The wine we drink and machines that can think

Meanwhile, back down here on Earth you probably assume that our emergency services, those tasked with getting us out of harm’s way, were always working with the full weight of scientific medical evidence behind them; if so, this story might come as something of a shock. This is because, in the case of rescue from car wrecks, research has outlined that the current approach, designed to minimise the movement of patients to guard against exacerbating spinal injuries, is counter productive. And it’s not marginal. In over 99% of cases, spinal injuries are not the main problem for the patient, while extending the amount of time they spend trapped in the car could render other injuries, where every second that treatment is delayed counts, potentially fatal. Speaking with James Tytko, Tim Nutbeam, an Emergency Medicine Consultant for the NHS, estimates that hundreds of people in this country, and many more worldwide, might have been saved if a scientifically driven approach had sooner been applied to car wreck rescue efforts…

Tim- The principles of current fire and rescue techniques are based around what we call absolute movement minimisation. So, when you suffer an injury to your spine, there is a concern that further movements might exacerbate that injury and make the primary injury worse, and we call that secondary spinal injury. That has been the paradigm, the focus of extrication techniques and how they've developed, particularly over the last 40 or 50 years.

James- What are the flaws with this approach?

Tim- It's a, a single consideration in a complex environment, and we need to have an understanding of what injuries patients have and make sure that we've weighed all those into balance to work out what is best for that patient and that particular extrication. We set out to fill in some of the gaps in the relevant scientific evidence, and then to re-evaluate - is what we are doing correct? And if it's not, what are the next steps?

James- What was the result of that re-evaluation? What did you find?

Tim- So we went back and looked at all the history, all the farm rescue manuals, and tried to work out where this paradigm of movement minimization had evolved from, and if it had a historical evidence base. We could find no evidence of that. There was never any underlying scientific evidence in terms of frequency of injuries or type of injuries, or a specific reason why that, that paradigm might have been chosen over, say, a head injury or a chest injury or an abdominal injury. The second part of the project was looking at the different injuries which these patients suffer and we worked with the trauma audit research network and is the biggest trauma database in Europe. What we did is we looked at patients who were trapped and patients who weren't trapped and then looked at what injuries they suffered and then reported those injuries and also used modelling techniques to see if being trapped led to more deaths than it should.

Tim- What we demonstrated was the rate of spinal injury, or spinal cord injury, was very low, less than 0.7%. All the other patients - so this is looking at majorly injured patients - had other significant injuries. Normally it's the head or the chest or the abdomen with spinal injuries right down at the bottom of this list of injury frequency. We also found that being trapped was associated with more deaths than it should be. So once we took into account people's age, their comorbidities, that's the other things that they've got wrong with them, and the injuries that they suffered, we found that being trapped was an independent predictor of mortality. So there's something about being trapped that kills you.

James- Is it fair to ask why this has taken so long for people to look at the way we deal with these accidents and to re-assess how we should be dealing with them?

Tim- Yeah, I think there's a number of different challenges to that. One is around, I guess, patient ownership. Who is responsible for casualties or patients when they are actually trapped? Are they actually a patient or are they a casualty which is the responsibility of the fire and rescue services? And I think these areas of shared ownership lead to potential difficulties in delivering research in that area.

James- I definitely appreciate what you're saying, but when you've outlined the situation as clearly as you have, how does it stand up to people out there who, obviously have my deep sympathies, maybe they've lost someone to an accident who might have stood a far better chance had their injuries been treated sooner, giving an updated approach, which moves away from the movement minimization way of dealing with things.

Tim- I think that's a difficult question to, to answer. I think the important thing is, is that we've identified that what we are doing could be better and we are working with all the right stakeholders to make sure that that information rapidly and efficiently translated into practice. It's a shame that we've not looked at this sooner, but now that we have, we seem to have captured momentum and the buy-in and support of all these stakeholders to ensure that this translates rapidly into not only guidance, but into the practice that we deliver on a day to day basis, moving forward. We've already seen some changes or results and, and that's really fantastic to see.

James- Yeah, that's good to hear. When it comes to this transition, are there any major sticking points in the way that you envisage or could, could things move quite quickly from here?

Tim- I think it's important not to underestimate how difficult it is to overcome years of institutionalized practice and the fire rescue services have been taught for many years, that even a very small movement can lead to catastrophic consequences. I think it's important that this work has, it's not delivered by doctors and it's not delivered by fire rescue personnel. It's not delivered by a certain group of practitioners, but it's been genuinely developed and delivered by a multidisciplinary group of stakeholders. I think, in the past, we've perhaps gone wrong by doctors telling people how to do things. And I think the principles of regularly revisiting this guidance and ensuring that what we're doing is patient centred and patient injury centred that we can continue to refine and get better at this area of practice and all those other areas of shared multidisciplinary practice.

Now, speaking of the underwater realm, Gansbaai in South Africa was renowned as the Great White capital of the world; at least until 5 years ago, when the animals disappeared, almost overnight, leaving researchers and locals puzzled. Since 2017 Alison Towner, from Rhodes University on the Eastern Cape, has been piecing together the different parts of the jigsaw puzzle to work out what’s happened…

Alison- It wasn't as if we saw a decline, you know, they just vanished. And initially it happened for about six to weeks and the sharks started to reappear again. What had happened in that time period was kilo whales had arrived and been here for 15 years. I'd never seen killer whales really in this area. Certainly I'd never seen the type of killer whale that's known to hunt sharks. So this is actually quite a rare morphotype of killer whale that specializes in selectively targeting sharks and their livers and, lo' and behold, here were these two very distinctive killer whales. So they were here in the study site and they proceeded to predate on various great white sharks in the area. We know this because the carcasses of the dead white sharks washed out and, in the wake of that, everything changed. So post 2017, when this happened, you know, the numbers like literally drastically declined and then the white sharks would sort of return again in much lower numbers. So, with the killer whales, and it was just a game of cat of mouse since then, until here we are five years later, the, the sciences finally published and we can show the world the evidence and the data. And it's, it's quite startling.

Harry- Is this the first time that we've witnessed this behaviour, this predation of the killer whale eating the, the great white or white sharks.

Alison- This behaviour has been documented once before off of San Francisco, California, at the Farallon Islands and scientists there, it's a 1999 paper so it's quite a while ago, described observational account of some offshore killer whales killing a great white shark. Biting it at the surface, towing it, pushing it through the water to asphyxiate it, and then sort of rolling on its back and, and extracting its liver. There was a written report, it wasn't direct evidence and it certainly wasn't any carcasses washing out for examination afterwards. So, lo and behold, what happened here was the carcasses were very coastal because these types of killer whales are generally more offshore. So the carcasses washed down, that was the first time in the world. We were able to sort of post mortem them. And I actually led all the necropsies, we've had eight so far, but yeah, having been part of that now and seen so many of them washed out is quite spectacular, but quite sinister at the same time, the killer whales literally rip them open at their fins and then just extract the liver and discard the carcass.

Alison- It's incredible.

Harry- Do we know why they're just taking the liver?

Alison- Well, the liver is a huge organ, very lipid rich, so very fatty nutrient high profile nutrient. It's just, it's right there for the taking in that if they flip the shark over and put it into a trance like state and they tear it, then the liver literally is so accessible, right? We've estimated that male adult killer whales would need to eat about one white shark liver a day to sustain itself. So <laugh> the calculations have been done. I mean, it's not gonna exactly fill them up for very long, but they certainly specialize in extracting this one organ.

Harry- Is it that these sharks then know that this is going on. And so that's why they're leaving the area or there's certain cues that they're taking before they run off, away from Cape town.

Alison- So if a white shark's taken off guard by a killer whale - if all of a sudden it turns around and there's multiple killer whales - I mean, we know there's at least two that are doing it. The sheer trauma of that have being chased of other of the same species in your area within, you know, range of you detecting it being predated on. It's probably enough to drive you out the area for one. But then it can be the rotten carcass. So, once it's discarded and it's laid on the sea bed, let's say it hasn't washed out, we do believe there's more that hasn't washed out. The scent of death, if you will, could keep the sharks away, but that would be momentarily, not long term. So all the questions are there, but somehow these white sharks have this evolutionary built in mechanism to know to avoid these <laugh> these areas where it's high killer whale risk. I'm sure the science will definitely unravel some more about that with regards to vocalizations of killer whales or exactly what mechanisms the sharks use.

Harry- I'm making the assumption that at the moment, you're kind of at the start of this bringing together of data. So with that in mind, you know, everybody will be aware that food webs and ecosystems are very fragile, they're very complicated. If you take away something like the great white shark from an environment where it is an apex predator, what happens to the rest of the sea floor? Do we know what happens to that environment?

Alison- At this point? Of course it's speculation, it's hypotheses, but I mean, removing top predators is never good for ecosystems full stop. And now the coastal bay where these white sharks sort of reign king, if you will, is home to so many other critically endangered species that are actually reliant on the white sharks being there as top predators. So, for example, we have the Greater Dyer island system here in Gaansbai, which has critically endangered African penguins on it and their numbers are right down. They can't sustain any more pressure. And now, because just adjacent to their colony is actually a colony of breeding cape fur seals. Now the seals don't have their natural predators around. So they're actually directly competing with the penguins for food, but also predating on them. So again, it's just that little perturbation at the top tier of the ecosystem in our Marine environment here, that's now out of balance and it has cascading effects right The way through the whole food chain. Yeah, If we leave it too long and you know, this isn't rebalanced, then we could have serious consequences in our hands. But what I will say is that we have a couple of great white sharks that have finally come back to this region. There's about four of them out there today that the boat's seeing, but it's been almost a year since they were here.

To the world of artificial intelligence or AI now; Google engineer Blake Lemoine recently captured the world’s attention when he went public with his conviction that the chatbot he was working with,  the“Language Model for Dialogue Applications or LaMDA for short, had displayed evidence of having its own feelings and consciousness. Since speaking to the press, Lemoine was put on Google gardening leave, and the company have roundly dismissed his claims. So is this a computer programme with feelings that knows its alive and fears the off switch, or just a clever piece of software? James Tytko asked Toby Walsh, professor of artificial intelligence at the School of Computer Science and Engineering at the University of New South Wales, whether LaMDA could really be sentient…

Toby - No, it's not really sentient, not in my opinion. We don't build machines with anything like sentience. On a strictly technical level, it's not sentient because it's not made of biological stuff and only biological things have consciousness have sentience. But what I think is interesting is how easily even smart people like a senior Google engineer can be taken in. So it says more about human gullibility than it does about intelligence of machines.

James - If it isn't sentient, how is Lambda so good at replicating the speech of a real person?

Toby - Well, it really is auto complete on steroids. It is essentially the same sort of thing that's on your smartphone that can finish the word or maybe finish the sentence when you're typing in a text or an email, but they've taken it to the next level by pretty much pouring in the contents of the internet into this large neural network. So it can't just complete the next word or the next sentence, it can complete whole paragraphs. But it's not understanding what it's saying. It's merely just trying to say things that will frequently turn up on the web.

James - But is it a concern that without him going public with this belief, we would not have known that a chatbot as sophisticated as this was in development at one of the biggest technology companies in the world, Google. Why are they interested in developing chatbots that we find difficult to differentiate from real people?

Toby - Well, there is an arms race going on between the big tech companies to develop these chat bots. And Google's not the only one, that's got a large chat bot; all the other tech giants are developing them. There's nothing special about what Google's done, it's their flavour of chatbot. And they're going to prove very useful. Google is going to be using it to help return better, more accurate search results for you. They're being used in customer service, they're being used in a variety of ways. They can do some remarkable things. They can summarise restaurant reviews for you. They can even write computer code; you just say what you would like the computer code to do and because there's quite a bit of computer code out there on the web that's been poured into this program, it can surprisingly enough actually write computer code.

James - I'm interested in the idea of sentience and AI. And I'm wondering whether, is it even in the realm of science, the idea of sentience, or can we ever expect scientists to understand sentience, to then be able to give it to machines?

Toby - We don't know if it's the stuff purely of biology or it's something that we could reproduce in machines. I always say it will be lucky if machines are never sentient, because then we won't have to worry about them. I can go back to my laboratory and I can take my robot apart, diode by diode, and no one's going to care because it doesn't have any feelings. It's not going to experience any pain. But if it did become sentient, then most things that have sentience, we give rights to like other humans and animals.

James - You've recently released a new book, "Machines Behaving Badly." Can you give me and our listeners a bit of a taste of your rough direction of travel in that new work?

Toby - Yeah. I don't think we have to get into some super intelligent machines - some Terminator-like robot - before we get to have to worry about these things. Indeed, I think we're already there. We already have to worry about the stupid algorithms that are starting to be given responsibilities that are that impacting upon our lives. As an example, the machine learning algorithm used by Facebook to decide your news feed or the machine learning algorithm that's used by Twitter to decide which tweets you read, that doesn't seem to be particularly well-aligned with human values. It's encouraging polarising of our debate, it's encouraging fake news, it's not encouraging a healthy, democratic debate, it's not encouraging us to understand other people's viewpoints.

James - Are there other implementations of AI currently in use in our society that similarly crop up as a point of concern for you?

Toby - Yes, for example, many people don't realise that their boss today is an algorithm. If you work for Uber or Deliveroo or one of these gig economy companies, your work is not decided by a human, it's decided by an algorithm. And it's demonstrated for example, that the algorithm is encouraging bad driving. It's encouraging people to break the speed limit, you'll get more jobs and more money. There's going to be more work for those people.

Have you ever tried to grab something under water? Chances are, you slipped and slid all over the shop trying to get hold of it. Octopuses, on the other hand - or perhaps that should be tentacle! - seem to have no problem sweeping up objects and moving and manipulating them. How they do this was the inspiration for a new wearable piece of tech that Michael Barlett, a mechanical engineer from Virginia Tech, showcased for Julia Ravey…

Michael - A lot of people know that the octopus has eight arms, but it also has over 2000 individual suckers across those eight arms. And those suckers allow it to grab objects and then to quickly release them. What the octopus also has is millions of sensors across those adhesives and those arms, which allow it to actually feel its environment, and chemical sensors actually allow it to taste its environment. So what the octopus is able to do is to take information from those sensors and then process it in its brain. This ability to have adhesion control with the ability to sensor your environment, process that information, and then that allows the octopus to actually individually control those thousands of adhesives to pick up and release objects.

Julia - How does this compare to humans when we're underwater trying to grip things?

Michael - A lot of us can relate to the concept of having to pick up something wet and slippery underwater. It's quite hard. So what the octopus can do is actually with their suckers, or with this control of adhesion, they can pick up things without actually having to grab them. They can just lightly press their skin onto an object and that allows them to attach to that object reliably.

Julia - You've designed a product which makes us a little bit more octopus. What did you come up with?

Michael - Exactly. So what we wanted to do was to develop adhesives to mimic the suckers and take advantage of that concept of using sensing, processing, and control to manipulate objects underwater. So first we needed to make an octopus inspired adhesive and this consists of a rubber stop with a rubber membrane on top. We changed the shape of that membrane to rapidly change adhesion, about 450 times different from an attached state to a release state and we do that in less than 50 milliseconds. We then needed a sensor. So then we used what are called micro-LiDAR sensors, which essentially look at their environment and detect objects that get close to it by shining beams of light. We take the signal from that, we send it through a microprocessor and that allows us to detect objects in realtime underwater. Next we took this sensor and this adhesive and we put it onto a glove. We can now automatically trigger adhesion just by moving your hand next to an object, similar to how the octopus would grasp something underwater.

Julia - So if I had this glove on and I wanted to pick something up, say in my sink, and there's a plate in the sink and there's lots of water in there, and I had this glove on - what would be the process by me putting my hand in the water? How could I pick it up and then release it wearing this glove?

Michael - A plate is a great object to try to think about picking up; you can't simply just put your hand on a plate and pull it out of water. But if you had one of these gloves on, what we call Octaglove, you would essentially be able to take your hand in a flat state, put it on the flat part of the plate, and if you just move your hand close enough, the sensors will detect the plate, which then will rapidly trigger the adhesion to turn on. All of a sudden, you'll be attached to that plate, just like an octopus would be attached to a shell underwater, and then you could pull it out of the sink and then put it in your drying rack.

Julia - It's like a magnet, but not magnetic.

Michael - It is similar to that in the sense that you just have to get close enough, and then the adhesives and the glove take care of the rest to pick up that object.

Julia - What do you think this octopus-inspired technology could be used for then?

Michael - I think some of the areas we're excited about are certainly underwater grasping and moving of objects, you know, in the same way the octopus would. So I think you could imagine undersea divers being able to pick up objects that are delicate. We also envision it being useful for assistive devices and rehabilitation where a user could simply bring their hand close to an object and then the adhesion could turn on to allow them to pick up that object effortlessly. And I also think there's possibilities in manufacturing and other industrial settings.