Machine fights for the working class (TV series: Machine, 2024)

French television studios have recently provided us with several series with female protagonists endowed with exceptional qualities. ‘HPI’ that I saw and wrote about two months ago, was dealing with a woman with an exceptionally high intellectual potential, which made her extremely competent in solving the most complicated murder cases, but also totally emotionally inadequate and socially unadaptable. The heroine of the ‘Machine‘ series whose first (and for now only) season I finished watching has other qualities. She went through military training that included the martial arts of Kung Fu and gained a fighting experience that made her a formidable beating and – when needed – killing machine. Do the authors of the scenarios want to tell us – at the extreme, of course – that in order to succeed or just survive in today’s world, women must not only be much better than men, but sometimes be downright superheroes? If we are to go by what we see in these two series, their special qualities do not bring them happiness and do not help them avoid the loneliness to which they seem condemned. What is certain, however, is that they make interesting heroines for TV series.

The story takes place in an area of France remote enough for the access roads to be at best two-way roads. A rather young but visibly scarred by life woman is assigned by the Human Resources Bureau to work temporarily as a mechanician at a factory of household electrical products. She is single and spends her time listening to fairly old rap and punk music tapes inherited from her mother, who had died a short time ago. Among his co-workers, those who lend her a helping hand are a maintenance technician named P.J. who turns out to be a staunch Marxist and Leila, a young accountant. The factory is about to be sold to a Korean concern. Workers resist, knowing that such transitions lead to worsening conditions and job losses, but economic and political interests go far beyond the local context. As the conflict becomes more and more violent (workers go on strike, the authorities call for the intervention of the police and other “maintaining of order” forces), the young woman whom those around her call Machine reveals her qualities as a fighter and puts them at the service of her fellow workers. At the same time we learn that the military authorities and a mysterious man who has personal reasons for revenge are on her trail.

The script is very well written, combining action films with films with social and political themes. It’s snappy, well-paced, with episode endings that make viewers look forward to the next episode or start watching it immediately if they’re watching on streaming. The actors’ performances are very good, but two roles stand out. The role of Machine is played by Margot Bancilhon, an actress that I confess I have not noticed before, who is excellent, including in the scenes that demand physical qualities and talent for martial arts (or miming them). The role of the Marxist is played by JoeyStarr who is also a singer and producer of rap music, but who in this film does not sing but quotes Karl Marx copiously instead. I also liked the social part of the plot, but less so the political part. For someone who was born and who lived in Eastern Europe for quite some time like myself, the writings of Karl Marx and the concept of ‘class struggle’ have dark connotations. The jokes and the necessary detachment cannot erase the sensation of ‘rehabilitation’ of Marxism, whose harmfulness I experienced firsthand. It’s the main reason this series gets a 7 from me and not a 9.

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from Casablanca to Vienna (film: The Third Man – Carol Reed, 1949)

Were the 1940s the best years in cinema history? The top three films on my personal list were made at the beginning of that decade. One of them is – you guessed it! – ‘Casablanca’. If we can say that ‘Casablanca’ opens the cinematic decade, this is masterfully closed by ‘The Third Man‘, the 1949 film by Carol Reed. In many ways these are mirror films. Both take place in the shadow of the terrible world war that is not seen on the screen. In one the fighting takes place in Europe, far from Casablanca, in the other the war has been over for several years and has left Vienna occupied, divided, in ruins. The locations are ‘exotic’, but in a very different way. Both films are about friendships at test and love stories, with love triangles between two men and a woman. In none of them does the ‘good guy’ end up with the woman he falls in love with. The actors, the cinematography, the soundtrack are formidable in both films.

The script of ‘The Third Man’ was written by Graham Greene. The screenwriter, the director, the producers all knew the war from personal experiences. Today we look at this film as a historical story, and the formidable images of Vienna bombed and divided into occupation sectors are also a document. Robert Krasker‘s cinematography also received an Academy Award, the only one won by this film and the first ever won by an Australian. For the filmmakers, however, it was about a realistic film in contemporary landscapes. This is the scene of a drama in which Holly Martins, an American writer of cheap novels, comes to meet Harry Lime, a childhood friend, to find that he has just died. Instead of a meeting, he arrives at the funeral. Accident? Crime? Or maybe none of these? Holly will try to solve the mystery of Harry’s disappearance. He will find out that he was involved in criminal business. He will meet Anna, his lover, an actress who was hiding under a false identity to avoid being sent beyond the Iron Curtain. The plot has subterranean ramifications – literally and figuratively.

The Third Man‘ is one of those films that can be pinpointed in geography and historical moment, and yet manages to be universal. One of the secrets is filming in the city that was experiencing the scars of the war and the consequences of the occupation. Filming on the streets of Vienna and using local extras, everything feels authentic. ‘Dutch angles’, i.e. shots with the tilted camera amplify the tension and uncertainty surrounding the fate of the characters. A special quality is given to the film by the music performed on the zither and composed by Anton Karas. The use of a single instrument recreated the atmosphere of musical accompaniments from the silent film era, where the piano musically accompanied the images seen on the screen. Orson Welles only appears halfway through the film – but what an appearance! This is one of his best roles, even if today it would be considered only a supporting role. Welles is said to have contributed much more – dialogue, direction suggestions – but today his degree of involvement in the production is disputed. I liked Joseph Cotten less in the lead role and think that if Jimmy Stewart or Cary Grant had played Holly (as other rumors claim it was considered) the film would have been better. I’m not a big fan of Trevor Howard either and this movie didn’t change my mind. Alida Valli on the other hand, as Anna, is fascinating. She radiates an exotic beauty and reflects an inner drama that makes her attachment at any cost to the man who doesn’t deserve her love seem painfully poignant. The final scene is masterful and seems to conclude not only the film but an entire cinematic decade.

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evil movie (film: When Evil Lurks – Demián Rugna, 2023)

It’s rare for me to recommend a movie not to be seen, but with ‘When Evil Lurks‘ (original title is ‘Cuando acecha la mandad‘) by Argentinian director and screenwriter Demián Rugna, I’m very close to doing so. I think this movie resonates with the word ‘evil’ in the title. It is a horror movie in the category of movies with demons taking over people, animals, entire cities, etc. I love horror movies, and while the demon and exorcism genre isn’t my favorite sub-genre, I’m okay with them as long as they either stick to the level of metaphor or treat the subject matter with enough humor. Horror effects don’t scare me. This film, however, has absolutely none of the elements that allow horror to become entertainment for the fans of the genre. First of all, there is a complete lack of humor and of any attempt at detachment. The film has as its heroes two brothers who live in a remote rural region, but neither they nor any other characters have a minimum of qualities that could make the audience care about them or identify with them in any way. Horror scenes seem to aim to break as many taboos as possible, including avoiding graphic violence when it comes to children or pregnant women. The ‘demonic’ part is also taken very seriously, at some point even, one of the characters recites a full manual of behavior about what one is supposed to do when Evil lurks. From a technical point of view the film is well made and shot with expressiveness, but even these qualities seem to be put entirely at the service of the viewers’ disgust. This kind of film probably has its audience who appreciate it enough to give it an acceptable average rating on IMDB, but I deeply disliked it. There are good movies, bad movies and evil movies. ‘When Evil Lurks‘ belongs to the latest category. Avoid it!

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international investigations (TV series: Hidden Assets – Peter McKenna, 2021)

A few weeks ago I was writing about the Irish series ‘Acceptable Risk’ (2017) and I noticed Angeline Ball, the actress who played the role of a competent and brave detective, whom I would have liked to see again in other films, maybe even in a series to span several seasons. Well, my wish was granted sooner than I had hoped. In fact, it had already been fulfilled since 2021, when the first season of ‘Hidden Assets‘ had been filmed, another Irish detective series, created by Peter McKenna, again dealing with a complex case, an international investigation with ramifications in the world of terrorism, big economic business and politics. Detective Emer Byrne from the first series has now become Emer Berry, although we have no explanation or clue as to the reasons of the name change. Unlike many other series of this kind, ‘Hidden Assets‘ does not go into the private lives of the detective heroes at all, which does not mean that we do not notice that the main heroine is suspiciously lonely. This, of course, allows her to devote her days and nights to investigations, but it does not make her insensitive to the presence of men around her. In the new series there is also a partner who may arouse her more than professional interest in the person of the Belgian police inspector Christian De Jong with whom she will form a team from a moment on. However, despite some hints, their relationship does not develop romantically.

The story is engaging, well-written, and the six episodes will be enjoyed greatly by most viewers. Emer Berry is now head of a Dublin police department that deals with economic crimes such as bank fraud, tax evasion and money laundering. De Jong investigates a terrorist bomb attack in Antwerp in which about 15 people lost their lives. Both investigations lead to the same character, an Irish businessman suspected of tax fraud, who is also the owner of the apartment in Antwerp where the suicide bomber hid and where the body of a woman had been found. In addition, the suspect’s sister, a wealthy woman based in Belgium with connections in the world of finance and politics in that country, is the owner of a shipping company where the victim was employed. How are the two businesses related? Irish and Belgian police begin to collaborate and the two investigations merge into one complex and interesting case.

Hidden Assets‘ has everything it needs to satisfy fans of detective series. The format of six episodes with a length of almost an hour each allows the development of a complex plot and for viewers enough time to know the main characters – policemen, suspects and those around them. The script is written by two woman screenwriters – which shows in the creation of interesting and believable female characters – and by Wouter Hendrickx, the actor who plays the Belgian policeman. The pace of the action is alert, the characters well defined, the solutions to the various problems that arise throughout the investigation believable. Apart from the roles of the two detectives, there is another character – the one played by the actress Cathy Belton – who deserves a series of his own. She a financial analyst who untangles the most difficult threads of global, complicated and suspicious financial affairs on the whiteboard and laptop screens. The finale leaves some issues only half resolved, which sets the stage for the second season. I haven’t seen it yet, but I’m quite disappointed as I read that Angeline Ball is no longer the lead. I can only hope that Emer Berry has been promoted to an even more interesting position, because that’s the life of a cop.

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bloody horror (film: Project Wolf Hunting / Neugdaesnyang – Kim Hong Sun, 2022)

Those who will dare to watch ‘Project Wolf Hunting‘ (the original title is ‘Neugdaesnyang‘), the 2022 film written and directed by Korean director Kim Hong Sun will have a good chance to see the bloodiest movie or one of the bloodiest movie that they have ever seen them. And yet it is not just a film aimed at fans of violent action and/or horror. ‘Project Wolf Hunting‘ is also a film that confirms the boldness and creativity of South Korean filmmakers, their ability to combine and transcend genres and make interesting films that are not shy of being extreme or bizarre.

Several dozen male and female prisoners, handcuffed and guarded by a detachment of guards and policemen armed to the teeth, are extradited from the Philippines to South Korea aboard a cargo ship. The inmates plan and execute a spectacular escape and take control of the ship. They are among the cruelest criminals and murderers, so that the revolt is violent from the beginning and the fights between the guards and the prisoners cause many victims. Before long, however, they will all realize that they face a common danger, even more deadly than their rivalries. The ship carries a secret passenger of a very special kind, a killing machine with seemingly supernatural powers. It will break free and go on a rampage, killing everything in its path. Meanwhile, a remote command center watches over the ship until all communications are cut.

Project Wolf Hunting‘ navigates (to use an appropriate expression) between cinematic genres. In the first half hour, which is about a quarter of the film’s duration, we get to know the characters – the policemen, the prisoners, the crew, the people in the command center. Then we start losing them one by one in the violence that ensues. What started out as a psychological thriller turns into an action film about a prison uprising, only to end in pure horror. There is also an explanation of what is happening, a combination of facts from the violent history of Asia during the Second World War with experiences of prisoners that are taken over in our era by big pharma concerns and by armies. Everything makes sense and is well filmed. Those who do not reject violence as cinematic entertainment have a good chance of enjoying this film. The finale opens the premises of some sequels, so we may hear more about ‘Project Wolf Hunting‘.

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much more than a revenge movie (film: Revenge – Coralie Fargeat, 2017)

Revenge‘ is the feature debut of French director Coralie Fargeat, a director who doesn’t seem to be in a hurry. She was already 40+ years in 2017 when this film was made, and only this year, as she approaches the age of 50, her second film will premiere in the official competition at Cannes. Even from the title it is suggested that it is a revenge movie, although, perhaps, if I had to choose the closest genre I would rather include it among survival movies. However, ‘Revenge‘ does not sit comfortably within the limits of any of these genres. It has a quality of its own and manages to be more than just a movie in one genre or another, although the amount of action and gore will please fans of those genres. It is also a feminist film, the main heroine being a woman and the director approaching two very ‘masculine’ cinematic genres without any complex. If anyone was in doubt, everything a man can do a woman can do as well, and often much better.

The film has four characters – three men and one woman. The action takes place in a desert hunting area. Richard, who is rich and married, brings Jen, his young and beautiful mistress, to the pool villa in the middle of the desert for two days of intimacy before his two other friends arrive. However, they appear earlier than expected. After a night of partying, Richard leaves to get hunting licenses, and in his absence, one of the friends rapes Jen, while the third man hesitates and decides not to help her. When Richard returns, he tries to appease and cover up the story, but Jen, perhaps shocked, doesn’t seem willing to cooperate. Richard decides to kill her and throws her into a precipice in the desert. Convinced that the young woman is dead, the three men attempt to continue their hunting program as if nothing had happened. But Jen survives. Or perhaps the more accurate term is that she is reborn. And she will take her revenge.

In many ways the movie is predictable and the characters do pretty much what we expect them to do in movies of this kind. And yet ‘Revenge‘ surpasses in quality just about everything we’ve seen in these categories. First of all, the story is very well written (Coralie Fargeat is also the author of the original screenplay) and the action never drags. A few well-placed symbols (the apple the heroine bites into at the beginning of the story, the Phoenix bird as rebirth and healing by fire) add meaning without being excessive. The cinematography is special – both in the way the desert is shot and in the alternation of fast action shots with long shots. For example, the final confrontation in the villa is preluded by a multi-minute single shot frame from Richard’s perspective, which helps build the tension. Matilda Anna Ingrid Lutz is the ideal actress for the role, and being directed by a woman adds to the psychological veracity of the character, who transforms from an object of attraction for the men in the film to a machine of survival and revenge. The amount of blood and scenes of cruelty that are the main source of horror place the film among the most violent in an already very violent genre. But ‘Revenge‘ is one of those films where the violence is motivated by the characters, and that’s why it looks credible despite the fact that the amount of blood that flows is much greater than can fit in the bodies of the four characters of the film.

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too nice to be true (film: Un homme hereux – Tristan Séguéla, 2023)

I am a big fan of Fabrice Luchini. The joy of seeing one of his latest films was immense. I was quite surprised that Tristan Séguéla‘s ‘Un homme hereux‘ (2023) seems to have been seen by very few people. The theme of acceptance of different LGBT+ communities always risks generating controversy, and there are viewers who shun films that set or touch on this space. On the other hand, the cinematography of the world in general and the French one in particular has recorded numerous successes – including blockbusters, including comedies – with films of this kind. The common denominator of the successful films, however, was audacity. Addressing sensitive subjects requires courage on the part of screenwriters and directors, and if it is a comedy, taking the risk of offending, within the limits of good taste and avoiding cheap humor. This is exactly what is unfortunately missing in ‘Un homme hereux‘, but the film is still worth seeing. Not just for Fabrice Luchini.

The story takes place in a city in the north of France. Mayor Jean Leroy, a rather conservative 63 years old politician who opportunistically keeps his homophobic views to himself, decides to run for another term. Just then, his wife, Édith, informs him that … she has felt like a man all her life, that she is tired of hiding her sexual identity and that she has begun the process of physical transition from woman to man. The two decide to postpone the public announcement of the transition until after the election, so as not to disturb Jean’s image in the eyes of the town’s conservative electorate. As you might suspect, such a plan cannot be kept a secret for too long, neither from the couple’s three adult children, nor from residents and voters, in a world where everyone has eyes, ears, and especially cameras and mobile phones. The revelation will blow up the electoral plans and transform the mayor and those around him. Meanwhile Édith continues her transition to becoming Édy.

Need I mention that Fabrice Luchini is formidable and his every moment on screen is a delight? The same can be said about Catherine Frot who plays the role of Édith – Édy. The two practically support the film along with Philippe Katerine, a formidable actor himself who I’ve seen perform well in so many supporting roles that I can’t help but wait for the moment when a brave director gives him a big leading role. The problem is the script. Trying not to upset anyone, the story avoids any violent confrontation (like those that happen in reality) and blunts all the arrows of satire. The most successful scenes are those in the LGBT+ support group, where the ‘politically correct’ language of the community is ironized, but here too the excessive restraint is obvious. The feeling of missing out is amplified by the ending. The last 15 minutes seem to belong to the American remake and not the original film, with a very predictable breakup and reunion and a completely missed opportunity to generate more fun and satire based on the opposites of gender cross-dressing at the carnival. We are left with the image of Luchini‘s sad and lonely clown face at the end, but I have already praised him enough. ‘Un homme hereux‘ is a film too nice to be genuine.

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the daemon of motherhood (film: Huesera – Michelle Garza Cervera, 2022)

Huesera‘ (2022) is the debut feature film of Mexican director Michelle Garza Cervera. And what a debut! The director, who is also a co-writer, has imagined a story that combines psychological thriller with elements of horror, tackles feminist themes and explores female psychology during pregnancy and the immediate post-natal period with an intensity worthy of the great masters of cinematic art. Not everything works in this film, but what we saw in the 93 minutes that the film lasts is the promise that this is a significant first film by a female filmmaker who can become a name in the world of cinema.

Valeria and Raúl are an ordinary Mexican couple. They have wanted a child for a long time and for this Valeria will travel with her mother on a pilgrimage to a huge golden statue of the Holy Virgin. She seems to answer prayers and Valeria becomes pregnant. The two spouses begin to plan and prepare for the baby’s arrival, she builds a wonderful bed and transforms her carpentry workshop into the baby’s future room. One night something happens. Victoria sees a woman throwing herself from the second floor of the building across the street and breaking her legs. Until she calles Raúl, the woman had disappeared. Nightmare? Hallucination? Other visions also happen. Memories also return – of an incident in the past when she had fallen with the child of neighbors in the arms, of the adventurous youth in which she had had an affair with another woman. In the eyes of those around her, even Raúl’s, her ability to be a good mother starts to be questioned. The birth of the baby girl should bring things back to normal, but not only is that not happening, the crisis is deepening.

What happens to Victoria is an open question. Is it mental disorders, natural to some point during pregnancy or after birth? Or maybe the young woman represses her sexuality and desire for freedom under social and family pressure? Or maybe it’s about something deeper and stranger. Mexico is a country that lives between tradition and modernity, between reality and magic. Victoria finds herself also between the two worlds. The solution to her problems will also belong to the world of magic. The ending is a variation on a legend that gives the film its name, but what we see is in terms of reality an abandonment, in terms of magic a liberation. The performer of the main role – Natalia Solián – is extraordinary. It can be seen that she worked on the role for a long time together with the director. The cinematography is also of very good quality, with the symbolism of the cobweb trap returning in different visual forms. Not everything works in this film, the horror scenes do not always manage to create the expected effects, but the minuses in the effects are compensated by the eyes and the face of the actress who shouts her feelings beyond the screen. ‘Huesera‘ is a special and impressive film, a spectacular debut.

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a softer Amy Winehouse (film: Back to Black – Sam Taylor-Johnson, 2024)

Amy Winehouse is the latest personality in a select and tragic list that includes Jimi Hendrix, Janis Joplin, Kurt Cobain, Jim Morrison, Brian Jones. They were all extraordinarily talented musicians. They all led intense lives marked by phenomenal creativity but also personal crises and substance abuse. All died at the age of 27 of lifestyle-related deaths. All left behind millions of grieving fans and musical legacies as sizable as they are focused, leaving us to guess what their careers and music history would have looked like without these tragic early deaths. An acclaimed and award-winning documentary has already been made about Amy Winehouse. Now, director Sam Taylor-Johnson offers us ‘Back to Black‘ – a biopic that proposes a somewhat ‘sweetened’ vision of the singer who not only lived and created intensely, but also never avoided controversy. It is possible that the original screenplay written by Matt Greenhalgh may have sinned in this very way.

The problem with a biography like Amy’s is that most of the viewers were her contemporaries, we each have our own memories of her person and career, and we can’t avoid comparing them to what we see on screen. From the biography of the musician, the script chose the few years between 2002 when she signed the collaboration with ’19 Management’ for her first album and 2008 when at the 50th edition of the Grammy Awards she received five awards in the same night. Connoisseurs will note the absence from Amy’s career story of Mark Ronson, the producer of the blockbuster album that also gives the film its title. From her private life, the focus is on her relationship with Blake Fielder-Civil. This is on the one hand presented as the only true love story of Amy’s life. On the other hand, the same relationship is blamed for the singer’s personal crises and heavy drugs addiction. The family also plays an important and largely positive role. Both Amy’s father and grandmother appear as luminouse characters, who support her in her career and try (unsuccessfully) to guide her in her personal life as well.

The writer and the director chose to present a somewhat embellished version of Amy. The final years of the artist’s life, her relapse into alcoholism, the missed concerts and the conflicts with the audiences are omitted. This vision seemed incomplete to me. Could those around her have saved her? Unanswered question. I really enjoyed the recreation of the atmosphere of London clubs and the north of the British capital in the first decade of the century. Marisa Abela‘s performance is overwhelming – she manages to get completely into character and does very well with the music also, coming close in sound but without touching the emotion and quality of the original. Eddie Marsan and Lesley Manville play the roles of Amy’s father and grandmother very well. I am not sure whether in real life the family came that close to the ideal, but that’s how it appears to have been in the movie, and the emotion crosses the screen. ‘Back to Black‘ is a film worth seeing for both the music and the story, but viewers should keep in mind that this is still fiction and not an official biography. And now, I’m going to listen to Amy Winehouse – the real one.

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CHANGE.WORLD: Doctor AI

Să lăsăm astăzi la o parte scenariile apocaliptice și avertismentele cu Apocalipsa care va fi cauzată în curând de Inteligența Artificială (AI) și să discutăm despre unul dintre domeniile în care progresele acestei ramuri a științelor calculatoarelor a înregistrat avansuri remarcabile și vizibile și are perspective să dea rezultate și mai spectaculoase în viitorul deceniu. Este vorba despre medicină și despre tot ceea ce se petrece în jurul ei, de la diagnosticare până la industria medicamentelor și sistemele de sănătate. Să începem cu câteva date statistice. Întreaga planetă se află de mulți ani într-o criză medicală continuă, care se adâncește. Se estimează că în 2030 vor lipsi la nivel global peste 10 milioane de medici, adică vreo 15% din forța de muncă necesară. În multe tari ale lumii spitalele nu acoperă corespunzător zonele geografice, iar acolo unde ele există, sunt sub-dotate ca personal și ca echipamente. Sistemele de asigurări medicale naționale și particulare sunt supra-solicitate și ineficiente. Cheltuielile legate de asistența medicală solicită procentaje imense din bugetele naționale și cele ale pacienților. Numai în Statele Unite, introducerea unora dintre sistemele aflate în lucru care se bazează pe Inteligența Artificială ar putea duce la economii între 200 și 360 de miliarde de dolari anual. Revista ‘The Economist’ a dedicat suplimentul ei tehnologic trimestrial acestei ramuri AI, identificând patru domenii în care s-au înregistrat progrese vizibile sau sunt în curs de planificare proiecte spectaculoase: diagnosticare, interfață medic-pacient, industria medicamentelor, optimizarea sistemelor de sănătate. Le voi trece și eu în revistă pe scurt, adăugând observațiile și pronosticurile mele.

(sursa imaginii: www.impactqa.com/blog/artificial-intelligence-ai-and-its-assistance-in-medical-diagnosis/)

Să începem cu diagnosticarea. În medicina modernă, ea se bazează pe examinare și dialog direct cu pacienții și pe prelucrarea informației care provine de la analizele medicale și de la diferitele tipuri de imagistică folosite pentru a explora corpul pacienților – de la radiografii (o tehnologie cu o vârstă de peste un secol) la investigațiile cele mai moderne, realizate prin intermediul mini-roboților ghidați și dotați cu camere, care sunt injectați în aparatul digestiv sau cel circulatoriu. Ochii doctorilor specialiști sunt acum amplificați de analizele computerizate ale imaginilor. Acestea sunt capabile să sesizeze detalii la dimensiuni care pot scăpa privirilor medicilor și pot sincroniza informația cu cea a altor analize și teste medicale ale aceluiași pacient (inclusiv cele din trecut), ca și cu imensa bibliotecă de cazuri acumulate prin procedeele de auto-învățare. Sistemele AI folosesc programe de identificare a formelor (pattern recognition). Într-una dintre aplicațiile cele mai cunoscute, imagistica este comparată în mod eficient cu biblioteca de date prin intermediul unei rețele neurale numite AlexNet, dezvoltată la Universitatea din Toronto, care și-a învins toți adversarii într-o competiție a aplicațiilor de acest fel. Această rețea, cu produsele derivate existente în Olanda, Suedia și Coreea de Sud, este livrată sub formă de produs hardware și software și a devenit o componentă din ce în ce mai prezentă în secțiile de imagistică (fostele secții de radiologie) ale spitalelor. O parte dintre acestea aplică și o tehnică numită ‘scanare oportunistă’. Aceasta pleacă de la examinarea de către sistemele automate a porțiunilor neexplorate ale imaginilor, pentru a detecta detalii (anomalii) care nu erau definite inițial în scopul examinării medicale. Cazuri menționate în articolele de specialitate documentează descoperirile unor tumori în fază incipientă sau ale unor deformări datorate unor accidente aparent fără repercusiuni, care scăpaseră primelor examinări ale medicilor specialiști. Firma EZRA din New York propune o scanare generală al cărei cost a reușit să-l reducă de la 1 350 la 500 de dolari, pe care o recomandă tuturor abonaților serviciului, inclusiv celor sănătoși, ca metodă preventivă de diagnosticare timpurie. Chiar și clasicul stetoscop a fost extins în ultimii ani cu capacități de scanare imagistică și electro-magnetică, care permit îmbunătățirea diagnosticelor bolilor de inimă și de plămâni.

(sursa imaginii: https://www.earth.com/news/artificial-intelligence-proves-very-useful-to-doctors-when-diagnosing-patients/)

Chatboții au devenit în ultimele 18 luni interfața umană preferată cu sistemele dotate cu capabilitati AI. Sute de milioane de utilizatori utilizează astăzi ChatGPT sau interacționează cu avataruri cum este Nova, simpatica ‘față umana’ a sistemelor firmei Soul Machines, specializată în crearea de ‘oameni digitali’ acționați de un sistem de aplicații pe care ei îl numesc HumanOS. Câți dintre acești utilizatori ar fi însă de acord ca medicul care le acordă consultația să fie o astfel de creatură digitală? Și dacă răspunsul este pentru majoritatea utilizatorilor „NU”, atunci care este răspunsul în cazul secretarei medicului care ne verifică identitatea și completează informațiile preliminare în sala de așteptare? În definitiv, aceste din urmă operații sunt deja în multe locuri automatizate și pacienților li se cere să completeze singuri formulare, de multe ori pe telefoanele lor mobile. Barierele sunt de două feluri: obiective și subiective. Barierele obiective sunt legate de nivelul de încredere pe care pacientul îl acordă medicului. Practica medicală arată că, în lipsa acestei încrederi, scad șansele de reușită ale tratamentelor și procedurilor. ChatGPT4 a reușit să treacă cu succes examenele anului trei al standardului medical american. Pe de altă parte, conform unor studii britanice, diagnosticele furnizate de sistemele AI au fost precise în proporție de doar 34% la prima întâlnire ‘medic’-pacienți. Până la urmă, siguranța sistemului depinde de capacitățile modelelor lingvistice mari (LLM) care stau la baza sistemelor AI. Paradoxal, într-o primă fază, s-a constatat că modelele mai simple, cum este cel oferit de firma germană Ada Health, oferă mai multă siguranță. Explicația este clară – model mai simplu, risc mai mic de ‘halucinații’, principala problemă în stadiul actual de dezvoltare al tehnologiilor. Google are în faza de proiectare o variantă LLM specializată în diagnostice, în timp ce Hippocratic AI, un start-up din Silicon Valley, construiește modele optimizate aplicațiilor medicale. Până la urma însă, cred că vor juca un rol important criteriile subiective. În unele locuri, unde medicii sunt în număr prea mic sau inaccesibili direct, sistemele AI cu interfață digitală vor fi aplicate dacă vor ști să câștige încrederea pacienților. Secretarele medicale exercită o profesie pusă în pericol. În cazuri speciale, pacienții înșiși se vor simți mai protejați discutând cu un avatar digital decât în persoană cu un medic – este cazul documentat al unora dintre pacienții suspectați de SIDA din Africa de Sud. În multe alte cazuri, pacienții vor căuta în final contactul cu medicul. Empatia omenească nu este încă programabilă.

(sursa imaginii: https://randomtrees.com/blog/ai-in-pharma/)

Care este rolul Inteligenței Artificiale în domeniul cercetării farmaceutice și inventării de noi medicamente? Aici, probabil, progresul este mai ușor de demonstrat. Să începem cu volumul de informații. În fiecare dintre ultimii ani, au apărut peste un milion de articole în domeniile medicinei, biomedicinei, farmaceuticii, producției de medicamente. Toate sunt rezultate ale cercetărilor specialiștilor din aceste domenii. Nimeni nu poate nici măcar cataloga aceste informații, cu atât mai puțin să le prelucreze, fără ajutorul sistemelor informatice. Sistemele AI au fost folosite pentru a alcătui ‘arbori cognitivi’ orientați spre cercetarea unor probleme specifice. Una dintre poveștile de succes este descoperirea potențialului unui medicament folosit pentru tratarea artritei în tratamentele de Covid-19, descoperire făcută posibilă de o aplicație a firmei BenevolentAI, specializată în dezvoltarea și aplicarea AI în proiecte de colaborare științifică. În luna ianuarie a acestui an, revista ‘Science’ a relatat un caz similar care a permis identificarea de biomarkeri în sânge, care duc la detectarea de covid persistent și semne timpurii de Alzheimer. Un alt domeniu foarte promițător de aplicație al AI este cel al creării de modele care analizează secvențele aminoacizilor în proteine. O întreagă disciplină numită biologie structurală se ocupă de compoziția și arhitectura proteinelor care stau la baza substanțelor folosite în producția de medicamente. Problema este că numărul combinațiilor posibile este imens și doar o mică parte a acestora este stabilă și reproductibilă în procese de producție. Programul AlphaFold al laboratorului de cercetare Google DeepMind a fost inițial antrenat să învețe să joace Go. A reușit atât de bine, încât i-a învins pe campionii mondiali ai jocului. Cercetătorii au aplicat capacitatea de predicție a mașinii în descoperirea regulilor care guvernează ordinea aminoacizilor la crearea proteinelor. Importanța acestei optimizări este imensă, căci forma proteinelor definește acțiunea acestora și a combinațiilor cu alte molecule. Găsirea moleculelor care să aibă acțiunile farmaceutice dorite este elementul-cheie în descoperirea de noi medicamente. Înainte ca AlphaFold să intre în acțiune, jumătate de secol de biotehnologie crease cam două sute de mii de structuri stabile. După introducerea programelor lui Google și a concurentei Meta, numărul acestora se ridică acum la peste 600 de milioane. Procesele de auto-învățare folosite de AI au avantaje față de cele umane, deoarece explorează forme inexistente în bazele de date precedente. Ele sunt capabile și să integreze informații din alte domenii, cum ar fi ingineria genetică sau microbiologia celulelor. O echipa de cercetători de la Universitatea Bloomington, din statul american Illinois, a antrenat un model AI în simularea efectelor diferitelor tratamente de cancer, cu analiza eficienței acestora, dar și a efectelor secundare asupra organismului uman. Între anii 2000 și 2015, aproximativ 86% dintre medicamentele propuse spre aprobare și fabricație au eșuat în testele de eficiență sau de evitare a complicațiilor. Sistemele AI încearcă să prevină astfel de situații și să îmbunătățească spectaculos statisticile, filtrând medicamentele înainte de testarea pe pacienți.

(sursa imaginii: www.lek.com/insights/ei/artificial-intelligence-life-sciences-formula-pharma-success-across-drug-lifecycle)

Costurile serviciilor medicale sunt imense. Un raport al Organizației Mondiale a Sănătății aprecia aceste costuri în 2021 la 9,8 trilioane de dolari sau 10,3% din produsul global brut. Este vorba doar despre cheltuielile directe. Distribuirea este însă inegală. În Statele Unite, procentajul este de 17% din PIB. În 2021, aproximativ 11% din populația lumii trăia în țări care cheltuiau mai puțin de 50 dolari de persoană pe an, în timp ce cheltuielile medii pe cap de locuitor pentru sănătate erau de aproximativ 4 000 dolari în țările cu venituri mari. Țările cu venituri mici reprezentau doar 0,24% din cheltuielile globale pentru sănătate, în ciuda faptului că aveau o pondere de 8% din populația lumii. Dar poate că tocmai țările mai puțin dezvoltate sunt cele care au șansa să beneficieze mai mult și mai spectaculos din introducerea tehnologiilor informatice, inclusiv AI, în serviciile medicale. În ultima jumătate de secol, cheltuielile medicale globale au crescut de vreo zece ori. Din această creștere, în țările membre OECD, între 25% și 50% din creștere se datorează investițiilor în tehnologie. Și totuși, în foarte multe sisteme medicale, inclusiv cele din țările cele mai avansate, există încă multe sisteme informatice neintegrate și incompatibile. De câte ori nu vi s-a întâmplat să apelați, indiferent unde trăiți, la un doctor în afara sistemului sau la un serviciu medical în timpul unei călătorii și cardul dumneavoastră a fost respins sau, daca a fost acceptat, datele dosarului medical nu au putut fi transferate? Și aceasta este o interfață simplă, care nu are nimic de-a face cu AI. Răspunsul ar fi standardizarea, însă tocmai în această fază de început a introducerii chatboților și a modelelor LLM, concurența dintre furnizori face neplauzibil în viitorii ani acordul asupra unor standarde care să asigure compatibilitatea. Este foarte posibil să fim martori și în domeniul sistemelor de sănătate a unor ecosisteme care se vor consolida în câțiva ani în 2 sau 3 sfere, iar acestea vor începe să comunice doar după ce și-au asigurat, fiecare în parte, rentabilitatea. Concurenții principali? În opinia mea, ei vor fi OpenAI care sunt deja asociați cu Microsoft, cu variante adaptate ale lui ChatGPT și Google, a cărei divizie de cercetare a lansat Med-PaLM – un model LLM conceput pentru a oferi răspunsuri de înaltă calitate la întrebări medicale. Microsoft a achiziționat în 2021 și firma Nuance, care oferă produse AI ce ajută medicii să creeze baze de date și informații clinice despre pacienți. Cum și dacă va integra într-o singură sferă AI Nuance și ChatGPT, rămâne de văzut. Nu l-aș exclude nici pe Amazon, al cărui Healthscribe este asemănător în funcționalitate cu Nuance.

(sursa foto: https://cnectgpo.com/blog/ai-the-latest-evolution-in-healthcare/)

Abilitățile viitoarelor sisteme informatice, puse pe steroizi de tehnici AI, promit să fie formidabile. Se vorbește deja despre sisteme de dispecerizare a pacienților și de utilizare optimă a paturilor și instalațiilor medicale din clinici și spitale sau despre integrarea datelor furnizate de senzori ‘wearables’ pentru o monitorizare permanentă a pacienților. Detectarea unui viitor infarct cu câteva minute în avans de declanșare este posibilă tehnologic și ar salva în fiecare an zeci de mii de vieți. La fel în cazul comoțiilor cerebrale. Aplicațiile AI ar putea descoperi alte combinații de senzori și markeri care să îmbunătățească aceste capacități preventive. Intervin însă aici două aspecte care au darul să frâneze excesul de entuziasm. Este vorba despre protecția datelor particulare ale fiecărui subiect (sănătos sau bolnav) și despre eliminarea cazurilor de hazard (așa numitele halucinații) care caracterizează încă sistemele AI în această fază de dezvoltare. Și apoi, este vorba despre costuri. Domeniul este însă ‘fierbinte’, și pe bună dreptate. Vom urmări și vom relata.

(Articolul a apărut iniţial în revista culturală ‘Literatura de Azi’ – http://literaturadeazi.ro/)

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