Tag Archives: Pope Francis

Pope Francis and Rhodes University’s Institute for Nanotechnology Innovation Director,Tebello Nyokong

I’d never heard of the Catholic Church’s Pontifical Academy of Sciences before this July 10, 2023 Rhodes University (South Africa) press release,

Rhodes University’s Institute for Nanotechnology Innovation Director, Distinguished Professor Tebello Nyokong, has been appointed to the Pontifical Academy of Sciences. As the head of the Catholic Church, the bishop of Rome and sovereign of the Vatican City State, Pope Francis appointed Professor Nyokong to the Academy.  

The Academy was founded in 1603 after a period of vicissitudes and was radically reformed by Pope Pius XI in 1936. The aim of the Academy is to promote the progress of mathematical, physical, and natural sciences and the study of epistemological problems relating thereto. The Academy chooses candidates for a seat in the Academy based on their eminent original scientific studies and their acknowledged moral personality, without any ethnic or religious discrimination. They are nominated for life by the sovereign act of the Pope.

Professor Nyokong said that when she first received the communiqué from the Pope, she deleted the correspondence, thinking it was spam. “Who receives an email from the Pope? I am not even catholic, so this came as a surprise for me,” she said. Only after receiving a call enquiring whether she had received the correspondence did she realise it was legit.

“It’s a great honour indeed. I will be travelling to the Vatican in 2024. How does the Pope even know me? I do not even know, but it means there is something holy about the work my students and I are doing,” said Professor Nyokong.

Pontifical Academy of Sciences Chancellor, Peter Kodwo Appiah Turkson, said: “Pope Francis will bestow on Professor Nyokong the insignia of her appointment during a Solemn Pontifical Audience at the next Plenary Session in October 2024.”

Professor Nyokong is researching a new cancer diagnosis and treatment methodology called photo-dynamic therapy, which is an alternative to chemotherapy. The new therapy is based on using a dye, which is used to colour blue denim clothing, and which is inert and harmless by itself but can be activated by exposure to a red laser beam. 

She is celebrated worldwide for the outstanding work she and her team continue to do. She has five honorary degrees including from her alma mater McMaster University in Ontario, Canada; University of South Africa (UNISA); Walter Sisulu University; the University of KwaZulu-Natal and another alma materWestern University in Ontario, Canada.

Professor Nyokong is an honorary fellow of the Royal Society of Chemistry, and a  Fellow of the Royal Society. Rhodes University Vice-Chancellor congratulated Professor Nyokong. “We are incredibly proud of Distinguished Professor Nyokong, and we congratulate her on this huge recognition. This recognition is fitting for someone of Professor Nyokong’s calibre. Her many years of ground-breaking intellectual contribution, hard work, dedication, and commitment to this research-intensive University do not go unnoticed. She has and continues to contribute to our vision of being foremost in the generation and advancement of locally-responsive and globally-engaged knowledge dedicated to creating a just and sustainable world,” concluded Professor Mabizela [Dr Sizwe Mabizela].

Congratulations to Professor Tebello Nyokong!

You can find the Pontifical Academy of Sciences here. In addition to learning about a new ‘science’ agency and finding out the Catholic Church is aware of nanotechnology, I received another surprise on reading the Rhodes University press release in its entirety: Professor Nyokong has two Canadian connections (or alma maters).

Technical University of Munich: embedded ethics approach for AI (artificial intelligence) and storing a tv series in synthetic DNA

I stumbled across two news bits of interest from the Technical University of Munich in one day (Sept. 1, 2020, I think). The topics: artificial intelligence (AI) and synthetic DNA (deoxyribonucleic acid).

Embedded ethics and artificial intelligence (AI)

An August 27, 2020 Technical University of Munich (TUM) press release (also on EurekAlert but published Sept. 1, 2020) features information about a proposal to embed ethicists in with AI development teams,

The increasing use of AI (artificial intelligence) in the development of new medical technologies demands greater attention to ethical aspects. An interdisciplinary team at the Technical University of Munich (TUM) advocates the integration of ethics from the very beginning of the development process of new technologies. Alena Buyx, Professor of Ethics in Medicine and Health Technologies, explains the embedded ethics approach.

Professor Buyx, the discussions surrounding a greater emphasis on ethics in AI research have greatly intensified in recent years, to the point where one might speak of “ethics hype” …

Prof. Buyx: … and many committees in Germany and around the world such as the German Ethics Council or the EU Commission High-Level Expert Group on Artificial Intelligence have responded. They are all in agreement: We need more ethics in the development of AI-based health technologies. But how do things look in practice for engineers and designers? Concrete solutions are still few and far between. In a joint pilot project with two Integrative Research Centers at TUM, the Munich School of Robotics and Machine Intelligence (MSRM) with its director, Prof. Sami Haddadin, and the Munich Center for Technology in Society (MCTS), with Prof. Ruth Müller, we want to try out the embedded ethics approach. We published the proposal in Nature Machine Intelligence at the end of July [2020].

What exactly is meant by the “embedded ethics approach”?

Prof.Buyx: The idea is to make ethics an integral part of the research process by integrating ethicists into the AI development team from day one. For example, they attend team meetings on a regular basis and create a sort of “ethical awareness” for certain issues. They also raise and analyze specific ethical and social issues.

Is there an example of this concept in practice?

Prof. Buyx: The Geriatronics Research Center, a flagship project of the MSRM in Garmisch-Partenkirchen, is developing robot assistants to enable people to live independently in old age. The center’s initiatives will include the construction of model apartments designed to try out residential concepts where seniors share their living space with robots. At a joint meeting with the participating engineers, it was noted that the idea of using an open concept layout everywhere in the units – with few doors or individual rooms – would give the robots considerable range of motion. With the seniors, however, this living concept could prove upsetting because they are used to having private spaces. At the outset, the engineers had not given explicit consideration to this aspect.

Prof.Buyx: The approach sounds promising. But how can we avoid “embedded ethics” from turning into an “ethics washing” exercise, offering companies a comforting sense of “being on the safe side” when developing new AI technologies?

That’s not something we can be certain of avoiding. The key is mutual openness and a willingness to listen, with the goal of finding a common language – and subsequently being prepared to effectively implement the ethical aspects. At TUM we are ideally positioned to achieve this. Prof. Sami Haddadin, the director of the MSRM, is also a member of the EU High-Level Group of Artificial Intelligence. In his research, he is guided by the concept of human centered engineering. Consequently, he has supported the idea of embedded ethics from the very beginning. But one thing is certain: Embedded ethics alone will not suddenly make AI “turn ethical”. Ultimately, that will require laws, codes of conduct and possibly state incentives.

Here’s a link to and a citation for the paper espousing the embedded ethics for AI development approach,

An embedded ethics approach for AI development by Stuart McLennan, Amelia Fiske, Leo Anthony Celi, Ruth Müller, Jan Harder, Konstantin Ritt, Sami Haddadin & Alena Buyx. Nature Machine Intelligence (2020) DOI: https://doi.org/10.1038/s42256-020-0214-1 Published 31 July 2020

This paper is behind a paywall.

Religion, ethics and and AI

For some reason embedded ethics and AI got me to thinking about Pope Francis and other religious leaders.

The Roman Catholic Church and AI

There was a recent announcement that the Roman Catholic Church will be working with MicroSoft and IBM on AI and ethics (from a February 28, 2020 article by Jen Copestake for British Broadcasting Corporation (BBC) news online (Note: A link has been removed),

Leaders from the two tech giants met senior church officials in Rome, and agreed to collaborate on “human-centred” ways of designing AI.

Microsoft president Brad Smith admitted some people may “think of us as strange bedfellows” at the signing event.

“But I think the world needs people from different places to come together,” he said.

The call was supported by Pope Francis, in his first detailed remarks about the impact of artificial intelligence on humanity.

The Rome Call for Ethics [sic] was co-signed by Mr Smith, IBM executive vice-president John Kelly and president of the Pontifical Academy for Life Archbishop Vincenzo Paglia.

It puts humans at the centre of new technologies, asking for AI to be designed with a focus on the good of the environment and “our common and shared home and of its human inhabitants”.

Framing the current era as a “renAIssance”, the speakers said the invention of artificial intelligence would be as significant to human development as the invention of the printing press or combustion engine.

UN Food and Agricultural Organization director Qu Dongyu and Italy’s technology minister Paola Pisano were also co-signatories.

Hannah Brockhaus’s February 28, 2020 article for the Catholic News Agency provides some details missing from the BBC report and I found it quite helpful when trying to understand the various pieces that make up this initiative,

The Pontifical Academy for Life signed Friday [February 28, 2020], alongside presidents of IBM and Microsoft, a call for ethical and responsible use of artificial intelligence technologies.

According to the document, “the sponsors of the call express their desire to work together, in this context and at a national and international level, to promote ‘algor-ethics.’”

“Algor-ethics,” according to the text, is the ethical use of artificial intelligence according to the principles of transparency, inclusion, responsibility, impartiality, reliability, security, and privacy.

The signing of the “Rome Call for AI Ethics [PDF]” took place as part of the 2020 assembly of the Pontifical Academy for Life, which was held Feb. 26-28 [2020] on the theme of artificial intelligence.

One part of the assembly was dedicated to private meetings of the academics of the Pontifical Academy for Life. The second was a workshop on AI and ethics that drew 356 participants from 41 countries.

On the morning of Feb. 28 [2020], a public event took place called “renAIssance. For a Humanistic Artificial Intelligence” and included the signing of the AI document by Microsoft President Brad Smith, and IBM Executive Vice-president John Kelly III.

The Director General of FAO, Dongyu Qu, and politician Paola Pisano, representing the Italian government, also signed.

The president of the European Parliament, David Sassoli, was also present Feb. 28.

Pope Francis canceled his scheduled appearance at the event due to feeling unwell. His prepared remarks were read by Archbishop Vincenzo Paglia, president of the Academy for Life.

You can find Pope Francis’s comments about the document here (if you’re not comfortable reading Italian, hopefully, the English translation which follows directly afterward will be helpful). The Pope’s AI initiative has a dedicated website, Rome Call for AI ethics, and while most of the material dates from the February 2020 announcement, they are keeping up a blog. It has two entries, one dated in May 2020 and another in September 2020.

Buddhism and AI

The Dalai Lama is well known for having an interest in science and having hosted scientists for various dialogues. So, I was able to track down a November 10, 2016 article by Ariel Conn for the futureoflife.org website, which features his insights on the matter,

The question of what it means and what it takes to feel needed is an important problem for ethicists and philosophers, but it may be just as important for AI researchers to consider. The Dalai Lama argues that lack of meaning and purpose in one’s work increases frustration and dissatisfaction among even those who are gainfully employed.

“The problem,” says the Dalai Lama, “is … the growing number of people who feel they are no longer useful, no longer needed, no longer one with their societies. … Feeling superfluous is a blow to the human spirit. It leads to social isolation and emotional pain, and creates the conditions for negative emotions to take root.”

If feeling needed and feeling useful are necessary for happiness, then AI researchers may face a conundrum. Many researchers hope that job loss due to artificial intelligence and automation could, in the end, provide people with more leisure time to pursue enjoyable activities. But if the key to happiness is feeling useful and needed, then a society without work could be just as emotionally challenging as today’s career-based societies, and possibly worse.

I also found a talk on the topic by The Venerable Tenzin Priyadarshi, first here’s a description from his bio at the Dalai Lama Center for Ethics and Transformative Values webspace on the Massachusetts Institute of Technology (MIT) website,

… an innovative thinker, philosopher, educator and a polymath monk. He is Director of the Ethics Initiative at the MIT Media Lab and President & CEO of The Dalai Lama Center for Ethics and Transformative Values at the Massachusetts Institute of Technology. Venerable Tenzin’s unusual background encompasses entering a Buddhist monastery at the age of ten and receiving graduate education at Harvard University with degrees ranging from Philosophy to Physics to International Relations. He is a Tribeca Disruptive Fellow and a Fellow at the Center for Advanced Study in Behavioral Sciences at Stanford University. Venerable Tenzin serves on the boards of a number of academic, humanitarian, and religious organizations. He is the recipient of several recognitions and awards and received Harvard’s Distinguished Alumni Honors for his visionary contributions to humanity.

He gave the 2018 Roger W. Heyns Lecture in Religion and Society at Stanford University on the topic, “Religious and Ethical Dimensions of Artificial Intelligence.” The video runs over one hour but he is a sprightly speaker (in comparison to other Buddhist speakers I’ve listened to over the years).

Judaism, Islam, and other Abrahamic faiths examine AI and ethics

I was delighted to find this January 30, 2020 Artificial Intelligence: Implications for Ethics and Religion event as it brought together a range of thinkers from various faiths and disciplines,

New technologies are transforming our world every day, and the pace of change is only accelerating.  In coming years, human beings will create machines capable of out-thinking us and potentially taking on such uniquely-human traits as empathy, ethical reasoning, perhaps even consciousness.  This will have profound implications for virtually every human activity, as well as the meaning we impart to life and creation themselves.  This conference will provide an introduction for non-specialists to Artificial Intelligence (AI):

What is it?  What can it do and be used for?  And what will be its implications for choice and free will; economics and worklife; surveillance economies and surveillance states; the changing nature of facts and truth; and the comparative intelligence and capabilities of humans and machines in the future? 

Leading practitioners, ethicists and theologians will provide cross-disciplinary and cross-denominational perspectives on such challenges as technology addiction, inherent biases and resulting inequalities, the ethics of creating destructive technologies and of turning decision-making over to machines from self-driving cars to “autonomous weapons” systems in warfare, and how we should treat the suffering of “feeling” machines.  The conference ultimately will address how we think about our place in the universe and what this means for both religious thought and theological institutions themselves.

UTS [Union Theological Seminary] is the oldest independent seminary in the United States and has long been known as a bastion of progressive Christian scholarship.  JTS [Jewish Theological Seminary] is one of the academic and spiritual centers of Conservative Judaism and a major center for academic scholarship in Jewish studies. The Riverside Church is an interdenominational, interracial, international, open, welcoming, and affirming church and congregation that has served as a focal point of global and national activism for peace and social justice since its inception and continues to serve God through word and public witness. The annual Greater Good Gathering, the following week at Columbia University’s School of International & Public Affairs, focuses on how technology is changing society, politics and the economy – part of a growing nationwide effort to advance conversations promoting the “greater good.”

They have embedded a video of the event (it runs a little over seven hours) on the January 30, 2020 Artificial Intelligence: Implications for Ethics and Religion event page. For anyone who finds that a daunting amount of information, you may want to check out the speaker list for ideas about who might be writing and thinking on this topic.

As for Islam, I did track down this November 29, 2018 article by Shahino Mah Abdullah, a fellow at the Institute of Advanced Islamic Studies (IAIS) Malaysia,

As the global community continues to work together on the ethics of AI, there are still vast opportunities to offer ethical inputs, including the ethical principles based on Islamic teachings.

This is in line with Islam’s encouragement for its believers to convey beneficial messages, including to share its ethical principles with society.

In Islam, ethics or akhlak (virtuous character traits) in Arabic, is sometimes employed interchangeably in the Arabic language with adab, which means the manner, attitude, behaviour, and etiquette of putting things in their proper places. Islamic ethics cover all the legal concepts ranging from syariah (Islamic law), fiqh ( jurisprudence), qanun (ordinance), and ‘urf (customary practices).

Adopting and applying moral values based on the Islamic ethical concept or applied Islamic ethics could be a way to address various issues in today’s societies.

At the same time, this approach is in line with the higher objectives of syariah (maqasid alsyariah) that is aimed at conserving human benefit by the protection of human values, including faith (hifz al-din), life (hifz alnafs), lineage (hifz al-nasl), intellect (hifz al-‘aql), and property (hifz al-mal). This approach could be very helpful to address contemporary issues, including those related to the rise of AI and intelligent robots.

..

Part of the difficulty with tracking down more about AI, ethics, and various religions is linguistic. I simply don’t have the language skills to search for the commentaries and, even in English, I may not have the best or most appropriate search terms.

Television (TV) episodes stored on DNA?

According to a Sept. 1, 2020 news item on Nanowerk, the first episode of a tv series, ‘Biohackers’ has been stored on synthetic DNA (deoxyribonucleic acid) by a researcher at TUM and colleagues at another institution,

The first episode of the newly released series “Biohackers” was stored in the form of synthetic DNA. This was made possible by the research of Prof. Reinhard Heckel of the Technical University of Munich (TUM) and his colleague Prof. Robert Grass of ETH Zürich.

They have developed a method that permits the stable storage of large quantities of data on DNA for over 1000 years.

A Sept. 1, 2020 TUM press release, which originated the news item, proceeds with more detail in an interview format,

Prof. Heckel, Biohackers is about a medical student seeking revenge on a professor with a dark past – and the manipulation of DNA with biotechnology tools. You were commissioned to store the series on DNA. How does that work?

First, I should mention that what we’re talking about is artificially generated – in other words, synthetic – DNA. DNA consists of four building blocks: the nucleotides adenine (A), thymine (T), guanine (G) and cytosine (C). Computer data, meanwhile, are coded as zeros and ones. The first episode of Biohackers consists of a sequence of around 600 million zeros and ones. To code the sequence 01 01 11 00 in DNA, for example, we decide which number combinations will correspond to which letters. For example: 00 is A, 01 is C, 10 is G and 11 is T. Our example then produces the DNA sequence CCTA. Using this principle of DNA data storage, we have stored the first episode of the series on DNA.

And to view the series – is it just a matter of “reverse translation” of the letters?

In a very simplified sense, you can visualize it like that. When writing, storing and reading the DNA, however, errors occur. If these errors are not corrected, the data stored on the DNA will be lost. To solve the problem, I have developed an algorithm based on channel coding. This method involves correcting errors that take place during information transfers. The underlying idea is to add redundancy to the data. Think of language: When we read or hear a word with missing or incorrect letters, the computing power of our brain is still capable of understanding the word. The algorithm follows the same principle: It encodes the data with sufficient redundancy to ensure that even highly inaccurate data can be restored later.

Channel coding is used in many fields, including in telecommunications. What challenges did you face when developing your solution?

The first challenge was to create an algorithm specifically geared to the errors that occur in DNA. The second one was to make the algorithm so efficient that the largest possible quantities of data can be stored on the smallest possible quantity of DNA, so that only the absolutely necessary amount of redundancy is added. We demonstrated that our algorithm is optimized in that sense.

DNA data storage is very expensive because of the complexity of DNA production as well as the reading process. What makes DNA an attractive storage medium despite these challenges?

First, DNA has a very high information density. This permits the storage of enormous data volumes in a minimal space. In the case of the TV series, we stored “only” 100 megabytes on a picogram – or a billionth of a gram of DNA. Theoretically, however, it would be possible to store up to 200 exabytes on one gram of DNA. And DNA lasts a long time. By comparison: If you never turned on your PC or wrote data to the hard disk it contains, the data would disappear after a couple of years. By contrast, DNA can remain stable for many thousands of years if it is packed right.

And the method you have developed also makes the DNA strands durable – practically indestructible.

My colleague Robert Grass was the first to develop a process for the “stable packing” of DNA strands by encapsulating them in nanometer-scale spheres made of silica glass. This ensures that the DNA is protected against mechanical influences. In a joint paper in 2015, we presented the first robust DNA data storage concept with our algorithm and the encapsulation process developed by Prof. Grass. Since then we have continuously improved our method. In our most recent publication in Nature Protocols of January 2020, we passed on what we have learned.

What are your next steps? Does data storage on DNA have a future?

We’re working on a way to make DNA data storage cheaper and faster. “Biohackers” was a milestone en route to commercialization. But we still have a long way to go. If this technology proves successful, big things will be possible. Entire libraries, all movies, photos, music and knowledge of every kind – provided it can be represented in the form of data – could be stored on DNA and would thus be available to humanity for eternity.

Here’s a link to and a citation for the paper,

Reading and writing digital data in DNA by Linda C. Meiser, Philipp L. Antkowiak, Julian Koch, Weida D. Chen, A. Xavier Kohll, Wendelin J. Stark, Reinhard Heckel & Robert N. Grass. Nature Protocols volume 15, pages86–101(2020) Issue Date: January 2020 DOI: https://doi.org/10.1038/s41596-019-0244-5 Published [online] 29 November 2019

This paper is behind a paywall.

As for ‘Biohackers’, it’s a German science fiction television series and you can find out more about it here on the Internet Movie Database.

Macchiarini controversy and synthetic trachea transplants (part 2 of 2)

For some bizarre frosting on this disturbing cake (see part 1 of the Macchiarini controversy and synthetic trachea transplants for the medical science aspects), a January 5, 2016 Vanity Fair article by Adam Ciralsky documents Macchiarini’s courtship of an NBC ([US] National Broadcasting Corporation) news producer who was preparing a documentary about him and his work,

Macchiarini, 57, is a magnet for superlatives. He is commonly referred to as “world-renowned” and a “super-surgeon.” He is credited with medical miracles, including the world’s first synthetic organ transplant, which involved fashioning a trachea, or windpipe, out of plastic and then coating it with a patient’s own stem cells. That feat, in 2011, appeared to solve two of medicine’s more intractable problems—organ rejection and the lack of donor organs—and brought with it major media exposure for Macchiarini and his employer, Stockholm’s Karolinska Institute, home of the Nobel Prize in Physiology or Medicine. Macchiarini was now planning another first: a synthetic-trachea transplant on a child, a two-year-old Korean-Canadian girl named Hannah Warren, who had spent her entire life in a Seoul hospital. …

Macchiarini had come to Vieira’s [Meredith Vieira, American journalist] attention in September 2012, when she read a front-page New York Times story about the doctor. She turned to [Benita] Alexander, one of her most seasoned and levelheaded producers, to look into a regenerative-medicine story for television.

When Alexander and Macchiarini found themselves together in Illinois for a period of weeks in the spring of 2013—brought there by the NBC special—they met frequently for quiet dinners. The trachea transplant on Hannah Warren, the Korean-Canadian girl, was being performed at Children’s Hospital of Illinois, in Peoria, and the procedure was fraught with risks, not least because Macchiarini’s technique was still a work in progress even for adults. (Christopher Lyles, an American who became the second person to receive an artificial trachea, died less than four months after his surgery at Karolinska.) “He’s a brilliant scientist and a great technical surgeon,” said Dr. Richard Pearl, who operated alongside Macchiarini in Illinois. Like others, Pearl described his Italian colleague as a Renaissance man, fluent in half a dozen languages. Another person, who would get to know him through Alexander, compared Macchiarini to “the Most Interesting Man in the World,” the character made famous in Dos Equis beer commercials.

In Peoria, Macchiarini’s medical magic appeared to have its limitations. Hannah Warren died from post-surgical complications less than three months after the transplant. Her anatomy “was much more challenging than we realized,” Pearl recounted. “Scientifically, the operation itself worked. It was just a shame what happened. When you’re doing something for the first time, you don’t have a textbook. It was the hardest operation I’ve ever scrubbed on.”

Then, there was the romance (from the Ciralsky article),

The personal relationship between Alexander and Macchiarini continued to blossom. In June 2013, they flew to Venice for what Alexander called “an incredibly romantic weekend.” Macchiarini bought her red roses and Venetian-glass earrings and took her on a gondola ride under the Bridge of Sighs. Like a pair of teenagers, they attached love locks to the Ponte dell’Accademia bridge, one of them bearing the inscription “B—P 23/6/13, 4 Ever.” Alexander told me that, “when he took me to Venice, we were still shooting the story … He always paid for everything … gifts, expensive dinners, flowers—the works. When it came to money, he was incredibly generous.”

It is a bedrock principle at NBC and every other news organization that journalists must avoid conflicts of interest, real or apparent. Alexander was not oblivious to this. “I knew that I was crossing the line in the sense that it’s a basic and well-understood rule of journalism that you don’t become involved with one of the subjects of your story, because your objectivity could clearly become compromised,” she told me. “I never once thought about him paying for the trip as him ‘buying’ me in some fashion, or potentially using money to influence me, because, from my perspective anyway … that just wasn’t the case. We were just crazy about each other, and I was falling in love.”

Alexander made her way to Stockholm at a later date (from the Ciralsky article),

Macchiarini was in Stockholm to attend to Yesim Cetir, a 25-year-old Turkish woman whose artificial trachea had failed. As Swedish television later reported, “It has taken nearly 100 surgeries to support the cell tissue around the airpipes. Her breathing is bad, and to avoid suffocation, her respiratory tract must be cleansed from mucus every fourth hour. She has now been lying in the hospital for nearly 1,000 days.” NBC’s special would come to include skeptical commentary from Dr. Joseph Vacanti, who questioned the sufficiency of Macchiarini’s research, but Cetir’s post-operative complications were not mentioned.

Prior to the NBC documentary’s (A Leap of Faith) airing, the romance became an engagement (from the Ciralsky article),

Macchiarini proposed to Benita Alexander on Christmas Day 2013, Alexander said. In the months leading up to the airing of A Leap of Faith, in June 2014, Macchiarini and Alexander went on trips to the Bahamas, Turkey, Mexico, Greece, and Italy. They went on shopping sprees and ate their way through Michelin-starred restaurants. Macchiarini even took Alexander and her daughter to meet his mother at her home, in Lucca. “She cooked homemade gnocchi,” Alexander recalled. Macchiarini’s mother shared pictures from the family photo album while her son translated. Emanuela Pecchia, the woman whom Macchiarini had married years earlier, lived only a short distance away. When Macchiarini informed Alexander, during a dinner cruise later that summer, that his divorce had finally come through, she recounted, he gave her an engagement ring.

In the months that followed, the doctor and his fiancée began planning their wedding in earnest. They set a date for July 11, 2015, in Rome. But their desire to marry in the Catholic Church was complicated by the fact that she is Episcopalian and divorced. Divorce would have been an issue for Macchiarini as well. However, Alexander said, Macchiarini insisted that he would fix things by visiting his friend and patient in the Vatican.

In October 2014, Alexander recalled, Macchiarini told her that he had met with Pope Francis for four hours and that the Pontiff consented to the couple’s marriage and, in yet another sign of his progressive tenure, vowed to officiate. Alexander said Macchiarini referred to himself as Pope Francis’s “personal doctor” and maintained that in subsequent meetings his patient offered to host the wedding at his summer residence, the Apostolic Palace of Castel Gandolfo.

Shortly after quitting her job in anticipation of her July 2015 wedding to Macchiarini, Alexander learned that Pope Francis who was supposed to officiate was in fact scheduled to be in South America during that time.  From the Ciralsky article,

As Alexander would discover with the help of a private investigator named Frank Murphy, virtually every detail Macchiarini provided about the wedding was false. A review of public records in Italy would also seem to indicate that Macchiarini remains married to Emanuela Pecchia, his wife of nearly 30 years. Murphy, who spent 15 years as a Pennsylvania State Police detective, told me, “I’ve never in my experience witnessed a fraud like this, with this level of international flair…. The fact that he could keep all the details straight and compartmentalize these different lives and lies is really amazing.

Ciralsky broaches the question of why someone with Macchiarini’s accomplishments would jeopardize his position in such a way,

To understand why someone of considerable stature could construct such elaborate tales and how he could seemingly make others believe them, I turned to Dr. Ronald Schouten, a Harvard professor who directs the Law and Psychiatry Service at Massachusetts General Hospital. “We’re taught from an early age that when something is too good to be true, it’s not true,” he said. “And yet we ignore the signals. People’s critical judgment gets suspended. In this case, that happened at both the personal and institutional level.” Though he will not diagnose from a distance, Schouten, who is one of the nation’s foremost authorities on psychopathy, observed, “Macchiarini is the extreme form of a con man. He’s clearly bright and has accomplishments, but he can’t contain himself. There’s a void in his personality that he seems to want to fill by conning more and more people.” When I asked how Macchiarini stacks up to, say, Bernie Madoff, he laughed and said, “Madoff was an ordinary con man with a Ponzi scheme. He never claimed to be the chairman of the Federal Reserve. He didn’t suggest he was part of a secret international society of bankers. This guy is really good.”

In addition to the romance, Ciralsky and Vanity Fair checked out Macchiarini’s résumé,

Vanity Fair contacted many of the schools at which Macchiarini claimed to have either earned a degree or held an academic post. While the University of Pisa confirmed that he indeed received an M.D. and had specialized in surgery, the University of Alabama at Birmingham denied that Macchiarini earned a master’s in biostatistics or that he participated in a two-year fellowship in thoracic surgery. In fact, according to U.A.B. spokesman Bob Shepard, the only record the school has for Macchiarini indicates that he did a six-month non-surgical fellowship in hematology/oncology—which according to the current Accreditation Council for Graduate Medical Education guidelines is 30 months shy of what is required for a clinical fellowship in that field. The University of Paris—Sud never responded to repeated requests for comment, but Hannover Medical School wrote to say that Macchiarini had been neither a full nor an associate professor there, merely an adjunct.

Comments

As I noted in part 1, there are medical science and ethical issues to be considered. As well, Macchiarini’s romantic behaviour certainly seems fraudulent as do parts of his curriculum vitae (CV) and there’s more about Macchiarini’s professional accomplishments (read Ciralsky’s entire January 5, 2016 Vanity Fair article for details).

The romantic and CV chicanery may or may not suggest serious problems with Macchiarini’s revolutionary procedure and ethics. History is littered with stories of people who achieved extraordinary advances and were not the most exemplary human beings. Paracelsus, founder of the field of toxicology and an important contributor in the fields of medicine and science, was reputedly a sketchy character. Caravaggio now remembered for his art, killed someone (accidentally or not) and was known for his violent behaviour even in a time when there was higher tolerance for it.

What I’m saying is that Macchiarini may be pioneering something important regardless of how you view his romantic chicanery and falsified CV. Medical research can be high risk and there is no way to avoid that sad fact. However, criticisms of the work from Macchiarini’s colleagues need to be addressed and the charge that a Russian patient who was not in imminent danger and not properly advised of the extremely high risk must also be addressed.

It should also be remembered that Macchiarini did not pull this off by himself. Institutions such as the Karolinska Institute failed to respond appropriately in the initial stages. As well, the venerable medical journal, The Lancet seems reluctant to address the situation even now.

Before dissecting the Alexander situation, it should be said that she showed courage in admitting her professional transgression and discussing a painful and humiliating romantic failure. All of us are capable of misjudgments and wishful thinking, unfortunately for her, this became an international affair.

More critically, Alexander, a journalist, set aside her ethics for a romance and what seems to be surprisingly poor research by Alexander’s team.  (Even I had a little something about this in 2013.) How did a crack NBC research team miss the problems? (For the curious, this Bryan Burrough April 30, 2015 article for Vanity Fair highlighting scandals plaguing NBC News may help to answer the question about NBC research.)

Finally, there’s an enormous amount of pressure on stem cell scientists due to the amounts of money and the degree of prestige involved. Ciralsky’s story notes the pressure when he describes how Macchiarini got one of this positions at an Italian facility in Florence through political machinations. (The situation is a little more complicated than I’ve described here but an accommodation in Macchiarini’s favour was made.) Laura Margottini’s Oct. 7, 2014 article for Science magazine provides a synopsis of another stem cell controversy in Italy.

Stem cell controversies have not been confined to Italy or Europe for that matter. There was the South Korean scandal in 2006 (see a Sept. 19, 2011 BBC [British Broadcasting Corporation] news online post for an update and synopsis) when a respected scientist was found to have falsified research results. Up to that  point, South Korea was considered the world leader in the field.

Finally,  if there are two survivors, is there a possibility that this procedure could be made successful for more patients or that some patients are better candidates than others?

Additional notes

Macchiarini is mounting a defence for himself according to a March 30, 2016 news item on phys.org and a Swedish survey indicates that the average Swede’s trust in researchers still remains high despite the Macchiarini imbroglio according to an April 15, 2016 news item on phys.org.

For anyone interested in the timeline and updates for this scandal, Retraction Watch offers this: http://retractionwatch.com/2016/02/12/reading-about-embattled-trachea-surgeon-paolo-macchiarini-heres-what-you-need-to-know/

Macchiarini controversy and synthetic trachea transplants (part 1 of 2)

Having featured Paolo Macchiarini and his work on transplanting synthetic tracheas into humans when it was lauded (in an Aug. 2, 2011 post titled: Body parts nanostyle), it seems obligatory to provide an update now that he and his work are under a very large cloud. Some of this is not new, there were indications as early as this Dec. 27, 2013 post titled: Trachea transplants: an update which featured an article by Gretchen Vogel in Science magazine hinting at problems.

Now, a Feb. 4, 2016 article by Gretchen Vogel for Science magazine provides a more current update and opens with this (Note: Links have been removed),

The Karolinska Institute (KI) in Stockholm “has lost its confidence” in surgeon Paolo Macchiarini, a senior researcher at the institute, and will end its ties with him. In a statement issued today, KI said that it won’t renew Macchiarini’s contract after it expires on 30 November 2016.

The move comes in the wake of a chilling three-part TV documentary about Macchiarini, a former media darling who was cleared of scientific misconduct charges by KI vice-chancellor Anders Hamsten last summer. Among other things, The Experiments, broadcast in January by Swedish public television channel SVT, suggests that Macchiarini didn’t fully inform his patients about the risks of his pioneering trachea implants. Most of the patients died, including at least one—a woman treated in Krasnodar, Russia—who was not seriously ill before the surgery.

For a profession that has “do no harm” as one of its universal tenets, the hint that a patient not in dire need agreed to a very risky procedure without being properly apprised of the risks is chilling.

Macchiarini’s behavriour is not the only concern, the Karolinska Institute is also being held to account (from the Vogel article),

The film has also raised questions about the way Hamsten and other administrators at KI, Sweden’s most prestigious university and home of the selection committee for the Nobel Prize in Physiology or Medicine, have handled the scandal. Today [Feb. 4, 2016], the Institute’s Board decided to launch an independent review, to be led by an experienced lawyer, into KI’s 5-year relationship with Macchiarini. Among the things the inquiry should address is whether any errors were made or laws were broken when Macchiarini was hired; whether misconduct charges against him were handled properly; and why, given the controversy, he was given a new 1-year contract  as a senior researcher after his appointment as a visiting professor at KI ended in October 2015.

Getting back to Macchiarini (from the Vogel article),

In 2014, colleagues at KI alleged that Macchiarini’s papers made his transplants seem more successful than they were, omitting serious complications. Two patients treated at Karolinska died, and a third has been in intensive care since receiving a trachea in 2012. The Illinois patient also died, as did three patients in Russia. Bengt Gerdin, a professor emeritus of surgery at Uppsala University in Sweden who investigated the charges at KI’s request, concluded in May 2015 that differences between published papers and lab records constituted scientific misconduct. But Hamsten rejected that conclusion in August, based on additional material Macchiarini submitted later.

The documentary shows footage of a patient who says Macchiarini reassured him before the surgery that experiments had been done on pigs, when in fact none had taken place. It also follows the wrenching story of the first patient in Krasnodar. A 33-year-old woman, she was living with a tracheostomy that she said caused her pain, but her condition was not life-threatening. The film suggests that she wasn’t fully aware of the risks of the operation, and that Macchiarini and his colleagues knew about problems with the implant before the surgery. The patient’s first implant failed, and she received a second one in 2013. She died in 2014.

So in May 2015, an investigator concluded there had been scientific misconduct and, yet, Macchiarini’s contract is renewed in the fall of 2015.

Kerry Grens in a March 7, 2016 article for The Scientist provides information about the consequences of the latest investigation into Macchiarini’s work (Note: Links have been removed),

Karl-Henrik Grinnemo, a surgeon at the Karolinska Institute and one of a number of colleagues who voiced concerns about the conduct of fellow surgeon Paolo Macchiarini, is no longer a coauthor on a 2011 The Lancet study led by Macchiarini that described an artificial windpipe. Grinnemo asked to be removed from the paper, and the journal complied last week (March 3).

Grinnemo’s removal from the study is the latest in a string of repercussions related to an investigation of Macchiarini’s work. Last month, the head of the Karolinska Institute, Anders Hamsten, resigned because the institution’s initial investigation concluded no wrongdoing. Hamsten said he and his colleagues were probably wrong about Macchiarini; the institute has launched another investigation into the surgeon’s work.

A March 23, 2016 news item on phys.org announces Macchiarini’s firing from the Karolinska Institute and provides a brief description of his work with synthetic tracheas (Note: A link has been removed),

Sweden’s Karolinska Institute (KI), which awards the Nobel Prize for Medicine, on Wednesday [March 23, 2016] dismissed a Italian transplant surgeon suspected of research fraud and ethical breaches, in an affair that has plunged the renowned institution into crisis.

“It is impossible for KI to continue to have any cooperation with Paolo Macchiarini. He has acted in a way that has had very tragic consequences for the people affected and their families. His conduct has seriously damaged confidence in KI,” human resource director Mats Engelbrektson said in a statement.

Macchiarini, a 57-year-old visiting professor at Karolinska since 2010, rose to fame for carrying out the first synthetic trachea, or windpipe, transplant in 2011.

It was a plastic structure seeded with the patient’s own stem cells—immature cells that grow into specialised cells of the body’s organs.

The surgeon performed three such operations in Stockholm and five others around the world, and the exploit was initially hailed as a game-changer for transplant medicine.

But six of the eight patients reportedly died, and allegations ensued that the risky procedure had been carried out on at least one individual who had not been life-threateningly ill.

Macchiarini is also suspected of lying about his scientific research and his past experience with prestigious medical research centres.

“Paolo Macchiarini supplied false or misleading information in the CV he submitted to KI” and “demonstrated scientific negligence” in his research, said the institute.

H/t to Don Bright, a reader who informed me about this April 2, 2016 posting by Pierre Delaere (a long time Macchiarini critic), published in Leonid Schneider’s blog, For Better Science,

I have written this overview as a trachea surgeon working at KU Leuven and privileged witness of the “Tracheal regeneration scandal” from the very start.

Because of its immense scale, the scandal is difficult to grasp and explain. Fortunately, we have recently been provided with an excellent overview in the 3 x 1-hour documentary by Bosse Lindquist on Swedish national TV. Due to Paolo Macchiarini’s appetite for the spotlights and thanks to the professional standards of the Swedish top producer this is probably the very first case of a medical crime played out in the media. Anyone who has seen this brilliant investigative documentary cannot help but wonder why there are still people who doubt that this is a case of gross medical misconduct.

The story began in Barcelona in 2008 with the publication in The Lancet of a report on a regenerated windpipe, featuring Paolo Macchiarini (PM) as its first author (Macchiarini et al. Lancet 2008). This ground-breaking achievement consisted of bringing to life a dead windpipe from a donor, by putting it in a plastic box, a so-called ‘bioreactor’ together with bone marrow fluid (stem cells). A few weeks later, I wrote a letter to The Lancet, pointing out:

    “The main drawback of the proposed reconstruction is the lack of an intrinsic blood supply to the trachea. We know that a good blood supply is the first requirement in all other tissue and organ transplantations. Therefore, the reported success of this technique is questionable” (correspondence by Delaere and Hermans, Lancet 2009).

Delaere goes on to recount and critique the story of the first synthetic trachea,

…  PM had mounted bone marrow extract (‘stem cells’) on a plastic tube (‘bioartificial trachea’) in a plastic box (‘bioreactor’). After a day or two this creation was ‘successfully’ transplanted in a patient with a trachea defect. This occurred in the Karolinska hospital in July 2011 and was reported on in The Lancet shortly afterwards . Biologically speaking, the procedure is absolutely implausible.

In reality an important part of the windpipe had been replaced by a synthetic tube, and the presence of stem cells made no difference to this whatsoever.

For those not in the field, this procedure may still seem acceptable. A blood vessel can also be replaced by synthetic material because the material can grow into the sterile environment of the blood stream. However, this is completely impossible if the synthetic material is exposed to an environment of inhaled air full of bacteria. The laws of biology allow us to predict accurately what will happen after part of the windpipe has been replaced by a synthetic tube. After some time, the suturing between the synthetic tube and the surrounding tissue will come loose, leading to a number of serious complications. These complications inevitably lead to death in the short (months) or in the mid-long term (a few years). How long the patient will survive also depends on the options still left to treat complications. In most cases so far, a metal stent had to be implanted to keep the airway open in the sutured area.It is entirely predictable that additional complications after placement of the metal stent will ultimately lead to the patient’s death, usually by asphyxiation or by bleeding out after complete rupture of the sutures. This gruesome fate awaiting patients was clearly shown in the documentary. Replacing a part of the trachea by a synthetic tube can therefore be compared to death by medical torture. The amount of suffering it induces is directly proportional to the duration between implantation and the patient’s death.

Delaere describes his own and others’ efforts to bring these issues to light,

Since 2011, I have contacted both the President of KI and the Editors of The Lancet with well-documented information to clarify that what had happened was completely unacceptable. These alerts were repeated in 2013 and 2014. Since 2014, four doctors from KI, who had seen it all happen, have been collecting evidence to show the extent of misconduct [Matthias Corbascio, Thomas Fux, Karl-Henrik Grinnemo and Oscar Simonsson, their letter to Vice-Chancellor Hamsten from June 22, 2015, and its attachments available here; -LS]. Not only did KI not react to the doctors’ complaint, these doctors were in fact intimidated and threatened with dismissal. KI’s Ethical Commission came to a verdict of ‘no misconduct’ in April 2015 following an inquiry based on a series of complaints filed by myself [verdict available from SVT here, -LS]. The Lancet Editor did not even bother to reply to my complaints.

In the reports, eight patients were given synthetic tracheas with six now dead and, allegedly, two still living. Delaere comments,

… To prove that this transplantation technique is effective, reports about the long-term success of this technique in the first 2 patients in Barcelona and London is still being spread. What the real situation of the two patients is at the moment is very difficult to establish. For some time now, reports about these two cases seem to have disappeared from the face of the earth. After the air has been cleared in Sweden, the same will probably happen in London and Barcelona.

Comments

Sometimes medical research can be very dangerous. While, a 25% chance of success (two of Macchiarini’s eight patients undergoing the synthetic trachea transplant have allegedly survived) is not encouraging, it’s understandable that people in dire circumstances and with no other options might want to take a chance.

It’s troubling that the woman in Russia was not in dire straights and that she may not have known how dangerous the procedure is. It would have been unethical of Macchiarini to knowingly perform the procedure under those circumstances.

I am wrestling with some questions about the composite used to create the synthetic trachea and the surviving patients. My understanding is that the composite was designed for eventual deterioration as the patient’s own harvested stem cells fully formed the trachea. Whether the trachea is the one I imagined or he plastic one described by Delaere, how did two patients survive and what is their condition now? The first patient Andemariam Teklesenbet Beyene in 2011 had apparently completed his PhD studies by 2013 (my Dec. 27, 2013 posting). Assuming Beyene is one of the two survivors, what has happened to him and the other one?

As for Delaere’s comments, he certainly raises some red flags not only regarding the procedure but the behaviour of the Lancet editorial team and the Karolinska Institute (they seem to be addressing the issues by firing Macchiarini and with the  resignations of the staff and board).

There are two more twists to this story, which carries on in part 2.