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#434508 The Top Biotech and Medicine Advances to ...

2018 was bonkers for science.

From a woman who gave birth using a transplanted uterus, to the infamous CRISPR baby scandal, to forensics adopting consumer-based genealogy test kits to track down criminals, last year was a factory churning out scientific “whoa” stories with consequences for years to come.

With CRISPR still in the headlines, Britain ready to bid Europe au revoir, and multiple scientific endeavors taking off, 2019 is shaping up to be just as tumultuous.

Here are the science and health stories that may blow up in the new year. But first, a note of caveat: predicting the future is tough. Forecasting is the lovechild between statistics and (a good deal of) intuition, and entire disciplines have been dedicated to the endeavor. But January is the perfect time to gaze into the crystal ball for wisps of insight into the year to come. Last year we predicted the widespread approval of gene therapy products—on the most part, we nailed it. This year we’re hedging our bets with multiple predictions.

Gene Drives Used in the Wild
The concept of gene drives scares many, for good reason. Gene drives are a step up in severity (and consequences) from CRISPR and other gene-editing tools. Even with germline editing, in which the sperm, egg, or embryos are altered, gene editing affects just one genetic line—one family—at least at the beginning, before they reproduce with the general population.

Gene drives, on the other hand, have the power to wipe out entire species.

In a nutshell, they’re little bits of DNA code that help a gene transfer from parent to child with almost 100 percent perfect probability. The “half of your DNA comes from dad, the other comes from mom” dogma? Gene drives smash that to bits.

In other words, the only time one would consider using a gene drive is to change the genetic makeup of an entire population. It sounds like the plot of a supervillain movie, but scientists have been toying around with the idea of deploying the technology—first in mosquitoes, then (potentially) in rodents.

By releasing just a handful of mutant mosquitoes that carry gene drives for infertility, for example, scientists could potentially wipe out entire populations that carry infectious scourges like malaria, dengue, or Zika. The technology is so potent—and dangerous—the US Defense Advances Research Projects Agency is shelling out $65 million to suss out how to deploy, control, counter, or even reverse the effects of tampering with ecology.

Last year, the U.N. gave a cautious go-ahead for the technology to be deployed in the wild in limited terms. Now, the first release of a genetically modified mosquito is set for testing in Burkina Faso in Africa—the first-ever field experiment involving gene drives.

The experiment will only release mosquitoes in the Anopheles genus, which are the main culprits transferring disease. As a first step, over 10,000 male mosquitoes are set for release into the wild. These dudes are genetically sterile but do not cause infertility, and will help scientists examine how they survive and disperse as a preparation for deploying gene-drive-carrying mosquitoes.

Hot on the project’s heels, the nonprofit consortium Target Malaria, backed by the Bill and Melinda Gates foundation, is engineering a gene drive called Mosq that will spread infertility across the population or kill out all female insects. Their attempt to hack the rules of inheritance—and save millions in the process—is slated for 2024.

A Universal Flu Vaccine
People often brush off flu as a mere annoyance, but the infection kills hundreds of thousands each year based on the CDC’s statistical estimates.

The flu virus is actually as difficult of a nemesis as HIV—it mutates at an extremely rapid rate, making effective vaccines almost impossible to engineer on time. Scientists currently use data to forecast the strains that will likely explode into an epidemic and urge the public to vaccinate against those predictions. That’s partly why, on average, flu vaccines only have a success rate of roughly 50 percent—not much better than a coin toss.

Tired of relying on educated guesses, scientists have been chipping away at a universal flu vaccine that targets all strains—perhaps even those we haven’t yet identified. Often referred to as the “holy grail” in epidemiology, these vaccines try to alert our immune systems to parts of a flu virus that are least variable from strain to strain.

Last November, a first universal flu vaccine developed by BiondVax entered Phase 3 clinical trials, which means it’s already been proven safe and effective in a small numbers and is now being tested in a broader population. The vaccine doesn’t rely on dead viruses, which is a common technique. Rather, it uses a small chain of amino acids—the chemical components that make up proteins—to stimulate the immune system into high alert.

With the government pouring $160 million into the research and several other universal candidates entering clinical trials, universal flu vaccines may finally experience a breakthrough this year.

In-Body Gene Editing Shows Further Promise
CRISPR and other gene editing tools headed the news last year, including both downers suggesting we already have immunity to the technology and hopeful news of it getting ready for treating inherited muscle-wasting diseases.

But what wasn’t widely broadcasted was the in-body gene editing experiments that have been rolling out with gusto. Last September, Sangamo Therapeutics in Richmond, California revealed that they had injected gene-editing enzymes into a patient in an effort to correct a genetic deficit that prevents him from breaking down complex sugars.

The effort is markedly different than the better-known CAR-T therapy, which extracts cells from the body for genetic engineering before returning them to the hosts. Rather, Sangamo’s treatment directly injects viruses carrying the edited genes into the body. So far, the procedure looks to be safe, though at the time of reporting it was too early to determine effectiveness.

This year the company hopes to finally answer whether it really worked.

If successful, it means that devastating genetic disorders could potentially be treated with just a few injections. With a gamut of new and more precise CRISPR and other gene-editing tools in the works, the list of treatable inherited diseases is likely to grow. And with the CRISPR baby scandal potentially dampening efforts at germline editing via regulations, in-body gene editing will likely receive more attention if Sangamo’s results return positive.

Neuralink and Other Brain-Machine Interfaces
Neuralink is the stuff of sci fi: tiny implanted particles into the brain could link up your biological wetware with silicon hardware and the internet.

But that’s exactly what Elon Musk’s company, founded in 2016, seeks to develop: brain-machine interfaces that could tinker with your neural circuits in an effort to treat diseases or even enhance your abilities.

Last November, Musk broke his silence on the secretive company, suggesting that he may announce something “interesting” in a few months, that’s “better than anyone thinks is possible.”

Musk’s aspiration for achieving symbiosis with artificial intelligence isn’t the driving force for all brain-machine interfaces (BMIs). In the clinics, the main push is to rehabilitate patients—those who suffer from paralysis, memory loss, or other nerve damage.

2019 may be the year that BMIs and neuromodulators cut the cord in the clinics. These devices may finally work autonomously within a malfunctioning brain, applying electrical stimulation only when necessary to reduce side effects without requiring external monitoring. Or they could allow scientists to control brains with light without needing bulky optical fibers.

Cutting the cord is just the first step to fine-tuning neurological treatments—or enhancements—to the tune of your own brain, and 2019 will keep on bringing the music.

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#434303 Making Superhumans Through Radical ...

Imagine trying to read War and Peace one letter at a time. The thought alone feels excruciating. But in many ways, this painful idea holds parallels to how human-machine interfaces (HMI) force us to interact with and process data today.

Designed back in the 1970s at Xerox PARC and later refined during the 1980s by Apple, today’s HMI was originally conceived during fundamentally different times, and specifically, before people and machines were generating so much data. Fast forward to 2019, when humans are estimated to produce 44 zettabytes of data—equal to two stacks of books from here to Pluto—and we are still using the same HMI from the 1970s.

These dated interfaces are not equipped to handle today’s exponential rise in data, which has been ushered in by the rapid dematerialization of many physical products into computers and software.

Breakthroughs in perceptual and cognitive computing, especially machine learning algorithms, are enabling technology to process vast volumes of data, and in doing so, they are dramatically amplifying our brain’s abilities. Yet even with these powerful technologies that at times make us feel superhuman, the interfaces are still crippled with poor ergonomics.

Many interfaces are still designed around the concept that human interaction with technology is secondary, not instantaneous. This means that any time someone uses technology, they are inevitably multitasking, because they must simultaneously perform a task and operate the technology.

If our aim, however, is to create technology that truly extends and amplifies our mental abilities so that we can offload important tasks, the technology that helps us must not also overwhelm us in the process. We must reimagine interfaces to work in coherence with how our minds function in the world so that our brains and these tools can work together seamlessly.

Embodied Cognition
Most technology is designed to serve either the mind or the body. It is a problematic divide, because our brains use our entire body to process the world around us. Said differently, our minds and bodies do not operate distinctly. Our minds are embodied.

Studies using MRI scans have shown that when a person feels an emotion in their gut, blood actually moves to that area of the body. The body and the mind are linked in this way, sharing information back and forth continuously.

Current technology presents data to the brain differently from how the brain processes data. Our brains, for example, use sensory data to continually encode and decipher patterns within the neocortex. Our brains do not create a linguistic label for each item, which is how the majority of machine learning systems operate, nor do our brains have an image associated with each of these labels.

Our bodies move information through us instantaneously, in a sense “computing” at the speed of thought. What if our technology could do the same?

Using Cognitive Ergonomics to Design Better Interfaces
Well-designed physical tools, as philosopher Martin Heidegger once meditated on while using the metaphor of a hammer, seem to disappear into the “hand.” They are designed to amplify a human ability and not get in the way during the process.

The aim of physical ergonomics is to understand the mechanical movement of the human body and then adapt a physical system to amplify the human output in accordance. By understanding the movement of the body, physical ergonomics enables ergonomically sound physical affordances—or conditions—so that the mechanical movement of the body and the mechanical movement of the machine can work together harmoniously.

Cognitive ergonomics applied to HMI design uses this same idea of amplifying output, but rather than focusing on physical output, the focus is on mental output. By understanding the raw materials the brain uses to comprehend information and form an output, cognitive ergonomics allows technologists and designers to create technological affordances so that the brain can work seamlessly with interfaces and remove the interruption costs of our current devices. In doing so, the technology itself “disappears,” and a person’s interaction with technology becomes fluid and primary.

By leveraging cognitive ergonomics in HMI design, we can create a generation of interfaces that can process and present data the same way humans process real-world information, meaning through fully-sensory interfaces.

Several brain-machine interfaces are already on the path to achieving this. AlterEgo, a wearable device developed by MIT researchers, uses electrodes to detect and understand nonverbal prompts, which enables the device to read the user’s mind and act as an extension of the user’s cognition.

Another notable example is the BrainGate neural device, created by researchers at Stanford University. Just two months ago, a study was released showing that this brain implant system allowed paralyzed patients to navigate an Android tablet with their thoughts alone.

These are two extraordinary examples of what is possible for the future of HMI, but there is still a long way to go to bring cognitive ergonomics front and center in interface design.

Disruptive Innovation Happens When You Step Outside Your Existing Users
Most of today’s interfaces are designed by a narrow population, made up predominantly of white, non-disabled men who are prolific in the use of technology (you may recall The New York Times viral article from 2016, Artificial Intelligence’s White Guy Problem). If you ask this population if there is a problem with today’s HMIs, most will say no, and this is because the technology has been designed to serve them.

This lack of diversity means a limited perspective is being brought to interface design, which is problematic if we want HMI to evolve and work seamlessly with the brain. To use cognitive ergonomics in interface design, we must first gain a more holistic understanding of how people with different abilities understand the world and how they interact with technology.

Underserved groups, such as people with physical disabilities, operate on what Clayton Christensen coined in The Innovator’s Dilemma as the fringe segment of a market. Developing solutions that cater to fringe groups can in fact disrupt the larger market by opening a downward, much larger market.

Learning From Underserved Populations
When technology fails to serve a group of people, that group must adapt the technology to meet their needs.

The workarounds created are often ingenious, specifically because they have not been arrived at by preferences, but out of necessity that has forced disadvantaged users to approach the technology from a very different vantage point.

When a designer or technologist begins learning from this new viewpoint and understanding challenges through a different lens, they can bring new perspectives to design—perspectives that otherwise can go unseen.

Designers and technologists can also learn from people with physical disabilities who interact with the world by leveraging other senses that help them compensate for one they may lack. For example, some blind people use echolocation to detect objects in their environments.

The BrainPort device developed by Wicab is an incredible example of technology leveraging one human sense to serve or compliment another. The BrainPort device captures environmental information with a wearable video camera and converts this data into soft electrical stimulation sequences that are sent to a device on the user’s tongue—the most sensitive touch receptor in the body. The user learns how to interpret the patterns felt on their tongue, and in doing so, become able to “see” with their tongue.

Key to the future of HMI design is learning how different user groups navigate the world through senses beyond sight. To make cognitive ergonomics work, we must understand how to leverage the senses so we’re not always solely relying on our visual or verbal interactions.

Radical Inclusion for the Future of HMI
Bringing radical inclusion into HMI design is about gaining a broader lens on technology design at large, so that technology can serve everyone better.

Interestingly, cognitive ergonomics and radical inclusion go hand in hand. We can’t design our interfaces with cognitive ergonomics without bringing radical inclusion into the picture, and we also will not arrive at radical inclusion in technology so long as cognitive ergonomics are not considered.

This new mindset is the only way to usher in an era of technology design that amplifies the collective human ability to create a more inclusive future for all.

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#434194 Educating the Wise Cyborgs of the Future

When we think of wisdom, we often think of ancient philosophers, mystics, or spiritual leaders. Wisdom is associated with the past. Yet some intellectual leaders are challenging us to reconsider wisdom in the context of the technological evolution of the future.

With the rise of exponential technologies like virtual reality, big data, artificial intelligence, and robotics, people are gaining access to increasingly powerful tools. These tools are neither malevolent nor benevolent on their own; human values and decision-making influence how they are used.

In future-themed discussions we often focus on technological progress far more than on intellectual and moral advancements. In reality, the virtuous insights that future humans possess will be even more powerful than their technological tools.

Tom Lombardo and Ray Todd Blackwood are advocating for exactly this. In their interdisciplinary paper “Educating the Wise Cyborg of the Future,” they propose a new definition of wisdom—one that is relevant in the context of the future of humanity.

We Are Already Cyborgs
The core purpose of Lombardo and Blackwood’s paper is to explore revolutionary educational models that will prepare humans, soon-to-be-cyborgs, for the future. The idea of educating such “cyborgs” may sound like science fiction, but if you pay attention to yourself and the world around you, cyborgs came into being a long time ago.

Techno-philosophers like Jason Silva point out that our tech devices are an abstract form of brain-machine interfaces. We use smartphones to store and retrieve information, perform calculations, and communicate with each other. Our devices are an extension of our minds.

According to philosophers Andy Clark and David Chalmers’ theory of the extended mind, we use this technology to expand the boundaries of our minds. We use tools like machine learning to enhance our cognitive skills or powerful telescopes to enhance our visual reach. Such is how technology has become a part of our exoskeletons, allowing us to push beyond our biological limitations.

In other words, you are already a cyborg. You have been all along.

Such an abstract definition of cyborgs is both relevant and thought-provoking. But it won’t stay abstract for much longer. The past few years have seen remarkable developments in both the hardware and software of brain-machine interfaces. Experts are designing more intricate electrodes while programming better algorithms to interpret the neural signals. Scientists have already succeeded in enabling paralyzed patients to type with their minds, and are even allowing people to communicate purely through brainwaves. Technologists like Ray Kurzweil believe that by 2030 we will connect the neocortex of our brains to the cloud via nanobots.

Given these trends, humans will continue to be increasingly cyborg-like. Our future schools may not necessarily educate people as we are today, but rather will be educating a new species of human-machine hybrid.

Wisdom-Based Education
Whether you take an abstract or literal definition of a cyborg, we need to completely revamp our educational models. Even if you don’t buy into the scenario where humans integrate powerful brain-machine interfaces into our minds, there is still a desperate need for wisdom-based education to equip current generations to tackle 21st-century issues.

With an emphasis on isolated subjects, standardized assessments, and content knowledge, our current educational models were designed for the industrial era, with the intended goal of creating masses of efficient factory workers—not to empower critical thinkers, innovators, or wise cyborgs.

Currently, the goal of higher education is to provide students with the degree that society tells them they need, and ostensibly to prepare them for the workforce. In contrast, Lombardo and Blackwood argue that wisdom should be the central goal of higher education, and they elaborate on how we can practically make this happen. Lombardo has developed a comprehensive two-year foundational education program for incoming university students aimed at the development of wisdom.

What does such an educational model look like? Lombardo and Blackwood break wisdom down into individual traits and capacities, each of which can be developed and measured independently or in combination with others. The authors lay out an expansive list of traits that can influence our decision-making as we strive to tackle global challenges and pave a more exciting future. These include big-picture thinking, curiosity, wonder, compassion, self-transcendence, love of learning, optimism, and courage.

As the authors point out, “given the complex and transforming nature of the world we live in, the development of wisdom provides a holistic, perspicacious, and ethically informed foundation for understanding the world, identifying its critical problems and positive opportunities, and constructively addressing its challenges.”

After all, many of the challenges we see in our world today boil down to out-dated ways of thinking, be they regressive mindsets, superficial value systems, or egocentric mindsets. The development of wisdom would immunize future societies against such debilitating values; imagine what our world would be like if wisdom was ingrained in all leaders and participating members of society.

The Wise Cyborg
Lombardo and Blackwood invite us to imagine how the wise cyborgs of the future would live their lives. What would happen if the powerful human-machine hybrids of tomorrow were also purpose-driven, compassionate, and ethical?

They would perceive the evolving digital world through a lens of wonder, awe, and curiosity. They would use digital information as a tool for problem-solving and a source of infinite knowledge. They would leverage immersive mediums like virtual reality to enhance creative expression and experimentation. They would continue to adapt and thrive in an unpredictable world of accelerating change.

Our media often depict a dystopian future for our species. It is worth considering a radically positive yet plausible scenario where instead of the machines taking over, we converge with them into wise cyborgs. This is just a glimpse of what is possible if we combine transcendent wisdom with powerful exponential technologies.

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#434151 Life-or-Death Algorithms: The Black Box ...

When it comes to applications for machine learning, few can be more widely hyped than medicine. This is hardly surprising: it’s a huge industry that generates a phenomenal amount of data and revenue, where technological advances can improve or save the lives of millions of people. Hardly a week passes without a study that suggests algorithms will soon be better than experts at detecting pneumonia, or Alzheimer’s—diseases in complex organs ranging from the eye to the heart.

The problems of overcrowded hospitals and overworked medical staff plague public healthcare systems like Britain’s NHS and lead to rising costs for private healthcare systems. Here, again, algorithms offer a tantalizing solution. How many of those doctor’s visits really need to happen? How many could be replaced by an interaction with an intelligent chatbot—especially if it can be combined with portable diagnostic tests, utilizing the latest in biotechnology? That way, unnecessary visits could be reduced, and patients could be diagnosed and referred to specialists more quickly without waiting for an initial consultation.

As ever with artificial intelligence algorithms, the aim is not to replace doctors, but to give them tools to reduce the mundane or repetitive parts of the job. With an AI that can examine thousands of scans in a minute, the “dull drudgery” is left to machines, and the doctors are freed to concentrate on the parts of the job that require more complex, subtle, experience-based judgement of the best treatments and the needs of the patient.

High Stakes
But, as ever with AI algorithms, there are risks involved with relying on them—even for tasks that are considered mundane. The problems of black-box algorithms that make inexplicable decisions are bad enough when you’re trying to understand why that automated hiring chatbot was unimpressed by your job interview performance. In a healthcare context, where the decisions made could mean life or death, the consequences of algorithmic failure could be grave.

A new paper in Science Translational Medicine, by Nicholson Price, explores some of the promises and pitfalls of using these algorithms in the data-rich medical environment.

Neural networks excel at churning through vast quantities of training data and making connections, absorbing the underlying patterns or logic for the system in hidden layers of linear algebra; whether it’s detecting skin cancer from photographs or learning to write in pseudo-Shakespearean script. They are terrible, however, at explaining the underlying logic behind the relationships that they’ve found: there is often little more than a string of numbers, the statistical “weights” between the layers. They struggle to distinguish between correlation and causation.

This raises interesting dilemmas for healthcare providers. The dream of big data in medicine is to feed a neural network on “huge troves of health data, finding complex, implicit relationships and making individualized assessments for patients.” What if, inevitably, such an algorithm proves to be unreasonably effective at diagnosing a medical condition or prescribing a treatment, but you have no scientific understanding of how this link actually works?

Too Many Threads to Unravel?
The statistical models that underlie such neural networks often assume that variables are independent of each other, but in a complex, interacting system like the human body, this is not always the case.

In some ways, this is a familiar concept in medical science—there are many phenomena and links which have been observed for decades but are still poorly understood on a biological level. Paracetamol is one of the most commonly-prescribed painkillers, but there’s still robust debate about how it actually works. Medical practitioners may be keen to deploy whatever tool is most effective, regardless of whether it’s based on a deeper scientific understanding. Fans of the Copenhagen interpretation of quantum mechanics might spin this as “Shut up and medicate!”

But as in that field, there’s a debate to be had about whether this approach risks losing sight of a deeper understanding that will ultimately prove more fruitful—for example, for drug discovery.

Away from the philosophical weeds, there are more practical problems: if you don’t understand how a black-box medical algorithm is operating, how should you approach the issues of clinical trials and regulation?

Price points out that, in the US, the “21st-Century Cures Act” allows the FDA to regulate any algorithm that analyzes images, or doesn’t allow a provider to review the basis for its conclusions: this could completely exclude “black-box” algorithms of the kind described above from use.

Transparency about how the algorithm functions—the data it looks at, and the thresholds for drawing conclusions or providing medical advice—may be required, but could also conflict with the profit motive and the desire for secrecy in healthcare startups.

One solution might be to screen algorithms that can’t explain themselves, or don’t rely on well-understood medical science, from use before they enter the healthcare market. But this could prevent people from reaping the benefits that they can provide.

Evaluating Algorithms
New healthcare algorithms will be unable to do what physicists did with quantum mechanics, and point to a track record of success, because they will not have been deployed in the field. And, as Price notes, many algorithms will improve as they’re deployed in the field for a greater amount of time, and can harvest and learn from the performance data that’s actually used. So how can we choose between the most promising approaches?

Creating a standardized clinical trial and validation system that’s equally valid across algorithms that function in different ways, or use different input or training data, will be a difficult task. Clinical trials that rely on small sample sizes, such as for algorithms that attempt to personalize treatment to individuals, will also prove difficult. With a small sample size and little scientific understanding, it’s hard to tell whether the algorithm succeeded or failed because it’s bad at its job or by chance.

Add learning into the mix and the picture gets more complex. “Perhaps more importantly, to the extent that an ideal black-box algorithm is plastic and frequently updated, the clinical trial validation model breaks down further, because the model depends on a static product subject to stable validation.” As Price describes, the current system for testing and validation of medical products needs some adaptation to deal with this new software before it can successfully test and validate the new algorithms.

Striking a Balance
The story in healthcare reflects the AI story in so many other fields, and the complexities involved perhaps illustrate why even an illustrious company like IBM appears to be struggling to turn its famed Watson AI into a viable product in the healthcare space.

A balance must be struck, both in our rush to exploit big data and the eerie power of neural networks, and to automate thinking. We must be aware of the biases and flaws of this approach to problem-solving: to realize that it is not a foolproof panacea.

But we also need to embrace these technologies where they can be a useful complement to the skills, insights, and deeper understanding that humans can provide. Much like a neural network, our industries need to train themselves to enhance this cooperation in the future.

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#433939 The Promise—and Complications—of ...

Every year, for just a few days in a major city, a small team of roboticists get to live the dream: ordering around their own personal robot butlers. In carefully-constructed replicas of a restaurant scene or a domestic setting, these robots perform any number of simple algorithmic tasks. “Get the can of beans from the shelf. Greet the visitors to the museum. Help the humans with their shopping. Serve the customers at the restaurant.”

This is Robocup @ Home, the annual tournament where teams of roboticists put their autonomous service robots to the test for practical domestic applications. The tasks seem simple and mundane, but considering the technology required reveals that they’re really not.

The Robot Butler Contest
Say you want a robot to fetch items in the supermarket. In a crowded, noisy environment, the robot must understand your commands, ask for clarification, and map out and navigate an unfamiliar environment, avoiding obstacles and people as it does so. Then it must recognize the product you requested, perhaps in a cluttered environment, perhaps in an unfamiliar orientation. It has to grasp that product appropriately—recall that there are entire multi-million-dollar competitions just dedicated to developing robots that can grasp a range of objects—and then return it to you.

It’s a job so simple that a child could do it—and so complex that teams of smart roboticists can spend weeks programming and engineering, and still end up struggling to complete simplified versions of this task. Of course, the child has the advantage of millions of years of evolutionary research and development, while the first robots that could even begin these tasks were only developed in the 1970s.

Even bearing this in mind, Robocup @ Home can feel like a place where futurist expectations come crashing into technologist reality. You dream of a smooth-voiced, sardonic JARVIS who’s already made your favorite dinner when you come home late from work; you end up shouting “remember the biscuits” at a baffled, ungainly droid in aisle five.

Caring for the Elderly
Famously, Japan is one of the most robo-enthusiastic nations in the world; they are the nation that stunned us all with ASIMO in 2000, and several studies have been conducted into the phenomenon. It’s no surprise, then, that humanoid robotics should be seriously considered as a solution to the crisis of the aging population. The Japanese government, as part of its robots strategy, has already invested $44 million in their development.

Toyota’s Human Support Robot (HSR-2) is a simple but programmable robot with a single arm; it can be remote-controlled to pick up objects and can monitor patients. HSR-2 has become the default robot for use in Robocup @ Home tournaments, at least in tasks that involve manipulating objects.

Alongside this, Toyota is working on exoskeletons to assist people in walking after strokes. It may surprise you to learn that nurses suffer back injuries more than any other occupation, at roughly three times the rate of construction workers, due to the day-to-day work of lifting patients. Toyota has a Care Assist robot/exoskeleton designed to fix precisely this problem by helping care workers with the heavy lifting.

The Home of the Future
The enthusiasm for domestic robotics is easy to understand and, in fact, many startups already sell robots marketed as domestic helpers in some form or another. In general, though, they skirt the immensely complicated task of building a fully capable humanoid robot—a task that even Google’s skunk-works department gave up on, at least until recently.

It’s plain to see why: far more research and development is needed before these domestic robots could be used reliably and at a reasonable price. Consumers with expectations inflated by years of science fiction saturation might find themselves frustrated as the robots fail to perform basic tasks.

Instead, domestic robotics efforts fall into one of two categories. There are robots specialized to perform a domestic task, like iRobot’s Roomba, which stuck to vacuuming and became the most successful domestic robot of all time by far.

The tasks need not necessarily be simple, either: the impressive but expensive automated kitchen uses the world’s most dexterous hands to cook meals, providing it can recognize the ingredients. Other robots focus on human-robot interaction, like Jibo: they essentially package the abilities of a voice assistant like Siri, Cortana, or Alexa to respond to simple questions and perform online tasks in a friendly, dynamic robot exterior.

In this way, the future of domestic automation starts to look a lot more like smart homes than a robot or domestic servant. General robotics is difficult in the same way that general artificial intelligence is difficult; competing with humans, the great all-rounders, is a challenge. Getting superhuman performance at a more specific task, however, is feasible and won’t cost the earth.

Individual startups without the financial might of a Google or an Amazon can develop specialized robots, like Seven Dreamers’ laundry robot, and hope that one day it will form part of a network of autonomous robots that each have a role to play in the household.

Domestic Bliss?
The Smart Home has been a staple of futurist expectations for a long time, to the extent that movies featuring smart homes out of control are already a cliché. But critics of the smart home idea—and of the internet of things more generally—tend to focus on the idea that, more often than not, software just adds an additional layer of things that can break (NSFW), in exchange for minimal added convenience. A toaster that can short-circuit is bad enough, but a toaster that can refuse to serve you toast because its firmware is updating is something else entirely.

That’s before you even get into the security vulnerabilities, which are all the more important when devices are installed in your home and capable of interacting with them. The idea of a smart watch that lets you keep an eye on your children might sound like something a security-conscious parent would like: a smart watch that can be hacked to track children, listen in on their surroundings, and even fool them into thinking a call is coming from their parents is the stuff of nightmares.

Key to many of these problems is the lack of standardization for security protocols, and even the products themselves. The idea of dozens of startups each developing a highly-specialized piece of robotics to perform a single domestic task sounds great in theory, until you realize the potential hazards and pitfalls of getting dozens of incompatible devices to work together on the same system.

It seems inevitable that there are yet more layers of domestic drudgery that can be automated away, decades after the first generation of time-saving domestic devices like the dishwasher and vacuum cleaner became mainstream. With projected market values into the billions and trillions of dollars, there is no shortage of industry interest in ironing out these kinks. But, for now at least, the answer to the question: “Where’s my robot butler?” is that it is gradually, painstakingly learning how to sort through groceries.

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