THE FUTURIST, May - June 2014 by World Future Society

Forecasts, Trends, and Ideas about the Future

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INSIDE MEDICAL FUTURES Thanks to technologies that promise to improve not only the practice of medicine but also the management of health, our bodies will be built better and last longer. See the special section beginning on page 31

Toward a More Perfect Sex Life, page 20 Our Pets in Sickness and Health, page 47 Mission for Worldwide Innovation, page 16 WORLD TRENDS & FORECASTS

Good Robots Gone Bad Altitude’s Vertical Limit to Population Growth The Unexpected Tolls of Racism The End of the Earth’s Oceans? 3-D Printing Keeps on Growing Choosing between Happiness and Meaning

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May-June 2014

Calling All Students!

Susan Echard Student Scholarships for 2014 In order to encourage more secondary school and college students to take an active role in shaping the future for themselves, their community, and the world, the World Future Society offers scholarships and grants to cover WorldFuture 2014 conference registration fees, lodging, and expenses for students from around the globe. Thanks to the generosity of members and friends of the World Future Society, discounted conference registration assistance at the student registration rate ($150) is available to full-time students under age 25; you must be prepared to provide appropriate documentation. However, if you are in need of additional financial assistance, you may apply online for a scholarship. Applications are due by May 15, 2014. Funding will be awarded on a case-by-case basis after all requests have been received, but it may include: complimentary or reduced conference registration, funds to cover lodging or meals, or reimbursement for transportation. When your application has been approved, you will automatically be registered for the conference. If you choose not to attend, you must notify the conference coordinator immediately so that the scholarship may be awarded to another applicant. Apply online at: www.wfs.org/worldfuture-2014-scholarship-application To donate to the Susan Echard Student Scholarship Fund, please visit www.wfs.org/support or send a check (payable to World Future Society) to: Susan Echard Student Scholarship Program World Future Society 7910 Woodmont Avenue, Suite 450 Bethesda, Maryland 20814, USA

May-June 2014 Volume 48, No. 3

A magazine of forecasts, trends, and ideas

Remote risks. Page 6

ARTICLES 16 Mission for Worldwide Innovation An Interview with Eric Dyson

In order to maximize innovation, the public and the private sectors need to cooperate. In order for innovation to grow around the world, developed and developing nations need to cooperate. To meet both of these challenges is the mission of CRDF Global, a foundation based in the United States with innovationbuilding projects around the world.

DEPARTMENTS 2

Tomorrow in Brief

Feedback

World Trends & Forecasts

• Good robots gone bad, by Steven M. Shaker • Altitude’s vertical limit to population growth • End of the Earth’s oceans? • Racism’s unexpected tolls • 3-D printing keeps growing • Choosing between happiness and meaning

52 Consultants and Services 55 Reviews

• State of the World 2013, the Worldwatch Institute • American Exodus, Slade • Human Purpose and Transhuman Potential, Chu • Pardon the Disruption, Rawlings, Smith, and Bencini • The Social Labs Revolution, Hassan

64 As Tweeted: What If? Questions Are Easy, Answers Are Hard

about the future

20 Euphoric, Harmless, and Affordable: A Trend Analysis of Sex By Karen Moloney

A psychologist examines several technological developments affecting sex, assessing their potential to deliver safe, affordable, and fulfilling experiences, as well as the economic, social, and legal questions that they raise.

26 Where Will the Century of Biology Lead Us? By Randall Mayes

A technology trend analyst offers an overview of synthetic biology, its potential applications, obstacles to its development, and prospects for public approval.

31 Rx Disruption: Technology Trends in Medicine and Health Care By Bertalan Meskó Doctors and patients alike are navigating wave after wave of new technologies that promise to alter how we manage our health. Digital technologies also offer opportunities for doctors and patients to become better strategic partners in medical decisions.

39 Sniffing out the Future of Medicine By Peter W. Huber

Labs on chips and low-cost genetic sequencing could vastly improve medicine in the coming decade, if we allow it. An expert in technology, science, and law argues that the next big revolution in medicine fits on a chip—and in patients’ hands.

43 Adventures in Personal Genomics By Verne Wheelwright

The public may demand a right to know their own genetic information, but interpreting their medical destinies without professional guidance might be off-limits.

47 Extending Pet Longevity: Our Companions in Sickness and in Health By Rick Docksai

Pet owners everywhere would like for their companion animals to live longer, and veterinary medicine is finally making that possible. Emerging developments in gene therapy, cancer treatments, surgery, and nutrition have the potential to give our four-legged friends many more years of life.

How long is “nine lives” in dog years? Page 47

COVER ILLUSTRATION: © GUNITA REINE / BIGSTOCK

© 2014 World Future Society. All rights reserved. Reproduction in whole or part without written permission is prohibited. THE FUTURIST is a registered trademark of the World Future Society. Printed in the U.S.A. THE FUTURIST (ISSN 0016-3317) is published bimonthly by the World Future Society, 7910 Woodmont Avenue, Suite 450, Bethesda, Maryland 20814, U.S.A. Included with membership in the World Future Society (dues: $79 per year for individuals; $20 for full-time students under age 25). Subscriptions for libraries and other institutions are $89 annually. Periodicals postage paid at Bethesda, Maryland, and additional mailing offices. • POSTMASTER: Send address changes to THE FUTURIST, 7910 Woodmont Avenue, Suite 450, Bethesda, Maryland 20814. • OWNERSHIP: THE FUTURIST is owned exclusively by the World Future Society, a nonpartisan educational and scientific organization incorporated in the District of Columbia and recognized by the U.S. Internal Revenue Service as a nonprofit taxexempt organization under section 501(c)3 of the Internal Revenue Code. • CHANGE OF ADDRESS: Write or call Membership Department at the Society. 1-800-989-8274.

Tomorrow

in brief PLEASED-FP7.EU / SCREEN CAPTURE VIA YOUTUBE

Plant Communications Will we be talking with the plants in the future? If by “talking” we mean sending and receiving signals—and understanding them—then maybe so. A research project led by computer engineering professor Andrea Vitaletti at the University of Rome’s W-LAB is attempting to interpret the electrical signals emitted by plants as they respond to sunlight, pollutants, nutrients, pests, or other external stimuli.

The goal is to turn plants into natural biosensors. Because plants need to respond to multiple sources of stimuli simultaneously, they could provide more real-time information than artificial devices, Vitaletti explains.

WordBuzz: CoBot

Solar Energy Storage

Collaborative (or cooperative) robots—they’re the ones who will not become our overlords. As the National Science Foundation describes them, CoBots are “help on wheels.” In an NSF-funded project at Carnegie Mellon University, CoBots are being developed as teams of indoor gofers—couriers, messengers, and escorts ready to answer any call for help in an office building or other programmable environment. They can execute their tasks unaccompanied by humans, learning where doors are and which elevator buttons to push.

One of the big hurdles that solar energy has had to overcome is that it’s only readily available roughly half the time (and less than that during the winter). Engineers at the University of North Carolina, Chapel Hill, now offer a potential storage solution. Instead of converting solar energy into electricity, the scheme developed by a team at the Energy Frontier Research Center converts it into hydrogen fuel as a storage medium. “Our new findings may provide a last major piece of a puzzle for a new way to store the sun’s energy,” says lead researcher Tom Meyer, Arey Distinguished Professor of Chemistry. “It could be a tipping point for a solar energy future.” The dye-sensitized photoelectrosynthesis cell (DSPEC), mimics the photosynthesis of plants, using the sun’s energy to split water into hydrogen and oxygen, then storing the hydrogen and releasing the oxygen. The molecule that does

Source: National Science Foundation, www.nsf.gov. SCREEN CAPTURE NSF VIDEO

Sources: PLEASED (PLants Employed As SEnsing Devices), pleased-fp7.eu; European Research Media Center, www.youris.com.

Safety in a Box A new sensing device offers a more-private alternative to “granny cams”—video surveillance cameras that keep watch over frail seniors who wish to live independently. The safe@home system under development at the Fraunhofer Institute for Manufacturing Engineering and Automation IPA consists of a CareBox that is installed like a smoke detector in a person’s home. Optical and acoustic sensors follow the occupant’s location and movement, sending an alarm if the person has fallen and remains motionless. Privacy is maintained because only the alert, not the data collected, is stored or transmitted. The system could be a boon for the large majority of seniors (70% of Germans, according to government statistics) who hope to stay in their own homes, despite the fact that as many as 40% of those age 80

the work of ripping electrons from water in the DSPEC is called a chromophore-catalyst assembly; nanoparticles then sequester the electrons, making hydrogen fuel. Coating the nanoparticles with titanium dioxide made the process faster. Source: UNC-Chapel Hill, uncnews.unc.edu. ENERGY FRONTIER RESEARCH CENTER AT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

Dye-sensitized photoelectrosynthesis cell uses the sun’s energy to split water, storing hydrogen fuel and releasing oxygen.

The CareBox observes an emergency situation in seconds and notifies the alarm unit in the home. and older will experience a fall at least once a year. Source: Fraunhofer-Gesellschaft, www.fraunhofer.de/en/.

Will Rats Inherit The Earth? Rats are poised for growth and increased power, according to University of Leicester geologist Jan Zalasiewicz. Their influence on the global ecology will grow as larger mammals become extinct. As they outcompete native species in ecosystems they’re introduced to, highly adaptable rats will also likely evolve in a wide variety of ways, including very small and very large, even gigantic sizes, depending on the environmental pressures they face. “So there will be future thin rats, future fat rats, slow and heavy rats, fast and ferocious rats, probably future aquatic rats,” Zalasiewicz speculates. “Other animals will likely follow the same pattern, such as domestic cats, rabbits, goats, and more.” Source: University of Leicester, www.le.ac.uk

About

this

Issue

A Publication of the World Future Society

Editorial Staff Edward Cornish Founding Editor

Cynthia G. Wagner Editor

Patrick Tucker Deputy Editor

Rick Docksai Senior Editor

Keturah Hetrick Staff Editor

Lane Jennings Research Director

Lisa Mathias Art Director

Contributing Editors Clement Bezold, Government Tsvi Bisk, Strategic Thinking Irving H. Buchen, Training Peter Eder, Marketing and Communications Thomas Frey, Innovation Joyce Gioia, Workforce/Workplace Jay Herson, Futurist Community Barbara Marx Hubbard, Images of Man Joseph P. Martino, Technological Forecasting Matt Novak, Historical Futures Joseph N. Pelton, Telecommunications Arthur B. Shostak, Utopian Thought David P. Snyder, Lifestyles Gene Stephens, Criminal Justice Timothy Willard, Biofutures Richard Yonck, Computing and AI

Contact Us Letters to the Editor: letters@wfs.org Subscription/Address Change: info@wfs.org Advertising: jcornish@wfs.org Submissions/Queries: cwagner@wfs.org Permission/Reprints: jcornish@wfs.org Back Issues/Bulk Copies: jcornish@wfs.org Press/Media Inquiries: info@wfs.org Partnerships/Affiliations: tmack@wfs.org Conference Inquiries: swarner@wfs.org Anything Else: info@wfs.org THE FUTURIST World Future Society 7910 Woodmont Avenue, Suite 450 Bethesda, Maryland 20814, USA Hours: 9 a.m.–5 p.m. eastern time, weekdays except U.S. holidays Telephone: 301-656-8274 or 800-989-8274 Fax: 301-951-0394 www.wfs.org/futurist

The Technologies of Well-Being Though some may argue that we rely too heavily on technofixes for all our problems, a variety of technological developments are in fact improving medicine and therapeutics, our health and overall physical well-being, and even our sex lives. But as authors in this issue suggest, one of the most important “breakthroughs” in medicine may be better communications and stronger partnerships between doctors and patients. Medical futurist Bertalan Meskó offers an overview of the state of medical arts and sciences, outlining what’s here, what’s in progress, and what’s on the way. Amid the hype for a medical Tricorder, artificial organs, and nanorobots in the bloodstream, he notes that digital communications technologies to connect doctors and patients will play an increasingly significant role in the future of health (See “Rx Disruption: Technology Trends in Medicine and Health Care,” page 31.) A major area of development in medical technologies is personalized diagnostics and therapies that may be possible with gene sequencing. Peter W. Huber, author of The Cure in the Code, describes the prospects for personal drug development. (“Sniffing out the Future of Medicine,” page 39.) Privacy is one of the reasons that people began demanding access to their own medical information, Huber notes, citing the rise of home pregnancy tests in the twentieth century. But still, one obstacle to a future of personal medicine is government regulation, he warns. Already, the FDA recently stopped one company (23andMe) from marketing its personal gene-sequencing technology as a medical service rather than merely a way to discover information about one’s ancestry. Futurist Verne Wheelwright describes his experience with receiving his personal information before the ban. Despite the FDA’s apparent concern that patients would try to self-medicate based on their genomic information, Wheelwright discussed his risk report with his own physician. (“Adventures in Personal Genomics,” page 43.) Sexual health and well-being is part of our future, and technologies are offering interesting prospects there, too. In a preview of her presentation at the World Future Society’s upcoming conference, Chartered Psychologist and business consultant Karen Moloney analyzes several developments on the basis of whether they will provide the healthy and fulfilling experiences that they promise. (“Euphoric, Harmless, and Affordable: A Trend Analysis of Sex,” page 20.) For more about the Society’s annual meeting, WorldFuture 2014: What If, see pages 59-62. And stay tuned for more session previews in the July-August issue! —Cynthia G. Wagner, Editor cwagner@wfs.org

Feedback How will humans behave as the accelerating pace of tech innovation and automation replaces their jobs faster than creating new opportunities and leaves them jobless and homeless? It’s happening now, and displaced workers are getting increasingly frustrated. What backlash can be expected? Will they unseat elected officials at the ballot box and push for more socialistic policies? Will they revolt against companies (some now already) or against governments? Which jobs are most at risk first? For two contrasting views, see www.mhealthtalk.com/2012/08/ automation-robots-and-the-pink-collar. Robin Hanson replies: We agree that it takes social and human sciences to predict the social conse“Favorite Read” (Via Twitter) quences of tech. Which particular sciences are most useful will, of Ive got mail! #favorite_read #futurist course, depend on the particular #megatrends #scenarios #forecasting question asked. On machines dis#wfs @WorldFutureSoc placing jobs, we have centuries of http://instagram.com/p/kUOYilsRIT/ experience with that. It rarely results in a revolt against firms or Moza Issa Al-Is’haq @mozishaq states.

Re: “When the Economy Transcends Humanity” by Robin Hanson (January-February 2014) Anonymous (via wfs.org): Won’t be happening. Humans probably will have destroyed themselves long before 75 years, perhaps even 30 years. Alternatively, if enough of us are still around, humans will be so fearful of this technology that they will prevent its development and implementation. No species, if it can help it, will allow another species to render it vulnerable to domination or extinction.

Economy in the Future New David Wolf (via wfs.org): I’d love to see a deeper exploration of ways the no-longer-employable could be helped to pay their rent and feed themselves. Maybe a tax on the profits of corporations using these Ems could be dedicated to that task. In terms of the technology for creating Ems, the concept of nondestructive total brain emulation is at the heart of my novel, Mindclone. In this book, the donor and his digital twin are free to interact, with interesting consequences. You might enjoy looking at the first few chapters. Robin Hanson replies: As always, there are lots of mechanically feasible tax and transfer arrangements. But better to ask which arrangements are politically feasible in the short run, and what long-run consequences do they have for the competitive viability of a society? Ethnographic Research, Not Technical or Economic Wayne Caswell (via wfs.org): It’s fun to think about future technologies, but is there a need for them, and will people adopt them? To answer that requires more than an understanding of what’s technically possible, or even what makes economic sense. It requires an understanding of human behavior in the form of ethnographic research that combines physiology, sociology, and anthropology.

Correction

In the article “Robotic Technology to Preserve Wildlife: A Scenario” by Princess Aliyah Pandolfi (March-April 2014), the photos of Kruger National Park on pages 35 and 37 should have been credited to Justin Leto.

Re: “Causal Layered Analysis Defined” by Sohail Inayatullah (January-February 2014) Patricia Kelly (via wfs.org): This is a really clear explanation of CLA and its benefits. It can also be a nonthreatening methodology in that you don’t need to get stuck at one level and it opens up opportunities for people to listen to each other.

Re: “The End of Public Promises? Governments and the Pension Deficit Disorder” by Rob Bencini (November-December 2013) Karl F Storck (via wfs.org): Rob Bencini’s article is really enlightening, especially for a non U.S. citizen. However, there is one prominent parameter, in my opinion, he didn’t mention explicitly that seems to pop up implicitly from the text: the way repetitive elections and short-term mandates are structuring the actions of public entities in a democratic system. Indeed, every retiree (ex–public employees) is a potential elector, and when they are taken as a whole, they constitute a kind of lobby that puts public authorities under pressure to pay them first. It is certainly against the common Western way of

continued on page 58

Officers

Staff

President: Timothy C. Mack

Business and Advertising Manager: Jeff Cornish

Treasurer: Kenneth W. Hunter

Conference Director: Sarah Warner

Secretary: Les Wallace

Conference Coordinator: Tom Warner

Directors Edward Cornish founder and former president, World Future Society

Nancy Donovan senior analyst, U.S. Government Accountability Office

Joyce Gioia president and CEO, The Herman Group

John Gottsman president, The Clarity Group

Kenneth W. Hunter (chair) senior fellow, Maryland China Initiative, University of Maryland

Timothy C. Mack president, World Future Society

Eric Meade senior futurist and vice president, Institute for Alternative Futures

Robert P. Moran partner, Brunswick Group

Clement Bezold

Julio Millán

chairman and senior futurist,

president, Banco de Tecnologias, and

Institute for Alternative Futures

chairman, Grupo Coraza, Mexico

Arnold Brown

Joergen Oerstroem Moeller

chairman, Weiner, Edrich, Brown, Inc.

visiting senior research fellow, ISEAS, Singapore

Adolfo Castilla

Ramez Naam

economist, communications professor, Madrid

computer scientist and author

Marvin J. Cetron

John Naisbitt

president, Forecasting International Ltd.

trend analyst and author

Hugues de Jouvenel

Burt Nanus

executive director, Association

author and professor emeritus of management,

Internationale Futuribles

University of Southern California

Yehezkel Dror

Joseph N. Pelton

professor, Hebrew University of Jerusalem

founder and vice chairman,

Esther Franklin

Arthur C. Clarke Foundation

executive vice president and director of cultural

Timothy M. Persons

identities, Starcom MediaVest Group

chief scientist, U.S. Government Accountability Office

William E. Halal

John L. Petersen

professor of management science and

president, The Arlington Institute

director of Emerging Technologies Project,

Mylena Pierremont

George Washington University

president, Ming Pai Consulting BV

Peter Hayward

Carol D. Rieg (vice chair)

program director, Strategic Foresight Program,

corporate foundation officer, Bentley Systems Inc.

Swinburne University of Technology, Australia

Les Wallace

Barbara Marx Hubbard

president, Signature Resources Inc.

president, The Foundation for Conscious Evolution

Jared Weiner

Sohail Inayatullah

vice president, Weiner, Edrich, Brown, Inc.

professor, Tamkang University, Taiwan

Global Advisory Council

Zhouying Jin

Stephen Aguilar-Millan European Futures Observatory

Raja Ikram Azam

president, Beijing Academy of Soft Technology

Francis Rabuck director, Technology Research, Bentley Systems Inc.

Paul Saffo managing director of foresight, Discern Analytics

Robert Salmon former vice president, L’Oreal Corporation, Paris

Marcio de Miranda Santos executive director, Center for Strategic Studies and Management in Science, Brasilia, Brazil

Eleonora Barbieri Masini professor emerita, Faculty of Social Sciences, Gregorian University, Rome

honorary chairman, Pakistan Futuristics Foundation

Sandra L. Postel director, Global Water Policy Project

Maurice F. Strong secretary general, U.N. Conference on Environment and Development

Graham May

Raj Bawa

principal lecturer in futures research,

president/patent agent, Bawa Biotech LLC, and

Leeds Metropolitan University, U.K.

adjunct professor, Rensselaer Polytechnic Institute

The World Future Society is a nonprofit educational and scientific association dedicated to promoting a better understanding of the trends shaping our future. Founded in 1966, the Society serves as a neutral clearinghouse for ideas about the future; it takes no stand on what the future will or should be like. The Society’s publications, conferences, and other activities are open to all individuals and institutions around the world. For more information on membership programs, contact Society headquarters Monday through Friday, 9 a.m. to 5 p.m. Eastern Time. 7910 Woodmont Avenue, Suite 450, Bethesda, Maryland 20814, U.S.A. Telephone: 1-301-656-8274, Toll free: 1-800-989-8274, Fax: 1-301-951-0394 Web site: www.wfs.org • E-mail: info@wfs.org

World Trends & Forecasts Robotics • Ethnicity • Oceans • Health • Manufacturing • Personal Futures

Robotics | Sci/Tech

Good Robots Gone Bad Drones harbor no ill-intent, as yet, but terrorists and hackers may turn sci-fi mischief into reality.

By Steven M. Shaker After several decades of largely being confined to the military arena, unmanned transport systems are rapidly penetrating the civil and commercial sectors. Amazon has revealed its vision of hexapod rotary packagedelivery drones. Google is poised to equip trucks with Google maps and self-driving technology, which will carry robots to deliver packages to the door. There are already robotic vacuum cleaners, lawnmowers, bartenders, and window washers. Unmanned systems are poised to revolutionize all aspects of daily life, from transportation to household care to entertainment. But all good systems and technology have a dark side when misused for applications other than what they were intended for. So now is the time for government and industry to put into practice measures that can eliminate or at least mitigate the harmful unintended consequences of commercial mobile robotic technology. The theme of evil robots has long been a staple of science fiction. The Terminator movies displayed a networked group of humanoid robots and unmanned ground and air vehicles, which turned against its developers and aimed to wipe out humanity. Star Trek: The Next Generation had Steven M. Shaker an episode in which

the android Data turned evil and nearly did in Captain Picard. Books, television, and film have portrayed the dark side of robots ever since the 1927 classic Metropolis. Recent decades have exhibited the adage that “life imitates art.” Such was the case in September 2011, when Rezwan Ferdaus—a bright but disenchanted young man with a degree in physics from Northeastern University in Boston—was arrested for a plan to attack Washington, D.C., with high-end hobby remote-controlled aircraft. Ferdaus envisioned taking a squadron of F-86 Sabre and F-4 Phantom model planes filled with C-4 explosives to attack the U.S. Capitol and the Pentagon. They were to be launched from the East Potomac Park, near the Jefferson Memorial, and then guided by GPS to their targets. Although many experts are skeptical that such hobby aircraft, which are approximately five feet long and capable of carrying a payload of about five pounds of C-4 plastic explosives, could do much against a target like the Pentagon, they certainly could demolish a car or motorcade. If you furnish an IED (improvised explosive device) with mobility, you have an unmanned mobile weapon. For the past 30 years, various terrorist groups have considered and experimented with using unmanned vehicles (both military-grade remote-controlled and r adio-controlled hobby) as ordnance-delivery platforms. Examples of such terrorist activities since the 1970s include: • The Irish Republican Army was able to take control of a British Army EOD (explosive ordnance disposal) robot carrying explosives and turn it against its operators. • Iranian Revolutionary Guards rehearsed attacks using bomb-laden remote-controlled boats. • The Basque separatist group ETA tried to blow up a Spanish patrol boat with four-foot-long remote-controlled boats packed with explosives.

BATON / BIGSTOCK

• Drug smugglers started using homebuilt unmanned submarines to hide contraband from the U.S. Coast Guard. • The FBI found catalogs and operator manuals for EOD robots within an Aryan Nations leader’s cabin. • Branch Davidians experimented with an enhanced bomb-laden remote-controlled plane. • Japanese cult Aum Shinrikyo examined using cropdusting radio-controlled helicopters for sarin payloads. More recently, there have been numerous attempts by al-Qaeda and other terrorist groups over the past decade to employ unmanned and hobby remote-controlled vehicles. Examples of these include: • In 2004, Canadians of Arab descent were charged with working on a GPS-navigated model airplane that could be fitted with explosives. They were being directed by a senior al-Qaeda figure in Pakistan who wanted the men to unleash a wave of simultaneous bombings in the UK. • In 2007, Iraqi terrorists drove bomb-laden remote-controlled cars toward American convoys in AlDurah and Al-Taji. • In 2008, Columbus, Ohio, resident Christopher Paul, an accused al-Qaeda member, pleaded guilty to

planning attacks in the United States and Europe using remote-controlled boats and five-foot-long helicopters. The historical record reveals that the notion of using unmanned vehicles as terrorist devices is not original or novel. Numerous study groups have indicated that this threat is growing for several reasons. The technical progress of lower-cost unmanned vehicles and their transfer of technology and applications from military to civilian usage makes them more accessible and easier to procure. The increasing sophistication of high-end radio-controlled hobby vehicles makes their adoption for terrorist usage more likely. Effective countermeasures are lacking. As we head into the commercial and civil sectors, new dangers lurk in the future of unmanned vehicles. Flying parcel-delivery drones, driverless vehicles and trucks, and other mobile robotic systems can be stolen, hacked into, and hijacked to deliver explosives and other agents of destruction. Many of the inventors and pioneers in unmanned systems were at first serious hobbyists experimenting with remote-controlled planes, cars, and boats. Restricting hobbyists’ access or usage both harms the industry and impedes the intellectual curiosity of potential future developers and scientists. So what can be done to lessen the feasibility of unmanned systems being used “by the dark side” for nefarious purposes? Prior to the arrest of Rezwan Ferdaus in Massachusetts, police in Montgomery County, Maryland, put out a warning to hobby shops to be aware of customers who didn’t appear to be regular hobbyists and were interested in modifying the model’s configuration and performance. In September 2011, federal agents asked the Academy of Model Aeronautics to watch fellow enthusiasts who may exhibit bad intentions. Other industry trade groups and their members, such as the Association for Unmanned Vehicle Systems International, should be vigilant in observing and reporting suspicious behavior. In particular, as the use of unmanned air vehicles grows in civilian applications, their misuse is more viable, so association members should monitor potentially abusive applications. Authorities should consider performing the following research: • M o n i t o r i n g t h e p u rc h a s e s o f “ h i g h e n d ” remote-controlled vehicles (aircraft, ground vehicles, submersibles, and boats) that are capable of delivering ordnance, and unmanned vehicles being sold to commercial concerns that can be adapted to deliver ordnance. • Maintaining a supply-chain database of manufacturers, vendors, and distribution channels, with particular focus in the Middle East and/or other geographical areas of interest.

www.wfs.org

•

THE FUTURIST

May-June 2014

World Trends & Forecasts • Correlating the purchases and supply chain with information on hobby groups and hobbyists, terrorist organizations, and other individuals involved with experimenting or conceptualizing the use of hobby vehicles to deliver ordnance. • Conducting interviews with U.S. and foreign specialists in unmanned vehicles, hobby remote-controlled vehicles, and security regarding possible safeguards and countermeasures. • Establishing a list of “early warning” indicators to monitor and track the development and use of mobile IEDs. Ingrained within our species is the predilection by some malcontents to take technologies developed for good purposes and misapply them for evil deeds. Preventing this abuse without imposing restrictions that thwart positive innovation is a difficult balancing act. Now is the time for proponents of unmanned systems and high-end remote-control hobbyists to help come up with solutions worth considering. Steven M. Shaker is a futurist, strategist, and author on advanced technology, robotics, and unmanned systems. He is co-author of War without Men: Robots on the Future Battlefield (Pergamon-Brassey’s, 1988) and was selected as the Association for Unmanned Vehicle Systems Member of the Year in 1990. He can be reached at steve.m.shaker@gmail.com.

Ethnicity | Humanity

Altitude’s Vertical Limit to Population Growth Ethnic integration on the Tibetan Plateau may be limited by genetics. Politics, resources, safety, and economic opportunity (or the lack thereof) all play a role in convincing populations to migrate from one place to another. Topography may also be an important factor: New evidence from a Princeton University study suggests that land elevation could play a bigger role than even economic incentives in the future of human migration. To understand why, you have to look upward, to Tibet. The Plateau of Tibet has an average elevation of about 16,000 feet above sea level—approximately three miles. At high altitudes, oxygen levels are much lower than those found at sea level, and, as a result, those who have not adjusted to the change in elevation can

THE FUTURIST

May-June 2014

•

www.wfs.org

ZZVET / BIGSTOCK

These Tibetan boys can withstand higher altitudes than Han Chinese living in Tibet—a result of thousands of years of genetic adaptation.

struggle to take in adequate amounts of oxygen. This condition is known as altitude sickness. Effects include headache and vomiting; more extreme cases involve convulsions and even death. Symptoms kick in within a matter of hours. Yet, Tibetans have inhabited the plateau for thousands of years. To geneticists, this phenomenon is a fascinating mystery. To the Chinese government, it may be complicating efforts to move nonnative Tibetans into parts of the region. The Han are China’s largest ethnic group and comprise about 90% of the country’s population. The remaining 10% is made up of 55 officially recognized ethnic minorities, which are mostly concentrated inland. For years, the Chinese government has provided tax incentives to encourage Han Chinese to move to Tibet. Although Tibetans make up a very small percentage of China’s total population—less than half of one percent—they number in the millions. Chinese Tibetans inhabit the Tibet Autonomous Region (TAR). Despite this “autonomy,” the Chinese government exercises strict control over various aspects of life in the region, according to findings from the humanitarian group Human Rights Watch (HRW). One aspect of the current policy is the forced migration of many Tibetans into “New Socialist Villages,” concrete housing units built to specific government standards. Many Tibetans who spoke with HRW re-

ported that the forced resettlement into the units made research’s political implications. “There are many more it impossible for them to practice their traditional herddimensions involved” in Han Chinese and Tibetan inteing way of life. gration than just elevation, he insists. —Keturah Hetrick Moreover, the Dalai Lama (whom China forbids Tibetans from worshipping) contends that the governSources: Interview with Christopher Paik, New York University. ment-sponsored Han migration is a part of the state’s “Altitude and adaptation: A study of geography and ethnic division” alleged plan for cultural genocide, aimed at forcing by Christopher Paik and Tsering Wangyal Shawa, Applied Geography Tibetans to assimilate with the Chinese majority. But if the government’s goal is ethnic integration, the (Volume 40, June 2013). effort seems to have fallen short, so far. Han Chinese comprise only about 6% of Tibet’s total population, according to reports by the Chinese government. The Princeton University study found that the Han and Oceans | Earth Tibetan populations aren’t distributed equally throughout the Autonomous Region. Instead, they remain largely segregated. The study argues that susceptibility to altitude sickness may be to blame. Using census figures and historical maps and data, A billion years from now, solar radiation will have set the the researchers examined elevations of Han towns and Earth’s oceans aboil. Tibetan towns. Both settlements historically settled by Han Chinese and settlements with significant Han Imagine a map of the Earth in the future. Depending Chinese populations (comprising more than one-third on how far in the future you’re imagining, you might of the population) are almost all found at less than 8,900 feet above sea level. There are no Han towns above 15,000 feet. Tibetans, however, seem to thrive at this elevation: The number of Tibetan settlements peaks at AND 14,650 feet and does not sharply decline until around 17,000 feet. “Rather than saying there is merely a correlation between settlement patterns and altitude, our A Cosmic Vision for Our Future Evolution research takes it one step further and suggests that altitude can directly by Ted Chu, PhD determine the settlement patterns we see today,” says New York Uniwww.transhumanpotential.com versity professor Christopher Paik, the study’s corresponding author. $26.95 cloth / $14.99 eBook 504 pages • Origin Press The report notes, “Numerous studies have shown that Tibetans “An elegantly written book that “An astonishing breadth of and Chinese have different genetic has, for me, the same status as Ray philosophical, religious, and compositions, and that certain genes Kurzweil’s The Singularity Is Near.” technological reflection on the most carried by Tibetans allow them to important questions we could ask.” —Michael E. Zimmerman, PhD, adapt better to the thin air surroundProfessor of Philosophy, —James Hughes, PhD, University of Colorado (Boulder) ings than Chinese.” Founder, Institute for Ethics and Emerging Technologies; Trinity College bioethicist Genetic adaptation to altitude and author of Citizen Cyborg sickness is not the only factor at play, though it’s difficult to conclude to what extent biology, culture, and A transhumanist and futurist, and the former chief economist of General politics each influences settlement Motors, Ted Chu makes the provocative claim that the human race may in patterns. fact be a means rather than an end—that humankind will give rise to its evolutionary successors in the posthuman future. Paik emphasizes that he does not want to draw conclusions about his

End of the Earth’s Oceans?

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May-June 2014

World Trends & Forecasts envision political boundaries redrawn after war, or major cities swallowed by rising sea levels. But if you picture a map of Earth’s distant future, you might be alarmed by a major change: The Big Blue Marble will be missing its requisite stretches of blue, as the oceans will have completely disappeared from Earth. When? About a billion years from now, according to the latest estimates. The good news is that this endpoint is considerably farther out than previous estimates of a water-free Earth—by hundreds of millions of years. Models for predicting when oceans will evaporate have previously been limited to simplified, one-dimensional models that don’t work well at estimating such high temperatures. A team of scientists from Parisbased Dynamic Meteorology Laboratory recently developed the first three-dimensional model to predict how the Earth will react to greatly increased luminosity. Unlike older methods, this model takes into account atmospheric circulation, such as clouds and greenhouse gas patterns in specific parts of the globe. (The researchers advise that this phenomenon is unrelated to human-induced global warming, which affects the

Earth over a matter of decades.) The Sun, like all stars, will become brighter over the course its life. Gradually increasing solar radiation means that, over hundreds of millions of years, the Earth’s temperature will rise. With it, water will begin to vaporize. Because water vapor is a greenhouse gas, the increased atmospheric water vapor will cause the planet to heat even faster and water temperatures to eventually boil and evaporate completely. The study found that the Earth will reach its “tipping point” in about 1 billion years, when surface temperatures reach about 70°C (158°F), triggering greenhouse gas instability and causing oceans to boil and evaporate until they are no more. The paper, published in Nature, notes that these findings can also be applied to the study of other planets, as well as Earth. The researchers plan to use their model to study the possibility of water retention on extrasolar planets. —Keturah Hetrick Source: “Increased insolation threshold for runaway greenhouse processes on Earth-like planets,” Jérémy Leconte et al., published in Nature, December 12, 2013.

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Health | Humanity

Racism’s Unexpected Tolls Lack of resilience against discrimination may be a factor in the aging process. White males outlive black males by an average of about five years, according to the Centers for Disease Control. A new study from the University of Maryland may explain why: Internalized racism inflicts measurable biological damage on its victims, literally causing their bodies to age faster. Chromosomes—strands of DNA—have protective “caps” on each end to preserve our genetic material, similar to the plastic tips found at the end of shoelaces. These telomeres get shorter each time a cell divides, and shortened telomeres are associated with accelerated aging, putting individuals at an increased risk for heart disease, dementia, and other medical problems. “Telomere length may be a better indicator of biological age, which can give us insight into variations in the cumulative ‘wear and tear’ of the organism net of chronological age,” study leader David Chae, an assistant professor of epidemiology, notes in a press statement. Researchers asked the participants—African-American men aged 30 to 50 years old—about their experiences with racism (ranging from encounters with the police to job and housing discrimination to discourteous treatment while shopping). The study also used a tool known as the Black-White Implicit Association Test, which measured the men’s unconscious biases about their own race. The researchers found that the telomeres were significantly shorter among men who both faced more discrimination and held a greater bias against their own racial group than were the telomeres among the other participants. Even after adjusting for health and socioeconomic factors, the researchers found that the difference in telomere length was equivalent to 1.4 to 2.8 years of normal chronological aging. Participants who reported racial discrimination but did not harbor signs of internalized racism did not have shorter telomeres. “African American men who have more positive views of their racial group may be buffered from the negative impact of racial discrimination,” Chae explains. “In contrast, those who have internalized an anti-black bias may be less able to cope with racist experiences, which may result in greater stress and shorter telomeres.” —Keturah Hetrick Source: University of Maryland, www.umd.edu. The paper, “Discrimination,

Racial Bias, and Telomere Length in African-American Men” by David H. Chae et al., was published in the American Journal of Preventive Medicine (February 2014).

Manufacturing | Commerce

3-D Printing Keeps Growing A booming sector could bring surprising new jobs. How about food and clothing architects? Manufacturers looking to cut production costs are increasingly achieving it by turning to 3-D printing, according to the market-research firm Freedonia Group. In a new report, World 3D Printing: Additive Manufacturing, Freedonia forecasts that worldwide demand for 3-D printers and software will grow 21% a year through 2017, at which point it will be a $5 billion global market. The United States will be the largest market—the report projects that U.S. buyers will account for 42% of sales through 2017. Western Europe and Asia will be the sources of, respectively, 25% and 23% of sales during this period. The technology is gaining ground in Africa and South America, as well. While each continent will account for only a very small share of the global sales totals through 2017, they will be the sites of the most dramatic sales growth: Africa’s and South America’s purchases of 3-D technology will make respective annual increases of 23% and 25% a year through 2017. Some African markets especially stand to benefit from 3-D printers. They include South Africa, which has large titanium powder reserves and could use 3-D

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World Trends & Forecasts PHOTOS: GE

A 3-D printer fashioned this aircraft turbine blade at a GE facility. Although GE currently manufactures its turbine blades with conventional factory machines, it’s working on turning the production process over to the 3-D printers.

A GE-owned 3-D printer shows off its artistic prowess. Lasers fashioned every last bit of these souvenirs’ intricate design from a raw metallic additive.

printing to fabricate the titanium powder into a variety of marketable wares, according to Freedonia analyst Pauline Tung. She also credits design adaptations such as compact desktop 3-D printers, which make the technology more affordable and accessible to developing markets that are short on cash and infrastructure. A 3-D printer synthesizes materials by spraying layers of particles atop each other. The printing technology has improved in the last few years, and the range of materials that printers can work with has expanded. More metal products are being printed, for example. That is a gain for aerospace industries, which are using more and more 3-D printing systems to manufacture aircraft parts. General Electric’s aviation division announced in October 2013 that it was installing new 3-D printers to fabricate fuel nozzles, which guide fuel from the fuel tank to the engine’s combustor so that it can mix with air and create the propulsion that keeps the airplane flying. GE now plans to print about 85,000 fuel nozzles from the printers between 2016 and 2021 for 5,000 new LEAP airplane engines—each engine gets 19 nozzles. Soon, GE will also start making turbine blades for the airplanes’ internal engines from 3-D printers, according to Rick Kennedy, GE’s director of media relations.

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A batch of jet-engine turbine blades are in the making within this experimental 3-D printer at a GE production facility.

GE’s aviation division has been fashioning the fuel nozzles and turbines for decades. The 3-D printers, however, make it possible to minutely fine-tune each part to a degree never before possible and thereby make every part far more efficient and deliver streams of fuel far more precisely. GE looks forward to the finished engines being cleaner-burning, less accidentprone, and able to combust fuel much more efficiently. In addition, GE’s engineers will be able to shed dozens of pounds off of every engine—the traditional manufacturing processes required brazing, or fusing, bits of metal onto every nozzle or turbine to shape it. The printed parts forgo all of this extra dead weight, so

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World Trends & Forecasts both the engine and the finished plane will be lighter. And a lighter airplane will use considerably less fuel, Kennedy observes. “When you’re dealing with weight, you’re dealing with drag on the engine. Weight is a huge, huge deal.” The technology’s popularity is rising among automobile and household-product manufacturers, also. Robert Seuffer, a German-based firm that produces components for commercial vehicles and home appliances, announced in October 2013 that it would incorporate 3-D printers into its production processes. Automotive parts that might take conventional manufacturing hardware eight weeks to produce could roll off a 3-D printer system within a few days, according to Andreas Buchholz, head of research and development at Seuffer. A 3-D printed part could also only cost a small fraction of the conventionally produced part. He projects that the new technologies could reduce prototyping and production costs by more than 90%. Applications abound in the medical and dental markets, also. Dentists have found that the technology comes in handy for making crowns, bridges, braces, prostheses, dental aligners, and models for restoration procedures. The 3-D printing phenomenon is even creating some new types of jobs. For instance, engineers in the food industry are now printing out chocolates, candies, and other foods that used to be the exclusive domain of chefs. “Similar to the melding of chemistry and cooking that ushered in molecular gastronomy in cooking, we believe the joining of 3-D technology and food could give rise to the need for food architects,” says Tung. The same upheaval is under way in fashion. Tung notes that, at a recent Victoria’s Secret show, a “clothing architect” designed, completed, and custom-fitted fashions over the course of the event, using scanning technology and CAD software. Freedonia doesn’t anticipate most conventional manufacturing jobs going by the wayside, however. The printers can only roll out so many products at a time. Their niche will most likely be more specialized and limited-edition items. “We do not see 3-D printing as a threat to traditional high-volume manufacturing, but it is certainly competitive with lower volume production that feature very complex design elements, like the jet fuel nozzles,” says Tung. —Rick Docksai Sources: Pauline Tung, The Freedonia Group. The report World 3D Printing (December 2013, 293 pages) is available for $6,100 from The Freedonia Group, Inc., www.freedoniagroup.com. Rick Kennedy, GE, www.ge.com. Andreas Buchholz, Robert Seuffer GmbH & Co., www.seuffer.de.

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Personal Futures | Futuring

Choosing between Happiness and Meaning Is the pursuit of happiness selfish? Will pursuit of meaning condemn us to misery? The future that most people probably want for themselves is one that is both happy and meaningful. But life isn’t always that simple, and the experiences of happiness and meaningfulness are not the same. At some point, we’ll have to make choices about which experiences will make for a better life. Happiness tends to be focused on the here and now, while meaningfulness links past, present, and future, according to a recent study in the Journal of Positive Psychology. But as someone with a “meaningful life” looks to the past for accomplishment and to the future for goals, it is not necessarily a happy experience. A nurse, for instance, may report living a very mean© MONKEYBUSINESSIMAGES / BIGSTOCK

Nursing offers a meaningful life but not necessarily a happy one. But pursuit of meaning may lead to deeper satisfactions than pursuit of happiness, a study finds.

ingful life, but the pressures of the job may cloud the satisfactions of a noble purpose, thus tipping the scale to unhappiness. On the other hand, the researchers observed that happy people unconcerned with meaningfulness are a little suspect, even viewed as selfish. And when that nurse retires to a less-stressful (happier) lifestyle, he or she may miss having a sense of purpose and direction. “Happiness was linked to being a taker rather than a giver, whereas meaningfulness went with being a giver rather than a taker,” says study co-author Jennifer Aaker, a social psychologist at the Stanford Graduate School of Business. The other problem with a happy life—one in which our needs and desires are met without much difficulty—is that it leaves us somewhat unprepared for any difficulties that lie ahead. What if I’m laid off from

my job, can’t pay my mortgage, and have only my drinking buddies to turn to? A more meaningful existence, one that seeks goals and directions, gives us more resources to endure life’s downturns. It also allows us to recognize life’s unhappy moments as temporary conditions, the study suggests. “People have strong inner desires that shape their lives with purpose and focus—qualities that ultimately make for a uniquely human experience,” Aaker concludes. Source: Stanford University, www.stanford.edu. The article “Some key differences between a happy life and a meaningful life” by Roy F. Baumeister, Kathleen D. Vohs, Jennifer L. Aaker, and Emily N. Garbinsky was published in the Journal of Positive Psychology ❑ (November 2013).

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Mission for Worldwide Innovation: An Interview with Eric Dyson Interview conducted by Rick Docksai

eveloping countries tend to lag their developed world counterparts in scientific output and technology development, but it’s not for lack of talented innovators. Millions of forward-thinking individuals with bold ideas live in the developing world, but they need infrastructure and connections to help them convert their ideas into breakthroughs. That’s where CRDF Global comes in. CRDF Global is a public-private U.S. foundation that helps scientific communities in the developing world to grow and thrive. It trains researchers, builds networks of collaboration, leads construction of new Web-based virtual libraries, and funds research-and-development projects. The foundation launched in 1995 under a 1992-authorized U.S. Congressional charter and with a combination of public and private funding. It worked exclusively in the former Soviet Union in its first few years, but it’s expanded since then to more than 50 nations, including North Korea, Egypt, Burma, and Afghanistan. CRDF Global aims to connect citizens with resources to help them make progress happen. Eric Dyson, CRDF Global’s communications manager, spoke with FUTURIST senior editor Rick Docksai about the foundation and its worldwide innovation mission.

THE FUTURIST: CRDF Global is essentially an organization that is helping to make innovation more feasible across the globe. Could you further describe how you go about this? Eric Dyson: What we focus on is the capacity for a knowledge economy—its innovation and infrastructure, and its access to information. Our approach to things is to build toward a knowledge economy. We’re looking for shared goals and objectives, whether that’s modernizing an information system, or helping a developing nation join the global body of knowledge, or a nation that is coming into its own and using science as a mechanism to stay there, or a nation that’s making the transition from dictatorship to democracy. We identify those opportunities for partnership. What we’re able to do is fund those initial partnerships that explore what’s possible, and we can sustain that research by building the infrastructure to support it. We frequently find local partners who can share in the funding. THE FUTURIST: And you give out grants, as well? Dyson: We do. Once we’ve identified the priorities, we find programs that support it. We find who the best and brightest are, we fund the top research, and use that as the basis to attract new funding. Then we look at how we can use that in other areas. THE FUTURIST: How do the R&D priorities compare from one area of the globe to the other—perhaps many researchers in South America have been at work in aiding the transition from military dictatorships to democracy, while more researchers in Russia and Ukraine are looking into energy issues? Dyson: I’d say it’s the opposite. If you think about our early years, we were concentrated in the now- former Soviet Union, and you had the Russian military industrial complex. There was a Russian company called Verta. In the Soviet structure, Verta was a bioweapons technology company. We were able to connect them with a small San Mateo company called SciClone, and they were able to redirect Verta’s bioweapons

knowledge to treatments for tuberculosis. They’re still partners to this day. Here’s another example: There were engineers in Ukraine who had created the cooling systems for stored ICBMs. They now make the refrigerators that Safeway uses in their trucks—it’s a more stable and environmentally friendly refrigeration system called natureFridge (which used to be called EcoFridge). THE FUTURIST: Many developing countries have been enjoying robust economic growth in recent years. To what extent is their increased wealth boosting their science sectors? Dyson: Where there are issues, there are scientific solutions. The countries who are winning understand that and are spending their money accordingly. We’d like to see every country have access to the knowledge to support their own innovation. We help countries define what their priorities are and help them get there based on what their resources are. Look at our Virtual Science Library (VSL) that we established in Iraq. Iraq was emerging from decades of war and isolation. There was no innovation infrastructure. The VSL was a way to connect Iraq’s scientists so they could find out what research was happening in the world and merge with that larger worldwide scientific community. And we now have libraries all over—in Africa, in central Asia, Morocco. We’ve adapted that model to many different places. In a flat world, innovation is currency. To be a competitor in the global economy, you have to generate an access to knowledge. What we do is help incentivize countries’ leaders by saying, if this is your goal, then you have to be willing to generate the tools to access information. THE FUTURIST: You’ve got much experience of Russia, and it sounds like a very interesting test case for innovation. An MIT professor named Loren Graham recently published a book, Lonely Ideas (MIT Press, 2013), in which he said that Russia has historically had many brilliant innovators but no support www.wfs.org

structures for them to develop their ideas into marketable products and services. He says Russia is working to create those support structures now, and he personally has advised Russian research institutions on some pro-innovation reforms. Dyson: Loren Graham is a former member of our advisory council. And he’s right on a lot of points. One of our programs in Russia was Basic Research and Higher Education, a program to modernize Russia’s higher education program. It used to be that you could basically graduate from a grad school without doing any research. We were able to modernize that and build original centers where they had specialized equipment. Russia fully adopted the program, and the program has been running now for more than 12 years. One of the things we’re good at is promoting that culture of entrepreneurship. You meet these young people who don’t want to go work in the factory for 30 years. They want to create something on their own, and we give them the tools to do that. We have a domestic pullback, as well. With projects like SciClone, there’s potential for a mutual utility. We can make something that’s mutually beneficial. THE FUTURIST: It’s surely going to benefit the developing countries’ economies, too. Countries where innovation is slow tend to suffer from brain drains as educated young people emigrate to job opportunities elsewhere. By facilitating in-country innovation, you can enable more job creation in the countries, and thereby offer the job seekers reasons to stay. Dyson: No country has a monopoly on good ideas. The speed of information trumps almost everything. For any country to compete internationally, you have to look for ideas wherever they are. Some of the projects that we’re funding are just amazing. We’re looking for innovation in unlikely places. For example, in Lebanon, Hind Hobeika has a project called InstaBeat. She created swim goggles that gives you heads-up dis•

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“We’re in nearly 50 countries now, so we’re able to see those things before they bubble up. The trend is innovation: There’s always something new every day.” play of your heart rate and lap time. She created it because she wanted that information quickly, and no product in the market offered it. So she made her own. We’re in nearly 50 countries now, so we’re able to see those things before they bubble up. The trend is innovation: There’s always something new every day. THE FUTURIST: How do you find the innovators within the countries in which you work? Dyson: We go to where the need is greatest, and to where people are working the hardest in those areas. Also, universities talk to each other, so we’ll often find new projects through them and through other partner organizations. And innovators can find each other through us, for example, through Newton’s List, an international marketplace for research grants. It has listings in every field. People can post to it and apply to postings on it. We launched it just 18

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last July [2013], and it’s really starting to take off. We help people to connect, to collaborate, and to create. The Internet is probably the greatest tool for democratizing everything since the book. We also did a business plan competition through the GIST [Global Innovation through Science and Technology] Program, running it in 40 countries. We said, Give us your one-minute pitch, and we’ll post it on the site. We let people vote on who they thought were the best. It took no time for people who had ideas to post them. You saw this great desire to be part of this knowledge creation around the world. We show you how to pitch to new people, and we connect you. But we also give you the tools to keep you going. It’s a continuum of care. The Virtual Science Library is a perfect example. In Iraq, we had to build a lot of the tools to sustain the VSL. We had to build networks in the universities and then train people to use it. By the time we were done, it was www.wfs.org

embedded. We’re not taking it with us. It stays there for them to use it. THE FUTURIST: You clearly find many interested partners in the private sector. But what role do government reforms and government support play in your efforts? Dyson: I think by the time we work with most governments, they are fully aware of the need to encourage innovation, and they become our most active partners. It’s that private-public partnership. We don’t do anything completely private sector or public sector; it requires both. It’s kind of like “the spirit is willing, but the flesh is weak.” When there’s readiness, there’s readiness. Look at Egypt. It has a history of math and science going back thousands of years. Even in the midst of all the revolutionary distress, there are still scientists reaching out. Farouk El-Baz, an Egypt-born researcher and now the director of the Center for Remote Sensing at Boston University, has put forth several plans for how to use science to engage Egypt and help get it back on track. He’s a board member of CRDF Global. When we first came here, our name was the U.S. Civilian Research and Development Foundation for the Independent States of the Former Soviet Union (CRDF). Since then, we’ve gone from those 18 to 50 nations. The need doesn’t show any sign of slowing down. The great thing about science is that you don’t need a magic wand; you just need to put the tools in place to make it work. An ancient proverb says that “when the winds of change blow, some build walls, and others build windmills.” We’re in the business of building windmills. ❑ About the Interviewee Eric Dyson is the senior communications manager on the U.S. staff of CRDF Global, based in Arlington, Virginia. Web site www.crdfglobal.org. About the Interviewer Rick Docksai is senior editor of THE FUTURIST and associate editor of World Future Review. E‑mail rdocksai@wfs.org.

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Euphoric, Harmless, and Affordable A Trend Analysis of Sex

By Karen Moloney Almost all of us hope for good, healthy sex lives—sex that leaves us feeling ecstatic, satisfied, fulfilled; sex that is free from risk or guilt and that doesn’t harm us in any way, mentally or physically, that even does us good; sex that is convenient, accessible, and within the budEUPHORIC HARMLESS AFFORDABLE gets of most households. A good quality, Healthy and Preferably free, I call this EHA sex: euphoric, harmless, and affordable. Because this is what most humans fulfilling, senbenign, physi- but within seek, these are the criteria that will determine sual experience cally and men- most people’s whether the future developments I am describtally budgets ing here become commonplace or not. 20 THE FUTURIST May-June 2014 • www.wfs.org © 2014 World Future Society • 7910 Woodmont Avenue, Suite 450, Bethesda, MD 20814, U.S.A. • All rights reserved.

Overview of Trends in Sex TRENDS

Sex in the past …

Sex at present …

Sex in the future …

Technological

… was manual.

… is still immature but about to exploit emerging technologies.

… will use very sophisticated technologies.

Economic

… was dominated by sole traders and small businesses.

… is still free for the majority of … will impact significantly on people, but pornography and sex global business, legitimate corpotourism are now contributing sigrate players paying tax. nificantly to some emerging economies. Industry is still dominated by illegitimate business.

Social and educational

… was a private matter between adults.

… is conflicted by differing moral and religious attitudes. In some societies, sex is ubiquitous and flagrant, and includes the sexualization of children.

… will tolerate greater personal freedoms; will need to be addressed at a younger age.

Environmental … wasn’t aware of its impact.

… is becoming aware but no significant impact.

… will require legitimate businesses to fulfill responsibilities for the environment.

Governmental

… is governed by legislation to protect the vulnerable and to manage the commercial sex industry.

… will surprise legislators who are lagging behind the trends.

… was thought of as a moral issue.

Wherever you seek it—within or outside of stable and loving relationships, with one or multiple partners, within heterosexual or homosexual relationships, and whether it comes free or you have to pay for it—sex is important. The drive for sexual satisfaction is among the strongest urges we feel, like the need to drink or breathe. The oldest profession and others who work in the commercial sex industry know this. The women of ancient Greece exhorted by Lysistrata to withhold sex from their husbands until they stopped fighting the war in the Peloponnese—and all sex strikers since then—knew this. Above all, businesses know the importance of sex and are increasingly moving to cash in. That’s why

it is essential that we examine the future of sex. Some technologies, in particular robotics, remote technologies, the Web, and human–computing interactions, have enhanced the delivery of medicine in the last 10 years, allowing surgeons to practice remotely across continents and researchers to impact upon objects just by thinking about them. The gaming industry, too, has become more sophisticated; voice activation and team participation, for example, have become commonplace. As the commercial sex industry becomes more aware of what’s possible, and as consumers become aware of how they can enhance their own personal pleasure, the cybersex www.wfs.org

revolution will reach a tipping point and become irreversible. As futurists, we watch for weak signals on the horizon and spot trends that could lead to significant shifts in the way we conduct our lives. I’m going to share with you some of the trends I have identified within the sex, gaming, social networking, and medical industries and suggest how they might collide into disruptive social change that will impact upon how, where, and with whom we have sex. Futurists study the past, manage the present, and envision the future. The table above, “Overview of Trends in Sex,” summarizes the story of sex— past, present, and future—against the five areas futurists use for their analyses. •

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In this article, I will address recent technological developments and how they will impact upon EHA sex, the economic impact of these trends, and how governments need to respond to this growth by providing legislation that defines and regulates what is acceptable.

Technological Developments 1. Improved Functionality of Sex Toys

Historically, sex toys were mechanical. With the onset of the Industrial Revolution, machines became employed to deliver movement, such as the steam-powered, rubber-covered dildo. Toys today are still basically clunky, but the more-sophisticated ones are able to deliver a better experience. Currently, mechanical sex toys are going through a phase of using electrical or electronic stimulation to sensitive parts of the body—in other words, electrocution. But given the lack of health and safety regulation in the sex industry, their bad track record of using phthalates, carcinogenic poisons in the manufacture of sex toys, and the risk of too much electrical current causing burning of tender tissue, we shouldn’t expect these to be too popular, except, of course, in the S&M side of the business, where they should generate healthy sales. Good news for women: In the information technology age, women are now able to program their intelligent dildos to remember specific preferences, as easily as new cars can remember seat height, mirror angles, etc. The SaSi, for example, is a handheld toy that allows you to create your own playlist of vibrations. Currently, it is programmed by the user pushing a button when she feels something she likes, and it learns what the user responds to. But it won’t be long before voice recognition allows her to tell it what she likes, and it will remember. This is just the beginning of more interactive experiences with intelligent sex toys that currently includes a dildo that vibrates in time to the songs on your playlists. For men, we will see an increase in the number of products that can be

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SCREEN CAPTURES VIA KONAMI.JP

placed on the penis to simulate the action of the hand or mouth, and again, these could be programmed to provide the optimum sensation. For both men and women, the use of a material called cyberskin in sex toy manufacturing will become widespread. It has a soft, stretchy texture, emulating human skin. It can be warmed and produce fluids. Consumers report that the use of toys covered in this material feels like real sex with a partner. For an experience greater than that provided by a handheld device, lifesized dolls are becoming much more sophisticated. Female dolls are no longer passive. They’re able to simulate reciprocation, produce fluids, and move in lifelike ways. Furthermore, they can be designed and programmed individually to fulfill the customer ’s dream of the perfect partner. EHA SCORE Euphoric

These developments should increase the sensual quality of the experience.

Harmless

The risk of disease is low, but physical harm is not unknown with misuse.

Affordable

Expect to pay up to $1,000 for a sophisticated sex doll.

2. The Rise of the Virtual Companion

In Japan, a shrinking, aging population has made it increasingly difficult for young men to find companions. For those who are socially awkward, a virtual girlfriend has always been an attractive possibility. So we will see a growth in some cultures of the social acceptability of virtual girlfriends, specifically those who can be realized from a Tamagotchi-like handheld device carried in the pocket. In 2010, the Wall Street Journal reported on a resort town south of Tokyo called Atami that welcomes young men and their virtual girlfriends. These aren’t sexbots of the kind described above, but rather a character in the game called Love Plus. These schoolgirl manga/anime characters are capable of holding conversations online, making deci-

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The girlfriend experience: Love Plus manga characters available from Konami.

sions, and accepting or rejecting ideas about how to spend the holiday. Hotels such as Ohnoya in the resort will check your girlfriend in and provide places where you can have your picture taken with a hologram of your girlfriend, just like holiday snaps, and have beds and restaurant tables that provide space for her. She may not be a sex partner, but she fulfills a fantasy. EHA SCORE Euphoric

This depends very much on the individual.

Harmless

No physical harm, but it could increase feelings of isolation.

Affordable

Virtual girlfriend software $800, plus weekends away.

IGN

Grand Theft Auto V offers gamers some sexual content, but crime and violence are the main attractions.

3. Pornography, Cybersex, and Virtual Reality

Pornography currently exploits the familiar channels: TV, computer, smartphones. It allows people to get access to sex, principally for purposes of masturbation, through visual and aural stimulation. The latest technology allows you to see your virtual world from your own point of view. For men, who tend to enjoy visual stimulation, cyberporn places them in control of their fantasy. It’s easy, relatively cheap, and can to a degree be tailored to your specific needs, including the filming of your own sexual activities and simulation of your particular chosen fantasy partner. It has even been used to cocreate erotic material by crowdsourcing. But even technologically enhanced pornography remains an activity shared by one or two people in their own homes. In the future, sex could become a gaming activity involving more than an individual or a couple, such as through Massive Multiplayer Online Role Play Games. The online gaming industry already allows virtual sex through avatars in Second Life, Final Fantasy, and Red Light Centre, which is a site set up specifically for cybersex and adult behaviors. In Second Life, there are avatar prostitutes—working girls who earn their wages in Linden Dollars. Grand Theft Auto is geared more toward crime and violence than sex, but there is already a soft porn add-on. Given that the latest version of this game, GTA5, made $1 billion in sales

in its first three days, the potential to extend this market is significant. We should anticipate large numbers of consenting adults playing these games together online in the future. EHA SCORE Euphoric

For some people, pleasure is increased alone; for others, with company.

Harmless

Virtual, so no risk of sexually transmitted infections (STIs), but a potential risk of mobbing and gang rape. Games can be addictive.

Affordable

Usual subscription costs to porn, VR, or gaming sites, purchase of game console (delivery will revert to PCs in the future).

4. Pharmasex

The recreational use of mind-altering drugs is not new. Prehistoric rock art and early shamanic imagery sug-

gest that it has been around as long as humankind. Mood-enhancer Modafinil and attention-deficit medication Ritalin are two well-known additions to this pharmacy. But the more we understand about the powerful effects of sex hormones, the more likely they are to be used for recreational purposes. We know that the male hormone testosterone seems to make us more aggressive and inclined to take risks, but doctors are also prescribing test o s t e ro n e f o r p o s t m e n o p a u s a l women to increase their libido. Menopausal women on replacement therapies of estrogen and progesterone have said it makes them feel younger, more positive, and more energetic, and that it controls their mood swings—all conditions that could lead to improved sex lives. SSRIs (selective serotonin re-uptake inhibitors), which enhance the feelgood hormone serotonin, are in demand currently for depression and could be seen as enhancing sexual experience. But studies show that they decrease dopamine levels and feelings of elation. Oxytocin and vasopressin are two hormones that enhance feelings of attachment and could be used to help bonding with partners during difficult times. Dopamine and noraprephamine present in romantic love are possible candidates, too. One can imagine women out on dates spiking their partners’ drinks with something that might make them more romantic, affectionate, considerate, or caring. Women might also welcome drugs that increase female libido. But despite the search for a “female Viagra”—including investigation of LH (luteinizing hormone), as well as testosterone and estrogen—a wom-

“Even technologically enhanced pornography remains an activity shared by one or two people in their own homes. In the future, sex could become a gaming activity involving more than an individual or a couple.” www.wfs.org

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an’s sex drive still evades chemical manipulation. It still seems that the answer is the right romantic partner at the right time and in the right place. Taking unapproved, non-prescribed medicines without a doctor’s advice is foolish and can lead to complex and dangerous side effects. But the fact is that hormones are mood-altering and mind-altering, occur naturally in the body, and can be cheaply made in a laboratory and released onto the Internet market, so we can anticipate an increased interest in their use and abuse.

prosthetic limbs just by thinking of it. Now imagine if those thoughts are sexual: All we have to do is imagine engaging in sexual activities, enhancing our experience manifold. It will be like sexual fantasy with Red Bull. Before consumers get too excited, though, it is important to say that these developments are still in the early stages of exploration in the laboratory. But as we know, developments as disruptive as these have a habit of finding investors. EHA SCORE Euphoric

These developments should increase the sensual quality of the experience.

Harmless

The risk of disease is low. Being able to experience constant sexual feelings may be addictive.

Affordable

Currently unaffordable and unobtainable outside the research community.

EHA SCORE Euphoric

These developments should increase the sensual quality of the experience.

Harmless

No risk of STI, but physical and psychological harm is possible with misuse of any non-prescribed drug.

Affordable

From $60 for 80 doses of oxytocin nasal spray to $4,000 for a course of SSRIs.

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Couples who are separated by geography might pursue teledildonics, which enables partners to operate a sensor that produces stimulation in one another. This brings phone and video sex to a whole new level. RealTouch, for example, is a male masturbator made up of synthetic orifice in a plastic tube and connected to a computer. Based on data from an Internet connection, the unit warms up, lubricates, pulses, and grips any item stuck into it. On the other end of a connection, a partner (or service provider) operates a sensor-covered rod to run the motors in the RealTouch. Its functions can even be synched with film images of your favorite character on screen, using the same technology that allows surgeons to perform operations across continents. The more-sophisticated technique of movement sensors such as found in Wii could also be used for remote sex. Promising uses of haptic tech-

“Perhaps the greatest impact on the future of our sex lives will come from technology that combines brain power with computing.”

WFS PHOTO ILLUSTRATION / CURAPHOTOGRAPHY, DOLGACHOV / BIGSTOCK

5. Mind Sex

Perhaps the greatest impact on the future of our sex lives will come from technology that combines brain power with computing and allows us to experience sexual feelings without touching the body at all. In other words, we can experience orgasm just by thinking about it. We will also be able to instigate sexual feelings in others remotely by sending suggestions. Researchers at Harvard Medical School have recently sent thoughts to a computer to stimulate movement in both a rat’s tail and a human finger. Japanese researchers have controlled the movement of a robotic hand by telepathy, and an international team has sent thoughts to move a robot around a room to pick up a teapot. Physicist Stephen Hawking is piloting a new device that means he doesn’t have to blink or twitch his face to communicate. He will soon just be able to think something, and those thoughts will be voiced. Patients will be able to activate their

6. Remote Sex

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nologies—where one or both partners wear suits lined with sensors and stimuli, allowing real physical responses on the body—are currently in laboratory phases, but they will be expensive. EHA SCORE Euphoric

These developments should increase the sensual quality of the experience.

Harmless

The risk of STI is low. Sex with partners who are separated may give comfort.

Affordable

$200 upwards for RealTouch.

Technology Assessment Conclusions On the positive side, these developments should mean that many of us have better sex in the future. In particular, women may benefit from intelligent dildos and from prescribed hormones to improve emotional attachments, bonding, and romance. Men can also use equipment to improve their experience, and couples living apart need not sacrifice their sex lives. Those who feel socially awkward and lonely can improve their sex lives without visiting prostitutes, breaking the law, or supporting sex slavery and human trafficking. Women engaging in cybersex don’t get pregnant, either. If sex with a device results in a better experience than the real thing, sex addicts may be able to satisfy their urges through technological means. But on the negative side, these developments offer the vulnerable, the lonely, the addictive, and the compulsive a helter-skelter toward selfdestruction. Other downsides include the increased social isolation of those who use the Internet, dolls, and virtual companions for sex, rather than attempting to have real relationships with real people. And, as with any Internet use, security of data is a big issue.

Economic Implications On the positive side, the amount of money to be made in the adult entertainment industry continues to

grow. In 2012, estimations of the size of the pornography industry alone were $97 billion globally and $12 billion in the United States. Add to these figures the other sex-related products and services, including prostitution, and the figure is much higher. If we add the invisible and black economies, it rises further. The amount of money to be made will ensure that the big as well as the small players seek ways of moving into the sex industry. Indeed, there are brokers on Wall Street who are now trying to connect investors openly with adult entertainment companies. With their technological know-how and ability to exploit efficient routes to market, the mainstream corporations will be there before long. In the meantime, the smaller, more agile startups will spearhead the innovations and enjoy the rewards. But they need to be careful. In the same way that one major player in the online gambling industry (Betfair) has attempted to be socially responsible by turning off the accounts of customers who lose too much, the adult entertainment industry will need to examine its increasing role in psychopathy of sex and pornography addiction and come up with measures that will protect its customers from self-harm.

Social and Educational Implications With little warning or foresight, our schools have been forced to respond to the increased sexualization of children by addressing issues such as: • The experience of real sex versus sex enacted in pornography: how are our expectations changing? • The use of sexually explicit imagery and lyrics in the music and entertainment businesses: Does it empower or exploit the artists? • Increased filming and posting of sexual acts on social media sites: Is this acceptable? And what are the data-privacy challenges? Very few schools have trained counselors or advisers, and few schools have written policies on sexual behavior on school premises; of those that do, many are reactions to inappropriate behavior when it is www.wfs.org

“Does cybersex count as infidelity? Should virtual partners have rights?” discovered. Our public school systems do not appear aware of these changes in social behavior, let alone ready to respond effectively to them.

Legal Implications A final challenge that arises from not being prepared for the future of sex is the familiar lagging of the law behind the social trends. Of course, legislation follows precedent, and there have to be test cases that challenge and create new laws. Some of these questions have already arisen and been examined by other authors, but more dilemmas will challenge us within the next 10 years: • Is a weekend away with a virtual girlfriend grounds for divorce? • Does cybersex count as infidelity? • Should sexbots (and all robots for that matter) have rights? Humanoid rights? • Should virtual partners have rights? • Should you be allowed to use photographic images to program virtual partners to look like someone you know or fantasize about? • Should sex with machines be regulated like it is with animals and children? • Who owns the intellectual property when a sex toy is programmed by its owner and then sold or passed on for others to use? ❑ About the Author Karen Moloney is a Chartered Psychologist, consultant, writer, speaker, and the founder and director of Moloney Minds, London, United Kingdom. Web site www.moloneyminds.com. Follow her on Twitter, @kazmoloney. This article is a preview of her presentation at WorldFuture 2014: What If, the World Future Society’s conference to be held in Orlando, Florida, July 11-13.

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Where Will the Lead Us? By Randall Mayes A technology trend analyst offers an overview of synthetic biology, its potential applications, obstacles to its development, and prospects for public approval. SNR / BIGSTOCK

Century of Biology T

he quality of our future will depend on the direction society takes regarding complex issues such as health care, sustainability, the economy, and national security. Successful resolutions to these complex issues will to some extent depend on the pace at which scientists and entrepreneurs develop technologies. Over the past decade, venture capitalists, governments, foundations, and the private sector began evaluating synthetic genomics—more commonly referred to as synthetic biology—as a potential industrial revolution. In addition to boosting the economy, synthetic biology projects currently in development could have profound implications for the future of manufacturing, sustain ability, and medicine. Before society can fully reap the benefits of synthetic biology, however, the field requires development and faces a series of hurdles in the process. Do researchers have the scientific know-how and technical capabilities to develop the field? Along with the technology push of societal benefits is the activist’s pull with concerns for health and environmental risks. Are activists’ concerns about synthetic biology’s risks rea-

sonable? And if so, how might scientists and policy makers address those concerns? Biology + Engineering = Synthetic Biology Bioengineers aim to build synthetic biological systems using compatible standardized parts that behave predictably. Bioengineers synthesize DNA parts—oligonucleotides composed of 50–100 base pairs—which make specialized components that ultimately make a biological system. As biology becomes a true engineering discipline, bioengineers will create genomes using mass-produced modular units similar to the microelectronics and computer industries. Currently, bioengineering projects cost millions of dollars and take years to develop products. For synthetic biology to become a Schumpeterian revolution, smaller companies will need to be able to afford to use bioengineering concepts for industrial applications. This will require standardized and automated processes, removing the need for specialized knowledge. A major challenge to developing synthetic biology is the complexity www.wfs.org

of biological systems. When bioengineers assemble synthetic parts, they must prevent cross talk between signals in other biological pathways. Until researchers better understand these undesired interactions that nature has already worked out, applications such as gene therapy will have unwanted side effects. Scientists do not fully understand the effects of environmental and developmental interaction on gene expression. Currently, bioengineers must repeatedly use trial and error to create predictable systems. The twentieth century was the century of physics, partially due to the successful interactions between theoretical and experimental physics. When aeronautical engineers developed early aircraft, they used flight simulation for the interaction of aircraft and the environment. The interplay between theoretical and experimental biology is currently less developed. Similar to physics, synthetic biology requires the ability to model systems and quantify relationships between variables in biological systems at the molecular level. The second major challenge to ensuring the success of synthetic biology is the development of enabling •

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technologies. With in nature they can “Synthetic biology is genomes having bilspread from birds to lions of nucleotides, mammals. reviving optimism this requires fast, In 2013, scientists powerful, and costlinked the avian inin many fields, efficient computers. fluenza A (H7N9), a Moore’s law, named new strain of bird flu particularly medicine.” for Intel co-founder that emerged in Gordon Moore, posChina, to a father its that computing who had visited a power progresses at a predictable bird market the week before becomrate and that the number of compo- ing sick, then infecting his daughter. nents in integrated circuits doubles Both later died, but other close coneach year until its limits are reached. tacts were not infected. When one Since Moore’s prediction, computer person infects another, this typically power has increased at an exponen- indicates the early stage of a pantial rate while pricing has declined. demic, as was the case in 1957, 1968, DNA sequencers and synthesizers and 2009. are necessary to identify genes and In the traditional approach to make synthetic DNA sequences. Bio- making vaccines, developed in the engineer Robert Carlson calculated 1940s, scientists culture and grow an that the capabilities of DNA se- influenza virus in chicken eggs. quencers and synthesizers have fol- When introduced into the human lowed a pattern similar to comput- body, the virus stimulates the proing. This pattern, referred to as the duction of antibodies. Ideally, vacCarlson Curve, projects that scien- cines reach consumers before the intists are approaching the ability to fluenza season begins. With the sequence a human genome for H1N1 strain in 2009 (the “swine $1,000, perhaps in 2020. Carlson cal- flu”), most doses became available culated that the costs of reading and only after that pandemic had run its writing new genes and genomes are course. falling by a factor of two every 18–24 After identifying a viral strain and months, and productivity in reading its genetic code, researchers are now and writing is independently dou- able to use rapid computerized sebling at a similar rate. Consequently, quencing and grow large quantities we are approaching the point where of vaccines in culture. This method major developments in synthetic provides a more effective response biology should occur. to seasonal and pandemic flu outbreaks, shortening the production time from months to days. Genomics Now—and Using this method, Novartis and Beyond the Bubble Synthetic Genomics Vaccines Inc. Futurists have touted the twenty- will work together to develop a bank first century as the century of biol- of synthetically constructed seed viogy based primarily on the promise ruses ready to go into production as of genomics. Medical researchers soon as the World Health Organizaaim to use variations within genes as tion identifies flu strains. The use of biomarkers for diseases, personal- synthetic biology will reduce the ized treatments, and drug responses. vaccine production time by up to Currently, we are experiencing a ge- two months, which is particularly nomics bubble, but with advances in critical in the event of a pandemic. understanding biological complexity • Malaria Drugs. Malaria infects and the development of enabling an estimated 300 million to 500 miltechnologies, synthetic biology is re- lion people annually, and it is fatal to viving optimism in many fields, par- roughly 1.5 million of those. Until malarial drugs were developed, ticularly medicine. • Avian Influenza Vaccines. Most people in areas prone to the disease influenza strains originate in Asia have used mosquito nets and head and travel around the world as the coverings, drained marshy areas flu season progresses. Although bird where mosquitoes lay their eggs, flus do not frequently infect humans, and used the insecticide DDT, which 28

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is now banned in many countries. Physicians used a synthetic form of quinine and sulfur drugs as treatments until the Plasmodium parasite developed resistance. During the Chinese Cultural Revolution in the 1960s, the Chinese government launched a project to investigate the properties of plants used in traditional herbal medicines. Chinese herbalists treat fevers with Qing hao, also known as Artemisia annua or sweet wormwood, which is indigenous to China and Vietnam. Farmers extract the active ingredient artemisinin from its dried leaves, which releases oxygen-based free radicals that destroy the Plasmodium parasite while in the red blood cells of the host. Artemisia annua has a nearly 90% efficacy rate against parasites resistant to other antimalarial drugs. But isolating and extracting artemisinin from plants is an expensive and laborious process. In 2004, the World Health Organization endorsed artemisinin combination therapy (ACT), the use of several antimalarial drugs, which reduces the chances of the parasite developing resistance. ACT is more expensive, however, and the supply is not meeting the demand. WHO estimates that up to 50% of malarial drugs sold in Africa and Asia are from the black market; these drugs provide a sublethal dose, helping the disease to develop resistance. So speculators are stockpiling the wild plant. Most patients in need of antimalarial drugs are from developing countries and unable to afford them. In response, the Bill & Melinda Gates Foundation granted $42 million to University of California at Berkeley professor Jay Keasling to create a vaccine using synthetic biology. Keasling is redesigning the genetic circuits in the metabolic pathways of E. coli and yeast to code for all of the enzymes to produce the precursors to artemisinin. Sanofi Aventis, which is producing the drug on a not-forprofit basis, has agreed to scale up production of the drug by growing gene cassettes in fermenting vats in a process similar to brewing beer. Although malaria patients benefit from bioengineered drugs, activists are concerned because bioengi-

neered artemisinin will displace thousands of Asian and African subsistence farmers who cultivate the plant. Rather than disrupt the livelihoods of thousands of small farmers, according to Elias Zerhouni, director of global research and development with Sanofi Aventis, the company has decided to release the synthetic drug when the natural production does not meet the demand. • Printing Human Tissues and Organs. The exponential acceleration of computing power applied to developments in genomics and 3-D printing has opened up the possibility of printing human body parts. Using custom-designed printers that can create both a synthetic scaffold and materials, bioengineers have printed prototype heart valves, artificial bone, joints, vascular tubes, dental implants, and skin grafts. Cornell University biomedical engineer Lawrence Bonassar ’s lab is printing ears. He first takes a 3-D image to determine the ear’s geometric pattern. Then, he prints ear tissue in layers composed of ink with living cells. For real applications, the patient’s body would accept the new ear since it is composed of its own cells. Even with the success of organ transplants, the supply of donated organs can’t keep pace with the demand. If we could print them, then waiting for a donor match could become a thing of the past for the millions of patients in need of organ transplants every year. But the challenge is that human organs are complex structures with dozens of cell types. Chinese researchers have printed miniature replicas of human kidneys. They use human kidney cells cultured in large volumes and blended with hydrogel. The mini kidneys are able to function in exactly the same ways as human kidneys—they can break down toxins, metabolize, and secrete fluids. However, researchers need to solve the problem of how to print blood vessel networks within organs. In North Carolina, a team at Wake Forest Baptist Medical Center’s Institute for Regenerative Medicine has built custom bioprinters that can print numerous cell types. The 3-D

printer has multiple cartridges for liquefied plastics and for cells cultured from the patient. The printer creates layers of alternating synthetic material and living cells in whatever shape a computer program specifies. The Wake Forest researchers envision some custom implants becoming available within in the next decade. • Biofuels and Bioplastics. The oil industry and the U.S. Department of Energy are major investors in the initiative for the transition from the oil-based to the bio-based economy. In order to reduce the carbon footprint, they are developing biofuels created from biomass derived from crops and agricultural waste. Bioengineered microorganisms provide a quicker, more cost-efficient method than traditional chemical processes for breaking down biomass from crops and converting it into biofuels. This shift not only involves fuels, but also oil used to produce numerous plastic products we use every day, such as carpeting, car parts, packaging for food, and apparel. Sustainable manufacturing is a trend for manufacturing companies developing their brands. Manufacturers are increasing the percentage of their plastic production to bio-based feedstock and ultimately hope to move away entirely from oil. In 2005, then-CEO Charles O. Holliday Jr. wore a pinstripe suit made from DuPont’s Sorona fibers, a polymer created by bioengineered bacteria and yeast that ferment corn sugars. These fibers are stain-resistant and more durable than nylon. They also require less energy to produce and emit less carbon dioxide. Nike is making shoes using polyurethane made from plants. Ford is using plant-based plastics for car parts. Similarly, Nestlé, Coca-Cola, Pepsi, Odwalla, Heinz, and Procter & G amble are using plant-derived plastic packaging. The biodegradable plastic containers are free of toxic BPA and endocrine disruptors that impact human health. Bioplastics and biofuels have many potential benefits, but currently are more expensive than oilbased products. In order for biofuels to compete, a carbon tax will be required on oil, gas, and coal to reflect www.wfs.org

the cost of externalities. Industrialscale production of biofuels and bioplastics requires biomass. When the biomass comes from crops, this competes with food production, which increases the cost to consumers. Feedstock from biomass requires land, water, and fertilizer. DuPont built an industrial biorefinery in Tennessee that turns 6.4 million bushels of corn annually into 100 million pounds of plastic. Growing the corn for just that one biorefinery requires 40,000 acres. Crop production for biofuels and bioplastics is also accelerating deforestation, runoff, and water contamination and increasing atmospheric pollution. Bioplastics release methane, a greenhouse gas, during decomposition. As Friends of the Earth points out, if you take into account the life cycle analysis of biomanufacturing, synthetic biology is not a panacea for the environment. • Investigating Life on Mars. Current conditions on Mars are not conducive to life as we know it on Earth. However, numerous missions to Mars have detected the chemical building blocks of life: nitrogen, oxygen, and carbon. So scientists have not ruled out life existing in the past. With evidence of frozen water on Mars at 4–8 km depth and the possibility of previous life, researchers would like to discover it, bring it back to Earth, and study it. However, this research project faces numerous challenges. NASA must find a way to drill into the ice, transport equipment and vehicles to Mars, and successfully return the samples back to Earth—a process that would take an estimated three years. Assuming discovered Martian life is based on DNA, genomics pioneer and entrepreneur Craig Venter has an alternative plan of action. In the Mojave Desert, he is developing robots to isolate microbe samples from soil on Mars. Once scientists obtain the samples, DNA sequencers will decipher their genomes. With funding from the U.S. Department of Defense’s research agency DARPA, Venter is developing a prototype Digital Biological Converter that can transmit digitized DNA information as electromagnetic •

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waves near the speed of light. The journey from Mars to Earth would take roughly 4.3 minutes. Also in development is a receiver that uses 3-D printing to recreate living cells here on Earth. This method would also eliminate the risk of Martian life forms contaminating Earth life. • Bioweapons. Now that genome sequencing and synthesizing technologies are more affordable and powerful, researchers frequently perform research that involves sequencing and synthesizing genomes of deadly pathogens. In order to better understand the various strains of bird flu, scientists are extremely interested in the Spanish influenza virus that killed an estimated 50 million people in 1918. Researchers have placed the genome of this deadly pathogen and others in the online database GenBank maintained by NIH for other researchers to use. With the pathogen’s genome sequence online and the availability of DNA synthesizers (a used machine could be purchased for less than $10,000 on eBay), someone with technical or graduate-school training in molecular biology could recreate a deadly virus. In a report financed by the Alfred P. Sloan Foundation, a group of scientists and policy analysts concluded that terrorists would find it easier to work with naturally occurring pathogens than synthesizing them. However, as a protective measure, the synthetic biology community is boycotting DNA-synthesizing companies that do not use DNA-screening software for customer orders. Given the dual-use nature of synthetic biology, the Department of Homeland Security has taken precautions to prevent the increasing number of DIY garage biologists from creating bioengineered pathogens for biological warfare. After analyzing the potential for bioterrorism, President Obama’s Bioethics Commission encouraged pursuing the benefits of synthetic biology, but with prudent vigilance. This entails monitoring the industry and updating regulations as needed. The U.S. National Science Advisory Board for Biosecurity and the World Health Organization have de30

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termined that the benefits of disseminating information through articles and Web sites outweigh the risks. The best way to develop responses to bioterrorism, they reason, is to perform synthetic biology research. • Bioremediation Organisms. Researchers are investigating the use of bioengineered enzymes in microorganisms to break down industrial wastes, oil, heavy metals, radioactive material, and pesticides in contaminated soil and water. The 2011 tsunami in Japan and subsequent Fukushima Daiichi nuclear accident resulted in more than 1,000 tons of contaminated water and radiation exposure. Bioengineers have modified Deinococcus radiodurans—a bacterium with rapid DNA repair mechanisms enabling it to live in environments with very high levels of radioactive material— to consume and digest the hazardous chemicals in radioactive nuclear waste. To clean up messes like the 2010 BP Deepwater Horizon oil spill—one of the worst environmental disasters in America’s history—researchers can create synthetic algae to break down the destructive chemicals in the oil that impact the flora and fauna in the Gulf of Mexico. Both of these cases required releasing modified organisms into the wild. As a precaution, these bioremediation microorganisms are infertile and have suicide genes to prevent unintended effects to the environment. Even with safeguards in place, activists see the bioremediation organisms as a potentially invasive species with emergent properties resulting from the interaction of genes. Gaining Public Acceptance for Synthetic Biology Through automation, bioengineers are currently making strides in developing vaccines and printing human body parts. However, the development of bioplastics, biofuels, bioweapons, and bioremediation organisms all raise legitimate concerns. A coalition of more than a hundred international environmental and human-rights organizations— led by ETC Group, the International www.wfs.org

Center for Technology Assessment, and Friends of the Earth—initially lobbied to persuade regulators to impose a moratorium on synthetic biology research, due to unknown environmental and health risks. When this strategy did not work, the activists are now advocating greater oversight and regulation of the field, referred to as the precautionary principle. This approach requires that companies demonstrate health and e n v i ro n m e n t a l s a f e t y t h ro u g h lengthy studies. But this approach will slow the field’s development, delaying any potential social benefits. Ideally, each bioengineered product would undergo extensive testing not only for health risks, similar to testing in the pharmaceutical industry, but also for environmental risks. However, the costs involved are prohibitive to the development of most industrial products. Even with the time and costs dedicated to pharmaceutical clinical trials, a 1988 study reported in the Journal of the American Medical Association revealed that roughly 106,000 people die each year in American hospitals as the result of side effects from medications. Compare that with the estimated 40,000 annual traffic fatalities over the last twenty years. The activists seem to hold synthetic biology development to a higher standard than other technologies. But, rather than focusing on the negative aspects of emerging technologies, addressing complex global issues requires solving these challenges. To address activists’ concerns with bioengineered products, James Greenwood, president of the Biotechnology Industry Organization, proposes that regulators pursue both risks and benefits. Using the proportionality approach for the problem that agencies seek to address, regulators must demonstrate that they are not squandering resources and delaying social benefits in order to address negligible risks for nominal gains in safety. ❑ About the Author Randall Mayes is Field Editor for Wild Cards at TechCast Global, www.techcast.org, and the author of Revolutions: Paving the Way for the Bioeconomy (Logos Press, 2012), from which this article draws.

i t o p Disru n: Technology Trends in Medicine and Health Care

Doctors and patients alike are navigating wave after wave of new technologies that promise to alter how we manage our health. Digital technologies also offer opportunities for doctors and patients to become better strategic partners in medical decisions.

By Bertalan Meskó Being a medical futurist means I work on bringing disruptive technologies to medicine and health care, assisting medical professionals and students in using these in an efficient and secure way, and educating patients about how to become equal partners with their caregivers, in both face-to-face and virtual relationships. As online platforms and digital technologies rapidly emerge and change, we need partnerships between patients and health-care professionals, as well as a guide to prepare for the future technologies that will have to be implemented quickly in everyday practices and in the health management of patients. Based on what we see in other industries, this is going to be an ex-

ploding series of changes. While redesigning health care takes a lot of time and effort, the best we can do is to prepare all stakeholders for what is coming next. The following overview of the major trends in health care offers guidance for preparing individuals, organizations, and medical practitioners for the health-care landscape ahead. This guide will be continuously updated, so reader feedback is welcome. The white paper was originally published on Medicalfuturist.com.

The Guide to the Future of Medicine Infographic The basic idea of this visual representation was to add three perspectives to one infographic featuring the

main trends that shape the future of medicine: 1. Which stage of the delivery of health care and the practice of medicine is affected by that (Prepare and Prevent, Data Input and Diagnostics, Therapy and Follow-Up, and Outcomes and Consequences). 2. Whether the trend affects patients or health-care professionals. 3. The practicability of the trend (already available, green boxes; in progress, orange boxes; and still needs time, red boxes). The infographic represents the way I see the development of key trends and innovations in the process of delivering health care. Some elements could certainly be added to other parts, as well, although I chose the points with the most potential.

Description of the Trends 1. PREPARE AND PREVENT Already Available Curated Online Information In the near future, whether it is correct and reliable medical informa32

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â&#x20AC;˘

tion, dynamic resources, or medical records online, everything will simply be available to everyone. This would clearly be the most important development in the history of medicine. As people have to deal with false or unreliable information and resources, curation by medical professionals and expert patients is crucial. Examples include Webicina.com. www.wfs.org

Digital Literacy in Medical Education The only way to prepare healthcare professionals for the digital technologies coming to medicine is to include digital literacy in the official medical curriculum. The Social MEDia Course (thecourse.webicina .com) at Semmelweis University in Budapest, Hungary, has been teach-

ing medical students about the use of social media and mobile applications. Medical students can access the materials in a game-based e‑learning platform and answer questions about the topics covered in the lectures on a Facebook page for bonus points. A new course, Disruptive Technologies in Medicine, aims at introducing students to technolo-

gies ranging from genomics to tele medicine that they will be using in practice. Such courses should be available in every medical school worldwide. Virtual Dissection Medical students will study anatomy on virtual dissection tables and www.wfs.org

not on human cadavers. What we studied in small textbooks will be transformed into virtual 3-D solutions and models using augmented reality. We can observe, change, and create anatomical models as fast as we want, as well as analyze structures in every detail. Examples include Anatomage, ImageVis3-D, and 4D Anatomy. •

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In Progress Microchips Modeling Clinical Trials Switching from long and extremely expensive clinical trials to tiny microchips that can be used as models of human organs or whole physiological systems provides clear advantages. Drugs or components could be tested on these without limitations, making clinical trials faster and even more accurate (in each case, the conditions and circumstances would be the same). Microchips with living cells that model how a lung works are already available. The Organs-onChips technology, such as that at the Wyss Institute at Harvard, has been developed for years and now provides a range of chips modeling organs. More-complicated microchips that can mimic the whole human body are needed, and this ultimate solution could arrive soon. DIY Biotechnology The methods and materials of biotechnology have increasingly become more available to anyone interested in them. Expensive laboratory equipment is no longer needed as much for performing biological experiments; materials for experiments can be ordered on demand, and the data or information required are much more accessible than before. For example, iGem events (International Genetically Engineered Machine competition) made it absolutely clear that opportunities to use biotechnology for different purposes are almost limitless. Biotechnology, especially among do-it-yourselfers, is the new IT industry. The new generation of scientists represented by Jack Andraka—who, as a highschool sophomore, invented an inexpensive cancer-detecting test—leverages the power of already available resources and materials in order to come up with real innovations.

Full Physiological Simulation What if it were possible to examine the human body with all its THE FUTURIST

Gamification-Based Wellness Gamification seems to be the key in persuading people to live a healthy lifestyle or stick to the therapy they have been prescribed to; 63% of American adults agree that making everyday activities more like a game would make them more fun and rewarding. Wearable gadgets, online services, or mobile health solutions can lead to better results if gamification with the right design is included. Improving our health or making our job more efficient can and should be fun. Examples include Shine, FitBit, and Lumosity.

2. DATA INPUT AND DIAGNOSTICS Already Available Digestible Sensors It is possible to swallow digital devices and tiny sensors for gathering and storing data and transmitting body temperature and heart and respiration rates to an external device. In diseases related to our gastrointestinal system, it could give instant diagnosis by combining the results of lab markers and colonoscopy (if the device swallowed includes a video camera). Examples include Proteus Digital Health and Equivital. Personalized Genomics

Still Needs Time

physiological functions without experimenting with people? One application being developed in this area is the Virtual Physiological Human, a framework enabling collaborative investigation of the human body. Medical students would be able to study the human body in detail like never before, understanding the core concepts of how our body works and the pathology of diseases. Another example, HumMod, consists of 5,000 variables describing cardiovascular and metabolic physiology, among others.

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Since the completion of the Human Genome Project, we have been envisioning the era of personalized medicine in which everyone gets customized therapy with customized www.wfs.org

dosages. The truth is that there are only about 100 cases when personal genomics can be applied with evidence in the background 11 years after the Human Genome Project was declared complete, according to the Personalized Medicine Coalition. As we move along this path, we will have more and more opportunities for using DNA analysis at the patient’s bedside, which should be a must-have before actually prescribing drugs. It means patients would get drugs and dosages exactly customized to their own genomic backgrounds. Fast and accurate DNA sequencing is needed to reach this goal. Smartwatch Smartphones have not been able to replace pagers due to practical reasons, but an easily accessible wearable device might have the potential to make this step. A smartwatch could be used for consultations, making calls, sending messages, scheduling visits, paging, or even displaying fresh lab test results. Real-Time Diagnostics in the Operating Room The intelligent surgical knife, iKnife, uses an electrical current to heat tissue to make incisions with minimal blood loss. The vaporized smoke is analyzed by a mass spectrometer to detect the chemicals in the biological sample. The device thus can identify whether tissue is malignant during an operation in real-time without need to send a biopsy to the pathology lab. A clinic in Germany started experimenting with an application using augmented reality on tablets in the OR. During operations, surgeons can see through anatomical structures, such as blood vessels in the liver. They can therefore perform more-precise excisions based on the patient’s radiology images. In Progress Embedded Sensors As an addition to digestible and wearable sensors, tooth-embedded

GOOGLE

sensors can recognize jaw movements, coughing, speaking, and even smoking. Imagine the same wireless technology used in organs providing real-time data from an artificial pancreas or constantly recording EEG (electroencephalography).

Wearable E-Skins

Medical Tricorder The concept of the medical tricorder that can diagnose diseases quickly, as seen in the TV series Star Trek, has tantalized us for decades; now there is a chance to make it real. The Qualcomm Tricorder X Prize challenge may lead to the development of a portable, wireless device that can monitor and diagnose several diseases and give individuals more choices in their own health. An example, Scanadu, can measure body temperature, heart rate, ECG (electrocardiogram), pulse oximetry, and other basic parameters simply by placing it on the forehead. What matters is that patients should be able to access bioparameters about themselves and get the right devices/data to control their own health. SCANADU

Scanadu Scout monitors vital signs and fits in the palm of your hand.

Semantic Health Records The only way to constantly improve a system is to generate and analyze data about it. The basic requirement of improving health care is to give everyone access to their own medical/health data, which is stored in semantic databases. This would facilitate public-health research, as well. Semantic datasets could generate alerts about upcoming medical issues and potential complications. Ongoing efforts include ElationEMR, CureMD, drchrono, Medopad, and Practice Fusion.

a safe way. In the next step, it might also perform analysis on the blood, detecting biomarkers or obtaining genetic data.

Google’s smart contact lens project aims to help diabetics monitor glucose levels.

Augmented Reality Augmented reality is a live view of a real-world environment that is supplemented with computer-generated input, such as sound, video, graphics, or GPS data. Getting information from the Internet by wearing a Google Glass or digital contact lenses would be a huge addition to the practice of medicine. Operations have already been streamed live from the surgeon’s perspective, but these streams could also display the patient’s electronic medical records in real time or organize live consultations with colleagues. IBM’s Watson would look for potential errors in the recorded operations. Augmented reality could also be used in emergency situations, such as summoning an ambulance to your GPS location while you’re performing CPR. Google Glass can be controlled through voice and hand gestures, while digital contact lenses will be controlled with brain waves. The potential to leverage the power of augmented reality is huge, but medical professionals should deal with patient privacy and put evidence behind using it in practice. Robotic Nurse Assistant With the growing number of elderly patients, introducing robot assistants to nursing homes and hospitals is inevitable. It could be a fair solution for moving patients and performing basic medical procedures, such as drawing blood. A prototype made by a U.S. company combines robotics and image-analysis technology to find a good vein on the patient’s arm and draw blood in www.wfs.org

Measuring easily quantifiable data is the key to better health. Therefore, the future belongs to digestible, embedded, and wearable sensors that work like a thin e-skin. These sensors will measure all important health parameters and vital signs— e.g., temperature, blood biomarkers, a n d e v e n n e u ro l o g i c a l s y m p toms—24 hours a day. They’ll transmit data to the cloud and send alerts to medical systems in real time when, for example, a stroke is happening. It will call the ambulance itself and send all the related data imm e d i a t e l y. E x a m p l e s i n c l u d e hydration sensors for athletes and intelligent textiles that change color to indicate diseases. Still Needs Time Holographic Data Input While better data input solutions arise, hardware will probably not even be needed to add data. Screens and keyboards will be projected on surfaces, such as a wall or table, making data accessible everywhere in the clinical settings. Holographic keyboards will make us forget about smartphones and tablets, while the data will be stored only in the cloud. Home Diagnostics Patients have been able to measure their own blood pressure for many years. Today, they can measure ECG, and tomorrow they will sequence genomes at home. Plenty of laboratory methods and procedures will be available at home, which could also mean the detection of diseases at an early stage, making intervention simpler and more effective. Patients will bring the data to the doctor on any device they use; therefore, a new role of digital health data analyst will appear soon. Examples include Nanobiosym, the Google Smart contact lens project, and AliveCor. •

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3. THERAPY AND FOLLOW-UP Already Available Robotic Interventions The number of studies examining the use of robots in the operating room has been increasing rapidly in the past couple of years. Robots can be used in remote surgery, surgical rehearsal in pre-operative planning, intra-operative navigation, and simulation and training, among other applications. It is clear that robotic interventions can add a lot to the success of operations and different procedures. One of the best ex amples is still the Da Vinci system, but other robots in the fields of emergency response and radiosurgery are also available. We might soon see operating rooms with no people inside except the patient. Surgical instruments will be so precise in a few years’ time that it will be impossible to control them manually; therefore, robotic or mechatronic tools will be needed in order to reach the required accuracy. Interdisciplinary Therapies Without a doubt, the future belongs to interdisciplinary innovations. Examples include neurosurgeons at the University of California, San Diego School of Medicine, and UC San Diego Moores Cancer Center using magnetic resonance imaging (MRI) guidance for delivering gene therapy as a potential treatment for brain tumors. This way, the rest of the brain remains unaffected, so the risk of the procedure is minimized. Medical specialists have to start looking at the same medical problem from different angles. As medical education focuses on developing specialized knowledge, social media and other digital technologies can help us get glimpses into other areas for new collaborations. Combining cognitive computing with the knowledge of physicians from different specialties could result in the best outcomes for patients. Telemedicine

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Virtual Trials In the era of open access and crowdsourced scientific information, we will have to find a solution for conducting clinical trials without experimenting on people. We will gather the same amount of information in the same quality as before, but in a much faster, noninvasive, humane, and reliable way. In order to reach this goal, a revolution is needed in medicine. Every country needs an E-patient Dave, a Jack Andraka, and a Regina Holliday to fulfill these goals. In Progress Optogenetics Optogenetics uses a combination of methods from optics and genetics to control the activity of individual neurons in living tissue. Optogenetics will provide new solutions in therapies. A recent study published in Science reported that scientists were able to create false memories in the hippocampus of mice. This is the first time that fear memory was generated via artificial means. In time, we will understand the placebo effect clearly. And just imagine the outcomes we can reach when false memories of taking drugs can be generated in humans, as well. The ultimate goal is to be able to modulate our senses, repair lost senses, or even perform specific DNA targeting with femtosecond lasers. Customized Mobile Apps

In the digital era, the use of IT so36

lutions in medical communication and even in health care is inevitable. In the future, it will include not only giving medical advice through online communication channels, but also sending life through the same channels. For example, DNA sequences would be sent over the Internet to synthesize proteins, viruses, and living cells. We are not far from breaking the barriers to exchanging medical information, drugs, medical equipment, or life itself through biological teleportation and the advances of 3-D printing.

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The number of medical mobile apwww.wfs.org

plications has been rising for years. Patients and doctors find it harder and harder to choose the right app for their health management or work. The next step could be customized mobile apps, such as the pApp, which lets doctors create mobile apps for their patients. Functions should include, for example, logging blood pressure or medications chosen from a menu; the patient should be able to download the app right away. 3-D Printed Biomaterials and Drugs More and more objects can be printed with 3-D printers, and the biotechnology industry is keeping an eye on potential opportunities. Printing medical devices in under developed areas, printing living tissues, and printing cells or drugs might not be far from everyday use. This capability will restructure the whole pharmaceutical industry and the world of biotechnology. However, regulation will be a huge challenge, as anyone will be able to print drugs containing patented molecules. Bionic ears and simpler organs will be printed at the patient’s bedside; printing transplantable human organs could eradicate waiting lists. Current technological issues such as the lack of available models and blueprints will be solved through crowdsourced and open-access databases from communities of designers. Meaningful Use of Social Media Medical communication is something that affects all patients and medical professionals worldwide, no exceptions. This is one reason why social media has the potential to become a huge “digital brain.” It will become possible to transmit, share, crowdsource, and store pieces of medical information, either for e-patients or for medical professionals, if such social platforms are used properly. Digital medical communication is a potentially powerful tool, but balance is needed: E-patients cannot and should not break from medical professionals entirely. This is why we have to train doctors to be ready for the digital era. Examples include online communities like Smart Patients, Patientslikeme,

and Sermo (for physicians).

medication should be as simple and comfortable for patients as possible.

Evidence-Based Mobile Health While the number of medical mobile applications has been rising, persuading users to keep on using the apps is a real challenge. The question is not whether such applications could be used in the process of practicing medicine or delivering health care, but rather which ones and to what extent they can be useful. Therefore, evidence-based background is needed for implementing mobile apps in clinical settings. The FDA has issued guidance that might facilitate the process. Artificial Organs An artificial organ is a device or biomaterial that is implanted into the body to replace a natural organ or its function. Three-dimensional printing is not the only solution for creating body parts and artificial organs, as such organs can also be grown in labs. Surgeons have been able to implant artificial skin, cartilage, synthetic windpipes, and blood vessels. In the near future, we will be able not only to replace the functionality of our organs with biomaterials and synthetic devices, but also to grow organs that can replace a nonfunctioning natural organ in its full physiological capacity. Artificial organs could also be used for other tasks, such as helping the body conserve water (as envisioned in Takram’s Shenu hydrolemic system). Adherence Control Adherence and compliance represent crucial issues in improving patients’ health and decreasing the cost of delivering health care. Several start-ups have targeted this issue with different solutions, such as the pill bottle that glows blue when a medication should be taken and red when a dose is missed to alert family members about it. In another example, tiny digestible sensors can be placed in pills and transmit pill digestion data to physicians and family members. In the future, it is going to be extremely difficult not to comply fully with the prescribed therapy. Moreover, compliance with

Still Needs Time Multifunctional Radiology Radiology will probably be a combination of imaging techniques and personalized diagnostics, with realtime interventions. One multifunctional machine will be able to detect plenty of medical problems, biomarkers, and symptoms at once. With one quick checkup, a machine like that used in the film Elysium would tell patients what percentage of their cells are cancerous. Further examples could include resting-state and taskfunctional MRI for examining cognitive patterns and large-scale initiatives involving neuroimaging and the brain macro-c onnectome. The recently launched Human Brain Project could become even bigger than the Human Genome Project.

time, we will be able to print these robots in 3-D based on specific blueprints. Whether serving as companions for sick children, teaching kids with autism, or providing personal assistance for elderly patients, humanoid robots have the potential to transform the face of health care. Augmenting Human Capabilities Medical research is meant to discover and develop methods to replace nonfunctioning organs and capabilities or to restore certain functions in the human body. But with the rapid advances of research, instead of only replacing functions, it would be possible to add to our current capabilities and create “superpowers.” We could decide what to dream about, how to metabolize drugs, or how to digest different types of food. We could choose to increase brain function or improve our strength through powered exoskeletons. Nanorobots in Blood

Remote Touch While the human touch is the key in the practice of medicine, we will eventually have to use remote touch due to the shortage of doctors and increasing number of patients. The force-feedback technique used by the video-game industry has the potential to be used in medicine, as well. It has been demonstrated that biopsy sampling can be simulated in a 3-D environment using a forcefeedback-controlled device. Surgeons could be trained with the technique to master a procedure before operating on real patients. It could also assist medical students in improving in palpatory diagnosis.

Medicine today is based on interventions after the diagnosis is given. What if nanorobots in the bloodstream could intervene even before the disease appears? Nanorobots called respirocytes could be used to keep a patient’s tissues safely oxygenated for up to four hours after a heart attack; they could serve as white blood cells, remove platelets, or repair damaged cells. The opportunities are almost limitless. Moving it to the next level, modules that self-assemble inside the stomach could perform more-sophisticated diagnosis and treatment. The number and range of noninvasive operations could increase with such selfassembling robots.

Humanoid Robots

4. OUTCOMES AND CONSEQUENCES

Robots built to resemble the shape of the human body might soon play a role in our lives. Due to the shortage of caregivers worldwide, humanoid robots could provide basic care or keep company for patients. Developments from DARPA such as Atlas, the 188 cm–tall humanoid robot, or the robotic AlphaDog, show the rapid advances and amazing potential in this area. In a few years’ www.wfs.org

Already Available Artificial Intelligence in Medical Decision Support The knowledge of even the most acclaimed professors cannot compete with cognitive computers. As the amount of information is exponentially growing, the use of such •

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computing solutions in assisting medical decision making is imminent. While a physician can keep a few papers in mind—maybe a few dozen papers with digital solutions—IBM’s supercomputer Watson can process more than 200 million pages in seconds. This is why Watson has been tested in oncology centers to see whether it could be used in the decision-making process of doctors regarding cancer treatments. Watson does not answer medical questions, but, based on the input data, it comes up with the most relevant and potential outcomes. The doctor has the final call; artificially intelligent support can only facilitate the work of physicians, not replace them. Still Needs Time Virtual-Reality Applications New disease categories as a result of the excessive use of virtual reality (VR) in gaming and other industries will appear. Examples include vir-

For Further Reading

•• The Singularity Is Near by Ray Kurzweil (Viking, 2005). •• Think Like a Futurist by Cecily Sommers (Jossey-Bass, 2012). •• You Tomorrow by Ian Pearson (CreateSpace Independent Publishing Platform; 2nd edition, 2013).

By the author: •• Scienceroll.com. •• Social Media in Clinical Practice by Bertalan Meskó (Springer, 2013).

Virtual-Digital Brains In his book You Tomorrow, futurologist Ian Pearson writes that we would one day be able to create digital selves based on neurological in-

•• The Medical Futurist Newsletter, medicalfuturist.com/newsletter/.

May-June 2014

Improving diagnostics and treatments is not enough anymore. We need to massively improve the health-care experience, whether the process takes place in a hospital or at home. The delivery of health care must acquire features regarding the customer experience from other industries. Clear, smart design ensuring comfort and privacy is needed. Patients should have access to transparent decision trees after getting a diagnosis, helping them to make informed decisions with their partner doctors. Early examples include the National Health Service in the UK, Stanford Hospital, and Ottawa Hospital. Companies such as Google’s recently launched Calico, focusing on health and well-being, will make attempts at reaching these goals.

Cyborgs will be everywhere around us, including a new generation of hipsters who implant devices and technologies in their bodies just to look better or have new functionalities. Advances in medical technology will not just repair physical disa d v a n t a g e s s u c h a s i m p a i re d eyesight, but will also create superhuman powers—the eyesight of an eagle, the hearing of a bat. Patients wearing implanted defibrillators or pacemakers can already be classified as cyborgs, but there will also be more cases of patients without medical problems asking for certain digital implants to augment their capabilities, creating biological “wealth” gaps.

•• Physics of the Future by Michio Kaku (Doubleday, 2011).

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Redesigned Hospital Experience

Recreational Cyborgs

•• Exploring Personal Genomics by Joel T. Dudley and Konrad J. Karczewski (Oxford University Press, 2013).

tual post-traumatic stress disorder, where gamers who participate in large virtual battles such as Call of Duty experience symptoms similar to soldiers who fought in real wars. But VR could also be used in psychotherapy or to prepare patients for an upcoming operation.

•

www.wfs.org

formation. This means that we could upload our minds to a computer and live on in a digital form. Since Google hired Ray Kurzweil, author of The Singularity Is Near, to create the ultimate AI-controlled brain, this opportunity should not be so far away. We might have been searching for the clues of living forever in the wrong places so far.

How to Prepare for the Future of Medicine 1. Whether you are a patient or a medical professional, follow the main trends and try to be up-to-date, using digital technologies ranging from message boards to mobile apps. 2. Constantly look for solutions to improve your practice as a medical professional or your health as a patient. 3. Embrace digital technologies in a comfortable way and use techniques that make your life easier and your work more efficient. 4. Look for examples and trends outside of medicine, as well. 5. Understand that evidence backed by massive data is needed for any uses of digital solutions in medicine. 6. Beware of hype in medicine. Strategically analyze trends and extrapolate to the future in a meaningful way. 7. Influence decision makers if your idea can make a change. Be bold and use social media channels to spread the word. 8. Remember that, no matter how important a role digital will play in our lives, the human touch is and will always be the key in the doctor– patient relationship. ❑ About the Author Bertalan Meskó, MD, PhD, is a medical futurist. He is the managing director of Webicina.com, a service that curates medical and healthrelated social media resources for patients and medical professionals. He is the author of the multiple award-winning medical blog Scienceroll.com, The Medical Futurist newsletter, and the book Social Media in Clinical Practice (Springer, 2013). Web site medicalfuturist.com/. E-mail berci@ medicalfuturist.com.

nlike human beings, any Alsatian in the dog pound can smell, at parts-per-trillion concentrations, biochemicals uniquely associated with low blood sugar levels in diabetics; epileptics on the threshold of a seizure; human lung, breast, or bladder cancer; dairy cows in heat (ready for artificial insemination); and things as varied as dynamite, cocaine, cell phones, bedbugs, mercury spills, weeds, toxic mold, and the polycarbonate of pirated DVDs. The stunted human brain, however, is now developing cheap, compact sniffers that allow it to perform just as well, and even better. Molecular sniffers give us a fundamentally new understanding of health and disease. They are also rapidly exposing the limits and frailties of the old medical media, beginning with the government licenses, labels, mandates, and proscriptions that attempt to dictate who may sell and who may use what kind of molecular medicine for what purposes. By pooling and distributing what the sniffers detect, the digital cloud will democratize our understanding of diseases and their antidotes. As biochemical knowledge accumulates and its implications become clear, free people will come to understand what they are missing, and insist on taking far more personal control of the sniffers and drugs that will let them control the arc of their biological lives. Precision Medicine Down at the very bottom, life is launched and propelled by two

Sniffing out the Future of Medicine By Peter W. Huber Labs on chips and low-cost genetic sequencing could vastly improve medicine in the coming decade, if we allow it. An expert in technology, science, and law argues that the next big revolution in medicine fits on a chip—and in patients’ hands.

COSMIN4000 / ISTOCK

groups of big, complex molecules— nucleic acids assembled into genes, and the proteins that those genes define. All life uses this bootstrap code to lift itself up from the stillness of inanimate matter. Like software, the information stored in this code can be erased, corrupted, infected, hijacked, and edited, letter by letter,

word by word. Good code keeps us healthy; bad code makes us sick. In three fantastically innovative decades, we have acquired the tools to read this code and design good code to control the bad. Drug designers have made the transition from blind guesswork to the systematic design of precision drugs that

modulate carefully selected molecular targets. And while designing such drugs isn’t easy, the process is, at its best, as inherently logical as the one that composes the software used to control your computer. We now have in hand the power to control almost any disease caused by our own rogue biochemistry or an infectious microbe. Targeted drugs don’t treat clinically observable fatigue, weight loss, fever, anemia, and recurring infections—you have that cluster of symptoms because you have a rare form of leukemia, so you need Gleevec, which attacks an abnormal enzyme churned out in excess by the flawed gene associated with the “Philadelphia chromosome.” Saquinavir doesn’t set out to kill a whole virus; it attacks a key bond in a molecule that helps replicate HIV. Modern pharmacology doesn’t resign itself to the inevitability of side effects; it tracks them to the molecular variations that make some people allergic to aspirin, for example, and others unable to tolerate Camptosar, a powerful cancer drug. Pharmacogenomics matches the drug to specific genetic profiles found in some patients and not others. Gene therapy takes molecular medicine to its logical limit, using viruses to implant genetic fixes into the patient’s own cells. At the front end of it all, the diagnostic end of medicine—the purely informational end—is now on the same plummeting cost curve as the microprocessor. Arrayed on chipsized, micro-electromechanical laboratories, molecular sensors are now becoming complete bioscanners that can, for a few dollars a whiff, search a cheek swab or drop of blood for hundreds—and soon thousands—of genes, proteins, fats, and other biomarkers. Sensor chemicals on the surface of plastic or paper cards mounted in a breathalyzer can detect a hundred or so biomarkers, including those signaling the presence of lung cancer and tuberculosis. More complex sequences of assays are now performed by huge, fully automated banks of compact diagnostic machines that can quickly and cheaply diagnose infections, genetic abnormalities, and biochemical im40

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balances of every kind, in as many specimens of urine, blood, saliva, or mucus as anyone cares to swab on a Q-tip, smear on a card, or dribble into a little cup. They can sense variations among our body’s tens of trillions of cells, salient features of the trillions of microbes that we also host, and the biochemical soup that bathes all the rest. The iPOPing of Michael Snyder In early 2012, scientists at Stanford University described how they had spent the previous two years tracking DNA, RNA, proteins, antibodies, metabolites, and molecular signals— some 40,000 biomarkers that yielded many billions of bits of data—in the

body of geneticist Michael Snyder, the team’s senior member, to create the first-ever “integrative Personal ‘Omics’ Profile”: an “iPOP.” The iPOPing of Michael Snyder began when he was, by all clinical appearances, perfectly healthy, and it thus established a biochemical baseline for his personal clinical health. The early scan, however, revealed a genetic propensity for high cholesterol, which he already knew about, and also for diabetes, which came as a surprise. He then watched his cholesterol level drop sharply when he started on a cholesterol drug. Though Snyder had no family history or conventional risk factors, the data also revealed a genetic predis-

Stanford University geneticist Michael Snyder used his own body to create an “integrative Personal ‘Omics’ Profile,” or iPOP.

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position to type 2 diabetes. On day 301 of the study, his blood sugar levels suddenly jumped, and the team tracked the onset of the disease in what has been described as “the first eyewitness account—viewed on a molecular level—of the birth of a disease that affects millions of Americans.” Then the iPOP team watched the diabetes markers revert to their normal state in response to treatment with aspirin and ibuprofen, exercise, and a low-sugar diet. For Michael the patient, that might have been enough. But for Professor Snyder the scientist, there was more to learn. Analysis of the iPOP data also revealed how his RNA was activating different genes as his health changed during the course of the study. As the patient recounts, “We generated 2.67 billion individual reads of the [relevant RNA molecules], which gave us a degree of analysis that has never been achieved before.... This enabled us to see some very different processing and editing behaviors that no one had suspected. We also have two copies of each of our genes and we discovered they often behave differently during infection.” The researchers suspected a possible link between a viral infection and Snyder’s blood sugar surge 12 days after its onset, and so they zeroed in on about 2,000 genes that were fired up during that period, plus another 2,000 that throttled down. They found some that help control insulin—links involving inflammatory proteins and antibodies, among them an autoantibody that targets a human insulin receptor. The data thus pointed to “unexpected relationships and pathways between viral infection and type 2 diabetes.” As one of Snyder ’s colleagues notes, an analysis of this kind reveals how a patient’s complex control systems interact with his or her own chemistry and the environment, and thus point to how medicine “can best target treatment for many other complex diseases at a truly personal level.” Personal Drug Science Today, the efficacy and safety of a drug are usually assessed by com-

IMAGE COURTESY OF THE DISNEY LAB, THE SCRIPPS RESEARCH INSTITUTE

paring the responses of two large groups of patients, one treated with the drug, the other with a placebo. With iPOPs, the assessment still involves a comparison of two or more patients, but they have the same name. “In a study like this, you are your own best control,” says Snyder. “You compare your altered, or infected, states with the Scientists at the Scripps Research Institute have developed values you see when a method to quickly identify new drug candidates from a genome sequence, such as this compound that causes you are healthy.” cancer cells to attack themselves and die. Such comparisons will play a key role in getting the right drugs developed in the first place. As Sny- on to control the thousands of differder points out, there are “many rea- ent strains of HIV. Similar databases sons why someone is at risk” of type and analytical engines are now being 2 diabetes. “Diabetes is really hun- developed to guide the treatment of dreds of diabetes, and they just have various cancers. By allowing medicine to assess a one common characteristic which is a high level of glucose,” he says. drug’s performance quickly and “Some respond to metformin [a drug cheaply, iPOP technology will have a that suppresses glucose production profound impact on the treatment of in the liver], some don’t. Some re- rare diseases. The FDA has desigspond to anti-inflammatory medi- nated as “orphans” about 7,000 rare conditions that collectively affect cine, some don’t.” This is a common problem: Many some 30 million Americans. But only disorders can’t be cured by one-size- about 200 of these disorders have befits-all drugs because down at the come treatable in the last 30 years. molecular level each one is in fact a Assembling large groups of patients cluster of different disorders. Re- in which to test drugs developed to peated with enough different pa- treat these diseases is difficult, and tients, iPOP tracking will reveal the conducting big, long clinical trials details of all the molecular pathways will often cost more than the drug is to a disease, and thus supply drug likely to earn. designers with the information they need to design targeted drugs to Doctors and Patients Take Control control each one of them. The advance of medicine anchored With the cooperation of doctors and patients, researchers will com- in molecular biology will inevitably pile large amounts of patient-specific shift control toward the doctor and molecular and clinical data that will on down to the patient. By fitting the molecular logic of allow sophisticated analytical engines to work out the details of the targeted drug to the biochemiscountless molecular chain reactions try presented by the patient’s cancer, and networks that propel disease oncologists now work out, one paand determine how patients respond tient at a time, how best to use availto drugs. Medicine has already built able cancer drugs, and often prethe huge databases and worked out s c r i b e t h e m f a r o u t s i d e t h e the biochemical details for at least boundaries set by the FDA-apone retrovirus. Without them, we proved label. Doctors have long renever would have managed to de- lied on informal case reports in medsign the drugs and assemble the ical journals to share what they learn drug cocktails that we currently rely in the course of treating individual www.wfs.org

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patients. They now have far more data to learn from, and are rapidly systematizing the process of pooling and analyzing the data they gather as they treat. A nonprofit alliance of 21 leading cancer centers, for example, evaluates and publishes information on off-label uses. Many patients are eager to get involved. The introduction of home pregnancy testing kits in the 1970s, as one medical historian observes, reversed the “medicalization of pregnancy” and shifted the “locus of control at the moment of discovery.” People may treasure privacy too much even to talk to a doctor, or they may reasonably lack faith in the what-happens-in-Vegas promises that doctors make about confidentiality. How about the government paymaster or private insurer that reviews the diagnosis and treatment before paying the doctor’s bills? Or the nurse, file clerk, janitor, or taxi driver who finds the laptop that the doctor forgot? Self-sniffing is cheaper, too—packaging diagnostic chemistry in a form suitable for sale from a rack located next to the gum and candy cuts the doctor and lab technician out of the loop. And the sniffer gives the patient the information that the law too casually assumes he or she already gets. “Informed consent” for treatment may often be a hollow formality when a doctor who answers to a government paymaster controls all the informing. Most importantly, giving consumers direct access to iPOP technology will promote monitoring that begins long before diseases surface. “You should be able to get 5,000 tests done with one drop [of blood] so we can get a better idea of what’s going on in your body,” says Snyder. “I think people who are at risk for certain diseases could do a simple home test. You could probably monitor yourself every month so you can catch diseases early.” With diabetes, as with many other diseases, the key to effective prevention or treatment is “to catch it earlier.” And patients, too, are finding ways to pool the data they collect and learn from each other. One Web site has coordinated a social- network-based online trial of lithium 42

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treatments for Lou Gehrig’s disease; another is compiling data from patients suffering from a rare gastrointestinal cancer; yet another recently identified five genetic associations for hypothyroidism from a comparison of 3,700 individuals with the disease from over 35,500 controls. Many other sites and services are coordinating similar ad hoc studies; they call it “crowdsourced science.” As HIV patients did so effectively (albeit without the help of the Web) in the 1980s, patients also use such sites to discuss what seems to work and what d oesn’t , lob b y for more research, and demand faster access to new drugs. When the rest of us catch up with the iPOPing professors at Stanford, the first thing we should do is establish a baseline profile of our excellent health, and keep it up to date thereafter. With that information securely stored and pooled with enough data from other patients, the computers will take it from there. When we suddenly find ourselves diabetic, they will probably be able to tell us whether a viral infection or some other factor was to blame. When we try a potential cure, we will be able to track and get a first read on its efficacy almost immediately, down at the molecular level. The accumulation of molecular and clinical data collected from many different patients will steadily improve medicine’s ability to make an accurate, personal prognosis of how the untreated disease is likely to progress inside the patient. The doctor and patient will thus gain access to concomitantly accurate estimates for how much benefit the individual patient is likely to derive from drugs that modulate molecules involved in propelling the disease. Together, the patient and doctor will then be better qualified than anyone else to decide when it makes sense to start fighting the clinical future of the disease by using one or more drugs to attack molecular problems here and now. Unleashing Sniffers The molecular medicine that works ends up cheap, but it starts out very expensive. Most of its frontwww.wfs.org

end cost is investment in the most valuable and durable form of capital—pure biological science and technical know-how. As it accumulates, this kind of capital continues to make us richer, not poorer. But by exposing all the healthrelated variations in patient chemistry and transforming the ignorant, passive patient into an informed, meddlesome, and demanding customer, sniffers will undermine every attempt to control costs by standardizing treatments. Public health authorities who can’t afford to invest in the medical future have little incentive to reform public policy in ways that will accelerate its arrival. By and large, drug regulators and government paymasters remain hostile to the idea that individual doctors and patients should play a significant role in deciding which drugs are needed and how they should be used. We need, instead, policies that will allow biochemists, doctors, and patients to collaborate in ways that will unravel how human bodies work, and how they can be controlled, without the process taking so long and costing so much that it never gets started at all. We will never catch up with nature, but we do have a pretty good idea of what we need to transform molecular medicine into a systematic and extremely powerful science. We need molecular profiles of the microbes that make us sick, as well as of the much larger number that dwell more or less peacefully inside us and help keep us healthy. And we need torrents of molecular data extracted from countless individual bodies—Stanford’s two-year iPOPing of Professor Michael Snyder foreshadows what lies ahead. ❑

About the Author Peter W. Huber is a senior fellow at the Manhattan Institute for Policy Research, where he specializes in issues related to technology, science, and law. This article was adapted with permission from his most recent book, The Cure in the Code: How 20th Century Law Is Undermining 21st Century Medicine (Basic Books, 2013).

Adventures in Personal Genomics By Verne Wheelwright The public may demand a right to know their own genetic information, but interpreting their medical destinies without professional guidance might be off-limits.

In May 2003, Francis Collins, then director of the National Human Genome Research Institute, testified before a House Subcommittee on Health and described his vision for the future of genomic medicine, as follows: While it always is somewhat risky to predict the future, I want to leave you with my view of where I believe genomic medicine is headed. In the next ten years, I expect that predictive genetic tests will exist for many common conditions in which interventions can alleviate inherited risk, MAGGIE BARTLETT / NHGRI

Francis Collins testifies before a 2003 congressional panel on the future of genomics.

so that each of us can learn of our individual risks for future illness and practice more effective health maintenance and disease prevention. By the year 2020, gene-based designer drugs are likely to be available for conditions like diabetes, Alzheimer’s disease, hypertension, and many other disorders. Cancer treatment will precisely target the molecular fingerprints of particular tumors, genetic information will be used routinely to give patients more appropriate drug therapy, and the diagnosis and treatment of mental illness will be transformed.

As a new graduate in Futures Studies from the University of Houston at Clear Lake, I was excited by Collins’s vision, and could hardly wait to see the benefits of the race to sequence the human genome. I had family members whom I believed would benefit in several ways, but most specifically by knowing how their bodies would react to different medications and dosages. It’s been more than a decade, and in October 2013 I received a letter f ro m A n n e Wo j c i c k i , C E O o f 23andMe, inviting me to order a DNA test kit for $99. I ordered two test kits the same day. Just 10 years after the completion of the genome sequencing project and Francis Collins’s presentation to the House subcommittee, I ordered

PHOTOS: 23ANDME

Personal genomic analysis starts with a spit (left). Samples are then mounted for analysis in 23andMe’s laboratory.

an analysis of my personal DNA for about $100. Right on schedule! Will the information be useful or valuable? I’m in my late 70s, so I have already learned a lot about my health and medications. For example, standard dosages of betablockers seem to affect my system differently than they do other people. I’ve suspected that about other medications, but have never been certain. I’m hoping the information from 23andMe will tell me something about how my body will react to different medications. But the truth is, I’m curious. What will a DNA report actually be able to tell me? Will it offer information that will be valuable to our children or

grandchildren? Will it confirm information I already know about? What is the potential for everyone? FDA Steps In: A Bump in the Genomic Road to the Future? About two months after I ordered my tests, I received two detailed reports from 23andMe. They sent a lot of information, and I am still working through it. The first report was about strengths and weaknesses in my health, plus information about how my body might respond to various medications. The second report related more to ancestry and genealogy. Then, three days later, there was an e-mail announcement, apparently

Samples from 23andMe customers arrive at the laboratory.

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sent to all 23andMe customers in response to a letter from the U.S. Food and Drug Administration: If you are a customer whose kit was purchased before November 22, 2013, your 23andMe experience will not change. You will be able to access both ancestry and healthrelated information as you always have. 23andMe has complied with the FDA’s directive and stopped offering new consumers access to healthrelated genetic results while the company moves forward with the agency’s regulatory review processes. Be sure to refer to our 23andMe blog for updates.

I beat the deadline and received the complete reports and will (I understand) continue to receive updates. Apparently, customers of 23andMe who ordered after November 22, 2013, will receive the genetic results relating to health and medications, but without the helpful interpretations provided by 23andMe. My first reaction was hostile to the FDA. I had received what I believe is valuable information, and the government doesn’t want me to know what’s going on in my own genome. Then I saw Matthew Herper’s article in Forbes, “23andStupid: Is 23andMe Self-Destructing?” Herper pointed out that the FDA letter stated that 23andMe had stopped communication with the FDA in May.

Here’s part of the FDA letter: Thus, months after you submitted your 510(k)s and more than 5 years after you began marketing, you still had not completed some of the studies and had not even started other studies necessary to support a marketing submission for the PGS [Personal Genome Service]. It is now eleven months later, and you have yet to provide FDA with any new information about these tests. You have not worked with us toward de novo classification, did not provide the additional information we requested necessary to complete review of your 510(k)s, and FDA has not received any communication from 23andMe since May. Instead, we have become aware that you have initiated new marketing campaigns, including television commercials that, together with an increasing list of indications, show that you plan to expand the PGS’s uses and consumer base without obtaining marketing authorization from FDA.

What I Learned about Myself Frankly, I was impressed with the re p or t s I re ce i ved—impressed enough that I planned to order 23andMe kits for our children and grandchildren. To be specific, the 23andMe “drug response” report showed an “increased” response to Warfarin. Coincidentally, my cardiologist had recently started me on a standard dose of blood thinner, then quickly reduced the dosage. He may have had similar information. The Drug Response report was the report I was most interested in when I ordered the 23andMe kit, as I have family members who are over- responsive to multiple medications and feel this is an area that should be of greater concern in the medical community, as “standard” dosages can be far too much or too little. The only problem I have had (so far) has been with beta-blockers. Reading the report and the postings from other people revealed that a lot of people have trouble with standard dosages of beta-blockers. In the “Health Risks” report, my

first three risks were gout, atrial fibrillation, and By James H. Lee prostate cancer. No problems with I’m also a 23andMe customer, along with my gout, and my docfamily physician. It is clear that personal genomtor has been moniics is still a work in progress, but the FDA’s patoring PSA and ternalistic approach is going to set this field back other tests for by a decade. After the FDA’s letter, blood got in years, so no surthe water, and now a law firm is filing a class acprises there. But I tion suit against the company. This is when bad had no clue, no edgets ugly. ucation, no prepaConsumers need to take some responsibility ration for atrial fifor their health, and the FDA’s recent ruling is brillation. My preventing that. education came f ro m a t e a m o f James H. Lee is the founder of Strategic Foresight Investdoctors at the foot ments (StratFI). He is also the author of Resilience and the of my bed after a Future of Everyday Life, available on Amazon.com. long night in the emergency room. A Verne Wheelwright replies: I believe 23andMe few years of adhas a good product that could be great. I have to vance notice from a believe, or at least hope, that 23andMe also has a re p o r t l i k e t h i s strategy. Ignoring the FDA is not a choice most would have been organizations make. We’ll see. very valuable. Despite the FDA’s attitude, we ordered kits for When I ordered Christmas. My cardiologist, after seeing part of the 23andMe kit, I my report, is ordering a kit for himself. didn’t expect many Ed. note: Readers are invited to comment on surprises. I’m 78, FUTURIST articles and blog posts at wfs.org. See so I’ve already exalso Peter W. Huber’s article in this issue. perienced most of the conditions that a genomic report would reveal, but I wanted to learn what genome test- politics, bureaucracy, lobbying, or ing can do for individuals. As I said, something else at work? Or is this a I am impressed by the information I legal challenge to the FDA? How received. This is helpful information will this play out? There are lots of on many fronts, and we are still very possible scenarios for this new inearly in the game—only 10 years dustry, as discussed in technology since Francis Collins’s report to Con- policy researcher Peter W. Huber’s gress. There is still a lot to learn book, The Cure in the Code (Basic, about the human genome that will 2013). I believe that there is far more gobe added to future reports. Imagine what new information will be avail- ing on in this interaction between this young business and federal regable over the next 10 years! But what about the FDA’s stated ulators than is yet apparent. We’ll concern that individuals will “self- have to wait for the next chapter. ❑ manage” their medications? Might About the Author knowledge and awareness of mediVerne Wheelwright is presical risks also help patients to better dent of the Personal Futures communicate with their physicians Network (www.personalfutures about their responses to medication? .net) and author of It’s Do some physicians hesitate to vary YOUR Future... Make it a from “normal” dosages because of Good One! (Personal legal risks? It would seem that an inFutures Network, 2012). Folformed patient is the best solution to low him on Twitter: @urfuturist. many potential problems. This article was adapted from the And what about the problem be- author’s posts on the Futurist Blog, tween the FDA and 23andMe? Is this www.wfs.org/blogs/verne-wheelwright.

Comment: FDA Over-Regulating

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A Special Message from the President of the World Future Society

Because the Future Matters… Dear Reader,

The World Future Society Needs You ... because the more complex that the future becomes, the more minds we need at work: • scanning the horizon, • scouting the opportunities and risks ahead, • envisioning inspiring possibilities, • deliberating and debating alternative scenarios, and • leading the teams that will build better futures not just for ourselves, but also for the generations to come. For nearly half a century, members of the World Future Society have supported the publications, resources, research, and networking opportunities that have helped develop the field of futures studies. Over the years, we have expanded the foresight capabilities of leaders in government, business, academia, and civil society; enabled people from all walks of life to come to terms with rapidly accelerating change and create better futures for their families and businesses; and promoted the more specialized work performed by professional futurists. As we look to our own future, the Society is now faced with the challenge of expanding its mission to more people via new media ventures and education initiatives. Our goals include: • Building a better Web community for members, with easier access to futures materials and connections to colleagues around the world. • Creating a dynamic network of futurist groups at the local level, enabling communities, villages, schools, and organizations to collectively envision and build sustainable futures. • Developing a meta-curriculum of futures studies that enables foresight to be incorporated into all classroom studies and learning activities. • Cultivating young futurists by providing resources, networking opportunities, and other support through the Global Youth Foresight program. • Improving the training and education of both professional futurists and those who need to incorporate futuring methodologies in their own professional activities or personal pursuits. But our goals cannot be met without your support, and membership dues alone cannot sustain the future we hope to achieve.

8 Ways You Can Help the World Future Society

1. Make a generous, tax-deductible donation to the Society. Donors are gratefully acknowledged in THE FUTURIST each year, and those who donate student scholarships for the conference are also acknowledged in the conference program. Donate online at www.wfs.org/support 2. Volunteer your expertise in fund-raising, grant-writing, sponsorship sales, and partnership program development. Contact me, Tim Mack, at tmack@wfs.org or 301-656-8274. 3. Renew your membership—NOW! Not a member? Join now, for just $79 a year. Learn more here: www.wfs.org/renew 4. Consider giving gift memberships to all your friends, family, neighbors, clients, colleagues, mentors, and mentees. The first gift is $79, and the rest are just $65 each: www.wfs.org/gifts 5. Consider giving gift student memberships, just $20 a year each for fulltime students under age 25. 6. Become an Institutional Member, enabling your organization to receive all publications produced by the Society and special assistance in finding resources and making connections tailored to meet your needs. Learn more at www.wfs.org/benefits 7. Become a Professional Member, entitling you to a subscription to World Future Review and exclusive invitations to the annual Professional Members Forum, in addition to all the other benefits of Society membership. Learn more at www.wfs.org/professional 8. Register for WorldFuture 2014, to be held July 11-13 in Orlando, F lorida. There is no better place to express your own ideas and pick up new ones. And there are many other ways that you can help spread the word about the World Future Society and its mission, resources, and activities: • Sign up to receive Futurist Update, the World Future Society’s free monthly e-mail newsletter, and share it with your own network of co-workers, friends, family, or clients: www.wfs.org/content/futurist-update • Follow the Society on Twitter, Facebook, LinkedIn, and other social- networking venues. • Join and help build a network or local chapter of futurists to share ideas and practices. Learn more about futurist groups, in both the real and virtual worlds, at www.wfs.org/chapters By taking action now, you will help the Society to sustain the services we have, develop new and useful services and products, promote educational efforts, and support the work of practicing futurists. With a general public educated to the benefits of futures studies, the field can only grow stronger—more people and organizations will recognize the critical need for foresight, because the future matters. Thank you for your support—now and in the future! Take care,

Tim Mack President tmack@wfs.org

Extending Pet Longevity:

Our Companions in Sickness and in Health By Rick Docksai Pet owners everywhere would like for their companion animals to live longer, and veterinary medicine is finally making that possible. Emerging developments in gene therapy, cancer treatments, surgery, and nutrition have the potential to give our four-legged friends many more years of life.

uman life spans have expanded dramatically in the last hundred years and could expand even more in the next hundred, thanks to progress in medicine. Yet, our dogs, cats, and other domestic animals are living only marginally longer than their ancestors. This might not be so for too much longer, however. Veterinary medicine is evolving. Injuries or illnesses that would have consigned a dog or cat to euthanasia just a few years ago are now very treatable. And more progress is yet to come, thanks to promising recent breakthroughs in genetics, along with continuing improvements in nutrition, surgery, and disease treatment. A dog today can enjoy 12 to 15 years of life, on average. Don’t be surprised, however, if it becomes normal late in this century for a dog to still be alive and tail-wagging at age 20 or 25—or even 30! Domestic dogs have been in our homes and lives for the past 10,000 years, according to anthropologists. But Labrador retrievers, Chihuahuas, whippets, and the thousands of other breeds we know today only came into being over the last few centuries. Dogs of 8000 BCE looked much more like wolves, their feral cousins. We all know how those ancient domestic dogs became today’s dogs: breeding.

BUDABAR / BIGSTOCK

Humans still selectively breed dogs, and other animals, as well. But one crucial difference sets today’s breeding apart: This is the “genetic age.” After J. Craig Venter and colleagues successfully sequenced the human genome circa 2000, other research groups went on to sequence the genomes of chimpanzees, dogs, pigs, horses, cats, chickens, and alpacas. Knowing an animal’s genome is a key to knowing the genes that compose it—and that, in turn, is the key to learning how to modify those genes as desired. The end result: the same animal breeds we know and love, sans the ailments that make their lives all too short. The University of California–Davis School of Veterinary Medicine is a hub of noteworthy work in this area. Its geneticists made key contributions to the mapping of horse, dog, and cat genomes, and they’re now figuring out how to apply this knowledge toward preventing and treating diseases. They have already discovered a genetic mutation for polycystic kidney disease in Persian cats, for example, and have created a diagnostic test that screens for the gene in kittens as young as eight weeks old. The school’s cardiologists, meanwhile, have found the gene mutation responsible for hypertrophic cardiomyopathy, the most common cause of feline heart disease. Another research group at UC– Davis identified a gene mutation that causes Dalmatians to suffer bladder stones and excessive uric acid levels, and they developed a diagnostic tool for breeders to screen it out of their litters. Still other UC– Davis researchers are getting to the bottom of the genetic factors for the canine ailments hyperuricosuria, brachycephaly, Alaskan Husky encephalopathy, spinal dysraphism in Weimaraners, and autoimmune hypoadrenocorticism in Nova Scotia Duck Tolling Retrievers. It’s the same process that breeders have been engaged in since the first domestic dogs. But whereas breeders through the ages have had only blind trial-and-error to guide them and have only been able to see the 48

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outcome of a mating after the puppies have been born, genetics can now let us control the outcomes from the moment of cell conception. What might have taken traditional breeders many generations of pups being born, maturing, and mating may now be done in one laboratory experiment. “It was humans who created all those breeds of dogs over thousands of years. Now we can do it more quickly with genes,” says José Luis Cordeiro, futurist and technologist who founded the World Future S o c i e t y ’ s Ve n e z u e l a c h a p t e r. Cordeiro has written and spoken extensively on genetics, among many other cutting-edge areas of technological innovation. The University of Pennsylvania hosted a remarkable test case in the new technology in 2013, in an experiment that gave sight to three puppies that had been blind from birth. The researchers identified a gene that codes for certain vital proteins in the eye—the puppies had a mutated gene that left this protein coding out. Next, the researchers synthesized a new version of the gene that did code for the protein. Then they planted it inside viruses and injected the virus into the puppies’ eyes. The virus “infected” the dogs’ eyes with the gene, and a month later, the puppies could see. Using viruses to implant new genes is actually an increasingly common practice, according to Emily Anthes, a science writer who described several such experiments in her book on animal bioengineering, Frankenstein’s Cat: Cuddling Up to Biotech’s Brave New Beasts (Farrar, Straus and Giroux, 2013). The viruses don’t make their hosts sick, but they do infiltrate the host’s cells and, in so doing, introduce the new gene into the host’s system. “Whatever the functional version of the gene is, they’ll place it in a virus and they inject it into the relative system in a dog, and the virus does what it does best: infects the dog’s body and implants the functional gene to replace the version of the gene that’s gone haywire,” says Anthes. www.wfs.org

If we can engineer blindness out of dogs, then we could surely engineer many more disorders from them, too—including those that kill them, such as diabetes, dementia, and cancer. The National Institutes of Health did something like this for mice in 2013. Toren Finkel of the National Heart, Lung, and Blood Institute led some colleagues in engineering mice so that their bodies would produce just a quarter of the usual levels of mTOR, a protein that regulates cell growth, metabolism, and energy balance. The engineered mice grew up smaller than average but lived 20% longer: median life span of 28 months among the males and 31.5 months among the females, as opposed to 22.9 and 26.5 months for average male and female mice. Genetic engineering won’t work for every condition, however. Many human and animal disorders have multiple genes behind them, and many individual genes code for many traits and functions. Deleting multiple genes in a dog’s genome would be very risky—change one gene, and we might negate the dog’s stomach cancer risk but inadvertently set the dog up for heart failure and brain death. Anthes looks forward to gene alterations becoming more common for a specific range of conditions—i.e., those in which the disorder is attributable to one solitary gene.

Making Old Cells Young Again More mouse life extension took place in 2012 at the University of Pittsburgh’s School of Medicine. A research team headed by Johnny Huard, professor of orthopedic surgery, microbiology, and molecular genetics, and Laura Niedernhofer, associate professor of microbiology and molecular genetics, obtained stemcell-like progenitor cells from several young mice and injected them into older mice that had been specially bred to age too quickly and were consequently showing advanced age-related physical decline, including major muscle loss. After the injections, the mice regained their muscle mass and lived two to three times longer

than expected: They were supposed to live 21 to 28 days, but some lived 66 days or even longer. According to Niedernhofer, as a human or animal’s body ages, many of its tissues come down with “stem cell dysfunction”—i.e., the cells don’t replicate and reproduce like they used to, so the tissue can’t repair itself or replace dying cells. So, halt the stem cell dysfunction, and you’ll slow age-related body damage. Cordeiro has an additional suggestion: Let’s look more closely at the cells that don’t age. He distinguishes somatic cells, the ones that constitute most of our and animals’ bodies’ tissues, from germinal cells, which include stem cells and many singlecelled microbes, such as bacteria. Somatic cells grow old and die; the germinal cells do not. A bacterium can live indefinitely, as long as it has stable food sources and isn’t eaten by a larger microbe. “Bacteria are basically immortal,” he says. “Life originated to live, not to die, and that is why bacteria basically do not age. It was with multicellular organisms and sex that the aging process began, since some cells specialized in reproduction and continuing life—the germinal cells— and other cells just supporting them—the somatic cells.” There are other cells that seem to live forever or close to it. Plant cells are among these, hence the forests whose trees are centuries old. Unfortunately for us and our four-legged pals, cancer cells are also germinal— they are deadly specifically because they live on and keep replicating when the body needs for them to die. If we study all of these cells further and discern what keeps them going, we may find ways to keep healthy cells living longer, too. Cordeiro notes one such clue in telomerase, an intracellular compound that sustains cells’ genomes. All cells have it, but they lose it gradually throughout their lives. Once it is gone, the cells can no longer replicate. Cancerous cells, however, somehow regenerate their telomerase supplies and keep going. Researchers in both human and veterinary medicine have been studying telomerase over the past 15

years to look for ways to use it constructively to give new life to aging healthy cells. There’s a huge difference between a bacterium and a dog. But both have DNA, and both run at the cellular level with many of the same enzymes and molecular processes. Further studies of bacteria could thus offer us some clues for keeping dogs and other pets alive. We also have some multicellular life forms that can teach us secrets to living longer. Cordeiro notes that lobsters can live a hundred to two hundred years before being killed and served up as dinner entrées, and that they show no signs of aging throughout. Certain water-dwelling

veterinary researchers have devised a very promising new tool for minimally invasive cancer treatment called the Varian Novalis Linear Accelerator, which zaps cancerous tumors with concentrated beams of radiation instead of scalpels or, worse, chemotherapy regimens. Using radiation to kill cancerous cells has been a treatment choice for both animal and human patients for a long while, although the radiation’s tendency to damage healthy cells near the tumors has made physicians and veterinarians alike reluctant to use it in many cases. North Carolina State’s device softens the treatment’s adverse impacts considerably, however, by utilizing

“There’s a huge difference between a bacterium and a dog. But both have DNA, and both run at the cellular level with many of the same enzymes and molecular processes. Further studies of bacteria could thus offer us some clues for keeping dogs and other pets alive.”

organisms, including hydra, planarian flatworms, tardigrades, and Turritopsis jellyfish, also pass the hundred-year mark with ease. “Longevity research is just beginning, and we do not know where it will lead us to, but we can certainly see that somatic cells in multicellular organisms can copy longevity characteristics from germinal cells, and also from stem cells,” Cordeiro says.

Making Surgery Less Invasive Whether the patient is a human or an animal, surgery always carries risks of complications and long-term aftereffects. Good veterinarians make surgery a last resort and, when they must use it, look for the lowestimpact surgical procedure that will get the job done. As such, the search for “minimally invasive” procedures is a key R&D area. North Carolina State University’s www.wfs.org

two new technologies: Image-Modulated Radiation Therapy (IMRT) and Image-Guided Radiation Therapy (IGRT). IMRT shapes the radiation beam to precisely match the contours of the tumor, so that the healthy tissue and vital organs surrounding the site will be left well enough alone. The IGRT function, meanwhile, uses on-board imaging and CT scanner tools to identify exactly where any single tumor is each day of treatment. The veterinary team can photograph the cancerous sites daily and pinpoint any changes in tumor size or position. Then they can adjust the radiation beams accordingly. The Novalis system’s IMRT and IGRT functions make it a much more attractive treatment for many more cases. Veterinarians in the past have had to write some cancer-stricken pets off as untreatable because the tumors were too close to vital organs •

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May-June 2014

for surgeons to remove them without risking severe organ damage. The Novalis system’s smart radiation beam negates this risk. Veterinarians can use it to excise many new cancerous sites that had up until now been beyond their reach. Moreover, treatment time could be much shorter and pose far fewer side effects—which could greatly up the chances that a pet owner will decide that more cancer treatments for his or her pet will be worth it. “The Varian Novalis will be able to treat some types of tumors and cancers that could not be treated with previous machines and technology,” says Mike Nolan, NC State assistant professor of radiation oncology and biology. UC–Davis is making similar strides forward in minimally invasive surgery. The campus’s One Health Institute, which fosters integrated research into human health, animal health, and ecology, is pioneering a new technique to deliver chemotherapy drugs directly into any tumors deep within a dog’s skull. Neurologists at the institute have used the procedure on several dogs, and the results have been so encouraging that they are now adapting it to use as a treatment for people. As surgical options such as these improve, veterinarians will gain more and more capability to treat animal cancers that they would previously have written off as untreatable. That’s important, since more than 50% of dogs and 33% of cats will develop some form of cancer during their lifetimes, according to NC State data.

Improved Pet Nutrition Ask any historian why we humans are living longer today than we were in the 1700s, and chances are one of the reasons given is: “We’re eating better.” Most of us have far more proteins, vitamins, and minerals in our diet than people 250 years ago did, and certainly, the nutrients in our diet strongly affect our chances for living long and healthy lives. The same holds true for our pets. UC–Davis studies have determined that cats, like people, need daily 50

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doses of chloride and vitamins A, B, D, and K; pregnant female cats that get enough daily zinc will be less likely to give birth to kittens with cleft palates. The supplement L‑Carnitine isn’t just for humans. Studies find that dogs need it, also, for their circulatory systems and muscles, and that canine heart disease is much less common and less acute in dogs that have enough L-Carnitine in their diets. The pet food industry has caught on to this and now has been selling L ‑ C a r n i t i n e s u p p l e m e n t s a n d L ‑Carnitine-enriched dog food for the past decade. How effective are they? Just ask Matthew Bryce Deutsch, a Maryland resident who has raised two shih tzus. One of them came down with heart palpitations. At the suggestion of Bill Faloon, a colleague and director of the Life Extension Foundation, he began feeding her daily L‑Carnitine supplements. The heart palpitations subsided considerably. It doesn’t surprise Deutsch much that the same nutrients that boost human longevity can help other mammals live longer, too. Our anatomy and theirs are a lot more similar than surface-level appearances would suggest, he notes: Ignore their fur, tails, snouts, and claws, and you find the same basic muscles and organ tissues in us and them, albeit in different sizes and shapes. “They’re basically us. It’s just that their organs are disproportionate. All mammals are basically the same except for their shapes and organ proportions,” says Deutsch. “Even rats have all the same organs that we do and muscles that we do. They just have their organs in different proportions.” That said, our pets also have some unique nutritional needs of their own. Researchers are finding these, too, and advising pet food companies accordingly. For example, UC– Davis researchers discovered the mitigating effect that the nutrient taurine has on feline dilated cardiomyopathy, a heart disorder that kills large numbers of cats. Many lines of www.wfs.org

cat chow are now taurine-enriched, and the cats have less heart disease to show for it.

New Pathways to Pet Health Human medical care has seen massive growth of specialized fields of care over the last 30 years. Veterinary care has, too. New fields of urology, neurology, and orthopedics have cropped up within veterinary hospitals, thanks to each discipline having more tools at its disposal and more training required to properly use them all. Boaz Arzi, assistant professor of veterinary dentistry and oral surgery at UC–Davis, sees it firsthand in new integrations taking place between veterinarians and researchers in other fields, such as bioengineering. He also sees it in the proliferation of new specialized-training programs over the last few years. A residentin-training at the UC–Davis veterinary school can now attend any of a wide array of three-year specialized programs, on top of the generalpractice fundamentals that the basic veterinary accreditation covers. Arzi himself benefited from this specialized-training option and attests to the many more career opportunities that it makes possible. “The training in veterinary dentistry and oral surgery in combination with training in biomedical engineering did wonderful things for my career and opened many doors,” he says. Good medical care isn’t cheap, unfortunately. We can expect veterinary care to become pricier and pricier, just like human medical care. And some of the cost drivers will be the same: higher-cost procedures to keep older patients—in this case, animal patients—living longer. But it’s a price that the human pet owners will, by and large, be willing to pay. Some soften the financial burden via insurance. The pet-insurance market is small but growing and could become a significantly sized industry in years to come. “I think certainly history has shown that pet owners will not spare any expense in taking care of their

pets,” says Anthes. “There has been a growth in end-of-life care and intervention for animals, and there will be a demand for these technologies.”

Healthier Humans, Too You don’t have to be a pet owner to benefit from all these advances in veterinary health. Thanks to the similarities of these animals’ bodies to ours, a treatment that saves an animal’s life often turns out to work well in people, as well. Modern medicine teems with medical treatments that first went into use in veterinary clinics. Many more are sure to follow, especially as new treatments under development at UC– Davis, NC State, and other institutions described above gain traction. “Both animals and humans may serve as a ‘disease model’ for each other and, when applicable, we integrate treatment approaches accordingly,” says Arzi. An example is the mTOR mouseengineering experiments. Finkel is hopeful that human Alzheimer’s patients could gain more years and undo some of the disease’s damage if

they undergo protein modifications like that which he and his colleagues achieved in the mice. The researchers intend to nail down exactly how aging in mice and human cells occurs at the molecular level. “Aging mechanisms seem to follow similar patterns in multicellular organisms, and once we discover some of these patterns in one species, we will be able to use them for other species,” says Cordeiro. Cancer research for humans is also moving forward more quickly, thanks to veterinary R&D. IMRT and IGRT therapies are now in use in human cancer surgery and are already saving human lives just as they are pets’ lives. When his first shih tzu died, Deutsch took a step that some might call extraordinary: He had her cryogenically frozen, in anticipation of tissue-regeneration or cloning technologies one day becoming sophisticated enough to bring her back. “These dogs were like siblings to me. And 15 years of life just isn’t enough. It’s not fair that I get to live so long a life and they couldn’t,” says Deutsch.

Many more pet owners besides Deutsch have frozen their pets, and for the same reason. Their sentiment is understandable. And the science is, in fact, quite sound—research into methods for regenerating and replicating cells is going places and could very well “resurrect” dead animals within our lifetimes. But what if we don’t have to wait until a future time to bring our dying pets back? Suppose that we can heal their bodies here and now and not have to freeze them in the first place. That, too, is a hope that dog owners—and cat owners, horse owners, and owners of just about any other pet or farm animal besides—can cling to, thanks to the real-life breakthroughs that researchers at UC–Davis, North Carolina State University, and other institutions are bringing forth. ❑ About the Author Rick Docksai is senior editor of THE FUTURIST. E‑mail rdocksai@wfs.org.

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S P E C I A L

A D V E R T I S I N G

S E C T I O N

CONSULTANTS AND SERVICES

listing of consulting futurists. For information about being listed in the directory, published in every issue of THE FUTURIST and available on the Web at www.wfs.org, call Jeff Cornish toll free at 1-800-989-8274 or 301-656-8274, or e-mail jcornish@wfs.org.

Karl Albrecht International

Center for Strategic Futurist Thinking

Common Sense Medicine

San Diego, CA U.S.A. Phone: 858-836-1500 E-mail: futures@KarlAlbrecht.com Web: KarlAlbrecht.com Contact: Dr. Karl Albrecht Planning a conference? Include a “Futures Update” keynote by renowned futurist Dr. Karl Albrecht.

46 B/4 Jerusalem St., Kfar Saba, Israel 44369 Phone: 972-54-558-7940 Fax: 972-9-766965 Web: www.futurist-thinking.co.il E-mail: bisk@futurist-thinking.co.il Contact: Tsvi Bisk Strategic futurism: “Getting from Here to There” (Keynote speaker) Jewish, Mid-East and Mediterranean Futures (consulting).

Alsek Research Economic Futures

Christensen Associates, Inc.

812 W. 8th St., Suite 2A, Plainview, TX 79072 Phone: 806-291-0700 Fax: 806-293-8229 E-mail: drjonzdo@yahoo.com Web: www.commonsensemedicine.org Contact: Lon Jones DO, Jerry Bozeman M.Ed., LPC Adaptations today are the future. The authors of The Boids and the Bees tell how to guide adaptations in our living systems: healthcare, education, economy, even us.

7650 S. McClintoch Dr., #103-233 Tempe, AZ 85284 Phone: 480-225-2507 E-mail: jfoltz@alsekresearch.com Web: www.alsekresearch.com Contact: Joan Foltz Keynotes, workshops, and anticipatory analysis of global markets, investing, and business structures. Author of Market Whipped: And Not By Choice.

8168 Manitoba St., No. 2, Playa Del Ray, CA 90293-8291 Phone: 310-578-0405 Fax: 310-578-0455 E-mail: chris@camcinc.com Web: www.camcinc.com Contact: Chris Christensen, CMC Avoid devastating surprises! Exploit ANY future! Stimulating and entertaining keynotes, workshops, assessments, and consulting.

Alternative Futures Associates 100 N. Pitt St., Suite 307, Alexandria, VA 22314-3134 Phone: 703-684-5880 Fax: 703-684-0640 E-mail: futurist@altfutures.com Web: www.altfutures-afa.com Contact: Clement Bezold, Jonathan Peck, Eric Meade Vision and scenario development, strategic planning, trend analysis, workshop design and facilitation, presentations, keynotes, consulting.

Atlas Safety & Security Design, Inc. 770 Palm Bay Ln., Suite 4-I, Miami, FL 33138 Phone: 305-756-5027 Fax: 305-754-1658 E-mail: ratlas@ix.netcom.com Web: www.cpted-security.com Contact: Dr. Randall Atlas, AIA, CPP Pioneers in crime prevention through environmental design. Design of jails, prevention of premises liability lawsuits.

Aviv Consulting 15363 NE 201st St. Woodinville, WA 98072 Phone: 425-415-6155 E-mail: avivconsulting@gmail.com Web: www.avivconsulting.com Contact: Aviv Shahar Helping leaders and teams develop their vision and design the future. Innovation, strategy, coaching, consulting, retreats.

Joseph F. Coates, Consulting Futurist, Inc. 5420 Connecticut Ave. NW, #619 Washington, DC 20015-2832 Phone 202-363-7440 Fax 202-363-4139 Email: joe@josephcoates.com Web: www.josephcoates.com The future is my business: futures research, consultation, trend analysis, scenario development, visioning, scientific, technological and social forecasting, training, briefings, workshops, presentations and keynotes. Coates has been one of the most frequently cited authors in Future Survey and one of the most popular speakers at the World Future Society annual meetings. He is the author or co-author of six books, most recently A Bill of Rights for 21st Century America, and of 2025: Scenarios of US and Global Society Reshaped by Science and Technology. He has had assignments from half of the Fortune 100 firms, and has had published 290 articles on the future since 1990. He is also responsible for 200 proprietary reports to business, government and association clients. Coates will enlighten you on the future of any subject. Prepare for an unforgettable encounter.

Creating the Future, Inc. with Edward D. Barlow, Jr. 2907 Division St., Suite 109, St. Joseph, MI 49085 Phone: 269-982-1830 Fax: 269-982-1541 E-mail: info@creatingthefuture.com Web: www.creatingthefuture.com Contact: Ed Barlow (staff: Sandy, Tammy, and Tresea) Relating influences of a changing world to industries, organizations, professions, communities. Presentations, strategic planning facilitation.

CREO Strategic Solutions 7710 Woodmont Ave., #211, Bethesda, MD 20814 Phone: 301-656-1034 Contact: Kevin Fickenscher, MD Email: drkevin@creostrategicsolutions.com Healthcare is undergoing dramatic change that extends far beyond the financing of healthcare. Understanding and embracing the future is critical. Keynotes, workshops, leadership training, strategic advisory services and consulting.

de Bono For Business 248 W. Loraine St., #103, Glendale, CA 91202 Phone: 818-507-6055 E-mail: info@LyndaCurtin.com Web: www.deBonoForBusiness.com Contact: Lynda Curtin, the Opportunity Thinker Lift your thinking. Learn breakthrough futurist tools—lateral thinking, six thinking hats. Workshops. Keynotes. Facilitation.

FutureManagement Group AG Wallufer Strasse 3a, Eltville, Germany D-65343 Phone: 49-6123-7 55 53 Fax: 49-6123-7 55 54 Web: www.FutureManagementGroup.com E-mail: Office@FutureManagementGroup.com Contacts: Pero Micic, Claudia Schramm Use the “Eltville Model” of FutureManagement to see more of the future than your competitors!

Future Problem Solving Program International, Inc. 2015 Grant Pl., Melbourne, FL 32901 Phone: 321-768-0078 Fax: 321-768-0097 E-mail: mail@fpspi.org Web: www.fpspi.org Contact: Marianne Solomon, Executive Director FPSPI is an established educational program that provides a 6-step problem solving process to assist students as they think about the future.

The Futures Corporation 1109 Main St., Ste. 299A, Boise, ID 83702 Phone: 208-345-5995 Fax: 208-345-6083 E-mail: JLuthy@futurescorp.com Web: www.futurescorp.com Contact: Dr. John Luthy Strategic thinking/planning; evolving leadership; organization redesign/development; trend analysis; scenario planning; business growth strategies.

The Futures Lab 2130 Goodrich Ave., Austin, TX 78704 Phone: 512-468-4505 E-mail: dwoodgate@futures-lab.com Web: www.futures-lab.com Contact: Derek Woodgate International futures-based consultancy specializing in consumer, business futures. Leaders in the future potential business.

Futurist Speaker Thomas Frey DaVinci Institute, 511 E South Boulder Road, Louisville, CO 80027 Phone: 303-666-4133 E-mail: deb@davinciinstitute.com Web: www.futuristspeaker.com Contact: Debra Frey Thomas Frey is Google’s top-rated futurist speaker and IBM’s most award-winning engineer. Author of Communicating with the Future—the book that changes everything. Speaking topics: future of business, work, education, transportation, government, and more.

The Greenway Group 25 Technology Pkwy. South, Suite 101, Norcross, GA 30092 Phone: 678-879-0929 Fax: 678-879-0930 E-mail: jcramer@di.net Web: www.greenway.us Contact: James Cramer, chairman Strategic change, trends, forecasts, research. Architecture and design technology. Journals: Design Intelligence. Publications: The Almanac of Architecture & Design, How Firms Succeed, Design + Enterprise, Leadership by Design, Communication by Design, Value Redesigned.

H.G. Hudson and Associates

KAIROS Future AB

34 Warren Dr., Newport News, VA 23608 Phone: 757-874-5414 E-mail: HUDSON2059@msn.com Contact: Henry G. Hudson, president and CEO Management consulting help in advanced administrative services, operations, systems, methods, procedures, policies, strategy, and management.

P.O. Box 804, S-10136 Stockholm, Sweden Phone: (46 8) 545 225 00 Fax: (46 8) 545 225 01 E-mail: info@kairosfuture.se Web: www.kairosfuture.se Contacts: Mats Lindgren, Anna Kiefer Values, work, technology, marketing. Methods: scenarios, studies, lectures, seminars, consulting. Public and private sectors.

Innovation Focus Inc. 111 E. Chestnut St., Lancaster PA 17602-2703 Phone: 717-394-2500 Web: www.innovationfocus.com Contacts: Christopher W. Miller, Ph.D.; Anne Orban, M.Ed. Innovation Focus is an internationally recognized consulting firm that brings innovation to all stages of product life cycle management and provides proven processes for deep customer understanding and meaningful innovation. Clients include: Kraft Foods, Kimberly Clark, WD-40, Bristol-Myers Squibb.

Institute for Alternative Futures 100 N. Pitt St., Suite 307, Alexandria, VA 22314-3134 Phone: 703-684-5880 Fax: 703-684-0640 E-mail: futurist@altfutures.com Web: www.altfutures.com Contacts: Clement Bezold, Jonathan Peck, William Rowley, MD Uses research reports, workshops, scenarios, and visioning to help organizations understand future possibilities and create their “preferred future.”

Institute for Global Futures 2084 Union St., San Francisco, CA 94123 Phone: 415-563-0720 Fax: 415-563-0219 E-mail: info@globalfuturist.com Web: www.GlobalFuturist.com Contact: Dr. James Canton Futures based keynotes, consulting and research for any vertical industry by leading futurist James Canton.

Institute for Participatory Management and Planning P.O. Box 1937, Monterey, CA 93942-1937 Phone: 831-373-4292 Fax: 831-373-0760 E-mail: ipmp@aol.com Web: www.ipmp-bleiker.com Contacts: Annemarie Bleiker, Hans Bleiker, Jennifer Bleiker We offer a Leadership Boot-Camp for guiding complex problem-solving and decision-making efforts.

Leading Futurists LLC 4420 49th St., NW, Washington, DC 20016 Phone: 202-271-0444 E-mail: jbmahaffie@starpower.net Web: www.leadingfuturists.biz Contacts: John B. Mahaffie, Jennifer Jarratt Futures consulting, workshops, scenarios, research, keynote talks to help organizations discover new opportunities and challenges. Members, Association of Professional Futurists.

MG Rush Performance Learning 1301 W. 22nd St., Suite 603, Oak Brook, IL 60523 Phone: 630-954-5880 Fax: 630-954-5889 E-mail: futurist@mgrush.com Contacts: Terrence Metz, 630-954-5882; Kevin Booth, 630-954-5884 Facilitation of, and facilitator training for: scenario planning, strategy development, group decision-making, workshop design, ideation, option development and analysis, and training of facilitative leadership.

Minkin Affiliates 135 Riviera Dr., #305, Los Gatos, CA 95032 Phone: 408-402-3020 E-mail: barryminkin@earthlink.net Web: minkinaffiliates.com Contact: Barry Minkin Keynote speaker, bestselling author, global management consultant, three decades linking emerging trends to consumer and market strategy.

Next Consulting 104 Timber Ridge Rd., State College, PA 16801 Phone: 814-237-2575 Fax: 814-863-4257 E-mail: g7g@psu.edu Web: nextconsulting.us Contact: Geoffrey Godbey, Ph.D. Repositioning leisure/tourism organizations for the near future. Speeches, ideation, imagineering. Client list on request.

More consultants and services, next page www.wfs.org

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Consultants

and

Services

Jim Pinto Technology Futurist 2805 Ocean St. #2, Carlsbad, CA 92008 Phone: 858-353-5467 E-mail: jim@jimpinto.com Web: www.JimPinto.com Contact: Jim Pinto Speaker and consultant: technology futures, industrial automation, global business trends, Internet business relationships.

Pinyon Partners LLC 140 Little Falls St., Suite 210, Falls Church, VA 22046 Phone: 703-651-0359 E-mail: pshoemaker@pinyonpartners.com Web: www.pinyonpartners.com Contacts: Peter B.G. Shoemaker; Dan Garretson, Ph.D. Quantitative and qualitative. Art and Science. However you want to characterize it, our distinctive combination of the hard-nosed and the deeply intuitive is perfectly suited for those navigating over the horizon. Expansive explorations of what’s next; engaging engagements with change; consultations, workshops, research, and talks aimed at creating future-oriented clarity, purpose, insight, and confidence. Member, Association of Professional Futurists.

Qi Systems 35 Seacoast Terr., Apt. 6P, Brooklyn, NY 11235 Phone: 718-769-9655 E-mail: QiSys@msn.com Web: www.qisystems.org Contact: Ronn Parker, Ph.D. Spectrum Counseling: conflict resolution, conscious evolution, martial arts, meditation methods, mindbody strategies, transformational learning.

David Pearce Snyder, Consulting Futurist The Snyder Family Enterprise, 8628 Garfield St., Bethesda, MD 20817-6704 Phone: 301-530-5807 Fax: 301-530-1028 E-mail: david@the-futurist.com Web: www.the-futurist.com Contact: Sue Snyder High-impact motivating presentations. Strategic assessments, socio-technologic forecasts/scenarios. Keynote addresses, strategic briefings, workshops, surveys.

Strategic Futures® Strategic Futures Consulting Group, Inc. 113 South Washington St., Alexandria, VA 22314 Phone: 703-836-8383 Fax: 703-836-9192 E-mail: info@strategicfutures.com Web: www.strategicfutures.com Contact: Ron Gunn or Jennifer Thompson

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Strategic planning, succession planning including mentoring, executive coaching, organizational change facilitation, and matrix management assistance.

Town and Gown Relations

455 Hazelwood Avenue, San Francisco, CA 94127 Phone: 415-298-3008 E-mail: info@synovationsolutions.com Web: www.synovationsolutions.com Contacts: Bruce L. Tow, David A. Gilliam Future-is-now resources to help you achieve key and mission-critical breakthroughs or creatively evolve your business to meet future challenges.

Kemp Consulting, LLC P. O. Box 342, Meriden, CT 06450-0342 Phone: 203-686-0281 E-mail: rlkbsr@snet.net Web (consulting): www.rogerlkemp.com Web (background): www.rogerkemp.org Contact: Roger Kemp, MPA, MBA, PhD, President Dr. Kemp has been author and editor of over a dozen books dealing with issues relating to cities (towns) and colleges (gowns). He gives keynote speeches, strategic briefings, and does futures research and consulting on emerging trends dealing with the dynamic and evolving field of town-gown relations.

Synthesys Strategic Consulting Ltd.

21st Century Learning LLC

SynOvation Solutions

Belsize Park, London NW3 UK Phone: 44-207-449-2903 Fax: 44-870-136-5560 E-mail: www.hardintibbs.com Web: www.synthstrat.com Contact: Hardin Tibbs, CEO Synthesys specializes in using futures research to develop innovative strategies. Based in London UK, with international experience in both the public and private sectors, across many different industries. Projects include horizon scanning, strategic sense-making, scenarios, vision building, assumption testing, and strategy formulation, either as expert input or by co-production directly with leadership teams.

The TechCast Project Department of Information Systems & Technology Management, George Washington University, Washington, D.C. 20052 Phone: 202-994-5975 E-mail: Halal@gwu.edu Web: www.techcast.org Contact: William E. Halal, professor, George Washington University; president, Techcast LLC TechCast is an online research project that pools the knowledge of 100 experts worldwide to forecast breakthroughs in all fields of science and technology. Results are updated in real time and distributed to corporations, governments, and other subscribers to aid in their strategic planning. The project has been featured in The Washington Post, Newsweek, The Futurist, and various journals. The National Academies consider TechCast among the best systems available, and Google ranks it No. 2 or 3 out of 45 million hits. TechCast also gives presentations, conducts customized studies, and performs most types of consulting related to technology and strategic change.

www.wfs.org

10 Jamaicaway, Suite #18, Boston, MA 02130 Telephone: 978-204-2770 Email: charlesfadel@gmail.com Web: www.21stcenturyskillsbook.com Contact: Charles Fadel, founder and best-selling author: 21st Century Skills; visiting scholar, Harvard GSE and MIT ESG. Education’s futures, as impacted by Technology, and along the dimensions of Knowledge, Skills, Character, and Metacognition. Keynotes and seminars on global education; education technology; neuroscience of learning; creativity & innovation; artificial intelligence & augmented intelligence.

van der Werff Global, Ltd. 4958 Crystal Circle, Hoover, AL 35226 Phone: 888-448-3779 Fax: 888-432-9263 E-mail: terry@globalfuture.com Web: www.globalfuture.com Contact: Dr. Terry J. van der Werff, CMC Confidential advisor to corporate leaders worldwide on global trends, executive leadership, and strategic change.

Weiner, Edrich, Brown, Inc. 200 E. 33rd St., Suite 9I, New York, NY 10016 Phone: 212-889-7007 Fax: 212-679-0628 E-mail: info@weineredrichbrown.com Web: www.weineredrichbrown.com Contact: Arnold Brown, Edie Weiner For over two decades, the pioneers in detecting emerging trends and linking them to a ction.

Xland sprl 111 Av Grandchamp, Brussels, Belgium 1150 Phone: 32-475-827-190 Fax: 32-2-762-46-08 Web: www.xland.be E-mail: xland@skynet.be Contact: D. Michel Judkiewicz Trend analysis, scenarios, forecasting opportunities/threats based on strong and weak signals for resilient strategies.

Reviews A Call to Eco-Action Beyond the Babble By Rick Docksai

More recycling, more alternative energy, and reduced carbon footprints —these are good, but they aren’t enough for a truly sustainable future, the Worldwatch Institute argues in State of the World 2013. What’s needed is a deeper, systemic transition toward a new human civilization that lives within the bounds of Earth’s finite resources. Countless words are expended nowadays over averting climate change and ensuring sustainability, but only so many have meaningful actions behind them, the Worldwatch Institute notes in its annual report, State of the World 2013. The report inveighs against what the authors call “sustainababble”—i.e., empty rhetoric about the environment and our use or abuse thereof. An airline that boasts of using 100% recycled cardboard while its o v e r a l l o p e r a t i o n s re m a i n a s resource-consumption-heavy as ever exemplifies sustainababble. So does the United Kingdom’s claim in 2012 that it was aiming for “the first sustainable Summer Olympics” when it hosted the Games that year. Whether the Games are environmentally “sustainable” or not, Worldwatch doesn’t have much confidence in the permanence of the Olympics or, for that matter, any fixture of modern life. Humanity’s chronic exploitation of the planet’s

resources runs so Worldwatch authors’ deep that all the posview. itive developments So, what does their in renewable energy, ideal society look recycling, environlike? It may look like mentally responsible Cuba. One chapter, business, and worldco-authored by Pat wide awareness of Murphy and Faith climate change put Morgan of the Artogether are not thur Morgan Instienough. What’s tute for Community needed is far more Solutions, encourdramatic action toages the world to folward resource-wise low the “Cuban exliving than we have ample.” They write ever taken before. admiringly of Cuba’s “Through overuse, State of the World 2013: Is downsizing of carthe words sustainable Sustainability Still Possible? by bon-dioxide emisthe Worldwatch Institute. Island and sustainability lose sions and its repurPress. 2013. 442 pages. $22. meaning and imposing of most pact,” the authors industry toward write. “Worse, frequent and inappro- meeting human needs rather than priate use lulls all of us into dreamy economic growth. And Cuba having belief that all of us—and everything made the necessary lifestyle changes we do, everything we buy, everything in light of the worldwide trade emwe use—are able to go on forever bargo is significant, too—the whole and ever, world without end, amen. world may face similar supply This is hardly the case.” shocks and have to make similar sacThe authors call upon the world rifices due to climate change and community to scrutinize every one natural resource depletions, they of its behaviors and to judge objec- write. tively which ones really are capable Other chapters find beacons of of going on indefinitely. Far more hope for sustainability in the demohuman activity falls short of this cratic world, too. For example, the ideal than we might like to think, Transition Towns movement, by they argue. Hence, true sustain which individual communities deability will be a far harder goal to velop neighborhood-based action achieve than many conservationists plans for car-free transportation, alacknowledge. ternative energy, and local food cul“ We m u s t a c c e p t t h a t t r u e tivation, has been gaining ground in sustainability may not arrive for dec- North America, Europe, Australia, ades, or even centuries, yet we’ll and New Zealand. Some chapters need to be vigilant about making also express approval of the global progress toward it now and at each expansion in energy-efficient buildpoint along the way,” the authors ing construction, and of communiwrite. ties in flood-prone areas developing The sustainability that the world emergency-preparedness and earlyreally needs involves stripping away warning systems. myriad “celebrated entitlements” Agriculture is a particularly promthat people of the affluent nations inent area of concern for the authors: routinely enjoy. These include family They find massive amounts of food pets, air-conditioned homes, pri- waste, poor food storage, energy vately owned cars, and two or more overuse, and too little growth of cliservings of meat a day. Fast food and mate-resilient crops throughout the vending machines proffering soft world’s farming sectors. But they see drinks likewise have no place in a l o c a l i z e d m o v e m e n t s t o w a r d truly “sustainable” economy, in the change, also. One earning plaudits is

Reviews

the Oberlin Project, a collaboration between the Ohio city of Oberlin and its resident campus Oberlin College to revive local crop production and cultivate sustainable economic growth. The authors also recognize the work of the Native Circle of Food Program, which seeks to bring more biodiversity into North America’s food supply by promoting and teaching Native American agricultural and nutritional knowledge. The report additionally praises initiatives to limit pesticide use, discourage food waste, and empower indigenous and rural communities through financial and educational tools. The world has a long way to go before attaining sustainability, nonetheless, the authors agree. And they acknowledge that their vision for sustainable societies is more demanding than the muddled steps toward carbon-emission reductions that world leaders have been attempting over the last few years. In fact, the Worldwatch authors aren’t very optimistic that presentday governments will of their own accord enact the degree of change that is necessary. The world’s people may have to take matters into their own hands—up to and including breaking the law. In a chapter on radical action, Bron Taylor of the University of Florida encourages environmental activists to consider civil disobedience and insurrections, taking inspiration from the nonviolent resistance of Mahatma Gandhi and Martin Luther King Jr. “Given the urgency of the situation, extralegal tactics should be on the table, as they were in earlier causes where great moral urgency was properly felt,” he writes. The Worldwatch Institute’s State of the World reports have been published annually since 1984, and their call for decisive global progress toward sustainability has been consistent throughout. This most recent report not only repeats its predecessor ’s demands, but amplifies them with an even stronger sense of urgency. 56

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Not all of the ideas in State of the World 2013 will be an easy sell— some conservationists may disagree on the unsustainability of pet food, and some technologists hold out much more hope for abundant new alternative energies negating the need for severe diminishments of our lifestyles. Almost all conservationists and conservation-minded global citizens, however, would agree with the authors on the reality of climate change and resource overuse, and of the necessity for our species to act now to mitigate both. They will find many points to consider and models to emulate in State of the World 2013. About the Reviewer Rick Docksai is senior editor of THE FUTURIST. E‑mail rdocksai@wfs.org.

Fleeing from Climate Disruption American Exodus: Climate Change and the Coming Flight for Survival by Giles Slade. New Society. 2013. 271 pages. Paperback. $19.95.

Growing numbers of immigrants are crossing national borders, not in search of better jobs and neighborhoods, but in flight from the harmful consequences of climate change, observes environmentalist and author Giles Slade. He warns that this trend of “environmental re f u g e e s ” w i l l only grow. Industrialized countries such as the United States had better make preparations to accommodate them, he warns—and all countries should make haste to halt further climatechange-exacerbating pollution. Slade tracks Latin American immigration to the United States from the twentieth century to the present. www.wfs.org

While struggling farmers and city workers in Central America and Mexico have been seeking better lives in the United States for generations, their numbers have grown in recent years. The changing climate has much to do with this, he argues. Farmers themselves attest that droughts, heat waves, and declining availability of arable land have been ravaging their home communities and putting farms out of business. The migration will only grow in years ahead and will come to include large masses of U.S. citizens, too, as climate change reduces the carrying capacity of cities and turns previously fertile farmlands into arid wastelands. Don’t expect Canada to be a safe haven, either: Dry spells and wildfires will hammer its forests with increasing frequency, while deadly storms become more commonplace in the cities and suburbs. Nor is the trouble by any means limited to the Americas. Climate change’s impacts are wrecking livelihoods and uprooting communities across the developing world and will continue to do so: By 2050, Slade writes, one out of every nine people on this planet could be homeless. American Exodus is a vivid depiction of what climate change means for the human communities that are in its wake, not only in the Americas, but everywhere across the globe. It’s an ecologically thorough account that audiences of any background and locale may find compelling and—rightly—disconcerting. —Rick Docksai

Becoming More Than Human Human Purpose and Transhuman Potential: The Cosmic Vision for Our Future Evolution by Ted Chu. Origin Press. 2014. 485 pages. $24.95.

Just as it took a significant evolution for life to leave the oceans and settle dry land, it will take another evolution for human life to leave Earth and take up habitation in deep space, states New York University

economist Ted Chu. He looks forward to our species breaking free fully of its present-day physical and mental limitations and becoming “cosmic beings” that can think and function on levels that we cannot even comprehend. Many of us are accustomed to thinking of human nature as fixed and unchanging, he notes, but he expects the future to prove us wrong. Human nature itself will change, and with it most of our existing social systems, all of which are based on conventional notions of human nature that will no longer be relevant in the cosmic-being paradigm. The posthuman cosmic beings will be more rational, more altruistic, and free from the dominion of our base impulses and from the limitations of modern-day human speech and thought. They may even branch out into highly divergent new body types. Chu is open to the possibility of our species becoming many more species. A profusion of biodiversity, comparable to that which gave rise to thousands of new forms of animal and plant life in the prehistoric Cambrian era, could unfold within humanity itself. Our transition toward cosmic beings won’t take place all on its own, however. Chu stresses the importance of individual innovators and change makers of all kinds to moving humanity forward. New technologies, social systems, and social values are forms of evolution, too, and Chu urges all of us to support their creators. Human Purpose and Transhuman Potential is a very philosophical and imaginative discussion about what humanity is and what it could be. Any readers who take an interest in the very far future will find it a worthwhile read. —RD

Robots, AI, and the Coming Paradigm Shifts Pardon the Disruption: The Future You Never Saw Coming by Clayton Rawlings, James Randall Smith, and Rob Bencini. Wasteland Press. 2013. 272 pages. $26.95.

Imagine a courtroom where the judge, lawyers, and jury members are all robots. Or, suppose that most adult workers quit their jobs and have robot companions work and earn paychecks for them. These are just a few of many technological transformations of law and commerce that economic futurist Rob Bencini, defense lawyer James R andall Smith, and former prosecutor Clayton Rawlings suggest could occur in decades ahead. The authors look forward to many longstanding social problems disappearing but warn that some whole new challenges could emerge in their place. The entire human legal profession could eventually find itself unemployed, as new robotic lawyers trump even the best human lawyers in knowledge and capacity to access it to form persuasive arguments in court, the authors argue. And whereas human judges or juries can misread evidence or render flawed verdicts based on emotion and prejudice, their robotic replacements might process the facts objectively and keep the proceedings honest. They might even utilize brain imaging and body-language sensors to tell—with superhuman accuracy— whether a defendant is telling the truth and if he or she is truly contrite and likely to reform. The innovation will come at a price, however. Machines will store and disseminate ever-growing amounts of data about their human users, which can and will be used against us. Also, new legal imbrowww.wfs.org

glios will erupt as human industry leaders challenge their replacement by robots. As courts debate whether to grant personhood to intelligent machines, humans will have uploaded themselves into machines and animals will have undergone cognitive enhancement, attaining human-level intelligence. Governments, meanwhile, will have to formulate new legal mechanisms to govern outer space. Lawyers aren’t the only ones whose jobs could go obsolete: Robots could take over for taxi drivers, firefighters, psychiatrists, truck drivers, and warehouse workers, too. Right now, the authors note, new and improved automated systems are eliminating human jobs on a scale that has no precedent in history. The authors weigh in on whether there will be new jobs in store for the tens of millions of displaced workers—and what those jobs might be. Pardon the Disruption is an invigorating discussion about technology’s capacity for reshaping life on Earth. Any readers with a curiosity about where the future is heading may find this book worth their while. —RD

Brainstorming the Revolution The Social Labs Revolution: A New Approach to Solving Our Most Complex Challenges by Zaid Hassan. BerrettKoehler. 2014. 185 pages. Paperback. $19.95.

Project management today frequently takes the form of centralized command and control, but this is just the kind of planning that society today does not need, argues social entrepreneur Zaid Hassan. Speaking from his firsthand experience leading change initiatives in •

THE FUTURIST

May-June 2014

Reviews

Europe, India, and elsewhere, he explains the difficulty that centralized planning in any setting—whether it’s a national government, a corporate board, or a town hall—will run up against as it confronts the volatility and unpredictability of conditions on the ground. A new, more adaptive problem-solving approach is necessary, he argues, and he finds it in the growing profusion of “social labs.” Social labs are autonomous creative spaces in which all stakeholders participate on an equal footing in active discussion. Interpersonal interaction, brainstorming, collaboration, and experimentation have free rein, and any and all ideas are welcomed. Participants are under few

rules, except to suspend disbelief and to be as creative as possible. Hassan recounts his own participation in two such labs: the Sustainable Food Lab, which is now an international forum for developing reforms for the global food system, and the Bhavishya Lab, an Indiabased group that comes up with policies for mitigating child malnutrition in India. He describes the challenges and setbacks encountered in getting each group off the ground, as well as the long-term successes they achieved—and his reasons for abiding pride in each group’s present-day state. There are many more social labs such as these, Hassan notes. Thousands of individuals around the

world have been participating in them or forming them over the last 20 years, and working together they have been spearheading problem solving for challenges ranging from poverty, water sustainability, climate change, and reforming political systems to transforming media and fostering social innovation. He concludes with some pointers for how readers can start social labs of their own. The Social Labs Revolution is a fresh perspective on how a community, organization, or network can band together and address the most complex of challenges. Policy makers, academics, citizen activists, and anyone else who is attempting to lead systemic change will find it to be a valuable resource. —RD ❑

Feedback

continued from page 4 thinking, but don’t you think that the short-term mandates lead to favored electorates preferring status quo, at the cost of others? In a new model, without the “eternal growth dogma,” how could the leadership and the local governance be structured? How could we stay on course (in the will of changing habits) without threatening democracy? We still have this problem in France and, as you know, we are the Western world champions for public employees! Rob Bencini responds: Thank you for your excellent questions. They are certainly germane to the conversation. There are a lot of factors involved in how local and state governments got into this fiscal mess. The one that seemed the most benign, yet became the most egregious, was the willingness by governments to make long-term promises under the assumption that growth was eternal. This is largely a government problem, but it is clear the private sector falls victim to it, as well (e.g., General Motors). The failure to accept the possibility that the world won’t grow forever at a growth rate that guarantees prosperity has some basis in the time frame in which 58

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many of the plans were put into place. It also shows a pronounced lack of strategic foresight, which was also representative of the times. Unfortunately, my sense is that the public sector, at least, still hasn’t adapted to the new paradigm. The best they can do is slam on the brakes and renege on earlier promises. The financial realities facing local and state governments are superseding the status quo desires of public-sector employees. Detroit’s bankruptcy filing was a prime example of that. More are on their way. Five years ago, your point about the strength of the lobby that publicsector employees represent carried the day. The financial realities brought to light through the Great Recession—and the breaking of the eternal-growth mind-set—largely eliminated that way of thinking. I covered your last question about the threatening of democracy in my new book, Pardon the Disruption: The Future You Never Saw Coming (co-authored with Clay Rawlings and Randy Smith). As trends converge— largely led by rapidly advancing technologies—to diminish the need for people to provide productivity, there is an increasingly likely scenario of many millions more who will have no connectivity to the workplace. That provides a threat to both our economic and our governance systems. The need for capable strategic foresight now becomes more essential than ever. ❑

WORLDFUTURE 2014:

What If

The Annual Conference of the World Future Society

July 11-13, 2014 • Hilton Orlando Bonnet Creek • Orlando, Florida, U.S.A. Preconference Master Courses July 10-11, 2014 Science Fiction Symposium July 12, 2014 Professional Members Forum July 14, 2014 KAZ OKADA FOR WFS

If you are curious, innovative, and passionate about creating a better future for yourself and for the world, we invite you to join a diverse and dynamic group of forward-thinking people at WorldFuture 2014: What If, to be held July 1113 in Orlando, Florida. Whether you choose to focus on a specific path or synthesize the ideas and trends emerging on the edges of your scanning horizon, the conference program offers fluid navigation and a community of peers from around the world.

Plenary Speakers Offer Experience and Perspective ◆◆ Pioneering forecaster Paul Saffo, managing director of Foresight at Discern Analytics, will open the conference by challenging us to make sure the long term is taken seriously in everything we do. ◆◆ Stacey Childress, deputy director of education for the Bill & Melinda Gates Foundation and

KAZ OKADA FOR WFS

Clem Bezold

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a former Harvard Business School faculty member, will close the conference with guidance for moving toward a learning future. ◆◆ “What If” Journeys: The six sectors or tracks of the program will each feature a keynote presenter on Saturday morning to help you focus your conference experience. And, on both Saturday and Sunday, special What If Journey lectures will feature expert speakers, including: ★★ Hazel Henderson and Brenda Cooper (Earth) ★★ Gil Meyer and Kenneth Hunter (Sci/Tech) ★★ Karen Moloney and Gary Marx (Humanity) ★★ Karl Albrecht and Susan Alman (Futuring) ★★ Joergen Oerstroem Moeller and Clem Bezold (Governance), and ★★ Robert Moran (Commerce).

Synthesize and Network The conference program will also offer plenty of opportunities to “cross-pollinate” ideas among the tracks while you engage with a community of other passionate future builders and world changers. ◆◆ Back for its third year, Speed Futuring with Cindy Wagner and Erica Orange offers mini-roundtable discussions in the six tracks, with equal time given for reporting insights to the rest of

the group. The goal is to help participants focus on what they’ve learned in the first half of the conference and create a strategy for the second half, with networking opportunities along the way. ◆◆ In What If... Taking It Home, creativity expert Marci Segal will offer ideas for organizing all the information and inspiration obtained during the conference. ◆◆ Special-interest group meetings will also be scheduled prior to the conference, and “Networking Stations” will be set up during the Saturday night reception to help participants with common interests (and uncommon ones!) to find each other and share new ideas.

Keynote Luncheon Presenters ◆◆ Saturday, July 12: As part of the Science Fiction Symposium, writer Charles Stross will explore the uses of fiction as a futuring tool in “Promise and Peril in Science Fiction.” ◆◆ Sunday, July 13: Cartoonist and inventor Steven M. Johnson, author of Public Therapy Buses, Information Specialty Bums, Solar Cook-A-Mats and Other Visions of the 21st Century, will share his “secrets for coming up with numbingly dumb, humorous invention concepts.” (Note, the luncheons are extra-fee events.) Register on page 62 or at wfs.org.

Marci Segal C.G. WAGNER / WFS

About the Hotel: Our Conference Home The Hilton Bonnet Creek is a full-service resort and spa within a 482-acre nature preserve, convenient to Disney World and other Orlando attractions. The hotel is offering conference participants a generous portfolio of amenities, including room rates starting at just $149 per night, free wireless Internet, complimentary continental breakfast on Saturday and coffee break on Sunday, and coupons and discounts for local services and attractions. Plus, the hotel is waiving the $22 per night resort fee. Reserve your room at the conference venue now so you’ll guarantee the most convenient access to all of the events—and your fellow participants—at WorldFuture 2014.

WORLDFUTURE 2014: What If The Annual Conference of the World Future Society July 11-13, 2014 • Hilton Orlando Bonnet Creek • Orlando, Florida, U.S.A. Yes! I want to meet, exchange ideas with, and learn from my futurist colleagues. Please reserve my place at the World Future Society’s WorldFuture 2014. I understand registration includes admission to all sessions, the welcome reception, entrance to exhibits, and a list of pre-registrants. And if for any reason I am unable to attend, I may cancel and receive a full refund until June 13, 2014. Register by April 30, 2014 Register by June 20, 2014

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(Please attach appropriate documentation.) 2-day Luncheon Package (with speakers) — $124................................................................................................................................... Single Luncheons — $69 Select one: ❑ Saturday (Charlie Stross) ❑ Sunday (Steven Johnson).............................................. ❑ Professional Members Forum (Monday, July 14) — $115 (for Professional Members).......................................................................... Professional Membership — $295 ($195 nonprofit /academic rate) ❑ Renewal ❑ New (Join now to qualify for the Forum.)....... World Future Society membership — $79 ($20 for full-time students under the age of 25) ❑ Renewal ❑ New (Join now and take advantage of the members’ rate.).......................................................................................... Tax-deductible Contribution to Scholarship Fund (Your $150 contribution will make it possible for a student to attend, but every dollar will help.)......................................................................................................................................................................................

Preconference Master Courses Thursday, July 10, 2014, 9:00 a.m.–5:00 p.m. ❑ C-1 Futuring: Introduction to Futures Studies (Peter C. Bishop)—$249................................................................................................ ❑ C-2 Foresight Educators Boot Camp (Jay Gary)—$249......................................................................................................................... ❑ C-3 Wiser Futures: Using Futures Tools to Better Understand and Create the Future (Clement Bezold)—$249.................................... ❑ C-4 Fierce Foresight: Creating Tomorrow Out of the Changing of Today (Michael Petty)—$249........................................................... ❑ C-5 MiniTrends and Macro-Change: Turbo-Charging Your Future (David Pearce Snyder, John Vanston, and Carrie Vanston)—$249... ❑ C-6 Science Fiction: The Mythology of the Future (Tom Lombardo)—$249.........................................................................................

Friday, July 11, 2014, 9:00 a.m.–5:00 p.m. ❑ C-7 Wicked Opportunities: A Foresight and Innovation Workshop (Frank Spencer and Yvette Montero Salvatico)—$249.................... ❑ C-8 How to Stratify Your Scenario (Madeline Ashby)—$249................................................................................................................ ❑ C-9 Understanding 3-D Printing and Supporting Technologies for Futurists 2.0 (Paul Tinari)—$249.................................................... ❑ C-10 Creating a “What If” Imaginarium (Marci Segal, Megan Mitchell, and Tom McMillian)—$249..................................................... ❑ C-11 Futurist Writers Workshop: Futurism and Science-Fiction Synergy (Cynthia G. Wagner, Patrick Tucker, and Brenda Cooper)—$249 ❑ W-1 How to Invent the Future (Steven M.Johnson)—$79.....................................................................................................................

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MAIL TO: World Future Society, 7910 Woodmont Avenue, Suite 450, Bethesda, Maryland 20814, U.S.A. • FAX TO: 1-301-951-0394 • CALL TOLLFREE: 1-800-989-8274 (If outside the toll-free calling area, call 1-301-656-8274.) • E-MAIL: info@wfs.org • WEB SITE: www.wfs.org

World Future Society Programs The World Future Society is a nonprofit educational and scientific organization chartered in the District of Columbia, U.S.A., and is recognized by the U.S. Internal Revenue Service as a tax-exempt organization. The Society has about 25,000 members and subscribers in 80 nations. PUBLICATIONS

• The Futurist: A magazine published bimonthly, covering trends, forecasts, and ideas about the future. • Futurist Update: An e-mail newsletter available monthly to all members, covering a range of future-oriented news and useful links. • World Future Review: A Journal of Strategic Foresight: A journal for futures practitioners and scholars, with articles on forecasting techniques and applications, profiles of futurists and organizations, and abstracts of current futures-relevant literature. ACTIVITIES AND RESOURCES

• Conferences: The Society holds at least one major conference per year, to which all Society members are invited. Most conferences cover a wide range of topics related to the future. Most conferences are in the United States, but the Society has also held meetings in Canada and Austria. • Groups: Futurist groups are active in a number of U.S. cities, such as Chicago, Washington, and Atlanta, and in more than two dozen countries. • Books: New books of special interest to members may be purchased through the Society’s partnership with Amazon.com. MEMBERSHIP PROGRAMS

• Regular Membership: Includes THE FUTURIST magazine; discounts on conferences and books published by the Society; and such other benefits as may be approved for members. Discounted memberships are also available for full-time students under age 25. • Professional Membership: Programs and publications are available to meet the special needs of practitioners, researchers, scholars, and others who are professionally involved in forecasting, planning, or other futureoriented activities, including education and policy making. Professional members receive all the benefits of regular membership, plus a subscription to the journal World Future Review, as well as invitations to Professional Members Forums, and other benefits. • Institutional Membership: The World Future Society’s Institutional Membership program offers special services for business firms, educational institutions, government agencies, associations, and other groups. Members receive all of the benefits of Professional Membership, plus copies of all books, monographs, conference proceedings, special reports, and other publications produced by the Society during the year of the membership; special discounts on bulk purchases of Society publications; assistance in locating sources of information, consultants, and speakers for conferences and meetings, getting information tailored specifically to the organization’s needs; and inclusion in the Society’s list of institutional members published on the Society’s Web site and annually in THE FUTURIST. For more information and an application, contact Membership Secretary, World Future Society, 7910 Woodmont Avenue, Suite 450, Bethesda, Maryland 20814 www.wfs.org.

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THE FUTURIST

May-June 2014

As Tweeted learning disorders academic longevity

What If? Questions Are Easy, Answers Are Hard Renewable marriages? Three-day weekends? Predictable sporting events? As we look forward to the World Future Society’s 2014 conference, the theme of “What If” has inspired us to ask some pertinent questions. World Future Society (@WorldFutureSoc): #WhatIf

marriage licenses had to be renewed every five years, following mutual agreement and passing of tests? @TheDeist: It’s a plan!!! If things have been going badly you just don’t renew and the marriage lapses. AWESOME! @WorldFutureSoc: or possibly people will work harder at their relationships? @TheDeist: Adding more Administrative processes will hardly help relationships. It will only add more strain. @tidewaters (Chrystal Ocean): I’ve proposed fiveyear marriage contracts in the past, minus the tests. No more divorces! @nevergonedrum (Nevergone): IMO, government shouldn’t have anything to do with marriage, license or otherwise. Original thought tho — I like that. @tidewaters: Civil libertarian in me agrees, but (in Canada) marriages also financial structures subj to diff. tax rules @jboyded (Julie Boyd): and the idea of having a civil registry office marriage, then not allowed to have an expensive wedding until 2 years later @claudiovgreco (Claudio V. Greco): Life is more complex and beautiful than this kind of provocation (with all the respect) @WorldFutureSoc: True. Problems are complex. If solutions were simple, everyone would agree. Important to keep being provocative #WhatIf @claudiovgreco: OK, let’s be provocative :-) What about children if marriage license not renewed? Separate 5yrs license with children lawyer? ••• @WorldFutureSoc: “What If” questions are always interesting. Agree? What #WhatIf question is on your mind? @nycreitz (Scott Reitz): #Whatif inclement weather was not a factor in work and the transport of goods. @nycreitz: #Whatif the human brain could work effectively even when the body was at rest? @nycreitz: Last one: #Whatif governments always conceded to the political demands of terrorist threats.

workforce economic development big data investment consumers genetic engineering Singapore infrastructure neuroscience aging belief imagination psychology crime data deconstruction transformative 3D printing transdisciplinary forestry nanomedicine exploration population innovation policy synthesis predictions libraries mentors complexity Delphi dynamics children USA solutions Venezuela process transhuman markets challenges opportunities media culture conservatism hypertechnology initiative China organizations activism prosperity nature quest storytelling tools learning narrative smartphones questions cities dystopia singularity Moore’s Law solar age Japan pandemic visualizing governance corporations Canada sex digital energy data-driven design Mexico

what if

@localrat (Emily Empel): What if we had universal 3

day weekends?

@WorldFutureSoc: Always a good question on a Friday. Better question on Monday. ;) #WhatIf #threeday-

weekend @localrat: Haha too true. On a more serious note:

what if we understood and could embed happiness into all human experience? @shyduroff: for nearly my entire 67/68years I’ve not recognised xistnce of so-called week-end; some say I paid heavy 4 it @libredealbedrio (Rodrigo René Cura): #WhatIf public transport were free? Think the effect in transit, environment and public transport itself. Good or bad? @ryonck (Richard Yonck): #WhatIf ALL technological enhancements were allowed in sports competitions? @WorldFutureSoc: #WhatIf big data made predictive analytics so powerful that we would know the outcome of the #SuperBowl without playing it? @StatSoft: No fun, that’s what! @SemprePhi (Tom Leckrone): I can tell you the score before it starts. @SemprePhi: (0-0) Follow the World Future Society on Twitter @WorldFutureSoc and THE FUTURIST magazine @WFSFuturist_Mag. WorldFuture 2014: What If will take place in Orlando, Florida, July 11-13. Details: www.wfs.org/worldfuture-2014-what-if.

❑

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World Future Review Free sample copy available online at wfr.sagepub.com World Future Review (WFR), published on behalf of the World Future Society, is the top forum for all who are professionally involved in the theory, methodology, practice, and use of futures research. Along with interviews with leading futures practitioners, WFR publishes important new foresight literature addressing topics informed by technology assessment, policy analysis, operations research, issues management, competition research and much more.

For more information and to subscribe, visit wfr.sagepub.com today! World Future Society members receive WFR at a low member price. See the World Future Society website for details: wfs.org. World Future Review also invites manuscripts from contributors worldwide at http:// mc.manuscriptcentral.com/wfr. For questions, contact tmack@wfs.org.

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About the World Future Society Why explore the future? The world changes so quickly that it‘s hard to keep up. New inventions and innovations alter the way we live. People‘s values, attitudes, and beliefs are changing. And the pace of change keeps accelerating, making it difficult to prepare for t omorrow. By studying the future, people can better anticipate what lies ahead. More importantly, they can actively decide how they will live in the future by making choices today and realizing the consequences of their decisions. The future doesn‘t just happen: People create it through their action—or inaction—today.

What can we know about the future? No one knows exactly what will happen in the future. But by considering what might happen, people can more rationally decide on the sort of future that would be most desirable and then work to achieve it. Opportunity as well as danger lies ahead, so people need to make farsighted decisions. The process of change is inevitable; it‘s up to everyone to make sure that change is constructive.

What is the World F uture Society? The World Future Society is an association of people interested in how social and technological developments are shaping the future. The Society was founded in 1966 by a group of private citizens, and is chartered as a nonprofit educational and scientific organization.

What does the Society do? The Society convenes and connects. Through meetings and publications, it serves as a neutral clearinghouse for ideas about the future, including forecasts, recommendations, scenarios, alternatives, and more. These ideas help people to anticipate what may happen in the next five, 10, or more years ahead. When people can visualize a better future, then they can begin to create it.

What does membership offer? • THE FUTURIST, a magazine of forecasts, trends, and ideas about the future. Every member receives a subscription to this exciting bimonthly magazine. Experts in various fields share their insights and forecasts in articles directed at a general audience. • Special rates for all annual PHOTOS: KAZ OKADA FOR WFS conferences. These conferences provide members with the opportunity for face-toface meetings with distinguished scholars, leaders, and experts from around the world. • Access to your local chapter. Cities and regions around the world have chapters for grassroots support of futures studies. They provide a way for members to get involved in their local communities through workshops, discussion groups, and speakers. A number of special interest groups also offer virtual and local How do I join networking.

Society?

Free e-mail newsletter! Visit www.wfs.org.

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Visit www.wfs.org or contact: World Future Society Membership Department 7910 Woodmont Avenue, Suite 450 Bethesda, Maryland 20814, USA Telephone: 301-656-8274