但是更是一個絕好的機會。所以,將你們迎面而來的,是無數的創新的機會,以及冒險卻令人興奮的全新挑戰。
因為臺灣,這是第一次跟全世界各個國家,同步的站在一個嶄新的共同起跑點上面。所以我要恭喜你們,你們躬逢其會,將要進入一個充滿希望、嶄新的時代。
我是1969年從臺大畢業的,所以我想今天就以我畢業之後的50多年,人生的一些學習和體會,來跟諸位分享,給諸位作個參考。
當我大學畢業的時候,我滿懷抱負,迫不及待地想要大展身手,我當時進入臺灣最大的貿易公司工作,但是我發現我所學的很多東西,只有一些國際貿易的實務跟英文有用,至於其他我所學習到的經營管理的很多知識,恐怕都要等到10年、20年之後,如果我有幸當上高級主管才能派上用場。
更諷刺的是,我是商學系畢業的,但是工作兩年後,我發現我真的不喜歡做商人,我也不喜歡做生意,我有興趣的是做事業。
後來,幸好我有聆聽我心裡面的微弱的聲音,決定踏進自行車業,放棄掉台北最好的貿易公司的金飯碗,而去參加在大甲一個只有38個人的小公司,來追求我的夢想。
那時候許多人認為我腦筋有問題,頭殼壞去,但現在回顧回來,我當時是做了人生一個非常好的決定。
創業的過程飽受艱辛,但是我也學到了很多寶貴的經驗:我首先學到的,是在做事之前,必須要先學做人。
人必須要誠信踏實,不能自私自利,而要利他共好。
要隨時心存感恩,尊重、關切別人。要熱愛這個世界,並且要了解到一個人的能力是有限的,而必須要去建立互信、互助的人際關係;要融入群體、要發揮團隊的精神。
在做事方面,一定要以正面積極的態度,認真努力去工作。 而且不要怕失敗,要勇於接受新的挑戰。因為如果有失敗了,那只是代表說你又更靠近成功一步了。要作中學,學中作,要虛心好奇的終身學習,開拓挑戰、追求卓越。
在這裡,我想要送給大家一個很特別的畢業禮物,就是兩個「成功的錦囊」。
第一個錦囊:不管你做什麼工作,不論你職務的高低,永遠都要站在顧客的立場,來為他們設想,還能做什麼,讓他們能夠得到更多的創新價值。
第二個錦囊:無論作什麼工作,不管你職務的高低,永遠都要站在經營者的角度來為公司設想,要做什麼,才能讓公司更健康,永續經營跟發展。
既使你們把我後面講的很多東西都忘記了,沒關係,但是這個畢業禮物你們一定要記得帶回去,因為這些「同理心」的兩個錦囊,在未來會給你們帶來意想不到的祝福!
其次我體會到,名跟利都是副產品。正產品是你成為什麼樣的人,成就什麼樣的事。當正產品是對的時候,名跟利都自然會來。
所以我鼓勵大家在找工作的時候,不要太計較開始的薪水和待遇。因為事實上,一個新人,在前面三年是很難有大的貢獻的,反過來只是公司發薪水來給你培訓而已。所以選擇一個有意義的行業,找一家你可以學習進步的好公司,這才是重要的。
第三,我學習到 知識不等於智慧。諸位都學有專精,有很多寶貴的知識,但這些知識必須要實際去做才能夠產生經驗,而累積的時候會有不同經驗的反省、學習、跟體會,尤其是從那些失敗的經 驗,才能夠漸漸地凝結成有用的智慧。
我的成長過程分成三段,開始我是一個「I」型的人,我擁有一些經營管理的基本的能力。後來因為工作的需要和我的好奇心,我漸漸地學習到技術開發、製造生產、品牌推廣、全球經營、以及行銷、服務等等寶貴的經驗,這樣漸漸地,我就形成一個「T」型的一個跨界的人才。但是到了我真正找到公司未來的使命跟方向,並且把它跟我的人生目標結合在一起,熱情的、積極去推動的時候,那時候我終於成為一個「十字架」型的一個領導者。
當公司發展得比較穩定之後,我就面臨要如何來替公司規劃願景、使命、定位,跟長期策略。在這個階段,我有一些新的體會:首先,你必須要能夠畫出一個「黃金正三角形」,正三角形是最穩定的,上面是戰略,中間是戰術,下面是戰鬥。先要有正確的戰略,才能衍伸出有效的戰術,再根據這個戰術去貫徹戰鬥的執行。換言之,戰略就是做對的事情,戰術就是對的方法,戰鬥就是用對的方法去把事情做對做好,並且不斷地去持續改善。
想要能夠思考出長期的戰略,就必須要有洞察力。
我很喜歡看地球儀,就是那種在一個架子上面,有一個可以轉動的地球模型。當你把地球轉動的時候,你看到上面每一個地方、每一個國家,它的地理位置、它的自然生態,以及你思考它的歷史的演變跟它的發展,這樣子你就能夠得出一個整體的,跟全方位的一個概念。
在思考長期戰略的時候,很不容易得出一個有突破性的一個創見,它的原因往往是因為「當局者迷」的關係。
所以當我考慮長期戰略的時候,我會把自己設想,好像從一個人造衛星上面,來觀看一個轉動的地球。以宇宙格局的高度,以全球視野的廣度,以歷史演進的長度,這樣子你就能夠以一個「旁觀者清」的姿態和角度,來正面、反面深入思考,這樣子你就可能得到一個突破性的一個解答。「世界的捷安特」跟「全球在地化」的品牌經營—這樣子的策略、願景就是這樣產生的。
另外一種洞察力,是如何推出給人們有創新價值的產品跟服務。這就要時時地站在人文跟科技的十字路口,仔細觀察它們的變化,然後活用科技的進步,為人文潛在的需求,適時地提供最佳的解決方案。捷安特的Cycling世界,就是用這種方法,不斷的推出創新價值的產品。
我們在經營上也有發展出一個特別的理念,那就是「不求第一,要作惟一」。全世界的人這麼多,但沒有兩個人的指紋是一樣的, 所以每一個人都是獨一無二、都是惟一的。可見當上帝造每一個人的時候,祂都有衪特別的計劃,而且也把成功所需要的能力跟要素,已經放在你的心中,等待你取用。所以每一個人不應該只是模仿別人,或者是按照別人的期望來生活,而應該要找出並且發揮自己的天賦,真正做自己,成為惟一,才能夠活出精采的生命。
企業也是一樣,不能隨波逐流,必須要找出什麼才是對的,什麼是合適你的,什麼才是有意義、對這個世界有貢獻的,這個才是惟一。當你精益求精,努力的想要成為惟一的時侯,你才能夠找到真正正確的目標,以及永續生存的價值。如果事事都想為第一,那麼你可能去追求很多不切實際的目標,而被你無法承受的巨大壓力所摧毀。或者,因為不擇手段,最後走上一些錯誤的道路。
在長期追求惟一的過程當中,我也得到兩個重要的體會:當你決心做一件對的事情,而且不屈不撓,勇敢堅持奮鬥的時候,全宇宙的力量都會起來幫助你。另外,把一件有意義的事情,用生命的力量把它作好,你就有可能改變這個世界!
我鼓勵你們,聆聽你們內心深處的微小的聲音,讓它引導你們,去尋找到你們的天賦,了解你們的命定。
不求第一,要作惟一。做你真正的自己,成為惟一。活出你精彩的生命,享受你幸福的人生!
很多人說,生長在臺灣的人,一輩子裡面一定要完成三項挑戰:登玉山、泳渡日月潭、還有騎自行車環島。我覺得這非常有道理。所以我建議大家在畢業以後,在去當兵、就業之前,不妨參加一個自行車環島的旅行團,用九天的時間,仔細的去體會、欣賞寶島臺灣的美好,用自行車的輪胎去親吻,這塊生你長你的美麗大地,就當作是送給你自己的一個畢業禮物吧!
那教授們跟家長們,可能會想說,啊!太可惜了,我畢業的時候沒有騎自行車環島,我現在已經五六十歲了。沒關係,你這個年紀正好來從事人生的壯遊。
我們臺大的校長-管校長,在今年的一月份,就勇敢的完成他夢寐以求的自行車環島的壯遊。我們給管爺一個掌聲好不好?
有人認為臺灣很小、沒有前途,真的是這樣嗎?世界經濟論壇每年都要把全世界的國家的實力做一個調查跟排名。讓我們來看一下臺灣的排名。全世界有235個國家,就面積來講,我們排名第137;就人口來講,第57;就經濟體來講,第21;就整體競爭力來講,排名第11;而創新力,臺灣排名第4。沒錯,臺灣的確不大,但是我們很強,我們可以很有前途!
可預見的,未來的世界將會成為美、歐、亞三區鼎力的這個新局面。就像三個圓圈,各自都以自己的利益為優先,並且彼此長期的競爭、對抗和抵制,但是同時又不得不相互的維持一些必要的連結。而在每一個圈裡面,它將持續的有很多劇烈的改變,就像一個暴風圈一樣。而這三個暴風圈連結在一起,就形成一個所謂完全風暴PERFECT STORM。
最近經濟學人雜誌,把臺灣當作封面,稱臺灣為地球上最危險的地方,但同時又是科技業最關鍵的地方。我個人倒認為,未來臺灣可能是處在一個最有利的地位,就在那三個暴風圈中間的那個颱風眼,也就是這三個圈圈彼此連結交會的中心點。這個地方看起來好像危險,其實是最安全、最有利、又是最關鍵的地方。
當三個暴風圈無可避免的,參與在一個長期的競爭、對抗、跟抵制-這樣一個零和的賽局裡面。那臺灣並不屬於任何一個圈圈,也不需要去參與這些競爭、對抗跟抵制。而可以去想說,我可以在這個關鍵的中心點,替這個世界來提供什麼樣子的創新價值的貢獻。
臺灣過去50年的努力累積了很多技術開發、製造管理、金融資本,社會資源,以及民主法治體制,這些稀有而寶貴的實力。而且如果以全世界作為舞台,那麼,能夠精通中文跟英文、能夠深切的了解東方西方的文化;有專業,又能跨界,謙卑而不自卑,自信而不自大的臺灣人,可能是全世界最優秀的人才。
未來無法被預測,但是可以被創造!30年前,有誰能夠預測到說臺灣會產生世界級的台積電跟捷安特?
台積電秉持著作惟一的理念,以全球晶圓代工的戰略,厚植實力,打造了優質高效的供應鏈,把臺灣變成一個科技島。以臺灣為核心,轉動引領全世界的半導體市場。
捷安特也秉持著作惟一的理念,以世界的捷安特,全球在地化的品牌戰略,帶領A-Team把臺灣變成全世界高級車的中心,又積極的推動Cycling的新文化,把臺灣發展成一個自行車島,以臺灣為核心,轉動引領全世界自行車的市場。
在這裡我也期許我們臺大,也能夠以作惟一這樣子的理念,轉動引領世界,變成全世界最優秀人才培養的最佳搖籃。
未來的50年,臺灣將迎來前所未有最大的機運!所以臺灣是不是應該要脫離過去單純競爭的心態,而來積極的謀求長期的未來生存之道,或者更進一步要問自己:臺灣可以為世界貢獻些什麼?臺灣不應該只是消極的「根留臺灣」,而應該更主動積極的「放眼全球、立足亞太、深根臺灣」。
臺灣過去的50年,那是一個非常艱辛跟特別的階段。很慶幸的,臺灣在那個階段裡面,是屬於勝利的這一組。
現在是應該到了必須要了解過去、深入現在、策劃未來,這個重要關鍵的時刻。要如何的以宇宙格局的高度、以全球視野的廣度、以及歷史演進的長度,衡外情,量己力,來為臺灣重新的定位,重新畫一個正確的戰略、戰術、戰鬥的黃金三角形。讓臺灣能夠真正發揮自己的長處,能夠打造創新價值的優勢,成為惟一、做Only One!要能夠創造一個更安全、更廣闊、更興盛-全新的藍海。臺灣必須要成為世界的好公民,繼續的為全世界做更多、更好的貢獻!
2021的畢業生們,在你們當中有未來國家的領導人、有全球企業的創造者、有在社會各行各業、方方面面的核心人才,所以臺灣未來50年的未來,就掌握在你們手中了。
最後,我想用一位著名科學家的名言來作結尾: Life is like riding a bicycle. To keep your balance, you must keep moving. 人生就像騎自行車,要保持你平衡最好的方法,就是繼續不斷地向前進。
你知道這是誰的名言嗎? 沒錯,就是愛因斯坦!
2021的畢業生們,請你騎上你人生的自行車,勇敢的向前邁進,去開創你獨一無二、精彩無比的新生命跟未來。再一次,恭喜你們,並且祝福你們每一位,將來都能夠有健康、幸福、精彩跟有意義的人生!
謝謝!
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President Kuan, Executive Vice President Luo, Distinguished guests, family, friends, and most importantly, the graduating class of 2021, good morning!
First of all, congratulations! Today, you are graduating from one of the best universities in the world – National Taiwan University!
Over the last few years, President Kuan led the university forward with his vision of “educational reform” and internationalization”. Together with all the faculty and students, NTU has made significant progress in both ranking and global visibility, making us, alumni, extremely proud.
I think we deserve to give ourselves a round of applause!
You are the graduating class of 2021 and already, you have set a new record for NTU: For the first time, there will not be a traditional graduation ceremony. Let this be a very special memory of your life and a sign of the difference you will make in your future with extraordinary achievements.
The world is now in a volatile state where the East and the West are confronting each other. The world’s economic activities are also greatly affected by the breakthrough and innovations in technology. The less-than-ideal and less-than fair globalization will gradually become global localization. And as a result of COVID-19, Taiwan and the rest of the world’s lifestyle, social structure, and economy have been disrupted, and must be comprehensively reorganized and restructured. This is certainly a crisis, but in the midst of every crisis, lies great opportunity. So, what lies before you are countless opportunities for innovation, and exciting new challenges.
Because, for the first time, Taiwan is standing with the rest of the world on a new race-track. Therefore, I would like to congratulate you, you are entering a new era full of hope.
I graduated from NTU in 1969. It has been more than 50 years and today, I would like to share some of my life experiences and insights.
When I graduated from college, I was filled with ambition. I couldn’t wait to make my mark. I joined one of the largest trading companies in Taiwan, where I quickly realized the only materials I learned in school that came in handy are a little bit of international trade practices and English. Much of what I had learned about business management would only be relevant 10 or 20 years down the road, if I was lucky enough to become a senior executive.
What’s even more ironic is that I graduated with a degree in business, but after working for 2 years, I realize I really don’t like being a businessman, and I don’t like doing business. What I am actually interested in is building an enterprise.
Fortunately, I chose to listen to the faint voice in my heart and decided to enter the bicycle industry. I left my position at the best trading company in Taipei to join a small company with only 38 employees in Dajia to pursue my dream.
At the time, many people thought I must’ve broken my skull and gone crazy, but looking back, I have made a great decision in my life.
The process of starting my own enterprise has been very difficult, but I have learned many valuable lessons. The first thing I learned is that before you can do anything else, you have to learn to be a person of good character.
We must be honest, down to earth, selfless, self-serving, and altruistic for the common good.
Be grateful, respectful and caring at all times. To love the world and to understand that one person’s ability is limited and that is necessary to build interpersonal relationships of mutual trust and support; to be part of a group and to play as a team.
When it comes to work, you must work hard with a positive attitude. And don’t be afraid to fail, be brave enough to accept new challenges. Because every time you fail, it just means you are one step closer to success. Learning is an active process. We learn by doing. We must stay open-minded and curious, aspiring to lifelong learning; to explore challenges and pursue excellence.
Here I would like to give everyone a special graduation gift, which are my two tips for success:
First, always put yourself in the customer’s shoes, regardless of what you’re doing or what kind of job title you hold. Think for them, think about what else you can do to create more value for the customers.
Second, regardless of what you’re doing or what kind of job title you hold, always think about the company from the proprietor’s point of view; what can we do to build a healthier company that’s sustainable.
Even if you are going to forget everything I say later, that’ ok. Just remember to take your graduation gift at heart, because these two tips on “empathy “are sure to bring you unexpected blessings in the future!
Later on, I realized that fame and money are merely byproducts. The real product is you, what kind of person you have become and what have you achieved. When the real product is identified, fame and money will come naturally.
So I encourage you, when you look for a job, don’t be too concerned about the starting salary and benefits. Because as a matter of fact, as a newcomer, it is very difficult to make a big contribution in the first three years, so really the company is paying to give you training instead. So choose a meaningful industry and find a good company where you can improve and grow, that’s what’s important.
Thirdly, I learned that knowledge is not the same as wisdom. All of you have learned a lot and have a lot of valuable knowledge, but this knowledge must be practiced in order to produce experience, and in the process of accumulation, there will be different experiences of reflection, learning and empathy, especially from failure, slowly and surely all these experiences will be condensed into useful wisdom.
My personal development can be divided into three stages. I began as a I-shaped person with some basic skills in business management. Later on, due to my job and curiosity, I gained respected experience in technology development, manufacturing, branding, global marketing, and service and thus gradually becoming a T-shape multidisciplinary professional.
However, when I combined the future mission and direction of the company with my life goals, promoting it enthusiastically and actively, that is when I finally became a X-shape transdisciplinary leader.
Once the company became more stable, I was faced with the challenge of planning the vision, mission, positioning, and long-term strategy for the company. At this stage, I had some new insights.
First, you must be able to draw a “golden triangle”, an equilateral triangle is the most stable shape with strategy on top, tactics in the middle, and operations at the bottom. In other words, the strategy is to do the right thing, the tactics is the using the right methods, and operations is using the right methods to excel on doing the right things while constantly improving them.
To develop long-term strategies, it is necessary to have insight.
I enjoy looking at the globe, yes, the spherical model of Earth that sits on a stand and can be rotated. When you rotate the globe, you can see every place and country on it, its geographical location, its natural ecology, and you can think about its historical evolution and development, so that you can come up with an overall comprehensive concept.
When thinking about long-term strategy, it is not easy to come up with a groundbreaking idea, because “men are often blind in their own cause”
Therefore, when I think about long-term strategy, I imagine myself as if I were looking at a rotating Earth from a man-made satellite. With the height of the universe, the breadth of global vision and the length of historical evolution, you will be able think about it from the perspective of an observer, and then you may have a breakthrough. This is how the strategy and vision of “GIANT for the World” and “glocalization” brand management came about.
Another kind of insight is how to introduce the products and services to create additional value to people. This requires standing at the crossroads of humanity and technology, observing their changes carefully, and then using technological advances to provide the best solutions for the potential needs of humanity in a timely manner. This is how GIANT’s Cycling World continues to introduce innovative values to its products.
We have also developed a special philosophy in our business, which is “don’t be the first one, be the only one”. There are so many people in the world, but no two people share the same fingerprints, making each person unique and one of a kind. God created each person with purpose and has gifted us with the abilities and elements needed for success. All of which is in your heart, waiting for you to take them. Therefore, we should not just follow each other’s footstep or live under the expectations of someone else. Instead, we should find and give reigns to our talents, to truly be ourselves, to become the only one and live a brilliant life.
The same applies to businesses, you can’t just go with the flow, we must find what is right and suitable and what is meaningful and contributive to the world, this is what it means to be the only one. When you strive for excellence and strive to be the only one, you will find the right goals and the value of sustainability. If you try to be first in everything, you may pursue many unrealistic goals and either be destroyed by unbearable pressure or resort to doing whatever it takes, and end up on the wrong path.
I have learned two important lessons in my long quest to be the “only one”. When you are determined to do the right thing and you are unyielding and persistent in your struggle, the power of the universe will rise up and help you. In addition, if you do something meaningful and do it well with the power of life, you may change the world.
I urge you to listen to the small voice deep within you and let it guide you to find your talents and understand your destiny.
Do not seek to be the first but to be the only. Be true to yourself and be the only one. Live your life to the fullest and enjoy your life to the fullest!
Many people say that growing up in Taiwan, you must complete three challenges in your lifetime: climb to the top of Jade Mountain, swim across Sun Moon Lake, and ride a bike around the island. I think this is very true. Therefore, I suggest that after graduation, before you go to the military or get a job, you might as well join a bicycle tour around the island and spend nine days to carefully experience and appreciate the beauty of Taiwan. As a graduation gift to yourself, let the tires kiss the beautiful land where you were born and raised.
All the professors and parents must be thinking in regret, “Ah! Too bad! I didn’t ride my bike around the island when I graduated and now I’m already in my 50s and 60s…” But that’s okay! You are actually at the perfect age to start your adventurous life.
Our President of NTU, President Kuan bravely completed his dream bike tour around the island in January this year. Let’s give President Kuan a round of applause!
Some people think that Taiwan is small and has no future. Every year, the World Economic Forum conducts a survey and ranking of the strength of countries around the world. Let’s take a look at Taiwan’s ranking. There are 235 countries in the world and we rank 137th in terms of landmass, 57th in terms of population, 21st in terms of economy, 11th in terms of overall competitiveness, and 4th in terms of innovation. It’s true that Taiwan is not big, but we are strong and we have a promising future.
In the foreseeable future there will become a new situation in which the United States, Europe and Asia will be the three focal regions. Just like three circles, each of which prioritizes its own interests and is in long-term competition, confrontation and resistance, but at the same time has to maintain some necessary links with each other. And in each circle, drastic changes will be endless, just like a storm circle. These three storm circles are linked together to form a so-called PERFECT STORM.
The Economist magazine recently featured Taiwan on its cover, calling it the most dangerous place on earth, but at the same time the most critical place for the technology industry. Personally, I think that Taiwan may be in the most favorable position in the future, right in the middle of the three storm circles, the eye of the typhoon, which is the center point where these three circles are connected. This place seems dangerous, but in fact it is the safest, most favorable, and most critical place.
When the three storm circles are inevitably involved in a long-term competition, confrontation, and boycott - a zero-sum game. Taiwan does not belong to any of these circles, nor does it need to participate in these competitions, confrontations, and boycotts. Instead, situated in this critical position, I should begin to think about what kind of innovative value I can provide to the world.
Taiwan's efforts over the past 50 years have accumulated many rare and valuable strengths in technology development, manufacturing management, financial capital, social resources, and the democratic rule of law system. If the world is our stage, Taiwanese people who are proficient in Chinese and English, who have a deep understanding of Eastern and Western cultures, who are professional, who can cross borders, who are humble but not inferior, and who are confident but not arrogant, may be the best talents in the world.
The future cannot be predicted, but it can be created! 30 years ago, who could have predicted that Taiwan would produce globally renowned TSMC and GIANT?
TSMC is committed to the concept of being the only one, and has built up its strengths with its global foundry strategy, creating a high-quality and efficient supply chain and turning Taiwan into a technology island. With Taiwan as the core, TSMC is leading the worldwide semiconductor market.
GIANT also upholds the concept of "Be the only one" and leads the A-Team to turn Taiwan into the center of the world's premium bikes with the brand strategy of globalization and localization, and actively promotes the new culture of cycling, developing Taiwan into a cycling island and leading the world's cycling market with Taiwan as the core.
Here I also hope that we, NTU, can also lead the world with the concept of being the only one, and become the best cradle for the cultivation of the best talents in the world.
In the next 50 years, Taiwan will have the greatest opportunity ever! Therefore, Taiwan should get rid of the simple competitive mentality of the past and actively seek the long-term survival of the future, or go even further and ask itself: What can Taiwan contribute to the world? Taiwan should not just "secure Taiwan" in a conservative way, but should be more proactive with global outlook and establish a foothold in the Asia Pacific.
The last 50 years, for Taiwan, has been very difficult and significant. Fortunately, Taiwan pulled through and came out as one of the winners.
Now is the crucial moment to understand the past, delve into the present, and plan for the future. We must take the height of the universe, the breadth of our global vision, and the length of historical evolution, weigh the external situation, and measure our own strengths to reposition Taiwan and draw the golden triangle of strategy, tactics, and operations. Taiwan should be able to give full play to its strengths, create innovative value, and become the only one! Taiwan must become a good citizen of the world and continue to make more and better contributions to the world!
Graduates of 2021, among you are the future leaders of the country, the creators of global enterprises, and the core talents in all walks of life, the future is in your hands.
Finally, I would like to conclude with a quote from a famous scientist: Life is like riding a bicycle. To keep your balance, you must keep moving.
Do you know who this quote belongs to? That's right, Einstein!
Graduates of 2021, please get ready for your life adventure, get on your bikes and peddle courageously forward to create your own unique and exciting future. Again, congratulations and best wishes to each and every one of you for a healthy, happy, and meaningful life!
Thank you!
詳見:
https://www.facebook.com/NTUCommencement/posts/2718162161807541
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#臺灣大學 #畢業典禮 #NTUCommencement2021 #貴賓致詞 #羅祥安
overall survival 在 新思惟國際 Facebook 的最佳貼文
#最新梯次僅剩最後4個名額
口腔癌的患者,如果淋巴結腫大時,很有可能代表疾病已經沿著淋巴散播出去。而蔡醫師團隊想要知道,如果我們在口腔癌患者身上觀察到腫大的淋巴結,是不是真的代表預後比較差。
收入了 2009 到 2019 年的 11 篇研究後,累積的受試者數為 20607。統合後發現,較多的淋巴結腫大,的確跟較差的 over all survival、disease-specific survival、disease-free survival 有關。
如果要找個最高 hazard ratio 的 cutoff value,在 overall survival 是 3,在 disease-specific survival 是 3,在 disease-free survival 則是 4。整體來說,在 3 以下,hazard ratio 會逐漸上升,但 4 之後的風險增加就不明顯。
作者總結認為,在口腔扁平細胞癌,淋巴結腫大量,的確是一個獨立的預後因子。
將臨床上曾經懷疑過,或者不確定的事情,藉由統合分析整理並量化,可以臨床工作參考,也是很好的發表主題。
【以發表 SCI 為學習目的,一天學會統合分析的技能!】
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✓ Meta-analysis 研究規劃技巧:以指定論文為例
✓ 拆解論文架構:照這樣做,最容易。
✓ 那些重要的專有名詞:Meta-analysis 重要數值
✓ 互動實作時間:完成一套 Meta-analysis 圖表
✓ 我是怎麼搜尋文獻的:以發表為導向
✓ Meta-analysis 圖表優化重點
✓ 給初學者的起步建議:減少卡關,邁向成功。
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🚩 無經費、無資源者的起步首選
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最新梯次|7 / 31(六)統合分析工作坊
瞭解課程|https://meta-analysis.innovarad.tw/event/
[快訊] 蔡宗佑醫師團隊,關於口腔癌淋巴結的預後價值之統合分析,獲 The Laryngoscope 刊登!
[快訊] 羅乾鳴醫師團隊,關於食道切除術使用單腔氣管內管之統合分析,獲 Journal of Cardiothoracic Surgery 刊登!
[快訊] 許智維醫師團隊,關於出生月與心理疾患關聯之健保資料庫與統合分析研究,獲 Acta Psychiatrica Scandinavica 刊登!
[快訊] 楊大緯醫師團隊,關於 X 光偵測上消化道異物之統合分析,獲 Diagnostics 刊登!
[快訊] 黃暉凱醫師團隊,關於 COVID-19 患者,BMI 與死亡率成 J 型關聯的統合分析,以致編者信形式,獲 Diabetes, Obesity & Metabolism 刊登!
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《#統合分析工作坊》,就是根據「統計不同」與「資源較少」,所提出的 solution。用新思惟一貫的高品質課程規劃,與高效率教學方法,加上廣獲好評的互動實作,以往的三大研究課程,已經帶出非常多學術起飛的校友。
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🎖 【年度回顧】新思惟研究課程之友,2020 年共 689 篇論文發表!
🎖 2021 年 4 月新思惟校友總計 96 篇發表,其中 11 位是首篇論文發表!
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無論你是想從 0 到 1 的完全新手,或是想提高論文量產的資深老手,現在正是把握 meta-analysis 的好時機!
越來越多年輕醫師,願意在繁忙訓練的同時,盡早奠定研究基礎、學會寫作技能,讓自己往後的醫學職涯,邁向更好的發展。⠀⠀
【學員評價】
真希望在醫學生或實習醫師時期就有機會上新思惟。
上完課,馬上就可以開始寫統合分析!
跟著講師的經驗走,這條路,最短、最快!
經驗豐富的講者,才能把複雜概念簡單化!
我要發表|7 / 31(六)統合分析工作坊
立即報名|https://meta-analysis.innovarad.tw/event/
overall survival 在 Benjamin Man — iBenTV Youtube 的最佳解答
[3/3] This piece took around 10-11 months to compose, thANKFULLY I GOT FULL MARKS SO HARD WORK PAID OFF!!! I was lucky enough to be able to work with an actual orchestra on this piece, and even got feedback from composer Dani Howard as well as conductor Pablo Urbina!
Themes:
A: "Awakening in The Unknown" - 0:01
B: "Survival" - 0:58
C: "Defeat" - 1:21
D: "Mischief" - 1:54
E: "Confliction" - 2:17
F: "Reconciliation" - 3:37
G: "Finalé" - 4:14
(btw, my second composition was 'Ascending Heaven' so I'm not going to upload that lmao)
Reflective Statement:
My intention for this piece was to compose a programmatic orchestral work inspired by the anime “灰と幻想のグリムガル”. Each section corresponds to a key theme presented in the anime. A performers note was included in the score so that performers will have a better understanding of the context of each theme.
Composing this piece took 10 months from start to finish. I started this composition as a piano quartet with the cello carrying the main melody. Each section was composed individually to match a particular theme, and was then pieced together by composing a transition section between them. With my teachers guidance, I was advised to expand the piece into a full orchestral composition, which was an immense difficulty for me as I’ve never composed one before. I overcame this difficulty by studying each instrument; how it’s played (or can be played), what techniques can be performed, and listening to other orchestral pieces to identify its role in the orchestra. I further developed the piece by experimenting with contrasting dynamics to add excitement in certain sections of the piece. Lastly, I leant and applied engraving rules to my score to appear professional.
This piece allowed me to grow as a composer in different ways. For example, because I had the opportunity to work with an actual orchestra, I became aware of how certain notes and phrases are played (e.g. bowing for strings at fortissimo), and how each instrument compliments another. I also learnt to avoid composing melodic “fluff”, to make sure that every note has its own purpose and contribution to the aim of the piece.
Overall, I am extremely proud of this piece and am very excited to hear it performed at my school’s spring concert in March!
(298 Words)
(IF ANYONE WANTS TO PERFORM THIS (IDK WHY BUT IF LMAO) AND WANT THE SCORE, MESSAGE ME!)
overall survival 在 What are Progression Free Survival (PFS) and Overall ... 的必吃
HealthTree University, provided by the Myeloma Crowd, offers a comprehensive online multiple myeloma curriculum with lessons, quizzes and ... ... <看更多>