“If you want to predict the future, build it.” This could be a quote from a science fiction film, but they are, in fact, the words of boundary-pushing technology entrepreneur Michael Lin. He is not alone in big, bold, and progressive proclamations directed towards a future not born from technology but with technology.

The Millennial Manifesto, created by the Global Shapers Community, states, “We will listen and learn from one another – past, present, and future. We will respect the global context and that all parts of the world co-exist. We will test, iterate, and Boost our approach to become better leaders and ancestors. We will ask big questions to advance bold solutions.”

Entrusting youth with technology growth is significant, according to a Berkman Klein Center at Harvard University report in 2019 titled "Youth and Artificial Intelligence: Where We Stand." Part of the conclusion suggests, “Youths need to be empowered to become designers of the digital future. Failing to do so means neglecting to cultivate a generation of stewards of future technology.”

Barry Chudakov, founder and principal at Sertain Research, describes the new frontier of limitless creative opportunity. “Taking and evolving simulation and virtual representation from the gaming world, digital spaces will morph from apps and social media platforms into mirror worlds – the metaverse and ‘the third platform,’ which will digitize the rest of the world,” he says. “All things and places will be machine-readable, subject to the power of algorithms.”

These so-called algorithms altering the course of our present and future also include elements of gameplay and character development best expressed by the anime sector.

Anime Industry

The anime industry is doubling at an eye-watering pace. Worth over $26 billion in 2022, it is projected to increase to $56 billion in 2030. Lin’s work brings anime characters and others into the third dimension, with nothing more needed than a phone and the ability to stream. A desire to interact with characters in real time has led to the potential to revolutionize medical exams, elderly care, and suicide prevention at universities.

Lin grew up playing video games and watching anime, specifically Pokemon. Like many from the Pokemon craze, Lin’s involvement centered on the characters. “My dream was to one day interact with these virtual entities. Whether through games, comic books, or novels, characters we connect with can have a big impact on us,” says Lin.

Lin was at The University of Southern California (USC) for one semester before transferring to Cambridge University in the U.K. to complete his bachelor’s and master’s degrees. During these formative collegiate experiences, Lin confronted the bounds of his creativity and tolerance for shame.

“In school, I played with the idea of bringing virtual characters to life. Users of the program had to wear a camera on their heads as a prototype. My peers and professors laughed, but I knew I was on to something,” says Lin.

The Oculus launched the year that Lin left the University of Southern California (USC) for Cambridge.

“It was an exciting time in the AI industry, so I wanted to be a part of it. I joined Magic Leap and developed our first game, ‘Wonder X,’” says Lin.

The effort was self-funded and served as the opening act of what is now Wonderverse, a part of Wonders.ai. “We experimented with humans interacting with full-size virtual characters.,” he adds.

After two years of research and development integrating humans with full-size virtual characters, Wonderverse launches this year. It is a mobile platform that allows users to interface with characters. Lin is partnering with v-tuber (virtual tubers) agencies and slowly releasing the technology behind the platform.

V-Tube Traction

The v-tuber trend continues to gain steam from a faction of fans between YouTube and Twitch. In short, v-tubers play video games with the illusion of a character. A real person is behind a virtual mask controlling gameplay, giving the audience the illusion that a character is playing the game.

To this point in the evolution of technology, v-tubers compete with each other through creative content that is short on quantity providing an opening for Lin and his venture. “They [gamers] are creatively bankrupt, limited by working in two dimensions, and that is where we come in,” smiles Lin.

The Wonderverse allows v-tubers to generate new types of streaming content, whether augmented reality (AR) or virtual (VR). When they are not streaming, their followers can still interact with the clone Lin and his team created at any time of day. “The only technology a user needs is a phone,” says Lin.

Wonders.ai collaborated for a concert where v-tubers performed and sang for a virtual audience. Currently, guests look at a screen to see themselves interacting with the character, but next year AR glasses will change that, according to Lin. “They (guests) will be able to see the character before them just as if they were real.”

Education Sector

A deep curiosity for the subject of AI has driven Lin to expand beyond the initial and glitzy entertainment value of engaging popular characters into settings steeped in physical reality.

“I had to find an environment that could nurture that passion. Personally, I found the infrastructure of the educational system a challenge because it was hard to express my opinion and collaborate with like-minded people. But, I guess those challenges positively impact my current desire to support education as a sector,” shares Lin.

As EdTech continues to evolve and incorporate more digital and actively engaging experiences, so too has the official position of federal guideposts.

Part of the official statement by the Office of Educational Technology at the United States Department of Education (USDOE) reads, “AI, machine learning, and related technologies will have powerful impacts on learning not only through direct supports for students but also by empowering educators to be more adaptive to learner needs and less consumed by routine, repetitive tasks. The statement adds, “There is little question that we need innovative approaches in education and that AI will be a major new capability that allows innovation. Simply put, we will be able to do things that we have never done before!”

Lin has turned his focus on pre-kindergarten-age children of about 3-5 years old. For example, during the pandemic, when kids were stuck at home, and their parents were busy working, Lin partnered with a Taiwanese chain of kindergartens to provide a virtual character to dance with the children and teach them English.

Patents and Expansion

Patenting is an aspect of Lin’s pursuits. In addition to efforts to patent technologies in the education sector, Lin also has patents pending in the medical field. In medical training, doctors undergo an Objective Structured Clinical Examination (OSCE), where an actor pretends to be a patient, and the student evaluates their diagnosis and treatment. AI creates a virtual patient, which cuts costs by a third for universities. Early efforts aim to automate the evaluation process and Lin plans on being an early player.

The Taiwanese government shares a similar vision with Wonders.ai and Lin on solutions for the elderly in healthcare settings. The collaboration would implement systems that detect physical symptoms or movement problems and report them to the doctor, as well as provide a virtual connection with loved ones.

The argument of man vs. machine may have already been settled beyond the augmented environment of a schoolyard fight. Research denotes the sheer and almost complete assimilation between young people and smartphones, with findings suggesting that 95% of Millennials have smartphones.

Pew Research quotes Jerome Glenn, co-founder, and CEO of the Millennium Project, as someone firmly committed to the overlapping relationship between humans and technology.

“As humans and machines become linked more closely, the distinction between the two entities will blur. Conscious technology will force us to confront fundamental questions about life,” says Glenn.

Lin is of the generation that sees engaging and assistive applications of AI to support not just one generation but the entire lifespan, from kindergarten students to the elderly.

As Lin says, “If you want to predict the future, build it.” It sounds like construction has already begun.

Interviews have been edited and condensed for clarity.

As Valentine’s Day approaches, couples come together joyously, but for one unfortunate pair of lovers, the season marks an untimely demise to their passionate romance.

What happens when technology becomes more advanced than the technologist? Christopher Lafayette, founder of Gatherverse.org, posed the question at the end of his keynote address at the current IME West show in Anaheim, CA, stating that technology has caught up to the same intelligence level as the people creating it.

In his presentation, “Medical Technology within the Metaverse – The Fundamental Shift,” he discussed the current and future state of immersive medtech in the metaverse and what it means for vendors, technologists, and medical practitioners. The metaverse generally refers to the concept of a highly immersive virtual world where people gather to socialize, play, or work. In Lafayette’s opinion, however, the concept means so much more, and gained major awareness during the pandemic because of increased virtual use, telemedicine, demand for personal protection equipment, changes in hospital operations, diagnostic technologies like PCR and antigen tests, and investment in medtech.

The use of telemedine took off at the beginning of the pandemic because of state shutdowns and increased chances of contracting COVID-19. In fact, virtual medical appointments increased by more than 50% between February and March of 2020, according to the American Medical Association, and has stayed popular as an easy way to checkup without driving to the doctor’s office. The pandemic also caused shortages for PPE due to increased demand for masks and gowns, and hospitals were made to adapt and change operations to accommodate COVID-19 only units and increased patient volume. The worldwide virus resulted in major research developments for COVID-19 diagnostic testing and vaccines, and the World Health Organization reported that, as of January 2021, over 1.3 billion diagnostic tests have been shipped internationally. The many changes in the medical environment since 2020 have also skyrocketed investment in medtech, with StartUp Health reporting that global venture capital funding for digital health companies reached $7.4 billion in 2020, a record high for the industry.

Regulatory changes from the pandemic became the linchpin that accelerated development and use of technology for medtech, Lafayette said, noting that many countries loosened regulations to allow for faster development and use of new technologies.

The metaverse continues to be used in educational settings for medical professionals. Virtual reality has become a key part in teaching students about human anatomy without the need for cadavers. Additionally, VR surgical simulation has been seen to help students refine their skills and reduce errors that could negatively impact a patient. Apart from education, Lafayette discussed surgeons using the metaverse during operations, meaning a surgeon could be across the country or a world away from the OR yet still be controlling surgery through robotic assistance. VR specific technology has also been used to help patients overcome the fear of undergoing physical therapy and to Boost patient education through simulation exercises.

In the future, Lafayette described the potential of the metaverse in medicine through three categories: hospital simulations, hospital operations, and VR spaces.

For hospital simulation, he outlined different scenarios that could be used for teaching purposes or preparedness, including outbreak simulations, catastrophic conditions, tornados, hurricanes, earthquakes, floods, power outages, and riots. Hospital operations include active ER environments, active hospital environments, utility flow, and contamination. For VR spaces, he said to expect the use of holopods, holochambers, and holodecks as well as a telepresence, experimental treatments, surgery simulations, body examinations, and therapy rooms. In addition to virtual reality, he said augmented reality will be next to take over the space.

Cautioning the audience, Lafayette said that while there are many opportunities for the metaverse in medtech, developers and investors must understand the quickness of technology advancement and come to terms with the likelihood of a product or service becoming irrelevant after one to two years.

“We have to think differently when building in the metaverse,” he said.

Amidst what many experts are calling a "mental health crisis" in the U.S.¹ lurks a disturbing yet overlooked medical reality: For an increasing percentage of youth and adults, their mental health symptoms are being caused or worsened by underlying metabolic diseases.

With roughly 9 out of 10 U.S. adults suffering from one or more forms of metabolic impairment² and increasing evidence demonstrating a direct relationship between metabolic and mental function^3-4, psychologists, psychiatrists and their patients should now be routinely considering the possibility that cognitive and emotional symptoms may be at least partly the result of disease rather than depression, metabolic dysfunction rather than mental illness. For this large and growing population, unfortunately, neither increasing conventional mental health treatment access nor addressing social injustices will be a sufficient remedy. Their solution must include a focus on improving metabolic health.

If the link between your metabolic health and mental health is new to you or seems unclear, consider the following:

• At just three pounds, your brain accounts for up to 25% of your resting energy expenditure. Your brain is highly metabolically active.
• Psychological functions such as thinking, speaking, memory, and emotions place massive demands on the brain. Good mental health and resiliency require large amounts of brain energy to achieve and maintain.
• Because the brain is so energy intensive, even small deficits in energy metabolism cause problems. Two of the most common causes of metabolic dysfunction are hyperinsulinemia (excess insulin) and insulin resistance (impaired tissue response to insulin).
• The presence of metabolic dysfunction essentially disrupts the brain's ability to produce and use energy. This is the equivalent of trying to ride a bicycle on flat tires or carve a Halloween pumpkin with a dull knife. Without a metabolically healthy brain, the challenges of modern life can become overwhelming.
• Cognitive, physical, and emotional impairments from metabolic dysfunction are present for most people years before they are diagnosed with major metabolic diseases such as diabetes, sleep apnea, fatty liver disease, or heart disease⁵.
• Because metabolic dysfunction is harmful to mental health yet usually unrecognized by either the person or their physician, we need practical tools to help identify when we're at risk.

3 simple approaches to identifying insulin resistance and metabolic dysfunction

In the current U.S. medical system, metabolic dysfunction usually isn't diagnosed until a person has advanced disease. By then, unfortunately, both the physical and mental health consequences may be severe and difficult to treat. Thankfully, by using data from conventional tests many of us already complete during our regular physicals, we can accurately estimate whether we are insulin resistant and how far progressed the condition may be. By identifying the presence of metabolic dysfunction early, it becomes much easier to reverse, often requiring only healthy lifestyle changes.

1. The waist/height ratio. If you want to know the simplest tool for estimating metabolic health, you first need to get rid of the dreadful body mass index (BMI). Far better than the BMI for assessing health is another ratio called the waist/height ratio. Just divide your waist (measured in inches at the level of your belly button. Note that this will not necessarily be the same as your waist size on clothing) by your height (in inches). For example, if you're 5'6" (66 inches) tall and have a waist size of 38 inches, the ratio would be 38/66=.575. If the waist/height ratio is >.50 — meaning that your waist is greater than half your height — this is a strong indication that you are carrying excess abdominal fat and experiencing insulin resistance (if you score above .50, take comfort, so do more than 91% of U.S. adults⁶!)

2. The triglyceride/HDL ratio. Triglycerides are a type of fat that circulates in our bloodstream and is produced by the liver using the foods we eat. Triglycerides are not the same as cholesterol but they are typically measured with the same blood lipid tests physicians order to check cholesterol levels. This test usually yields total cholesterol, LDL, HDL, and triglycerides values. When performed after an overnight fast, the ratio between triglycerides and HDL levels is a highly accurate test for predicting metabolic health risk (e.g., superior to cholesterol levels). In general, a ratio of 2.0 or higher (e.g., triglyceride levels of 150 versus an HDL level of 50 would result in a ratio of 160/50=3.0) is indicative of potentially compromised metabolic health⁷.

3. The alanine transaminase (ALT) liver function test. ALT is an enzyme produced by the liver that can be measured in a conventional blood test. The ALT test is among the most common tests physicians perform to evaluate liver health. Although very high ALT levels (e.g., >100) may be indicative of severe liver disease, ALT levels as low as 28 U/L are predictive of fatty liver disease and insulin resistance in research populations⁸.

Are there more tests that your physician can perform to help you identify insulin resistance and other signs of metabolic dysfunction? Yes! Fasting insulin levels, uric acid tests, HOMA-IR tests, oral glucose tolerance tests, etc., are just some of the additional measures available. However, all the latter are either more difficult to perform, more expensive, or both, making them less convenient for the typical person.

What should you do if one or more of these tests are elevated?

A positive result on one of the above three metabolic tests should be a source of empowerment, not discouragement. Armed with the result — along with the growing evidence of how important metabolic health is to our cognitive and emotional functioning — any person can take steps towards improvement. Whether it is a regular exercise program, better quality nutrition and eating patterns, greater quality sleep, or better approaches to managing stress, health behaviors are highly effective for enhancing metabolic function and reversing insulin resistance.

Copyright 2023 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

More than 1 million users signed up within a week of the online release of the artificial intelligence (AI) tool ChatGPT on November 30, 2022, a date dystopians think will live in infamy. In just two months, 100 million users signed up, a record for any new software, app, or online tool.

ChatGPT—along with other recent, if less famous, competitors—does in fact constitute a radical advance in software, far more consequential than when IBM’s Deep Blue defeated chess champion Gary Kasparov in 1997, back in the Internet’s first “century.” ChatGPT puts us one giant step closer to normal people having the ability to access supercomputing performance using natural language. So, the chattering classes are all a-twitter with the usual tropes about how automation will bring about the end of work, in this case for “knowledge workers.”

We will, in due course, see news stories about practical “use cases” for ChatGPT. But for now, a lot of people are having a lot of fun playing with it and discovering just how much better this latest AI software is compared with, say, computer interfaces like Alexa or Siri.

Since ChatGPT was trained to recognize and produce language—a fact telegraphed by the word “chat”—I joined the rush to test the new tool, asking it to write a short blurb to promote a Caribbean cruise and to do so in the style of William Shakespeare. Within a fraction of a second, ChatGPT came back with a C+ effort:

Hark! good sirs and fair maidens, lend an ear
To news of grandeur and luxury rare.
A Caribbean cruise doth now appear
For those with hearts that do adventure dare.
Upon the azure seas, our grand barque
Shall bear ye to fair isles of sand and sun
Where comfort and opulence shall embark
And memories forever to be won.

One user gave ChatGPT a standard medical exam; it passed. Another gave it a standard test for Wharton MBA students; passed again. Impressive parlor tricks, but such stunts tell you more about the simplicity of the tests than about the brilliance of ChatGPT. Passing a written test that indicates proficiency with medical, business, or finance rules and nomenclature doesn’t say anything really useful about whether the test taker will be a great surgeon or business leader. Nor would passing the written test for driving a car predict anything about whether the test-taker could be a safe driver, much less a winning Formula One racer.

Engineers love to perform stunts with new technologies. Of course, depending on the stunts, the performance does say something about the state of a technology. The lesson of Kasparov’s loss was to see the “overnight” progress, nearly 20 years later, of Google’s AlphaGo supercomputer beating the world’s Go champion in that much more complex game. Now, almost a decade after that, comes the sonnet-writing, test-passing ChatGPT. The point is that even in the seemingly high-velocity world of computing, so-called exponential change takes quite a while. That’s the reality of commercializing at scale all forms of engineering progress.

For a way to think about what comes next for AI, consider what followed analogous stunts in the history of aviation—a field more relevant to computing than most realize.

The feat that made it clear that an age of useful aviation was possible was Charles Lindbergh’s 1927 barnstorming of all 48 contiguous U.S. states over a period of 95 days, following his better-known stunt of the first nonstop flight across the Atlantic Ocean, which was in retrospect a kind of Kasparov–Deep Blue moment. Even though, following Lindbergh’s odyssey, aircraft would be used in business, industry, and warfighting, it took another three decades until the engineering was good enough to yield, in 1957, the Boeing 707, which launched the age of mass commercial aviation. From there, as entirely new industrial edifices and national infrastructures were built out, the number of revenue-passenger-miles (to use that industry’s term of art) would soar more than a hundredfold by the year 2000.

The emergence of useful, broadly available aviation brought big shifts to the structure and nature of business and employment in transportation. But it ended neither the role of, nor the expansion of uses for, ships, trains, or trucks; and it didn’t end employment in those sectors. Overall, in fact, employment in U.S. transportation services doubled by the turn of the century. It’s no exaggeration to frame ChatGPT as a Boeing 707 moment.

But we’re being told that, well, this time is different. In part, that’s because it seems somehow spookier when technology accelerates tasks performed invisibly in cyberspace—that is, cognitive rather than physical tasks. ChatGPT has reanimated the now-ancient philosophical debates about whether machines think and whether, as they get better at imitating human behaviors, they’ll make a lot of humans redundant and bring on the often-predicted age of unemployable humans.

It is true that there is something different this time, as there is every time. The specifics of the existing machines are different. But what’s not different is the overall effect of automation. Not to diminish the social and political challenges that all disruptions bring to markets and people, but automation has always boosted productivity and thus overall wealth and employment. If labor-saving technologies—namely, automation—were a net job destroyer, unemployment should have been continually rising over the course of modern history as (physical) automation inexorably expanded. It didn’t. MIT economist David Autor has been particularly eloquent on the apparent paradox of seeing continued rise in employment despite advances in labor-reducing technologies, observing that “the fundamental threat [to employment growth] is not technology per se but misgovernance.”

Of course, where and how most people are employed has changed over time. It’s going to change again. And that is disruptive. But the central and unprecedented difference between our time and previous eras is the demographic reality of a shrinking workforce. In the near future, we will need lots of new tools to amplify the efforts of the declining labor supply. Even in our own present, despite the best efforts of the Federal Reserve to increase unemployment (that is, to reduce the pressure employers face to offer “inflationary” salaries to keep workers), job openings still outnumber people available to fill them. Demographics dictate that this gap will widen. Since most jobs in a modern economy are found in so-called knowledge work, the only way to close the labor gap will be with AI tools useful enough to amplify the efficacy of people in those areas.

AI, of course, is not a specific tool per se but a class of tools under that loosely defined term. To extend the earlier analogy, there are many radically different kinds of engines; no single engine is suitable for every class of machine, task, or vehicle—from aircraft to mining trucks. It’s the same for the silicon engines at the core of all AI machines. Much of the misdirection about AI’s implications comes from the sloppy term itself, “artificial intelligence.” It’s no more informative or accurate than calling a car an artificial horse, or an airplane an artificial bird, or an electric motor an artificial waterwheel.

While ChatGPT is a whiz with words, it wasn’t trained on math and, as some users have already observed, performs poorly there. Similarly, ChatGPT couldn’t drive a car, wield a hammer to drive a nail, or carry a box. One needs differently designed and trained AI tools to perform each kind of task. The category confusion about the realities of AI tools is, to put it crudely, the equivalent of seeing that a tool like a hammer makes it easier to push a nail into a board and then trying to use a hammer to drill a precise hole, weld steel, or measure voltage.

The letters GPT in ChatGPT stand for Generative Pre-trained Transformer—computer lingo for an algorithm that, when paired with a powerful computer, can be trained iteratively by looking repetitively at a very large set of samples—in this case, written texts. The same has been done for images and myriad areas where routine tasks entail patterns and rules. The “chat” in ChatGPT will doubtless find early commercial application precisely where chatbots are already used: in online commerce and with the many tasks in all businesses that involve often-confusing or arcane rules, regulations, or standards that a computer can more usefully, quickly, and accurately parse to answer questions put to it in “natural language.”

The management literature is replete with analyses of the productivity-robbing burdens imposed on employees trying to comply with routine tasks in education, health care, business in general, and even in basic research. Such tasks are precisely where the narrow power of AI is most powerful. As it happens, it’s also where one could free up easily re-trainable humans to be redirected to more challenging non-routine tasks.

A latest Federal Reserve analysis divided the U.S. workforce into just two high-level categories: manual and cognitive labor. No surprise that the majority are now employed in the latter. The analysis also created two sub-categories within each: routine and non-routine tasks. Thus classified, about 60 million people in the U.S. work on routine tasks, split almost evenly between manual and cognitive domains. Total employment in both routine manual and routine cognitive tasks hasn’t changed significantly since 1980. Meantime, the non-routine manual labor pool has risen from 15 million to 25 million people since 1980, and employment in non-routine cognitive work has grown from about 30 million to 60 million people.

Four decades of job growth has all been in non-routine tasks. If we want to find more people to take on the jobs where growth is happening—and where they can be paid more—we’ll need to move people out of the routine job domains, while still ensuring that those tasks are fulfilled. That is precisely what’s made possible by AI tools that can increase the efficacy of a shrinking number of people performing routine tasks. Ensuring that that can happen will require AI tools even easier to use, more accurate, and cheaper than what’s available today with ChatGPT and its (jealous) competitors.

We know from history that when new technologies are found to be broadly useful, engineers drive down costs and make them easier to use. The latter is the “user interface,” in the jargon of tech. Again, witness the capabilities of ChatGPT versus, say, Alexa. With Natural Language Processing (NLP), the human-machine interface makes it easier for non-experts to engage casually in computational feats previously reserved for supercomputers and the expert class. The overall effect of NLP, in addition to taking up the burden of routine tasks, will also be to reduce routine burdens for employees in non-routine types of work. It will also enable the upskilling of more people to become “knowledge workers,” including even coding. It’s no coincidence that AI tools are bringing greater productivity to writing computer code. One company touts that its AI-based tool can help a coder write software ten to 100 times faster.

The good news, at least from a macroeconomic perspective, is that there’s been a land-rush of activity to develop mission-specific machine-learning algorithms. One measure of the scale of that activity is in the amount of private capital chasing AI deals and companies. We’re in the early stages of billions of dollars directed at another tech hype cycle.

Another measure of the scale of AI activity can be found in the total quantity of the world’s computer processing power used to “train” deep-learning models; it’s been doubling every few months for the past half-dozen years. That translates into a 300,000-fold increase in computing power used for AI training over that short time. You don’t need a crystal ball to predict that such prodigious efforts will soon yield a fusillade of useful AI tools to succeed ChatGPT.

Coming back to our aviation analogy, it’s the inescapably physical world of energy that reveals the implications of the scale of AI and machine learning. Even AI cognoscenti are surprised to learn that the energy equivalent of the fuel used to fly a jumbo jet from Austin to Asia is gobbled up by an AI-centric computer being trained on “large language models” or other similar sets of “parameters” needed for machine learning. That’s not a one-time investment; it happens every time and for each kind of similar application of learning. As “use cases” for AI expand, the proliferation of AI training will follow apace.

Ah, but for those who are anxious about energy issues, we also know that emerging and next-generation AI chips and algorithms are far more energy-efficient—some are already tenfold better. This will tamp down AI’s voracious energy appetite, even as the tools improve. But it’s that reality—more efficiency and higher performance—that will lead to a repeat of the trajectory of the first, pre-cloud era of the Internet.

Radical gains in efficiency have always been critical to unlocking the commercial viability of any new machine or infrastructure for society. In 1958, when Pan Am began passenger jet service with the 707, no one forecasted (much less exhibited angst about) the aggregate fuel consumption that commercial aviation would induce. Since then, aircraft have become 300 percent more energy-efficient, not to mention safer and more reliable. Those features are what enabled today’s trillions of passenger-miles flown, an activity that consumes some 4 billion barrels of oil each year, compared with a trivial amount in 1958.

Similarly, decades of inexorable gains in computing energy efficiency are illustrated by the fact that, if today’s smartphones operated at 1980 computing-efficiency levels, just one phone would use as much electricity as an office building. A single datacenter at 1980 efficiency levels would require the entire U.S. grid to power it. Instead, staggering reductions in energy-per-logic-operation, again along with gains in performance, are what made possible a commercial world of billions of smartphones and thousands of datacenters. And that yielded today’s global cloud infrastructure—still in a pre-AI era—that already uses about as much energy as global aviation.

In a future when AI machines perform not dozens but tens of thousands of simulations entailing trillions of computing-hours, overall energy use will balloon again. And that will happen because of the economic benefits AI offers to people, businesses, and even—and especially—in the pursuit of science and new discovery.

As Regina Barzilay, an AI researcher at MIT, put it when asked about the power of AI-assisted discoveries to invent new life-saving drugs: it’s “not the machine that invented the molecule. It’s that the machine helped humans to scan the huge space of possibilities and zoom in on the fruitful set of hypotheses that they tested.” Or, as economist Alexander Salter succinctly observed: “Data doesn’t interpret itself.” The AI machines are knowledge amplifiers.

Even so, we will see disruptions to the nature of jobs and businesses. Indeed, the scale of those disruptions will echo the magnitude of the opportunities that AI creates. Some educators have voiced worries about disruptions to teaching, including detecting cheaters. ChatGPT will indeed require adjustments, perhaps even a return to Socratic methods of in-class learning and testing—hardly a new idea. Nor is dealing with cheating, especially in the age of the Internet. Teachers found ways to teach math in the age of the calculator. Adaption to AI is not just possible, but arguably beneficial.

A clear-eyed recognition of benefits from any new technology doesn’t constitute a Pollyanna’s perspective. It’s also true that AI machines won’t all be useful or put to good use; such is the (sometimes sad) state of human nature. As science-fiction author and technology seer Cory Doctorow recently quipped in a long interview, “I think that the problems of A.I. are not its ability to do things well but its ability to do things badly, and our reliance on it nevertheless.” His cautions—and these are a constant refrain in his dystopian fiction—center around the need to recognize the limits of any machine and the kinds of risks arising from misuses.

Coming back to where we started, looking over the long period since the emergence of the modern information era, circa 1970, Census data show a significant shift in the structure of employment—away from production and toward services. Economists David Autor and Anna Salomons have done pioneering work in mapping those dynamics as a kind of hollowing out of highly paid “middle-skilled” jobs that don’t typically require a college degree, and a simultaneous shift toward more low- and high-skilled employment.

Autor recently posed a question as to “whether a countervailing set of economic forces will soon reverse the decline of middle-skill work?” I think the answer to that question is yes. The countervailing forces will come from the fact that computing has finally become widely useful with the advent of commercially viable AI. And that’s happening just in time to rescue the economy from demographic dystopia.

Mark P. Mills is a senior fellow at the Manhattan Institute, a strategic partner in the energy-tech venture fund Montrose Lane, and author of The Cloud Revolution: How the Convergence of New Technologies Will Unleash the Next Economic Boom and a Roaring 2020s. He hosts The Last Optimist podcast.

Although the terms are sometimes deployed interchangeably in a healthcare setting, augmented reality, virtual reality, the metaverse and extended reality refer to different ways of interacting with a digital environment. Augmented reality layers information onto what a user sees in real life—such as a car displaying speed and navigation on the windshield, so the driver doesn’t have to look elsewhere. Virtual reality conveys a completely different set of visuals, usually requiring goggles ranging from less than $10 for a piece of cardboard that holds a user’s phone to upward of $5,000 for more immersive set-ups. While the metaverse has been defined several ways since its creation in the early 1990s, its latest iteration, popularized by the company formerly known as Facebook, involves a 3-D social platform where users can interact with each other’s avatars. And extended reality is an umbrella term to describe any or all of the above concepts.

Curiosity about the use of technology to access a digital world is growing in the medical field. The number of studies and research articles mentioning virtual reality on PubMed, a biomedical literature database maintained by the National Center for Biotechnology Information, has increased each year over the past decade. In the first two weeks of 2023, the syllabu was mentioned more than 150 times.

Some leaders believe the technology has the potential to change care delivery. A report from Accenture last year found nearly half of executives from payer and health provider organizations believed digitally enhanced interactions would have a “breakthrough” or “transformational” impact on their systems.

“It’s important to start thinking about this, if you haven’t already,” said Rich Birhanzel, senior managing director and global health lead at Accenture.

Health systems have begun to use virtual reality to supplement education for new doctors. Five years ago, the Hospital for Special Surgery found it was dedicating significant staff time to training residents on the fundamentals of surgical procedures that could be learned just as easily outside of the operating room.

Leaders at the organization’s education institute proposed seeking an alternative. Dr. Michael Ast, chief medical innovation officer and an associate professor of orthopedic surgery at the academic health system, helped create a virtual reality training program for orthopedic surgery residents to complete before entering the operating room. By wearing goggles, residents at the main campus in New York City simulate several procedures they’re likely to perform during a surgery.

Ast said the virtual programs have helped residents make better use of their training time. While the organization doesn’t evaluate residents based on their performance in the modules, it is gathering data to potentially set eventual benchmarks.

“We ask our residents to go through the basic surgical procedures for each of those subspecialties—fracture, joint replacement, hand and pediatrics—right as they start the rotation,” Ast said. “Go through it 10, 20, [or] 50 times, whatever fits within their schedule.”

The training “allows them to get a lot more out of the rotation, since they really come in at a very different level of experience,” Ast said.

The hospital worked with Osso VR, a virtual reality surgical training and assessment platform, to help create the clinical training software. Ast said the level of vendor involvement enabled the program to grow over the past five years from a small number of modules to its campus-wide expansion.

“I think that’s just the way innovation is done,” he said.

Some older surgeons were initially skeptical, but Ast hasn’t encountered much pushback once they enter the virtual operating room and see the technology firsthand. He said finding clinical employees to work with technology officers and push for adoption internally is vital to integrating virtual reality in any health system.

“You want to find the person within your system who believes in it—who wants to put some time into understanding and developing how you’re going to implement it,” Ast said. “You want to find your champion.”

Dr. Justin Barad, Osso VR co-founder and CEO, said he presents the technology to healthcare organizations as a way to augment, rather than replace, training. Osso VR provided the platform and equipment for free, but the Hospital for Special Surgery has devoted what Ast characterized as significant staff time to developing and maintaining the program. The leaders are considering co-developing a training initiative for use at other orthopedic hospitals.

“This is going to take a little time to be implemented [in other health systems], but ultimately, I see this as eventually the standard of care for the training of orthopedic residents,” Ast said.

It is customary for husbands and wives to argue, and to sometimes walk away in a huff. Except, when Aklu Ram, 28, did just that after a fight with his wife Sunita Devi, 26, she panicked. Lying in a hospital bed for over 150 days now, her body about 10 kg lighter, after both her perfectly healthy kidneys were removed ‘by mistake’ in a ‘clinic’ that had no licence to run, she thought her husband had left her for good.

“I was upset; that’s why I had left the hospital for some time, but I came back the same day,” says Mr. Ram, who has been by his wife’s side, taking care of their three children, as they navigate the hospital’s long and somewhat ageing corridors and doctors’ orders. They hope for a kidney donor, Mr. Ram’s not being a match for his wife.

“How can I desert my wife in such a condition? I have been with her like her shadow ever since the incident took place,” he says, his voice choking, as he sits outside the dialysis room of Sri Krishna Medical College and Hospital (SKMCH) in village Rasulpur Saidpur Bazid, Muzaffarpur district in Bihar.

Mr. Ram and Ms. Devi, who married in 2010, have a young family: an 11-year-old daughter, and two sons, 8 and 6. While Sonam Kumari helps her father, the boys have been sent back to their village, Mathurapur, where Mr. Ram’s parents are currently looking after them.

Sunita Devi, 26, who has lost both her kidneys when a quack took them out thinking they were tumours | Photo Credit: Nagendra Kumar Singh

As the dialysis is on, Ms. Devi asks the nurse to bring her husband to her bedside. She’s still nervous he may leave, never to come back. But father and daughter are preparing for a meal she must have after the dialysis, a thrice-a-week session that lasts four hours. “I hope someone donates a kidney so that I can survive and look after my three small children,” Ms. Devi says, perhaps conscious of the role reversal, with her daughter washing her clothes and running errands.

The Dalit family stays within the hospital, laying out a thin mattress next to Ms. Devi’s bed, as they wait for a kidney donor. It’s Guru Ravidas Jayanti and the family would have gone to a local mela to celebrate the life and teachings of the poet-preacher who was himself a part of what in the 15th and 16th centuries, was considered an untouchable community.

As a mason, Mr. Ram would earn ₹10,000 to ₹12,000 every month and with the little money they have saved, some that his brother sends, and some from a local not-for-profit, he is able to sustain the family.

But it’s not just about the money or that the children haven’t attended school for five months now, or even that his wife, for no fault of hers may die soon. It’s about a world-weary man who doesn’t know where to put his anger and grief at the loss: “Every passing day I am finding it difficult to survive,” he says.

He directs some anger at his mother-in-law, saying she forcefully took Ms. Devi to Subhakant Clinic to have her uterus removed. Then there’s hopelessness: “Do you think anybody will offer their kidney to poor people like us?” And desperation: “Can you get me any money from anywhere; you’re a journalist; you are influential.”

What went wrong

On September 3, 2022, Ms. Devi went to the Subhakant Clinic, 2 km from Baji Raut in Sakra block, where her parents live. Her mother, Tetri Devi, 63, had taken her for a consultation before, when Ms. Devi had complained of pain in the abdomen. They had met Pawan Kumar, who allegedly said her uterus needed to be removed.

About 24 hours after the operation, at home, Ms. Tetri suspected there was a problem, when her daughter did not urinate. She went back to meet Mr. Kumar, who gave her ₹5,000, booked a car, and accompanied them to Shree Ganga Ram Trauma Hospital, Patna. Thereafter, the family did not hear from him again.

At Shree Ganga Ram, several tests were conducted, and they were charged ₹42,000. The family then took a decision to transfer her to SKMCH, the biggest government hospital in Muzaffarpur. From here, they were referred to Patna Medical College and Hospital (PMCH) where it was found that both Ms. Devi’s kidneys were missing.

PMCH recommended that she be admitted at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, where she spent October 2022. However, once the Ayushman Bharat money of ₹50,000 was exhausted, they came back to SKMCH in November, and have been here ever since. Unfortunately, there are no nephrologists at SKMCH, nor does the facility have the capacity to do a kidney transplant in case a donor is found.  

Now in SKMCH, Ms. Devi has developed chicken pox and so the hospital has taken her out of the ICU and put her into the dengue ward, since it is currently empty.

“I really don’t know how long my wife will survive without a kidney. She is in pain and only I can understand. The hospital authorities are saying that their only duty is to do the dialysis, and they are not responsible for finding a donor. If they don’t, who will?” Mr. Ram said.

Since the story has made the national news, the entire hospital is on alert for Ms. Devi. Mr. Ram says medicines, procedures, doctors’ fees, and food are all free. His only problem is that he is unable to earn. 

SKMCH superintendent B.S. Jha doesn’t say what Ms. Devi’s chances of survival without a kidney and regular dialysis are though. 

An FIR was lodged on September 9, in the Bariyarpur police station and then transferred to the Sakra police station for further investigation. Investigation Officer (IO) Saroj Kumar, who is station house officer of the Sakra police station said that during the investigation the police did not find any sign of a kidney racket.

“Pawan Kumar, the owner of the clinic has been arrested,” he said, adding that he had been hiding out at a friend’s house in Delhi. “During the investigation he accepted that it happened by mistake, assuming that the kidney was a tumour. They had shown the kidneys to Sunita’s mother as well, calling it a tumour,” he added. Later, they realised their mistake, and threw them into the medical waste dustbin. “During the interrogation, Pawan said he had not operated on Sunita, and it was Dr. R.K. Singh who had,” Mr. Kumar said.

The FIR names Pawan Kumar; Sangeeta Devi, his wife, who used to help him at the clinic; and Dr. R.K. Singh. He added that the so-called doctor’s name is not registered in the district civil surgeon’s office; neither was the clinic. 

The ‘doctor’ has given a plea in court stating that from September 2 to 6, he was not in Muzaffarpur, and was in fact hospitalised in Patna with dengue. “As per the investigation, the main accused is Dr. R.K. Singh and the police are working on catching him,” the IO has stressed.

The case was lodged under the Transplantation of Human Organs and Tissues Act 1994 and the Scheduled Caste and Scheduled Tribes (Prevention of Atrocities), Act 1989. The State Human Rights Commission and the National Human Rights Commission have also issued notice to the State government seeking a reply in this case.  

A senior official working with the health department said they were doing their best to provide all possible help to Ms. Devi, including finding a kidney donor. They also said that the department has instructed the Muzaffapur district administration to ensure that the people responsible for the heinous act be put behind bars.

The parents plead

Ms. Devi’s parents live a 20-km bumpy ride from SKMCH, and about 40 km away from where the couple and their children live. Their home is a kuccha structure with an asbestos roof, and can be accessed down a 200-metre dirt track. Ms. Tetri and Laldeo Ram, 71, sit on a khaat (rope cot) and cannot imagine what to do next. They have tried asking people in the village if anyone would donate a kidney, but no one has offered so far.

Tetri Devi, 63, and Laldeo Ram, 71, struggle to come to terms with their daughter’s loss | Photo Credit: Nagendra Kumar Singh

Even as Ms. Tetri opens her mouth to speak, her hands fold in a plea, almost begging anyone who will listen, to help. “He [the quack] has made my daughter’s life hell. She is counting her days lying on the hospital bed. Who will take care of her three children if anything happens to her?” she says.

As she speaks, the tears come quickly. She had fainted the day she came to know that her daughter’s kidneys had been removed. She says morosely, with some measure of guilt, that she was the one who had taken her to the clinic, as the nearest primary health centre is about 12 km away, and there’s no public transport to reach it. “The roads are in a poor condition, so it’s not easily accessible,” she added.  

Despite the misery, Mr. Ram is supportive of his wife, saying that the decision to go to the private ‘clinic’ was because it was close to home, and most villagers used its services. It had opened two years ago in Bariyarpur. “Family and friends had also suggested we take her there,” he says.

Mr. Ram too breaks down, saying that if there had been a good hospital in the village, his daughter would not have been in this situation. He is a daily wage labourer, earning ₹5,000 to ₹7,000 a month. The couple had managed to save a little money despite their meagre earnings. That is gone now, and they are in debt.

“We took money on interest from the villagers and spent more than one lakh on my daughter’s treatment. I made many trips to Patna for better treatment, but at last she is being treated at SKMCH. We are left with no money and now struggling to get two meals a day. I have three grandsons with me, and they sometimes sleep on an empty stomach,” she says.

The couple have six children — two sons and four daughters. One daughter died last year, and the husband of another daughter had passed away a few years ago. Their sons stay with them and work in a brick kiln in the village. They earned too little for any financial support towards their parents or sister.

“Now, we have only one demand: to get a donor for my daughter apart from some financial help,” Mr. Ram said, never once alluding to the arrest or punishment of the perpetrators.

Bihar’s quack trap

The signboard of the unauthorised clinic has been removed and the premises sealed by the Bihar police after the incident. The clinic, a one-room outfit, is constructed in the middle of agricultural land, with just one gate to enter.

The people around the clinic were initially not ready to talk to the media, but soon opened up. A man who runs a sweet shop nearby said that on an average 20 to 30 villagers would visit, usually for first aid or to get medicine for pain relief. He seemed unaware that the clinic had also been performing operations, but said he’d seen Mr. Pawan sweeping the place.

Illegal operations by quacks are not new in Bihar. “There are about 5 lakh unlicensed medical practitioners commonly known as jhola-chhaap (quacks) in Bihar,” said Dr. L.B. Singh, Chairperson, State Advisory Committee for Vocational Training and Programme, Health Department, Bihar. “Out of 5 lakh only 50,000 are trained [by the State government] as rural medical officers who are responsible for primary health check-ups. To be a medical officer, a person should have passed the Class X exam.”

This is not the only bizarre case in Muzaffarpur district: in 2021, upto 13 people lost their eyesight after a cataract operation in a government hospital. In Khagaria district, 23 women were forced to undergo tubectomy without anaesthesia by a doctor at a primary health centre in November 2022.

While the government figures out an appropriate reaction, and the medical needs of its citizens overwhelm the State, there is the unheard voice of Sonam Kumari, Ms. Devi’s daughter. “I hope my mother can come home soon; unke bina man nahin lagta [without her, I feel disengaged],” she says.

HB23-1071 passed the House 56-6 and will now move onto the Senate.

Five new, state-of-the-art dental simulator machines have been installed at the University of Saskatchewan’s College of Dentistry, the first of their kind in Canada.

These innovative machines designed by a company in the Netherlands will deliver the college, and its students, a competitive advantage in their training.

“This is the first time that dental schools in Canada are having these state-of-the-art machines that really help the students train before going into real-life situations,” said Dean of the College of Dentistry, Walter Siqueira.

He says this technology will replace the previous dental simulation models that used plastic teeth, which have a number of drawbacks.

“Plastic teeth are not as hard as the enamel of the tooth,” Siqueira told CTV News. “So It’s a big difference when you’re learning with plastic teeth and then you go to real life.”

Another benefit of the machine is that there’s less waste.

“In terms of sustainability, that is extremely extremely important for our planet,” he said.

“Here we can save a huge number of plastic teeth because we don’t have to drill plastic. We go to everything with mixed reality and this new simulator, in terms of the big picture of the next 20 years.”

The machines deliver students a wide variety of valuable learning experiences, but they’re also fun.

“It honestly does feel like you’re playing,” said Neelan Verma, a fourth-year student.

“But then you’re also refining your skills and getting better. So once you get into clinical settings, you’re good to go.”

And whether it’s students or practicing dentists with decades of experience, they’re all amazed by the realism of the simulator.

“As someone who’s been part of virtual reality for a lot of years, these are unlike anything I’ve ever experienced,” said Matthew Hazelwanter, IT support specialist.

“The realism of it, the fact that it actually stops your movement, that is next level.”

The college plans to install five more simulators in March, and students could be using them in testing as early as next year.