Episode #37: Three Breakthroughs: Search 2.0, Advances in Exo-Suits, & New blood Tests Change Everything

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  Sam Herrick:
  So you’re telling me Google is outdated, someone made an Iron Man suit, and blood tests can tell me even more than ever before?

  Mike Collins:
  Being really good at that tool has proven to be really a professional attribute.

  Matt Caspari:
  So depending on your posture and what you’re doing, this exoskeleton provides real-time support.

  Mike Collins:
  Hand in glove, I think that’s really exciting that we’re finally starting to see it on one of the most terrible diseases that our society has to deal with.

  Sam Herrick:
  All right, everyone. You know the drill. Welcome back to this episode of the Tech Optimist: Three Breakthroughs. The voices you’ll hear today are from Mike Collins, as always, founder and CEO at Alumni Ventures, and his partner today is Matt Caspari, a managing partner also here at Alumni Ventures. And of course, as always, you’ll hear me, your tech note writer, your guide, your narrative savant, Sam Herrick. Let’s get into it.

  In a world captivated by criticism, it’s easy to overlook the groundbreaking technologies shaping our future. Let’s shine a light on innovators who are propelling us forward.

  As the most active venture capital firm in the US, we have an exceptional view of tech’s real-world impact. Join us as we explore, celebrate, and contribute to the stories of those creating tomorrow. Welcome to the Tech Optimist.

  As a reminder, the Tech Optimist Podcast is for informational purposes only. It is not personalized advice and it is not an offer to buy or sell securities. For additional important details, please see the text description accompanying this episode.

  Mike Collins:
  I’m good. It looks like you got a little sun.

  Matt Caspari:
  I have been getting some sun. It’s nice.

  Mike Collins:
  Good.

  Matt Caspari:
  We were in the south of France for a few days, so I got a lot of sun in a short period of time.

  Mike Collins:
  All right. Ready to hop in? I’ll let you get back to better things.

  Matt Caspari:
  Yeah, I’m ready.

  Mike Collins:
  Okay, so welcome to the Tech Optimist Podcast, our three breakthroughs segment, where we talk about things that we’re really excited about in the world of science and technology. I’m here with my partner Matt Caspari. I’m Mike Collins, the founder and CEO of Alumni Ventures.

  And I think I’m kicking it off this week, and my breakthrough of the week is what I’m calling the end of search.

  Matt Caspari:
  Okay.

  Mike Collins:
  I think one of the fantastic things that Google—Alphabet—has done is they’ve made it such a part of white-collar work that actually being really good at Google is a differentiator in a lot of white-collar jobs. It’s how people do research, it’s how they get a lot of things done during the day. It’s: “I’m going to Google it.” And being really good at that tool has proven to be a professional attribute.

  Sam Herrick:
  What we’ve slowly found is the purpose of these tech notes is for my curiosity to flourish and really develop into what it is. A thought popped into my head: “Huh, I wonder if there are any crazy Google stats out there?” Like, how many people use it a day, how many searches there are?

  Of course, there are stats out there. Some are directly from Google itself, some from people who worked at Google on Reddit, and some from a website called Semrush, which also has a lot of Google search statistics.

  Google processes approximately 8.5 billion searches per day. This breaks down to about 5.9 million searches every minute. The total number of Google searches per year is estimated at 3.1 trillion, and 63% of these searches in the US occur on mobile devices, meaning they’re coming from cell phones instead of desktop computers.

  In terms of search query length, the most common Google searches contain three to four words—specifically 38.2% of US Google searches on desktop and 39.9% on mobile fall into this category.

  The Google Search Index, which is used to provide results for all of these daily searches, is over 100 million gigabytes in size.

  Let’s think about that for a second. The most common storage size for an iPhone—like the one in your pocket, on your desk, or on your dashboard—has about 64 GB of storage. You can upgrade to 128 or 256 GB if you want. But 100 million GB?

  To put that in perspective: a blockbuster movie like Dune or Oppenheimer (a fantastic, high-quality, borderline 6K film about three hours long for IMAX screens) is likely around 400–430 GB in digital 4K format.

  If Google was just a storage device, it could hold 250,000 copies of the digital Oppenheimer movie. That’s massive. Pretty insane.

  All right, there’s my little tangent—let’s get back into the interview.

  Mike Collins:
  And it’s obviously evolved a lot. I mean, I go back to when there were multiple search engines and Google—

  Matt Caspari:
  I remember those days, yeah.

  Mike Collins:
  Alta Vista.

  Matt Caspari:
  Alta Vista, yeah, yeah.

  Mike Collins:
  All this stuff. And they’ve turned it into basically a trillion dollars of value. Really clever. It’s evolved. I think it’s gotten worse personally with a lot of sponsored stuff at the top.

  Matt Caspari:
  Yeah, rising to the top, yeah.

  Mike Collins:
  But I’m going to tell you, I think we’re at an inflection point where your search is going to become AI-driven and answer-driven. And so I’m just going to tell you a story from literally this morning, Matt. Again, I’ve been married 35 years—that’s an approximation, it’s a long time—and we discuss yogurt disproportionately to normal people.

  So it’s like, “What do you look for? What’s your kind, my kind? Oh, that has too much sugar in it. I’m looking for more protein,” blah, blah, blah. Just boring, old married couple stuff.

  And there was an article—I think it was in The New York Times this morning—about yogurt. The gist was: don’t think of it as a pure health food.

  Matt Caspari:
  Okay.

  Mike Collins:
  So what I did, bringing this to life, is:

  One, I didn’t read the whole article. I basically had AI summarize it for me. I sent the original article and the summary to my wife. Then I went into ChatGPT and basically said, very simple prompt: “I want you to tell me what the healthiest yogurts are. I want it to be fact-based, scientific-based. I want you to footnote what you’re using to make this claim. And I want you to be very specific about brand recommendations.”

  I pushed the button and the answer was fantastic. I went back and fact-checked it—it was pretty darn good.

  Matt Caspari:
  I feel like the hallucinations—

  Mike Collins:
  —that’s as bad as it’s ever going to be, right?

  Matt Caspari:
  Yeah, exactly. I was just about to say it seems like it’s getting much better just in the last several months, less hallucinations.

  Mike Collins:
  The pace of improvement on these things—three months ago I couldn’t do that, I wouldn’t trust it to do that. But it seems like every three to six months, we’re getting another big step function.

  We saw the announcement this week of OpenAI directly offering a search product in the works. Apple released 18.1, which is starting to put AI directly into the Apple operating system ecosystem. And then you have Alphabet—I’m glad I’m not in that chair, because—

  Matt Caspari:
  Yeah, what is the crystal ball over the next five or ten years for maybe the best money-making machine that’s ever been invented?

  Mike Collins:
  Yeah. So what do you do, right?

  Matt Caspari:
  Yeah.

  Mike Collins:
  You can’t just say, “You know what, forget that old business. We’re burning the boats, we’re leaning all into Gemini and we’re going to do it.” You can’t do that.

  Matt Caspari:
  Yeah.

  Mike Collins:
  Your stock could be down 90%. So you have to finesse it. They’ve been doing that with AI, trying to walk this tightrope of: “Yes, we know. Yes, we’re doing it. Yes, we’re leaning in, but we’re still preserving SEO, Google, AdWords, all that kind of stuff.”

  But I think they’re fighting the past.

  I’ll tell you, I don’t use Google to search for stuff anymore. I’m using ChatGPT, Perplexity. I’m using Gemini when I need to find stuff out.

  And again, I’m an early adopter, but I’m not a technologist. But if I’m doing it to answer my yogurt questions and nine other things during the day, I do think search is dead. Search 1.0 is dead. We’re on search 2.0, and we’re in the early phases of it.

  Given the pace of improvement, I think it’s going to go pretty quickly. If I can get the answer, and I have some trust in that answer, why would I go through the nonsense of blue links and sponsors?

  Because if I typed that into Google, I’d be getting five sponsored ads from yogurt companies, then pseudo-ads, and I’m just trying to find out the truth: what yogurt should I buy? Give me the answer with some logic behind it.

  Matt Caspari:
  Yeah.

  Mike Collins:
  So that’s my number one breakthrough of the week—

  Matt Caspari:
  I like it. I like it.

  Mike Collins:
  What do you got?

  Sam Herrick:
  We got a quick break, and then we’ll be right back.

  Matt Caspari:
  Hey everyone, just taking a quick break so I can tell you about the Deep Tech Fund from Alumni Ventures. AV is one of the only VC firms focused on making venture capital accessible to individual investors like you. In fact, AV is one of the most active and best-performing VCs in the US. And we co-invest alongside renowned lead investors.

  With our Deep Tech Fund, you’ll have the opportunity to invest in innovative solutions to major technical and scientific challenges, which can have a hugely positive effect on society—companies that have the potential to redefine industries, create a more sustainable future, and deliver significant financial returns. So, if you’re interested, visit us at av.vc/funds/deeptech.

  Now, back to the show. So I came across an article published in the journal Science Robotics, where researchers at Seoul National University wrote about a robotic back support device they created. I thought this was pretty cool.

  They highlighted that back injuries from heavy or repetitive lifting are a real problem in the workplace. So, they developed this robotic device they call the bilateral back extensor exosuit—which they did—

  Mike Collins:
  Yeah, clever, catchy.

  Matt Caspari:
  Yeah, not marketing guys, but they did get that down to BEX. So we’ll just call it BEX.

  This BEX provides support to lower back muscles during lifting tasks, reducing the risk of spine injuries. What’s cool is that if you check out the videos, the device looks pretty lightweight. It consists of soft, flexible components that conform to the user’s body, giving support without restricting natural movement.

  It combines soft robotics with wearable sensors to actively monitor and assist the user’s movements. Depending on posture and activity, this exoskeleton provides real-time support, reducing strain on back muscles. Pretty cool. If you’re lifting something heavy, it gives more support; if not, it adjusts.

  In their research trials, participants performed various tasks while wearing the suit, and measurements showed significant reductions in muscle strain and spinal load. So—it works. Pretty cool.

  Sam Herrick:
  This thing is pretty cool. This BEX exosuit is really interesting—it reminds me of Iron Man or Marvel or something. But as always, I have the article in front of me, and I want to read part of the abstract for all you science and engineering minds out there who like to really dig into papers and technical details.

  Here’s the abstract from the article Matt brought to the table:

  “Lumbar spine injuries resulting from heavy or repetitive lifting remain a prevalent concern in workplaces. Back support devices have been developed to mitigate these injuries by aiding workers during lifting tasks. This paper introduces the bilateral back extensor exosuit, or BEX, a robotic back support device designed to address both functionality and safety concerns. The design of the BEX draws inspiration from the anatomical characteristics of the human spine and back extensor muscles. Using a multi-degree-of-freedom architecture and serially connected linear actuators, the device’s components are strategically arranged to closely mimic the biomechanics of the human spine and back extensor muscles.”

  That’s really cool.

  “Comprehensive safety validation was achieved through analysis of muscle fatigue in the upper and lower erector spinae muscles, as well as mechanical loading on spinal joints during lifting scenarios. By seamlessly integrating functionality inspired by human biomechanics with a focus on safety, this study offers a promising solution to address the persistent challenge of preventing lumbar spine injuries in demanding work environments.”

  Matt Caspari:
  I’ve been hearing a lot about robotics in the venture capital world. My mind, and probably a lot of other people’s, goes to large robots in factory settings or humanoid robots. But this got me thinking about a whole other world of robotics that’s probably coming relatively soon—soft robotics with wearable components that can help humans improve performance in everyday activities, like lifting heavy weights. Pretty cool.

  Mike Collins:
  No, that’s super cool. Again, it reminds me—you’ve seen this in science fiction and military concepts—of robotic-assisted soldiers.

  Matt Caspari:
  Yes.

  Mike Collins:
  So I think we can see a spectrum of robotics: highly repetitive, assembly-line robots that are fully automated, and then areas where we’re not quite there yet with full automation but where these assistive devices make a ton of sense.

  Matt Caspari:
  Yeah, augmenting humans is a much—

  Mike Collins:
  —augmented humans. Off the top of your head, you could see obvious applications in warehousing.

  Matt Caspari:
  Definitely.

  Mike Collins:
  Some farming examples for sure. It makes a whole lot of sense. And as you point out, Matt, there’s a lot of buzz right now, with lots of investment and cool startups working on AI-robotic combination technologies. These could not only physically assist humans but also have sensors to detect things our biological senses can’t.

  The hybrid model is really a super interesting one.

  Matt Caspari:
  Agree.

  Mike Collins:
  Okay. The third one I’ve got today is a series of things related to new blood tests. Over the last month, we’ve seen some really exciting developments. The beauty of blood tests is they’re relatively routine and accessible—most people have blood work done as part of an annual physical.

  We’re now seeing advancements in blood tests for Alzheimer’s disease, which is especially promising when combined with new potential therapies. It’s one thing to get a blood test and know you’re at elevated risk but have nothing you can do about it—that’s just depressing. But with treatments coming online that you can act on, early detection through blood tests could make a real difference.

  I think that’s really exciting—that we’re finally starting to see progress on one of the most terrible diseases our society faces.

  We’ve also seen progress with Shield, a new colorectal cancer screening test. The more tools we have—ColonGuard, traditional colonoscopies (which are still very effective but inconvenient), and now blood tests—the better. These tests add another tool in the quiver, allowing for early detection as part of your normal annual checkup.

  Matt Caspari:
  Yeah, I love the idea of no additional friction for the patient. They’re already getting blood work anyway. This also fits with the bigger trend toward preventative medicine: catching things early, identifying people at higher risk, and then guiding them to take action or start treatment before they experience symptoms. So yeah, I think it’s a great trend.

  Sam Herrick:
  One more sponsor spotlight, and then we’ll get right back into it. Don’t go anywhere.

  Speaker 4:
  Do you have a venture capital portfolio of cutting-edge startups? Without one, you could be missing out on enormous value creation and a more diversified personal portfolio. Alumni Ventures—ranked a top-20 VC firm by CB Insights—is the leading VC firm for individual investors. Believe in investing in innovation? Visit av.vc/foundation to get started.

  Sam Herrick:
  As of August 2nd, 2024—just four days before I edited and recorded this episode—NPR published a short podcast segment on this exact topic. The article title is “New Blood Test Can Help Diagnose Alzheimer’s. Are Doctors Ready for What’s Next?”

  Reporter Jon Hamilton from NPR takes us through research findings and expert perspectives. I think it’s a great snippet that complements Mike’s point, so here it is.

  Speaker 5:
  A new generation of blood tests promises to change the way doctors diagnose and treat Alzheimer’s disease, but there’s a snag. Tests have arrived so quickly that there’s little guidance on who should get them or how to interpret the results. NPR’s Jon Hamilton reports from the Alzheimer’s Association International Conference in Philadelphia.

  Jon Hamilton:
  The blood tests show whether a person with memory and thinking problems also has Alzheimer’s. Dr. Suzanne Schindler of Washington University in St. Louis says just a few months ago, many of these tests were still unreliable.

  Suzanne Schindler:
  Blood tests have developed incredibly fast for Alzheimer’s disease, and I think people aren’t used to that rate of change.

  Jon Hamilton:
  The tests indicate sticky amyloid plaques and tangled fibers called tau in the brain—the hallmarks of Alzheimer’s. Until now, finding these meant getting an uncomfortable spinal tap or an expensive PET scan. But Schindler says that’s changing thanks to blood tests that detect an abnormal protein called p-Tau 217.

  Suzanne Schindler:
  When you’re just looking at cognitively impaired individuals like you might see in a clinic, these p-Tau 217 tests perform very well.

  Jon Hamilton:
  They’re right about 90% of the time. Several p-Tau 217 tests are already commercially available, though none is FDA-approved yet. Schindler says more doctors—not just specialists—are beginning to order them.

  Suzanne Schindler:
  Physicians really need to educate themselves about these tests because this is coming—and it’s coming really soon.

  Jon Hamilton:
  One major reason is the approval of two drugs that can slow down Alzheimer’s. These drugs are only available to people with confirmed amyloid plaques in the brain. Dr. Eliezer Masliah of the National Institute on Aging says blood testing reflects a larger shift in Alzheimer’s diagnostics.

  Eliezer Masliah:
  The trend now is to move toward a biological diagnosis of Alzheimer’s disease—one based on biomarkers rather than just clinical symptoms.

  Jon Hamilton:
  Biomarkers like p-Tau 217. Masliah says new markers are being discovered all the time.

  Eliezer Masliah:
  All this really points to the idea that we’re going to use blood tests to diagnose Alzheimer’s disease. And I think we are very close to that.

  Jon Hamilton:
  Yet many primary care doctors don’t know how or when to use these tests, says Dr. Heather Whitson of Duke University.

  Heather Whitson:
  The field is moving at a pace that I never imagined 10 years ago.

  Jon Hamilton:
  Whitson says physicians should reserve the tests for patients showing clear signs of impairment—for example, repeatedly asking the same question during a visit or forgetting to take medications. These tests aren’t for people who are just anxious about their brain health.

  Heather Whitson:
  Sometimes patients struggle to remember a name or place, but they might have a family history of Alzheimer’s. So every time they forget a name, they worry that this is it.

  Jon Hamilton:
  These patients aren’t eligible for drug treatment, and a positive test might cause needless anxiety.

  Heather Whitson:
  A percentage of the population has amyloid in their brain and will live a normal lifespan without symptoms. We know this.

  Jon Hamilton:
  Experts at the Alzheimer’s Conference say that within a few years, it’s likely that primary care doctors will be offering blood tests to many of their older patients with memory problems. And they’ll know what to do when a test is borderline rather than positive or negative. But Dr. Howard Fillit of the Alzheimer’s Drug Discovery Foundation says getting a diagnosis is just the first step.

  Howard Fillit:
  What does it mean for the family? What does it mean for the spouse? There’s a huge effect. And while the primary care doctor can make the diagnosis, the question is, will they spend the hour that’s needed to do the education and counseling?

  Jon Hamilton:
  And will payers like Medicare cover those services? Jon Hamilton, NPR News.

  Mike Collins:
  Yeah. And again, there are other things I could have mentioned that are also early screening tools. There’s a new multi-cancer screen coming out as well. So, yeah, all these trends are really positive. They empower individuals to catch issues early, manage their health proactively, instead of waiting until there’s a major problem and then trying to fix it.

  Unfortunately, our healthcare system’s incentive structure is designed around reacting to big problems rather than preventing them. But to the extent that we can all take more control of our own healthcare—being healthy, focusing on prevention, and getting these low-friction tests done—it’s a huge win.

  I know there’s a lot of talk in the tech community about calcium tests and encouraging people to find a way to get those done. They’re not expensive, and if you find something, the upside is huge. It’s a great way to know whether you’re accumulating calcium in your arteries.

  We have excellent lipid management infrastructure, but there are many asymptomatic people who have underlying issues. We even had a board member—a really healthy, relatively young person—who suddenly had an unexpected episode. The more we can catch things like that early, before requiring invasive remedial healthcare, the better.

  So let’s remind each other—these kinds of blood tests are really good news.

  Mike Collins:
  Again, exciting stuff. I appreciate you doing your tour of duty here, Matt, on Three Breakthroughs.

  Matt Caspari:
  No, it was fun. My pleasure.

  Mike Collins:
  We’ll give you a break. We’re passing the baton to Mike Perry, who’ll be taking over for the next month or two, and then—

  Matt Caspari:
  That’s good.

  Mike Collins:
  Keep doing your thing.

  Matt Caspari:
  Yeah, thanks, Mike. Appreciate it. This was fun.

  Mike Collins:
  Excellent. All right. Have a good one.

  Matt Caspari:
  Take care.

  Mike Collins:
  Enjoy France.

  Matt Caspari:
  You too. Bye. Thanks.

  Mike Collins:
  Bye.

  Sam Herrick:
  Thanks again for tuning into the Tech Optimist. If you enjoyed this episode, we’d really appreciate it if you’d give us a rating on whichever podcast app you’re using, and remember to subscribe to keep up with each episode. The Tech Optimist welcomes any questions, comments, or segment suggestions. Please email us at [email protected] with any of those, and be sure to visit our website at av.vc. As always, keep building.