All right, well hello everyone and welcome to another edition of the Hyperledger Healthcare Special Interest Group. My name is Mike McCoy, I'm the chair of the group and we're going to get started into our first session of 2022 here. So one, I want to be able to preference that this is an open-source working group. Please do not share anything that is under NDA or that wouldn't be necessarily publicly available for you and your consistent ones and your stakeholders and your teams that you work with. We want to be able to make sure that no one is shamed here that every idea and experience level of part of the blockchain and healthcare ecosystem working group is not downed, is not frowned upon and that we don't down anyone for their experiences of what they actually know in the space. So please have an open mind, please have a positive mind when interacting with people here in the forum. I also then want to be able to give room for introduction so Michael was able to give an introduction as he hasn't been part of the group for a while. I believe Baldwin, I don't know if you've been joining us before but if you want you have the floor you can give an introduction on yourself. Hello, I'm just turning on my videos here. My name is Baldwin Mack, I'm actually crashing this meeting because I was extended the invitation by one of my colleagues, Uli Broto, who's part of this group I believe. I am coming from Borenger Engelheim, a pharmaceutical company based in Germany. Physically I am located in Canada and what I, the organization that I'm part of within BI is we're part of the clinical development and operations organization. So we're the ones who are developing the drugs and running the clinical trials to develop our new compounds for the various indications that we work in. So my interest in joining this group in in blockchain is because a couple years ago in Canada we ran a pilot looking at blockchain technology and clinical trials and we've completed that project and I've since continued to work on applying blockchain and healthcare as part of the pharma ledger which you can see in the back background of that I have here which is the IMI consortium of industry partners that is halfway through our mandate to look at use cases of blockchain in healthcare. So I'm leading one of the groups, one of the work streams within that consortium and so I'm joining this meeting because we introduced me to this group and I thought I'd sit in and just to find out what the discussion is about and to learn from everyone else that's on the scene. Very happy to be here. Albin thank you very much we've had many different pharma ledger members either present or be part of the discussion so glad to have you added to the group. And then Sean I apologize Sean have you ever given an introduction before in this group? I don't believe so and I'm sorry I was late I was on another call my name is Sean Bohan I am a new community architect on the hyper ledger team and I'm just lurking on calls to get speed on what's going on I was involved in hyper ledger indie from 2017 to 2019 and I'm back so hi. Sean's back that's all that matters now welcome and glad to know you're part of the hyper ledger team that's awesome new folks am I missing anyone that would like to give an introduction? I think that's everybody. All right moving on is there any community announcements I see Pete actually mentioned one in the chat Pete if you want to talk further we have it on according events and presentations between for Lakes Foundation Public Health and Consensus Health with Daniella and Jim and Heather and I believe there's others but please Pete tell us more about it. Sure thanks thanks Mike and happy new year to everyone. Yeah as some people know Consensus Health has really over the last few months really sort of developed and defined the veteran community as a group as a population group community really requires a special focus in terms of healthcare and we're doing a lot of stuff in that area made some announcements which are on the Consensus Health website and one of the things we kicked off with Jim from the Lakes Foundation Public Health is a special I guess focus on that within LFPH I'm going to let Jim talk about that when he's ready to do so I think he still needs to jump through one one hurdle to before he can talk too much about that but I think that's coming in about a couple of weeks but kind of as a precursor to that we pulled together a webinar at the last minute as we always do at Consensus Health as Mike probably remembers but we've got a great lineup I mean notably with Jim and Daniella and the webinar is focused on open source and how it is how using it can really benefit the veterans community and obviously Heather's on the webinar talking about what we're doing in that space and also Dave Metcalf from Global Blockchain Ventures who's invested in some healthcare companies and in one of the initiatives that we're doing in the Veterans space so would love to see everyone on it. Alright Pete thank you very much yeah Global Blockchain Ventures is an investor of Consensus Health and of Kaleido who provides a lot of blockchain solutioning in the space as well. Before we do move forward I want to make sure Lincoln Fellingham I don't know if you've been part of our group before and we'd love to have an introduction learn what interests you in joining the group. Yeah you bet I've I've actually been on the distribution list for a couple of years now very infrequent attender but I'm a technology executive for a healthcare supply chain company a large one in the United States and have some substantial interest in blockchain and how it's developing was particularly interested in the the item that made today's agenda around meta ledger my firm is actually starting to evaluate it so got some some particular interest in that part for today. Absolutely well welcome thank you for joining us so we already got information on an upcoming event within Linux Foundation Public Health and Consensus Health there's also one all the way in March coming up with the British Blockchain Association which is going to be the Blockchain International Science Conference it's their fourth running of this show and I attended I believe two years ago and I found it very beneficial it had more of a worldview more of an EU UK view than we typically get here within a hyperledger in the United States activity when it comes to blockchain and healthcare but I highly encourage anyone if their company can sponsor it I think it's about a hundred US dollars to be able to join but something like that but British International Science Conference check out the link and also I will share this link in the chat so everyone can just access the links instead of just staring at the thing that I'm sharing so I'm putting that on right now cool all right and we'll go into industry news and research group items but also before we get into that is there any events I'm missing are there any upcoming events and presentations that people can add in the chat that I can add into here as well that we should be looking out for in January or February all right I guess I got it covered okay industry news research and group action items so research came out about two weeks ago that was accredited and published broadly though most of the research came in 2019 and 2020 from the University of Birmingham on the health sector's experience of blockchain and cross disciplinary investigation of real transformative potential I thought this was substantial like very good research and showed some of the difficulties and the strengths of the space very well they went into a lot of great detail in the use cases and mostly through use cases within the United States and within the UK so we'll go through this paper a little bit they talked about you know there's more people are more talking about the experiences like they mentioned professional credentials exchange which is the blockchain physician credentialing use case they mentioned the one that I am very close with within humana and the snap to health alliance for provider data exchange and using a blockchain to be able to bring those records and things together and they also mentioned I believe melody and and the substrate project as well let me be in another page but oh they mentioned the coalesce health alliance so coalesce is not active anymore they are they're the ones that used the entities within Blue Cross Blue Shield to help in providing organizational units with length real-time access to standard set of spend data across Blue Shield members so they highlighted those they highlighted the United Kingdom yeah this is where I believe they mentioned melody and they mentioned the guard time and instant access medical health gateway project there so they highlighted some very beneficial consortia and projects that are out there in industry today they also talked about some transnational blockchain systems this is where they talked about melody so we're all pretty familiar with these use cases and these these concepts and talked about federated learning how that's beneficial the challenges though I thought they were pretty spot-on so blockchain and healthcare implementation challenges it's organizational commitment it's the interoperability approach it's internal governance standardization and then the normative tensions I think were pretty spot-on as well so I thought this research really hit the nail on the head when it comes to not many people understand it there's not enough rails to be able to connect different bridges most of these things are permissionless and though permission blockchains do have value within the members if they want to be able to expand more value they need to go into public blockchain solutions to be able to to hash and be able to connect with many different multidisciplinary members of cooperative models and that only permission blockchains will give you incremental improvements though public blockchains will give you radical and disruptive improvements into different sectors and and that was kind of like the overview of this research it had more of a negative bent that like these concepts unless you get the they're more social trust problems and computational trust problems which we have discussed in these forums as well as being major to development but I wanted to know if anyone else took a look at this research or has an opinion on the things we just mentioned anything whatsoever did anything hit a chord for anybody all right well I assume everyone has to take a read at this and and give it some more thought but yeah I thought this was highly accurate it does have more of a dated publication as most of this research came from 2019 but I highly encourage everyone to take a look at this and and give it a read it has a lot of good commentary from people in the space that we all respect so give it a go all right next up I wanted to be able to highlight I believe it's region strife institute and the national institutes of health have created privacy-preserving record linkage technology for COVID-19 clinical research what that looked like was being able to leverage the region strife record linkage technology they were able to advance co-19 clinical research the data as we know that federally learning and privacy-preserving technologies where you can be able to send the model not the data and be able to keep actual data that may be compromising at bay while interacting with the valuable data sets in the the the clinical data sets that may be valuable this was not the use case of how to be able to do so and he knows that when sites contribute to EHR data for their patients they can define what kind of linkage they agree to for instance if they choose to link to mortality data but not test data and consent and prior auth data in networks and consortias are highly valuable I know that my group in humanity has done a lot of research into this and has been looking to find ways where we could be able to maximize consent to data in networks rather than the things that may be compromised or not valuable for consortias and another valuable example of how a company has done this and for NIH it's it's it's very it's very applicable for one they they made a contract that's worth more than 2.3 million dollars over the first year and they're looking to expand in with that and this is for COVID specific data right so uh in emergency situations some data may be more valuable than others like mortality data or like respiratory data than other things there so any other opinions or commentary here so uh so so Mike uh the just first glimpse you know over this paper and then uh so I touch it touch a uh important uh topic is you know it is you know privacy preserving and then uh so this is one thing that you know blockchain's been looking at because it is an inherent characteristics and of the system so I would look more about this paper and share with you about okay why inspirations you know this can bring to academia and also to the industry so I would love to discuss with you more about this later on if I get a chance thank you yeah yeah and part of that privacy preservation is that the tokens contain no relationship with the true identifiers and they can't be used to reproduce the identifiers so uh like we all know within blockchain like the data is now actually live on chain it just shows a hash and so the hashes that are agreed upon to be able to be distributed to the members within the network of the consortia are then made into a token and then when that token is approved upon that is inaccessible to all the participants as part of the network as well so that's a part of it but yeah we definitely could uh could enjoy a further discussion on this and how it's valuable and then it's interesting here that someone serves as a as a linkage linked honest broker because I guess someone in the that federated consortia needs to be able to combine the different datasets together and so they kind of if anything have access to all the data that's usable within this which strikes me as it doesn't it's not truly privacy preserving because then someone or you know even though it's a trusted broker it's still like a third party that could like humans inevitably uh cannot be fully trusted uh just the machines can know because machine just told yes or no right or wrong whereas humans you know we have different conventions and things that make us uh potentially compromise things or not like we're more in a gray area and they're not a game t that there's full privacy preservation but I think for this small set and this use case it's valuable because you know you just want to be able to have an or curator or orchestrator be able to get it out to all the right parties uh which is probably valuable but I think for datasets that are more compromising where no one would want to have anything transacted or shared uh this could be uh less beneficial yes adrian go ahead so if anybody's looked at this uh what kind of transparency provisions are there for the individual uh patient uh when technologies like this whether they're being centralized or not in the sense that you just mentioned uh I find it really concerning that uh a lot of this sort of presumes HIPAA's uh de-anonymization rules and things like that as a way to avoid transparency and what's going on uh both at the community level and at the individual level uh so if anybody is familiar with uh tprl in this respect I'd love to know more thank you I'm personally not as uh familiar with pprl but if anyone else please chime in in other words it says right there it's a it's a way of avoiding patient consent uh you know it's right there at the top of your screen um and um you know that's the point I'm making not sure identifiers are used yeah I'd be interested what identifiers are used then in that transaction so so so this is the first time I hear about this term p uh pprl so so you talk about is a way to avoid patient consent so does that mean that traditionally we want to collect anything from a respondent or the people who hope we hope to get information from we need to get a consent from them right so so this is saying that like most of the data that could be compromised and uh in HIPAA or GDPR standards isn't transacted and that is preserved in privacy through the pprl method I think is what they're they're saying okay so does that mean that once we use this technique or this uh technology called p uh pprl we no longer need to get the patient's consent or we still that is what they're claiming that they're able to do with NIH and potentially CMS here as well I'd say okay I mean I want to just I'm not going to belabor this I want to just put this in context uh you know the Tuskegee experiment fiasco is kind of the the example case the uh the poster child for what I'm talking about um it's easy uh whether it's Tuskegee or uh you know uh Google make a deal with London hospital trust to get data it's easy to have an impact on a population or society as a whole that is acceptable to the participants of this federation like the one they're describing but is otherwise secret or not shared uh openly uh with uh other people and so we have to be very very careful when we talk about arrangements like this uh because it's uh both parties you know both the parties that collect the data and the parties that uh learn from the data or use the data have an interest in these things going forward and uh there's often very little oversight uh from the social perspective totally agree and they'll soon incorporate CMS claims data which good luck I've been living in that for a while now and it's it's not fun but that'll be interesting to see how it grows all right next up uh so recently in the kessions shared their experience with working chronicle in the meta medilegic consortium uh with uh in regards to contracts and charge backs in pharmaceutical management uh they will pull this up uh so through the medilegic consortium which is created by Chronicle then the company led by Suzanne Somerville uh they've used the digital solution where chargebacks happen in wholesale distributors to sell medicine but pressing and eligibility contracts are negotiated separately which can complicate the transactions leading to all those charge backs so it helps smooth out that they use a blockchain technology to be able to reduce complexity of procurement for health systems as they face challenges with rebuilding and the effort towards optimizing the process expected reduce errors by 90 percent on meta ledger and uh these are some of the findings that they published out with meta ledger and and everything within their working group uh this is still within uh it's is still just a working group similar to all you have within hyper ledger and hasn't been uh productized and hasn't been made widely available for anyone to be able to join but through McKesson and their partners they've been able to create an estimated 500 million dollars in value by eliminating duplicate efforts due to using a chain system uh I believe don't quote me on this I believe they're using a quorum blockchain that might be using hyper ledger fabric as well I know in different uh working groups and consortias they've used both but uh very interesting and uh and love to hear anyone else's opinion on this so it sounds like they actually would have transaction pricing product pricing verified against contract based on records on the blockchain is that so we're interpreting here as well so I think a lot of times is once a particular pharmaceutical is tied to an an event that that event is then hashed in time stamps and so the original time stamp of that pharmaceutical is then realized as the record of truth and then anyone moving forward can then be tied back like no the original payment actually happened here or some reconciliation goes through smart contracts to be able to make sure that the either the patient or the distributor the manufacturer all can agree upon this time stamp this date and just automates the process of getting to reconciliation quicker and and that's more so where I think the the blockchain network comes in but it's permissioned so you have to be a permissioned entity to be able to access that um that reconciliation piece through smart contract okay yeah because it doesn't sound like they're they're chasing the pharmaceutical provenance right it's it's really about the the transaction itself yeah it's a transaction payment not actually like if the pharmaceutical so I guess part of that is like the provenance of it like it was the right drug that actually made it to the patient's hands I believe they're not getting patients to validate this per se it's mostly just the manufacturer and the distributor uh so that's more so where I'm seeing this being used okay yeah so as I mentioned I'm in the in the um the healthcare supply chain at my firm and I'm quite familiar with the contracting process that pricing and eligibility piece that they mentioned up front is where it gets really interesting because the contracts themselves are complex the price is just negotiated um they they have a lot of uh there's a lot of conditions to achieving a certain price for a healthcare provider and so that that's the part that I'm interested in is capturing the transaction is one thing but my sense is that the charge backs are largely happening because the the transaction executed at a price that wasn't consistent with the actual contract that is in place because everyone at all parties to the transaction have such a hard time of confirming that the correct price is determined and there are also like one-to-one relationships like let's just say you have all these I know traditionally a lot of people have them on like share points or excel sheets where they just they validate that this is the drug pricing that's agreed upon and and they have that between one or two partners but if there's many different organizations that are then trying to agree upon and be able to as a coordinated group agree upon this instead of using one-to-one centralized relationships they use a distributed uh method to be able to see the price all in real time more so and then agreeing upon whether that's right or wrong or whether it's in the framework so yeah that's exactly right there's usually I think typically four parties to these transactions when you include reimbursement for them and so yeah everyone has a different opinion of what the price should be and that's where all this charge back and manual work comes in is trying to after the fact then figure out whether it was correct okay interesting anyone else on this piece and this was just after the fact kind of just you know it's kind of like a market marketing play to showcase that they have a real a real product that exceeded value so um kudos to the team over at chronicle we'll go on to the next one so a couple of progress points from uh Vita or Vidodal I say different ways because I'm an American but uh team at molecule molecule is kind of a blockchain DAO orchestration company where they're looking to create many different DAOs to be able to incentivize scientific funding and research for specific cases where maybe they're not getting funded in major entities but they could be in individual basis so one molecule created their second IP rights and data access function via an IP NFT they did one earlier this summer that transacted value this one was more of a creating an art for like an NFT so you're also selling like the artistic value but then you're also then granting access to specific data that could be used for uh autography so uh I can't say that words are I some scientific words I'm just not great at but uh the the benefit here is that a community in a DAO was able to then benefit and fund this NFT that then gave access to particular data that would be great for this type of solution and problem and it was particular to uh the coral chuck lab coral chuck lab uh I think they're based in yeah they're based in Newcastle and so people from all over the world and online community were able to fund this data be publicly accessible for others to utilize uh within longevity research so another had to divide it down everything they've done there very beneficial for the space and showcases another reason why decentralized science or the design movement as now is coming on and twitter and all these other online forums could be highly valuable and uh it was transacted for 285 USDC very valuable and beneficial to the lab so this lab may not be able to be funded by University of Newcastle or by investment or private equity but a community thought it was valuable enough to transact $285,000 or USDCs into it so Hey Mike it's Erica I have a question um so whoever purchased this what do they get they get access to the data from the lab or I'm just trying to wrap my head around so Vitadal the DAO owns the piece of art and they own the IP rights and they purchase it okay yeah the DAO the DAO like voted on it and purchased it yeah so anyone that's part of the DAO can then access that data and the data is coming from this lab correct okay I'm just yeah interesting all right I know it's tough to get your mind around at first glance but yeah okay thanks so um so so Mike so the use of the uh unable to is actually nothing to do with the the data the data set right the use of art the art is just uh it's kind of just like the um look it was like the profile picture of the data um okay it's kind of just a pretty thing to make it look cool um when you're okay so I don't like to put on a motion for publicity right there's a lot of motion so it would be like a promotion for or like for publicity purposes right yeah for sure okay okay okay so this is interesting okay so uh the the nft you know non-contractable token can be used for the marketing or promotion purposes I'll beat the the actual thing being transact at is the data set the data set is transacted with people within the Vita DAO so if you're part of the DAO right if you're a member of that DAO and you pay whatever the the membership is to be part of the DAO you then through that membership get the access rights to that data oh okay okay so you you are like you know paying to join a club and once you are into the club and you have access to that asset you know which the data you need to do for the research or for for analysis correct but the the fee and the the you know what you have to pay to be part of that is less within the DAO because it's distributed across many other like-minded scientists or people that really could want to access that data so you individually if you wanted to access that data from the Coral Chuck Lab at Newcastle uh at the University of Newcastle it may cost you thousands hundreds of thousands of dollars but as an individual it may only cost you maybe 500 to a thousand dollars to be able to access it so it makes it cheaper for the individual but as a group and a whole you all have mutually beneficial access to the data now oh that's a great innovation that's good that's good innovation why we highlighted here yeah I wonder if there would be restrictions for the DAO who can access it within the DAO because could I just join the DAO and then look at the data I'd want to imagine they wouldn't want that uh that's kind of what you could join the DAO and access this data yeah but I mean what's prohibiting someone from joining right like they uh the onboarding in the verification process I think they're trying to validate through orc IDs or you know different like you have to have an edu email in some cases for some of these things so uh the validation the the digital identity verification process is probably the toughest thing within molecule by the DAO to try and manage but I definitely know they're working on it so that just not like but even so that they kind of encourage like biohackers and anyone to be part of this as well so I don't think it's a very strenuous process yeah it makes sense Mike just to get a broader understanding so data DAO are they in the the um research data space they're in the crypto web 3 space so molecule is founded by one person who I used to work with at a company called consensus consensus is like an ethereum blockchain solution fighter and then another person named Tyler Galato who is a former research scientist uh and believes in certain research that has been underfunded for years where individuals and potential biohackers can be part of it as well and not biohackers like they're trying to destroy people's lives it's more people that are interested in pharmaceuticals and interested in the benefits of of certain things and how they could do another own rather than being part of a lab and so molecules creating different DAOs like they have Vita DAO which is for longevity research they have another one called Psi DAO which is for psychedelics and mental health research and uh in these DAOs they're going to target specific members to be to help with scientific funding and research that could utilize the data information and can uh want to benefit or fund specific research that they believe and they're passionate about and they'll do it with their own time and money but they'll do it because they're passionate about it or the individual contributor or the group is very passionate about it and so more decentralizes instead of leaving like private equity investors major universities and funds and labs as the only people that can fund these things it decentralizes the model for individuals to be able to contribute funds to it. Great thank you for that. Hey Mike are they actually doing the research or are they like how are they how are they taking that step to actually use the data that they're receiving and and doing something with it? I imagine a lot of the members of the DAO are data researchers or CROs or could benefit from this because it'll benefit them in the pharmaceuticals and the therapeutics they create um I assume like you're only putting mind in this if you could utilize the actual thing right like I'm only going to be part of uh like for one there's something called links DAO for golfers out there right I'm only going to be part of links DAO if I like to play golf right or if I can utilize a course that they're going to eventually own as a group one day right so I assume most of the people that are part of that DAO either utilize that data or can receive some type of monetary or social benefit from access me. Interesting I'd just be interested to see if I actually deal with that. Yeah thanks. Absolutely cool and we will move on to the other part so another thing from B to DAO by I call it by DAO whatever I'm just going to keep on calling it by DAO you're now able to purchase a glycogen test believe uh yeah a glycan age test to get your insights of your glycomb and biological age through your Vita tokens so if you're part of VitaDAO or VitaDAO in particular and you can use Vita and other cryptocurrencies to buy this test to be able to get insights into your glycomb and biological age very interesting very all you have to do is just scan the QR code pay the certain amount of Vita or whatever the standard like conversion rate is between like if you're in bitcoin whatever your crypto is and you pay to be able to access this test very beneficial because I think people that are crypto rich would benefit in this whereas if they don't have fiat currency or other things to purchase this it uh but they have crypto it makes it valuable for them so very interesting use case here wanted to share it for everyone. Next uh Brian Armstrong in the holiday break actually so Brian Armstrong is the founder of Coinbase he came out with an epigenic epigenetic reprogramming company to help extend the human lifespan we're continuing on the whole longevity piece here so uh he's creating a company that's helping to reprogram the human gene expression similarly what this really is is he's trying to reprogram and treat the end of human life as the disease right so we're only on average I think males last about 80 years old or 78 years old women last about 80 years old especially in the United States in particular and Brian's trying to create a company that'll target that problem as the disease and create solutions and and concepts and therapeutics that help uh people live longer is his uh general goal here so it to be fair why is he focused so much in the space his wife is actually a geneticist or she's either like a clinical informatics, a geneticist or a geneticist somewhere in the San Francisco California area at an actual hospital so I think he's getting a lot of these motivations from his wife where his wife can eventually work in these type of things too but a very interesting concept then uh he hasn't said anything about crypto or blockchain being involved in this I just thought it was interesting that the man who runs one of the largest centralized exchanges in the world uh is focused so much in the space I want to have it verbal and also doesn't hurt when you're worth billions you can work on projects that are interesting for you so all right uh one of the ones that last things that are particularly involved in blockchain healthcare uh an individual named uh Nikhil oh god I was free his last name but his twitter handles Nikhil in it he comes up with a lot of different marketing material and ideas within the healthcare space through his blog called Autopocket he had some interesting ideas for crypto and healthcare such as decentralized EMRs insurance styles and drug picking models uh that I thought were highly interesting and should be relevant for us to discuss here so um he featured some jobs he's talked about crypto how blockchain works and all those things uh decentralized EMR could be interesting start attracting users and third-party developers to build features on top to make the user experience more valuable it's like epic it ends up attracting more users tracking third-party developers eventually it makes more sense for platforms to extract increasingly more value now why does someone believe this will work or why does someone believe this won't work one I think it won't work because uh Epic Inciner don't have the incentive to do so they pay a lot of developers on their teams already to add certain features and to work with hospitals and to do the educational piece here and making sure this is actually relevant for them uh and and they have a fee for service to have a model right where they they don't really open source of decentralized many if anything out and they are making a very good dollar on that service so uh unless you know they have the incentive to really change their model like unless more their users and more hospitals are going to decentralize file storage or they're going to other things like that I don't know if it would be as relevant for them to do it though their features would get better and this could be a way for them to enhance features and enhance experiences I'm not sure that they have the the real incentive to do so yeah I was just going to say Mike um we don't really have a way to prove that you know this can offer something better than what they already offer in an evidence-based way that that healthcare organizations will listen to um so there's it's really hard to you know aside from the incentive we don't have like a proof in a way that is digestible for healthcare executives and organizations to listen to anyone else have an opinion on that within the EMRs in general I also think generally a lot of people that utilize EMRs and EHRs the most that have rare and chronic conditions um that could extract the most valuable from value from their EMR a lot of times if you ever notice when you're sick or if you and this is not across the board this is just generally speaking and most data and analytics coming from here generally when you're sick you actually want to look at screens less and you want to interact with online communities less a little bit uh due to various different factors uh I think you know healthy people's data is not as valuable in EMRs and unless you're talking about certain other things and those those things just aren't as valuable to create pharmaceuticals or therapies for until you get people uh who are in rare chronic state wanting to constantly be online I don't know if that'll be a really valuable thing but I can prove and roll I think insurance styles have a actual um have actual relevance here so you mentioned about Nexus Mutual we've done that a lot here in this group uh Nexus Mutual is a global mutual fund that you can pull insurance together with other people yet uh they've had some issues recently when it comes to like cases that were verbally disclosed to being covered actually weren't covered through the smart contract and the smart contracts as we all know that once you create a smart contract uh unless you're using Tesos uh you can't really edit or improve the smart contract unless you're in a private permission blockchain if you're in a public one it's very hard to edit those smart contracts they're kind of once you make it it's it's very hard to change or or edit um but I do believe like for claims uh of catastrophic events like not like covering your dental or covering your vision but if you were to get in a car accident or you would have a heart attack things like that I think insurance styles in those cases would be highly valuable for people to join um and instead of covering the minimal things just doing for things that really uh really take uh take some of the most catastrophic catastrophic events it could be highly valuable so it could work like this does anyone else have an opinion on this too all right guess that uh so Mike yeah so my my first impression about this uh this flow chart is that this is a process right and then from the beginning to the end that you know I think blockchain offers you know a perfect platform to to implement this for sure and now you know the point is if you won't try if we try to approach it from like startups or like innovators perspectives you know who's gonna stand out to propose this would this uh belongs more to the the the private sector or individuals or this uh belongs to more about the the public sector the government and then so who who enjoys the better position to to to to propose this it's a very good question um I think you propose this if you're well for the insurance case you propose of your health insurance company to you and your stakeholders and say hey we want to take less risk on some of the lower things but we'll take it on the higher things and we'll allow our members to make the decision there and you kind of do it that way that's the most effective way a government entity to propose this and be pretty successful I don't think like a patient community could be very successful in doing this right uh there's plenty of patient-based communities out there on Facebook groups and and uh health union and another type of social media outlets but uh but yeah those are some of the methods to do so yeah the my first impression is that the the insurance companies or the medical institutions they may have more incentive to build this right so if we yeah to separate themselves from the actual insurance provider for sure yeah yeah yeah but this is a local and community-based house yeah it is a very good idea you know I really appreciate it thank you mm-hmm the last one on here was the drug pictures a meta model and they talked about numeri the trades meta model data on top of models from data scientists he was thinking of doing this particular for uh for drug pictures I forget this one particularly but he pretty much wanted to create a numeri in particular for data scientists who were working with pharmaceutical data in particular so uh and yeah I originally I think this is valuable because I think of your like for algorithms like numeri sells like AI algorithms in a marketplace for someone else to pick up and utilize I think if you were to do is for pharmaceutical algorithms though the pharmaceutical companies pay hundreds of thousands of dollars to people to create these models and to be part of their team only in a centralized way if someone who's just really good at creating algorithmic models can put this on an open marketplace they can probably benefit from doing this as well so uh it's just more decentralized in the model rather than having an individual company just benefit from it it's a the contributor of the AI model put it in a marketplace see how it's utilized and beneficial to the the the actual pharmaceutical company or therapeutic company and they decide on there so highly interesting on there and then also had a story on botanical water technologies uh blockchain first transparent and secure water trading uh for those that are interested in environmental cases and then uk.gov is moving to fully digital documents for right to work criminal record checks and digital IDs they're one of the first governments to do it fully digital I believe Singapore is there and Estonia is there but now UK is uh looking to migrate into the digital world as well uh we have five minutes left so I want to make room for anyone to talk about comments or things that are educational in the space to them I would like to highlight here in the educational nuggets these are more so for people they're just learning blockchain and want to be able to understand how it's being used uh in industry and likewise uh the siki the siki science show was with Brian Armstrong and Patrick Joyce who has actually spoken with us here at the hyperledger healthcare sig before about research hub his project longevity and why scientific research should be open source highly encouraged take the hour to listen to that uh there's a recording of the european blockchain convention on health data on blockchain that will benefit patients doctors manufacturers with some people from farm ledger consensus health and others uh this news article talking about how passwordless authentication and blockchain can help in cyber security in 2022 especially healthcare they'll take a look at that uh and oh I really liked this pioneer square labs engineering and the engineers hype free observations on web three and what it potential can be uh but plenty of uh beneficial things to learn about and read on your spare time uh but yeah there are any other questions or comments the community would like to share like you know i i'm already three or you know to to uh attend this meeting so after today's meeting uh do you have a couple seconds so that we can stay so that we I can check with you if you get some time or we can uh set up another time uh I have an 11 o'clock meeting but uh you if you email me or the gmail I sent earlier uh we can find time to talk okay great fantastic thank you Mike of course anyone else happy new year Sean thank you all right well I'm going to stop the share then and uh happy new year everyone does anyone have any fun stories or things that


Speculation about the origins of human language is as old as history. Although there is disagreement about the exact time, language, as we know it today, probably appeared relatively late in the prehistory of humans. We will look at two central aspects of language evolution in this e-lecture. First, we will discuss the biological prerequisites for human language, and then we will speculate a little bit and discuss the main hypotheses about the origin of human language. Let us start with the biological prerequisites. The evolution of human language is closely connected with changes in two organs essential for the use of language. The structure and the size of the human brain and the shape of the vocal tract. Anthropologists have collected evidence that from about two million years before Christ onwards, Homo habilis and Homo erectus had developed a brain fit for basic linguistic tasks. And they discovered that with the advent of Homo sapiens at around 400,000 years before Christ, from Archaicus via Neanderthalensis to Homo sapiens himself, that Homo sapiens developed a vocal tract that gradually became ready for the use of some sort of speech. Let us look at these two prerequisites in more detail. The most important prerequisite for the production of language is a well-developed central nervous system with an elaborate cortex. While the Australopithecus cortex volume did not exceed 600 cubic centimeters, Homo sapiens exhibits an average brain volume of roughly 1,400 cubic centimeters. Here are the approximate figures. Now Australopithecus brain, as we heard, has a volume of roughly 500 cubic centimeters.  Homo erectus had a brain whose size was something like 900 cubic centimeters and Archaicus, the first representative of Homo sapiens, increased this once more to 1,200 cubic centimeters. And Homo neanderthalensis brain was even larger with 1,500 cubic centimeters. However, brain size alone is not the key factor. The brain of Homo neanderthalensis was even larger than ours. Yet, well, you all might know what happened. Thus we shouldn't solely examine the size, but rather the structure of the brain. And here it is known that three brain centers are primarily responsible for the production and comprehension of speech. The first of these centers is referred to as Broca's area. It can be found in the front of the left hemisphere of the cortex. And it was named after the French physiologist Paul Broca who lived in the 19th century. It is commonly known as the motor center for speech. According to recent insights, Broca's area is not a unit.  The second brain center is referred to as Wernicke's area. Named after the German physiologist Karl Wernicke, it is commonly known as the sensory center for speech that is primarily for the reception of speech. Last but not least we have the gyros angularis which is a kind of switchboard for all sorts of neural impulse. For example, it establishes neural associations between the shape and the sound of objects. The investigation of hominid skulls has shown that as early as Homo habilis, who was around from 2.3 million years before Christ onwards, all these centers were relatively well developed. Thus the brain of Homo habilis was ready for the cognitive foundations of some sort of language. The second prerequisite is a particularly shaped vocal tract and this vocal tract must be in a position to produce a sufficiently large sound repertoire. This involves, apart from the lips that are involved in rounded versus unrounded vowels such as u versus e, a special source of phonation. That is, we need the larynx with the vocal folds and also we need a flexible resonance chamber that can amplify and modify the fundamental frequency created by the sound source in the larynx. Interestingly, the larynx and the size and shape of the oral cavity are closely connected. Let's look at this connection in more detail. Now here you see the vocal tract on the left-hand side and two views of the larynx, the anterior view and the side view. Now on top of the larynx we have a very interesting bone here in the two views, referred to as the hyoid bone. This horseshoe shaped hyoid bone is linked to the tongue by means of a particular connection referred to as the hyoglossus. Let's illustrate this by moving this sort of larynx into the vocal tract. Now this would be roughly the larynx position and here is the connection between the tongue and the larynx, the hyoid bone, the so-called hyoglossus. The interesting effect is the following. A lower larynx position leads to a retraction of the tongue and this is exactly what happened during evolution. The larynx of early representatives of Homo was relatively high, enabling him to breathe and eat simultaneously. The sound production capabilities however were restricted. During evolution probably due to the increasingly erect position the human larynx descended into the throat leading to a separation of uvella and epiglottis. This in turn has the consequence that the human vocal tract is now subdivided into two chambers responsible for the essential formant frequencies. Now the lower larynx position has led to these two resonance chambers. And now with this lower larynx position and a vocal tract which is clearly subdivided into an oral cavity and into a pharyngeal cavity Homo sapiens can produce a wide range of speech sounds. Now with the advent of Homo sapiens at around 400,000 years before Christ the vocal tract gradually became ready for the use of some sort of speech with a relatively large sound repertoire. But why did language emerge? Well, this leads us to the discussion of hypotheses of language origin that the predecessors of Homo sapiens were capable of using some sort of communication system is undisputed. How then could we explain the constant growth of the brain from Homo habilis to Homo sapiens? However, the initial impetus for the use of language is unclear. Ignoring these theological claims of language origin represented by these pictures there are several modern hypotheses about the emergence of language. One of them is referred to as the gestural hypothesis. Even though there are no apes in the ancestral line of Homo sapiens the discovery that apes can learn to communicate by means of gestures constitutes the basis of the gestural hypothesis of language origin. This scenario is obvious. Once Homo stood erect he had his hands free for complex social interactions. The problem is explaining how and why and when gestures gave way to vocal signals of communication. One proposal is that tongue movements accompanied hand gestures. Whenever we have to perform complex tasks our tongue supports our hands. For example, if young children write their tongue often goes like this or if you have to thread something through a needle's eye you go is this evidence for relationship between tongue flexibility and language emergence we may speculate. The vocalization hypothesis suggests that language evolved from a relatively small set of instinctively used discrete calls shared by all hominids. They could have sounded like that. Well, whether it was really like that you may speculate again. But such a hypothesis might explain why all languages of the world are still so much alike in terms of their sound repertoire. However, before any significant precursor to real language came into being our ancestors had to become capable perhaps by means of sudden genetic mutation of combining vocal signs in sequences having indefinitely different meanings. And thereafter our ancestors who had shared millions of years of common evolutionary changes rapidly dispersed over our planet beginning racial and linguistic diversification. The neural hypothesis holds that language resulted from a gradual increase in general intelligence documented by an increase in brain volume as we saw earlier on and thus an increase in the precision of the wiring of the neural network. An interesting hypothesis of how modern language could have emerged is referred to as the mother-child interaction hypothesis. Language could have evolved through time as a consequence of the interaction between the immature newborn baby and its mother. The newborn infant, unlike any other mammal is highly immature and has to be looked after all the time. When hominids started walking on two legs it became more and more difficult for them to look after their babies. Increasing mobility required that adults primarily the mothers had to take their babies with them. At first this was relatively easy. The baby simply holding on to the mother's fur. However, with a gradual loss of fur and nothing to hold on to the young ones had to be carried preferably on their left arm as this picture here illustrates. It may be that during those many occasions when it was being carried the baby first used vegetative sounds like burping, crying, then comfort cries and eventually some sort of babbling like mum, mum, mum, mum, mum and its mother reacted. Such phases can today be observed during the early periods of language acquisition. Well, let's summarize. The development of language was not a matter of sudden changes but rather a continuous development over millions of years. The phases of this development can still be seen in many features of modern language behavior. Gestures, facial expressions, primitive crying and shouting, babbling and intonation are steps towards real language. Initial traces of language could thus have appeared as early as Australopithecus or even earlier. Homo habilis and Homo erectus were even more likely to have used language already. They left behind stone tools that suggest some degree of acquired technology. Some sort of language can be assumed to have contributed to this level of technical sophistication. Homo sapiens appeared at around 400,000 years before Christ and it is extremely difficult to believe that he lacked language.


I'm Tim Apachele, your host and this week's topic and title is agreement on the debt limit at a huge price and with me today to discuss this issue is my co-host Jay Fidel and our special esteemed guest Chuck Crumpton. Good morning gentlemen. Morning Tim. You know we're getting very busy. We're going to be discussing the deal struck between Kevin McCarthy and President Joe Biden. There's a lot of people who are very upset. The MAGA GOP are flaming red hot mad. And on the Democratic progressive side we have a lot of environmentalists who are none too pleased. But to discuss that but before we discuss that hey Chuck I want to go to you. I want to talk about how the media is portraying the negotiation and how they're portraying the negotiation right at this moment. That's a really good question because the media presents its own perspective on things as we know. And they can do it either with a comprehensive truth and accuracy orientation or they can do it with a whatever is going to attract the most readers, viewers, audience. The media for at least the last few years, the Trump years and continuing have chosen route too which is viewership over truth and accuracy at any expense. So what we're seeing right now is media portraying the debt to the public. And that's what we're seeing right now is media portraying ceiling negotiations as a win-lose competition who won. If they were going to choose an approach that was designed to maximize the risk to approval of such an agreement and the public interest harm from the risk of disapproval or misrepresentation of the debt to the public. And nobody is portraying it as this was a compromise. Everybody got something except Joe Biden. Let me ask you, this one appears that's going to pass. I think Hakeem Jeffries from the House has expressed that he's encouraging all Democrats to vote for this in the House of Representatives. I'm not saying it's a slam dunk but it looks like this thing is going to pass. What if this thing was a lot closer and the media was playing this off as the way they are? A win-lose negotiation and could that have disrupted the apple cart so to speak? You've got to think about one other thing though, Tim, which is from McCarthy who took 15 votes to get his vote. He's not going to get the vote. He's not going to get the vote allegedly agreed to some conditions that put him at an especially high risk of losing that speakership and that authority. He can't afford to have a situation where the majority of Republicans vote against a deal that he may. He needs at least a majority of Republicans to get his vote. That's 100% by any means. He may get enough Democratic votes to put the vote over the top. That's the negotiation. That's the bipartisan aspect of this that really deserves far more media attention and investigation than its receipt. Let's see how that works out. I think we're going to have to get this thing passed. To what degree do you think Joe Biden's favorability and or credibility has been damaged by the way this deal has been negotiated from the very start? There was a piece of paper which we put on our daily e-mail advisory about that. There's no question that it has to do with the credibility and popularity in some circles anyway. He started out with a red line and then he crossed his own red line. He said I won't negotiate and then promptly negotiated. I don't know if people forgot that. What I mean is that a lot of people walking around thinking what happened? He explained why he ignored his own red line. He has been silent on explaining that and very troublesome I think. It's troublesome to me and I think it's troublesome to a lot of people and I think in terms of his credibility for 2024 he's lost credibility. But whenever the result is he has not been strong. If he had never said anything about the red line he would have lost credibility. But this whole scenario does not work in his favor and you think of other things that have happened during his administration and you say this guy doesn't stick with it. This guy is not strong. That's what you think. Is it just an issue of him not being able to separate the debt ceiling increase from the budget itself for the next 10 years? Did he fail on that effort? Is that his problem? To me this is all out of Kafka. I really need to know if you agree with that. It's all a very strange alternative universe. We have a debt ceiling. We've already incurred the debt. Trump himself incurred $4.0 trillion in the last few years. The last couple of years of his administration $4 trillion. A lot of the money that the Republicans are hammering on is money that was adopted and enacted during the Trump administration. I get a complete disconnect on this. There should be no issue about the debt ceiling. Lift the debt ceiling and then you negotiate the budget separately. And I think that it would have been just fine for Joe Biden to stick on that point because that's historically what usually has happened. We are in this alternate universe. Another part of the alternate universe is that the Republicans themselves don't represent the negotiated results by Kevin McCarthy. That's extraordinary. They have these negotiations. They spend weeks negotiating with other Republicans. A number of them in the Freedom Caucus don't agree. And so what you have is chaos. They're creating chaos again more even among themselves. And this is very threatening to the country that we can't seem to respect the old red line of keep the debt ceiling different from the budget. Correct. Well, let me just run past the positives and what the Democrats will perceive as negatives of this deal struck. Number one is Joe Biden did avoid a debt default that would have thrown this economy and the world economy in real chaos. Number two is that he was able to extend it for two years. So that's off the table for at least two years. Biden did protect Social Security, Medicaid, and other benefits. I'm sure there's some other benefits that were preserved, but those are the top that come to mind. Things that progressive Democrats are very upset about is there are now work requirements associated with SNAP benefits. SNAP is the term for old food stamps. Supplemental nutrition and I don't remember the last two letters of that. But that now kicks in for anyone younger for work benefits for food stamps. SNAP benefits. There's expedited permits for energy products, especially a natural gas pipeline from Virginia all the way through the state, and that makes the environmentalist of the Democratic wing fuming mad. There's steam rolling out of the ears. There is a military spending limited to 1%. So there's a cap on for quite a while for the 1% increase of budget spending. They're going to shift $10 billion out of Biden's IRS funding that was passed. I think that was $80 billion. Now $10 billion gets stripped out of that, and I think that's over a 10-year period. And then there's the return of $50 to $7 billion unspent in COVID funds. They go back to the budget for redistribution. And at least there is the reinstatement of payments that students will now need to start paying on as a result. Remember in COVID, there was a suspension of school debt. Now that suspension has been removed off the table. So let me get your reaction, Jay and Chuck to what I just stated, both on the positive side and potentially on the negative side. Jay. Well, I think a lot of that is ideological policy is something else. It's the Republican non-platform operating. What strikes me is a lot of the people who are going to suffer because those cuts are Republicans, or Trump's base. I find it extraordinary that it's sort of throwing on the wall and see if it sticks kind of negotiation. When you have this, you don't have good, thoughtful public policy where reasonable men and women will get into a room and really negotiate. This is just an expression of one side beating up on the other. It is a win-lose mentality on various issues. For example, knocking off some of the additional funding for the IRS will have a leverage effect. They won't be able to collect as much money. What's that about? Of course, we should talk about the tax side of this. There's no additional taxes as I understand it. What we have is a libertarian view of making governments smaller. That's what happened here. I think we have an example of divisiveness on a lot of these issues. Climate change, any broad-based journalist will tell you is the most important story, the most existential threat to our planet and our global society. And yet, we don't care about it. A lot of this is ideological. A lot of it is the old Republican platform. I think they made inroads in Biden's initiatives. They wanted to show that they had the clout. They wanted to show that they could really have an effect on things and they have. Check was your question. Did Biden have either Biden's accomplishments or the things that he had to trade away in order to get this deal with House Speaker McCarthy? Well, three things. First of all, if you look at Joe Biden as you want him to be or you believe he should be, then Jay's assessment holds water. If you look at him who he really is in Washington, which is a center right Democratic politician who is deeply committed to bipartisan deals to implement government policy. He's been exactly who he has always been and that's worked for him. If you look at the media as of today, most of them, even the conservative media, are saying Biden won the negotiation, the Democrats won the negotiation. They prevented the Republicans from getting what they really wanted, what the MAGA GOP wanted and they held on to the things. Let me jump in right there. What in your opinion does the MAGA GOP want? Well, first of all, they claim they wanted actual spending reduction. They didn't get that. They got limited spending increases but they did not get a reduction. They got some reductions in some general areas, but if you look at those six categories you laid out, every one of those can be administratively managed and adjusted. The office of budget management and budget is run by the administration. Yeah, Congress sets out guidelines and parameters and limitations but unless somebody actually takes it all the way through court up to the US Supreme Court, what the administrative executive branch people do is going to dictate what the operational level actions on behalf of the government are in all those areas. So, if you look at what the Republicans especially the MAGA GOP said they wanted most budget reductions work requirements cuts to areas that would include everything except social security and veterans benefits. They didn't get that. Well, let me just float a balloon here because I would argue that the MAGA GOP doesn't want the deal because quite frankly I think they're looking for chaos. Chaos within government. Chaos in our financial economic markets. Chaos for an opportunity for their agenda, their true agenda which they don't like to overtly discuss but it's all about bringing in fascism and a fascist dictator by the name of Donald Trump. I think that's really why they're upset because this thing's going to go through and maybe I'm wrong but many times on this. Can I stop you there Tim? Yes. There's a fair chance it will go through. There's also a fair chance it won't go through. If it doesn't go through we still have the same problem we talked about last week and I really worry that A. There will be pushback by the most conservative Republicans that may actually stall it which is really amazing given the fact that the President of the United States and the Speaker of the House spent weeks negotiating this. The other aspect is that don't forget guys that this is kind of precedent. It will happen again. It will happen in two years. We'll be back to square one first base again trying to get the debt ceiling raised or whatever it is and we'll be held hostage again. We'll be held hostage again. We'll be held hostage again. We'll be held hostage again. I have left an office for his first term. Is this the time for him to explore the provisions of the 14th Amendment to make sure that doesn't happen? I assume he's been exploring that for the last few weeks. If Larry Tribe has been exploring it and presumably he's aware of the issue and he should be exploring it. It's not going to mean anything if it's not ratified. It'll mean a lot. The point is do they be preparing for the next round of potential anarchy in our government system by the MAGA GOP? I would. I would. Chuck, is House Speaker McCarthy going to hear or feel any of the ramifications of his support for this deal by the MAGA GOP? Is it going to try to vote him or remove him as Speaker of the House? It only takes one vote or one person to bring it up. Yeah. If you look at what's happened within the last week and we know that polls are consistently unreliable but the polls were indicating that a substantial majority of Americans polled faulted the Republicans for putting the default risk out there. McCarthy has to be aware of that. He's got a completely split party and he had to make a choice in these negotiations which element of that party he was going to have to hold on to to try to maintain his power and his image. He's an ambitious guy so I don't think he gave up anything that he didn't very carefully intend to do. His alliance with the MAGA GOP is artificial temporary and if he could get rid of it I'm sure he would. You know we talked a little bit about those couple of provisions that were given up in order to get this negotiation straight forward. One of them of course was work requirements for SNAP benefits. I recall back in the Ginnrich days that there was something called welfare to work and that was quite the Herculean effort to get those who are receiving welfare payments to actually go to work. So there's that one provision now for students to start paying on their debt. For those individuals in this country that are on the economic fringe does this push them over the edge or even closer to the edge? Chuck? Well first of all both of those are subject to administrative executive decisions as to what and when and how they choose to enforce any of that stuff. The likelihood that the Biden administration is going to aggressively enforce the collection of student debt whether it's on the books and accruing or not is no more likely now than it was two weeks ago or two months ago. I have not seen a policy change on behalf of Biden or the Democrats on that. The problem for the Republicans is because they didn't get anything that gives them more power or more leverage in debt ceiling negotiations. Yeah, it's only a year and a half. January 1st of 2025 whoever that new president may be they're going to face this thing again and Jay is exactly right. It's going to be another war. But who will run that war? Who will dominate that war at that point in time is going to depend on the 2024 elections. We're just guessing that McCarthy has bet that the 2024 elections are going to go better for him than they will for Trump and the MAGA GOP. He has to bet that because if MAGA GOP prevails over him and whoever his faction might be he's out. He doesn't really have any choice as to who he casts his lot with. But you know let me add that this not only has an effect on Biden's prospects in 2024 it evolves the rest of the horse race and so you get Trump opposing the deal saying you guys should have stuck with the right-wing approach on this and you get DeSantis one of my favorite people ever you know he is taking the same position Nikki Haley is taking this position and Scott is taking this you know all of the Republican candidates all of them that we know about maybe there's an exception out there somewhere are saying this deal is not good enough for the Republicans and you know I don't know if you asked this implicitly or expressly Tim but you know the country has to have a reaction to the list of horribles that got thrown away in this negotiation and as I said before some of the people who are affected are Republicans they may be disadvantaged but they're also Republicans so they're not going to be really happy when they realize how they're affected but there are other people maybe independents and certainly Democrats are going to say this is really awful and if these guys that is the guys in the Republican horse race saying it's not good enough and we like the original hard-nosed approach so they're also going to come to the conclusion that the Republican party that is the people both sides come to the conclusion the Republican party is unhinged they're not even respecting an agreement that they participated in making so I think that at the end of the day this has got to be confirmed by the Republicans including the Freedom Caucus or else they will have such a stink-eyed black-eyed in the view of the public in general that they will suffer greatly in the 2024 election it seems to me when Janet Yellen multiple times was talking about the ill effects of not extending the debt ceiling she used generic broad-based terms like recession, interest rate increase you know financial markets and chaos but they really didn't dig down deep enough I don't think that described exactly what does that mean what does it mean when the United States for the first time defaults on its ability to pay its its creditors and the damage that it's very difficult to describe but I don't think they did a very good job of it so the benefits of extending this ceiling I think Joe Biden gets a round of applause and the things that were given up it could have been far, far worse am I wrong in that assessment either of you I would agree with you but I would add one point that came up in your comment a minute ago and that is this although Joe Biden did not speak loudly enough about the red line problem he had Janet Yellen and a number of other members of administration giving us what would happen if this deal failed that is if the the debt ceiling were not raised and they saturated the airwaves with that for weeks you think Americans understood it not necessarily and I'm not saying that they were correct either this is speculative but the fact is they made it sound so horrible so nightmarish that in effect they pasted that risk on the Republicans and I think that also works in the crucible of 2024 that we would have been in Armageddon and Janet Yellen did convey that message and so I think that's a factor here Chuck you had a comment on that yeah I think that's an important insight that both you and Jay have shared and that is that if the Republicans and certainly McCarthy have learned anything it's that you got to be careful where you place your chips if you place your chips on election denial which most Republicans did Senate and House in at the time of the insurrection that hasn't worked out well for them if they place their chips we're going to push this to the edge of default on the national debt nationally, domestically and internationally that doesn't work well for them I think Jay's exactly right I think if you ask the question who blinked everybody blinked but to come out after and say we didn't just cost them even more credibility so I think Jay is exactly right when it comes around to 2024 you know if you look at the economic measures that have been put in place if you look at the debt ceiling and budget deal that is being worked out and as Jay indicates probably will be passed that's more favorable to Biden than it is to the Republicans because their faction lies I want to add one other point to your point earlier you said this is Biden's career in Congress and especially in the Senate he's been bipartisan seeking solutions avoiding ranker and all that and I think the bottom line of everything we've talked about here today favors him why? is because he said after he failed on the bottom on the red line because he did negotiate a deal he did raise the debt limit he did avoid Armageddon and for that he looks like the peacemaker he looks good he looks like the one that solves problems so when you shake it and bake it you mentioned here today I think he won this game doesn't matter what the exact terms and the giveaways are on one side or the other he looks like the reasonable statesman that's the way it came off good point and I agree hey we're almost out of time so last question we have probably in the next week or so we have former Vice President Mike Pence and former Governor of New Jersey Chris Christie they're going to enter into the GOP presidential ring for 2024 does the discussion or the debate change significantly for new rounds of negotiation no matter what it is does that sound different with these two candidates in the ring? some people say that the more candidates you have on the Republican side of that debate I say debate because that's where he went as he did before the more candidates you have on the stage with him the better it is for him because he knows how to distinguish himself and that would be the presumptive answer to your question however in past debates in past contensions among a field of Republican candidates they were either intimidated or unprepared for his style on the stage that is no longer the case I mean Pence to me is a non-event but Christie he has attacked Trump before and he may lead a charge against him so if Trump thinks he's going to have the same kind of experience with all the games he played with Hillary Clinton with all the games he played with the other Republican candidates I think he's wrong Christie may is likely to openly attack Trump in that debate and encourage other Republican candidates to do the same so I don't think we can assume that what happened before will happen again I think it will be different Chuck same question yeah I think Jay is exactly right that if you look at it superficially the script looks the same it looks like an ideal setting for Trump the more people in the mix the better for him because he stands out in his own way no matter how offensive it might be but Jay is right if you've got people like Christie who are willing to attack him much more aggressively than anyone ever has and you've got people like Tim Scott on the other side you know there are people who can actually coexist with other people and deal rationally and civilly with other people I happen to be one of those people I offer that a whole turn to Tim are you running for president Chuck we need to know Tim Scott oh sorry I took it the same way you did Jay I I would nominate if I had the power to do so alright guess what we've run out of time so quickly your last thoughts in the last month and a half on this whole mess and it hasn't passed but I think it's going to pass and I think they'll get both enough Democrat and Republican not GOP excuse me mega GOP Republicans but just good old fashioned Republicans that will vote this through in the house Jay your last thoughts on this whole thing having a stroke by stroke public disclosure public discussion of everything that goes back and forth it's all theater and it's not good for the country they should have done what they did in years past just raise the debt ceiling and get into hearings about the budget they didn't do that this is all this is all theater and it demonstrates that our congress is broken and I all I can say is that I am not encouraged in general I'm encouraged by the fact that we won't have Armageddon but in general I'm not encouraged with the efficiency the functionality of our congress and meanwhile they have not addressed so many problems facing this country they have abandoned public policy it's all theater alright Chuck can we get the last word on this well I think the key contrast over here you look over at the Democratic side of the fence and although there is resistance verbally from some of the progressive Democrats overall the Democrats and Biden have maintained a far more unified consistent front the Republicans are split against each other that offers a clear contrast so which voting coalitions come together to pass this debt ceiling budget combo deal in the House and in the Senate may tell us a lot more about the coalitions that are going to offer the most promise for the future and that may have an impact on the 2024 elections and connect with those coalitions the best so in the sense this whole thing has been beneficial if those coalitions do combine forces and get things done for the American people and with that I'd like to thank my co-host Jay Fiedel and our esteemed guest Chuck Crumpton for joining us today on American Issues Take One I'm Tim Apachele your host and won't you join us next week and until then aloha thank you so much for watching Think Tech Hawaii if you like what we do please like us and click the subscribe button on YouTube and the follow button on Vimeo you can also follow us on Facebook Instagram and LinkedIn and donate to us at thinktechhawaii.com Mahalo


Hey, this is Brett, and this 2023 Jeep Compass Trailhawk is stock number 24J152A. I am here at Summit Automotive in Fond du Lac, Wisconsin, you're new and used Jeep and Jeep Compass Headquarters, this 2023 Jeep Compass Trailhawk has the 2.0-liter turbo charge 4-cylinder engine, puts out 200 horsepower, it's paired up with the 8-speed automatic transmission. This Jeep has been fully safety and inspected by our service shop, has a fresh oil and filter change, all the fluids have been checked and topped off, and this Jeep is 100% ready to go. Absolutely perfect all the way around, that's exactly what I'm going to do in this video, go all the way around, inside, start it up, take a look under the hood, and just give you the most accurate representation of the vehicle possible, show you all the options. Diamond black crystal pearls of color, shoot all my videos in 4K, if you like the video subscribe to the YouTube channel, click the bell notifications, get updates on the videos I do each and every day, as well as having access to one of the largest catalogs of vehicle and Jeep walkarounds on YouTube. This one comes with the painted 17-inch alloy wheels, and it has Falcon Wild Peak HT tires, these are 215-65R17s, I would say that they have probably 70-80% of the tread left on them, frame and underbody looks really good, this is a one-owner clean title history, clean car facts from right here in Wisconsin, headlights are nice and clear, fog lights down there, you get the red tow hooks with the Trailhawk package, no dents, stings, scuffs or scrapes on that front bumper, the 7-slotted grille, the granite crystal Jeep lettering, you also get the anti-glare hood decal and the Trailhawk decal on there as well, hoods in really nice condition, passenger side front fender is in excellent shape as well, and the passenger side front wheel, no major scuffs or scrapes on there, diamond black crystal pearl, one of my favorite blacks on the market, it's got a lot of metal flake, a lot of purples, a lot of greens, a lot of blues, really a cool color, and a lot of gold metal flake as well, this thing really pops in the sun, and as you go down this side of this 2023 Jeep Compass Trailhawk, take note of how clean that body is, how reflective and mirror-like that paint is, I take these HD videos so if you're far away or even if you're close by, you just cannot make the trip down but you're still interested in purchasing the vehicle, you can see the vehicle, hear the vehicle, and have confidence in what you're looking at before you even get here so you can make a smart and informed buying decision from wherever you're at, if this video helps you make that buying decision let your salesman know that you saw the video that was helpful and that Brett sent you. Back wheels in excellent shape, back tires have just as much tread as the front tires, and it does have the capitalist feel-fill which is a really nice feature, never get gas on your hands. Again, coming around to the back of the vehicle, you get the backup parking sensors, the towing package with the receiver hitch and four pin wiring, you get the red tail hook, powder coated back here, the granite 4x4 and Jeep logo as well as the Trailhawk logo, one of my favorite logos on the Jeeps, rear gates in nice condition, back storage area is very nice and clean, and you get a spare tire with the Trailhawk package, those seats fold down for extra storage and you can see that the rear gate is doing a nice job, or the shocks are doing a nice job holding that rear gate up, there is a little Jeep logo there and right there, a couple little Easter eggs, shuts nice and solidly and as we go down the driver's side just as clean as that passenger side, no major dents or dings on the rear quarter or door and for full disclosure this back wheel is just as nice as the rest. Paint looks really good on this side, does have the blind spot monitoring, heated mirrors, built-in directional signals, this one has the enter and go system as well, just put your hand in there, it'll automatically unlock those doors.  Inside the door looks good, child safety locks in the back doors and the inside and bottoms of the doors all look fantastic, what you'd expect on a 2023 for being honest here, there's the VIN sticker, no previously owned in Canada vehicles here, inside the trail-hawk package gives you that same vinyl and cloth interior, no rips, no tears on those seats, side curtain air bags, power driver seat with lumbar, factory all-weather floor mats up here, auto headlamps, you get this kind of Gore-Tex material on the dash, power windows, locks and mirrors, hop inside, check out the miles, the radio and everything that this one has to offer on the interior, you can see that this one has 7,346 miles on it, instrument cluster is nice and clean, you get the 7-inch LCD display on there, range to empty, compass, you can change all that to read pretty much whatever you want and the digital speedometer, you get the leather-wrapped steering wheel, this one does have adaptive cruise controls and regular cruise controls on the right, Bluetooth and information center controls on the left, audio controls on the back of the steering wheel, you get that red stitching on the steering wheel as well, this was the 10.1 UConnect 5 radio, you get AM, FM and Sirius XM radio capabilities on here as well as USB and Bluetooth hookups, this is where your climate controls are including your dual climate controls and then you have your home screen here where you can change all these widgets out and then you have all your different apps on here, including your heated steering wheel, heated seats and phone hookup, you can hook up your phone up here with Android Auto and Apple CarPlay and project your cell phone to the screen, so it's like you have nav on the screen, so if you got Waze or Google Maps on your phone, project it right to the screen, it's like you have nav up there, down here is your start stop capabilities, stability control, lane departure warning, hazard lights and your parking sensors, down here your more tactile volume tuning and dual climate controls, including those dual climate controls, USB-C, USB and your 8-speed automatic transmission shifter, electronic parking brake, get your different terrain settings for rock, sand, mud, snow and auto, four-wheel drive low, downhill assist control and you can lock your four-wheel drive in right there, it's probably my favorite feature, keyless entry with remote start and that dash and passenger side format and seat are in excellent condition, this vehicle smells very clean inside, it's never been smoked in and the headliner is absolutely perfect, you get map lights up there, we'll start it up and take a look under the hood, starts right up, no check engine lights or anything like that, I would personally like to thank you for checking out the video today and hopefully from this HD video you've been able to verify the quality condition options and of course cleanliness of this Jeep all the way around inside out, you can see it does have LED headlamps and all the lights are working nicely, under the hood you have the 2 liter turbocharged four cylinder engine, 200 horsepower engine base very clean, runs very smooth, once again this Jeep has been fully safe and inspected by our service shop per the state of Wisconsin inspection process and has a fresh oil and filter change, all the foods have been checked and topped off and it is 100% ready to go, there is the emissions sticker and I would highly recommend this compass from a quality and conditions standpoint basically brand new all the way around with only 7,000 miles and to see more pictures of this Jeep or one of our other 400, 550 new news cars, trucks, SUVs, minivans, Wranglers, compasses, you name it we got to go to the website right there summitauto.com full pictures and descriptions of every single vehicle all at summitauto.com if you want to check out more HD videos you can go to youtube.com slash summitauto click the bell notifications get updates in the videos they do each and every day as well as having access to one of the largest catalogs of vehicle and SUV walkarounds on YouTube 9,000 videos in county and also stay current on our ever-changing and vast inventory here at summit auto fact any second was one of the fact any second if you want to subscribe to YouTube channel in the upper left hand part of the screen a link to subscribe to that YouTube channel a link to all the Jeep compass videos I've ever done in the upper right link to this vehicle on our website lower left and a link to one of our latest YouTube videos and lower right click those check us out we're super excited to help you with this ultra clean 2023 Jeep compass trailhawk in diamond black crystal pearl thanks again for checking out the video remember remember to like subscribe and share on the YouTube channel I really appreciate it thanks again


Hello. Bonjour à tous. Welcome to KubeCon. And welcome to Cilium and EBPF Day. So today is going to be about all the Cilium projects that are powered with EBPF. And before we start, first of all, we want to thank our diamond sponsors. So please give a round of applause to Solo and to Isovelin2. Something we really care about at KubeCon is the code of conduct. So please treat everybody as you would want to be treated. And if you want details, everything is in there so you can just flash the QR code and see the code of conduct from the CNCF. So something we wanted to announce is the Cilium certification is now GA. And you will be able to get a coupon to do it with a discount. So we just checked this morning and we're north of 18,000 stars for the Cilium project. And we hope we will hit 20,000. So maybe not this week, but definitely by next KubeCon. Yesterday, we had the first Cilium developer summit. And I think it was really nice to get so many people, so many developers of Cilium together. And definitely something we plan to do again in the future. Yeah, and also thank you Laurent and DataDog for hosting us. We had a great time and a great view of Paris and some great conversations for the future of the project. So there's a lot of things happening around Cilium, not just today, but the rest of the conference. There's going to be 26 different talks about the project. There's a maintainers' track session. There's a project booth to go to. There's many different ways to meet the different maintainers of the project. So please come say hi to real people, not like these AI developers. Yeah, if you scan this code, it will lead you to a project page that will list all the different things that are happening around CubeCon. So if you have information, I'll leave it up for a second so people can take a picture if they want to. And this is the list of all the different talks. It's a fine print because there are so many. I think this is what makes me really excited about the future of the Cilium project is that there's so much great things happening from the community. From different talks about introduction to Cilium to running it in high security or regulated environments to Tetragon. There's lots of different things happening around the Cilium project. And I'm excited for you to learn all about it this week. Just a little update from the project. The 1.15 release just came out. And we have a lot of exciting announcements, support for Gateway API, BGP session authentication, new Hubble observability features, a new provider for Terraform and open tofu and cluster mesh scales to over 500 clusters now. And there's a lot of exciting things happening around the project. And if you want to be a part of the community, please come talk to me afterwards. We like to hear how actual end users are using the project. So if you want to tell a story about how your company is using Cilium, come talk to me. It's a fun conversation. We get to discuss all the things you love about the project. And I think it's a great benefit for your company to show kind of like the engineering power and talent that you have and also promote your brand a little bit too. You can see a couple examples here. And also if you're considering whether to use Cilium in your own production environment, I encourage you to check out these case studies. They're real world experience of people using different features around the project. There's currently nine and we have eight more on the way. I think they're really great stories, but I'm biased because I wrote a couple of them. And I guess kind of to wrap it all up today. We called the opening here, Connecting Cloud Native, because I think this is really where the Cilium project started. I talked about some of the features that came out in 1.15 and here are a few more. We have things like BGP, network policy, load balancer, EBPF service mesh, network flow observability, gateway API, multi cluster. The Cilium project is really able to do is to provide you a networking layer for all of your cloud native needs. And I think this is what is excited about this. I also really like this slide because I changed all the colors for the Cilium logo. So I hope you enjoyed that too. With that, there are throughout the day captioning and translation. This is the QR code too, if you'd like that. I'm from the US. I live in Germany. I know how difficult it is to speak another language or to interpret some things. So we're providing this and thank you for CNCF to providing this to the project. A little bit of housekeeping too. There's going to be refreshments in meal. It's going to be found in the South foyer. I think you probably saw them as you were coming in too. And also please join us afterwards for the reception. You can discuss with the other attendees everything that you've learned today. There is also going to be table topics and networking. So if there's something you want to talk about, please check out the Cilium and EBPF day lunch topic and find other participants to do that. But I'm sure the room is already packed. So I'm sure you won't miss out finding someone to talk to. And with that, we have a packed schedule. This is just the morning. And yeah, I'm excited to have you all here. Our first talk is going to be from UC and Martinez. And they're going to be talking about the deep dive into the Cilium resilient architecture. So with that, yeah, thank you for coming. And I'm excited to spend today with you.


The study investigates the use of semi-supervised natural language processing, NLP, of electronic health records, EHR, free text information combined with structured EHR data to improve the discovery and treatment of background non-valvular atrial fibrillation, NVAF, a major contributor to stroke but significantly undiagnosed and undertreated despite explicit guidelines for oral anticoagulation. The study found that the structured plus unstructured method would have identified 3,976,056 additional true NVAF cases and improved sensitivity for CHA2DS2 VASC and has blood scores compared with the structured data alone, causing a 32.1% improvement. The study also found that this method would prevent an estimated 176,537 strokes, save 10,575 lives, and save US $3.5 billion. This article was authored by Peter L. Elkin, Sarah Mullen, Jack Mardekian, and others.


Hey, what's up guys welcome to our training reviews. So I've just received this in the post this morning It's my official one plus six invite to the global launch here in London So I'll be going there next Wednesday the 16th of May and I'm just gonna give you a quick opening of this invitation I haven't opened it yet. It's still locked. So I'm gonna see what's inside how it looks and Let me know what you guys think Alright guys, let's go ahead and open this Now I like the texture of this invitation. It's quite rubbery. It's not plastic It's got a little cutout that you have to pull out. So let's go ahead and see Now that is pretty cool. There's some things a glass panel Oh, I think this is the entire Invitation so it's actually a a mirrored glass I don't know if you can just see there what it says Speed you need one plus six launch 16th of May 2018 London and then it's got Some text at the back let me point in position where you guys can read it There you go. It says friend You played an important role in shaping the way we build our products Which is why we'd like you to be among the first to witness our most beautiful device yet Mastering new levels of glass craftsmanship We've refined this natural element to achieve a unique and timeless look A beauty to hold and striking to see This invitation gives you a glimpse of the excitement to come We invite you to join us in May to go hands-on with our latest flagship and witness true speed the speed to do more And faster we're confident this experience will be So smooth and fast that you'll instantly notice the difference never settle Now this is a pretty cool invitation. I'm going to be taking this with me next week and I'm not sure if you actually need this to get in but I have a confirmation email as well to to get me into the Event but this is going to be awesome if this has anything to do with how the glass looks like or the screen looks like on the phone itself I think we got some really cool things coming up from one plus six and I'm going to be bringing you all of those updates next week So the event is on the 16th of May. I'm going to be taking all of the pictures videos Check me out on instagram at trending reviews. I'm going to be posting them on the day from the event as well And subscribe and the next day on the 17th of May I'll have uploaded all of the videos and snapshots from the key parts of the launch next week So that's it guys. I'm going to be at the launch next week on wednesday So make sure you subscribe I'm going to bring you all the latest updates on what the phone looks like all of the official specs And possibly I'm going to try and get my hands on one as well to play around with a little bit So keep an eye out for that and if you have any questions, let me know below and I'll catch you guys next week at the launch