Good evening, everyone. Thank you for joining us tonight in our community meeting for area. Street improvement 2018 bond year 3 contract 5 city project number 1 0 1 4 5 2. And my name is Megan and I am a project manager with the city of 4 tours, transportation and public works. Capital delivery team and I will be the project manager for this project. You are in the construction. First, I would like to welcome Mr Michael clean our district director. For attending this meeting, Mr Michael, do you want to say anything before we start the meeting? Yeah, I just say, hey, thanks for hosting this for the neighborhoods and everybody to know. I'm always a fan of being open and transparent of any of the processes that we're doing as part of the city. And I think these public meetings are important for that to happen so people can understand what's happening, ask questions. And do what they need to do and thanks for all of y'all Jeff and all the team there. For for making these things happen and improvements that really need to happen in the city. So thank you very much for taking the time and doing this tonight. Thank you, sir. So, back in September, last year, we had the public meeting for this project during the design phase. And tonight, we'll have the meeting before we start the construction. So this presentation to provide you with some information. About the scope of this project that is happening in your area. And give you a little bit of a heads up about what to expect with upcoming construction. In this presentation, I will talk in detail about the project overview and the scope of the work. Also, I will provide you with some information on the schedule of this construction. So, you will be able to know when we'll start and finish the construction in your street. During the meeting, you can send your question during the chat option in Webex. The chat button is located at the lower right side of the Webex screen here. And at the end of the meeting, I will answer all your questions. If you are joining the meeting from your phone, or you cannot send your question, please feel free to unmute yourself and ask your question. So, in this project, we have five streets. First street is Boulder Drive from Burtain Hill Road to Oak First Drive. We have also Luck Avenue from Sabington Place to Mary's Lane. We have Harvey Street from Dales Avenue to Winsley Avenue. Libby Avenue from Little Beach Street to Farron Street. And Humbert Avenue from Holm Street to Farron Street. In this slide, you can see the existing condition of the streets. The picture on the left side here, this picture, most pictures are from Harvey Avenue. And as you can see, the poor condition of the asphalt, bathing, no concrete, carpenter gutter, and broken or damaged driveways. Also here, the picture on the left side is from Humbert Avenue. Also, you can see the poor condition of the bathing, no carpenter gutters, and the other picture from Libby Avenue. And it is clear that we can see there is no concrete driveway, just broken or damaged concrete on some ground. So, now let us talk about the scope of each street and what the city is going to do. So, on Volgar Avenue, we are going to replace the 6-inch water line with new 8-inch water lines. We are going also to replace the old 6-inch symmetry sewer lines at the back of the houses with new 8-inch sewer line. We are going to construct new concrete driveways for all the properties. With minimum 11 feet width and 10 feet length. We are constructing also new concrete sidewalk, 5 feet on the north side of Volgar Avenue with new ADR amps. Also, back in September during the design meeting, I have mentioned that the bathing will be asphalt. But the good thing is that the city has received a good price for concrete bathing, which is less longer and better than the asphalt. So, all the street in this project will be a concrete bathing instead of asphalt. The second street is Luck Avenue, and we are going to replace the 6-inch water line with new inch water line. Also, we have sewer line going to be replaced from 6-inch to 8-inch. We are also replacing all the driveways with new concrete driveways, 11 feet width and 10 feet length. Also, we are going to construct new concrete sidewalk, 5 feet on the north side of Luck Avenue, between Seventon and Olive Blaze. The area between Olive Blaze and Mary's Lane will be a part of another project, which will come later this year. The street also will have a new concrete bathing. On Harvest Street, we are going to construct all the driveways, as I mentioned, with 11 feet width and 10 feet length, and concrete bathing. Libby Avenue will have a new 8-inch water line instead of 6-inch, the old one. Also, we are going to construct new concrete driveways with minimum 11 feet width and 10 feet length. And also, on Humbert Avenue, also, we are going to replace the 6-inch water line with new 8-inch water line. We will construct new concrete driveways with minimum 11 feet width and 10 feet length. Also, we are going to put a new concrete sidewalk, 5 feet on the north side of the street with ADA ramps. Also, at the end, the street will have a new concrete bathing. So, here in this slide, you can see the proposed improvement. So, every street in this project will look like that when we finish the construction. New streets will have a new concrete bathing, nice curved undercutter, new concrete driveways. Also, the street will have a new concrete sidewalk and new ADA ramps. Here is the most important part in my presentation. This slide shows you our expected phase and schedule of the construction. The project duration is 360 calendar days or 12 months. Before I go into this project schedule, I would like to make everyone aware that these dates are estimated. We will do our best to stick with this schedule, but as you know, we may be a little bit late on some street or maybe we are ahead of schedule on the other street. This will depend on the weather, condition, and rains during the construction. Also, back in our public meeting before, we have mentioned that we are going to start in April, but the good thing is that we are going to start the construction on Monday, March 8th, and we are going to start on Luck Avenue, and we anticipate to complete the construction there by October 19th. The next street will be Boulder Avenue, and we will start by June 7th, and we anticipate to finish there by March 2nd, 2022. Libby Street will start on May 26th, and to November 1st, this year, Harvey Street, and we will start on July 9th, 2021, to September 29th, 2021. Hamburg Avenue will start on July 27th, 2021, to November 2nd, 2021. We anticipate to complete the construction by March 2nd, 2022. Here is my phone number and my email address. Please don't hesitate to contact me if you need any information. Brian McGill is the city construction inspector on this job. And he will be your first point of contact. He will be on your street on daily basis, so feel free to contact him at any time. I hope that I have covered everything in my presentation. Again, thank you so much for taking the time to listen and attend this meeting. I am so sorry that we couldn't meet in person due to all this issue and public health concerns. And now this is the time to listen to your question. If you have any, please feel free to send in the chat button or unmute yourself. I think we have two questions in chat already. The first one is, can we ask the concrete contractors to redo an entire driveway for an additional, personally paid fee? Definitely, yes. You can reach out to our contractor when they start the work, contractor, when they start to work on your streets and discuss that issue with them. All right. And also for on Boulder Drive, will it start at Oak Forest and move towards Burton Hill or vice versa? I don't have this information right now, but I believe the contractor is with us now in the meeting. So we can ask him then, do you have any idea which side you're going to start? No, honestly, I do not. The first work done on the job will be the water line work in Boulder. I don't know that even the subcontractor doing a water work would have decided which direction to go. They tie into existing lines on both ends. So I really don't think it's going to make any difference if there's a way that we can accommodate the resident by going one direction or the other. We'll be glad to see if we can't do that. Yeah. So please let us know if you have any concern on which side we're going to start, you can send to me and we can discuss it with the contractor. And while I'm still unmuted here in answer to the other gentleman's question, yes, we frequently do replace driveways. If they will approach the work crew when they're out there on the job, it's much easier for us to allow the supervisors of the crew to deal directly with them because we get a lot of requests like this and we don't try to run them all through the office basically. So it's better just to handle it on the site, but yes, we can replace existing driveways. I think they'll find the pricing is very, very reasonable and it can get done concurrently with street work so that they're not inconvenienced twice. Just have them, if you get any other requests like that, just have them get with the contractors once they see the ex debate, I mean, the work force, they'll all be my employees, but they'll work with you directly and we can get anything like that done. That's all I had. Thank you, Dan. Any other questions? So I want to make sure that everyone be aware that before we start the construction, our city inspector and the contractor will go and put a door handle in every house to let them know that we are going to start the construction one week in advance. So you will know what time we are going to start the construction. Also, I will leave this slide for you. If you want to take my contact information and inspector also and feel free to reach us at any time. Maggie, could you read both of all that information out? We have multiple column users on who probably they won't be able to see the screen. Okay. So my name is Maggie and I am the project manager for this project and my phone number is<PHONE_NUMBER>-817-392-5448 and my email address is maggot.zackymaged.zaki at Fort Worth, Texas.gov and the city inspector is Brian McGill and his phone number is<PHONE_NUMBER>-817-647-2514, Brian P-R-I-A-N dot m-c-g-i-l-l at Fort Worth, Texas.gov. This is the email. Also, I want to make sure that everyone knows that this presentation will be uploaded on the city YouTube channel so you can see it after some time. And as I said to you, if you have any questions, please feel free to contact us. Excuse me. Hello. Yes, go ahead. Yes. I'm kind of confused. Are you all talking about the streets out in Como, Humbert, from Humbert to Fair and to Horne Street? I'm sure you said from Humbert, too. It said Humbert Avenue, Fair and to Horne Street. Are you all talking about repairing the streets out in the Como area? So our limit on Humbert Avenue from Horne Street to Fair and Street. Yes, that's what I got on the email. You know, I was saying something about Humbert, Fair and to Horne Street. I'm kind of confused about Humbert to Fair and because I rode down on their street and I'm looking at Fair and on Fondsworth, where this is where the water mains busted, right? Are you all going to redo some of the streets? You just repairing the streets due to water mains broke right? Thank you. I'm sorry. That's the project we are talking about was approved as birth of 2018 bond. The streets, the water break is going to be fixed like by next week. This should be fixed, but that doesn't have anything to do with the water break. Okay, so, okay, so are you all, you are going to fix any industry that my main concern is I'm worried about two streets out in Como that I'm wondering if they're going to ever open these streets back up. Fondsworth, I talked to Brian Bird and several other guys about these two streets, I know like three to four years ago, they were going to open up Humbert and it's never gotten opened up. They always said that they run out of money when it comes time to fix an evidence. I'm not understanding why Fondsworth has ever closed. I grew up on Fondsworth and the street was never closed, but I was suddenly closed now because water used to run down the way. So maybe you have to tell me, I'm in the wrong meeting or something. I'm just trying to see what streets you all going to repair out here in Como. The projects as part of this, the streets as part of this project is voted in 2018 bond, like whatever we do is already the voter approved it in May 2018. We cannot go and do another street because it was not approved as part of the bond. I know Fondsworth, the street you are talking about was closed due to storm drain. There is, there used to be a creek going there and then it's the vibe under the street collapsed. So it was becoming so dangerous to keep it open because the water over the street, someone can get swept away. So I understand that street was closed because of a storm drain issue. So there is, it's dangerous to keep it open. That's, you may need to contact storm water about that. We'll be happy to put in the chat who you can contact with the customer service. And if any other street you want to ask about, we can also put the customer service email. We can check and we'll get back with you as soon as like immediately you will get an email or something responding to any concern you have in any street. But the project we are presenting now, it's whatever was voted in as part of the bond. Like I'm saying, we only deliver what was approved. So some other departments may be able to do like help with extra other street or about fall or answer the question about the fund was hopefully that answer your question. We have another question in chat. Dorothy was asking about Libby Street and I see that Magnus put that back up. Yeah, so I started, yeah, go ahead. So our concern on Libby Street that we put this street during the summer holiday for the school, because we know there is a school there on Libby Street between Little Beach and home street. So our intention to do this street during the summer. So we are going to start between May 26th to November 1st. The other part of the home of Libby Street will be after the summer. So our intention first is to complete the area between Little Beach and home during the summer between May and September or by the end of August and the other part of Libby Street after after the school starts. Any other questions? I have a question about Boulder. I came in a little bit late on Boulder Drive. Is this there going to be a cost to the homeowners because of the new driveways and the sidewalk? No ma'am, the city is not asking for any additional cost. Do you mean as a tax paying?  Is that going to cost me anything? Is any of this going to cost me anything personally?  And our city standard to put minimum 11 foot widths and 10 feet clearance. With no cost. OK, thank you. I get, I think that clarification probably need to be there that it will be up to the property line, not inside private property. Right, right. That's what I assumed. So that we mentioned it is tendence to the property line. Yeah, that's going to be the, I guess, the easement the first five feet or 10 feet of the property that the city owns. Yes ma'am. OK. Any other questions? I do have one other question. I have a single car driveway. If I were wishing to increase the width of my driveway. Would that be able to be done at that time? Or would that, you know, cost me or could it? I mean, how would that? How would I undertake that as far as your portion to make it like enough for two cars side by side? So I mean, I know I did responsible for the remainder of the driveway. Yeah, so maybe I believe the city is providing only 11 feet widths. Yeah, so ma'am, you can get the 11. So no, you can get if you can go if you want to get a team, you can get you can get to the blaming department development and you get a permit and you can work with the contractor. He can install it in so you would pay for the difference. So for two car garage when it's all 18 feet, this is the standard. So you can pay the difference between 11 and 18. And we can install it for you. But you have to pay for the country. Yeah, you will pay the difference to the contractor and install it. OK, now I have it. You have to get a permit because it will be depending on the location and you cannot encroach, of course, to your neighbor. So probably right in your property. So we can direct you to the person. You can get the permit from and tell them I want it that way. And there is a contractor already working on my street. OK, and who would I contact? That would be development customer service. We can send an email to make it and we'll send you the contact information in the development. OK, what's the email address? I'd be sending that to I see you just put it up there. Yeah, it's here. Yes. OK, thank you. You're welcome. And I just put on the check if someone wants to report any part of all any want to know if the street is going to be done and when this is the back on our transportation, public work, customer service, that's her phone and her email there. And or you can use the chat. In the Fort Worth and you will get a response. Oh, OK. Any other questions? Thank you so much for attending this meeting and we are looking forward to working with you all and have a good night. Thank you so much.


We got a in the May auto it's gonna be two out of three Conor McGregor Very nice one there two out of three on the auto Conor McGregor first one of him. I pulled out of here The double jump the double jump two out of three best McGregor S talkers and oh absolutely


Jewish point of view, or we don't believe in the divinity of Christ, I think that there you can make an argument that the Gospels which were written, he was just a prophet and significant. No, no, no, we don't believe he's a prophet What do you think he was? What do you guys think? I mean, I what I what I think he was historically I think he was a Jew who tried to lead a revolt against the Romans and got killed for his trouble Just like a lot of other Jews at that time who were crucified for trying to lead revolts against the Roman and got killed For their trouble Jesus was unlike every other man who ever existed His arrival and ministry was prophesied about hundreds of years before it actually happened But he was pierced for our transgressions. He was crushed for our iniquities Upon him was the chastisement that brought us peace and by his wounds. We are healed Jesus was not merely a social revolutionary or good teacher John the baptist said behold the lamb of god who takes away the sins of the world This wasn't an ordinary man. Jesus is lord repent for your sin and put your faith in him today He will bring you from spiritual death into spiritual life. That's good news


Welcome to our presentation called Leveraging Social Media to Flatten Your Classroom Walls as part of the K-12 online conference with the theme Learn, Share, Remix. Each morning I check my email before heading off to school where I am a fourth grade classroom teacher in Kansas. In my inbox I responded to emails, one from Paula about scheduling a time for our classes to do an introductory Skype call as a get-to-know-you activity at the beginning of the school year. The other was a request from a Minnesota fourth grade teacher looking for a partner class to be guest readers in each other's class during the upcoming Global Read Aloud Project of the book The One and Only Ivan. Another email was a discussion notice from the classroom 2.0 Ning that a comment had been posted. I'd also received an email that was a Twitter direct message from Rebecca, whom I met at ISD-12 in San Diego, wanting to bounce around an idea for connecting our classes. As I do the same thing in Louisiana before heading off to school, I find an email from Jan reminding me that our classes will be doing a Skype call to Stack Oreo Cookies for the O-R-E-O project which is hosted by Jen Wagner in California as part of her projects by Jen. I also have a Google Calendar email reminder about moderating 4th Chat on Twitter and add moto notifications from my students who were replying to assignments. My Skype I am reminds me that my class will be doing a mystery Skype call with another 4th grade class. I also have a Google Chat notice from Bill Kay reminding me that a group I am connected with will be completing a conference proposal about our global classroom projects in a Google Hangout that evening. Is this how your day begins? How did we get so connected? Let us share with you the various social media tools we leverage to flatten our classroom walls. We both began finding connections on NINGS way back when. In fact that is how Paula and I met on a NING in the summer of 2009 and started figuring out how we could connect our classrooms and collaborate with each other. Some NINGS you might consider joining to find connections are the Classroom 2.0 NING, the Flat Classroom Project NING, the Flipped Learning Network NING, and the Educators PLN NING to just name a few. From there we started using Skype as our tool of choice to connect our two classes because our 4th graders did not need to sign up for anything. We simply set a date to Skype and put our students in front of the webcam and it took off from there. Of course we learned how to turn a Skype call into a learning call, assign Skype jobs to our students, and set up an Edmeto Skype collaboration group so that some of our students could back channel during our Skype calls. We have used Skype to flatten our classroom walls by sharing poems, readings, songs, as you will see in this video. Also doing collaborative projects such as the OREO Project and in math, data collection and graphing, or having authors Skype into our classroom as you will see in this video. Good morning boys and girls, how y'all doing? Good! Yay! Good morning Mr. Jerry! Good morning! I am Skyping in from Florida and I want to show you today how I wrote one of my many activity booklets. This one today was on the Energy Kit. I've written many books on energy, on lawyer, on job awareness, on careers, electric history, where the little lightbulb gifts is juiced. Now we do magazine books exploring your environment. One great event happened recently about the environment. Every April we celebrate. Right now I'm working on a book on water, revising it. And what was our big project we did for Earth Day, Nicholas? We decorated these bags for Earth Day. What part of Florida are you from? Let's see, I live, I don't know if you know, on the east coast of Florida, south of West Palm Beach, or right near Jupiter Island, where Tiger Woods and Saliti are living. In this next video, Paula's class shares a guest speaker. Mr. Adams, would you please introduce yourselves to us and to Ms. Wells' class in Kansas. Sure. My name is James Adams. I'm here today to talk to you about the Constitution and the Bill of Rights. So I hope you get some really good questions about this. I've already given me a lot of questions. Yeah, I sent Mr. Adams our list that we generated, so that he has your list of questions. Can you all see that in Kansas? What are you seeing? Um, a three-headed eagle. Ah, very good. What do you think a three-headed eagle might represent? Just raise your hands. Anybody in Kansas think they have an answer? I have to speak with you all because I'm very passionate about the Constitution. I love the Constitution. I think it's the greatest document that was written in this country's history. Our Constitution was written in 1787. Prior to our Constitution, our country was ruled by the Articles of Confederation, which was basically an agreement between the 13 different states. Unfortunately, it had some problems. It was very, very difficult. Another way we've used Skype to flatten our walls is by having a celebrity speak about anti-bullying. Let's look at this video. Sharing projects our students have done, such as Mardi Gras research, and stayed in a container exhibits. Doing mystery Skype calls, or doing impromptu calls. Next, we decided to increase our personal learning networks and join Twitter. Did you know you could benefit from Twitter by following these steps? Go to www.twitter.com forward slash search. Then type in a hashtag such as pound sign mystery Skype, or pound SS chat, which stands for social studies chat. And you can see the tweets without even having a Twitter account. But you can only truly be connected on Twitter when you join the conversation, which you need an account to do.  Discover other projects to join like global read aloud and quad blogging. Share surveys your students made to gather data for math classes. Join educational chats, such as LM chat and 4th chat, where we learn so much to take back to our classrooms. Help each other learn new tools over the summer, such as Edmodo and Google Hangouts, because of Twitter conversations we've had. Use a Twitter class account to do live tweeting from a field trip. Tweet about connections made between classes, such as when a student in my class won a Glogster contest sponsored by a student in a Wisconsin classroom. Speaking of Edmodo, Paula and I had our classes start using it during the 2009-2010 school year. Edmodo is another great social media tool you need to leverage for you and your students. You can join communities and share best practices, ask questions, share lesson ideas, find other teachers to connect with. Have your students join collaborative groups to do projects together, identity day or global read aloud, two others to mention are pen pals who write and virtual USA. Also, extend the learning and conversations with a Skype collaboration group for summer reading. Do professional development through Edmodo to find even more connections and ways to flatten your classroom walls. Facebook tends to be the social media site that many think of as a way to connect with family members and high school classmates. Have you ever used Facebook as a professional tool? There are so many ways to use Facebook to find connections and projects. Here are some examples. If you'd like, you can like their page to follow them. International.day Choose to matter Youth choose to matter Classroom blogging buddies For educators by educators Some teachers have a class Facebook page to update parents. Many web tools you use have a Facebook page where educators share innovative ways they use the tools in their classroom. Pinterest burst onto the scene and took the social media world by storm. This site allows you to pin things you find online to boards you create on different topics. It quickly rose to the third largest social media site. When I first discovered it, like many social media sites, I saw it was mostly being used for personal reasons. Boards for wedding planning and crock pot recipes seem to dominate. It didn't take long for me and other educators to see the power of creating educational theme boards and connecting with other like-minded educators on Pinterest. When I need some common core information, Pinterest boards on CCSS is now one of the first places I check. You might also like to check out Global Project Pins, Project Based Learning Boards, My Boards on Pinterest, which are mostly educational, and also Jan's Boards on Pinterest. Do you want to create a sign-up for classes to Skype with or collaboratively on a presentation like Jan and I did for the K-12 online conference? Well, Google Docs is the best way to do that, in my opinion. We have used Google Docs for everything from Skype sign-ups, such as my Mardi Gras Skype one, to locate other classrooms that use a Twitter account, to find motor groups to join, and we've even had our students create surveys using the forms part of Google Docs to gather data for math classes. Over this past summer, we learned how to use Google Hangouts as a video conferencing tool. It is quickly becoming our favorite video conferencing tool. Why? Because it's totally free, and up to 10 people think classes can video conference at one time. We have done several Google Hangouts now as part of our personal professional development, and have even helped other members of our PLN give presentations on Google Hangouts. The quality of Hangouts has remained constant with almost no lag or screen freezes like you often get on Skype. I've been on a Google Hangout where five of the participants were in countries as far away as India and South America, and we had a great connection. In fact, my first mystery location call this year was done via a Google Hangout instead of Skype. Currently, Jan and I and other connected educators from our PLN are working on ways to leverage Google Hangouts to flatten our classroom walls during this school year. Some of the ideas that have been generated include inviting other classes to work on math problems together, having a class of older students read the several classes of younger students at one time, having several classes write a collaborative book together, sharing about your state or region, sharing your best science demo with several other classes, having a guest speaker present to several classes at once. As these projects unfold, we are certain that even more ways will come to mind. We envision Google Hangouts becoming a regular part of our blended classroom during the 2012-2013 school year. Sometimes, after years of collaborating online, you have the opportunity to meet face to face like Paula and I did this summer for ISTI in San Diego. We are setting up a challenge for you. Please fill out this Google form or add to this spreadsheet and tell us the next step you're going to do to use social media to flatten your classroom walls. I find when I tell others I'm going to do something in my classroom, I tend to get it done. Thank you to everyone involved with the K-12 Online Conference 2012 for the opportunity to present this session. As always, with everything we collaborate on, Paula and I have learned some new skills and have fun while doing so. We hope you have enjoyed our presentation and that you will take us up on the challenge.


Sure, sure, no, I've got this. No, you have to use this. Oh, I have to use this as well. Okay. Hello. Hi. Thanks for sticking with us until the end, so I won't take too much of your time. So I'll just introduce a little bit about myself, what I do, and then, you know, she mentioned something about Challenge News Asia, you know, so I'll do a little bit of a plug for that as well. So I'm the venture capital person. I've been doing this for the last five, almost six years in Singapore. I've been in, I'm from Taiwan, but I've been Singapore for about almost 10 years. I was working for some of the, you know, banks and large companies, you know, some of the names have been mentioned before. So I bounced around a little bit and then finally ended up in venture capital. So for me, you know, my story into VC and looking at startups was actually more of a realization, which is kind of going a little bit to what Christina mentioned before of like, hey, I actually hated working in big companies. I mean, I'll just be honest, you know, I was working at some of the companies in here in the US and I just like, I just, you know, it wasn't really what I liked. So because I discovered that whenever I get back after a long day at work, I still, for me, if I have a couple of minutes, I still spend a little bit of time on stuff that I like, which is actually like gadgets and stuff.  So I like gadgets. I like tech.  My parents will tell you like, hey, as a kid, I like to take stuff apart. And I just enjoy playing around with that. And I think, you know, I guess we never change. I'm still a kid in some sense. So I figured that, hey, that's what I like to do. But I actually like finance. I actually like investing. So that's kind of the road that I got, you know, that got me into VC because I play around with tech all day and then I get to invest money. So that's what I do a little bit more about what I look at. So which is a little bit different than some of the speakers earlier. I focus a lot more on the consumer side. So these are the things that probably, you know, you guys maybe have seen or heard or maybe even used.  It's kind of like Carousel. I don't know many have maybe heard of Carousel. So those kinds of companies are some of the ones that I look at more frequently. So things that I guess you and I and, you know, things I can explain to my parents or my grandma and maybe they'll hear about it. So a little bit less on the enterprise side. So that's what I typically look at. I invest in Southeast Asia. I've invested in about 30, 30, almost 40 companies so far. And, you know, they've kind of went on and grown in Southeast Asia. Some of them got bought out and so on and so forth. So that's a little bit about what I look at. And then I think one of Christina's question for me and in case any one of you is interested in this whole startup and pitching all that, you know, what I typically get about probably a thousand or so pitches this is a year. So don't worry. It's not like, you know, per month or anything. So I get about a thousand pitches or so a year. So, you know, that means what I have to do. I have to like, you know, I can't look at all that stuff all day and all night long because I can't do my job, right? Or help the companies that I invested in. So I have to have a very efficient way to sort through all that stuff. So one of the things I like to mention to some of the people that I work with is that, hey, actually our acceptance rate is actually lower than getting into like Harvard or Stanford or some of these like colleges are literally is less than like 2.5% in case you're wondering. That's the acceptance rate for Stanford. So we have to be super, super selective in terms of looking at the pitch. And some elements, the previous speaker I mentioned about is, hey, are you looking at a really big market? Can this business really scale? You know, how good is the team and things of that nature?  So some people, many people ask me like, hey, is idea like the most important thing? If I have a great idea, like, should I just keep it to myself?  And if someone wants to ask me about the idea, they have to sign some legal document or anything like that before I can tell them all the details because that's my secret sauce.  So I get that all the time. My response to that usually is don't worry because a couple of things. One, if your idea is so easily copied by other people by just listening to you talk for a couple of minutes, you probably have to rethink the idea. Probably, right? I mean, you know, so for example, let's take the example of like Grab or Uber, right? Like the idea may sound simple now, but more than 10 years ago when they started, everyone thought they were crazy, right? Like, huh, what, what are you talking about? Like why would I drive around and pick up strangers I don't know, right? This is 10 years ago, right? But now he's like, oh yeah, of course.  But again, back then everyone thought it was crazy, right? So actually some of these guys who started all these companies did the exact opposite. They went around to as many people as they can and share their idea. Hey, what do you think about this idea? What do you think about that idea?  So they get a ton of feedback which helped them to fix their idea and improve upon their idea, right? But again, idea is just one element, right? The other stuff that was mentioned is the team, right? Which actually to me, team also means like, can you really get the stuff done, right? I think some of the earlier comments was, yeah, you can think all day long, you know, you can collect all the data and like, have all these like Excel spreadsheet, blah, blah, blah, but if you don't do anything about it, no one cares because it's never done, right? So it's the same exact concept here, right? Like to be honest, like seriously, I've probably seen maybe more than like 50 or 60 just in Singapore. Like ideas exactly just like Uber or Graph, exactly. And they have all the same ideas, all right? Down to all the details because it's easy because they can just copy Uber, right? Uber has been doing it for a couple years. So they just copy Uber. But again, why does certain companies succeed where others fail, especially when the model has already been successful somewhere else? It comes down to how well can the team get the stuff done, right? So I think if any of you, right, are keen in getting into the startup world and wanted to give this a shot, you know, don't worry too much about your idea. And in fact, I would encourage you to talk to as many people as you can and get as many advice as you can before you jump into it, right? And then the other is, okay, as also mentioned, you know, find a good team member because you can't do everything yourself. I mean, just don't try, right? It's not the most fun thing in the world. So for me, for example, right, yeah, I'm a VC, but I also consider myself a startup because this is a, you know, my own fund that I launched with a partner of mine, right? So we've been like struggling. I came from, you know, way bigger companies in the past. I was working, actually, I was working for Temasek in Singapore, right? So it was coming from a completely different background where if I had some problem with my computer, right, I just call someone and someone will come and fix it, right? Now I have to fix everything myself, right? I have to fix everything in myself. I have to even build our own website, right? Like stuff like that. Or if you're in big company, you don't have to think about these things, right? You don't have to go like, oh, I have to remember to file my own acrophilings and all that stuff if I change my address, right? Like, I never have to think about stuff like that, right? And if you try to do it by yourself, you know, just don't, it's extremely, extremely difficult. Find ideally one, if not, you know, more than one people who can help you in different ways. All right, so let's say, okay, if you're really good with numbers, maybe you want to find someone who's really good at marketing, right? Or find someone who's really good at a certain industry that you're thinking of attacking, right? So you have complementary skills because it's impossible for one person to do everything. Just impossible. So the VC's investors will take a look at that, especially in the early stage when you only have like a piece of paper, right? Oh, this is what I think of, you know, I want to do. Then there's really nothing to evaluate except for what you have done in the past and perhaps the team that you can rally around you. So that would probably be my very quick five minutes. It's up, right? Okay, five minutes, yes. Advice to any of you who's thinking about stepping into this thing. But it's a great time to get in. There's all sorts of funding and grants and everything that's available. Very lucky to have that system here in Singapore to support the startups. So if any of you are thinking about it or even just curious about how to go about launching a startup, I'm happy to hear you to talk. All right, thanks. Thank you. Thank you.


The RM Planning and Evaluation Framework, first conceptualized two decades ago, has been widely applied in public health and health behavior change research as well as diverse content areas and settings, and its focus is on increasing the emphasis on cost and adaptations to programs, expanding the use of qualitative methods, and evolving to include contextual and explanatory factors related to RM outcomes. This article was authored by Russell E. Glasgow, Samantha M. Harden, Bridget Gaglio, and others.


I can do it without a script on the beach. Okay. Hello, Brenda. Yeah. Hey, Brenda, this is Cody. Hey, I'm getting back to you about your request for the new final expense information. I'm assuming you remember that online just a few minutes ago. Yeah, I can. If I may real quick, I'll actually be out in your way on Tuesday. Should I just drop that off in the morning or afternoon? Okay. Do you think two o'clock is okay? Okay. Okay. Yeah, well, talk to me. What could possibly... Oh, I hear the dog. There he is. Okay. Okay. Well, what we'll do is I'll be out there anyway. I hope it works. If it doesn't, that's okay too, and I'll just give you a call back to reschedule, but I'll try for Tuesday at two, okay? I think so. Perfect. Thanks so much for your time. Appreciate it. I'm maybe wouldn't have said it. She's 10 minutes from my office. I might as well. And also, you've heard multiple calls to where they've given me an objection. They're like, hey, you know, I can't do it or Monday won't work. I've got doctor's appointments or I'm with company. Can you call me back? I've got her on the phone. I don't want to call her back. So at the end of the day, I'm in Jamaica calling leads live on vacation. At the end of the day, I'm calling these legit, real leads. I've gotten 10 in like the last hour. All it comes down to is, can you buy leads? Can you call them and can you repeat the things that I'm saying? If you can, our leads help agents make six figures, 200, 300, 400 grand, even half a million dollars all the time. So what are you waiting for? Live from Jamaica? You might as well try these things out.


Wow, we got a big turnout today. I'm impressed So everybody have a good holiday? Yeah, it's kind of hard to get started nothing like doing pathology the you know Morning that you guys come back from a nice holiday. So all right, so we're going to go back to Copenhagen, so this is the Classic tour boat the funny thing is is they keep the bridges really low So in high tide when you go through there You have to like fill your head sideways if you're on the end or you know bang your head underneath the bridges as you go Various canals and waterways, but it's a good way to see the city Copenhagen interesting city It's you know a lot of 400-year-old buildings and then interspersed with some really ultra modern Architecture, which is kind of interesting. So this is their opera house Right on the water very nice You know glass and steel and very very ultra modern and of course you've got your old You know government building here, you know Castle that the King had lived in and so that was built probably in the 1600s And so a real juxtaposition of old with new in here This is the new Main library, so this is kind of their the country's Library kind of library of Congress again if they call it the black cube and so it's it's black glass It's a Cuban. It's got a big atrium kind of like Moran and these are all escalators going up. It's it's pretty cool inside What's interesting is is again the juxtaposition of old with new it's a bunch of musty old stacks And then a bunch of computer terminals and so again mixture of old and middle And this this kind of summer as a scope, but you can hear the ubiquitous quaint crane There's cranes everywhere. I think that's their national bird is the crane So you see cranes everywhere building and you see the old Tower so a good mix of old with new so we're going to talk about lens path today and You know if you remember Five weeks ago. I know it seems like an eternity, but last year when we talked about Embryology since you're in the the hot seat there Reese Tell me a little bit about the embryology the lens. What layer does it come from and how does it form? Okay, what kind of ectoderm Surface so it's really important to remember remember the important parts of the eye the retina the pigment epithelium come from neural ectoderm Whereas the surface ectoderm gives rise to not only the skin The epithelium of the skin the epithelium of the conch in the cornea, but it gives rise to the lens itself So early on in gestation You'll get this neural ectodermal out pouch Then it'll touch the surface ectoderm and then we'll induce it to thicken and then you'll get an Invagination and so this neural ectoderm forms the you know the sensory parts of the eye But the surface ectoderm eventually pinches off Informed the lens itself. So the lens is it's coming from the surface ectoderm and when you look at these these are in Embryos, I think mice or something. I mean they're very much like humans at this stage But they've highlighted it here. You see the here you see the pinching off and here's the surface ectoderm And then eventually it pinches off and forms the lens All right, so this just shows it schematically what's interesting is as the lens begins to form its first of all just a round ball But then the cells in the back Will migrate forward and as they migrate forward they fill that in that's an important point because throughout life There normally should not be Lens epithelial cells along the posterior capsule we've migrated anteriorly and when the lens grows throughout life These cells will go out along the equator No, thank you. This is not an Apple computer. So I really don't think we need new Apple software So what happens is is the cells will then grow out along the equator And then fan out and that's how the lens grows throughout life So this just shows this in that this is actually human embryo You can see the cells have come from the posterior surface growing anteriorly Feel that circle with the lens fibers themselves All right, so this is what the lens looks like with the slit lamp On something you rarely see at the VA at least when you're there, which is a nice clear lens But you see as we become older the lens goes from round to being more of an oblong So it's more of an oval than it is a circle itself. This is what it looks like in pathology And let's go a little bit You know, there's several parts of the lens you want to think about and and you can put it into different layers The embryologic nucleus the fetal nucleus the adult nucleus the cortex the capsule And then the zonials around it All right, ashley. What kind of stain are we showing here? They look closely at what's picking up a lot a lot of bright stain there All right, so this is this is PAS because what is PAS stain? basement membrane. So what is the lens capsule? The thickest basement membrane in the body. All right, so we're number one So the thickest basement membrane in the body is the lens capsule You got to remember that the lens capsule is truly a basement membrane but if you look the anterior capsule is probably 50% thicker than the posterior capsule So when you're looking at pathology specimens, you're not quite sure where it came from The thicker of the two is the anterior capsule And ashley, what are these underneath the anterior capsule? Those are the theos cells. Remember we said there should normally be none posteriorly So that looks really thick in this big picture, but that's really only about 10 microns thick. So that's all that's between You and vitreous when you're in there with a 40,000 hertz ultrasound machine with suction going full blast So always be sure that that's all that's between you and disaster So be really careful around that lens capsule when you're operating All right, what part are we showing here Chris? The equatorial region of the so-called lens bow And so as you look right here when the lens fibers grow throughout life, they come to the equator And then they fan out and if you see this in three dimensions, they fan out along the edge of the equator So if the if the lens were flying saucer there on the edge of that flying saucer And then they send fibers both anteriorly and posteriorly Nico, what are we looking at? I'm sorry, renais pulled out there, but you're still in order renais What are we looking at here? Zonior fibers So it's important to know here's the lens Here's the ciliary body. This is a scanning EM Look at where those zonials go they go some of them attached to the ciliary processes Some of them go all the way back here Almost to the par's planus. So it's really anchored in tightly Those zonials really really hold that lens in place And so I like to think of the zonials as like the springs on around trampling And so they're the ones that hold the lens in place But if you look the anchor way back here, so they can go back all the way from the process These almost to the par's plan of the flatter part of the ciliary body Nico, what are we showing here? We're seeing kind of the y-suture Well, actually if you look carefully even in adult lens, you'll see some variation of a y-suture So, you know, if you guys want, you know, you'll say, yeah, I don't really notice y-sutures You know, when you go to clinic today, just take a second and somebody nicely dilated look at their lens And see if you can't find the y-sutures. Why do they form? I think it's like the intersection of Migrate Well, it's where their processes come anteriorly and posteriorly And so remember because that lens is more oval than round Those fibers don't come to a complete point because it's not perfectly round So they come because it's oblong they will come to a different point Often form a y and what's interesting is you can see a y up and down and a y inverted Depending on when you look at the lens itself And oftentimes the inverted y is in front and the straight up and down y is in the back But these kind of denote the nucleus, especially the anterior part of the fetal nucleus And then the beginnings of the adult nucleus And here you can see the fiberverse The lens fiberverse And when you look at them, they're shaped almost like a honeycomb Which is interesting and so the nuclei are at the equator, but those fibers go both anteriorly and posteriorly Okay, so taro, what is the what's in those lens fibers? What are they mostly made of? Well, they've got a lot of proteins in them That's what you want to remember and you've got alpha and beta crystalline proteins and they tend to form Certain networks with the proteins and the reason that they're important is As you get older and older Or sometime the proteins in those fibers will clump together and then they'll start cross-linking And when they do, that's when the lens becomes both harder and less transparent So as it becomes cloudier, it becomes harder, it becomes a cataract as we age All right, what uh, sorry, I'm on this slide Sranath, what do we look at right here? No, this is a contact lens And it's a special type of contact lens because what else is going on with this patient? Here's the pupil right here. What is this? Now look at it. It's actually still behind the pupil So what's happened to that lens? Yeah, it's dislocated And note the direction if this is a left eye, it's dislocated superiorly And temporarily does that tell you anything? Actually, that's the pattern of lens dislocation that you see in Marfan syndrome Now why that is, I have no idea. I mean gravity pulls down, it doesn't pull up and out So why Marfan's dislocates superior temporarily? I don't know, but it does. It's very weird And so Marfan's tends to dislocate superior temporarily in the zonio's giveaways If you saw Nealopathy, and this is an AFAKE in contact lens And this is him. This picture is so old. This is the original Maran clinic Which was in the old building on the A level, which is now I think he had tea But in any event, that's when the whole Maran had 10 exam rooms. There was no Maran department of ophthalmology This is one of our old tags And this gentleman has got Marfan's, look at his fingers And his legs in his arms. So that was him, Marfan's And he wore AFAKE lenses for years, and then that Nuclea or that lens started to get a little bit more dislocated and there was risk of people are in block So he eventually ended up with cataract surgery So dislocation of the lens is a common thing that you see in Marfan syndrome Because Marfan's is a disease where there's You know disruption of some of the strength of the fibers And so these people get aortic dissections They get all kinds of other things that that are due to the Problem with the strength of the fibers So because the zonular fibers are weakened in Marfan's, they tend to get dislocation This is one I've never seen one of these. This is another common cause of dislocation. This is homocystinuria And the only reason I have to show this is because they put it on like OCAPS every other year And I've never seen one in 30 years, but they exist and the weird thing is in homocystinuria They dislocate inferior nasal Whereas Marfan's they dislocate superior temporal again. Why I have no idea Becker, what do we see in here? I'll give you a hint pupil is Exactly so lenses can also dislocate enter in this particular gentleman. It was a trauma This is a traumatic dislocation. And so if you have a severe bone trauma, it's not common But you can have a lens dislocation the anterior chamber now There's another condition you have to memorize for boards that can cause Dislocation of the lens into the anterior chamber. What could that be? It's actually sphero fakia So sphero fakia is an interesting disorder where the lens is spherical shaped instead of oblong. It's round and it's small So sphero fakia literally sphere shaped lens So sphero fakia and they are at increased risk of a spontaneous dislocation Enter because these lenses tend to be small and you get the weak zonials and then they can pop anteriorly Here's a man I can't blame the fellows on this one. This is a copy of an old AFIP slide This is probably 50 years old, but you can see that there is lens that spontaneously dislocated Into the anterior chamber all right now Chris This is a younger child With a cataract and I'm not sure why the eye was removed the child died or not But and this just shows you that the eye is small As you see in terms of the size it's only it's only about 12 milliliters down a very small line. What do you make of the shape of that lens? The left over so it's cut in half I'm sorry. This is a normal size for the kid and this is one next to it just showing the difference. Okay, so it's very round correct So what could a child Have that can cause a smaller round or lens in addition to maybe some damage to their retina and other things Elsewhere in their body Of the infectious process the kids hear exactly and what's so infectious process that can give you Smalls, you know, micro-sphere Rubella exactly so this is a rubella cataract And that's important to remember because you may be seeing these more often because that well-known physician Jenny McCarthy Has told people that vaccines cause autism and so therefore a lot of people are not vaccinating their kids And so you're going to start to see outbreaks of things like measles and rubella as people are not Vaccinating now I find it interesting that you know somebody who listens to Jenny McCarthy Well, maybe they're not sophisticated, but there's a pocket of people in park city You know very intelligent very bright people are not vaccinating their kids now And so you're going to see clusters of these You know infectious diseases that we thought were wiped out coming back And so you may actually see rubella And it can cause this micro-sphere of fakia And the other thing that's weird about rubella is is that you get retention of these Rubella you get virus fibers even in these lens nuclei So even after they've had the virus there still be viral particles there within the lens itself So very very interesting entity All right, so we're going to talk about cataracts so so leave what kind of cataract are we looking at here Well it Polar means kind of in the anterior posterior Center this Is bigger than just that what part of the lens is this taking up? That is actually the entire field nucleus And so this is a congenital nuclear cataract And what's interesting also is with this one there's kind of the male symbol.  So this is a We shouldn't say that now because he died this year. So that's really steep because he laid prince And so this is a congenital cataract involving the lens nucleus So it's involving the center of the nucleus the field nucleus Right here and this woman is interesting. She never had it removed. She's she's like 70 And her vision in that eye is count fingers and yet she functions through in life She's been functioning with this since she was a child And this is just showing you a different view. Here's the edge of the pupil dilated here And this is a slip beam. I was trying to show this on here. See how that Fade opacity is in the center of the nucleus Again in the fetal nucleus so congenital Nuclear cataract in the very very center. So they're very discreet very very central nuclear opacity. So What's that? This is a different patient. Another patient. All right, what do we see in here back to Vectories So it's a White lens and then This is just what you normally see You know in an aqua one it's been kind of this is just showing you kind of a A dense dense cataract from an eye that's been cut sagittally Okay, so now we're looking this is called the Miyake apple view So Miyake's a guy in japan who figure out if you cut an eye in half and go to a slide You can actually look at the inside at the same time as you're working You know enter as you move posters So this is if you're sitting on the optic nerve looking out And so you can see here's the ciliary body and then the zonules are here And so you can see right here. This is a nuclear Cataract and so nuclear is the most common type of cataracts we see in an adult So an adult nuclear cataract. This is the ultimate nuclear cataract. What do we call this actually? Renneson means brown light And so you can have a remeson cataract you can even get I don't see them in the first world But in the third one you can even get cataracts at all almost from black. They're so hard So this is a remeson a brown light cataract. That's a dense dense dense.  We usually don't do the path of cataracts that are removed because you don't really see anything Here's the nucleus And here's the cortex you could say well, yeah, that's Kind of denser. It's taking up more stain. But to be honest I couldn't look at this pathology and say is that a trace nuclear or a three plus nucleus They all look the same pathologically So it's really hard to tell anything on the pathology of a nuclear cataract Chris, what do we see in here? Cortical cataracts. Cortical cataracts. You see the classic wedge pie shape cataracts So they come to a point in the center and then they have this wedge or this pie shape So these are the cortical cataracts and then here's one posteriorly you kind of see the A little wedges there of the cortical cataract and what happens to the fibers that causes a cortical cataract? So they get fluid filled? Exactly. So you get liquefaction, so you actually get fluid in there And so it's kind of fun Next time you guys are with me I'll show you when you have a the cone with really distinct cortical spokes when you go to start the capsule raxus if you just push the lens Push on the capsule those bubbles will just go away. So it just liquefies and so there's these little liquefaction bubbles all over here that are really The sign of a cortical cataract And this shows you severe liquefaction of the of the cortex So you've got these fibers broken up with little globules and then you've got just fluid basically liquefaction And you know as the cortex breaks down Renee what we see in here? sunny side up this looks like Hyper mature like we have more gagmian cataracts. Okay, and what causes more gagmian cataracts? What causes that appearance? Exactly so this this is an example where the cortex completely liquefies And so it's basically just a bag of liquid and then what happens is is that dense nucleus in the center? Drops down and so you'll see these that nucleus will be sinking down and Instead of the capsule being really tense like you see in uh Intimacy of white cataract the electricity still wrinkles in the cataract because as that liquid leaks out the cataract Actually shrinks a little bit in the capsule bag And as Renee said it's got the sunny side up look to it. So This is the more gagmian sunny side up cataract And there you see one that was actually removed. Here's the dense nucleus Here's the what's left of the capsule and you see there's virtually no cortex in there It's all completely liquefied Nico what are we seeing here? Yeah, if you look right here, look there's the anterior surface of the lens right there You can see we're focused really deep. So this is actually What we call a posterior subcapsular psc And here it is on retroalumination. So these really show up well on retroalumination There's a higher probability. This is a student volunteered in my lap this summer He said oh someone told me how to cataract one. So we dilated him and looked at him sure enough Pse cataract and they're showing you a more diffuse one And so these show up best on retroalumination So when you look at these you put that beam straight on Move it to the temporal side of the pupil and then look at the orange light coming back And you'll see these outline posterior What's the pathology characterized by? Exactly. So I guess that the proper ostium would be vatal W e v l vatal cells And so you get these very decon bladder cells and they're very swollen Now the other thing this is the posterior capsule. By the way, this picture is upside down Next year, I'll ask you if that's right side up or upside down. Let's see if you remember it But this is actually the posterior capsule and you can see we've had migration Of nuclei along the posterior capsule and then they become very swollen like bladders There's the nuclei in the center. And so this this is what we see characteristically in The posterior subcapsular now. They always love asking this Tara, what's a differential diagnosis for causes of a posterior subcapsular cataract? Okay, so cortical steroids trauma trauma One other main area main area that can cause pscs Diabetes can't help another one Drop then not really I have a main area that can cause pscs inflammation And so you see these often in uvias You'll see these in like especially like people with intermediate uvias so called pars planias We get a lot of inflammation You will get these psc cataracts and so some of it can come from the inflammation Some of it can come from the treatment of the inflammation Which is the cortical steroids that the tarant said right at first So cortical steroids are a common cause of these Diabetes inflammation and then some of the less common causes So pscs are one where we can actually Find a particular cause that these can also be due to aging But oftentimes they come on earlier and they come on secondary to other things All right back up what we see in here What what part of the lens are we looking at at this point? That's actually part of that. That's some denuded iris at the top Part of the lens are we looking at here? This is the anterior part. So this is the iris here This is the anterior part. Look, there's a capsule completely intact and then underneath the capsule You see this area of opacity So this is called an anterior subcapsular So believe it or not you can get anterior subcapsular just a giga posterior subcapsulars These are a little bit different because these are caused by Those anterior lens epithelial cells Undergoing a metaplasia meaning they change their characteristic and they become fibrous And so anterior lens epithelial cells can actually undergo fibrous metaplasia This can be congenital. It can be due to an insult Now a good example of that is when you guys are looking at somebody you had counteract surgery 10 years ago with a beautiful rexis And they're dilated look at them. What do you see? You see the edge of the anterior capsule look kind of white Or it leave and constrict it will cause what's called thymosis That's anterior fibrous metaplasia Of the anterior lens epithelial cells so you can see that every day in clinic But this is an anterior subcapsular counteract, which is actually not very common And here's what it looks like boy bonus points if you can name this stain anybody Tri-chrome very good. Is that ashlyn? Sorry, I'm under the lights here so I can you guys are like just outlines So this is actually a trachrome stain and the reason it's very interesting is it stains Fibrous type tissue collagen blue And so you can see right here. This is fibrous metaplasia those anterior lens epithelial cells start laying down fibrous And that capsule's still intact And the normal cortex is down here and you get this focal area this anterior fibrous metaplasia So anterior subcapsular cataracts can be congenital they can be post-traumatic Other entities are very weird obscure Syndrome don't worry. Well, they may show up once in a while, but don't waste neurons at this point What do we see in here chris? Actually, this is a normal eye. It's just been cut in cut Sagittale and these are the this is the central collage.  What's the shape of that? It's bone or horseshoe. Yeah, it's kind of a horseshoe shape And if we have a cut that went On all the way around believe it or not, this would go all the way around almost like a ring This is called a summering ring and and it's not summer like the season Summerings was a was a pathologist so e m m e r i n g s summerings This is called a summering ring. These are initially seen As people would have trauma. So if you had a traumatic rupture of the lens And the lens nucleus gets extruded But you have some cortex left in the periphery. Remember at the At the fornix there you've got all those little lens epithelio cells and they can grow And so you end up with this is a traumatic summering ring cataract But more commonly We see that leaf What are we looking at here? That's a summering string, but what's this this patient hasn't had trauma. What have they had? Cataract surgery. So believe it or not, there's an iol bearing here They've also had glaucoma surgery. There's a A tube in the anterior chamber, but you can see that the lens implant is here and you see this this proliferation. So Initially people were doing What we call intra capsular cataract surgeries meaning they would dissolve the zonus and yank the whole lens out And then give the patient thick coke bottom glass as they take expectacles But as intraocular lenses Were invented and people started going down to extra capsular surgeries So what you did was you would extrude the nucleus and then you'd suction out as much cortex as you could but you know without a Capsule rexis and feco you really couldn't get that all out. So there'd be lots of cortex left in the fornix But there'd be lots of lens epithelio cells left and as they grew We saw summering during very commonly In the early extra capsular surgeries with poster chamber iol. So this is circa 283 And so you see it was very common to see this summering dream proliferation And even in more modern surgery, this is now maybe 1990s Here's a three-piece iol in the capsular bag this patient had feco You could still see a peripheral summering dream these lens epithelio cells growing And this is what it looks like in cross-section It literally looks like a dumbbell or a dome it So if you take a dome it or cut it in half it looks like a dome And you've got for the first of the cortical material here in the fornix on both sides But in the center it's still clear All right, so lea a chance to redeem yourself. What's the thing is this? Try growing very good. So here's the anterior capsule. Look how thick that is Compared to the posterior capsules. You see it's twice as thick And they will almost fuse together at the edge of where the capsule raxus was and here's proliferative cortex In the fornix. So this sort of summering dream looks like pathologically All right back to Reese. What are we seeing here? um Looks like there's maybe Exfoliated material from the iris Large and then on the interior lens capsule. Okay, so this is a classic picture of exfoliation syndrome now People used to call this exfoliation of the lens capsule And it's not so much that that the lens capsule exfoliates It's that exfoliating material gets deposited on the lens capsule and the reason why you see this pattern is Where the pupil? So the pupil goes back and forth almost like a windshield wiper So as your pupil goes in and out it kind of sweeps that material more to the center more to the periphery And so when you look at a lens with exfoliation syndrome, you'll often have a clear zone here where the pupil normally goes back and forth So this is a classic picture of exfoliation syndrome Here you can see the so-called scalloped edge. Now, this is blatant Now oftentimes when you see these in Crandall's clinic, it's much more subtle than that You maybe you'll see a little ruffle at the edge of the pupil You see the pupil may be not dilating quite so well. So not quite as Dramatic as this, but here's a nice dramatic Scalloped edge that's set material on the lens capsule and then you can see on retro-lumination Again that nice scalloped edge. So this is blatant exfoliation syndrome Now um Ashley What is this showing? The iron phyton. So when you were kids you ever take a magnet and Put it on those scrapings of iron and they would stand up on there So this is what they call the iron phyton pattern. So when you look at Pathologically here's the lens capsule. Here's lens of the cells underneath and this is the anterior capsule Here you see the exfoliation on the anterior lens capsule. So What is the importance of exfoliation to a cataract surgeon? Okay, in what ways? Well, it's a triple threat. And so it does weaken the zonials, but it weakens the zonials by where it deposits And so this exploitative material can deposit anteriorly where the zonials insert the lens capsule So they make that insertion weak They deposit on the zonials themselves which makes them more brittle And then even posteriorly you forget this stuff can be deposited posterior on the ciliary body Where the zonials insert to the ciliary body so it weakens them in three different places So when your cataract surgeon not only does the pupil dilate poorly the capsule is more brittle too So it's a little bit more brittle, but the zonials are weaker. So you got to be really careful And the reason that that's important here in Utah, we see tons of exfoliation in Utah Chris, why is that? Yeah, so what what populations didn't have more exfoliation Cocculations, but there's a subgroup you finish Yeah, even just Scandinavian in general and even northern Germany And so where do a lot of you know people's families from Utah come from? The yasha area, you know speed Norway and Denmark yasha, you betcha And so where do you see a lot of exfoliation? It's interesting in the u.s You see it in minnesota and you see it in utah And so that's where Scandinavian populations have come and so you see very commonly Exfoliation you may not necessarily see this in like alabama, but you see this more frequently in People of northern european ancestry and so we see tons of exfoliation here in utah All right, boy, this is kind of subtle lene Here's our answers that we They ground a little bit of scrolling. Yeah, let's scroll over that capsule. What causes that? True exfoliation true exfoliation So we had to call it true exfoliation to differentiate from the pseudo exfoliation exfoliation sensor So this is truly where the lens capsule has split Now this was just a normal You know nine-year-old lady with no real history. What have we historically seen true exfoliation in? Yeah, people exposed to heat or infrared heat especially so glass blowers people used to work at steel Blast furnaces, you know nowadays it's mostly automated, but they used to be people who would open the things up and push stuff in there And this you know hot stuff would come out and a glass blowers especially And so you would get a very brittle anterior capsule and it would actually scroll And so this is uh sam masker. Give me this picture. This is actually intraoperative And you can see that little scroll Of that anterior capsule curled up. So it's interesting He was going to do a rexess And realize that that's not the entire anterior capsule Sam's a good observer. So it took a nice picture of this and He set me the capsule which was fun. We actually put this in you know how they do that Inet It's the academies little magazine that comes out every every month and they put interesting stuff on the cover So we got an inet cover with this and so this is the anterior capsule and here is There's lens up through cells and there is and it's literally In the capsule itself. So you get splitting of the capsule. So you truly get an exfoliation True exfoliation a true splitting of the capsule And there you can see there's lens up through your cells. There's the capsule. There's the split So true exfoliation Nico what do we see in here? So this is an external photograph of the You can't see iris So not only is that corneal pacified that cornea is pretty quality but there's almost like some Stuff here some whitish stuff in the anterior chamber if you look at it Now this is a nevada rancher I've been hurting like crazy for the last week because you know nevada rancher never come in right away Well, how long have you not been seeing a lot of that? I spent a while Any history of trauma?  So You see this pressure's 50 50 Not well, yeah, it could be antigenic if the lens has been ruptured What else could it be? What if the lens capsules completely intact? Exactly. So there's an entity called fecal lytic glaucoma. It's really weird because lytic means splitting and so it's not Nothing's really split. But what happens is is in this fecal lytic glaucoma the lens liquefies So this can be from an old trauma, but it's just from a long-standing Intimescent liquefied lens And in fact it liquefies so much the proteins leak Through the intact lens caps on the anterior chamber and when they are I'm leaking into the anterior chamber. They induce an inflammatory cell reaction of these cells. What kind of cells are these? Exactly. So they're macrophages So again, if you put an english accent it sounds intelligent Macrophages and in fact the eyes are often enlarged. They often measure two centimeters And so you see these macrophages and look how big they are. I mean, that's a normal macrophage right there Look, they're just totally engorged and so they try to eat up this pigment And as a result these engorge macrophages not pigment protein So these engorge macrophages and the protein Clog up the trabecatal mesh work and so you get a severe glaucoma It's called fecal lytic glaucoma What do we see in right here? Tara, yeah, there's even optic capture here. You can start to see the eye well through that thin Um, iris it's really been thin. There's optic capture and there's all this white stuff in here This eye has high pressure. They've got chronic uveitis What's this condition called? Well, it could be if you had hythema it could be an ugg syndrome exactly you guys call coma hythema But this is an entity where you get inflammation and then secondary glaucoma from Reaction to leftover cortex And so the setting here usually is there's been a capsular bacteria They haven't cleaned up the cortex well. They try to put an implant in the sulcus They got out to capture that you get this it's called a phaco toxic uveitis So it's due to inflammation from leftover cortical material in there and so You see these non uncommonly capsular back here cortex left in there Difficult to control glaucoma difficult to control uveitis. You don't have to clean everything out to get rid of that Eye, that's right. What do we see in here? Exactly. In fact, not only are those crusadic erratic precipitates we abbreviate as kp, but look at the size of them They're they're kind of big and even greasy looking. What do they call these?  And so what's that indicative of?  There's a ring of this inflammatory material surrounding And involving the lens capsule. So we call that cyclic meaning the space of the ciliary body So what other inflammatory entity can you get involving the lens? Exactly. So the proper word you need to remember now is facoantigenic uveitis meaning you get an autoimmune reaction To some of the proteins in the lens. They used to call it what Actually, it used to be called facoanaphylactic endothelitis. It was you know, again, it was one of those misnomers. It wasn't anaphylactic. There was no IgE involved in this but You didn't this was reported all the time in like the 1920s Believe it or not people were doing crude extra caps in the 1920s They were going in there carrying off the capsule and then kind of flushing out the lens And then of course as I said people went to intra caps for about 30 years Where you remove the whole lens and the lens capsule. So this disease disappeared Well in the early 80s people started doing extra caps again Where you would do a counter capsillotomy try to force out the nucleus suction up cortex And there was a resurgence of facoanaphylactic endothelitis because we were leaving behind lots and lots of cortex So you would trigger an immune reaction to it And the only reason I know all of this is there was a Swarmy Dark-haired guy with the mustache and Dave apples lab that wrote Up the first case that had been reported in like 30 years And so this is indeed that case we see this very rarely I think I've seen about two or three of these since then why because we now do capsillotomies with a brown Rexis was totally intact and we're better at sucking out the cortex So there's not a whole lot left over And so this is actually a reaction to the lens cortical material and it's You can also occur due to trauma And so again, this guy literally got kicked by a horse And It's a similar reaction of fatal toxic is actually due to the cortex itself causing inflammation It's not very momentous and it's not Antigenic induced, but it's the same idea Here's an eye this gentleman lost this eye Here's what's left of his lens. It's ruptured here and then you've got this big inflammatory cell reaction around it So dramatically ruptured lenses will give you this also Here's pathology here. I know it's hard to tell Where we're looking at here, but believe it or not. This is the lens capsule here. This is the Corning up here. That's what's left of iris solar body And you can see there's some lens cortex here There's capsular bag and you just see this inflammation and it's a zonal inflammation Remember when we talked about differentiating lumbar simplifications? And so you will often see Giant cells epithelial cells macrophages here Munching up that cortex and then around that you'll have a zone of some lymphocytes around it So this is the so-called fecal anaphylaxis or now they call it fecal antigenic UBI this is the proper word. There's a lens capsule And it's hard to see there's some giant cells here Some macrophages There's a giant cell Sitting on the lens capsule munching up that stuff And so this can occur In a dramatically ruptured lens, but also in a very badly done surgery Lots and lots and lots of cortex left over Now people have argued about what triggers this immune reaction and initially in the 1920s When they were describing this you do cataract surgery in one idea would get this You would do it in the other eye no matter how good you did the surgery They'd still get an inflammation So there's some kind of immune component to this that we don't understand But as we've gotten better at doing cataract surgery, I just not seeing this anymore Okay, and there's this almost looks like the Horseman that you have above the Grandinburg gait and the lander. This is actually getting So next week You guys get a reprieve because next week we're going to talk about eye allowance And there's really nothing about iowls in your bcsc books, so you get a reprieve But we're going to talk about history right now talk about anything you guys use now We're going to talk about the history of iowls because I think it's important to understand how we got where we are now And I'll often have you know residents and students will come up and say, oh, why don't you do this?  That didn't work And so it's kind of nice to get a little bit of a history. So next week history of iowls you get a week off Now we'll go back to glaucoma after that


Alright guys today, we're going to be telling you how to astral project and then at the end of the video I'll explain a bit about whether it's been proven and some interesting things you might want to know So stick with me till the end guys. This would be a very short video and hope you enjoy it. So To ask for projects the first step is throughout the rest of today You need to tell yourself and build up your positive Affirmations that you can do it. You need to constantly tell yourself. I can ask for project I will ask to travel that sort of stuff Tell yourself this throughout the whole day and then when it comes to time to go to sleep You went to step two, which is you need to meditate relax go through a rate of relaxation routine Okay, you need to do things like make your room as relaxing as possible and You know spray your pillow spray, which has been proven to work by the way pillow spray Have your dream journal by your bed and make sure there's no annoying lights or sounds in your room The next step Probably the easiest step of all I would say is you need to actually go to sleep now If you're really excited about astral projecting if you really want to astral projects like tonight now Then it's gonna be hard to sleep because you'll be excited, right?   This is quite important You need to make sure not to move anything because the way this works is you're going to go through sleep paralysis, which is a natural Paralysis situation where your body is paralyzed.  That's all normal That's all nothing to worry about and then that's that's known as the vibrational stage by the way the vibrational part Then as you go through that as you go into the astral experience what you need to then do is You can either imagine something physical above you Like a bar or rope. This is known as the rope technique.  Important points for this you need to really believe that it will work and you also need to So let's just go back a bit.   And then pulling yourself up out of your body with the rope and then from there You'll be in the astral plane. You'll be able to move around to do whatever you want And then to come back obviously follow the what's known as the silver cord Which will take you back to your body Now that's how to do it. That's how to astral project now This is the interesting part which I wanted to wait till the end to explain just because there are People that will find this video will be people that want to learn how to astral project or people that don't believe It's real and just want to see how it works because they're curious You may have seen my other video where I say lucid dreaming versus astral projection, which one is real In a nutshell my opinion and the opinion of many other scientifically minded people Around the world is that lucid dreaming is proven. It has been proven using a test Which tracks people's eye movements and they can confirm certain patterns looking left to right Which have been arranged beforehand in a lucid state Or is astral projection is different because astral projection is something where The idea is you visit the astral plane, which is a physical or non-physical. I guess you could say measurable place where you can go and meet other people meet other astral travelers and exchange ideas talk to them communicate and then come back to the real world and apparently Know what you've just experienced as in say if there was a room in your friend's house in The real world the theory is he could put something on a piece of paper write write a number on a piece of paper and the astral traveler would be able to visit his room and Read the number and then come back to the real world and Tell people the number right this test has never been proven the idea behind that has never been proven No one's ever done that in a controlled scientific environment Which thereby proves that you when you ask project you can't enter the real world, and you're not Visiting anywhere other than a part of your own mind a Internal world a dream world right now as I was explaining that technique you may have noticed That it sounds very similar To the weight-induced lucid dreaming technique and that's because it pretty much is it's the same thing You're targeting your REM sleep. You're then going back to sleep right entering sleep paralysis Going through sleep paralysis is going back to sleep and falling back asleep And then you're entering the dream through hipnagogic imagery the flashing lights the vibrations Whatever you want to call it is hypnagogic imagery Meaning the state between being awake and being in a dream it only happens usually when you're keeping your mind conscious throughout the process and It only really happens when you're dreaming So this is an important distinction to make The actual protecting technique that I've just explained to you the rope technique is a lucid dreaming technique fundamentally It's not been proven that it can work outside of a dream And it's not been proven that the experience you would have doing the technique isn't a lucid dream because it is So that's an important thing I wanted to mention Hopefully this has been helpful and by the way even if you even if it's not a real provable state Okay, astral projection is just another name for lucid dreaming. So the technique I've just explained you can use to lucid dream Okay, you just can't astral project with it because astral projection fundamentally is the same thing as lucid dream So hopefully this has been helpful leave a comment letting me know what you think Maybe you think I'm wrong. Maybe you think I'm right. I'd love to hear and I'll see you next time


It's easier to be outside, but as you learned, it's very difficult to get anything done. It's very difficult to learn. And we ultimately do need to be making a commitment to our corporal structures. And this is a call to all sensitives and all intuitives and people that feel overwhelmed by being an empath. It's there's work to do. And yes, it's uncomfortable. But right now, really in the world, we need all hands on deck for being able to tip the scales of including our incredible senses of knowing our sixth sense, our gut sense. It's really time. So I'm so glad you came around to it. I had to too. It's really just about a willingness.


It's already been a long day It's 10 a.m. It's been a long day. We're gonna have a great day today. I believe that Your hair looks good. Let's go Phil's. Let's go Phil's the hard part got some sun yesterday. Yeah, he'll do that Do that you put Sun ten lotion right down the strip do a ring Let's go 86 one didn't want to mess up the shot Stop it back bounce. It's makes just drop. We are on the berm at Spectrum field I want to say spectrum stadium because I'm an alliteration guy, but we'll say field This is one of the nicer ones.  Give me the mics guys. This is what the people want I have hit some home runs here. Yes. I have especially onto this berm not enough for them to name it after me That's an in target field. They named the berm after me out there But you ever get worried that you might hit a kid who's not paying attention. No, okay? That's the reason I wouldn't even think about it Okay, well, we're trying to drink Jake's already got a lady drink I took a little bit to keep it from spilling a banana. What are you accurate? Is that a that's a yingling give me the Young long this is a cigar city highlights a Tampa beer So we're staying local that might be the most popular beer in Florida like Around yeah cigar city gross cigar city Banana daiquiri Jake. How was it? It's pretty good I uh, I think a lot of people look at me and see banana daiquiri.  Are you guys sharing that thing?  Thank you Roosevelt done that from the start Hey, you like bananas, huh? You like banana runts. Mm-hmm.    I've got a quick story. This is pretty good You want to put a number on it?  He started making him boozy Blasted in the Dominican Republic as a 13-year-old follow up to that gain 15 pounds on that trip because all I was drinking was pina coladas Disgusting high-level athlete that trip in this trip got brain freeze Have something in common How many how many LBs you think you're up on this trip? Honestly, I've been keeping this diet for the past couple weeks just because I've been busy So this is just my life now. I think I'm I think for this trip. I'm honestly flatlining, which is bad Should we do like a team John boy weight loss thing? Oh my god Hold the phone. He's got a cannon. It's a rum runner popsicle They have a picture of these popsicles in a drink and I was like that looks fun We'll get that. Yeah, I said, can I get one of those popsicle drinks? She said what flavor do you want? I said whatever she gave me this. I said, where's the drink? She said you didn't order the drink part It's like kind of did I kind of did so give me that point out the drink thing. She's like what drink do you want it in? It's like my Dominican Republic story Starting pitcher Bryce Wilson getting loose in the outfield.   He has either a lax rum runner rum runner popsicle as Jake dies.  Yeah taste like booze Tastes like a freezy pop We have been drinking nonstop for a week orange juice pineapple water spiced rum cane sugar bananas blackberry Brandy grenadine. It's not good. I don't like it. You want the rest of it? Put a score on it, Jim Put a score on it. Oh two Know what this is good. Yeah more. I drink it's good. I'm up it to an eight. Were any of your teammates six seven What is that like Six seven height. Yeah, I don't know Mike Pelfrey. Maybe ready your teammates six seven pitchers Out of ten were you like their skill level you'd put it. Yeah, I had a ton of those on this way How tall were you today I Think you got me at five seven But I'll go six one six one How is that you just can't stop I didn't like it. I like this a lot Put that in here now.  That's what the picture look like I won't I won't be getting the coronavirus. All right. This has been over for a while now I feel like yeah, we've been spinning saying ridiculous stuff. This is what berm season is like berm season is the best They want to fight Gone we're at the Phillies game. So naturally we're gonna be reviewing Cheese steaks cheese stonk. This is a cheese steak. I got a I got a chicken cheese stonk one chicken cheese steak No onions Mine kind of looks like a tuna salad, which I'm a little worried about Did we say it's Delco cheesesteak? I don't know if I'm just really hungry This is really good Like I'm all about this right now It's a little worried because it doesn't look like it's got a bunch of cheese on it It's in there. It looks disgusting. It tastes delicious. I agree with that It's good. I am still a little thrown off by the look of it, but it's good You get that a lot. How's that one?  I'm gonna eat more I think it's a little better that guy was watching I was watching and then he was not watching 8.3 love it Wow That one's worse. This one's better.  I took a chance and I knew that Why'd you do that? I like chicken. I like chicken and I got to show the people man three Yeah 8.3 out of 10. They're going Philly. You should go cheese just cheese stick. I messed up 8.3 for the steak 6.7 for the chicken high tea 3.5 for Jake's brain. We're out All right, we are here with Jamie Brooks from Philadelphia Here, okay. All right. So you saw this cheese steak and you said no. No, thank you I did say no. Thank you the cheese steak because I wanted a hoagie What's what's the number one cheese steak place in Philly? Some other Philly people here. Yeah, how do you not know that? DeLaSandro's in Rocksboro DeLaSandro Steve's Steve's is another one. Okay, and what'd you get today at the ballpark? I ordered an Italian hoagie and I got an Italian sandwich Now that now I'm gonna sound a little dumb here. What's the difference a hoagie is on and it's the roll It's the roll. This is some French bread right there. I see that Roll it's not a hoagie roll So this is that's two slices a hoagie's the fold in the circular okay like this like this So New York they call it a hero in Connecticut.  What do you got? You got a review here. How about a score we go one through ten? Okay, hey an eight from the crowd song song Or said board said it's always good mustard. Yes. It's like a white wine Mustard and it's good very good.  My girlfriend does that you should get this with a pretzel. Yeah Weird okay. Okay. There you go. That's our first fan food review. Yes. Thank you very much Jamie. Thank you Let's get it in the back Water Florida at the site of the original Hooters We are wrapping up Trevor Ploof's portion of the trip one more day for the rest of the gang Little exit interview nine days eight days on the RV with us Ending it out of Hooters fitting. How you feeling? The original hooters I got to be honest to you I thought that I might be a little bit tired and worn out after all the trips we've done. We've done a lot But I'm still raring to go. I had a lot of fun Baseball seasons here. I can't wait for the regular season start We had a good time at spring training, but like I always tell you guys It's about this time where it's you're just ready for the regular season start I feel that way as a player and I feel that way now Well, what was your Trevor Ploof Jake storielli here John boy media? Hey, what was your low point of the trip because I think we all had one There's one point where I had to lay down for 15 minutes. We saw John boy in the heat on red What would you say your low point of the trip was driving in the rain? That was a tough one Yeah, I Overcame that but I think it was today when we only had a 40 minute drive and we missed we missed a turn Hello, we missed it. Hello. We're doing his exit interview. How do you think he did? I think he did really well Perfect good job. I get that a lot. Yeah We missed an exit and it had an extra half an hour on our drive that was a low point that might have been today I'm serious. I had a great time and hopefully it comes off in the videos because we we've been working hard It's a weird.  We just did a 12-hour day But within those 12 hours is like just fun Yeah, we had a ton of fun. It was three days you when we would look at the end of day recaps I was literally shocked that we did stuff that day all day But it was fun. We talked baseball. We saw the parks We talked to people. We hopefully we showed that baseball is thriving a lot of youth out there loves baseball I can't believe there's another month of spring training for these. I told you guys now you get it now you get it What did uh, would you learn from the fan perspective? I? Think there's people need to get creative when they go to the parks like if you're worried about expenses There's ways to get around that, but I would say always plan ahead Sunscreens and sun screens a must. Yep. I think we need to make a beer on the berm shirt Yeah, berms are key if there's any time I would do standing only tickets if there was a berm That's where I would sit every time then you just hunt shade if you if it's too sunny for the berm sure Feels right being here Spring training original Hooters the end of the trip But spring training signifies one thing The beginning of baseball season we got a lot of shit going on this year So this is only the beginning You dove into media now. You're about to take the deep dive into coaching any thoughts on that Coaching little league is tough four-year-olds. Yeah, I got four and five-year-olds tomorrow. I'll be there My only goal is for them to not hit each other with the bat that and keep your hands to yourself That's those are the my two rules. Okay? Coronavirus I Didn't even think about that. It's more like just up touching each other and and like horsing around and listen to coach tripp Yeah, basically, I've I practiced with you guys all week. I should be locked in tomorrow. All right. Well cheers So good Yeah, yeah, yeah, I mean I'm from the hard part I'm a hard first hard part. We told Andy Faye to do whatever you want. Are you using haircut guy or what? Okay higher Watch your shins watch your shins What's up, what up? What are you doing? Are you doing you left them big fella you left this guy hanging the other day? Like yo, I want to go home Can I sit on it? Sorry man The taco dirty people were excited. It's times are high right now. We'll see where we finish tonight You