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‘Walking away from an amazing tech career in Silicon Valley is a scary thing’

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Engineering leader Michelle Concannon explains how a career break helped her find her feet back in Ireland and take on a new role with Signify Health.

Michelle Concannon is a tech and machine learning expert with more than two decades of experience across Ireland, Europe, the US and Asia. After holding senior positions at Optum, Cisco and Avaya, she went on to play a global engineering and product role in Microsoft’s cloud and AI organisation.

Concannon recently returned to her native Galway, after almost a decade living in Silicon Valley and Dublin, to take on a new role at Signify Health. She is now senior vice-president of engineering at the US health-tech company, which has set up a new base in Galway.

In this role, she will lead engineering teams in Ireland and the US that are developing tech-enabled healthcare services. Signify Health’s platform uses analytics and tech to create value-based payment programmes connecting patients and healthcare providers in the US.

‘As a technologist, it’s a huge privilege to be working with teams that make a real difference to people’s lives’
– MICHELLE CONCANNON

What are the biggest challenges facing your sector and how are you tackling them?

Fragmentation, complexity, cost and access to the US healthcare system are a few of the bigger challenges facing the sector, as well as a general lack of implemented standards. Our teams at Signify Health are tackling these challenges in a number of ways for our network of burnt-out providers and often-overwhelmed patients by connecting disparate data sets to create a longitudinal patient view.

We leverage that data to build and integrate a portfolio of healthcare capabilities to predict and get ahead of conditions before they are exacerbated, improving healthcare outcomes and lowering the cost of the care.

We are building experiences that enable providers and patients to better navigate the healthcare system and manage their care, making it simple and intuitive to do the right thing and more difficult to do the wrong thing – anticipating the next best action for a patient and guiding them to that action.

What are the key sector opportunities you’re capitalising on?

Signify Health’s mission is to transform how care is paid for and delivered so that people can enjoy more healthy, happy days at home.

Our teams are uniquely positioned to leverage the home as a primary point of care deploying scalable technology-based capabilities that support real-time management of quality and cost.

What set you on the road to where you are now?

Professionally, it was a conversation with a mentor and sponsor almost 10 years ago about what I wanted my long-term career to look like. I was fortunate enough at that juncture to be encouraged to take a step back and consider what I enjoyed, didn’t enjoy or wanted to do more of, and I went through an exercise of writing down what my ideal role would look like.

That mentor also gave me some great advice about the value of helping and supporting other people through my own career. I feel very fortunate that my new role at Signify Health includes all the elements of what I transcribed during that exercise and our mission couldn’t be more aligned with helping others. As a technologist, it’s a huge privilege to be working with teams that make a real difference to people’s lives.

Personally, the pandemic has offered us all huge perspective on what’s important in life. Being close to family and friends is more important to me than ever and relocating to Galway after 10 fantastic years of adventure could not come at a more perfect time.

What’s the biggest risk you’ve ever taken?

Choosing to leave a fantastic role and team at Cisco after nine years – and Silicon Valley more broadly speaking – in 2016 to take a year out of my career and travel with my partner.

Choosing to walk away (however temporary) from an amazing technology career at an amazing company in an amazing part of the world is a scary thing to do when you’ve identified with your professional self for so many years. I spent the first three months wondering if I’d ever get rehired, frantically researching tech trends for fear of not staying relevant!

Turns out it was also one of the most personally and professionally rewarding decisions I’ve ever made. It set me on my path back to Ireland and new career opportunities with greater life perspective, exposure to different cultures, adaptability and appetite for learning, unlearning and relearning.

What one work skill do you wish you had?

Only one? Masterful storytelling.

How do you get the best out of your team?

By listening. Listening to what’s going on for them personally as well as professionally and being as supportive as possible.

Understanding long-term career goals and offering coaching directly and indirectly to help my teams move closer to those goals or make connections that may accelerate them.

Adopting a people-first approach, creating and communicating our collective purpose and having fun has been the basis for any team successes to date.

Have you noticed a diversity problem in your sector?

Yes. Despite ongoing media attention and some genuine efforts to improve the situation, there is a lot of work still to do. For me, there is a big distinction between hiring diverse candidates and promoting an environment of inclusivity in the workplace, so I personally compartmentalise the two.

I believe fundamentally that education lies at the heart of overcoming bias inherent in all hiring managers so investment in meaningful training programmes is critical. Hiring processes need to have the appropriate checks and balances in place to complement the training and companies need to get more involved in community-based programmes that are in direct support of pipelining diverse talent from non-traditional backgrounds. Hybrid working arrangements and offering more flexibility are also critical to attracting more diverse talent.

Fostering an inclusive environment where every employee feels like they truly belong and can show up as themselves is more onerous. This only occurs as a result of investment being made in culture, allyship training, tools and techniques around meeting etiquette as well as regular sentiment surveys etc. It also depends on how a company’s leadership is modelling that inclusivity.

How business results are achieved is as important as what is achieved and establishing real leadership accountability around that at every level in an organisation is critical.

What’s the best piece of career advice you have ever received?

‘You’re not the first person to have experienced this issue!’

Google, partner, collaborate, speak up – do your research before setting about to solve a problem that someone else may have already solved and be willing to help you with. Build upon what already exists or make a conscious choice to move forward with an independent solution having performed the cost-benefit analysis, but invest some time in the research – it generally pays off.

What books have you read that you would recommend?
  • The Brain: The Story of You by David Eagleman – a great reminder of why we don’t all see things the same way!
  • Dare to Lead (or anything) by Brené Brown
What are the essential tools and resources that get you through the working week?

Breathing, fresh air and sleep! Yoga, meditation and getting outside to exercise are my work (and life) ‘tools’ of choice to keep me in balance.

With hybrid working arrangements, it’s more important than ever to manage calendars in such a way that there are regular breaks built in and to model that for teams. To do otherwise inevitably results in a lack of productivity, however counter-intuitive.

10 things you need to know direct to your inbox every weekday. Sign up for the Daily Brief, Silicon Republic’s digest of essential sci-tech news.

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EU-backed project to trial uncrewed flight ecosystem in Shannon

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The Shannon-based project aims to integrate the operations of uncrewed and conventional aircraft to modernise air traffic management in Europe.

A European consortium based in Shannon has received EU funding to develop a flight ecosystem for drones and help integrate uncrewed aircraft into our airspace.

Coordinated by Future Mobility Campus Ireland (FMCI), this consortium will conduct a three-year engineering project to develop, deploy and optimise this type of system in Europe.

Describing itself as Ireland’s “first testbed for future mobility”, FMCI is a development centre based in the Shannon Free Zone focused on innovation in both ground and air mobility tech.

Illustration of an unmanned vehicle testing site, with drones visible. A landing and take off zone is highlighted, along with a mobile operations unit where a van is parked. A small building is labelled as the AAM operations centre.

Illustration of the Advanced Aerial Mobility Hub at FMCI. Image: FMCI

FMCI said the research project, known as EALU-AER, represents a “major vote of confidence” in Ireland’s local expertise, industry operators and the resourcing of air mobility development.

Other members of the consortium include Shannon Group, the Irish Aviation Authority, Collins Aerospace, Dublin-based Avtrain, and Deep Blue in Italy.

The consortium has received the three-year funding award to develop uncrewed aviation business opportunities in Ireland, as part of a collaborative research project that could help modernise air traffic management in Europe.

The consortium said the new funding will help build an end-to-end ecosystem that supports the safe operation of uncrewed flights. The goal is to help integrate the operations of both uncrewed and conventional aircraft.

“This will result in developing and building out the critical infrastructure to allow advanced air mobility proliferate across Europe,” FMCI CEO Russell Vickers said.

“It will secure access to airspace for large numbers of drones and eVTOL [electric vertical take-off and landing] aircraft, resulting in safe, cost-effective and sustainable transport of freight and people in the future.”

The project’s work will be based at FMCI’s Advanced Aerial Mobility Research Test and Development Facilities in Shannon, but will include a network of Advanced Air Mobility routes across Ireland.

FMCI has already worked with Avtrain and Shannon Group to trial freight delivery services using beyond visual line of sight (BVLOS) drones.

“We are entering a new era of innovation where the success of the industry will depend on the integration of uncrewed aircraft into our airspace, rather than the segregation of airspace,” Avtrain CEO Julie Garland said.

Funding for the project came from the SESAR 3 Joint Undertaking, which is partnership of private and public sector entities in the EU that aim to accelerate the delivery of the Digital European Sky through research and innovation.

It comes as people are increasingly looking at the potential of drones and uncrewed flight technology. A Dublin City Council initiative recently looked to show how local government can utilise drones in areas such as civil defence, emergency response, public safety and environmental monitoring.

10 things you need to know direct to your inbox every weekday. Sign up for the Daily Brief, Silicon Republic’s digest of essential sci-tech news.

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Goodbye silicone? A new era of breast reconstruction is on the horizon | Breast cancer

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Having an ice pack strapped to your chest – that’s how some describe the experience of taking a walk in cold weather when you have breast implants. Silicone only slowly reaches body temperature once out of the cold, so that icy feeling can persist for hours. As well as being uncomfortable, for breast cancer survivors it can be an unwelcome reminder of a disease they would rather put behind them.

Every year, 2 million people worldwide are diagnosed with breast cancer and the treatment often involves removing at least one breast. But most choose not to have their breasts reconstructed; in the UK, it is only about 30%. Now a handful of startups want to change that, armed with 3D-printed implants that grow new breast tissue before breaking down without a trace. “The whole implant is fully degradable,” says Julien Payen, CEO of the startup Lattice Medical, “so after 18 months you don’t have any product in your body.”

It could spell the end not only of cold breasts, but the high complication rates and long surgeries associated with conventional breast reconstruction. The first human trial of such an implant, Lattice Medical’s Mattisse implant, is scheduled to begin on 11 July in Georgia. Others will soon follow. “We expect to start clinical trials in two years’ time,” says Sophie Brac de la Perrière, CEO of another startup, Healshape.

“It’s exciting,” says Stephanie Willerth, professor of biomedical engineering at the University of Victoria, Canada, who is not involved with the companies. “As engineers, we’ve been playing with 3D printing for half a decade”, but having a clinical use that doctors recognise as useful for patients is key to getting the technology out there, she says.

But in a field fraught with difficult medical compromises, unequal access issues and expectations about what women want, the question is how big an impact the new technology will actually have.


Today, there are two main types of breast reconstruction: silicone implants and flap surgery. While implants are easy to install, flap surgery is a highly specialised business that requires a tissue “flap” being taken from the stomach, thigh or back. Surgeons often recommend flaps because, while there’s a lot of initial surgery and a longer recovery period, it gives a good, long-lasting result.

Silicone is still the most common choice. It is easy and simple, which appeals to cancer patients who either medically can’t have or mentally can’t face having tissue removed from another part of their body. But “it’s far from perfect”, says Shelley Potter, an oncoplastic surgeon at the University of Bristol and the Bristol Breast Care Centre. “It’s quite high risk. There’s a 10% chance of losing an implant.”

Healshape’s 3D-printed hydrogel implant
Healshape’s 3D-printed hydrogel implant, designed to be colonised by the patient’s fat cells over six to nine months. The company hopes to start trials in two years’ time. Photograph: Healshape

Silicone implants also require replacement every 10 or so years and they have had their fair share of scandals: the 2010s PIP scandal, in which a major implant manufacturer was found to have made its implants of dodgy silicone, and the 2018 Allergan scandal, in which popular textured implants were linked to an increased risk of a rare lymphoma. And as an American study from last year shows, it is mainly the idea of having that foreign object stuck inside your body that puts many off reconstruction altogether.

“So what we want to do,” says Brac de la Perrière, “is to give the benefits of the different solutions without the constraints.” In other words: the single, simple surgery of an implant, but without any lingering foreign material to cause trouble.

This can be achieved in different ways. Healshape uses a hydrogel to 3D-print a soft implant that will slowly be colonised by the person’s own fat cells, the initial batch of which is injected, while the implant disappears over six to nine months. The company CollPlant is developing something similar using a special collagen bioink, extracted from tobacco leaves it has genetically engineered to produce human collagen. “I think it will change the opinion of many patients,” says CEO, Yehiel Tal.

Lattice Medical has a different approach. Its implant is a 3D-printed cage made of a degradable biopolymer, in which they encase a small flap from underneath the breast area. This flap then grows to fill the cage with fat tissue, while the cage itself is absorbed by the body, ultimately leaving a regrown breast in its place.

Lattice Medical’s Mattisse implant
Lattice Medical’s Mattisse implant. Vascular adipose tissue is inserted into a bio-resorbable ‘tissue engineering chamber’, which degrades over 18 months. Trials are imminent. Photograph: Lattice Medical

Regrowing breasts using a cage has been shown to work in humans before, in a 2016 trial. However, it only worked in one of five women and the cages were not degradable. Andrea O’Connor from the University of Melbourne, Australia, who led the trial’s engineering team, hopes the new trial will address the problems raised in the first – for example, that patient responses can vary greatly. But if successful, it “would have the potential to help many women to achieve a superior reconstruction”, she says. Lattice Medical says its cage is an improvement because a flat base and larger pores help the tissue grow.

One big unknown is how much feeling the regrown breasts will have. A mastectomy usually means losing some sensation and, according to plastic surgeon Stefania Tuinder from the Maastricht University Medical Centre+ in the Netherlands, reconstruction affects it too. “From our data, it seems that implants have a negative effect on sensation, so the feeling in the skin is less than when you have only a mastectomy,” she says. In comparison, reconstruction from a flap with connected nerves can bring back some feeling within a few years.

Tuinder suspects the implant numbness is both because of nerve damage when the implants are inserted, and because the nerves can’t grow back once they are blocked by a lump of silicone. Whether that will also apply to the new implants remains to be seen, but since eventually there will be nothing to block the nerves, hopes are that sensation will be better.


Tissue engineered implants, however, are not the only recent innovations in the field. Many groups are working on perfecting a reconstruction technique using injections of the person’s own fat, boosted with extra stem cells to help the tissue survive. Medical professionals are still debating the safety and how the breasts hold up long term. In contrast to the new implants, the procedure might have to be done several times.

While any of these new techniques could result in something better than what’s currently on offer, Potter warns that we have a tendency to jump at new and shiny tech – an optimism bias. “We always think it’s going to be brilliant,” she says, but “we don’t want a situation like with vaginal mesh, where in 10 years’ time … we find out we have done something that isn’t helpful.”

Other solutions to the problems of reconstruction do exist. One is living without breasts, known as “going flat”. Contrary to the companies that think they can turn the reconstruction statistics around, people within the flat movement argue that if people were better informed, even more would opt out. “I reckon if [going flat] was given as an equal option,” says Gilly Cant, founder of the charity Flat Friends, “at least another 30-50% of women wouldn’t have [reconstruction].”

A Healshape scientist using software to determine the shape of an implant prior to 3D printing. The implants can be custom-made to suit the patient.
A Healshape scientist using software to determine the shape of an implant prior to 3D printing. The implants can be custom-made to suit the patient. Photograph: Healshape

At the moment, the guidance from the National Institute for Health and Care Excellence (Nice) says that doctors should be aware that some might not want reconstruction. But Cant says it is often presented to people as part of the treatment process. “It’s like, ‘OK, we need to do a mastectomy. Then you have chemo. Then you’ll have your radiotherapy and then we’ll do reconstruction.’ So women live for that reconstruction at the end,” she says. It comes to signal the finish line.

It is particularly contentious when only one breast is removed, because some might want the other taken off to feel and look symmetrical, rather than have a new one made. But according to Cant, many doctors don’t want to remove a healthy breast. Part of the doctors’ concern is that women will regret their decision, says Potter, but “women know what they want to do with their own bodies. We should help and support them to do what they want to do.”

Potter herself would like to see more of the ultimate alternative: not having a mastectomy in the first place. “There’s no evidence that mastectomy gives you better cancer outcomes than a breast-conserving operation,” she says. In this case, the tumour is removed but the breast is kept. For example, one of her patients had a breast reduction that removed her cancer while giving her breasts a lift. “She calls them her silver lining breasts.”


So even without tissue-engineered implants, there are enough options to make the choice a hard one. To help people choose, some charities pair up people considering a specific procedure with someone who has already been through it. At the charity Keeping Abreast, show and tell sessions give people the chance to ask the questions they might be uncomfortable asking their doctor and see the results for themselves.

But according to a 2018 report by the all-party parliamentary group on breast cancer, knowing what you want is not the same as having access to it. “There’s a massive postcode lottery,” says Potter. It stems from flap surgery being so involved that it often requires specialist plastic surgeons who can do minute surgery under a microscope. Many clinics don’t have such experts in-house and while the Nice guidance says people should still have the option, in practice it limits access.

The companies say this won’t be a problem with the new implants, because they are specifically designed to be easy to put in. Flap surgery can take from three to 12 hours depending on the flap, but insertion of Lattice Medical’s implant, for example, takes only one hour and 15 minutes. “It’s really accessible to all plastic surgeons,” says Payen.

This accessibility will no doubt be crucial in taking the new implants from a cool technology to something with real impact. But from Potter’s perspective, it’s just one potential piece in a big puzzle, not a techno-fix. The implants “would be an option for a lot of women”, she says. “But I think the main advance is all around access, proper information, giving women choice and hopefully reducing the number of mastectomies that we need.”

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What to do about inherent security flaws in ICS? • The Register

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The latest threat security research into operational technology (OT) and industrial systems identified a bunch of issues — 56 to be exact — that criminals could use to launch cyberattacks against critical infrastructure. 

But many of them are unfixable, due to insecure protocols and architectural designs. And this highlights a larger security problem with devices that control electric grids and keep clean water flowing through faucets, according to some industrial cybersecurity experts.

“Industrial control systems have these inherent vulnerabilities,” Ron Fabela, CTO of OT cybersecurity firm SynSaber told The Register. “That’s just the way they were designed. They don’t have patches in the traditional sense like, oh, Windows has a vulnerability, apply this KB.”

In research published last week, Forescout’s Vedere Labs detailed 56 bugs in devices built by ten vendors and collectively named the security flaws OT:ICEFALL. 

As the report authors acknowledged, many of these holes are a result of OT products’ being built with no basic security controls. Indeed, Forescout’s analysis comes ten years after Digital Bond’s Project Basecamp that also looked at OT devices and protocols and deemed them “insecure by design.”

A few hours after Forescout published its research, CISA issued its own security warnings related to the OT:ICEFALL vulnerabilities.

CVEs: The problem? Or the fix?

“Up until this point, CVEs haven’t been generated for these insecure-by-design-things, and there’s a reason for that,” Fabela said. “It’s bad for the industry.”

Once a CVE is generated, it sets into motion a series of actions by industrial systems’ operators, especially in heavily regulated industries like electric utilities and oil and gas pipelines. 

First, they have to determine if the environment contains any affected products. But unlike enterprise IT, which usually has centralized visibility and control over IT assets, in OT environments, “everything is distributed,” Fabela noted.

If industrial and manufacturing environments do have any products impacted by the vulnerability, that triggers an internal review and regulatory process that involves responding to CISA and developing a plan to improve security.

One SynSaber customer sarcastically described OT:ICEFALL as “the gift that keeps on giving,” Fabela said. “He said, ‘Now I have this on top of all my other like, the real vulnerabilities’,” which present a slew of other problems when it comes to patching — such as having to wait until a planned maintenance outage that may be months out — if the manufacturer has a patch at all.

OT protocols don’t use authentication

For example: The current Modbus protocol, which is very commonly used in industrial environments, does not have authentication. 

Forescout’s analysis details nine vulnerabilities related to unauthenticated protocols and disputes the argument that against assigning a CVE ID to a product with an insecurity OT protocol.

“On the contrary, we believe a CVE is a community recognized marker that aids in vulnerability visibility and actionability by helping push vendors to fix issues and asset owners to assess risks and apply patches,” the authors wrote.

While this makes sense from an IT security perspective, Fabela said it’s unrealistic from an OT perspective, and ultimately doesn’t make critical infrastructure any more secure.

Modbus, as a protocol that does not use authentication, could generate “thousands” of CVEs that “affect every product line in the world,” he Fabela. “You’re tying up the product security teams with the OEMs and you’re tying up the customers, the asset owners with CVE that they can’t do anything about.” 

Basecamp researcher weighs in

Reid Wightman is a senior vulnerability researcher with OT security shop Dragos’ threat intel team. He’s also one of the original Project Basecamp researchers, and, more recently has done work on the ProConOs and MultiProg software vulnerabilities.

Forescout cited some of his research, and dedicated a section of the ICEFALL analysis to security flaws with the ProConOS runtime in PLCs.

In an email to The Register, Wightman noted that a lot of industrial controllers have the same set of problems that isn’t going away: “they allow unauthenticated code to run on the PLC.” 

“This means that one malicious logic transfer to the PLC may permanently compromise the PLC,” he added, noting that, because the control logic is causing the change, it can happen outside of a normal firmware update. “It’s kind of a thing I’ve harped on since the Basecamp days, but may be worth repeating. Over and over again. Until the sun burns out, probably.”

Lately, one of Wightman’s “big, personal concerns” is that some vendors say they can use TLS and client certificates to secure controllers, presumably to avoid. In reality, this would just make the traffic more difficult to inspect, Wightman said.

“If an attacker gets onto the engineering system, they may load a malicious payload using CVE-2022-31800/CVE-2022-31801 (or any of the similar problems that exist in almost every logic runtime) into the controller,” he added. “Only, now we have no way of telling whether they did it because the traffic is encrypted.”

So how do we fix the problem? 

“I guess my answer would be: if your engineering system is compromised, throw away all of the controllers that it was allowed to talk to,” Wightman said. “And I doubt most end users would go to that level of paranoia.”

Which, again, points to the insecure-by-design nature of how these systems are engineered.

“Thankfully, we see no signs of any widespread abuse of these protocols or ‘features’ in spite of some of the bugs being well-known for years,” Wightman added. “I really do hope it stays that way.” ®

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