Brain Downloads for the Future?

A warm hearted congratulations to the consortia of the Human Brain Project, having won the highly sought after €1 billion from the EU as a flagship project.  Of course the task is to say the least, monumental; mapping the anatomy itself will be challenging, but the physiology is a completely new dimension; given that we are still learning how to define physiological processes in terms of mathematics.  Nevertheless, despite these challenges, the virtual brain offers possibilities when realised.  If a person's functional brain is successfully regenerated on computer so that the computer could run a simulation of the brain that is very faithful to the real person's, then in theory, this offers the intriguing possibility of Whole Brain Emulation or 'mind transfer', where the person's brain is preserved on a computing device so that if the real brain is either irreversibly damaged or the person died, the copy of the brain on computer could be downloaded..  Does this open the prospect of a form of quasi-immortality?  Big idea for a big project....

How Do We Make a Digital Patient?

Following the recent Second Consultation Meeting in Barcelona (see blog from 20 November 2012) and all the material that was gathered regarding the scientific and technical challenges that needed to be overcome in other to 'make' a Digital Patient, the next logical question is.'How do we overcome these challenges to make the Digital Patient?'  The first step to answering this question is writing a roadmap that will guide future research projects that will eventually answer the question.  Sounds like something out of a politician, doesn't it?  That's because some of the knowledge that will enable the question of how we make the Digital Patient to be answered, is still unknown.  It could well be that no new physics is required, but we are clearly incapable of delivering the Digital Patient at this point in time.  A focused look at the problem in the form of a roadmap is the prescription for our Digital Patient.  This roadmap will be written by an international team of experts.and is due to be completed in March/April 2013.

An 'Intelligent' Digital Patient

This month sees an important event in the journey towards the goal of realising the Digital Patient.  The Second Consultation Meeting on 26 and 27 November 2012 in Barcelona will attempt to identify the scientific and technical challenges that need to be overcome for that realisation to occur.  Perhaps the most difficult challenge to overcome will be that of artificial intelligence where the Digital Patient computer program 'learns' and acquires 'experience' from previous simulations, enabling it to arrive at the correct prediction a lot sooner with less input information over the coming years from its creation.  Inductive reasoning is the basis for computer 'learning', and in the journal, Artificial Intelligence, Ontañón and coworkers, using a technique called mathematical proofs, show that a subtype of inductive reasoning called inductive concept learning (ICL) is a form of defeasible reasoning (i.e., reasoning that is open to revision and questioning - a key property in intellectual thought that is not present in algorithmic execution).  Although the tasks illustrated in this article are relatively simple, the mathematics that Ontañón and coworkers produce in making the execution of the tasks by the computer program appear intelligent and thoughtful, are impressively complicated.  It will be interesting to see how their work converges with the Digital Patient program over the coming years.

The Digital Patient and the Law

A perplexing aspect of the Digital Patient is how the Law will affect it.  Remember that the digital patient will effectively be "you living in a computer".  However, unlike real life you, which is made up of cells and molecules, your digital you, will be made up of "noughts and ones".  These noughts and ones otherwise known as "bits" in computer terminology (8 bits = 1 byte), will form (using mathematical calculations) a pattern unique to you (based on your appearance) that will generate not just your full body avatar (or other variants of your avatar), but come as close as possible to mimicking the physiological processes (based on your medical data) that make you... you.  The law can affect this digital you, in three ways: First, and this will certainly be the case initially, the digital patient is no more than a form of medical data; this means that the laws governing confidentiality will equally apply here.  However, there is a second and more intriguing possibility, and that is laws that govern how the digital patient avatar interacts with real life people either directly or indirectly through their properties.  Professor Joshua Fairfield of Washington and Lee University School of Law wrote a fascinating and thought-provoking article in UC Irvine Law Review 2012;2:695-772.  In Fairfield's article titled "Avatar Experimentation: Human Subjects Research in Virtual Worlds", he argues that avatars (he was referring to video game avatars, but his thoughts on this equally apply to medical avatars) can cause real harm to real life people and their properties (think viruses and Trojans).  Fairfield continues by saying that social networks have now become so intertwined with virtual worlds that harm to the virtual aspect of a person is increasingly indistinguishable from harm to the real life aspect of the same person.  Could the Digital Patient be used in this way?  This leads to the third area involving the Digital Patient and the Law, and this regards copyright and ownership of your digital you - in most cases, your real you, will not own your digital you.  The latter will be owned by the people that developed the computer program that enabled that program to generate your digital you.  The law is quite clear on copyrighted products (which is what your digital you will be), but it also brings home the point that there could be several versions of your digital you, one per computer program (capable of generating a digital you) and even one per hospital.  How do you choose which version of your digital you, most accurately reflects the real you, and should you seek legal redress, if one version of your digital self (in or from one hospital), gets one aspect of yourself wrong causing serious harm to you?  These issues will affect all of us when the Digital Patient is finally realised, and will walk hand-in-hand, with the potential good that this remarkable technology will bring.

Exercise Video Game: A Future Digital Patient?

The most difficult task of the roadmap for the digital patient currently being built is trying to ascertain what technologies will be required to make the digital patient happen.  This month saw the circulation of a questionnaire to industry and academia by DISCIPULUS (the European Commission project tasked with building the digital patient roadmap).  The questionnaire contains general questions, scenario-stimulated questions, and technology-stimulated questions.  The technology-stimulated questions start with a known technology with the aim of sparking people's imagination.  The exercise video game (or 'exergame') has been identified as one such technology that could spark imagination into a future digital patient prototype.  Exergames already have many of the features that will have to appear in the digital patient program: avatar generation, real-time feedback, basic personal information such as identity, body mass index (BMI) and heart rate.  Exergames have also been scrutinised in clinical trials and published in journals such as the BMJ 2007;335:1282-4 and Am J Clin Nutr 2011;94:156-63.  These trials show that exercise video games do in fact have a beneficial health effect compared to non-exercise video games, but not as good as actual exercise itself.  What subpopulation could exergames really be of benefit to?  If such a population could be identified and exergames can already monitor your heart rate, combined with information on your calorie burn, could they be given multiple levels of calorie burn monitoring, from total burn to more specific burn such as glucose utilisation?  If glucose utilisation monitoring bacame possible in exergames, could that be extended to diabetes modelling?  If diabetes modelling in turn, became possible in exercise video games, why not include the modelling of some of the complications of diabetes?  This "bottom-up" approach has proved hugely successful for the Apple Mac franchise, and such approach is being explored for the roadmap.

3D Scanning App for the iPhone

One article from the online science and technology news, Singularity Hub, of significance to the future digital patient caught our attention this month (15th) - a 3D scanning app for the iPhone.  Although the real cleverness of the digital patient will lie in its potential for high performance computing, for most of the public however, it will only really be appreciated in its visuals and accessibility.  These two points are crucial if the program is to get widespread uptake (as was the case with PCs).  3D scanning is of course, one of the core component technologies that the digital patient program will have to have, but today, it is still very much a "professional's art" (partly because of the price).  However, as 3D scanning comes down to iPhones (and presumably, it's only a matter of time before the technology makes it to android devices), the price is surely going to come down and accessibility will conversely go up.

A Spray Device for Damaged Heart

Mechanical engineer, Dr Suwan Jajasinghe at UCL, has developed a spray device that can deliver viable heart cells to a damaged heart.  To control the movement of the cells through the spray needle, 10 000 volts of electricity are applied.  According to the British Heart Foundation, the hope is that this device could find application in conditions that destroy heart tissue such as myocardial infarction (heart attack).  The next major milestone for this device would be clinical trials.