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Where are we?

Question: When you read the newspaper or watch the news, what issues stand out to you?

 

Ezekiel Emanuel: Well first of all, I don’t look at the news. I don’t own a TV, and I haven’t had a TV for more than 30 years now. I think that’s actually one of the dreadful things science has given us is television. And I say this as where my relative makes all his money. My brother makes all his money on TV.

Look. You can’t be conscious and not worry about global warming, and about what we’re doing to our planet, and about the use of resources. You also have to be really horrified about our inability in this country to tackle that problem. There is a classic case of where we have the technology to solve the problem. We have the insight as to how to marshal that. If we let researchers go wild and support that, we would have a lot more technology. And yet we have not created the infrastructure, or the steady stream of funding, or the political will to actually do that. And that has to sour you on the notion of democracy. That fact that we can’t seem to address a very critical problem; again, the issue isn’t so much, “Is this going to pay off?” It’s going to pay off hugely. The issue isn’t, “Do we have the technology?” We already have the technology to do this.

The problem is we can’t seem to organize it. And that, for me, is a recurring theme in lots of problems. I mentioned it in relationship to the healthcare system. And I think that is something which really does bother me about the United States; that we can see the problems, we can have the ability to solve the problems; and we can’t seem to marshal the forces – social and political forces – to get it right.

 

Question: What is the world’s biggest challenge in the coming decade?

 

Ezekiel Emanuel: Energy use and global warming is one. Wars and the breakdown of political order is another. I mean when you look around this world at the number of “failed states” – Somalia, Haiti, Congo -- you really have to be scared about what that breeds.

Pakistan may turn out to be one of those states. Iraq may turn out to be one of those states. I think we all have to be very worried about that.

We have to be religious fundamentalism; there you really have, I think, something which is; worry about the culture of death. The notion that you go out and kill people and that’s a good thing. Either because you are so alienated from society and you see no future; or because the culture has created the idea that somehow killing people is a way to purity and to being saved.

We had a period; the war or religions was like that. The Catholics and the Protestants in Europe were killing each other to no end. _______ disappear.

Unfortunately, we now have that. And we’re not dealing with bows and arrows, but we’re dealing with much more sophisticated weaponry – maybe even weapons of mass destruction. That’s seemingly worrisome to me. I would not be surprised if we ended up with a nuclear explosion, and hundreds of thousands – if not millions – of people – dead. Maybe we would then step – take a step back. But I actually think that’s a real possibility.

 

Question: What are the challenges confronting the U.S.?

 

Ezekiel Emanuel: Well we’re in for a perfect storm. Medicare bankrupting the federal government because we have an increasing number of retirees. And not only an increasing number of retirees, but they’re also living longer. I think the average lifespan now, if you get to 65, is 17 and plus more years. That’s going to be a huge cost on a shrinking number of people who are going to be able to fund that; who are in the working population. So the increase of costs of Medicare, which is going to dwarf the Social Security problem. An increasing number of retirees, and tremendous problems with how to fund that.

Secondly, I worry tremendously about the primary and secondary school educational system. I don’t think we’re investing enough. And one of the reasons we’re not investing enough because so much money is going to Medicare and Medicaid that we have not been spending enough on primary and secondary education.

Educated populous is critical for economic growth. It’s also critical for a functioning democracy. And I think we need a lot more focus on education in this country. Not only primary and secondary school, but even before nursery school and probably early childhood development. That would be a major place of investment in my opinion.

 

Question: What should be the big issues of the 2008 US presidential election?

 

Ezekiel Emanuel: Look. What I think is irrelevant. They are going to be Iraq. They are going to probably be a tax situation because we’re facing a problem in 2010 – a major tax issue.

Healthcare is going to be up there, and probably global warming. Those are probably, in my view, going to be the big four issues. Whatever I have to say about it is irrelevant.

 

Recorded: July 5, 2007

 

If we let researchers go wild, we would solve a lot of our problems.

Does conscious AI deserve rights?

If machines develop consciousness, or if we manage to give it to them, the human-robot dynamic will forever be different.

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  • Does AI—and, more specifically, conscious AI—deserve moral rights? In this thought exploration, evolutionary biologist Richard Dawkins, ethics and tech professor Joanna Bryson, philosopher and cognitive scientist Susan Schneider, physicist Max Tegmark, philosopher Peter Singer, and bioethicist Glenn Cohen all weigh in on the question of AI rights.
  • Given the grave tragedy of slavery throughout human history, philosophers and technologists must answer this question ahead of technological development to avoid humanity creating a slave class of conscious beings.
  • One potential safeguard against that? Regulation. Once we define the context in which AI requires rights, the simplest solution may be to not build that thing.

A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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