Welcome folks. Happy Friday. Welcome to Kubernetes release team, the wise and house ways and means. So we are, my name is Ray Lajano. I am the co-chair for Kubernetes SIG docs. I've also been a member of seven release teams highlighting as the 123 release lead, the 125 advantages advisor. I'm also a sub project lead for SIG security for the external security audits, which was just published on Wednesday. So please take a look at that. Hey everyone, my name is Priyanka Sagu. I am currently the technical lead for SIG Contribux and I have been part of the release team for five cycles now starting with 123 as enhancement shadow, leading enhancements in 125 and release lead shadow in 126 and 27. Yeah, so 123 has a special meaning to both of us. It's the release that I led and it's also the release that Priyanka started with the release team. So the Kubernetes release team is part of SIG release. There is a new release team for each release cycle. So there's three release cycles a year and we're from all over the world. As a whole team, we are responsible for the day-to-day work required to successfully release Kubernetes and the release team has a shadow program. The shadow program is a mentorship for folks without any contributor experience. There are some folks as well that are veterans of Kubernetes contributions. We also have folks who are also SIG leads as well and SIG technical leads as well who are also joined as shadows in the Kubernetes release team. So the shadow program is pretty popular. It's a structured program for folks to learn about the Kubernetes release process, to actively do work to help release Kubernetes as well. And folks learn how Kubernetes is released from generating release notes, creating the documentation for new or graduating features. They help to gather enhancements. So with help gathering enhancements, they learn about the enhancements, they're reading the enhancement proposals. And they also make sure that all the code PRs are merged before code freeze and lots more. So there's lots of responsibilities that the release team is responsible for to help successfully release the largest open source Golang project. And also one of the points of the Kubernetes release team is as well is that it grows the community. So our shadow is a mentorship program like I mentioned before. And other SIGs have also incorporated a shadow program as well. So it helps bring new folks as contributors to the community. And also it kind of has that structured contributor ladder in the shadow program. So folks who and we'll talk about the different roles in the release team in a few slides here. So the shadow program helps folks learn about the specific task that's part of releasing Kubernetes. And from there, they can become role leads. So we have role leads for each role. Then we have also a release lead as well. And even the release lead will have lead shadows who are who have been experienced release team members. So the release team is not only just brings folks to release Kubernetes, but also helps grow the whole community as well. So like I mentioned before, the release cycle, we have we do three releases a year. There are about a 15 week cycle. The last release cycle of the year tends to be difficult with holidays. We also take a break for KubeCon NA as well for the last release cycle. So it might be from 15 weeks, might be 16 weeks, but might be just 15 working weeks or might be a 15 week cycle, but might be 14 working weeks. We do like to take a two week break between cycles as well, where we do your retrospectives of the previous cycle. So we learn if we talk about what we could do, what, what, what well, what we could do better, what we can, what can or what can we improve. And we're always iterating on the release team cycle or process and the release process as well. Every single release cycle and that's two week period also gives us time and we'll talk about towards the end of the talk to open the application for new shadows for the new release cycle. So there are some delays as well that might impact the release cycle. I think for 124 there was a three week delay because of a near going version as well. And 119 was one, I think 119 was severely delayed as well because that's when COVID happened. So release dates are aspirational and that's what we like to say, but we definitely have release date targets for it. So I'll just highlight some of the, some of the release cycle as well. It's like I said, it's usually a 15 week process, but we actually start before the release cycle, where we assemble the team about about a month before the next release cycle starts and starts, then comes in the first major phase of the release cycle where we collect enhancements. So Kubernetes each release, there are enhancements that are introduced to Kubernetes. There's also enhancements that are graduating from alpha beta GA or being deprecated as well or removed as well. Like POTS credit policies was removed in 1.25. It was deprecated, I believe in 1.22. So there, so we start to, we, so we now we have a process where the 24 different special interest groups of Kubernetes or SIGs. So Kubernetes is broken into all the code and GitHub repositories are broken into 24 different special interest groups. And these 24 different special interest groups opt opt in into what their, their own enhancements will be ready for the release cycle. So the first part of the release cycle is when the SIGs opt in enhancements that will be, that will be parts of the release, like enhancements that will take features from alpha to beta, beta to GA. It might also, it might also be reinstated as beta as well, because they might have changed something, like if they might have changed a controller or something like that. So that's usually the first step. The first major milestone is the enhancements collection, and then we have an enhancements freeze as well. And with enhancements freeze, that's where all the enhancements wishing to be parts of the current release cycle would have to be what we call in, in implementable states. There is, they have testing plans, they have graduation criteria. So they have to satisfy us very specific criteria to meet an enhancements freeze. And we'll talk about all the different teams and their roles and what they do in the next few slides here. So next milestone after that is after enhancements freeze is code freeze. That's where all the enhancements going into the release must be code complete, including tests as well. And the docs for requesters. So every enhancement in Kubernetes, most of the time they're user facing, so they need some sort of documentation. So for users to learn and to know about how to use that enhancement or feature. So around this time, around code freeze, a little bit after code freeze is usually a few days, there's usually a documentation pull request deadline as well, what we call the placeholder PR, meaning that they intend to create documentation for that enhancement. It doesn't have to be ready. They just have to have the intent and clear and make some effort into that.  Next is the test freeze when all and this state also aligns as well with the with the branch cuts as well. So along the way, the other teams will talk about what the other teams are in a little bit, they will continue to do their work as well, enhancements team with code freeze will make sure that all the code PRs emerge. Docs will start pinging folks about to make sure that if they do need to, if they need to update feature gates, then make sure that the documentation is, it's noted that they need to do those updated docs. CI team and the bug triage team will will do will continue to do their work as well. Next is test freeze. So test freeze code lines also with the branch cuts as well. So the branch cut, we will create a release branch just for that release here also with test freeze. This is pretty close to the release time already. So the other teams get involved. We start generating finalizing the release notes. We start to decide what the major themes are because once we've reached code freeze, we know which enhancements are going to stable. When you key enhancements are going to be removed or deprecated, they might be part of major themes. Also some key enhancements might be very big that they might want to write a feature blog about it as well, kubernetes.io. After that, after the branch cuts with test freeze, we start doing a release candidates as well. So we do release candidates for the last few weeks, then come actual, the actual release dates, where we also do we do co-thaw as well. And the release dates as well aligns with just the finalization of the release cycle, except for the comms team. We'll talk about that a little bit because the feature blogs will will be published after the release. So there's one team that's whose work continues on a few weeks after the release. And the release team is made up about 35 to 40 community members. And there's nine roles with the release team. Most roles have four shadows. So there's always a release lead who is responsible for the release cycle and release process. The release, there's also an emeritus advisor. The emeritus advisor is you typically most time a former release lead, or has been on many different release teams. The release lead will have release lead shadows. The release lead shadows will will also be veteran release team members. They will have have been most likely been have been role leads in the past. We have a branch manager and a branch manager shadow. The branch manager does the actual cutting of the branch does the actual work on the on the final release cuts. The branch manager shadow might cut the alpha releases, the beta releases, the RCs as well. We'll talk about the exact functions of each role, but I'll just briefly highlight there's bug triage, there's CI signal, there's communications, there's docs, there's enhancements, and there's release notes. So we start with first with enhancements, enhancements come active into the release cycle very early. Usually we start even before the release cycle has started preparing the k enhancements repo for new enhancements to come in new features to opt in. So how it works is enhancements team is the team responsible for tracking all Kubernetes enhancements proposal that will be opted in into a release cycle. How we do that is by opening and kept issue, kept stands for Kubernetes enhancements proposal. We open those issues on a repo called Kubernetes slash enhancements. Now if a kept has to be included into a release cycle, one of the SIG leads chair or TL would need to go to the kept issue and add a few labels. And usually we have some, we have put in some automation now to recognize those labels on the kept issue and dump all of those tracked enhancements on a GitHub project beta board that looks something like this. So here during this enhancements, till enhancements freeze time, enhancements, shadows and leads would be talking to reaching out to SIG leads, different SIGs, asking them to finish their kept issue templates, add all the metadata that are required for the proposal. Yeah, that's all. And these kept issues would be helping the community to know which features would be moving from alpha to beta or beta to stable or maybe deprecations. Next we have CI signal. So this team starts to come in once we have the enhancements freeze in place and folks are now working on implementing code for the track and enhancements. So what this team does is we have a tool called test grid. CI signal team tracks all the tests that are running against a new code are Kubernetes, Kubernetes, Kubernetes slash Kubernetes master branch. They track the status of our master blocking and master informing boards and keep giving the community a weekly update. This signal also helps us to cut various release cuts during the release cycles, alpha, beta and RCs and eventually leading to the actual release cut. Next we have bug triage. This team is responsible for triaging all issues and pull requests that are targeting the release. They also track any potential issues that might be a release blocker. Next we have docs or documentation. So like I mentioned before, every new feature or new enhancements or any graduating enhancements needs to have the appropriate documentation ready when on release day. The docs team also helps generate the reference docs. So they help generate the API docs, the CUBE ADM docs and CUBE control docs as well. They also make sure that the feature gates page is updated as well. And also we have a deprecated API migration page as well. That started about a year and a half ago because we're out of this maturity level now that we're actually deprecating and removing APIs like 1.22 removed, ingress beta ingress APIs, beta CRD APIs, pod security policies removed, was removed in 1.25, etc. So now we need to create a place to keep track of those deprecated APIs in the documentation. Next is comms or communications. So comms helps create the official release blog. So the official release blog is published when after the release is cut, after some GitHub branching things are done as well. So once the release blog is cut, we communicate to the whole community through various mailing lists as well, that the release is official. There's also a theme to each release. So each release actually has a theme, a name, since 1.10, I believe, and also has a logo if you didn't know. So 1.23 was the next frontier to take on Star Trek. So there's a lot of Star Trek themes in Kubernetes. So 1.27 is the chill release, I believe. So there's always themes for each release since 1.10. The comms team also helped create the feature blogs. So a lot of new features, a lot of six want folks to use those features in one way, not just the documentation page, but they'll write a blog about it as well. And also they coordinate webinars about the release. And the release webinar will do an overview on the enhancements that are part of the release. Also coordinate interviews and press releases as well. And usually the interviews are done by the release lead. And there's release notes. Release notes help generate and edit the release notes. So there's a tool called Corel that helps to release Kubernetes. So there's a sub-command for Corel to generate release notes. And the release notes team actually created that tool itself. And I was part of that team in 1.18. I was a release note shadow. And my fellow release note shadows actually created this tool in Corel to actually scrape and create the release notes. And some of the teams afterwards helped to iterate on that tool to scrape all the PRs to create the release notes. So it's not just, you know, it's not just, so there's various levels of work that can be done on a release team. Like Docs, I didn't mention four, tends to be more of a Git heavy role as well. Because there's a lot of Git, there's lots of Git syncs. So it's lots of merge, there's always merge conflicts that have to be fixed. So it's not, so there's kind of a, each role kind of has their own like traits that it does not, it's not as obvious as one might think. So like Docs, you know, it'll be helpful. You don't need to, you don't need to have Git experience, but it'll be helpful to have that Git experience. Release note, since you are using a Go program, you'd probably, it'll be helpful if we do have documentation as well. But if you want to help iterate on the tool, you know, you would need a little go-ling experience, but you don't need to as well. Like you can just use a tool as is. So there's various levels where folks can help within the release team efforts.  So we have a role called branch manager, and they also have shadows who actually help us cut the release, different release cuts, and actually the final cut as well. So this is a diagram for how actually cutting any release cut looks like. So we start with a tracking issue. One of the branch manager or somebody who is responsible for cutting the release in the moment starts with creating an issue on Kubernetes slash Sig release repo. An issue looks something like the first picture. After that, they also put the same notifications on different Slack channels we use on slag.ks.io. So our release process is divided into two parts. We start with a mock release cut, which is also two parts. We start with mock stage, and then we do a mock run. And if everything goes well in mock stage, mock phase, we move to our no mock run. So meanwhile, when we are running our mock stage and mock run, we would be tracking all our logging, all our progress, whether something is green, something failed, what version of tools we are using at that moment, everything, all information will be logged in our tracking issue. Once we have a green mock stage and mock run, we'll move to no mock run. And that is followed by promoting images. What promoting images means here is whatever container images, whatever artifacts we have created during our no mock stage run would be moved to production buckets, and then we'll have our no mock run step. After that, once we have our no mock steps also green and running successful, we would be needing help from one of the Googlers, because right now, currently, as of this talk, our tooling for building RPMs and debt packages is under Google infrastructure. So the release branch manager or shadows, they coordinate with one of the Google people and move the responsibility to them for the RPM and debt packages. And once everything is done, same is again, logged on our tracking issue and an announcement is said into the dev mailing list to the community. I do want to make a note that there is work to remove the reliance on a Googler for the dev and RPM packages, so where we've done tests on using open build system or OBS to build the dev and RPM packages. So that is some work that is being done, that was done last year, will continue this year as well. So lastly, we have the upcoming release cycle for 1.28. So the shadow application program is actually open until May 2nd. There's a QR code to apply and folks are notified by May 9th. The official start date for the release cycle is May 15. The plan release date for 1.28 is August 15. Grace 1 is a release team lead for 1.28. Leo Pauquet is the Emeritus Advisor for 1.28. Leo was the release lead for 1.26. Anyway, so that's all for our talk. I want to thank you very much for attending on a KubeCon Friday afternoon. This is the QR code for our talk for any feedback. And any questions? Yeah, there's microphones on the sides here if you have any questions. Hello, thank you for the talk. I'm just asking about what are the requirements top life for the shadow program and the working hours all over this kind of detail. Yeah. Yeah. So there's no requirements at all. You don't need any experience if it gets. You don't need any programming experience. You don't need Kubernetes experience at all. So that's the beauty about the shadow program.  We have playbooks or runbooks to help guide folks on each role or we call them handbooks. Handbooks for each role as well. And if you need help, we are very friendly to show folks as well. I always do sessions on how to sync branches for the docs team, how to do merge conflicts. I actually have YouTube videos on how to fix merge conflicts for the K-Website repository. So you don't need any experience at all. I think the only thing you need is just a GitHub. You don't even need a GitHub profile yet, I guess, but maybe that's what I don't think you need. There's no other requirements except for an email address. Just to add, if you are looking for what is expected out of different roles, more on what we discussed, we have road handbooks, which you would find in github.com slash Kubernetes slash Sig release. You would find dedicated handbooks for each of the roles that we discussed here and also that would help you to answer the time expectations questions. Usually shadows are expected to work around maybe two or three hours or two to five hours a week and not really expected to work during the working days. They can work during weekends, but it vary from role to role as well and also what part of the release cycle you are in. So there is more information about that on our GitHub repo. Yeah, I just have seen that this is a very long running big process on the release, of course, because it's very complex. And what do you do if you have a serious issue after code phrase during testing where you say, ah, maybe we should not roll this out. Do you pause then and fix or what do you do? Different situations. They could be, we've had PRs reverted before. We've also have had to cherry pick in changes as well. We've also had to cut in for 123. We had to cut an extra RC. We had to do a fix for 123 was released on Tuesday, the Friday before there was a regression. We had a PR to fix it. We had to create a new RC, but yeah, on Friday nights. So yeah, so we do try to fix it. And, you know, and we do delay as well. We have delayed 118 was delayed a few days for an issue. 119 was delayed months. 124 was delayed three weeks. So yeah, so we do all of it. Yeah. Yeah, good. Thank you. Welcome. All right. Any other questions? If not, thank you very much for coming. Have a wonderful QCon, the rest of the QCon.


Let's straighten my hair for the first time in four years. I hardly ever use heat on my hair. It's a really rare occasion when I do, but I really wanted to see what this hair color looked like straight, especially the raccoon tails. I'm dying to see what they look like.  And even though I used a heat protectant on my hair when I blow dried it, I'm going to spray this all over the rest of my hair right before putting the flat iron on because honestly, I don't know the protocol of how long this lasts on your hair because I blow dried it yesterday, but the first Google search I found said to do a light mist after blow drying before straightening. So that's what I'm gonna do. I'm gonna roughly section off the top and then clip it out of the way. And I'm just trying to make sure I protect my hair as much as possible. So I'm just gonna get this nice and damp. I feel like this is kind of ruining the blow dry right now. Like it's reverting my hair back to curly because it's getting wet, but I'm gonna do it anyways because I just don't want any heat damage. Yeah, this is definitely getting curly again. I used a little bit less on this side. So I think I just used too much over here. I'm also using the Color Wild Dreamcoat and I've seen this everywhere on Curly Girlies and I really hope it works for me. It's a shampoo-conditioned towel-dry divided into sections spray each section liberally comb through. Blow dry each section using tension, dryer heat required to activate this product. So I'm hoping that the straightener heat will activate the product. Let me know if you guys know in the comments but if the dryer can do it, I'm pretty sure the straightener can. So while I'm spraying the bottom sections, I'm just gonna add a few sprays of this as well. Then I'm gonna use my Pro's hair brush and just gently brush that through and try to make sure that the sprays got everywhere. Also just using my hands to kind of spread out both of the sprays evenly. Take down the top, heat protectant, Dreamcoat, brushing. And now I'm gonna take the back sections out again and tie up the top so I can start from the bottom up. I think it's just easier to work that way and then your top sections lay flatter in the end. My hair is like already curling and like not blow-dried looking anymore. I'm gonna just touch up this blow-dry. One thing I really wanted to avoid was putting the flat iron on wet hair because it would start sizzling and steaming so I wanted to make sure that I don't do that. I'm gonna start this bottom section because I'm working my way from the bottom to the top. And this is always like my test section. It's my test strand for hair dye. I guess it might as well be my test section for the first pass. And I'm using the Lioness two inch red tourmaline that I've just had for like a long time and it has a heat control on the side. The bottom is 180 degrees and it goes up to 480. So I'm gonna go somewhere maybe like 200-ish. So I'm just gonna start low and do it slightly past the 180. I'm a hair girly. Of course I use the chase method. I'm a hair girly. Of course I protect my hair from heat. I'm a hair girly. Of course I have three straightening irons but mostly wear my hair curly. Anyways, I'm using the chase method. So get a fine tooth comb and make sure that you comb this section out from the bottom to the top. So you got a tiny section at a time and that's the key to only doing one pass on your hair. Then you use the comb and you stick it at the top to keep everything detangled and then you go in with your straightening iron. And I like to not pull too much because I don't want to pull my scalp and then get burnt.  That's why it's called the chase method and everything stays detangled and it should end up super straight. But let's see. That's so straight. That's crazy. Now I only have like 50 more of these to do. I'm gonna grab another section that's next to it, comb it, chase it. Now it's done and evaluate. I don't think this looks as straight and as flat as the first one. So maybe I went slower on this section, but maybe I should also turn the heat up just a tiny bit, maybe to like 250. And I'm really staying low with that temperature because I just, I wanna find the lowest temperature that gives me the best result and then just never go over that. Okay, let's do this again. And I am clamping kind of hard because you do want some sort of tension and I'm not gonna pull on my hair. So clamping it hard will hopefully help. And there we go. Beautiful. So so far the key is to take tiny sections and make sure that you comb it out very well. Then use the chase method on about 250 degrees and just go really slowly while clamping super hard on the section to make it as flat as possible so you don't have to do another pass and it should turn out pretty straight. The back is completely done now so it's time to move on to the top sections. There are two tips that I noticed work really well. Right now I'm kind of pulling with this hand while flattening with the other hand so the hair is as straight as possible. And once I've gone through this full section, what I like to do is as soon as it's let down, I pull it straight down and comb through it. So when it's cooling, it will cool in a very straight and stretched out texture. And the reason I thought of this is because I've been seeing a lot of people do curls and blowouts and after they do the curl, they roll it back up and pin it until it cools. So I was like, if my hair is cooling right now, I might as well just hold it straight so it can cool even straighter. And that seems to be working pretty well. I'm not even gonna blow dry this top section. I'm just gonna go for it because it is dry so I'm not worried about steaming any of the products and it's already stretched out enough. So I think next time I would probably blow dry right before straightening it but it was getting late in the day and I had had a long day and I was tired so I figured I would do it today. But that would also solve the problem of having to double apply the heat protectant and I think it would just make it faster overall if I just do it in one go. But this is what you get today. So this is how my hair looks straight. I think it is so beautiful and it's just such a different vibe than curly hair. And the last thing I'm gonna do is add some hair oil. This is the oil that I make myself for hair growth and I'm just gonna put a little bit in my hand, rub it around and then gently comb it through my hair with just my hands and then smooth some on the top, brush it through. That oil really helped with flyaways and making my hair look super smooth and look at how these raccoon tails look. They are so cute. I am so glad that I did the experiment to try them on curly hair, but on straight hair, oh, it is giving, I knew it was going to give what it was supposed to have gave, but it did and it looks amazing. I feel like everyone had very pin straight hair back in Disney Channel's Prime and I used to straighten my hair for school, especially like middle school, early high school and I never really got it such a beautiful straight. So I definitely impressed my young self with getting it this straight and this smooth. And as you can tell, I have layers and I have a tutorial on how I cut my hair, but I am so excited to use these layers and do a little bit of a blowout in my next video. I have this heated round brush, the one that's like everywhere on TikTok and I got it so I can like blow out my hair and do like face framing layers and just all sorts of layers going on. So I am so excited to see what these layers are gonna look like once I give myself a blowout. Let me know what you think about the raccoon tail straight versus curly versus braided. You can see I have videos for all of those on my pages and don't forget to follow if you wanna see what this looks like blown out.


This is stock number 9128, a 2011 Ford F250 Crew Cab Short Box. Lariat, this vehicle has a 6.7 liter power stroke diesel. From this video, you'll be able to tell that this truck is extremely clean all the way around. We take these videos in HD, so if you have HD capabilities, turn them on right now. Which is so you can see exactly how clean this truck is and get a really good idea of the overall condition so that you can make a smart buying decision. This one has Michelin LTX tires on it, LT27565R18s. Factory painted alloy rims with a polished aluminum. These tires have roughly about half the tread left. Frame and underbody is very clean on this truck. Tuxedo black is the color, over pale adobe. Front grille and emblem is in excellent shape. The chrome looks really good on the front here. I didn't see any dents or dings on the hood. You can really see that metal flake in that tuxedo black. Passengers side rim is in excellent condition as well. No scuffs or scrapes. And as you go down this side of the truck, you can see just how clean the body is. How reflective the paint is. We take these videos so if you are far away, or even if you're close by and you just can't make the trip down but you're still interested in purchasing the vehicle, you can still see the truck here, the truck, and have confidence in what you're looking at before you even get here. We sell a lot of these trucks out of state, so we like to provide the most accurate representation. I didn't see any dents or dings down this side of the vehicle. Back rim is in excellent condition as well. No scuffs or scrapes on that. And you can see that the back tires have just as much tread as the front tires. Frame and underbody, very, very clean. You can see it does have the camper package. That's what this anti-sway bar is right there. And it has all the remaining factory exhaust, which is important to some people on these diesels. Lower rockers look great. It has the factory painted step bars. I think they look really good on the black truck. A lot of times you get the chrome ones, but the painted black ones look really nice. Rear bumper, absolutely perfect. No dents or dings. Four pin and seven pin wiring. Full towing package, which includes that receiver hitch, the four pin and seven pin, along with the transmission cooler. Inside you have a gooseneck hitch, and you have the tailgate step assist. Very easy to use. Just goes up like that. Makes it really easy to get into the bed to put it back in. Just push this up. And it goes down. Tailgate must have the lift assist. It's real light. No dents or dings on that tailgate, and you can see it does have the backup camera right there and a locking tailgate. Down this side of the truck, just as clean as the passenger side, I didn't see any dents or dings on this truck anywhere. Very nice condition. Very well maintained. Driver side door code entry, which we do have the code for that. Power fold in, power fold out, and telescoping tow mirrors. They call those power scope mirrors. You have the memory driver's seat, power windows, power locks, power mirrors, auto headlamps, and power pedals. Factory all-weather floor mats. You get the tan, adobe leather seats. No rips or tears on these seats. Both of these seats are power, heated, and cooled, along with the memory driver's seat. And you can see that this truck indeed does have 48,669 miles on it. You get the audio controls on the steering wheel. That is leather-wrapped, cruise controls. Very clean inside here. Turned out four-wheel drive. The truck smells like it's never been smoked in. Very clean inside. Heated, cooled seats. Factory brake controller, or the tow command, as Ford calls it, four up-fitter switches so you can hook up lights and stuff to those to add power points. A CD player with the sync system. So you got Bluetooth audio controls. You can sync your Bluetooth device to this truck. You have the power sliding rear window button up there. Headliner is in real nice condition. No rips or tears. And right here is where that backup camera shows up. Passener's seat, very clean as well. No rips or tears on that. And you do have an all-weather floor mat on that side as well. Very quick look at the back seats and then under the hood. Much of the same back here. Seats are in really nice condition. No rips or tears. Has power sliding rear window. Seats are in excellent condition. Underneath you do get a lockable storage space that locks with the ignition key. You also have the all-weather floor mats back here.  This one does have the power sliding rear window. And we'll take a quick look under the hood. Very nice truck all the way around. I'd highly recommend it from a condition standpoint. No matter where you're coming from you won't be disappointed in this one. Engine bay is very clean, runs very smooth. This truck has been fully safety and inspected by our service shop. Has a fresh oil and filter change. All the fluids have been checked and topped off. And it is 100% mechanically ready to go. Cosmetically ready to go. And just waiting for you to call and make it yours. And to see more pictures of this truck or one of our other 400 new and used cars, trucks, SUVs, minivans, Wranglers, heavy-duty trucks, half-toned trucks, you name it, we got it. Go to our website www.summitauto.com Full pictures and descriptions of every single vehicle and our videos of every single used vehicle that we have all at www.summitauto.com Thank you so much for checking out my video and if you want to make this truck yours, give us a call right now,<PHONE_NUMBER> Ask for one of our sales associates to make this truck yours today. Once again, that number is<PHONE_NUMBER> Thank you so much for checking out my video. If you like it you can check out more at www.youtube.com. That's our YouTube channel. 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in this presentation we will continue on with our comprehensive problem for the payroll register going to our second pay period that being september we have our first pay period here of august support accounting instruction by clicking the link below giving you a free month membership to all of the content on our website broken out by category further broken out by course each course then organized in a logical reasonable fashion making it much more easy to find what you need then can be done on a youtube page we also include added resources such as excel practice problems pdf files and more like quickbooks backup files when applicable so once again click the link below for a free month membership to our website and all the content on it we're going to continue with that information for september note that we don't have


Mae'r grwp y gallwn cynyddiad arall o'r perthynau bwysig iawn cymdiann désig neu'i ddechrau eistedd yn ysafelwyr. Fe dweud o hyd arni, mae'r fryd neu'r bywau sydd yn ddiforol a'r ardal yn rharm�odd ddweud, ac yna'r bwysig iawn am y ff Ganhwysig, ac yna'r bwysig, ac mae'r bwysig iawn angen i gwybod â'r bywau hwnnaeth和fyn nhw yn eu cymunod. a'r cyd-fagwadau newydd yw'r cyd-fagwadau. Mae'r cyd-fagwadau newydd o'r cyd-fagwadau yn ymgyrch yn ymgyrch i'ch gweithio'r ysgol ac mae'r cyd-fagwadau yn ymgyrch ymddynt yn bobl a gwybod ei hwn yn ymgyrch o'r rhanwg. Mae'n mynd i'w ddweud ymgyrch yn y poddwyll yn y cyd-fagwadau yn y gweld â'r cyd-fagwadau. Ymgyrch yn ymgyrch ymgyrch yn cyd-fagwadau is the development of the SARS-CoV-2 vaccines, and as we can see from this figure, the development of these SARS-CoV-2 vaccines happened at record time, not one, but several candidates were developed, trialled and approved within 12 months, but this was just the beginning of their journey. The next stage is to deliver these to the target population, which is the whole world at the moment, and Tanahashi, in a classic paper, outlined five dimensions or five challenges in terms of achieving high coverage of interventions. The first is availability, so that it's about achieving delivery supply chains and training the healthcare workforce to deliver the interventions. The next challenge is making the intervention accessible. So even though we provide it in our health services, not all of the population may be able to reach the service and there may be barriers to do with cost, transport or physical barriers. And even for the population that can access the intervention, there may be a smaller proportion who are willing to use the intervention and that's reflected in the acceptability ring. And then the next level is of those who accept the intervention, a smaller proportion will actually use it for various reasons. And of those who use the intervention, not all of them will receive effective care due to lack of adherence or not using the intervention as it was intended. So going back to the COVID vaccine example, we can see here huge global disparities in. Coverage and availability of vaccines with North American, Western Europe having very good availability and being on track to achieve high coverage by the end of this year, but Sub-Saharan Africa and much of Asia having very limited supply and being on a much slower trajectory towards achieving full coverage. But even with plentiful supply of vaccines and even a surplus of vaccines, there may be a limit to the coverage that can be achieved. And what we can see here with the UK, Germany and the United States is that they're reaching a plateau in terms of the level of coverage. And a lot of this is to do with the acceptability. There's a section of the population who aren't willing to be vaccinated. So now moving on from one global pandemic to another, which has been with us for longer, which is anti antibiotic resistance. And specifically, I want to focus for the rest of this talk on interventions aimed to reduce antibiotic prescribing in primary health care. In this paper by Katie Bell and colleagues, they looked at several interventions to minimise antibiotic prescribing for acute respiratory infections in primary care and tried to estimate which of them would have the highest impact at population level. So they multiplied the reported trial effectiveness by the population uptake. They compared four interventions, delayed prescribing, pro-calcitonian tests, C reactive protein tests and shared decision making. And they extracted from Cochran systematic reviews, the summary relative risks. And these were all very highly effective interventions. Then they looked at the uptake and they saw what you can see here in green is a very small proportion of doctors use these interventions and use them as intended. And so thereby they didn't prescribe antibiotics. Another small proportion in yellow use the intervention, but they didn't follow the recommendations and they still prescribed antibiotics. But the biggest proportion here is doctors who didn't use the intervention at all. And that poses the biggest constraint for these interventions in achieving population impact. So then looking at the numbers, we can see here that none of the interventions had very high uptake. They were all below 30 percent and this translates into population impacts that are much smaller than the effectiveness reported in the trials. So now I want to illustrate this with an example from our work in Vietnam. We've just completed the ICAP trial, which is looking at the implementation of C reactive protein point of care testing to improve antibiotic prescribing in primary health care settings. The background to this comes from the same systematic review that was reported by Katie Bell and showed a significant effect of C reactive protein tests in reducing antibiotic prescribing. But these trials were all done in high income countries. So following on from this, our colleagues at our crew did a trial in Vietnam, which also demonstrated that CRP was highly effective at reducing antibiotic prescribing in primary health care. And this was followed by another trial in Thailand and Myanmar, which showed a small but significant reduction in antibiotic prescribing in this setting as well. But both of these trials were traditional randomised control trials. They were individually randomized and they weren't delivered in routine care settings. There had been no pragmatic trial in a lower middle income country. So we wondered what would happen if we translated these interventions into routine care. And we looked back at the systematic review article where they had done a subgroup analysis on individually randomized trials and cluster randomized trials. So trials randomized by health facility, which are more like routine care. And the routine care trials showed a much stronger effect. And they hypothesized that this was because of contamination in the individually randomized trials with the same doctors seeing patients in both the intervention and the control groups and transferring some of their changed prescribing practice into the control group as well. But on the other hand, when we translate our intervention into a real world setting, as we've seen in the example of covid vaccines, we may lose some impact because of lower uptake. So in the the original trial in Vietnam, it showed a 30% relative reduction in prescribing, but there was 100% uptake because it was a controlled trial setting and all patients were given the CRP test. In a real world setting, the uptake may be much lower than that. And if it's 50% uptake will have the population impact. And as the uptake decreases, the impact will decrease. So now let's go on to the study design. The primary research question was what impact does CRP points of care testing have on the proportion of patients aged 1 to 65 with respiratory infections who are prescribed an antibiotic and this is in routine primary care. So it's a pragmatic randomized control trial. In a traditional randomized control trial, the risk population is screened to see if they meet the eligibility criteria and patients who meet the criteria and consent to being part of the trial are randomized. In a pragmatic trial, we train the doctors to identify which patients the test is recommended for. So the doctors decide who to use the test for and consent is done at facility level, so it's not done at patient level and it doesn't interrupt the routine clinical consultation. This is one of the commune health centres included in our study. And the study was done in Nandling province, which is 100 kilometres southeast of Hanoi. It was in three districts and 48 commune health centres. These were randomized to two arms, half with the CRP testing intervention, half with routine care. And a subsample of patients was followed up after two weeks to ask about subsequent antibiotic use, duration of symptoms and any adverse events. And we also linked to hospital data to look at hospitalization rates. The intervention was the ACTIM CRP rapid diagnostic test kit, which comes with a lateral flow test and a tube of buffer. The doctor takes a prick of blood from the finger and puts it onto the test strip. Results are available in five minutes and provide a semi-quantitative measure of C reactive protein, which is a biomarker of inflammation and can be used to differentiate between bacterial and viral infections. So doctors were trained to follow the following guidelines. If the level of CRP was below 10 milligrams per litre, no antibiotics are recommended. It's very unlikely to be a bacterial infection. If the CRP is between 10 and 40, antibiotics are also unlikely to be needed, but doctors can prescribe on their discretion based on their clinical decision. And above 40 milligrams per litre, we combined the top two groups. Antibiotics are recommended and referral if necessary. And now I'll hand over to Ngha, who will give us an overview of the preliminary results. Thanks, Sonia. So I applied to present firstly about the trial profile. In total, 73 common health centres were accessed for the eligibility and among 25 centres were excluded because did not fulfill the inclusion criteria. For example, 14 centres did not have a physics and and 11 centres recruited less than 40 AI patients per month. That is not a sufficient number of the case load. So the remaining 40 centres were then enrol and randomized to either the routine care arm or the CRP point of care test intervention arm. Next, please. So the trial started in June last year and the data were collected monthly from the common health centre electronic system. And now over the first month of the intervention, the average take rate of the CRP intervention was 11 percent. This were calculated based on the total eligible AI patient recorded in the CAC electronic system, where we aware that there's number of the patients did not visit the CAC in person, but they were restricted. So the CRP intervention could not could not target those patients leading to the underestimate of the rap take rate calculations. Next, please. So to try to to be able to calculate the rap take rate of the interventions more accurately, since October last year, we introduced a screening log book beside the CAC existing electronic system to require the healthcare provider recasted only the patient that visited the CAC in person and to exclude the non-presenting patients. And also additionally in early this year, the community sensitisation package will also added to increase the exposure to the intervention in the intervention arm by the loudest speaker by advertising the CRP test in 24 village of the CRP. Next, please. So after the introducing the screening log book in both arm to improve the documentation of the total eligible AI patients, we can see the uptake rate increase with the average of the 41 percent in the eight months. This increase not because of the increasing in the number of the CRP tested, but because of the decline in the eligible AI patients recorded in the screening log book. Next, please. However, the data from the log book, we also also be biased in the recommendations because several common health common health centres, they just recorded the patients with the CRP tested only so the data in the log book was not reliable enough for us to do the analysis. That's why we decided to base the intention to treat analysis in the whole population of AI patients from the CSC electronic system with nearly 40,000 patients because were extracted from this system and the absolute reduction in antibiotic prescription was 5 percent from 98 percent in the control arm to the 93 percent in the CRP. Next. And the larger reduction was observed in the purple phone analysis for the group of the 2,606 patients received the CRP test. That antibiotic prescription in this group was 71 percent. In about half of the patients with the CRP tested, they have low CRP value, less than 10 in the ground per litre, which is antibiotic prescription was not recommended. And only 51 percent of those patients received initial antibiotic prescriptions. The reduction remains significant for the patient with the immediate CRP value from 10 to 40 milligram per litre. And for the patient with the high CRP value of about 40, we didn't see any increase of antibiotic significant increase in the antibiotic prescription next week. So it's mean that when the CRP were performed, the healthcare worker did comply with the guidance of the CRP based therapy and one of the secondary end points assessing about the duration of symptoms, we observed the similarity between arms indicating that the CRP intervention could help to reduce antibiotic prescription without compromising patient recovery as similar to the fighting from previous published trials in what time come and low and middle income settings as Soniarity presented in the previous slides next week. However, we also observed the considerable low CRP uptake rate. So we conducted a number of the interviews with healthcare workers and the patients to understanding better about the reason associated with this low uptake rate. And from the healthcare worker perspective, several reasons were reported instructing the patient expectation for antibiotics when they visit the health facilities. Doctors want to maintain the relationship with their patients who are living in the same and small village. Lack of the consultation time, limited consultation skill and some healthcare workers so expressed their doubts in the CRP credibility. And as I mentioned in the earlier slide that there was the number of the non-presenting patient that our intervention could not target. And obviously some impact from the COVID-19 situation that restricted the number of visits for the patient with the COVID-like symptoms next week. From the patient perspective, the interview patient reported some reasons regarding then limited knowledge about the AI, the acute respiratory illness, antibiotics and antibiotic resistance in general. And most of them show the mis-perception about the antibiotic functions that can have to recover disease quickly. And also they received the limited explanation about the CRP test. So they do not really understand about the purpose and also why they did to take the CRP test. Last but not least, some patients also expect the fee of the pain. So they refuse to take the test next week. So with the pragmatic trial to minimise the disruption to the practice, I will intervene and face to the big challenge of the low uptake rate. So among the 98% of the patient, nearly 100% of the AI patient receiving antibiotics in the common health centres, only 40% of them be sending the CFC in person and only 41% of the patient be sending accepted the CRP test, resulting in only 16% of the patient with the AI expo to the intervention and the remaining bigger parts of the 48% send it the other activities or more appropriate intervention to reduce the appropriate antibiotic use. So even you see the positive outcomes were achieved. The finding from considerable low uptake rates emphasised that in different settings with the country's face health facility and culture feature, likely have different barriers that need to be identified and addressed with appropriate interventions, for example, combining CRP intervention with other ASP activities to achieve optimal effectiveness in uptake of any new diagnostic technology. Next week. So to end our talk, I would like to thank to all the investigators in the study team from Bokhrul, Vietnam, Moru, Thailand, and Fai in Switzerland, also with the local partners from National Hospital for Tropical Diseases, the province of this Department of Health and especially thanks to all the doctors, nurses and the patients from participating 14 common health centres for their great collaboration in doing the study implementations. Thank you very much for your listening.