to Think Tech. I'm Jay Fidel. This is Keeping the World Company today and we're talking to Gene Rosenfeld who is an independent scholar, a history professor from UCLA who is in Hawaii. Gene, welcome to the show. Thank you, Jay. Today we're going to talk about the vision, the agenda of Xi Jinping and the Chinese government, the PRC, and how that feeds into the world events maybe to follow. But I think before we ever get to that, you have to help us set the stage and give us an historical perspective of where China, how China got to be where it is today. Well, that's an enormous question that Chinese experts can address in their seminars. Generally speaking, China is one of the oldest continuous civilizations on the face of the earth and one of the greatest. We have to admire China except China. Democracy is a relatively new creation in the history of the world. And prior to the French Revolution, let's say, it was unknown. So most of human history has engaged with autocratic systems. And we can't judge China because it has an autocratic system. We have to judge China in its own terms. Also, the second point I would make is that for most of its history, after it has established its borders, of course, particularly on the Eurasian continent to the West, where there were different peoples, China has not been externally aggressive. We have to be very careful how we interpret China's moves today outside of its own borders as we recognize those borders. Because in the context of great powers, China has not been externally aggressive. In fact, if you look back 100 years, Japan has been much more aggressive than China. So that's the second thing. The third thing is we have to understand that China developed independently of the United States. We talked about Russia last week. Russia and the United States histories have been intertwined at least since the early 19th century. This is not the case with China. Our interactions, our relationship with China is very recent and post-colonial. So taking all those things into consideration and the fact that this is a closed government and a closed system to the outside world, everything we have to say today must be taken with a grain of salt. Well, let me remind myself that there were books written about this, popular books, about China's economic prowess and its global trade, and I guess its acquisitions back in what, the 16th century. And it was a world power of sorts back then. And then it declined as a world power as you get closer to the 20th, 21st century. How did that affect things? I mean, do people in China know about their past glory as a global trading partner? People in China? Oh, I'm sure.  As a matter of fact, reminding of the Greeks, who really thought they were superior to every other people in the world. And there is a certain amount of comparison, Europe, Greece, vis-a-vis China, Eurasia, or Asia, I think. So, yes, I think there's an enormous sense of ethnic identity and pride in China. Yeah. The other thing is, you know, I know this is popular culture, and I hate to throw references on popular culture, but if you remember Steve McQueen and the Sand Pebbles movie way back when. And the lesson was that the U.S. was really unfair. The U.S. had treated China and the Chinese badly. And I think there's a lot of truth to that in the 19th century, I guess. And query how much of what happened then, if the United States, and probably Europe also, you know, carving up China, being very aggressive against China. How did that affect this sense of, what did you call it, a government that people turned in on itself, kind of isolationist mentality? You know, we're talking about colonialism now. And the British were far more aggressive than we were in China. I really don't think we had much of a dog in that fight, except as a Western colonial power, of course. But as I've pointed out before, we have to sort of pat ourselves on the back a little bit as a colonial power, because yes, we have acted colonially, but we have also returned our so-called colonies to their people and given them independence from other great powers. So as far as I know, we're the only great power that has done this. I mean, you can argue that Britain has done this under duress, but Britain was far more extended into colonization than we were. So, but what happened was that the Chinese are a very proud people and deservedly so. They had a great civilization, they still do. What happened after World War II, though, is we cast our lot with the nationalists, Zheng Kai-shek, not Mao Zedong, and the Bolsheviks won in China. So the near history of the relationship between China and the United States is very fraught, very conflict-ridden, and it still is. We raise those tropes all the time. I have to give Richard Nixon and Henry Kissinger credit for opening up diplomacy and trade with China today.  So, okay, so Mao arises to power after World War II, and he beats off, you know, Zheng Kai-shek and sends him to Taiwan, whatever. But what's left is a communist government, and I'm just, you know, connecting dots, but it seems to me that Mao's concept of communism, the way he set things up in China, the way he established China in 1949, has to be with a tremendous amount of influence from Russia. That's where it all came from. That's where communism came from, although certainly his brand is different. Yes, the Russian Revolution happened first in 1917, and it provided a model for other communist parties to follow. There was a great deal of inequity, inequality in the world, and people seized upon the Marxian explanation of this, the dialectic of this, the opposition between the worker and the dominant party elites to justify or explain what was happening in their own countries. But we have to look at communism in China as communism in a Chinese context, and the great history of China. Anything China takes into itself from Buddhism to trade from Europe in the Middle Ages and opening up to, you know, the Catholic Jesuits that were there at that time, close to the emperors, or what is happening today. China gives it a uniquely Chinese cast brand. They recast everything in their own terms. So if we really want to have optimal relationship with China or avoid disasters with China and our own stupidity sometimes, we really need to study China and understand how the Chinese have operated for thousands of years, because they're still operating that way. I mean, to some extent Mao Zedong was a warlord who succeeded and took over the government. And that has happened in numerous times over thousands of years in Chinese history. There's a concept called the mandate of Kevin. And if we look at Xi Jinping today, he is disappearing, high officials, notably even the ones he himself emplaced a little over a year ago, the minister of defense, the foreign secretary, they're disappeared somewhere. I mean, they're probably alive, but who knows what's going on with them. It gives us pause that perhaps there's something going on in China today, a certain fear of instability. When the dominant government fears instability, it's usually because of disasters or famine. And then conflict occurs. And these conflicts have been among the greatest conflicts in history in terms of loss of life. They haven't been external, they've been internal, but millions, hundreds of millions of people have died in the eighth century, in the 19th century, and the centuries in between. Even more so than other countries, because it has a huge population and the numbers that die are just proportional even to what we see in the loss of life in World War II. So a lot of the carnage that has taken place in China has been a result of the loss of the mandate of Kevin. We can translate the mandate of Kevin, which originated about 1000 BCE, with the Zhao dynasty as a divine right for the government to exist. And then philosophers seized upon it as a reason to question the justice of the current government and to give rise to rebellion. And the current administration is an absolutist administration, which they always are. And yet, maybe feeling some concerns about the mandate of Kevin right now, because there's huge shake-ups going on and posturing. And for the first time, we have seen some aggressive external moves on the part of China. Well, it certainly sounds like an autocracy. It sounds like what happened in Russia years ago and what's happening in Russia now. But what strikes me is this, and this may this may be a little off the path, but when you live in the United States and you enjoy civil rights and freedom of expression and economic opportunity equal economic opportunity. Despite the fact that we have a conflict, we are a conflict society. We've been fighting with each other for a long time from the beginning. But we have a certain concept that is realized of freedom. If I live in China or Russia and I worry about being turned in, I worry about being targeted politically, I worry about being disappeared for no reason without a trial or any sense of fairness or justice. I conduct myself differently. I am much quieter. I don't speak out when I see that people who do speak out are disappeared or punished or banished. And I think that affects everything in the society, doesn't it? It certainly affects everything in our society and it's got to be affecting their society, right? You know, my research on fascism based on a source from a woman who lived during the time of Mussolini and lived in Germany during the time of Hitler, perhaps the only person who have done that, brought home to me the fact that people do self-censor when they're living under an absolutist government. Yes, you're absolutely right. And we talked about the Russian population being hesitant to join the Progression Rebellion because they wanted to step back and see and wait and determine who was going to be top dog first. They want to go with the top dog. What people, what people, the Chinese culture values prosperity and stability. If all you have known is a government that is absolute, if that government provides for you and yours to the point where you can live a normal life and not worry about politics. And all that government asks of you is loyalty and stability and it provides you with the means of two prosperity, which is, I mean, every Chinese public ritual is resolving around prosperity, which is why there's such good trade partners or bad trade partners as you want to look at it. But at least their ambitions are to be prosperous. So with that in mind, we can tailor our approach to China and our interactions with China, respecting where they're coming from. Well, I'm thinking of, for example, the scapegoats that we saw under Hitler, and for that matter, Stalin, including Jewish people, minorities, what have you, who those guys had no compunctions about doing genocide. But we have the Uyghurs now in the west of China, and we have anybody who would speak against China or the government and they become, in a sense, not a good parallel, but it is a parallel. In a sense, they become the scapegoats. They get attacked for this false corruption kind of charge, and who knows what, inability to fully support the state, perhaps, communist kinds of deprivation of civil liberties. But where I get stuck, and I hope you can help me with this, is that what's the connection between this mandate of heaven and the notion that economics are everything and the well-being of the individual and his family is top notch on the list of priorities. Where does that connect with the South China Sea? Where does that connect with the Belt Road Initiative? Where does that connect with the clear, obvious, nefarious aggression that China has been demonstrating in recent years? Where does it come from? Is that part of the history you're talking about, or is that something that's been generated more recently for some reason perhaps rooted in history? Well, big question. Ultimately, you have to say, I don't know where that comes from, because as I noted, it's not necessarily the way China has acted in the past. We have to look to ourselves, I think, more as to why China is doing this, in what context, and also we have to look at China's relationship with Russia. You pointed out earlier that the impetus for Mao Zedong's revolution was Russia, in terms of the philosophy and ideology, which is mainly what I study in history, because ideology is what motivates people, and it can change history. I think, too, we have to look to Russia today, and again, go back to what we were talking about last week, Putin's vision, and China's vision are like the Venn diagram. They overlap strategically in very important ways, and then there are important ways in which China and Russia are historically and perhaps just generically enemies. They're close neighbors in a neighborhood that is an autocratic neighborhood and a very nationalistic neighborhood. China and Russia are in and out, and in and out, but they have a common enemy now. If you can unite your people ideologically around a common enemy, and you can characterize that enemy, and then fashion a seductive recruitment policy for other countries. I'll give you just one example. Putin's vision is that the United States is the great hegemon in the world, and the United States and its satellites in Western Europe are responsible for an array of injustices that still exist in equities, poverty, all the inequality in the world, and they sell this message to the Bricks countries to Asia, not Asia, parts of Asia, definitely yes, but also to other continents, Africa and Latin America. Pakistan today is in a rough neighborhood. It's got the Taliban on one side, and it's got India on the other side, which is its generic enemy. Pakistan and India have been enemies since the partition. They're still in hot conflict in Kashmir over borders, but India and China are also in hot conflict in the high Himalayas. They've been fighting the longest, highest conflict between armies in the world for many, many years, and there's a conflict of borders there, so there is an uneasiness. China exists between India, which is becoming a major rival of China's in terms of development, and then there's Pakistan that's caught between these two major countries that want to free themselves from the hegemony of the United States, and the idea for this is Russia. We went back to Ilyan and Dugan last week, and these philosophers, how they have affected Putin's vision. Now, he needs China and is using China today and co-opting countries like Pakistan to transact, which is very transactional country. It's not a country that has loyalties to other countries or even necessarily to its own governments. It's ruled by the military, and it's like a, I don't know, like a cartel of some sort, where they're transactional with everybody, including us. So it's very complicated, but there is a general vision of dumping the United States and particularly getting rid of the dollarist currency and establishing economic dominance. So this is where China steps in. And in terms of this vision of the world, of a, quote, multi-polar world instead of a unipolar world, China wants to be the elephant in the room in terms of economics. And its currency, the Yuan, is already being utilized in transactional arrangements between Russia, Pakistan, and China. So it's very complicated, but undoubtedly there is a polarization between Russia, China on one side, the United States, and Europe on the other side. Well, yeah, I mean, I keep thinking of Steve McQueen, and I keep thinking of a slogan, which I never could remember in Mandarin, but it was something but it was something like, China stand up. And it was, I think it came up in the time of Hu Jintao, where he was saying, you know, we've been dominated by others for long enough now, and we are not only going to stand up, but we're going to stand very tall. And I want the loyalty and, you know, support of everyone in China to do that. And lo and behold, you know, that work, especially when you feed into little capitalism alongside and you're using capitalism against the capitalist. There's an interesting twist on that one. But, you know, back in 20 years ago, they were very clearly trying to establish an economy that would dominate.  And when they decide, for example, that they want to have a Navy almost as big as ours, they can do it because they have that economic ability. So I am just wondering where that comes from. I suggest that we are the big, you know, enemy. We are the, you know, the one that they use to show who the enemy is. And you know what? It seems to me that at the end of the day, be interested in your thought about this, at the end of the day, it's political. He is saying, she is saying to the people of China, we have to fight the United States. They are our big enemy. And a lot of what you do has to be directed at building a China that can resist them. And in saying that he's politicizing the relationship, and he's getting loyalty from them, and they're coming along on a political, and that's the way onocrats remain in power, isn't it? Well, again, everything we have to see through a Chinese lens. Xi Jinping is having some problems right now, not just political problems, but he's having economic problems. The overinvestment in real estate by the state over a period of time has resulted in what may be a serious economic crisis for Chinese. So he's having that to manage. He's just come out of trying to manage the COVID crisis, where there were resistance in the streets. That's something that a Chinese ruler cannot abide, no matter if he's an emperor, or he's a president or whatever he is. The crackdown on Xinjiang, the Muslims to the West, was a result of actual terrorist operations by jihadist Muslims in Xinjiang, in the mainland of China. China will not abide that. So they cracked down on the entire population. Internal resistance of any sort in China is cracked down on because of the mandate of the heaven. Things can change so quickly, and the consequences can be so dire that whoever is in power in China is going to do whatever they think is necessary to stop this thing before it gets out of camp. I don't think that we should look at our conflict with China in terms of autocracy and democracy. China is open to accepting capitalism. We have seen this capitalism with a Chinese face. Yes, but capitalism, open trade, development, they have in essence challenged us to a contest, and after all, we are a country that's based on contest, on may the best team win, and we can accept that. But I don't, I think it's very dangerous for us to look upon China as we looked upon something like Vietnam as a threat to the United States because it embraced a certain ideology. I think we have to look for ways to connect with China that are not ideological, as far as what China is doing in the South China Sea right now. You can look upon that as part of the economic vision because the South China Sea is a major route for world trade, especially through the Malacca Straits, and China wants control of that. They also fear the militarism they believe is coming from the West, so they want to establish bases in response to the bases we've had established. Now granted, this government is responding differently from previous governments. Xi Jinping seems to be wanting to go back to a more purely communist program in his government, and unfortunately, he can't do that and maintain China's economic strength because that kind of collectivism doesn't work economically. So when the state takes over the major capitalist enterprises as it has done and relegates people like Jack Ma to the margins, it undermines China, undermines the stability and prosperity of China, and then they're caught in this circular thing where they need capitalism. They can't use capitalism because it threatens the mandate of heaven. They have to crack down, establish communist or absolutist programs that don't work in the modern world. China has the capacity to accept modern society, civilization, science, trade, everything brilliantly, but they have to do it in terms that they understand and their stability must not be undermined or threatened. You know, 20 years ago, there was a clear possibility of a kind of Chinese version of democracy where you voted, and there was representative government. It was flawed in the sense that you voted for the lowest level of official, and then that level voted for the next level and on up seven or eight steps before you got to the Politburo, but it was voting, and maybe it was make-believe democracy, but they touted it as democracy. I think these days, they don't tout it as democracy so much, but I agree with you and that they have the possibility of making a form of government that would really allow for a lot more self-expression, economic activity, and diplomatic relations with the West. Seemed to be heading in another direction, which is sort of sad because it makes more contention with the West, but what I want to get to here, and it's kind of, we're getting to the end of our time, is how is that possible? Is it possible that we could have a win-win relationship with them? Because I think it's in everyone's interest in the world that we have a win-win relationship with them, and yet they seem to be going into something else, and granted that we have flaws, and maybe we're finding out just how flawed we are by virtue of what's going on in federal government right now, but ideally, isn't it the better thing to have a win-win, and if so, how do we take these two ideologies, these two huge economies, and make them work together for global success? Number one, we have to have a win-win. China is a nuclear power, Russia is a nuclear power, United States is a nuclear power. Recently, Signal's Intelligence has demonstrated that all three of these powers are preparing their major sites for atomic testing. They're expanding them and preparing them for atomic testing. China is developing a formidable military presence. It's not anywhere near the United States power. We don't have to worry about that now, but they are engaging in this because this is what modern powers do. Modern powers have to be nuclear, they have to have strong military establishments, but the win-win idea, I've been trying to point out throughout this entire discussion, ways in which we can achieve that, and I think we have to start with our own country. We have to start with our own government, which is in disarray. We are electing the wrong people. We are decrying, quote, the elites, which is a radical revolutionary concept that we have to get rid of the people in government and just put in ideological loyalists. You know, since we have to conquer the virus of fascism in our own country, have people in charge who are responsible, and I will say this, the Biden administration has put responsible people in power. The National Security Advisor, Lincoln, the Secretary of State, special envoys like John Kerry have done an absolutely fantastic job of trying to clean up the mess that Trump wanted to leave behind because he has absolutely no concept of how to run foreign policy. And we need to understand, as Americans, we need to grow up and be adults and get rid of these radicals that are elected by these gerrymandered districts and which are hyped on social media to people who think only in terms, in ideological terms. We have to conquer our problems first. If we do that, I guarantee you, we get better people in government. I don't worry about our relationship with China. Well, let's turn to the ghost of Christmas future, not to bring dickens in this conversation, but suppose we don't do that. You know, one thing I can see happening is that she and the Chinese in general, they make fun of us. They say, you know, we are winning this competition. We are better than you are economically. We are better than you are in terms of diplomacy, although that that'll take a lot of doing. And we are better than you in terms of stability.  So what I'm saying is you say that we need to clean up our act to reach a win-win. But I'm asking what's the flip side, and if we don't do that? Well, we don't even have to blame it on China. We blame it on ourselves. You can imagine what it is. And one of the big problems right now that we could clean up is for the press to stop making Trump the major subject of every story that comes across their desk. We're just giving him free publicity. We don't need that. We need to put this man in his place. He's a major loser. He's lost every single contest. Even when he won, he didn't win by a majority. And he's obsessed with his crowd size, which is lousy. So we just have to kind of put the virus. We have a worse virus than COVID. Right now it's called MAGA. I totally agree. Let's control what we can control first. What it tells me is that our success or lack of it is in an echo chamber, a global echo chamber. So if we want to succeed in the world, we have to clean up our act. And if we want to fail in the world and we fail locally, then it's nationally, we are going to have a huge effect on the world. And who knows exactly what will happen with respect to Russia and China and other autocracies. But I fear that we are the only thing that could stand between success and failure globally. I mean, there are organizations now that are pushing back on the money being spent in Europe on climate change. They're complaining that the European countries are spending too much. And so we need a global leader to speak to them. Maybe somebody like Joe Biden, say stop that. Bottom line is that we are in an echo chamber like it or not. And what we do or don't do affects not only the relationship we have with China and Russia, but what they do to others. Everything if the United States sneezes, it's going to go around the world right now. Because the fact is whether you want to call us a hegemon or we want to refer to the Pax Americana. So either as we phrase it negatively or positively, whatever we do in the world has consequences. However, there are continents full of aspiring peoples who have their own desires for freedom, autonomy, prosperity, health, and so forth. I think we have to look at our common humanity. We have to go beyond politics and geopolitics and appeal to our common humanity. The individuals who do this in human history are the ones that are most highly guarded. These are the individuals that speak person to person across great distances of cultural difference because there is a certain biological and psychological basis to human behavior that forms a common ground. Maybe we can reach out and meet on that common ground. Whenever we have person to person relationships with people in other countries, if we have person to person relationships, cultural exchanges between Russia and the United States during the Cold War, for example, it sets a tone for eventual cooperation and collaboration. Peace Corps has done this. It's a person to person kind of program. We need more of that even under the most dire circumstances. We can reach out and touch somebody in another country. I'm so worried that the cost of getting to a kind of balance is dire. It's a huge cost. People who are of bare-mindedness will be at risk. Sometimes in global history, you will have to agree that a lot of people who were decent, law-abiding people were killed in the process. Those leaders you're talking about who have the right idea, we need them now. We need them soon. We do have them. We do have them. I mean, think of Navalny and Karamazat and of course Mandela in his time. These were not individuals that the United States government necessarily supported for their philosophy that we recognize them across borders and across political ideology as individuals that are animated by an unusual sense of justice. We place our hopes in them. We regard them as heroes. We remember them over centuries. All the great religious leaders have been such types of leaders and they transcend everything else in human history. I would like to explore that more with you, Jane. I would like to explore with you how somebody who has the right sensibilities, the right ideology, the right words and thoughts can get to be a leader or not. Because I'm sure there are a lot of people who had very good ideas and thoughts who didn't get to be leaders. How does the better leader emerge in our world and change things for the better? I hope I can get you back for that discussion, Jane. Well, we go to the appeal of Joseph Campbell and the hero of Thousand Faces and Star Wars and all of our cultural entertainment today and our preoccupation with heroes and saviors and messiahs. It's very much a part of our culture because we're so frightened by what media now is unloading on our doorsteps. I agree with everything that you say. Thank you, Jane Rosenfeld. Thank you for coming down on keeping the world company. I so enjoy these shows and I hope we can get you back in the next few weeks. Thank you, Jane.


I think that business can do a lot. I think everybody around the world who works for a corporate, international or domestic are focusing on the global goals, the 17 global goals for 2030. And we can do a lot by offering products and services that supports a reduced environmental degradation, that supports biodiversity, that supports zero hunger and fights poverty and works for human rights. This we can do by the products we sell and by the services we sell, and make them more, so to say, integrate these perspectives and provide actual services so that consumers can choose. So all the consumers that comes to us, if they buy an apple or a piece of meat or a pension fund, they should be able to make a choice that supports the global goals. If corporates have not done that, they have not succeeded with their mission to actually work for a better agenda for 2030. I think that in 10 years' time it would be great if consumer corporates and scientists would use their common knowledge and activism for striving to achieve the global goals, the 17 global goals, and there you also have, of course, climate and biodiversity issues and corporate. I think the knowledge is there. We know enough. We don't need maybe so much more science in order to act. And I think it's important that we come together like here today and we meet from different disciplines, both academic, policy, government, business, and talk about what can we do and what can we do in a short-term perspective and a long-term perspective and agree and take some steps. Because we need to do things better, faster, and now.


Okay, my name is Donna Messer Smith, and I'm at NHGRI, the National Human Genome Research Institute, within the education community involvement branch. And welcome everyone to our presentations of our 2021 to 2023. This is the ISCC pegs scholar group. We're really proud to have this. This project going especially in the sense that this gives an opportunity for people early in their careers to connect through the ISCC peg with people more senior in their genomics related careers. So this is our presentation or clinicians or educators themselves, creating resources, and connecting with other clinicians. So, this is our second class. And today we have presentations from Aviv Bola Olodeo and Sarah Roth, and we're happy to say that the mentor for Aviv Bola is present. And we're going to have an introduction I believe from because I saw you on the call. Dr. Brody is that correct, Dr. Brody. I was going to introduce Sarah. Sarah, right. So Sarah will have an introduction from Dr. Brody. And I think we can jump in and begin with the introduction from Dr. Wilkins Hogg of Aviv Bola, and then I'll share this. You can share, let's see, you need to be able to share the screen. All right, so. Great, so I can go ahead and introduce Amid Bola. As you see here, she's currently at the University of Iowa. Her training is in dentistry and her particular interests are in the genetics of oral facial complications and oral facial developmental changes. She reached out as a mentee and we were looking at her interest in wanting to educate providers, but also my interest within educating providers with an OBGYN. So we were trying to marry the two of those to develop a project. So I will let her take it away. Thank you for the introduction, Dr. Louise, and I'll just ask and everybody see my screen without a comment. Perfect. So good day, everyone. I am Abin Bola that I has introduced and I'm a member of the 2021 to 2023 class of scholars and I'm also 1890 fellow at the College of Dentistry University of Iowa. The opportunity to be mentored by Dr. Louise Wu just introduced me in the OBGYN work group and I'd like to thank all for giving me the opportunity to share my presentation today. To give a brief overview of our project, our project goal was to improve access to genetics and genomics education resources, by creating a central resource point for assisting of up to date information. This is because a lot of efforts have gone into and it's still going into curating resources and tools to foster genomics literacy of providers. However, a lot more could be done to ensure that the audience benefits from this resources optimally and has a value of my involvement in the OBGYN work group. Our target audience would be OBGYN providers. And we know that the advances in our understanding of the molecular basis of inherited disorders have led to the increased adoption of genomic technologies at different point of care. And this would include diagnosis, prognosis treatment and preventive intervention. And as advances in the science of genomics continue, it is essential for providers to have access to evidence based information to guide their management options for their patients. And genetics and genomics testing are increasingly becoming a more integral part of routine medical practice, including OBGYN practice. And as such, a thorough knowledge or lack of these advances may impact treatment and prevention approach to fetal and maternal care. And this further speaks to the needs to improve OBGYN providers understanding of basic principles of genetic screening and interpretation. Although the importance of genomic literacy in healthcare providers have been emphasized, lower level of literacy, genomics literacy in non-genetic healthcare providers, including OBGYN professionals still persist. Clinicians should understand the basic genomics principles and how they apply to their chosen specialty, because having this basic understanding allows an appropriate response to queries that can arise from either patients or their families, and also the knowledge to seek for the expertise or help if required. And research has shown OBGYN professionals are limited due to limited literacy to manifest in different ways, and this include limited knowledge regarding testing options, low confidence about using genetic tests results in patient care, limited knowledge about when and how to make a referral to a specialist or not knowing I'm out of conduct risk assessment using various information in care decisions. And again, because of the shortage of genetic counselors, OBGYN providers who would be called upon to be involved in genetic testing and its outcomes. All of this would impact the delivery and incorporation of genomics into care. So what are the barriers to provide a genomic education that has been identified. This includes time requirements for elective education, having commercial or for-profit entities being major sources of information. The pace of advancement of genomic technology is not matching the pace at which the available resources are being updated and providers awareness of educational resources that currently exists and how easy it is to navigate these resources. And for example, we will see that on the ACOG's website, even after having these educational resources, you have the statements that these resources are for informational purposes only, or they reflect emerging clinical and scientific advances as of the date issues and they are subject to change. These can be very frustrating for providers that are already very busy and would need a short point of information to assess or help that patient quickly adding to the workload that they already have to deal with. And again, for the ACOG or members of Specialty Society, they may be able to assess this information by going to their organization. But what about care providers that are not part of or do not have a relationship with a specialist society. And furthering awareness about the availability of educational resources would be somewhat difficult for them. And as such, education needs to be maintained consistently for these clinicians to be able to keep pace with rapid advances in genetics and genomic technology and its application. This is an imperative for health systems to develop scalable strategies to engage, educate, and empower non-genetic health care providers in large numbers to be able to use genetic information. And thus, they need to curate resources providing up to that information on basic genetic concepts of and diagnostic techniques for OBGYN providers and by extension other providers becomes very important. And another abstract by the ACOG that was released earlier in the year looked at a survey of prenatal care providers including OBGYN providers and they looked at professionals knowledge, barriers, and confidence in prenatal genetic counseling.  More than half of the participants could not correctly identify ACOG's recommendations and they listed barriers such as time constraints, health literacy, lack of a visual aid, and language barriers as things that have affected their knowledge and confidence. And the future direction from this abstract pointed to the need to develop and assess prenatal genetic education tools to supplement counseling. So what we did was to conduct a review of available information through Google Scholar, PubMed, and websites of scientific, clinical, and professional organizations to see what resources were existing. And from professional organization, the top obviously was the American College of Obstetricians and Gynecologists. We also had information from the American Medical Association, the ACMG and European Society of Human Genetics. Looking at public data bases, we had a list of his data base that provided information on, or ranging from the clinical relevance of genes and variants, points of care resources for clinicians, and an archive of information about genomic variations and phenotypes and the impact of variation on drug response. We also looked at a list of government-supported programs that either had gotten a grant from the government to develop these resources and on the top of the list was NGRI with healthcare provider resources for genomics education and this might be a little tiny to read, I'll just read it out. We also looked at the genomics education resource center, that's Genome Ed, Global Genetics and Genomics Community, TRIG, healthcare provider and genomics education, also on genome.gov and the OBG projects. And we also have information for providers and also patients from the CDC, State Health Departments and the National Coordinating Center for the original genetics network. So for educational portals we had information from non-profits, MOCs and also the Genome Ed program, which is not in the United States but I'm out of the country. And earlier in the year, one of the educational portals that existed, by the time I had a meeting with Donna some weeks ago, it no longer exists and this is what you would see when you go to that website which again points to the very fluid nature of the availability of resources and how this can make it difficult for providers who clearly don't know where to go to to find information. So going through all of this, is there any evidence that web-based genome education approaches are effective? Well, this study described the content and impact of a mandatory system-wide program that was implemented on Southport Health. It's called the Image Genetics Initiative and they developed a two-year genetics education program with quarterly web-based models and this was made mandatory for physicians and advanced practice providers. And they reported that web-based genome ed programs or this program was highly effective in increasing health care providers' confidence about using genetics. So based on what we found, the first thing that we would recommend is that for the existing resources, it would be helpful for providers to find if they were organized based on keywords or common categories. And going through genome ed quickly, you can type OBGYN or GYN resources and see what the output of the search would be. The second recommendation was also to find a way to improve providers' awareness about education resources and a clear plan for dissemination. For example, the way that G2C2 became non-existent and the website is also something unrelated to genomics education and also a review of the available education resources, which is thankfully ongoing from my discussions with Donna. And again, extending that to the understanding and supporting of patients following testing. So how do we educate our providers to make better reference to genetic counselors and also familiarity with practical and ethical issues. For example, patient identity protection, not withholding information from patients regarding their health, including test results, and managing secondary findings which could raise complex or ethical and legal issues. And also propose an alliance consisting of multiple organizations to develop a standard and central education approach. And ICCPEG could be able to take a lead on this or reach out to organizations that will be able to take the lead on this. I would like to acknowledge my mentor for taking a time in the past two years to offer expertise and guidance and also the OBGYN genetic curriculum co-chair Barbara, the ICCPEG co-chairs Rich and Donna, I'm very grateful for your support. The NDRI for putting this program together and my mentor at the University of Iowa and NIH for providing my training grant. These are my references. Thank you for listening and I'll take questions now. Thank you, Abinbola, and that I've also had the pleasure of working with Abinbola particularly on that last point about how web resources are rather fluid. Thanks Donna. We're happy to entertain other questions. So I have a question, and do you think there is a role for trying to centralize them? For me or for Donna? For Abinbola. Abinbola, yeah. Oh yes, obviously, because having to go to several points to look for resources can be exhausting. So if we have a central point, we're, you know, reducing that search time and also we're able to, you know, point to a resource that it is going to die to this coming from an organization that obviously not for profit and all of that. So you're having some form of confidence that the resources that you're getting is a good quality. So I think yes, there's a role for that centralization. Great. Donna? One question that we consider is NHGRI the central place to do so. I mean, obviously I'm staffier so I'm biased. But what are your thoughts on that? Obviously, I would say that, yes, that's that would be the logical way to, you know, go about that, but how do we ensure that providers know that NHGRI is ready to be the one stop shop for all of their genome admins? Happy to hear other people's thoughts, including yours, Louise. Yeah, and I think several people have beaten to it in the chat already saying that NHGRI would be a good place. Because I think many of the other sites are challenged with how fluid they are with support and such so that they disappear.  But I think the other key aspect to this is that under an umbrella like NHGRI, there's also a commitment to keeping these items updated, which I think is very important as the whole area changes very rapidly. There has to be like a yearly review, you know, a process of commitment to continue to update. I believe we have folks on the call who are in project groups within ISCCPEG who've been very dedicated to keeping resources updated. It's a challenge as we all know. So it's something that we have to keep at. Yeah, and someone just suggested in a partnership with ACOG, which I think is a great, a great idea as well. Yeah, and the ISCCPEG of course is began as a core component of ISCCPEG was the professional societies. Yeah, those partnerships are key. Yeah, no, I think that's great. I would love to see that move forward. I think Lawrence Brody has his hand up. You mentioned commercial parts and this maybe is for the clinicians in the audience as to what is the threshold to have this tip over so now up to date or some of the other commercial providers actually take it on. I believe that they do a reasonably good job at keeping the material up to date. I know they employ a bunch of professional experts to make sure it's accurate. Not that I'm trying to shirk the genome's responsibility here, but they reach a large audience, and it's really a viable business model. And so, is there, does anyone know what the threshold is on when they actually would say, oh, we're going to create modules on this. So, I can comment and then also with a disclosure that I'm one of the editors for up to date. And I think that they are commercial but the difference is that they're not driven by the sale of a product that, except for the knowledge that they're putting forward they're not producing the test that you're ordering. I think that that's also another good idea because a lot of a lot of clinicians either independently or now or now through epic are tied to up to date modules. Thank you. I see a hand from Dr. Tracy Weiler. So just regarding up to date in the, we've created an FAQ that is hosted on genome.gov and our approach was to go talk to the up to date editor and say hey, can you put a link to our stuff on the up to date site because you're right. It's really, really important to get to where the people are, the people aren't going to come from it, you know, from their, you know, OBGYN office to an HDRI, they're just not. So we've got to get them where they're going to go and, you know, shepherd them to where the information is. So that's one point. As a site and disclosure, my wife has done now up to date stuff and everybody gets a check. So it is an opportunity for some of the genetics education people to monetize their knowledge. Thank you everyone. Evan Bola, did you want to have any wrap up comments. So I think, please, I had a question on how G2C2 fits into the idea of a central repository. And as I said, my last question we've done at G2C2 is no more. And at the content, I'm a bit more to many JRI. So it looks like any JRI is consolidating resources from external resources or from representatives that used to be. So G2C2 might be no more, but you can also access the resources on genome.gov. Even correct, Donna. That's correct, right. Genome Ed is where we're centralizing the repository that was G2C2, which served an important role, but needed to be updated. Yeah, so this is Kathy Blazer. I'm the one who posted that question. So I did go to it. I see that it is. And so would this be what a place we would build from if we were to try to take Amagola's idea and make a more robust central resource, and then taking Tracy's idea and then disseminating access to that resource or links to that resource for different groups. Would that be something that would be the way we look at this because we already, there already is a repository, right? It's not like it doesn't exist. I agree it's a staffing and, you know, question of how we can manage that. Yeah, so it's, I mean, it's not starting from, it's not cutting it from whole cloth. There already is this wonderful, robust and very attractive resource that is Tracy mentions is underutilized and perhaps many people don't recognize it and are not going to go out searching for it. But I think to your point, Tracy, a lot of the work is going down into making people aware of it and making it easy for them to access. Yeah, absolutely. I think that was one of the motivations also that Emma Boll and I spoke about is like, at least to get this out into an article that Obigine's read so that they have the links there, you know. But up to date, it's a good idea as well. Right, the partnerships I think are going to be key in getting this out. All right, I think we're to time. Thank you everyone and we really appreciate the contributions on the chat and the discussion that we've had. Thank you. And I have to put a shout out to our mentor. In this case, Louise Wilkins hard and certainly to our mentee. This might be the time for me to say we're looking for mentors for our new class. Certainly it was my pleasure it was it was great fun and she did a wonderful job. Thank you. I think this is the point in our agenda where I believe. Dr Brody put your camera on and introduce our next scholar, which is on over here. And so it's my pleasure to introduce Sarah Roth either her mentor or advisor. I would say I'm an acquaintance and someone who's had opportunities to discuss lots of different topics with Sarah over over the years. Actually, it's now many years since we first met.  So she gives me good restaurant advice as well. But Sarah is takes the approach that is sometimes a difficult road to follow in the academic world where you're interested broadly and a lot of different things. And you want to bring them all together. It is just for those of you that are trainees that kind of career path, it can be greatly rewarding it's a little bit tougher because it's easier if what you do is study one organelle. Then people know how to define you so I have a hard time defining what Sarah does she's interested in history interested in humanities interested in the sciences is a genetic counselor having been through our joint genetic counselor and is currently a PhD candidate in anthropology at Hopkins. As I said she's interested in the broad use of biomedical stuff from the humanities that the personal view the community view and as well as having seen her and invited her to present at a meeting that I helped run in Montreal is an excellent presenter as well her mentors who I guess are not here and we'll see them. Otherwise they would be doing a better job at introducing Sarah than I am our archery squire. Seattle Children's Hospital and Daniel McKenna at Penn University of Pennsylvania School of Medicine, and they should take credit for anything nice that the Sarah present because I cannot take credit for it and Sarah obviously will take deserves most credit. So take it away Sarah. Thank you Dr Brody I did want to mention that Dr Larry Brody is our division director of genomics and society. Thank you. Thanks Dr Brody for that introduction and I will share my PowerPoint. Are you all able to see just just the PowerPoint. Yes. Okay, great. Well, hello everybody. My name is Sarah. I've been a ISCC pig scholar cohort from the last two years. I think maybe think it's possible that someone need to mute themselves here. Yes, ISCC pig scholar cohort from the last couple years. I recently graduated from the Hopkins NIH genetic counseling program and I'm currently wrapping up a PhD in medical anthropology at Hopkins. I am a sort of lead stage PhD student and bringing together these two things as Larry just shared to. So my project as an ISCC pig scholar has been a qualitative study designed to explore the lived experiences of trans and gender diverse folks with hereditary cancer risk. My mentors as Dr Brody mentioned are Daniel McKenna and Audrey Squire at Penn and Washington. But also Leila Jamal and Kellen Baker who have also been involved with ISCC pig. They were both on my committee for the project at Hopkins so also both quite involved with the project development and Leila has been my advisor for the project as well. So before I dive into talking about the project I just wanted to note that language is important in this field. And here I'll be talking about sex as assigned at birth, gender as lived and expressed, and transgender or trans folks as having a gender identity that's different from sex assigned at birth. And here I use gender diverse as an umbrella term that more broadly encompasses folks whose gender identities differ from sex assigned at birth, but that also includes non binary gender non conforming and gender queer identities. So at the beginning of this project and I went into a greater detail about this in my initial scholars talk. But I thought I would I would highlight the background a little bit because then and kind of iteratively as I write up analysis I've turned to the medical literature to see what it says about trans experiences of cancer risk. I think trans folks are sort of vastly underrepresented in medical and epidemiological studies of cancer risk, which then creates these exclusions from data sets as well as standards of care used to care for these populations as I'm sure many of you are very aware if you're this is especially notable in cancer care where risk figures are inscribed with the presumed gender of these big population data sets. And so in my thesis as well as in my ICC pick scholars project, I held space for this work to address these gaps and needs through interviews. So last year for this project, I interviewed 19 gender diverse folks the majority of whom had BRCA one or two pathogenic variants were in their 20s or 30s, and were non binary or gender queer. And also importantly mostly white. Because this is generally what the participants in patient advocacy groups look like and that is where I met and recruited folks. This wasn't a terrible surprise, but it definitely points to very necessary future directions in working with other underrepresented groups in after looking, looking over transcripts and recordings from interviews as well as reflexive field notes that I took as I was conducting the projects. I really moved between interviews and the literature to articulate three main themes that I'll focus on to highlight. These are also the themes that I outline in the first public publication on the project that I'm working on, which is it's currently under review for the Journal of Genetic Counseling and hopefully will will be forthcoming soon. So firstly, interviewees described experiences of discrimination and dysphoria as they navigated care experiences as well as care environments. They also shared narratives of gender identity and genetic diagnosis intertwining in terms of access to interventions, shifting relationships to gender identity and expression, and navigating multivalent forms of medical uncertainty in their care. Throughout interviews participants also shared their aspirations for what hereditary cancer care could or should look like for other gender diverse folks navigating it. So as highlighted in my last talk, interviewees really pointed to what anthropologist Lachlan Jane has called the redoubling of femininity in cancer care, marking experiences of dis-ease they had navigating interactions and care environments. These three participants reflected this remark by Ben, sorry, the second quote, a trans BRCA2 carrier that the worst thing that the worst space to navigate for them was the waiting rooms. They also pointed to screening appointments and interactions with admins and texts as especially difficult as these were the most common places that they were misgendered. So interviewees explored the social and emotional ways that they responded to these experiences, in particular describing how they would brace for misgendering in advance of appointments. This really supports lit documenting trans experiences of anticipatory anxiety around genetic counseling encounters that role a describes in a recent article in the Journal of Genetic Counseling, and also suggests that cancer genetic counselors who are working in oncology can anticipate anxiety from their patients stemming from previous experiences of mistreatment of mistreatment or anticipating future experiences of mistreatment. And this really calls for specialized compassionate care, which I will circle back to after I dive into a couple more sets of quotes. So in interviews, participants explored the complex ways that their care journeys intertwined, and this theme from interviews is really at the heart of our article manuscript. And it's also dear to me as a queer BRCA1 carrier myself because it's really up for folks in the community as they navigate these intertwining fields. And as Fern described in their interview, there were care from these experiences were tied up or interleaced together for many cancer risk on the one hand presented a crossroads in gender expression, how to respond to the embodied risk prophylactic conditions or disease. For some also the risk or genetic diagnosis presented a different kind of turning point when that enabled them to overcome barriers to gender affirming care through insurance coverage for surgeries in particular. At the same time, though, an alert to elevated risk and recommended screenings introduced new forms of medical uncertainty. And hopefully you can read more about this soon in our article manuscript. And in the meantime, if you're interested in reading more about these kind of intertwining journeys, it suggests taking a look at the article cancer butch by Lachlan Jane in the cultural anthropology journal. And these are two sub themes that I that I just highlighted and should have clicked click through as I was talking. So as they navigated largely unwelcoming environments and these complex care experiences, interviewees also shared about experiences that were affirming or give them insight on a future that they'd like to see for hereditary cancer care. Jason, a non-binary BRCE2 carrier reflected on how it felt when a clinician honored the identity that they had shared on an intake form. I feel like my identity is included in the room they said rather than just my biology. So reflecting on these experiences and needs and barriers that they encountered navigating care participants shared that they appreciated when providers communicated a sense of allyship so implicitly or explicitly through cues, pins or lanyards were attentive to gendered language partnered around difficult and complex care decisions and validated and normalized their preferences. They also expressed importantly a real longing for providers to work to hold space for the emotional complexity of pre-viborship. So living with cancer risk over time and through many different kinds of difficult and complex care junctures. As I conclude, I thought I'd spend my last couple minutes discussing some ways that providers can use these insights to work more inclusively with patients and communities since the majority of folks present are likely providers working in these intersecting or allied spaces. And I'll also note that the experience of working on this project has helped me to develop some of these practice implications modules and I've used them to help give guest lectures for trainings in the Hopkins NIH program. So that's something that I should note and highlight because it's an education piece. So, okay. So in the context of use complex care journeys for gender diverse folks navigating hereditary cancer care, and also keeping in mind mounting attempts to censor trans existence within the US and around the world through anti trans legislation. It's really important to consider how we can build trust with queer and trans clients. And here are some ways that we can do it in this space specifically. So in addition to listening well, asking for pronouns and conveying a sense of implicit or explicit allyship. We can also ask for input on a family tree as we document it so if you're working in person you can kind of like share the document as you're mocking it up, ask them how does this look asked for input about how you represent the gender of family members. We can also partner through counseling skills around experiences of dysphoria as they come up as cancer related experiences are narrated. And importantly, you can use gender neutral or patient first language to describe parts of the body, as well as care experiences. So we can also especially in cancer genetic counseling explore gender identity and expression in the clinic. We can do this again by using these counseling skills that we developed through our specialized training to compassionately explore gender as a hemoventrist. So asking open ended questions, following the patient's lead on language around labels and exploring what their vision for gender affirmation looks like or could look like. That said, especially in the context of clinical environments and the sort of like transphobic political milieu especially in in specific regions of the states. People aren't always going to come into a genetic counseling or oncology session expecting to get vulnerable, and they may be primed by difficult passage points before meeting with us and so it's also okay. We can feel safe getting vulnerable and exploring this in a clinical setting. Finally, as clinicians and as genetic counselors in particular we can refer clients to support, and there's no reason not to refer folks to queer friendly support settings with affinity group offerings. So we can share information about forces LGBTQ support group which full disclosure I'm now a co-leader for and I'm happy to provide information about. And we can also share information about the breasties LGBTQ support group. These are both monthly virtual and they're accessible from anywhere. And these groups are not perfect, but they do provide a kind of support and affinity that is hard to find elsewhere, and that folks report feeling really sort of disconnected from when navigating oncology settings. And with that, thank you so much to ICT peg for the whole thing space to work on this project to my mentors and committee to the HBO C advocacy groups and to our study participants. If any of you would like to get in touch my contact info is under the bird in the lower right hand corner of this slide. I'm an open book and happy to talk about this work, discuss collaborations, or come to your class or program to talk about queer health or qualitative research. Thanks so much. And with that, I will turn to questions. Thank you, Sarah. This was terrific presentation and we really appreciate your work as well as the dedication to your team. And the email was blocked briefly so. Yeah, there we go. S a r a h r o t h at jhu.edu. Yes, please questions. I have a nerdy question Sarah so your data set is, you know is probably the largest data set of interviews of folks out there who are in this situation. You have any idea how many what the total number of people in the US might be. I guess we could probably calculate the intersection between trans and your state carriers and cancer susceptibility but you thought about that. Yeah, that's a good question and not. I'm afraid it's not one that I can answer with the knowledge that I have. I think, you know, the going number going around the literature I think is that like 1.2% of the population is trans or maybe it's 1.4 it's depending on what what data set you look at. In terms of how many people are gender diverse and living with hereditary cancer risk. I honestly I have no idea, but it, whatever it is it's more than you think. I think that's why I was asking because I bet it is more than I think. Yeah, I I'm honestly I feel like even just going about my day to day life, not in a research setting I feel like I'm constantly meeting people who are gender diverse and affected by hereditary cancer risk and that's just in Baltimore just you know, navigating life as a graduate student in Baltimore. And so I think it's it's more than his thought, but I don't know how many. So I just did the rough calculation based on your top estimates that if you just do breast ovarian cancer it's probably 5000 people in the US and if you throw in colon cancer susceptibility and double that. That was more complicated implications than the other. Right. Yeah, I mean, that's not that sounds. That sounds appropriate to me. Those are little kids so it's not I mean the whole population US right. Oh, and actually. Yeah, no, it's an estimate. So Andrew has a question. Thank you for this great presentation and this really interesting qualitative work. I'm interested to hear you meant talked about gender dysphoria I'm wondering if you heard had any emergent themes from these interviews that identified maybe a gender affirming philosophy or behaviors or attitudes of clinicians created a sense of gender euphoria in any of your interviews. Yeah, that's that's a really lovely question. So, so like the easy answers is yes. In interviews, there are discussions both of dysphoria and euphoria emergent from care experiences. Generally speaking, I think clinical environments, especially for for people with diagnosis navigating surveillance and just really complicated tough decisions. They're stressful encounters that there's just a baseline stress to them and so I think it's a lot easier for a care experience to trigger dysphoria than to bring up gender euphoria even in the most affirming and supportive of interactions. And so mostly when people were talking about clinical interactions specifically, mostly, you know, I would say the spectrum range from like a lot of dysphoria to like a feeling of support, and maybe affirmation that felt, you know, like someone was helping to shepherd them through a really tough decision or through a complex, complex decision, but people did did talk about gender euphoria as emergent from their experiences of navigating intersecting care journeys. And that mostly came from experiences of community support and like queer community connection through, especially for, and this this is a big theme and it comes out in the manuscript a lot, a lot of folks feel felt very affirmed by the experience of having the preventative mastectomy. And even if they hadn't been thinking they would have top surgery prior to the genetic diagnosis, some people found that through the experience of having a preventative mastectomy they felt very affirmed and very comfortable and euphoric in their body, though it still carried the trace of the trauma of the genetic diagnosis and all of the, you know, familial and, you know, ontological orbits of illness and risk. There were lots of discussions of a feeling of coming into oneself and one's gender expression in a way that felt really really good. It was very it was just rarely like a key, a key interaction with a provider that got someone there. It was like just the long term journey of coming into a body and expression that felt good and feeling a sense of legibility and support and affirmation in that new bodily expression, which like the medical piece helped, you know, was a was a piece of the journey that got there but yeah sadly there were there were very few clinical interactions cited that like brought up up gender euphoria, but other stuff did. So Tracy really, really lovely question. Weiler had a somewhat of a related questions that you restricted your study to the clinical interactions around cancer, what other clinical actions are also particularly complex for trans folks which, I guess is a lot. Yeah, yeah, that's that's a good question and in interviews and an observation I talked with folks and observed conversations beyond just cancer I just, I just talked about cancer here and and in the manuscript I'm generally focused on cancer but people talked about, there are a couple of people who had, who had had carried pregnancies and had given birth and so they reflected on their experiences of navigating prenatal care as as gender diverse, and people also talked about navigating broader social barriers that people use and not just their clinical cancer care environments. Something that I have been reflecting on. Even if I am like connecting cancer care to other clinical interactions is that, and I think I just mentioned this but people. There's a lot about waiting rooms and imaging appointments as particularly stressful and and triggering of dysphoria and also like sites of misgendering. And I know in the clinical literature on prenatal and repro care there's a lot of of that precedent as well in particular there was a 21 2021 study from Ruderman. That cited waiting rooms and imaging appointments as particularly stressful and gendered like overtly gendered spaces. And so I feel like there is a sense of resonance between cancer care and prenatal care in the in those specific in the context of those specific sites being stressful or triggering. Yeah, so something that emerged from people's discussions of cancer care, but is also applicable to other sites is that a lot of people cited being misgendered in their clinical notes. Of course people have access to their clinical notes after encounters now, and when people see that they've been misgendered in their notes after the fact, even if everything went well in the clinical interaction there's a sense of like being let down. That is definitely applicable across settings and not just unique to cancer care and something that's a takeaway for anyone working clinically is to have a sense of consistency between, you know, the intake form, the interaction and the notes because people are people are watching and they're not when they experience inconsistency there. Okay. I think we're getting up to the time we predicted for our presentations thank you. And any other questions or comments before rich provides some concluding remarks, I think I still see which I know his time was here. You're here. Great. Now so I was just adjusting my camera which is a little out of whack, but oops. There we go. Hi everybody. But yeah, like Kathy just said, thank you very much. I mean the scholar program was an idea that came out from one of our annual meetings and has just been incredible and I hope that both of our scholars got a lot of the program because we got a lot of working with both of you and learned about a lot from your discussion so as you go out. Hopefully you'll remain associated with us, but if you can also help spread the word about the scholars program that would also be great. And I CC pick but, and thanks to Donna, and the others that in each year I would really made you know it's one thing to come up with an idea it's another thing to actually make it happen so very much thanks to them as well but. Yeah so we hope we'll see you around. So, thanks a lot. Thanks a lot to the mentees, the mentors, and you will be getting some certificates. You'll see us a little bit more with those communications and like Rich says, we're certainly not ending our relationships we're hoping you all will stay with us and continue to contribute. Let me just add sorry, definitely thank the mentors as well, we know it's a significant time commitment so, but I hope you found it rewarding as well but thank you so much for doing that, but. All right. Any other comments or are we wrapped up. I think we're good. Thanks, Donna. I think we're good. All right, thank you so much everyone and this is recorded and we will post it on genome.gov eventually. Thank you all so much as well. Good to see y'all.


All right, oh, it's 11.45, so I may as well just kick it off because the sooner I'm done the sooner I can get food So hi there, I'm Mel. I'm one of the lead developers a hide-and-seek digital I've been a full-stack developer for too long So I'm always on the hunt for ways that help me spend more time doing the things that I love like solving complex problems or just getting that extra caffeine boost in my day in This talk I'm gonna take you through leveraging Cypress in Drupal to optimize your testing processes Which will save you valuable time for both yourself and the entire team When deployment day rolls around and you find yourself as a sole developer Responsible for a considerable number of sites Testing can often become a challenging task It actually might look something like this All right, I've gone to dub dub dub my site and it loads. Thank God. All right, but I should probably test my search Cool done a search. It's bringing back results. Oh, it's testing so easy Finally, you should probably check that the document types still work and I can download things Awesome. Oh, that's still loads. Well, thank goodness for that. My code was perfect I'm done So you've deployed the websites and it's working you've tested it after all Everything's great. You believe this to be true because it's been a few hours No one said a word to you so you get back to doing the things that you do best like develop things Now it's been a few days since that deployment everything's roses and went out of the blue You get a critical support ticket labeled broken page You open that ticket to see the attached screenshot How'd you miss this? You checked that page. It loaded fine Of course in the case where there's a document body It's got conflicting styles and something's breaking the download links Something like this has probably happened to everyone in the room and look most times. It's a time crunch issue You don't have time to test every variation of a page template Multiple searches and then even everything that a content author has to do Usually we're also times in these tests by like five or more Because many of us are working with multiple websites daily not just Drupal This is where Cypress can step in to give you a hand Cypress for those who don't know is an end-to-end testing framework for web applications It allows us to write and execute tests for our web apps quickly and efficiently Cypress provides a user-friendly interface for writing tests and offers various features such as Automatic waiting real-time reloading and built-in debugging tools to help developers create robust and reliable tests Additionally Cypress provides a powerful and intuitive command-line interface making integrating with continuous integration and delivery workflows easy Basically Cypress runs in both a headless mode and a head of mode Cypress is deceptively easy to set up on an existing project. It's as simple as running MPM install Cypress save dev Once installed we have a folder structure for Cypress that contains your end-to-end tests. I Put mine in different folders, but you don't have to you can put them all in the root We've got fixtures. These are data sets that you are not going to change, but you're going to reuse a lot and We've got support which contains our custom commands and also additional plug-in setup We also have a screenshots and videos folder where test outputs are generated on the right We have a basic Cypress config file But we set up the envs with either a dot env or a Cypress dot env file because you don't want to accidentally push up public things on Your repositories told you max Cypress can test against many different browsers and versions by default it detects what's available in your machine But we can either download anything missing or use docker to also spin up the missing browsers Cypress has an experimental support for webkit, which is what Safari's browser engine is using so it's a little bit more config to set it up When we're running in a headless mode We need to set the browsers using the browser flag by defining this or by defining this in our Cypress config setup Speaking of setup, let's get into how we can use this to create tests The bread and butter of everyone's first Cypress test is automating the exact situation. We just went through Cypress can visit a page and do a set list of actions and fail for us when it is unable to reach any of the steps This kind of test is good to ensure that a user is able to get around the site without an issue, but This test does not care if your site is broken or styles are wrong We're only really looking at the data stored in the HTML So that brings us to our next type of test Say you've gone to style a button on a document page You've tripped over and you've accidentally applied that style to all the links on the page While this is an extreme example, we find that large sites have complex styles and is incredibly easy Even in the days of linting and prettier to accidentally forget that one parent class To allow for Cypress to capture a baseline of your page and then compare it to a new screenshot I use an open source package called Cypress image diff.js, which is a bit of a mouthful But basically it's a set of helper commands that will do this all for me So let's see it in action It's evident that the test has failed because in the new screenshot does not meet the thresholds that was set That button is blue. We're expecting green When the change is not as obvious as us doing a major color change This package also provides assistance by generating and displaying diff image files in the diff file We see the problem elements in red To help where things went wrong, it's also muted the rest of the site so we can quickly locate the changes as well And the code for this test is only seven lines Now that test before gave me an idea One of the key teams that we work with are Designers, and I'm sure I'm not the only one who's had a ticket go back and forth over the padding of components So how can we use Cypress to help us ensure that the component we've built follows the same fail-on threshold rule That package before doesn't really help us, but it's using something called pixel match to do it smart So let's hook into this Our designers use Figma as their tool of choice. There isn't any reason that this couldn't be adjusted to like Adobe XD As long as you can get the component with API you can generate a test like this Here I'm finding the button component in our design library and then storing a screenshot of it to test against Next we need to grab the component off the website and grab a screen to grab at that too I'm going directly to the home page You probably don't want to use your home page as the place where you test the buttons, but for ease of use We're going to deal with that Finally, we need to compare these two screenshots using pixel match In my case, I've written a little nice little reusable function here. I can call it multiple times for different outcomes It's also for different components. You want to use it against many tests. This is kind of where that would go The first time I'm using it. I'm simply making the return fail when the difference comes out greater than 10% and Finally after this happens I need to be able to get that diff image file that'll show me as before in red what parts are different So our first round is a success. Yay But then we've decided to experiment a little bit and added more of a border radius and change the font from upper to lower Now it fails and it prints out this diff image for us to see the problem areas again I've gone through tests that solely focus on the front end of the website But there are two parts of Drupal and one very important user group your content authors And we can use Cypress to ensure that they can still do all the things that they need to do First off, we want to create our own custom Cypress commands so we can use this to run drush commands I've made this one that'll create ourselves some dummy users Just want to note the drush path here Because I want to be able to run my test locally and on my hosting provider of choice I need to be able to switch paths from Lando drush to say platform drush It really depends where you need to call it from With this custom command, I call it in my tests creating the user and ensuring they can still log into the site without an issue but Continent author is going to probably want to publish content So we can write a test that will follow a content author's journey to create this in my case I'm doing this as an article Then we need to check that the page was created successfully And then we need to remove it when we're done because you probably don't want to have a hundred test articles on your site So we should all be getting a good idea of how this all works at this point Cypress everything is broken into set Our first round we're creating our dummy user against again with that command from before Logging them into the site and Then we want to start creating an article and I've created some dummy data that I've stored in a fixture because I want to use that again and again Finally once publishing we need to check that the page contains the title and if so, we're going to delete it Currently, I've only gone through what I've gone through only really helps an individual There are no rules in place to have your team also use these tests and as Dom once said many times in the Fast and Furious movies We don't turn our backs on family So how do we include this as part of our build and I'm going to go more into pass here But for sass users where there's a will there is a way I'm going to use github actions as an example for this, but or repo hosts have a version of this Having Cypress run for your team can be as simple as adding a github action It simply changes the base URL and drush path to your development server In here, I'm simply saying on each push to stage. I want to run my Cypress test But in this case I've said I only want to run the button one Removing that spec means that all tests were run Finally, I want to save the Cypress output when we're all said and done as this will help us find the errors as we run on a headless mode in a visual way Now Cypress also has this thing called Cypress dashboard and essentially you can hook it up and it will store those Videos and images for you It costs money once you get past the free tier and I'm very frugal. So I like to find free ways to do things now As with many things in life, this is just one way to run Cypress for teams There's about a million ways that we could handle doing this Another way would be to include your Cypress test as part of the build pipeline run and that way if they were to fail on stage You build wouldn't go out at all That might be really annoying if the build fails because you've moved a pixel five five to the left But it saves you if we've just destroyed an entire page Well now that we've got our teams using the test That's great. How do we then use this to justify the dreaded change release request? Cypress also has a handy plug-in called the Cypress Moco awesome reporter And it gives us the ability to take these tests and export them out as HTML reports Now you're probably thinking I can't upload a whole HTML microsite to my change request release Well, we can use puppeteer to then look at that HTML and generate it out as a PDF file Which you can then connect to your request Now you have something to attach as additional proof of the stability of your build because sometimes word of mouth is All the tests that we've gone through today can be found on my github I hope this gives you the kickstart that you need to get some automated testing in your Drupal projects Just a couple of things that we need to note Unfortunately, your tests are only as smart as you write them. I know weird but The benefits of that is because the web things that we work on change every single day your testing requirements change every single day You're only having to adjust those tests to meet the needs and as a human It's really easy to forget steps, but a test an automated test isn't going to forget something It's going to do exactly what it's told And a super unfun fact is Cypress 12 is not data that chat dbt has a lot of right now So it tends to spit out the wrong answers if you use it But apparently yesterday. It's just recently allowed itself to open itself to the web in Australia So it can actually search things now Cool any questions The things that I've noticed with it So basically was the question was have I used Cypress with web forms and it's yes I have the only con that I have with it is there's a lot of a weights because you kind of have to wait if you're doing like Ajax or something you have to wait for things to happen and depends on how fast you're like What you're using your internet speed with because you put a wait for like one second that might help 90% of the times but then you have that one time where it's going to go over just a little bit and just go off that threshold It'll come back and fail It's like front end and like the back end stuff because you can use it to do It's not like just where you write like unit tests or anything like that It's solely focused on the user journey more than fun. Yeah


In this video, I want to explain to you why you should be chasing revenue and not per se profit in the e-commerce model. I'm saying this specifically for if you are running e-commerce companies, physical product for example. You are able to sell this asset for example. I'm going to show you why. I'm going to go over to the whiteboard to explain to you as well why you should chase revenue at first. So let me go over to the whiteboard. In the e-commerce model, you are running a business where you can operate without you. Any business can be acquired in the future. If you want to be worth $3-5 million in the next 3-5 years for example. You really want to build a company that can impact a lot of people. Sorry about this. My terrible drawing. But a lot of people and they are extremely happy. They are like, wow, this guy is really good. We really like your products. So if that's the type of company that you want, you should definitely change revenue, not profit. Purely because top-line growth is super, super important. Once you get the money and once you get the basically cash flow coming in, you will be able to hire more people. You will be able to pour that money back into product development and ensuring that your customers are happy, customer service support, blah, blah, blah. But people don't understand that. The product business is a very capital intensive business. So you do need to actually focus on these things to grow top-line revenue. So let me show you why revenue and not profit is important.  In your front-end offer, you're probably going to be break-even. Or you're going to be very marginally above your break-even rows. So it's either you are losing money on this product or you are basically making very, very little money here. The reason why is because you're spending on ads. So the margin is going to be very, very tight here. However, if you're able to just break-even here on the front-end, for example, in the physical product business on e-com side, you're going to be able to collect email addresses over time. And so if you're driving a lot of traffic from ads and stuff, so I'm just going for the ads anywhere from YouTube to Facebook to Google, stuff like that, then you should be able to drive tons of traffic to collect tons of email addresses. And if you ask any smart business person in the world, the most important thing your business owns is your email list. Or your customer channel basically. And so the email list is super important purely because you do not have to pay for any sort of advertising in order to reach this audience right here. So I'll give you an example. I know a blogger from Singapore, for example, and she does SEO content on her site. And so over time, she has built up an email list of 40,000 people in her audience. She has barely spent anything on paid advertising on Facebook ads. And so this is actually quite a substantial amount considering that this is all organic. Okay. However, all of these people like no like and trust her, okay. They LTR her, right, which means that hey, they're going to be willing to buy from her over time or in the future. Okay. And so, for example, if you spend tons of money to break even here, for example, you make $0, imagine the worst case scenario, right. You don't make any money at all. Okay. What have you gained in the process? Okay. You basically gain $0, right. It's okay. We didn't lose anything. We didn't take else here. But you have gained 40,000 people who potentially are going to buy from you again. Okay. And if 40,000 people, if we sell them a $49 product in the future, right, how many of them are going to take that amount? Right. It's going to be probably a lot of people, for example. Okay. So like a lot of the times people are like new newbies, noobs. Okay. They play at this level. They play on the front end. They want to make money here. Okay. They don't want to make money on the back end. Okay. There could be a few reasons, right. It's probably they don't even have a back end or they don't even know it exists. Okay. So probably don't have, right. Or don't, don't even know. Don't even know. Yes. Okay. So they don't know how to play on this area here. Okay. So the, the, the concept of lifetime value is very important because imagine I spend, you know, I don't make any, any money here, right. But then I start retargeting these people, right. The cost to acquire an additional sale here is significantly lower than the cost to acquire a customer here. Okay. This is a matter of fact. Okay. And so the reason why you should always focus on chasing revenue, right. And not necessarily profit, right. It's because actually the health of your business, right.  Right. And you gain back like 300K in revenue. Okay. And these 40,000 customers, right. Everything you sell to them on the back is pure profit. It's pure profit. Okay. So this is where the real money is made. And this is where, how do I say this? As the rising acquisition costs on Facebook and Google and stuff increase over time, right. Everybody who is not doing this, right. It's going to get killed. Like it's 1000%. I see it already. Okay. It's more, it's increasingly difficult to be break even on the front end. And it's, it's like, how do I say this? It's very, very essential that you try to be break even and making money on the front end. But if you cannot write, then the worst case scenario is break even. Okay. So like if people who do not do this, this part of the business, it's not going to like boot well for you over time purely because everyone is like playing this game. And you are here stuck on the low level and trying to sell like, for example, like $19, $29 stuff online. Right. You're going to get crushed. You're absolutely going to get crushed. Okay. So how do I say this? There's so many things going on in business already. Okay.  Why is my back end? How are we going to monetize when people actually come in? What is the customer journey like? Are we going to sell product one, for example? What is product two? You know, how can we increase the amount that they spend here? For example, stuff like that. Okay. So yeah, when you think about profit, right, when do you actually think about profit? Okay. So you should think about profit when, for example, like you're three years into the business. Okay. You have all your operations ready, which means that you probably already have like a media buyer, which means person running ads. Right. You have a team. You have a marketing team. You have a supply chain guy, probably like operations and stuff. You have a manager. So you're not even in the business, which means that the company is making money without you even having to say anything or like do anything. Okay. That is probably when you should start thinking about profit. Okay. And the reason why is because, right, once this happens, right, it means that the business is a real business. Like everybody on the team, imagine I put team here, right? And this is you. Okay. The team still makes money without you, which means that if someone comes in and says that, hey, I want to buy your business, right, they're going to buy anywhere from like, for example, a three to five X valuation. Okay. So imagine you're making a million dollars profit. They can buy it from you at three mil and five mil, for example. Okay. And so this is the game that you want to play. Okay. Not like the game that is all about, oh, we're not making money here, stuff like that. So every time I see, for example, in the Facebook groups where people are complaining about the ads are not being profitable and stuff. I really feel like I don't think they understand this concept of the backend. Okay. The backend, this is, sorry.  This is like, if you told me, right, you, I make zero dollars for example on the front end.  It's more important to me than anything because in the future I can sell them other things that they might be interested in. Does that make sense? Okay. So hopefully this, okay, this is very messy. Sorry. Okay. But I, I hopefully, hopefully you understand what all of this means, but people in the internet marketing space, right? Especially if you are, if you are watching this video at this point in seven minutes and like you are a beginner to the space, right? Everyone is going to tell you this. Everyone is going to tell you, learn the new ad strategy, learn the new ads, ads, ads. Okay. But actually ads, ads is just a medium, a channel to get your customers. Okay. What's important is actually not so much ads. Okay. So hopefully this makes sense to you and hopefully this gives you some perspective of it. But I'm serious when I say, I tell you this, right?  If you are still doing the, this stuff here, right? You're going to get crushed. Like seriously, seriously going to get crushed. And with like so many like algorithmic changes or like email spam or like, you know, every, it seems like every single day there's like a file somewhere in your business, right? Then you should definitely try considering doing this. Okay. So yeah. Okay. Yep. If you need help with your advertising and stuff, I'll put some links in the description and hopefully if you want to book a call with us, you can. Okay. That's pretty much it from me and hopefully I'll see you in the next video as well.


Hello everyone. My name is Ignacio and we're talking about the workflow hub, which is a versus a for different kind of workflows. So, first of all, what's the idea of the workflow hub. I guess, pretty much everyone knows that in the context of reproducible research and sharing a workflow description is actually the most important part, mainly because it should contain the description of all the steps that are done in the in analysis, both the steps and also the inputs the outputs and any kind of environment description that is required or it's needed to be able to reproduce the analysis. So, with this mind the idea of the platform is to provide a really easy to use registry that the users can upload their workflow definitions. However, they are created and also search in a fair way and access the entries that are resisted there. So with this in mind and for the sake of time, first of all, I would like to encourage everyone to to actually access the platform and make use of it. And for the rest of the talk I will, I will try to explain a bit of the details of how it works. So, the workflow have actually has a really broad definition of a workflow, because it can contain entries from waffles or any kind of discipline, and also what was described in different kinds of ways, different kinds of language and also created with different types of management systems. So it tries to be really agnostic in terms of the, the details of how it was defined, but just focus on the description, and really a human readable description of what the workflow is about. In this in mind it's of important to know that it's not just a registry, it can also work as a repository so users can upload their workflows, or they can also link if they are for example, located in, in GitHub or even in a galaxy instance. They can make a link to that workflow, and the workflow have will then contain some information extracted from this workflow. So, what is this information about so for each workflow, each entry will have uses some community driven standards to describe them to, for example, it uses a common word for language to describe to create a really abstract description of what are the inputs, what are the steps of the workflow and what are the outputs. It also uses by schemas to describe the workflow for example to describe a, yeah actually which execution platform is supposed to be working on. And all these data metadata is packed into workflow create, which is a really lightweight packaging system. So the important part of this you can read more about this in this links that are here, but important part of this is that it then has this really standard of exchange format that is being used by work for her. So the idea of having a standard is the integration with all the services. And for example, first of all, you can upload your workflow, just your files and all the associated data sets, and then you can download this arrowquate. And this one can be for example linked to a, to a publication where you want to share your workflow and how the analysis was done, and ultimately associated with it with this following this standard. And another thing related with having a standard of storing the information about the workflow is for example that you can store associated data like testing data. And then you can follow in this standard link it to testing platform for example, and then it will automatically be able to fetch a workflow. So where the data sets for the testing are located, and make use of the testing data and test if the welfare is running okay. So, with this in mind, what I mentioned so it's pretty much agnostic so each of the entries independently of how the welfare itself is defined, have more or less the same description. So, entry has for example the input that it requires all the steps at the outputs. And in this case, we can see for example, a welfare defined using the serial as well as the welfare defined in galaxy, they all have the same kind of interface presented to the user. So, with that, I would just like to conclude by shouting out to them to the communities that really make this possible. There's a lot of people that contributed to them to the development of this platform. And you as galaxy community know how much of how important it is actually for the people to contribute to it. So if you want to join to these communities here are some links that you can use. And you're always welcome.