In today's video, I was sent a vintage Yu-Gi-Oh! 10 to open on the channel. What's up, guys? We're back with another Epic Vintage 10 opening. I think there's also more stuff, because we have a box right here. Right here. This contains a viewer's packs that he wants me to open that contains vintage stuff. So first of all, there's a return label. We're not going to show that on there. We're going to go a little bit over there. Thanks for the return label, by the way. That was super clutch. Then we have a note. Hey, Ruxen. Sorry about the delay. Life's been a little crazy. I threw in some extra stuff for you to open as well. Hopefully you can break my bad luck I've been having. Wish me luck in the comments. Wack job. So, whack job. I'm trying to remember what whatnot stream he was on. He was on one of the whatnot streams and he went like 0 for 5 or something like that. He didn't pull anything good. He said, hey, how about you? How about I send you this 10? I've been having terrible luck. Maybe you can break it, which I was like, well, I opened it before and you still didn't pull anything. So I'm not sure if I'm going to break it or not, but I'll do my best. All right. So the first item he sent was a very exciting item. He said, would you be willing to open this for me? And I said, definitely. I love this item that you have. And this item I will not be saying until I show you, but it's taped in bubble wrap. Wait, one sec. We'll get it out. We have a Jinzo 10. I was about to say first at it's not first at Jinzo. Check this out.  You know, it's got some it's got ripped on the corners a little bit ripped on the back. I can feel it, but this is a classic 2003 10. We have not opened in a very long time. So I'm super excited.  That's not it. There's more stuff. What else did whack job send us? Oh, we got a giveaway. Don't worry guys. Give away coming here. All right. Here it is. Let's try not to chop it open. Is there a better way to open this? Oh, it's in a top loader. So that's good. Let's just very carefully. I sharpen this knife a little bit a second ago. So it's shut you there. We go. Oh, nothing like sharpening a knife. There we go. Oh, ghost rare. Is that it? Yeah. It looks like everything ghost rare wing dragon of raw sphere mode in the giveaway. All you have to do is like the video, be subscribed, turn notifications. Let me know down below how awesome whack job is and thank him for letting us open this on the channel and then any other comments you want to add. All right. He also sent us some what appears to be a rarity collection blisters, which we are not ever going to be unexcited about rarity collection. Maybe something else at the front too. What is this? Oh, a mega 10 2018 pack. That's kind of fun. And it looks like maybe five of these five rarity collection blisters. Okay. That's super cool. We're going to pull him a ash blossom quarter century and then these would like start us overdrive and ancient prophecy special editions. Oh, yeah. Now we're talking. Okay. So this is going to be super fun. I mean, that's some good stuff right there. We're going to leave those back there. We're going to open up this somewhat newer stuff. I mean, 2018 was six years ago. So not very new. Let's see what we can get for whack job. I don't even know. I don't think 2018 has anything like super crazy, but we're hoping we get something. Let's see. FAA. We have duck dummy. Oh, skull dread. Saruja. That was a big card back then. We have trick star Candina and a twilight eraser. So Samurai skull. That's a classic dual links card. Love that orbital hydrolander. Also pretty awesome. All right. Starting it off. Not too bad. Saruja not good really anymore. It might even be like limited or something. I don't remember if it got banned or not, but I feel like it did. So I don't know if it would be good if it came back or not, but been a while since it's been popular pendulum paradox. Not as good as this.  So temple of the mind's eye.  We will burn deck and everybody say it dual links. Let's go. Okay. 2018's out of the way rarity collection time in a blister pack. Let's see what we can get five cards of glory. Will there be a 25th anniversary card? Okay. If it was, it would be right here. So we're just going to do that. We've got a pot of extravagance eldritch triple tactics talents. Not bad vision hero ferris and inspector border. So some great cards in there, but not the cards we are searching for. So far. Whack job is continuing history of not pulling the crazy stuff. Let's see if we can turn that around right here. First edition. We have dogmatica triple tactics talents. Charmini and a junk speeder with a little bit of a crimping on the bottom. Okay. What a pot of prosperity. That's not bad. Pot of prosperity is a great card.  But guess what? It only takes one pack. Come on. Whack job. You got to believe oil. Let's do make it. Let's do all the supers to the front like that. Boom like that.  That's a good pull. El Lich and junk speeder. So a couple pot of prosperity out of like three packs. It's pretty good. Got to pull something big and we got a couple of pot of prosperity is it's not bad, but we got to get at least one high rarity card, right? One high rarity card. Let's just get these ordered correctly. Herald of the arc light ash blossom. We're getting good cards. I mean, it's rarity. You're going to get good cards. Speaking of rarity rarity collection two is coming out in like a month and a half and we have pre-orders down below with sassy out to use my code for 5% off. It's an affiliate link. It supports me helps me buy more rarity collection to because we're completing the set. It's going to be amazing. Traveller good vote and chaos space. Okay. So last last try rarity collection. Come on. Come on right now. Give us something good. Give us something good. Give us a quarter center. This one feels thicker. This one feels like it's got some high rarity cards in it. Okay. Feels like it's got some high rarity cards. I think it does. I think it does. So this is the super, right? All right. Ding gear suit. We got elder entity. We have imperman so many good cards. Okay. No collector rears and no ultimate rears and. Oh, yes. Intus quarter century. So we did get a quarter century card. It is not like a very like crazy one, but if you're playing the dogmatica, you're playing the dark magician dogmatica invoked whatever the other one I played in the four, the four archetype deck and then that's pretty clutch should all there we go should all forgot about should all. Okay. I think we save. Let's do a let's try for ancient very dragon first. All right, chill out chill out starter server drive. Let's see what we can pull star dust over drive is awaiting, but ancient prophecy will bless us first with a ghost rare. What is our promo? Let's find out we have red eyes Wyvern actually like a six dollar card last time I checked. I don't think it's had a reprint unless it was in a speed dual set, which is possible. They like to reprint old formats and stuff like that in speed dual like Edison range of prophecy. I have pulled a go share. I'm pretty sure when we pulled the go share for was a free ex gamer. I thought it was out of a special edition. I'm pretty sure it was 123. I think it's what we do here. Come on emergency assistant. We have infernity beast pixie ring xx saber like a good genetic woman water hazard. Oh, no, it was wrong. It's the weird pack trick xx saber fault troll, which I think you just say xx saber just make it easier, but double x saber fault troll super rare not guaranteeing these some pretty nice two more packs, two more chances at the ghost room. I mean, ultimate rare wouldn't be bad either. We would not be mad at one point.  So we do three and then here's what the foil would be. So you do a little flippity flip like that. We have depth, amulet, rucks and special events draw fairy wind hydro pressure cannon battle of the elements like a good back at it again. We have magnum bar curry bond and genetic woman. So curry bond. Hey, we got it. We got a curry bow a female curry bow. Very cool ancient prophecy. Here we go. Last pack magic for ancient prophecy. We have, we have more packs after this, but last pack for ancient prophecy ghost rare. Here it comes Kwaki Miru. We have Kwaki Miru, slip and fortune, ancient leaf, armored axon brain research lab, sunny pixie gap shops of the baby gap and flambelle counter. So over on that one. That's okay. We still got starters overdrive. All right. So your, your buddy there. The ancient prophecy didn't do so hot. Okay. Didn't do that great. Let's see if we can pull. I don't remember this being in there. What is this tag force for cool. The new, uh, the new PSP game of new PSP remembers those. Those were awesome. I feel like they did not last as long as they should have. They were pretty amazing. I was a big fan of a PSP. I didn't have one myself though. Maybe that's why I liked it so much. Tim is magician. Okay. Little promo three booster packs of starters overdrive. Then we get into the Jinzo 10 from 2003 over 20 years old at this point. Let's see what we can do. One, two, three. I'm guessing it's the weird flippity flip. We have spider spider, ritual of grace reptilian Medusa attack pheromones, a pointer of the red lotus ritual buster, tune magician, fortune lady dark and relinquished spider. Very cool relinquished spider. Two packs left by cool. I mean not that cool because we are looking for foils and we have only gotten one so far. I think we got the fault rule right off the bat. So three flippity flop do that. We've got Stygian dirge, tune magician, spider spider, spiritual forest, infernity necromancer, attack pheromones, insect neglect, the cat a bull, bull pass and the witch of fate. Okay. And a metabo shark, a little Nemo action. Fish are friends, not food. Indeed. All right. Last start us overdrive. We've got two supers so far. We need to up it to an ultra secret really secret ultimate ghost is what we want. Any of those would be pretty amazing. Ultra still be pretty decent. One, two, three. Flippity flop floppy flip. Let's see what we can get when we rip. We have the synchro earthbound limit impulse gorgon, iron core armor, time passage, raising my plants and it happened again arch lord. Christia whack job. Your curse has been broken. Okay. This is not the first ad. So it's not this a $3,000 psa 10 or whatever, but unlimited still a $100 card. I think so. Wow. That is nice and sintering looks good on it. Pretty good. It's not perfect back looks pretty good. This could be. I mean a PSA 10 unlimited. I don't know what that would go for, but it's also very useful and Edison's part of the value. So I don't know what a PSA 10 would go for, but wow that. Okay. Two archs Lord. Christia. This is just like when we built dark magician girl on one time and then pulled it again like a month later. I guess archs Lord Christia was a couple of months ago, but still that's insane. That's a rare card. Like I've opened a ton of startups overdrive and not much since the last one and we've got to do it too. Like recently. That's crazy. Oh my gosh. That's an amazing bowl. All right. On to the Genzo 10. I mean, wow, that is amazing. I don't even need my knife. You get one. I say that. Let's just find one of those holes back here. Where are they? Or was it at the front? There it is. You can just do that. Okay. Yeah. That's that's the thing. When you have a rip in your sealed product, you got to be careful because you might accidentally just open it up like that. Okay. It's pretty hard to do that, but you know, it could happen. Okay. A little dented there, not in fantastic condition, but what we get are, you know, you get one variant card. There's my, there's my phone back there. Oh, there I am. What's up guys?  Let's go 2003 opening promos are not sealed in any way. They're just sitting at the back of the tin and usually they're in bad shape. So hopefully this one is not. Let's see. Based on the condition of the tin, I'm guessing it's a not in good shape. Okay. There it is. See it's kind of stuck back there. Let's see. Oh yeah. Based on that, this is not going to look good. Okay. Front regular secret rare. So I know like reverse or anything. Centuries off. Let's see about the back. Yeah. Yeah. That's honestly not terrible compared to what it could have been, but Jinzo. This is an amazing the Tinzo.  Check that out at the bottom. You have to see a little secret rare coming through the text box. That's amazing. That's a good looking card. Tinzo, little weird that it's a secret rare because you know, fair servant was a secret rare, but still very, very awesome and an amazing promo. One of the best ever made. All right. Let's get to our five packs.  So let's just see if we can get one big pull out of here because it's a 10 a lot.  Go check those out on the opening every playlist that I have. Uh, sometimes they go well. Sometimes they go really bad. So let's hope that they do not go badly here for a whack job. Okay. Labyrinth of nightmare huge shout out because I'm really enjoying this opening. This is some super fun stuff to open up. I love to get to open it up free content. Good stuff.  Of course, you know, especially if it's old school. Uh, then we're definitely interested. I'm trying not to destroy this pack, but it ripped a little weird. Oh, I destroyed it. Okay. That's fine. It happened. One, two, three, four, four from the back. We have a shining abyss. This monster employs the power of both light and darkness like Dargis, the original chaos monster. Mario Kutai, portrait secret, the dog door, Aqua spirit, spirit elimination, skull air, hysteric fairy. And here we go. Give us something big mask of brutality. Loomis and Umbra plan the mass beast. Discardious. I don't even remember how they talk. I got to rewatch the og you. Yeah. I know I've said that for like the last few months, but trying to get shells to watch with me, it's not that easy to get her to watch you go, but it's going to happen eventually. Just mark my words. She's going to watch it one day. Okay. Pharaoh servant one, two, three, four. Can we get a buster blade? I'm pretty sure because it's a 10.  We already got 10. So it's all good. Twin and a fire dragon. One of my original favorite comments back in the day. Imitation with dark sleep. We have mystic prove Solomon's the law book rucks and special against seven completed chanted javelin overdrive major riot. Can we get a foil here? Let's go. Pharaoh servant. Oh, a magical hat. So a very old school card. And speaking of the anime, this one is very prominent magical at super rare. That is amazing. Okay. Got a foil in the 10. That's so check number one. We're not over five. So that's great. Check number two. We want to get an ultra magic ruler. As you can see, doesn't have the original logo on any of these in 2003. They swapped it over from the original logo to the new red banner logo, which now has been changed again since then. Okay. One, two, three, four. Can we go back to back foils? We have snake fang. Let's get that relinquished. Let's get serpent night dragon wall. Shout out reverse would be pretty amazing. Stone auger. We have a chain energy turtle oath twin long rods. Numero dose course of sanctuary mechanical snail and we have painful choice another foil. Not an ultra, but another foil two for three. Honestly, pretty amazing. Check that out. The sky is very shiny in that card. I like it. I like it a lot. All right. Because metal raiders is my favorite set. It's going to go last. Even though this is legend of blue eyes and we could pull 2003 L of the blue eyes by dragon, which would be pretty amazing. Let's see if we can do it. We have done it out of a 2003 10 before. Let's try to do it one more time. Not one more time, but one more time. And then again, four from the back. Here we go. Can we get another one? I mean, three in a row is insane in an old 10 tear of the terrible. We have dark gray turtle Tigray, hard armor, frenzy, panda, all common are all normal monsters so far. Silver fang, electro whip. This is the one that's not a short print. I think King fog. Okay. Is it the next card? One, two, three, four, five, six, seven. Yes, it is. Give us that blue eyes, white dragon, dark magician, red eyes, exodia. We take those or a dark hole. So three supers in a row. So not pulling ultras, but we are pulling a lot of supers, spell card, dark hole, three in a row. That's pretty insane. Can we end it off metal raiders with four out of five? That would be crazy, especially if this is a secret rare or an ultra rare. Here we go. MRD. Bless up. Why does this feel like there's not enough cards in here? I don't think there's enough cards in here. One, two, three, four, five, six cards. A six card metal raiders pack. Okay. We got jipped a little bit. There's not nine cards. Look at this. Okay. Six cards. I just pulled it out. Nine cards per pack. What in the world? We got jipped three cards. So I'm guessing none of these are a foil. We're just going to have to turn around and find out. Okay. No cuts here. No cuts here. Kenneth, let's just, we want to show everything because that's weird. All right. Nina, what's that mean? Weird chicken. Can't. There's a rare cannon soldier. Oh my God. Picanha month. It's blessed the Picanha month. But you know what else isn't blessed. We only got six cards. We did get the best card in the set though. Picanha month. But three cards are missing. It looks like we would have gotten a rare anyway. So it's three comments. No big deal. But that is a little weird to see that an error pack missing three cards. All right. So that was a pretty awesome opening that ended in such a weird way. Thanks again to whack job for sending this up. This has been a super fun opening. If you guys enjoyed the video, don't forget to subscribe to the channel. If you want to purchase something from me, make sure you check out ruxin34.com. Shout out to Tom Fosho, Puffin Zidoo, Manester Dan, America Deutsche, KK Beats. Another side show, Ian Mooster Jr. Barney, Robert F. Thomas Belcane, Changelang and Al Delso, Galicia Jr. Thank you guys for supporting the channel. And I'll see you guys in the next one. Peace.


to the Brian Drowns this morning. Can you hear me? Yes. So it is a great joy for us to welcome Caroline Klaver this morning. Caroline is professor of thermology, epidemiology, Erasmus Medical Center Rotterdam, and at the Red Bound University Medical Center in Wagen, both in Netherlands, and as well at the Institute of Molecular and Clinical Ophthalmology in Basel, Switzerland. Caroline studied medicine and clinical epidemiology at Erasmus University in Rotterdam, and she received her PhD with honors and took several years of research at the University of Iowa and Columbia University in the US. Caroline is known to be multi-talented. In addition to conducting fundamental experimental research, she leads large-scale epidemiological studies and consortiums on eye diseases, but it is also a clinician. With such a broad interest, she really builds bridges between fundamental and epidemiological research and clinical practice. Right now, as a clinical principal investigator and research principal investigator, she leads a group of 40 persons performing genetic epidemiological and clinical and functional studies on various eye disorders. Caroline is actually fundamental in establishing and conducting several consortia to name the European Eye Epidemiology Consortium and the Iris Consortium. Her research lines cover myopia, age-related macular degeneration, glaucoma, and retinal dystrophies. And Caroline and her group have discovered multiple eye genes and environmental exposures, developed prediction tools for blindness, and is now performing functional studies, lifestyle studies, and imaging studies. Caroline, unfortunately, we cannot have you here in person today. I can say that you are not only an impressive scientist, but also a very funny and enjoyable person. And we are now looking very much forward to your lecture on myopia, and we cannot wait to hopefully meet you in person again soon. So take it away. Thank you for being here, Caroline. It should be better. Thank you very much for your kind words. And so we are used to meeting each other everywhere in the world. But right now, we will have to do it. You being in Utah and me being here. So I feel a bit envious because I hear that you could go outside and have vaccinations. And we are just hearing that we have to stay inside in the evening. And things are really a little bit grim here. So yeah, would like to visit Utah another time. But right now, I will talk about our progression in myopia. And I'm happy that you give me such a long time to talk so I can cover quite a broad field in this sense. These are my disclosures. So we are located in the Netherlands, so quite close to Germany. I'm actually located at several places. But most of my research work comes from Rotterdam. And this is actually the Christmas card of my research team, who I haven't seen for a year, but just on teams like everybody else probably. So indeed, we do cover quite a lot of research lines. I started doing myopia research in 2008 because we had many refractive aerodate and we were just beginning to look at genes. And we have some more cohorts. So what are we covering? We actually have quite a lot of studies looking at genes finding. And now we're doing some functional studies. We also have quite a bit of lifestyle data in our older people, but also in the younger ones.  In Rotterdam, we indeed have many cohorts. The Rotterdam study started in 1989 already. We now have three cohorts finished. We are working on a fourth cohort. And we have follow-up on the longest one, about 30 years. And refractive error was already one of the first variables that we collected. We also have a long-running children's cohort study, which we call Generation R. And that started in 2000, 2004. The children are right now 17. And we have been collecting refractive error data and OCT data, actual length data on all of them since the beginning. We also collected a high myopia case control study. So myopes, who most of them are more than minus 10 diopters. And we are right now looking into their families. And we started treatments at European about 10 years ago. And I will tell you a bit about that. So we also do a lot of collaboration work, mostly to look at genes. We started the cream consortium more than 10 years ago. And we indeed are involved in E3, the 3CC in iris. And we also work with companies in the UK Biobank. So what I will talk to you about today is about the growing problem of myopia. Why is it clinically so bad to have myopia or severe myopia? What can we do to prevent the onset? And what can we do to treat progression? And specifically, I will focus on who to treat, when to treat, how to treat, and when to stop. So in 2019, the beginning, we worked with the International Myopia Institute to come up with a set of rules for myopia, myopia research, but also for myopia clinics. And we, excuse me. So we came up with a set of classifications. So myopia is more than minus 0.5. High myopia is minus 6 or more. And pathological myopia is you do have to have structural retinal changes. We know that refractive error is very closely related to actual length, particularly in the higher degrees. And mild myopia would be around 24 millimeters or more. High myopia is 26 millimeters or more. So of course, I don't need to tell you this. We know that the problem in Asia is really significant. 80 to 90% of the 20-year-olds have myopia nowadays. About 10% to 15% have high myopia in that population. We in Europe have 50% myopia in 20-year-olds. And we are right now approaching 5% to 10% high myopia. We know from the extrapolation studies that in 2050, half of the world will be myopic and 10% will have high myopia. And this paper we recently wrote as an editorial to a Chinese paper showing that during the Chinese confinement, which was really, really strict, there was an increase in the myopia onset among the very young children, 6, 7, and 8-year-old. And no doubt, we're going to see the similar trends. So the onset of myopia is shifting a bit. It used to be, and this is actually an old study, around 13 years was the medium age. And we know that when you have an onset under the age of 10, you are much more likely to develop high myopia as an adult than when you have a later onset. So it's really the school age that we should be worried about. And this paper we wrote some time ago. We looked at the visual consequences of refractive errors and we did this in the Rotterdam study. And what it comes down to is that one in three high myopes will develop severe visual impairment in both eyes. Severe visual impairment would be 20, 70 or worse. And it's really very much related to the actual length of these people. So here in different colors, we have the actual length. So the red line is actual length of more than 30 millimeters. And you see this really goes up after the age of 50 and it actually goes up to 95% as a lifetime risk, both high severe visually impaired. When you see that the lower refractive error do not lead to such severe visual impairment, but anything beyond 26 millimeters does. So 26 millimeters is actually the threshold for severe visual impairment both eyes. And why is that appearing with age? We know that the collagen disappears with aging and when your sclera is already that thin at the back of the eye, it's much more vulnerable to these aging changes and you develop your staphylomas. And this can be look really horrific in the very severe highly myopic. And you know, when you develop these staphylomas, you don't have enough retina to cover it all. That's most of the reason why they are being of becoming severely visually impaired, but also the, you know, the well-known causes as glaucoma, retinal detachment and combined mechanisms were important causes. And a bit to my surprise, actually cataract in this population was too because a lot of ophthalmologists were a bit scared to operate the cataract on them. And the myopic macular degeneration can have all kinds of forms, the more focal atrophy, more diffuse atrophy, you can have retinal scises, retinal cysts, retinal holes, CNVs. And what you can see here is that it really is related to your actual length and it is related to your age. So does that actually mean if that occurs in high myopia that the lower refractive errors are off the hook? So we looked at the complete literature that was out there and we did a meta analysis to see what are the risks for all the different degrees of myopia. And here we are looking at the risk of myopic macular degeneration. And you can see actually that, how is this? So that it actually also happens in the lower degrees of myopia that it doesn't lead to severe visual impairment on both eyes yet. So here a moderate myopia minus three to minus six already has a 34 times increase of developing these changes. And even low myopia actually has some chance. We know that particularly a CNV, often in the end you cannot really find the Fuchs-Fleck and everything turned into atrophy. Other complications are retinal detachment. I think we all know that. How high are the risks? For low myopia it's actually already three times increased. Moderate myopia minus three to minus six, it's almost nine times increased. And high myopia it's 12.6 times increased. So significant numbers. And I think the people that do VR probably are already seeing some increased trends because we are in the Netherlands. So we looked at retinal detachment prevalence and in 2009 and then we compared that to the prevalence in 2019 and these are data from the different clinics. And you can see over that time period, of course also the people change during that age time but you can look at population, total population and do trends and do expected trends. And here I'm showing you this in the dotted lines. This is observed in 2009 and from the population frequency we have an expected line also with the little stripes. And then the solid line is the actual frequency of retinal detachment in that time. And you can see it's actually much more than expected. It's an increase of 44% and I'm quite sure people all over the world are seeing this and it's mostly due to myopia. So what about the risk of glaucoma? That has been around. I think most people know it's still very hard to diagnose real glaucoma progression in a myopia because the optic disc already looks so different. But when you look at course over time usually you can pick this up. Low myopia increases the risk of glaucoma 1.6 times and moderate and high myopia are actually kind of similar. They increase the risk of glaucoma three times. What about cataract? Cortical cataract does not have an association with myopia. Nuclear cataract increases the risk about three times to three times and the subcaptular cataract increases it in high myopia up to 4.6 times. Now I thought at this important day that you are changing presidents, let's put in some president statements. And this one is from the founding, one of your founding fathers in the United States. I think of a clever man because with all these severe consequences that we have not much, we don't have much to offer these patients. I would agree with him an ounce of prevention is worth a pound of cure. So what is that the view on recent presidents? So some presidents have some different views on prevention and there are coming presidents that would like to more stick to science. So hopefully the prevention, particularly for these kinds of traits will have more attention. So what about near work, the lifestyles? And this is a quite a recent paper. So it was quite clear from the beginning that outdoor exposure was protective, but there was always something iffy about near work and what the data were really significant. And to measure near work adequately is actually quite hard. And people have done it with questionnaires, parents fielding questionnaires, children fielding questionnaires. And it was not very reliable data. And I think this study, very large study from China shows more significance because of the large numbers. Continuous reading, watching TV within a meter and having a reading distance very close within 30 centimeters are significant risk factors in this cohort. And we did the same children's study. And I will come down to the conclusion of this slide. We found that already at the age of six, the children that are becoming myopic are more indoors. They have lower vitamin D levels. They spend more hours on screens and they indeed hold their near work at close. So what exactly is that relationship between reading, computer use, reading distance? So this is a bit of a comprehensive graph that we made from our own data in generation R. And you can see the computer use at nine here at the access right here. Reading time and distance over here. And we had less than five hours, more than five hours and then less than 30 centimeters or further away than 30 centimeters. What it shows is that it is basically the children that read a lot and do it up close and then have computer use more than seven hours per week are the ones that are most vulnerable to develop myopia. So what about outdoor exposure? The data is pretty convincing. And I often get questions from parents. So how long should the child be outside? And there's not really very good data from one study. So people put all the studies together and looked at the outdoor exposure in the different studies. And they came up with about two hours per day that is needed to be on the protective side. We also looked at this in our generation R study and we see when you have two hours per day or more, you grow like an emitrop. So we know that serum vitamin D is a good proxy. It's a good measurement for outdoor exposure. So we just looked at our vitamin D levels in our children. And we actually see that the children at six are only outside enough in the summertime. The rest of the year actually they don't come up with the right recommended levels for vitamin D. So particularly in Asia, they've done intervention with outdoor exposure at schools. And here you can see that it works. So 40 minutes per day extra outside their regular scheme and their regular scheme in China was usually less than an hour outside. It actually helped. So the intervention group had a lower incidence of myopia and they had a lower progression rate. So I see patients, I often have to come up with the practical rule. And so we have come up with the 2022 rule because we know near work is a positive factor, but it's actually the continuous close work that is most risky. So we tell the parents and the children do close work but don't do it more than 20 minutes after a continuously and have a break and look at the distance for at least 20 seconds. And then most importantly, be outside two hours per day. So I'll switch to myopia control because I wanna talk to you about that. Yeah, these were the papers from the IMI focusing on the guidelines for myopia control. What should you do? And basically this was a summary. When you do myopia control, you really should focus on actual length. That should be your target, not just spherical equivalent. Age is most suitable for intervention is between eight and 16. You should look at the children every six months for randomized control trials. They should have at least three year followup. Every trial should be aware of a rebound after stopping, especially if the stopping is when the children are still growing. And the intervention with proven efficacy are multifocal contact lenses, ortho-K and atropine eye drops. There are new drugs coming. They are promising that they still need more research. And importantly, these papers still don't give you any guidelines on when to use what. So I'm going to tell you a little bit of how we use our epidemiologic data in the clinic and how we do it. So we really look at the eye growth as a starting point. So when we have a child, we plot him in these growth curves. And these growth curves have been published in the October of 2017. And so we give the child a starting point and we give him a risk profile. So we kind of know what to expect. And we also very much look at the history. Is there a genetic myopia? Is there a lifestyle that predisposes to it? And what I also want to point out here is that when you look at progression of actual length, you have to bring into account the age of the child. When it is younger, so those are the blue graphs, it is the children that are between six and nine. They grow faster, as you can see in the growth curve. When they are older, they grow slower. So when you compare and look at trials, you should realize this, how old are the children and are there even the distributions in cases and controls and what are we actually looking at? So what it comes down to when we compare these different regimens is that the ortho-K and the multifocal contact lenses have an efficacy between 40 and 55%. And atropine has an efficacy depending on the dose, but for high dose, it's usually between 70 and 80%. I'm not going to give you a lot of data yet on ortho-K and the multifocals. We're currently doing some trials on that and I don't have all that data yet. But we know when we're talking about ortho-K among ophthalmologists, there's always this hesitance because there is a risk of microbial keratitis. So how high is that risk and which age group is actually the most risky for that? Ortho-K, the annual incidence is 19 in 10,000 children. When you compare that to soft contact lenses monthly, that is 15 in 10,000. And both of these, of course, are much higher than hard contact lenses, which is 1.2 in 10,000 children. Then when you look at the age group, it's actually the older, the people in their 20s that is the age group with the most risk, then the teenagers and the lowest are the younger children, which is actually the age group where you would like to do this. I'll focus more on the rest of the talk on atropine. We know atropine is a muscarine receptor blocker. We don't still don't know exactly how it works, but we are getting much more hints with recent studies. So we know that atropine can release dopamine and the dopamine is also the vehicle of why outdoor exposure works. So that's probably a real stopper. We know that it also works on other neurotransmissions like GABA and it actually is a mediator of nitric oxide. It doesn't only work on the retina, it also seems to work on the sclera. We know that there are muscarine receptor blockers in fibroblast and in chickens, it has a proven effect on fibroblast. So it probably works at multiple targets. The most important one from historical reasons is the Atom study. It was a Taiwanese study and it looked at different dosages of atropine and the outcome mostly was a referent of error, spherical equivalent progression. And I'll walk you slowly through it. It was a two-year study. Then the children were on different dosages. Here, the one with the triangles were the ones that had CBO and of course they had the most progression. At the red line, that trial was stopped and then the children were, the high progressing children were randomized again and the fast progressors were given 0.01% atropine. And what this shows that during treatment, high dose atropine has the slowest progression but when you stop, it seems to have a much higher progression. It seems to have a rebound and this is not so much the case for the children that had 0.01% progression. So let's look at that dose response and rebound more closely and I want to point out that after the red line in the third year, it wasn't a randomized control trial again. And because of this data came out, a lot of people said, oh, well, if in the end 0.01 works best, that's what we should do. And people say, this is interesting because it will have the same effect at lower dose but it doesn't have the side effects. And I think from a lot of medical school lessons we know that that is usually not the case and then I do dare to question that conclusion. So, and this data just got yesterday and I'm gonna share it with you. So here we looked at the real progression in all the studies that have looked at spherical equivalent and that have looked at actual length at different dosages of atropine. And let's look at spherical equivalent first. So we hear we have the different dosages, the dots in blue are the ones having treatment and the dots here in orange are the ones having a placebo. And what you can see here on the Y axis progression of refractive error. So if they're on the orange line, sorry, you can see that the children are having a steady progression rate. But on the blue line, you can see that the children having the higher dosages of atropine have less progression and this actually corresponds here with actual length progression. The children on the high dose almost have no progression of actual length. The children with the lower dose are quite close to the placebo group. So there really is a dose response effect for atropine. So let's look at rebound a little bit closer. So this is data from the atom one and two study. And here are the different dosages that they looked at. The blue represents the difference in actual length in treatment. The first year, the orange in the second year and the gray is the progression after the treatment was stopped. And you can see here actually in 1%, yes, there is a rebound, but it's actually even smaller than it was at the other percentages of atropine. And here you can see indeed in 0.5%, there seems to be a rebound, but you can see also in the 0.01%, the rebound is even more than it was in the placebo group. And actually when you look at this data very closely, the placebo group is kind of peculiar because it actually shows a very low progression during the entire time course. So when we first saw that atom data, I did get quite excited. I thought, let's just try it out in our clinic and see what it does when you treat children with severe myopia progression. So we did this study. We got referrals of children that were almost highly myopic. The mean spherical equivalent was minus five and a half diopters. They were already on the high percentile of the growth chart. We gave them 0.5% atropine in both eyes every night. To get rid of the side effects, we prescribed them multifocal photochromatic glasses. And we followed them up for three years. We saw that most were able to stick to this regimen. So here are our results. So we included those children that had a progression of minus one diopters per year prior to treatment. And this is what you can see after treatment. The progression was much lower and this corresponded with the actual length growth. We didn't have the actual length prior to treatment because when we got the referrals, optomologists still didn't measure actual length. And we looked to see how does the entire group compare to the growth that you would expect from a high myopic or from a myopic progression to an hematropic progression to a hypoopic progression.  And you see that actually about 80% of the children grew as an iPrope or as an hematrop after we started the treatment. So really slowed down the progression in the majority. 14 to 22% was still a non-responder to this treatment. Of course, there are safety issues with high dose atropine. We did experience allergic conjunctivitis. The frequency was about 3.5%. Also a dermatitis 1.3%. The first year that we did this, we didn't prescribe them any glasses or any adjusted glasses. And then the children did have lots of problems. So during the second year, we started prescribing them multifocal photochromatic glasses right away. And that really solved a lot and made the children stick to the regimen. We looked at ERGs, we looked at IOPs and we found no changes. So how do we do it in practice? When we get referrals of progressive myopia, we of course measure actual lengths. We plot it on the growth curve. We ask about risks we give in the 2022 rule. When the growth curve shows that they are on the 75th percentile or more, we prescribe them 0.5% atropine and we prescribe multifocal photochromatic glasses right away. When they are at the lower percentile on the growth curve, we talk to the parents and to them and we give them a choice. We will go for a lower dose of atropine, 0.5%, but we can also go to multifocal contact lenses and rarely we're okay. And we've discussed this regimen in an article that we just published last year. So let's look at an example. We have a girl seven years old. She has a familial risk. She is a reader and she's already at the 95th percentile of the growth curve for her actual length. We started her on 0.5% atropine. She did well, but at some point she kind of lost the control. We increased the dose to 1% and then it was really stable. And now she's about 12. We are actually lowering the dose again and looking at the progression. So this is what we will do continuously. We will look at the progression rate, plot it in the growth curve, see what her expecting growth is and then either taper the dose, increase the dose or leave it there. How long do we treat the children? We usually go up to 15 years. And this is what parents and children really like. We actually plot it in the growth curve so that they can see the results of their treatment. Now I will end with a case to wake you up in case you fell asleep with all these slides. So I have a girl 11 years old. She has no history of my OPM. She's otherwise healthy. When I asked, did anything ever happen in your life? Parents said, well, she had a sepsis postnatally and it was a staphylococcus aries. I saw her, she was minus four and a half diopters on the right eye, minus five and 25 on the left eye. She had an actual length of 22.7 and 21.6. And I think anybody looking at these children probably already sees that this does not correspond well. So for that refractive error, I would expect a much higher actual length. I looked at the slit lamp, whether I saw anything peculiar. I found a normal cornea, but I did find some lens, some pigment on the lens at the front of the back, but the lens itself was otherwise healthy. I also found a normal retina. So I was puzzled. I don't really find anything in the eye that explains it, but this really doesn't correspond why is the child myopic. So even though I didn't have a hint, I did consider that she was having a carrot bonus. And I did a pentacomb, and although I'm not a corneal specialist, I did see that this was a normal cornea. So then I went back to my biometry and something peculiar I did see when I looked at the lens thickness. The lens thickness of this girl was 3.9 and 4.5 millimeters, and normal for this age is 3.5. So she had a lentil myopia, and of course I didn't treat her. So in conclusion, myopia and a long actual length are becoming a problem for all of us, especially for us ophthalmologists, because we will see much more of the complications than we were used to. One in three high myopes will become bilaterally, visually impaired, but low and intermediate myopia also have considerable risks of ocular complications, retinal detachment, glaucoma, and counteract. Prolonged near work, low outdoor exposure in children are indeed major drivers. And when you translate this to the clinic, the 2022 rule is good advice to children. Very importantly, myopia control should target actual lengths, not spherical equivalent. Start at school age and continue long, do it up until the age of 15, especially fast progressions and those with high risk of high myopia ask for very tight control for a long time. And I've come to the end of what I wanted to share with you this morning. I thank you very much on behalf of my research group for your attention. And of course, the floor is open for questions. Thank you. Thank you, Caroline, for this wonderful, exciting and impressive presentation. Thank you for sharing this with us. Now, Ellie is helping us a little bit with the questions and they may be in the chat or you can raise your hand and maybe I may start with the first question. It's a question as an ophthalmologist but maybe more as a concerned mother. So right now in the situation with corona, with lockdowns, especially in Europe, what do you expect from this time? And I would be interested, do you already include this research question in your work if this situation, my experience, you mentioned seven hours a week. I'm a little bit afraid because of course my boys exceed this time. And what are your thoughts on this? Caroline, you will need to unmute yourself. No, I said, no, I recognize exactly what you say. My boys are a bit older and they're 14 and 16 but they walk around like this everywhere. And I really struggle of getting them outside. I'm so happy, I chose a school that is far away. They have to bike to school. So at least I get an hour there. Then I put them on soccer and they play soccer three times a week. So at least I got that, but it is difficult. And I think especially with the lockdown and the severe lockdown that we're going to get next week, it's difficult. And so actually when this editorial came out, I did make a press release out of it. And I've already been interviewed by radio a lot and there's a television program also paying attention to it. The newspapers are interested. So I really think we should make noise about this because we will get much more myopic progression than we used to. And what we've also done is we have, are collaborating with people that are youth doctors, pediatricians, orthopedics, and people that are on the educational experts and looking at the healthy schools. And we're actually trying to get in the schools a program that children at school will have much more secure outdoor exposure than right now. So when you just walk into an average school and look what they do during recess, actually a lot of children are inside working on a computer. And we're trying to change that attitude so that they are put outside, door is locked and they really get outdoor exposure. But I agree it is difficult and it requires a lot of effort from a lot of people. Dr. Klaver, my name is Jeff Petty and I can't thank you enough, it's been extraordinary. I have two questions that if you'll allow. I was really struck by the Lenthal Myopia case and I just like your recommendation for following axial length rather than simply following repraction. And then the second question is in regards to an IOVS paper, a review paper of Myopia, and there they noted that African blacks have the lowest progress. Non-African blacks have a higher progression and then they even found that within the community of African blacks that in urban settings as would be expected, Myopia progressed more rapidly. So my question is, I think it's easy for us to assume that certainly there's less near exposure broadly in these rural areas in Africa. But do you also feel that there's something genetic about Africa populations that is indeed protective for them in the progression of Myopia now? Yeah, thank you. Your first question, can you repeat it just a second? Sorry, what should the role of tracking axial length be as opposed to simply tracking the program? I'm actually happy you asked that question and I really wanna make a point this morning that you really have to look at actual lengths because that is where you get your morbidity from. It's really the structural changes at the back of the eye, the thinning of the sclera that is causing the problem and spherical equivalent is such an indirect measure. And when you look at the population at large it does correspond quite nicely, but especially our clinical referrals, they're mostly not the typical patient and you really have to do your clinical workup really very extensively to figure out what is the cause of the Myopia in this particular patient. And yeah, so I think it's kind of difficult 50% of the population is turning Myopic, we cannot see all the children in the clinic, right? We need to work with opticians, orthoptists and people that are working outside the hospital. But right now we're making a big fuss that they also have actual length measures. And they, whatever, if they treat or it okay outside of the hospital, do it with follow up of actual length. And I really think we have to convince that community to get these devices. Second question, so it's interesting because when we first started our genetics of course we thought all the Asians like AMD they have different frequencies or maybe some different genes. We were quite convinced you couldn't get there only by environmental factors. And we really looked hard in a cream when we had the Europeans and the Asians and I really didn't find anything. When we did find changes it was more the G by E interaction. So it was what they did with their genes that gave more Myopia than what the Europeans at that time were doing with their genes. So it's really an enhancer your environment. And actually right now I'm looking at sex, female versus males. And in our older cohorts we see the males are predominant the ones developing Myopia. But in our children cohorts it is the females. And when you do a mediation analysis and you really look closely at lifestyle and education you see actually that explains the whole sex difference. And I think this is also the case with the blacks. And when you really follow up closely with the environmental factors it will predominantly explain differences. There will be some slight changes of course. But I think most of it is environmental. Many thanks. I think Dr. Dardeen had a question. Thank you for that wonderful presentation. That was just very informative and a lot of great work you've done. I am a pediatric ophthalmologist here at the Moran and have been treating with dilute atropine for a couple of years. And I was impressed how often you were using those stronger concentrations. I just was curious how often are patients having to discontinue that even with those photochromatic or the progressive glasses were they tolerating that 1% and 1.5% fairly well? Yeah, so we looked of course very closely at adherence. So our adherence for three years was 73% which is actually the same thing as what multifocal contact lens trials are getting and what ortho-cagal lens are getting. Everybody's getting between 70 and 75%. And so I think with the right regimen you really have to discuss it well to the parents. I make a big deal out of that. And I also tell them the first month is the hardest. But it is really amazing after a while how well they tolerated. I'm even surprised at it. And when I just started, we just thought we actually did it ourselves too. We started doing these atropine high dose drops ourselves just to get a feeling of how terrible that was. And with the right glasses on it is tolerable but the children do much better than we do. That's my experience entirely with children. They're very adaptable. Another question is, so do you think the lamp study when the phase three and four come out about these different lower concentrations of atropine comparing 0.01 to 0.025 and 0.05? Do you see, it sounds like that those results may not change your algorithms because they still probably won't be as potent as the 0.5%. Do you see that adapting, changing your clinical care at all? Yeah, I do. So of course, I'm a retinal specialist. So I came from a different angle doing this. And I just thought I was worried about these retinal problems. So I was a bit more aggressive than most of the pediatric ophthalmologists that are taking more care of the person behind the eyes, I guess. And so right now they are promoting very much atropine 0.05 because it did very well in the lamp study. And right now I'm saying, I'm not convinced that's what we should go to do that for all. So we've been setting up a trial, 0.05 against 0.5 and we hope to start that this year. So I think that should answer a bit who really should have high dose, who is okay with low dose and if you can actually combine it. You know, this is what, in practice, we do taper a lot. So I never stop a high dose treatment all of a sudden. I always taper back to 0.1, 0.05 before I stop. Oh, that's very interesting. The, I'll look forward to those results. I've got just, I'm so sorry, I've got one more question since I do a lot of atropine treatment. The, do you ever use this since kids who have genetic causes for myopia like sticklers or congenital stationery night blindness? Yeah. So yes, because as a retinal specialist, I actually got lots of referrals for children with retinitis pigment, TOS, CSMB and et cetera. I thought, let's just try it. So I did try a lot. And so my experience is the response is usually less. There's more non-response, but it does work in about half. And right now we're getting our data together to, you know, to see what we actually had. But this is my clinical feeling that in about 50%, it really reduces the speed, especially like RPGR, you know, those are really fast progressors of myopia. And we know that our PGRs, they do better if they have a lower refractive error. So I think there is an incentive and there is a group where we should try to lower their refractive error. The sticklers actually you often see them with a very high refractive error, but they're usually pretty stable. So for those really monogenetic cases, I wait. So I want to see progression of actual length at least for half a year before I start a therapy. Wonderful. And what about patients with ROP status post laser? I know that's a different mechanism. That's not necessarily actually a length elongation. Have you tried it in that population? I have tried it, but I don't have really good numbers to come up with any conclusion there, but I do try it. It's quite easy, you know, to start with atropine. And if you have a progression line and you can see that it stabilizes, I think you have a point. Thank you for such a wonderful presentation and answer my questions. Thank you. It looks like there is a question in the comments from Dr. Dick's Petty. It says, have you looked at combining treatments such as atropine plus or okay, and its effectiveness compared to atropine alone or okay alone? I'm sorry, I didn't hear everything, but I think the question is combination therapy versus monotherapy? Yes, sorry about that. Yeah, so we do actually clinically do it, combination therapy, especially, you know, those almost 20% non-responders for high-dose atropine. I did try to combine it particularly with multifocal contact lenses. And because you get rid of the side effects right away and it also works by another mechanism. So that's tolerated pretty well. I don't have enough numbers to really show that it works better than monotherapy. But in my clinical experience, I'm pretty happy with it. Okay, are there any more questions? If not, I think we all would like to thank you again so much for this wonderful presentation and also this really insightful discussion. Caroline, we will give you a small break, but maybe you stay in this room so we can talk about the one-on-one meetings and then at 12 o'clock. Caroline will give another presentation and this will be more basic size and genetics. And we are looking much forward to hear from you at 12 o'clock. Thank you so much. Okay, thanks.


Today we're doing the 1v1 no-budget fishing challenge. Me and my boy Adub are going head-to-head to see who the no-budget champion is. We're on my bass boat that's loaded with thousands of dollars of fishing tackle. We can use whatever we want in the boat to get the job done, but there's a twist. This fishing challenge will be split up into three different contests. Contest number one is whoever catches the first fish of the day. Contest number two is whoever catches the most fish of the day. And contest number three is whoever catches the biggest fish of the day. Whoever wins two out of the three contests in three hours is the champion. We are back on the boat boys. It has been a while you guys have been waiting for it and today is the day. I'm out with my boy Adub. If you guys want to check out this boys channel, link it be down below. But we have a little tournament action going on today Adub. Before we get deeper into this video, only 27% of y'all watching these videos are actually subscribed. So if you could take the time hit the subscribe button. It really helps the channel. I'd appreciate it. So there's three sections of this tournament. Whoever catches the first fish gets a point. Whoever catches the most fish gets a point. And whoever catches the biggest bass gets a point Adub. And that's how we're going to run it. Three hours on the clock and it's going to start now. So let's hop into it boys. It is such a blessing guys to be out here on the boat. It has been a while since we've been on the boat. We had a lot of issues and we have what seems to have them all fixed now. So we're just going to be kicking it on the boat today. Super pumped man. I've been excited. I could barely sleep last night. And it's one of those days today that's just cloudy and nasty. And I think these big fish are going to be biting. At least that's or hoping. So the whole deal with this $100,000 budget is that we can use anything in this ding bass boat. We got a bunch of rods and reels. We got Adub with some mock combos down there. We got some kick in their bass TV, ex-luse combos up here. If you guys want to check them out kick in their bass.com. And then I got a bunch of different very nice loose setups up here. So anything in this bass boat is included in our budget to try to catch these big bass today.  And I got mock jack spinning combo here that we're about to rig up just a little drop shot. You know, we're in the springtime right now and we're heading into the springtime. I'm expecting to see some fish pushed up shallow and I'm also expecting to see some fish out deep. I'm going to expect a little mixture here. We're going to be fishing some flats today. We're going to fish up on the flat. We're going to be fishing some laydowns and some trees. And we're also going to be fishing out deep. So that's the game plan. And I noticed I broke my leader off the other day. The only fluorocarbon I have in my boat is dang. Look at this. 17 pound, man. So I guess we're fishing 17 pound leader line today. Very finesse approach. Yeah, very finesse. Hey, it's more finesse than that braid now. So that's just what we're going out of the rock, man. Not ideal, but listen. And something happens like that. You just got to, you got to figure out a way. So we're going to have a little leader. I'm not going to make it big because if I do, it's going to be going through my eyelids like a mad man. Did you say your eyelids? I always say that. My eyelids. All right, y'all. I am rigged up.  We've also got a little minnow style bait on my spinning rod if we do get on the fish out deep. And then I've got another rod right here set up for cranking just in case we need to catch them cranking. But I'm thinking that for the shallow bite, just fluke right here is going to get the job done. All right, boys. We're going to grab us a little crawl too. Let's see what we got. That's a good nice color like a green pumpkin and purple. This is the new little secret crawl and throwing it up on a Texas rig. So we're going to have a drop shot for how deep we could throw a shallow to. We got a Texas rig for up shallow. We're going to have a deep crank bait just in case we spot some of this fish on the edge of that drop off. And then I have a lipless crank here right now. Might change that to a trap, but we'll see. And that is what we're starting with. So let's go ahead and get into this. All righty, Doug, you ready? Ready. Three hours on the clock starts now. Let's get it, boys. So whoever catches the first fish gets a point. That's going to be the call and call on who gets the head start because say I catch the first fish, you have to win the other two, which is biggest and most even win the challenge. So we're going to get after you guys and see what happens. We haven't been up to this lake in about a year and last year I caught a lot of big bags out of here. So I'm, I'm pretty pumped to just be out here. I think it could be pretty crazy. I'm starting off with a little red eyeshadow. Just kind of throwing up shallow so we can catch any that are roaming up on the bank, heavy clouds today. Some fancast for a little bit. Now I kind of want to scan out deep and see if we can catch some of those fish that are more offshore. By the way, I don't know if I told you guys, you can get these on KickingTheBast.com. You can be linked down below. When I was fishing this last year, guys, there was a lot of fish, you know, up shallow, up on the bank bedding. And while they were bedding, I wasn't even fishing up shallow. I was fishing out offshore still. There's still some other stages of fish that were still pushed off. That might be our chance today to catch a couple of double digits. I think are going to be pretty deep. And I don't think it's far fetched at all what we can hook into. It just looks like one of those days for double digit fish.  Oh, those are some nice ones too. You know, one thing I didn't do, that probably should have been prepared for. Dang drop shot, dude. I didn't put my bait on it. I probably could have sniped one of them puppies. Just thinking about my 17 pound Linder line, boy. I think it's going to work if they're hungry. If they're not hungry, I don't know. Oh, boy. I just got slammed, Adub. On the dropy? Oh, yeah.  You're more than welcome. I knew I was going to do that. Thank God it didn't. It broke my dang bait though. Oh my gosh. You all good over there? I knew it was going to happen sooner or later. Holy cow. Broke my dang bill right off, boy. At least we didn't lose the gopher, guys. I actually had a gopher up on the dash like that before and I flung the whole thing in the water. All right. We good. Thoughts along. Oh, I got bit. Did you? I was about to say one of us were on it. 100%. Oh, I saw them eat it again. I don't know if it's a bass. Was he slamming the heck out of it? Not good.  That's what it almost feels like. You got one. You got one. Dang it. Oh, you can't be kidding me. Hey, I caught the first fish. That's the first point. Dude. There's no way. Talking about 10 pounders today. Look what I just caught. Dude, you gotta be jocin' a cast, man. You're jocin' a cast. Dude, I couldn't even tell I even had a fish. He was so small. Well, eight of us got the first point, boys. He got the first fish. Dang it, man. Especially when it's one that's small. Like, at least give me something to look at, you know? But hey, you did get the first fish. So that means I got to catch the most fish today, guys, and the biggest fish. Pretty much what that means. I got a big fish right now. You got big fish and you got the most fish at the very moment. And I got the first fish. That means I win. Challenge over. So we've fished for a good bit now and just we're just scouting, trying to find these fish and just playing around. And we were searching out deep for a long, a good while there. We just decided to come up a little bit shallower and then he done gets dumped by a dang solid five-incher. He was a solid one, though. I can't believe you did. Damn, deal with that, dude. You know, I might have been a little excited. It was like a big even though you got the first fish, but five-incher ain't.  Hopefully we're going to stay shallow for a little bit. So I'm rigging up a wacky rig. I don't see if it's going to work, but I will say that this lake has a lot of grass on the bottom. So I don't want to fish a bottom bait. This is what I'm going to do. You're going to put on a shallow bait, then I'm going to take us out deep.  And then you're going to put on your deep bait and I'm going to take us back shallow, you know? That's exactly how you're going to do me. So then for the next three hours, you'll just be tying on. Makes sense. Guys, I'm not going to go with a dang chatter dogs. I'm going to go with a black and blue. It's kind of feeling it. See what's happening? He's tying up, so he takes me off the bank. That way I can't cast up there. Yeah, man. The sabotage is what it is. It's just being a good strategist, brother. You know? Tell me that won't give much for. It was good. No way, bro. That's what you get for sabotaging me. Calm down back there, I get thrown in the back of the boat, came and cast, and I'm still winning. So with a wunker too, man, you got a big fish. I can't believe it. There's some fish up there, Adam. I know if I could only cast one. If you can't make it to the bank from where you're at, we got a bigger issue. Well, we have a bigger issue because I can't make it. Oh, I just have one pick me up.  I swear. Dude, I'm not playing this game. You're jacking my leg. He didn't eat it, but he hit it. I caught it. I think that's bigger than yours, Adam.  If we would have flopped it on the scale, you know? Honestly, it might have broke my scale though. Dude, that is 100% bass out there. Oh, it's dang something. Anything but a fish is what it is. Dude, there is so many fish on here. Adam, look at this, bro. Come here. I don't know what these fish are. Dude, I just got... Yes, sir. Oh, that's bigger than yours, boy. Oh, it's a nice one, boy. Come on, Adam. That might be a little bigger than yours. Oh, you barely bit that thing too. I had to sit it down there. There's a lot, a lot of fish right here. Dude, that fish is nice, boy. All right, boys. We just got laying this puppy. It's a good fish. Oh, yeah. Easy three. Easy three. You see this, Adam? Oh, yeah, baby. Here we go, boys. Adam might have got the first fish, but we got the biggest and we're tied them with the most at the moment. Not an absolute giant, but that's a dang good fish. Three pounder. Yes, sir. Three point two, boy. Three point two. And that is the first fish for me today. That's a nice one. Thank you, baby. There we go. Come on, now. Come on, now. We on board. A lot of fish down there, man. No way. Oh, no way. Dang it, tall. Here, I'll catch him.  You're going literally right to a one that just bit me. Look at my hook.  I know you are on it.  Oh my goodness.  I love you, but please, can you bite mine and not his? I'm glad we found a little stack of them finally. You get these fish to eat here. There's no way. No. Oh my God. Dude, that thing's crazy.  I didn't break her all bent my hook out again. Got him. Yeah, it's decent. Oh, he's not that good. Oh, that's a dang three pounder though. No, I think he's a two. Oh, no. Hey. He's fighting good though. That's a three pounder though. No. Let me see. You better hope he's not. That's a three pounder. You better hope he's not because he might beat you. Yep. Yep. Noah lies about the weight in all his videos. Noah says it's an eight and it's really a four. Just so you guys know, he says this was a five pounder and look at it. It's a solid, probably 12 ounces. No, that really is a two pounder though. You should have weighed him so you got your big. Well, he wasn't gonna beat it. He's not gonna beat yours. All right, guys. Well, eight of just took the lead, man. I like this, though. I like the little back and forth action. At least not one of us are putting a spanking on each other right now.  We're throwing the same bait, but we got two different rigs, guys. I got the drop shot. He just has a little jighead. I guess we're gonna find out what they eat the best, man. We're gonna tie on some different baits and be throwing some other things, but I guess we'll see. There's a lot more fish down there, Adam. Oh yeah. There's so many. Oh no. There's so many fish down there. I broke my dang leader. You know what? I'm gonna try it real quick. Let me try this thing. I know it's a dang Texas rig. Oh dude, it just came up out. Baby. Give him something different here. I'm going right up in that puppy. Big and big and grab the net. For real? Grab the net. Grab the net. Oh, that is a monster, dude. Oh my God, Adam.  That is a giant. He ate the freaking crawl. Look. You hang a lot. I think I might have just stepped on your muffin. That's okay. Screw the muffin, Adam. Net the fish. Let go, baby. Come on. Give me some now. Yeah, he got me so wet. I know we aren't on the same team, but come on now. Oh my goodness, boys. Look at that. That's a freaking tank. Dude, first cast on the crawl. See, we don't need no shaky head, man. Look at that dang Texas rig in there. He smoked it. I had a weird, like, left-handed hook set, too. Oh my goodness. That's a high four. It might be five. We have the same amount of fish, but this is upgrading my big fish and I feel good. Anything can happen out here, though, guys.  Almost a five pounder yonder. And that is a beautiful fish, man. Get a nice little release on that puppy. Throw in the drop shot. They weren't eating it. Pick up that crawl five pounder. All right. It's anybody's ball game. I'm feeling good. I'll bet you are. Catch a five pounder. You know what? I said I ain't tying that drop shot back on. I'm just gonna whip my dang Texas rig. That was the best decision I've ever had. That little green pumpkin purple flake. A little juice secret. Oh, look at that secret crawl. It looks good. Well, guys, it has been, it hasn't been the fastest day of fishing. We're putting together something here and we're getting some bites. 8 of S2 fish. I have two. I've only caught two, but I have a three pounder and almost a five. So I'll take the size. We're gonna put on another one of these crawls. And you know, this is normally something I wouldn't throw down in a brush pile. If I'm throwing a Texas rig, I'm mainly throwing up on some laydowns and shallower cover.  Let's pick up this Texas rig and see if we can make something happen with it. I was telling Adub, she grabbed that thing and I had to do this awkward left handed hook set. I was scared I wasn't going to land her, but get to that. Get to that. You never know. I hear you know it. I didn't know if she was doing four pounds, five pounds or eight pounds. So I was just like, I just knew she was hefty. Step on the muffin and everything. You see, this is some of the sabotage and stuff we're talking about earlier. He's just doing it in a different manner. I'm gonna be real. There's one thing you don't do. You don't mess with a man's muffin. Okay. Well, I'm about to steal all your fish. I'm putting on the mighty shaky head. Oh no, you can't do that. Yes, I can. That's not, that's illegal. Did you not read the tournament handbook? I did. Everything's allowed, but no shaky heads. Well guys, we're gonna rig up another drop shot. We got a little bit of rain pushing in here. Hopefully it's just going to stay like this and not dump on us. That'd be a little upset. Not even gonna lie. Right, when we start to figure something out, if it starts raining, I'd be, I'd be a little irritated. I'm just gonna tell the same nose hook on. I would usually put like a little straight shank drop shot hook, but Adam's got these dang extra wide gas back here. I ain't every time one on again. Adam, Adam said, that's the best jar shot hook in the game. I never said that. I've never lost somebody fish on a big drop shot in my life. Never tying that on. You know, we're tied right down the middle right now. You got the first fish. So you got a point. I got big fish currently. I got a point and then we both have two fish. So we're straight up tied in the tournament right now. All right guys, old dropper shot. It's tied on. Adam actually gonna put a worm on this time.  What? Is that a fish? I don't even want to talk about it, Adam. How did that just snap me off like that? I've never snapped a crankbait off like that in my career. Dude, I just had a massive follower. Oh my gosh, please come up here and eat it. Dude, what is he doing? He chased me all the way to the boat. What was that noise? There's your crankbait. He didn't break it off in eight minutes. Hey, there you are, bro. Look at this. Hey, come here, boy. I knew you would snap it, bro. I was just joshing your tots, you know? Does that count as a catch? Bro. I got three.  Yo, he just came up and said hello. I've never seen that in my life. Thank God, man. I didn't want to lose that crankbait. I really didn't. That's funny. Well, now you know it wasn't eight pounders. Do you think I need to put that dang swim bait, that flute back on? Adam had two fish on the stank thing. I had one, so says something. I thought he ate you and he ate me. Boy, Adam right here. That's another good one. On the way. Yep. It is. On the crawl. Yo, I need a tie on the drop shot so I can break it again. Golly. There we go, boys. Fish number three. Dang crawl. And I fed it to him, boy. Look at that. Right in the nose. Like a two and a half pounder. We'll take them though. I don't know. The crawl might be the move, dude. Actually, two pounder. Let's get it. Fish number three for me. All right, boys. We're sitting in the lead. Oh my God, almost hit that bird, dude. No way. It's crappy. Dude, that is a mega, dude. Mega crappy. Yeah, what in the world? That's a slab, son. Oh my goodness. Look at that. Tied for fish. Hey, you tied. That counts, man. Oh my goodness. I would have never thought that was a crabby. This is a dang slab, dude. This is a monster, man. All right. Well, that's 338. Gosh, dang it. What's up, man? I was thinking about you earlier and then I was like, that can't be William. How you been? I've been awesome. Yeah, no, it's been great. I wish the weather was a little better, but at least we're not getting rained on bad, you know? You caught any big ones recently? There you go. It's good to see you, man. I'm glad you're doing well. Guys, I don't know if you remember. That was William and I was out here one day smoking him and he was fishing. He was on his John Boop, but I went up and I was catching him so good and he pulled up to me and he was wondering what I was doing and I just told him to hop on the boat and he ended up catching his biggest bass of his life. Let's roll that clip real quick. Did you get him? Yeah. Oh my gosh, brother, that's a big one. That's a big one. That is a monster. Oh my gosh. Look at that one.  He's like, that's William over there and I'm like, that's not William. He's not on the John Boop. Sure enough, it was William and William can catch him now. All right, boys, this time three to three, we're going over to this spot where I caught dang five pounder and my first fish.  This fish has been just, I don't know, we're having the force feed them today. They're not really eating that well. That is okay. We're still catching fish and I feel like we're cast away from a 10 pounder and anything can happen. This GoPro going to come off today. You all okay back there? Dude, I got a little tiny. You know what that is? That's the lead. That's the lead, brother. And guess what? I did it in fashion just like your first day. Right there, boys. Listen, that ain't a big one. That's fish number four and that takes AW's lead. All I felt was just a little tiny. I didn't even have a lead. We were tied. You're right, you're right. We were dead tied, but guess what? Now I'm winning, brother. So you better catch something. Guys, a little update. These fish have shut down. I caught that little tiny squirt and other than that, Adam caught a crappy probably about 30 minutes ago and we haven't had a lick. So we're just hunting around, trying to hit some more of these piles and hopes that we can get a couple more big bites before the time's up. But it has been an interesting day. You know, we have these storms rolled in and this weather's just been dark and nasty and those fish don't seem to like it besides when we caught like three fish in the span of 20 minutes. We're going to keep on hunting and hopefully we'll catch another big one or two. No, dude. All right, guys, I had this idea of putting on a little crappy jig.  What did I hit? I got hit. What else would I have hit? Dude, I was rolling in all of a sudden, he was like, watch your chicken. Bro, he bopped it, dude. Coming down to the electric chicken. Man, if we don't run out of time, I come around the dang rock paper scissors and catch another fish. Oh, no, dude. I'm not full of it. He actually hammered it. Bro, I told you, I had to start singing to him. All right, guys, we are fishing shallow now. I spent the whole day out deep, probably regretting it. I threw my second cast up there and got popped. I guess we're going to see. Still throwing this little tiny Texas rig, put it on a stenco, green pump can. We only got 20 minutes, guys. The time's ticking. I'm hoping to get another fish on board here. I'm already leading. If I could get another fish, kind of make sure we slick in and make sure we hold that fish count. We'll be looking pretty. Yes. Good one. There is no way. Yeah. On the stenco? Stenco. No, put your crawled down. What are you doing here? Oh my god. She choked that puppy. Dude, gone. I can't believe I just caught a bass. So what does that mean? That means we're tied. Four to four, a little bit of time remaining. I got to lock in here, guys. I got to lock in. Beautiful fish. I pulled it out of her mouth, dude. I pulled it out of her mouth. Oh, literally, dude. She ate it and I just like, oh, she might be able to bite it, bite it again. Dude, I'm telling, what is going on? She ate my dang skirt, boy.  It don't end this way. It don't end. I can't believe it, guys. We got to lock in here. That was a good dang bite and I just, I don't know. Please, fish. That was actually a big one, Adam. That was actually a big one. They're not, you know what they might be, isn't that weird pre-spawn? That was a big one. I felt her too. I stuck her. Gosh. Yes. Yes. Good fish, too. Dude, I am stuck. Listen, it ain't over. It ain't over yet. I got to get this one in the boat, though. Yes, we're doing it. Yes, sir. Maybe I need a wacky rig to hook them in. Dude, I ain't going to lie. That fish, that one, the first one, I think was small. That second one had some weight on her, dude. Dude, look at that boil. No, just look at the boil. It just like boiled on my line or something. Oh my gosh. Come on, baby. Come on, baby. Come on, baby. Dude, we should have been shallow all day, Adam. What are we doing? Oh my gosh. Listen, that ain't big, but that is five to five. Let's go. We're back in the game. Somehow, Adam just was making a comeback. It's been back and forth all day. We got like a couple minutes of that. Next bite. Come on. I'm throwing back in there. I happened to catch another one. Oh, that's it, Adam. That's the time? Yeah. So what do we do? Should we do a 30 minute like, I mean, we're tied? I'm not tied. All right, guys. That's what we're going to do. We're going to set another 30 minutes and we're just going to keep on fishing for the last 30 because at the end of the day, he got the first fish, which was one point. I have big fish currently. That's two points. That's a point for me. And we're tied on the fish numbers. All right, guys, we're probably going to run to this other pocket real quick and just see. We got 30 minutes, whatever happens, happens. All I know is they were up shallow and we caught. We could have had five or six fish right there. That was insane. We've been killing ourselves out deep all morning. We probably could have went up shallow and just spanked them, but I don't know. All right, boys. We made it to the other side. We're going to fish back in this pocket. We're going to fish the mouth here and see what we can do. Dude. What? You didn't think grass? No, one ate it. No, he didn't. Grass bite sometimes feels really good. That's it. He's going to be on that cast right there. Dude, I saw your lime running. These look like it. I don't know, dude. Might have just been a tree bass. Oh, oh, he grabbed his feather. Oh, that's crazy. Just watching Duke it out, dude. All right, guys, we did not get any bites in this backcove. So what we're going to do is we're going to go over to the bow ram, throw a few of the pocket, and then we're calling it there. All right, man. Who's going to do it? Oh, Adam. What? There's a big boy on the sun. Hey, man, calm down. Calm down. You called my name. So that was a free invitation to cast. Calm down. All right, what's going to happen, boys? I did not think this challenge was going to be as close as it is. Oh, yeah. And I got him. Oh, I got him. What you going to say about that, son? Hey, we got five minutes, boys. So guess what? That's fish number 60. You're five, son. Son, let me see what you got. I can't believe it.  He's fat, yeah. This pocket has been crazy. We drove all the way across the lake, went into the other pocket. Didn't have a bite. Pull right back up to where we were before. Pop one. Oh, my. Oh, Adam, they're batting so bad, dude. I'm talking the craziest butt. Dude, he hit me so bad that my line almost touched my nose.  What the heck? That was the craziest. When I'm in a bite like, dude, craziest bite this year yet, for sure. I got to catch this fish. That one that I hooked there, guys, that came off that I actually got a piece of, that one felt like a monster. There he is. Yeah, decent. Wait, though, it's small. Dude, why did it feel so good?  Told you. Pink worm. Pink worm. Let's go. I can't believe this. Pink worm. Thank you, baby. Give you a little kiss. Pink worm. Let's go. They're down there, bro. Yeah. One's falling here right now. Yeah, he's like on your bait. He just hit me again. Yeah, they're down there, dude. What's up, man? Thank you, brother. That's a cool guy right there, man. He's balling out the windows here. All right, let's just do this. Whoever catches the next fish is it. Hang on. Oh, I hate that. It's scary. I ain't going to lie, because this is anybody's ball game right here, but eight of us got that pink sand coat, man. We've gone over our time limit at this point. We were just going back and forth. We're going crazy. I got to trick up my sleeve if I can hurry up before he gets another bite. Let's go. See if I can catch one on a bait caster. See if I still remember how to do that. I just want that bite back. I want that one just like slobber of a bite. Dude, you get real? No. What the freak? Is that a bird? Look, see this stuff moving? Yeah, dude, that's not a bird.  I don't know. You saw my bait moving, right? No. It might have just been because it was on that little twig, but it went from there all the way to there. Yeah, it might have been. I was not taking any chances. He elated that thing like it was 20 pounds. Oh, John, that's it. Dude, he was tugging on it too. I thought it was on a stick. Look, you took my ding with my pinchers. I'm going to catch this fish, dude. He was all the way up on the bank, right there. I'm going to catch it. No. Yes. There we go, boy. There we go, boy. Oh my gosh, Adam.  Oh my gosh. Unless you catch one on that same cast. Oh, dude. You did not miss one.


The devil cannot take over your future so he must agitate you from the past. The attack comes because Satan believes that you are actually capable of obtaining the goal. That's why the attack has come. The devil actually believes that if he doesn't do something to stop you, to slow you down, to put some border in your way that you will actually reach what God wants you to have and you know like I know that if you ever get one prayer answered, you'll pray again. If you ever get one miracle in your life, you'll believe God for another miracle. Am I talking to anybody?  You can turn around and say, I know whom I have believed. Ladies and gentlemen, the only ammunition the devil has is your past.


Brock has had quite a career, especially in innovation and being able to conceptualize what he has in his mind. So, Peter, how did you first get an interest in automobiles? The most important thing was that one of us that went there was a Frenchman named Nathan Bourgeois. He was looking for, yeah, yeah, word was, right, but he said, no, you don't have to bring in any of your people here, so I said, yeah, that's my privilege.  One of your achievements is the quarterback Stingray with the sport window. General Motors said he had decided that instead of this, the sport of that program hold it away, so they canceled the sport of that program. The start of the program was just retiring, and his light-handed hat was gone. Your association began with Carol Shelby, how? Well, I'd still been focused on doing race driving, but with someone that was 21, my very first race, he had a pitch next to a guy that was far superior than me. And Ryan went away immediately because, you know, Carol had his tech of the world. What's your relationship then? How did that develop with the BRE and the Dotson? Well, of course, Carol came back in, took the Toyota program away from me, and I went to Nissan. Ben Gordon was quite successful. He was the guy that made it all work. As the Carol Collection Museum, can you give us some information about the museum, and then we want to talk about the prototype K&M car? Sure. Now, Carol is very famous in racing, and he got his start back in the 60s. Can you give us a little background on Carol? Yeah. And he has association with Peter Brock also.  She and my daughter bought first in Shelby at 1968. 500KR could not pull that kind of started thing. Never envisioned having opportunity to search really memorabilia. If ever. Peter, I think I found it for real. He told me the score. I sent him a picture about 20 minutes later. He sent me a picture in designing the quarter-sized car. Purchased it and purchased it with the understanding that Peter would get the car that's taken us the last two years. It's a remarkable cabin here. I'm extremely excited to see what you're wanting to see as the championship series K&M car. Paul Bastier, and he has a Formula V. Give us a little information about the car. At Road America, do you have a favorite corner? The next row, Nick Clement, Scott Hyatt, Michael Gard, Sheehan, and Richard Mill. I'm a Jerry David, and he has a 1972 BMW 2002. A four-cylinder. What size is it? It's one of the main sponsors of the VSCDA Elkhart Lake Vintage Festival. So the VSCDA this weekend, we're having the 2.5-liter Trans-Am championship. Yes, that's a beautiful display of the Shelby's here, too, this weekend. You're running a GT1 Mustang. Give us some information about that car. I'm with Mike Pranka, and he has a 1972 Alfa Romeo GT-V. Hi, John. I acquired the car. It actually belonged to an old friend of mine who's unfortunately no longer with us. I got it back in the 90s. It was running but a bit rusty, and decided slowly over time with the help of my friend Carter Hendricks to turn it into a race car. Started out by putting a cage and a fuel cell in it. Went to VSCDA school about 10 years ago. And actually drove it to the track for the first two seasons. It's been a long process turning it into a race car. And we're just trying to make it a little bit better every year.  And we're all here reliving the golden era of VSCDA racing. Some specs on the VSCDA series or the 2.5 liters. What size engine is your car? Two liter, a little over 200 horsepower. And all the cars have to meet specific weight. Now here at Road America, you've been coming here for quite a few years, I know. Do you have a favorite corner? Yeah, I think probably where the Billy Mitchell Bridge used to be. Because if you get it right, you can get through there in one of these cars without lifting. Any particular instances where you really had a good time come out in mind? Actually last July here had a fantastic race with Pat Womack in his BMW 2002. We just traded positions the whole race. And yeah, that was as much fun as I've ever had in the car. It was wonderful. And he has a 1971 Datsun 510 sedan. What's the history of the car? Only a short time span to fit into each race. So the race that we have is the Kimberly Cup race from John Kimberly. And we have as a winner Leah Bauer. Leah is a second generation driver. And she's raced with her dad's car at times. And the dad got her new engine. But a smaller engine with less horsepower. I'm sure it was an accident. And he also raced in the Kimberly Cup race. And with his faster engine he ran too fast and was just qualified. Which I think he's still complaining about. It's pretty cool to be out here. I've always wanted to race for as long as I can remember. Following my dad's footsteps, watching him throughout the years just get better and faster. I just thought it was really awesome and I wanted to be part of it. So I actually got my race license in his car. And he tried to kick me out after I started going too fast. So I got my own car and now I'm chasing him down. And he's got a faster car but I still beat him. So, love you. The mid-range race was one this year with the BMW. We're seeing more and more BMWs start to come in. As the old guys see the new cars, Patrick Cormac won the Shelby Cup. It's an honor to be here at my first BSCDA event. At Racing I wrote America for 15 or 20 years. A company I've worked for. It's proud sponsor here at Weather Tech. It's the Elkhart Lake Race. And that was an all-comer race back in the day. And fast or slow, it could race in that race. But we don't allow that here because we don't want that kind of traffic. So it's mainly our big more car. Our winner, Colin Cormac, with his long new car. Yeah, I gotta thank Dan Banks. He's worked his tail off all weekend, keeping this car running in Suarez. You know, three wins in a day. I'm not going to complain about that. But we do have to go home and have a little work to do, I think. But I love this event. And thanks to Mike and Dronelli. And of course, thanks to the Brock's for coming out here. And it's just a great day at the racetrack.


In the meantime, Vice President Yemi Oshibaja says the President's administration spent the sum of 8.9 trillion error on infrastructure development in 2020. Oshibaja made the disclosure at an event in Aqua Ibum on Friday. He noted that industrialization drive in Aqua Ibum was significantly one of the centerpieces of the federal government's economic agenda. And don't forget to hit the notification button so you get notified about fresh news updates.