Artificial Intelligence Needs Doctors As Much As They Need It
The media loves to hype concerns about artificial intelligence: What if machines become super-intelligent and self-aware? How will humanity compete and survive? But artificial intelligence today is a far cry from a robot takeover. "AI" is a catch-all term that often refers to machine training or machine learning: There is an abundance of data, vastly more than the human mind can assimilate, being tagged, captured and stored. This systematic data processing requires methodologies that can put it in usable form and formats. While these new developments stoke fear in some corners, the ability to predict outcomes is generally seen as a good thing, as it can mitigate risks and even save lives.
We, collectively, want AI even though it is seldom expressed this way.
The prospects and attempts toward artificial intelligence has been with us for decades. Only recently have the underlying technologies and infrastructure--including computer processing, storage, networking speed and advanced software platforms--become omnipresent. These technological advances enabled the implementation of data mining concepts and the subsequent advantages that were not feasible just a decade ago.
AI is fantastical by vision, evolutionary by experience, and disruptive upon reflection. In the world of health care, AI is already transforming research and clinical practice. We, collectively, want AI even though it is seldom expressed this way. What we, the patient population, patient advocates and caregivers, agree on and want is: (1) timely, precise and inexpensive diagnoses of our ailments, injuries and disorders; (2) timely, personalized, highly effective and efficient courses of therapies; and (3) expedited recovery with minimum deficits, complications and recurrence.
"Artificial intelligence and machine learning will impact healthcare as profoundly as the discovery of the microscope."
Implicitly, we all are saying that we want our healthcare systems and clinicians to accomplish truly inhuman feats: to incorporate all sources of structured data (such as published statistics and reports) and unstructured data (including news articles, conversational analysis by care givers, nuances of similar cases, talks at professional societies); to analyze the data sourced and uncover patterns, reveal side effects, define probable success and outcomes; and to present the best personalized course of treatment for the patient that addresses the ailment and mitigates associated risks. It is hard to argue against any of this.
In a recent published interview, Keith J. Dreyer, executive director of the Massachusetts General Hospital and Brigham and Women's Hospital Center for Clinical Data Science, says that "artificial intelligence and machine learning will impact healthcare as profoundly as the discovery of the microscope."
But as AI helps physicians in profound ways, like detecting subtle lesions on scans or distinguishing the symptoms of a stroke from a brain tumor, we humans can't get too complacent. Evolving AI platforms will provide more sophisticated sets of "tools" to address both mundane and complex medical challenges, albeit with humans very much in the mix and routinely at the helm.
Humans do not appear endangered to be replaced anytime soon.
Human beings are capable of a level of nuance and contextual understanding of complex medical scenarios and, consequently, do not appear endangered to be replaced anytime soon. These platforms will do some heavy lifting for sure and provide considerable assistance across the healthcare industry. But human involvement is crucial, as we are best at adaptive learning, cognition, ensuring accuracy of the data, and continually providing feedback to improve the machine learning components of the AI platforms that the health industry will increasingly rely upon.
The human/machine interface is not binary; there is no line in the sand. It is fuzzy and evolutionary, a synchronicity that we all will surely witness and experience. In the future, it may be possible that all recorded knowledge, including genetic, genomic and laboratory data, from structured and unstructured sources, can be at the fingertips of your clinician, and then factored into diagnosing your condition and prescribing your course of treatment. This is precision and personalized medicine on a grand scale applied at the micro level--you!
But none of this will diminish the importance of doctors, nurses and all assortment of care providers. Though they all will undoubtedly become more effective with such awesome AI assistance, their job will always be to heal you with compassion, wisdom, and kindness, for the essence of humanity cannot be automated.
Stronger psychedelics that rewire the brain, with Doug Drysdale
A promising development in science in recent years has been the use technology to optimize something natural. One-upping nature's wisdom isn't easy. In many cases, we haven't - and maybe we can't - figure it out. But today's episode features a fascinating example: using tech to optimize psychedelic mushrooms.
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These mushrooms have been used for religious, spiritual and medicinal purposes for thousands of years, but only in the past several decades have scientists brought psychedelics into the lab to enhance them and maximize their therapeutic value.
Today’s podcast guest, Doug Drysdale, is doing important work to lead this effort. Drysdale is the CEO of a company called Cybin that has figured out how to make psilocybin more potent, so it can be administered in smaller doses without side effects.
The natural form of psilocybin has been studied increasingly in the realm of mental health. Taking doses of these mushrooms appears to help people with anxiety and depression by spurring the development of connections in the brain, an example of neuroplasticity. The process basically shifts the adult brain from being fairly rigid like dried clay into a malleable substance like warm wax - the state of change that's constantly underway in the developing brains of children.
Neuroplasticity in adults seems to unlock some of our default ways of of thinking, the habitual thought patterns that’ve been associated with various mental health problems. Some promising research suggests that psilocybin causes a reset of sorts. It makes way for new, healthier thought patterns.
So what is Drysdale’s secret weapon to bring even more therapeutic value to psilocybin? It’s a process called deuteration. It focuses on the hydrogen atoms in psilocybin. These atoms are very light and don’t stick very well to carbon, which is another atom in psilocybin. As a result, our bodies can easily breaks down the bonds between the hydrogen and carbon atoms. For many people, that means psilocybin gets cleared from the body too quickly, before it can have a therapeutic benefit.
In deuteration, scientists do something simple but ingenious: they replace the hydrogen atoms with a molecule called deuterium. It’s twice as heavy as hydrogen and forms tighter bonds with the carbon. Because these pairs are so rock-steady, they slow down the rate at which psilocybin is metabolized, so it has more sustained effects on our brains.
Cybin isn’t Drysdale’s first go around at this - far from it. He has over 30 years of experience in the healthcare sector. During this time he’s raised around $4 billion of both public and private capital, and has been named Ernst and Young Entrepreneur of the Year. Before Cybin, he was the founding CEO of a pharmaceutical company called Alvogen, leading it from inception to around $500 million in revenues, across 35 countries. Drysdale has also been the head of mergers and acquisitions at Actavis Group, leading 15 corporate acquisitions across three continents.
In this episode, Drysdale walks us through the promising research of his current company, Cybin, and the different therapies he’s developing for anxiety and depression based not just on psilocybin but another psychedelic compound found in plants called DMT. He explains how they seem to have such powerful effects on the brain, as well as the potential for psychedelics to eventually support other use cases, including helping us strive toward higher levels of well-being. He goes on to discuss his views on mindfulness and lifestyle factors - such as optimal nutrition - that could help bring out hte best in psychedelics.
Show links:
Doug Drysdale full bio
Doug Drysdale twitter
Cybin website
Cybin development pipeline
Cybin's promising phase 2 research on depression
Johns Hopkins psychedelics research and psilocybin research
Mets owner Steve Cohen invests in psychedelic therapies
Doug Drysdale, CEO of Cybin
How the body's immune resilience affects our health and lifespan
Story by Big Think
It is a mystery why humans manifest vast differences in lifespan, health, and susceptibility to infectious diseases. However, a team of international scientists has revealed that the capacity to resist or recover from infections and inflammation (a trait they call “immune resilience”) is one of the major contributors to these differences.
Immune resilience involves controlling inflammation and preserving or rapidly restoring immune activity at any age, explained Weijing He, a study co-author. He and his colleagues discovered that people with the highest level of immune resilience were more likely to live longer, resist infection and recurrence of skin cancer, and survive COVID and sepsis.
Measuring immune resilience
The researchers measured immune resilience in two ways. The first is based on the relative quantities of two types of immune cells, CD4+ T cells and CD8+ T cells. CD4+ T cells coordinate the immune system’s response to pathogens and are often used to measure immune health (with higher levels typically suggesting a stronger immune system). However, in 2021, the researchers found that a low level of CD8+ T cells (which are responsible for killing damaged or infected cells) is also an important indicator of immune health. In fact, patients with high levels of CD4+ T cells and low levels of CD8+ T cells during SARS-CoV-2 and HIV infection were the least likely to develop severe COVID and AIDS.
Individuals with optimal levels of immune resilience were more likely to live longer.
In the same 2021 study, the researchers identified a second measure of immune resilience that involves two gene expression signatures correlated with an infected person’s risk of death. One of the signatures was linked to a higher risk of death; it includes genes related to inflammation — an essential process for jumpstarting the immune system but one that can cause considerable damage if left unbridled. The other signature was linked to a greater chance of survival; it includes genes related to keeping inflammation in check. These genes help the immune system mount a balanced immune response during infection and taper down the response after the threat is gone. The researchers found that participants who expressed the optimal combination of genes lived longer.
Immune resilience and longevity
The researchers assessed levels of immune resilience in nearly 50,000 participants of different ages and with various types of challenges to their immune systems, including acute infections, chronic diseases, and cancers. Their evaluation demonstrated that individuals with optimal levels of immune resilience were more likely to live longer, resist HIV and influenza infections, resist recurrence of skin cancer after kidney transplant, survive COVID infection, and survive sepsis.
However, a person’s immune resilience fluctuates all the time. Study participants who had optimal immune resilience before common symptomatic viral infections like a cold or the flu experienced a shift in their gene expression to poor immune resilience within 48 hours of symptom onset. As these people recovered from their infection, many gradually returned to the more favorable gene expression levels they had before. However, nearly 30% who once had optimal immune resilience did not fully regain that survival-associated profile by the end of the cold and flu season, even though they had recovered from their illness.
Intriguingly, some people who are 90+ years old still have optimal immune resilience, suggesting that these individuals’ immune systems have an exceptional capacity to control inflammation and rapidly restore proper immune balance.
This could suggest that the recovery phase varies among people and diseases. For example, young female sex workers who had many clients and did not use condoms — and thus were repeatedly exposed to sexually transmitted pathogens — had very low immune resilience. However, most of the sex workers who began reducing their exposure to sexually transmitted pathogens by using condoms and decreasing their number of sex partners experienced an improvement in immune resilience over the next 10 years.
Immune resilience and aging
The researchers found that the proportion of people with optimal immune resilience tended to be highest among the young and lowest among the elderly. The researchers suggest that, as people age, they are exposed to increasingly more health conditions (acute infections, chronic diseases, cancers, etc.) which challenge their immune systems to undergo a “respond-and-recover” cycle. During the response phase, CD8+ T cells and inflammatory gene expression increase, and during the recovery phase, they go back down.
However, over a lifetime of repeated challenges, the immune system is slower to recover, altering a person’s immune resilience. Intriguingly, some people who are 90+ years old still have optimal immune resilience, suggesting that these individuals’ immune systems have an exceptional capacity to control inflammation and rapidly restore proper immune balance despite the many respond-and-recover cycles that their immune systems have faced.
Public health ramifications could be significant. Immune cell and gene expression profile assessments are relatively simple to conduct, and being able to determine a person’s immune resilience can help identify whether someone is at greater risk for developing diseases, how they will respond to treatment, and whether, as well as to what extent, they will recover.