A New Web Could be Coming. Will It Improve Human Health?
The Web has provided numerous benefits over the years, but users have also experienced issues related to privacy, cybersecurity, income inequality, and addiction which negatively impact their quality of life. In important ways, the Web has yet to meet its potential to support human health.
Now, engineers are in the process of developing a new version of the Web, called Web3, which would seek to address the Web’s current shortcomings through a mix of new technologies.
It could also create new problems. Industrial revolutions, including new versions of the Web, have trade-offs. While many activists tend to focus on the negative aspects of Web3 technologies, they overlook some of the potential benefits to health and the environment that aren’t as easily quantifiable such as less stressful lives, fewer hours required for work, and a higher standard of living. What emerging technologies are in the mix to define the new era of the digital age, and how will they contribute to our overall health and well-being?
In order to answer these questions, I have identified three major trends that may help define the future landscape of Web3. These include more powerful machine intelligence that could drive improvements in healthcare, decentralized banking systems that allow consumers to bypass middlemen, and self-driving cars with potential to reduce pollution. However, it is the successes of the enabling technologies that support these goals—improvements in AI, blockchain and smart contracts, and fog computing—that will ultimately define Web3.
Machine Intelligence and Diagnosing Diseases
While the internet is the physical network equipment and computers that keep the world connected, the Web is one of the services that run on the internet. In 1989, British scientist Tim Berners-Lee invented the World Wide Web and, when Web1 went live in 1991, it consisted of pages of text connected by hyperlinks. It remained that way until 2004 with the introduction of Web2, which provided social media websites and let users generate content in addition to consuming it passively.
The Semantic Web could expand the impact of new cognitive skills for machines by feeding data to AI in more readily accessible formats. This will make machines better at solving hard problems such as diagnosing and treating complex diseases.
For the most part, Web2 is what we still have today but, from the beginning, Berners-Lee, now an MIT professor, envisaged a much more sophisticated version of the Web. Known as the Semantic Web, it would not only store data, but actually know what it means. The goal is to make all information on the Internet “machine-readable,” so it can be easily processed by computers, like an Excel sheet full of numbers as opposed to human language. We are now in the early stages of the Semantic Web, which incorporates his vision. For example, there is already a cloud of datasets that links thousands of servers without any form of centralized control. However, due to the costs and technological hurdles related to converting human language into something that computers can understand, the Semantic Web remains an ongoing project.
Currently, AI is only able to perform certain tasks, but it can already make healthcare business practices more efficient by leveraging deep learning to analyze data in supply chains. DeepMind, the company that developed AI for defeating chess masters, has also made huge advances in figuring out protein folding and misfolding, which is responsible for some diseases. Currently, AI is not that useful for diagnosing and treating many complex diseases. This is because deep learning is probabilistic, not causal. So, it is able to understand correlation, but not cause and effect.
Like the Web, though, AI is evolving, and the limitations of deep learning could be overcome in the foreseeable future. A number of government programs and private initiatives are dedicated to better understanding human brain complexity and equipping machines with reasoning, common sense, and the ability to understand cause and effect. The Semantic Web could expand the impact of these new cognitive skills by feeding data to AI in more readily accessible formats. This will make machines better at solving hard problems such as diagnosing and treating complex diseases, which involve genetic, lifestyle, and environment factors. These powerful AIs in the realm of healthcare could become an enduring and important feature of Web3.
Blockchain, Smart Contracts and Income Inequality
The Web2 version of the digital age was certainly impactful in altering our lifestyle both positively and negatively. This is predominately because of the business model used by companies such as Meta (formerly Facebook) and Google. By providing useful products like search engines, these companies have lured consumers into giving away their personal data for free, and the companies use this information to detect buying patterns in order to sell advertising. The digital economy made high tech companies billions of dollars while many users became underemployed or jobless.
In recent years, a similar model has been emerging in the realm of genetics. Personalized genomic companies charge a relatively small fee to analyze a fraction of our genes and provide probabilities of having specific medical conditions. While individual data is not valuable, cumulative data is helpful for deep learning. So, these companies can sell the anonymous DNA data to pharmaceutical companies for millions of dollars.
As these companies improve their ability to collect even more data about our genetic vulnerabilities, the technologies of Web3 could protect consumers from giving it away for free. An emerging technology called blockchain is able to provide a Web-based ledger of financial transactions with checks and balances to ensure that its records cannot be faked or altered. It has yet to reach mass adoption by the public, but the computer scientist Jaron Lanier has proposed storing our genomes and electronic health records in blockchain, utilizing electronic smart contracts between individuals and pharma healthcare industry. Micropayments could then be made to individuals for their data, using cryptocurrency.
These individual payments could become more lucrative in the coming years especially as researchers learn how to fully interpret and apply a person’s genetic data. In this way, blockchain could lead to improvements in income inequality, which currently drives health problems and other challenges for many. A number of start-ups are using this business model which has secure data and eliminates middlemen who don’t create any value, while compensating and protecting the privacy of individuals who contribute their health data.
Autonomous Vehicles, Fog Computing and Pollution
A number of trends indicate that modernizing the transportation industry would address a myriad of problems with public health, productivity and the environment. Autonomous vehicles (AVs) could help usher in this new era of transportation, and these AVs would need to be supported by Web3 technologies.
Automobile accidents are the second leading cause of death worldwide, with roughly 1.3 million fatalities annually, according to the World Health Organization. Some estimates suggest that replacing human drivers with AVs could eliminate as many as a million global fatalities annually. Shared AVs would help to reduce traffic congestion that wastes time and fuel, and electric vehicles would help minimize greenhouse gases.
To reap the benefits from replacing gas vehicles with electric, societies will need an infrastructure that enables self-driving cars to communicate with each other. Most data processing in computers is performed using von Neumann architecture, where the data memory and the processor are in two different places. Today, that typically means cloud computing. With self-driving cars, when cameras and sensors generate data to detect objects on the roads, processors will need to rapidly analyze the data and make real-time decisions regarding acceleration, braking, and steering. However, cloud computing is susceptible to latency issues.
One solution to latency is moving processing and data storage closer to where it is needed to improve response times. Edge computing, for example, places the processor at the site where the data is generated. Most new human-driven vehicles contain anywhere from 30 to 100 electronic control units (ECUs) that process data and control electrical systems in vehicles. These embedded systems, typically in the dashboard, control different applications such as airbags, steering, brakes, etc. ECUs process data generated by cameras and sensors in AVs and make crucial decisions on how they operate.
Self-driving cars can benefit by communicating with each other for navigation in the same way that bacteria and animals use swarm intelligence for tasks involving groups. Researchers are currently investigating fog computing which utilizes servers along highways for faster and more reliable navigation and for communicating data analytics among driverless cars.
The Future Landscape of Web3 is Uncertain
The future of Web3 has many possibilities. However, there is no guarantee that blockchain, smart contracts, and fog computing will achieve public acceptance and market saturation or prevail over other technologies or the status quo of Web2. It is also uncertain if or when the breakthroughs in AI will occur that could eradicate complex diseases through Web3.
An example of this uncertainty is the metaverse, which combines blockchain with virtual reality. Currently, the metaverse is primarily used for gaming and recreational use until its infrastructure is further developed. Researchers are interested in the long-term mental health effects of virtual reality, both positive and negative. Using avatars, or virtual representations of humans, in the metaverse, users have greater control of their environment and chosen identities. But, it is unclear what negative mental health effects will occur. As far as regulations, the metaverse is still in the Wild West stage, and bullying or even murder will likely take place. Also, there will be a point where virtual worlds like the metaverse will become so immersive that we won't want to leave them, according to Meta’s Zuckerberg.
The metaverse would rely on virtual reality technology that was developed many years ago, and adoption has been slower than some experts predicted. But most emerging technologies, including other examples related to Web3, follow a similar, nonlinear pattern of development that Gartner has represented in graphical form using the S-curve. To develop a technology forecast for Web3, you can follow the progress along the curve from proof of concept to a particular goal. After a series of successes and failures, entrepreneurs will continue to improve their products until each emerging technology fails or achieves mainstream adoption by the public.
What mix of emerging technologies ultimately defines Web3 will likely be determined by the benefits they provide to society—including whether and how they improve health—how they stimulate the digital economy, and how they address the significant shortcomings of Web2.
A new type of cancer therapy is shrinking deadly brain tumors with just one treatment
Few cancers are deadlier than glioblastomas—aggressive and lethal tumors that originate in the brain or spinal cord. Five years after diagnosis, less than five percent of glioblastoma patients are still alive—and more often, glioblastoma patients live just 14 months on average after receiving a diagnosis.
But an ongoing clinical trial at Mass General Cancer Center is giving new hope to glioblastoma patients and their families. The trial, called INCIPIENT, is meant to evaluate the effects of a special type of immune cell, called CAR-T cells, on patients with recurrent glioblastoma.
How CAR-T cell therapy works
CAR-T cell therapy is a type of cancer treatment called immunotherapy, where doctors modify a patient’s own immune system specifically to find and destroy cancer cells. In CAR-T cell therapy, doctors extract the patient’s T-cells, which are immune system cells that help fight off disease—particularly cancer. These T-cells are harvested from the patient and then genetically modified in a lab to produce proteins on their surface called chimeric antigen receptors (thus becoming CAR-T cells), which makes them able to bind to a specific protein on the patient’s cancer cells. Once modified, these CAR-T cells are grown in the lab for several weeks so that they can multiply into an army of millions. When enough cells have been grown, these super-charged T-cells are infused back into the patient where they can then seek out cancer cells, bind to them, and destroy them. CAR-T cell therapies have been approved by the US Food and Drug Administration (FDA) to treat certain types of lymphomas and leukemias, as well as multiple myeloma, but haven’t been approved to treat glioblastomas—yet.
CAR-T cell therapies don’t always work against solid tumors, such as glioblastomas. Because solid tumors contain different kinds of cancer cells, some cells can evade the immune system’s detection even after CAR-T cell therapy, according to a press release from Massachusetts General Hospital. For the INCIPIENT trial, researchers modified the CAR-T cells even further in hopes of making them more effective against solid tumors. These second-generation CAR-T cells (called CARv3-TEAM-E T cells) contain special antibodies that attack EFGR, a protein expressed in the majority of glioblastoma tumors. Unlike other CAR-T cell therapies, these particular CAR-T cells were designed to be directly injected into the patient’s brain.
The INCIPIENT trial results
The INCIPIENT trial involved three patients who were enrolled in the study between March and July 2023. All three patients—a 72-year-old man, a 74-year-old man, and a 57-year-old woman—were treated with chemo and radiation and enrolled in the trial with CAR-T cells after their glioblastoma tumors came back.
The results, which were published earlier this year in the New England Journal of Medicine (NEJM), were called “rapid” and “dramatic” by doctors involved in the trial. After just a single infusion of the CAR-T cells, each patient experienced a significant reduction in their tumor sizes. Just two days after receiving the infusion, the glioblastoma tumor of the 72-year-old man decreased by nearly twenty percent. Just two months later the tumor had shrunk by an astonishing 60 percent, and the change was maintained for more than six months. The most dramatic result was in the 57-year-old female patient, whose tumor shrank nearly completely after just one infusion of the CAR-T cells.
The results of the INCIPIENT trial were unexpected and astonishing—but unfortunately, they were also temporary. For all three patients, the tumors eventually began to grow back regardless of the CAR-T cell infusions. According to the press release from MGH, the medical team is now considering treating each patient with multiple infusions or prefacing each treatment with chemotherapy to prolong the response.
While there is still “more to do,” says co-author of the study neuro-oncologist Dr. Elizabeth Gerstner, the results are still promising. If nothing else, these second-generation CAR-T cell infusions may someday be able to give patients more time than traditional treatments would allow.
“These results are exciting but they are also just the beginning,” says Dr. Marcela Maus, a doctor and professor of medicine at Mass General who was involved in the clinical trial. “They tell us that we are on the right track in pursuing a therapy that has the potential to change the outlook for this intractable disease.”
Since the early 2000s, AI systems have eliminated more than 1.7 million jobs, and that number will only increase as AI improves. Some research estimates that by 2025, AI will eliminate more than 85 million jobs.
But for all the talk about job security, AI is also proving to be a powerful tool in healthcare—specifically, cancer detection. One recently published study has shown that, remarkably, artificial intelligence was able to detect 20 percent more cancers in imaging scans than radiologists alone.
Published in The Lancet Oncology, the study analyzed the scans of 80,000 Swedish women with a moderate hereditary risk of breast cancer who had undergone a mammogram between April 2021 and July 2022. Half of these scans were read by AI and then a radiologist to double-check the findings. The second group of scans was read by two researchers without the help of AI. (Currently, the standard of care across Europe is to have two radiologists analyze a scan before diagnosing a patient with breast cancer.)
The study showed that the AI group detected cancer in 6 out of every 1,000 scans, while the radiologists detected cancer in 5 per 1,000 scans. In other words, AI found 20 percent more cancers than the highly-trained radiologists.
Scientists have been using MRI images (like the ones pictured here) to train artificial intelligence to detect cancers earlier and with more accuracy. Here, MIT's AI system, MIRAI, looks for patterns in a patient's mammograms to detect breast cancer earlier than ever before. news.mit.edu
But even though the AI was better able to pinpoint cancer on an image, it doesn’t mean radiologists will soon be out of a job. Dr. Laura Heacock, a breast radiologist at NYU, said in an interview with CNN that radiologists do much more than simply screening mammograms, and that even well-trained technology can make errors. “These tools work best when paired with highly-trained radiologists who make the final call on your mammogram. Think of it as a tool like a stethoscope for a cardiologist.”
AI is still an emerging technology, but more and more doctors are using them to detect different cancers. For example, researchers at MIT have developed a program called MIRAI, which looks at patterns in patient mammograms across a series of scans and uses an algorithm to model a patient's risk of developing breast cancer over time. The program was "trained" with more than 200,000 breast imaging scans from Massachusetts General Hospital and has been tested on over 100,000 women in different hospitals across the world. According to MIT, MIRAI "has been shown to be more accurate in predicting the risk for developing breast cancer in the short term (over a 3-year period) compared to traditional tools." It has also been able to detect breast cancer up to five years before a patient receives a diagnosis.
The challenges for cancer-detecting AI tools now is not just accuracy. AI tools are also being challenged to perform consistently well across different ages, races, and breast density profiles, particularly given the increased risks that different women face. For example, Black women are 42 percent more likely than white women to die from breast cancer, despite having nearly the same rates of breast cancer as white women. Recently, an FDA-approved AI device for screening breast cancer has come under fire for wrongly detecting cancer in Black patients significantly more often than white patients.
As AI technology improves, radiologists will be able to accurately scan a more diverse set of patients at a larger volume than ever before, potentially saving more lives than ever.