I'm very happy to be here, I'm from Switzerland and I work for a small workshop called Simplificator. Actually I'm very surprised at how many women are here attending this conference and it makes me very happy. But I'm sure if you're a female developer you know the feeling of being the only woman in a software team. And I really would like to change that. First of all we have to ask ourselves why don't we have more women in programming. So first of all I think reputation is a really big problem.  And these stereotypes can be very strong and people are also not too shy about them. For example one old Australian guy I met in France told me, but you don't look like a programmer, I thought you'd be a fun girl. Or my grandmother who lives in a small village in Central Switzerland asked me, now child, do I really have to tell the other village people that you are a computer programmer now? And my favorite when I came here at the airport I was coding while waiting for the plane and then a small girl was watching me and then she turned to her mother and said, mommy what is wrong with this little lady? And then her mother watched me too and she said, I don't know honey let's go sit somewhere else. So this can be a really big problem because there are very bad associations about programmers. And another problem is I think self doubts. And I can totally understand that because two and a half years ago I was the same. So people have to think you have to be ridiculously intelligent to be a programmer and that you have to know a lot about math. And also when you watch the movies and you know the coder has to stop the bomb from exploding and then the console goes very fast and then people think I would never be able to do that. And in combination with this I like this statement from GitHub CEO, he said everyone has the potential to be a great developer but not everyone has the opportunity. And normally we associate opportunities or lost opportunities with financial or political restrictions, but I think it's important to know that these can also be due to social values and what society thinks about the profession. So if someone would be really talented and would like to be a programmer but decides not to do so because of the stereotypes, it's a lost opportunity. Then you might ask ourselves why do we need more women in programming? We're fine. So I think diversity is really important and people with more diverse backgrounds bring different values and views into a community and then eventually make the community better. And this again leads to better decisions. And if we all have different strengths and weaknesses and people with different backgrounds have different strengths and then we have a higher chance to actually level out each other's weaknesses. Now the most important thing, what can we do? I think basic answer is open doors. So to spread the word and to tell people how programming is actually a very creative job and that you actually have to be very sociable and communicate to people and that you can't be just alone in your room and program. And the second one is to provide opportunities if you can. For example, I knocked at my company store and asked for an internship even though they didn't have one. And then they asked me, well what can you already do? And I said, well I know about strings and numbers. And then they hired me anyway and now I'm working as a full-time developer. So I'm really grateful for this opportunity. And also coaching at courses. For example, I co-founded a free programming course for women that's happening weekly or I'm organizing Rails Girls in Zurich this year. So maybe if there's a Rails Girl happening in your city, you might consider coaching there. And also one important thing I think is to tell the teachers. Because children and especially girls start very early to think about what they might do later in their lives. And I think it's important that the career of programming is not ruled out this early in their lives. So I'm also in contact with different primary schools to talk to children and to show them some of my coding work. And if you now say, well this consumes a lot of time I don't have time to go to schools or to organize events, well there's more you can do. You can just, if you're picked up by a friend at work, you can show him or her your code. And to tell people what programming is about and what fascinating things we can create with code. Because the more people know the better and hopefully these stereotypes will disappear eventually. One colleague of mine told me that well now you chose a men's profession and you just have to deal with being in a team as the only woman. And I really hope that at some point we don't have to call it a men's profession anymore but it's normal for everybody to be a developer. Thank you for your time.


Hello everybody, welcome back to my channel. It's Eva from Bohemian Crafting and today I'm going to make a pause in my newspaper craft videos for the 100 Days Project Challenge. I'm going to share with you my small page layout on Altering Book where I am using beautiful collections, digital collections. I bought from Shaby Daby Doodah Etsy Shop, Tina, who is owner of this Etsy shop, is going through to very hard time right now and I know how important it is support to each other. I know how hard time we can get in our lives and it's always good to have someone who is listening and who is here to help you. So if you can, please go to have a look to Tina's channel, go to see her videos, you will understand what is going on and if you can, please give her some support because, you know, life is hard and if we will be not here for each other, it will be even harder. That's why we do have this craft, that's why we do have this craft family to support each other, to make life better and more easy and it's not that easy to do it. But what is easy, it's to give likes to videos you like and to give this support to the artist and crafters you like. It doesn't cost too much, it's just one click, so please think about that and if you are watching videos on the channels you like, that every single like you will give them, it will support them, it will support their channel and it will move that crazy algorithm to the better place and these amazing crafters, creators, people who are spending hours and hours to create good content in their video they will get paid some money back because trust me, it's not easy to make money from YouTube. You have to have really high amount of views to get paid something and I know it, my highest amount of money I received this year will be probably now, it will be 288 pounds for the May month where I had really huge amount of videos it was very hard and not hard, it was very time consuming and if there will be no my patreons and here huge shout out to all of my patreons, to those who were my patreons and to those who are my patreons thank you so much guys, just because of you, I am on YouTube as well if I will don't have my patreons, I will have to find another job and I will quit YouTube because I will don't have time so please always when you are watching your favorite YouTube channels, give them the like and as I said Tina from Shabidabidudah, right now she needs our help so if you can please go to watch her video and if you can please go to spend some money on her Etsy shop and help her in her hard time any good you will give to the world will came back to you, I do believe that and I am always trying some way to keep this as my habits any good you will send out, it will somehow get back to you so I hope you will enjoy this video I am gonna put here some music and let you watch what I have created how I was enjoying these beautiful images I really love that collection, I will put links for that collection for the digital I bought from Tina's Etsy shop, I will put links down below if you like these images but really go to have a look, she does have amazing stuff on her Etsy and I do believe you will find your favorite thank you so much for joining me today and thank you to all of you for all amazing support you are giving to me and to my YouTube channel huge thank you to all my Patreons I hope you know how much, how much you are supporting me not just to be on my Patreon but also to talk to me to listen to me when I do have hard times so I do appreciate that very much to all of you have a beautiful day take care of yourself and enjoy this video, thank you


Hello again. As pointed out in the evolution of writing, the first video of this short series about writing, not all modern writing systems encode information in the same way. They emerge from symbols that represented animals and other images and can be divided into two central branches. Into logographic writing systems whose symbols represent words or concepts where the shape of the symbol employed is often closely related to the meaning of the respective concept. And into phonographic writing systems which establish some sort of relationship between the written symbol and its pronunciation. Let us look at logographic writing systems first. They make use of symbols that represent words or concepts where Greek logos means word or idea. The shape of the symbol employed is often closely related to the meaning of the respective concept. There are three variants of logographic writing systems. Pictographic systems, idiographic systems and abstract logographic writing systems. In the earliest logographic writing systems, the relationship between symbol and object is clearly visible. Such variants of logographic writing systems are referred to as pictographic, where pictographs are pictorial symbols that directly represent the object to which they refer. One of the earliest examples of a pictographic writing system is the system of simple Sumerian pictographs from around 3000 before Christ. Well, and here are some pictograms used today. Another way of relating logographic symbols to concepts is the use of idiographic systems. Here is an example. The dog illustration is a pictogram. The red circle and the bar is an idiogram representing the idea of no or not allowed. Thus, unlike pictographs, the shape of idiographic symbols is not a direct representation, but an associative representation of a concept. Idiographs are often mixed up with pictographs. For example, in the Egyptian hieroglyphic system of around 3000 before Christ, typical for idiographs is their additional customary use. Examples of modern idiograms are traffic signs, those without additional writing. The symbols found on the control buttons of high-five systems and other technical equipment. Often, logographic writing systems make use of abstract logographic symbols whose meaning is no longer identifiable from their shape. Such symbols, for example, the percent symbol or the ampersump symbol used for AND are even employed in phonographic writing systems. In Chinese, the most well-known logographic writing system, the symbol for human, Ren, is relatively clearly identifiable and even more so the historical predecessors of this symbol. To understand the compound symbols, Na Ren and Nu Ren for man and woman, however, that requires some sort of fantasy. Let's now turn our attention to the phonographic writing systems. As already said, phonographic systems establish some sort of relationship between the written symbols and their pronunciation. There are three possible systems of realising the sound-symbol relationship. Segmental systems, syllabic systems and phonographic alphabetic systems. The oldest way of showing the pronunciation of words is the segmental method where only selected phonetic aspects, primarily the consonants, are represented by orthographic symbols. Here is the example of the Egyptian system of hieroglyphs where a symbol stood for a consonantal skeleton. Vowels were not represented in writing. They had to be added during the reading process by reference to syntax and semantics. A modern system is the Arabic abyad, where abyad means alphabet, which is used in the Semitic languages. It is written from right to left and its characters exhibit consonantal values. The syllabic phonographic writing system represents the pronunciation of entire syllables by specific symbols. Syllabic writing systems are relatively old. One of the oldest syllabic writing systems is the Crete linear B system. More modern ones are, for example, the Devanagiri alphabet used in Hindi, the GAS alphabet used in languages spoken in Ethiopia, or the Khmer alphabet used in Cambodian. The most advanced and historically the most recent technique makes use of a limited inventory of symbols, where ideally one symbol stands for one sound. The first of these alphabetic systems was the Phoenician alphabet, which developed during the 15th century before Christ. Before then, the Phoenicians wrote with a cuneiform script. Like the Arabic abyad, the Phoenician alphabet did not represent vowels and it was written from right to left in horizontal lines. The origin of most modern alphabetic writing systems can be traced back to the Phoenician alphabet. Here are some examples, the Roman or Latin alphabet, the Cyrillic alphabet used in some of the Balthoslavonic languages, for example in Russian, the Greek alphabet, the Creduli alphabet used in Georgian, or the Hangul system used in Korean. Some languages use combinations of several writing systems. The most well-known example is perhaps Japanese, where a set of logographic characters, the Kanji, is supplemented by two types of syllabic characters. One is known as Katakana and is generally reserved for loanwords. The second system, the Hiragana, is employed for grammatical formatives. Despite their goal to represent the pronunciation of their words, the alphabets of most languages exhibit at least some discrepancies between sound and spelling. Take present-day English OUGH as an example. This character combination can be pronounced in several ways, for example as tough, though, cough, plough, through, thorough and some more examples. To overcome these discrepancies, the International Phonetic Alphabet was introduced in the late 19th century. Here you find a selection of the symbols used in this alphabet. Until today, it is the only alphabet that exhibits a one-to-one correlation between sound and spelling. The most widely used alphabets are the Latin or Roman alphabet and the Cyrillic alphabet. They have been adapted to write hundreds of different languages and are used on every continent. So many people think that logographics writing systems such as the one used in Chinese are too complicated and should be given up in favor of an alphabetic system. However, the advantage of logograms such as the one used for book in Chinese is that everyone can read and understand them, irrespective of dialectal variation, such as the variants here. So all these are variants. The symbol remains the same. In a language such as German, with an alphabetic system, by contrast, the spelling of book is related to the standard only. In a dialect where you have variants such as Buch, Buch, Buch, Buch, you either have to respell the word to avoid confusion or the relationship between standard writing and pronunciation in a dialect becomes completely void. So we should leave the situation as it is. Alright, so much for modern writing systems. I hope that my short two-video series about writing was informative enough to provide you with an overview of the historical development, the classification and the use of writing systems in the languages of the world. Thanks for your attention. Have a nice time.


Have you ever felt unhappy with your life? Have you ever wished that something would happen to magically change your life? No hard work required. Have you made a wish like that before? When we're children, adults and stories and even movies will lead us to believe that wishes will come true. Remember when you were a young child and one of your teeth had fallen out, that you would put the tooth under your pillow in hopes the tooth fairy would come? On our birthday cake, we gaze at the candles flickering flames, close our eyes, and make a wish before blowing out the candles. And even in the darkness of night, when we see a star shining brightly, we silently make a wish. We believe that anything we wish for can come true. The story, The Monkey's Paw, is also about making wishes. But in this case, they don't come with a happily ever after ending like in the movies. These wishes involve curses. They're horrifying and dark, leaving the wish are terrified, anxious, and uneasy. The characters may have their wishes come true, but it goes horribly awry and they are shocked by the unexpected events. What if you had three wishes? What would you wish for? Money? A new car? World peace? Could your wishes result in horrifying outcomes you never imagined?


Diabetic retinopathy is the leading cause of blindness among adults worldwide. One key to managing this condition is predicting which patients are most likely to require treatment. Photographs of the retina can be adopted for this purpose. However, the correlation between structural features of the retina and the probability of receiving intervention for diabetic retinopathy is not always reliable. For example, the ETDRS trial reported that patients with high-risk diabetic retinopathy have only a 16% probability of having severe vision loss in the next five years. This study demonstrates a powerful way for clinicians to better predict which patients may need treatment by using the red eval device. Unlike fundus photography, which assesses structural features, the red eval device measures the function of the retina in two distinct ways. One is through an electroretinogram, or ERG, which measures the functional status of the rods and cones, much like an electrocardiogram, and the other is the pupillary response. The red eval device combines these responses into a single number called the DR score. To understand how well photography and the DR score predicted the need for intervention, alone or in combination, clinicians examined the medical records of 279 patients with varying levels of diabetic retinopathy over three years. For fundus photography, patients were considered at-risk if they showed signs of severe proliferative or non-proliferative diabetic retinopathy, or if they had clinically significant macular edema as seen in fundus imaging. For the red eval device, patients were considered at-risk if they registered a DR score of 23.5 or higher. Findings showed that after two years, 22% of patients needed an intervention when showing signs of proliferative or non-proliferative diabetic retinopathy, while 35% of patients who had a score of 23.5 or higher on the red eval device received an intervention. Thus, the red eval score showed a 60% improvement in assessing the risk of intervention, not only versus those with a lower score, but also versus those who showed signs of diabetic retinopathy using the fundus photography criterion. This higher predictability of the red eval test persisted at three years. In fact, the red eval DR score was found to indicate the highest risk of requiring ocular intervention in this study. Patients scoring 23.5 or higher were 11 times more likely to have a future ocular intervention than patients scoring below 23.5, compared to a 3.5 fold increase using the fundus photograph retinopathy severity criterion. When both the red eval and the fundus criteria were positive, the risk was determinant. In fact, 70% of patients required an intervention within three years when both tests were positive. Conversely, if the photographic results were positive, but the red eval results were negative, the intervention rate was only 18%. But if both tests were negative, the rate was 6%. Overall, the results demonstrate that incorporating ERG and fundus imaging would improve clinicians' ability to predict which patients will likely need an intervention and which will not, well beyond what is currently possible with fundus photography alone. Patients with a high DR score are much more likely to require an intervention, even if photography indicates that they have normal structural features. The red eval test is quick, comfortable for the patient, and easy to perform, providing simple numerical results that can be useful in managing diabetic retinopathy. Alone or in combination with observation of retinal structure, the red eval device will allow you to make better management decisions and improve programs designed to manage visual health in patients with diabetes.


Okay, we're back real live. I'm Jay Fidel. This is Think Tech and this is a corona watch and we have today Randall Holcombe MD MBA at the Cancer Research Center In Japsum and we're going to talk to him about the immune system and cancer and how those things relate to corona violence It's not easy. It's complicated Randall. Thank you so much for joining us today. Jay, my pleasure So, you know, I guess the the first thing is the immune system is central in Coronavirus but the immune system is also central in in cancer So there must be multiple intersections. Can you can you can you drill down on some of those intersections? Sure, I think there there are many things related to the immune system for cancer patients that are important while we think about this coronavirus pandemic We know that patients with cancer tend to get a suppressed immune system. Most of that suppression of the immune system is due to treatment due to chemotherapy and Radiation therapy. There are a few kinds of cancer that in and of themselves suppress the immune system. Leukemia, for example, and lymphoma tend to markedly suppress the immune system But most of the more common malignancies such as breast cancer and prostate cancer, colorectal cancer and lung cancer Don't in and of themselves suppress the immune system that much But the immune system is markedly suppressed when people get chemotherapy and radiation therapy Our main concern is with the coronavirus is that patients with cancer who have a suppressed immune system May have much more difficulties with handling the virus infection than other patients Now, how does that reconcile with the notion that You know what what really hurts a coronavirus patient is the immune system overreacting to the virus in the lungs So if my immune system is suppressed, then maybe it won't overreact. Maybe that's a good thing I know this sounds ridiculous, but could that be a good thing? So the answer is yes, it could be a good thing or it could be a bad thing And I think we really don't know One of the things that we've done here at the University of Hawaii cancer center is we've signed on to a national study Which is led by a group at Vanderbilt And this study actually collects information about cancer patients Who are infected with the COVID-19? virus and tracks how people do and we submit all of that information into a large database So that we can try to ascertain What happens to cancer patients who ever suppressed immune system when they get this virus? I think we all worry that they might do worse Because their immune system can't fight off the viral infection But we do know that some of the damage to the tissues is caused by the immune response and so Perhaps that lessening of the immune response may in some ways be beneficial for these patients It's really hard to know and I think we don't have the information at the moment And that's why it's so important that we collect the information One of the other things that we found and I think you've probably heard on the news is that some populations are Much more severely affected than other populations across the united states And one of the things that We'll have the advantage of doing Here in hawaii is collecting information On a population that's particularly relevant to the people here in hawaii And is not information that's generally being collected across the rest of the united states So that's one of the reasons we thought it was so important for us to participate in this study Yeah, well, you know hawaii is a living laboratory of diverse cultures and and then dna and what have you and That could be very valuable As it seems to me that we need to know as much about how the immune system works In the in the face of uh covid as we can because ultimately am I right about this ultimately We want to be able to tune The immune system to do the right thing to fight the virus but not fight the body And if you can get it right down the center of the track that way by tuning it somehow Therapeutically or otherwise Then you can have the best of best of those two alternatives. Am I right about that kind of analysis? That would be great. I think we don't have the tools To fine-tune the immune system that well We do have medications that will suppress the immune system We have medications that will stimulate the immune system And understanding how to stimulate a part of the immune system and not another part is really difficult And I think we're not quite there yet from a scientific point. Okay, but hold that thought you never know these days What about what about the antibody thing? You know, we have antibodies and antibodies are part of the testing protocol now I although I doubt it's available in many places Um, and then you have antibodies from somebody who had the disease and maybe that can help somebody somebody else In fighting the disease Um, where where does that fit with the immune system and is it is it really true? Is it really useful? Well, I think antibodies are always good when you get infected with something you typically get antibodies You get some immunity for some period of time um, I think we don't know with uh, COVID-19 how long people will have immunity We do know that some common colds are caused by coronavirus And you will get immunity for a short period of time, but then it goes away And you can get that cold again from that same virus. So We're hoping that it's more long-lasting immunity that people get one of the things for cancer patients is that when Especially when they're under treatment and we affect the B cells with that's one component of the immune system that makes antibodies The Thing we don't know is whether The B cells will function normally to produce antibodies against this coronavirus And so we we don't even know if if cancer patients who get infected with coronavirus are going to generate antibodies at the same Rate as other people are I think that's something we're going to have to learn over time, but we don't know that at the moment One thing it strikes me is that you know, and it goes back to the the common flu um I mean the one that doesn't kill you necessarily Where where every year you have to get another another shot a whole fresh vaccine And that means that the virus is different year to year And that means to me and i'm i'm just going you know deductively here. That means the virus Has mutated. It's a different virus. Therefore you need a different vaccine a different You know dead virus. I guess whatever they put in a vaccine To deal with it. So if you tell me and I've seen this too in the in the media If you tell me that the antibodies From a person who has had covet will only last so long Say, I don't know say six months I'm just throwing that number out. That means within that six month period Something has changed It could be that the antibodies that you have available Lose their vitality in the six months. It could be the blood changes You know the carrier system that changes in order to make the antibodies effective for longer than a x month period But it also could mean That the virus that's coming down the pike Is mutating So at the end of that period of time we have another virus and the antibodies are only addressed to virus a But not virus b Is there any thinking about that? So I think corona virus is a bit different from the influenza virus influenza is uh very commonly known to Mutate fairly rapidly so that new strains appear Each year they're usually multiple strains of the influenza virus So the vaccine you get actually is is trying to provide protection for multiple different strains Not just a single strain. I think when we from what we know about corona virus from the sars epidemic That that you know occurred many years ago It doesn't have that same frequency of of mutating And we hope that that remains the case Because then we could develop a vaccine For covet 19 that Would hopefully be a single vaccine and could be used even if you had to even if you had to get it every year It could be the same vaccine that could be used Hmm. Well, that would be great. That would be great. That would be a good result Although As everybody says nobody knows exactly when that's coming down the pike or what it's and there are so many people in the world It was I saw a newspaper article today with all the candidates For that vaccine and a lot of candidates and you don't know what's going to happen You don't know whether the trials would be successful or what? But I wanted to ask you about the the plight of the cancer patient because it's a real plight So now you have cancer. That's scary. That's scary because it threatens your life And you have to deal with that and you know, you're in a sort of state of mind I'm sure you you've seen that many many times About how you know, you know your life Mortality Okay, then the bad news is that something Gives you coronavirus So if god, it shouldn't be me and it shouldn't be you but if I had a combination of those things I would be terrified Um What would is that a legitimate terra? I mean is it is it significantly worse to have both of them? Uh, and what happens to people who are faced with the double whammy like that? What what happens to them in the daily course of Dealing with doctors hospitals researchers. How do they react? So I think I think cancer patients are generally worried about possibly getting uh coronavirus They you know, they're they're fighting cancer That's difficult enough and then you throw another terrible illness on top of it I mean, that's a terrible terrible thing to happen to somebody what that has done has it has Uh directly changed how we're caring for cancer patients at the moment. So a lot of patients Don't really want to come into the doctor's office to get checked as often as they should get checked When they're undergoing cancer therapy They're worried when they come into the infusion center to get their chemotherapy They know they have to get their chemotherapy But they're worried because it's a hospital type setting or a doctor's office type setting and they're worried there may be other people Who have uh coronavirus and they might catch that from so we've had uh lots of Uh disruptions in cancer care related to this We're trying to do a lot of physician visits by teleconference which Is okay for some patients, but not okay for some other patients But we're trying to do that as much as possible We've been delaying Some appointments that we don't think are are critically necessary Some patients are having difficulty in scheduling surgeries for their cancer. So For many types of cancer for instance We often treat it up front with chemotherapy or radiation therapy and then follow that In four to six weeks with surgery. Well, that's not really an elective surgery Like getting a knee replacement that could be an elective surgery could be done this year could be done next year but But it's not an urgent surgery either and some patients have had some difficulties especially In the hard hit areas in the country in getting those types of surgeries scheduled Because going to surgery requires anesthesia that requires an anesthesiologist that requires a ventilator And those things are in short supply And so uh scheduling these surgeries is has been been quite difficult for many cancer patients That just adds to the stress of All of the journey with cancer The other thing that I really I think is very important as well and that that a lot of people aren't talking about Is that because uh, we have been delaying routine type visits and routine care a lot of people are not getting their routine mammograms And scheduled colonoscopies and things that are really important For cancer screening and to catch cancers early and to prevent cancers if possible And i'm worried about that because the longer that this goes on the longer those things are going to be delayed And i'm worried that we're going to have patients with more advanced uh cancer sometime Down the road because they've missed out on their regularly scheduled screening. So I think that's another aspect of COVID-19 that's affecting cancer patients or potential cancer patients That is a little bit unrecognized Something that we're really going to have to address moving forward and try to get people there screening in a safe way And you can have a double whammy there too. You could not screen So you have a great number of cases that require more aggressive treatment And then you can have a a curve that hasn't hit the apex yet a curve that's going up We can have that in a way. I hope we don't I don't think we will but it's a possibility And and then the medical resources are not available to you. So you have an increased number of patients And you have a decreasing amount of medical resources to treat them. What a combination of events This could this could happen So, you know I talking about You know About what we do about about solutions Two two questions. I want to ask you about that one is one is for the individual patient Who could screen who knows he asked the screen or she asked the screen? Then he should make she should make every effort to be screened, right? Even if it's a little scary to go into, you know, a medical office with people all around Um and screen. Maybe he should stick to stick to the protocol and get screen Wouldn't that be your advice my recommendation at the moment would be To not worry about screening today But to not put it off for more than a few months. So, uh Perhaps in the summer or the fall get the screening done But don't wait a year and don't decide to skip out on it altogether Okay, and what about situations where, you know, the medical community really doesn't have the resources It's it's kind of direct the resource to the more existential threat Which is uh, you know, the current coronavirus cases themselves I mean, you can make an effort of x units of effort or you can make an effort of y units of effort if you are a cancer patient Uh, how much effort do you put into that? Or do you just leave it to the system to carry you along and and find the resources when it's appropriate? What do you think? You know cancer patients do require a lot of resources, but uh They're pretty high on the list of of needy patients so I think that most centers, uh when they get past the initial problems with uh, a large number of uh, COVID-19 patients that they have to take care of Are are really going to try to address the cancer patients pretty quickly and much more quickly than uh, then Perhaps other elective health problems that people may have so I'm not too worried about that. I think all of the oncologists are are very worried about trying to make sure that We keep our patients on schedule as much as possible and we don't Impair their therapy. We know that treatment delays for instance or delays in initiating treatment for cancer patients Directly correlates with the mortality from cancer. So we don't want those treatment delays We want to try to keep things on time. We want to get people treated As best we can because we know we have the best chance of curing them if we can do that So I think it's going to be a pretty high priority to get uh cancer patient therapy Back on track as quickly as possible Yes, yes Uh, and and something you said, I mean, it's it's not just cancer patients who Have the need for medical services non coronavirus medical services treatment diagnosis, what have you I mean if you if if something is bothering you You don't know exactly what it is. It could be anything And so query should you go to the doctor maybe hold back And if you find out what it is query whether you should you know pursue some sort of treatment or not Then it seems to me I want to throw an idea at you is that all of this is sort of intimidating It's intimidating for the patient because he doesn't want to go through an environment Like there's a case in Maui that was in the paper today about an elderly woman who went to the hospital And she had some unrelated problem completely unrelated problem And she wound up getting coronavirus in the hospital in Maui This is not so good So, you know, people are afraid to go into the medical world knowing that that's where coronavirus is being treated and therefore That's where there's a risk So I'm wondering the you know, how important testing is in that context and You know, pp. What is it ff ffe? um Sorry I'm not going to medical school anytime soon But I wonder how we didn't talk about ppe very much until until this anyway, I mean we knew what it was but it wasn't It wasn't like we used the The abbreviation every day now now we all know Anyway, so I'm wondering, you know, that becomes a kind of important thing not necessarily Limited to protecting people but to give them confidence that if you go into a medical facility You know, it'll be okay that you know, this is a risk worth taking And that even if they don't know exactly what's wrong with them. It's okay to go see a doctor. It's okay to be Exposed that nurses technicians would have you for a routine what might be routine medical issues Um, so, you know, it seems to me if I was running a hospital I would say really got to get testing got to be sure everybody in the room or at least most people in the room Who are at risk of having it of you know being able to shed virus? um They're they're they're tested and they're protected and everybody else is protected And short of the PPE and the testing, you know, you you can't have a hundred percent Level of confidence about that So how important is that at least in your analysis? And and how important is our effort to get those things to our medical professionals here in Hawaii? well, I think as as a lot of people have been talking about in the news, uh testing is key uh to getting back to some level of normalcy Because you you want to be able to be sure That you're not infected and the people you're interacting with are not infected Really testing is going to have to be much more widespread It isn't available to that extent right at the moment And we don't really even have the clinical laboratory infrastructure set up to do The level of testing that would be optimal. I think I think we're fortunate in Hawaii at the moment we've had A quite a flattening of the curve as they say We've had a low number of cases that have been Diagnosed especially compared to many other areas of the country so I think that people can feel a little safer here, but At the moment everybody's going to be a little nervous about going to the doctor's office and going to the hospital because That's where sick people are going to be And that's always been the case.  They know that Going to the pediatrician's office.  Um, how are they how are they dealing with it? And how is it changing their their practices? I think we're going to be doing a lot more telemedicine I think the structure of our offices is going to change As as you know, you go to the doctor's office You're usually sitting in a room with a whole bunch of other people and There's no way that you can do social distancing In the in that sort of situation. So I I think a lot of things are going to structurally change and it's going to affect the medical Community as well One of the things I know we talked a little bit before we went on air that That has really affected us And we know it's going to affect us moving forward is Our clinical research and clinical trials for cancer patients This is the way that we find new treatments for patients And the re one of the reasons that we've seen a decrease in mortality from cancer over the last decade Is because we've developed better therapies for patients. Some of it has to do with earlier detection Some of it has to do with prevention But a lot of it has to do with treatment as well And we find new treatments by doing clinical trials You've heard a lot about clinical trials for things related to covet 19 It's it's in every press conference, you know, we're doing a clinical trial for this a clinical trial for vaccines You do the clinical trials because without the clinical trials You cannot figure out if something is effective and safe for patients And for cancer patients, it's really the same. We have to do these trials. Otherwise, we can't Advance therapy the therapy we give to people today is wholly different from what we gave 10 years ago And the reason is because we did clinical trials. We found out what was better We replaced the old stuff with the new better stuff. That's basically what we do We want to continue to do that during this pandemic Our clinical research efforts have really taken a hit. It's been very difficult To keep our studies up and going It's hard to enroll patients onto studies because everybody's focused on this other threat And I don't I don't blame them for that and we've had to cut way back on Our access to clinical trials trying to make those that are Particularly important for treatment of patients available But a lot of the other trials that we do are supportive care treatments developing new anti nausea medications some Prevention studies sleeping the hypnotic sleeping medications that Anything like that. We've had to put most of those on hold And that's been really difficult. It's it's happened across the country We have conference calls with our other nci designated cancer centers At least twice a week to discuss what we do about clinical research how we can make it available to our patients Whether we can do things by telemedicine Whether we can consent patients for trials without having them come into an office and sign a Consent form we can do that over the phone or over a video These are all things that are completely changing and I think are going to change How we do clinical research for cancer patients and other patients Moving forward. So it's been a real impact on us. It's made it difficult and we have to also think about Our staff which are usually not Healthcare providers our clinical research associates who do data management on trials They we have to make sure that they're safe. Also when they go to to an environment In the hospital and take care of patients and interact with them Yeah, do you think you think that research should include tracking or is tracking something that doesn't require any medical training is just fact-finding Uh tracking doesn't I think it doesn't necessarily require medical training And so uh, some of the people in the department of health who are doing epidemiology tracking I think they're they're they're uh, lay people. They aren't uh, medical professionals Okay, I just I wanted to um, ask you about, um The effect on uh, on research funding So we have we have 2.3 trillion Plus another four or five hundred billion Coming down from the federal government Are your research programs at Japson or the cancer researchers? center seeing any of that money Not at the moment. Nothing that's been allocated is going to be going to Uh, to research except for research specifically for uh, COVID-19 which is certainly understandable I think from a cancer point of view, uh, we've actually Are very concerned uh, because A lot of the way we get funding is through foundations like the american cancer society The v foundation stand up to cancer a lot of these organizations have seen a drop In donations and some of them have actually Cancelled their grant programs. So we're a little concerned about that We're also concerned, uh, here at the university of Hawaii cancer center because we're a state institution We get support from the state and we know the state's going to have a big budget Uh deficit coming up because of the impact of this on the travel industry And so that means that the university is likely to see a significant budget impact as well That's going to affect, uh, how well we can do cancer research here at the cancer center And the reason I think that's so important is because the research we do is specifically targeted Toward reducing the burden of cancer for the people of hawaii for the populations We have here for the specific kinds of cancer that we have here And so if we aren't doing this research here, it's not going to be done elsewhere. So We really, uh, are a little concerned about the climate for funding For cancer research moving forward I know that in 2008 after the recession Some money went to the national institutes of health and the national cancer institute That provided some funding broadly for lots of different diseases I don't know if there are any plans to do that at the moment I hope so because uh funding research actually Is a great thing for helping the economy recover Because research funding leads to good jobs which leads to people buying, uh Groceries and going to restaurants and paying taxes. So Research funding is a good way to diversify the economy. So I'll put that in as a plug That we need to have good research funding for cancer research. It'll help the state overall I remember Ed Cadman's dream as he built the medical school 20 years ago And he had this this dream of big pharma with these large research facilities all around the medical school Unfortunately, it hasn't been been realized, but that doesn't make it less important We do bring in a lot of a lot of money. We bring in about 50 million dollars a year in Federal money to support research and most of that goes to paying for people who are Have good jobs here in Hawaii. So it does help One last question before we break, uh, Randall. Um, there's been so much talk about drugs that are Repurposed drugs drugs that have no clinical trial background and and you can see watching, uh, you know Donald Trump's press conferences that you can just see it on the television. They don't all agree and uh, some You know people Fauci for example, you know, you can see from his body language and from his remarks That's not a good idea and and and then you hear other doctors who have left the federal government They tell you in no uncertain terms. It's not a good idea So, you know for a person who has been tested positive and all that who is worried about it What how should he deal with this or she? Um, you know, because it's very threatening and, uh, and maybe Through a kind of black market mechanism Uh, a friend of a friend who knows what he can get a whole he can get a whole of, uh, Hydroxychloroquine and uh, maybe that'll help him even save his life Daniel Day Kim the the movie actor made a big video about that saying that it saved his life How do I deal with that or or do I say wait a minute medical protocols should prevail here? Let's not take silly chances. What's your thought? I put it in three words science saves lives So we should focus on the science And not just focus on anecdotes About what might help I think all of these things that people have talked about. Oh, this may be useful. This this might be useful They're being tested in studies. There was a recent study from the va with hydroxychloroquine It actually looks so good people who got hydroxychloroquine did worse than people who didn't This is why you need to do studies and you need to focus on the real data and the real science Behind it. I think that it's not bad to repurpose drugs repurposing drugs is a great idea but you have to do it in a Constructive way and it's best to do it with a scientific foundation Randall holicom holicom of the cancer research center In chapsum right here in hawaii doing world-class work. Thank you so much Randall. Great to talk to you today. Thank you