• Brick Journey / Volume Matrix studio

    Brick Journey / Volume Matrix studioSave this picture!© Prayoon Tesprateep•Bangkok, Thailand

    Architects:
    Volume Matrix studio
    Area
    Area of this architecture project

    Area: 
    1500 m²

    Year
    Completion year of this architecture project

    Year: 

    2025

    Photographs

    Photographs:Prayoon Tesprateep

    Lead Architects:

    Kasin Sornsri

    More SpecsLess Specs
    this picture!
    Text description provided by the architects. Brick Journey is an architectural project that harmonizes conceptual interpretation with spatial design, blending various functions and local aesthetics. This vibrant space encompasses a residence, café, and art galleries. The initial concept is inspired by the journey of the owner, a doctor with a profound passion for ancient art. As an art collector, he has traveled the world to acquire unique masterpieces. He envisioned his home not only as a place to live but also as a sanctuary for his cherished collection. The architect responded to this vision by creating a spatial narrative that encourages exploration. A curving wall weaves through the layout, guiding and distorting the circulation to create a sense of wandering-inviting visitors to discover the space as their own personal journey.this picture!this picture!this picture!this picture!this picture!Upon approaching the site, the first impression is marked by a small, enclosed entrance framed by the curved wall. This design element creates a sense of tension and curiosity, gently pushing visitors to step inside. Above this entrance lies an observation area, symbolizing a point where beginning and end converge. Passing through the threshold, visitors encounter a small pond on the right, accompanied by an empty frame moment of reflection that the owner holds dear. This area includes a multipurpose space used for temporary exhibitions and gatherings, and includes bathroom facilities. This room is connected to an outdoor courtyard, which also takes advantage of the beautiful view and ventilation.this picture!this picture!On the left side of the site lies the café and reception area. A significant feature here is the expansive courtyard, which benefits from the shade of a large, existing tree that has grown since the owner's childhood. The café is designed with floor-to-ceiling windows, providing unobstructed views of the courtyard and artifacts suspended throughout the space. A unique element is the incorporation of antique doors from the owner's collection, seamlessly merging art and architecture.this picture!this picture!The second floor is dedicated primarily to galleries. A staircase leads to a temporary exhibition space suitable for smaller-scale paintings. The two main buildings are connected via a steel bridge, which leads to the upper level of the café. This section houses an exhibition featuring pieces from the Indian subcontinent. Turning at this point leads visitors back to the multipurpose area via an original Art Nouveau staircase, while continuing forward completes the journey, returning to the elevated observation point—the symbolic end of the path.this picture!this picture!This architecture prominently features brick; the choice of using brick as the main material is due to the revival of ancient architecture, as brick used to be the dominant material used in building and construction. Therefore, utilizing various types of brick and construction techniques to create texture, depth, and a sense of timelessness throughout the project is metaphorical to a journey of brick building this architectural piece.this picture!

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    About this officeVolume Matrix studioOffice•••
    MaterialBrickMaterials and TagsPublished on June 16, 2025Cite: "Brick Journey / Volume Matrix studio" 16 Jun 2025. ArchDaily. Accessed . < ISSN 0719-8884Save世界上最受欢迎的建筑网站现已推出你的母语版本!想浏览ArchDaily中国吗?是否
    You've started following your first account!Did you know?You'll now receive updates based on what you follow! Personalize your stream and start following your favorite authors, offices and users.Go to my stream
    #brick #journey #volume #matrix #studio
    Brick Journey / Volume Matrix studio
    Brick Journey / Volume Matrix studioSave this picture!© Prayoon Tesprateep•Bangkok, Thailand Architects: Volume Matrix studio Area Area of this architecture project Area:  1500 m² Year Completion year of this architecture project Year:  2025 Photographs Photographs:Prayoon Tesprateep Lead Architects: Kasin Sornsri More SpecsLess Specs this picture! Text description provided by the architects. Brick Journey is an architectural project that harmonizes conceptual interpretation with spatial design, blending various functions and local aesthetics. This vibrant space encompasses a residence, café, and art galleries. The initial concept is inspired by the journey of the owner, a doctor with a profound passion for ancient art. As an art collector, he has traveled the world to acquire unique masterpieces. He envisioned his home not only as a place to live but also as a sanctuary for his cherished collection. The architect responded to this vision by creating a spatial narrative that encourages exploration. A curving wall weaves through the layout, guiding and distorting the circulation to create a sense of wandering-inviting visitors to discover the space as their own personal journey.this picture!this picture!this picture!this picture!this picture!Upon approaching the site, the first impression is marked by a small, enclosed entrance framed by the curved wall. This design element creates a sense of tension and curiosity, gently pushing visitors to step inside. Above this entrance lies an observation area, symbolizing a point where beginning and end converge. Passing through the threshold, visitors encounter a small pond on the right, accompanied by an empty frame moment of reflection that the owner holds dear. This area includes a multipurpose space used for temporary exhibitions and gatherings, and includes bathroom facilities. This room is connected to an outdoor courtyard, which also takes advantage of the beautiful view and ventilation.this picture!this picture!On the left side of the site lies the café and reception area. A significant feature here is the expansive courtyard, which benefits from the shade of a large, existing tree that has grown since the owner's childhood. The café is designed with floor-to-ceiling windows, providing unobstructed views of the courtyard and artifacts suspended throughout the space. A unique element is the incorporation of antique doors from the owner's collection, seamlessly merging art and architecture.this picture!this picture!The second floor is dedicated primarily to galleries. A staircase leads to a temporary exhibition space suitable for smaller-scale paintings. The two main buildings are connected via a steel bridge, which leads to the upper level of the café. This section houses an exhibition featuring pieces from the Indian subcontinent. Turning at this point leads visitors back to the multipurpose area via an original Art Nouveau staircase, while continuing forward completes the journey, returning to the elevated observation point—the symbolic end of the path.this picture!this picture!This architecture prominently features brick; the choice of using brick as the main material is due to the revival of ancient architecture, as brick used to be the dominant material used in building and construction. Therefore, utilizing various types of brick and construction techniques to create texture, depth, and a sense of timelessness throughout the project is metaphorical to a journey of brick building this architectural piece.this picture! Project gallerySee allShow less About this officeVolume Matrix studioOffice••• MaterialBrickMaterials and TagsPublished on June 16, 2025Cite: "Brick Journey / Volume Matrix studio" 16 Jun 2025. ArchDaily. Accessed . < ISSN 0719-8884Save世界上最受欢迎的建筑网站现已推出你的母语版本!想浏览ArchDaily中国吗?是否 You've started following your first account!Did you know?You'll now receive updates based on what you follow! Personalize your stream and start following your favorite authors, offices and users.Go to my stream #brick #journey #volume #matrix #studio
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    Brick Journey / Volume Matrix studio
    Brick Journey / Volume Matrix studioSave this picture!© Prayoon Tesprateep•Bangkok, Thailand Architects: Volume Matrix studio Area Area of this architecture project Area:  1500 m² Year Completion year of this architecture project Year:  2025 Photographs Photographs:Prayoon Tesprateep Lead Architects: Kasin Sornsri More SpecsLess Specs Save this picture! Text description provided by the architects. Brick Journey is an architectural project that harmonizes conceptual interpretation with spatial design, blending various functions and local aesthetics. This vibrant space encompasses a residence, café, and art galleries. The initial concept is inspired by the journey of the owner, a doctor with a profound passion for ancient art. As an art collector, he has traveled the world to acquire unique masterpieces. He envisioned his home not only as a place to live but also as a sanctuary for his cherished collection. The architect responded to this vision by creating a spatial narrative that encourages exploration. A curving wall weaves through the layout, guiding and distorting the circulation to create a sense of wandering-inviting visitors to discover the space as their own personal journey.Save this picture!Save this picture!Save this picture!Save this picture!Save this picture!Upon approaching the site, the first impression is marked by a small, enclosed entrance framed by the curved wall. This design element creates a sense of tension and curiosity, gently pushing visitors to step inside. Above this entrance lies an observation area, symbolizing a point where beginning and end converge. Passing through the threshold, visitors encounter a small pond on the right, accompanied by an empty frame moment of reflection that the owner holds dear. This area includes a multipurpose space used for temporary exhibitions and gatherings, and includes bathroom facilities. This room is connected to an outdoor courtyard, which also takes advantage of the beautiful view and ventilation.Save this picture!Save this picture!On the left side of the site lies the café and reception area. A significant feature here is the expansive courtyard, which benefits from the shade of a large, existing tree that has grown since the owner's childhood. The café is designed with floor-to-ceiling windows, providing unobstructed views of the courtyard and artifacts suspended throughout the space. A unique element is the incorporation of antique doors from the owner's collection, seamlessly merging art and architecture.Save this picture!Save this picture!The second floor is dedicated primarily to galleries. A staircase leads to a temporary exhibition space suitable for smaller-scale paintings. The two main buildings are connected via a steel bridge, which leads to the upper level of the café. This section houses an exhibition featuring pieces from the Indian subcontinent. Turning at this point leads visitors back to the multipurpose area via an original Art Nouveau staircase, while continuing forward completes the journey, returning to the elevated observation point—the symbolic end of the path.Save this picture!Save this picture!This architecture prominently features brick; the choice of using brick as the main material is due to the revival of ancient architecture, as brick used to be the dominant material used in building and construction. Therefore, utilizing various types of brick and construction techniques to create texture, depth, and a sense of timelessness throughout the project is metaphorical to a journey of brick building this architectural piece.Save this picture! Project gallerySee allShow less About this officeVolume Matrix studioOffice••• MaterialBrickMaterials and TagsPublished on June 16, 2025Cite: "Brick Journey / Volume Matrix studio" 16 Jun 2025. ArchDaily. Accessed . <https://www.archdaily.com/1031113/brick-journey-volume-matrix-studio&gt ISSN 0719-8884Save世界上最受欢迎的建筑网站现已推出你的母语版本!想浏览ArchDaily中国吗?是否 You've started following your first account!Did you know?You'll now receive updates based on what you follow! Personalize your stream and start following your favorite authors, offices and users.Go to my stream
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  • Stanford Doctors Invent Device That Appears to Be Able to Save Tons of Stroke Patients Before They Die

    Image by Andrew BrodheadResearchers have developed a novel device that literally spins away the clots that block blood flow to the brain and cause strokes.As Stanford explains in a blurb, the novel milli-spinner device may be able to save the lives of patients who experience "ischemic stroke" from brain stem clotting.Traditional clot removal, a process known as thrombectomy, generally uses a catheter that either vacuums up the blood blockage or uses a wire mesh to ensnare it — a procedure that's as rough and imprecise as it sounds. Conventional thrombectomy has a very low efficacy rate because of this imprecision, and the procedure can result in pieces of the clot breaking off and moving to more difficult-to-reach regions.Thrombectomy via milli-spinner also enters the brain with a catheter, but instead of using a normal vacuum device, it employs a spinning tube outfitted with fins and slits that can suck up the clot much more meticulously.Stanford neuroimaging expert Jeremy Heit, who also coauthored a new paper about the device in the journal Nature, explained in the school's press release that the efficacy of the milli-spinner is "unbelievable.""For most cases, we’re more than doubling the efficacy of current technology, and for the toughest clots — which we’re only removing about 11 percent of the time with current devices — we’re getting the artery open on the first try 90 percent of the time," Heit said. "This is a sea-change technology that will drastically improve our ability to help people."Renee Zhao, the senior author of the Nature paper who teaches mechanical engineering at Stanford and creates what she calls "millirobots," said that conventional thrombectomies just aren't cutting it."With existing technology, there’s no way to reduce the size of the clot," Zhao said. "They rely on deforming and rupturing the clot to remove it.""What’s unique about the milli-spinner is that it applies compression and shear forces to shrink the entire clot," she continued, "dramatically reducing the volume without causing rupture."Indeed, as the team discovered, the device can cut and vacuum up to five percent of its original size."It works so well, for a wide range of clot compositions and sizes," Zhao said. "Even for tough... clots, which are impossible to treat with current technologies, our milli-spinner can treat them using this simple yet powerful mechanics concept to densify the fibrin network and shrink the clot."Though its main experimental use case is brain clot removal, Zhao is excited about its other uses, too."We’re exploring other biomedical applications for the milli-spinner design, and even possibilities beyond medicine," the engineer said. "There are some very exciting opportunities ahead."More on brains: The Microplastics in Your Brain May Be Causing Mental Health IssuesShare This Article
    #stanford #doctors #invent #device #that
    Stanford Doctors Invent Device That Appears to Be Able to Save Tons of Stroke Patients Before They Die
    Image by Andrew BrodheadResearchers have developed a novel device that literally spins away the clots that block blood flow to the brain and cause strokes.As Stanford explains in a blurb, the novel milli-spinner device may be able to save the lives of patients who experience "ischemic stroke" from brain stem clotting.Traditional clot removal, a process known as thrombectomy, generally uses a catheter that either vacuums up the blood blockage or uses a wire mesh to ensnare it — a procedure that's as rough and imprecise as it sounds. Conventional thrombectomy has a very low efficacy rate because of this imprecision, and the procedure can result in pieces of the clot breaking off and moving to more difficult-to-reach regions.Thrombectomy via milli-spinner also enters the brain with a catheter, but instead of using a normal vacuum device, it employs a spinning tube outfitted with fins and slits that can suck up the clot much more meticulously.Stanford neuroimaging expert Jeremy Heit, who also coauthored a new paper about the device in the journal Nature, explained in the school's press release that the efficacy of the milli-spinner is "unbelievable.""For most cases, we’re more than doubling the efficacy of current technology, and for the toughest clots — which we’re only removing about 11 percent of the time with current devices — we’re getting the artery open on the first try 90 percent of the time," Heit said. "This is a sea-change technology that will drastically improve our ability to help people."Renee Zhao, the senior author of the Nature paper who teaches mechanical engineering at Stanford and creates what she calls "millirobots," said that conventional thrombectomies just aren't cutting it."With existing technology, there’s no way to reduce the size of the clot," Zhao said. "They rely on deforming and rupturing the clot to remove it.""What’s unique about the milli-spinner is that it applies compression and shear forces to shrink the entire clot," she continued, "dramatically reducing the volume without causing rupture."Indeed, as the team discovered, the device can cut and vacuum up to five percent of its original size."It works so well, for a wide range of clot compositions and sizes," Zhao said. "Even for tough... clots, which are impossible to treat with current technologies, our milli-spinner can treat them using this simple yet powerful mechanics concept to densify the fibrin network and shrink the clot."Though its main experimental use case is brain clot removal, Zhao is excited about its other uses, too."We’re exploring other biomedical applications for the milli-spinner design, and even possibilities beyond medicine," the engineer said. "There are some very exciting opportunities ahead."More on brains: The Microplastics in Your Brain May Be Causing Mental Health IssuesShare This Article #stanford #doctors #invent #device #that
    FUTURISM.COM
    Stanford Doctors Invent Device That Appears to Be Able to Save Tons of Stroke Patients Before They Die
    Image by Andrew BrodheadResearchers have developed a novel device that literally spins away the clots that block blood flow to the brain and cause strokes.As Stanford explains in a blurb, the novel milli-spinner device may be able to save the lives of patients who experience "ischemic stroke" from brain stem clotting.Traditional clot removal, a process known as thrombectomy, generally uses a catheter that either vacuums up the blood blockage or uses a wire mesh to ensnare it — a procedure that's as rough and imprecise as it sounds. Conventional thrombectomy has a very low efficacy rate because of this imprecision, and the procedure can result in pieces of the clot breaking off and moving to more difficult-to-reach regions.Thrombectomy via milli-spinner also enters the brain with a catheter, but instead of using a normal vacuum device, it employs a spinning tube outfitted with fins and slits that can suck up the clot much more meticulously.Stanford neuroimaging expert Jeremy Heit, who also coauthored a new paper about the device in the journal Nature, explained in the school's press release that the efficacy of the milli-spinner is "unbelievable.""For most cases, we’re more than doubling the efficacy of current technology, and for the toughest clots — which we’re only removing about 11 percent of the time with current devices — we’re getting the artery open on the first try 90 percent of the time," Heit said. "This is a sea-change technology that will drastically improve our ability to help people."Renee Zhao, the senior author of the Nature paper who teaches mechanical engineering at Stanford and creates what she calls "millirobots," said that conventional thrombectomies just aren't cutting it."With existing technology, there’s no way to reduce the size of the clot," Zhao said. "They rely on deforming and rupturing the clot to remove it.""What’s unique about the milli-spinner is that it applies compression and shear forces to shrink the entire clot," she continued, "dramatically reducing the volume without causing rupture."Indeed, as the team discovered, the device can cut and vacuum up to five percent of its original size."It works so well, for a wide range of clot compositions and sizes," Zhao said. "Even for tough... clots, which are impossible to treat with current technologies, our milli-spinner can treat them using this simple yet powerful mechanics concept to densify the fibrin network and shrink the clot."Though its main experimental use case is brain clot removal, Zhao is excited about its other uses, too."We’re exploring other biomedical applications for the milli-spinner design, and even possibilities beyond medicine," the engineer said. "There are some very exciting opportunities ahead."More on brains: The Microplastics in Your Brain May Be Causing Mental Health IssuesShare This Article
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  • WHEN Fertility

    WHEN provides at-home egg count testing and access to the country's leading fertility experts ? prompting a conversation about how and when women can access their own fertility information. They came to Universal Favourite to conceive a brand that could balance credibility and compassion in equal measure. One that felt just as comfortable in a trusted doctor's office as the shiny shelves of a global beauty store.
    #when #fertility
    WHEN Fertility
    WHEN provides at-home egg count testing and access to the country's leading fertility experts ? prompting a conversation about how and when women can access their own fertility information. They came to Universal Favourite to conceive a brand that could balance credibility and compassion in equal measure. One that felt just as comfortable in a trusted doctor's office as the shiny shelves of a global beauty store. #when #fertility
    WWW.BEHANCE.NET
    WHEN Fertility
    WHEN provides at-home egg count testing and access to the country's leading fertility experts ? prompting a conversation about how and when women can access their own fertility information. They came to Universal Favourite to conceive a brand that could balance credibility and compassion in equal measure. One that felt just as comfortable in a trusted doctor's office as the shiny shelves of a global beauty store.
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  • How AI is reshaping the future of healthcare and medical research

    Transcript       
    PETER LEE: “In ‘The Little Black Bag,’ a classic science fiction story, a high-tech doctor’s kit of the future is accidentally transported back to the 1950s, into the shaky hands of a washed-up, alcoholic doctor. The ultimate medical tool, it redeems the doctor wielding it, allowing him to practice gratifyingly heroic medicine. … The tale ends badly for the doctor and his treacherous assistant, but it offered a picture of how advanced technology could transform medicine—powerful when it was written nearly 75 years ago and still so today. What would be the Al equivalent of that little black bag? At this moment when new capabilities are emerging, how do we imagine them into medicine?”          
    This is The AI Revolution in Medicine, Revisited. I’m your host, Peter Lee.   
    Shortly after OpenAI’s GPT-4 was publicly released, Carey Goldberg, Dr. Zak Kohane, and I published The AI Revolution in Medicine to help educate the world of healthcare and medical research about the transformative impact this new generative AI technology could have. But because we wrote the book when GPT-4 was still a secret, we had to speculate. Now, two years later, what did we get right, and what did we get wrong?    
    In this series, we’ll talk to clinicians, patients, hospital administrators, and others to understand the reality of AI in the field and where we go from here.  The book passage I read at the top is from “Chapter 10: The Big Black Bag.” 
    In imagining AI in medicine, Carey, Zak, and I included in our book two fictional accounts. In the first, a medical resident consults GPT-4 on her personal phone as the patient in front of her crashes. Within seconds, it offers an alternate response based on recent literature. In the second account, a 90-year-old woman with several chronic conditions is living independently and receiving near-constant medical support from an AI aide.   
    In our conversations with the guests we’ve spoken to so far, we’ve caught a glimpse of these predicted futures, seeing how clinicians and patients are actually using AI today and how developers are leveraging the technology in the healthcare products and services they’re creating. In fact, that first fictional account isn’t so fictional after all, as most of the doctors in the real world actually appear to be using AI at least occasionally—and sometimes much more than occasionally—to help in their daily clinical work. And as for the second fictional account, which is more of a science fiction account, it seems we are indeed on the verge of a new way of delivering and receiving healthcare, though the future is still very much open. 
    As we continue to examine the current state of AI in healthcare and its potential to transform the field, I’m pleased to welcome Bill Gates and Sébastien Bubeck.  
    Bill may be best known as the co-founder of Microsoft, having created the company with his childhood friend Paul Allen in 1975. He’s now the founder of Breakthrough Energy, which aims to advance clean energy innovation, and TerraPower, a company developing groundbreaking nuclear energy and science technologies. He also chairs the world’s largest philanthropic organization, the Gates Foundation, and focuses on solving a variety of health challenges around the globe and here at home. 
    Sébastien is a research lead at OpenAI. He was previously a distinguished scientist, vice president of AI, and a colleague of mine here at Microsoft, where his work included spearheading the development of the family of small language models known as Phi. While at Microsoft, he also coauthored the discussion-provoking 2023 paper “Sparks of Artificial General Intelligence,” which presented the results of early experiments with GPT-4 conducted by a small team from Microsoft Research.     
    Here’s my conversation with Bill Gates and Sébastien Bubeck. 
    LEE: Bill, welcome. 
    BILL GATES: Thank you. 
    LEE: Seb … 
    SÉBASTIEN BUBECK: Yeah. Hi, hi, Peter. Nice to be here. 
    LEE: You know, one of the things that I’ve been doing just to get the conversation warmed up is to talk about origin stories, and what I mean about origin stories is, you know, what was the first contact that you had with large language models or the concept of generative AI that convinced you or made you think that something really important was happening? 
    And so, Bill, I think I’ve heard the story about, you know, the time when the OpenAI folks—Sam Altman, Greg Brockman, and others—showed you something, but could we hear from you what those early encounters were like and what was going through your mind?  
    GATES: Well, I’d been visiting OpenAI soon after it was created to see things like GPT-2 and to see the little arm they had that was trying to match human manipulation and, you know, looking at their games like Dota that they were trying to get as good as human play. And honestly, I didn’t think the language model stuff they were doing, even when they got to GPT-3, would show the ability to learn, you know, in the same sense that a human reads a biology book and is able to take that knowledge and access it not only to pass a test but also to create new medicines. 
    And so my challenge to them was that if their LLM could get a five on the advanced placement biology test, then I would say, OK, it took biologic knowledge and encoded it in an accessible way and that I didn’t expect them to do that very quickly but it would be profound.  
    And it was only about six months after I challenged them to do that, that an early version of GPT-4 they brought up to a dinner at my house, and in fact, it answered most of the questions that night very well. The one it got totally wrong, we were … because it was so good, we kept thinking, Oh, we must be wrong. It turned out it was a math weaknessthat, you know, we later understood that that was an area of, weirdly, of incredible weakness of those early models. But, you know, that was when I realized, OK, the age of cheap intelligence was at its beginning. 
    LEE: Yeah. So I guess it seems like you had something similar to me in that my first encounters, I actually harbored some skepticism. Is it fair to say you were skeptical before that? 
    GATES: Well, the idea that we’ve figured out how to encode and access knowledge in this very deep sense without even understanding the nature of the encoding, … 
    LEE: Right.  
    GATES: … that is a bit weird.  
    LEE: Yeah. 
    GATES: We have an algorithm that creates the computation, but even say, OK, where is the president’s birthday stored in there? Where is this fact stored in there? The fact that even now when we’re playing around, getting a little bit more sense of it, it’s opaque to us what the semantic encoding is, it’s, kind of, amazing to me. I thought the invention of knowledge storage would be an explicit way of encoding knowledge, not an implicit statistical training. 
    LEE: Yeah, yeah. All right. So, Seb, you know, on this same topic, you know, I got—as we say at Microsoft—I got pulled into the tent. 
    BUBECK: Yes.  
    LEE: Because this was a very secret project. And then, um, I had the opportunity to select a small number of researchers in MSRto join and start investigating this thing seriously. And the first person I pulled in was you. 
    BUBECK: Yeah. 
    LEE: And so what were your first encounters? Because I actually don’t remember what happened then. 
    BUBECK: Oh, I remember it very well.My first encounter with GPT-4 was in a meeting with the two of you, actually. But my kind of first contact, the first moment where I realized that something was happening with generative AI, was before that. And I agree with Bill that I also wasn’t too impressed by GPT-3. 
    I though that it was kind of, you know, very naturally mimicking the web, sort of parroting what was written there in a nice way. Still in a way which seemed very impressive. But it wasn’t really intelligent in any way. But shortly after GPT-3, there was a model before GPT-4 that really shocked me, and this was the first image generation model, DALL-E 1. 
    So that was in 2021. And I will forever remember the press release of OpenAI where they had this prompt of an avocado chair and then you had this image of the avocado chair.And what really shocked me is that clearly the model kind of “understood” what is a chair, what is an avocado, and was able to merge those concepts. 
    So this was really, to me, the first moment where I saw some understanding in those models.  
    LEE: So this was, just to get the timing right, that was before I pulled you into the tent. 
    BUBECK: That was before. That was like a year before. 
    LEE: Right.  
    BUBECK: And now I will tell you how, you know, we went from that moment to the meeting with the two of you and GPT-4. 
    So once I saw this kind of understanding, I thought, OK, fine. It understands concept, but it’s still not able to reason. It cannot—as, you know, Bill was saying—it cannot learn from your document. It cannot reason.  
    So I set out to try to prove that. You know, this is what I was in the business of at the time, trying to prove things in mathematics. So I was trying to prove that basically autoregressive transformers could never reason. So I was trying to prove this. And after a year of work, I had something reasonable to show. And so I had the meeting with the two of you, and I had this example where I wanted to say, there is no way that an LLM is going to be able to do x. 
    And then as soon as I … I don’t know if you remember, Bill. But as soon as I said that, you said, oh, but wait a second. I had, you know, the OpenAI crew at my house recently, and they showed me a new model. Why don’t we ask this new model this question?  
    LEE: Yeah.
    BUBECK: And we did, and it solved it on the spot. And that really, honestly, just changed my life. Like, you know, I had been working for a year trying to say that this was impossible. And just right there, it was shown to be possible.  
    LEE:One of the very first things I got interested in—because I was really thinking a lot about healthcare—was healthcare and medicine. 
    And I don’t know if the two of you remember, but I ended up doing a lot of tests. I ran through, you know, step one and step two of the US Medical Licensing Exam. Did a whole bunch of other things. I wrote this big report. It was, you know, I can’t remember … a couple hundred pages.  
    And I needed to share this with someone. I didn’t … there weren’t too many people I could share it with. So I sent, I think, a copy to you, Bill. Sent a copy to you, Seb.  
    I hardly slept for about a week putting that report together. And, yeah, and I kept working on it. But I was far from alone. I think everyone who was in the tent, so to speak, in those early days was going through something pretty similar. All right. So I think … of course, a lot of what I put in the report also ended up being examples that made it into the book. 
    But the main purpose of this conversation isn’t to reminisce aboutor indulge in those reminiscences but to talk about what’s happening in healthcare and medicine. And, you know, as I said, we wrote this book. We did it very, very quickly. Seb, you helped. Bill, you know, you provided a review and some endorsements. 
    But, you know, honestly, we didn’t know what we were talking about because no one had access to this thing. And so we just made a bunch of guesses. So really, the whole thing I wanted to probe with the two of you is, now with two years of experience out in the world, what, you know, what do we think is happening today? 
    You know, is AI actually having an impact, positive or negative, on healthcare and medicine? And what do we now think is going to happen in the next two years, five years, or 10 years? And so I realize it’s a little bit too abstract to just ask it that way. So let me just try to narrow the discussion and guide us a little bit.  
    Um, the kind of administrative and clerical work, paperwork, around healthcare—and we made a lot of guesses about that—that appears to be going well, but, you know, Bill, I know we’ve discussed that sometimes that you think there ought to be a lot more going on. Do you have a viewpoint on how AI is actually finding its way into reducing paperwork? 
    GATES: Well, I’m stunned … I don’t think there should be a patient-doctor meeting where the AI is not sitting in and both transcribing, offering to help with the paperwork, and even making suggestions, although the doctor will be the one, you know, who makes the final decision about the diagnosis and whatever prescription gets done.  
    It’s so helpful. You know, when that patient goes home and their, you know, son who wants to understand what happened has some questions, that AI should be available to continue that conversation. And the way you can improve that experience and streamline things and, you know, involve the people who advise you. I don’t understand why that’s not more adopted, because there you still have the human in the loop making that final decision. 
    But even for, like, follow-up calls to make sure the patient did things, to understand if they have concerns and knowing when to escalate back to the doctor, the benefit is incredible. And, you know, that thing is ready for prime time. That paradigm is ready for prime time, in my view. 
    LEE: Yeah, there are some good products, but it seems like the number one use right now—and we kind of got this from some of the previous guests in previous episodes—is the use of AI just to respond to emails from patients.Does that make sense to you? 
    BUBECK: Yeah. So maybe I want to second what Bill was saying but maybe take a step back first. You know, two years ago, like, the concept of clinical scribes, which is one of the things that we’re talking about right now, it would have sounded, in fact, it sounded two years ago, borderline dangerous. Because everybody was worried about hallucinations. What happened if you have this AI listening in and then it transcribes, you know, something wrong? 
    Now, two years later, I think it’s mostly working. And in fact, it is not yet, you know, fully adopted. You’re right. But it is in production. It is used, you know, in many, many places. So this rate of progress is astounding because it wasn’t obvious that we would be able to overcome those obstacles of hallucination. It’s not to say that hallucinations are fully solved. In the case of the closed system, they are.  
    Now, I think more generally what’s going on in the background is that there is something that we, that certainly I, underestimated, which is this management overhead. So I think the reason why this is not adopted everywhere is really a training and teaching aspect. People need to be taught, like, those systems, how to interact with them. 
    And one example that I really like, a study that recently appeared where they tried to use ChatGPT for diagnosis and they were comparing doctors without and with ChatGPT. And the amazing thing … so this was a set of cases where the accuracy of the doctors alone was around 75%. ChatGPT alone was 90%. So that’s already kind of mind blowing. But then the kicker is that doctors with ChatGPT was 80%.  
    Intelligence alone is not enough. It’s also how it’s presented, how you interact with it. And ChatGPT, it’s an amazing tool. Obviously, I absolutely love it. But it’s not … you don’t want a doctor to have to type in, you know, prompts and use it that way. 
    It should be, as Bill was saying, kind of running continuously in the background, sending you notifications. And you have to be really careful of the rate at which those notifications are being sent. Because if they are too frequent, then the doctor will learn to ignore them. So you have to … all of those things matter, in fact, at least as much as the level of intelligence of the machine. 
    LEE: One of the things I think about, Bill, in that scenario that you described, doctors do some thinking about the patient when they write the note. So, you know, I’m always a little uncertain whether it’s actually … you know, you wouldn’t necessarily want to fully automate this, I don’t think. Or at least there needs to be some prompt to the doctor to make sure that the doctor puts some thought into what happened in the encounter with the patient. Does that make sense to you at all? 
    GATES: At this stage, you know, I’d still put the onus on the doctor to write the conclusions and the summary and not delegate that. 
    The tradeoffs you make a little bit are somewhat dependent on the situation you’re in. If you’re in Africa,
    So, yes, the doctor’s still going to have to do a lot of work, but just the quality of letting the patient and the people around them interact and ask questions and have things explained, that alone is such a quality improvement. It’s mind blowing.  
    LEE: So since you mentioned, you know, Africa—and, of course, this touches on the mission and some of the priorities of the Gates Foundation and this idea of democratization of access to expert medical care—what’s the most interesting stuff going on right now? Are there people and organizations or technologies that are impressing you or that you’re tracking? 
    GATES: Yeah. So the Gates Foundation has given out a lot of grants to people in Africa doing education, agriculture but more healthcare examples than anything. And the way these things start off, they often start out either being patient-centric in a narrow situation, like, OK, I’m a pregnant woman; talk to me. Or, I have infectious disease symptoms; talk to me. Or they’re connected to a health worker where they’re helping that worker get their job done. And we have lots of pilots out, you know, in both of those cases.  
    The dream would be eventually to have the thing the patient consults be so broad that it’s like having a doctor available who understands the local things.  
    LEE: Right.  
    GATES: We’re not there yet. But over the next two or three years, you know, particularly given the worsening financial constraints against African health systems, where the withdrawal of money has been dramatic, you know, figuring out how to take this—what I sometimes call “free intelligence”—and build a quality health system around that, we will have to be more radical in low-income countries than any rich country is ever going to be.  
    LEE: Also, there’s maybe a different regulatory environment, so some of those things maybe are easier? Because right now, I think the world hasn’t figured out how to and whether to regulate, let’s say, an AI that might give a medical diagnosis or write a prescription for a medication. 
    BUBECK: Yeah. I think one issue with this, and it’s also slowing down the deployment of AI in healthcare more generally, is a lack of proper benchmark. Because, you know, you were mentioning the USMLE, for example. That’s a great test to test human beings and their knowledge of healthcare and medicine. But it’s not a great test to give to an AI. 
    It’s not asking the right questions. So finding what are the right questions to test whether an AI system is ready to give diagnosis in a constrained setting, that’s a very, very important direction, which to my surprise, is not yet accelerating at the rate that I was hoping for. 
    LEE: OK, so that gives me an excuse to get more now into the core AI tech because something I’ve discussed with both of you is this issue of what are the right tests. And you both know the very first test I give to any new spin of an LLM is I present a patient, the results—a mythical patient—the results of my physical exam, my mythical physical exam. Maybe some results of some initial labs. And then I present or propose a differential diagnosis. And if you’re not in medicine, a differential diagnosis you can just think of as a prioritized list of the possible diagnoses that fit with all that data. And in that proposed differential, I always intentionally make two mistakes. 
    I make a textbook technical error in one of the possible elements of the differential diagnosis, and I have an error of omission. And, you know, I just want to know, does the LLM understand what I’m talking about? And all the good ones out there do now. But then I want to know, can it spot the errors? And then most importantly, is it willing to tell me I’m wrong, that I’ve made a mistake?  
    That last piece seems really hard for AI today. And so let me ask you first, Seb, because at the time of this taping, of course, there was a new spin of GPT-4o last week that became overly sycophantic. In other words, it was actually prone in that test of mine not only to not tell me I’m wrong, but it actually praised me for the creativity of my differential.What’s up with that? 
    BUBECK: Yeah, I guess it’s a testament to the fact that training those models is still more of an art than a science. So it’s a difficult job. Just to be clear with the audience, we have rolled back thatversion of GPT-4o, so now we don’t have the sycophant version out there. 
    Yeah, no, it’s a really difficult question. It has to do … as you said, it’s very technical. It has to do with the post-training and how, like, where do you nudge the model? So, you know, there is this very classical by now technique called RLHF, where you push the model in the direction of a certain reward model. So the reward model is just telling the model, you know, what behavior is good, what behavior is bad. 
    But this reward model is itself an LLM, and, you know, Bill was saying at the very beginning of the conversation that we don’t really understand how those LLMs deal with concepts like, you know, where is the capital of France located? Things like that. It is the same thing for this reward model. We don’t know why it says that it prefers one output to another, and whether this is correlated with some sycophancy is, you know, something that we discovered basically just now. That if you push too hard in optimization on this reward model, you will get a sycophant model. 
    So it’s kind of … what I’m trying to say is we became too good at what we were doing, and we ended up, in fact, in a trap of the reward model. 
    LEE: I mean, you do want … it’s a difficult balance because you do want models to follow your desires and … 
    BUBECK: It’s a very difficult, very difficult balance. 
    LEE: So this brings up then the following question for me, which is the extent to which we think we’ll need to have specially trained models for things. So let me start with you, Bill. Do you have a point of view on whether we will need to, you know, quote-unquote take AI models to med school? Have them specially trained? Like, if you were going to deploy something to give medical care in underserved parts of the world, do we need to do something special to create those models? 
    GATES: We certainly need to teach them the African languages and the unique dialects so that the multimedia interactions are very high quality. We certainly need to teach them the disease prevalence and unique disease patterns like, you know, neglected tropical diseases and malaria. So we need to gather a set of facts that somebody trying to go for a US customer base, you know, wouldn’t necessarily have that in there. 
    Those two things are actually very straightforward because the additional training time is small. I’d say for the next few years, we’ll also need to do reinforcement learning about the context of being a doctor and how important certain behaviors are. Humans learn over the course of their life to some degree that, I’m in a different context and the way I behave in terms of being willing to criticize or be nice, you know, how important is it? Who’s here? What’s my relationship to them?  
    Right now, these machines don’t have that broad social experience. And so if you know it’s going to be used for health things, a lot of reinforcement learning of the very best humans in that context would still be valuable. Eventually, the models will, having read all the literature of the world about good doctors, bad doctors, it’ll understand as soon as you say, “I want you to be a doctor diagnosing somebody.” All of the implicit reinforcement that fits that situation, you know, will be there.
    LEE: Yeah.
    GATES: And so I hope three years from now, we don’t have to do that reinforcement learning. But today, for any medical context, you would want a lot of data to reinforce tone, willingness to say things when, you know, there might be something significant at stake. 
    LEE: Yeah. So, you know, something Bill said, kind of, reminds me of another thing that I think we missed, which is, the context also … and the specialization also pertains to different, I guess, what we still call “modes,” although I don’t know if the idea of multimodal is the same as it was two years ago. But, you know, what do you make of all of the hubbub around—in fact, within Microsoft Research, this is a big deal, but I think we’re far from alone—you know, medical images and vision, video, proteins and molecules, cell, you know, cellular data and so on. 
    BUBECK: Yeah. OK. So there is a lot to say to everything … to the last, you know, couple of minutes. Maybe on the specialization aspect, you know, I think there is, hiding behind this, a really fundamental scientific question of whether eventually we have a singular AGIthat kind of knows everything and you can just put, you know, explain your own context and it will just get it and understand everything. 
    That’s one vision. I have to say, I don’t particularly believe in this vision. In fact, we humans are not like that at all. I think, hopefully, we are general intelligences, yet we have to specialize a lot. And, you know, I did myself a lot of RL, reinforcement learning, on mathematics. Like, that’s what I did, you know, spent a lot of time doing that. And I didn’t improve on other aspects. You know, in fact, I probably degraded in other aspects.So it’s … I think it’s an important example to have in mind. 
    LEE: I think I might disagree with you on that, though, because, like, doesn’t a model have to see both good science and bad science in order to be able to gain the ability to discern between the two? 
    BUBECK: Yeah, no, that absolutely. I think there is value in seeing the generality, in having a very broad base. But then you, kind of, specialize on verticals. And this is where also, you know, open-weights model, which we haven’t talked about yet, are really important because they allow you to provide this broad base to everyone. And then you can specialize on top of it. 
    LEE: So we have about three hours of stuff to talk about, but our time is actually running low.
    BUBECK: Yes, yes, yes.  
    LEE: So I think I want … there’s a more provocative question. It’s almost a silly question, but I need to ask it of the two of you, which is, is there a future, you know, where AI replaces doctors or replaces, you know, medical specialties that we have today? So what does the world look like, say, five years from now? 
    GATES: Well, it’s important to distinguish healthcare discovery activity from healthcare delivery activity. We focused mostly on delivery. I think it’s very much within the realm of possibility that the AI is not only accelerating healthcare discovery but substituting for a lot of the roles of, you know, I’m an organic chemist, or I run various types of assays. I can see those, which are, you know, testable-output-type jobs but with still very high value, I can see, you know, some replacement in those areas before the doctor.  
    The doctor, still understanding the human condition and long-term dialogues, you know, they’ve had a lifetime of reinforcement of that, particularly when you get into areas like mental health. So I wouldn’t say in five years, either people will choose to adopt it, but it will be profound that there’ll be this nearly free intelligence that can do follow-up, that can help you, you know, make sure you went through different possibilities. 
    And so I’d say, yes, we’ll have doctors, but I’d say healthcare will be massively transformed in its quality and in efficiency by AI in that time period. 
    LEE: Is there a comparison, useful comparison, say, between doctors and, say, programmers, computer programmers, or doctors and, I don’t know, lawyers? 
    GATES: Programming is another one that has, kind of, a mathematical correctness to it, you know, and so the objective function that you’re trying to reinforce to, as soon as you can understand the state machines, you can have something that’s “checkable”; that’s correct. So I think programming, you know, which is weird to say, that the machine will beat us at most programming tasks before we let it take over roles that have deep empathy, you know, physical presence and social understanding in them. 
    LEE: Yeah. By the way, you know, I fully expect in five years that AI will produce mathematical proofs that are checkable for validity, easily checkable, because they’ll be written in a proof-checking language like Lean or something but will be so complex that no human mathematician can understand them. I expect that to happen.  
    I can imagine in some fields, like cellular biology, we could have the same situation in the future because the molecular pathways, the chemistry, biochemistry of human cells or living cells is as complex as any mathematics, and so it seems possible that we may be in a state where in wet lab, we see, Oh yeah, this actually works, but no one can understand why. 
    BUBECK: Yeah, absolutely. I mean, I think I really agree with Bill’s distinction of the discovery and the delivery, and indeed, the discovery’s when you can check things, and at the end, there is an artifact that you can verify. You know, you can run the protocol in the wet lab and seeproduced what you wanted. So I absolutely agree with that.  
    And in fact, you know, we don’t have to talk five years from now. I don’t know if you know, but just recently, there was a paper that was published on a scientific discovery using o3- mini. So this is really amazing. And, you know, just very quickly, just so people know, it was about this statistical physics model, the frustrated Potts model, which has to do with coloring, and basically, the case of three colors, like, more than two colors was open for a long time, and o3 was able to reduce the case of three colors to two colors.  
    LEE: Yeah. 
    BUBECK: Which is just, like, astounding. And this is not … this is now. This is happening right now. So this is something that I personally didn’t expect it would happen so quickly, and it’s due to those reasoning models.  
    Now, on the delivery side, I would add something more to it for the reason why doctors and, in fact, lawyers and coders will remain for a long time, and it’s because we still don’t understand how those models generalize. Like, at the end of the day, we are not able to tell you when they are confronted with a really new, novel situation, whether they will work or not. 
    Nobody is able to give you that guarantee. And I think until we understand this generalization better, we’re not going to be willing to just let the system in the wild without human supervision. 
    LEE: But don’t human doctors, human specialists … so, for example, a cardiologist sees a patient in a certain way that a nephrologist … 
    BUBECK: Yeah.
    LEE: … or an endocrinologist might not.
    BUBECK: That’s right. But another cardiologist will understand and, kind of, expect a certain level of generalization from their peer. And this, we just don’t have it with AI models. Now, of course, you’re exactly right. That generalization is also hard for humans. Like, if you have a human trained for one task and you put them into another task, then you don’t … you often don’t know.
    LEE: OK. You know, the podcast is focused on what’s happened over the last two years. But now, I’d like one provocative prediction about what you think the world of AI and medicine is going to be at some point in the future. You pick your timeframe. I don’t care if it’s two years or 20 years from now, but, you know, what do you think will be different about AI in medicine in that future than today? 
    BUBECK: Yeah, I think the deployment is going to accelerate soon. Like, we’re really not missing very much. There is this enormous capability overhang. Like, even if progress completely stopped, with current systems, we can do a lot more than what we’re doing right now. So I think this will … this has to be realized, you know, sooner rather than later. 
    And I think it’s probably dependent on these benchmarks and proper evaluation and tying this with regulation. So these are things that take time in human society and for good reason. But now we already are at two years; you know, give it another two years and it should be really …  
    LEE: Will AI prescribe your medicines? Write your prescriptions? 
    BUBECK: I think yes. I think yes. 
    LEE: OK. Bill? 
    GATES: Well, I think the next two years, we’ll have massive pilots, and so the amount of use of the AI, still in a copilot-type mode, you know, we should get millions of patient visits, you know, both in general medicine and in the mental health side, as well. And I think that’s going to build up both the data and the confidence to give the AI some additional autonomy. You know, are you going to let it talk to you at night when you’re panicked about your mental health with some ability to escalate?
    And, you know, I’ve gone so far as to tell politicians with national health systems that if they deploy AI appropriately, that the quality of care, the overload of the doctors, the improvement in the economics will be enough that their voters will be stunned because they just don’t expect this, and, you know, they could be reelectedjust on this one thing of fixing what is a very overloaded and economically challenged health system in these rich countries. 
    You know, my personal role is going to be to make sure that in the poorer countries, there isn’t some lag; in fact, in many cases, that we’ll be more aggressive because, you know, we’re comparing to having no access to doctors at all. And, you know, so I think whether it’s India or Africa, there’ll be lessons that are globally valuable because we need medical intelligence. And, you know, thank god AI is going to provide a lot of that. 
    LEE: Well, on that optimistic note, I think that’s a good way to end. Bill, Seb, really appreciate all of this.  
    I think the most fundamental prediction we made in the book is that AI would actually find its way into the practice of medicine, and I think that that at least has come true, maybe in different ways than we expected, but it’s come true, and I think it’ll only accelerate from here. So thanks again, both of you.  
    GATES: Yeah. Thanks, you guys. 
    BUBECK: Thank you, Peter. Thanks, Bill. 
    LEE: I just always feel such a sense of privilege to have a chance to interact and actually work with people like Bill and Sébastien.   
    With Bill, I’m always amazed at how practically minded he is. He’s really thinking about the nuts and bolts of what AI might be able to do for people, and his thoughts about underserved parts of the world, the idea that we might actually be able to empower people with access to expert medical knowledge, I think is both inspiring and amazing.  
    And then, Seb, Sébastien Bubeck, he’s just absolutely a brilliant mind. He has a really firm grip on the deep mathematics of artificial intelligence and brings that to bear in his research and development work. And where that mathematics takes him isn’t just into the nuts and bolts of algorithms but into philosophical questions about the nature of intelligence.  
    One of the things that Sébastien brought up was the state of evaluation of AI systems. And indeed, he was fairly critical in our conversation. But of course, the world of AI research and development is just moving so fast, and indeed, since we recorded our conversation, OpenAI, in fact, released a new evaluation metric that is directly relevant to medical applications, and that is something called HealthBench. And Microsoft Research also released a new evaluation approach or process called ADeLe.  
    HealthBench and ADeLe are examples of new approaches to evaluating AI models that are less about testing their knowledge and ability to pass multiple-choice exams and instead are evaluation approaches designed to assess how well AI models are able to complete tasks that actually arise every day in typical healthcare or biomedical research settings. These are examples of really important good work that speak to how well AI models work in the real world of healthcare and biomedical research and how well they can collaborate with human beings in those settings. 
    You know, I asked Bill and Seb to make some predictions about the future. You know, my own answer, I expect that we’re going to be able to use AI to change how we diagnose patients, change how we decide treatment options.  
    If you’re a doctor or a nurse and you encounter a patient, you’ll ask questions, do a physical exam, you know, call out for labs just like you do today, but then you’ll be able to engage with AI based on all of that data and just ask, you know, based on all the other people who have gone through the same experience, who have similar data, how were they diagnosed? How were they treated? What were their outcomes? And what does that mean for the patient I have right now? Some people call it the “patients like me” paradigm. And I think that’s going to become real because of AI within our lifetimes. That idea of really grounding the delivery in healthcare and medical practice through data and intelligence, I actually now don’t see any barriers to that future becoming real.  
    I’d like to extend another big thank you to Bill and Sébastien for their time. And to our listeners, as always, it’s a pleasure to have you along for the ride. I hope you’ll join us for our remaining conversations, as well as a second coauthor roundtable with Carey and Zak.  
    Until next time.  
    #how #reshaping #future #healthcare #medical
    How AI is reshaping the future of healthcare and medical research
    Transcript        PETER LEE: “In ‘The Little Black Bag,’ a classic science fiction story, a high-tech doctor’s kit of the future is accidentally transported back to the 1950s, into the shaky hands of a washed-up, alcoholic doctor. The ultimate medical tool, it redeems the doctor wielding it, allowing him to practice gratifyingly heroic medicine. … The tale ends badly for the doctor and his treacherous assistant, but it offered a picture of how advanced technology could transform medicine—powerful when it was written nearly 75 years ago and still so today. What would be the Al equivalent of that little black bag? At this moment when new capabilities are emerging, how do we imagine them into medicine?”           This is The AI Revolution in Medicine, Revisited. I’m your host, Peter Lee.    Shortly after OpenAI’s GPT-4 was publicly released, Carey Goldberg, Dr. Zak Kohane, and I published The AI Revolution in Medicine to help educate the world of healthcare and medical research about the transformative impact this new generative AI technology could have. But because we wrote the book when GPT-4 was still a secret, we had to speculate. Now, two years later, what did we get right, and what did we get wrong?     In this series, we’ll talk to clinicians, patients, hospital administrators, and others to understand the reality of AI in the field and where we go from here.  The book passage I read at the top is from “Chapter 10: The Big Black Bag.”  In imagining AI in medicine, Carey, Zak, and I included in our book two fictional accounts. In the first, a medical resident consults GPT-4 on her personal phone as the patient in front of her crashes. Within seconds, it offers an alternate response based on recent literature. In the second account, a 90-year-old woman with several chronic conditions is living independently and receiving near-constant medical support from an AI aide.    In our conversations with the guests we’ve spoken to so far, we’ve caught a glimpse of these predicted futures, seeing how clinicians and patients are actually using AI today and how developers are leveraging the technology in the healthcare products and services they’re creating. In fact, that first fictional account isn’t so fictional after all, as most of the doctors in the real world actually appear to be using AI at least occasionally—and sometimes much more than occasionally—to help in their daily clinical work. And as for the second fictional account, which is more of a science fiction account, it seems we are indeed on the verge of a new way of delivering and receiving healthcare, though the future is still very much open.  As we continue to examine the current state of AI in healthcare and its potential to transform the field, I’m pleased to welcome Bill Gates and Sébastien Bubeck.   Bill may be best known as the co-founder of Microsoft, having created the company with his childhood friend Paul Allen in 1975. He’s now the founder of Breakthrough Energy, which aims to advance clean energy innovation, and TerraPower, a company developing groundbreaking nuclear energy and science technologies. He also chairs the world’s largest philanthropic organization, the Gates Foundation, and focuses on solving a variety of health challenges around the globe and here at home.  Sébastien is a research lead at OpenAI. He was previously a distinguished scientist, vice president of AI, and a colleague of mine here at Microsoft, where his work included spearheading the development of the family of small language models known as Phi. While at Microsoft, he also coauthored the discussion-provoking 2023 paper “Sparks of Artificial General Intelligence,” which presented the results of early experiments with GPT-4 conducted by a small team from Microsoft Research.      Here’s my conversation with Bill Gates and Sébastien Bubeck.  LEE: Bill, welcome.  BILL GATES: Thank you.  LEE: Seb …  SÉBASTIEN BUBECK: Yeah. Hi, hi, Peter. Nice to be here.  LEE: You know, one of the things that I’ve been doing just to get the conversation warmed up is to talk about origin stories, and what I mean about origin stories is, you know, what was the first contact that you had with large language models or the concept of generative AI that convinced you or made you think that something really important was happening?  And so, Bill, I think I’ve heard the story about, you know, the time when the OpenAI folks—Sam Altman, Greg Brockman, and others—showed you something, but could we hear from you what those early encounters were like and what was going through your mind?   GATES: Well, I’d been visiting OpenAI soon after it was created to see things like GPT-2 and to see the little arm they had that was trying to match human manipulation and, you know, looking at their games like Dota that they were trying to get as good as human play. And honestly, I didn’t think the language model stuff they were doing, even when they got to GPT-3, would show the ability to learn, you know, in the same sense that a human reads a biology book and is able to take that knowledge and access it not only to pass a test but also to create new medicines.  And so my challenge to them was that if their LLM could get a five on the advanced placement biology test, then I would say, OK, it took biologic knowledge and encoded it in an accessible way and that I didn’t expect them to do that very quickly but it would be profound.   And it was only about six months after I challenged them to do that, that an early version of GPT-4 they brought up to a dinner at my house, and in fact, it answered most of the questions that night very well. The one it got totally wrong, we were … because it was so good, we kept thinking, Oh, we must be wrong. It turned out it was a math weaknessthat, you know, we later understood that that was an area of, weirdly, of incredible weakness of those early models. But, you know, that was when I realized, OK, the age of cheap intelligence was at its beginning.  LEE: Yeah. So I guess it seems like you had something similar to me in that my first encounters, I actually harbored some skepticism. Is it fair to say you were skeptical before that?  GATES: Well, the idea that we’ve figured out how to encode and access knowledge in this very deep sense without even understanding the nature of the encoding, …  LEE: Right.   GATES: … that is a bit weird.   LEE: Yeah.  GATES: We have an algorithm that creates the computation, but even say, OK, where is the president’s birthday stored in there? Where is this fact stored in there? The fact that even now when we’re playing around, getting a little bit more sense of it, it’s opaque to us what the semantic encoding is, it’s, kind of, amazing to me. I thought the invention of knowledge storage would be an explicit way of encoding knowledge, not an implicit statistical training.  LEE: Yeah, yeah. All right. So, Seb, you know, on this same topic, you know, I got—as we say at Microsoft—I got pulled into the tent.  BUBECK: Yes.   LEE: Because this was a very secret project. And then, um, I had the opportunity to select a small number of researchers in MSRto join and start investigating this thing seriously. And the first person I pulled in was you.  BUBECK: Yeah.  LEE: And so what were your first encounters? Because I actually don’t remember what happened then.  BUBECK: Oh, I remember it very well.My first encounter with GPT-4 was in a meeting with the two of you, actually. But my kind of first contact, the first moment where I realized that something was happening with generative AI, was before that. And I agree with Bill that I also wasn’t too impressed by GPT-3.  I though that it was kind of, you know, very naturally mimicking the web, sort of parroting what was written there in a nice way. Still in a way which seemed very impressive. But it wasn’t really intelligent in any way. But shortly after GPT-3, there was a model before GPT-4 that really shocked me, and this was the first image generation model, DALL-E 1.  So that was in 2021. And I will forever remember the press release of OpenAI where they had this prompt of an avocado chair and then you had this image of the avocado chair.And what really shocked me is that clearly the model kind of “understood” what is a chair, what is an avocado, and was able to merge those concepts.  So this was really, to me, the first moment where I saw some understanding in those models.   LEE: So this was, just to get the timing right, that was before I pulled you into the tent.  BUBECK: That was before. That was like a year before.  LEE: Right.   BUBECK: And now I will tell you how, you know, we went from that moment to the meeting with the two of you and GPT-4.  So once I saw this kind of understanding, I thought, OK, fine. It understands concept, but it’s still not able to reason. It cannot—as, you know, Bill was saying—it cannot learn from your document. It cannot reason.   So I set out to try to prove that. You know, this is what I was in the business of at the time, trying to prove things in mathematics. So I was trying to prove that basically autoregressive transformers could never reason. So I was trying to prove this. And after a year of work, I had something reasonable to show. And so I had the meeting with the two of you, and I had this example where I wanted to say, there is no way that an LLM is going to be able to do x.  And then as soon as I … I don’t know if you remember, Bill. But as soon as I said that, you said, oh, but wait a second. I had, you know, the OpenAI crew at my house recently, and they showed me a new model. Why don’t we ask this new model this question?   LEE: Yeah. BUBECK: And we did, and it solved it on the spot. And that really, honestly, just changed my life. Like, you know, I had been working for a year trying to say that this was impossible. And just right there, it was shown to be possible.   LEE:One of the very first things I got interested in—because I was really thinking a lot about healthcare—was healthcare and medicine.  And I don’t know if the two of you remember, but I ended up doing a lot of tests. I ran through, you know, step one and step two of the US Medical Licensing Exam. Did a whole bunch of other things. I wrote this big report. It was, you know, I can’t remember … a couple hundred pages.   And I needed to share this with someone. I didn’t … there weren’t too many people I could share it with. So I sent, I think, a copy to you, Bill. Sent a copy to you, Seb.   I hardly slept for about a week putting that report together. And, yeah, and I kept working on it. But I was far from alone. I think everyone who was in the tent, so to speak, in those early days was going through something pretty similar. All right. So I think … of course, a lot of what I put in the report also ended up being examples that made it into the book.  But the main purpose of this conversation isn’t to reminisce aboutor indulge in those reminiscences but to talk about what’s happening in healthcare and medicine. And, you know, as I said, we wrote this book. We did it very, very quickly. Seb, you helped. Bill, you know, you provided a review and some endorsements.  But, you know, honestly, we didn’t know what we were talking about because no one had access to this thing. And so we just made a bunch of guesses. So really, the whole thing I wanted to probe with the two of you is, now with two years of experience out in the world, what, you know, what do we think is happening today?  You know, is AI actually having an impact, positive or negative, on healthcare and medicine? And what do we now think is going to happen in the next two years, five years, or 10 years? And so I realize it’s a little bit too abstract to just ask it that way. So let me just try to narrow the discussion and guide us a little bit.   Um, the kind of administrative and clerical work, paperwork, around healthcare—and we made a lot of guesses about that—that appears to be going well, but, you know, Bill, I know we’ve discussed that sometimes that you think there ought to be a lot more going on. Do you have a viewpoint on how AI is actually finding its way into reducing paperwork?  GATES: Well, I’m stunned … I don’t think there should be a patient-doctor meeting where the AI is not sitting in and both transcribing, offering to help with the paperwork, and even making suggestions, although the doctor will be the one, you know, who makes the final decision about the diagnosis and whatever prescription gets done.   It’s so helpful. You know, when that patient goes home and their, you know, son who wants to understand what happened has some questions, that AI should be available to continue that conversation. And the way you can improve that experience and streamline things and, you know, involve the people who advise you. I don’t understand why that’s not more adopted, because there you still have the human in the loop making that final decision.  But even for, like, follow-up calls to make sure the patient did things, to understand if they have concerns and knowing when to escalate back to the doctor, the benefit is incredible. And, you know, that thing is ready for prime time. That paradigm is ready for prime time, in my view.  LEE: Yeah, there are some good products, but it seems like the number one use right now—and we kind of got this from some of the previous guests in previous episodes—is the use of AI just to respond to emails from patients.Does that make sense to you?  BUBECK: Yeah. So maybe I want to second what Bill was saying but maybe take a step back first. You know, two years ago, like, the concept of clinical scribes, which is one of the things that we’re talking about right now, it would have sounded, in fact, it sounded two years ago, borderline dangerous. Because everybody was worried about hallucinations. What happened if you have this AI listening in and then it transcribes, you know, something wrong?  Now, two years later, I think it’s mostly working. And in fact, it is not yet, you know, fully adopted. You’re right. But it is in production. It is used, you know, in many, many places. So this rate of progress is astounding because it wasn’t obvious that we would be able to overcome those obstacles of hallucination. It’s not to say that hallucinations are fully solved. In the case of the closed system, they are.   Now, I think more generally what’s going on in the background is that there is something that we, that certainly I, underestimated, which is this management overhead. So I think the reason why this is not adopted everywhere is really a training and teaching aspect. People need to be taught, like, those systems, how to interact with them.  And one example that I really like, a study that recently appeared where they tried to use ChatGPT for diagnosis and they were comparing doctors without and with ChatGPT. And the amazing thing … so this was a set of cases where the accuracy of the doctors alone was around 75%. ChatGPT alone was 90%. So that’s already kind of mind blowing. But then the kicker is that doctors with ChatGPT was 80%.   Intelligence alone is not enough. It’s also how it’s presented, how you interact with it. And ChatGPT, it’s an amazing tool. Obviously, I absolutely love it. But it’s not … you don’t want a doctor to have to type in, you know, prompts and use it that way.  It should be, as Bill was saying, kind of running continuously in the background, sending you notifications. And you have to be really careful of the rate at which those notifications are being sent. Because if they are too frequent, then the doctor will learn to ignore them. So you have to … all of those things matter, in fact, at least as much as the level of intelligence of the machine.  LEE: One of the things I think about, Bill, in that scenario that you described, doctors do some thinking about the patient when they write the note. So, you know, I’m always a little uncertain whether it’s actually … you know, you wouldn’t necessarily want to fully automate this, I don’t think. Or at least there needs to be some prompt to the doctor to make sure that the doctor puts some thought into what happened in the encounter with the patient. Does that make sense to you at all?  GATES: At this stage, you know, I’d still put the onus on the doctor to write the conclusions and the summary and not delegate that.  The tradeoffs you make a little bit are somewhat dependent on the situation you’re in. If you’re in Africa, So, yes, the doctor’s still going to have to do a lot of work, but just the quality of letting the patient and the people around them interact and ask questions and have things explained, that alone is such a quality improvement. It’s mind blowing.   LEE: So since you mentioned, you know, Africa—and, of course, this touches on the mission and some of the priorities of the Gates Foundation and this idea of democratization of access to expert medical care—what’s the most interesting stuff going on right now? Are there people and organizations or technologies that are impressing you or that you’re tracking?  GATES: Yeah. So the Gates Foundation has given out a lot of grants to people in Africa doing education, agriculture but more healthcare examples than anything. And the way these things start off, they often start out either being patient-centric in a narrow situation, like, OK, I’m a pregnant woman; talk to me. Or, I have infectious disease symptoms; talk to me. Or they’re connected to a health worker where they’re helping that worker get their job done. And we have lots of pilots out, you know, in both of those cases.   The dream would be eventually to have the thing the patient consults be so broad that it’s like having a doctor available who understands the local things.   LEE: Right.   GATES: We’re not there yet. But over the next two or three years, you know, particularly given the worsening financial constraints against African health systems, where the withdrawal of money has been dramatic, you know, figuring out how to take this—what I sometimes call “free intelligence”—and build a quality health system around that, we will have to be more radical in low-income countries than any rich country is ever going to be.   LEE: Also, there’s maybe a different regulatory environment, so some of those things maybe are easier? Because right now, I think the world hasn’t figured out how to and whether to regulate, let’s say, an AI that might give a medical diagnosis or write a prescription for a medication.  BUBECK: Yeah. I think one issue with this, and it’s also slowing down the deployment of AI in healthcare more generally, is a lack of proper benchmark. Because, you know, you were mentioning the USMLE, for example. That’s a great test to test human beings and their knowledge of healthcare and medicine. But it’s not a great test to give to an AI.  It’s not asking the right questions. So finding what are the right questions to test whether an AI system is ready to give diagnosis in a constrained setting, that’s a very, very important direction, which to my surprise, is not yet accelerating at the rate that I was hoping for.  LEE: OK, so that gives me an excuse to get more now into the core AI tech because something I’ve discussed with both of you is this issue of what are the right tests. And you both know the very first test I give to any new spin of an LLM is I present a patient, the results—a mythical patient—the results of my physical exam, my mythical physical exam. Maybe some results of some initial labs. And then I present or propose a differential diagnosis. And if you’re not in medicine, a differential diagnosis you can just think of as a prioritized list of the possible diagnoses that fit with all that data. And in that proposed differential, I always intentionally make two mistakes.  I make a textbook technical error in one of the possible elements of the differential diagnosis, and I have an error of omission. And, you know, I just want to know, does the LLM understand what I’m talking about? And all the good ones out there do now. But then I want to know, can it spot the errors? And then most importantly, is it willing to tell me I’m wrong, that I’ve made a mistake?   That last piece seems really hard for AI today. And so let me ask you first, Seb, because at the time of this taping, of course, there was a new spin of GPT-4o last week that became overly sycophantic. In other words, it was actually prone in that test of mine not only to not tell me I’m wrong, but it actually praised me for the creativity of my differential.What’s up with that?  BUBECK: Yeah, I guess it’s a testament to the fact that training those models is still more of an art than a science. So it’s a difficult job. Just to be clear with the audience, we have rolled back thatversion of GPT-4o, so now we don’t have the sycophant version out there.  Yeah, no, it’s a really difficult question. It has to do … as you said, it’s very technical. It has to do with the post-training and how, like, where do you nudge the model? So, you know, there is this very classical by now technique called RLHF, where you push the model in the direction of a certain reward model. So the reward model is just telling the model, you know, what behavior is good, what behavior is bad.  But this reward model is itself an LLM, and, you know, Bill was saying at the very beginning of the conversation that we don’t really understand how those LLMs deal with concepts like, you know, where is the capital of France located? Things like that. It is the same thing for this reward model. We don’t know why it says that it prefers one output to another, and whether this is correlated with some sycophancy is, you know, something that we discovered basically just now. That if you push too hard in optimization on this reward model, you will get a sycophant model.  So it’s kind of … what I’m trying to say is we became too good at what we were doing, and we ended up, in fact, in a trap of the reward model.  LEE: I mean, you do want … it’s a difficult balance because you do want models to follow your desires and …  BUBECK: It’s a very difficult, very difficult balance.  LEE: So this brings up then the following question for me, which is the extent to which we think we’ll need to have specially trained models for things. So let me start with you, Bill. Do you have a point of view on whether we will need to, you know, quote-unquote take AI models to med school? Have them specially trained? Like, if you were going to deploy something to give medical care in underserved parts of the world, do we need to do something special to create those models?  GATES: We certainly need to teach them the African languages and the unique dialects so that the multimedia interactions are very high quality. We certainly need to teach them the disease prevalence and unique disease patterns like, you know, neglected tropical diseases and malaria. So we need to gather a set of facts that somebody trying to go for a US customer base, you know, wouldn’t necessarily have that in there.  Those two things are actually very straightforward because the additional training time is small. I’d say for the next few years, we’ll also need to do reinforcement learning about the context of being a doctor and how important certain behaviors are. Humans learn over the course of their life to some degree that, I’m in a different context and the way I behave in terms of being willing to criticize or be nice, you know, how important is it? Who’s here? What’s my relationship to them?   Right now, these machines don’t have that broad social experience. And so if you know it’s going to be used for health things, a lot of reinforcement learning of the very best humans in that context would still be valuable. Eventually, the models will, having read all the literature of the world about good doctors, bad doctors, it’ll understand as soon as you say, “I want you to be a doctor diagnosing somebody.” All of the implicit reinforcement that fits that situation, you know, will be there. LEE: Yeah. GATES: And so I hope three years from now, we don’t have to do that reinforcement learning. But today, for any medical context, you would want a lot of data to reinforce tone, willingness to say things when, you know, there might be something significant at stake.  LEE: Yeah. So, you know, something Bill said, kind of, reminds me of another thing that I think we missed, which is, the context also … and the specialization also pertains to different, I guess, what we still call “modes,” although I don’t know if the idea of multimodal is the same as it was two years ago. But, you know, what do you make of all of the hubbub around—in fact, within Microsoft Research, this is a big deal, but I think we’re far from alone—you know, medical images and vision, video, proteins and molecules, cell, you know, cellular data and so on.  BUBECK: Yeah. OK. So there is a lot to say to everything … to the last, you know, couple of minutes. Maybe on the specialization aspect, you know, I think there is, hiding behind this, a really fundamental scientific question of whether eventually we have a singular AGIthat kind of knows everything and you can just put, you know, explain your own context and it will just get it and understand everything.  That’s one vision. I have to say, I don’t particularly believe in this vision. In fact, we humans are not like that at all. I think, hopefully, we are general intelligences, yet we have to specialize a lot. And, you know, I did myself a lot of RL, reinforcement learning, on mathematics. Like, that’s what I did, you know, spent a lot of time doing that. And I didn’t improve on other aspects. You know, in fact, I probably degraded in other aspects.So it’s … I think it’s an important example to have in mind.  LEE: I think I might disagree with you on that, though, because, like, doesn’t a model have to see both good science and bad science in order to be able to gain the ability to discern between the two?  BUBECK: Yeah, no, that absolutely. I think there is value in seeing the generality, in having a very broad base. But then you, kind of, specialize on verticals. And this is where also, you know, open-weights model, which we haven’t talked about yet, are really important because they allow you to provide this broad base to everyone. And then you can specialize on top of it.  LEE: So we have about three hours of stuff to talk about, but our time is actually running low. BUBECK: Yes, yes, yes.   LEE: So I think I want … there’s a more provocative question. It’s almost a silly question, but I need to ask it of the two of you, which is, is there a future, you know, where AI replaces doctors or replaces, you know, medical specialties that we have today? So what does the world look like, say, five years from now?  GATES: Well, it’s important to distinguish healthcare discovery activity from healthcare delivery activity. We focused mostly on delivery. I think it’s very much within the realm of possibility that the AI is not only accelerating healthcare discovery but substituting for a lot of the roles of, you know, I’m an organic chemist, or I run various types of assays. I can see those, which are, you know, testable-output-type jobs but with still very high value, I can see, you know, some replacement in those areas before the doctor.   The doctor, still understanding the human condition and long-term dialogues, you know, they’ve had a lifetime of reinforcement of that, particularly when you get into areas like mental health. So I wouldn’t say in five years, either people will choose to adopt it, but it will be profound that there’ll be this nearly free intelligence that can do follow-up, that can help you, you know, make sure you went through different possibilities.  And so I’d say, yes, we’ll have doctors, but I’d say healthcare will be massively transformed in its quality and in efficiency by AI in that time period.  LEE: Is there a comparison, useful comparison, say, between doctors and, say, programmers, computer programmers, or doctors and, I don’t know, lawyers?  GATES: Programming is another one that has, kind of, a mathematical correctness to it, you know, and so the objective function that you’re trying to reinforce to, as soon as you can understand the state machines, you can have something that’s “checkable”; that’s correct. So I think programming, you know, which is weird to say, that the machine will beat us at most programming tasks before we let it take over roles that have deep empathy, you know, physical presence and social understanding in them.  LEE: Yeah. By the way, you know, I fully expect in five years that AI will produce mathematical proofs that are checkable for validity, easily checkable, because they’ll be written in a proof-checking language like Lean or something but will be so complex that no human mathematician can understand them. I expect that to happen.   I can imagine in some fields, like cellular biology, we could have the same situation in the future because the molecular pathways, the chemistry, biochemistry of human cells or living cells is as complex as any mathematics, and so it seems possible that we may be in a state where in wet lab, we see, Oh yeah, this actually works, but no one can understand why.  BUBECK: Yeah, absolutely. I mean, I think I really agree with Bill’s distinction of the discovery and the delivery, and indeed, the discovery’s when you can check things, and at the end, there is an artifact that you can verify. You know, you can run the protocol in the wet lab and seeproduced what you wanted. So I absolutely agree with that.   And in fact, you know, we don’t have to talk five years from now. I don’t know if you know, but just recently, there was a paper that was published on a scientific discovery using o3- mini. So this is really amazing. And, you know, just very quickly, just so people know, it was about this statistical physics model, the frustrated Potts model, which has to do with coloring, and basically, the case of three colors, like, more than two colors was open for a long time, and o3 was able to reduce the case of three colors to two colors.   LEE: Yeah.  BUBECK: Which is just, like, astounding. And this is not … this is now. This is happening right now. So this is something that I personally didn’t expect it would happen so quickly, and it’s due to those reasoning models.   Now, on the delivery side, I would add something more to it for the reason why doctors and, in fact, lawyers and coders will remain for a long time, and it’s because we still don’t understand how those models generalize. Like, at the end of the day, we are not able to tell you when they are confronted with a really new, novel situation, whether they will work or not.  Nobody is able to give you that guarantee. And I think until we understand this generalization better, we’re not going to be willing to just let the system in the wild without human supervision.  LEE: But don’t human doctors, human specialists … so, for example, a cardiologist sees a patient in a certain way that a nephrologist …  BUBECK: Yeah. LEE: … or an endocrinologist might not. BUBECK: That’s right. But another cardiologist will understand and, kind of, expect a certain level of generalization from their peer. And this, we just don’t have it with AI models. Now, of course, you’re exactly right. That generalization is also hard for humans. Like, if you have a human trained for one task and you put them into another task, then you don’t … you often don’t know. LEE: OK. You know, the podcast is focused on what’s happened over the last two years. But now, I’d like one provocative prediction about what you think the world of AI and medicine is going to be at some point in the future. You pick your timeframe. I don’t care if it’s two years or 20 years from now, but, you know, what do you think will be different about AI in medicine in that future than today?  BUBECK: Yeah, I think the deployment is going to accelerate soon. Like, we’re really not missing very much. There is this enormous capability overhang. Like, even if progress completely stopped, with current systems, we can do a lot more than what we’re doing right now. So I think this will … this has to be realized, you know, sooner rather than later.  And I think it’s probably dependent on these benchmarks and proper evaluation and tying this with regulation. So these are things that take time in human society and for good reason. But now we already are at two years; you know, give it another two years and it should be really …   LEE: Will AI prescribe your medicines? Write your prescriptions?  BUBECK: I think yes. I think yes.  LEE: OK. Bill?  GATES: Well, I think the next two years, we’ll have massive pilots, and so the amount of use of the AI, still in a copilot-type mode, you know, we should get millions of patient visits, you know, both in general medicine and in the mental health side, as well. And I think that’s going to build up both the data and the confidence to give the AI some additional autonomy. You know, are you going to let it talk to you at night when you’re panicked about your mental health with some ability to escalate? And, you know, I’ve gone so far as to tell politicians with national health systems that if they deploy AI appropriately, that the quality of care, the overload of the doctors, the improvement in the economics will be enough that their voters will be stunned because they just don’t expect this, and, you know, they could be reelectedjust on this one thing of fixing what is a very overloaded and economically challenged health system in these rich countries.  You know, my personal role is going to be to make sure that in the poorer countries, there isn’t some lag; in fact, in many cases, that we’ll be more aggressive because, you know, we’re comparing to having no access to doctors at all. And, you know, so I think whether it’s India or Africa, there’ll be lessons that are globally valuable because we need medical intelligence. And, you know, thank god AI is going to provide a lot of that.  LEE: Well, on that optimistic note, I think that’s a good way to end. Bill, Seb, really appreciate all of this.   I think the most fundamental prediction we made in the book is that AI would actually find its way into the practice of medicine, and I think that that at least has come true, maybe in different ways than we expected, but it’s come true, and I think it’ll only accelerate from here. So thanks again, both of you.   GATES: Yeah. Thanks, you guys.  BUBECK: Thank you, Peter. Thanks, Bill.  LEE: I just always feel such a sense of privilege to have a chance to interact and actually work with people like Bill and Sébastien.    With Bill, I’m always amazed at how practically minded he is. He’s really thinking about the nuts and bolts of what AI might be able to do for people, and his thoughts about underserved parts of the world, the idea that we might actually be able to empower people with access to expert medical knowledge, I think is both inspiring and amazing.   And then, Seb, Sébastien Bubeck, he’s just absolutely a brilliant mind. He has a really firm grip on the deep mathematics of artificial intelligence and brings that to bear in his research and development work. And where that mathematics takes him isn’t just into the nuts and bolts of algorithms but into philosophical questions about the nature of intelligence.   One of the things that Sébastien brought up was the state of evaluation of AI systems. And indeed, he was fairly critical in our conversation. But of course, the world of AI research and development is just moving so fast, and indeed, since we recorded our conversation, OpenAI, in fact, released a new evaluation metric that is directly relevant to medical applications, and that is something called HealthBench. And Microsoft Research also released a new evaluation approach or process called ADeLe.   HealthBench and ADeLe are examples of new approaches to evaluating AI models that are less about testing their knowledge and ability to pass multiple-choice exams and instead are evaluation approaches designed to assess how well AI models are able to complete tasks that actually arise every day in typical healthcare or biomedical research settings. These are examples of really important good work that speak to how well AI models work in the real world of healthcare and biomedical research and how well they can collaborate with human beings in those settings.  You know, I asked Bill and Seb to make some predictions about the future. You know, my own answer, I expect that we’re going to be able to use AI to change how we diagnose patients, change how we decide treatment options.   If you’re a doctor or a nurse and you encounter a patient, you’ll ask questions, do a physical exam, you know, call out for labs just like you do today, but then you’ll be able to engage with AI based on all of that data and just ask, you know, based on all the other people who have gone through the same experience, who have similar data, how were they diagnosed? How were they treated? What were their outcomes? And what does that mean for the patient I have right now? Some people call it the “patients like me” paradigm. And I think that’s going to become real because of AI within our lifetimes. That idea of really grounding the delivery in healthcare and medical practice through data and intelligence, I actually now don’t see any barriers to that future becoming real.   I’d like to extend another big thank you to Bill and Sébastien for their time. And to our listeners, as always, it’s a pleasure to have you along for the ride. I hope you’ll join us for our remaining conversations, as well as a second coauthor roundtable with Carey and Zak.   Until next time.   #how #reshaping #future #healthcare #medical
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    How AI is reshaping the future of healthcare and medical research
    Transcript [MUSIC]      [BOOK PASSAGE]   PETER LEE: “In ‘The Little Black Bag,’ a classic science fiction story, a high-tech doctor’s kit of the future is accidentally transported back to the 1950s, into the shaky hands of a washed-up, alcoholic doctor. The ultimate medical tool, it redeems the doctor wielding it, allowing him to practice gratifyingly heroic medicine. … The tale ends badly for the doctor and his treacherous assistant, but it offered a picture of how advanced technology could transform medicine—powerful when it was written nearly 75 years ago and still so today. What would be the Al equivalent of that little black bag? At this moment when new capabilities are emerging, how do we imagine them into medicine?”   [END OF BOOK PASSAGE]     [THEME MUSIC]     This is The AI Revolution in Medicine, Revisited. I’m your host, Peter Lee.    Shortly after OpenAI’s GPT-4 was publicly released, Carey Goldberg, Dr. Zak Kohane, and I published The AI Revolution in Medicine to help educate the world of healthcare and medical research about the transformative impact this new generative AI technology could have. But because we wrote the book when GPT-4 was still a secret, we had to speculate. Now, two years later, what did we get right, and what did we get wrong?     In this series, we’ll talk to clinicians, patients, hospital administrators, and others to understand the reality of AI in the field and where we go from here.   [THEME MUSIC FADES] The book passage I read at the top is from “Chapter 10: The Big Black Bag.”  In imagining AI in medicine, Carey, Zak, and I included in our book two fictional accounts. In the first, a medical resident consults GPT-4 on her personal phone as the patient in front of her crashes. Within seconds, it offers an alternate response based on recent literature. In the second account, a 90-year-old woman with several chronic conditions is living independently and receiving near-constant medical support from an AI aide.    In our conversations with the guests we’ve spoken to so far, we’ve caught a glimpse of these predicted futures, seeing how clinicians and patients are actually using AI today and how developers are leveraging the technology in the healthcare products and services they’re creating. In fact, that first fictional account isn’t so fictional after all, as most of the doctors in the real world actually appear to be using AI at least occasionally—and sometimes much more than occasionally—to help in their daily clinical work. And as for the second fictional account, which is more of a science fiction account, it seems we are indeed on the verge of a new way of delivering and receiving healthcare, though the future is still very much open.  As we continue to examine the current state of AI in healthcare and its potential to transform the field, I’m pleased to welcome Bill Gates and Sébastien Bubeck.   Bill may be best known as the co-founder of Microsoft, having created the company with his childhood friend Paul Allen in 1975. He’s now the founder of Breakthrough Energy, which aims to advance clean energy innovation, and TerraPower, a company developing groundbreaking nuclear energy and science technologies. He also chairs the world’s largest philanthropic organization, the Gates Foundation, and focuses on solving a variety of health challenges around the globe and here at home.  Sébastien is a research lead at OpenAI. He was previously a distinguished scientist, vice president of AI, and a colleague of mine here at Microsoft, where his work included spearheading the development of the family of small language models known as Phi. While at Microsoft, he also coauthored the discussion-provoking 2023 paper “Sparks of Artificial General Intelligence,” which presented the results of early experiments with GPT-4 conducted by a small team from Microsoft Research.    [TRANSITION MUSIC]   Here’s my conversation with Bill Gates and Sébastien Bubeck.  LEE: Bill, welcome.  BILL GATES: Thank you.  LEE: Seb …  SÉBASTIEN BUBECK: Yeah. Hi, hi, Peter. Nice to be here.  LEE: You know, one of the things that I’ve been doing just to get the conversation warmed up is to talk about origin stories, and what I mean about origin stories is, you know, what was the first contact that you had with large language models or the concept of generative AI that convinced you or made you think that something really important was happening?  And so, Bill, I think I’ve heard the story about, you know, the time when the OpenAI folks—Sam Altman, Greg Brockman, and others—showed you something, but could we hear from you what those early encounters were like and what was going through your mind?   GATES: Well, I’d been visiting OpenAI soon after it was created to see things like GPT-2 and to see the little arm they had that was trying to match human manipulation and, you know, looking at their games like Dota that they were trying to get as good as human play. And honestly, I didn’t think the language model stuff they were doing, even when they got to GPT-3, would show the ability to learn, you know, in the same sense that a human reads a biology book and is able to take that knowledge and access it not only to pass a test but also to create new medicines.  And so my challenge to them was that if their LLM could get a five on the advanced placement biology test, then I would say, OK, it took biologic knowledge and encoded it in an accessible way and that I didn’t expect them to do that very quickly but it would be profound.   And it was only about six months after I challenged them to do that, that an early version of GPT-4 they brought up to a dinner at my house, and in fact, it answered most of the questions that night very well. The one it got totally wrong, we were … because it was so good, we kept thinking, Oh, we must be wrong. It turned out it was a math weakness [LAUGHTER] that, you know, we later understood that that was an area of, weirdly, of incredible weakness of those early models. But, you know, that was when I realized, OK, the age of cheap intelligence was at its beginning.  LEE: Yeah. So I guess it seems like you had something similar to me in that my first encounters, I actually harbored some skepticism. Is it fair to say you were skeptical before that?  GATES: Well, the idea that we’ve figured out how to encode and access knowledge in this very deep sense without even understanding the nature of the encoding, …  LEE: Right.   GATES: … that is a bit weird.   LEE: Yeah.  GATES: We have an algorithm that creates the computation, but even say, OK, where is the president’s birthday stored in there? Where is this fact stored in there? The fact that even now when we’re playing around, getting a little bit more sense of it, it’s opaque to us what the semantic encoding is, it’s, kind of, amazing to me. I thought the invention of knowledge storage would be an explicit way of encoding knowledge, not an implicit statistical training.  LEE: Yeah, yeah. All right. So, Seb, you know, on this same topic, you know, I got—as we say at Microsoft—I got pulled into the tent. [LAUGHS]  BUBECK: Yes.   LEE: Because this was a very secret project. And then, um, I had the opportunity to select a small number of researchers in MSR [Microsoft Research] to join and start investigating this thing seriously. And the first person I pulled in was you.  BUBECK: Yeah.  LEE: And so what were your first encounters? Because I actually don’t remember what happened then.  BUBECK: Oh, I remember it very well. [LAUGHS] My first encounter with GPT-4 was in a meeting with the two of you, actually. But my kind of first contact, the first moment where I realized that something was happening with generative AI, was before that. And I agree with Bill that I also wasn’t too impressed by GPT-3.  I though that it was kind of, you know, very naturally mimicking the web, sort of parroting what was written there in a nice way. Still in a way which seemed very impressive. But it wasn’t really intelligent in any way. But shortly after GPT-3, there was a model before GPT-4 that really shocked me, and this was the first image generation model, DALL-E 1.  So that was in 2021. And I will forever remember the press release of OpenAI where they had this prompt of an avocado chair and then you had this image of the avocado chair. [LAUGHTER] And what really shocked me is that clearly the model kind of “understood” what is a chair, what is an avocado, and was able to merge those concepts.  So this was really, to me, the first moment where I saw some understanding in those models.   LEE: So this was, just to get the timing right, that was before I pulled you into the tent.  BUBECK: That was before. That was like a year before.  LEE: Right.   BUBECK: And now I will tell you how, you know, we went from that moment to the meeting with the two of you and GPT-4.  So once I saw this kind of understanding, I thought, OK, fine. It understands concept, but it’s still not able to reason. It cannot—as, you know, Bill was saying—it cannot learn from your document. It cannot reason.   So I set out to try to prove that. You know, this is what I was in the business of at the time, trying to prove things in mathematics. So I was trying to prove that basically autoregressive transformers could never reason. So I was trying to prove this. And after a year of work, I had something reasonable to show. And so I had the meeting with the two of you, and I had this example where I wanted to say, there is no way that an LLM is going to be able to do x.  And then as soon as I … I don’t know if you remember, Bill. But as soon as I said that, you said, oh, but wait a second. I had, you know, the OpenAI crew at my house recently, and they showed me a new model. Why don’t we ask this new model this question?   LEE: Yeah. BUBECK: And we did, and it solved it on the spot. And that really, honestly, just changed my life. Like, you know, I had been working for a year trying to say that this was impossible. And just right there, it was shown to be possible.   LEE: [LAUGHS] One of the very first things I got interested in—because I was really thinking a lot about healthcare—was healthcare and medicine.  And I don’t know if the two of you remember, but I ended up doing a lot of tests. I ran through, you know, step one and step two of the US Medical Licensing Exam. Did a whole bunch of other things. I wrote this big report. It was, you know, I can’t remember … a couple hundred pages.   And I needed to share this with someone. I didn’t … there weren’t too many people I could share it with. So I sent, I think, a copy to you, Bill. Sent a copy to you, Seb.   I hardly slept for about a week putting that report together. And, yeah, and I kept working on it. But I was far from alone. I think everyone who was in the tent, so to speak, in those early days was going through something pretty similar. All right. So I think … of course, a lot of what I put in the report also ended up being examples that made it into the book.  But the main purpose of this conversation isn’t to reminisce about [LAUGHS] or indulge in those reminiscences but to talk about what’s happening in healthcare and medicine. And, you know, as I said, we wrote this book. We did it very, very quickly. Seb, you helped. Bill, you know, you provided a review and some endorsements.  But, you know, honestly, we didn’t know what we were talking about because no one had access to this thing. And so we just made a bunch of guesses. So really, the whole thing I wanted to probe with the two of you is, now with two years of experience out in the world, what, you know, what do we think is happening today?  You know, is AI actually having an impact, positive or negative, on healthcare and medicine? And what do we now think is going to happen in the next two years, five years, or 10 years? And so I realize it’s a little bit too abstract to just ask it that way. So let me just try to narrow the discussion and guide us a little bit.   Um, the kind of administrative and clerical work, paperwork, around healthcare—and we made a lot of guesses about that—that appears to be going well, but, you know, Bill, I know we’ve discussed that sometimes that you think there ought to be a lot more going on. Do you have a viewpoint on how AI is actually finding its way into reducing paperwork?  GATES: Well, I’m stunned … I don’t think there should be a patient-doctor meeting where the AI is not sitting in and both transcribing, offering to help with the paperwork, and even making suggestions, although the doctor will be the one, you know, who makes the final decision about the diagnosis and whatever prescription gets done.   It’s so helpful. You know, when that patient goes home and their, you know, son who wants to understand what happened has some questions, that AI should be available to continue that conversation. And the way you can improve that experience and streamline things and, you know, involve the people who advise you. I don’t understand why that’s not more adopted, because there you still have the human in the loop making that final decision.  But even for, like, follow-up calls to make sure the patient did things, to understand if they have concerns and knowing when to escalate back to the doctor, the benefit is incredible. And, you know, that thing is ready for prime time. That paradigm is ready for prime time, in my view.  LEE: Yeah, there are some good products, but it seems like the number one use right now—and we kind of got this from some of the previous guests in previous episodes—is the use of AI just to respond to emails from patients. [LAUGHTER] Does that make sense to you?  BUBECK: Yeah. So maybe I want to second what Bill was saying but maybe take a step back first. You know, two years ago, like, the concept of clinical scribes, which is one of the things that we’re talking about right now, it would have sounded, in fact, it sounded two years ago, borderline dangerous. Because everybody was worried about hallucinations. What happened if you have this AI listening in and then it transcribes, you know, something wrong?  Now, two years later, I think it’s mostly working. And in fact, it is not yet, you know, fully adopted. You’re right. But it is in production. It is used, you know, in many, many places. So this rate of progress is astounding because it wasn’t obvious that we would be able to overcome those obstacles of hallucination. It’s not to say that hallucinations are fully solved. In the case of the closed system, they are.   Now, I think more generally what’s going on in the background is that there is something that we, that certainly I, underestimated, which is this management overhead. So I think the reason why this is not adopted everywhere is really a training and teaching aspect. People need to be taught, like, those systems, how to interact with them.  And one example that I really like, a study that recently appeared where they tried to use ChatGPT for diagnosis and they were comparing doctors without and with ChatGPT (opens in new tab). And the amazing thing … so this was a set of cases where the accuracy of the doctors alone was around 75%. ChatGPT alone was 90%. So that’s already kind of mind blowing. But then the kicker is that doctors with ChatGPT was 80%.   Intelligence alone is not enough. It’s also how it’s presented, how you interact with it. And ChatGPT, it’s an amazing tool. Obviously, I absolutely love it. But it’s not … you don’t want a doctor to have to type in, you know, prompts and use it that way.  It should be, as Bill was saying, kind of running continuously in the background, sending you notifications. And you have to be really careful of the rate at which those notifications are being sent. Because if they are too frequent, then the doctor will learn to ignore them. So you have to … all of those things matter, in fact, at least as much as the level of intelligence of the machine.  LEE: One of the things I think about, Bill, in that scenario that you described, doctors do some thinking about the patient when they write the note. So, you know, I’m always a little uncertain whether it’s actually … you know, you wouldn’t necessarily want to fully automate this, I don’t think. Or at least there needs to be some prompt to the doctor to make sure that the doctor puts some thought into what happened in the encounter with the patient. Does that make sense to you at all?  GATES: At this stage, you know, I’d still put the onus on the doctor to write the conclusions and the summary and not delegate that.  The tradeoffs you make a little bit are somewhat dependent on the situation you’re in. If you’re in Africa, So, yes, the doctor’s still going to have to do a lot of work, but just the quality of letting the patient and the people around them interact and ask questions and have things explained, that alone is such a quality improvement. It’s mind blowing.   LEE: So since you mentioned, you know, Africa—and, of course, this touches on the mission and some of the priorities of the Gates Foundation and this idea of democratization of access to expert medical care—what’s the most interesting stuff going on right now? Are there people and organizations or technologies that are impressing you or that you’re tracking?  GATES: Yeah. So the Gates Foundation has given out a lot of grants to people in Africa doing education, agriculture but more healthcare examples than anything. And the way these things start off, they often start out either being patient-centric in a narrow situation, like, OK, I’m a pregnant woman; talk to me. Or, I have infectious disease symptoms; talk to me. Or they’re connected to a health worker where they’re helping that worker get their job done. And we have lots of pilots out, you know, in both of those cases.   The dream would be eventually to have the thing the patient consults be so broad that it’s like having a doctor available who understands the local things.   LEE: Right.   GATES: We’re not there yet. But over the next two or three years, you know, particularly given the worsening financial constraints against African health systems, where the withdrawal of money has been dramatic, you know, figuring out how to take this—what I sometimes call “free intelligence”—and build a quality health system around that, we will have to be more radical in low-income countries than any rich country is ever going to be.   LEE: Also, there’s maybe a different regulatory environment, so some of those things maybe are easier? Because right now, I think the world hasn’t figured out how to and whether to regulate, let’s say, an AI that might give a medical diagnosis or write a prescription for a medication.  BUBECK: Yeah. I think one issue with this, and it’s also slowing down the deployment of AI in healthcare more generally, is a lack of proper benchmark. Because, you know, you were mentioning the USMLE [United States Medical Licensing Examination], for example. That’s a great test to test human beings and their knowledge of healthcare and medicine. But it’s not a great test to give to an AI.  It’s not asking the right questions. So finding what are the right questions to test whether an AI system is ready to give diagnosis in a constrained setting, that’s a very, very important direction, which to my surprise, is not yet accelerating at the rate that I was hoping for.  LEE: OK, so that gives me an excuse to get more now into the core AI tech because something I’ve discussed with both of you is this issue of what are the right tests. And you both know the very first test I give to any new spin of an LLM is I present a patient, the results—a mythical patient—the results of my physical exam, my mythical physical exam. Maybe some results of some initial labs. And then I present or propose a differential diagnosis. And if you’re not in medicine, a differential diagnosis you can just think of as a prioritized list of the possible diagnoses that fit with all that data. And in that proposed differential, I always intentionally make two mistakes.  I make a textbook technical error in one of the possible elements of the differential diagnosis, and I have an error of omission. And, you know, I just want to know, does the LLM understand what I’m talking about? And all the good ones out there do now. But then I want to know, can it spot the errors? And then most importantly, is it willing to tell me I’m wrong, that I’ve made a mistake?   That last piece seems really hard for AI today. And so let me ask you first, Seb, because at the time of this taping, of course, there was a new spin of GPT-4o last week that became overly sycophantic. In other words, it was actually prone in that test of mine not only to not tell me I’m wrong, but it actually praised me for the creativity of my differential. [LAUGHTER] What’s up with that?  BUBECK: Yeah, I guess it’s a testament to the fact that training those models is still more of an art than a science. So it’s a difficult job. Just to be clear with the audience, we have rolled back that [LAUGHS] version of GPT-4o, so now we don’t have the sycophant version out there.  Yeah, no, it’s a really difficult question. It has to do … as you said, it’s very technical. It has to do with the post-training and how, like, where do you nudge the model? So, you know, there is this very classical by now technique called RLHF [reinforcement learning from human feedback], where you push the model in the direction of a certain reward model. So the reward model is just telling the model, you know, what behavior is good, what behavior is bad.  But this reward model is itself an LLM, and, you know, Bill was saying at the very beginning of the conversation that we don’t really understand how those LLMs deal with concepts like, you know, where is the capital of France located? Things like that. It is the same thing for this reward model. We don’t know why it says that it prefers one output to another, and whether this is correlated with some sycophancy is, you know, something that we discovered basically just now. That if you push too hard in optimization on this reward model, you will get a sycophant model.  So it’s kind of … what I’m trying to say is we became too good at what we were doing, and we ended up, in fact, in a trap of the reward model.  LEE: I mean, you do want … it’s a difficult balance because you do want models to follow your desires and …  BUBECK: It’s a very difficult, very difficult balance.  LEE: So this brings up then the following question for me, which is the extent to which we think we’ll need to have specially trained models for things. So let me start with you, Bill. Do you have a point of view on whether we will need to, you know, quote-unquote take AI models to med school? Have them specially trained? Like, if you were going to deploy something to give medical care in underserved parts of the world, do we need to do something special to create those models?  GATES: We certainly need to teach them the African languages and the unique dialects so that the multimedia interactions are very high quality. We certainly need to teach them the disease prevalence and unique disease patterns like, you know, neglected tropical diseases and malaria. So we need to gather a set of facts that somebody trying to go for a US customer base, you know, wouldn’t necessarily have that in there.  Those two things are actually very straightforward because the additional training time is small. I’d say for the next few years, we’ll also need to do reinforcement learning about the context of being a doctor and how important certain behaviors are. Humans learn over the course of their life to some degree that, I’m in a different context and the way I behave in terms of being willing to criticize or be nice, you know, how important is it? Who’s here? What’s my relationship to them?   Right now, these machines don’t have that broad social experience. And so if you know it’s going to be used for health things, a lot of reinforcement learning of the very best humans in that context would still be valuable. Eventually, the models will, having read all the literature of the world about good doctors, bad doctors, it’ll understand as soon as you say, “I want you to be a doctor diagnosing somebody.” All of the implicit reinforcement that fits that situation, you know, will be there. LEE: Yeah. GATES: And so I hope three years from now, we don’t have to do that reinforcement learning. But today, for any medical context, you would want a lot of data to reinforce tone, willingness to say things when, you know, there might be something significant at stake.  LEE: Yeah. So, you know, something Bill said, kind of, reminds me of another thing that I think we missed, which is, the context also … and the specialization also pertains to different, I guess, what we still call “modes,” although I don’t know if the idea of multimodal is the same as it was two years ago. But, you know, what do you make of all of the hubbub around—in fact, within Microsoft Research, this is a big deal, but I think we’re far from alone—you know, medical images and vision, video, proteins and molecules, cell, you know, cellular data and so on.  BUBECK: Yeah. OK. So there is a lot to say to everything … to the last, you know, couple of minutes. Maybe on the specialization aspect, you know, I think there is, hiding behind this, a really fundamental scientific question of whether eventually we have a singular AGI [artificial general intelligence] that kind of knows everything and you can just put, you know, explain your own context and it will just get it and understand everything.  That’s one vision. I have to say, I don’t particularly believe in this vision. In fact, we humans are not like that at all. I think, hopefully, we are general intelligences, yet we have to specialize a lot. And, you know, I did myself a lot of RL, reinforcement learning, on mathematics. Like, that’s what I did, you know, spent a lot of time doing that. And I didn’t improve on other aspects. You know, in fact, I probably degraded in other aspects. [LAUGHTER] So it’s … I think it’s an important example to have in mind.  LEE: I think I might disagree with you on that, though, because, like, doesn’t a model have to see both good science and bad science in order to be able to gain the ability to discern between the two?  BUBECK: Yeah, no, that absolutely. I think there is value in seeing the generality, in having a very broad base. But then you, kind of, specialize on verticals. And this is where also, you know, open-weights model, which we haven’t talked about yet, are really important because they allow you to provide this broad base to everyone. And then you can specialize on top of it.  LEE: So we have about three hours of stuff to talk about, but our time is actually running low. BUBECK: Yes, yes, yes.   LEE: So I think I want … there’s a more provocative question. It’s almost a silly question, but I need to ask it of the two of you, which is, is there a future, you know, where AI replaces doctors or replaces, you know, medical specialties that we have today? So what does the world look like, say, five years from now?  GATES: Well, it’s important to distinguish healthcare discovery activity from healthcare delivery activity. We focused mostly on delivery. I think it’s very much within the realm of possibility that the AI is not only accelerating healthcare discovery but substituting for a lot of the roles of, you know, I’m an organic chemist, or I run various types of assays. I can see those, which are, you know, testable-output-type jobs but with still very high value, I can see, you know, some replacement in those areas before the doctor.   The doctor, still understanding the human condition and long-term dialogues, you know, they’ve had a lifetime of reinforcement of that, particularly when you get into areas like mental health. So I wouldn’t say in five years, either people will choose to adopt it, but it will be profound that there’ll be this nearly free intelligence that can do follow-up, that can help you, you know, make sure you went through different possibilities.  And so I’d say, yes, we’ll have doctors, but I’d say healthcare will be massively transformed in its quality and in efficiency by AI in that time period.  LEE: Is there a comparison, useful comparison, say, between doctors and, say, programmers, computer programmers, or doctors and, I don’t know, lawyers?  GATES: Programming is another one that has, kind of, a mathematical correctness to it, you know, and so the objective function that you’re trying to reinforce to, as soon as you can understand the state machines, you can have something that’s “checkable”; that’s correct. So I think programming, you know, which is weird to say, that the machine will beat us at most programming tasks before we let it take over roles that have deep empathy, you know, physical presence and social understanding in them.  LEE: Yeah. By the way, you know, I fully expect in five years that AI will produce mathematical proofs that are checkable for validity, easily checkable, because they’ll be written in a proof-checking language like Lean or something but will be so complex that no human mathematician can understand them. I expect that to happen.   I can imagine in some fields, like cellular biology, we could have the same situation in the future because the molecular pathways, the chemistry, biochemistry of human cells or living cells is as complex as any mathematics, and so it seems possible that we may be in a state where in wet lab, we see, Oh yeah, this actually works, but no one can understand why.  BUBECK: Yeah, absolutely. I mean, I think I really agree with Bill’s distinction of the discovery and the delivery, and indeed, the discovery’s when you can check things, and at the end, there is an artifact that you can verify. You know, you can run the protocol in the wet lab and see [if you have] produced what you wanted. So I absolutely agree with that.   And in fact, you know, we don’t have to talk five years from now. I don’t know if you know, but just recently, there was a paper that was published on a scientific discovery using o3- mini (opens in new tab). So this is really amazing. And, you know, just very quickly, just so people know, it was about this statistical physics model, the frustrated Potts model, which has to do with coloring, and basically, the case of three colors, like, more than two colors was open for a long time, and o3 was able to reduce the case of three colors to two colors.   LEE: Yeah.  BUBECK: Which is just, like, astounding. And this is not … this is now. This is happening right now. So this is something that I personally didn’t expect it would happen so quickly, and it’s due to those reasoning models.   Now, on the delivery side, I would add something more to it for the reason why doctors and, in fact, lawyers and coders will remain for a long time, and it’s because we still don’t understand how those models generalize. Like, at the end of the day, we are not able to tell you when they are confronted with a really new, novel situation, whether they will work or not.  Nobody is able to give you that guarantee. And I think until we understand this generalization better, we’re not going to be willing to just let the system in the wild without human supervision.  LEE: But don’t human doctors, human specialists … so, for example, a cardiologist sees a patient in a certain way that a nephrologist …  BUBECK: Yeah. LEE: … or an endocrinologist might not. BUBECK: That’s right. But another cardiologist will understand and, kind of, expect a certain level of generalization from their peer. And this, we just don’t have it with AI models. Now, of course, you’re exactly right. That generalization is also hard for humans. Like, if you have a human trained for one task and you put them into another task, then you don’t … you often don’t know. LEE: OK. You know, the podcast is focused on what’s happened over the last two years. But now, I’d like one provocative prediction about what you think the world of AI and medicine is going to be at some point in the future. You pick your timeframe. I don’t care if it’s two years or 20 years from now, but, you know, what do you think will be different about AI in medicine in that future than today?  BUBECK: Yeah, I think the deployment is going to accelerate soon. Like, we’re really not missing very much. There is this enormous capability overhang. Like, even if progress completely stopped, with current systems, we can do a lot more than what we’re doing right now. So I think this will … this has to be realized, you know, sooner rather than later.  And I think it’s probably dependent on these benchmarks and proper evaluation and tying this with regulation. So these are things that take time in human society and for good reason. But now we already are at two years; you know, give it another two years and it should be really …   LEE: Will AI prescribe your medicines? Write your prescriptions?  BUBECK: I think yes. I think yes.  LEE: OK. Bill?  GATES: Well, I think the next two years, we’ll have massive pilots, and so the amount of use of the AI, still in a copilot-type mode, you know, we should get millions of patient visits, you know, both in general medicine and in the mental health side, as well. And I think that’s going to build up both the data and the confidence to give the AI some additional autonomy. You know, are you going to let it talk to you at night when you’re panicked about your mental health with some ability to escalate? And, you know, I’ve gone so far as to tell politicians with national health systems that if they deploy AI appropriately, that the quality of care, the overload of the doctors, the improvement in the economics will be enough that their voters will be stunned because they just don’t expect this, and, you know, they could be reelected [LAUGHTER] just on this one thing of fixing what is a very overloaded and economically challenged health system in these rich countries.  You know, my personal role is going to be to make sure that in the poorer countries, there isn’t some lag; in fact, in many cases, that we’ll be more aggressive because, you know, we’re comparing to having no access to doctors at all. And, you know, so I think whether it’s India or Africa, there’ll be lessons that are globally valuable because we need medical intelligence. And, you know, thank god AI is going to provide a lot of that.  LEE: Well, on that optimistic note, I think that’s a good way to end. Bill, Seb, really appreciate all of this.   I think the most fundamental prediction we made in the book is that AI would actually find its way into the practice of medicine, and I think that that at least has come true, maybe in different ways than we expected, but it’s come true, and I think it’ll only accelerate from here. So thanks again, both of you.  [TRANSITION MUSIC]  GATES: Yeah. Thanks, you guys.  BUBECK: Thank you, Peter. Thanks, Bill.  LEE: I just always feel such a sense of privilege to have a chance to interact and actually work with people like Bill and Sébastien.    With Bill, I’m always amazed at how practically minded he is. He’s really thinking about the nuts and bolts of what AI might be able to do for people, and his thoughts about underserved parts of the world, the idea that we might actually be able to empower people with access to expert medical knowledge, I think is both inspiring and amazing.   And then, Seb, Sébastien Bubeck, he’s just absolutely a brilliant mind. He has a really firm grip on the deep mathematics of artificial intelligence and brings that to bear in his research and development work. And where that mathematics takes him isn’t just into the nuts and bolts of algorithms but into philosophical questions about the nature of intelligence.   One of the things that Sébastien brought up was the state of evaluation of AI systems. And indeed, he was fairly critical in our conversation. But of course, the world of AI research and development is just moving so fast, and indeed, since we recorded our conversation, OpenAI, in fact, released a new evaluation metric that is directly relevant to medical applications, and that is something called HealthBench. And Microsoft Research also released a new evaluation approach or process called ADeLe.   HealthBench and ADeLe are examples of new approaches to evaluating AI models that are less about testing their knowledge and ability to pass multiple-choice exams and instead are evaluation approaches designed to assess how well AI models are able to complete tasks that actually arise every day in typical healthcare or biomedical research settings. These are examples of really important good work that speak to how well AI models work in the real world of healthcare and biomedical research and how well they can collaborate with human beings in those settings.  You know, I asked Bill and Seb to make some predictions about the future. You know, my own answer, I expect that we’re going to be able to use AI to change how we diagnose patients, change how we decide treatment options.   If you’re a doctor or a nurse and you encounter a patient, you’ll ask questions, do a physical exam, you know, call out for labs just like you do today, but then you’ll be able to engage with AI based on all of that data and just ask, you know, based on all the other people who have gone through the same experience, who have similar data, how were they diagnosed? How were they treated? What were their outcomes? And what does that mean for the patient I have right now? Some people call it the “patients like me” paradigm. And I think that’s going to become real because of AI within our lifetimes. That idea of really grounding the delivery in healthcare and medical practice through data and intelligence, I actually now don’t see any barriers to that future becoming real.  [THEME MUSIC]  I’d like to extend another big thank you to Bill and Sébastien for their time. And to our listeners, as always, it’s a pleasure to have you along for the ride. I hope you’ll join us for our remaining conversations, as well as a second coauthor roundtable with Carey and Zak.   Until next time.   [MUSIC FADES]
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  • Dave Bautista’s Next Franchise Play? Becoming a ‘Cat Assassin’

    After hanging up his daggers as Drax the Destroyer and getting got as Glossu Rabban in Dune: Part Two, Dave Bautista is stepping into video games and animation with a new franchise by the name of Cat Assassin. The wrestler-actor and his production company Dogbone Entertainment will bring to life a new idea from Steve Lerner, who wrote 2022’s feline adventure game Stray. This would-be franchise will comprise a stealth-action video game—influenced by titles such as Assassin’s Creed, Splinter Cell, and Sifu—from developer Titan1Studiosand a “neo-noir adult animated series.” Cat Assassin focuses on Hugh, an expert killer “caught between various cartels and power brokers in a dark and twisted city.” Bautista’s part of the enterprise’s “creative vision,” but at the moment, it’s unclear if that also means he’ll lend his voice to Hugh in either animated or video game form.Titan1 has several TV and game projects in the works, so at the moment, there’s no real window on when to expect Cat Assassin. Still, in a statement on Titan1’s website Bautista called teaming with the company “a pleasure … Their ability to build worlds through animation has been so impressive and they’ve created a truly unique world in this game that I can’t wait to share with players.”

    While the game is seemingly expected for release in October 2027 for PC and several consoles, including the Nintendo Switch 2, Titan1 said more details on the overall franchise’s future is expected “in the coming months.” Want more io9 news? Check out when to expect the latest Marvel, Star Wars, and Star Trek releases, what’s next for the DC Universe on film and TV, and everything you need to know about the future of Doctor Who.
    #dave #bautistas #next #franchise #play
    Dave Bautista’s Next Franchise Play? Becoming a ‘Cat Assassin’
    After hanging up his daggers as Drax the Destroyer and getting got as Glossu Rabban in Dune: Part Two, Dave Bautista is stepping into video games and animation with a new franchise by the name of Cat Assassin. The wrestler-actor and his production company Dogbone Entertainment will bring to life a new idea from Steve Lerner, who wrote 2022’s feline adventure game Stray. This would-be franchise will comprise a stealth-action video game—influenced by titles such as Assassin’s Creed, Splinter Cell, and Sifu—from developer Titan1Studiosand a “neo-noir adult animated series.” Cat Assassin focuses on Hugh, an expert killer “caught between various cartels and power brokers in a dark and twisted city.” Bautista’s part of the enterprise’s “creative vision,” but at the moment, it’s unclear if that also means he’ll lend his voice to Hugh in either animated or video game form.Titan1 has several TV and game projects in the works, so at the moment, there’s no real window on when to expect Cat Assassin. Still, in a statement on Titan1’s website Bautista called teaming with the company “a pleasure … Their ability to build worlds through animation has been so impressive and they’ve created a truly unique world in this game that I can’t wait to share with players.” While the game is seemingly expected for release in October 2027 for PC and several consoles, including the Nintendo Switch 2, Titan1 said more details on the overall franchise’s future is expected “in the coming months.” Want more io9 news? Check out when to expect the latest Marvel, Star Wars, and Star Trek releases, what’s next for the DC Universe on film and TV, and everything you need to know about the future of Doctor Who. #dave #bautistas #next #franchise #play
    GIZMODO.COM
    Dave Bautista’s Next Franchise Play? Becoming a ‘Cat Assassin’
    After hanging up his daggers as Drax the Destroyer and getting got as Glossu Rabban in Dune: Part Two, Dave Bautista is stepping into video games and animation with a new franchise by the name of Cat Assassin. The wrestler-actor and his production company Dogbone Entertainment will bring to life a new idea from Steve Lerner, who wrote 2022’s feline adventure game Stray. This would-be franchise will comprise a stealth-action video game—influenced by titles such as Assassin’s Creed, Splinter Cell, and Sifu—from developer Titan1Studios (Love is a Roguelike, The Events at Unity Farm) and a “neo-noir adult animated series.” Cat Assassin focuses on Hugh, an expert killer “caught between various cartels and power brokers in a dark and twisted city.” Bautista’s part of the enterprise’s “creative vision,” but at the moment, it’s unclear if that also means he’ll lend his voice to Hugh in either animated or video game form. (His current voice work includes the upcoming Army of the Dead animated series and playing himself in WWE games since 2003.) Titan1 has several TV and game projects in the works, so at the moment, there’s no real window on when to expect Cat Assassin. Still, in a statement on Titan1’s website Bautista called teaming with the company “a pleasure … Their ability to build worlds through animation has been so impressive and they’ve created a truly unique world in this game that I can’t wait to share with players.” While the game is seemingly expected for release in October 2027 for PC and several consoles, including the Nintendo Switch 2, Titan1 said more details on the overall franchise’s future is expected “in the coming months.” Want more io9 news? Check out when to expect the latest Marvel, Star Wars, and Star Trek releases, what’s next for the DC Universe on film and TV, and everything you need to know about the future of Doctor Who.
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  • Sony is Still Putting Its Faith in ‘Marathon’

    Bungie’s Marathon is still coming out, and when it does, PlayStation plans on giving the extraction shooter a fair shot. During a recent investor interview, Sony Interactive Entertainment head Herman Hulst assured the game would come out before March 31, 2026, when Sony’s fiscal year ends. Touching on its recent alpha test, he descbied the feedback as “varied, but super useful.The constant testing, the constant re-validation of assumptions that we just talked about, to me is just so valuable to iterate and to constantly improve the title, so when launch comes, we’re going to give the title the optimal chance of success.” Hanging over PlayStation is 2024’s sci-fi shooter Concord, which shut down weeks after launch and later led to developer Firewalk Studios closing down. That’s been just one of several botched attempts from PlayStation’s attempts to enter live-service games, which includes several canceled projects and layoffs across its first-party studios. While acknowledging these “unique challenges” and attributing Concord’s failure to the “hypercompetitive market” of hero shooters, Hulst talked up how they’re avoiding the same mistakes with Marathon. “It’s going to be the first new Bungie title in over a decade, and it’s our goal to release a very bold, very innovative, and deeply engaging title. We’re monitoring the closed alpha cycle the team has just gone through. We’re taking all the lessons learned, we’re using the capabilities we’ve built and analytics and user testing to understand how audiences are engaging with the title.”

    One thing Hulst didn’t touch on, though, was the recent accusations of art plagiarism levvied against Bungie. In May, artist Fern “Antireal” Hook released evidence alleging the studio stole assets she made from previous work and failed to credit her. After investigating, Bungie attributed the theft to the work of a former employee, publicly apologized, and said it would do “everything we can to make this right” with Hook. It also promised to review all in-game assets and replace “questionably sourced” art with original, in-house work. With the mention of its arriving before the fiscal year ends, Marathon may be delayed out of its current September 23 launch. At time of writing, Bungie and PlayStation have kept mum on a potential delay, but the game failed to make an appearance at PlayStation’s recent State of Play in early June.Want more io9 news? Check out when to expect the latest Marvel, Star Wars, and Star Trek releases, what’s next for the DC Universe on film and TV, and everything you need to know about the future of Doctor Who.
    #sony #still #putting #its #faith
    Sony is Still Putting Its Faith in ‘Marathon’
    Bungie’s Marathon is still coming out, and when it does, PlayStation plans on giving the extraction shooter a fair shot. During a recent investor interview, Sony Interactive Entertainment head Herman Hulst assured the game would come out before March 31, 2026, when Sony’s fiscal year ends. Touching on its recent alpha test, he descbied the feedback as “varied, but super useful.The constant testing, the constant re-validation of assumptions that we just talked about, to me is just so valuable to iterate and to constantly improve the title, so when launch comes, we’re going to give the title the optimal chance of success.” Hanging over PlayStation is 2024’s sci-fi shooter Concord, which shut down weeks after launch and later led to developer Firewalk Studios closing down. That’s been just one of several botched attempts from PlayStation’s attempts to enter live-service games, which includes several canceled projects and layoffs across its first-party studios. While acknowledging these “unique challenges” and attributing Concord’s failure to the “hypercompetitive market” of hero shooters, Hulst talked up how they’re avoiding the same mistakes with Marathon. “It’s going to be the first new Bungie title in over a decade, and it’s our goal to release a very bold, very innovative, and deeply engaging title. We’re monitoring the closed alpha cycle the team has just gone through. We’re taking all the lessons learned, we’re using the capabilities we’ve built and analytics and user testing to understand how audiences are engaging with the title.” One thing Hulst didn’t touch on, though, was the recent accusations of art plagiarism levvied against Bungie. In May, artist Fern “Antireal” Hook released evidence alleging the studio stole assets she made from previous work and failed to credit her. After investigating, Bungie attributed the theft to the work of a former employee, publicly apologized, and said it would do “everything we can to make this right” with Hook. It also promised to review all in-game assets and replace “questionably sourced” art with original, in-house work. With the mention of its arriving before the fiscal year ends, Marathon may be delayed out of its current September 23 launch. At time of writing, Bungie and PlayStation have kept mum on a potential delay, but the game failed to make an appearance at PlayStation’s recent State of Play in early June.Want more io9 news? Check out when to expect the latest Marvel, Star Wars, and Star Trek releases, what’s next for the DC Universe on film and TV, and everything you need to know about the future of Doctor Who. #sony #still #putting #its #faith
    GIZMODO.COM
    Sony is Still Putting Its Faith in ‘Marathon’
    Bungie’s Marathon is still coming out, and when it does, PlayStation plans on giving the extraction shooter a fair shot. During a recent investor interview, Sony Interactive Entertainment head Herman Hulst assured the game would come out before March 31, 2026, when Sony’s fiscal year ends. Touching on its recent alpha test, he descbied the feedback as “varied, but super useful. […] The constant testing, the constant re-validation of assumptions that we just talked about, to me is just so valuable to iterate and to constantly improve the title, so when launch comes, we’re going to give the title the optimal chance of success.” Hanging over PlayStation is 2024’s sci-fi shooter Concord, which shut down weeks after launch and later led to developer Firewalk Studios closing down. That’s been just one of several botched attempts from PlayStation’s attempts to enter live-service games, which includes several canceled projects and layoffs across its first-party studios. While acknowledging these “unique challenges” and attributing Concord’s failure to the “hypercompetitive market” of hero shooters, Hulst talked up how they’re avoiding the same mistakes with Marathon. “It’s going to be the first new Bungie title in over a decade, and it’s our goal to release a very bold, very innovative, and deeply engaging title. We’re monitoring the closed alpha cycle the team has just gone through. We’re taking all the lessons learned, we’re using the capabilities we’ve built and analytics and user testing to understand how audiences are engaging with the title.” One thing Hulst didn’t touch on, though, was the recent accusations of art plagiarism levvied against Bungie. In May, artist Fern “Antireal” Hook released evidence alleging the studio stole assets she made from previous work and failed to credit her. After investigating, Bungie attributed the theft to the work of a former employee, publicly apologized, and said it would do “everything we can to make this right” with Hook. It also promised to review all in-game assets and replace “questionably sourced” art with original, in-house work. With the mention of its arriving before the fiscal year ends, Marathon may be delayed out of its current September 23 launch. At time of writing, Bungie and PlayStation have kept mum on a potential delay, but the game failed to make an appearance at PlayStation’s recent State of Play in early June. [via IGN] Want more io9 news? Check out when to expect the latest Marvel, Star Wars, and Star Trek releases, what’s next for the DC Universe on film and TV, and everything you need to know about the future of Doctor Who.
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  • McDonald's in Trouble as Ozempic Takes Hold

    Image by Getty / FuturismRx/MedicinesBroken ice cream machines aren't the only thing bedeviling stalwart fast food chain McDonald's.Financial services firm Redburn Atlantic put the company's stock in the bear category, coinciding with a slumpy week in which it lost about three percent of its value — because analysts are betting that GLP-1 agonist weight loss drugs like Ozempic are going to disrupt the fast food business model, CBS News reports.The eyebrow-raising conclusion comes as the analysts reason that people with lower incomes who go on the drugs will tend to shun food outside the home. Meanwhile, people at a higher income level who take Ozempic and similar go back to their food spending habits after a year or so."Behaviour changes extend beyond the individual user — reshaping group dining, influencing household routines and softening habitual demand," wrote the analysts, as reported by CBS. "A 1 percent drag today could easily build to 10 percent or more over time, particularly for brands skewed toward lower income consumers or group occasions."This could have a huge impact on the bottom line of fast food chains like McDonald's, which could stand to lose as much as million annually as they see the disappearance of 28 million visits from formerly hungry customers.This is all complete speculation at this point, because only about six percent of American adults are currently taking these weight loss medications. And they're prohibitively expensive, prices starting at around per month, meaning that extremely few poor people are currently able to afford them.But there's a movement by some policymakers to lower the price of the drugs, which have been proven to not just help people lose weight, but they come with a rash of benefits from preventing certain cancers to treating addictions, among other positives.So if lawmakers force a reduction in price in the future, expect fast food chains like McDonald's to be left holding the bag.And maybe that's a good thing, because the kind of fried foods that McDonald's traffics in are just plain bad for your health.More on Ozempic: Doctors Concerned by Massive Uptick in Teens Taking OzempicShare This Article
    #mcdonald039s #trouble #ozempic #takes #hold
    McDonald's in Trouble as Ozempic Takes Hold
    Image by Getty / FuturismRx/MedicinesBroken ice cream machines aren't the only thing bedeviling stalwart fast food chain McDonald's.Financial services firm Redburn Atlantic put the company's stock in the bear category, coinciding with a slumpy week in which it lost about three percent of its value — because analysts are betting that GLP-1 agonist weight loss drugs like Ozempic are going to disrupt the fast food business model, CBS News reports.The eyebrow-raising conclusion comes as the analysts reason that people with lower incomes who go on the drugs will tend to shun food outside the home. Meanwhile, people at a higher income level who take Ozempic and similar go back to their food spending habits after a year or so."Behaviour changes extend beyond the individual user — reshaping group dining, influencing household routines and softening habitual demand," wrote the analysts, as reported by CBS. "A 1 percent drag today could easily build to 10 percent or more over time, particularly for brands skewed toward lower income consumers or group occasions."This could have a huge impact on the bottom line of fast food chains like McDonald's, which could stand to lose as much as million annually as they see the disappearance of 28 million visits from formerly hungry customers.This is all complete speculation at this point, because only about six percent of American adults are currently taking these weight loss medications. And they're prohibitively expensive, prices starting at around per month, meaning that extremely few poor people are currently able to afford them.But there's a movement by some policymakers to lower the price of the drugs, which have been proven to not just help people lose weight, but they come with a rash of benefits from preventing certain cancers to treating addictions, among other positives.So if lawmakers force a reduction in price in the future, expect fast food chains like McDonald's to be left holding the bag.And maybe that's a good thing, because the kind of fried foods that McDonald's traffics in are just plain bad for your health.More on Ozempic: Doctors Concerned by Massive Uptick in Teens Taking OzempicShare This Article #mcdonald039s #trouble #ozempic #takes #hold
    FUTURISM.COM
    McDonald's in Trouble as Ozempic Takes Hold
    Image by Getty / FuturismRx/MedicinesBroken ice cream machines aren't the only thing bedeviling stalwart fast food chain McDonald's.Financial services firm Redburn Atlantic put the company's stock in the bear category, coinciding with a slumpy week in which it lost about three percent of its value — because analysts are betting that GLP-1 agonist weight loss drugs like Ozempic are going to disrupt the fast food business model, CBS News reports.The eyebrow-raising conclusion comes as the analysts reason that people with lower incomes who go on the drugs will tend to shun food outside the home. Meanwhile, people at a higher income level who take Ozempic and similar go back to their food spending habits after a year or so."Behaviour changes extend beyond the individual user — reshaping group dining, influencing household routines and softening habitual demand," wrote the analysts, as reported by CBS. "A 1 percent drag today could easily build to 10 percent or more over time, particularly for brands skewed toward lower income consumers or group occasions."This could have a huge impact on the bottom line of fast food chains like McDonald's, which could stand to lose as much as $482 million annually as they see the disappearance of 28 million visits from formerly hungry customers.This is all complete speculation at this point, because only about six percent of American adults are currently taking these weight loss medications. And they're prohibitively expensive, prices starting at around $900 per month, meaning that extremely few poor people are currently able to afford them.But there's a movement by some policymakers to lower the price of the drugs, which have been proven to not just help people lose weight, but they come with a rash of benefits from preventing certain cancers to treating addictions, among other positives.So if lawmakers force a reduction in price in the future, expect fast food chains like McDonald's to be left holding the bag.And maybe that's a good thing, because the kind of fried foods that McDonald's traffics in are just plain bad for your health.More on Ozempic: Doctors Concerned by Massive Uptick in Teens Taking OzempicShare This Article
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  • Is Chris Evans Secretly Returning For ‘Avengers: Doomsday’?

    Doing press for his latest movie, Chris Evans was flat-out asked by a journalist: Are you returning for Marvel’s Avengers: Doomsday? That rumor has floated around the internet for months, no doubt buoyed by the fact that Evans made a surprise cameo in last summer’s Deadpool vs. Wolverine, despite the fact that he was supposed to be “retired” from the Marvel Cinematic Universe after the last Avengers movie, Endgame.Evans claimed he wasn’t involved. But he wouldn’t be the first Marvel star to lie about a role in an MCU movie — and he wouldn’t be the first “retired” Marvel hero returning for Doomsday either.Avengers: Doomsday video we look at the facts and speculate about whether Evans might or might not appear in the filmWatch our full discussion on Chris Evans and Doomsday below:READ MORE: The Weirdest Marvel Comics Ever PublishedIf you liked that video on whether Chris Evans is secretly in Avengers: Doomsday, check out more of our videos below, including one on the original plan for Madame Web and why it was so much better than what Sony actually made, one on the connection between Wanda and Doctor Doom, and one on the canceled X-Men vs. Fantastic Four film we never got to see. Plus, there’s tons more videos over at ScreenCrush’s YouTube channel. Be sure to subscribe to catch all our future episodes. Avengers: Doomsday is scheduled to open in theaters on December 18, 2026.Sign up for Disney+ here.Get our free mobile appEvery Marvel Cinematic Universe Movie, Ranked From Worst to BestIt started with Iron Man and it’s continued and expanded ever since. It’s the Marvel Cinematic Universe, with 36 movies and counting. But what’s the best and the worst? We ranked them all.
    #chris #evans #secretly #returning #avengers
    Is Chris Evans Secretly Returning For ‘Avengers: Doomsday’?
    Doing press for his latest movie, Chris Evans was flat-out asked by a journalist: Are you returning for Marvel’s Avengers: Doomsday? That rumor has floated around the internet for months, no doubt buoyed by the fact that Evans made a surprise cameo in last summer’s Deadpool vs. Wolverine, despite the fact that he was supposed to be “retired” from the Marvel Cinematic Universe after the last Avengers movie, Endgame.Evans claimed he wasn’t involved. But he wouldn’t be the first Marvel star to lie about a role in an MCU movie — and he wouldn’t be the first “retired” Marvel hero returning for Doomsday either.Avengers: Doomsday video we look at the facts and speculate about whether Evans might or might not appear in the filmWatch our full discussion on Chris Evans and Doomsday below:READ MORE: The Weirdest Marvel Comics Ever PublishedIf you liked that video on whether Chris Evans is secretly in Avengers: Doomsday, check out more of our videos below, including one on the original plan for Madame Web and why it was so much better than what Sony actually made, one on the connection between Wanda and Doctor Doom, and one on the canceled X-Men vs. Fantastic Four film we never got to see. Plus, there’s tons more videos over at ScreenCrush’s YouTube channel. Be sure to subscribe to catch all our future episodes. Avengers: Doomsday is scheduled to open in theaters on December 18, 2026.Sign up for Disney+ here.Get our free mobile appEvery Marvel Cinematic Universe Movie, Ranked From Worst to BestIt started with Iron Man and it’s continued and expanded ever since. It’s the Marvel Cinematic Universe, with 36 movies and counting. But what’s the best and the worst? We ranked them all. #chris #evans #secretly #returning #avengers
    SCREENCRUSH.COM
    Is Chris Evans Secretly Returning For ‘Avengers: Doomsday’?
    Doing press for his latest movie, Chris Evans was flat-out asked by a journalist: Are you returning for Marvel’s Avengers: Doomsday? That rumor has floated around the internet for months, no doubt buoyed by the fact that Evans made a surprise cameo in last summer’s Deadpool vs. Wolverine, despite the fact that he was supposed to be “retired” from the Marvel Cinematic Universe after the last Avengers movie, Endgame.Evans claimed he wasn’t involved. But he wouldn’t be the first Marvel star to lie about a role in an MCU movie — and he wouldn’t be the first “retired” Marvel hero returning for Doomsday either.Avengers: Doomsday video we look at the facts and speculate about whether Evans might or might not appear in the film (or, for that matter, its sequel, Avengers: Secret Wars)Watch our full discussion on Chris Evans and Doomsday below:READ MORE: The Weirdest Marvel Comics Ever PublishedIf you liked that video on whether Chris Evans is secretly in Avengers: Doomsday, check out more of our videos below, including one on the original plan for Madame Web and why it was so much better than what Sony actually made, one on the connection between Wanda and Doctor Doom, and one on the canceled X-Men vs. Fantastic Four film we never got to see. Plus, there’s tons more videos over at ScreenCrush’s YouTube channel. Be sure to subscribe to catch all our future episodes. Avengers: Doomsday is scheduled to open in theaters on December 18, 2026.Sign up for Disney+ here.Get our free mobile appEvery Marvel Cinematic Universe Movie, Ranked From Worst to BestIt started with Iron Man and it’s continued and expanded ever since. It’s the Marvel Cinematic Universe, with 36 movies and counting. But what’s the best and the worst? We ranked them all.
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  • CERT Director Greg Touhill: To Lead Is to Serve

    Greg Touhill, director of the Software Engineering’s Institute’sComputer Emergency Response Teamdivision is an atypical technology leader. For one thing, he’s been in tech and other leadership positions that span the US Air Force, the US government, the private sector and now SEI’s CERT. More importantly, he’s been a major force in the cybersecurity realm, making the world a safer place and even saving lives. Touhill earned a bachelor’s degree from the Pennsylvania State University, a master’s degree from the University of Southern California, a master’s degree from the Air War College, was a senior executive fellow at the Harvard University Kennedy School of Government and completed executive education studies at the University of North Carolina. “I was a student intern at Carnegie Mellon, but I was going to college at Penn State and studying chemical engineering. As an Air Force ROTC scholarship recipient, I knew I was going to become an Air Force officer but soon realized that I didn’t necessarily want to be a chemical engineer in the Air Force,” says Touhill. “Because I passed all the mathematics, physics, and engineering courses, I ended up becoming a communications, electronics, and computer systems officer in the Air Force. I spent 30 years, one month and three days on active duty in the United States Air Force, eventually retiring as a brigadier general and having done many different types of jobs that were available to me within and even beyond my career field.” Related:Specifically, he was an operational commander at the squadron, group, and wing levels. For example, as a colonel, Touhill served as director of command, control, communications and computersfor the United States Central Command Forces, then he was appointed chief information officer and director, communications and information at Air Mobility Command. Later, he served as commander, 81st Training Wing at Kessler Air Force Base where he was promoted to brigadier general and commanded over 12,500 personnel. After that, he served as the senior defense officer and US defense attaché at the US Embassy in Kuwait, before concluding his military career as the chief information officer and director, C4 systems at the US Transportation Command, one of 10 US combatant commands, where he and his team were awarded the NSA Rowlett Award for the best cybersecurity program in the government. While in the Air Force, Touhill received numerous awards and decorations including the Bronze Star medal and the Air Force Science and Engineering Award. He is the only three-time recipient of the USAF C4 Professionalism Award. Related:Greg Touhill“I got to serve at major combatant commands, work with coalition partners from many different countries and represented the US as part of a diplomatic mission to Kuwait for two years as the senior defense official at a time when America was withdrawing forces out of Iraq. I also led the negotiation of a new bilateral defense agreement with the Kuwaitis,” says Touhill. “Then I was recruited to continue my service and was asked to serve as the deputy assistant secretary of cybersecurity and communications at the Department of Homeland Security, where I ran the operations of what is now known as the Cybersecurity and Infrastructure Security Agency. I was there at a pivotal moment because we were building up the capacity of that organization and setting the stage for it to become its own agency.” While at DHS, there were many noteworthy breaches including the infamous US Office of People Managementbreach. Those events led to Obama’s visit to the National Cybersecurity and Communications Integration Center.  “I got to brief the president on the state of cybersecurity, what we had seen with the OPM breach and some other deficiencies,” says Touhill. “I was on the federal CIO council as the cybersecurity advisor to that since I’d been a federal CIO before and I got to conclude my federal career by being the first United States government chief information security officer. From there, I pivoted to industry, but I also got to return to Carnegie Mellon as a faculty member at Carnegie Mellon’s Heinz College, where I've been teaching since January 2017.” Related:Touhill has been involved in three startups, two of which were successfully acquired. He also served on three Fortune 100 advisory boards and on the Information Systems Audit and Control Association board, eventually becoming its chair for a term during the seven years he served there. Touhill just celebrated his fourth year at CERT, which he considers the pinnacle of the cybersecurity profession and everything he’s done to date. “Over my career I've led teams that have done major software builds in the national security space. I've also been the guy who's pulled cables and set up routers, hubs and switches, and I've been a system administrator. I've done everything that I could do from the keyboard up all the way up to the White House,” says Touhill. “For 40 years, the Software Engineering Institute has been leading the world in secure by design, cybersecurity, software engineering, artificial intelligence and engineering, pioneering best practices, and figuring out how to make the world a safer more secure and trustworthy place. I’ve had a hand in the making of today’s modern military and government information technology environment, beginning as a 22-year-old lieutenant, and hope to inspire the next generation to do even better.” What ‘Success’ Means Many people would be satisfied with their careers as a brigadier general, a tech leader, the White House’s first anything, or working at CERT, let alone running it. Touhill has spent his entire career making the world a safer place, so it’s not surprising that he considers his greatest achievement saving lives. “In the Middle East and Iraq, convoys were being attacked with improvised explosive devices. There were also ‘direct fire’ attacks where people are firing weapons at you and indirect fire attacks where you could be in the line of fire,” says Touhill. “The convoys were using SINCGARS line-of-site walkie-talkies for communications that are most effective when the ground is flat, and Iraq is not flat. As a result, our troops were at risk of not having reliable communications while under attack. As my team brainstormed options to remedy the situation, one of my guys found some technology, about the size of an iPhone, that could covert a radio signal, which is basically a waveform, into a digital pulse I could put on a dedicated network to support the convoy missions.” For million, Touhill and his team quickly architected, tested, and fielded the Radio over IP networkthat had a 99% reliability rate anywhere in Iraq. Better still, convoys could communicate over the network using any radios. That solution saved a minimum of six lives. In one case, the hospital doctor said if the patient had arrived five minutes later, he would have died. Sage Advice Anyone who has ever spent time in the military or in a military family knows that soldiers are very well disciplined, or they wash out. Other traits include being physically fit, mentally fit, and achieving balance in life, though that’s difficult to achieve in combat. Still, it’s a necessity. “I served three and a half years down range in combat operations. My experience taught me you could be doing 20-hour days for a year or two on end. If you haven’t built a good foundation of being disciplined and fit, it impacts your ability to maintain presence in times of stress, and CISOs work in stressful situations,” says Touhill. “Staying fit also fortifies you for the long haul, so you don’t get burned out as fast.” Another necessary skill is the ability to work well with others.  “Cybersecurity is an interdisciplinary practice. One of the great joys I have as CERT director is the wide range of experts in many different fields that include software engineers, computer engineers, computer scientists, data scientists, mathematicians and physicists,” says Touhill. “I have folks who have business degrees and others who have philosophy degrees. It's really a rich community of interests all coming together towards that common goal of making the world a safer, more secure and more trusted place in the cyber domain. We’re are kind of like the cyber neighborhood watch for the whole world.” He also says that money isn’t everything, having taken a pay cut to go from being an Air Force brigadier general to the deputy assistant secretary of the Department of Homeland Security . “You’ll always do well if you pick the job that matters most. That’s what I did, and I’ve been rewarded every step,” says Touhill.  The biggest challenge he sees is the complexity of cyber systems and software, which can have second, third, and fourth order effects.  “Complexity raises the cost of the attack surface, increases the attack surface, raises the number of vulnerabilities and exploits human weaknesses,” says Touhill. “The No. 1 thing we need to be paying attention to is privacy when it comes to AI because AI can unearth and discover knowledge from data we already have. While it gives us greater insights at greater velocities, we need to be careful that we take precautions to better protect our privacy, civil rights and civil liberties.” 
    #cert #director #greg #touhill #lead
    CERT Director Greg Touhill: To Lead Is to Serve
    Greg Touhill, director of the Software Engineering’s Institute’sComputer Emergency Response Teamdivision is an atypical technology leader. For one thing, he’s been in tech and other leadership positions that span the US Air Force, the US government, the private sector and now SEI’s CERT. More importantly, he’s been a major force in the cybersecurity realm, making the world a safer place and even saving lives. Touhill earned a bachelor’s degree from the Pennsylvania State University, a master’s degree from the University of Southern California, a master’s degree from the Air War College, was a senior executive fellow at the Harvard University Kennedy School of Government and completed executive education studies at the University of North Carolina. “I was a student intern at Carnegie Mellon, but I was going to college at Penn State and studying chemical engineering. As an Air Force ROTC scholarship recipient, I knew I was going to become an Air Force officer but soon realized that I didn’t necessarily want to be a chemical engineer in the Air Force,” says Touhill. “Because I passed all the mathematics, physics, and engineering courses, I ended up becoming a communications, electronics, and computer systems officer in the Air Force. I spent 30 years, one month and three days on active duty in the United States Air Force, eventually retiring as a brigadier general and having done many different types of jobs that were available to me within and even beyond my career field.” Related:Specifically, he was an operational commander at the squadron, group, and wing levels. For example, as a colonel, Touhill served as director of command, control, communications and computersfor the United States Central Command Forces, then he was appointed chief information officer and director, communications and information at Air Mobility Command. Later, he served as commander, 81st Training Wing at Kessler Air Force Base where he was promoted to brigadier general and commanded over 12,500 personnel. After that, he served as the senior defense officer and US defense attaché at the US Embassy in Kuwait, before concluding his military career as the chief information officer and director, C4 systems at the US Transportation Command, one of 10 US combatant commands, where he and his team were awarded the NSA Rowlett Award for the best cybersecurity program in the government. While in the Air Force, Touhill received numerous awards and decorations including the Bronze Star medal and the Air Force Science and Engineering Award. He is the only three-time recipient of the USAF C4 Professionalism Award. Related:Greg Touhill“I got to serve at major combatant commands, work with coalition partners from many different countries and represented the US as part of a diplomatic mission to Kuwait for two years as the senior defense official at a time when America was withdrawing forces out of Iraq. I also led the negotiation of a new bilateral defense agreement with the Kuwaitis,” says Touhill. “Then I was recruited to continue my service and was asked to serve as the deputy assistant secretary of cybersecurity and communications at the Department of Homeland Security, where I ran the operations of what is now known as the Cybersecurity and Infrastructure Security Agency. I was there at a pivotal moment because we were building up the capacity of that organization and setting the stage for it to become its own agency.” While at DHS, there were many noteworthy breaches including the infamous US Office of People Managementbreach. Those events led to Obama’s visit to the National Cybersecurity and Communications Integration Center.  “I got to brief the president on the state of cybersecurity, what we had seen with the OPM breach and some other deficiencies,” says Touhill. “I was on the federal CIO council as the cybersecurity advisor to that since I’d been a federal CIO before and I got to conclude my federal career by being the first United States government chief information security officer. From there, I pivoted to industry, but I also got to return to Carnegie Mellon as a faculty member at Carnegie Mellon’s Heinz College, where I've been teaching since January 2017.” Related:Touhill has been involved in three startups, two of which were successfully acquired. He also served on three Fortune 100 advisory boards and on the Information Systems Audit and Control Association board, eventually becoming its chair for a term during the seven years he served there. Touhill just celebrated his fourth year at CERT, which he considers the pinnacle of the cybersecurity profession and everything he’s done to date. “Over my career I've led teams that have done major software builds in the national security space. I've also been the guy who's pulled cables and set up routers, hubs and switches, and I've been a system administrator. I've done everything that I could do from the keyboard up all the way up to the White House,” says Touhill. “For 40 years, the Software Engineering Institute has been leading the world in secure by design, cybersecurity, software engineering, artificial intelligence and engineering, pioneering best practices, and figuring out how to make the world a safer more secure and trustworthy place. I’ve had a hand in the making of today’s modern military and government information technology environment, beginning as a 22-year-old lieutenant, and hope to inspire the next generation to do even better.” What ‘Success’ Means Many people would be satisfied with their careers as a brigadier general, a tech leader, the White House’s first anything, or working at CERT, let alone running it. Touhill has spent his entire career making the world a safer place, so it’s not surprising that he considers his greatest achievement saving lives. “In the Middle East and Iraq, convoys were being attacked with improvised explosive devices. There were also ‘direct fire’ attacks where people are firing weapons at you and indirect fire attacks where you could be in the line of fire,” says Touhill. “The convoys were using SINCGARS line-of-site walkie-talkies for communications that are most effective when the ground is flat, and Iraq is not flat. As a result, our troops were at risk of not having reliable communications while under attack. As my team brainstormed options to remedy the situation, one of my guys found some technology, about the size of an iPhone, that could covert a radio signal, which is basically a waveform, into a digital pulse I could put on a dedicated network to support the convoy missions.” For million, Touhill and his team quickly architected, tested, and fielded the Radio over IP networkthat had a 99% reliability rate anywhere in Iraq. Better still, convoys could communicate over the network using any radios. That solution saved a minimum of six lives. In one case, the hospital doctor said if the patient had arrived five minutes later, he would have died. Sage Advice Anyone who has ever spent time in the military or in a military family knows that soldiers are very well disciplined, or they wash out. Other traits include being physically fit, mentally fit, and achieving balance in life, though that’s difficult to achieve in combat. Still, it’s a necessity. “I served three and a half years down range in combat operations. My experience taught me you could be doing 20-hour days for a year or two on end. If you haven’t built a good foundation of being disciplined and fit, it impacts your ability to maintain presence in times of stress, and CISOs work in stressful situations,” says Touhill. “Staying fit also fortifies you for the long haul, so you don’t get burned out as fast.” Another necessary skill is the ability to work well with others.  “Cybersecurity is an interdisciplinary practice. One of the great joys I have as CERT director is the wide range of experts in many different fields that include software engineers, computer engineers, computer scientists, data scientists, mathematicians and physicists,” says Touhill. “I have folks who have business degrees and others who have philosophy degrees. It's really a rich community of interests all coming together towards that common goal of making the world a safer, more secure and more trusted place in the cyber domain. We’re are kind of like the cyber neighborhood watch for the whole world.” He also says that money isn’t everything, having taken a pay cut to go from being an Air Force brigadier general to the deputy assistant secretary of the Department of Homeland Security . “You’ll always do well if you pick the job that matters most. That’s what I did, and I’ve been rewarded every step,” says Touhill.  The biggest challenge he sees is the complexity of cyber systems and software, which can have second, third, and fourth order effects.  “Complexity raises the cost of the attack surface, increases the attack surface, raises the number of vulnerabilities and exploits human weaknesses,” says Touhill. “The No. 1 thing we need to be paying attention to is privacy when it comes to AI because AI can unearth and discover knowledge from data we already have. While it gives us greater insights at greater velocities, we need to be careful that we take precautions to better protect our privacy, civil rights and civil liberties.”  #cert #director #greg #touhill #lead
    WWW.INFORMATIONWEEK.COM
    CERT Director Greg Touhill: To Lead Is to Serve
    Greg Touhill, director of the Software Engineering’s Institute’s (SEI’s) Computer Emergency Response Team (CERT) division is an atypical technology leader. For one thing, he’s been in tech and other leadership positions that span the US Air Force, the US government, the private sector and now SEI’s CERT. More importantly, he’s been a major force in the cybersecurity realm, making the world a safer place and even saving lives. Touhill earned a bachelor’s degree from the Pennsylvania State University, a master’s degree from the University of Southern California, a master’s degree from the Air War College, was a senior executive fellow at the Harvard University Kennedy School of Government and completed executive education studies at the University of North Carolina. “I was a student intern at Carnegie Mellon, but I was going to college at Penn State and studying chemical engineering. As an Air Force ROTC scholarship recipient, I knew I was going to become an Air Force officer but soon realized that I didn’t necessarily want to be a chemical engineer in the Air Force,” says Touhill. “Because I passed all the mathematics, physics, and engineering courses, I ended up becoming a communications, electronics, and computer systems officer in the Air Force. I spent 30 years, one month and three days on active duty in the United States Air Force, eventually retiring as a brigadier general and having done many different types of jobs that were available to me within and even beyond my career field.” Related:Specifically, he was an operational commander at the squadron, group, and wing levels. For example, as a colonel, Touhill served as director of command, control, communications and computers (C4) for the United States Central Command Forces, then he was appointed chief information officer and director, communications and information at Air Mobility Command. Later, he served as commander, 81st Training Wing at Kessler Air Force Base where he was promoted to brigadier general and commanded over 12,500 personnel. After that, he served as the senior defense officer and US defense attaché at the US Embassy in Kuwait, before concluding his military career as the chief information officer and director, C4 systems at the US Transportation Command, one of 10 US combatant commands, where he and his team were awarded the NSA Rowlett Award for the best cybersecurity program in the government. While in the Air Force, Touhill received numerous awards and decorations including the Bronze Star medal and the Air Force Science and Engineering Award. He is the only three-time recipient of the USAF C4 Professionalism Award. Related:Greg Touhill“I got to serve at major combatant commands, work with coalition partners from many different countries and represented the US as part of a diplomatic mission to Kuwait for two years as the senior defense official at a time when America was withdrawing forces out of Iraq. I also led the negotiation of a new bilateral defense agreement with the Kuwaitis,” says Touhill. “Then I was recruited to continue my service and was asked to serve as the deputy assistant secretary of cybersecurity and communications at the Department of Homeland Security, where I ran the operations of what is now known as the Cybersecurity and Infrastructure Security Agency. I was there at a pivotal moment because we were building up the capacity of that organization and setting the stage for it to become its own agency.” While at DHS, there were many noteworthy breaches including the infamous US Office of People Management (OPM) breach. Those events led to Obama’s visit to the National Cybersecurity and Communications Integration Center.  “I got to brief the president on the state of cybersecurity, what we had seen with the OPM breach and some other deficiencies,” says Touhill. “I was on the federal CIO council as the cybersecurity advisor to that since I’d been a federal CIO before and I got to conclude my federal career by being the first United States government chief information security officer. From there, I pivoted to industry, but I also got to return to Carnegie Mellon as a faculty member at Carnegie Mellon’s Heinz College, where I've been teaching since January 2017.” Related:Touhill has been involved in three startups, two of which were successfully acquired. He also served on three Fortune 100 advisory boards and on the Information Systems Audit and Control Association board, eventually becoming its chair for a term during the seven years he served there. Touhill just celebrated his fourth year at CERT, which he considers the pinnacle of the cybersecurity profession and everything he’s done to date. “Over my career I've led teams that have done major software builds in the national security space. I've also been the guy who's pulled cables and set up routers, hubs and switches, and I've been a system administrator. I've done everything that I could do from the keyboard up all the way up to the White House,” says Touhill. “For 40 years, the Software Engineering Institute has been leading the world in secure by design, cybersecurity, software engineering, artificial intelligence and engineering, pioneering best practices, and figuring out how to make the world a safer more secure and trustworthy place. I’ve had a hand in the making of today’s modern military and government information technology environment, beginning as a 22-year-old lieutenant, and hope to inspire the next generation to do even better.” What ‘Success’ Means Many people would be satisfied with their careers as a brigadier general, a tech leader, the White House’s first anything, or working at CERT, let alone running it. Touhill has spent his entire career making the world a safer place, so it’s not surprising that he considers his greatest achievement saving lives. “In the Middle East and Iraq, convoys were being attacked with improvised explosive devices. There were also ‘direct fire’ attacks where people are firing weapons at you and indirect fire attacks where you could be in the line of fire,” says Touhill. “The convoys were using SINCGARS line-of-site walkie-talkies for communications that are most effective when the ground is flat, and Iraq is not flat. As a result, our troops were at risk of not having reliable communications while under attack. As my team brainstormed options to remedy the situation, one of my guys found some technology, about the size of an iPhone, that could covert a radio signal, which is basically a waveform, into a digital pulse I could put on a dedicated network to support the convoy missions.” For $11 million, Touhill and his team quickly architected, tested, and fielded the Radio over IP network (aka “Ripper Net”) that had a 99% reliability rate anywhere in Iraq. Better still, convoys could communicate over the network using any radios. That solution saved a minimum of six lives. In one case, the hospital doctor said if the patient had arrived five minutes later, he would have died. Sage Advice Anyone who has ever spent time in the military or in a military family knows that soldiers are very well disciplined, or they wash out. Other traits include being physically fit, mentally fit, and achieving balance in life, though that’s difficult to achieve in combat. Still, it’s a necessity. “I served three and a half years down range in combat operations. My experience taught me you could be doing 20-hour days for a year or two on end. If you haven’t built a good foundation of being disciplined and fit, it impacts your ability to maintain presence in times of stress, and CISOs work in stressful situations,” says Touhill. “Staying fit also fortifies you for the long haul, so you don’t get burned out as fast.” Another necessary skill is the ability to work well with others.  “Cybersecurity is an interdisciplinary practice. One of the great joys I have as CERT director is the wide range of experts in many different fields that include software engineers, computer engineers, computer scientists, data scientists, mathematicians and physicists,” says Touhill. “I have folks who have business degrees and others who have philosophy degrees. It's really a rich community of interests all coming together towards that common goal of making the world a safer, more secure and more trusted place in the cyber domain. We’re are kind of like the cyber neighborhood watch for the whole world.” He also says that money isn’t everything, having taken a pay cut to go from being an Air Force brigadier general to the deputy assistant secretary of the Department of Homeland Security . “You’ll always do well if you pick the job that matters most. That’s what I did, and I’ve been rewarded every step,” says Touhill.  The biggest challenge he sees is the complexity of cyber systems and software, which can have second, third, and fourth order effects.  “Complexity raises the cost of the attack surface, increases the attack surface, raises the number of vulnerabilities and exploits human weaknesses,” says Touhill. “The No. 1 thing we need to be paying attention to is privacy when it comes to AI because AI can unearth and discover knowledge from data we already have. While it gives us greater insights at greater velocities, we need to be careful that we take precautions to better protect our privacy, civil rights and civil liberties.” 
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  • Star Trek: Strange New Worlds’ third season falls short of its second

    This is a spoiler-free preview of the first five episodes of season three.
    Star Trek: Strange New Worlds ended its second season with arguably the single strongest run of any streaming-era Trek. The show was made with such confidence in all departments that if there were flaws, you weren’t interested in looking for them. Since then, it’s gone from being the best modern Trek, to being the only modern Trek. Unfortunately, at the moment it needs to be the standard bearer for the show, it’s become noticeably weaker and less consistent. 
    As usual, I’ve seen the first five episodes, but can’t reveal specifics about what I’ve seen. I can say plenty of the things that made Strange New Worlds the best modern-day live-action Trek remain in place. It’s a show that’s happy for you to spend time with its characters as they hang out, and almost all of them are deeply charming. This is, after all, a show that uses as motif the image of the crew in Pike’s quarters as the captain cooks for his crew.
    Its format, with standalone adventures blended with serialized character drama, means it can offer something new every week. Think back to the first season, when “Memento Mori,” a tense action thriller with the Gorn, was immediately followed by “Spock Amock,” a goofy, starbase-set body-swap romantic comedy of manners centered around Spock. Strange New Worlds is the first Trek in a long while to realize audiences don’t just want a ceaseless slog of stern-faced, angry grimdark. And if they want that, they can go watch Picard and Section 31.
    Marni Grossman/Paramount+
    But, as much as those things are SNW’s greatest strength, it’s a delicate balance to ensure the series doesn’t lurch too far either way. And, it pains me to say this, the show spends the first five episodes of its third season going too far in both directions. No specifics, but one episode I’m sure was on the same writers room whiteboard wishlist as last season’s musical episode. What was clearly intended as a chance for everyone to get out of their usual roles and have fun falls flat. Because the episode can never get past the sense it’s too delighted in its own silliness to properly function.
    Marni Grossman/Paramount+
    At the other end of the scale, we get sprints toward the eye-gouging grimdark that blighted those other series. Sure, the series has gone to dark places before, but previously with more of a sense of deftness, rather than just going for the viscerally-upsetting gore. A cynic might suggest that, as Paramount’s other Trek projects ended, franchise-overseer Alex Kurtzman — who has pushed the franchise into “grittier” territory whenever he can — had more time to spend in the SNW writers’ room.
    Much as I’ve enjoyed the series’ soapier elements, the continuing plotlines take up an ever bigger part of each episode’s runtime so far. Consequently, the story of the week gets less service, making them feel weaker and less coherent. One episode pivots two thirds of the way in to act as a low-key sequel to an episode from season two. But since we’ve only got ten minutes left, it feels thrown in as an afterthought, or to resolve a thread the creative team felt they were obliged to deal with.
    In fact, this and the recently-finished run of Doctor Who suffered from the same problem that blights so many streaming-era shows, which is the limited episode order. Rather than producing TV on the scale broadcast networks were able to — yearly runs of 22-, 24- or 26 episodes, a lot ofgenre shows get less than half that. The result is that each episode has to be More Important Than The Last One in a way that’s exhausting for a viewer.
    But Strange New Worlds can’t solve all the economic issues with the streaming model on its own. My hope is that, much like in its first season, the weaker episodes are all in its front half to soften us up for the moments of quality that followed toward its conclusion.
    ASIDE: Shortly before publication, Paramount announced Strange New Worlds would end in its fifth season, which would be cut from ten episodes to six. It's not surprising — given the equally-brilliant Lower Decks was also axed after passing the same milestone — but it is disappointing. My only hope is that the series doesn't spend that final run awkwardly killing off the series' young ensemble one by one in order to replace them with the entire original series' roster as to make it "line up." Please, let them be their own things. This article originally appeared on Engadget at
    #star #trek #strange #new #worlds
    Star Trek: Strange New Worlds’ third season falls short of its second
    This is a spoiler-free preview of the first five episodes of season three. Star Trek: Strange New Worlds ended its second season with arguably the single strongest run of any streaming-era Trek. The show was made with such confidence in all departments that if there were flaws, you weren’t interested in looking for them. Since then, it’s gone from being the best modern Trek, to being the only modern Trek. Unfortunately, at the moment it needs to be the standard bearer for the show, it’s become noticeably weaker and less consistent.  As usual, I’ve seen the first five episodes, but can’t reveal specifics about what I’ve seen. I can say plenty of the things that made Strange New Worlds the best modern-day live-action Trek remain in place. It’s a show that’s happy for you to spend time with its characters as they hang out, and almost all of them are deeply charming. This is, after all, a show that uses as motif the image of the crew in Pike’s quarters as the captain cooks for his crew. Its format, with standalone adventures blended with serialized character drama, means it can offer something new every week. Think back to the first season, when “Memento Mori,” a tense action thriller with the Gorn, was immediately followed by “Spock Amock,” a goofy, starbase-set body-swap romantic comedy of manners centered around Spock. Strange New Worlds is the first Trek in a long while to realize audiences don’t just want a ceaseless slog of stern-faced, angry grimdark. And if they want that, they can go watch Picard and Section 31. Marni Grossman/Paramount+ But, as much as those things are SNW’s greatest strength, it’s a delicate balance to ensure the series doesn’t lurch too far either way. And, it pains me to say this, the show spends the first five episodes of its third season going too far in both directions. No specifics, but one episode I’m sure was on the same writers room whiteboard wishlist as last season’s musical episode. What was clearly intended as a chance for everyone to get out of their usual roles and have fun falls flat. Because the episode can never get past the sense it’s too delighted in its own silliness to properly function. Marni Grossman/Paramount+ At the other end of the scale, we get sprints toward the eye-gouging grimdark that blighted those other series. Sure, the series has gone to dark places before, but previously with more of a sense of deftness, rather than just going for the viscerally-upsetting gore. A cynic might suggest that, as Paramount’s other Trek projects ended, franchise-overseer Alex Kurtzman — who has pushed the franchise into “grittier” territory whenever he can — had more time to spend in the SNW writers’ room. Much as I’ve enjoyed the series’ soapier elements, the continuing plotlines take up an ever bigger part of each episode’s runtime so far. Consequently, the story of the week gets less service, making them feel weaker and less coherent. One episode pivots two thirds of the way in to act as a low-key sequel to an episode from season two. But since we’ve only got ten minutes left, it feels thrown in as an afterthought, or to resolve a thread the creative team felt they were obliged to deal with. In fact, this and the recently-finished run of Doctor Who suffered from the same problem that blights so many streaming-era shows, which is the limited episode order. Rather than producing TV on the scale broadcast networks were able to — yearly runs of 22-, 24- or 26 episodes, a lot ofgenre shows get less than half that. The result is that each episode has to be More Important Than The Last One in a way that’s exhausting for a viewer. But Strange New Worlds can’t solve all the economic issues with the streaming model on its own. My hope is that, much like in its first season, the weaker episodes are all in its front half to soften us up for the moments of quality that followed toward its conclusion. ASIDE: Shortly before publication, Paramount announced Strange New Worlds would end in its fifth season, which would be cut from ten episodes to six. It's not surprising — given the equally-brilliant Lower Decks was also axed after passing the same milestone — but it is disappointing. My only hope is that the series doesn't spend that final run awkwardly killing off the series' young ensemble one by one in order to replace them with the entire original series' roster as to make it "line up." Please, let them be their own things. This article originally appeared on Engadget at #star #trek #strange #new #worlds
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    Star Trek: Strange New Worlds’ third season falls short of its second
    This is a spoiler-free preview of the first five episodes of season three. Star Trek: Strange New Worlds ended its second season with arguably the single strongest run of any streaming-era Trek. The show was made with such confidence in all departments that if there were flaws, you weren’t interested in looking for them. Since then, it’s gone from being the best modern Trek, to being the only modern Trek. Unfortunately, at the moment it needs to be the standard bearer for the show, it’s become noticeably weaker and less consistent.  As usual, I’ve seen the first five episodes, but can’t reveal specifics about what I’ve seen. I can say plenty of the things that made Strange New Worlds the best modern-day live-action Trek remain in place. It’s a show that’s happy for you to spend time with its characters as they hang out, and almost all of them are deeply charming. This is, after all, a show that uses as motif the image of the crew in Pike’s quarters as the captain cooks for his crew. Its format, with standalone adventures blended with serialized character drama, means it can offer something new every week. Think back to the first season, when “Memento Mori,” a tense action thriller with the Gorn, was immediately followed by “Spock Amock,” a goofy, starbase-set body-swap romantic comedy of manners centered around Spock. Strange New Worlds is the first Trek in a long while to realize audiences don’t just want a ceaseless slog of stern-faced, angry grimdark. And if they want that, they can go watch Picard and Section 31. Marni Grossman/Paramount+ But, as much as those things are SNW’s greatest strength, it’s a delicate balance to ensure the series doesn’t lurch too far either way. And, it pains me to say this, the show spends the first five episodes of its third season going too far in both directions (although, mercifully, not at the same time). No specifics, but one episode I’m sure was on the same writers room whiteboard wishlist as last season’s musical episode. What was clearly intended as a chance for everyone to get out of their usual roles and have fun falls flat. Because the episode can never get past the sense it’s too delighted in its own silliness to properly function. Marni Grossman/Paramount+ At the other end of the scale, we get sprints toward the eye-gouging grimdark that blighted those other series. Sure, the series has gone to dark places before, but previously with more of a sense of deftness, rather than just going for the viscerally-upsetting gore. A cynic might suggest that, as Paramount’s other Trek projects ended, franchise-overseer Alex Kurtzman — who has pushed the franchise into “grittier” territory whenever he can — had more time to spend in the SNW writers’ room. Much as I’ve enjoyed the series’ soapier elements, the continuing plotlines take up an ever bigger part of each episode’s runtime so far. Consequently, the story of the week gets less service, making them feel weaker and less coherent. One episode pivots two thirds of the way in to act as a low-key sequel to an episode from season two. But since we’ve only got ten minutes left, it feels thrown in as an afterthought, or to resolve a thread the creative team felt they were obliged to deal with (they didn’t). In fact, this and the recently-finished run of Doctor Who suffered from the same problem that blights so many streaming-era shows, which is the limited episode order. Rather than producing TV on the scale broadcast networks were able to — yearly runs of 22-, 24- or 26 episodes, a lot of (expensive) genre shows get less than half that. The result is that each episode has to be More Important Than The Last One in a way that’s exhausting for a viewer. But Strange New Worlds can’t solve all the economic issues with the streaming model on its own. My hope is that, much like in its first season, the weaker episodes are all in its front half to soften us up for the moments of quality that followed toward its conclusion. ASIDE: Shortly before publication, Paramount announced Strange New Worlds would end in its fifth season, which would be cut from ten episodes to six. It's not surprising — given the equally-brilliant Lower Decks was also axed after passing the same milestone — but it is disappointing. My only hope is that the series doesn't spend that final run awkwardly killing off the series' young ensemble one by one in order to replace them with the entire original series' roster as to make it "line up." Please, let them be their own things. This article originally appeared on Engadget at https://www.engadget.com/entertainment/tv-movies/star-trek-strange-new-worlds-third-season-falls-short-of-its-second-020030139.html?src=rss
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