Results for “human challenge” 150 found
A Systematic Review of Human Challenge Trials, Designs, and Safety
One of the most bizarre aspects of the COVID era was the institutional unwillingness to perform human challenge trials, which likely would have sped up vaccines and other treatments and saved lives. We let people join the military, indeed we advertise to encourage people to join the military, but for some reason running a human challenge trial is considered ethically fraught.
A new review find that HCTs are quite safe–more evidence that we have too few of these trials.
Human challenge trials (HCTs) are a clinical research method in which volunteers are exposed to a pathogen to derive scientifically useful information about the pathogen and/or an intervention [1]. Such trials have been conducted with ethical oversight since the development of the modern institutional review system of clinical trials in the 1970s. More recently, there has been renewed discussion about the ethical and practical aspects of conducting HCTs, largely fueled by interest in conducting HCTs for severe acute respiratory syndrome coronavirus 2. Past reviews of HCTs focused on reporting methods [2] and safety for single pathogens [3–6], but these did not explicitly evaluate the safety of HCTs by assessing reported adverse events (AEs) and serious adverse events (SAEs) across a range of pathogens. Furthermore, many additional HCTs have been performed since the publication of these reviews. To better inform discussions about future uses of HCTs, including during pandemic response, this article presents a systematic review of challenge trials since 1980 and reports on their clinical outcomes, with particular focus on risk of AEs and risk mitigation strategies.
Hat tip: Alec Stapp.
The Strange Death of Human Challenge Trials
A good post at the Effective Altruism Forum on all the stuff we could have done to stop the pandemic but didn’t:
Probably the biggest mistake was not intentionally infecting vaccinated volunteers. This could be done in 1 month, vs 6.5 months for the ecological trials that the entire world did out of misguided PR ethics. (2.5 is probably more realistic given signups, approvals, and big pharma’s slow data analysis and reporting. That’s still hundreds of thousands of lives.)
1DaySooner wrote a letter. The world’s foremost consequentialist signed. The world’s foremost deontologist signed. Two of the most prominent bioethicists in the world signed. 15 Nobelists signed. Dozens of philosophers who otherwise agree on extremely little signed. But they’re unethical.
Rarely do I so strongly feel the boot of others on my neck, and humanity’s neck.
The one distinctively courageous thing about the UK – the human challenge trials which got 40,000 volunteers – actually eventually started!.. In January 2021, with n=90.
I am extremely puzzled why China or one of the other ahem non-individualist governments didn’t do these.
Lots more at the link.
The public is fine with Human Challenge Trials
A vaccine for COVID-19 is urgently needed. Several vaccine trial designs may significantly accelerate vaccine testing and approval, but also increase risks to human subjects. Concerns about whether the public would see such designs as ethically acceptable represent an important roadblock to their implementation, and the World Health Organization has called for consulting the public regarding them. Here we present results from a pre-registered cross-national survey (n= 5; 920) of individuals in Australia, Canada, Hong Kong, New Zealand, South Africa, Singapore, the United Kingdom, and the United States. The survey asked respondents whether they would prefer scientists to conduct traditional trials or one of two accelerated designs: a challenge trial or a trial integrating a Phase II safety and immunogenicity trial into a larger Phase III efficacy trial. We find broad majorities prefer for scientists to conduct challenge trials (75%, 95% CI: 73-76%) and integrated trials (63%, 95% CI: 61-65%) over standard trials. Even as respondents acknowledged the risks, they perceived both accelerated trials as similarly ethical to standard trial designs, and large majorities characterized them as “probably” or “definitely ethical” (72%, 95% CI:70-73% for challenge trials; 77%, 95% CI 75-78% for integrated trials). This high support is consistent across every geography and demographic subgroup we examined, including people of diverging political orientations and vulnerable populations such as the elderly, essential workers, and racial and ethnic minorities. These findings bolster the case for these accelerated designs and can help assuage concerns that they would undermine public trust in vaccines.
Here is the paper by David Broockman, et.al.
The NIH Should Run Human Challenge Trials for COVID
As I have been warning, social distancing measures are making it more difficult to test COVID vaccines even as the cost of COVID remains very high.
WashPost: The Oxford group earlier boasted that it had an 80 percent chance of developing an effective vaccine by September. Hill said the difficulty of testing the vaccine in Britain may mean there’s only a 50 percent chance of success within that time frame now.
The probability of an Oxford vaccine by September has fallen by 30 percentage points. Oxford isn’t the only vaccine and we may be able to find clinical trial candidates in Brazil and the United States where infections continue to occur. So let’s be generous and convert this into say a 10% increase in a one month’s delay of any vaccine. The world economy is losing $375 billion a month so this means we have lost an expected $37.5 billion. That number highlights why we should be willing to pay large sums to speed vaccines and it also indicates the immense value of human challenge trials.
More than 28,000 people have already volunteered to be part of a challenge trial and if we paid a few hundred volunteers a million dollars each it would be worthwhile (and would surely increase the number of volunteers).
The main impediment to human challenge trials appears to be skittish firms rather than bureaucratic governments which is why challenge trials should test multiple vaccines under the auspices of the NIH. The NIH umbrella can protect the firms and increase the efficiency of the trials.
Addendum: China is adopting a bold approach. We used to be bold. Apathy is killing us.
Vaccine Testing May Fail Without Human Challenge Trials
In Why Human Challenge Trials Will Be Necessary to Get a Coronavirus Vaccine I asked, “What if we develop a vaccine for COVID-19 but can’t find enough patients–healthy yet who might get sick–to run a randomized clinical trial?” Exactly that problem is now facing the Oxford vaccine in Britain.
An Oxford University vaccine trial has only a 50 per cent chance of success because coronavirus is fading so rapidly in Britain, a project co-leader has warned.
…Hill said that of 10,000 people recruited to test the vaccine in the coming weeks — some of whom will be given a placebo — he expected fewer than 50 people to catch the virus. If fewer than 20 test positive, then the results might be useless, he warned.
As I wrote, “A low infection rate is great, unless you want to properly test a vaccine.” Challenge trials have issues of external validity and they take time to setup properly but they produce results quickly and they can be especially useful in whittling down vaccine candidates to focus on the best candidates.
1DaySooner now has over 25 thousand volunteers from over 100 countries.
Human Challenge Trials
What if we develop a vaccine for COVID-19 but can’t find enough patients to run a randomized clinical trial? It sounds absurd, but this problem has happened in the past. Ebola was identified in 1976, and candidate vaccines were proven safe and effective in mice and primates in 2004 and 2005, respectively. But no human vaccine was produced [at that time] because it was extremely difficult, bordering on impossible, to trial an Ebola vaccine. The problem? Ebola is so deadly that people take precautionary measures long before a vaccine can be tested.
A few pieces have been written about human challenge trials, clinical trials in which healthy people are infected with a disease in order to see if a treatment or vaccine works, but most of them focus on the ethical issues. I don’t think there are serious ethical issues so writing at The National Interest I focus on why challenge trials are useful statistically and why they may even be necessary.
Even health care workers, however, have a low enough infection rate that you either need many months to determine if there is a significant effect, or you need large populations. In Italy, about 6,000 doctors were infected over two months, out of a population of about 241,000 Italian doctors. This is a monthly infection rate of 1.2 percent. If the vaccine is 50 percent effective, then to detect this within a month, you need a sample size of 7,776 people equally divided between a vaccinated group and a non-vaccinated group. You could run the test in a smaller sample of 1,322 but then the trial would take six months. A more effective vaccine would make detecting an effect easier, but flu vaccines work at 40 to 60 percent effectiveness, so an assumption of 50 percent is not unreasonable.
But will Italian doctors still be getting infected at a rate of 1.2 percent per month when a vaccine becomes available for trial in six months or a year? We hope not. The hope is that social distancing and the use of personal protective equipment will have greatly lowered the infection rate. A low infection rate is great, unless you want to properly test a vaccine.
…The virtue of a challenge trial is that the results would be available very quickly, within a few weeks, and using only a small population. If the vaccine is 50 percent effective, for example, then we would need around 100 volunteers or perhaps even fewer depending on how many people exposed to the virus in laboratory conditions contract the disease.
By advancing a vaccine by many months, a challenge trial could save many thousands of lives and spare the world the huge economic costs of the lockdowns and social distancing that we will be using to combat the virus.
Challenge trials, however, don’t solve all problems. In particular, to limit the risk we would want to restrict the patients in a challenge trial to be young and healthy. But that raises a problem of external validity. We also want the vaccine to be safe and effective in less healthy and elderly people which requires secondary challenge trials or field testing in that population. Nevertheless, as Athey, Kremer, Synder and myself argue in our NYTimes op-ed, the high risk of vaccine failure means that we would like 15-20 vaccine candidates and challenge trials could help us whittle this number down to the best two to three substantially speeding up the vaccine discovery process.
One more point is worth bearing in mind.
[A]n ordinary vaccine trial is not without risk—a vaccine could backfire and make the disease worse—so exposing fifty or so volunteers to the virus in a challenge trial must be balanced against exposing thousands to a potentially dangerous vaccine in an ordinary clinical trial.
Thus, the total risk may be lower with a combination of challenge trials and longer, larger field trials.
Challenge trials have a long history in medicine and their statistical advantages make them powerful and even necessary. As The Guardian notes:
Scientists, however, increasingly agree that such trials should be considered, and the WHO is the latest body to indicate conditional support for the idea.
“There’s this emerging consensus among everyone who has thought about this seriously,” said Prof Nir Eyal, the director of Rutgers University’s Center for Population-Level Bioethics in the US.
Human Challenge Trials for vaccines
From an anonymous reader:
As you are of course aware, testing on vaccines for Covid-19 are beginning to be undertaken. The scientific community has seemingly decided that Human Challenge Trials (HCT) where test subjects are directly exposed to the virus following vaccination are unethical, instead using the typical protocol of vaccine/placebo inoculation followed by months of observation in order to observe effectiveness. This seems to me a grave moral error based on the following argument.
1) There exists a large cohort of young, healthy, fully informed, willing participants who would undergo HCT.
2) Given the mortality profile of this disease, these participants would be undertaking an exceptionally small mortality risk (perhaps 5-10 per 100k, based on data from Spain/Italy/NYC, assuming zero vaccine effectiveness).
3) Society deems acceptable other activities with much higher fatality risk (at least 5-10x) in both professional (soldiers, logging workers) and recreational (motorcycling, mountaineering) capacities.
4) HCT would speed up the vaccine testing process by many months, saving tens of thousands of lives and avoiding enormous economic damage.
5) HCT actually poses significantly less risk to participants in terms of allergic reaction or ADE risk compared to a standard testing protocol since the number of participants could be much smaller and they would be medically observed.
I fail to find any ethical justification for the current stance of the medical community, from either a utilitarian or deontological perspective, and believe a highly consequential error is being made. This error may be based on false analogies to past unethical testing practices in history where participants were not informed or willing and danger was significant. The current case bears no ethical resemblance, in my judgement, to these past cases.
The simplest model of such errors is that many members of the biomedical establishment do not wish to have bad feelings about any “sins of commission” and to see their status lowered as a result of “dirty hands,” and the readily criticized logistics of Human Challenge Trials. Since HCTs do not “feel right” to them, they self-deceive into associating that feeling with a concern for the greater public good.
You should not be surprised to see grave moral errors committed in a crisis, however. Our “mainstream” protection against grave moral errors, in normal circumstances, simply is that usually we are not given the opportunity to commit them.
I do understand that a Human Challenge Trial does not necessarily suffice to show that a given vaccine is safe. Nonetheless it should be in the “armor of our discourse,” so to speak, as a morally acceptable alternative. So if you are a biomedical professional, or a public intellectual, I hope you will speak up.
Here is a Matt Yglesias piece on the urgency of developing a vaccine as quickly as possible. Eric Weinstein notes that women risk their lives every time they proceed with having children.
Existential risk, AI, and the inevitable turn in human history
In several of my books and many of my talks, I take great care to spell out just how special recent times have been, for most Americans at least. For my entire life, and a bit more, there have been two essential features of the basic landscape:
1. American hegemony over much of the world, and relative physical safety for Americans.
2. An absence of truly radical technological change.
Unless you are very old, old enough to have taken in some of WWII, or were drafted into Korea or Vietnam, probably those features describe your entire life as well.
In other words, virtually all of us have been living in a bubble “outside of history.”
Now, circa 2023, at least one of those assumptions is going to unravel, namely #2. AI represents a truly major, transformational technological advance. Biomedicine might too, but for this post I’ll stick to the AI topic, as I wish to consider existential risk.
#1 might unravel soon as well, depending how Ukraine and Taiwan fare. It is fair to say we don’t know, nonetheless #1 also is under increasing strain.
Hardly anyone you know, including yourself, is prepared to live in actual “moving” history. It will panic many of us, disorient the rest of us, and cause great upheavals in our fortunes, both good and bad. In my view the good will considerably outweigh the bad (at least from losing #2, not #1), but I do understand that the absolute quantity of the bad disruptions will be high.
I am reminded of the advent of the printing press, after Gutenberg. Of course the press brought an immense amount of good, enabling the scientific and industrial revolutions, among many other benefits. But it also created writings by Lenin, Hitler, and Mao’s Red Book. It is a moot point whether you can “blame” those on the printing press, nonetheless the press brought (in combination with some other innovations) a remarkable amount of true, moving history. How about the Wars of Religion and the bloody 17th century to boot? Still, if you were redoing world history you would take the printing press in a heartbeat. Who needs poverty, squalor, and recurrences of Ghenghis Khan-like figures?
But since we are not used to living in moving history, and indeed most of us are psychologically unable to truly imagine living in moving history, all these new AI developments pose a great conundrum. We don’t know how to respond psychologically, or for that matter substantively. And just about all of the responses I am seeing I interpret as “copes,” whether from the optimists, the pessimists, or the extreme pessimists (e.g., Eliezer). No matter how positive or negative the overall calculus of cost and benefit, AI is very likely to overturn most of our apple carts, most of all for the so-called chattering classes.
The reality is that no one at the beginning of the printing press had any real idea of the changes it would bring. No one at the beginning of the fossil fuel era had much of an idea of the changes it would bring. No one is good at predicting the longer-term or even medium-term outcomes of these radical technological changes (we can do the short term, albeit imperfectly). No one. Not you, not Eliezer, not Sam Altman, and not your next door neighbor.
How well did people predict the final impacts of the printing press? How well did people predict the final impacts of fire? We even have an expression “playing with fire.” Yet it is, on net, a good thing we proceeded with the deployment of fire (“Fire? You can’t do that! Everything will burn! You can kill people with fire! All of them! What if someone yells “fire” in a crowded theater!?”).
So when people predict a high degree of existential risk from AGI, I don’t actually think “arguing back” on their chosen terms is the correct response. Radical agnosticism is the correct response, where all specific scenarios are pretty unlikely. Nonetheless I am still for people doing constructive work on the problem of alignment, just as we do with all other technologies, to improve them. I have even funded some of this work through Emergent Ventures.
I am a bit distressed each time I read an account of a person “arguing himself” or “arguing herself” into existential risk from AI being a major concern. No one can foresee those futures! Once you keep up the arguing, you also are talking yourself into an illusion of predictability. Since it is easier to destroy than create, once you start considering the future in a tabula rasa way, the longer you talk about it, the more pessimistic you will become. It will be harder and harder to see how everything hangs together, whereas the argument that destruction is imminent is easy by comparison. The case for destruction is so much more readily articulable — “boom!” Yet at some point your inner Hayekian (Popperian?) has to take over and pull you away from those concerns. (Especially when you hear a nine-part argument based upon eight new conceptual categories that were first discussed on LessWrong eleven years ago.) Existential risk from AI is indeed a distant possibility, just like every other future you might be trying to imagine. All the possibilities are distant, I cannot stress that enough. The mere fact that AGI risk can be put on a par with those other also distant possibilities simply should not impress you very much.
Given this radical uncertainty, you still might ask whether we should halt or slow down AI advances. “Would you step into a plane if you had radical uncertainty as to whether it could land safely?” I hear some of you saying.
I would put it this way. Our previous stasis, as represented by my #1 and #2, is going to end anyway. We are going to face that radical uncertainty anyway. And probably pretty soon. So there is no “ongoing stasis” option on the table.
I find this reframing helps me come to terms with current AI developments. The question is no longer “go ahead?” but rather “given that we are going ahead with something (if only chaos) and leaving the stasis anyway, do we at least get something for our trouble?” And believe me, if we do nothing yes we will re-enter living history and quite possibly get nothing in return for our trouble.
With AI, do we get positives? Absolutely, there can be immense benefits from making intelligence more freely available. It also can help us deal with other existential risks. Importantly, AI offers the potential promise of extending American hegemony just a bit more, a factor of critical importance, as Americans are right now the AI leaders. And should we wait, and get a “more Chinese” version of the alignment problem? I just don’t see the case for that, and no I really don’t think any international cooperation options are on the table. We can’t even resurrect WTO or make the UN work or stop the Ukraine war.
Besides, what kind of civilization is it that turns away from the challenge of dealing with more…intelligence? That has not the self-confidence to confidently confront a big dose of more intelligence? Dare I wonder if such societies might not perish under their current watch, with or without AI? Do you really want to press the button, giving us that kind of American civilization?
So we should take the plunge. If someone is obsessively arguing about the details of AI technology today, and the arguments on LessWrong from eleven years ago, they won’t see this. Don’t be suckered into taking their bait. The longer a historical perspective you take, the more obvious this point will be. We should take the plunge. We already have taken the plunge. We designed/tolerated our decentralized society so we could take the plunge.
See you all on the other side.
Why Artificial Intelligence Increases the Importance of Humans in War
Recent scholarship on artificial intelligence (AI) and international security focuses on the political and ethical consequences of replacing human warriors with machines. Yet AI is not a simple substitute for human decision-making. The advances in commercial machine learning that are reducing the costs of statistical prediction are simultaneously increasing the value of data (which enable prediction) and judgment (which determines why prediction matters). But these key complements—quality data and clear judgment—may not be present, or present to the same degree, in the uncertain and conflictual business of war. This has two important strategic implications. First, military organizations that adopt AI will tend to become more complex to accommodate the challenges of data and judgment across a variety of decision-making tasks. Second, data and judgment will tend to become attractive targets in strategic competition. As a result, conflicts involving AI complements are likely to unfold very differently than visions of AI substitution would suggest. Rather than rapid robotic wars and decisive shifts in military power, AI-enabled conflict will likely involve significant uncertainty, organizational friction, and chronic controversy. Greater military reliance on AI will therefore make the human element in war even more important, not less.
That is from a new paper by Avi Goldfarb and Jon R. Lindsay, via the excellent Kevin Lewis.
Comparing dogs and wolves, with reference to human self-domestication
Based on claims that dogs are less aggressive and show more sophisticated socio-cognitive skills compared with wolves, dog domestication has been invoked to support the idea that humans underwent a similar ‘self-domestication’ process. Here, we review studies on wolf–dog differences and conclude that results do not support such claims: dogs do not show increased socio-cognitive skills and they are not less aggressive than wolves. Rather, compared with wolves, dogs seek to avoid conflicts, specifically with higher ranking conspecifics and humans, and might have an increased inclination to follow rules, making them amenable social partners. These conclusions challenge the suitability of dog domestication as a model for human social evolution and suggest that dogs need to be acknowledged as animals adapted to a specific socio-ecological niche as well as being shaped by human selection for specific traits.
That is from a new article by Friederike Range and Sarah Marshall-Pescini, via Michelle Dawson.
Challenge Trials in Britain!
London is to host the world’s first Covid-19 human challenge trials — in which healthy volunteers are deliberately infected with coronavirus to assess the effectiveness of experimental vaccines. The UK government-funded studies are expected to begin in January at a secure quarantine facility in east London, according to several people involved in the project, which will be announced next week.
…The project’s academic leader is Imperial College London, and it will be run by hVivo, a spinout from Queen Mary University of London that was bought earlier this year by Open Orphan, a Dublin-based pharmaceutical research organisation.
…The petition organiser of 1Day Sooner in the UK is 18-year-old Alastair Fraser-Urquhart who is devoting his time to the campaign before going to University College London to study cancer biology next year.
All hail Alastair Fraser-Urquhart!
This part enraged me:
The NIH is also investigating the technical and ethical requirements for challenge trials. But Nadine Rouphael, a leading vaccine researcher at Emory University in Atlanta and one of several scientists who are keen to carry out challenge studies in the US, said: “There is no urgency at NIH. The UK is well ahead — and that’s great.”
No urgency!!! I raised challenge trials with the administration in April.
Addendum: Previous MR posts on challenge trials. And here is the UK petition and the Canadian petition from 1daysooner.
Failing the Challenge
CNN says “In one word, this is why there likely won’t be a vaccine available before Election Day: biology.” Wrong. The one word is complacency. What CNN refers to as biology is the time it takes to run clinical trials.
Here’s how the trials work: You take 30,000 people, give half of them a vaccine and half of them a placebo, which is a shot of saline that does nothing. Then those 30,000 people go about their lives, and you wait to see how many in each group become infected and sick with Covid-19, the “endpoint” in medical parlance.
That waiting takes time, especially since the coronavirus vaccines currently being studied in the US are two-dose vaccines with each dose several weeks apart.
But it gets worse because trial volunteers are not random:
“Who’s in the trials – the kind of people who tend to stay at home or the kind of people who attended the Sturgis rally?” said John Moore, an immunologist at Weill Cornell Medicine, referring to a motorcycle rally in South Dakota that led to at least dozens of cases of Covid-19.
Historical precedent, as well as the demographics of the participants in the current coronavirus vaccine trials, suggest more the stay-at-home type.
That does not bode well for bringing the trials to a speedy conclusion.
Typically, those who volunteer for clinical trials tend to be “White, college-educated women,” said Frenck, who has been the principal investigator on dozens of vaccine clinical trials, and has served on the Data and Safety Monitoring Board for many others.
All three of those factors are potentially bad news for the coronavirus clinical trials, because data indicates White college-educated women are at lower risk for being exposed to the novel coronavirus.
None of this, however, is actually about biology. It’s about complacency. We could have run human challenge trials and paid for diverse volunteers but we decided that was too risky or too new or too radical or too something and so thousands of people die every week as we wait.
Addendum: Previous posts on challenge trials.
Oxford’s Jenner Institute to Prepare for Challenge Trials for COVID-19
I am one of the signatories to an open letter from 1DaySooner on challenge trials sent to Dr. Francis Collins at NIH. A major development announced with the letter is that 1Day Sooner and Oxford’s Jenner Institute are collaborating to prepare viral production for use in challenge trials.The Jenner Institute is the creator of the AstraZeneca produced vaccine, the vaccine farthest along in development.
A key goal of the letter is to encourage the NIH to start its own preparation for challenge trials:
The undersigned urge the U.S. government…its allies, international funders, and world bodies (e.g. the World Health Organization), to undertake immediate preparations for human challenge trials, including supporting safe and reliable production of the virus and any biocontainment facilities necessary to house participants.
Among the signatories are 15 Nobel prize winners including Oliver Hart and Al Roth, Molecular geneticist Mario Capecchi, professor of medicine William G. Kaelin and physician Barry Marshall (who knows a thing or two about volunteer trials.)
As I discussed earlier, since challenge trials restrict the volunteers to be young and healthy, you can’t apply their results directly to the sick and elderly (the external validity problem) but “challenge trials could help us whittle down [candidate vaccines]… to the best two to three, substantially speeding up the vaccine discovery process.” You could also use challenge trials to help figure out the right dosing which is unusually important in the current situation because if a vaccine can work with .5ml instead of 1ml that’s equivalent to doubling the available supply. The Director of the Jenner Institute, Adrian Hill, agrees writing:
We see considerable potential in the use of human challenge studies to accelerate COVID-19 vaccine development, down-select and help validate the best candidate vaccines, and optimise vaccination approaches.
You can read the whole letter here.
Can We Network (and Augment) the Human Brain?
How realistic is it to directly send data in and out of the brain? That is the core scientific innovation underlying my novels. From a longer piece in which I discuss neurotechnology. (The Ultimate Interface: Your Brain):
Neural implants could accomplish things no external interface could: Virtual and augmented reality with all 5 senses (or more); augmentation of human memory, attention, and learning speed; even multi-sense telepathy — sharing what we see, hear, touch, and even perhaps what we think and feel with others.
What’s actually been done in humans?
In clinical trials today there are brain implants that have given men and women control of robot hands and fingers. [..] More radical technologies have sent vision straight into the brain. And recently, brain scanners have succeeded in deciphering what we’re looking at.
In animals, we’ve boosted cognitive performance:
In rats, we’ve restored damaged memories via a ‘hippocampus chip’ implanted in the brain. Human trials are starting this year. [..] This chip can actually improve memory. And researchers can capture the neural trace of an experience, record it, and play it back any time they want later on.
In monkeys, we’ve done better, using a brain implant to “boost monkey IQ” in pattern matching tests.
The real challenges remain hardware and brain surgery:
getting even 256 channels in generally requires invasive brain surgery, with its costs, healing time, and the very real risk that something will go wrong. That’s a huge impediment, making neural interfaces only viable for people who have a huge amount to gain, such as those who’ve been paralyzed or suffered brain damage.
Quite a bit of R&D is going into solving those hardware and surgery problems:
Researchers across the world, many funded by DARPA, are working to radically improve the interface hardware, boosting the number of neurons it can connect to (and thus making it smoother, higher resolution, and more precise), and making it far easier to implant. They’ve shown recently that carbon nanotubes, a thousand times thinner than current electrodes, have huge advantages for brain interfaces. They’re working on silk-substrate interfaces that melt into the brain. Researchers at Berkeley have a proposal for neural dust that would be sprinkled across your brain.
You can read the whole thing here:The Ultimate Interface: Your Brain.
The Toilet Challenge
In our textbook, Modern Principles, Tyler and I write:
In the United States, diarrhea is a pain, an annoyance, and of course an embarrassment. In much of the developing world, diarrhea is a killer, especially of children. Every year 1.8 million children die from diarrhea. To prevent the deaths of these children we do not need any scientific breakthroughs, nor do we need new drugs or fancy medical devices. What these children need most is one thing: economic growth.
Economic growth brings piped water and flush toilets, which together cut infant mortality from diarrhea by 70 percent or more.
Bill Gates and the Gates Foundation think that some scientific breakthroughs are needed and they are putting millions into the Toilet Challenge a new project to build a better toilet.
“No innovation in the past 200 years has done more to save lives and improve health than the sanitation revolution triggered by invention of the toilet,” Sylvia Mathews Burwell, president of the foundation’s global development program, said in a statement. “But it did not go far enough. It only reached one-third of the world. What we need are new approaches. New ideas. In short, we need to reinvent the toilet.”
So what is wrong with the current commode?
It’s too expensive for people in the developing world; it requires water and a sewer-system hook-up, which aren’t always available; and it does nothing to actually treat human waste, said Frank Rijsberman, the foundation’s director of water sanitation and hygiene.
Gates is to be credited with taking on an important and unsung task. Some of the ideas he has spent money on, however, seem to be highly unrealistic. Consider:
Professor Georgios Stefanidis and his team at Delft University of Technology propose to develop a toilet system that will apply microwave technology to transform human waste into electricity. The waste will be gasified using plasma, which is created by microwaves in tailor-made equipment. This process will yield syngas, a mixture of carbon monoxide (CO) and hydrogen (H2). The syngas will then be fed to a solid oxide fuel cell stack for electricity generation. This toilet system will be able to serve single households or groups of households.
My rule is that any society capable of managing and maintaining such a system will already have flush toilets (either that or they live on the space station).