If you are a blind child in India, you will very likely have to contend with at least two big pieces of bad news. The first bad news is that the chances of getting treatment are extremely slim to none, and that's because most of the blindness alleviation programs in the country are focused on adults, and there are very, very few hospitals that are actually equipped to treat children. In fact, if you were to be treated, you might well end up being treated by a person who has no medical credentials as this case from Rajasthan illustrates. This is a three-year-old orphan girl who had cataracts. So, her caretakers took her to the village medicine man, and instead of suggesting to the caretakers that the girl be taken to a hospital, the person decided to burn her abdomen with red-hot iron bars to drive out the demons. The second piece of bad news will be delivered to you by neuroscientists, who will tell you that if you are older than four or five years of age, that even if you have your eye corrected, the chances of your brain learning how to see are very, very slim -- again, slim or none.
如果您是在印度的盲童, 您將很有可能必須面臨 至少兩個重大的壞消息。 第一個壞消息是 得到治療的機會 幾乎渺茫至零, 這是因為在這國家大多數的 盲人扶助專案 都只關注成人, 而只有非常非常少的醫院 真正有能力治療病童。 事實上,如果您接受治療, 您可能最後是被 沒有醫療證書的人員治療 就像拉賈斯坦所揭發的這個實例。 這個三歲大孤女 患了白內障。 所以她的看護帶她 到村醫那兒, 然而村醫卻不是建議看護 帶小女孩去正規醫院, 相反地那人決定用燒紅的鐵棒 炙燙小女孩的腹部 以驅逐惡靈。 接下來第二個壞消息 是從神經學家得來, 他將告訴您 如果您的年紀超過四或五歲 即使您接受視力矯正 您大腦學習如何解析所見的機會 也十分十分地渺茫 再一次地,渺茫或零。
So when I heard these two things, it troubled me deeply, both because of personal reasons and scientific reasons. So let me first start with the personal reason. It'll sound corny, but it's sincere. That's my son, Darius. As a new father, I have a qualitatively different sense of just how delicate babies are, what our obligations are towards them and how much love we can feel towards a child. I would move heaven and earth in order to get treatment for Darius, and for me to be told that there might be other Dariuses who are not getting treatment, that's just viscerally wrong. So that's the personal reason.
所以當我知道這兩件事情 我同時因為個人 以及科學因素 深深感到困擾。 讓我從個人因素開始說起吧 這聽起來像陳腔濫調,但是由衷的。 這是我兒子,Darius。 身為一個新手父親, 對於寶寶有多脆弱 我們對他們有多少義務 還有我們能感覺到對一個孩子 有多麼深的愛 有截然不同而美好的感受 我可能會為了治療Darius 在天堂和現實間穿梭。 對我而言,被告知 別的地方還有更多像Darius這樣的孩子 並沒有得到治療 這直覺地就是個錯誤。 以上是我的個人因素。
Scientific reason is that this notion from neuroscience of critical periods -- that if the brain is older than four or five years of age, it loses its ability to learn -- that doesn't sit well with me, because I don't think that idea has been tested adequately. The birth of the idea is from David Hubel and Torsten Wiesel's work, two researchers who were at Harvard, and they got the Nobel Prize in 1981 for their studies of visual physiology, which are remarkably beautiful studies, but I believe some of their work has been extrapolated into the human domain prematurely. So, they did their work with kittens, with different kinds of deprivation regiments, and those studies, which date back to the '60s, are now being applied to human children.
科學方面 神經科學有個關鍵時期之說 也就是,如果大腦年齡大於 四歲或五歲, 大腦就喪失學習能力這個觀點。 這無法說服我, 因為我不認為這想法 被充分地驗證過。 這想法是從 David Hube和Torsten Wiesel的研究成果孕育而來, 這兩位科學家曾在哈佛任職 並且在1981年因為他們視覺生理學 的研究得到諾貝爾獎, 那的確是傑出而漂亮的研究, 但我相信其中的一部分成果 已被貿然地 用於人類領域 他們用不同治療剝奪 的小貓群組進行實驗 而這些可追溯到 六零年代的研究 現今被套用於人類孩子上。
So I felt that I needed to do two things. One: provide care to children who are currently being deprived of treatment. That's the humanitarian mission. And the scientific mission would be to test the limits of visual plasticity. And these two missions, as you can tell, thread together perfectly. One adds to the other; in fact, one would be impossible without the other. So, to implement these twin missions, a few years ago, I launched Project Prakash. Prakash, as many of you know, is the Sanskrit word for light, and the idea is that in bringing light into the lives of children, we also have a chance of shedding light on some of the deepest mysteries of neuroscience. And the logo -- even though it looks extremely Irish, it's actually derived from the Indian symbol of Diya, an earthen lamp. The Prakash, the overall effort has three components: outreach, to identify children in need of care; medical treatment; and in subsequent study. And I want to show you a short video clip that illustrates the first two components of this work.
所以我覺得我需要做兩件事。 一是提供 目前被剝奪治療的孩子 醫療照護。 這是基於人道主義的使命。 而科學的使命則是 試探視覺可塑性 的極限 你可以看出,這兩個任務 完美地結合在一起,相輔相成。 事實上是缺一不可。 為了執行 這個雙生任務, 幾年前我開始了Prakash計畫 Prakash,也許你們很多人都知道, 是梵文中光的總稱 我們的理念亦是如此 將光明引入孩子們的生命中, 同時也有 一窺某些 神經科學奧秘的機會 再看看這標誌,雖然它看起來很像幸運草 事實上它是源自 一種印度陶燈 Diya 的象徵 Prakash整體工作內容 包含三個部分, 宣傳理念、定義病童是否需要照護、醫藥治療, 以及後續追蹤研究。 我想要在此分享一段節錄短片 來說明前兩個部份的工作。
This is an outreach station conducted at a school for the blind.
這是一個由為盲童設立的學校 的宣傳站。
(Text: Most of the children are profoundly and permanently blind ...)
(字幕: 大多數的孩童嚴重且永久地失明...
Pawan Sinha: So, because this is a school for the blind, many children have permanent conditions. That's a case of microphthalmos, which is malformed eyes, and that's a permanent condition; it cannot be treated. That's an extreme of micropthalmos called enophthalmos. But, every so often, we come across children who show some residual vision, and that is a very good sign that the condition might actually be treatable. So, after that screening, we bring the children to the hospital. That's the hospital we're working with in Delhi, the Schroff Charity Eye Hospital. It has a very well-equipped pediatric ophthalmic center, which was made possible in part by a gift from the Ronald McDonald charity. So, eating burgers actually helps.
Pawan Sinha: 因為這是間為盲人而辦的學校, 許多盲童是永久地失明。 這是一個小眼症的例子 也就是有畸形的眼睛, 並且是永久性的。 它沒有辦法被治癒。 這和極端的小眼症 稱為眼球陷沒。 但偶爾,我們遇見有 殘存視力的孩童 這是很好的徵兆 顯示病情實際上可能是可治療的。 於是經過篩檢,我們帶這些病童到醫院去。 這是我們在德里工作的醫院, 修福慈善眼科醫院 裏頭有非常裝備完善的 小兒眼科中心, 這得以實現有部分 來自麥當勞叔叔慈善基金的贈與。 所以吃漢堡的確可助一臂之力。
(Text: Such examinations allow us to improve eye-health in many children, and ... ... help us find children who can participate in Project Prakash.)
(字幕: 這樣的檢查允許我們增進 許多孩童的眼睛健康,並且 幫助我們找到可參與Prakash計畫的孩子。)
PS: So, as I zoom in to the eyes of this child, you will see the cause of his blindness. The whites that you see in the middle of his pupils are congenital cataracts, so opacities of the lens. In our eyes, the lens is clear, but in this child, the lens has become opaque, and therefore he can't see the world. So, the child is given treatment. You'll see shots of the eye. Here's the eye with the opaque lens, the opaque lens extracted and an acrylic lens inserted. And here's the same child three weeks post-operation, with the right eye open.
補充一下,當我放大這個孩子眼睛的影像, 你將可以看到他失明的原因。 你看到在瞳孔中間白色部分 是先天性的白內障, 所以水晶體是不透明的。 我們的眼睛水晶體則是透明的。 但是這個孩子的水晶體已經變得不透光, 因此他沒有辦法看見這世界。 所以這孩子接受治療。你所看到的是眼球置換手術。 這是有不透明水晶體的眼球, 不透明的水晶體被吸取出 然後置入丙烯酸人工水晶體。 這是剛剛那孩子 在接受手術後三個星期, 使用右眼的情形。
(Applause)
(鼓掌)
Thank you.
謝謝大家。
So, even from that little clip, you can begin to get the sense that recovery is possible, and we have now provided treatment to over 200 children, and the story repeats itself. After treatment, the child gains significant functionality. In fact, the story holds true even if you have a person who got sight after several years of deprivation. We did a paper a few years ago about this woman that you see on the right, SRD, and she got her sight late in life, and her vision is remarkable at this age. I should add a tragic postscript to this -- she died two years ago in a bus accident. So, hers is just a truly inspiring story -- unknown, but inspiring story. So when we started finding these results, as you might imagine, it created quite a bit of stir in the scientific and the popular press. Here's an article in Nature that profiled this work, and another one in Time. So, we were fairly convinced -- we are convinced -- that recovery is feasible, despite extended visual deprivation.
所以,即使從這小片段,你也能開始感覺到 治癒是可能的, 而我們已經 對超過兩百位孩童施予治療 而成功復明故事不斷重演。 經過治療,孩子 得到重要的視覺官能。 事實上,這情節即使對你知道的 某個被剝奪視力多年的人 也同樣為真。 我們幾年前撰寫了一篇報導 是有關你看到在右邊,得了SRD(漿液性網膜剝離)的女人, 她在晚年復明, 而且在這年紀她的視力是相當好的。 我在這故事末加個悲劇附錄。 她兩年前因為一場巴士意外 而去世了。 她的故事正是非常激勵人心的, 不為人知,但激勵人心的故事。 當我們開始發掘這些成果, 就像你想像的,它在科學以及普及的 出版物造成旋風。 這是在自然期刊側寫這工作 的一篇文章, 另一篇則是在時代雜誌。 我們非常確信,我們確信 儘管長久地失去視力。 復明是可能的。
The next obvious question to ask: What is the process of recovery? So, the way we study that is, let's say we find a child who has light sensitivity. The child is provided treatment, and I want to stress that the treatment is completely unconditional; there is no quid pro quo. We treat many more children then we actually work with. Every child who needs treatment is treated. After treatment, about every week, we run the child on a battery of simple visual tests in order to see how their visual skills are coming on line. And we try to do this for as long as possible. This arc of development gives us unprecedented and extremely valuable information about how the scaffolding of vision gets set up. What might be the causal connections between the early developing skills and the later developing ones?
下一個要問且顯而易見的問題是: 痊癒的過程如何發生? 所以,我們研究的方法是, 假設我們找到一個對光線有反應的孩子 提供他治療, 我要強調這治療 是完全無條件的。 是無償的。 我們治療的孩童比參與計畫的更多。 每個需要醫療的孩子都被治療。 治療後,約每個星期一次, 我們讓孩童 接受簡單視覺測試 以了解他們看的技能 是否如預期恢復。 我們試著盡可能長時間追蹤。 這些發展曲線, 給了我們有關 如何建構視覺 不同以往且十分有價值 的資訊 早期發展的視覺技能和 較晚發展的兩者之間的 因果關聯為何?
And we've used this general approach to study many different visual proficiencies, but I want to highlight one particular one, and that is image parsing into objects. So, any image of the kind that you see on the left, be it a real image or a synthetic image, it's made up of little regions that you see in the middle column, regions of different colors, different luminances. The brain has this complex task of putting together, integrating, subsets of these regions into something that's more meaningful, into what we would consider to be objects, as you see on the right. And nobody knows how this integration happens, and that's the question we asked with Project Prakash.
我們已經用這套公認的研究方法來研究 許多不同的視覺熟練程度, 但我想要強調其中特別的一項, 那就是將圖像解析為物體的技能。 在這兒,左邊任何一種你所見的圖, 是真實影像還是合成的? 這是由中間 那張有不同顏色、不同照度 的區域合併起來做成的。 大腦的複雜任務包括 組合、整合, 將這些區域統整 成為更有意義的某樣物品, 是我們認知的實物, 就像右邊你所看到的那樣。 而沒有人知道這些整合工作如何發生。 這就是我們在Prakash計畫中所問的問題。
So, here's what happens very soon after the onset of sight. Here's a person who had gained sight just a couple of weeks ago, and you see Ethan Myers, a graduate student from MIT, running the experiment with him. His visual-motor coordination is quite poor, but you get a general sense of what are the regions that he's trying to trace out. If you show him real world images, if you show others like him real world images, they are unable to recognize most of the objects because the world to them is over-fragmented; it's made up of a collage, a patchwork, of regions of different colors and luminances. And that's what's indicated in the green outlines. When you ask them, "Even if you can't name the objects, just point to where the objects are," these are the regions that they point to. So the world is this complex patchwork of regions. Even the shadow on the ball becomes its own object. Interestingly enough, you give them a few months, and this is what happens.
這就是發生歷程 一旦開始建構視覺便變化快速。 這個人他才在兩個星期前恢復視力, 再看到Ethan Myers,來自麻省理工的大學生, 正在和他一起做實驗。 他的視覺運動協調十分地差, 但你大約可知 他正試著描繪的區域為何 如果向他展示真實世界的影像 如果你向其他跟這個人相似的病友展示真實世界的影像, 他們不能辨識出大部分的物體 因為這樣的世界對他們來說太支離破碎。 他們所見是由不同顏色、照明的 小區塊拼貼、補綴而成 而這就是綠色輪廓所表示的東西。 當你要求他們, 即使他們不能說出物體的名字,僅僅指出在哪裡就好, 這些就是他們所指的地方。 所以世界是如此複雜的 區塊拼貼。 即使是球上面的陰影 也是一個獨立的物件。 非常有趣的是, 你給他們幾個月的時間, 這就是後來所發生的事。
Doctor: How many are these?
醫生:這裡有多少個?
Patient: These are two things.
病人:這裡有兩個東西。
Doctor: What are their shapes?
醫生:他們的形狀是?
Patient: Their shapes ... This one is a circle, and this is a square.
病人:他們的形狀... 這個是圓的, 這個嘛 是方的。
PS: A very dramatic transformation has come about. And the question is: What underlies this transformation? It's a profound question, and what's even more amazing is how simple the answer is. The answer lies in motion and that's what I want to show you in the next clip.
附註:非常戲劇化的轉變已經發生。 而問題是: 這轉變是根據什麼? 這是個深奧的問題, 而令人驚訝的是答案有 多麼地簡單。 答案就是移動 這也是我想要在下個影片中呈現給大家的。
Doctor: What shape do you see here?
醫生: 你在這兒看到的是什麼形狀?
Patient: I can't make it out.
病患: 我無法回答這個問題。
Doctor: Now?
醫生: 現在呢?
Patient: Triangle.
病患: 三角形。
Doctor: How many things are these? Now, how many things are these?
醫生: 這裡有多少東西? 現在,這裡有多少東西?
Patient: Two.
病患: 兩個。
Doctor: What are these things?
醫生: 這些東西是什麼呢?
Patient: A square and a circle.
病患: 一個方塊跟一個圓。
PS: And we see this pattern over and over again. The one thing the visual system needs in order to begin parsing the world is dynamic information. So the inference we are deriving from this, and several such experiments, is that dynamic information processing, or motion processing, serves as the bedrock for building the rest of the complexity of visual processing; it leads to visual integration and eventually to recognition.
附帶說明,我們看到這個模式不斷重複。 視覺系統所需 解析世界的要件就是 動態資訊。 從這結果和多次這類的實驗 我們推論, 動態資訊的處理 或動作資訊處裡, 就像是建立後續複雜的 視覺處理流程的基石。 它成就了視覺整合 以及最終的辨認能力。
This simple idea has far reaching implications. And let me just quickly mention two, one, drawing from the domain of engineering, and one from the clinic. So, from the perspective of engineering, we can ask: Goven that we know that motion is so important for the human visual system, can we use this as a recipe for constructing machine-based vision systems that can learn on their own, that don't need to be programmed by a human programmer? And that's what we're trying to do.
這簡單的概念在科學研究上有深遠的含意。 讓我快速地簡介其中兩個。 一是從工程上來說, 另一個是臨床上的意義。 從工程的透視法, 我們能問,我們已知 動作對人類的視覺系統是如此重要, 我們可以利用這結果建立 不需要程式設計師 設計程式就可以自我學習的 機械視覺系統嗎? 這就是我們正試著達成的。
I'm at MIT, at MIT you need to apply whatever basic knowledge you gain. So we are creating Dylan, which is a computational system with an ambitious goal of taking in visual inputs of the same kind that a human child would receive, and autonomously discovering: What are the objects in this visual input? So, don't worry about the internals of Dylan. Here, I'm just going to talk about how we test Dylan. The way we test Dylan is by giving it inputs, as I said, of the same kind that a baby, or a child in Project Prakash would get. But for a long time we couldn't quite figure out: Wow can we get these kinds of video inputs? So, I thought, could we have Darius serve as our babycam carrier, and that way get the inputs that we feed into Dylan? So that's what we did. (Laughter) I had to have long conversations with my wife. (Laughter) In fact, Pam, if you're watching this, please forgive me.
我在麻省理工,在那兒你需要運用 任何你得到的基礎知識。 所以我們創造了Dylan 它是套有遠大目標 的運算系統 可以接收的和一個人類孩童 相同的視覺輸入後, 自主地發現 這些視覺輸入有什麼東西。 不用擔心Dylan裡面有什麼。 在這裡我只想簡單提到 我們如何測試Dylan。 我們測試它的方式是利用 給它輸入,像我先前說的,跟一個孩童, 或是Prakash計畫中的孩子會得到的一樣。 但是長久以來我們無法真正知道 我們如何能的到這樣的視訊輸入。 所以,我就想, 我們是否能使Darius 像我們的嬰兒攝影機攜帶者, 使我們得以將視訊輸入至Dylan。 這就是我們的方法。 (眾笑) 我必須跟我妻子談很久。 (眾笑) 事實上,Pam,如果你正看著, 請原諒我。
So, we modified the optics of the camera in order to mimic the baby's visual acuity. As some of you might know, babyies are born pretty much legally blind. Their acuity -- our acuity is 20/20; babies' acuity is like 20/800, so they are looking at the world in a very, very blurry fashion. Here's what a baby-cam video looks like.
為了更生動模擬寶寶的視力 我們修改了攝影機的光學元件。 也許你們有些人知道, 寶寶剛出生的時候幾乎是看不見的。 寶寶看20英尺外的東西, 就像正常視力在800英尺看見的。 所以他們是非常非常模糊地 看著這個世界。 這就是嬰兒攝影機所見的影像。
(Laughter) (Applause)
(眾大笑) (鼓掌)
Thankfully, there isn't any audio to go with this. What's amazing is that working with such highly degraded input, the baby, very quickly, is able to discover meaning in such input. But then two or three days afterward, babies begin to pay attention to their mother's or their father's face. How does that happen? We want Dylan to be able to do that, and using this mantra of motion, Dylan actually can do that. So, given that kind of video input, with just about six or seven minutes worth of video, Dylan can begin to extract patterns that include faces. So, it's an important demonstration of the power of motion.
謝天謝地,這段影片 沒有任何聲音。 令人驚訝的是,即使是這麼 高度劣化的影像輸入, 寶寶還是可以很快地 知道影像的意義。 經過兩三天, 寶寶開始把注意力放在 他們的爸爸或媽媽臉上。 這是如何發生的? 我們希望Dylan可以做到這樣。 利用移動的奧秘, 事實上Dylan可以做到, 即使是那麼糟糕的影像輸入。 大概只有六或七分鐘可用的影片, Dylan可以開始取得 包含臉部的圖樣。 所以這是重要效果 的重要展示。
The clinical implication, it comes from the domain of autism. Visual integration has been associated with autism by several researchers. When we saw that, we asked: Could the impairment in visual integration be the manifestation of something underneath, of dynamic information processing deficiencies in autism? Because, if that hypothesis were to be true, it would have massive repercussions in our understanding of what's causing the many different aspects of the autism phenotype.
臨床應用上,要從自閉症開始說起。 視覺整合已經被好幾位研究學者證實 和自閉症有關。 當我們知道這結果,我們問: 是否動態資訊處理缺損 就是視覺整合損傷 造成的自閉症的背後肇因 因為,若是這個假說成立, 這將對我們了解 是什麼使得自閉症有不同方面的外顯特徵 有重要的回饋。
What you're going to see are video clips of two children -- one neurotypical, one with autism, playing Pong. So, while the child is playing Pong, we are tracking where they're looking. In red are the eye movement traces. This is the neurotypical child, and what you see is that the child is able to make cues of the dynamic information to predict where the ball is going to go. Even before the ball gets to a place, the child is already looking there. Contrast this with a child with autism playing the same game. Instead of anticipating, the child always follows where the ball has been. The efficiency of the use of dynamic information seems to be significantly compromised in autism. So we are pursuing this line of work and hopefully we'll have more results to report soon.
接下來的一段短片是 兩個孩子在玩乒乓球,一個非自閉症, 另一個有自閉症。 當孩子在玩壁球的時候,我們追蹤他們看著哪兒。 紅色的就是眼球移動的紀錄, 這是非自閉症孩子的,而你所看見的是 這個孩子可以利用 動態資訊給的暗示 預測球會往那兒跑。 即使在球到達之前, 這孩子已經看著那邊。 對照另一個玩著相同遊戲的 自閉症孩子。 這個孩子的視線總是 跟著球到過的地方跑而非預測它。 自閉症患者利用 動態資訊的效率 似乎明顯地被抑制。 所以我們持續進行這工作 並且希望我們將很快有 更多結果可以報導。
Looking ahead, if you think of this disk as representing all of the children we've treated so far, this is the magnitude of the problem. The red dots are the children we have not treated. So, there are many, many more children who need to be treated, and in order to expand the scope of the project, we are planning on launching The Prakash Center for Children, which will have a dedicated pediatric hospital, a school for the children we are treating and also a cutting-edge research facility. The Prakash Center will integrate health care, education and research in a way that truly creates the whole to be greater than the sum of the parts.
未來,如果你把這圓盤看作 我們目前為止 治療過的孩子們的數量, 這就是問題的嚴重程度。 這些紅點表示孩子我們尚未能治療的孩子。 所以,世界上還有更多的孩子需要治療, 為了拓展這個計畫所及的區域, 我們正計畫創建 Prakash孩童中心, 它將有專門的小兒科醫院, 一所為治療中的病童設立的學校, 以及尖端研究設施。 Prakash中心將真正地 創造一個真正整合健康照護、 教育以及研究為一體 比單純結合各部分更出色的機構。
So, to summarize: Prakash, in its five years of existence, it's had an impact in multiple areas, ranging from basic neuroscience plasticity and learning in the brain, to clinically relevant hypotheses like in autism, the development of autonomous machine vision systems, education of the undergraduate and graduate students, and most importantly in the alleviation of childhood blindness. And for my students and I, it's been just a phenomenal experience because we have gotten to do interesting research, while at the same time helping the many children that we have worked with.
在此,我做個小結,Prakash,在過去五年裡, 已經對許多領域造成衝擊, 範圍從基礎的神經科學裡 大腦的學習力及可塑性, 到臨床相關的理論,如自閉症, 還有自主性機器視覺系統的發展, 大學生及研究生們的教育, 最重要的,是減少了 盲童的數目。 而對我和我的學生來說,這計畫已是 非比尋常的經驗, 因為我們做著有趣的研究, 同時也幫助 許多參與實驗的孩子們。
Thank you very much.
非常感謝大家
(Applause)
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