Face Recognition

Biometric verification. Face recognition on polygonal grid is constructed by the points

Apple announced Face ID during the unveiling of the iPhone X in September 2017. The feature was presented as the successor to Touch ID, Apple’s previous fingerprint-based authentication technology. With a simple glance, Face ID securely unlocks your iPhone X. Also with Face ID, you can make purchases from Apple and make payments with Apple Pay. Apple opened up the interface to Face ID and now many apps take advantage of the feature.

The technology behind Face ID is quite impressive. The camera captures and analyzes more than 30,000 invisible dots projected onto your face plus an infrared image of your face. The data is compared to the data from when you enrolled yourself on the iPhone. Face ID works in the dark and can adapt to shaving a beard, and wearing a hat, scarf, or sunglasses. While the odds of someone stealing your iPhone and having a fingerprint just like yours is 1 in 50,000, with Face ID, the odds of a thief having a face the same as yours is 1 in a million.

Face recognition is here to stay. What Apple has done to recognize your face is benign. The data about your face is stored on your iPhone in a special area inside the phone called  the Secure Enclave. The data is not stored in iCloud. If you get a new phone, you have to scan your face again. Delta Airlines has announced they will be using face recognition to help you check in faster. The TSA has laid out plans to use facial recognition for domestic flights. Banks and hotels are planning to use face recognition. And then there is Government. Face recognition will be ubiquitous. Where will Marriott store data about our faces? In their cloud? Will they use the same protocols to protect that data as was used to protect Starwood’s data which was breached for 500 million guests?

And, how will government use face recognition? Cameras on every street corner will not just show someone in a monitoring center video of who is walking by. They will know WHO is walking by. Will we be tracked? Or will just certain people be tracked? The policy questions abound. The need for regulation here is obvious. Will it be left up to our tech savvy Congress?

The issues surrounding face recognition are going to be much broader and deeper than what I have outlined so far. A team of researchers funded by the German Research Foundation has published a paper called, “Face2Face: Real-Time Face Capture and Reenactment of RGB Videos“. What they have done is mind boggling. They call it facial reenactment in real-time. Five examples appear in the images below. I made a few highlights to help you see what is going on. Look at the person with the red box around his face. He is the “target”. The person whose face is outlined in green is one of the researchers, he is the “source”. While the video of the target is playing, video of the source is captures and used to “reenact” the video of the target. Notice in the original video the target had his mouth closed. But, using the research technology, the video was modified from video of the source and, voilà, the target has his mouth opened.

The German research is incredibly profound. The researchers said, “Our approach is a game changer.” The technology will enable editing of videos in real time on a home PC by non-experts. In 1994, the cover of Scientific American showed a picture of Marilyn Monroe with Abraham Lincoln. It demonstrated what was possible with computer graphics, and it was stunning at the time. The technology demonstrated by the German researchers could be called face manipulation. It can bring “Fake News” to a whole new level. The researchers said, “We hope that the numerous demonstrations of our reenactment systems will teach people to think more critical about the video content they consume every day, especially if there is no proof of origin.” And where will we get the proof of origin? From Facebook?

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An Apple a Day For a Healthy Heart

Picture from Apple

In the 1860s, a proverb originated in the country of Wales; “Eat an apple on going to bed, and you’ll keep the doctor from earning his bread.” By the end of the 19th century, the phrase morphed into “An apple a day keeps the doctor away”. There is actually some scientific backing to the proverb. 

A 2011 study found consumption of apples and pears might prevent strokes. A 2012 study found apple consumption significantly lowered bad cholesterol levels in middle-aged adults. In 2013, leading general medical journal BMJ published a study as part of its humorous Christmas issue comparing the effects of prescribing everyone in the UK over age 50 either an apple or a lipid-lowering statin a day. The study concluded that both interventions had the same effect. A 2015 study looked directly at the relationship between apple consumption and physician visits and found no evidence that the proverb was true. The study did, however, find that people who ate an apple a day did use fewer prescription medications. A Cupertino, California based company hopes the phrase means everyday more people buy an Apple Watch to monitor their health.

As promised to happen before end of the month, Apple released an Apple Watch update which adds a new capability, the addition of an algorithm which can detect arrhythmia of the heart. It was not obvious from the announcement, but the new capability is available for existing Apple Watches, not just the new Series 4 Watch.

The pre-Series 4 watches will have a new capability in the Heart app. In addition to measuring heart rate, the app will apply an FDA approved algorithm which can detect irregularities in the heart rate and correlate what it finds to atrial fibrillation (AFib). It is believed 6 million people may have AFib and the number is expected to double over the decade ahead. AFib is not in itself life threatening, but it can lead to stroke or heart failure.  You can set preferences for the Heart app to alert you if one of three things happen. First is your heart rate is above a number you select, such as 120. Second is your heart rate is below a rate you set, such as 50. Third, is an alert if the Watch algorithm detects an irregularity in your heart rate. 

Picture from Apple

The new Series 4 Watch takes things further and enables a 30-second ECG by simply placing your finger on the watch crown. Apple has added new sensors behind the crown to pick up additional information. As a result it can display your heart rate pattern, save it as a PDF, and enable you to send it to a doctor. The new ECG app is not equivalent to the gold-standard 12-lead ECG you would get from a doctor. It is equivalent to Lead 1, and the FDA has approved it as capable to reliably detect AFib.

In my opinion, Apple approached this new strategic area for them in exactly the right way. They collaborated with Stanford University and designed a study meeting all the standards of a clinical study including clearance by an Institutional Review Board to ensure there would be no harm to study participants. I can attest this is a rigorous process, as I went through the same thing as part of my research and doctoral dissertation in 2014. The Apple study The study was able to identify with 98% accuracy the patients who had AFib, and with 99% accuracy the patients who had healthy heart rates. This is the beginning of Apple’s understanding, not the end. With millions of Apple Watch users, the potential for learning is unprecedented to say the least. 

Picture from Apple

I view the new features in the Series 4 Watch as important healthcare breakthroughs, but not without controversy. Some doctors are skeptical. An electrophysiologist at a leading university said the new Apple capability puts tech ahead of medicine. I agree, but don’t feel the progress should be slowed down to allow medicine to catch up. The biggest concern of the medical community is the Watch will produce false positives among the millions of people who have not been diagnosed with AFib. The concern is undue anxiety will be created, people will seek unneeded medical care, and in some cases medication will be prescribed which can have negative effects. I agree with this concern also, but how about the people who may have afib, not be aware of it, and have even more serious consequences. Apple has received multiple communications from people who believe the Watch saved their life because of previously unknown rapid heart rate or arrhythmias.

I view the new monitoring capability as release 1.0 of a new generation of mHealth. (See my peer-reviewed journal article about mHealth here.) Our healthcare system is under great pressure. It is short on resources and under attack for being so expensive. Every day, 10,000 people turn 65 and join Medicare at a cost of $10,000 per year. Something has to give. Consumer led healthcare monitoring is part of the solution. People who track their health will be healthier. If you are interested in this topic, please read Health Attitude: Unraveling and Solving the Complexities of Healthcare.  

Source: Apple’s Newest Watch Features Will Transform Heart Health | WIRED

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Solar Powered Pacemakers

Solar Pacemaker

A pacemaker device implanted in the abdomen or chest can control abnormal heart rhythms. Millions of people have a pacemaker and more than one million additional ones are implanted every year. Pacemakers utilize electrical impulses to assist the heart in maintaining a proper rhythm and heart rate. The small but sophisticated pacemaker devices get their power from a battery which, like all batteries, eventually loses its charge. The depletion phase of the battery life usually begins at about seven years. Although the battery replacement is not complicated and can be done in an outpatient setting, there is the risk of complications. For some, it can be a stressful experience.

Power Electronics magazine reported there have been a number of battery alternatives considered over the years.

Various power sources have been used for pacemakers—among them a radioactive material power source using plutonium-238. Another approach involved inductive transfer in a manner similar to charging a smartphone battery. Several other techniques have utilized the movement of the heart to harvest energy for powering the pacemaker. These approaches all had problems that limited their commercial use. In addition, some of these solutions are affected by cell phone signals or an MRI procedure.

A group of Swiss researchers believes they may have a better idea: power the pacemaker with solar cells implanted under the skin. The researchers found a solar cell less than 1.5 square inches is adequate to generate enough electricity to power a typical pacemaker. The lead research author, Lukas Bereuter of Bern University Hospital and the University of Bern in Switzerland, said that wearing power-generating solar cells under the skin will one day save patients the discomfort of having to undergo a surgical procedure to change the batteries of life-saving devices. More research is needed but the initial research is very promising.

Source: Subcutaneous Solar Cells Could Power Pacemakers

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Amazing Landing on Mars

This was a big week for NASA. The InSight spacecraft traveled 300 million miles to the red planet, slowed down from 13,000 mph to 5 mph and then gently landed on the dusty surface of Mars. Less celebrated but also technologically amazing  was the MarCO project. Two CubeSats, made up of 4 inch square cubes containing communications and other technology. When the Insight craft landed, a briefcase sized craft made from four CubeSats took a picture and then one of the CubeSats relayed the digital picture to Earth in real time. Quite amazing.

The $800 million dollar project has been in planning for eight years, and in the mind of some NASA researchers for several decades. The expected valuable results will take months to arrive. A seismometer will be placed on the surface by a seven-foot robot arm on the InSight spacecraft. It will measure seismic disturbances below the surface. Another instrument placed by the robot will drill 16 feet into the surface. Not only will the scientific discoveries made benefit the understanding of Mars, where some of our grandchildren may live in the future, they will also help scientists better understand the mysteries of the evolution of Earth and other planets.

I can’t resist a simple comparison. We can launch a spacecraft from California, adjust the course over a 300 million mile seven month journey, and land on Mars after flawlessly executing millions of precise instructions. Here on Earth anti-Internet voting activists don’t believe we can conduct secure, private, and verifiable elections with the Internet. The problem is not technical. It is lack of technological and political will.

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Medicare to Negotiate with Pharmaceutical Industry

In March 2015, Health Attitude: Unraveling and Solving the Complexities of Healthcare was published. One of the recommendations made in the book, to address the spiraling healthcare cost for Americans, was to allow Medicare to negotiate the price of drugs. It was a lone voice at the time, but since then more and more people, including the President, have echoed the point. It is so obvious to anyone who looks into the double digit rises in the cost of medications. A friend of mine was at a cocktail party attended by a pharmaceutical company CEO. My friend asked the CEO why he kept raising drug prices. The answer was, “Because we can.” We need someone to stand up to big pharma. The new head of HHS is the one.

To put our healthcare cost in perspective, consider two astounding points:

  • The InSight Spacecraft mission to Mars cost roughly $800 million. Many have said Wow that is a lot!  In America, we spend $10 billion PER DAY on healthcare.
  • Every day, 10,000 Americans turn 65 and join Medicare. Each of them will cost taxpayers roughly $10,000 per year. In other words, each day, we add $100 million dollars to the healthcare bill for Medicare. 

Needless to say, the cost of healthcare is out of control. By 2026, the current estimate is the healthcare bill will be $5.5 Trillion per year and continuing to grow. Something has to give. There is a long list of reasons for the extraordinary cost of American healthcare. One of the culprits is the double digit rise in the cost of prescription drugs. 

Health and Human Services (HHS) head Alex Azar is saying all the right things. In a March post, “Big Changes Coming to Healthcare“, I quoted from Mr. Azar’s first major speech after taking on the HHS role. He said, “Change is possible, change is necessary, and change is coming.” An October post, “Drug Pricing Transparency“, was about Mr. Azar’s view of TV prescription drug advertising where he said the list price of the drugs big pharma is pushing should be shown clearly in the ad. The industry has pleaded that would be a violation of their first amendment rights. Huh? My view, shown in a number of articles and media interviews has been we don’t need TV advertising at all. We are the only country (except New Zealand) which allows it. Forcing the industry to show the price of the drugs is a good compromise.

The biggie is letting Medicare negotiate the price of drugs. Azar knows the industry and has gained bipartisan support for big changes. On Tuesday, HHS announced a major revamp of how Medicare drug pricing will change. The CNBC interview above makes it clear what Mr. Azar thinks and how he is approaching the problem. I found it refreshing. Take a look above or here.

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