The advent of mass working from home has made many people more aware of the security risks of sending sensitive information via the internet. The best we can do at the moment is make it difficult to intercept and hack your messages – but we can’t make it impossible.
What we need is a new type of internet: the quantum internet. In this version of the global network, data is secure, connections are private and your worries about information being intercepted are a thing of the past.
My colleagues and I have just made a breakthrough, published in Science Advances, that will make such a quantum internet possible by scaling up the concepts behind it using existing telecommunications infrastructure.
Our current way of protecting online data is to encrypt it using mathematical problems that are easy to solve if you have a digital “key” to unlock the encryption but hard to solve without it. However, hard does not mean impossible and, with enough time and computer power, today’s methods of encryption can be broken.
Quantum communication, on the other hand, creates keys using individual particles of light (photons) , which – according to the principles of quantum physics – are impossible to make an exact copy of. Any attempt to copy these keys will unavoidably cause errors that can be detected. This means a hacker, no matter how clever or powerful they are or what kind of supercomputer they possess, cannot replicate a quantum key or read the message it encrypts.
This concept has already been demonstrated in satellites and over fibre-optic cables, and used to send secure messages between different countries. So why are we not already using in everyday life? The problem is that it requires expensive, specialised technology that means it’s not currently scalable.
Previous quantum communication techniques were like pairs of children’s walkie talkies. You need one pair of handsets for every pair of users that want to securely communicate. So if three children want to talk to each other they will need three pairs of handsets (or six walkie talkies) and each child must have two of them. If eight children want to talk to each other they would need 56 walkie talkies.
Obviously it’s not practical for someone to have a separate device for every person or website they want to communicate with over the internet. So we figured out a way to securely connect every user with just one device each, more similar to phones than walkie talkies.
Each walkie talkie handset acts as both a transmitter and a receiver in order to share the quantum keys that make communication secure. In our model, users only need a receiver because they get the photons to generate their keys from a central transmitter.
This is possible because of another principle of quantum physics called “entanglement”. A photon can’t be exactly copied but it can be entangled with another photon so that they both behave in the same way when measured, no matter how far apart they are – what Albert Einstein called “spooky action at a distance”.
When two users want to communicate, our transmitter sends them an entangled pair of photons – one particle for each user. The users’ devices then perform a series of measurements on these photons to create a shared secret quantum key. They can then encrypt their messages with this key and transfer them securely.
By using multiplexing, a common telecommunications technique of combining or splitting signals, we can effectively send these entangled photon pairs to multiple combinations of people at once.
We can also send many signals to each user in a way that they can all be simultaneously decoded. In this way we’ve effectively replaced pairs of walkie talkies with a system more similar to a video call with multiple participants, in which you can communicate with each user privately and independently as well as all at once.
We’ve so far tested this concept by connecting eight users across a single city. We are now working to improve the speed of our network and interconnect several such networks. Collaborators have already started using our quantum network as a test bed for several exciting applications beyond just quantum communication.
We also hope to develop even better quantum networks based on this technology with commercial partners in the next few years. With innovations like this, I hope to witness the beginning of the quantum internet in the next ten years.
For many of us, work often competes for time with sleep – which is why many of us look forward to the weekend for a chance to “catch up” on sleep. But how much sleep is lost on days when we work? Our latest research shows that we get about 30 minutes less sleep than we would ideally need on each night of the working week.
We followed 100 people aged from 60 to 71 over two years, covering their transition into retirement. We measured their sleep on three separate occasions, with one year in between, and compared the sleep habits while they were working against when – and for how long – they slept after retirement.
After retirement, we found that every day was like a weekend – at least when it came to how long people slept for. Sleep duration increased, but only on weekdays, from 6.5 to seven hours a night on average. This meant retired people got about an equal amount of sleep every night of the week.
The amount of sleep people tended to get on their weekends while still in work seemed to be their preferred sleep duration, rather than “catch-up” sleep. If weekend sleep was prolonged to compensate for the working week’s sleep loss, we would have expected a drop after retirement (when there’s no sleep loss to compensate for) – but we this wasn’t the case.
Given that participants’ weekend sleep was their preferred sleep duration, weekend lie-ins will not compensate for sleep lost on weekdays while working. This means that our study participants had chronic partial sleep deprivation when they were working, of about 2.5 hours each week.
While adults are recommended to get at least seven hours per night for optimal health, sleep needs vary both between people and as we age. We need less sleep when we are older than when we are younger.
Different people need different amounts of sleep, which makes it hard to estimate what constitutes “too little” sleep for any given individual, but otherstudies have in experiments found that getting only six to seven hours of sleep affects attention and reaction time negatively compared to getting eight to nine hours of shuteye. This performance drop remained, even after getting a full night’s sleep three days in a row.
Partial sleep deprivation as a result of work can continue for years, which is why the accumulated effects needs to be considered. Sleeping less than seven hours on a regular basis is related to increased risk for various health conditions, including diabetes, stroke and depression. It’s also associated with impaired immune system function, as well as increased risk of accidents.
Not only did sleep duration change with retirement, but people also went to bed later and woke later. Getting rid of the alarm clock seemed to be what drove the increase, as retired people went to bed about half an hour later and woke up an hour later on average during weekdays compared to when they were working.
Going to bed in time to get plenty of sleep before getting up for work is not always easy – especially for the majority of the population who have a late “biological clock”. This means they naturally prefer to go to sleep later and wake up later than people with an early biological clock.
Those with a late biological clock also have a tendency to postpone their bed and wake times on weekends more than others, which unfortunately sets their biological clock even later – making it hard to go to bed early on Sunday and even harder wake up early on Monday morning.
When our biological clock is out of sync with the social clock (which is the timetable imposed on us by society) it can result in “social jetlag”. Social jetlag acts a bit like regular jetlag, and can make us feel down and tired. It’s also associated with higher risk for metabolic disorders and depressive symptoms.
But even though sleep patterns became more stable after retirement, people still went to bed and woke up around half an hour later on weekends compared to weekdays. This hints that other social factors – such as visiting with friends – also affect when and how much we sleep.
We also found that retired participants with a full-time working partner changed their sleep timing to a smaller extent than the rest, highlighting that sleep is social, as opposed to a purely individual phenomenon.
But there are some things you can do yourself to adjust your sleep patterns more to work and avoid “social jetlag” on Monday morning, including making sure you get plenty of daylight in the mornings. Morning light pushes our biological clock backwards, making it easier to fall asleep at night. However, the opposite is also true, so bright light should be avoided in the evenings and bedrooms should be dark.
It also helps to prioritise your sleep and keep a more regular sleep schedule, even on weekends. Allow yourself some extra time in bed on weekend mornings if you need it, but try to avoid throwing your weekend sleep schedule off too much in order to stay away from the vicious cycle of sleep loss and social jetlag.
That being said, our study suggests that work generates sleep loss and hinders people from sleeping in line with their natural rhythm. But just as later school start times are an effective way to improve sleep in adolescents, later (or flexible) start times at work could potentially have the same effect for working people – and may mean people won’t have to wait until retirement to get enough sleep.
Young people have probably spent much more of their time than usual playing video games over the last few months thanks to the coronvirus pandemic. One report from telecoms firm Verizon said online gaming use went up 75% in the first week of lockdown in the US.
What impact might this have on young people’s development? One area that people are often concerned about is the effect of video games, particularly violent ones, on moral reasoning. My colleagues and I recently published research that suggested games have no significant effect on the moral development of university-age students but can affect younger adolescents. This supports the use of an age-rating system for video game purchases.
Our sense of morality and the way we make moral decisions – our moral reasoning – develop as we grow up and become more aware of life in wider society. For example, our thoughts about right and wrong are initially based on what we think the punishments and/or rewards could be. This then develops into a greater understanding of the role of social factors and circumstances in moral decisions.
Yet the moral dimension of video games is far more complex than just their representation of violence, as they often require players to make a range of moral choices. For example, players from the game BioShock have to choose whether to kill or rescue a little girl character known as a little sister.
A player with more mature moral reasoning may consider the wider social implications and consequences of this choice rather than just the punishment or rewards meted out by the game. For example, they may consider their own conscience and that they could feel bad about choosing to kill the little girl.
We surveyed a group of 166 secondary school students aged 11-18 and a group of 135 university students aged 17-27 to assess their gaming habits and the development of their moral reasoning using what’s known as the sociomoral reflection measure . This involved asking participants 11 questions on topics such as the importance of keeping promises, telling the truth, obeying the law and preserving life. The results suggested a stark difference between the two groups.
Among secondary students, we found evidence that playing video games could have an affect on moral development. Whereas female adolescents usually have more developed moral reasoning, in this case we found that males, who were more likely to play video games for longer, actually had higher levels of reasoning. We also found those who played a greater variety of genres of video games also had more developed reasoning.
This suggests that playing video games could actually support moral development. But other factors, including feeling less engaged with and immersed in a game, playing games with more mature content, and specifically playing the games Call of Duty and playing Grand Theft Auto, were linked (albeit weakly) with less developed moral reasoning.
No effect after 18
Overall, the evidence suggested adolescent moral development could be affected in some way by playing video games. However, there was little to no relationship between the university students’ moral reasoning development and video game play. This echoes previous research that found playing violent video games between the ages of 14 and 17 made you more likely to do so in the future, but found no such relationship for 18- to 21-year-olds.
This might be explained by the fact that 18 is the age at which young people in many countries are deemed to have become adult, leading to many changes and new experiences in their lives, such as starting full-time work or higher education. This could help support their moral development such that video games are no longer likely to be influential, or at least that currently available video games are no longer challenging enough to affect people.
The implication is that age rating systems on video games, such as the PEGI and ESRB systems, are important because under-18s appear more susceptible to the moral effects of games. But our research also highlights that it is not just what teenagers play but how they play it that can make a difference. So engaging with games for a wide variety of genres could be as important for encouraging moral development as playing age-appropriate games.
With the advances on technology we’ve gone through these last two decades things have changed and will keep changing in the future – one the instigators of this change is Artificial Intelligence (AI).
AI has seen quite an advancement on a lot of sectors – automation aims to have less human assistance to fulfil the same tasks, as with automation with vehicles. Car manufacturers such as Tesla are already using Autopilot technologies to assist human drivers with day-to-day tasks and to run diagnostics on and even repair their cars. Others such as Waymo are equally working towards making vehicles that are self-driving with no human interaction.
The field of Law is however an altogether different kettle of fish.
Today, we see assisting AI that are wrongfully called Robo-Lawyers – while it’s true that there are some tools such as DoNotPay which aim to servethe public, they are nonetheless rooted in case-law made by humans. Solicitors and Barristers also work with vendors such as iManage or NetDocuments which use ‘AI’ this is in fact Machine Learning and Automation. We cannnot replace a good old flesh-and-blood Lawyer just yet – perhaps never.
Thus, the term “robo-lawyer” doesn’t fully capture a complete Artificially Intelligent system that can thoroughly act on a matter: it can analyse data, sort files and information, yes, but as with the medical profession upholding the laws of the land are simply too human to be left to a bare-metal server.
Solicitors and Barristers are not out of a job yet, nor do we think they will be in the near or far future.
Artificial Intelligence is a very broad term, well explored by a Lords Committee on the subject. The APPG on AI would likely agree with us at Hayachi Services that rules and laws have been present in human societies for a very long time indeed.
So what will AI change: Can machines learn faster than humans for example? Not really, no. Machines can process some kinds of information faster than humans, but the human mind is still the most powerful information processing system on this planet. Perhaps Bio-Computers may one day match a Solicitor’s years of expertise or a Barrister’s way with words, but because law is as organic as the fabric of our culture it is doubtful that machines will ever ‘lead-the-field’.
What we consider ‘AI’ today is actually Machine Learning, a very complicated way of saying that we train the computer to run a ‘monkey see, monkey do’ exercise and to detect patterns in line with the variables we humans have set. Indeed a lot of engineering and expertise goes into such an exercise, and it can greatly assist work in the field of Law (such the Lexis Nexis Precedent Database) – but it is what it is.
I will always prefer a real lawyer to an robo-lawyer, what about you?
I spent much of the late 1990s as a reserve military intelligence officer involved in the hunt for war criminals in Bosnia. We got most of them in the end. A couple of years later, as a civilian human rights officer, I visited dozens of shallow graves and killing sites in Kosovo to document investigations and exhumations.
Many of these killings were carried out by Serbian and Croatian units which called themselves “special forces”. At that time, I was confident that British special forces were different. Now, not so much.
Military emails revealed recently by the Sunday Times have shown yet again, that the British special forces seem to have been operating Balkan-style death squads in Afghanistan, killing unarmed men. Last year the BBC raised the alarm on dozens of suspicious deaths during night raids – including children.
The Ministry of Defence said all these cases and many, many others have been “independently investigated” by the British Army’s own military police. The Ministry does not explain how an investigation of the Army by the Army is “independent”. A subsequent article, written in response to the revelations by well-known historian Andrew Roberts, reveals that the government and others apparently think that some of the alleged activities constitute acceptable behaviour. Roberts’ article was given the headline “Tie its hands and the SAS will lose”. It is worth pointing out that the SAS, along with the rest of the British Army, did lose in Afghanistan. This despite the fact that it is luminously clear that the only hands being “tied” were their prisoners. It is also worth saying that their actions have left a poisonous legacy in the country.
Arguments by those who advocate giving “leeway”, as Roberts puts it, for those inclined to war crimes, are important now. They are part of a move by some senior military figures and acolytes in parliament to remove the constraints applied by law on British forces through a proposed piece of legislation called the “Overseas Operations Bill”. This went through its first reading in parliament in March and, if implemented, would make it much harder to prosecute war crimes by the British military.
The proposed law provides a five-year time limit, after which prosecutions for war crimes have to pass through a so-called “triple-lock” procedure before they can proceed. This includes a “presumption against prosecution” once that five-year limit has passed. Cases brought after that time would be “exceptional” and would require the consent of the Attorney General. All this amounts to what is called in legal terms “qualified immunity” for those who have committed war crimes. War criminals simply need to run down the clock.
The basis for this law is the idea of“tank-chasing lawyers” who persecute soldiers with supposedly dishonest claims concerning their activities abroad. However, this is seriously misleading. Criminal prosecutions for war crimes are brought by military prosecutors, not unscrupulous “tank-chasers”. Cases supposedly involving immoral lawyers were brought on behalf of Iraqi and Afghan alleged victims for compensation. These were not war crimes prosecutions. The disgraceful implication of this is that the activities of a single law firm should form the basis for undermining decades of consistent international leadership in this field. Britain has been at the forefront of dealing with war crimes since the Nuremberg tribunals just after the second world war.
This squalid piece of legislation is not going to have an easy ride. Sensible and experienced military voices are now being raised. These officers take seriously their commission from the Queen to carry out their duties “according to the rules and disciplines of war”. David Benest, a leading expert on the history of British war crimes, wrote before his recent death that the bill risks reinforcing an already well-entrenched “cover-up” culture. Equally powerfully, one of the most senior retired officers Charles Guthrie, a former commander of the SAS, has written that the provisions of the bill “appear to have been dreamt up by those who have seen too little of the world to understand that the rules of war matter”.
There is disquiet elsewhere, and for very good reasons. The chairman of the House of Commons Defence Committee has asked whether discussions have taken place with the International Criminal Court about the bill. Such discussion, had it taken place, might have reminded the relevant politicians that were it ever to be made law there is every possibility that the ICC would take over war crimes prosecutions themselves. If that were to happen, the death-squad trigger-pullers won’t be in the ICC’s sights. They will be investigating the generals who ignored, allowed or condoned the soldiers’ actions. They’ll be looking at the ministers who signed off on the operations, and who failed to ensure adequate oversight of what was happening. Unlike in Bosnia, we won’t need search teams to find them.
Individualistic western societies are built on the idea that no one knows our thoughts, desires or joys better than we do. And so we put ourselves, rather than the government, in charge of our lives. We tend to agree with the philosopher Immanuel Kant’s claim that no one has the right to force their idea of the good life on us.
Artificial intelligence (AI) will change this. It will know us better than we know ourselves. A government armed with AI could claim to know what its people truly want and what will really make them happy. At best it will use this to justify paternalism, at worst, totalitarianism.
Every hell starts with a promise of heaven. AI-led totalitarianism will be no different. Freedom will become obedience to the state. Only the irrational, spiteful or subversive could wish to chose their own path.
To prevent such a dystopia, we must not allow others to know more about ourselves than we do. We cannot allow a self-knowledge gap.
The All-Seeing AI
In 2019, the billionaire investor Peter Thiel claimed that AI was “literally communist”. He pointed out that AI allows a centralising power to monitor citizens and know more about them than they know about themselves. China, Thiel noted, has eagerly embraced AI.
We already know AI’s potential to support totalitarianism by providing an Orwellian system of surveillance and control. But AI also gives totalitarians a philosophical weapon. As long as we knew ourselves better than the government did, liberalism could keep aspiring totalitarians at bay.
But AI has changed the game. Big tech companies collect vast amounts of data on our behaviour. Machine-learning algorithms use this data to calculate not just what we will do, but who we are.
The accuracy of AI’s predictions will only improve. In the not-too-distant future, as the writer Yuval Noah Harari has suggested, AI may tell us who we are before we ourselves know.
These developments have seismic political implications. If governments can know us better than we can, a new justification opens up for intervening in our lives. They will tyrannise us in the name of our own good.
Negative freedom is “freedom from”. It is freedom from the interference of other people or government in your affairs. Negative freedom is no one else being able to restrain you, as long as you aren’t violating anyone else’s rights.
In contrast, positive freedom is “freedom to”. It is the freedom to be master of yourself, freedom to fulfil your true desires, freedom to live a rational life. Who wouldn’t want this?
But what if someone else says you aren’t acting in your “true interest”, although they know how you could. If you won’t listen, they may force you to be free – coercing you for your “own good”. This is one of the most dangerous ideas ever conceived. It killed tens of millions of people in Stalin’s Soviet Union and Mao’s China.
The Russian Communist leader, Lenin, is reported to have said that the capitalists would sell him the rope he would hang them with. Peter Thiel has argued that, in AI, capitalist tech firms of Silicon Valley have sold communism a tool that threatens to undermine democratic capitalist society. AI is Lenin’s rope.
Fighting for ourselves
We can only prevent such a dystopia if no one is allowed to know us better than we know ourselves. We must never sentimentalise anyone who seeks such power over us as well-intentioned. Historically, this has only ever ended in calamity.
The problem is not AI improving our self-knowledge. The problem is a power disparity in what is known about us. Knowledge about us exclusively in someone else’s hands is power over us. But knowledge about us in our own hands is power for us.
Many of us have been spending more time at home than ever before, and chances are unless you live by yourself in the middle of nowhere, at some point unwanted noise will have infiltrated your lockdown.
Whether it’s cars passing nearby, a neighbour’s blaring music or the constant drone of a lawnmower, the trouble with sound is that – unlike light – it can be hard to block out completely. This is because it’s a pressure wave in air that readily diffracts around objects and easily passes through porous obstacles such as trees and shrubs.
The wind and temperature gradient in the atmosphere also affects transmission of noise. This is why we may hear the noise from a distant motorway if the wind is blowing from that direction – or think the motorway has moved to the bottom of the garden on a cold still morning when there is a temperature inversion – this is when there are warmer layers of air above colder ones.
Another issue with sound is that people living in a quiet area may be more seriously disturbed by the odd passing vehicle than people living in an area where traffic noise is more constant.
Reducing noise at source is usually the best course of action. Ideally, many of us would like to reduce the number of noisy vehicles passing our homes and gardens but unfortunately, we can’t control this. In the case of road traffic, reducing the speed limit would help – as would a smoother road surface or, better still, a surface that absorbs sound such as porous asphalt. These are all jobs for the highway authority – but they may have more pressing claims on their budgets.
There are, however, things you can do around your house and garden to make things a little more peaceful. A barrier such as a close boarded fence, earth mound or wall close to the road should help – but they will have to be long enough and high enough to have much effect.
Much depends on where the house is in relation to the road. The aim would be to position any barrier so that the road is not in view from any exposed window or part of the garden.
If noise can’t be controlled over the whole garden then consider making a tranquil zone in part of the garden where you can relax. This might involve building a wall or fence around part of the area to block the major sources of noise while not forgetting that the house itself can act as an effective barrier.
A water feature may also help to mask residual noise. The more natural sounding this is the better – but make sure it’s not too noisy, as this may be disturbing to you or your neighbours.
A study involving brain scans has shown that we process auditory information differently depending on the scene in view. The noise of a sandy beach and motorway at distance are quite similar, but research has shown that if using the same sound recording while showing a beach scene (as opposed to a motorway scene) to volunteers in an MRI scanner, the resulting brain patterns differ significantly. The rated tranquillity also differs significantly.
In fact, research on tranquility has shown that the rated tranquillity of a place depends on both the percentage of natural features – such as greenery, rock, sand and water – in view and the level of man-made noise.
This means there is a trade-off in the sense that if you cannot control the noise, the perceived tranquillity improves if the amount of greenery or water in view increases. This is worth bearing in mind when creating a tranquil garden space.
Finding tranquillity indoors
Inside the home, some of the same principles apply. Reduce sources of noise by installing double glazing to windows and doors and add a thicker insulation layer in the loft to control aircraft noise.
If it proves difficult to control noise in the bedroom then think about changing rooms so that you sleep on the non-traffic side of the house. Another thought is to include pictures of nature as wall art – the bigger the better – as research has shown that installing pictures of nature scenes on the walls, as well as playing relaxing sea sounds as background music, can significantly improve people’s experiences of tranquillity and anxiety in a doctor’s waiting room.
Many of us have enjoyed listening to the birds more often with the reduced traffic levels of lockdown. It would be nice to think the “new normal” would include some of these gains. Hopefully people will realise that many of the journeys they make by car are not strictly necessary. And it’s important not to forget that nature is around us all the time – if only we just take a moment to stop and listen.
The UK’s coronavirus contact-tracing app has been kicked into the long grass, with the government now saying it isn’t a priority and may not be ready until winter. The app – which has so far cost nearly £12 million – was supposed to be a key part of plans to identify and isolate anyone who had come into contact with someone reporting COVID-19 symptoms.
If the app does finally appear, it will now be based on a Google and Apple system, which means it won’t store information in a central database. This had been the plan for the original government-developed system that had worried privacy researchers, including myself. But even if the app never gets off the ground, that shouldn’t distract us from seeking more insight into what the government and a few companies with strong political connections are still doing with our health data.
I was one of nearly 200 UK information security and privacy academics who published a joint letter in April asking the government’s digital health agency, NHSX, key questions about its plans for the app. At the time there was no data protection impact assessment (DPIA) – even the data privacy watchdog the Information Commissioner’s Office (ICO) hadn’t seen one.
There was no publicly available information on how the app would work or keep the data secure, and it was not clear that it would work at all. There was also no justification for the choice of a centralised data matching model that was intrinsically riskier to privacy.
One of the purposes for the app was centralised planning for the COVID-19 response. In parallel, NHSX has been developing a “data dashboard” to manage all the data it is collecting for this purpose. The NHS website lists 59 sources of such data, several of which include records about individual patients, such as the Emergency Care Data Set.
More worrying was the choice of partners by NHSX for this project. The data was to be stored on a platform developed by US company Palantir, which was originally funded by the CIA and counts numerous US government agencies as its customers. These include the FBI and the National Security Agency responsible for the secret government internet surveillance programme revealed by Edward Snowden.
The other contracted company, Faculty, has even stronger links to the government via Boris Johnson’s chief adviser, Dominic Cummings, who gave it a key role in the Vote Leave campaign (under the firm’s old name of AIS). The firm’s director Marc Warner has also attended the government science advisory committee SAGE.
The inhabitants of the internet cobbled all this together into a nice conspiracy theory, which might be summarised as “the app is giving all our data to Dom’s mates”. This can be seen all over social media, for example in the responses to a popular tweet about our letter.
But while it appears the app is off the table – or at least that England and Wales will get a more privacy respectful one run by internet giants – there’s still reason to be concerned about NHSX’s use of patient data and how it’s being shared with private firms. Palantir’s original contract was published under legal pressure but its renewed contract has not. In particular, we do not know whether NHSX is paying Palantir properly this time.
We also know more clearly that there’s a lot that we’re not being told, as the government has only published a DPIA for data being combined and stored but not for how it is then being used for planning, including possibly through AI. The DPIA only assesses Palantir’s role for data storage, and yet the firm’s original contract also mentions “data analytics”, “support tracking, surveillance, and reporting”, and none of that is covered in the document. It also doesn’t mention Faculty, which says it is working on data dashboards and modelling as part of its contract with NHSX.
Consultation with stakeholders and external experts is recommended for DPIAs, but none was done here. Even branches of the NHS in charge of health data handling, such as NHS Digital, do not appear to have been consulted.
A DPIA should examine how the rights and freedoms of the people whose data is collected might be affected and ask: “What could possibly go wrong?” When you construct a large database including individual medical data, there are many possibilities for it to be used beyond its original function and for abuse, bias and unexpected harmful side-effects. Unfortunately, this DPIA only recognises low-level risks with their technical and organisational mitigations.
Overall, that leaves us in a position where we do not know what Palantir, Faculty and others are doing with NHS medical data. We do not know whether the risks of abuse of the data have been properly recognised and mitigated. But we do know that this kind of database is not protected against access by intelligence services.
A full DPIA for the NHSX’s COVID-19 data operation might help. A more comprehensive solution would include a law to protect the pandemic-specific data programmes. But the proposal by the Joint Human Rights Committee has been rejected by the government. So for now, there’s plenty still to worry about.
The Conversation has approached NHSX, Palantir and Faculty for comment.
For thousands of Syrian refugees who have suffered horrific blast injuries after being hit by barrel bombs and other devices of death in their war-torn homeland, the only option is amputation. When you see the damage a blast injury can do it’s a shock to the system and is so very sad and upsetting.
Barrel bombs have been dropped throughout the long conflict that has torn Syria apart and caused untold misery and pain to so many innocent civilians. At the start of 2018, Amnesty International reported that barrel bombs had killed more than 11,000 civilians in Syria since 2012, injuring many more.
The barrel bomb is a type of improvised explosive device which – according to the UN – is used extensively by the Syrian Air Force. They are made from large oil barrels and are typically filled with TNT, oil and even chunks of steel. Due to the large amount of explosives that can be packed into a barrel, the resulting explosion can be devastating.
Even if a person survives such a blast, their limbs are at risk of suffering a large, often jagged break which, even in the best conditions, would be a major challenge to repair. In a fully equipped, state-of-the-art hospital such patients would be able to access expert orthopaedic surgery and a lot of expensive aftercare.
But in a refugee camp, far away from any sophisticated surgical intervention, these types of complex procedures with timely recovery and care implications are just not possible. So at the moment, amputation is unfortunately the most likely outcome in many of these cases.
This article is part of Conversation Insights The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.
Many of these bone shattering injuries are untreatable because of the constant risk of infection from procedures carried out in the field and the collapse of the healthcare system. A simpler and cheaper way to help these people needed to be invented and my colleagues and I believe we have done just that.
Our treatment uses a temporary, 3D printed “bone brick” to fill the gap. They are made up of polymer and ceramic materials and can be clicked together just like a Lego brick to fit perfectly into whatever gap has been created by the blast injury. The bricks are degradable and allow new tissue to grow around them. This structure will support the load like a normal bone, induce the formation of new bone and, during this process, the bricks will dissolve. The idea is that the surgeon can open a bag of bricks and piece them together to fit that particular defect and promote the bone growth.
The solution has been a long time coming and it was very much the plight of Syrian refugees that inspired it. It struck a very personal chord. I recognise that misery and pain and see my younger self on the faces of the children. I was born and grew up in Mozambique in South-East Africa in 1968. It was the middle of the war of independence and the country was in turmoil.
My family inevitably became caught up in the decade-long conflict that involved the Portuguese community that was living and working in Mozambique and the Frelimo (The Mozambique Liberation Front) resistance movement that were seeking independence and self-rule.
It was 1973 and these were dangerous times. I was about five years old and it was a very frightening and disruptive period of my life. We moved up and down the country as my father’s job in civil administration changed and required us to move to the Niassa government base in Vila Cabral (now Lichinga).
One episode sticks out vividly. My one-year-old brother, Jose Manuel, and I were taken from our home in Maragra and moved to a refugee camp in an area of South Africa called Nelspruit, as we tried to escape the escalating violence. We were safe but I was always anxious and scared about the security of our family.
Although we were only in the camp for around a month before we were transferred to start a new life in Portugal when I was six, that experience stayed with me for life. It gave me a strong sense of empathy for others who are being displaced by war. And it would eventually strengthen my commitment to use my bio-medical expertise to try and do something to help other refugees.
Blast injuries and amputations
The first time I was made fully aware of the impact of blast injuries in the Syrian conflict was when Amer Shoaib – a consultant orthopaedic surgeon at Manchester Royal infirmary – came to my university to discuss his experience and the problems he faced in treating these injuries in Syrian refugees.
Shoaib is a limb-injury expert with experience of working on the frontline of various conflicts and crisis zones as a humanitarian worker. He told us that in Syria the after effects of blast injuries were sometimes untreatable because of the constant risk of infection. The collapse of the healthcare system has also led to many treatments being done by people who are not, in fact, trained medics.
Shoaib was working in refugee camps in Turkey and I, along with my Manchester research colleagues Andy Weightman and Glenn Cooper, decided we needed to help and apply our expertise. We all wanted to make a difference and we continued our discussion late into the evening. This conversation developed into the idea of the “bone bricks”.
My own academic interests include biofabrication for tissue engineering. This involves fabricating bone, nerve, cartilage and skin through the use of 3D printing. 3D printing technology can now reproduce biocompatible and biodegradable materials that can be used in the human body.
Current grafting techniques have several limitations, including the risk of infection and disease transmission. They are also quite costly and present a high risk of further injury and serious bleeding. This work is centred on creating orthopaedic devices – or scaffolds – that can enable the regeneration of bone tissues to repair fractures.
I had been busy responding to the calls from clinicians to make these tools more agile, smaller in scale and responsive to more personalised healthcare. But the challenge set by the Syrian situation was a game-changer: we had to consider other new factors, such as making the scaffolds even more cost-effective and useable in demanding environments where it is very difficult to manage infection.
Part of our solution to these challenges was to use relatively low-cost 3D printing technology to create bone bricks with a degradable porous structure into which a special infection-fighting paste can be injected. The bone brick prosthesis and paste will prevent infection, promote bone regeneration and create a mechanically stable bone union during the healing period.
The challenge of creating this pioneering prosthesis led us on a journey to Turkey in 2016 where we met with academics, surgeons and medical companies. We were convinced that our proposed new technique could dramatically improve the medical response to life-changing limb injuries in the challenging conditions of these camps. It was clear that our project should be focused on patients within the Syrian refugee community in Turkey where they have found a safe haven from the horrors of war.
Once we secured the backing of the Global Challenges Research Fund (a £1.5 billion pot provided by the UK government to support cutting edge research that specifically addresses the challenges faced by developing countries) we began to put our project into motion. As a first step Weightman, Cooper and I visited Sabanci University in Istanbul to meet with our lead collaborator there, Bahattin Koç, who introduced us to a group of clinicians who had been dealing with the refugees and their injuries firsthand and were able to share their knowledge. Their experiences gave us insight into the challenges of treating serious bone injuries in the field.
Our collaborators in Turkey helped to ensure we shaped the design and specifications of the bone bricks so they aligned as closely as possible to the needs of the frontline clinicians. During our stay in Istanbul we were constantly reminded of the human cost of the Syrian civil war. We would often witness groups of displaced families, including children, who had fled the conflict and were seeking refuge and the chance to rebuild their lives. What we had seen on TV about Syria, with helicopters dropping bombs, was brought home to us. Some of my colleagues have children the same age as those we want to help and it made us even more determined to do something.
War in Syria
The Syrian conflict has displaced around 3 million refugees into Turkey, accounting for around 4% of its population. Turkey provides free healthcare services to Syrians and, as such, the burden on the healthcare system is significant, with 940,000 patients treated, 780,000 operations and 20.2 million outpatient services taken up between 2011 and 2017 alone.
The Turkish government says it has spent more than US$37 billion hosting Syrian refugees. We hope that our bone bricks innovation can make a contribution to this crisis, helping to mitigate Turkey’s healthcare costs and also significantly improve the human cost of this crisis.
Our project is focused on bone injuries that are often caused by blast explosions, which are powerful enough to throw a person many yards and shatter bodies. Shoaib once said to us:
This is certainly true for the Syrian crisis where thousands of people are suffering terrible injuries. Given that almost 2 million people have been injured in the Syrian civil war, we estimate that 100,000 people have been affected by large bone loss and of those injured since 2013 there have been more than 30,000 amputations – equating to about 7,500 a year. Amputation has associated physical complications including heart attack, slow wound healing and the constant risk of infection.
Current bone repair techniques are complex. They include:
The leg or arm being harnessed in a metal fixing device or cage which allows slow-growing bone tissue to reconnect. But this process frequently creates complications caused by metal wires transfixing and cutting through soft tissues as the frame is extended to lengthen the bone. It is a lengthy and meticulous.
Placing a pin or plate implant to stabilise the bone gap and enable the tissue to reconnect. This procedure requires complex surgery in specialist centres of excellence and can only be considered in extreme and selected cases.
Bone shortening procedures, where healing is stimulated by removing damaged bone tissue. Or there are forms of bone grafting techniques which use transplanted bone to repair and rebuild damaged bones.
And it must be remembered, traumatic limb amputation is a catastrophic injury and an irreversible act that has a sudden and emotionally devastating impact on the patient. As a consequence, this not only impacts a person’s ability to earn a living but also brings very serious psychological issues for the patient because of the cultural stigma associated with limb loss.
External prosthetic limbs after amputation provide some with a solution but they are not suitable for all. Studies show that the long term healthcare costs of amputation are three times higher than those treated by limb salvage. Clearly, saving a limb offers a better quality of life and functional capacity than amputation and external prosthetics.
Just like Lego
With many blast injuries, the bone defects are totally impossible to heal. What we are doing is creating a temporary structure using bone bricks to fill the gap. Our treatment uses medical scaffolds, made up of polymer and ceramic materials, which can be clicked together like a Lego brick, creating a degradable structure which then allows new tissue to grow.
We are also developing software to allow the clinician, based on the information on the bone defect, to select the exact number of bone bricks with the specific shape and size and information on how to assemble – just like Lego instructions. The connection between the bone brick design and the 3D printing system is completed. We’re now in the process of integrating with the software that will link the scanning of information from the wound area with the identification of the correct type of bone bricks and assembly mechanism.
An antibiotic ceramic paste is stored in a hollow in the middle of the brick and is a highly practical way to combat infection while the limb repairs and hugely improves the chances of success.
The bone brick solution is much more cost effective than current methods of treatment. We expect our limb-saving solution will be less than £200 for a typical 100mm fracture injury. This is far cheaper than current solutions, which can cost between £270 and £1,000 for an artificial limb depending on the type needed.
When will they be used on humans?
My team and I are entering the final stages of a three-year project. Our team consists of academics and clinicians from Manchester and Turkey, as well as a pool of ten bone injury patients drawn from the UK, Turkey and Syria. We have already evaluated the modular bone bricks system in a computer simulation, created prototypes of the modular bone bricks using 3D printing technologies in the lab, and conducted in-vitro (laboratory) testing of mechanical and biological characterisation of the bricks. This will be followed by in-vivo (animal) testing to prepare the device for regulatory approval and a pathway to implementation by clinicians. Once all these stages are complete the project we will be ready to trial on human patients.
The final stage will then be to translate the research into building a useable, medical device. This will be undertaken by a follow-on clinical trial on about 20 patients with large bone loss, some of which we expect will be drawn from the Syrian refugee community. The project will be subject to strict ethical scrutiny and approval.
We hope this project will lead to further development of emergency healthcare in the developing world and could bring hope to a Syrian refugee community in dire need while their country rebuilds. Our long term hope is that bone bricks will be of use, not only in refugee crises, but also in many other healthcare situations, such as accidents and natural disasters – in both developing and developed nations. For example, in the UK around 2,000 patients a year receive treatment for severe fractures requiring surgical reconstruction for bone loss.
The burden to the health service relating to major traumatic injuries is estimated to be in excess of £0.5bn. In addition, the estimated loss of contribution to the economy due to extended periods of rehabilitation is another £3.5 billion.
We believe the bone brick project could help alleviate some of those economic burdens and drastically improve the patient experience. But it is the plight of the Syrian refugees that continues to inspire and inform this project. We hope that, perhaps in five years’ time, bone bricks will be used in the field on humans, finally giving medics and victims an alternative to catastrophic limb amputation.
In the middle of the night, invisible to anyone but special telescopes in two Chinese observatories, satellite Micius sends particles of light to Earth to establish the world’s most secure communication link. Named after the ancient Chinese philosopher also known as Mozi, Micius is the world’s first quantum communications satellite and has, for several years, been at the forefront of quantum encryption. Scientists have now reported using this technology to reach a major milestone: long-range secure communication you could trust even without trusting the satellite it runs through.
Launched in 2016, Micius has already produced a number of breakthroughs under its operating team led by Pan Jian-Wei, China’s “Father of Quantum”. The satellite serves as the source of pairs of entangled photons, twinned light particles whose properties remain intertwined no matter how far apart they are. If you manipulate one of the photons, the other will be similarly affected at the very same moment.
It is this property that lies in the heart of the most secure forms of quantum cryptography, the entanglement-based quantum key distribution. If you use one of the entangled particles to create a key for encoding messages, only the person with the other particle can decode them.
Micius has previously produced entangled photons and delivered them to two ground stations (observatories) 1,200km apart via special telescopes. Scientists showed the photons reach Earth as entangled as they were in orbit.
Then, in 2017, Micius was used to distribute quantum cryptographic keys to ground stations near Vienna and Beijing, enabling a secure virtual meeting between the Austrian and Chinese science academies – 7,400km apart.
None of the communication went through Micius. It only produced and distributed the encryption keys. But both ground stations had to talk to and trust Micius as part of their communication systems and use it as a relay before establishing a link with each other.
A new paper from Pan Jia-Wei’s lab published in Nature shows that Micius has again successfully brought entanglement-based quantum cryptography to its original ground stations 1,200 km apart. But this time the satellite sent simultaneous streams of entangled photons to the ground stations to establish a direct link between the two of them.
This gave them robust, unbreakable cryptographic protection without the need to trust the satellite. Until now, this had never been done via satellite or at such great distances.
Again, none of the communication went through Micius. The satellite provided entangled photons as a convenient resource for the quantum cryptography and the two ground stations then used them according to their agreed protocol. This also involved designing the machinery for distributing the keys and a mechanism for preventing malicious attacks, such as blinding the telescopes with other light signals.
The new paper doesn’t specify how the messages were transmitted in this instance, but in theory it could be done by optical fibre, another communications satellite, radio, or any other method they agree upon.
Secure long-distance links such as this one will be the foundation of the quantum internet, the future global network with added security powered by laws of quantum mechanics, unmatched by classical cryptographic methods.
The launch of Micius and the records set by the scientists and engineers building quantum communication systems with its help have been compared to the effect Sputnik had on the space race in the 20th century. In a similar way, the quantum race has political and military implications that are hard to ignore.
Pan Jian-Wei credited Edward Snowden’s 2013 disclosures of internet surveillance by western governments with prompting China to boost quantum cryptography research in order to create more secure means of communication. As a result, Micius has been dubbed Sputnik for the ultra-paranoid.
Any country could theoretically trust Micius to provide entangled photons to secure its communications. But the satellite is a strategic resource that other countries are likely to want to replicate, just as Europe, Russia and China now have their own versions of the US-controlled GPS. However, the news of a successful long distance quantum communications link is a sign that we are already living in a new era of communication security.
This article has been amended to correct the time at which distribution machinery and attack prevention were developed