Nothing generates high-profile fallouts and conservative rage quite like a debate about the Union Jack. And this week we've been treated to an almighty one. The Ferrari began with this moment from an interview on BBC Breakfast between hosts Charlie State and Nagamanchetti, and Communities Minister Robert Jenrick. Robert Jenrick, thank you. I think your flag is not up to standard size government interview measurements. I think it's just a little bit small, but that's your department really. It's just a thought. The picture of the Queen. You'll be aware that every time we have, we've seen it every day, and it's a stock thing, isn't it? The picture of the Queen there as well, though, in the Westminster office, I'm assuming. That was a very funny TV moment. The point was, not really to say the British flag is terrible, but it was just to say every time a Tory minister does an interview now, there's a huge flag behind them, wherever they are, often in very incongruous places. So you'll notice that was just next to a window, right? Flag is supposed to hang off stuff. You don't just have a huge Union Jack in whatever room you're working in. It's completely bizarre. That's why they're laughing. And the image of the Queen only made it more ridiculous, of course. Anyway, later that day, Jenrick tweeted this image alongside a message saying, we're always proud to fly the Union flag at the Ministry of Housing, Communities and Local Government. It's a symbol of liberty and freedom that binds the whole country together, because it's just a flag next to a couch, another place where they aren't supposed to really be. I did promise you controversy, though. We've got to get on to that. And what really provoked Aya was when someone noticed that Nagamunchetti, one of the BBC presenters you just saw, had hit the like button on a tweet. Now, the tweet in question said, what has Charlie done? The flag shaggers will be up in arms. Tell him we love him. That got the like. And that led to fire and fury. And the BBC were not going to let Munchetti get away with it. And she's had to apologize for some other ridiculous things before, I think, before for suggesting that Donald Trump might be racist. Now she's had to apologize for liking a tweet. I liked tweets today that were offensive in nature about the use of the British flag as a backdrop in a government interview this morning. I have since removed those likes. This does not represent the views of me or the BBC. I apologize for any offence taken. This might all seem a bit silly to you. Of course, though, it wasn't too silly for the culture secretary, Oliver Dowden, to get involved. I'm concerned that what started as light-hearted banter became sneering, which is not the BBC at its best, as I've said before. It is so important that the BBC reflects and respects the values of the whole of the UK, which presumably is to have giant Union Jacks behind you wherever you are and whatever you're doing. Is there a huge giant Union Jack next to your sofa? If not, you've got your British values all messed up. Maybe you don't have them. Heaven forbid. What do you make of this? Should Naga have apologized? No.  Only in the UK are there so many independent organizations dedicated to drumming people out of public life for insufficient deference to the government. I mean, that's what we're talking about. We're talking about a very sinister direction we're heading in, which I do keep talking about Hungary a lot. I went to Hungary in 2016. Hungary is ruled by a party called Fidesz, who used to be part of the Liberal International. They were a centre-right party which radicalized in power, waged so-called cultural wars against their opponents, and are now in a right-wing authoritarian government which has shut down vestiges of democracy. They rely on a combination of whipping up hatred against migrants, Muslims, trans people, anti-Semitism, throwing in for good measure. I just worry that the so-called cultural wars that are being waged are as much an attempt, their backlash against the struggle of minorities for their rights. That's partly what it is. It's also about essentially creating a hostile environment for any vague dissent or perceived dissent from the government and its supposed national mission and encapsulating its interpretation of Brexit. And I think the BBC has long been cowed. I mean, its coverage is as favourable to the government as I think the government could be satisfied with with a broader press ecosystem which overwhelmingly supports the Conservatives. We just had tonight, it reported, by the way, that Boris Johnson's director of communications James Slack quits months into his role to join the son's deputy editor-in-chief. So he'll carry on his role as director of communications then, just at the Sun newspaper. That revolving door of the press and the government is very much, you know, we've seen it, of course, with, as I've already mentioned, Boris Johnson's spokesperson, Allegra Stratton, formerly of the BBC, ends up at ITV. There's a huge division that generally in government. That's my worry. It's just this, you know, an authoritarian atmosphere, a kind of all-band light, all-banding the ruler of Hungary atmosphere and that's partly what this is about. Whipped up by right-wing outriders attempting to intimidate and harass anyone who's seen as deviating from allegiance to the British government. It's disturbing. I do think the path we're headed on is essentially towards Hungary. And I think this is an example of it. The revolving door you mentioned, we do have a good example of next. Robbie Gibb is the brother of a Tory MP. He was Theresa May's director of communications at number 10 and before that, he was head of BBC's political programme. This is probably the most worrying revolving door there is. Someone who's in charge of making the news on the most important outlet and platform in the country, which is the BBC News at 6, the BBC News at 10, who then goes on to work for the politician who he was supposed to be holding to account. Anyway, in response to this, on the day the BBC announces the welcome news that is moving more programmes out of London, the BBC Breakfast clip reveals a sneering and cynical attitude towards our monarchy and flag that shows it's not just about where people are based. The BBC has a wider cultural problem. BBC Breakfast is filmed in Salford. So I suppose he's in a way, he could say, that proves my point. You move them to Salford, they're still liberal elites who laugh at flags and pictures of the Queen. Again, I'll repeat, the problem with that argument is that ordinary Brits do not have huge two metre wide flags on big flag poles next to their couches or in front of their windows. These are not places where flags are supposed to be. That's why it's hilarious and ridiculous that every government minister who goes on every breakfast show, every interview, however big or small and they have these two incredibly out of place, or one or two incredibly out of place Union Jacks behind them. Presumably they do quite like these outrages happening. It's exactly the kind of culture war that they want to start. Labour also putting their huge flags behind them. So I don't necessarily think this is the fight that the left should be having on this terrain more than just to say, this is ridiculous.  I mean, I don't find it particularly offensive to have a huge flag behind you when you're doing a TV interview. I just think it's ridiculous. And I think it's even more ridiculous if you get outraged at someone else pointing out that it's ridiculous. The thing I want to know from you, the last thing I want to know from you is how much do you think the Tories are going to try and sort of push their flag war agenda between now and 2024? Do you think this has got legs, or do you think they're going to have to give up at some point, especially as you know, Keir Starmer's not averse to a Union Jack himself? There's only so many flags you can drape yourself in or how big your flag can be. Because I mean, that's what we're going to end up with, isn't it?  I think we should try and reframe it.  They want us to get angry and all the rest about it. And I'm like, yeah, I'm like, if you want to put a flag behind you, treat yourself. I don't care. I mean, I obviously think it's very patronizing, but I think we should reframe it as, you know, what shows more love for your country, wanting to feed all of its children instead of forcing them to, you know, forcing hundreds of thousands of children into poverty, into hunger, or sticking a flag behind you. It's very easy to put a flag behind you. Just buy a flag. You can get one on Amazon, I'm sure. Probably get one for a fiver. Whack it behind you. Done. Or is it about, you know, what's more patriotic than wanting to rid your own country of injustice? Not everyone on the left is comfortable talking about this. I get that. But I do think you can redefine it and start talking about the history of people who fought at great cost and sacrificed for the rights and freedoms we have today about making sure that every person has a decent affordable home. Everyone has a decently paid job. Everyone has a decent standard of living. No child grows up in poverty. That shows love for your country. What better way to express your love for country than that? And I think, you know, that's what Podemos have done in Spain. It's a different context. I mean, I can't. You know, in Ireland, Sinn Féin can talk about this because obviously, Irish nationalism is about struggle against the oppressed, the oppression nation, against empire. Our nationalism clearly, you know, so not our nationalism, but patriotism, demarcating it from nationalism attached to the history of empire. There are complexities involved in that. I get that. But I do think we can redefine it and we can talk about the struggles of our ancestors if we can talk about real, genuine love for your country's ridding of these injustices, not sticking a flag behind you and expecting people to love you off the back of it. If Labour do it, by the way, it looks so inauthentic because I just don't think anyone thinks, yeah, their heart really beats a little bit faster when they see the flag. It just doesn't look authentic. It looks like, you know, people trying to be down with the kids, the equivalent, whatever that is, with patriotism. And I think inauthenticity greats on people. I think instead of fighting on that to reign, I mean, it's just finally on that, is what Ed Miliband did, which I think he would regret, is when he was leader of the Labour Party, his big passion was inequality. But he did lots of, he didn't do a single speech about inequality. He just did speeches about immigration. And that didn't diffuse the issue. It drove it up the agenda. And obviously the Conservatives could always outflank the Labour Party on immigration. It just shifts the political debate onto terrain that's favourable for your opposition. So what you should do is shift it onto your terms. And obviously things like the fact that people in this country, children cannot afford to eat. I think that is obviously terrain which is far better for the Labour Party and they can claim it's patriotic if they want. I think that would be a better approach.


This is one of the greatest things here, seeing all the people coming in and spread the joy to all the good girls and boys and the adults just to see the smiles in their faces. I do like the room where they had the antiques. I thought that was really charming. The beauty of the Christmas trees and all the decorations, meeting Governor Wolf because we've never met him before. He and his wife and that was a treat. I liked the decorations and I liked all the stuff in here and the governor was really nice. I'll be playing at two o'clock the piano over in the ballroom. I'm just happy to be here and you got the best hot chocolate I've had. I'm actually intrigued by the wallpaper so I heard that the wallpaper came from France in the first room and so I can't wait to see more murals and see what else there is. And we like the mouse hole. Yeah. Back in the corner.  Our favorite room is the room with the cookies. We came up, we visited some mansions in Philadelphia and then we drove up here to Harrisburg for the tour up here so we're having a good time. It's a nice family day and just a nice thing to see. You don't get to see very often so it's something different. And as the governor said, it's our house. Yeah, he said welcome to our house. Yeah, your house.


Hello and welcome to the NPTEL course on an Introduction to Programming through C++. I am Abhiram Ranade and the topic for today is some advanced features of functions and the reading for this is from chapter 12 of the text. So here is an outline for this lecture sequence. I am first going to talk about passing functions as arguments to other functions and this will be in two ways functions, function parameters, there will be two subtopics sort of and I will also talk about lambda something called lambda expressions. Then I will talk about how to assign default values to parameters of a function and I will also talk about something called function overloading. So let me start off with the function bisection that we wrote some time ago to find the square root of 2. Let me begin with the function bisection to find square root of 2. So here is the function. So this function is meant to find the root of any function and we are going to use it to find the square root of 2 by finding the root of a function x squared minus 2. So x squared minus 2 would be 0 at square root 2, so if we found a root of this function x squared minus 2, we would have found square root of 2. So this function does do that and we could use this to find other things also. So say you want to find the cube root of 3, what should we do? Do we need to write everything again? Well not really, we should only write things which have to be different as compared to finding the square root of 2 and there really are only 2 places. So this is the place where we were evaluating the polynomial x squared minus 2 and here is a place where again we were evaluating the polynomial. So only in these 2 places the actual polynomial that we are evaluating is important and for this we would need to evaluate the polynomial x cube minus 3. So over here this should be x cube minus 3, xm cube minus 3 and this should be xm cube xl cube minus 3 again. So that is really the change that we want to make. So we could change the text but is there a better way of doing it? So the general question is can we write a bisection function which finds the root of any mathematical function whatsoever provided it satisfies the requirements of bisection and those requirements were that we need to supply to bisection 2 values xl and xr such that the signs of the function whose root we want to find are not identical at xl and xr. So that is what bisection depended on and we should satisfy that but we would like it like a single function to be used to find the root of any mathematical function. So a natural idea for doing this is well to bisection we should pass somehow pass the mathematical function whose root we want to find. So there is an extra argument and that argument should specify the mathematical function whose root we want to find. Now how do we represent a mathematical function? How do we tell bisection that look here is the function? Well a natural idea again is that after all we have C++ functions which compute the function which whose root we want to find. So suppose we could somehow send that C++ function that should somehow be adequate. So in the case of our square root of 2 we were trying to find the root of this function f of x equals x squared minus 2 or the new thing that we want to do use bisection to find the cube root of 3 we want to find the root of this function. So somehow we should supply these functions f and g to the bisection function through that extra argument and maybe that should somehow be able to make it work. So now the question is that we have a C++ function bisection and to it we want to pass another C++ function so f or g whichever one we might be interested in. So how do we do that? So in short this is what we would like to write as far as the rest of the code goes. So here we have defined our f we have defined our g and in the main program we have an extra argument. So this time we have given the argument f presumably they should somehow send this function over to bisection to the function bisection and bisection should print the root of root corresponding to this that is it should print the root of square root of 2. And similarly in this case bisection should be sent this function this g over here and again after it executes bisection should print the cube root of 3. Now exactly how do we pass a function h to another function v well let us say let us see suppose h has this declaration. So return type h and the parameter list. Then in the parameter list of b to which we want to pass s we need to put in the type of h. Now it turns out the type of h of a function defined in this manner is something like this. So it is this funny looking quantity or funny looking string so it begins with this word function and then angle braces return type all of these things. Now this is for a general h but the function we want to pass to bisection takes a single double argument and returns a double all such functions that we want to pass are going to take a single double argument and return a double. So we can say that the type of all such functions is function return type double and single parameter type also double. So we have discovered how we can declare what should be in the parameter list of bisection. So we need to put this in the parameter list of bisection. So bisection is going to have this declaration. So these were the original parameters and this now is the new parameter. So this way we can that extra argument that we sent for g will be received by bisection as this argument h and in fact inside bisection we can write calls to h. So bisection can just directly use, we do not need to modify the function. Modify a function to include the code for h explicitly. Of course we need to modify the function because we have added that parameter. So here I am showing you the new version of bisection. So what has happened over here is that the red portions are where some changes happen. So first of all we need to have, we need to include a new header file. So this header file is called functional. So this file contains code which allows you to write something like this. So function is a name which is defined in the standard name space. So if you want to use all these things you must include this header file functional. So we have the bisection function and we have an extra parameter now. And then if you remember here we were calculating that function whose root we wanted to find and now we want to find the root of h. So we are going to calculate that h of xl and here also we were calculating that function at xm. And again since we now want to find the root of h we are just going to find h of xm. What this is going to do is this is going to call h, h is after all a function which is present in the memory of the computer. So it will call h with argument xm and xl here and get that value and use that value. That is it. So now we can use this together with this same main program that we had written. This together with the bisection function that we just showed will allow us to do what we found desirable over here. So this will indeed print the square root of 2 and the cube root of 3. So let us do a quick demo of this. So many roots is this program. So at the top I have written down the bisection as we had in the slides. Then we have f and g also as in the slides and then over here we have our main program. So main program is doing just what we said. So ideally if this runs correctly we should expect square root of 2 to be printed and cube root of 3 to be printed. So let us run it. So let us first compile it and then run it. So indeed it prints out 1.41418 which is a good approximation to square root 2 and 1.4422 which is a good approximation to cube root 3. So here is a exercise for you. Now what is given over here is a function which does take as an argument a function f which takes two integer arguments and returns an integer. And it is somehow using this inside and it is going to return this result value. What you are supposed to do is write a main program which calls this twice with appropriate functions passed for f so that the first time around it should return the sum of the numbers between 1 and n. The first call should return the sum of the numbers and then the second call should return the product of the numbers 1 through n. So this should be n factorial. And here is a little bit more detailed exercise where you are supposed to take a function and a range of x values and y values. So you should plot the values of the function which start at x0 and go to x1 and which lie in the range y0 and y1. And to look nice you should do things like maybe plot that rectangle, show that rectangle, maybe leave some margin. So just try to make it nice. But here is a really good use of why you might, another good use of why you might want to pass a function. If you want to find, if you want to show the plot of a function then you might want to write a single function which does the plotting and to which you can just pass functions, whatever functions we want. So what have we discussed? So we said that we often want to write functions that operate on functions. So say for example functions which find roots of other functions or plot functions. Such functions can be written conveniently because C++ provides a mechanism to pass a function to another function. And for this you need to include the header file functional which tells you, so which allows you to define the type of the functions that you are passing. This concludes this segment. In the next segment I am going to talk about lambda expressions which are, which is one more way of doing all this and a little bit more convenient way at that. So we will take a short break.


You like it. Okay. All right, it's on gosh. I think I think it's pretty cool, but I'm so scared No, you'll be you'll be fine. I'll be ready. I'm ready So Shannon, um, did you see anything in a video that you can talk about or um? Well, the the video I did was Embargo'd so but I think it's gonna come out on Tuesday. So you see that yeah But yeah, I got to see the g-force garage where they do all of their filming and they let me take some photos of like the PC builds that they do in there. So that was really cool And I got to see the new building where they have it's called the Nvidia endeavor building and it's like a Gigantic triangle. It's huge and like all of it looks the same So it's very easy to get lost in this giant triangle of a building and at the very top. They have a bar It's called Shannon's so I was like we have to go there So does the there's a company run that bar or do they contract it out to Lake?  I didn't check the prices. I think currency my hair there. I have no doubt that they're cheaper than what we find online from Alternative retailers, but they didn't have any ten eighties in stock They had they had three that I saw sitting on a dude's desk. I was like, oh, that's where all the ten eighties are But that was it I am a guy who's making buy with a 1060. I just bought a 1070 for Close to MSRP. So I was I was satisfied with the price. It was a 1070 ti Oh, no, so I was pretty happy with that But man, I wish I could get a 1080, but I don't really need it 1070 is close enough. All right Think we're ready to start.  Hey three two The Daily Tech news show is brought to you by its audience and not outside organizations To find out more hit the Daily Tech news show comm slash support This is the Daily Tech news for Friday, May 18th 2018 Tom Merritt is away in Australia, but I sir Lane holding down the ports And I am Shannon Morse in studio hack 5 here in Oakland, California And from the shores of Lake Erie, I'm Len Peralta, you know, it's so funny whenever Tom's out I'm like, how is the show gonna start? Feel I don't actually have a feline in my studio today, which is rare actually Also holding on the fort and keeping everybody's saying all week is producer Roger Chang. Hello everyone Hello, how's it going over there? Good a little breezy a little overcast, but Nice Good. Well, all right Without further ado, it's Friday guys been a long week. Let's start with a few tech things you should know This should be good news for anybody who is a fortnight fan Epic Games announced that the game is coming to Android phones this summer with customized features for mobile and battery saving mode Among others fortnight hit iOS and March and it was really popular in fact Sensor tower, which is a mobile analytics firm estimated that epic made 15 million dollars in in-app purchases in three weeks The first three weeks it was in the app store. Wow. That's a lot of money. It is. I will say I'm horrible I should have been a gamer battle royale. That game is so hard So a new report from strategy analytics says Apple sold an estimated 600,000 home pod speakers during the first quarter of 2018 about six percent of the global smart speaker market Amazon shipped an estimated four million Echo smart speakers during the quarter a 43.6 percent market share Google shipped an estimated 2.4 million Google home speakers for twenty five twenty six point five percent market share Alibaba racked up 700,000 shipments and Xiaomi shipped 200,000 Kind of a two company Race at this point. Yeah Yeah We have some more Apple news and let's talk a little bit more about it in our top stories Apple paid 1.5 billion euros Into an escrow account set up by the Irish government to hold 13 billion euros total in disputed taxes in August of 2016 if you recall the European Commission ordered Apple to pay the taxes it ruled Apple had received as a legal state aid Apple and Ireland are both appealing this ruling last October the Commission said it was taking the Matter to the European Court of Justice over delays in recovering that money So it looks like Apple is trying to be proactive even if they're late Also in Apple news after rumors all week local news station. W. R. A. L. That's in Raleigh, North Carolina Reports that Apple is set to open at second headquarters there Apple announced in January It wanted to establish a second HQ beyond where it is in Cupertino and hire an additional 10,000 people WRL reports that the only real hurdle Apple faces in Raleigh now is local legislators passing a bill to give the company a package of tax incentives a lot of tech companies already in the area IBM Cisco Pfizer it's a whole tech and and and biotech industry Yeah, surprisingly, I have a lot of family over there in the Raleigh area and the tech scene over there is Crazy booming like there's construction all over the place. So I'm not surprised that Apple is deciding to do this Well, you know the tax incentive thing when I was up in San Francisco You know, I lived there for a long time. That was the talk of the town, right? There were a lot of tech companies that you know threatened to leave Twitter was a one of the the biggest Examples of that and you know the city cities want to retain obviously companies and and and people and talent and the tax Incentive thing is kind of controversial. I don't know the details of of Raleigh's specific, you know proposals But it is a hub. What do they call it? Like it's like the tech triangle or it's a tech hub. Yeah Exactly. So it makes sense that they would be there because you've already got You know a whole industry of you know, at least the right, you know, tech talent. Yeah, absolutely It's it's one of those markets that's up and coming. So a lot of people could see it as like, oh I could grow family here. So they definitely would be incentivized to move there, especially if Apple's there Moving on the verge got hold of a leaked copy of an internal Google video that illustrates how data could direct human behavior The video was made in 2016 by Nick Foster the head of design at Google's research and development division X But the video itself is being called creepy and disconcerting by some referring to Richard Dawkins 1976 book the selfish gene the video premise imagines that people have an ever evolving online data record which Foster calls the selfish ledger and In the future tracking behavior can determine the direction of how that behavior will have Desired results Google tells the verge that the video was designed to be provocative and did not relate to any products in development At least in development yet. It's kind of funny. I kept seeing these headlines this morning black mirror. Oh, what's Google doing? It's like it sounds like somebody put something together to to you know, get an internal team thinking about something You know, it wasn't meant for the public. It's like it doesn't mean that they're building products that you know We're gonna you know ruin everybody's lives However Especially because it was you know in Google's a sort of, you know, sandbox, you know They test a lot of stuff in the X department having at least people in charge who are putting together Videos to get the employees of Google thinking about how data collection can influence people's behavior Especially these days is something that obviously people are going to find troubling Yeah, a little bit especially with AI and our issues with like security and privacy and everything it could definitely be seen as a Little bit too close to home. You know what I mean? Yeah. Yeah, I have not read the selfish gene but Perhaps I should In this day and age. All right, moving on PayPal is buying that Swedish payments provider I zettle for 2.2 billion dollars It's an all-cash deal and it happens to be PayPal's biggest purchase to date Has people bought a lot of companies, but this is the the most expensive the deal is expected to close in Q3 of this year I zettles co-founder and CEO Jacob de Geer will report to PayPal's COO bill ready and I zettled filed for an IPO Just over a week ago. So this timing is probably not coincidental It's not surprising to me that PayPal is doing this I recently spoke to somebody who works in the credit card industry, which I used to so we totally geeked out over beers for a Long time, but I discovered that there is a lot of countries overseas that PayPal is currently not accepted And I believe PayPal is currently able to be accepted in Sweden But the issue that they run across is a lot of people can't make further payments to other countries So it completely makes sense that people is trying to outreach and get the Acceptance into other countries so that from there they can market towards, you know Other EU countries or other ones in you know the Middle East or wherever it might be and it sounds like in this You know in this case, you know would remains to be seen but I zettle Having I zettles CEO now report to a COO at PayPal means that it doesn't sound like it's going to be operating Independently right because yeah, it's sort of merging a new market unlike Venmo, which PayPal bought and actually it's been a while now 2013 and I mean for you know all intents and purposes. They're totally separate products Absolutely, so this definitely is it's a good merger on PayPal's part And it gives them the ability to become a worldwide company that can be accepted everywhere no matter where you live So this is cool. Good on you PayPal a title announced It is hiring an independent third-party cyber security firm to investigate a possible data breach saying we feel it is important to make sure that Our artist employees and subscribers know that we are not taking the security and integrity of our data lightly And we will not back down from our commitment to them The action comes after a Norwegian financial newspaper published a story alleging title stats were manipulated And that the company was behind on payments to three major record companies after receiving a hard drive Filled with title play data title, of course denied the reports Shannon I am not a title user I actually signed up for like I used it for its free trial period and then it ran out and I Just switched back to Apple music But you know no problem with title necessarily but for title which is backed by you know It's Jay-Z's company and and and and obviously it has has quite a bit of investment to not be able to pay Royalty fees which is the whole business strategy You know title says that this isn't true, but where are these stories coming from right? It's it seems it's Very surprising to hear hear this come from a newspaper unless they have some kind of valid proof because if they didn't want it be considered slander So so the whole the whole gist of it is that this and I left out the name because Everyone would have a hard time pronouncing the paper And they received the hard drive data and they had it they had it they had it verified through a Secondary a third third party on the data now what so interesting is that title has vehemently denied like saying that the information was all Slander and it was there to just basically, you know, can't you know throw shade on the company? It's doing fine But a lot of critics arguing well If it's all fake then why are you launching an investigation into a data breach if nothing happened, right? Why why are you looking into it? if If you do indeed believe that there's there's not you know those that information that's been quote-unquote leaked Is all fake kind of and so it's it's it's very interesting and it there's a lot more that's gonna happen out of this whole thing because really what they were you know what they're alleging to have had happened is that they were inflating certain artists play play stats and in favor of other ones and so We're not in favor at the expense of other artists Basically people were getting not paid for the actual V are listens that they were actually getting and so that would then call into Question whether or not title is you know playing on a on a fair level table with all the people that they've signed on contract I Mean with all the music streaming service news that we cover and Roger and I were talking about this this morning before the show It's like when was the last time we talked about title two days in a row Title tends to get buried and it's not because you know again It's I'm sure they're you know, it's a great product in its own way, but it's so far down market share that You know you see stories like this and it's like you I think that lends itself to believing that maybe something really bad is going on behind the scenes because They just don't seem to be and you know again. These are all allegations So that you know it remains to be seen, but it is this is a very interesting story Could we say that title has not been making waves? We could That someone will choose that for the show Later on alright, so Shannon It's so great that you're here today because you are a security person and there's so much security news Even in you know just even today on a Friday, so I'm gonna try to set this up For you based on location smarts most recent news and then we can kind of backtrack and and fill in the blanks So location smart a data aggregator that collects real-time location data on millions of cell phone customers via cell carriers This is across North America had a bug in its website that allowed anybody to see where a person is located Without obtaining that person's consent now the site had like a trial period page That lets you test the accuracy if it's data before you you know sign up and give it money the page required It's plus consent they have to do this from the user before location data can be used Sent you a text message, you know you authenticate the whole thing. However, Robert Jiao He's a PhD student at the human computer interaction Institute at Carnegie Mellon Tell ZD net that skipping the consent step still revealed location data because one of the API is used on that page Was not validating and he kind of called it like a really elementary bug that they should have known a lot better about Yeah, it's it sounds like and from what I was able to collect from his video Although he did not release the actual script that he created What's he wrote a very simple Python code that basically bypassed what was happening on their website to? Secure that yes I have given my consent consent from my my phone via that text message or downloading an app or whatever it might be so that you can track my data and I've allowed you to do this and The reason why location smart ended up on everybody's radar is because of this earlier story about Secura and I believe we're going to talk about that a little bit more in our longer story But it's it's amazing that you have this company who's been working in the background for so long and Nobody really knew about them until now and it's just this teeny tiny Python script that could unlock all sorts of information And I don't know about you Sarah, but given you know that we do videos online That scares me a lot because I've I've had like a real-life stalker show up You know at my workplace, so it's scary to think that anybody could go to this website Bypass that consent Authentication and be able to track wherever I might be within very very good GPS coordinate coordinates within a few feet very scary. Yeah, you mentioned Secura So we might as well just get into how location smart played a role in you know a carrier like AT&T Talking to Secura's they're not supposed to be able to sell that data to certainly not to the government But there if there's a third-party company it gets a little bit murky, right? We covered location smart this week basically as the middleman on whether US carriers were sharing user location data with data aggregators And were there legal loopholes that would allow them to do so? so how How does Secura's and location smart talk to each other? so it's it's not Completely public as far as like what the back-end agreement is here but basically what I have understood from the gist of my reading is that the the carriers online have Agreed with Secura as far as like giving giving Secura information and then Secura works with location smart as a third-party To unlock all of the data about GPS coordinates But what's going on between? With Secura and the government is that they are using it for Police calls like with inmates and stuff like that. So It's not the main reason that they're using the company. It's like an offshoot But it's such a bit like okay. It's an offshoot, but it's a yeah, it's a huge privacy issue for Everyone who has a cell phone it's a huge concern and a lot of privacy advocates were really irritated with this This policy that came out of the federal government because it did have this loophole It was only for the carriers, you know ATT Verizon and everybody like that You can't share that consumer data But when they're working with a third-party provider that third-party is able to do whatever they want with that data because they're a private company So private companies aren't relegated or aren't You know Worked with the federal government the way that carriers are so let me jump in here. I'm sorry But I'm okay. So is this more of a A Legislation issue like if we had laws in place that would prevent this would this not be an issue or is There's still some gray area because of the way the technology works that they could still do it Even if it were you know in a you know hush-hush kind of way Well, I think the problem is a lot of times with you know, US regulations They they work really well, but they only work whenever they're catching somebody doing something wrong So these companies could still collect all sorts of information with the technology that they have at hand It's not until if we had some kind of regulation to For these private companies that they would actually get caught and then they would have to like pay a fine or something like that And that's not to say that they would never get closed down or something if they did have to pay a fine But there's nothing currently in place as far as technology goes to block them from being able to do this So we as consumers can't block them from tracking our phones if they know, you know our phone number Which is really unfortunate from that privacy standpoint. So I don't know if regulation would actually fix the issue I think it's more of a technological issue Well, the electronic communications Privacy Act prevents carriers from sharing user location directly to the government US government It sounds like there aren't any restrictions in place on other companies, right? However, there could be the FCC has been asked to investigate the matter. It sounds sort of like hey, we just had to add another Yeah, really really what was going on and you know that now we can fix it But but that's the way you do a figure things out sometimes now another thing that actually happened this week, which was kind of like, you know, like scratching the head of Security was the whole PGPS s-mime issue now, of course There was that story that that the EFF Pushed out there saying like everyone using PGP plugins. Stop right now Don't use it till we figure out what's going on You know use an alternate communication method, but from what I understand It's it's not really an inherent PGP flaw, but rather a third-party Plug-in flaw or if you could explain or yeah Yeah, totally. Sorry. I hit my mic, but I'll I'll kind of go into it and break it down by segments So in order to understand what the heck is going on with all these other news articles you kind of got to understand what PGP and s-mime is and they Kind of work the same not technical and technically on the background But for the most part they they work with the same kind of idea you have a public key and a private key and You allow anybody to have your public key and then you are the only person that has your private key and if somebody wants to send you an encrypted message all they have to do is Stick their public or stick your public key with their private key Mix it up a little bit and then send it on your way and then when you receive that message You can unlock it with your private key and hopefully you're the only one that has your private key So you're the only one that can see the plain text of that message So if anybody else receives that message, whether it's PGP or s-mime, they shouldn't be able to see anything It's just a bunch of garbledy gunk that doesn't make any kind of sense The unfortunate thing with e-fail is it uses this technique to gain access to those PGP encrypted messages so first it needs to get access somehow whether that's like Watching your network and stealing your emails or it could be as simple as knowing your email address and passwords So they can log in and they can read your emails or it could be somehow gaining access to the email server like whether it's Gmail servers or Yahoo servers or whoever it might be so they need to have access to those emails first off to make it work Once they get access though that's when they can actually use this e-fail technique to to kind of Make those messages a little bit different than what they originally were They end up adding a little bit of code into the encrypted message So you have an encrypted message that looks like garbledy gunk Up at the top they stick a little line of HTML code and this HTML code usually links to a picture and HTML when written out it looks like a little bracket IMG src and then an image link Sounds pretty easy as far as concerned But when they create this link they stick half of it at the top and then half of it at the bottom of the encrypted message then they send it on their way and When you open it up with your third-party email provider, whether it's Gmail or Windows Windows Outlook I don't use outlook or if it's I believe it's called Apple Mail for Apple users when you open it These are automatically look at that HTML and they say oh this must be a picture in your email let me go ahead and Figure out this HTML code for you and turn it into an image and oh it also looks like a link So I'm gonna go ahead and send this to the link server. Well that link server is the attacker So when it looks at this picture It's actually the plain text of your email and that gets turned into the link for the picture That gets sent to the attacker server So when they when the attacker opens up or gets a notification about this plain text message That should have been encrypted the whole time what they're gonna. See is you know HTTP the attacker server slash Instead of an image. It's your plain text Message it's your private private details that you sent to somebody and I think what makes it so In genius and dangerous is that they can't actually see the email until you decrypt it And essentially what this is is that they're literally peeking over your shoulder when you decrypt this encrypted mail So you are looking at your mail, but they're able to look at it too at the same time And I think that's I mean it does does Present a huge security risk, but this isn't an issue with PGP. This is an issue with yeah Outlook or the or your email client But the the HTML thing has kind of been known for for decades like GNU PG I believe they're called they came out with some information a long time ago And they were like hey, this is an issue You need to make sure that if you use a third-party email service or if you run one you need to either Not accept HTML not Roll out each HTML or parse it out and give people these image links Or you need to make sure that you're not linking out to external links whenever people automatically decrypt these emails So you can totally bypass this flaw if you're decrypting your PGP messages If you're already using it by either using a decrypter in the command line Or you can use one of the third-party services that don't even have the flaw in their email service So it only affects a few of the many different email providers that are available on the web right now I know Gmail is affected for SMIME. I believe it is one of the ones that is not affected at all is Proton mail and they're one of the best like security providers I know of that does email services So if I don't like the fact that a lot of companies including the EFF are saying stop using PGP because I feel like that's It's going to scare a lot of people away from that security and one of the great quotes I saw from the GNU PG website was that's like telling people all the locks are flawed Take all the locks out of your houses, you know, take that lock off your front door because It's not perfect. So just have nothing. Yeah, it's not perfect. So might as well not have any security We know PGP isn't perfect But it's better than having no security because they it's still a targeted attack So I recommend that people still use PGP. Just don't unlock it with a third-party service. That is vulnerable Good explanation Shannon. Thank you. Wow. Yeah, of course. Of course. No, that's that's why we love you No, that's great And I'm sure there will be more update to the story and we will obviously cover them here on DTNS Thanks to everybody who's participates in our subreddit You help us choose our stories and learn a little bit more about what you're interested in submit stories and vote on them Daily tech news show dot reddit.com. We also have a Facebook group if Facebook's your bag great hang out there Facebook comm slash groups slash daily tech news show We got an email from Russell Boyer who is a Instructor of business admin at Kansas State University And he had some thoughts on our discussion with Scott the other day about exam cheating That was on Wednesday He says educators are always gonna be in an arms race with students because students are gonna cheat Wearables are problematic because a lot of faculty just don't realize the capabilities of these devices. That's the problem I started asking my students to remove smartwatches during exams about three years ago partly to prevent distractions But also to block students from trying to crib from Notes on their watch or using a watch with a camera to take notes or take pictures of the exam Very spy of them cheating on assignments outside of class has also become very problematic though Many faculty now employ some variety of online tool to help monitor their students work Many of my students homework is in the form of Excel and I use a system that adds digital fingerprints to homework assignments That alerts me when a student submits an assignment with any identifier other than their own And then he wraps up by saying DTNS is the first podcast I recommend to my students as a way to keep up with what is happening in the world of tech So thank you very much Russell Shannon Yeah, I know you don't have children and you know in in school and ready to cheat yet But the idea that there's this whole new, you know, can't have a phone in class But now can't have a smartwatch. Yeah, and you know, perhaps in the you know in the future glasses as well It's a it's a it's a real problem Well, I went to college when cell phones were just starting to become a thing And it was an absolute problem for a lot of teachers because not only would the phones bring in the middle of class But people were figuring out that you can take what used to be black and white photos on your on your little flip phones But you could read the notes while you were in class just like stick them right underneath your textbook or something And you you would have access to whatever you needed. So it's it's a total arms race It's like a tennis match between the students and the teachers But you know, I always had vives don't cheat because you know, I think you could get thrown out of colleges if you cheat these days, so Right, like if you get away with it, you still know you did it. Yeah Someone who does not cheat though is Len Peralta who it joins us every Friday and has been drawing a Customized illustration of what we talked about in the show Len. What do you guys? Yeah, you know I'm always impressed like you Sarah by the knowledge that Sarah that's Shannon brings to the show and This is a little, you know Something I did for her cuz I felt that she was she was she's just such an amazing person Amazing Really, this might be my favorite thing I've ever drawn for the show So accurate It's really cool For those of you who aren't watching It's it is the Obama Hope's poster of course that meme But it says hack and it's pictures of Shannon. Oh my gosh You didn't have your don't have your pink hair anymore, but that's sort of her. That's okay I'll get some overtone and we'll make it happen again Beautiful shepherd fairy was the original artist, right? Yes I'm getting that right. Yeah, I love it. Oh Ram it. Yes, and this is of it. Oh, you're very welcome Shannon I mean your your knowledge goes. It's just crazy. It's crazy good And you can actually go to Len Peralta store.com and if you want this poster You can do a digital download or you can get it. You can just buy it and I'll sign it and send it to you So there you go. Well, thank you Len for being here today and every week your artwork is unparalleled and Couldn't do it out. Yeah. Also. Thanks to Shannon Morris Shannon besides, you know researching PGP and location smart What what you've been doing lately? Oh, man We've been doing a lot of stuff over on tech thing T. E. K. Thing calm Recently Patrick Norton reviewed this really cool universal remote that you can speak to and it's supposed to be able to get you Exactly to the thing that you want to watch whether it's on your Roku or your Apple TV or wherever you might have this information So it's really easy to use and it was very very fun to check out And I've also been working really hard on threat wire over at threat wire comm So if you want to learn all the ins and outs about the whole PGPS Mime thing that was going on and those email vulnerabilities definitely check it out I also have a patreon account if you want to support me there We absolutely do. What is it? patreon.com slash threat wire. It's real easy Awesome. Well, thank you Shannon and Len. I'm speaking of patreon. We have one too patreon.com slash DTNS We also have a great store with some new merchandise if you haven't been there lately check it out Daily tech news show comm slash store our email address is feedback at daily tech news show comm We love your feedback. Keep it coming. We're also live Monday through Friday for 30 p.m. Eastern 2030 UTC you can find out more at daily tech news show comm slash live Monday is a special day. Tom is taking over special edition of DTNS from down under It's an Australian round table with Peter Wells and Raj Dutte Roger and I and the whole gang will take back over on Tuesday. See you then this show is part of the frog pants network Get more shows like this at frog pants comm Diamond Club hopes you have enjoyed this program Sorry, that was a long outro That was a good outro though I was trying to cram all that information. I should have kept it down to a sense. No, no, it's fine. It's fine No, it was great Shannon. You were great Len. You're great. I know you need to book lens Yeah, don't you won't hurt anyone's feelings. Okay, thank you for the photo.  It might it literally might be my favorite thing. I've ever drawn. It's just really cool You better sign my coffee. I will of course All right, everybody. Have a good weekend. Bye Len. Thank you. Have a good one. You too How's a great show? It was I kind of have like I have the sniffles a little bit.  So great So of course title was one of the title was one of the titles Fails to make waves Making waves Tied a tidal wave of security news. I love that one because it covers Both topics that we we two topics we covered in the show There's also a title and a Royal T mess Tidal wave of rumors But my fav is a tidal wave of security news What if it was like a tidal wave of security breaches? Because that's kind of the news, right? Yeah breaches beaches close Synergies of She's trying to the Shannon trying to join and is unable to She's back. Yay, she's back So Shannon, what do you think of this title a tidal wave of security news or a tidal wave of security breaches? I like security news And that's what we're going with You have plucked the final pedal off the floor Isn't that how people used to vote on things yeah, well it used to be like like What was it true or fall or what was it with the He loves me. He loves me. He loves me. Not. Yeah, that's what it was I don't think I ever did that that only worked on early marriages in the 21st century. We use we use Tinder Right, right. Yeah, I definitely wished on a shooting star once or twice Oh, yeah, I've done that because those always felt special Did you ever did you ever have the one where if you blew on a dandelion of the little things flew away? Yeah, yeah used to do a lot of that. It's probably why we had so many dandelions in our yard Spreading the seeds It's all your fault me it is Spent a lot of time as a kid looking for a four leaf clover because I truly believed that I would get three wishes I Did I really like I my wishes were all laid out like I just had to find that clover. Oh, that's so cute I know never found it I always thought that there really was a pot of gold at the end of the rainbow if you could find it and I can never find the end of the rainbow What about a double rainbow? Double rainbow double the gold I actually forgot about that guy, you know, like people say double rainbow now and it's like it's just part of our thing like yeah Yeah, cool it's It's interesting because There's things there's certain memes that I totally don't remember Yeah, and you know, I don't know there ones that like the double rainbow for some reason stick in my head I work with some young ins who Who weren't around during like e-bombs world and all those things back in the day So sometimes I'll like link them to the YouTube Versions of these old flash videos and they're just like wow, this is weird Shannon This is what you are you watch this? Yeah, I was like, this is what I used to watch at high school Well, so there was um, I won't spoil anything but there was an episode of Berry, which is a really good show recently and There's this scene where somebody says Leroy Jenkins We all know what that means, you know, and I laughed and the person next to me was like what what? Leroy and I'm like, yeah, it's like this really old joke from a video game. I never mind But like I was like that Barry show for like knowing that most people are just gonna be like, why did he say that? That's amazing. I love it Oh, man, that's okay. That was one of the ones I sent to my very young Assistant in the studio. I was like, you need to watch Leroy Jenkins. She was just like, I don't know what what's going on It's the sort of thing where like maybe if enough time passes, you're just like, this is funny Yeah, was at the time. Yes. It was ridiculous Charlie the unicorn. I went to a museum of ice cream and they had a unicorn So I started posting a crapload of pictures of this thing on Instagram and I was like, look I found Charlie the unicorn. He's on Candy Mountain. I found him and he's in San Francisco and people are just like What's wrong with you? What are you doing? Why why are you writing the unicorn? Wasn't Charlie where you got his kidney removed at the end? Yeah. Okay. Yeah, just spoiled it. Come on Like come on Do do do unicorns like do they need their kidneys? I mean They're magical animals. I mean they should be able to get by just they just need one of the four and not Charlie Yeah, it's funny how these things sort of yeah, like Roger you've got, you know, the one meme that sticks for you or There was somebody the other day on Facebook who like referenced Keyboard cat and you know, everybody loves keyboard cat, but like he linked a video and I'm like, that's not keyboard cat Like that's like some other cat and so like I like couldn't help myself in the comments I like couldn't help myself in the comments. I'm like the original keyboard cat was fat. So who died in 1989? like Like the like conversation stopped Look at us old us old cronies.  Yeah. No, it's it. We're gonna have Our own tall tales, right? Dude, did you see whatever like surf like a tsunami or something because it's on, you know, youtube or Something it's it's gonna be crazy and we're gonna have a mishmash of like intergenerational ideas That will only make sense to a future generation like we'll like you just basically Like crammed together five different things that don't belong together But to that generation all be the same. I think tom and I were talking about this how The way we pull music from like say everything before the 20th century Doesn't matter in the 100 year period of the 1800s. We just assume all its music from the 1800s So we'll put it together Like one from 1810 and one from 1890 even though there's like an 80 year difference It will just assume that they belong together. It's like putting like um motley crew with uh Brittany like just to be yeah, britney or justin beaver. It's like well, it happened all in the same couple of decades It's all the same music Well, you know, it was like we were talking about decades the other day, right like the 1800s. Yeah, we'll just throw that on one genre It's true. It'll be it's gonna be crazy. It's gonna be crazy like the entire 20th century We'll include the depression world war two You know the space shuttle and You know, whatever popular movie like it'll all be at one time Oh, wow, Lord of the Rings Lord of the Rings came out in the 20th century, right? Yes, it did Yeah, so like Lord of the Rings the matrix Lord of the Rings works I think the movies are Yeah, the movie came out in high school and I was still oh no wait. I was in that was in the 2000s Yeah, that was 2000s. I remember who I saw the first Lord of the Rings with and I know that was After 2000 yeah, I was in high school I remember because I ended up buying a legolas shirt because I had a crush on him Orlando bloom or just the character Orlando bloom as legolas. I didn't like the actor and stuff. I just wanted an elf as a boyfriend Um, what did that work out up too lately? Didn't work out. I haven't seen him in anything Well, he got married to uh, ori dated or something a victoria secret model And then they had a baby and the only reason I know this is because she was my favorite vs model Well, she's no married to evan spiegel CEO snap. Yeah, that didn't uh, didn't work out Yeah Hollywood Hollywood and technology we should find more intersections of the of the two. Yeah. Yeah Like how captain kirk a k a william shatner used to hawk Commodores on tv. What? Yeah, it used to be in a bunch of uh vik 20 and commodore 64 television ads That's amazing. It was captain kirk and who who else to tell you about the wonders of technology than a guy who Supposedly ran a starship. Oh, of course.   They're it's so weird how that works though, right if morgan freeman came knocking on your door And that kind of demeanor. He's he's known for in his movies Like and he's just selling you like vacuum cleaners But if he does it in a way, it's like, yeah, I'll buy a vacuum cleaner for me Right I want morgan freeman to come over and just like read a threat wire episode for me Oh, who's we're like read my wedding announcement I think we were talking about I think tom said he would like morgan freeman to eventually be you know a smart speaker voice Or somebody god one of our guests on the show, but I was I've been thinking about that ever since like, okay, if I could pick anybody who would it be I still haven't figured it out. Yeah, I don't know who my favorite voice is I like richard attenborough the guy from uh, who does the nature the nature things the um, the british Naturalist who did all the voiceovers for all his Naturemoop films planet earth Well planet earth is the most recent one. Yeah, but yeah, he's that guy Yeah, can I uh, can I tell y'all a story about smart speakers that's somewhat incriminating but really funny? Yes Okay Uh, I went to the this thing in the city called the designer showcase or something like that and it's it's where all these like super Fancy design like house designer people they come in and they do all this decor And they do all these different showrooms in a house And it's like millions of dollars that they spend in these rooms and just go like completely nuts with these decorations Well, one of the rooms had an alexa in it or an echo And I was like, oh I wonder if it's tied to somebody's account. So I started talking to it. I was like Alexa, what's on my schedule for today? I mean stuff. What's on my schedule for today? And she let me know and then I was like, uh Thing order me a pizza and she was like, which service would you like to use? And then I was like, hmm a thing add a Really awful thing that you shouldn't be able to buy on amazon to my amazon wishlist or my amazon shopping list and she was like, okay I feel bad for this person But at the same time I was like you left your amazon echo in a public place What do you think was gonna happen? Well, also if it's like designed to look cool. I mean, you didn't have to plug it in It would yeah When it's like there's like fake tv's and stuff Everything is like out of it. Is that the future of pranking people just messing with their smart speakers? It's not like tp'ing their house or putting saran wrap over the toiling bowl. Right? Yeah, I'm gonna mess with your digital life Yeah I'm gonna put stuff on your shopping list. You would never have bought Like I hope I didn't mess up the relationship, but it was really funny They're gonna find out it was me and be like My girlfriend broke up with me because you put blah blah blah on my amazon wishlist. I'll be like, oh, sorry, man It was me So what is the point of the showcase? You know besides smart speakers like uh, they actually they they raise funds for a local like Designer like art university in the city So you pay for a ticket to go into the room And then you you get to meet the designers and talk to them and you can take pictures of their different rooms And it's really gorgeous like the art that they include in the rooms and the way that they tie in all the colors together And you get to see some really cool like furniture like there was a heated outdoor um porcelain A bench that they had set up and I was like It was so it was like it made your bum warm and you could just sit there forever Even though the bay sometimes gets really cold. I was like, man, I could sit here all night I wouldn't even need a fire pit So it's sort of like inspiration the way that like a runway show would be like none of us were buying that stuff But it will like influence. Yeah It was really cool No, they had like they had it set up outside and they made a bench out of it And it was very pretty and it had heating inside of it So you can sit down and your bum would be heated. It was amazing All this happens after I leave All right. Thank you everyone for listening to this entire week We hope uh, we've been able to fill you with plenty of technology and give you a couple of gaffas along the way Monday tom again is doing a round table this month's round table episode from australia with uh, peter wells and raj Dute uh, so tune in for that and then sarah and I will be back Tuesday to felt the rest of the week Tell them thank you again. Thank you everybody. We love you. Thank you for your support


There you go. Okay, perfect. First of all, I want to thank everyone and especially Deb and Kathy for this incredible opportunity to be here at Joll's 50th anniversary of the Texas Art Institute School of Perfusion. It is certainly an icon of education in our profession. It's where our profession from a modern perspective, I think, began of course with the founder Charlie Reid. I understand that Charlie's son is somewhere in this audience. There's somebody that kind of looks like him, but maybe a little older, not as crazy maybe, not as wild, but certainly here. And it's just a tremendous honor and I appreciate you guys being here, the senior students, the junior students too. You get your chance next year and you guys are welcome to participate if you'd like to. But just being here is incredible. So thank you for very much for the opportunity. So my talk, I'm going to start my little timer and I'm actually going to let it only go for 15 minutes because if I don't, I talk too much and you'll all find that out about me. So my talk is on ECMO overview, why, how and outcomes. Now, in reality, I could probably talk on this subject for 15 days and still not cover a portion of it. It's just such a complex issue. So why do we do it? Well, we use it for circulatory support when we have circulatory collapse, cardiogenic shock, MI, PE, post cardiotomy failure, failure to wean from cardiopulmonary bypass, you know, obviously. And of course, we use it for pulmonary failure, ARDS, status asthmaticus, any cause of pulmonary failure could be pre-transplant support. There's just so many different reasons we do it. But at the end of the day, we either need circulatory support or we need circulatory and pulmonary support or we just need pulmonary support. That's kind of the way this whole thing works. So how do we do it? Well, you have VA, so we can do venoarterial ECMO, right? We can do venovenous ECMO, we can do exotic cannulations where you have VA-V, venoarterial to venous, we can have venous venous to arterial. And for those of you who don't know, friend of Tammy's in mind, Tammy, I think you heard from Tammy next, maybe or second after me, John Ingram pointed this out to me. And I think intuitively we knew it, but he pointed it out. Where the dash is, is where the oxygenator goes. So when you're describing ECMO, it's really good to know what are we doing? Do we have two accesses, two returns? Do we have two different circuits? Do we have one access, two returns? And so where that dash goes tells you a lot. For example, in the VVVV, clearly two different circuits, two oxygenators. That's the one at the very bottom. We can have central cannulation. We can have peripheral cannulation. You can have combinations of those cannulations. So really, at the end of the day, there's all kinds of ways, all kinds of places to put these tubes, where you put them, however, is going to depend on what you're trying to accomplish and whether you accomplish it well or not. So here's just a diagram of all the available options. I won't go through them all, but you can see the ones on the far right of the screen being the butterfly technique. You have dual circuits, and the ones on the left are different iterations of VVA, VAB, and so forth. I know you can review all of these, Chair Leisure, but leave it to say this is only a partial representation of all of the different things that you can do. Now, for the senior students, outcomes. Outcomes is a big deal, and I'm actually spending probably a little more time on that than anything else today. I think if you find six folks believe that when you go and they give a consult, we're going to have to put this patient on ECMO, and we really think it may benefit your patient, that they tell with VA, it's 20%. If you think it's 20% is what is normally consulted as the survivability. So keep in mind, this is survival that the patient will survive. How many of you think it's 20%? 20% raise your hand. Okay, how many think it's 40%? Okay, two hands. How many think it's 60%? Okay, and how many think it's 80%? Okay, good. 10 bucks each. Okay, the VACMO. When you consult for that, the just average, how many people think that they tell the family, we think it's going to be about, and this is for any cause, not specific, so keep that in mind, 20%. 40%, 60%, and 80%. Okay. So very good. So all of you get 20 bucks. Fantastic. 10 bucks, 10 bucks, 10 bucks, 10 bucks, 20, 20. Okay, I may need to borrow some money, Deb, Tammy, anybody, collection jar out there. They're smarter than I thought. This isn't going well. So let's look at survival. Survival is such an important thing. And this is public survival. And it's very, very, I think inconsistent at best, and confusing even to me. And in some ways concerning, because this stuff gets published, people read it and decisions are made about using ECMO in various circumstances that may or may not be a great choice. So we have to look at the data, however, in order to understand. So in this one year outcomes with VV ECMO, this is for COVID-19 published in the STS. We see here that they, and numbers relatively low, it's 30. All VV, BMIs were about 30, and I highlighted a couple of things we can just look through some stuff. Days from intubation to ECMO cannulation were two, which is really short and good because that's important. I think a key indicator, the longer you're on vent support with all the barotrauma, the less likely you're going to recover. And that's something that's very important. Do you have a recoverable disease? Putting people on ECMO, if you aren't going to transplant, you have to recover because you cannot stay on ECMO forever. There are some who have been on ECMO for a very long time and actually survived. So you have to remember there's outliers, but then there's also everyone else. Who's the outlier? No one really knows. You look at their CRP and their PCTs and you can see what those elevations or lack of really gross elevation is. Their PF ratio, surprisingly, were 80, which is low, but I've seen much, much lower before a decision to put a patient on ECMO existed. And you can see their peak pressures and our plateau pressures were 30 and 32. Again, those are high, but not unreasonably high. We've seen much higher numbers than that. Creatinines down in the middle bottom were relatively normal. Not a lot of renal failure in this population of patients. And let's just get right to the thing. They actually used 33%. So out of 10 of the patients, they used cytokine hemo adsorption, which is like the cytosorb filter that you use for removing cytokine. So molecular adsorption recirculation technology. Those that survived ECMO 93%. Those that survived the discharge 90%. Duration of the ECMO was about 19 days. We've seen much, much longer than that on COVID patients. And when you go to the final slide, their one year survival was 86.7%, 26 of the 30. That is absolutely remarkable. I worked here in Houston in a variety of different hospitals, including right here at the Medical Center with patients that were on VV ECMO for COVID. And none of the places that I worked, I saw this kind of survival. But yet this is still published and published in the STS. So small in number, respect that, but how selective were they on their patient population. And that's something that always has to be asked. When you take a look at this other study here monitoring cerebral oxygenation, and this in introspore transport, this basically the study was done to take, and this is published in the SIO 2022 again COVID patients. And this was to determine whether or not the use of cerebral oxygenation would be beneficial for taking a patient from hospital A and transporting them to hospital B. And if you just look at it, the survival of these patients after ECMO support for VV was 50%. So now this was a smaller end number, it was 16, but I still believe that there's a definite difference between a 50% mortality. And in 93, 86% mortality, 86.7, almost 87 at the end of one year. That is a very remarkable difference. And why is that? Well, I mean, we can look at the data and try to understand it. Hours on mechanical ventilation for those that survived were 83 hours, those died were 98 hours, so they were on mechanical ventilation longer than the previous group. Their PF ratios, remember I showed you it was 80, now they're 70, 72, so for average 72 for the survivors and 68 for the non-survivors, though that was not quite statistically significant. Their peak inspiratory pressures were a little bit higher. 34 was the average, 33.5 for the survivors, 35 for those that died. You can see acute injury was higher in this population of patients as well, and obesity seemed to be a little bit higher also. Is this a patient selection issue? Is this a, we waited longer and kept them on the vent and their disease is now irreversible? Is it that the previous study was that we put the patients on ECMO, maybe they really didn't need it? And I think that it's very important to understand that ECMO is in and of itself not good for us. If we take a normal healthy person and put them on ECMO, it will hurt them. And there's a whole host of things that happen without getting into that, but you have to take that into consideration. Deciding to put somebody on ECMO can be the worst thing you can do for somebody if they cannot necessarily go on ECMO and still survive their disease. And how you make those determinations, man, I'll tell you what, I've been doing this for a long time and I can't answer that question. It is just clinical judgment and trying to do the right thing at the right time for the right person. It's very difficult to do, but you will be confronted with this because I could assure all of you guys, especially the senior students and the junior students in the back. ECMO, I believe, will continue to advance as a therapeutic modality. And the harsh reality, and you can feel how you wish, but I'll tell you my perspective, is that there will never be enough profusionists in the market to accommodate what is a seasonal and fluctuating volume of patients for a therapeutic modality. If you have enough profusionists to cover every ECMO that could happen during the pandemic, you will have so many profusionists when there's not that pandemic or there's not that high acuity, you will not know what to do with yourselves and it will be very bad for our market. On the other hand, if you just give it away and have zero control of it, then that can be very deleterious for our industry as well. We have to somehow find a balance between the management of a tool and a modality, while at the same time being able to utilize people who are going to manage the technical component of it at the bedside, hour by hour, and then use us for rounds consulting and so forth. I think that's the only way it's going to survive and not exclude us, but other people may have different views about that, and certainly I respect those, but that's what I think. Moving on from here, we look at this predicted, how about this? No, this is, no, that's not it. I'm sorry, I went to a different, different study. So we look here, then we look at, that was the 16. Then we look at this last study, so there's three studies. This is the next one, also in ASIO 2022, and this was done with a large N number, now almost 2000 patients. And if you look at their mortality in this particular study, it's pretty close to 50-50, and this is their numbers, much larger N, but you can see we went from, and it's about 50-50, it's a little bit better of survival. It's 55, I can't really tell you what that percentage is, somebody could do the math on it, but keep in mind, we're going from a 93%, 87 to 93% survival to a 50% survival to a plus or minus 53% survival. So those are consistent, but there are lots of other studies out there, lots of them that show variation from 80% survival, 50% survival, 30% survival, our data, which we're not quite complete in putting it all together to make sure that we are as accurate as possible. From what, just on a, with a caveat that this is not ready to be necessarily disseminated, TAMI were somewhere around 15% survival with an N of 100, so we have an N of 100, and we had about a 15% survival. And that's dismal. It was very discouraging, and my experience, again, coming to the Med Center and being some of the hospitals, excluding those patients that were able to be transplanted, but I'm talking about patients that recovered from their disease, left the hospital, having survived COVID, ECMO, my experience here, not necessarily Texas Heart, but over at some of the other institutions was that their outcomes were just as abysmal. So it's surprising to me and concerning to me when I see these extraordinarily high survivors, if I have five minutes left. If you're in the REST score, you can see your higher REST score, you have a higher probability of survival, a lower REST score, and you can get the REST score online is very easy. And you can look at your patient, you can put in all the information if you have a very low REST score, you have a much higher probability of mortality. But again, I think it's a very good tool to use. It's been validated several times. There's been also people have validated it and found that it really wasn't as accurate as they believe it to be. So again, you have to take everything with a grand assault, consider all of the resources, look at the patient, make determinations. I remember I was speaking very overweight patients don't do as well, but yet there are patients who had either a patient that was 18 years old had a BMI of 79 and they published it was on ECMO for three months. Yeah, 79 can you believe that that's three people needed three ECMOs at one time, but that patient survived. And those are outliers one never knows when that's going to happen. And so but is that the norm and really no predictably it's, it's not. So, yeah, you just don't know. Okay, test for you guys this is for this is the bonus round and this is for the big money now. Okay, this is for the big money. There's no trick. So if you I can't tonight. Is there a mouse I can use on this. Does it work. Okay, good. So if you look here. Yeah. Okay. Can you take this away. How do I make that go away. Just drag it. Oh, you're doing it. Okay, I let go. Perfect. Okay. So this line right here is in the right femoral artery. This line here is in the right femoral vein. This line here is in the left femoral vein. And this line here is in the left femoral artery. So my question to the students and you could just blur it out first one to blur it out wins that round. What is this and where is it. Okay, it's not too at a time so whoever spoke first whoever spoke first stand up say what you got to say. The SFA Superficial Femoral. Very good. Okay, you won that round. Don't let me forget. Okay. Now, next question just boarded out if you want. What do you notice about these two access lines. This is in the right femoral vein. This is in the left femoral vein. What do you notice about these two accesses anybody see it boarded a stand up raise your hand boarded out color difference very good. Okay. Now, for the final question on this round. Where is this cannula. Where's the where what is this draining. It's in the femoral vein and it's red. This is in the femoral vein and it's blue. Why is it red. What's it draining. You moved. Come on, you left. Anybody say it. Junior students anybody got an idea is where near the RA. Okay, you're staying a junior student sorry. Wrong answer. Anybody else. Okay, so any of the any of the experience profusion is where is it. I'm sorry. That's a good thought but no, that's a good thought though you can join those guys back there. So, it basically so let's think about it. I'm going to give you guys a chance. It's red right. It's draining arterialized blood. It is in a vein. It's in the right femoral vein it's kind of hard to get to the pulmonary vein from there you can do it. But how would you get weight you're you're getting there. Where is it. How did it get there. Transseptimal approach is that what you're going to say. It's got to be a tandem you are correct. Good job kids. That's a catheter that's punctured through this atrial septum into the left atrium to decompress the left side. Very good. That concludes my talk. Thank you all very much.


On Thursday Israeli forces fired at hundreds of people in Gaza who had gathered to collect essential food aid. The death toll has crossed 110 and over 750 people have been injured at least. Now this is not the first time Israeli forces have fired at those who have gathered to collect aid. We know that the aid flow to Gaza has been quite less and people are in extremely difficult situation. The humanitarian crisis has been worsening but this is by far one of the most brutal incidents of this sort especially considering the death toll, considering the number of injured and considering the fact that it was not only army soldiers who were firing but the reports say that even tanks were present to it artillery was involved and this is there's perhaps no greater example of the brutality of Israel's assault since October 7th. We go to Abdul to talk more about this. Abdul, thanks so much for joining us. We did talk about the massacre in brief yesterday but could you maybe take us a bit more in detail as to what happened and we'll talk about the responses and the larger situation after that. Well Prashant as we all know there were hundreds of Palestinians gathered in Gaza city at Nablusi Square waiting for food aid. Of course as we know the humanitarian situation inside Gaza is quite bad primarily because of the war Israel has waged against Palestinians and also because of course the aid delivery has been disrupted by the Israelis because of the bombings because of the ground offensive because of restrictions imposed on it. So whenever there is some hope of aid coming a large number of Palestinians gather to collect it and that basically when they were waiting for it Israeli forces started firing at them later they claimed they fired because there was some kind of chaos of course the large number of Palestinians gathered they were moving here and there they were desperate to get food and other things and they used this situation to kind of instead of kind of attempting to create an order they basically fired at the Palestinians killing more than 100 people Palestinians and wounding around 750 plus people and there are reports coming that some of the people killed don't only have gun shots gun wounds but also they were trampled by the tanks there were also firing from the drones which were flying all over the place and apparently they were also fired from other unknown sources. So this is the situation in which of course this all Israelis claim first they denied that it is because of them that Palestinians have died but later on after it was clear that they have been responsible they admitted that of course their soldiers fired at Palestinians but they claimed that this was fired only after some of the Palestinians apparently started moving towards them of course this allegation has been rejected by a lot of eyewitnesses who claim that this basically happened because Israeli forces use the last gathering to basically target the Palestinians as they have done it before this is nothing new there are other instances in the past in the last five months of war where we have seen that how large number of Palestinians gathered at one place particularly for food and other aid delivery or for other reasons have been targeted by the Israeli forces and some of them been killed but this is the largest number of Palestinians killed at waiting for food aid so far. Right Abdul like you said this is nothing new for Israel it has happened in the past but I think the scale is something that has been that is quite unprecedented what have been the kind of responses that have emerged from various sections well of course most of the world has criticized the calling it masakir some of the countries of course called it masakir and some of them basically called it war crimes also of course for example a brazilian president call it another example of how israel is basically committing war crime after war crime in Gaza then of course most of the Arab countries in the neighbor have also condemned the killing and called it of course part of the genocide which israeli is carrying against the Palestinians some of them have also demanded thorough investigation and of course accountability for those who are responsible the most of course that is again not shocking but if you see US of course saying that the killing of so many people is sad and so and so forth but when the Algerians presented a kind of draft note in the United Nations Security Council basically condemning the violence and calling Israel responsible for it US blocked that statement and did not let it go even the US spokesperson have not kind of taken a kind of strong of course they avoided directly alleging Israeli forces for the killing and they have tried to kind of kind of some kind of kind of give Israel some kind of clean cheat if you see if you want to say it then there are also attempts made by for example UN has criticized the killing called it condemnable but their their spokesperson as per the reports avoided taking the name of Israel so these two kind of responses we see that of course the killing is bad but whether they are ready to name Israel at that where where it becomes a crucial because if you are not taking the name of the culprit which is who is responsible for for the killing of more than 100 people at one waiting for humanity in aid of course basically you are trying to kind of give some kind of indication that all these kind of killings are acceptable in the name of so-called security which Israel has been cleaning sorry claiming so the responses of course are varied most of the countries have condemned it but US and its allies have and even of course have not have avoided to take strong stand which is required at the moment to kind of force Israel to stop such kind of massacre of Palestinians. Thank you so much for that update. Doctors in Korea have been on strike over the past few days in protest against an increase in medical quotas now we talked about this issue before and this is a complex issue there are many views within the health community in Korea itself but the key news point here is that the government has begun cracking down on these doctors in various ways doctors were striking demanding better working conditions as well as any other demands we go to Anish to more talk about this. Anish thanks so much for joining us we have talked about this issue in the past and there are some nuances which we'll get to in some time but the immediate news is that the government is cracking down on the protesting doctors so maybe could you start by telling us a bit about that. Yes so the fact that most of the doctors pretty much like apart from a couple of hundred of the nine thousand or so doctors have not returned to work and they have essentially held back against the government's deadline for the return to work orders to come into effect which was yesterday. Now this they have been they have been raiding offices of the KMA the Korean Medical Association both in Seoul and other parts of the country they have you know seized electronic devices of the doctors there the organizers are being held and detained for actually for instigating that some of the charges include like they have instigated the doctors to strike and you know for the mass workout that is still in effect. So the whole point is pretty much to intimidate the striking doctors there's nothing new the UN government has been guilty of doing this for any kind of labor mobilization under his administration we have seen construction workers moments and other unions being targeted by the UN administration over various under various pretenses including in some cases of you know aiding the enemy which is North Korea in this case. So there has been targeting of workers unions workers movements trade unions and this is nothing new in that regard nevertheless most doctors have held on to it as of now there has been no announcement and most of them are in favor of continuing the strike which have you know some several sets of demands that the government right now is not ready to negotiate or even have any kind of talks with at the current moment. Right Anish but also in this context would you tell us a bit about the demands especially considering that even in the health community there are some divisions about it. Yes so some like the most important and immediate demand and the reason why the strike has happened is primarily the steep hike in doctors admissions they have increased the number by 2000 seats for the upcoming year which on top of the 3000 and so seats it's a massive hike and basically two-thirds more than what they have already. The doctors are arguing that at least the KMA are arguing that the the hike in the number of seats for medical admissions would actually put a strain on the existing infrastructure which is not up to the mark but there are definitely differences because multiple health movements and health organizations are you know of the opinion that there is severe medical workers and you know doctor shortage in South Korea we have talked about that in our previous show as well South Korea has the the lowest doctor to patient doctor to civilian ratio in real terms if you take out all the traditional medicine practitioners and other paramedical group professionals the actual number of medical doctors and the ratio that it brings down to two per 100 per thousand and that's a that's a very massive massively low proportion and that clearly shows the kind of shortage and it's even worse in some of the most essential sectors like gynecology, pediatrics and you know elderly care in many of these doctors are limited especially for in the physician like physicians are obviously a larger group because it's a it's it's a profession that actually brings you greater returns and greater income so there are other demands that the KMA and other medical health organizations have also brought out which is the fact that there needs to be better in investments the infrastructure needs to be you know brought out like simply and cosmetically increasing the number of doctors will not help the the already you know crisis rate in health infrastructure it was seen the severity of this shortage was seen during the pandemic but it was also seen that outside of Seoul pretty much and it's a larger surrounding metropolitan area the health infrastructure in South Korea is quite lacking especially rural outbacks and that those areas many of them have hospitals without any proper doctors even and this is something that needs to be that requires a more comprehensive plan than the government right now wants to do they are actually more concerned of preserving the existing market based model which pretty much has created this sort of very uneven shortage among the professions among specialties even and it has like you have more and over you know surplus number of doctors in cosmetics and you know allied fields disciplines and not enough for pediatrics that clearly shows there is a big big problem and the market based model is not working because obviously doctors are anybody any new incoming doctors would prefer to opt for professions and specialties that actually give them better results and on top of that infrastructure as I said needs to be chalked out and this is something that pretty much all of the unions agree on but it's the matter of you know quotas because obviously a large number of these doctors who are striking our physicians and for them in their sector it is you know it is not necessary to have more doctors and this is kind of their perspective which is not something that is shared by most others nevertheless there's a larger systemic problem that is being underdressed right now by the UN government Renanish in this context any suggestions or signs from the doctors as to what their future course of action will be holding on to the strike is something that we are seeing the previous like right before the government imposed deadline of return to work orders to be implemented there was some talks between the unions and including junior doctors about whether or not they want to return to work after you know the end of February but that did not happen either most of them refuse to do that nevertheless you know the continuing the strike might have significantly bigger legal implications and we need to wait and see if the trade of the doctors unions are you know ready to take on that sort of you know political repression in many ways and we also need to wait and see if how because there is general you know public disenchantment because there is a crisis because of lack of doctors but we also need but we need to wait and see if other unions are going to pitch in in the matter if they are going to pitch into the negotiations that may or may not happen we are still not sure the government is pretty much on a very belligerent mode at this point in time where it does not want to have any talks with any unions it's not just doctors unions it's pretty much any unions that they do not want negotiations at all so that is pretty much the situation that most of these doctors striking doctors have you know have to work under right now thank you so much Anish for that update that's all we have time for in today's daily debrief we'll be back with a fresh episode tomorrow meanwhile do visit our website follow us on all the social media platforms and if you're watching this on youtube please hit the subscribe button