Hello everyone, and welcome to another episode of Jurassic World, the game where you have seen the thumbnail, you have seen the title, and that is right, Bumpy, the star from season 1, 2, 3, I think from 4 or 5, it vanished, or maybe it was in one episode of 4, is here, in, from Camcretaceous, we have Bumpy, Bumpalupu, the world's most loyal and kind of sore, is here with its asymmetry in its head, which is amazing. So, I was, I mean we've already put the video up today, I think it was, it's Dino Bash, we've already done that, but then I was messaged by Ludia. Oh, actually I will need to get up my phone, because I'll need to, I have a disclaimer to put into the video, and there it is, something adorable, this way comes, oh lovely. Bumpy was gifted to me on behalf of Ludia as an exclusive sneak peek of what's to come in Jurassic World, the game, but B will be officially released as the prize for finishing in Dominator League at the end of the tournament, it starts Friday, this Friday coming tomorrow, if you're watching it today, and will end on Sunday, so it is only going to be up for this weekend. I like how it just was all of a sudden. I think this is what it's all about right now. It just pulls on something. So, I don't know why I have that saved, it's brilliant though.  We've got a maintenance break, so we can collect that, I think that's already passed. So, a thousand? Maybe it was a thousand, sorry. Oh, we are so professional here at the game. So, let's have a look, we've got news from Ingen, say hello to Bumpy, so I guess we collected and fingers crossed? Yeah, oh look at that, it's got its own little background and stuff. No, so it is a legend and you will be able to get this from, you know, the weekend tournament. So, it's not something that's really hard to get, it's just joining the ranks of all the other tournament creatures. So, let's have a look, what's it got? So, 2068 help, a 970 attack. Well, it will be interesting, and this is a precedent. Now, remember back in 2015, when Jurassic World the Gamer just came out and you had the brawlers and stuff. I said, why don't we get celebrity dinosaurs in the game? Like the T-Rex from Lost World, like the book, or maybe the Spinosaur from Jurassic Park 3. And they never did it, or at least until today, seven years later, they have finally put in like a celebrity character. It should be like all-stars, if you'd class that like a, you know, you've got legendary, super rare, all-star, should be its own thing. So, we'll pop it in. I don't think I have any free hatches.  Okay, here it is, bumpy. Oh, it looks so small, a bit like it does in Jurassic World Live, it's really tiny in there too. Oh, it's going over to Isla Sorna.  Oh, I don't know if they fixed the light. Do we have it unlocked, actually? I don't know. No, we don't. Oh, that is interesting. So, it's almost like it's in its preview form? Yeah, it's in its preview form, like the lighting is exactly the same.  Bumpy's horns are asymmetrical, with one being rounder and less blunt than the other, giving her a uniquely adorable appearance. So, for all intents and purposes, it does look like a regular Ankylosaur, like the model looks the same, it's symmetrical everywhere except for the head, where the crest on its left, our right, or the horn, sorry, I should say, a nodule, is actually, yeah, it is a little bit shorter, that's interesting. And also another thing interesting to note, is that its icon is different too. I would love to see what we can hybridize this with, and I'm very curious what level 40 it looks like. So, at level 10, 560 health and 262 attack. That kind of puts on par with, yeah, just like a regular ledger. I think tournaments are, I was gonna say, is it level 40 ledger? No, it's definitely not level 40. So, if we have a look and we have a look at what level 40 Bumpy looks like, oh, it actually has a glow on it, oh, that is so cool. And so, I mean, if we can increase the brightness in editing, or something, just to try and see this the best we can, it looks like for the first time ever in this game, a level 40 of a dinosaur does not look like every other level 40. And in fact, it has its own green glow, because if we have a look, unless the colorings are different, which they might be, I can't really see because it's quite dark, they just get a glow, like a level three, oh! So, level two, it has like a slight haze, level three, it picks it up a little bit, level four, it's ultra instinct, it's like a dragon ballsy. Oh, that's interesting, it gets extra smelly. Interesting, so if we can actually see the creature facts, Bumpy is particularly loyal in Kylosaur, acting as a protector to that, to those she is bonded with. This makes her an invaluable companion. And Fwayne. Bumpy is roughly 60% the size of a normal in Kylosaur, due to her short incubation period. That's why she's small, okay, that makes sense. I wonder if she was always smaller, huh? The Armaged Shell and Heavy Club at the end of her tail provide Bumpy with protection from any potential enemies. Well, that is as much as we can show, I mean, that's probably actually the best lighting that we can show Bumpy in. That's from this one, because otherwise it's all like in the shadows. Oh, that is interesting.  But we can, if we go here, speculate. So at a level 40, it's better than Enosaurus. So we can say that a Bumpy is probably gonna be 6,600, I would say. It looks very similar to the Nodosaurus, and then the next jump is another 50, or sorry, 150. It's kind of going those leaps. So it could be 6,700. But I mean, if you have a look, there's no 50 jumps. It's 500 jump, 500 jump, 100 jump. Actually, maybe it might be 50. It could be even, it could be 6,700, but it's not gonna be more than 6,600. And as far as it's, you know, it's competitors go, 700 less health than a Nodosaurus, but 100 not extra attack. 1,700 less health than an Enosaurus, but double the attack. So it's kind of tricky. If it is the same price as a Nodosaur, I don't know, I think Nodosaur might be slightly better than Bumpy just in terms of what you get. 700 health is a lot to trade for like 100 attack. If it was 200 attack, 700 would be nothing. That'd be easy. But 700 for 100? I don't know. We'll see, we'll see. It's not gonna be cheaper. We're gonna show you that. So now that we are in Jurassic World the game, let's see what's going on. Is there anything I can trade? Oh yes, I'll trade those for some books. Thank you very much. Also trade that. I mean, we kind of do need DNA. I wonder if I have any John Hammond statues. Do I? I have 31 John Hammond statues. Yes. Beautiful, beautiful. I was talking to my contact at Ludia. Or shall I say Jam City? I guess it's both the same. It doesn't matter what I say. But the thing is when it comes to like this content, it always has been the case that if you get the video of the newest creature, then you get views. But if you wait weeks, then you don't get views. So I mean, I really appreciate them doing this. But the only problem is with Jurassic World the Live. Jurassic World the Live just came out with a new update. And I was excited. I was like, oh yeah, new hybrid. This is gonna be brilliant. Went on, tried to make all of the new hybrids, literally all of them, and couldn't do it. Couldn't make a single new hybrid. So I can't make a video on it. Because what am I gonna say? Oh look, there's new stuff, but I can't use it. No one's gonna watch. So unfortunately, I can't really cover it. And it sucks, because I do. You know, I want to support them. I want to support what they're doing. But the thing is, I've got nothing to showcase. And it's not that I don't play the game. I do. I play it a lot. But when you release uniques and apexes and dinosaurs that have ingredients that are super hard to get, what can I say? I can't do anything. I'm just looking and go, cool. Right, next thing. I guess I'm recording the aisle again. Nobody wants the aisle. Don't be silly. So, oh, we're getting some DNA here. That's good, because we actually are gonna need it. And I don't want to get the situation where I have to sell things. You know what, elixir source? Don't need it. Don't need it. You can have that. Oh, yes. Oh, we're interested to actually see what we've got going on. So, yes, there it is, the bumpy. In 15 hours, the bumpy tournament is gonna be here. Test your strength. Glacial shift. Interesting. Okay. Okay. I always like the Marsage Infinite. Marsage Infinite's loads of fun.  What? Hell, yeah. That's what I'm talking about. You thought it was gonna end there? You lucky few that stayed around. You're gonna look at the glow. Oh, that is cool. It's even got its green stink, the stinky lines. Right. So, pretty much the best team we could do for this, and I do have a level 40 Scorpius Rex. We do have it. I don't know whether I did a level. I must have leveled it up in a video. I must have. Damn. Should have put that in the thumbnail. Bugger. Next time. So, carnivals. Pretty much carnivals. So, I'm gonna go Pachigalasaurus. Then I'm gonna go Scorpius Rex, and then we're gonna finish with Indoraptor. Pachigalasaurus just to, you know, take hits. I think it can only take two hits from the Uteranus, like everything else, even though there's 18,000 health. 8,000, you know, two hits is 16,000, and another 2,000 is gonna be more than enough. It's gonna get that stack. So, here we go. Oh, this is gonna be interesting. A level. Oh, look at it. Oh, yeah. A level 40 pufferoo. This is interesting. Oh, well, I guess this is the thumbnail, I suppose.  But actually, there it is. And we can quite clearly see that, you know, for the first time ever, we have a celebrity dinosaur, and we have a dinosaur, as it evolves, it does not change design at all, which in a way, saves the Jurassic World, the game team a lot of time, you know, in order to have to do that. They just put the effect on. It's just like effects, and going forward, I can see this being more of a thing, like having dinosaurs that are celebrity dinosaurs, all-stars, and they just have a haze on them. And I've said this for seven years, or at least I started seven years ago, saying that that would be a really cool idea, but I haven't done it yet. Except for today, it was brilliant. And this, of course, coincides with Jurassic World Alive, has also got, you know, their new hybrids and stuff. Because I would love to showcase those hybrids, but the legit is no way for me to do that. Oh, well, I went for an eight attack, I think. It was amazing. It's happening, I'd say. I don't want to kill Bumpy, though. Oh, no, Bumpy, I'm so sorry. Oh, okay, okay. Yeah, Bumpy and Dad, I'm so sorry. I didn't mean to do it. I didn't mean it, Bumpy. I didn't mean it. I kind of want Bumpy to win. Bimpy. Bimpy Bumpy. But that's really interesting that that's happened. And I wonder if it's just pure sheer coincidence, because they generate automatically, but I haven't clicked on Ballstage Infinite since Bumpy's come into the game after an update. So maybe now that I've clicked on it, it went up, Bumpy, yep, put you in. Otherwise, if Ludi and yourselves have done that, thank you, that's really good. So, Scorpius Rex, I think... I don't know if it had any... I'll factor in one, just in case. Yeah, I think it went all out. Yeah, look at it. Bam! There's a video on YouTube, actually, asking of, you know, put the question, who would win in the Raptor of Scorpius Rex? And I kind of want to do, like, a watch with it, like, you know, a reaction to it. Scorpius fold over. Oh, here it is, Indoraptor level 40. It's a shame, I mean, is there any way that we could showcase Bumpy? I guess we could, we'll do one battle with Bumpy, sure. Sure, why not? And eight attacks, right? I didn't just waste that, did I? No, yes. Right? No, there's not anymore? Oh, thank God. Oh, my God, I just wasted my best creatures. Look at Bumpy there, so cute. So there you go, a hundo, a mystery pack, and we got 60 bucks for it. Oh, we're getting that. So we're down 190 bucks from, you know, instantly hatching that Bumpy there. So a couple of million to get some more food. Just collect some of this as well. Charlie, come here. So let's go into PvP. Um, let's go ascent... No, not ascent ascent. I wish there was just a land one, but there isn't, is there? Kind of want to do a boosted Bumpy, but at the same time, I can't... Yeah, should we do it? We'll do a boosted Bumpy. So we want to find Bumpy first. Now it'll be level 10. It's going to be around here. Look at that! How many alumbias do I have? That's amazing. There is Bumpy. Okay, so we're going to put Bumpy in. Um, now I don't want those. I mean, it doesn't matter what I have. I'll put those guys in. Yeah, these two. Now, what do we do with Bumpy? If it's going to average out to what we have, we kind of want more attack because I think Bumpy, as far as dinosaurs go, has loads of attack. Only downside, it's a herbivore. So there's a high chance we're going to come up against carnivores. Um, so with that being said, I think nullifying is probably the best, just in case we come up against some nasty things. And then the next is give an extra 100 attack. So Bumpy coming into this will have 462 attack, which is loads. Now hopefully averages, please do. Please do. Oh, Bumpy to win. Come on, average. Don't just do something crazy. Oh, it's in the Senezoics. Damn! Damn! Whenever you get Senezoic, you get pulled into this. But at least we get a seed Bumpy and use Bumpy. So intimidation, which is interesting, because aren't we just going to not... Terrify? Oh! Uh, yeah, but we're going to nullify that. Do we nullify the terrify? I don't know if we do. Uh, although saying that, I don't think we did nullify that, which is interesting. Okay, well, I mean, if we got to go first, which we don't, I was going to say we do get a kill-up. Uh, we get a kill-up anyway, and then next is an Alankwer. So, I like, you know, they've done it. They've done a good job with Bumpy. It's not the Bumpy from Camp Cretaceous. Like, they haven't got the model. But what they've done is they've taken their own callouss, or they've changed it a little bit, and then they've put the colorings on and stuff. Um, maybe that's asking a bit too much to, you know, take the Camp Cretaceous model. Because Bumpy's very... I guess it's the same as Ankylosaur's in Camp Cretaceous, but in comparison to this Ankylosaur, yes, it's very different. Um, it would have been just cool to, you know, have a, um... Oh, wow. Okay, I need to go for a block here. Ooh, dear. Oh, no. Oh, no, no, no, no. I don't like this. Oh, no, no. He could kill me. And then it's game. Uh, uh... Ooh! Tell you what, I kind of want to go all out here. So he had four. If I go for two, I kill him. I'm pretty sure. Yeah. So, you know what? I'm going to factor in two. Uh, oh, it went for three. You bogger you. He's got four. He's killed me. He's got five. Okay, yeah, we've lost. Oh, no! What were the chances? No! Oh, yeah, we're dead. We're dead. We're dead. We're killed in three. It's going to go for three. Uh, so, yeah.  And, uh, yeah, there we go. Sorry, Bumpy. Kind of died there. Sorry. And then, yeah, just... There's no... There's no... No, there's nothing. There's nothing to be done. But we'll try it one more time and see if we can just get Bumpy into the heli, you know, the helicopter. Uh, you know, Code 19 may as well do it. Really need to hatch some more of these superhybrids, because I've just been, you know, I haven't really spent any of this stuff. I think we did a video where I spent loads of the SuperDNA, but I've probably still got a bunch left over on other hybrids. That's the thing, though. Um, I don't know. You ducky kind of don't... With these games. I know right, I can't even talk.  Or make something better, because... The same with Dressable the Live and with Dressable the Game, they could all of a sudden decide, actually, this DNA is also going to make something else really good.  And that's it. Unfortunately, that's the environment that these games have led to, is you... If you... If you want to do something right now and you want to make something better, you get punished for it. Because at a later date, either your dinosaur will get nerfed or there'll be something else to use that DNA for. And it's like, ah, damn.  What have you. You can't. Because you have to sit here and wait. Like, what if in the next update something really good comes out and then I need this again? Or I need that DNA. So we'll go on to... Ooh, not flyers. Herbivores! Right, worry. Should be easy to pick you out now. Yes. Instant. 34 bucks. You know what, I'm just going to 34 bucks. I don't care. Ha ha, 34 bucks as well. We'll go for those. Health would have been better. Health actually would have been better. So you know what? I'm going to give it an extra... I should have just done that. I've given it a thousand extra health instead of 200 attack.  Please don't be any son of a... Yes! It's the helipad. Oh, I love this one. This one looks so pretty. Yes!  It's gorgeous. Right. So we nullify. Ooh, is that random? Ooh. Was that random mods for dinosaurs? I think it might have been. Oh, and if we get to go first, we kill it anyway in one hit. Yeah, it doesn't matter about that. It can increase its attack. We're not going to do much. Oh, no. There it is. There it is. Ah, now we don't get to kill a piece to go first.   What's up, I don't want to go first. And of course, I go first. Go on then two. Go on then two. What you going to do? Interesting. I've just clocked on. Now, for the longest time, this game would always show people's pictures. And, you know, for opponents and stuff. But they've stopped it recently. Now, I'm wondering how much of that is to do with Jam City taking over. Because I kind of want to go back and find out when Jam City took over and when the names disappeared and when the pictures disappeared. Because I wonder if that was the case of Jam City going, we don't have permission to use people's pictures and names. What are you doing? Then again, though, when you first play this game, you have to accept the terms and conditions. So, is part of those terms and conditions you sign away your likeness? Oh, love the bureaucracy. Don't you? It's so much fun. Okay. I kind of want to save up.  The showcase, the bumpy. Now, at least here we get to see it in all of its glory. And we get to see it's like win animation. So, I think it's just going to be the same as a regular. I kind of saw. It would be cool if it's different, but I highly doubt it seeing as it's got the same animations. Oh, we go for a full on aid attack at level 10. What up? Yes. Bumpy, you did it. Yay. Whoa. Bumpy with no bang. It just doesn't look right. But, hey ho, here we are. So, intermediate boosted prize. I'm assuming that's not the worst. And we got a... How much was that? And we got a Shunasaurus. What? How much did that cost to enter? No way, intermediate. So, it was this. 2% chance of getting a Shunasaurus. Oh, we got it. Oh, my God. That was so rare. So, technically it cost us 20 bucks. And would I...  No, because it's on a Shunasaurus and I've already got it. But, if I hadn't got it and I just started the game and I, you know, I was able to win that. That's a no brainer. Hell yeah. Well anyway guys, just a quick little video to showcase Bumpy coming soon this weekend. Enjoy this video. Of course, leave a like and until next time, I'll see you guys later. Oh, bye-bye.


I got some new toys I Can't see it.  I'm Rick. You follow Instagram Twitter for these kind of things How does it go? How about today? This is that spotlight things sitting there always been sitting right there. No Okay, I thought I was losing my mind. It's actually been there for I know why that's there You've been doing kinky things in the room. It's been there for a few weeks since the bookshelf the new bookshelf So yeah, you are kind of blind it has been there for a little while. Yeah Anyways, any old who you can't see it. Nope. It's right over there, and I'm not putting it on screen either Nope, but this trailer came out a few days ago. I know it's called a it's called a telugu It's it's a telugu. It's a telugu trailer, and it's called It's called kid a cola kid a cola. Yes with say these names. They're unbuck busker VG Sinema Vivek Sagar And that is all I know. All right. Here we go. What is this?  Oh I don't know if you heard anything, but that new Tiger Shroff film. Mm-hmm awful. Oh Like people saying like the worst film of the year Well, there you go, and there you have it very bad So let us know if you think I have not heard of one even even even half decent even the action sequences are just They say they're like the same old same old. Oh, yeah. All right.    What about the carpenter? If you don't have 20 problems for the launch work, I want problems. Hey! Hey! Uh, yeah, the doctor. Yeah, the doctor.        That teabag just hit him? Yeah. Damn. What is going on? That looks like a trip, man. It actually was giving me vibes in terms of like the comedy style of doctor. Yeah. In terms of like it's going to be kind of serious, but it's not going to take itself too seriously. Right. It's going to have a lot of funny, a lot of laughs, a lot of stupid laughs. Yeah. But there's also a bunch of like quirky, interesting shooting style choices, and there's a lot going on. There's a lot going on. What do you think? Yeah, very original, really interesting. Kept me looking at the screen thinking, what is going on? Yeah. Trying to figure out what is going on. And it felt, we often say this, any of the trailers that are very strange and make you wonder what is going on remind us of a huge number of Malayalam trailers. Yeah. It felt like that. Yeah. The originality of it, what is happening here.  Yeah. So yeah, I'm interested. Directed by Thauron Bhaskar Dasyam. He didn't direct Sita Raman. Did he? No, he didn't. Oh, he's an actor as well. Let's see. Director, nine directing credits. I'm trying to see if we've seen anything he's directed before. I don't think we have. No. A lot of shorts. What about acting credits? So he was in Sita Raman. Sita Raman. So we did see him in that, in some... Oh, we saw him in this one as well. Mahanadi. The biopic of the... Yeah. ...an actress lady. So we've seen him a few times, but he's directing this one now. I don't know much about him, obviously. The log line of it says, it's a hilarious group that takes on a challenge of a lifetime when they decide to make quick money by planting a cockroach into a soft drink bottle. Well, they hit the jackpot. Okay. Gotcha. I was wondering what the... I didn't know if it was like a... It was going to turn them into like super... I didn't know where it was going. Got it. So it looks like it's going to be like they're going to try to make some fast money and everything goes wrong. By make it seem they got a cola that had a cockroach in it and so they can sue the company for the health risk. Everything goes wrong. And everything goes wrong. Kind of similar to different synopsis, but that whole concept of... Wasn't that in Vishal's son's film in terms of... Yeah. Getting rich quick. Everybody was wanting to do this and then they would get this money and then... But everything goes wrong. Right. It's a common thing. It's very funny. It looked really original. Yeah. It looked like it could be a lot of fun as well. I don't recognize a lot of the cast either though. No. We only recognized... Don't know his name, but yeah. Just because the doctor. Because of doctor. Because he looks exactly the same in this as he did in the movie. Yeah. And maybe it's because it's such recency since we saw it, but it has given me a lot of doctor, especially in the humor vibes. Yeah. Of it. Of... It was Nelson right there. Yeah. In terms of his kind of corky black company. Mm-hmm. It's interesting. I'd be interested in seeing it. I know a lot of people have been praising this trailer. So, especially to the Tolugo audience, there's probably a lot more laughs that you got as well in the trailer. And probably some faces you guys know better than we do for sure. If there's somebody we know, please let us know. He directed, wrote and produced it there. Composed by Vivique... Shugger? Shugger? Shugger. Anyways, that was really cool. Yeah. If you thought about the trailer, if you're interested in seeing this, what should be the next Tolugo film? We'll do for a Tolugo film that we should watch. Let us know down below.


Going home in for this? Yeah. Good. Yeah. I thought you were going to come tomorrow. Sorry. You're going first then? Yeah. Your career. Yeah. Her rest then. That's right. That's right. Now it doesn't really matter. I can go first. I can go last. It doesn't matter. It doesn't matter to me. I've never gone first, probably. Otherwise, you're like sitting here for half an hour. Yeah. That's a tradition. Yeah. Better than Chris does that. That's true. That's true. That's true. I'll go up. Let's start it up, man. The pressure is off, honey. All right. Good morning. We're very few in numbers. Maybe seven of us here, I guess. We'll go ahead and get started. I'm just going to briefly introduce both of our speakers today. We're excited to have two of our residents talking to us. First, we're going to hear from Marshall Huang. He's one of our first years of PGY2 residents. And he's going to talk about passing on side pass. So I don't see any alcohol on reps here. That's good. And then we're going to hear from Chris Bear. He's going to talk to us about the ocular hazards of trumpet playing. We all kind of got our hopes up that there would be a live performance. But Chris Bear is not feeling up to it today. So excited to have both of them take it away, Marshall. Thanks to Dr. Burrow for that wonderful introduction. My name is Marshall Huang, PGY2 resident here at the Murray and I Center. And today I'll be talking about side pass. And why we decided to pass on it. So the story for side pass, at least for the general public, begins in 2016 when they announced the side pass microstem at the AAO meeting. This was approved after a two-year data study that suggested that it was safe with no significant adverse events. But then the story changed two years later, less than two years later, in 2018 when they decided to withdraw the side pass microstem. They cite in the release that at the two-year post-surgery group, there's little difference in endothelial cell loss between the side pass microstem and the cataract surgery only groups that were the controls. However, they extended the study from the Compass, the Compass XT trial, where they collect an additional three-year data on the, adding on to the two-year data they initially had. At five years they showed a statistically significant difference in endothelial cell loss compared to the group that was cataract only. This was really the only adverse event that they cited, and because of that they decided to withdraw the side pass. They do note that it was out of abundance of caution, and they suggest that they may consider changing the labeling and reintroduce the side pass at a later date. They don't suggest what changes they might make. So, as far as they, at least as far as they report, the endothelial cell loss was the only concern that they had. But when did we care about endothelial cells, at least in the setting of glaucoma? So the question is, what causes endothelial cell loss? There have been many reports that suggest that increased IOP by itself, so glaucoma by itself, can cause endothelial cell loss, and there is indeed a trend towards decreasing endothelial cells with increasing intraocular pressure. There are also studies that suggest aging causes a consistent decline in endothelial cell density. Reports show that there's a decrease anywhere from 0.3% per year to 1% per year in patients who aren't on other treatments or had other surgeries. This paper here is based on 211 patients from 20s to 90s showing a consistent decline. There's even a question of whether top glaucoma medication might cause endothelial cell loss. I don't think it's accepted that it does, but there are some studies that suggest that it might. In this paper, they looked at dorsolamide, timelaw, and betaxalol, which all showed a decrease in endothelial cell density. On average, this shows about 3.6 to 4.5% decrease year over year. On the left here, this is looking at corneal thickness. You can see that there's no significant change in corneal thickness over this period of time. So this endothelial cell loss they saw wasn't clinically significant. On average, the patients here were about 80 years old, and they all had glaucoma or ocular hypertension that deserved treatment with glaucoma medications. And then eye surgery itself. That could be cataract surgery, corneal transplants, or glaucoma surgery, all of which have been reported to decrease endothelial cell density over time. The suggested mechanisms include mechanical damage, whether that's from direct corneal touching from either the implant or intraoperative techniques, or even from the turbulence of the aqueous that goes through the implant or during the operation. Other studies suggest that it could be changes in the aqueous environment that causes damage to endothelial cells over time. Here's a review looking at some of the major glaucoma surgeries over time, and these are the reported endothelial cell losses year over year. They range from 2.6% of the deep sclerotomy, all the way up to 18% with the auto-intuitive in that particular study. You can see that's pretty significant. If you can imagine, that's a year over year decline. And these are basically our most common major glaucoma surgeries that we continue to do today. So the question is, what about the MIGS surgeries, or the microinvasive glaucoma surgeries? So first, we want to define what that might mean. And Zahab and Ahmed define MIGS with the following five factors, which are still relatively accepted today. First is an ad-internal microincisional approach. There are some people who consider an external approach part of the MIGS category, but in general, most MIGS are ad-internal. They're minimally traumatic to the target tissue. So what that means is that we really want to preserve real estate in the eye, in the event that they need additional glaucoma surgeries in the future. They obviously need to lower IOP because that's the goal. So all of these surgeries show some kind of IOP lowering efficacy. And there must be a high safety profile. Because these patients are usually mild to moderate glaucoma patients, we need this to be a first line option so there can't be high safety issues. And then there needs to be a rapid recovery with minimal impact. This is usually accomplished by combining it with cataract surgery, so there's little recovery time beyond what would be standard for them. So there are four general types of MIGS. The first is trabecular, which improves the trabecular outflow through Schlem's canal, generally either with an implant or by bypassing it through trabeculotomy or trabeculotomy. In this presentation, I'll be focusing mostly on the implantable devices, the eyeset and the hybrids. In this photo, this is an example of the hydras. This is a crescent-shaped device which helps the stent open the Schlem's canal, whereas the eye stent is a heparin-coded device that kind of creates a passage through Schlem's canal. The suprachoroidal version is what the Psypass is. And here is an example. So this improves the uveous curl outflow as opposed to the conventional outflow by connecting the anterior chamber to the suprachoroidal space. You can see here it's kind of like a straw that goes right from the anterior chamber out and into the suprachoroidal space. The eye stent suprach does a similar technique except it uses a titanium sleeve over a PES tube. And then in terms of a subcontractable type of MIGS, here's the Zen gel stent, which is a collagen-based device that directly shunts the flow to the subcontractable space. This kind of device is considered to be more effective, considered to have higher IOP lowering efficacy, and therefore has a less of a concern on the safety profile. This was approved because it was shown to be relatively similar to other tube-shut devices, so it didn't require the same kind of approval processes that the trabecular device is required. And then finally, the endocyclofoam coagulation attacks the ciliary body epithelium to decrease aqueous humor production directly. So the question is how effective are these MIGS and how can we compare the safety profile versus the benefit of the MIGS? You can see here, here's one of the ones I'll mainly focus on in this presentation. You can see the ranges from about 7.4 to 9.4 in terms of IOP lowering efficacy of all these implantable MIGS devices. Here, this is the I step. This is the high-dress, the side-pass, and the Zen. These are probably the most comparable in terms of their desired safety efficacy and their IOP lowering efficacy. So what was the data that finally caused them to recall the side-pass? You can see here, for the first two years, this is what they published initially. There's no significant difference between the side-pass and the control, which were cataract distraction-only patients. At year four, they first detect a significant difference, and here's the year five published data. This chart here shows a percentage of patients who had greater than 30% endothelial cell loss. The paper suggests that the industry or regulators, rather, requested that they include this data. Again, it shows a significant difference in the percentage of patients that have greater than 30% endothelial cell loss between control and the side-pass patients. It's notable that the month 36 time point is hard to interpret because they only had about 15, 16 patients or so in that time point. But looking at that, how can we compare it to the safety outcomes of the other MIGS devices? Here at the top, this is from Der and Ahmed. It's a great chart showing all the randomized control trials, showing safety data and efficacy data of these MIGS devices. The ISTEN inject, you can see that all they have is 24-month follow-up time, at least with endothelial cell loss data. They've 10 years of data published for the ISTEN overall, but they did not initially look at endothelial cell densities. So all we have is 24 months, which shows a significant difference. They'll show the p-values or anything, but you can believe that. The hydrous microstat showing also no large difference between the treatment groups and the control groups, and not a large difference in the number of patients with greater than 30% endothelial cell loss. But if you see here, there's almost double and almost triple in these groups. This is reported at 60 months, but it's actually with knowing this is a 48-month time point that they report here, and this is indeed a 60-month time point. As I mentioned before, the ZEN GELSTEN was considered similar enough to other subcontractival shunting devices, so they didn't require as much approval, and therefore they only have 12 months, and this was only with 11 patients or so. So not much safety data for the ZEN. So this is the raw data that was published with the Compare XT trial. It's kind of a busy chart, but I want to draw your attention to right down there. So this is the 24-month time point. Up here, this shows the endothelial cell densities that they measure. This is the change, and this is the percentage change. So overall, you see a 12% decrease and a 9% decrease compared to the microstat group and the control group. It's only until you get to year 4 and year 5 that they see the significant difference appear. And as I mentioned before, we really don't have any data at all for the other devices. And if you look at just the data up to the two-year time point, which is all we have for the other devices, it's about the same as what the other devices report. And then again, this highlights the 60-year time point. This is what they reported in that last chart. It's the 48-month, but showing the same information. So here, this again shows a proportion of eyes with greater than 30% endothelial cell loss. If you note down here, there's no significant difference here. It only appears at month 60, where it's not even statistically significant based on this analysis, but definitely approaching it. And in this paper, there's separate also how many rings are available in the side-pass device. So I'll explain that in the next slide, but basically there are three retention rings that you can visualize as you plant the side-pass. In this case, they separate the people with less than one ring available. So no rings available, one ring available, and two or more rings available. And you can see not so much difference here, but as you move to years four and years five, you can see that the difference in the percentage of patients with greater than 30% endothelial cell loss is significantly different. Three or four times more with the patients with greater than two rings available. It is worth noting that they recommend in planting the device with one ring available. And if you do see multiple rings available, especially early on, you can consider moving the device or trimming the device, which they did in the study. In this study, they showed that there are three patients with focal corneal edema, but not corneal decompensation. There are also four patients that require trimming of the side-pass implant. Usually trimming was done if it was found that more than two rings were seen within the first post-operate, the first post-operative week. And here is a chart kind of showing the last table's data. So here's the control, which they took the endothelial cell densities of patients six months into the control. So six months after cataract surgery. Here's the side-pass overall, the statistically significant difference between the endothelial cell losses per year. And here, this is no rings, one ring, and two rings and three rings available, showing a trend towards increasing endothelial cell loss as you have more of the side-pass protruding. Again, this is what they initially published as a recommended implantation technique, one ring available. And the difference between control and that one ring is about 1% difference. It's also worth noting that the control that they published here is only 0.36% endothelial cell loss per year. As I mentioned before, even in the natural course of aging, they published 0.3% to 1% endothelial cell loss per year. And these are patients that have undergone cataract surgery in addition to their normal aging process. Previous studies have reported much higher endothelial cell losses in the control itself. So here's an example of what I was talking about with the implantation. Here you can see three rings, one, two, three retention rings available. This is the collar that sits in the front. And here is optimal implantation position. One ring available right here in the collar that's at the level of the, excuse me, Schwalbe's line. It's important to know that there shouldn't be any contact with the corneal endothelium, because that would require either trimming or replacement of the device. And here's another view. This one shows no rings available. And this here is implanted at the collar. This is an interior chamber OCT showing the implantation of the device going into a super corroded space. So the question overall is, does Cypass really deserve a recall? The endothelial cell loss was a subclinical finding. Nobody had corneal decompensation related to this endothelial cell loss, which makes sense because studies report that people generally have corneal decompensation at around 300 to 500 square millimeters of endothelial cell density. Sometimes they have issues as high as 800, but most of these patients were far from that threshold. The two- to three-year data that was initially published when the device was approved is quite similar to other mixed devices, notably the hydrous and the isent. No other data currently has any five-year data that show endothelial cell loss. The hydrous currently published their third-year data and they're working on four- and five-year data, so they will be published soon, but we currently don't have it. And when we compare the endothelial cell loss and the treatment versus the control arm, the control arm is very important. And in this arm, they had very low endothelial cell loss among the lowest reported in these randomized control trials. And then further, when you subcategorize the groups into patients with just zero or one retention ring available, they had even lower endothelial cell losses, almost consistent with the other mixed devices or with other reported controls. In previous sense. It's worth noting that they do recommend having one retention ring available, at least in the initial publication, because they suggest that the device might be less effective if it was implanted too deeply with one zero retention ring available. They don't really make a comment on that in the CompareXT, so we might have to see whether or not there's an efficacy change if you were into implants a little bit deeper. But this does suggest that zero retention rings available at least causes less endothelial cell loss. And so I would ask, maybe if anyone has a comment, what if instead of recalling the device, they changed implant implementation instructions to suggest that it had to be either one or zero retention ring available? Does anyone have any thoughts about how that could have changed things, Dr. Sinclair? Yeah, have they looked at the relationship with the maybe corneal OCT between the depth of the implantation, not the extent, but maybe the depth of the implantation, those relatively closer to the cornea, causing more localized swelling of the cornea in that area and suggesting more endothelial cell loss? Have they looked at all of that? I don't know if they did it with OCT, but they definitely did it clinically. So the three patients that had some corneal edema, they're noted all to be a focal corneal edema right near the stem. One of those patients had two or more retention rings available, so that was trimmed. The other two were seen as subclinical, so they just watched those. Initially, they weren't even reported as adverse events and only in post-analysis that they decided those were adverse. So I think overall they agree that the closer it is to the corneal endothelium, the more likely there is to be an issue, and that's kind of done with the retention rings, because the more out it is, because of the position, it's more vertical in the angle, the further out it is, the closer it is going to be to the anterior chamber. Now these were the same concerns that we had with the augment and the bear valve that were coming from posterior and sort of angled, that the deeper you could implant it under the sclera and going into the anterior chamber and the less amount of the tube available in the anterior chamber would seem to be associated with less corneal secondary changes when you're trying to implant it in the anterior chamber. I think that's a good point and that's kind of what they're trying to suggest here. They definitely do care about the same adverse events as they do with the tubes. The problem is that when you do a tube, you more likely have a need for a higher intervention, higher IOP lowering, and you care a little bit less about the safety profile compared to these MIGS devices. So you certainly have the same concern, but I think with the MIGS, we have to be very careful about having a much higher bar of safety. In terms of whether or not it's close to the endothelium, I think that could be worth checking with a more objective test. Bill? I think it's a really interesting question if they could have just changed the recommendations. And also find it interesting that you asked the question, did it deserve a recall? Because as you stated, they hadn't had patients with decompensated coordinates. They just had this accelerated endothelium cell loss. And if I'm the company thinking about this, one, I'm really thinking about, yes, I'm thinking about the patient, but I'm really projecting forward what's the potential financial cost if we do have patients that begin to decompensate. And I would assume that was the primary driver of why they recalled them. Brian, I'm curious, in my conversation with our Guacoma faculty, I never started inserting this because they said the complications were quite significant. I mean, when you did have a complication, it was really, really difficult to manage. And I also wonder if you think that might have something to do with holding a trigger on the recall. Yeah, I'm not plugged in, so I don't know all their decision process. But I think it did like... So some of the other ones, like the eye stent or the hydras, have a better risk-to-benefit profile. So for the side pass, I don't think it worked much better than those, but it's definitely riskier just in terms of the surgery. And so I don't know about their implantation, how many they thought they were doing, or I don't know. It probably was more than played into it than just the endothelial cell loss, I think. Yeah, I agree. I think those are both really good points. I think the endothelial cell loss was the only thing they pointed to. And the published data doesn't make it obvious how different the adverse events are between the different MIGs devices. And there was an article that suggested that perhaps they were more worried about future litigation by doing the recall early. They protected themselves from future lawsuits and issues for the patients that have had it implanted already, since they've made this recall decision. And furthermore, they do seem to suggest to spin it off into potentially a sub-company where they might repackage it and re-release it. Dr. Rammels. I can't really tell you anything or I have to kill you first, but I can say I do not disagree at all with your statements. Does that put nicely enough? You say. Okay, very good. And I think it's worth noting that other... Oh, sorry, yes. No, one more. We've always done microstents and stuff in the superior quadrants because that's where we did the trajectory of the drug. That was our history. But that's where patients rub their eyes and maybe distorting the stints more. Has anybody tried surgical procedures below? I'm not sure, actually. That's a good thought. I hadn't thought about the eye-rubbing component. Yep. Dr. Eric. Any patient... Do studies show any... ...chemistry studies at all? They do, yes. They call the compensation even though... Yeah, so that's a really good point and almost all of these studies do indeed look at the symmetry, central symmetry, and they don't show any significant corneal thickening associated with endothelial cell loss. And again, that's not necessarily unexpected because most of these patients still have well over 1,000 cells per cubic word square millimeter of endothelial cell density. But they don't see it in our data. And yes. One other point with these mixed devices is when you do run into a complication, how hard it is to fix it. So how can you get any of these devices out? Side pass is particularly hard, I think, to get out. And I think people have struggled with that. Yeah, so I think that is a major challenge with the side pass. They mentioned that if you're trying to modify the side pass beyond seven to ten days post-implementation, they suggest that removing it could cause more harm than good and instead they would suggest trimming it if at all possible. Before the seven-day mark, they suggest that you can move it, but the fibrosis will be too severe to move it later on. Unless it's causing corneal decompensation where the benefits are where there is. And another question I had was whether or not there's a structural propensity to cause more corneal damage with this device and other mixed devices like the hydrous or the ice then. And some papers suggest that it does. Because it's a stiffer implant, it's more likely to sit vertically in the angle. So if there's any change in the position of it, it's more likely to protrude out and touch the corneal endothelium than other mixed devices just because of how it's designed. And then my final question here would be why not just implant the hydrous? Based on the randomized control trial, it suggests that the hydrous is more effective with a similar safety profile to the ice then. And it's not recalled. And theoretically there might be higher IP load efficacy of the hydrous compared to side-pass anyways. So does anyone have any thoughts, I guess, on why not implant hydrous over any other mixed device? Or at least these implantable mixed devices? Because just do hydrous. I would totally do hydrous. Okay. Well, I think that's a good take-home point then. But in terms of related to the side-pass itself, I think some things that we need to remember are that gonioscopy is essential when we evaluate a patient with a previous side-pass implant. We don't necessarily need to intervene on them, but we need to be able to assess where exactly the side-pass is, how many retention rings available, whether or not it's touching the cornea. And only if there is actual corneal decompensation, which is clinically significant, do they recommend any kind of intervention. Overall, the safety profile is superior to traditional glaucoma surgeries. But the reason that it's not accepted is because we demand a much higher safety profile for all of these mix. And as far as I can tell, there's no good evidence that endothelial cell loss doesn't occur at a similar rate, a higher rate or a lower rate, really, for any of these other mixed devices, since we just don't have that data. That's really what I did know. And finally, why do we care so much about the endothelial cells? And in the end, of course, we care because it keeps our corneas healthy. We show that there is a decrease, a steady decline in endothelial cell density over time as we age. So it's important to preserve it as much as we can. And since there's almost no regenerative potential for the endothelial cells, there's really no going back if we cause damage that might cause issues 15 to 20 years down the line. And I think for that reason, we'd be extra cautious for these patients with just mild to moderate glaucoma, usually just undergoing cataract surgery for the purposes of decreasing the drop burden. As I mentioned, we don't see any clinical findings, no corneal decompensation, but with the amount of cells that we need to maintain detragestion, it's not unlikely that we did it. Any questions? Comments overall? Nick would know of this, too, but historically, just the early days of implants, just a critical how of this implant. I mean, think about the endothelial layer just wasn't even recognized. That was a problem. So the most common cause of corneal edema was to take the corneal edema in those years. So just how we progressed to really watch it now is to carefully be aware of it. Yeah, that's a really good point. And I saw that it looks like topical medications and intravitural medications all require a monitoring of endothelial cell loss over time in order for approval. And I was wondering if anyone knew, Dr. Manson, if that's required for IOLs these days, by any other kind of implant? It's not required at this point, but to Dr. Harry's point from 1984 to 1989, Pseudo-Fakit Bullis Caretapathy was the number one reason for corneal transplants in the U.S. So I mean, it really was a major issue. And interestingly enough, there were anterior chamber IOLs that succeeded in IOLs that were approved and did not really show any endothelial damage during the first six months when they were evaluated. But two and three years later, slowly but surely they were showing endothelial damage eventually leading to corneal decompensation. So this is something that we should be aware of and that people should be looking at. Thanks for your attention, everyone.


Hey guys, what is up? Welcome to my channel. For today's video, I am going to just get ready and do kind of like a fall inspired look. I've been really inspired by all of the fall decor that I've seen out and the fall drinks. So I just, I want a red lip, warm eyes. Look, I went to the Dollar Tree and I found fall decor. Three bucks, you can't beat it. So yeah, if you want to get ready with me, I have some new stuff to try, but I also shopped my stash for a lot of these products. The majority are not new to me. I just felt like using them. If you want to see that, then just keep watching. This video is very kindly sponsored by Florisys. And I'm really excited because Florisys is a brand that you guys recommended to me. You're the reason that I've even heard of them in the first place. And if you guys don't know, I am half Chinese. So in a video in the past, I was talking about what Chinese makeup brands do I need to try and what's the most luxurious and has the prettiest packaging, prettiest embossments. And a huge number of you guys actually suggested that I looked into Florisys.  They looked so detailed and intricate and beautiful. And at the time that I looked it up, I did not know how to get it shipped to me. I couldn't find a way that I could order their products into the U.S. And Florisys actually reached out to me and now if you're in the U.S., you are able to receive their products. They ship internationally now. They have a website that's in English. So I'm really excited to work with them on today's video because I've been absolutely dying to try out their products. They are so beautiful. They were kind enough to just send me a few pieces, but I'm looking at their website and I'm very tempted to order more because they have so many beautiful options on their website. Now, like I said, Florisys is a Chinese makeup brand. Within their products, they are committed to inherit and promote traditional Chinese culture. Like I said, beautiful Chinese packaging and embossments that these all have are so beautiful to me. I named Florisys is actually a combination of the word flower and sister. And I'm going to read this directly off their website because I can't say this better myself. But Florisys explores wisdoms in traditional beauty rituals, inherits the philosophy of Chinese aesthetics and adapts modern technologies in creating their cosmetic products, which feature nourishment from flower and natural essences, unity of makeup and skincare, which is very big in Asian beauty and promotion of both inner and outer beauty and excellence of craftsmanship. And the craftsmanship you guys will see in this video. Oh my goodness. I'm going to link in the description box. The website, of course, for you to shop the products, but as well as the About Us page because I've never seen a About Us page like this. You get to see the people behind the brand, the craftsmans behind the brand, inspiration. I really enjoyed reading everything on this page. It's really neat. Some of the products that you're going to see sprinkled in today's video. Of course, the eyeshadow palette. This is what inspired this fall video because I think the fall colors look absolutely stunning. I also have their silk powder to try and the red lipsticks are going to be these beautiful lipsticks. So let's get into the video. Pull our hair back. Like I said, I shopped my stash today for a lot of the products. So we're going to start off with primer. I used this for the first time in a while yesterday and I was like, this is really good. This is the Fenty Hydrating Primer. This reminds me a lot of the Gucci silk primer that I really, really love. This one is just a lot cheaper and it's still high end, but the Gucci is so expensive. So this is a really great alternative if you don't want to spend the Gucci price. But I just love the way that both the Gucci and this Fenty make my skin feel. It's so hydrating, but also makes the skin feel so silky. I love it so much back into using this now. Foundation. I haven't been hot at what foundation I wanted to use, what I haven't used in a while. And I settled on the Gerlain L'Essential Natural Glow Foundation. I love this foundation and I think it's a really great fall appropriate foundation. I would say it's a great transitional foundation because it does have a nice glow to it, but it still gives a good amount of coverage and it can be matted down with a little bit of powder. I just think it's a great in between, you know, not too matte, but still glowy, still giving your skin some life. I'm just using this Elb sponge that I've been using. We're gonna spread her out. You see how beautiful that looks on the skin. I love this foundation. It's one of my absolute favorites. This one and they have a matte version as well. They both are phenomenal foundations. For eyebrows, I'm going to use the Gucci Hyperscision Natural Finish Eyebrow Pen. I have mine in the shade Brune. I think this is a little bit darker than what I prefer for my eyebrows, but he's fine. This isn't my favorite eyebrow pencil in the world. It's nice, definitely does the job, but I think it deposits too much color. Like I have to use the lightest hand possible to get the shade of strokes that I like. Gotta move my mirror closer for this one. So it's going to get in camera. Yeah, you guys, I am very excited for fall. Probably is going to be my last cold fall for a while because Jose and I are probably going to move to Florida early next year is what we're thinking. I don't know at this point, but we're going to be in Florida next year. That's the plan and I'm sad. I like fall. It's I don't know. It's my thing is I much prefer spring more of a spring kind of person because it's brighter out, but I'm always just excited for a change from the hot, hot summer, which is funny because I'm moving to Florida, but I like the smell of fall. I think it just smells really good. And I wanted to take Jose to a pumpkin patch for years because it's such an American thing and our schedules haven't lined up so that he's ever really been able to go and this is going to be the first year that I can take him to a pumpkin patch. It's the simple things, but I feel like it can't get more fall than that. Okay, and that's as good as eyebrows are going to be today. I need to sit down and really focus on my brows one day. One of the eyebrow gels that I've been obsessed with lately is the Patrick Tom major brow lamination gel. I still don't like feather brows. Okay, it's not for me. I don't have the eyebrow thickness for it, but I do like the look of kind of making them look a bit fluffier.  I also just don't have the thickness in my eyebrows to be able to make it look okay, but a little bit of unruliness, I really like and this gel has done an amazing job of keeping it unruly looking, but you know, it's still where you placed it. So I've been loving this eyebrow gel lately. It's awesome. It makes my brows like thicker because of the way this really is. You see that my eyebrows are like barely related. I'm aware that's the way it's gotta be. Okay concealer. I pulled out the Tom Ford shade and illuminate concealer that just came out. Listen, I'm not saying you need to get this concealer because it's $90. That's why I'm using this concealer because I paid $90 for it, but price aside quality wise, this is my favorite concealer that I've tried lately. I've tried the ABH, the one size and this one and all three are really good concealers. The Tom Ford performance wise is the best, but I do think I recommend the ABH the most because it's $30 as opposed to $90. While it doesn't outperform the Tom Ford, it certainly does not justify $60 price difference if that makes sense. So the ABH is super duper good, but I can't deny I love this concealer and it's my favorite of the three and I have it. So I'm going to use it not paying $90 for it. So I'm definitely still going to use it. I love this concealer. If you have the money, it's really, really nice. So for setting powder, I'm really excited about this because this is really unique from my swatch. This is from Floresis. This is called the Gorgeous Peach Blossom silk powder. So it comes in a box that looks like this really beautiful intricate details on the box. A lot of it's in Chinese, so I might be have Chinese. I don't, I can't read Chinese. I can't speak Chinese, but here is the compact itself really pretty and then here is the back and I was very confused when I first opened this because the powder is literally so silky. I thought it looked like paper. I thought it had a paper overlay, but this is the powder that you can see on my fingers. Oh, okay. Let me put it on my face. I've been absolutely dying to try this. It looks like this is going to be around $51 from what I can see on the website. Let's take a look. Yeah, you don't really get much kickback and it adds a slight glow to the face. I want to show you the difference on both sides and it feels so silky and I feel like that silkiness is translating very well on the skin. It's extremely lightweight. You can't feel anything at all. I think it's impossible to apply too much of this. It's like an invisible powder. Wow, really nice. That's so cool. So it doesn't disrupt the foundation underneath at all. So I feel like if you have a really glowy product on your skin and you want to set it, but you still want to keep that glow, this would be a nice powder for that feels very, very high end. But I think what I like about this is that it's not disrupting the skin at all. And what's underneath just a completely weightless powder. Very cool. I do not have a powder like this in my collection. That's really neat. For bronzer, I picked out the makeup by Mario self sculpt bronzer in light medium. I haven't used this too much since I bought it. So semi new product that came out within the last two months, but it's not super recent. I loved the tones in this collection. Just think they're so good. Like look at that. I think formula wise, this isn't my favorite bronzer in the world, but tone wise is what's giving it a fighting chance. You know, and it's still a really nice formula. I think Mario did a really great job with this sculpt collection. He came out with colors that really just make sense. So I hadn't used this bronzer in a while. So I want to teach this and for blush, I dug into my favorite Pat McGrath blush and this is the one that I recommend the most for fall. This for me is the ideal fall blush. This is in the shade Desert Orchid. It's honestly probably my most used Pat McGrath blush. It's my favorite. But this is such like a light orange blush, but it's not, you know, super garish orange and it has a gold shift to it. It's really beautiful for the fall and the formula of these are so good. When I first reviewed these, I was like, I mean, it's an expensive blush and there are so many great blushes out there at a much more affordable price point. But at the end of the day, this formula, it's stunning. It's such an easy formula to grab for. It deposits the perfect amount of color and this color in particular, I love it. Perfect fall blush. Definitely a number one recommendation for me for the fall season. Of course, you can wear whatever you want during whatever season, but this really gives me those fall vibes. Before I choose my highlight color, let's go into eyeshadow. And this is what I was dying to pick up from florises when I first saw the brand, but I like couldn't figure out how to get it shipped to me. So I'm so ecstatic to be able to finally try it. And I'm looking at their website. They have this other eyeshadow palette that I really want to try. This is called the floral engraving Phoenix makeup palette. It's $67. There is the box that it comes in. I'm going to open it and then you'll get the palette. And here's what the palette looks like. It has the same packaging as the powder. And then here is what the back looks like. And this is the selling point of florises to me. Now this I've swatched. So it's not as beautiful. It honestly hurt me to swatch this because it's so beautiful. I've never seen a more intricate embossment in an eyeshadow palette. I don't know if you appreciate these kind of things because I know there's a number of you guys who don't care. You just care how the product works. I'm such a packaging person like this. That's a selling point for me. This brand has the most beautiful eyeshadow presentation that I've ever seen. You hear the squeaking? It's my chair. I should probably oil it or something. Okay. So I have swatched these. I haven't used these. So I'm going to create a look and then I'll be back to do it with you. So I'll be right back. So one thing that I went in mind with while I was playing with this eyeshadow palette is that it's an Asian brand and the Asian style of eyeshadows is different than what's popular in the U.S. It's not about pigment. But I have to say very shocked. There's no really true, true mattes in here. The mattes had a very slight shade which I find to be extremely flattering for the eye. So I don't have a problem with that. Interesting textures here. Very pretty. There was like almost a really metallic foil shade right here and then some shimmers. The only two shades I didn't swatch quite as well were the red. The red was one that didn't have a lot of pigment and then this is almost like blue black. It's a little bit softer, which I like and I'm going to use it on camera. This one I couldn't get to show up on a blending brush. It's really, really subtle. So you're going to have to use this for a very subtle red eye. I didn't really use it for today's video, but let me just show you the presentation. First, I'm going to start off with the cream shade. I love that there's a cream shade in here and I'm going to set underneath my brow bow like so. Better nice. I mean, you can't go wrong with the cream shade and I'm going to use this shade right here, which if you look at this, it's not matte, but it's going to work great as a crease color. And look at this. This has a good deal of pigmentation to it much more than I was expecting and it blends very, very nicely. So I'm quite impressed with this shade right here. Looks beautiful in the crease. You can see it working itself out. I mean, $67, this is a very pricey palette, but I mean the presentation, it's so beautiful. I'm going to take some of that on a refer 14 brush and we are going to run this along the lower lash line and make sure we blend these edges out. You go back into the cream shade. That's also going to help blend those edges out. And then for a little bit of added definition, I'm going in the shade right here. This doesn't have the most pigmentation, but it's just enough to add that depth in the outer corner, which is really nice. Definitely a lot more pigmentation than I was expecting. What a gorgeous fall look. I'm excited for this. And I'm going to dig into the gold shade right here. I'm using a Sonia G builder brush and you do have to kind of go in with a couple layers to get the opacity that I'm looking for, but you can use a wet brush or use your finger. Fingers probably the best option, but I don't feel like putting my finger in a shadow right now. But again, definitely shocked with the opacity. Really beautiful. And then this shade I want to put all over my lid. It's kind of like a glittery shade. But for now, I'm just going to put it in my inner corner. But that's going to be really stunning. I'd love to see more of that formulation. And I'm going to take an Alomar cosmetics brush. I'm going to go into this black.  It doesn't have a ton of pigmentation to it and it has a bit of a blue turn to it. But you see it's perfect for just adding that little touch of definition in the outer corner without it being too much. So it's quite user friendly just for adding definition. Now if you're going to put this all over the lid, I don't think it would look that good. But as far as just deepening, it serves that purpose well. So I'm going to blend this and I told you I was waiting to see what my eyeshadow looked like before I decided on my highlight. I picked this up a couple of months ago and I haven't used it too much since I got it. So I figured we'd pull it in today. This is the Huda Beauty light glow up sessions. It's a mini face palette. So we have four highlights here. I think I'm going to mix the bottom two shades because this is a little bit lighter, more champagne and then I want some more of a gold element. And this palette is definitely not a need. It's kind of nondescript, but it's nice and you have four different tones of highlights all in one little compact palette. Doesn't knock my socks out of the water. But it works. It's a decent highlight palette for sure. I don't dislike it.  I guess that's what an eyeliner pen does, right? Okay, I need to be quiet for this because concentration is needed. I'm going to use my current mascara that I'm using. I wouldn't call it a favorite, but it's a good mascara. This is the Patrick Tell major volume mascara. I did just do a comparison between this and the new Rare Beauty and this one I like a little bit better. They're both good, but a moment of silence for the ugly faces that you are about to witness. I've been wearing a lot more natural lashes lately. Put on a pair of Lily lashes in Miami. They're so big. Okay, let's move on to lips. I definitely want to do a red lip. So I'm going to start off with my Wonder 2 lip liner and give me red. This is a really creamy lip liner. Okay, let's move on to the lipsticks. So one of the things I was most excited about from Florisys besides the eyeshadow palette were the lipsticks because the embossment, embossment, embossment on these lipsticks. So let's start off with the packaging. The box that they're going to come in is going to look like these. Really, really cute. And then you open it and then the lipstick will come out. So these are called the blooming rouge engraved lipsticks. They are $33 each and they come in this packaging. So I got sent three different shades of red, but let me show you the embossment. So this one is M122. And I think they got a little bit melted in transit because they're all a little slanted. But I want you to look at this embossment. Look at that detail. Gorgeous. And this has a little bit of a shine to it. And then let me show you the next one. Next one is M126. This one's a little bit brighter. I think it might go brighter. I don't know, but take a look at the embossment. And this one, this one's a little bit different. It has birds on it. I love it. And then the last one that they sent was M409. This one is a little bit peachier. And this one also has birds on it. See, the tone and the red can make the biggest difference. So I like that they offer so many reds with different tones here. I think I'm going to go with M409. Let's see. Super creamy. You see, it has that sheen to it. Very easy to apply. Very smooth on the lips. It's a nice lipstick formula. I like it a lot. I like the shine to it. Easy to apply. All right, I'm going to get myself together and let you know my final thoughts on the look in the products. All right, guys. So here's the final look. My first warm fall inspired look of the year. I really love how it turns out. Love red and gold together. Love the red lips. Love my crazy red accessories here. So I have fun digging into some products that I hadn't used in a while. My skin looks fabulous. This blush is incredible. And a huge thank you to Florisist for being the sponsor. In today's video, I had a lot of fun testing their products out. Kind of a final overview. The eyeshadow palette. Awesome. Love the look. Shades seem to work really nice. I was impressed with the pigmentation. Honestly, absolutely beautiful. The powder seems really nice. Very weightless if you're not a big powder person. The lipstick's super creamy. Really great variations in red colors. And overall, I'm very pleased with honestly everything that I used in today's video. The lashes are a little out of my comfort zone at this point, but everything worked great together. When you pair a bunch of random products together, sometimes it doesn't always turn out the greatest. So I'm happy with today. So make sure you guys check out Florisist. I will have my link down below for you guys to check out their website. Even if you don't want to buy anything, just look because their products are so beautiful. I didn't know makeup could be so pretty. And that's all I have for today's video. I hope you guys enjoyed it. If you aren't subscribed to my channel already, I would love it if you would consider taking the time to do so. I will see you all in the next one. Bye guys. Have a good one.


This paper presents a detailed analysis of the weather, climate, and climate variability in the Andes Cordillera region of South America based on instrumental observations, highlighting the influence of the long meridional extent of the Andes and the disruption of large-scale circulation by this topographic barrier, as well as the impact of the El Nino Southern Oscillation phenomenon on temperature and precipitation regimes in the area. This article was authored by Art D. Garode.


The study of neurogenesis in diverse insect taxa, including Drosophila melanogaster and Heliconinibutterflies, provides valuable insights into the evolution of nervous systems and their development. This article was authored by Amaya Alcaldé Anton, Max S. Farnworth, Laura Hebracht, and others.


So, thinking about this question of navigating the credentialing marketplace, I already confessed that I moved on Monday, so let me tell you just a quick little anecdote here. So my husband and I, two kids and a dog, were moving and were moving from a small house to a bigger house. My dad and his wife are also moving, they're moving from a bigger house to a small house. And we both have real estate agents, we sold first, he cannot sell. This house, which is a bigger family home, there were five of us at home. And so I think when we consider navigating the space, we have to think about the different generations of learners and workers and their entry points into the marketplace. So for my husband and I, we immediately went online and the entire experience, including our interactions with the realtor, was via text, online signature and Zillow. And I even got my data reported to me every day to see how many people were looking at my home and how many had saved it and where were we headed. My dad's realtor is a friend who he grew up with and it got posted in the local newspaper, which is perfect for my dad, but not perfect for a young family like mine, who I didn't even think about looking in my local newspaper for a new home. So as we consider how we coordinate navigating this very complex, often fragmented space that people are going in and out of, I think that it makes sense for us to think about the various needs for navigating that space. If you are an aging adult learner or if you are a young millennial or somewhere in between, if you are a first generation student, what are the different needs and access points that are already available to you? I really like and I so appreciate that UMUC is in the room and others like Thomas Edison, a lot of our folks who are part of the competency-based education network. We see a lot of the CBE institutions, competency-based ed institutions who are sort of front runners in rethinking navigational supports and student support services and unpacking them a little bit because I think we are realizing that as the higher education landscape is evolving, we need to, as a professional community, become more adaptable and malleable with that. As the face of today's college student continues to change, we need to mimic that malleability that we have done on the academic end but now on the student support services end.


Hello and welcome to this STM32-L4-R9i Discovery Kit, Getting Started video. ST has stretched the STM32-L4 architecture to reach 150 MIPS based on its ARM Cortex-M4 core, with FPU and ST Art Accelerator at 120 MHz while keeping best-in-class, ultra-low-power or ULP figures. Enhanced graphic acceleration and innovative peripherals are embedded to optimize the bomb cost. Two megabytes of flash and 640 kilobytes of SRAM with safety and security features, smart and numerous peripherals, advanced and low-power analog circuits in packages as small as 5.24 x 5.24 mm. This new STM32 family member benefits from the pin-to-pin compatibility of the STM32 family and the STM32 ecosystem. Now, let's take a look at this STM32-L4-R9i Discovery Kit and unbox it. This kit contains a blister, the Discovery Board and an expansion board. To operate the board and access the functions of the pre-programmed application, we will supply it using USB ST-Link connector. The pre-programmed application has an info page and three graphical demos. Now, let's take a look at the main components of the STM32-L4-R9i Discovery Board. On the front face, we can see a 1.2-inch 390 x 390 pixel LCD screen with capacitive touchscreen, a fan-out expansion board, the STM32-L4-R9A1 MCU, a USB OTG 2.0 full-speed interface, a microSD slot, a camera connector and microphones. The STM32 graphic ecosystem proposes three software solutions. There is STM-WIN, which is a free entry-level solution. We also have TouchGFX and Embedded Wizard, both of which are advanced solutions. The embedded firmware of the Discovery Board is part of the STM32 Cube F4, which is an open-source software which can be reused. The menu launcher enables us to launch graphical demos and check board information. Let's first have a look at STM-WIN. TouchGFX Embedded Software enables development of impressive graphical interfaces. We can see on this bird game the efficiency of the 2D graphic accelerator. Embedded Wizard software also enables the development of impressive graphical interfaces. More information is available on the ST.com website. STM32-L4-R9I Discovery Kits can be ordered online.