IT and Me: Reflections of a Pathologist, Futurist,

Technology Advocate Doctor Guy!

 Kim Solez, MD

Over 20 Years Here I Have Never Had A Problem IT Could Not Solve

Who Am I?

Twenty-three years ago Kim Solez and Lorraine Racusen presided over a unique Meeting in Banff Canada.

Banff Classification of Kidney Transplant Pathology

Histologic criteria for the diagnosis of rejection and other conditions in the transplanted kidney, began 1991, updated and expanded every two years in consensus meeting.

1991 First Conference 1993 First Kidney International publication 1994 NEPHROL First websites and Email groups 1995 Integration with CADI 1997 Integration with CCTT classification, NKF cyberNephrology and ISN

Informatics Commission Formed 1999 Second KI paper. Clinical practice guidelines. Implantation biopsies. 2001 Classification of antibody-mediated rejection: Regulatory agencies

participating 2003 Genomics focus, ptc cell accumulation scoring 2005 Gene chip analysis. Elimination of CAN, identification of chronic

antibody-mediated rejection. 2007 First meeting far from a town called “Banff” – La Coruna, Spain. 2009 Working groups. Meeting in Banff, Alberta, Canada 2011 Technology and Future of Medicine Course created LABMP 590 2013 Establishment of Banff Foundation for Allograft Pathology

Banff Classification and IT Milestones

Significance of ‘Banff papers’• 4244 citations of the 9 Banff meeting reports• 790 Banff / Transplantation papers in PubMed• Banff 2003 meeting report (ABMR criteria) = most cited AJT

paper• 3 Banff meeting reports are among the top 4 cited AJT articles

Organizational structure of the Banff Foundation For Allograft Pathology

Board of Trustees: K. Solez (Chair), L. Racusen, D. Glotz, J. Demetris, M. Mengel, M. Mihatsch, D. Seron, N.

Schmidt

2015 Local Conference chair: Michael Mengel

Organ Steering committee Chairs: Composite tissues: Linda CendalesHeart : Rene RodriguezKidney: Mark HaasLiver: Jake DemetrisLung: William Wallace and Carol FarverPancreas: Cinthia Drachenberg

Banff Working Group (BWG) Leads: Molecular transplantation pathology: Michael Mengel, Banu SisIsolated v-lesions: Banu Sis, Ed KrausQuality assurance in transplantation diagnostics: Michael Mengel and Parmjeet RandhawaC4d-negative ABMR: Mark Haas, Banu Sis, Alexandre LoupyFibrosis scoring: Robert Colvin, Brad Farris, Michael MengelDigital Pathology in Transplantation: Jake Demetris

2015 Scientific program committee: Alex Loupy (Chair)Mark Haas, Banu Sis, Kathryn Tinkham, Candice Rofousse, Chris Bellamy, Lynn Cornell, Carmen LeFaucheurComposite tissues: Linda CendalesHeart : Rene RodriguezLiver: Jake DemetrisLung: William Wallace and Carol FarverPancreas/Islets: Cinthia Drachenberg and John Papadimitriou

Secretary/Treasurer: Michael Mengel

funding

collaboration

reports to

reports to

collaboration

collaboration

reports to

collaborationprogress reports to Budged

proposal and accountability for meeting costs

support

BANFF Conferences On Allograft Pathology 1991-Forever?

Target Audience for the 2015 joint CST/Banff meeting: total ~600 expected delegates Basic Scientists Pathologists Immunogeneticists and HLA experts Transplant Physicians: Internal Medicine, Surgery,

Infectious Diseases, Critical Care Allied Health Care Students, Trainees, Fellows

The Banff ProcessConsensus communication in renal transplantation

a

The Banff lesions

g, i, t, v - score

The Banff communityPathologistsNephrologistsTx-SurgeonsLab-Medicine

established by

consensus in 1991

The Banff classificationCurrent consensus for diagnostics

moderatedBanff meetings

thesis-antithesis-synthesis

tentative

thresholds

participate

refinementBanff Working Groups

Feedback concerning weaknesses and strengths by results from independent research

New membersBiostaticiansMolecular Biologists“Omics”-specialists

Off-springsLiverPancreasLung, HeartCTA

The Banff Allograft Pathology Meetings Are Sometimes Said to be the “Best Meetings In Transplantation”. How Can This Possibly Be So?

The Banff Schema was first developed at a meeting of pathologists, clinicians and surgeons in Banff, Alberta, Canada, August 2-4, 1991 and has become the worldwide standard for the interpretation of transplant biopsies.

What People Mean is that They Like the Size, Atmosphere, Spirit, and Productivity of the Banff Meetings. These Attributes Must be Maintained.

The Banff Schema was first developed at a meeting of pathologists, clinicians and surgeons in Banff, Alberta, Canada, August 2-4, 1991 and has become the worldwide standard for the interpretation of transplant biopsies.

Dunbar’s Number of 150 People You Can Have Significant Empathetic Friendships With. Need to Maintain This Intimate Feeling in A Larger Meeting of 600.

Unique Course on Technology

and the Future of Medicine

LABMP 590 Created in

2011

Click icon to add picture

Future ConceptsMoore’s Law&Eroom’s Law , the

technological Singularity and exponential change, exponential decline in # new drugs per billion dollars R&D expenditure.

Moore’s Law Predicts Singularity

The Technological Singularity

Soft Transhumanism – Ross LockwoodThe last decade has brought a profound change in the way we humans interact. Our imagined future of merger between human and electronic interface has crept into our lives; social networks, adept at instantaneous byte-sized communications, now permeate the younger generations. There is still a chasm between hard-Transhumanism, and this soft-Transhumanism, defined by our interactions with personal electronics, but there is no sign of these interactions abating. Fully embracing this technological revolution, within the University classroom and beyond, is beneficial to the learning experience and to our cultural growth as human beings.– Ross Lockwood HI-SEAS sMars mission May 4, 2014!

The Technological SingularityThe technological singularity occurs as artificial intelligences surpass human beings as the smartest and most capable life forms on the Earth. Technological development is taken over by the machines, who can think, act and communicate so quickly that normal humans cannot even comprehend what is going on. The machines enter into a "runaway reaction" of self-improvement cycles, with each new generation of A.I.s appearing faster and faster. From this point onwards, technological advancement is explosive, under the control of the machines, and thus cannot be accurately predicted (hence the term "Singularity"). – Ray Kurzweil

Major Singularity Developments in February 2011

All natural disease may be eliminated, leaving only man-made diseases. But that may leave as much for physicians to do as there is today!

Challenging responses to bioterrorism and stem cell technologies.

Focus of medicine no longer disease but enhancement, elevating the human condition, which will extend beyond the physical to the moral and spiritual.

Social responsibility an important aspect of medicine and one of the focuses of the course.

2045 is only 31 years from now. Many of you will still be working then. What will

medical careers be like then?

Focus Groups in May 2011

Course conceptualized in March 2011, tested with

focus groups in May for its suitability as a

course for both undergraduate and graduate students.

Over Time Our Course’s Sessions Have Developed a Pedagogical

Rhythm, Leading To A Self-organized Structure

Ten minute introduction Fifty minute lecture Twenty minute discussion In the course we talk about

machines replacing many of the functions of human beings. This picture was taken by a machine without human intervention, as were many of the best still images from the course. The video camera is constantly comparing the scene to algorithms and takes still pictures when the requirements of the interesting picture algorithm are satisfied.

Video and Audio Quality Superb Now!

First teaching session 2011 Recent teaching session 2014

Hot-linked tables of contents in YouTube descriptions at http://www.youtube.com/user/kimsolez allow one to jump right to content of interest.

Director of Social Media at Kandu Inc.

The Normal, Outgoing, Personable Students in the Course are Little by Little Changing the World! Student Presentation Videos Have Had Amazing Positive Effects!

Heather Graves, from Department of English and Film Studies, in Faculty of

Arts. Diversity of views and backgrounds is an important feature of the course. Tech

skeptics represented.

Diverse Faculty from Across The Campus Teach in the Course. All Views Represented.

We shoot broadcast quality video of each lecture & discussion. http://www.singularitycourse.com IT staff is intergral part of course, essential to it!

Previous lectures at http://www.youtube.com/user/KimSolez . Students critique one past lecture, and suggest improvements in presentation and hot-linked table of contents (20% of grade).

Students write one 3,000 word paper (40%) and give 20 min. presentation on same subject (30%). Also graded on class participation (10%).

No required reading. Suggested reading list in course outline, readings suggested by Email.

Course Specifics

The technological Singularity. Existential risks, AI, genomics, and nanotech.

Ways to optimize a positive outcome for humanity in the co-evolution of humans and machines . The influence of these considerations on medicine of the future.

Dean of Science speaking, prominent people internationally. Most lectures not very “medical”. Easily understood.

Balanced view provided by incorporating both tech skeptics and tech advocates.

Course Content

Medical student elective participation in course, med student club. International peer review of YouTube videos, modifications made.

Two Quantum Biology lectures. Young person old person point counterpoint lecture January 30th,

Abdullah Saleh/Earle Waugh Medical Ethics in a World of Robots(What will we allow when everything is possible).

Collaboration with Disruptive Technologies in Medicine course in Budapest, Hungary, the only other course somewhat like this one.

Accommodation for the shy student, working directly with videographer for final presentation, texting questions.

Space orientation, 3D printing in space, usabilityof iOS devices in space, Mars habitat simulation, analog space missions in context.

Other Innovations New in 2014

The Banff Foundation for Allograft Pathology Must Remain Youthful and Relevant for the Future – Must Adapt, Plan for Changes

As the field changes and stem-cell-grown organs replace transplantation, the organization must change with it

Transplantation may be loosing its luster but luster of the Banff Foundation for Allograft Pathology can remain strong.

As an exercise in alternative realities I asked participants to consider the very different life of David Crippen, my counterpart in critical care medicine. We need to consider changes that large!

The spectacular dynamics influencing the pace of stem generation of organs replacing transplantation in the future.

There were YouTube videos (now removed) suggesting that stem cell generation of complex organs in humans would be routine by 2020. Problems of clotting, endothelial loss, and cell type selection errors not mentioned.

The dramatic slowdown of new drug approvals (Eroom’s Law) by the FDA suggests that the FDA is ripe for disruptive innovation. Has happened.

However stem cell therapies may be the last area the FDA will relax regulation in, as unproven bogus stem cell therapies are causing widespread suffering and protection of the general public is needed.

Banff Foundation for Allograft Pathology and Banff Meetings Must Adapt to Future Changes in Field of Transplantation

Transplant pathologists will also become tissue engineering pathologists, pathologists who analyse organs grown from stem cells. This is not something beyond us, we can adapt to a work life that includes stem cells.. Someone needs to cross the disciplines.

Turtles All

the Way

Down abstrusegoose.com/155

Animal Analogies

Limited.Need Human

Alter Egos

CCM-L Characters Off-Topic

DiscussionsNEPHROL

No CharactersNo Off-Topic Discussions

Many Military Awards, Karate

Black BeltNo Civilian AwardsNever Served in

MilitaryMany Civilian

Awards

Rock BandMotorcycles

Colorful History in 60’s and 70’s

No Band orMotorcycle

Boring Young Person

Crippen A Myth?

Proves the Metaphor

Works!

In our original location we had mule deer poking their heads

into the meeting rooms!We’ve come a long way!