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The Power of Place: Growth and Challenges of Milwaukee's Neighborhoods

Dr. Michael Carriere, professor and Honors Program director at Milwaukee School of Engineering, is an urban historian with expertise in Milwaukee and Wisconsin history and politics, urban agriculture, creative placemaking, and the Milwaukee music scene. He is available to discuss the growth of Milwaukee's neighborhoods; the challenges many of them are facing; and some of the solutions that are being implemented. Things such as urban gardens, hydroponic farms, neighborhood improvement districts, and pocket parks. Carriere's creative place-based initiatives focus on harnessing the unique characteristics and resources of Milwaukee's neighborhoods to generate solutions that are tailored to its specific needs. His approach recognizes that one-size-fits-all strategies often fail to address the nuanced realities of different communities. Carriere also works toward solutions with long-term sustainability and actively involved and invested community members.

From Facial Recognition to Deepfakes: What Could Be Done With Your Image?

Facial Recognition: Convenience and Controversy Facial recognition technology is everywhere, making our day-to-day tasks faster and more convenient. It offers substantial benefits, from enhanced security measures to streamlined user experiences. Airports utilize it for faster check-ins, smartphones use it for secure authentication, and law enforcement agencies employ it for identifying suspects. However, the technology also raises considerable privacy concerns. The pervasive deployment of facial recognition without adequate oversight can lead to unwarranted surveillance, potential biases in profiling, and the erosion of personal privacy. The Rise of Deepfake Technology Meanwhile, deepfake technology has advanced rapidly, leveraging AI to create highly realistic synthetic, or "fake", media. These hyper-realistic videos, showing individuals doing or saying things they never actually did, have become a significant concern. The potential misuse of deepfakes ranges from spreading misinformation and manipulating elections to causing personal distress by enabling crimes like fraud and defamation. Dr. Derek Riley, a seasoned media expert, professor and program director of the B.S. in Computer Science program at Milwaukee School of Engineering, is available to discuss how these technologies work, how they're regulated, how they can be used in a positive manner, and how individuals can protect themselves.

Exploring Milwaukee and Wisconsin's Cultural and Urban Landscape

As the Republican National Convention 2024 approaches, journalists from across the nation and the world will converge on Milwaukee, not only to cover the political spectacle but also to uncover the rich cultural, architectural, and urban tapestry that makes this city truly unique. Milwaukee, often referred to as the "Cream City" for its distinctive cream-coloured bricks, with many historical and contemporary narratives is waiting to be explored. To help visiting journalists navigate and understand the depth of Milwaukee's heritage and modern vibrancy, our MSOE experts are available to offer insights. Discover the rich tapestry of Milwaukee and Wisconsin through the lens of two distinguished experts. Dr. Michael Carriere and Kurt Zimmerman bring unparalleled expertise in the fields of culture, architecture, and urban planning, offering deep insights into the region's unique historical and contemporary narratives. Dr. Michael Carriere Professor, Honors Program Director Expertise: Sustainability, American History, General Social Science, Honors Program, History, General Humanities, Student Affairs, Urban Studies View Profile Dr. Michael Carriere, a Professor and Honors Program Director, is an urban historian specializing in American history, urban studies, and sustainability. With a focus on the growth and challenges of Milwaukee's neighborhoods, Dr. Carriere provides valuable perspectives on urban agriculture, creative placemaking, and the Milwaukee music scene. His extensive knowledge of Milwaukee and Wisconsin history and politics makes him a key resource for understanding the region's evolving urban landscape. “To me, it’s a no-brainer,” says Carriere, now a professor of history at Milwaukee School of Engineering and author of The City Creative: The Rise of Urban Placemaking in Contemporary America. “Cities like Louisville, like Buffalo, like Boston have really leveraged the Olmsted spaces in their cities. … The reason I’m really excited about [the bicentennial] is that this could be the chance to have useful, and in some cases uncomfortable, conversations on how public spaces should look and operate in a 21st-century city like Milwaukee.” The Lasting Legacy of Frederick Law Olmsted and His 3 Signature Milwaukee Parks Milwaukee Magazine April 1, 2022 Kurt Zimmerman Assistant Professor Expertise: Deep Energy, Retrofit Integrated Project, Delivery Architecture, Design, Building Envelope, Building Science, Sustainability, LEED AP View Profile Kurt Zimmerman, an Assistant Professor, offers expertise in Milwaukee's architectural history, urban planning, and sustainable design. His insights into the city's architectural evolution and design principles contribute to a deeper appreciation of Milwaukee's unique urban fabric and sustainable development efforts. “If you’re trying to build buildings that are meant to last, look back in history and see what is still standing. Those are your models. It’s all about build it once, build it right, build it to last. I’m very conscious of the environmental aspects of our projects, whether the clients ask for it or not.” The Daily Reporter October 2, 2014 For further information and to arrange interviews with our experts, please contact: JoEllen Burdue Senior Director of Communications and Media Relations Phone: (414) 839-0906 Email: burdue@msoe.edu About Milwaukee School of Engineering (MSOE) Milwaukee School of Engineering is the university of choice for those seeking an inclusive community of experiential learners driven to solve the complex challenges of today and tomorrow. The independent, non-profit university has about 2,800 students and was founded in 1903. MSOE offers bachelor's and master's degrees in engineering, business and nursing. Faculty are student-focused experts who bring real-world experience into the classroom. This approach to learning makes students ready now as well as prepared for the future. Longstanding partnerships with business and industry leaders enable students to learn alongside professional mentors, and challenge them to go beyond what's possible. MSOE graduates are leaders of character, responsible professionals, passionate learners and value creators.

Key topics at RNC 2024: Artificial Intelligence, Machine Learning and Cybersecurity

As the Republican National Convention 2024 begins, journalists from across the nation and the world will converge on Milwaukee, not only to cover the political spectacle but also to cover how the next potential administration will tackled issues that weren't likely on the radar or at least front and center last election: Artificial Intelligence, Machine Learning and Cybersecurity With technology and the threats that come with it moving at near exponential speeds - the next four years will see challenges that no president or administration has seen before. Plans and polices will be required that impact not just America - but one a global scale. To help visiting journalists navigate and understand these issues and how and where the Republican policies are taking on these topics our MSOE experts are available to offer insights. Dr. Jeremy Kedziora, Dr. Derek Riley and Dr. Walter Schilling are leading voices nationally on these important subjects and are ready to assist with any stories during the convention. . .    . Dr. Jeremy Kedziora Associate Professor, PieperPower Endowed Chair in Artificial Intelligence Expertise: AI, machine learning, ChatGPT, ethics of AI, global technology revolution, using these tools to solve business problems or advance business objectives, political science. View Profile “Artificial intelligence and machine learning are part of everyday life at home and work. Businesses and industries—from manufacturing to health care and everything in between—are using them to solve problems, improve efficiencies and invent new products,” said Dr. John Walz, MSOE president. “We are excited to welcome Dr. Jeremy Kedziora as MSOE’s first PieperPower Endowed Chair in Artificial Intelligence. With MSOE as an educational leader in this space, it is imperative that our students are prepared to develop and advance AI and machine learning technologies while at the same time implementing them in a responsible and ethical manner.” MSOE names Dr. Jeremy Kedziora as Endowed Chair in Artificial Intelligence MSOE online March 22, 2023 . .     . Dr. Derek Riley Professor, B.S. in Computer Science Program Director Expertise: AI, machine learning, facial recognition, deep learning, high performance computing, mobile computing, artificial intelligence View Profile “At this point, it's fairly hard to avoid being impacted by AI," said Derek Riley, the computer science program director at Milwaukee School of Engineering. “Generative AI can really make major changes to what we perceive in the media, what we hear, what we read.” Fake explicit pictures of Taylor Swift cause concern over lack of AI regulation CBS News January 26, 2024 . .    . Dr. Walter Schilling Professor Expertise: Cybersecurity and the latest technological advancements in automobiles and home automation systems; how individuals can protect their business operations and personal networks. View Profile Milwaukee School of Engineering cybersecurity professor Walter Schilling said it's a great opportunity for his students. "Just to see what the real world is like that they're going to be entering into," said Schilling. Schilling said cybersecurity is something all local organizations, from small business to government, need to pay attention to. "It's something that Milwaukee has to be concerned about as well because of the large companies that we have headquartered here, as well as the companies we're trying to attract in the future," said Schilling. Could the future of cybersecurity be in Milwaukee?: SysLogic holds 3rd annual summit at MSOE CBS News April 26, 2022 . .     . For further information and to arrange interviews with our experts, please contact: Media Relations Contact To schedule an interview or for more information, please contact: JoEllen Burdue Senior Director of Communications and Media Relations Phone: (414) 839-0906 Email: burdue@msoe.edu . .     . About Milwaukee School of Engineering (MSOE) Milwaukee School of Engineering is the university of choice for those seeking an inclusive community of experiential learners driven to solve the complex challenges of today and tomorrow. The independent, non-profit university has about 2,800 students and was founded in 1903. MSOE offers bachelor's and master's degrees in engineering, business and nursing. Faculty are student-focused experts who bring real-world experience into the classroom. This approach to learning makes students ready now as well as prepared for the future. Longstanding partnerships with business and industry leaders enable students to learn alongside professional mentors, and challenge them to go beyond what's possible. MSOE graduates are leaders of character, responsible professionals, passionate learners and value creators.

Can you benefit in transferring high-interest credit card debt?

Photo credit: paulaveryevans According to Lendingtree, Americans have over $1 trillion in credit card debt. The average American has around $6,500 in credit card debt. When you factor in the high interest that credit cards charge, it can be a daunting task to get the balance to zero. Many cards offer 0% APR on balance transfers for certain length of times. But is it worth it if you don’t plan on paying off the entire balance during the promotional period? Wendy Habegger, PhD, senior lecturer in the James M. Hull College of Business, said you need to be careful when taking advantage of such offers. “The benefit one would get in this situation is short-lived,” said Habegger. “While one might enjoy no interest for the promo period, when that period is over, the interest rate they are charged could be more than the credit card from which they transferred. My recommendation is that if one does a balance transfer, then only do so if you are able to pay off the balance before the period ends.” Some may think of doing a second balance transfer but Habegger said that it is not a good idea and could have a negative impact on a person’s credit score. It also gives the appearance the customer is at increased risk of default, which could trigger an even higher interest rate and higher fees. Not only may one incur higher rates, it could certainly impact their credit score, which can have a long-lasting financial impact. Even a large purchase on a 0% APR card will affect someone’s credit score. “A large purchase indirectly impacts one’s credit score based on credit utilization,” she added. “If one uses more than 30% credit utilization, it could impact credit scores.” Personal debt and credit are trending and important topics in America today - and if you're looking to know more, we can help. Wendy Habegger is a respected finance expert available to offer advice on making the right money moves during volatile times. To arrange an interview, simply click on her icon now.

Expert Q&A: Should We Permit AI to Determine Gender and Race from Resumes?

The banner ads on your browser, the route Google maps suggests for you, the song Spotify plays next: algorithms are inescapable in our daily lives. Some of us are already aware of the mechanisms behind a targeted ad or a dating profile that lights up our phone screen. However, few of us may actually stop to consider how this technology plays out in the hiring sector. As with any major technological advancement, it usually takes society (and legislation) a while to catch up and adjust for unintended consequences. Ultimately, algorithms are powerful tools. Like any tool, they have the potential for societal benefit or harm, depending on how they’re wielded. Here to weigh in on the matter is Assistant Professor of Information Systems & Operations Management Prasanna Parasurama, who recently joined Emory Goizueta Business School’s faculty in fall of 2023. This interview has been edited for clarity. Describe your research interests in six words. Six words…that’s difficult to do on the spot. How about “the impact of AI and other digital technologies on hiring.” Is that condensed enough? That works! What first interested you in the intersection of AI and hiring practices? Before I did my PhD, I was working as a data scientist in the HR analytics space at a start-up company. That is where my interest in the topic began. But this was a long time ago. People hadn’t started talking much about AI, or algorithmic hiring. The conversation around algorithmic bias and algorithmic fairness picked up steam in the second or third year of my PhD. That had a strong influence on my dissertation focus. And naturally, one of the contexts in which both these matters have large repercussions is in the hiring space. What demographics does your research focus on (gender identity, race/ethnicity, socioeconomic status, all of the above)? Do you focus on a particular job sector? My research mostly looks at gender and race for two main reasons. First, prior research has typically looked at race and gender, which gives us a better foundation to build on. Second, it’s much easier to measure gender and race based on the data that we have available—from resumes, from hiring data, like what we collect from the Equal Employment Opportunity Commission. They typically collect data on gender and race, and our research requires those really large data sets to draw patterns. They don’t ask for socioeconomic status or have an easy way to quantify that information. That’s not to say those are less important factors, or that no one is looking at them. One of the papers you’re working on examines resumes written by self-identified men and women. It looks at how their resumes differ, and how that influenced their likelihood of being contacted for an interview. So in this paper, we’re essentially looking at how men and women write their resumes differently and if that impacts hiring outcomes. Take resume screening algorithms, for example. One proposed way to reduce bias in these screening algorithms is to remove names from resumes to blind the applicant’s gender to the algorithm. But just removing names does very little, because there are so many other things that serve as proxies to someone’s gender. While our research is focused on people applying to jobs in the tech sector, this is true across occupations. "We find it’s easy to train an algorithm to accurately predict gender, even with names redacted." Prasanna Parasurama What are some of those gendered “tells” on a resume? People write down hobbies and extracurricular activities, and some of those are very gendered. Dancing and ballet tend to denote female applicants; you’re more likely to see something like wrestling for male applicants. Beyond hobbies, which is sort of obvious, is just how people write things, or the language they use. Female applicants tend to use a lot more affective words. Men, on the other hand, use more of what we call agentic words. Can you explain that a little more? In social psychology, social role theory argues that men are stereotyped to be more agentic, whereas women are stereotyped to be more communal, and that their communication styles reflect this. There’s essentially a list of agentic words that researchers have come up with that men use a lot more than women. And women are more likely to use affective words, like “warmly” or “closely,” which have to do with emotions or attitudes.  These communication differences between men and women have been demonstrated in social sciences before, which has helped inform our work. But we’re not just relying on social science tools—our conclusions are driven by our own data. If a word is able to predict that an applicant’s resume belongs to a female versus male applicant, then we assign different weights, depending on how accurately it can predict that. So we’re not just operating on theories. Were there any gendered patterns that surprised you? If you were to assign masculinity and femininity to particular words, an algorithm would likely assign “married” to be a feminine term in most contexts. But in this particular case, it’s actually more associated with men. Men are much more likely to use it in resumes, because it signals something different to society than when women use it. "One of the most predictive terms for men was references to parenthood. It’s much easier for men to reference kids than for women to reveal information about their household status. Women face a penalty where men receive a boost." Prasanna Parasurama Studies show that people perceive fathers as being more responsible employees, whereas mothers are regarded as less reliable in the workplace. We haven’t studied this, but I would speculate that if you go on a platform like LinkedIn, men are more likely to disclose details about fatherhood, marriage, and kids than women are. There were some other tidbits that I didn’t see coming, like the fact that women are much less likely to put their addresses on their resume. Can AI predict race from a resume as easily as it can predict gender? There’s surprisingly very little we know on that front. From existing literature outside of algorithmic literature, we know differences exist in terms of race, not just on the employer side, where there might be bias, but we also on the worker side. People of different races search for jobs differently. The question is, how do we take this into account in the algorithm? From a technical standpoint, it should be feasible to do the same thing we do with gender, but it just becomes a little bit harder to predict race in practice. The cues are so variable. Gender is also more universal – no matter where you live, there are probably men and women and people who identify as in between or other. Whereas the concept of race can be very specific in different geographic regions. Racial identities in America are very different from racial identities in India, for instance. And in a place like India, religion matters a lot more than it does in the United States. So this conversation around algorithms and bias will look different across the globe. Beyond screening resumes, how does AI impact people’s access to job opportunities? A lot of hiring platforms and labor market intermediaries such as LinkedIn use AI. Their task is to match workers to these different jobs. There’s so many jobs and so many workers. No one can manually go through each one. So they have to train algorithms based on existing behavior and existing design decisions on the platform to recommend applicants to particular jobs and vice versa. When we talk about algorithmic hiring, it’s not just hiring per se, but spaces like these which dictate what opportunities you’re exposed to. It has a huge impact on who ends up with what job. What impact do you want your research to have in the real world? Do you think that we actually should use algorithms to figure out gender or race? Is it even possible to blind AI to gender or race? Algorithms are here to stay, for better or worse. We need them. When we think about algorithmic hiring, I think people picture an actual robot deciding who to hire. That’s not the case. Algorithms are typically only taking the space of the initial part of hiring. "I think overall, algorithms make our lives better. They can recommend a job to you based on more sophisticated factors than when the job was chronologically posted. There’s also no reason to believe that a human will be less biased than an algorithm." Prasanna Parasurama I think the consensus is that we can’t blind the algorithm to gender or other factors. Instead, we do have to take people’s demographics into account and monitor outcomes to correct for any sort of demonstrable bias. LinkedIn, for example, does a fairly good job publishing research on how they train their algorithms. It’s better to address the problem head on, to take demographic factors into account upfront and make sure that there aren’t drastic differences in outcomes between different demographics. What advice would you give to hopeful job candidates navigating these systems? Years of research have shown that going through a connection or a referral is by far the best way to increase your odds of getting an interview—by a factor of literally 200 to 300 percent. Hiring is still a very personal thing. People typically trust people they know. Prasanna Parasurama is an Assistant Professor of Information Systems & Operations Management at Emory University’s Goizueta Business School. Prasanna’s research areas include algorithmic hiring, algorithmic bias and fairness, and human-AI interaction. His research leverages a wide array of quantitative methods including econometrics, machine learning, and natural language processing. Prasanna is available to talk about this important and developing topic - simply click on his icon now to arrange an interview today.

Is the U.S. banking system on the edge of collapse? Our #expert can explain

The recent bailout of First Foundation Inc, parent of First Foundation Bank, by a group of investors has reignited concerns about the stability of the U.S. banking system, specifically banks exposed to debt in the commercial real estate market teetering on the verge of collapse. First Foundation Bank reported more than $6 billion in commercial real estate mortgages on its financial statements for the first quarter of the year, equal to almost six times its equity capital and almost half of its $13.6 billion in total assets. Bank regulators consider any exposure greater than three times equity to be excessive. An analysis by Rebel Cole, Ph.D., Lynn Eminent Scholar Chaired Professor of Finance in the College of Business at Florida Atlantic University, previously found that the First Foundation Bank was fourth highest among the largest banks in the nation in terms of its exposure to commercial real estate debt. It’s likely that other banks are also at similar risk: among banks with more than $10 billion in total assets, there are 67 that exceed this 300% concentration ratio, Cole’s analysis showed. Among the approximately 4,600 banks of any size, Cole reports that 1,871 have total CRE exposures greater than 300%, 1,112 have exposures greater than 400%, 551 have exposures greater than 500%, and 243 have exposures greater than 600%. Cole is available for expert commentary on the stability of the U.S. banking system, other banks at risk due to their CRE exposure, and investor confidence.

On the T-Swift beat? Our expert can fill any of the blank spaces you might have in your coverage

She's everywhere - and this month Taylor Swift restarts her world tour meaning coverage of this American mega-star will be global. Recently TCU's Naomi Ekas was featured in USA Today and Time Magazine where her expert opinion and insight into Taylor Swift's impact on American psychology is helping to explain her place atop planetary pop-culture. Professor Naomi Ekas teaches a course about the connection between psychology and Swift's place in pop culture at Texas Christian University in Fort Worth, Texas. She believes there are universal themes listeners have experienced in Swift's lyrics but notes that the pop star's particular worldview may not translate to everyone. At the beginning of the spring semester, Ekas asked her students what labels they attached to Swift. Many of the responses reflected that were "these are white girl experiences, and this is white girl music and there isn't kind of that representation or that connection kind of outside of that particular racial group," she tells USA TODAY. "Everyone's dated the bad boy and they’ve had the friendship breakups and they’ve, you know, crashed and burned in relationships, revenge – these are pretty common themes across humankind, but then her particular life and how she's living them out might not connect to everybody," Ekas says.  April 24 - USA Today Last year, when millions of people were trying to snag Eras Tour tickets, students at Texas Christian University were working just as hard to get into "Psychology (Taylor’s Version)," a new class offered by developmental psychologist Naomi Ekas. “We take different topics and themes from her music or her life and apply a developmental perspective to it,” she says. Classes have centered, for example, on infidelity, revenge, attraction, and breakups. During one recent class, Ekas played Marjorie, the devastating Evermore tune that pays tribute to Swift’s grandmother. (I should've asked you questions, I should've asked you how to be, she sings.) Many of the 120 students started crying and asked if they could have a few minutes to text their grandmother or their mom or their dad. “We were all like, ‘Do we continue with class today? Because we’re very sad,’” Ekas recalls. April 19 - Time Magazine There will be no shortage of Taylor Swift coverage in the coming months - and if you're a journalist looking to fill a blank space in your story and avoid a cruel summer with no expert sources - then let us help. Naomi Ekas's research program utilizes a developmental psychology approach to understanding children’s social and emotional development. She also  teaches a course about the connection between psychology and Swift's place in pop culture. Naomi is available to speak with media - simply click on her icon now to arrange a time today.

Cosmetic or Drug? The FDA's Classification of Sunscreen Limits Which Products Hit US Shelves

As stifling rays of sunshine beat down across the United States, it’s the time of year citizens flock to the store to load up on sun protection. It’s also the time of year consumers and media raise the annual question of why Europe is able to market sunscreen that contains more potentially effective ingredients, but the U.S. isn’t. The answer is not related to sunscreen or its ingredients, but rather how the country’s regulatory body – The Food and Drug Administration (FDA) – legally operates. “In order for the FDA to legally regulate products, those products are given classifying labels,” said Ana Santos Rutschman, a professor of law at Villanova University who studies health law. “A toothbrush, for instance, is labeled a medical device. That’s because it has to fit in one of the sources of authority of the FDA and the FDA, per the law, regulates drugs or medical devices.” Here is where it gets tricky. The FDA does not have to approve cosmetics, aside from certain color additives, before those products go to market. In the European Union’s European Medicines Agency (EMA), sunscreen is labeled as a cosmetic. Many other countries also classify it as such. In the U.S., however, sunscreen is labeled a drug because it has a therapeutic effect, and thus falls under the authority of the FDA. To make the classification system even more convoluted, some items are labeled as both a cosmetic and drug by the FDA. Shampoo, for instance, is inherently cosmetic. “But if it’s anti-dandruff shampoo, then it’s also a pharmaceutical,” said Santos Rutschman. “It’s super common for this to happen with a lot of products that you and I would not think are classified as drugs. It’s very natural under the regulatory regime that we have, but then it is very hard to bring anything to market – harder than other countries.” Case in point, sunscreen used in the EU that contains ingredients which may be more effective against certain types of ultraviolet rays cannot simply just come to market in the U.S. “If sunscreen fits the definition of a drug, then it must meet drug requirements,” said Santos Rutschman. “If you want a new drug to enter the U.S., you have to show efficacy and safety. But in order to do that, there must be clinical trials, and if those trials happened elsewhere, they would not conform to our domestic protocols. “Even if another country performed their own clinical trials, the odds the FDA would utilize the data are not incredibly high. If you think another country recognizes something we should, based on their data, then immediately this is going to raise questions of why we are deferring to a foreign regulator.” The FDA could go through the process of approving ingredients in question – and has indicated it will do so – but it’s a complicated process, and there is “also a matter of risk,” according to Santos Rutschman. “The FDA has always been less risk averse than its counterparts in Europe. I understand the market concerns, but this seems about right from a regulatory perspective… We aren’t talking about a specific drug that people need and cannot access. Sunscreen is available for the average American to purchase.” Barring an overhaul to the regulatory system in the U.S. to include an agency for cosmetics – an idea some argue has merit, but Santos Rutschman described as “not feasible” with the available funding – the only way Europe’s sunscreen would be available for Americans to purchase is if the FDA moved forward in regulating the ingredients. And that will continue to take time. “The FDA has never moved quickly on anything,” said Santos Rutschman. “It just can't.”

Expert Insight: Training Innovative AI to Provide Expert Guidance on Prescription Medications

A new wave of medications meant to treat Type II diabetes is grabbing headlines around the world for their ability to help people lose a significant amount of weight. They are called GLP-1 receptor agonists. By mimicking a glucagon-like peptide (GLP) naturally released by the body during digestion, they not only lower blood sugar but also slow digestion and increase the sense of fullness after eating. The two big names in GLP-1 agonists are Ozempic and Wegovy, and both are a form of semaglutide. Another medication, tirzepatide, is sold as Mounjaro and Zepbound. It is also a glucose-dependent insulinotropic polypeptide (GIP) agonist as well as GLP-1. Physicians have been prescribing semaglutide and tirzepatide with increasing frequency. However, both medications come with a host of side effects, including nausea and stomach pain, and are not suitable for every patient. Many clinics and physicians do not have immediate access to expert second opinions, as do the physicians at Emory Healthcare. Creating a Digital Twin That lack of an expert is one of the reasons Karl Kuhnert, professor in the practice of organization and management at Emory University’s Goizueta Business School, is using artificial intelligence to capture the expertise of physicians like Caroline Collins MD through the Tacit Object Modeler™, or TOM. By using TOM, developed by Merlynn Intelligence Technologies, Kuhnert and Collins can create her “decision-making digital twin.” This allows Collins to reveal her expertise as a primary care physician with Emory Healthcare and an Assistant Professor at Emory School of Medicine, where she has been leading the field in integrating lifestyle medicine into clinical practices and education. Traditional AI, like ChatGPT, uses massive amount of data points to predict outcomes using what’s known as explicit knowledge. But it isn’t necessarily learning as it goes. According to Kuhnert, TOM has been designed to learn how an expert, like Collins, decides whether or not to prescribe a drug like semaglutide to a patient. Wisdom or tacit knowledge is intuitive and rooted in experience and context. It is hard to communicate, and usually resides only in the expert’s mind. TOM’s ability to “peek into the expert’s mind makes it a compelling technology for accessing wisdom.” “Objective or explicit knowledge is known and can be shared with others,” says Kuhnert. "For example, ChatGPT uses explicit knowledge in its answers. It’s not creating something new. It may be new to you as you read it, but somebody, somewhere, before you, has created it. It’s understood as coming from some source." Karl Kuhnert “Tacit knowledge is subjective wisdom. Experts offer this, and we use their tacit know-how, their implicit knowledge, to make their decisions. If it were objective, everyone could do it. This is why we hire experts: They see things and know things others don’t; they see around corners.” Mimicking the Mind of a Medical Expert Teaching TOM to see around the corners requires Collins to work with the AI over the course of a few days. “Essentially what I do is I sit down with, in this case, a physician, and ask them, ‘What are thinking about when you make this decision?'” says Kuhnert. “The layperson might think that there are hundreds of variables in making a medical decision like this. With the expert’s tacit knowledge and experience, it is usually between seven and twelve variables. They decide based on these critical variables,” he says. "These experts have so much experience, they can cut away a lot of the noise around a decision and get right to the point and ask, ‘What am I looking at?’" Karl Kuhnert As TOM learns, it presents Collins with more and different scenarios for prescribing semaglutide. As she makes decisions, it remembers the variables present during her decision-making process. “Obviously, some variables are going to be more important than other variables. Certain combinations are going to be challenging,” says Collins. “Sometimes there are going to be some variables where I think, yes, this patient needs a GLP-1. Then there may be some variables where I think, no, this person really doesn’t need that. And which ones are going to win out? That’s really where TOM is valuable. It can say, okay, when in these difficult circumstances where there are conflicting variables, which one will ultimately be most important in making that decision?” The Process: Trusting AI After working with TOM for several hours, Collins will have reacted to enough scenarios for TOM to learn to make her decision. The Twin will need to demonstrate that it can replicate her decision-making with acceptable accuracy—high 90s to 100 percent. Once there, Collins’ Twin is ready to use. “I think it’s important to have concordance between what I would say in a situation and then what my digital twin would say in a situation because that’s our ultimate goal is to have an AI algorithm that can duplicate what my recommendation would be given these circumstances for a patient,” Collins says. “So, someone, whether that be an insurance company, or a patient themselves or another provider, would be able to consult TOM, and in essence, me, and say, in this scenario, would you prescribe a GLP-1 or not given this specific patient’s situation?” The patient’s current health and family history are critical when deciding whether or not to prescribe semaglutide. For example, according to Novo Nordisk, the makers of Ozempic, the drug should not be prescribed to patients with a history of problems with the pancreas or kidneys or with a family history of thyroid cancer. Those are just the start of a list of reasons why a patient may or may not be a good candidate for the medication. Kuhnert says, “What we’re learning is that there are so many primary care physicians right now that if you come in with a BMI over 25 and are prediabetic, you’re going to get (a prescription). But there’s much more data around this to suggest that there are people who are health marginalized, and they can’t do this. They should not have this (medication). It’s got to be distributed to people who can tolerate it and are safe.” Accessing the Digital Twin on TOM Collins’s digital twin could be available via something as easy to access as an iPhone app. “Part of my job is to provide the latest information to primary care physicians. Now, I can do this in a way that is very powerful for primary care physicians to go on their phones and put it in. It’s pretty remarkable, according to Colllins.” It is also transparent and importantly sourced information. Any physician using a digital twin created with TOM will know exactly whose expertise they are accessing, so anyone asking for a second opinion from Colllins will know they are using an expert physician from Emory University. In addition to patient safety, there are a number of ways TOM can be useful to the healthcare industry when prescribing medications like semaglutide. This includes interfacing with insurance companies and the prior approval process, often lengthy and handled by non-physician staff. “Why is a non-expert at an insurance company determining whether a patient needs a medication or not? Would it be better to have an expert?” says Collins. “I’m an expert in internal medicine and lifestyle medicine. So, I help people not only lose weight, but also help people change their behaviors to optimize their health. My take on GLP-1 medications is not that everyone needs them, it’s that they need to be utilized in a meaningful way, so patients will get benefit, given risks and benefits for these medications.” The Power of a Second Opinion Getting second, and sometimes third, opinions is a common practice among physicians and patients both. When a patient presents symptoms to their primary care physician, that physician may have studied the possible disease in school but isn’t necessarily an expert. In a community like Emory Healthcare, the experts are readily available, like Collins. She often serves as a second opinion for her colleagues and others around the country. “What we’re providing folks is more of a second opinion. Because we want this actually to work alongside someone, you can look at this opinion that this expert gave, and now, based on sourced information, you can choose. This person may be one of the best in the country, if not the world, in making this decision. But we’re not replacing people here. We’re not dislocating people with this technology. We need people. We need today’s and tomorrow’s experts as well,” according to Kuhnert. But also, you now have the ability to take an Emory physician’s diagnosing capabilities to physicians in rural areas and make use of this information, this knowledge, this decision, and how they make this decision. We have people here that could really help these small hospitals across the country. Caroline Collin MD Rural Americans have significant health disparities when compared to those living in urban centers. They are more likely to die from heart disease, cancer, injury, chronic respiratory disease, and stroke. Rural areas are finding primary care physicians in short supply, and patients in rural areas are 64 percent less likely to have access to medical specialists for needed referrals. Smaller communities might not have immediate access to experts like a rheumatologist, for example. In addition, patients in more rural areas might not have the means of transportation to get to a specialist, nor have the financial means to pay for specialized visits for a diagnosis. Collins posits that internal medicine generalists might suspect a diagnosis but want to confirm before prescribing a course of treatment. “If I have a patient for whom I am trying to answer a specific question, ‘Does this patient have lupus?’, for instance. I’m not going to be able to diagnose this person with lupus. I can suspect it, but I’m going to ask a rheumatologist. Let’s say I’m in a community where unfortunately, we don’t have a rheumatologist. The patient can’t see a rheumatologist. That’s a real scenario that’s happening in the United States right now. But now I can ask the digital twin acting as a rheumatologist, given these variables, ‘Does this patient have lupus?’ And the digital twin could give me a second opinion.” Sometimes, those experts are incredibly busy and might not have the physical availability for a full consult. In this case, someone could use TOM to create the digital twin of that expert. This allows them to give advice and second opinions to a wider range of fellow physicians. As Kuhnert says, TOM is not designed or intended to be a substitute for a physician. It should only work alongside one. Collins agreed, saying, “This doesn’t take the place of a provider in actual clinical decision-making. That’s where I think someone could use it inappropriately and could get patients into trouble. You still have to have a person there with clinical decision-making capacity to take on additional variables that TOM can’t yet do. And so that’s why it’s a second opinion.” “We’re not there yet in AI says Collins. We have to be really careful about having AI make actual medical decisions for people without someone there to say, ‘Wait a minute, does this make sense?’” AI Implications in the Classroom and Beyond Because organizations use TOM to create digital twins of their experts, the public cannot use the twins to shop for willing doctors. “We don’t want gaming the system,” says Collins. “We don’t want doctor shopping. What we want is a person there who can utilize AI in a meaningful way – not in a dangerous way. I think we’ll eventually get there where we can have AI making clinical decisions. But I don’t think I’d feel comfortable with that yet.” The implications of using decision-making digital twins in healthcare reach far beyond a second opinion for prescription drugs. Kuhnert sees it as an integral part of the future of medical school classrooms at Emory. In the past, teaching case studies have come from books, journals, and papers. Now, they could come alive in the classroom with AI simulation programs like TOM. "I think this would be great for teaching residents. Imagine that we could create a simulation and put this in a classroom, have (the students) do the simulation, and then have the physician come in and talk about how she makes her decisions." Karl Kuhnert “And then these residents could take this decision, and now it’s theirs. They can keep it with them. It would be awesome to have a library of critical health decisions made in Emory hospitals,” Kuhnert says. Collins agreed. “We do a lot of case teaching in the medical school. I teach both residents and medical students at Emory School of Medicine. This would be a really great tool to say, okay, given these set of circumstances, what decision would you make for this patient? Then, you could see what the expert’s decision would have been. That could be a great way to see if you are actually in lockstep with the decision-making process that you’re supposed to be learning.” Kuhnert sees decision-making twins moving beyond the healthcare system and into other arenas like the courtroom, public safety, and financial industries and has been working with other experts to digitize their knowledge in those fields. "The way to think about this is: say there is a subjective decision that gets made that has significant ramifications for that company and maybe for the community. What would it mean if I could digitize experts and make it available to other people who need an expert or an expert’s decision-making?" Karl Kuhnert “You think about how many people aren’t available. Maybe you have a physician who’s not available. You have executives who are not available. Often expertise resides in the minds of just a few people in an organization,” says Kuhnert. “Pursuing the use of technologies like TOM takes the concept of the digital human expert from simple task automation to subjective human decision-making support and will expand the idea of a digital expert into something beyond our current capabilities,” Kuhnert says. “I wanted to show that we could digitize very subjective decisions in such areas as ethical and clinical decision-making. In the near future, we will all learn from the wisdom codified in decision-making digital twins. Why not learn from the best? There is a lot of good work to do.” Karl Kuhnert is a Professor in the Practice of Organization & Management and Associate Professor of Psychiatry, School of Medicine and Senior Faculty Fellow of the Emory Ethics Center. If you're looking to connect with Karl to know more - simply click on his icon now to arrange a time to talk today.