I taught kindergarten for 10 years. I worked on curriculum, the Cree Language curriculum for two years and or a year and a half and I've worked with the Cree language for four years now as a Cree language instructor. Please describe your program what called age groups target audience, aim of the program and the learning objectives and your opinion that makes it excellent in Indigenous education. My program is a Cree language program, Nehiawewin in our language is how we say it and I use the ASLA developed by Dr. Steven Graymorning. ASLA stands for Accelerated Second Language Acquisition. The age group that it's targeted towards is grade one to grade six. I currently teach it to the grade sixes only. I also do land-based education with grade threes and basically that's just going out and mother nature is is our teacher. We just go out on land and we learn. We sit and observe a bug. We sit and observe a tree or we sit and just feel the wind and then the kids make notes and tell me of what they felt, how was it warm, cold and stuff like that. Just learning to connect to mother earth and to nature and to understand and know how to read it I guess and and feel it. The aim of the program, using the ASLA, I actually use ASLA in the land-based program as well. The aim and goal of it is to develop fluent Cree speakers. What Dr. Steven Graymorning developed with his ASLA program is you start with it you teach in sets and you use and you use only visuals and the oral language. So the first set is 16 nouns and those 16 nouns consist of four people, four animals, four transportation and four in reference to animacy, animate and inanimate. So that that's your set one and then you move on to set two and set two introduces connectors first. It teaches you how to connect two nouns in a sentence. A man and a woman like that in the language and then you go into plurals and you're required to teach four connectors and extend them to eight and then the plurals you teach 12 plurals, 12 to 16 plurals and then you go into the next set which is verbs. You teach verbs in a singular form and then you teach verbs. You start to introduce verbs in a plural form and then it goes into set four. It goes on like that so it teaches you colors and numbers but you're not not through counting. You're not counting like you're not going one two three four. You're showing a picture with four dots on it and you have to be able to say four when you see it and and not and not count those four dots. So it teaches you numbers out of order and so that when you see when you see six horses in a field you're able to say six horses instead of you know count them but in the target language show you would say when you saw that picture of six horses in a field you'd be able to think in the language using a number and a noun and pluralizing it all at once right and then it goes on it extends it it extends the set five and six that go to clothing. You learn about clothing.  You learn the terms like sewing. You learn how the verb putting on a jacket taken off your shoe so you learn those terms in the target language as well using visuals and only visuals and you can apply and use TPR total physical response where you actually bring me take off your shoe and put on your shoe you know so I do that as well. So that's one way that I've adjusted it for me is by using TPR I include TPR in it and and then it goes in we're clothing and then it goes into foods foods so you go into foods and use you teach the traditional foods first of the target language and then where do we get these foods from so you're extending it from foods to where do you get these foods from you hunt so you're teaching them about you're teaching them verbs and and that the traditional and traditional hunting skills like how to hunt a matzit and so you're teaching you're teaching terms like tracking an animal and aiming at the animal shooting that animal getting that animal and then butchering that animal and drying the meat and frying the meat and boiling it so all of those different phrase phrases come in into play and then the the colors you work that in with the food as well which is fruit and that's a set of its own because traditionally we we picked a lot of fruit like the raspberries the blueberries the strawberries and they are colors right so you say blue red emi quake ayos ka nah red raspberries so you're not teaching the color in isolation you're teaching it with with with the noun of the berry a because they shouldn't they should already know color at a certain grade we shouldn't be teaching it wrote memory anymore right and then I work in liquids because liquids is is kind of a topic of its own because of the fact that it has that certain ending because of the suffix that a that a liquid has in our language so I teach those in isolation and drinking spilling pouring so you get those verbs in there as well so you're always adding verbs and if you can get through that program which is a right now we haven't achieved it because it's still very new or in our third year this is our fourth year and we continue to adjust it because like the grade threes have been exposed to it the kids that are in grade six now have had this program since grade three so now in grade six I'm having to adjust it more each time so instead of adding two two verbs that relate to to food and cooking in grade two I'm adding 12 you know so it's constantly changing that's where the assessment is changing and hopefully in another year I always said five years that then we'd have this program set but that's basically how it goes and you can use any verbs or nouns in your language throughout those sets in any of those sets but it's the first set that's very important that you stick to four people those are your four nouns your four your four transportation your four animals and and your animacy for for animacy it's successful because it dictates it makes you work with four and you take and you take and find animals that are native to your area like I wouldn't teach about I wouldn't put an elephant up there because it's from Africa and we don't even have a term for it in our language it's there's a term has been made so like in the area that we're in a bear was very common we're name our name the community is muskwachis right so muskwa buffalo was our livelihood so I teach buffalo ermine skin is a ermine sikos so I teach that because it's it's got a lot of significance and important to the kid importance to the kids say the kids need to know what an ermine skin is and how it relates to our name and the history of our people and then what's the last one I do a moose because moose a moose is something we lived off of it provided for us as well a another characteristic or aspect that makes this ASLA program work is the fact that there's so much repetition like when you're teaching one new word whether it's a noun or a verb phrase and you have 24 kids in the classroom you teach it to them first they're listening you say it two times three times four times and then you have them repeat after you because they've heard it and they're fine-tuning their ear to your sound to the sound system of the target language while while they're listening and then there's by the time you get them to say it they're able to say it without any problems and then they come up they rotate and each child has to come up each student has to come up and go through that new word or those four new words those four new pictures so by the time the class is over and you have 20 kids in there and each kid has said it I've said it and each child so that's two times two times 22 that's 44 and then I said it four times before that so by the time they leave the class they've heard those four new phrases almost 50 times and there's that repetition repetition is what makes it stick and work what are the programs learning objectives oh that would be like the look the ultimate learning objective is is to develop flu-increase speakers and to have the children thinking in in the language in the target language which is the Cree language that they be able to think in it and speak in it at by the time they leave grade six it's partially used in our high school too but I'm not sure how extensive they use it a what in your opinion makes it an example of excellence in indigenous education the fact that it forces the children to think in the target language I think that's what makes it a successful and excellent program and the fact that the the teacher who was instructing it has to use the language and stay in the language and not once translate any of what she's teaching in the language into another language and always staying in the target language which in my case is the Cree language how do you measure the success of your program the success is measured through benchmarks I've created assessment tools such as benchmarks which we we test on every year every year for grade twos and grade fives we have certain measures where say like for grade two by the time they get to grade two the kids are expected to learn 24 nouns and and 12 verbs but within that they have to know how to use those nouns in singular form and in plural form and they also have to know how to use those nouns with connectors such as and in which in our language is a gua and they have to know how to use those verb in singular form and in plural form and also with connectors and they also know how to know how to use the pronouns demonstrative pronouns like this is and that is and when in our language it's been termed as animacy where they learn how to use a wa and oma in relation to the noun that they're they're using so just knowing when to use proper term a wa or oma there's a term for them yeah I'm pretty sure it's demonstrate them demonstrative pronoun I'm pretty sure that's what it is but like I said I don't concern myself with that stuff but I and I know I should and then of course we assess quarterly we we assess every semester so we have within for each semester we have an assessment tool that that we use that measures the kids comprehension level like do they understand the language do they understand when I say not bail a wa do they understand that I'm saying this is a man and can they tell and and when I point to the picture can they say to me in the language and can they can they properly say it when I point this is a man will they say not bail a wa which is the correct answer or will they say is square a wa so we're we're assessing comprehension that way and then we also have a section in that test where we're we're assessing the application can they give me a sentence of their own using then a noun and the verb that's not displayed as a pictorial phrase on on the wall say we have all these pictures of a man standing a man walking a bear running but we don't have a picture of a woman in any of them can the child come back to me and say when I ask them to create their own phrase and sentence can they come back to me and say because they already know the the noun woman and the noun bird can they say a square a pin part that a woman is running even though they haven't seen that picture yet so taking what they already know and applying it to different visual and in their own mind so it forces them and makes them think in in in the target language decree language and so we have say like in the first term the grade fives have to know what do we have for them they have to know 34 36 nouns 38 now sorry grade fives have to know 38 nouns for the course of 48 nouns for the course of the year so we break those 48 nouns into the three semesters and then there's a final assessment that comes with with everything on a date well not everything but certain ones so those those 48 nouns are broken and broken up and taught into each semester same with the verbs we are in grades 6 they have to know 48 verbs and they have to know them in singular and plural and know how to apply them and use them so same thing indigenous education to me is learning is being taught in our own language and learning about our own culture and our own history as opposed to learning being taught in a foreign language the English language and being taught about English concepts and English perspective English life English world views in the indigenous education to me means that we as indigenous people First Nation people teach our own world views and our own history in our own language and that they not be taught inside of four walls and that it be taught on the land and outside like it was five six hundred years ago before European contact what is your vision for indigenous education over the next ten years my vision is that we are able to take control we do to a certain extent have control of our own education on the First Nation on the reserves however it's still being dictated as to what we can teach we have to teach those six core subjects English science social math my vision of it is that be pushed away and that we come up with our own topics or core subjects in relation to who we are as First Nations people like we need our language again our culture again and again it needs to be outdoors and we indigenous education also needs to be coming from our own people with the help and guidance the whole way through from elders in this day and age our world is so multicultural it's so diverse we have so many cultures and so many different races in our world today that we still need to have a balance and be able to function and communicate in two languages and in two worlds which is basically what we are the First Nations the indigenous world and then the European or the modern American European so I just wanted to add that you know we we still need to be able to learn the English language and how the English how the Western or the modern Western societies function and their their rules and everything just for the sake of history not repeating itself in that loss of communication and then not being able to communicate right like it did happen in history and we just don't want to repeat history and this way if we're both educated in in the Western world and in the indigenous world then that communication will always be there what information materials resources do you need to achieve that vision aside from funding we would need to be able to gather that knowledge from our elders those elders who are the knowledge keepers of the language and the culture who are you know the ones that are that aren't gonna be here with us much longer we need to seek them and get their permission to document or record their knowledge so that we can make curriculum out of it so that it can guide us in creating our own curriculum so we need to make our own curriculum that would be like the material the material and the resources we would probably need not probably I know we would need because it's very hard to take field trips and go to certain areas to be able to teach them about the river we don't have a big clean river like we do in the mountains we don't have that here in muscovites so we would need like a designated area where some of our plants and herbs still grow that are important to us so that we could take the kids there the children there so we'd need designated land I guess or land areas where we could do a lot of our land-based learning and I know buses and stuff like that would fall under funding so we'd need that transportation we'd need that transportation to be able to deliver a program like land-based learning because we we picked and gathered roots not just in the area we lived in we traveled back and forth across this land like from the Great Lakes the Rocky Mountains and in between along the way we always gathered and traded and picked roots because they didn't grow in the region that we lived or whatever right so that kind of knowledge that kind of a resource is something you need transportation for


My name is Rikind Gandhi. I lead Digital Green and essentially what we're trying to do is to bring together technology and social organization to amplify the effectiveness of existing agricultural extension systems. And we're doing so largely with four main components. One is participatory video in which videos are created by farmers, for farmers and of farmers, short modules of content that are shared in the local area using a model of mediated instruction through local community service providers who bring together small groups of farmers on a week-to-week basis and really create an interactive environment where farmers can learn using these videos and where they share a lot of feedback about their needs and interests and progressively the system aligns better to their needs and interests. The system really builds upon these existing agricultural extension systems that are already working with farming communities. So assuming that we have sort of the strong foundation already laid of domain expertise of some scale and operations and some level of community rapport already established, then bits of the model can really just build upon those existing interventions. Both the technology bits, which are elements of hardware in the way that we're producing and sharing the local content using pocket video cameras and Pico projectors, as well as the way that we're capturing various metadata and feedback from the community using online and offline systems and analytics, dashboards, as well as an interactive voice response system to provide a faster feedback mechanism. You know, it really depends on obviously the local context about the amount of infrastructure that's already in place, both in terms of the extension system as well as sort of the the local context. And then for the model itself and how it sort of gets institutionalized and integrated with these existing extension systems. Yeah, so I mean, I think just to some extent in places where there's no existing extension system, then this model may not be appropriate, though you can use bits of the model still if depending on sort of the existing foundation with the community. For instance, if they have the infrastructure for accessibility to mobile phones, they could use elements of the interactive voice response system. If they have access to data connectivity, whether through mobile phones or from computers, they could access the video content independently. But really to have the structured sort of activity where we're really looking at seeing how does the information that's being shared really translate itself into new types of actions in the form of new farming practices and technologies that farmers take up for themselves on their own fields. We really believe that we really need to partner with existing organizations, but the system itself also helps actually often strengthen an existing system that might be perhaps weak in that just through the process of going through through video production, the extension agents and the subject matter specialists about particular domains really need to think about what are the topics of interest that we're going to be sharing with the community and how relevant are they and how can we modularize them into short eight to ten minute videos. And over the course of time as we're capturing a lot of data from the communities, we're also able to inform the extension system about really what are the needs and interests of the community and how can we strengthen sort of the extension system more generally and particularly through this video-based approach, how can we target our interventions more appropriately.


Now, it wasn't too long ago when James Hendricks was a star quarterback for the Bemidji High School Lumberjacks football team. Now a sophomore at North Dakota State, Hendricks is switching positions and will be playing on the other side of the ball starting this upcoming season. Hendricks will be moving from the signal collar on offense to the strong safety position on defense in 2017. He is already seeing first and second team reps out at the position in preparation for NDSU's spring game this week. Hendricks says he's excited for the new challenge and has learned a lot from past bison players including current Philadelphia Eagles quarterback Carson Wentz. It was different but I mean I was excited, I was excited for the challenge and I was excited that hey maybe if I compete and I work hard enough I can get on the field next year as soon as possible. Every week when we're breaking down film for other teams I mean I was listening to Easton and Carson a little bit for that year and Easton and Cole this year about what that coverage is and what they do here so I mean all the terminology is pretty much the same you just got a you're the one doing it now so all that helps I mean getting a head start and having a base understanding of what the defense is. Now as a lumberjack Hendricks was a three-year starter quarterback passing for 3,735 yards and 36 touchdowns while adding 2,273 yards and 23 touchdowns on the ground. If you've enjoyed this segment of Lakeland News please consider making a tax deductible contribution to Lakeland Public Television.


Now, let's begin by discussing broadly the key events that happen in the 12th night. So as you can see behind me, essentially, I've created a mind map explaining the main major events that happen in the play that you should be aware of. Now, let's go through it. So the play begins with us learning about two twins, Viola and Sebastian. So Viola is a girl and Sebastian is a boy. They are separated in a shipwreck and Viola seems to be the only survivor and she believes that her brother, her twin brother, has been killed in the shipwreck. So Viola, believing that Sebastian's dead, she, because she realizes that she's completely alone in the world, we also learned that her father has died, so she's basically an orphan. She believes that she's alone in the world and as a woman it will be very difficult for her to navigate this new complicated environment. So she decides to disguise herself as a man, to disguise herself as a man and also to rename herself as Cesario. Once she disguises herself as a man and becomes a man called Cesario, she seeks employment at the Duke's place. So bear in mind, the setting is Illyria and the Duke of Illyria is Duke Orsino. So she decides to work for Duke Orsino, however, whilst she's working for him, they have a real close connection, a bond, and she falls in love with Duke Orsino. However, she can't do anything about it. She's a man. She is of a totally lower class and Duke Orsino working as one of his courtiers and servants, so she really can't do anything about it and she believes that this love will be unrequited. Now Duke Orsino quickly starts trusting Cesario, so of course this is Viola that he trusts, and we learn that Duke Orsino is in love with another lady, another lady who's part of the nobility in Illyria called Olivia. He's in love with her and he's tried to woo her and get her to marry him, however, she has rejected him and the main reason for her rejecting him is because her brother has died and she's decided that she's going to reject all male suitors for seven years. So Duke Orsino believes that maybe Cesario will be able to somehow navigate this and try to convince Olivia to marry him and to of course return his love for him. Now Orsino therefore sends Viola of course as Cesario. He sends Viola to try to win over Olivia. However, of course this ties into the element of comedy. Once Olivia meets Cesario and just feels like this instant connection with him, she falls in love with Cesario and she completely forgets this vow that she made, that she will have no male suitors as she's mourning for her brother. So actually she switches from being very anti-talking to anybody who is connected to Duke Orsino to actually wanting Cesario to propose to her and to marry her. So she falls in love with Cesario. I've been honest to her, of course she doesn't know that she's talking to Viola who's a woman. And of course Viola is stuck between a rock and a hard place because she doesn't want to reject outwardly Olivia and make her upset and angry but at the same time she needs Olivia to accept Duke Orsino's hand in marriage. Then we learn about Olivia Stewart and of course within the royal household in Olivia's own household there's also a lot of politics amongst the servants. So Olivia has a lady in waiting called Maria who's one of her servants, a very close servant and she also has another steward called Malvalio. Now we learn Malvalio is very pompous, he thinks he's better than other servants and Maria really hates him so she decides to play a trick on him. There's also Sir Toby Belch who is Olivia's drunken uncle and he's trying to hook Olivia up with Sir Andrew and of course Olivia totally refuses. However Maria decides to play a trick on Malvalio and Maria along with Sir Toby, he's on the trick as well as Sir Andrew, they decided to trick him into thinking that Olivia loves him. Now Malvalio is convinced not only that Olivia loves him but he's also convinced to dress up in a certain way as he reads a letter which basically he believes is from Olivia, it's Maria that's written it. He reads this letter, it tells him to dress in a very flamboyant way because Olivia, according to the letter, will like it but also of course this is his way of trying to woo her and seduce her and of course Malvalio is really happy that Olivia loves him because if you were to marry her his social status would go up.  Then Sebastian who was ultimately rescued so he didn't die in the shipwreck initially, he was rescued by another man called Antonio who really dedicated himself and helped him get to Illyria. Sebastian arrives to Illyria of Antonio. Now, we realise that Antonio is actually an enemy of Ducos. You know, however, Antonio is very, very loyal to his friend Sebastian who's Viola's twin. Once he arrives in Illyria, he's a wanted man and he is arrested and taken away, okay? And of course, Sebastian, once he arrives in Illyria, Olivia encounters him. Now, Sebastian looks exactly like the male version of Viola, okay? So when Olivia encounters him, she is really happy because she believes it's Cesario. Sebastian is a bit confused. He doesn't understand why this royal woman is in love with him. However, he goes along with it and Olivia says, let's get married and they get married, okay? And of course, that's what adds all the more to the humor. Sebastian married someone who literally doesn't know but Olivia is also really happy because she's now married Cesario or who she believes to be Cesario. Now, this gets back to Ducos, who hears that Cesario, his servant, has married Olivia and he is furious at first. However, Viola and Sebastian ultimately end up meeting and it's then ultimately revealed that Viola had took on this elaborate disguise. Cesario is Viola but also Sebastian hasn't betrayed Ducos because he's not the same person that was working for Ducosino. We also realize that Ducosino was slowly falling in love with Cesario and Viola and he feels relieved that he wasn't falling in love with the man, he actually was falling in love with the woman. So Ducosino and Viola, who's now her true identity is shown, they marry Sebastian and Olivia marry and also separately, Maria and so Toby also marry but sadly for Antonia and Malvolio, things don't end that well. Malvolio is still left in terms of believing that he's mad but equally also Antonia is still imprisoned. So this is an interesting but fairly complex play. As I've mentioned before, this play is very short so it seems deceptively easy and straightforward to understand, however, there's lots of disguise using this play, there's lots of humor but also there are a lot of underlying messages relating to gender, relating to class that we're going to unpack and discuss in a bit more depth. But that's really it when it comes to understanding the plot of the play 12th night in a nutshell and hopefully you found this summary useful.


So let's do this problem. It says, identify the reaction types that each of these reactions are, and they could be more than one of the list of them. OK, so they're all balanced for us, so that's nice. You just have to remember, well, what do these things mean? So some of the easier ones may be combination and decomposition. So combination means if you've got one or two things, and they make one thing. So two or more, and they make one. So if we look here, we've got this one, where we've got potassium plus chlorine, and it goes to potassium chloride. So you see we have two starting materials, and it goes to one product. So that's definitely a combination reaction. So since we started with this one, well, it can be combination. Remember, combinations can be redox or non-redox. So this one is going to be more than one type of reaction. It's going to be a combination. It'll be a redox or a non-redox. So let's figure out what it is. Well, if you recall your oxidation number rules, this is zero here. And in a compound, they're not going to be zero. These ions, in particular, are regular ions. Potassium's always plus one, and chlorine's always minus one. So here, we see potassium changing from a zero oxidation state to a plus one oxidation state like that, and chlorine going from a zero to a minus one. So that's a change in oxidation state. So that means that it's a redox reaction. Does that make sense? But you said that potassium and chlorine, they're always zero. Well, in this case, because they're uncombined elements. Remember, that's the first rule of identifying what oxidation state your atom is at. So here, they're uncombined. So they're at an oxidation state of zero. But here, they're combined. So they're going to have their own oxidation state. Does that make sense? So let's look at some of these other reactions. So decomposition, well, that's one thing breaking into two things, or two or more things. And if I do a quick scan, well, see, here we have an aluminum trifluoride. And here, we have aluminum and three fluorines. So it's one thing breaking into two things. So that's a decomposition. Again, decomposition can be redox or non-redox. So this one, we're going to have to decide. Recall what we said about the last one. When we have an uncombined element, it's the oxidation number is zero. And if we have a combined element, its oxidation number is something other than zero, like in a compound. So if we look here, if we've got combined elements in a compound, and we look here, that guy's uncombined. That one's uncombined. So we went from, those guys are at zero. This is something other than zero. In fact, it's maybe to one and positive three. So you can see the oxidation number change. So this also is a redox reaction. Does that make sense? So let's keep going along with that oxidation number changing and uncombined, combined element thing, since we're getting good at it at this point. So hopefully, you see here in this next reaction, we have aluminum, which is uncombined here. So zero for aluminum. Over here, aluminum is in the form of aluminum oxide. So it's combined. So it went from zero to something else, right? So already, and iron here is zero over there, already we know this is a redox reaction. Does that make sense? Because aluminum went from zero to something else here. Remember, oxygen's always minus two. So three oxygens is going to be minus six. So aluminum here is going to be plus three. So it went from zero to plus three. Iron went from zero over there. So this is minus two, plus three, same thing. So you see it went from three to zero. So iron got reduced in that reaction. Remember, when the oxidation number goes down in value of its reduction. So if you want to think about it, aluminum got oxidized in that reaction. Because aluminum went up, yeah. The other thing is, if you get oxidized, you're the reducing agent. And if you get reduced, then you're the oxidizing agent. So it's kind of an opposite. I don't know, term knowledge. So since this is a redox reaction, but it's also something else, hopefully you can see, we've got the aluminum here stealing iron's partner. So aluminum stealing oxygen from iron. Do you see that? And like bumping iron out of the way, and iron has to go off by himself. Do you see that? That's called a single displacement reaction. Because one thing is displacing another thing, as opposed to a double displacement where two things are displacing each other. So this guy is switching partners with the iron. That's a single displacement. If we would have noticed that first, we would have all automatically been able to say it's a redox reaction. Why? Because single displacements are always redox reactions. So does that make sense? So let's continue along with, well, we know what a decomposition reaction is. So it's where we have one starting material and it breaks into more than one product. If we look at our remaining reactions, this one, this one, and this one, hopefully you see this is a decomposition reaction. Because we've got one thing breaking into one, two things. So this thing here, this decomposition. So let's just write that really quick. So decompositions we know can be redox or non-redox. So in this case, just like in the last one, we had to figure out what the redox numbers were. So here we've got combined. Here we've got combined. Here we've got combined. So we can't just say 0 on any of those things. So we're going to have to figure it out for everything. Remember, sodium is always plus 1. If you remember the carbonate, that's a polyatomic anion. If you didn't remember that before, hopefully you realize that it's supposed to be a minus 2 charge because there's two sodiums attached to it. So this is minus 2 for the carbonate all to get. So if you want to think about it that way, so CO3 2 minus, oxygen is always 2 or minus 2. There's three of them. And then carbon. So what's the oxidation number of carbon? So C plus minus 6, minus 2, C equals plus 4. So I'm putting, well, so that was for the whole thing, but oxygen is minus 2, carbon is plus 4. Is it OK that we did that? I'm going to erase all of this work here, just so it doesn't get in the way. OK, so those are our oxidation numbers. If those don't change, if any of those don't change over here, then it's a non-redox reaction. So remember, we said that oxygen for our class is always minus 2. So here, we've got a minus 2 oxygen. Since we've got two of them, minus 4, the whole thing is 0. So carbon must be plus 4. So carbon, we can already say, went from plus 4 to plus 4, so it did not change oxidation state. Does that make sense? It went from plus 4 here to plus 4 here. So no change. And oxygen, we said, is always minus 2 for our class. So that means that oxygen is a minus 2 as well. So that one's minus 2, that one's minus 2, and that one's minus 2. Did oxygen's oxidation number change? No. So now, all we've got to do is look at sodium, but what do we know about sodium? Always plus 1, right? Always plus 1. So did its oxidation number change? No. So this is a decomposition reaction that's also a non-redox reaction. So you've got these two decomp reactions that you want to compare to each other. OK, so does that make sense so far? We'll leave that. OK, so we've got two more reactions to do. Let's look at them individually. The top one, hopefully, you can see straight away that sodium is taking the place of hydrogen, and we've got sodium and chlorine paired up instead of hydrogen and chlorine paired up. And if you can kind of think about the structure of water, you can kind of think of it like HOH, like that, instead of how we write it shorthand, H2O. So if you look at it that way, hopefully, you can see that the OH and H have paired up. So they've switched partners. Does that make sense? Do you see that? So the OH is the polyatomic ion. If you didn't know that, it's called a hydroxide ion. That's something that you need to know. So OH is one entity, and it's paired up with H now, to make water. And sodium is paired up with chlorine. So we call this, since they switched partners, a double displacement. You can go about finding oxidation numbers, because it's going to make this video so long if we do all the oxidation numbers for both of these remaining two reactions. The one thing I'm going to tell you is that double displacement reactions are always non-redox. So I'm never reading them. So you should go, Carly, you should go home and prove it to yourself that this is a non-redox reaction. But we're just going to take the shortcut and say, non-redox, because it's double displacement. But double displacement reactions, that's where these two choices come into play. Acid base or precipitation. A lot of times these double displacements will be one of those two types of reactions. And if you remember what we said about acid base reactions, it's whenever an OH or something that has a lot of electrons takes an H away from something else. So you'll learn more about it in a few chapters. But for right now, since we're just introducing it, that's what you want to think about, when an H is removed from something by something else. In particular, an OH for this class, OH minus the hydroxide. So that is called an acid base reaction. So this one, you can classify with three terms. Acid bases are always double displacements. That's a way to think about acid bases. And when you have hydroxide and it's the thing removing the hydrogen, you're always going to be making the water. So that's another good way to kind of remember if it asks you what are the products or something like that. You know you're going to be making water. So that kind of helps you out. How much is this supposed to make CO2 and water? Always, yes, CO2 and water. I mean, for our class, pardon me. Both of them were just like one. No, both of them. Yeah, because what you're going to do in a combustion reaction, and unfortunately, we don't have one up here. That was when I was like, man, I wish we could squeeze one more in here with a combustion reaction. Combustion reactions, you always start off with something that has carbon in it. Of the H. C-H-O something.  And that will go, and that doesn't necessarily have to have oxygen in it. But C something, H something. And that will always go to carbon to the outside of water because with combustion reactions, you're always reacting with oxygen. So that's where your oxygens are coming from in your carbon dioxide water. If you don't have oxygens to start out with in that carbon compound, or organic compound we call them. Okay, so since we just got done with this double displacement reaction, I kind of saved these. I did them in an order that I wanted to, okay? So if we look down here, hopefully, since we have experience with the double displacement reaction up here, hopefully you can see down here, this is also a double displacement reaction where lead is stealing iodide from sodium. Do you see that? And sodium is taking the nitrate from the lead. So here we've got sodium iodide and here we've got sodium nitrate. Here we've got lead two iodide. Here we've got lead two nitrate. So they kind of switched partners. Did like the docy-dough or something like that, okay? So that's always a double displacement. Whenever you see them switching partners. So my red hand is like, no, I can't get a displacement. What do we say about double displacement? They're always what? Non-redox, right? So that's something to make you remember. That's good. But is this an acid base reaction? Can you tell me that? So if I see somebody, no, it's not, right? Yeah, no, it's not. How do we know? Well, there's no hydrogens being transferred, right? So nothing's taking a hydrogen away from something else. In fact, what you hopefully see is that on this side we have an aqueous solution. On this side we have an aqueous solution, right? So two aqueous solutions. And what we're getting in the product side is a solid here. So that means something precipitated out. So this is a precipitation reaction. So I think we have one of those, two of those, one of those, two of those, none of those, but we talked about it. One of those, one of those. Remember, this is double displacement, this is double displacement, okay? Maybe we should write this. And redox, non-redox. Every one of them you wanna label whether it's a redox or non-redox, okay? Are there any questions? I know we went through a lot of stuff, but this is a good mini lecture on this stuff, so.


Hi, I'm Mitch Parker, Information Security Officer at IU Health in Indianapolis, Indiana. And today's topic is going to be advancing medical device security, how collaboration with screen providers, manufacturers and pen testers is advancing what's possible with security. And with us today, we have an incredibly distinguished panel of people we've been able to find who I'd like to have introduce themselves right now. We're going to start with Florence Hudson. Very good. Thank you so much, Mitch, for having me join you. And hey, Defconn crowd, heeks and all, Engoons. So I'm Florence Hudson, and I'm founder and CEO of FDHINT, which is an international consulting firm for advanced technology, diversity and inclusion. I also work for the NSF Cybersecurity Center of Excellence in Indiana University. I lead the cybersecurity research transition to practice program. And I'm also executive director for the Northeast Big Data Innovation Hub at Columbia University, leading translational data science opportunities in the Northeast U.S. Oh, and I should say, I'm also working group chair for IEEE UL P2933 for those who aren't acronym queens and kings. It stands for Institute for Electronic Engineers and Underwriters Laboratories, working group on creating a standard around clinical, innovative things, data and device interoperability with TIPS, which stands for Trust, Identity, Privacy, Protection, Safety and Security. And Mitch is one of our co-vice chairs. So thank you very much for having me, Mitch. Thank you. Florence, I'll take it over to Rob Suarez. Hi. Hi, Defconn. This is my name is Rob Suarez, and I'm the Chief Information Security Officer for BD at Specton Dickinson, and we're a global medical technology company offering some of the most advanced products across the continuum of care. It's my job at BD to make sure that we are protecting those products that we're delivering a secure product and also the environment in which they reside in, which is typically a hospital, but increasingly a patient bedside at home as well. And so I'm very excited to talk to my fellow panelists today about medical device cyber security. There's a passion of mine, and I've had the honor actually of working alongside Mitch and Michael as well on several industry initiatives. And so again, looking forward to the discussion today. Thank you. And last but not least, Mr. Michael McNeil. Hi, Defconn. This is Michael McNeil. I'm the Senior Vice President and Global Chief Information Security Officer at McKesson, and just recently got to the organization. But as Rob has just stated, have had a number of years collaborating with the team here. And my days go back into Phillips as well as into Metronic from a medical device perspective over the past 10 years. Really looking forward to this particular session. And again, have collaborated with these guys in a number of different industry and forums. And again, I think you'll find our conversations today to be pretty enlightening because it takes that ecosystem and for us to come together to really execute here. Thank you so much, Michael. So I'm going to launch right into the first question here. First question is, what are the biggest concerns that each of you see related to medical device security these days? So I'll start if I might. So what I mentioned when we were first opening up, I talked about tips, tips for the Internet of Things. This is a framework we've been creating with IEEE for four years now. As I mentioned, it stands for trust and identity, privacy, protection, safety, and security. I'm worried about all those things. I'm worried about the trust and identity of the devices, the device to device communication, the device to human, the doctor to the device to the human, the human to everything. So I'm concerned about trust and identity, how we're going to maintain that and make sure we're vigilant about it. I'm concerned about privacy of data, whether you're in your home country or another country and what the different regulations are and how we're going to manage it. I'm concerned about protection and safety, how we're going to keep the human safe, how we're going to keep the device safe, the infrastructure, the financial side of the institution. If your device is hacked, everybody finds out, like some of the FDA and DHS and U.S. CERT recalls, and I'm concerned about the cyber security. So we have a lot to do as the leaders in this space for IT and for cyber security and for medical devices. So I look forward to continuing the collaboration we're doing through groups like this and also like the MIEE working group where we have over 250 humans from 22 countries and six continents who are worried about this too, including device manufacturers and providers and payers and regulators and everybody as we know Mitch. So I'm worried about all that stuff. What about the rest of you? Are you worried? So I'll go next on that one. Thank you, Florence. For me, it's actually very similar to what you'll find was reported out. I believe it was 2017 and what was the healthcare industry cyber security task force report. In fact, on that task force, I got to serve alongside Michael McNeill and several other individuals across the industry and produce a report that outlined observation and recommendations for improving cybersecurity across the industry in healthcare. And there was a specific section that was dedicated just for medical device cybersecurity. And I got to tell you, that was three years ago. A lot of those findings still apply to this day. And one that pops out to me immediately is that, you know, medical devices are in hospital settings for 15 to 20 years. But new cybersecurity threats emerge daily.  So there's no one size fit all approach. And, you know, at BD, we're working closely with healthcare providers on understanding medical device cybersecurity as it exists out in a clinical setting out in the real world. And we're also working, we're really committed to transparency.  But, you know, unfortunately, it's just not enough. There's a, there's really a long time span to medical devices in these environments. And so, increasing transparency absolutely helps. But we also need to build stronger relationships and stronger collaborations across, you know, for instance, you really describe across the continuum of stakeholders that we have when it comes to just using a medical device and managing it when it's in use. Yeah.   It doesn't change. It just, you know, kind of perpetuates itself. So as Rob just talked about, you know, legacy devices as we call them and in the, you know, in the ecosystem and how we manage that, you know, that to me ties right into what I've always said is, you know, sort of the three deadly sins that I've kind of communicated over time. You know, because you have these types of devices, you need to make sure that you can patch and update them in a timely manner. So one of the deadly sins, if I can patch and update a device, I'm not going to be able to maintain the security of that solution out in the marketplace. When I look at the types of devices and a number of them when they were designed and developed and they're in these environments, if they got hard coded credentials, those are the keys to the kingdom.  And then for us, when it comes to the type of information, you know, again, as I would say that Florence had talked about in terms of thinking of the type of data and the type of, you know, the information that needs to be held secure. If you don't do encryption and, you know, de-identify and make sure that that's not available to cause the kinds of harm, you know, to individuals to the solution itself, you know, you get to those deadly sins. So the sins are there and, you know, we're doing a much better job, I believe, in having an awareness around the design and how we need to build that into our solution set.  Yeah. So I totally agree. It's the products we have today. It's the new products and how we create design in plans so that you design in a defense and depth level of security at the hardware, firmware, software and service level. I suggest we go all the way down to the IP of the design of the chip, you know, we need to go all the way down and all the way up. And we also need, I know in the standards work we're doing, we're saying that we need to be able to look forward too. I'm, I'm an old rocket scientist or experienced, my girlfriends say not to use the term old, but I'm an experienced rocket scientist. I used to work on future missions around Jupiter. Did we know exactly what we were doing?  So in the standards work that we're doing, we're agreeing that it has to be a standard that is extensible into the future. You know, so what we're also doing is envisioning, well, how can we use it, you know, artificial intelligence and machine learning better? What about when it's a hologram and the doctor's like, oh my gosh, she's right here.  I'm like, how do you know that? You know, I'm in my pajamas. How did that just happen? Right? So when we're in XR, AR, VR, how's all this stuff going to play? And then if you want to get excited about protocols, think of what, you know, communications protocol, that's going to be all about. That's going to get into your EHR, or how they're going to read, you know, from your, from your devices. So we're also trying to think of what could happen. So being an aerospace engineer and designing, you know, not just spacecraft, but also planes and jets, you have your heads down display, right? Your altimeter. And then you have your heads up display. We need both. I am in full agreement with you and can tell you the biggest challenge I saw with all these years of working for healthcare and hospitals. I've been in the provider space for about a dozen years as a CISO and biggest challenge I've always found has actually been paying for it all because a lot of, a lot of hospitals out there, especially with COVID have significant financial challenges these days. And right now, I mean, every hospital has a problem paying before January or February of this year. You still would have had about, I'd say about half the hospitals in the United States, whereby I asked them to update good junketer clinical engineering equipment, they would have likely looked at me and said, when I can fix my roof, when I can fix my floor, and when I can pass the hole in the boiler, and what do you want?  And I've actually once had a clinical chair from the department sit me down and say, I'd like to update my devices, but I need to get different ones in here because I'm not able to do women's health proper. And it's to me that put a lot of items in perspective and I've always worked with my customers to make sure that we can get them on at least a good path to where they need to be using minimal cost solutions because to be very blunt, 15 to 20 years also because that's all they have money for. And that's sadly the situation used in the United States. And after things happen, after we have some leveling off with COVID, we're going to be in a much different place more like 2009 when it comes to the economy. But to get these good items in place, you need to have standards and that leads me to the second question, which is what should standards efforts are in play for medical device security that you're currently working. So again, over to you Florence, because of all the IEEE work. Absolutely. And I have to apologize. I have a robocaller who won't give up. So you're going to hear my phone in the background. So anyone else been through this? Hands up. So the standards efforts, we have a number of standards efforts in play. And we're trying to hold hands and work together. So at IEEE, we have this IEEE UL P2933, which is the project for clinical IOT data and device intraoperability with tips as we discussed. There are also efforts on blockchain for healthcare and how that plays in. There are efforts going on with ISO and IEC and open mobile health and communications interoperability. So we actually just had a really cool session last week where Mitch and I presented along with a number of our colleagues from around the world regarding addressing clinical IOT interoperability and security challenges globally. And so one of our colleagues representing underwriter's laboratories, after we each spoke about P2933, you know, this kind of IOT thing and then open mobile health and a few other things, he got up and said, okay, here's one page with like all this stuff on it. You know, we have a pyramid here, we have a triangle and we have all these other pieces. We have to figure out how we're going to work together. So if any of you out there are interested in getting involved in this, we're actually hoping to have a longitudinal plan here. We had Julian Goldman from Harvard and Mass General, who was on the panel, and Ida Sim from UCSF. We have Mitch, Nick, Ken Fuchs, Drager, Anura, Fernando from underwriters laboratories. And I always forget at least one. Oh, and Ken, I think that's most of it. And so we're all going to be getting together again in the fall and we're interested in anybody else who wants to join us. So Mitch, I don't know if we're giving out our email addresses or how you want to do that, but you know, we can. We'll find a way to make the P2933 web page completely accessible and get information over there. Get it out to people. So in the meantime, you can send me an email along with my robo caller at Florence at fdhint.com and I think I'm going to give them my email address so you're not so disruptive the next time. Hey, I just, Florence, I'm really excited to hear that IEEE is getting involved in this space. And, you know, it's exciting to hear that there's not enough that we can do actually to really formalize the process of medical device cybersecurity across the life cycle of these technologies. I would like to also recognize, you know, a lot of the work that the FDA has done in producing cybersecurity guidance documents over the last, oh my gosh, you know, many years. And so, you know, whether it's pre-market requirements for submissions and cybersecurity or it's post-market surveillance, right, and knowing how to do coordinated vulnerability disclosures, those guidance documents are very helpful. Also, very relevant today, you know, is cybersecurity for off the shelf software components. Again, you know, FDA has some good guidance documents on a good guidance document on that. Recently, and, you know, they've taken a very collaborative approach to cybersecurity and engaging very different stakeholders and a great example of that is, you know, FDA has engaged NTIA on creating a software bill of materials, standard and a set of deliverables around that as well. And it's all around how manufacturers can be more ready to identify vulnerabilities in third-party components and then extending that capability out to hospitals, you know, who have this technology in an operational environment. And, you know, the last thing, last two things here I'll mention is international medical device regulators forum. You know, it's not just the U.S. and FDA that's going through this problem. This is a global issue in medical device cybersecurity. And the international medical device regulators forum, INDRF, has come together to produce a cybersecurity guidance document that really sets to harmonize, provide harmonized guidance to regulators globally. So, you know, different countries and regions can set up their own guidance documents and map that to their own regulatory bodies. And the last one here I'll mention, I have to mention it because, boy, it was a lot of work, but the healthcare sector coordinating council and, you know, Michael also and Mitch, you know, were contributors to this effort as well, produced what's called the joint security plan, the Medtech joint security plan, otherwise referred to as the JSP. And, you know, in this document, you know, anyone can find, it's not just, it's not standard. It's actually a plan, a way to put in motion a security program from design, development, all the way out to, you know, complaint handling for medical devices and what to do when these devices are out in the field and risk management, again, throughout the continuum of care. So, if you want to know how to do a risk assessment on medical devices, if you want to know, you know, when to do a penetration test, what types of design requirements are helpful for a medical device and cybersecurity, how to structure your organization. You know, those things you can find in the JSP today and working with MDIC, we're also developing an effort to actually benchmark against those different capabilities. So that way, if you're a small, multiple device manufacturer or a large one, you want to know where to go next and how to build out your program and what's good enough. And so this benchmarking initiative with MDIC will help us create that set of metrics and again, the benchmark itself so that we can share it openly across our industry stakeholders and collectively improve our programs, be able to speak to our executive leadership, too, as well to have to pay and make and commit to this investment in melted cybersecurity. That sounds really cool. Do they have guidance for manufacturers as well as providers? So, a healthcare sector coordinating council also has a, yes, guidance for healthcare providers, too. It's called HICUP, H-I-C-P. And then you have the joint security plan, which is focused on melted devices and healthcare IT solutions. And so, yes, they have guidance for both set to stakeholders. Right. And yeah, so as Rob stated, the IMDRF also, the way it was documented, it addresses, here's what's the pertinent areas for the manufacturer, the health delivery organization, the different stakeholders, even patients, as it pertain to the different topics that was put into that type of guidance. And again, that one was was global. A couple of others that I would just want to make sure that we have included when you talk about health delivery organizations, MITA has always championed and updated their, you know, MDS2 documentation, which is utilized for the procurement process with health delivery organizations. And that MDS2 is something that has been maintained as a part of the release schedule and with the inclusion of the SBOM as a component and a deliverable of that, it gives organizations like MITCH's the ability of being able to understand the ingredients of the product and the solutions that they are acquiring and how they need to develop and execute that. And then as Rob said, the AMI organization has taken on the ability of taking a look at some of those, you know, pre-market and post-market type of guidance documentation, and then they created their technical, you know, references in their TIR 57 and 97, which allows you to provide some of the how-to on those different stakeholders in the industry, how they need to execute against those particular technical references and standards. So I think that kind of, we gave you the alphabet soup and then some. Yeah. Absolutely. Those excuses now. Yeah, I can tell you that 2019 MDS2 form, thank you very much for that, Michael. That's been incredible in our organization. We've actually started using that a lot. The first vendor that actually gave us one was Philips. So very happy that- I'll put the old pets on the back for that. We're starting to get those in from our vendors and they've been helping us out with a lot of new purposes. So this is my next question here, is what are the most difficult medical device security issues to solve? Want to throw a real ringer in there? Okay, go ahead, Rob. Yeah. Yeah, I'll take a first stab at that. So I think one of the most difficult issues to solve, just to change it up here aside from, and it does relate to, you know, the issue of legacy malware devices is also that hostile environments may have hundreds of thousands of connected malware devices at one time and from thousands of different vendors. And so while I may not directly feel that pain, I feel for our customers at BED that our healthcare providers and have to manage this tremendous complexity. And what compounds this situation is that not every medical device manufacturer is doing things like patching of their medical devices or routine updates to their medical devices. And also that's why transparency is so important because these new threats emerge daily. And boy, I'm sure there's a lot of homework that healthcare providers have to do when a new security vulnerability pops up. And you don't find a timely and effective or meaningful communication from a medical device manufacturer to facilitate a response. So yeah, I think those are really, really important issues that we need to address. You know, one of the things I would add on where Rob is at, and again, I do agree that the level of connectivity and the complexity of the type of solutions is definitely, you know, a critical one. But let me be a little bit more provocative and throw something else out there. I think when you look at potentially, and again, you know, and this gets back to again, I think where Florence was at when we talk about taking it down to the chip level when I think when I look at the greed that exists in society around, you know, the revenue that either wants to be made or maintained, you know, on devices and then what that would be from your brand and impression. I think one of the best things that happened was the fact when, you know, the health sector coordinating council and HISAC and others have come together and petition organizations like Microsoft, especially during this time of COVID to extend, you know, the patching and the updates for Windows 7 and to make that, you know, date in the hospital sector, you know, not, you know, you know, to extend it. So the more that we can do activities as a community like that to either extend the life or to be much more economical around how these, you know, products and solutions are being used. And again, my provocativeness, get away from the potential greed that, you know, might exist out there. I think that'll help us, you know, to try to address, you know, some of the issues that might exist, you know, in the ecosystem as one thought. Safe. Florence, you got something? Yeah, greed and jealousy are motivators, you know, that we can use in business to get people to do things. And so there's always, it's the human condition, I think. So if we could figure out how to leverage that, I think that would be good. So in the standards work that we do, you know, it's IEEE, it's at the individual level, it doesn't cost anything to join the working group. And what I tell people is, you know, this will be like a take home test if you get involved now, because you can help define it, you know, and then you could be the first ones to have it. And you could be at the leading edge when, you know, I was at Yale New Haven a couple years ago talking about this TIPS framework, and very bright as they are, the chief information and chief medical officers looked at me and said, so do you have a TIPS maturity model that you could hand us today that we could use tomorrow to look at all these hundreds of thousands of devices in our hospital and our patients? Like, whoa, I wish the answer to that was yes, but it's going to take a village, right? Ah, the biohacking village, look where we are, how handy is this? So maybe that's something, you know, we can end up working on together, and people can get involved in creating this TIPS maturity model, validating it, certifying it, you know, maybe that's, you know, what we can do is get other people jealous, like, ooh, ooh, you know, I want to go to the head of the class. That would be great. I agree with you, and I think, and again, there's other challenges as well. I'm going to be just as provocative as Michael right here and bring out another big one, which is the electronic medical record systems of record themselves. So we have to make sure that the systems of record that we eventually store all this information in, we have to make sure we keep them as updated and up to date and able to support these devices just as much as the devices themselves. There was actually an interesting paper I read from the late Michael Sinnoh and some other people that had put together this model for electronic medical record system implementation at a health system in New Jersey they were at. And what it came down to is that 25% of the cost was the EMR, 75% was the cost of the ancillary devices themselves. So I think we could stand to make sure that we have a good budgeting model that we make sure that we understand what devices work, what version of an EMR and be able to cost it all out. And we can solve that challenge with simply doing a lot of good financial work and making sure also that the system of record aka the EMR also stays updated, easier said than done. So talking about challenges for the future leads to question number four, which is how do you solve the challenges today with an anticipatory eye on what the next threats may focus on that right here? I'll start off again with Florence. So heads down display, heads up display. What is it you're trying to deal with today? And we have, we'll start with that. And we have to have the guts to look at what we haven't done yet. And we're all talking about standard this, you know, we haven't done this snow med and low ink and this and that and firing it till seven. Oh my God, this episode is so incredible because people are brilliant who created it, right? But it's not done. And it will probably never be done, right? Because there's a lot of hacking that, you know, continues to evolve as we know. The bad dudes and dudettes and robots are just as smart as the good ones, unfortunately. So what we have to do is not be afraid to look at what haven't we done yet. So as an example, so we're talking about trust and identity and security and devices. So what if we had, you know, what if we figured out a federated identity management system for devices with, you know, digital identifiers, decentralized identifiers, UDIs, and we try to do that globally? People go, Oh, we haven't done that yet. I'm like, exactly. That's exactly the point. So is that exactly what we need? Maybe not. But go wide and then decide, you know, how we start today and where we need to go. So we have the guts, we have to have the guts to say we haven't figured it all out yet, figure out what we can do today, and then build a step function, you know, a plan going forward. And, you know, you should, we should do some brainstorming, like I was about holograms and VR and AR and XR and UR and my R and all this other kind of stuff that's going to happen. And stuff that we don't even have terms for yet. They're going to be part of this. So I'd say that, you know, we have to start by being brave enough to understand what we already have from Amy and ISO and IEC and IEEE and all this other cool stuff and all the providers and all the manufacturers. Then look at what we haven't done yet. Have the guts to do that, figure it out and then create a step function toward the future. So that's my recommendation. Yeah, I love the comments from Florence and the direction. I've built a few homes because of having to relocate. And I always look at what your current environment is as an organization, as a team. And to her point, I want to make sure that foundation is in place. And one of the biggest hurdles is to be able to consistently execute in a number of these organizations, you know, that foundational piece that she described, you know, in terms of making sure that we're doing consistently the activities and efforts that we should have in place right now. And so when you have, you know, multinational organizations, different business units, different variations of releases and schedules of products and devices, different mixes of, you know, solutions, whether or not they're, you know, capital related or implantables. And I mean, there's a myriad of things that exist out there. But you have to be pretty consistent with how am I developing that solution? How am I maintaining that? How am I updating that? How are we interacting and getting the right information at a consistent level, like those MDS-2s updated, you know, on that entire product portfolio? That's the basics in terms of the blocking and tackling, you know, that usually isn't the most sexy thing that you think of, and sometime is really overlooked. And so we really need to get that foundational, you know, areas in place across all of the elements of, you know, as we say in the ecosystem, you know, for devices and solutions. And even as Mitch just pointed out from his earlier statements around, you know, the electronic health and medical records, you know, Rob and I know that our counterparts in some of those entities, when we were on the cybersecurity task force, it was like pulling teeth to get them to want to even come to the table, you know, and having the discussions. And even when you have certain solutions where we are there was astonished to say, man, you had the ability to maintain the certain level of the release and not go back multiple, you know, inversions, but you did that to increase the, you know, to want to be supposedly, you know, in compliance and supporting your customers. But you were doing a total detriment to the industry by not aligning and forcing that you couldn't have stuff out there. But they were in a much easier position to maintain their devices at the most current levels and updates.   So don't hold back, Michael. It's DEF CON. So when I think about what we can do right now, I think about the current environment that we're in. And it, you know, touches on a little bit of what you've heard from others on this panel, actually, you know, we're in an environment where I think most of our organizations, if you work in healthcare, we're distracted, really distracted. If you're even just the general public, you're distracted, okay? COVID has taken a lot of the focus away from other things, like cybersecurity. If we're not careful in tying the story behind how cybersecurity is the underpinning to providing a resilient and thriving healthcare system, it's just essential. We can't have resilient and effective healthcare without securing it. They go hand in hand. And I say that because the other issue we're facing here is that, you know, most healthcare delivery organizations don't even have a single person dedicated to cybersecurity. And this is one of the findings of the healthcare industry cybersecurity taskforce report that went to Congress in 2017. So there's not enough people working in this space. We need to bring in more stakeholders from different backgrounds into the healthcare industry and into the cybersecurity industry to really, and even if it's not their title, but to build a community of practice around everyone's shared responsibility around cybersecurity. And the last thing I'll say from the stuff that we can control us, the cybersecurity professionals, I think especially, you know, Michael and Mitch and myself, we need to as healthcare and medical technology companies as healthcare providers, we need to look at our investment in security and ask ourselves this, are we protecting what society values most? And if you ask anyone, what is important to protect in healthcare to protect, they will tell you most likely even, you know, even if it's my mom, all right, she will tell you, it's probably going to be patient safety, patient health, right? And probably also patient privacy, you know, and so, you know, there's, so look at our investment today and figure out if there's changes that we need to take in our approach. And maybe touching on Florence's, you know, idea there to make it even more tangible around creating some sort of model for identity management in healthcare, you don't have to go too far. I mean, there's, for many years, the cybersecurity industry has been talking about what's called zero trust principles. And so, the idea behind zero trust principles are, you know, instead of trusting devices inside the network, you know, in this approach, it means trusting no one by default and operating as though the network had already been compromised. And so, this means incorporating different types of criteria for authenticating and authorizing users. And the fundamental technologies exist today. It's just changing your strategy as a cybersecurity professional to focus on the idea that you've already been compromised. And how do we strengthen authentication through multi-factor authentication, through conditional access for devices and users connecting to the network. And so, those types of technologies exist today. There is hope in, again, what's available to cybersecurity professionals today. But I would also go back and say, we need to expand our community of practice. So, if we get all geeky-weeky, which we could do with each other, fire this, and HL7 that, and we're so cool, and to see that, and, you know, trust zone and hardware with the trust, they'd be like, whoa, I was sitting next. I got upgraded for free one day on a plane when I was flying planes. And I was sitting next to a guy who runs a hospital, a doctor. And I was telling him what we're doing. He said, well, you know what, I'm glad you're working on that, because my job is to keep that patient on the table alive. That's what I focus on all day. So, in our, in our working group, our IEEE P9, 2933, and UL Working Group, actually, it's all about, we always talk about it, protecting the humans, keeping the humans alive. That's why we're doing this. That's exactly why, you know, my background, my mother died the day I was born. It was a medical error, you know, whole stuff here. So, I carry this with me. How do you keep the humans alive? And that's what we're focused on. And if you actually read our project authorization request at IEEE, it says to improve health outcomes. We're not doing this for us geeky-weekies. We're doing it to improve health outcomes and to keep the humans alive. And eventually what I would love to see, and we actually had a meeting in my last firm and with Microsoft a few years ago, we were talking about creating like a cybersecurity learning hub for humans, you know, normal people.  And we said, ah, that's kind of rude. Let's say pre-K to AARP. And we're going to teach them what tips is. You know, so when I was a little girl, remember I'm a geek. I was a rocket scientist. So I used to look for the little UL tag on my electric cords. Any of you guys, I did. I always looked for them because that meant safety, right? And so what we want to do is teach them why they should ask for this. So someday, I don't know if it's two, three or five years from now, some little five-year-old is going to be at the doctor and they're going to try to give her an insulin pump and she's going to say, does that have tips? And she doesn't need to know what it stands for. We do. We're the geeks. We need to understand that it's trust and identity and federated identity management. And when the doctor, you know, goes into the little device next to grandma's bed that goes into her and plant a pacemaker, you check the credentials of that doctor every single time. You make sure they're still, you know, related to whatever their provider is. You make sure they still are credential. You make sure it's really the doctor and you have to figure out how to do it. So that's our vision is that we really want this to protect the humans and make the humans aware of it.  And then make sure that the manufacturers are delivering that because then you have demand. You have push and pull from the citizens, from the patients, right? And then the providers and the payers should care about this. It reduces their liability. You know, I used to work on smart buildings years ago when we were first creating the smart building strategy when I was a VP at IBM. And I remember, you know, we were talking to these building management system companies and one of them said, Oh, you know what? Security is like number 11 on my list of top 10 things to worry about and their device was hacked nine months later and the whole leadership team was out. And now it's part of their brand promise. Oh, imagine that, right? So we need to make that a requirement. You know, we need people to be incented to do that and to have the citizens and patients asking for it. Absolutely. Florence and also one other thing that my organization's had a big challenge with has also been privacy because one of the areas we've got to worry about is not only do we have, we're collecting all this data on people and we have numerous data points on all of the people we're collecting from these devices and we need to make sure that we're protecting that. So important question I have here is what about privacy? How are we incorporating this into our products? How are we incorporating it into our data governance plans? So lead off here, I believe this can be our final question for the three of you. So start off with Michael. Sure. I think that the, you know, privacy takes on, you know, from a legal perspective, you want to understand, you know, the requirements by the different geographies, by the different jurisdictions, by, you know, what the hospitals and the, you know, the different entities have in terms of managing that type of information. But to me, Mitch, it's nothing more than another component of your requirements. So if you design privacy as you would security by design in your development process, you take into account what are those sets of requirements and you have to harmonize for, you know, some of us, you know, like, you know, Rob and I and others out there that deal in multi, you know, geographies, you know, multi types of regulatory and compliance environments and you have to develop what your baseline is. And then once you develop that baseline and you include those sets of requirements, I would look at the steward of, you know, the CISOs, you know, and it's three of us on the call to be able to make sure that we're executing against that. We go to our legal teams and the privacy organization, really for that foundation to make sure that we're interpreting those requirements and we're executing those requirements, you know, effectively with the tools and the solutions that we then deploy out in the marketplace. And so I have always had, you know, kind of a mix of the privacy and the data protection elements kind of be able to be co-mingled within, you know, the team operationally. If you do it right, you want the CISOs side of the house to be managing that and you want your legal and your compliance arms to be able to help you develop and, you know, and document what those requirements need to be, you know, from a privacy perspective, in my opinion. So I gotta tell you, I don't think I could describe it any better than Michael or I should say Professor McNeil. It's so well said, really. I can't do better than that. I mean, you know, to address privacy requirements alongside security requirements, I absolutely agree.  And then also, you know, vice versa, actually. And so I do like, again, what Michael said around, you know, bringing your legal professionals, especially, you know, when you're addressing privacy requirements, the complexity is, as he mentioned, this is different across every single country. And you do have to, you know, establish as a company, a common foundation based off of values, based off of values and principles, you know, as a company, what do we stand for? What is it that we want to do when it comes to this civil rights issue, you know, of privacy? And sometimes that means we want to do everything that we can. And we are going to establish, you know, the strictest, you know, governance of privacy across all of our technologies and product platforms, you know, that is, again, a decision that companies need to make. And I gotta tell you, I don't think there's many customers that would complain, you know, about, about a company creating a position and a very robust and comprehensive position on privacy across their different technologies for customers. So. Agreed. So I'll make a couple of comments. I'm sorry. I didn't agree with you. So what do you think? Oh, you know, Mia, I always think something. So there are a couple of things. One is on the privacy side. It's one of our subgroups. It's part of tips, you know, choice identity, privacy, right in the middle of protection, safety and security. And we have a woman from the European Union who's leading that subgroup, which is great, because she actually found the privacy rules by country in Europe. Not surprising, right? So what we're doing is making sure that we're going deep on those, identifying the patterns, and then figuring out what are the little things we have to worry about here if we're creating a standard that's international. So if I'm wearing an implanted device, I'm in the U.S., I'm in the U.K., I'm in Russia, I'm in China, I'm in South Africa. Am I going to be safe? You know, is my data going to be private? What does that mean? What are the implications? So we're already baking that in to the plan. The other thing is that I was at an event at my alma mater at Princeton and Sonya Sotomayor was there. She's a Supreme Court Justice in the U.S. for those of you who don't know her. She's brilliant. And so I asked her, what do you think about privacy and security and the Internet of Things, all these devices all over the place? I said, I'm working on security. She said, that's good, because I'm working on privacy, because I don't think the citizens realize the human rights that they're giving up. Very interesting. So she's on it. And she's already written a couple of things on it, if you want to look at what she's done. And then the other thing I just want to mention very quickly, we were talking about, you know, what's our goal here? I spoke at an event at academic medical center conference a few years ago, and then about a year or so ago, a gentleman reached out to me and said, oh, I wrote a book and I found your presentation, and I refer to you in my book.  What's the name of your book? The Doctor Will Kill You Now. And he talked about the security and privacy issues, and this guy who like, you know, lives in his mother's basement and then moves to another state. It's not bad living in your mother's basement. I have that going on too, but moves to another state, fakes a PA license, gets into a doctor's office, gets into the system, actually turns off the power in the hospital so someone on event dies. Then he gets into somebody's personal medical record, changes his blood type, they're given a transfusion and they die, and then his next target is a children's hospital. So if anybody is looking at, so why should I worry about the security and privacy stuff? That's a good book. It's only 15 bucks. And the guy who wrote it is an MD, and he used to lead the IEEE chapter in Rochester, New York years ago. So he, you know, he's on both sides. He's an electrical engineer, computer scientist, more doubly, and then, and then he's also a doctor. So we all have to work on this. This is serious. It's just going to get worse. A lot more things are connected. There are attack surfaces all over the place. We need a defense and depth strategy, and it's for privacy and security and protection and safety. And impressed by the depth of knowledge everyone brings here. And I speak from the provider perspective here. I'm very happy to be working with you all, especially from the standards perspective as well. I think we have a good foundation. We just all need to continue to keep working together. And you have my commitment. And for all of you in the medical device industry know you have my organization's commitment as well. So thank you so much for all taking the time today. This is incredibly appreciated. And I hope all of you out there appreciate this today as well. So thank you all so much for taking the time. And this is the group here signing off.


and welcome back welcome back as you can see on my background we have the band and this is a special kind of band not your ordinary band it has some under age if i can call them that the youngest next to me being four years old and she's called joy i don't know if you're ready for this band i hope you i'll just introduce the main leader the band master band master yes tell us your name okay my name is Daniel Mutua from AICU Moja trainer of the AICU Moja brass band yes all right so this is AICU Moja brass band and we are ready for them i'll be back but now i just want us to enjoy the music would we take it away yes no problem all right let's have it in three two one you asked for great and Daniel this okay this is AICU Moja brass band and in case you don't know what a brass band is this is a brass band different instruments making melodies making you know singing without singing it's so beautiful and people some of them will be leaving but before they do or as they do Daniel will tell us you know tell us about the group we have two sets right so this is the first set that are leaving and some others are coming in tell me about the group a little bit about it well AICU Moja brass band started the 2016 it's part of a cd groups in the church we have the juniors we have the seniors and we have the middle age okay yeah so everyone plays band in our church AICU Moja okay yes most most of the ones that are here are the middle age yes the young ones pre primary primary and secondary preferring primary and secondary joy i have the youngest one here she's very cute just like the rest joy but we have one of the one of the members i don't know if he's already left yes Alan you know i also want him to tell us about the group his experience here yes a little bit about group is it your passion my name is Alan Killonzo i've just finished my closet i'm anticipating for the results wow look at Alan waiting for the results now he could just perform i joined band in 2018 i just saw how they played and i i gained the passion of playing the band you just fell in love with it yes what what instrument are you playing connect connect connect yes okay connect okay uh there are different types of instruments that are here daniel to and be about the different uh types that are here no what do i live with well each instrument has its own sound let me just use layman's language we have in band we have a soprano that is played by the connect we also have the soloist those who solo use the solo connect we have a baritone baritone baritone negani baritone yeah is the tenor voice in the band okay it can be played by either the baritone itself or trombone we have trombones that play tenor where the trombone the trombone is here there all right then we have the euphonium euphonium doubles up can play bass can play tenor tenor can play bass one bass two depending on the player okay whatever he wants to play then we have the shakers for the young one joy do the shakers play the shakers yeah we have the bass drum just behind you okay this is the bass drum no or this is the bass drum the big one is the bass drum terrible with music ahead and then we have the side drum side drum is this way all right all of them the pandia drums is in itangua percussion yeah all right this is quite interesting incredible you know when we think of a band to talk to higher bands you know to create a big band but you guys do you perform in you know in events do you go with them to perform in events ceremonies yes we do events both the either be hit government event barrio um wedding birthday any kind of event that you need a brass music call aicu moja we will come and serve ours is purely ministry so anytime we are playing the band we enjoy serving god through the brass so yours is purely ministry so any events in like the event should be in line with what you're doing right yeah of course uh calling us you'll part with some amount that we call a maintenance fee and yeah you will facilitate some uh few things okay because after another it is a free after all they are kids but yes they well this is what they're doing yes which is amazing um back to you alex island how is it working you know how is it uh being in the band how hard is it the practice before you got to know the instrument um in the beginning it was right hard for me to get good luck and i so it's it's it's for me to play this um i just have to encourage you not to to i have to encourage you not to give up give up yes and just come just come and you will be blessed all right do you want to play for us a little bit not to yellow with something small not to scare this is the connect connect yeah connect again all right now that's the connect can we also have a a little bit of everything the tone and again yours that is the baritone baritone aha then we have hers hey remind us yours is the trombone i know the side drum to funny a side drum hopper okay that's the side drum to to lisha's can shake us which one am i missing the euphonium euphonium you know how complicated okay so all of this sounds together you know make the make the band yes do you have the trumpet yes it's uh elisha or this one yeah no i always thought the trapeze a big one took some of our bible the trapeze will be blown tonight imagining it let's have the trapeze right now all of that makes the band now we want to hear from the second lord that's coming in please come in please come in so that's me and you will just hear them listen to the music and then move on from there they're coming in they're coming in from this side yes yes and i wish i knew all your names but you're awesome you're doing a great job come in come in there we have it none of your older older ones are coming inside all right so the song that they have played so far is nina siri nina siri your plate and the other one so what do we have for us uh now daniel now we are going to do a swahili medley it's like a praise it's like praise yeah yeah but the old school ones yeah yeah i hope you will enjoy yeah so yeah and before they start in aisu moja we have a leadership so we are under reverend jeremia moaki yeah our cd pastor who is a reverend ilove and then we have uh pastor roda mga yeah so those are our pastors and the entire congregation we must recognize them okay very important thank you we we know we appreciate that the church can support such a noble cost you know we we definitely don't take that for granted seeing young people young children using their talent so now i will allow you to perform and then close for us this interview before we get to the next all right ready to take it away yeah all right i am ready to listen enjoy


The use of artificial intelligence, AI, techniques has enabled researchers to identify and characterize populations and subpopulations of different cell types in hearts recovering from myocardial infarction, MI. AI auto-encoding separates data from different cell types and subpopulations of cell types, cluster analysis. AI sparse modeling identifies genes and signaling mechanisms that are differentially activated between subpopulations, pathway, gene set enrichment analysis, and AI semi-supervised learning tracks the transformation of cells from one subpopulation into another, trajectory analysis. Auto-encoding was often used in data denoising, however, in our pipeline, auto-encoding was exclusively used for cell embedding and clustering. The performance of our AI SCI Nasek toolkit and other highly cited non-AI tools was evaluated with three SCI Nasek datasets obtained from the gene expression on Nibus database. Auto-encoder was the only tool to identify differences between the cardiomyocytes subpopulations found in mice that underwent MI or sham MI surgery on postnatal day P1. Statistically significant differences between cardiomyocytes from this article was offered by Ton Nguyen, Yuhua Wei, Yuji Nakada, and others. We are article.tv links in the description below.


The following video is approximately five minutes long and includes audio description for people who are blind or have low vision. Title card. This presentation was prepared under federal financial assistance provided by FEMA's Grant Programs Directorate, U.S. Department of Homeland Security. Points of view or opinions expressed in this video are those of the authors and do not necessarily represent the official position of policies of FEMA's Grant Programs Directorate of the U.S. Department of Homeland Security. Title card. Cal OES Logo, Governor's Office of Emergency Services, host in Wheelchair. Hi, I'm Richard DeVelder, Chief of the Office of Access and Function. I have the California Governor's Office of Emergency Services. I'm speaking to you today from the California State Operations Center. The typical response during an earthquake drop cover and hold on may not be the right choice for those of us who have disabilities or are older adults with other functional needs. Earthquakes strike suddenly without warning and they can occur at any time of the year day or night. Nearly every state and territory in the United States is at moderate to very high risk of earthquakes. In the event of a major earthquake, the damage it can inflict could include power outages and down power lines, gas leaks, fires, broken windows, and falling objects which are dangerous for everyone and could be a greater threat to people with disabilities and older adults. We must plan for our response as if no one is coming to rescue us because they are not. It is unrealistic to believe that there are enough resources for everyone to receive assistance. Those of us who have disabilities or are older adults need to adapt earthquake preparation and response as the decisions we make could save our lives. The following simulation is for individuals with mobility needs. What message would you like to give to others who have mobility disabilities? Well I'm pretty independent but this whole experience has taught me that I may need to be a little bit better prepared and get to know my neighbors better. Yes it's very important for your neighbors and those around you most of the time know how to assist you in an emergency. We have just seen an example of how a person with a disability or older adult should respond during an earthquake. Have you thought about this scenario and made preparations for what you would do? Let's always remember that we are not helpless and we can take control of our plan and our response. Practice as if no one is coming to rescue you. You are in charge. A simple buddy system is not enough. We need to build a support team, which include neighbors, coworkers, friends and family. Have practice sessions with them to ensure that they can help you. Know what you need and be able to quickly provide instructions to others on how to assist you. Plan for all disasters. Think about what needs you would have after a disaster. Would you need to evacuate or shelter in place? What if technology fails? What if the power goes out and you no longer have cell service? Then why? If you have a family member with specific emergency preparedness needs, think about all the different scenarios that could affect them. Be realistic. The government does not have enough resources and responders to help everyone. If you need to evacuate, how can you leave the area? What if you cannot independently get downstairs? Do you have family, neighbors or friends to assist you? Practice with earthquake drills. To know it is to do it. Being ready to evacuate or shelter in place is the key to staying safe in an emergency. In your plan, don't forget to build an emergency kit with essential items you need to keep with you. This includes medications, any consumable medical supplies, a whistle and something very important. A USB drive that includes important documents like your most recent medications, a copy of your driver's license or ID, emergency contacts. I really hope you take this to heart.