Hello, this is Bruce Mal. Thank you for the invitation. I'm thrilled to be part of this program, even though I was not able to be with you in person. I want to address today resilience and design. In some ways, design seems to be at odds with resilience. Design is classically about control. Resilience, on the other hand, is about elasticity. Design is thought of as singular, as authorship. Resilience is complex and plural. Typically, design is a monoculture. Resilience is defined as a diverse ecology. It begs the question, how do we imagine designing resilience? Is it even possible? The traditional approach to design has been to create a one-to-one relationship between problem and solution. Define the problem off from its context and locking a solution onto the problem. The mantra in design for half a century has been to tighten the brief, focus the challenge, define the problem, and target the design solution. The shorter and tighter the design brief, the better. This thinking came from the Fordist strategy that dominated our imagination for the last 100 years, optimization, cutting things into pieces and optimizing each piece. It is a staggeringly efficient and effective model out of context. It relies on an exterior to the problem. But today we realize there is no exterior to our ecology. There is only one ecology and we're all in it. Everything is in context. There is no Enron off-book accounting when it comes to the environment. There are no externalities. Everything counts. This demands an entirely new approach to design, a way of thinking about and understanding the problem in the most complex way, expanding the brief to think about the implications of our solutions, both upstream and downstream. It means designing systems, not objects. It is a new ethics of design. We call it massive change. When we launched massive change, we established a new school to do it called the Institute Without Boundaries. Together, we did 20-person years of research to understand what is happening in design. But by design, I don't mean the monoculture of fancy expensive objects of singular authorship. Instead, we disconnected design from the visual from its formal straight jacket and liberated the idea of design to be applied to the way that we live and work. We defined design as leadership, our ability to envision a future and systematically work to execute and realize the vision. That ability to visualize a future condition and organize, inspire and galvanize people to go there is the first most important potential of design. We focused our research on what we call design economies, the reasons of our lives that are being transformed and in some cases invented by radically expanding design capacities. We documented the economy of the image where we have colonized the entire electromagnetic spectrum in order to look into the universe and make better decisions about our future. We looked at the urban economy to understand our global commitment to providing shelter for an ever-expanding population and the need for designing complex urban systems. We researched the market economy. This is perhaps where we find the most urgent requirement for resilient design and the strategies of massive change. Markets are not natural spaces. They are design spaces. And how we design them determines what has value and what gets exchanged there. When the design of the market, what we call regulation, is turned off and becomes brittle, while innovation in the market races ahead, we can predict disaster. We need methods of innovative, resilient market design to keep pace with the creative voluptuousness of the market innovators. Finally, we explored the living economy, the design of life itself. When Crick, Franklin, Watson, and Wilkins unlocked the structure of DNA and handed us a system of information, they handed us a system of design, and we are hard at it. We are designing life. We have been designing life for thousands of years. If you think labradoodles are natural and tomatoes have always been red and strawberries are naturally the size of apples, you don't understand our capacity to design living things. We design life. Now we need to design resilient living systems. We need to push the complexity of the challenge and expand the brief for living design by orders of magnitude. I know what you're thinking. This is hubris. This guy just wants to control everything. He's a megalomaniac. But that is the old idea of design. In the new way of thinking, design is not about singular objects. It's about systems. It's not fancy and expensive. Its aim is the highest efficiency of resources. It's not about individual authorship. It's about our collective responsibility. Take the idea of designing nature. At first you say that's not possible, too complex, can't predict the outcomes, can't fully understand the system. We shouldn't have even been doing that. All true to some degree. A perfectly sensible position if there were less than a billion people on the planet. As there has been for most of our history. However, with seven billion people welcoming more than a million more every week, we have collectively decided to design nature. Look around the world today and you will see that where we fail to design the ecologies that sustain us, we design to fail. It is critically urgent that we understand the power we have to design natural systems and develop our best designers to design our ecologies and economies for resilience. Think for a moment how often it happens that you are able to close your eyes and open them in a place where you only see natural things. Rarely. And often when it does happen that we have designed that place to create the experience of nature. In our research for Massive Change, we discovered a transformation that connects directly to the issue of resilience. We discovered that design has changed its place in the order of things. What has transpired over the last 150 years or so is a radical expansion of our ability to understand the world and build tools that amplify our capacity for shaping it. We can see today that we have a new world. Massive Change is not about the world of design it's about the design of the world. In this new world, design is the ability to envision and produce desired outcomes. Design has radically changed its scale of operation. If we look at this diagram on the left we see the natural order of things the way that we imagine things to be. Design is really a subset of business, a category within culture, culture and envelope within a natural context. But we know now that business is design, that culture is a design project and even life itself has now fallen to the capacity of design. To meet those challenges we will need to redesign design, reimagine design education, develop new ways to put the tools of design into the hands of as many people as possible at the lowest possible cost. That is our objective with the Massive Change Network. By building a network rather than a campus we begin with a resilient idea. Then we will need to allow greatest access at the greatest speed for the lowest cost. That is why we are developing programs like 24 Hours to Massive Change. These are the 24 key concepts you will need to design Massive Change. The same ideas you will need to design resilient systems. Let me end by introducing a few of these principles of design. We are not separate from or above nature. The idea that nature was given to us and belongs to us and that we are somehow above and in charge is a fiction from the age of ignorance and superstition. New wicked problems demand new wicked teams. We will not succeed by respecting the boundaries of the past and our academic disciplines. We need to collaborate across boundaries of all sorts to create the great wealth and abundance and sustainable life of the 21st century. Always search for the worst. Designers see the world upside down. If it's bad, for a designer it's good. If it's terrible, it's awesome. Designing Massive Change does not conform to the classical models of design. It cannot be accomplished with a seven step-by-step approach. It takes more than brainstorming. It takes a field methodology of design strategies informed by the best science, synthesizing the best art to create something new, resilient design. In the end, it takes what design is all about. Leadership. Thank you.


Welcome everybody, this is the session to show how to make fabric even faster, I mean, even easier to use, because fabric is already very easy to use, right? Okay. So we're going to look at a demo of FarFly component. It's part of the FarFly ecosystem. It's a component called FabConnect. I don't have any slides, but I do have two architecture charts to show, and then we'll look at a demo of FabConnect. First off, who knows FarFly or has been using FarFly? Yes. Okay. A few hands. Nico here, if you don't know him already, he's our community lead and lead developer on FarFly. So after the session, if you have any questions about FarFly, make sure to seek him out. That's right, unless it's about FabConnect. So FarFly is a collection of many components working together to make blockchain much easier to use. That's basically what FarFly is. Supports many protocols, both permissioned, also public. So in fact, I'm not going to steal Nico's thunder. He has a session on FarFly dedicated to FarFly at 430 along with Steve, our CEO of Kaleido. But I'm very happy to tell you guys that the 1.1 version just got released 15 minutes ago or something like that. So it's a major milestone for us. You will hear more about it in his session. I'm Jim Zhang, one of the co-founders of Kaleido. So FarFly is, as you can see, a core component FarFly is the central microservice that coordinates all the things that happen around the other components. On the very bottom are the ledgers. You can see there are flavors of public chains like Ethereum. We actually support as of 1.1 of FarFly, all different flavors of EVMs on different public chains are all supported. You can go to Ethereum, Polygon, Arbitrum, Optimism, even Polkadot, Moonbeam, for example. There's a whole range of them. Wherever EVM and standard JSON RPC are supported, you can use FarFly to connect to them and manage your tokens, manage your digital assets, and then on the permission side, Fabric, Quorum Besu are all supported, and there's partial support for Quorta as well. So on the very bottom are the Perl calls, and IPFS is also useful for file sharing. Then on top of that are the connectors. This is where FabConnect belongs to. So the connectors will do protocol translation so that the high-level FarFly API requests will be translated into native JSON RPC or GRPC requests, and events will flow in the other direction. Then on top of that, you have the Transaction Manager. This is not very applicable to Fabric, because Fabric is very efficient. You're throwing a transaction, it'll be there in one way or another, either successful or failed, but it'll be there. But that's not the case with Ethereum, especially if you are talking to a public chain. If you've all attempted to work with Ethereum, especially in the public chain, you will know there are many hundred ways to fail for your transaction to not end up in the block, even both before it gets accepted by the note or even after it gets accepted by the note. So we have a Transaction Manager that manage all kinds of errors that the server gives you, and try to compensate to make your transaction have a much higher chance of getting onto a block. On top of that, we have the Token Connectors that understands Token Standard based on the underlying protocol. So we have built-in support for ERC-20, 721, which is for fungible token, non-fungible token, as well as ERC-1155, which is a combination of fungible and non-fungible. At all these layers, each layer is pluggable. So if you have other protocols, if you have other token standards, you can plug those in as well. At the very top is the brain that orchestrate everything. So each of these boxes is a standalone microservice that work together. So that's a very quick overview of Farfly. I can't do it just enough justice, but that's not the focus of today. Today's focus is on this component called FEP Connect, which connects Farfly to a fabric network. It supports fabric CA and fabric order and peer nodes. What it does is it gives you a RESTful interface. So you can post JSON payload to it at various endpoints. So you can create identities with the fabric CA, enroll them, and then submit transactions to it. You don't have to worry about lining up the transaction parameters. You can use a strong typed JSON structure to send to your transaction endpoints, and then you can create subscriptions for events. So when certain types of events are happening on the peer, you get notified either through WebSocket connections or through a WebHook endpoint that you implement yourself. Transaction submission are supported both in sync and async mode. Sync mode means your request is blocked until the transaction gets mined into a block and it returns at that point. Async mode, you just send it in and forget about it. You have a receipt endpoint to query for the status of that transaction, whether it succeeded or not. So that's the high-level overview, and we're going to spend most of the time of the session looking at FabConnect in action. I could be doing this in my local environment, so you can use Nico's fantastic tool to bring down all the images that you need to build a local far-flying environment, including the underlying ledger. So we will stand up a Ethereum blockchain locally or a fabric blockchain locally. When we do fabric, we will give you order and peer, create a channel, deploy some chain code for you. So I could do all that in that way, but that will be all mostly commit line, which could be a little boring, especially after lunch. So instead, let's look at this graphical experience with Kaleido. Kaleido is a commercial platform that allows you to manage blockchains. So we support all the major flavors of enterprise, DLT protocols, Corum on the Ethereum side, Corum Hyperledger Bessu, Go Ethereum, Hyperledger Fabric, and Corda. Recently, we just added Polygon Edge, which is a new entry in the permissioned blockchain side. You can easily create a blockchain network on Kaleido, just add your own node. For example, in this fabric environment, I have two organizations, each one have their own order node and their own peer node, and each have their own CA. To add a new node, you can just add an order node and then give it a name, and then you can click Go. In about 10 seconds, 15 seconds, sometimes 30 seconds, you have your node running in the started state. So we don't have to do that. We already have this network up and running. So let's deploy some chain code. I've already got some chain code compiled locally. So what I can do is let's see. So let's create a new chain code, let's say it can be Golang or Node.js. So we'll pick Golang. So now let's upload a new version. So on my laptop, I already got a bunch of chain code, each slightly different version. So I'm gonna just pick a random version, and then for this implementation, we don't need chain code to be initialized. So leave that check box unchecked. So now this has been uploaded to Clido. We can now promote it to the fabric environment we have. So the target, because within each consortium, you can have many, many blockchain instances. So this step is to say, push the chain code that I just uploaded to my network, to my consortium, to this particular blockchain network. So now, so the nodes on this network have received it. So next step is to deploy it to a channel. So all fabric networks created on Clido have a default channel. This way, you add your nodes and you already have a channel ready to go. You don't have to worry about defining channels, think about the different channel policies or that. This is a very quick way to get started. Of course, if you wanna create your own channel with your own policy, you can do that with both the UI and the API. We'll just go with the default and you can see this is gonna be installed on the various peers in the channel and it'll be approved for the org and then committed. Because this channel only has two memberships, these two memberships don't have any approval, but it's ready to go because all the memberships in this channel have approved it and have it committed. So this chain code, as far as the demo is concerned, is ready to be invoked. Now, finally, we're getting to FabConnect. So FabConnect is a one-to-one binding to a target order and a target peer. So we have our peer one.  So under the cover, what the platform have done is in order to launch a FabConnect instance, you need to give it two configuration files. One is a simple configuration that tells it a few high-level parameters, but importantly, it tells it where to look for the CCP, the common connection profile that tells the node, because under the cover, it uses fiber SDK, so it needs to use the profile to know how to talk to the endpoints. So these are the REST endpoint that FabConnect supports. For example, let's try to see what identities we have already created. Before the demo, I created a user, user one as a signing identity. Let's go ahead and create a new one. So we will just do a post and we call it user two. We don't need any of these others. You get the secret, so go ahead and copy. So now you can do a post. So now this user will be rolled, so it's got an enrollment certificate, and we're ready to use that to send in some transactions. So as I mentioned, if you do sync equals to true, then this will log until the response is back. So we can use the signer as user two. The channel is default, function is this is a create asset demo. And it is false, so it says, we must have misspelled it. What was the name? Of course, this has never happened, right? Until you do a live demo. The time is up, but if you try this yourself, you can create a free account on Clido. So we have perpetual free tier, quit in the account and just try this yourself. We have a demo video on Clido channel in YouTube. Just follow along, try yourself. The demo also shows you how to do event subscription. We do a chat with any of you guys, and thanks for coming. Correct, yeah. Nico, do you want to take this one? So the question is, is there a place to compare the features between open source version of Farfly versus enterprise version? I know it's in your head, but yes, sir. The question is, can Farfly connect to permissioned and permissioned list blockchains? Yes, so the answer is yes. The same Farfly instance can be connected to multiple blockchains. In fact, if you go to Nico's demo, it's at 430, he will show a demo where a Farfly instance is configured to connect to a chain running on Clido, I believe. Okay, a permissioned chain somewhere running, and to Polygon, which is a public chain. The isolation is by namespace, and namespace is top level construct on Farfly. You can say this namespace is dedicated to this blockchain. It can be permissioned or permissionless. The next namespace is dedicated to another blockchain. So fabric 2.4.3 is what you get on Clido. Farfly itself has been tested with 2.3 and 2.4. Yes, sir, I'm being kicked out. So happy to be around in the hallway, and we can chat more.


I'll pass this back. If anyone's down in our overflow room, there are seats here, please come and join us. You're going to miss out on half of the experience. I hope you've all been enjoying yourselves. Welcome to our last day. Well, the last day for you, possibly not the last day for us, but I mean, yeah, you'll hear more about that at the close. I think it's gone on.  So usual, bitter housekeeping. We want to keep this fast. You're here for a reason and it isn't me. I know that. Lost and found at Reggio. We've had lots of things handed in. Please go and see them. You guys are really, really awesome. You know, helping out your fellow attendees. Mind that no smoking on campus, not just in the buildings. Even when you're up on the grassy knoll, you're still on campus. In fact, you're standing on the roof of the building. That is not a fire evacuation point. You may get slightly warm feet if there's a fire. Room changes. We've mostly been lucky. Please bear with us. We did try and get the best range of rooms possible. There's still toilet trees left. Some of you will hear a few more days. Go and help yourselves. T-shirts and stuff off of Reggio. We'll come back to that in a minute. If you've got any coffee cards left, they're still valid for today. The guys are going to be running that machine as long and hard as possible. Apparently they did a record day yesterday, which is amazing. For those of you who are in Nikai for the hardware and radio mini-comps, the guys have collected a whole series of pictures from all of the assembly and production and everything that's been going on there. If you have any issues about your photographs being published, please come to Reggio and let us know as soon as possible because they'd like to be able to publish those online and catalogue what you guys have been up to over there. Oh, sorry. People. Humans. Sorry. It's very hard to change the way we speak. For those of you who are in the Leslie Hawthorne session, please watch the video. It is incredibly important to realize that our default behaviors aren't always appreciated by other people. Some of you are going home soon. So check out for the university accommodation is 10 a.m. on whichever your last day is. If you wish to extend that, please come and see us at Reggio as soon as possible rather than go and see your accommodation provider and we can try and work some magic in the background. What are we doing about luggage? Come and talk to us if you have luggage issues. There's things we can try and work out. We're going to be here tomorrow packing out anyway, so there are options. If you're trying to get to the airport, please use the wiki, use the arrivals and departures page, use the chat list and hook up with other people. There's a big group of you leaving on flights around 7 a.m. tomorrow. So try and hook up because you're looking at a 4 a.m. transfer to get out to the airport if it's an international flight for a kind of 5, 5.30 check-in. I warn you, it's not much fun waiting at the airport for the actual customs and immigration gates to open at 5.30 because that's when they do open. So come and see the Reggio team if you need any assistance with booking minivans and buses and things to get out to the airport. The usual thing, we don't have any more buses or any more functions officially today. That's where the fire evacuation points are and the University Food Court really likes us at the moment. You guys have been finding that and congregating there in the lunchtimes. Conference programme, as usual, you've all got that bookmarked. Need to thank our sponsors. Catalyst, IBM and HP. Each of our MPRA sponsors is also responsible in the afternoon teas. Today it's HP's turn, so big thank you to them. And please remember that Catalysts are doing their beer o'clock at their Auckland office this afternoon so we can get you all off-site. Red Hat and Google, big thank you to them. OSS, who've been our Lanyard sponsor and also provided numerous facilities leading up to this event. Just an extra thank you to our diversity sponsors because the last few days I've talked to several of the participants that we funded to get here under that programme. One has had very limited work for the last few years and now has three jobs lined up thanks to coming to this conference. Another one was a co-presenter in a talk that was on yesterday. They've had several people come up to me and say it was the highlight of their time at LCA. It was one of the most technical involving talks. It was two presenters from India and they were outstanding and we managed to get the co-presenter here thanks to that diversity fund. There's limited swag left. I think we may be sold out of the power banks now. Right, so there's some coffee cups, bags, t-shirts, the stickers go and help yourselves. You have been truly awesome. This has been an awesome event because of you. Thank you. That's my Daniel. I'm just going to hand this over for a moment. Double click. Technology. Now, yeah, because I don't really donate a $2,000 printer to us which is freaking awesome. Thank you Diamond Age. We're raising money for cystic fibrosis and we haven't even raised $5,000 yet. Runners, we have raffle tickets.  So raffle tickets. I have old eyes. One for five, three for 10, six for 20, 60 for 200. We've got 15 books to sell. Runners, look for hands. $350 a book. You buy 15 books right now. We can get this keynote going. $350.  If you want to get a whole book, $350. There's one. $350 for a book of raffle tickets. Who's the next? Who is the $350 over there? Get them that book. Yeah, someone just pulled a fold. Hold up your hands for runners to get your raffle. $350. Just keep your hands up if you want to run or to bring your raffle tickets. Wave your arms furiously if you want to get $350 worth. $350, $350. Runners, stay on here. Runners, Mark Atwood from HP. Mark Atwood from Emperor Sponsor HP. HP did not buy this book. He just dropped $350 on raffle tickets. If you don't, you rock Mark. If you don't happen, and we have a book for Nick Clifford from Call Plus, who is awesome, just bought a $350 book raffle tickets. Again, wave your arms furiously if you want a book. If you do not need a 3D printer, you can donate it back to us. We'll put it on trade me and auction that off for 66 fibrosis. Hello. In the meantime, keep your hands up so the runners can get to you. They look like they're keeping busy right now. Anybody else for a $350 book? I don't remember, sadly I could not afford to fly to Perth last year, but we usually raise over $10,000 for charity. We're just trying to bring this number up. Make diamond ages contribution count even more, so keep your hands up. Thank you. So we're going to start the keynote in a couple minutes. Just keep your hands up. Again, wave your arms vigorously if you suddenly want to spend $350 because that would be great. People with cystic fibrosis, seriously, you've seen in the videos the last few days, do need this. Your help is deeply appreciated. All the runners have got them. We can sort it out when we get outside, okay? Right. You shout it out and then it'll happen. Since people want to donate money and don't necessarily want tickets, we are now officially passing the literal hat. If you don't care about the tickets, just wave me down and throw money. Throwing money is perfectly fine. You don't have to have raffle tickets. You don't need a printer. Anybody else just throwing money? I wonder if Daniel is we do need to get things moving? We need to get things moving. So I will be randomly walking through just taking money for the hat. Once the keynote is through, feel perfectly encouraged to come outside because after the keynote... When we wrap up... After the keynote, we'll be showing that it's outside of the back door if the printer might be coming back down the other side. Daniel, when we wrap up, we'll have people at the back door selling tickets. We also have people back at radio selling tickets. After the keynote, we're going to let this thing get going now. We'll have people with bags. I need to stop the load of American money. That would be awesome. Thank you very much. You are all amazing. Thank you. So in return, we have some more prizes. So... Oh, I need to run my random random generator. Someone asked me last night how far in advance we generate these things usually when I'm standing here. So, you better be here or you don't get to take this home. Big prize, the raffle. You don't have to be here for the clothes. We will make sure that gets to you. But this prize, if you're not in the room, we'll move on to the next name is Hadley Rich Presence. We're still using a couple of these at Red Joe. Please come and see us around lunchtime or around the clothes so we can reset it and hand it over. The same for those I've not already contacted about picking up the prizes from earlier in the week. Now, today, we've got more prizes. So the guys, the team at Catalyst, ooh, I told you it's hard. Very, very hard. The team at Catalyst have given us one of these cute little drones to give away. So, Anton Blanchard. Actually missing out on a joke here. Is Anton present? He's up there. Yeah, it was tempting. In addition to that, the team at Catalyst are running a pure open source, open stack based cloud service here in New Zealand and they're going to donate $500 worth of cloud hosting to someone here today. Yay. And just to keep an international flavor, we're actually going to donate it to somebody based in Denmark. Jesper Brower. Now, I'm going to reach a certain point. Though it's also apparently a very special day. I wasn't going to do this, but then a whole bunch of people came up and arm-bent me a few minutes ago. So I'm sorry Beedale, but I'm afraid it's Beedale's birthday. Isn't this incredible that, you know, participants in this conference are willing to give up some very important family time and come and spend it with you. So I think Beedale deserves a happy birthday. This is family. Yes, but I think we need to move on. So, I really need to thank you. If I can't sing, Beedale has been a terrific confident and a terrific force to open source in general, but particularly to myself and Cherie. We've known him a number of years, so when I phoned him and said, does this friend of yours, and can you have a word with him and see if we can do something, he went, I've got an idea. Please thank Mr Beedale Garby. While Beedale is getting ready, there's another birthday boy at least. There's a Juan, who also has a birthday today, right there. That Lena snows all of your birthdays.


letters are somehow like friends. Each one has a personality. If you have one person all alone or one person talking to another person, it's a different relationship. And of course that fascinated me. Typography, as I went on with design, became more and more important to me. The Z was hard, the V was hard, the Q, that was easy. The prints in front of me are from an alphabet I designed called Euclid. The reason it's called Euclid was when Alvin had his print shop in the late 30s and early 40s, he worked with geometric forms from the type case. I kept looking at that word and saying I can do a whole alphabet based on that. I certainly never thought about being an artist because in my generation and in my parents, the milieu that came from, I was going to be a nice Jewish art teacher. The thing about not being a famous artist, you can do whatever you want. The little money I could make, you know, by painting for friends on blouses or on walls, wasn't very much. So my mother said to me, well, there's this new museum opening in Beverly Hills, why don't you go offer your services for the summer? And that's what I did. It was called the Institute of Modern Art. The first opening, I was asked to help at the punch table. At the punch table, two men came up to me. One was Alvin Lustig. He came up to me and said, it's very hot in here. And I said it must be the lights. That was the end of our conversation. Another man came up to me, very suave, handsome Hungarian who worked for, who was a painter and worked for Disney. And he got my number and called me up. And the first place he took me was a party. And there was Alvin Lustig. And from that moment on, Alvin Lustig never let me allow it. He called every day. He had a few students working for him. And the first year we were married, I had committed myself to teaching in a junior high school, which I did, which I hated because I would leave this interesting office every day because we lived and worked in these three rooms. But I wasn't a designer, so I couldn't say to Alvin, well, you can use me. But I decided after that first year that I couldn't go on teaching. So I ended up hanging around the office doing odd little jobs, typing Alvin's letters, but absorbing everything that was going on. That's where I got my training. I got it by observing. Finally, Alvin did permit me to do pastes, which I was a disaster with at the beginning. The room tent, which most people don't know what it is anymore, is one of my favorite tools. There's a kind of intimacy when you draw a line in ink. Here, there are lots of them because when I heard someone said they were going to stop making them, I got hysterical and went out and bought as many as I could. That would give you a very wide line, but you can do really very, very thin lines. When you first start to use this, you make the biggest mess in the world. It took me a long time. Alvin finally died in 1956 from all the complications. At that point, I wasn't quite sure what I was going to do. I mean, I knew I wanted to continue design. And luckily, two people called me on the phone, Philip Johnson and Arthur Cohen, and said, we're waiting for the designs. Never asking me what I wanted to do, just presuming I was going to do this. And I just did it. I mean, I just said, you know enough, you have enough experience, you can do it. And so that's what I did.


Design for us is just an incredible way of life. We're constantly pushing ourselves to just really think about the world through this incredible lens that we know is design. The National Design Award, it's of course amazing because it's awarded by your peers and we appreciate the community of designers, architects and artists, etc. that we're in conversation with.


Thank you very much so we're already I already thank you but that's not we first have to go through something I think before we that's for okay so yeah I'll speak today about the connection Chris repositories possibilities and values that's the title and it's more or less about the interoperability between Chris systems and repository systems my name is Ed Siemens I'm from I work at the Red Boat University in Nijmegen where the last 10-15 years I mainly do international projects IT projects for several university networks but also for some developing countries one important thing I think related to this meeting and to my being here apart from being from Eurochris is that I was the initiator and the project leader of one of the first Chris systems in Europe that was that's called mateys it's a Dutch current research information system and it's currently used by all universities in the Netherlands and the Royal Academy of Sciences so being one of the first systems it's already came about around 1992 when we started so since January 2013 I'm president of Eurochris and this of course also is the main reason why I will speak to you today about the interoperability between Chris systems because we at Eurochris are dealing very much with Chris systems so the structure of the presentation I will give you a short introduction to the Eurochris organization then I will say something about research metadata and the serif data model then I will go a bit into the position of Chris in the research information network as I call it then I will focus more specifically on the topic of the interoperability and I will end with some conclusions now the Eurochris organization we are a foundation legally registered in the Netherlands and we are an international network for information research information expert more specifically developers managers and users of Chris systems I will tell you more about that later we have 177 members today being 117 institutions and 1660 personal members they come from 43 countries 32 European and 11 non-European we have for instance members from Canada the US and South Korea Mexico our structure is we have a board that takes care of the strategy the policy and the management of the organization and excuse me actual work is done by the task groups so we have a task groups on architecture and development what we call best practice and directory of research information systems serif Chris IR so the the link between Chris's and repositories linked open data projects and indicators executive members for conferences strategy and communication our main activities are developing and maintaining the serif data model probably you heard about that model already and providing a platform and a meeting place is also very important for people interested are working in the domain of research information systems we have be annual conferences the next one will be in Rome in 2014 and the team for that conference will be data intensive science we have two members meetings a year the next one will be in bond in May and in November we will be very close to you in Porto and I'm very glad that Lisa Ribeira Professor Lisa Ribeira from the University of Porto is here she will organize the meeting and we have a yearly seminar in Brussels where we exchange ideas visions with our strategic partners one thing we decided recently in the board that we also should start to develop services for the community and one of the first things we will do is to develop what we call a compliance test or compliance application for Chris systems so that developers or vendors who develop Chris systems can then test against our application and then they will get a kind of serif compliance certificate another thing is that we are planning to organize some trainings for instance we submitted a proposal within the framework of EU program for the training of research managers so here are our strategic partners at the moment I think most of you you know ARMA is the European Association of Research Managers Casra is a Canadian organization who is doing a lot of work in the standardization of vocabularies and and semantics concerning the terminology around research information I think that's very important too so I think I have to speed up a bit projects we are engaged in is EU funded programs like projects engage Nikas will tell you later about that in the next presentation your risk net and open air plus and the involvement of your Chris in all of these projects is directed towards let's say the introduction or the implementation of mostly parts of the serif data model outside of Europe we have cooperation with Casra one of the executive director of Casra is also board member of your Chris concerning standardization of vocabularies and we have contacts with Vivo to see whether we could define a joint project in the near future and your Chris board members of course are involved in various projects in their countries and as you may know the UK has been very active last years when it comes to research information because they are changing to a new audit system or a new assessment system ref and in this respect they are thinking about how do you measure for instance impact and impact in the sense of impact on society so not counting numbers of publications or citations but how can you measure for instance impact on a certain policy snowball metrics is another project in the UK where you're Chris was involved and together with Elsevier and there out of that project came a set of benchmarking metrics so that institutions could benchmark their performance against each other among the members were also Oxford and Cambridge so I think this is an important result this is our website I will not go into that well now I talked about the structure the organization of your Chris now what do we do what's our main goal well I phrased it like this and this is a personal a personal like like formulation well the core of our work is to develop find or promote solutions for optimal registration discovery access and presentation of research information in all its aspects and for all possible stakeholders so this is in a nutshell what you're a crisis aiming for so we are not only dealing with publications but with a whole range of aspects of and I will I will in the next few slides come back to that and you're a Chris and this is important is of the opinion that the relationship database technology is a very good instrument to make this happen now when you talk about stakeholders who can that be well there are a lot of them you see them here in the slide we have researchers of course we have decision makers like the politicians but also on the local level university managers etc project managers publishers people from education general public media small and middle-sized enterprises information brokers research organizations and funding organizations all these people need research information want research information and they want it in a certain way okay so you cannot make one package that fits all now a lot of text on these slides because there are also a lot of aspects involved in research information it's not about only about publications it's about the activities the projects it's about the other institutions involved the people involved the researchers the managers the funders the data sets the research is based on our water research has produced the output the equipment that is used the rights of authorization the distribution rights intellectual property rights the semantics very important how do you classify your research when it comes to subject areas or thematic fields the impact I already mentioned that and of course the metrics we all like to play around these days with numbers and then show beautiful graphs and how I our our graphs have reached compared to the other ones and that we have gone up in the ranking of the Shanghai etc so there's always fairly as now real-world situation I would go very quickly through that one but what what are we dealing with in Europe is we are dealing with complex use cases for instance this one here a researcher could be working for various and this is real life and this is a researcher from our university so working for various organizations various departments various institutes at the same time from from these affiliations he or she can be working for various projects with various the subjects etc projects can have a different time frame some starts in July and other in January some has ended already etc and they have different roles in one project again the manager in the other a senior researcher etc etc projects could have different funding sources from the government from funding organizations from the institution itself they can publish in different languages and when you especially when you're dealing with women no offense but a researcher can have different names for instance as you all know researchers do not publish always under the same name sometimes they use like a Jones Jones a ABC Jones etc when women got married sometimes they changed their name entirely are they at the name of their husband now how do you deal with that when you say I want that person for that project etc etc it's not it's a complex thing so what kind of question is various stakeholders what could they ask they could ask for a list of publications but not just a list of public cases not on the screen mr. Jones has published this no that's that's not really it should be specified and this is where this metadata that you're a crisis dealing with come in you see here a few examples of that all the public cases in a certain period from a certain project also the colleagues I mean if you enter the research information domain with a search query you throw you get out the list of publications of a certain researcher it would be very nice if you could have immediately to the surrounding public cases of his colleagues are of the most so all very it comes down to specification it's not about give me the public cases of this or that because then we end up in another Google situation no we have to specify into make this intelligence for that you need metadata contextual metadata as we call it within your occurs so now we say okay relational database technology is a good instrument for that and as a starting point you should have a model and that's what you're a crisis focused upon a lot in the in the last few years to define a sound relational database model that we call Sarif the common European research information format and it's a EU recommendation to member states it has grown in the years now we are in the version 1.5 we think that's a reef is a strong model okay why is that so first of all because it's complete all the things I showed you all these aspects are covered in Sarif we have worked a lot for proper normalization to make it fine granular and to use the possibilities of the of the relational database based technology to its full this means that for instance as an example all repeating attributes are not are all attributes that can repeat are not in the table for instance where the person is but are separated okay for instance an author we don't say this is mr. Jones that is the author is something that we define separately we what we call in linking entities we say okay it's it the author has his own person table and it's linked to publication by means of the publication person link table this is very important then we we separated the semantics all things that to do with meaning we separated them in a separate layer we are for everything we have timestamps okay so when a person you say a person from that day to that day he was in function for that project that's in that role but this role changed so you can always specify your query saying I want only these publications from that person in that period when he was working on the project that in the end got him the Nobel Prize for instance and we have multi-linguality on all relevant fields so this is the model 1.4 ski schematic representation the basic entities are in the middle and you see all these things around corresponding to things we previously so now these are these linking tables so for instance between a person and the result and between a person and a project etc so you see a person can at the same time be an author or a reviewer or whatever and he can be at the same time the coordinator or a manager okay this is endless I mean he can get 10 or 100 different roles this is the nice thing about the model so okay this is a table view of it where you see the illustration of the semantic layer where you have all this but I will not go into that very important when it comes to interoperability is that we have produced a serif version of the serif relational database model and I think this would be a good candidate for the interoperability between for instance open-air applications and grises and I'm glad that yesterday Michael already mentioned this as a priority okay so Chris systems of course serif is meant to be the base for a Chris system currently we have more than 200 Chris's in Europe and these are the bit the major vendors converis pure symplectic and mate is okay now I will go a bit further into the interoperability and I think given these two aspects that Chris is dealing with all these the full specter of the of the research metadata on the one hand and on the other end that it has this fine detailed structure this fine highly normalized fine grained structure we think makes it like a spider in the web for the research information domain why is that because Chris covering all aspects need a lot of data that are already registered elsewhere why should you register them again put in these data in another system while it's in PubMed or in an author in reference manager or in scopus or in a web of science no that's not the way to do you should get it out of these systems automatically put it into your Chris system and the researcher should just have nothing to do with that should be so here you see on the on the left side you see the the input side as I say this for this example I am concentrating on our mate system now so we have the mate is Chris server in the middle and this one concerns the output of the Chris system so as I said what we do is we got automatically by means of web services etc we get things out of PubMed and all these external things scopus web of science researchers also they have a personal dashboard to enter data because it's possible for research to now and then enter a publication from scopus also we got to the citation information okay on the output side we provide the metadata for the university repository of course we provide a lot of presentations in all kind of formats I will show you some of them later and we provide of course also the other formats like linked open data and and the OAI PMH now what can you do with it like this this is not only mate is but this is common use for Chris is for modern Chris is nowadays if you want to see via researcher with all these things one push on the button and you get things like this this is done in our institutions daily okay this is this is no rocket science I mean this is just what a Chris can yeah another one wondering a bit oh yeah I will switch a bit and show you yeah but it's very we started later because actually the most interesting thing yeah here you see for instance our researcher puts input into the repository so the researcher got his publications as they are in mate is the list and then he pushed the button and he is and he is directed to an upload screen where you can upload the full text of the publication the mate is ID is it goes together with that publication oh yeah with the full text and in the night there is a web service now I don't know what happened because I have to do it again so okay this is the schema of the interoperability situation you see there are three entry of data metadata all the metadata goes into the Chris system okay whether it comes automatically through harvesting from things like scopus or pop meta or whatever the secretariat in the middle there they can put information in are the individual researcher all the metadata goes into the Chris system when they push the metadata there the full text they can upload the full text then in the next stage during the night every night the web service get the metadata of the newly put publications in the Chris system automatically into the repository and outputs this full text URL to the mate is system mate is itself can also expose directly oh AI PMH so what the University of Amsterdam for instance is doing they don't they want to throw out so to speak they're these space because they say we don't need it we will we will just use a Chris I mean we'll directly harvest on the Chris it's perfectly possible why should you make this detour here okay so but still in a lot of situations the metadata goes from the Chris in the repository and then the repository expose it as DC and little mods like we do for Narciss etc okay so yes since it's time I think I have to close my presentation we've seen this already okay one thing I wanted to say still is that this is interoperability on let's say the input side where you put metadata into your system and you throw it into the repository or that's even not necessary etc but I think we should also take a look at other forms of interoperability for instance internationally I think the Serif XML would be a good standard for to communicate with Chris systems and there is also other types of interoperability non technical things like interoperability concerning the development of services yesterday Natalia talked about services within the open air but I think we should work together to see we have a I think Chris's and the metadata in Chris's and our experience I mean you've seen these these things you can do with a Chris our experience that can can be an added value to your community I'm sure about that and also on an organizational level what what we see is that in a lot of cases within institutions the Chris and the repository world there are different cultures the one is in the library and the other one is somewhere in the research administration in the central administration they work alongside each other in a lot of cases we have a few very good best good practices in the Netherlands of how you can optimally integrate them to the benefit of both and now I will stop I think because it's time so here are my conclusions you can read them and now I would briefly present Danica there she is yeah Danica she is the task group leader of a task group we have in Eurochris that's called Chris IR and Chris IR is especially dedicated to study and to to deal with problems or possibilities related to the working together of Chris's by the way Danica please could you say a few words so this is also important the last slide here that I think we should also see broader thank you very much I think one of today's breakout groups would be about serif models so we'll have a chance to talk more about it and maybe then you can show the videos and because robots are an article in open air plus newsletter about serif model and interoperability between open air and serif so let's introduce myself my name is Danica Zendulkova I work in Slovak Center of Scientific and Technical Information in Bratislava Slovak Republic I am responsible for Slovak current research information system and this system now starts and it is made based on serif I am a member since 2007 and board member since 2011 our institute is institution that is library scientific library and scientific institute involved in several project also since this year is involved to open air tools institute we provide not only information system Chris but also some bibliographic database and several application we have no time for it but I think it's very interesting also to tell you about my employer but I would like to tell about short what about Chris IR that group that page is on Euro Chris pages and so I would like to say that if you have some Chris application and in the same time you provide and repository this application is connect in several many air you should insert your data to the directory of research information system on that page Chris IR so it will okay I don't think we have a chance maybe no problem so I would like to invite you to task group Chris IR meeting it's not only task group IR meeting but it is part of spring membership meeting 13 and 14 my 2013 so this year in Bonn in Germany and the topic of our Chris IR meeting will be introduction to the Chris IR interconnection so we need to we need to find some nice application based of Chris system and the repository and find some interesting software and technical solution for best practice for another Chris and repository users for help for help them to join this application so it's all for me thank you very much thank you my be webpage no okay thank you very much if you have a burning question I think we can take one question now is there any questions please make up one question to Ed Simmons about you know Chris systems taking a role as a repository as well so this is a very known situation also then my one thing that concerns me is that the Chris system is not so concerned about the whole open access area so and sort of interoperability with initiatives there are in the open access movement about sharing statistical information of usage and you know making sure that there is well some of the initiatives there is what's your opinion yeah this depends well my answer to that is that it depends on local situation and local management because first of all with a Chris system you can connect them and I mean it would be possible to deliver some information what apparently you are missing now that but this depends on on the practice and the policy of local management it's not it's not a technology I'm completely agreeing on that it's more like sort of and discourse that you have with the system and what would you talk about when you have a Chris system this you talk about you know research assessment getting the whole picture of what is the output of the university activities of the university and sometimes the whole open access part of it just yeah it's not there yeah that's true but you know the Chris systems evolved as systems for evaluation and for assessment but I think in the course of time they they have broadened their scope significantly and for instance I can speak from my my myth is case is but again this is this this depends heavily again on the policy of the local management in the university what you do with English if you do it let's say if you have do it from starting from a vision that you want to use the full possibilities of a Chris then you couldn't do a lot with it I mean if I look at the universe technically University and end often they are doing wonderful things when it comes to interoperability between Chris's and and semantic web applications linked open data I mean they have the screens where the data come from the Chris system they expose MS LOD and they do all kind of wonderful mashups with these things others like the Erasmus Institute of Management that's why I'm saying it depends a lot on the on the environment yeah when it comes to to presentation of research groups for instance and also alerting people to open access publications they do it and they do it from within the Chris they for instance one wonderful thing they do is they create they do not create they generate that's the proper word they generate websites web environments for researchers who are virtually what they call virtual networks who are not working together in a formal structure but who are working together a lot in an informal structure these researchers appreciate this very much because they say now we have a window to show ourselves also as a group to broadcast ourselves as a group to the world and it attracts for instance in this special case they have attracted very talented young scientists they even didn't know that we're working in their field and of course to me if my experience within within the Chris within the Chris world I mean it's no problem to make the link with the open access and to provide the information that the open access community need and to provide the statistics certainly that is not a problem I think I think we'll have more time to talk about


Hello and welcome to EM Ottawa Toxicology video. This is about the basic approach to the poisoned patient. A 35-year-old comes into your emergency department after a family member found him confused at home with a suicide note. He's taken something, but family is unable to provide any information. How do we go about looking after this patient? This video will take you through the basic approach to the patient with an unknown overdose. If you have not already done so, we suggest you review the Toxidram video prior to this. The general approach of the poisoned patient is a two-armed method. On the left has treatment and the right diagnosis. In real life, these two happen at the same time. We will discuss each component starting with the treatment arm. The first step in the treatment arm consists of the basic approach to any patient in the emergency department, A, B, C. First, airway. As with all emergency patients, we must ensure their airway is patented. This might mean an intubation in the patient with a decreased GCS. Two, breathing. We need to ensure the patient is ventilating and oxygenating properly. If the patient is hypoxic, we will give them supplemental oxygen. Three, circulation. We give fluids to ensure their circulation and end organ perfusion is adequate. We also put patients on a cardiac monitor since different toxins can cause bradycardia, tachycardia, or arrhythmias. And ECG should also be done. Since the poisoned patient can fluctuate quickly, it is important that we reassess them frequently. Next step, D for don't. The don't mnemonic stands for these antidotes, dextrose, oxygen, naloxone, and thiamine. Since many toxins can cause hypoglycemia, every poisoned patient should get a bedside glucose test. If it is low, dextrose is given intravenously. If the patient is hypoxic, oxygen is given. In patients who have a suspected opioid toxodrome and who have respiratory depression, naloxone should be given. Thiamine is given for selected chronic alcoholics with potential bronchies and cephalopathy. However, this antidote is rarely given. D also stands for decontamination. If the patient still has toxin on their skin or clothes, they should remove all clothes and irrigate the skin copiously with water. As a note, as care providers, you should be wearing gloves, goggles, and gowns to prevent contamination. If there is eye involvement, the eye should also be irrigated. What if the toxin is already ingested? The two main methods to remove it from the GI tract are activated charcoal and whole bowel irrigation. Another charcoal can be given for an ingestion that presents within the first one to two hours. The toxin is still in the stomach. We bind to the charcoal and then excrete it. Charcoal will not bind to liquids or metals. It can also cause aspiration in patients with decreased GCS. Whole bowel irrigation is used for specific toxins that do not bind to charcoal. It involves giving large volumes of fluid to flush out the contents of the bowel. Once the toxin is absorbed in the bloodstream, a way of getting rid of it is by dialysis. This method of elimination is used for specific toxins such as aspirin, digoxin, and toxic alcohols. F is for focus therapy or antidotes. There are a small number of specific antidotes for specific toxins. We will discuss a few of these in the antidote video. G is for get tox help. The local poison center always has staff available to answer questions and they should be involved early in the patient's care. Let's go back to our patient. He was able to tell you that he checked something four hours ago and was illiquid. Since he was able to talk to you, his airways patent at this point. His breathing shows a tachypnic respiratory rate at 24, even though his saturation is 100%. His blood pressure is 130 over 80, but his heart rate is 120. His blood glucose is normal. He is quickly put on a cardiac monitor and IV fluids are started. In terms of a universal antidote, since his blood sugar is normal, no dextrose is given. Since his oxygenation is good at this point, no oxygen is given. His presentation really does not look like an opioid, toxidrome, and so no naloxone is given. In terms of decontamination, there is no more of that toxin on his body. Because he's taken this about four hours ago, there's no role for activated charcoal. Because this is illiquid, there's also no role for whole-hour irrigation. You then look up to see if there is a specific antidote for this liquid that he mentioned. Another colleague has already started to call the poison center for advice. We now return to the diagnosis arm of our approach. The diagnosis arm consists of history, physical, toxidrome recognition, and diagnostic tests. History. It is often extremely difficult to get a history from a poisoned patient. They might be confused, sleepy, reluctant to speak, or in some cases, they don't even know what they've taken. Whatever little piece of information you can get, that would be very helpful. Start by asking about what toxins, when the time of exposure, the amount, and why they took the toxin. Ask them and their family member about all possible medication in the house, including over-the-counter medications or any herbal remedies. Have family members go through the pill bottles at home and bring the empty bottles to the emergency department. Ask the paramedics what bottles they have found at home. Next physical. It is tied in with the toxidrome recognition. The physical for the poisoned patient is not overly detailed. The main components include vital signs, neurological examination, and skin examination. The vital signs should include temperature, and the usual heart rate, blood pressure, rest rate, and O2S. And you should refer to the toxidrome video about the specific changes in vital signs that fit with each toxidrome. In terms of neurological examination, toxins should produce a globally decreased level of consciousness rather than a focal deficit. Phenetoxins can also cause seizures. You want to focus on global motor sensory examination and the patient's pupils. The size of the pupils will give you clues about the kind of toxidrome the patient might be in. For skin. Again, specific toxidromes will either cause dry skin or diephoresis. You may also want to look for medications that are still stuck to the skin such as nitro-patch or fentanyl patches. Diagnostic tests. Diagnostic tests can include blood gas, anion gap, osmol gap, specific drug levels, drug screen, and x-ray. Let's see how we can use them. First, blood gas. A lot of toxins create morbidity and mortality by creating metabolic acidosis. Therefore, we often get a blood gas telling us whether the patient is acedotic or not. Getting a venous blood gas will often suffice instead of an arterial one. Let's go back a bit to our patient. In our patient, his blood gas shows a pH of 7.2, which is acedotic. His bicarb is low, pointing towards a metabolic acidosis. In compensating for that acidosis, he's blowing off his CO2, causing a low CO2. Therefore, our patient has a metabolic acidosis, likely because of this toxin. Second, anion gap. Anion gap is calculated this way. A normal gap is about 12. If the patient has an elevated anion gap, there is a list of toxins that can cause an elevated anion gap metabolic acidosis. The mnemonic is mud piles cats. These are the toxins in medical conditions that can cause an anion gap metabolic acidosis. We will go through each letter of the mnemonic. M stands for methanol and metformin. U stands for uremia, really, not a toxin. G stands for DKA, P stands for pereldohyd, I stands for iron and isanizid, a medication used to treat TB, L stands for lactate, E stands for ethylene glycol, S stands for acylicylates, T stands for carbon monoxide and cyanide, and finally T stands for toluene. This is an important list that you'll find you go back and forth during your medical career when a patient presents with an anion gap metabolic acidosis. Let's go back to our patient. A patient's blood work shows a sodium 140 and a chloride of 95. What is the anion gap? Using a formula, the anion gap is 140 minus 95 plus 10, maybe 140 minus 105 equals to 35. There is definitely an anion gap that's elevated. Therefore a patient has an anion gap metabolic acidosis. We know he must have taken one of the toxins on the mud piles cat list. Another question is which one? We now try to narrow it down by doing another calculation called the osmogab. To calculate the osmogab, we first calculate the expecting osmolality. And this is created by 2 times sodium plus glucose plus BUN. Once you have that expected osmolality number, you now compare it with what's measured in this serum. The difference between the two, or the osmogab, can vary from individual to individual. However, an osmogab that's more than 10 is regarded as being abnormal. And there are only a handful of things that can cause an osmogab. A few of them include alcohol, ethylene glycol, and methanol. There are other things that can also cause an osmogab such as mannitol. But that's not usually a medication that people usually take. It is a medication that we often give to patient. And so we should know about the fact that there's mannitol in the system. Let's go back to our patient. He has a sodium of 140, glucose of 10, and BUN of 10. What is the calculated osmolality? That's right. So it should be 2 times 140 plus this 10 and this 10, and therefore gives you 300. If the measured osmolality is 330, what is the osmogab? And hopefully you figure this out, and that's the difference between the calculated osmolality, the 300, and the measured osmolality, giving it a gap of 30. And as you can see, our patient has an anion gap, metabolic acidosis, and also has been exposed to a toxin that also gives you an osmogab. Under those two headings, there are not a lot of medications that do that. And the two that will do both are either ethylene glycol or methanol. And you have just now solved his mystery ingestion just by these very simple blood tests. Sometimes once we have more information, we like to know the specific drug level to confirm how much the patient's serum drug level is, whether it is in the toxic range. These levels can be obtained, such as for acetaminophen, aspirin, digoxin, anti-seizure medications or toxic alcohol such as methanol, ethylene glycol, and just simple alcohol as well. These drug levels give you the amount that's in the body or what's known as a quantitative test. In this case, in order to sort out whether the patient has taken methanol or ethylene glycol, you might want to order methanol and ethylene glycol level to confirm the diagnosis. And then as you draw the ethylene glycol and methanol level, it comes back that there is no methanol in a system but there's lots of ethylene glycol. We call the poison center who suggests a specific antidote, which again we'll talk about in the antidote video. Sometimes tox screen is also being ordered for patients with an unknown overdose. These are screens that we can do in urine or blood to look for the presence or absence of toxins. These are qualitative measures such as whether the drug is in the system or not. It does not give you a level. There are a lot of problems with toxicology screen. A lot of medication will cross-react with the reagent for other drugs and therefore making them very nonspecific when you get the result. Often these results do not come back in a timely fashion for us to decide on treatment and sometimes they're not particularly helpful for us in the emergency department. And therefore, tox screen is really rarely used. And the last for diagnostic are x-rays. Some medications will show up on plain x-rays such as drug packets or heavy metals. In those case, a plain abdominal film can be taken. If the patient has respiratory difficulty, a chest x-ray is done to look for cause of hypoxia. In this video we discuss the simultaneous approach of treatment and diagnosis of the poison patient. In the treatment arm we have ABC, DON'T, enhanced elimination, focus therapy or specific antidote and to get tox help. In the diagnosis arm we have history, physical examination, toxodrome recognition and diagnostic tests. We hope this video will help you look after your next poison patient. In the antidote video we will also be revisiting these concepts as well.