Da Ciao 2001 a Vice Magazine

Da quando avevo 10-11 anni e per buona parte della mia vita, il mio soprannome è stato Vice, o Il Vice.  Viene dal mio cognome, Viceconti, ma è un bel soprannome, carico di significati secondari.  A un certo punto persino molti dei miei famigliari mi chiamavano Vice. L’ho dismesso quando sono andato a vivere in Inghilterra, dove il primo significato per la parola “Vice” è vizio, e come soprannome non mi sembrava carino, ma gli amici storici lo usano tutt’ora.

Vi racconto questo perché alcuni mesi fa ho scoperto Vice Magazine, una rivista in lingue inglese di controcultura giovanile pubblicata a partire dagli anni 90. Trovate la sua storia in questa pagina di Wikipedia.  Nel 1994, quando Vice Magazine nacque, nacque anche mia figlia, ed io non avevo certo il tempo o l’interesse di leggere riviste di controcultura.  La cosa mi è tornata in mente oggi quando un amico mi ha mandato il link ad un articolo intitolato “Si stava meglio quando c’era Vice”, che parla appunto della rivista, ma visto il mio percorso di pensionamento, gli si può dare anche un altro significato.

Leggere di Vice Magazine mi ha fatto ricordare il ruolo fondamentale che alcune riviste hanno avuto nella mia formazione: Ciao 2001, Il Male, e Frigidaire.  

Non ricordo quando ho iniziato a leggere Ciao 2001, ma direi attorno al 1975. In quegli anni Ciao 2011 era l’unica rivista con distribuzione nazionale in cui si parlava di musica rock.  L’altra rivista storica, il Mucchio Selvaggio, nascerà alcuni anni dopo, e negli anni della mia giovinezza trovarla era quasi un’impresa, per chi come me abitata in provincia.  E che provincia: la bassa ferrarese degli anni 70 dove sono cresciuto distava anni luce dal mondo della scena rock internazionale che Ciao 2001 raccontava. 

Grazie a Ciao 2001 ho imparato tante cose su una serie di gruppi rock di cui ancora non avevo sentito una sola canzone, dato che i dischi erano ancora più difficili da trovare che le riviste.  Per trovare dischi di musica un po' alternativa (nel 1976 Sanremo fu vinta da Peppino di Capri, quindi praticamente tutto era alternativo) bisognava andare a Bologna, o addirittura a Milano, luoghi lontanissimi e quasi irraggiungibili.  Grazie a Ciao 2001 però leggevo di questi gruppi musicali straordinari, e in ogni numero la doppia pagina centrale era un poster con una foto di un artista, di solito durante un concerto.  Presto la mia stanza fu tappezzata di questi posterini.  Quando poi finalmente la musica internazionale mi divenne accessibile, e potei ascoltare tutti questi artisti, era come se li conoscessi da sempre.  Ciao 2001 mi aiutò a superare l’isolamento culturale della bassa ferrarese, facendomi sognare di girare il mondo, come poi ho fatto.

Il Male uscì nel 1978 e in breve tempo divenne un fenomeno importante della controcultura italiana. Era chiaramente ispirato a Le Canard Enchaîné, che veniva pubblicato dal 1915, ma noi non lo sapevamo, e quindi per noi il Male era qualcosa di assolutamente nuovo. Il motto del Canard è "La libertà di stampa si consuma solo quando non si usa" e il Male quella libertà la usò fino in fondo, testandone i limiti.  Tra tutte le invenzioni, ne cito due. Convinsero Ugo Tognazzi e Raimondo Vianello, allora famosissimi, a partecipare ad una gigantesca goliardata che si materializzò con la riproduzione dentro al Male delle prima pagine di alcuni quotidiani nazionali che annunciavano che Tognazzi era il capo delle Brigate Rosse.  Come decine di altri adolescenti, lasciai il bella vista la prima pagina finta di Paese Sera sul tavolo di cucina, e a mio padre venne quasi un colpo.

Era Maggio del 1979; un mese prima il 7 Aprile 1979, erano stati arrestati i maggiori leader di Autonomia Operaia, tra cui Toni Negri, Emilio Vesce, Oreste Scalzone e Lanfranco Pace.  La questione del Processo 7 aprile, come poi venne chiamato è storicamente molto complessa, ma anche chi come me non aveva alcuna simpatia per Autonomia Operaia sentiva puzza di reati di opinione.  Lo “scherzo” del Male non fu quindi banalmente una goliardata ma un modo per far riflettere sul rischio di criminalizzare le opinioni invece delle azioni.

La seconda è stata talmente pesante anche dal punto di vista legale, che non sono riuscito a trovare online la vignetta originale. Durante l'Angelus del 10 settembre 1978, l’allora Papa Giovanni Paolo I (Albino Luciani) affermò che ““Dio è papà; più ancora è madre”. Nel numero successivo del Male c’era una vignetta che ritraeva un Dio piuttosto arrabbiato che prende il Papa, lo infila sotto al sottanone e grida: “ciuccia un po’ e dimmi se sa di latte!”.  Si fa molta fatica a trovare notizie online su questa storia, ma se ricordo bene il giornale fu sequestrato per vilipendio alla religione.  Per un diciasettenne come me, il Male apriva la porta ad una satira senza sconti: si può ridere di tutto, e i veri democratici sanno accettarla.  Sandro Pertini venne sfottuto da Andrea Pazienza in una vignetta sul Male: Pertini si fece due risate e invitò Pazienza al Quirinale per pranzo.

La rivista Frigidaire fu fondata da Sparagna, Scòzzari e Tamburini nel 1980.  C’erano un po' di cose sulla musica, un po' di inchieste, ma per me il cuore erano i fumetti.  Ne cito due: RanXerox e Zanardi.  Il primo scritto da Stefano Tamburini e disegnato da Tanino Liberatore, con qualche aiuto da Andrea Pazienza, che invece era autore unico di Zanardi. La prima storia di Zanardi esce su Frigidaire nel 1981, e nel 1988 Pazienza muore. Raccontare cos’era Bologna negli anni 80, richiederebbe un capitolo a sé, e poi è già stato fatto da tanti più titolati di me.  Il DAMS, Pazienza, Freak Antoni e gli Skiantos, il Gran Pavese.  Per me, appassionato di fumetti di supereroi fin da bambino, la scoperta di personaggi come RanXerox, Zanardi, o Ramarro, il supereroe masochista di Giuseppe Palumbo, apriva nuovi orizzonti.  Dopo la pesantezza degli anni 70 catto-comunisti, si parlava con allegria di sesso, droga e rock’n roll. Non andrà a finire bene: l’AIDS per il sesso, l’eroina per la droga e anche il rock non sta tanto bene.  Ma in quegli anni era tutto bellissimo.  Io quando non studiavo vivevo allo Spleen, circolo ARCI di Copparo dove facevamo rock demenziale, teatro comico, e gigantesche feste disco.  La controcultura che Frigidaire rappresentava è stata essenziale per me in quegli anni.

Stamattina ho letto un articolo che si leggono sempre meno libri e anche sempre meno riviste.  Forse non è così grave come sembra, forse i modi di consumare cultura e informazione stanno cambiando.  Ma sicuramente, per me almeno, Ciao 2001, Il Male, e Frigidaire hanno contribuito molto all’adulto che sono diventato.

 

2025: clinical trials are 1000 years old. Time to change them?

Abū ʿAlī al-Ḥusayn bin ʿAbdullāh ibn al-Ḥasan bin ʿAlī bin Sīnā al-Balkhi al-Bukhari is the formal name of Ali ibn Sina, known in Europe with his Latinised name, Avicenna.  In 1025, he completed The Canon of Medicine, an encyclopedia of medicine in five books, which remained a fundamental reference in any decent medical library for centuries, in one of the many translations from Farsi (Persian language).

However, one element of the Canon survives nearly untouched after 1000 years: how to assess the efficacy of a new treatment through experimentation, in short, clinical trials.  The seven conditions Ibn Sina proposes are purity of the drug, testing for only one disease, use of a control group, use of dose escalation, need for long-term observation, need for reproducible results, and the need for a human in addition to animal testing.  These are pretty much still the cornerstone concepts of contemporary clinical trial design.

The epistemological perspective of Ibn Sina was what we would today refer to as frequentist inference.  This worldview, mainly rooted in social sciences, relies on a few fundamental assumptions (epistemologists will forgive me a certain degree of oversimplification):

• Experimental observations can rarely be quantitative and are always biased (i.e., affected by systematic errors).
• Truth exists but is hidden.
• Experimental observations are collectively informative, whereas prior knowledge is considered scarcely informative; decisions are based solely on the likelihood of observing the data under various assumptions.
• Decisions are reduced to a binary choice between H0 (null hypothesis), which is the choice we would make in the absence of any experimental observation, and the alternative hypothesis H1, which is the opposite of H0.
• By default, we assume H0 to be true; we change our decision to H1 if there is overwhelming experimental evidence that H0 is false.

The key concept here is prior knowledge.  Prior knowledge is what we believe to be true before we start the experimental observations.  There are other domains of knowledge, such as physical sciences, where it is believed that we can provide causal explanations in the form of prior knowledge for some manifestations of reality. In such cases, prior knowledge can indeed be informative. This worldview can be summarised in the Bayesian inference, which assumes:

• Most experimental observations are expected to be quantitative, and our measurement methods are nearly free of systematic errors.
• Truth does not exist: there are beliefs (hypotheses that someone believes are true) that are more or less probable.
• Every hypothesis has a posteriori probability, defined as the product of the probability derived from the a priori knowledge available (prior) and that derived from experimental observations (likelihood).
• The hypothesis with the highest probability is used to make a decision.

The fact that two fundamentally different and largely incompatible worldviews coexist in science has always fascinated me. But it makes sense: in social science, very little can be "measured", and no one expects any "law of sociology" to exist any time soon (Interestingly, this has not always been the case: look at the concept of psychohistory in Isaac Asimov's science fiction novels). On the other hand, in physics and engineering, we trust we can observe experimentally natural phenomena in ways that yield reproducible, reasonably unbiased quantifications.  From these, we can formulate sufficiently universal causal explanations that, when resisted by extensive attempts of falsification, are considered "laws of physics". Within their limits of validity, we expect the laws of physics to be universally true; thus, we can use them as reliable prior knowledge in decision-making. 

The birth of modern physics is usually placed between 1543 (publication of Copernicus' "De Revolutionibus Orbium Coelestium" on heliocentric model) and 1687 (publication of Newton's "Philosophiæ Naturalis Principia Mathematica", unifying law of motion and universal gravitation). Maybe being biased by my being Italian, I like 1638 (publication in Leiden of "Discorsi e dimostrazioni matematiche intorno a due nuove science", The Discourses and Mathematical Demonstrations Relating to Two New Sciences, Galileo Galilei's final book.  Whatever the date, this is some six hundred years after ibn Sina canon.  And, to be fair, Galileo's new science dealt mostly with falling stones, which are much simpler than living organisms.

Thus, I dare to say that ibn Sina was right in conceiving the testing of new treatment as the purest frequentist investigation. So were the many medical researchers followed him through the centuries, always using the same approach.  For centuries, investigating human health and diseases was quite close to social science: little could be measured, every observation was inevitably biased, and prior knowledge had little informative value.

I teach my students that the music changed in 1943 when renowned physicist Erwin Schrödinger was invited to give a course of public lectures at Trinity College in Dublin. Schrödinger was already world-famous for his quantum theory work, so it surprised everyone when he announced that the course would be titled "What is life?".  In 1944, he published a book from these lectures entitled "What Is Life? The Physical Aspect of the Living Cell".  Schrödinger's ideas apparently had zero impact on biomedical researchers. Still, the seed was planted: "How can the events in space and time which take place within the spatial boundary of a living organism be accounted for by physics and chemistry?". Or, in our words, can we use the laws of physics and chemistry as prior knowledge to investigate the efficacy of new treatments better?

It was a long and winding journey from Schrödinger's book to the Avicenna Research Roadmap, which postulated the possibility of using in silico methodologies to better investigate the efficacy of new treatments by leveraging on a large body of prior knowledge developed by physiologists, biophysicists and bioengineers, starting from the seminal work of Hodgkin and Huxley on the action potential of neurons, published in 1952.  But today, the body of prior knowledge about the causation of human pathophysiology phenomena which resisted extensive falsification is substantial.  Why should we not use it also for the assessment of new treatments? 

The clever combination of computer modelling and clinical experimentation offers alternatives to animal experimentation, the reduction of the cohorts to be enrolled in clinical trials, a drastic reduction of the attrition rate (number of new drugs that fail to show safety and efficacy), reduce drastically the time to market, and the costs of development.  Why are we resisting such innovation?

My explanation is that most experts working for drug regulatory agencies share the classic frequentist inference worldview; moving to a Bayesian inference worldview is a vast cultural change, a true cultural revolution that scares many practitioners.  But as we celebrate the 1000 years of the Canon of Medicine, I beg all stakeholders to stop postponing this radical change.  Like all revolutions, it will be painful and ridden by mistakes, but ultimately, it is worth the risk.

In Silico World is over; long live In Silico World

Five minutes ago, we uploaded the last contractual deliverable on the EC portal; tomorrow, the In Silico World project will come to its planned end after four years of intense activities.

This is, for me, an emotionally overloaded end for several reasons.  We started writing the ISW proposal in 2019 as I had just returned to Italy after seven years as Director of the Insigneo Institute for In Silico Medicine at the University of Sheffield, UK.  For the third time in my life, I was starting a research group from scratch, but I was also going back to full-time research after years of serving in a leadership position that left little time for my own research interests.  

I had put a lot of energy into the Avicenna support action and the relative research roadmap on In Silico Trials, and I was delighted that after a long gestation in 2018, the Avicenna Alliance was finally established to give all companies involved in this emerging sector the possibility to speak with one voice.  However, the Avicenna roadmap's vision was not becoming a reality, at least not with the speed we hoped. 

I had experience, time (as my new research group was slowly forming and my teaching had not started yet), and a clear goal in mind. The missing element arrived when the EC published, as part of the H2020 work programme, the call for proposal "SC1-DTH-06-2020: Accelerating the uptake of computer simulations for testing medicines and medical devices".  Leveraging on 30 years of networking, I quickly formed the core consortium, inviting only people I had already worked with in the past and that I trusted unconditionally. We got excellent scores from the reviewers, and we got funded.

It was a fantastic journey; ISW was the project of my maturity, everything came easy, and the management office I formed to help me run the project was excellent.  I am proud of our results; I genuinely believe that ISW has profoundly impacted the adoption of In Silico Trials in Europe, something not every EU-funded project can say.

This end is more emotionally loaded than the beginning.  The end of the ISW project overlaps with the end of my active research career; as I explained in another blog post, I will not apply for any further research funding and will focus the remainder of my career before retirement on teaching.  So, ISW will be my last EU-funded project.

As the first events to present FP10 are being announced, I cannot avoid returning with the memory to the end of FP4, when I got my first tiny EU grant funded. If I had a successful career, this is mainly due to the European Framework Program funding system, which allowed me to conduct independent research for over 30 years, even when my national environment would have made it impossible.  Having my own funding gave me the freedom I wanted if not a fast career progression (meritocracy has never been a thing in Italy). 

The European Union and its Framework Program funding system sustained my research, advanced my career, and allowed me to work and befriend amazing people all over Europe and, to a lesser extent, even abroad. It forced me to structure my scientific curiosities into a vision I pursued relentlessly for 25 years or so. It exposed me to very different cultures, giving me a healthy relativism about the “right” way to conduct yourself.

So, thank you, European Union, with all my heart.  I am, and I will be until I live, a European Citizen.

From the tyger to the dying of the night

Around 1996, I chose a stanza from the poem The Tyger by William Blake as my email signature: I already blogged in the past about this: The Tyger is back. Here it is:

    Tyger Tyger, burning bright,

    In the forests of the night;

    What immortal hand or eye,

    Could frame thy fearful symmetry?

Here, you can find the full poem.

What fascinated me in that verse was the "fearful symmetry", that emotion a young engineer like me experienced looking closely at living organisms. 

I used it for 15 years, dropping it when I moved to the University of Sheffield.  In 2018, when I returned to Bologna, the temptation was too strong, and I put it back as part of my email signature.

Today, I am going to replace it.  My new signature citation will be:

    Do not go gentle into that good night.

    Rage, rage against the dying of the light.

    Do not go gentle into that good night, Dylan Thomas, in  Collected Poems (1952)

It is the closing verse of a poem Dylan Thomas wrote in the form of a Villanelle, a nineteen-line poetic form consisting of five tercets followed by a quatrain. The full text can be found here.  The sentence "Rage, rage against the dying of the light" closes every other stanza.  This reminds me of one of the folk songs I loved most when I was young, Riturnella, in the version of Musica Nova. It is a traditional from Calabria, recovered in the seventies.

But the reason for this change is another.  I am entering a time in my life when you are constantly confronted with death.  That of your parents, your youth's hero, and your own. It is something new for me; trust me, it is tough.  Now, I suddenly understand something I read years ago: "all elders have a baseline of depression".  Yes, sure, I can see it now.

You need to fight it; you cannot abandon yourself to it. But how?  Well, today, I found a citation to Dylan Thomas's poem, and I had a lamplight moment: considering who I am, the best way is to be pissed off about it. So this is my plan: I do not want to go gentle into that good night; I will rage, rage against the dying of the light.

And since I am still spending half of my life reading and writing emails ( I need to do something about this as well), the best place to remind me of this is my email signature, right? 

That's done, and I also added to my daily playlist a good song from Rage Against the Machine.

done.  Let's rage.

Does interdisciplinary science truly exist?

This is a rhetorical question; the answer is, of course, “yes” because there are researchers who stray out of the confines of their specific scientific domain and wander out toward another scientific domain, ending in that no man’s land so dear to Michel Foucault. 

The In Silico World consortium has recently released in open access a report entitled “Regulatory barriers to the adoption of in silico trials”, which summarises years of work on this specific topic.  In chapter 4 of this report, entitled “A reflection on interdisciplinary decision-making”, we debate with a very narrow focus the complex issue of recognising justified true belief in an interdisciplinary domain”. But from it, we drew a more general reflection that we propose here.

Suppose we accept Thomas Kuhn's idea that in each scientific domain, periods of cumulative progress are periodically interrupted by periods of revolutionary science when the whole domain jumps from one paradigm to another. In that case, we see how interdisciplinary scientists are heralds of a particular class of paradigm change, modifying the confines of that scientific domain (or creating a new one). 

But these researchers travel in dangerous, unexplored lands. The biggest risk is the lack of well-tested pragmatic epistemology. There are many reasons why science fractions knowledge space into scientific domains.  A particularly important one is the need for a pragmatic, operational interpretation of the process through which a group of peers agree on a particular belief.  The best way to collectively decide when a belief is a Justified True Belief varies considerably over the knowledge space.  The ways physical and social sciences decide what a Justified True Belief is are very different and form what we call the pragmatic epistemology of each subdomain of science.

The scientific method is unforgiving; in particular, if the peers of a scientific domain choose an ineffective pragmatic epistemology, the result will be that they will tend to assume as true (and build upon it) tentative knowledge that is then falsified at a later stage. Everything produced using that tentative knowledge must be trashed when this happens, and the overall cost can be very high.  So eventually, the peers of each scientific domain develop a set of operational rules tempered at the fire of experience to decide how, in that specific knowledge territory, a Justified True Belief is considered as such.

If you are conducting interdisciplinary research, you are wandering out of the comfort zone of your domain of origin.  For example, say you are a physicist who has started exploring particular aspects of living organisms, a topic traditionally within the remit of biology.  The pragmatic epistemologies of biology and physics are profoundly different, and rightfully so. Our physicist is faced with two choices: either continue to be coherent with his/her domain of origin and use the pragmatic epistemology of physics or adopt that of the host domain, biology.  The first option is usually healthier: not having been trained as a biologist, the choice to adopt the pragmatic epistemology of biology can be challenging for a physicist (and vice versa, of course).  But in both cases, the choice is always poor.  That is because that researcher is not investigating physics or biology but a new knowledge domain (let us call it biophysics) for which a well-tested pragmatic epistemology is not yet available. 

Interdisciplinary research is precious because it expands the scientific enquiry to previously untouched portions of the knowledge space. However, we must accept that it operates in difficult conditions from an epistemological point of view, and the quality of the knowledge produced might not be as high as that provided by other, more established domains. It also requires a very special mindset, which is less rigid and more accepting. However, the biggest challenge is the need for epistemological attention. Most scientists are uninterested in how knowledge is produced from a philosophical point of view; like cops, they apply the existing laws with little interest in how the legislative process works.  Interdisciplinary scientists do not have this luxury; they need to understand the philosophical basis of their work and spend time debating how to decide what is true.

“Does interdisciplinary science truly exist?” ©2024 by Marco Viceconti is licensed under Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0).

This opinion piece was published in my personal blog, and as an Open Access document on Zenodo.

European Union: from the land of rights to the land of rules

As usual, this blog post is inspired by a series of events, conversations, news, and opinions I collected in the last few weeks, which condensated the need to share an opinion piece through this channel publicly. As always, for everything posted in this blog, these are my personal opinions, which do not necessarily represent the official views of my employer or any of the organisations I am affiliated with in various roles.

The topic is complex and politically sensitive. It is also very general, dealing with how the European Union produces its policies. My narrow perspective refers to the specific domain of in silico medicine technologies. I am not qualified to generalise, but I suspect the problem I am describing below is not specific to a particular area of innovation.

I always have been a champion of the European Union. Compared to the USA, the European Union has been, for many years, the land of rights. Coherent with the values of the majority of its citizens, we created a society where healthcare and education are rights, citizens' privacy is protected, and so on. I am very proud of this. But I am afraid the last few years transformed the EU into the land of rules and bureaucracy. This is crippling our ability to innovate and compete, I believe.

The introduction of in silico medicine is revolutionising healthcare. The ability of computer models, built with advanced techniques such as Artificial Intelligence, to predict changes in the health state of individual subjects opens amazing opportunities but also, as is always the case with disruptive technologies, a whole new set of potential risks for individuals and society. The differences in recent policy-making between the USA and the EU are creating dramatic disparities between researchers and companies working in this field.

When the General Data Protection Regulation (GDPR) was introduced in 2016, many, including myself, praised the European Commission. Eight years ago, it was already evident that information technology companies were abusing the personal data they collected, health information being very sensitive, which was already having a major impact on my research domain.  However, as the GDPR was enforced, biomedical researchers in some member states faced huge difficulties.  The idea of demanding the member states define the rules under which exceptions to the GDPR could be made for scientific research, while it was probably a smart political move to achieve complex legislation within a reasonable timeframe, created a nightmare in which every member state has different rules and multicentric studies across member states are very difficult.  I am sure the legislators had no intention to prevent ethically robust biomedical research, but de facto, this is what has happened. 

This story is well known to all operators in the field and shows, in my opinion, a pattern.  The European Parliament decides to legislate on a socially relevant topic, which has significant implications for complex innovations, usually technological.  Technical advisors are mobilised to support the legislative process, and the legislation tries its best to capture all possible implications of such innovation and how the legislation will impact the socioeconomic processes that involve such innovation. The results are large, complex legislations aimed to “cover all bases”.

However, for disruptive innovation, no group of experts, no matter how good, can foresee all the special cases and all the implications that such extensive policies can have. And the more complex the legislation is, the higher the chance it will produce unforeseen and undesired effects.  In many cases, the issues are related to the correct interpretation of the law and its application into procedures that streamline whatever legal process economic operators need to do to comply with.  The problem is that no one is in a position to handle this post-legislative process.  The European Parliament cannot manage the application of its laws, and the European Commission does not always have the in-house technical expertise necessary to do this.

I suggest that for such complex pieces of legislation, a federal agency should be appointed to oversee the application of such legislation, providing guidelines addressing concrete cases as they emerge, offering support and training, and uniforming the procedures across the union.

In silico medicine, particularly In Silico Trials, has been one of these disruptive innovations.  In the USA, where such federal authority exists (Food and Drug Administration, FDA), the first guideline on using computer modelling and simulation in the certification of medical devices was published in 2016.  The Medical Device Regulation (EU 2017/745) acknowledges the growing role of software artefacts in medical products. However, in 2024, we still do not have a guideline that assists notified bodies in deciding when evidence obtained in silico can be accepted.  The only technical standard for in silico methodologies is the ASME VV40:2018, whose production was driven by the FDA, which recognised the need.  Only this year, the IEC-ISO started a workgroup on the topic that will produce an EU-harmonised standard in some years, but this is only because the community of practice has lobbied for it.  When a new in silico methodology for all types of medical products is developed, one can ask the FDA for qualification advice to explore if such methodology suits regulatory purposes. In Europe, the European Medicine Agency (EMA) provides this only for drug development tools; nothing is available for medical device development tools.

Such a condition is reversing the flow: historically, medical companies would certify their products first in the EU and then in the USA. Today, for in silico solutions, many companies choose the opposite strategy and start with the USA regulator, ensuring clear, reliable regulatory pathways for such products.

In front of us, we have the application of the Artificial Intelligence Act in the next three years and the completion of the legislative process for the European Health Data Space regulation.  Both pieces of legislation could have a tremendous impact on health technology innovation. Without central authorities with the technical skills to provide guidelines on these new legislations, the EU will face the same shortcomings as the MDR and GDPR.  

“European Union: from the land of rights to the land of rule” ©2024 by Marco Viceconti is licensed under Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0).

This opinion piece was published in my personal blog, and as an Open Access document on Zenodo.

“European Union: from the land of rights to the land of rules” © 2024 by Marco Viceconti is licensed under Creative Commons Attribution-NoDerivatives 4.0 International.

How to gently retire

It has been two years since I have posted on this blog.

The reason is simple: 2023 and 2024 have been crazy, so busy that I could never find the time to let my mind go free and produce stories that, in my humble opinion, are worth to be shared.

I hope things will improve in 2025, primarily because I am starting to implement my "Gentle Retirement" plan.  I decided to write about such a plan for two reasons: the first is that one element of this plan will drastically reduce my attendance at conferences and other similar events, so I want to inform my many friends and colleagues who will not see me anymore about my future.  The second and most important is that all my closest work friends are in their sixties, or close to that,  so I am sure they are all wondering the best way to retire.  I am not sure mine is the best, but it might be worth sharing how and why I plan to approach this final passage of my professional career.

First, I will give a brief history of myself to contextualise this.  After a short but fundamental period in the USA working with Prof Alì Seireg (see this article on one of his many achievements), I returned to Bologna (IT) and, in late 1989, started the Medical Technology Lab at the Rizzoli Orthopaedic Institute. I worked there until 2011. When I left, the lab hosted 45 between PhD students, post-docs and researchers. I moved to the University of Sheffield, where in 2012, we started the Insigneo Institute for In Silico Medicine. I directed Insigneo for seven years, driving it to become the largest research institute on this topic in Europe.  In 2018, I returned to Bologna as a full professor of industrial bioengineering at the Alma Mater Studiorum - University of Bologna. I also had a joint appointment as director of my old lab at Rizzoli. For the third time, I had to restart from scratch, and despite my promises to take it easy after the crazy years with Insigneo, at the end of 2023, my group counted around 40 researchers.

Comes in 2024, and life is getting complicated.  Working in Italy has never been easy, but the considerable funding of the COVID-19 recovery plan combined with our proverbial administrative ineptitude makes our daily work a nightmare.  The right-wing government is underfunding public healthcare, and working in a research hospital like Rizzoli is becoming more and more difficult. On top of this, I experienced some serious health problems.  And suddenly, I realise that for the first time in my career, the pain is more than the gain.  Time to retire.  But how can I retire while preserving as much of my legacy as possible? 

The first thing I have already cut is the time spent travelling to conferences and similar events.  All the travel budget is now spent to support the travelling of my coworkers; they slowly have to become the faces of our team, replacing me in the perception of our community. 

I still have substantial funding until 2026.  However, I will not apply for any further funding; on the contrary, I will support my coworkers who are in the position to have their own research funding to pursue opportunities.

From Sept 1st, 2024, I will resign as Director of the Medical Technology Lab at the Rizzoli Institute.  The lab has three senior researchers who already run it without me for the seven years while I was in Sheffield; in addition, two of my younger coworkers have a tenure-track position, so I am optimistic the lab will survive my departure. 

At the end of the year, we will close my largest EU grant as coordinator, the In Silico World project.  This four-year endeavour has been a fantastic journey; On Sept 3rd, 2024, we will present the results to the research community in Stuttgart in conjunction with the VPH conference. 

After that, I will be left with primarily national funding that will finish in 2025, except for one project.  As these projects close, I will support the post-doctoral staff in finding a new position elsewhere.  I also hope there will be a tenure-track position in my university department to continue my academic legacy. 

By the end of 2025, I will be left only with the coordinating role in the DARE project, in which my responsibility as a spoke leader is primarily managerial.  Any research activity will be continued by those coworkers who managed to retain a tenure-track position in Bologna.

I will close all my professional social network accounts as my research career fades. I might open one to stay in touch with friends, but only to discuss non-professional topics. I will continue to post occasionally on this blog, but only about culture, society, and philosophy. 

In April 2027, I will be 66 years old.  Depending on my health, I could retire then or wait a few more years, during which I will focus on teaching and tutoring. The mandatory retirement age for full professors in Italy is 70, so I could keep teaching until 2031.

I do not have much more to offer regarding scientific discovery.   In math, the Field Medal can be won only by those 40 or younger. I always thought that was an exaggeration, but I must admit that my creativity has constantly decreased in the last years.  What I can still do is share the significant experience I accumulated in these many years with the researchers in training through teaching and tutoring.

Those who know me tend to describe me as a workaholic. So how will I manage with all that free time?  My wife and I would love to spend time in other places worldwide, so if you need a visiting teacher, talk to me.  Then, I need to go back and brush up on my musical skills, which I did not cultivate in the last 40 years. I would also like to volunteer; it seems a moral imperative in this growingly egoistic society. So, do not worry about me; I will manage even without working 14 hours per day, seven days per week. 

As I fade from the public eye, being part of this international research community has been an honour.  thanks to all of you who worked, debated, revised, laughed, and argued with me during this long career. 

Farewell.

Marco