to Texas Heart Institute educational programs on innovative technologies and techniques. The purpose of these presentations is to inform and educate physicians, allied medical personnel, and general public on the latest advances in cardiovascular medicine. I'm your host. My name is Van Ver Krazier. I'm an international cardiologist at Texas Heart Institute. Our special guest today is Dr. Brianna Costello. She's an international fellow at Texas Heart Institute in Baylor. And Dr. Costello, welcome to this program. Thank you, Dr. Krazier, for having me. It's a pleasure to be here. I look forward to our talk today. The topic is May Turner syndrome or Iliac vein compression syndrome. Dr. Krazier, to start, can you briefly describe the anatomy and the natural history of this syndrome? Well, as we mentioned, this is commonly known as May Turner syndrome. But also it is known as Crockett syndrome and also Iliocable compression syndrome. This syndrome was first described by a German pathologist, Rudolf Ludwig Karl Werho, in 1851. He was a well-known pathologist that identified this particular problem to exist on his evaluation of patients after tragic events. Interesting. So can you describe a little bit more about how he found this syndrome or how this was identified? Was this all post-mortem on autopsy? Right, this was a post-mortem analysis. And really, it didn't become well-known for almost a century after that. Interesting. So in October of 1957, two individuals, again, pathologist May and Turner, described in the Journal of Angiology this particular condition, again repeating the same description that was described by Werho. And they call it Iliac vein compression syndrome. And they identified that the problem occurred because the Iliac artery compressed the Iliac vein. And namely, they described that the right Iliac artery was crossing over the left Iliac vein and causing this compression syndrome, which is described here and shown clearly in their pathological analysis. Dr. Kreiser, it's pretty here just with illustration. You can understand why the left is often more involved compared to the right side. But I know that you've mentioned in the past that the right side can also be involved, the right Iliac vein. Have you seen that frequently or is it pretty uncommon? Of course, the most common scenario is the left Iliac vein compression by the right common Iliac artery. But there are many other scenarios. And actually, May Turner or May and Turner described this clearly. And they found it on 430 cadavers that it occurs somewhere between 22% to 32% of cases. So it's a very, very common occurrence. Not only that it causes compression, but it can also produce a lot of other complex and problematic scenarios, such as thrombosis of the Iliac vein and also a lot of fibrotic changes in scarring and spurring, as is shown here after the thrombosis disappears. So obviously, this is a very, very common problem that is present in a huge number of individuals in the United States as if it occurs in 30% of female population or about 20% of male population, you can imagine that millions of people have this type of a problem. And the consequence is related to this particular problem. So we just touched on this a little bit. The incidence is 20% to 30%. And do you think that we under-diagnose this because not many people are looking for it? Yes, this syndrome is obviously grossly under-diagnosed because the great majority of patients do not have symptoms or they do not have symptoms in their early stages of May Turner syndrome. And the only time when it's really typically diagnosed is when the problems happen, such as thrombosis or a DVT of the lower extremity or problems related to chronic venous inefficiency, which this leads to. So I would say probably no more than maybe 5% of patients with May Turner syndrome develop symptoms at one stage of their life, but when it happens, it could have serious consequences. And obviously, it is very important to identify it early to prevent problems that could happen later. This is particularly of importance in patients that have a hypercoagulable syndrome because they are at higher risk. Also females during pregnancy or individuals that undergo various type of surgeries, particularly abdominal surgery or even lower extremity surgery, they are at significant risk of thrombosis and problems related to DVT and also chronic venous inefficiency. So touching a little bit more on this in pregnancy, in women that are pregnant, do the symptoms usually arise during pregnancy or is it after pregnancy or is it mostly just clot related? For example, do they have significant left lower extremity edema out of proportion to the right when they're pregnant if they have this disorder or is it just post delivery? They have more of the issues. Well, as I mentioned, this compression occurs in more than 25% of health individuals. As I mentioned, it's more common in female population and male population. And this obviously has to do something with anatomy. There is a much steeper angle between the lumbar spine and pelvis or coccyx in female population. And of course, it also is related to pregnancy and compression that occurs in addition to compression that is present from the right common iliac artery on the left iliac vein. So this obviously plays a significant role during pregnancy. So a lot of individuals during pregnancy will have findings and classical symptoms of leg edema, more pronounced in the left lower extremity, and evidence of venous insufficiency. But also it presents itself with thrombosis. And that is a challenging situation because any intervention in this type of scenario has potential complications and consequences. Absolutely. All right, so Dr. Acasio, we talked a lot about the right common iliac artery on the left vein. What about other places that can be compressed in this syndrome? What other areas of the venous system? Here we have listed all the possible scenarios. Of course, the most common one is proximal left common iliac vein. But as we can see in this schematic drawing, the iliac arteries can compress iliac veins either on one side or the other side or both sides at any location. Of course, that certainly has more serious consequences when we have several areas that could be compressed from that particular anatomic variation. All right, so now that we kind of know what this syndrome is, what are the tests that are used to diagnose it or to evaluate the problem? Typically, obviously, the most important part is to talk to the patient, evaluate patient symptoms, evaluate the patient's findings. And once you see problems related to pronounced, unexplained left leg edema, evidence of varicose veins, or even telangiectasis, you have to suspect a possibility of may turn a syndrome. So of course, we start first with very simple, non-invasive readily available tests such as duplex ultrasound evaluation. Of course, one has to have expertise in this because it is not easy to diagnose and establish proper diagnosis unless you have a significant experience in evaluating those patients with may turn a syndrome. There are scenarios where this is more challenging, such as in patients that did not have adequate preparation for the ultrasound and also morbidly obese patients as well. But duplex ultrasound, as we will see, is a very reliable and useful tool in doing a non-invasive evaluation prior to proceeding with more invasive or more costly type of procedures, such as contrast vinaigrafy, CTA of the abdomen and pelvis, magnetic venous resins evaluation, and then finally, intravascular ultrasound that we typically use during the intervention. Very good. So what would be your initial approach for any patient that you suspect has a iliac vein compression? Do you automatically do a Doppler or are there patients that come into the office and have a clear cut story that you're convinced is may turn or you'd go right to the MRV or the CT? I always proceed with non-invasive evaluation using Doppler and one has to pay attention and recognize what are the normal values and what are the abnormal values? For instance, we know that the inferior vina cava is typically more than two centimeters in diameter and common iliac vein should be at least one centimeter in diameter or larger, as we can see here. We can see normal findings as far as the ultrasound image is concerned but also as far as Doppler images are concerned. Another thing that we use very frequently is phasic flow because if you have no compression, you will have a normal phasic flow during inspiration, expiration and unsolvable maneuver and that is very important step in evaluation of patients with this condition. Then as we move forward with additional information from the duplex ultrasound, we can look at other parameters such as extrinsic compression which is seen here on the left upper corner image and this is with color Doppler as we can see here. There's a significant compression of the common iliac vein and so what are the normal values? Obviously more than 50% diameter reduction is considered significant. Also changes in velocities are more than 2.5 to one ratio between a normal segment and a normal segment and turbulent flow with mosaic as we can see on the right-hand side is another important parameter to take into consideration. We also measure the velocities approximately and decently so that is very, very useful as is seen here on the bottom image and of course we can do plymetry which is very important as far as identifying the severity of stenosis. You have to measure it in the segment that's narrowed as well as approximately and decently as well. Then there are several other what we call indirect criteria for detecting iliac vein obstruction using duplex ultrasound. There is so-called non-phasic or asymmetric flow in a proximal, common, formal vein. There is also non-phasic low or no flow on augmentation with ulcalva. It means that obstruction is so severe that ulcalva cannot augment the flow. There might be also a reversed flow in the ipsilateral iliac vein and the difficulty in compressing common formal vein because of such high venous pressures as we can see here. All of those parameters are very important. And then we have also additional indirect criteria that we could use, presence of collateral veins that are easily identifiable on the duplex ultrasound as well as on angiography, as we can see here. There is a cephalod flow in the inferior pigastric vein, which normally is in the opposite direction. So that has to be evaluated as well. And then there is a reverse flow in the deep external pudendal vein, which is again very unusual and abnormal observation. Very interesting. So we talked a little bit about the ultrasound in the duplex studies. When are MRV and CT indicated for this diagnosis? Or what do we find usually in patients with Materna when we have these studies? So we use MRV very frequently. We less frequently use CTA, particularly female population in childbearing age because it adds extra radiation. And MRV obviously doesn't have that risk. And here we can see two images. One in a view where we can see clearly the compression on the left-hand side from the MRV of the iliac vein. And the other one also, we can see the anatomical finding where the right common iliac artery is totally compressing left common iliac vein. And actually there is an obstruction, there is no flow. This vein is completely thrombosed. And we can see extensive collateral here that are connected as we can see to the flow up higher, which is actually in this particular scenario, the ovarian vein. So both CTA and MRV are very, very useful and meaningful tools in further evaluation. We can see furthermore as far as CTA is concerned on the left upper panel mild compression from the iliac artery. And on the bottom panel, more significant compression of the iliac vein from the iliac artery. And then on the right-hand side, the lateral view where we can see again, significant compression of the iliac vein from overlying iliac artery. Another image here, we can see again compression that causes dilatation of the iliac vein due to that compression of so-called pancaking. And on the right-hand side, actually when we remove the overlying iliac artery, we can see indentation in the left common iliac vein. So all those tools are extremely important in evaluating patients with this particular condition. All right, so that's very interesting. Now tell me more about when we're in the procedure or when you're in the procedure, how do you use intravascular ultrasound to guide you in your intervention and tell us the steps that you take for pre- and post-intervention? So I was, in my opinion, is extremely important tool. It's almost mandatory tool during the intervention because it will give you a detailed information on the location of the compression, the extent of the compression and the presence of collateral as well. And also it will guide you as far as selection of interventional tools, such as stents, what size stents should be used and also on the outcomes after the stenting is performed. As I mentioned, stents are routinely used for this type of condition because plain or balloon angioplasty is inadequate and you will not achieve satisfactory results with balloon angioplasty alone. Very good, so a little bit more on the stenting. So there are a couple of venous stents now on the market. Can you tell us a little bit about those and what sizes we might have for those or maybe the difference in the, you know, build the makeup of those stents if you choose one over the other for May Turner in particular. And then what generally do you send people home on in regards to any medication-wise anti-platelets or anti-coagulation? If you could just briefly summarize, I know it's a lot to talk about there. Well, a little bit about the history of stenting of the iliac veins, particularly related to the May Turner syndrome. This started in the early 90s and at that time we only had one large stent available for this particular application, it was wall stent. And it comes in various sizes from very small, let's say eight millimeter diameter to 24 millimeter in diameter. So larger wall stents have been or have been used for that particular scenario. For the last four or five years, particularly abroad in Europe and now more in the United States for the last several months, we have dedicated stents that were specifically designed for this particular use, their self-expanding stents. And there are precise as far as placement is concerned, which is advantageous in comparison with the wall stent, which sometimes gives us challenges in placing exactly where we have to. For instance, wall stent typically is placed protruding into the inferior vena cava, just to make sure that we do not have a difficulty in assessing where the main compression is. While newer stents, and there are two of them available on the market in the United States, they can be precisely placed in the location where the compression is. Of course, the guidance is with the ultrasound and also determining the location and the outcomes is using the ultrasound. Let me give you a few examples and we will show this in one particular image, but our optimal goal in stenting iliac vein is to achieve a round type of end result rather than an oval end result. There is now evidence with recent publications that round type of an expansion of the stent is preferential as far as preventing restenosis or thrombosis. So the diameter by itself is not a good indicator. Actually, proper expansion is more important and that is achieved with newer generation of stents that have a significantly higher radial force. Very good, very good. So now that we talked about the stenting and what we have available to do that, what is the follow-up of these patients after you stent them? Are you repeating duplexes, six months, one month, three months to check on the patency of the stent or just going by symptoms? The classic treatment that I think is the most appropriate for the great majority of patients unless there are contraindications is we use antiplatelet agents for at least two or three months but we also use anticoagulants more frequently recently, NOAAX, but before warfarin. However, when there are contraindications to anticoagulants such as pregnancy or whatever, we will only use antiplatelet agents. Typically, anticoagulants are used for at least three months, maybe six months, particularly in patients that had thrombotic event and or complications related to that. So I think that's a probably standard of care for a great majority of interventionists as far as may turn a syndrome is concerned. Very good. We touched earlier on contrast vinaigrafy. In your use of IVAS now that IVAS is pretty mainstream for treating these lesions, what can you say about your experience in the past just by doing procedures with vinaigrafy alone versus now doing it with IVAS? Vinaigrafy is obviously a suboptimal test as far as assessment of severity of obstruction in May Turner and also as far as management of patients during the intervention. As we can see here on this particular image, we can see that there is probably suspicion of compression but we cannot assess the severity of obstruction. This is particularly true in antroposterior type of imaging but if we do it in oblique or lateral projection, there are certain scenarios where this might be more visible. Of course the gradients are not important as well because venous pressures are very low so that's not very meaningful. Frequently see so-called pancaking as we have seen on the previous one or flattening of the vein. There might be some stagnation of flow. There is a contralateral cross-filling and preferential collateral flow as we can see here through the pervertibular vessels and stenosis and presence of thrombus. All of those things are useful but they are not extremely beneficial in guiding us as far as size of the stents or location of the stents and all of those things that are very important in treatment of patients with early vein compression syndrome. Just interrupt for a second. The significant collaterals that a lot of these patients develop over the years because they most likely had this syndrome since they were born. After you stent them and fix the obstruction, do those collaterals go away? They're not used anymore and then is there any implication for those shutting down? I have seen scenarios where a collaterals vessel disappear instantaneously after appropriate stenting of the iliac vein so yes, they can disappear. Some of them will disappear a little bit slower and particularly if there are also other comorbid conditions or associated conditions present such as ovarian vein insufficiency or the nutcracker syndrome and compression in other areas that could be playing a role. Very interesting. So we talked a little bit about IVIS and I think these pictures are pretty telling at what you were saying about the ovaloid shape versus the circular shape and after you put the stent in, this one here on the right seems to be the more optimal round shape stent. Right, so here we have two perfect examples of on the left-hand side suboptimal expansion with a stent on the right-hand side optimal expansion and that should be done routinely with the IVIS at the end of the procedure. Obviously different stents offer different type of results. On the right-hand side, we can see a very good result with the later generation stents and suboptimal result in a patient that had practically total occlusion of the iliac vein and suboptimal expansion. So that is very important as far as long-term outcomes are concerned. Certainly. Can you summarize now after we touched on all the imaging modalities and therapeutic options the role for in the future after these patients leave the CAF lab? If you use this, you know, vinaigrafy or CT or MRV or an ultrasound or if you have them follow-up at all or if the symptoms just dictate what you do. So typically what we'll do, we will see the patient at one month follow-up and we will obtain a duplex ultrasound. We will compare the findings with the previous one that was performed prior to the intramational procedure. This particular tool is extremely practical. It's inexpensive, has no side effects and is easily repeated. So I will do this on a routine basis. What we didn't mention before and it's important to mention, in every patient with iliac vein compression, we will also look for any finding of venous insufficiency or regurgitant valves or venous incompetence in the lower extremity. We will assess this pre-procedure and also after the procedure. Occasionally, we will see almost complete resolution of venous insufficiency if the valves are not grossly deformed and distorted after adequate expansion of the iliac vein with stenting. Now some of the patients will continue to have chronic venous insufficiency and symptoms related to it because the veins have been stretched to the point of no return. So, again, duplex ultrasound is extremely important. Now as I mentioned, IVAS is the gold standard for measurements as far as location is concerned, diameter, length, stead selection and assessing the results during the procedure. Other imaging modalities that we mentioned such as CT and MRV are also very useful, but obviously we cannot use them during the intervention so IVAS would be the most appropriate one for that particular purpose. All right, so the bottom line is who, at least in your mind, actually needs the intervention, the stenting of the iliac vein. Are there clear-cut guidelines or is it, you know, I know it's a gray area for those patients who maybe have symptoms but have never had a thrombotic event. What do you generally do for practice? So this is a very kind of debatable type of a situation. There are no clear-cut guidelines. I think that most of the experienced operators would agree that only patients that have symptoms should be treated. So it's not for cosmetic reasons or not even for anatomical reasons because there is compression of the iliac vein. Typically, the patients will be referred to us because they develop thrombosis, either during pregnancy, after pregnancy, with trauma or with surgery. That's the great majority of patients. The second subset of patients that are referred to us are patients that have chronic venous insufficiency and symptoms related to it. And we see it in a lot of families. We have seen that where every single member of the family has findings of chronic venous insufficiency of the left lower extremity with a diagnosis of May Turner syndrome. And then the question is, who should be treated? Again, only those that have symptoms. First, we'll try medical therapy, exercises, weight reduction, elastic stockings, but in patients that have a severe stenosis and persistent symptoms, we will resort to stenting. And then, if needed, treatment of chronic venous insufficiency, which is easily treated on our patient basis on the local anesthesia without any surgery or incisions. Very good. All right, so can you give us a recap of everything we kind of talked about, from who gets it, who needs workup, and then ultimately, who needs to be referred as an outpatient provider? Who do you need to think of to send to a cardiologist or interventionalist to help your patients? Well, as I mentioned previously, only a small number of patients with complications related to May Turner syndrome will require treatment. Iliac vein stenting is essential to achieve good long-term results. And now we have dedicated Iliac vein stents, and I think that the treatment for this particular condition is better, will be better than it has been in the past. So I'm quite optimistic that we will be able to treat those patients in the best possible way. Yeah, stent technology seems to really be improving, especially in the venous side, which we didn't have options for before, which is great. Well, Dr. Costello, thank you very much for participating in this program. It was a pleasure to have you here. Pleasure to be here, thank you for having me.


Forget how I do a pic. I don't know. I was a man covers. I don't really remember. I Made a mistake though. I like trolled Oh buyers get up out of there Ain't no way. It's no way. You just turned around and tackled me. There's did y'all diesel Yo exclamation point passing where you watch that video. I'll help you out a lot Jerry who pops you in the tournament, bro. I thought you want to make it Let's go out down, bro.  Yeah, we gotta have we're worried about Jerry here chat Contained I really feel like I'm about to get contained crazy. I feel like this is man coverage. Just not pressed at all Thank you, son. I appreciate you. I'm glad you see the jerseys looking good Chat knows me brah. I really be saying I got cheated unless I really got cheated.  I don't know why I thought I was gonna get open I really don't know I really don't know why I thought that was gonna work But you know most people that call time out to run offense or running some bazooka.  It's taking this long to set audibles You have you running some nasty offense to set this many audibles See I have seven snap throws here That's why you gotta be there for me, bro No way you drag them forward to come on man.  All right pick set Madden How did I turn the ball over? I forget how I do a pick. How do I do a pick? I forget how I do a pick I don't know. I was in man covers. I don't really remember Made a mistake though. I like trolled. Ain't no way.  Oh, I remember the trail route. That's exactly what I did I can't believe that dude took me on a kick return. All right, what can we do about this offense? I mean, he'd do a pick six right there. I can't lie. Oh, tell me now strip specials right there.   Like what? No fight at all. I'm just like I like dude. We just like oh my god Nice quick pass bro. Like dog. How do you know?  I like I need to really I don't know what it is.  Thank you man Why can't burn them up a bro, that's all I want to know why can't dub that W burn somebody That's what I want to know in the chat.  Nice throw bro. Let's do it again. Everybody on the street. Come on. That's high-powered right there.  I'm not mad. He caught me lacking on the egg, man About time for me to fumble on boys. Let's see if they're running man coverage, you know Bro like what zone is going to cover that? He don't even look. God. I mean, I do we have Oh, we don't match one. Maybe I hope oh my god This is just give me a pick on just chucking the ball in the air, dude All right, we got I can't lie. We got we got to take Tyler out on that spot getting egg to life, man Tyler was just I mean, we got good at SWAT. We just like just too small Just literally couldn't reach high enough. I gotta like get more physical there. Let me stop trolling. All right, boys Trying to lob to my running bag every play. It's just for what reason that juke was crazy though That juke was crazy though. That's why you I mean I was Bruce Smith, bro I don't want here. No crying about that when Bruce Smith the guy you putting on his own, bro That's what happened, bro. I swear to god, dude. My sea rouges never cooks, bro. It never does Dude, he's so what the I do three times. I did that three times. I do just that we're running back I just feel like it looked like he got him beat and then I just like don't get the throw that I want I just can't get there for a pick artist Thank you lit up and everything god good swats out there boys. Thanks boys.    It's my account is glitched. I I don't think I've ever got a sea rouges to really like Oh, it works You know what's even better is that when W throws tries to burn Sean Taylor with a running back three times in those three picks and keeps the game close You know, we're getting a just drive right because we're winning because we're winning We're definitely getting eggs. Let's put Calvin.  Yeah, that's why I make stuff you bumming it. Yeah That's why eggs are not that bad because you can actually like That's why eggs are tough. That's why eggs are like annoying, but you can swat the hell out of them That's why like no matter what boys you always got to have like them big bodies on the fields somewhere, dude Like they gotta play somewhere in them big bodies. I really should get woolen just for the bench Like I don't know. I really looked at my lineup. Like I really don't have no like I don't have no big body to put so I had to switch Calvin out there Like just not agging that bro Calvin on Calvin crime Calvin on Calvin crime Like you're not agging that like you really not agging that the swat is actually like no bulls The swat is OP this year. It really is the problem is like a lot of people are too short But that's a good ag like that's a good ag because that's a good ag animation or anything the swat is OP


Hey! Where where where where? Kidogo kofi先 wa it Zoe Okay Let's just get composed for a moment there baby Sorry I lost the kauwah But it's not like Mr Rajitakshaw need to doing good vibes Without good vibes I have never done good vibes I mean really he has lodge of me this We cannot go anywhere. Anywhere. Hey! How do you punch that nukonazo? What? Okay. He's impressive me today. Hashtag is social Friday. It's on Facebook, Y254 channel, on Twitter, Y54 underscore channel, on the gram. And today is all about Reggie's the DJ. So ask him something, ask him anything, and he will answer honestly. Yeah. Abekwa honest sofa. Venye mi, nimeski aizo vitu najua. Chukuna vitu mingi zinjui. Soze najua, he was honest so. Just ask away, use the hashtag, social Friday na masai. Your favorite presenter is back and it's game time. So nani akua stand by. Na kukati. This is that part, one of the most useless segments. It won't really help you in your life. But yeah, we do have fun. Happiness, that helps. That's very useful. That makes it, that makes sense. Niliyambiwa squeeze in mihanzaku juwaku dance, kidogo. So I've been practicing a lot. So thank you for all, for those who are noting, since I started dancing and the developments I've been making. It's the likes of Kina Patrick's here who come to the show and then they force me to dance at least. So non-effect ya kuhostikto creators. In a full zoom to steak, geni e biki apambele. Muhimo. Beki ena taka. Grende, masai. So the game is called whose line is it anyway.  So what we have to do in the game I'll give you a sentence to act out the sentence or say the sentence. For example, I'm going to ask Val in time because she's used to it. Val. I'm going to ask you one and then we have to demonstrate here for our guests. No pressure. I think so. Kasi powa, forgive me. Vings, you wouldn't do a say in a hosipto. Kospitali. Kospitali. You said that you can demonstrate. Yes. Alo. Niko tuwa pakuwa kawode. Kuna patienta me escape. Walu kuwa atatu. Sifa kucheka, sorry. Okay. Nimeju na reference ni ni matzawa. If you don't know, don't give up. A barit. Let me demonstrate. Niko tuwa pakuwa. Niko tuwa pakuwa na kudunga sindano. Oh, ya. Walu kuwa pakuwa. Lekini akiliako, I'd like to just split it up. Mio nini wendelea pondani. How did he come up with that? Okay. Are you now feeling the vibes? Yes. Would you like to demonstrate things that you wouldn't do or say in a hosipto? I'm going to turn it up. We'll just flow with it. What not to say to a police officer? It's been a long time since I was a kid. So, I pulled over. Ah, brave. Muna daiki moja. Ah, ah, ah, ah. Ah, ah. Hashtag. Challenges kwa kwa setukali. Tiliana, tiliana. Bariako nifu nanimzuri afande. Ia kwa niyambao. Nyeza guza. Isasa bunduki. You've got jokes, man. You don't dream about playing with fire. I know my rights. Nashikura. I know my rights. You'll be left with your rights. Would you like to try? Ya. Stand erect, officer. Ah, ah, ah. Ha. Ia kwa. Ia kwa. Ia kwa. Ia kwa. Ia kwa. Ia kwa. Ia kwa. Let's try a simpler one. Things. Things you can say about your breakfast, but you can't say about your partner. Ehi. Mbona izisiriyosiku sogi sogi, vizime kakumaziwa shawana. Why is my egg dripping? Ah, ah. Ii sausage mone kukombo. Hei. Buklong sausage breakfast. Me, like meat. Okay. Hot. Okay. Una lond. We're trying to get away now. Something you can say about your breakfast, but not your partner. You're next to the cook. You're next to the cook. Next guy. What about the gender to the next one? I met upima. Tumfugiwa. That's a tumfugiwa. One last one before. Ijaiwa. Mya ii nielosana. Okay. You can say about your partner. Ii nielosana. You don't pay enough. No. But I don't pay any additional money. I will pay you any compliment. I will ask if you can give me a very big compliment. You look nice. I don't pay any additional money. I will give you any compliment. Allah. There is a difference between a lot of money and not enough news. Ni kwa news. Nye usi tu na daxi si di same tu. Nye wadiko na uzito. Tiswa hini na sa umimbo ni daxi ni. Kiki tu na news. Mas mimi mousi tii rasta tii. Na nefrenzo jini ambili. Mwaja mwaja ni muzito sana. Mwaja ni mi accusation. Mwaja ni mwaja ni mwaja ni kudiko eh, zaiti. Na wana. Mwaja na spend too much time kwa basa sana. Binge. Binge na wanahama ni ya dansa na wana na wanda ni mwaja ngaji. Gouji. Ceza Soyure, Ceza Cektaou, ni waji na zaiti ni waja kutiko eha. Nye na chilangatme, nye wa zaiti. Nye waja kutiko eha, Ngaji na zaiti ni waja kutiko eha. Nye za Nye нашейu. Aya yaa, nye za nye nye. Nye pula? Natsukami turi Auniaza semi hivu Kaka ni cross I Okay Kasirika lakini kai wiyadu fekume Kasirikuk semi okitu Will you marry me?   I object Moneha ato Okay Unlikely things to hear during Christmas Christmas It's Christmas season Unlikely things to hear during that season It was in hand On hand in hand Gosh It is My team is not cooperating I don't know Jesus is risen How is that unlikely? On Christmas It's the birth of Jesus Okay, but let me assume two Jesus Let me have a moment guys I think that's a hard one for me For the first time I don't have anything to say Christmas That's weird That's weird Christmas you can say almost any except Jesus has risen And it can also apply if you are referring from Giving birth, then he dies, then he rises But to tell me my name is Susasa Hey Unlikely ways to impress women or men Hey I don't know what to say I don't know I don't know what to say I don't know what to say I don't know I don't know what to say I love Susasa Why would you say that? What is that information for? I love you I love you Okay Hey I'm striking out Loading Loading Let me repeat Nothing There is no unlikely where you can impress a man I don't know what to say Okay we just zoom Let me impress you I don't know Patrick can impress But in the most unlikely way Huh? Wala Okay Things you don't want to hear in the dark Things you don't want to hear To hear in the dark To hear in the dark Kuponatufkiri Help Wala You can't see Okay So you're sleeping So you're sleeping This will make you laugh Okay Okay Give me another chance Thank you OK Just a man, Nile, mi lango higine Ehh, hee, that's something you don't hear tonight Wee Wee The other thing you don't, I don't wanna hear it now Nuna jyoku na paka Nuna iskili na kwa niyuma Namu sta ki kumuzii ai yo, sasa Tafa thale Hee, ah ee Nubunja, ni kama hiu ko Ah Ah Samtafuha, na ni nasteen ma leo Okay Fave presenter, wika ra li wika ruko So nikuwa nombatotumalizia na kusumat least tweeter jua tuja ingiha po. Is that okay? That's very okay. It's fine. Let me do Rajiza favor. Jua alimame sumasana. Nyakwa Roda says bondo is watching. Nadiemu kami eheyo seti ya nadia. I think kataimiku wa 2 seti mzima. Binti Halima 2, 5 voices watching from Baringo. Obote says. Uli za huyu yama. Ainda comments nikuwa tafta by the way. Bona uwa hua wongi kama sayi. Bona uwa kama sayi. Godja ma sayi wongi ajin do same. Mkwacha jibu alafwa ta jibu yako. I think you all know that. Westman wongi agi sana. Westman wongi. So onajibu kama. Uzdo minakudin beat. Siyoni kama mekwambia vizuri ma sayi. Inibita Rajiz. Do something. Let's go. Let's go. 20 inje. Rajiz nafunga shona wewele. 20 inje. That's why. That's why. Okay. Now everyone has watched that. Otakation tu mekwana. One run town. Eh run town. Soeter. Run town. Eh. Isibia isibishkana. I can't tell that. Eh I can't. Sorry. I say sayi kalo mivalta. Hai. Thank you so much. Nan mekwana ume piga. Kanin ingine pause. I like it. Tu me discuss your pause. Mneza muita gidion vanyameva boots. Eh. Hai ya. Ili kwekwa ziri ya. Mtu simuiti safari. Bikos piya kuna safari. Gidion boots. Edoit izimu zile gidion boots. Zawarast. Natshaik. Atwetwefo Facebook. Wetwefo channel. Wetwefo underscore channel on the ground. Our hashtag of the day is social Friday. Mne lemi allow the gentleman to begin.  So be kind to a boy child today. Just one. No need for many sir. How do you find your social media and in conclusion? All my social media platforms are by Patrick on Tik Tok, Instagram, YouTube, Facebook are by Patrick. My favorite presenter. At ma secta on every social media platform. Ya. Yo meyam kailikwa. Ili kwekwa ksa matizu biti tatu. Nani bine. Let's continue later. Okay. Mr. Kvait. I'll transcribe the region. I'm just inviting you to come and see. Kiesho. Kiesho is Bambookask Parklands. Were you working on that? I posted on Instagram for the doors. I'm just inviting you to come and visit Bambookask Parklands. Thank you so much for your bambui me pita na mimi ki dago. Yes, thank you. So very much we have had an amazing time. Not for everyone. Yes, you had an amazing time. Yes, I tell you, him has had an amazing time. Also, them, they are not even. No, no, no. Ya. One of them snaka to 40. Muna kwa na marasa wu mingine. Thank you for that visual. Ayani wa nani. Have yourself a wonderful weekend. And please be safe. Muna kwa na next week. Natchna kufenda sana. Bye bye. Have a good one.


Now, the Managing Director of the Benin Electricity Distribution Company in BDC, Fungke Oshibodui, has described an arrest attempt made on her as illegal, as the takeover process is still a subject of court litigation. Recorded about five distribution companies' discos were announced for restructuring and for the takeover by the federal government on the Nigerian Electricity Regulatory Commission. Now, the bank and the news of her arrest, which went viral on social media, Oshibodui stated that the move to arrest her was flouting the restraining order of the court, as well as posing a threat to her life. Till today, the core investor, Fijiopa, never pledged BDC shares. Those shares are still being held by them. Now, one of the investors pledged shares of his own shares in the company of the core investor, his own shares, but not the core investor. So, absolutely, if they were doing this with video power, I can even understand, they are not doing it with BDC that has absolutely nothing. There's a rule of law, there's a process. But in addition, even that loan is a case in court which the court has not taken a decision on. So, somebody using his office to do something that is not by the rule of law. That is why there's an injunction and that was why this thing. And because they were not successful that way, they now decided to use today's gangsterism. They broke the doors of my office and when we finish, you must go and see those doors that were broken. Self-help by an illegal party. Please do subscribe to our YouTube channel and don't forget to hit the notification button so you get notified about fresh news updates.


This is Beatrice Cantelvo, your host of Perspectives on Global Justice. We had a rough week for civil and human rights in our state and in this country. And today we're going to cover a little bit of that and in perspective also thinking of Cinco de Mayo to help us digest some of the news that we had. So I think the biggest concern for most Americans this week at a domestic level was the surprising passing on the housing on a affordable act with Trump Care, which hopefully will not pass at the Senate. And we're going to talk about that a little bit today. And also we're going to talk about the end of our legislative session for the state of Hawaii, which just happened. And we have a very special guest with us, which is Ian Davidson. He walks here, take back with us. But he also is the owner of Minersons Productions. So Ian, welcome to our show. Thank you. I'm excited to be on this side of the table. Actually, you know, it was not too long ago that they was what turned it. Indeed they were. It was a pretty good show. You can find that on YouTube. See, what did you talk me to? You're amazing. You come on one show and then boom, you have your whole sort of thing laid out for you. It's super cool. That's one of the cool things about think tech is someone can come in here, give their opinion, say stuff, talk about the things that they're into and find themselves with the ability to get that message out more. It's pretty cool. I agree. And I think that it's really nice to be able to be at the other end, receive and to be a little bit more thoughtful about matters that impact all of us and to hear the perspective of so many different individuals too. So on that note, I know you have a lot on your mind and that we would like to cover a little bit of what has happened this week with Affordable Care Act. Absolutely nothing happened. I'm sort of a political junkie. I stay in touch with what's going on. I like to see what our government is doing. It's one of my sort of things. At this point in my life, I've figured it out like how this sort of works and really what we watched was a bunch of Republicans voting just to look as if they're doing something for themselves, like for their constituents that voted them in. They're trying to secure their jobs is all it is. You clearly can see that when it gets to the Senate, it's going to change. Nobody has the stomach to take away all of that stuff. All those benefits from people the way that this House sort of built has moved into the process. It's so amusing to me actually. It's sort of theater. What were your thoughts? I mean it was a very thin margin. It was like 217 votes in favor of the bill passing to the Senate versus 213. So four votes made a difference. But in terms of the content of the bill, I think a lot of people, I think the good news of it is that a lot of people are calling their Senators and saying even if you are a Republican supporter, please do not support this bill in the Senate because it will impact me personally with all of the pre-existing conditions that wouldn't cover individuals and also just to think about it by 2025, 25 million people would be uninsured. It doesn't make much sense. But were there any parts of the bills that you were like shocked to hear? No, it's Republicans. It's a Republican. They have all the power. As far as that number, it's the number that they needed to reach to give their President or all of our President, I guess, a win so they can go out on TV and smile and say, look, we did what we said we would do, which they've all done a million times all along with the President. They did all this. This is nothing new. We've seen where that went. If it gets to the President's desk for him to sign it, it will be a completely different thing. I suspect that the Senate will do something about it or tiptoe around it and try to avoid making the mistakes that the House did. As far as stuff in it, have we been able to see it? I'm under the impression that nobody's read this thing, that they rushed it through. My guess is all the things that people have screamed about, Obamacare, all the sort of frightening stuff. I'm sure people are saying that kind of thing. But ultimately, it's just sort of part of the process. You kind of have to wait and see. So to wig out about certain things, it's premature, I think, at this point. You can call it Trumpcare, but no law has been changed. Obamacare is still intact. At this point, I understand why people get all hopped up about it, like they want to scream and shout, because that's how you motivate a politician to do what you want to do, want them to do for you. So a lot of this is all theater to me. I'd like to think that this is all sort of a movement towards what ultimately should be. Everybody just gets health insurance. So universal health insurance. I feel pretty firm that we're heading in that direction. I'm just going to take some time. Well, one of the provisions of this new bill that really shocked me, aside from all of the lists of the pre-existing conditions from asthma to HIV to any kind of brain disorder to angioplasty, was rape being considered a pre-existing condition, which if you would go through, somebody who'd be raped would have to choose between seeking medical coverage for that immediate need, whose most people have to be screened for STIs, HIV, pregnancy, also the lacerations that occurs during rape is not pretty, not to mention the mental health support that's necessary to recover from such trauma. That would not be really services available to someone who'd find themselves in that kind of circumstances, because they would fear not being covered later on because of that pre-existing condition. So I think that even though we hope, that this does not go forward, that the pledge that I would have for someone who is a Republican supporter, who may support this bill, is to think about the cost in their own health and the health of their loved ones because it will impact people negatively in things that we take for granted with the current health care system. So that was the big, I think, shocker of the week in that regard, but we had the end of our legislative session for the State of Hawaii, and I know you're dying to talk to me. Oh, yeah? Some of the bills that were introduced and not even heard in some of the ones that were heard and killed at the end. So what would you like to start? Which one? Working here, I have the opportunity to hear a lot of the past few days, I've heard a lot of people talking about it. The rail, I think that's one, I think that's more, why did our government not really do anything? Why did they not figure some sort of solution, which is sort of their job, the idea that they get paid by the taxpayer to do something and they really didn't do nothing. They didn't come to a conclusion on that or figure it out how they pay for it, all that kind of stuff. It's all kinds of banter about how they do it. It's cool to see them do it. The death with dignity has been an issue that people have been talking about in its future. I'm hopeful that something like that gets passed. I've had sort of experience with people being ill, going through hospice, and the sort of horrible side of dying and why I can understand why someone would want to end their lives on their own terms, and they should be. But hopefully that's something that will change. Yeah, compassion and care at the end of life. I have someone very close and dear to me right now, my high-knife father, who is so miserable. He's 83 years old. He has vascular dementia. His body is failing him. He really has no quality of life whatsoever. And he's in pain all the time. It's horrible. And it's just horrible. I don't think that he's trapped in his body and in his mind. And I don't think that's how he wished to spend the last days of his life on Earth. Despite all of the efforts that modern medicine and technology has available to mask or soothe some of the symptoms, the matter of the fact is that we're prolonging his suffering. And it's very difficult. I've had the experience watching people die and I could be easier and more compassionate for sure if they were able to. And I think that, you know, I understand both sides of the sort of mission. You know, I get it. Like it's sort of killing yourself. You know, it is. But humans being should have the ability to have a quality of life that they like or are okay with. And at some point, if that quality of life gets to a point where it's terminal or it's not great, you know, they should be able to. To make that choice. They should be able to be somehow, an avenue for people to be able to make that choice whatever way it is, whichever way they can figure it out. And it would be nice if politicians, you know, opened up to the idea that people have the ability to make these decisions wisely. What do you think happened? Why do you think the bill did not go through? My guess is religion. You know, that's generally what keeps people from doing these things and fear that they're politicians that may not be persuaded by their religion or other religious groups that say, you know, that's, you know, don't do that. I think that they're just afraid. They're afraid that they're going to step on the wrong toes and that there's going to be some repercussion. And it's funny because it's Hawaiian. We've had people come through here and it's the same people every year. And so it's like, what are they afraid of? You know, like, they're going to be there next year or the next election. They'll be re-elected. Well, you know, what actually brought up a really wonderful point which is the calculated risk that a representative or a senator may take when considering a new bill in that part of having to answer to their constituents about also the worry about their public image and the ability to have longevity in their role. I really have a hard time with that because I do think in many ways, sometimes there are bills that have enough support, enough testimonies of constituents saying, this is important to me. This impacts my life or my district and I would like for you as a representative to hear that. Yet many times that does not happen. That's government for you, though.  I don't think that they should be going about their daily lives or their job as a government person for representing people here in Hawaii or elsewhere in the United States to be thinking about their job. I'm under the understanding that people that get it to government are doing it for the people they want to make things better, but ultimately their employment sits out but all employment is trying to stay employed. Well, my hope still as an optimist is that a lot of people say, we don't want to know what goes into politics or making sausages, what goes into it. I do hope that the high level of transparency and accountability to the constituents really becomes the priority, not the job because these are public service types of oppositions which is quite an all-night. I know that there's a lot of people doing hard work out there, not only in the state of Hawaii, but across the nation. I think more than ever there is an important factor which is civic engagement, having constituents really be in a representative's case and say, what are you doing with these views or with issues that are important to us and that there's a little bit more of that checking balance so that we don't end up with surprises like that and you get so disenchanted with the process. There's nothing more than having to write to testimony knowing that there are so many people concerned and wishing the same thing and I feel that the people are just not being heard. Yeah, I agree. The civic engagement is super big on that and it's one of the things that's great about Think Tank is sort of what we're promoting. But just earlier today, Colin Moore from the University of Hawaii was in and he made a point about how it's not, civics isn't something that people are learning. So the idea of what civic engagement is and you just said it to me, I know what you're saying, perhaps somebody watching right now that just went right over their head or their impression of what that is is something far off here, far, you know. And so I really, I don't really hold much hope in the legislators. I kind of hope that people on the grassroots of a movie trying to teach civics to the people so that they understand how that sausage making gets made and what it takes to make that happen. And ultimately it's the people that supposedly are going to make change or push the change and if they're not really aware of how it works, then you can't play the game if you don't know rules. So I'm more hopeful that the public is able to figure out how the future public's people, citizens will learn more about the things that, you know, like some people will watch TV and think that Trump care is something that is actually happening right now. And none of that is happening. They're just part of the process. Like Joe Travolbaum and all these things, they're just on hold. You know, because it's the process and you just have to know that when somebody makes a mother's across the house. So we're going to take that little break And we'll be right back and we'll talk a little bit more about this. Hi, I'm Carol Cox. I'm the new host of Eyes on Hawai'i. Make sure you stay in the know on Hawai'i. Join us on Tuesdays at 12 noon. We will see you then. Aloha. You're watching Think Tech Hawai'i, which streams live on ThinkTechHawaii.com, uploads to YouTube.com, and broadcasts on cable OC16 and Ollello 54. Great content for Hawai'i from Think Tech. Aloha, my name is Steven Phillip Katz. I'm a licensed marriage and family therapist, and I'm the host of Shrink Rap Hawai'i, where I talk to other shrinks. Did you ever want to get your head shrunk? Well, this is the best place to come to pick one. I've been doing this. We must have 60 shows with a whole bunch of shrinks that you can look at. I'm here on Tuesdays at 3 o'clock every other Tuesday. I hope you are too. Aloha. Welcome back to Perspectives of Global Justice. This is Bea, and I'm back with Ian. So, in our short break that we took, we were talking about a little bit of our hopes moving forward on how to engage our community in the idea of being more civically engaged and the lack of knowledge that many people have, and also the missing opportunities by not being engaged. Ian, I know you've been here with Think Tech for a while, and you've seen so many guests coming and going. What do you think would be helpful to an average adult that was born and raised in Hawai'i who does not really take the time to understand the bills that are being introduced or how that will impact them? What would the government or all the organizations could do to help engage that individual? One, I don't know if their government really wants to. They'll talk again, and I think that if they had their way, they probably wouldn't let people walk into their offices. I would tell people to go to the state capitol and walk into an office. I didn't know this for the longest time. You could just walk into anybody's office in there and just say, hey, and put them on the spot. When I have the opportunity to go into these people's office, I love to bring up C-level rise. It's one of my things because they don't want to touch it, and you can watch their faces just like, because they know that they can't talk about those things. The public should go and get into these people's faces and talk to them and learn from them and go to their neighborhood board meetings and all that kind of good stuff so they can hear what people are talking about and get a sense of it and then make your sort of mind up on it. Right. When I started to visit the capitol more often, it's quite intimidating process because you're going to talk to a government official and I used to be so scared that I was going to make a mistake. I didn't need to start to shake up and your hands are really clammy and cold. But I think as you start reading more and learning more, one of the things that really has helped me over the years has been the ability to connect with your representative at a personal level. So I think even saying which district you come from, why a matter is important to you, you don't need to really be an expert on a subject, but the way that you interpret a certain bill and how do you bring meaning to that into your life, makes a big difference. And also another thing that I've noticed is that a lot of people will go through the whole process and they'll maybe connect with other representative once. But every time that a bill is heard, it goes to the next level. So they need to go back and write a new testimony. I think a lot of people also feel that they have to take time off from work to give life testimony, which is helpful in many ways. But it doesn't all have to be so. You can provide that information in writing ahead of time and it will count, you know, a record. The other thing too is that most people don't think about doing that on their days off, but they can actually schedule times to meet with their representatives ahead of time and having a face-to-face meeting in their office. And that's what they're there for also. I really would hope that there would be more efforts to work with youth and children to visit the Senate more, the schools. The other day, two weeks ago, I actually was at the Senate with a Blue Planet Foundation. We had about 600 children from the school districts in Oahu coming to learn more and to advocate for green energy, which unfortunately was a bill that was killed at the very last hour. And what was very fascinating to me was to talk to the children and many of them did never step their foot into the capital or talked to a representative or a senator and they loved it. And I think that some representatives and some senators really made the effort to bring meaning to their visit in a way that would make sense for them. So we had one representative from Lanai, sorry, Lanikai. And she was mentioning that she was working on budget for the cafeteria at their school, the elementary level. And I thought it was really sweet because the kids were like, really, you're doing that? You can do that? And they got to talk about budget and they got to talk about how everything works. And it had to start young, but it's never too late to get started because our lives depend on it. That's pretty cool. I mean, I like it when companies or groups do those kinds of things. I personally would like to see the state doing these things and paying for it to bring them in. Those children are very fortunate that there's this group that has money that can afford to bring these kids down there and take the time out to do that. But I love it. There's nothing wrong with it. I'd like to see that stuff happening on a regular like, guess what? Every year your school goes to the state capitol and it's all on us, the taxpayer, we pay money. I'll pay more money if I had to, if I knew that it was going to go to something like that. I'd gladly pay that. I think that there is a brilliant idea brewing here which is introducing a bill where budget allocation would be created to support children elementary through high school to really learn about civics by actually visiting and having hands-on experiences throughout the, you know, both the county and also state levels. So I don't know, maybe you can cook. Wait, I got to write it up? We can find people. See, that's why I draw the line and actually having to do the work. I'm kidding. No, that's good stuff. I mean, I'd like to see stuff like that. I'd like to see the taxpayers money going to fixing the problems or fixing sort of the direction of how these things get done. Absolutely. I think a lot of people feel disenchanted where it's like, no matter what I do or where my vote goes, that it will matter. You know, my voice does not matter. But I think our last election has shown something different. The election was not decided necessarily by those who voted. I mean, it was a very small margin if you compare the votes that Hillary received and Trump. But, you know, most staggering to me was to find out that about 40% of people in this nation did not vote at all. And so you drafted that, you know, there's a lot of division and traction, you know, in the country. But there is a lot of invitation to walk with people who may feel apathetic or disenchanted with the whole political arena.  We're seeing that, you know, right now. And I don't bring that up, you know, because we have, you know, one political party, you know, I know that because I really like in many ways I look at, you know, issues from a bipartisan standpoint, but many of the legislations that are being, you know, proposed and approved the impacts are people from both Republican and Democratic parties. And so we need to be able to look beyond party affiliation and really start doing our jobs as, you know, educated citizens too. And if we're not, we need to find the tools to be able to get that.  And there were many bills that were, you know, opened and proposed and they were not hard or killed. So anyone in particular that stood out to you? No, I think they're all, that's one of those hot button things. It's like, well, there's a lot, I think that goes into why they don't really care about homeless people or why it's always pushed off and economics, all these kinds of things where they kind of don't count to them and they're more than likely are going to be people that don't vote. So they don't really matter to them. But I think that homelessness is the biggest sure that they should be doing stuff about that. I think it's one of the more pressing ones. Affordable housing, homelessness here in Hawaii, which go hand in hand. You know, there's a lot of people that don't have homes. They have jobs, they have children. They just don't have a home because they got all those things, but they can't afford to live here in Hawaii. Affordable housing, so that will be the promise for next year's legislative session that we bring new bills, you know, for that money to be available so we can have affordable housing instead of Hawaii. Well, I can't believe how quickly our show has come to an end. Well, at least today we have Cinco de Mayo. So we can celebrate and commemorate about, you know, Kuliana, the privileges and the responsibilities that we have in our state and in our nation moving forward. But I love it. I just want to say really quickly that, you know, in America we like to jump on people's sort of holidays, sort of things and turn them into big drinking things. I find it quite interesting that Americans love Cinco de Mayo and aren't so fond of Mexicans in general, as far as the government and the way they treat them. It's a whole other story. All refugees are mindful of you. On that spirit, Viva Cinco de Mayo, Viva Mexico. Well, thank you for watching Perspectives on Global Justice. This is your house to be, you can tell more. And stay tuned for next week's show. Until then, hui hou.


Alright, so now I'm gonna give you a sneak peek inside our lab I don't think there have been any cameras in inside before so I think you you'll you'll get a chance to see how we do our validation and bring up So this is the main x gene lab that we have here in our headquarters in Sunnyvale and as you can see it's a little chaotic But the reason is because we have lots of these stations and you'll see multiple boards that we have x gene one That is being that is going through stress test and now we have the x gene 2 That is also going through the stress test as if we prepare to take x gene 2 to production You'll see some of our Some of customer chassis and boards 24 hour 24 7 that's the HP moonshot testing around here. You'll see these are these are woven to die It's a little noisy, but Systems and applications right so when we test our chips We not only run the testing on each interface, but then we put in a real-world applications And in fact we boot multiple operating systems, and we're actually running a whole bunch of operating systems here an application so here are a whole bunch of chips and you're able to just put them in the And here you can see we're testing the 10 gig Oh Then this is our so these are some of the guys so these are the guys who actually designed the CPU you design the CPU So these are the guys who design CPU now. They're actually testing the CPU So we do a lot of as I mentioned stress testing so we've got lots of systems here We've got systems over here so we do Interoperability testing with lots of the memory and the CPU guys are constantly, you know doing performance benchmarking trying to improve the Processor so every generation of CPU. We see about a 10 to 15 percent improvement in IPC so Do you want to talk quickly what you're doing right now? Well right now that these are systems We're running some tests benchmarks to evaluate the latest silicon Yeah, just running more for configurations with some different stimulus running a bunch of benchmarks right here Yeah, so this is actually true. So this is our second generation silicon That's that that that we're really getting up for production. All right. Yep. What's going on here? the here is some of the so, you know, so this is some of the Test gig where we can actually increase we can heat up the processor And we heat it up to really high temperature. We can lower the temperature Looking at people would take so we really kind of break the silicon To make sure that we know when we actually All the code can get Up and running. We've got PCI stress link. We've got data The amount of stress that we put on this chip, right? If you think about it We've got lots of interfaces the amount of we try to stress it day in and day out So we've got really software that we've been trying to design to try and break it to find make sure that it's actually reliable Under all operating Yeah, then this is more of the same. This is one of our SATA jigs You can see that these we've got multiple SATA ports and we're constantly reading and writing those SATA disks Again Then India how soon is xg2 in the end to match production So xg2 is is functional and it's it's it's it's it's very close to production We're at the tail end of making sure that we've characterized every IO That we can actually make sure that we can put the specs of the IOs on the sheets So I think what we publicly announced is that xg2 will be in production in the middle of next year. All right, so This is it. This is the future of the amp server being engineered right here and And What's happens in the other areas in the building? Well, so this is where we design it So downstairs, we have the CPU design team. We have the SOC team up here We've got marketing and sales. So it's pretty much well contained in this in this building We also have design centers all over the world in multiple different sites But this is really where the the chip comes comes and we do all the bring up and characterization here


Live from the Moscone Center in San Francisco, California, it's The Cube at AWS Summit 2015. Live in San Francisco at the Moscone North for Amazon Web Services Summit. This is one of their shows that they do, real technical in nature, but they get all the key developers here, all their partners, and they go geek, they go deep, they go talk about technology, and of course we're here covering it live, but this is different than reinvent the big, the ancient lot of the big show for Amazon. This is one of the fun shows we get down and dirty. Look under the hood. I'm John Furrier, the co-founder of Silicon Hill. My co-host, Mark Farley. Our next guest is Colin from Time Inc. Come Bodell, CTO of Time Inc. Welcome to The Cube. Thank you, son. Great to see you. You were up on stage in your keynote. I kind of sneak out to kind of get ready for prep here, but you are the grand finale of the fireworks for Andy Jassy, which had a lot of patterns in it, and the pattern was a word that he toss around, really teasing out the theme of the show, more power, more compute, more agile, machine learning, big data analytics, more of a buffet of more goodness from Amazon today. So, share with the folks out there, what you're on stage, and what you're talking about, and we'll get into some of the analysis of the horses on the track here. So, and full disclosure, I used to work at Amazon. I was there for eight years from 2006 until 13 months ago. I moved from Seattle out to New York to be the CTO of Time. And, you know, the reason I was on stage is part of my job at Amazon, I used to run all the website application platforms, so the rendering stack on which all the Amazon retail site runs. And probably about five years ago, my memory gets hazy as I age, about five years ago, we moved all of the Amazon retail sites up onto AWS. And we actually did it, you know, treating AWS as a vendor and we were the customer. And, you know, it helped us save a lot of money and a lot of flexibility. It helped AWS, you know, further test out how to work with customers before, you know, the big marketing push. So- This was just a throwaway opportunity. This is real money on the table. Oh, yeah. I mean, I mean, we're all right. We're supposed to order magnitude of- Yeah, we're running hundreds of thousands of servers within the fleet, so get them on. And, you know, the key thing for us was the ability to do reactive auto scaling. So at two o'clock in the morning when there aren't that many customers, provide the hardware back to AWS. They sell it on the spot market when people wake up in the morning, traffic increases, we can pull it back. And that was a huge saving. You know, at some points of time, you know, 40, 50% of the hardware, we could pass back. And that's hundreds of thousands of servers. So yeah, it's big bucks. So when I, when I walked into time, I think there were a couple of things.  And also, you know, I wanted to take advantage of some of the low hanging fruit. And because we had five major global data centers that were just sucking up a lot of held capital, they were inflexible. Some of them, you know, we owned and operated others. We were working with third parties. There were three P co-location facilities. So we didn't have the control that we wanted. I said to the team, I want to be out of the data center business. And it was funny, I, I got down to a quick win. Oh yeah, you wanted a quick win. Yeah, let me just throw that one back. No, I wanted a quick win. You're out of the data center business. That's a quick win. Yeah, but we said, you know, we did some back of the envelope numbers.  I think next year our hosting costs have dropped by about $6 million. This is the bubble year, when we're still running some of the data centers where, you know, we're finishing off our work with AWS. Next year we're in the clear. And it's about a $6 million annual saving, which, you know, is not a bad deal. You know, time is a three, three and a half billion dollar annual revenue company. And, you know, that's a good chunk of my budget that I can apply to other things. So, you know, when I came in, you know, I said to the team, I was thinking about saying, well, get 80% of the way there. And I thought, well, if I say 80%, they'll get 60%. So I'm going to say 100%. Let's see where they get to. And they can argue and talk me out of parts of it. And some of the- And get to 60 where you want it to be. Yeah. And, you know, some of the stuff we've got to have on-premises. You know, when you're dealing with, with, you know, video, video editing, you know, it's not an Amazon issue, it's just the intra-webs issue. We're just not getting the bandwidth. So we have those local systems. Everything else I want to get up on the cloud. Or if it's a third-party application that we are hosting in our own system, I want to move to that vendor and take their managed system. And if they don't have a managed service, then fine, I'll find somebody else that does. But I want to get out of that hosting business. So are you migrating applications or are you rewriting them or redoing them? What's- Yes. All of the aforementioned. A number of them are lift and shift that we'll move across. They fit very well inside the Amazon ecosystem. Others were re-engineering as we go to take much better advantage of the breadth of services that Amazon has.   And you know, we're committed to them for, you know, a long period of time. There's probably millions of man-hours or person-hours gone into them. So we'll still run those, but we'll re-engineer parts of them and the re-engineered parts will go on AWS. And we may bring in some additional packaged applications. So, you know, we're just making, we're doing the right thing for the business. It's not a one-size-fits-all, but it is based on the premise of get out of the data center because it's just expensive and unwielding. How big is the timing? Operations, employees, you got brands, obviously publishing, media, a lot of media action. Yeah, 80 brands worldwide. 120 million unique views of our print every month. 120 million unique... Like print, print, not online print. Print, print, not digital. Like real hard, yeah. Real, honest to God, magazines. That's right. That's exactly right. Oh, it's cool. See, you got your books. See, Amazon's not killing everything. So yeah, 120 million uniques on that and 120 million uniques for digital. And when you put the numbers together, it's probably 140, 150 million uniques. Large audience. But there's a lot of crossover between digital and print. So yeah, I mean, it's big. It's a three and a half billion dollar brand of fortune, right? So fortune, time, sports illustrated. People are going to hate me if I forget. Entertainment Weekly, People. This old house, Essence Magazine. Actually, some of the people that watch this might not care so much about people. Any video, do you accept video operations? Huge video operations. So yeah, I think about 12 months ago, I remember the number was about 80, 8,000 unique pieces of video. And I could be getting that number completely wrong. But you know, it's doubled, it's quadrupled. It's gone up significantly over the last 12 months. From the media profits, do you have a TV brand? Yeah, so you know, there's SI now, there's People Today, the shows that stream out. But that's not a broadcast TV kind of thing. It's not broadcast, no. It's part of the existing, yeah, because they're all blurring together anyway. And you know, we have a property called the Daily Cut that aggregates all of the video that we have. So you can watch that video on Sports Illustrated, on People, on Time. Daily Cutter, you know, it's our aggregation location. We do a lot of live streaming on it as well. But that's on web, it's on iPhone, it's on Android, it's on Roku, and we're going to be rolling out Xbox and Surface and Microsoft phones. Yeah, more distribution channels. Yeah, I mean, it's just wherever our customers are, we want to meet them there. I think you're on Snapchat too, if I remember correctly. So I'm sure we're everywhere. Yeah, you're on one of the tiles there. Anyway, so you got a lot of stuff going on in real time. So what is Amazon doing? See, when you walked in, what was the, what was the pointing at all the cobwebs? Let's get that out of there, rip that out, go to the cloud. Where was your low-hanging fruit, and then where was your more strategic work done? Yeah, a lot of the low-hanging fruit was duplication. Time had been a collection of companies under the Time banner that was owned by Time Warner. We spun out as our own public company about nine months ago. So there was a lot of duplication to remove, but that's straightforward. It's not a strategic play that's just tactical, you just got to get it done. The strategic play was websites and mobile applications, getting them onto a single content management system. So when I joined, there were probably about 10 or 11 different CMSs in use, and we'd made the call to get them all, get everybody onto Drupal. So we take an open source stack, we can extend it, and that made people much more fungible. We could move engineers around, we could also move editorial and journalists around that can work at different brands as appropriate. So partnering up with people like Acquia, who of course run a wonderful Drupal instance, getting to know VAM, getting to know Dries, the creator of Drupal, that's the caliber of resource they've got. We got that as part of the, coming into the Amazon ecosystem for AWS. So that was incredibly valuable. And getting those properties up, so all of our UK sites now, and that's probably 45 brands, as of the end of last year, we're all running up on AWS. So our hosting costs went from 70,000 US dollars a month down to 17. So this is hosting cost. So this is our own data centers or 3P co-location data centers. So to go from 70 to 17, in the universal scheme of things for a three and a half billion dollar company, it's not huge, but it's a number of additional staff that I can hire, it's removing distraction. And this is why the whole journey for us has been, technology, getting out of the data center business, leveraging more Amazon web services, so our staff can focus on things that are really important to our customers. Our customers don't care that we've run data centers. Our customers don't care that we've built services now that somebody else can build for us. But the other thing that's been going on is that cultural shift. As our engineers now have been able to do things much faster using AWS, it's been much easier to bring in DevOps. It's been much easier to spread agile development methodologies across the business. Probably easier to hire too, right? Oh yeah, no kidding.  When I graduated, I was in university college, computer science in the 80s, it's like, oh, you want to go work on some cutting edge languages or COBOL and Fortran. And you look at it and say, hey, that's not my generation. It wasn't even punch cards. That was way off the radar. I want to work on some cutting edge lists. We got some C++. I mean, Mark, this is now the model where he's old school storage. We know the days where people were actually loading Linux. Right now, young kids come out of school, they've never loaded Linux on anything. Never loaded a patch. So this culture shift is here. So the reality is it's here. So I got to get your take on this. Okay, you're in the middle of a transformation yourself, digital transformation, ironically, double entendre, time, and double digital, double digital. But reality is, is that other people are scared of it. Okay, and there are other vendors out there. So compare, contrast, what are the, what's the old school guys? Who's, who's, don't, you know, the name needs, you can name names, but like who's losing, who's winning?  Yeah, that's a really good question. And I'm, you know, I would consider myself an old school guy. I mean, when I came out of college, I was working for a company writing backends for cobalt compilers. So, you know, if that doesn't date me, I don't think anything does. There you go.   If it hasn't been successful, at least you know it, you can avoid it. The thing that I particularly like, that you know is not being done by other folks and certainly to the level of sort of purity of Amazon is it's my, you know, it's my data center. It is a very clean and crisp stack. I can roll an army. I can launch, you know, a Linux-based application. I can write it in whatever language. I can monitor it. I can manage it. I can roll it back. I can catch it in all the ways that I could do if I held the data center. Some of the other cloud vendors, you've got to twist the way in which you do things. And there's also a lot more vendor lock. You know, we do a little bit, we dabbled a little bit with Azure. And it's a great system. It's just, it's not for us at this time, at this place of our evolution. Because historically all our applications have been Linux-based applications. We run a few Windows-based applications. But our ecosystem is all Linux. It's Unix-based. And open source. Oh, absolutely. You know, that's a huge part of it. So, you know, not only the technology and also it's the corporate culture as well that the people we're building relationships with, that kind of sets that forward. Hey, you know, Microsoft have got great folks internally that know an awful lot about open source and drive an awful lot of open source. And I meet up with them at open source think tank and other events. It's just, it's not the right landscape for us. And you know, at some point in the future it might be and we come back and take a look at it. I'll never say never. But at the moment, for what we wanted to achieve in terms of cost saving or flexibility, the picking up and moving and dropping down on AWS was just straightforward. It's what we knew. We had the skill set internally. We had to build out subject matter expertise in AWS and bring in some third parties. But- How about personnel? Did you have to swap out personnel? Or was there a migration, natural? There was, you know, the business was going through an evolution anyway. You know, new leadership team in time over the last 18 months or so. And you know, we needed to, I certainly brought in, you know, brought in some new people, you know, married them up with the expertise, the experience internally so you get the best of both worlds. I brought in some cloud experts, but maybe I was going to say surprisingly, maybe unsurprisingly, some of the engineers that we had at the time when I came in looked at the opportunity to learn more about the cloud, looked at the power and control it gave them and just went running forward. So in fact, the reason that we're all up on our websites in the UK is because our UK team, Elliot Moore and Simon Loxham and that organization out across in the UK, they just dove in. They solved a lot of problems, they worked out a deal with Cloudreach to come in and get them up to speed because they knew they couldn't do it on their own at the speed that I wanted it. But now they've become deep subject matter experts and are teaching the rest of the organization on how to go about doing it. So, and it's not been just the cost savings and efficiency and the cultural change, it's been a lot of fun. And that allows me to attract people, it allows me to retain people. Folks can see very clearly the direction we're heading and if it's for them, great. If it's not, that's okay. There's plenty of other opportunities. I'd like to ask about the whole industry, right? The media industry. So you've got this group that spun out time from Time Warner and they had an idea of remaking media, it sounds like. And so part of the reason I'm sure they brought you in was bringing somebody that had cloud experience, Amazon experience because if you're going to have media, you're all about content, you're about content distribution, you're about getting things, preparing content, coming it into pieces, making it available in all these other places. So you have to have a different type of model. I assume that that was part of the thinking that went into it, you know. Absolutely. People will ask me, why did I join Time? 22 years in the valley, working for startups and retrats, eight years at Amazon. I've worked all my life for tech companies. Why would I go to a media company? And when the recruiter came to me, I looked at the content and I was familiar with Time and Fortune. I had no idea about the breadth of content and how well it respected it was around the world. Then I looked at the technology and it was okay. But it certainly wasn't world beating. And my logic was, if I can take some of, if not a lot of the best content in the world, marry it with the best technology in the world, then that's world beating. And you know, you've got a lot of new media companies, you know, the buzzes, the vices, great technology, not as much original content. And I'll bet that I can build more, or my team can build, and I don't know, but I bet my team can build, you know, better technology faster than those sort of companies can build up that journalistic editorial discipline. That takes a long time to put together. Well, we're going to be a formal competitor to you.  We've got to crowd chat. I mean, we're tiny. But the point is, we're doing it the same way. We're born in the cloud. I mean, we're fast. I mean, our costs are lower. So that gives up more freedom to do things. So as time transforms themselves, they got to be fast. So as someone who's been at Amazon knowing what's available and what might be coming, I mean, I thought you have inside information, but you can see the dots connecting.  But at the end of the day, digital distribution will win everything, right? So that's the future. So let's talk about, can we have a second? Do we still have time to talk about editors, video producers, you know, these kinds of things. Have you had much interaction with them and what do they think? You know, the people creating the content, what do they see? A huge amount of interaction because it's, you know, and the objective is when an idea comes in, a news story comes in, an article comes in, especially if it's one of our news brands, from the minds of the editor or the journalist, you know, how fast can we get it out?  And, you know, shortening that chain. And, you know, once upon a time, it could take, you know, hours if not days. Now we can turn stuff around in minutes by putting the right tools in the hands of the editorial staff, the journalist staff. And yeah, changing the way.  Others, you know, have been used to, you know, the speed and the pace of print, but are now beginning to see the opportunities and speed and how they can reach, you know, their existing customers or existing readers, but also a different type of reader as well. So, you know, they're going to think a little bit differently about what it means. And, you know, what are they doing? Long form, short form, is it, you know, how's the best way to tell a story? And what's the best way to get that story out in front of the customers? And it's our job to understand what they want to do in terms of telling their story and give them the tools to do it. I'm not an editor. I'm not a journalist. I can only begin to appreciate the value that they bring. But what I can do is listen to them and give them the tools that are going to make their job better. Yeah, standardizing the CM mesh, that's a good call. But I wanted to get to the question I was going with distribution. Yeah. You know, security omni-channels is permanent listed from a security standpoint. You hear about that in the cloud, but that opens up more distribution.  Absolutely. So with APIs, with mobile, with aggregation, what does Amazon have to make that future possible? What do you see technically like, okay, machine learning can be more predictive, patterns on audience, aggregation, it's all free form? I mean, you know, a number of things for us. One is, you know, when I came into time 13 months ago, a lot of our assets were held in multiple different places. So bringing it all together into a single dam, a single digital asset management system with rights management built in. Because ironically, there were times when we were dealing with photography, we were dealing with text, we didn't know who owned it. And we couldn't do reprints, we couldn't republish, we couldn't syndicate. So solving all of that problem, EC2, S3, the relational database products at Amazon, gives us a platform that's massively scalable. We got a lot of assets that we need to bring together. And we want to put it in the hands of our editors and our journalists immediately. So they can't be having to go to four or five different systems, we want to give them a central system they go to wherever they are in the world. So it brings that. We then collect a ton of data from our customers online and also print. We print as a very well oiled machine. So we collect all of these data and again it lives in different silos. Bringing that together, we've got a big data strategy. That could be really interesting. Things like Redshift, we've got a really good relationship with Pivotal, that's a great open source play, plug and play, they're doing great things with them. The Redshift is out there, the announcements today on machine learning. That's the kind of system that we need to get in, root around in that data. And not only advise channels of distribution, but also advise editorial staff, this is what people are interested in. And of course those data we can syndicate, we can license out, there's a whole bunch of things we can do to unlock the power of the knowledge or the data, turn those data into knowledge for our organization. Yeah, I mean single sign-ins, is that a challenge for you guys? Across the properties or is that? Yeah, I mean, it's a challenge. I mean, we're on the road to solving it. And there's plenty of good single sign-on solutions. So now we've been fragmented and honestly people that read Southern Living are unlikely to be, I'm trying to think of maybe a fortune reader, probably insulting somebody terribly.   But I want to give people the freedom to serendipitously discover different parts of our content, wherever they are. You know, if you look at time.com these days, a year ago, it was just, it was news. Now we tease celebrity stories from people, we tease stuff out of fortune, we tease stuff out of money. And it gives people a chance to see it and go and explore those brands. So, yeah, a lot of fun things. Super exciting to chat with you.  So we know the opportunity. And it is really a technology dev ops mindset in media. I mean, you think of a mobile connected consumer, people are things and internet of things is data, right? So, super exciting. And you know, I've been a big fantasy and fortune for instance, doing really well. We read that a lot in our beat. So, Colin, thanks for joining us on theCUBE. Congratulations on a great keynote. Again, super exciting conversation. Really all positive Amazon is just continuing to extend their lead in the cloud business. And again, just in there, and their strategy is very clear. Just be faster and just move faster and just keep outpacing the competition. And that is ultimately their competitive strategy. And I think their scale is their lock in. And we're seeing examples of enablement and if anyone can catch up, that's second place is available. So, I'm sure people are going to give me some hate mail for that. I'll be right back here in theCUBE after this short break.