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IT and me reflections Kim Solez


Published on Dr. Kim Solez speaking here Thursday noon August 21, 2014 on "IT and Me: Reflections of a Pathologist, Futurist, Technology Advocate Doctor Guy! "

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IT and me reflections Kim Solez

  1. 1. Kim Solez, MD
  2. 2. Over 20 Years Here I Have Never Had A Problem IT Could Not Solve
  3. 3. Who Am I?
  4. 4. Banff Classification of Kidney Transplant Pathology Histologic criteria for the diagnosis of rejection and other conditions in the transplanted kidney, began 1991, updated and expanded every two years in consensus meeting.
  5. 5.  1991 First Conference  1993 First Kidney International publication  1994 NEPHROL First websites and Email groups  1995 Integration with CADI  1997 Integration with CCTT classification, NKF cyberNephrology and ISN Informatics Commission Formed  1999 Second KI paper. Clinical practice guidelines. Implantation biopsies.  2001 Classification of antibody-mediated rejection: Regulatory agencies participating  2003 Genomics focus, ptc cell accumulation scoring  2005 Gene chip analysis. Elimination of CAN, identification of chronic antibody-mediated rejection.  2007 First meeting far from a town called “Banff” – La Coruna, Spain.  2009 Working groups. Meeting in Banff, Alberta, Canada  2011 Technology and Future of Medicine Course created LABMP 590  2013 Establishment of Banff Foundation for Allograft Pathology
  6. 6. Significance of ‘Banff papers’ • 4244 citations of the 9 Banff meeting reports • 790 Banff / Transplantation papers in PubMed • Banff 2003 meeting report (ABMR criteria) = most cited AJT paper • 3 Banff meeting reports are among the top 4 cited AJT articles
  7. 7. Organizational structure of the Banff Foundation For Allograft Pathology Board of Trustees: K. Solez (Chair), L. Racusen, D. Glotz, J. Demetris, M. Mengel, M. Mihatsch, D. Seron, N. Schmidt 2015 Local Conference chair: Michael Mengel Organ Steering committee Chairs: Composite tissues: Linda Cendales Heart : Rene Rodriguez Kidney: Mark Haas Liver: Jake Demetris Lung: William Wallace and Carol Farver Pancreas: Cinthia Drachenberg Banff Working Group (BWG) Leads: Molecular transplantation pathology: Michael Mengel, Banu Sis Isolated v-lesions: Banu Sis, Ed Kraus Quality assurance in transplantation diagnostics: Michael Mengel and Parmjeet Randhawa C4d-negative ABMR: Mark Haas, Banu Sis, Alexandre Loupy Fibrosis scoring: Robert Colvin, Brad Farris, Michael Mengel Digital Pathology in Transplantation: Jake Demetris 2015 Scientific program committee: Alex Loupy (Chair) Mark Haas, Banu Sis, Kathryn Tinkham, Candice Rofousse, Chris Bellamy, Lynn Cornell, Carmen LeFaucheur Composite tissues: Linda Cendales Heart : Rene Rodriguez Liver: Jake Demetris Lung: William Wallace and Carol Farver Pancreas/Islets: Cinthia Drachenberg and John Papadimitriou Secretary/Treasurer: Michael Mengel funding collaboration reports to reports to collaboration collaboration reports to collaboration progress reports to Budged proposal and accountability for meeting costs support
  8. 8. Target Audience for the 2015 joint CST/Banff meeting: total ~600 expected delegates  Basic Scientists  Pathologists  Immunogeneticists and HLA experts  Transplant Physicians: Internal Medicine, Surgery, Infectious Diseases, Critical Care  Allied Health Care  Students, Trainees, Fellows
  9. 9. The Banff Process Consensus communication in renal transplantation a The Banff lesions g, i, t, v - score The Banff community Pathologists Nephrologists Tx-Surgeons Lab-Medicine established by consensus in 1991 The Banff classification Current consensus for diagnostics moderated Banff meetings thesis-antithesis-synthesis tentative thresholds participate refinementBanff Working Groups Feedback concerning weaknesses and strengths by results from independent research New members Biostaticians Molecular Biologists “Omics”-specialists Off-springs Liver Pancreas Lung, Heart CTA
  10. 10. The Banff Schema was first developed at a meeting of pathologists, clinicians and surgeons in Banff, Alberta, Canada, August 2-4, 1991 and has become the worldwide standard for the interpretation of transplant biopsies.
  11. 11. The Banff Schema was first developed at a meeting of pathologists, clinicians and surgeons in Banff, Alberta, Canada, August 2-4, 1991 and has become the worldwide standard for the interpretation of transplant biopsies.
  12. 12. Unique Course on Technology and the Future of Medicine LABMP 590 Created in 2011
  13. 13. Moore’s Law&Eroom’s Law , the technological Singularity and exponential change, exponential decline in # new drugs per billion dollars R&D expenditure.
  14. 14. Moore’s Law Predicts Singularity
  15. 15. The Technological Singularity
  16. 16. Soft Transhumanism – Ross Lockwood The last decade has brought a profound change in the way we humans interact. Our imagined future of merger between human and electronic interface has crept into our lives; social networks, adept at instantaneous byte- sized communications, now permeate the younger generations. There is still a chasm between hard- Transhumanism, and this soft-Transhumanism, defined by our interactions with personal electronics, but there is no sign of these interactions abating. Fully embracing this technological revolution, within the University classroom and beyond, is beneficial to the learning experience and to our cultural growth as human beings.– Ross Lockwood HI-SEAS sMars mission May 4, 2014!
  17. 17. The Technological Singularity The technological singularity occurs as artificial intelligences surpass human beings as the smartest and most capable life forms on the Earth. Technological development is taken over by the machines, who can think, act and communicate so quickly that normal humans cannot even comprehend what is going on. The machines enter into a "runaway reaction" of self-improvement cycles, with each new generation of A.I.s appearing faster and faster. From this point onwards, technological advancement is explosive, under the control of the machines, and thus cannot be accurately predicted (hence the term "Singularity"). – Ray Kurzweil
  18. 18.  All natural disease may be eliminated, leaving only man-made diseases. But that may leave as much for physicians to do as there is today!  Challenging responses to bioterrorism and stem cell technologies.  Focus of medicine no longer disease but enhancement, elevating the human condition, which will extend beyond the physical to the moral and spiritual.  Social responsibility an important aspect of medicine and one of the focuses of the course. 2045 is only 31 years from now. Many of you will still be working then. What will medical careers be like then?
  19. 19. Focus Groups in May 2011 Course conceptualized in March 2011, tested with focus groups in May for its suitability as a course for both undergraduate and graduate students.
  20. 20. Over Time Our Course’s Sessions Have Developed a Pedagogical Rhythm, Leading To A Self-organized Structure  Ten minute introduction  Fifty minute lecture  Twenty minute discussion  In the course we talk about machines replacing many of the functions of human beings. This picture was taken by a machine without human intervention, as were many of the best still images from the course. The video camera is constantly comparing the scene to algorithms and takes still pictures when the requirements of the interesting picture algorithm are satisfied.
  21. 21. Video and Audio Quality Superb Now! First teaching session 2011 Recent teaching session 2014 Hot-linked tables of contents in YouTube descriptions at allow one to jump right to content of interest.
  22. 22.  Director of Social Media at Kandu Inc. The Normal, Outgoing, Personable Students in the Course are Little by Little Changing the World! Student Presentation Videos Have Had Amazing Positive Effects!
  23. 23. Heather Graves, from Department of English and Film Studies, in Faculty of Arts. Diversity of views and backgrounds is an important feature of the course. Tech skeptics represented. Diverse Faculty from Across The Campus Teach in the Course. All Views Represented.
  24. 24.  We shoot broadcast quality video of each lecture & discussion. IT staff is intergral part of course, essential to it!  Previous lectures at . Students critique one past lecture, and suggest improvements in presentation and hot-linked table of contents (20% of grade).  Students write one 3,000 word paper (40%) and give 20 min. presentation on same subject (30%). Also graded on class participation (10%).  No required reading. Suggested reading list in course outline, readings suggested by Email. Course Specifics
  25. 25.  The technological Singularity. Existential risks, AI, genomics, and nanotech.  Ways to optimize a positive outcome for humanity in the co-evolution of humans and machines . The influence of these considerations on medicine of the future.  Dean of Science speaking, prominent people internationally. Most lectures not very “medical”. Easily understood.  Balanced view provided by incorporating both tech skeptics and tech advocates. Course Content
  26. 26.  Medical student elective participation in course, med student club.  International peer review of YouTube videos, modifications made. Two Quantum Biology lectures.  Young person old person point counterpoint lecture January 30th, Abdullah Saleh/Earle Waugh Medical Ethics in a World of Robots(What will we allow when everything is possible).  Collaboration with Disruptive Technologies in Medicine course in Budapest, Hungary, the only other course somewhat like this one.  Accommodation for the shy student, working directly with videographer for final presentation, texting questions.  Space orientation, 3D printing in space, usability of iOS devices in space, Mars habitat simulation, analog space missions in context. Other Innovations New in 2014
  27. 27. The Banff Foundation for Allograft Pathology Must Remain Youthful and Relevant for the Future – Must Adapt, Plan for Changes  As the field changes and stem-cell-grown organs replace transplantation, the organization must change with it  Transplantation may be loosing its luster but luster of the Banff Foundation for Allograft Pathology can remain strong.  As an exercise in alternative realities I asked participants to consider the very different life of David Crippen, my counterpart in critical care medicine. We need to consider changes that large!
  28. 28. The spectacular dynamics influencing the pace of stem generation of organs replacing transplantation in the future.  There were YouTube videos (now removed) suggesting that stem cell generation of complex organs in humans would be routine by 2020. Problems of clotting, endothelial loss, and cell type selection errors not mentioned.  The dramatic slowdown of new drug approvals (Eroom’s Law) by the FDA suggests that the FDA is ripe for disruptive innovation. Has happened.  However stem cell therapies may be the last area the FDA will relax regulation in, as unproven bogus stem cell therapies are causing widespread suffering and protection of the general public is needed.
  29. 29.  Transplant pathologists will also become tissue engineering pathologists, pathologists who analyse organs grown from stem cells. This is not something beyond us, we can adapt to a work life that includes stem cells.. Someone needs to cross the disciplines.
  30. 30. Turtles All the Way Down
  31. 31. Animal Analogies Limited. Need Human Alter Egos
  32. 32. CCM-L Characters Off-Topic Discussions NEPHROL No Characters No Off-Topic Discussions
  33. 33. Many Military Awards, Karate Black Belt No Civilian Awards Never Served in Military Many Civilian Awards
  34. 34. Rock Band Motorcycles Colorful History in 60’s and 70’s No Band or Motorcycle Boring Young Person
  35. 35. Crippen A Myth? Proves the Metaphor Works!