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Today, over 77 percent of Americans own a smartphone with access to the world’s information and near-limitless learning resources.
Yet nearly 36 million adults in the US are constrained by low literacy skills, excluding them from professional opportunities, prospects of upward mobility, and full engagement with their children’s education.
And beyond its direct impact, low literacy rates affect us all. Improving literacy among adults is predicted to save $230 billion in national healthcare costs and could result in US labor productivity increases of up to 2.5 percent.
Across the board, exponential technologies are making demonetized learning tools, digital training platforms, and literacy solutions more accessible than ever before.
With rising automation and major paradigm shifts underway in the job market, these tools not only promise to make today’s workforce more versatile, but could play an invaluable role in breaking the poverty cycles often associated with low literacy.
Just three years ago, the Barbara Bush Foundation for Family Literacy and the Dollar General Literacy Foundation joined forces to tackle this intractable problem, launching a $7 million Adult Literacy XPRIZE.
Challenging teams to develop smartphone apps that significantly increase literacy skills among adult learners in just 12 months, the competition brought five prize teams to the fore, each targeting multiple demographics across the nation.
Now, after four years of research, prototyping, testing, and evaluation, XPRIZE has just this week announced two grand prize winners: Learning Upgrade and People ForWords.
In this blog, I’ll be exploring the nuts and bolts of our two winning teams and how exponential technologies are beginning to address rapidly shifting workforce demands.
Meeting 100 percent adult literacy rates
Retooling today’s workforce for tomorrow’s job market
Granting the gift of lifelong learning
Let’s dive in.
Adult Literacy XPRIZE
Emphasizing the importance of accessible mediums and scalability, the Adult Literacy XPRIZE called for teams to create mobile solutions that lower the barrier to entry, encourage persistence, develop relevant learning content, and can scale nationally.
Outperforming the competition in two key demographic groups in aggregate—native English speakers and English language learners—teams Learning Upgrade and People ForWords together claimed the prize.
To win, both organizations successfully generated the greatest gains between a pre- and post-test, administered one year apart to learners in a 12-month field test across Los Angeles, Dallas, and Philadelphia.
Prize money in hand, Learning Upgrade and People ForWords are now scaling up their solutions, each targeting a key demographic in America’s pursuit of adult literacy.
Based in San Diego, Learning Upgrade has developed an Android and iOS app that helps students learn English and math through video, songs, and gamification. Offering a total of 21 courses from kindergarten through adult education, Learning Upgrade touts a growing platform of over 900 lessons spanning English, reading, math, and even GED prep.
To further personalize each student’s learning, Learning Upgrade measures time-on-task and builds out formative performance assessments, granting teachers a quantified, real-time view of each student’s progress across both lessons and criteria.
Specialized in English reading skills, Dallas-based People ForWords offers a similarly delocalized model with its mobile game “Codex: Lost Words of Atlantis.” Based on an archaeological adventure storyline, the app features an immersive virtual environment.
Set in the Atlantis Library (now with a 3D rendering underway), Codex takes its students through narrative-peppered lessons covering everything from letter-sound practice to vocabulary reinforcement in a hidden object game.
But while both mobile apps have recruited initial piloting populations, the key to success is scale.
Using a similar incentive prize competition structure to drive recruitment, the second phase of the XPRIZE is a $1 million Barbara Bush Foundation Adult Literacy XPRIZE Communities Competition. For 15 months, the competition will challenge organizations, communities, and individuals alike to onboard adult learners onto both prize-winning platforms and fellow finalist team apps, AmritaCREATE and Cell-Ed.
Each awarded $125,000 for participation in the Communities Competition, AmritaCREATE and Cell-Ed bring yet other nuanced advantages to the table.
While AmritaCREATE curates culturally appropriate e-content relevant to given life skills, Cell-Ed takes a learn-on-the-go approach, offering micro-lessons, on-demand essential skills training, and individualized coaching on any mobile device, no internet required.
Although all these cases target slightly different demographics and problem niches, they converge upon common phenomena: mobility, efficiency, life skill relevance, personalized learning, and practicability.
And what better to scale these benefits than AI and immersive virtual environments?
In the case of education’s growing mobility, 5G and the explosion of connectivity speeds will continue to drive a learn-anytime-anywhere education model, whereby adult users learn on the fly, untethered to web access or rigid time strictures.
As I’ve explored in a previous blog on AI-crowd collaboration, we might also see the rise of AI learning consultants responsible for processing data on how you learn.
Quantifying and analyzing your interaction with course modules, where you get stuck, where you thrive, and what tools cause you ease or frustration, each user’s AI trainer might then issue personalized recommendations based on crowd feedback.
Adding a human touch, each app’s hired teaching consultants would thereby be freed to track many more students’ progress at once, vetting AI-generated tips and adjustments, and offering life coaching along the way.
Lastly, virtual learning environments—and, one day, immersive VR—will facilitate both speed and retention, two of the most critical constraints as learners age.
As I often reference, people generally remember only 10 percent of what we see, 20 percent of what we hear, and 30 percent of what we read…. But over a staggering 90 percent of what we do or experience.
By introducing gamification, immersive testing activities, and visually rich sensory environments, adult literacy platforms have a winning chance at scalability, retention, and user persistence.
Exponential Tools: Training and Retooling a Dynamic Workforce
Beyond literacy, however, virtual and augmented reality have already begun disrupting the professional training market.
As projected by ABI Research, the enterprise VR training market is on track to exceed $6.3 billion in value by 2022.
Leading the charge, Walmart has already implemented VR across 200 Academy training centers, running over 45 modules and simulating everything from unusual customer requests to a Black Friday shopping rush.
Then in September of last year, Walmart committed to a 17,000-headset order of the Oculus Go to equip every US Supercenter, neighborhood market, and discount store with VR-based employee training.
In the engineering world, Bell Helicopter is using VR to massively expedite development and testing of its latest aircraft, FCX-001. Partnering with Sector 5 Digital and HTC VIVE, Bell found it could concentrate a typical six-year aircraft design process into the course of six months, turning physical mockups into CAD-designed virtual replicas.
But beyond the design process itself, Bell is now one of a slew of companies pioneering VR pilot tests and simulations with real-world accuracy. Seated in a true-to-life virtual cockpit, pilots have now tested countless iterations of the FCX-001 in virtual flight, drawing directly onto the 3D model and enacting aircraft modifications in real time.
And in an expansion of our virtual senses, several key players are already working on haptic feedback. In the case of VR flight, French company Go Touch VR is now partnering with software developer FlyInside on fingertip-mounted haptic tech for aviation.
Dramatically reducing time and trouble required for VR-testing pilots, they aim to give touch-based confirmation of every switch and dial activated on virtual flights, just as one would experience in a full-sized cockpit mockup. Replicating texture, stiffness, and even the sensation of holding an object, these piloted devices contain a suite of actuators to simulate everything from a light touch to higher-pressured contact, all controlled by gaze and finger movements.
When it comes to other high-risk simulations, virtual and augmented reality have barely scratched the surface.
Firefighters can now combat virtual wildfires with new platforms like FLAIM Trainer or TargetSolutions. And thanks to the expansion of medical AR/VR services like 3D4Medical or Echopixel, surgeons might soon perform operations on annotated organs and magnified incision sites, speeding up reaction times and vastly improving precision.
But perhaps most urgently, virtual reality will offer an immediate solution to today’s constant industry turnover and large-scale re-education demands.
VR educational facilities with exact replicas of anything from large industrial equipment to minute circuitry will soon give anyone a second chance at the 21st-century job market.
Want to become an electric, autonomous vehicle mechanic at age 44? Throw on a demonetized VR module and learn by doing, testing your prototype iterations at almost zero cost and with no risk of harming others.
Want to be a plasma physicist and play around with a virtual nuclear fusion reactor? Now you’ll be able to simulate results and test out different tweaks, logging Smart Educational Record credits in the process.
As tomorrow’s career model shifts from a “one-and-done graduate degree” to continuous lifelong education, professional VR-based re-education will allow for a continuous education loop, reducing the barrier to entry for anyone wanting to try their hand at a new industry.
Learn Anything, Anytime, at Any Age
As VR and artificial intelligence converge with demonetized mobile connectivity, we are finally witnessing an era in which no one will be left behind.
Whether in pursuit of fundamental life skills, professional training, linguistic competence, or specialized retooling, users of all ages, career paths, income brackets, and goals are now encouraged to be students, no longer condemned to stagnancy.
Traditional constraints need no longer prevent non-native speakers from gaining an equal foothold, or specialists from pivoting into new professions, or low-income parents from staking new career paths.
As exponential technologies drive democratized access, bolstering initiatives such as the Barbara Bush Foundation Adult Literacy XPRIZE are blazing the trail to make education a scalable priority for all.
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Training a doctor takes years of grueling work in universities and hospitals. Building a doctor may be as easy as teaching an AI how to read.
Artificial intelligence has taken another step towards becoming an integral part of 21st-century medicine. New research out of Guangzhou, China, published February 11th in Nature Medicine Letters, has demonstrated a natural-language processing AI that is capable of out-performing rookie pediatricians in diagnosing common childhood ailments.
The massive study examined the electronic health records (EHR) from nearly 600,000 patients over an 18-month period at the Guangzhou Women and Children’s Medical Center and then compared AI-generated diagnoses against new assessments from physicians with a range of experience.
The verdict? On average, the AI was noticeably more accurate than junior physicians and nearly as reliable as the more senior ones. These results are the latest demonstration that artificial intelligence is on the cusp of becoming a healthcare staple on a global scale.
Less Like a Computer, More Like a Person
To outshine human doctors, the AI first had to become more human. Like IBM’s Watson, the pediatric AI leverages natural language processing, in essence “reading” written notes from EHRs not unlike how a human doctor would review those same records. But the similarities to human doctors don’t end there. The AI is a machine learning classifier (MLC), capable of placing the information learned from the EHRs into categories to improve performance.
Like traditionally-trained pediatricians, the AI broke cases down into major organ groups and infection areas (upper/lower respiratory, gastrointestinal, etc.) before breaking them down even further into subcategories. It could then develop associations between various symptoms and organ groups and use those associations to improve its diagnoses. This hierarchical approach mimics the deductive reasoning human doctors employ.
Another key strength of the AI developed for this study was the enormous size of the dataset collected to teach it: 1,362,559 outpatient visits from 567,498 patients yielded some 101.6 million data points for the MLC to devour on its quest for pediatric dominance. This allowed the AI the depth of learning needed to distinguish and accurately select from the 55 different diagnosis codes across the various organ groups and subcategories.
When comparing against the human doctors, the study used 11,926 records from an unrelated group of children, giving both the MLC and the 20 humans it was compared against an even playing field. The results were clear: while cohorts of senior pediatricians performed better than the AI, junior pediatricians (those with 3-15 years of experience) were outclassed.
Helping, Not Replacing
While the research used a competitive analysis to measure the success of the AI, the results should be seen as anything but hostile to human doctors. The near future of artificial intelligence in medicine will see these machine learning programs augment, not replace, human physicians. The authors of the study specifically call out augmentation as the key short-term application of their work. Triaging incoming patients via intake forms, performing massive metastudies using EHRs, providing rapid ‘second opinions’—the applications for an AI doctor that is better-but-not-the-best are as varied as the healthcare industry itself.
That’s only considering how artificial intelligence could make a positive impact immediately upon implementation. It’s easy to see how long-term use of a diagnostic assistant could reshape the way modern medical institutions approach their work.
Look at how the MLC results fit snugly between the junior and senior physician groups. Essentially, it took nearly 15 years before a physician could consistently out-diagnose the machine. That’s a decade and a half wherein an AI diagnostic assistant would be an invaluable partner—both as a training tool and a safety measure. Likewise, on the other side of the experience curve you have physicians whose performance could be continuously leveraged to improve the AI’s effectiveness. This is a clear opportunity for a symbiotic relationship, with humans and machines each assisting the other as they mature.
Closer to Us, But Still Dependent on Us
No matter the ultimate application, the AI doctors of the future are drawing nearer to us step by step. This latest research is a demonstration that artificial intelligence can mimic the results of human deductive reasoning even in some of the most complex and important decision-making processes. True, the MLC required input from humans to function; both the initial data points and the cases used to evaluate the AI depended on EHRs written by physicians. While every effort was made to design a test schema that removed any indication of the eventual diagnosis, some “data leakage” is bound to occur.
In other words, when AIs use human-created data, they inherit human insight to some degree. Yet the progress made in machine imaging, chatbots, sensors, and other fields all suggest that this dependence on human input is more about where we are right now than where we could be in the near future.
Data, and More Data
That near future may also have some clear winners and losers. For now, those winners seem to be the institutions that can capture and apply the largest sets of data. With a rapidly digitized society gathering incredible amounts of data, China has a clear advantage. Combined with their relatively relaxed approach to privacy, they are likely to continue as one of the driving forces behind machine learning and its applications. So too will Google/Alphabet with their massive medical studies. Data is the uranium in this AI arms race, and everyone seems to be scrambling to collect more.
In a global community that seems increasingly aware of the potential problems arising from this need for and reliance on data, it’s nice to know there’ll be an upside as well. The technology behind AI medical assistants is looking more and more mature—even if we are still struggling to find exactly where, when, and how that technology should first become universal.
Yet wherever we see the next push to make AI a standard tool in a real-world medical setting, I have little doubt it will greatly improve the lives of human patients. Today Doctor AI is performing as well as a human colleague with more than 10 years of experience. By next year or so, it may take twice as long for humans to be competitive. And in a decade, the combined medical knowledge of all human history may be a tool as common as a stethoscope in your doctor’s hands.
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One of the most contentious debates in technology is around the question of automation and jobs. At issue is whether advances in automation, specifically with regards to artificial intelligence and robotics, will spell trouble for today’s workers. This debate is played out in the media daily, and passions run deep on both sides of the issue. In the past, however, automation has created jobs and increased real wages.
A widespread concern with the current scenario is that the workers most likely to be displaced by technology lack the skills needed to do the new jobs that same technology will create.
Let’s look at this concern in detail. Those who fear automation will hurt workers start by pointing out that there is a wide range of jobs, from low-pay, low-skill to high-pay, high-skill ones. This can be represented as follows:
They then point out that technology primarily creates high-paying jobs, like geneticists, as shown in the diagram below.
Meanwhile, technology destroys low-wage, low-skill jobs like those in fast food restaurants, as shown below:
Then, those who are worried about this dynamic often pose the question, “Do you really think a fast-food worker is going to become a geneticist?”
They worry that we are about to face a huge amount of systemic permanent unemployment, as the unskilled displaced workers are ill-equipped to do the jobs of tomorrow.
It is important to note that both sides of the debate are in agreement at this point. Unquestionably, technology destroys low-skilled, low-paying jobs while creating high-skilled, high-paying ones.
So, is that the end of the story? As a society are we destined to bifurcate into two groups, those who have training and earn high salaries in the new jobs, and those with less training who see their jobs vanishing to machines? Is this latter group forever locked out of economic plenty because they lack training?
The question, “Can a fast food worker become a geneticist?” is where the error comes in. Fast food workers don’t become geneticists. What happens is that a college biology professor becomes a geneticist. Then a high-school biology teacher gets the college job. Then the substitute teacher gets hired on full-time to fill the high school teaching job. All the way down.
The question is not whether those in the lowest-skilled jobs can do the high-skilled work. Instead the question is, “Can everyone do a job just a little harder than the job they have today?” If so, and I believe very deeply that this is the case, then every time technology creates a new job “at the top,” everyone gets a promotion.
This isn’t just an academic theory—it’s 200 years of economic history in the west. For 200 years, with the exception of the Great Depression, unemployment in the US has been between 2 percent and 13 percent. Always. Europe’s range is a bit wider, but not much.
If I took 200 years of unemployment rates and graphed them, and asked you to find where the assembly line took over manufacturing, or where steam power rapidly replaced animal power, or the lightning-fast adoption of electricity by industry, you wouldn’t be able to find those spots. They aren’t even blips in the unemployment record.
You don’t even have to look back as far as the assembly line to see this happening. It has happened non-stop for 200 years. Every fifty years, we lose about half of all jobs, and this has been pretty steady since 1800.
How is it that for 200 years we have lost half of all jobs every half century, but never has this process caused unemployment? Not only has it not caused unemployment, but during that time, we have had full employment against the backdrop of rising wages.
How can wages rise while half of all jobs are constantly being destroyed? Simple. Because new technology always increases worker productivity. It creates new jobs, like web designer and programmer, while destroying low-wage backbreaking work. When this happens, everyone along the way gets a better job.
Our current situation isn’t any different than the past. The nature of technology has always been to create high-skilled jobs and increase worker productivity. This is good news for everyone.
People often ask me what their children should study to make sure they have a job in the future. I usually say it doesn’t really matter. If I knew everything I know now and went back to the mid 1980s, what could I have taken in high school to make me better prepared for today? There is only one class, and it wasn’t computer science. It was typing. Who would have guessed?
The great skill is to be able to learn new things, and luckily, we all have that. In fact, that is our singular ability as a species. What I do in my day-to-day job consists largely of skills I have learned as the years have passed. In my experience, if you ask people at all job levels,“Would you like a little more challenging job to make a little more money?” almost everyone says yes.
That’s all it has taken for us to collectively get here today, and that’s all we need going forward.
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The causes of aging are extremely complex and unclear. With the dramatic demonetization of genome reading and editing over the past decade, and Big Pharma, startups, and the FDA starting to face aging as a disease, we are starting to find practical ways to extend our healthspan.
Here, in Part 2 of a series of blogs on longevity and vitality, I explore how genome sequencing and editing, along with new classes of anti-aging drugs, are augmenting our biology to further extend our healthy lives.
In this blog I’ll cover two classes of emerging technologies:
Genome Sequencing and Editing;
Senolytics, Nutraceuticals & Pharmaceuticals.
Let’s dive in.
Genome Sequencing & Editing
Your genome is the software that runs your body.
A sequence of 3.2 billion letters makes you “you.” These base pairs of A’s, T’s, C’s, and G’s determine your hair color, your height, your personality, your propensity to disease, your lifespan, and so on.
Until recently, it’s been very difficult to rapidly and cheaply “read” these letters—and even more difficult to understand what they mean.
Since 2001, the cost to sequence a whole human genome has plummeted exponentially, outpacing Moore’s Law threefold. From an initial cost of $3.7 billion, it dropped to $10 million in 2006, and to $5,000 in 2012.
Today, the cost of genome sequencing has dropped below $500, and according to Illumina, the world’s leading sequencing company, the process will soon cost about $100 and take about an hour to complete.
This represents one of the most powerful and transformative technology revolutions in healthcare.
When we understand your genome, we’ll be able to understand how to optimize “you.”
We’ll know the perfect foods, the perfect drugs, the perfect exercise regimen, and the perfect supplements, just for you.
We’ll understand what microbiome types, or gut flora, are ideal for you (more on this in a later blog).
We’ll accurately predict how specific sedatives and medicines will impact you.
We’ll learn which diseases and illnesses you’re most likely to develop and, more importantly, how to best prevent them from developing in the first place (rather than trying to cure them after the fact).
CRISPR Gene Editing
In addition to reading the human genome, scientists can now edit a genome using a naturally-occurring biological system discovered in 1987 called CRISPR/Cas9.
Short for Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR-associated protein 9, the editing system was adapted from a naturally-occurring defense system found in bacteria.
Here’s how it works:
The bacteria capture snippets of DNA from invading viruses (or bacteriophage) and use them to create DNA segments known as CRISPR arrays.
The CRISPR arrays allow the bacteria to “remember” the viruses (or closely related ones), and defend against future invasions.
If the viruses attack again, the bacteria produce RNA segments from the CRISPR arrays to target the viruses’ DNA. The bacteria then use Cas9 to cut the DNA apart, which disables the virus.
Most importantly, CRISPR is cheap, quick, easy to use, and more accurate than all previous gene editing methods. As a result, CRISPR/Cas9 has swept through labs around the world as the way to edit a genome.
A short search in the literature will show an exponential rise in the number of CRISPR-related publications and patents.
2018: Filled With CRISPR Breakthroughs
Early results are impressive. Researchers from the University of Chicago recently used CRISPR to genetically engineer cocaine resistance into mice.
Researchers at the University of Texas Southwestern Medical Center used CRISPR to reverse the gene defect causing Duchenne muscular dystrophy (DMD) in dogs (DMD is the most common fatal genetic disease in children).
With great power comes great responsibility, and moral and ethical dilemmas.
In 2015, Chinese scientists sparked global controversy when they first edited human embryo cells in the lab with the goal of modifying genes that would make the child resistant to smallpox, HIV, and cholera.
Three years later, in November 2018, researcher He Jiankui informed the world that the first set of CRISPR-engineered female twins had been delivered.
To accomplish his goal, Jiankui deleted a region of a receptor on the surface of white blood cells known as CCR5, introducing a rare, natural genetic variation that makes it more difficult for HIV to infect its favorite target, white blood cells.
Setting aside the significant ethical conversations, CRISPR will soon provide us the tools to eliminate diseases, create hardier offspring, produce new environmentally resistant crops, and even wipe out pathogens.
Senolytics, Nutraceuticals & Pharmaceuticals
Over the arc of your life, the cells in your body divide until they reach what is known as the Hayflick limit, or the number of times a normal human cell population will divide before cell division stops, which is typically about 50 divisions.
What normally follows next is programmed cell death or destruction by the immune system. A very small fraction of cells, however, become senescent cells and evade this fate to linger indefinitely.
These lingering cells secrete a potent mix of molecules that triggers chronic inflammation, damages the surrounding tissue structures, and changes the behavior of nearby cells for the worse.
Senescent cells appear to be one of the root causes of aging, causing everything from fibrosis and blood vessel calcification, to localized inflammatory conditions such as osteoarthritis, to diminished lung function.
Fortunately, both the scientific and entrepreneurial communities have begun to work on senolytic therapies, moving the technology for selectively destroying senescent cells out of the laboratory and into a half-dozen startup companies.
Prominent companies in the field include the following:
Unity Biotechnology is developing senolytic medicines to selectively eliminate senescent cells with an initial focus on delivering localized therapy in osteoarthritis, ophthalmology and pulmonary disease.
Oisin Biotechnologiesis pioneering a programmable gene therapy that can destroy cells based on their internal biochemistry.
SIWA Therapeuticsis working on an immunotherapy approach to the problem of senescent cells.
In recent years, researchers have identified or designed a handful of senolytic compounds that can curb aging by regulating senescent cells. Two of these drugs that have gained mainstay research traction are rapamycin and metformin.
Originally extracted from bacteria found on Easter Island, Rapamycin acts on the m-TOR (mechanistic target of rapamycin) pathway to selectively block a key protein that facilitates cell division.
Currently, rapamycin derivatives are widely used as immunosuppression in organ and bone marrow transplants. Research now suggests that use results in prolonged lifespan and enhanced cognitive and immune function.
PureTech Health subsidiary resTORbio (which started 2018 by going public) is working on a rapamycin-based drug intended to enhance immunity and reduce infection. Their clinical-stage RTB101 drug works by inhibiting part of the mTOR pathway.
Results of the drug’s recent clinical trial include:
Decreased incidence of infection
Improved influenza vaccination response
A 30.6 percent decrease in respiratory tract infections
Impressive, to say the least.
Metformin is a widely-used generic drug for mitigating liver sugar production in Type 2 diabetes patients.
Researchers have found that Metformin also reduces oxidative stress and inflammation, which otherwise increase as we age.
There is strong evidence that Metformin can augment cellular regeneration and dramatically mitigate cellular senescence by reducing both oxidative stress and inflammation.
Over 100 studies registered on ClinicalTrials.gov are currently following up on strong evidence of Metformin’s protective effect against cancer.
Nutraceuticals and NAD+
Beyond cellular senescence, certain critical nutrients and proteins tend to decline as a function of age. Nutraceuticals combat aging by supplementing and replenishing these declining nutrient levels.
NAD+ exists in every cell, participating in every process from DNA repair to creating the energy vital for cellular processes. It’s been shown that NAD+ levels decline as we age.
The Elysium Health Basis supplement aims to elevate NAD+ levels in the body to extend one’s lifespan. Elysium’s clinical study reports that Basis increases NAD+ levels consistently by a sustained 40 percent.
These are just a taste of the tremendous momentum that longevity and aging technology has right now. As artificial intelligence and quantum computing transform how we decode our DNA and how we discover drugs, genetics and pharmaceuticals will become truly personalized.
The next blog in this series will demonstrate how artificial intelligence is converging with genetics and pharmaceuticals to transform how we approach longevity, aging, and vitality.
We are edging closer to a dramatically extended healthspan—where 100 is the new 60. What will you create, where will you explore, and how will you spend your time if you are able to add an additional 40 healthy years to your life?
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