Lecture 7, As-Salaam-Alaikum. Welcome to the virtual university's course on business and technical communication. In the previous lesson, we looked at defining objectives and appropriateness in business and technical communication. Today, we will talk about accuracy, clarity, conciseness and coherence when writing for technical communication. In this lecture, we will talk about the characteristics of effective technical communication and also learn to recognize and cultivate the qualities of effective technical communication. Good technical communication is accurate, clear, concise, coherent and appropriate. We have talked of appropriateness. Let us now look at the other qualities. In the pros of science and technology, these qualities are sometimes difficult to achieve and not only do science and technology depend heavily on specialized concepts and terminologies, they also make use of numbers and graphics and that is why it sometimes becomes difficult for scientific and technical writing to be concise and clear to a lot of people. Let us consider an example of technical writing where a lot of scientific terminology has been used. The flow of electrical current can induce the migration of impurities or other defects through the bulk of a solid. This process is called electromigration. In simple electromigration, the force on the defect is thought to have two components. The first component is the force created by direct interaction between the effective charge of the defect and the electric field that drives the current. The second component called the wind force is the force caused by the scattering of electrons at the defect. Now, this is a text taken from a scientific journal and it is accurate in two ways. It is stylistically accurate in its precise use of language and it is technically accurate in its use of specialized terms such as electromigration, charge, electric field and scattering whose meanings are based on the context of a technical discipline. Now, both kinds of accuracy, accuracy of phrasing and accuracy of technical concept are very important in technical and scientific and professional writing. This example that we just looked at is also clear because it is written in simple direct sentences. Even though it is heavily technical, the terminology is very technical. It is clear because the sentences are direct and they are simple. Although the technical context is specialized, the word order also is simple. It is restrained. The structure is easy to understand. So, despite the technical realm of the topic, it is easy to understand. Although it is a very technical concept, it is technical terms but still, the example that was written in it, if it is read, it is not that difficult to understand. Part of this clarity is achieved by the rhetorical device of defining a term, electromigration. Now, the majority of clarity that came in this example, the majority of the words that came in this example, it also happened that the term of electromigration was defined. And because of that, in the beginning, the reader got a definition that what is this term? Because of that, it was easy to understand what was read in the future. The example is concise and it is used of a minimum number of words to express the basic idea of electromigration. And also, it is not wordy. It does not digress from the point. There are not many difficult words to be used. Where a word is used, there is only one word used. It is not that instead of one word, there are three or four words used to impress the reader. Because of that, the text gets confusing. The example is also coherent because it develops the subject matter in an easy-to-follow manner. There is a clear line of thinking. The sentences are linked together by words like this process, the first component, the second component. These are links. The first, the second, this process. They are referring other things in the text. And that is why the line of thinking of the reader is not broken. The thought remains in the text and it knows what it is talking about. Because there are clear markers in the text. Finally, the example is also appropriate to its purpose because it is presenting a description of the process of electromigration. So, the way it is written is appropriate because it is obviously meant for a scientific audience. The writer knows that the audience are educated readers of science and they may not be experts in the field of nanotechnology about which this is talking about electromigration. So, the writer has definitely understood that it should be described by the electromigration because he knows that these readers are experts in science and technology but he may not be able to tell them about this concept. But the rest, he used terminology and did not define everything because he knows that his audience will understand it. Now, what is accuracy and why is it important? It is important that you cultivate accuracy in your writing and it is the careful conforming of truth or facts and it has three main aspects. There is document accuracy, there is stylistic accuracy and there is technical accuracy. Now, let us see what these three aspects mean and why is it important? Document accuracy, stylistic accuracy, technical accuracy. What is document accuracy and what is the need for it in a document? It refers to the proper coverage of your topics in appropriate detail. Whatever your document topic is, how much detail is in it, how much you have covered it, there is not much detail, and how accurate is the accuracy in that document. Often an accurate document needs to focus clearly on a problem. Document accuracy is generally cultivated by a clear problem statement and by preliminary outline. Most of the time, document accuracy comes only in a document. When the problem is clear in the document and in the beginning, the outline of the document is given and then accuracy increases in the document. These writing tools help you focus your writing efforts by reducing your data in a way that solves a theoretical or practical problem. So, because these are basically tools that you have. If you have a problem statement or if you have a preliminary outline, these are tools that will help you as a writer identify your goals better, that will help you as a writer make sure that your document is accurate and they also serve as a kind of a check for you so that you do not digress from your point. If you start discussing other topics then when you look at your problem statement or outline, you will realize that we are moving away from the point. Now, what is stylistic accuracy and why is this important? Stylistic accuracy concerns the careful use of language to express meaning. Accurate language requires the careful use of paragraph and sentence structure and word choice to describe and analyze your topics effectively. Whatever paragraph structure, word choice, sentence structure you are using will affect how effectively you express what you want to say. So, that then is stylistic accuracy. If you structure your paragraph in such a way that you do not want to clear or what you are trying to say does not reach that message but some other message. Then the document's accuracy will decrease because the reader will get some other message and you want to give another message. Just because you have structured your paragraph or used your words creates some misunderstanding. So, obviously where there is misunderstanding your accuracy will decrease. As a writer, you gain command of accuracy by studying the elements of style and by learning to apply these elements to your drafting, revising, editing and proofreading. When you read a document again or when you draft it for the first time and make your points rough revise it once again and edit it again. Whatever changes you have to make and when you proofread it and find some mistakes then your accuracy will increase because of all these points in four steps, revising, editing, drafting, revising, editing and proofreading will increase your accuracy in your document. And stylistic accuracy obviously is also a matter of choosing your words precisely. The words that can be understood are the words used so your accuracy will increase and this also doesn't come with stylistic accuracy. Now, what is technical accuracy? We've looked at document accuracy and stylistic accuracy. What is technical accuracy and why is that important in a document? Technical accuracy requires stylistic accuracy but is not based solely on it. A very important part of technical accuracy is also stylistic accuracy which we talked about. But it doesn't mean that technical accuracy and stylistic accuracy are the same. There are two different things. Stylistic accuracy can be a part of technical accuracy but not the whole part. The effective document in science and technology must be grounded in a technically accurate understanding and representation of the subject. Especially when we give scientific or technological explanations or descriptions, our document shows that the facts we present are correct and correct because what we are talking about can reach anywhere and according to the reader they can understand some wrong things and what you are trying to show you can also show some other things. That is why it is very important that you use technical terms and use technical concepts to explain something that is absolutely clear and correct. Technical accuracy depends on the writer's conceptual mastery of the subject and its vocabulary as well as on his or her ability to analyze and shape data with a minimum of distortion. Obviously if you as a writer are not a master at the concepts that you are presenting if you do not know the concepts that you are presenting then your document will not be technically accurate. That is why it is important that the people who are going to write should know about their subject matter so that the people who write write it correctly. Other than this, use the words so that they are also correct. The information you give has a minimum distortion and a minimum chance of making a mistake. This is why in science and technology there is so much emphasis given on mastering this technical aspect of subject development. Until you develop a subject and write any topic about it it is very important that it is technical accuracy so that there is no indication Now what about clarity? Why is clarity important in technical writing? Clarity which refers to ease of understanding is a special problem in technical and professional writing because a lot of the times people find it very difficult to be clear in what they are saying and they either use too many words or they use very long sentences or the information has not been presented properly and that leads to misunderstanding. Specialized languages mathematically described detailed analysis and complex conceptual schemes can make technical subjects hard to grasp even when prepared by skill writers and read by expert readers because in technical writing there is so much that is difficult to explain and there is so much emphasis on the right language and presenting the concepts in a particular manner if you vary from those it becomes difficult for you as a writer to explain the concepts and for the reader to understand as well because of the complexity of what you might be explaining and you can increase the clarity of your material by either using structural clarity or stylistic clarity and or contextual clarity generally you would be striving for all of these structural stylistic as well as contextual clarity to make your document more clear let's have a look at what these are what is structural clarity and why is it important at the level of the whole document you can promote structural clarity making it easy for the reader to get the large picture so this is from the large part of the document we are looking at the whole document and seeing how we can use structural clarity to make the general image of the whole document more easily accessible to the reader you should use abstracts and other forecasting strategies such as introductions that state the purpose and scope of the document or table of contents etc and because these add to the structural clarity of the document basically structural clarity means the structure of the document we should improve it to make it easy for the reader the way we have designed the document should be better and we should add elements to make it easy for the reader for example if table of contents it is easy for the reader to see what is written or if it is abstract or introduction we get tools for the reader now how can you promote as I said table of contents problem statements even strategic repetition promote structural clarity many times we repeat many things in a document it is better not to repeat because your readers get bored but if you are repeating then do it strategically and do it on such points where you feel you have to emphasize what is written and it teaches it graphs and tables if they are effectively designed and effectively placed help focus and they also clarify information they help the reader in focusing on particular information they also help you as a writer in emphasizing particular information so if you want to emphasize the information then put it in tables or graphs descriptive titles and frequent subject headings guide readers and they help them in keeping the larger picture in focus obviously not much but where it is important where titles, headings they help a lot to structure a document obviously if there are a lot of headings and there is very less description then it is not suitable headings should be there where it is suitable and there are a lot of headings now what about stylistic clarity why is that important stylistic clarity is promoted by simple direct language and this simplicity in language is obtained with directly worded sentences the word the sentences should be in direct speech they should be addressed directly to the reader and this simplicity then promotes stylistic clarity the sentences should be simple and they should not be overloaded with information or words so that clarity can be increased word choice is also a factor in fact a very important factor in stylistic clarity you should use simple language wherever possible and try to reduce abstract specialized terms of science and technology especially if you feel that the audience is not going to understand it if you feel that the audience is expert and they can understand the scientific and technical language then use simple words to counteract to balance out the scientific and technical language so having talked about structural clarity and stylistic clarity let's have a look at contextual clarity and what we mean by that contextual clarity in which the importance authorization and implications of your work are made available also contribute to ease of understanding all work has a context and your readers want to understand what the context of your document is as a writer things which contribute to contextual clarity are questions like what is prompting you to write which basically means why are you writing what is your purpose what do you hope to achieve through this writing whose work has preceded your writing and whose work has influenced you was there any work done on this topic or this area before you which has influenced you that is important because then you will need to refer to that or maybe you will assume that your readers know of that work what is the organizational and intellectual context of your problem that you are writing about now you can achieve contextual clarity by answering all these questions in your introductions, problem statements and in your citations and references etc you don't have to allude to them directly all the time but you need to be clear about them and you need to make sure that they are somehow that your introductions and citations etc are somehow answering all these questions in introductions problem statements, citations and other references but this doesn't mean that you need to write about them or you need to answer them directly all the time a lot of the times you will just allude to them or you will just refer to them but you need to be clear yourself what you are referring to so that your purpose what is prompting you to write any work that has influenced you the context of your problem is clear to the reader as well what about conciseness why do we consider that important when we are writing technical documents why is it important to learn the strategies of conciseness why does conciseness have such a special value technical phase writers are often tempted to include everything that could be relevant to the subject or everything that they know in the document including things that are relevant to the communication task at hand so a lot of the times as writers we are tempted that whatever we know we should show our knowledge and we try to include that we forget that whatever we might know is not necessarily important for the communication task right now if we know this document we should fix it somewhere somewhere so that our readers one of them was very eager that our readers would be impressed but we forget that our readers think this is irrelevant and what we are writing there is no need for this this is irrelevant for our reader so instead of being impressed or bad so therefore the concise document is a piece of writing that should convey only the material that is needed at that particular point at the level of the whole document conciseness is helped most by focus the narrowing of document scope to a manageable problem and response if you as a writer can find the focus of your problem what it says about your particular topic you want to write about what is the problem that you want to target and narrow the problem in its scope not talk about the problem in such a large context or large detail that it cannot be managed in one document you need to narrow it down to a particular focus that will help your document in being concise preparing a clear introduction and developing a detailed outline are two strategies that give you control so if you have got a clear outline point by point you have made an outline in your document and you have written a clear in the introduction you have defined your objectives in the clear news introduction so it will be very easy for you to keep your document concise and not move away from the point it will be very easy for you you also need to identify and eliminate material that is not necessary to support your claims if in your document you are giving a clear outline for which you have given additional information to make it clear then it is very important to see that the additional information that you are giving to make it clear how important it is how relevant it is and how detailed it needs many times it happens that people give more explanation they don't need any explanation so that is why you have to remove unnecessary material that is false material from your document also you need to look for sections including appendices which are not essential to your work if you have any sections any chapters, paragraphs you have put some information in appendix which is not necessary to be in your document then it is better to remove it if you feel that we have written this extra then reduce it Graphics are a powerful aid to conciseness because they cut down on words they cut down on the amount of prose that is necessary to describe objects, to develop your arguments to describe processes they also help in summarizing data and in demonstrating relationships so a lot of the time if you want your document to be concise then using graphs, tables, figures it is a very good aid they are very good tools so you can use them to make your document concise and rely less on prose but obviously you cannot use graphs to explain all kind of materials so you have to be selective in where you are using graphs and where you are using prose and also you need to be careful because the graphics that you are using are actually suitable for the information that you are projecting how would you make your document more concise? we have talked about graphs conciseness could also require careful revising once you have written your document you need to revise it you need to go over it once again and you need to then see what changes need to be made and what are some of the aspects maybe there is text that needs to be replaced for graphs you might not have thought of it in the first instance you need to become familiar with the strategies for reducing wordiness look for ways of cutting useless words sentences, sections from the document if you feel that you are using too many words to explain one thing cut that down if you feel that there are too many sections which are irrelevant or if they are sentences cut those down coherence is another factor which is very important in writing technical documents and professional documents coherence is the quality of hanging together of your writing being together being stuck together so that it does not seem as if you are writing about different things and it does not seem choppy or it does not seem that you are taking jumps from one idea to another it's basically providing the reader a unique path to follow writers promote coherence by making the material logically and stylistically consistent the information in your material the logic of it should come together the stylistic components that you are using the style components in your writing should also be the same not that you have one writing style in one paragraph and in another paragraph in the beginning of a paragraph you were very formal and by the end of the paragraph you have become informal so that is not your stylistically coherent paragraph coherence is also achieved by organizing and expressing ideas in specific manner in specific patterns when we talked about earlier we talked about using a dividing and alternating pattern of comparison now if you want the document to be coherent then if you have chosen a dividing pattern then you will stick to a dividing pattern if you have chosen an alternating pattern then you will stick to an alternative pattern for that document it is not possible that you tell in the three points in the alternating pattern and then you come to the dividing pattern the reader will get confused so the coherent document will be consistent throughout your document among the elements of a document strengthen its impact whatever relationships are between different elements between different chapters or in different paragraphs if you make an effort that those relationships are clear then the coherence in your document will increase it also increases the reader's ability to understand your topic because it has increased the flow of what you have written it improves the readability of your material coherence is specially valued in technical communication and writing because of the inherent complexity of the subjects for writing which is written for lay people for people who have no expert knowledge generally the topics are easy but when writing is done for a technical audience the concepts that need to be explained are more complicated and therefore it is even more important that coherence is present in your writing that your document is coherent and you use all the strategies we talked about to achieve this coherence so that because the text is heavy in terms of the content it has at least if you are writing it in a coherent manner then it serves as a tool for your audience to understand what you have written in the direction of the whole document coherence helps to provide the larger picture in which the connections amongst the parts of a document are made clear to the audience by the writer and it also helps the readers in the sense that it gives them a road map to help them anticipate the content of your work a lot of the times in your writing you refer forward to what you have written or you use the words or the sentences that are written so that the reader gets an idea that the next sentence or the next paragraph will be about this type so you are showing your audience a road map for them so that it is easier to read abstracts, clear titles, introductions, problem statements all promote coherence making various parts of a piece of writing because of all of this abstracts, clear titles or introduction or problem statements clearly stated because of all of this the coherence of your document increases because the different parts of your document make a relationship and provide a link the paragraph with the most powerful instruments of coherence I have already told you all the areas that are important in coherence but the most important thing to emphasise is your paragraph construction because if it is not your coherence or if it is not your tightly knit then in your document no matter how many headings abstracts, problem statements if your paragraphs are not good then your document will not be coherent and by organising material into a topic sentence in a paragraph and then in supporting sentences you are pulling the paragraph material together so it is important to make sure that every paragraph has a topic sentence and those topic sentences are then supported by the supporting sentences and so that the various forms of the concepts are developed properly so it is important that one sentence in your paragraph which is generally the beginning which is called topic sentence it is important because from that topic sentence the reader gets to know what will be discussed in this paragraph and you also get to know what you have to keep in mind in this paragraph in this paragraph your concepts are clarified and then the supporting sentences the other sentences in the paragraph are all related to this topic sentence paragraph development is achieved partly through the specific strategies of exemplification analysis, comparison and contrast definition, enumeration and description the paragraphs most of them follow these 6 patterns or there is an exemplification in a paragraph in which examples are used or analysis is used which is analysed or comparison and contrast is used or something is defined or enumeration is given point by point or general description is given not point by point but the overall process is described all of these furnish distinct approaches to developing ideas now you as a writer can decide which way of developing a paragraph you wish to use for a particular paragraph it is not necessary that in a document all the paragraphs are developed in the same way in fact not all the paragraphs will be developed in different ways and this will affect what you want to show in the paragraph and how you want to express it so all paragraphs may have different patterns of development and that pattern will be determined by the content that goes in the paragraph transitional devices also operate at the paragraph level to provide links between sentences and between paragraphs although it is important for you to be clear in your mind what pattern of organisation you are using for a paragraph it is important that you use transitional devices so that in the sentences within your paragraph there are very definite links and also you need to use transitional devices between different paragraphs so that where one paragraph ends and where the other paragraph starts there is no transition there is no link not that one paragraph ends and when the other one starts the writer who is going to read what is the link from the paragraph so that the transition where you are taking the reader from one idea to another that transition is very important so that the link and flow is coming to you in terms of paragraph development writers use enumeration in paragraphs when they want to itemise a list itemise or list a set of properties or topics or series of some kind enumeration is a powerful way of observing observations and to emphasise each element so there could be distinct elements that you will list and that you will emphasise by enumerating them in a paragraph let's have a look at what we mean when we talk about enumerating in this paragraph that we are going to see now the items are enumerated in a series of itemised recommendations if you have instructions to have your blood cholesterol measured if you have never had it done finger prick tests at health fairs and other public places are generally very accurate especially if they are offered by a hospital or other reputable health groups when you know your number follow these guidelines from the national cholesterol education program now this is an introduction within a paragraph and now comes the enumeration part if your cholesterol is under 200 maintain a healthy lifestyle including eating a low fat diet getting regular exercise, maintaining a health body diet and not smoking and get another test within 5 years if your cholesterol is between 200 and 239 have a second test performed and average the results if that number falls in the same range and if you do have any form of cardiovascular disease change your diet to improve your cholesterol in addition eliminate any other risk factors you have and get tested again in about 1 year if your cholesterol is 240 or more your physician should order cholesterol analysis and recommend therapy based on the results you should begin a cholesterol improving diet immediately now if you see in this example all these 3 points if your cholesterol is under 200 between 200 and 239 if your cholesterol is 240 or more all these 3 points are listed separately and it makes it very clear to the reader that the writer is talking about 3 different scenarios so instead of just talking about them generally the writer has enumerated them put them as separate points talked about them in specific detail there is a link because they are all talking about cholesterol there is a link to the way they have been written as well if you notice the language is similar the sentence patterns are similar but the scenarios are different obviously because each scenario is talking about a different cholesterol level but instructions are following the same pattern now it's not necessary that enumeration patterns are always in bullet form enumerated paragraphs could also be in a paragraph form you don't have to set them aside as bullets or numbers you could enumerate things by saying firstly, secondly, thirdly for example or in the first place in the second place and that is also enumeration exemplification is used to clarify your topic statement and generally exemplification would be used as examples in the paragraph that you are going to see the topic sentence is supported in examples that illustrate, support and clarify the main point vitamins and minerals can be added to enrich, replace nutrients lost in processing or fortify, add nutrients not normally present foods to improve their nutritional quality bread and cereals are usually enriched with some B vitamins and iron common examples of fortification include the addition of vitamin D to milk, vitamin A to margarine vitamin C to fruit drinks calcium to orange juice and iodine to table salt, iodide to table salt now this if you see the writer has given examples, the writer has clarified terminology like enrich by giving in brackets what he means he has talked about fortify given a very clear direct link to it and then gone on to examples, he is exemplifying all that he is saying by giving you concrete terms, concrete examples that will relate to what he is trying to say and that will support his topic statement that vitamins and minerals enrich and fortify foods to improve their nutritional quality comparison and contrast is used to develop a topic examining its similarities or dissimilarities to another thing similarities or dissimilarities of processes or states etc. comparison emphasizes the similarities and contrast emphasizes the differences a paragraph may use both comparison and contrast let us have a look at an example where two kinds of electrical cable are compared the aim here is to convey the superiority of a type over b type for two categories of performance the heading here is coaxial versus fiber optic cable so obviously the heading is it is clear from the title that there is some kind of a comparison or a contrast being done and then after colon it says comparative cable length performances so here obviously it is even more clear by the use of the word comparative we are comparing the cable length performances for a number of critical performance characteristics fiber optic cable offers considerable advantage over standard coaxial cables the most obvious distinction between the two is the great bandwidth distance capacity of fiber the high frequency capacity of coaxial cables decreases rapidly with increased length but the bandwidth of a commercial fiber optic system will remain constant with length the commercial fiber optic system like that of RTEL remains constant for a bandwidth over a distance of 4000 feet while three different sizes of coaxial cable rapidly drop in less than half the distance now this as you can see is a paragraph where the two different types of cables have been compared to each other by looking at different aspects different elements of the cables themselves the two different types of cables that are present are things like the length the bandwidth etc and these have been compared from cable A to cable B or the coaxial cable to the fiber optic cable the use of transitional words and phrases greatly adds to the coherence of a piece of writing and writers need to use transitional words and phrases to clarify and smooth the movement from idea to idea so this paragraph which has weak transition would be something like reducing drag in an aerospace vehicle is an important design consideration with financial and operational consequences poorly designed rocket fuselage scan triple fuel and launch costs drag increases stress on key joints this proposed project will develop a model to reduce aerodynamic drag on the RX100 now let's have a look at the same paragraph but with better transitional devices and improved version of the same paragraph reducing drag in an aerospace vehicle is an important design consideration for example poorly designed rocket fuselage can triple fuel and launch costs moreover drag increases stress on key joints therefore this proposed project will develop a model to reduce aerodynamic drag on the RX100 now as you see words and phrases like for example moreover and therefore have provided better links between the sentences and these are the transitional devices that have been used by the writer to make the writing more coherent so with this we come to the end of this lecture lecture 7 where you learnt the importance of accuracy clarity, conciseness and coherence until next time Allah Hafiz


Thank you very much. I just wanted to say first, thank you for coming to hear my talk and to let you know that there are a few firsts going on right now, so it's my first time being at CCC, so I'm excited to be here. So my first time giving a talk this late at night, so when I got my time slot, I asked myself the question, just how drunk will my audience be? So you can report back to me later about how drunk you are. And then the last thing that's a first that's a little more serious is this is my first time showing work in progress, so I'm a little bit nervous about that, so be gentle with me. So when we start talking about edible soft robotics and this exploration of candy as an engineered material, it was kicked off by just this thought I had while making cast silicone actuators that there's an intense similarity between cast silicone and gummy candies. And it's like one of those idle thoughts you have when you're fabricating something. But I was really captured by this like joking not joking place. I wanted it to be something that is totally ridiculous that I could also take very seriously. And so when I was trying to identify like should I do this project or not, since I've been a government contractor, when you propose a project, you have to like turn in these sheets about what your project is going to be. So I went ahead and made one about making candy soft robots. So this is my quad chart if I were going to try to get the government to finance my project. But for me, it was really about this place in the potential benefit zone that says I see food as the highest form of interactivity and that it that means it engages all five of your senses.  I couldn't think of anything more interactive than that. So that seemed like a good enough reason to go down this pathway. So kind of the next thing I do when I have a project is I ask myself, what's the history and the state of the art? I don't want to reinvent the wheel. I don't want to start from zero if I don't have to. So who is doing the work? What are the related fields if you want to make a candy robot? So soft robotics was obviously a starting point. Luckily, it's something I've spent a lot of time thinking about. So I had a good foundation there. And then the next one is molecular gastronomy. So molecular gastronomy is this idea of using food as an art and an experience, using the tools of science to get there. And the thing that was interesting to me about this field is that all cooking is technology. Just some technology is technology we're used to. So for example, a microwave. That was the cutting edge of technology not so long ago. And now it's just a typical tool. So as we look at this molecular gastronomy place, I'm interested to see which things that seem very far out there right now will become part of our regular cooking. If you look up edible robotics, the first thing that comes up is all health-related projects. So this, for example, is a robot that is made out of meat. It's made out of sausage casings. And its purpose is to, if you swallow a watch battery, it can do a lot of damage to your stomach. So this is supposed to go through your stomach and collect the watch battery and then flush it out of your system. Then the next one is kind of the other side of the same problem. So since you don't want to swallow a watch battery, but you might want to swallow a robot, they came up with a battery that's made from cuttlefish ink that you can swallow it and then it gets digested over time. So then to move from the health space to the art space, which is the other people who are making edible robots, there's this project called Living Food. It's inspired by the synthetic biology movement. So the idea was that they wanted to make living food that moved and breathed and like that would be part of the dining experience. Sadly, this was only a theoretical project, so there weren't any technological takeaways I could apply to my work, but it was interesting to consider. Then the other thing that happened is when I was talking to people about edible robots, people kept pointing me back at NYC Resistor, which is the hacker space that I'm part of.  So the top project is called Lady Godiva, and it's a chocolate that's a closed circuit made with edible silver foil. So when you eat it, the chocolate moans and you have kind of this experience. And then below is a jello piano. So the things about these projects is that they're dealing with sound, but I've always been much more interested in motion. So there wasn't a lot for me to take away from these. And then finally, there was this robotic big project, it was a large collaboration through an art space and a university and a private company. So they were making edible robots that moved. The Rice Krispy robot is Rice Krispy's covering a cable pole system. So I really like the motion and I like the form, but I don't really like that you have to eat around the cables. I was a lot more interested in the cucumber robot because the cucumber is strong enough that it can use its own material to be the cables. So it's like, this is where I want to be in the robotic space, but I didn't really want to eat a cucumber after it, been a robot. Like I wasn't really drawn to that. So that's why I was more interested in candy. So that's the state of the art as we go down this road. Then the next thing I like to do is consult with experts, which is a really interesting question when you're working on an emerging problem, an emerging field. Who are the experts? When I go down this path, I like to go as broadly as possible. Like I might get information I might not use, but the further I go afield into who I think experts are, the more surprising information and the better synthesis of ideas I will get across the problem space. So in this particular case, I consulted with Matthew Bargati, who is actually my collaborator at Super Releaser, and he is actually the person who convinced me to get into soft robotics at all. And he's also the person who told me that I had to make candy robots once I said it. Because I said, well, it doesn't really fit our soft robotics agenda. And then he said, part of our soft robotics agenda is to be awesome. So you have him to thank or blame about this project. And you can watch his talk from last year's CCC about soft robotics in general, if you want to learn more about the general field. The next person I consulted with is a friend of mine, Tim Rodriguez. He's most known for being a board game designer, but he also has a degree in food science. So one of the things that was really useful to talking to him about food science is that he took me down the pathway of looking at candy at the molecular level. Because it's actually all of these very, very simple systems in terms of the chemistry. And he had some great insights too about the relationship between why candy is sometimes not a very strong material and why vegetables are strong. So that's something that will come up again a little later. And then my friend Liz Hara, she is a professional puppet builder. I have worked with her at the Jim Henson Company and other places. And she is also an extreme candy enthusiast. She has eaten every kind of candy that is mass produced in America, which is quite a feat. And then one of the other things that's been really wonderful about talking to her is because she made edible puppets once. So she gave me this fabulous insight. I can tell you stabbing licorice into a hot dog does not make a durable puppet. This is the voice of experience. And then the other thing that's been so great about working with her is that she's very enthusiastic about the candy actuator space. So she's been texting me more information even while I've been here. So now that I've talked to the experts, I needed to bound my project. I needed to decide what the evaluation criteria was. Whether or not I was succeeding at making a soft robot.  As I said before, I'm not really a fan of the eating around cables. Also, it needs to be easy to reproduce. The primary reason that I'm doing this project other than to be awesome is to make a how-to to put into a book about soft robotics that I'm co-writing. And so what I decided easy to reproduce looked like was that it could use special specialty ingredients. You could have to go far afield to find the right things, but you shouldn't have to buy specialty equipment in order to do this project because I don't want people filling up their lives with all of these things. They're only going to use once or twice to make a candy robot. The other was that it had to be not too fussy to make. When I talk about fussy to make, I don't know if any of you have ever made a meringue, but it's incredibly sensitive to the humidity and you have to adjust everything very carefully. So I wanted the robot to be something that it wouldn't be temperature or weather dependent. I wanted it to elicit an emotional response that was strong. And for me, when you deal with candy, you either get two directions. You get this joyful space, this fun and happy space, or you get something that's really gross, like snot or those jelly beans that taste like vomit. So those were the two most exciting places for me in the edible robotics place. And then I wanted there to be a baseline-fit flavor standard. So I didn't want it just to be technically edible. So a lot of people I talked to about this were like, well, you can eat fabric or you can eat paper. And I was like, I think that's really not in the spirit of the project. Like I think that there has to be a baseline deliciousness that makes this an appealing thing. And then it needs to be durable enough to make the day before. I don't like the pressure of having to perform making something to the last minute right before I serve it to someone, especially for something as complicated as a robot. So I wanted you to be able to make it the day before and then serve it. And then also, there was no need for long-term stability, though, because once you get into the place where you're making a food actuator, long-term storage just sounds like dusty, dirty, handled by a lot of people, which then went away from kind of the delightful edible component I was looking for. So those are the specs that I'm going to measure success against. So now, since I got into technology, kind of through being a fabricator and through my experience working with materials and like direct relationship with the material world, it makes the most sense to me to spend time with the materials and to touch the materials and to experience what they do. And aside from it being my comfort zone, the other thing I wanted to bring to the process was that I have seen many, many people build projects out of inappropriate materials. And you can see that they're spending a lot of time over and over again trying to make something do an object that it cannot achieve. So because I don't know anything about candy as a engineering material before I started, I needed to spend time with the materials to know what appropriate use cases were. So first thing I did was start acquiring some materials. So Calloustians, the place to buy hydrocolloids in New York City. I'm going to say hydrocolloid a lot. That's what makes a gummy candy, a gummy candy. So just so we have a definition to start with, a hydrocolloid is a stable suspension of hydrophilic molecules. So most of them are sugars, but some of them are proteins. So for example, gelatin's are proteins and they're a hydrocolloid.  Now what I didn't realize when I started down this pathway, gelling of hydrocolloids is a foundational problem of molecular gastronomy. I thought that I was going into a space where everything was going to be mostly solved. But what I found instead is in this book, this is 22 different options for gelling agents. So there's a lot of ways to achieve this outcome. And I'm actually going to read directly a quote from the book because it made me laugh. Unfortunately, relatively little theory exists that can help cooks know which gelling agents or coagulants will have synergistic effects. We can recommend several good combinations based on trial and error in our kitchen and others, but more information would be helpful. There are many possibilities out there awaiting discovery. Now the reason why this quote is funny to me is because I work in soft robotics. And essentially, if you swap out kitchen for lab and like one other noun, it's exactly what you would read in an academic paper. So I started on my hydrocolloid path by doing pectin. Now pectin was a good case because it actually illustrated what doesn't work. It's a hydrocolloid that is made of monomers that are very dense and very small. And they only have a single point where they join to the other ones. And because there is no motion within the monomer and then there's only the single point of connection, this makes a gel that's incredibly brittle and breaks apart under any kind of snapping force. So it's totally inappropriate for soft robots, but it is very good for learning about hydrocolloids. Number two iteration or number two material exploration was I burned the gelatin. This was horrible, it smelled awful. And it was also really interesting because it reminded me that I was working with a protein. I think that we don't really think about how the materials within candy are things that are kind of surprising if you pick it apart a little more. So I made my third version, my third batch was too much gelatin. And this was yet another reminder that I was working with an animal product because the outcome looked and smelled like and taste like skin, which is not a desirable outcome in candy. So now we get to some slightly more successful gels. So this is Jell-O-Brand gelatin. It was a good compromise between flavor and ease of handling because it already had sugar, it already had some measurements done for you. But this is an example of an elastic hydrocolloid. So what happens is collagen is a tri helix form. So it's inherently very, very stretchy as you can imagine the space between the three components of the tri helix stretch out. Well, when you make gelatin, it breaks into these single strands. So they're all like a free floating spiral. As you treat the material, the gelatin, as you heat it up to a certain point, you actually start making these bonds again and you start getting tri helix sometimes, but not all of the time. So you end up with this combination where the tri helix parts are very stretchy still. All of the free floating ends that didn't make bonds end up in this tangled mess that a chemist told me is a lot like spaghetti. So when spaghetti is really hot and moist, it slides out and you can pull some strands away. But as soon as it gets cold, that tangled mess is stuck together and becomes a very, very solid thing. And so that relationship between the tangled mess and the tri helix is what gives gummies. They're like very, very signature texture. So this is an experiment that I made out of gelin. Gelin is a different kind of hydrocolloid. It's a plant-based. It actually is a bacteria that grows on the bottom of lily pads in nature, which is pretty interesting. Now the great thing about gelin is that it makes this extremely stretchy material, but at the same time it's very tender and soft. And when they were talking about synergies between hydrocolloids, it's often combined with carrageenan to give it a stiffness. But the thing that's interesting about mixing hydrocolloids is that you don't get an average between the two. When you start mixing them, you get entirely new behaviors that aren't reflected by the individual. So that is a future experiment. So I went back to the Jell-O brand gelatin recipe and then I was starting to be like, okay, this is working a little bit. So I'm going to go ahead and cast it in a soft robotic mold. So this is dusted with cornstarch. Traditional gummies are actually made in cornstarch molds. They press metal shapes into cornstarch and then pour the gel directly into it. This is not food safe, so please don't do this in the future. So when I do future robots, I'm probably going to make silicone molds, but this mold was just one that I 3D printed. So then my seventh experiment making gelatin base, the making hydrocolloid ballast gels, was I used what they called the Harry Bowel recipe. I don't know if that's how you pronounce it here. But the thing that was really interesting about this one was that they sub out regular white sugar for other sugars. You use glycol and sorbetol because it changes the moisture amounts in the mixture and you can eliminate some of the water when you switch the sugar source. So unsurprisingly, this one was the most delicious one that I made. And I think part of that was that it has added acid. So you can use citric acid or you can use, I can't remember the name of the other acid, but a lot of different food acids can be used, but it really improves the flavor profile of your candy. Oops. So in the future, I have some plans for testing the assessment of these gels and I didn't even get to it because the gel problem was so much deeper than I anticipated. So I'm planning to test the durometer, the elasticity, the flexibility, and the durability of all my future iterations of the candy making. So in the store-bought material side, I went to Economy Candy. I bought a lot of different candy. I spent way too much money on candy. Also, I learned don't eat your mistakes if you start working in candy robotics. I ate three iterations and then I didn't feel so well. So I'm not a purist when it comes to soft robotics. I also love hybrid robots. So I did some tests where I drilled into chalky candies to see whether or not they could be spacer components, which successful, they were totally clean and had durable holes and I could drill in a variety of sizes. Inspired by the Octobot, which is a soft robot that runs a liquid across, I think it's a platinum plate and that creates gas. I was like, oh, maybe I can make an explosive gas actuator by using pop rocks, but you can tell that it does not have any explosive action at all. Nothing happened, just a very slow fizzle. So if I want to make a chemical reaction robot, I'll probably go to Mentos and Diet Coke because the internet has really well documented that that works well. Another thing I tried was buying pre-purchase candy and then heating them. So one of the things that's interesting about this set of hydrocolloids that I'm exploring is that they are not single state, like one time reactions. They actually can revert, so you can heat them up and cool them down and it will cause the same chemical reaction set over and over again. So actually there's lots of do-overs if you're working in gummies. And so these ones were microwaved and I thought that would be an interesting option if people didn't want to make candy robots from scratch. And then fruit leather. I was inspired by the fact that there's a lot of soft robots that are made out of airtight fabric that doesn't flex but just holds air. So this is me using a compressor to pump air into some fruit leather. And it also made a pretty good seal just with its own stickiness, which was a surprise. So I said something before about vegetable matter. A lot of the things I used for pulling force that were made of candy didn't hold up to the amount of force I needed to cause the actuation. So I tried dried mangoes, which are excellent. You can, they fit the taste profile. They go well with candy. But you can tie it in knots. You can bind things off. You can use them as cable controls. Excellent material for this space. And then also there's these licorice vines that are hollow so you can pull things through them. They're also airtight so you can use them as tubing. So if you wanna make a pneumatic system. So I'm gonna move on now to, my next plan in this process was that I was going to do an iteration of a wide field. So usually what I do is I take all of my promising materials and I'll do a single iteration of each of the promising materials. But the thing is that in this case, I ran out of time. The gel problem was so much bigger than I ever thought it would be that I only got through one iteration so I wanted to let you know that right now. So in addition to iterating on all the promising materials, I wanted to do one iteration of each control method that is popular in soft robotics. So that's cable controlled, pneumatic, hydraulic and chemical reaction. The only one I got through is cable controlled. But this is my first iteration of a cable controlled robot made of candy. So ta-da, it kind of works. And then when I do my first iterations, I have to go back and assess what worked and didn't work. And one of the things that I found about a cable controlled candy robot was I wanted a lubricant. So I tried oil, oil was terrible. It was a solvent. It worked a lot like water. Everything started breaking down and getting stickier. And then I was like, oops, of course, sugar dissolves in moisture, should have thought of that. But sometimes when you switch from one domain to the next, the things you know don't transfer with it. I tried corn starch because I was like dry lubricant seems the way to go. It got a little gummy as it rolled. So it was good short-term lubricant but you couldn't have high cycles. With confectioner sugar, it was the most promising. So confectioner sugar is a mixture of very, very fine sugar with corn starch. The second iteration would be a narrowed field based on my first set of iterations, TBD. And the same thing is true to getting the final soft robot. So repeat iterations till your specs are met. No excess and iterate. Yes, you're done, TBD. So the thing though about this whole conversation is I really wanted to take the risk of showing work in progress and showing unfinished work. And the reason why I wanted to show unfinished work is because it incentivized me to show you my failures. I think that innovators spend a lot of time talking about how we're willing to fail. But what happens is you either get all the way to the end or you give up on the project and there's not any airtime for what your failures were. And the other thing I was interested in, why I wanted to give this talk is because I'm talking about candy robots today but my deeper interest is in systems and processes. And particularly how a robust process can give you a framework in which you can succeed on something that's never been done before and also how being in a good process means when you get stuck, there's a way to correct for that. There's a way to get unstuck. For me in this process, when I get stuck, I can always go back to an expert or find a new expert and it means that I never hit a bottleneck where I stop innovating. So hopefully people will think about processes for working on emerging technologies that are from their toolkit. I'd love to hear about that or use this one to work on your own problems. Some final thoughts. I think design thinking and other processes yield effective pathways through the unknown. I think people in general should work on emerging fields wherever you find them. It's where you find the most exciting problems and the most interesting opportunities. And then in general, I want people to reach out if you wanna share or collaborate about edible robotics. I could use more help in chemistry. Control systems for soft actuators is a juicy problem or you tell me, maybe you're an expert in something related to this that I haven't even thought of yet. And also please reach out if you wanna talk process. So this is me and where you can find me on the internet. And if you wanna talk to me about the other things that she introduced me before, I like to talk about soft robotics, spacesuits, costumes, and puppets, so. Thank you. Thank you.


There is a genocide being carried out by the State of Israel against Palestinians in Gaza, and still this Labor government stands with Israel and supports the invasion of Gaza. That is the bottom line. The South African case against Israel laid out in stark, horrific detail the undeniable evidence of genocide in Gaza. And if South Africa was able to find this evidence, then we know now without a shadow of a doubt that Labor knows as well. They knew last year when the Israeli Defence Minister said, and I quote, I have ordered a complete siege of the Gaza Strip. There will be no electricity, no food, no fuel. Everything is closed. We are fighting human animals, and we will act accordingly. They knew the Israeli Defence Minister then said to soldiers, I have removed all restraint and Gaza will never be the same. Or when the Israeli President said there are no innocent civilians in Gaza. Israel has made its intentions brutally and horrifically clear. Labor knows now there are 28,000 Palestinians who have been murdered by the Israeli military, over 10,000 children. What about Al-Nazra Hospital? I quote from the Washington Post. It was the height of Israel's assault on the northern Gaza last month, and Al-Nazra Children's Hospital was a war zone. The day before, airstrikes had cut off the Gaza city's facilities' oxygen supplies. Israeli tanks had surrounded the hospital complex, and the Israeli Defence Forces were calling and texting doctors, urging them to leave. Ambulances couldn't reach Al-Nazra Hospital to transport the wounded. Five premature babies were particularly vulnerable. They needed oxygen, medication administered at regular intervals. There were no portable reciprocators or incubators to transport them. Then the IDF delivered an ultimatum, get out or be bombarded. An Israeli official meanwhile provided insurances that the ambulance would be arranged to retrieve the patients. All five of those babies were found to have died slow, painful deaths, decomposing two weeks later. Labor no more will die from Israel's engineered famine in Gaza than from bombs, yet still they stand with Israel and support the invasion. But then Labor went one worse and followed the United States in pausing UNRAR funding, crucial aid funding to Palestinians in Gaza. I quote from the Lemkin Institute. As of January 2024, 500,000 Gazans were forced into Phase 5 catastrophic levels of hunger, imminent risk of mass starvation and death. This represents fully 80% of all people in the world currently at risk of death by hunger. Each malnourished child, starving family and refugee camp without access to food is a tragedy. Collectively, it is a crime, the liability for which rests on those who actively and knowingly prevent access. These are little Palestinian boys and girls dying slow, painful deaths, growing weaker by the day while their parents, if they haven't been murdered themselves, watch on in horror, unable to do anything to prevent their deaths. International lawyer Francis Boyle said these states are now directly violating Genocide Convention Article 2 ced by themselves, deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or part. I want to be clear. What he is saying is Australia is breaching the Genocide Convention. Now Netanyahu orders 1.4 million Palestinians who Israel has corralled into a very small area in Gaza to evacuate. But where to? We aren't told. And now we know that the Israeli military is on the verge of turbocharging this genocide in Gaza. And God only knows the horrific, outrageous crimes against humanity and furthering of the genocide that will occur. Now South Africa has proved what moral and political courage looks like. South Africa has proved what a middle power can do to prevent genocide. And Labor keeps saying, well, oh, we're doing all we can. We're issuing these weasel words without ever directly doing what is clear that they should do in these scenarios and these circumstances. Indeed, this is a moral and political test for this government that so far they have catastrophically failed. Call for a permanent and immediate ceasefire. Ban immediately the sale of military equipment or weapons to the State of Israel. Apply sanctions on Israeli ministers and government ministers facilitating the carrying out of genocide. And join and support South Africa's case in the ICJ against Israel and their case of genocide in Gaza. It is so clear that what we need right now is moral clarity and understanding that regardless of the actions on October 7th, which were horrific, nothing that happened on October 7th or the terrible deaths of Israeli civilians, can surely justify the mass murdering and genocide of Palestinian civilians. This will not bring about peace. This will create more radicalism, more hate, more death. And at the end of this, there will be weasel words from this government and claim they care about peace.


So this is going to be a clinical demonstration of the liver. I'm holding the e-viscerated liver in front of me to bring up to speed This is an anatomical right lobe, anatomical left lobe. This memorial structure that you see here This is the fancy-form ligament and attached to the free margin of the fancy-form ligament is this round ligament of liver Let's talk about the Petronium spaces around the liver. This is under the right dome of the diaphragm So between the right dome of the diaphragm and the liver we have this space where my hand is located This is referred to as the sub-phrenic recess. This sub-phrenic recess Convigates with the general peritoneal cavity and it is divided into two halves Right and a left half by this fancy-form ligament The next space that we have is on the visceral surface of the liver where my hand is located This is known as the sub-hypatic space and if I were to push my finger beyond the sub-hypatic space Where my hand is going right now then it goes into yet another deep recess and that is known as the Hepatorenal recess. This is a very special recess It is also called the Morrison pouch and this is located between the right anatomical lobe of the liver and The right kidney. This is one of the two most dependent parts of the peritoneal cavity When there is a peritoneal fluid the other dependent part being the pelvis So what is the clinical significance of these three spaces? Whenever there is excess fluid in the peritoneal cavity or pus collection They tend to collect here and then they tend to gravitate into the hepatorenal recess And from there they gravitated along the paracolic gutters and they collected to the pelvis Not only that after surgery if there's any collection of blood they tend to collect in these spaces Now let's come to some interventions on the liver itself. Most of the liver is located in the right hypochondrium So the extent of the liver is from the seventh to the eleventh ritz When do you have to do a liver puncture an ultrasound or a CT scan guided liver puncture? Of course pre-vetal that we have to do pro thrombin type an international normalized ratio and After that when it is normal only then we can do a liver puncture We should do it in the ninth intercostal space in the mid-axillary line And we must remember that the glistens capsule is painful We can use the same procedure for taking a liver biopsy earlier days They used to use a Wim silver man needle nowadays. They use Tiba needle which has been designed by the Chiba University of Japan Now let's come to some other aspects. This is the portahepatus The portahepatus is not covered by peritoneum So only the margins of the portahepatus are lined by the peritoneum So what are the three structures which are entering or leaving the portahepatus first we have this structure here This is the common bile duct Next structure we have is the hepatic artery and the third structure we have is the portal vein So these three structures together constitute extra hepatic portal triad So here we have several important clinical correlations I have held up the three structures of the extra hepatic portal triad in my instrument here These three structures are running in double fold of peritoneum referred to as the hepato-duodenal ligament It touches it to the first part of the duodenal When we are doing a liver surgery it is bleeding from the hepatic artery or from the cystic artery And we cannot control the blood and the whole area gets filled with blood We can do what is known as a Pringles maneuver and that is exactly what I have done with my finger I have put two of my fingers behind the extra hepatic portal triad into the epiploid foramen My thumb is in front and it is compressing the structures of the portal triad And by so doing I can compress the hepatic artery And then we can stop the bleeding and then we can look for the source of bleeding and then we can ligate it This is a very useful in a life-saving procedure for the surgeon as well as for the patient And that is known as Pringles maneuver Now let's quickly look at some of the other structures in the portal triad As I mentioned, this is the common bile duct In this particular cadaver she has only undergone cholecystectomy And if you look very closely you can see that the cystic duct there is a clip here So this is the remnant of the cystic duct And if we trace the common bile duct we notice that it is dividing into a right hepatic duct and a left hepatic duct We can get a special type of cholangiocarcinoma where the cholangiocarcinoma involves a bifurcation between the two hepatic ducts And that is referred to as claskin tumor Cholangiocarcinoma occurs when there is a asiatic cholangio hepatitis or long-standing inflammation or due to some parasitic inflammation Then there is a condition which is referred to as congenital biliary atresia Where the whole biliary system is atritic at newborn itself Only dilated portions are the intra-hepatic biliary radicals And those are used in the portahepatitis to anastomers with the gigenome And that is referred to as hepatic co-gigenostomy and that procedure is also referred to as Kasi operation Now let's come to portal vein here The portal vein as it goes inside the portahepatitis again we can see it is dividing into a right branch and a left branch This left branch of the portal vein communicates with paraumbilical veins To show you the paraumbilical veins let me just turn the liver again Come back to the phasemom ligament This is the phasemom ligament and as I said the phasemom ligament has got the round ligament in its free margin The round ligament is the fibrose remnant of the umbilical vein which carried oxygenary blood in the fetal life If you look closely we can see some small venous channels here These are referred to as the paraumbilical veins which are present in adults These paraumbilical veins run with the round ligament of liver and they open into the left branch of the portal vein Approximately they communicate with the veins around the umbilicus This is the umbilicus The veins around the umbilicus are tributaries of the superficial epigastric vein which drains into the femoral vein So therefore paraumbilical veins are a source of portah systemic communication In a patient with cirrhosis with portal hypertension These paraumbilical veins can become engorged with blood because of reversal of flow And the patient can present with dilated superficial epigastric veins around the umbilicus Which will radiate out around the umbilicus in a radial fashion And that is a clinical sign, syn cirrhosis And that is referred to as Gapot Medusa So that is the significance of the left branch of the portal vein Communicating with the paraumbilical veins Now let me show you the hepatic artery itself This is the hepatic artery And if you were to look closely, we notice that the hepatic artery is making a sharp right angle bend here This portion of the hepatic artery is coming from the celiac trunk So this is the celiac trunk which I have lifted up here We have completely removed all the celiac plexus around here And we can see three branches coming out from the celiac trunk The largest branch of course is the spleenic artery which is highly tortuous And the second largest branch, this is the common hepatic artery And this is the left gastric artery This common hepatic artery runs to the right This is the other end of the common hepatic artery that we see here And then it makes a right angle bend At the place where it makes a bend, it gives up this branch here This is the gastrodural artery This gastrodural artery runs behind the first part of the diurnal And this gastrodural artery can be a source of bleeding in a posterior diurnal ulcer After it makes a bend, then the rest of the hepatic artery which we see here Is referred to as hepatic artery proper From the hepatic artery proper, we have this another branch coming out here This is the right gastric artery The hepatic artery proper ideally is supposed to divide into a right hepatic artery And a left hepatic artery But here we can see one, two, three And from the right hepatic artery is supposed to arise the cystic artery Which runs in the cholecystoo hepatic triangle of callot And supplies the gallbladder But again, as I mentioned in this particular cadaver The gallbladder has been removed So therefore this is the stump of the cystic artery And we can see the clip is attached here So therefore we have seen two clips We have seen the clip of the cystic duct here And we can see the clip of the cystic artery here This is the fossil for the gallbladder So therefore when we do cholecystic to me We are operating in this region That is called the cholecystoo hepatic triangle of callot This triangle is bounded by the liver above And the common hepatic duct And the content of this triangle is cystic artery Which I showed you just now And the cystic lymph node So these are some of the clinical aspects of the liver That I wanted to mention to you Thank you very much for watching Dr. Sanjay Sanyath signing out Dr. Gomthi Chundilal is the camera person If you have any questions or comments Please put them in the comment section below Have a nice day


So next, we're hearing from Sandra Swain and Bill Powell. I think you're doing a duet from the Society for Clinical Oncology. Right. So thank you very much. And I'd really like to thank Gene Passamani particularly for organizing this. And when we had the discussions, he said the main goal was about education in this area. And I think already we're all educated about what each of us are doing. And I think you've achieved one great goal. From what I see and what I hear, we all have a lot of similar issues that we're working with. So if we can do, as some of us suggested, work together on the guidelines. And it's interesting hearing this discussion about guidelines and the heated remarks at our board meetings, probably that causes more discussion than anything else. So it's clear that, you know, all of us need to do more work in that area and figure that out. So Cantor, I think, is a little different as a specialty than some of the other diseases in that five to 10% are, at least as we know now, are caused by mutations in specific genes. But most of the cancers are caused by somatic mutations of genes. So most oncologists certainly, you know, deal with it on a daily basis and do learn about it in their fellowships and their training. And I really especially liked what Tom Nazca said that it's going to be changed in the future. It's going to be part of the fabric of what everyone knows. And I think that that's critically important. It'll be, I like what he said a lot, that it's going to be the pathophysiology or part of the pathophysiology for everyone. So just, and I think that, Bruce, you already showed this example, but I'm going to show it again. The example, the big one for us from the lab to the clinic is a matneb. And the Philadelphia chromosome was discovered in 1960. It's almost 50 years ago now in chronic myeloid leukemia, just to show you a little bit of genetics. You said genetics were important, but they're interesting anyway. It's a translocation where the BCR-ABL fused cancer gene is formed and becomes an abnormal growth of white cells or CML. And the treatment that was discovered was a matneb, approximately 30 to 40 years after the Philadelphia chromosome was discovered. And it caused a lot of excitement, FDA approval and accelerated approval in 2001, and even a Time Magazine cover, as you, I'm sure, are all familiar with, calling it the magic bullet. It's really been the poster child for targeted therapy for cancer treatment that we've all heard about. And later on, it was also found that it affected other genes, C-kit, and is used for other diseases like GIST. So I just show you this as an example for us in our field. It took 50 years now to have a treatment for GIST, and it's changing a lot. We have the alkygine and lung cancer. That took about four years to go from the laboratory to the clinic. So the rapid dissemination of this information from the laboratory to the clinic is really happening, fortunately, because our patients can't wait this long anymore to find the cures for them. So I think you all are probably familiar with all of this, as the major challenges in completing the cancer molecular map are sequencing the exomes, and we can change. I misspelled that. It should be, I guess, H-O-L-E, genomes. Thank you, Deborah. And differentiating between what the driver and passenger mutations are, because there are thousands of mutations and we need to really sort out what's what and what's important, because the tumors are very unstable and they do change over time. So even if you biopsy at one time, it may be different later on. We do have a lot of mutations integrating these data across platforms and then finding solutions when you have multiple testing of all this massive amount of data. So how do we get from the research to the clinic? You've got the multiple targets and these tumors, as I said, they continue to mutate. They don't always tell you how the cancer is going to act. The genomic discovery has been very, very rapid. I mean, tons and tons of information has already been said, but the therapeutic agents really have not kept up with that. So are we going to be able to deliver? And I think that's one of the reasons for this meeting, too, and the meetings you've had, the last three or so meetings, is to try to sort that out. Quality diagnostics, Deborah commented on that already. At the community level, as you probably know, about 85% of patients with cancer are treated in the community. I think that that's a really important point to remember, and we're all talking about embedding geneticists. It can't happen for 85% of people in the community as a person. Cannot do that. I mean, that's just not going to be physically possible, so we have to find other ways to really get our message and the education to the community. And then how do we help the general oncologist really keep up with the massive amounts of information? I think what's really important is that the paradigm is changing from being at the bedside and saying, you know, what's your differential diagnosis, doctor, for these 10 things for this patient? I mean, people can look it up now, and that's okay. It's all right to look it up.  They're looking everything up. I mean, that's okay because the information's accurate. There's good evidence. So we need to incorporate those kind of things into how we work. So we have a leadership development program, and I think Debra mentioned it, too, that you also have one in pathology. And we started this several years ago, and unfortunately, Dr. Nelowoski, who was supposed to be sitting here from Mayo Clinic, was Rochester, was not able to get out because of the weather. And so he wasn't able to be here. But he is one of our trainees in our leadership development program. And they chose, as this area of genomics and genetics and what resources that our membership of about 30,000 members need, did a small, focused, not really survey, but they interviewed people, community medical oncologists, academic medical oncologists, people in the leadership, surgical oncologists and pathologists, to try to determine what was needed for education in this area. And they just came up with the same things that everyone else has said here. There's overwhelming amount of data. It's coming very quickly. And I really like what, I can't remember what your name was, said that, you know, we just have to assume it's going to be there because it's there. Patients are coming in with their genetic data now. They want to know, Dr., what do I do with this information? So there's no standard resources available. We can use the path reports and drug device reps to tell us what to do, but obviously doesn't seem to be the right thing to do. So they came up with these recommendations that they're simple, searchable, clinically relevant, updated, user-friendly, patient-friendly things should be available. Not a laundry list. It should be in the guideline format, again, guideline. What is a guideline? We do also have vigorous discussions about this because in oncology we have the NCCN guidelines, which are consensus-based. And those guidelines, only 6% are really on level one evidence. And that's not because they didn't find the evidence or they didn't look it up. It's because that's what exists. You can't have level one evidence on absolutely everything, the hundreds of decisions we as practitioners make every day when we're treating our patients. So they came up with it, was going to be most effective, was a website, and they wanted to be able to find it quickly, bookmark it, use it, or a mobile device application. And then decision supports tools embedded in the EMR, which has already been mentioned already today. So what is ASCO doing in trying to answer all the questions that Gene handed out to us in education and training? We have ACGME program requirements for medical oncology, which we've been active in working with ACGME for. And these are just, I'm not going to read the whole thing, but I think it kind of goes with what you would expect, the things that people should know. And that was effective on July 1st, 2012. We have an ASCO self-evaluation program, which includes chapters on molecular biology and biologic therapy. And at our annual meeting, because I felt like this, this was actually even before Gene, you contacted me, felt like it was such an important topic because of what I see in my patients coming to me with, you know, 23andMe or whatever, they're, you know, coming to you with this data or wanting to get their cancer gene looked at by Foundation Medicine. So I felt like it's overwhelming for people in practice to figure this out. So I organized, and William Powell is one of the co-chairs for our annual meeting in June, a course for genetics and genomics for the practicing clinician. It will be one and a half days. And these, we had these last year, we just started doing these last year, these kind of pre-annual meeting courses, very, very successful. And they were basically oversold. I mean, people really wanted to come to them. And it will be CME as everything that we do pretty much in ASCO is CME. So the main thing that I was really interested in, and I put practicing clinicians on the steering committee, is it's got to be something that's, when a practicing clinician goes home to their community that they have some tools to work with, or they understand what they don't have and what they need. So I'm really looking forward to that.  So I think it would be great if we can put all the stuff on the website that Dr. Green mentioned and learn from each other on that. We have several 75-minute educational sessions at our annual meeting on lung cancer, for example, on bridging science and clinical practice, how to use molecular markers and brain cancer, and then barriers and expanding access to genomic information. We have what we call ASCO University, and this is again all based digitally. It's e-learning center. It hosts online, digital, and app-based educational products. We also have tumor boards. And I know some people, at least in the oncology field, are now having these multidisciplinary genomic tumor boards. And that might be something that we will do in ASCO University, too. I know at least two or three centers are doing that now. We have CME accredited courses, the cancer genetics review, molecular oncology, and genetic testing in oncology. And then getting into guideline development process. We have chosen as a society to be evidence-based. And because we are evidence-based, we only have about 23 guidelines. When you're evidence-based, you have to review all the literature. It takes forever. It takes two years. You go back and forth about, is this really evidence? Is that really evidence? They're very non-Nimble documents. But we have done it, and I think people really appreciate those and do use them. However, we just can't do it for everything. So that's been our struggle, too, is to how to go forward with guidance or guidelines and how to incorporate that into our practice. So we have a formal consensus development process used when there's insufficient evidence, so we haven't done a lot of that. And now the whole goal will be to focus on evidence that informs the clinical utility of the genomic assay results. As Deborah already mentioned, we had collaborations with CAP for the HER2 testing and the ER testing, which I think have been very successful and very important because as oncologists, we work extremely closely with our pathologists as colleagues. So to show to the community that we're working together, I think, was very critical and to have the expertise both there sitting there at the same time. And then also, more recently, the Association for Molecular Pathology with the Colorectal Cancer Markers guideline. So the policy on the release of the joint guidelines is that there's concurrent posting, publication of joint guidelines and respective websites or journals, coordination with sister societies about press releases. All these things are really important because everybody puts a lot of effort into this. So we really want to make sure that we get along and we do these appropriately for all the different societies that we work with. So next, I'm very excited to talk to you about this because I've heard a lot of people really wanting what I'm going to talk about now. And our board a couple of years ago had similar discussions to what we're hearing in here today. And as a practicing oncologist, care is fragmented all over the place. I get a lot of patients for second, third, fourth opinion. They could have had their path report at one place. There are three things everywhere. It's just kind of scattered. Then you give an opinion, it's in your EHR, and it's really problematic to kind of get that information everywhere. Plus, you don't have outcomes. Only 3% of our patients in oncology that have cancer go on clinical trials, 3%. So 97% of the patient's information for treatment that I give or other people give is lost. We have no outcomes. The data is totally lost. So you're talking about with genomic data having a problem. We have a problem with clinical data and that we're not utilizing it to the fullest extent. So based on the Institute of Medicine's rapid learning system ideas, which they have put forth over the last few years and they've put out several documents on this, we decided to take on a very ambitious project, the rapid learning system, which we have called Cancer Link. And what we will do and what we've done, it's actually the prototype has been very successful. We were concerned that there would be many hurdles. One, just getting people to give us the information because it's data on patients. It's not anonymized data initially. And we have now decided to do a breast cancer prototype in the last few months.  So this is like the biggest amount of data, clinical data is available anywhere. Work through all the issues of the different electronic records. And actually right now, 30,000 of those records are dumped into one network system. The whole idea is that there'll be a central knowledge base. As shown here, you have data that's going to come in patient data. Then you have provider data, also research data. And all of these things will be able to generate knowledge. So there's several aspects of this Cancer Link. One is that it will help the physician right there at the point of service. And I don't have all the slides to show you what we've done in the prototype. But at the point of service, embedded in that are our guidelines and our quality oncology practice initiative, which is something we've worked on for several years. So physicians can look and see if they, for example, give herceptin for patients who have her too positive or negative disease, which is the wrong thing to do. So that will pop up and say, you shouldn't do that. Or give Tamoxifen to a patient who's had a DVT in the past. It'll pop up and say the guidelines say, no, you shouldn't do that. And so far, it's actually working, as I said, in 30,000 patients. We have another 100,000 to put in there. And this is just the prototype. A lot of what's been done is using open source computer software. So it's an expensive project. So we'll see how that goes in the future and the ability to do it. But we're very excited about it. Everyone was concerned about whether we could do it. But it really looks like we're definitely going to be able to. And be able to do a lot of the things you all said, embed. You can embed the genetic recommendations and the guidelines that you have. And it will be helpful for physicians. So our next step for ASCO or recommendations to ASCO from the Leadership Development Program that I mentioned to you about what they're going to recommend that we do, incorporate the genomics into our rapid learning system or our cancer link plans, discussions with other societies, not just pathologists. But I hear a lot of people here are doing similar things and would be really delighted to talk to anyone about this and involvement and follow up, certainly from today's meeting. So I wanted to, I was going to give a couple minutes of my time to William Powell. Because I think what he's done is really pretty remarkable already in helping generate information for practicing oncologist. So he's going to talk for a few minutes about that.