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#434658 The Next Data-Driven Healthtech ...

Increasing your healthspan (i.e. making 100 years old the new 60) will depend to a large degree on artificial intelligence. And, as we saw in last week’s blog, healthcare AI systems are extremely data-hungry.

Fortunately, a slew of new sensors and data acquisition methods—including over 122 million wearables shipped in 2018—are bursting onto the scene to meet the massive demand for medical data.

From ubiquitous biosensors, to the mobile healthcare revolution, to the transformative power of the Health Nucleus, converging exponential technologies are fundamentally transforming our approach to healthcare.

In Part 4 of this blog series on Longevity & Vitality, I expand on how we’re acquiring the data to fuel today’s AI healthcare revolution.

In this blog, I’ll explore:

How the Health Nucleus is transforming “sick care” to healthcare
Sensors, wearables, and nanobots
The advent of mobile health

Let’s dive in.

Health Nucleus: Transforming ‘Sick Care’ to Healthcare
Much of today’s healthcare system is actually sick care. Most of us assume that we’re perfectly healthy, with nothing going on inside our bodies, until the day we travel to the hospital writhing in pain only to discover a serious or life-threatening condition.

Chances are that your ailment didn’t materialize that morning; rather, it’s been growing or developing for some time. You simply weren’t aware of it. At that point, once you’re diagnosed as “sick,” our medical system engages to take care of you.

What if, instead of this retrospective and reactive approach, you were constantly monitored, so that you could know the moment anything was out of whack?

Better yet, what if you more closely monitored those aspects of your body that your gene sequence predicted might cause you difficulty? Think: your heart, your kidneys, your breasts. Such a system becomes personalized, predictive, and possibly preventative.

This is the mission of the Health Nucleus platform built by Human Longevity, Inc. (HLI). While not continuous—that will come later, with the next generation of wearable and implantable sensors—the Health Nucleus was designed to ‘digitize’ you once per year to help you determine whether anything is going on inside your body that requires immediate attention.

The Health Nucleus visit provides you with the following tests during a half-day visit:

Whole genome sequencing (30x coverage)
Whole body (non-contrast) MRI
Brain magnetic resonance imaging/angiography (MRI/MRA)
CT (computed tomography) of the heart and lungs
Coronary artery calcium scoring
Electrocardiogram
Echocardiogram
Continuous cardiac monitoring
Clinical laboratory tests and metabolomics

In late 2018, HLI published the results of the first 1,190 clients through the Health Nucleus. The results were eye-opening—especially since these patients were all financially well-off, and already had access to the best doctors.

Following are the physiological and genomic findings in these clients who self-selected to undergo evaluation at HLI’s Health Nucleus.

Physiological Findings [TG]

Two percent had previously unknown tumors detected by MRI
2.5 percent had previously undetected aneurysms detected by MRI
Eight percent had cardiac arrhythmia found on cardiac rhythm monitoring, not previously known
Nine percent had moderate-severe coronary artery disease risk, not previously known
16 percent discovered previously unknown cardiac structure/function abnormalities
30 percent had elevated liver fat, not previously known

Genomic Findings [TG]

24 percent of clients uncovered a rare (unknown) genetic mutation found on WGS
63 percent of clients had a rare genetic mutation with a corresponding phenotypic finding

In summary, HLI’s published results found that 14.4 percent of clients had significant findings that are actionable, requiring immediate or near-term follow-up and intervention.

Long-term value findings were found in 40 percent of the clients we screened. Long-term clinical findings include discoveries that require medical attention or monitoring but are not immediately life-threatening.

The bottom line: most people truly don’t know their actual state of health. The ability to take a fully digital deep dive into your health status at least once per year will enable you to detect disease at stage zero or stage one, when it is most curable.

Sensors, Wearables, and Nanobots
Wearables, connected devices, and quantified self apps will allow us to continuously collect enormous amounts of useful health information.

Wearables like the Quanttus wristband and Vital Connect can transmit your electrocardiogram data, vital signs, posture, and stress levels anywhere on the planet.

In April 2017, we were proud to grant $2.5 million in prize money to the winning team in the Qualcomm Tricorder XPRIZE, Final Frontier Medical Devices.

Using a group of noninvasive sensors that collect data on vital signs, body chemistry, and biological functions, Final Frontier integrates this data in their powerful, AI-based DxtER diagnostic engine for rapid, high-precision assessments.

Their engine combines learnings from clinical emergency medicine and data analysis from actual patients.

Google is developing a full range of internal and external sensors (e.g. smart contact lenses) that can monitor the wearer’s vitals, ranging from blood sugar levels to blood chemistry.

In September 2018, Apple announced its Series 4 Apple Watch, including an FDA-approved mobile, on-the-fly ECG. Granted its first FDA approval, Apple appears to be moving deeper into the sensing healthcare market.

Further, Apple is reportedly now developing sensors that can non-invasively monitor blood sugar levels in real time for diabetic treatment. IoT-connected sensors are also entering the world of prescription drugs.

Last year, the FDA approved the first sensor-embedded pill, Abilify MyCite. This new class of digital pills can now communicate medication data to a user-controlled app, to which doctors may be granted access for remote monitoring.

Perhaps what is most impressive about the next generation of wearables and implantables is the density of sensors, processing, networking, and battery capability that we can now cheaply and compactly integrate.

Take the second-generation OURA ring, for example, which focuses on sleep measurement and management.

The OURA ring looks like a slightly thick wedding band, yet contains an impressive array of sensors and capabilities, including:

Two infrared LED
One infrared sensor
Three temperature sensors
One accelerometer
A six-axis gyro
A curved battery with a seven-day life
The memory, processing, and transmission capability required to connect with your smartphone

Disrupting Medical Imaging Hardware
In 2018, we saw lab breakthroughs that will drive the cost of an ultrasound sensor to below $100, in a packaging smaller than most bandages, powered by a smartphone. Dramatically disrupting ultrasound is just the beginning.

Nanobots and Nanonetworks
While wearables have long been able to track and transmit our steps, heart rate, and other health data, smart nanobots and ingestible sensors will soon be able to monitor countless new parameters and even help diagnose disease.

Some of the most exciting breakthroughs in smart nanotechnology from the past year include:

Researchers from the École Polytechnique Fédérale de Lausanne (EPFL) and the Swiss Federal Institute of Technology in Zurich (ETH Zurich) demonstrated artificial microrobots that can swim and navigate through different fluids, independent of additional sensors, electronics, or power transmission.

Researchers at the University of Chicago proposed specific arrangements of DNA-based molecular logic gates to capture the information contained in the temporal portion of our cells’ communication mechanisms. Accessing the otherwise-lost time-dependent information of these cellular signals is akin to knowing the tune of a song, rather than solely the lyrics.

MIT researchers built micron-scale robots able to sense, record, and store information about their environment. These tiny robots, about 100 micrometers in diameter (approximately the size of a human egg cell), can also carry out pre-programmed computational tasks.

Engineers at University of California, San Diego developed ultrasound-powered nanorobots that swim efficiently through your blood, removing harmful bacteria and the toxins they produce.

But it doesn’t stop there.

As nanosensor and nanonetworking capabilities develop, these tiny bots may soon communicate with each other, enabling the targeted delivery of drugs and autonomous corrective action.

Mobile Health
The OURA ring and the Series 4 Apple Watch are just the tip of the spear when it comes to our future of mobile health. This field, predicted to become a $102 billion market by 2022, puts an on-demand virtual doctor in your back pocket.

Step aside, WebMD.

In true exponential technology fashion, mobile device penetration has increased dramatically, while image recognition error rates and sensor costs have sharply declined.

As a result, AI-powered medical chatbots are flooding the market; diagnostic apps can identify anything from a rash to diabetic retinopathy; and with the advent of global connectivity, mHealth platforms enable real-time health data collection, transmission, and remote diagnosis by medical professionals.

Already available to residents across North London, Babylon Health offers immediate medical advice through AI-powered chatbots and video consultations with doctors via its app.

Babylon now aims to build up its AI for advanced diagnostics and even prescription. Others, like Woebot, take on mental health, using cognitive behavioral therapy in communications over Facebook messenger with patients suffering from depression.

In addition to phone apps and add-ons that test for fertility or autism, the now-FDA-approved Clarius L7 Linear Array Ultrasound Scanner can connect directly to iOS and Android devices and perform wireless ultrasounds at a moment’s notice.

Next, Healthy.io, an Israeli startup, uses your smartphone and computer vision to analyze traditional urine test strips—all you need to do is take a few photos.

With mHealth platforms like ClickMedix, which connects remotely-located patients to medical providers through real-time health data collection and transmission, what’s to stop us from delivering needed treatments through drone delivery or robotic telesurgery?

Welcome to the age of smartphone-as-a-medical-device.

Conclusion
With these DIY data collection and diagnostic tools, we save on transportation costs (time and money), and time bottlenecks.

No longer will you need to wait for your urine or blood results to go through the current information chain: samples will be sent to the lab, analyzed by a technician, results interpreted by your doctor, and only then relayed to you.

Just like the “sage-on-the-stage” issue with today’s education system, healthcare has a “doctor-on-the-dais” problem. Current medical procedures are too complicated and expensive for a layperson to perform and analyze on their own.

The coming abundance of healthcare data promises to transform how we approach healthcare, putting the power of exponential technologies in the patient’s hands and revolutionizing how we live.

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Posted in Human Robots

#434648 The Pediatric AI That Outperformed ...

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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Posted in Human Robots

#434637 AI Is Rapidly Augmenting Healthcare and ...

When it comes to the future of healthcare, perhaps the only technology more powerful than CRISPR is artificial intelligence.

Over the past five years, healthcare AI startups around the globe raised over $4.3 billion across 576 deals, topping all other industries in AI deal activity.

During this same period, the FDA has given 70 AI healthcare tools and devices ‘fast-tracked approval’ because of their ability to save both lives and money.

The pace of AI-augmented healthcare innovation is only accelerating.

In Part 3 of this blog series on longevity and vitality, I cover the different ways in which AI is augmenting our healthcare system, enabling us to live longer and healthier lives.

In this blog, I’ll expand on:

Machine learning and drug design
Artificial intelligence and big data in medicine
Healthcare, AI & China

Let’s dive in.

Machine Learning in Drug Design
What if AI systems, specifically neural networks, could predict the design of novel molecules (i.e. medicines) capable of targeting and curing any disease?

Imagine leveraging cutting-edge artificial intelligence to accomplish with 50 people what the pharmaceutical industry can barely do with an army of 5,000.

And what if these molecules, accurately engineered by AIs, always worked? Such a feat would revolutionize our $1.3 trillion global pharmaceutical industry, which currently holds a dismal record of 1 in 10 target drugs ever reaching human trials.

It’s no wonder that drug development is massively expensive and slow. It takes over 10 years to bring a new drug to market, with costs ranging from $2.5 billion to $12 billion.

This inefficient, slow-to-innovate, and risk-averse industry is a sitting duck for disruption in the years ahead.

One of the hottest startups in digital drug discovery today is Insilico Medicine. Leveraging AI in its end-to-end drug discovery pipeline, Insilico Medicine aims to extend healthy longevity through drug discovery and aging research.

Their comprehensive drug discovery engine uses millions of samples and multiple data types to discover signatures of disease, identify the most promising protein targets, and generate perfect molecules for these targets. These molecules either already exist or can be generated de novo with the desired set of parameters.

In late 2018, Insilico’s CEO Dr. Alex Zhavoronkov announced the groundbreaking result of generating novel molecules for a challenging protein target with an unprecedented hit rate in under 46 days. This included both synthesis of the molecules and experimental validation in a biological test system—an impressive feat made possible by converging exponential technologies.

Underpinning Insilico’s drug discovery pipeline is a novel machine learning technique called Generative Adversarial Networks (GANs), used in combination with deep reinforcement learning.

Generating novel molecular structures for diseases both with and without known targets, Insilico is now pursuing drug discovery in aging, cancer, fibrosis, Parkinson’s disease, Alzheimer’s disease, ALS, diabetes, and many others. Once rolled out, the implications will be profound.

Dr. Zhavoronkov’s ultimate goal is to develop a fully-automated Health-as-a-Service (HaaS) and Longevity-as-a-Service (LaaS) engine.

Once plugged into the services of companies from Alibaba to Alphabet, such an engine would enable personalized solutions for online users, helping them prevent diseases and maintain optimal health.

Insilico, alongside other companies tackling AI-powered drug discovery, truly represents the application of the 6 D’s. What was once a prohibitively expensive and human-intensive process is now rapidly becoming digitized, dematerialized, demonetized and, perhaps most importantly, democratized.

Companies like Insilico can now do with a fraction of the cost and personnel what the pharmaceutical industry can barely accomplish with thousands of employees and a hefty bill to foot.

As I discussed in my blog on ‘The Next Hundred-Billion-Dollar Opportunity,’ Google’s DeepMind has now turned its neural networks to healthcare, entering the digitized drug discovery arena.

In 2017, DeepMind achieved a phenomenal feat by matching the fidelity of medical experts in correctly diagnosing over 50 eye disorders.

And just a year later, DeepMind announced a new deep learning tool called AlphaFold. By predicting the elusive ways in which various proteins fold on the basis of their amino acid sequences, AlphaFold may soon have a tremendous impact in aiding drug discovery and fighting some of today’s most intractable diseases.

Artificial Intelligence and Data Crunching
AI is especially powerful in analyzing massive quantities of data to uncover patterns and insights that can save lives. Take WAVE, for instance. Every year, over 400,000 patients die prematurely in US hospitals as a result of heart attack or respiratory failure.

Yet these patients don’t die without leaving plenty of clues. Given information overload, however, human physicians and nurses alone have no way of processing and analyzing all necessary data in time to save these patients’ lives.

Enter WAVE, an algorithm that can process enough data to offer a six-hour early warning of patient deterioration.

Just last year, the FDA approved WAVE as an AI-based predictive patient surveillance system to predict and thereby prevent sudden death.

Another highly valuable yet difficult-to-parse mountain of medical data comprises the 2.5 million medical papers published each year.

For some time, it has become physically impossible for a human physician to read—let alone remember—all of the relevant published data.

To counter this compounding conundrum, Johnson & Johnson is teaching IBM Watson to read and understand scientific papers that detail clinical trial outcomes.

Enriching Watson’s data sources, Apple is also partnering with IBM to provide access to health data from mobile apps.

One such Watson system contains 40 million documents, ingesting an average of 27,000 new documents per day, and providing insights for thousands of users.

After only one year, Watson’s successful diagnosis rate of lung cancer has reached 90 percent, compared to the 50 percent success rate of human doctors.

But what about the vast amount of unstructured medical patient data that populates today’s ancient medical system? This includes medical notes, prescriptions, audio interview transcripts, and pathology and radiology reports.

In late 2018, Amazon announced a new HIPAA-eligible machine learning service that digests and parses unstructured data into categories, such as patient diagnoses, treatments, dosages, symptoms and signs.

Taha Kass-Hout, Amazon’s senior leader in health care and artificial intelligence, told the Wall Street Journal that internal tests demonstrated that the software even performs as well as or better than other published efforts.

On the heels of this announcement, Amazon confirmed it was teaming up with the Fred Hutchinson Cancer Research Center to evaluate “millions of clinical notes to extract and index medical conditions.”

Having already driven extraordinary algorithmic success rates in other fields, data is the healthcare industry’s goldmine for future innovation.

Healthcare, AI & China
In 2017, the Chinese government published its ambitious national plan to become a global leader in AI research by 2030, with healthcare listed as one of four core research areas during the first wave of the plan.

Just a year earlier, China began centralizing healthcare data, tackling a major roadblock to developing longevity and healthcare technologies (particularly AI systems): scattered, dispersed, and unlabeled patient data.

Backed by the Chinese government, China’s largest tech companies—particularly Tencent—have now made strong entrances into healthcare.

Just recently, Tencent participated in a $154 million megaround for China-based healthcare AI unicorn iCarbonX.

Hoping to develop a complete digital representation of your biological self, iCarbonX has acquired numerous US personalized medicine startups.

Considering Tencent’s own Miying healthcare AI platform—aimed at assisting healthcare institutions in AI-driven cancer diagnostics—Tencent is quickly expanding into the drug discovery space, participating in two multimillion-dollar, US-based AI drug discovery deals just this year.

China’s biggest, second-order move into the healthtech space comes through Tencent’s WeChat. In the course of a mere few years, already 60 percent of the 38,000 medical institutions registered on WeChat allow patients to digitally book appointments through Tencent’s mobile platform. At the same time, 2,000 Chinese hospitals accept WeChat payments.

Tencent has additionally partnered with the U.K.’s Babylon Health, a virtual healthcare assistant startup whose app now allows Chinese WeChat users to message their symptoms and receive immediate medical feedback.

Similarly, Alibaba’s healthtech focus started in 2016 when it released its cloud-based AI medical platform, ET Medical Brain, to augment healthcare processes through everything from diagnostics to intelligent scheduling.

Conclusion
As Nvidia CEO Jensen Huang has stated, “Software ate the world, but AI is going to eat software.” Extrapolating this statement to a more immediate implication, AI will first eat healthcare, resulting in dramatic acceleration of longevity research and an amplification of the human healthspan.

Next week, I’ll continue to explore this concept of AI systems in healthcare.

Particularly, I’ll expand on how we’re acquiring and using the data for these doctor-augmenting AI systems: from ubiquitous biosensors, to the mobile healthcare revolution, and finally, to the transformative power of the health nucleus.

As AI and other exponential technologies increase our healthspan by 30 to 40 years, how will you leverage these same exponential technologies to take on your moonshots and live out your massively transformative purpose?

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Posted in Human Robots

#434585 This Week’s Awesome Stories From ...

ARTIFICIAL INTELLIGENCE
The World’s Fastest Supercomputer Breaks an AI Record
Tom Simonite | Wired
“Summit, which occupies an area equivalent to two tennis courts, used more than 27,000 powerful graphics processors in the project. It tapped their power to train deep-learning algorithms, the technology driving AI’s frontier, chewing through the exercise at a rate of a billion billion operations per second, a pace known in supercomputing circles as an exaflop.”

ROBOTICS
iRobot Finally Announces Awesome New Terra Robotic Lawnmower
Evan Ackerman | IEEE Spectrum
“Since the first Roomba came out in 2002, it has seemed inevitable that one day iRobot would develop a robotic lawn mower. After all, a robot mower is basically just a Roomba that works outside, right? Of course, it’s not nearly that simple, as iRobot has spent the last decade or so discovering, but they’ve finally managed to pull it off.”

3D Printing
Watch This Super Speedy 3D Printer Make Objects Suddenly Appear
Erin Winick | MIT Technology Review
“The new machine—which the team nicknamed the ‘replicator’ after the machine from Star Trek—instead forms the entire item all in one go. It does this by shining light onto specific spots in a rotating resin that solidifies when exposed to a certain light level.”

GENETICS
The DIY Designer Baby Project Funded With Bitcoin
Antonio Regalado | MIT Technology Review
“i‘Is DIY bio anywhere close to making a CRISPR baby? No, not remotely,’ David Ishee says. ‘But if some rich guy pays a scientist to do the work, it’s going to happen.’ He adds: ‘What you are reporting on isn’t Bryan—it’s the unseen middle space, a layer of gray-market biotech and freelance science where people with resources can get things done.’i”

SCIENCE
The Complete Cancer Cure Story Is Both Bogus and Tragic
Megan Molteni | Wired
“You’d think creators and consumers of news would have learned their lesson by now. But the latest version of the fake cancer cure story is even more flagrantly flawed than usual. The public’s cancer cure–shaped amnesia, and media outlets’ willingness to exploit it for clicks, are as bottomless as ever. Hope, it would seem, trumps history.”

BOOKS
An AI Reading List—From Practical Primers to Sci-Fi Short Stories
James Vincent | The Verge
“The Verge has assembled a reading list: a brief but diverse compendium of books, short stories, and blogs, all chosen by leading figures in the AI world to help you better understand artificial intelligence.”

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Posted in Human Robots

#434324 Big Brother Nation: The Case for ...

Powerful surveillance cameras have crept into public spaces. We are filmed and photographed hundreds of times a day. To further raise the stakes, the resulting video footage is fed to new forms of artificial intelligence software that can recognize faces in real time, read license plates, even instantly detect when a particular pre-defined action or activity takes place in front of a camera.

As most modern cities have quietly become surveillance cities, the law has been slow to catch up. While we wait for robust legal frameworks to emerge, the best way to protect our civil liberties right now is to fight technology with technology. All cities should place local surveillance video into a public cloud-based data trust. Here’s how it would work.

In Public Data We Trust
To democratize surveillance, every city should implement three simple rules. First, anyone who aims a camera at public space must upload that day’s haul of raw video file (and associated camera meta-data) into a cloud-based repository. Second, this cloud-based repository must have open APIs and a publicly-accessible log file that records search histories and tracks who has accessed which video files. And third, everyone in the city should be given the same level of access rights to the stored video data—no exceptions.

This kind of public data repository is called a “data trust.” Public data trusts are not just wishful thinking. Different types of trusts are already in successful use in Estonia and Barcelona, and have been proposed as the best way to store and manage the urban data that will be generated by Alphabet’s planned Sidewalk Labs project in Toronto.

It’s true that few people relish the thought of public video footage of themselves being looked at by strangers and friends, by ex-spouses, potential employers, divorce attorneys, and future romantic prospects. In fact, when I propose this notion when I give talks about smart cities, most people recoil in horror. Some turn red in the face and jeer at my naiveté. Others merely blink quietly in consternation.

The reason we should take this giant step towards extreme transparency is to combat the secrecy that surrounds surveillance. Openness is a powerful antidote to oppression. Edward Snowden summed it up well when he said, “Surveillance is not about public safety, it’s about power. It’s about control.”

Let Us Watch Those Watching Us
If public surveillance video were put back into the hands of the people, citizens could watch their government as it watches them. Right now, government cameras are controlled by the state. Camera locations are kept secret, and only the agencies that control the cameras get to see the footage they generate.

Because of these information asymmetries, civilians have no insight into the size and shape of the modern urban surveillance infrastructure that surrounds us, nor the uses (or abuses) of the video footage it spawns. For example, there is no swift and efficient mechanism to request a copy of video footage from the cameras that dot our downtown. Nor can we ask our city’s police force to show us a map that documents local traffic camera locations.

By exposing all public surveillance videos to the public gaze, cities could give regular people tools to assess the size, shape, and density of their local surveillance infrastructure and neighborhood “digital dragnet.” Using the meta-data that’s wrapped around video footage, citizens could geo-locate individual cameras onto a digital map to generate surveillance “heat maps.” This way people could assess whether their city’s camera density was higher in certain zip codes, or in neighborhoods populated by a dominant ethnic group.

Surveillance heat maps could be used to document which government agencies were refusing to upload their video files, or which neighborhoods were not under surveillance. Given what we already know today about the correlation between camera density, income, and social status, these “dark” camera-free regions would likely be those located near government agencies and in more affluent parts of a city.

Extreme transparency would democratize surveillance. Every city’s data trust would keep a publicly-accessible log of who’s searching for what, and whom. People could use their local data trust’s search history to check whether anyone was searching for their name, face, or license plate. As a result, clandestine spying on—and stalking of—particular individuals would become difficult to hide and simpler to prove.

Protect the Vulnerable and Exonerate the Falsely Accused
Not all surveillance video automatically works against the underdog. As the bungled (and consequently no longer secret) assassination of journalist Jamal Khashoggi demonstrated, one of the unexpected upsides of surveillance cameras has been the fact that even kings become accountable for their crimes. If opened up to the public, surveillance cameras could serve as witnesses to justice.

Video evidence has the power to protect vulnerable individuals and social groups by shedding light onto messy, unreliable (and frequently conflicting) human narratives of who did what to whom, and why. With access to a data trust, a person falsely accused of a crime could prove their innocence. By searching for their own face in video footage or downloading time/date stamped footage from a particular camera, a potential suspect could document their physical absence from the scene of a crime—no lengthy police investigation or high-priced attorney needed.

Given Enough Eyeballs, All Crimes Are Shallow
Placing public surveillance video into a public trust could make cities safer and would streamline routine police work. Linus Torvalds, the developer of open-source operating system Linux, famously observed that “given enough eyeballs, all bugs are shallow.” In the case of public cameras and a common data repository, Torvald’s Law could be restated as “given enough eyeballs, all crimes are shallow.”

If thousands of citizen eyeballs were given access to a city’s public surveillance videos, local police forces could crowdsource the work of solving crimes and searching for missing persons. Unfortunately, at the present time, cities are unable to wring any social benefit from video footage of public spaces. The most formidable barrier is not government-imposed secrecy, but the fact that as cameras and computers have grown cheaper, a large and fast-growing “mom and pop” surveillance state has taken over most of the filming of public spaces.

While we fear spooky government surveillance, the reality is that we’re much more likely to be filmed by security cameras owned by shopkeepers, landlords, medical offices, hotels, homeowners, and schools. These businesses, organizations, and individuals install cameras in public areas for practical reasons—to reduce their insurance costs, to prevent lawsuits, or to combat shoplifting. In the absence of regulations governing their use, private camera owners store video footage in a wide variety of locations, for varying retention periods.

The unfortunate (and unintended) result of this informal and decentralized network of public surveillance is that video files are not easy to access, even for police officers on official business. After a crime or terrorist attack occurs, local police (or attorneys armed with a subpoena) go from door to door to manually collect video evidence. Once they have the videos in hand, their next challenge is searching for the right “codex” to crack the dozens of different file formats they encounter so they can watch and analyze the footage.

The result of these practical barriers is that as it stands today, only people with considerable legal or political clout are able to successfully gain access into a city’s privately-owned, ad-hoc collections of public surveillance videos. Not only are cities missing the opportunity to streamline routine evidence-gathering police work, they’re missing a radically transformative benefit that would become possible once video footage from thousands of different security cameras were pooled into a single repository: the ability to apply the power of citizen eyeballs to the work of improving public safety.

Why We Need Extreme Transparency
When regular people can’t access their own surveillance videos, there can be no data justice. While we wait for the law to catch up with the reality of modern urban life, citizens and city governments should use technology to address the problem that lies at the heart of surveillance: a power imbalance between those who control the cameras and those who don’t.

Cities should permit individuals and organizations to install and deploy as many public-facing cameras as they wish, but with the mandate that camera owners must place all resulting video footage into the mercilessly bright sunshine of an open data trust. This way, cloud computing, open APIs, and artificial intelligence software can help combat abuses of surveillance and give citizens insight into who’s filming us, where, and why.

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