always here. The section on tractor for clinical use and supervision. I'm Mike Ross, the product manager for Tracker. I come from the public health side. I've worked in public health since 2007. My first large project was about collecting data for malaria that was coming from clinical records. And my sin was that what I ended up designing was a quarterly survey that was done in 18 countries every year, which was a terrible way to get the kind of data that was needed. It consisted of teams going out into the field and randomly pulling patient files to capture all of this data and then submit it as a survey. It never fed into the HMIS. It was basically data that was going back to the donor level. It was not really being used extensively in the country, and it costs over a million dollars a year per country. So since that time, I have tried to change my ways and focus much more on trading systems for countries that will actually serve the country's needs and not just at the decision making level, but all the way down to where the data are actually generated, which is the clinical level. And it's a driving belief on the product management side of Tracker that you can collect all of the data you need at the point of care without turning it into a massive burden. And so that's the underlying philosophy is to try to make something that actually benefits the people collecting the data, provides them with the kinds of tools that will make their job easier rather than more difficult. So I'm just going to do a tiny intro here to give us all on the same page of how we're talking about Tracker in terms of clinical use. So I'm creating some slides here from GFF they were presenting to the World Bank. I asked this question pretty much every time that I present is Tracker and EMR. So I'm just going to show you at least how somebody else decided to describe Tracker versus EMRs. I think everybody's familiar with EMR, and you know what the EMR is, and you wonder whether collecting data through Tracker might also make Tracker an EMR. But at least under the definitions that they used here, they distinguish between Tracker as a category, not talking specifically about the HS2 Tracker. But in general, there's a category of data collection tools that can describe those Trackers, which are much more targeted than an EMR. So the concept thing that in the kinds of lower level health facilities, community health workers, kind of the periphery in where a lot of the services are being provided, those are areas where they're not likely to be able to use an EMR. The EMR may not be appropriate. It's a much heavier tool. Whereas at least how we see both public health programs being monitored and managed and funded, it's often more disease specific. It's health program specific. They at this moment in time have an initiative of funding and a cadre of health workers for malaria, and they're ready now for any malaria disease. And so the idea behind a Tracker is that you can build a clinical facing tool for that specific program, very lightweight, easy to use, can capture the required data elements there, can be used for things like decision support, while also reporting out the chain. So always explicitly in the kind of use of this clinical data, we like it ideally into the reported requirements as well. So a little bit of a distinction, but also thinking that in those areas, the next group that sees this malaria system would be the TV group. And they think, oh, we want one too. So you add on TV and then the HIV group wants to get involved in the emergency. And after a few of these, you start to see you created a full shared health record at that site, or at least at that level on the system. And in that sense, it starts to look a lot more like an EMR, but you built it kind of one step at a time. And hopefully you're feeding it into a shared health record that is also being used at the hospital level that is being used to link to the EMRs. And that's kind of what we're thinking of that the directions that many countries are going. We've seen an explosion of this kind of use of EHIS-2 tractor in the last couple of years. We have 85 countries that are using tractor on a larger national scale, and many of them are using this kind of clinical phases today. Just wanted to say we keep in mind the few recommendations that so far have come out of WHO with regards to digital interventions for health systems. And these seven or eight are the ones that we think specifically tractor is targeting and able to provide a solution for. In fact, maybe the one that we're talking about the most today and that is most on our minds as we design tractor is this kind of combined recommendation that is digital tracking of patients combined with decision support and targeted client communication. And you can see in this recommendation we're talking about data, data that goes up, we're talking about decision support for the person that's collecting the data, and we're talking about information going to the client for the patient itself. So we really do have in mind this that the entire universe of who needs this data and where it comes from we're trying to support them in a single application which would really reduce the reporting burden while also the increase in quality of care, supporting the team of care, and enabling the patient to have more ownership over their data. My last slide before I turn it over to colleagues to share what they're actually doing and what they're doing with tractor is to say that this space is very challenge. This report, some of you may be familiar with, came out a couple of years ago. Talking back over the US, it's spent $36 billion on EMRs and it's been a big small fail. And I loved this quote that was included because this sounds like it could have come from any of the people that I'm working with all around the world. Every single idea was well meaning, potentially a societal benefit, but the combined burden of all of them being conditioned simultaneously to make office practice basically impossible. I've heard the same story all around the world over and over, clinics that only have the date and see patients because they spend the rest of the day filling out reports and giving all of the data collection that they're supposed to do, nurses that are being given multiple devices from different health programs trying to report everything through these in a way that is not useful to them at all. And so we again keep this very much in mind as we're designing a factor, trying to make it a purpose built tool that can be very tailored to your specific use space and match the workflow that the clinician actually wants to use and can collect the data that will be useful again up the chain and also how to do the patient itself. So with that, I'm going to stop talking. I'm going to turn it over to Ann from the Reed Institute of Public Health who's going to talk to us and make about the use of Tracker for anti-natal care and applying the digital adaptation here in WHO. Hi everyone, my name is Ann and I'm here today on behalf of the Chief Executive of Public Health and I would talk to you a little bit about the Tracker for Campaigns and Civilization Attitude. Okay, so the WHO has published anti-national guidelines for digital health performance in their team and interventions for different health domains and that includes how to do delivery and start from health assistance. So there are however a lot of challenges related to Frank's monitoring of guidelines adherence and non-standard contents of the DHIs and also the lack of any digital research and evidence specifically related to DHIs and so to ensure countries can effectively benefit from digital health investments and DHIs are designed to facilitate the accurate reflection of the WHO guidelines within the digital assistance companies are adopting. So the DHIs are operational and software neutral and they're also an attempt to standardize the health content for the DHIs. So the evidence-based policies on the health systems interventions for anti-natal care is helpful. It's also known as the E-POSIT. It's a research project for ANC in Uganda which is conducted in collaboration with the University of Austin, the University of Bergen, Mathias University in Uganda, Kisbyganda, and Sysmark and Kings College in London. And the project was funded by the Research Council of Norway to act age. So in this project we have the ambition to assist Uganda with better evidence to improve essential services for pregnant women and their babies. And so the project is twofold. It's supporting Uganda in adopting two WHO guidelines in line with national guidelines and policies and providing recommendations on anti-natal care for positive pregnancy experiments and recommendations on digital intervention for health system strengthening. So we will provide these through implementation by building local innovations on the WHO and the DHI for ANC. So the DHI is part of the SMARC guidelines. It's also known as the National DHI for health information systems and interventional science by conducting cluster-involved control trials of the transition from four ANC contexts to eight ANC contexts. So the DHI is part of the SMARC guidelines. These are a comprehensive set of useful digital health components for instance interoperability standards, code libraries and algorithms. These transform the guideline adaptation and implementation process to preserve fidelity and accelerate uptake. So they inform guideline developers, technologists and countries in their transition from paper-based systems to SMARC digital assistance. Yes. And these also aid the countries to more effectively and accurately adopt and benefit from the WHO health and data recommendations through the digital assistance, which is the last bit. For this particular DHI for the ANC, their requirements are based on systems that provide the functionality of digital tracking and decision support, including some other components for data elements and decision support budget. And this documentation will be used in this project with the DHI to include international WHO recommendations for ANC and your type of tracker to improve the government health system informing evidence-based policies and other initiatives. So hopefully this will result in better overall health care for, for example, other cases. Thanks for that set of feedback on this project. My name is Brian Adano. I work with the University of Oslo as an implementation advisor mostly on the DHI to metadata packages. But for a number of years, I've been working with the Ministry of Public Health on adapting behavioral care guidelines into DHIs to tracker modules for clinical care. And so I'm going to walk through a bit of the process of adapting this DHI that we did into a global and generic DHIs to tracker modules. So within the DHI, you can see that it has a number of components here. The one that was very helpful for us was this 2.5 of some core data elements, because these are essentially spreadsheets that describe an ideal, an ideal system for collecting data on antial care expressing the WHO guidelines. And so you can see here that these core data elements are described for something like gestational age. What are the types of ways that you can collect gestational age? And then also some of the descriptions, definitions, it also includes things like ICD-10 codes and glowing codes, options and option sets. And so it's a very rich resource for people who want to adapt WHO guidelines for a local context. So if we were going to actually use this in a situation like the Uganda trial that we were describing, what are the actual steps that we take? I mean, imagine here that you have apologies for the other slide, but you have a matrix where you have local guidance and local adaptation, and you have software diagnostic guidelines like the WHO, a DAK, and very software specific templates you can call them. So you're trying to adapt this global guideline in a generically expressed way, the DAK, into a locally context, local context of Uganda healthcare setting with a DHIS-2 application. So the process I would describe today is about transitioning from the DAK into a DHIS-2 system. And we use this the DAK core data elements, they also add user profiles and user personas, as well as business processes and workflows that were included, as well as the L4 of the smart guidelines, which is these open SRP demo application, which we could use as a template for contributing the DHIS-2 program. So the DHIS-2 mother's program that actually was produced through this process, it's been about 18 months so about application. We have 17 factors, we have to do seven different program stages in 76 total sections. That's a very large DHIS-2 tracker program because we're trying to adapt this for a clinical context. Not only do we have a number of different data elements that were incorporated into the DHIS-2 system, but we also have a number of programmable projects for clinical decision support that are part of the DHIS that we could try to express in DHIS-2. So these are 260 programmable as well. As I mentioned, the open SRP module was very helpful for getting an idea of this workflow that is expressed through this WHO DAK, and we were able to actually sort of mimic a little bit of the work for things like program rules. So in DHIS-2, for example, we have, we see like the a bit called the registration data elements in the DAK, but these are actually tracked into the attributes. So you can enroll a client in the system, and the first thing that you want to do before you can enter any data for this client is do a quick check. You want to make sure that this woman does not have any danger signs, that means that she needs to be referred to an emergency facility or to a high level of care. So we can actually say, hide these other stages by program rules to make sure that there are no danger signs for this patient, and then they can open up all of the other stages that would be involved with it. And you can see that there's a number of different sections as well, like moving on to profile and history, and there you see the same data elements that were in this DAK module for calculating gestational age. And so these are now in a DHIS-2 program, which we plan to make publicly available and for others to use and adapt. But there are a number of different challenges that come with this process of just taking this global generic slide sheets and then actually translating them into DHIS-2. So the first is like deciding what is a TEI attribute and what is a data element? How do we actually describe what is in the first visit of this stage versus a routine visit? Do we want to have it separate and see one program stage or make it repeatable? And then I mentioned a quick check. But one of the great benefits of having this DAK was that we could do both imported metadata by CMC. There were additional technical challenges of saying they made your field maps are exactly the same into DHIS-2. So this is something that you kind of have to learn by doing. The other big one was there is no multiple select option in DHIS-2, so finding a workaround for that was a challenge. But one of the key things I want to bring up here is that we would have had these same challenges with adapting the guidelines if we had actually used a fire adapter, for example. If we actually used the L3 guidelines, which are the implementation guide of fire, we would have had many of these same internal discussions about how do you model multiple selecting DHIS-2. We would have had the same questions of how should we do a repeatable program stage, for example. And so a lot of these topics that we had, a lot of these topics that were brought up during the transition from CSV into DHIS-2, we had to find workarounds. So for example, I mentioned that the CSV file included blowing ICD-10 codes. And there's no field in DHIS-2 to include the ICD-10 code where you can update a custom attribute for all the data elements, these ICD-10 codes. So now if the country were to adopt this program in their own context, then they can find some other ways to use these ICD-10 codes to integrate with other systems. So that's one point to work around. I did mention earlier about like the fire implementation guide and also this, the L4 that's called the template software or code, sorry, the executable code is called. And these are helpful to sort of get a sense of the type of structure that you can actually have with your program. And it's just another expression of these WHO guidelines. The one thing that we weren't able to do, and this is kind of how it relates to this session, is that if you're actually going to create a global version of a clinical tracker system, the one thing that's very locally contextual or clinical care algorithms. So there's a lot of work that goes into developing program rules and workflows for something like pre-eclampsia for a loan. And so if we're going to build a global generic system, and then go into the local adaptation, maybe we can just skip that global set, have a sort of skeleton architecture, and then the local country, the country partners can go program rules, for example, here's like an example of preeclampsia and severe hypertension based on their own country guidelines. So this is one way in which we're trying to bridge the gap between global guidelines, local adaptation, and also a generic expression of software standards and a DHI to implementation. So I'm a bit over time, but thank you, and I think I'll do the next session. Now we can take questions out of this. Just a warning, we are likely to run over time on this session, but the next thing is lunch. So if you'd like to stay with us, we want to make sure that we give the presenters enough time. There's also a community of practice link where you can be posting questions now, and we'll be trying to answer throughout the session. So we'll try to get some questions, but yes, coming over to Leona. Good morning. Hi everyone. My name is Leona Rosenblum. I'm here representing the Country Health Information Systems and Data Use Project, which is a USAID funded five-year program looking at data use and health information systems globally. And I'm here today to talk about digital awareness to support supervision. I think this session is about Tracker, and we're really excited about some of the existing implementations of Tracker for supervision, but also wanting to sort of plant the seed in all of your minds that while we often think about Tracker for the clinical health records, like EMR sort of approach, that it's actually also a powerful tool for supervisors and for monitoring health reports or performance, providing feedback, lunch, journal, data-driven tracking of performance. So that's where we're heading. Just a quick overview of what I'm going to talk about today. Just explain a little bit more about what CHISU is, and then talk about this activity that we're working on. And then I'm really going to spend most of my time talking about the framework that we're building out around digitizing support and supervision. Talk a little bit about what's already being done, what couldn't be done with the ATIS-2 and specifically with Tracker, and then about next steps where I hope maybe some of us can all collaborate in the future. So as I mentioned, CHISU is a project that's really focused on country health information systems. We're trying to support countries to have actionable data available that is being used to drive health decision making at all levels of the health system. And we do that by looking across four objectives, which I think are well-blinded. I reckon what we're talking about here this week is strengthening governance and the enabling environment, increasing availability and interoperability of the data and information systems themselves, increasing the demand and use of health data and information systems, and then strengthening organizational capacity of partners and post-market governments to do this work going forward. The activity that I'm talking about here today is around, is looking at developing a framework and some guidance to documentation around how countries can look at digitizing and supporting supervision system. So what we've been working on is a landscape assessment, looking at all the different ways that support supervision has been digitized in a variety of contexts so far. We've done that through a docking interview and a lot of conversation, including with colleagues here at the University of Oslo, which is how we had the idea that this was actually a relevant topic to submit an abstract for for this conference. And then we're working on this framework and guidance document. So I do want to be clear that this is about, we're putting together guidance that will hopefully be a useful way for countries to think about how to digitize either components or the whole of a supported supervision system. We are not developing any sort of application out of this. We think that countries have a variety of clinical and aggregate data systems already in place and which pieces of that and how to digitize them together in a way that will be interoperable and that will meet country needs is going to be different in every context. So we're putting forward that framework, that skeleton of how you can think about it and what to keep in mind when you're looking at digitizing one piece and where all those other parts might need to fit together. But just to be clear, we're not putting out an application. So what are we talking about when we say digitizing and supporting supervision? I have a feeling that if I asked her a joke man, so everyone here who had heard of the term supported supervision, you will probably all raise their hands. But we find that it's actually quite hard to find an additional sort of formal definition of supported supervision. I think what we can all agree on is we're talking about a set of processes and activities that involves a health worker, their direct supervisor, and someone who's managing a health program facility or project. So we've got these three personas who are involved. Depending on the level, you might have a community health worker, their supervisor might be at the health facility and their manager might be at the health facility themselves or at the district. At other levels, it might be a health worker who's at a hospital and their supervisor from the district level and manager of the program might be at the regional or national level. So there's a variety of constellations, but in general, we're looking at the interplay of these three actors. And when you think about what is supported supervision, it involves these three actors that we talked about conducting a variety of activities, right? There's a preparation, planning, and budgeting process around supervision. What facilities need to be supervised? How much does it cost to get there? Where is the fuel coming from? Which ones have I been to recently? Which ones are really hard to get to in the rainy season? So I better go before it starts raining. There's also a reporting process both before and after the visits, looking at data that has come in, looking at data that's missing, looking at the data that you collected when you were out at your visit. When you're actually there at the point of care or at the facility with the supervisor, the health provider, it's a mixture of direct visit observation, inspection of the facility, interviews with the health provider, sort of spending that time with the provider in the facility, getting information that isn't available to you for next day at your office in the district. And then based on that sort of information gathering and observation, there's sort of immediate points and follow-up points of feedback that can be part of this process, right? On the doubt training or pressure content that can be shared with the health worker, there can be follow-up. Oh, I'm noticing that there's a stockout. I need to follow up with the supply chain person responsible at my level. There can be problem-solving, coaching, and other sorts of support and joint consensus building between the supervisor and the supervisor. And so when you think about all of those pieces, I think what has jumped out to us as we are looking at this, there's digital interventions that can help with all of these things, right? And so next slide. Sorry, I'm going to do that a little bit here, but we're trying to talk, think through what are all of these individual digital health interventions that can support all of those tasks that go into a supported supervision system? So, thanks for coming, sorry about the formatting. But so if you're looking at in the planning and reporting and preparation process, you know, pulling in data from other systems so that you can prioritize which facility to go to based on low performance according to their aggregated health service delivery data that's already available in your DHS2-based HMIS system, right? That data source can help you in the planning. When you go out to actually do a supervision, having your data in, having the health worker that you're supervising be a case and tracker where you can be tracking their performance over time, you can see where they were strong, where they were weak last time, what were some of the issues last time, what were your follow-up actions as supervisors? Did you take them? What were their follow-up actions as a health provider? Did they take that? As opposed to what we see often on paper systems or on less developed digitized systems, it's a single snapshot, right? It's a piece of paper checklist or a capture checklist, but it's not longitudinally tracking over time and you lose that follow-up and consistency piece. There's also a huge opportunity to look at digital training materials and interact both for the supervisor to bring with them to the facility to look at together with the provider or to push out to devices after the session to help follow-up on areas of weakness. I'm not going to name every single of the green slots out there because there's a lot of different points. The general point that I want to make is when you think about the whole of the supervision system with all this component system on the left side, there are a lot of different entry points that you can digitize and punches tend to be taking pieces of them at a time and I think that's probably the most appropriate way to bring any of this forward, but thinking of it as a whole as you start with, okay, we're going to build this large two-piece management system, but where will we eventually want to pull in data in from? What kinds of follow-up actions will we want to be able to track? It's a helpful process. So I wanted to just, you don't have a lot of time, but I wanted to just flag one example that's already being done using VHS to your end as a specific tracker, which is the HNQIS system that was developed by BSI, but it's being used or was being developed as well with support from University of Oslo and is running in many countries already and they have built out components that help with planning, assessing, improving, and monitoring, so that's how they've broken out those four categories and a little blurry and I have to see, but this is pretty, the yellow one is looking at the checklist to watch what happens during the counseling session and the testing session and did the health worker actually accomplish these activities and then the blue one is showing actual scoring in terms of quality of care, so it's based on the data that you're encountering, while you're observing when you're on a fair visit, you're actually in real time providing a score and then you can share that right while you're there with the health worker. There's a lot of documentation available on this particular system and I think there's a lot of work going on to make it available as a core HHS2 product as well and to make it easier for countries to take it on, so if that's something you're interested in, I'm happy to help send you to the right folks too who might be able to help with that. I'll just wrap up by saying we're going to have a draft document of this framework to share with health worker consultation in the next one or so and we really love your feedback, your thoughts on whether this is helpful framing, how we might be able to use it and then next year we'll be working with countries that are already developing different types of support supervision digital tools to look at those in the context of this framework and think about how those tools might fit into a larger digitized support supervision system, so if you're, if any of the countries where you're working might be interested in participating with that in that activity, please let me know and we're happy to cooperate, so thank you and thank you very much. So our final speaker is Ruby Jeremy Dore which I probably didn't know about, it's pronounced correctly, it's finished with 80 and had troubles with this slide so we re-accommodated for this session so please stick around come so we can hear the full presentation if you're able to and again if you have questions please try to find it on the community of practice the link for this session we'd love to interact with you there. Hi everyone, my name is Samuel O'Neill, I'm from CUNHELY, it will be more easier to make this presentation in front of me, so thank you my mother there, so unless you have a short time and I will meet you in front of my show English, I will join you today, so we are going to talk about the TV tracker here from the database to the DHIS2 tracker, so what we did, what was the training, which step we used to go forward and where we are right now. Okay for the overview for the presentation we are going to talk quickly about the ABC TV program overview and we're going to talk about the TV program digital transformation, we're going to talk about DHIS2 towards sustainability, the challenges and some key programs extension. That's okay, you can understand me. So it's the reality of the TV program overview will help the high TV providers in America and in 2004 there were 12,097 pulmonary and proformin cases in Haiti and then that's what the reality, the mortality is high, 58 for 100,000, this is the big fact that there are only 40. The national TV program works to control material resistance and TVHR and co-election in doing so close collaboration with the district and the national network of laboratories is needed. The measure of the program is starting information, legal information is available at central report that is from program implementation and the monitoring of the activities. So what is the reality right now in Haiti? The TV data were only available after each quarter and were of two points. What we did every three months they called off the facility with the register to have a meeting and to discuss about data and about the program. So at the national level we have the contact of the data, the TV data everything. So we don't have enough time to make the data consistency. So we don't have enough time to report and to show data at the national level for this is in Haiti. That was the reality. So what is the main project when we make the TV tracker? It's to improve data availability. Improves overall TV data quality. Improves the availability and quality of the TV program monitoring indicators. Decrease data pollution towards 20 costs to claim the registered movement in Haiti is a pro country. And increase the use of TV data to improve passenger management and self-delivery. What we did? First of all, we like I might say truck as you know in Myanmar. So we select the register. What kind of the register that we are using on the TV program? Does it call that the TV doesn't catch on the phone? So when the person have a tuberculosis, criminally positive or negative or extra criminally tuberculosis, they give to the person the card in the contact for the monitoring, for each one of them. Okay, I think they run it in English, right? Yeah. So they use the pharmaceutical sensor to be registered. In French, it's a form of a surgery. So in English, it's a form of a surgery. Okay, to register each index case. And we have a register for each contact. So if we have a case, we have to track all the contact. So we have a register for the contact. And for HIV TV, HIV connection with the HIV population register, in which is registered the population alienation. Okay. And it's for HIV connection. And at the end of the day, we have a special register for mid-register. So what we did is the configuration inside the LHX2 for the four registers. That's the reality. So we have to start all the register, we have to do two questions. It was very, very difficult. And then what was the difference? So for the world, we have to understand the norm and protocols and the algorithm of the program. Because we have to do a stage inside the LHX2. So for that, we have to work with the peak energy is the program, the national program that managed the HIV program, HIV, and then at the end of it. And UPP is the immunity responsible for HIV transmission. We are working. So we have to work together to understand the norm, protocols, algorithm, and so on and so forth, and to create a stage inside the LHX2. We make the configuration of 14 registers using the LHX2 tracker. And the direct care and treatment protocol are used to make the configuration inside the LHX2 tracker integrate the link between all different registers. That means when I have a first stage in the stage inside the sensitive registers, so I make the link between the contact registers and the HIV person, HIV case, I make the link between the HIV prophylaxis registers and I make the link between the mid-resistant register. That means I don't have to for each person to identify. So with the system, I track the person and I track the contact and if the person is HIV person, I can put him directly on on the IMH technology. And if the patient takes drugs and develops some resistance to the drug, I can track him and put him on the multi-resistant resistance. So that's the process. It wasn't very easy automated because we need advocacy. And what we made a trend, a trend of health care to the use of the TB tracker for personnel. Medi-Train is quite, it was very easy to make it because at the facility level, the nurse, it doesn't, the nurse was very poor person. So train nursing, nursing at the facility to use tablet in terms of the test. You have to train, we train, we train, we train, supervision to the vision. So what we made, at the national level we put data center. No, it's not the data center, it's called center. So every week we have to call directly the nurse at the facility level to see what's all the data. Why do we don't make the data out here? And then we make the monitoring, it was micro monitoring, it wasn't easy, we make it. And then we made training at the disability level, they make the coordination, the supervision of all the facilities. And we buy tablets with the USID support and CDC. And we have tablets with SIM card, with internet to give to the facilities to deliver the data directly. And then we continue data points assessment and nation learning meeting. So even though every week we may call to know what happened at the facility level, everything more, everything more, we have meeting, special meeting with the, with all the facilities are disagreeable to make the data assessment, to measure the data consistency and so on and so forth. So that in terms of technology what we did at the, we have the TV pressure for the TV server, okay? And we use the dash tracker to have analysis dashboard, data for laboratory entries, data for broadcasting, data for the reporting, data for lab entries, data for this manager, and data for passion. So here is the purpose of we have a lot of partners. So we have to make advocacy, to make coordination, and sometimes to find partners to follow the needs of the management. It's not easier, it's a fight, we are fighting. So what is the reason it's not? So an increase in number of passion are not being monitored through the system. From 30,000 in the second quarter of 2019 to more than 74,000 has helped with the thing. All 203 TV sites are electronically monitored in passion and data for the decision making for government management to be dual forecasting and reporting purposes. They are one of the active users of the system and to be 40 non-useful users and 90 for anyone in international organizations. That's the tendency of the number of cases of TV password node and track between 2018 and 2020. So this is the engagement in terms of sustainability. So we've all worked in the discipline to see, to assess the data consistency, see how the nurses feel the resistance and what the data issues are making on the system. It's at the national level of the data consistency and we assess the data and make feedback at the discipline and facility level. This is the data model that we create using the dashes, the DHS tracker, TV program. What is the challenge? We need for what is human resources capability at facility level. What I say, at the facility level, the nurses for the TV program is not very young person, so we have to train in the discipline. After the facility, we learn more internet connectivity and quality of coverage on the area. On the countryside, even though we have a company which think up, so we don't have a good connectivity in there. So we use the Android version of the DHS tracker that means we can make the data entry without internet and go on the area as connectivity in the other track. It's that easier, so we're community. Making a set of data quality and data access with the program of internet connectivity and the capacity of the human resources at the facility level to the data entry and that after the data we have on the system. The coordination of the six observatory all in the facility data quality. And the use of the TV data at the facility level for decision making as a challenge in training for the secure context and for security issues. Sometimes it's very difficult for the nurses to go to the facility level because there are, again, the security violence and that after the performance on the system. For gravitation, and the first one is the ability to track TV vaccination in the children, Mr. J. Ability to track TV fashion, COVID-19, vaccination status, and the question of the community health information system. We are using the tracker to the, the chase community health information system for the community-based information system for the community health workers, okay, they get the tablet for the workers and make the data entry. So at the workers, the community health workers can give drugs to the patient, right? So we have to make delay with the community health information system and what we are using at the facility level because the tracker for TV are using at the facility level. So we have to work to make this design. Include management dashboard for head of the TV program at the security level in the fast distribution, testing and work ability management. Increase the number of the TV point of service with direct access to the TV tracker for patient management. Integration of the TV tracker data and to the catameter. Catameter is a map of all the facilities that are available at facility level. Okay, so we have to make the track to the tracker and with the mapping to see where the services are available and what is the reality for each facility. And it was to be tracked analysis, visualization and interpretation of data from decision-making. I think that all, I hope that my English is well been clear. Ha, ha, ha. Ha, ha, ha. Ha, ha, ha.


what's up guys we're back with another epic video today we have a suspicious pack half faded half not so we're going to be opening this in this video probably shouldn't sure a lot of people get mad at me but i really want to see what's inside we also have some other booster packs like more shadow specters first edition we have some unlimited extreme victories that's gonna be cool oh there's our storm of ragnarok we have some of those as well then we have legendary duelist first edition and some hidden arsenal trishelis triumph can we pull the trishela gonna be a fun opening but before that the giveaway i'm gonna be giving away these three cards we have three fusion monsters all you have to do is like this video be subscribed let me know your favorite set we opened in this video let me know what you think about this crazy fated pack and let's get into it all right let's start off with a trishelis triumph hidden arsenal four so this one can have the trishelis i think there's also another big card in here can't remember what it is i'm gonna have to check honestly oh yeah right at the front slain vell saber warlock garuda pegolas and and gustaclavi yeah they haven't always been i mean it's always been hard to pronounce names all right so the the expensive card in this pack is dragoonity knight barca like over 40 dollars apparently that's crazy so we're gonna hopefully pull that we have legendary duelist this is before they reprinted them this is the very first legendary duelist pack came out like 2017 i think so you get some cool stuff in here like red eyes red eyes cards and uh yeah cyber dark apparently golden apples and cyber dark canon okay i actually opened legendary duelist a booster box in 2018 i think it was the very first booster box i opened on my channel and it was in two parts so yeah if you guys want to check out that old school video check it out all right we have storm of ragnarok we've never pulled the odin in ghost have we pulled an ulti i don't think we have so we have kagamush of the six samurai so he's of the blue flame denny's of the six samurai we've got a needle ball that's classic car curry gold dust scrap shark overpowering eye and a dd sprite super rare it's a nice card god or demoron there's the uh the odin right there and the sleeper bar first hollow pull the video well not hollow pull because in our snows all hollows but okay extreme victory haven't opened this in a while we could pull the tour guide we could pull the what am i forgetting there's some other card but there's a coaster in here as well it's like there was an ulti that was decent i don't know i can't remember i'll do the sixth samurai we opened a booster box of this like two years ago and we got some pretty good pulls it was first edition too now it's got a little more expensive back then it was like a 60 dollar first edition booster box brain hazard oh ultimate rare over mind arch fiend okay that's a sick card oh and the back is not indented wow and it's centered wow could we get a ps a 10 on this card that's very unusual for new old like new ulti so the new style where they have like the border and stuff they're usually very easy to like the imprint is usually very pronounced on the back but on the back you guys don't see really see anything do you that's pretty good over mind arch fiend i don't know what's worth but it looks freaking awesome that's cool so this is a good start to this opening i have more of these packs as well that i'm probably going to be opening at some point but right now okay we're gonna save the uh the crazy pack for the end let's put this at the end all right shadow specters i would love to pull the cover card in ghost or ulti um yeah and as you can see these are like i don't know if they were stored weird i mean that's probably what happened to that pack it was probably just from sunlight or something but there's some weird stuff going on with these shadow specters hopefully we'll pull something good though ghost rare vampire duke the ghost rare um divine knight something i think it's what's called okay for this we're gonna have to do a pack pack trick so is it at the front i think it was at the front right right when you open it up it shows you so let's go like this let's pull it out like that there we go flip it to the back look at that damage on that back card that's unfortunate dragoonity brandy stock nechuria strawberry genex ally crusher nechuria mantis and the same card the neoflameville sabre that's weird okay so another one let's try legendary duels again i don't know what is still valuable in here oh you can pull on millennium eyes millennium eyes restricted here i don't know what it's worth now that's been reprinted in the secret rare and legendary legendary duels season one emerge your roid call so it is an ultra rare you're not guaranteed supers in this which is pretty cool i know this one is not good it wasn't good even back then before it was reprinted because it is a roid card and does anybody actually like roid cards besides cyrus let me know in the comments if you're a roid fan i would be interested to see that oh i totally forgot that pegasus was a completely different set so no you can't get millennium eyes restrict this is red eyes baby dragon and stuff like that and gear freed the sword map not sword master gear freed the red eyes iron knight that's it all right we got chenay we got the triple impact come on storm dragon rock have we ever gotten a big pull out of storm i think we got an issue or something that was cool i think that was i think we did pull that double warrior that's from this right i think it is i think it is all right so extreme victory started us off hot i'm not expecting too much now after that first ultimate rare pull but you never know maybe there's a ghost sure in here as well secret rare tour guide mental seeker tigerus the jet falcon ceiling ceremony the seal okay all right shadow specters here we go these weird clear packs i don't know what in the world is going on with them but it looks very sketchy vampire gate grace which big win swords at dawn and the pun paco we got the prince the pump princess the princess of ghosts gotta love it all right here we go we gotta keep this we can't spoil it let's get this open without spoiling here we go nice and nice and open oh man this is a painful sound this is not one open there we go okay that'll work all right no card damage on the back this time that's good partisan ragweed okay melaton chawa and the ancient flame bill deity okay they look really nice he's hitting arsenal cards just most of them apparently one of them though is not are not worth much let's get some classic red eyes cards oh there we go again a big old thing right there that's not good red eyes fusion that used to be worth something in common and i think it's been reprinted but we'll set it aside anyway oxy get on red eyes black dragon we got the classic red eyes like i asked for and d2o so not bad not bad storm of ragnarok ghost rare odin can we do it can we pull it divine relic something shanae cyber shield compass upside down rare and car curry cash cash just a cash cash okay extreme victory let the victory be extreme let the victory be extreme here we go esp amplifier the mech lord factory lantern junk servant that's a good rare i think it's been reprinted though we'll still grab it tg catapult dragon jar turtle oh that's very weird i've never seen that card each time jar of greed is activated draw one card huh so if you got that guy out there you can uh get some crazy jar of greed combos going get some double draws gets like a pot of greed if that guy's on the field but it's a trap so still not as good yangxi collapse serpent swords at dawn and the labradorite dragon pump princess we've got a super rare the 2400 one star tribute tutor that is very strange but okay it looks pretty cool though he's got a very similar uh head to blue eyes except no horns and stuff interesting all right back to tritula's triumph here we go oh uh oh it's a synchro i don't know what it is i didn't see what it was i saw it with synchro though will it be the tritula can we do it genex vulcanin and belflame those look very similar javelin oh jerak yellow this was one that was really good yeah this card's worth a few dollars that's pretty good and ancient flame bell deity all right okay this is pretty decent legendary dualist man that that was a troll i thought it was gonna be the the tritula tritula is not worth too much either but it would be really cool to pull it because it's a cool card legendary ocean we got the fisherman oxy get on red eyes retro dragon and see still the tackies be worth something too i think it's been also reprinted so it's the value in this set has been really hurt i think it's a common in legendary dualist season one that's why all right worm illidan we got a token stampede scrap shark miss valley the kakeki and risto the tail wind by long matter another extreme victory so the biggest pull was right at the beginning of stream victory so can we pull another big one out of extreme victory ghost rare force resonator we got the fortissimo the mobile fortress lindworm ceremony of something necro defender and red carpet and the dock resonates okay wait did i do this did i not get enough extreme victory i don't i think i only grabbed four for some reason here we go shadow specters clear pack ghost trick mansion we got the mythic tree dragon wiper buster uh-oh ruckson special and swarm of crows and spoon just a spoon ah back to the trishel's triumph can we pull that dragoonity card that's the one we're really looking for all right we got it open spin it around give it a little switch back jinnx ally changer secret guards of the ice barrier dragg dino mature hissing bug and oh driden okay this one's actually good though dragoonity knight tried it's the third highest on tcg the other one is the one we want the other dragoonity knight that's still good at around five dollars is what i'm seeing there legendary dualist here we go so let's pull a red eyes baby dragon leotor we got the red eyes retro dragon wonder balloons ooh red eyes fang with chain this used to be a twenty dollar card but after the reprint i'm sure it's not but it's still gonna be decent original legendary dualist first edition that's pretty good ultra pull we will take that storm the ragnarok come on ragnarok here we go come on thore let's go token stampy we got the strap scrap shark divine win barrier resonator tire and black boost okay nothing solemn authority so we're down to the last one of these i think i grabbed one less so maybe we'll keep that for the last round let's go to shadow specters here with another clear pack ripping apart like really weird okay secret sect druid dru all right the rabbit puncher tan tan vampire grace vivid knight and the ghostrick stein all right that looks like typhlosion i think we've already said that before but it looks like a blue typhlosion all right final round hidden arsenal let's see if we can not spoil perfect there you go that's how you do it right there get it down there's another damaged back card so that's not great here we go gen x ally bell flame we got the gen x ally volcano they look the same javelin alo that's good for that burn oh power cell all right power cell is not great i don't think still still secret rare we'll take it and another jerak ilo pretty nice all right legendary duelist here we go here we go what can we pull red eyes fusion that's not bad oxy get on red eyes red eyes black dragon and red eyes snake dragon the original okay before it got repaired in secret rare this is awesome that's a that's a nice original pull first edition red eye slash dragon very cool looking card gotta love it okay those those were pretty good we got two ultras out of there that's awesome okay storm veragon rock did you did it give us anything at all maybe now's the time maybe now's the time here we go we got legendary duelist six samurai shinae the cyber shield the sci-fi cosmic compass triple impact i don't know what i'm saying start us phantom and here we go tan grisner of the nordic beast all right our glass of courage we've got ourselves a sheep or a ram whatever you want to call it or a goat i don't know but uh yeah not that exciting but nice guard nice super rare two packs left we're going to save the weird pack for last let's go extreme victory we only had four of these packs we did pull an ultimate rare though which is crazy let's go tour guide red dragon vase the nebula meteorite tg1 em1 force resonator blackwing gin the rain shadow and tg catapult canon all right this dude has a very that is a very strange thing on his head all right final pack the weird shadow specter's pack it's ghostly on one side is i mean there's a ghost in here let's see here we go can we pull something big from the weird pack probably shouldn't have opened it dragon shield ghost or vanish soul dragon drain dragon by the way let me know in the comments if i should have kept it sealed malice ever a tonight okay secret sanctuary the spellcasters and malice ever is fork okay so we did not pull anything out of the weird pack definitely should not have opened that oh well hope you guys enjoyed this video if you did like the video subscribe for more epic openings and i'll see you guys later peace


party started. This is yesterday's drawing. My name is Kim Dias Holm, also called then unge her Holm. And I'm an artist releasing art for free use. So what you see here will be made available for everyone as soon as it's scanned. Good morning Kim, good morning Kermito. Good to see you. Okay, today is another one of those days where I will try to get through this live as quickly as I can due to all the reasons. Just for fun, good evening. Good to see you too. Excellent. And Mona, we have a whole bunch of regulars here today. That's fantastic. Thank you so. Oh, leafy. Thank you so much for still sick. I mean, the COVID has released its grip, but I'm still after COVID feeling and my mental health is not good at all. Not good at all. It has taken loads of things, has taken a toll on me lately and especially, I mean, the COVID seems to be the straw that broke the camel's back, so to speak. But I am used to these things. I've been living with my bipolar disorder for, you know, since I was, I mean, 13, 14. So I've been living maybe like 30 years like this soon. So I'm kind of used.  I need physical, I need physical exercise for my health, for my mental health. I need to have a balance between a lone time and social time. And I need creativity and to express myself. So that's something I need. New feature. Yes, the YouTube live stream is the new feature. I mean, cold showers, running, lifting weights, being outside, being creative, having time to relax, having time by myself and having a little bit of social time as well are all things that help my mental health. But the thing is, no matter if I have all those things, my overall moods seem to be going up and down in some sort of written rhythm. And that's why I've gotten the diagnosis of bipolar. I imagine every shower in Norway is cold. No, we have electricity. COVID takes a little bit of time. Brain fog after COVID is normal. Hope you get better soon. Yeah, it's not just brain fog. It is also without going into details. It's been a challenging month on many fronts. And everything has taken its toll. And I'm very blessed and very lucky and very privileged to be in the position I am in. Hey, Ellen Gertamer. But it still feels hard from my point of view. Leafy says I am autistic. Do you have experience with it or things similar? So there are definitely things in how my mind functions that is close to close to the spectrum. And there are things in how my mind functions that are close to ADHD. And these are also all of those types of definitions are not, they're not set in stone. They are gliding fluid definitions. But I have taken a lot of tests for things like ADHD and autism. And the signs are very clearly that even though I have a few traits that are similar or typical of autism, there are a few things where I don't only lack the traits, but I am fundamentally differently built than most autistic and also than most people with ADHD. And bipolar seems to fit my diagnosis. That being said, there are a lot of similarities between bipolar, ADHD, borderline personality disorder and autism. Not always, but there are some. And in my view, and you can correct me if you think otherwise, the thing we call bipolar disorder is probably at its core a difference in, and it is in itself perhaps not linked to depression and mania, but as a result of having to live in a society that is fundamentally opposed to those rhythms, we get traumatized and that results in hypomania and depression and or mania and depression. I have had a few classes for people with autism. There are classes and I see a lot of fields where I can relate very much to the autistic experience, even though the autistic experience is different for every person, of course, but there are also some parts where it is particularly difficult for me to relate to or to communicate with some autistic, but it is difficult to communicate with some people. I mean, that is people are different, people are difficult, no matter what. But I do think there are a lot of methods and experiences that neurodivergent people can share and learn from each other. So, yeah.  I mean, that's sort of up to them. I almost have no energy lately, to be honest.  Today, I'm going to try to do this as quick as possible and just end the live because I also have no energy and I mean, this is good for me, coming here and chatting and having to focus a little bit. That's perfect for me, but I can't be sitting around for an hour and chat like I always or usually end up doing. So, I have to set down rules for myself and protect myself because my mental health isn't good these days.  You don't know this guy. Looks like a Pokemon, but he's not. So, you don't know him. You don't know. You don't know what it's like. That's what I'm going to say. And you don't know what it's like. Oh, it looks like it's from Wonderland. Yes, because it's so wonderful.   That's the word for today. So, hopefully you will still enjoy this short live. Hi Anthony. I still love it. Thank you. Your dreams have meanings. My dreams. Hey Kim, I love all your artwork and videos. Thank you. For all the creativity that you bring to my For You page. Thank you. Thank you. It is a very thankful position to be in to have strangers compliment you like that. What do you do to make your day better when you have bad difficult days? So, today I haven't done much to help myself get better. I've rather focused on doing a lot to help myself get worse, which isn't quite as ideal, but that happens some days. And you know what? I'll just be honest and say that today I I know a lot of things I should have done. I should have exercised. I should have gone for a walk. I should have, could have, would have, but I didn't. And that's okay. I could sit here and be angry at myself for all the things I could have done. Or I can say, that's okay. I forgive myself. I'll try again. Well, this is trying again. So, the tone of your voice is different on your bad days. I notice more low with gravity. I'm also a bit, my throat isn't quite okay after the COVID either. But your voice is soothing like here audiobook from Kim. I really love how you work with a paintbrush and I love watching it personally. I'm better with pencils, but you absolutely, but absolutely admire work with a brush. I could honestly use some guilt. I'm way too comfy with being lazy. Yeah, me too. But my experience is that feeling guilty for being lazy isn't really a good way to keep from being lazy. It is, at least for me, more a good way to keep on being lazy. You seem like the type of guy who have a favorite poet. I'm not a type of guy that's terrif, terrif, terrifically familiar with poetry.  So, I love Edgar Allen Poe for just the sheer use of language and rhythm. I love T.S. Eliot. And maybe those are the only two that I've sat down with and which have spoken to me. Thank you for being you. Thank you, Black Talia.  No. I do notice sort of the opposite. There are things that happen with my mind when there's too much sun. So, there are some theories about bipolar disorder and hypomania and blue light. And I have actually noticed a difference when I wear blue light, blue light blocking glasses. I get a little less erratic and so I should be doing that. But I also should be going outside. I think that we've been going on for 18 minutes. I think this is the shortest of our Inktober, is Pinktober streams, but I will end it here still, just to take care of myself and hopefully come back and have had a better day tomorrow. Not have a better day, but having made a better day for myself tomorrow. King is the brightest star in the North, even in darkness he shines his light over us. Oh, thank you. Get better, King. I prefer gloom and rain. It makes me happy and relaxed. I'm not bipolar, but I was misdiagnosed. Has CPST. Okay, I need to, sorry, I need to just stop reading the comments because I want to answer every one of them, but I can't. But I have to do my sales pitch because we have to make a thing as well. And no matter how fun it is to draw Inktober and no matter how fun it is to draw Be Live, it's also how I make my living this art thing. So if you like my art, then please consider becoming a member. If you become a member like Moona and Leafy and just for fun, then you help me and my team to be able to do more stuff for you. More videos, more longer videos, more lives, more of everything. Supporting on Patreon.com slash Kim Holm does also help in the exact same way. But if you like my art and want to purchase something from me, then go to den ungehardhorm.com and use the promo code Inktober 23 for 20% of all October. So that's a couple of days now. And then we're done. And if you don't have any money to spare or simply have better things to use your money on, that's okay. You can still support me. You can support me by using my art. All my art is released for free use. So you can download it, you can copy it, you can share it, you can send it to your long lost uncle in the Philippines. And he will be happy with that because apparently the Philippines loves my art. You can even sell my art. I release it under a Creative Commons license, a Creative Commons attribution license. So all you have to do is credit me as artist and you can sell it for a profit. And maybe my art can help make your life easier or help promote your course or gather money for your course or whatever. And then sharing my art or even making money off my art is supporting me because all art should be free as in freedom of speech. Art is freedom of speech. As artists, we all stand on the shoulders of giants. Make free art or die. See you tomorrow. Kim should record this monologue so I can press a button every time instead of saying it. That is correct.


Some cats are simply clingy by nature, with some purebred cat breeds like the Siamese and the Abyssinian known for their clingy personalities. But in some cases, clinginess can be a sign that something is up with your kitty, therefore, it's important to pay attention to what might be causing this behavior. One or more of the following causes might be behind your kitty's clinginess. Your cat might be clingy simply because they aren't getting enough mental and physical stimulation. Taking breaks to play with your cat and providing interactive toys to help keep them active and entertain throughout the day can help in these cases.


with the graduate school lectures, and it's my great pleasure to introduce Zhenya Evgenia Malynnikova from Norwegian University of Science and Technology, who will be talking about the frequency function of solutions to second-order elliptic degrees and zero sets of Laplace-Betteramina items. Thank you. Thank you, Svetlana, for introduction, and thank you, everyone, for coming. It's a great pleasure, and I wanna be here, so thank you for the agonizes for this opportunity. I will use the bell-upboards most of the time. I'll just have some pictures to show you in the middle of the lecture on the screen, but I can start with a very short overview of what you would expect during these four lectures. We will start with a very short note about elliptic degrees and then spend most of the first lecture on agon functions of Laplace-Betteramina operator. If you're working with those, I will not tell you anything new today. Tomorrow, the plan is to look at the frequency function, define it, and see how it helps to understand the properties of growth of solutions of elliptic degrees and also zero sets. And then the last two lectures, I want to prove something, so I will show you how to use frequency function and some iteration schemes to prove a quantitative unique continuation result for elliptic degrees. I will always refer to agon functions and tell you what is the story with agon functions behind. So let me start slowly what kind of PDs we are looking at. For me, elliptic will be always second order, divergence form, no law at the terms, nice operator by uniformly elliptic. I mean that we have a matrix of coefficients with usual condition that this is an elliptic operator, the matrix is always symmetric and uniformly elliptic will mean that I have the same lambda for the whole domain where I'm considering the equation. Well, most of the time, assume that our coefficients are good enough, Lipschitz, so we have an uniform constant age, sorry, uniform constant C such this is true for all points in our domain and this is the regularity that we will assume. It's well known that for such elliptic operators, we have weak unique continuation property. If you have a solution in a connected domain and the solution is zero on an open set, then it's zero in the whole domain. Something that it's very easy to believe when you have the usual or pass operator or you have a elliptic operator with real analytic coefficients, but this is something that is about ellipticity not analyticity of the same say we have the same result for elliptic situation. Moreover, there is strong in incontonation principle tells you that if you have a solution to this equation and one point in this connected domain where solution vanishes of infinite order to formulate it in a right way when we don't have smoothness of solution, we say that the integral over a ball of radius r is bounded by r to the power n for any n or small enough. So we have a vanishing of infinite order in this integral sense, then the function is zero. So this is stronger than the weak in incontonation and strong in incontonation implies that solutions of elliptic equations are not allowed to vanish on sets of positive measure. If you have set of positive measure where solution vanishes, take any density point of this measure and you'll find vanishing of infinite order in this density point. So one of the aims of this for lectures is to prove a quantitative version of this result of non-vanishing on sets of positive measure. It will come back to it in the last two lectures and another aim of the lectures is to connect to what we are going to learn to eigenfunctions so we'll spend most of the time today talking about eigenfunctions. Assume that we have a remaining manifold with nice metric, should be smooth enough to apply our theory and what we need is those two assumptions on the elliptic equation that we get. We'll have a plausible trim operator on this manifold with just on functions usual divergence of the gradient. You can write it down in local coordinates, I won't do it by the way there are lecture notes where most of the things are written down explicitly and also there is an appendix in lecture notes about facts on elliptic PDs that could be useful if you don't remember them. So we are looking at functions that satisfy the eigenvalue equation. Most of the time I will talk about compact manifold M so there is no zero condition here. Sometimes we will assume that it's a manifold with boundary then we're talking about Dirichlet but plus eigenfunctions. For example when M is a domain in RN, you can think about this scheme as description of Dirichlet Laplace eigenfunctions on bounded domains as well. So what we know about this operator, we know that this is self-adjoint, nice operator if you integrate Laplace F times G over manifold as usual, this is minus integral of the product of the gradients and this manifold, sorry this operator has discrete spectrum. So we have eigenvalues for minus Laplacian, they are all non-negative and form an increasing sequence. On compact manifold M, the first eigenvalue is zero and the corresponding first eigenfunction is just a constant, you can take function one, it's harmonic there. If we think about domain with a boundary, our first eigenvalue is positive so we have strict inequality here. Let me start with a very elementary example when our manifold is just the union circle. Laplace operator is the usual second derivative so the eigenfunctions are usual cosine and sine functions. Eigenvalues are squares of integers to be more precise, should write it like that. And the corresponding eigenfunctions are linear combinations of cosine and phi and sine. So any eigenfunction that corresponds to eigenvalue n squared is a shifted cosine function, it has n zero points. This is a very trivial simple example, you can change it a little bit, change the metric on the torus. Introduce another metric, not the uniform one and you'll get a standard Sturm-Leuville operator for which the Sturm series say that you have the same phenomenon. You have still n zeros of eigenfunction of number to n and to n plus one. We'll try to down, but it's relatively well-known, I think. In higher dimensions, there is no such good control of the zeros of eigenfunctions but what we know is the current model domain theorem it tells you that if you have Laplace-Biltrami operator on manifold or domain with a boundary and you look at eigenfunction corresponding to the eigenvalue number n, then this eigenfunction, the zero set of this eigenfunction divides the whole manifold into not too many pieces. Let me do it more carefully. So we'll use the notation z of phi all the time, it just, the zero set of any function and the current model domain theorem says that the number of connected components of this set, we call them model domains and this number is bounded by n. So for the first eigenfunction, you have just one little domain and the case of compact manifold, your function was constant, it's zero set as empty and there is only one domain here. In the case of domain with boundary, when you have say domain in Rd with Dirichlet boundary value, current model domain tells you that the first eigenfunction is positive or negative, it doesn't change sign, there is no zero set there, you don't divide this into pieces. It's a textbook theorem and I will just say a couple of words what is nice to know to prove it. We can characterize eigenvalues using minimax property. We know that the first eigenvalue is the minimum of the ratio of this kind just from the formula here. And if you want to construct all other eigenvalues, one way to look for them is to minimize the same ratio but now you're not allowed to use all the functions, you use the fact that you already know the other, the first K minus one functions and look at the minimum over this ratio or the functions that are orthogonal to first K minus one here. From this one, you can prove current model domain theorem using weakening continuation result. This is L2 in the product, this is L2, what is? Yes, orthogonal to. So the useful piece of information in the first eigenfunction is strictly positive up to multiplication by minus one, definitely. And if you have two eigenfunctions with distinct eigenvalues, then they are orthogonal in L2 and if you take all eigenfunctions, they form a basis for L2 of M. Definitely there are some eigenvalues that have non-trivial multiplicity and we have to take the right amount of eigenfunctions for each eigenvalue count the multiplicity. But this formula will do it for you. So two more examples, very standard ones. If instead of the circle would take a sphere in Rd, sorry, I'll take the dimensional sphere in Rd plus one, try to denote the dimension of my manifold by d. So then, what are the eigenfunctions and eigenvalues of the Laplace-Beltrami operator and sphere to find eigenfunctions, you can look at the Laplace in Rd plus one and separate the variables using polar coordinates. You'll see that if P is a polynomial of degree n and homogenous with zero Laplace, so harmonic polynomial in Rd plus one of homogenous degree d, then its restriction to the sphere is an eigenfunction and the eigenvalues n plus d minus one. All such harmonic polynomials give eigenfunctions on the sphere and there are no other ones. These eigenfunctions form a basis in L2 on the sphere. You can write down some simple formulas and look for simple harmonic polynomials and you'll see very nice pictures of zero sets on the sphere. For example, you can see this orange or watermelon zero set on the sphere. Or you can choose your harmonic polynomial to see this nice zero set. You can combine those and see something like that as well. Another very standard example is the torus. Yes, thank you. And you also have simple eigenfunctions. You can divide the variables and look at eigenfunctions of the form that are products of trigonometric functions, say cosines, theta. Then...