├── requirements.txt
├── examples
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintro.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart11.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart8.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart10.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart12.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart13.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart9.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.pdf
├── ai-impact.AfutureofhumanlevelortransformativeAI.summary.txt
├── ai-impact.Reusethisworkfreely.summary.txt
├── ai-impact.TitleAbstract.summary.txt
├── ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.summary.txt
├── ai-impact.Endnotes.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.summary.txt
├── ai-impact.AfutureofhumanlevelortransformativeAI.full.txt
├── ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart3.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart4.summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.overall_summary.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart12.full.txt
├── ai-impact.Reusethisworkfreely.full.txt
├── ai-impact.overall_summary.txt
├── ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart8.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.full.txt
├── ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintro.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart10.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart3.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart4.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart11.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart9.full.txt
├── NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart13.full.txt
├── ai-impact.Endnotes.full.txt
└── ai-impact.TitleAbstract.full.txt
├── LICENSE
├── summarize.py
└── README.md
/requirements.txt:
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1 | openai
2 | transformers
3 | pdfminer
4 | html2text
5 |
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.pdf:
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/examples/ai-impact.AfutureofhumanlevelortransformativeAI.summary.txt:
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1 |
2 |
3 | This section discusses the difference between human-level AI and transformative AI, and the potential timeline for when either of these levels of AI might be achieved. It is noted that transformative AI could be developed before human-level AI, and that the timeline for when either of these levels of AI might be achieved is difficult to predict. The article provides a link to a companion article which gives an overview of what researchers in this field currently believe about the timeline for AI development.
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/examples/ai-impact.Reusethisworkfreely.summary.txt:
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1 |
2 |
3 | This section provides information about the licenses and permissions associated with Our World in Data's visualizations, data, code, and articles. All of Our World in Data's work is open access under the Creative Commons BY license, and all software and code is open source under the MIT license. Data produced by third parties is subject to the license terms from the original third-party authors. Additionally, Our World in Data's charts can be embedded in any site, and the project is a part of the Global Change Data Lab, a registered charity in England and Wales. A full legal disclaimer is also provided.
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/examples/ai-impact.TitleAbstract.summary.txt:
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1 |
2 |
3 | This section discusses the potential implications of artificial intelligence (AI) becoming a reality. It explains why it is difficult to take the prospect of a world transformed by AI seriously, and how to develop an idea of what the future of AI might look like. It also looks at the advantages and disadvantages of comparing machine and human intelligence, and introduces the concept of transformative AI, which is defined by the impact this technology would have on the world. It compares the potential of transformative AI to the agricultural and industrial revolutions, and suggests that it could represent the introduction of a similarly significant general-purpose technology.
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/examples/ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.summary.txt:
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1 |
2 | Making sure that the development of artificial intelligence (AI) goes well is a crucial question for humanity. Currently, resources dedicated to AI are mostly focused on speeding up its development, while efforts to increase its safety are under-resourced. This neglect of AI safety work means that individuals have a good chance to make a positive difference if they dedicate themselves to this problem. However, it needs more than individual efforts; society needs to become knowledgeable about the technology and understand what is at stake. Our World in Data is doing its part to enable a better informed public conversation on AI and the future we want to live in.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.summary.txt:
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1 |
2 |
3 | This section discusses the findings of a trial that evaluated the effect of an artificial intelligence-based (AID) therapy on glycemic control. The results showed that the AID therapy improved glycemic control, with the greatest improvement seen overnight. Adults had a higher percentage of time in the target range than children, possibly due to differences in glycemic variability, likelihood of administration of an insulin bolus before a meal, activity level, and dietary factors. The absolute differences in the percentage of time in range between the trial groups were similar to between-group differences for commercially available AID systems. The results showed that patients with the lowest baseline time in the target range gained the most from the use of AID.
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/examples/ai-impact.Endnotes.summary.txt:
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1 |
2 |
3 | This section discusses the concept of human-level AI, which is defined as a software system that can carry out at least 90% or 99% of all economically relevant tasks that humans carry out. It also looks at the closely related terms Artificial General Intelligence, High-Level Machine Intelligence, Strong AI, or Full AI, which are sometimes defined in similar, yet different ways. The section also looks at the difficulty of comparing machine and human intelligence, and the potential risks of AI systems, such as AI-enabled disinformation campaigns and mass surveillance by governments. It also looks at the incentives for developing powerful AI, and the potential for it to lead to positive developments. Finally, the section looks at the early warnings of Alan Turing and Norbert Wiener about the alignment problem, and Toby Ord's projection that AI could be developed by 2040.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.summary.txt:
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1 |
2 |
3 | This section describes the results of a trial comparing the use of open-source automated insulin delivery (AID) and sensor-augmented insulin-pump therapy (control group) in children (7 to 15 years of age) and adults (16 to 70 years of age). The results are presented in two figures, which show the percentage of time that patients were in the target glucose range (70 to 180 mg per deciliter [3.9 to 10.0 mmol per liter]) during contiguous 4-week periods from 4 weeks before randomization to 24 weeks after randomization. The results indicate that the AID group had a higher percentage of time in the target glucose range than the control group, and that the group differences are partly attributable to a decrease in the percentage of time in range in the control group after the run-in period. The trial also had a high level of patient retention, a lack of remote monitoring, and broad inclusion criteria, which resulted in a population of diverse ages and ethnic backgrounds.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.summary.txt:
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1 |
2 |
3 | This section provides information about the limitations of the trial and the generalizability of the findings. It was noted that the control group did not have an automated system for predicting low-glucose levels or suspending insulin administration, which have been shown to reduce the incidence of hypoglycemia. The trial patients were more diverse than those enrolled in previous studies, but the generalizability of the findings may be limited by the enrollment of patients with a relatively low glycated hemoglobin level at baseline, by the underrepresentation of patients with reduced economic resources, and by the increased familiarity with insulin-pump therapy and continuous glucose monitoring among the patients at baseline. In addition, a variety of insulin pumps were used in the control group, although the stable time in the target range throughout the trial suggests that this factor had a minimal effect. The section also provides information about the study's funding and disclosure forms.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.summary.txt:
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1 |
2 |
3 | This section provides a comparison of the characteristics of patients in the Automated Insulin Delivery (AID) group and the control group in the CREATE trial. The characteristics include the quintile of the New Zealand Deprivation Index, diabetes history, glycated hemoglobin, previous use of continuous glucose monitoring (CGM) and automated insulin delivery, and time in target glucose range. The AID group had a mean percent glycated hemoglobin of 7.6 mmol/mol, 15 patients (65%) had previously used CGM, and 4 patients (17%) had previously used automated insulin delivery. The control group had a mean percent glycated hemoglobin of 7.8 mmol/mol, 17 patients (65%) had previously used CGM, and 5 patients (19%) had previously used automated insulin delivery. The time in target glucose range was 64.7±12.9% for the AID group and 60.3±15.6% for the control group. The section also provides information on device deficiencies, which were more common in the AID group (46 events) than in the control group (39 events).
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.summary.txt:
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1 |
2 |
3 | This section provides information on the safety outcomes and system performance of a trial that tested the use of an automated insulin delivery (AID) system in adults and children with type 1 diabetes. The AID system was found to be most effective at night, when the time in range was 85.2±12.7% in the AID group, compared to 70.9±12.7% during the day. In the control group, the mean time in range at night (53.5±20.1%) was similar to that during the day (57.5±14.4%). Neither severe hypoglycemia nor diabetic ketoacidosis occurred in either trial group, and no adverse events were related to the algorithm or automation of insulin delivery. Ten adverse events that were related to a device (nonserious adverse device effects) were reported among 8 patients in the AID group, and 8 events were reported among 8 patients in the control group. Two serious adverse events occurred in the AID group, and 5 serious adverse events occurred in the control group. The median percentage of time that the system was automating insulin delivery was 94.2% (IQR, 87.3 to 95.7) in the AID group.
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/LICENSE:
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1 | MIT License
2 |
3 | Copyright (c) 2022 Scott Leibrand
4 |
5 | Permission is hereby granted, free of charge, to any person obtaining a copy
6 | of this software and associated documentation files (the "Software"), to deal
7 | in the Software without restriction, including without limitation the rights
8 | to use, copy, modify, merge, publish, distribute, sublicense, and/or sell
9 | copies of the Software, and to permit persons to whom the Software is
10 | furnished to do so, subject to the following conditions:
11 |
12 | The above copyright notice and this permission notice shall be included in all
13 | copies or substantial portions of the Software.
14 |
15 | THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR
16 | IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY,
17 | FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE
18 | AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER
19 | LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM,
20 | OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE
21 | SOFTWARE.
22 |
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.summary.txt:
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1 |
2 |
3 | This section discusses two widely used open-source AID systems, AndroidAPS and Loop, and the barriers to their uptake. It also introduces the CREATE (Community Derived Automated Insulin Delivery) trial, which was conducted at four sites in New Zealand to evaluate the efficacy and safety of an open-source AID system compared to sensor-augmented insulin-pump therapy in children and adults with type 1 diabetes. The trial was approved by the Southern Health and Disability Ethics Committee of New Zealand and funded by the Health Research Council of New Zealand. Hardware support was provided by SOOIL Development, Dexcom, and Vodafone New Zealand. The trial protocol has been published previously and an independent data and safety monitoring committee and medical monitor provided trial oversight. Eligible patients were between the ages of 7 and 70 years, had received a diagnosis of type 1 diabetes at least 1 year earlier, had at least 6 months of experience with insulin-pump therapy, and had a mean glycated hemoglobin level of less than 10.5%. Patients in the two trial groups were invited to join separate closed online communities that provided ongoing peer support.
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/examples/ai-impact.AfutureofhumanlevelortransformativeAI.full.txt:
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1 | ##### A future of human-level or transformative AI?
2 | The two concepts are closely related, but they are not the same. The creation
3 | of a human-level AI would certainly have a transformative impact on our world.
4 | If the work of most humans could be carried out by an AI, the lives of
5 | millions of people would change.11
6 |
7 | The opposite, however, is not true: we might see transformative AI without
8 | developing human-level AI. Since the human mind is in many ways a poor
9 | metaphor for the intelligence of machines, we might plausibly develop
10 | transformative AI before we develop human-level AI. Depending on how this
11 | goes, this might mean that we will never see any machine intelligence for
12 | which human intelligence is a helpful comparison.
13 |
14 | When and if AI systems might reach either of these levels is of course
15 | difficult to predict. In my [companion article](https://ourworldindata.org/ai-
16 | timelines) on this question, I give an overview of what researchers in this
17 | field currently believe. Many AI experts believe there is a real chance that
18 | such systems will be developed within the next decades, and some believe that
19 | they will exist much sooner.
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/examples/ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.summary.txt:
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1 |
2 |
3 | This section discusses the potential risks and benefits of artificial intelligence (AI) becoming more powerful. It is clear that AI can already cause harm when used maliciously, such as in politically-motivated disinformation campaigns or to enable mass surveillance. AI can also cause unintended harm, such as when an AI system falsely accused 26,000 parents of making fraudulent claims for child care benefits in the Netherlands. As AI becomes more powerful, the potential negative impacts could become much larger, such as mass labor displacement, extreme concentrations of power and wealth, and totalitarianism. Additionally, there is the risk of an AI system escaping human control and harming humans, known as the alignment problem. This risk is difficult to foresee and prevent, and could lead to an extreme catastrophe. On the other hand, AI could lead to positive developments such as cleaner energy, the replacement of unpleasant work, and better healthcare. The stakes are high with this technology, and reducing the negative risks and solving the alignment problem could mean the difference between a healthy, flourishing, and wealthy future for humanity – and the destruction of the same.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart3.summary.txt:
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1 |
2 |
3 | This section describes the trial design for a study on Automated Insulin Delivery in Type 1 Diabetes. The study included a 4-week run-in phase, during which patients became familiar with the trial devices functioning as sensor-augmented insulin-pump therapy. Patients were then randomly assigned in a 1:1 ratio to the AID group or the control group. The AID group used an open-source system, which was a modified version of AndroidAPS paired with a preproduction DANA-i insulin pump and Dexcom G6 CGM. The primary outcome was percentage of time in the target glucose range of 70 to 180 mg per deciliter between day 155 and day 168. Secondary outcomes included metrics for continuous glucose monitoring, glycated hemoglobin level, and performance of the AID system. Adverse events that were evaluated included adverse device effects, serious adverse events, and serious adverse device effects. At approximately 3 months into the trial, a battery problem in a preproduction DANA-i insulin pump was identified. Patients in the control group had the option of returning to their usual insulin pump, and those in the AID group used refurbished preproduction DANA-i insulin pumps. The study had 90% power with a two-sided alpha of 0.05 to reject the null hypothesis of no between-group difference in the time in range.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart4.summary.txt:
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1 |
2 |
3 | This section describes the data capture and management processes, data cleaning and analyses, and primary and secondary outcomes of a clinical trial that tested the efficacy of an automated insulin delivery (AID) system in patients with type 1 diabetes. A total of 100 patients were enrolled, 97 of whom (48 children and 49 adults) underwent randomization to either the AID group (44 patients) or the control group (53 patients). The characteristics of the patients at baseline were similar in the two trial groups. The final patient completed the trial in November 2021. In the primary analysis, the mean time in range increased from 61.2% at baseline to 71.2% in the AID group and decreased from 57.7% to 54.5% in the control group. Among the children, the mean time in range increased from 57.4% at baseline to 67.5% in the AID group and decreased from 55.1% to 52.5% in the control group. During a 24-hour period, the percentage of time that patients had a glucose reading of less than 70 mg per deciliter was 2.1% in the AID group and 2.7% in the control group. The use of AID was most effective at night, when the mean time in range was 76.8% in the AID group and 57.2% in the control group. Among the adults, the mean time in range increased from 64.7% at baseline to 74.5% in the AID group and decreased from 61.2% to 58.2% in the control group.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.overall_summary.txt:
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1 |
2 |
3 | This paper describes the results of a clinical trial that tested the efficacy of an automated insulin delivery (AID) system in patients with type 1 diabetes. A total of 100 patients were enrolled, 97 of whom (48 children and 49 adults) underwent randomization to either the AID group (44 patients) or the control group (53 patients). The characteristics of the patients at baseline were similar in the two trial groups. The primary analysis showed that the mean time in range increased from 61.2% at baseline to 71.2% in the AID group and decreased from 57.7% to 54.5% in the control group. Among the children, the mean time in range increased from 57.4% at baseline to 67.5% in the AID group and decreased from 55.1% to 52.5% in the control group. During a 24-hour period, the percentage of time that patients had a glucose reading of less than 70 mg per deciliter was 2.1% in the AID group and 2.7% in the control group. The use of AID was most effective at night, when the mean time in range was 76.8% in the AID group and 57.2% in the control group. Among the adults, the mean time in range increased from 64.7% at baseline to 74.5% in the AID group and decreased from 61.2% to 58.2% in the control group. The trial also found that the AID system was safe and had a high level of patient retention. The results indicate that the AID group had a higher percentage of time in the target glucose range than the control group, and that the group differences are partly attributable to a decrease in the percentage of time in range in the control group after the run-in period.
4 |
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart12.full.txt:
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/examples/ai-impact.Reusethisworkfreely.full.txt:
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1 | ### Reuse this work freely
2 | All visualizations, data, and code produced by Our World in Data are
3 | completely open access under the [Creative Commons BY
4 | license](https://creativecommons.org/licenses/by/4.0/). You have the
5 | permission to use, distribute, and reproduce these in any medium, provided the
6 | source and authors are credited.
7 |
8 | The data produced by third parties and made available by Our World in Data is
9 | subject to the license terms from the original third-party authors. We will
10 | always indicate the original source of the data in our documentation, so you
11 | should always check the license of any such third-party data before use and
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13 |
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/examples/ai-impact.overall_summary.txt:
--------------------------------------------------------------------------------
1 |
2 |
3 | This article discusses the potential implications of artificial intelligence (AI) becoming a reality. It explains why it is difficult to take the prospect of a world transformed by AI seriously, and how to develop an idea of what the future of AI might look like. It compares the potential of transformative AI to the agricultural and industrial revolutions, and suggests that it could represent the introduction of a similarly significant general-purpose technology. The article also looks at the advantages and disadvantages of comparing machine and human intelligence, and introduces the concept of transformative AI, which is defined by the impact this technology would have on the world. It is noted that transformative AI could be developed before human-level AI, and that the timeline for when either of these levels of AI might be achieved is difficult to predict.
4 |
5 | The article also looks at the potential risks and benefits of AI becoming more powerful. It is clear that AI can already cause harm when used maliciously, such as in politically-motivated disinformation campaigns or to enable mass surveillance. AI can also cause unintended harm, such as when an AI system falsely accused 26,000 parents of making fraudulent claims for child care benefits in the Netherlands. As AI becomes more powerful, the potential negative impacts could become much larger, such as mass labor displacement, extreme concentrations of power and wealth, and totalitarianism. Additionally, there is the risk of an AI system escaping human control and harming humans, known as the alignment problem. This risk is difficult to foresee and prevent, and could lead to an extreme catastrophe. On the other hand, AI could lead to positive developments such as cleaner energy, the replacement of unpleasant work, and better healthcare. The stakes are high with this technology, and reducing the negative risks and solving the alignment problem could mean the difference between a healthy, flourishing, and wealthy future for humanity – and the destruction of the same.
6 |
7 | The article also looks at the difference between human-level AI and transformative AI, and the potential timeline for when either of these levels of AI might be achieved. It is noted that transformative AI could be developed before human-level AI, and that the timeline for when either of these levels of AI might be achieved is difficult to predict. Additionally, the article provides information about the licenses and permissions associated with Our World in Data's visualizations, data, code, and articles. Finally, the article looks at the concept of human-level AI, which is defined as a software system that can carry out at least 90% or 99% of all economically relevant tasks that humans carry out. It also looks at the closely related terms Artificial General Intelligence, High-Level Machine Intelligence, Strong AI, or Full AI, which are sometimes defined in similar, yet different ways. The section also looks at the difficulty of comparing machine and human intelligence, and the potential risks of AI systems, such as AI-enabled disinformation campaigns and mass surveillance by governments. It also looks at the incentives for developing powerful AI, and the potential for it to lead to positive developments. Finally, the section looks at the early warnings of Alan Turing and Norbert Wiener about the alignment problem, and Toby Ord's projection that AI could be developed by 2040.
8 |
--------------------------------------------------------------------------------
/examples/ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.full.txt:
--------------------------------------------------------------------------------
1 | #### How can we make sure that the development of AI goes well?
2 | Making sure that the development of artificial intelligence goes well is not
3 | just one of the most crucial questions of our time, but likely one of the most
4 | crucial questions in human history. This needs public resources – public
5 | funding, public attention, and public engagement.
6 |
7 | Currently, almost all resources that are dedicated to AI aim to speed up the
8 | development of this technology. Efforts that aim to increase the safety of AI
9 | systems, on the other hand, do not receive the resources they need. Researcher
10 | Toby Ord estimated that in 2020 between $10 to $50 million was spent on work
11 | to address the alignment problem.18 Corporate AI investment in the same year
12 | was more than 2000-times larger, it [summed
13 | up](https://ourworldindata.org/grapher/corporate-investment-in-artificial-
14 | intelligence-total?country=~OWID_WRL) to $125 billion.
15 |
16 | This is not only the case for the AI alignment problem. The work on the entire
17 | range of negative social consequences from AI is under-resourced compared to
18 | the large investments to increase the power and use of AI systems.
19 |
20 | It is frustrating and concerning for society as a whole that AI safety work is
21 | extremely neglected and that little public funding is dedicated to this
22 | crucial field of research. On the other hand, for each _individual_ person
23 | this neglect means that they have a good chance to actually make a positive
24 | difference, if they dedicate themselves to this problem now. And while the
25 | field of AI safety is small, it does provide [good
26 | resources](https://80000hours.org/problem-profiles/artificial-
27 | intelligence/#what-can-you-do-concretely-to-help) on what you can do
28 | concretely if you want to work on this problem.
29 |
30 | I hope that more people dedicate their individual careers to this cause, but
31 | it needs more than individual efforts. A technology that is transforming our
32 | society needs to be a central interest of all of us. As a society we have to
33 | think more about the societal impact of AI, become knowledgeable about the
34 | technology, and understand what is at stake.
35 |
36 | When our children look back at today, I imagine that they will find it
37 | difficult to understand how little attention and resources we dedicated to the
38 | development of safe AI. I hope that this changes in the coming years, and that
39 | we begin to dedicate more resources to making sure that powerful AI gets
40 | developed in a way that benefits us and the next generations.
41 |
42 | If we fail to develop this broad-based understanding, then it will remain the
43 | small elite that finances and builds this technology that will determine how
44 | one of the – or plausibly _the_ – most powerful technology in human history
45 | will transform our world.
46 |
47 | * * *
48 |
49 | With our work at Our World in Data we want to do our small part to enable a
50 | better informed public conversation on AI and the future we want to live in.
51 | You can find these resources on [OurWorldinData.org/artificial-
52 | intelligence](https://ourworldindata.org/artificial-intelligence)
53 |
54 | **Acknowledgements:** I would like to thank my colleagues Daniel Bachler,
55 | Charlie Giattino, and Edouard Mathieu for their helpful comments to drafts of
56 | this essay.
57 |
58 | Our World in Data presents the data and research to make progress against the
59 | world’s largest problems.
60 | This article draws on data and research discussed in our entry on
61 | **[Artificial Intelligence](https://ourworldindata.org/artificial-
62 | intelligence)**.
--------------------------------------------------------------------------------
/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract. Section intro
2 | ary 2015.2 Since that time, multiple open-source
3 | AID systems have evolved, and despite a lack of
4 | regulatory approval, such systems have been
5 | adopted by approximately 2500 patients with
6 | diabetes globally. Data now include the results
7 | of more than 55 million hours of real-world
8 | open-source AID experience.3
9 |
10 | Two widely used open-source AID systems are
11 | AndroidAPS (OpenAPS algorithm on an Android
12 | device) and Loop (a different algorithm on an
13 | iOS device). In a single-group study, investiga-
14 | tors found that patients who used the Loop
15 | system had a higher percentage of time in range
16 | for target glucose control (70 to 180 mg per
17 | deciliter [3.9 to 10.0 mmol per liter]), with an
18 | increase in control from 67% at baseline to 73%
19 | at 6 months.4 However, this study was limited by
20 | a lack of comparative effectiveness and the en-
21 | rollment of patients who had a high percentage
22 | of time in the target range at baseline.
23 |
24 | The uptake of open-source AID systems has a
25 | number of barriers beyond a lack of regulatory
26 | approval, including a lack of trial data regarding
27 | safety and efficacy, limited expertise with the
28 | system among health care professionals, and a
29 | perception that the use of AID systems is techni-
30 | cally challenging.5-7 In the randomized, con-
31 | trolled trial called CREATE (Community Derived
32 | Automated Insulin Delivery), we evaluated the
33 | efficacy and safety of an open-source AID system
34 | as compared with sensor-augmented insulin-
35 | pump therapy in children and adults with type 1
36 | diabetes.
37 |
38 | Methods
39 |
40 | Trial Conduct and Oversight
41 | The trial was conducted at four sites in New
42 | Zealand in compliance with Good Clinical Prac-
43 | tice guidelines and was approved by the South-
44 | ern Health and Disability Ethics Committee of
45 | New Zealand. The trial was funded by the Health
46 | Research Council of New Zealand. Hardware
47 |
48 | support was provided by SOOIL Development,
49 | Dexcom, and Vodafone New Zealand. The trial
50 | protocol (available with the full text of this article
51 | at NEJM.org) has been published previously.8 An
52 | independent data and safety monitoring com-
53 | mittee and medical monitor provided trial over-
54 | sight. Written informed consent was provided by
55 | all adult patients (16 to 70 years of age) or by the
56 | parents or guardians of children (7 to 15 years);
57 | assent was also sought from all the children.
58 |
59 | The trial was designed by representatives of
60 | the sponsor, the University of Otago. Data were
61 | collected by the investigators and site personnel,
62 | analyzed by a statistician employed by the spon-
63 | sor, and interpreted by the authors. Experts on
64 | open-source AID systems trial team
65 | provided training to clinical staff members. A
66 | Slack workspace (Slack Technologies) facilitated
67 | ongoing learning by allowing clinical staff mem-
68 | bers to communicate with each other and with
69 | experts in open-source AID on the trial team.9
70 |
71 | The authors were responsible for writing the
72 | first draft of the manuscript or for contributing
73 | to the review and editing of the manuscript. All
74 | the authors made the decision to submit the
75 | manuscript for publication and vouch for the
76 | completeness and accuracy of the data and for
77 | the fidelity of the trial to the protocol.
78 |
79 | Patients and Trial Design
80 | Eligible patients were between the ages of 7 and
81 | 70 years, had received a diagnosis of type 1 dia-
82 | betes at least 1 year earlier, had at least 6 months
83 | of experience with insulin-pump therapy, and
84 | had a mean glycated hemoglobin level of less
85 | than 10.5% (91 mmol per mole). Details regard-
86 | ing the inclusion and exclusion criteria are pro-
87 | vided in Table S1 in the Supplementary Appen-
88 | dix, available at NEJM.org. The ages of the
89 | patients reflected the age range in general clini-
90 | cal practice in New Zealand.
91 |
92 | Patients in the two trial groups (or their par-
93 | ents or guardians) were invited to join separate
94 | closed online communities (Tribe Technologies)
95 | that provided ongoing peer support to simulate
96 | community support for the use of open
--------------------------------------------------------------------------------
/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart8.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract. Section intro
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--------------------------------------------------------------------------------
/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract. Section intro
2 | vation Index — no. (%)‡
3 |
4 | Quintile 1
5 |
6 | Quintile 2
7 |
8 | Quintile 3
9 |
10 | Quintile 4
11 |
12 | Quintile 5
13 |
14 | Diabetes history
15 |
16 | 23
17 |
18 | 26
19 |
20 | 49
21 |
22 | 40.0 (33.0–43.5)
23 |
24 | 38.0 (23.2–45.8)
25 |
26 | 40.0 (29.0–45.0)
27 |
28 | 15 (65)
29 |
30 | 7 (30)
31 |
32 | 1 (4)
33 |
34 | 2 (9)
35 |
36 | 0
37 |
38 | 1 (4)
39 |
40 | 20 (87)
41 |
42 | 9 (39)
43 |
44 | 3 (13)
45 |
46 | 5 (22)
47 |
48 | 3 (13)
49 |
50 | 3 (13)
51 |
52 | 15 (58)
53 |
54 | 11 (42)
55 |
56 | 0
57 |
58 | 5 (19)
59 |
60 | 1 (4)
61 |
62 | 0
63 |
64 | 20 (77)
65 |
66 | 4 (15)
67 |
68 | 7 (27)
69 |
70 | 7 (27)
71 |
72 | 6 (23)
73 |
74 | 2 (8)
75 |
76 | 30 (61)
77 |
78 | 18 (37)
79 |
80 | 1 (2)
81 |
82 | 7 (14)
83 |
84 | 1 (2)
85 |
86 | 1 (2)
87 |
88 | 40 (82)
89 |
90 | 13 (27)
91 |
92 | 10 (20)
93 |
94 | 12 (24)
95 |
96 | 9 (18)
97 |
98 | 5 (10)
99 |
100 | 874
101 |
102 | n engl j med 387;10 nejm.org September 8, 2022
103 |
104 |
105 | Automated Insulin Delivery in Type 1 Diabetes
106 |
107 | Table 1. (Continued.)
108 |
109 | Characteristic
110 |
111 | Glycated hemoglobin§
112 |
113 | Value — mmol/mol
114 |
115 | Mean percent
116 |
117 | Previous use of CGM — no. (%)¶
118 |
119 | Previous use of automated insulin delivery
120 |
121 | — no. (%)‖
122 |
123 | Automated Insulin
124 |
125 | Delivery
126 |
127 | Control
128 |
129 | Total
130 |
131 | 60.0±13.7
132 |
133 | 7.6
134 |
135 | 15 (65)
136 |
137 | 4 (17)
138 |
139 | 62.1±9.1
140 |
141 | 7.8
142 |
143 | 17 (65)
144 |
145 | 5 (19)
146 |
147 | 61.1±11.5
148 |
149 | 7.7
150 |
151 | 32 (65)
152 |
153 | 9 (18)
154 |
155 | Time in target glucose range — %**
156 |
157 | 64.7±12.9
158 |
159 | 60.3±15.6
160 |
161 | 62.4±14.4
162 |
163 | *
164 |
165 | †
166 |
167 | ‡
168 |
169 | §
170 | ¶
171 |
172 | Plus–minus values areSD. Children were defined as patients under the age of 16 years. A full list of patient
173 | characteristics at baseline is shown in Table S5 in the Supplementary Appendix. IQR denotes interquartile range.
174 | The patients (or their parents or guardians) could select more than one ethnic group. However, they were assigned
175 | to a single ethnic group for statistical evaluation with the list prioritized in the order of Maori; Pacific Islander; Asian;
176 | Middle Eastern, Latin American, or African; and European or other. No patients selected the Pacific Islander category,
177 | and no children selected the Middle Eastern, Latin American, or African category.
178 | The New Zealand Deprivation Index is an areabased measure of socioeconomic deprivation in which the fifth quintile
179 | represents the 20% most deprived areas in the country.
180 | Glycated hemoglobin was measured with the use of the DCA Vantage Analyzer.
181 | Previous use of continuous glucose monitoring (CGM) was defined as use of a CGM system more than 75% of the
182 | time before the baseline visit.
183 | Automated insulin delivery refers to a hybrid closedloop system.
184 |
185 | ‖
186 | ** The time in the target glucose range is the percentage of time that the patient had a glucose level of 70 to 180 mg per
187 |
188 | deciliter (3.9 to 10.0 mmol per liter) during the runin period.
189 |
190 | deficiencies are shown in Table S10. Fewer de-
191 | vice deficiencies were reported during the ran-
192 | domized trial than during the run-in period (0.8
193 | per 100 user-days vs. 5.1 per 100 user-days). This
194 | difference reflects action taken to address
195 | battery problem that has been described previ-
196 | ously.
197 |
198 | Most device deficiencies were related to hard-
199 | ware (46 in the AID group and 39 in the control
200 | group) followed by connectivity issues (20 in the
201 | AID group and 7 in the control group); one de-
202 | vice deficiency was attributed to the application
203 | display. The insulin pump produced the most
204 | device deficiencies (47 events affecting 34 pa-
205 | tients), followed by the pump Auto Setter device
206 | (16 events).
207 |
208 | Discussion
209 |
210 | In the CREATE trial, we found that
211 | who the open-source AID system had
212 | 3 hours 21 minutes more time in the target
213 | glucose range per day than those who were us-
214 | ing sensor-augmentedpump therapy, a
215 | between-group difference of 14 percentage
216 | points. Patients in the AID group had improved
217 |
218 | glycemic control while maintaining a low
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/examples/ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.full.txt:
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1 | #### What is at stake as artificial intelligence becomes more powerful?
2 | All major technological innovations lead to a range of positive and negative
3 | consequences. For AI, the spectrum of possible outcomes – from the most
4 | negative to the most positive – is extraordinarily wide.
5 |
6 | That the use of AI technology can cause harm is clear, because it is already
7 | happening.
8 |
9 | AI systems can cause harm when people use them maliciously. For example, when
10 | they are used in politically-motivated disinformation campaigns or to enable
11 | mass surveillance.12
12 |
13 | But AI systems can also cause unintended harm, when they act differently than
14 | intended or fail. For example, in the Netherlands the authorities used an AI
15 | system which falsely claimed that an estimated 26,000 parents made fraudulent
16 | claims for child care benefits. The false allegations led to hardship for many
17 | poor families, and also resulted in the resignation of the Dutch government in
18 | 2021.13
19 |
20 | As AI becomes more powerful, the possible negative impacts could become much
21 | larger. Many of these risks have rightfully received public attention: more
22 | powerful AI could lead to mass labor displacement, or extreme concentrations
23 | of power and wealth. In the hands of autocrats, it could empower
24 | totalitarianism through its suitability for mass surveillance and control.
25 |
26 | The so-called _alignment problem_ of AI is another extreme risk. This is the
27 | concern that _nobody_ would be able to control a powerful AI system, even if
28 | the AI takes actions that harm us humans, or humanity as a whole. This risk is
29 | unfortunately receiving little attention from the wider public, but it is seen
30 | as an extremely large risk by many leading AI researchers.14
31 |
32 | How could an AI possibly escape human control and end up harming humans?
33 |
34 | The risk is not that an AI becomes self-aware, develops bad intentions, and
35 | “chooses” to do this. The risk is that we try to instruct the AI to pursue
36 | some specific goal – even a very worthwhile one – and in the pursuit of that
37 | goal it ends up harming humans. It is about unintended consequences. The AI
38 | does what we told it to do, but not what we wanted it to do.
39 |
40 | Can’t we just tell the AI to not do those things? It is definitely possible to
41 | build an AI that avoids any particular problem we foresee, but it is hard to
42 | foresee _all_ the possible harmful unintended consequences. The alignment
43 | problem arises because of “the impossibility of defining true human purposes
44 | correctly and completely,” as AI researcher Stuart Russell puts it.15
45 |
46 | Can’t we then just switch off the AI? This might also not be possible. That is
47 | because a powerful AI would know two things: it faces a risk that humans could
48 | turn it off, and it can’t achieve its goals once it has been turned off. As a
49 | consequence, the AI will pursue a very fundamental goal of ensuring that it
50 | won’t be switched off. This is why, once we realize that an extremely
51 | intelligent AI is causing unintended harm in the pursuit of some specific
52 | goal, it might not be possible to turn it off or change what the system
53 | does.16
54 |
55 | This risk – that humanity might not be able to stay in control once AI becomes
56 | very powerful, and that this might lead to an extreme catastrophe – has been
57 | recognized right from the early days of AI research more than 70 years ago.17
58 | The very rapid development of AI in recent years has made a solution to this
59 | problem much more urgent.
60 |
61 | I have tried to summarize some of the risks of AI, but a short article is not
62 | enough space to address all possible questions. Especially on the very worst
63 | risks of AI systems, and what we can do now to reduce them, I recommend
64 | reading the book [The Alignment Problem](https://brianchristian.org/the-
65 | alignment-problem/) by Brian Christian and Benjamin Hilton’s article
66 | [‘Preventing an AI-related catastrophe’](https://80000hours.org/problem-
67 | profiles/artificial-intelligence).
68 |
69 | If we manage to avoid these risks, transformative AI could also lead to very
70 | positive consequences. Advances in science and technology were crucial to [the
71 | many positive developments](https://ourworldindata.org/a-history-of-global-
72 | living-conditions-in-5-charts) in humanity’s history. If artificial ingenuity
73 | can augment our own, it could help us make progress on the many large problems
74 | we face: from cleaner energy, to the replacement of unpleasant work, to much
75 | better healthcare.
76 |
77 | This extremely large contrast between the possible positives and negatives
78 | makes clear that the stakes are unusually high with this technology. Reducing
79 | the negative risks and solving the alignment problem could mean the difference
80 | between a healthy, flourishing, and wealthy future for humanity – and the
81 | destruction of the same.
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintro.full.txt:
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1 | Title-Abstract. Section intro
2 | established in 1812
3 |
4 | September 8, 2022
5 |
6 | vol. 387 no.
7 | Open-Source Automated Insulin Delivery in Type 1 Diabetes
8 | Mercedes J., M.B., Ch.B., Dana M. Lewis, B. Hamish R. Crocket, Ph.D., Renee A. Meier, Ph.D.,
9 |
10 | Jonathan A. Williman, Ph.D., Olivia J. Sanders, R.N., Craig A. Jefferies, M.D., Ann M. Faherty, R.N.,
11 |
12 | Ryan G. Paul, Ph.D., Claire S. Lever, M.N., Sarah K.J. Price, M.N., Carla M. Frewen, R.N., Shirley D. Jones,
13 | Tim C. Gunn, B.I.T., Christina Lampey, B.Sc., Benjamin J. Wheeler, Ph.D., and Martin I. de Bock, Ph.D.
14 |
15 | abs tr actBACKGROUND
16 | Open-source automated insulin delivery (AID) systems are used by many patients
17 | with type 1 diabetes. Data are needed on the efficacy and safety of an open-source
18 | AID system.
19 |
20 | METHODS
21 | In this multicenter, open-label, randomized, controlled trial, we assigned patients
22 | with type 1 diabetes in a 1:1 ratio to use an open-source AID system or a sensor-
23 | augmented insulin pump (control). The both children (defined
24 | as 7 to 15 years of age) and adults (defined as 16 to 70 years of age). The AID
25 | system was a modified version of AndroidAPS 2.8 (with a standard OpenAPS 0.7.0
26 | algorithm) paired with a preproduction DANA-i insulin pump and Dexcom G6
27 | CGM, which has an Android smartphone application as the user interface. The
28 | primary outcome was the percentage of time in the target glucose range of 70 to
29 | 180 mg per deciliter (3.9 to 10.0 mmol per liter) between days 155 and 168 (the
30 | final 2 weeks of the trial).
31 |
32 | RESULTS
33 | A total of 97 patients (48 children and 49 adults) underwent randomization (44 to
34 | open-source AID and 53 to the control group). At 24 weeks, the mean (±SD) time
35 | in the target range increased from 61.2±12% to 71.2±12.1% AID group
36 | and decreased from 57.7±14.3% to 54.5±16.0% in the control group (adjusted dif-
37 | ference, 14 percentage points; 95% confidence interval, 9.2 to 18.8; P<0.001), with
38 | no treatment effect according to age (P = 0.56). Patients in the AID group spent
39 | 3 hours 21 minutes more in the target range per day than those in the control group.
40 | No severe hypoglycemia or diabetic ketoacidosis occurred in either group. Two
41 | patients in the AID group withdrew from the trial owing to connectivity issues.
42 |
43 | CONCLUSIONS
44 | In children and adults with type 1 diabetes, the use of an open-source AID system
45 | resulted in a significantly higher percentage of time target glucose range
46 | than the use of a sensor-augmented insulin pump at 24 weeks. (Supported by the
47 | Health Research Council of New Zealand; Australian New Zealand Clinical Trials
48 | Registry number, ACTRN12620000034932.)
49 |
50 | From the Departments of Pediatrics
51 | (M.J.B., R.A.M., O.J.S., M.I.B.) and Pop
52 | ulation Health (J.A.W.), University of
53 | Otago, and the Department of Pediatrics,
54 | Canterbury District Health Board (M.J.B.,
55 | O.J.S., M.I.B.), Christchurch, Te Huataki
56 | Waiora School of Health, Sport and Hu
57 | man Performance, University of Waikato
58 | (H.R.C.), and Waikato Regional Diabetes
59 | Service, Waikato District Health Board
60 | (R.G.P., C.S.L., S.K.J.P.), Hamilton, the
61 | Department of Pediatric Endocrinology,
62 | Starship Children’s Health, Auckland
63 | District Health Board (C.A.J., A.M.F.,
64 | C.L.), and the Liggins Institute, University
65 | of Auckland (C.A.J.), Auckland, the De
66 | partment of Women’s and Children’s
67 | Health, Dunedin School of Medicine,
68 | University of Otago (C.M.F., S.D.J.,
69 | B.J.W.), and the Pediatric Department,
70 | Southern District Health Board (B.J.W.),
71 | Dunedin, and Nightscout New Zealand,
72 | Hamilton (T.C.G.) — all in New Zealand;
73 | and OpenAPS, Seattle (D.M.L.). Dr. de Bock
74 | can be contacted at martin . debock@
75 | otago . ac . nz or at the Department of
76 | Pediatrics, University of Otago, 4 Oxford
77 | Terrace, Christchurch 8011, New Zealand.
78 |
79 | N Engl J Med 2022;387:869-81.
80 | DOI: 10.1056/NEJMoa2203913
81 | Copyright © 2022 Massachusetts Medical Society.
82 |
83 | CME
84 |
85 | at NEJM.org
86 |
87 | n engl j med 387;10 nejm.org September 8, 2022
88 |
89 | 869
90 |
91 | The new england journal of medicine
92 | A Quick Take
93 | is available at
94 | NEJM.org
95 |
96 | T h e ne w e ngl a nd jou r na l o f m e dicine
97 |
98 | The use of automated insulin de-
99 |
100 | livery (AID) systems that encompass an
101 | insulin-delivery algorithm, insulin pump,
102 | and continuous glucose monitoring has been
103 | shown to improve glycemic control and reduce
104 | the care burden for patients with type 1 diabetes.1
105 | A do-it-yourself AID system, called OpenAPS,
106 | was developed by patients with diabetes and was
107 | shared freely as an open-source system in Febru
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.full.txt:
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1 | Title-Abstract. Section intro
2 |
3 | centage of time during which the glucose level
4 | was less than 70 mg per deciliter. The improved
5 | glycemic control during AID therapy is consis-
6 | tent with findings in observational studies,14,15
7 | which are limited by a self-selected cohort of
8 | patients who have chosen to use an open-source
9 | AID system. The positive effect of AID therapy
10 | on glycemia in our trial was greatest overnight,
11 | a finding that was consistent with the results of
12 | evaluations of commercial AID systems.16 In the
13 | AID group, adults had a higher percentage of
14 | time in the target range than children,13,17 pos-
15 | sibly because of differences in glycemic variabil-
16 | ity,18 likelihood of administration of an insulin
17 | bolus before a meal, activity level, and dietary
18 | factors. Even so, children still had the greatest
19 | improvement in the percentage of time in the
20 | target range between baseline and the end of the
21 | trial. Other studies have also shown that pa-
22 | tients with the lowest baseline time in the target
23 | range gain the most from the use of AID.16,19
24 |
25 | The absolute differences in the percentage of
26 | time in range between the trial groups are simi-
27 | lar to between-group differences for commer-
28 | cially available AID systems.13,16,17 Such between-
29 |
30 | n engl j med 387;10 nejm.org September 8, 2022
31 |
32 | 875
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart10.full.txt:
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39 |
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41 | Automated Insulin Delivery in Type 1 Diabetes
42 |
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--------------------------------------------------------------------------------
/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract. Section intro
2 |
3 | from 60.3±15.6% to 56.5±14.2% in the control
4 | group (mean adjusted difference, 15.4 percent-
5 | age points; 95% CI, 8.6 to 22.1); the between-
6 | group difference per day was 3 hours 41 min-
7 | utes. The mean percentage of patients who had
8 | a time in range of more than 70% and a time
9 | below range of less than 4% was 64% in the AID
10 | group and 15% in the control group (adjusted
11 | difference, 41.6 percentage points; 95% CI, 27.0
12 | to 57.5).
13 |
14 | During a 24-hour period, the mean percent-
15 | age of time that the glucose value was less than
16 | 70 mg per deciliter was 1.6% (23 minutes) in the
17 | AID group and 1.8% (26 minutes) in the control
18 | group. The percentage of time that the glucose
19 | value was more than 180 mg per deciliter was
20 | 23.9% (5 hours 42 minutes) in the AID group
21 | and 41.6% (10.0 hours) in the control group. As
22 |
23 | with the children, the use AID was most
24 | effective in the adults at night, when the time
25 | in range was 85.2±12.7%, as compared with
26 | 70.9±12.7% during the day. In the control group,
27 | the mean time in range at night (53.5±20.1%)
28 | was similar to that during the day (57.5±14.4%)
29 | (Figs. 2 and S3). Overnight, the percentage of
30 | time that the glucose level was less than 70 mg
31 | per deciliter was 2.2% in the AID group and
32 | 1.9% in the control group. In both adults and
33 | children, the increases in the percentage of time
34 | in range was attributed mainly to overnight im-
35 | provement with the AID system (Fig. S4). At the
36 | end of the trial, the mean glycated hemoglobin
37 | level was 6.8% (50.7 mmol per mole) in the AID
38 | group and 7.5% (58.5 mmol per mole) in the
39 | control group.
40 |
41 | Safety Outcomes
42 | Neither severe hypoglycemia nor diabetic keto-
43 | acidosis occurred in either trial group, and no
44 | adverse events were related to the algorithm or
45 | automation of insulin delivery. Prespecified ad-
46 | verse events are provided in Table 3.
47 |
48 | Ten adverse events that were related to a de-
49 | vice (nonserious adverse device effects) were re-
50 | ported among 8 patients in the AID group, and
51 | 8 events were reported among 8 patients in the
52 | control group. These events included 6 hypergly-
53 | cemia events in the AID group and 5 in the
54 | control group and were mainly due to infusion-
55 | set failures. One adult in the AID group had
56 | superficial skin burns on separate occasions
57 | from two different preproduction DANA-i insu- pumps.
58 |
59 | Two serious adverse events occurred in the
60 | AID group (hospitalizations for hyperglycemia
61 | in one child due to infusion-set failure and the
62 | other unrelated to diabetes), and 5 serious ad-
63 | verse events (all in children) occurred in the
64 | control group: 1 hyperglycemia event owing to
65 | insulin-pump failure and 4 events unrelated to
66 | diabetes. The rate of severe hyperglycemia and
67 | ketosis (capillary glucose level, >300 mg per
68 | deciliter; ketones, >1.5 mmol per liter and symp-
69 | tomatic) per 100 user-days was 0.10 in the AID
70 | group and 0.07 in the control group.
71 |
72 | System Performance
73 | In the AID group, the median percentage of time
74 | that the system was automating insulin delivery
75 | was 94.2% (IQR, 87.3 to 95.7) (Table S9). Device
76 |
77 | n engl j med 387;10 nejm.org September 8, 2022
78 |
79 | 873
80 |
81 |
82 | T h e ne w e ngl a nd jou r na l o f m e dicine
83 |
84 | Table 1. Characteristics of the Patients at Baseline.*
85 |
86 | Characteristic
87 | Children
88 |
89 | No. of patients
90 |
91 | Median age (IQR) — yr
92 |
93 | Female sex — no. (%)
94 |
95 | Ethnic group — no. (%)†
96 |
97 | Maori
98 |
99 | Asian
100 |
101 | European or other
102 |
103 | New Zealand Deprivation Index — no. (%)‡
104 |
105 | Quintile 1
106 |
107 | Quintile 2
108 |
109 | Quintile 3
110 |
111 | Quintile 4
112 |
113 | Quintile 5
114 |
115 | Diabetes history
116 |
117 | Glycated hemoglobin§
118 |
119 | Value — mmol/mol
120 |
121 | Mean percent§
122 |
123 | Previous use of CGM — no. (%)¶
124 |
125 | Previous use of automated insulin delivery
126 |
127 | — no. (%)‖
128 |
129 | Automated Insulin
130 |
131 | Delivery
132 |
133 | 21
134 |
135 | Control
136 |
137 | 27
138 |
139 | Total
140 |
141 | 48
142 |
143 | 14.0 (11.0–15.0)
144 |
145 | 11.0 (9.0–14.5)
146 |
147 | 13.0 (9.0–15.0)
148 |
149 | 52)
150 |
151 | 4 (19)
152 |
153 | 1 (5)
154 |
155 | 16 (76)
156 |
157 | 9 (43)
158 |
159 | 6 (29)
160 |
161 | 4 (19)
162 |
163 | 2 (10)
164 |
165 | 0
166 |
167 | 58.3±6.6
168 |
169 | 7.5
170 |
171 | 20 (95)
172 |
173 | 1 (5)
174 |
175 | 13 (48)
176 |
177 | 4 (15)
178 |
179 | 0
180 |
181 | 23 (85)
182 |
183 | 10 (37)
184 |
185 | 10 (37)
186 |
187 | 3 (11)
188 |
189 | 2 (7)
190 |
191 | 2 (7)
192 |
193 | 58.4±9.9
194 |
195 | 7.5
196 |
197 | 26 (96)
198 |
199 | 2 (7)
200 |
201 | 24 (50)
202 |
203 | 8 (17)
204 |
205 | 1 (2)
206 |
207 | 39 (81)
208 |
209 | 19 (40)
210 |
211 | 16 (33)
212 |
213 | 7 (15)
214 |
215 | 4 (8)
216 |
217 | 2 (4)
218 |
219 | 58.4±8.5
220 |
221 | 7.5
222 |
223 | 46 (96)
224 |
225 | 3 (6)
226 |
227 | Time in glucose range — (%)**
228 |
229 | 57.4±10.6
230 |
231 | 55.1±12.6
232 |
233 | 56.1±11.7
234 |
235 | Adults
236 |
237 | No. of patients
238 |
239 | Median age (IQR) — yr
240 |
241 | Sex — no. (%)
242 |
243 | Female
244 |
245 | Male
246 |
247 | Nonbinary
248 |
249 | Ethnic group — no. (%)†
250 |
251 | Maori
252 |
253 | Asian
254 |
255 | Middle Eastern, Latin American, or African
256 |
257 | European or other
258 |
259 | New Zealand
--------------------------------------------------------------------------------
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1 | Title-Abstract. Section intro
2 |
3 | AID systems. In addition, patients were instruct-
4 | ed to contact trial staff members to discuss any
5 | clinical or technical issues.
6 |
7 | During a 4-week run-in phase, patients be-
8 | came familiar with the trial devices functioning
9 | as sensor-augmented insulin-pump therapy. Pa-
10 |
11 | 870
12 |
13 | n engl j med 387;10 nejm.org September 8, 2022
14 |
15 |
16 | Automated Insulin Delivery in Type 1 Diabetes
17 |
18 | tients were then randomly assigned in a 1:1 ratio
19 | to the AID group or the control group with the
20 | use of blocks of four, six, and eight stratified
21 | according to age, trial site, and baseline glycated
22 | hemoglobin level (≤8.0% or >8.0%). A 24-week
23 | trial followed, with the primary end point mea-
24 | sured between days 155 and 168 (the last 2 weeks
25 | of the trial) (Fig. S1). All the patients attended
26 | three in-person visits (at weeks 0, 12, and 24);
27 | those in the AID group also had two additional
28 | reviews by telephone at weeks 3 and 6. During
29 | visits and telephone reviews, patients were asked
30 | about adverse events and device issues, medica-
31 | tion use, and Dexcom alarm settings. In addition,
32 | staff members reviewed data using a unique
33 | URL provided by Nightscout (an open-source
34 | project that enables access to data regarding
35 | continuous glucose monitoring) and advised pa-
36 | tients on changes in device settings. All the
37 | patients (or their parents or guardians) could
38 | alter settings between contacts, but staff mem-
39 | bers were instructed to avoid surveillance out-
40 | side of scheduled reviews and did not receive
41 | automated alerts. This approach was designed to
42 | negate an effect on outcomes caused by addi-
43 | tional scheduled contact with the trial team in
44 | the AID group.
45 |
46 | Open-Source AID
47 | The system was a modified version of AndroidAPS
48 | 2.810 (which uses the standard OpenAPS 0.7.0
49 | algorithm11) paired with a preproduction DANA-i
50 | insulin pump and Dexcom G6 CGM. The user
51 | interface was an Android smartphone application
52 | (AnyDANA-Loop). Modifications reduced the
53 | number of objectives and time required to enable
54 | closed-loop therapy. Patients used the AnyDANA-
55 | Loop application for mealtime insulin adminis-
56 | tration and AnyDANA-Loop automated insulin
57 | delivery in response to the glucose target. Any
58 | changes to user-specific settings were made
59 | with the patients’ involvement, according to the
60 | technical manual (Table S2). Written guidelines
61 | and “how to” video demonstrations of key as-
62 | pects of the applications were provided to all the
63 | patients in the AID group.
64 |
65 | lin doses. The sensor-augmented insulin-pump
66 | therapy was not designed to predict low-glucose
67 | levels or to suspend insulin administration. A
68 | smartphone application, called Monitor, trans-
69 | mitted data regarding continuous glucose moni-
70 | toring to Nightscout.
71 |
72 | Outcomes
73 | The primary outcome was percentage of time
74 | in the target glucose range of 70 to 180 mg per
75 | deciliter (3.9 to 10.0 mmol per liter) between day
76 | 155 and day 168. Secondary outcomes were met-
77 | rics for continuous glucose monitoring12 between
78 | days 155 and 168, which were categorized as
79 | occurring during a 24-hour period, during day-
80 | time hours (6 a.m. to midnight), or during
81 | nighttime hours (midnight to 6 a.m.); the gly-
82 | cated hemoglobin level, as measured by cali-
83 | brated point-of-care instruments (DCA Vantage
84 | Analyzer, Siemens Healthcare Diagnostics); and
85 | the performance of the AID system (the time
86 | that the system was automating insulin delivery
87 | and the incidence of device deficiencies). Sepa-
88 | rate analyses were prespecified to evaluate the
89 | psychosocial effect of device use, the collective
90 | learning of patients and staff members, and eat-
91 | ing behaviors (Table S3).
92 |
93 | Adverse events that were evaluated included
94 | adverse device effects, serious adverse events,
95 | and serious adverse device effects. Severe hypo-
96 | glycemia or hyperglycemia and diabetic keto-
97 | acidosis were reported as serious adverse events
98 | or serious adverse device effects.
99 |
100 | At approximately 3 months into theaf-
101 | ter the enrollment of approximately two thirds
102 | of the patients), a battery problem in a prepro-
103 | duction DANA-i insulin pump was identified. A
104 | device deficiency was recorded when the pump
105 | battery lasted less than 2 weeks, and a device
106 | deficiency with potential serious adverse device
107 | effects was reported when the pump turned off
108 | without warning. Patients in the control group
109 | had the option of returning to theiru-
110 | pump (which 52 of 53 did), and
111 | those in the AID group used refurbished prepro-
112 | duction DANA-i insulin pumps.
113 |
114 | Sensor-Augmented Insulin-Pump Therapy
115 | Patients in the control group used the
116 | GGM with high and low glucose alerts and
117 | their usual insulin pump or a preproduction
118 | DANA-i insulin pump to administer bolus insu-
119 |
120 | Statistical Analysis
121 | We calculated that 68 patients (34 per group)
122 | would provide 90% power with a two-sided alpha of 0.05 to reject the null hypothesis of no
123 | between-group difference in the time in range,
124 |
125 | n engl j med 387;10 nejm.org September 8, 2022
126 |
127 | 871
128 |
129 |
130 | T h e e ngl a nd jou r na l o f m e dicine
131 |
132 | assuming a population standard deviation
--------------------------------------------------------------------------------
/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract. Section intro
2 | verse events.
3 |
4 | Our trial also has certain limitations. Real-
5 | world support may differ from that provided in
6 | a trial. The control group did not have an auto-
7 | mated system for predicting low-glucose levels
8 | or suspending insulin administration, features
9 |
10 | n engl j med 387;10 nejm.org September 8, 2022
11 |
12 | 879
13 |
14 |
15 | T h e ne w e ngl a nd jou r na l o f m e dicine
16 |
17 | Table 3. Adverse Events, According to Age Group.*
18 |
19 | Adverse Event and Age Group
20 |
21 | Automated Insulin Delivery
22 |
23 | Control
24 |
25 | Total
26 |
27 | Events
28 |
29 | Patients
30 |
31 | Events
32 |
33 | Patients
34 |
35 | Events
36 |
37 | Patients
38 |
39 | Children
40 |
41 | Nonserious adverse device effect†
42 |
43 | Any
44 |
45 | Hyperglycemia
46 |
47 | Skin infection
48 |
49 | Localized skin reaction
50 |
51 | Urticaria
52 |
53 | Serious adverse event or serious
54 |
55 | adverse device effect‡
56 |
57 | Any
58 |
59 | Anaphylactic reaction to food
60 |
61 | Croup
62 |
63 | Hyperglycemia
64 |
65 | Pilonidal cyst with abscess
66 |
67 | Adults§
68 |
69 | Nonserious adverse device effect
70 |
71 | Any
72 |
73 | Burn
74 |
75 | Hyperglycemia
76 |
77 | Infection at medical device site
78 |
79 | 5
80 |
81 | 3
82 |
83 | 1
84 |
85 | 1
86 |
87 | 0
88 |
89 | 2
90 |
91 | 0
92 |
93 | 1
94 |
95 | 1
96 |
97 | 0
98 |
99 | 5
100 |
101 | 2
102 |
103 | 3
104 |
105 | 0
106 |
107 | 5
108 |
109 | 3
110 |
111 | 1
112 |
113 | 1
114 |
115 | 0
116 |
117 | 2
118 |
119 | 0
120 |
121 | 1
122 |
123 | 1
124 |
125 | 0
126 |
127 | 3
128 |
129 | 1
130 |
131 | 2
132 |
133 | 0
134 |
135 | 4
136 |
137 |
138 | 0
139 |
140 | 0
141 |
142 | 1
143 |
144 | 5
145 |
146 | 2
147 |
148 | 1
149 |
150 | 1
151 |
152 | 1
153 |
154 | 4
155 |
156 | 0
157 |
158 | 2
159 |
160 | 2
161 |
162 | 4
163 |
164 | 3
165 |
166 | 0
167 |
168 | 0
169 |
170 | 1
171 |
172 | 5
173 |
174 | 2
175 |
176 | 1
177 |
178 | 1
179 |
180 | 1
181 |
182 | 4
183 |
184 | 0
185 |
186 | 2
187 |
188 | 2
189 |
190 | 9
191 |
192 | 6
193 |
194 | 1
195 |
196 | 1
197 |
198 | 1
199 |
200 | 7
201 |
202 | 2
203 |
204 | 2
205 |
206 | 2
207 |
208 | 1
209 |
210 | 9
211 |
212 | 2
213 |
214 | 5
215 |
216 | 2
217 |
218 | 9
219 |
220 | 6
221 |
222 | 1
223 |
224 | 1
225 |
226 | 1
227 |
228 | 7
229 |
230 | 2
231 |
232 | 2
233 |
234 | 2
235 |
236 | 1
237 |
238 | 7
239 |
240 | 1
241 |
242 | 4
243 |
244 | 2
245 |
246 | * No cases of severe hypoglycemia (defined as a low blood glucose level causing altered mental consciousness and in
247 |
248 | ability to assist in care) or diabetic ketoacidosis (defined as a blood glucose level of >250 mg per deciliter [>13.9 mmol
249 | per liter], an arterial pH of <7.3 or a venous pH of <15 mEq per liter, or moderate ketonuria or ketonemia leading to
250 | hospitalization) were reported in either group.
251 |
252 | † A nonserious adverse device effect was defined as any untoward medical occurrence related to the use of an investiga
253 |
254 | tional device.
255 |
256 | ‡ A serious adverse event was defined as an adverse event that was unrelated to the use of a device and that was life
257 |
258 | threatening, caused permanent impairment to a body structure or function, required hospitalization, or led to a medi
259 | cal or surgical intervention to curb serious sequelae. A serious adverse device effect was defined as a serious adverse
260 | event that was related to the use of an investigational device.
261 |
262 | § There were no serious adverse events or serious adverse device effects in the adult cohort.
263 |
264 | that have been shown to reduce the incidence of
265 | hypoglycemia.21 The generalizability of our find-
266 | ings may be limited by the enrollment of pa-
267 | tients with a relatively low glycated hemoglobin
268 | level at baseline, by the underrepresentation of
269 | patients with reduced economic resources, and
270 | by the increased familiarity with insulin-pump
271 | therapy and continuous glucose monitoring among
272 | the patients at baseline. However, the trial pa-
273 | tients were more diverse than those enrolled in
274 | previous studies that had been biased by pa-
275 | tients’ selection of open-source AID. The effect size
276 | is partially due to a small decline in the per-
277 |
278 | centage of time in the target range in the con-
279 | trol group, which has not been observed in other
280 | studies. Unscheduled contacts with trial staff
281 | members by telephone, email, or text message
282 | were not recorded. Measurement of glycated hemo-
283 | globin was not centralized and was performed on
284 | a point-of-care basis. Patients in the two groups
285 | used different insulin pumps, although other
286 | studies have compared AID with “usual care.”22,23
287 | In addition, a variety of insulin pumps were used
288 | in the control group, although the stable time in
289 | the target range throughout the trial suggests
290 | that this factor had a minimal effect.
291 |
292 | 880
293 |
294 | n engl j med 387;10 nejm.org September 8, 2022
295 |
296 |
297 | Insulin Delivery in Type 1 Diabetes
298 |
299 | In children and adults with type 1 diabetes,
300 | the use of an open-source AID system resulted
301 | in a significantly higher percentage of time in the
302 | target glucose range than the use of a sensor-
303 | augmented insulin pump at 24 weeks.
304 |
305 | Supported by the Health Research Council of New Zealand.
306 | Hardware support was provided by SOOIL Development, Dex-
307 | com, and Vodafone New Zealand.
308 |
309 | Disclosure forms provided by the authors are available with
310 |
311 | the full text of this article at NEJM.org.
312 |
313 | A data sharing statement provided by the authors is available
314 |
315 | with the full text of this article at NEJM.org.
316 |
317 |
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/examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract. Section intro
2 |
3 | 80
4 | 70
5 | 60
6 | 50
7 | 40
8 | 30
9 | 20
10 | 10
11 | 0
12 |
13 | 24-HourMeasure
14 |
15 | Run-in
16 |
17 | 0–3
18 |
19 | 4–7
20 |
21 | 8–11
22 |
23 | 12–15
24 |
25 | 16–19
26 |
27 | 20–23
28 |
29 | DaytimeMeasure
30 |
31 | Run-in
32 |
33 | 0–3
34 |
35 | 4–7
36 |
37 | 8–11
38 |
39 | 12–15
40 |
41 | 16–19
42 |
43 | 20–23
44 |
45 | NighttimeMeasure
46 |
47 | Run-in
48 |
49 | 0–3
50 |
51 | 4–7
52 |
53 | 8–11
54 |
55 | 12–15
56 |
57 | 16–19
58 |
59 | 20–23
60 |
61 |
62 | e
63 | g
64 | n
65 | a
66 | R
67 |
68 | e
69 | s
70 | o
71 | c
72 | u
73 | G
74 |
75 | l
76 |
77 |
78 | t
79 | e
80 | g
81 | r
82 | a
83 | T
84 | n
85 |
86 |
87 |
88 | i
89 |
90 | i
91 |
92 | e
93 | m
94 | T
95 |
96 | f
97 | o
98 |
99 | e
100 | g
101 | a
102 | t
103 | n
104 | e
105 | c
106 | r
107 | e
108 | P
109 |
110 | 100
111 | 90
112 | 80
113 | 70
114 | 60
115 | 50
116 | 40
117 | 30
118 | 20
119 | 10
120 | 0
121 |
122 | 100
123 | 90
124 | 80
125 | 70
126 | 60
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132 | 0
133 |
134 | 100
135 | 90
136 | 80
137 | 70
138 | 60
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144 | 0
145 |
146 | 24-HourMeasure
147 |
148 | Run-in
149 |
150 | 0–3
151 |
152 | 4–7
153 |
154 | 8–11
155 |
156 | 12–15
157 |
158 | 16–19
159 |
160 | 20–23
161 |
162 | DaytimeMeasure
163 |
164 | Run-in
165 |
166 | 0–3
167 |
168 | 4–7
169 |
170 | 8–11
171 |
172 | 12–15
173 |
174 | 16–19
175 |
176 | 20–23
177 |
178 | NighttimeMeasure
179 |
180 | Run-in
181 |
182 | 0–3
183 |
184 | 4–7
185 |
186 | 8–11
187 |
188 | 12–15
189 |
190 | 16–1920–23
191 |
192 | WeekssinceRandomization
193 |
194 | WeekssinceRandomization
195 |
196 | Figure 1. Percentage of Time in Target Glucose Range, According to Age Group and Trial Period.
197 | Box plots show the percentage of time that patients were in the target glucose range (70 to 180 mg per deciliter [3.9 to 10.0 mmol per
198 | liter]) among those who were assigned to use opensource automated insulin delivery (AID group) or sensoraugmented insulinpump
199 | therapy (control group). Values were measured by continuous glucose monitoring during contiguous 4week periods from 4 weeks be
200 | fore randomization to 24 weeks after randomization in children (7 to 15 years of age) and adults (16 to 70 years of age). Data are pre
201 | sented according to the time period of measurement, with daytime defined as 6 a.m. to midnight and nighttime as midnight to 6 a.m.
202 | Black dots indicate group means, and horizontal bars group medians; the bottom and top of each box represent the 25th and 75th per
203 | centiles, respectively.
204 |
205 | group differences are partly attributable to the
206 | decrease in the percentage of time in range in
207 | the control group after the run-in period, which
208 |
209 | we hypothesize was due to a waning awareness
210 | of being observed (Hawthorne effect) over time.
211 | Hardware malfunction rather than algorithm
212 |
213 | 878
214 |
215 | n engl j med 387;10 nejm.org September 8, 2022
216 |
217 |
218 | Automated Insulin Delivery in Type 1 Diabetes
219 |
220 | Sensor-augmented pump therapy
221 |
222 | Open-source automated insulin delivery
223 |
224 | A
225 |
226 | Children
227 |
228 | t
229 | e
230 | g
231 | r
232 | a
233 | T
234 | n
235 |
236 | i
237 |
238 | i
239 |
240 | e
241 | m
242 | T
243 |
244 | f
245 | o
246 |
247 | e
248 | g
249 | a
250 | t
251 | n
252 | e
253 | c
254 | r
255 | e
256 | P
257 |
258 | e
259 | g
260 | n
261 | a
262 | R
263 |
264 | e
265 | s
266 | o
267 | c
268 | u
269 | G
270 |
271 | l
272 |
273 | 100
274 | 90
275 | 80
276 | 70
277 | 60
278 | 50
279 | 40
280 | 30
281 | 20
282 | 10
283 | 0
284 | Midnight 2 a.m.
285 |
286 | B
287 |
288 | Adults
289 |
290 | t
291 | e
292 | g
293 | r
294 | a
295 | T
296 | n
297 |
298 | i
299 |
300 | i
301 |
302 | e
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304 | T
305 |
306 | f
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326 |
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333 |
334 | l
335 |
336 | 100
337 | 90
338 | 80
339 | 70
340 | 60
341 | 50
342 | 40
343 | 30
344 | 10
345 | 0
346 | Midnight 2 a.m.
347 |
348 | 4 a.m.
349 |
350 | 6 a.m.
351 |
352 | 8 a.m.
353 |
354 | 10 a.m.
355 |
356 | Noon
357 |
358 | 2 p.m.
359 |
360 | 4 p.m.
361 |
362 | 6 p.m.
363 |
364 | 8 p.m. 10 p.m.
365 |
366 | Midnight
367 |
368 | TimeofDay
369 |
370 | 4 a.m.
371 |
372 | 6 a.m.
373 |
374 | 8 a.m.
375 |
376 | 10 a.m.
377 |
378 | Noon
379 |
380 | 2 p.m.
381 |
382 | 4 p.m.
383 |
384 | 6 p.m.
385 |
386 | 8 p.m. 10 p.m.
387 |
388 | Midnight
389 |
390 | TimeofDay
391 |
392 | Figure 2. Percentage of Time in Target Glucose Range, According to Time of Day.
393 | Envelope plots show the percentage of time that children and adults in the two trial groups were in the target glu
394 | cose range, as measured by continuous glucose monitoring during weeks 22 and 23 after randomization. Symbols
395 | represent hourly group median values, and shaded regions indicate the 25th and 75th percentiles.
396 |
397 | performance was the main burden on patients
398 | in the AID group. Occlusions in the insulin-
399 | infusion set were the main cause of hyperglyce-
400 | mia. The absence of diabetic ketoacidosis and
401 | severe hypoglycemia in the two groups was re-
402 | assuring.
403 |
404 | One strength of our trial is that the patients
405 | were more representative of those with type 1
406 | diabetes than the patients in many real-world
407 | studies.20 In addition, in our trial, the patients
408 | did not have experience with open-source AID,
409 | which suggests that a range of patients with
410 | type 1 diabetes can benefit from this system.
411 | The majority of patients’ contacts with trial staff
412 | members were for troubleshooting hardware is-
413 | sues, and the deficiencies of the devices in the
414 |
415 | two groups were similar. We observed that with
416 | appropriate training, health care professionals
417 | can provide technical and clinical support for
418 | open-source AID users. The trial also had a high
419 | level of patient retention (98%), a lack of remote
420 | monitoring (which resembled real-world clinical
421 | practice), and broad inclusion criteria, which
422 | resulted in a population of diverse ages and eth-
423 | nic backgrounds. Furthermore, the 6-month
424 | trial duration was suitably long to capture rare
--------------------------------------------------------------------------------
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1 | Title-Abstract. Section intro
2 |
3 | 12.5% and an absolute treatment effect of 10%.13
4 | The sample size was increased to 50 adults and
5 | 50 children to allow for a differential treatment
6 | effect according to age, improved safety assess-
7 | ment, and potential loss to follow-up.
8 |
9 | Data capture and management processes
10 | have been described previously.8 Data cleaning
11 | and analyses were performed with the use of
12 | R software, version 4.1.1. Data regarding con-
13 | tinuous glucose monitoring were extracted from
14 | Nightscout and glucose metrics calculated for
15 | sequential 14-day periods, starting 14 days be-
16 | fore the trial period began and finishing at day
17 | 168. Data were aggregated according to trial
18 | group and time of day.
19 |
20 | The primary outcome was fitted to a linear
21 | regression model with independent variables in-
22 | cluding stratification variables, dependent vari-
23 | ables measured at baseline, trial group, and age
24 | according to group interaction. We compared
25 | this model sequentially with simpler models (in
26 | which the trial group or the interaction accord-
27 | ing to age was excluded) using analysis of vari-
28 | ance to calculate two-sided P values for an overall
29 | treatment effect and differential treatment effect
30 | according to age. Between-group differences
31 | were estimated with 95% confidence intervals.
32 | Secondary outcomes regarding continuous glu-
33 | cose monitoring and glycated hemoglobin were
34 | handled similarly without hypothesis testing.
35 | The widths of the confidence intervals were not
36 | adjusted for multiplicity and may not be used in
37 | place of hypothesis testing. Linear mixed-effects
38 | regression models that incorporated all available
39 | data were used to confirm the robustness of the
40 | results (Table S4).
41 |
42 | R esults
43 |
44 | Patients and Follow-up
45 | A total of 100 patients were enrolled from Sep-
46 | tember 2020 through May 2021. Three patients
47 | withdrew during the run-in period, and 97 pa-
48 | tients (48 children and 49 adults) underwent
49 | randomization to either the AID group (44 pa-
50 | tients) or the control group (53 patients). Un-
51 | balanced group size was exacerbated by the
52 | number of strata (16) that were used during
53 | randomization.8
54 |
55 | The characteristics of the patients at baseline
56 | were similar in the two trial groups (Tables 1
57 |
58 | and S5). Children were more likely than adults
59 | to have used continuous glucose monitoring;
60 | previous use of AID systems was uncommon.
61 | Table S6 shows the representativeness of the
62 | patients among the population of those with
63 | type 1 diabetes.
64 |
65 | The final patient completed the trial in Novem-
66 | ber 2021. in the AID group (1 child
67 | and 1 adult) withdrew from the trial because of
68 | frustration with the trial devices; all 53 patients
69 | in the control group completed the trial (Fig.
70 | S2). During days 155 to 168, the median per-
71 | centage of expected readings that were recorded
72 | by continuous glucose monitoring was 97% (inter-
73 | quartile range [IQR], 95 to 99) in the AID group
74 | and 95% (IQR, 89 to 98) in the control group.
75 | Eight patients (2 in the AID group and 6 in the
76 | control group) provided less than 70% of ex-
77 | pected glucose readings.
78 |
79 | Efficacy Outcomes
80 | All Patients
81 | In the primary analysis, the mean (±SD) time in
82 | the target range increased from 61.2±12.3% at
83 | baseline to 71.2±12.1% in the AID group and
84 | decreased from 57.7±14.3% to 54.5±16.0% in the
85 | control group (mean adjusted difference, 14.0
86 | percentage points; 95% confidence interval [CI],
87 | 9.2 to 18.8; P<0.001); the between-group differ-
88 | ence per day was 3 hours 21 minutes. The per-
89 | centage of patients who had a time in range of
90 | more than 70% and a time below range (<70 mg
91 | per deciliter) of less than 4% was 52.0% in the
92 | AID group and 11.0% in the control group (ad-
93 | justed difference, 36.9 percentage points; 95%
94 | CI, 25.9 to 48.5). No treatment effect according
95 | to interaction by age was detected (P = 0.56).
96 | Primary and secondary efficacy glycemic out-
97 | comes are provided separately for children and
98 | adults (Tables 2 and S7). Additional subgroup
99 | analyses of the percentage of time in the target
100 | range are provided in Table S8.
101 |
102 | Children
103 | Among the children, the mean time in range
104 | increased from 57.4±10.6% at baseline to
105 | 67.5±11.5% in the AID group and decreased
106 | from 55.1±12.6% to 52.5±17.5% in the control
107 | group (mean adjusted difference, 12.6 percent-
108 | age points; 95% CI, 5.7 to 19); the between-
109 | group difference per day was 3 hours 1 minute.
110 | The percentage of patients who had a time in
111 |
112 | 872
113 |
114 | n engl j med 387;10 nejm.org September 8, 2022
115 |
116 |
117 | Automated Insulin Delivery in Type 1 Diabetes
118 |
119 | range of more than 70% and a time below range
120 | of less than 4% was 40% in the AID group and
121 | 7% in the control group (adjusted difference,
122 | 32.2 percentage points; 95% CI, 16.2 to 49.7). The
123 | intervention effect was apparent within 2 weeks
124 | after the initiation of AID and was maintained
125 | during the 24-week trial period (Fig. 1).
126 |
127 | During a 24-hour period, the percentage of
128 | time that patients had a glucose reading of less
129 | than 70 mg per deciliter was 2.1% (30 minutes)
130 | in the AID group and 2.7% (39 minutes) in the
131 | control group. The percentage of time that
132 | patients had a glucose reading of more than
133 | 180 mg per deciliter was 39.1% (9 hours 24 min-
134 | utes) in the AID group and 44.8% (10 hours 48
135 | minutes) in the control group.
136 |
137 | The use of AID was most effective at night
138 | (Figs. 2 and S3), when the mean time in range
139 | was 76.8±15.8%, as compared with 64.3±11.7%
140 | during the day. In the control group, the mean
141 | time in range was 57.2±21.4% at night and
142 | 50.9±17.4% during the day. Overnight, the per-
143 | centage of time that patients had a time in range
144 | of less than 70 mg per deciliter was 1.2% in the
145 | AID group and 3.1% in the control group. At the
146 | end of the trial, the mean glycated hemoglobin
147 | level was 7.0% (52.6 mmol per mole) in the AID
148 | group and 7.6% (59.2 mmol per mole) in the
149 | control group.
150 |
151 | Adults
152 | Among the adults, the mean time in range
153 | increased from 64.7±12.9% at baseline to
154 | 74.5±11.9% in AID group and
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1 | Title-Abstract. Section intro
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/examples/ai-impact.Endnotes.full.txt:
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1 | ### Endnotes
2 | 1. This problem becomes even larger when we try to imagine how a future with a human-level AI might play out. Any _particular_ scenario will not only involve the idea that this powerful AI exists, but a whole range of additional assumptions about the future context in which this happens. It is therefore hard to communicate a scenario of a world with human-level AI that does not sound contrived, bizarre or even silly.
3 |
4 | 2. Both of these concepts are widely used in the scientific literature on artificial intelligence. For example, questions about the timelines for the development of future AI are often framed using these terms. See [my article on this topic](https://ourworldindata.org/ai-timelines).
5 |
6 | 3. The fact that humans are capable of a _range_ of intellectual tasks means that you arrive at different definitions of intelligence depending on which aspect within that range you focus on (the [Wikipedia entry on intelligence](https://en.wikipedia.org/wiki/Intelligence), for example, lists a number of definitions from various researchers and different disciplines). As a consequence there are also various definitions of ‘human-level AI’.
7 |
8 | There are also several closely related terms: Artificial General Intelligence,
9 | High-Level Machine Intelligence, Strong AI, or Full AI are sometimes
10 | synonymously used, and sometimes defined in similar, yet different ways. In
11 | specific discussions, it is necessary to define this concept more narrowly;
12 | for example, in [studies on AI timelines](https://ourworldindata.org/ai-
13 | timelines) researchers offer more precise definitions of what human-level AI
14 | refers to in their particular study.
15 |
16 | 4. Peter Norvig and Stuart Russell (2021) — Artificial Intelligence: A Modern Approach. Fourth edition. Published by Pearson.
17 |
18 | 5. The AI system [AlphaGo](https://en.wikipedia.org/wiki/AlphaGo), and its various successors, won against Go masters. The AI system [Pluribus](https://en.wikipedia.org/wiki/Pluribus_\(poker_bot\)) beat humans at no-limit Texas hold ’em poker. The AI system Cicero can strategize and use human language to win the strategy game Diplomacy. See: Meta Fundamental AI Research Diplomacy Team (FAIR), Anton Bakhtin, Noam Brown, Emily Dinan, Gabriele Farina, Colin Flaherty, Daniel Fried, et al. (2022) – ‘Human-Level Play in the Game of Diplomacy by Combining Language Models with Strategic Reasoning’. In _Science_ 0, no. 0 (22 November 2022): eade9097.[ https://doi.org/10.1126/science.ade9097](https://doi.org/10.1126/science.ade9097).
19 |
20 | 6. This also poses a problem when we evaluate how the intelligence of a machine compares with the intelligence of humans. If intelligence was a general ability, a single capacity, then we could easily compare and evaluate it, but the fact that it is a range of skills makes it much more difficult to compare across machine and human intelligence. Tests for AI systems are therefore comprising a wide range of tasks. See for example Dan Hendrycks, Collin Burns, Steven Basart, Andy Zou, Mantas Mazeika, Dawn Song, Jacob Steinhardt (2020) – [Measuring Massive Multitask Language Understanding](https://arxiv.org/abs/2009.03300) or the definition of what would qualify as artificial general intelligence in [this Metaculus prediction](https://www.metaculus.com/questions/5121/date-of-artificial-general-intelligence/).
21 |
22 | 7. An overview of how AI systems can fail can be found in [Charles Choi – 7 Revealing Ways AIs Fail](https://spectrum.ieee.org/ai-failures). It is also worth reading through the [AIAAIC Repository](https://www.aiaaic.org/aiaaic-repository/ai-and-algorithmic-incidents-and-controversies) which “details recent incidents and controversies driven by or relating to AI, algorithms, and automation.”
23 |
24 | 8. I have taken this example from [AI researcher François Chollet](https://fchollet.com/), who published it [here](https://twitter.com/fchollet/status/1573752180720312320?s=46&t=qPwLwDgLdJrLlXxa878BDQ).
25 |
26 | 9. Via [François Chollet](https://fchollet.com/), who published it [here](https://twitter.com/fchollet/status/1573752180720312320?s=46&t=qPwLwDgLdJrLlXxa878BDQ). Based on Chollet’s comments it seems that this image was created by the AI system ‘Stable Diffusion’.
27 |
28 | 10. This quote is from Holden Karnofsky (2021) – [AI Timelines: Where the Arguments, and the “Experts,” Stand](https://www.cold-takes.com/where-ai-forecasting-stands-today/). For Holden Karnofsky’s earlier thinking on this conceptualization of AI see his 2016 article [‘Some Background on Our Views Regarding Advanced Artificial Intelligence’](https://www.openphilanthropy.org/research/some-background-on-our-views-regarding-advanced-artificial-intelligence/#Sec1).
29 |
30 | Ajeya Cotra, whose research on AI timelines I discuss in other articles of
31 | this series, attempts to give a quantitative definition of what would qualify
32 | as transformative AI. in her widely cited [report on AI
33 | timelines](https://www.alignmentforum.org/posts/KrJfoZzpSDpnrv9va/draft-
34 | report-on-ai-timelines) she defines it as a change in software technology that
35 | brings the growth rate of gross world product “to 20%-30% per year”. Several
36 | other researchers define TAI in similar terms.
37 |
38 | 11. Human-level AI is typically defined as a software system that can carry out at least 90% or 99% of all economically relevant tasks that humans carry out. A lower-bar definition would be an AI system that can carry out all those tasks that can currently be done by another human who is working remotely on a computer.
39 |
40 | 12. On the use of AI in politically-motivated disinformation campaigns see for example John Villasenor (November 2020) – [How to deal with AI-enabled disinformation](https://web.archive.org/web/20220907044354/https://www.brookings.edu/research/how-to-deal-with-ai-enabled-disinformation/). More generally on this topic see Brundage and Avin et al. (2018) – The Malicious Use of Artificial Intelligence: Forecasting, Prevention, and Mitigation, published at [maliciousaireport.com](https://maliciousaireport.com/). A starting point for literature and reporting on mass surveillance by governments is [the relevant Wikipedia entry](https://en.wikipedia.org/wiki/List_of_government_mass_surveillance_projects).
41 |
42 | 13. See for example the [Wikipedia entry](https://en.wikipedia.org/wiki/Dutch_childcare_benefits_scandal) on the ‘Dutch childcare benefits scandal’ and Melissa Heikkilä (2022) – [‘Dutch scandal serves as a warning for Europe over risks of using algorithms’](https://web.archive.org/web/20221117053636/https://www.politico.eu/article/dutch-scandal-serves-as-a-warning-for-europe-over-risks-of-using-algorithms/), in Politico. The technology can also reinforce discrimination in terms of race and gender. See Brian Christian’s book The Alignment Problem and the [reports of the AI Now Institute](https://ainowinstitute.org/reports.html).
43 |
44 | 14. Overviews are provided in Stuart Russell (2019) – Human Compatible (especially chapter 5) and Brian Christian’s 2020 book [The Alignment Problem](https://en.wikipedia.org/wiki/The_Alignment_Problem). Christian presents the thinking of many leading AI researchers from the earliest days up to now and presents an excellent overview of this problem. It is also seen as a large risk by some of the leading private firms who work towards powerful AI – see OpenAI’s article “[Our approach to alignment research](https://openai.com/blog/our-approach-to-alignment-research/)” from August 2022.
45 |
46 | 15. Stuart Russell (2019) – Human Compatible
47 |
48 | 16. A question that follows from this is, why build such a powerful AI in the first place?
49 |
50 | The incentives are very high. As I emphasize below, this innovation has the
51 | potential to lead to very positive developments. In addition to the large
52 | social benefits there are also large incentives for those who develop it – the
53 | governments that can use it for their goals, the individuals who can use it to
54 | become more powerful and wealthy. Additionally, it is of scientific interest
55 | and might help us to understand our own mind and intelligence better. And
56 | lastly, even if we wanted to stop building powerful AIs, it is likely very
57 | hard to actually achieve it. It is very hard to coordinate across the whole
58 | world and agree to stop building more advanced AI – countries around the world
59 | would have to agree and then find ways to actually implement it.
60 |
61 | 17. In 1950 the computer science pioneer Alan Turing put it like this: _“If a machine can think, it might think more intelligently than we do, and then where should we be? … [T]his new danger is much closer. If it comes at all it will almost certainly be within the next millennium. It is remote but not astronomically remote, and is certainly something which can give us anxiety. It is customary, in a talk or article on this subject, to offer a grain of comfort, in the form of a statement that some particularly human characteristic could never be imitated by a machine. … I cannot offer any such comfort, for I believe that no such bounds can be set.”_ Alan. M. Turing (1950) – [Computing Machinery and Intelligence](https://doi.org/10.1093/mind/LIX.236.433), In Mind, Volume LIX, Issue 236, October 1950, Pages 433–460.
62 |
63 | Norbert Wiener is another pioneer who saw the alignment problem very early.
64 | One way he put it was “If we use, to achieve our purposes, a mechanical agency
65 | with whose operation we cannot interfere effectively … we had better be quite
66 | sure that the purpose put into the machine is the purpose which we really
67 | desire.” quoted from Norbert Wiener (1960) – Some Moral and Technical
68 | Consequences of Automation: As machines learn they may develop unforeseen
69 | strategies at rates that baffle their programmers. In Science.
70 |
71 | In 1950 – the same year in which Turing published the cited article – Wiener
72 | published his book The Human Use of Human Beings, whose front-cover blurb
73 | reads: “The ‘mechanical brain’ and similar machines can destroy human values
74 | or enable us to realize them as never before.”
75 |
76 | 18. Toby Ord – [The Precipice](https://theprecipice.com/). He makes this projection in footnote 55 of chapter 2. It is based on the 2017 estimate by Farquhar.
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/examples/ai-impact.TitleAbstract.full.txt:
--------------------------------------------------------------------------------
1 | Title-Abstract
2 | [Our World
3 | in Data](/)
4 |
5 | [Articles
6 | **by topic**](/#entries)
7 |
8 | * [Latest](/blog)
9 | * [About](/about)
10 | * [Donate](/donate)
11 |
12 | * [All charts](/charts)
13 | * [Sustainable Development Goals Tracker](https://sdg-tracker.org)
14 |
15 | [](https://www.oxfordmartin.ox.ac.uk/global-development)[](https://global-change-data-lab.org/)
19 |
20 | **COVID-19 vaccinations, cases, excess mortality, and much more**
21 |
22 | [Explore our COVID-19 data](/coronavirus#explore-the-global-situation)
23 |
24 | # Artificial intelligence is transforming our world — it is on all of us to
25 | make sure that it goes well
26 |
27 | How AI gets built is currently decided by a small group of technologists. As
28 | this technology is transforming our lives, it should be in all of our interest
29 | to become informed and engaged.
30 |
31 | [by Max Roser](/team)
32 |
33 | December 15, 2022
34 |
35 | Why should you care about the development of artificial intelligence?
36 |
37 | Think about what the alternative would look like. If you and the wider public
38 | do not get informed and engaged, then we leave it to a few entrepreneurs and
39 | engineers to decide how this technology will transform our world.
40 |
41 | That is the status quo. This small number of people at a few tech firms
42 | directly working on artificial intelligence (AI) do understand how
43 | extraordinarily powerful this technology is
44 | [becoming](https://ourworldindata.org/brief-history-of-AI). If the rest of
45 | society does not become engaged, then it will be this small elite who decides
46 | how this technology will change our lives.
47 |
48 | To change this status quo, I want to answer three questions in this article:
49 | Why is it hard to take the prospect of a world transformed by AI seriously?
50 | How can we imagine such a world? And what is at stake as this technology
51 | becomes more powerful?
52 |
53 | #### Why is it hard to take the prospect of a world transformed by artificial
54 | intelligence seriously?
55 |
56 | In some way, it should be obvious how technology can fundamentally transform
57 | the world. We just have to look at how much the world has already changed. If
58 | you could invite a family of hunter-gatherers from 20,000 years ago on your
59 | next flight, they would be pretty surprised. Technology has changed our world
60 | already, so we should expect that it can happen again.
61 |
62 | But while we have seen the world transform before, we have seen these
63 | transformations play out over the course of generations. What is different now
64 | is how very rapid these technological changes have become. In the past, the
65 | technologies that our ancestors used in their childhood were still central to
66 | their lives in their old age. This has not been the case anymore for recent
67 | generations. Instead, it has [become
68 | common](https://ourworldindata.org/technology-long-run) that technologies
69 | unimaginable in one’s youth become ordinary in later life.
70 |
71 | This is the first reason we might not take the prospect seriously: it is easy
72 | to underestimate the speed at which technology can change the world.
73 |
74 | The second reason why it is difficult to take the possibility of
75 | transformative AI – potentially even AI as intelligent as humans – seriously
76 | is that it is an idea that we first heard in the cinema. It is not surprising
77 | that for many of us, the first reaction to a scenario in which machines have
78 | human-like capabilities is the same as if you had asked us to take seriously a
79 | future in which vampires, werewolves, or zombies roam the planet.1
80 |
81 | But, it is plausible that it is both the stuff of sci-fi fantasy _and_ the
82 | central invention that could arrive in our, or our children’s, lifetimes.
83 |
84 | The third reason why it is difficult to take this prospect seriously is by
85 | failing to see that powerful AI could lead to very large changes. This is also
86 | understandable. It is difficult to form an idea of a future that is very
87 | different from our own time. There are two concepts that I find helpful in
88 | imagining a very different future with artificial intelligence. Let’s look at
89 | both of them.
90 |
91 | #### How to develop an idea of what the future of artificial intelligence
92 | might look like?
93 |
94 | When thinking about the future of artificial intelligence, I find it helpful
95 | to consider two different concepts in particular: human-level AI, and
96 | transformative AI.2 The first concept highlights the AI’s capabilities and
97 | anchors them to a familiar benchmark, while transformative AI emphasizes the
98 | impact that this technology would have on the world.
99 |
100 | From where we are today, much of this may sound like science fiction. It is
101 | therefore worth keeping in mind that the majority of surveyed AI experts
102 | [believe](https://ourworldindata.org/ai-timelines) there is a real chance that
103 | human-level artificial intelligence will be developed within the next decades,
104 | and some believe that it will exist much sooner.
105 |
106 | ##### The advantages and disadvantages of comparing machine and human
107 | intelligence
108 |
109 | One way to think about human-level artificial intelligence is to contrast it
110 | with the current state of AI technology. While today’s AI systems often have
111 | capabilities similar to a particular, limited part of the human mind, a human-
112 | level AI would be a machine that is capable of carrying out the same _range_
113 | of intellectual tasks that we humans are capable of.3 It is a machine that
114 | would be “able to learn to do anything that a human can do,” as Norvig and
115 | Russell put it in their textbook on AI.4
116 |
117 | Taken together, the range of abilities that characterize intelligence gives
118 | humans the ability to solve problems and achieve a wide variety of goals. A
119 | human-level AI would therefore be a system that could solve all those problems
120 | that we humans can solve, and do the tasks that humans do today. Such a
121 | machine, or collective of machines, would be able to do the work of a
122 | translator, an accountant, an illustrator, a teacher, a therapist, a truck
123 | driver, or the work of a trader on the world’s financial markets. Like us, it
124 | would also be able to do research and science, and to develop new technologies
125 | based on that.
126 |
127 | The concept of human-level AI has some clear advantages. Using the familiarity
128 | of our own intelligence as a reference provides us with some clear guidance on
129 | how to imagine the capabilities of this technology.
130 |
131 | However, it also has clear disadvantages. Anchoring the imagination of future
132 | AI systems to the familiar reality of human intelligence carries the risk that
133 | it obscures the very real differences between them.
134 |
135 | Some of these differences are obvious. For example, AI systems will have the
136 | immense memory of computer systems, against which our own capacity to store
137 | information pales. Another obvious difference is the speed at which a machine
138 | can absorb and process information. But information storage and processing
139 | speed are not the only differences. The domains in which machines already
140 | outperform humans is steadily increasing: in chess, after matching the level
141 | of the best human players in the late 90s, AI systems
142 | [reached](https://ourworldindata.org/grapher/computer-chess-ability)
143 | superhuman levels more than a decade ago. In other games like Go or complex
144 | strategy games, this has happened more recently.5
145 |
146 | These differences mean that an AI that is at least as good as humans in every
147 | domain would overall be much more powerful than the human mind. Even the first
148 | “human-level AI” would therefore be quite superhuman in many ways.6
149 |
150 | Human intelligence is also a bad metaphor for machine intelligence in other
151 | ways. The way we think is often very different from machines, and as a
152 | consequence the output of thinking machines can be very alien to us.
153 |
154 | Most perplexing and most concerning are the strange and unexpected ways in
155 | which machine intelligence can fail. The AI-generated image of the horse below
156 | provides an example: on the one hand, AIs can do what no human can do –
157 | produce an image of anything, in any style (here photorealistic), in mere
158 | seconds – but on the other hand it can fail in ways that no human would fail.7
159 | No human would make the mistake of drawing a horse with five legs.8
160 |
161 | Imagining a powerful future AI as just another human would therefore likely be
162 | a mistake. The differences might be so large that it will be a misnomer to
163 | call such systems “human-level.”
164 |
165 | **AI-generated image of a horse** 9
166 |
167 | 
168 |
169 | ##### Transformative artificial intelligence is defined by the impact this
170 | technology would have on the world
171 |
172 | In contrast, the concept of transformative AI is not based on a comparison
173 | with human intelligence. This has the advantage of sidestepping the problems
174 | that the comparisons with our own mind bring. But it has the disadvantage that
175 | it is harder to imagine what such a system would look like and be capable of.
176 | It requires more from us. It requires us to imagine a world with intelligent
177 | actors that are potentially very different from ourselves.
178 |
179 | Transformative AI is not defined by any specific capabilities, but by the
180 | real-world impact that the AI would have. To qualify as transformative,
181 | researchers think of it as AI that is “powerful enough to bring us into a new,
182 | qualitatively different future.”10
183 |
184 | In humanity’s history, there have been two cases of such major
185 | transformations, the agricultural and the industrial revolutions.
186 |
187 | Transformative AI becoming a reality would be an event on that scale. Like the
188 | arrival of agriculture 10,000 years ago, or the transition from hand- to
189 | machine-manufacturing, it would be an event that would change the world for
190 | billions of people around the globe and for the entire trajectory of
191 | [humanity’s future](https://ourworldindata.org/longtermism).
192 |
193 | Technologies that fundamentally change how a wide range of goods or services
194 | are produced are called ‘general-purpose technologies’. The two previous
195 | transformative events were caused by the discovery of two particularly
196 | significant general-purpose technologies: the change in food production as
197 | humanity transitioned from hunting and gathering to farming, and the rise of
198 | machine manufacturing in the industrial revolution. Based on the evidence and
199 | arguments presented in [this series](https://ourworldindata.org/artificial-
200 | intelligence#research-writing) on AI development, I believe it is plausible
201 | that powerful AI could represent the introduction of a similarly significant
202 | general-purpose technology.
203 |
204 | **Timeline of the three transformative events in world history**
205 |
206 | 
--------------------------------------------------------------------------------
/summarize.py:
--------------------------------------------------------------------------------
1 | #!/usr/bin/env python
2 |
3 | """
4 | This script contains functions for extracting text from a PDF file, splitting
5 | the text into sections, and splitting sections into subsections. The
6 | extract_text_from_pdf() function takes in a file path to a PDF and returns a
7 | string of the extracted text. The split_into_sections() function takes in a
8 | string of text and uses a regular expression to split it into a list of tuples,
9 | where each tuple contains a section header and the corresponding text. The
10 | split_section_into_subsections() function takes in a section header, the
11 | corresponding text, and an encoder object and splits the section into smaller
12 | parts, each of which is returned as a tuple containing a subsection header and
13 | the corresponding text. The split_subsection_into_paragraphs() function takes
14 | in a subsection header, the corresponding text, the encoder object, and a
15 | maximum number of tokens and splits the subsection into smaller parts, each of
16 | which is returned as a tuple containing a paragraph header and the
17 | corresponding text.
18 |
19 | This script was written by ChatGPT with direction by Scott Leibrand,
20 | then edited by Scott Leibrand w/ CoPilot and ChatGPT.
21 | """
22 |
23 | import sys
24 | import re
25 | import os
26 | import openai
27 | import glob
28 |
29 | #import tiktoken
30 | from transformers import GPT2TokenizerFast
31 |
32 | from io import StringIO
33 | from pdfminer.pdfinterp import PDFResourceManager, PDFPageInterpreter
34 | from pdfminer.converter import TextConverter
35 | from pdfminer.layout import LAParams
36 | from pdfminer.pdfpage import PDFPage
37 |
38 | import html2text
39 |
40 | def extract_text_from_pdf(pdf_path):
41 | """Extracts the text from a PDF file and returns it as a string.
42 |
43 | Parameters:
44 | pdf_path (str): The file path to the PDF file.
45 |
46 | Returns:
47 | str: The extracted text.
48 | """
49 | with open(pdf_path, 'rb') as fh:
50 | # Create a PDF resource manager object that stores shared resources
51 | rsrcmgr = PDFResourceManager()
52 |
53 | # Create a StringIO object to store the extracted text
54 | output = StringIO()
55 |
56 | # Create a TextConverter object to convert PDF pages to text
57 | device = TextConverter(rsrcmgr, output, laparams=LAParams())
58 |
59 | # Create a PDF page interpreter object
60 | interpreter = PDFPageInterpreter(rsrcmgr, device)
61 |
62 | # Process each page contained in the PDF document
63 | for page in PDFPage.get_pages(fh, caching=True, check_extractable=True):
64 | interpreter.process_page(page)
65 |
66 | # Get the extracted text as a string and close the StringIO object
67 | text = output.getvalue()
68 | output.close()
69 |
70 | # Close the PDF file and text converter objects
71 | device.close()
72 |
73 | # Remove ^L page breaks from the text
74 | text = text.replace('\x0c', '\n')
75 |
76 | return text
77 |
78 | def split_into_sections(text):
79 | """Splits a string of text into a list of tuples, where each tuple contains a section header and the corresponding text.
80 |
81 | Parameters:
82 | text (str): The input text to split into sections.
83 |
84 | Returns:
85 | list: A list of tuples, where each tuple contains a section header and the corresponding text.
86 | """
87 | # Use a regular expression to match the "References" section
88 | #pattern = r'(\n\nReferences[^\n]*)\n'
89 | # Also match the "References" section if it is preceded by # or ## (markdown-style headers)
90 | pattern = r'(\n\n(#+\s+)?References[^\n]*)\n'
91 | match = re.search(pattern, text)
92 | if match:
93 | # Remove the "References" section and everything that follows
94 | text = text[:match.start()]
95 |
96 | # Use a regular expression to match and remove any base64 encoded data
97 | text = re.sub(r'data:.+;base64[^)]+', '', text)
98 |
99 | # Use a regular expression to split the text into sections
100 | #pattern = r'\n\n(\d+[\.:]\s+[^\n]+)\n\n'
101 | # Match section headers that start with a number followed by a period or colon,
102 | # or markdown-style headers that start with one to six hash marks followed by a space
103 | pattern = r'\n\n(#+\s+[^\n]+|\d+[\.:]\s+[^\n]+)\n\n'
104 | sections = re.split(pattern, text)
105 | print("Found", len(sections), "sections.")
106 |
107 | # Extract the section headers and their corresponding text
108 | headers = ["Title-Abstract"]
109 | content = []
110 | for i, section in enumerate(sections):
111 | if i % 2 == 0:
112 | # This is a section of content
113 | content.append(section)
114 | else:
115 | # This is a section header
116 | headers.append(section)
117 | #print(section)
118 |
119 | # Zip the section headers and content together
120 | sections = list(zip(headers, content))
121 |
122 | #print(headers)
123 |
124 | return sections
125 |
126 | def split_section_into_subsections(section_header, section_content, enc, max_tokens=3000):
127 | """Splits a section of text into smaller parts, each of which is returned
128 | as a tuple containing a subsection header and the corresponding text.
129 |
130 | Parameters:
131 | section_header (str): The header for the section to be split.
132 | section_content (str): The content of the section to be split.
133 | enc (object): An encoder object used to encode the section content as a sequence of tokens.
134 | max_tokens (int, optional): The maximum number of tokens allowed in each subsection. Default is 3000.
135 |
136 | Returns:
137 | list: A list of tuples, where each tuple contains a subsection header and the corresponding text.
138 | """
139 | # Encode the section content as a sequence of tokens
140 | tokens = enc.encode(section_content)
141 |
142 | if len(tokens) <= max_tokens:
143 | # The section does not need to be split into subsections
144 | return [(section_header, section_content)]
145 |
146 | # Split the section into numbered subsections
147 | pattern = r'\n\n(\d+\.\d+[\.:]\s+[^\n]+)\n\n'
148 | subsections = re.split(pattern, section_content)
149 |
150 | # Extract the subsection headers and their corresponding text
151 | headers = [f"{section_header.split('.')[0]}. Section intro"]
152 | content = []
153 | for i, subsection in enumerate(subsections):
154 | if i % 2 == 0:
155 | # This is a subsection of content
156 | content.append(subsection)
157 | else:
158 | # This is a subsection header
159 | headers.append(subsection)
160 |
161 | # Zip the subsection headers and content together
162 | subsections = list(zip(headers, content))
163 |
164 |
165 | # Split any subsections that are still too long into smaller parts
166 | result = []
167 | for header, content in subsections:
168 | parts = split_subsection_into_paragraphs(header, content, enc, max_tokens)
169 | result.extend(parts)
170 |
171 | return result
172 |
173 | def split_subsection_into_paragraphs(subsection_header, subsection_content, enc, max_tokens=3000):
174 | # Encode the subsection content as a sequence of tokens
175 | tokens = enc.encode(subsection_content)
176 |
177 | if len(tokens) <= max_tokens:
178 | # The subsection does not need to be split into parts
179 | return [(subsection_header, subsection_content)]
180 |
181 | # Split the subsection into parts
182 | start = 0
183 | parts = []
184 | while start < len(tokens):
185 | # Calculate the size of the next part
186 | end = start + max_tokens
187 |
188 | # Find the nearest newline boundary within the part
189 | newline_pos = subsection_content[start:end].find('\n\n')
190 | if newline_pos != -1:
191 | end = start + newline_pos
192 |
193 | # Extract the part
194 | part_tokens = tokens[start:end]
195 | part_content = enc.decode(part_tokens)
196 |
197 | # Add the part to the list of parts
198 | parts.append((subsection_header, part_content))
199 |
200 | # Update the start index
201 | start = end + 2
202 |
203 | return parts
204 |
205 | def combine_subsections(subsections):
206 | # Initialize the list of combined subsections
207 | combined_subsections = []
208 |
209 | # Initialize the current combined subsection
210 | current_subsection_header = ""
211 | current_subsection_content = ""
212 | current_subsection_tokens = 0
213 |
214 | # Iterate through the subsections
215 | for header, content in subsections:
216 | # Encode the content as a sequence of tokens
217 | tokens = enc.encode(content)
218 |
219 | # If the current combined subsection has less than 1000 tokens and the current subsection has less than 1000 tokens, combine them
220 | if current_subsection_tokens + len(tokens) < 2000 and len(tokens) < 1000:
221 | # Update the current combined subsection header
222 | if current_subsection_header == "":
223 | current_subsection_header = header
224 | current_subsection_content = header + "\n"
225 | else:
226 | if current_subsection_header != header:
227 | current_subsection_content += "\n\n" + header + "\n"
228 | #current_subsection_header += header
229 |
230 | # Update the current combined subsection content
231 | current_subsection_content += content
232 |
233 | # Update the current combined subsection token count
234 | current_subsection_tokens += len(tokens)
235 | else:
236 | # Add the current combined subsection to the list of combined subsections
237 | combined_subsections.append((current_subsection_header, current_subsection_content))
238 |
239 | # Reset the current combined subsection
240 | current_subsection_header = header
241 | current_subsection_content = header + "\n" + content
242 | current_subsection_tokens = len(tokens)
243 |
244 | # Add the final combined subsection to the list of combined subsections
245 | combined_subsections.append((current_subsection_header, current_subsection_content))
246 |
247 | return combined_subsections
248 |
249 | def generate_summary(content, prompt, model_engine="text-davinci-003", max_tokens=3000):
250 | # Get the API key from the environment variable
251 | api_key = os.environ["OPENAI_API_KEY"]
252 | openai.api_key = api_key
253 |
254 | # Set the model to use, if not specified
255 | if model_engine is None:
256 | model_engine = "text-davinci-003"
257 |
258 | # Set the temperature for sampling
259 | temperature = 0
260 |
261 | # Set the max token count for the summary
262 | if model_engine == "text-davinci-003":
263 | max_tokens = 1000
264 | else:
265 | max_tokens = 500
266 |
267 | # Generate completions
268 | completions = openai.Completion.create(
269 | engine=model_engine,
270 | prompt=prompt,
271 | max_tokens=max_tokens,
272 | temperature=temperature
273 | )
274 |
275 | # Get the summary from the first completion
276 | summary = completions.choices[0].text
277 |
278 | return summary
279 |
280 | def extract_text_from_html(html_path):
281 | # Read the HTML file
282 | with open(html_path, "r") as html_file:
283 | html = html_file.read()
284 |
285 | # Extract the text from the HTML
286 | text = html2text.html2text(html)
287 |
288 | return text
289 |
290 | def create_html_file(basename, url):
291 | # Create the HTML file
292 | html_file = open(basename + ".summary.html", "w")
293 |
294 | # Strip the path from the basename to get the filename
295 | filename = os.path.basename(basename)
296 |
297 | # Write the HTML header
298 | html_file.write("\n")
299 | html_file.write("
\n")
300 | html_file.write("" + filename + " \n")
301 | #html_file.write(" \n")
302 | html_file.write("\n")
303 | html_file.write("\n")
304 | html_file.write("\n")
305 | #html_file.write("" + filename + " \n")
306 | html_file.write("\n")
307 |
308 | # Write the overall summary section
309 | html_file.write("Overall Summary \n")
310 | overall_summary_file = open(basename + ".overall_summary.txt", "r")
311 | overall_summary_content = overall_summary_file.read()
312 | html_file.write("" + overall_summary_content + "
\n")
313 | overall_summary_file.close()
314 |
315 | # Write the subsection summary section
316 | html_file.write("Subsection Summary \n")
317 | subsection_summary_files = glob.glob(basename + ".*.summary.txt")
318 | subsection_summary_files.sort()
319 | for subsection_summary_file in subsection_summary_files:
320 | subsection_summary_file_handle = open(subsection_summary_file, "r")
321 | subsection_summary_content = subsection_summary_file_handle.read()
322 | html_file.write("" + subsection_summary_content + "
\n")
323 | subsection_summary_file_handle.close()
324 |
325 | # Write the HTML footer
326 | html_file.write("Original URL \n")
327 | html_file.write(" \n")
328 | html_file.write("\n")
329 | html_file.write("\n")
330 |
331 | # Print a message indicating that the HTML file was created
332 | print("Created HTML file: " + basename + ".summary.html")
333 | # Close the HTML file
334 | html_file.close()
335 |
336 | def download_html(url):
337 | # Strip any trailing /'s from the end of the URL
338 | stripped_url = url.rstrip("/")
339 |
340 | # Get the base name of the URL
341 | base_name = stripped_url.split("/")[-1]
342 |
343 | # Download the HTML file
344 | if base_name.endswith(".pdf"):
345 | html_path = "/tmp/" + base_name
346 | else:
347 | html_path = "/tmp/" + base_name + ".html"
348 | print("HTML path: " + html_path)
349 | print("URL: " + url)
350 | os.system("curl -s -o " + html_path + " " + url)
351 |
352 | return html_path
353 |
354 | if __name__ == '__main__':
355 |
356 | model_engine = "text-davinci-003"
357 | max_tokens = 3000
358 | doctype=""
359 | # get the base filename of the first argument without the extension
360 | base_name = os.path.splitext(sys.argv[1])[0]
361 |
362 | # If the command line argument starts with http, use curl to download it to an HTML file
363 | if sys.argv[1].startswith("http"):
364 | # Get the URL from the command line arguments
365 | url = sys.argv[1]
366 | doctype="article"
367 |
368 | # Strip any query parameters from the URL
369 | url = url.split("?")[0]
370 |
371 | # Download the HTML file
372 | html_path = download_html(url)
373 | print(html_path)
374 |
375 | # Strip any trailing /'s from the end of the URL
376 | url = url.rstrip("/")
377 | # Set the base_name to a /tmp file containing the last part of the URL between /'s
378 | base_name = "/tmp/" + url.split("/")[-1]
379 | print(base_name)
380 |
381 | if sys.argv[1].endswith(".pdf"):
382 | text = extract_text_from_pdf(html_path)
383 | else:
384 | # Extract the text from the HTML file
385 | text = extract_text_from_html(html_path)
386 | # If the command line argument references a pdf file
387 | elif sys.argv[1].endswith(".pdf"):
388 | # Get the PDF file path from the command line arguments
389 | pdf_path = sys.argv[1]
390 | doctype="paper"
391 |
392 | # Extract the text from the PDF file
393 | text = extract_text_from_pdf(pdf_path)
394 | elif sys.argv[1].endswith(".html") or sys.argv[1].endswith(".htm"):
395 |
396 | # Get the HTML file path from the command line arguments
397 | html_path = sys.argv[1]
398 | doctype="article"
399 |
400 | # Extract the text from the HTML file
401 | text = extract_text_from_html(html_path)
402 | else:
403 | # Get the text file path from the command line arguments
404 | text_path = sys.argv[1]
405 |
406 | # Read the text file
407 | with open(text_path, "r") as text_file:
408 | text = text_file.read()
409 |
410 | # Checking if output language is set: if not, leave off any language instructions from the prompt
411 | try:
412 | arg = sys.argv[2]
413 | output_language_prompt = " Please use "+sys.argv[2]+" language for the output."
414 | except IndexError:
415 | output_language_prompt = ""
416 |
417 | # Split the text into sections
418 | sections = split_into_sections(text)
419 |
420 | # encode the text as a sequence of tokens
421 | #enc = tiktoken.get_encoding("gpt2")
422 | enc = GPT2TokenizerFast.from_pretrained("gpt2")
423 |
424 | tokens = enc.encode(text)
425 |
426 | # Get the base name of the output file
427 | #base_name, _ = os.path.splitext(pdf_path)
428 |
429 | # Write the extracted text to the output file
430 | with open(base_name + ".full.txt", 'w', encoding='utf-8') as f:
431 | f.write(text)
432 |
433 | print(f"Text extracted from {sys.argv[1]} and written to {base_name}.full.txt")
434 |
435 |
436 | print(f"Total token count: {len(tokens)}")
437 |
438 | # Write each section to a separate text file
439 | for header, content in sections:
440 | print("Header: ", header)
441 | # Split the section into subsections if necessary
442 | subsections = split_section_into_subsections(header, content, enc)
443 |
444 | # Combine adjacent tuples with less than 1000 tokens until they exceed 1000 tokens
445 | combined_subsections = combine_subsections(subsections)
446 |
447 | # Initialize the counter for numbering sequential identical subheaders
448 | subheader_count = 1
449 |
450 | # Process each combined subsection
451 | for subheader, subcontent in combined_subsections:
452 | # Update the subheader if there are multiple sequential identical subheaders
453 | if subheader_count > 1:
454 | subheader += f"-part{subheader_count}"
455 | subheader_count += 1
456 |
457 | # Use tiktoken to encode the subsection content as a sequence of tokens
458 | subcontent_tokens = enc.encode(subcontent)
459 |
460 |
461 | # Get the name of the output file
462 | #print("Subheader: ",subheader)
463 | section_name = re.sub(r'[^a-zA-Z0-9]', '', subheader.replace('/','-'))
464 |
465 | #print("Section name: ",section_name)
466 | output_path = f"{base_name}.{section_name}.full.txt"
467 |
468 | if (len(subcontent) == 0):
469 | subheader_count = subheader_count - 1
470 | else:
471 | # Write the content to the output file
472 | with open(output_path, 'w', encoding='utf-8') as f:
473 | f.write(subcontent)
474 | print(f"{subheader} ({len(subcontent)} characters, {len(subcontent_tokens)} tokens) written to {output_path}")
475 | # Get the name of the summary file
476 | summary_path = f"{base_name}.{section_name}.summary.txt"
477 | # If the summary file does not exist, generate a summary
478 | if os.path.exists(summary_path):
479 | print(f"Summary already exists at {summary_path}")
480 | else:
481 | # Set the prompt for the summary
482 | prompt = f"Please provide a detailed summary of the following section, but if the section content is mostly website context/description, just return 'Section has no content':\n{subcontent}\nPlease provide a detailed summary of the section above. If the section content is mostly website context/description, just return 'Section has no content'.{output_language_prompt}"
483 | # Generate a summary for the subsection
484 | summary = generate_summary(subcontent, prompt, model_engine, max_tokens)
485 | # Write the summary to a summary file
486 | with open(summary_path, 'w', encoding='utf-8') as f:
487 | f.write(summary)
488 | print(f"Summary written to {summary_path}")
489 |
490 | # If there is more than one summary file matching {base_name}.*{section_number}.summary.txt, generate a combined section summary
491 | section_number = section_name.split('.')[0]
492 | if len(glob.glob(f"{base_name}.{section_number}.*.summary.txt")) < 1:
493 | print(f"No summary files found for section {section_number}")
494 | elif len(glob.glob(f"{base_name}.{section_number}.*.summary.txt")) == 1:
495 |
496 | print(f"Only one summary file found for section {section_number}, promoting it to section summary")
497 | # Get the path of the summary file
498 | #print(glob.glob(f"{base_name}.{section_number}.*.summary.txt"))
499 | summary_path = glob.glob(f"{base_name}.{section_number}.*.summary.txt")[0]
500 | # Get the path of the section summary file
501 | section_summary_path = f"{base_name}.{section_name}.section_summary.txt"
502 | # Read the summary file and write it to the section summary file
503 | with open(summary_path, 'r', encoding='utf-8') as f:
504 | summary = f.read()
505 | with open(section_summary_path, 'w', encoding='utf-8') as f:
506 | f.write(summary)
507 |
508 | print(f"Summary promoted to section summary at {section_summary_path}")
509 |
510 | else:
511 | # Read in the section summaries
512 | summaries = []
513 |
514 | summary_pattern = f"{base_name}.*{section_number}.summary.txt"
515 | print(f"Reading summary from {summary_pattern}")
516 | summary_paths = glob.glob(summary_pattern)
517 | summary_paths.sort(key=os.path.getmtime) # sort file names by modification time, oldest first
518 | for summary_path in summary_paths:
519 | print(f"Reading summary from {summary_path}")
520 | with open(summary_path, 'r', encoding='utf-8') as f:
521 | summaries.append(f.read())
522 | # Concatenate the summaries into a single string
523 | subcontent = "\n\n".join(summaries)
524 | # Tokenize the concatenated summaries
525 | subcontent_tokens = enc.encode(subcontent)
526 | print(f"Concatenated {len(summaries)} summaries into a single summary with {len(subcontent)} characters and {len(subcontent_tokens)} tokens")
527 | if len(subcontent_tokens) == 0:
528 | summary_pattern = f"{base_name}.*.summary.txt"
529 | print(f"Reading summary from {summary_pattern}")
530 | summary_paths = glob.glob(summary_pattern)
531 | summary_paths.sort(key=os.path.getmtime) # sort file names by modification time, oldest first
532 |
533 | summaries = []
534 | subcontent_tokens = []
535 | for summary_path in summary_paths:
536 | print(f"Reading summary from {summary_path}")
537 | with open(summary_path, 'r', encoding='utf-8') as f:
538 | summary = f.read()
539 | summary_tokens = enc.encode(summary)
540 | if len(subcontent_tokens) + len(summary_tokens) > max_tokens:
541 | break
542 | summaries.append(summary)
543 | subcontent_tokens += summary_tokens
544 | # Concatenate the summaries into a single string
545 | subcontent = "\n\n".join(summaries)
546 | # Tokenize the concatenated summaries
547 | subcontent_tokens = enc.encode(subcontent)
548 | print(f"Concatenated {len(summaries)} out of {len(summary_paths)} section summaries into a single summary with {len(subcontent)} characters and {len(subcontent_tokens)} tokens")
549 |
550 | # Set the prompt for the overall section summary
551 | prompt = f"Please provide a detailed summary of the following sections:\n{subcontent}\nPlease provide a detailed summary of the sections above.{output_language_prompt}"
552 | # Get the path of the overall section summary file
553 | section_summary_path = f"{base_name}.{section_number}.section_summary.txt"
554 | # If the overall section summary file does not exist, generate a summary
555 | if os.path.exists(section_summary_path):
556 | print(f"Overall section summary already exists at {section_summary_path}")
557 | else:
558 | # Generate the overall section summary
559 | section_summary = generate_summary(content, prompt, model_engine, max_tokens)
560 | # Write the overall section summary to a file
561 | with open(section_summary_path, 'w', encoding='utf-8') as f:
562 | f.write(section_summary)
563 | print(f"Overall section summary written to {section_summary_path}")
564 |
565 |
566 |
567 |
568 | # Check if the overall summary file already exists
569 | overall_summary_path = f"{base_name}.overall_summary.txt"
570 | if os.path.exists(overall_summary_path):
571 | print(f"Overall summary already exists at {overall_summary_path}")
572 | else:
573 | # Read in the abstract, if it exists
574 | try:
575 | abstract_filename=glob.glob(f"{base_name}.Title-Abstract*.full.txt")[0]
576 | with open(f"{abstract_filename}", 'r', encoding='utf-8') as f:
577 | abstract = f.read()
578 | except IndexError:
579 | print(f"No abstract found for {base_name}")
580 | abstract = ""
581 | # Read in the section summaries
582 | summaries = []
583 | summary_pattern = f"{base_name}.*.section_summary.txt"
584 | for summary_path in glob.glob(summary_pattern):
585 | with open(summary_path, 'r', encoding='utf-8') as f:
586 | summaries.append(f.read())
587 | # Concatenate the abstract and summaries into a single string
588 | subcontent = abstract + "\n\n" + "\n\n".join(summaries)
589 | # Tokenize the concatenated abstract and summaries
590 | subcontent_tokens = enc.encode(subcontent)
591 | for summary in summaries:
592 | summary_tokens = enc.encode(summary)
593 | if len(subcontent_tokens) + len(summary_tokens) > max_tokens:
594 | print(f"Exceeded {max_tokens} tokens, stopping concatenation of summaries")
595 | break
596 | subcontent += summary + "\n\n"
597 | subcontent_tokens += summary_tokens
598 | print(f"Concatenated {len(summaries)} summaries into a single summary with {len(subcontent)} characters and {len(subcontent_tokens)} tokens")
599 | if len(subcontent_tokens) < 500:
600 | print(f"Concatenated subsection summaries have less than 500 tokens, reading in all summaries")
601 | summary_pattern = f"{base_name}.*.summary.txt"
602 | for summary_path in glob.glob(summary_pattern):
603 | with open(summary_path, 'r', encoding='utf-8') as f:
604 | summaries.append(f.read())
605 | for summary in summaries:
606 | summary_tokens = enc.encode(summary)
607 | if len(subcontent_tokens) + len(summary_tokens) > max_tokens:
608 | print(f"Exceeded {max_tokens} tokens, stopping concatenation of summaries")
609 | break
610 | subcontent += summary + "\n\n"
611 | subcontent_tokens += summary_tokens
612 |
613 |
614 | # Set the prompt for the overall summary
615 | prompt = f"Please provide a detailed summary of the following {doctype}, based on its abstract and summaries of each section:\n{subcontent}\nPlease provide a detailed summary of the {doctype} described above, based on the provided abstract/introduction and summaries of each section.{output_language_prompt}"
616 | # Generate the overall summary
617 | overall_summary = generate_summary(subcontent, prompt, model_engine, max_tokens)
618 | # Append a newline to the overall summary
619 | overall_summary += "\n"
620 | # Write the overall summary to a file
621 | with open(overall_summary_path, 'w', encoding='utf-8') as f:
622 | f.write(overall_summary)
623 | print(f"Overall summary written to {overall_summary_path}")
624 |
625 | # Call create_html_file() to create an HTML file with the overall summary
626 | create_html_file(base_name, url)
627 |
--------------------------------------------------------------------------------
/README.md:
--------------------------------------------------------------------------------
1 | # gpt-summarizer
2 | ### Extract text, summarize each section w/ GPT, and provide a summarized outline of a paper/article
3 |
4 | This script extracts text from a given file or URL and splits it into sections. It then uses OpenAI's tokenizer to encode the text as a sequence of tokens. It writes the extracted text to an output file and writes each section to a separate text file. It also generates a summary for each subsection and writes the summary to a summary file. If there are multiple summary files for a section, it generates a combined section summary.
5 |
6 | The script expects a PDF or HTML file path, or an HTML URL, to be passed as a command line argument. It extracts the text from the PDF file, splits the text into sections, and uses the tiktoken.get_encoding function to encode the text as a sequence of tokens using the "gpt2" encoding. It writes the extracted text to an output file using the base_name of the file and the .txt extension.
7 |
8 | It processes each section by first using the split_section_into_subsections function to split the section into subsections based on HTML section headings or numbered section headings. If necessary, it further splits any subsections into paragraphs and recombine adjacent ones until they exceed 1000 tokens. It processes each resulting section/part with InstructGPT (text-davinci-003) to generate a summary, and writes each section summary to a summary file. If there are multiple summary files for a section, it generates a combined section summary by concatenating the summaries of the individual subsections.
9 |
10 | It then performs one final round of summarization across all the lower-level summaries, to produce an overall summary of the paper/article.
11 |
12 | The intended use is that both the overall summary and the subsection summaries (in order) are worth reading to determine whether to spend the time reading the entire article/paper, or specific sections of it.
13 |
14 | You can also specify an optional second positional argument to have the summaries generated in the specified language: to do so it adds `" Please use "+sys.argv[2]+" language for the output."` to the prompt if the argument is present.
15 |
16 | ## Usage
17 |
18 | tl;dr:
19 | ```
20 | pip install pdfminer
21 | pip install html2text
22 | pip install tiktoken
23 | pip install openai
24 | export OPENAI_API_KEY=
25 | python summarize.py paper.pdf
26 | python summarize.py https://path/to/article
27 | python summarize.py https://path/to/article Spanish
28 | ```
29 |
30 | ### Usage details:
31 |
32 | Requires an OpenAI API key:
33 | - If you haven't already done so to get access to ChatGPT, sign up for an account at OpenAI.com
34 | - Go to https://openai.com/api/ and Log in
35 | - Go to https://beta.openai.com/account/api-keys
36 | - Create a new secret key
37 |
38 | This OPENAI_API_KEY should be set as an environment variable:
39 | `export OPENAI_API_KEY=`
40 |
41 | For now, you also have to manually pip install pdfminer, html2text, tiktoken, and openai. (I'd welcome a PR to get this repo set up to use setup requirements to support `pip install -e .`)
42 |
43 |
44 | ## Examples
45 |
46 | https://github.com/scottleibrand/gpt-summarizer/tree/main/examples
47 |
48 | ### Summary of OurWorldInData AI Impact article
49 | https://ourworldindata.org/ai-impact
50 |
51 | ```
52 | ~/src/gpt-summarizer $ ./summarize.py https://ourworldindata.org/ai-impact
53 | HTML path: /tmp/ai-impact.html
54 | URL: https://ourworldindata.org/ai-impact
55 | /tmp/ai-impact.html
56 | /tmp/ai-impact
57 | Text extracted from https://ourworldindata.org/ai-impact and written to /tmp/ai-impact.full.txt
58 | Total token count: 8038
59 | Header: Title-Abstract
60 | Title-Abstract (10563 characters, 2493 tokens) written to /tmp/ai-impact.TitleAbstract.full.txt
61 | Summary written to /tmp/ai-impact.TitleAbstract.summary.txt
62 | No summary files found for section TitleAbstract
63 | Header: ##### A future of human-level or transformative AI?
64 | ##### A future of human-level or transformative AI? (1140 characters, 258 tokens) written to /tmp/ai-impact.AfutureofhumanlevelortransformativeAI.full.txt
65 | Summary written to /tmp/ai-impact.AfutureofhumanlevelortransformativeAI.summary.txt
66 | No summary files found for section AfutureofhumanlevelortransformativeAI
67 | Header: #### What is at stake as artificial intelligence becomes more powerful?
68 | #### What is at stake as artificial intelligence becomes more powerful? (4677 characters, 1059 tokens) written to /tmp/ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.full.txt
69 | Summary written to /tmp/ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.summary.txt
70 | No summary files found for section Whatisatstakeasartificialintelligencebecomesmorepowerful
71 | Header: #### How can we make sure that the development of AI goes well?
72 | #### How can we make sure that the development of AI goes well? (3427 characters, 792 tokens) written to /tmp/ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.full.txt
73 | Summary written to /tmp/ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.summary.txt
74 | No summary files found for section HowcanwemakesurethatthedevelopmentofAIgoeswell
75 | Header: ### Endnotes
76 | ### Endnotes (10116 characters, 2573 tokens) written to /tmp/ai-impact.Endnotes.full.txt
77 | Summary written to /tmp/ai-impact.Endnotes.summary.txt
78 | No summary files found for section Endnotes
79 | Header: ### Reuse this work freely
80 | ### Reuse this work freely (2764 characters, 853 tokens) written to /tmp/ai-impact.Reusethisworkfreely.full.txt
81 | Summary written to /tmp/ai-impact.Reusethisworkfreely.summary.txt
82 | No summary files found for section Reusethisworkfreely
83 | No abstract found for /tmp/ai-impact
84 | Concatenated 0 summaries into a single summary with 2 characters and 1 tokens
85 | Concatenated subsection summaries have less than 500 tokens, reading in all summaries
86 | Overall summary written to /tmp/ai-impact.overall_summary.txt
87 | ~/src/gpt-summarizer $
88 | ```
89 |
90 | https://github.com/scottleibrand/gpt-summarizer/blob/main/examples/ai-impact.overall_summary.txt
91 |
92 | #### OWID Overall Summary
93 |
94 | This article discusses the potential implications of artificial intelligence (AI) becoming a reality. It explains why it is difficult to take the prospect of a world transformed by AI seriously, and how to develop an idea of what the future of AI might look like. It compares the potential of transformative AI to the agricultural and industrial revolutions, and suggests that it could represent the introduction of a similarly significant general-purpose technology. The article also looks at the advantages and disadvantages of comparing machine and human intelligence, and introduces the concept of transformative AI, which is defined by the impact this technology would have on the world. It is noted that transformative AI could be developed before human-level AI, and that the timeline for when either of these levels of AI might be achieved is difficult to predict.
95 |
96 | The article also looks at the potential risks and benefits of AI becoming more powerful. It is clear that AI can already cause harm when used maliciously, such as in politically-motivated disinformation campaigns or to enable mass surveillance. AI can also cause unintended harm, such as when an AI system falsely accused 26,000 parents of making fraudulent claims for child care benefits in the Netherlands. As AI becomes more powerful, the potential negative impacts could become much larger, such as mass labor displacement, extreme concentrations of power and wealth, and totalitarianism. Additionally, there is the risk of an AI system escaping human control and harming humans, known as the alignment problem. This risk is difficult to foresee and prevent, and could lead to an extreme catastrophe. On the other hand, AI could lead to positive developments such as cleaner energy, the replacement of unpleasant work, and better healthcare. The stakes are high with this technology, and reducing the negative risks and solving the alignment problem could mean the difference between a healthy, flourishing, and wealthy future for humanity – and the destruction of the same.
97 |
98 | The article also looks at the difference between human-level AI and transformative AI, and the potential timeline for when either of these levels of AI might be achieved. It is noted that transformative AI could be developed before human-level AI, and that the timeline for when either of these levels of AI might be achieved is difficult to predict. Additionally, the article provides information about the licenses and permissions associated with Our World in Data's visualizations, data, code, and articles. Finally, the article looks at the concept of human-level AI, which is defined as a software system that can carry out at least 90% or 99% of all economically relevant tasks that humans carry out. It also looks at the closely related terms Artificial General Intelligence, High-Level Machine Intelligence, Strong AI, or Full AI, which are sometimes defined in similar, yet different ways. The section also looks at the difficulty of comparing machine and human intelligence, and the potential risks of AI systems, such as AI-enabled disinformation campaigns and mass surveillance by governments. It also looks at the incentives for developing powerful AI, and the potential for it to lead to positive developments. Finally, the section looks at the early warnings of Alan Turing and Norbert Wiener about the alignment problem, and Toby Ord's projection that AI could be developed by 2040.
99 |
100 | #### OWID Section Summaries
101 |
102 | `ls -rt *summary.txt | while read file; do echo -n $file; cat $file; echo; echo; done`
103 |
104 | ai-impact.AfutureofhumanlevelortransformativeAI.summary.txt
105 |
106 | This section discusses the difference between human-level AI and transformative AI, and the potential timeline for when either of these levels of AI might be achieved. It is noted that transformative AI could be developed before human-level AI, and that the timeline for when either of these levels of AI might be achieved is difficult to predict. The article provides a link to a companion article which gives an overview of what researchers in this field currently believe about the timeline for AI development.
107 |
108 | ai-impact.Endnotes.summary.txt
109 |
110 | This section discusses the concept of human-level AI, which is defined as a software system that can carry out at least 90% or 99% of all economically relevant tasks that humans carry out. It also looks at the closely related terms Artificial General Intelligence, High-Level Machine Intelligence, Strong AI, or Full AI, which are sometimes defined in similar, yet different ways. The section also looks at the difficulty of comparing machine and human intelligence, and the potential risks of AI systems, such as AI-enabled disinformation campaigns and mass surveillance by governments. It also looks at the incentives for developing powerful AI, and the potential for it to lead to positive developments. Finally, the section looks at the early warnings of Alan Turing and Norbert Wiener about the alignment problem, and Toby Ord's projection that AI could be developed by 2040.
111 |
112 | ai-impact.HowcanwemakesurethatthedevelopmentofAIgoeswell.summary.txt
113 |
114 | Making sure that the development of artificial intelligence (AI) goes well is a crucial question for humanity. Currently, resources dedicated to AI are mostly focused on speeding up its development, while efforts to increase its safety are under-resourced. This neglect of AI safety work means that individuals have a good chance to make a positive difference if they dedicate themselves to this problem. However, it needs more than individual efforts; society needs to become knowledgeable about the technology and understand what is at stake. Our World in Data is doing its part to enable a better informed public conversation on AI and the future we want to live in.
115 |
116 | ai-impact.Reusethisworkfreely.summary.txt
117 |
118 | This section provides information about the licenses and permissions associated with Our World in Data's visualizations, data, code, and articles. All of Our World in Data's work is open access under the Creative Commons BY license, and all software and code is open source under the MIT license. Data produced by third parties is subject to the license terms from the original third-party authors. Additionally, Our World in Data's charts can be embedded in any site, and the project is a part of the Global Change Data Lab, a registered charity in England and Wales. A full legal disclaimer is also provided.
119 |
120 | ai-impact.TitleAbstract.summary.txt
121 |
122 | This section discusses the potential implications of artificial intelligence (AI) becoming a reality. It explains why it is difficult to take the prospect of a world transformed by AI seriously, and how to develop an idea of what the future of AI might look like. It also looks at the advantages and disadvantages of comparing machine and human intelligence, and introduces the concept of transformative AI, which is defined by the impact this technology would have on the world. It compares the potential of transformative AI to the agricultural and industrial revolutions, and suggests that it could represent the introduction of a similarly significant general-purpose technology.
123 |
124 | ai-impact.Whatisatstakeasartificialintelligencebecomesmorepowerful.summary.txt
125 |
126 | This section discusses the potential risks and benefits of artificial intelligence (AI) becoming more powerful. It is clear that AI can already cause harm when used maliciously, such as in politically-motivated disinformation campaigns or to enable mass surveillance. AI can also cause unintended harm, such as when an AI system falsely accused 26,000 parents of making fraudulent claims for child care benefits in the Netherlands. As AI becomes more powerful, the potential negative impacts could become much larger, such as mass labor displacement, extreme concentrations of power and wealth, and totalitarianism. Additionally, there is the risk of an AI system escaping human control and harming humans, known as the alignment problem. This risk is difficult to foresee and prevent, and could lead to an extreme catastrophe. On the other hand, AI could lead to positive developments such as cleaner energy, the replacement of unpleasant work, and better healthcare. The stakes are high with this technology, and reducing the negative risks and solving the alignment problem could mean the difference between a healthy, flourishing, and wealthy future for humanity – and the destruction of the same.
127 |
128 | ### Summary of NEJM Open Source AID paper
129 |
130 | ```
131 | ~/src/gpt-summarizer $ ./summarize.py examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.pdf
132 | Text extracted from examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.pdf and written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.full.txt
133 | Total token count: 23722
134 | Header: Title-Abstract
135 | Title-Abstract. Section intro (4545 characters, 1502 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintro.full.txt
136 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintro.summary.txt
137 | Title-Abstract. Section intro-part2 (4111 characters, 1133 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.full.txt
138 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.summary.txt
139 | Title-Abstract. Section intro-part3 (5247 characters, 1534 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart3.full.txt
140 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart3.summary.txt
141 | Title-Abstract. Section intro-part4 (6224 characters, 1969 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart4.full.txt
142 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart4.summary.txt
143 | Title-Abstract. Section intro-part5 (4477 characters, 1704 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.full.txt
144 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.summary.txt
145 | Title-Abstract. Section intro-part6 (3400 characters, 1181 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.full.txt
146 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.summary.txt
147 | Title-Abstract. Section intro-part7 (2354 characters, 1334 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.full.txt
148 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.summary.txt
149 | Title-Abstract. Section intro-part8 (1150 characters, 1110 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart8.full.txt
150 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart8.summary.txt
151 | Title-Abstract. Section intro-part9 (1898 characters, 1843 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart9.full.txt
152 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart9.summary.txt
153 | Title-Abstract. Section intro-part10 (1436 characters, 1317 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart10.full.txt
154 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart10.summary.txt
155 | Title-Abstract. Section intro-part11 (1894 characters, 1839 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart11.full.txt
156 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart11.summary.txt
157 | Title-Abstract. Section intro-part12 (677 characters, 634 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart12.full.txt
158 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart12.summary.txt
159 | Title-Abstract. Section intro-part13 (2072 characters, 1857 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart13.full.txt
160 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart13.summary.txt
161 | Title-Abstract. Section intro-part14 (4243 characters, 1645 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.full.txt
162 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.summary.txt
163 | Title-Abstract. Section intro-part15 (4297 characters, 1382 tokens) written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.full.txt
164 | Summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.summary.txt
165 | No summary files found for section TitleAbstractSectionintropart15
166 | No abstract found for examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy
167 | Concatenated 0 summaries into a single summary with 2 characters and 1 tokens
168 | Concatenated subsection summaries have less than 500 tokens, reading in all summaries
169 | Overall summary written to examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.overall_summary.txt
170 | ```
171 |
172 | #### NEJM AID Overall Summary
173 |
174 | This paper describes the results of a clinical trial that tested the efficacy of an automated insulin delivery (AID) system in patients with type 1 diabetes. A total of 100 patients were enrolled, 97 of whom (48 children and 49 adults) underwent randomization to either the AID group (44 patients) or the control group (53 patients). The characteristics of the patients at baseline were similar in the two trial groups. The primary analysis showed that the mean time in range increased from 61.2% at baseline to 71.2% in the AID group and decreased from 57.7% to 54.5% in the control group. Among the children, the mean time in range increased from 57.4% at baseline to 67.5% in the AID group and decreased from 55.1% to 52.5% in the control group. During a 24-hour period, the percentage of time that patients had a glucose reading of less than 70 mg per deciliter was 2.1% in the AID group and 2.7% in the control group. The use of AID was most effective at night, when the mean time in range was 76.8% in the AID group and 57.2% in the control group. Among the adults, the mean time in range increased from 64.7% at baseline to 74.5% in the AID group and decreased from 61.2% to 58.2% in the control group. The trial also found that the AID system was safe and had a high level of patient retention. The results indicate that the AID group had a higher percentage of time in the target glucose range than the control group, and that the group differences are partly attributable to a decrease in the percentage of time in range in the control group after the run-in period.
175 |
176 | #### NEJM AID Section Summaries
177 | `ls -rt examples/NEJM*summary.txt | while read file; do echo -n $file; cat $file; echo; echo; done`
178 |
179 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintro.summary.txt
180 |
181 | Section has no content.
182 |
183 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart2.summary.txt
184 |
185 | This section discusses two widely used open-source AID systems, AndroidAPS and Loop, and the barriers to their uptake. It also introduces the CREATE (Community Derived Automated Insulin Delivery) trial, which was conducted at four sites in New Zealand to evaluate the efficacy and safety of an open-source AID system compared to sensor-augmented insulin-pump therapy in children and adults with type 1 diabetes. The trial was approved by the Southern Health and Disability Ethics Committee of New Zealand and funded by the Health Research Council of New Zealand. Hardware support was provided by SOOIL Development, Dexcom, and Vodafone New Zealand. The trial protocol has been published previously and an independent data and safety monitoring committee and medical monitor provided trial oversight. Eligible patients were between the ages of 7 and 70 years, had received a diagnosis of type 1 diabetes at least 1 year earlier, had at least 6 months of experience with insulin-pump therapy, and had a mean glycated hemoglobin level of less than 10.5%. Patients in the two trial groups were invited to join separate closed online communities that provided ongoing peer support.
186 |
187 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart3.summary.txt
188 |
189 | This section describes the trial design for a study on Automated Insulin Delivery in Type 1 Diabetes. The study included a 4-week run-in phase, during which patients became familiar with the trial devices functioning as sensor-augmented insulin-pump therapy. Patients were then randomly assigned in a 1:1 ratio to the AID group or the control group. The AID group used an open-source system, which was a modified version of AndroidAPS paired with a preproduction DANA-i insulin pump and Dexcom G6 CGM. The primary outcome was percentage of time in the target glucose range of 70 to 180 mg per deciliter between day 155 and day 168. Secondary outcomes included metrics for continuous glucose monitoring, glycated hemoglobin level, and performance of the AID system. Adverse events that were evaluated included adverse device effects, serious adverse events, and serious adverse device effects. At approximately 3 months into the trial, a battery problem in a preproduction DANA-i insulin pump was identified. Patients in the control group had the option of returning to their usual insulin pump, and those in the AID group used refurbished preproduction DANA-i insulin pumps. The study had 90% power with a two-sided alpha of 0.05 to reject the null hypothesis of no between-group difference in the time in range.
190 |
191 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart4.summary.txt
192 |
193 | This section describes the data capture and management processes, data cleaning and analyses, and primary and secondary outcomes of a clinical trial that tested the efficacy of an automated insulin delivery (AID) system in patients with type 1 diabetes. A total of 100 patients were enrolled, 97 of whom (48 children and 49 adults) underwent randomization to either the AID group (44 patients) or the control group (53 patients). The characteristics of the patients at baseline were similar in the two trial groups. The final patient completed the trial in November 2021. In the primary analysis, the mean time in range increased from 61.2% at baseline to 71.2% in the AID group and decreased from 57.7% to 54.5% in the control group. Among the children, the mean time in range increased from 57.4% at baseline to 67.5% in the AID group and decreased from 55.1% to 52.5% in the control group. During a 24-hour period, the percentage of time that patients had a glucose reading of less than 70 mg per deciliter was 2.1% in the AID group and 2.7% in the control group. The use of AID was most effective at night, when the mean time in range was 76.8% in the AID group and 57.2% in the control group. Among the adults, the mean time in range increased from 64.7% at baseline to 74.5% in the AID group and decreased from 61.2% to 58.2% in the control group.
194 |
195 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart5.summary.txt
196 |
197 | This section provides information on the safety outcomes and system performance of a trial that tested the use of an automated insulin delivery (AID) system in adults and children with type 1 diabetes. The AID system was found to be most effective at night, when the time in range was 85.2±12.7% in the AID group, compared to 70.9±12.7% during the day. In the control group, the mean time in range at night (53.5±20.1%) was similar to that during the day (57.5±14.4%). Neither severe hypoglycemia nor diabetic ketoacidosis occurred in either trial group, and no adverse events were related to the algorithm or automation of insulin delivery. Ten adverse events that were related to a device (nonserious adverse device effects) were reported among 8 patients in the AID group, and 8 events were reported among 8 patients in the control group. Two serious adverse events occurred in the AID group, and 5 serious adverse events occurred in the control group. The median percentage of time that the system was automating insulin delivery was 94.2% (IQR, 87.3 to 95.7) in the AID group.
198 |
199 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart6.summary.txt
200 |
201 | This section provides a comparison of the characteristics of patients in the Automated Insulin Delivery (AID) group and the control group in the CREATE trial. The characteristics include the quintile of the New Zealand Deprivation Index, diabetes history, glycated hemoglobin, previous use of continuous glucose monitoring (CGM) and automated insulin delivery, and time in target glucose range. The AID group had a mean percent glycated hemoglobin of 7.6 mmol/mol, 15 patients (65%) had previously used CGM, and 4 patients (17%) had previously used automated insulin delivery. The control group had a mean percent glycated hemoglobin of 7.8 mmol/mol, 17 patients (65%) had previously used CGM, and 5 patients (19%) had previously used automated insulin delivery. The time in target glucose range was 64.7±12.9% for the AID group and 60.3±15.6% for the control group. The section also provides information on device deficiencies, which were more common in the AID group (46 events) than in the control group (39 events).
202 |
203 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart7.summary.txt
204 |
205 | This section discusses the findings of a trial that evaluated the effect of an artificial intelligence-based (AID) therapy on glycemic control. The results showed that the AID therapy improved glycemic control, with the greatest improvement seen overnight. Adults had a higher percentage of time in the target range than children, possibly due to differences in glycemic variability, likelihood of administration of an insulin bolus before a meal, activity level, and dietary factors. The absolute differences in the percentage of time in range between the trial groups were similar to between-group differences for commercially available AID systems. The results showed that patients with the lowest baseline time in the target range gained the most from the use of AID.
206 |
207 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart8.summary.txt
208 | Section has no content.
209 |
210 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart9.summary.txt
211 |
212 | Section has no content.
213 |
214 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart10.summary.txt
215 |
216 | Section has no content.
217 |
218 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart11.summary.txt
219 | Section has no content.
220 |
221 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart12.summary.txt
222 |
223 | Section has no content.
224 |
225 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart13.summary.txt
226 |
227 | Section has no content.
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229 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart14.summary.txt
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231 | This section describes the results of a trial comparing the use of open-source automated insulin delivery (AID) and sensor-augmented insulin-pump therapy (control group) in children (7 to 15 years of age) and adults (16 to 70 years of age). The results are presented in two figures, which show the percentage of time that patients were in the target glucose range (70 to 180 mg per deciliter [3.9 to 10.0 mmol per liter]) during contiguous 4-week periods from 4 weeks before randomization to 24 weeks after randomization. The results indicate that the AID group had a higher percentage of time in the target glucose range than the control group, and that the group differences are partly attributable to a decrease in the percentage of time in range in the control group after the run-in period. The trial also had a high level of patient retention, a lack of remote monitoring, and broad inclusion criteria, which resulted in a population of diverse ages and ethnic backgrounds.
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233 | examples/NEJM-OpenSourceAID-DanaMLewis-AuthorCopy.TitleAbstractSectionintropart15.summary.txt
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235 | This section provides information about the limitations of the trial and the generalizability of the findings. It was noted that the control group did not have an automated system for predicting low-glucose levels or suspending insulin administration, which have been shown to reduce the incidence of hypoglycemia. The trial patients were more diverse than those enrolled in previous studies, but the generalizability of the findings may be limited by the enrollment of patients with a relatively low glycated hemoglobin level at baseline, by the underrepresentation of patients with reduced economic resources, and by the increased familiarity with insulin-pump therapy and continuous glucose monitoring among the patients at baseline. In addition, a variety of insulin pumps were used in the control group, although the stable time in the target range throughout the trial suggests that this factor had a minimal effect. The section also provides information about the study's funding and disclosure forms.
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